Judge Recommends Fining Delivery Nurse for Vulgar TikTok Video “Wish[ing] a Gruesome Birth Injury on the White House Press Secretary, Karoline Leavitt, While She Was Pregnant”

From Dep’t of Health v. Lawler, decided Sept. 1 by Florida Administrative Law Judge Robert Cohen:

On or about January 22, 2026, Respondent … posted a video on her TikTok account in which she wished a gruesome birth injury on the White House press secretary, Karoline Leavitt, while she was pregnant and awaiting the birth of her child[:]

As a labor and delivery nurse, it gives me great joy to wish Karoline Leavitt a fourth-degree tear. I hope that you f***ing rip from bow to stern and never s**t normally again, you c**t [redaction in the judge’s recommended order]….

Respondent identified herself in the Video as a labor and delivery nurse but made no mention of her employer Baptist Health and was unable to testify as to why she included her profession in the Video. Perhaps it was to lend credence to the fact she knew exactly what impact a “fourth-degree tear” could have on Ms. Leavitt.

Respondent’s testimony was that she was so frustrated and disgusted with the current administration in Washington, D.C., that her way of expressing it, lending her expertise in exactly what she was hoping happened to a complete stranger to her, was to wish a fourth-degree tear on President Trump’s press secretary….

[Another] experienced advanced registered nurse practitioner and a registered nurse … testified that “a fourth-degree tear is the worst tear that can potentially happen during the birth process.” It is so severe that, if occurring, the patient would have to have anywhere from a spinal anesthetic to general anesthesia to have the repair performed in an operating room. There can even be additional surgery required down the road to make further repairs to the affected area….

No evidence was produced that confirmed the TikTok account on which the Video was posted was private. Respondent produced no testimony or evidence that limited the audience that could view the Video by her efforts to keep the account private.

In fact, a group known as “Libs of TikTok” posted the Video on TikTok and, after obtaining the place of employment for Respondent, posted that as well. In short, thanks to a third-party group viewing the Video, which was obviously not private, the Video went viral….

Probably the most naive or outright untrue statements made at the final hearing by Respondent were that she was attacking Ms. Leavitt, not because she was both pregnant and the White House press secretary, but because she was part of “our government [that] commits human right’s [sic] violations on a daily basis by locking up women and children in concentration camps.” I sincerely doubt the “fourth-degree tear” statement would have been made if the subject of the Video was President Trump or Vice President Vance or any other male or a non-pregnant individual. The vile statement made in the heat of the moment, when Respondent was clearly angry, was targeted at the press secretary, a pregnant mother, and no one else….

As a nurse who has been recognized by her employer for her compassion, skill, and caring nature for her patients, directing such a specific, intrusive, vile outcome to a specific individual demonstrates a total lack of compassion and professionalism towards a person she has never even met….

Respondent is charged with violating section 464.018(1)(h) for committing “unprofessional conduct, as defined by board rule.” Rule 64B9-8.005 lists 17 different types of conduct that constitute “unprofessional conduct.” Subsection (14), which Respondent is charged with violating, states that unprofessional conduct includes “using abusive, threatening or foul language in front of a patient or directing such language toward a patient.” None of the bases for unprofessional conduct specifically refer to social media posts by a nurse.

When it comes to social media, the defense that the video was made in the privacy of Respondent’s own home and on her own time is insufficient. True, no evidence was presented to show that Respondent used her work computer at Baptist Health or was on the job in labor and delivery at the hospital when she posted the Video. Equally true is the fact that Respondent did not personally show the Video to or share the Video with a patient of Baptist Health in the presence of that patient. However, the rule language also includes the phrase “or directing such language toward a patient.”

Does subsection (14) of the rule state that the “abusive, threatening or foul language” must be directed to a specific patient or that the rule requires that the name of the specific patient must be included in the language (e.g., “this labor and delivery nurse hereby directs this language to Baptist Health patients E.G. and S.B.”)? It would be absurd to think a rule that can only be read to contemplate a statement (here, the Video which makes a crystal-clear statement) must be uttered by the nurse to the patient’s face while standing in front of that patient. According to the Merriam-Webster Dictionary, the base verb “direct” means “to cause to turn, move, or point undeviatingly or to follow a straight course” or “to point, extend, or project in a specified line or course.” It follows that combining the past participle of the verb “direct” and the preposition “to” (making “directed to”) would further refine the meaning to be “moved, pointed, … extended, or projected” toward a specific person, place, or purpose.

