Serial killer Peter Tobin was suffering from dementia, heart disease and prostate cancer and had contracted pneumonia when he died in 2022, a fatal accident inquiry has revealed.

Tobin was serving three life sentences for the murders of Vicky Hamilton, Dinah McNicol and Angelika Kluk when he sustained a broken leg during a fall in his cell at HMP Edinburgh on 8 September 2022.

He was taken to hospital the following evening, but died a month later on 8 October at Edinburgh Royal Infirmary aged 76.

His ashes were scattered at sea after no-one came forward to claim his remains.

Tobin had been receiving palliative care before his death due to worsening health.

He was monitored by officers from custody service firm GeoAmey at all times while he was in hospital.

The Crown Office and Procurator Fiscal Service (COPFS) ordered the fatal accident inquiry, which is mandatory for any prisoners who die while in custody, in April.

Its findings revealed he had multiple health issues, including previously undisclosed vascular dementia.

He contracted pneumonia after undergoing surgery on the broken leg.

Tobin also refused treatment for suspected prostate cancer in 2020, the inquiry found.

Tobin was only revealed to have been a serial killer after the remains of his final victim, Ms Kluk, were found under the floor of a church in Glasgow in 2006.

He was later convicted of raping and murdering the 23-year-old.

A UK-wide investigation later tied him to the killings of 15-year-old Vicky Hamilton and 16-year-old Dinah McNicol, who both disappeared in 1991.

The two teenagers’ remains were found in the garden of a home previously belonging to Tobin in Kent.

He is suspected of having been been involved in the murders of several other women.

Investigations into his background revealed he had lived under more than 40 aliases and owned more than 150 cars.

Police Scotland said unsuccessful attempts had been made to prompt Tobin into revealing information about other suspected victims towards the end of his life.