Maria Alejandra Ramirez Rodriguez and Cristian Andres Guzman de la Ossa, individually and as next friends of their minor son, I.R. v. Nancy Sanders Harper; Hennepin County; Hennepin Healthcare System, Inc., d/b/a Hennepin County Medical Center; The University of Minnesota Physicians, d/b/a U of M Physicians; and Megan Dillman

Opinion

UNITED STATES DISTRICT COURT DISTRICT OF MINNESOTA

MARIA ALEJANDRA RAMIREZ Case No. 25-cv-2266 (LMP/SGE) RODRIGUEZ and CRISTIAN ANDRES GUZMAN DE LA OSSA, individually and as next friends of their minor son, I.R.,

Plaintiffs, ORD ER ON DEFENDANTS’ v. MOTIONS TO DISMISS

NANCY SANDERS HARPER; HENNEPIN COUNTY; HENNEPIN HEALTHCARE SYSTEM, INC., d/b/a Hennepin County Medical Center; THE UNIVERSITY OF MINNESOTA PHYSICIANS, d/b/a U of M Physicians; and MEGAN DILLMAN,

Defendants.

Jerome Reinan and Jordana Gingrass, Law Offices of J.M. Reinan, P.C., Denver, CO, for Plaintiffs.

Mark R. Whitmore and Nicolas L. Hanson, Bassford Remele, Minneapolis, MN, for Defendants Nancy Sanders Harper and University of Minnesota Physicians.

Chase Webber and Marissa K. Linden, Hennepin County Attorney’s Office, Minneapolis, MN, for Defendant Hennepin Healthcare System, Inc.

Kelly K. Pierce and Susan Fleurant, Hennepin County Attorney’s Office, Minneapolis, MN, for Defendant Hennepin County.

Mark A. Solheim, Patrick H. O’Neill, III, and Chasse R. Thomas, Larson King, LLP, St. Paul, MN, for Defendant Megan Dillman.

Plaintiffs Maria Alejandra Ramirez Rodriguez and Cristian Andres Guzman de la Ossa brought this lawsuit against a physician, medical systems, Hennepin County, and a foster parent, alleging that they engaged in a conspiracy to falsely report incidents of child abuse in order to secure false child abuse prosecutions and convictions, earn political

influence, and secure governmental funding. Plaintiffs allege that their family fell victim to this conspiracy, as these individuals and institutions were involved in accusing them of abuse against their child I.R. in 2023. They argue that these reports of child abuse were false but nevertheless led Hennepin County to remove I.R. from their custody and seek termination of their parental rights. Defendants move to dismiss the second amended complaint on various grounds. See ECF Nos. 47, 52, 59, 65.

BACKGROUND I. Background of Alleged Conspiracy The second amended complaint begins by recounting the historical development of the condition known as “shaken baby syndrome” or “abusive head trauma” (referred to in this Order collectively as “SBS/AHT”). ECF No. 45 ¶¶ 24–53. Plaintiffs allege that

although SBS/AHT has been discredited as a medical diagnosis, physicians, educational institutions, law enforcement, and social workers “prop up the medical and evidentiary deficiencies of SBS/AHT” for personal influence and financial gain. See id. ¶¶ 36–44. Plaintiffs allege that identifying SBS/AHT is an “easy way to prosecute and imprison parents and caregivers,” is politically popular, and rewards medical and legal professionals

with funding to research, investigate, and prosecute incidents of SBS/AHT. Id. ¶¶ 28, 33– 41. Plaintiffs allege that Dr. Nancy Sanders Harper is a leader in the field of child abuse diagnostics. Id. ¶¶ 54–62. Dr. Harper is the Child Abuse Pediatrics Fellowship Program Director and a Professor of Pediatric Emergency Medicine at the University of Minnesota. Id. ¶ 9. She is also the Medical Director of the Otto Bremer Trust Center for Safe & Healthy

Children, which is a “sub department” of the University of Minnesota and is operated by the University of Minnesota Physicians (“UMP”). Id. Plaintiffs allege that Dr. Harper believes in the validity of SBS/AHT as a medical diagnosis and has attempted to suppress any perspective that casts doubt on the validity of SBS/AHT. Id. ¶¶ 54–59. According to Plaintiffs, Dr. Harper developed a series of policies, protocols, and customs with other child abuse pediatricians that incentivize medical professionals to find evidence of child abuse

and to ignore and not document other explanations for a child’s injuries. Id. ¶ 54. Plaintiffs allege that these protocols were implemented by Dr. Harper in Hennepin County. Id. ¶¶ 127–34. Specifically, Plaintiffs allege that Dr. Harper has implemented policies at Hennepin County hospitals that require child abuse pediatricians, not hospitalists, to examine a potential child abuse victim; forbid hospitalists from making

entries in a child’s medical records that conflict with a child abuse related diagnosis; forbid hospitalists from communicating with families of potential child abuse victims; require physicians to allow Dr. Harper to edit their reports of suspected child abuse; and fabricate or shade evidence in medical records to support a finding of child abuse See id. ¶¶ 45, 54. Plaintiffs allege that through “contractual agreements and informal agreements, Hennepin

County has delegated final policymaking to [Dr.] Harper in regard to the diagnosis, generation of medical evidence, and medical investigation/factfinding for child abuse cases brought in Hennepin County.” Id. ¶ 14. To support their assertion that these policies have led to an increase in false accusations of child abuse, Plaintiffs allege that after Dr. Harper arrived in Hennepin

County in 2014, the number of reported child abuse cases in Hennepin County increased 228% over the previous eight-year average, which disproportionately exceeded the rates of reported child abuse in the eight-county Twin Cities metropolitan area. Id. ¶ 62. Plaintiffs also allege that at least one of Dr. Harper’s former colleagues at UMP and the University of Minnesota, Dr. Bazak Sharon, raised concerns about Dr. Harper’s child abuse diagnostic practices in two of his cases, including her alleged practice of “falsely, fraudulently and

unconscionably causing . . . false child abuse prosecutions.” See id. ¶¶ 55–57. Plaintiffs allege that Dr. Sharon was eventually terminated by UMP and the University of Minnesota for criticizing Dr. Harper’s practices in diagnosing cases of child abuse. Id. II. Plaintiffs’ Experience Plaintiffs allege that their family became entangled in these policies and practices

in 2023. Plaintiffs are citizens of Colombia who arrived at the United States-Mexico border sometime in late 2022 or early 2023. Id. ¶ 66. At the time, Ramirez Rodriguez was pregnant. Id. Plaintiffs were detained by immigration officials, and Ramirez Rodriguez alleges that she was denied sufficient nutrition, prenatal care, and adequate sleep while in immigration detention. Id. Plaintiffs were eventually released from immigration detention

and moved to Minnesota, where Ramirez Rodriguez’s medical providers deemed her pregnancy high risk because of Ramirez Rodriguez’s juvenile scoliosis and her recent immigration. Id. ¶ 68. Subsequently, Ramirez Rodriguez developed a subchorionic hemorrhage,1 bloody mucus, and intrahepatic cholestasis of pregnancy (“ICP”),2 which can delay the infant’s creation of blood clotting factors. Id. ¶¶ 67–68. In March 2023, Ramirez

