convulsions. Although the Metropolitan Hospital is a private hospital it requires authorization to
function from the Ministry of Health, a State entity. She was placed under the care of Dr.
Ramiro Montenegro Lopez, a neurologist, and the attending physician, and she remained under
his care until she died on December 18, 1987. Dr. Ramiro Montenegro Lopez, the resident
physician, administered the lethal morphine on December 17, 1987.
6. The petitioners allege that they suffered inhumane treatment from the time they entered
the hospital. The authorities demanded Laura's identification card and two blank checks as a
guarantee. Laura was immediately placed in the intensive care unit and the petitioners were
informed that she would be under the care of a physician and a head nurse. The petitioners,
anxious for their daughter's well-being, entered her room, despite the hospital prohibition on
their doing so, and found her in an isolated cubicle, complaining of thirst and a headache and
with no one attending to her. The only nurse present was on the phone and did not respond to
petitioner's request that a doctor be called.
7. The petitioners are primarily concerned about the impunity granted the physicians by the
Ecuadorian judicial system. On November 6, 1990, following the death of their daughter, the
petitioners were unable to obtain her hospital file from the hospital authorities. Consequently
they went to court to obtain a copy of the clinical history of their daughter's case, a procedure
that took two years. The Court, the Juzgado Octavo de lo Civil de Pichincha, obtained a copy of
the file, but it was not made available to the petitioners.
8. In December 1990, some physicians analyzed the case on the basis of the clinical history. It
was determined that the cause of death was the administration of morphine to the patient, a
drug which is totally counter-indicated in cases of meningitis, convulsions and inter-cranial
hypertension, the three symptoms which Laura suffered from.
9. On November 25, 1993 the petitioners filed a complaint before the Medical Association of
Pichincha. On January 4, 1995, the Honor Tribunal of the Medical Association issued a decision
acquitting the accused physicians of any responsibility. This decision was rejected by the
petitioners and their lawyers for violating the norms of logic and ethics, and for ignoring the
medical evidence available.
10. In November 1993, following the appropriate presentation of a cause of action, the
petitioners again went to Court. In the Court, the Juzgado 1º de lo Civil de Pichincha, Dr.
Ramiro Montenegro López, the accused attending physician was summoned to appear. He was
summoned three times and Dr. Montenegro refused to appear. On February 17, 1994 the
Judge cited him for contempt and imposed a daily fine until he appeared before him. Dr.
Montenegro continued to refuse to appear.
11. On August 3, 1995 petitioners presented a complaint before the then Attorney General
(Ministro Fiscal General), Dr. Fernando Casares, who refused to intervene in the case and
returned the complaint to the petitioners.
12. On November 1, 1996 the petitioners brought the case to the attention of the Attorney
General (Ministro Fiscal General de la Nación), Dr. Guillermo Castro Dager. On November 25,
1996 Dr. Castro received them in his office and the petitioners presented their complaint
against the Metropolitan Hospital, and against the two doctors for the death of their daughter,
Laura, for having administered an inappropriate drug that caused her death. They based their
complaint on Articles 456 and 457 of the Penal Code that renders the administration of drugs,
leading to the death of the patient, a crime of intentional homicide when committed by a
physician. 2
2 Art. 456 [Homicidio preterintencional por suministro de sustancias]. - Si las sustancias administradas
voluntariamente, que pueden alterar gravemente la salud, han sido dadas sin intención de causar la muerte, pero la
han producido, se reprimirá al culpado con reclusión menor de tres a seis años. Art. 457.- [Presunción legal].- En la
infracción mencionada en el artículo anterior, se presumirá la intención de dar la muerte si el que administró las
2