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A respiratory therapist has been charged with murder 20 years after a spate of strange deaths and emergencies at a small rural hospital in Missouri.

Jennifer Anne Hall, 41, was charged in the murder of Fern Franco, who died at Hedrick Medical Center in Chillicothe, Missouri, in May 2002.

A subsequent autopsy revealed that Franco had succinylcholine, a paralytic, and morphine in her system when she died, even though doctors never ordered those drugs for her, according to

During Hall's employment, from Dec. 16, 2001 through May 18, 2002, hospital employees said there was an increase in cardiac emergencies -- a total of 18, which was odd for a facility that would see about one code blue per year, according to reports.

Nine of those 18 patients died, and doctors and nurses at the hospital thought the incidents were suspicious, according to reports. The odd emergencies eased after Hall was let go, reports stated.

According to the Fox4 story, a nurse said Hall was near Franco's room when she stopped breathing, and that Hall entered the room with the nurse, which she thought was strange.

"Because of Hall's singular proximity to stricken patients, her access to pharmaceuticals which are deadly if misused, and her discovery and method of notifying staff of every patient's cardiac emergency, nursing staff believed Hall was responsible for the patient deaths," Chillicothe police officer Brian Schmidt .

Before she was hired by Hedrick Medical Center, Hall worked as a respiratory therapist at Cass Medical Center in Harrisonville, Missouri -- where she had been convicted of setting the facility on fire, according to a

She was imprisoned for a year before an appeals court vacated her conviction on the grounds that she had ineffective counsel at trial, and a jury acquitted her at a subsequent retrial, according to the local NPR affiliate.

Families of five patients who died during Hall's employment filed wrongful death lawsuits against the hospital in 2010, several years after the deaths, according to St. Louis Public Radio. Filing was delayed, the families said, because the hospital covered up what had happened, so they only learned of foul play years later.

The civil lawsuits charged that the hospital forced employees to conceal information about Hall's alleged actions, didn't request autopsies, disbanded committees that had been formed to evaluate the deaths, and neglected to preserve evidence, according to St. Louis Public Radio.

Ultimately, in 2019, the Missouri Supreme Court ruled the families had brought the lawsuits too late, determining that "fraud" wasn't enough of a reason to negate the 3-year statute of limitations for wrongful death cases.

Interest in the case was renewed after an analysis of Franco's tissue samples revealed the presence of succinylcholine and morphine, neither of which were ordered by her doctors, St. Louis Public Radio reported.

Since there's no statute of limitation for homicide, the first-degree murder charge was able to be brought 20 years later, by the Livingston County prosecutor.

The complaint against Hall lists 34 state witnesses, all of whom are listed only by their initials. Schmidt's probable cause statement said the witnesses "expressed fear for their lives and the safety of their families if Hall were to discover their names and personal information."

Hall, of Overland Park, Kansas, is not in custody, but she's now on the Livingston County Sheriff's most wanted list, and she's believed to be aware of the warrant out for her arrest. She may be using the last name of Semaboye, according to reports.

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