Attorneys for Kowalski family finish their side against All Children’s
Editor’s note: If you or someone you know is struggling or in crisis, call the 988 Suicide and Crisis Lifeline, text 988, or chat at 988Lifeline.org.
The Kowalski family’s attorneys rested their case on Monday, a little over a month after jury selection began in the civil trial against Johns Hopkins All Children’s Hospital, with the defense for the hospital beginning their portion of the case.
Greg Anderson, attorney for the Kowalskis, called a psychiatrist Monday to testify about the factors that led to Beata Kowalski’s suicide in January 2017.
The defense called their first witness in the early afternoon — a video deposition of Dr. James Lewis, a neuropsychologist who evaluated Maya Kowalski in 2016, and who passed away in December 2022.
Keep reading:Kowalskis testify about personal, economic impact for damages
In case you missed it:‘Take Care of Maya’ trial: Maya Kowalski testifies about hospital experience
The Kowalski family sued All Children’s Hospital in 2018 for false imprisonment, negligent infliction of emotional distress, medical negligence, battery, and other claims more than a year after the family matriarch, Beata Kowalski, took her life following allegations she was abusing her daughter.
The family took 10-year-old Maya Kowalski to All Children’s Hospital in October 2016 after she complained of severe stomach pain, believed by the family to be a relapse of her Complex Regional Pain Syndrome, a disorder that impairs the central nervous system and heightens pain sensations. The illness is sometimes also referred to as Reflex Sympathetic Dystrophy Syndrome.
Maya Kowalski was separated from her family, friends, and community following a Florida Department of Children and Families investigation and ordered by a judge to remain at the hospital. She remained separated for three months before reuniting with her father and brother shortly after her mother’s death.
![Beata Kowalski with her daughter, Maya. [Provided by the Kowalski family]](https://www.heraldtribune.com/gcdn/presto/2023/06/12/NSHT/a2018ab2-b270-4e8f-95c6-9a4e5d7cc8b7-iSallySmith27_002.JPG?width=300&height=315&fit=crop&format=pjpg&auto=webp)
Beata Kowalski was desperate, and she was faced with a Sophie’s Choice decision: Continue to stand by as her isolated 11-year-old daughter suffered without further treatment for her CRPS or make a bargain with the Lord to take her life instead of her daughter’s, a psychiatrist testified on Monday.
Dr. Scott Richards, a psychiatrist from Port St. Lucie, appeared via Zoom from Philadelphia.
Richards explained that in the 48 to 72 hours leading up to Beata Kowalski’s suicide, her defense mechanisms had failed after multiple risk factors contributed to her loss of control over her life.
Richards told the jury that risk factors for suicidal ideations, or thoughts about self-harm, can include family history, genetic predisposition, past attempts, substance abuse issues, and intrusive stressors that can overwhelm an individual’s defense mechanisms.
In this case, Richards reviewed thousands of pages of depositions, Beata and Maya Kowalski’s medical records, met with the family, and spoke with Maya Kowalski a handful of times.
He determined that in Beata Kowalski’s history, there were many significant factors that could have played a role in her death: Beata Kowalski was born and raised in Communist-era Poland under an oppressive regime which could have led her to feel somewhat restricted and controlled; the fact that her father was taken away during the Solidarity movement, a civil resistance to advance workers’ rights and social change within the country, further added to the lack of control in life; and she grew up with strong ties to Roman Catholicism, which Richards explained is a rigid and strict faith.
Beata Kowalski was also a nurse, and most nurses tend to be altruistic in nature and that they want to help patients, Richards said.
More trial coverage:Sarasota judge expresses frustrations with attorneys in ‘Take Care of Maya’ case
‘Take Care of Maya’ trial:Jury hears Maya’s former attorney, doctor and social worker
“The ability to keep control over her life, the ability to keep control over the health of her children, was gradually being diminished,” Richards said. “And I do feel strongly that the events that occurred during the hospitalization, the early hospitalization specifically, that she had total control taken away from her in a variety of areas of her life.”
Beata’s personal and professional lives were being scrutinized, she was accused of medical child abuse, and threatened with legal action, her marital status was targeted by someone at the hospital, and her integrity was challenged.
“When we lose control of life, we cling to our defense mechanisms to get some control back, and in my opinion, she used every defense mechanism at her fingertips,” Richards said.
In addition, Beata’s strong maternal instinct was also a significant factor, Richards said. The jury earlier in the trial heard from family and friends how strong Beata Kowalski’s maternal instinct had been during her son’s birth and how she researched extensively to try to find the right treatment for Maya.
Richards said in his opinion, Beata Kowalski reached an impulsive moment in that she found she couldn’t do anything more to help her daughter.
