Re: L. (E.)
ORB File No: 6565
Hearing held on: Wednesday, June 18, 2025
Place of hearing: North Bay Regional Health Centre – North Bay Site
Pursuant to: Sections 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. C. Fraser
Members: Dr. R. Kunjukrishnan Dr. G. Stones Ms. C. Murray Mr. A. Bouvier
Parties Appearing:
Accused: L. (E.) Counsel: Mr. D. Northcott
The person in charge of hospital: Counsel: Mr. P. Trenker
The person on behalf of hospital: Ms. C. Condie
Attorney General of Ontario: Counsel: Ms. M. Mazurski
REASONS FOR DISPOSITION
(Dated August 15, 2025)
Overview
On June 25, 2014, L. (E.) was found not criminally responsible (NCR) on the Criminal Code charge of second-degree murder.
L. (E.) is currently subject to an Ontario Review Board (the Board) disposition dated July 19, 2024, which detains him at the Forensic Programs of the North Bay Regional Health Centre – North Bay Site (the Hospital) with the outer limit privilege to live in the community of North Bay, in 24-hour supervised accommodation, approved by the person in charge of the Hospital.
On June 18, 2025, this panel of the Board convened a hearing at the Hospital for the annual review of L. (E.)’s disposition, pursuant to s. 672.81(1) of the Criminal Code. L. (E.) was present for the hearing and was represented by counsel.
The issues for the Board to decide at the hearing were first whether L. (E.) remains a significant threat to the safety of the public and, if so, what is the necessary and appropriate disposition for the coming year based on the factors in s. 672.54 of the Criminal Code.
At the outset of the hearing, the parties were asked for their positions. Hospital counsel recommended a continuation of the current detention order disposition, unchanged. Crown counsel supported the Hospital position. Counsel for L. (E.) conceded the issue of significant threat to the safety of the public and took no issue with the recommended terms and conditions for the detention order disposition. Counsel requested, pursuant to a rule 13 letter dated June 3rd, 2025, to Thunder Bay Regional Health Sciences Centre, to transfer L. (E.) to that hospital. Hospital counsel and Crown counsel did not support, or oppose, the transfer request.
There was another issue that arose during the hearing that related to a significant recent incident involving L. (E.) and assaultive behaviour. More will be said about this later in these Reasons as it was relevant to the transfer request.
The Board received a Campbell letter from the Hospital dated June 12, 2025, regarding a period of seclusion from June 7 to June 13 (six days). The parties submitted that the period of seclusion was less than seven days and therefore did not trigger a Restriction of Liberty notice and hearing. During the hearing, there was evidence that after the seclusion ended on June 13, L. (E.) was transferred to a segregation unit (not a rehabilitative unit), which continued restrictions on his liberty, albeit to a lesser degree than seclusion. He remains on that unit as of the date of today’s hearing.
After hearing submissions from the parties, the Board determined that a formal notice would be required pursuant to s. 672.56(2.1) with a proper evidentiary record to consider the issue of L. (E.)’s total period whether in seclusion or on a segregation unit. In the result, the Board was only tasked with considering the issues relating to L. (E.)’s annual hearing.
For the reasons which follow, the Board finds that L. (E.) remains a significant threat to the safety of the public and the necessary and appropriate disposition for the coming year is a continuation of the detention order disposition, unchanged. The Board declined to order the transfer of L. (E.) to Thunder Bay, for reasons which will be expanded on later.
Index Offence
- The circumstances of the Index Offence are excerpted in last year’s Board Reasons dated July 19, 2024, at paragraph six as follows:
On November 27, 2012, L. (E.) committed the Index Offence. (Note: he would have been 17 at the time.) It involved entering the residence of the Index victim in a state of intoxication from alcohol and beating him to death. L. (E.) acknowledged heavy drinking in the hours leading up to the Index Offence.
