Ontario Review Board
Re: Quan Hong Dang
ORB File No: 7586
Hearing held on: Thursday, March 27, 2025
Place of hearing: Southwest Centre for Forensic Mental Health Care (Via Zoom Video Conference)
Pursuant to: Section 672.81(2.1) of the Criminal Code
Before:
Alternate Chairperson: Mr. J. Goldenberg Members: Dr. R. Kunjukrishnan Dr. H. Moulden Mr. D. D’Intino Ms. B. Little
Parties Appearing:
Accused: Quan H. Dang Counsel: Ms. C. Francis
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Ms. K. Dalrymple
REASONS FOR DECISION
(Dated April 17, 2025)
On August 14, 2019, Quan H. Dang was found not criminally responsible on account of mental disorder, on charges of assaulting a peace officer and mischief not exceeding $5000.
Mr. Dang is currently subject to a Disposition of the Ontario Review Board dated October 7, 2024, by which he was ordered to be detained at the Southwest Centre for Forensic Mental Health Care, St. Joseph's Health Care London (“Southwest”).
On February 13, 2025, Dr. Amir Ardani wrote to the Ontario Review Board advising as follows:
“Mr. Dang was utilizing full hospital and grounds privileges (level 6). On January 3, 2025, Mr. Dang was experiencing delusions targeting a co-peer, yelling at him and pushing the dining room table into him. Staff were able to quickly intervene and direct Mr. Dang to his room. Mr. Dang was placed on constant observation while in his room and his privileges reduced to a level 0. Mr. Dang was later moved to the observation room where he voiced he felt safer. As his behaviour was subsequent to a deterioration of psychotic presentations, he remained on a level 0 for further monitoring/assessment until January 20, 2025. He has since started on new antipsychotic medication and achieved a level one privilege (30 minutes within hospital three times per day).”
- As a result of Dr. Ardani’s letter, the Ontario Review Board convened a hearing on Thursday, March 27, 2025. This hearing was conducted virtually using Zoom audio/visual technology.
Preliminary Matter
At the outset of the hearing, Ms. Francis asked for an appointment of counsel. The Board had no hesitation in doing do. The Board understands that Ms. Francis has been acting for this gentleman for a considerable period of time.
In connection with this matter, the Board had ordered a Vietnamese interpreter to be present to assist Mr. Dang. The Board is aware that Mr. Dang speaks English and that the doctor communicates with him in the English language. Ms. Francis was also kind enough to advise that she has frequent telephone conversations with her client and they are all conducted using the English language. The Board had ordered an interpreter. There apparently had been some confusion as to which meeting invitation to accept. Counsel in an earlier hearing this morning also received a reminder and a direction to a different site. Counsel, in that earlier hearing were able to figure out that the other invitation was incorrect, and were able to join the morning hearing within a few minutes. Unfortunately, the interpreter in this hearing did not join this hearing and attempts were made to direct an appropriate invitation to the interpreter but without success.
Ms. Francis was kind enough to have a further meeting with her client in a breakout room. On her return Ms. Francis advised that her client was anxious to get this hearing done today and did not wish for this hearing to be adjourned. Ms. Francis was fully prepared to deal with this matter. Ms. Francis noted that her client was in complete agreement with the hospital position but she had some questions concerning the length of time before Mr. Dang’s privileges had been returned to the prior level. She stressed that Mr. Dang was fully in agreement with the hospital position but she, as counsel, felt obliged to raise an issue as to the length of time the privileges were reduced.
Dr. Ardani also noted a conversation he had with his patient in the English language to the effect that Mr. Dang thought it would be appropriate to proceed without an interpreter since this was not an annual review but would prefer to have an interpreter for his annual reviews. As a result, the Board proceeded with this hearing, and it was conducted using the English language only.
Position of the Parties:
The hospital’s position is that the removal of privileges was absolutely warranted and that Mr. Dang’s period of time with reduced privileges was the least onerous and least restrictive decision available to the hospital.
Ms. Dalrymple agreed fully with the hospital.
As indicated, Ms. Francis advised that her client is in full agreement with the hospital position but that she had a number of questions that she intended to ask and is concerned about the length of time that had taken place before Mr. Dang returned to a comparable level of privileges.
Evidence at Hearing:
The Board admitted into evidence the letter from Southwest and a ROL Report from Southwest dated March 20, 2025.
In addition to the documentary evidence, the Board heard from Dr. Ardani. Dr. Ardani has been Mr. Dang’s most responsible physician since December 2023. He adopts the contents of the ROL Report.