Rodriguez delivered I.R. Id. ¶ 70. Plaintiffs allege that I.R.’s physicians were aware of his medical background, including his ICP, his family history of coagulation disorders, Ramirez Rodriguez’s history of spontaneous bruising, and Ramirez Rodriguez’s complications during pregnancy. Id. Twelve days after birth, I.R. demonstrated an abnormal lack of blood clotting and testing demonstrated that I.R. had an unusually low level of Factor IX, which is a blood-

clotting protein. Id. ¶ 71. Ramirez Rodriguez became alarmed at I.R.’s spontaneous bleeding and subsequently brought I.R. to Hennepin Healthcare for strange bruising on I.R.’s body. Id. ¶ 72. Dr. Harper was then called to consult on I.R.’s injuries because of a child abuse screening established by Hennepin Healthcare. Id. ¶ 73. Dr. Harper concluded that I.R.’s injuries were due to child abuse by Plaintiffs. Id.

¶ 75. Plaintiffs allege that in coming to that conclusion, Dr. Harper ignored I.R.’s medical difficulties and Ramirez Rodriguez’s complications during pregnancy. Id. The Hennepin County Attorney’s Office (“HCAO”) then filed an expedited termination of parental rights

1 A subchorionic hemorrhage is a collection of blood between the uterine wall and the outer sac surrounding the embryo. See Subchorionic Hematoma, Cleveland Clinic (Feb. 23, 2026), https://my.clevelandclinic.org/health/diseases/23511-subchorionic- hematoma [https://perma.cc/ZQ4V-9QXG].

2 ICP is a disorder during pregnancy that impacts the liver and slows the flow of bile, leading to an abnormal build-up of bile in the body. See Cholestasis of Pregnancy, Cleveland Clinic (Mar. 27, 2026), https://my.clevelandclinic.org/health/diseases/17901- cholestasis-of-pregnancy [https://perma.cc/8T85-PYRU]. petition, leading I.R. to be placed into foster care with N.C. Id. ¶¶ 76, 84. Plaintiffs allege that Ramirez Rodriguez provided N.C. with breast milk to feed I.R. but that N.C. secretly

discarded the breast milk and switched I.R. to formula. Id. ¶ 84. This resulted in I.R. becoming fussy when Ramirez Rodriguez tried to get I.R. to breast feed during supervised visits, and Plaintiffs allege that N.C. and Dr. Harper used this “fussiness” as a basis to convince the family court that I.R. was afraid of Ramirez Rodriguez. Id. Plaintiffs allege that while in the care of N.C., I.R. continued to develop the “same kinds of bruising” that led to Dr. Harper’s original finding of child abuse. Id. ¶ 85.

Plaintiffs assert that although this new bruising demonstrated that it resulted from a medical condition, not Plaintiffs’ abuse, Dr. Harper maintained that the new bruising resulted from Plaintiffs’ continued abuse, even though Plaintiffs’ visits with I.R. were supervised and recorded on video. Id. Given I.R.’s new bruising, he was moved to a new foster home with foster parent Defendant Dr. Megan Dillman. Id. ¶ 87. Plaintiffs allege that Dr.

Dillman “wanted and intended to adopt” I.R. and therefore “had an incentive to cause the court to terminate Plaintiffs’ parental rights.” Id. ¶ 88. Although the family court required I.R. to be placed with a Spanish-speaking foster family, the Dillman family did not speak Spanish. Id. ¶¶ 86–87. While in Dr. Dillman’s care, I.R. continued to develop bruises, which were

documented and photographed at visitation sessions by I.R.’s caseworker, who is described in the second amended complaint only as “Reyes.” Id. ¶¶ 89–91. Plaintiffs allege that Dr. Harper examined I.R. while he was in Dr. Dillman’s care but intentionally omitted the new bruising from her medical reports. Id. ¶ 90. Plaintiffs also allege that Dr. Harper and Dr. Dillman sought to discredit Reyes and “explain away” the photos that Reyes had taken of I.R.’s new bruises. Id. ¶ 91. They did so mainly by seeking to terminate Plaintiffs’

visitation rights, which would increase Dr. Dillman’s chance of adopting I.R. and would prevent Reyes from continuing to take photographs of the new bruises during visitation. Id. ¶¶ 91–92. According to Plaintiffs, Dr. Harper and Dr. Dillman worked with a UMP psychologist, Dr. Maria Kroupina, to provide the family court with a medical opinion that I.R. was afraid of his parents. Id. ¶ 93. Dr. Harper also deleted notes from I.R.’s medical records that made her opinion of child abuse look “less credible,” and included “false”

statements in I.R.’s medical file that I.R. was inconsolable during visits with his parents and that Plaintiffs “did not behave appropriately” around I.R. Id. ¶¶ 94, 96. Reyes informed the HCAO and Dr. Harper that the information in the medical file regarding I.R. being inconsolable and his parents behaving inappropriately during visits was false. Id. ¶ 95. Reyes also submitted a declaration to the family court refuting Dr. Kroupina’s

conclusion that Plaintiffs acted inappropriately around I.R. and that I.R. was afraid of his parents. Id. ¶ 98. The family court denied HCAO’s request to suspend parental visitations. Id. ¶ 100. Ultimately, the expedited termination of parental rights proceeding was converted to a non-expedited, non-termination case, and I.R. was sent home with Plaintiffs for a trial

visit. Id. ¶ 101. Plaintiffs performed “very well” during the trial home visit, so after nearly a year of family court proceedings, the case against Plaintiffs was dismissed. Id. ¶¶ 102, 104. Plaintiffs allege that their experience during the family court proceedings led to “immeasurable emotional harm,” as well as financial harm, as they (1) lost their jobs because of their inability to reconcile the visitation schedule and their work schedules; (2) spent a significant portion of their income on transportation for visits and required

appointments; and (3) were disqualified for benefits that they would have otherwise been eligible for. Id. ¶¶ 105–07. I.R. was also harmed by spending most of his first year of life away from his parents and delaying his acquisition of the Spanish language. Id. ¶ 108. Plaintiffs brought suit on May 29, 2025, ECF No. 1, and filed the operative second amended complaint on March 3, 2026, ECF No. 45. Plaintiffs bring eight substantive claims on their own behalf and on behalf of I.R.:

(1) Section 1983 claim against Dr. Harper;

(2) Monell claims against Dr. Harper in her official capacity, Hennepin County, Hennepin Healthcare, and UMP;

(3) A claim under the Racketeer Influenced and Corrupt Organizations Act (“RICO”) against Dr. Harper and UMP;

(4) RICO conspiracy claims against Dr. Dillman, Hennepin Healthcare, and UMP;

(5) A claim for false reporting of child abuse under Minn. Stat. § 260E.08 against Dr. Harper;

(6) Common-law intentional infliction of emotional distress (“IIED”) claims against Dr. Harper, Dr. Dillman, UMP, and Hennepin Healthcare;

(7) Consumer fraud claims pursuant to Minnesota’s Private Attorney General Statute against Hennepin Healthcare and UMP; and

(8) Civil conspiracy claims against all Defendants.

