Case Files 19: Rady Children's Part 3

True Story Media.

If you just can't get enough of me in your ears, first of all, thank you.

I have a job because of you.

And secondly, did you know that I have a new audiobook out this year?

The Mother Next Door, which I co-authored with Detective Mike Weber, is available in all formats wherever books are sold.

It's a deep dive into three of Mike's most impactful munches and biproxy cases, and I think you'll love it.

Here's a sample.

When Susan logged in, what she discovered shocked her to the marrow of her bones.

Though the recent insurance records contained pages and pages of information about Sophia, there was nothing about Hope.

Susan dug deeper and looked back through years of records.

There wasn't a single entry about Hope's cancer treatment.

For eight years, the Putcher family had lived with a devastating fear that their beloved daughter and sister was battling terminal cancer.

For months, they'd been preparing for her death.

But in that moment, a new horror was dawning.

For nearly a decade, Hope had been lying.

Your sausage McMuffin with egg didn't change.

You receipt it.

The sausage mcmuffin with egg extra value meal includes a hash brown and a small coffee for just $5.

Only at McDonald's for a limited time.

Prices and participation may vary.

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.

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 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 the central line.

Her treatment spanned multiple healthcare systems, including Kaiser Permanente, where 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 5th, 2020, juvenile court judge Michael Imhoff dismissed the second Health and Human Services Agency, HHSA, complaint and returned custody of Madison to her parents, 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 Munchhausen by proxy to be, quote, unfounded.

Now, as 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.

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 Meyer and Dana Gaske, had been, quote, branded with their own scarlet letter, meaning that of being Munchhausen 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, an insensitive invasion of privacy.

And this covert video surveillance is pretty central to this lawsuit.

So what do we know about what was 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 that this was, quote, debunked at trial.

Without any records from the trial, this is impossible to verify, but this appears to be the linchpin of 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 inpatient at Rady's, which certainly speaks to her having some ongoing medical complexity, 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.

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 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 Does 1 through 10, at HHSA and that all of them together, quote, subjected Madison 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 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 even possibly face jail time.

There is no documented proven case in U.S.

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 poor 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.

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.

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, 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, 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 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 29th, 2020.

In February of 2021, Dana Gasquet and Bill Meyer filed their original lawsuit against the County of San Diego, the San Diego County Health and Human Services, Rady Children's Hospital, the Regents of the the University of California, named employees of Rady Children's Hospital, HHSA, University of California, and Shaylin Mino, 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.

This 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 23, 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.

determined the new sexual abuse allegations 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 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, 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 distress was caused and generated 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 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 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 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 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 well 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.

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.

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-Danlow syndrome.

I've heard from a bunch of you that have Ehlers-Danlow syndrome that also have POTS or one or both of those conditions.

And we're so appreciative of this feedback.

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 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 Ellers Danlos syndrome.

I am not a doctor of any kind.

And also neither 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, 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.

And we will also have a doctor who specializes in Ehlers-Stanlow 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 hello at nobodyshouldbelieveme.com, 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.

The complaint of Madison Meyer.

So this is what we have 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 Gasque 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.

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 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

you know, 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.

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 of keep going forward with the case and following along kind of in real time from there.

So what is in this?

So first, yeah, what is in this third amended complaint?

So now they're just going claim by claim and using all like kind of 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 and then the judge kind of decides but at this point this is where we stand so i'm just going to go um 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 um ability to just kind of talk them through I think before we know where everything goes from here.

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 kind of tie back to those kind of federal statutes when they make the claims.

So the first one is a violation of federal civil rights.

And this is on the unwarranted search and surveillance and the invasion of privacy.

So the kind of 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're saying 38 days of video surveillance that occurred 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 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?

Kind of the word, the parentheses or manufacture kind of stuck out to me a bit.

Yeah, I mean, there's some real complexity here because as we've discussed, you know, 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, again, not being a lawyer, 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, you know, Supreme Court cases play out in the last few years and such, it's like, you know, the law is constantly open to interpretation and challenge, right?

And so just because there's precedent,

you know, and some, I think a lot of lawyers, you know, a lot of things I've heard from people about medical child abuse cases is that lawyers don't like to set precedent or like DAs don't like to set precedent.

But then I think there are some lawyers maybe that do and that really that is like sort of more activist-y lawyers that really do want to like overturn things.

I kind of think about these things as like when you think about the kind of the trajectory that overturned Roe v.

