Kowalski v. Johns Hopkins All Children’s Hospital: ‘Take Care of Maya’ Trial

Posted at 2:29 PM, January 22, 2024
Lauren Silver Lauren Silver and Emily Kean Emily Kean and Court TV Staff Court TV Staff

ST. PETERSBURG, Fla. (Court TV) — Months after a jury awarded a family a historic judgment of more than $200 million for ill-treatment by a hospital, a judge has reduced the amount the family will receive.

After deliberating for just over 16 hours over three days, a Florida jury concluded that a hospital’s actions led to a mother’s suicide.

Johns Hopkins All Children’s Hospital was found liable for all civil claims in the “Take Care of Maya” Trial and the jury preliminarily awarded the Kowalski family $211,451,174. The same jury then awarded the family an additional $50 million in punitive damages.

In an order dated Jan. 16, 2024, the judge who presided over the trial lowered the damages awarded by the jury by $47.5 million in response to post-trial motions filed by the hospital. In his decision, the judge deemed some of the damages which he deemed “excessive,” reducing the total to $213.5 million.

The judge also denied the hospital’s request for a new trial. The hospital had alleged juror misconduct in their motion for a new trial.

WATCH: ‘Take Care of Maya’ Trial: Watch the Verdict

JHACH was found liable for the following:

  • False imprisonment of Maya Kowalski
  • Battery of Maya Kowalski
  • Fraudulent billing of Jack Kowalski
  • Inflicting emotional distress on Beata Kowalski
  • Wrongful death claim for the estate of Beata Kowalski
  • Intentionally inflicting emotional distress on Maya Kowalski

The punitive phase of the trial began immediately after the liability phase. The jury deliberated for less than an hour before returning a judgment ordering Johns Hopkins All Children’s Hospital to pay a total of $50 million on top of the initial damages of more than $200 million.

WATCH: ‘Take Care of Maya’ Trial: Punitive Phase Verdict

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Maya Kowalski, whose story has been viewed by millions in the Netflix documentary, “Take Care of Maya,” took the stand briefly on Tuesday outside the jury’s presence to authenticate a letter she wrote to her family while she was separated from them.

Jack Kowalski, on behalf of his children Maya and Kyle and the estate of his late wife Beata, filed the lawsuit against Johns Hopkins All Children’s Medical Center, which treated his children beginning in 2015. Kowalski said the hospital’s treatment and accusations of child abuse against Beata led her to take her own life in Jan. 2017.

Opening statements in the case began on Sept. 21. The prosecution accused the hospital of medical malpractice, battery, Maya’s false imprisonment, intentional infliction of emotional distress and alleged fraud. The attorney representing the hospital said in his opening statement that actions taken by John Hopkins were reasonable and in the best interest of the patient.

maya kowalski appears in court

Maya Kowalski appears in court Thursday, Sept. 21, 2023. (Court TV)

While the lawsuit was initially filed against multiple people, an eighth amended complaint filed on Jan. 24, 2023, listed only the hospital and Catherine Bedy, a social worker, as defendants. A filing on Monday, after jury selection had already started, removed Bedy as a defendant.

According to the lawsuit, Maya was initially admitted to JHACH in July 2015 for a severe asthma attack and began experiencing severe pain and significant weakness. In Sept. 2015, Maya was diagnosed with Complex Regional Pain Syndrome, a neuropathic disease “generally caused by damage to or malfunction of the central nervous system,” according to the suit. To treat the diagnosis, Maya was given Ketamine infusion treatments, which caused her symptoms to steadily improve.

In Oct. 2016, Maya began to experience abdominal pain and vomiting. She was taken back to All Children’s Medical Center for treatment. Beata was with her daughter and asked for Maya to be given the appropriate dosages of pain medications she needed.

“Upon information and belief, certain JHACH personnel, despite their unfamiliarity with treating CRPS and despite Dr. Hanna’s corroboration of Beata and Jack’s relaying of the recommended CRPS treatments, became offended and defensive by the suggestions given by the mother (a registered IV nurse) and father (a retired Chicago firefighter). Almost immediately, Defendants, and specifically Debra Hansen, a social worker employed by JHACH, reported Beata to the DCF Child Abuse Hotline, claiming that Beata was interfering with Maya’s treatment and there was a disagreement about dosages of Ketamine.”

