Nobody Should Believe Me - Case Files 19: Rady Children's Part 3

Episode Date: May 15, 2025

We left off in the previous episode with Madison Meyer being returned to her parents after more than a year in state custody—yet still hospitalized at Rady Children’s Hospital in San Diego. Today,... Andrea and Bex unpack the complaint filed by her parents in 2021 and Madison’s own 2024 lawsuit.  *please note that this episode contains mentions of suicide and sexual assault of a minor.  For resources please go to:  RAINN https://rainn.org/ International Association for Suicide Prevention: https://www.iasp.info *** This podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. *** Follow Dr. Bex on instagram: @secretdoctorbex Order Andrea's new book The Mother Next Door: Medicine, Deception, and Munchausen by Proxy.  Click here to view our sponsors. Remember that using our codes helps advertisers know you’re listening and helps us keep making the show!   Subscribe on YouTube where we have full episodes and lots of bonus content.  Follow Andrea on Instagram: @andreadunlop Buy Andrea's books here. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Transcript
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Starting point is 00:00:00 Just a quick reminder that my new book, The Mother Next Door, Medicine, Deception, and Munchausen by Proxy, is on sale right now wherever books are sold. The book was an Amazon editor's pick for nonfiction, and the Seattle Times called it a riveting deep dive into MBP. And if you are an audiobook lover and you like hearing my voice, which I'm assuming you do since you're listening here, you should know that I narrate the audiobook as well. If you have already read the book, which I know so many of you have, thank you so much. Please let me know your thoughts and questions at helloandnobodyshouldbelieveme.com and we will bring my co-author, Detective Mike Weber, on for a little book Q&A and post-retirement tell-all special.
Starting point is 00:00:49 Thanks for your support. Where's your playlist taking you? Down the highway? To the mountains? Or just into daydream mode while you're stuck in traffic? With over 4,000 hotels worldwide, Best Western is there to help you make the most of your getaway. wherever that is, because the only thing better than a great playlist
Starting point is 00:01:10 is a great trip. Life's the trip. Make the most of it at Best Western. Book, direct, and save at bestwestern.com. Hello, it's Andrea, and today we are sharing part three of our coverage of the lawsuit against Rady Children's in San Diego, California. If you have not listened to the first two episodes, please do go and listen to those first as this episode will make a lot more sense.
Starting point is 00:01:38 So we have previously covered the events that led up to Dana Gasquet and her husband Bill Meyer suing Rady Children's and a number of other defendants. Today, we're going to be jumping back into the story in early 2020 and learning a little bit more about what happened with Madison Meyer, Bill and Dana's daughter, after she was returned to the custody of her parents and how she ends up ultimately joining this lawsuit. I'm starting off with a solo mission to recap some of the events and then I will be back with Dr. Becks to pick up our conversation about the legal case as it stands today. As a quick refresh, in the first two episodes of the series, we covered
Starting point is 00:02:17 this complex and escalating medical and legal odyssey of Madison Meyer, who was a teenager during the time of these events. Her story begins with a reported surfing injury in 2016. Following this, according to the lawsuit, she was then diagnosed with Ehlers-Danlos syndrome, CRPS, and POTS. Over the course of several years, Madison then undergoes multiple surgeries and treatments for chronic pain and ends up with a host of other complications, including GI symptoms, feeding tubes, and a central line. Her treatment spanned multiple healthcare systems, including Kaiser Permanente, where
Starting point is 00:02:53 her parents work, and a controversial specialist in New York, who we will be covering in an upcoming episode. Ultimately, Madison ends up being admitted to Rady Children's in early 2019. During this time, the hospital's suspicions of medical child abuse prompted covert video surveillance and two reports to Child Protective Services, or HHSA, as it's known in California. The second of these reports leads to a court-ordered separation from Madison's parents, which takes us up to where we begin our episode today. On February 5, 2020, juvenile court Judge Michael Imhoff dismissed the second Health and Human Services Agency, HHSA, complaint and returned custody of Madison to her parents,
Starting point is 00:03:37 Bill and Dana. So importantly, we do not have a copy of this judge's order because it's not part of the public record. So we do not have the full story of why the judge made this decision. But there are several interesting quotes included in the lawsuit that have also appeared in the media coverage that give us a bit of insight. As to the evidence presented at trial about the abuse itself, all we know is that the judge ultimately ruled that he found the allegations of Munchausen by proxy to be quote unfounded. Now as
Starting point is 00:04:06 a reminder, the role of a juvenile court judge in a case like this is to determine whether or not the parents can provide a safe home for their child, which this judge evidently believed that they could at this time. Now as we've discussed many times on this show, this judge's decision could mean a lot of things. It could mean that he didn't find the evidence presented at trial to be convincing. It could mean that he didn't have any understanding of what Munchausen by proxy abuse is, which unfortunately is often the case with judges. It could also mean that he doesn't believe Munchausen by proxy even exists.
Starting point is 00:04:42 Again, not as uncommon as one would hope. And in fact, this order includes a pretty charged comment about Munchausen by proxy from Judge Imhoff, who said that Madison's parents, Bill Meyer and Dana Gaske, had been quote, branded with their own scarlet letter, meaning that of being Munchausen by proxy perpetrators. This judge also seems to have pretty strong feelings about the use of covert video surveillance, saying, quote, "'The way it was implemented was an unbelievable invasion of privacy,
Starting point is 00:05:14 an insensitive invasion of privacy.'" And this covert video surveillance is pretty central to this lawsuit. So what do we know about what was captured on this video surveillance, which took place while Madison was in the hospital with her parents? So during the juvenile court proceedings, county officials claimed that the footage showed, quote, Madison fabricating her symptomology and the mother being complicit. Now the plaintiffs assert that this was, quote, patently and demonstrably untrue, and
Starting point is 00:05:45 that this was, quote, debunked at trial. Without any records from the trial, this is impossible to verify, but this appears to be the lynchpin of the argument that the officials, quote, falsified evidence of Munchausen by proxy. So, we've basically got a he said she said about what's on the video at this point, and importantly, this wouldn't have been the only piece of evidence presented in court as this was a lengthy investigation. Details about Madison's health during her time at Rady's are sparse. However, interestingly, after the judge returned custody of Madison to her parents, she remained impatient at Rady's,
Starting point is 00:06:20 which certainly speaks to her having some ongoing medical complexity, and also was, I can only imagine, an extraordinarily tense situation given the court battle. The paperwork around these two lawsuits is immensely complicated. There are a number of amendments to the original complaint, so just to note that these next pieces of information did not appear in either of the original complaints filed by Madison or her parents, but in the first amended complaint. And it's in this filing that we learn a really shocking new allegation, that Madison had disclosed to staff at Rady's that she had been sexually abused by her parents,
Starting point is 00:06:57 and the plaintiffs, Madison and her parents, are alleging that this disclosure was a result of false memories being implanted in Madison's mind by the hospital staff. The lawsuit further frames this as part of the ongoing medical, emotional, and psychological abuse that the hospital had been subjecting Madison to as part of a conspiracy between dozens of people named and unnamed. Here is the language that appears in the lawsuit about this. Quote, in addition to many various unwarranted tests
Starting point is 00:07:29 and surgeries, these procedures also included mental, emotional, and psychological manipulation, which focused on implanting false memories of sexual abuse. And furthermore, the lawsuit claims that HHSA was in on this as well, saying that the doctors worked with a number of people, both named individually in the lawsuit and anonymously as Doze 1 through 10, at HHSA and that all of them together, quote, subjected Madison
Starting point is 00:07:57 to intensive emotional and psychological manipulation, which included the use of, among other things, memory implantation techniques in order to implant false memories of sexual abuse in Madison's mind. So let's examine this claim just a bit. There were a number of court cases in the 1990s that involved falsely recovered memories in children, which led to the so-called memory wars. And again, we are going to unpack these discrepancies in a future episode. But needless to say, this is an absolutely
Starting point is 00:08:30 explosive accusation on the part of the plaintiffs in this case. If, as this lawsuit suggests, a group of licensed professionals conspired to implant a false memory of sexual abuse in teenage Madison's mind, which would not, by the way, be easy to pull off based on the literature about how and why the phenomenon of false recovered memories takes place, these people would be risking their licenses, their careers, and
Starting point is 00:08:55 even possibly face jail time. There is no documented, proven case in US legal history where a group of medical and child welfare professionals conspired to implant false memories of sexual abuse on purpose to remove a child from parental custody, which is to be clear what this lawsuit is alleging they did. There are certainly cases where child welfare workers have been overzealous, where children have recanted sexual abuse allegations, or where therapists have used poorer or suggestive techniques. But that is not what this lawsuit is alleging. They're arguing that this was but one piece of a many-pronged plot to remove Madison from her parents.
