Ontario Review Board
Re: Sami Kazi (DOB 10.11.01)
ORB File No: 8566
Hearing held on: Tuesday, January 14, 2025
Place of Hearing: Royal Ottawa Mental Health Centre
Pursuant to: Sections 672.81(2.1) and 672.81(2) of the Criminal Code
Before: Alternate Chairperson: Mr. J. Weinstein Members: Dr. H. Bloom Dr. S. Lessard Ms. C. Finley Mr. A. Bouvier
Parties Appearing:
Accused: Sami Kazi Counsel: Mr. M. Davies
Person in charge of hospital: Representative: Dr. J. Gojer
Attorney-General of Ontario: Counsel: Ms. M. Dufort
AMENDED REASONS FOR DECISION AND DISPOSITION
(Dated January 23, 2025)
Please see underlined change to original reasons made January 27, 2025: “Sami Kasi” has been replaced with “Sami Kazi” at the top of the first page.
Introduction
[1]. On May 27, 2024, Mr. Sami Kazi, was found not criminally responsible on account of mental disorder, on charges of assault with a weapon, dangerous operation of a vehicle, failure to stop after an accident, and utter threats to cause death or bodily harm, all contrary to the Criminal Code of Canada (“Criminal Code”).
[2]. Mr. Kazi is subject to the terms of a Disposition of the Ontario Review Board (the “Board”), dated October 24, 2024, which ordered that he be detained at the Secure Forensic Unit of the Royal Ottawa Mental Health Centre (“Royal Ottawa”).
[3]. Pursuant to s. 672.56(2) of the Criminal Code, Royal Ottawa notified the Board, by letter dated December 4, 2024, that Mr. Kazi’s liberty had been restricted: Mr. Kazi was readmitted to Royal Ottawa.
[4]. Pursuant to s. 672.81(2) of the Criminal Code, Royal Ottawa notified the Board, by letter dated November 26, 2024, that they were requesting an early hearing of the current Disposition.
[5]. On January 14, 2025, the Board convened a hearing at Royal Ottawa to conduct an early review of the current Disposition and a restriction of liberty hearing (“ROL”).
[6]. Mr. Kazi was present at the hearing and was represented by his counsel, Mr. Davies.
[7]. When a hospital significantly restricts the liberty of an accused for more than seven days, it has an obligation, under s. 672.56(2)(b) of the Criminal Code, to provide notice to the Board, as soon as practicable. Under s. 672.81(2.1), the Board is then required to convene an ROL hearing to review the hospital’s decision, as soon as practicable. Since Mr. Kazi’s early hearing was scheduled for January 14, 2025, it was agreed that his early hearing and the ROL would happen concurrently.
[8]. A Hospital Report, (the “Hospital Report”), dated September 23, 2024, was entered as Exhibit 1.
[9]. A work assessment report (“Assessment Report”) dated December 18, 2024, was entered as Exhibit 2.
[10]. An updated hospital report (“Updated Report”) dated December 17, 2024, was entered as Exhibit 3.
[11]. An Addendum, dated January 13, 2025, was entered as Exhibit 4.
[12]. For the early hearing, the Board was required to determine whether the changes to the current Disposition requested by Royal Ottawa were necessary and appropriate.
[13]. For the reasons set out below and based on the expert evidence and opinions before it, the Board concluded that the initial restriction of liberty was warranted, necessary and appropriate, as is the ongoing restriction of liberty. It found that these restrictions were necessary for public safety, and that they represented the least onerous, and least restrictive, interventions available.
[14]. For the reasons set out below and based on the expert evidence and opinions before it, the Board agreed with the recommended amendments to the current Disposition agreed to by the parties.
Index Offences
[15]. The circumstances giving rise to the Index Offences are extracted from the current Board Reasons, dated November 20, 2024:
“Mr. Kazi was employed as a delivery driver by the victim in this matter, Mr. Issa, for a brief time in early November 2022. In the early morning of Friday, December 2, 2022, Mr. Kazi attended the Greek on Wheels restaurant but remained in his vehicle in the parking lot while texting Mr. Issa to come outside and talk. When Mr. Issa left the storefront, he observed Mr. Kazi’s vehicle and heard the engine rev, and then Mr. Kazi drove the car right at him. Mr. Issa was able to jump onto the hood of the vehicle to avoid being crushed but was knocked into the building behind, hitting and breaking the front window. He suffered a sore and swollen knee.
