Take Care of Maya Trial

[ucladoc2b]

‘Take Care of Maya’: Jury finds Johns Hopkins All Children’s Hospital liable, awards damages in $200M case

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.’

www.fox13news.com

This verdict is really out of hand, IMO. Almost $300MM considering the facts of the case (and that the trial judge disallowed any evidence of medical child abuse).

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[nimbus]

Similar lawsuit.

Rady Children’s Hospital secretly surveilled teen and her parents in failed attempt to prove abuse

The family’s federal lawsuit alleges the hospital, working alongside San Diego County investigators, used covert video surveillance to monitor the family.

www.kpbs.org

 

[Ronin786]

These CRPS kids are some of the hardest patients to take care of. I can totally see why the hospital thought there was munchausen by proxy going on. Their parents usually walk in with a leaflet of the most unorthodox treatment plans and their receptors are so jacked up from the hundreds of meds they're on. And the parents usually are more demanding of medication than the kid themself.

 

[ucladoc2b]

These CRPS kids are some of the hardest patients to take care of. I can totally see why the hospital thought there was munchausen by proxy going on. Their parents usually walk in with a leaflet of the most unorthodox treatment plans and their receptors are so jacked up from the hundreds of meds they're on. And the parents usually are more demanding of medication than the kid themself.

No doubt there. Although (RN) mom pushed this to an extreme: 5 day ketamine comas in Mexico, high dose oxy, injecting oral ketamine into her daughter’s port, demanding IT pumps, exaggeration of asthma (she went to the ED and got a neb. Mom then claimed she required NIPPV in the ICU).

Unfortunately, a lot of these facts were deemed inadmissible at trial by whatever logic.

 

[TheLoneWolf]

No doubt there. Although (RN) mom pushed this to an extreme: 5 day ketamine comas in Mexico, high dose oxy, injecting oral ketamine into her daughter’s port, demanding IT pumps, exaggeration of asthma (she went to the ED and got a neb. Mom then claimed she required NIPPV in the ICU).

Unfortunately, a lot of these facts were deemed inadmissible at trial by whatever logic.

Hospital will fight tooth and nail to have such evidence brought in as evidence in the appeal. Juries don't care about evidence....put a sick kid in front of them and make a spectacle...uneducated juries are empathetic and such high emotional allegations will often times override their logic and evidence.

Im pain trained. I have experience with treating chronic pain in a pediatric hospital setting. I experienced such demanding parents, and I am concerned that this case reeks of munchausen by proxy from what I can gather. When the mother (almost always the mother) loses control of both the medical situation and the child, they usually lash out to every governing body with an HR dept and the media claiming the medical field is mistreating their child. If that fails, actions such as what happened in this case are not unusual. Her nursing background and subjecting her kid to ketamine comas and mediport placements, as alleged; if proven to be true are abhorrent.

Let's go through this:
Ketamine treatment is not the standard of care in CRPS. Neither is an IT pump. It's aggressive amounts of PT, pain psych, behavioral modification, and antineuropathics. Clear boundaries on the limitations of medical intervention from the first visit. Don't let them doctor shop.

To even consider the stuff she was "requesting" for her child one would need a university level multidisciplinary conference showing all trialed interventions before even considering such things. Even assuming they had really done every else, doubtful the conference would sign off on any of her requests citing uncontrolled psychiatric comorbidity in either the controlling parent, the child, or both.

Let's be honest here, do you really believe a world class pediatric hospital wanted to bully a mom crying out to help her sick kid. Any other part of the world would bring derision on such allegations. Here we twiddle our thumbs while crafty personal injury lawyers limit the scope of presented evidence to achieve their desired legal outcomes.

Lastly, let us not forget that pretty much every state has a duty to report such concerns to the relevant authorities and leave the investigating to them. In this particular case, "A state judge and Florida’s Department of Children and Families later sided with doctors who suspected Beata was suffering from Munchausen-by-proxy syndrome, a psychological disorder where parents’ fabricate their child’s illness".

 

[ucladoc2b]

Hospital will fight tooth and nail to have such evidence brought in as evidence in the appeal. Juries don't care about evidence....put a sick kid in front of them and make a spectacle...uneducated juries are empathetic and such high emotional allegations will often times override their logic and evidence.

