DALLAS — Dallas police on Wednesday arrested a 59-year-old Richardson anesthesiologist on a federal warrant on suspicion of allegedly contaminating IV bags at a North Dallas surgical center, resulting in the death of a fellow Dallas physician and injuries to several other patients.
Dr. Raynaldo Rivera Ortiz Jr. is accused of allegedly tampering with an IV at Baylor Scott & White Surgicare North Dallas, located 12230 Coit Road.
He was arrested in Plano on Wednesday.
So far, at least seven -- possibly more -- patients claim to have experienced severe, life-threatening medical emergencies while undergoing routine surgical procedures at Surgicare North Dallas between May and August, according to local attorneys representing patients and their families.
On June 21, Dr. Melanie Kaspar, 55, an anesthesiologist who had also worked at Baylor Scott & White 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 “almost immediately had a serious cardiac event and died,” according to an order temporarily suspending the medical license of Ortiz issued Friday by the Texas Medical Board.
Ortiz is expected to make his initial appearance, and possibly enter a plea to the charges, in front of a federal magistrate judge Friday. At that hearing, prosecutors could ask the judge to hold Ortiz pending trial. It’s unclear if he has an attorney.
U.S. Food and Drug Administration agents are investigating the case.
On Friday, Sept. 9, the Texas Medical Board temporarily suspended Ortiz’s medical license calling him "a continuing threat to public welfare."
In their order of temporary suspension, the medical board said Ortiz was seen on surveillance footage in the Surgicare North Dallas facility “depositing IV bags into the warmer in the hall outside the operating rooms. When he deposited an IV bag into the warmer, shortly thereafter a patient would suffer a serious complication.”
In August, the Dallas County Medical Examiner ruled Kaspar died from an overdose of bupivacaine. Bupivacaine is an anesthetic used to numb areas of the body and provide pain relief during surgical, medical and dental procedures.
Her death had initially been ruled accidental, but the ME has since reopened the case for more investigation.
“She was beloved by her patients, peers, and everyone she worked with," Melanie Kaspar's husband John Kaspar said in a statement to WFAA. “To watch her die in such a tragic manner is something I will have to live with forever. She was a beautiful woman.”
Don Tittle, John Kaspar's attorney, told WFAA his client is "relieved to hear that progress is being made" on the investigation.
"John is supportive and grateful for the efforts of law-enforcement," Tittle said in a statement Wednesday.
"There really is little doubt that Melanie Kaspar's death was the result of an IV bag that had been tampered with," he said. "We have credible information to believe that over the course of several months between 10 and 15 patients of the surgery center experienced a life-threatening medical crisis soon after receiving an IV bag. They were believed to be standard saline bags but almost certainly had been tampered with to contain bupivacaine, a drug known to be highly toxic if introduced into the bloodstream."
"Tragically, Mel was at home when she unknowingly gave herself a bupivacaine tainted IV bag and, unlike the others, there was no one there to save her life," he said.
Bupivacaine is the same substance that testing showed was present in the IV bags from the Surgicare North Dallas warmer, the medical board order states. The bags “displayed visible tiny holes in the plastic wrap around the bags,” the order states.
Tests were run on the remaining contents from an IV bag that was given to another otherwise healthy patient who had a serious cardiac event during a routine surgery, the board order states.
“The tests indicated that the IV fluid contained similar drugs that should not have been in the IV bag,” the order said. “Such drugs could and would be fatal when administered unknowingly and intravenously.”
The Texas Medical Board said it only found out about the death of a patient from possible IV bag contamination from media reports on Sept. 2. The board said its staff received information from federal authorities on Sept. 8 about the investigation, and set an emergency suspension hearing for Dr. Ortiz for the next day, Sept. 9.
Brandon McCarthy, a former federal prosecutor not connected to the case, said investigations like this are extremely rare, and the severity of the sentence -- if there's a conviction -- can vary greatly.