See id. ¶¶ 109–81. Plaintiffs seek monetary damages, declaratory and injunctive relief, and attorneys’ fees. Id. ¶ 182. All Defendants now move to dismiss. ECF Nos. 47, 52, 59, 65. ANALYSIS In reviewing a motion to dismiss for failure to state a claim under Federal Rule of

Civil Procedure 12(b)(6), the Court must accept as true all the factual allegations in the complaint and draw all reasonable inferences in the plaintiff’s favor. Gorog v. Best Buy Co., 760 F.3d 787, 792 (8th Cir. 2014) (citation omitted). The complaint must “state a claim to relief that is plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007) (citation omitted). “A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable

for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009). I. Dr. Dillman’s Challenge to Jurisdiction Dr. Dillman first challenges the Court’s subject-matter jurisdiction over the claims against her. See ECF No. 53 at 4–5. The Court will consider this argument first because “[s]ubject matter jurisdiction is a threshold matter that [courts] are obligated to address at

the outset” of a case. Sianis v. Jensen, 294 F.3d 994, 997 (8th Cir. 2002). Dr. Dillman asserts that a federal court does not have subject-matter jurisdiction over a child custody proceeding. ECF No. 53 at 4–5. It is true that federal courts lack subject-matter jurisdiction over a federal action “inextricably intertwined with a state domestic proceeding,” but only when “the requested federal remedy overlaps the remedy

at issue in the state proceeding.” Wallace v. Wallace, 736 F.3d 764, 767 (8th Cir. 2013) (citation omitted) (internal quotation marks omitted). In child protection cases, then, this “domestic relations” exception to federal jurisdiction ordinarily applies when a federal case seeks to override a state-court’s custody determination. See Phillips v. Hennepin Cnty. Hum. Servs. Child. Servs., No. 19-cv-2807 (WMW/BRT), 2020 WL 6106266, at *6 (D. Minn. June 8, 2020) (seeking remedy that would implicitly return the plaintiff’s child

to her custody), report and recommendation adopted, 2020 WL 4727432 (D. Minn. Aug. 14, 2020); Johnson v. St. Louis Cnty. Pub. Health & Hum. Servs., No. 19-cv-111 (SRN/LIB), 2019 WL 5677871, at *5 (D. Minn. Nov. 1, 2019) (seeking remedy that would “vacate a state court judgment relating to child custody and reinstate [plaintiffs’] own parental rights”). Here, the domestic relations exception does not apply because Plaintiffs’ requested

remedy does not “overlap[] the remedy at issue in the state proceeding.”3 Wallace, 736 F.3d at 767. The state-court family proceedings against Plaintiffs related to their custody of and parental rights over I.R. ECF No. 45 ¶¶ 76, 84. But this case has nothing to do with Plaintiffs’ custody of and parental rights over I.R.—those issues have been long settled. Id. ¶¶ 102, 104. In no way is the Court being asked to “modify, nullify, or

predetermine” the outcome of the family-court proceedings. Wallace, 736 F.3d at 767. And, contrary to Dr. Dillman’s suggestion, the domestic relations exception does not apply to federal cases that “merely arise out of a domestic relations dispute.” Foulger v. Avertest, LLC, No. 4:22-cv-00878, 2025 WL 3538973, at *2 (E.D. Mo. Aug. 27, 2025) (citation

3 It is unsettled within the Eighth Circuit whether the domestic relations exception applies only to cases invoking the Court’s diversity jurisdiction or whether the domestic relations exception applies more broadly to cases like this one invoking a federal cause of action. See Mumin v. Grieser, No. 8:25CV440, 2025 WL 3459777, at *4 (D. Neb. Dec. 2, 2025). The Court need not wade into that debate because even if the domestic relations exception applies to a case brought pursuant to the Court’s federal question jurisdiction, the exception does not apply to the facts of this case. omitted). Because the Court is not being asked “to tell a state court how to handle child custody proceedings,” id. at *3, the “narrowly” interpreted domestic relations exception

does not apply here, Crain v. Crain, 72 F.4th 269, 276 (8th Cir. 2023). II. Merits Arguments A. Section 1983 Claim (Count 1) Dr. Harper offers three reasons to dismiss the Section 1983 claim against her: a lack of state action, statutory immunity, and qualified immunity. ECF No. 61 at 6–23. At this stage, none of those arguments warrant dismissal.

i. State Action Dr. Harper argues that the second amended complaint does not plausibly allege that she is a state actor for purposes of liability under Section 1983. ECF No. 61 at 13–21. Generally, only a state actor can face Section 1983 liability, Doe v. N. Homes, Inc., 11 F.4th 633, 637 (8th Cir. 2021), because “the text and structure of the Constitution . . . enforc[e]

[a] constitutional boundary between the governmental and the private,” Manhattan Cmty. Access Corp. v. Halleck, 587 U.S. 802, 808 (2019). But “a private entity can qualify as a state actor in a few limited circumstances.” Id. at 809. Whether a private entity may be appropriately characterized as a state actor is “a matter of normative judgment, and the criteria lack rigid simplicity.” Brentwood Acad. v. Tenn. Secondary Sch. Athletic Ass’n,

531 U.S. 288, 295 (2001). Nonetheless, the Supreme Court has identified several circumstances under which it is fair to characterize the action of a private entity as state action. See Meier v. City of St. Louis, 934 F.3d 824, 829 (8th Cir. 2019). State action may be found, for example, “when the government acts jointly with the private entity.” Halleck, 587 U.S. at 809.

As Dr. Harper candidly admits, courts are “squarely divided on whether pleadings such as the operative [complaint] are plausibly pled and can survive a Rule 12 motion.” ECF No. 81 at 5. Both Dr. Harper and Plaintiffs offer a variety of authorities that, to an extent, support their positions that a private physician is (or is not) a state actor when reporting child abuse. Id.; ECF No. 73 at 14. Admittedly, the lines drawn by these cases are not entirely clear, leading the parties to do what another court aptly described in

surveying a similar body of case law: “Each side seeks to call to its aid caselaw that assertedly deals with analogous situations and that assertedly supports the desired result . . . . By the same token, each side denigrates as nonanalogous the caselaw authority advanced by the other.” Mohil v. Glick, 842 F. Supp. 2d 1072, 1076 (N.D. Ill. 2012). A few rules emerge from this body of case law, however. On one end of the

spectrum, courts generally hold that a private physician is not a state actor for merely reporting suspected child abuse to state authorities, even when the physician is mandated to do so under state law. See Tracy v. SSM Cardinal Glennon Child.’s Hosp., No. 4:15-cv-1513 CAS, 2016 WL 3683000, at *8 (E.D. Mo. July 12, 2016) (collecting cases). On the other end of the spectrum, when a private physician becomes “part of the

reporting and enforcement machinery” for state child protection authorities, it is appropriate to characterize that physician as a state actor. Kia P. v. McIntyre, 235 F.3d 749, 756 (2d Cir. 2000); see Thomas v. Nationwide Child.’s Hosp., 882 F.3d 608, 616 (6th Cir. 2018) (explaining that a private medical provider may become a state actor if the state “conscript[s]” the provider “as an investigative arm of the State”).