With regard to the Index Offence, based on the information available, there was no reason to believe that the victim or L. (E.) had any significant prior knowledge of each other and any history of negative interactions. The killing was reported as occurring in the context of heavy drinking and considerable substance misuse on his part. The killing occurred while L. (E.) was suffering with auditory hallucinations, which did not appear to provide L. (E.) with commands to complete the act, based on Dr. Krasnik's assessment. While L. (E.)'s account of the occurrence was inconsistent over the course of the assessment completed by Dr. Krasnik, there is no doubt that the killing was particularly brutal.
The NCR report contains the following information from an interview with Dr. A. McDonald on December 11, 2013, wherein L. (E.) indicated the following:
He indicated that he had been in custody Portage in Kenora between approximately April and October of 2012. Upon his discharge, he was released back to Grassy Narrows. While in his home community he reported that he was 'smoking weed' daily, doing cocaine as well as Tylenol 3 and oxycontin. He also admitted to "drinking a lot" estimating his use of alcohol as anywhere from 26-40oz of hard liquor and 4 extra large bottles of beer every 2-3 days. He indicated that he was not taking his risperidone at the time and that his chronic auditory hallucinations did continue. He reported that they did not play a role in the incident. He did however state that the night of the incident, he was intoxicated on alcohol and indicated that he was 'scared of everyone on the reserve'. He did not wish to answer any further questions about this.
- The Hospital Report notes that the victim died several days after the Index Offence from “blunt force trauma to the head”.
Background
L. (E.)’s personal background is set forth in the Hospital Report (Exhibit 1) dated May 20, 2025. Briefly stated, L. (E.) is a 29-year-old First Nations man who was born in Winnipeg, Manitoba and was raised in Grassy Narrows First Nation. L. (E.) suffered in utero exposure to alcohol. He is the eldest of four children. His mother passed away when he was five years old because of alcohol abuse. Following this, L. (E.) went to live with his grandfather. Unfortunately, his grandparents also abused alcohol. L. (E.) reported that he was physically and emotionally abused in the home. As a result, between the ages of 6 and 11, L. (E.) was involved with the Anishinaabe Abinoojii Family Services and lived in foster care for a year beginning when he was approximately 10 years old. This was an abusive environment.
L. (E.) sporadically attended school and was bullied. In September 2012, he was assessed as suffering from fetal alcohol spectrum disorder. He was also diagnosed with attention deficit disorder and mild-to-moderate intellectual disabilities. L. (E.) also has a significant history of substance use commencing at a young age. He started using alcohol and marijuana at 12 or 13 years old. This use continued through his teen years, and he also started using oxycontin, heroin, cocaine, and ecstasy.
Prior to the index offence, L. (E.) had a significant criminal record beginning at the age of 14. He was convicted of arson in 2010 at the age of 15. Other youth charges include failure to comply, uttering threats, aggravated assaults and sexual assault. As an adult, L. (E.)’s criminal record includes convictions for aggravated assault, and assault causing bodily harm. Some of these incidents occurred while under the jurisdiction of the Board and include staff and co-patients at the Hospital. His most recent convictions (on his CPIC- criminal record), which were for assault causing bodily harm, occurred in 2017, and arose out of incidents occurring in December 2016 at Thunder Bay Regional Health Sciences Centre (Thunder Bay).
The full extent of L. (E.)’s criminal antecedents is not reflected in the Hospital Report. The Board asked Crown counsel to provide an updated CPIC as there was evidence at the hearing that L. (E.) has more recent convictions for behaviour which resulted in a period of probation. It was later clarified that L. (E.) was convicted of mischief and sentenced to six months of probation in the fall of 2024.
Current Diagnoses and Capacity
- L. (E.)’s current diagnoses are set out in the Hospital Report as follows:
(a) Schizophrenia
(b) Substance Use Disorder (Cannabis, Alcohol, Cocaine, Methamphetamine and Amphetamine)
(c) Alcohol Related Neurodevelopmental Disorder
(d) Attention Deficit Hyperactive Disorder
(e) Intellectual Disability - Mild to Moderate
(f) History of Antisocial Personality Disorder
- L. (E.) is capable to consent to treatment and the Office of the Public Guardian and Trustee manages his finances.
