‘Take Care of Maya’ - Kowalski v. Johns Hopkins Trial

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Obviously by the information that came out late in the trial, the hospital was put on notice long before Maya about their practices.

My guess is that this is the vital piece of evidence that led to this verdict. It's one thing to be less than perfect, as you do your best -- but when you have been told your care is problematic, and then later on it still causes big issues that flowed onto this family and may have led to loss of life, you're not going to fare well with a jury. It simplifies the issues for them considerably, because it hints you don't care.
 
While we await the jury decision on punitive damages, this link is the most recent JHACH 2021 Form 990 - for tax year beginning 07-01-2021 and ending 06-30-2022:
 
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My guess is that this is the vital piece of evidence that led to this verdict. It's one thing to be less than perfect, as you do your best -- but when you have been told your care is problematic, and then later on it still causes big issues that flowed onto this family and may have led to loss of life, you're not going to fare well with a jury. It simplifies the issues for them considerably, because it hints you don't care.
I agree. No wonder the defense fought so hard to hide that evidence.
IMO, the defense has only themselves to blame. They opened the door when their own expert testified— and the plaintiffs pounced.
 
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I agree. No wonder the defense fought so hard to hide that evidence.
IMO, the defense has only themselves to blame. They opened the door when their own expert testified— and the plaintiffs pounced.
I don't know the history of settlement or not here but JH would have been smart to do all possible to have avoided this spectacle. <modsnip: Removed opinion stated as fact>....but I would caution him to go easy on the spending as the appeal will no doubt get the awards more in line with the actual damages.
 
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I don't know the history of settlement or not here but JH would have been smart to do all possible to have avoided this spectacle. <modsnip: Removed opinion stated as fact>...but I would caution him to go easy on the spending as the appeal will no doubt get the awards more in line with the actual damages.

I agree, it would have been great if they’d been able to reach a settlement.
IMO though, the family’s primary motivation was not the money but to expose wrongdoing. Watching their reactions in court yesterday, to me, it appeared they finally felt vindicated after a long arduous fight.

I hope their lawyers have cautioned the family about the possibility of appeal and next steps.
 
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I haven't been following this thread but did see the doc and have seen bits and pieces of the trial coverage. My daughter spent 5 weeks in the NICU at JHACH in 2019 and my experience there was less than stellar (and that's putting things kindly). Not to say that there aren't great docs there because there are some that are wonderful, but the continuity of care and some of the treatment decisions were questionable. And I can tell you for a fact that these people do NOT like to be questioned. When my husband (politely) challenged something that the attending doc said, her response was "are you questioning my care??" Yes, yes he was. Doctors are not infallible. I am happy to see some vindication for Maya and her family and I hope this will lead to big changes at JHACH so that no other family has to go through a similar trauma.
 
Wonder how long the damages payout will be tied up in appeals court? Years, possibly?
 
Wonder how long the damages payout will be tied up in appeals court? Years, possibly?
It will probably be years and NOW she's claiming that she was sexually abused by a doctor that she <modsnip> remember when the trial was going on.

Nobody knows who this Dr is or what happened but anyways, another lawsuit is coming
 
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For depression, it is FDA approved. In 2019. It is an inhaled, compounded version (esketamine), not IV.

also, If you're not aware of off-label uses of just about every medication out there, do some reading. Docs prescribe off label all the time.

On a limb, but...Even for depression, Esketamine is not yet approved for kids. I know Yale is doing a study, the cutoff point is 13 y.of age, and it might be long overdue, as the rate of adolescent suicide is so high, and between ECT and SPRAVATO in suicidal depression, I'd say, SPRAVATO should be give
precedence, given the side effects of ECT. But, it is in study, everyone is careful. Unless ketamine in children is a mainstay treatment, studied by peers and approved for the indication, I absolutely understand how CH would be concerned.

CPRS is a complex diagnosis, and I am not sure whether it is underdiagnosed, overdiagnosed or not studied enough.

I remember the time when "chronic Lyme disease" seemed to be almost a fad, sorry, I don't mean to be insensitive to people who have it. But it was diagnosed it areas not even known for Borrelia Burgorpheri, so I always wondered what was the motivation for diagnosing the condition.

