expert opinion and, if this coincided with the recommendation made by the COF doctor, the judge proceeded to grant permission.55 b) Based on preexisting medical appointments, the Director or Deputy Director of the COF would request permission from the judge for her to attend the San Juan de Dios General Hospital (hereinafter “HSJD”), attaching her medical appointments card.56 The judge would then order the Social Information Service to confirm the appointment and, once this was done, the judge would grant permission for her to leave the prison.57 c) If there were scheduled medical appointments, the Director of the COF would forward the request to the judge so that Mrs. Chinchilla could be treated, attaching her medical appointments card; based on that information the judge would grant her permission to leave the prison.58 B.2 Mrs. Chinchilla’s health between 1997 and 2004 i. 1997 45. Mrs. Chinchilla’s health records date from 1997, two years after her imprisonment, when she was 43 years old. She received treatment as an outpatient at the San Juan de Dios Hospital (hereinafter “the HSJD”) on March 4, 1997, after being diagnosed with venous insufficiency of the lower limb, with a history of a previous varicose vein removal procedure on her left leg. In May 1997, Mrs. Chinchilla was “diagnosed with an ANTERIOR VAGINAL BULGE;” in June and July of that year she was seen for “a diagnosis of COMPENSATED DIABETES MELLITUS” and in July she was “examined again for a PARAURETHRAL MASS.”59 She also presented dysuria and the sensation of having a “mass” in the vaginal region and “a stage I-II uterine prolapse.” In addition, she was reported to have “tooth decay, missing teeth, loose teeth and periodontitis.”60 46. In 1997, the judge granted Mrs. Chinchilla permission to attend medical appointments on the following dates: March 25; May 8; May 20; and May 27 (an appointment that she did not attend);61 June 5; June 25 , June 17, and July 23 and 29; July 31; August 5; August 20; Cf. Certification of Enforcement 429-96. Judicial order. Judge of the Second Criminal Enforcement Court. February 27, 1997. (evidence file, folio 121) 55 Cf. Certification of Enforcement 429-96. Request for authorization to receive specialized medical assistance outside of the COF. Director of the COF. Official letter No. 111-97. March 4, 1997. (evidence file, folio 122) 56 Cf. Certification of Enforcement 429-96. Judicial orders. Second Criminal Enforcement Court. March 5 and 18, 1997. (evidence file, folios 125 and 130) 57 Cf. Certification of Enforcement 429-96. Request of authorization to receive specialized medical assistance outside of the COF, Director of the COF, Official letter No. 233-97 of May 14, 1997 and Judicial order, Second Criminal Enforcement Court, May 15, 1997 (evidence file, folios 137 and 138). 58 Cf. Certification of Enforcement 429-96. “San Juan de Dios” General Hospital Official Letter No. 375, 22 September 1997 (evidence file, folio 210). 59 Cf. Certification of Enforcement 429-96. Women’s Orientation Center. Communication of the COF dentist of June 19, 1997 (evidence file, folio 159). 60 Mrs. Chinchilla obtained permission from the Judge of the Second Criminal Enforcement Court; however, she did not go “to get the lung x-ray” because she was “not notified that she was authorized to have that examination.” The Judge authorized a subsequent visit by Mrs. Chinchilla to the “San Juan de Dios” Hospital on June 5, 1997, to have a “lung X-ray”. On May 27, two appointments appear, because one was at clinic No. 31 of the San Juan de Dios 61 19