Brisbane, March 22 (IANS) India-born doctor Jayant Patel caused the deaths of three patients and left a man permanently impaired after he performed on him a 'useless' and 'careless' operation to remove his bowel, an Australian court was told.

Prosecutor Ross Martin gave an overview of the accusations against the former Bundaberg Base Hospital surgeon in his opening address in the Supreme Court in Brisbane Monday, Australian news agency AAP reported.

Martin said they would be presenting evidence to prove Patel, 59, was responsible for the manslaughter of Mervyn John Morris, James Edward Phillips and Gerry Kemps. Patel, however, has pleaded not guilty to the charges.

The charges relate to Patel's time as director of surgery at the Bundaberg Base Hospital between 2003 and 2005.

Martin told the court that 75-year-old Morris was 'neither a young man or a well man' when he died in June 2003. He said the patient had a history of prostate cancer and heart disease, but his condition worsened after the doctor removed part of his bowel 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,' Martin was quoted as saying.

Phillips was 'very unwell' and in the end stage of renal failure in April 2003 when Patel undertook major surgery to treat cancer. 'Without adequate consultation or consideration of the alternatives, the accused performed an operation called an oesophagectomy,' the prosecutor said.

'Mr Phillips never regained consciousness and died a few days later.'

Martin observed that Vowles, 62, had been left with a colostomy bag after Patel performed a 'useless' and 'careless' operation to remove his bowel. He said that Patel 'leapt to the conclusion' that Vowles had cancer, despite a biopsy returning a negative result.

Patel's case is probably the worst medical-negligence scandal in this country. He allegedly falsified his application to practice medicine in Australia and then falsified death certificates and refused patients' transfers to other hospitals to cover up 'botched treatment and surgery'.

Patel, banned from surgery in two US states, was employed at the regional Bundaberg Base hospital for A$200,000 ($195,000) per annum in 2003. In late 2003, he was promoted to director of surgery at the hospital.