Verrees v. Davis CA5 ( 2021 )


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  • Filed 12/20/21 Verrees v. Davis CA5
    NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS
    California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for
    publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication
    or ordered published for purposes of rule 8.1115.
    IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
    FIFTH APPELLATE DISTRICT
    MARGARET VERREES,
    F079517
    Plaintiff and Appellant,
    (Fresno Super. Ct.
    v.                                                               No. 18CECG01307)
    JAMES DAVIS et al.,
    OPINION
    Defendants and Respondents.
    APPEAL from a judgment of the Superior Court of Fresno County. Rosemary T.
    McGuire, Judge.
    Margaret Verrees, in pro. per., for Plaintiff and Appellant.
    McCormick, Barstow, Sheppard, Wayte & Carruth, Michael F. Ball, and Gary A.
    Hunt for Defendants and Respondents.
    -ooOoo-
    Plaintiff Margaret Verrees, M.D., filed this lawsuit against the fellow members of
    her employing neurosurgery practice group, the practice group, the teaching hospital
    affiliated with the practice group, and others, asserting causes of action for fraud, breach
    of contract, negligent infliction of emotional distress, intentional infliction of emotional
    distress and civil conspiracy. Defendants filed a demurrer to the first amended
    complaint, which the superior court sustained without leave to amend.
    Verrees appealed, contending she adequately alleged facts to state her causes of
    action or, alternatively, she should have been granted leave to amend. Defendants’
    demurrer was filed after Verrees unsuccessfully took her discrimination claims to
    arbitration and then unsuccessfully sued various defendants in federal court. As
    explained below, we conclude Verrees’s allegations are not sufficient to state a cause of
    action, and she has failed to carry her burden of demonstrating a reasonable possibility
    that the defects could be cured by amendment.
    We therefore affirm the judgment of dismissal.
    FACTS
    Verrees is a neurosurgeon who in 2008 was persuaded to come to Fresno from
    Cleveland to practice medicine. She was employed in Fresno by the Central California
    Faculty Medical Group, Inc. (Practice Group). Practice Group is an organization of
    faculty physicians and is affiliated with the University of California, San Francisco-
    Fresno Medical Education Program (UCSF Fresno). Verrees also secured privileges to
    practice medicine at Fresno Community Hospital and Medical Center (CRMC)1 under
    CRMC’s affiliation agreement with UCSF Fresno. Verrees’s work within Practice Group
    was overseen by, among others, Dr. Jim Davis, its chief of surgery.
    Beginning in late 2010, tensions and disagreements arose between Verrees and
    Davis regarding Verrees’s work performance. On April 22, 2011, Davis sent a
    memorandum to Joyce Fields-Keene (Fields-Keene), chief executive officer of Practice
    Group, recounting 27 incidents of concern involving Verrees that Davis characterized as
    “extremely alarming.” These incidents included both performance and behavior-related
    1Verrees referred to this entity as Community Medical Centers, Community
    Regional Medical Center, and CRMC. For convenience, this opinion uses CRMC to
    designate that entity.
    2.
    matters. At that time, two incidents had been referred by Davis to Practice Group’s
    performance improvement committee. Also, Verrees was asserting other Practice Group
    physicians were harassing and discriminating against her. On May 3, 2011, Davis
    informed Fields-Keene that Verrees had left an operating room for an extended period of
    time during a procedure and wrote a memoranda to Fields-Keene and the performance
    improvement committee regarding an operation performed by Verrees that took an undue
    amount of time and produced a nominal outcome for the patient. Davis recommended to
    Fields-Keene and the Practice Group executive committee that they not renew Verrees’s
    employment contract. The executive committee agreed and elected to not renew her
    contract. Practice Group bought out Verrees’s contract, and her employment ended on
    May 16, 2011. Verrees’s academic appointment at UCSF Fresno also was terminated
    around this time.
    On July 26, 2011, CRMC notified Verrees that six of her cases, all performed
    during her employment with Practice Group, were being sent out for an independent
    review by Dr. Shuer, a board-certified neurosurgeon, professor of neurosurgery at the
    Stanford University School of Medicine, and former chief of staff for Stanford Hospital
    and Clinics. Shuer concluded that all six cases constituted a “significant deviation from
    the standard of care,” and that one case resulted in a patient’s death. Shuer also opined
    that Verrees was temperamentally unable to practice neurosurgery in a clinical education
    setting and, therefore, Practice Group was justified in electing not to renew her
    employment contract.
    In February 2012, Verrees was granted privileges at Saint Agnes Medical Center
    (St. Agnes). A June 15, 2012 letter from St. Agnes reprimanded Verrees for a “large
    number of incident reports over a short period of time.” In August 2012, St. Agnes
    confirmed restrictions on Verrees’s privileges. In October 2012, Verrees resigned her
    position at St. Agnes. In addition, CRMC revoked Verrees’s medical privileges at its
    facilities in November 2012.
    3.
    Arbitration
    In February 2012, Verrees filed an arbitration claim against Practice Group,
    asserting claims of retaliation, discrimination, and sexual harassment. In June 2014, the
    arbitrator issued a decision granting Practice Group’s motion for summary judgment.
    The arbitrator found that Verrees’s belief that she was improperly treated during her
    employment with Practice Group was ultimately only supported by Verrees’s “own
    statements, feelings and suppositions” rather than by admissible evidence.
    Verrees alleges that the arbitration proceeding was “marred by Defendants
    threatening witnesses, suborning perjury, creati[ng] false evidence via inducing an expert
    to provide corroboration of wrongdoing that never occurred, [and using] false evidence
    during the legal procedure.”
