was an excessive number of healthcare staff; force was used; her requests and her expressions of anxiety and pain were not respected; and the examination was not conducted in a safe, appropriate, and nonintimidating environment.164 Circumstances similar to this were already evaluated by the Inter-American Court in a similar case, and they led it to conclude that they amount to not only arbitrary interference with the victim’s privacy but, because force was used and there was a lack of consent for continuing with the examination, they also constitute grave institutional acts of sexual violence.165 38. Also, at the Trial Court level, Brisa was subjected to another forensic gynecological examination in 2008, which was absolutely unnecessary, as there was no dispute as to whether the alleged victim and the accused had had sexual relations, and an expert examination of this type performed almost seven years after the facts could prove nothing. The irrelevance of this examination does not change based on the "agreement" of the private prosecution with it, as the State has argued,166 as this agreement was reached precisely because original forensic examination was excluded during the second criminal proceeding, leading the Court to reach the absurd conclusion that Brisa and Eduardo "had sexual relations, as their testimony given during the trial stated as much, without specifying the date. However, due to the evidentiary weakness of the public and private prosecutions, the Court cannot find whether these sexual relations were consensual or sexual assault, or even if sexual relations took place, because there is no forensic medical report to indicate such situation.”167 39. Likewise, due to the errors and failures in the investigation and prosecutions, the criminal proceeding has not been decided within a reasonable period of time, as to date, no final judgment has been reached, neither to convict or acquit, even though almost 18 years have passed since the facts under investigation took place. This excessive delay is not attributable to the complexity of the matter or the procedural activity of the interested party. Rather, it is without question the results of the conduct of the prosecutorial and judicial authorities who, because of their errors and failures, caused significant delays in the processing of a number of remedies; the overturning of two final judgments; and the case being sent for a new trial on two occasions. Also, they did not take the necessary measures to prevent the suspect from fleeing despite sufficient indications of such risk during the process, which has prevented completion of the criminal proceeding. 40. Regarding this latter point, as described in the proven facts, from the moment of his original arrest in August 2002, the Office of the Public Prosecutor was aware that Eduardo Gutiérrez presented a flight risk, which was taken into account when he was issued precautionary measures. In addition, in his testimony during the second criminal proceeding, the accused himself stated that he had been "subjected to this process for three years, punctually complying with the requirements, and did not try to escape, even when his own family begged him to do so."168 This indicates that there was a clear risk that he would flee as soon as the ban that had been implemented on leaving the country was lifted. The proceedings give no indication that new precautionary measures were requested after the Supreme Court of Justice annulled the judgment to acquit in May 2007, nor that his arrest and extradition from Colombia had been requested after he fled in November of that year and the holding of contempt of court and arrest warrant were issued in November 2008. 41. As previously noted, judicial ineffectiveness and inefficiency in cases of violence against women, such as is described above, constitutes in itself discrimination against women with regard to access to justice and creates: an environment of impunity that facilitates and promotes the repetition of acts of violence in general and sends a message that violence against women can be tolerated and accepted, fostering the perpetuation and social acceptance of the phenomenon, the feeling and impression of insecurity among women, and persistent mistrust of the justice system.169 42. Therefore, in view of the failure to comply with its duty to act with enhanced due diligence and provide special protection in the investigation of and proceedings surrounding the abuse, violence, and sexual assault alleged by Brisa Liliana De Angulo Lozada, the Commission concludes that the Bolivian State is responsible for In a similar sense, see: Inter-American Court. Judgment of V.R.P., V.P.C. et al., paras. 174-179. Inter-American Court. Judgment of V.R.P., V.P.C. et al., paras. 178-179. 166 Comments on the merits of Bolivia, May 11, 2018, paras. 268-272. 167 Judgment, second oral trial, second criminal proceeding A, page 279. 168 Testimony of Eduardo Gutiérrez Angulo, Second oral trial, second criminal proceeding A, page 271. 169 Inter-American Court. Judgment of V.R.P., V.P.C. et al., para. 291. 164 165 21