Johns Hopkins Hospital to Pay $261 million to Kowalski Family for Not 'Taking Care of Maya'

If you're a Netflix junkie, you might have caught the popular documentary Taking Care of Maya. Or you might have seen headlines in the past few years about the tragic case of the little girl that is the subject of the film: Maya Kowalski.

The legal controversy around Maya's case highlights the dangers of child abuse accusations and the importance of careful medical diagnosis. The case was a civil lawsuit filed against Johns Hopkins All Children's Hospital in St. Petersburg, Florida, by Maya's family. The lawsuit alleged that the hospital had wrongly accused Maya's mother, Beata Kowalski, of child abuse, leading to her separation from her daughter and ultimately her suicide.

Recently, the jury trial came to a conclusion with a verdict that awarded Maya's family over $261 million in damages. Let's get into the facts of the case and what the result of the trial means.

What Happened at the Hospital

Maya had already been diagnosed and treated for "complex regional pain syndrome" (CRPS) by the time she was 10. In October, 2016, she was admitted to the hospital with severe abdominal pain. Dr. Smith, a defendant in lawsuit, oversaw her treatment. She underwent numerous medical procedures during her three months in the hospital, including multiple abdominal scans and imaging, a colonoscopy, and endoscopy. She was prescribed a variety of medications, including opioids, antidepressants, anticonvulsants, and antipsychotics.

But Dr. Smith and his team thought they smelled something fishy. They suspected that Maya's mother, Beata Kowalski, was abusing her. Purportedly following Florida mandatory reporting laws and perhaps also per hospital protocol, they reported their suspicions to the Department of Children and Families (DCF). DCF launched an investigation. After a judge ordered that Maya be removed from her family and sheltered at the hospital, the girl was taken into protective custody and her family was kept from seeing her.

Maya's treatment was controversial because she was never diagnosed with a specific cause for her abdominal pain, apart from "abuse" and something called "Munchausen syndrome by proxy" (MSP). If this sounds very serious, note that another name of it is "factitious disorder imposed on another." MSP is a mental health disorder in which a caregiver, typically a parent, exaggerates or fabricates the illness of a child in their care. The caregiver may fabricate or induce symptoms in the child, or they may exaggerate or distort real symptoms. The caregiver's goal is to gain attention or sympathy from others, and they may also enjoy seeing their child receive medical attention. According to the complaint, however, Maya never exhibited any of the classic symptoms of this syndrome, and Beata never admitted to abusing her daughter.

Dr. Smith called in a second opinion to a doctor who disagreed with his suspicion of abuse and thought it was instead CRPS. The other doctor said that the signs that Dr. Smith thought were abuse (such as the fact that Maya would recoil from the doctor's touch, but was fine if sheets touched her) was a consistent reaction for CRPS. He also specifically warned Dr. Smith against accusing Maya's family of criminal conduct like Munchausen by Proxy.

Despite the lack of evidence, the hospital staff continued to treat Maya for MSP. They isolated her from her mother and subjected her to various allegedly "unnecessary" medical procedures. Maya was also denied access to a therapist, which compounded her emotional distress.

Maya was allegedly traumatized by her experiences at the hospital and suffered from severe emotional trauma. Beata was allegedly heartbroken to be separated from her daughter and was devastated by the accusations of child abuse. In January 2017, Beata committed suicide.

Kowalski Family Brings Suit

The Kowalskis soon took the case to Florida court. Maya's lawyers claimed that hospital's actions had a devastating impact on Maya and Beata.

The defense for Johns Hopkins All Children's Hospital denied negligence in Maya's treatment. It argued that Maya's medical procedures were necessary to diagnose her condition. It denied that the hospital had isolated Maya from her mother or subjected her to unnecessary medical procedures. Instead, it argued that Maya's emotional distress was caused by her illness, not by her treatment at the hospital. It maintained that Beata's suicide was a tragic event that was not caused by the hospital's actions.

The hospital also argued that it had reported Maya's suspected abuse to DCF in accordance with Florida's mandatory reporting law. The attorney for the hospital stated that when the doctors' suspicions were confirmed by the district court, the hospital fully complied with Department of Children and Families 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," he said.

Civil Jury Trial Goes Forward

The hospital didn't settle the case because, according to its attorney, it would have a chilling effect on medical workers and others that are required by law to report suspected child abuse.

Before the trial was underway, the presiding judge had ruled that the hospital could not be blamed for the state's decision to shelter Maya at the hospital since this had been ordered by a court. He also ruled that the hospital could not be blamed for the decision by its doctors to report Beata Kowalski to the abuse hotline.

Maya took the stand at trial, testifying that her caregivers ignored symptoms such as "spontaneous and debilitating pain, muscle wasting and impaired movement." She said she felt "humiliated" because when she expressed a symptom, they said "No, you're making it up. It's in your head." She also claimed that instead of telling her that she or her mother had MSP, doctors told her that her mother was "sick" and made her "believe she was also sick."

One of the plaintiffs' witnesses was a retired hospital administrator who reviewed reports on the hospital. The administrator testified that employees had reported a culture of retaliation against those who spoke up and that the hospital's governing board did not provide effective oversight.

Results and New Case

The hospital lost big time. The jury found the hospital guilty on all seven claims.

The jury awarded the Kowalski family $261 million in damages, finding that the hospital had been negligent in its treatment of Maya and had caused her mother's death. The jury found that the hospital had failed to properly investigate Maya's condition and had jumped to the conclusion that Beata was abusing her daughter. The jury also found that the hospital had failed to provide Maya with adequate emotional support and had isolated her from her family.

But the hospital's problems with the Kowalski are not over. One of the claims brought by her attorneys in the original trial were allegations of assault. Maya's attorney claimed that during Maya's time at the hospital, a man she assumed was a doctor came in and asked, "May I take a peek?" The man allegedly then pulled down her pajamas and underwear and stared at her privates for "long enough for her to be not only startled but start to cry."

Maya's attorney told the court that he wanted to speak to potential witnesses to corroborate this story before bringing a case in court based on it. But adding the claim of sexual assault would require a motion to amend the complaint. The defense argued that this would push the trial back by a year, so the judge ultimately decided not to allow it to be included in the case.

Now done with the main trial, Maya and her legal team are bringing a separate case based on the claims of sexual assault. We can expect charges of "an assault, battery and intentional infliction count against the hospital acting through an employee or physician" or in the alternative, "counts involving premises liability, negligent supervision and negligent security" and claims that the hospital "failed to maintain the appropriate security and protection for the [patients]."

Related Resources:

• Patient Rights (FindLaw's Learn About the Law)
• False Imprisonment in Healthcare (FindLaw's Law and Daily Life)
• What Is Health Care Law? (FindLaw's Learn About the Law)