Notorious former gynaecologist Graeme Reeves "made a mistake" when he misdiagnosed a seriously ill new mother but does not deserve criminal punishment, his barrister says.
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Dubbed the "Butcher of Bega" after being convicted of mutilating a woman's genitals, the deregistered doctor is now on trial charged with manslaughter over the death of a female patient more than 20 years ago.
Kerry Ann McAllister, 38, died from septicaemia after she gave birth to her third son in The Hills Private Hospital in May 1996.
In his opening address in the NSW District Court on Friday, prosecutor David Price said a "reasonably competent" obstetrician could have diagnosed Ms McAllister as having a bacterial virus.
"His failure to take steps to appropriately investigate Kerry's condition and his failure to assume and treat for bacterial infection was a gross deviation from the standard of care of a reasonably competent obstetrician," Mr Price said.
"It seems evident that Kerry had a bacterial infection from the outset ... If Dr Reeves had acted in a different manner it is highly likely that Kerry would have received appropriate treatment much earlier."
The court heard that Reeves maintained that Ms McAllister had a viral infection and had repeatedly brushed off the concerns nurses had about her increasing temperature and pain.
As her temperature climbed to 40.3 degrees, Reeves allegedly told one worried nurse: "I'm well aware of her temperature, she's got a virus".
Reeves, the court heard, refused to examine Ms McAllister and said he would not enter her hospital room because he did not want to "catch it".
It was only after Reeves saw the results of the blood tests ordered by another doctor that he organised for Ms McAllister to be transferred to Westmead Hospital where she died the next day.
Reeves' barrister Ragni Mathur told the court that her client had held the erroneous belief that Ms McAllister was labouring at all times under a viral infection.
The court heard that Ms McAllister had complained of a painful throat and congested lungs and had mentioned multiple times that both her son and husband had been sick with the flu.
Ms Mathur said she expected the trial would hear evidence that the symptoms of viral and bacterial infections are "indistinguishable" and that other physicians who saw Ms McAllister had also failed to prescribe antibiotics.
There is expected to be evidence that when Ms McAllister arrived at Westmead Hospital she was left in limbo and transferred to a ward not appropriate for a critically ill patient.
"Graeme Reeves made a mistake but that mistake, that misdiagnosis, in our submission, does not amount to gross criminal negligence deserving of criminal punishment," Ms Mathur said.
Reeves was released from Long Bay jail in 2013 after he successfully appealed to the High Court against an 18-month increase to his sentence for mutilating a woman's genitals.
He was found guilty by a District Court jury in 2011 for maliciously inflicting grievous bodily harm with intent on patient Carolyn DeWaegeneire after he surgically removed her clitoris and labia without her consent during an operation to take out a pre-cancerous lesion.
Sixty charges against him – including allegations of sexual assault – were dropped by the Director of Public Prosecutions in 2013.
The trial continues.
