Thomas Ashcroft, aged 39, of Musgrave Crescent, Shirecliffe, is alleged to have started a fire at Royal Stoke Hospital after which an 89-year-old woman, May Maxfield, died.
The blaze, on Wednesday, June 7, led to the evacuation of hundreds of patients while dozens of firefighters battled to prevent the flames spreading.
Some patients had to be wheeled outside in their hospital beds after the fire was discovered in an area close to the operating theatres.
The fire led to the closure of the hospital's accident and emergency department for one night.
Ashcroft is also charged with an arson attack at Staffordshire University on the same day.
He has been remanded in custody ahead of his next appearance at court.