The Otty Sanchez Case: A Forensic Autopsy of a Psychotic Filicide

In the early hours of July 26, 2009, in a house on San Antonio’s north side, Otty Sanchez, 33, killed her son, Scott Wesley Buchholz-Sanchez, who was less than four weeks old. Police found the baby decapitated and mutilated, and Sanchez screaming that the devil had made her do it. She was indicted for capital murder. On July 1, 2010, under an agreement with prosecutors, she was found not guilty by reason of insanity and committed to a maximum security state hospital in Vernon, Texas, where, according to the San Antonio Express-News, a judge reviews her case every year.

The case is remembered as much for what happened in the week before the killing as for the killing itself. Six days earlier Sanchez had been taken by ambulance to an emergency room in a psychiatric crisis, asked to be admitted, and was sent home.

Before the Baby

Much of what is known about Sanchez’s life comes from a January 14, 2010, investigation by The Texas Observer, “Gone Baby Gone,” which was given access to her medical records with her permission and drew on her court appointed psychiatric evaluation.

Sanchez was an only child who never knew her father. She grew up in a crowded household with seven other relatives, moving between at least three states before the family returned to San Antonio from California when she entered high school. Her mother, aunts and cousins had experienced similar mental illness. According to the court appointed psychiatrist, Brian Skop, she had heard voices since the age of five. Some were “good voices telling her everything is going to be OK.” Others were “bad voices,” including one she called “Lucy,” “which is telling me to do bad things like eat my hand.”

She finished high school and took pharmacy technician classes. There, in 2003, she met Scott Buchholz, who also has schizophrenia, and they began what the Observer called an on again, off again relationship. Over the following years her behavior became erratic and she moved between low paying jobs.

2008: Austin State Hospital and a Closed File

In late May 2008, on a trip to Austin, Sanchez wandered into a CVS store and stayed for seven hours. Police took her to the Austin State Hospital, where she spent 16 days. According to the Observer, that was the first time her family learned how serious her illness was. She was diagnosed with paranoid schizophrenia.

The hospital referred her to the Center for Health Care Services, San Antonio’s public mental health clinic. Through the summer of 2008 she received free outpatient counseling and antipsychotic medication there, and her records showed she was much better. In early September 2008, the Observer reported, the strapped clinic could no longer provide her free care: she would have to pay or qualify for a government benefit. Her lawyer said she believed she could never afford it. She missed her next appointment, and a month later the clinic closed her file. “They let her drop out, and they have to, because they don’t have the money,” her lawyer, Ed Camara, said.

The clinic’s director, Leon Evans, told the Observer that the state funded it to treat 4,240 people a month, that it stretched that to about 6,000, and that it still had a waiting list of several hundred a month. “We’re way under-funded,” he said.

Pregnancy and Birth

Around the time her treatment ended, Sanchez reunited with Buchholz, and in late September 2008 she became pregnant. The Observer reported that she managed the pregnancy without incident, off her medication. Scott Wesley was born on June 30, 2009.

Her obstetrician prescribed antipsychotic medication after the birth, but Sanchez said it made her too tired and stopped taking it on July 17, nine days before the killing. Camara later told reporters she had also been prescribed the antidepressant citalopram after the birth, but had taken it only the day before, according to the Associated Press account carried by Fox News. Such drugs take weeks to work.

July 20, 2009: The Emergency Room

On July 20 Sanchez left Buchholz after a fight and moved in with her mother and cousins. That day she saw Luinda Combs, a counselor at her obstetrics clinic. Combs’s notes, quoted by the Observer, say Sanchez was “hearing voices which have informed her others would like to take her baby away,” and reported “visual images of other children’s faces transposed on her baby’s face.” Combs suspected postpartum psychosis, called an ambulance and phoned ahead to Metropolitan Methodist Hospital’s psychiatric unit. Her notes say the “hospital worker did not want to take information over the phone.”

The hospital records obtained by the Observer give a timeline:

• 11:39 a.m.: The ambulance arrives at Metropolitan Methodist, a private hospital.
• 12:05 p.m.: Sanchez is examined in the emergency room. For about three hours she receives physical tests and lab work.
• Just before 3 p.m.: A trained counselor from the psychiatric team, not a psychiatrist, evaluates her for 44 minutes. The notes record “voices and hallucinations” and that she “sees babies [sic] face change.” She asks to be admitted: “[Patient] states she needs to be admitted for voices.”
• 3:53 p.m.: Eleven minutes after the evaluation ends, she is discharged.

The deciding question was whether she was suicidal or homicidal. The counselor recorded her as “not suicidal, not homicidal, no command hallucinations” and checked “no” beside the line asking about suicidal or homicidal ideation. The phrase “postpartum psychosis” appears nowhere in her hospital records, the Observer reported. A hospital spokesperson said by email that the doctor makes the admission decision and “bears liability for decision.”

