On Pentecost Saturday, May 18, 2024, staff on the palliative care ward of the Rhein-Maas Klinikum in Würselen, near Aachen, sat down and wrote up what they had been noticing for weeks. Large numbers of 15-milligram ampoules of the sedative midazolam had been ordered for the ward, a strength the ward rarely needed, and many of them could not be accounted for. Empty ampoules had turned up in the sharps container. Patients cared for overnight by one particular nurse were barely rousable the next morning. The deputy head of the ward phoned the head of nursing, who was on call. That evening the two men met the nurse before his night shift began. He told them he liked to use midazolam to ease patients' suffering and that he had not wanted to bother the doctors. He was sent home and never worked another shift there.
The nurse, a 44-year-old German identified in the regional press as Ulrich S., was convicted by the Aachen Regional Court on November 5, 2025 of ten murders and 27 attempted murders committed on that ward between December 2023 and May 2024. He was sentenced to life in prison with a finding of particular gravity of guilt. He denied the charges throughout. Prosecutors in Aachen and Cologne have since opened inquiries into more than a hundred further deaths, and dozens of bodies have been exhumed.
Little about Ulrich S.'s private life has been published, in keeping with German practice for defendants. According to the indictment as reported by dpa and AFP, he began training as a nurse in 2007 and qualified as a Gesundheits- und Krankenpfleger, a registered general nurse. He then worked for several employers. Colleagues and prosecutors described him as experienced and professionally very capable, and he chose to work night shifts only.
From 2014 to 2020 he worked at the Merheim hospital, part of the city-owned Kliniken Köln in Cologne, according to t-online, which reported that the two sides parted by mutual agreement. Most reports say he joined the Rhein-Maas Klinikum in Würselen in 2020. When he read a prepared statement in court in May 2025, he gave a different date: "I was an employee at the Rhein-Maas Klinikum since October 2022."
In court he mentioned inviting a colleague to his wedding, said he was going through a divorce, and said that he and his wife had the same tattoo of their dogs. Reporters at the opening of the trial described him as heavily tattooed. A deputy ward head who worked with him in Würselen said he knew little more about him than that he had married and owned a dog; other witnesses called him a loner.
The palliative care unit in Würselen, in the Bardenberg district, looked after seriously ill patients, many of them very old, in the last stage of illness. Prosecutors described them in the indictment as "terminally ill and predominantly very elderly." On such a ward, sedatives and strong painkillers are part of ordinary care, given in measured doses on a doctor's order. A former colleague told the court that the usual dose of midazolam on the ward was up to 5 milligrams.
That ordinary use is part of why the case was hard to see from inside and hard to prove afterward. A patient in palliative care is expected to die, and drowsiness is not in itself alarming. The trial would turn on whether particular doses, given at particular times, had killed particular people who would otherwise have lived longer.
None of the patients has been named in the reports reviewed for this page, and German courts and newspapers generally protect the identities of victims as well as defendants. The indictment covered 26 patients, some of whom, prosecutors said, were injected more than once, which is why 26 people accounted for 34 alleged attempts. Nine of those 26 were charged as murder victims; the court later found ten deaths proven.
One case was described in some detail when the trial opened. Prosecutors said a 69-year-old man with Parkinson's disease had been given a strong sleeping drug and morphine that were not medically indicated. Prosecutor Marius Saalmann told the court that the defendant had "denied the patients their right to life."
Relatives of several patients joined the case as co-plaintiffs, as German law allows, and gave evidence. Presiding Judge Markus Vogt said at the opening that one aim of the trial was to end their uncertainty about what had happened to the people they had lost.
Much of the trial consisted of former colleagues describing remarks they had at first taken as jokes. A nurse who started working with him shortly after her exams told the court in May 2025 that she had noticed patients were hard to wake after his night shifts and had asked him about it, with no suspicion in mind. He laughed, she said, and answered: "Yeah, yeah, I'm killing them all here." She took it as irony, and they both laughed.
A second former colleague described him as lacking empathy. She said he had remarked that the ward held "only zombies lying around, they're only here to die," and that his earlier commitment had turned into an attitude of not caring. Another colleague testified in April 2025 that he often said at the start of a shift that he did not feel like dealing with "annoying patients," and that he once said: "If they aren't quiet, I'll make sure of it." After a patient nearly bled to death, she said, he laughed and said that if it had happened on his shift he would have shut the door and let the man bleed. She also told the court that a woman who had been "very lively" one day was "half dead" the next morning, and that one patient said he had been injected with something in the night and did not know what it was.
The same colleague said he had twice come into the hospital at night while off duty, saying he wanted to clean the medication cabinet and pick up a urine cup for his dog. The second time he spent more than an hour in the building unsupervised. She reported it, and after a talk with a supervisor he stopped coming.
