What happened to Maya Kowalski? The horror story behind Netflix’s hit documentary

The footage is desperate, heartbreaking and the stuff of every parent’s worst nightmares. Beata Kowalski sits in a doctor’s office — the latest in a long line of medical rooms — alongside her daughter, not yet 10 years old, whose formerly vivacious energy has been slipping away before her family’s eyes. Beata and her husband, retired firefighter Jack, have watched as Maya began suffering headaches, pain and lesions, her feet turning inwards as the use of her legs deteriorated.

The doctor mentions anxiety as a possible cause, and both Beata and Maya, turning to each other when he briefly steps outside, seem sad and exasperated.

“It’s not anxiety,” says Maya, her voice small as she sits in her tiny wheelchair.

“I know, baby, I know,” her mother replies. “He’s just trying to figure it out. You just stay as calm as you can.”

The encounter was recorded by Beata, a trained and exacting nurse, as she and Jack fought to get a diagnosis and treatment for Maya after she began experiencing mysterious symptoms in 2015. The uncertainty, coupled with Maya’s worsening pain, seemed bad enough.

But the Kowalskis’ medical journey would plunge the family into heretofore unimagined depths of hell. Doctors would accuse Beata of deliberately making her daughter sick. Maya would be taken from the family’s custody. And her mother, shockingly and tragically, would take her own life.

The horrifying story would later play out in court, after the Kowalski family filed a $200m lawsuit against the Department of Children and Families and Johns Hopkins All Children’s Hospital. The trial began on 21 September with jurors returning a verdict just over a month later on November 9.

The hospital was found liable on multiple counts of abuse, including false imprisonment, battery and intentionally inflicting emotional distress on both Maya and her mother.

The trial came months after Netflix released its documentary Take Care of Maya, featuring interviews with Maya, now a teenager, as well as Jack and the family’s younger child, Kyle. Through tears and anger, they chronicle how their family fell apart after entering the medical, legal and child welfare vortex.

They say they’re sharing their painful story for Beata — and for the countless other families touched by medical abuse allegations, many of whom also come forward in the jaw-dropping film.

“I want people to see that I wasn’t lying, and that other families who are going through similar situations, they’re not lying either,” Maya, now more than halfway through her teens, says in the documentary. “I have CRPS. My mom was not making me sick. I just wish people would believe me.”

Not even a decade ago, the family had been living the true American dream in Florida. Beata had emigrated from Poland as a teenager and thrown herself into her studies and American life, excelling at nursing school and in her career; her bond with Jack is evident as he reminisces about their meeting and romance, wistfully describing his wife as “magic.”

Maya was born in 2005 and her brother shortly thereafter. Beata doted on the children, working as an infusion nurse and reveling in the comfortable family life she and Jack had built in their sparkling Venice suburb.

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When Maya began suffering an array of worrying symptoms in the spring of 2015, Beata applied her nursing knowledge and meticulous nature to the family’s search for answers. Eventually, she sought out Dr Anthony Kirkpatrick, an anesthesiologist and expert in complex regional pain syndrome (CRPS.)

According to the Mayo Clinic, CRPS “is a form of chronic pain that usually affects an arm or a leg” and “typically develops after an injury, a surgery, a stroke or a heart attack.

“The pain is out of proportion to the severity of the initial injury,” the Mayo Clinic site continues. “CRPS is uncommon, and its cause isn’t clearly understood. Treatment is most effective when started early. In such cases, improvement and even remission are possible.”

To explain the rare condition, Dr Kirkpatrick says in Take Care of Maya, “the best way to think about it is the way it evolves.

“Let’s say you have an injury; you know that, probably in a week or two, the pain is going to go down, the swelling is going to go down, the redness and all that is going to go down,” he says. “But what happens in these patients with CRPS is that it actually intensifies over that period of time ... The patients describe it primarily as a burning sensation, that their skin becomes exquisitely sensitive to light touch.”

Following his initial evaluation for Maya — and portions of his intake video are included in the film — “it was clear to me that, because of the magnitude of her symptoms (the lesions, this burning sensation in her legs, in the pain throughout her entire body, that Maya had advanced CRPS that we had to right away get aggressive with it, get under control,” he says.

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“We’ve treated over 3000 patients with complex regional pain syndrome,” Dr Kirkpatrick says. “And we know what the best therapy is for. It’s called ketamine.”

Treatments were extreme and required tough choices. Given the severity of Maya’s symptoms, the Kowalskis decided to take her to Mexico for an induced ketamine coma that, while unapproved by the FDA, offered some possibility of relief. It seemed to have a positive effect, and, when the family returned from Mexico, they “couldn’t afford to keep up with Dr Kirkpatrick’s treatments, so he recommended his colleague, Dr [Ashraf] Hanna, who took our insurance and prescribed low dosages of ketamine for Maya,” Jack says in the documentary.

