Woman sues BCSO, University Health over lithium overdose that occurred at jail, left her in coma

Heather Aguilar slipped into a coma after lithium treatments in custody, lawsuit states. Her charges were later dropped.

SAN ANTONIO – A San Antonio woman with a documented history of bipolar disorder claims she nearly died while in Bexar County Sheriff’s Office custody late last year after suffering a lithium overdose at the jail, according to a federal lawsuit filed this month and an interview with the KSAT 12 Defenders.

The lawsuit, filed on Aug. 12 against Bexar County and University Health, raises questions about the treatment Heather Aguilar received while spending 46 days in custody on assault charges that were eventually dismissed by prosecutors. Aguilar suffered a seizure and slipped into a coma, according to the lawsuit.

Aguilar’s lawyer claims her civil rights were violated and alleges the conditions during her confinement were unconstitutional. The San Antonio police officer who decided to arrest Aguilar instead of having her committed to a mental hospital was also named as a defendant in the suit.

Aguilar, who was a registered nurse, continues to go through multiple therapy sessions each week as she works to regain her ability to walk and speak properly, her lawyer wrote.

BCSO officials this month said they could not comment on Aguilar’s time in custody, and referred all inquiries to University Health since its staff provides the medical treatments for inmates. A University Health spokeswoman said federal law prohibits her from discussing or confirming any patient information about Aguilar.

“Third-world country type treatment”

Aguilar was arrested on Nov. 1 after her mother called 911 and said Aguilar tried to break her arm during a dispute at a home, the suit states.

Responding officers arrived to find a driveway full of items that had been thrown around and broken and were told that neighbors had held Aguilar down after she damaged some property, the suit states.

Though the call was labeled a “mental health disturbance in progress” and a responding officer noted Aguilar’s erratic behavior and history of mental illness, Aguilar was arrested and charged with assault of the elderly causing bodily injury, records show.

As Aguilar was taken into custody, she struggled against her restraints and at one point struck her head as she was being dragged out of a vehicle, the lawsuit claims.

“Her handcuffs were fastened so tightly that it broke the skin on her wrists and ankles. The deputies took Heather to a private room in the booking area. Heather tried to tell the deputies that her handcuffs were too tight and that she was losing sensation in her wrists. The deputies saw Heather but ignored her,” the suit states.

The suit also details a second incident during Aguilar’s booking in which a deputy used a stun gun on her. She then bit a responding deputy on his ankle after removing the barbs of the stun gun from her thigh.

Aguilar was moved into a holding cell without a toilet and eventually defecated on herself after deputies ignored her pleas to use a toilet, the suit states. Deputies did not give her a chance to clean herself before she was moved to suicide watch, according to the lawsuit.

Aguilar received sporadic medical care over the next week while the wounds on her wrist became infected, the suit claims.

Pictures included in the suit show deep lacerations on both of her wrists and a badly swollen right hand as well as a deep cut on one of Aguilar’s ankles.

Jail medical staff eventually decided that Aguilar needed to be transferred to University Hospital to be treated for cellulitis, a skin infection, on her hand.

“There is a culture or a practice or custom in that area, which is basically people are ignored,” said Aguilar’s attorney Leslie Sachanowicz, when asked about the nearly two weeks it took for Aguilar to receive significant medical care while in custody.

While hospitalized, officials determined that Aguilar was severely manic and psychotic and informed the Bexar County District Attorney’s Office that she would need a competency hearing for her criminal charges, records show.

Doctors also began treating Aguilar with lithium, a powerful mood stabilizer used to treat bipolar disorder.

Aguilar, a registered nurse since 1999 whose license went inactive in December, told KSAT 12 that she herself had administered the drug to patients only a handful of times the past two decades.

After Aguilar was returned to jail Nov. 17, her treatments of lithium and antibiotics continued, records show.

Aguilar, however, began to have blurred vision, diarrhea and problems with her balance that included the inability to stand or walk, the suit states.

She also told jail medical staff that she needed to stop taking lithium, according to the suit.

She was eventually examined by a nurse on Dec. 5, but was not taken to a hospital.

A day later, as deputies tried to get her off the floor of her cell, Aguilar suffered a seizure, records show.

Her next memory was waking up in the intensive care unit, back at University Hospital, where she underwent dialysis treatments and blood transfusions, according to records.

