1 MAN AIT, PHELPS & PHILLIPS, LLP

BARRY S. LANDSBERG (SBN 117284)

2 blandsberg@manatt.com
HARVEY L. ROCHMAN (SBN 162751)
3 hrochman@manatt.com
COLIN M. MCGRATH (SBN 286882)
4 cmcgrath@manatt.com
11355 West Olympic Boulevard
5 Los Angeles, CA 90064-1614
Telephone: (310)312-4000
6 Facsimile: (310) 312-4224

7 Attorneys for Defendant

St. Joseph Health Northern California, LLC
8 d/b/a St. Joseph Hospital - Eureka

10 SUPERIOR COURT OF THE STATE OF CALIFORNIA

11 FOR THE COUNTY OF HUMBOLDT

12
OLIVER KNIGHT, Case No. DR190259
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Plaintiff, DEFENDANT'S VERIFIED ANSWER TO
14 PLAINTIFF'S VERIFIED COMPLAINT
vs.
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ST. JOSEPH HEALTH NORTHERN
16 CALIFORNIA, LLC d/b/a ST. JOSEPH
HOSPITAL - EUREKA,
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Defendant.
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DEFENDANT'S VERIFIED ANSWER TO PLAINTIFF'S VERIFIED COMPLAINT

 1 Defendant St. Joseph Health Northern California, LLC d/b/a St. Joseph Hospital - Eureka

2 (the "Hospital") hereby answers Plaintiff Oliver Knight's ("Knight") Verified Complaint for

3 Damages (the "Complaint") as follows:

4 SPECIFIC DENIALS1

5 1. With respect to the allegations in paragraph 6 of the Complaint, the Hospital

6 admits that Knight is a transgender man. The Hospital admits that Knight sought a hysterectomy

7 at the Hospital as part of his gender transition. The Hospital affirmatively alleges that the

8 Hospital did not permit Knight's hysterectomy procedure because the procedure did not comply

9 with (i) the Ethical and Religious Directives for Catholic Health Care Services ("ERDs"), which

10 are binding on Catholic hospitals, and (2) the Hospital's Reproductive Sterilization Policy. The

11 allegation regarding the meaning of "transgender man" is not a factual allegation but rather is

12 plaintiffs own interpretation of the phrase which need not be admitted nor denied. Except as

13 specifically admitted above, the Hospital lacks sufficient information to admit or deny the

14 remaining allegations in this paragraph and on that basis denies generally and specifically the

15 allegations in this paragraph.

16 2. With respect to the allegations in paragraph 24 of the Complaint, the Hospital

17 admits that Knight was diagnosed with gender dysphoria. The Hospital further admits that

18 Knight underwent a double mastectomy in August 2016. The Hospital lacks sufficient

19 information to admit or deny the remaining allegations in this paragraph and, on that basis, the

20 Hospital denies generally and specifically the allegations in this paragraph.

21 3. With respect to the allegations in paragraph 25 of the Complaint, the Hospital

22 admits that a bilateral salpingo-oophorectomy procedure involves the removal of a patient's

23 uterus, fallopian tubes, and ovaries. The allegation that "In Mr. Knight's case, hysterectomy was

24 medically necessary care to treat his gender dysphoria" is a conclusory medical opinion, which is

25 necessarily the subject of expert opinion testimony and argument, and on that basis the allegation

26 need not be admitted or denied. The I lospital lacks sufficient information to admit or deny the

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28 1 The Complaint is not verified in its entirety, but only with respect to paragraphs 6 and 21- 37.
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PENDANT'S VERIFIED ANSWER TO PLAINTIFF'S VERIFIED COMPLAINT
 1 remaining allegations in this paragraph and on that basis the Hospital denies generally and

2 specifically those allegations.

3 4. With respect to the allegations in paragraph 26 of the Complaint, the Hospital

4 admits that Knight was scheduled to undergo a hysterectomy procedure at the Hospital on August

5 30, 2017. The Hospital lacks sufficient information to admit or deny the remaining allegations in

6 this paragraph and on that basis the Hospital denies generally and specifically those allegations.

7 5. With respect to the allegations in paragraph 27 of the Complaint, the Hospital

8 admits that Knight's surgeon, Dr. Deepak Stokes, is a board-certified obstetrician/gynecologist

9 who has performed hysterectomies at the Hospital. The Hospital lacks sufficient information to

10 admit or deny any of the allegations in this paragraph and on that basis the Hospital denies

11 generally and specifically each and every allegation in this paragraph.