Not all testimony held up. In August 2025 t-online reported that a nurse who had told police the defendant deliberately overdosed patients said in court that she no longer remembered saying so. The ward's chief physician, who had approved medication orders during his shifts in the hospital's computer system, at first declined to testify, and a police officer described her interview instead. According to that officer, she had noticed that patients were very tired into the afternoon after his night shifts, and had told police that the approvals were "three clicks, we often release them in passing." The officer said he believed she knew more than she had disclosed, probably so as not to incriminate herself. In October 2025, t-online reported that several witnesses had contradicted themselves or could not recall statements made to police, to the visible surprise of Judge Vogt.
The deputy head of the ward told the court that before Pentecost 2024 staff had found that records were wrong: some doses entered were far too high, and sometimes nothing was entered at all. On May 18 the staff documented what they had found and called the head of nursing. In the meeting that evening, the deputy said, the defendant, normally self-assured, sat with his head lowered, hands folded and lip trembling. "I only wanted to help the patients," he said. "I am not a euthanasia nurse." The deputy told the judge the scene struck him as "almost psycho." The clinic suspended him the same day and reported excessive midazolam use, which started the criminal investigation.
The ward's chief physician told the court that the rules were clear: irregularities with medication had to be reported to her at once, especially where patients might be at risk. "That did not happen," she said. She learned of the matter only after he had been placed on leave. She then had midazolam locked in the narcotics cabinets, ordered stock checks, informed department heads, had patient files reviewed and commissioned a risk review from an outside law firm, whose results, she said, she had not been shown. The hospital later introduced an anonymous incident reporting system. Its lawyer said the acts could have been committed "only by deliberately disregarding documentation duties and contrary to clear instructions."
Police set up a homicide commission named "Fluss" (River), which reviewed more than 100 patient files from Würselen, according to t-online. The defendant was questioned on June 26, 2024. According to the Kölner Stadt-Anzeiger, as reported by dpa and the Berliner Kurier, he cast himself in that interview as a scapegoat, said he deserved the Federal Cross of Merit for his work, and admitted giving the injections himself without the required medical order, because he wanted quiet on his night shift. The same paper reported that a wiretapped phone call with his brother recorded him saying the patients' fate meant nothing to him. These accounts come from investigation files quoted by the press; the court's own findings on them were not published in the sources reviewed.
A judge issued an arrest warrant in July 2024. In court, the defendant complained that police arrested him at six in the morning and refused him a lawyer. That summer it became public that prosecutors were investigating a former nurse at a Würselen clinic for several attempted killings.
Investigators exhumed and autopsied several patients. By March 2025, five exhumations had been carried out and more graves were expected to be opened. An expert told the court that the ward's orders of midazolam had risen from 50 ampoules in 2022 to 180 in 2023 and to 230 in 2024 up to Pentecost, and said he doubted that nobody had noticed.
On February 14, 2025, the Aachen Regional Court announced that prosecutors had indicted the former nurse on five counts of murder and 25 of attempted murder. A month later, the Aachener Zeitung reported a supplementary indictment adding four murders and nine attempts, for a total of nine murders and 34 attempted murders. The court tried both together.
Prosecutors charged murder rather than manslaughter on the basis of two of the aggravating features in German law: base motives (niedrige Beweggründe), for killing to spare himself work, and in some cases treachery (Heimtücke), for attacking patients who were asleep or unable to suspect anything. The indictment said he injected sleeping and waking patients alike, then left the room and left them alone. It described him as having developed a sense of superiority over colleagues and doctors and as ignoring medical instructions.
Eugen Brysch, of the German Foundation for Patient Protection, reacted to the new charges by saying serial killers in nursing and medicine had it too easy. He called for an official medical examination whenever a person in care dies, and for a "culture of looking," noting that it is almost always colleagues who uncover such crimes.
The trial opened on March 24, 2025, before the Aachen Regional Court presided over by Judge Markus Vogt. The defendant, defended by Volker Breyer and Tanja Tomasso, said nothing on the first day. Vogt described it as an extensive case with many counts and said it was also about "structures and general connections." Fourteen hearing dates were set at first, through early June; the trial ran until November.
Witnesses included former colleagues from Würselen and from Cologne-Merheim, supervisors, relatives and medical experts. A nursing assistant who had worked with him at Merheim (given the pseudonym Sebastian F. by t-online) testified in May 2025 that he suspected the defendant had begun in Cologne. He said his suspicion rested on rumors and his sense of the man's character rather than on anything he saw. He described one Merheim patient who was moved to intensive care after an overdose that a colleague blamed on the defendant; the patient recovered, and the matter was dropped. He quoted the defendant as saying of a patient who needed more care, "Hopefully he croaks, then I'll have my peace," and said a patient had asked not to be cared for again by "the tattooed one." Asked by Vogt whether such things should have been reported, he said: "I felt lousy that we had been so blind."