Im pain trained. I have experience with treating chronic pain in a pediatric hospital setting. I experienced such demanding parents, and I am concerned that this case reeks of munchausen by proxy from what I can gather. When the mother (almost always the mother) loses control of both the medical situation and the child, they usually lash out to every governing body with an HR dept and the media claiming the medical field is mistreating their child. If that fails, actions such as what happened in this case are not unusual. Her nursing background and subjecting her kid to ketamine comas and mediport placements, as alleged; if proven to be true are abhorrent.

Let's go through this:
Ketamine treatment is not the standard of care in CRPS. Neither is an IT pump. It's aggressive amounts of PT, pain psych, behavioral modification, and antineuropathics. Clear boundaries on the limitations of medical intervention from the first visit. Don't let them doctor shop.

To even consider the stuff she was "requesting" for her child one would need a university level multidisciplinary conference showing all trialed interventions before even considering such things. Even assuming they had really done every else, doubtful the conference would sign off on any of her requests citing uncontrolled psychiatric comorbidity in either the controlling parent, the child, or both.

Let's be honest here, do you really believe a world class pediatric hospital wanted to bully a mom crying out to help her sick kid. Any other part of the world would bring derision on such allegations. Here we twiddle our thumbs while crafty personal injury lawyers limit the scope of presented evidence to achieve their desired legal outcomes.

Lastly, let us not forget that pretty much every state has a duty to report such concerns to the relevant authorities and leave the investigating to them. In this particular case, "A state judge and Florida’s Department of Children and Families later sided with doctors who suspected Beata was suffering from Munchausen-by-proxy syndrome, a psychological disorder where parents’ fabricate their child’s illness".

Not to mention collaborating with very biased widely released documentaries. I’m sure this was done with the intent shaping potential juror opinions.

 

[Airway]

Hospital will fight tooth and nail to have such evidence brought in as evidence in the appeal. Juries don't care about evidence....put a sick kid in front of them and make a spectacle...uneducated juries are empathetic and such high emotional allegations will often times override their logic and evidence.

Im pain trained. I have experience with treating chronic pain in a pediatric hospital setting. I experienced such demanding parents, and I am concerned that this case reeks of munchausen by proxy from what I can gather. When the mother (almost always the mother) loses control of both the medical situation and the child, they usually lash out to every governing body with an HR dept and the media claiming the medical field is mistreating their child. If that fails, actions such as what happened in this case are not unusual. Her nursing background and subjecting her kid to ketamine comas and mediport placements, as alleged; if proven to be true are abhorrent.

Let's go through this:
Ketamine treatment is not the standard of care in CRPS. Neither is an IT pump. It's aggressive amounts of PT, pain psych, behavioral modification, and antineuropathics. Clear boundaries on the limitations of medical intervention from the first visit. Don't let them doctor shop.

To even consider the stuff she was "requesting" for her child one would need a university level multidisciplinary conference showing all trialed interventions before even considering such things. Even assuming they had really done every else, doubtful the conference would sign off on any of her requests citing uncontrolled psychiatric comorbidity in either the controlling parent, the child, or both.

Let's be honest here, do you really believe a world class pediatric hospital wanted to bully a mom crying out to help her sick kid. Any other part of the world would bring derision on such allegations. Here we twiddle our thumbs while crafty personal injury lawyers limit the scope of presented evidence to achieve their desired legal outcomes.

Lastly, let us not forget that pretty much every state has a duty to report such concerns to the relevant authorities and leave the investigating to them. In this particular case, "A state judge and Florida’s Department of Children and Families later sided with doctors who suspected Beata was suffering from Munchausen-by-proxy syndrome, a psychological disorder where parents’ fabricate their child’s illness".

But after this trial I think I’ll just give whatever they want. Demoralizing. Ivermectin ketamine anything goes

 

[powermd]

I treat CRPS in adults and kids all the time. Maya doesn't remotely look like a kid with CRPS. This whole thing stinks to high heaven, and mom's suicide is the psycho-cherry on top. I think Maya was somehow traumatized by mom at an early age and that's why she put so much energy into "fixing"her- it's due to guilt.

I would agree that ketamine comas are not standard care for CRPS, but I don't see a problem with subanesthetic ketamine infusions (think 50-125 mg over 60-90 min). I do them all the time for depression and chronic neuropathic pain, including CRPS. Some patients do quite well and it's low risk.

