A pre-existing medical condition that was not raised at the plea hearing, and which has become significantly more symptomatic in custody, may be admitted as fresh evidence on sentence appeal under the Eliasen/Duy Duc Nguyen principles where it demonstrates the true significance of facts in existence at the time of sentence. The case is distinguishable from R v Beyer where the medical condition had progressed in a foreseeable way and the burden on the offender was not significant.
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