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Lai Changxing is led away in handcuffs from an immigration hearing in Vancouver on July 11, 2011.Simon Hayter/The Globe and Mail

He was the brazen smuggler who bootlegged oil and luxury cars, operated a bordello the size of a small apartment building and drove around in an armoured Mercedes that once belonged to a president – a man known in his hometown as the Emperor and to his biographer as "one of China's greatest crooks."

For years, Lai Changxing was also one of the biggest irritants between Beijing and Ottawa, a man accused of epic graft who had escaped to Vancouver, where he became the subject of furious Chinese demands that he be sent back home to face justice.

Canada finally agreed, in 2011, after receiving assurances that Mr. Lai would not face execution or mistreatment, and that Canadian officials would be allowed to monitor his treatment and his health.

Now, his family is accusing Canada of failing to keep its side of the bargain and threatening to drag the federal government back into court over a man who has already consumed huge amounts of Canadian political effort.

Ottawa should "carry out what it promised, which was to guarantee China deals with my father's case fairly," said his son, Kenny Lai, in an interview.

The family, which lives in China now, wants Ottawa to pressure Beijing to give Mr. Lai better medical care. The 58-year-old is a diabetic with three severely blocked arteries, and the prison system has not given him either the treatment he wants or, his family says, sufficient access to specialist doctors.

"Tomorrow or some day you may hear that he is dead in prison. That is the danger he is facing right now for his health," Kenny Lai said.

The family also wants Canadian officials to support their bid for a reduction in Mr. Lai's sentence to a fixed term, which would make it easier for him to secure bail on medical grounds. And they hope Canada can advocate for them as they push Chinese courts to scrutinize assets that were seized from Mr. Lai.

Those demands also stand to underscore a difficult question for Ottawa, which has agreed to discuss an extradition treaty with Beijing that would formalize the process for sending back others who are living in Canada but accused of corruption at home: How much responsibility does Canada hold for the people it sends back to China?

Ottawa has argued that its responsibility ended in May, 2012, when Mr. Lai was sentenced to life in prison. In an e-mail sent to the family in 2013, the Canadian embassy in Beijing said it had only been given the right to monitor Mr. Lai before he went to trial.

"The Chinese government has no obligation to grant Canadian officials the right to visit Mr. Lai after conviction, nor do Canadian officials have a continuing right to visit Mr. Lai, or to monitor his treatment in prison," said the e-mail.

Canadian diplomats have not seen him since he was convicted.

Yet the assurances China made to Canada about Mr. Lai make no reference to a "pre-trial" period, according to a copy of the assurances statement seen by The Globe and Mail.

Nor do they broadly commit Ottawa to ensuring Mr. Lai is treated fairly, as his family has demanded.

Instead, they specify that China tell Canada where he is being detained, allow Canadian officials to contact him, permit Ottawa to request an independent medical examination and require that he not be subjected to poor treatment. They do not stipulate a particular duration of time for Canada to exercise those privileges, except to say some requirements apply during his detention – without defining what constitutes detention.

That leaves it unclear whether China agreed to submit to Canadian scrutiny over the entire course of Mr. Lai's incarceration or solely during his pre-trial detention.

Now Mr. Lai wants to force Canadian authorities to keep pressing his case.

"What he has done is asked me to go to a court [in Canada] to get a ruling on the interpretation of the assurances, whether the government of Canada can legally take the stance that they don't apply after trial," said David Matas, a lawyer who represented Mr. Lai before his deportation, and has recently been hired again by the family.

Mr. Matas plans to submit a federal court filing in the next few days. He expects to ask the court to compel Ottawa to ask Beijing for access to Mr. Lai.

But the convicted smuggler, by the account of his lawyer and his son, has not been mistreated in that time. He can speak by telephone with his family nearly every day, an uncommon privilege. A doctor is available day and night to take basic health measurements such as blood pressure. The central government even bought five vehicles – a small fleet of cars and minivans – that can be used by the Zhangzhou prison where he is detained to transport people involved in his medical care.

"Other people can use them, too, but his needs take priority, as far as seeing doctors," said Shu Jie, a Chinese lawyer also representing Mr. Lai.

"The guards actually treat him very well in all respects. They pay more attention to his care than others – that's for sure."

Mr. Lai's complaint is that a specialized heart doctor from Beijing has not been to see him since May 27, 2016, breaking a previous schedule of visits every six months. That doctor had led his care, and Mr. Lai has recently experienced episodes of severe chest pain. "I think it's getting very urgent," Mr. Shu said.

"No one should keep him from seeing a doctor. It's about saving a life."

Prison authorities are also slow to process his requests for checkups, his son said, and have denied his demand for surgery to insert stents – although Mr. Lai's diabetes makes such a procedure risky. The former smuggler has been on a doctor-ordered diet and has lost five kilograms.

China's foreign ministry did not respond to questions about Mr. Lai's case. "China protects the legal rights of prisoners according to the law," a spokesperson said.

Global Affairs Canada did not immediately reply to questions. In the past, the Canadian government has said of Mr. Lai: He "is not a Canadian citizen, and therefore officials cannot provide consular services. Canadian and Chinese authorities continue to work together on law enforcement and legal-judicial issues."

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