“She was getting stronger,” he says. “The dystonia [bent legs] was straightened out. She was unable to use her legs, but she was using her arms, and she was doing very very well ... She went back to school, to laughing and playing. We were just blessed that we were finally seeing something working. And for a year, it did.”

Then — as Hurricane Matthew barreled through Florida in October 2016 — Maya’s symptoms came roaring back with a vengeance. Jack took her to the emergency room at Johns Hopkins All Children’s Hospital.

“Maya relapsed; it came back, and it was very severe,” he says in the documentary. “She started complaining of pain in her tummy, and it got to the point where she was screaming and crying and begging for help.”

Jack contacted Beata, who was at work, and she arrived at All Children’s about an hour after he’d entered triage with their daughter. The medical care team had already been asking questions about Maya’s rare syndrome and even rarer ketamine treatment. When Beata turned up, the situation deteriorated.

Hugely concerned for her daughter, intimately acquainted with her treatment and authoritatively explaining it, Beata never could have guessed that her demands for her daughter’s health would quickly spiral into a maelstrom that would dismantle her family, her health and drive her to take her own life.

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Beata insisted that Maya needed far higher doses of ketamine to manage her pain — with one healthcare worker calling Beata “belligerent” in a deposition — and the demanding mother raised more eyebrows in the process.

“We were told, if we plan on trying to leave, that security would be called,” Jack Kowalski says in the documentary, and it wasn’t long before child welfare services were contacted by medical staff. When child abuse investigator Sally Smith — a doctor with the Suncoast Center, a company contracted by Pinellas County for its privatised child welfare system — walked into Maya’s room, her father had no idea who the woman was.

“She came in and she acted like a regular doctor that worked for the hospital, and she started to ask questions,” Jack says in the film. “She asked what’s wrong with Maya, where is she being treated, about medications, how could I let somebody give such high dosages, and I told her, ‘That’s what the doctors prescribed.’”

“She did a ten-minute interview at most — and, shortly after she walks out, the nurse walks back in that was helping me. She told me I had to leave — that my daughter is under state custody,” he says, choking up. “I remember looking at my daughter’s eyes, and she’s looking at me. I’m wondering if I would ever see her again.

“They accused her of over-medicating Maya,” he says of Beata. “And they thought Maya was faking this syndrome. At that time, I said we need to get a hold of a lawyer.”

They hired attorney Debra Salisbury, who also becomes emotional during interviews for the documentary. Describing Beata as perhaps “a little too direct sometimes,” Ms Salisbury says she believes “maybe some of the doctors took that offensively. I believe somebody at all Children’s Hospital was offended — and a conflict started.”

Whatever the root cause, the consequences of the “conflict” escalated quickly, exponentially and, upon review years later, almost inexplicably.

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“As soon as I was made aware that Sally Smith was investigating, I called her immediately,” Dr Kirkpatrick says in the film. “And I explained to her, ‘This is what the diagnosis is. If you want to see the objective evidence, I’ve got it for you.’ I told her that on the phone.

“She writes a report two days later,” the doctor says. “Does she include that in the report? No ... I told her that if she goes forward with this, it would not only be a catastrophic outcome for the child, it would be a permanent injury to the whole family.”

Dr Smith’s report, and the testimony of other healthcare workers, led to the court’s refusal to return Maya to her parents’ custody or even see Beata — who continued to try to manage her daughter’s care and check on her from afar, causing tensions with her husband and the system. In recordings featured in the film, he pleads with her to stop any antagonisation, guessing — correctly — that it will only make things worse. Beata can’t seem to understand why her rights as a mother don’t trump everything else.

Maya, in pain and confused, remained at the hospital as child welfare advocates insisted she was being abused, her mother making her sick through Munchausen by proxy. It is described by the American Psychological Association as “a psychological disorder in which caregivers fabricate or intentionally cause symptoms in those they are caring for in order to seek and obtain medical investigation or treatment (i.e., to assume the sick role by proxy).

“Typically, the caregiver is the mother, who behaves as if distressed about her child’s illness and denies knowing what caused it,” APA continues in its definition. “She is believed to be motivated by the hope that she will be seen as an exceptionally attentive parent, and her behavior may be an attempt to arouse sympathy.”

While advocates were suggesting Beata could be facilitating — or Maya could be faking — CRPS, the hospital was billing the insurance company for treatment of the exact same disease being questioned, the Kowalskis’ lawyers claim in Take Care of Maya.

The hospital declined comment to The Independent about this specific allegation, citing “strict patient privacy laws” precluding further information sharing without the Kowalskis’ release of Maya’s medical records.

A hearing was held in December 2016, shortly before Christmas; Maya had written a letter to the judge, begging to see her family for the holiday and outlining how she felt worse and worse. During proceedings, a lawyer for the child asked the judge whether “there was any way ... she could just see her mom, just to like hug her mother?”

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The judge said no — and, the following month, Beata took her own life in the garage of the family’s home.

