WEBVTT - Introducing: Nobody Should Believe Me — The Catalyst | EP 1 0:00:00.240 --> 0:00:02.880 Please note that this show discusses child abuse, which may 0:00:02.920 --> 0:00:06.640 be difficult for some listeners. For resources about abusive head trauma, 0:00:06.680 --> 0:00:08.399 go to shakenbaby dot org. 0:00:10.680 --> 0:00:13.600 Take care of Maya Trial new details as well, and 0:00:13.600 --> 0:00:15.840 now take care of Maya Trial well. Maya Kowalski and 0:00:15.920 --> 0:00:18.400 her family have waited out five years to hear a 0:00:18.480 --> 0:00:21.760 verdict and their two hundred and twenty million dollar lawsuit 0:00:21.840 --> 0:00:23.959 against Johns Hopkins All Children's. 0:00:23.520 --> 0:00:26.840 Hospital, And did the conduct of Johns Hoist All Children's 0:00:26.840 --> 0:00:28.120 Hospital in fact? 0:00:28.360 --> 0:00:29.479 Are my class? 0:00:31.360 --> 0:00:35.199 What happened to Maya? That was the question posed by 0:00:35.240 --> 0:00:38.520 Diane Neary in her viral feature for New York Magazine 0:00:38.520 --> 0:00:41.600 that ran in the fall of twenty twenty two. There 0:00:41.800 --> 0:00:45.479 was that headline, along with a closeup of Maya Kowalski's eyes. 0:00:46.000 --> 0:00:49.000 I remember reading this article long before I'd end up 0:00:49.040 --> 0:00:52.920 reading thousands of pages of court documents, medical records, testimony, 0:00:52.960 --> 0:00:57.280 and police records about the case and thinking, I don't 0:00:57.320 --> 0:01:02.120 think this reporter understands what actually happened here. And then 0:01:02.160 --> 0:01:05.160 of course there was the Netflix film. 0:01:05.280 --> 0:01:08.399 No matter what we did, the court sided with the 0:01:08.440 --> 0:01:09.480 hospital staff. 0:01:09.840 --> 0:01:12.520 Judget don't care about the evidence. 0:01:12.360 --> 0:01:14.880 You don't get to the truth by accepting was in 0:01:14.880 --> 0:01:17.679 front of you without questioning it. And I realized that 0:01:17.720 --> 0:01:19.760 this was a lot bigger than just the kowalskis. 0:01:21.080 --> 0:01:23.920 How many times are you allowed to be wrong and 0:01:24.000 --> 0:01:27.080 destroy lives before they say, okay, that's enough. 0:01:28.000 --> 0:01:31.679 These families walked in hoping for help for their child, 0:01:32.600 --> 0:01:34.760 and some of them walked down in handcuffs. 0:01:38.640 --> 0:01:41.480 And this was followed by a high profile court battle. 0:01:42.200 --> 0:01:44.160 Nobody Should Believe Me had been on the air for 0:01:44.160 --> 0:01:46.440 about a year at this point, and this was the 0:01:46.440 --> 0:01:49.760 biggest story about Munchausen by proxy since Gypsy Rose blanched. 0:01:50.320 --> 0:01:52.600 So I felt like I needed to address it. I 0:01:52.680 --> 0:01:56.040 pulled in some experts for a roundtable discussion about the film. 0:01:56.320 --> 0:02:00.080 My impressions were was a huge opportunity lost. What they 0:02:00.120 --> 0:02:02.320 could have done is looked at the actual issues in 0:02:02.360 --> 0:02:04.800 this abuse. They could have looked at, you know, in 0:02:04.840 --> 0:02:05.400 this case. 0:02:05.200 --> 0:02:07.400 There was and that was all I originally planned to do, 0:02:08.080 --> 0:02:12.040 but everyone else just kept getting it so wrong. But 0:02:12.120 --> 0:02:14.520 it is not the person who's doing the medical record 0:02:14.560 --> 0:02:17.000 reviews job to interview every doctor. 0:02:17.120 --> 0:02:20.960 It's to look through those records. And that is how 0:02:22.080 --> 0:02:22.840 how do you get that? 0:02:23.400 --> 0:02:25.440 Why do you believe that that's the case if she 0:02:25.560 --> 0:02:28.720 is making if she is the sole person making the 0:02:28.800 --> 0:02:30.359 recommendation to. 0:02:30.320 --> 0:02:33.680 The judge, the judge is relying on. She was not 0:02:33.840 --> 0:02:35.640 the sole person. She was not the sole person. I'm 0:02:35.680 --> 0:02:36.200 sorry there was. 0:02:36.320 --> 0:02:42.600 There was Affi David's and testimony other doctors Johns Hopkins 0:02:41.760 --> 0:02:45.880 in What actually happened to Maya Kwalski is that she 0:02:46.120 --> 0:02:50.880 was the victim of extremely well documented Munchausen by proxy abuse. 