Jury deliberations expected Tuesday following final testimony in 'Take Care of Maya' trial

Jury deliberations will begin Tuesday in the weeks-long trial for a Venice family suing Johns Hopkins All Children’s Hospital.

Attorneys for the family and the hospital on Monday discussed the issue of whether the hospital had misrepresented its image before the jury through previous expert testimony and whether to allow some of the new evidence to be presented.

Last week, the family's attorneys called on Dr. Joseph Corcoran, an expert witness who served as chief medical officer at Brandon Medical Hospital, to testify to his knowledge of a Joint Commission review that indicated possible systemic failures at the hospital and an immediate jeopardy citation.

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Several days earlier, a retired hospital administrator who worked at a children's hospital in Wisconsin and was asked to review Johns Hopkins All Children's Hospital's policies and procedures, had testified that the hospital had met accreditation standards in 2016.

Nick Whitney, an attorney for the family, said after reviewing documents given by the defense and taking the deposition of a hospital administrator, it was apparent that the hospital had cultural and systemic failures which cumulated in how Maya Kowalski was treated when she was a patient in late 2016.

The Kowalski family sued the St. Petersburg-based hospital in 2018 for $220 million over complaints of battery, intentional infliction of emotional distress, false imprisonment, and fraudulent billing, among others.

The family claims it was the hospital’s actions that led Beata Kowalski to take her life after allegations of child abuse were reported and an investigation by the Florida Department of Children and Families led to a court order separating Maya from her family, specifically from her mother.

In October 2016, the family took then-10-year-old Maya Kowalski to All Children’s Hospital due to severe stomach pain which they believed was a relapse of her Complex Regional Pain Syndrome, a disorder that impairs the central nervous system and heightens pain sensations.

While at the hospital, staff began to suspect possible child abuse, stating that Maya displayed inconsistencies in her behavior and symptoms.

Howard Hunter, counsel for the hospital, argued the testimony by the hospital’s expert did not mislead the jury because the hospital had been accredited in 2016 by the Joint Commission and anything that happened afterward did not overturn that accreditation.

Carroll ruled the rebuttal testimony would move forward for the jury to hear the evidence, with Corcoran taking the stand later Monday afternoon.

On Tuesday, attorneys for both sides will present their closing arguments, and jury deliberations are expected to begin in the afternoon.

The jury will deliberate on seven claims: false imprisonment, battery, negligent medical treatment, fraudulent billing and intentional infliction of emotional distress. The sixth claim brought by the Estate of Beata Kowalski states the hospital acted extremely and outrageously during the time Maya Kowalski was a patient which caused Beata Kowalski to take her life, while the seventh claim is brought by Maya Kowalski stating the hospital acted extremely and outrageously while she was a patient at the hospital.

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Systemic failures throughout hospital

In the afternoon, Corcoran took the stand for the last time to discuss the findings of the Joint Commission reports which included the immediate jeopardy findings.

Corcoran said that according to the report, there were systemic issues that were first identified at the end of 2015, however, the cultural issues within the hospital could have started as early as 2011 when Johns Hopkins acquired All Children's Hospital into its health system.

According to an email from a hospital administrator shared with the jury, there were four areas where deficiencies were found that were so egregious and widespread that they contributed to the immediate jeopardy.

The hospital had to address a lack of communication between elevating issues from the hospital to its Board and CEO, improve the complaint grievance process, address a culture of retaliation and retribution, and improve infection control.

Previous trial coverage: Kowalskis testify about personal, economic impact for damages

Keep reading: Maya Kowalski testifies about hospital experience

Another issue revealed in the report was that in the over 15 months prior to the survey being conducted in September 2018, there was no evidence that Risk Management collected data related to quality of care to track, trend, and analyze what was going on in the hospital. Corcoran explained when data for quality of care isn't collected, if something goes off course, there's no way to correct it before it shoots way off course.

Also, despite All Children's being a part of the Johns Hopkins healthcare system, it was revealed to the jury that All Children's was the only hospital where risk management at the hospital level wasn't reporting issues to the system level. This lack of elevating issues was also a part of the hospital, with adverse medical incidents that impacted patients being reported to risk managers but weren't elevated to a system level.

Corcoran said it was equivocal to stuffing the problems into a drawer.

Corcoran was surprised the jury didn't hear from anyone who was a patient advocate for Maya, and simply heard from physicians, nurses, and other hospital staff.

"I don't recall hearing from anyone that was really playing 'guardian angel', somebody who was really looking out for Maya and her care," Corcoran said.

Gabriela Szymanowska covers the legal system for the Herald-Tribune in partnership with Report for America. You can support her work with a tax-deductible donation to Report for America. Contact Gabriela Szymanowska at gszymanowska@gannett.com, or on Twitter.

This article originally appeared on Sarasota Herald-Tribune: 'Take Care of Maya' trial: Jury deliberations to begin Tuesday