"Stupidity, greed, lack of judgment," Venger said, describing his involvement in the scheme to get rich while cheating clients. Without the kickbacks, he made $3 million a year from his practice.

Venger testified Monday in the trial of personal injury lawyer Noel Gage, who, with Awand, has been indicted on conspiracy and fraud charges. Venger agreed to testify in exchange for immunity from criminal charges.

Venger said he referred the case of Carlos Pachas to Awand, who in turn delivered it to Gage. During a kidney surgery in 2001, oxygen to Pachas' brain was inadvertently cut off, leaving him in a permanent vegetative state.

Gage ultimately secured an $18 million settlement.

"Howard Awand called and said Noel Gage received a settlement for the case and he wanted to show me he was grateful for the referral," Venger told jurors.

Venger said he and Awand hid the kickbacks from the Pachas settlement by crafting bogus invoices. At Awand's direction, Venger penned letters citing fees for using his private airplane or for reviewing documents related to the Pachas case, the surgeon said.

"I never reviewed any records nor did I discuss them with Howard Awand or Noel Gage," Venger said, adding that Awand never used his private plane.

Venger said he became involved with Awand after the consultant told Venger he could protect him from medical malpractice lawsuits. Venger was fearful that he would be left uninsured after his insurance company -- the only one in the state that covered doctors who perform high-risk surgeries -- threatened to leave the state.

Venger said Awand also promised to involve him in additional lucrative personal injury cases.

In 2002, Gage represented Claire Michaels, a woman who was injured in a head-on traffic accident and later suffered from a dizzy spell that caused her to fall from her attic. Awand called upon Venger to examine the woman prior to Michaels' civil trial.

Venger said Awand directed him to come to the conclusion that Michaels' head injuries were a result of the car accident, not the fall.

"They did not want there to be an alternate cause of her condition," Venger said. "It would diminish the value of the case."

Days before Venger's deposition, he met Awand at a Summerlin hotel, he testified. With Gage on the phone, the three went over questions Gage would ask Venger and answers that would be given. Venger admitted he lied during the deposition and later during the civil trial.

In September 2003, Venger told jurors that he abruptly ended his relationship with Awand after the consultant and Gage threatened his wife. He did not elaborate on the threats.

Defense attorney Thomas Pitaro pounced on Venger's testimony, and hammered on the point that Venger is an admitted liar who was willing to be untruthful under oath.

"You don't have to be a brain surgeon to know you're supposed to tell the truth, correct?" Pitaro said. "What we've established so far in your testimony today is that you're a liar."

Venger said he only lied on cases related to Awand in order to keep up their lucrative relationship.

"Everybody makes mistakes and sometimes you get the opportunity to correct them," said Venger, who added that he has paid restitution for the money taken and returned funds he received from Gage and Awand. "Part of the mistake I made was getting caught up in the network here."

Pitaro attempted to show jurors that Venger lied when testified that he ended his relationship with Awand in 2003. The attorney pointed out that Venger cashed a check for $216,000 a month after he said he ended their relationship.

Venger testified that he continued to care for patients even if they had a connection to Awand.

"I didn't want any more of his business or be part of this scheme," he said, adding that did not deal directly with Awand as he had in previous years.

Pitaro suggested that Venger approached the government in part because of a vendetta against Gage. One year before Venger's first meeting with federal agents, Gage's law firm sued Venger's partner for medical malpractice.

Contact reporter Adrienne Packer at apacker@reviewjournal.com or (702) 384-8710.