JANE LS DOE, AN INDIVIDUAL vs DR. STEPHEN FREDERICK KNOX, et al.

The function of a demurrer is to test the sufficiency of the pleading it challenges by raising questions of law. (Salimi v. State Comp. Ins. Fund (1997) 54 Cal.App.4th 216, 219; Nordlinger v. Lynch (1990) 225 Cal.App.3d 1259, 1271.)

A demurrer “tests the pleadings alone and not the evidence or other extrinsic matters.” (SKF Farms v. Superior Court (1984) 153 Cal.App.3d 902, 905.) The purpose of a demurrer is to test the legal sufficiency of a claim. (Donabedian v. Mercury Ins. Co. (2004) 116 Cal.App.4th 968, 994.) For the purpose of determining the effect of a complaint, its allegations are liberally construed, with a view toward substantial justice. (Code Civ. Proc. §452; Amarel v. Connell (1988) 202 Cal.App.3d 137, 140-141; Quelimane Co. v.

Stewart Title Guaranty Co. (1998) 19 Cal.4th 26, 43, fn. 7.) In this respect, the Court treats the demurrer as admitting all material facts properly pleaded, but not contentions, deductions or conclusions of fact or law, and considers matters which may be judicially noticed. (Blank v. Kirwan (1985) 39 Cal.3d 311, 318; Poseidon Development, Inc. v. Woodland Lane Estates, LLC (2007) 152 Cal.App.4th 1106, 1111- 1112.) A general demurrer does not admit contentions, deductions, or conclusions of fact or law alleged in the complaint; facts impossible in law; or allegations contrary to facts of which a court may take judicial notice. (Blank v.

Kirwan (1985) 39 Cal.3d 311, 318, William S. Hart Union High School Dist. v. Regional Planning Com. (1991) 226 Cal.App.3d 1612, 1616, fn. 2.)

A demurrer may be sustained only if the complaint lacks any sufficient allegations to entitle the plaintiff to relief. (Financial Corp. of America v. Wilburn (1987) 189 Cal.App.3d 764, 778.) “Plaintiff need only plead facts showing that he may be entitled to some relief . . . we are not concerned with plaintiff’s possible inability or difficulty in 12 Cal. 4th 291 proving the allegations of the complaint.” (Highlanders, Inc. v. Olsan (1978) 77 Cal.App.3d 690, 696-697.) “[Courts] are required to construe the complaint liberally to determine whether a cause of action has been stated, given the assumed truth of the facts pleaded.” (Picton v.

Anderson Union High School Dist. (1996) 50 Cal.App.4th 726, 733.) A demurrer admits the truth of all material facts properly pled and the sole issue raised by a general demurrer is whether the facts pled state a valid cause of action – not whether they are true. (Serrano v. Priest (1971) 5 Cal.3d 584, 591.)

III.

Discussion

A. First Cause of Action – Intentional Infliction of Emotional Distress

SUPERIOR COURT OF CALIFORNIA COUNTY OF SACRAMENTO

24CV013840: JANE LS DOE, AN INDIVIDUAL vs DR. STEPHEN FREDERICK KNOX, et al. 06/16/2026 Hearing on Demurrer in Department 16C

Defendant argues that, as a matter of California law, an employer cannot be held vicariously liable for an employee’s sexual assault under the doctrine of respondeat superior. Defendant argues that Plaintiff alleges no facts showing that Knox’s assaults were a foreseeable outgrowth of Defendant’s enterprise or that they were undertaken to serve Defendant.

Plaintiff contends that she has sufficiently alleged each element of the claim. In particular, Plaintiff argues that she has sufficiently alleged Defendant knew Knox was a sexual predator, knew that he was continuing to abuse and assault patients, and nevertheless continued to refer patients to Knox’s care.

In order to state a claim for intentional infliction of emotional distress, a plaintiff must show (1) extreme and outrageous conduct by the defendant with the intention of causing, or reckless disregard of the probability of causing emotional distress; (2) extreme emotional distress suffered by the plaintiff and (3) proximate causation between the defendant’s extreme and outrageous conduct and the plaintiff’s severe emotional distress. (Carlsen v. Koivunaki (2004) 227 Cal.App.4th 879, 896).

Initially, the Court notes a general demurrer must be overruled if the plaintiff states the essential facts of a valid cause of action. The test is whether the complaint states any valid claim entitling plaintiff to relief. (Quelimane Co., Inc. v. Stewart Title Guar. Co. (1998) 19 Cal.4th 26, 38-39; New Livable Calif. v. Association of Bay Area Governments (2020) 59 Cal.App.5th 709, 714-715; see also Sheehan v. San Francisco 49ers, Ltd. (2009) 45 Cal.4th 992, 998 [general demurrer may be upheld “only if the complaint fails to state a cause of action under any possible legal theory”].)

