WINSTON-SALEM, N.C. (WGHP) — Prosecutors are set to seek the death penalty against a former nurse at the Atrium Health Wake Forest Baptist Medical Center who is accused of killing two patients and attempting to kill a third.

Johnathan Howard Hayes was in Forsyth Superior Court on Wednesday during a Rule 24 hearing, which is where a judge decides if someone can face capital punishment.

Speaking during a news conference in Oct. 2022 after Hayes was arrested, District Attorney Jim O’Neill described Hayes as a rogue nurse acting alone.

Hayes is accused of killing two patients by giving them lethal doses of insulin.

Prosecutors believe the death penalty is warranted in the case since the crimes are especially heinous and cruel.

Background

Johnathan Hayes is accused of killing two women and attempting to kill another between Dec. 2021 and Jan. 2022 while he worked at the Atrium Health Wake Forest Baptist Medical Center. 

Warrants state that in March 2022, detectives met with staff from Atrium Health Wake Forest Baptist, where they told detectives about what they believed were suspicious circumstances around the deaths of two patients.

The death of Gwen Crawford

Gwen Crawford died in intensive care on Jan. 8, 2022, after a hypoglycemic episode on Jan. 5, 2022. Warrants state that her blood was drawn and doctors verified that she had been given over 100 units of insulin. 

“Medical professionals present at this meeting could offer no explanation as to why anyone would administer such a high dosage of insulin to a patient,” warrants said.

The morning of Crawford’s episode, Hayes drew up 12 units of insulin for Crawford, which is “generally accepted” as being the highest dose of insulin given to an average patient by nursing staff, despite notes from the prior shift indicating her blood sugar had been normal and Crawford having not needed external insulin since Dec. 31, 2021.

“Medical professionals present at this meeting could offer no explanation as to why anyone would administer such a high dosage of insulin to a patient,” warrants said.

He was seen on camera taking a full vial of insulin, 300 doses, from the medicine room. When asked about the amount of insulin, he claimed he “wasted” the vial, disposing of it in the sharps container. Surveillance did not corroborate Hayes’ claim. 

He made a written statement at the time acknowledging that he “may have accidentally given Crawford insulin that was meant for another patient.”

The death of Vicky Lingerfelt 

Vicky Lingerfelt was a patient in January 2022, and she had a hypoglycemic episode on Jan. 22, 2022, dying on Jan. 28, 2022. When her blood was drawn, a doctor verified that her death resulted from the application of over 100 units of insulin. Lingerfelt was not diabetic and had no orders to receive insulin for any reason. 

While Hayes was not the primary nurse for Lingerfelt on that day, he helped move her to a new bed earlier in the day.

Lingerfelt’s hypoglycemic episode happened while her primary nurse was on lunch. 

Hayes was seen on video again removing a full vial of insulin from the medication room, documenting that he needs 12 units for a different patient, and hours after her event he allegedly accessed her medical chart, which he would have no reason to do.

The assault of Pamela Little

On April 12, 2022, detectives were made aware of a third patient who suffered a hypoglycemic episode, Pamela Little. 

Her episode was on Dec. 1, 2021. She was under the care of Hayes at the time of her episode, and warrants state that he pulled insulin for Little but noted in the chart that the insulin was not provided. However, she suffered a hypoglycemic episode within hours. 

She was moved out of the hospital. 

Detectives spoke with Little on May 3, 2022, about the episode. She confirmed that she was a type 1 diabetic, and she only knew of one time she had received insulin at the hospital, from a female nurse, but that she normally didn’t take insulin. She told detectives that she was “scared of a male nurse because he was sneaky.” She said she saw him two times before her attack and said she saw him put a white pill in her IV line, but he removed it when another nurse came into the room. 

Little did not recall the name but gave a description that approximately matched Hayes. 

Little passed away two days after speaking with detectives, on May 5, 2022.

Hospital investigation

“Further investigation by hospital staff generated the following information about Johnathan Hayes and his usage of insulin within Atrium Health Wake Forest facilities,” according to the warrants. 

Hayes was found to be the top insulin dispenser in the facility by seven times the facility average, and the highest user of insulin by any employee over three months and there were discrepancies over Hayes’s record keeping. 

“It was explained to detectives that insulin is a ‘high alert’ medication, thus prompting additional steps to monitor its use,” warrants said. “It was further explained that in a ‘high alert’ medication, it is requested that the administering professional draw the medication and have the type of medication and the dosage amount verified by another nursing professional. This is known as the dual verification process implemented by hospital administration.”

