21 64. In the instant case, it has been proven that Laura Albán arrived at the Metropolitan Hospital, a private health institution located in Quito, Ecuador, on December 13, 1987.42 She was admitted that very same day by instruction of the attending physician, Dr. Ramiro Montenegro-López, on account of said doctor’s diagnosis of a clinical manifestation of bacterial meningitis rendered once clinical tests had been run on the patient.43 In the night of December 17, Laura Albán complained of a great deal of pain.44 Because Dr. Montenegro-López was not at the hospital at such moment, Dr. Fabián Espinoza-Cuesta, the resident physician, treated Miss Albán and prescribed a 10 milligram injection of morphine to relieve the pain.45 Laura Albán died at 1:30 a.m. on December 18, 1987.46 Her medical file47 reflects that the cause of death was “respiratory and cardiac arrest, intracranial hypertension, fulminating acute purulent meningitis.”48 A) Steps taken prior to the criminal proceedings 1) Production and acknowledgment of documents: Medical file 65. According to Laura Albán’s parents, “[…] about six [or] seven months after the passing of [their] daughter […],” they repeatedly attempted to obtain a copy of the medical file from the Metropolitan Hospital. The Metropolitan Hospital refused to release the medical file of Laura Albán49. Accordingly, her mother appeared before Julio Prado Vallejo, the President of the Ecuadorian National Branch of the International Society for Human Rights, who requested the medical file to the Hospital’s Director on June 28, 1990.50 On August 6, 1990, further to such request, 42 Cf. Metropolitan Hospital’s patient admission form of December 13, 1987 (file of internal proceeding, criminal case No. 010-97-AP, Volume I, p. 790). 43 Cf. brief of admission to floor of the Metropolitan Hospital of December 13, 1987 (file of appendixes to the application, appendix 1, pp. 11 and 12). 44 p. 8). Cf. Medical record form of December 13, 1987 (file of appendixes to the application, appendix 1, 45 Cf. record of statement by Dr. Ramiro Montenegro-López, made before the Fifth Criminal Court on January 4, 1987 (file of internal proceeding, case No. 010-97-AP, Volume I, folio 836) and the medical file of Laura Albán (file of appendixes to the application, appendix 1, p. 21). 46 Cf. Simple Free Certificate for the Interment of Laura Albán, Bureau of Civil Records, of December 18, 1987 (file of appendixes to the application, appendix 5, p. 53). 47 The terms medical record, medical file and clinical history have been used interchangeably. For the purposes of the current Judgment, the Court will use the term “medical file.” The medical file includes the set of documents regarding the treatment processes for each patient, identifying the physicians and other professionals involved in them, with a view to achieving maximum integration of the clinical documents for each patient, clinical and surgical data, lab tests, and x-rays performed on the patient, at least within each institution. 48 Cf. medical file (file of internal proceeding, criminal case No. 010-97-AP, Volume I, p. 802, and file of appendixes to the application, Appendix 5, p. 53) 49 Cf. statement of Carmen Cornejo de Albán, delivered before the Court at the public hearing held on May 16, 2007 in the city of Guatemala, Guatemala; and statement of Bismarck Albán-Sánchez, delivered through an affidavit on April 16, 2007 (file on merits, reparations, and costs, Volume II, pp. 276 to 283). 50 Cf. brief by Carmen Cornejo de Albán, addressed to Julio Prado-Vallejo, the President of the Ecuadorian National Branch of the International Society for Human Rights, of December 26, 1989 (file of