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

Nearly two weeks after a jury awarded $261 million in damages against Johns Hopkins All Children’s Hospital, its attorneys on Wednesday filed for a retrial in a motion that accused the jury foreman of violating strict conduct rules during the trial.

In a motion filed in Sarasota County, hospital attorneys claimed that during the trial, juror Paul Lengyel shared information about the case with his wife, who then shared it on social media platforms. Yolanda Lengyel also attended at least one day of the trial in Venice, meaning she could have heard attorney discussions with the judge that were made outside of the jury’s presence, the motion states.

 
My 2c on reading the motion ...

1 The basis of the motion is an assumption that Juror 1 and his wife living in the same house means they MUST be discussing the case. No actual proof at all.
2 All of their arguments are based on what impact came from Juror 1 being such a blabbermouth - but with no proof that he was. Just their claim.
... None of what Wifey did proves she talked to Juror 1. Could have. But maybe she's like us, someone who was watching and commenting and interested and making logical guesses anyone can make.
3 Hospital wants Juror 1's wife to have had an obligation to be impartial, and keep her thoughts and observations to herself. They don't defer to the fact she's NOT the juror and NOT under oath to be impartial. So I don't trust their version of the "facts."
4 Many of Hospital's arguments are nonsense, such as claiming that Wifey somehow was able to control the courtroom, and did so by conversations after the fact with Juror 1. For that reason and more, this feels like about 90% (or more) a fishing expedition.
5a It's possible (but not certain, because of the transparent nonsense of so many of these claims) that Juror 1 will be asked to submit to an interview. If he violated his oath, there will be a new trial. If he didn't, this all goes away.
...b It's 50-50 that Wifey will be interviewed. She was under NO obligation to the court, but jury tampering (if she actually did so) is not allowed.
...c Even if the hospital were to get a new trial, the facts they are facing won't change. So I'd guess that the MAIN goal here is to gain leverage for a negotiated settlement to reduce the judgment amount.

I think this case is going to be settled, and this claim is merely an attempt to change the math. Even if the K's win this round, they may want to accept a somewhat-smaller check (in exchange for no more litigation) and move on. And the hospital, with the assault claims still looming, also have incentive to put this thing to bed and be done.
 
My 2c on reading the motion ...

1 The basis of the motion is an assumption that Juror 1 and his wife living in the same house means they MUST be discussing the case. No actual proof at all.
2 All of their arguments are based on what impact came from Juror 1 being such a blabbermouth - but with no proof that he was. Just their claim.
... None of what Wifey did proves she talked to Juror 1. Could have. But maybe she's like us, someone who was watching and commenting and interested and making logical guesses anyone can make.
3 Hospital wants Juror 1's wife to have had an obligation to be impartial, and keep her thoughts and observations to herself. They don't defer to the fact she's NOT the juror and NOT under oath to be impartial. So I don't trust their version of the "facts."
4 Many of Hospital's arguments are nonsense, such as claiming that Wifey somehow was able to control the courtroom, and did so by conversations after the fact with Juror 1. For that reason and more, this feels like about 90% (or more) a fishing expedition.
5a It's possible (but not certain, because of the transparent nonsense of so many of these claims) that Juror 1 will be asked to submit to an interview. If he violated his oath, there will be a new trial. If he didn't, this all goes away.
...b It's 50-50 that Wifey will be interviewed. She was under NO obligation to the court, but jury tampering (if she actually did so) is not allowed.
...c Even if the hospital were to get a new trial, the facts they are facing won't change. So I'd guess that the MAIN goal here is to gain leverage for a negotiated settlement to reduce the judgment amount.

I think this case is going to be settled, and this claim is merely an attempt to change the math. Even if the K's win this round, they may want to accept a somewhat-smaller check (in exchange for no more litigation) and move on. And the hospital, with the assault claims still looming, also have incentive to put this thing to bed and be done.
Thank you very much for this analysis. I tend to agree with much of what you wrote. There’s quite a bit of supposition and innuendo in the motion that I think would be very hard to prove. IMO.
 