Richards said that social worker Catherine Bedy’s actions, the information she gleaned from her husband about Maya’s condition, and how Maya Kowalski was treated were direct and significant factors in Beata’s decision.
Defense attorney Ethen Shapiro in his questioning focused on the fact that Richards and Anderson have been friends since after college. The two had attended the same university and were a part of the same fraternity, according to Richards’s testimony, although they didn’t become friends until years after graduating.
Richards added that he had told Anderson when he started consulting for Anderson’s law firm that in order to remain unbiased and professional, all requests to review files had to go through an official request.
Shapiro also pointed out that it was a Sarasota judge who made the order during the dependency case which prevented Beata Kowalski from having physical contact with Maya from Oct. 13, 2016, and prevented Beata from hugging her daughter at a January 2017 hearing. Less than 48 hours later after that hearing, Beata Kowalski took her life.
Dr. James Lewis, a neuropsychologist who consulted for the Pinellas County Child Protection Team when asked, gave his deposition on Aug. 12, 2019, according to the date on the video.
Lewis spent three hours evaluating Maya Kowalski on Oct. 18, 2016, after he was contacted by the child protection team to perform an evaluation, which included a letter mentioning “concerns for Munchausen’s syndrome by proxy,” according to questioning.
Lewis said in his experience having done more than 7,000 child welfare system evaluations in his career, in every single case where medical professionals thought a parent had Munchausen by Proxy, “there was an underlying either mental disorder or personality disorder or both with the parent.”
“In 100% of those cases, the treating doctors had done a multidisciplinary evaluation before instituting treatment, meaning that they did a thorough assessment of possible psychological pain, and emotional distress of the child and mother, before instituting any kind of more invasive treatments,” Lewis said, adding that by invasive treatment he meant ketamine, opioids and benzodiazepines.
When asked if he knew if Maya Kowalski’s treating physicians, including Dr. Anthony Kirkpatrick and Dr. Ashraf Hanna, had performed a multidisciplinary evaluation, Lewis said he didn’t know.
Keep reading:Father takes stand, Sarasota judge denies 2 mistrial motions
More trial coverage:Pain medicine specialist testifies about Maya’s crippling pain
When he was further asked if a multidisciplinary evaluation should be performed by every doctor who becomes involved in Maya’s treatment or even when a PICC line was installed at All Children’s Hospital, Lewis again said it should have been the doctors “instituting invasive forms of chronic pain management.”
The neuropsychologist also said that he wasn’t the first to say something about a “dramatic link” between Maya Kowalski’s psychological pain and the intense physical pain that was triggered.
During the course of the evaluation, Lewis said he had Maya perform a series of tests, noting some of what transpired during the evaluation and then dictating the meeting, his observations, and Maya’s results right after he left. Lewis admitted that he did not review any of the Johns Hopkins All Children’s Hospital admissions notes, documents, or medical records, nor did his file contain any psychological or psychiatric records for Maya or Beata Kowalski.
Lewis said that during the evaluation, Maya Kowalski expressed emotional and psychological distress concerning her mother.
He said that Maya told him that her mother had been abused by her father. Lewis also added that Maya was depressed because her mother was depressed, and she was traumatized by finding out she had a 50/50 chance of dying from the ketamine treatment in Mexico.
While Lewis did not make a diagnosis of Munchausen Syndrome by Proxy, as it’s a medical diagnosis, he explained that in those diagnoses there is either a child who has psychological distress caused by a parent’s psychological distress which contributes to the child’s pain, or their pain is exaggerated by the parent’s psychological distress.
In his report, Lewis stated that Maya was the “witting or unwitting subject of ‘Munchausen’s Syndrome by Proxy,’ leaning more towards “unwitting.”
He said that Maya Kowalski’s pain flare-ups seemed to coincide with news that Beata Kowalski may have delivered while upset to her daughter. Lewis said that there should have been a discussion with the treating doctor who should have instructed Beata Kowalski to avoid giving distressing information to Maya to avoid triggering a flare-up.
In case you missed it:‘Take Care of Maya’ trial: Sexual abuse allegations arise, could be added to complaints
“My experience has been … when you treat mom, dad, child — the psychological issues in the family, you treat those — you identify those and then treat those, at that point the amount and frequency and levels of medicals are far less than if you ignore it and don’t even check that it’s there,” Lewis said.
Gabriela Szymanowska covers the legal system for the Herald-Tribune in partnership with Report for America. You can support her work with atax-deductible donation to Report for America. Contact Gabriela Szymanowska at gszymanowska@gannett.com, or onTwitter.
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