Mr. Issa then entered the Greek on Wheels and locked the door. Mr. Kazi exited his vehicle and approached the door, attempting to get in with a knife in his hand. When he realized the door was locked, he returned his vehicle. He drove around the parking lot erratically, eventually driving into the front door of Greek on Wheels, shattering the door and damaging the front wall.
Mr. Kazi then exited his vehicle and entered the Greek on Wheels through the smashed front door, openly carrying a knife. Mr. Issa escaped the shop through the back door, and Mr. Kazi left through the shattered front door, got into his vehicle, and drove off.
On December 18, 2022, Mr. Kazi sent text messages to a friend of Mr. Issa making threats toward Mr. Assi, making comments about his life expectancy and stating that Mr. Assi should rethink offering Mr. Kazi a peace treaty.”
[16]. Mr. Kazi’s personal history, criminal history and psychiatric history are outlined in the hospital report and they are accurately summarized in the most recent Reasons as follows:
Personal History
[17]. Mr. Kazi was born and raised in Ottawa. His father, Sarwar Kazi, 55, is a data analyst and his mother, Syema Quazi, 52, is currently completing a medical administration student placement. His mother immigrated to Canada in 1989, and his father joined her a year later. He has one sister, Samara, 22, who is studying biomedicine in her 4th year at the University of Ottawa. He met his developmental milestones at the expected ages. He was a healthy child. Mr. Kazi played various sports, including basketball, hockey, baseball, and golf. According to his father, he is the most sociable cousin and loved by everyone. He is very good with children and is close with all his cousins. He easily made friends.
[18]. There were no behavioural issues at school. Mr. Kazi achieved grades in the 80s and 90s. He graduated from university with a biology major and a psychology minor. Mr. Kazi began working for a pharmacy in February 2022 before moving to a different pharmacy in May 2022.
Criminal History
[19]. Mr. Kazi has no prior criminal record.
Psychiatric History
[20]. Mr. Kazi reports that his mood was “always up and down,” but this did not significantly affect his functioning until after the index offences. He recalled being suicidal around grades 10 and 11 due to stress at school and home. He remembers taking pills from his parents’ medicine cabinet in an overdose attempt, not expecting to wake up in the morning. He did this after unsuccessfully trying to drown himself by staying underwater in the bathtub. However, he reported that the longest he would have felt depressed at that time would be for one week. His mood improved in grade 12. In university, he had no significant issues with his mood.
[21]. After December 2022, he was not motivated and could not get himself to do anything. He was always in bed, and his enjoyment in life vanished. This did not improve until he started taking Paxil.
[22]. Mr. Kasi indicated that he had been using cannabis daily, about half a gram daily in relatively small quantities after work. For the five days between November 28 and December 2, 2022, he was not using at all because his sister kept him from doing so. His alcohol use is occasional and social, approximately five times per year. He reports having tried cocaine on three occasions, the last of which was a year prior to the index offenses. Approximately two years ago, he used hallucinogenic mushrooms and had a “bad trip.” He experienced seeing “a lot of black figures like demons, and a lot of crazy things happened.”
Course and Reason for Restriction of Liberty
[23]. Mr. Kazi’s course since his most recent Disposition and reasons for restriction of liberty are set out in the Exhibits. The following extracted paragraphs are relevant to this hearing:
“Due to ongoing paranoia and odd requests, I raised questions about his medication compliance. He reported that he had not taken the prescribed olanzapine. I encouraged him to continue taking the medication. He stated that paliperidone had been more helpful in the past but it was too expensive for him to continue. As risperidone is similar, I switched his prescription to risperidone.
On November 19, 2024, I assessed Mr. Kazi urgently as requested by the nurse who had concerns about his deteriorating mental health. When I entered the room, Mr. Kazi put on his sunglasses and said, "Everything is being recorded for privacy purposes."
It was apparent that he was developing delusions and disorganized thoughts.
Since this appointment, Mr. Kazi attended the Royal daily. On November 21, 2024, staff had increasing concerns about Mr. Kazi’s disorganized behaviour around the outpatient department. I saw him for another urgent assessment.
On December 19, 2022, Mr. Kazi was discharged from the Queensway-Carleton Hospital. On December 31, 2022, he was taken to the Ottawa Hospital – Civic Campus by his family for worsening symptoms and he was admitted voluntarily for one week. On admission he endorsed ongoing paranoid delusions and suicidal ideation. His father then said that he was getting concerned about Mr. Kazi's mental health and recommended Mr. Kazi to be admitted to the hospital.
