Anesthesiologist Accused of Tampering With IV Bags

A Dallas anesthesiologist has been arrested for injecting several IV bags of saline with two local anesthetics and a powerful stimulant that led to the death of his colleague and caused several cardiac events in patients.

Raynaldo R. Ortiz Jr., MD, was booked last week in connection with the death of fellow anesthesiologist Melanie Kaspar, MD, who died June 21 of a heart attack at her home. Dr. Kaspar had taken one of the IV bags Dr. Ortiz allegedly tampered with from Baylor, Scott & White Surgicare North Dallas, where they both worked, to rehydrate herself. Dr. Kaspar’s autopsy showed she died from bupivacaine toxicity, a common local anesthetic that’s injected into the spine, not administered intravenously.

"Minutes after the IV bag was attached to Dr. Kaspar intravenously, she experienced a major medical event and died before emergency medical personnel arrived on the scene," says the criminal complaint that charges Dr. Ortiz with tampering with a consumer product, causing death or serious bodily injury and other offenses. The Texas Medical Board suspended Dr. Ortiz’s license on Sept. 9.

In addition to Dr. Kaspar’s fatal event in June, incidents involving tainted IV bags took place at Baylor, Scott & White Surgicare on or around May 26 and 27; June 27; July 7, 15 and 18; and Aug. 1, 4, 9, 19 and 24. The incident on Aug. 24 involved an 18-year-old man who suffered a cardiac emergency, which required him to be intubated and transferred to a nearby hospital ICU. An investigation revealed his IV bag had been tampered with and contained bupivacaine, epinephrine and lidocaine.

On several occasions, video surveillance showed Dr. Ortiz placing single IV bags into a stainless steel warmer outside the ORs at Scott & White Surgicare shortly before the cardiac emergencies took place. The bags were retrieved by surgical nurses and used on patients who became stricken minutes later. "There is a direct and likely correlation between Dr. Ortiz placing IV bags in the warmer and the incidents under investigation in which patients experienced severe adverse medical events," says the criminal complaint, which notes the cardiac events never took place during cases Dr. Ortiz worked.

Dr. Ortiz had apparently been upset about two disciplinary inquiries regarding care he provided in the past. The alleged tampering events began days after he learned of one of the inquiries and continued after he was disciplined in the other. A pending case involved a May 19 incident at Baylor, Scott & White Surgicare in which a patient stopped breathing while Dr. Ortiz failed to maintain the patient’s airway. The Texas Medical Board disciplined him at its Aug. 19 meeting for deviating from the standard of care during a November 2020 incident at a different facility.

Baylor, Scott & White Surgicare has been closed in the wake of the events. Calls and email messages from Outpatient Surgery requesting comment were not returned. Facility officials provided the following statement to Dallas media outlets last week: "There is nothing more important than the safety and well-being of those we serve. We actively assisted local and federal authorities in their investigation and will continue to do so. We will continue to limit our comments as this is an active investigation."

Attorney Bruce Steckler, who is representing at least one of the victims, says the case raises questions about how IV bags and medications are stored. "We are investigating the practices and procedures at Baylor Scott and White Surgicare that led to my client likely receiving a tainted or compromised IV fluid," says Mr. Steckler. "It’s extremely concerning that controlled substances were able to get into IV bags causing patients to go into cardiac arrest."

The case is particularly troubling because there were multiple victims, according to U.S. Attorney Chad E. Meacham. "At this point, however, we believe that the problem is limited to one individual, who is currently behind bars," he says.