Starting point is 00:09:36 Now we don't get any additional details about the allegations themselves, but from this we can assume that Madison made some kind of disclosure to hospital staff. Under what circumstances or exactly when, we don't know. The next major revelation from the first amended complaint is that Madison attempted suicide on June 16th of 2020, just a few months after custody was returned to her parents. And it was this event that led HHSA to file their third report about Madison and a second petition to remove Madison from her parents' custody. The lawsuit includes an excerpt from this HHSA petition.
Starting point is 00:10:14 The petition does describe details of the suicide attempt, but they are very upsetting, so we are not going to include those here. It goes on to say that, quote, the child had been hospitalized since August 2018 and has a diagnosis of conversion disorder, factitious disorder, somatic symptom disorder, post-traumatic stress disorder, and anxiety disorder. The child left a suicide note expressing her extreme anxiety at the prospect of leaving Rady Children's Hospital and eventually being returned to parental care,
Starting point is 00:10:45 stating that she would rather die than return to her parents. The child continues to have extensive mental health needs and her anxiety regarding returning to the care of her parents has jeopardized her physical safety, all of which renders the parents incapable of meeting her mental health needs at this time. So obviously all of this is absolutely heartbreaking
Starting point is 00:11:06 no matter your thoughts on this case. You may have also noticed that the diagnoses here may sound familiar if you listen to our coverage of the Kowalski v. Johns Hopkins case. So in this case, it would appear that the parents are arguing the child suffers from CRPS, POTS, and EDS while the hospital is pointing to conversion disorder, factOTS, and EDS, while the hospital is pointing to conversion disorder, factitious disorder, and somatic symptom disorder as Madison's true medical condition. And we are going to unpack all of this a bit further. Following the HHSA report, Madison was once again detained from her parents on June 29, 2020. In February of 2021, Dana Gasquet and Bill Meyer filed their original lawsuit against
Starting point is 00:11:47 the County of San Diego, the San Diego County Health and Human Services, Rady Children's Hospital, the Regents of the University of California, Named Employees of Rady Children's Hospital, HHSA, University of California, and Shailen Nino, the child abuse pediatrician. The second petition to remove Madison from her parents goes to court on March 12th of 2021, at which point Madison appears to be out of Rady and at a short-term residential therapeutic program called Milestones.
Starting point is 00:12:17 The second petition to remove Madison from her parents' custody is based on the suicide attempt and the sexual abuse allegations, and the county rests its case on April 23rd, 2021. And the lawsuit makes yet another explosive claim about this part of the proceedings. Here's a quote. On April 23rd, 2021, after the county rested, it was reported to the juvenile court and all parties that Madison's short-term residential treatment program milestones was going to eject Madison from the home within 24 hours of the entry of dismissal in the event the juvenile court refused to find jurisdiction, i.e. determine the new sexual abuse allegations
Starting point is 00:12:56 were untrue. This is obviously quite a dense bit of legalese, so I did a little research around what the lawsuit is actually saying happened here. Basically, they're alleging that Madison was going to be kicked out of her residential treatment center if the court didn't remove custody from her parents. We don't have any direct quotes in this piece, so that is, again, the lawsuit's interpretation of what happened here. Now, there are definitely regulations around discharging a minor from a facility like this, and Madison was 17 at the time, but I'm not going to claim that these systems are perfect or that people never fall through the cracks. However, according to this lawsuit, the threat of Madison's ejection from Milestones was
Starting point is 00:13:35 tactical. So basically, they're arguing that Milestones was now in on the conspiracy to keep Madison separated from her parents and that they pressured the court to keep Madison in state custody. The lawsuit claims that because Dana and Bill didn't want to see their child, quote, homeless, disabled, and on the street, that the parents stipulated to the juvenile court's jurisdiction,
Starting point is 00:13:55 meaning they conceded to let the court keep Madison in state custody. So they are positing that they were given the choice between agreeing with the court that they shouldn't have custody of Madison or their child being homeless. And again, we cannot verify the veracity of this claim based on the information we have. The lawsuit also alleges that the county's petition to remove Madison itself was, quote, knowingly fraudulent because, again, I'm quoting, Madison's distressed was caused and generated
Starting point is 00:14:25 not by any real fear or concern about returning to her parents, but rather as a direct result of the months of psychiatric and psychological manipulation and coercion she had endured at the hands of defendants. Okay, so that was a lot. Let's recap. So what we know is that Madison made a disclosure of sexual abuse at some point during this time period and that she attempted suicide, leaving a note that said she would rather die than return to the custody of her parents. And this is all happening on top of the existing investigation into her parents for munchausen by proxy abuse, which led to the first petition to remove Madison. That petition was ultimately dismissed by the
Starting point is 00:15:11 courts, but the second petition was granted and reunification services were ultimately terminated. Madison then turned 18 in August of 2021. The lawsuit argues that all of this, the Munchausen by proxy allegations and the sexual abuse disclosures, were a result of a conspiracy of dozens of individuals across different agencies to separate Madison from her parents, and that Madison's suicide attempt was a result of their coercion and manipulation, not out of a genuine fear of her parents as she herself said in her note. As to why all of these people would put their reputations, livelihoods, and potentially even their freedom at risk to remove one teenage girl from her parents, it's hard to divine from this legal back and forth exactly what the plaintiffs are saying motivated all of
Starting point is 00:16:01 this coercion and conspiracy by all these people. Their argument is honestly pretty tough to track. At various points in the lawsuit, they suggest it was these individuals trying to cover up for their own illegal activities with video surveillance, that it was their confirmation bias, that it was them trying to protect themselves and their reputations, or that this all was born out of plain old malicious intent and a desire to encroach on parental rights and control medical decision-making for Madison. Perhaps some of you listening find these motivations credible. I have to say I do not. I just don't see what any of these people had to gain by doing this. Providers who want to protect themselves get rid of these
Starting point is 00:16:43 patients. They don't dedicate themselves to going after the parents. They know the stakes and they know they could easily end up in a lawsuit just like this. The argument this lawsuit is making is not that someone made a mistake in reporting this abuse, which is certainly a thing that happens, or that someone got their facts wrong or was overzealous in their efforts to protect a child, but rather that all of these people were part of a conspiracy. The suit alleges that a broad network of professionals from Rady Children's Hospital, San Diego
Starting point is 00:17:16 HHSA, and the juvenile court system colluded to secretly surveil Madison, fabricate abuse claims, implant false memories of sexual assault, lie to the court, and ultimately sever the parent-child relationship, all while knowing these claims were untrue. So that brings us up to speed on where this lawsuit stands today. And now we are going to be talking to Dr. Becks about the third amended complaint in this lawsuit. Hello. Hi, Dr. Becks about the third amended complaint in this lawsuit.