    Medical Board
    In 2013, while the arbitration was pending, Davis submitted allegations about
    Verrees to the Medical Board of California (Medical Board). The Medical Board
    conducted an investigation, with both Verrees and defendants submitting information in
    2014. Near the end of 2015, the Medical Board completed its investigation and
    exonerated Verrees.
    2016 Federal Lawsuit
    In September 2016, representing herself, Verrees filed a complaint in the United
    States District Court for the Eastern District of California, against Davis, Wells, Fields-
    Keene, CRMC, UCSF Fresno, Practice Group, University Neurosurgery Associates
    (UNA)2, Santé/Advantek Benefits Administrators (Santé)3, and Joan Voris, a UCSF
    2Verrees alleged UNA was a subsidiary of Practice Group.
    3In their federal pleadings, the Community Medical Center defendants asserted
    that CRMC, Community Medical Center and Santé/Advantek Benefits Administrators are
    not separate legal entities; instead, CRMC and CMC were described as business aliases
    of Fresno Community Hospital and Medical Center. Santé was described as Santé Health
    System, Inc., pursuing a line of business under the name Advantek Business
    4.
    Fresno assistant dean. Verrees asserted (1) violations of the Racketeer Influenced and
    Corrupt Organizations Act, 18 United States Code section 1961 et seq.; (2) violations of
    federal antitrust law, (3) interference with prospective economic advantage; and
    (4) defamation. In December 2016, Verrees filed a 92-page first amended complaint.
    In October 2017, after Verrees had unsuccessfully attempted to file a 2,185-page
    second amended complaint and a 290-page second amended complaint, the federal
    district court ordered the action to proceed on her first amended complaint. The
    defendants filed motions to dismiss the first amended complaint. In April 2018, the
    motions were granted with leave to amend, and Verrees was warned that any amended
    complaint was to comply with Rule 8(a), in that it had to “clearly and concisely set forth
    her claims, should not address matters not directly related to any of her claims, that ‘any
    excessively long or digressive amended complaint will not meet the Rule 8 standard,’ and
    that this would be [her] final opportunity to plead her case.”
    Verrees filed a 166-page second amended federal complaint with 32 pages of
    exhibits. In June 2018, the district court dismissed Verrees’s second amended federal
    complaint with prejudice, stating the pleading was “neither clear nor concise, nor was it
    in compliance with Rule 8.”
    PROCEDURAL HISTORY
    On April 16, 2018, while her federal lawsuit was pending, Verrees initiated this
    lawsuit by filing a complaint in Fresno County Superior Court. Verrees alleged fraud,
    breach of contract, negligent infliction of emotional distress, intentional infliction of
    emotional distress, and civil conspiracy against Davis, Wells, Fields-Keene, CRMC,
    Practice Group, UNA, and Santé.
    In September 2018, Verrees filed a 145-page first amended complaint for fraud,
    breach of contract, negligent infliction of emotional distress, intentional infliction of
    Administrators. Santé had denied Verrees’s request to designate her as an “approved
    provider.”
    5.
    emotional distress, and civil conspiracy. The primary difference between Verrees’s
    initial and first amended complaint was the addition of “the California Regents” as a
    named defendant. Verrees stated the California Regents subsumed UCSF Fresno and, for
    convenience, this opinion uses UCSF Fresno to refer to that defendant.
    In October 2018, Practice Group, UNA, and Fields-Keene filed a demurrer
    asserting that all of Verrees’s causes of action were time-barred under the applicable
    statute of limitations, barred by the doctrine of collateral estoppel, failed to state facts
    sufficient to state a cause of action, and were fatally uncertain. These defendants argued
    collateral estoppel effect should be given on the issue adjudicated in the arbitration
    proceedings. CRMC, Wells and Santé also filed a demurrer asserting Verrees’s first
    amended complaint failed to state facts sufficient to constitute a cause of action and was
    uncertain.
    In November 2018, the trial court heard argument on defendants’ demurrers and
    took the matter under advisement. Two days later, the court issued a minute order
    sustaining the demurrers without leave to amend.
    On December 20, 2018, the trial court signed and filed a joint order dismissing
    Verrees’s first amended complaint with prejudice as to Fields-Keene, Practice Group,
    UNA, CRMC, Wells, and Santé. A notice of entry of order was filed and served the next
    day.
    In February 2019, Davis and UCSF Fresno filed a demurrer to Verrees’s first
    amended complaint, asserting it was uncertain, failed to state facts sufficient to constitute
    a cause of action, and failed to allege fraud with the requisite particularity. In April 2019,
    the trial court held a hearing and adopted its tentative ruling to sustain the demurrer to the
    first amended complaint without leave to amend. On May 1, 2019, an order dismissing
    Verrees’s first amended complaint with prejudice as to Davis and UCSF Fresno was
    filed. A notice of entry of this order was filed and served on May 21, 2019. The
    following month, Verrees filed a notice of appeal. The timing and contents of the notice
    6.
    of appeal are significant for this appeal because they determine the issues and parties
    properly before this court.
    DISCUSSION
    I.     SCOPE OF THE APPEAL
    A.     Dismissal Orders
    1.     Appealability
    Code of Civil Procedure section 581d provides in part: “All dismissals ordered by
    the court shall be in the form of a written order signed by the court and filed in the action
    and those orders when so filed shall constitute judgments and be effective for all
    purposes.” Under this statute, the December 20, 2018 order dismissing Verrees’s first
    amended complaint with prejudice as to six defendants constitutes a “judgment.”
