During the time when nurse Niels Högel served in a hospital in Delmenhorst, the death toll in the intensive care unit had culminated to an unprecedented high. Police investigations have concluded that the former nurse had murdered at least 84 people, who were weak and vulnerable, entrusted in his care.

"The death toll is unique in the history of the German republic," remarked chief police investigator, Arne Schmidt. He added there was "evidence for at least 90 murders, and at least as many [suspected] cases again that can no longer be proven."

Combing through medical records of more than 500 patients, the Special Commission set up in October 2014 had based its conclusions in part on toxicology tests on the remains of 134 possible victims, who were exhumed to check traces of the lethal doses of heart medication.

Toxicology reports in 41 cases are pending, and police suspected that the actual figure of deaths may be greater – with some which were never uncovered, as those bodies of former patients were cremated and exhumation was not possible.

"The realisation of what we were able to learn is horrifying," expressed Johan Kühme, chief of police in Oldenburg. "It defies any scope of the imagination."

“Eighty-four killings… leave us speechless,” added Kühme. “And as if all that were not enough, we must realise that the real dimension of the killings by Niels Högel is likely many times worse.”

German nurse enjoyed reviving patients – failed efforts resulted in unwarranted deaths

Högel was given life imprisonment in 2015 on two counts of murder and two counts of attempted murder.

During his trial, the former nurse, now 40, admitted he had intentionally induced cardiac arrest in 90 of his patients by administering overdoses of heart medication. He said he enjoyed trying to revive his patients, but sometimes failed.

"The nurse used five different drugs including ajmaline, sotalol, lidocaine, amiodarone and calcium chloride,” police said. “Overdoses can lead to life-threatening cardiac arrhythmia and a drop in blood pressure, causing a rapid decline in an already ill patient."

Police records revealed that Högel’s grisly act was first carried out in February 2002, when he was a staff at a clinic in Oldenburg in Lower Saxony, close to the Dutch border.

However, his lethal injections aroused suspicion among hospital staff. He was later transferred to a position in the anaesthesiology unit. There, a doctor whom he had worked with, recalled that Högel would always put himself in the spotlight, trying to resuscitate patients.

According to police records, the former nurse moved to a hospital in Delmenhorst in 2002, after causing the deaths of at least 35 patients.

Killing streaks were unreported, deaths continued to escalate in ICU

In 2005, a colleague was said to have seen Högel injecting a patient with ajmaline – but there was no action taken by the management. By then, Högel had killed his patient.

A senior physician, upon the promptings of nurses, checked death records and medicines administered by Högel. He then alerted the authorities when he suspected the former nurse was involved in the premature deaths of his patients.

"The murders could have been prevented," highlighted Kühme. He added that Högel was given a clean reference which allowed him to move to the Delmenhorst hospital and continue killing people. "People at the clinic in Oldenburg knew of the abnormalities."

In 2016, six employees at the hospital at Delmenhorst have been charged with negligent manslaughter for failing to notify authorities. An investigation into negligence at Oldenburg is ongoing.

Högel is expected to face trial on additional charges based on further findings from police investigations. MIMS

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