I'm just watching this trial now even though I know what the verdict was. I purposely have not watched any of the sidebar arguments since I only wanted to hear what was presented to the jury. There are so many things about this story that resonate with me personally, but I think it would be hard to be on this jury. I would definitely need to review closely what the requirements are to find the hospital guilty of these charges, and personally I find that amount of money to be ridiculous.

I'm still confused on why sleuthers or the hospital staff thought it was Munchausen by proxy. I don't find fault with the hospital for contacting CPS or following court orders, but I haven't seen any evidence of Munchausen by proxy. What am I missing? Here is some of the evidence I have heard and my thoughts from the lens of my own personal experience.
1. Doctor shopping
My son has cerebral palsy, which is not even rare. In my experience, we have been to a physiatrist, neurologist, physical therapist, an orthopedist...sometimes multiple physicians in these specialties...three different children's hospitals. I'd like to mention I wasn't "doctor shopping." We ended up at all of these healthcare providers by referral from another healthcare provider. Most of the time these healthcare providers did not agree on a course of treatment, and this is for a condition that I think is fairly well known. I didn't get the impression that the Kowalskis' journey was any different.
2. Documenting everything
Beata was a nurse so this makes absolute sense to me. Every time I went to a doctor, I had to give an oral history of what had happened. It would take up to 9 months to get an appointment, and the doctors never referenced their own notes much less bothered to communicate with other healthcare professionals before the 10 minute allotted time to see my son. So I had to be prepared to tell them what had changed, who we had seen, what they suggested, etc. My son doesn't even take medication so I can't imagine adding that element on top of it.
3. Ketamine treatment
As someone else pointed out, if you are a parent with a suffering child it is not unusual to do everything in your power to try to help in some way. From my experience, we took my son to have a controversial surgery when he was 9. The doctors in my area thought we were bonkers since it involved cutting nerves in his spinal column and requiring him to learn to walk again. Sounds crazy, right? The only difference in our case is that we went to a children's hospital in the US where a world renown neurologist performed the procedure, and he also did continuing research of long term effects and outcomes of the procedure. It didn't stop the other professionals where I lived thinking I was nuts, but they knew nothing about the procedure or any of the data associated. I'm not saying this is exactly the same, but I understand where she was coming from, and the ketamine treatment was recommended by a healthcare professional. I don't understand how giving prescribed medication per 1 doctor's orders equates to MBP.
4. Crazy emails to herself
I would never do this, but I know other parents whose children have the same condition as my son that did the exact same thing as Beata. That is putting up a blog with progress surrounding a treatment, and even using the "child's voice." Again, it seems unusual, but how is that MBP?

I understand why the referral to CPS was made, and why the court orders existed. Yet I still don't understand this determination or why the hospital staff was so over the top about it. I'll even say the MBP issue itself wouldn't sway me if I were on the jury. It is more of how the hospital implemented the court orders and treated Maya while in the hospital.

Thanks for indulging the long post.
 
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.

Kids are absolutely given opioids in the US. Fentanyl is routinely administered in pediatric ERs for acute matters, for example, and virtually every pediatric hospital has guidelines for acute and chronic pain management.
 
Kids are absolutely given opioids in the US. Fentanyl is routinely administered in pediatric ERs for acute matters, for example, and virtually every pediatric hospital has guidelines for acute and chronic pain management.

The poster didn't say it doesn't happen. He/she said it isn't approved, and he/she is correct. Links for proof from the FDA and various other cites are posted in this thread.
 
The poster didn't say it doesn't happen. He/she said it isn't approved, and he/she is correct. Links for proof from the FDA and various other cites are posted in this thread.
Duragesic (fentanyl) and OxyContin are the only extended-release opioid products with FDA-approved labeling regarding pediatric use.”

