30 December 1976
|Criminal penalty||Life imprisonment|
Span of crimes
Niels Högel (born 30 December 1976) is a German serial killer and former nurse who was sentenced to life imprisonment, initially for the murder of six patients, and later convicted of a total of 85 murders.
Estimates of Högel's alleged victim count have increased since his first conviction. In 2017 a police investigation concluded that he was responsible for at least 90 deaths, and later that year German prosecutors stated there were at least 106 victims. In October 2018, Högel confessed to murdering 43 patients. By May 2019, he was believed to be the most prolific serial killer in peacetime Germany, with up to 300 victims over fifteen years.
Early life and education
Niels Högel was raised in the coastal town of Wilhelmshaven, Lower Saxony in northern Germany. Both a grandmother and his father worked as nurses, his father formerly being employed at the Sankt-Willehad-Hospital of Wilhelmshaven. His mother worked as a paralegal. He has an older sister. According to Högel, he had a sheltered or "protected" childhood and was not exposed to violence at home. On completing his vocational training in 1997 at the Sankt-Willehad-Hospital, Högel became a nurse and continued working there.
Employment at Klinikum Oldenburg
From 1999 onwards, he was employed at the "Klinikum Oldenburg", stationed in its cardiac surgery intensive care unit. In August 2001, doctors and medical orderlies of the hospital's ward 211 began discussing an unusual spike in both reanimations and deaths during the preceding months. Högel himself attended the aforementioned meeting. Most of the attempted reanimations and deaths were found to have occurred while Högel was on duty. Years later, after having been apprehended by authorities, Högel admitted to the police that, at the time of the meeting, he had thought to have been found out.
After the meeting, he called in sick for the duration of three weeks. During that time, only two patients in ward 211 died, significantly fewer than had prior to his sick leave. Statistically, 58% of all deaths at the hospital occurred while Högel was on duty. Under pressure by the cardiac surgery's head physician, Högel was transferred to the anaesthesiology ward in 2001. The ward's head physician allegedly also became suspicious of him, as Högel was frequently present in emergency situations. In September 2002, the Oldenburg Clinic's head physician pressured Högel to resign from his position at the hospital, after multiple patients under Högel's care had been found in life threatening condition, for, at the time, inexplicable reasons. It was suggested, he either resign and continue to receive full wages for another three months, or transfer to the hospital's logistics unit, where he would assist moving patients throughout the hospital. On 10 October 2002, he received a reference letter, issued by the Oldenburg Clinic's Director of Nursing. Therein, she testifies 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 praises his "devotedness" and "cooperative conduct". The letter concludes with an overall assessment of Högel having completed assigned tasks "to the utmost satisfaction".
Employment at Klinikum Delmenhorst
In December 2002, Högel transferred to Klinikum Delmenhorst. Emergencies and fatalities occurred there, too, when Högel was on duty, mostly due to arrythmia or sudden decreases in blood pressure. This lead to some of his coworkers distancing themselves from Högel. Off duty, Högel rode along in an ambulance, operated by the German Red Cross (DRK) station in Ganderkesee-Bookhorn.
In later court proceedings, it was reported that Högel had initially been held in high regard in Delmenhorst, which changed when 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.
Marriage and birth of daughter
Högel married in 2004, the year of his daughter's birth.
Investigation and convictions 2006 and 2008
On 22 June 2005, colleagues caught Högel intentionally manipulating a patient's syringe pump, administering the anti-arrhythmic Gilurytmal (Ajmaline) without medical indication. The incident prompted the Delmenhorst police inspectorate to initiate an investigation into Högel. In the course of the investigation, multiple Klinikum Delmenhorst employees independently came forward to voice their concerns, suspecting Högel's possible responsibility for numerous complications, resuscitations and further unexplained deaths at the hospital. The extensive police investigation that followed these allegations examined all deaths at the hospital between 2003 and 2005. The investigation uncovered the number of deaths at Klinikum Delmenhorst had doubled during Högel's employment there. In 2005, 73% of deaths could be connected to Högel's working hours. In multiple statements and reports of investigation, these investigatory insights were subsequently officially communicated to the Oldenburg district attorney's office.
In December 2006, adjudicating the 22 June 2005 incident, the Landgericht Oldenburg (German regional court) sentenced Högel to five years in prison and an employment ban of equal length for attempted voluntary manslaughter. A joint plaintiff appealed the verdict and a higher court subsequently reversed it. In June 2008 Högel was then given a seven and a half year prison sentence as well as a life-long employment ban.
