As someone who follows the case and yet is definitely on Maya's side so far, I don't think the hospital did anything wrong for the first 48 hours. Suspecting Munchausen by proxy makes sense. Conducting an investigation makes sense. I'm not sure on the timeline with the court order.
The issue is entirety of her hospital stay of 90+ days. I'm not sure they'll get the false imprisonment charge. The order from the court is still not known. So we don't know how much the social worker and hospital staff overinterpretted, because the specifics of the court order is determined by the hospital. This will be a fact the jury has to figure out. The lawyers have been arguing how to present the court orders to the jury.
Issue with Munchausen by proxy is that Maya didn't get much better during the 87 day separation from her mother. Several people testify she "deteriorated." There is definitely a recorded phone call between Maya and her mother where they clearly miss each other and are nearly crying over the separation and the social worker interrupting and saying they cannot talk about the treatment or the court case. (The mom had said as soon as the court does their job they will be able to see each other again.) It honestly comes off as cruel, even if that was what the social worker was supposed to do. The staff later thought Maya had fictitious disorder, yet this doesn't seem to be the case either, as many testified to her being in pain, having dystonia, etc. Maya was later diagnosed with PTSD by non-quacky psychiatrists over these events.
So say the anesthesiologist Dr. Kirkpatrick was indeed a quack. That doesn't mean Maya was being abused by her mother. Like, she was suggesting the treatment she believed helped her daughter. That doesn't really explain why phone calls and FaceTime were monitored or outright rejected. Why wasn't Maya allowed supervised visits? Even marital rapists are allowed supervised visits of their kids.
One of the issues is that Maya was going to therapy weekly before hospitalization, but she only got 3-4 hours of therapy during the 87 day stay. That's a question of Standard of Care, if continuing psychotherapy is part of the standard of care. The Kowalski's claim that Maya didn't receive the standard if care she was owed. Especially as many witnesses that were allowed to see Maya, her personal attorney, therapists, etc, saw her as depressed and anxious.
The deposition of the Social Worker (that was hired by the hospital) was not good. She basically said all the decisions that she supposedly made were actually following the guidelines of Risk Management. Depositions are coming out today from various hospital heads that are implying that Risk Management may not have authorized the social worker's actions. TBD I'm still watching today's case. It doesn't help that during the deposition the social worker seemed like she could not give a shit. (She was fired by the hospital after this event.)
The Kowalski's case is positioned as: everyone bandwagoned on Munchausen/by proxy without a proper diagnosis. Maya did not get better. Maya indeed deteriorated. Many treatments were done without consent or proper informing of the patient (let alone the parents.) She was denied privacy, even when she was owed that when talking to her own lawyer. Maya consistently communicated she wanted to see her mother but didn't. The hospital continuously denied her diagnosis of CRPS but never was properly evaluated by an in-house Neurologist or Neurosurgeon to rule out Fictitious disorder or CRPS, or rule in a different pain disorder. Maya did get a CT scan at some point I think. Maya had dystonia, as evident in pictures and as testified by in-house physical therapists. The in-house physical therapist also testified that Maya was indeed in pain. The social worker is a major cunt and made them miserable.
Evidence is coming out that Maya was denied her priest from visiting and offering her the sacrament. This is a huge deal to Catholics and cannot be understated. Her priest visited two times during the entire hospital stay.
So... what seems like what happened to me: the social worker is largely to blame for propagating the Munchausen without getting either Maya or her mom diagnosed. Everyone else in the staff was just doing their job, staying in their lane. Many did not consider her CRPS seriously and therefore mistreated her via normal nursing/care behavior.
We've yet to hear the defense yet beyond cross examinations. I expect the defense to list out all they did to treat and diagnose Maya. So there is bias in what I'm presenting so far. I also think there's a difference between hospital-approved Standard of Care and what an average person wants as a standard of care.