CDER Conversation: Pediatric pain management options | FDA



“To give health care providers more information on the safe use of drugs in pediatric patients, FDA can use its authority to ask manufacturers of drug products to conduct studies to obtain pediatric-specific information. We requested the manufacturer of the pain management drug OxyContin perform studies evaluating safety and other important information about oxycodone and OxyContin when used in pediatric patients.”

“The studies supported the addition of a pediatric indication to the OxyContin label for patients 11 to 16 years old, and provided the much-needed data to health care providers.The new study data and resulting pediatric indication for OxyContin give doctors more specific information on how to safely manage pain in their pediatric patients following these types of surgery or traumas.”

CDER Conversation: Pediatric pain management options | FDA
CDER Conversation: Pediatric pain management options

This is why it is confusing to me, a lay person, but I defer to you, @BeginnerSleuther
 
Duragesic (fentanyl) and OxyContin are the only extended-release opioid products with FDA-approved labeling regarding pediatric use.”

CDER Conversation: Pediatric pain management options | FDA



“To give health care providers more information on the safe use of drugs in pediatric patients, FDA can use its authority to ask manufacturers of drug products to conduct studies to obtain pediatric-specific information. We requested the manufacturer of the pain management drug OxyContin perform studies evaluating safety and other important information about oxycodone and OxyContin when used in pediatric patients.”

“The studies supported the addition of a pediatric indication to the OxyContin label for patients 11 to 16 years old, and provided the much-needed data to health care providers.The new study data and resulting pediatric indication for OxyContin give doctors more specific information on how to safely manage pain in their pediatric patients following these types of surgery or traumas.”

CDER Conversation: Pediatric pain management options | FDA
CDER Conversation: Pediatric pain management options

This is why it is confusing to me, a lay person, but I defer to you, @BeginnerSleuther

I should have corrected the poster above you who was responding about Fentanyl, but was responding to a poster who specifically said:
"Ketamine for kids, especially for a complex diagnosis, is not approved in the US."

This statement is correct. Ketamine is not approved for pain management in children in the US.
 
Nearly two weeks after a jury awarded $261 million in damages against Johns Hopkins All Children’s Hospital, its attorneys on Wednesday filed for a retrial in a motion that accused the jury foreman of violating strict conduct rules during the trial.

In a motion filed in Sarasota County, hospital attorneys claimed that during the trial, juror Paul Lengyel shared information about the case with his wife, who then shared it on social media platforms. Yolanda Lengyel also attended at least one day of the trial in Venice, meaning she could have heard attorney discussions with the judge that were made outside of the jury’s presence, the motion states.


The motion states that Juror #1's wife shared "insider information" about the trial on social media. The information she shared could only have been obtained from her husband (Juror #1). The information was shared during the trial.

Wow, that's a clear violation. What was the jury foreman thinking? Had he never served on a jury before? Did he think it was ok to ignore the rules?

Post-trial research and information obtained regarding Mrs. Lengyel’s social media history reveals that her personal engagement with the public commentary of this trial is unlike that of a member of the public who shares a general interest in the case, and is particularly inappropriate given her role as the wife of the jury foreman. Mrs. Lengyel’s social media posts foreshadowed questions from Juror #1 to witnesses, shared information on the thought-processes of the jury, and highlighted her heavy personal bias in favor of the Plaintiffs and emotional investment in a verdict in their favor – a bias apparently shared by her husband, Juror #1.
 

“Anderson responds to defense's motion​

Anderson said he would file a response to the motion soon, likely by Monday, but added he doesn't believe the defense has the substantive evidence for the judge to grant the interview
He cited the defense's raising of the use of the term "creature comforts."

“In the motion, the defense claims that Paul Lengyel had conducted research during the trial because one of the questions he posed on Oct. 9 to Maya Kowalski included the term "creature comfort," which the defense states hadn't been used by a witness at trial before then. The defense states that the only way he would have known the term is if he had looked at the website of Dr. Anthony Kirkpatrick, one of the physicians who treated Maya for CRPS and was called to testify.”