According to the lawsuit, despite DCF finding valid prescriptions for the dosages of Ketamine on file and JHACH being told to close the investigation, the hospital then tried to fight Jack and Beata when they tried to remove Maya from the hospital. At that point, the suit alleges, the hospital brought in Dr. Sally Smith, who was introduced as a pediatrician but was, in fact, the hospital’s director of child abuse and was “improperly granted … access to Maya’s medical record in order to build a case of child abuse against the family.”

“Upon information and belief, Dr. Smith directly and/or indirectly issued orders to JHACH physicians and staff, such as isolating Maya, covertly surveilling Maya by video for a period of approximately 48 hours, ordering a regime of physical therapy, issuing directions to wean Maya off pain medications, and placing restrictions on the Kowalskis’ visitation rights within JHACH.”

The lawsuit accuses the hospital of working with its staff to “imprison” Maya without legal justification and barring her family from visiting. “The resulting prolonged separation from their suffering daughter manifested in Beata’s depression, fatigue, and overwhelming sense of hopelessness. … Despite specific and documented warning signs, JHACH and Dr. Smith continued a campaign of degradation and threats towards the Kowalskis, and specifically, Beata.”

In a statement following the jury’s finding of liability, Johns Hopkins All Children’s Hospital released a statement from Howard Hunter and Hill Ward Henderson:

“We thank the jury for their time and attention during this trial and intend to pursue an appeal based on clear and prejudicial errors throughout the trial and deliberate conduct by plaintiff’s counsel that misled the jury. The evidence clearly showed that Johns Hopkins All Children’s Hospital followed Florida’s mandatory reporting law in reporting suspected child abuse and, when those suspicions were confirmed by the district court, fully complied with Department of Children and Families (DCF) and court orders. We are determined to defend the vitally important obligation of mandatory reporters to report suspected child abuse and protect the smallest and most vulnerable among us. The facts and the law remain on our side, and we will continue to defend the lifesaving and compassionate care provided to Maya Kowalski by the physicians, nurses and staff of Johns Hopkins All Children’s Hospital and the responsibility of all mandatory reporters in Florida to speak up if they suspect child abuse.”

The emotional case has already been the subject of a Netflix documentary, “Take Care of Maya,” which was viewed more than 10 million times within a month of its release, Scripps News Denver reported.

DAILY TRIAL UPDATES

DAY 30: 11/9/23

DAY 29: 11/8/23

DAY 28: 11/7/23

DAY 27: 11/6/23

  • The jury was dismissed for the morning, while Judge Carroll heard arguments about the imminent/immediate jeopardy issue that came up last week.
  • Plaintiffs presented and rested their rebuttal case.
  • Judge Carroll instructed the jurors.
  • One juror (an alternate) was dismissed for a medical issue.

DAY 26: 11/1/23

  • Two nurses testified about Maya’s modesty and the process for her taking a shower while she was in the hospital.
  • The defense rested its case.
  • The plaintiffs recalled Dr. Pradeep Chopra as a rebuttal witness, who said that CRPS can start in one part of the body and move to the whole body.
    • Chopra said that ketamine was approved by the FDA in 2019 for treatment of CRPS as an “orphan drug”
  • Jack Kowalski returned to the stand and described meeting Sally Smith, saying she wore a white coat at the time.
  • Dr. Joseph Corcoran, a policy and procedure expert, testified that a joint commission found that the hospital’s heart unit was in “immediate jeopardy,” in contrast to testimony from the defense expert Mark Anderson, who testified that the hospital was well-run and without issues.
    • Judge Carroll was alarmed that an evidentiary issue like this would appear so late in the trial. The defense is working to get a copy of the report showing that the hospital passed with no problems and a self-report that reflected the issues with the heart unit.
  • Maya Kowalski was recalled to address photos that the defense introduced.

