An Italian doctor who made headlines for pioneering windpipe surgery went on trial in Sweden on Wednesday, charged with assault for performing the experimental procedure.
Paolo Macchiarini won plaudits in 2011 after claiming to have performed the world's first synthetic trachea transplants while a surgeon at Stockholm's Karolinska Institute.
The procedure was hailed as a breakthrough in regenerative medicine.
But allegations soon emerged that the risky procedure had been carried out on at least one individual who had not been critically ill at the time of the operation.
Dressed in a blue suit, the 63-year-old listened to translated audio as prosecutors listed the charges of "aggravated assault" against three patients.
The Karolinska Institute has confirmed that the three individuals have since died, but did not directly link the deaths to the operations.
"Paolo Macchiarini has carried out the surgery with complete disregard for science and tried experience," prosecutor Karin Lundstrom-Kron told the court.
Macchiarini has maintained they constituted treatments and not experiments, and denied being criminally responsible.
"His only motivation has been to treat the patients," his lawyer Bjorn Hurtig told the court.
Downplayed risks
In 2013, the Karolinska hospital suspended all transplants and refused to extend Macchiarini's contract as a surgeon.
A year later, several surgeons at the hospital filed a complaint alleging that Macchiarini had downplayed the risks of the procedure.
Macchiarini carried out three surgeries at Karolinska University Hospital - where he also worked as a surgeon - in 2011 and 2012, using an artificial windpipe made of plastic and coating it with the patient's own stem cells.
Together with his colleagues, he performed a total of eight such transplants between 2011 and 2014, the five others taking place in Russia.
In 2013, the Karolinska hospital suspended all transplants and refused to extend Macchiarini's contract as a surgeon.
A year later, several surgeons at the hospital filed a complaint alleging that Macchiarini had downplayed the risks of the procedure.
An external review in 2015 found Macchiarini guilty of research misconduct, but despite sacking him, the Karolinska Institute repeatedly defended him until 2018, when it found him and several other researchers guilty.
The university's principal stepped down over the scandal, as well as a number of other people.
Medical journal The Lancet in 2018 retracted two papers authored by Macchiarini.
The trial, held in the Solna district court near the Karolinska Institute, is scheduled to take place over 13 days.