 

[coffeebythelake]

The mom is a sociopath and this is classic munchaussen by proxy. Investigated through and through by doctors and child protective services. But the lawyers sold a sob story to a jury of gullible idiots and got their mega win. **** thjs country

 

[coffeebythelake]

Not to mention collaborating with very biased widely released documentaries. I’m sure this was done with the intent shaping potential juror opinions.

This should be enough to get the verdict appealed. Plus the judge denying the full scope of information relating to treatments, which is very relevant to the defense.

 

[powermd]

In one of the news videos a NP said Maya confessed to her "I'm tired of all the lies". Hmmm...

 

[Neopolymath]

The mom killing herself honestly says it all. That alone is reason to believe this is Munchausen by proxy.

 

[TheLoneWolf]

I know from friends in Indiana that a three physician panel is convened whenever a complaint or potential malpractice is alleged to have occurred. They review the allegations and determine if there is enough merit to proceed with medicolegal action.

It doesnt stop a civil suit from proceeding but having a signed report from three practicing physicians stating no evidence of wrongdoing is a strong counter to the legal chicanery such as in this case.

I would argue that if such a case had happened in Indy, the complaint would never have gotten off the ground.

I don't understand why the whole country wouldn't adopt such common sense legislation. Of course, every personal injury lawyer would be up in arms over this as it closes the never ending pipeline of "nuisance" type lawsuits.

 

[Bertelman]

I don't understand why the whole country wouldn't adopt such common sense legislation. Of course, every personal injury lawyer would be up in arms over this as it closes the never ending pipeline of "nuisance" type lawsuits.

One word answer for you:

Florida.

 

[nimbus]

What Happened to Maya Kowalski

When a 10-year-old girl complained of mysterious pain, a doctor suspected child abuse. How far would she go to prove it?

www.thecut.com

This account makes it clear that there was child abuse although it is unclear which parties were committing child abuse.

The child apparently got worse when she was removed from her parents’ custody.

I think it is possible that the subspecialty of “child abuse pediatrics” can disproportionately attract certain personality types too.

And the mom didn’t come up with “ketamine coma”on her own. They spent $10k/pop cash for a series of treatments here.

<The Reflex Sympathetic Dystrophy / Complex Regional Pain Syndrome Institute Opened Its Ambulatory Surgical Center >

Seems to me like there were several parties with their own agendas involved in her care.

 

[Dr. Rude]

I know from friends in Indiana that a three physician panel is convened whenever a complaint or potential malpractice is alleged to have occurred. They review the allegations and determine if there is enough merit to proceed with medicolegal action.

It doesnt stop a civil suit from proceeding but having a signed report from three practicing physicians stating no evidence of wrongdoing is a strong counter to the legal chicanery such as in this case.

I would argue that if such a case had happened in Indy, the complaint would never have gotten off the ground.

I don't understand why the whole country wouldn't adopt such common sense legislation. Of course, every personal injury lawyer would be up in arms over this as it closes the never ending pipeline of "nuisance" type lawsuits.

Where you stand depends on where you sit. What to you and me is “common sense legislation” to others is a system “rigged” against patients getting a “fair” chance at being compensated for being harmed by negligence.

 

[nimbus]

Hospital will fight tooth and nail to have such evidence brought in as evidence in the appeal. Juries don't care about evidence....put a sick kid in front of them and make a spectacle...uneducated juries are empathetic and such high emotional allegations will often times override their logic and evidence.

Im pain trained. I have experience with treating chronic pain in a pediatric hospital setting. I experienced such demanding parents, and I am concerned that this case reeks of munchausen by proxy from what I can gather. When the mother (almost always the mother) loses control of both the medical situation and the child, they usually lash out to every governing body with an HR dept and the media claiming the medical field is mistreating their child. If that fails, actions such as what happened in this case are not unusual. Her nursing background and subjecting her kid to ketamine comas and mediport placements, as alleged; if proven to be true are abhorrent.

Let's go through this:
Ketamine treatment is not the standard of care in CRPS. Neither is an IT pump. It's aggressive amounts of PT, pain psych, behavioral modification, and antineuropathics. Clear boundaries on the limitations of medical intervention from the first visit. Don't let them doctor shop.