Here, although the specific argument regarding ratification was not raised in connection with this cause of action, the Court concludes that Plaintiff has sufficiently alleged a cause of action for intention infliction of emotional distress against Defendant through Defendant’s alleged ratification of Knox’s conduct.

As an alternative to respondeat superior, an employer may be liable for an employee’s act where the employer subsequently ratifies the originally unauthorized tort. (C.R. v. Tenet Healthcare Corp. (2009) 169 Cal.App.4th 1094, 1110.) “Ratification is not itself a tort, but a doctrine that holds the ratifying party liable for the tort committed by another party.” (Ratcliff v. The Roman Catholic Archbishop of Los Angeles (2022) 79 Cal.App.5th 982, 1002.) “It is the voluntary election by a party to adopt, as its own, an act purportedly done on its behalf by another, the effect of which is to treat the act as originally authorized by the ratifier.” (Id., at pp. 1002-1003.) The failure to investigate or

SUPERIOR COURT OF CALIFORNIA COUNTY OF SACRAMENTO

24CV013840: JANE LS DOE, AN INDIVIDUAL vs DR. STEPHEN FREDERICK KNOX, et al. 06/16/2026 Hearing on Demurrer in Department 16C

respond to charges that an employee has committed an intentional tort or the failure to discharge the employee may be evidence of ratification. (C.R., supra, at p. 1110.) Generally, ratification is a question of fact. (Ibid.)

Here, Plaintiff has alleged that Defendant was aware of prior complaints of sexual misconduct against Knox. (3AC, ¶ 41.) Plaintiff alleges that despite this actual knowledge Defendant intentionally retained and continued to assign Knox unsupervised access to female patients, failed to initiate meaningful investigation or disciplinary action, and failed to report his misconduct to police or the Medical Board. (Id., ¶¶ 42-55, 70-72.) This is sufficient, at the pleading stage, to allege that Defendant ratified Knox’s conduct by retaining him after becoming aware of sexual misconduct complaints by other female patients such that it may be liable for his intentional torts against Plaintiff.

Thus, Plaintiff has sufficiently alleged extreme and outrageous conduct (3AC, ¶¶ 33, 54), a reckless disregard for the probability of causing emotional distress (Id., ¶¶ 41-55, 70-75), Plaintiff’s severe emotional distress and causation (Id., ¶¶ 60-61, 77.)

As a result, Defendant’s demurrer to the first cause of action is OVERRULED.

B. Third Cause of Action – Sexual Harassment

Defendant argues that the Plaintiff has failed to allege sufficient facts to support her claim for sexual harassment pursuant to Civil Code section 51.9, because she does not allege that she had a qualifying professional relationship directly with Defendant and has failed to allege that the Defendant ratified Knox’s misconduct.

Plaintiff opposes, arguing that she has alleged sufficient facts to hold Defendant liable for Knox’s misconduct based on either a respondeat superior theory of liability or based on Defendant’s alleged ratification of Knox’s conduct.

Civil Code section 51.9 provides, in relevant part:

A person is liable in a cause of action for sexual harassment under this section when the plaintiff proves all of the following elements:

(1) There is a business, service, or professional relationship between the plaintiff and defendant . . .

(2) The defendant has made sexual advances, solicitations, sexual

SUPERIOR COURT OF CALIFORNIA COUNTY OF SACRAMENTO

24CV013840: JANE LS DOE, AN INDIVIDUAL vs DR. STEPHEN FREDERICK KNOX, et al. 06/16/2026 Hearing on Demurrer in Department 16C

requests, demands for sexual compliance by the plaintiff, or engaged in other verbal, visual, or physical conduct of a sexual nature or of a hostile nature based on gender, that were unwelcome and pervasive or severe.

(3) The plaintiff has suffered or will suffer economic loss or disadvantage or personal injury, including, but not limited to, emotional distress or the violation of a statutory or constitutional right, as a result of the conduct described in paragraph (2).

Defendant does not demur to this cause of action on any other grounds or argue that Plaintiff has failed to allege sufficient facts to state a cause of action under Civil Code section 51.9. Instead, Defendant challenges only whether Plaintiff’s allegations are sufficient to allege Defendant’s respondeat superior liability or ratification. The Court need not address the respondeat superior issue, because, as discussed above, Plaintiff has alleged sufficient facts to allege that Defendant ratified Knox’s misconduct. (3AC, ¶¶ 42-55, 70-72.) “Principles of ratification apply to a section 51.9 cause of action.” (C.R., supra, 169 Cal.App.4th at p. 1111.)

Therefore, Defendant’s demurrer is OVERRULED as to the third cause of action.

