A nurse serving a life sentence for two murders is facing trial for allegedly killing a further 100 patients at two hospitals in Germany.
When he was asked by the judge whether the charges against him were accurate, the nurse said: "yes". If convicted, his admission would make him one of Germany's most notorious post-war serial killers.
Around 126 relatives of the victims are co-plaintiffs in the trial, which is expected to run until May next year, a court spokeswoman told CNN.
Prosecutors in the northern German city of Oldenburg say an investigation and toxicology reports showed that he injected 35 people at one clinic, in Oldenburg, and 62 at another in nearby Delmenhorst, with drugs that could kill them.
Culprit's choice of victim appears to have been entirely random, with their ages ranging from 34 to 96.
Hoegel, 41, was sentenced to life behind bars in 2015 for murdering two patients by giving them an overdose.
A former nurse in Germany has admitted killing a hundred patients in his care.
Judge Buehrmann opened the proceedings by asking everyone present to stand for a minute of silence for the deceased patients.
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'All of their relatives deserve that their memory be honoured, ' independently of whether or not Hoegel had anything to do with their deaths, Buehrmann said.
"We will do our utmost to learn the truth", he said, DW reported.
He promised Hoegel a fair trial.
The bearded, heavyset Hoegel took his seat in the courtroom wearing a hoodie and covered his face with a folder as long as photographers and camera teams were allowed to remain.
Police have said if local health officials had not hesitated in alerting authorities, Hoegel could have been stopped earlier.
Authorities are pursuing criminal cases against former staff at the two medical facilities.
But investigators say the actual toll of his deadly game with human life could top 200, though the true number may never be known because several presumed victims' bodies were cremated before they could be autopsied.
However, during the trial he confessed to a psychiatrist that he had killed up to 30 people.
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