Updated

Richard Ramirez, the demonic serial killer known as the Night Stalker who left satanic signs at murder scenes and mutilated victims' bodies during a reign of terror in the 1980s, died early Friday in a hospital, a prison official said.

Ramirez, 53, had been taken from San Quentin's death row to a hospital where authorities said he died of liver failure. Prison officials said they could not release further details on the cause of death, citing federal patient privacy laws.

Ramirez had been housed on death row for decades and was awaiting execution, even though it has been years since anyone has been put to death in California.

At his first court appearance, Ramirez raised a hand with a pentagram drawn on it and yelled, "Hail, Satan."

His marathon trial, which ended in 1989, was a horror show in which jurors heard about one dead victim's eyes being gouged out and another's head being nearly severed. Courtroom observers wept when survivors of some of the attacks testified.

Ramirez was convicted of 13 murders that terrorized Southern California in 1984 and 1985 as well as charges of rape, sodomy, oral copulation, burglary and attempted murder.

The killing spree reached its peak in the hot summer of 1985, as the nocturnal killer entered homes through unlocked windows and doors and killed men and women with gunshot blasts to the head or knives to the throat, sexually assaulted female victims, and burglarized the residences.

He was dubbed the "Night Stalker" by the press while residents were warned to lock their doors and windows at night.

Some of the crimes were grisly beyond imagining: A man was murdered in his bed and his wife was raped beside the dead body. The killer beat a small child and attempted to sodomize him.

There were also signs of devil worship -- a pentagram drawn on the wall at one murder scene and survivors' accounts of being ordered to "swear to Satan " by the killer.

Ramirez was finally chased down and beaten in 1985 by residents of a blue-collar East Los Angeles neighborhood as he attempted a carjacking. They recognized him after his picture appeared that day in the news media.

The trial of Ramirez took a year, but the entire case -- bogged down in pretrial motions and appeals --  lasted four years, making it one of the longest criminal cases in U.S. history.

Because of the notoriety, more than 1600 prospective jurors were called.

The trial was almost aborted in its final stages when a woman juror was murdered during deliberations. Jurors were 13 days into talks when the juror failed to appear one morning. She was found beaten and shot to death at the home she shared with her boyfriend. The next day, the man committed suicide and left a note saying he killed her in an argument.

Jurors wept when they learned of the tragedy, and Los Angeles Superior Court Judge Michael Tynan was faced with one of his most trying legal challenges. Lawyers said there were no legal precedents for the situation.

Defense attorneys argued the jurors were too distraught to resume their talks and noted the murder was similar to the gruesome attacks attributed to the "Night Stalker."

Tynan decided to move forward. "We must get on with the task life has given us," he told jurors, ordering them to begin deliberations with an alternate juror.

Jurors later said the death of the juror did not influence their decision.

After his conviction, Ramirez flashed a two-fingered "devil sign" to photographers and muttered a single word: "Evil."

On his way to a jail bus, he sneered in reaction to the verdict, muttering: "Big deal. Death always went with the territory. See you in Disneyland."

The black-clad killer, unrepentant to the end, made his comment in an underground garage after the jury recommended the death penalty for his gruesome crimes.

Inexplicably, Ramirez, a native of El Paso, Texas, had a following of young women admirers who came to the courtroom regularly and sent him love notes.

Some visited him in prison, and in 1996 Ramirez was married to 41-year-old freelance magazine editor Doreen Lioy in a visiting room at San Quentin prison.

Relatives called Lioy a recluse who lived in a fantasy world.

In 2006, the California Supreme Court upheld Ramirez's convictions and death sentence. The U.S. Supreme Court refused in 2007 to review the convictions and sentence. Ramirez still had appeals pending when he died.

His lawyers claimed the case should have been moved out of Los Angeles and said Ramirez was incompetent to stand trial.

Two years after his arrest, San Francisco police said DNA linked Ramirez to the April 10, 1984, killing of 9-year-old Mei Leung. She was killed in the basement of a residential hotel in San Francisco's Tenderloin neighborhood where she lived with her family.

Ramirez had been staying at nearby hotels.

Ramirez previously was tied to killings in Northern California. He was charged in the shooting deaths of Peter Pan, 66, and his wife, Barbara, in 1985 just before his arrest in Los Angeles, but he was never tried in that case.