Prosecutors in the northern Italian city of Forlì are investigating an ambulance driver on suspicion of murdering five elderly patients.

All the suspicious deaths occurred while or soon after the patients were transported in an ambulance driven by the 27-year-old man, lawyers of the victims told the Guardian.

Investigative sources told the ANSA state news agency they believe the man, who worked for the Italian Red Cross but has now been suspended, may have administered harmful substances to the patients during transfers between hospitals and care homes in the Emilia-Romagna region.

Authorities are also examining additional cases, raising concerns that the number of potential victims could rise as the inquiry widens.

The most recent case being investigated is that of an 85-year-old woman who died of a cardiac arrest in November 2025.

All the patients suffered cardiac arrests while being transported in the ambulance operated out of Forlimpopoli, near Forlì. One died en route, the others either shortly afterwards or in the days that followed.

For months, none of the relatives – most of whom believed their loved ones had been gravely ill – raised concerns. It was only when the family of one of the victims reportedly requested an autopsy that suspicions began.

“It is important to stress that these are not ordinary ambulances with sirens blaring for patients rushing to hospital,” said Max Starni and Massimo Mambelli, lawyers representing the family of the patient, who died in November.

They added: “These ambulances are generally used for routine transport … for example taking patients from a care home to hospital for an appointment. That is why there are only two drivers on board, and no nurse.”

In the case handled by Starni and Mambelli, the elderly woman was travelling from a residential care facility to a physiotherapy session when she died in the ambulance.

Prosecutors have placed the driver under investigation on suspicion of aggravated murder, alleging premeditation and the use of poisonous substances or other insidious means. He has not been arrested or placed in custody.

The local branch of the Italian Red Cross was notified of the investigation four days ago and the driver was suspended from duty.

In a statement, the organisation said it had “learned with shock of the reports concerning the involvement of one of our operators in a serious criminal matter”, and expressed hope that the inquiry would shed light on what it described as a tragic episode “entirely alien to the mission of our association in Italy and around the world, and to the work of the 150,000 volunteers who every day support those in need”.

The suspect’s lawyer, Gloria Parigi, told la Repubblica her client denied the allegations and was “deeply shaken”. He had made himself immediately available to prosecutors, she added.

“We are talking about elderly people who were terminally ill,” Parigi said. “Only one died in the ambulance; the others passed away in the days that followed, in one case as long as 13 days after the transfer. All five experienced respiratory crises during the journey, but on each occasion a medical response vehicle intervened.”