Texas anesthesiologist allegedly caused woman’s death by injecting saline IV bags with drugs

Raynaldo Rivera Ortiz Jr., 59, was arrested Wednesday in the Dallas suburb of Plano for
allegedly causing the death of a woman by injecting heart-stopping drugs into a
saline IV bag. Photo courtesy of Dallas County Jail

The Dallas County Jail lists Ortiz as being held for the U.S. Marshall’s Service without bond. If convicted, he faces a maximum penalty of life in prison.

Ortiz allegedly injected a lethal dose of bupivacaine, a nerve blocking agent often used during the administration of anesthesia, into an IV bag of saline, Chad Medaris, a special agent with the U.S. Food and Drug Administration Office of Criminal Investigations, wrote in a criminal complaint.

In June, a 55-year-old woman who worked with Ortiz, identified in court documents as M.K., treated herself for dehydration at home with the tainted bag and “died immediately” after she experienced a medical emergency.

An autopsy report found that the woman, named as anesthesiologist Melanie Kaspar by the Fort Worth Star-Telegram, died of accidental bupivacaine toxicity — which was found in her bloodstream.

“Medical professionals with whom I consulted as part of the investigation told me that it is highly unlikely that a medical professional knowingly injected herself with bupivacaine intravenously,” Medaris wrote.

“Furthermore, the investigation has shown that the circumstances of M.K.’s death do not indicate that she desired to commit suicide.”

Ortiz has also been accused of causing 10 other people treated with tainted IV bags to experience cardiac arrest at the facility, identified by WFAA as Baylor Scott & White Surgicare North Dallas.

Medaris wrote in the complaint that Ortiz’s legal woes began in November 2020 when a patient at another surgical facility in Garland “suffered serious complications” during anesthesia.

Ortiz relinquished his medical staff membership and clinical privileges for that facility, which was not identified in the court documents, in lieu of having it revoked.

Last month, Ortiz entered into an agreement with the Texas Medical Board stemming from the Garland incident.

The anesthesiologist agreed to pay a fine of $3,000, submit to ongoing monitoring by a physician selected by the Texas Medical Board at his expense and to retake the state’s medical jurisprudence exam — as well as complete 16 hours of continuing medical education credits.

But just days later, an 18-year-old male identified as J.A. went into surgery at Baylor Scott & White Surgicare and experienced complications when his heart was beating out of control.

Doctors used CPR to save his life and the teen was transferred to an emergency medical facility where he was intubated and spent four days in the hospital.

It was later determined that two IV bags used during his surgery had been injected with epinephrine and investigators found puncture holes in the walls of the bags.

Medaris wrote that Baylor Scott & White officials became suspicious of a likely “pattern of attentional adulteration of IV bags after the incidents with J.A. and M.K.

“Personnel determined that there were approximately ten other suspected incidents since late May 2022 where patients experienced unexpected cardiovascular complications during otherwise unremarkable surgeries,” Medaris wrote.

“Personnel related that the incidents generally seemed to follow the same pattern — a patient’s blood pressure would spike to dangerous levels at some point during the surgery, usually after the placement of additional IV bags.”