‘Take Care of Maya’ trial: Lawyers, judge to hash out jury instructions in $220 million case

Jurors in the $220 million case against Johns Hopkins All Children’s Hospital featured in the Netflix documentary ‘Take Care of Maya’ had the day off Wednesday as the lawyers and the judge discuss motions and go over jury instructions.

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 after she was separated from her daughter for three months while allegations of child abuse, made by hospital staffers, were investigated. 

Supervised calls between Maya and her mother were the focus of the case on Tuesday morning as hospital attorneys argued that it was the Department of Children and Families, not Johns Hopkins All Children’s Hospital that was monitoring calls between mother and daughter. 

Pictured: Maya at a Halloween event at the hospital.

Pictured: Maya at a Halloween event at the hospital. 

Tori Niehus with the Safe Children’s Coalition also testified for the defense on Tuesday and stated that Maya was happy in the hospital and doctors were doing their best for her.

However, when it was time for cross-examination, an attorney for the Kowalski family had Niehus read from a deposition she recorded in 2020 in which Niehaus said that Maya had told her she wasn’t doing well and she stated was in pain.

The defense also called nurse practitioner Bonnie Rice to the stand Tuesday afternoon. She worked at Tampa General Hospital and was a part of Maya’s care team in 2015. 

She said Maya’s case was frustrating for the medical team because she said Maya and her mother, Beata Kowalski weren’t open and she couldn’t move them down the road of recovery. 

According to defense attorneys, a blog written by Beata Kowalski accused Rice of practicing witchcraft. Rice says she doesn’t believe in witches, but she did seek Reiki, yoga and other holistic forms of therapy for Maya. 

Pictured: Maya Kowalski and her brother Kyle

Pictured: Maya Kowalski and her brother Kyle

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. 

On Monday, Dr. Lewis, a neuropsychologist and a consultant for the Child Protection Team, took the stand and 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. 

Maya Kowalski

Pictured: Maya Kowalski

Before the plaintiffs rested on Monday, 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 send it. In this case there was no delete. You couldn’t unsend the impulse," he added. 

Pictured: Maya and Beata Kowalski

Pictured: Maya and Beata Kowalski

What Happened to Maya from ‘Take Care of Maya’?

The Kowalskis 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. 

Last Monday, Maya told jurors her condition would leave her screaming in pain and unable to walk at the time. She said she received the painkiller ketamine during a series of intense treatments in Mexico, in which she was told there was a 50 percent chance of death.

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. 

Pictured: Maya Kowalski

Pictured: Maya Kowalski

Her mother, Beata Kowalski, insisted that she receive ketamine at Johns Hopkins All Children’s Hospital. But staff at the hospital disagreed with the treatments.

RELATED: ‘Take Care of Maya’ trial: Maya’s aunt testifies in $220 million case against All Children’s Hospital

Her 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. 

Beata Kowalski

Pictured: Beata Kowalski

Last Thursday, in a video deposition, Dr. Sally Smith, who was the medical director for the Child Protection Team providing a medical evaluation for Maya while she was at Johns Hopkins All Children's Hospital, said she knew that four other physicians had diagnosed Maya with CRPS.

RELATED: ‘Take Care of Maya’ trial: Jury watches Dr. Sally Smith deposition in case against All Children’s Hospital

When questioned, she said that she did not believe that a mother who failed to tell a new doctor about their child’s entire medical history, or who does not follow the directions if a doctor or the prescriptions of a doctor to the letter was committing an act of child abuse. 

However, she added that she believed Maya’s mother, Beata Kowalski, was committing medical child abuse though she admitted that she had never testified in a case involving CRPS in the past. 

Jurors watched a video deposition of Dr. Sally Smith on Thursday.

Jurors watched a video deposition of Dr. Sally Smith on Thursday. 

"Upon review of all the extensive medical records, observations of the child in the hospital, review of the unconventional treatments including hyperbaric oxygen treatment and high dose ketamine treatment repeatedly. It was my opinion that there was ample evidence of medical child abuse and it appeared Mrs. Kowalski was the primary one who was resulting in instigating or perpetrating child abuse," Dr.Smith stated.

Dr. Smith also said she recalled that Dr. Anthony Kirkpatrick, who diagnosed Maya with CRPS and recommended ketamine treatment, advised her not to move forward with allegations that Beata Kowalski was suffering from Munchausen by proxy. 

