What happens if police never find out who is responsible for the deaths of Honey and Barry Sherman?

An autopsy concluded last weekend that the billionaire couple died from ligature neck compression, or hanging or strangulation with a ligature. Homicide investigators have taken over the case, but it hasn’t been labelled a homicide.

“There are only two possibilities,” David Perry, a 28-year veteran of Toronto police’s homicide and sexual assault squads now working as a private investigator, told the Star. “These two people died at their own hands or somebody else’s.

“So that’s what they’re trying to figure out and, I would imagine, it’s quite a piece to put together to come up with an exact or definite determination. And there are cases where we can’t, you know?”

The bodies of Barry Sherman, 75, founder of generic drug giant Apotex, and his wife, 70, were discovered in their North York home on Dec. 15. Their deaths were deemed “suspicious” and an investigation began.

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Though it’s still early in the case — Perry was quick to note that it’s been just over a week since the bodies were found — he recalled cases he’s worked on or reviewed where police didn’t rule a death one way or another because they could not say with 100-per-cent certainty that it was a suicide, a death by misadventure, or a homicide.

“So the case kind of stays open,” he said. “Sometimes, everybody looking at the case would agree on a theory about what happened — but they didn’t have the evidence to support it.

“You might know the manner and the mechanism of how somebody died, but you’re not sure at whose hands,” Perry said.

Even in cases where a determination is made, the public can still be left without answers. An intentional explosion in Mississauga last year that destroyed dozens of homes and killed the centre house’s inhabitants — Robert Nadler and Diane Page — prompted similar questions to the Sherman case. Was it murder-suicide? An accident?

In the end, Nadler’s and Page’s deaths were deemed double suicide. There had been speculation during the months-long investigation that the explosion was Nadler’s idea — he had a past criminal record including a conviction for a Peel Region murder decades before. Investigators found no evidence to suggest that was the case. No one can know for sure what happened inside that day, and whether one spouse persuaded the other to go along with it.

In other cases, such as the case of Cameron Bailie, the cause of death could remain unknown. Bailie’s body was found in Lake Ontario in the summer, after he disappeared from his Oshawa home in January. His death remains listed as “unexplained” following the autopsy, Staff Sgt. Bob Elliot of Durham Regional Police said Saturday. The toxicology report could offer more insight, but it has yet to be completed, he added.

Even when a death is ruled a homicide, it may still go unsolved. Of the 61 deaths ruled as homicides this year in Toronto, 36 remain unsolved, according to the Toronto police website. Twenty-eight of the 74 homicides in 2016 and 18 of the 57 homicides from 2015 also remain unsolved.

In the Sherman case, another possibility Perry floated was that police were prepared to make an announcement, but are holding back “out of respect for the family,” to let them grieve and bury their loved ones before an announcement was made.

The family has criticized media reports of police sources divulging an early theory that the deaths were a murder-suicide.

“Given the high-profile nature of this case, and the fact that the family is already concerned about what the police have said and what police sources have said, I think they’re going to make sure that they’ve really got it right before they make any announcements,” Perry said.

Beyond the police investigation, the Sherman family has sought the help of lawyer Brian Greenspan to conduct an independent investigation into the couple’s deaths.

Meanwhile, police continue their investigation at 50 Old Colony Rd., the Shermans’ house near Bayview Ave. and Highway 401.

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Police have inspected the roof and taken one of the Sherman’s cars away for examination. A car search could be looking for signs of a struggle, blood, or any other evidence to hone the investigation, Perry told the Star.

On Saturday, investigators took their search underground to the sewer system. Sewer searches can sometimes find objects that someone tried to stash, an officer stationed outside on watch the Sherman house told the Star.

A Toronto police spokesperson, Allyson Douglas-Cook, said there were no new announcements from homicide about the case Saturday.

In the days since his death, Barry Sherman has been remembered as a generous philanthropist, as well as a shrewd and litigious businessman. Under his leadership, Apotex launched hundreds of lawsuits against competitors.

In one of Apotex’s most high-profile battles, the company went head to head with Dr. Nancy Olivieri, a blood disease specialist at SickKids who was researching the drug deferiprone as an alternative treatment for thalassemia, a disorder that can lead to unsafe buildups of iron.

Olivieri and Dr. Gideon Koren, the discredited doctor at the centre of the Motherisk scandal, were running a clinical trial for Apotex.

When Olivieri, the lead researcher, raised concerns about the efficacy and potentially life threatening risks of the drug, Sherman’s company threatened legal action and pulled funding for her clinical trial. Neither Apotex nor Koren, who would later disparage Olivieri and her supporters, shared her concerns.

In the years that followed, lawsuits were launched by both parties. It was more than a decade before Olivieri and Apotex settled in 2014.

Research integrity and patient safety were at the heart of the issue, said Arthur Schafer, a University of Manitoba professor and the founding director of the school’s Centre for Professional and Applied Ethics, who supported Olivieri as an unpaid ethics consultant throughout the legal battle.

“The Olivieri scandal was the greatest ethical scandal I would say in Canadian corporate history and certainly in pharmaceutical history,” he said. “It’s included now in bioethics textbooks, it’s a standard illustration of how drug company power can be used to subvert the integrity of research hospitals and universities when the profitability of the company and the effectiveness and safety of their drugs is challenged by a researcher.”

“The company was ruthless,” he said, adding that neither the University of Toronto nor SickKids supported Olivieri and in fact attacked her integrity when she came under fire from Apotex.

While Sherman may have “sincerely believed” Olivieri was wrong, the case doesn’t “say much for his concern about patient safety or research integrity,” Schafer said.

“I think it took a tremendous toll on her,” he said, but “ultimately, she was completely vindicated.”

With files from Ainslie Cruickshank and Rachel Mendleson

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