C. Sixth, Seventh, Eighth, and Ninth Causes of Action – Negligence

Plaintiff alleges four causes of action for general and specific types of negligence: negligence, negligent supervision, negligent hiring/retention, negligent failure to warn, train, or educate. All four causes of action are premised on essentially the same allegations of misconduct by Knox.

For each cause of action, Defendant argues that Plaintiff has failed to adequately allege that Defendant owed Plaintiff a duty. Specifically, with respect to the sixth cause of action, Defendant contends that Plaintiff does not sufficiently allege the substance of the prior complaint against Knox and therefore cannot demonstrate that Defendant had actual knowledge of Knox’s propensities or that such misconduct was reasonably foreseeable. Defendant also argues that seventh, eighth, and ninth causes of action similarly fail because the 3AC “contains no allegations of any particular complaint against Dr. Knox that was communicated to SMG, no allegation of any investigation undertaken or disregarded by SMG, and no factual support for the assertion that SMG had notice of any risk.” (Memorandum at p. 9:11-13.)

Plaintiff argues that she has sufficiently alleged Defendant has a special relationship

SUPERIOR COURT OF CALIFORNIA COUNTY OF SACRAMENTO

24CV013840: JANE LS DOE, AN INDIVIDUAL vs DR. STEPHEN FREDERICK KNOX, et al. 06/16/2026 Hearing on Demurrer in Department 16C

with Plaintiff such that it had to duty to ensure patient safety. Plaintiff also argues that whether the alleged sexual assault was foreseeable is a question of fact for the jury.

To state a cause of action for negligence, a plaintiff must allege (1) the defendant owed the plaintiff a duty of care, (2) the defendant breached that duty, and (3) the breach proximately caused the plaintiff’s damages or injuries. (Thomas v. Stenberg (2012) 206 Cal.App.4th 654, 662.) Whether a duty of care exists is a question of law to be determined on a case-by-case basis. (Parsons v. Crown Disposal Co. (1997) 15 Cal.4th 456, 472.) “California case law recognizes the theory that an employer can be liable to a third person for negligently hiring, supervising, or retaining an unfit employee. [Citation.] Liability is based upon the facts that the employer knew or should have known that hiring the employee created a particular risk or hazard and that particular harm materializes.” (Doe v. Capital Cities (1996) 50 Cal.App.4th 1038, 1054.)

Here, Plaintiff has alleged that prior to her assault in June 2021, two other female patients had submitted written complaints alleging similar sexual abuse by Knox to Defendant’s staff, which are documented in Defendant’s internal records. (3AC, ¶¶ 41, 42, 89, 110.) Plaintiff alleges that despite Defendant’s alleged actual knowledge, Defendant failed to supervise, train, investigate, or otherwise report Knox’s alleged misconduct. (Id., ¶¶ 42-43, 111-118.) Plaintiff’s allegations sufficiently alleged that Defendant knew or should have known of Knox’s prior, similar sexual misconduct. In light of Defendant’s alleged actual knowledge of Knox’s misconduct and its alleged failure to investigate, the Court cannot conclude, as a matter of law, that Knox’s later sexual assault of Plaintiff was unforeseeable such that a duty should not be imposed.

There, the demurrer to the sixth, seventh, eighth, and ninth causes of action is OVERRULED.

D. Uncertainty

Defendant argues that the 3AC is uncertain as Plaintiff impermissibly lumps Defendants “Sutter Medical” and “Sutter Health” together without distinguishing which entity allegedly employed Dr. Knox, which entity allegedly received or ignored complaints, or which entity allegedly owed Plaintiff any legal duty.

Plaintiff argues that “the internal corporate structure, employment agreements, and supervisory chains of command among the Defendant entities are facts peculiarly within their exclusive possession.” (Opposition at 13:17-19.) Therefore, Plaintiff contends that it is not required to allege the specific details that Defendant demands, such as which

SUPERIOR COURT OF CALIFORNIA COUNTY OF SACRAMENTO

24CV013840: JANE LS DOE, AN INDIVIDUAL vs DR. STEPHEN FREDERICK KNOX, et al. 06/16/2026 Hearing on Demurrer in Department 16C

defendant failed to supervise Dr. Knox and which entity received a purported complaint, as those details are already in Defendants’ possession.

A demurrer will lie if the pleading is uncertain, which means ambiguous or unintelligible. (Code Civ. Proc., § 430.10, subd. (f).) “[D]emurrers for uncertainty are disfavored, and are granted only if the pleading is so incomprehensible that a defendant cannot reasonably respond.” (Lickiss v. Financial Inds. Reg. Auth. (2012) 208 Cal.App.4th 1125, 1135.) The favored approach is to clarify theories in the complaint through discovery. (See Khoury v. Maly's of Calif., Inc. (1993) 14 Cal.App.4th 612, 616.) Nevertheless, a demurrer for uncertainty may be sustained when a defendant cannot reasonably determine what it is required to respond to; for example, when a plaintiff joins multiple causes of action as one, fails to properly identify each cause of action, or fails to state against which party each cause of action is asserted if there are multiple defendants. (Ibid.)

