An animal’s horn sank deep into Jaime Alvarez’s neck and fractured part of his cheekbone.
Doctors said was it “beyond miraculous” that the horn didn’t hit his jugular vein or major arteries.
The bull ran over and gored Mr Alvarez during the first run of this year’s San Fermin festival in Pamplona, an annual event at which hundreds of runners race close to bulls through a cobblestone street course to a bullring.
The others included three Spaniards and two other Americans. Another man was stabbed in the back with a bull’s horn and treated on the spot, the Red Cross said.
Recovering from surgery, Mr Alvarez, 46, a California lawyer, said: “The joy and the excitement of being in the bullring quickly turned into a scare, into real fear for my life.
“In the course of a few seconds, a million thoughts came to my mind, and that of dying was definitely one of them.”
He said his wife and daughter, who had warned him against racing bulls, had told him off.
The charge happened as he was taking a video clip and a stray bull ran at him. Animals racing in Pamplona usually weigh up to 600kg (95st).
“The impact was unlike anything I’ve ever felt. It was like being hit by a car or a truck,” Mr Alvarez said. “It was scary.”
Someone grabbed him by the arm and pushed through the crowds to get to paramedics, possibly saving his life.
He said he would return to watch the festival but only as a spectator.
The running of the bulls — and the nine days of partying during the festival — draws a million spectators to the city every year.
Records dating back to 1910 list 16 deaths from the event.
It is controversial because the animals are said to be terrified by the race, then “tortured” in the bullring. Animal-rights group Peta says at least 48 bulls are killed in the “barbaric bloodbath” at Pamplona, suffering a slow death as they are repeatedly stabbed.
“Many bulls are paralysed but still conscious as their ears or tails are cut off as trophies,” according to Peta.
Support for bullfights that kill about 7,000 animals a year is waning, with 56 per cent fewer official fights last year in Spain than in 2007.
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