Britain's worst serial killer Harold Shipman was jailed four years ago for killing 15 of his women patients.
Shipman never accepted responsibility for his crimes
But a public inquiry later decided the 57-year-old had killed at least 215 patients over 23 years.
His death, hanging from bedsheets in his prison cell, means the true extent of his crimes while a trusted family GP in Greater Manchester and West Yorkshire may never be known.
And the families of the victims will never have the satisfaction of an explanation from the mass murderer.
During his three-month trial Shipman never admitted responsibility for his crimes, nor hinted at a motive nor expressed remorse.
'Unparallel betrayal of trust'
High Court judge Dame Janet Smith, who led the public inquiry into the case, said the doctor's betrayal of trust had been
"unparalleled in history".
At her inquiry two years ago she said: "It is possible that he was addicted to killing."
Shipman's crimes first came to light in 1998 when he made a clumsy attempt to forge the £386,000 will of one of his victims, 81-year-old Kathleen Grundy.
Her daughter Angela Woodruff became suspicious after her mother's death and alerted police.
She later told the inquiry: "We kept thinking it looked as though Dr Shipman had done something but it couldn't be and we couldn't believe it."
Soon it became apparent that the doctor entrusted to care for his patients was in fact murdering them, mostly by injecting them with fatal doses of diamorphine.
Mrs Grundy was the last known victim in a long line of patients killed by their GP.
Shipman preyed on vulnerable people, usually choosing women living alone as his victims, who may have been elderly but were not seriously ill.
The killer jab was often administered on home visits.
His oldest victim was a 93-year-old woman and the youngest a 41-year-old man.
Shipman was given 15 life sentences four years ago this month for murdering 15 patients by administering fatal doses of diamorphine and found guilty of forging Mrs Grundy's will.
But the public inquiry heard a fuller account of the number of victims who died at his hands.
Of the 215 victims 171 were women and 44 were men.
Five of these people lived on the same street. Nine lived in the same sheltered housing complex.
Shipman's first victim was Eva Lyons, killed the day before her 71st birthday in March 1975.
He had been working at the Abraham Ormerod Medical Practice in Todmorden at the time.
Another 71 patients were killed during when Shipman moved to the Donneybrook House group practice in Hyde.
The remaining 143 were murdered after 1992 when Shipman became a solo GP, working in Hyde, Greater Manchester.
Shipman had previously been sacked from a job at another practice after being fined for making out drug prescriptions to feed his addiction to the morphine-like drug pethidine.
The General Medical Council disciplined him, but failed to strike him off.
Dame Janet added: "The way in which Shipman could kill, face the relatives and walk away unsuspected would have been dismissed as fanciful if it had been described in a work of fiction."