Defendant’s argument regarding the purported ambiguity lacks merit. Defendant does not contend that Plaintiff’s allegations are incomprehensible such that it cannot reasonably respond. Instead, Defendant contends that Plaintiff was required to allege her allegations with more specificity with respect to which corporate entity bears more or less responsibility for Knox’s alleged misconduct. This information is presumptively in Defendant’s possession and/or could further be clarified during discovery.

Defendant’s demurrer on the ground of uncertainty is OVERRULED.

IV.

Disposition

Accordingly, Defendant’s demurrer is OVERRULED in its entirety.

Nevertheless, the Court has granted in part Defendant’s motion to strike Plaintiff’s alter ego allegations. Therefore, Plaintiff may file and serve a fourth amended complaint no later than July 7, 2026, to cure the defects identified in the Court’s concurrent ruling on the motion to strike.

Although not required by Court rule or statute, Plaintiff is directed to present a copy of this order when the amended complaint is presented for filing. Defendant shall file and serve its response within 30 days thereafter, 35 days if the fourth amended complaint is served by mail.

This minute order is effective immediately. No formal order or other notice is required.

SUPERIOR COURT OF CALIFORNIA COUNTY OF SACRAMENTO

24CV013840: JANE LS DOE, AN INDIVIDUAL vs DR. STEPHEN FREDERICK KNOX, et al. 06/16/2026 Hearing on Demurrer in Department 16C

(Code Civ. Proc., § 1019.5; Cal. Rules of Court, rule 3.1312.)

NOTICE:

Consistent with Local Rule 1.06(B), any party requesting oral argument on any matter on this calendar must comply with the following procedure:

To request limited oral argument, on any matter on this calendar, you must call the Law and Motion Oral Argument Request Line at (916) 874-2615 by 4:00 p.m. the Court day before the hearing and advise opposing counsel. At the time of requesting oral argument, the requesting party shall leave a voice mail message: a) identifying themselves as the party requesting oral argument; b) indicating the specific matter/motion for which they are requesting oral argument; and c) confirming that it has notified the opposing party of its intention to appear and that opposing party may appear via Zoom using the Zoom link and Meeting ID indicated below. If no request for oral argument is made, the tentative ruling becomes the final order of the Court.

Unless ordered to appear in person by the Court, parties may appear remotely either telephonically or by video conference via the Zoom video/audio conference platform with notice to the Court and all other parties in accordance with Code of Civil Procedure §367.75. Although remote participation is not required, the Court will presume all parties are appearing remotely for non-evidentiary civil hearings.

The Department 16C Zoom Link is https://saccourt-ca-gov.zoomgov.com/j/16030877014 and the Zoom Meeting ID is 160 3087 7014. To appear on Zoom telephonically, call (833) 568-8864 and enter the Zoom Meeting ID referenced above. NO COURTCALL APPEARANCES WILL BE ACCEPTED.

Parties requesting services of a court reporter will need to arrange for private court reporter services at their own expense, pursuant to Government code §68086 and California Rules of Court, Rule 2.956. Requirements for requesting a court reporter are listed on the Court Reporter Services webpage available on the Sacramento Superior Court website at https://saccourt.ca.gov/general-information/court-reporter-services-transcripts. Parties may contact Court- Approved Official Reporters Pro Tempore by utilizing the list of Court Approved Official Reporters Pro Tempore available at https://saccourt.ca.gov/home/showpublisheddocument/227/639084034465370000.

A Stipulation and Appointment of Official Reporter Pro Tempore (CV/E-206) is required to be signed by each party, the private court reporter, and the Judge prior to the hearing, if not using a reporter from the Court’s Approved Official Reporter Pro Tempore list.

SUPERIOR COURT OF CALIFORNIA COUNTY OF SACRAMENTO

24CV013840: JANE LS DOE, AN INDIVIDUAL vs DR. STEPHEN FREDERICK KNOX, et al. 06/16/2026 Hearing on Demurrer in Department 16C

Once the form is signed it must be filed with the clerk. If a litigant has been granted a fee waiver and requests a court reporter, the party must submit a Request for Court Reporter by a Party with a Fee Waiver (CV/E-211) and it must be filed with the clerk at least 10 days prior to the hearing or at the time the proceeding is scheduled if less than 10 days away. Once approved, the clerk will forward the form to the Court Reporter’s Office and an official reporter will be provided.