Many viewers of the documentary ‘Take Care of Maya’ are left wondering about Maya’s medical condition and the details of her diagnosis. This article delves into the complete and heartbreaking story that inspired the documentary, focusing on Maya Kowalski’s diagnosis and the subsequent legal battles.
After a protracted legal fight, in November 2023, Maya Kowalski, then 17, and her family received the verdict in their $220 million lawsuit, widely known as the ‘Take Care of Maya Trial’. The jury sided with Maya and her family, awarding a total of $261 million, encompassing $211 million in compensatory damages and an additional $50 million in punitive damages. These damages were for false imprisonment, battery, medical negligence, and other charges including the wrongful death of Maya’s mother, Beata, and the emotional distress inflicted upon Maya and her parents.
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“I’m sorry but I no longer can take the pain being away from Maya and being treated like a criminal. I cannot watch my daughter suffer in pain and keep getting worse while my hands are tied by the state of FL and the judge.”
Unraveling Maya’s Story and CRPS Diagnosis
For those unfamiliar with the case, Maya Kowalski’s deeply moving and tragic journey is the subject of the Netflix documentary ‘Take Care of Maya’. Upon its release in June 2023, the documentary quickly gained widespread attention, amassing over 14 million views within its first two weeks.
Maya’s ordeal began in 2015 when she started experiencing a range of perplexing symptoms. These included breathing difficulties, skin lesions, extreme fatigue, persistent headaches, blurred vision, lower limb dystonia, and widespread chronic pain.
Driven by a mother’s unwavering love and determination, Maya’s parents, Beata and Jack, consulted numerous doctors and specialists in their relentless pursuit to understand the cause of Maya’s debilitating symptoms. Beata, in particular, was unyielding in her quest for answers. Eventually, their persistence led them to Dr. Anthony Kirkpatrick, a renowned pain specialist in the USA. In September 2015, Dr. Kirkpatrick diagnosed Maya with Complex Regional Pain Syndrome (CRPS). This diagnosis became central to understanding Maya’s suffering and the subsequent events.
Following her CRPS diagnosis, Maya underwent various treatments under medical supervision. One notable treatment was a 5-day procedure in Mexico involving high-dose ketamine infusions, requiring sedation and intubation. This treatment initially proved successful in alleviating Maya’s symptoms, allowing her to experience some relief. However, to maintain the benefits and prevent symptom recurrence, Maya needed ongoing lower doses of ketamine upon returning to the USA.
The Hospital Admission and the Beginning of Misunderstandings
The turning point, where Maya’s and her family’s lives took a dramatic and tragic turn, occurred when Maya was just ten years old. Her parents brought her to the paediatric emergency department at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida, USA. They believed Maya was experiencing a flare up of her CRPS, causing severe abdominal pain.
Upon arrival at the hospital, Beata and Jack Kowalski informed the Emergency Department staff about Maya’s Complex Regional Pain Syndrome (CRPS) diagnosis. They explained that CRPS affected Maya’s feet and legs and caused extreme hypersensitivity [Learn more about CRPS signs and symptoms via this link]. Beata, a registered nurse herself, possessed a thorough understanding of Maya’s condition and the treatments that had previously been effective.
Due to her CRPS, Maya required a wheelchair as her feet turned inward, and her legs were unable to support her weight. Like many individuals with CRPS, Maya experienced burning pain in her legs and feet and had limited mobility. Early in her CRPS journey, Maya had developed lesions on her legs, which the ketamine coma treatment had aimed to address.
At the hospital, when a nurse attempted to perform an ultrasound to investigate Maya’s abdominal pain, Beata insisted that Maya would only tolerate the procedure if she received a ketamine infusion or dose. This request for ketamine, a powerful drug, raised a “red flag” for the nurse, leading to the involvement of social worker Debra Hansen in the Kowalski’s case.
Child Abuse Allegations and Munchausen by Proxy Misdiagnosis
The social worker found Beata’s insistence on ketamine for a routine procedure highly unusual. This concern triggered a formal child abuse or neglect notification to the State. Although the Florida Department of Children and Families initially dismissed the report due to insufficient evidence, hospital staff persisted in their suspicions of child abuse or neglect.
Later that day, Dr. Beatriz Teppa Sanchez, an ICU doctor, contacted Dr. Sally Smith, medical director of the child-protection team for Pinellas County, Florida, seeking her expert opinion. Dr. Smith had extensive experience in child abuse cases, spanning over 30 years.