Plaintiffs’ allegations fall somewhere within this spectrum, but plausibly closer to the line of cases describing a physician within the “reporting and enforcement machinery” of the state. First off, the second amended complaint alleges that Hennepin Healthcare— a state actor—charges Dr. Harper with supervising and managing its child abuse evaluation process and interfacing with Hennepin County law enforcement and investigators involved in child protection matters. See ECF No. 45 ¶ 15. Indeed, it appears that Dr. Harper became

involved in I.R.’s case not as a treating physician, but because of a “child abuse screening” policy implemented by Hennepin Healthcare (again, a state actor) that requires Dr. Harper (or another child abuse pediatrician) to become involved in a case when evidence of child abuse arises. Id. ¶¶ 44, 73. These policies, enacted by a state actor, plausibly suggest that Hennepin Healthcare considered Dr. Harper and her child abuse pediatrician colleagues as

“part of the reporting and enforcement machinery” for child abuse cases at the hospital. Kia P., 235 F.3d at 756. Moreover, Plaintiffs allege that Dr. Harper went beyond mere medical treatment of I.R. and involved herself intimately in the child abuse investigation process. See Estiverne v. Esernio-Jenssen, 581 F. Supp. 2d 335, 345–46 (E.D.N.Y. 2008) (explaining that private

medical providers were plausibly state actors “when the rationale behind their [treatment of a child] ceased to be medical necessity and became solely the investigation of child abuse”). Plaintiffs allege that after I.R. was placed into foster care, Dr. Harper continued to investigate and prosecute a case of child abuse against them, primarily by: (1) enlisting Dr. Kroupina to provide the family court with a medical opinion that I.R. was afraid of his parents in order to terminate Plaintiffs’ parental rights; (2) deleting notes from I.R.’s

medical records that made her opinion of child abuse look “less credible”; and (3) including “false” statements in I.R.’s medical file submitted to the family court that I.R. was inconsolable during visits with his parents and that Plaintiffs “did not behave appropriately” around I.R. ECF No. 45 ¶¶ 91–96. These actions, presumably, were not taken for any medical treatment of I.R., but were directed toward gathering (or fabricating, on Plaintiffs’ telling) evidence of child abuse for the family court. Combined with the

entwinement between Dr. Harper, Hennepin Healthcare, and Hennepin County personnel described in the complaint, see ECF No. 45 ¶¶ 59, 73, 76, 92, it is plausible that these actions were taken “in concert with” state actors for the purpose of furthering a child abuse investigation, A.L. v. Eichman, 376 F. Supp. 3d 547, 560–61 (W.D. Pa. 2019); see Hunter v. S.D. Dep’t of Soc. Servs., 377 F. Supp. 3d 964, 979–80 (D.S.D. 2019) (holding that two

private nurses were plausibly alleged to be state actors when their treatment of a child was not for “medical purposes” but instead was “to collect evidence for the state”). These allegations go beyond the facts of cases cited by Dr. Harper involving the mere reporting of child abuse to state authorities. See, e.g., Thomas, 882 F.3d at 613; Tracy, 2016 WL 3683000, at *8; Young v. Ark. Child.’s Hosp., 721 F. Supp. 197, 198 (W.D. Ark.

1989).4 Instead, the second amended complaint plausibly alleges that the policies of

4 This case is also a bit unique because unlike in Thomas, Tracy, and Young, which involved private medical professionals working with a private hospital, this case involves a private medical professional who was working with a public hospital which is Hennepin Healthcare (a state actor) directed Dr. Harper to get involved in I.R.’s case when child abuse was suspected, to investigate those suspicions, and to work with Hennepin

County law enforcement and social services in those investigations. See, e.g., ECF No. 45 ¶¶ 15, 59, 73, 76, 92. Absent those policies implemented by a state actor, it is unclear whether Dr. Harper would have involved herself in I.R.’s case. At base, the second amended complaint asserts that Dr. Harper is the state’s in-house child abuse investigator at Hennepin Healthcare. That sufficiently alleges that the state “has so far insinuated itself into a position of interdependence with [Dr. Harper] that [she] must be recognized as a joint

participant in the challenged activity.” Loe v. Jett, 796 F. Supp. 3d 541, 562 (D. Minn. 2025) (quoting Burton v. Wilmington Parking Auth., 365 U.S. 715, 725 (1961)). Dr. Harper argues that Plaintiffs must allege that the state exercised a “degree of control” over her to find joint action with the state. See ECF No. 81 at 4 (relying on Brown v. Linder, 56 F.4th 1140, 1145 (8th Cir. 2023)). But that’s not quite what Brown says.

Rather, in Brown, the Eighth Circuit “suggested that, at least for certain state employment, whether a defendant’s conduct is ‘fairly attributable to the state’ depends more on the degree of control that the state exercises over such conduct than on the mere fact that the conduct was within the scope of the defendant’s employment.” Brown, 56 F.4th at 1144 (emphasis added). Brown then listed two types of state employment to which this rule

might apply: a state prison chaplain and a public university professor. Id. at 1144–45. Dr.

unquestionably a state actor. Working in concert with Hennepin Healthcare renders Dr. Harper more susceptible to a finding of state action than the professionals in Thomas, Tracy, Young, and other cases involving a private physician at a private institution. Harper offers no case law suggesting that a physician working with a public hospital is among the “certain state employment” to which Brown’s rule might apply. And, in any

event, the second amended complaint plausibly alleges that Hennepin Healthcare’s policies direct Dr. Harper to involve herself in a case after a positive child abuse screening, ECF No. 45 ¶¶ 15, 44, 73, suggesting at least some measure of “coercive power” or “encouragement” of the state toward Dr. Harper, Blum v. Yaretsky, 457 U.S. 991, 1004 (1982). That leads to the procedural skirmish between Plaintiffs and Dr. Harper, who have

strayed far from the second amended complaint by offering various exhibits purportedly relevant to Dr. Harper’s status as a state actor. This includes the University of Minnesota’s internal policies and procedures, ECF No. 62-1 at 2–22, ECF No. 77 at 6–7, 19–20, 35–40; Dr. Harper’s offer letters of employment from the University of Minnesota Medical School and UMP, see ECF No. 62-1 at 24–32; a contract between UMP and Hennepin County, see

