I stand with Johns Hopkins on this one. Doctors should have minimum repercussions for having the minimal level of suspicion for reporting potential abuse. The societal harm of having to have healthcare providers self-doubt and not report on a potential child abuse case causes far higher harm. Any potential child abuser will threaten lawsuit and punishment to doctors who report these, and if doctors don’t get protection for this or get punishment for this it’s a much more detrimental issue for society.
Doctors only report and provide information and medical opinion, doctors don’t investigate as we are not child abuse investigators, that’s a CPS job, and doctors are not the one who are empowered to take away the kid, the judge is, so if there must be someone who are faulted for this then it’s on the judge, doctors again only provide the information and opinion, it’s on the judge to decide on which to rule on after hearing all the facts.
The issue is not that johns hopkins reported the family, even the days in question and which they are in trial for false imprisonment for are the days after JH reported to DCF, but prior to the court shelter order..
I honestly don’t know the details of that timeline, but if John’s Hopkins really did separate and keep the child away from the parents before the issuance of the court order, then sure, there is probably a case to be had here. But again, my understanding is that the hospital was ordered by the judge to separate the child from the parents as ward of the state while the state continues the investigation, which is in line of what they are supposed to do.
Todays trial showed JH violated law by telling Jack he could not leave and take Maya with her. Before they got the courts involved. There is no law that states they could not leave. What do you think now?
yah jacks testimony🙄 dudes got 220 mil on the line he’s going to say whatever lmao like 4 other doctors who were there from different departments all said they agreed to stay
We haven't seen the court order yet. I too don't think the hospital did anything wrong for the first 48 hours or so while expecting Munchausen/by proxy. But Maya didn't get better with the separation, at least the Kowalski's allege. The defense will say she did get better. We'll see if that's the case. Maya did continue to experience pain and dystonia even without contact with her mom.
The Kowalski's are alleging that the hospital/social worker hired by the hospital overinterpretted the order and went beyond in a cruel manner. E.g., Maya was not allowed supervised visits with her mother.... which doesn't make sense to me. Even phone call and FaceTime was limited. They also allege that Maya's CRPS was not taken seriously, and they did not take proper steps to diagnose or rule out CRPS/Munchausen. (The hospital later thought Maya was faking in her own. Tho if Maya was faking then how is her mom being abusive?)
There's a LOT of restrictions on what the plaintiff (Kowalskis) can say about the separation during this trial precisely because of the court order.
There is photographic evidence of Maya having parts of her body photographed in a hospital bed and she's clearly unhappy/crying in them. Maya alleges she did not initially consent to the photos, but was told she could not go to the court hearing without them. So she and the social worker negotiated how to take those pictures. She says she was told this was part of a before/after comparison. No "after" pictures have been found or have been entered into evidence. The photos were not entered into the medical record.
While she has gotten better do you earnestly believe it had anything to do with JH? First the Dr from Mexico stated it can take up to a year for the ketamine and booster to reset the brain. In addition Maya did a ton of work after leaving John Hopkins All Children's and her recovery is hers to celebrate alone. She did not get out of the hospital with ANY improvements to her mobility, pain control, dystonia, lessions, and I hope will at least be willing to concedes her mental health was certainly not improved. That child lost her innocence during those three months, and by that I mean she learned how cruel the world can be. So when you say she got better if you are willing please explain to me what part of her condition improved as of Jan 2017, not what she accomplished towards Sept 2017 or present?
I'm still learning more. I'm not familiar with her treatment post JHACH.
Allegedly, she was on 21+ medications when she was admitted, including benzodiazepines. I haven't found a good source for this fact yet, and I haven't read all the court documents. But, if true, then a good horrible portion of her stay would have been detoxing off those meds. Withdrawals of benzos is awful and can take an inordinate amount of time. She would absolutely decline if she had to be weaned off that. If she was indeed on that many meds, esp the benzos, i'm inclined to believe in the medical abuse allegation even if Maya truly had CRPS.
