‘Take Care of Maya': Jury finds Johns Hopkins All Children’s Hospital liable, awards damages in $200M case
VENICE, Fla. - After eight weeks of arguments and testimony, jurors have reached a verdict in the $220 million case against Johns Hopkins All Children’s Hospital that was the premise of the Netflix documentary ‘Take Care of Maya.’
On Tuesday, lawyers on both sides presented their closing arguments before the judge handed over the case to the jury made up of four women and two men around 2 p.m.
After two days of deliberation, the jury returned a verdict, finding the hospital liable for all seven claims levied against it. The Kowalski family - Maya, Jack, and Kyle - shed tears as the jury read their decision on a case that was years in the making.
The jury was given 80 Pages of instructions from Judge Hunter Carroll and had to decide on seven claims, including:
- False imprisonment – The jury ruled in favor of the Kowalski family
- Battery – The jury ruled in favor of the Kowalski family
- Medical negligence – The jury ruled in favor of the Kowalski family
- Fraudulent billing – The jury ruled in favor of the Kowalski family
- Survivor claim for intentional infliction of emotional distress (Estate of Beata Kowalski) – The jury ruled in favor of the Kowalski family
- Wrongful death claim for intentional infliction of emotional distress causing death – The jury ruled in favor of the Kowalski family
- Maya Kowalski’s claim for infliction of emotional distress – The jury ruled in favor of the Kowalski family
In compensatory damages, the family will receive $211,451,174. The jury decided that the family would also receive an additional $50,000,000 in punitive damages for false imprisonment and false imprisonment with battery.
In total, the Kowalski family was awarded more than $261 million.
Maya spoke with FOX 13 for the first time since the months-long trial started after the ruling.
She was adamant that this trial carried far more weight than just a financial payout.
"To me, it was about the answer – knowing that my mom was right. I want people to know that she wasn’t harming me at all," Maya said. "I mean, for the first time, I feel like I got justice."
She met the media outside the courtroom with some of her mother’s, Beata’s, mementos, and she shared the meaning and importance of those mementos to her.
"I have her engagement band on my ring finger, I have her rosary," Maya said. "I have this necklace, which I actually gifted to her from Johns Hopkins All Children’s Hospital, and I added one pendant, which is a picture of my mom and I in Monterrey, Mexico, around the time I got my Ketamine."
"It’s comforting. It feels like she’s closer to us."
Her father, Jack, expressed his relief at the jury’s decision, as well.
"Parents have rights," he said. "And they make the decision for their children."
The Kowalski family and their attorneys met with the media after the emotional verdict.
"If it was us up there, she would’ve did the same for us."
The Kowalski family’s attorney Greg Anderson expressed his own personal relief after having navigated the lengthy trial.
"This was nine weeks of an extremely difficult case, and it was so tough on all of them, and I can’t say enough about how tough this family is even in the face of unbelievable tragedy," he said.
When asked what was next for the family after the trial, Jack said "a little rest" with a chuckle.
Jack did add that he felt the punitive damages doled out to the hospital might not be enough to get the message across.
Attorney defends Dr. Sally Smith
At the center of the testimony was Dr. Sally Smith, the former head of Pinellas County's Child Protection team.
Smith has decades of experience in child abuse pediatrics and is a trusted resource by All Children's Hospital when it comes to the first signs of abuse or neglect. She was the doctor who urged physicians to take a closer look at Maya’s case, specifically at her mother.
This week, a jury decided that the hospital and Dr. Smith were wrong. But this isn’t the first time Smith has been at the center of controversy.
There have been reports of more than a dozen instances where parents had credible claims of innocence, but were accused of abuse; one even sent to jail because of it. Many times, charges were dropped after other doctors disputed the claims.
Among the cases were infants, where rare bone diseases were said to be fractures and rashes - seen instead - as bruises.
On the night of Maya’s family’s win, the defense attorney for the hospital told FOX 13 they still trusted Dr. Smith’s judgment.
"Dr. Smith is a very competent, very professional, and very valued member of our medical staff. She is an independent pediatrician, still on our staff as a consultant, not an employee of Johns Hopkins Hospital," said defense attorney Howard Hunter.
Why is Maya's family suing Johns Hopkins All Children's Hospital?
Maya Kowalski's family is suing Johns Hopkins All Children’s Hospital for $220 million, claiming its actions led family matriarch Beata Kowalski to take her own life. A judge ordered Maya to be sheltered at the medical facility under state custody while allegations of child abuse were investigated. The judge said Maya was not allowed to have physical contact with her mother. After 87 days without seeing her daughter, Beata Kowalski died by suicide.
