A former home care worker in Japan has been sentenced to death for a series of grisly murders. Satoshi Uematsu, 30, was sentenced Monday to hang for stabbing 19 disabled patients at the Yamayuri-en residential home, where he had previously worked.

In addition to the killings, Uematsu also injured two dozen other residents and two staff members. Patients at the Sagamihara-based facility ranged in age from teens to those in their 70s.

The incident from July 2016 was the deadliest mass killing in Japan since the end of World War II.

Uematsu admitted to authorities during the investigation that he targeted the patients at the residential home because he viewed them as “burdens” to society. He also reportedly explained the inspiration he took from Adolf Hitler and Nazi ideologies in planning his attack.

“The attacks were premeditated, and the defendant was acting consistently to achieve his goal,” Chief Judge Kyoshi Aonuma said. “The crime, which took the lives of 19 people, was extremely heinous and caused damage that is incomparable to any other case.”

Attempts by Uematsu’s defense to have him acquitted on the grounds of being mentally incompetent were dismissed by Judge Aonuma. The defense argued that his crime was brought by his abuse of marijuana, but the prosecution was able to argue against this, insisting that his own prejudices were the primary motivator.

Prior to the attack, Uematsu reportedly sent a letter outlining his plan to the Japanese parliament. When confronted about the letter, he quit his job at the home and submitted to psychiatric treatment. He was released from treatment after only two weeks.

Japan and the U.S. are the only members of the Group of Seven international organization of countries that still practice capital punishment.

Satoshi Uematsu did not deny involvement in the grisly attack that killed 19 people at a care home
Satoshi Uematsu did not deny involvement in the grisly attack that killed 19 people at a care home JIJI PRESS / STR
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