CHILLICOTHE, Mo. — Prosecutors have charged a former Kansas City-area respiratory therapist with first-degree murder in the death of a hospital patient 20 years later.

The Livingston County, Missouri, prosecutor charged 41-year-old Jennifer Anne Hall with the 2002 murder of Fern Franco.

Franco had been hospitalized at Hedrick Medical Center in Chillicothe. She died in May 2002.

Court documents show Hall and another employee discovered Franco wasn’t breathing in her hospital bed. The nurse said Hall was near Franco’s room at the time Franco stopped breathing and Hall entered Franco’s room with her, which she thought was strange.

Staff attempted to revive Franco as she was “coding” and gave her atropine and epinephrine, but no other substances.

During an autopsy, a coroner found the presence of succinylcholine and morphine. An investigation determined the drugs were not prescribed to Franco or ordered by her doctors.

A medical expert said succinylcholine paralyzes a patient’s muscles, leaving the victim unable to breathe. The victim would suffocate while still maintaining full consciousness, according to the probable cause statement.

The probable cause statement shows Hall was a respiratory therapist at the medical center from December 2001 through May 2002.

She was placed on administrative leave May 18, 2002, two days after Franco died.

According to the probable cause, hospital employees reported the number of cardiac emergencies among patients receiving care at the medical center rose to 18 during Hall’s employment. Before she was hired, the hospital averaged one incident a year. The hospital reported the number of cardiac emergencies dropped after Hall was places on leave.

Of the 18 patients who suffered cardiac emergencies during that time, nine died.

Court documents show other nurses believed Hall was responsible for the patients deaths because of her proximity to the patients, her access to drugs which are deadly if misused, and the fact that she was involved in reporting each of the victim’s deaths.

Hall is not in custody at this time, and a warrant for her arrest was issued last week.

The Livingston County Sheriff’s Office asked anyone with information about Hall’s location to call (660) 664-0515.