46 162. Although the State informed that at some point during her imprisonment it had installed a special toilet and hand-washing basin, and that Ms. Chinchilla had her own room with a refrigerator and a television, the Commission believes that such measures are insufficient to denote special care in ensuring the conditions appropriate to her special needs as a result of her disabilities, a fact reflected in her own statements, when she said, "[T]he condition in which I find myself is torture. I cannot fend for myself and, as I said, I am going blind. The other inmates do not help me, much less the prison warders because they are under no obligation to do so." 163. In light of the foregoing, the Commission finds that the State breached its special obligation to ensure Ms. Chinchilla’s dignity and human treatment given her disabled condition. 3.4 The State’s response on the day that Ms. Chinchilla died 164. The Commission has already concluded that the COF did not provide treatment that adequately met Ms. Chinchilla’s special needs. Specifically with respect to life-threatening emergencies, the Commission notes that at the hearing of February 14, 2003, the Public Prosecution Service medical examiner said that Ms. Chinchilla was suffering a decompensation of her "underlying problem," needed hospital treatment, and that her life would be in danger without adequate treatment. At the same hearing, the COF doctor stated that for a diabetic to die their sugar levels would have to be above 600, so someone with between 500 and 600 could be taken to a hospital emergency room in time. However, for permission to be granted to leave the prison it was necessary to do a blood sugar level test and if it was high, permission was granted. The judiciary medical examiner, for his part, agreed at the hearing of April 21, 2004, that if the patient went into a state of diabetic ketoacidosis and then into a coma she would have a “chance” but the time taken to evacuate her would be critical. 165. The Commission further notes that by the day Ms. Chinchilla died no additional studies had been carried out on her, despite the fact that her blood pressure was high and that around a month earlier the Medical Services Coordinator was informed that Ms. Chinchilla presented “epigastric hardness” and it was suggested, therefore, that she undergo an ultrasound scan “to screen for any significant pathology.” 166. From the foregoing, the Commission notes that by the day she died Ms. Chinchilla had multiple ailments, many of them neither diagnosed nor treated, as the preceding paragraphs show. Furthermore, as noted, the diabetes had progressed without it being properly treated. It was in these circumstances that the events of May 25, 2004 occurred. 167. The following is a summary of the facts that Commission has collated about what happened on the day Ms. Chinchilla died: - Ms. Chinchilla suffered a fall because of a step that prevented her from getting by in her wheelchair, due to the fact that she had no one to help her move. As mentioned above, this situation is attributable to the State of Guatemala which neglected to implement reasonable modifications at the COF so as to afford Ms. Chinchilla conditions that were compatible with her disabled condition. - After her fall a nurse was called, who said in her statement that she examined her and found “her blood pressure was 170/100, pulse 72x, breathing 16 x”; she also said that “she had a scraped knee, which was painful and hot on palpation” and “she administered two tablets of diclofenac and one tablet of captopril.” The Commission notes that the nurse did not perform a glucose test on Ms. Chinchilla which, according to the doctor’s statement, was essential to determine if hers was an emergency case so as to authorize her to go to hospital for treatment. - According to the statements of Ms. Angélica Romano and Ms. Quintana Mendoza, Ms. Chinchilla’s fall occurred between 7:00 and 7:30 a.m. or at 8:15 a.m. According to the nurse’s