Starting point is 00:17:50 Hello. Hi, Dr. Becks. Hi, Andrea. Good to see you. Thanks for being with us. Of course. I actually just got to see you in real life a few days ago. But if you want to know more about that, you guys are going to have to stay tuned for season six and the special cameo from our favorite pediatric hospitalist, former secret doctor friend. We've come so far.
Starting point is 00:18:15 We've come so far. It's been such a journey. It's been such a journey. So just a little bit of table setting before we get into today's discussion. First of all, thank you so much to everyone who has gotten in touch with their thoughts about this series and with their feedback about Ehlers-Danlos syndrome. I've heard from a bunch of you that have Ehlers-Danlos syndrome that also have POTS or one or both of those conditions. And we're so appreciative of this feedback.
Starting point is 00:18:47 And we are always trying to address these conditions in a way that is respectful to the people that have them. And we think it's important to talk about how some of these conditions get used wrongly because we want to protect the people that have these conditions. And we have actually heard from a lot of you that this is a pretty known problem
Starting point is 00:19:10 within these communities, which is really fascinating. And that that has affected your experience with doctors, which is exactly kind of the fear of these things really getting utilized by perpetrators or by people who are engaging in munchausen behaviors. So really fascinating to hear. And just to say, you know, Bex is obviously a very knowledgeable pediatric hospitalist. She is not an expert in Ehlers-Danlos syndrome. I am not a doctor of any kind. And also, neither
Starting point is 00:19:41 Bex nor I are lawyers. But we are going to talk through this lawsuit. We have obviously spent a lot of time with a similar lawsuit with the Kowalski trial and have encountered a number of similar lawsuits in the time since then. Sophie Hartman had a similar lawsuit. My sister has had several similar lawsuits. There is a big situation in Lehigh, Pennsylvania that is a little bit different,
Starting point is 00:20:06 but is sort of a similar strategy. So we are talking about these lawsuits regularly. So we're offering our perspective in that context. We are going to have, if not the lawyers from this case, who we are still talking to about coming on for an interview. That obviously is always a little bit tricky when there's pending litigation. If not, we will have another lawyer who can help talk us through the specifics of the legal stuff.
Starting point is 00:20:33 And we will also have a doctor who specializes in Ehlers-Danlos syndrome come on and speak to us about that to really give us a better grounding. And in the meantime, if you are someone who would like to share your personal experiences with this, with any of these related conditions, please feel free to get in touch. You can send us a voice memo at helloatnobodyshouldbelieveme.com
Starting point is 00:20:55 or you can just send us an email there or you can leave a comment on Spotify. Those are the ways to kind of get in touch. And yeah, we really appreciate that feedback. And with that, Bex, we're going to pick up the story with the third amended complaint. Is that right? Right.
Starting point is 00:21:14 The complaint of Madison Meyer. So this is what we focused on prior to this was the complaints and the court process that was kind of going on between the parents William Meyer and Dana Gasquet against the defendants, including Rady Children's Hospital, and then the County of San Diego, and all of the other defendants that kind of came along with that.
Starting point is 00:21:37 Now we started jumping into the story of Madison Meyer, who rejoined, kind of came back in, or we started to hear about again in 2023. And then now we're at the third amended complaint by Madison Meyer since the two court cases have been merged. So now it's the parents and Madison are all involved in one kind of court proceeding. And this is the third amended complaint
Starting point is 00:22:04 that actually just came out this year in 2025 and just very recently within the last couple of weeks. And so I just looked last night, and there has been a response by the defendants to basically dismiss the whole claim, the whole thing. But the judge has not responded. The court has not responded. So that's where it stands as of recording today.
Starting point is 00:22:26 And now what I wanted to do is kind of go through each of the claims that are standing right in front of the court right now, hoping that maybe we can talk a little bit about them and kind of see how we're feeling or thinking. And then that way, when the response comes or things happen, then we can kind can keep going forward with the case and following along in real time from there.
Starting point is 00:22:48 So what is in this third amended complaint? So now they're just going claim by claim and using all the legal terminology and really stating out why each of these claims should hold in their mind. And then I guess it goes to the defendants to come back and say if there's kind of legal precedent in cases that would justify dismissing any of these.
Starting point is 00:23:10 And then the judge kind of decides, at this point, this is where we stand. So I'm just going to go complaint to complaint and then kind of let I have some questions for you specific to each one just because, again, from our experiences and then my experiences you know as a physician I think we kind of have a unique ability to just kind of talk them through I think before we know where everything goes from here.
Starting point is 00:23:32 So the first complaint is a violation of federal civil rights. So again like we talked about we are in federal court for this case so a lot of the claims are going to tie back to federal statutes or even amendments to the Constitution or things like this one goes into the American Disabilities Act. So again, it's all going to tie back to those federal statutes when they make the claims. So the first one is a violation of federal civil rights.
Starting point is 00:23:59 And this is on the unwarranted search and surveillance and the invasion of privacy. So the basis or the gist, if you read all of the parts of this portion of the complaint, are speaking more to the video surveillance. So like we talked about last time, it was those, I believe at this point they were saying 38 days of video surveillance that occurred
Starting point is 00:24:20 in the hospital room of Madison, 24 hours a day, seven days a week, and involved the surveillance of Madison and her parents at any point that they were within the hospital room. And the claim states that these efforts or the efforts to do the video surveillance were basically undertaken in an investigatory capacity. So they are saying that it was the express purpose and intent So they are saying that it was the express purpose and intent of uncovering evidence of child abuse if such evidence even ever existed. And then they even say in an effort to uncover or manufacture evidence of child abuse. So we talked a little bit about this last time, but what are your thoughts on that?