“Anderson pointed out that one of his witnesses, a physical therapist, had mentioned that term in her testimony.”

“As far as Yolanda Lengyel's social media posts, Anderson said she has a First Amendment right to express her opinions, and just because she did doesn't mean she discussed it with her husband. He also pointed out that Carroll repeatedly affirmed that jurors hadn't discussed the case outside of the courtroom.”

 
The Plaintiff’s response is also available, but I’m not sure the best way to post it here. I’ve read/watched some recaps, but not the whole motion yet— seems like they do a pretty good job refuting the defense’s claims from what I’ve seen. IMO. I’ve read there is a hearing scheduled Dec 15, but not sure it will be open to the public?
 
The motion states that Juror #1's wife shared "insider information" about the trial on social media. The information she shared could only have been obtained from her husband (Juror #1). The information was shared during the trial.

Wow, that's a clear violation. What was the jury foreman thinking? Had he never served on a jury before? Did he think it was ok to ignore the rules?

"...that's a clear violation" -- That's only a violation if it happened. However, what the motion "states" is merely a claim (or an opinion) about what they think (or want the court to think) has happened. Don't assume that what is written in a motion is just a recitation of facts, because they can be filled with total fiction (or deceptive half-truths), as well as with arguments that are completely irrational.

I read this motion. It is lengthy. I certainly didn't memorize it or analyze it in great detail, but my observation was that it was a long list of suppositions and speculation leading to lots of opinion or claims, and yet nothing I saw was an objective fact proving the Lengyels indeed discussed the case.

Overall, it seemed to me that their main "proof" was the fact that they were husband and wife living together, so therefore they MUST HAVE discussed the case, and anything that was said or opined or noticed by either must have come from a discussion of the case. But when they used that supposition ("they must have discussed the case") as the main "fact" to prove their point ("so they discussed the case"), it's a circular argument, and proves nothing.

Some of their arguments were about how Mrs L predicted accurately what would happen next in the courtroom, and this (supposedly) proved she had been talking to her juror husband -- which is silly nonsense, since Juror Husband didn't control what happened next. And don't we, in this forum as a trial unfolds, offer guesses of what's ahead that can prove true? Aren't some of the guesses (and guessers) helpful and on track at times? Are we talking to jurors about the case? Their claims seem to be absurd.

Another oft-repeated argument they used was based on the idea that Mrs L should have been impartial in what she said online in the trial, so she stepped out of line. C'mon, that's just wrong. She was not the juror. Yet the defense claims she stepped over the line by her opinions. Seems like more nonsense to me.

Furthermore, they say JH must have been unfairly influenced by Mrs L's anti-defense opinions, 'since obviously they were discussing the case' (assuming the idea they are claiming to prove). Again, just circular assumptions.

One more important thing to note - the court already had this issue raised during the trial, and it led nowhere. Isn't the defense just wishfully re-fishing the same dry hole?

I'm not sure this level of wild supposition even leads to a hearing. I sure didn't see anything persuasive in their novel. But it's the courts call, not mine.

Just my 2c.
 
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I'm just watching this trial now even though I know what the verdict was. I purposely have not watched any of the sidebar arguments since I only wanted to hear what was presented to the jury. There are so many things about this story that resonate with me personally, but I think it would be hard to be on this jury. I would definitely need to review closely what the requirements are to find the hospital guilty of these charges, and personally I find that amount of money to be ridiculous.