“I know it’s because he turned her down,” Jack sobbed on the phone after the family discovered her body; the audio is included in the documentary. “That killed her. All the way home, that’s all she talked about. I don’t know how I’m gonna tell Maya later, because I can’t go there and tell her and then leave.”

He’d been on the phone to Ms Salisbury, who says in the film: “It never made any sense to me why she was denied giving her child that hug — and I can tell you, as we left the courthouse that day, that Beata was devastated. Devastated.

“And the one thing that I know, to this day, is: None of us can get that hug back now. That hug is gone.”

Jack, Maya, Kyle and their wider family were left equally devastated.

“It’s very difficult to understand what went through Beata’s mind, thinking that was the only way to get her daughter out,” Jack says in Take Care of Maya. “I miss her dearly. But I have anger here and there. It is so difficult to try to play both roles. In as much as you try, you cannot replace their mother.

“Something good has to come from all this pain.”

What has come from the pain is the family’s realisation that they are not alone in their anger — and that their story of what they say are false abuse allegations is anything but an anomaly. Families from Pinellas County and all over the country began coming forward, some appearing on film in Take Care of Maya to detail how their own children were ripped from them.

What has also come from the tragedy is a court case — an ongoing legal battle by the Kowalski family against Johns Hopkins All Children’s Hospital.

“We want Beata’s voice to be heard,” Jack says in the documentary. “We want Maya’s voice to be heard.”

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And it was Beata’s voice — her recordings, her studious notes — along with her vigilance that enabled legal action in the first place, according to one of the family’s lawyers.

“If she hadn’t taken such an aggressive approach, we couldn’t have sued,” attorney Gregory Anderson says int he film. “So we’re going after the hospital, Dr. Sally Smith and Suncoast based on what’s known as infliction of emotional distress, meaning that they knew what they were doing, pushing her towards some form of harm. So they should pay punitive damages, which are designed to punish them for their wrongdoing.”

Dr Smith and the Suncoast Center settled their portion of the lawsuit with the Kowalskis in December 2021, according to the documentary. Dr Smith declined to be interviewed by filmmakers, and the Suncoast Center did not respond to request for comment from The Independent.

The trial for the Kowalskis to pursue punitive damages began on 21 September — 2,530 days after Maya first entered the hospital.

During the month-long civil trial, the Kowalskis’ lawyer Greg Anderson argued that Maya was “falsely imprisoned and battered, she was denied communication with her family”. Johns Hopkins All Children’s Hospital repeatedly denied the allegations and insisted that they meant no harm to Ms Kowalski.

The hospital’s lawyer Howard Hunter told the court that hospital staff acted “reasonably and prudently” in order to treat a “difficult and challenging case”.

He said Ms Kowalski had “challenged” doctors to give Maya a large dose of ketamine, which was not approved for children, and that doctors were also suspicious that the girl’s symptoms were being “fostered and encouraged by the mother”.

Maya, now 17-years-old, gave emotional testimony during the trial, in which she described the time she was kept apart from her family. She and members of her family wept loudly as jurors returned verdicts in their favour on November 9.

The family were awarded millions of dollars in damages.

Following the verdict, Howard Hunter, counsel for the hospital, maintained that the hospital had acted appropriately. In a statment to The Independent Mr Hunter said the institution intended to appeal “based on clear and prejudicial errors throughout the trial and deliberate conduct by plaintiff’s counsel that misled the jury.

While referring to the constraints of patient privacy laws, a lawyer for Johns Hopkins All Children’s, in a statement to The Independent, pointed to allegations of medical child abuse within the family that had predated their time at the hospital.

“If DCF, two circuit judges, and a Sheriff’s Deputy found probable cause to suspect abuse, the conclusion is inescapable that JHACH providers had reasonable cause to suspect and report it,” reads the hospital’s motion to obtain statutory immunity for the phone call made to child services.

“There are hundreds of additional publicly available court documents that completely contradict the Netflix narrative; a narrative that has been unfortunately echoed by media outlets with scrutiny,” attorney Ethen Shapiro told The Independent, pointing, among other documents, to a police interview in which Jack Kowalski admitted he would support Beata’s move from the house if Maya were returned home.

A police investigator “confirmed under oath that the police investigation — separate and apart from the input at my client’s hospital — was heading towards criminal charges of Beata Kowalski prior to her suicide,” he continued.

But other families who felt victimised by the system are looking to the Kowalskis and their case as a beacon of vindication.

“This young girl, Maya, represents hope for all of us,” one mother tells the filmmakers in Take Care of Maya.

And Maya herself outlines the family’s determination in a heart wrenching letter to her mother read aloud near the end of the compelling film.

“As soon as we step foot into our home, we brought back to reality,” she tells Beata. “We miss you. I miss you. For five years, we have been promised a trial. Yet it seems that the closer we get to a set date, the further it gets pushed. Even though we are discouraged, we will not settle.

“We will fight for you, and we will fight for the thousands of other families who find themselves in the same unfortunate circumstances,” the teenager says. “The day will come.”

This story was originally published in June 2023 and has been updated.