Starting point is 00:25:00 Kind of the word, the parentheses or manufacturer kind of stuck out to me a bit. Yeah, I mean, there's some real complexity here. Because as we've discussed, covert video surveillance has been used for decades in an investigatory capacity to determine whether or not child abuse is happening. We've covered a lot of cases where that evidence has held up in court. So I think one of the things, again, not being a lawyer,
Starting point is 00:25:25 but one of the things that's been so interesting as I've gotten into the legal side of this, and I think even as we've seen some of these huge cases, Supreme Court cases play out in the last few years and such, it's like the law is constantly open to interpretation and challenge. And so just because there's precedent, I think a lot of lawyers, a lot of things
Starting point is 00:25:46 I've heard from people about medical child abuse cases is that lawyers don't like to set precedent, or DAs don't like to set precedent. But then I think there are some lawyers maybe that do, and that really that is more activisty lawyers that really do want to overturn things. I think about these things as, when you think about the kind of the trajectory
Starting point is 00:26:06 that overturned Roe v. Wade, right? It was a series of cases along the line that then ended up overturning 40 years of precedent, or 50 years of precedent. So I think there is precedent where this kind of evidence has been accepted in sort of the, in order to don't know the exact legal language, but basically there is no reasonable expectation
Starting point is 00:26:28 of privacy when you're in a hospital room. I think beyond probably being in the bathroom or something. But that this is included in hospital policy and that kind of thing. So obviously this case, part of the point of it seems to be to challenge that, right? And to say that to set a new precedent that you actually cannot surveil families when you suspect that they're abusing their child. And again, it's this tension between a parent's rights to privacy
Starting point is 00:26:56 versus the safety of their child. And so I think it just kind of speaks to that tension. So certainly like that piece about this covert video surveillance will be interesting to see how it plays out. The manufacturing piece, that obviously sounds like because I think it's not an argument I agree with that parents should have, that their privacy should go over the child's well-being. But I sort of see the argument that right, that like, I see where you're
Starting point is 00:27:26 making a privacy argument and you're making, you know, like a Fourth Amendment type of complaint, right? Like that, that makes sense. The manufacturing piece, I think that really speaks to more of this like conspiratorial language of implying that hospital staff is doing something to create an allegation of abuse. It's just not a very, yeah, it's not a very reasonable argument. I mean, I don't quite know how else to say it. It gets us back into conspiracy territory, I think, whereas the other one is just an argument about privacy and who should have rights to privacy.
Starting point is 00:27:59 I mean, it's interesting because I feel like they are sticking very much, right? And I think when we read these claims, I've now read so many, I feel like they stick to the script. They know the terminology, they say things that fit. It is a complaint or it is a breach of this federal statute because of this, this, and this. But that little parentheses or manufacturer, that just felt a little bit, felt to me a little bit more emotionally charged or they were throwing that in as more of a,
Starting point is 00:28:26 so maybe you don't think the surveillance is bad, but what if they were manufacturing it, dot, dot, dot, and then it kind of goes on to the next thing. And so I think, I mean, to me, it sounds like it's intended to kind of get, kind of grab your attention or make you think, oh wait, was this intentional or something? But that's my own kind of thought.
Starting point is 00:28:42 No, I think it's inflammatory. And I think it's like, those are two separate things, right? It's like, OK, well, I would argue, OK, again, that where I stand on this is that I think covert video surveillance should be allowed. There have been many cases we've looked at where that's been a life-saving measure. So I certainly understand.
Starting point is 00:29:00 And I also understand why it makes parents uncomfortable. But I think it's more important to keep children safe. That's where I stand on that. But do I think it would be wrong if providers set up covert video surveillance and then somehow tampered with it in many? Of course. Those are two very, very different claims, right?
Starting point is 00:29:19 So that is striking for sure. And I think the expectation of privacy in the hospital room, I think, again, right now, it seems like it's very hospital dependent based on what the hospital's individual policies are, whether hospitals have private rooms or have double rooms, or how many patients are in a room, because right then and there, you've
Starting point is 00:29:38 lost some of the privacy aspect. For instance, in an emergency room where there may be curtains separating beds, what is the privacy versus in a case where it is a private room with its own entrance. And so I think the way hospitals are changing more to having private rooms, which as a mother, as a patient, I think is wonderful.
Starting point is 00:30:00 But does that change, I guess, that overall assumption of privacy that maybe a family or a patient has coming into the hospital? So I guess time will tell, or we'll see how this case or other cases go. And I think I just wanted to briefly touch on the different amendments, because I think I took government in high school, AP government.
Starting point is 00:30:20 And so I was like, I'm just going to brush up a little bit. But I think the three amendments just for those that have been following along with us that really come into play in most of these cases are the first, fourth, and 14th. The first speaks to, and it comes into this claim, this idea of the right to intimate association
Starting point is 00:30:38 or the right to familial association, meaning I guess this idea that it protects intimate association or your family's association with each other from kind of intrusion by the government. And so this question of if a family is having private conversations within a hospital room and they are assuming, I guess, that they are not being surveilled or watched, you know, is it okay to be kind of being through this video surveillance also listening in potentially on private family conversations? The fourth amendment is the one that is search and seizure. But they bring this in about kind of protecting a family's home.
Starting point is 00:31:18 So in the sense of if CPS shows up at your door or child protective services shows up at your door, do you have to let them in? Or in a hospital situation like happened here, they basically called the dad, it sounds like from the court documents anyway, into a room to tell him that at that point that the custody had been changed to the County of San Diego. And he did not get to go back in that room
Starting point is 00:31:42 from that moment. So this is where the Fourth Amendment plays in, I think, is the seizure aspect, but also the coming into your place that is assumed to be yours or your private space. And then the 14th is probably the one that gets, I think, interpreted in a lot of court cases. So there's a lot of case history that you can go back to. This is that due process doctrine. So the idea that you should be protected, your decision should be protected,
Starting point is 00:32:13 and basically nothing should be able to come to you without due process. So meaning that you deserve due process before any of your rights are taken away. And so this is the parents' rights, really I think their hub is the 14th Amendment. And so all of that is used in this first claim regarding the video surveillance, as it's an intrusion
Starting point is 00:32:33 into a family association. It's an intrusion into a family's privacy. And then the idea that should that freedom be taken away without any due process, so basically without the family being aware. Yeah. It's really interesting. There's just such interesting tensions in these cases.
Starting point is 00:32:51 And I think it really comes down to how you view the parent and child relationship and how you view children. And I think that there are wider differences in this than I realized when I set out on this work. And due process is obviously something that is being talked about a lot in the news right now because there are both immigrants and citizens in some cases being removed without due process. And that is obviously a horror.
Starting point is 00:33:19 And I think there are some really important lines to draw here about what freedom means, right? Like taking away your freedom, like if you are unlawfully deporting you to another country or jailing you, right, without going through, without getting a hearing even, without going through a trial, without having due process. To me, fundamentally, that is very different than your child being removed because there
Starting point is 00:33:43 is a very credible threat to your child, I understand where that's upsetting and where people could see that as a violation of rights and where it can be in some cases. I mean, there is a history of child removal in this country that is extremely dark, right, from indigenous populations, where they took their children away from families and put them in these residential schools. And I mean, it's put the children, took their children away from families and put them in these, you know, residential schools.
Starting point is 00:34:05 And I mean, it's not, it's not without precedent, right? So it is an important conversation. But I think like there is a real tension there between, you know, the welfare and safety of a child and their human rights basically, you know, versus their parents' rights to have them in the House, it's certainly very nuanced. So yeah, it's really interesting to think about those amendments that this speaks to. So the next claim is another violation of federal civil rights. And this one talks to the deception and the presentation of evidence and false reporting.
Starting point is 00:34:45 So we did touch on this a little bit last time, but this concept of, you know, the wording in the lawsuit says that these defendants basically knowingly falsified child abuse reports that there was knowingly false evidence and based on and that this decision to remove the child was based on a juvenile court order, which the defendant fraudulently obtained, caused to be fraudulently obtained, or knew was fraudulently obtained. So again, the words false and fraudulent kind of continue to come up. And then they even say it to the point of that these defendants acted, agreed, and or conspired to employ these tactics, and then to continue
Starting point is 00:35:27 to employ them, basically, to extend, I think, the time that she was detained. And so I think I've said this probably 100 times on the podcast, this concept of conspiring in medicine, when anyone who lives in the world of medicine knows that it is difficult to get three doctors to agree on a diagnosis, sometimes, let alone get a group of doctors that would all be willing to conspire, quote unquote, against a family,
Starting point is 00:35:50 I guess, as some of these cases have claimed. That seems very far-fetched. And that's because I work in this field, and I cannot imagine walking around being like, hey, guys, we should really do this and having everyone buy into it. It's just not how kind of things work. We all have our own set of principles. We all have our different specialty.
