A former German nurse has emerged as the country's worst serial killer after police linked him to at least 106 deaths.
Niels Hoegel, who is already serving a life sentence for six murders, is suspected of killing the patients during his time working at two clinics in northern Germany.
But astonishingly he is only known as Niels H. inside the country because reporting restrictions mean journalists are legally blocked from releasing his second name, the Daily Mail reports.
German privacy laws mean authorities will not fully identify criminals, sometimes even after they have been convicted.
Suspects in criminal cases are often only identified in German media by their first name followed by the first letter of their surname.
Journalists only printed the first name of Berlin truck attack Anis Amri and censored his face, even while asking the public to help track him down.
Hoegel was jailed in 2015 after admitting to police that he injected two patients with life-threatening drugs before trying to revive them to play the hero.
When quizzed further by police he said he was unable to remember the full extent of his activities, though bragged: "To be honest I stopped counting after 50."
That lead authorities to exhume 134 bodies at cemeteries in German and as far afield as Turkey and Poland in their search for the truth.
Investigators have now linked Hoegel to 106 deaths but say the total is likely far higher because many patients who died in his care were cremated, obliterating any evidence that would have implicated him.
He will now face charges of killing a further 100 people at two clinics.
Inquiries into how he was allowed to go on killing for so long will likely continue long after he dies behind bars, but it is clear that bureaucratic inertia coupled with fears of police probes costing executives their jobs were partly to blame.
Hoegel was born on 30 December 1976 in the German port city of Wilhelmshaven.
He grew up in a Catholic household he would later describe to his court-appointed psychiatric expert Konstantin Karyofilis as "warm-hearted and sustainable".
Hoegel's father is a nurse and a solid supporter of the SPD - Germany's Labour Party equivalent.
His mother trained as a lawyer's assistant but only found work as a cleaner.
Hoegel's older sister became a dental assistant.
"A thoroughly helpful family", say acquaintances from Wilhelmshaven. "Helpful, kind, caring," said a neighbour to a local radio station.
The first sign of trauma in the family came when Niels was 11 and his parents briefly split, which appeared to have a profound effect on his young mind.
During this period, he told his psychiatrist, he developed "fears, insecurities".
His performance at the local comprehensive school, previously all As, slipped.
He assumed the mantle of "class clown" - a role guaranteed to bring him some of the attention he craved.
Hoegel decided at 16 that he wanted to become a firefighter but discovered he suffered from vertigo, and entertained thoughts of being a doctor but found the study too difficult.
He dropped out of school shortly before his Abitur exams, the German equivalent of A Levels, before deciding to become a nurse like his father.
At the age of 17 he began nurse training at St Willehad Hospital where alcohol and drugs began to occupy a large place in his life, he later told police.
He passed the nursing exams with "mediocre" results and 1999 he started at the highly regarded heart surgery intensive care unit of the Oldenburg Clinic.
Hoegel struggled with the demands of the work, describing the first surgery he assisted on as a "traumatising experience".
He went on to develop depression and anxiety and began to drink more as a result.
An attention-seeker from birth, Hoegel uses his access to potentially lethal drugs in an attempt to play the hero.
His first known murder was in February 2000 at the clinic in Oldenburg in Lower Saxony, close to the Dutch border, where he injected a patient and tried to revive them without success.
After killing at least another 35 patients, he moved in 2002 to a hospital in Delmenhorst near the northwestern city of Bremen, where he resumed his grisly practice within a week of starting his new job.
It is believed Hoegel was suffering from Munchausen by Proxy syndrome, in which sufferers harm others to act as "reviving angel".
Hoegel's preferred drug of choice was potassium-based medication used to treat heart patients with circulatory problems, though he would use five types of cardiovascular medications over the next few years.
But his grim practices soon began to attract attention, and a co-worker noted all of the deaths and resuscitations while he was on duty.
In just one weekend the worker noted 14 reanimations to five patients.
All five ultimately died, but rather than calling the police, Hoegel's bosses simply transferred him to the anesthesia department.
Fearing that the net may be closing in on him at Oldenburg Hospital he applied for another job in nearby Delmenhorst in 2002 and began work there on December 15.
A week later, he killed his first patient there.
In 2003 and 2004, superiors note, the death rate on the intensive care unit was about twice as high as in previous years.
The consumption of the drug Gilurytmal - his preferred killing tool - was seven times higher than usual, doctors noted.
But still nobody reported the young nurse to authorities or raised concerns.
Even after Hoegel was caught injecting a 63-year-old patient who died shortly after, superiors took no action.
It was only towards the end of that year a leading doctor at the hospital audited the cardiac drugs, calculated the number of patients who had died while Hoegel was on duty, and went to the police with his suspicions.
Hoegel was arrested and sentenced to seven and-a-half years imprisonment for murder in 2008, a sentence upped to life in 2015 after he confessed to more deaths.
His parents are still alive in Wilhelmshaven and have visited him in jail.
"The victims were play figures for him in a game in which only he could win and the others could lose everything," said the presiding judge in his 2015 sentencing.
Ten years ago, a German nurse was convicted of killing 28 elderly patients, saying he gave them lethal injections because he felt sorry for them.
He was sentenced to life in prison.