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The Tennessee Bureau of Investigation has opened its own investigation into the medication error at a Nashville hospital that left four surgery patients seriously harmed, including one paralyzed, on Aug. 14.

A bureau spokesperson confirmed to The Epoch Times that the investigation into the incident at Ascension St. Thomas Midtown Hospital in Nashville is active and ongoing.

The possibility of criminal charges comes on top of an ongoing administrative inquiry by the Tennessee Health Facilities Commission, which has rejected the hospital’s initial corrective action plans after a five-day onsite investigation.

The facility self-reported the error the day it happened, according to a hospital statement.

The joint-replacement patients were given potassium phosphate, normally used to treat low levels of blood phosphorus, instead of the spinal anesthetic Mepivacaine when undergoing joint replacements.

All four patients experienced neurological systems, trouble breathing, and poor circulation. The most severely affected patient was paralyzed below the midsection.

According to a Health Facilities Commission report, a cascade of errors led to four of seven surgery patients receiving the wrong drug.

Starting on Aug. 13, the day before the surgeries, video surveillance showed hospital employees preparing the medication for the following day, the report said.

One employee retrieved the wrong medication from supply bins. A second drew the medication into syringes. And a third signed off on the preparation and set the drug out for use the following day, as documented in the commission’s report.