7. The petitioner alleges that as a result the patient sought an outpatient visit at the Luis Vernaza hospital where she was diagnosed with acute post-surgical abdomen. When they operated on her again, they found numerous sutures, “intestinal fluid, purulent matter, fecal content, and abdominal viscera, covered by fatty fibrin []” and thus had to perform various procedures2 and wash and drain the pelvic abdominal cavity. The petitioner alleges that the diagnosis from the anatomical-pathological study was “acute post-operative abdomen, dehiscence of the appendicular stump”3 as a result of medical malpractice.4 8. The petitioner states that the partial spill of feces inside Mrs. Suárez Peralta’s intestine led the doctors to remove a portion of her intestine to prevent total contamination of her body and at the time the petition was submitted to the Commission she had to follow a strict diet and take special care of her food. The petition also states that Mrs. Suárez Peralta still needed to undergo another surgery to correct the effects of medical malpractice. 9. It is alleged that on August 3, 2000, Mrs. Melba Peralta Mendoza, mother of Melba Suárez Peralta, filed a criminal complaint for medical malpractice against Dr. Emilio Guerrero Gutiérrez in her daughter’s name. The petition states that on August 16, 2000 the First Judge for Criminal Matters of Guayas issued an Order to Open the Judicial Process and precautionary measures in order to determine liabilities. The petitioner alleges that during 2000 the aforementioned judge issued a series of official letters and notices ordering relevant investigations and various procedures. These included a request to the National Police to conduct forensic tests on Mrs. Suárez Peralta. In addition, the petitioner alleges that it was demonstrated that Dr. Emilio Guerrero Gutiérrez had not begun procedures for approval of his employment or professional identification, and he is thus alleged to have been practicing medicine illegally. 10. The petitioner alleges that on November 14 and December 27, 2000 Mrs. Peralta Mendoza filed complaints with the judge due to the delay in processing her briefs and handling her requests for inspection of the location where the events took place. That inspection was finally carried out on February 6, 2001. On March 22, 2001, the First Court for Criminal Matters of Guayas declared the preliminary phase concluded as the period for it had expired and ordered Mrs. Peralta Mendoza to present a formal accusation to send the case files to the Public Prosecutor’s Office for issuance of an opinion. 11. The petitioners allege that the accusation was formalized by Mrs. Peralta Mendoza on March 29, 2001 and that on May 29, 2001 the First Prosecutor for Criminal Matters of Guayas issued an opinion accusing Dr. Emilio Guerrero Gutiérrez. They also state that on June 7, 2001, a request was made to extend the summary proceeding to include Dr. Wilson Benjamín Minchala Pinchú, the owner of the Minchala clinic, because of his complicity in having allowed Dr. Guerrero Gutiérrez to practice medicine without authorization from the Ministry of Health. On August 14, 2001, the First Judge for Civil Matters of Guayaquil ordered expansion of the preliminary proceeding and an Order to Open the Judicial Process against Dr. Minchala Pinchú. On August 29, 2001, Drs. Minchala and Guerrero asked the judge to declare the case invalid and on September 19, 2001 the judge declared the preliminary proceeding concluded because the period for reopening the case had more than expired. On September 25, 2001, Mrs. 2 “Right hemicolectomy, plus ileo-transverse anastomosis”. Original petition received by the IACHR on February 23, 2006, p. XXX. Citing the version prepared by Dr. Héctor Luis Taranto Ortiz, who attended the patient. The report from the forensic physician, Juan Montenegro Clavijo, dated September 18, 2001, indicates that the reason for the patient’s admission was “post-operative fever, vomiting, abdominal pain, suture dehiscence (right parietal). On July 12, 2000 it was appendicular stump. Operation performed: Reexplorative laparotomy: Right hemicolectomy plus ileo-transverse anastomosis and washing and draining of cavity. Surgical findings: dehiscence of the appendicular stump (suture), localized peritonitis, fibrin clumps. Pathological diagnosis: transverse colon and ileum: acute peritonitis. Vascular thrombosis (area of appendicular stump). Clinical history of appendectomy seven days prior. Abdominal sepsis.” Original petition received by the IACHR on February 23, 2006, p. XXIX. 3 Original petition received by the IACHR on February 23, 2006, p. XXIX. 4 The petitioner states that the crime of medical malpractice is defined in Arts. 436, 456, and 457 of the Penal Code of Ecuador, but its passive subjects are only those who have been harmed by having been given a substance. Original petition received by the IACHR on February 23, 2006, p. XXX. 2