12 6. With respect to the allegations in paragraph 28 of the Complaint, the Hospital

13 admits that Knight was required to complete an at-home vaginal douche as part of his pre-op

14 procedures in advance of the hysterectomy procedure and that Knight's medical records correctly

15 referred to Knight as male. The Hospital lacks sufficient information to admit or deny the

16 remaining allegations in this paragraph and on that basis the Hospital denies generally and

17 specifically each and every allegation in this paragraph.

18 7. With respect to the allegations in paragraph 29 of the Complaint, the Hospital

19 admits that Knight did not undergo a hysterectomy at the Hospital on August 30, 2017. The

20 Hospital specifically denies that the reason Knight's surgery was cancelled was because he is a

21 transgender man. The Hospital affirmatively alleges that Knight's surgery did not take place

22 because the procedure did not comply with the ERDs or the Hospital's Reproductive Sterilization

23 Policy. The Hospital lacks sufficient information to admit or deny the remaining allegations in

24 this paragraph and on that basis the Hospital denies generally and specifically those allegations.

25 8. With respect to the allegations in paragraph 30 of the Complaint, the Hospital

26 admits that David Groe conducted an "Ethics Assessment'" regarding Knight's requested

27 hysterectomy and determined that it did not meet the Hospital's parameters for sterilization. The

28 Hospital lacks sufficient information to admit or deny the remaining allegations in this paragraph
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DEFENDANT'S VERIFIED ANSWER TO PLAINTIFF'S VERIFIED COMPLAINT
 1 and on that basis the Hospital denies generally and specifically those allegations.

2 9. With respect to the allegations in paragraph 31 of the Complaint, the Hospital

3 admits that it allows doctors to perform hysterectomies under circumstances that comply with the

4 ERDs and the Hospital's Reproductive Sterilization Policy. The Hospital specifically denies that

5 the gender of the patient is a factor in the Hospital's decision regarding whether to allow a patient

6 to undergo a hysterectomy procedure at the Hospital.

7 10. With respect to the allegations in paragraph 32 of the Complaint, the Hospital

8 admits that Dr. Stokes prescribed Ativan for Mr. Knight. The Hospital lacks sufficient

9 information to admit or deny the remaining allegations in this paragraph and on that basis the

10 Hospital denies generally and specifically those allegations.

11 11. With respect to the allegations in paragraph 33 of the Complaint, the Hospital

12 admits that Knight was discharged from the Hospital on August 30, 2017. The hospital lacks

13 sufficient information to admit or deny the remaining allegations in this paragraph and on that

14 basis the Hospital denies generally and specifically those allegations.

15 12. With respect to the allegations in paragraph 34 of the Complaint, the Hospital

16 specifically denies that the reason Knight's scheduled hysterectomy procedure was cancelled was

17 "because of his transgender status". The Hospital affirmatively alleges that the Hospital refused

18 to allow Knight's hysterectomy procedure because the procedure did not comply with the ERDs

19 or the Hospital's Reproductive Sterilization Policy. The allegation that "Mr. Knight suffered—

20 and continues to suffer—severe emotional distress caused by Defendant's actions, and by the

21 dignitary harm of having been denied full and equal access to medical treatment by Defendant"

22 constitutes argument and/or conclusions of law and therefore need not be admitted or denied.

23 The hospital lacks sufficient information to admit or deny the remaining allegations in this

24 paragraph and on that basis the Hospital denies generally and specifically those allegations.

25 13. With respect to the allegations in paragraph 35 of the Complaint, the Hospital

26 admits that Mad River Community Hospital is located in Areata, California. The Hospital further

27 admits that Mad River Community Hospital is not affiliated with the Hospital. The hospital lacks

28 sufficient information to admit or deny the remaining allegations in this paragraph and on that
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DEFENDANT'S VERIFIED ANSWER TO PLAINTIFF'S VERIFIED COMPLAINT
 1 basis the Hospital denies generally and specifically those allegations.

2 14. With respect to the allegations in paragraph 36 of the Complaint, the Hospital

3 lacks sufficient information to admit or deny any of the allegations in this paragraph and on that

4 basis the Hospital denies generally and specifically each and every allegation in this paragraph.

5 15. With respect to the allegations in paragraph 37 of the Complaint, the Hospital

6 lacks sufficient information to admit or deny any of the allegations in this paragraph and on that

7 basis the Hospital denies generally and specifically each and every allegation in this paragraph.