For eight weeks, jurors heard from the Kowalski's, doctors, nurses and experts. Jurors will ultimately have to decide whether what happened to the Kowalski family could have been prevented and if the hospital’s actions pushed Beata Kowalski to take her own life. The Kowalski family says the hospital medically kidnapped Maya and battered her while in its care.
Last week, the case nearly came to a standstill as the Kowalski's attorneys questioned a witness on the hospital’s Joint Commission review. They pointed out the hospital had an immediate jeopardy citation, which they believe was during the time Maya was hospitalized. Days prior, the hospital presented expert witness Mark Anderson who told the jury they met accreditation standards in 2016.
RELATED: Funding at risk after Johns Hopkins All Children's cited for 'immediate jeopardy to patient safety'
The Kowalski family’s attorneys said that could have misrepresented the St. Petersburg hospital’s image to the jury. While the defense team for the hospital said it was only for the hospital’s heart institute, the Kowalski’s attorneys wanted a closer look and so did Judge Hunter Carroll.
"This thing kind of exploding on the last day of testimony, the last thing I want to do is make a wrong call on this issue because this issue has the perspective of causing this whole thing to be done over again," said Judge Carroll.
Judge Carroll listens to lawyers on both sides Monday morning.
Before the jury was in the courtroom on Monday, the Kowalskis’ attorneys told Judge Carroll they had not received corrective action plans, town hall meetings or internal emails until they did a deposition from a former hospital staff member. He said at that time they received a stack of documents that was 8–10 inches thick that correlated with fixing the cultural issues of Johns Hopkins All Children's Hospital not just with its Heart Institute.
RELATED: Fallout continues from All Children's federal report
The lawyers for the Kowalski family said that the information they were provided revealed a culture of retaliation and retribution for people who raised issues at Johns Hopkins All Children's Hospital. It has been noted that several nurse practitioners brought up issues at the hospital as early as 2015.
The attorneys added that the documents revealed that eight key executives were forced out during this time and the hospital conducted a massive re-education campaign encouraging all team members to speak up and speak out.
On Monday. the jury heard from Dr. Joseph Corcoran, a policy and procedure expert, before the plaintiffs rested their rebuttal case. He told the jury, despite claims from the St. Petersburg hospital that all was well, it was not. He stated that the hospital may have passed their accreditation, but they had several red flags raised, including how the hospital reported problems, complains and claims of mismanagement.
What Happened to Maya from ‘Take Care of Maya’?
The Kowalski's say they took Maya to Johns Hopkins All Children’s Hospital in October 2016 when she was experiencing a flare up of pain from Complex Regional Pain Syndrome, or CRPS, a disease she was diagnosed with by a doctor not affiliated with Johns Hopkins All Children's Hospital.
Maya told jurors her condition would leave her screaming in pain and unable to walk at the time. She said she had been receiving ketamine to treat the pain and even underwent a ketamine coma in Mexico.
RELATED: ‘Take Care of Maya’ trial: Maya testifies again in $220 million case against All Children’s Hospital
She explained that the ketamine treatment worked, and she was improving until the October 2016 flare up. During rebuttal testimony, her father said he decided to take her to the emergency room because she had a severe stomach ache, and he had never seen her in that much pain. It was noted during the trial that Maya had a ketamine treatment the day before.
Pictured: Maya Kowalski
While at the hospital, Beata Kowalski insisted that Maya receive ketamine treatments, but hospital staff did not agree.
Beata Kowalski's persistence alarmed hospital staff, and they called in a report to the Child Abuse Hotline. They suspected Beata Kowalski, who was a registered nurse, was making her daughter sick.
When the hospital’s attorney, Howard Hunter, began his opening statements, he noted that several hospital staffers believed Beata Kowalski suffered from Munchausen by proxy (MBP) and they were trying to protect her.
Pictured: Beata Kowalski
Maya said, during her three months in state custody at the hospital, there was a 48-hour period where she was isolated in a hospital room. Maya said staff wouldn't help her go to the bathroom and, instead, tried to see if she could actually walk, but she couldn't.
A video of Marissa Higgins helping Maya try to walk was shown in court on Friday.
"They left me there for 48 hours under surveillance, which they did not tell me about. They had a commode in there, and they just put it far enough away from the bed. So, I would have to physically stand up and use the bathroom," said Maya. "I called the nurses whenever I had to use a bathroom because obviously, I'm not able to walk. And when they refused to help me go to the bathroom, I would defecate on myself."
RELATED: ‘Take Care of Maya’ trial: Maya testifies in $220 million case against All Children’s Hospital
She described some nurses as mean and unhelpful, and others as compassionate and willing to help. Her testimony on Monday was emotional at times as she expressed her frustration.
"When I express to them a symptom or like my pain, they would say, 'No, you're making it up,' or 'it's in your head,'" Maya said.
