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The recent verdict in the Kowalski v. Johns Hopkins case has sent shockwaves through the medical and legal communities, highlighting how major systemic injustices in child abuse pediatrics are harming vulnerable families.

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, which was adjusted down to $213.5 million after strenuous objections by JHACH, followed 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 just the tip of the iceberg.

Each year, hundreds of families across the nation find themselves facing this type of 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. Current policies and contracts give CAPs outsized power without requiring any transparency or accountability, leaving innocent families at risk of harm.

Too often, child abuse pediatricians operate as cops in white coats without transparency or sufficient checks and balances to protect family rights. 

CAPs don't just gather evidence and testify for the prosecution; their role as a doctor also impacts the course of the child's treatment. 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 operate with conflicting roles that combine forensic investigation and medical treatment with insufficient oversight.


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.

This toolkit highlights how current child abuse pediatric policies violate established medical ethics, constitutional law, and professional regulations:


Why the Kowalski Verdict Inspires a Call to Action

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 Investigations

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.


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?


Books & Media Detailing False Allegations

The bank of media highlighting wrongful allegations of abuse includes books, documentaries, and podcasts.


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?


Other High-Profile Cases of Wrongful Allegations

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


Relevant Articles, Publications & More Resources

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

The Kowalski verdict is a wake up call, shining a light on harmful child abuse pediatric practices and highlighting an urgent 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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