[…] [5.] The State […] must enact or amend laws concerning health care professionals, which must include the relevant national and international standards, emphasizing and according full validity to patients’ rights. [Also …], it undertakes to present a bill that includes the pertinent reforms concerning medical malpractice and patients’ rights [October 2012]. [6.] The State [will provide] training to health care professionals about patients’ rights in both the public and the private sphere in a planned and sustainable manner [October 2012]. 77. On September 14 and 15, 2011, the representatives and the State, respectively, advised the Commission about the signature of the agreement. In addition, in its brief, the State asked the Commission to endorse the said document. 120 The Commission did not comment on this aspect. Then, on October 10, 2011, the State asked the Commission for an additional period of three months in order to report on the progress achieved in compliance with its recommendations. 121 In this regard, on October 24, 2011, the Commission advised that it had granted the requested extension; that the new time frame for complying with the recommendations would expire on January 26, 2012, and that, on January 5, 2012, the State should provide information on progress in this regard. 122 78. Subsequently, on December 28, 2011, Melba Suárez Peralta and her mother, Melba Peralta Mendoza, together with the State, prepared a second Compliance Agreement, which explicitly replaced the first document signed on September 8, 2011. This document would also have established a new timetable for execution of the provisions that had previously been agreed on, but it was never formalized. In this regard, on January 18, 2012, the representatives informed the Commission that they had signed this second agreement and indicated that the State had not yet complied with it. For its part, the State advised the Court that the second Compliance Agreement had not been signed on behalf of the State, because the payment vouchers did not cover the amount claimed. 79. On January 26, 2012, the State provided information to the Commission on the status of compliance with the agreement of September 8, 2011. 123 In this regard, it advised that it had not complied with the payment of the agreed compensation because it had asked the husband of the “victim for supporting documentation to justify the pecuniary damage suffered”; his supporting documents “justif[ied] expenses of nineteen thousand six hundred and twenty nine dollars and thirty seven cents ($19,629.37).” The difference with the amounts agreed on “limited the State’s actions when complying with the payment of three hundred thousand dollars.” Thus, the State advised the Commission that, “for the second time, [it would] request additional documentation that would justify, objectively and absolutely, the expenses incurred since 2001.” In this regard, the Court observes that the Agreement did not establish that the expenses had to be authenticated, and that the payment was not subject to any conditions. Also, with regard to the recommendation concerning medical services, the State indicated that officials from “the health sector would ensure the logistics necessary to attend Melba Suárez Peralta,” but, according to the State, following a visit to the victim at her home she rejected the services of the public health system. 120 Briefs of the representatives (file of proceedings before the Commission, folios 856 to 865, and 837 to 849) and note No. 06982 of the Attorney General’s Office of September 25, 2011 (file of proceedings before the Commission, folio 841). 121 Note No. 04124 of the Attorney General’s Office of October 10, 2011 (file of proceedings before the Commission, folios 837 to 849). 122 Communication of the Inter-American Commission of October 24, 2011 (file of proceedings before the Commission, folios 826 to 828). 123 Note 4-2-91/12 of the Ministry of Foreign Affairs, Trade and Integration of Ecuador of January 25, 2012 (file of proceedings before the Commission, folios 1624 to 1637). 24