Niels Hoegel, 42, was initially tried on 100 counts of murder but was found guilty in the deaths of 85 patients, ages 34 to 96, that he murdered sometime between 2000-2005. The court was forced to dismiss 15 counts on a lack of evidence.
Hoegal, who is currently serving a life sentence for two previous murder convictions, was handed a second life sentence by Judge Sebastian Buerhmann.
“Your guilt is incomprehensible,” he said.
Hoegel worked at a hospital in Oldenburg between 1999 and 2002 and another hospital in nearby Delmenhorst from 2003 to 2005. The killings were said to have taken place between 2000 and 2005.
In his first trial in 2015, Hogel admitted to intentionally bringing 90 patients in Delmenhorst into cardiac arrest because he enjoyed the feeling of resuscitating them. However, many of those victims did not survive.
"The fact is sometimes the worst fantasy is not enough to describe the truth," Buehrmann said during Thursday’s sentencing.
During the first investigation, Hoegel also admitted to killings in Oldenburg which led authorities to review more than 500 patient files and hundreds more hospital records. They also exhumed 134 bodies from 67 cemeteries, and questioned Hoegel multiple times, concluding that he had used a variety of drugs to attempt resuscitation of his patients, and was fully aware they might die.
While pleas are not entered in courts in the German judicial system, Hoegal admitted to 43 killings and disputed five in his most recent trial. He also said he could not remember the other 52 suspected killings.
Prosecutors noted that many of Hoegel's victims were not terminally ill patients, but were on the path to recovery.
Hoegel, who suffered from personality disorders, said he a good childhood and came from a family of nurses. He apologized to the victim’s families during closing statements on Wednesday.
"To each and every one of you, I sincerely apologize for all that I have done.”
There are no consecutive sentences in the German system, but Buerhmann noted in his verdict the "particular seriousness" of Hoegel's crimes, a finding that all but ensures he will remain incarcerated after the standard 15-year term is up.
The Associated Press contributed to this report.