ECF No. 77 at 22–33; and various court filings in cases in which Dr. Harper has been involved, see id. at 42–72. It is true that on a Rule 12(b)(6) motion, the Court is limited to reviewing the complaint, exhibits attached to the complaint whose authenticity is unquestioned, and documents “necessarily embraced by the complaint.” Zean v. Fairview Health Servs.,

858 F.3d 520, 526 (8th Cir. 2017) (citations omitted). But even if all of these documents were necessarily embraced by the complaint—a dubious conclusion—both Plaintiffs and Dr. Harper point to language in these documents that plausibly supports (for Plaintiffs) or negates (for Dr. Harper) a finding that Dr. Harper is a state actor. ECF No. 61 at 14–17; ECF No. 73 at 15–20. In essence, then, Plaintiffs and Dr. Harper ask this Court to resolve factual disputes from these documents about Dr. Harper’s status as a state actor. That is

assuredly not the role of the Court at this procedural juncture. See BJC Health Sys. v. Columbia Cas. Co., 348 F.3d 685, 688 (8th Cir. 2003) (reversing district court’s consideration of extrinsic documents on a Rule 12(b)(6) motion when those documents’ “significance is disputed”); see also Piper Jaffray Cos., Inc. v. Nat’l Union Fire Ins. Co., 967 F. Supp. 1148, 1152 (D. Minn. 1997) (explaining that on a Rule 12(b)(6) motion, a court may not “resolve factual disputes on the basis of preemptive (and untested)

submissions”). In fact, any reasonable factual disputes must be resolved in Plaintiffs’ favor on a Rule 12(b)(6) motion. See Gorog, 760 F.3d at 792. Accordingly, whatever factual disputes the submitted documents reflect, they are immaterial to resolving Dr. Harper’s motion. The second amended complaint plausibly alleges state action on Dr. Harper’s part. ii. Statutory Immunity

Dr. Harper next argues that she is entitled to statutory immunity under federal and state law. ECF No. 61 at 6–12. Section 20342 of the federal Child Abuse Prevention and Treatment Act provides: [A]ny individual making a good faith report to appropriate authorities of a suspected or known instance of child abuse or neglect, or who otherwise, in good faith, provides information or assistance, including medical evaluations or consultations, in connection with a report, investigation, or legal intervention pursuant to a good faith report of child abuse or neglect shall not be subject to civil liability or criminal prosecution, under any Federal law, rising from making such report or providing such information or assistance.

34 U.S.C. § 20342(1). Section 20342 also provides that “there shall be a presumption that the person acted in good faith” when a federal civil action is “brought against a person based on the person’s reporting a suspected or known instance of child abuse or neglect, or providing information or assistance with respect to such a report.” Id. § 20342(2).

Minnesota law provides similar immunity.5 The Minnesota Reporting of Maltreatment of Minors Act (“MRMMA”) provides that “a person making a voluntary or mandated report” of child abuse is “immune from any civil or criminal liability that otherwise might result from the person’s actions if the person is . . . acting in good faith.” Minn. Stat. § 260E.34(a)(1), (b). Because both the federal and state immunity statutes require “good faith” on the part of the reporter, the Court considers the federal and state

statutory immunity questions together. See Reynolds v. Harper, No. 25-cv-754 (LMP/SGE), 2026 WL 622283, at *23 (D. Minn. Mar. 5, 2026). “Generally speaking, good faith is a matter of subjective intent.” J.E.B. v. Danks, 785 N.W.2d 741, 749 (Minn. 2010). Reporting child abuse in good faith means that the report was “made without an ulterior motive, made without malice and made for a proper

purpose.” Id. at 750; see Reynolds, 2026 WL 622283, at *23. This Court’s decision in Reynolds is instructive. There, the plaintiff alleged that Dr. Harper falsely accused his wife of child abuse. Id. at *23. This Court concluded that Dr. Harper was not entitled to statutory immunity under Section 20342 and MRMMA at the pleading stage because the complaint plausibly alleged that Dr. Harper had not acted in

5 Minnesota’s statutory immunity does not apply to the Section 1983 claim because “[c]onduct by persons acting under color of state law which is wrongful under 42 U.S.C. § 1983 . . . cannot be immunized by state law” without trampling upon the United States Constitution’s Supremacy Clause. Martinez v. California, 444 U.S. 277, 284 n.8 (1980) (citation omitted). However, because the state statutory immunity question is relevant to the state-law claims, the Court considers the immunity question here. good faith when reporting the plaintiff’s wife for suspected child abuse. Id. at *23–24. Several factual allegations plausibly alleged Dr. Harper’s lack of good faith, including the

plaintiff’s allegations: (1) that Dr. Harper had excluded information from the child’s medical records that would negate a finding of child abuse; (2) that Dr. Harper had included false information in her medical reports; (3) that Dr. Sharon raised concerns about Dr. Harper’s child abuse diagnostic practices, including an alleged practice of ignoring, omitting, and concealing medical opinions inconsistent with a finding of child abuse; and (4) that Dr. Harper was motivated by ulterior motives to report the plaintiff’s wife for

suspected child abuse. Id. The second amended complaint here contains similar allegations. Plaintiffs allege that in reporting them for suspected child abuse and seeking termination of their parental rights, Dr. Harper: (1) ignored or excluded information from I.R.’s medical history that would negate a finding of child abuse (including I.R.’s clotting complications);

(2) provided false information to the family court that supported a finding of child abuse; and (3) was motivated by an ulterior motive—namely, to assist Dr. Dillman in adopting I.R. ECF No. 45 ¶¶ 75–76, 85, 90–96. As in Reynolds, these allegations are substantiated by Dr. Sharon’s concerns about Dr. Harper’s child abuse diagnostic practices, id. ¶¶ 55–56, and are further substantiated by I.R.’s caseworker, Reyes, who informed the HCAO and

Dr. Harper that the information in I.R.’s medical records regarding him being inconsolable and his parents behaving inappropriately at visits was false, id. ¶ 95. These allegations plausibly challenge whether Dr. Harper’s reporting of child abuse was made “for a proper purpose.” J.E.B., 785 N.W.2d at 750. Dr. Harper offers several reasons to distinguish this case from Reynolds, but none are availing. She first argues that the second amended complaint fails to plausibly allege

that she was aware of I.R.’s medical history when she purportedly excluded it from her report of child abuse. See ECF No. 61 at 7–11. But Plaintiffs allege that I.R.’s “physicians” were provided with a “detailed medical background” of I.R., ECF No. 45 ¶ 70, and that Dr. Harper “knew” about I.R.’s medical history, id. ¶ 76. Dr. Harper also faults Plaintiffs for not providing more “specificity,” “concrete factual support,” or “external evidence” in their complaint about these allegations, ECF