Mr. Kazi agreed to be admitted to the hospital voluntarily. There were no beds available on FAU or FRU. The earliest bed available was on Wednesday. Crisis unit did not have a bed. QCH was called as Mr. Kazi had previously been admitted there. The psychiatrist there reported that they would not be able to accept Sami Mr. Kazi's care. While the phone calls were being made to look for beds, Mr. Kazi left the hospital to obtain his car from the people that took it from him. This interaction was not observed by me but Sara had followed Mr. Kazi out. Please refer to Sara's notes for details.
Code White was called. I was told by Sara that Mr. Kazi had walked into the traffic carelessly and stood in the middle of the road. The lights were red and therefore there were no cars passing by but despite Sara calling out his name to come back to the pedestrian side, Mr. Kazi did not move. He eventually had his car keys returned and the staff escorted him back to the hospital. He was brought into the holding area of the FAU.
Based on this behaviour in addition to the statements he made about thoughts of suicide, it was clear that Mr. Kazi was unable to keep himself safe. Form 1 was filled and he was sent to the Montfort hospital with police for possible involuntary admission.
In the course of these events, I received an email from the nurse that his UDS was positive for cannabis.
Mr. Kazi was sent to the Montfort as an involuntary patient based on Dr. Hwang’s findings. He was transferred to the Royal and has been on the FAU since the 22nd of December 2024.”
Current Psychiatric Diagnoses
- Schizoaffective Disorder
- Cannabis Use Disorder, in remission while in a controlled environment
- Rule out PTSD
Position of the Parties
[24]. At the conclusion of the hearing, Dr. Gojer (as representative for the hospital and most responsible treating physician) and counsels for the Attorney-General and for Mr. Kazi advised that this was a joint submission:
a) All parties agreed that the initial restriction of liberty was warranted, necessary and appropriate, as is the ongoing restriction of liberty.
[25]. All agreed that the current Disposition should be amended as follows:
i) Paragraph 4(e), which currently contains a prohibition from driving a motor vehicle, should be changed to read as follows: “Refrain from driving a motor vehicle, except with the prior, written consent of the person in charge, or his or her delegate.”
ii) Paragraph 4(f) should be changed to reduce his reporting period while living in the community from not less than once every two weeks to not less than once every four weeks.
iii) Permit passes for up to seven days, upon first obtaining the approval of his itinerary by the person in charge, or his or her delegate, to travel within the Province of Ontario, indirectly supervised.
Evidence at the Hearing:
[26]. The Board had available to it the evidence and documents forming the Record, the Exhibits, and oral evidence from Dr. Gojer. Dr. Gojer testified as follows.
a) In consultation with him, Mr. Kazi agreed to be treated with a long-acting injectable Invega Sustenna, which is given every four weeks. The team noticed that he responded extremely well, within a few days of taking this long-acting injection. His manic-like symptoms and paranoid ideation have all abated and his insight has improved.
b) Mr. Kazi now appreciates the benefits of his medication. He has indicated that, in addition to continuing on this medication regimen, he would also participate in various groups on the unit.
c) It is the unanimous assessment of the treatment team that Mr. Kazi is ready to be discharged from the current Forensic Assessment Unit directly to his parents’ residence. Appropriate paperwork must still be completed to designate this residence as an approved accommodation.
d) Mr. Kazi has indicated that, while he would like to go back to London to complete his nursing degree, he agreed with the treatment team’s recommendation that he focus on his recovery, and participate in programs at the Royal Ottawa, before returning to London.
e) It was necessary to readmit Mr. Kazi to the Royal Ottawa because of concerns about his mental health and behaviour. He needed to be readmitted so that the team could monitor his mental health and restore him to stability.
f) It was necessary to keep Mr. Kazi in hospital until the treatment team could approve his parents’ house as appropriate accommodation.
g) The treatment team will hold a discharge meeting next week, at which time, they are certain, Mr. Kazi will be discharged to live in his parents’ residence.
[27]. In response to questions for counsel for the Attorney-General, Dr. Gojer testified:
a) Mr. Kazi had stopped taking his oral medication prior to being readmitted to Royal Ottawa.
b) It takes Mr. Kazi over 90 minutes by public transportation to travel from his parents’ house to the hospital for treatment. The treatment team is hopeful that the Royal Ottawa will be able to allow Mr. Kazi to drive his vehicle for specific purposes, as he progresses through the forensic system, if he stays on his current, positive trajectory.
c) The treatment team will proceed very cautiously before granting Mr. Kazi permission to drive a motor vehicle, including weekly visits by the case manager. Dr. Gojer will also be following up with Mr. Kazi, initially on a weekly basis.
d) Travel passes are being added to facilitate Mr. Kazi’s desired return to nursing school; he may need to meet with staff at the school before the next annual review of his Disposition.
e) He will be meeting with Mr. Kazi’s parents, who were present at the hearing, after this hearing to discuss Mr. Kazi’s condition. Mr. Kazi has given consent to the treatment team to discuss his personal health matters with his parents. His family are close-knit and quite supportive.
f) Mr. Kazi is no longer on any other anti-psychotic medications.