0:02:51.600 --> 0:02:55.079 In the year preceding her faithful hospitalization at Johns Hopkins 0:02:55.080 --> 0:02:59.480 All Children's, Maya Kowalski was subjected to fifty five infusions 0:02:59.520 --> 0:03:04.079 of ketmie, a powerful drug that can cause hallucinations, memory loss, 0:03:04.080 --> 0:03:09.079 and bladder issues, among other side effects. Her treatment course 0:03:09.120 --> 0:03:13.760 also included a highly experimental five day ketamine coma in Mexico, 0:03:14.360 --> 0:03:18.600 doctor Fernando Cantu, who performed the treatment, told Maya's parents 0:03:18.639 --> 0:03:22.160 that the procedure had a fifty percent chance of death. 0:03:23.040 --> 0:03:27.160 Maya was pulled from school wheelchair bound and dangerously underweight. 0:03:27.720 --> 0:03:32.680 Her mother, Beata Kowalski, an infusion nurse by trade, administered ketamine, 0:03:32.840 --> 0:03:37.320 delauded and other drugs orally intramuscularly and into Maya's port 0:03:37.400 --> 0:03:42.040 at home, often against doctor's orders. Biata talked online and 0:03:42.080 --> 0:03:45.040 elsewhere about Maya's impending death and pushed to get her 0:03:45.080 --> 0:03:48.920 daughter labeled as terminal and attempted to seek out hospice care, 0:03:49.320 --> 0:03:52.600 despite the fact that complex regional pain syndrome isn't a 0:03:52.680 --> 0:03:56.680 terminal diagnosis, and that diagnosis was handed out to Maya 0:03:56.760 --> 0:04:00.760 by a dubious doctor after three world class hospitals diagnosed 0:04:00.760 --> 0:04:05.440 her with conversion disorder. On October seventh, twenty sixteen, when 0:04:05.440 --> 0:04:09.560 Maya was hospitalized with reports of excruciating pain, Biatta told 0:04:09.560 --> 0:04:12.400 staff at Johns Hopkins All Children's that if they refused 0:04:12.440 --> 0:04:15.120 to administer the unheard of amount of ketamine she was 0:04:15.120 --> 0:04:19.080 requesting that they quote might as well consult hospice so 0:04:19.120 --> 0:04:22.200 she can finally get enough medication and just let her die. 0:04:23.520 --> 0:04:26.440 So how did such a clear and obviously life threatening 0:04:26.440 --> 0:04:29.800 case of abuse get twisted into a story about evil 0:04:29.839 --> 0:04:38.719 doctors kidnapping a child? What was going on here? Once 0:04:38.760 --> 0:04:42.120 I started pulling at this thread, I couldn't stop the case, 0:04:42.120 --> 0:04:45.400 and the civil trial consumed my life for months. We 0:04:45.520 --> 0:04:47.960 just recapped this case in a mini series. By the way, 0:04:48.080 --> 0:04:50.160 if you don't have time to listen to the previous 0:04:50.320 --> 0:04:53.880 eighteen episodes I made about this. I ended up covering 0:04:53.920 --> 0:04:57.240 the trial as it unfolded over eight weeks, ending in 0:04:57.240 --> 0:05:00.440 a jury awarding the Kuwalski's two hundred and se sixty 0:05:00.480 --> 0:05:04.200 one million dollars, and two years later, the story continues 0:05:04.240 --> 0:05:08.120 to unfold. Late last year, a Florida appeals court vacated 0:05:08.120 --> 0:05:11.760 the verdict and the Kowalski's request to reconsider the appealed 0:05:11.760 --> 0:05:15.320 decision was denied. And as all this has been playing 0:05:15.320 --> 0:05:18.640 out in court, the impact of Kowalski v. Johns Hopkins 0:05:18.720 --> 0:05:21.800 has been felt far and wide because, as reporter Daphne 0:05:21.920 --> 0:05:24.440 Chen said in the trailer you just heard, this has 0:05:24.560 --> 0:05:29.120 always been bigger than just the Kowalskis. Kowalski lit the match, 0:05:29.520 --> 0:05:32.200 and no matter what ultimately happens in their court battle, 0:05:32.640 --> 0:05:38.000 the fire won't easily be contained. People believe their eyes. 0:05:38.680 --> 0:05:41.799 That's something that is so central to this topic, because 0:05:42.200 --> 0:05:43.960 we do believe the people that we love when they're 0:05:44.000 --> 0:05:47.240 telling us something. If we didn't, you could never make 0:05:47.279 --> 0:05:51.440 it through your day. I'm Andrea Dunlop, Welcome to Season 0:05:51.560 --> 0:06:09.640 seven of Nobody Should Believe Me. The Kowalski's legal battle 0:06:09.680 --> 0:06:12.160 had already