Sally Jordan Hill, a former nurse anesthetist accused of intentionally killing a cosmetic surgery patient, appeared in Mecklenburg District Court on Monday with her wrists and legs shackled.

Hill, 50, is charged with murder in the April 2001 death of Sandra Baker Joyner, who stopped breathing in the recovery room after having a mini-face-lift at the Center for Cosmetic and Plastic Surgery in Charlotte.

Hill had been monitoring Joyner in recovery. The women also had been classmates at Olympic High School in the 1970s, and a source has said they didn't get along.

No details of the alleged crime were revealed during the hearing, which lasted less than a minute. Neither Hill nor prosecutors spoke. Police and prosecutors have declined to talk about a motive in the killing, which until Hill's arrest Friday had been considered an accidental poisoning.

Hill was brought into the courtroom in a red jumpsuit. District Court Judge Phil Howerton appointed her a lawyer, then set a bond hearing for Sept. 25 and a probable cause hearing for Oct. 2. She was then led out.

"I've gone into all the facts of this case," Golding said. "From the information I had, there wasn't any basis to arrest her. If there is some other evidence, I haven't heard about it yet."

According to police and court records, Joyner, 45, came through surgery without problems and then stopped breathing minutes after she was moved to the recovery room. She was rushed to Mercy Hospital, where she died five days later when doctors disconnected life support.

An autopsy showed she died from "probable medication toxicity." Hill admitted giving her a narcotic that authorities said caused her to go into respiratory arrest. Medical examiners ruled the death accidental.

The N.C. Medical Board investigated, and Joyner's family filed a malpractice lawsuit naming Hill and the surgeon, Dr. Peter Tucker. Terms of the court settlement have not been disclosed.

The Medical Board disciplined Tucker for failing to supervise Hill but "stopped short of laying the death at Dr. Tucker's feet," said Thom Mansfield, director of the board's legal department.

In October 2003, Tucker reached an agreement with the Medical Board. In it, the board said Hill was "grossly negligent" by failing to notify Tucker about Joyner's worsening condition. Hill also performed "medical acts without supervision," it said, by giving Joyner a potent painkiller, fentanyl, without getting the doctor's authorization.

"He didn't back away from his admissions in the consent order, but the only way he could understand what happened is that something very strange and unusual and extraordinary happened. Those are my words."

The meeting was not recorded, so there is no transcript of Tucker's remarks. One of his lawyers said Tucker would not comment on the pending criminal investigation.

Hill was fired after Joyner's death. Then in September 2004, the N.C. Board of Nursing charged her with failure to maintain an accurate record and failure to report information crucial to the safety of a patient in connection with Joyner's death.

Olympic High School yearbooks show they attended at least one year of high school together, 1972. Sandra Joyner's future husband, John Joyner, also attended Olympic that year.

Sandra Joyner, then Sandra Baker, graduated in 1973. She was on the student council, a cheerleader, and in the pep club, according to yearbooks.

Hill, then Sally Jordan, graduated in 1974. That year, she was head of the Trojanettes, the school's flag team. She is not listed in the 1973 Olympic High yearbook, and some members of that class have said they thought she left the school for a while.

After high school, Sandra Baker went to Western Carolina University. She later married John Joyner and had two sons. The Joyners had filed separation papers before her death.

Hill attended Central Piedmont Community College and was licensed as a nurse in 1977. After further training at Carolinas Medical Center, she was certified as a nurse anesthetist in 1982.

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