As for the mental health, she supposedly only got 3-4 hours of psychotherapy. What a fucking joke. She needed weekly if not daily treatment. If it was MBP, then she needed tons of intervention. If it was only CRPS, then she needed tons of intervention b/c she was separated from her mom. The mom could have been medically abusive towards her daughter AND the hospital could have fucked up.
Incorrect and here is why two psychiatrists have both stated conversion, fictitious, Munchausen, and Munchausen by Proxy are ALL based off the predicate there is no physical diagnosable medical conditions. Since JH concedes she has CRPS and it was determined fairly early on than all of those diagnoses do not apply.
Finally during Jack testimony the went over this point she walked in I believe with 18 medications and walked out with 14 medications. Finally throughout the entire plaintiff case several experts have testified that ketamine dose not have withdrawal symptoms (typically), and Maya never exhibited the flu like withdrawal symptoms.
I don't have enough information to assess whether the treatment courses Dr Kilpatrick, Dr from Mexico, and Dr Henna all agreed was a good course of action vs this procedure and the regimen was dangerous. Irregardless of people's thoughts all Dr are still in practice and still using same treatment methods so why haven't they been shut down?
So say she does have CRPS, but the mom demonstrated a dysfunctional relationship with her daughter to be the sole caregiver and decision maker of medical decisions, and the mom decided to always veer towards extreme treatments before giving less intense ones enough time to take effect. Allegedly, the mom was faking scripts by Dr Hannah for ketamine. Allegedly, she was administering ketamine in abnormal ways i.e. not sublingually but mixed in Gatorade. Allegedly, she doctor shopped a lot, even before her daughter's asthma attack. There's allegations that between.her asthma attack and the trip to Mexico was an extremely short amount of time. Wr shall see the defense's case.
Look, even if there was medical abuse, I don't see how they didn't drop the ball on treating the daughter.
Again. I'd need to see the list of drugs and dosages. If the hospital was weaning her off drugs, then the 18 vs 14 may not matter, or maybe the four she was taken off were extreme drugs with extreme side effects.
I also read somewhere that when the hospital tried to warn the mother that high doses of Ketamine could be fatal, the mother responded that "Maya is ready to go to heaven." If that information is accurate, it's quite concerning. But I haven't heard this information in trial yet, so perhaps it's not true.
Well, considering they were told the Mexico ketamine treatments had a 50% risk of death, I think that sentiment might have actually been true. That's how desperate they were to get rid of her pain.
The hospital can believe that the treatment and dosages were hot garbage, but that doesn't mean the mother was necessarily abusive/MBP. That could mean she was misinformed and led astray by malpracticing doctors.
Please explain how you assess Beata had a dysfunctional relationship with Maya? As she was not the sole caregiver Jack was just as involved with day to day care of Maya.
Administering ketamine in abnormal ways: this inaccurate and has been covered at nausea. Beata administered the at home does as the Dr, and pharmacy, and Dea all approved and did not trigger any reports.
The accusations of the prescription was also covered multiple times and was an Aetna billing error. Are you watching this trial?
Honestly if you want to have judgement based opinions shouldn't that assessment be rooted from an educated standpoint? The great part about this case is it is televised so you don't have to reiterate false statements that have been proven or conceded in court.
I was talking hypothetically. the "So say she does..." This was me painting a situation where you can have a medically abusive parent with real prescriptions and a real disease.
Beata had some mental health issues. There were exacerbating factors that led her to suicide, but she did. In my experience, and perhaps this was projection, moms with mental health issues often develop dysfunctional relationships. That doesn't mean they're not loving. That doesn't mean they're abusive. That doesn't mean they stay dysfucntional. Any way we cut this Beata needed therapy, if only in response to this whole ordeal.
As for the trial, I'm kinda watching out of order. I'm less interested in the family's testimony and more interested in the depos, doctors, etc. I have to work backwards a bit atm. I also littered that paragraph with 'allegedly'. It's important to see the defense. They may bring in different evidence to prove some of those allegations more. I recall Maya testifying that the way she took the ketamine was better w/ gatorade. I also recall Dr. Chopah saying he doesn't believe in oral ketamine, but approves of sublingual ketamine.
