Years prior to the events of Quantum of Solace, General Luiz Medrano was sent by the opposition in Bolivia to kill the father of Camille Montes. He traveled to her home, where he shot her father before raping her mother and sister, then strangled them both. He then set fire to the house, leaving Camille to burn. She survived, but was left with burn scars on her back. She joined the Bolivian Secret Service with the goal of one day hunting down Medrano and getting her revenge on him.
Some time later, Medrano was exiled from Bolivia.
In 2006, Medrano meets Quantum board member Dominic Greene, from who he was seeking help in overthrowing the Bolivian government. Greene agrees as he has hatched his own plot to steal all of Bolivia's water and sell it back to Medrano's new government at inflated prices. While visiting Greene in Haiti to discuss their scheme, Medrano is introduced to Greene's lover, who he fails to recognize as Camille, who had begun dating Greene as a means of getting close to Medrano.
Medrano also turns out to be in league with the corrupt Bolivian police colonel Carlos, who has René Mathis killed on Medrano's orders. This further draws Camille's new ally James Bond into Quantum's plot.
Medrano meets with Greene and Carlos in the Perla de las Dunas hotel in the Atacama Desert in order to finalize the coup. Here Greene reveals his significantly higher water prices to Medrano and threatens him into signing a contract agrees to the new terms. Frustrated, Medrano decides to take his anger out on a maid by luring her into a hotel room to rape her. He puts his Lieutenant Orso and another soldier on the door to keep watch, just as Greene, Carlos and the rest of Greene's men are preparing to depart.
Suddenly, Bond arrives and kills Carlos, avenging Mathis, then begins to kill the rest of Greene's men (including Elvis and Greene's driver). Meanwhile, Camille sneaks into the hotel, where she kills Orso and the other guard, allowing the maid to escape. Camille then struggles violently with the general while the hotel begins to burn down around them thanks to the unstable fuel cells in the walls. Medrano throws Camille to the ground, saying that "this time, [she] will burn" but Camille manages to retrieve her gun and fatally shoot him in the chest, finally avenging her family.
Medrano appears in the 2008 video game adaptation of Quantum of Solace. This version of Medrano is voiced by American actor Alex Fernandez and is seen chasing Bond onto the roof of the hotel at the climax. Bond shoots him in the leg, but when Medrano pulls out a gun of his own to get Bond, Camille appears and shoots him in the chest.