No. 61 at 7–11, but none of that is necessary to plausibly allege a claim under Rule 8. See Iqbal, 556 U.S. at 678 (citation omitted) (“[T]he pleading standard Rule 8 announces does not require detailed factual allegations.” (internal quotation marks omitted)); Cummins L. Off., P.A. v. Norman Graphic Printing Co., 826 F. Supp. 2d 1127, 1129–30 (D. Minn. 2011) (explaining that a plaintiff “is under no obligation at [the pleading stage] to supply

evidence” of its claims). In any event, the second amended complaint’s allegations against Dr. Harper are far from “vague and speculative,” as Dr. Harper asserts. ECF No. 61 at 11. The second amended complaint pleads specific information of which Dr. Harper was allegedly aware yet failed to include or consider in her child abuse report (specifically, Ramirez Rodriguez’s

“clotting disorder, the complicated pregnancy, IR’s clotting panel, the blood panel abnormalities, and the lack of soft tissue injuries”). ECF No. 45 ¶ 76. The second amended complaint also pleads specific information provided to the family court by Dr. Harper that was allegedly false (specifically, Dr. Kroupina’s report and the statements that I.R. was inconsolable around and afraid of his parents). Id. ¶¶ 94–95. And the second amended complaint pleads a very specific improper motive underlying Dr. Harper’s report of child

abuse (specifically, assisting Dr. Dillman in adopting I.R.). Id. ¶¶ 91–92. Just because Dr. Harper disagrees with those allegations or finds them lacking in evidentiary support does not warrant dismissal at the pleading stage. Finally, Dr. Harper argues that her actions are “completely consistent with her statutory and professional obligations,” and that she “engaged in the type of consultative, diagnostic, and discretionary professional review that her role required.” ECF No. 61 at 9,

11. That may be proven so, but as this Court explained in Reynolds, a “[d]etermination of what constitutes good faith necessarily involves factual findings.” Reynolds, 2026 WL 622283, at *23 (quoting Tonka Tours, Inc. v. Chadima, 372 N.W.2d 723, 728 (Minn. 1985)). And at the pleading stage, the Court must accept Plaintiffs’ plausible factual allegations as true. Gorog, 760 F.3d at 792. Those allegations plausibly allege bad faith reporting, so the

question of statutory immunity cannot be resolved at this time. iii. Qualified Immunity For similar reasons, the Court cannot resolve the Section 1983 claim in Dr. Harper’s favor on qualified-immunity grounds at this juncture. “Under the doctrine of qualified immunity, a court must dismiss a complaint against a government official in [her]

individual capacity that fails to state a claim for violation of ‘clearly established statutory or constitutional rights of which a reasonable person would have known.’” Hager v. Ark. Dep’t of Health, 735 F.3d 1009, 1013 (8th Cir. 2013) (quoting Harlow v. Fitzgerald, 457 U.S. 800, 818 (1982)). Qualified immunity analysis requires a two-step inquiry: “(1) whether the facts shown by the plaintiff make out a violation of a constitutional or statutory right, and (2) whether that right was clearly established at the time of the

defendant’s alleged misconduct.” Nord v. Walsh County, 757 F.3d 734, 738 (8th Cir. 2014) (citation omitted) (internal quotation marks omitted). Unless both questions are answered affirmatively, qualified immunity applies. Id. Here, Plaintiffs allege that Dr. Harper deprived them of their constitutional due process right to familial integrity. ECF No. 45 ¶¶ 109–25. “Parents have a liberty interest in the care, custody, and management of their children,” but this interest is “limited by the

state’s compelling interest in protecting a child.” Swipies v. Kofka, 348 F.3d 701, 703 (8th Cir. 2003). Accordingly, it has been clearly established for at least several decades that “when a state official pursuing a child abuse investigation takes an action which would otherwise unconstitutionally disrupt familial integrity, he or she is entitled to qualified immunity, if such action is properly founded upon a reasonable suspicion of child abuse.”

Manzano v. S.D. Dep’t of Soc. Servs., 60 F.3d 505, 510–11 (8th Cir. 1995). The question, then, is whether Dr. Harper’s report was founded upon a reasonable suspicion of child abuse. Reynolds, again, is instructive. There, the Court found that the plaintiff had raised factual disputes about whether Dr. Harper had reasonable suspicion of child abuse when

the complaint plausibly alleged (1) Dr. Harper omitted exculpatory evidence from her report of child abuse; and (2) Dr. Harper was motivated by ulterior motives (specifically, financial and political ones) to report the plaintiff’s wife for suspected child abuse. Reynolds, 2026 WL 622283, at *25. The same allegations feature in Plaintiffs’ second amended complaint. Plaintiffs allege that Dr. Harper was aware of exculpatory evidence yet failed to include or consider that evidence in her child abuse report. ECF No. 45 ¶ 76.

Under the “reasonable suspicion” standard, “an official is not free to disregard plainly exculpatory evidence when it undermines substantial inculpatory evidence that reasonable suspicion exists.” Stanley v. Finnegan, 899 F.3d 623, 628 (8th Cir. 2018). Allegations that Dr. Harper disregarded “plainly exculpatory evidence” plausibly alleges a lack of reasonable suspicion. Id. Plaintiffs’ allegations that Dr. Harper provided false information to the family court, see ECF No. 45 ¶¶ 94–95, further plausibly alleges that Dr. Harper

lacked reasonable suspicion of child abuse, see Dennis v. DeJong, 867 F. Supp. 2d 588, 631–32 (E.D. Pa. 2011) (holding that social worker was not entitled to qualified immunity on a motion to dismiss when complaint alleged that she made misrepresentations to a judge to obtain removal of a child from their parents). As in Reynolds, Plaintiffs here also allege that Dr. Harper was motivated to accuse

Plaintiffs of child abuse for an improper purpose (specifically, assisting Dr. Dillman in adopting I.R.). Id. ¶¶ 91–92. That is an audacious accusation, but “[t]hough perhaps unlikely, this theory is not implausible.” Stanley, 899 F.3d at 328 (holding that complaint plausibly alleged that removal of children from parents’ home was motivated by an improper purpose—specifically, disagreement with the parents’ decision to homeschool);

see Twombly, 550 U.S. at 556 (“[A] well-pleaded complaint may proceed even if it strikes a savvy judge that actual proof of those facts is improbable, and that a recovery is very remote and unlikely.”). Plaintiffs’ only response is to criticize the lack of specificity in the second amended complaint. ECF No. 61 at 22. This is an argument that the Court has rejected in addressing

Dr. Harper’s statutory-immunity argument. Dr. Harper offers no other reason to distinguish this case from Reynolds. Accordingly, in line with Reynolds, the Court holds that Plaintiffs’ Section 1983 claim against Dr. Harper survives a motion to dismiss based on qualified immunity. B. Monell Claims (Count 2) Plaintiffs next bring Monell claims against Dr. Harper (in her official capacity),

