Welcome to another episode of Behind the Headlines, where we feature experts and journalists discussing a variety of topics.

In this latest episode, Virginia Annable, a reporter for Lee Enterprises Public Service Journalism team based in Hickory, North Carolina, discusses her story about Johnathan Howard Hayes, a nurse in Winston-Salem, North Carolina.

Hayes stands accused of murder and attempted murder of patients in a hospital where he worked. Hayes is accused of intentionally administering a near-lethal dose of insulin to a patient in the same year he was nominated to be a nurse of distinction.

He is also accused of administering similar lethal doses of insulin to two other patients in early 2022, killing both, according to Winston-Salem police. Hayes was arrested in October 2022, on one count of attempted first-degree murder and two counts of murder.

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NC nurse accused of killing 2 patients was family man with history of medicine mismanagement

About this program

Host Terry Lipshetz is a senior producer for Lee Enterprises. Besides producing interviews for this Behind the Headlines program, he produces the daily Hot off the Wire news podcast, co-hosts Streamed & Screened movies and television program and is the producer of Across the Sky weather and climate podcast.

Lee Enterprises produces many national, regional and sports podcasts. Learn more here.

Episode transcript

Note: The following transcript was created by Headliner and may contain misspellings and other inaccuracies as it was generated automatically:

Terry Lipshetz: Welcome to another episode of behind the Headlines, where we feature experts and journalists discussing a variety of topics. I'm Terry Lipshetz, a senior producer for Lee Enterprises, and your host in this latest episode, Virginia Annable, a reporter for Lee Enterprises public service journalism team based in Hickory, North Carolina, discusses her story about Jonathan Howard Hayes, a nurse in Winston Salem, North Carolina, who is accused of killing two patients with fatal doses of insulin. Hayes was arrested in October 2022 on one count of attempted first degree murder and two counts of murder. Virginia, welcome to the program.

Virginia Annable: Thank you for having me.

Terry Lipshetz: Can you talk a little bit about the case, what exactly happened and where things stand at the moment?

Virginia Annable: Sure, yeah. This case came to public attention in October 2022, when the district, attorney of Forsyth County and the atrium, Wake Forest Baptist Hospital, came out with a press conference and announced that they had arrested Jonathan Howard Hayes. He was a nurse at Wake Forest, and he was accused of killing two patients and attempting to kill a third. Since then, there hasn't been a lot of movement in the case, but it really caught the public's attention. Just the fact that there was this nurse who lived in the community, had been a nurse for 20 years, on the surface, seemed like everything was right. And then they were accusing him, of some pretty horrific things. So it really caught the attention of the whole state with these accusations.

Terry Lipshetz: Has there been a trial date yet? What's the status?

Virginia Annable: He has only appeared in court for his first appearance. They gave him no bond. And since then, there's been a couple dates set for an appearance. And it just keeps getting pushed back. It's really gotten dragged out. I mean, it's been almost a year now and, there's been very little movement on it.

Jonathan Hayes is accused of killing two patients with lethal doses of insulin

Terry Lipshetz: You talk a little bit about the two patients that died and also the one that survived, but what was the cause of death and what is he essentially being accused of here?

Virginia Annable: The hospital gave a really thorough timeline and a lot of information into the police, and that was all detailed in the search warrant application. So we have a really good look at what happened and what the hospital is saying. Their investigation found the first accusation was Pamela Jean Little. In December of 2021, she had an overdose of insulin and had a hypoglycemic event, which is when their blood sugar drops very, very low and it can cause a coma or death. Little was lucky enough to survive, but the accusation is that Jonathan Hayes overdosed her with potentially 100 units of insulin. When the typical, largest amount you would get is twelve. Then the second patient is Gwenda Zelda Crawford. And on January 5, at least, the doctors say that she had an overdose of about 100 units of insulin. She went into a coma. They took her to the ICU. Ah. But she unfortunately passed away a few days later. And then there was a third patient, Vicky Lynn Lingerfeld. And on January 22, she also had a hypoglycemic event where her blood sugar just dropped out. They did the blood test. They believe it was again over 100 units of insulin. And she went to the ICU, but she also passed away a few days later. The documents and all the hospital investigation found that Hayes was the only nurse present at all three events.

Terry Lipshetz: In your reporting, it mentions that Hayes administered seven times more insulin than others at the hospital. Can you talk a little bit about that finding?

Virginia Annable: So it sounds like after these three events, the hospital started looking into it and realized there was something wrong. And, then they kind of found the link to Hayes. And once they saw that, they did investigation into his medication usage and the amount of insulin he was using. And it's really interesting, the number that they found was he was the top administrator of insulin in the entire hospital. It's a very big hospital of any employee for a three month period. And he was also administering seven times the average of the whole hospital staff. So for how much insulin? Everyone the average of what everyone was administering, he was typically administering, like, seven times that. So there's a pretty big indication that there are some issues with medication administration. There is also some it's a little bit more tricky to explain, but the way that he was supposed to be verifying, medication administration, he was oftentimes saying it was given by other instead of putting a specific name down when administering medication. The hospital says that of the 130 times that given by other was used during medication administration, he did it 88 times. And that's for the entire hospital.

What is the dual verification process for certain medications?

Terry Lipshetz: Yeah, I wanted to follow up on that a little bit, because in your story, you talked a little bit about a dual verification process. So the idea being that with certain medications or maybe all medications, when a nurse is about to administer it, somebody else is there. Can you talk a little bit about that and what the expectation is under normal circumstances?

Virginia Annable: Yeah. So with hospitals, certain medications they call high alert. Medications that are maybe like an opiate or something like insulin that's more regulated. Nurses or doctors, et cetera, are required to have two people present and two people verify that this dose is acceptable and this is how much we're giving to the patient. There is a small way to get around that. And that's the given by other designation, which is typically reserved for, like, if there's an emergency or someone gave the patient the medication while they were getting an X ray or just something a little bit out of the ordinary where it might be harder to get that dual verification. But then medication was needed. But it seems very rarely used.

Terry Lipshetz: So under a normal circumstance, if a patient's in a hospital room and there's nothing else crazy going on, the expectation would be there'd be a dual verification and not just given by just one person.

Virginia Annable: Not just one person and given by other. Like, there's two medical personnel who kind of sign off on it.

What is a risk management team at hospital?

Terry Lipshetz: You mentioned a little bit, too, about the risk management team at the hospital. What exactly is that, and what's the function?

Virginia Annable: The risk management team, they kind of look into when the, hospital staff or anyone kind of says, there's a problem here. So in this case, they saw a pattern of these hypoglycemic episodes, and the risk management team steps in and does an evaluation, and they actually have a whole form that they fill out for each event and what happens, and they go as far to interview employees, and they check all of the records related to it. And they were, like, a full system check of what nurses were accessing, what information related to the incident. it's pretty interesting, just the amount of detail that they looked into. And the risk management team was able to meet with the police and turn over all of that information. And so the police can investigate from there and kind of verify everything they found.

Terry Lipshetz: Once this risk management team discovered there were some issues here with this case in particular, what did they do?

Virginia Annable: It sounds like as soon...

North Carolina nurse accused of killing patients with lethal doses of insulin

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