Surgeon Jayant Patel caused the death of three patients and permanent injury to a fourth when he performed a series of unnecessary and poorly planned operations, a court has heard.
In his opening address in the Supreme Court in Brisbane on Monday, prosecutor Ross Martin, SC, gave an overview of the allegations levelled at the former Bundaberg Base Hospital doctor.
Mr Martin told the court the crown would be presenting evidence in an attempt to prove Patel, 59, was responsible for the manslaughter of Mervyn John Morris, James Edward Phillips and Gerry Kemps.
Patel has pleaded not guilty to the charges.
He has also denied causing grievous bodily harm to a fourth man, Ian Rodney Vowles.
The charges relate to Patel's time as director of surgery at the Bundaberg Base Hospital between 2003 and 2005.
Surgeon denies charges
Mr Martin on Monday detailed the allegations relating to Mr Morris, 75, who the court heard was "neither a young man or a well man", when he died in June 2003.
Mr Martin said Mr Morris had a history of prostate cancer and heart disease, but his condition deteriorated significantly soon after Patel removed part of his colon in May that year.
"For a variety of reasons this was simply the wrong thing to do... as a consequence of this Mr Morris did not survive," Mr Martin said.
Mr Martin said Patel failed to investigate properly the reasons for Mr Morris's rectal bleeding, and his decision to remove part of the patient's colon was "unjustified" and "unnecessary".
"There was no clear identification of what was wrong," Mr Martin said.
Mr Martin said the removed section of colon was sent to pathologists for analysis, who confirmed there were no malignant growths and no evidence of a bleeding site.
'Criminally responsible'
Mr Morris' condition deteriorated after the operation as he lost his appetite and continued to bleed, the court was told.
Mr Martin said Patel told the dying man's family he had done all he could to help him.
Mr Martin told the jury they would conclude Mr Morris died because of Patel's operative procedures and post-operative care, which he said was "so far below the standard of care that was appropriate that he should be held criminally responsible".
"He was the wrong doctor to do the operation... this was the wrong patient... the wrong preparation was done... this was the wrong hospital to do this operation (and) he got the wrong post-operative care," Mr Martin said.
Mr Phillips was also "very unwell", and in the end stage of renal failure in April 2003 when Patel undertook major surgery to treat cancer, Mr Martin said.
"Without adequate consultation or consideration of the alternatives, the accused performed an operation called an oesophagectomy," Mr Martin said.
'Useless, careless' operation
"Mr Phillips never regained consciousness and died a few days later."
The crown alleges that Mr Kemps, 77, died after Patel botched an oesophagectomy and then failed to diagnose and treat internal bleeding.
"The accused either did not accept it was happening or chose to do nothing about it," Mr Martin said.
He said Mr Vowles, 62, has been left with a colostomy bag after Patel performed a "useless" and "careless" operation to remove his bowel.
Mr Martin said Patel "leapt to the conclusion" Mr Vowles had cancer, despite a biopsy having returned a negative result.
The trial, before Justice John Byrne at the Brisbane Supreme Court, is expected to last between eight and 10 weeks and hear from up to 160 witnesses.
The case will be broadcast to a viewing room in Bundaberg.