been going on for years by the time 0:06:12.200 --> 0:06:15.599 this story got traction in the media. Jack Kowalski filed 0:06:15.600 --> 0:06:20.000 his original lawsuit in October of twenty eighteen, two years 0:06:20.120 --> 0:06:23.479 almost to the day after Maya was originally hospitalized with 0:06:23.520 --> 0:06:26.280 the defendant, Johns Hopkins All Children's So. 0:06:26.320 --> 0:06:30.839 The original lawsuit against Johns Hopkins All Children's Hospital, brought 0:06:30.839 --> 0:06:35.080 by the Kowalski family alleged a lot of things, some 0:06:35.120 --> 0:06:39.720 of which were dismissed before trial. The original lawsuit brought 0:06:39.760 --> 0:06:45.120 claims for everything from malicious prosecution for the hospital and 0:06:45.200 --> 0:06:49.520 their healthcare providers, calling the Department of Children and Family 0:06:49.680 --> 0:06:54.480 Services reporting suspicions of medical child abuse and neglect. 0:06:55.000 --> 0:06:57.680 We spoke to Ethan Shapiro, an attorney for Johns Hopkins 0:06:57.760 --> 0:07:01.040 All Children's about how this court case and its aftermath 0:07:01.120 --> 0:07:01.800 have played out. 0:07:02.640 --> 0:07:08.000 The counts that survived included everything from medical malpractice for 0:07:08.279 --> 0:07:12.760 the alleged misdiagnosis of medical child abuse, the alleged failure 0:07:12.880 --> 0:07:16.720 to give what we considered to be extreme doses of 0:07:16.800 --> 0:07:21.280 ketamine and other dangerous drugs. There were allegations of battery, 0:07:21.360 --> 0:07:26.400 and there were allegations of intentional infliction of emotional distress, 0:07:26.440 --> 0:07:30.240 some of which the family alleged caused the mother to 0:07:30.240 --> 0:07:33.720 commit suicide. As you saw from the appellate court ruling, 0:07:34.280 --> 0:07:38.080 the Appella Court sided with my client, JOHNS. Hopkins All 0:07:38.160 --> 0:07:43.160 Children's Hospital, ultimately finding that the hospital complied in good 0:07:43.160 --> 0:07:47.440 faith with the mandatory protection statutes and were not liable 0:07:47.840 --> 0:07:49.800 as a matter of law or as a matter of 0:07:49.840 --> 0:07:53.720 fact for the unfortunate death of missus Kowalsky. 0:07:55.040 --> 0:07:58.000 There were two possible far reaching issues with the Kowalski 0:07:58.120 --> 0:08:01.440 verdict had it wisted appeal. One is the potential legal 0:08:01.480 --> 0:08:04.720 precedent set by allowing a family to claim damages against 0:08:04.760 --> 0:08:08.320 an institution for a suicide, and the other, of course, 0:08:08.560 --> 0:08:11.360 was holding the hospital libel for reporting abuse. 0:08:12.120 --> 0:08:17.600 The attempts to hold healthcare providers liable for mandatory reporting 0:08:17.680 --> 0:08:21.440 under Chapter thirty nine are rare, but not unheard of. 0:08:22.200 --> 0:08:25.600 In fact, if you looked at the published decisions, a 0:08:25.640 --> 0:08:28.800 lot of them are for the flip side, where you know, 0:08:28.880 --> 0:08:32.439 for example, a parent whose child was ultimately abused or 0:08:32.520 --> 0:08:36.600 harmed is suing a state agency or a mandatory reporter 0:08:37.120 --> 0:08:40.880 for failing to report suspected abuse. I think for example, 0:08:41.160 --> 0:08:44.120 you know, in a case of a contested divorce where 0:08:44.160 --> 0:08:47.319 a child reports symptoms of sexual abuse to a teacher 0:08:47.360 --> 0:08:50.120 and the teacher doesn't bring that forward, you could see 0:08:50.120 --> 0:08:54.120 a situation where the other custodial parent finds out about 0:08:54.120 --> 0:08:56.960 that and then would have a lawsuit or potential prosecution 0:08:57.040 --> 0:09:00.440 against a mandatory reporter. Now, all of that being said, 0:09:00.480 --> 0:09:04.760 we've seen a spate of these lawsuits more in frequency 0:09:05.320 --> 0:09:09.560 since the Kowalski case, since the movie, and since the 0:09:09.559 --> 0:09:13.640 fact that it survived the initial motions to dismiss based 0:09:13.679 --> 0:09:19.200 on statutory immunity. How often do we see these types 0:09:19.240 --> 0:09:22.559 of cases go to trial? Incredibly rare, and I think 0:09:22.559 --> 0:09:24.679 they're going to become more rare now that the Second 0:09:24.720 --> 0:09:30.040 District Court of Appeal has reaffirmed statutory rights and immunities 0:09:30.040 --> 0:09:31.280 for mandatory reporters. 