    Therefore, that order is appealable pursuant to Code of Civil Procedure section 904.1,
    subdivision (a)(1), which states an appeal may be taken “[f]rom a judgment.” (See
    McAllister v. County of Monterey (2007) 
    147 Cal.App.4th 253
    , 278 [an order dismissing
    a complaint with prejudice constitutes an appealable judgment].) Similarly, the May 1,
    2019, order dismissing Verrees’s first amended complaint with prejudice as to Davis and
    UCSF Fresno constitutes an appealable judgment.
    2.     Timeliness
    On June 25, 2019, Verrees filed a notice of appeal using Judicial Council form
    APP-002. Verrees marked the box indicating the appeal was taken from a “Judgment of
    dismissal after an order sustaining a demurrer” and stated the judgment was entered on
    May 21, 2019 – the filing date of the notice of entry of order dismissing Verrees’s first
    amended complaint as to Davis and UCSF Fresno.
    First, Verrees’s appeal is timely with respect to the order dismissing the first
    amended complaint with prejudice as to Davis and UCSF Fresno. The notice of appeal
    was filed 35 days after the notice of entry of that order. Under California Rules of Court,
    7.
    rule 8.104(a)(1)(B), 4 a notice of appeal is timely if it is filed within 60 days of a party
    serving a notice of entry of the judgment.
    Second, Verrees’s appeal is not timely with respect to the December 2018 order
    dismissing Verrees’s first amended complaint with prejudice as to Fields-Keene, Practice
    Group, UNA, CRMC, Wells, and Santé. The notice of entry of that order was served on
    December 21, 2018, which is 151 days before Verrees filed her notice of appeal. “[T]he
    filing of a timely notice of appeal is a jurisdictional prerequisite.” (Silverbrand v. County
    of Los Angeles (2009) 
    46 Cal.4th 106
    , 113.) Therefore, we have no jurisdiction – that is,
    power or authority – to determine the merits of Verrees’s challenges to the December
    2018 order.
    Verrees refers to the principle that “ ‘[a] notice of appeal shall be liberally
    construed in favor of its sufficiency’ [citation].” (Vibert v. Berger (1966) 
    64 Cal.2d 65
    ,
    67.) Verrees contends that, under the rule of liberal construction, a mistake in
    designating the parties is not fatal. She cites Boynton v. McKales (1956) 
    139 Cal.App.2d 777
     as a case where the notice of appeal identified only one defendant and was construed
    to include both defendants. (Id. at pp. 787–788.) Even if Verrees’s notice of appeal is
    construed to include the December 2018 order, that construction does not cure the
    untimeliness of the appeal as to that order of dismissal. Therefore, our jurisdiction is
    limited to the May 2019 order dismissing the case as to Davis and UCSF Fresno.
    B.       Order Denying Motion for Leave to Amend
    Verrees’s opening brief lists the denial of a motion for leave to amend as one of
    the issues on appeal. We do not separately address her claim of trial court error relating
    to that specific motion because that claim is redundant to her argument that the trial court
    erred in sustaining the demurrer without leave to amend. (See Code Civ. Proc., §§ 472
    4   Subsequent references to a numbered “Rule” are to the California Rules of
    Court.
    8.
    [amendment without leave], 473, subd. (a) [discretionary authority to grant leave to
    amend].)
    As background for this conclusion, we note that Verrees filed the motion for leave
    to amend after Davis and UCSF Fresno filed their demurrer and before that demurrer was
    heard. The motion attached a copy of a proposed second amended complaint alleging
    five causes of action against all defendants. Davis and UCSF Fresno filed an opposition
    to and request that the trial court strike Verrees’s motion for leave to file a second
    amended complaint. On June 24, 2019, the day before Verrees filed her notice of appeal,
    the court issued a tentative ruling denying the motion for leave to amend as moot because
    the demurrers of all defendants already had been sustained without leave to amend.
    Neither side requested argument. Accordingly, on June 27, 2019, the trial court issued a
    minute order adopting its tentative ruling and denying Verrees’s motion for leave to file a
    second amended complaint. Verrees did not file a separate notice of appeal from that
    order or amend her June 25, 2019 notice of appeal.
    The absence of a separate appeal does not, as a practical matter, affect the outcome
    of this appeal. Our consideration of the proposed second amended complaint is
    appropriate because the “issue of leave to amend is always open on appeal.” (City of
    Stockton v. Superior Court (2007) 
    42 Cal.4th 730
    , 746; Code Civ. Proc., § 472c.) Thus,
    we are not limited to considering the showing made in Verrees’s opposition to the
    demurrer. If the proposed second amended complaint failed to state facts sufficient to
    constitute a cause of action, then the motion for leave to amend was properly denied.
    (California Casualty General Ins. Co. v. Superior Court (1985) 
    173 Cal.App.3d 274
    ,
    280, disapproved on another ground by Kransco v. American Empire Surplus Lines Ins.
    Co. (2000) 
    23 Cal.4th 390
    , 407, fn. 11.)
    Alternatively, if the second amended complaint did allege facts sufficient to state
    one or more causes of action, we will conclude Verrees has shown the defects in her first
    9.
    amended complaint could be cured by amendment and, thus, has shown the trial court
    abused its discretion in sustaining the demurrer without leave to amend.
