Niels Högel

From 1999 onwards, Högel was employed at the Oldenburg Clinic, stationed in its cardiac surgery intensive care unit, Ward 211.[8] In August 2001, doctors and medical orderlies at the hospital held a meeting, which Högel attended, discussing an unusual spike in both resuscitations and deaths during the preceding months. Fifty-eight percent of these incidents were found to have occurred while Högel was on duty.[9] After the meeting, Högel called in sick for the duration of three weeks; during that time, only two patients in Ward 211 had died, significantly fewer than had prior to his sick leave. Years later, after having been apprehended by police, Högel admitted that, at the time of the meeting, he had thought he had been found out.

Under pressure by Ward 211's head physician, Högel was transferred to the anaesthesiology ward in 2001. Soon the anaesthesiology ward's head physician became suspicious at how Högel was frequently present in emergency situations. In September 2002, the Oldenburg Clinic's head physician confronted Högel after multiple patients under his care had been found in life-threatening conditions for seemingly inexplicable reasons. It was suggested that he either resign his position at the Clinic and continue to receive full wages for another three months, or transfer to the Clinic's logistics unit where he would assist moving patients throughout the hospital.[10]

On 10 October 2002, Högel received a reference letter issued by the Oldenburg Clinic's director of nursing. Therein, she testified to Högel's "circumspect, diligent and autonomous" work ethic, as well as to him having acted "prudently and in an objectively correct manner in critical situations". She also praised his "devotedness" and "cooperative conduct". The letter concluded with an overall assessment of Högel having completed assigned tasks "to the utmost satisfaction".[11]

In December 2002, Högel transferred to the Delmenhorst Clinic, where emergencies and fatalities, mostly due to arrhythmia or sudden decreases in blood pressure, began spiking whilst Högel was on duty. This led to some of Högel's coworkers distancing themselves from him. In later court proceedings, it was reported that Högel had initially been held in high regard in Delmenhorst until suspicions against him began to arise. His superiors allegedly did not act on these suspicions, even when four empty vials of gilurytmal (ajmaline) surfaced in Högel's ward, in spite of no doctor having prescribed any such medication at the time.[12]

On 22 June 2005, colleagues caught Högel intentionally manipulating a patient's syringe pump to improperly administer ajmaline. He was arrested in the summer of 2005.[13]

Out of the thirty-two witnesses present at the trial, eight testified under oath. Three testimonies were heard in camera.[31] Four medical experts presented the court with detailed information on the courses of the patients' diseases as well as the effects of the medication administered by Högel. A forensic expert in testimony psychology,[36] examined the truthfulness of Högel's testimony. He concluded that Högel, although in principle both capable and willing to lie or provide false testimony, had provided the court with truthful confessions. Staller saw no indications for a false confession.[31]

The state's attorney's office moved for convictions in 97 and acquittals in three cases. The defense saw the state of evidence to be too insufficient to convict in far more instances and moved for acquittals in 31, murder convictions in 55 and attempted murder convictions in 14 cases.[31]

On 6 June 2019, the court in Oldenburg sentenced Högel to life imprisonment. Taking prior convictions into account, the court determined Högel's "severe gravity of guilt", a German legal term which significantly increases the respective sentence's severity and precludes a chance of early release after serving 15 years. He was found guilty on 85 separate murder charges and not guilty on 15 further murder charges.[37][1][31] The court described Högel's motive, to emerge as a hero after a potential reanimation, as "base" ("niedriger Beweggrund"),[38] which is a precondition for a murder conviction in Germany.

Högel and a joint plaintiff appealed the verdict,[31] which became final on 11 September 2020, when the Federal Court of Justice dismissed both appeals.[39]

A total of 80 seats were provided to media representatives and an additional 118 seats for the general public.[31] Contrary to prior trials under high public and media attention, public interest did not decline, but rose as the trial progressed. On the first day of trial, numerous seats had remained empty. The number of attendees increased significantly throughout the trial, peaking at approximately 190 spectators and 25 media representatives.[31]

The court decided that a further pending indictment against four employees of the Delmenhorst Clinic would be tried once Högel's verdict was final.[31] Only then would he be obligated to testify at the trial against those employees, because until he had received a final verdict he still had the right to refuse testimony, and he had stated that he wished to exert that right.[31]

Following Högel's conviction in April 2015, the Oldenburg state's attorney's office pressed obstruction of justice charges against a former Oldenburg chief prosecutor. He had allegedly not acted on conclusive evidence incriminating Högel, thereby protracting investigations.[40] The district court dismissed the case.[41] The Oldenburg state's attorney's office's official objection to the court's decision to dismiss was subsequently finally dismissed by the Oberlandesgericht Oldenburg at a higher judicial level.[42]

After the 2015 sentence became valid, both the Delmenhorst Clinic (now Josef-Hospital Delmenhorst) and the Oldenburg Clinic stated their intention to compensate the victims' relatives. In July 2015, both clinics announced plans to become the first clinics in Germany to introduce a process termed 'qualified necropsy', involving an additional coroner.[43] The introduction of this two-man-rule aims at preventing unnatural causes of death owing to criminal actions going unnoticed.[44]

A trial against seven former supervisors of Högel commenced in February 2022 in Oldenburg. According to the prosecution, the accused suspected Högel's involvement in the patient's deaths but neglected to take action, in order to protect the reputation of their hospitals.[45][46] They were acquitted in September 2022 after both prosecution and defense moved for such verdict. [47][48]