The hospital said Maya Kowalski was being abused. The truth was even worse.

Content warning: This post includes discussions of suicide.

Beata Kowalski had taken her daughter, Maya, to hospital for an asthma attack when the pain first started. The little girl described a burning sensation in her legs and feet.

Within weeks, Maya could hardly walk, her legs no longer supporting her body. They were covered in lesions and her feet turned inwards. Kowalski was a home-care nurse, but couldn’t figure out what was causing her daughter’s painful screams.

Watch: The trailer for Netflix's Take Care of Maya. Post continues after video.

A mysterious illness.

Maya’s family took her to All Children’s Hospital, but doctors were baffled. At Tampa General Hospital, staff attributed Maya’s muscle weakness to an oral steroid she’d been prescribed for her asthma.

Upon a friend’s recommendation, the Kowalskis took their daughter to visit local anesthesiologist, Dr Anthony Kirkpatrick, who ran a centre that studied Complex Regional Pain Syndrome (CRPS).

Dr Kirkpatrick diagnosed Maya with CRPS — a mysterious disorder causing chronic pain, sensitivity, stiffness and muscle atrophy, usually after an injury, that can last years. While there are few viable treatments, Dr Kirkpatrick suggested a controversial approach — ketamine infusions.

Ketamine is more commonly associated with recreational use than medical use, though it’s reportedly used in emergency rooms as an FDA-approved anaesthetic. Dr Kirkpatrick told the family the infusions might inhibit the effects of elevated amino acid glutamate levels on the nervous system.

For the next 12 months, Maya received ketamine infusions every three or four weeks at a cost of $10,000 per four-day session. With the fees not covered by health insurance, the family shifted Maya’s treatment to a different specialist with lower costs. Although Maya still used a wheelchair, the family reported significant progress.

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What happened to Maya Kowalski's mum?

In 2016, the Kowalskis took Maya to All Children’s Hospital after she complained of severe abdominal pain. It didn’t take long for Maya’s mother to start arguing with a nurse about the ketamine infusions.

The little girl had been screaming and writhing in pain for hours, and the nurse had wanted to conduct an ultrasound. Maya’s mother said the only way her daughter would agree to the procedure was if she received an infusion of ketamine.

Concerned about the demand for such a strong drug, a social worker was called in, who agreed Beata's conduct was a red flag, and filed a formal notice with the state. Florida’s Department of Children and Families discarded the report for lack of evidence, but hospital staff remained concerned, and called in Dr Sally Smith, a doctor with more than 30 years' experience in child-abuse paediatrics.

Dr Smith found Beata's story unconvincing and far-fetched and agreed the ketamine infusions were particularly worrying, especially for a young child. Dr Smith was told Maya complained of pain less often when her mother wasn’t in the room. The following day, the social worker made a second report, this time suggesting overtreatment by a mother with suspected “mental issues”. As a result, Dr Smith was asked to officially investigate.

When Dr Smith looked back on Maya’s medical history, she saw what she believed was evidence of “doctor shopping”, including visits to more than 30 medical providers. At one stage, Maya was taken to Mexico for a five-day procedure where she was sedated and intubated to receive high-dose infusions of ketamine.

Dr Smith's initial suspicion was Munchausen syndrome, where a parent deliberately makes a child ill to garner sympathy and attention. As time went on, the Kowalskis became frustrated and requested Maya be discharged. They were told doing so would be against medical advice — if they proceeded, they would be arrested.

Dr Smith knew her decision would be instrumental in Maya’s future health. The wrong decision could have catastrophic consequences. The right decision could save her life.

Maya Kowalski was initially diagnosed with CRPS. Image: Instagram/@nymag.

In the end, Dr Smith made a formal diagnosis of Munchausen syndrome by proxy, and a shelter order was issued, requiring Maya to remain at the hospital and forbidding her parents from seeing her.

Under observation, Maya continued to complain about pain, even without her parents around. But the hospital staff noticed something else. Maya seemed to be moving herself around in her wheelchair using her feet. She was only 10 years old after all. She couldn’t keep up the act all the time, the doctors thought.

By the end of the year, Maya’s diagnosis had been changed from Munchausen by proxy to factitious disorder. Dr Smith believed it was Maya making everything up, not her parents.

Despite the change, Maya remained in the custody of the hospital, which subsequently billed her insurer more than $650,000 for her treatments, including 174 entries for CRPS, despite the hospital believing this was a misdiagnosis.

The shelter order was revised to allow Maya’s father visitation rights, but her mother was only permitted contact via phone and video. The hospital used its discretion to decide whether to allow contact when requested, and it was often denied without explanation. Extended family and friends were frequently prevented from visiting Maya.

