SARASOTA COUNTY, Fla. — A key witness in the Kowalski versus Johns Hopkins All Children's Hospital lawsuit, Maya Kowalski, took to the witness stand on Monday.
The Venice family is suing Johns Hopkins All Children's Hospital for hundreds of millions for alleged malpractice and false imprisonment. The story of Maya Kowalski and her family is the subject of the Netflix documentary "Take Care of Maya."
The documentary, released back in June, details the family's harrowing experience and the tragedy that followed after Maya was taken away from her family amidst accusations of child abuse and Munchausen syndrome by proxy.
The Kowalski family's story began in October 2016. Maya's parents, Jack and Beata, drove from their home in Venice to the emergency room after their then 10-year-old daughter was experiencing excruciating pain. They said the pain was from debilitating Complex Regional Pain Syndrome and that Maya was receiving doses of ketamine as part of her medical treatment as recommended by specialists.
In court Monday, Maya Kowalski broke down several times as she testified in her trial against the hospital and spoke about the last time she saw her mom.
"My mom was picking up her work bag and little things she had brought to the hospital, she said 'I love you and I'll see you tomorrow' and I never saw her again," Maya recalled through tears.
She also spoke about the moments before she eventually learned the news of her mother's death.
"At two in the morning, I broke down in tears. I was just crying uncontrollably," she said.
Maya said she called out to a nurse and told her she missed her mom.
"I miss my mom, I love my mom. I want to go home to my mom. Turns out that's when she ended her life. That's why I say it was really January 8th when she died and not the 7th because I just had this feeling that it was then."
She also spoke about a necklace she made for her mom with the inscription "to the moon and back."
"I found out later that she wore it every single day and when she was found in the garage she was still wearing it and I have it on my neck right now," Maya said. "It was actually so unbelievably cruel. The amount of time they allocated for me to spend with my family after hearing such awful news."
According to the family's lawsuit, hospital staff accused Beata Kowalski of child abuse and Munchausen syndrome by proxy. They said she had made the child's illness up and was overtreating her and shopping for doctors.
The allegations were levied and court orders sought, despite support from various medical reports about Maya's diagnosis, physician-recommended treatments and referrals, the lawsuit stated.
Maya, now 17, was separated from her family for three months after a judge ordered her to be sheltered at the hospital. It was during this time her mother took her own life, leaving behind notes — including ones for the judge and hospital staff — that expressed her despair and frustration at not being able to see her child and the weight of the accusations.
The lawsuit stated that this "extreme and outrageous" conduct caused Maya's mother, Beata Kowalski, to take her own life.
In December 2021, Dr. Sallie Smith, who initially escalated into an investigation of the report that triggered the family's ordeal, reached a $2.5 million settlement with the family. Smith was the former director of Pinellas County Department of Children and Family but was working with the group Suncoast Advocacy Services at the time.
To see what has occurred so far in the trial, read below:
Social worker's testimony
Last week's testimonies ended with jurors hearing from a social worker accused of inappropriate contact with Maya. Catherine "Cathi" Bedy was a social worker with the hospital, at that time, who facilitated orders from the Department of Children and Families in relation to the patient, Maya Kowalski. Bedy is among hospital staff who lodged abuse accusations against the Kowalskis.
In the deposition video, dated Jan. 30, 2019, Bedy answered questions about her background, career experience, responsibilities at the hospital and how she treated Maya while she was under her supervision.
Bedy admitted that she was not an expert with Munchausen Syndrome or Complex Regional Pain Syndrome and said she had briefly learned about them during an advanced degree course and had only dealt with around three cases involving the conditions.
"I heard and saw on numerous occasions the mother demanding from the doctors that the child be given amounts of ketamine and I heard discussions from the doctors saying that was too dangerous," Bedy said.
Bedy said she saw a different side of Maya that informed her otherwise about her diagnosis and how she behaved.
"There were many days in the hospital that we saw Maya doing well with the therapists that were involved with her, yes," she added. "95% of the time Maya was up in her wheelchair and the times that she would report extraordinary pain was when she was prompted by her mom."
Bedy's testimony revealed her presence was constant and at times invasive including taking photos of Maya in her underwear and admitting to listening in on sensitive conversations with family members or legal representatives. Bedy said those directives came directly from the Department of Children and Families and it was her job to make sure everyone complied and adhered to its stipulations.
Jack Kowalski's testimony
Throughout the past week, the main plaintiff in the case, Maya's father Jack Kowalski, told his side of the story to jurors. He spoke about the events that led up to his wife Beata's death.
Jack Kowalski is hoping to bring this seven-year-long battle with entities related to the case including the hospital to an end with a court ruling in his family's favor.
His testimony highlighted surveillance videos taken of his then-10-year-old daughter without parental consent.
"It was a one-sided story and if we had that at the time, we would not be here," Jack Kowalski said. "She was trying to use her arms as much as possible, that's not a child faking."
Jack Kowalski spoke of his interaction with hospital staff, Dr. Sallie Smith of Child Protective Services, and even the moment Maya was taken into state custody.
Jack Kowalski also said the hospital did not allow some of Maya's doctors to see her or allow gifts from her family including Holy Communion.
He also said that at different times, even when he was on his visitation with Maya, he was threatened with arrest and on one occasion was interrogated by a Sarasota County Sheriff's deputy without his counsel.
