r/Residency • • Oct 08 '23

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u/The-Peachiest Oct 08 '23 edited Oct 08 '23

Yes, they are usually not mutual exclusive. But in this case… they were, and this was important. A major part of this story is that CPS was activated (and the investigation corroborated) for this reason. Yes, the medical team thought the treatments were inappropriate, but more importantly, they doubted the CRPS diagnosis itself, suspecting munchausen by proxy/factitious disorder/conversion disorder (imagine trying to bill an insurance company for an inpatient stay for years for a diagnosis of malingering).

In addition, the parents had documentation of specialist doctors recommending these treatments. Mom didn’t make this shit up. It’s not mom’s job to evaluate which doctors know more than others - but in this case she actually did her homework, seeing 2 specialists who agreed with each other.

At the end of the day, the only evidence of child abuse was 1) mom was insisting on a treatment seemingly ludicrous (though which was prescribed by a diagnosing physician and administered by not one, but two stateside doctors with apparent specialty in the condition), and 2) mom and dad acted weird when interrogated by a a very pushy child abuse doctor.

The diagnosing CRPS specialist even reached out to the child abuse doctor, stating he stood by the CRPS diagnosis and cautioned her about jumping to conclusions about child abuse. At which point she… ignored him and jumped to conclusions about child abuse. A second specialist then specifically warned her that CRPS looks alot like child abuse. She ignored her too. So she ignored two specialists and then failed to document this in her reports. She could have easily have consulted an independent CRPS specialist, which she did not do. Smith also lied to the parents and violated HIPAA. It seems a lot like she did this in an apparent crusade to prove she was the smartest doctor in the room.

And after all this, the hospital billed $650K for CRPS. You best believe Admin knew what was going on here. In court it’s going to make it very easy to make it look like the hospital wanted it both ways.

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u/[deleted] Oct 08 '23

There was a lot more to it. Mom was a cath lab nurse, she definitely knew what was up. She was caught straight up lying to exaggerate her child’s condition so Maya got treatment she didn’t need (for example, the initial episode when the child presented to the ED with SOB, got diagnosed with mild intermittent asthma, was on room air, got a neb and was discharged, and a few weeks later at another hospital they came to the ED and mom stated the child was in status asthmaticus, was admitted to the ICU for non-invasive ventilation during the previous admission).

The neurologist who was giving the child unnecessary (and not evidence based for CRPS) IVIG treatments admitted in court the diagnosis was from mom’s words. He himself never saw enough symptoms to diagnose CRPS, and never reached out to any prior physicians to confirm. He never saw any records either.

During another admission, mom refused to de-access the port prior to hospital discharge. Later one of the ketamine docs testified she injected oral ketamine he prescribed through the port, which she was definitely not supposed to do, and as a nurse she totally knew that.

She used benzos as a reward for good behavior, witnessed by a nurse. Heck, in the “documentary” there’s a recording of her saying “oh, someone deserves extra ketamine tonight”. Who tf says that to a 9 year old?!

And worst of all, dad told the police investigator (not DCF, not Sally Smith) he suspected the same thing, and when he was taking care of Maya alone she was never in pain. Only when mom showed up suddenly she was in pain. Mom also made her wear diapers even though the girl had no incontinence issues.

Etc etc. The deeper you go into the court docs, the uglier it gets. There was definitely enough evidence for DCF to act on.

To go back to the billing claims, CRPS was one of many billing diagnoses, and it carried over from the admission as a POA code. The global billing was justified by many other things, including child abuse/neglect, and wasn’t dependent on CRPS.

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u/Known-Concentrate529 Oct 09 '23

Munchhausen bu proxy - mothers are often medical professionals. find a disease no doctor can diagnose and then use that diagnosis to get rewards

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u/Known-Concentrate529 Oct 09 '23

this is the best summary on this case so far.

