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Issues at Stake as the 'Take Care of Maya' Case Heads to Trial

— Case could have far-reaching implications

Last Updated September 21, 2023
MedpageToday
The cover art for the documentary Take Care of Maya.
Solomon is a legal analyst and legal editor.

Editor's Note: Since this piece was originally published, the charges against social worker Cathi Bedy were from the lawsuit. The case against All Children's Hospital will proceed.

The Beata Kowalski incident, featured in the documentary "" is a tragic story that has raised many legal questions. With the involved parties heading to court this month, it is back in the public spotlight.

Background on the Case

Kowalski was a registered nurse and immigrant from Poland who lived in Venice, Florida, with her two kids and husband. In 2015, when her daughter, Maya, was 9-years-old she began experiencing unexplained such as muscle weakness and burning sensations, following a severe asthma attack. After visiting many doctors to find answers, she was eventually diagnosed with complex regional-pain syndrome, a rare pain disorder. Maya's symptoms were managed with ketamine infusions and other interventions, but in October 2016, the symptoms returned and she was admitted to Johns Hopkins All Children's Hospital for abdominal pain.

A nurse quickly became suspicious of Kowalski after she requested Maya receive a large ketamine infusion before even routine tests were performed. Amid suspicion from the nurse and other hospital staff, the medical director of the child protection team for Pinellas County, was called to investigate. After several days of reviewing medical records and looking deeper into the case history, Smith alleged that Kowalski had a Munchausen-by-proxy diagnosis and was abusing her child. The state quickly issued a "shelter order": Maya was to be kept in the hospital and barred from seeing her parents.

After 87 days of Maya being held in the hospital by the state, Kowalski died by suicide. According to her husband, Kowalski was a force of nature in taking care of her family -- a profoundly dedicated mother to Maya.

Going to Court

In October 2018, the surviving Kowalski family members took against several parties, including All Children's Hospital, the Florida Department of Children and Families, Cathi Bedy (one of the social workers at All Children's assigned to the case), Smith, and Suncoast Center, where Smith worked.

Their lawsuit made grave allegations encompassing a range of misconduct against specific parties, including medical negligence, unjust detainment of Maya, disregard for the counsel of her pediatricians, overlooking indicators of the mother's impending emotional collapse, and even preventing Maya from accessing her essential rosary and prayer materials.

In December 2021, the Kowalski family settled with two of the defendants -- Suncoast and Smith -- for $2.5 million. The legal battle with All Children's and Bedy is the subject of the upcoming trial, with jury selection starting on September 14.

The Legal Issues at Stake

A range of legal issues will be addressed in the trial. As Insider , as per the legal filing, the charges span various offenses, including false child abuse reports by All Children's and Smith. All Children's is linked to Maya's wrongful confinement, with Bedy and All Children's facing battery allegations. Medical malpractice charges involve All Children's, Suncoast, and Smith. The case also cites harm to the Kowalski family, alleging emotional distress, and accuses All Children's, Smith, and Suncoast of malicious prosecution. Notably, the suit claims All Children's negligence in hiring Bedy, who was charged with child abuse prior to her hospital employment. As mentioned, Smith and Suncoast settled their parts of the lawsuit in late 2021.

Here is my analysis of some of the key issues in the upcoming trial against All Children's and Bedy:

False Imprisonment and Battery

The Kowalski family is seeking punitive damages for false imprisonment and battery. As Florida medical malpractice and catastrophic injury lawyer, frames the facts, "The family's claim is that Maya was taken away from her mother without just cause and that the hospital staff physically restrained Beata Kowalski when she tried to see her daughter. The hospital denies these allegations and argues they had good reason to suspect Maya was a victim of Munchausen's by proxy."

Medical Malpractice

The Kowalski family also alleges medical malpractice. They claim the hospital staff misdiagnosed Maya and subjected her to unnecessary medical procedures. The hospital has denied these allegations and argues that they acted in Maya's best interests.

It will be very interesting to see how the medical malpractice piece plays out in court. Part of what made this family's tragedy into something film-worthy is, at least on its face, how far from industry standard the actions of the doctors and hospital appeared to be. This is why we have lawsuits when things go wrong in the care and treatment of patients: it's for the lawyers to present their case in the best possible light and for a jury to figure it all out.

Mental Health

The defense argues that Kowalski was being treated for before the conflict with the hospital and that this may have contributed to her suicide. Her family denies this and argues that the hospital's actions caused Kowalski's mental health to deteriorate.

Simply being treated for anxiety and depression doesn't automatically remove any causal link between the care providers' actions or inaction and Kowalski's death. A jury may very well decide that any care Kowalski received beforehand was overridden by the mental strain caused by these hospital "bad actors," which compounded any pre-existing issues.

As a relevant aside, court documents show that an investigator said that the case appeared to be moving towards a against the family until Kowalski's suicide. However, no criminal charges were ever filed.

No Easy Decision

All legal issues aside, the inevitable media coverage of the trial is going to be difficult to digest because of how profoundly sad this story is.

The Kowalski family has suffered a great deal, and they deserve to have their day in court. At the same time, it is important to remember that the hospital staff involved were trying to protect a child who they believed was being abused.

The outcome of this trial could have far-reaching implications for the responsibilities of medical professionals. But it is also a reminder for everyone of our fragile collective humanity and how critically important it is to understand the weight and impact of medical decisions.

Correction: An earlier version of this piece implied that the jury will be deciding whether the hospital had authority to remove Maya from her mother's care, but that is not at question in this trial. It also incorrectly stated that an investigator cited in court documents was affiliated with the hospital. This correction was issued September 8.

is the Chief Legal Analyst for and the editor of . He has taught entrepreneurship at McGill University and the University of Pennsylvania, and was elected to Fastcase 50, recognizing the top 50 legal innovators in the world.