Toronto physician Dr. Alvin Chang unilaterally placed a “do not resuscitate” order on an elderly patient at Toronto East General Hospital last October against the repeated wishes of her family, a statement of claim filed in court alleges.

Canh Luong, who was 94, died later that evening as her family rushed to get a court injunction that would stop the order long enough to have her transferred to another hospital, the family alleges.

Chang and Toronto East General committed “wrongful death, abuse of power, negligence and breach of fiduciary duties,” reads the claim, which seeks $1.2 million in damages for four of Luong’s family.

The allegations have not been proven in court.

A Toronto East General official declined interview requests because the matter is before the courts.

Chang, in an email response, said he could not comment on the case for reasons of patient privacy.

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Luong, a Vietnamese immigrant and Buddhist who raised five children on her own after her husband died in a 1962 accident, arrived in Canada in 1980 as a refugee and settled in Toronto with her family. Despite her advanced age, Luong led an “independent, meaningful and fulfilling existence,” reads the statement of claim.

She was healthy, ate and slept well, walked and climbed stairs and played mah-jong on weekends, it says.

“My mother was a very strong, independent, simple lady, only care and love for others, never asked anything in return,” her son, Thang Hua, who lives in Australia, said in an interview.

Her new life in Canada was spent in the same home with her youngest son, Toan Hua, a dental technician in Toronto.

“I took medicine more than her because she was so healthy,” Toan said in an interview.

That changed last September, when she was hospitalized at Toronto East General with a bout of flu. The physician who admitted her told her family “he expected Luong would die in two hours or so,” says the statement of claim.

“He vigorously attempted to convince them that she should not be saved, as it would represent a waste of time and resources. He added that she would die anyways, she was 94 and had lived long enough.”

The family rejected that advice, demanding she be listed as “full code,” meaning all reasonable efforts would be made to resuscitate her in case of emergency.

In accordance with Vietnamese culture, the final decision had to be made by Luong’s eldest son, Thang.

Thang told Toronto East General physicians that “every measure should be taken to save Luong and that he should not make a judgment based upon her age,” the statement reads.

Physicians complied with that request at first.

Thang, who was on a cruise at the time, disembarked in Alaska and immediately flew to Toronto to be by his mother’s side.

Luong’s condition improved to the point where she was preparing to go home until she suffered a respiratory failure on Sept. 24, the statement reads.

Thang was again interviewed by medical staff about his mother’s status and was asked if he had discussed it with his mother. He said it was her wish to keep living, the statement reads.

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“Luong’s family consistently made it clear that she was to be the subject of resuscitation in the event that her life was failing,” it reads. “The numerous physicians involved in her care and who were consulted therewith were fully aware of her full code status.”

In early October, Dr. Chang called the family to a meeting to inform them she would likely suffer a respiratory failure in the coming weeks and would not be resuscitated by medical staff despite her family’s orders to the contrary, the statement says.

“(Chang) said that she would be transferred from the ICU to a general ward that night because the ICU did not have room,” it says. “He needed her bed for another patient. He added that he decided to write a do not resuscitate (DNR) order.”

The family rejected the status change, demanding she be moved to another hospital and asking that the hospital wait until the next day so that the family could hire a lawyer to obtain a court injunction against the DNR order.

“Chang walked away without saying anything and the family took it that he would defer the writing of the DNR order for the one day,” the statement reads.

After the meeting, the family approached Mount Sinai Hospital and Toronto General Hospital to inquire about Luong’s possible transfer to one of those campuses.

Meanwhile, Chang changed Luong’s order to DNR without the family’s consent, the statement claims.

She died within hours.

“We were shocked by the meaning of DNR,” Thang said in an email response to the Star’s questions. “My siblings, who lived in Toronto over 30 years, did not know, nor my family in Australia (have) ever heard of such horrific measure … (They) disregarded the family wishes/requests, decided who should live or die by skipping all the legal procedure.”

Barry Swadron, who is representing the family along with lawyer Mercedes Perez, said Chang should have taken the dispute with Luong’s family to a provincial body called the Consent and Capacity Board, which hears end-of-life cases such as this and issues orders.

“It is imperative that physicians recognize and accept that they are not the ultimate authority when it comes to life and death,” said Swadron.

The statement of claim alleges Chang was negligent in preferring “his own opinion over that of the plaintiffs with respect to the code status of Luong,” for failing to consult them before making the change, and for failing “to provide Luong with the necessaries of life.”

It also claims damages against Toronto East General for failing to ensure “appropriate procedures are followed in respect of the code status of patients” and failing “to have an emergency mechanism available to resolve the dispute.”

“I asked her if she wanted to live or go,” says Toan Hua, 58, who says his mother was clear about her wishes prior to her death.

“She said she wanted to live. Her mind was very clear. We told the doctor that she wanted to be alive. They kept saying my mother is too old and to let her go peacefully. This hospital didn’t want to save her life.”

Now, he says, just to walk past her room each day in the home they shared is emotional.

“I’m still missing her.”