8 GENERAL DENIAL

9 Except as expressly admitted above, pursuant to California Code of Civil Procedure

10 section 431.30(d), the Hospital generally denies each and every allegation set forth in the

11 Complaint and deny that Knight has been damaged in the amount alleged or in any amount.

12 AFFIRMATIVE DEFENSES

13 FIRST AFFIRMATIVE DEFENSE

14 (Failure to State a Cause of Action)

15 The Complaint fails to allege facts sufficient to state a cause of action upon which relief

16 may be granted.

17 SECOND AFFIRMATIVE DEFENSE

18 (Mootness)

19 No grounds exist for injunctive relief under the because Knight is no longer seeking or

20 eligible for a hysterectomy at the Hospital, and thus there is no ongoing allegedly wrongful

21 conduct to enjoin.

22 THIRD AFFIRMATIVE DEFENSE

23 (Lawful Conduct)

24 Knight's claims are barred because the Hospital's alleged conduct was authoriz.cd by

25 applicable law, including but not limited to federal and state statutes, regulations, and advisory

26 opinions issued by federal and regulatory state bodies.

27 FOURTH AFFIRMATIVE DEFENSE

28 (Free Exercise of Religion)

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DEFENDANT'S VERIFIED ANSWER TO PLAINTIFF'S VERIFIED COMPLAINT
 1 Knight's claims are barred under the Free Exercise Clause of the First Amendment of the

2 United States Constitution and Article 1, Section 4 of the California Constitution.

3 FIFTH AFFIRMATIVE DEFENSE

4 (Freedom of Expression)

5 Knight's claims are barred under by the Hospital's right to freedom of religious

6 expression provided in the First Amended of the United States Constitution and Article 1, Section

7 2 of the California Constitution.

8 SIXTH AFFIRMATIVE DEFENSE

9 (Church Abstention Doctrine)

10 Knight's claims are barred under the church abstention doctrine because the relief sought

11 would excessively entangle the Court in Catholic religious doctrine and impermissibly intrude on

12 matters of church governance.

13 SEVENTH AFFIRMATIVE DEFENSE

14 (Church Autonomy)

15 Knight's claims are barred under the church autonomy doctrine grounded in the First

16 Amendment of the United States Constitution.

17 EIGHTH AFFIRMATIVE DEFENSE

18 (Conscience Protections)

19 Knight's claims are barred under Federal and California laws that protect religious

20 healthcare providers from being forced to perform procedures that violate their religious

21 principles, including but not limited to, 42 U.S.C. § 300a-7(b); Cal. Prob. Code §§ 4734(b) and

22 4740(d); Cal. Bus. & Prof. Code § 733(b)(3); Cal. Health & Safety Code § 123420.

23 NINTH AFFIRMATIVE DEFENSE

24 (Waiver/Estoppel)

25 Knight has waived any right to assert the claims in the Complaint and is barred from any

26 relief sought by virtue of his own conduct, actions or inaction.

27 TENTH AFFIRMATIVE DEFENSE

28 (Laches)
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DEFENDANT'S VERIFIED ANSWER TO PLAINTIFF'S VERIFIED COMPLAINT
 1 Knight's claims are barred by the doctrine of laches because Knight unreasonably delayed

2 asserting his claims, to the prejudice of the Hospital.

3 ELEVENTH AFFIRMATIVE DEFENSE

4 (No Causation)

5 Knight's claims are barred because no act or omission by the Hospital was a substantial

6 factor in causing any harm to Knight.

7 TWELFTH AFFIRMATIVE DEFENSE

8 (Conduct Not Arbitrary Or Capricious)

9 Knight's claims are barred because the Hospital's conduct was not arbitrary or capricious

10 but was based on requirements provided in the ERDs and the Hospital policies.

11 THIRTEENTH AFFIRMATIVE DEFENSE

12 (Legitimate Business Judgment)

13 Knight's claims are barred because the Hospital's actions were done pursuant to exercise

14 of legitimate business judgment, and were based on legitimate business reasons, justifications,

15 and motives.

16 FOURTEENTH AFFIRMATIVE DEFENSE

17 (Business Necessity/Justification)

18 Knight's claims are barred because the Hospital's actions were taken due to business

19 necessities and were therefore justified and legitimate.