    II.     BASIC PRINCIPLES GOVERNING DEMURRERS
    A.     Stating a Cause of Action
    A complaint must contain “[a] statement of the facts constituting the cause of
    action, in ordinary and concise language.” (Code Civ. Proc., § 425.10, subd. (a)(1).)
    When a complaint “does not state facts sufficient to constitute a cause of action,” a
    defendant may raise that objection by filing a demurrer. (Id., § 430.10, subd. (e).)
    Whether a pleading alleges facts sufficient to constitute a cause of action is a question of
    law. (Neilson v. City of California City (2005) 
    133 Cal.App.4th 1296
    , 1305.)
    The facts that must be written down in a complaint to properly allege a cause of
    action are referred to as the cause of action’s essential elements. The essential elements
    are determined by the substantive law that defines the cause of action – that is, defines
    the circumstance in which a plaintiff has a right to relief from a harm suffered. (Weil &
    Brown, Cal. Practice Guide: Civil Procedure Before Trial (The Rutter Group 2020)
    ¶ 6:121, pp. 6–36.)
    B.     Standard of Review
    Under California’s constitutional doctrine of reversible error, a trial court’s order
    is presumed correct, and the appellant must affirmatively demonstrate prejudicial error.
    (Denham v. Superior Court (1970) 
    2 Cal.3d 557
    , 564; see Jameson v. Desta (2018)
    
    5 Cal.5th 594
    , 609 [“the burden is on an appellant to demonstrate … that the trial court
    committed an error”].) When determining whether a trial court erred in sustaining a
    general demurrer without leave to amend, appellate courts address two separate
    questions, each with its own standard of review. (Blank v. Kirwan (1985) 
    39 Cal.3d 311
    ,
    318.)
    10.
    First, an appellate court reviews the complaint de novo to determine whether the
    complaint states facts sufficient to constitute a cause of action. (Blank v. Kirwan, supra,
    39 Cal.3d at p. 318.) In conducting this de novo review, we treat the demurrer as
    admitting all material facts properly pleaded, but do not assume the truth of contentions,
    deductions or conclusions of law. (Ibid.) The pleader’s contentions or conclusions of
    law are not controlling because appellate courts must independently decide questions of
    law without deference to the legal conclusions of the pleader or the trial court. (Neilson
    v. City of California City, 
    supra,
     133 Cal.App.4th at p. 1304.)
    Second, the question of whether leave to amend should have been granted requires
    the appellate court to determine whether there is a reasonable possibility that the defect
    can be cured by amendment; if it can be the trial court has abused its discretion and we
    reverse; if not, there has been no abuse of discretion and we affirm. (Blank v. Kirwan,
    supra, at p. 595; see Sierra Palms Homeowners Assn. v. Metro Gold Line Foothill
    Extension Construction Authority (2018) 
    19 Cal.App.5th 1127
    , 1132 [plaintiff may meet
    burden of proving an amendment would cure a legal defect for the first time on appeal].)
    “ ‘To satisfy that burden on appeal, a plaintiff “must show in what manner he can amend
    his complaint and how that amendment will change the legal effect of his pleading.”
    [Citation.] … The plaintiff must clearly and specifically set forth … factual allegations
    that sufficiently state all required elements of that cause of action. [Citations.]
    Allegations must be factual and specific, not vague or conclusionary. [Citation.]’
    [Citation.]” (Rossberg v. Bank of America, N.A. (2013) 
    219 Cal.App.4th 1481
    , 1491,
    quoting Rakestraw v. California Physicians’ Service (2000) 
    81 Cal.App.4th 39
    , 43–44.)
    Another principle of appellate review states that “that a ruling or decision, itself
    correct in law, will not be disturbed on appeal merely because given for a wrong reason.
    If right upon any theory of the law applicable to the case, it must be sustained regardless
    of the considerations which may have moved the trial court to its conclusion.” (Davey v.
    Southern Pacific Co. (1897) 
    116 Cal. 325
    , 329.) Under this principle, we uphold a trial
    11.
    court’s ruling “on any sufficient ground, whether relied on by the court below or not.
    [Citation.]” (Wheeler v. County of San Bernardino (1978) 
    76 Cal.App.3d 841
    , 846, fn.
    3.)
    III.   MERITS OF THE APPEAL
    A.     Fraud
    1.      Elements
    The essential elements of a cause of action for fraud and deceit are
    (1) misrepresentation, (2) knowledge of the falsity or scienter, (3) intent to defraud – that
    is, induce reliance, (4) justifiable reliance, and (5) resulting damages. (Lazar v. Superior
    Court (1996) 
    12 Cal.4th 631
    , 638; see Mirkin v. Wasserman (1993) 
    5 Cal.4th 1082
    , 1092
    [plaintiff in action for deceit must plead common law element of actual reliance]; cf. Civ.
    Code, § 1572 [actual fraud] with Civ. Code, § 1710 [deceit defined].) These elements
    “must be pled specifically; general and conclusory allegations do not suffice.
    [Citations.]” (Lazar, supra, at p. 645.) The requirement for specific allegations
    “ ‘necessitates pleading facts which “show how, when, where, to whom, and by what
    means the representations were tendered.” ’ [Citation.]” (Ibid.) Stated another way, a
    plaintiff must allege “with particularity who made the statements, when they were made,
    what was actually stated, [and] why they were false. [Citations.]” (Scott v. JPMorgan
    Chase Bank, N.A. (2013) 
    214 Cal.App.4th 743
    , 763.) Under these pleading rules, a
    plaintiff’s conclusory allegation of reliance is insufficient to state that essential element.