I'm still confused on why sleuthers or the hospital staff thought it was Munchausen by proxy. I don't find fault with the hospital for contacting CPS or following court orders, but I haven't seen any evidence of Munchausen by proxy. What am I missing? Here is some of the evidence I have heard and my thoughts from the lens of my own personal experience.
1. Doctor shopping
My son has cerebral palsy, which is not even rare. In my experience, we have been to a physiatrist, neurologist, physical therapist, an orthopedist...sometimes multiple physicians in these specialties...three different children's hospitals. I'd like to mention I wasn't "doctor shopping." We ended up at all of these healthcare providers by referral from another healthcare provider. Most of the time these healthcare providers did not agree on a course of treatment, and this is for a condition that I think is fairly well known. I didn't get the impression that the Kowalskis' journey was any different.
2. Documenting everything
Beata was a nurse so this makes absolute sense to me. Every time I went to a doctor, I had to give an oral history of what had happened. It would take up to 9 months to get an appointment, and the doctors never referenced their own notes much less bothered to communicate with other healthcare professionals before the 10 minute allotted time to see my son. So I had to be prepared to tell them what had changed, who we had seen, what they suggested, etc. My son doesn't even take medication so I can't imagine adding that element on top of it.
3. Ketamine treatment
As someone else pointed out, if you are a parent with a suffering child it is not unusual to do everything in your power to try to help in some way. From my experience, we took my son to have a controversial surgery when he was 9. The doctors in my area thought we were bonkers since it involved cutting nerves in his spinal column and requiring him to learn to walk again. Sounds crazy, right? The only difference in our case is that we went to a children's hospital in the US where a world renown neurologist performed the procedure, and he also did continuing research of long term effects and outcomes of the procedure. It didn't stop the other professionals where I lived thinking I was nuts, but they knew nothing about the procedure or any of the data associated. I'm not saying this is exactly the same, but I understand where she was coming from, and the ketamine treatment was recommended by a healthcare professional. I don't understand how giving prescribed medication per 1 doctor's orders equates to MBP.
4. Crazy emails to herself
I would never do this, but I know other parents whose children have the same condition as my son that did the exact same thing as Beata. That is putting up a blog with progress surrounding a treatment, and even using the "child's voice." Again, it seems unusual, but how is that MBP?

I understand why the referral to CPS was made, and why the court orders existed. Yet I still don't understand this determination or why the hospital staff was so over the top about it. I'll even say the MBP issue itself wouldn't sway me if I were on the jury. It is more of how the hospital implemented the court orders and treated Maya while in the hospital.

Thanks for indulging the long post.
In the same boat as you, misantha, and wondering many of the same things. I’ll go down your list with my own experiences, because I don’t understand the MBP thought either. As you said, I can understand concern.. but MBP seems to have been pulled out of thin air as an “abuse disorder” of sorts - as in, hospital staff said it’s MBP just because they suspected abuse. Children can be abused and not be a victim of MBP, and from what I’ve seen that claim seems really erroneous.

1. Doctor shopping
I’ve suffered from treatment resistant mental illnesses since I was 11 years old. When I was about 12, my mother had to take me to 5 different child psychiatrists within about 18 months because no one would take the manic episodes I was having when put on an antidepressant seriously. We encountered several doctors who felt I wasn’t old enough to have bipolar I, or at least not old enough to be having such severe symptoms. But there I was, 12 and severely suffering from bipolar I disorder. It took until I was 17 to get put on lithium, which is something my mother specifically advocated for despite how hard lithium is on your body because I needed relief or I was absolutely going to end my own life. Sometimes a medication or treatment IS necessary even if it’s not the first line of treatment or the gold standard. Not everything works for everyone.

2. Documenting everything
This is not weird at all to me, and I think if you’ve been to multiple doctors for the same issue/have experience with being dismissed by doctors, you’re absolutely going to start recording your encounters with these people. As mentioned, meds make things even more complicated. Plus, doctors only have very short time slots to see these kids, who may have been waiting months to see this doctor. It makes sense that a parent would want these interactions recorded and all together, even if just for continuation of treatment purposes.