Wade, right?

It was a series of cases along the line that then ended up overturning, you know, 40 years of precedent or 50 years of precedent.

So I think there is precedent where this kind of evidence has been accepted and sort of the, you know, I don't know the exact legal language, but basically there is no reasonable expectation of privacy when you're in a hospital room,

you know, I think beyond probably like being in the bathroom or something, but like, you know, but that this is encoded in hospital policy and that kind of thing.

So obviously this case, like part of the point of it seems to be to challenge that, right?

And to say that like 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 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, the covert video surveillance will be interesting to see how it plays out.

The manufacturing piece.

that obviously sounds like,

because I think like 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, right that like i see where you're 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 this like conspiratorial language of implying that a 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.

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, like, I feel like they stick to the script.

Like, they, they know the terminology.

They say things that kind of fit, like, 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 kind of like they were throwing that in as more of a, 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, 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 thing.

Yeah, well, no, I think it's inflammatory.

And I think, um, I think it's like, those are two separate things, right?

It's like, okay, well, like, I would argue, okay, that I, again, that where I stand on this is that I think like covert video surveillance should be allowed.

There's been many cases we've looked at where that's been a life-saving measure.

So I certainly understand.

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 like, do I think it would be wrong if providers set up covert video surveillance and then somehow tampered with it and manufactured, like, of course, but I just don't, like, those are two very, very different claims, right?

So that is striking for sure.

And I think the expectation of privacy in the hospital room, 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 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.

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 at AP government.

And so I was like, I'm just going to brush up a little bit.

But I think the three 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 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.

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 his, you know, at that point that the custody had been changed to the, to the county of San Diego and he did not get to go back in that room 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 decisions should be protected, 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 this,

is the 14th Amendment.

And so all of that is used in this first claim regarding the video surveillance as it's an intrusion into a family association.

It's an intrusion into,

you know, a family's privacy.

And then the idea that should that freedom be taken away without any due process?

So like basically without the family being aware.

Yeah,

it's really interesting.

And there's just such interesting tensions in these cases.

And I think it's like really comes down to sort of how you view the parent-child relationship and sort of how you view children, right?

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.

And I think there are some really important lines to draw here about what freedom freedom means, right?

Like taking away your freedom, like if you are, you know, unlawfully deporting you to another country or jailing you, right, without going through, without getting a hearing even, you know, without going through a trial, without having due process.

To me, fundamentally, that is very different than your child being removed because there 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 of child removal in this country that is extremely dark, right?

From Indigenous populations,

you know, where they put the children, took their children away from families and put them in these, you know, residential schools.

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, that's really interesting to sort of think about those amendments that this speaks to.

September is here, and you know what that means.

Soweta weather is coming.

If you've been listening to the show for a while, you know that I love Quince.

And if you know me in real life, you also know that I love Quince because even when I'm off the clock, I talk about this brand.

Quince has an amazing array of products from jewelry to footwear to bedding, bedding, but they are known for their sweaters.

Sweaters is where they shine.

I get so many compliments on my Quince cashmere sweaters.

I was wearing one once while I was actively buying a Quince gift card for my daughter's teacher, and the checkout person said, I've been wanting to try this brand.

I heard about them on a podcast.

And I was like, I'm wearing Quince.

I have a podcast.

You got to try Quince.

This is, by the way, a 100% true and fact-check story.

Quince is known for their famous cashmere.

They also have cotton and merino wool sweaters, cardigans, and dresses, all for a fraction of the price you'd pay for this quality anywhere else.

And don't even get me started on their beautiful coats.

They've got wool coats, dusters, capes, puffers, trenches, leather bombers, and embarrassment of riches.

Keep it classy and cozy this fall with long-lasting staples from Quince.

Go to quince.com/slash believe for free shipping on your order and 365-day returns.

That's q-u-in-ce-e.com/slash believe to get free shipping and 365-day returns.

Quince.com/slash believe.

And remember that shopping our sponsors is a great way to support the show.

In these turbulent economic times, the last thing any of us need to worry about is unexpected fees and other nonsense from our banks, which is why I love Chime.

QIIME understands that every dollar counts.

That's why when you set up direct deposit through QIIME, you get access to fee-free returns like free overdraft coverage, getting paid up to two days early with direct deposit, and more.

Something I love about QIIME is their 24-7 customer service.