2015 trial and confession
From January 2014 onward, the Oldenburg district attorney's office initiated another investigation into the incidents at Klinikum Delmenhorst. In September 2014 he was charged with three counts of murder and two counts of attempted murder. After confessing to the charges, Högel stated he had committed 30 additional murders. The patient's deaths were caused by Högel's administering 90 unauthorized injections. 60 patients were successfully resuscitated. On 28 February 2015, the Landgericht Oldenburg (German regional court) sentenced Högel to life in prison. The sentence became final in March 2015.
Prosecutors claim Högel acted out of boredom and the desire to show off his resuscitation skills.
Amidst mounting suspicion that Högel may be responsible for further deaths, police launched a major investigation in October 2014, after which 200 suspicious deaths were identified. From November 2014 onward, the special commission "Kardio" examined further deaths during Högel's tenure as nurse at various places of employment.
A total of 134 bodies in Germany, Poland and Turkey were exhumed and autopsied. During the three-year investigation, more than 200 cases were reevaluated. The 134 exhumed bodies were distributed across 67 different cemeteries. In many cases decomposition had progressed too far to be able to detect any traces of medication. 101 patients from Delmenhorst, who died during Högel's tenure, could not be autopsied, as their remains had been cremated. In 2015, suspected victims were exhumed in Ganderkesee and Delmenhorst. The bodies' autopsies revealed traces of heart medication.
In November 2016, authorities said they were able to prove 37 homicides attributed to Högel in Delmenhorst between December 2002 and June 2005. According to an August 2017 statement by the director of the special commission "Kardio", the "provable Oldenburg and Delmenhorst homicides [...] were only the tip of the iceberg". As Högel had been sentenced to life in prison without eligibility for parole at the time, further court cases would not alter Högel's sentence, but either find him innocent or guilty of further charges. As capital punishment is constitutionally prohibited in Germany, Högel's prior conviction had already entailed the maximum punishment of life without parole.
On 28 August 2017, police announced they had concluded that Högel was responsible for the deaths of at least 90 patients, including 6 for which he had already been convicted. Högel admitted to an undisclosed number of deaths but in most cases was unable to remember specific details, although he did not deny possibly being responsible. In November 2017, the total number of victims attributed to Högel was revised and increased to 106, with some suspicious deaths still under investigation. In January 2018, German prosecutors charged Högel with the murder of 97 patients and announced their intention to file charges against other hospital staff who failed to act. Prosecutors again claimed Högel wanted to impress colleagues by reviving the patients he had previously attacked.
On 28 August 2017, police said that Högel had used five different drugs, including ajmaline, sotalol, lidocaine, amiodarone and calcium chloride. Overdoses can lead to life-threatening cardiac arrhythmia and a drop in blood pressure, causing rapid physiological deterioration in patients already ill.
On 7 March 2018, the Oldenburg labour court sentenced Högel to a compensatory payment of 47,000 Euro, for two medical opinions and various lawyers' fees.
2018-2019 trial, life sentence and appeal
In January 2018, the Oldenburg state's attorney's office pressed charges against Högel, accusing him of having murdered 100 patients between 7 February 2000 and 24 June 2005 (four separate charges that were jointly tried). The deceased were aged between 34 and 96 years. The indictment stated that, in his position as a nurse, Högel had killed patients by administering the following substances or medication without medical indication: Potassium, Gilurytmal (Ajmaline), Sotalex (Sotalol), Xylocain (Lidocaine) and Cordarex (Amiodarone).
The main trial at Landgericht Oldenburg commenced on 30 October 2018. Due to the high number of people involved in the trial (there were 120 joint plaintiffs), it was held in the Weser-Ems-Hallen ballrooms.
The 2018-2019 court proceedings spanned a total of 24 days of trial. Out of the 100 murder charges, Högel confessed to 43 on the first day of trial, stated he could not recall 52 and denied his involvement in the five remaining deaths.
Witness and expert testimonies
Out of the 32 witnesses present at the trial, eight testified under oath. Three testimonies were heard in camera. 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. Prof. Staller, a forensic expert in testimony psychology, 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.
End of evidentiary hearing and final charges
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.
Sentencing and appeal
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.
As both Högel and a joint plaintiff have appealed the verdict, it is not yet final.
Media and public access
A total of 80 seats were provided to media representatives and an additional 118 seats for the general public. 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.
Prospective further trials
The court decided that a further, currently pending, indictment against four Klinikum Delmenhorst employees will be tried once Högel's verdict is final. Only then would he be obligated to testify at the trial against the Klinikum Delmenhorst employees, as he currently still has the right to refuse testimony and has stated he wishes to exert that right.
Aftermath, criticism and legislative changes
Scrutinizing investigatory vigour
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. The district court dismissed the case. 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.
Affected clinics react
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 their plans of being the first clinics in Germany to introduce a process termed 'qualified necropsy', involving an additional coroner. The introduction of this two-man-rule aims at preventing unnatural causes of death owing to criminal actions going unnoticed.
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