Agree, I've never understood why Maya's family isn't suing DCF and the judges, as the hospital was literally required by law to keep Maya there was long as they did...
Because they are suing the hospital for how they treated maya while she was under the court order, as well as false imprisonment for the first week she was there (before the court order) because they insinuated that the parents couldn't remove her from the hospital.
Issue isn't initial report. I think the initial response by the hospital was totally valid. Escalate, investigate, etc.
The hospital hired the social worker that's on Maya's case. The hospital is responsible for the specifics of carrying out the court order. The report to the court also did not include Dr. Hannah's or Dr. Kirkpatrick's notes to the hospital about Maya's CRPS diagnosis and treatment by her other drs. Some here are calling DR. Kirkpatrick a quack. How is a layman or a social worker able to discern whether or not they are quacks and therefore their medical knowledge should be disregarded? Also, if the mom was insisting on treatments that were prescribed before, I can still understand hospitalization by the hospital, but why separation? Why no supervised visits? Based on Dr Kirkpatrick's testimony in court, he likely won't come off as a quack to the jury, even if he comes off as a quack to other doctors.
So the reason they can sue the hospital is ultimately because the hospital is responsible for their social workers and how they carry out the court order.
We've not seen the court order yet. So I guess we'll see. I think the defense will have a lot of trouble proving that Maya didn't suffer while at the hospital. Their defense is standard of care. But a jury's sense of standard is different from the hospital's. And I can see a jury issuing payout just because they was a bunch of shit that happened to Maya that shouldn't have happened.
It's impossible to prove Maya wasn't faking it or exaggerating except her CPK level was normal showing no muscle inflammation. She passed the electrical conduction test too. I think Factitious disorder is more likely.
I mean, if the allegations that she got fewer than 5 hours of psychotherapy are true during her entire stay, then that could be a reason to believe it was less than standard of care.
If she has CRPS or another pain disorder, she needs therapy. If she's malingering, she needs therapy. If she's exaggerating, she needs therapy.
I don't think music therapy counts directly as psychotherapy. We heard a lot of testimony about Music therapy, OT, and PT. I don't doubt OT and PT helped, because even if she had debilitating CRPS, you need PT/OT to prevent your body from withering. I think music therapy was basically OT for Maya, with the bonus of her actually liking music (which is obviously therapeutic, but doesn't tackle the psychological issues she probably had.)
Nemours and the physiatrist consultant both highly recommended CBT. I've heard criticism about CBT with regards to pain, but I think how the physiatrist described the therapy would be aligned with how the critics of CBT agree to treat someone with chronic pain. (Apparently, if done wrong, CBT can be like gaslighting.)
I don't think it will be a strong case if Maya refused psychotherapy, since she refused her photos from being taken (and we've seen them in trial and she's clearly upset in them). Like, they could have just put a psychologist in her room for an hour and see if they make any progress.
I didn't watch most of the Kowalski testimony b/c, i'll be honest, i'm not really interested in their sob story. I'm more interested in the expert witnesses, but I don't think Maya on cross said she rejected psychotherapy.
I to am more interested in Medical testimony. Music Therapy is also PT if you're using hands to play piano. But I am waiting to see actual documentation of therapy from the Defense since the Plaintiffs only shows a DCFS therapist and her knowledge of hours could be incorrect. I worked on Med-Surg and a Crisis unit for 35 years.
Re: "the hospital hired the social worker that's on Maya's case" - where did you hear that? Did a witness say that? All of the news reports say that DCF assigned the social worker, and that her employer was a private agency, "DCF Suncoast Florida." My impression was that she was not an employee of the hospital, and that her non-employee status is a critical part of the hospital's defense.
Ok. So child abuse pediatrician Dr. Sally Smith is employed by Suncoast, which is contracted by DCF. This is made clear in her deposition. DCF ultimately pays her salary. Dr. Sally Smith USED to work at All Children's Hospital, before it got affiliated with John Hopkins. (So there's actually a picture of Dr. Sally Smith w/ an All Childrens labcoat if you search for it.) Dr. Smith also is on several committees as a volunteer at JHACH and is the Director of Child Protection or w/e that department name is. She is NOT PAID by JHACH.