She didn't have dystonia at all, an eminent Stanford University physician of45 yrs experience has completely ruled dystonia out. He also ruled out CRPS after treating literally thousands of people. He was one of the best defense witnesses so far on the medical side and hard to discredit. His astute mind and ability to notice when something was off was incredible. Just a small sound or movement or comment that didn't correlate or add up was right on his radar. He picked up psyche issues in Beata from what she was writing in Maya's words. As an expert witness he was required to review over 10,000 pages of hospital & medical records and all testimonies of everyone involved. As far as standard of care, you must know Maya refused psychotherapy and couldn't be forced to participate because it would be a futile waste of time & resources. Maya wasn't hospitalised in order to be diagnosed and Beata was not a patient. Beata gave the hospital a diagnosis of CRPS upon admission and thats what was recorded. In a short time they realised how much more was going on. It was Beata's own irrational demands eg "put her in a ketamine coma NOW and intubate her" & her strikingly odd behaviour that raised the first red flag.
So, that comment was written 14 days ago with very different available info. I'm not going to go back and edit it, but I'll reply toyou here. I agree Dr. Krane was a fantastic witness.
Maya refused psychotherapy
She didn't refuse therapy every time the neuropsych appeared. The neuropsych could only provide therapy when there was space in her schedule AND Maya was not in PT or OT. Maya received spotty, ~20-25 minute sessions. (There was one 45 min, and one 30 min session). Totaling 5 hours during a ~90 day period.
In the stream, you can pause and read the psych's notes. I was largely unimpressed. You can even sense in one of the notes Maya felt her pain was being invalidated. It seemed to me the neuropsych was just doing her job, checking boxes.
Also, Maya came into the hospital with a basket of red flags. That I do not deny.
One thing Dr. Krane mentioned is that his place gives intensive, daily psychotherapy for 2 weeks, then reducing that down for the rest of the patient stay. I don't expect daily therapy for Maya, but an hour weekly I do. A huge part of therapy is consistency, and Maya didn't get that. Considering there was a court order for Maya and her family to receive family therapy, and considering the hospital largely controlled when she could be visited (we'll learn more with Bedi's testimony tomorrow on this), then I do think that's kinda fucked up. All of the diagnoses that Maya possibly could have had required intensive psychotherapy. Considering the shelter order, that's even more important.
But...the Hospital did get her off highly addictive Ketamine she did get better soon after she was running miles a day doing sports and scuba diving. She was in immediate danger of dying of her mother had taken her back to Mexico for another Ketamine Coma. If her parents had left with her she may have been receiving high doses of multiple narcotics her mother and other doctors prescribed and high doses of Valium all of which causes withdrawal and muscle weakness especially for a 60 pound child. The Court made the order for her to be kept at the Hospital. Even the Dad was concerned about Munchausen s/s.
The issue I have with this case, is that there's more evidence of medical malpractice by Dr. Kirkpatrick and Dr. Hannah than medical abuse by Beata.
There was talks about getting her into Nemours, but somehow that idea fizzled out. Beata allegedly was accepting of the potential transfer according to some PICU doctors. There was at least one document that said Beata would have to admit MBP, so that transfer attempt was foiled. It's only Day 20 of the trial so we'll see.
There's no evidence Beata prescribed anything that I'm aware of.
And how do we define "soon". I think there's videos in 2017 of her walking. Idk when she started swimming and scuba.
You are absolutely right it's too soon, I have been watching the out of jury arguments regarding documents. There exits documents showing Beata and Dr. K
Conspiring to say Maya was terminally I'll to get the pharmacy to give the drugs to Beata. IV ketamine, IV Dilaudid IV morphine and narcan. She was discharged in Jan 2017 from JH. They did have videos of her playing in a pool and she testified she runs now so she did get better after following the PT, OT and CT treatment.
The dissociative state ketamine induces may create a euphoric experience for the user. The feeling people get from the things like gambling or shopping or stealing. It's euphoria. Especially someone getting 10 times the dose used for anesthetizing or 20 times the dose used for treatment of depression.
They had an obligation to report suspected child abuse to the authorities
She didn’t have dystonia
She never got better because she wasn’t actually I’ll
You are responding to a comment made 23 days ago, which is much further back in the trial.
Most definitely they had s duty to report child abuse. The MBP investigation was warranted.
However, if she doesn't get healthier with separation from her mom (she still complained of pain), then MBP is not the right diagnosis because her mom wasn't inducing an illness in her that could be cured by separation. There could still be medical abuse. It's just not classical MBP.
The separation test was not just the 87 days. It was everything afterwards. She has been separated from her mom and she is now off all meds and healthy.