UMP, Hennepin Healthcare, and Hennepin County, alleging that their policies and customs resulted in the unconstitutional deprivation of Plaintiffs’ and I.R.’s right to family integrity. ECF No. 45 ¶¶ 126–35. A municipality cannot be held liable for a constitutional violation under Section 1983 solely because it employs a tortfeasor. See Monell v. Dep’t of Soc. Servs. of

N.Y., 436 U.S. 658, 691 (1978). Rather, under Monell, “[l]iability for a constitutional violation will attach to a municipality only if the violation resulted from an official municipal policy, an unofficial custom, or a deliberately indifferent failure to train or supervise an official or employee.” Bolderson v. City of Wentzville, 840 F.3d 982, 985 (8th Cir. 2016).

i. Monell Claim Against UMP and Dr. Harper (Official Capacity) The Monell claim against UMP fails as a matter of law because Plaintiffs do not allege that UMP is a municipality subject to suit under Monell. “[D]epartments or subdivisions” of a municipal government are not legal entities subject to suit under Monell. Ketchum v. City of West Memphis, 974 F.2d 81, 82 (8th Cir. 1992); see Shimer v. Shingobee Island Water & Sewer Comm’n, No. 02-cv-953 (JRT/FLN), 2003 WL 1610788, at *3–4

(D. Minn. Mar. 18, 2003); Seelye v. Fisher, No. 06-cv-2848 (RHK/RLE), 2007 WL 951604, at *6 (D. Minn. Mar. 29, 2007). Rather, the appropriate defendant for a Monell claim is the municipality itself. See Shimer, 2003 WL 1610788, at *4. Here, the second amended complaint does not allege what relationship, if any, UMP has with a municipal government. Plaintiffs’ briefing suggests that UMP is related to the University of Minnesota. ECF No. 73 at 23. But if that’s true, then UMP would be an

instrumentality of the state, and the Monell claim against it would be barred by sovereign immunity. See Treleven v. Univ. of Minn., 73 F.3d 816, 818 (8th Cir. 1996). And if UMP is a division of a municipal government, then it is not a legal entity subject to suit under Monell. See Ketchum, 974 F.2d at 82. Either way, the result is the same: the Monell claim against UMP must be dismissed.

The Monell claim against Dr. Harper in her official capacity also fails. First, as already explained, the appropriate defendant for a Monell claim is the municipality itself. See Shimer, 2003 WL 1610788, at *4; see also Kentucky v. Graham, 473 U.S. 159, 167 n.14 (1985) (“There is no longer a need to bring official-capacity actions against local government officials, for under Monell, . . . local government units can be sued directly for

damages and injunctive or declaratory relief.”). Second, there is no allegation that Dr. Harper is an employee of a municipal government as opposed to the state government. Monell only allows for a municipality’s liability “for the unconstitutional acts of its officials or employees.” Johnson v. Outboard Marine Corp., 172 F.3d 531, 535 (8th Cir. 1999) (emphasis added). Because the second amended complaint does not allege that Dr. Harper is an official or employee of a municipal government, the Monell claim against her must

be dismissed. ii. Monell Claim Against Hennepin Healthcare and Hennepin County

Hennepin Healthcare and Hennepin County are entities that may be sued under Monell. See Reynolds, 2026 WL 622283, at *17. As noted above, municipal liability may attach under Monell for constitutional violations if the violations resulted from: (1) an official municipal policy; (2) an unofficial custom; or (3) a deliberately indifferent failure to train or supervise an official or employee. Bolderson, 840 F.3d at 985. The second amended complaint invokes the first two theories of Monell liability. ECF No. 45 ¶¶ 126– 35. 1. Official Municipal Policy An official policy is “a deliberate choice to follow a course of action” by an “official who is determined by state law to have the final authority to establish governmental policy.” Ware v. Jackson County, 150 F.3d 873, 880 (8th Cir. 1998) (citation modified).

An official-policy Monell claim therefore requires that the challenged policy be made by someone with “final policymaking authority” for the municipality. Atkinson v. City of Mountain View, 709 F.3d 1201, 1214 (8th Cir. 2013). Whether an individual has “final policymaking authority” is a question of law decided by the Court; only after the Court determines that the challenged policy was implemented by someone with final

policymaking authority can the Court consider whether that policy resulted in a constitutional violation. See id. at 1215 (citing Jett v. Dallas Indep. Sch. Dist., 491 U.S. 701, 737 (1989)). The Court consults two “key sources” to determine whether an

individual is a final policymaker: (1) “state and local positive law” and (2) state and local “custom or usage having the force of law.” Id. (internal quotation marks omitted) (quoting Jett, 491 U.S. at 737). This Court has already held that “state and local positive law” does not afford Dr. Harper with “final policymaking authority” over Hennepin County and Hennepin Healthcare, see Reynolds, 2026 WL 622283, at *18, and nothing in Plaintiffs’ second

amended complaint undermines a similar conclusion here. Nor do Plaintiffs raise any non-conclusory allegations that Dr. Harper has final policymaking authority through a “custom or usage having the force of law.” Atkinson, 709 F.3d at 1215. A “custom or usage” may arise when an entity delegates final policymaking power to an individual. See id. at 1215–16; Soltesz v. Rushmore Plaza Civic

Ctr., 847 F.3d 941, 946–47 (8th Cir. 2017). A subordinate official possesses delegated final policymaking authority when the official acts “(1) free of review and (2) without any constraints imposed as a matter of policy by the original policymaker.” Soltesz, 847 F.3d at 946 (citing City of St. Louis v. Praprotnik, 485 U.S. 112, 127 (1988)). The delegation must be of “legal power,” so if “the board retains the authority to review, even though it

may not exercise such review or investigate the basis of the decision, delegation of final authority does not occur.” Id. at 946–47 (citation omitted) (emphasis omitted). “Simply going along with discretionary decisions made by one’s subordinates . . . is not a delegation to them of the authority to make policy.” Praprotnik, 485 U.S. at 130. To be sure, the second amended complaint alleges that through “contractual” and “informal agreements,” Hennepin County has “delegated final policymaking to [Dr.]

Harper in regard to the diagnosis, generation of medical evidence, and medical investigation/factfinding for child abuse cases brought in Hennepin County.” ECF No. 45 ¶ 14. But Plaintiffs’ allegation that Hennepin County “delegated” final policymaking authority to Dr. Harper is entirely conclusory; indeed, although the second amended complaint repeats again and again that Dr. Harper is delegated Hennepin County’s authority to diagnose and investigate child abuse cases, ECF No. 45 ¶¶ 4, 14–15, 17, 60, 75, never

does the second amended complaint actually say how that delegation happens, save for vague gesturing toward “contractual agreements and informal agreements,” id. ¶ 14. All that Plaintiffs offer are “[t]hreadbare recitals of the elements” of final policymaking authority, “supported by mere conclusory statements,” which do not suffice to plausibly allege an official-policy Monell claim. See Iqbal, 556 U.S. at 678.

