The nurse allegedly injected an overdose in medicine that stopped the patients' hearts in order to try and resuscitate them and be praised for his so-called efforts.
Numerous killings could have been prevented if local health authorities had acted on their suspicions at the time, Mr Kühme said.
The accused, a 40-year-old Niels Hoegel was jailed in February 2015 for killing two and for attempting to murder four other Intensive Care Unit patients in the Delmenhorst hospital near the northern city of Bremen. He was sentenced to life in prison.
It was only when a female nurse caught Hoegol red handed the murders came to light. "The murder cases could have been prevented", said Kuehme, Police Chief.
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The man, identified only as Niels H. under reporting rules, has "confessed in many of those cases", a police statement said, but could not remember all the details of his actions.
Johann Kuehme, the Oldenburg police chief, told journalists at a press conference Monday that the number of victims had left authorities "speechless".
'And as if all that were not enough, we must realise that the real dimension of the killings by Niels is likely many times worse'.
He faulted local health authorities for being slow to act.
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Authorities are already pursuing criminal cases against former staff at the two facilities.
Following the confession, relatives of patients who died in the clinics where Hoegel worked urged German police to investigate the horrific claim.
Kuehme said other medical workers at Oldenburg were aware of an elevated number of resuscitations, and initial indications of possible wrongdoing by the nurse in Delmenhorst emerged as early as April 2003.
Hoegel admitted to injecting patients with deadly drugs and then trying to revive them in an apparent ploy at playing hero, according to Al Jazeera Monday.
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The special commission, launched in October 2014, combed through evidence that included more than 500 patient files.