Evidence at the Hearing
Dr. Munro gave the evidence for the Hospital at the hearing. The doctor has been L. (E.)’s treating psychiatrist since January 1st of this year. The doctor authored the Hospital Report and adopted its contents in her evidence.
The doctor described a variable year for L. (E.) with some good periods and other periods where he has not done as well.
The doctor referenced incidents from January 2024 which resulted in a code white, and L. (E.) was charged and placed on a probation order. This is the information the Board requested be provided by Crown counsel as the details were unclear.
More recently, Dr. Munro described a very serious outburst on Owl Lodge Unit where L. (E.) was a resident at the time. The incident occurred on June 7. L. (E.) had lost certain indirectly supervised privileges due to an inability to follow rules and not observing personal boundaries. L. (E.) became angry, and a code white was called. He threatened the personal support worker (PSW) who he believed was responsible for his loss of privileges. L. (E.) became physically aggressive and pushed a female nurse to the ground causing her glasses to come off her face. During staff responding to the code white, L. (E.) went to his room and staff spoke with him there. He punched two male nursing staff and a male PSW who he punched in the nose causing his nose to bleed. He was placed in four-point restraints and transferred to a seclusion room for the period from June 7 to June 13 (a period of six days).
Since transitioning out of seclusion into a segregation unit, L. (E.) is currently a resident on Deer Lodge, which is comprised of a flex unit and an assessment unit. L. (E.) is on the assessment unit with significantly restricted privileges. For the most part, he is in his room, and he is allowed off the unit to the secure courtyard (for one hour periods). The plan is to eventually return L. (E.) to a rehabilitation unit (for example Owl Lodge). However, he will need to first be transferred to the flex unit on Deer Lodge where his privileges will be gradually increased, commensurate with the safety of other patients and staff.
Dr. Munro anticipated that criminal charges would be forthcoming. Based on the evidence, it is likely there will be multiple charges of assault. The doctor said one of the staff assaulted (the PSW whose nose was bloodied) remains off work for reasons which appear to be directly related to the assault.
Prior to the assaultive behaviour on June 7, L. (E.) had supervised privileges, hospital, and grounds and into the community. He also had indirect privileges to group programs in the Hospital.
Dr. Munro intends to take a different approach in the care and treatment of L. (E.). She noted that L. (E.) has a mild to moderate intellectual disability with an IQ in the range of 50 to 60 on scoring. His verbal memory and verbal comprehension is in the one (1) percentile, which is severely limiting in terms of his overall cognitive functioning. For example, L. (E.) presents as understanding what people are saying but he actually does not.
To address this, L. (E.) has started to work with a behavioural therapist and will continue to do so in the coming year. The team intends to establish a care plan specific to L. (E.)’s needs and, according to Dr. Munro, it is important to recognize that you cannot treat L. (E.) in the same manner as a regular mental health patient. That is because of his lack of comprehension, which as noted is severe. L. (E.) will become demoralized when confronted with situations where he simply does not understand but will give the appearance of understanding.
L. (E.) is an Indigenous person and values highly his program participation in cultural- specific programs where he is highly engaged. He regularly attends these programs, including smudging ceremonies. He also enjoys gym activities, walks, and hikes.
Regarding the transfer request, Dr. Munro noted that the waiting list in Thunder Bay can be upwards of four to five years. Placing L. (E.) in Thunder Bay would put him closer to family in the Kenora area. In the past year there have been two to three family visits. It is difficult for L. (E.) to be so far away from his grandparents who are his closest family. It is anticipated that in the coming summer months there will be further family visits.
The doctor believed there was value in transferring L. (E.) to Thunder Bay to be closer to family. However, the wait lists are so long that it makes planning for this very difficult. The doctor agreed that L. (E.) will need to be in the North Bay area to deal with the imminent criminal charges.
The doctor remained very concerned about the serious assault on four of her colleagues, some of whom were injured in the incident. It was unclear if any of the four persons assaulted by L. (E.) required serious medical attention. It appears not.