Having a banking issue is extremely stressful, especially when you run a business.

And I want to talk to a person right now when I have one.

I also travel a lot for work these days.

And with QIIME, I have access to 47,000 fee-free ATMs nationwide.

47,000?

That's so many.

QIIME is banking done right.

Open a checking account with no monthly fees and no maintenance fees today.

Work on your financial goals through QIIME today.

Open an account at chime.com slash nobody.

That's chime.com slash nobody.

And remember that shopping our sponsors is a great way to support the show.

Chime is a financial technology company, not a bank.

Banking services and debit card provided by the Bank Corporate Bank NA or Stripe Bank NA, members of FDIC.

Spot me eligibility requirements and overdraft limits apply.

Timing depends on submission payment file.

Fees apply at out of network ATMs, bank ranking, and number of ATMs, according to U.S.

News and World Report 2023.

Chime, checking account required.

So the next claim is another violation of federal civil rights.

And this one talks to the deception in the presentation of evidence and false reporting.

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 to employ them basically to extend the, 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, 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.

We all have things we're coming in with previous experience.

And to me, the word knowingly, And I'm going to 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 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 is knowingly, intentionally falsifying.

The thing is, a lot of medicine is still subjective, meaning you can have three x-rays, 100 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 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, you know, because mental health and biproxy abuse is a pattern of abuse.

So, it's not incident-specific.

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?

It 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, like, the reason that doctors do a medical record review and try and be as holistic as possible 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, right?

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.

um both for finding abuse 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 the video surveillance and all of the doctors came in and planted something on the bed that looked suspicious and then said the mom did it or something just like smoking gun-ish.

And it doesn't sound like we have that information.

And of course, we don't have her medical record.

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 to like when we're, you know, we are in the golden and by golden, I mean terrible age of conspiracy theories, right?

You really have to just put some critical thinking skills on it.

And also like, it's just, it is a pretty like wild allegation.

And again, it's a really common one.

The conspiratorial language comes up a ton in these cases.

And

Yeah, it's, it's strange that this is palatable to so many people to me because I, because for that exact question, I think you just really need to like sit there and sit with it and picture it and be like, okay, three doctors go into a room and they say, what exactly?

Like, 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 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 we, I would hope most physicians are doing that 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.

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 you know nurse was in the room and when you say in quotes you mean like mom says yes and 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.

So I think having another, you know, 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 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,

you know, 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 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 want to get involved.

I mean, it's like not easy to get doctors to recognize.

as a group that abuse is happening right in front of their faces because it's so against their training.

It's so against their instincts.

And they always want to like something that I love and appreciate about doctors, but that also can really work against some of these cases is that doctors have this like

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 along the way for abuse.

Like that happens really frequently.

So I think it makes it doubly unlikely that this group of people specifically is going to conspire about abuse.

And there's a lot of people who can't even get them to do that.

Yeah.

Okay.

All right.

So what else, what else have we got?

in this third complaint?

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 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 right i think it's kind of it's used a little bit in both ways yeah yeah and i mean it it is it's it's tricky once you're in a potential abuse situation because, you know, if you think about like 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's, it, it like makes a lot of sense that they did that.

Um, yeah, but we have, we have talked about that quite a bit, but it's, it's, I think, especially striking because of how many other extremely invasive procedures this child had had up until this point that it doesn't seem like a swallow study would stick out.

But again, 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.

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 not allow them to?

Right.

Well, and it's not, and feeding tubes are not without risk, right?

I mean, there's a risk of infection.

There's, yeah.

So that's not good medicine.

Like you're, 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 an interesting thought experiment 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 circumstance is.

But my thought is if you can get a tube out of a kid and they can't eat, that would still like in most cases, I think, be my, be my goal.

Of course.

Yeah.

And so number four.

So this is where we start getting into the question of Madison 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 at this time or under the custody of the County of San Diego.

So now we're talking about the time from...

that shelter 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 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 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.

This is kind of a function of the two complaints being combined at this point because that was 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, and this makes me think of the Kowalski case that Andrea and I covered a couple years ago.

This idea that I, you know, 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, you know, know, it starts on patient education, lifestyle changes,

you know, teaching awareness of their own body, self-management techniques, physical therapy.

It's, 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 are available 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 mayakowalski was being treated as a munchhausen by proxy victim as opposed to a patient with crps right or they were saying they one of the one of the like yeah malpractice complaints in the kowalski case was that

they did not treat her for crps and then they also claimed fraudulent billing because they put CRPS on there.

