Texas doc gets 190 years in prison: Why didn’t his past misdeeds alert colleagues sooner?

By Stephanie Srakocic | Fact-checked by Davi Sherman

Published December 5, 2024

Key Takeaways

Over the course of the investigation, Raynoldo Rivera Ortiz Jr., MD, was linked to at least 10 cardiac emergencies and one death within a 5-month period.
An FDA investigation found security camera footage of Dr. Ortiz tampering with IV bags, leading to his sentence by federal court to 190 years in prison.

The US Department of Justice sentenced Texas anesthesiologist Raynoldo Rivera Ortiz Jr., MD, to 190 years in prison, according to a November 2024 press release.^[]

Dr. Ortiz was charged in September 2022 and indicted the next month on charges related to tampering with IV bags at a North Dallas surgical center. At least one death and multiple cardiac emergencies that took place between May and August 2022 have been linked to Dr. Ortiz.

Why Dr. Ortiz was found guilty

The patient who died was also an anesthesiologist at Baylor Scott & White SurgiCare North Dallas, Melanie Kaspar, MD, who unknowingly used a contaminated IV bag to treat herself for dehydration.^[]

Another affected patient, 18-year-old Jack Adlerstein, was rushed to the ICU after checking into the surgical center in August 2022 to repair his deviated septum.^[] During surgery, Adlerstein experienced pulmonary edema; his blood pressure spiked to 200/150, and he went into cardiac arrest. When he awoke hours later in the ICU, he could not speak or move, leading to fears of chronic neurological damage.

In August 2022 alone, the surgical center saw the same number of transfers of patients to an emergency medical facility as it did in all of 2021. There had been at least 11 unexplained medical emergencies in the summer of 2022.

The affected patients did not have treating physicians, nurses, or procedures in common. Adlerstein’s case, along with the unusually high number of recent cardiac emergencies and the death of Dr. Kaspar, led facility physicians to suspect something serious was occurring.^[]

Chad Marsden, MD, another anesthesiologist at the North Dallas center, began investigating the string of emergencies in late August 2022.^[] Dr. Marsden read through months of records, including Dr. Kaspar’s recently released autopsy report. The report found that Dr. Kaspar’s death was the result of high levels of bupivacaine in her bloodstream.

Dr. Marsden was on-site during Adlerstein’s medical emergency. After Adlerstein was transferred to the ICU, Dr. Marsden inspected the IV bags used during the procedure and found a small puncture hole in the bag that had been changed out. The bags were later tested and found to be contaminated with medications that can cause cardiac events, including epinephrine and bupivacaine. The company that operates the surgical center notified the FDA about the potential tampering discovered by Dr. Marsden.

An FDA investigation later found video surveillance footage of Dr. Ortiz tampering with surgical IV bags.

What the investigation revealed

The center’s parent company, Tenet Healthcare, notified the FDA about the potential IV bag tampering on August 24, 2022.^[] The FDA temporarily closed the surgical center and began an investigation. During their review of surveillance footage, FDA investigators observed Dr. Ortiz handling IV bags before several of the facility’s summer 2022 cardiac emergencies. In the footage, Dr. Ortiz could be seen glancing around and concealing IV bags before swapping them with other bags.

The Texas Medical Board suspended Dr. Ortiz’s medical license in September 2022. Reportedly, Dr. Ortiz was unaware of his license suspension until a local reporter called him to ask for a comment. During this call, Dr. Ortiz denied all allegations. A few days later, he was arrested and denied bail.

The trial began in April 2024. By this time, Dr. Ortiz had spent over a year and a half in jail and was millions of dollars in debt. During the trial, testimony against Dr. Ortiz included victim impact statements from Dr. Kaspar’s husband and other family members.

The defense argued that the evidence against Dr. Ortiz was not substantial.^[] They claimed that underlying health issues, not IV tampering, led to cardiac events for affected patients. Additionally, they claimed that multiple other physicians and members of hospital staff had access to the IV bags.

After 9 days of trial, a jury found Dr. Ortiz guilty. He was convicted on five counts of intentional adulteration of a drug, four counts of tampering with consumer products resulting in serious bodily injury, and one count of tampering with a consumer product. He was not charged with Dr. Kaspar’s death.

During a November 2024 federal sentencing hearing, Dr. Ortiz was sentenced to 2,280 months, or 190 years, in prison, to be served consecutively.^[]

His known criminal record

The 61-year-old anesthesiologist had a history of aggression and violence against women, and was arrested for assaulting his wife in 1995.^[]

A woman filed for an emergency protective order against Dr. Ortiz in 2005, and he was arrested for assaulting another woman in 2014. The woman involved in the 2014 assault also filed for an emergency protective order against Dr. Ortiz. Roxanne Bogdan, Dr. Ortiz’s neighbor, testified against him in the protective order hearing. A few months later, Dr. Ortiz shot Bogdan’s dog with a pellet gun. He was subsequently charged with a misdemeanor.

The Texas Medical Board fined Dr. Ortiz $2,000 for failing to notify all hospitals of this charge. However, he was only given a 14-day license suspension. By 2020, Dr. Ortiz was working at Baylor Scott & White SurgiCare Center in Garland, TX.

In November of that year, a patient under his care had to be resuscitated and transferred to the ICU after Dr. Ortiz allegedly failed to notice that the patient was experiencing difficulty breathing. It’s unknown whether this incident was accidental or a precursor to Dr. Ortiz’s subsequent harm to patients. He left the facility shortly after this incident.^[]

What this means for you

It can be hard to imagine a colleague intentionally causing harm to patients, but it does happen. Although rare, physicians and other practitioners do occasionally injure or kill patients. More commonly, colleagues can make mistakes that lead to unintentional patient harm. As a physician, it’s always important to prioritize patient safety. There may be times when you need to have a tough conversation with a coworker or report a colleague to the administration.