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Texas doctor Raynaldo Ortiz Jr. charged with tampering with IV bags

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In June, a Dallas area doctor who was feeling unwell wanted to use a saline IV bag she had gotten from her work to try to rehydrate. She tapped it into her veins while at home. Minutes later, she suffered a major medical event and died, court records say.

Now, Raynaldo Rivera Ortiz Jr., an anesthesiologist at her surgical facility, faces federal charges for allegedly tampering with IV bags in a way that resulted in the death of his colleague as well as several other cardiac emergencies, according to a criminal complaint filed in the U.S. District Court for the Northern District of Texas that was unsealed Thursday.

The complaint alleges that Rivera Ortiz, who was arrested in Plano, Tex., this week, injected nerve-blockers and bronchodilators — asthma drugs that relax lung muscles — into patient IV bags. He is charged with tampering with a consumer product, and tampering with a consumer product causing death and/or serious bodily injury; and with intentionally adulterating drugs having a reasonable probability of causing serious adverse health consequences.

Rivera Ortiz could not immediately be reached by The Washington Post. Court records do not list an attorney for him. He is expected to make his first court appearance in Dallas on Sept. 16.

The charges come less than a week after the Texas Medical Board temporarily suspended Rivera Ortiz’s license, after federal authorities alerted the disciplinary board that he was the subject of a criminal investigation “relating to serious cardiac complications and one patient’s death” at the north Dallas facility from May through September, according to the board’s news release.

Rivera Ortiz, who is not board-certified and was licensed to practice medicine in Texas, also operates a group consultancy in Dallas, according to the order released last week.

On June 21, a 55-year-old anesthesiologist who worked at the facility, identified in court records as “Facility 1,” was at home because she was feeling dehydrated. The woman, identified in court records as “M.K.,” suffered a “major medical event” minutes after intravenously attaching the bag and died before medical responders arrived at her home, the complaint states.

An autopsy completed Aug. 24 by the Dallas medical examiner concluded that her death was caused by accidental bupivacaine toxicity, court records state. Bupivacaine, a “nerve block” agent used in local anesthesia procedures, was found in her bloodstream, the complaint says. Investigators found that the substance was stored at the Dallas facility, and the circumstances of her death indicated “M.K.” had no intent of dying by suicide.

The same day the autopsy was completed, an 18-year-old man listed in court records as “J.A.” who underwent surgery at “Facility 1” suffered unexpected complications when his heart started beating out of control and his blood pressure spiked above normal, the complaint states. The man, who needed CPR to save his life, was transferred to an emergency facility and intubated for some time, court records say. He spent four days in the hospital.

Investigators collected four IV bags from “Facility 1′s” warmer — a medical device used to heat fluids, court records say. Two of these bags were used during J.A.’s surgery and investigators suspected the other two had been compromised, federal authorities said. Upon further inspection, small holes were found in the clear plastic packaging bags that encase the IV bags, the complaint states.

“The bags with puncture holes appeared to have been physically tampered with, as there is no explanation for why a supposedly sealed IV bag would have a puncture hole in the packaging surrounding it,” the complaint states.

According to the Texas Medical Board’s suspension order released last week, security cameras at Baylor Scott & White Surgicare North Dallas, which is only named as “Facility 1” in the criminal complaint, caught the anesthesiologist walking up to a warmer sometime this year and placing several IV bags inside the device outside the operating rooms. Investigators obtained video showing Rivera Ortiz placing IV bags inside the warmer on multiple occasions, the complaint states.

The bag attached to “J.A.’s” arm tested positive for epinephrine, a potent pharmaceutical stimulant that could easily cause cardiac symptoms, along with bupivacaine and lidocaine, court records state. The bag was not labeled accordingly, and the other two suspected compromised bags also tested positive for bupivacaine and lidocaine, the complaint states.

Staff interviewed by authorities at “Facility 1″ said it was unlikely that “J.A.” and “M.K’s” incidents were isolated, adding that they thought that there were about 10 other “suspected incidents since late May 2022 where patients experienced unexpected cardiovascular complications during otherwise unremarkable surgeries,” according to court records.

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Although Rivera Ortiz was the anesthesiologist at “Facility 1” during multiple surgeries since May, staff members told investigators that none of the suspected cardiovascular complications from IV bags had happened during any surgery in which Rivera Ortiz Jr. was the anesthesiologist. However, investigators found that Rivera Ortiz Jr., who had access to the IV bags and the substances found in the them, did perform services at the facility on or around days leading up to the surgeries in question, the complaint states.

The Texas Medical Board has disciplined Rivera Ortiz in the past.

In August, the board announced that another physician would monitor Rivera Ortiz after it found that he “failed to meet the standard of care for a patient during a procedure.” Rivera Ortiz was disciplined for that incident, including being fined $3,000, according to court records. The anesthesiologist also has a pending nonpublic investigation related to a patient identified in court records as “G.A.” who stopped breathing during a routine procedure under Rivera Ortiz’s care.

According to a review ordered by “Facility 1,” court records state, Rivera Ortiz “deviated from the standard of care by failing to maintain the patient’s airway and failing to document critical aspects of the incident.”

Matthew Olivolo, a spokesman with Baylor Scott & White Health, the surgery center’s larger health-care network, told The Post in an email that the north Dallas facility contacted authorities after discovering that an IV bag “had potentially been compromised.”

“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,” Olivolo told The Post.

Rivera Ortiz was no longer a physician at the surgery center at the time the Texas Medical Board suspended his license, Olivolo said.