So it was sort of like a double-edged sword there, but like,

but 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 diet, you know, this amount of ketamine that the hospital did not, um, would not give.

So we don't know specifically what their complaint is in regards to like, she should have received XYZ for her Eller Stanlos, but she didn't.

We don't know those specifics.

They're just saying that her Eller Stanlos wasn't treated appropriately.

Yep.

One of the, we'll talk quickly about the Americans with Disability Act a little bit later where we talk, there are a few specifics mentioned, but I think this one as a physician 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, in this position, and I've thought about times I've been in it, like 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?

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.

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 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 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,

it 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

for me, which is enjoyed decision making.

I think that we strive for, but is it's getting harder and harder.

I'm not going to lie, as a physician.

But 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 your kids to the dentist, even if they're getting a ton of infections?

Like, no, we would call that medical neglect.

I think like to some degree, we have to decide like as a society, how we see children and how we regard that relationship and where the boundaries are on that relationship.

It's like, that's, that's why child protection at rests exist.

This podcast is sponsored by Squarespace, the all-in-one website platform designed to help you build your career.

Whether you're brand new new or looking for ways to grow your business, Squarespace has everything you need to find customers, get paid, and streamline your workflow.

I love it when brands that I already use and like sponsor the show, and I've been using Squarespace for years.

As both my team and my husband can attest to, while I have many other gifts, being tech savvy isn't one of them.

And usually, asking me to do something like create or update a website would make me want to jump out a window.

But Squarespace is so intuitive and they offer an array of beautiful design templates and AI tools that help you create the website you want.

They also have an incredible suite of new tools and features that I didn't even know about, but am very excited to try.

They've got everything from monetization and invoicing to analytics, email campaigns, and built-in appointment scheduling.

If you have a small business in a creative industry like I do, packaging this all together is a dream, especially if you are also a person who perpetually has about 27 tabs open.

Squarespace brings together so many elegant, easy-to-use tools, I just cannot recommend it enough.

So if you want to up your game and support Nobody Should Believe Me, you can head to squarespace.com backslash nobody for a free trial.

And when you're ready to launch, use offer code nobody to save 10% off your first purchase of a website or domain.

Do you remember the first thing you ever got paid to do as a kid?

Your first job?

Mine was weeding for my neighbors, for which I got paid $5 and a package of Oreos.

I was thrilled.

Now I weed my garden to relax, so times change.

With my daughter heading into first grade and growing up so fast that if I keep talking about this, I'm going to cry, we want to make sure that she's learning life skills in addition to what she's learning at school.

And we've been loving using Acorns Early with her.

Acorns Early is the smart debit card and money app that grows kids' money skills as they grow up.

You can use the in-app chores tracker to help them make the connection that money does not just come from mom, dad, and the tooth fairy.

And then kids can spend what they've earned with their very own customizable debit card, which is some real big kid business, if you ask my daughter.

And with Acorns early spending limits and real-time spend notifications, parents always stay in control.

Ready to teach your kids the smart way to earn, save, and spend?

Get your first month on us when you head to acornsearly.com backslash nobody or download the Acorns Early app.

That's one month free when you sign up at acornsearly.com backslash nobody.

Acorns Early card is issued by Community Federal Savings Bank, member FDIC, pursuant to license by MasterCard International.

Free trial from new subscribers only, subscription fee starting from $5 per month unless canceled.

Terms apply at acorns.com backslash early terms.

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, that they should have been taking into account all elements of her 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 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, 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 Social Security Administration 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 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?

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.

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 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.

So often we put kind of 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 is 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, I can read my own way based on my own experience.

But this question of the appropriate wheelchair is was it the physicians thought one thing was appropriate and the family thought another.

Is that grounds for, you know, a lawsuit?

That's, 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 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 for this entire time, right?

Yes.

At least from these, the point of view of these complaints, it was while she was underrated children that they're claiming she was, you know, discriminated against.

Yeah, I mean, it's, it's a hard one to unravel without more information.

But I think like 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 like this horrible video going around on tick tock that if anybody saw and i don't know like i i try to keep anything having to do with medicine or medical child abuse off my tick tock because my tick tock is the place that i go to brain rot and watch like videos of sheep being crazy and things like that

um and la place on steve which is my producer mariah and i's favorite obsession of late um 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 like putting her wheelchair in her car and was in a handicap parking spot.