When asked what she would like to see from L. (E.) in the coming year, Dr. Munro emphasized the need for L. (E.) to be more comfortable in communications with staff. It was noted that L. (E.) had not disclosed to staff some troubling news that he had received regarding family, and this may have been a precipitating event for a decline in his behaviour. The doctor would also like L. (E.) to fully participate in the new care plan which they will implement in the coming year.
It was confirmed that in the past year, despite the recommendation in last year’s Board reasons for a PTSD assessment, it has not yet been completed. Dr. Munro said it can be done by any psychiatrist. It is not a resource issue, and she intends to do the assessment very soon for L. (E.). The doctor noted the traumatic childhood for L. (E.) with extensive exposure to abuse in foster care.
No further evidence was called at the hearing. In final submissions, the parties maintained their initial positions from the outset.
Analysis and Conclusion
The Board finds L. (E.) is a significant threat to the safety of the public based on s. 672.5401 of the Criminal Code, and Winko, and its related authorities. The Board notes that the parties did not contest a finding that L. (E.) continues to pose a significant threat to the safety of the public. Despite this, the Board makes its own finding of significant threat based on the expert evidence of Dr. Munro, as supplemented by the Hospital Report.
L. (E.) suffers from Schizophrenia, a serious and persistent mental illness. The manifestations of his illness include severe thought disorder, bizarre behaviour that has resulted in harm to others, delusional thinking, increased anger, irritability, hostility, grandiosity, and threatening, intimidating and aggressive behaviour. The Board also notes that L. (E.) has previously been diagnosed with an antisocial personality disorder.
The gravity of the index offence speaks for itself. L. (E.) has a history of violent criminal offences including assault, assault causing bodily harm, sexual assault, and aggravated assault. L. (E.) has been convicted of offences of violence while under the jurisdiction of the Ontario Review Board, including an assault in 2024.
The Board accepts that if L. (E.) was not under the jurisdiction of the Board and subject to the oversight of the Hospital, his risk for future violent recidivism is high and the risk for serious physical harm is also high. The supports he currently has in place are protective factors to ameliorate these obvious significant risk factors and the potential for serious harm to others.
The Board considered the transfer request of L. (E.) to go to Thunder Bay. The response from Thunder Bay was not supportive of the transfer request as the unit is based on community reintegration and it was their view that L. (E.) was not similarly situated to other patients in their small (20 bed) unit such that he was not well suited to their community reintegration-based unit.
The Board notes L. (E.) will be facing serious Criminal Code charges which he will have to address in this jurisdiction.
The Board also notes the evidence before the Board that the waiting lists at Thunder Bay are in the four-to-five-year range, which makes short and long term planning difficult in his current placement at the Hospital.
The Board also believes it is important for L. (E.) to stabilize in his current setting. The Board is hopeful that the renewed approach to his care plan as described by Dr Munro will lead to a lasting change in L. (E.)’s troubling behaviour. His ongoing violence to others clearly requires attention. The prospect of a transfer (albeit several years away) may have the effect of undermining current measures to be taken by Dr. Munro and the treatment team.
The Board accepts the importance of family support, but notes that even if L. (E.) was in Thunder Bay, his family would still be several hours away in the Kenora area.
For these reasons, the Board declines the transfer request.
As to the necessary and appropriate disposition, the parties were jointly in agreement with the terms and conditions of the current detention order. The Board agrees with the joint submission. There is ample latitude in the current order to further L. (E.)’s community reintegration, commensurate with ongoing concerns for public safety.
In considering the appropriate disposition, the paramount factor for the Board was public safety. The Board also considered L. (E.)’s community reintegration, his mental condition, and his other needs, all as required by s. 672.54 of the Criminal Code. A disposition will issue accordingly.
DATED this 15th day of August 2025, at the City of Toronto, in the Toronto Region.
Mr. Craig Fraser Alternate Chairperson
Office of the Registrar Ontario Review Board