Starting point is 00:36:10 We all have things we're coming in with previous experience. And to me, the word knowingly, and I'm gonna ask you kind of what you think after, but this idea of intentionality, right? That it was intentional. You knew you were lying and you lied, or you knew you were falsifying and you falsified. So to me, that is I am looking at a lab result that says a child's hemoglobin is low, meaning his blood count is low or he has anemia. And I knowingly look
Starting point is 00:36:35 at my report and I'm like, well, patient's blood count was normal for age. Something that is so drastically, it is right in front of you and you are writing it a different way. To me, that isn't knowingly intentionally falsifying. The thing is a lot of medicine is still subjective, meaning you can have three x-rays, a hundred labs, and you're looking at everything. And it's kind of how you, based on experience, based on knowledge, based on your specialty, how all that ties together into a diagnosis is not so objective all the time. And so I think, again, the way things are worded or the way someone interprets information, that's why you have another side of the story, right? It doesn't
Starting point is 00:37:16 mean they're right or wrong. It means that in their medical opinion, this is like how to interpret this data. And so I think it's that intentionality that I know they say because it makes it more a stronger case, I think. But what are your thoughts? Yeah, I mean, I think there's so much complexity here. And I think there's like, because munchausen by proxy abuse is a pattern of abuse. So it's not incident specific.
Starting point is 00:37:41 So if you are saying, and that's why it's important to look at the whole medical record, and I think even like just this sort of like holistic approach to medicine, which child abuse pediatrics is a subspecialty of medicine, right, is not separate from medicine. There are pieces of the child protection apparatus that are separate from medicine, but child abuse pediatrics and the doctors, which is what we're talking about here, are part of the medical system. So the reason that doctors do a medical record review and try and be as holistic as possible
Starting point is 00:38:12 and get as many records as they possibly can is because you have to see the complete picture to understand whether or not it is abuse. Because this is also important for ruling out abuse, which we talk about frequently, that child abuse pediatricians are less likely to have findings of abuse and they find abuse in less than 50% of the cases that they evaluate, right? And so it's important both for finding abuse,
Starting point is 00:38:35 but also for ruling it out because you could have specific things that look like red flags, right? And then you could have an expert look at that whole record and be like, oh, actually there's no evidence of deception here. So this isn't munchausen by proxy abuse, there might be something else going on with this parent, but it's not this abuse pattern. And so we're not going to move forward as though it's an abuse pattern, right? So I think, yeah, if there were something where they're like, well, you know, we watched them go into the like, we saw video surveillance, and all of the doctors
Starting point is 00:39:06 came in and planted something on the bed that looked suspicious and then said the mom did it, or something just smoking gun-ish. But it doesn't sound like we have that information. And of course, we don't have her medical records. So it's really hard to say. But I think as a concept, you're right. And I think it's really important not for just these cases, but when we are in the golden, and by golden I mean terrible,
Starting point is 00:39:29 age of conspiracy theories. You really have to just put some critical thinking skills on it. And also, it is a pretty wild allegation. And again, it's a really common one. The conspiratorial language comes up a ton in these cases. And yeah, it's strange that this is palatable to so many people to me, because for that exact question, I think you just really need to sit there and sit with it
Starting point is 00:39:55 and picture it and be like, OK, three doctors go into a room and they say, what exactly? We don't like these parents. We think they're bad parents. We don't agree with the way they're parenting their child. So we're going to put our jobs at risk, put ourselves in the legal line of fire, and to accuse these families so that we can get this child
Starting point is 00:40:15 away from them, for what benefit? I mean, it just doesn't, it doesn't make any sense. You can't make it make sense because it doesn't make sense. And I think we put stuff into the medical record. We know that is forever discoverable, forever there. It is not hearsay. It is you wrote the words. So again, I think I would hope most physicians are doing that
Starting point is 00:40:34 with a sense of integrity, meaning that I am not going to write something that I did not see with my own eyes. I mean, again, of course, we've talked about there are bad, you know, I'm sure there are people that may, or you may document a physical you didn't do because it's a checkbox or whatever might happen. But they talk a lot about like misquoting.
Starting point is 00:40:50 And I think this is going to be difficult because of the he said, she said aspect. If I put something in quotes in a note, it is something I know I heard and that usually someone also heard, like meaning a resident was with me and can also document that they heard it or a resident was with me and can also document that they heard it or a nurse was in the room.
Starting point is 00:41:07 When you say in quotes, you mean like, mom says. Yes. Again, I would only quote the part that they said. That is something that goes back to my training, but also I could see where that could be human error. I think having someone else there and being able to say the same thing or also being able to document in a note what they heard, I think is useful because it and being able to say the same thing or also being able to document in a note what they heard I think is useful,
Starting point is 00:41:27 because it is going to turn he said, she said at that point. Yeah, and I think one last point about the sort of conspiracy of it, what we see is actually the opposite, that even when there is every red flag and just the most damning evidence. I mean, I'm thinking about this case I'm working on right now. The most damning evidence that you could possibly imagine that abuse is happening, it is still
Starting point is 00:41:53 hard to get doctors to buy in 100%, right? You're still going to have your outliers that just really like the mom, or they have strong feelings about parents rights, or they don't believe that much housing by proxy exists, or they don't believe that much house and my proxy exists, or they don't want to get involved. I mean, it's not easy to get doctors to recognize as a group that abuse is happening right in front of their faces,
Starting point is 00:42:12 because it's so against their training. It's so against their instincts. And they always want something that I love and appreciate about doctors, but that also can really work against some of these cases, is that doctors have this need to get to the bottom of things. And they will chase the wild goose chase diagnosis to the ends of the earth and ignore every red flag
Starting point is 00:42:33 along the way for abuse. That happens really frequently. So I think it makes it doubly unlikely that this group of people specifically is going to conspire about abuse because you can't even get them to do it. And there was a long list in this one also. All right, so what else have we got in this third complaint?
Starting point is 00:42:47 This is claim three for the unwarranted non-consensual medical procedures and examinations. So we talked about this last time with that swallow study that we went into a little bit of detail about. And I think it also speaks to the covert video surveillance in the sense of if it was used for diagnosis of Munchausen by proxy, then it is a diagnostic procedure. So then they should have been notified of it like any other diagnostic procedure. This seems like a little bit of a catch 22 to me because it's, if you're
Starting point is 00:43:19 using it for the word diagnose, okay, then it is a diagnostic measure. So I see how it fits under does it need consent or not, I guess under that what we were talking about last time, like would this hospital consider it a procedure that requires a consent or not? And then but if you see it as they were coming in with this covert surveillance to manufacture, I think was the word evidence of abuse, then was it for diagnosis? I think it's used a little bit in both ways. Yeah. Yeah.
