A special police commission reviewed hundreds of cases and exhumed more than 130 bodies before concluding many deaths could never be proven
For years, dozens of patients kept dying whenever nurse Niels Högel was on duty at two hospitals in northern Germany — and the deaths would ultimately be linked to a man who turned medical emergencies into his own twisted performance.
Högel was ultimately convicted in 2019 of murdering 85 patients between 2000 and 2005, and investigators believe the true toll is far higher, according to police and court records cited by The Guardian, BBC News and The New York Times.
Authorities would learn that Högel had been injecting patients with unauthorized heart drugs — ajmaline, amiodarone and sotalol — to induce cardiac arrests, before he returned to perform dramatic resuscitations, per NPR.
“It was the clinical daily routine which failed to challenge me,” Högel said in court, per German outlet Deutsche Welle, explaining that he would feel good for days after resuscitating a patient.
In the early 2000s, Högel — whose nickname “Resuscitation Rambo” came from his predilection for dramatic resuscitations — was working at Oldenburg Clinic, where physicians noticed an unusual number of emergencies and deaths when he cared for patients. But the pattern was never reported to authorities, The Guardian reported.
Instead of alerting authorities, hospital leaders encouraged him to move on to another clinic — and later provided him with what police described as a “spotless” reference when he applied to a second facility in Delmenhorst.
Once he arrived in Delmenhorst, the pattern intensified. A later review of hospital records found that out of 411 deaths recorded over three years in the intensive care unit, 321 occurred during or shortly after Högel’s shifts, per the Times.
Investigators and prosecutors said the death rate in the unit roughly doubled during his tenure — but the spike was never reported to police.
The killings finally came to light in 2005, when another nurse in Delmenhorst saw Högel inject a patient with an unprescribed heart drug. The patient died the next day.
Hospital management waited two days before contacting law enforcement, and in that interval, Högel was able to kill one last patient, per NPR.
He was arrested and, in 2008, convicted of attempted murder in connection with the 2005 case and sentenced to prison. But the full scope of his crimes was not yet known. Years later, after the case returned to court and Högel admitted to dozens more unauthorized injections, investigators ordered a sweeping review of deaths at the Oldenburg and Delmenhorst hospitals.
Under pressure from families, authorities exhumed more than 130 bodies from cemeteries across Germany and neighboring countries to test for traces of the drugs Högel used, The Guardian and BBC reported.
But because many patients had been cremated, police warned they would never be able to determine the true number of victims.
By 2017, a special police commission announced it had evidence that Högel had murdered at least 90 patients, with at least as many additional deaths suspected but impossible to prove.
“The death toll is unique in the history of the German republic,” chief investigator Arne Schmidt said at the time, adding that the findings left him “speechless.”
Police and prosecutors have since said they suspect the final toll may exceed 200 victims, though they acknowledge that gaps in Högel’s memory and the number of cremations mean they may never know exactly how many people he killed.
At his 2019 trial, Högel was charged with 100 murders tied to deaths at both hospitals.
During seven months of court proceedings, he admitted to 43 killings, denied five and said he could not remember the rest, per the Times.
Judges ultimately convicted him of 85 murders in 2019 and imposed a life sentence, calling his crimes “incomprehensible” and saying his guilt surpassed “human imagination.”
“The extent of the killings is unique in the history of the German republic,” Schmidt said, according to the BBC.
