Matthew Blafman, 33, denies the manslaughter of Jessie Harris, 78, at St George's hospital, Hornchurch, in October last year.
Brian Barker QC, for the prosecution, told the court that the defendant had taken up a post as a senior house officer at St George's in September 1991 despite having no medical qualifications.
'He was a bogus, a sham, an imposter,' Mr Barker said. 'He was a man not short of confidence with an ability to perhaps pull the wool over people's eyes.'
Mr Blafman was the doctor on call at St George's, which specialises in geriatric care, when Mrs Harris was admitted after a fall. The doctor who initially examined her diagnosed hypothermia and a chest infection and expected her to be discharged a few days later.
'She should have left hospital alive and well and recovered but within some 12 hours of being under the defendant's care she had deteriorated rapidly and died,' Mr Barker told the Recorder of London, Lawrence Berney QC.
He said that Mr Blafman's treatment of Mrs Harris, far from helping her, 'had completely the opposite effect' and provoked a life-threatening situation.
'When it was quite clear that . . . he had an emergency on his hands, instead of facing reality and seeking help from one of the more senior doctors, he brazened it out and took away the last chance for her to be properly and professionally treated.'
The court heard that Mr Blafman was in the army for 12 years. Attached to various hospitals in the United States and Europe, he became a staff sergeant.
Despite courses and training, his level of expertise was at highest that of a registered nurse, Mr Barker said. In the summer of 1991 he left the army because of back problems and came to Britain with his English wife.
He had, Mr Barker said, 'a reasonable bedside manner'. 'He was self-confident, firm in his views. At one stage he was seen in green operating theatre uniform despite the fact there was no theatre at the hospital.'
The jury was told that Mrs Harris was cheerful and independent despite a long history of Parkinson's disease, asthma and breathing problems. The exact cause of her death was not known because her body had been cremated.
'It is not suggested that he wanted to kill or seriously harm her, but in the extraordinary circumstances of this case he displayed real negligence and a reckless disregard of the obvious dangers,' Mr Barker said.
Initially admitted to the casualty department of a sister hospital, Mrs Harris was transferred by ambulance in the morning to St George's. She was in good spirits and gave no cause for concern.
However, at about 6pm she began to deteriorate. Nurses telephoned Mr Blafman, who had examined her earlier, and he told them to give her five units of insulin. About three hours later she was found dead.
Mr Barker said that Mr Blafman's acts and omissions had contributed significantly to Mrs Harris's death. He had prescribed the insulin without looking at an earlier blood test which showed she was not diabetic and had failed to give her antibiotics for her chest infection.
'Neither did he alert any relatives when she was clearly taking a massive turn for the worse,' Mr Barker said. 'Taking no guidance was arrogance; taking no action was negligence.'
The case continues tomorrow.Reuse content