An American doctor charged with manslaughter in the deaths of three patients at a rural Australian hospital repeatedly botched operations and performed surgeries he was not capable of handling, a prosecutor said Monday.

In his opening statement in the pretrial hearing of Jayant Patel, prosecutor Ross Martin also said the doctor lied on his application to Bundaberg Base Hospital by neglecting to reveal he had been reprimanded by medical boards in the United States.

Patel's court appearance comes more than a quarter-century after questions were first raised over his competency, and follow years of complaints from colleagues and patients about his care.

Patel, 58, faces more than a dozen charges, including manslaughter, causing grievous bodily harm and fraud relating to his job as director of surgery between 2003 and 2005 at the state-run hospital in Bundaberg town, 230 miles north of Brisbane. He faces life in prison if convicted.

Patel has not entered a plea or spoken publicly about the accusations. He said nothing and gripped his wife's hand as he walked through a throng of journalists outside the courthouse before and after Monday's hearing. His lawyers also declined comment.

Martin said Patel showed a pattern of negligence by performing surgeries he'd been banned from undertaking in the U.S., misdiagnosing patients and using sloppy surgical techniques.

In one case, Martin said, Patel found a benign cyst during a patient's colonoscopy and responded by removing the man's bowel without bothering to do a biopsy. The specimen later showed no sign of cancer. The patient lived.

In another surgery, Patel operated on a patient's throat but left him bleeding internally for several hours while he attended to another patient, Martin said. The man eventually died of blood loss, leading to one of the manslaughter charges.

In 2004, Patel operated on man with thyroid cancer. Instead of removing the tumor — large enough to be seen by the naked eye — Patel removed a healthy salivary gland, Martin said.

Another doctor later noticed the scar from Patel's surgery was not near the cancerous mass and sent the patient back to surgery to remove the tumor.

Much of Monday's hearing was dedicated to allegations by the prosecution that Patel lied by failing to tell Australian authorities that he'd been forced to resign from his position in the U.S. state of Oregon because of medical negligence, and that New York state had canceled his license.

His resume to the Bundaberg hospital "effectively removed substantial gaps in his career that might have been questioned," Martin said.

In 1984, Patel was fined by New York state health officials and placed on probation for three years for failing to examine patients before surgery.

He later worked at Kaiser Permanente Hospital in Portland, Oregon. In 1998 — after reviewing 79 complaints about Patel — Kaiser restricted his practice. The Oregon Board of Medical Examiners later cited him for "gross or repeated acts of negligence."

Dr. Kees Nydam, who hired Patel in 2003, testified Monday that he would not have given Patel the job had he known about the restrictions placed on the surgeon by medical boards in the U.S.

"I would not have employed him," said Nydam, the first of 74 witnesses the prosecution planned to call during the three-week hearing at Brisbane Magistrates Court, where the magistrate will decide if prosecutors have enough evidence to send the case to trial.

Beryl Crosby, a former patient of Patel's who heads a support group for those who say they were hurt by the doctor, said outside court that it was difficult to see Patel again, but felt "huge relief" that the case was finally moving forward.

"I think it's going to be emotional all the way through," she said.

Patel resigned two years after joining Bundaberg hospital and went back to the United States. He was extradited in July from his home in Portland to Brisbane.