    (Glaski v. Bank of America (2013) 
    218 Cal.App.4th 1079
    , 1091.)
    A cause of action for fraud and deceit based on concealment “is not actionable
    absent all the elements of fraud.” (Persson v. Smart Inventions, Inc. (2005) 
    125 Cal.App.4th 1141
    , 1168.) Thus, “concealment does not amount to fraud unless and until
    there is reliance upon it.” (Ibid.) Furthermore, the rule that fraud must be pleaded with
    particularity “applies equally to a cause of action for fraud and deceit based on
    12.
    concealment. [Citation.]” (Cansino v. Bank of America (2014) 
    224 Cal.App.4th 1462
    ,
    1472.)
    2.   Facts Alleged
    The fraud cause of action in the first amended complaint begins by stating that
    Verrees realleges the allegations in the preceding 114 pages and then states: “Defendants
    made multiple false representations against [Verrees] through blackmailing sources.
    Dr. Davis knew the accusations were false as he had manufactured them; they were his
    fiction.” It also alleges that (1) CRMC bolstered the accusations by sending them to an
    expert (Shuer), accompanied by unknown supporting material, and the expert
    corroborated the alleged wrongdoing related in the accusations; (2) Davis submitted
    Verrees’s “name and the fraudulent allegations, obtained through blackmail and
    extortion, to the Medical Board of California” in 2013; (3) defendants transmitted to St.
    Agnes the fraudulent allegations that they had induced the expert to corroborate, which
    poisoned her chance of working at St. Agnes and competing with her former employer;
    and (4) defendants used fraudulent documentation and suborned perjury in the 2014
    arbitration proceeding on Verrees’s sex discrimination claim. Although the Medical
    Board completed its investigation and exonerated Verrees near the end of 2015, Verrees
    alleges defendants’ fraudulent allegation devastated her professionally and financially
    and ruined her future prospects in the field of neurosurgery. More specifically, she
    alleges defendants’ actions ruined her opportunity to complete Neurosurgery Board
    Certification.
    The first amended complaint also describes an incident where a patient Verrees
    treated had a shunt malfunction six weeks after surgery, and the patient and the patient’s
    husband wanted Verrees to continue as the neurosurgeon on the case, but the husband’s
    view changed when Davis beckoned him into an outer hallway at the hospital, CRMC,
    13.
    and told him falsehoods, It also alleges that in October 2012, Davis falsely told a
    patient’s husband that Verrees did not have privileges at CRMC.
    The first amended complaint also alleges defendants acted intentionally to conceal
    unethical and corrupt practices, delayed discovery, and obstructed justice. It alleges
    defendants threatened and intimidated witnesses, which caused witnesses to withhold
    testimony and prevented the revelation of material facts.
    In allegations preceding the fraud cause of action, the first amended complaint
    alleges that Verrees “found cold rejection without debate, discussion or reason in
    response to her suggestions” concerning patient care from Davis and trepidation from
    members of the trauma team to question Davis about the protocols used and espoused by
    Davis. Eleven pages of the first amended complaint describe Verrees’s great frustration
    with the rejection of her suggestions and attributes such rejection to nefarious motives.
    Our review of the first amended complaint did not locate allegations of the
    specificity needed to state a fraud cause of action. For instance, the pleading did not state
    how Verrees reasonably relied on a misrepresentation of Davis or UCSF Fresno to her
    detriment. With respect to UCSF Fresno, the pleading does not specifically state the
    contents of any misrepresentations made by UCSF Fresno, when the misrepresentation
    was made, who made it, and when. Thus, the allegations with respect to fraud by Davis
    and UCSF Fresno lack the specificity need to state the essential elements of a fraud cause
    of action.
    3.     Verrees’s Contentions
    Verrees’s opening brief contends her cause of action for fraud was based on
    concealment, not deceit, and such a claim was adequately pleaded. Verrees asserts the
    trial court “did not consider concealment whereby the Defendants does not make a
    representation.” As to the element of reliance, Verrees argues she need only allege she
    14.
    was unaware of the concealed or suppressed fact and would not have acted as she did if
    she had known of that fact.
    Verrees contends she alleged the defendants “continue to conceal the true facts
    about [her] employment” and cites paragraph 35 of her proposed second amended
    complaint. That paragraph states that defendants “continue to make the fraudulent
    representations based on the concealments.” The next paragraph states that Verrees
    “reasonably relied on Defendants’ deception.” The concealments referred to are
    described in paragraph 18 of the proposed second amended complaint, which states in
    full: “Definitely beginning in 2016 and continuing through the present, Defendants have
    failed and refused to accurately report that [Verrees] left her position in good standing
    and have refused and failed to accurately acknowledge and report that she had committed
    no wrongdoing during her time with Defendants.”
    In Mirkin v. Wasserman, 
    supra,
     
    5 Cal.4th 1082
    , our Supreme Court recognized
    that it is possible to prove reliance on an omission or concealment by proving “that, had
    the omitted information been disclosed, one would have been aware of it and behaved
    differently.” (Id. at p. 1093.) The court’s use of the word “one” in this statement refers
    to the plaintiff. Thus, a plaintiff must plead and prove that he or she would have behaved
    differently if the information had been disclosed.
    Neither the first amended complaint nor the proposed second amended complaint
    state what Verrees would have done differently if defendants had accurately reported
    information about her employment. In addition, neither document states how her
    different behavior would have avoided any damage or injury caused by the concealment
    alleged. The conclusory allegation that Verrees “reasonably relied on Defendants’
    deception” does not provide the particularity necessary to establish she would have
    behaved differently in the absence of the concealment.
