The Queens pain doctor who prescribed pills to Medford pharmacy gunman David Laffer was denounced for putting greed above his duty to patients as his manslaughter trial began Wednesday in state court in Manhattan.

"This is a case about a doctor who put money above lives," prosecutor Charlotte Fishman told jurors in her hourlong opening statement. "And not just any lives. Lives with which he was entrusted."

Stan Xuhui Li, 60, a Hamilton, N.J., anesthesiologist who ran a Flushing pain clinic, is charged with manslaughter in the deaths of two men, including Joseph Haeg of East Moriches, by prescribing oxycodone and other drugs while ignoring danger signs.

Li also is charged with reckless endangerment of seven patients, and criminal sale of a controlled substance to 20 patients, including Laffer, who is serving a life term for killing four people in the 2011 robbery of Haven Drugs. Seven of the 20 patients died of overdoses.

Fishman said Li, who ran his Queens clinic only on weekends, doled out prescriptions like popcorn for painkillers, anti-anxiety drugs and other medications, and took payments in cash from as many as 90 patients a day, raking in more than $450,000 from 2009 to 2011.

But he ignored obvious signs of addiction, warnings from other doctors and entreaties from family members, and never did real exams or provided real treatment, Fishman said.

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"He had ceased to practice medicine," she argued. "Instead, Dr. Li sold prescriptions."

Defense lawyer Raymond Belair told the jury that pain management was not as simple as prosecutors made it seem -- arguing that Li could not dismiss patients' claims that they were in pain, and was obligated to try to help unless abuse was obvious.

"Doctors are not trained to be police officers, to be detectives," he said.

The 20 patients involved in the trial are a small subset of a total clientele of 1,000, he said, and everyone who overdosed or died had violated Li's instructions by taking more pills than he instructed or mixing drugs.

"No one who took the medications the way he prescribed got into trouble," the lawyer said.

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Prosecutors opened their case by calling the sister of Haeg, 37, a former stockbroker found dead of an overdose on Dec. 29, 2009, after getting three prescriptions in six weeks from Li for more than 300 oxycodone pills, 240 Percocet and 240 Xanax.

Weeping repeatedly, Kristin Delumen of Manorville described how her brother turned from a "handsome," "funny" and "smart" family guy into a troubled man who couldn't sleep and called at all hours to discuss imaginary friends and jobs.

When he visited in late November 2009, she said, his "clammy skin" and "dark eyes" made him so scary she kept her children away. "When I first saw him, I almost didn't recognize him," she testified. "I said, 'You're going to die if you don't get help.' "