104. Finally, following his release from the DISIP Pre-Trial Detention Center, medical examinations were conducted on Mr. Díaz Peña on July 19, 2010, and on February 25, 2011. The former verified that there was evidence of the abscess in the rectal region in 2005 and 2007 that had not been operated on and that had drained spontaneously, resulting in the presence of a rectal fistula, diagnosed as “Anal-rectal fistula, third-degree hemorrhoids.”202 While the latter confirmed that Mr. Díaz Peña had a problem in his left ear similar to the one he had had previously in his right ear for which he had undergone surgery on July 7, 1999; thus, his left ear had been treated with medication, but “it has not been operated on to date.”203 105. Regarding the constant problems that Mr. Díaz Peña had in his left ear while he was in the DISIP Pre-Trial Detention Center, it has been proved that, on November 15, 2004, the ear, nose and throat specialist of the DISIP Medical Service had suggested carrying out a computerized axial tomography (CAT scan) of the middle ear and mastoids, and pure tone audiometry,204 but these test were not carried out until January 28205 and March 18, 2008206 (that is, more than three years later). Although it is true that Mr. Díaz Peña received medical treatment during that period and his condition improved transitorily, it is also true that his symptoms returned constantly. 106. It has also been proved that, in his diagnosis of March 24, 2008, the ear, nose and throat specialist of the DISIP Medical Service concluded that Mr. Díaz Peña “ha[d] no clinical or paraclinical criteria (CAT scan of the middle ear and mastoids, vocal and tonal audiometric tests and impedance measurement) that would reveal surgical pathology in area of the ear.”207 In this regard, the Court notes that the ear, nose and throat specialist of DISIP Medical Service had twice insisted not only on tonal audiometric testing and the CAT scan of the middle ear and mastoids, but also on a tomography of para-nasal sinuses (coronal and axial cross sections), in order to determine whether Mr. Díaz Peña required an operation in the area of otorhinolaryngology.208 However, when making his diagnosis on March 24, 2008, he did not request that the latter test be 201 Cf. Criminal Investigations Unit decision of March 18, 2008 (evidence file, tome XVIII, folio 12232); Note sent by the Director General of the General Directorate of Intelligence and Prevention Services to the Fourth First Instance Trial Court of the Criminal Judicial Circuit of the Caracas Metropolitan Area dated March 26, 2008 (evidence file, tome XVIII, folio 12231), and X-ray diagnosis by Dr. Félix Salas Barraez dated March 18, 2008 (evidence file, tome XVIII, folios 12234 to 12238). 202 Cf. Medical report of July 19, 2010, signed by the Surgeon General, Dr. Francisco Manzanilla (evidence file, tome VI, folio 3300). 203 Medical report of February 25, 2011, signed by Dr. José Ramón Gutiérrez Longobardi (evidence file, tome VI, folio 3302). 204 Cf. Note No. Inst. 0212-05 of the DISIP National Director of Investigations of February 18, 2005 (evidence file, tome XI, folio 6133); Ruling of the Twenty-eighth First Instance Trial Court of the Criminal Judicial Circuit of the Caracas Metropolitan Area on March 11, 2005 (evidence file, tome XI, folio 6136), and Medical report of November 15, 2004, signed by Dr. Lily Viseras Gutiérrez (evidence file, tome XI, folio 6134). 205 Cf. Medical report of March 5, 2008, signed by Dr. Efraín González Prato (evidence file, tome XVIII, folios 12135 to 12136), and Note sent by the Director General of the General Directorate of Intelligence and Prevention Services to the Fourth First Instance Trial Court of the Criminal Judicial Circuit of the Caracas Metropolitan Area of March 5, 2008 (evidence file, tome XVIII, folio 12134). 206 Cf. Criminal Investigations Unit decision of March 18, 2008 (evidence file, tome XVIII, folios 12232 to 12233); Note sent by the Director General of the General Directorate of Intelligence and Prevention Services to the Fourth First Instance Trial Court of the Criminal Judicial Circuit of the Caracas Metropolitan Area of March 26, 2008 (evidence file, tome XVIII, folio 12231), and X-ray diagnosis by Dr. Félix Salas Barraez of March 18, 2008 (evidence file, tome XVIII, folios 12234 to 12238). 207 Medical report of March 24, 2008, signed by Dr. Efraín González Prato (evidence file, tome XVIII, folios 12239 to 12240). 208 Cf. Medical report of November 8, 2007, signed by Dr. Efraín González Prato (evidence file, tome XVII, folios 11185 to 11192), and Medical report of March 5, 2008, signed by Dr. Efraín González Prato (evidence file, tome XVIII, folios 12135 to 12136). 38