0:09:32.679 --> 0:09:36.840 The Kowalski lawsuit and its imitators position this legal battle 0:09:37.080 --> 0:09:41.280 very clearly as a parent's rights issue, claiming that quote 0:09:41.480 --> 0:09:45.400 doctor Smith and Johns Hopkins all Children's knowingly and recklessly 0:09:45.520 --> 0:09:49.679 violated Jack and Beata's constitutional right to make medical decisions 0:09:49.720 --> 0:09:53.960 for their child by refusing to discharge Maya following repeated 0:09:54.000 --> 0:09:57.080 requests from Jack and Beata and by conspiring to abuse 0:09:57.120 --> 0:10:01.000 a process and legislative provisions designed to purtat children from 0:10:01.040 --> 0:10:04.280 imminent harm. And while some of the counts of the lawsuits, 0:10:04.280 --> 0:10:07.760 such as conspiracy, malicious prosecution, and the First and Fourteenth 0:10:07.800 --> 0:10:11.520 Amendment claims were dismissed before trial, the spirit of these 0:10:11.559 --> 0:10:15.040 claims remained. The plaintiff's story was that the doctors had 0:10:15.080 --> 0:10:18.120 conspired to separate Maya from her mother. They'd known their 0:10:18.160 --> 0:10:20.960 abuse claims were fake, and they made them anyway, and 0:10:21.040 --> 0:10:24.679 their wanton disregard for this family had driven Biata Kowalski 0:10:24.840 --> 0:10:28.040 to take her own life. And these claims have served 0:10:28.080 --> 0:10:30.599 as inspiration for a number of other lawsuits around the 0:10:30.640 --> 0:10:34.480 country against child abuse pediatricians, and hospitals, from San Diego 0:10:34.559 --> 0:10:39.080 to Minnesota to Pennsylvania. According to these lawsuits, doctors aren't 0:10:39.120 --> 0:10:42.760 just making mistakes. They're all powerful entities who are conspiring 0:10:42.840 --> 0:10:46.000 to remove children from their innocent parents for their own 0:10:46.080 --> 0:10:50.760 financial gain and career advancement. The terminology varies depending on 0:10:50.800 --> 0:10:52.920 the venue, but there is in fact a name for 0:10:53.000 --> 0:10:57.600 all of this medical kidnapping. Like any other conspiracy theory, 0:10:57.760 --> 0:11:00.320 it's hard to trace the exact origins of the term 0:11:00.440 --> 0:11:03.600 medical kidnapping, but it appears to have gained a foothold 0:11:03.640 --> 0:11:07.360 in parents' rights focused internet spaces sometime in the twenty tens, 0:11:07.679 --> 0:11:12.000 and gained significant traction during the highly publicized Justina Pelletier case, 0:11:12.320 --> 0:11:19.240 a precursor lawsuit involving Munchhausen by proxy. Medical kidnapping is 0:11:19.280 --> 0:11:22.600 deeply entwined with the idea that Munchausen by proxy isn't 0:11:22.640 --> 0:11:27.200 a real form of abuse, that every allegation is necessarily false, 0:11:27.600 --> 0:11:31.000 a witch hunt against carrying moms, and that CPS workers 0:11:31.000 --> 0:11:35.280 and physicians are hiding behind their legal immunity protections. This 0:11:35.440 --> 0:11:39.079 concept has even deeper Internet origins than medical kidnapping itself, 0:11:39.520 --> 0:11:43.480 going back to the Mothers Against Munchhausen Allegations website, which 0:11:43.480 --> 0:11:47.160 popped up in the late nineties. Medical kidnapping, like so 0:11:47.240 --> 0:11:50.120 many things, is a fringe idea that has migrated from 0:11:50.120 --> 0:11:53.760 the dark corners of the Internet into mainstream publications such 0:11:53.760 --> 0:11:57.120 as The New York Times and Pro publica People magazine 0:11:57.200 --> 0:11:59.800 where Take Care of Maya producer Caitlin Keating worked when 0:11:59.800 --> 0:12:03.079 she did discovered this story. Published an article in November 0:12:03.160 --> 0:12:06.840 of twenty twenty five, titled where is Maya Kowalski Now? 0:12:07.120 --> 0:12:11.080 All about her life after getting medically kidnapped ten years ago. 0:12:11.600 --> 0:12:15.559 This was weeks after the verdict was reversed. So how 0:12:15.600 --> 0:12:18.760 did we get here and how did hospitals become such 0:12:18.760 --> 0:12:19.319 a target? 