DAY 25: 10/31/23

  • Dr. Randell Alexander, a child abuse pediatrician, testified about the typical process in place after an allegation of child abuse and said that Dr. Smith followed protocols.
  • Dr. Jenny Dolan, Chief of Pediatrics at Johns Hopkins All Children’s Hospital, testified that she had never seen high-dose ketamine used to treat CRPS
    • She initially thought her nurse practitioner had made an error after seeing notes about the dosages Maya was receiving.
    • Dolan said she believed that Maya had CRPS.
    • Dolan described Maya’s parents as using foul language and insisting they weren’t crazy when she wanted to change the course of treatment.

DAY 24: 10/30/23

  • Catherine Bedy, a licensed social worker who was involved in Maya’s case, took the stand.
  • Dr. Sharon Levy, pediatrician and addiction medicine expert, testified about the addictive qualities of ketamine and what withdrawals look like.
    • Levy never met with or examined Maya, just reviewed records.
  • Kelly Thatcher, a pediatric nurse practitioner, described Maya as upset and cursing with staff.

DAY 23: 10/27/23

  • Defense’s Witness #27 – Dr. Sally Smith, Former Director of Pinellas County DCF – Suncoast Advocacy, JHACH
    DIRECT

    • Maya’s behavior drastically changed when something was happening with her family
    • Maya complained of pain everywhere? She only said her stomach did not hurt and rated her head pain 8 or 9 out of 10
    • Maya in a wheelchair? She was sitting straight up and had no difficulty
    • Mr. Kowalski understood her behavior is filled with exaggerations
    • What was mom’s reaction to conversion disorder? She had observed the same thing as the diagnosis
    • Met with Maya alone and her dad came in later…I told Maya that she could return to school because of her improvements
    • She said she wanted to spend more time with mom because she was working all the time
    • Mr. Kowalski reaction? Mom worked a lot and that mom had decreased interaction with the family and he was the primary caretaker.
      CROSS
    • Is there a diagnosis of conversion disorder? No.
    • It is not exactly rare for a 9-year-old girl to want to spend time with her mother?
    • And a young girl to be more expressive with family than a stranger? Not necessarily
    • I don’t what a normal 9-year-old is but would be objective to be open to someone else
    • She was happy when they were gone
  • Defense’s Witness #32 Dr. Ashrah Hanna, Florida Spine Institute (Maya’s Doctor) – VIDEOTAPED DEPOSITION
    • She would show me video of Maya jumping in a pool and being with family and thought she was improving…
    • Did you tell her to go to JHACH? Yes
    • Why? I failed to help her and she needed to go to a bigger place to figure out what was going on….
    • Who gave the order to have port placed? I did.
    • You went up to 1250 mg of ketamine and 50 mg ketamine inbolis…
    • Her mother came in and said she’s screaming and crying….the father was there…I told them I am really running out of options and see if I gave it to her in a shorter period of time and gave her the maximum amount and if she could not respond…she would have to go to the hospital…
    • (Aggressively) You have not seen CRPS patients sir….
    • Your office was contacted by the emergency room? Yes. I told them that we were treating her with ketamine infusions and I gave her the maximum amount and I failed to help her and there was nothing else I could do for her and I told them to go to the hospital….
    • Can high dose of ketamine cause a patient not to eat in five days? I was not aware of that she was not eating and I know that her mother was giving her IV fluids….

DAY 22: 10/26/23

DAY 21: 10/25/23

  • Registered nurse Lisa Rek testified about Maya’s morning routine in the hospital.
  • Pediatric physical therapist Dr. William Siesel testified that he saw areas of improvement while working with her, as well as inconsistencies with Maya’s complaints.

DAY 20: 10/24/23

  • The defense presentation continues with a variety of doctors who speak to pain management, neuropsychology and Maya’s treatment at John Hospikins All Children’s Hospital.

