A man charged with killing five people after a car rammed into a pub beer garden is accused of ignoring repeated alerts to treat his low glucose levels for almost an hour before the crash.
William Swale, 66, was charged with five counts of culpable driving causing death, two counts of negligently causing serious injury and seven counts of reckless conduct endangering life.
Emergency services responded to reports an SUV mounted the kerb and hit several patrons on the front lawn area of the Royal Daylesford Hotel just after 6pm on November 5.
Pratibha Sharma, 44, her daughter Anvi, 9, and partner Jatin Kumar, 30, and their friend Vivek Bhatia, 38, and his son Vihaan, 11, all died.
The Mount Macedon man appeared in Melbourne's Magistrate Court via video link from a police station on Monday.
In his summary to the court, Sergeant Peter Romanis said Swale had been returning from a clay shooting tournament in Clunes when he stopped in Daylesford.
Swale, who was diagnosed with diabetes in 1994, was wearing a blood glucose monitoring device which sends an alert to his phone when his glucose levels are outside the normal range.
It is alleged he scanned his blood glucose levels at 5.17pm on the day which returned a low reading and an alarm sounded one minute later indicating he should check his levels.
CCTV footage showed him entering a restaurant opposite the pub a few minutes later asking for a table but he returned to his car as there were none available, Sgt Romanis told the court.
Swale was then seen on CCTV at 5.42pm driving his car around the area, performing a U-turn to drive down another street, before it crashed into the pub patrons about 6pm.
Prosecutors alleged he received and ignored nine alerts leading up to the crash.
"The decision to return to his vehicle and continue to drive whilst knowing his blood glucose levels were low and without sourcing the required treatment has caused catastrophic and fatal consequences for all the families involved," Sgt Romanis said.
Swale's defence lawyer said his client often monitored his glucose levels and put to the police informant the possibility Swale was already in the midst of a medical episode.
"Other than he had a low reading, you don't know whether he was in a position to adequately understand the reading," the defence said.
"We don't know what condition he was in other than that he was driving, performing U-turns and went to a restaurant."
He pointed to his client's clean criminal history barring the more than 30 driving infringements.
Sgt Romanis recounted first responders finding the 66-year-old in his car sweaty, hot and clammy, and unable to effectively communicate.
Swale had been approved for a conditional driver's licence for two years in the months before the crash with a medical report handed to VicRoads stating his condition was well controlled.
Information downloaded from his monitor pointed to Swale checking his glucose levels eight times between 6.58am and 5.17pm on the day.
"The data indicates that when the blood glucose levels dropped to a low level, they began to rise quickly owing to intervention by the accused," Sgt Romanis said.
Mr Bhatia's wife, a 36-year-old woman, and his other son, aged six, were injured and taken to hospital, and have since been released.
A 43-year-old Kyneton woman, a 38-year-old Cockatoo man and an 11-month-old baby boy were taken to hospital and have been discharged.
Swale was remanded in police custody until his bail hearing on Friday.