3. Ketamine treatment
Same sentiments as above; if you don’t know what it’s like to have a child suffering like that, you dont know what you’d do. Also, people tend have a really negative view of ketamine treatment without knowing what it entails. It’s not really just giving the patient loads of ketamine and letting them be high or whatever. A lot of times it’s a nasal treatment, and it can help with a lot of different things. I’m kind of appalled that Sally Smith was so scandalized by the thought of ketamine treatment that that’s part of the reason she did all of this. It’s common and can be very helpful, whether she likes it or not… Reminds me of many psychiatrists I’ve had who refused to put me on certain things because THEY’VE never seen a patient improve on said medication… but have you ever had a patient with this illness/this level of this illness? Right… (doctors always want to be right, and in many cases, they are! But when you have a chronic health condition, you as the patient do have good insights that should be listened to).

4. Crazy emails
I feel like Beata likely had some mental issues of her own from dealing with doctors and treatment and just the general toll of having a sick child (NOT blaming Maya in the least!!! Not Maya’s fault at all, I’m just saying this was obviously very stressful). I think that’s clear based on the fact that Beata tragically ended her own life upon being briefly separated from Maya. Mom with anxiety/depression ≠ MBP or abuse, though. IMO this aspect is just more proof that Beata was already cracking a little, rather than proof that she was abusing Maya.

All IMO & JMO, and thanks for reading such a long post if you did. I have strong feelings about this case and doctors who abuse their power in general. Obviously. :)
 
In the same boat as you, misantha, and wondering many of the same things. I’ll go down your list with my own experiences, because I don’t understand the MBP thought either. As you said, I can understand concern.. but MBP seems to have been pulled out of thin air as an “abuse disorder” of sorts - as in, hospital staff said it’s MBP just because they suspected abuse. Children can be abused and not be a victim of MBP, and from what I’ve seen that claim seems really erroneous.

By definition, MBP is abuse. If there is suspected child abuse, then it is the job of the healthcare team to report it and to consider how that abuse -- if true -- is impacting the patient's presentation and in a case like this, that includes considering MBP.

3. Ketamine treatment
Same sentiments as above; if you don’t know what it’s like to have a child suffering like that, you dont know what you’d do. Also, people tend have a really negative view of ketamine treatment without knowing what it entails. It’s not really just giving the patient loads of ketamine and letting them be high or whatever. A lot of times it’s a nasal treatment, and it can help with a lot of different things. I’m kind of appalled that Sally Smith was so scandalized by the thought of ketamine treatment that that’s part of the reason she did all of this. It’s common and can be very helpful, whether she likes it or not… Reminds me of many psychiatrists I’ve had who refused to put me on certain things because THEY’VE never seen a patient improve on said medication… but have you ever had a patient with this illness/this level of this illness? Right… (doctors always want to be right, and in many cases, they are! But when you have a chronic health condition, you as the patient do have good insights that should be listened to).

SBMFF. Per court documents, it doesn't sound like Maya received nasal ketamine nor is that what Beata was requesting. Ketamine is not approved by the FDA for any mental health condition in children due to its risks. Per the documents and trial, it wasn't that the doctors didn't see anyone improve on Ketamine; it was that they weren't going to sign off on a dangerous unapproved treatment for a diagnosis they couldn't make. I think that's an important distinction.

MOO
 
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Maya was interviewed on local NPR radio station this morning. I will post the interview when it is on the website.

 

‘Absolutely disgusting’: Hospital demands new Maya Kowalski trial after juror note allegedly compares doctor to ‘a notorious Nazi organization’

Dec 8th, 2023, 1:48 pm
[...]
The crux of the latest juror misconduct claim, which was filed as a second supplement to the overarching new trial motion on Thursday, is the idea that Juror Number 1 had an extreme dislike of one of the defense witnesses, a hospital employee named Sally Smith.
[...]
“Juror Number 1 has printed letter ‘S’ throughout the note normally, with a curve in the spine, EXCEPT that he printed his ‘S’ with sharp angles when printing Dr. Sally Smith’s name,” the second supplemental motion reads. “Both the second and third times that Juror No. 1 prints Dr. Sally Smith’s name, the letter ‘S’ is shaped in a manner identical to the symbol of the Nazi Schutzstaffel.”
[...]
1702264583754.png
 

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