20 62. In February 2000, on becoming aware of the existence of the Universal Health Insurance for Mothers and Children and the basic health insurance program, I.V., who was 35 years of age at the time and pregnant with her third daughter, began to attend the Women’s Hospital in La Paz to receive pre-natal health care.42 63. On the afternoon of July 1, 2000, I.V. was admitted to the Women’s Hospital in La Paz, after experiencing the spontaneous rupture of the membranes at week 38.5 of her pregnancy and pain at the level of the caesarean section she had undergone in 198243 (supra para. 61). Since the attending physician verified that she had previously had a caesarean section, that she had not gone into labor, and that the fetus was in transversal position, he decided to perform a caesarean section.44 During the procedure, the surgical team consisted of the obstetrician-gynecologist, who was the head of the doctors on call at the time and acted as the instructing surgeon and second surgeon; the third-year resident doctor acting as the main surgeon; the anesthetist45 and the assistant.46 An intern, acted as a second assistant, and an operating theater assistant were also present during the procedure.47 64. The caesarean section was started by the third-year resident doctor just after 19:00 hours.48 However, during the caesarean section surgical procedure, the presence of numerous adhesions in the lower uterine segment was verified49 and, therefore, owing to the complexity of the case, the obstetrician-gynecologist took charge of the operation in his capacity as instructing surgeon. 50 After Cf. Medical record (file of the procedure before the Commission, volume II, folios 339 to 378); Record of the Medical Audit Decisions Committee of March 13, 2001 (evidence file, volume VII, annex 3 to the submission of the case, folios 2120 to 2134), and Statement made by I.V. before the Inter-American Court during the public hearing held on May 2, 2016. 42 43 Cf. Medical record (file of the procedure before the Commission, volume II, folios 339 to 378). Cf. Preoperative note dated 1, 2000 (evidence file, volume X, annex 16 al Answering brief of the State, folio 3650); Medical Audit record of the operation performed on I.V. (evidence file, volume VII, annex 1 to the submission of the case, folios 2115 and 2116); Final conclusions of the medical audit by the Departmental Medical Audit Committee of March 9, 2001 (evidence file, volume VII, annex 2 to the submission of the case, folio 2118), and Report issued by the Medical Audit Decisions Committee of March 13, 2001 (evidence file, volume VII, annex 3 to the submission of the case, folios 2120 to 2134). 44 Cf. Record of the surgical procedure transcribed by the Women’s Hospital (evidence file, volume VII, annex 8 to the submission of the case, folio 2138); Medical Audit record of the operation performed on I.V. (evidence file, volume VII, annex 1 to the submission of the case, folios 2115 and 2116); Statement made by Edgar Torrico Ameller before the Inter-American Court during the public hearing held on May 2, 2016, and Affidavit prepared by Marco Vladimir Vargas Terrazas on April 28, 2016 (evidence file, volume XI, affidavits, folios 3929 to 3939). 45 Cf. Resolution issued by the Second Trial Court of the La Paz Judicial District on November 18, 2002 (evidence file, volume X, annex 17 to the State’s answering brief, folio 3654). 46 Cf. Medical Audit record of the operation performed on I.V. (evidence file, volume VII, annex 1 to the submission of the case, folios 2115 and 2116); Report of the Audit Committee on the case of patient I.V. of August 22, 2000 (evidence file, volume VII, annex 4 to the submission of the case, folio 2136), and Affidavit prepared by Marco Vladimir Vargas Terrazas on April 28, 2016 (evidence file, volume XI, affidavits, folio 3936). 47 Cf. Affidavit prepared by Marco Vladimir Vargas Terrazas on April 28, 2016 (evidence file, volume XI, affidavits, folios 3929 to 3939); Statement made by Edgar Torrico Ameller before the Inter-American Court during the public hearing held on May 2, 2016; Statement made by J.E. on July 27, 2004, according to the record of the oral hearing issued by the Copacabana Trial Court (evidence file, volume XII, annex 1(c)) to the State’s final arguments, folio 4755), and Resolution issued by the Second Trial Court of the La Paz Judicial District on November 18, 2002 (evidence file, volume X, annex 17 to the State’s answering brief, folios 3652 to 3659). 48 Cf. Affidavit prepared by Marco Vladimir Vargas Terrazas on April 28, 2016 (evidence file, volume XI, affidavits, folio 3937); Statement made by Edgar Torrico Ameller before the Inter-American Court during the public hearing held on May 2, 2016; Record of the surgical procedure transcribed by the Women’s Hospital (evidence file, volume VII, annex 8 to the submission of the case, folio 2138); Final conclusions of the medical audit by the Departmental Medical Audit Committee of March 9, 2001 (evidence file, volume VII, annex 2 to the submission of the case, folio 2118), e Report of the Audit Committee on the case of patient I.V. of August 22, 2000 (evidence file, volume VII, annex 4 to the submission of the case, folio 2136). 49 Cf. Statement made by Edgar Torrico Ameller before the Inter-American Court during the public hearing held on May 2, 2016; Affidavit prepared by Marco Vladimir Vargas Terrazas on April 28, 2016 (evidence file, volume XI, affidavits, folios 3929 to 3939), and Resolution issued by the Second Trial Court of the La Paz Judicial District on November 18, 2002 (evidence 50