Dr. Sanchez described Beata as “pushy” and expressed concern about the high dosage of ketamine Beata requested for Maya. Hospital staff also characterized Beata as demanding, belligerent, and controlling, alleging she persistently pressured them to administer ketamine. Dr. Sanchez also noted that Maya appeared to exhibit less pain when her mother was absent. However, Dr. Smith’s greater concern arose from learning about Maya’s regular ketamine infusions for CRPS management, deeming it an unconventional approach for paediatric CRPS treatment.
Consequently, a second formal report was filed, this time citing overtreatment instead of parental neglect. This report alleged that Beata Kowalski “is believed to have mental issues” and asserted that Maya was not in pain but “Mom insists that Maya is in pain.” The DCF accepted the second report and formally engaged Dr. Sally Smith to investigate further, although she was already involved.
“Maya was not in any pain but Mom insists that Maya is in pain”
Disbelief in CRPS and Accusations of Fabricated Illness
The hospital staff and authorities involved increasingly doubted Maya’s CRPS diagnosis and the necessity for high-dose ketamine to manage her condition. They began to suspect that Maya was feigning her illness. A judge ordered Maya’s removal from her parents’ custody based on the belief that Maya was not only fabricating her symptoms but also that her mother, Beata, was suffering from Munchausen-by-proxy, now known as Factitious Disorder Imposed on Another (FDIA) or Fabricated or induced illness (FII).
Munchausen-by-proxy, or FDIA/FII, is a mental health condition where a caregiver, typically a parent, fabricates or induces physical or psychological symptoms in a child under their care. This can lead to the child undergoing unnecessary and potentially harmful medical interventions. This form of child abuse can have severe and lasting consequences on a child’s physical and emotional well-being.
Prior to this hospital admission, the Kowalski family had consulted over 30 medical professionals seeking answers about Maya’s condition and effective management strategies. Seeking multiple medical opinions and exploring various treatment options is a common path for individuals with CRPS and their families. Beata meticulously documented Maya’s condition, symptoms, and treatments.
Obtaining a diagnosis of Complex Regional Pain Syndrome (CRPS) can be a lengthy and challenging process, often taking months or even years, due to the condition’s complexity and limited awareness within the medical community. Tragically, accusations of symptom exaggeration, fabrication, or Munchausen syndrome are not uncommon for CRPS patients.
After Johns Hopkins Hospital requested Maya’s medical records, both doctors who had previously diagnosed and treated Maya contacted the hospital. They clarified Maya’s condition to Dr. Smith, and Dr. Kirkpatrick cautioned against accusing family members of criminal conduct, emphasizing the potential for “needless and permanent harm to the child and family.” Dr. Hanna, another specialist, also informed Dr. Smith that Munchausen by proxy was a frequent misdiagnosis in CRPS cases. However, these crucial warnings were notably absent from Dr. Smith’s report.
“Even though we are discouraged, we will not settle”
Three Months of Hospital Confinement and Isolation
Following the Munchausen-by-proxy accusation, the State issued a ‘shelter order,’ mandating Maya’s hospital stay and prohibiting parental visits. When a nurse delivered this devastating news to Maya’s hospital room, she found Maya’s father, Jack, cleaning up after Maya had lost bowel control. Beata had already left for work, leaving Jack to manage the situation alone. The nurse informed Jack that Maya was now in state custody and instructed him to leave immediately. As Jack left, Maya cried out for her father from her hospital bed, marking the beginning of a harrowing separation.
Over the next three months, Maya endured a traumatic ordeal of separation from her parents. According to the subsequent legal complaint, medical orders dictated Maya’s “isolation” and restricted family visits. Despite being isolated from her family, Maya consistently reported experiencing high pain levels.
Disturbingly, Dr. Smith remained unconvinced of Maya’s CRPS diagnosis and considered Munchausen-by-proxy a less likely explanation. Consequently, Dr. Smith instructed staff to secretly record Maya to “try to catch her moving her legs.”
One healthcare professional texted Dr. Smith after a visit, reporting, “I watched her use her feet to push herself several feet in her wheelchair … She was distracted and I’m not even sure she realized she did it bc i didn’t call attention to it.”
Dr. Smith responded, “Fortunately at 10 years old she can’t perform the charade effectively 24/7. And doesn’t even know if she’s making ‘physiological’ mistakes. I’m coming to take some pictures of her ‘affected’ legs.”
