Jury hears from family physician, psychologist during third day of 'Take Care of Maya' trial

The third day of the highly publicized civil case involving a Venice family suing the St. Petersburg-based Johns Hopkins All Children’s Hospital included testimony from the family physician and a hired psychologist who evaluated the family.

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.

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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 91 days before reuniting with her father and brother shortly after her mother’s death.

Maya Kowalski briefly took the stand Tuesday to confirm the authenticity of a letter she’d written to her family while at All Children’s, which included a small drawn heart with stick figures representing her family and what were supposedly three slight impressions where she placed kisses for her mom, dad, and brother on the back of the letter.

Family physician walks through Maya Kowalski’s health journey

For almost three hours Tuesday, the Kowalskis’ family physician, Dr. John Wassenaar, testified about Maya Kowalski’s health over the years since he first saw her for an initial new patient assessment in 2014 after the family moved to Florida.

Wassenaar, who works at First Physicians of Sarasota and has practiced medicine for 33 years, said that prior to the summer of 2015, Maya Kowalski was a healthy child beyond having an allergy and asthma.

Wassenaar described Beata Kowalski as being an attentive and loving mother, which was echoed by others interviewed by Dr. Tashawna Duncan, a licensed psychologist hired by the family to perform an evaluation of them in 2016.

Wassenaar said while it was noted in Maya Kowalski's files from the other hospitals that she had possible conversion disorder and there were suspicions that Beata Kowalski had Munchausen by Proxy, he didn't find anything that supported those suspicions.

Starting in September 2015 through Maya Kowalski's admission into All Children's Hospital in October 2016, Wassenaar noted in his records that Maya Kowalski was wheelchair-bound during most, if not all, her visits. There were times she was too sensitive to be touched for a physical exam, and nonspecific skin lesions appeared on her body.

Wassenaar added he knew of Maya Kowalski's trip to Mexico for the ketamine-induced coma and the high-dose ketamine treatments, noting in his records there was some improvement in her condition.

He explained to the jury that the Kowalskis were doing everything to help treat Maya's pain, and when the standard pain management treatments didn't work, they tried finding others. All the while, Maya Kowalski continued physical and occupational therapy to help prevent permanent damage to her body.

When asked why Wassenaar had filled out a homebound form indicating Maya Kowalski should remain in the homebound program, he said he was trying to help the family and it would help his patient.

Following Maya Kowalski's release from the hospital in January 2017, Wassenaar said she weighed the same as she had during her last visit in August 2016, seemingly nullifying the hospital's claims that they'd helped her gain weight while she was under their care. He added she had less physical strength, there were scattered lesions on her arms, and it appeared the CRPS had gotten worse, in his opinion.

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Defense attorney Howard Hunter, representing All Children’s Hospital, aimed his questioning of Wassenaar about the apparent lack of communication between the physician and other doctors, specialists, and therapists Maya Kowalski saw while she was under his care.

Specifically, Hunter pointed out how Wassenaar didn’t get Maya Kowalski’s previous medical history from her doctor in Chicago, nor did Wassenaar get records from Maya’s visit to two local hospitals, one of which he didn’t know she visited; he also wasn’t called for a consultation by doctors at Tampa General Hospital when Maya Kowalski went there nor had he really read through the discharge summary from the hospital when he saw her in September 2015.

Despite not having records or consulting with the other specialists who treated Maya Kowalski prior to a September 2015 visit, Wassenaar didn’t believe Maya Kowalski had conversion disorder, a mental health condition that causes physical symptoms, according to the Cleveland Clinic.

Up until that point in his career, Wassenaar said he had seen several adult patients who had CRPS but he’d never seen it in a child. CRPS is an uncommon condition in adults, and rare in children, Wassenaar testified.

Wassenaar also said he’d never heard of a child being treated using high-dose ketamine and that he hadn’t called Dr. Anthony Kirkpatrick — the specialist who had diagnosed Maya Kowalski with CRPS — to ask about her treatments. When asked if he’d heard of Kirkpatrick at that point, Wassenaar said no, but that he was in agreement with Kirkpatrick’s assessment of Maya.

“So, you were dealing with a doctor you’d never heard of, a disease that you’d never seen before in this setting, and two sets of treatment — the initial ketamine treatment by Dr. Kirkpatrick and now this coma — two sets of treatment that you’d never heard of before,” Hunter said.

Hunter also in his questioning pointed out that despite seemingly improving with the high-dose ketamine treatments, Maya Kowalski remained wheelchair-bound during all her subsequent visits to Wassenaar until her October 2016 admission into All Children’s Hospital.

