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(NEWSER) – Italian police have arrested a nurse who possibly killed up to 38 patients because they or their families "annoyed" her, officials say. Daniela Poggiali, 42, was arrested Friday in connection with 11 patient deaths and had already been under suspicion of killing another in April, the New York Post and ANSA report.

Police then found a selfie on her phone of Poggiali giving a thumbs-up beside a dead patient in northeast Italy. "I can assure you in that all my professional years of seeing shocking photos, there were few such as these," says a prosecutor.

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