Dallas doctor seen on video swapping IV bags prior to patients suffering heart attacks, complaint says

A Dallas anesthesiologist who allegedly injected patients' IV bags with nerve-blocking agents and other drugs, leading to at least one death and multiple heart attacks, could face life in prison if convicted.

Dr. Raynaldo Rivera Ortiz Jr., 59, was arrested Wednesday on federal charges. Ortiz faces charges of tampering with a consumer product causing death and intentional drug adulteration.

Ortiz is expected to make his first appearance in court on Friday at 10 a.m.

RELATED: Police arrest North Texas doctor at center of IV bag tampering investigation

According to the criminal complaint, on June 21, a 55-year-old physician, who was a coworker of Dr. Ortiz at Baylor Scott & White Surgicare North Dallas, died immediately after using an IV bag of saline to treat herself for dehydration.

An autopsy report revealed that she died from a lethal dose of bupivacaine, a nerve-blocking agent used during the administration of anesthesia.

Two months later, on August 24, an 18-year-old patient experienced a cardiac emergency during a routine sinus surgery.

Analysis of the saline bag used during the surgery found bupivacaine, epinephrine, and lidocaine inside.

The Texas Medical Board previously said inspection of the IV bags found tiny holes in the plastic wrap around the bags.

According to the criminal complaint, personnel at Baylor Scott & White concluded that there was a pattern of intentional tampering with IV bags used at the surgical center.

They identified 10 additional instances of cardiac emergencies during otherwise normal surgeries between May and August 2022.

Investigators believe the events occurred on or around May 26 and 27, June 27, July 7, 15 and 18, and Aug. 1, 4, 9, and 19. None of the events occurred during one of Dr. Ortiz's surgeries.

Dr. Ortiz, who had a history of disciplinary actions against him, allegedly told other physicians that the center was trying to "crucify" him.

RELATED: Dr. Raynaldo Ortiz, doctor deemed 'threat to public' by Texas Medical Board, had previously been disciplined

Most of the surgeries that resulted in the cardiac emergencies involved more than one IV bag, including one or more bags taken from a stainless steel bag warmer.

The incidents began just two days after Ortiz was informed of potential discipline in which he allegedly "deviated from the standard of care" during a procedure in which a patient required CPR.

The U.S. Attorney's Office says surveillance video shows Dr. Ortiz placing IV bags into the bag warmer prior to patients experiencing unexpected cardiac emergencies.

According to the complaint, Dr. Ortiz can be seen in one of the videos placing a single IV bag in the warmer before looking around the empty hallway and quickly walking away. Just over an hour later, a 56-year-old woman in for cosmetic surgery suffered a cardiac emergency after a bag from the warmer was used during her procedure.

Video also allegedly captured Ortiz exiting his operating room with an IV bag hidden in a paper folder. He is then seen swapping the bag with another from the warmer and walked away. About 30 minutes later a 54-year-old woman getting cosmetic surgery suffered a cardiac emergency.

A nurse who worked on one of Dr. Ortiz's surgeries allegedly told law enforcement he refused to use an IV bag she got from the warmer during one of his surgeries.

No abnormal cardiac emergencies occurred when Dr. Ortiz went on vacation.

"Our complaint alleges this defendant surreptitiously injected heart-stopping drugs into patient IV bags, decimating the Hippocratic oath," said U.S. Attorney Chad E. Meacham. "A single incident of seemingly intentional patient harm would be disconcerting; multiple incidents are truly disturbing."

Bruce Steckler represents seven patients who say they suffered emergencies during surgeries at the center.

"They had, what I would call, a routine or day-type procedure. cleared as healthy. They were elective procedures. They all suffered respiratory distress, cardiac arrest, had to be intubated, ventilated and rushed to a hospital for supportive care," he said. 

The Texas Medical Board suspended Ortiz’s license last week after being notified of the criminal investigation.

Baylor Scott & White told FOX 4 that "immediately upon determining an IV bag had potentially been compromised, Surgicare North Dallas paused all operations and notified the appropriate local and federal authorities. There is nothing more important than the safety and well-being of those we serve. We actively assisted authorities in their investigation and will continue to do so; we also remain focused on communicating with patients."

Steckler questions why the cases did not draw attention sooner.

"That is the main concern for all of my clients," he said. "Having two to three, that's a lot of red flags, especially for young people. But seven is astounding."

The FDA Office of Criminal investigations and the Dallas Police Department conducted the investigation with the help of scientists at the University of North Texas.

Ortiz has practiced medicine in North Texas since 1991.