Updated at 1:32 p.m. ET

Former nurse Niels Högel — who has admitted to giving potentially lethal drugs to patients so he could try to resuscitate them — has been sentenced by a German court to life in prison for murdering 85 people.

"Your guilt is unimaginable," Oldenburg district court Judge Sebastian Bührmann said as he sentenced Högel, according to Deutsche Welle. "The human mind struggles to take in the sheer scale of these crimes."

It's the latest judgment in what the local police chief in Oldenburg has called a "horrifying" serial killer case. Högel is already serving a life sentence for killing two patients.

The disgraced nurse's victims ranged in age from 34 to 96, according to the district court in Oldenburg. Högel was found to have injected them with a variety of drugs that included the heart medicines ajmaline, amiodarone and sotalol, along with potassium and the anesthetic lidocaine.

As the scope of Högel's crimes became clear, authorities exhumed dozens of bodies to test them for the cocktail of drugs he had administered to his victims. The true extent of his killings may never be known — in some cases, the bodies of people who died under Högel's care already had been cremated.

He was initially accused in a handful of deaths but was discovered to have been involved in dozens more. In the current case, Högel had been charged with committing 100 murders between early 2000 and the middle of 2005, but prosecutors were unable to prove he was responsible for 15 of those deaths.

The former nurse carried out the killings to gain attention at two different jobs: in an Oldenburg medical clinic and a hospital in Delmenhorst. While he admitted to inducing cardiac arrest in scores of patients, there were so many victims that in some instances, he said he simply couldn't recall details about the people who died. In others, he denied playing a role.

"I feel like an accountant of death," Judge Bührmann said Thursday, noting the scope of the crimes.

The judge's ruling includes a notation on the "special severity" of the crimes, which will likely complicate any attempts to parole Högel after 15 years, as is common for people serving life sentences in Germany.

German courts cannot impose multiple life sentences. But in a message to NPR, a representative of the court said that because of the judge's notation, "in the end it is possible that Mr. Högel will not be released ever."

This week, Högel offered an apology to families and others who lost loved ones. Some of those surviving relatives spoke outside of the district court today — including families of former patients whose cases remain painfully unresolved.

"That is very, very bitter," said Frank Brinkers, according to The Associated Press. The cause of his father's death is still unconfirmed, although Högel is suspected of playing a role. Brinkers added, "I have gone through hell, and that is hard to bear."

As they explored the case, investigators criticized some of Högel's colleagues, saying they could have done more to stop the nurse after noticing his irregular behavior. Some hospital employees in Delmenhorst, near Bremen, were charged with negligent manslaughter for not taking quick and decisive action to stop Högel — even after a colleague saw him inject a patient with ajmaline.

And police have complained that Högel was given a clean reference when he moved to the Delmenhorst hospital from the clinic in Oldenburg, where police said people were aware of his "abnormalities."

Copyright 2019 NPR. To see more, visit https://www.npr.org.

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