[28]. In response to questions from the panel, Dr. Gojer testified:
a) Cannabis use by Mr. Kazi is still a concern, and the treatment team will continue to administer regular urine drug screens. The treatment team has advised Mr. Kazi that there will be zero tolerance for cannabis use.
b) Mr. Kazi driving a motor vehicle while using cannabis would represent a significant threat to the safety of the public.
c) Mr. Kazi’s insight with respect to his need to abstain from cannabis still needs to be developed.
d) Mr. Kazi has indicated that he is willing to attend a program called “Risk and Recovery,” which helps people to understand their index offences, the risks associated with them, and the issues that led to them.
e) It would be beneficial to interview the victim of the Index Offences, to broaden the team’s understanding of how and why the index offense came about, and to see if Mr. Kazi had been suffering from PTSD at the time.
f) While Mr. Kazi is not showing symptoms of any brain injury that might have resulted from an injury to his head during an altercation, it could be of value to have an MRI carried out on an outpatient basis.
g) Because of the bureaucracy of the Ontario Ministry of Transportation, it would not be sufficient to rely on the treating physician advising the Ministry that Mr. Kazi should refrain from driving. Utilizing the driving condition in Mr. Kazi’s Disposition would allow the hospital to supervise his driving in a more immediate hands-on manner.
h) The prohibition on Mr. Kazi’s driving should remain in his current Disposition.
[29]. No other evidence was called.
Analysis and Conclusions:
[30]. The Board agrees that a restriction of liberty has taken place, pursuant to the decision of the Ontario Court of Appeal in R vs M.L.C. (2010 ONCA 843), as well as Regina v. Campbell (2018 ONCA 140). The Board has also concluded, based on the evidence before us, that the hospital’s decision to significantly restrict Mr. Kazi’s liberty, by readmitting him on November 27, 2024, and his ongoing restriction, were warranted and necessary. Mr. Kazi had to be readmitted to hospital on a Form 1, both for his protection and the safety of the public. Mr. Kazi’s mental status had to be stabilized and monitored. Mr. Kazi is now on a long-acting, injectable medication and will be shortly discharged to his parents’ residence. Mr. Kazi cannot be discharged until his accommodation is approved by the person in charge, or by his or her delegate.
[31]. The Board agrees with the joint submission with respect to the necessary and appropriate amendments to the current Disposition:
a) Mr. Kazi should continue to be prohibited from driving a motor vehicle, until the treatment team concludes that it is safe for him to do so. This permission must be in writing. The Board did not feel that it would be appropriate to rely solely on the Ministry of Transportation, with their bureaucratic delays, to prohibit Mr. Kazi from driving a motor vehicle. The Board wishes to note that this amendment does not derogate from the physician in charge’s responsibility to notify the Ministry of Transportation to suspend Mr. Kazi’s driving privileges, in the appropriate circumstances.
b) Mr. Kazi has a history of non-adherence to his medication, but he has shown an excellent response to his current long-acting, injectable.
c) If Mr. Kazi maintains his positive trajectory, and engages in appropriate therapeutic programming, it is quite realistic that the hospital would be able to reduce his reporting period gradually, to not less than once per month. In the interim, the hospital has indicated that both the case manager, and Dr. Gojer, will be seeing Mr. Kazi on at least a weekly basis.
d) The evidence is quite clear that Mr. Kazi has no reason to travel to London in the short term. However, his goal is to resume his nursing studies, and he may need to travel to London before his next hearing, to meet with staff at his nursing school. Accordingly, this provision allowing travel passes is the least onerous and least restrictive provision, and it is necessary and appropriate at this time.
e) Having heard and considered the entirety of the evidence, the submissions of the parties and the criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of Mr. Kazi, his reintegration into society, and his other needs, the necessary and appropriate Disposition is to continue with the existing detention order, with the agreed upon amendments, as set out in our formal Disposition.
DATED this 23rd day of January 2025, at the City of Toronto, in the Toronto Region.
Mr. J. Weinstein Alternate Chairperson
____________________________________ Office of the Registrar Ontario Review Board