DAY 19: 10/23/23

  • Dr. Elvin Mendez recalled Maya and her mother visiting him at his office. They were seeking a second opinion on a matter regarding immunodeficiency.
    • Maya was in a wheelchair and appeared to be in pain.
    • He was concerned about Munchausen by Proxy because the information he had did not line up with the examination or correlate with what he saw.
  • Pediatric Neuropsychologist Dr. Jennifer Katzenstein testified about meeting with Maya, Maya’s family, and the pain team to discuss care.
    • Beata asked her to review her blogs and fundraisers to better understand Maya’s condition but the doctor preferred to make her own assessment.
    • Said that during evaluations, Beata and Jack (not Maya) answered all her questions; but in interactions without her parents, Maya was able to articulate was was going on.
    • Testified that Dr. Dally Smith was an external provider contracted by DCF, that Dr. Smith was not treating Maya through Johns Hopkins All Children’s Hospital, rather, she was working for DCF.
    • Dr. Katzenstein said she worked with Maya on her goals and that Maya was rewarded for working on goals with things like art supplies, Shopkins toys, and gelato.
  • Pediatric anesthesiologist Dr. Richard Elliott testified that he was concerned about the the very large doses of ketamine that Maya was getting — that they were over 50 times higher than he would give anyone.
    • Said ketamine WAS approved by the FDA to use in low doses.
    • His working diagnosis was that Maya had CRPS.
    • He was aware that the Kowalski’s might be jailed, but his concern was Maya’s safety.
    • Said that he was notified that Maya had had about 50 ketamine treatments before becoming a patient at Johns Hopkins All Children’s Hospital.
    • Said he never ruled out the possibility that Maya had CRPS but believes she showed some inconsistencies, and was skeptical about her numbers and the symptoms she displayed.

DAY 18: 10/20/23

  • Dr. Zachery Pittsenbarger testified that he touched the top of Maya’s foot very lightly and she began screaming in pain, she then stopped and talked to him normally without any pain during the conversation, and once the conversation ended she went back to moaning and crying and screaming in pain.
  • Det. Stephanie Graham of the Sarasota County Sheriff’s Office testified that Maya’s dad, Jack Kowalski, was appalled by the behavior of Maya’s mother, Beata Kowalski.
    • Det. Graham recalled a conversation where Jack said he would have Beata move out if Maya could come home.
  • Lindsay Masica, a CPI supervisor with the Florida DCF recalled that she did not allow Jack to bring communion wafers or a razor into Maya’s room because she was concerned there might be liquid ketamine on the communion.
    • She did allow him to bring in body wash, Chapstick, deodorant, and a nail file.
  • Dr. Gadi Revivo with Rehabilitation Institute of Chicago testified that he has never seen full-body CRPS. He’s seen it in a patient’s leg or arm, and had a patient that had pain move from one leg to the other.

DAY 17: 10/19/23

  • After a day off, jurors returned on Thursday to continue hearing the defense’s case.
  • Dr. Michelle Smith, a doctor at JHACH, testified to her treatment of Maya on Oct. 7-12, 2016.
    • Smith described Beata as cooperative and polite.
  • Dr. Beatriz ‘Teppa’ Sanchez, a critical care doctor at JHACH testified that Maya repeatedly said she needed her medication and that she needed her anesthesia medication.
    • Sanchez said that the Kowalskis told her about traveling to Mexico for ketamine treatments.
    • Sanchez said that she consulted with the hospital’s pain team because she did not feel comfortable giving the high dosages of ketamine that Beata was requesting Maya be given.
  • Johanna Klink, a former RN, said that Beata would not let her check Maya’s blood pressure, and said that Maya was unable to walk because of her CRPS, but she remembered seeing her move her legs on the bed.
    • Klink described Maya as behaving differently when her mother was present.
    • Klink testified that she was bothered by Maya’s use of profanity.
  • Dr. Paul Kornberg testified that he recommended Maya stop taking medication upon discharge.

DAY 16: 10/17/23

  • The child welfare case manager who oversaw Maya’s case while at the hospital told jurors that it was her, not Catherine Bedy, who ‘redirected’ the phone conversations between Beata and her daughter.
  • A former nurse with Tampa General Hospital raised concerns in 2015 that Maya may have had a psychogenic issue more than a need for physical therapy, citing that her condition deteriorated when her mother, Beata, was around and less when her father and brother were around.
  • Ketamine was mostly banned in Tampa area hospitals and was used in small dosages for extreme medical conditions.