Wassenaar did point out that while Maya Kowalski was on about 20 medications when she was admitted into the hospital, some of the medications listed were vitamin supplements or “as are needed” medications.

'Warehoused': Psychologist hired by family testifies about her report

Dr. Duncan, the licensed psychologist hired by the family in 2016, testified she reviewed medical records and interviewed family, teachers, friends and neighbors for her evaluation.

Duncan said she spoke with Maya Kowalski twice, once in the hospital as part of an interview about the family and an evaluation at the courthouse in December 2016. During the first visit, Duncan said Maya's condition stood out: Maya Kowalski was in a wheelchair with her feet turned inward the entire time, which would have been hard to maintain if she was faking it, and she was nervous about people overhearing their conversation.

When asked by opposing counsel about visiting Maya Kowalski in the hospital, Duncan said she had no problem checking in at the front desk and being escorted to see Maya in a recreational area, and the staff tried to find an empty room for them to use, but they ended up speaking in a mostly empty hallway.

During her evaluation of Maya at the courthouse, Duncan observed small lesions on her face and hands, didn't see Maya move her legs or feet, and said Maya apologized for her "messy hair" which Duncan noted didn't appear to be too disheveled, but needed a wash.

The 11-year-old expressed frustration that medical professionals didn't believe when she told them she was in pain or felt ill, Duncan said, and Maya expressed a dislike for social worker Catherine Bedy, one of the people she said interfered with her communication with others.

"As a result of the lack of coherent approach, it appears that she received little to no medical treatment with hospital administration and DCF insisting her condition was psychological," a sentence in Duncan's report said.

Duncan also reported that prior to Maya Kowalski being removed from her home, there was no evidence that Beata Kowalski suffered from mental health problems.

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Ethen Shapiro, counsel for the hospital, pointed out that when Maya spoke with Dr. James Lewis, a neurophysiologist whose report Duncan reviewed, she said she was told her RSD was because of her asthma attacks, she didn’t know what to believe, she knew she had a 50% chance of dying during the ketamine-induced coma and she didn’t want to be on all the medications.

Shapiro in his questioning of Duncan also pointed out that it was Beata and Jack Kowalski who refused to transfer their daughter to Nemours Children’s Specialty Care, a pediatric health center in Orlando, where Maya Kowalski would have received physical, occupational, and cognitive behavioral therapies.

Shapiro also pressed Duncan about whether Maya Kowalski had ever outright complained of being physically abused, inappropriately touched, or being held down while semi-nude for photos that were taken while at the hospital. Duncan said Maya never outright said those words, and if she had, she would have reported it as she's a mandatory reporter.

Catholic priest, community member testify about Maya’s stay in hospital

Linda Brown, a member of Epiphany Church and Legion of Mary, recalled how she and another member of the Kowalski’s church drove up to St. Petersburg after Beata Kowalski called in hysterics about Maya Kowalski being taken from her family.

When Brown entered the hospital room, she described Maya Kowalski as sitting on her hospital bed with her legs crisscrossed and was excited to see Brown, who gave her a big hug. Right after, Brown said she felt a dark presence enter the room.

“We were the light coming in and there was the devil behind me,” Brown said, adding she and the second church member were told they couldn’t be in the room and had to leave.

When the two members tried explaining why they were at the hospital — to drop off a statuette of Mother Mary, some rosaries and a prayer book for Maya Kowalski to pray with — they were told they couldn’t leave anything in the room with Maya.

Patricia Crauwels, another attorney representing the hospital, asked Brown if she had checked in with security or received a visitor’s badge before seeing Maya, but Brown said she hadn’t. She also added she didn’t know there were restrictions on who could visit Maya Kowalski.

Father Jack Costello, a retired rector of Epiphany Church, was the family’s priest and heard about their plight from another congregation member in the fall of 2015. Following an initial meeting, Costello helped raise over $14 thousand to help the family pay for Maya’s ketamine-infusion treatment in Monterrey, Mexico.

Costello was able to meet with Maya Kowalski at least two times in the hospital, however, during the initial meeting he wasn’t allowed to speak with Maya about anything related to religion, he said. It was insinuated that Beata Kowalski was attempting to control her daughter through religion, according to testimony.

Costello also told the jury that Beata Kowalski confided in him at one point around the time of a court dependency hearing that her daughter was deteriorating at the hospital, and they needed to bring her home, as well as that she was being blamed for her daughter’s illness.

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: Jury hears from family physician, psychologist in 'Maya' trial