To even consider the stuff she was "requesting" for her child one would need a university level multidisciplinary conference showing all trialed interventions before even considering such things. Even assuming they had really done every else, doubtful the conference would sign off on any of her requests citing uncontrolled psychiatric comorbidity in either the controlling parent, the child, or both.

Let's be honest here, do you really believe a world class pediatric hospital wanted to bully a mom crying out to help her sick kid. Any other part of the world would bring derision on such allegations. Here we twiddle our thumbs while crafty personal injury lawyers limit the scope of presented evidence to achieve their desired legal outcomes.

Lastly, let us not forget that pretty much every state has a duty to report such concerns to the relevant authorities and leave the investigating to them. In this particular case, "A state judge and Florida’s Department of Children and Families later sided with doctors who suspected Beata was suffering from Munchausen-by-proxy syndrome, a psychological disorder where parents’ fabricate their child’s illness".

This is the same world class pediatric hospital that had to shut down its congenital heart program a few years ago.

Despite warnings, All Children’s kept operating. Babies died.

The heart program’s mortality rate tripled since 2015.

projects.tampabay.com

 

[Anesthesia_Guy]

legal chicanery

❕

 

[coffeebythelake]

This is the same world class pediatric hospital that had to shut down its congenital heart program a few years ago.

Despite warnings, All Children’s kept operating. Babies died.

The heart program’s mortality rate tripled since 2015.

projects.tampabay.com

The CT surgeons there should be ashamed. But most of the blame goes to the hospital administrators at Hopkins.

 

[nimbus]

The CT surgeons there should be ashamed. But most of the blame goes to the hospital administrators at Hopkins.

When Hopkins took over, the long-time existing surgeon was pushed out. When the program shut down due to bad outcomes with the newly recruited hot shot academic surgeon, they got the old guy back to get the program up and running again. And several administrators resigned.

Johns Hopkins All Children’s plans to restart Heart Institute

A cardiothoracic surgeon who worked for 26 years at Johns Hopkins All Children's Hospital is returning to the hospital to lead the Heart Institute. Dr. James Quintessenza, the former medical director and chief of pediatric cardiac surgery at the St. Petersburg pediatric hospital, left All...

stpetecatalyst.com

Top All Children’s executives resign following Times report on heart surgeries

‘The events described in recent news reports are unacceptable,’ the hospital’s parent company said.

www.tampabay.com

 

[IlDestriero]

This is the same world class pediatric hospital that had to shut down its congenital heart program a few years ago.

Despite warnings, All Children’s kept operating. Babies died.

The heart program’s mortality rate tripled since 2015.

projects.tampabay.com

Definitely not so world class.
That place has a lot of long standing problems.

 

[ucladoc2b]

Definitely not so world class.
That place has a lot of long standing problems.

This apparently came up during the trial (JC reviews). I can’t exactly figure our how it was relevant to the case at all.

 

[Bertelman]

The CT surgeons there should be ashamed. But most of the blame goes to the hospital administrators at Hopkins.

If your Peds CT Surg program is good, that’s something you don’t really mess with. Stay in, or get out, but don’t make big changes.

 

[coffeebythelake]

When Hopkins took over, the long-time existing surgeon was pushed out. When the program shut down due to bad outcomes with the newly recruited hot shot academic surgeon, they got the old guy back to get the program up and running again. And several administrators resigned.

Johns Hopkins All Children’s plans to restart Heart Institute

A cardiothoracic surgeon who worked for 26 years at Johns Hopkins All Children's Hospital is returning to the hospital to lead the Heart Institute. Dr. James Quintessenza, the former medical director and chief of pediatric cardiac surgery at the St. Petersburg pediatric hospital, left All...

stpetecatalyst.com

Top All Children’s executives resign following Times report on heart surgeries

‘The events described in recent news reports are unacceptable,’ the hospital’s parent company said.

www.tampabay.com

I mean it speaks very much to Dr James Quintessenza's skill. He was the most experienced surgeon there who got kicked out prior to this whole mess. It seems like he carried the program all these years. And now he is back.

 

[abolt18]

I mean it speaks very much to Dr James Quintessenza's skill. He was the most experienced surgeon there who got kicked out prior to this whole mess.

Yeah, he went to University of Kentucky and was awesome (so I'm told). People were devastated when he left to go back to FL.

 

[nimbus]

Definitely not so world class.
That place has a lot of long standing problems.

