Pier Paolo Brega Massone, the former chief of Milan's Santa Rita Clinic, dubbed 'clinic of horrors', “did not hesitate” in performing 90 unnecessary operations, four of which allegedly led to the deaths of elderly patients, prosecutor Grazia Pradella was quoted by La Repubblica as saying.

She said Massone, who in a previous trial was sentenced to 15 years and six months in prison, “has an evil nature” who “showed no compassion for other humans”.

Pradella added that Massone was “motivated by money” when he performed the operations, even on those who were terminally ill, as part of a lucrative "system" that allowed him to claim reimbursements from government health funds.

She is also calling for a life sentence for Fabio Pietro Presicci, another surgeon described as Massone’s “right-hand man”.

The scandal came to light in May 2008, when they were jailed on murder charges, and dates back to 2006, when four elderly patients died after unnecessary operations were performed on them.

One of the patient’s died after having a lung removed, while another woman died after being “fatally weakened” following three operations to remove a tumour. At least two women had breasts removed for benign cysts.

Pradella argued that there was “no clinical justification” for the operations other than “to make money”.

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