0:12:19.920 --> 0:12:24.240 So hospitals are in a very unique situation for children 0:12:24.280 --> 0:12:27.600 that are at risk for suspicions of neglect or abuse 0:12:28.120 --> 0:12:32.280 because often healthcare workers are the frontline defense and being 0:12:32.280 --> 0:12:35.360 able to diagnose it and being able to report it. 0:12:36.120 --> 0:12:38.240 If you think of a situation where a child would 0:12:38.240 --> 0:12:42.160 come into a hospital with an unexplained fracture that couldn't 0:12:42.240 --> 0:12:45.800 be a result of anything other than trauma, and potentially 0:12:45.880 --> 0:12:49.400 trauma in an area that couldn't be explained in the 0:12:49.480 --> 0:12:53.840 absence of intentional abuse, the healthcare worker would be the 0:12:53.880 --> 0:12:56.520 one that would be in the best position to make 0:12:56.559 --> 0:12:59.360 that call of reasonable suspicion to the Department of Children 0:12:59.360 --> 0:13:02.720 and Families. Now, in that unique situation where the child's 0:13:02.760 --> 0:13:06.320 an impatient in the hospital, already the easiest thing for 0:13:06.360 --> 0:13:08.800 the courts to do to try to find an immediate 0:13:08.920 --> 0:13:12.679 safe placement for the child before the court can figure 0:13:12.679 --> 0:13:15.600 out whether one of the custodial parents or perhaps a 0:13:15.640 --> 0:13:19.600 grandparent or a relative could be filled in that role 0:13:19.720 --> 0:13:22.679 is to shelter the child immediately at the hospital. So 0:13:22.800 --> 0:13:27.120 hospitals are put in sort of a precurious position that 0:13:27.360 --> 0:13:32.360 other mandatory reporters don't have to deal with. Think firefighters, 0:13:32.400 --> 0:13:37.319 teachers in some states. Journalists are never going to be 0:13:37.320 --> 0:13:39.760 in the situation that the person making the report may 0:13:39.800 --> 0:13:43.120 also be the person required by order of the court 0:13:43.160 --> 0:13:46.199 to provide safe shelter to the child in the short 0:13:46.240 --> 0:13:47.280 and the medium term. 0:13:48.040 --> 0:13:52.560 And does a hospital, once a child is sheltered there, 0:13:52.640 --> 0:13:55.600 does a hospital have any choice about whether or not 0:13:55.640 --> 0:13:58.400 to keep that child there Under the law, No. 0:13:58.760 --> 0:14:01.920 The hospital is required to follow the court order, just 0:14:01.960 --> 0:14:05.280 as anyone would be required to follow the court order. Now, 0:14:05.320 --> 0:14:09.960 the hospital can make recommendations as to what they believe 0:14:10.000 --> 0:14:11.800 is in the best interests of the child from a 0:14:11.840 --> 0:14:16.600 medical standpoint, for whatever medical treatment is necessary. And if 0:14:16.640 --> 0:14:20.800 you remember back to the Kwalski case, once all children 0:14:21.000 --> 0:14:26.480 reasonably believe that Maya would have benefited from intensive impatient 0:14:26.600 --> 0:14:30.880 or outpatient psychotherapy to treat whatever her pain syndrome was, 0:14:31.920 --> 0:14:35.240 they made a recommendation to transfer to Nemours Hospital in Orlando, 0:14:35.240 --> 0:14:38.200 who are experts in that so they can make recommendations, 0:14:38.200 --> 0:14:43.479 but absent an order from the court releasing the jurisdiction, 0:14:43.560 --> 0:14:53.320 the hospital has to keep the child in custody. 0:14:53.360 --> 0:14:56.440 There are many worthwhile critiques about how child protection is 0:14:56.480 --> 0:14:58.840 handled in the US, and we're going to dig into 0:14:58.880 --> 0:15:02.280 those this season. But sorry if this is a spoiler. 0:15:02.640 --> 0:15:05.800 There is no evidence that doctors are conspiring to kidnap 0:15:05.920 --> 0:15:10.040 children or even making a significant number of incorrect abuse diagnoses. 0:15:10.600 --> 0:15:13.400 So why has this idea gotten so much traction? What 0:15:13.600 --> 0:15:14.720 is this actually about? 0:15:15.400 --> 0:15:18.920 I think what the plaintiff ultimately wanted to try was 0:15:18.920 --> 0:15:23.160 a civil rights case. And Andrew, when you spoke earlier 0:15:23.200 --> 0:15:29.320 about this, you know, influx of what's been called generously 0:15:29.360 --> 0:15:32.560 a parents' rights movement, which is always in tens with 0:15:32.680 --> 0:15:35.840 what may be best for the child. This case was, 0:15:36.320 --> 0:15:40.280 in the plaintiff's mind, one of those cases in the forefront. 