I was quoting @thelonewolf. “World class” should have been in quotes.

 

[TheLoneWolf]

What Happened to Maya Kowalski

When a 10-year-old girl complained of mysterious pain, a doctor suspected child abuse. How far would she go to prove it?

www.thecut.com

This account makes it clear that there was child abuse although it is unclear which parties were committing child abuse.

The child apparently got worse when she was removed from her parents’ custody.

I think it is possible that the subspecialty of “child abuse pediatrics” can disproportionately attract certain personality types too.

And the mom didn’t come up with “ketamine coma”on her own. They spent $10k/pop cash for a series of treatments here.

<The Reflex Sympathetic Dystrophy / Complex Regional Pain Syndrome Institute Opened Its Ambulatory Surgical Center >

Seems to me like there were several parties with their own agendas involved in her care.

That article reads like it was written by her family's malpractice lawyer. In a word: subversive. Really paints the pediatric child abuse subspecialist with 30 years experience at times both malevolent and incompetent. It paints the mother as a down and out immigrant who was simply misunderstood given that English was not her native language as the article subtly suggests to the reader.

The social worker and DCF staff are painted as co-conspirators, yet lacking a tangible motive other than protecting a vulnerable child in a case which is clearly pointing to florid psychiatric disease in one or more individuals.

Symptoms make no sense. Wheelchair bound without a known cause...losing control of her bowel function without a known cause...continously screaming and crying, unexplained skin lesions. Pushy mother asking for specific doses of controlled substances for something as simple as an ultrasound? Yeah, I could see how someone would alert child protective services for suspected Munchausen-by-proxy. Article says everyone in Florida has a duty to report such concerns, which is arguably more strict than most states.

I think the text messages at the end of the article between the treating physicians are telling of the "boots on the ground" assessment of the situation.

One of the two pain guys named continues to advertise 4 day high dose ketamine infusions at their surgery center ( super questionable...imagine the facility fees) and "ketamine comas" at their institutes website. The other guy is just a run of the mill private practice pain guy. Could not find the breadth of their life changing and oft cited CRPS papers on ye Olde pubmed so their opinions are as good as any nonpublished person on the matter.

The truly terrifying stuff is in the comments section under the article.

Here is a portion of the top comment:
"this is another perfect example of the kidnapping of children for profit"

Many such comments in full support of the actions of the mother and an unsettling distrust of the medical establishment and child protective services. Yikes

The pain doctor at Brown who ultimately reinforced the diagnosis of CRPS is anesthesia pain boarded. I hold the same qualifications. I could not definitely say on any case that Munchausen-by-proxy and fictitious disorders are "incorrect " as the article points out. There is certainly room for overlap and psychiatric comorbidity in CRPS is rather common. These diagnoses are for boarded psychiatrists to rule out definitively. In such a murky case, probably 2 psychiatrists who independently interacted and reported their findings would have been more fruitful.


The article goes on to say:

"When Maya left All Children’s Hospital in January 2017, she weighed less than she did when she was admitted — a dark verdict on the separation test meant to detect Munchausen by proxy"

One could make the counterargument that the child ultimately improved because of her mother's self imposed permanent seperation.

 

[TJRock]

What Happened to Maya Kowalski

When a 10-year-old girl complained of mysterious pain, a doctor suspected child abuse. How far would she go to prove it?

www.thecut.com

This account makes it clear that there was child abuse although it is unclear which parties were committing child abuse.

The child apparently got worse when she was removed from her parents’ custody.

I think it is possible that the subspecialty of “child abuse pediatrics” can disproportionately attract certain personality types too.

And the mom didn’t come up with “ketamine coma”on her own. They spent $10k/pop cash for a series of treatments here.

<The Reflex Sympathetic Dystrophy / Complex Regional Pain Syndrome Institute Opened Its Ambulatory Surgical Center >

Seems to me like there were several parties with their own agendas involved in her care.

No, Maya got better, not worse. They got her off of the high dose ketamine and opioids and kept her from her mom. She hasn't had ketamine (by court order) since CPRS stepped in and, viola, she got better. That is one of the most frustrating things about this whole case - she is now massively better than when she entered the hospital without ketamine or her mom.

