The knife does a lot more damage than a normal knife - more than twice that of any other knife in the game. This results in it almost always dismembering the target. It can be repaired with other knives, including unique variants.
The knife is obtained along with the Pint-Sized Slasher mask during the Tranquility Lane quest if you decide to help Betty kill all the residents of Tranquility Lane. It is then located in the doghouse beside the abandoned house and is automatically equipped when you receive it.
At the end of the quest or upon exiting the simulation, the knife is automatically removed from your inventory. The glitch which allows you to take items out of the Anchorage Reclamation simulation does not work here due to the fact that it is a "quest item" and cannot be removed from the player.
When acquiring the knife by using console commands, using the command player.unequipitem once allows you to equip and unequip them as normal. It is impossible to get off your character without using the command player.removeitem (since they are quest items).
The item has no assigned icon, displaying the placeholder icon "PipOS Error #-26 (File Not Found)" in inventory.