    In sum, Verrees has not alleged and has not shown she can allege a cause of action
    for fraud based on deceit or concealment with the particularity required by California
    15.
    law. Rather, she appears to be claiming that defendants are deceiving the public and
    health care community about her merits as a neurosurgeon and that deception has harmed
    her professionally and financially. The fundamental problem with this approach is that a
    cause of action for fraud requires the deception to be directed at the plaintiff and causes
    the plaintiff to detrimentally rely on that deception. A fraud cause of action does not
    reach the deception of others. 5 Accordingly, the trial court properly sustained the
    demurrer to the fraud cause of action without leave to amend.
    B.     Breach of Contract
    The essential elements of a breach of contract cause of action are (1) the existence
    of the contract between the parties, (2) plaintiff’s performance or excuse for
    nonperformance, (3) defendant’s breach of a contract term, and (4) the resulting damages
    to the plaintiff. (Oasis West Realty, LLC v. Goldman (2011) 
    51 Cal.4th 811
    , 821, citing
    Reichert v. General Ins. Co. (1968) 
    68 Cal.2d 822
    , 830.) To properly plead a cause of
    action for breach of contract, “the complaint must indicate on its face whether the
    contract is written, oral, or implied by conduct. [Citation.]” (Otworth v. Southern Pacific
    Transportation Co. (1985) 
    166 Cal.App.3d 452
    , 458–459, fn. omitted.) “If the action is
    based on an alleged breach of a written contract, the terms must be set out verbatim in the
    body of the complaint or a copy of the written instrument must be attached and
    incorporated by reference. [Citation.]” (Id. at p. 459.)
    Verrees’s breach of contract cause of action is set forth on pages 117 through 127
    of the first amended complaint. Nowhere on those pages does Verrees state whether an
    alleged contract with Davis or UCFS Fresno is written, oral, implied by conduct, or a
    combination of these methods for manifesting the mutual assent necessary to form a
    contract. Furthermore, the first amended complaint did not set forth verbatim the terms
    5Verrees’s causes of action for antitrust violations, interference with prospective
    economic advantage, and defamation were asserted in her federal lawsuit. Thus, we need
    not analyze whether her allegations state these types of claims.
    16.
    of the employment agreement or the terms of any other agreement and no written
    agreement was attached to the first amended complaint. Therefore, we conclude the first
    amended complaint failed to comply with the basic rules governing the pleading a breach
    of contract cause of action. The first amended complaint’s reference to an “Employment
    Agreement” does not overcome these defects. Thus, the trial court properly sustained the
    demurrer to the breach of contract cause of action.
    Consequently, the key issue is whether Verrees should have been allowed to
    amend her breach of contract cause of action to cure its defect. The arbitration decision
    describes a “Physician Employment Agreement” entered into by Practice Group and
    Verrees and signed by Verrees on July 22, 2008. The decision states that under the
    agreement, Practice Group employed Verrees as a neurosurgeon for a term beginning
    September 1, 2008, and ending August 31, 2011. However, neither Davis nor UCSF
    Fresno are a party to that agreement and, therefore, they cannot be held liable for a breach
    of its terms. Therefore, Verrees has not shown her employment agreement can served as
    the basis for a breach of contract cause of action against Davis or UCSF Fresno.
    Next, we consider Verrees’s attempt to plead a breach of contract cause of action
    in paragraphs 13 through 19 of her proposed second amended complaint. Paragraph 14
    states: “On or about September 2008, [Verrees] entered into a written contract with
    Defendants, the relevant terms of which provided for [Verrees] to practice as a
    neurosurgeon at CRMC and [Practice Group], with an academic appointment from UCSF
    [Fresno] .… In the written and implied terms of the Agreement, Defendants could
    investigate complaints and conduct disciplinary reviews of [Verrees] under the guise of
    maintaining professional standard. Defendants were obligated to accurately and
    truthfully report [Verrees’s] status.” The contents of the proposed second amended
    complaint do not satisfy the basic rules governing the pleading a breach of contract cause
    of action because the terms of the alleged contract are not set forth verbatim or,
    alternatively, a copy of the written contract was not attached to the proposed pleading.
    17.
    Consequently, Verrees had not carried her burden of demonstrating she could cure the
    defects in her breach of contract cause of action by alleging Davis, UCSF Fresno, or both
    were a party to a written contract and breached a term of that contract. Furthermore,
    Verrees made no showing that she could allege that she and these defendants entered into
    an oral contract or a contract implied by conduct. Therefore, the trial court did not abuse
    its discretion in refusing to grant Verrees leave to amend her breach of contract cause of
    action against Davis and UCSF Fresno.
    C.     Intentional Infliction of Emotional Distress
    1.     Elements
    The essential elements of a cause of action for intentional infliction of emotional
    distress are (1) extreme and outrageous conduct by the defendant with the intention of
    causing, or with reckless disregard for the probability of causing, emotional distress;
    (2) the plaintiff’s suffering extreme or severe emotional distress; and (3) actual and
    proximate cause of the plaintiff’s extreme or severe emotional distress by the defendant’s
    outrageous conduct. (Potter v. Firestone Tire & Rubber Co. (1993) 
    6 Cal.4th 965
    , 1001
    (Potter).) The alleged conduct must be so extreme as to exceed all bounds usually
    tolerated in a civilized community. (Cochran v. Cochran (1998) 
    65 Cal.App.4th 488
    ,
    494.) The requisite severe emotional distress must be such that no reasonable person in
    civilized society should be expected to endure it. (Potter, 
    supra, at p. 1004
    .) Liability
    for emotional distress does not extend to “ ‘ “mere insults, indignities, threats,
    annoyances, petty oppressions, or other trivialities.” [Citation.]’ [Citations.]” (Hughes
    v. Pair (2009) 
    46 Cal.4th 1035
    , 1051.)