And some man like came up to her window and like berated her for like 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

place that things like leg braces and wheelchairs, you know, play in these cases of children that are either don't need them at all or are overutilizing 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.

But, you know, sounds like the reading between the lines.

But I think also I've thought about the whole discrepancy in healthcare where, you know, a family can take up a GoFundMe to get the fancier, more motorized wheelchair.

But I have children on, you know, the CMS plan, which is like children's medical services for complex children, children who live in, you know, maybe nursing facilities and things 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, my goal with any child is.

is getting to be a kid and getting to live life to the fullest.

And like, if you want to play baseball, let's find out a way you can play baseball.

Like 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 and i think um 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.

Like if I am writing an order for equipment, it is something that based on the evaluation we've done, we have determined is medically necessary.

Writing it because a family wants 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.

But it is a slippery slope.

And I think we've seen it in these cases.

And that's why, you know, these things kind of jumped out at me, I think specifically.

Yeah.

And I mean, there is this like broader question, I think, which I really worry about a lot with

this show, because I think it's really, it's really important, obviously, to bring this abuse to light.

It's totally underrecognized.

I think it doesn't, it slips under the radar for the most part.

And it is very hard for people to get what they need healthcare wise when they actually need it.

Right.

And so like wheelchairs, you mentioned, you know, I saw a headline the other week that was like, it's impossible to get

because like so many pieces of healthcare, so many parts of healthcare have been taken over by private equity companies.

They're very involved in hospice, which is horrifying.

They're very involved in like a lot of things.

But I mean, like, there's, there's some big thing in private equity with like 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, I mean, you think about things like that and you're like, God, it's like impossible for people to get what they need.

And so I think that makes it, that has like a twofold thing.

It makes people like on with people react to kind of that information like one of two ways, right?

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 like time and devotion and fundraising and like 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, you know, 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 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 like, we can't have people taking advantage of the system, you know, and so it's like, you see those two things and like, there's just a lot of nuance here.

And I think that in both of those 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 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 and are, you know, trying to like 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, you know, these people that are like 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, oh, what a morass, you know?

And it goes into the education system.

It goes into every aspect of this.

Like there are kids, I've talked to families about getting like 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 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, you know, 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 the, you know, these things that money does not come out of the equation, like 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, you know, 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, it is entering scary levels.

And I think, again, we will 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 as like be as much of a child as they can.

If we are working against each other in that, we're going to hit impasses, I think, on all of these things.

And the next couple of claims, it's the Monel-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 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 10th 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 RAIDIS and the medical defendants in this case to not comply with these requests.

Again, I think at this point, this one is going to 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 think curious to see where it goes, because if this was done all legally and she was requesting the records, you know, 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 specific policies.

Interesting.

So, okay, so this is, so this is the complaint as it stands.

So now the judge.

That's where we are today.

Yeah.

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, because the hospital then filed a motion to dismiss these claims?

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, it was, I just looked last night.

They have just filed a general dismissal of all claims.

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 kind of trying to kind of close this on a bigger picture point.

And then that's where it stands.

So I think.

And is there anything, like, have we been able to glean anything from the hospital's response or are they basically just kind of pointing to statue?

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

on this claim itself 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 going to be combined and then which defendants will be potentially taken off completely, which can happen.

Will they combine defendants?

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 going to be then what goes forward.

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.

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.

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.

Becks is my co-host and the lead researcher for the Ratty Children's case.

Mariah Gossett is our supervising producer.

Greta Stromquist is our producer and editor.

Aaron Ajay is our fact checker.

And thanks also to Nola Karmouche for administrative support.

You want your master's degree.

You know you can earn it, but life gets busy.

The packed schedule, the late nights, and then there's the unexpected.

American Public University was built for all of it.

With monthly starts and no set login times, APU's 40-plus flexible online master's programs are designed to move at the speed of life.

Start your master's journey today at apu.apus.edu.

You want it?

Come get it at APU.

You're juggling a lot, full-time job, side hustle, maybe a family, and now you're thinking about grad school?

That's not crazy.

That's ambitious.

At American Public University, we respect the hustle and we're built for it.

Our flexible online master's programs are made for real life because big dreams deserve a real path.

At APU, the bigger your ambition, the better we fit.

Learn more about our 40-plus career relevant master's degrees and certificates at apu.apus.edu.