Tierra Walker was 37, a dental assistant and the mother of a 14-year-old son on San Antonio's East Side. In the fall of 2024 she found out she was pregnant. She was already sick — high blood pressure, diabetes, seizures — and she had lost twins to preeclampsia a few years earlier.
On December 30, 2024, her son found her in bed, not breathing. It was his birthday. An autopsy confirmed what she had feared: "Preeclampsia killed her at 20 weeks pregnant."
This week her family sued. The first name on the list of people they blame is Ken Paxton.
What the lawsuit says
The wrongful-death petition, filed Tuesday in Bexar County, names eight defendants: Paxton, the head of the Texas Medical Board, the University of Texas Health Science Center at San Antonio, the county hospital system University Health, three of her doctors, and the Bexar County district attorney.
It opens with one line:
"Tierra Walker is dead and those responsible must be held accountable."
The petition says that during four months of pregnancy, "as she suffered through seizures, blood clots, and one hypertensive crisis after another, Ms. Walker repeatedly asked for an abortion to save her life." It says the University Health side answered only "your baby is fine."
Then it turns to Paxton. From the moment Texas's first ban took effect in 2021, it says, Paxton and the Medical Board director "have imposed a merciless blanket prohibition on abortion that intimidates doctors into inaction and breeds extreme fear among Texas's medical establishment."
It says Paxton's "deliberate indifference to the concrete suffering of countless Texas women and families caused by the abortion bans" directly contributed to her death. He is sued personally, not just as attorney general.
According to The 19th, it is the first lawsuit over a death linked to an abortion ban, and the first to sue Paxton directly. The family wants a jury trial, money damages, and a ruling that Texas's abortion laws break the state constitution.
These are claims in a lawsuit. A court has not ruled on them.
What happened to her
The best reporting on Walker's death comes from ProPublica, which read more than 6,500 pages of her medical records last year.
On October 14, 2024, weeks after learning she was pregnant, Walker asked a hospital doctor: "Wouldn't you think it would be better for me to not have the baby?" Her family says the doctor told her what many others would say over the next weeks — there was no emergency; nothing was wrong with her pregnancy, only her health.
It kept getting worse. A blood clot in her leg was so bad she needed surgery to remove it. One doctor wrote in her chart that she was at "high risk of clinical deterioration and/or death."
ProPublica found that more than 90 doctors were involved in her care, including 21 OB-GYNs. According to her medical records, not one of them talked to her about ending the pregnancy. More than a dozen OB-GYNs who reviewed her case told ProPublica that offering her that choice would have been standard medical practice. Every one of them believed she would have lived if she had ended the pregnancy.
Why would so many doctors stay quiet? ProPublica's answer: in Texas, the law bars "aiding and abetting" an illegal abortion, so many doctors avoid even mentioning it.
On December 27, at about 20 weeks, a doctor sent her to University Hospital's emergency room with spiking blood pressure. Doctors there wrote down preeclampsia. Most of the experts who reviewed her vital signs for ProPublica questioned the choice not to call it severe — and the treatment for severe preeclampsia at 20 weeks is an abortion. Instead, they lowered her blood pressure with medication and sent her home. She died three days later.
She could not have simply left the state. The family's lawyer, Molly Duane, told The 19th that Walker's seizures and hospital stays kept her from traveling.
Paxton made the fear
The lawsuit's case against Paxton isn't that he treated Walker. It's that he spent years making sure Texas doctors were afraid to help women like her. His own public record backs that up.
He threatened doctors who had a judge's permission. In December 2023, Kate Cox of Dallas learned her fetus had a fatal condition and won a court order letting her end the pregnancy. The same day, Paxton wrote to three Houston hospitals warning that the order would "not insulate hospitals, doctors, or anyone else, from civil and criminal liability for violating Texas' abortion laws." His press release reminded them of first-degree felony charges and civil penalties of at least $100,000. Paxton went to the Texas Supreme Court to block the order. Cox left Texas to get care. The message to every doctor in Texas was plain: even a judge's order might not protect them.
He sued to keep emergency rooms from being told to save women. After Roe fell, the federal government reminded hospitals that the emergency-care law requires them to treat pregnant women in crisis, abortion included. Paxton sued to block it. When a judge sided with him, he celebrated: "We're not going to allow left-wing bureaucrats in Washington to transform our hospitals and emergency rooms into walk-in abortion clinics."
Walker went to emergency rooms again and again.
He fought the women who asked for clear rules. When women who had been denied abortions during medical emergencies sued Texas asking the courts to spell out when doctors could act, Paxton sought to have their case dismissed, The 19th reports.
He made the fall of Roe an office holiday. The day Roe was overturned, Paxton closed his office and sent staff home to celebrate. His office still marks it every year as "Sanctity of Life Day."
He has gone after people who help women get pills. CBS News notes he has filed lawsuits against doctors and groups that ship abortion pills into Texas. Walker's aunt suggested ordering pills online. According to ProPublica, Walker was worried she could go to jail.
The lawsuit adds one more thing. While Walker was getting sicker in the fall of 2024, the deaths of other Texas women under the ban were in the news — Josseli Barnica, Nevaeh Crain, Porsha Ngumezi. The petition says Paxton never once used his office to condemn those deaths. We laid out what happened to those women in our State of the State post on Texas.
The fix that wouldn't have saved her
After Walker died, the Legislature passed a bill meant to make the ban's medical exception clearer. It says a woman no longer has to be in "imminent" danger before a doctor can act.
Duane, one of the family's lawyers, said at a news conference Wednesday that the law would not have prevented Walker's death. ProPublica reported that doctors expect most hospitals still won't give abortions to women like Walker, who have dangerous long-term conditions but no certain threat to their lives.
Texas is not alone. In the states with the strictest bans, the death rate from ectopic pregnancy is now nearly double the rate in states without one.
Paxton's office didn't answer
The Texas Tribune, The 19th and CBS News all asked Paxton's office about the lawsuit. None got an immediate reply.
Paxton is now the Republican nominee for U.S. Senate, and his record was already long. The family's lawyers told CBS the timing is not about the election: the two-year deadline to sue was about to run out.
"I want justice for her," Walker's aunt, LaTanya Walker, said Wednesday. "I want it to not happen to anyone else. It needs to stop."
What the record shows
Tierra Walker, a 37-year-old San Antonio mother with dangerous health problems, asked doctors about ending her pregnancy. More than 90 doctors were involved in her care, and none of them offered her that option before she died of preeclampsia at 20 weeks pregnant. Her family is suing Ken Paxton, saying his enforcement of Texas's abortion ban scared doctors into doing nothing. His own record includes warning hospitals that a judge's order would not shield doctors from felony charges, suing to stop federal guidance on emergency abortion care, and making the end of Roe an annual office holiday.
Source
Lawsuit blames Texas abortion ban for San Antonio woman's death — The Texas Tribune, September 16, 2026. Also: "Ticking Time Bomb": A Pregnant Mother Kept Getting Sicker. She Died After She Couldn't Get an Abortion in Texas. — ProPublica; SA family sues Ken Paxton, University Health, others after mother dies mid-pregnancy, lawsuit says — KSAT. Photo of Tierra Walker via The Texas Tribune (social media).