    2.     Timeliness
    A general demurrer, besides challenging whether the facts alleged are sufficient to
    state all of the essential elements of a cause of action, may be used to assert a statute of
    limitations defense. (SLPR, L.L.C. v. San Diego Unified Port District (2020) 49
    18.
    Cal.App.5th 284, 316.) The two-year statute of limitations in Code of Civil Procedure
    section 335.1 for person injuries “caused by the wrongful act or neglect of another”
    applies to claims for intentional or negligent infliction of emotional distress. As a general
    rule, the untimeliness of the cause of action must clearly and affirmatively appear on the
    face of the complaint and matters judicially noticed before a demurrer will be sustained
    on that ground. (Committee for Green Foothills v. Santa Clara County Bd. of
    Supervisors (2010) 
    48 Cal.4th 32
    , 42.)
    Here, Verrees’s lawsuit was filed on April 16, 2018. As a result, the outrageous
    conduct intended to cause Verrees emotional distress must have occurred on or after
    April 16, 2016. This date is after the proceedings before the Medical Board were
    concluded in late 2015. Therefore, the allegations that defendants presented false
    accusations to the Medical Board in 2013 and confirmed false allegations throughout
    2014 cannot serve as the outrageous conduct necessary for a timely intentional infliction
    of emotional distress claim. Similarly, the allegations that defendants’ conduct
    precipitated Verrees’s resignation from St. Agnes in October 2012 occurred too long ago
    to serve as the requisite outrageous conduct.
    3.     Facts Alleged
    The allegations constituting the intentional infliction of emotional distress claim
    are stated on a single page of the first amended complaint. Verrees incorporated her
    preceding allegations and alleged (1) “[t]he conduct of Defendants was extreme and
    outrageous”; (2) “Defendants’ conduct, using known fictitious allegations to cause
    cumulative damage to [her], and Defendants’ active obstruction of justice to prevent
    exposure of the fraudulent material, and the illegal means used to obtain it, further
    worsening the agony to [her], exceeds all bounds of that usually tolerated in a civilized
    community”; (3) “Defendants knew using their fraudulent allegations as they did in
    cumulative fashion, through 2015, against [her] in multiple ways over multiple years
    19.
    would result in the devastation of [her] neurosurgery career and potential in
    neurosurgery”; and (4) “Defendants intended to inflict injury, acting as described
    knowing that injury would result.”
    On appeal, Verrees contends the first amended complaint “does allege outrageous
    comments not only in 2016, but into 2017 and 2018.” Verrees refers to the allegations
    that “Defendants continued to wield fraudulent allegations to harm [her] in numerous
    ways over the years – 2011, 2012, 2013, 2014, 2015, 2016, causing cumulative damage”
    and that an assistant dean at UCSF Fresno “became responsible for fabricated offenses
    originated from crime and discrimination, targeted to dog [Verrees’s] footsteps for years
    – through 2011, then 2012, 2013, 2014, 2015, 2016 – and including 2017 and 2018 – to
    the present, demolishing her career and potential.”
    To be actionable, the allegedly outrageous conduct must cause severe emotional
    distress. The allegations in the first amended complaint’s cause of action for intentional
    infliction of emotional distress do not address this element. Elsewhere, the first amended
    complaint described an incident that occurred in 2009, involved two male neurosurgeons,
    and generated “fear, anxiety and doubt.” Also, the negligent infliction of emotional
    distress allegations state that the defendants’ conduct “set off a destructive chain of
    events which plagued [her] for years and destroyed her career, peace of mind, and
    potential” and the fraud and other misconduct “caused [her] suffering and severe
    emotional distress.”
    4.       Severe Emotional Distress
    First, we conclude an allegation that a plaintiff suffered severe emotional distress
    is conclusory and is insufficient to adequately plead that element. Also, the additional
    allegation that Verrees’s peace of mind as destroyed fails to provide the necessary facts. 6
    6The allegation about fear, anxiety and doubt occurred in 2009, and it is unclear
    whether those feelings were experienced by Verrees or “the Neurosurgery PAs.”
    Because the statute of limitations has run on any outrageous acts done in 2009, that
    20.
    In Hughes v. Pair, 
    supra,
     
    46 Cal.4th 1035
    , the plaintiff sued a trustee for, among
    other things, intentional infliction of emotional distress, alleging that he made sexually
    explicit, offensive, and threatening comments, in effect, demanding sex if she wanted her
    request for funds from the trust to be granted. (Id. at p. 1040.) The appellate court
    upheld a summary judgment against the plaintiff, concluding her allegations that “she has
    suffered discomfort, worry, anxiety, upset stomach, concern, and agitation” as a result of
    the defendant’s conduct “do not comprise ‘ “ ‘emotional distress of such substantial
    quality or enduring quality that no reasonable [person] in civilized society should be
    expected to endure it.’ ” ’ [Citation.]” (Id. at p. 1051.) In comparison, in Hailey v.
