A former nurse has been convicted of murdering 85 patients at two hospitals in northern Germany and handed a life sentence.
Judge Sebastian Buehrmann described Niels Högel's killing spree as incomprehensible.
Högel, who is already serving life for two murders, administered lethal doses of heart medication to people in his care between 1999 and 2005.
He is believed to be the most prolific killer in Germany's modern history.
Prosecutors said he attacked patients in order to impress colleagues by subsequently trying to revive them.
A former colleague told a German newspaper that Högel was nicknamed "Resuscitation Rambo" because of the way he pushed everyone else aside when patients needed to be resuscitated.
On the last day of his trial, Högel, who is 42, asked the families of his victims for forgiveness for his horrible acts.
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