fever. 26 During this consultation, Emilio Guerrero diagnosed chronic appendicitis and informed her that se required an urgent operation. 27 According to the testimony of Jenny Bohórquez, Emilio Guerrero told Melba Suárez Peralta that she should undergo some laboratory tests; 28 however, Mrs. Suárez Peralta indicated that these tests were not performed. 29 41. On July 1, 2000, Melba Suárez Peralta consulted the same doctor again, this time in the Minchala Clinic (a private clinic located in Guayaquil, Ecuador). During this consultation, Emilio Guerrero decided that she should undergo surgery, under the diagnosis of acute appendicitis. 30 According to her medical record in this institution, the operation took place on July 1, performed by Dr. Jenny Bohórquez, first assistant Emilio Guerrero Gutiérrez, anesthetist César García, and the nurse Olga, whose last name was not mentioned. 31 B. Facts subsequent to the operation 42. After the operation, Melba Suárez Peralta suffered intense abdominal pain, vomits and other complications. 32 On July 11 she went to the Luis Vernaza Hospital, and was seen by Dr. Héctor Luis Taranto, who indicated that she was pale, with abdominal swelling, anorexia and diffuse abdominal pain. 33 The doctor also diagnosed acute post-surgical abdomen and, classified her as a patient in an extremely serious condition, so that she had to undergo surgery again on July 12. During the operation, the doctor performed a reexploratory laparotomy, in the course of which he found “dehiscence of the appendicular stump, localized peritonitis, and fibrin clumps.” The abdominal cavity was also cleaned and drained, with the aspiration of purulent matter, and part of her colon was removed. 34 26 Cf. Medical record of Melba Suárez Peralta issued by the Polyclinic of the Guayas Traffic Commission No. 11794 (file of annexes to the final arguments, folios 2995); Medical record of Melba del Carmen Suárez Peralta issued by the Minchala Clinic, No. 975 (file of annexes to the Merits Report, folio 112), testimonial statement provided by Wilson Benjamín Minchala Pichu on October 19, 2001 (file of annexes to the Merits Report, folios 105 and 106), and testimony provided by Jenny Bohórquez on November 13, 2001 (file of annexes to the Merits Report, folios 130 a 134). 27 Cf. Medical records of Melba Suárez Peralta issued by the Polyclinic of the Guayas Traffic Commission No. 11794 (file of annexes to the final arguments, folio 2995). 28 Cf. Testimony provided by Jenny Bohórquez on November 13, 2001 (file of annexes to the Merits Report, folio 130). 29 Cf. Testimony provided by Melba Suárez Peralta on September 6, 2000 (file of annexes to the Merits Report, folio 16). 30 Cf. Medical records of María del Carmen Suárez Peralta issued by the Minchala Clinic (file of annexes to the Merits Report, folios 109 a 120) 31 The reason for the operation was “pain in the right iliac fossa accompanied by hyperthermia, vomits and difficulty in walking”; while she was described as a “patient who states that, yesterday, she consulted a doctor about pain in the epigastric region that, in the afternoon, extended to the right iliac fossa, accompanied by hyperthermia, vomits and difficulty in walking, […] this became more intense today, so that it was decided to intern her in order to operate on her.” Cf. Medical records of María del Carmen Suárez Peralta issued by Minchala Clinic, No. 975 (file of annexes to the Merits Report, folio 112); Testimony provided by Jenny Bohórquez on November 13, 2001 (file of annexes to the Merits Report, folio 130), and statement made by Melba Suárez Peralta during the public hearing held in this case on February 11, 2013. 32 2013. 33 21). Cf. Statement made by Melba Suárez Peralta during the public hearing held in this case on February 11, Cf. Testimony by Héctor Luis Taranto on November 12, 2001 (file of annexes to the Merits Report, folio 34 Cf. Operation protocol of the Luis Vernaza Hospital (file of annexes to the Merits Report, folio 19), and Testimony by Héctor Luis Taranto on November 12, 2001 (file of annexes to the Merits Report, folio 21). 13