    California Physicians’ Service (2007) 
    158 Cal.App.4th 452
    , the plaintiff alleged the
    wrongful rescission of his health coverage caused severe emotional distress, which
    resulted in vomiting, stomach cramps, and diarrhea. (Id. at pp. 476–477.) The appellate
    court concluded these allegations satisfied the element of severe emotional distress and
    reversed the order sustaining the defendant’s demurrer. (Id. at pp. 477–478.)
    Applying the standard of severity established by the foregoing cases, we conclude
    the first amended complaint does not provide sufficient facts to show that the alleged
    emotional distress was severe. Accordingly, we conclude the first amended complaint
    did not sufficiently allege that element and, as a result, the demurrer was properly
    sustained on that ground.
    5.     Leave to Amend
    Next, we consider whether Verrees has demonstrated a reasonable probability of
    curing the defect in an amendment. Our evaluation of this question focuses on the
    content of her proposed second amended complaint. Paragraph 43 of that document
    states Verrees “suffered severe emotional distress as a result of Defendants’ conduct and
    conduct and Verrees’s reaction cannot be used to satisfy the elements of a viable cause of
    action for the infliction of emotional distress.
    21.
    action, and Defendants’ continued conduct and actions.” No details are provided to
    explain why the alleged emotional distress was severe. Accordingly, Verrees has not
    carried her burden of demonstrating she could allege facts showing her emotional distress
    was severe. (See Rossberg v. Bank of America, N.A., supra, 219 Cal.App.4th at p. 1491
    [to show appellate court an amendment could cure the defective pleading, plaintiff must
    clearly set forth factual allegations sufficient to state the cause of action’s missing
    element].)
    Because the element of severe emotional distress is missing, we need not consider
    other elements. In particular, we do address whether Verrees could allege that conduct
    by Davis or UCSF Fresno and occurring after April 16, 2016, was extreme and
    outrageous.
    D.     Negligent Infliction of Emotional Distress
    “[T]here is no independent tort of negligent infliction of emotional distress.
    [Citation.] The tort is negligence, a cause of action in which a duty to the plaintiff is an
    essential element. [Citations.] That duty may be imposed by law, be assumed by the
    defendant, or exist by virtue of a special relationship. [Citation.]” (Potter, 
    supra,
     6
    Cal.4th at pp. 984–985.) The requisite duty “may be imposed by law, be assumed by the
    defendant, or exist by virtue of a special relationship. [Citation.]” (Id. at p. 985.)
    Another limitation on negligent infliction of emotional distress claims is that “with rare
    exceptions, a breach of the duty must threaten physical injury, not simply damage to
    property or financial interests. [Citations.]” (Ibid.)
    On appeal, Verrees contends there was a preexisting relationship between her and
    defendants that gave rise to a duty and refers to article IV in a written agreement. The
    shortcoming of this argument is that Verrees has not shown that Davis or UCSF Fresno
    were parties to that written agreement – an issue discussed in part III.B. of this opinion.
    Thus, her arguments based on that alleged duty do not demonstrate she has, or could,
    22.
    allege the existing of a duty necessary to support the negligent infliction of emotional
    distress claim.
    Verrees also refers to the general rule that when a person with no duty to speak
    “ ‘undertakes to do so, either voluntarily or in response to inquiries, he is bound not only
    to state truly what he tells but also not to suppress or conceal any facts within his
    knowledge which materially qualify those stated. If he speaks at all he must make a full
    and fair disclosure.’ [Citations.]” (Rogers v. Warden (1942) 
    20 Cal.2d 286
    , 289.) This
    rule and the duty to speak truthfully does not aid Verrees because she had not identified
    any incomplete or misleading statements about her made by Davis or UCSF Fresno in the
    two years preceding her complaint.
    Consequently, we conclude the first amended complaint’s negligent infliction of
    emotional distress claim is deficient because it does not adequately allege the existence of
    a duty (1) imposed by law, (2) assumed by Davis or UCSF Fresno, or (3) existing by
    virtue of a special relationship. (See Potter, 
    supra,
     6 Cal.4th at p. 985.) Similarly,
    Verrees’s proposed second amended complaint and the contents of her appellate brief do
    not demonstrate she can amend to allege the existence of such a duty. Therefore, the trial
    court did not err in sustaining the demurrer to the negligent infliction of emotional
    distress claim without leave to amend.
    E.     Civil Conspiracy
    “Conspiracy” is not itself a cause of action; rather, it is “a legal doctrine that
    imposes liability on persons who, although not actually committing a tort themselves,
    share with the immediate tortfeasors a common plan or design in its perpetration.
    [Citation.]” (Applied Equipment Corp. v. Litton Saudi Arabia Ltd. (1994) 
    7 Cal.4th 503
    ,
    510–511.) A “civil conspiracy,” therefore, standing alone, “ ‘ “does not per se give rise
    to a cause of action unless a civil wrong has been committed resulting in damage.” ’
    [Citation.]” (Id. at p. 511.)
    23.
    As discussed above, Verrees did not properly allege a valid cause of action and,
    therefore, has not identified an underlying “civil wrong” upon which a conspiracy claim
    could be based. Therefore, we conclude Verrees’s first amended complaint also fails to
    state Davis or UCSF Fresno engaged in a civil conspiracy. Similarly, because Verrees
    has not shown she could cure the defects in her other causes of action by amendment, she
    has not shown an ability to cure the defect in her civil conspiracy claim.
    DISPOSITION
    The judgment is affirmed. Respondents shall recover their costs on appeal.
    POOCHIGIAN, ACTING P. J.
    WE CONCUR:
    DETJEN, J.
    SMITH, J.
    24.