A GERMAN doctor who is facing manslaughter charges for killing eight of her patients is suspected of systematically inducing the deaths of hundreds of others in her care on a scale beyond the British mass murderer Dr Harold Shipman.

State prosecutors in Hanover said yesterday they were widening their investigation into Dr Mechthild Bach, aged 54, a physician at the city's Parcelus cancer clinic, who was charged last month with the manslaughter of eight of her patients with massive doses of morphine.

Dr Bach has denied the charges, and says she "accompanied people into death", but only after consultations with the patient and their family.

A spokesman for the prosecutors confirmed that the relatives of a further five of Dr Bach's patients who had died while in her care had asked for the deaths to be fully investigated. "The relatives are concerned that there was something odd about the treatment. Some of the cases go back to the 1990s," the spokesman said.

Dr Bach was suspended from duty after a routine audit at the hospital revealed above average orders for morphine and an unusually high death rate among her patients.

She has begun a lawsuit contesting her suspension.

German health insurance officials who looked at medical files from Dr Bach's clinic said they were shocked by the high number of deaths, and demanded action. "The contents of the files gave me goose pimples," admitted one official at the time. A state prosecutor's investigation led to Dr Bach being arrested a fortnight ago. Dr Bach insists she was relieving the pain of patients who were dying anyway.

However, state prosecutors are now concerned that during her 20- year career at the Parcelus clinic Dr Bach may have killed hundreds more patients with massive doses of morphine and the tranquilliser valium. They say that between January 2000 and June last year 251 patients died while under her care.

One case drawn to the attention of the investigators involved 63- year- old Christa Dudel, who was referred to Dr Bach's clinic in May 2001 suffering from shingles. As she was fit enough to walk, her adult children were confident that she would fully recuperate. Fourteen days later Mrs Dudel was dead. Dr Bach had diagnosed her complaint as water on the lung and had injected her with lethal doses of morphine, allegedly to alleviate her suffering, without consulting her relatives. After her death her children said: "None of us spoke to Dr Bach, none of us knew what she had been given and none of us had given permission for any treatment."

A 52-year-old man suffering from throat cancer died 16 days after being admitted to Dr Bach's clinic. After the patient complained of chest pains, Dr Bach allegedly administered four 20mg morphine injections daily and took him off all other cancer combating drugs.

Investigators later described the morphine dosage as "terminal sedation" and noted that the patient could have lived for "months, perhaps longer - even without chemo or radio therapy." Dr Bach claimed that her patient had complained of breathing difficulties and that as his condition had continued to deteriorate, she had decided to offer him the chance of "dying in dignity".