There are several conditions that, if studied genetically, will probably fall into complex syndromes.
 
And why didn't she tell her father about this after she got out of the hospital so they could file a police report?
 
I watched the Netflix documentary months ago and unless something comes up in the trail that wasn’t disclosed on the documentary (I’m aware there can be bias and misrepresentations in theses types of shows), I think Johns Hopkins and that awful doctor, Sally Smith (I think it was) should be held financially liable and Sally should face criminal charges. If she had a problem with Mayas treatment plan, she should have taken it up with her doctor rather than blaming the mother. She was on an ego trip with some sort of control complex and destroyed a family. Beata may have been difficult to deal with but she was a mother advocating for her sick child who was being falsely accused of child abuse. If Sally Smith can’t handle distressed parents of sick kids, then she shouldn’t be in the business of dealing with them. She did kidnap Maya and is responsible for Beata’s suicide. And this is apparently not the first family she’s done this to. She should go to prison…all my opinion.

Personally, I think that the hospital should have said, sorry, CRPS is not our specialty and referred her back to her initial doctor. At the very beginning. This is not a situation when the doctor sends a kid to the hospital for a second opinion on the diagnosis. This is when the doctor diagnoses, prescribes ketamine, then sends a child to Mexico for ketamine coma treatment. Of course there will be pain after that. It is a bad situation already. But at this point in time, JHACH is yet not involved - it is between her local doctor and the Mexican physicians. So, should JHACH send her back to her doctor, and her PCP can refer her to Rhode Island, or Mayo or anywhere else?

Not supporting JHACH at all, but with so many kids in the community getting help from it, is it reasonable to financially ruin the institution?
 
Ketamine can be a very dangerous medication, much more dangerous than naltrexone, causing addiction, it can slow breathing and heart activity leading to death, especially in high doses. We literally use Ketamine to put people to sleep during surgery, and their vitals have to be monitored when we use it. We use it for other reasons too, but against the advice of the FDA. Imagine a scenario in which the doctors granted Beata's request to give her daughter high doses of Ketamine and Maya died. They would have likely been held criminally responsible for her death. This isn't really about off-label uses, which is done quite often in medicine. This is about risk vs benefit, compounded by lack of FDA-approval, compounded by lack of clarity around her diagnosis, compounded by parent-request for medication rather than evidence behind said medication. As a physician, when I prescribe something, I have to give very clear indication as to why I thought this was the best treatment for the patient and if it's not FDA approved, I have to explain very clearly why I am prescribing it off-label. That also requires me to document the diagnosis and why this is the diagnosis. Even then, if something happens, I put myself at substantial risk. This is magnified significantly when (a) it's a drug that could kill a person and (b) the patient is a child. "The mother told me to prescribe" doesn't cut it in any court of law. I can't blame any doctor for not putting their own freedom (not to mention their livelihood) on the line for a treatment they didn't 100% believe in at a dose they all agreed was too high for a diagnosis they couldn't confirm she had.

We know the end result of this case, but hindsight is 20/20. Let's turn some the facts around and imagine a scenario where a child's parent advocates for a non-FDA-approved treatment of a potentially life-threatening and addictive drug for a diagnosis that isn't entirely clear. Let's say that a parent walked in with a child in pain and requests high doses of opiates for their child, higher than any doctor felt comfortable prescribing and at a dose Mom had to travel to Mexico to get previously. And let's say we didn't have the benefit of hindsight. I doubt there are many people who would say the doctors should prescribe it, especially if the doctor isn't sure exactly what the diagnosis is. That would definitely set off red flags for me.

JMO.

One more red flag that I see. The family was quite happy with the Mexican doctors but after a while, trips to Mexico for ketamine become expensive, and the family goes to a local hospital, demanding the same. Ketamine for kids, especially for a complex diagnosis, is not approved in the US. Nor are opiates. At that point, no one had the reason to sue the hospital. JHACH should have left it there. But somehow, the case grew big between the social care workers and doctors who projected their impressions on the family. The hospital got overinvolved. This is how it got big.
 

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