Response from NY Mag re: “What Happened to Maya”

I reached out to New York Magazine about the numerous and significant errors in their 2022 piece. Below is my note to them and the response from their senior director of communications.

Smith, who retired this summer, tended to interpret cases aggressively. Children in Pinellas are removed from their homes at one of the highest rates of Florida’s 67 counties, and Smith said this is because the child-protection team she directed does “a more thorough, higher-quality job.” 

The pain baffled everyone. The Kowalskis took Maya to All Children’s, but the staff was unable to come up with a diagnosis. Doctors at yet another hospital, Tampa General, thought that Maya’s muscle weakness could be explained by an oral steroid she’d been prescribed for her asthma. Then one of Beata’s patients, whose child suffered from an acute pain condition, recommended that they consult a local anesthesiologist named Anthony Kirkpatrick, who ran a center in Tampa that studied CRPS.

Maya still required a wheelchair, but the ketamine led to “huge progress,” Jack says. Maya’s feet straightened, the lesions healed, and there were periods when her distress seemed manageable.

Smith found the stories unconvincing. In her report to DCF, she wrote that Beata “veered off regarding herself getting ‘no sleep for weeks’ and the struggles of ‘working to maintain insurance.’” On October 11, Kirkpatrick’s office received a request for Maya’s medical records, and he asked to speak to the person conducting the investigation. When Smith called him back, she told him that she believed Maya was a victim of child abuse. The doctor reminded Smith that he had been the one to first diagnose Maya with CRPS; he’d also recommended the procedure in Mexico.

Please see below statements from Dr. Smith:

None of the above were told to me by Mr or Mrs. Kowalski, so I would not have characterized those comments in any manner in a report.

Incorrect – None of the above is accurate. In assessing a child for Medical Child Abuse, a child abuse pediatrician should gather and review all available medical records and consider the totality in reaching a diagnostic impression. Termination of a complex medical evaluation at a very early stage based on commentary from 1 or 2 providers would have been irresponsible as a CPT Medical Director.Dr. Kirkpatrick is listed online as the Chair of the International Research Foundation for Reflex Sympathetic Dystrophy RSD/CRPS in Tampa and reports that he has sent hundreds of children and adults he has diagnosed with “RSD/CRPS” to Germany and Mexico for treatments that are not approved in the United States over the past 20 years. This includes referrals to Mexico for “Ketamine Coma” in which patients are given increasing daily doses from 5000 to 12000 mg of ketamine over 5 days. Multiple published studies have indicated some evidence for short-term efficacy of IV ketamine treatment of Complex Regional Pain Syndrome at maximum daily doses of 100 to 200 mg for an adult. A physician’s advocacy for unconventional treatments particularly for a child would be something I would take into consideration in assessing that physician’s credibility in an alleged Medical Child Abuse scenario. Similarly, if it was determined that Dr. Hanna had given a child in an outpatient setting 1000 mg of ketamine combined with high doses of midazolam, ondansetron, magnesium sulfate, glycopyrrolate and diphenhydramine on dozens of occasions, that would be something I would take into consideration in a

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