20 FIFTEENTH AFFIRMATIVE DEFENSE

21 (Other Affirmative Defenses)

22 The Hospital reserves the right to assert additional affirmative defenses based on

23 additional facts that may be revealed by future discovery, and reserve the right to assert additional

24 defenses at a later time if such defenses are appropriate.

25 PRAYER

26 WHEREFORE, the Hospital prays for relief on the Complaint as follows:

27 1. That Knight takes nothing by virtue of his Complaint;

28 2. That the Complaint be dismissed with prejudice;

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DEFENDANT'S VERIFIED ANSWER TO PLAINTIFF'S VERIFIED COMPLAINT
 1 3. That the Hospital be awarded all costs, including reasonable attorneys'

2 fees, to the extent permitted by law, incurred in defending this action; and

3 4. For such other relief as the Court deems proper.

6 Dated: October 25, 2019 MANATT, PHELPS & PHILLIPS, LLP

8
Barry S. Landsberg
9 irvey L. Rochman
Colin M. McGrath
10 Attorneys for Defendant ST. JOSEPH HEALTH
NORTHERN CALIFORNIA, LLC d/b/a ST.
11 JOSEPH HOSPITAL - EUREKA

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DEFENDANT'S VERIFIED ANSWER TO PLAINTIFF'S VERIFIED COMPLAINT
 1 VERIFICATION

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I am Chief Executive for St. Joseph Health Northern California, LLC d/b/a St. Joseph
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Hospital - Eureka ("St. Joseph Hospital - Eureka"), a party to this action. I am authorized to
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make this verification for and on behalf of St. Joseph Hospital - Eureka. I have read the
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foregoing DEFENDANT'S ANSWER TO PLAINTIFF'S VERIFIED COMPLAINT and
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know its contents. I am informed and believe and on that ground allege that the matters stated in
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it are true.
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9 I declare under penalty of perjury under the laws of the State of California that the

10 foregoing is true and correct. Executed at Eureka, California on this 25lh day of October 2019.

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 1 PROOF OF SERVICE

2 I, Regina Coprich, declare as follows:

3 I am employed in Los Angeles County, Los Angeles, California. I am over the age
of eighteen years and not a party to this action. My business address is MANATT, PHELPS &
4 PHILLIPS, LLP, 11355 West Olympic Boulevard, Los Angeles, California 90064-1614. On
October 25, 2019,1 served the within:
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DEFENDANT'S VERIFIED ANSWER TO PLAINTIFF'S VERIFIED
6 COMPLAINT

7 on the interested parties in this action addressed as follows:

8 Jessica Riggin, Esq. Amanda Goad, Esq.

Dylan Cowart, Esq. ACLU FOUNDATION OF SOUTHERN
9 RUKIN HYLAND & RIGGIN LLP CALIFORNIA
1939 Harrison Street, Ste. 290 1313 West Eighth Street
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Oakland, CA 94612 Los Angeles, CA 90017
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Phone: (415) 421-1800 Phone: (213)977-9500
12 Fax: (415)421-1700 Fax: (213) 977-5297
E-Mail: iriggin@rukinhvland.com E-Mail: agoad@aclusocal.org
13 dcowart@rukinkvland.com
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Elizabeth Gill, Essq.
15 ACLU FOUNDATION OF NORTHERN
CALIFORNIA
16 39 Drumm Street
San Francisco, CA 9411
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18 Phone: (415)621-2493
Fax: (415) 255-8437
19 E-Mail: egill@aclunc.org

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(BY MAIL) By placing such document(s) in a sealed envelope, with postage
21 thereon fully prepaid for first class mail, for collection and mailing at Manatt,
Phelps & Phillips, LLP, Los Angeles, California following ordinary business
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practice. I am readily familiar with the practice at Manatt, Phelps & Phillips, LLP
23 for collection and processing of correspondence for mailing with the United States
Postal Service, said practice being that in the ordinary course of business,
24 correspondence is deposited in the United States Postal Service the same day as it
is placed for collection.
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PROOF OF SERVICE
 1 (BY ELECTRONIC MAIL) By transmitting such document(s) electronically
from my e-mail address, rcoprich@manatt.com at Manatt, Phelps & Phillips, LLP,
2 Los Angeles, California, to the person(s) at the electronic mail addresses listed
above.
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I declare under penalty of perjury under the laws of the State of California that the
5 foregoing is true and correct and that this declaration was executed on October 25, 2019, at Los
Angeles, California.
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