Britain's worst mass murderer Harold Shipman hanged himself with a noose of bed sheets in his prison cell Tuesday, never having said what drove him to kill at least 215 of his patients.

Victims' relatives said they felt cheated by what they saw as a final act of cowardice by Shipman, nicknamed "Dr. Death" after his horrific 23-year-long killing spree was discovered.

Britain's Dr. Harold Shipman is shown in this undated police handout file photograph after his arrest. Shipman was found hanging dead in his cell on January 13, 2004, the prison service said.  [Reuters]

"He was found dead, hanging in his cell," a prison service spokesman said.

Shipman was convicted in 2000 of murdering 15 of his patients and sentenced to life in prison. An inquiry later ruled he had murdered at least 215 patients with heroin injections, making him Britain's -- and one of the world's -- most prolific serial killers.

The bearded, bespectacled doctor killed his patients between 1975 and 1998. Of his victims, 171 were female and 44 male. The oldest was a 93-year-old woman and the youngest a man of 41.

Danny Mellor, whose 73-year-old mother Winifred was one of Shipman's victims, said the killer was a coward whose death made it "desperately hard" for families to live with the mystery.

"I always harbored the remote possibility that one day I could confront him and ask him why," he told Reuters. "Now that's been taken away from me."

ADDICTED TO KILLING?

Prosecutors at Shipman's trial said his drive to kill was fueled by his need for a God-like power over life and death.

Others say the killer was profoundly affected by the experience of watching his own mother die from cancer -- and taking diamorphine to ease her pain.

(serial-killing cases around the world)

The official inquiry found Shipman murdered his victims quietly, coldly and systematically, in a betrayal of trust "unparalleled in history." It said he may have been "addicted to killing," but found no conclusive motive.

A statement from Wakefield high-security prison in northern England said he was found dead there at 1:20 a.m. EST Tuesday, the day before his 58th birthday.

"Despite the best efforts of staff who immediately attempted resuscitation, he was pronounced dead by a doctor at 8.10 a.m. (3:10 a.m. EST)," it said.

Shipman's body was driven away from the prison in a funeral service van flanked by a police escort.

The prison said Shipman was alone when he hung himself from the cell bars and an investigation would be carried out.

Shipman's lawyer said the doctor had been planning an appeal against his conviction on the grounds that 14 of his victims did not have a second post mortem.

"He did not have a fair trial," Giovanni di Stefano told Reuters. "I think all of us have failed him.

"In an interview last year, I said this man was sentenced to death -- how right my words were."

Shipman's conviction in 2000 sparked horror among Britons at how a doctor who had previous convictions for forging prescriptions to feed his own drug addiction was able to continue his career and run a one-man practice.

Working alone, he was able to stockpile huge amounts of diamorphine -- the medical name for heroin -- at his home and surgery, ready to use on his often elderly victims.

He was finally captured after the daughter of Kathleen Grundy, his last victim, challenged a new will that left all her mother's wealth to Shipman. Her body was exhumed and traces of the fatal dose of heroin were found in her remains.

The trial judge said Shipman's actions were a "calculated and cold-blooded perversion" of his medical skills.

Ann Alexander, a lawyer who represents some of the victims' families, said many of them would feel cheated.

"They had hoped that one day they would be able to find out why...and would have some understanding of why he did what he did. Now, of course, they are never going to know."

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