Indian-born American doctor Jayant Patel, facing accusations of botching operations and causing death of three patients, pleaded not guilty to manslaughter charges at a court in Brisbane in Australia on Monday.
Extradited to Australia from the US, the 59-year-old doctor replied, "Not guilty, your honour", as judge John Byrne read out three charges of manslaughter and a charge of injuring another patient in a crowded courtroom in the presence of his wife Kishori, also a doctor.
Patel's high-profile trial comes more than 25 years after questions were raised about his surgical competence to carry out major operations at Bundaberg hospital in Queensland between 2003 and 2005.
He faces life imprisonment if convicted.
Patel, labelled 'Dr Death' by the media, was charged by the prosecution of performing a series of unnecessarily and poorly executed surgeries including a botched operation he performed after misdiagnosing cancer.
A large number of Patel's former patients and others turned out to watch the beginning of the trial in which up to 160 witnesses, most of them doctors and nurse, are expected to testify during the 10-week hearing being broadcast live in the Bundaberg court house. Patel was originally charged on more than dozen counts, but is being tried only for three counts of manslaughter and one count of causing bodily harm.
The prosecution charged that Patel had repeatedly performed surgeries that he had been banned from undertaking in US, from where he was extradited in 2008.
Patel faced complaints of his competency since the early 1980s when he practised in US. In 1984, he was fined by New York health officials and was placed on probation for three years for failing to examine patients before operations.
Shifting later to Portland Oregon, he was banned from undertaking liver and pancreatic surgeries at the Kaiser Permanente hospital.
Patel moved to Bundaberg hospital in Australia in 2003. But two years later, he resigned and left for US after accusations of his competence were raised against him in the state parliament.
The court heard prosecution charges that Patel had wrongly removed a patient's healthy bowel, leaving him with a permanent colostomy bag, according to media reports.
Patel is accused of manslaughter of Mervyn John Morris, James Edward Phillips and Gerry Kemps.
Opening the Crown case, prosecutor Ross Martin described a series of botched and unnecessary operations performed by Patel that allegedly resulted in the deaths of the three patients and the harming of Vowles.
Instead of performing a total biopsy on a polyp discovered in the man's bowel, Patel decided to wholly remove what was left of the healthy organ. This left Vowles needing a colostomy bag and Martin described the operation as "useless and devastating".
Martin also told the court of operations on Morris, Kemps and Phillips -- after which all three died in hospital.
In case of Morris, 75, Patel allegedly wrongly decided to remove part of the patient's bowel. Three weeks after the operation, Morris died on June 14, 2003.
Phillips, 46, was in end-stage renal failure. He was diagnosed with oesophageal cancer in April 2003, and the prosecution alleges that Patel wrongly decided to conduct a major operation on Phillips at the Bundaberg Hospital.