Victorino Chua was first arrested in January 2012 but was released on bail
A nurse has been charged with the murder of three people following their deaths at Stepping Hill Hospital in Stockport in 2011.
Victorino Chua, 48, of Churchill Street, Heaton Norris, is also charged with 31 other offences including GBH and attempted poisoning.
He is accused of murdering patients Tracey Arden, 44, Arnold Lancaster, 71, and Alfred Derek Weaver, 83.
He was remanded in custody to appear at Manchester Magistrates' Court later.
Greater Manchester Police (GMP) said Mr Chua faced one count of causing grievous bodily harm with intent, 22 counts of attempting to cause grievous bodily harm with intent and eight offences of attempting to administer poison, under the Offences Against the Person Act.
Investigators have been examining the contamination of various medical products, between June 1 and July 15, 2011 at the hospital.
They were first called to Stepping Hill following reports that saline ampoules and bags had been contaminated with insulin.
Wider community
Eighteen patients were deliberately poisoned by contaminated products, according to GMP, and eight later died.
In addition to Ms Arden, Mr Lancaster and Mr Weaver, those who died were William Dickson, 82, Linda McDonagh, 60, John Beeley, 73, Beryl Hope, 70, and Mary Cartwright, 89.
Mr Chua, a father of two who is originally from the Philippines, was first arrested in January 2012 and was later released on bail.
GMP's Assistant Chief Constable Steve Heywood said: "Our thoughts continue to be with those people who were deliberately poisoned and their families.
"From day one, we made a commitment to those people, as well as the wider community, to thoroughly and robustly investigate what occurred.
"In close to three years we have conducted many painstaking inquiries and engaged with numerous medical experts.
"We are now at a point where we have charged Victorino Chua with a number of very serious offences."
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