undergone appropriate surgical treatment, his chances of surviving the gunshot wound would have been good.” According to the experts, “[t]he lack of relevant medical intervention during the period of ten days after he was shot until he was transferred for operation is totally unacceptable and an example of gross medical negligence.”87 73. Mr. Pedro Miguel Vera Vera was shot with a firearm which caused an injury on April 12, 1993, and he did not undergo surgery until April 22 of that year (supra paras. 46 and 48). In light of this, though the Court deems that the ten day period that passed from the day he was shot until he underwent the ordered surgery caused a deterioration of his physical condition that led to his death. This occurred despite the existence of a judicial order that the operation be carried out. Due to this ten day delay, the medical care he received prior to undergoing surgery was not appropriate, as well as the fact that Ms. Vera Valdez was forced to push for her son's surgery to be carried out, the Court considers that Ecuadorian authorities did not offer adequate and timely medical care to Mr. Pedro Miguel Vera Vera. 74. Last, this Court notes that the expert report of Hans Petter Hougen and Önder Özkalipci (supra para. 20) mention that in the Eugenio Espejo Hospital, Mr. Vera Vera “was [admitted] in very poor conditions” and that “the fact that the doctors identified intestinal necrosis in the autopsy indicates that the surgery was not optimal.” The expert report indicates, moreover, that “the fact that the bullet was not recuperated during the surgery, but rather during the autopsy, increases [the] suspicion [of the experts] of an insufficient operation.”88 In this regard, the Court considers that the evidence is insufficient to conclude that the surgery carried out in the Eugenio Espejo Hospital on April 22, 1993, was negligent. Moreover, neither the Commission nor the representatives have explained or proven why such surgery was inappropriate. B.3. Violation of Articles 5(1), 5(2), and 4 of the Convention, in relation to Article 1(1) thereof 75. In short, the Court observes that in this case, the State of Ecuador did not provide adequate and timely medical care to Mr. Pedro Miguel Vera Vera because he was released after his first hospitalization at the Hospital of Santo Domingo de los Colorados without having undergone relevant diagnostic tests or examinations in light of the injuries he sustained (supra paras. 52 to 54); when he was held at the Provisional Detention Center in Santo Domingo, the State did not immediately transfer Mr. Vera Vera to hospitals with facilities that met his healthcare needs, but rather, he was negligently kept there until the complications from his wound became evident (supra para. 55, 62, and 65); once transferred to the Hospital of Santo Domingo de los Colorados, Mr. Vera Vera did not undergo surgery nor were the appropriate measures adopted to attend to his serious health condition, which only led to a more 87 Expert testimony of Messers. Hans Petter Hougen and Önder Özkalipci (case file of Merits, tomo I, folios 571 to 573). 88 Expert testimony of Messers. Hans Petter Hougen and Önder Özkalipci (case file of Merits, tomo I, folio 573). 30

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