Jurors also heard Smith say she suggested doctors at Johns Hopkins All Children’s Hospital take Maya off of all medications. 

Maya and Beata Kowalski perform a figure skating routine.

Maya and Beata Kowalski perform a figure skating routine. 

Why was Maya kept away from her family?

A judge ordered Maya to be sheltered at the hospital while the child abuse allegations were investigated. She wasn’t allowed to be discharged to her family or another treatment facility and could not see her mother. A judge ordered her to remain at the hospital under state custody. Beata Kowalski died by suicide after being kept away from her daughter for 87 days. The Kowalskis say Johns Hopkins All Children’s Hospital  medically kidnapped Maya and battered her while in their care.

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.

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.

Jack Kowalski, Maya’s father, testified last week that his family was told they would be arrested if they left the facility with Maya. 

He went on to describe how the hospital treated those who tried to visit Maya. 

"Did you learn through the course of this that they believed Beata was slipping ketamine through the holy water and wafers?" the Kowalski's family attorney Greg Anderson asked.

"I know it didn’t happen, but they had all different ideas," Jack Kowalski replied. 

Anderson argued those theories resulted in Beata Kowalski’s desperation and death by suicide. 

"I saw my child deteriorating. I go home, I see my wife deteriorating," shared Jack Kowalski while on the witness stand. 

PREVIOUS: ‘Take Care of Maya’ trial: What will the jury hear? Lawyers argue over evidence, witnesses in case

Attorney Mark Zimmerman, who represented Maya when she was at Johns Hopkins All Children’s Hospital, said he felt as if the facility, and, in particular, social worker Catherine Bedy, tried to put up barriers for him to access Maya. 

Beata Kowalski with Maya and Kyle

Beata Kowalski with Maya and Kyle

A phone call between Beata and Maya that was monitored by woman Maya identified as Bedy was also played in court. 

Maya’s former Guardian Ad Litem, Jessica Blackrick, testified that Bedy cut a phone short a phone call in which Maya and her mother were praying together. 

Blackrick added that a phone call that Maya wanted to make to her mother on Thanksgiving was blocked by Bedy because she couldn’t make herself available to monitor it.

Blackrick went on to state that she never told Bedy to monitor those phone calls. 

Pictured: Maya Kowalski

Pictured: Maya Kowalski with boots on her feet.

Jurors watched a video deposition of Bedy, who the Kowalski family dropped its case against Bedy shortly before the trial began

Bedy began her deposition by explaining how she was written up by the hospital after yelling at a co-worker after an attorney asked her if she had ever been disciplined at work. 

The battery allegations from the Kowalski family stem from Bedy and others holding Maya down for unwanted photos and unwanted comforting. 

She went on to describe how she met Maya and accused her mother, Beata Kowalski, of having Munchausen by proxy, but admitted she was not an expert on the disease and stated she had only worked with three similar cases. 

READ: ‘Take Care of Maya’ trial: Social worker Catherine Bedy testifies via video deposition in $220 million case

Bedy said she saw Beata Kowalski demand ketamine for her daughter. Although the hospital says it believed the ketamine treatments were too dangerous, Bedy admitted that the facility did not take into consideration that Maya had been prescribed the ketamine treatments. 

Maya Kowalski in hospital.

Maya Kowalski in hospital. 

After seeing Bedy’s deposition, the jury was dismissed, while the court held a hearing on future evidence in the case. During the hearing, Maya’s father Jack Kowalski was asked about Bedy, and he said Maya couldn’t stand her. 

"She stated she placed her on the lap. I never gave consent by the way on that. She stated that she used to come in and slap her leg to see if she was in pain, she said she wanted to adopt her that her mother was in a mental home, so she could be like her mother while in the hospital," he said. 

Pictured: Beata and Maya Kowalski

Pictured: Beata and Maya Kowalski

Why was Maya taking ketamine? 

Beata Kowalski, who was a registered nurse, learned about CRPS from an infusion patient and began researching the disease. Her research led her to Dr. Anthony Kirkpatrick, who diagnosed Maya with CRPS and prescribed ketamine treatments.