Why did medical staff think Maya was being abused?
When critical care physician Dr. Beatriz Teppa-Sanchez took the stand, she described a chaotic scene when Maya and her mother, Beata Kowalski, first entered the pediatric intensive care unit.
She said Maya appeared to be in intense pain, though it was difficult to pinpoint where the pain was located. The doctor also said Maya kept demanding pain medication, which surprised her.
Dr. Teppa-Sanchez noted that Beata Kowalski said she had been very stressed and at times wanted to die and just go to heaven. The doctor added that Beata Kowalski said that when Maya was in a lot of pain, she too wanted to die and go to heaven.
The doctor told the jury she informed Beata Kowalski that the hospital could help her get resources to help, but the offer was declined.
Dr. Teppa-Sanchez said she felt those statements were even more reason for Maya to receive psychological help though Beata Kowalski said she didn’t want that for her daughter at that time.
Nurse practitioner Johannah Klink echoed the statements of Dr. Teppa-Sanchez. She testified that Maya appeared to show more intense pain symptoms when her mother was present.
She went on to state that she witnessed Maya moving in ways that someone in intense pain would not be able to move such as get up on her knees on a hospital bed.
Klink also recalled Maya saying, "I’m tired of these lies. My whole life is a lie. That stuck me. That struck me very hard…It sounded to me like it was a cry for help."
However, during cross-examination, Klink told the jury that she never followed up on that statement or asked Maya to elaborate. She did note that she reported the statement to doctors.
Nurse practitioner Johannah Klink testified for the defense.
Pediatric nurse Kelly Thatcher also told jurors that Maya’s behavior would change drastically when her mother was in the room.
She also claimed Beata Kowalski offered Maya Valium as a reward.
"Mrs. Kowalski was very upset, in her opinion, by the lack of medication that was being administered, and she did say, ‘She might as well be in hospice. That way she can have enough medication and let her die because she doesn’t deserve to live this way," Thatcher testified.
Pediatric nurse Kelly Thatcher testified on Monday.
Before the plaintiffs rested, psychiatrist Dr. Scott Richards took the stand and told jurors how he believed Beata Kowalski felt she had no choice but to end her life.
"I believe the impulse happened for Beata Kowalski when she finally had the impulse that ‘I can do no more. I’ve gotten everyone in my life involved, no one can seem to help,’" said Dr. Richards.
"I liken it to someone who is impulsively having emotions, they write an email, and they hit send, and they wish they hadn’t of sent it. In this case there was no delete. You couldn’t unsend the impulse," he added.
Nurse practioner Bonnie Rice who worked at Tampa General Hospital and was a part of Maya’s care team in 2015, said Maya’s case was frustrating for the medical team because she said Maya and her mother weren’t open, and she couldn’t move them down the road of recovery.
Rice added that Beata Kowalski was strictly seeking medical help for her daughter when the team at TGH suspected Maya’s pain may be psychological.
The team at TGH weren't the only ones to raise psychological suspicions.
Dr. James Lewis, a neuropsychologist and a consultant for the Child Protection Team, told jurors he met with Maya after staff at Johns Hopkins All Children’s Hospital raised concerns that her mother may have been medically abusing her.
In a video deposition, Dr. Lewis stated that he believed Maya may have been suffering from a psychological symptom of pain, which may have triggered physical pain symptoms.
According to testimony from Dr. Teppa-Sanchez, Johns Hopkins All Children’s Hospital did give Maya ketamine for her pain shortly after she was admitted, but it was at a lower dose than Beata Kowalski wanted for her daughter and staff wanted to wean her off of it.
Pictured: Maya Kowalski
Dr. Teppa-Sanchez noted that she reached out to Dr. Sally Smith, a pediatrician who specialized in child abuse because she wanted her guidance on Maya’s case.
Dr. Smith took the stand for the defense last week. She was the medical director for the Child Protection Team in Pinellas County when Maya was in the hospital. She had worked for All Children’s Hospital for 12 years before it was acquired by Johns Hopkins and still had privileges at the facility.
Dr. Smith explained that she was contacted by Dr. Teppa-Sanchez shortly after Maya was admitted to the hospital because she was concerned about the amount of ketamine the child had been receiving to treat Complex Regional Pain Syndrome or CRPS, which was diagnosed by a physician not associated with the hospital.
Pictured: Maya and Beata Kowalski
Dr. Smith told jurors she tried to give general advice in terms of how pediatricians can approach potential cases of Munchausen syndrome by proxy, or what she refers to as medical child abuse. However, she noted she could not do anything unless a report was made to the Child Abuse Hotline.
Two days later, medical staffers contacted the hotline, and a child abuse investigation began.