A former nurse who liked to put patients into cardiac arrest because he enjoyed the feeling of being able to resuscitate them has been jailed for life after being convicted of 85 counts of murder.
The death toll makes Niels Hoegel what is believed to be the worst serial killer in modern German history.
Oldenburg court judge Sebastian Buehrmann sentenced the 42-year-old to life in prison and noted the "particular seriousness of the crimes" in his verdict.
Hoegel worked at a hospital in the north-western city of Oldenburg between 1999 and 2002 and another hospital in nearby Delmenhorst from 2003 to 2005, and the killings took place between 2000 and 2005, according to the dpa news agency.
The victims were aged between 34 and 96.
Hoegel was convicted in 2015 of two murders and two attempted murders and is already serving a life sentence. There are no consecutive sentences in the German system, but the court's ruling on the seriousness of the crimes all but ensures he will remain incarcerated after the standard 15-year term is up.
Hoegel said at his first trial that he intentionally brought about cardiac crises in 90 patients in Delmenhorst because he enjoyed the feeling of being able to resuscitate them. He later told investigators that he also killed patients in Oldenburg.
Authorities subsequently investigated hundreds of deaths, exhuming bodies of former patients.
Hoegel was tried in Oldenburg on 100 counts of murder but the court found him not guilty on 15 counts because of lack of evidence.
During the seven-month trial, Hoegel admitted 43 of the killings, disputed five and said he could not remember the other 52.
In his closing statement to the court on Wednesday, he expressed shame and remorse, saying he realised how much pain and suffering he had caused families with his "terrible deeds".
"To each and every one of you I sincerely apologise for all that I have done," he said.