Evidence in court also showed the hospital billed Jack Kowalski's insurance using the code for treating complex regional pain syndrome.
Expert testimonies explained CPRS prognosis and treatments
The case has drawn attention to Maya's diagnosis of Complex Regional Pain Syndrome and the impact of ketamine treatments on patients with the condition.
CRPS is a term that describes excessive and prolonged pain and inflammation in parts of the body. Over the past two weeks, jurors have heard witness testimonies from doctors and therapists, including those who treated Maya.
The experts painted a picture of what living with and treating CRPS looked like for different patients as well as what they saw when treating Maya. The condition often medically referred to as Reflex Sympathetic Dystrophy Syndrome, was described by one of the doctors as "the world's worst pain."
In court, one of the witnesses, a pediatric neurologist, explained some potential concerns he had regarding Maya.
"There were some questions about whether or not she had an immune deficiency, which could be an underlying cause for her pain. I suggested that we might try IVIG, which she has been treated with previously and had some benefits," Dr. Carl R. Barr, a pediatric neurologist, explained.
Intravenous Immunoglobulin (IVIG) is a therapy treatment used for patients with antibody deficiencies, according to the American College of Rheumatology's website. Doctors would use a pool of immunoglobulins (antibodies) from the plasma of thousands of healthy donors to prepare it and administer it intravenously.
Also taking the stand was a physical therapist who was among the first to conduct an early physical assessment of Maya.
She spoke about her August 2015 observations and how she used various methods to get around Maya's pain during in-patient care. The testimony included several photos and videos showing Maya in rehab.
"She was in pain occasionally, she would writhe in pain, and just the fact that she was limited from doing the activities that a normal 9-year-old would want to participate in because she was nervous about experiencing increased discomfort," Dr. Marissa Higgens said.
Maya's uncle's testimony
The first set of witness testimonies in the trial were from Maya's uncle Kyle, who was also her former elementary school teacher.
A heartbreaking moment came when the lawyers played back the 911 call of when the family had discovered the mother deceased in the garage after she took her own life.
The audio played during the session with the second witness Robert Rynes, Jack Kowalski's younger brother, who also lived across the street from the family.
The family and some in the courtroom gallery became visibly emotional and grabbed tissues as the call played to the courtroom.
"Jack called me and said Beata just hung herself and you need to get over here right away," Rynes said.
"Did you rush over?" asked the lawyer.
"Yes. Immediately I told my wife, 'Beata hung herself, I'm going to Jack's,' and I took off across the street," Rynes responded.
Rynes also told the court about how he connected the family with a friend in Mexico to assist them after they had been referred to a doctor who could treat Maya with ketamine.
Kyle Kowalski's testimony followed after that. The teen described when he started noticing Maya getting sick, first with an odd-sounding cough, followed by other agonizing symptoms like severe pain, then frequent trips to the doctors, and when she started to lose mobility with her legs inverting. He also talked about her demeanor after they found a treatment that seemed to work.
"After Maya got back from Mexico, she gained a lot of her strength and along with that her happiness, and she was able to do stuff that she was never able to do before. For example, Maya, even unscrewing a water bottle cap will be very difficult for her, and after the trip from Mexico, she gained strength all over her body and was able to do stuff," Kyle Kowalski, Maya's brother and co-plaintiff, said.
"That is Maya. She is trying to build upper body strength, doing some exercises on the walker, and I am there to help her because it's still not exactly possible but she was very determined," Kyle said referring to a photo evidence exhibit.
At one point during the questioning, the lawyer asked Kyle if he thought it was possible that Maya was faking her illness and how she would react to seeing him and other children playing. That conversation can be read below.
Kyle Kowalski: I will be with my friends, doing something outside and then I could see her watching from the window.
Lawyer: And how does she look?
Kyle Kowalski: She looked very sad and I felt extremely bad.
Lawyer: She wanted to get out of that wheelchair?
Kyle: She was extremely determined.
Johns Hopkins All Children's Hospital provided the following statement following the start of the trial:
"Our priority at Johns Hopkins All Children's Hospital is always the safety and privacy of our patients and their families. Therefore, we follow strict federal privacy laws that limit the amount of information we can release regarding any particular case. Our first responsibility is always to the child brought to us for care.
"Our staff are required by law to notify Florida's Department of Children and Families (DCF) if they suspect abuse or neglect. It is DCF and a judge – not Johns Hopkins All Children's Hospital – that investigates the situation and makes the ultimate decision about what course of action is in the best interest of the child. We are determined to prevent any chilling effect on the obligation to report suspected child abuse in order to protect the most vulnerable among us."
Johns Hopkins also responded to the allegations of a discovery of a possible sexual abuse incident brought up by the plaintiffs during the trial.
"The new allegations raised by the Kowalski family's attorneys were a complete surprise to Johns Hopkins All Children's Hospital. As soon as we became aware of the allegations, and in accordance with our policies, we promptly initiated an investigation. While ongoing litigation and strict federal privacy laws restrict us from sharing more at this time, we take allegations of this nature very seriously and always put the safety of our patients above all else," according to the statement from a spokesperson for the hospital.
The judge denied a motion to include the allegations in the trial as well as two other motions for mistrial presented by either side.
Maya Kowalski and her family are suing the hospital for $220 million, divided into $55 million in compensatory and $165 million in punitive damages.