In the spring of 2023, a nurse practitioner at the El Paso County jail made four appointments to take Walmart gunman Patrick Crusius out of the jail for mental health testing, without seeking permission of defense attorneys.
The effort was stopped after defense lawyers alerted federal and state judges of the plan, according to records recently made public at the request of El Paso Matters.
The appointments were scheduled by Jamie Wyman, a psychiatric nurse practitioner who works at the El Paso County Detention Facility, according to a motion filed May 1, 2023, by Crusius’ defense team. The motion was unsealed this month by U.S. District Judge David Guaderrama in response to an El Paso Matters request to make public federal court records that had been sealed during the prosecution of the Walmart mass shooter.
Joe Spencer, one of Crusius’ defense attorneys, said health providers at the jail should have consulted with them before scheduling any mental health appointments.
Otherwise, he said, unscrupulous prosecutors could use jail medical personnel to gain access to psychiatric information about a defendant that they weren’t legally entitled to. He stressed that he doesn’t believe that was what happened in this case.
“It’s very important (to contact an inmate’s attorney), because the client, especially one that has mental health issues, is at a disadvantage in the sense that he is not all there, and he just is going to go along with whatever anybody tells him to do,” Spencer said.
Bill Hicks, who was district attorney in 2023, said his office didn’t request any tests, and was never informed of the jail’s plans to conduct medical tests on Crusius.
“We did not make any requests for medical or mental health examinations during my tenure. We did file motions with the court which would have authorized psychological examinations in preparation for sentencing, but those motions had not been heard nor ruled on. So, the orders could not have been as a result of any request by us, during my term,” Hicks said.
Assistant County Attorney Carlos Madrid said referrals for specialized treatment of jail inmates are made by medical and mental health professionals who are contracted through University Medical Center and Emergence Health Network.
He said the Texas Commission on Jail Standards requires that “(a)ll medical instructions of designated physicians shall be followed.”
“In this case, any referrals for outside evaluation or treatment would have been initiated by medical or mental health professionals, not by Sheriff’s Office personnel. The underlying reasons for those referrals involve protected health information, which we are not authorized to disclose,” Madrid said.
Wyman scheduled four appointments outside the jail for Crusius, according to the federal court filing: a psychiatric evaluation April 21, a CT scan of the head in Northeast El Paso on April 26, a “3-hour sleep deprived video monitored EEG” on May 2 at a West El Paso sleep clinic, and a neurological exam May 26 in Central El Paso.
Spencer said each of those appointments would have required massive security for moving Crusius.
“At one point we did have Patrick leave the jail to do a testing that we wanted to have done, and the amount of security and detail that was involved in that movement was incredible, because the sheriff was very concerned about safety and by a lot of other issues, and that that took great effort to do that,” he said.
The defense lawyers said they discovered the appointments through records the jail was required to regularly provide them.
The federal court motion said 409th District Judge Sam Medrano, who was overseeing the parallel state prosecution of Crusius, issued an order April 18 canceling the appointments and requiring that medical providers consult with defense attorneys before ordering medical tests of evaluations of Crusius.
The defense asked Guaderrama, the federal judge, to issue an order barring the U.S. Marshals Service from transporting Crusius to the medical appointments. In the spring of 2023, Crusius was held in the county jail under federal custody. Guaderrama ruled on May 2 that the request was moot because the appointments had been canceled by Medrano.
The federal court motion said that because Crusius hadn’t filed a notice of intent to pursue an insanity defense, the state had no right of access to perform medical or mental exams.
“By ordering these examinations and diagnostic studies, the state is gaining unauthorized access to the mental state of the defendant, which actions stampede into protected defensive strategies,” the motion said.
Crusius pleaded guilty in February 2023 to federal hate crimes and weapons charges in the Aug. 3, 2019, shooting at the Cielo Vista Walmart that killed 23 people and wounded 22 others. He wrote in an online post shortly before the shooting that he was acting to stop “the Hispanic invasion of Texas.”
In July 2023, Crusius was sentenced to 90 consecutive life terms in federal prison.
He pleaded guilty in April 2025 to state charges of capital murder and aggravated assault with a deadly weapon, and received 23 life terms without possibility of parole.
Crusius pleaded guilty after federal and state prosecutors separately decided not to seek the death penalty. He is serving his sentence at a state prison in Palestine, Texas.
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