0:15:40.960 --> 0:15:44.800 They brought constitutional actions that were dismissed. I mean, you 0:15:45.000 --> 0:15:49.800 heard the backstory from the Kwalskis escaping a communist system 0:15:50.680 --> 0:15:54.480 with the implication to only find themselves, you know, at 0:15:54.560 --> 0:15:59.960 the center of a deep state conspiracy, amongst multiple acts 0:16:00.440 --> 0:16:04.200 to harm Maya and target the mother for reasons that 0:16:04.240 --> 0:16:07.440 were never fully explained, at least not with evidence, and 0:16:07.520 --> 0:16:09.680 as a second district said, there was no evidence of 0:16:10.120 --> 0:16:15.160 any intent directed at YadA Kuwalski whatsoever. But that was 0:16:15.200 --> 0:16:18.160 certainly what they wanted to put in front of the jury, 0:16:19.320 --> 0:16:20.960 and that was certainly one of the things that they 0:16:20.960 --> 0:16:24.640 thought that they could exploit for the purpose. From my 0:16:24.760 --> 0:16:28.720 perspective of drumming up dureror emotions, the. 0:16:28.680 --> 0:16:32.760 Plaintiff's lawyers and the Netflix film told an emotionally evocative 0:16:32.800 --> 0:16:36.040 story about a suffering family, but by leaving out so 0:16:36.240 --> 0:16:40.360 much crucial information, that story obscured a very big question. 0:16:41.040 --> 0:16:43.760 What would have happened if there hadn't been a report? 0:16:44.200 --> 0:16:47.600 What if Beata had been allowed to carry on? Should 0:16:47.680 --> 0:16:50.640 parents just be allowed to give their children fifty to 0:16:50.720 --> 0:16:54.120 one hundred times the recommended dose of ketamine and subject 0:16:54.120 --> 0:16:57.480 them to experimental procedures that carry a fifty percent risk 0:16:57.560 --> 0:17:01.360 of death? According to Jack Kwall's these post vertic comments 0:17:01.360 --> 0:17:02.920 in the press, Yes. 0:17:03.600 --> 0:17:05.360 Parents have rights and. 0:17:06.800 --> 0:17:11.399 They make the decision for their children. Ethan disagrees. 0:17:12.040 --> 0:17:15.399 So hospitals are not burgering. You can't walk into a 0:17:15.480 --> 0:17:19.680 hospital and have it your way and demand medical careent 0:17:19.760 --> 0:17:25.199 that is wildly outside accepted medical standards. You can't do 0:17:25.320 --> 0:17:28.359 it for yourself, and it's going to draw extra scrutiny 0:17:28.400 --> 0:17:31.080 if you're going to demand it on behalf of a 0:17:31.160 --> 0:17:35.200 vulnerable child or a vulnerable adult that truly cannot consent 0:17:35.280 --> 0:17:38.560 on their own behalf. And that's fine. Our system is 0:17:38.600 --> 0:17:41.959 set up where we have parents be the natural guardians 0:17:42.080 --> 0:17:46.440 of the children, who are empowered to make reasonable medical decisions, 0:17:46.520 --> 0:17:48.480 just the same way that you can be appointed to 0:17:48.560 --> 0:17:52.240 be the medical guardian for somebody becomes gold and infirm. 0:17:52.680 --> 0:17:56.560 But it doesn't give the guardian the unfettered right to 0:17:56.640 --> 0:18:01.040 demand treatment that medical providers know to be dangerous. You know, 0:18:01.119 --> 0:18:05.600 there are protocols and pathways for the safe treatment of 0:18:06.000 --> 0:18:09.879 chronic regional paident syndrome, for the safe treatment of conversion 0:18:09.920 --> 0:18:14.160 syndrome of factitious disorder, and none of them call for 0:18:14.760 --> 0:18:18.320 doses of ketamine that I think the evidence showed were 0:18:18.359 --> 0:18:22.160 twenty three milligrams per kilogram per hour, which is more 0:18:22.200 --> 0:18:25.639 than what you need to anesetize a two thousand pounds horse. 