A Florida in-home nurse accused of repeatedly muting a premature infant’s oxygen monitor instead of providing emergency care is set to face trial after a judge refused to accept her negotiated plea agreement during a tense court hearing.
Sharlene Janet Pflugrad, 65, is charged with felony child neglect in Lee County. She had planned to resolve the case by entering a no-contest plea, but Lee County Judge Bruce Kyle rejected the agreement after determining that Pflugrad did not clearly acknowledge and accept its terms.
Allegations Stem From Overnight Care of Premature Infant
According to a probable cause affidavit filed by the Cape Coral Police Department, the incident occurred during an overnight nursing shift on Sept. 15, 2025. Pflugrad had been assigned to care for a medically fragile infant who had been born at just 24 weeks of pregnancy and required continuous oxygen monitoring while sleeping.
Investigators said the child’s physician-approved care plan required the nurse to administer up to two liters of oxygen whenever the infant’s oxygen saturation dropped below 88%. She was also required to immediately notify the parents, contact the nursing agency and call 911 if necessary.
Police allege that instead of following those procedures, Pflugrad sent the child’s mother a text message at about 11:24 p.m. containing photos showing oxygen saturation levels of 81% and 79%, but did not wake the parents or seek emergency medical assistance.
Parents Found Baby Still Struggling Hours Later
The child’s mother told investigators she did not see the message until approximately 6:13 a.m. the next morning.
After discovering the text, she and the child’s father rushed to check on their son and found him still struggling to breathe. The parents attempted to increase his oxygen levels themselves. When four liters of oxygen failed to improve the child’s condition, they called 911 for emergency assistance.
Surveillance Video Allegedly Shows Nurse Muting Alarms
Investigators reviewed home surveillance footage from the overnight shift and said the recordings showed Pflugrad repeatedly silencing the baby’s pulse oximeter alarms rather than responding to them.
According to police, detectives examined 147 separate video clips that allegedly showed the nurse:
- Muting the oxygen monitor’s alarms multiple times.
- Repositioning the infant.
- Replacing oxygen sensors several times.
- Telling the monitor to “shut up.”
- Briefly performing chest cupping.
- Continuing to silence alarms without administering oxygen or contacting emergency responders.
Authorities allege the repeated alarms indicated the infant was experiencing ongoing respiratory distress throughout the night.
Doctors Diagnosed Serious Oxygen Deprivation
The infant was transported to Golisano Children’s Hospital, where doctors diagnosed RSV bronchiolitis, respiratory acidosis and prolonged oxygen deprivation.
Medical professionals later concluded there was evidence of medical neglect, stating that Pflugrad failed to carry out even basic nursing assessments while the child remained in respiratory distress.
Fortunately, the infant recovered after treatment and was discharged from the hospital the following day.
Equipment Tested After Nurse Raised Concerns
During the investigation, Pflugrad reportedly suggested the oxygen monitor may have produced inaccurate readings because of equipment problems.
To verify the claim, investigators sent the pulse oximeter to manufacturer Masimo for testing.
According to the affidavit, technicians found the monitor was functioning properly and identified no defects that would have explained the repeated low oxygen readings.
Written Statement Contradicted Internal Investigation
Police said Pflugrad declined to provide detectives with an interview.
However, investigators obtained a written statement she had submitted to her employer, Aveanna Healthcare.
In that statement, Pflugrad reportedly said she believed the oxygen readings were fluctuating because of sensor issues. She stated that she repositioned the child, replaced the sensors several times and texted the child’s mother, but did not administer oxygen because she believed the readings did not remain below the threshold long enough to qualify as an emergency.
Aveanna Healthcare’s internal investigation reached a different conclusion.
According to records cited in the affidavit, company officials concluded that Pflugrad failed to administer oxygen, did not perform required nursing assessments and inadequately documented the infant’s care. She was subsequently suspended without pay.
Investigators Referenced Earlier Case
Court records also note that Pflugrad had previously been investigated in 2024 involving another medically fragile child.
Detectives in that earlier case alleged she ignored multiple medical alerts that allegedly resulted in permanent brain damage to another child. Prosecutors ultimately declined to file criminal charges in that investigation.
Judge Rejects Negotiated Plea Agreement
Prosecutors had offered Pflugrad a plea agreement that included:
- 364 days in the Lee County Jail.
- 48 months of probation.
- Permanent surrender of her nursing license.
- No contact with the child or the child’s family.
- Submission of a DNA sample.
- Payment of court costs.
During Monday’s hearing, however, confusion arose regarding both Pflugrad’s legal representation and whether she fully accepted the plea agreement.
Judge Bruce Kyle warned that if she rejected the agreement, the case would move directly to trial.
After spending more than an hour outside the courtroom, Pflugrad returned and indicated she wanted to proceed with the plea.
However, when the judge asked whether the signature on the plea form reflected that she agreed with its terms, Pflugrad reportedly answered, “Not really, but.”
Judge Kyle immediately rejected the agreement.
“See you tomorrow morning, 8:30 for trial. I cannot accept the plea after that,” the judge reportedly told her.
Pflugrad attempted to clarify, saying, “No, I meant yes, sir,” and repeatedly pleaded with the judge to reconsider. Despite her requests, the judge refused to accept the plea and ordered the case to proceed to trial.
Trial Scheduled
Court records show Pflugrad’s trial is scheduled to begin Tuesday morning in Lee County. Prosecutors will seek to prove that the former in-home nurse failed to provide required emergency medical care to a medically fragile premature infant by repeatedly silencing oxygen alarms instead of responding to the child’s deteriorating condition.
