A nurse from Rotterdam appeared in court in Rotterdam on Friday charged with four murders and seven attempted murders carried out by injecting elderly patients with insulin.

Rahiied A, 22, was earlier charged with murdering six patients and attempting to kill six more after prosecutors investigated 15 suspicious deaths of patients at nursing homes. A worked at the homes as a trainee or locum nurse between January 2016 and November 2017.

The public prosecution department said in a short website statement on Friday that 11 of the 15 cases have now been included in the charge sheet but did not disclose why two murder charges have since been dropped.

The case came to light at the end of 2017 after a female resident in one of the care homes became seriously ill and was taken to hospital, where doctors found a high quantity of insulin in her blood.

A is also accused of stealing medicines and medical documents and falsifying his ‘declaration of good behaviour’ (Verklaring Omtrent Gedrag), which is a prerequisite for jobs that involve working with vulnerable people.