SAN ANTONIO (AP) — A woman was presumed dead and left in a car's wreckage with a tarp over her body for an hour after a paramedic failed to check her pulse, officials said.

A medical examiner discovered the woman was breathing and equipment was rushed to the scene that could remove her from the wreckage, officials said. Erica N. Smith, 23, died the next day.

She had suffered a severe head injury, and officials said the paramedic had judged Smith to be dead by looking at her, a violation of city policy to check vital signs regardless of injury.