A Florida appeals court has reversed a judgment of more than $200 million against Johns Hopkins All Children's Hospital in a famous case involving Maya Kowalski — while opening up the door for a new trial.
This comes after a jury ruled in 2023 the hospital falsely imprisoned Maya when she was 10 years old, contributing to her mother's suicide. The case gained notoriety in the June 2023 Netflix documentary, "Take Care of Maya."
How did the Maya Kowalski case start?
Maya was diagnosed in 2015 with Complex Regional Pain Syndrome (CRPS). This is a central nervous system disorder that can cause chronic pain — usually affecting an arm or a leg, according to the Mayo Clinic.
In October 2016, 10-year-old Maya was rushed to the emergency room at Johns Hopkins All Children's Hospital. Her mother was adamant that Maya receive ketamine infusions to help with her condition.
According to court documents, the hospital reached out to a doctor who was giving Maya the infusions and confirmed the high dosage. But the hospital emergency room was not able to administer the levels demanded. Through their interactions, medical professionals became concerned.
ALSO READ: What role did 'Take Care of Maya' play in a jury siding with the Kowalski family?
A social worker at the hospital then called the Department of Children and Families abuse hotline and an investigation started.
During this time, Maya remained at the hospital but was taken into the department's custody. According to court documents, the department filed a dependency shelter petition requesting that she be placed in the hospital's care. The department also requested no contact between Maya and her mother but allowed supervised visits between Maya, her father and her brother.
For over three months, Maya had little to no contact with her parents. During that time, her mother, Beata, committed suicide. She left behind notes that expressed her anguish with being separated from Maya as well as the abuse accusations.
The no contact order with her mother pended psychological evaluations of both parties, according to court documents. At trial, Maya testified that not being able to speak to her mother "infuriated her."
"One instance Maya relayed involved a specific nurse verbally accosting her for not moving during a bed change. Despite Maya advising the nurse that she could not walk, stand or roll, the nurse said, 'If you don't move right now or else,'" court documents wrote about Maya's testimony.
During the trial, Maya's father testified that he and his wife requested Maya be released from the hospital, but said hospital officials "subsequently threatened them with arrest if Maya were to leave the hospital against medical advice." He also said the hospital advised him that Maya could not leave because she had to be safely weaned off medications, including the ketamine.
In November 2023, after an eight-week trial in Venice, a jury found the hospital liable for mistreatment of Maya and for contributing to Beata’s death.
The jury initially ordered All Children’s to pay $261 million to the Kowalski family and an additional $50 million in punitive damages.
The judgement was later decreased to $213 million.
What does the appeals court ruling mean?
In 2024, lawyers for the St. Petersburg hospital filed an appeal arguing the damages were excessive and saying testimony by Maya emotionally inflamed the jury.
On Wednesday, the three-judge panel for Florida's Second District Court of Appeal ruled that the trial court erred by not considering the entirety of a statute that involves immunity from liability in cases of child abuse, abandonment or neglect.
The panel stated the court did not consider anything beyond the hospital's immunity from claims "premised on or immediately resulting from the reports of suspected child abuse."
The ruling argues that the statute provides immunity from liability that might result from "good faith reporting" or "good faith participation."
"And nothing in the record suggests that (the hospital's) participation in implementing the dependency court orders, as it was required to do so, was not done in good faith," the ruling reads.
The ruling also said the trial court implicitly recognized that dependency court orders, like prohibiting visitation, may result from reporting or investigating abuse, but failed to make this interpretation clear.
"The trial court failed to give effect to its interpretation by permitting the jury to hear significant and inflammatory testimony concerning the restrictions put in place by the dependency court and the impacts of those restrictions on the Kowalskis," the ruling reads.
The three-panel judges sided with All Children's that this error in interpreting the statute pervaded the trial — so a "new trial on all remaining counts is necessary."
Only a claim of intentional infliction of emotional distress on behalf of Maya and the remaining false imprisonment, battery and medical negligence claims can be retried.
One of the judges wrote a concurring opinion elaborating on the threshold issue of "outrageousness" in Maya's claim for the intentional infliction of emotional distress. Judge Smith said these kinds of claims exist "where one is susceptible to emotional distress or due to the unequal positions." The judge added that this had been raised by the Kowalskis.
Nick Whitney with Childers Law represented the Kowalskis and said they're disappointed by the appeals court's decision.
"But the Kowalskis will persevere," Whitney wrote. "Judge Smith's concurring opinion emphasized Johns Hopkins’ outrageous actions towards Maya, and the next jury will see things just like the first one did. Johns Hopkins was 'in charge of caring for and treating Maya. Instead, they exploited their position with full knowledge that Maya, a 10-year-old child, would not be able to endure such outrageous conduct.'"
Ethen Shapiro of Hill Ward Henderson law firm represented All Children's and said that Wednesday's decision vacates the $213 million verdict.
"This opinion sends a clear and vital message to mandatory reporters in Florida and across the country that their duty to report suspicions of child abuse and, critically, their good faith participation in child protection activities remain protected. The facts and the law have always prioritized protecting children, the most vulnerable among us," Shapiro wrote in a statement. "We look forward to vigorously defending our doctors, nurses, and staff in a fair trial on the few remaining claims after rigorous and proper application of immunity. We thank the judges for their time and attention to this matter, and we appreciate that they understood what many did not: that a one-sided movie is no substitute for a fair judicial process.”
WUSF's Meghan Bowman contributed to this report.
If you or someone you know is in crisis, please call the National Suicide Prevention Lifeline at 988 or contact the Crisis Text Line by texting HOME to 741741.
