DALLAS — A Dallas anesthesiologist told a colleague that hospital supervisors were trying to “crucify” him over an alleged medical mistake shortly before he allegedly injected nerve blocking agents and other drugs into patient IV bags at a local surgery center, resulting in at least one death and as many as 11 other cardiac emergencies, according to a criminal complaint unsealed Thursday.
Raynaldo Rivera Ortiz Jr, 59, faces up to life in prison if convicted on federal charges of with tampering with a consumer product causing death, and intentional drug adulteration at Baylor Scott & White Surgicare North Dallas, located 12230 Coit Road.
Dallas police arrested Ortiz in Plano Wednesday on a federal warrant. He is currently in the Dallas County jail. He is expected to appear before a federal judge Friday. It’s unclear if he has an attorney.
The Texas Medical Board temporarily suspended his license last Friday, Sept. 9, calling him a threat to public safety.
“The safety of the nation’s pharmaceutical supply is critically important,” said Principal Deputy Assistant Attorney General Brian M. Boynton. The Justice Department “will vigorously prosecute this case consistent with the evidence gathered by our law enforcement partners.”
Last month, after identifying two instances of alleged IV bag contamination, Surgicare North Dallas “personnel determined that there were approximately ten other suspected incidents since late May 2022 where patients experienced unexpected cardiovascular complications during otherwise unremarkable surgeries,” the criminal complaint states.
On June 21, Dr. Melanie Kaspar, 55, a fellow anesthesiologist who had also worked at Surgicare North Dallas, took a saline bag from the facility to her Lakewood home to treat herself for dehydration. When she gave herself the IV, she “experienced a major medical event and died before emergency medical personnel arrived on the scene,” the criminal complaint says.
Don Tittle, attorney for her husband John Kaspar, told WFAA that as many as 15 patients were affected by tainted IV bags.
“We're following the investigation closely and John is relieved to hear that progress is being made,” Tittle said. “There really is little doubt that Melanie Kaspar's death was the result of an IV bag that had been tampered with.”
Surveillance video from the center’s operating room hallway allegedly showed Ortiz placing IV bags into a stainless-steel bag warmer shortly before other doctors’ patients experienced cardiac emergencies, the complaint states.
Ortiz has twice been disciplined by the Texas Medical Board – once for failing to report a conviction for shooting a neighbor’s dog in Collin County, and again for not administering life-saving measures to a patient in distress in 2020 at the North Garland Surgery Center. The second incident resulted in Ortiz losing medical privileges at that Garland facility.
A third disciplinary inquiry is detailed in the criminal complaint. On May 19, 2022, one of Ortiz’s patients at Surgicare North Dallas stopped breathing during a routine procedure, the complaint states. According to a review by the facility, Ortiz failed “to maintain the patient’s airway,” which was similar to the 2020 incident in Garland, the complaint states.
Ortiz “was aware” of the latest investigation into the May incident, and “expressed his unhappiness with it” to a colleague, the complaint states. “He expressed to a fellow doctor that (Surgicare North Dallas) was trying to ‘crucify’ him” and that losing the ability to work at the facility “would be financially ‘devastating,’” the complaint states.
Read the full complaint below:
“There appears to be a likely correlation between Ortiz coming under scrutiny for medical errors and the adverse events affecting other anesthesiologists’ patients,” the complaint states.
Hospital officials say they became aware of the tainted IV bags on Aug. 24 and “paused all operations” and notified “the appropriate local and federal authorities.”
That day, the Dallas County Medical Examiner’s office released its autopsy and toxicology test results in Kaspar’s June death. They ruled she died not from a heart attack, but from an overdose of bupivacaine, a drug used to numb patients in surgery. Also that day an 18-year-old man having routine surgery at Surgicare North Dallas “started bleeding out of control and his blood pressure spiked to around 200/150,” the criminal complaint says. The teen was intubated and transferred to a local ICU.
Investigators analyzed the IV bag used in the 18-year-old’s surgery and found traces of the potent stimulant epinephrine, as well as bupivacaine and lidocaine.
Two other suspected compromised IV bags from the facility’s warmer also tested positive for bupivacaine and lidocaine, the complaint states. Investigators also found small puncture holes in the clear plastic packaging bags that encase the IV bags, the complaint states.
Investigators say in addition to the 18-year-old, other patients went into cardiac distress at Surgicare North Dallas on May 26 and 27; June 27; July 7, 15 and 18; and Aug. 1, 4, 9 and 19, the complaint states.
In each case, the complaint said medics were able to stabilize the patients only through the use of emergency measures. Most of the incidents occurred during longer surgeries that used more than one IV bag, including one or more bags retrieved mid-surgery from a stainless steel bag warmer where Ortiz was seen on video placing bags.
Investigators said no cardiac incidents occurred from July 23-28 which is when Ortiz was on vacation. The incidents started occurring again after he returned around July 29, investigators say.
A nurse told investigators that during an August surgery where Ortiz was the anesthesiologist “she retrieved an IV bag from the warmer to use during the surgery, but … Ortiz strongly refused to use the bag and physically waived the bag off.”
Prosecutors have asked a judge to hold Ortiz pending trial, saying he is a flight risk.
“Our complaint alleges this defendant surreptitiously injected heart-stopping drugs into patient IV bags, decimating the Hippocratic oath,” said Chad Meacham. U.S. Attorney for the Northern District of Texas, which is prosecuting the case. “A single incident of seemingly intentional patient harm would be disconcerting; multiple incidents are truly disturbing. At this point, however, we believe that the problem is limited to one individual, who is currently behind bars.
The U.S. Food and Drug Administration Office of Criminal Investigation is investigating the case.
“Patients expect that their doctors will use only safe and effective medical products during their surgeries,” said FDA Office of Criminal Investigations Special Agent in Charge Charles L. Grinstead. “When illicit tampering occurs, serious harm and even death can result. Working with our law enforcement partners, we will continue to monitor, investigate and bring to justice those who would risk patients’ health and safety.”
If anyone has any additional information about the situation, or had any adverse reactions during surgery, WFAA would like you to email us at firstname.lastname@example.org.