Dr. Smith and other staff members frequently referred to Maya using dehumanizing terms like ‘ketamine girl’. After two months of isolation, the hospital paediatrician changed Maya’s diagnosis from Munchausen-by-proxy to factitious disorder. This revised diagnosis implied that doctors believed Maya herself was fabricating her illness, rather than her parents. Dr. Smith further asserted in her reports that the recurring ‘strange bumps and lesions’ on Maya’s legs, arms, and forehead were self-inflicted.
Restricted Visitation and Further Trauma
In December, visitation orders were modified, allowing Maya to see her father under strict supervision, while completely prohibiting visits from her mother. Beata was limited to phone or video calls. However, the hospital imposed further restrictions beyond the court’s orders.
Maya’s social worker, Cathi Bedy, frequently denied Beata’s FaceTime/video calls, reducing contact from daily to weekly. Beata was even denied the opportunity to see Maya during Christmas. Visits from Maya’s teachers and the family priest were also blocked, halting her education and spiritual support.
Adding to the distress, Maya was subjected to unwanted physical contact and constant video surveillance. In one particularly disturbing incident, Maya was instructed by her social worker, Cathi, and a nurse to undress for photographs allegedly needed for a report. When Maya refused, she was threatened with denial of a court-arranged visit with her mother. Despite Maya’s protests, the social worker forcibly removed her pants and shirt.
Maya recounted, “I was crying and saying, ‘No, stop.’ But she wouldn’t stop. Bedy pinned me face down and either she or the nurse took photos of me in my training bra and shorts.”
Beata witnessed Maya’s condition deteriorate significantly due to the hospital’s actions. The legal complaint stated that “her symptoms worsened: her lesions reappeared, her legs atrophied, she regressed and became wheelchair-bound.”
At a court hearing, Maya’s request to hug her mother, supported even by their lawyer, was denied by the Judge.
Beata Kowalski’s Tragic Decision
When Beata finally saw Maya after more than three months of separation, she observed that Maya was using a wheelchair and appeared “in worse shape” than upon hospital admission. The judge’s denial of a simple hug from her daughter overwhelmed Beata with grief. She became deeply despondent and lost considerable weight. In a phone call with Maya the day before her death, Maya remembered her mother saying, “I love you, and I’ll see you tomorrow.” Tragically, Maya would never see her mother again.
On the day of a family birthday celebration, Beata remained home, telling her husband she had a headache. Upon returning home, Jack assumed Beata was asleep in their son’s room. The following day, a relative’s bloodcurdling scream from the garage alerted Jack. Rushing to the garage with his son, he discovered his wife had taken her own life. This devastating event occurred just two days after being denied a hug from Maya, on January 8, 2017, after 87 days of separation from her daughter. Beata was only 43 years old.
In a suicide email, Beata wrote: “I’m sorry but I no longer can take the pain being away from Maya and being treated like a criminal. I cannot watch my daughter suffer in pain and keep getting worse while my hands are tied by the state of FL and the judge.”
Beata’s desperate wish was for Maya’s release from the hospital and proper CRPS treatment. She tragically believed that her suicide was the only way to achieve this. On January 13, 2017, Jack Kowalski finally regained custody of Maya.
Beata had never been diagnosed with any mental health condition. She had even undergone a state-ordered psychiatric evaluation to disprove the Munchausen-by-proxy accusation. The psychiatrist’s report stated “no evidence that would support the conclusion that Beata has falsified her daughter’s medical condition for any psychological purpose” and concluded that “factitious disorder by proxy may safely be ruled out.”
When Jack informed Maya about her mother’s suicide at the hospital, she was moved to a private room where she met her father, brother, and family priest. They mourned together for an hour before Jack was forced to leave. In a subsequent court hearing, Maya, wearing a necklace gifted to her mother, expressed, “It was actually so unbelievably cruel, the amount of time they allocated for me to spend with my family after hearing such awful news.”
After Jack left, a hospital doctor texted the ICU Paediatrician Dr. Beatriz Teppa Sanchez, “Ketamine girl’s mom committed suicide yesterday. Sorry to say my prediction was correct.” This text implied the doctor’s assumption of Beata’s mental instability. Dr. Sanchez replied, “Omg, this is terrible … I know we did the right thing. But this is really f***ed up. I feel bad.”
The Civil Court Victory and Ongoing Legal Battles
Maya, now 17, became a co-plaintiff in the civil court case in Florida. She and her family sued Johns Hopkins All Children’s Hospital and the Department of Children and Families for over $200 million. The lawsuit followed Beata’s suicide, which the family attributed to the hospital’s actions and Munchausen-by-proxy accusations.
