30-year Grudge?

updated 10/02/2006 AT 01:00 AM EDT

originally published 10/02/2006 AT 01:00 AM EDT

Sandra was captain of the cheerleading squad, a member of the pep club, on the student council—"just beautiful, bubbly and popular," as one high school classmate recalls. Sally was pretty too, but she didn't make the cheerleading team and settled for heading the school's flag corps. Sandra and Sally moved in the same circles at Olympic High School in Charlotte, N.C., and even dated the same handsome jock. After graduation they went their separate ways, until their paths crossed again 30 years later in a plastic surgeon's office.

The encounter left one of them dead and the other charged with murder.

Sandra Joyner, 45, died after undergoing cosmetic surgery in 2001; her death, from an overdose of a painkiller, was at first ruled an accident. But this Sept. 8, police arrested Sally Jordan Hill, 50—the nurse anesthetist who gave Joyner the painkiller—and charged her with murder. Charlotte police won't discuss Hill's motive or the tip they received in January that led to the arrest. But according to published reports, police believe Hill may have held a 30-year grudge against Joyner, possibly for stealing her boyfriend in high school. Hill's arrest "was a shock," says Sandra's husband, John Joyner, 52, her high school sweetheart and father of her two college-age sons. "But I never understood how a healthy woman could go into cosmetic surgery and come out in a vegetative state."

Hill, whose attorneys did not return calls from PEOPLE, is in jail awaiting a bond hearing Sept. 25. "That she would hold a grudge for 30 years is ridiculous," says her mother-in-law Anita Hill. But the Charlotte Observer reported that the investigating officer, Det. Chuck Henson, had been told that the doctor and a surgical technician overheard Hill say Joyner "stole my boyfriend." Former classmate Mark Perry recalls that Joyner dated the jock after Hill did and that "there may have been some competition between them. But it was a losing battle for anyone who thought they could compete with Sandra."

Sandra Joyner separated from her husband, a mining company manager, in 2001 and decided to have plastic surgery as a way to start over. By all accounts she did not recognize Sally Hill when she saw her at the Center for Cosmetic and Plastic Surgery in Charlotte, which she first visited in 1999 to fix a droopy eyelid. The four procedures in 2001—a mini face lift, lip graft, and laser therapy on the lower eyelids and facial scars—went smoothly, and Joyner was walking and talking when she went to the clinic's recovery room. Then she complained of face pain.

So Hill—filling in for the recovery room nurse, something she often did—allegedly injected her with 2 cc of the painkiller Fentanyl. After that, "the first thing I noticed was the pulse ... had dropped," Hill later said. "I went and got Robinul [regulates heart rate] and ephedrine [a bronchodilator]." Seconds later Joyner was in respiratory arrest. Yet according to nurses in attendance, Hill didn't alert Joyner's surgeon Peter Tucker. The nurse who noticed Joyner's condition and summoned Dr. Tucker told investigators, "I don't recall Sally doing anything but standing back" during efforts to revive Joyner. "She seemed calm."

An EMS crew rushed Joyner to a hospital, where she was pronounced brain dead. Five days later her family pulled her off life support. The North Carolina Medical Board found a failure to take immediate action (intubation and resuscitation) may have led to Joyner's death. But Hill—who has battled leukemia since before the incident, and who recently separated from her husband of 20 years—told investigators, "I've reviewed this a million times [and] I can't think of anything I'd do different."

Yet the nursing board cited Hill for, among other offenses, giving medications without authorization and failing to promptly notify the doctors in an emergency. She was also cited for poorly documenting the amount of medication she gave patients. Even so, the board ruled the death an accident. "There was no reason to charge her with criminal liability," says attorney John G. Golding, who represented Hill in the malpractice suit filed by Joyner's family (the settlement was not disclosed). A month after the death, the center fired Hill, and in 2004 she gave up her nursing license. "She was really upset" by Joyner's death, says Patty Campbell, a nurse who worked with her at the center. "Sally is a devout Christian and she wouldn't hold a grudge for 30 years. I know she didn't do it."

Prosecutors will now try to prove otherwise and try to trace a tragic death all the way back to a high school feud. Only "Sandra Joyner, me and Jesus were there" in the recovery room, Sally Hill told investigators, "and [we know] what happened."

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