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The recent verdict in the Kowalski v. Johns Hopkins case is a wake-up call, highlighting major systemic concerns within child abuse pediatrics.

On November 9, 2023, the jury in Kowalski v. Johns Hopkins All Children’s Hospital (JHACH) spoke; it awarded Maya Kowalski, her father, and her brother $261 million in compensatory and punitive damages on seven counts that included three periods of Maya’s false imprisonment at JHACH, medical malpractice, battery, and intentional infliction of emotional distress. This verdict followed a reported individual settlement of $2.5 million with Dr. Sally Smith, the child abuse pediatrician who wrongly accused Maya’s mother, Beata Kowalski, of child abuse due to Munchausen’s Syndrome by Proxy. This landmark case was spotlighted in the Netflix documentary, Take Care of Maya.


While the Kowalski story is uniquely tragic, the details of the case are really just the tip of the iceberg.

Each year, hundreds of families across the country find themselves facing the same injustice at pediatric hospitals, and each of these cases share one common detail—an allegation from a child abuse pediatrician (CAP) who works with or consults with the hospital’s treatment team while simultaneously working directly with child welfare agencies, law enforcement, and prosecutors. A single child abuse pediatrician can make an initial hotline call and then go on to oversee the child’s medical care, direct state actions, recommend family separation, urge the state the file criminal charges, and even testify at trial and sentencing.

Child abuse pediatricians are essentially cops in white coats, operating with an alarming absence of checks and balances to protect families' rights.

Current policies and contracts give child abuse pediatricians (CAP) outsized power without requiring any transparency or accountability, leaving innocent families at risk of harm. A single CAP can make a hotline call, sit on the multidisciplinary team at the child advocacy center that makes decisions about juvenile and criminal charges, recommend the removal of the child from the family, and even testify at trial. Black families and parents of children with rare diseases are especially vulnerable to experiencing family separations and criminal convictions due to medically-based wrongful allegations from CAPs who lack the proper diagnostic protocols to differentiate between complex medical conditions and child abuse.


Health care institutions and policymakers must enact key changes to establish guardrails that will protect children and families from wrongful separation.

What happened to Maya's family can easily happen to any family in America. Health care, child welfare, and law enforcement systems are needlessly putting children like Maya and their families at risk. Reform is imperative to keep children safe and ensure that families can seek treatment from health care providers without fear. In response to these concerns, the Family Justice Resource Center has proposed clear steps for reform in child welfare policy. 

Navigate the Toolkit


An Overview of the Historic $261 Million Verdict

The Kowalski verdict shines a light on child abuse pediatric practices and highlights a need for systemic reforms.


How CAPs Are Embedded in Investigations

CAP became embedded in child abuse investigation teams under federal policy and funding streams due to CAPTA


Medical Ethics Considerations in the Kowalski Case

The Kowalski case brings up numerous medical ethics concerns highlighting a clear need for systemic reform.


The Heartbreaking Story of Maya Kowalski

Maya Kowalski's story highlights the devastation that is enabled by prevalent child abuse pediatric policies.


Other High-Profile Cases of Wrongful Allegations

Numerous stories in the media, litigation, and auditor's reports emphasize systemic issues in child abuse pediatrics.


Books & Media Detailing False Allegations

The bank of media highlighting wrongful allegations of abuse is constantly growing.


The Role of CAPs in the Child Protection System

How do child abuse pediatricians have the power and authority under state policies to influence a hospital's treatment of a child?


Interacting with CAPs: A Parent's Perspective

What is the typical experience of a parent interacting with a CAP at the hospital as a result of their child's medical condition?


Relevant Articles, Publications & More Resources

A vast literature exists concerning the health care system, child welfare system, and law enforcement system.

The Kowalski verdict shines a light on child abuse pediatric practices and highlights a need for systemic reforms.

Join us in a constructive dialogue about our proposed solutions encouraging hospitals and other institutions to refine their policies and procedures. This involves moving away from investigative and prosecutorial medical practices and instead embracing ethical forensic practices that operate independent from patient-centered care. Your valuable input is pivotal as we collectively work towards fostering a healthcare environment grounded in ethical considerations that prioritizes the well-being of patients.

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