A 93-year-old Hungarian man who was in Toronto to visit family was slapped with a $920 ambulance bill despite refusing service from paramedics, raising questions about a patient's right to decline treatment.

Istvan Vago was shopping in a Richmond Hill dollar store with his son on Wednesday when he began clutching his stomach and sank to his knees.

But Vago simply needed to use the washroom, his daughter-in-law, Milla Vago, told CBC Toronto.

"There was a customer, who was also a nurse, who witnessed the whole thing," Vago said.

The nurse insisted on calling an ambulance, she said.

Vago's husband tried to tell the nurse that Istvan only needed rest and water.

He kept repeating, 'We do not need an ambulance.' She said it's up to her, and that she knew what she was doing," Vago said.

Milla Vago says her father-in-law was shaken by the ordeal, and plans to dispute the ambulance and hospital bill. (Mehrdad Nazarahari/CBC News)

When her father-in-law emerged from the washroom, Vago said, paramedics were waiting for him.

"They put him on the stretcher and started checking for different symptoms," she said.

Vago alleges that the paramedics checked her father-in-law's blood pressure, but even though it was normal, they transported him to the hospital anyway.

Legal right to deny medical attention

Medical law expert Bernard Dickens said the case seems to be a violation of Istvan Vago's legal right to refuse medical service.

"If people choose not to be patients, they're entitled to that," Dickens said.

​But there's an exception, he said. When a person's life is imperilled, anybody can attempt to rescue them, legally speaking.

In this case, Dickens said, the Vago family's claims that Istvan didn't need help were "vindicated" by his normal blood pressure and vital signs.

"He had no contractual obligation to the ambulance service to pay a bill" for a service that wasn't needed, Dickens said.

Iain Park, deputy chief of York Region Paramedic Services, said in a statement to CBC Toronto that paramedics follow standard protocol when assessing patients.

When a patient refuses transport to a hospital, it must be determined that they have the "capacity to understand they are refusing medical transport."

Vago said her father-in-law does not speak much English, and repeatedly told paramedics "drink" and "water," trying to convey that he was simply dehydrated.

'It didn't sink in at first'

According to his daughter-in-law, Vago was asked if he was covered by the province's health-care plan on the way to the hospital. Once there, he was placed in a hallway where staff took his information and asked to run tests.

He refused, and the family tried to leave, but were told they first needed to pay their bill, which totalled $920 for the ambulance, emergency visit and doctor's fees.

"I was in shock. It didn't sink in at first," Vago said.

The Vago family was told they had to pay the bill before the 93-year-old could leave the hospital. (Mehrdad Nazarahari/CBC News)

Vago said the family wasn't informed of the cost of the three-kilometre ride to the hospital.

"If they had told us it's not an emergency, which they obviously knew it wasn't … we could have driven him," she said. "We were not given any other options."

When her father-in-law was released, Vago said, "he was fine physically, but emotionally scarred," thinking the paramedics had caught on to some illness he wasn't aware of.

"He's still badly shaken," Vago said.

Vago said the family has sought legal help and will dispute the charges.​ Istvan Vago had out-of-country medical insurance, but it will not cover the hospital visit as it was not medically necessary, his family said.