Five years ago, Joyner died after cosmetic surgery at a clinic where Hill worked.

On Friday, police charged Hill with murder. Hill had administered Joyner's anesthesia during a mini-facelift at the Center for Cosmetic and Plastic Surgery in Charlotte.

Joyner, 45, stopped breathing in the recovery room and later died. She had been given an excessive dose of a narcotic, which caused respiratory arrest.

The state Medical Examiner's Office ruled the April 2001 death an accidental poisoning. But Friday, Charlotte-Mecklenburg police said it was intentional.

Hill, 50, of Matthews was arrested Friday. She had worked as a certified nurse anesthetist, police said, and had been monitoring Joyner in recovery.

Detective Chuck Henson, who investigated the case, said the outpatient surgical procedure went well and that Joyner was awake and talking when she was moved to the recovery room. Moments later, she became unresponsive.

The center's staff performed life-saving procedures, and Joyner was rushed to Mercy Hospital, Henson said. She died five days later, when doctors ended life support.

Police would not talk Friday about a motive.

At a news conference, Henson said the women knew each other "when they were girls" and had gone went to Olympic High School together. But he declined to talk about their relationship or how well they knew each other, saying it could reveal a motive.

Although Joyner's death had been ruled an accident, the N.C. Medical Board investigated, and Joyner's family filed a malpractice lawsuit naming Hill and the surgeon, Dr. Peter Tucker.

In 2003, Tucker reached an agreement with the board, accepting responsibility for the death but avoiding suspension of his license. He is still a surgeon at the center. A woman who answered the phone at Tucker's office on Friday said he had no comment.

A consent order that Tucker signed with the board put much of the blame on Hill, calling her "grossly negligent." In court papers, both Tucker and Hill denied responsibility for Joyner's death. The lawsuit was settled in October 2003, and the parties agreed not to release the terms.

Hill told The Observer that she had given Joyner fentanyl, a painkiller that authorities say caused her death. Hill had been a nurse for more than 20 years and had administered anesthesia to Joyner at the clinic during one earlier cosmetic surgery. She said she had previously been told to give the drug to patients.

Hill said she had been "tormented" by Joyner's death. She said that she had been fired after the death.

Flaws in records

The state Board of Nursing charged Hill with failure to maintain an accurate record and failure to report information crucial to the safety of a patient.

The medical board's consent order said that Hill failed to alert the doctor about Joyner's deteriorating condition and performed medical acts without supervision from a licensed physician.

In 2004, she voluntarily surrendered her license for a year and never applied to get it back, records show.

Police get involved

Police Capt. Sean Mulhall said that Joyner's death was not reported to police in 2001 and had not been investigated until this year. Henson, a member of the cold case homicide squad, said prosecutors asked his team to look at it.

District Attorney Peter Gilchrist said his office asked for an investigation after receiving information about Joyner's death. He declined to be more specific.

Henson said Joyner's family was shocked by news of the investigation and the arrest. The Observer could not reach them Friday. Henson said they were out of town.

Joyner was a longtime Charlotte resident who went to Western Carolina University after Olympic High. She and her husband, John, had two sons.

After high school, Hill went to Central Piedmont Community College and got a certified nurse anesthetist license in 1977. Police said she was not employed at the time of her arrest.

Late Friday, she was in the Mecklenburg County jail.