Dr. Joel Sabean, a prominent South Portland dermatologist, sent millions of dollars to a family member in Florida to keep her quiet about a long-term sexual relationship between the two, federal prosecutors said Tuesday on the first day of Sabean’s trial in U.S. District Court in Portland on charges of tax evasion, illegally distributing controlled substances and health care fraud.

One of Sabean’s lawyers countered that the relative “engaged in an elaborate scheme” to bilk Sabean of millions of dollars, claiming to be sick with illnesses she didn’t have and telling him she was getting experimental treatments to encourage him to send her more money.

The allegation of a sexual relationship is a lie, defense attorney Thimi Mina said.

The Portland Press Herald is not identifying the family member because she is allegedly the victim of sexual abuse. Sabean has not been charged in the alleged sex abuse.

DESCRIPTIONS OF TROUBLED LIVES

Outwardly, Sabean was a successful doctor, but “he had a profoundly unhappy personal life” and suffers from mental illnesses, a personality disorder and perhaps a delusional disorder, Mina said. The doctor ultimately “gave away everything he had,” the attorney said.

Sabean is charged with claiming more than $2.3 million in improper medical deductions over five years to avoid paying nearly $900,000 on his taxes. He’s also accused of making out dozens of prescriptions for the family member, mostly anti-depressants and sleeping pills, which is a violation of laws on distributing controlled substances. The relative was not a patient of Sabean.

The charge of health care fraud stems from allegations that Sabean also prescribed pills in his wife’s name, but they were obtained by the other family member so that part of the cost of the prescription could be covered by Sabean’s health insurance.

The first day of the trial culminated with the family member taking the stand and crying even while she was being led into the courtroom. She told a jury that Sabean began having sex with her when she was “12 or 13” and that the relationship continued over a period of years as she went back and forth from Maine to Florida. She settled in Florida permanently in 2007 and Sabean began sending her money via Western Union, pre-paid debit and credit cards, deposits in joint banking accounts and via Paypal.

Prosecutors showed a statement from one of the bank accounts in which Sabean had deposited $25,000 in a month, sometimes making three deposits in one day. The family member said she typically would withdraw hundreds of dollars each day and spend it on opiates and at casinos. Dressed in an orange prison jumpsuit – she has been in jail since spring for violating probation on a shoplifting charge – she admitted that she has drug and gambling addictions and difficulty telling the truth.

“I’ve had a problem with lying my whole life,” she said.

The family member, who was given immunity in exchange for her testimony against Sabean, cried repeatedly during an hour of testimony, particularly when she was asked to identify Sabean and again when prosecutor David B. Joyce asked her point-blank if she and Sabean had ever had sex.

She initially refused to answer, but eventually said yes after she had turned away in the witness chair and sobbed for a minute or two.

“Frequently,” she said, saying they had sex at Sabean’s home on Shore Road in Cape Elizabeth, in his doctor’s office in South Portland and in a succession of apartments the woman had in Portland. Sabean never traveled to see her in Florida, prosecutors said, but they communicated daily by phone and email, with the family member sending him pictures of barely clothed or naked women.

At one point, the woman said, she claimed to have taken some of the photos of the women herself, explaining that she had talked about becoming a photographer and wanted Sabean to be proud of her.

RELATIVE TO RETURN TO STAND

Sabean showed no emotion as the woman testified. He mostly stared in her direction, but a direct view was blocked by computer monitors and the court reporter.

The woman is expected to return to the stand Wednesday while prosecutors continue to lay out much of the story that they told in their opening statement.

Assistant U.S. Attorney James W. Chapman said Sabean claimed the medical expenses to avoid having to pay gift taxes and as a way to lower his income taxes. During the period in question, the 2008 through 2013 tax years, Sabean’s practice took in between $1.6 million and $2 million annually and his annual income ranged from $700,000 to $1.1 million, Chapman said.

MONEY AND ELABORATE STORIES

He said Sabean made up elaborate stories when he told his bookkeeper and accountant to send the woman checks or make deposits into their joint accounts.

He told his bookkeeper that the woman had a drug-resistant infection, bone grafts, gall and kidney stones, a kidney transplant, bowel surgeries, three toe amputations – with one toe re-attached – heart bypass surgery, the installation of a pacemaker and the removal of her uterus.

“That is what the doctor told his bookkeeper what (the woman) went through, just in 2008,” Chapman said. “None of this was true. (The woman) was fine.”

“This was an enormous amount of cash” transferred, he said.

But Mina said the story was one of “family dysfunction,” and that Sabean truly believed that his money was going to help the family member with her medical expenses.

“Sometimes he sent more money than he had,” Mina said, adding that Sabean and his wife, Karen, who is also ill, lived a relatively spartan life while the woman in Florida was spending extravagantly.

“She fleeced him of all his money,” Mina said.