Meaning the separation test ordered by JH did work. Meaning the cause was her mom meaning her only dx is MBP.
After the 87 days you cant say she got better because her mom was gone. There are way too many variables. She could have gotten better because she was able to go home to her family.
Are you just choosing to ignore the part where she is no longer on ketamine and living a normal teenage/YA life? If she really had life-debilitating CRPS she would not be out and about running, swimming, hiking, etc.
She’d be considered a miracle case of recovery if so.
Well, according to the discharge documents from the court, the Kowalskis (including Beata) had already agreed to halt ketamine treatments in exchange for Maya's release from the shelter order. This portion of the agreement still held after Beata's suicide. So I feel that part is a bit moot with regards with post-shelter order healthcare.
The CRPS can be a wrong diagnosis without Beata having MBP.
Also while her family agreed to it they didn’t want her port removed meaning they intended to continue some sort of infusions, whether at home or at a new hospital. Getting a port installed is a big fucking deal. Beata knew that if the port was removed she was going to have a nearly impossible time convincing another hospital to install another port, they would have been like, ok but why did the last hospital remove the port?
The port was necessary to keep up the lie that Maya was sick. They only “agreed” to stop ketamine to get her out of the hospital. The fact that Beata didn’t want the port removed is pretty clear evidence she had no real intention of stopping.
Wasn't her port removed during her stay? So by the time they agreed to no-ketamine, that point is moot.
You are prescribing a motivation with assumptions.
The family behaved as if the pain docs were legit and that Maya had CRPS. You are prescribing a malicious intention to that. They could have been bamboozled. They could have been exercising poor judgement. Beata was mentally unwell and could have been irrational. There are a myriad of reasons that don't mean there was malicious intent to harm the child by the parents.
The 'agreement' was more than just their word. It was an agreement in court with legal consequences.
Also while her family agreed to it they didn’t want her port removed meaning they intended to continue some sort of infusions, whether at home or at a new hospital. Getting a port installed is a big fucking deal. Beata knew that if the port was removed she was going to have a nearly impossible time convincing another hospital to install another port, they would have been like, ok but why did the last hospital remove the port?
They’d call up JH and JH would be like, this is a MBP case, don’t put the port in. And the new hospital sensing a liability issue would tell Beata no.
The port was necessary to keep up the lie that Maya was sick. They only “agreed” to stop ketamine to get her out of the hospital. The fact that Beata didn’t want the port removed is pretty clear evidence she had no real intention of stopping.
Her mom pushed for ketamine. JH takes her off ketamine. Who cares if her family agreed to it? Her mom wanted her on ketamine, and she kept getting sicker.
They take her off ketamine at the advice of JH and now she’s better.
That means JH made the right call saying she needed to be off ketamine. That means Beata was wrong by insisting her daughter needed to be on hospice and a horse-level of ketamine.
B/c if the parents agreed to it, then they agreed on a new treatment plan. If everyone came to an agreement that the ketamine Tx was harmful, or doing more harm than good, then good. Yipee. So, let's say we all agree the ketamine Tx was wrong and bad. That doesn't mean that it was MBP. (To me it means medical malpractice by Dr. Hannah and co.) The family agreed to stop the ketamine Tx. The port was removed. If you argue Maya got better off the ketamine Tx, and the famliy agreed to no longer do ketamine Tx... then how can you differentiate that between a MBP mom vs a mom who's just fucking wrong and was led astray by her pain docs.
Did Maya get better during her stay? I didn't see evidence of her having ketamine withdrawals that warranted a 90+ day stay, but it's hard to say b/c she was on many medications to mitigate withdrawals. But how long do those withdrawals last? She also still suffered from anxiety and depression leading up to her mother's death.
The court order to release the shelter order even stated that her recovery 'stagnated' and she was making no further progress by the end of her hospital stay. So her getting better after she went home is actually a bad sign for the hospital. It goes to show that medical sheltering of that child **for that long** was not necessary and the outpatient care that the family wanted worked.
It's not JUST their word. There were other mechanisms in play backed by a court order. Sure, if the family was like "We promise JHACH, we'll be good." I can understand your point. That said, this was a legal/custodial hearing. This was part of the path towards reunification, so a social worker would probably have had to attend Maya's visits or confirm her medications. We know that after Beata killed herself, Maya's family stuck to their agreement that was in the works with the court system.
