Former nurse Niels Hoegel announced on Tuesday that she killed 100 patients on the first day of the trial in the biggest serial murder case in German post-war history.
Hoegel, 41, has spent nearly a decade in prison to obtain life imprisonment for other patients. He is accused of deliberately administering medical overdoses to the victims so that he can bring them back to life at the last moment.
When the trial began in the northern city of Oldenburg, presiding judge Sebastian Bührmann asked whether the charges against him were correct. Hoegel answered calmly "yes".
"What I've admitted has taken place," he told the courtroom, which was stuffed with dozens of grieving relatives.
Bührmann said that the main purpose of the trial was to determine the full extent of the series of murders, which was allowed to run unchecked for years at two German hospitals.
"It's like a house with dark rooms – we want to bring light into the darkness," he said.
After a minute's silence in the courtroom for the victims, the bearded, heavy-weighted Högel listened impassively, his head lowered as prosecutor Daniela Schiereck-Bohlmann read the name of each dead patient and the charges against the defendant.
"Small, vulnerable mass murderer"
According to the prosecution, at least 36 patients were killed in a hospital in Oldenburg, where he worked, and about 64 others in a clinic in nearby Delmenhorst between 2000 and 2005.
More than 130 bodies of patients who died on Hoegel's guard were exhumed, in a case that investigators have called "unprecedented in Germany to our knowledge."
One of the more than 100 co-prosecutors, Christian Marbach, said it was a scandal that Hoegel was allowed to kill for so long with impunity, without the hospital authorities or law enforcement agencies intervening.
"They had everything they needed (to stop him) – you do not have to be Sherlock Holmes," said Marbach, the grandson of one of the patients, AFP.
Hoegel told the court that he was "surprised" when, at the end of 2002, a senior physician at the Oldenburg hospital asked him to resign. He said he would get a positive referral and holiday pay if he volunteered.
"I felt bad as if I had been caught," Hoegel said, adding that he was never explicitly told why they wanted to let him go.
Marbach said the defendant had been remarkably calm when he admitted to the extraordinary list of killings.
"He looks like a small, vulnerable mass murderer."
In 2005, Hoegel was sued for injecting a non-prescribed drug into a patient in Delmenhorst and sentenced to seven years in prison for attempted murder in 2008.
Another trial followed in 2014-15 under pressure from families of alleged victims.
He was found guilty of murder and attempted murder of five other victims and sentenced to a maximum of fifteen years.
It was then that Hoegel confessed to his psychiatrist at least 30 more in Delmenhorst committed murders. This prompted the investigators to take a closer look at suspicious deaths in Oldenburg.
At the booth on Tuesday, Hoegel said he had taken painkillers in 1999, shortly after he became a nurse, feeling overwhelmed by the stress of working in the intensive care unit.
"I should have stopped," he said.
Asked by the judge why he did not admit the murders so far, Hoegel said it was "out of shame" and because it took him a long time to face what he had done in the first hospital.
Only by reading the court records and the therapy did I recognize "the full dimension," he said.
Investigators say the last number could exceed 200, but they feared that they would never be safe because the bodies of many potential victims were cremated.
Hoegel seems to have performed a similar procedure each time by first injecting a drug that has triggered a cardiac arrest, followed by an often unsuccessful attempt at resuscitation.
Prosecutors say he is motivated by vanities to show his ability to save lives and simple "boredom".
The choice of the victim seems to be completely random, with an age between 34 and 96 years.
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