A hospital nurse murdered three patients and poisoned 18 others by contaminating saline bags and ampoules with insulin, a court heard.
Victorino Chua, 49, also deliberately altered the dosages on prescription charts while working as a staff nurse at Stepping Hill Hospital in Stockport, Manchester Crown Court heard.
In all 21 patients suffered as a result of his "handiwork" with three of them murdered, Tracey Arden, 44, Arnold Lancaster, 71, and Derek Weaver, 83, jurors were told.
Chua, a Filipino who first came to the UK in 2002 and had worked at Stepping Hill since 2009, sat in the dock listening impassively as Peter Wright QC, began outlining the prosecution case against him.
Chua has pleaded not guilty to 36 charges in all, including the three alleged murders, one count of grievous bodily harm with intent, 23 counts of attempted grievous bodily harm, eight counts of attempting to cause a poison to be administered and one count of administering a poison.
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