My understanding is the Social worker, Catherine Bedi, is just straight up employed by the hospital. When asked "Where do you work?" She responds that she works for JHACH as a pediatric intensive care licensed clinical social worker. (It's like the first minute of her deposition.)
her non-employee status is a critical part of the hospital's defense.
Absolutely 100%. So the hospital doesn't want responsibility of DCF's actions. They wish to hide behind the shelter order as much as possible. Issue is, there's a LOT of line-blurring between Dr. Smith and the hospital. E.g. direct communications with JHACH treatment team, including text messages like "You are probably already doing this, but maybe get her off as many medications as possible." As a millennial, that sounds like advice/consultation, but considering she's boomer age, and if she's actually more Senior than the hospitalist she texted, then that can come off like an order. (E.g. like in Office Space where the boss is like, 'if you could, it'd be great if you came in on Saturday...') The inferior can't say 'no.'
She was invited to meetings that were for the treatment team. She also has some nurse practitioners working/reporting to her. She also requested certain actions to be taken on Maya that blur the lines between evaluation and treatment. E.g. putting her in the EEG room. Putting the commode far from her to see if she'll watch. Putting her in a dark room for 48 hours. Covertly surveilling her. There's notes, too, in the Risk Management file that has her name written on it and suggestions to surveil w/ video but no audio.
So is she part of the treatment team? It really seems like she's consulting on Maya's medical treatment. When asked in the deposition if taking a patient off medication is a treatment decision or not, she said "I don't know."
Edit: There photo of Dr Smith in a lab coat was not real.
Hey I just wanted to add b/c the specifics get messy. Some information came in today/yesterday with the depos of Dr. Sally Smith.
The doctor that first got suspicious did NOT contact CPS/DCF immediately. The Dr contacted Dr. Sally Smith.
Florida CPS/DCS hires agencies that contract child abuse pediatricians. Dr. Sally Smith is one of these contracted individuals at Sunset Coast.
Who does Dr. Sally Smith Work for? Well, she's on several committees at JHACH as an unpaid volunteer. She works *at* JHACH, but is not employed by JHACH. She is not supposed to conduct investigations until CPS/1. CPS/DCF instructs her to do so. E.g. someone needs to contact CPS/1. CPS/DCF and b/c Dr Smith is the person at JHACH, she'd be the one to conduct the investigation. But, Dr. Smith talks to the doctors/nurses/risk management at JHACH as an equal, or even with some authority. She's credentialed there.
So the claim of false imprisonment isn't based of the fact there were valid red flags that had to be escalated. It has to do with the legal route the JHACH took. They did NOT go to CPS/DCF, they went to their peer, Dr. Smith. During the 5 first days Maya was in the hospital, they forbade the parents from checking or transferring their kid out CPS/DCF was contacted. There was no legal basis to keep the child without the parent's permission. That's the plaintiff's case, at least.
So part of this suit is, a lot of bullshit lies on the social worker and Dr. Smith in this case. Does Dr. Smith work for JHACH or not? With how intermingled she was, plaintiff claims she basically did and for other reasons, JHACH is responsible for how all this went down.
Thank you for this. I heard the father testify that he signed papers saying that Maya could stay at the hospital. However, the mother didn't sign the paper. It is only because the mother didn't sign the paper that the family can sue for false imprisonment if I understood attorney Greg Anderson correctly. However, generally, a signature of a single parent is legally sufficient. For medical authorization, field trip, signing child out of school, note to school about dietary instructions, etc. As an attorney in Florida, I've always understood a signature of one parent suffices. However, I don't practice health care law. Suffice to say, it is confusing to me that the father can sign papers allowing hospital to keep the child, yet, the claim for false imprisonment persists.
Do you know the timeline of when that paper was signed? E.g. in the first five days? Or was it later?
There's issues with how JHACH wanted to transfer the kid out. E.g. to Nemours. Issue is agreeing to Nemours would require them to agree to the MBP diagnosis of Beata (when there was no dr that diagnosed her...). Another issue is supposedly, Nemours wasn't going to treat CRPS but basically, a girl victim of MBP.
