TORONTO — The Office of Ontario’s Chief Coroner has announced that the inquest into the death of Robert Twiss, who died while in custody at the Central North Correctional Centre in Penetanguishene, will commence on Monday, November 17, 2025, at 9:30 a.m.
The announcement was made by Dr. Kenneth Peckham, Regional Supervising Coroner for the Central Region, Central West Office, who confirmed that the inquest will be presided over by Murray Segal, with Grace Alcaide Janicas serving as inquest counsel.
According to the official statement, “Dr. Kenneth Peckham, Regional Supervising Coroner, Central Region, Central West Office, announced today that a date has been scheduled for the inquest into the death of Robert Twiss. The inquest will begin at 9:30 a.m. on Monday, November 17, 2025. Murray Segal will be the presiding officer and Grace Alcaide Janicas will be the inquest counsel.”
Circumstances of the case
Mr. Twiss was 47 years old at the time of his death on December 3, 2018, while incarcerated at the Central North Correctional Centre, a provincial facility that houses both remanded and sentenced inmates. The Ontario Coroners Act mandates an inquest in cases involving individuals who die while in custody.
The upcoming inquest will examine the circumstances surrounding Twiss’s death, with a view to identifying systemic issues and opportunities for preventing similar incidents in the future. “The inquest will examine the circumstances surrounding Mr. Twiss’ death. The jury may make recommendations aimed at preventing further deaths,” the Ministry of the Solicitor General confirmed in its release.
While no details about the cause of death have been publicly disclosed, inquests of this nature typically assess institutional policies, medical care protocols, emergency response measures, and conditions of confinement. The proceedings are not designed to assign blame but to promote transparency and improvement within Ontario’s correctional and healthcare systems.
Structure and scope of the inquest
The inquest is expected to last five days and hear testimony from approximately 11 witnesses. It will be conducted by video conference, reflecting the continued adoption of digital platforms for public and administrative proceedings in Ontario.
The Ministry noted that members of the public will be able to view the inquest proceedings live online. “The inquest will be conducted by video conference. Members of the public who wish to view the proceedings can do so live at the link provided below,” the statement said.
The webcast will be available through the following official link:
https://firstclassfacilitation.ca/office-of-the-chief-coroner/inquest-into-the-death-of-robert-twiss/
Additional information about the inquest process is accessible on the provincial government’s website at ontario.ca/page/coroners-inquests.
Purpose and public accountability
Coroner’s inquests serve a vital public function in Ontario’s justice and health systems. By law, they are convened to review deaths that occur in custody, at workplaces, or under circumstances that may raise concerns of systemic risk.
Through the inquest process, a jury of citizens hears evidence from witnesses, reviews relevant documents, and ultimately delivers findings along with non-binding recommendations. These recommendations are often directed to ministries, correctional institutions, law enforcement agencies, and healthcare providers, with the intent of improving safety standards and preventing future deaths.
The forthcoming inquest into the death of Robert Twiss follows several similar proceedings in recent years examining inmate deaths across Ontario’s correctional facilities. Each has contributed to the province’s evolving framework for correctional healthcare, mental health support, and staff training.
Broader context
Ontario’s Chief Coroner’s Office has emphasized the importance of transparency and learning from past incidents. While the recommendations arising from inquests are not mandatory, they frequently lead to policy reviews, procedural reforms, and the implementation of enhanced oversight measures within institutions.
As correctional systems across Canada face growing scrutiny over inmate care and safety, this inquest is expected to attract attention from legal experts, advocacy groups, and correctional policy analysts.
The proceedings scheduled for November will once again highlight the delicate balance between security and human rights in custodial settings — and the ongoing responsibility of government institutions to safeguard individuals under their care.