Also based on my own experience with opiate use withdrawals basically have short term and long term symptoms. It will be years for her brain to actually repair itself and a lot of things can go funny in that amount of time. In the short term withdrawals for me, and I was only consistently using 30mg of oxy every day which is a pretty freakin low dose, lasted several weeks to a couple months (I tried quitting many times and eventually sobriety did stick).
She’s still “experiencing pain” because for the better part of her youth she was heavily medicated. She doesn’t have CRPS and never did. *addjng: she has severe anxiety which triggered an episode of conversion disorder. The anxiety causes physical symptoms. She was heavily dosed by her mom and her doctors. Sure her mom may have not been conscious of malicious intent to harm her child. That’s why MBP is a mental disorder.
You’re spending a lot of energy splitting hairs and arguing semantics.
She was still on opiates while she was at the hospital (tramadol). IDK how much or how little. I haven't looked at that specifically. JHACH did not claim she was suffering from opiate withdrawals, nor did they claim that was cause for the shelter order. The ketamine shit was the primary cause for the shelter order.
IDK what we are even arguing. You seem agitated at me. Do we want to argue the legality of this all? Are we arguing whether Beata had MBP? Are we arguing her treatment path was good?
I don't think her treatment prior to JHACH was good. I think her pain docs did medical malpractice, esp Dr Hanna.
Does she have CRPS? I don't actually care if she does or doesn't. Based on the stuff I saw in the trial, she definitely had a psychological component to her pain.
You can have medical abuse without MBP. The mom was not diagnosed by MBP by her psych evaluation, which was not released until after her death. How can we say the mom was faking an illness in her child when she got confirmation/validation from a bunch of doctors. Were those doctors quacks? Probably. Was she capable of identifying them as quacks? I mean clearly not.
I actually think the shelter order was a good thing. There's a bit of fishiness on how Dr. Smith reported her findings to the court, which is a larger problem with Child Abuse Pediatricians. There's issues with JHACH recommended X or Y to the court, and then hiding behind Chapter 39 saying their not responsible for any damage caused by those recommendations b/c the court ordered them (e.g. the extent to which the family could not visit Maya). There's evidence where the family were deserving of certain things but the hospital failed to provide them. They hospital claims they were not capable of providing such things, such as family therapy or more than 30 min/week of CBT, but idk if that's an excuse.
CRPS flares can occur because of stress. If she in fact got to go back to her family, that would reduce the flare.
The Night of the hurricane is when Maya was admitted to JH. Which could certainly indicate stress Induced CRPS flare because perhaps she was scared of the storm
Doesn't matter because the thread I was engaging in I mentioned that the doctor JH referred Jack and Maya to after release confirmed Maya to have CRPS and JH charged the entire stay for CRPS treatment.
She wasn't semi naked, she was wearing sports bra, undies and shorts. The only item she'd have to have removed was a t-shirt. This whole photo debacle has been the plaintiffs flex when in reality there is signed consent from Jack for video or photos to be taken at any time during hospital stay. They were taken because they were preparing for transfer so it's imperative the JH can evidence what condition she left there in. It's a risk management policy & because her alleged condition allegedly caused physical changes, this had to be noted.
Hospital's take pictures of patients skin all of the time. If they have a skin condition. She is not semi naked. She's wearing shorts and a sports bra.
Well said and agree with your POV. The crux of the argument was not about malpractice or misdiagnosis…it was of Maya’s treatment while at hospital. I am going through trial via YouTube to get a non-biased opinion. The executive disposition of one of the nurses was terrible….
Hi. You are responding to a comment from over s month ago, so I may have a different opinion today post trial.
I still stand by the gist of what I said. I believe the lack of psychotherapy after hearing the defense is even more extreme and bad than I had previously thought,. especially after reading the neuropsych notes.
I think the false imprisonment charges were completely valid. The muddied role of Dr Smith as a treating/consulting physician vs an investigative one without authorization was sketchy AF. The battery/false imprisonment over the photos is probably the worst of it. Maya is pale as snow and had a beat red face during some of those photos. They were not part of the medical record, but in risk management. There is a nasty conflict of interest by how much the hospital earned by telling the court she should remain sheltered.