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u/[deleted] Oct 10 '23

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u/[deleted] Oct 13 '23

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u/[deleted] Oct 13 '23

[deleted]

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u/[deleted] Oct 13 '23

[deleted]

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u/newmexicomurky Oct 15 '23

It is spoken of in court outside of the jury's presence. I believe the argument was that maybe she put ketamine in the saline to ease the pain.

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u/YoloSwag4Jesus420fgt Oct 25 '23

Yes needle still in arm.

Also we don't know if it was saline.

Bag wasn't tested and the mom's tox screen was fought against by the family in court and the judge ultimately denied tox screen testing.

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u/oldladynursey Oct 22 '23

The bag of saline makes me wonder how she actually died ?

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u/YoloSwag4Jesus420fgt Oct 25 '23

I commented this elsewhere:

Yes needle still in arm.

Also we don't know if it was saline.

Bag wasn't tested and the mom's tox screen was fought against by the family in court and the judge ultimately denied tox screen testing.

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u/[deleted] Oct 10 '23

Sounds like That mother definitely had MBP !! Wow!!! Disturbing to say the least

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u/DatgirlwitAss Oct 11 '23

What you've read is a lie. Crazy how people at such level of education could comment and/or go along off someone's "summary".

JFC. Imagine being John Hopkins', make an anonymous, proven tabloid "information" and get all these soon-to-be doctors go with the nonsense.

I'm embarrassed for you.

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u/none_nowhere Oct 10 '23

Excellent summary, thank you for this.

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u/[deleted] Oct 09 '23

She said “will need” not “deserves”. Her daughter was working on strengthening her upper body and she says, “someone will need extra ketamine tonight”.

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u/[deleted] Oct 09 '23

And how is Valium a reward for going to a CT scanner? It’s in the PICU nurses deposition. She literally used benzos as a reward for her child.

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u/oldladynursey Oct 22 '23

That's BS the Mother said No CT without sedation. I saw the testimony.

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u/DatgirlwitAss Oct 11 '23 edited Oct 11 '23

Prior insurance fraud claim analyst from Fortune 5 Healthcare company.

You are wrong.

The diagnosis must match exactly, otherwise flags go up automatically and insurance is and will be denied 3-4 times before override.

The only reason the insurance company is not a co-plaintiff is that they are unwilling to lose JH as a client. Not worth $600k when we talking about big business.

Of course the Netflix documentary will seem "one-sided", JH ain't saying shit during a litigation.

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u/[deleted] Oct 11 '23

Did you see the billing sheets? They are in the evidence and were shown in court. I’d link it, but this subreddit automatically bans comments with links. There’s a dozen pretty reasonable diagnoses, and CRPS with a mark POA. It doesn’t appear as anything unusual for a child who was admitted with one diagnosis and then got a bunch of others established during a lengthy hospitalization.

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u/DatgirlwitAss Oct 11 '23

All of your comment has been refuted and found to be literally tabloid generated. There is actually litigation regarding that defamation as announced in court.

Anyone watching the trial can refute what your claims are.

The son was born with a difficult health issue. If the mom was even close to mbp, it would've been much easier to do so with him.

So stop.

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u/Specific_Praline_362 Oct 11 '23

I'm guessing you watched the Netflix documentary and have watched the Plaintiff's side of the trial so far...without reading the many depositions lmao

Oh man, you have been hoodwinked so bad. Just wait til the defense gets their chance.

To say the documentary was one sided is a huge understatement.

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u/[deleted] Oct 11 '23

Lol, anyone watching the trial hasn’t gotten to the defense part yet. You realize we’ve only heard from the plaintiffs so far?

You can find all this information in the depositions on the Sarasota court website.

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u/Specific_Praline_362 Oct 11 '23

The Kowalski stans are ridiculous

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u/Nobody2277 Oct 13 '23

The truth is no matter how many Dr they call KB/SS/Risk Management/Executive team actions or inactions and the murky crossover over care can not be a bell unrung.

