A French doctor accused of intentionally poisoning 30 child and adult patients, 12 of whom died, went on trial Monday, saying before the hearing he was not responsible for the "distress" of his alleged victims and their families.

Frederic Pechier, 53, worked as an anaesthetist at two clinics in the eastern city of Besancon when patients went into cardiac arrest in suspicious circumstances between 2008 to 2017. Twelve could not be resuscitated.

What's he accused of?

He is accused of triggering heart attacks in patients so he could show off his resuscitation skills and discredit co-workers. 

Pechier's youngest alleged victim, a four-year-old identified as Teddy, survived two cardiac arrests during a routine tonsil operation in 2016. The doctor's oldest alleged victim was 89.

The trial caps an eight-year investigation that stunned the medical community. Pechier has denied the charges.

"It's necessary to lay all the cards on the table," Pechier told broadcaster RTL earlier Monday, adding that he had "strong arguments" in his defense.

Asked about the suffering of the families who will attend the trial, set to last until December, Pechier said: "I understand it completely, but on the other hand, I am not responsible for their distress."

Pechier, a father of three, faces life imprisonment if convicted. He is not currently in custody but under judicial supervision, an alternative to pre-trial detention.

A 17-year wait for justice?  

Pechier has not practised medicine since 2017, even though in 2023, he was authorized to work provided he does not come into contact with patients.

"I've been waiting for this for 17 years," said Amandine Iehlen, whose 53-year-old father died of cardiac arrest during kidney surgery in 2008. An autopsy revealed an overdose of lidocaine, a local anaesthetic. 

Prosecutor Etienne Manteaux has said the case is "unprecedented in French legal history".

An investigation was opened in 2017 after suspicious cardiac arrests during operations on patients considered low-risk.

Pechier is suspected of tampering with his colleagues' paracetamol bags or anaesthesia pouches to create operating room emergencies where he could intervene to show off his resuscitating talents. 

"What he is accused of is poisoning healthy patients in order to harm colleagues with whom he was in conflict," Manteaux said. "Frederic Pechier was the first responder when cardiac arrest occurred. He always had a solution."

Pechier has blamed "medical errors" by his colleagues for most of the poisonings. 

'Legal marathon' 

Some colleagues described Pechier as a "star anaesthetist", while others said he came across as arrogant and manipulative. 

One co-worker claimed Pechier was "certain he was the best" and liked to "think of himself as Zorro".

Over the course of the inquiry, investigators examined more than 70 reports of "serious adverse events", medical jargon for unexpected complications or deaths among patients.

More than 150 civil parties will be represented at the trial. 

"It's going to be a legal marathon, but we're ready," Stephane Giuranna, a lawyer for several civil parties, said. "All roads lead to Pechier."