UPDATE: All Children’s must also pay $50 million in punitive damages in Maya case

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VENICE — Johns Hopkins All Children’s Hospital falsely imprisoned and battered a 10-year-old Venice girl and contributed to her mother’s suicide, according to a jury that awarded damages of more than $261 million to her family.

In a major legal defeat for the St. Petersburg hospital, the jury on Thursday found that the hospital engaged in “extreme and outrageous” conduct in its treatment of Maya Kowalski and her family after an October 2016 emergency room visit. The girl’s mother, Beata Kowalski, took her own life after Maya was removed by the state and sheltered at All Children’s for three months.

The jury of four women and two men sided with the Kowalskis on every question they were asked to adjudicate. All Children’s conduct contributed to Beata’s Kowalski’s death, they said, and the hospital falsely imprisoned Maya when it blocked the family from leaving the hospital with their child.

Damages were awarded for the hospital’s decision to place the then 10-year-old girl in a room equipped with video surveillance for 48 hours and to strip her down to her shorts and training bra and photograph her without permission from her parents or a court.

There was also an award for the conduct of a hospital social worker who conducted the photography of the girl and who sometimes kissed and hugged the girl and sat her on her lap.

An award of $50 million in punitive damages for the counts of false imprisonment and battery were made after a second jury deliberation Thursday evening. Punitive damages are intended to punish harmful behavior and deter similar future conduct.

Maya, now 17, said it had been tough to hear what she described as misrepresentations of her mother during the trial. She wanted a verdict that would clear her mother’s name, she said.

“It was about the answer, knowing that my mom was right,” she said. For the first time, I feel like I got justice,”

The verdict in a sometimes fractious eight-week civil trial in Sarasota County came on the third day of jury deliberation. As it was read to the court, the family, who had fought for five years to get the case in front of a jury, sobbed and held each other. Maya clung onto her mother’s rosary beads.

In addition to the financial blow to All Children’s, the case has generated worldwide headlines after it was turned into a documentary called “Take Care of Maya.” Released on Netflix, it was viewed almost 14 million times in the first two weeks after its June release.

Hospital attorneys said they will appeal the verdict based on “clear and prejudicial errors” and accused the Kowalskis’ attorneys of misleading the jury.

“The facts and the law remain on our side, and we will continue to defend the lifesaving and compassionate care provided to Maya Kowalski by the physicians, nurses and staff of Johns Hopkins All Children’s Hospital and the responsibility of all mandatory reporters in Florida to speak up if they suspect child abuse,” said attorney Howard Hunter in a statement.

In closing statements on Monday, Greg Anderson, lead counsel for the Kowalski family, characterized the hospital’s defense of its actions as “revisionist history” that attempted to blame the family for the hospital’s mistreatment of Maya and her mother. All Children’s doctors, he said, wanted to punish a mother who dared to question their medical expertise.

“What was the purpose of all this other than arrogance and the belief they could get away with it,” he said.

Maya already had a diagnosis and had been treated for complex regional pain syndrome roughly a year before her family brought her to All Children’s.

But doctors there were skeptical of the diagnosis and, instead, called the state abuse hotline to report Maya’s mother, Beata Kowalski, for suspected medical child abuse. After a child protection investigation, a judge ordered that Maya be removed from her family and sheltered at the hospital. After 3 months with no physical contact with her daughter, Beata Kowalski took her own life.

Judge Hunter Carroll had ruled before the trial that the hospital could not be blamed for the state’s decision to shelter Maya at the hospital nor for a decision by doctors to report Beata Kowalski to the abuse hotline.

Attorneys for the Kowalskis centered their case on the hospital’s failure to treat Maya for the pain syndrome, a rare neurological condition that can cause spontaneous and often excessive pain from something as mild as a touch.

Pradeep Chopra, a pain management and anesthesiology doctor from Rhode Island who provided the dependency court with an evaluation of Maya’s medical condition, testified that the girl had the rare pain syndrome often nicknamed the suicide condition because the pain can be so debilitating.

In doing that, he said, All Children’s doctors deviated from the accepted standard of care for the pain condition and caused Maya’s health to worsen. She had previously been treated with infusions of ketamine, an anesthetic drug.

Timothy Brewerton, an adult and pediatric forensic psychiatrist, testified that Maya; her brother, Kyle Kowalski; and her father, Jack Kowalski, all suffer from post-traumatic stress disorder, major depressive disorder and complicated traumatic bereavement from the trauma they endured.

Maya cried as she testified about her separation from her mother and how she was told she would not be able to attend a court hearing where her mother would be present if she did not agree to being photographed.

Joseph Corcoran, a retired hospital administrator who reviewed reports on All Children’s as a witness for the family, told jurors that All Children’s employees had reported a culture of retaliation against those who spoke up and that the hospital’s organization prevented effective oversight by its governing board.

“It was a totally dysfunctional organization and the Kowalskis paid the price,” Anderson said Tuesday during closing statements.

All Children’s attorney Ethen Shapiro said the hospital’s treatment of Maya was safe and evidence based. The hospital decided against settling the case out of court because it would have a chilling effect on those in the medical field and others who are required by law to report suspected child abuse.

The hospital’s defense included testimony and medical documents showing that doctors from other hospitals who had treated Maya were also skeptical of the pain syndrome diagnosis. Their notes included references to her condition including a psychological component or conversion disorder, where a patient experiences pain or other symptoms even though there is no underlying cause.

The defense also showed the jury emails written by Beata Kowalski that they said showed that ketamine treatments were causing memory loss and hallucinations. One referred to when the family went to Mexico for a ketamine coma, a procedure where a patient is given a dose high enough to induce a coma that lasts several days. The procedure is not approved by the FDA.

Shapiro said Maya’s medical records confirmed what other doctors had testified: her medical history was one of “unnecessary medication given at dangerous levels.”

Hospital doctors were right to report suspected child abuse and to question the treatment her parents were demanding when they arrived at the hospital, he said.

The coward’s way out is to let them leave,” Shapiro said. “People who care about children do not let that child walk out the door without talking to the family.”