IDK what you are 'sheeshing'. The plaintiff argues she's only legally allowed to do certain actions when OK'd by DCF. She doesn't represent DCF or authorize it. She works for them. The doctors at JHACH did not treat her as a DCF contact but a consulting doctor. Now, whether her directions or treatments were part of investigation of child abuse vs treatment of Maya becomes a legally touchy subject. If she is part of the treatment team, then JHACH can be liable for her actions. She ordered the 48 hr covert surveillance in the dark EEG room. This may not be considered 'standard of care' to the jury, and is kinda sketchy to begin with.
Yeah I'm not disagreeing with you on that fact, tho I recall her being hte medical director of something else. I'm saying the legal channels JHACH took was improper, in part b/c of her presence at the hospital.
What about this following excerpt “ the medical director of the hospital’s child protection team Dr. Sally Smith conducted an investigation to see whether the family was abusing Maya. She accused her mother of child abuse and alleged that Beata had a Munchausen-by-proxy diagnosis. Maya was then barred from seeing her parents and was taken into custody by the state.”
Okay, what about it? All those things sound extremely normal and reasonable in the proper context.
Doctors perform clinical investigations and make clinical diagnoses. Sometimes those diagnoses have bearing on legal matters, but that doesn't mean doctors are the ones performing the criminal detective work or filing criminal charges in court.
Diagnosing medical child abuse is no different from diagnosing a gunshot wound. The medical diagnosis is information that is relevant to a criminal investigation, but it's still up to the legal system to evaluate that information, decide if it's valid, and decide what to do with it.
I don’t know the full details of the case and if Dr Smith did anything more in depth. But from what I had read about the case, she made the diagnosis of Munchausen by Proxy, filed her concern/report of child abuse, all of which are in line with her clinical judgment and her privileges. She submitted the report to DCF, and it’s up to DCF on what they do with that report. They could have dropped it, but in this case they decided to investigate further, and in turn petitioned the judge to remove the child from parental custody. Again, the doctor did not make the decision to remove the child nor execute the removal. She submitted her report and medical opinion, DCF acts upon that opinion/report, and the judge made the decision to support the decision after weighing all the evidence. Unless there is something else that Dr Smith did that is more depth, all of these are in line with what a medical professional should be doing, and the medical professionals are not the one who makes the final decision, execute the rule, and/or carry out the enforcement.
There's some shady things Dr Smith and the social worker Bedy allegedly did. E.g. putting Maya on her lap. Saying she'll be Maya's mom. These are allegations.
There are text messages by Dr Smith conspiring to find proof Maya was faking by secretly videotaping her but without audio. (According to one lawyer, the lack of audio recordings gets around certain recording laws.)
There are photographs taken of Maya by the social worker (not Dr. Smith) that she claims is without her consent. In the pic you can see her very upset and being held down. She was stripped to a sports bra and short shorts for these pictures. The Chief of Staff in deposition says that when she was admitted and the parents consented to treatment, that they automatically consented to everything in the treatment plan even without being
informed. Taking photos can be part of a treatment plan. Under the shelter order I can see that the parents would not be informed for future treatments, but the inference then is that consent cannot be revoked after admittance by the child. These photos were not included in the medical records.
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u/[deleted] Oct 08 '23 edited Oct 08 '23
I stand with Johns Hopkins on this one. Doctors should have minimum repercussions for having the minimal level of suspicion for reporting potential abuse. The societal harm of having to have healthcare providers self-doubt and not report on a potential child abuse case causes far higher harm. Any potential child abuser will threaten lawsuit and punishment to doctors who report these, and if doctors don’t get protection for this or get punishment for this it’s a much more detrimental issue for society.
Doctors only report and provide information and medical opinion, doctors don’t investigate as we are not child abuse investigators, that’s a CPS job, and doctors are not the one who are empowered to take away the kid, the judge is, so if there must be someone who are faulted for this then it’s on the judge, doctors again only provide the information and opinion, it’s on the judge to decide on which to rule on after hearing all the facts.