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Dr. Brian Day an orthopaedic surgeon during an operation at the Cambie Surgery Centre in vancouver September 30, 2010 .John Lehmann/The Globe and Mail

Dr. Brian Day's legal battle over the constitutionality of the Medicare Protection Act gained steam Tuesday with the addition of four B.C. residents as plaintiffs on his civil claim. Dr. Day is challenging the act's ability to restrict residents from privately accessing health care services that are also funded under the province's Medical Services Plan.

"They are just four of the many thousands who continue to suffer irreversible harm as a direct result of such laws," said Dr. Day, the former president of the Canadian Medical Association.

The four patients – selected from a group of volunteers – each represent a slightly different aspect of what is wrong with the province's health care system, said Dr. Day. Their individual cases are outlined in the amended notice of civil claim filed Tuesday.

Chris Chiavatti, a recent high-school graduate, injured his knee during a gym class in January 2009. After about eight months of being waitlisted in the public system, he opted for private treatment at the Specialist Referral Clinic – where he was immediately diagnosed based on an MRI previously done at a public hospital and had surgery within a few weeks.

Mandy Martens, who is in her mid-30s, chose to have a colonoscopy at the private clinic after being advised by her family doctor to seek private care for her concerns over blood and mucus in her stool, which started in April 2011. Dr. Jean Lauzon of the Cambie Surgery Centre confirmed Ms. Martens had colon cancer and all of her cancer cells are believed to have been removed during subsequent treatments.

Krystiana Corrado, 17, injured her knee ligaments during a soccer game in April 2011. The elite soccer player missed practices, games and try-outs until she opted for private health care in January 2012.

Erma Krahn, 79, was diagnosed with lung cancer in May 2008. In September, she tore her meniscus in her knee and doctors informed her she would have to wait three years for surgery. She chose to be treated at the Cambie Clinic and underwent surgery about two weeks later. She has since torn her meniscus in her other knee in April 2012 and is scheduled to have surgery at the clinic on August 13.

Dr. Day said these and thousands of other B.C. patients on long waitlists for health care services deserve the choice to seek private care. He said employees injured at work, prisoners, police officers and those in the Canadian armed forces are able to receive expedited care. This week, he said, he received one request from Corrections Canada for expedited treatment for a prisoner.

"In our health system, we have this arbitrary differentiation … and we think that ordinary citizens should have the same rights," he said.

The B.C. Medical Services Commission ordered Cambie Surgery Centre and the Specialist Referral Clinic Inc. to stop extra-billing patients for services covered by the province's Medical Services plan in mid-July. If the clinics do not comply, the commission planned to seek a legal injunction. Dr. Day is the medical director of both clinics in question.

"We would welcome our day in court sooner rather than later," said Dr. Day, whose clinic has never been secretive about its practices.

The plaintiffs are prepared for the case to go as high as the Supreme Court of Canada, said Peter Gall, a partner at Heenan Blaikie, the firm representing Dr. Day.

With files from The Canadian Press.