Mom didn't come up with the ketamine coma, but she shopped around until she found the ketamine doctor who admitted, under oath, that his ketamine treatments were not working. He did tell the mom, however, that Maya would die a slow, painful death without his treatment.

The defense put on numerous doctors, psychologists and therapists who identified Maya's pain to be mostly psychological. Doctors also who flat out said that she did not have CRPS. All of those doctors, psychologists and therapists were from other hospitals and saw Maya when her mom was shopping her around for a diagnosis and treatment that she liked.

I really, really hope that the verdict and award is reversed on appeal. The hospital had no chance with a pretty, blonde girl as the plaintiff. I think that this was a sympathetic verdict, one that wasn't based on the evidence presented at trial.

 

[Ronin786]

Definitely not so world class.
That place has a lot of long standing problems.

Let's also not pretend that Johns Hopkins hospital in Florida is remotely the same as Baltimore. These big hospital systems love to throw their name around with very little quality associated. Mayo might be the only one that has done it well in AZ/Jax

This apparently came up during the trial (JC reviews). I can’t exactly figure out how it was relevant to the case at all.

Yeah, the trial was suspended because they hadn't disclosed Joint Commission reviewing the heart program. Not sure how that impacts this specific scenario, but the lawyers made it seem it was a culture of safety problem.

 

[ToKingdomCome]

I’m not a pain doc, but couldn’t she have gotten a spinal cord stimulator ?

 

[powermd]

I’m not a pain doc, but couldn’t she have gotten a spinal cord stimulator ?

She’d never make it past the psych eval.

 

[Agast]

I’m not a pain doc, but couldn’t she have gotten a spinal cord stimulator ?

I’ve been deliberately avoiding reading about this case and the Netflix show, but CRPS in adults and pediatrics is different. Kids usually get better. I’ve only had to take care of one kid (13 yo and left the peds pain doc because she is afraid of male physicians) and the thing that “cured” her was a really good peds PT program and me respecting the psych/anxiety component of her pain. She’s 95% better and only taking pregabalin/low dose naltrexone. Her leg was so bad even when she slept her knee was permanently bent and they thought she had a contracture, it wasn’t.

Anyway, no kid should be getting an intrathecal pump or spinal cord stimulator because managing the psych component should help resolve it.

 

[powermd]

I’ve been deliberately avoiding reading about this case and the Netflix show, but CRPS in adults and pediatrics is different. Kids usually get better. I’ve only had to take care of one kid (13 yo and left the peds pain doc because she is afraid of male physicians) and the thing that “cured” her was a really good peds PT program and me respecting the psych/anxiety component of her pain. She’s 95% better and only taking pregabalin/low dose naltrexone. Her leg was so bad even when she slept her knee was permanently bent and they thought she had a contracture, it wasn’t.

Anyway, no kid should be getting an intrathecal pump or spinal cord stimulator because managing the psych component should help resolve it.

I watched the first part of the documentary again with a more critical eye. Maya's "syndrome" started with pain in the arms, legs, and feet. She "felt lethargic" and couldn't "move efficiently". This was accompanied by "chest congestion", a "sinus infection", "breathing problems", headaches, blurred vision, burning skin, legs "turning in", inability to walk, and skin lesions. I don't know what was wrong with her, but I can say this doesn't resemble any case of CRPS, childhood or adult, that I've ever seen. The cough/respiratory part seemed to play as large a role as her pain, and was just as baffling to the doctors. She had nausea to the point where they put her on TPN. They show the mother's handwritten notes and you can see she was tried on a ton of meds.

I find it interesting that Maya's mother is a nurse. At one point at the ketamine clinic, she tells Maya "mommy's not a monster". It's interesting how much audio/video she recorded, some at doctor visits surreptitiously. At one point an investigator is asking the dad if he thinks his wife is injuring the child and he responds "I hope not." The doctors at JH at one point had observed Maya using her feet normally despite her supposed dystonia. A nurse recalled a conversation with Maya in which she said she was "tired of all the lying".

The part that gives me the most trouble is that despite supposedly being 100% devoted to her daughter's well-being, she commits suicide, thus guaranteeing her a lifetime of suffering. There has to be a lot more to this story than we heard. Mom had worked as an infusion nurse. I personally suspect she was poisoning her daughter. It's not unheard of. This situation sounds like a board question where the answer is MBP.