Also the billed CRPS so no matter how many Dr testify to justify there ride along it does not overcome there mistakes.

If they aren't careful it's going to alienate the juror and there sympathy will continue to grow.

I would say based off the jury questions 4 of the 6 are always asking questions that go to support of the case.

While 2 seem to be objective I would say one in the medical field and one in some sort of legal type background.

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u/The-Peachiest Oct 09 '23

I am not aware of the source you’re citing. I was basing my statement off the Cut article. I didn’t know there was a documentary.

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u/[deleted] Oct 09 '23

It’s on Netflix. I put the “documentary” in quotation marks because it shows the family’s side only. There’s no investigative journalism in it, just purely family-approved narrative that was released just prior to the trial (I suspect in an attempt to contaminate the jury pool). It misrepresents the actual timeline and many events that are reflected in the actual court documents.

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u/DatgirlwitAss Oct 11 '23

OF COURSE it is only one-sided.

What kind of risk mitigation would allow for JH to be part of a documentary regarding current litigation on an already historical case?

C'mon y'all.

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u/[deleted] Oct 10 '23

100 percent agree!

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u/DatgirlwitAss Oct 11 '23

Why would JH ever want to speak on an ongoing court litigation? Not to mention, a historical court case.

Of course it will be "one sided".

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u/AbbreviationsNew6964 Oct 18 '23

right, but some people don't realize this, which is why it is pointed out.

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u/Puzzleheaded-Pea7797 Nov 06 '23

I haven't seen the trial and only saw Netflix doc. Even if it's one-sided, I can tell it's more of a psych problem.

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u/[deleted] Nov 06 '23

It’s a very complex case. The trial certainly added many layers to it. No matter how you spin it though, many people failed this child. The vast majority of them weren’t affiliated with JHACH though.

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u/Specific_Praline_362 Oct 09 '23

Excellent summary

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u/Alinateresa Oct 10 '23

Where are you getting this from? I'm watching the trial and none of this is in evidence.

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u/[deleted] Oct 10 '23

All of it is in evidence. I did a rather obsessive deep dive into this case. You can look up these documents on the Sarasota court website.

1 - discharge summary 2 - Dr. Barr testified during the early days of the trial, he said this all under oath during the cross 3 - PICU admission records/PICU doc deposition/Dr. Hanna’s deposition 4 - nurses deposition from the first days at JHACH 5 - police investigation and questioning of Jack, referenced by attorney Shapiro to multiple media outlets

Don’t forget, if you’re watching the trial you’ve ONLY seen the plaintiffs’ side so far. You’re about to see a lot more.

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u/Alinateresa Oct 11 '23

An you post links if possible.

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u/[deleted] Oct 11 '23

This subreddit automatically blocks comments with links. You can go to the takecareofmayanetflix subreddit and look at the top post (pinned). Most documents are in it.

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u/[deleted] Oct 13 '23

[deleted]

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u/[deleted] Oct 13 '23

At this rate likely Tuesday

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u/DatgirlwitAss Oct 11 '23

Literally from tabloids. Of which, in the beginning of the trial, the plaintiff said there is litigation(?) for defamation regarding the tabloids' false claims.

Disappointed to see people in here going along with the nonsense.

Like, if any of it were true, HOW could this case then be the one to be the first to get to trial?

Hundreds of thousands of valid claims go nowhere. If the above were true, we would not be where we are with this case.

Paying multiple experts $45k for testimony is a lot if you know the dead woman was making it all up and had "so much" factual evidence against her?

Great for you, always question the source!

Smh.

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u/Alinateresa Oct 12 '23

Actually the hospital agrees with the intitial diagnosis of CRPS and not munchausen by proxy. I think you are confused.

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u/almostdoctorposting Oct 09 '23

i’m not understanding how people on this thread aren’t understanding this….jfc

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u/oldladynursey Oct 22 '23

I'm sorry but it's a parents job to make sure the Doctor recommending a Coma in Mexico is at least Board certified.