On May 9, 2025, the defendant read out a written statement. According to t-online, it dealt with his working conditions and his colleagues rather than with the charged cases. He said that from four in the afternoon there was usually only one doctor on call, and that in three years of night duty he had seen a doctor come to the ward only once. He criticized colleagues he considered lazy or careless, and accused one male colleague of giving a struggling patient midazolam, after which, he said, "the patient was dead." He denied giving anyone medication to shorten their life and said he had only made sure patients were free of pain, adding that younger nurses were cautious with strong drugs and left them to him as the more experienced nurse. "A great many people want to push their own mistakes onto me," he said. He became agitated, and his lawyers repeatedly urged him to calm down. "It's only my head!" he shouted. "It's only murder." Vogt put off detailed questions for that day. In other hearings the defendant said he was "not a euthanasia nurse," that he had followed patients' advance directives, and that he had only wanted to relieve pain.
By mid-October the court signaled doubts. According to the Aachener Zeitung, as summarized by t-online, the chamber said it would convict of a completed killing only where no alternative cause of death was indicated, and that it had considerable doubts in some cases, including doubts raised in the reports of a palliative care expert. It also questioned whether treachery could be proved. Acquittal on some counts was possible, it said, because it was unclear whether some patients had been harmed at all.
In closing arguments at the end of October, prosecutors asked for life imprisonment with a finding of particular gravity of guilt and argued that the evidence showed 13 completed murders, four more than charged. They described the defendant as having made himself "master of life and death" over the patients, said he had a personality disorder, and said he had shown no compassion and no remorse. The defense asked for acquittal. The defendant told the court he had not given any medication with the aim of shortening a life.
On November 5, 2025, the court convicted him of ten murders and 27 attempted murders and imposed a life sentence, finding particular gravity of guilt, as prosecutors had asked. It counted one case charged as an attempt as a completed killing; other counts were not proved. Judge Vogt's oral reasons took about two and a half hours, according to 20 Minuten, which reported with dpa.
The court found that he gave patients excessive doses of sedatives, sometimes combined with painkillers and sometimes repeatedly, without a medical order. Patients fell into a coma-like sleep and often did not wake until the next afternoon; on later nights he sometimes dosed them again. Vogt said the defendant had accepted that the patients might die. As the court saw it, he acted to secure several hours of quiet and to maintain his sense of order. He was irritated by breathlessness, restlessness, pain and soiling, and in the middle of the night he gave patients full-body washes. The judge described "a heightened need for order" and said the defendant felt "misjudged and underestimated." He also said the defendant believed he had "done a good job" by enabling the patients to fall asleep peacefully. ZDF reported that the court found a combined personality disorder with dissocial, emotionally unstable, obsessive and narcissistic traits, and noted his arrogant and cynical conduct during the trial.
The court also found that he had recorded smaller doses in the hospital's system than he actually gave and then had doctors confirm the entries afterward, and that no one questioned the poor documentation or the sharply rising drug orders. According to 20 Minuten, the court concluded that the way the ward was organized, and the attitudes of staff, created an environment that reinforced his conduct. "We hope that this trial will also bring a certain awareness," Vogt said.
After the verdict, defense lawyer Tanja Tomasso said her client did not personally see "that his behavior led to them dying faster, earlier."
In German law, a life sentence normally allows an application for release on parole after 15 years. A finding of particular gravity of guilt means that release at that point is in general ruled out, and a later court decides how much longer must be served.
No source fetched for this page says whether the defense lodged a Revision, the appeal on points of law to the Federal Court of Justice (Bundesgerichtshof), or whether the November 2025 judgment has become final. Global News reported at the time of the verdict that he was entitled to appeal but did not say whether he had. As of the AFP report of August 10, 2026, he was in prison. The status of the judgment is therefore given here as of that date, with the question of finality open.
The Aachen prosecutors made clear before the verdict that the case was not closed. In March 2025 a spokeswoman said they would go through his earlier working years "year by year." In late August 2025, Senior Public Prosecutor Katja Schlenkermann-Pitts told t-online that a further indictment for murder or attempted murder would follow, concerning suspected cases from 2023 and in some instances 2022. She also said prosecutors were checking whether there was an initial suspicion against several other hospital employees, while stressing that the focus remained on the accused nurse. On the eve of the verdict an Aachen spokesperson said: "There will probably be a further indictment."
