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An Overview of the Historic $261 Million Verdict

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. Smith’s actions at JHACH involving Maya and her mother were spotlighted in the Netflix documentary, Take Care of Maya.


The verdict and the settlement were predicated on Smith’s and JHACH actions in holding Maya at JHACH for nearly three months and denying Beata Kowalski contact with her daughter, Maya.


Unable to see her daughter, care for her, or secure her discharge from JHACH’s confinement, Beata Kowalski—in despair—committed suicide. Only then was Maya released from the hospital and returned home to her surviving family members.

Take Care of Maya

Image shared from Tribeca Film 

JHACH sought to reverse the verdict, but on January 16, 2024, the trial judge issued a ruling that excoriated JHACH for continuing to defend its actions as exemplary medical care in the face of clear findings by the jury of conduct towards Maya and her family akin to “torture.” The judge did, however, reduce multiple specific items of damage by a total of 47.5 million, leaving intact an award to the Kowalski family totaling 213.5 million.

An appeal is likely to ensue in Maya’s case. While this may result in some changes in the eventual outcome of Maya’s specific verdict, the practices highlighted by this case clarify an urgent need for change regardless of the specific details of the verdict. 

Months’ long hospital confinements that deprive parents of all contact with their children and end with a parent committing suicide are fortunately rare, but many aspects of the Kowalski story are far more common for families who come into contact with the child abuse pediatric system. Indeed, JHACH’s strong defense of its own conduct in the Kowalski case demonstrates how entrenched and systemic many of the practices documented actually are, insisting that its treatment of Maya was “ordinary" (see Jan. 16, 2024 Order on Post Trial Motions in the Kowalski case). Countless family members are left deeply traumatized by wrongful accusations initiated and perpetuated by child abuse pediatricians (“CAP”) who are embedded in the hospital setting while simultaneously acting as agents of law enforcement and child protective services (CPS).


Most of these family members’ stories never make the news, never become the subject of a Netflix documentary, and never reach a jury. Wrongly accused families suffer enduring and profound post-traumatic consequences due to the entanglement of the state-funded child protection system with hospitals, child abuse pediatricians, law enforcement, and prosecutors. 

Many families who are wrongly accused don’t have a fighting chance for exoneration or vindication. Maya’s family is white and middle class—Beata herself was a nurse, and Jack was a firefighter prior to Maya’s hospitalization. Families who are impoverished or from minority communities face punitive judgments and higher rates of state intervention across the board. Indeed, the same county in which Maya’s case arose—Pinellas County—is itself notorious for being the site of an early racial disproportionality study that demonstrated that Black families were reported to child services authorities at nine times the rate of white families. 

Child abuse pediatricians are central to each one of these cases.


Interlocking systems empower and even encourage doctors like Sally Smith to play a simultaneous role in influencing the treatment of children and the policing of families. These systems also fail to provide minimal checks and balances against the sorts of abuses that caused such a tragic outcome for Beata Kowalski and her family. It is these systemic policies and practices—defended as the status quo in hospitals across America—that operate with cruelty (in the words of the Kowalski judge) and urgently call out for change. 

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