Crime Library: Criminal Minds and Methods

Angels of Death: The Male Nurses

**New Chapter: Killing Spree

Sonthofen Hospital Clinic
Sonthofen Hospital Clinic

The tabloids called him the "Death Nurse" and "Angel of Death," as Stephan Letter admitted early in 2005 to killing 16 patients at the Sonthofen hospital clinic in the Bavarian Alps (some sources say he admitted to 12). He'd been arrested in July 2004, after a high death toll among elderly patients alerted clinic staff to missing medicine and Letter's presence during the deaths; some of the medication was found in Letter's home — an amount sufficient to kill ten people. He said he had wanted to "liberate" the souls of people he knew were suffering.

But for investigators, a confession wasn't good enough, as Letter could always recant (and had done so the day after his initial confession). He'd also admitted under interrogation that he didn't actually know how many people he had killed; it could have been more. To prove the details of Letter's confession about mixing a muscle relaxant with the respiratory drug Lysthenon to administer fatal injections, authorities exhumed 42 bodies as they considering bringing even more charges against the 26-year-old nurse. However, at least six suspected victims had already been cremated, and possibly many more.

Stephan Letter
Stephan Letter

While Letter claimed he was killing people to end their misery, prosecutors believed otherwise. Eventually, 13 more charges were added, according to Bavarian news sources, bringing the total to 29. Initially, six charges were for murder and 22 for manslaughter (including one attempt), while one case was viewed as "killing on demand" — a patient had requested it. The charges were eventually changed to 16 counts of murder, 12 of manslaughter, and one of killing on demand. Letter was also charged with the theft of some of the patients' belongings. His victims had ranged in age from 40 to 95.

Chief prosecutor Herbert Pollert cited proof from the autopsies that the fatal medication had been administered. While the drug mixture was difficult to detect in bodies buried more than a year earlier, at least they knew what they were looking for. With sophisticated analysis, pathologists were able to determine that, just before a patient's death, the drugs had been administered in high doses. Criminal investigation Chief Albert Muller indicated that the work done on this case to prove the MO had "broken new ground," scientifically.

Shockingly, it had not taken Letter long to start killing. He'd been hired at the clinic in January 2003; he apparently gave the first injection only a month later. He stole the drugs to inject, and the mostly-elderly patients died within five minutes. However, two women in their 40s were subjected to Letter's special form of "mercy" as well, and at least six patients were in no danger of dying. They'd even been lively and cheerful rather than the suffering victims that Letter had described. One 73-year-old woman had even made plans for when she was to be released. Instead, he killed her. A few had died soon after admission, before being fully examined.

Letter was given psychological assessments to try to determine if he really believed his motives or was just using them as a way to mitigate what he had done. As his trial approached, he stood by his story.

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