With respect to Dr. Ftizpatrick's very certain diagnosis of CRPS, at one point the dad says they couldn't afford his treatments anymore. Makes me wonder how clouded his judgment might be.

 

[Bertelman]

Only winner in all of this is the lawyer

 

[DocMcCoy]

Though still not understanding the entire sequence of events and process, it absolutely terrifying to me that you could be one doctor and one judge removed from having your children stripped away from you. If that is in fact what happened.

 

[coffeebythelake]

Though still not understanding the entire sequence of events and process, it absolutely terrifying to me that you could be one doctor and one judge removed from having your children stripped away from you. If that is in fact what happened.

It's not that simple.

 

[anbuitachi]

i read the other long article about it. didnt watch documentary. its pretty crazy what they did to her. her mother committed suicide because of it. and she and her rest of family suffered immensely. again didnt watch documentary. not sure where people are getting she improved. at least the article said she got worse. and when she was finally united with family, she had to undergo intense PT to even walk, which wasnt the case prior to the separation

dont know the other sides story. but if what the story said is true. im not surprised at the verdict. sounds like juror agree as well.

 

[VA Hopeful Dr]

Though still not understanding the entire sequence of events and process, it absolutely terrifying to me that you could be one doctor and one judge removed from having your children stripped away from you. If that is in fact what happened.

Not speaking to this case specifically, but there absolutely should be situations in which a single doctor and a single judge take children away from parents.

I imagine this does not come up often in an anesthesia, and thankfully has not come up in my career to date, but bear in mind we are all mandated reporters for child abuse. If a severe enough case were to come to one of our attentions, we would report it and hopefully social services in our respective states could go before a judge and get a child taken out of parental custody at least temporarily. The news is full of stories where that didn't happen and children died because of it.

 

[DocMcCoy]

Not speaking to this case specifically, but there absolutely should be situations in which a single doctor and a single judge take children away from parents.

I imagine this does not come up often in an anesthesia, and thankfully has not come up in my career to date, but bear in mind we are all mandated reporters for child abuse. If a severe enough case were to come to one of our attentions, we would report it and hopefully social services in our respective states could go before a judge and get a child taken out of parental custody at least temporarily. The news is full of stories where that didn't happen and children died because of it.

Don’t get me wrong, the only thing worse would be not intervening and then a kid suffering or dying from inaction.

BUT, if from what I read is true, this institution, specifically this doctor (Smith) makes calls like this twice the average. It appears she may have made some other controversial calls. Also, this is obviously a complex case, certainly not a straight forward child abuse case. It appears the separation went on for months? Both parents? Then a judge denies any type of in person contact with mom?

I don’t know enough to criticize every call from the armchair. I do know to be falsely accused of abuse resulting in my children taken away from me would probably result in some suicidal and or homicidal ideation and despair.

 

[Ronin786]

I imagine this does not come up often in an anesthesia, and thankfully has not come up in my career to date, but bear in mind we are all mandated reporters for child abuse. If a severe enough case were to come to one of our attentions, we would report it and hopefully social services in our respective states could go before a judge and get a child taken out of parental custody at least temporarily. The news is full of stories where that didn't happen and children died because of it.

Always tough when you have cases like this An ER doctor was charged with abusing his baby. But 15 medical experts say there’s no proof.

But then again, the actually abusive parents aren't making the news.

 

[TJRock]

i read the other long article about it. didnt watch documentary. its pretty crazy what they did to her. her mother committed suicide because of it. and she and her rest of family suffered immensely. again didnt watch documentary. not sure where people are getting she improved. at least the article said she got worse. and when she was finally united with family, she had to undergo intense PT to even walk, which wasnt the case prior to the separation

dont know the other sides story. but if what the story said is true. im not surprised at the verdict. sounds like juror agree as well.

But she did get better. She was a mess when she had to be taken to the hospital for severe stomach pain. She was in a wheelchair, begging for ketamine (at least when her mom was around), claimed 10/10 pain (at least when mom was around), couldn't use her arms (at least when mom was around) and screamed and cursed doctors and nurses (at least when mom was around). The doctor who was prescribing the large doses of ketamine testified that the ketamine wasn't helping her anymore, so he directed the family to take her to the ED where mom insisted on large doses of ketamine.

Her behavior was documented at at least two other hospitals prior to JHAC.