“It really kind of, you know, smacks of kind of a third-world country type treatment,” Sachanowicz said.

Attorney Leslie Sachanowicz. (KSAT)

Aguilar answered several questions about her time in custody during an off-camera interview, but asked that Sachanowicz speak on her behalf on camera and that her face not be shown in order to save her family from further embarrassment.

Prosecutors dismissed both criminal charges against Aguilar on Dec. 15, court records show.

Aguilar, who lost more than 40 pounds during her 46 days in custody, was released from the hospital a week later into the care of a rehabilitation center.

She has permanent scars on her wrists and ankles and went through physical therapy to improve her gait, balance, lower body strength and mobility and to regain her functional independence, her attorney said.

She also went through occupational therapy to increase her upper body strength and attended speech therapy for cognitive and vocabulary issues and to correct motor skills impacted while she was in custody, Sachanowicz said.

A city spokesperson, in a written statement attributed to City Attorney Andy Segovia this week, claimed they are aware of the suit and defended Aguilar’s arrest.

“When police arrived on the scene, Plaintiff was still behaving violently and resisted arrest, despite attempts to deescalate the situation. Due to her on-going violent behavior and the visible injuries she had already inflicted on her mother, SAPD had no choice but to take her into custody. Plaintiff was arrested for assault on an elderly person (her mother) and assault on the two neighbors. The City is prepared to litigate this case.”

BCSO’s attempted pivot on mental health

Two weeks before Bexar County Sheriff Javier Salazar was named as a defendant in Aguilar’s suit, he heaped praise on the county’s mental health response team.

Sheriff Javier Salazar speaks during a July 26 press conference on the county's mental health response team. (KSAT)

“So this specialized team that you see way surpasses anything that I could have hoped for,” said Salazar July 26, while discussing the county’s Specialized Multidisciplinary Alternate Response Team - known as SMART.

The unit, created last fall after BCSO deputies shot and killed military veteran Damian Daniels outside of his far west Bexar County home, sends a clinician and a trained paramedic to mental health calls instead of deputies.

During the SMART press conference, which included medical and mental health stakeholders in the project, Bexar County Judge Nelson Wolff claimed the team had already saved thousands of lives without any evidence to back up the assertion.

“I just would call it political speak,” said Sachanowicz, who represents the families of multiple people with mental illness who died while in custody at the jail.

County officials declined to comment on Aguilar’s suit, since it is pending litigation.

“Why are people with mental health issues dying at the jail? Why are people with mental health issues getting shot down in the street,” said Sachanowicz, describing questions he would have asked had he attended the press event.

Earlier this year, Bexar County and UHS settled a 2019 wrongful death lawsuit filed by Sachanowicz on behalf of the family of Jack Ule.

The $85,000 settlement, $20,000 of which was paid by the county with the rest paid out by UHS, accused both entities of improperly caring for Ule, 63.

Ule died in jail in April 2019, weeks after being booked on a low level criminal trespassing charge.

At the time the suit was filed, Sachanowicz referred to the jail as “the Death Row for the mentally ill.”

Sachanowicz also represents the family of Janice Dotson-Stephens, another Bexar County Jail inmate who died in custody while being held on a criminal trespassing charge.

A Defenders investigation in late 2018 revealed that Dotson-Stephens, who had been jailed for five months at the time of her Dec. 2018 death, could have been released for as little as $30.

Janice Dotson-Stephens (left) and Jack Ule (right) died while at the Bexar County Jail. (KSAT)

The wrongful death lawsuit stemming from Dotson-Stephens’ death is scheduled to go to mediation next month, according to Sachanowicz.

“Heather is a human being, Janice Dotson-Stephens was a human being, Jack Ule was a human being,” said Sachanowicz.


About the Authors:

Emmy-award winning reporter Dillon Collier joined the KSAT 12 Defenders in 2016. Dillon's investigative stories air weeknights on the Nightbeat. He provides restaurant health reports for KSAT's "Behind the Kitchen Door." Dillon is a two-time Houston Press Club Journalist of the Year and a Texas Associated Press Broadcasters Reporter of the Year.

Joshua Saunders is an Emmy award-winning photographer/editor who has worked in the San Antonio market for the past 20 years. Joshua works in the Defenders unit, covering crime and corruption throughout the city.