The highly publicized ‘Take Care of Maya’ trial has captivated audiences, bringing to light the complex and tragic story of the Kowalski family and Johns Hopkins All Children’s Hospital. A central figure in this legal battle is Doctor Sally Smith, whose testimony for the defense has been pivotal in understanding the hospital’s perspective and the controversial allegations of medical child abuse. This article delves into the crucial testimony of Doctor Sally Smith, exploring her background, her involvement in Maya Kowalski’s case, and the key points she raised during the trial.
The Background of Doctor Sally Smith and Her Role
Doctor Sally Smith is an experienced professional with a long-standing career in child protection. Prior to Johns Hopkins All Children’s Hospital’s acquisition, she dedicated 12 years of service to the institution. Furthermore, her expertise extended to the Child Protection Team in Pinellas County, where she collaborated on cases of child abuse and neglect. It’s important to note, as Doctor Sally Smith clarified in her testimony, that while the Department of Children and Families relies on the Child Protection Team, it is not directly managed by them. Instead, the team acts as an independent entity providing evaluations in situations where a child’s safety might be compromised.
In 2016, when Maya Kowalski’s case emerged, Doctor Sally Smith held the position of medical director for the Child Protection Team. While she wasn’t a direct employee of Johns Hopkins All Children’s Hospital at that time, she maintained medical staff privileges and participated in several hospital committees as a community representative. This background established her as a figure with authority and experience in child welfare, making her testimony particularly significant in the context of the trial.
Initial Concerns and Involvement in Maya Kowalski’s Case
Doctor Sally Smith’s involvement in Maya Kowalski’s case began with a referral from Dr. Beatriz Teppa-Sanchez. Dr. Teppa-Sanchez, a physician at Johns Hopkins All Children’s Hospital, raised concerns about a potential case of Munchausen syndrome by proxy. This referral, made just two days after Maya Kowalski was admitted to the hospital, initiated the involvement of the Child Protection Team and, consequently, Doctor Sally Smith.
Pictured: Beata and Maya Kowalski
Alt text: Beata Kowalski and her daughter Maya Kowalski pictured together, relevant to the ‘Take Care of Maya’ trial and Doctor Sally Smith’s involvement.
Dr. Teppa-Sanchez’s concerns stemmed from observations in the pediatric intensive care unit (PICU) where Maya and her mother, Beata Kowalski, were present. She noted a chaotic environment and, crucially, the persistent demands from both Maya and Beata for ketamine to manage Maya’s pain. Maya had been previously diagnosed with Complex Regional Pain Syndrome (CRPS) by a physician unaffiliated with Johns Hopkins, who had also prescribed the ketamine treatments. This context of pre-existing CRPS diagnosis and ketamine use became a critical point in the subsequent legal proceedings and Doctor Sally Smith’s evaluation.
Doctor Sally Smith’s Medical Evaluation and Testimony
Upon receiving the referral, the Child Protection Team requested a medical evaluation, and Doctor Sally Smith, in her role as medical director, was tasked with this assessment. She clarified that her initial contact was a consultation based on concerns raised by Dr. Teppa-Sanchez. As part of this consultation, Doctor Sally Smith accessed Maya’s medical records to understand the child’s medical history and the circumstances surrounding her hospital admission. However, at this stage, Doctor Sally Smith did not directly examine Maya.
It was only after the hospital staff contacted the Child Abuse Hotline, triggering a formal investigation, that Doctor Sally Smith was officially asked to conduct a medical evaluation on behalf of the Child Protection Team. This evaluation was intended to assist investigators in assessing the allegations of potential child abuse. Doctor Sally Smith’s testimony highlighted that her role was to provide expert medical insight to the ongoing investigation, rather than to directly dictate Maya’s medical treatment within the hospital.
Pictured: Maya Kowalski
Alt text: Maya Kowalski, a central figure in the ‘Take Care of Maya’ trial, shown in a photograph relevant to Doctor Sally Smith’s involvement in her case.
During her testimony, the Kowalski family’s attorney, Gregory Anderson, questioned Doctor Sally Smith about the extent of her involvement in Maya’s care. While Doctor Sally Smith maintained she wasn’t directly involved in treatment decisions like medication orders, she acknowledged that her evaluation of potential medical child abuse included considering the implications of altering Maya’s medication regime. This nuanced point became a subject of contention, with the plaintiff’s attorney attempting to portray Doctor Sally Smith as having more influence over Maya’s hospital care than she claimed.
The Hospital’s Stance and Doctor Sally Smith’s Expert Opinion
A critical aspect of Doctor Sally Smith’s testimony revolved around the reasons why Maya was kept at Johns Hopkins All Children’s Hospital under state custody. Following the child abuse allegations and investigation, a judge ordered Maya to be sheltered at the hospital. This meant Maya could not be discharged to her family or another facility and was separated from her mother, Beata Kowalski. Tragically, Beata Kowalski died by suicide after being separated from Maya for 87 days.