Dr. Ardani, in response to questions from Ms. Zamprogna, indicated that privileges 1 to 6 are all indirectly supervised hospital and grounds privileges.
At this point the Alternate Chair wanted clarification on a particular issue. The Alternate Chair noted that at the time of the loss of privileges (January 3), Mr. Dang was exercising level 6 privileges. The Alternate Chair also noted that on March 10, 2025, Mr. Dang was not exercising level 6 privileges but was exercising level 4 privileges.
Ms. Zamprogna asked the doctor to explain this issue. Dr. Ardani did so. He noted that levels 1 to 6 are all indirectly supervised hospital grounds privileges. The difference between levels 4, 5 and 6 is the amount of time that Mr. Dang could utilize indirectly supervised hospital and grounds privileges.
Dr. Ardani pointed out that although Mr. Dang was entitled to use level 6 privileges before January 3, he in fact never used such privileges. The difference is as to the amount of time that one could be on hospital and grounds, indirectly supervised. Even though Mr. Dang was entitled to use the amount of time in level 6, he would only use about 30 minutes of time indirectly supervised which is the amount of time permitted on level 4. Dr. Ardani put it that Mr. Dang’s “liberty norm” was utilizing 30 minute indirectly supervised passes. The doctor went on to explain that Mr. Dang simply could not and cannot at this time tolerate more than 30 minutes on his own on the hospital and grounds.
Ms. Zamprogna asked the doctor why it took two months to get Mr. Dang to utilize the 30 minute privileges following the events of January 3. The doctor pointed out two reasons: the first is the practice of gradually increasing the level of privileges to ensure the patient can appropriately use them. The second reason arose from the decision of the hospital and Mr. Dang to switch medication, and in particular, to reintroduce treatment with clozapine. Dr. Ardani noted that Mr. Dang had been treated with clozapine in 2021 but at that time was unable to tolerate the side effects of that medication. Dr. Ardani believes the side effects may have been the result of the combination of medication in 2021 and was carefully monitoring Mr. Dang’s current medication. The doctor noted that his patient was saying that he is not experiencing any side effects. We note the previous comment made by Ms. Francis that her client is feeling “really good” following the introduction of clozapine this year. Dr. Ardani also noted his opinion that at the present time Mr. Dang is receiving 50 percent of the optimum dose. Dr. Ardani noted some modest improvement since the introduction of clozapine this time and his expectation that there will be even greater improvement as clozapine is titrated to a more appropriate level.
In response to questions from Ms. Francis, Dr. Ardani repeated that his patient was only using 30 minutes indirectly supervised hospital and grounds privileges up to the decision of January 3 to discontinue all privileges. The doctor noted that level 4 permits 30 minutes indirectly supervised. Level 5 would permit one hour. The doctor repeated, however, that to date Mr. Dang is uncomfortable using more than 30 minutes indirectly supervised privileges and the doctor put it that Mr. Dang’s “liberty norm” on this issue is 30 minutes of indirectly supervised hospital and grounds privileges.
Finally, in response to questions from Ms. Francis, the doctor acknowledged that to date the hospital has not been able to move forward with an application to Developmental Services Ontario for some form of financial assistance for Mr. Dang.
No other evidence was heard at this hearing.
Findings of the Board:
At the conclusion of the evidence, Ms. Francis acknowledged that she no longer is concerned with the fact that Mr. Dang is only back to utilizing level 4 passes. She accepts that his liberty norm was strictly up to 30 minutes for such passes. Ms. Francis also understands and accepts that the hospital needed more time given the introduction of clozapine. Ms. Francis put it that the parties were making a joint recommendation.
The Board accepts the evidence of Dr. Ardani and the evidence contained in the Hospital Report. We accept the hospital was justified in removing all indirectly supervised passes following the events of January 3. The Board accepts that Mr. Dang’s liberty norm was in fact utilizing 30 minutes of indirectly supervised hospital and grounds privileges just prior to January 3 and accordingly, the length of time to get back to a position where Mr. Dang can utilize 30 minutes of indirectly supervised hospital and grounds privileges was in fact both necessary and appropriate.
Accordingly, we repeat the decision to remove all privileges was warranted and the ongoing time to reach the use of 30-minute indirectly supervised hospital and grounds passes was appropriate and that the hospital’s decision in this regard was the least onerous and least restrictive decision available to the hospital.
DATED this 17^th^ day of April 2025, at the City of Toronto, in the Toronto Region.
Mr. J. Goldenberg
Alternate Chairperson
Office of the Registrar
Ontario Review Board