The family’s claims included medical malpractice, battery, false imprisonment of Maya, intentional infliction of emotional distress, and fraud. They argued that despite the hospital’s denial of Maya’s CRPS diagnosis, they continued billing their insurance company for CRPS treatments.
The court case placed immense emotional and physical strain on Maya. She had to endure relentless questioning and relive the traumatic hospital experiences and her mother’s tragic death. In their opening statement, the defense argued that mandatory reporting was initiated because Maya was “given levels of medication they had never heard of before, that the literature did not support.”
During the approximately eight-week trial, the Defendants questioned the legitimacy of Maya’s condition when she couldn’t attend court. They presented photos of Maya at her prom, seemingly happy and enjoying herself. Maya clarified that these photos, while showing her smiling, did not negate her pain and CRPS symptoms. She often masked her pain. She testified, “…I cried for an hour to my dad before that picture was taken because of how bad my leg pain was…I wasn’t sure if I was going to be able to go. That was my physical condition and mental condition.”
The Defendants’ lawyers argued, “This is the life of Maya Kowalski today….We did not aggravate a pre-existing condition. She’s at her prom, she’s out in heels, has friends — it’s in complete contradiction to her testimony.” Despite objections from Maya’s lawyers, the Judge admitted the photos as evidence.
It is crucial to understand that CRPS is not a linear condition. Individuals with CRPS experience fluctuations in symptoms. Outsiders often do not see the considerable effort required for someone with CRPS to participate in events or the subsequent flare-ups, exhaustion, and symptom exacerbation that follow.
Ultimately, the family won their civil claim and were awarded $261 million in damages, including findings of false imprisonment and $50 million in punitive damages for false imprisonment and battery. Punitive damages are intended to punish harmful conduct and deter future similar actions.
Upon hearing the verdict, Maya broke down in tears. She stated, “It was about the answer, knowing that my mom was right,” she said. “For the first time, I feel like I got justice.” In a recent Instagram post, she expressed, “*We are feeling so blessed! I will forever be grateful.”***
The jury concluded that the emotional distress caused by preventing Beata from seeing or hugging Maya directly contributed to her suicide in January 2017.
The hospital is appealing the damages, meaning the final amount remains uncertain until the appeals process concludes, with no clear timeline. Hospital lawyers claim the decision was based on “clear and prejudicial errors” and accused Maya’s lawyers of misleading the jury.
Maya’s family’s lead lawyer argued in his closing statement, “All Children’s doctors wanted to punish a mother who dared to question their medical expertise … What was the purpose of all this other than arrogance and the belief they could get away with it.”
Sexual Abuse Allegations Emerge
Following the civil trial, Maya Kowalski has filed a criminal complaint alleging sexual abuse, specifically assault and battery, occurring between October 8-13, 2016, during her hospital stay. Maya recalls specific details about the perpetrator, including hair color, height, weight, and clothing, although she cannot identify him.
She alleges that an individual appearing to be a doctor entered her room without a female chaperone, knocked briefly, approached her bed, pulled down her pajamas and underwear, and proceeded to ‘stare at [and] touch her private parts.’
Maya’s lawyer, Greg Anderson, stated that Maya suppressed these memories until recently. However, Maya had previously mentioned these events in notes to both the hospital psychiatrist and a subsequent psychiatrist, Dr. Henschke.
The Future and Seeking Support
The legal proceedings surrounding Maya’s case are ongoing. The hospital’s appeal of the civil claim is pending, as they maintain their denial of responsibility for Beata’s suicide and intend to appeal based on “clear and prejudicial errors throughout the trial and deliberate conduct by plaintiff’s counsel that misled the jury.” The criminal complaint regarding sexual abuse is also awaiting further investigation and potential trial.
Seeking Help and CRPS Information
If you believe you may have symptoms of Complex Regional Pain Syndrome (CRPS), it is crucial to seek medical advice and ask for a referral to a pain consultant or a CRPS specialist center. Please visit our page ‘How to get symptoms assessed‘ for more information. If you or someone you know is affected by CRPS, Burning Nights CRPS Support offers various Support Services, including online support groups, live chat, and community forums.
If you have been affected by any of the issues discussed in this article, please call the Samaritans on 116 123 in the U.K. Or in the USA, call the 988 Suicide & Crisis Lifeline. The Samaritans provide confidential emotional support to individuals in suicidal crisis or emotional distress, 24/7.
