This story was originally reported by Shefali Luthra of The 19th. Meet Shefali and read more of their reporting on gender, politics and policy.
The family of a woman who died after she could not get an abortion in Texas is suing doctors and state officials including Attorney General Ken Paxton. It is the first lawsuit over a death linked to an abortion ban.
“Tierra Walker is dead and those responsible must be held accountable,” the suit reads. “At every turn, Texas’s political and medical establishments not only failed but actively harmed Ms. Walker.”
The case, filed Tuesday in state court by a malpractice firm and the abortion rights group Amplify Legal, argues that Texas’ abortion bans violate both the state and U.S. Constitution. This case is also the first to directly sue Paxton, who has taken a leading role in enforcing Texas’ ban. Paxton is locked in a tight race for the U.S. Senate.
“Both the Texas Constitution and the Federal Constitution prohibit state actors from killing their citizens,” the suit reads.
Walker is one of the numerous women whose deaths have been linked to abortion bans. Other deaths have occurred in North Carolina and Georgia, states with bans less restrictive than Texas’. Texas’ near-total abortion ban provides exceptions only if staying pregnant puts someone “at risk of death or poses a serious risk of substantial impairment of a major bodily function.” In 2025 — after Walker’s death — the state passed a law meant to clarify what constitutes a risk of death. But the penalties for violating the state’s ban remain onerous, and many doctors have said it is not obvious what care they can provide or how sick a patient must be before they can intervene.
Walker, whose case was first reported on last year by ProPublica, died December 30, 2024, when she was 37 years old and 20 weeks into her pregnancy. Her medical history of chronic conditions — including diabetes, hypertension, obesity and severe asthma — made her pregnancy particularly high-risk. She was hospitalized multiple times during her pregnancy and repeatedly asked for an abortion. According to the lawsuit, doctors did not give her information on how she could get an abortion, instead dismissing her after telling her “your baby is fine.”
Walker died days after being discharged from the University of Texas Science Center at San Antonio, also known as the University Health System, according to the lawsuit. Her son discovered her dead on his 15th birthday.
After Walker’s death, a medical examiner ruled that she died of hypertensive cardiovascular disease with preeclampsia, the latter of which is a dangerous pregnancy-related high blood pressure condition that doctors had identified in Walker.
Medical records cited in the suit note that on her last hospital visit, her blood pressure was dangerously high and only temporarily responsive to medication. According to those records, the doctor caring for her at that point, who is a named defendant in the suit, wrote that “delivering the baby” — which would terminate the pregnancy — “may be the best treatment for preeclampsia.”
Doctors who reviewed the case for ProPublica all told the news outlet that, given Walker’s medical risks, she should have been offered an abortion.
The suit names Paxton and Stephen Brint Carlton, the executive director of the Texas Medical Board, in their official and individual capacities, as well as Bexar County District Attorney Joe Gonzales in his official capacity. It also names the University of Texas Science Center at San Antonio and three of the doctors who cared for Walker.
The 19th reached out to Paxton’s office and Senate campaign, Carlton and the Bexar County District Attorney’s Office for comment, but received no immediate reply.
University Health said it cannot comment on ongoing litigation or individual patient’s cases.
“In general, our clinicians make patient care decisions based on each patient’s clinical condition, applicable medical standards and legal requirements,” it said in a statement. “Our priority is to provide medically appropriate and timely care, while safeguarding patient privacy and complying with all applicable laws and regulations.”
Paxton has been a staunch defendant of Texas’ abortion ban. In another case, he threatened legal action against anyone who gave an abortion to one woman — despite a court saying she qualified for an exception to the state’s ban. He has also sought to dismiss a case brought by women who had been denied abortions in medical emergencies, and who were pushing for greater clarity over when someone could receive an abortion in Texas.
The plaintiffs, Walker’s family, are seeking a jury trial and pursuing both damages and a judgement finding that Texas’ abortion laws violate the state constitution.
Bastards all! Letting a patient die.