WINSTON-SALEM (AP) — A former nurse at a North Carolina hospital has been charged in the deaths of two patients after officials said he injected them with lethal doses of insulin.

Forsyth County District Attorney Jim O’Neill announced at a news conference Tuesday that Johnathan Howard Hayes, a registered nurse, was charged with two counts of murder and one count of attempted murder, news outlets reported. Hayes worked at Atrium Health Wake Forest Baptist Medical Center in Winston-Salem.

Hayes was ordered held without bond at a first appearance Wednesday, police said. His case was referred to the public defender’s office, but one hasn’t been assigned yet, according to the clerk of the court’s office.

The 47-year-old Winston-Salem man, described by O’Neill as a “rogue nurse,” is accused of administering a near-fatal dose of insulin to Pamela Little on Dec. 1, 2021, O’Neill said. Little survived. On Jan. 5, Hayes administered a lethal dose of insulin to patient Gwen Crawford, who died three days later, O’Neill said. On Jan. 22, Hayes gave another lethal dose of insulin to Vickie Lingerfelt, who died five days later, he said.

O’Neill said he and detectives met in March with Atrium Health officials, who presented details of an investigation that appeared to show that Hayes had injected a lethal dose of insulin into a patient, causing that patient’s death and possibly others. Winston-Salem police took on the investigation and after consulting with the Office of the Chief Medical Examiner and Winston-Salem police, O’Neill said he found that police had probable cause to charge Hayes. It doesn’t appear that Hayes knew the patients and there’s no apparent motive, O’Neill said. Evidence indicates Hayes acted alone, he said.

O’Neill, whose wife is a doctor at Atrium Health, stressed that Hayes’ alleged actions don’t reflect the care that the hospital provides.

“Johnathan Hayes has forfeited the honor of being called a nurse,” O’Neill said. “From this day forward, he will be known as a defendant.”

Hayes, who had worked at the hospital at various times over the past 15 years, was fired March 18, Atrium Health spokesman Joe McCloskey said. Hayes had worked at the hospital at various times over the past 15 years.

When Atrium Health officials learned of these “disturbing events, they reached out to the patients’ families, said Denise Potter, vice president of marketing, communications and media.

“As soon as we identified a deviation from patient care as part of our established safety protocols, we took immediate action to remove the employee from the patient care environment and terminated his employment,” she said. Officials also analyzed safety protocols to ensure something like this doesn’t happen again, Potter said.

Last year, Hayes’ wife, Misty, nominated Johnathan Hayes as a nurse of distinction for the Celebrating Nurses of the Triad special section coordinated by the Winston-Salem Journal, News & Record and the N.C. Nurses Association. In her nomination, Misty Hayes said her husband would make sure patients had everything they needed and knew “that they will be taken good care of,” the Winston-Salem Journal reported.

Hayes had been in nursing for 21 years and worked during the COVID-19 pandemic, according to the article.

“The biggest takeaway from the pandemic has been to never take your life for granted,” Hayes said in the article. “Always treat everyone the same as you would want to be treated.”