Detectives were told that Hates had properly documented “high-alert” medication but improperly documented it in one instance. 

“This demonstrates that Johnathan Hayes is aware of how to properly document the use of these ‘high-alert’ medications, as well as his willingness to not properly document their usage.”

He allegedly said that Crawford was “very sick” and “needed to go.”

Hayes’s employment records showed that his resume stated he had worked, in the past 20 years, at Baptist Hospital, Novant Health, High Point Regional Hospital, Moses Cone Wesley Long Hospital, Iredell Memorial/Davis Regional Hospital and UNC Wayne Memorial Hospital among others.

Hayes interview

Detectives interviewed Hayes, who said that he did not remember giving Crawford insulin, as she didn’t need any. He allegedly said that Crawford was “very sick” and “needed to go,” but said later he meant she needed to be transferred to the ICU. 

He said he drew up the insulin for Crawford before checking records that indicated she didn’t need it and would have “wasted” the insulin as a result. 

Hayes claimed most nurses pull medications for patients without checking to see if they’re needed and claimed he did not know he was supposed to use “dual verification,” which contradicts his proper use of documentation in the past. 

He told detectives that “he had never given the wrong patient medication in his 20-year career. Johnathan Hayes also stated that he did not remember taking out full vials of insulin on each of these dates but stated that he had been shown a video of doing so by Risk Management.” 

When he was told that 100 dosage units were given to Crawford, he responded that it was “an incredible amount” that would have had to have been administered intentionally. He denied that he injected Crawford and Lingerfelt with insulin. 

Hayes also said that “it would be extremely rare that a nurse would access medical records of a patient not under their care,” denying that he accessed Lingerfelt’s records the day she had her emergency and then claimed he “may have checked to see if she ‘needed a bag’” when confronted with evidence that he had in fact accessed the records. 

The warrants claim that Hayes said, “If it would make it right for these people and their families to have someone to pin it on, he could live with that.”

Then he claimed that Lingerfelt’s sister had caused her episode as they had allegedly been arguing that day. Lingerfelt’s sister works as a nurse practitioner near Lake Norman. 

“Hayes stated he would not have killed somebody and he would not have tried to kill somebody,” but when asked about those two patients he allegedly said, “I guess I gave it to her, that would make sense.” 

Then when pressed to tell the truth, he allegedly said that if it “made it right, then he did it” and that he “guessed he did it.” 

The warrants claim that Hayes said that, “if it would make it right for these people and their families to have someone to pin it on, he could live with that.”

Electronics seized

While reviewing electronic devices seized from Hayes’s home, he had texted his wife a message on March 2, 2021, that he’d sent his own fecal matter to get analyzed under a patient’s name to “see if he had worms.” He didn’t.

He also sent a picture of a dead man to his wife, saying he wanted to say goodbye to his “old friend who passed away that morning” on April 4, 2021. 

On Dec. 1, 2021, he sent a picture of a patient’s penis, saying he was a “dirty mess” and commenting on the patient’s smell.

There were also pictures of 25 patients’ hospital wristbands found on his phone. 

A rehire eligibility request for Novant Health, dated Feb. 23, 2022, was found on his computer, and there was a condition of employment notice for Novant Health dated March 9, 2022. He had worked there from 2018 to 2020 and said he left because of a “misunderstanding” about education hours and time-clock issues, and he claimed he “had trouble scanning medications on time.” 

Warrants were issued on Oct. 25, 2022, after both victims were exhumed and medical examiners noted the manner of death for both women was homicide. Hayes was charged with two counts of murder and one count of attempted murder.

Lawsuit

A class action lawsuit was filed on behalf of the estate of Crawford and other victims in relation to the alleged crimes committed by Hayes at Atrium Health Wake Forest Baptist.

The lawsuit is being filed by Lanier Law Group, P.A.

The class action lawsuit alleges that there were “red flags” that should have alerted the hospital administration that Hayes was giving more insulin to patients than any other employees at the hospital.

It further alleges that Hayes was not following hospital policies for “high alert” medication and that he was terminated from his previous employment for not handling medication properly.

The lawsuit accuses the hospital and Atrium Health of failing to properly supervise Hayes and failing to perform “audits to ensure patient safety” and alleges that patients were killed as a result.

You can read the full lawsuit here.