"The categories of crimes are very different," McCarthy said.
"You've got some where people are trying to negatively impact the business, they're not trying to hurt anybody, that's were you see the three-year statute kick in," McCarthy said.
"Then you have these more egregious ones, where they're doing things -- and the motive is always the question here -- they're doing things for nefarious purposes, and they don't care, like it sounds like here, they didn't care if someone died or there's serious bodily injury, and that's where you see it jump to the 20 years and life statute."
A Texas Medical Board spokesperson would not say when Baylor first informed the board about concerns over the rash of patients having negative reactions during surgeries.
"While we cannot disclose any complaints due to statutory confidentiality, the board scheduled a temporary suspension hearing as soon as it had actionable information," said board spokesman Jarrett Schneider.
Baylor Scott & White said the following in statements issued on Wednesday:
“We actively assisted authorities in their investigation and will continue to do so. We also remain focused on communicating with patients."
"On August 24, immediately upon determining an IV bag had potentially been compromised, Surgicare North Dallas paused all operations and notified the appropriate local and federal authorities. It elected to close the same day, and it remains closed as we focus on assisting investigators. There is nothing more important than the safety and well-being of our patients. We have created a dedicated phone line for patients with questions: 214-818-2794. Dr. Raynaldo Ortiz was no longer a member of the medical staff of Surgicare North Dallas at the time the Texas Medical Board suspended his license."
Attorney Bruce Steckler said Wednesday he now represents seven clients who had procedures at Surgicare North Dallas. They include:
- An 18-year-old woman who had her gallbladder removed
- A 39-year-old man who underwent a reverse vasectomy
- A 21-year-old woman who had breast reduction surgery
- An 18-year-old man who had nose surgery after a dirt bike accident
"All the clients that we represent seem to have the exact same story," Steckler said Wednesday. "They all went in for a routine surgical procedure, a day surgery. All in good health. No major underlying issues whatsoever. And they found themselves being rushed to a major hospital because they had to be intubated and ventilated because they suffered respiratory distress and cardiac arrest."
A fifth client of Steckler's, a man in his 50s, suffered a cardiac episode during surgery, Steckler said. The surgery was then halted, and while the client did not end up in the hospital, it took him all day to recover. He was told at that time that he had an underlying heart condition, “but when he went to follow up, they could not figure out" why the episode occurred, Steckler said.
Steckler said his two newest clients include a patient who was having a hernia repair, and another who came in for a cosmetic procedure.
"My clients are cooperating with law enforcement agencies," Steckler said.
Ortiz has at least twice been disciplined by the Texas Medical Board -- once in 2018 and again as recently as last month.
On Aug. 19, 2022, the medical board reprimanded Ortiz for not performing cardiopulmonary resuscitation on one of his anesthesia patients who needed it at the North Garland Surgery Center in November 2020, board documents state. The surgery center’s Medical Executive Committee issued an “adverse recommendation,” and Ortiz relinquished his medical staff membership and all clinical privileges. The state medical board ordered his practice be monitored by an outside physician and fined him $3,000, documents state.
In 2018, the board disciplined Ortiz for not reporting a conviction of misdemeanor animal cruelty. In 2016, he was convicted in Collin County of using a pellet gun to shoot and injure the dog of a neighbor in retaliation for her helping his partner escape domestic violence, board documents state. In that case, the board fined him $2,000 and gave him a public reprimand. The discipline was lifted in 2020 “due to the completion of all requirements,” medical board documents state.
In 1995, according to medical board documents, Ortiz was arrested for misdemeanor assault causing bodily injury to a spouse.
In 2005, another female partner filed for an emergency protective order against Ortiz, board documents state.
Reporters Tanya Eiserer, Ariel Plasencia and William Joy, and producer Mark Smith, contributed to this report.
If you have been affected by the situation at Baylor Scott & White Surgicare North Dallas, please reach out to the WFAA Investigative team here.