In a case that has horrified Germany, nurse Niels Högel has admitted to killing scores of patients in several hospitals. Högel is believed to be the most prolific serial killer in Germany's postwar history.
When asked by the presiding judge whether the charges against him were accurate, Högel replied: "Yes."
The massive trial opened in the northern German city of Oldenburg with a minute of silence in memory of the victims. Court proceedings had to be held in a nearby festival hall instead of in Oldenburg's regional court to accommodate the 126 plaintiffs in the case and the high level of public interest.
"The plaintiffs want to look the defendant in the eye," lawyer Gaby Lübben said on Tuesday.
Presiding Judge Sebastian Bührmann said that the goal of the trial was to reveal the full scope of the murders that were allowed to go unchecked for years.
"We will do our utmost to learn the truth," he said. "It is like a house with dark rooms — we want to bring light into the darkness."
The 41-year-old nurse is already serving a life sentence after being convicted in 2015 of killing two patients. Investigators later determined that the total number of his victims was likely much higher — making him one of the most prolific serial killers in German postwar history.
Intentionally causing cardiac arrest
According to the indictment, Högel is accused of carrying out the murders between February 2000 and June 2005 in two hospitals in the northern German cities of Oldenburg and Delmenhorst.
The youngest of his victims was 34-years-old and the oldest was 96.
Prosecutors argue that Högel randomly selected patients and injected them with a cocktail of drugs that caused them to go into cardiac arrest or to suffer other complications so that he could revive them.
"The prosecutor's office assumes that he did this in order to create a life-threatening situation in order to demonstrate his resuscitation skills to colleagues and superiors," the indictment states. Prosecutors have also said he may have done it out of boredom.
He was caught in the act by a nurse in Delmenhorst in the summer of 2005, but it took years for the full extent of the killings to be revealed.
Investigators looked into 200 suspicious cases and have exhumed 130 bodies for tests — including two bodies in Turkey. However, many of the patients who died at the hospitals while Högel was there were cremated and their remains didn't offer any evidence.
German police have said that Högel likely would have been stopped earlier if local health officials hadn't hesitated to inform the authorities. Criminal cases are currently also being pursued against former staff at the two hospitals where Högel worked.
The trial is expected to run until May of next year, with dozens of witnesses expected to testify.
With a view to kill: Germany's worst serial killers
Many of the world's most horrifying crimes are committed by serial killers — among them rapists, child molesters and cannibals. DW takes a look at some of Germany's most notorious and prolific over the last century.
Image: picture alliance/dpa/C. Jaspersen
Cannibal of Münsterberg
Karle Denke murdered and cannibalized at least 42 people, mostly villagers, between 1903 and 1924 in his Münsterberg apartment in then Prussia (pictured). It is thought that he even sold the flesh of his victims at the Breslau (now Wroclaw, Poland) market as pork. A victim was able to escape and later police found cured human flesh in his home. Denke hung himself in his jail cell two days later.
Image: 171413picture-alliance/arkivi
Horror of Hanover
Fritz Haarmann is thought to have sexually assaulted, murdered, mutilated and dismembered at least 24 boys and young men between 1918 and 1924.The full extent of his crimes were revealed after 500 pieces of human bone, some with knife marks, were found by Hanover residents worried about the disappearance of children in the area. Haarmann, who was once a police informant, was beheaded in 1925.
Karl Grossmann killed his victims and sold their meat on the black market and at his hot dog stand. After neighbors heard screaming, police burst into his home to find a dead young woman on his bed. It's unclear how many lives Grossmann took, but he was suspected of dismembering 23 women and involvement in up to 100 missing cases in Berlin. He hanged himself in 1922.
Image: Gemeinfrei
Terror of Falkenhagen Lake
Friedrich Schumann was a locksmith who raped, murdered and stole from 1918 to 1920. After a confrontation with a local forester — whom he shot — Schumann was arrested and charged with the murder of six people and attempted murder of 11 others. He was sentenced to death six times. The night before his execution at aged 28, he admitted to killing 25 people, including his first victim — his cousin.
Image: picture-alliance/dpa/P. Pleul
S-Bahn murderer
Paul Ogorzow was convicted of 31 sexual assaults, the murder of eight women and attempted murder of six others in Nazi-era Berlin between 1940 and 1941. Ogorzow worked for the German commuter rail system and would threaten, stab or bludgeon his rape victims before sometimes throwing them off the moving train. He was sentenced to death and beheaded two days later.
Image: Gemeinfrei
Human trafficker and killer
In 1946 and 1947, Rudolf Pleil worked as a border guard in the Harz Mountains and illegally trafficked people, mostly women, from East to West Germany. For a while, he had two accomplices who would help trap victims. Pleil was convicted of killing a salesman and nine women but he claimed to have killed 25 people. Sentenced to life in prison in 1950, Pleil committed suicide eight years later.
Image: picture-alliance/dpa
Man-eater of Duisburg
Joachim Gero Kroll was a serial killer, rapist, child molester and cannibal. Between 1955 and 1976 he murdered up to 14 people, mainly women and young girls. When he was arrested in 1976, human remains were packed in his refrigerator and he was in the process of cooking the arms and hands of a 4-year-old girl he had just killed. Imprisoned for life in 1982, Kroll died of a heart attack in 1991.
Image: picture-alliance/dpa/P. Sieländer
Smoking out murder
Fritz Honka was notorious for killing at least four women between 1970 and 1975. He strangled prostitutes in his apartment and cut up their corpses. Firefighters found hidden body parts in his apartment after a fire broke out while he was gone. Honka was sentenced to 15 years in a psychiatric institution. After his release in 1993, he lived in a retirement home until his death five years later.
Image: picture-alliance/dpa
St. Pauli killer
Werner Pinzner was a for-hire killer for pimps in Hamburg's red light district. He is thought to have killed between seven and 10 people. Pinzner gained nationwide fame in 1986 when he was brought to the Hamburg police department for interrogation with his wife and lawyer. He suddenly pulled out a gun and shot the investigating prosecutor before turning the gun on his wife and himself.
Image: picture-alliance/dpa
Death by poison
Marianne Nölle, a nurse from Cologne, killed patients in her care by poisoning them with an anti-psychotic drug between 1984 and 1992. Police believe she actually killed 17 people and attempted a further 18 murders, but she was only convicted of killing seven patients. She has never confessed to any of her crimes. Since 1993, Nölle has been serving a life sentence.
Image: picture-alliance/dpa/DB
Killer on the roads
Volker Eckert was a German trucker who murdered at least nine women, most of them between 2001 and 2006. According to police, there were probably four others. His first victim was a classmate whom he strangled aged 15. Most of his victims were prostitutes he picked up across Europe, and he kept trophies like his victims' hair. Eckert hanged himself in his cell during his trial in 2007.
Image: Imago
Angel of death
Stephan Letter is a former nurse responsible for the death of at least 29 patients by lethal injection at a Bavarian hospital between 2003 and 2004. Arrested for drug theft, Letter confessed to some of the killings, insisting that he was trying to relieve suffering. He is serving a life sentence and until recently, his acts were described as Germany's worst killing spree since World War II.
Image: picture alliance/AP/U. Lein
Killer nurse
Keen to impress colleagues with his life-saving skills, Niels Högel would inject patients with cardiovascular medication to induce heart failure or circulatory collapse. He was convicted of killing two people and was jailed for life in 2015. However, after a multiyear probe, investigators now believe the former nurse was responsible for 100 more deaths, making him Germany's most prolific killer.