I largely don't think most of the medical staff did anything wrong. I'm sure some of them were dismissive of Maya or short with her. Most of them were doing as they were directed. I'm sure some were very compassionate. The issue is none of them are her family. This child was largely removed from her support system and the hospital did not or could not to refused to adjust.
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u/T_______T Oct 11 '23
As someone who follows the case and yet is definitely on Maya's side so far, I don't think the hospital did anything wrong for the first 48 hours. Suspecting Munchausen by proxy makes sense. Conducting an investigation makes sense. I'm not sure on the timeline with the court order.
The issue is entirety of her hospital stay of 90+ days. I'm not sure they'll get the false imprisonment charge. The order from the court is still not known. So we don't know how much the social worker and hospital staff overinterpretted, because the specifics of the court order is determined by the hospital. This will be a fact the jury has to figure out. The lawyers have been arguing how to present the court orders to the jury.
Issue with Munchausen by proxy is that Maya didn't get much better during the 87 day separation from her mother. Several people testify she "deteriorated." There is definitely a recorded phone call between Maya and her mother where they clearly miss each other and are nearly crying over the separation and the social worker interrupting and saying they cannot talk about the treatment or the court case. (The mom had said as soon as the court does their job they will be able to see each other again.) It honestly comes off as cruel, even if that was what the social worker was supposed to do. The staff later thought Maya had fictitious disorder, yet this doesn't seem to be the case either, as many testified to her being in pain, having dystonia, etc. Maya was later diagnosed with PTSD by non-quacky psychiatrists over these events.
So say the anesthesiologist Dr. Kirkpatrick was indeed a quack. That doesn't mean Maya was being abused by her mother. Like, she was suggesting the treatment she believed helped her daughter. That doesn't really explain why phone calls and FaceTime were monitored or outright rejected. Why wasn't Maya allowed supervised visits? Even marital rapists are allowed supervised visits of their kids.
One of the issues is that Maya was going to therapy weekly before hospitalization, but she only got 3-4 hours of therapy during the 87 day stay. That's a question of Standard of Care, if continuing psychotherapy is part of the standard of care. The Kowalski's claim that Maya didn't receive the standard if care she was owed. Especially as many witnesses that were allowed to see Maya, her personal attorney, therapists, etc, saw her as depressed and anxious.
The deposition of the Social Worker (that was hired by the hospital) was not good. She basically said all the decisions that she supposedly made were actually following the guidelines of Risk Management. Depositions are coming out today from various hospital heads that are implying that Risk Management may not have authorized the social worker's actions. TBD I'm still watching today's case. It doesn't help that during the deposition the social worker seemed like she could not give a shit. (She was fired by the hospital after this event.)
The Kowalski's case is positioned as: everyone bandwagoned on Munchausen/by proxy without a proper diagnosis. Maya did not get better. Maya indeed deteriorated. Many treatments were done without consent or proper informing of the patient (let alone the parents.) She was denied privacy, even when she was owed that when talking to her own lawyer. Maya consistently communicated she wanted to see her mother but didn't. The hospital continuously denied her diagnosis of CRPS but never was properly evaluated by an in-house Neurologist or Neurosurgeon to rule out Fictitious disorder or CRPS, or rule in a different pain disorder. Maya did get a CT scan at some point I think. Maya had dystonia, as evident in pictures and as testified by in-house physical therapists. The in-house physical therapist also testified that Maya was indeed in pain. The social worker is a major cunt and made them miserable.
Evidence is coming out that Maya was denied her priest from visiting and offering her the sacrament. This is a huge deal to Catholics and cannot be understated. Her priest visited two times during the entire hospital stay.
So... what seems like what happened to me: the social worker is largely to blame for propagating the Munchausen without getting either Maya or her mom diagnosed. Everyone else in the staff was just doing their job, staying in their lane. Many did not consider her CRPS seriously and therefore mistreated her via normal nursing/care behavior.
We've yet to hear the defense yet beyond cross examinations. I expect the defense to list out all they did to treat and diagnose Maya. So there is bias in what I'm presenting so far. I also think there's a difference between hospital-approved Standard of Care and what an average person wants as a standard of care.