RELATED: ‘Take Care of Maya’ trial: Doctor who prescribed ketamine treatments testifies in $220 million case

On Tuesday, jurors heard from Dr. Kirkpatrick, he told the jury that initially Maya said the ketamine treatments helped, but not enough so he recommended a high-intensity treatment in Mexico, which he said was a success. 

"He explained the procedure. He talked about how it’s been around for quite a long time. He mentioned it’s used for many things, and it’s safe," Jack Kowalski stated during testimony on Monday. "The side effect when they’re coming out of it is a hallucination for a short time, but then everything is back to normal."

RELATED: ‘Take Care of Maya’ trial: Maya's former attorney, doctor testifies in case against All Children's Hospital

Upon cross-examination of Jack Kowalski, defense attorneys for the hospital questioned the family’s decision to move forward with ketamine coma treatment in Mexico. 

File: Ketamine

File: Ketamine

"Were you aware that the risk of death from that coma was 50%?" asked Ethen Shapiro. 

"There is a risk in every procedure," Kowalski responded. 

"I understand that Mr. Kowalski but respectfully there’s a risk and then there’s a risk that’s a coin flip in which your daughter could pass. Did you know it was 50%" Shapiro pressed on. 

RELATED: ‘Take Care of Maya’ trial: Doctor who's treated thousands for CRPS testifies on behalf of Maya

"They stated it was 50%, but they stated no one every died from that procedure," responded Kowalski. 

Side by side images of Maya Kowalski as she battled CRPS.

Side by side images of Maya Kowalski as she battled CRPS. 

Maya’s father told the jury he and his family saw Maya slowly returning to herself following the ketamine therapy. 

Dr. Kirkpatrick shared a similar testimony

"She could take care of herself, comb her hair, brush her teeth, eat with her hands and so forth" he recalled.

During a video deposition on Monday, Dr. Lewis stated that Maya had overheard doctors telling her mother that she had a 50 percent chance of dying during the ketamine treatment, which added to her anxiety. 

RELATED: ‘Take Care of Maya’ trial: Doctor who prescribed ketamine treatments testifies in $220 million case

When Maya relapsed in 2016, the Kowalski family says staff at Johns Hopkins All Children's Hospital didn’t agree with the ketamine treatments.

Maya Kowalski in the hospital.

Maya Kowalski in the hospital.

Dr.  Kirkpatrick said he discussed Maya’s condition with the hospital. 

"I emphasized that if she doesn’t get the ketamine, it’s going to be a slow, painful death," Dr. Kirkpatrick stated. 

On Wednesday, Dr. Fernando Cantu, the doctor who administered Maya's ketamine coma, explained that while it will not cure CRPS, it is a treatment for the disease. 

However, staff at Johns Hopkins All Children's Hospital disagreed with the ketamine treatments and suspected Maya was a victim of child abuse. 

Maya and her physician Fernando Cantu.

Maya and her physician Fernando Cantu. 

What is Complex Regional Pain Syndrome?

CRPS is a rare pain disease that can follow an injury, and it’s tough to diagnose and sufferers are sometimes accused of faking their pain.

PREVIOUS: ‘Take Care of Maya’ trial: CRPS takes center stage in $200 million case against All Children’s Hospital

There’s no cure for CRPS and treatments can range from acupuncture and nutrition to physical therapy and massage or ketamine therapy.

The Kowalski family attorney argued that the hospital staff refused to believe Maya had CRPS even after Dr. Kirkpatrick, who did not work for All Children’s Hospital, confirmed her diagnosis. 

PREVIOUS: ‘Take Care of Maya’ trial: Testimony continues in $200 million case against All Children’s Hospital

The Kowalski family claims that while hospital staff was accusing them of lying about CRPS and refusing to treat Maya, the facility was billing the family and their insurance more than half a million dollars for that exact cause of illness. 

File: Johns Hopkins All Children's Hospital

File: Johns Hopkins All Children's Hospital 

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. 

PREVIOUS: ‘Take Care of Maya’: Jury selection begins in civil case against Johns Hopkins All Children’s Hospital

"We ask in this case for you to consider not only compensatory damages to try to make them whole for these terrible things, but also punitive damages to deter them to punish them and to deter this type of behavior in the future," said Greg Anderson, Maya Kowalski’s lawyer. 

On Friday, an economist detailed expenses the family has incurred and will incur on the future and came up with $220 million. 

Maya KowalskiSarasota County