DAY 15: 10/16/23

DAY 14: 10/13/23

DAY 13: 10/12/23

  • Jack and Kyle Kowalski returned to the witness stand to testify about punitive damages.
  • Maya’s designated ad litem told jurors that Cathy Bedy facilitated all phone calls between Maya and her mother, Beata. It was Bedy who interrupted their conversations.
  • Jurors watched the taped deposition of Dr. Sally Smith, who is not an employee of JHACH and worked for the Suncoast Advocacy Services for the State of Florida.

DAY 12: 10/11/23

  • Beata’s sister, Regina Chmiel, testified.
  • Jurors watched the taped deposition of Laura Ann Voes, JHACH’s ethics committee member who labeled Maya as “Ketamine Girl.”
  • JHACH Board of Directors and department heads were unaware of Maya’s situation and only learned about it by reading recent news articles.
  • Joseph Corcoran, policy and procedure expert, testified that “Staff at JHACH did not follow their own safety protocol.”

DAY 11: 10/10/23

  • Dr. Timothy Brewerton, a child forensic psychologist who evaluated Maya, Jack and Kyle Kowalski testified that all three have PTSD, major depressive disorder and complex bereavement disorder from Beata’s death, and they cannot help each other heal because they are so damaged.
    • Maya’s PTSD causes her avoidance issues, making it difficult for her to go to the doctor for the medical care she needs for CRPS because she is scared of anyone in a white coat.
    • Maya had three major depressive episodes.
  • Dr. Anthony Kirkpatrick, the doctor who diagnosed Maya with CRPS, described Beata as “informed” and “inquisitive” and Maya as “involved” and “curious.”

DAY 10: 10/9/23

DAY 9: 10/5/23

  • The jury was shown a recorded deposition by Dr. Rebecca Johnson, a psychologist who saw both Maya and Kyle Kowalski.
  • A recorded deposition of social worker Catherine Bedy was shown to the jury.
  • The jury was sent home early for a long weekend.

DAY 8: 10/4/23

  • Jack Kowalski’s testimony continued Tuesday with no other witnesses called.
  • Plaintiffs allege JHACH placed Maya in a different hospital room to record “covert” surveillance video to catch her moving out of her hospital bed.
  • Per the advisement of their legal counsel, Jack and Beata Kowalski filed for legal separation in order to get Maya back home.
  • During a meeting with hospital staff, Beata wanted Maya to leave the hospital, but Jack agreed leave Maya at the hospital and follow the treatment and discharge plan at JHACH.
  • After Maya left the hospital in January 2017, she had one relapse in 2019 where she was in the hospital for one week. She has not received ketamine or hyperbaric treatment since her discharge from JHACH.Maya Kowalski

DAY 7: 10/3/23

  • Jack Kowalski’s testimony continued Tuesday with no other witnesses called.
  • Plaintiffs allege JHACH placed Maya in a different hospital room to record “covert” surveillance video to catch her moving out of her hospital bed.
  • Per the advisement of their legal counsel, Jack and Beata Kowalski filed for legal separation in order to get Maya back home.
  • During a meeting with hospital staff, Beata wanted Maya to leave the hospital, but Jack agreed leave Maya at the hospital and follow the treatment and discharge plan at JHACH.
  • After Maya left the hospital in January 2017, she had one relapse in 2019 where she was in the hospital for one week. She has not received ketamine or hyperbaric treatment since her discharge from JHACH.

DAY 6: 10/2/23

DAY 5: 9/29/23

  • The plaintiffs made shocking allegations that an employee at Johns Hopkins All Children’s Hospital may have inappropriately examined Maya while in state custody.
  • The use of Ketamine was not approved by the FDA a year after Maya was taken to JHACH.
  • Physical therapy along with the Ketamine helped Maya prior to going to the hospital.
  • Physical therapy records show that Maya’s level of pain was 8/10, but handwritten hospital records listed Maya’s pain as a zero.

