A court hearing the manslaughter case against Jayant Patel was today told that the Indian-American doctor was a "rotten surgeon" who did not have the skills to perform major operations.
Prosecutor Ross Martin told the jury that Patel's negligence caused the deaths of three patients, and serious injury to another.
The trial, Martin told the court, was about "judgements", and that Patel's negligence extended to his poor decisions about when to operate, and his choices about appropriate post-operative care.
"You'll be satisfied that the accused was a bad surgeon," Martin said.
Patel was dubbed as 'Dr Death' by the Australian media after the case was highlighted, he was later extradited from the US to undergo trial.
"Surgery is not only about cutting - it involves pre-and post-surgical choices as well. If you don't have all of these skills you ought not to be offering surgery to patients," he said.
He said Patel's comment to Bundaberg nurse Damien Bondarenko in 2005 was illustrative of his "ego and lack of insight" into his actions.
"(Patel) said to Bondarenko: 'Don't you think the community's lucky to have someone like me? I've brought a lot of money to the hospital. I've increased its activity'," Martin said.
The prosecutor said this was Patel's view after all the events, surrounding his tenure at the hospital.
"The lack of insight that that reveals is remarkable," he said.
Martin said he would speak at length about the evidence given during the trial, which is now in its 13th week.
The lawyer is currently focusing on the events relating to patient Morris, who died on June 14, 2003.
It is alleged Patel failed to properly investigate the cause of Morris's rectal bleeding and "unnecessarily" removed part of the 75-year-old's colon.
Patel has pleaded not guilty to the manslaughter of Mervyn Morris, Gerardus Kemps and James Phillips during his time as director of surgery at the Bundaberg Base Hospital between 2003 and 2005.
He has also pleaded not guilty to the grievous bodily harm of Ian Vowles.