If you see her now, she is a beautiful young lady (any effect on the jury???) who dances, swims and is looking forward to college. No CRPD flare ups in the last several years, few if any since she was released from JHAC.

It will be interesting to see if she goes back to ketamine once she turns 18. Currently, she is still under court order not to receive ketamine as a treatment.

 

[Ashers]

Always tough when you have cases like this An ER doctor was charged with abusing his baby. But 15 medical experts say there’s no proof.

But then again, the actually abusive parents aren't making the news.

I was thinking of this case because I did my intern year with the mom. It was awful.

 

[JAK2-STAT3]

I'm a med student who watched parts of this trial whenever I could. My humble opinion is by the end of the trial the CRPS vs. Factitious disorder argument became less relevant.

1. Before the trial it was ruled that the call to the abuse hotline was in good faith and legit. Similarly, the hospital sheltered Maya as directed by the court. The plaintiffs were forbidden from claiming that the hospital took Maya away from her family.

2. For me, the crux of the case hinged on Dr. Smith, the child abuse pediatrician. She had privileges at JHACH but was employed by DCF, which was contracted to a private company. Under Florida law DCF has immunity, so a central question was whether she was acting as an agent of the hospital or as an agent of DCF. If the former, the plaintiffs had a case. If the latter, it fell under DCF immunity. The plaintiffs alleged that after she was notified by the hospitalist but before a formal DCF investigation was launched, she unduly influenced Maya's treatment. Per the Kowalskis, when she first met them she did not introduce herself as a member of the child protection team and wore a white coat with a JHACH logo, though she denied this.

3. And then there's Cathy Bedy, the social worker who herself had previously been arrested for child abuse, though she was later exonerated. This was not allowed into evidence, though her disciplinary record at JHACH was. She had a history of behaving aggressively towards coworkers. Allegedly she took it upon her self to be the "point person" in Maya's case, and in a nutshell, went above and beyond what the DCF orders directed as far as keeping Maya away from her parents (especially her mother), eavesdropping on Maya while she was meeting with her attorney, etc. The family had a litany of allegations against her, which if true are unprofessional at best and arguably battery at worst. Allegedly she sat Maya on her lap, kissed her against her will, and told her that she would adopt her. This took place in the chapel where there were conveniently no cameras, and importantly, before the parents lost their parental rights. Maya also alleged that she stripped her to take photos before court, telling her that that was the only way she could see her mother. These photos were never entered into Maya's medical record.

4. The immediate jeopardy drama was a fascinating turn. The plaintiffs dropped hints throughout the trial that there were systemic issues at JHACH, exemplified by Bedy's conduct. During the rebuttal, the defense put a witness on the stand who testified that the JHACH was fine with JCAHO. On cross, he admitted that he based this off a 2-3 page outline given to him by defense council. That opened the door for the plaintiffs to bring in the IJ finding. While this finding may have started with the heart institute, apparently it was more widespread than that. So the last thing jurors heard in this case was that JHACH had so many systemic issues they were about to for all intents and purposes shut down.

I have no basis to form an opinion on whether Maya had/has CRPS, whether this was child abuse, or what was going on with her mother. But I think that that becomes less relevant when the case centers on what a hospital is or is not allowed to do when interpreting DCF orders (or lack thereof). Please feel free to correct me if I'm gotten any of these facts wrong. If nothing else, this trial gave me a very real look into how brutal the legal system can be towards physicians who are trying their best to make good decisions for patients with the information they have.

 

[HemeOncHopeful19]

It's not that simple.

Yeah… sometimes you might get the overzealous child abuse NP

Former Children's Wisconsin pediatrician who was investigated in 2019 child abuse claim sues hospital

John Cox, a former ER pediatrician at Children's Wisconsin, has sued the hospital and former colleagues over a 2019 child abuse investigation

www.jsonline.com

 

[DocMcCoy]

Yeah… sometimes you might get the overzealous child abuse NP

Former Children's Wisconsin pediatrician who was investigated in 2019 child abuse claim sues hospital

John Cox, a former ER pediatrician at Children's Wisconsin, has sued the hospital and former colleagues over a 2019 child abuse investigation

www.jsonline.com

I’d like to think these are isolated cases. In reality it’s probably just those with means making their stories heard. Can’t imagine how many marginalized persons there are with similar stories and the inability to fight the system.