SAN ANTONIO – A federal judge’s blunt assessment of a Bexar County Jail inmate’s condition is drawing attention to the medical care the man received while in custody.
The judge was referring to a photograph of Alfredo Escamilla, who is suing Bexar County and the University Health System after his health deteriorated while he was held in custody at the Bexar County Jail from August 2023 to July 2024.
Escamilla had his right leg amputated after developing a serious infection.
Inmate’s Health Deteriorated While in Custody
Escamilla was booked into the Bexar County Jail in August 2023 on charges of assault of a peace officer and assault of a public servant. According to court records, his health worsened during his time in custody, culminating in a medical emergency in July 2024.
Escamilla was found “down in his jail cell” and suffering from septic shock, the suit states. Doctors discovered a serious infection that led to surgery to amputate his right leg at the knee.
Weeks later, in August 2024, Escamilla underwent an above-knee amputation revision surgery, a procedure to reshape what remained of his limb, alongside a skin graft, records show.
The lawsuit, filed in federal court in late April against Bexar County and the University Health System, states that medical staff at the jail repeatedly noted Escamilla’s refusals of care while he was in custody. However, the staff were aware that Escamilla suffered from a serious mental illness and failed to seek psychiatric evaluation or court-ordered treatment to override these dangerous refusals.
The suit also claims that jail medical staff did not adequately respond to Escamilla’s worsening condition and made a “conscious choice to allow preventable harm to occur.” The lawsuit seeks at least $5 million in damages.
‘Help Me Understand What Went On Here’
The severity of Escamilla’s condition drew pointed questions from Judge Rodriguez during a hearing in late July on a motion to dismiss the case. During the hearing, the judge referenced a photograph included in Escamilla’s court filings showing him in a hospital bed and made a comment comparing the situation to the Holocaust.
The Holocaust was the systematic persecution and murder of six million Jews and millions of others by Nazi Germany during World War II. The judge’s comment highlighted the gravity of Escamilla’s plight as attorneys debated whether his claims should proceed.
The lawsuit remains ongoing, and University Health officials have declined to comment, citing the active case. Records indicate that both criminal charges against Escamilla were dismissed on July 31, 2024, just a day after his first leg amputation surgery. A third charge was removed due to it being entered in error.