The Kowalskis hired a lawyer to represent them in family-dependency court, but delays saw Maya kept from her mother at Christmas time.

In January, Maya was scheduled to leave the hospital for a court hearing. Just before she left, Maya says her clothes were forcibly removed by hospital staff, who took photos without her consent. The hearing was the first time Maya had left the hospital in months, having spent Christmas, New Year’s Eve and her 11th birthday there.

Maya was not permitted to see or speak to her mother. Beata began to spiral. She cried constantly and drank too much. She slept often.

One day, her husband, Jack, heard a scream from the garage. When he walked in, he found his wife had died by suicide.

“I’m sorry,” her suicide note reportedly said, “but I no longer can take the pain being away from Maya and being treated like a criminal. I cannot watch my daughter suffer in pain and keep getting worse while my hands are tied by the state of FL and the judge!”

After being told of her mother’s death, Maya was once again left alone at the hospital. At the next hearing, the Judge ruled Maya could be evaluated by a professor who specialised in CRPS, who ultimately agreed she did in fact have both the symptoms and response to treatments that were consistent with CRPS.

When Maya was released from All Children’s Hospital, six days after her mother’s death, she was underweight and weak. Her father took her to a range of therapies, and more than a year later, Maya stood up from her wheelchair. Maya was kept away from her parents for 87 days. She is now 19.

Who is to blame for Maya Kowalski's case?

In early November 2023, a Florida jury delivered a significant payout to the surviving members of Maya's family. Her father filed the lawsuit, which became the basis for the Netflix documentary, Take Care of Maya.

Maya Kowalski at an event for Take Care of Maya. Image: Instagram @mayakowalsk1.

The six-person jury was unanimous in determining the hospital was liable for the incidents leading up to Beata’s death. They agreed the hospital should pay the family more than $210 million as compensation for their losses.

Maya and her brother, Kyle, cried as the verdict was read, deeming the hospital guilty of multiple claims of false imprisonment, battery, intentional infliction of emotional distress, medical negligence, negligent infliction of emotional distress, negligent training of doctors and healthcare providers, and fraud.

During the nine-week trial, the jury heard from Dr Anthony Kirkpatrick, who diagnosed her condition and said ketamine can benefit certain CRPS patients.

“The pain is coming from within the nerves itself, as opposed to the kind of pain you get when you injure yourself,” Dr Kirkpatrick told jurors.

“It was a low-dose conscious sedation, but they are talking to you. It is called conscious sedation; the higher you get the dose, the longer the response, the more vigorous the response, but there is a limit to how far you can go.”

In the hospital’s defence, Dr Elliot Krane testified that he believed Maya did not have CRPS, and criticised Dr Kirkpatrick for the dosages of ketamine that were prescribed. Although Dr Krane has never met Maya, he believed Maya had become dependent on ketamine before she was admitted to All Children’s.

Several other witnesses testified that Maya’s mother exaggerated her daughter’s symptoms. While lawyers cited Instagram photos of Maya at a school dance as proof that she lived without pain.

Maya said her symptoms came and went, and she was not pain-free.

While the hospital maintains its efforts saved Maya’s life, after nearly 16-and-a-half hours of deliberations, the jury disagreed.

A judge denied the hospital's request for a retrial. The hospital is now appealing the decision, arguing it was not responsible for Beata's death as she was not in its care.

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Where is Maya Kowalski today?

Today, Maya can walk unassisted but still deals with flare-ups of CRPS.

"I do my best to push through," she told People last year. "I've already missed a lot, so I want to make the most of life now."

According to her Instagram, she's an actor, advocate and artist based in Los Angeles.

Acting has allowed her to let go of some of her sadness and hurt.

"When you're able to excavate those emotions and apply them to these projects, it's actually very healing, as well," she told Daily Mail.

"I'm able to have this outlet to kind of project all of it in a healthy way... I've gotten to this place where I feel very grounded. I feel very calm.

"Obviously, I still struggle with sadness and anger and frustration, but the difference is, I have a coping mechanism — and for all people, at the end of the day, you have to learn how to forgive."

Maya's moved to LA to pursue acting. Image: Instagram/mayakowalsk1.

Once the hospital court case wraps, Maya said she hopes to start charitable work in her mum's honour, to help others with chronic illnesses.

"Sometimes bad things need to happen for progress to be made," she said.

If you think you may be experiencing depression or another mental health problem, please contact your general practitioner. If you're based in Australia, 24-hour support is available through Lifeline on 13 11 14 or beyondblue on 1300 22 4636.

This article was originally published in 2023, and has since been updated.

Feature Image: Netflix.