0:18:26.800 --> 0:18:30.240 So the parents have rights to direct reasonable medical care, 0:18:30.280 --> 0:18:33.600 but they don't have an unfettered right to direct and 0:18:33.680 --> 0:18:35.720 demand dangerous medical care. 0:18:36.280 --> 0:18:38.960 The question of what rights children should have as human 0:18:39.000 --> 0:18:42.560 beings isn't a new one, and the tension between children's 0:18:42.640 --> 0:18:44.960 rights to be safe and cared for and their parents' 0:18:45.000 --> 0:18:47.760 rights to make decisions on their behalf is something that 0:18:47.800 --> 0:18:50.040 hospitals have always been caught in the middle of. 0:18:50.600 --> 0:18:53.320 Hospitals have been dealing with this for years. There are 0:18:53.400 --> 0:18:57.800 religious sects that do not believe in blood transfusions, so 0:18:58.560 --> 0:19:02.199 hospitals have attorney on standby that they call it to 0:19:02.280 --> 0:19:04.880 in the morning to say, we have a child here 0:19:04.920 --> 0:19:07.880 who's been in a horrific accident. The child's bleeding out. 0:19:08.320 --> 0:19:11.760 The only way to survive is to transfuse blood, and 0:19:11.840 --> 0:19:14.240 the parents are saying that they're object on religious and 0:19:14.280 --> 0:19:17.440 moral grounds. We file motions with the court, We wake 0:19:17.520 --> 0:19:20.080 up the judge in the middle of the night, We 0:19:20.160 --> 0:19:23.280 get an order from the judge for immedia blood transfusions, 0:19:23.280 --> 0:19:25.720 and we transfuse the child to save the child's life 0:19:27.119 --> 0:19:31.000 above what the parents' wishes are. That's the tension in 0:19:31.080 --> 0:19:34.879 society where you know your religious rights and your rights 0:19:34.920 --> 0:19:38.800 to direct medical care. We've decided as a society end 0:19:38.880 --> 0:19:41.080 when it's going to jeopardize the life of a child. 0:19:41.920 --> 0:19:44.320 So it's not a new concept. It's not a new 0:19:44.359 --> 0:19:46.800 concept in the law, and it's not isolated to cases 0:19:46.840 --> 0:19:47.080 like this. 0:19:48.240 --> 0:19:51.160 Halfway through the trial, just as the defense was going up, 0:19:51.359 --> 0:19:55.199 Judge Hunter Carroll ruled to dramatically limit testimony pertaining to 0:19:55.280 --> 0:19:59.720 Munchausen biproxy abuse. This was baffling given that the abuse 0:19:59.880 --> 0:20:02.359 was the reason Maya had been separated from her parents 0:20:02.400 --> 0:20:04.919 in the first place, not to mention the fact that 0:20:04.960 --> 0:20:07.479 the plaintiff had already been allowed to assert in their 0:20:07.520 --> 0:20:11.840 opening statement and had one witness testify that Biata Kowalski 0:20:11.920 --> 0:20:15.280 did not have Munchausen biproxy, which they framed as a 0:20:15.280 --> 0:20:18.000 psychological condition rather than a form of abuse. 0:20:18.680 --> 0:20:22.800 So I'm certainly not here to criticize tough decisions made 0:20:22.840 --> 0:20:26.959 by the trial court on evidence. But to your question 0:20:27.320 --> 0:20:34.040 about whether this particular issue brought in the mother's psychological diagnosis, 0:20:34.640 --> 0:20:38.919 there could be ways you could start the trial and 0:20:39.080 --> 0:20:41.520 go through the entire trial where that becomes less of 0:20:41.560 --> 0:20:46.080 an issue. However, if the plaintiffs are permitted to stand 0:20:46.160 --> 0:20:52.280 up an opening argument and talk about how the collective 0:20:52.440 --> 0:20:58.480 they set about to destroy this family with an erroneous 0:20:58.520 --> 0:21:03.480 diagnosis of munch by proxy, or to talk about how 0:21:04.440 --> 0:21:08.200 even though Johns Hopkins All Children's Hospital made the reasonable 0:21:08.240 --> 0:21:11.600 medical choice to try to escalate Maya's condition, whatever it 0:21:11.600 --> 0:21:15.080 may be, to the specialist set nomors, that the family 0:21:15.160 --> 0:21:20.000 objected to that because of this erroneous diagnosis of medical 0:21:20.080 --> 0:21:25.600 child abuse from munchausen Brod proxy. That, from my perspective, 0:21:26.320 --> 0:21:30.680 necessitates the defense to be able to justify to the 0:21:30.760 --> 0:21:33.960 jury that's now heard this testimony for several weeks to 0:21:34.320 --> 0:21:39.480 justify that that diagnosis or that working diagnosis, whether it 0:21:39.520 --> 0:21:42.840 appears in the medical record or on medical billing, was 0:21:42.880 --> 0:21:46.040 made reasonably. And I think the question that you're getting 0:21:46.080 --> 0:21:50.840 to next is if that's true, then why didn't we 0:21:51.480 --> 0:21:54.760 watching this trial get to see all of Sally Smith's 0:21:54.760 --> 0:21:59.119 detailed report that the hospital relied on in part in 0:21:59.320 --> 0:22:01.080 arriving at some more diagnoses. 