DAY 4: 9/27/23

  • Attorneys met with the judge to litigate the admissibility of exhibits and discuss jury instructions.
    • Judge Carroll will draft an instruction for the jury to read before Maya Kowalski’s testimony, including dates and times the plaintiffs allege John Hopkins is guilty of falsely imprisoning Maya.
    • Attorneys from both sides will hash out the language in jury instructions and the verdict form – jury instructions are currently up to 60 pages, and the verdict form is 15 pages.
    • Scheduling for next week – No decision as of yet.
  • WATCH: Kowalski’s Lead Attorney Discusses ‘Take Care of Maya’ Trial

DAY 3: 9/26/23

  • Plaintiffs’ Witness #5 Dr. John Wassenaar: Kowalski family doctor
    • Treated Beata, Maya, and Kyle has a specialty combo pediatrics and internal medicine
    • Testified that he did not observe anything that would indicate that Beata would harm her child
    • Family was stressed looking for a solution to Maya’s pain complaints
    • Tried a variety of different treatments before the ketamine coma in Mexico
    • Observed it helped Maya
    • She had a relapse after being released from JHACH
    • Testified standard of care was compromised when doctors at John Hopkins All children’s suspected Beata of Munchausen’s syndrome by proxy
  • Plaintiffs’ Witness #6 Linda Brown
    • Lived in the same neighborhood and attended the same church as the Kowalski’s
    • Asked to pray for Kowalski’s daughter Maya
    • Brown belongs to a group that travels with a statue of Mary and uses it to bring hope and prayer to those suffering.
    • She did this with the Kowalskis
    • Received a phone call from Beata one day. Beata was so distraught she didn’t understand what she was upset about
    • She went to their house and Beata told her that ‘They took her’ when she asked who? She said, ‘The Hospital.”
    • Brown said she went to the hospital to pray with Maya, but a ‘dark force’ told them they had to leave, and they were barred from praying with Maya
  • Plaintiffs’ witness # 7 Dr. Tashawna Duncan
    • Evaluated the Kowalski
  •  Plaintiffs’ witness #8 Father John Costello
    • Parish priest knew the Kowalskis between 8 months and a year
    • Asked to perform the healing sacrament on Maya
    • Met case worker at the hospital
    • Visited Maya at the hospital, but told he could not do anything religious with her
    • He was told that Maya’s mother was trying to control her through religion
    • Disclosed a conversation he had with Beata before she killed herself
    • Told him that they needed to get Maya out of the hospital, because she was deteriorating, and they were blaming her.

DAY 2: 9/22/23

DAY 1: 9/21/23

  • The jury hears opening statements.
  • WATCH: ‘Take Care of Maya’ Trial: Plaintiff Opening Statement
    • The plaintiff’s attorney said that the hospital misdiagnosed Maya and spent three months trying to force the family to accept their diagnosis.
    • The core claims in the case are medical malpractice, battery, Maya’s false imprisonment, intentional infliction of emotional distress and alleged fraud.
  • WATCH: ‘Take Care of Maya’ Trial: Defense Opening Statement
    • The hospital’s attorney said that its staff was alarmed at the levels of Ketamine Maya had been administered and was suspicious about the cause of her condition.
    • Maya had been on 21 medications when she was admitted to the hospital and was on only three when she was released after gaining 4.5 pounds.
  • WATCH: ‘Take Care of Maya’ Trial: Day 1
The Kowalski Family seen riding bikes
Photos of Maya Kowalski and her family were introduced as evidence in the first day of the family's trial for their lawsuit against Johns Hopkins All Children's Hospital. (Court TV)
  • The Kowalski Family seen riding bikes
  • Maya Kowalski in physical therapy
  • Maya Kowalski in the hospital
  • Maya Kowalski in a wheelchair
  • Maya Kowalski sits in a wheelchair
  • Maya Kowalski's feet are seen in a photo
  • Maya Kowalski in a pool
  • Maya Kowalski sits in a photo
  • Maya Kowalski seen laying on a hospital bed
  • Photo of smiling Maya Kowalski
  • photo of maya kowalski on crutches
  • Maya Kowalski Photo

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