The Kowalski family’s lawsuit against Johns Hopkins All Children’s Hospital for $220 million alleges that the hospital’s actions directly led to Beata Kowalski’s death. The hospital, however, chose to go to trial, with defense attorney Ethan Shapiro stating they aimed to defend the hospital and its staff against what they deemed “unfounded” allegations. Shapiro argued that the case had created a “chilling effect” on mandatory reporting of medical child abuse nationwide, emphasizing the hospital’s intent to stand up for mandatory reporters like Doctor Sally Smith and the medical staff involved.
Doctor Sally Smith testified that she examined Maya while the child was in the PICU. She recounted seeing Maya twice, for approximately 10 minutes each time, and communicating with Maya’s physicians. While she did not directly write orders in Maya’s chart, her professional opinion as a child abuse expert was clearly sought and considered by the hospital.
Maya Kowalski
Alt text: Maya Kowalski pictured in a hospital setting, reflecting the context of Doctor Sally Smith’s evaluation and testimony during the ‘Take Care of Maya’ trial.
During her medical examination, Doctor Sally Smith noted Maya’s refusal to undergo a physical exam. She also mentioned her responsibility to document her findings for investigators, including attempting to photograph Maya’s lower extremities to assess for any physical issues. Doctor Sally Smith also detailed taking an extensive medical history from Beata Kowalski and a shorter interview with Jack Kowalski. She emphasized that these interviews were conducted separately and in the presence of child protective investigators and law enforcement officers, highlighting the formal and investigative nature of these interactions. Importantly, Doctor Sally Smith clarified that during her meetings with the Kowalskis, she identified herself as Doctor Sally Smith from the Child Protection Team, wearing her Johns Hopkins All Children’s Hospital identification badge, but not a lab coat, to maintain a less intimidating demeanor.
Dr. Sally Smith testifies for the defense.
Alt text: Doctor Sally Smith providing testimony for the defense, a crucial aspect of the ‘Take Care of Maya’ trial coverage.
Cross-Examination and Key Admissions by Doctor Sally Smith
During cross-examination, several key points emerged from Doctor Sally Smith’s testimony. She confirmed her resignation from the Child Protection Team in July 2022. Crucially, she stated that as part of her evaluation, she did request that Maya be taken off all medications. Her rationale was to observe Maya’s condition without the influence of medication, a standard procedure in cases where medical child abuse is suspected. However, she also acknowledged that the hospital’s treatment team was already in the process of weaning Maya off medications, suggesting this was a parallel decision driven by clinical considerations as well.
Maya in a hospital bed.
Alt text: Maya Kowalski in a hospital bed, an image associated with the ‘Take Care of Maya’ trial and Doctor Sally Smith’s evaluation of her medical condition.
It was revealed that this was not the first time Doctor Sally Smith’s deposition had been presented in court; a video deposition was played earlier during the plaintiff’s presentation. In that earlier deposition, Doctor Sally Smith admitted to knowing that four other physicians had diagnosed Maya with CRPS. Despite this, she maintained her belief that Beata Kowalski was committing medical child abuse. Notably, she acknowledged that she had never previously testified in a case specifically involving CRPS, highlighting the novel and complex nature of Maya’s situation.
Doctor Sally Smith’s Firm Belief in Medical Child Abuse
Doctor Sally Smith delivered a strong and unwavering opinion regarding her assessment of Maya’s case. She stated, “Upon review of all the extensive medical records, observations of the child in the hospital, review of the unconventional treatments including hyperbaric oxygen treatment and high dose ketamine treatment repeatedly. It was my opinion that there was ample evidence of medical child abuse and it appeared Mrs. Kowalski was the primary one who was resulting in instigating or perpetrating child abuse.” This statement encapsulates Doctor Sally Smith’s professional conclusion based on her expert evaluation.
Adding further complexity, Doctor Sally Smith also mentioned that Dr. Anthony Kirkpatrick, the physician who diagnosed Maya with CRPS and prescribed ketamine, had advised her against pursuing allegations of Munchausen by proxy. This divergence of medical opinions underscores the contentious nature of Maya’s diagnosis and treatment, which was central to the entire trial. It was also noted that the Kowalski family had reportedly settled their dispute with Doctor Sally Smith and the DCF Suncoast Center, further highlighting the complex web of legal actions surrounding this case.
Jurors watched a video deposition of Dr. Sally Smith on Thursday.
Alt text: Jurors watching a video deposition of Doctor Sally Smith, highlighting the significance of her testimony in the ‘Take Care of Maya’ trial.
Conclusion: Doctor Sally Smith’s Pivotal Role in Unraveling the ‘Take Care of Maya’ Narrative
Doctor Sally Smith’s testimony provided a critical perspective in the ‘Take Care of Maya’ trial. As an experienced child protection expert, her assessment of potential medical child abuse carried significant weight. Her detailed account of her involvement, her medical evaluation, and her expert opinion offered a crucial counter-narrative to the Kowalski family’s claims against Johns Hopkins All Children’s Hospital. While the jury was left to ultimately decide the outcome of the case, Doctor Sally Smith’s testimony undoubtedly played a pivotal role in presenting the defense’s perspective and illuminating the complex medical and ethical considerations at the heart of this deeply tragic case. The trial and the testimony of figures like Doctor Sally Smith continue to raise important questions about parental rights, medical decision-making, and the delicate balance between protecting children and respecting family autonomy.