Starting point is 00:43:50 And I mean, it's tricky once you're in a potential abuse situation because if you think about something like a swallow study, well, if they're claiming that the child cannot eat and that child has a feeding tube and the hospital suspects that she doesn't need it, then they need to determine whether or not she needs it to properly treat that child. And so I don't know. Yeah, I mean, I think it makes a lot of sense that they did that. Yeah, but we have talked about that quite a bit. But it's, I think, especially striking because of how many other extremely invasive procedures
Starting point is 00:44:22 this child had had up until this point that it doesn't seem like a swallow study would stick out. But again, we've covered that. And I think a swallow study too, if the parents did refuse that, would that be something you would then go to a court order for, to be honest? Because I mean, I'm thinking for me myself as a physician, feeding through a G-tube is not, I'm sorry,
Starting point is 00:44:40 sometimes I have to tell a family, look, if that's the one thing they need to be safe and be healthy, big picture, it's a little procedure, you know, like you get a little tube. I can kind of say it that way in the sense of if they can still live their life and do everything else, then isn't that great? But at the same time, you're saying, but if they can eat, why are we doing it this way? Right? I mean, like if they don't have a physiologic reason they can't eat, is it harmful to then
Starting point is 00:45:05 not allow them to? Right. Well, and it's not... And feeding tubes are not without risk, right? Exactly. There's a risk of infection. There's... Yeah.
Starting point is 00:45:14 So that's not good medicine. Like, if you're giving a child a feeding tube that doesn't need one, that's not good medicine. That's not do no harm. And so, yeah, it's this interesting thought experiment of, like, if they'd refuse the swallow study. And I think I it's an interesting thought experiment of like if they'd refuse the swallow study. And I think I would say I probably would have. In my experience, if I thought it would, there was a true chance that it would change the outcome for the child, I think I would at least argue in favor of doing it. But I don't know what the exact circumstances. But my
Starting point is 00:45:38 thought is if you can get a tube out of a kid and they can eat, that would still, like in most cases, I think be my goal. Of course. Yeah. and they can eat, that would still, like in most cases, I think, be my goal. Of course. Yeah. And so number four. So this is where we start getting into the question of Madison having the diagnosis of hypermobile Ehlers-Danlos along with the other things we've spoken of. This one is now a violation of federal civil rights that they failed to provide adequate supervision, safety, security, and health care to her. And the idea that she was under the custody of the government
Starting point is 00:46:11 at this time or under the custody of the County of San Diego. So now we're talking about the time from that shelter or detain order forward, which we don't have a lot of information about in the documentation. But the idea that if the government has custody of a child, they owe them reasonable safety, minimally adequate care, and then also appropriate medical and mental
Starting point is 00:46:32 health care, which I think should go without saying, but also it is stated. And I think we have talked about before, when a child is in a hospital, I think that there have been times where they become less of an urgent priority to get them into placement elsewhere, like into a foster care situation, because a hospital is seen as a safe and healthy place
Starting point is 00:46:54 for a child. And so their argument is, I think, that the defendants were aware of her true medical condition, which implying they list off but hypermobile Ehlers-Danlos is at the top, and that they failed to investigate the actual cause, failed or refused to provide treatment, and then they do get into this use of unapproved and unauthorized hypnotic techniques to inject false memories. So this plays into the whole sexual assault claims.
Starting point is 00:47:22 This is kind of a function of the two complaints being combined at this point, because that was from Madison's complaint. Correct. And I think this, yeah, this wouldn't have been available or information that was in the parents' complaints just because we didn't know this piece. But I think it always makes me think,
Starting point is 00:47:37 and this makes me think of the Kowalski case that Andrea and I covered a couple of years ago, this idea that I looked up for myself, and as we said, we will probably speak, hopefully speak with an Ehlers-Danlos specialist, but kind of what the standard of treatment is. And it starts on patient education, lifestyle changes, teaching awareness of their own body,
Starting point is 00:48:00 self-management techniques, physical therapy, it lists as the cornerstone of Ehlers-Danlos care. And then pain management, obviously starting with non-opioid pain medicines and so on. And then you start getting into kind of managing the coexisting conditions that come into Ehlers-Danlos. So those foundational things, to me, in most hospitalizations, those very basics are available
Starting point is 00:48:24 or are being offered to a child. So again, because we don't have the medical records, I cannot speak to exactly what her treatment plan looked like. But to me, this feels a lot like where they were saying that Maya Kowalski was being treated as a munchausen by proxy victim as opposed to a patient with CRPS. Right, or they were saying, one of the malpractice complaints in the Kowalski case was that they did not treat her for CRPS.
Starting point is 00:48:52 And then they also claimed fraudulent billing because they put CRPS on there. So it was sort of like a double-edged sword there. Because the standard of care for CRPS is PTOT pain management. What the Kowalskis wanted was horse size, in their words, doses of ketamine and ketamine five-day ketamine comas in other countries. So they were arguing that because the hospital, and that was what brought the whole thing to a head originally, was that the mother was demanding these days, this amount of ketamine that the hospital would not give. So we don't know specifically what their complaint is
Starting point is 00:49:33 in regards to like, she should have received X, Y, Z for her Ehlers-Danlos, but she didn't. We don't know those specifics. They're just saying that her Ehlers-Danlos wasn't treated appropriately. Yep. We'll talk quickly about the Americans with Disability Act a little bit later, where we talk, um, there are a few specifics mentioned, but I think this one as a physician
Starting point is 00:49:51 really stuck out to me as I kind of feel like if we are doing the standard of care, like does every child look forward to PT and OT every day? No, like there are times they may have pain after it. So we have to talk about like, how can we make it work for them, make it work. But I still think that as long as you are following the standard of care, I guess at that point, it becomes, what if the parent thinks the care should be different? And I put myself kind of in this position.
Starting point is 00:50:19 And I've thought about times I've been in it. A parent says they want a lumbar puncture to know for sure that something doesn't exist. But in my medical opinion, it does not exist based on my exam. And that is a procedure I do not feel is warranted and I therefore won't do. Can a parent make me do a procedure I don't want to do? You know what I mean?
Starting point is 00:50:40 And where is that line of what if one specialist says, Oh, do the lumbar puncture? Okay, but what if, what if I still don't know that in my experience, that is standard of care, I think these questions are going to come up more and more. Because there was a time when a parent wouldn't even know to come in and ask for a lumbar puncture, frankly, you know, so now they know how do we navigate that. And that's what this, I think what this claim really brought up for me as a physician was thinking about these things. Yeah, I think we're unfortunately in the do your own research, era of medicine, and people have too
Starting point is 00:51:14 much access to too much misinformation. And it's really, I mean, I think this is why there's so much crossover with the anti vax conversation, right It's like, well, you're making a medical decision for your child that is not in their best interest based on your opinion as a non-medical professional, right? And that's just like, that's not the way that medicine should work. Or like, to a point, right? I mean, you can decide, like there's obviously like
Starting point is 00:51:45 realms of this where it is in the parental decision, you know, like if your child has a fever, like you can decide whether or not to like, if they're not super high, whether or not you want to give them Tylenol right now or whether you want to wait a little while or like, so obviously there are like, there is a space for parental decision making, but it just shouldn't, just shouldn't involve things that put the child at risk. And I think that's like a really important line to draw. And I think it's a joint decision making.