On January 22, 2026, Schlenkermann-Pitts said the suspected cases in the continuing proceedings numbered "well over 100." She stressed that these were initial suspicions that could still fall away. By then 27 exhumations had been carried out in connection with the new allegations, and about 30 more were pending, according to dpa reports in the Ärzteblatt and the Berliner Kurier. (An automatically generated summary box on the NWZonline page gave different figures; the main dpa text is used here.)
On August 10, 2026, a spokeswoman for the Aachen prosecutors told dpa that more than 120 further suspected cases were under investigation, reaching back to September 2022, that 39 exhumations had been carried out, and that more cases could be added. She said a new indictment was expected "probably in the course of next year." AFP reported the same day that prosecutors were examining dozens of suspicious deaths.
In Cologne, the picture changed over the course of the trial. In March 2025, Chief Public Prosecutor Ulrich Bremer told t-online that no proceedings were pending there and no complaints had been filed, and that Cologne would pursue any leads that came out of the Aachen inquiry. t-online reported that anonymous tips at Merheim had once mentioned the use of unprescribed medication. By the autumn, Cologne prosecutors were investigating possible homicides at the city clinics and had seized documents and data storage devices there in July 2025. In December 2025, Bremer confirmed to dpa, after a report in the Kölner Stadt-Anzeiger, that two bodies had been exhumed: a 94-year-old woman who died in 2018 and a 78-year-old patient who died in 2015, both former Merheim patients. Prosecutors suspected that he had given them morphine without authorization, which might have caused their deaths. A toxicology examination was looking for elevated morphine levels; a third exhumation was planned. By August 2026, Cologne had exhumed seven bodies, and a spokesman described the inquiry as very complex and likely to take a long time.
The trial drew attention to the hospital as well as the nurse. The midazolam orders, the doctor's remark about approvals given "in passing," the colleagues who heard his comments and laughed, and the court's finding that ward culture had reinforced his conduct were all part of the public record by the end of the trial. In August 2025 prosecutors were examining whether other employees should face an initial suspicion; no result had been reported in the sources reviewed. No investigation of other staff was under way in Cologne, according to t-online at that time.
After the verdict Eugen Brysch said there were still hospitals without complete, standardized electronic control of how medicines are dispensed, and that serial offenders had "far too easy a game."
Proven at trial (subject to the open question of finality): ten murders and 27 attempted murders of patients on the Würselen palliative ward between December 2023 and May 2024.
Alleged but not found proven: the prosecution's additional three killings argued in closing (13 in all), and the attempts charged in the indictment that did not end in a conviction. The indictment's 34 attempts became 27 attempts plus one killing, which leaves six counts on which, from the reports, he was not convicted.
Under investigation, not charged: more than 120 deaths in Aachen reaching back to September 2022, and possible killings at Cologne-Merheim between 2014 and 2020, including the two exhumed patients who died in 2015 and 2018. Prosecutors have called these initial suspicions.
Reported from investigation files but not tested in the sources reviewed: the wiretapped call with his brother, and the police interview in which he is said to have admitted unauthorized injections and claimed he deserved a state decoration.
Rumor: the Merheim colleague's belief that he had started killing in Cologne, which the witness himself said rested on rumors and impressions.
The defendant's account: he denied intending to shorten any life, said he relieved pain and followed advance directives, and blamed staffing, absent doctors and colleagues.
2007: begins nursing training.
2014 - 2020: works at Cologne-Merheim (Kliniken Köln).
2015 and 2018: deaths of two Merheim patients later exhumed by Cologne prosecutors.
2020 (or October 2022, by his own account): joins the Rhein-Maas Klinikum, Würselen.
September 2022: earliest point of the Aachen prosecutors' further investigation.
2022 - 2024: ward orders of midazolam rise from 50 ampoules to 230 (2024, to Pentecost).
December 2023 - May 2024: the period of the convicted offenses.
May 18, 2024: staff document irregularities; he is confronted and suspended.
June 26, 2024: questioned by police.
July 2024: arrest warrant issued.
February 14, 2025: indictment for 5 murders and 25 attempts announced.
March 2025: supplementary indictment; totals 9 murders and 34 attempts.
March 24, 2025: trial opens at the Aachen Regional Court.
May 9, 2025: reads a statement denying the charges.
July 2025: Cologne prosecutors seize records at the city clinics.
Late August 2025: Aachen prosecutors announce a further indictment will follow.
November 5, 2025: convicted of 10 murders and 27 attempts; life sentence with particular gravity of guilt.
December 2025: Cologne exhumations confirmed.
January 22, 2026: "well over 100" suspected cases; 27 exhumations done, about 30 pending.
August 10, 2026: more than 120 suspected cases in Aachen; 39 exhumations; 7 in Cologne; new indictment expected next year. Finality of the 2025 verdict not reported.