Authorities noted in charging documents that the incidents began after a separate disciplinary investigation into the doctor, about which he had expressed his displeasure. Dr. A.S. Raynaldo Rivera Ortiz Jr. (Dallas Police Department) Dr. A.S. Raynaldo Rivera Ortiz Jr., 59, was taken into custody in Plano on Wednesday, Dallas police said. He faces federal charges of adulteration of a consumer product causing death and intentional drug adulteration. Ortiz was being held in the Dallas County Jail on Thursday. He did not have an attorney listed in court records. Ortiz, an anesthesiologist, is part of an ongoing criminal investigation into serious heart complications suffered by patients at Baylor Scott & White Surgery North Dallas and the death of 55-year-old Melanie Kaspar, another anesthesiologist at the facility. In a statement, the health care system — which suspended operations at its North Dallas facility — said it was assisting authorities in the investigation and would continue to do so. “There is nothing more important than the safety and well-being of those we serve,” the statement said. If convicted, Ortiz faces a maximum sentence of life in prison. “Patients expect their doctors to use only safe and effective medical products during their surgeries. When an illegal breach occurs, serious harm and even death can result,” Charles Grinstead, special agent in charge of the FDA’s Office of Criminal Investigation, said in a written statement. “Working with our law enforcement partners, we will continue to monitor, investigate and bring to justice those who would endanger the health and safety of patients.”
A pattern emerges
On June 21, authorities were called to Kaspar’s Lakewood home after her husband said she gave herself an IV and then complained of severe pain about half an hour later before collapsing, according to a police incident report. Rescuers were unable to revive her. Although Kaspar was initially thought to have died of a heart attack, the Dallas County Medical Examiner’s Office later determined that the cause of her death was the toxic effects of bupivacaine, a local anesthetic. The Texas Medical Board said Caspar used an IV bag from the facility, where Ortiz was seen on surveillance footage placing IV bags in a warmer outside operating room. According to the board, lab testing of the IV bags from the warmer showed they had been tampered with and were not labeled to reveal they contained bupivacaine. “Such drugs could and would be fatal when administered unknowingly and intravenously,” the board wrote. Another compromised IV bag left an 18-year-old man on a ventilator after what the panel called “routine surgery.” On August 24, the patient went in for surgery at the center to repair a deviated septum, but the procedure was stopped when his blood pressure rose so high it caused severe respiratory distress. The patient was intubated and placed on a ventilator. He was released five days later in good condition, said Bruce Steckler, the family’s attorney. An analysis of the fluid from the saline bag used during the teenager’s surgery revealed the presence of bupivacaine, epinephrine and lidocaine, other drugs that could have caused the patient’s sudden symptoms. Those two incidents indicated “a pattern of intentional tampering with the IVs used,” surgery center staff found, according to the criminal complaint against Ortiz.
10 more emergencies
Surgery center staff identified 10 additional “unexpected cardiac emergencies” that occurred during “otherwise minor surgeries” between May and August, an “extremely high rate of complications in a short period of time,” the US attorney’s office said. The majority of incidents occurred during longer surgical procedures using more than one IV bag, including bags retrieved intraoperatively from a stainless steel bag warmer. The criminal complaint described an instance in which Ortiz was seen on video walking quickly from the operating room to the bag warmer, placing a bag inside, looking both ways down the empty hallway and then quickly walking away. A little more than an hour later, according to the document, a 56-year-old woman suffered a cardiac emergency during a cosmetic procedure after a bag from the heater was used during the procedure. In another instance, the complaint says, video showed Ortiz leaving an operating room carrying an IVF bag hidden in a paper envelope, swapping the bag with another bag from the warmer and walking away. About half an hour later, a 54-year-old woman suffered a cardiac emergency during a cosmetic procedure after using a bag from the heater. Authorities wrote in the criminal complaint that no other workers were seen placing individual IV bags in the heater. “Our complaint alleges that this defendant secretly injected heart-stopping drugs into patients’ IV bags in violation of the Hippocratic Oath,” U.S. Attorney Chad E. Meacham said in a written statement.
The license has been suspended
Last Thursday, federal authorities contacted the Texas Medical Board about the criminal investigation. They suspended Ortiz’s medical license Friday after concluding he posed an “imminent risk” to public health. Ortiz was previously disciplined by the state medical board in August regarding a 2020 procedure in which he administered anesthesia and the patient required CPR. The board ordered Ortiz to have another doctor monitor his practice, receive additional training and pay a $3,000 fine. In 2018, he was reprimanded for not reporting his arrest on animal cruelty charges. Days before the incidents began in May, Ortiz learned of another disciplinary investigation into a patient who stopped breathing while under his care during a procedure at Surgicare North Dallas, according to the criminal complaint. According to the US attorney’s office, Ortiz “expressed concern” to other doctors about the disciplinary action and complained that the center was trying to “crucify” him. A doctor at the surgery center told authorities that losing Ortiz’s job at the facility would be financially devastating. According to Collin County records, Ortiz accrued $4.1 million in unpaid taxes to the IRS from 2015 to 2020. The IRS removed a lien on his home after he paid a portion of that amount, but tax liens filed in 2021 and in 2022 he said he owed more than $570,000. Property records show Ortiz’s 7,700-square-foot home in Murphy is assessed at $1.3 million. Baylor Scott & White said it is contacting recent patients, and patients with questions can call 214-818-2794.