Starting point is 00:52:12 Yeah, joint decision making. I think what we strive for, but it's getting harder and harder. I'm not gonna lie, as a physician. Physicians do have to draw boundaries, you know? And I think as a society, we have to draw boundaries. Like, is it okay to decide that you don't believe in dental care and you're never going to take
Starting point is 00:52:26 your kids to the dentist, even if they're getting a ton of infections? No, we would call that medical neglect. I think to some degree, we have to decide as a society how we see children and how we regard that relationship and where the boundaries are on that relationship. That's why child protection at rest exist. So claim five and six both speak to this idea, kind of like what we were already talking about. But the first one is about in the creation of the case plan for Madison,
Starting point is 00:52:56 that they should have been taking into account all elements of her medical condition and that she should have been aware of this case plan and kind of how these discussions went down as far as the case plan, meaning where we go from here, it sounds like. And then going into the Americans with Disability Act and the Vocational Rehabilitation Act, the idea that Madison had a disability and was she in any way kind of discriminated against based on that disability. And so I think all of these counts get to the heart of
Starting point is 00:53:27 if standard of care or if what is needed for this specific child with Ehlers-Danlos is seen differently by the parents and by the physicians taking care of her, how do you reach that joint decision-making? And if the hospital or doctor is potentially going down the path of what they see the standard of care to be or the hospital sees the standard of care to be,
Starting point is 00:53:49 then how do you even play out one of, I think, one of these lawsuits in the sense of, if we started from different points, can we ever kind of see it the same? And then the idea of this being a disability. So I did look this up just so I could kind of speak a little bit to it. But Ehlers-Danlos in and of itself is not in this blue book that the Social Security Administration
Starting point is 00:54:09 puts out for like standalone diagnoses that basically put you in the ability to be able to have like disability services. And so it is seen as a disability, but it is not in that book. It has to be Ehlers-Danlos plus. So Ehlers Danlos plus some like substantial functional impairment, inability to maintain walking or standing for long periods, chronic severe instability or pain, things that are actually interfering with your ability to work, your ability to, I think it says to perform quote, substantial gainful activity. So basically does this diagnosis have enough of these other features to say that it would do that?
Starting point is 00:54:52 And I know that's not really what these claims are saying, but the idea is they are claiming she does have a disability, so by that definition, she would meet those criteria. And then did the hospital, did the physicians potentially withhold or discriminate against her in any way based on that disability? This is where one of the specifics comes up.
Starting point is 00:55:13 The idea that they denied transfer to a facility that specializes in Ehlers-Danlos. I don't know what the specifics of that were. The use of an appropriate wheelchair, her use of her phone and her tablet were things that were mentioned. And again, as a physician, I was thinking through this. If physical therapy evaluations are saying a child has
Starting point is 00:55:35 the ability to walk and therefore we are working on them with that, we tend to opt for the least invasive and using maybe the other one as a backup or something like if it is needed. This can be a bit of a gray area. If you send someone home with a walker or a wheelchair, it is very easy for that to become what they need and what they use.
Starting point is 00:55:58 So often we put timelines on things like, we will send you home with this, but you follow up in this long, and then we'll kind of keep reassessing whether this need continues. The hard part is you can buy these things on Amazon now or anywhere, so even if we don't order a wheelchair, they can still get a wheelchair. So again, this is a slippery slope that as a physician,
Starting point is 00:56:20 I can read my own way based on my own experience. But this question of the appropriate wheelchair is, was it the physician thought one thing was appropriate and the family thought another? Is that grounds for a lawsuit? Or is that discrimination based on the disability? I think these counts all just kind of keep bringing up these things. And I did look up in Ehlers-Danlos, at least from the data we have, it is a small percentage of people with Ehlers-Danlos, and usually on an as-needed basis
Starting point is 00:56:48 that a wheelchair is needed. So you're going to spend the day at Disney. Maybe that may be a long day, and you may need the wheelchair. So it's that as-needed basis, and then still a very small percentage. So I don't know what your thoughts are. Yeah. I mean, and she was in the hospital
Starting point is 00:57:05 for this entire time, right? Yes, at least from the point of view of these complaints, it was while she was under-raiding children's that they're claiming she was discriminated against. Yeah, I mean, it's a hard one to unravel without more information. But I think the idea of a hospital discriminating against a child because of their disability
Starting point is 00:57:24 is sort of hard to square. And certainly, the idea of a hospital discriminating against a child because of their disability is sort of hard to square. And certainly the presence of the wheelchair and the insistence that a child needs a wheelchair when they actually don't is so ubiquitous in these cases, right? And also just want to say too, because there was this horrible video going around on TikTok that if anybody saw, and I don't know, I try to keep anything
Starting point is 00:57:45 having to do with medicine or medical child abuse off my TikTok because my TikTok is the place that I go to brain rot and watch like videos of sheep being crazy and things like and Le Poisson Steve, which is my producer Mariana's favorite obsession of so late. But anyway, there was a video that popped up, and a bunch of people mentioned it to me, where a woman uses a wheelchair occasionally, was putting her wheelchair in her car, and was in a handicapped parking spot.
Starting point is 00:58:13 And some man came up to her window and berated her for faking. So that's obviously horrible behavior on behalf of that man who chose to insert himself into the situation. And yeah, it's worth saying, right, that there are people that are not like wheelchair bound in the way that people think of it, where they cannot get out of a wheelchair, but do need it from time to time. So that exists. But I think certainly like the the place that things like leg braces and wheelchairs, you know, play in these cases of children that either don't need them
Starting point is 00:58:47 at all or are over utilizing them. So this more sounds like the family wanted the child to be in a wheelchair either because they thought she needed it or because they wanted to prove their point. And the hospital didn't do what they thought they should do. And I don't quite see how that can be construed as discriminating against someone with a disability.
Starting point is 00:59:07 But it sounds like I mean. It's kind of the reading between the lines. But I think also I've thought about the whole discrepancy in health care where a family can take up a GoFundMe to get the fancier, more motorized wheelchair. But I have children on the CMS plan, which is like Children's Medical Services for Complex Children, children who live in maybe nursing facilities and things
Starting point is 00:59:30 like that, who can't even get the very basic wheelchair, who need it. And so I do start to think bigger picture with some of this stuff, that it is sometimes, like I said, ordering it on Amazon or taking up a fund for something, it doesn't really matter what the doctors say. And this is a scary piece of the world to me as well, because I've told you time and time again,
Starting point is 00:59:53 my goal with any child is getting to be a kid and getting to live life to the fullest. And if you want to play baseball, let's find out a way you can play baseball. If that's your dream, you know what I mean? What could we do? Or really, is there no way that it's safe because of your condition?
Starting point is 01:00:09 And I think that's that idea of like, where make a wish came from, right? This idea of doing that thing that maybe you never would have gotten that chance to do. Like, we want them to feel like kids and be kids. And I think sometimes when the two concepts go very awry, that is a tough decision as a physician. Sometimes when the two concepts go very awry, that is a tough decision as a physician. Like if I am writing an order for equipment,
Starting point is 01:00:31 it is something that based on the evaluation we've done, we have determined is medically necessary. Writing it because a family wants it, or I don't know, that starts to cross into, you know, unethical territory for me, at least assuming I am looking at the whole picture and I'm listening to all sides and I'm seeing what I'm supposed to see as a physician.
Starting point is 01:00:52 But it is a slippery slope, and I think we've seen it in these cases, and that's why these things kind of jumped out at me, I think, specifically. Yeah, and I mean, there is this broader question, I think, which I really worry about a lot with this show. Because I think it's really important, obviously, to bring this abuse to light.
