The next day, a social worker filed a second report with the state. After hanging up, Smith logged on to an internal All Children’s portal and began to read through Maya’s medical records. Smith was particularly concerned to learn that Maya was already receiving regular ketamine infusions and agreed with Teppa Sanchez that it seemed unorthodox as a way of treating CRPS in a child. Maya appeared to shake, squirm, and cry out in pain less often when her mother was out of the room. She described Kowalski as pushy and said that she had asked for her daughter to be given 1,500 milligrams of ketamine, which seemed like a huge dose. Teppa Sanchez told Smith several disquieting things about Beata Kowalski. She had spent so much time at the hospital that physicians knew to call her at the first indication of abuse or neglect, and they nearly always deferred to her judgment. Virtually everyone at All Children’s - maybe even most medical providers in Pinellas County - regarded her as the doyenne of the field. Smith is a doctor with more than 30 years of experience in child-abuse pediatrics. But some at the hospital remained concerned about Maya’s case, and a pediatric ICU physician named Beatriz Teppa Sanchez placed the Saturday-afternoon phone call to Smith, seeking her expert opinion. A parent being uncooperative or failing to heed a medical professional’s suggestions is considered a red flag for neglect, and Hansen filed a formal notice with the state.īy the next morning, Florida’s Department of Children and Families had discarded her report for lack of evidence. Maya was also thrashing about.” Hansen agreed that it was strange for Beata to demand pain medication before allowing a routine test. “There was a lot going on, and Maya was” - she widened her eyes at the memory - “captivating. “They were very distressed,” Hansen later recalled. The nurse, concerned by the demand for such a powerful drug, asked a social worker named Debra Hansen to meet with the Kowalskis. When a nurse attempted to conduct an ultrasound, her mother insisted that the only way Maya could tolerate the contact was if she received an infusion of ketamine. Maya spent 24 hours in the intensive-care unit at All Children’s, screaming and writhing. They said that she was acutely sensitive to stimuli of all kinds and that disabling pain radiated through her legs and feet, requiring the use of a wheelchair. The girl’s parents, Beata and Jack Kowalski, had told the hospital that Maya suffered from a neurological disorder called complex regional pain syndrome, or CRPS. Smith listened as a doctor detailed the case. The name belonged to a 10-year-old girl who had just been admitted for abdominal pain. Smith was the medical director of the child-protection team for Pinellas County, and she grabbed a piece of paper to take notes. Sally Smith received a call from the pediatric emergency room at Johns Hopkins All Children’s Hospital in St. One Saturday afternoon in the fall of 2016, Dr.
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