Sanchez left with the name of an outpatient clinic, but no address or contact details, and an information sheet describing “Hallucinations and Delusions” and “Schizophrenia.” It told her: “Call your doctor or go to the emergency room right away if your symptoms get worse.” She never made the appointment. “They’re telling a crazy person that ‘you’re crazy,’ and to take care of yourself,” Camara said.

July 25: The Last Warning

On the afternoon of July 25, about 12 hours before the attack, Sanchez visited Buchholz and his mother, Kathleen, to collect the diaper bag and her medication. She had not taken a pill in eight days. According to Camara’s account to the Observer, Kathleen Buchholz found her erratic and paranoid, and Sanchez would not let her hold the baby because she feared she would steal or breastfeed him. When the family told her she needed help, Sanchez fled the house with the baby. Kathleen Buchholz called law enforcement and told officers Sanchez had run off with the child and was an unstable schizophrenic. The Observer reported that the Bexar County Sheriff’s deputies took no action.

July 26, 2009

Sanchez was staying at her relatives’ home on Wayside Drive, according to the Express-News. The Observer reported that at about 4:30 a.m., while the family slept, she attacked her son with a large kitchen knife. The Express-News, citing police, said she used a steak knife and two swords, and that she ate parts of his body, including the brain, nose and toes.

A relative called 911. The Express-News identified the caller as her cousin, Priscilla Garcia. The Associated Press, via Fox News, described the caller as the boy’s aunt. On the recording Sanchez can be heard screaming, “I didn’t mean to do it! He told me to!” The Express-News also reported her yelling “I loved him.”

Officers arrived at about 5 a.m. to find a bedroom soaked in blood. The Observer reported that some later needed counseling, and the Express-News said San Antonio police provided counseling for the officers who entered the home. Sanchez was taken to the city’s public hospital under police escort, her face still smeared with blood. Camara said she believed killing her son was necessary to prevent an apocalypse.

Capital Murder

Sanchez was arrested that day and charged with capital murder, and in September 2009 a Bexar County grand jury indicted her. Some residents openly called for the death penalty. Buchholz told a San Antonio television reporter in late July: “She killed my son. She should burn in hell.” When the Observer published in January 2010, prosecutors had said they planned to seek death, and Camara intended to plead insanity, as Andrea Yates had done.

In jail, with steady medication and counseling, Sanchez stabilized and was found competent to stand trial by experts for both the court and the defense.

Not Guilty by Reason of Insanity

On Thursday, July 1, 2010, the defense entered a plea of not guilty by reason of insanity, and it was accepted as part of an agreement with prosecutors. District Attorney Susan Reed said three examinations by separate doctors had found Sanchez legally insane when she killed her son, so the court had no choice but to accept the plea. “This was probably one of the most horrendous cases that we have seen as far as the murder of a child,” Reed said.

“She will be committed until the court decides she is not a danger to herself or anyone else,” Reed said. She also said she was disturbed that Sanchez had sought treatment and not received the care she needed. “A lot of people are OK when they are taking their medications but once they stop taking them, they are a danger again.” Camara told reporters in 2010 he did not think “realistically this is ever the type of thing that can be cured.”

Vernon

Sanchez was committed to the Vernon campus of North Texas State Hospital, a maximum security facility. According to Wikipedia, the campus treats forensic patients, including people found not guilty by reason of insanity. In a retrospective marking 13 years since the killing, the Express-News reported that a judge reviews her mental competency each year and that officials do not believe she will ever be released. Wikipedia reports that North Texas State Hospital was split on September 1, 2025, into two separate hospitals, Vernon State Hospital and Wichita Falls State Hospital, so the Vernon facility now operates under that name. We found no public report of any change in her status.

Timeline

• 2003: Sanchez meets Scott Buchholz.
• May 2008: She spends 16 days in Austin State Hospital.
• Summer 2008: She is treated free at the Center for Health Care Services.
• September 2008: Her free treatment ends and her file is later closed. She becomes pregnant late that month.
• June 30, 2009: Scott Wesley is born.
• July 17: She stops her antipsychotic medication.
• July 20: She is taken to Metropolitan Methodist Hospital and discharged at 3:53 p.m.
• July 25: She flees the Buchholz home with the baby. A call to law enforcement brings no action.
• July 26: She kills her son at about 4:30 a.m. and is arrested.
• September 2009: She is indicted for capital murder.
• July 1, 2010: She is found not guilty by reason of insanity and committed.
• September 1, 2025: The Vernon hospital becomes Vernon State Hospital.

Legal Status

Otty Sanchez was found not guilty by reason of insanity on July 1, 2010, in the capital murder of her son, Scott Wesley Buchholz-Sanchez. She was not convicted. She was committed to the maximum security state hospital in Vernon, Texas, where, according to the most recent report we found (the San Antonio Express-News retrospective “13 years later”), a judge reviews her case annually and officials do not expect her to be released.

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