Starting point is 01:01:09 It's totally under-recognized. I think it slips under the radar for the most part. And it is very hard for people to get what they need, health care-wise, when they actually need it. And so, like, Wheelchair, as you mentioned, I saw a headline the other week that was like, it's impossible to get because so many parts of health care
Starting point is 01:01:31 have been taken over by private equity companies. They're very involved in hospice, which is horrifying. They're very involved in a lot of things. But I mean, there's some big thing in private equity with the wheelchair manufacturers. And so it's now impossible to get wheelchairs repaired because they just want you to buy a new one. And so you think about things like that,
Starting point is 01:01:50 and you're like, god, it's impossible for people to get within it. And so I think that has a twofold thing. It makes people react to that information one of two ways. They're like, well, how could people fake it when it's impossible to get what you need when you really need it, right? And they totally underestimate the time and devotion
Starting point is 01:02:10 and fundraising and absolute obsession that families do put towards this, right? Where they just, they are the family that will go to the ends of the earth and can be very manipulative, et cetera. And then on the other side of the spectrum, I think there are some people that get so obsessed with the idea that someone might be taking advantage of the system that they're like, well, if one person's taking advantage of the spectrum, I think there are some people that get so obsessed with the idea that someone might be taking advantage of the system that they're like, well,
Starting point is 01:02:26 if one person is taking advantage of the system, we're going to get rid of the whole thing, even if that affects the 99% of people that need it, don't get it. But we can't have people taking advantage of the system. And so it's like, you see those two things. And there's just a lot of nuance here. And I think that in both of those
Starting point is 01:02:45 ways for both of those reasons people that do fake it people who are abusing their kids or people who are engaging in munchausen behaviors on themselves make it worse for everyone like they make it worse for people who are trying to run those programs and give the people what they need you know and then it's making things worse for the people who are making to run those programs and give the people what they need, and that it's making things worse for the people who are making policies around it. And it's really, really making things worse for the population that actually needs those things. And the people that are having to jump through those hoops
Starting point is 01:03:16 and are trying to live their lives and work their jobs and take care of their kids, and then also trying to get a dang wheelchair repaired. And then over here, you have these people that are casting doubt on you because they are faking it, and they are using it to abuse their children. And it's like, yeah, it's really a horror show. But yeah, I just, ooh, what a morass.
Starting point is 01:03:39 And it goes into the education system. It goes into every aspect of this. There are kids, I've talked to families about getting a 504 plan for a child with true disability, and how many calls a family has to make, and how many meetings, and how many things. And yet some of these children that I have met, I'm saying over my whole career, that are developmentally
Starting point is 01:04:00 normal, who could excel in a normal classroom, who these parents do fight to get them these services. But there are only so many services to go around. These things are finite. And it is not just they may have a wheelchair. They may have the wheelchair embroidered with the child's name, with all of the newest things, with these things that money does not
Starting point is 01:04:20 come out of the equation. There is some piece of that. And the number of times I have fought for a patient who needs to get a G-tube, but whether it makes sense for that family socially, economically, and yet other people can come in and demand one and get one, it's really the system is entering scary levels. And I think, again, we will see how this case specifically
Starting point is 01:04:42 plays out. But this does bring into question, I think, a lot of what see how this case specifically plays out. But this does bring into question, I think, a lot of what we do in medicine in terms of trying to get a child home and trying to get a child to function and trying to get a child to be as childlike or be as much of a child as they can. If we are working against each other in that,
Starting point is 01:05:01 we're going to hit impasses, I think, on all of these things. And the next couple of claims, it's the Monell-related claims, or claims seven and eight. That is the exact same claims, this idea of the medical procedures, the deception of evidence, but taken to the level of policy. And are there policies that basically promote these things, or are there not policies to prevent these things? So this is the systemic charge of like, this is the whole system is bad. Yeah. Right. And then the ninth claim is the UNRWA Civil Rights Act. This is again, speaking to
Starting point is 01:05:34 if you are in a business in California, they shouldn't be able to discriminate against you. So the idea of the hospital as a business and therefore the same claims just under a different act. And then the last claim that Madison brings in this third complaint, the tenth claim that she brings is denial of access to medical and mental health records. And this is a very short claim and it doesn't give a lot of detail, but basically the statement is that she herself made multiple requests for a complete copy of her records and that there has been refusal on the side of Rady's and the medical defendants in this case
Starting point is 01:06:13 to not comply with these requests. Again, I think at this point, this one is gonna be probably a he said, she said, or they can go back to any email communications and kind of see what holds water. But this to me, I mean, again, I'm curious to see where it goes. Because if this was done all legally
Starting point is 01:06:31 and she was requesting the records, where does that line cross? And I think depends on the state. It depends on the county. It depends on the institution, all of those specific policies. Interesting. So OK, so this is the complaint as it stands.
Starting point is 01:06:43 So now the judge. This is where we are today, yes. OK, so the is the complaint as it stands. So now the judge. This is where we are today, yeah. Okay, so the judge, hot off the presses. So the judge will decide which of these claims can move forward and against whom, and then we'll have motions and hearings and possibly eventually a trial. What do we know about what the hospital,
Starting point is 01:06:59 because the hospital then filed a motion to dismiss these claims, correct? I think all of the defendants. So there's the county and their defendants, Rady and their defendants. And so from what I could see, again, I just looked last night. They have just filed a general dismissal of all claims.
Starting point is 01:07:16 And so that's the last document in the court doc right now. I don't know if they're going to come back specifically with each individual claim, as they did with some of the parents complaints, or they're trying to close this on a bigger picture point. And then that's where it stands. So I think. And is there anything, have we been
Starting point is 01:07:36 able to glean anything from the hospital's response, or are they basically just pointing to statutes about, OK, so like, yeah, so we're not getting a ton of information on theutes about, okay, so like. I think it's very much on like foundational. Yeah. So we're not getting a ton of information on the specifics from the hospital at this point. They're just saying like. At least now on this claim itself. Got it.
Starting point is 01:07:52 And so I think we will know now, I think, how it goes forward as far as the delineation, which this gets into some of the legalese of which plaintiffs are claiming each. Like, you know what I mean? Is it still going to be parents have claims and Madison has claims? Is all of that gonna be combined? And then which defendants will be potentially taken off completely, which can happen? Will they combine defendants?
Starting point is 01:08:12 Or, and then which of these counts will actually even stand at the end? And so this is, I think, a very, very important part of this process is where we stand today with, I don't know what the timeframe that the judge has to come back with their response, but it sounds like that's gonna be then what goes forward
Starting point is 01:08:33 and that will be the point at which they determine if this is going to head forward into trial or settlement or kind of where it goes from there. Got it. Well, thank you so much, Bex, for walking us through where the case stands today. So as I mentioned before, Nobody Should Believe Me four part series is the three hour tour of this show.
Starting point is 01:08:51 So we will be back with however many question mark more episodes, but we are actually going to be back next week. So thank you so much for following along with us. The this real time reporting is always an interesting challenge and adventure. So thanks for doing this with me, Bex. Thanks for your amazing research on this case. And we will be back next week with a little bit more. Thanks, everyone. This episode of Nobody Should Believe Me Case Files was hosted and executive produced by me, Andrea Dunlop. Dr. Bex is my co-host and the lead researcher for the Raddy Children's case.
Starting point is 01:09:30 Mariah Gossett is our supervising producer. Greta Stromquist is our producer and editor. Erin Ajayi is our fact checker. And thanks also to Nola Karmouche for administrative support.

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