33 wheelchair, complaining and crying from the pain in her knee.”289 The duty nurse reported that at 9:20 a.m. she was informed that Ms. Chinchilla had fallen and that when she examined her “her blood pressure was 170/100, pulse 72x, breathing 16 x.” In addition, “she had a scraped knee, which was painful and hot on palpation,” so “she administered two tablets of diclofenac and one tablet of captopril. In addition, Doctor Renato Estrada Chinchilla, Medical Services Coordinator was informed of the inmate's fall and what she had been administered.”290 113. After the nurse arrived, Ms. Claudia Fedora Quintana said, “Blanqui Hernández, the labor officer, arrived, went to see what had happened, and made notes. I went back to bathe and I told [Ms. Chinchilla] what had happened with the books. She told me that she felt alright and in that she was going to make some food. When I came back she was sitting in the chair leaning on the bed and she didn't answer me when I spoke to her, so I nudged her and saw that she was blue. I got scared and went and called the nurse and other girls who were nearby. They began to lift her up with the chair and she sighed. They called the fire department but there was nothing they could do ... The fall happened around 7:00 or 7:30 in the morning and when I returned and saw her in the room it was about 10:30 or 11:00 in the morning. I talked to Dr. Moran and asked her what had happened, and she told me that she had been diagnosed with generalized decompensation and that when she was looking for me it was because she was already in agony. 291 114. With regard to this fact, the duty nurse said that around 11:05 a.m. inmates informed her that Ms. Chinchilla could not breathe and “upon examining her she presented bp: 0/0; pulse: undetectable; breathing: undetectable; pupils dilated and not reflecting light; CPR proceeded to be given but she did not respond, so she was not put on an I.V. drip of Hartmann’s solution”. The nurse said that the actual time of death was declared at 11:25 a.m. and efforts to resuscitate her were made without success.292 115. The Deputy Coordinator of Medical Services informed that he was called at 11:15 a.m. and that upon arriving noted that her face showed “facies cadaverica.” He said that the patient could have presented: “(a) acute myocardial infarction; (b) type II diabetes mellitus (*insulin-dependent).”293 116. With regard to what happened, Osiris Angélica Romano said that “there is too much negligence.” She explained that on that day “Ms. Alba, the deputy director was on duty” y “she does absolutely nothing without authorization from the medical services authorities. She showed no initiative.” Ms. Romano said that after Ms. Chinchilla's fall, the nurse “went and called the doctor on duty, the chief of medical services [who] was Renato Estrada, because they wanted to get her to hospital because her diabetes problem was very advanced ... unfortunately they told her that she could not go.”294 Ms. Quintana Mendoza said that “the 289 Appendix 7 Affidavit of Osiris Angélica Romano before a notary public. Appendix to the representatives’ brief of April 16, 2006. 290 Appendix 10. Female Orientation Center. Communication from the duty nurse to the medical services coordinator. March 25, 2004. Appendix 11 to the State’s brief of July 13, 2010. 291 Appendix 11. Affidavit of Claudia Fedora Quintana Mendoza before a notary public. March 20 January 18, 2005. 292 Appendix 5. Certification of final decision 429-96. Judiciary Final Decision No. 429-96 OF- 7º Office of the Deputy Director of Forensic Sciences. Female Orientation Center. Communication from the duty nurse to the Deputy Director of the COF. May 25, 2004. Page 787. Appendix to the petitioner’s communication of May 26, 2005 received on May 31, 2005. 293 Appendix 5. Certification of final decision 429-96. Judiciary Final Decision No. 429-96 OF- 7º Report of the Correctional System Medical Services Deputy Coordinator. May 25, 2004. Page 788. Appendix to the petitioner’s communication of May 26, 2005 received on May 31, 2005. 294 Appendix 7. Affidavit of Osiris Angélica Romano before a notary public. Appendix to the representatives’ brief of April 16, 2006.