Markel Jason Downey, 22, of Cole Harbour, N.S., has been charged with first-degree murder in the death of Ashley MacLean Kearse, who died four years after she was paralyzed in a triple shooting and home invasion.

Downey was arrested July 11. He is also charged with two counts of attempted murder in relation to the 2014 incident.

He was initially acquitted of 28 charges, including three of attempted murder, at a trial that concluded in February 2017.

The Crown appealed Downey's acquittal a year later. And in April, the Nova Scotia Court of Appeal agreed that the original trial judge made "serious errors" in his decision to dismiss the case against Downey.

The new charge was prompted by Kearse's death on July 2. The Nova Scotia Medical Examiner's office determined she died as a result of injuries sustained during the shooting on Nov. 30, 2014. Kearse was in her early 20s at the time of her death.

Downey's lawyer, Patrick MacEwen, said he's been told it will be months before the full autopsy report is complete.

"The medical examiner has concluded that the death is likely a homicide. That's their opinion. We haven't seen any medical evidence to support that," said MacEwen.

Crown attorney Scott Morrison said the Crown will provide the defence with the autopsy report as soon as it can.

"We've received a certificate from the medical examiner and had some preliminary conversations with her," he said.

Downey appeared via video link from jail in Nova Scotia Supreme Court in Halifax Thursday morning. Since the Crown decided to proceed with charges via direct indictment, Downey will automatically face both a judge and jury at the new trial.