there are different charges for intentional vs non-intentional crime, with usually more lenient sentencing for non-intentional crime, so the distinction does matter
The legal definition of fraud requires intent
If you take the feds at their word, they seem to consider 'reckless disregard for the truth' as a stand-in for intent.
Depending on how connected you are.
Elizabeth Holmes was pretty well connected. She heads off to jail in April.
Also, contrary to popular claims made here and everwhere else, the prison she's going to does in fact seem to have fences. With razorwire even.