Raynaldo Rivera Ortiz Jr.: IV Tampering, 190-Year Sentence, Appeal

Raynaldo Rivera Ortiz Jr. is a former Dallas-area anesthesiologist sentenced in November 2024 to 190 years in federal prison for tampering with intravenous saline bags at a Baylor Scott & White surgical center, poisoning at least eleven patients during routine operations and causing the death of a fellow physician. A federal jury convicted him on all ten counts in April 2024, and the U.S. Court of Appeals for the Fifth Circuit affirmed the conviction in May 2026.¹²

What Ortiz Did at Surgicare North Dallas

Between May and August 2022, patients undergoing ordinary surgeries at Baylor Scott & White Surgicare North Dallas began suffering unexplained cardiac emergencies. Investigators later determined that Ortiz, an independent anesthesiologist at the facility, had injected IV saline bags with a cocktail of bupivacaine (a nerve-blocking agent), epinephrine (a stimulant), and lidocaine (an anesthetic), then placed the contaminated bags into a warming bin used by surgical teams throughout the center.³ The bags were supposed to contain only saline.⁴

At least eleven patients suffered cardiac emergencies after receiving the tainted fluid. Blood pressure spiked mid-procedure, surgical teams had to abandon operations to stabilize patients, and many required emergency intubation and transfer to intensive care.⁵ One victim, an 18-year-old undergoing sinus surgery in August 2022, was rushed to the ICU in critical condition with extremely high blood pressure, cardiac dysfunction, and pulmonary edema.¹ Another spent five days in the hospital.³

The Death of Dr. Melanie Kaspar

The most serious consequence was the death of Dr. Melanie Kaspar, a 55-year-old anesthesiologist who also worked at Surgicare North Dallas. In June 2022, feeling ill, Kaspar took an IV bag home to rehydrate. The bag had been tampered with. She suffered a fatal cardiac event and died on June 21, 2022, in front of her husband.⁶ An autopsy attributed her death to bupivacaine toxicity, and investigators later found tiny visible holes in the plastic wrapping of the bag she had used.⁷

Trial testimony established that Kaspar and Ortiz did not know each other personally.⁸ Ortiz was not separately charged with murder, but at sentencing the judge would address the death head-on.

How He Was Caught

The scheme unraveled after the 18-year-old patient’s cardiac emergency in August 2022. Physicians at the facility grew suspicious, and a local lab analyzed fluid from the IV bag used in that surgery, identifying the drug cocktail and a puncture in the bag.⁹ On August 24, 2022, Tenet Healthcare filed a complaint with the FDA’s Office of Criminal Investigations, which opened a formal investigation with the Dallas Police Department and scientific support from the University of North Texas.¹⁰

Investigators reviewed surveillance footage covering more than 250 people with access to the facility. The video showed Ortiz retrieving IV bags from the warming bin, concealing them, and returning bags to the warmer shortly before surgeries in which patients later collapsed. In one clip, agents saw him carry an IV bag hidden inside a paper folder, swap it with a bag already in the warmer, and walk away. Other footage captured him mixing medication vials and watching as emergency responders rushed to aid patients.³

The Texas Medical Board suspended Ortiz’s license without notice on September 9, 2022, finding that his continued practice posed a “continuing threat to public welfare.”¹¹ Federal agents arrested him on September 14, 2022.⁷

Why Prosecutors Said He Did It

Prosecutors argued that Ortiz acted out of professional desperation. At the time of the tampering, he was facing new disciplinary proceedings tied to an earlier medical mistake and risked losing his license outright. The government’s theory was that by poisoning random IV bags, he could cause other doctors’ surgeries to go wrong and divert scrutiny from his own record.¹²

His prior record supported the account of a doctor already in trouble. In 2020, the Texas Medical Board found that at a surgical center he had failed to respond appropriately to a patient’s issues and to document critical events. In April 2021, court records show, he failed to recognize a patient’s inadequate oxygenation during a procedure, and CPR was needed to revive the patient. After that incident he relinquished all clinical privileges at the Garland facility rather than have them revoked.¹³

Trial testimony also documented financial strain. A financial expert told the jury that gross revenue for Ortiz’s businesses fell from $9 million in 2017 to $4 million by 2021, and his office manager testified that payroll was sometimes difficult to meet. An FDA investigator testified that Ortiz owed approximately $570,000 in unpaid taxes for 2021 and 2022.¹⁴ Prosecutors noted that despite the decline, he maintained five luxury vehicles and a home valued at $1.3 million.¹⁵ The defense attributed the downturn to the COVID-19 pandemic and argued his personal income had held up better than the business figures suggested.

