Inset: Sharlene Pflugrad (Lee County Jail). Background: Lee County Circuit Courthouse (Google Maps).
A 65-year-old Florida home health nurse accused of ignoring repeated oxygen alarms while caring for a vulnerable premature baby will now face trial, after a judge declined to approve her proposed plea agreement during a strained hearing.
Sharlene Janet Pflugrad had expected to settle a felony child neglect case with a no-contest plea. But Lee County Judge Bruce Kyle rejected the deal after Pflugrad appeared uncertain when questioned in court about whether she fully accepted the terms of the agreement.
Court records, including a probable cause affidavit from the Cape Coral Police Department, say Pflugrad was assigned to an overnight shift on Sept. 15, 2025, caring for an infant born at just 24 weeks gestation who needed constant oxygen monitoring while asleep.
The baby’s parents told investigators that the child’s doctor-approved care plan required Pflugrad to provide up to two liters of oxygen if the infant’s oxygen saturation fell below 88%. She was also supposed to alert the parents, contact the nursing agency and call 911 if the situation required emergency help.
Authorities allege that instead of following those steps, Pflugrad texted the child’s mother at 11:24 p.m. with photos showing oxygen levels at 81% and 79%, but did not wake the parents or take the emergency actions outlined in the care plan.
The mother later told police she did not see the message until about 6:13 a.m. the next morning. When she and the child’s father checked on their son, they allegedly found him still having difficulty breathing. According to the affidavit, the parents tried to improve his oxygen levels themselves before calling 911 after even four liters of oxygen failed to bring him back into a safe range.
Investigators said home surveillance video appeared to show Pflugrad silencing the pulse oximeter alarms again and again through the night. Police reviewed 147 clips that allegedly captured her muting alerts, replacing sensors multiple times, telling the machine to “shut up,” briefly doing chest cupping, and continuing to quiet the alarms without giving oxygen or seeking emergency medical assistance.
The infant was taken to Golisano Children’s Hospital, where doctors diagnosed RSV bronchiolitis, respiratory acidosis and prolonged oxygen deprivation. A medical evaluation later concluded there was evidence of medical neglect, finding Pflugrad failed to perform even basic nursing assessments while the child remained in respiratory distress. The child ultimately recovered and was discharged the following day.
Investigators also sent the pulse oximeter to its manufacturer, Masimo, for testing after Pflugrad suggested the readings may have resulted from equipment problems. According to the affidavit, technicians found the monitor functioned properly and identified no defects.
Pflugrad declined to provide a statement to detectives, though investigators obtained a written statement she submitted to her employer, Aveanna Healthcare. In it, she wrote that she believed the oxygen readings were fluctuating because of sensor issues, repositioned the child, changed sensors several times and texted the child’s mother but did not administer oxygen because she believed the readings did not remain low long enough to constitute an emergency.
Aveanna’s internal investigation reached the opposite conclusion. According to records cited in the affidavit, company officials found Pflugrad failed to administer oxygen, perform required assessments or properly document the child’s care. She was suspended without pay.
The affidavit also notes Pflugrad was previously investigated in 2024 in connection with another medically fragile child after detectives alleged she ignored multiple medical alerts that resulted in permanent brain damage. Prosecutors ultimately declined to file charges in that case.
Prosecutors had offered Pflugrad a plea agreement that would have required her to serve 364 days in the Lee County Jail followed by 48 months of probation, Fort Myers-based CBS affiliate WINK reported. The deal also would have required Pflugrad to forfeit her nursing license, have no contact with the victim or the victim’s family, submit a DNA sample, and pay court costs.
However, during Monday’s hearing, confusion arose after Pflugrad appeared uncertain regarding both her legal representation and her negotiated plea deal. Judge Kyle warned that if she rejected the plea, the case would proceed to trial immediately.
After more than an hour outside the courtroom, Pflugrad reportedly returned and indicated she wanted to accept the agreement. But when Kyle asked whether the signature on the plea form reflected that she agreed with its terms, she allegedly responded, “Not really, but.”
Pflugrad’s response was enough for the judge to reject the deal.
“See you tomorrow morning, 8:30 for trial,” Kyle reportedly said. “I cannot accept the plea after that.”
“No, I meant yes, sir,” Pflugrad said as the judge spoke. “Please,” she added repeatedly, as the judge appeared to ignore her and insist on seeing her at trial the following morning.
The station reported that Pflugrad pleaded with the judge to reconsider, but he refused. Pflugrad’s trial is scheduled to begin Tuesday morning, records show.