0:22:01.320 --> 0:22:04.320 And I think you know, importantly with the framing of 0:22:04.359 --> 0:22:08.120 this right, the question is whether there was number one 0:22:08.200 --> 0:22:10.760 cause for concern to make that immediate call, and then 0:22:10.880 --> 0:22:16.879 was there evidence of abuse that necessitated this separation period 0:22:16.880 --> 0:22:19.680 and her being sheltered in the hospital, And in fact, 0:22:19.680 --> 0:22:23.880 there was extensive evidence, And so that's the question. However, 0:22:24.000 --> 0:22:27.960 the plaintiff did have several witnesses testify that Beata, including 0:22:28.000 --> 0:22:32.000 doctor Chopra, who is not an expert on this, that 0:22:32.040 --> 0:22:35.760 Beata Qualsky did not have Munchausen by proxy, and so 0:22:36.000 --> 0:22:38.600 they were permitted to testify, as you said, like in 0:22:38.680 --> 0:22:44.080 the negative, that this was an outrageous allegation and that 0:22:44.200 --> 0:22:46.400 you know, Biata was a caring mother who was making 0:22:46.400 --> 0:22:49.919 appropriate medical decisions. So there was evidence allowed to be 0:22:49.960 --> 0:22:53.159 presented about Munchausen by proxy by the plaintiff. Can you 0:22:53.200 --> 0:22:56.639 talk about the decision that the trial court made halfway 0:22:56.680 --> 0:23:01.640 through the trial, Uh, when it was the defense's turn 0:23:02.040 --> 0:23:02.520 to present. 0:23:03.200 --> 0:23:08.080 So from my perspective sitting at council table, it appeared 0:23:08.160 --> 0:23:13.040 the court wanted to refocus the trial on the remaining 0:23:13.080 --> 0:23:18.560 allegations medical malpractice, intentional infliction of emotional distress, and I 0:23:18.560 --> 0:23:20.960 think there were some battery allegations in there as well. 0:23:21.440 --> 0:23:25.080 And the court's central question was what does the mother's 0:23:25.080 --> 0:23:29.280 state of mind or whether she suffers from this psychological 0:23:29.400 --> 0:23:35.480 diagnosis have to do with whether the hospital provided medically 0:23:35.520 --> 0:23:39.320 acceptable care to Mia Kwalski. In the abstract, that's a 0:23:39.359 --> 0:23:43.560 completely fair question, right because if you take it one 0:23:43.600 --> 0:23:48.159 step back further, my client's position from day one was 0:23:48.680 --> 0:23:52.720 whether this is CRPS or whether it's factitious disorder or 0:23:52.760 --> 0:23:57.600 conversion disorder or a psychological pain response. The treatment for 0:23:57.680 --> 0:24:01.200 this is still not wild doses of ketmie third enough 0:24:01.240 --> 0:24:05.800 to nessetize the horse. Now back to your question, you know, 0:24:05.880 --> 0:24:08.600 in real time from my perspective, and it's just mine 0:24:09.040 --> 0:24:12.639 at defense council table, we felt it necessary to paint 0:24:12.640 --> 0:24:14.680 the full picture for the jury, so we didn't look 0:24:14.760 --> 0:24:18.119 like monsters that were coming up with this diagnosis to 0:24:18.200 --> 0:24:22.919 target the family. But in the abstract, that was the 0:24:22.960 --> 0:24:25.440 way the court was looking at the question in real time, 0:24:26.280 --> 0:24:30.080 and you know, certainly that affected the presentation of evidence 0:24:30.119 --> 0:24:30.480 after that. 0:24:31.760 --> 0:24:36.879 Yeah, because while there was quite a lot of evidence 0:24:37.240 --> 0:24:40.720 that was admitted at trial and during the pre trial period. 0:24:40.760 --> 0:24:43.399 I mean, this has been one of the benefits as 0:24:43.400 --> 0:24:45.600 a journalist about reporting on this case is that we 0:24:45.840 --> 0:24:49.639 just have so much information to work with, there are 0:24:49.680 --> 0:24:53.920 only pieces of that that were actually presented at trial. 0:24:55.000 --> 0:24:57.720 I don't think beyondest blog was ever presented at trial, 0:24:57.760 --> 0:24:59.639 which was a pretty strong piece of evidence. And so 0:24:59.720 --> 0:25:03.639