As the proceedings opened in the northern city of Oldenburg, presiding judge Sebastian Buehrmann asked whether the charges against him were accurate, to which Hoegel replied "yes". But prosecutors pushed for a new trial after details indicated that Hoegel may have killed 100 more victims, injecting them with deadly drugs such as lidocaine and calcium chloride, according to prosecutors who said Hoegel acted out of "boredom".
The 41-year-old was jailed for murdering two patients in 2015, but investigators later discovered the extent of his crimes were likely to be much greater than previously thought.
Prosecutors said Hoegel should have been aware that the drugs he gave to patients at hospitals in Delmenhorst and Oldenburg could cause life-threatening cardiac problems.
The German nurse has already spent almost a decade in prison for other patient deaths.
The Oldenburg State Court is conducting Hoegel's trial at a courtroom set up in a conference centre, a venue chosen to accommodate a large number of co-plaintiffs and public interest in the proceedings. "We will do our utmost to learn the truth", Bührmann said. Prisoners serving life sentences are usually considered for parole after 15 years.
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The country, however, continues to lag in areas such as "enforcing contracts" (rank 163) and "registering property" (rank 166). The country now ranks first among South Asian countries, compared to the sixth slot it held in 2014, he added.
Prosecutors say an investigation and toxicology reports show he injected 35 people at the clinic Oldenburg clinic and 62 in Delmenhorst.
Hoegel has already served ten years of his "life sentence" but the Post says a life sentence in Germany usually amounts to about 15 years.
"We have fought for four years for this trial and expect Hoegel to be convicted of another 100 killings, ' said Christian Marbach, a representative of the patients" relatives.
The man was first arrested in 2005, when I noticed that he enters the patient's medication he was not prescribed.
He is believed to be the most prolific serial killer in modern German history.
Police said fellow nurses and doctors should have brought Hoegel's actions to light sooner.