As stated by the Department, Respondent is attempting to hide behind the internet. In effect, she has testified that “I made this video exercising my First Amendment right to free speech on my own time in my own home.” Making a video and sending it to a few friends and family, or even a host of friends and family, via email or text might have completely changed the complexion of this case by truly keeping this private, even if friends or family members took the video and posted it themselves under their own names.

By posting the Video on TikTok, with some clearly provocative language aimed at a pregnant mom who happens to be a public figure, on a popular public social media platform, she should have known there was a risk of the posting going viral. On top of the risk of this “getting out” to the public, Respondent made things worse by identifying herself as a labor and delivery nurse. As an experienced labor and delivery nurse, she knew exactly what she was wishing upon Ms. Leavitt, and it was something pretty horrific for any woman experiencing labor and delivery, whether the White House press secretary or a regular mom presenting herself to a hospital hoping and praying for a routine and uneventful labor and delivery.

While the undersigned has no authority to determine, as a constitutional matter, whether the Video constitutes free speech, the undersigned finds that it does constitute a violation of rule 64B9-8.005(14), because the Video became widely enough distributed to reach two labor and delivery patients of Baptist Health. I will not speculate as to how many others might have viewed the Video and chosen not to choose that hospital for the birth of their babies.

Respondent warns me not to expand the plain language of rule 64B9-8.005(14) to implicitly include language “knew or should have known” and that my finding a violation somehow means that “anyone could see it who might be a patient someday.” This was not a someday in the future situation. Respondent knowingly posted the Video, the Video went viral because there were no private message controls in place, and two actual labor and delivery patients from Baptist Health viewed the Video before or close in time to when it was created, and they were disturbed by what they saw. Thankfully, neither of these patients actually received services from Respondent or were injured while Respondent served as their labor and delivery nurse. Had anything physically adverse to the patients who testified at hearing occurred, the penalty to follow could have been aggravated to a greater degree….

The undersigned believes that Respondent was somewhat naive as to the ease with which a video posted on a social media platform can be copied, modified, or even created from whole cloth when a member of the public views the video and wants to republish because they agree with its content or when they disagree with the content to show what they think of the person who posted it. The undersigned believes Respondent has learned from this experience, a costly one in terms of her losing her employment of many years with Baptist Health.

Further, the evidence from the two patients who testified was that they had neither filed nor contemplated filing lawsuits against Baptist Health or Respondent based upon their viewing of the Video. Moreover, no evidence was presented by the Department that Respondent has been disciplined by the Board of Nursing in the past. Finally, Respondent has been licensed as a registered nurse for about 14 years and, as just stated, has not been disciplined for any statutory or rule offenses during that time….

The undersigned believes that an appropriate penalty to be imposed in this matter is a reprimand from the Board of Nursing, a $250 fine, and continuing education to include at least one course in the appropriate use of social media and the pitfalls associated with its abuse….

I don’t think that the government may constitutionally impose such penalties on professionals for their public political speech, offensive and unprofessional as it might be. In most states, private employers would be free to discipline or even dismiss their employees for such speech (Lawler’s employer indeed fired her), and public employers may sometimes do the same, if the speech proves disruptive enough (the rules are complicated). But I don’t think this should be the business of licensing agencies who are using the government’s coercive power over all regulated employees, public or private, in the state. Still, the recommended decision struck me as worth noting, whether you think it’s right or wrong.

Note that the state had argued that Lawler’s license should be revoked, and it was indeed suspended on an emergency basis in January, but a Florida Court of Appeal had blocked the suspension, on condition that Lawler “practice nursing only in administrative roles that would require no patient contact, such as education, managed care case review, and records and claims auditing.” Presumably if the Administrative Law Judge’s recommendation is accepted by the Board of Nursing, her license would be fully reinstated.

Christina Shideler and Matthew Witters represent the Department.