Charges, Conviction, and 190-Year Sentence

A federal grand jury in the Northern District of Texas indicted Ortiz in October 2022 on ten counts: four counts of tampering with a consumer product resulting in serious bodily injury, one count of tampering with a consumer product, and five counts of intentional adulteration of a drug. After an eight-day trial in April 2024, the jury convicted him on every count.¹

On November 20, 2024, Chief U.S. District Judge David Godbey imposed the maximum sentence: 190 years in federal prison, with the terms on each count running consecutively. Judge Godbey stated on the record that Ortiz caused the death of Dr. Kaspar and described his conduct as “tantamount to attempted murder.” U.S. Attorney Leigha Simonton compared Ortiz to a gunman “spraying bullets indiscriminately into a crowd,” saying he “wielded an invisible weapon, a cocktail of heart-stopping drugs, concealed inside an IV bag designed to help patients heal.”¹⁶

Seven victims gave impact statements. John Kaspar, Dr. Kaspar’s widower, told the court he was haunted by his wife’s “lifeless” eyes as she waited for an ambulance, and called Ortiz a “coward” who acted with “sheer calculation.” Jimmy Eller described lingering health problems including heart trouble, kidney stones, and depression, saying he felt like “a prisoner in my home.” Jack Adlerstein, whose 18-year-old son nearly died in surgery, called the premeditated nature of the attacks “mind-boggling.” Nelly Naylor, the first patient to suffer a cardiac crisis, said of Ortiz: “He did not stop until he was stopped by others.”¹⁷ After hearing the statements, Judge Godbey affirmed his view that Ortiz was responsible, saying flatly: “He did it.”¹⁸

The Appeal

Ortiz appealed to the Fifth Circuit. Public defender Kevin Joel Page argued that the trial evidence was “fundamentally ambiguous,” pointing out that no direct video or witness testimony captured Ortiz actually injecting substances into the bags. The defense also challenged the trial court’s decision to admit emotional testimony from John Kaspar, contending it inflamed the jury.¹²

On May 20, 2026, a three-judge panel issued a per curiam opinion affirming the conviction. The court found “overwhelming evidence” supporting the verdict, citing Ortiz’s access to medical supplies, his specialized knowledge of how to tamper with IV bags to avoid detection, and the surveillance footage of his behavior at the warming bin.²

Civil Lawsuits and What Changed After

The Kaspar family filed a civil lawsuit against Baxter International, the manufacturer of the IV bags used at the facility, alleging that the design allowed for undetected tampering and that Baxter failed to add tamper-resistant features such as foil seals or tamper-evident caps. Baxter denied the claims, stating in court filings that the bags were “designed, manufactured, and sold in compliance with all applicable codes, standards, regulations, and laws” and that the incidents were “caused solely by criminal acts.” A separate suit was filed by the family of another patient who allegedly suffered a near-fatal cardiac event at the facility. Both cases were set for trial in May 2026.¹⁹²⁰

As of mid-2025, the case had not produced new federal regulations or industry-wide safety standards for IV bag packaging. The FDA confirmed no new regulatory changes were under way, and standard IV bags remain without tamper-evident features. Surgicare North Dallas suspended operations for more than four weeks after the tampering was discovered and later stated that expert reviews found its handling and storage of IV bags consistent with industry standards.¹⁹

1
U.S. Department of Justice. Dallas Anesthesiologist Convicted Tampering IV Bags Sentenced 190 Years Prison
2
U.S. Court of Appeals for the Fifth Circuit. United States v. Raynaldo Rivera Ortiz Jr., No. 24-11032
3
U.S. Food and Drug Administration. FDA Office of Criminal Investigations Agents Catch Doctor Who Poisoned Patients With Tainted IV Bags
4
Becker’s Hospital Review. Anesthesiologist Convicted of Tampering With IV Bags at Baylor Scott & White ASC
5
Fox 4 News. Raynaldo Ortiz Trial Testimony Day 1
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NBC News. Doctor in Texas Suspended After Tainted IV Bag Colleague Death
7
People. Texas Doctor Died From Contaminated IV Bag Colleague Accused Tampering
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NBC DFW. Dallas Doctor Trial IV Bags Baylor Defense Rest
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U.S. Food and Drug Administration. Dallas Anesthesiologist Convicted Tampering IV Bags Linked Cardiac Emergencies During Routine Surgeries
10
U.S. Department of Justice. Texas Anesthesiologist Arrested Criminal Charges Related Alleged Tampering IV Bags
11
Texas Medical Board. TMB Suspends Richardson Physician Ortiz
12
Courthouse News Service. Dallas Anesthesiologist Challenges Conviction for Poisoning IV Bags
13
Fox 4 News. Why Dallas Doctor Accused of Tampering With IV Bags Was Allowed to Practice While Under Investigation
14
CBS News Texas. Raynaldo Ortiz Trial Day 5 Dallas Anesthesiologist
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Fox 4 News. Dr. Raynaldo Ortiz Tainted IV Doctor Trial Day 5
16
NBC News. Texas Anesthesiologist Sentenced 190 Years Federal Prison Tampering IV
17
CBS News Texas. Dallas Doctor Sentenced Prison Tampering IV Bags
18
NBC DFW. Former Dallas Anesthesiologist IV Bag Tampering Sentence Prison
19
CBS News Texas. IV Bags Tampering Raynaldo Ortiz Dallas Lawsuit
20
Becker’s ASC Review. Manufacturer Sued After ASC Anesthesiologist Sentenced to 190 Years for IV Bag Tampering