Critically, although Plaintiffs allege that Hennepin Healthcare and Hennepin County have adopted Dr. Harper’s preferred child abuse protocols, and that Dr. Harper has the authority to edit medical records and to supervise and manage the child abuse evaluation process at Hennepin Healthcare, ECF No. 45 ¶¶ 14–15, the second amended complaint never alleges that she does so completely “free of review” and “without any constraints

imposed as a matter of policy” by Hennepin Healthcare and Hennepin County, Soltesz, 847 F.3d at 946. That pleading deficiency is fatal to Plaintiffs’ official-policy Monell claim. 2. Unofficial Custom “A municipal custom is a practice of municipal officials that is not authorized by

written law, but which is so permanent and well-settled as to have the force of law.” Russell v. Hennepin County, 420 F.3d 841, 849 (8th Cir. 2005) (citation modified). That custom must encompass “a widespread and persistent pattern of unconstitutional misconduct . . . policymakers were either deliberately indifferent to or tacitly authorized.” Leonard v. St. Charles Cnty. Police Dep’t, 59 F.4th 355, 363 (8th Cir. 2023) (citation omitted). “Notice is the touchstone of deliberate indifference” for a Monell claim. Atkinson, 709 F.3d at 1216.

Accordingly, a plaintiff must allege a “persistent, widespread pattern of unconstitutional conduct of which officials have notice and subsequently react with deliberate indifference or tacit authorization.” Sorcan v. Rock Ridge Sch. Dist., 131 F.4th 646, 651 (8th Cir. 2025) (emphasis added) (citation omitted). Plaintiffs fail to demonstrate that at the time of their injuries, Hennepin County and

Hennepin Healthcare had notice of a “widespread and persistent pattern of unconstitutional misconduct.” Plaintiffs first cite allegations regarding Dr. Harper’s alleged wrongful diagnosis of child abuse against a parent named Shablya Ferba. ECF No. 45 ¶ 59. But the second amended complaint does not allege when this alleged wrongful diagnosis took place, so Plaintiffs fail to show that Hennepin County and Hennepin Healthcare had

“notice” of this incident and “subsequently react[ed] with deliberate indifference or tacit authorization” to Plaintiffs’ case. Sorcan, 131 F.4th at 651 (emphasis added). Plaintiffs also highlight an allegation that Dr. Harper and one of her colleagues “falsely, fraudulently and unconscionably caus[ed] the false child abuse prosecutions of two of [Dr.] Sharon’s pediatric patients’ parents.” ECF No. 45 ¶ 55. This allegation is inadequate not only because it fails to state when these incidents occurred (and accordingly,

whether Hennepin County and Hennepin Healthcare would have been on notice of them at the time of Plaintiffs’ injuries), but also because there are zero details about these incidents other than the fact that Dr. Harper concluded that these children had suffered abuse. That’s a problem for Plaintiffs because to establish an unofficial custom under Monell, Plaintiffs must allege that the pattern of past unconstitutional conduct bears a “factual similarity” to their own constitutional injury. Mettler v. Whitledge, 165 F.3d 1197, 1205 (8th Cir. 1999);

see D.B. v. Hargett, No. 13-cv-2781 (MJD/LIB), 2014 WL 1371200, at *7 n.10 (D. Minn. Apr. 8, 2014) (dismissing Monell claim when the plaintiff failed to plead specific facts that would allow the court to conclude that “prior incidents” were sufficiently similar to the plaintiff’s experience to “constitute a pattern of behavior”). Without any details about these incidents beyond the generalized assertion that they involved false accusations of child

abuse, the Court cannot determine that they are sufficiently similar to Plaintiffs’ experience. That leaves Plaintiffs’ passing reference to Reynolds, the facts of which are not described at all in the second amended complaint, but with which the Court is familiar. Id. ¶ 58; see Reynolds, 2026 WL 622283, at *1–4. Even assuming that the allegations of a false child abuse report in Reynolds bear a “factual similarity” to the allegations of a false

child abuse report here, Mettler, 165 F.3d at 1205, the Court concludes that these two incidents—Plaintiffs’ and Reynolds’s—are legally insufficient to demonstrate a “widespread and persistent pattern of unconstitutional misconduct,” Leonard, 59 F.4th at 363; see Brewington v. Keener, 902 F.3d 796, 802 (8th Cir. 2018) (holding that two incidents of alleged unconstitutional conduct “cannot be considered a pattern of widespread and pervasive unconstitutional conduct,” and citing cases holding that two, four, and eleven

incidents were insufficient to demonstrate a widespread and persistent pattern). Plaintiffs put forward a few other rejoinders, but none quite stick. Plaintiffs make the perplexing argument that Hennepin Healthcare was on notice because it had adopted Dr. Harper’s preferred child abuse protocol. ECF No. 75 at 9–10. That is not what the notice requirement means: it demands Hennepin Healthcare’s notice of a “persistent, widespread pattern of unconstitutional conduct” and subsequent reaction with “deliberate

indifference or tacit authorization.” Sorcan, 131 F.4th at 651. Hennepin Healthcare’s knowledge that it adopted such protocols says nothing about Hennepin Healthcare’s knowledge of whether those protocols led to a widespread pattern of unconstitutional misconduct. Plaintiffs also suggest that Hennepin Healthcare and Hennepin County were on

notice of a pattern of unconstitutional conduct given that child abuse reports in Hennepin County disproportionately exceeded the rates of child abuse reports in other counties in the Twin Cities metropolitan area after Dr. Harper arrived in Hennepin County. See ECF No. 75 at 10; see ECF No. 45 ¶ 62. But as Hennepin Healthcare points out, that county- wide statistic draws data from multiple health systems and other reports of child abuse

outside of Hennepin Healthcare. ECF No. 82 at 6. To suggest that Hennepin County and Hennepin Healthcare should have divined notice of a pattern of unconstitutional conduct from this county-wide statistic about child abuse reporting generally is sheer speculation, which is not enough to survive a motion to dismiss. See Twombly, 550 U.S. at 555 (“Factual allegations must be enough to raise a right to relief above the speculative level.”).

With neither a plausible official-policy or unofficial-custom Monell claim, the Court dismisses the Monell claim in its entirety.6 C. RICO Claims (Counts 3 and 4) Plaintiffs next allege RICO claims against Dr. Harper and UMP, alleging they participated in a “child protection enterprise” that engaged in a pattern of racketeering activity to wrongfully incentivize false child abuse diagnoses. ECF No. 45 ¶¶ 136–47.

RICO makes it “unlawful for any person employed by or associated with any enterprise engaged in, or the activities of which affect, interstate or foreign commerce, to conduct or participate, directly or indirectly, in the conduct of such enterprise’s affairs through a pattern of racketeering activity.” 18 U.S.C. § 1962(c). RICO is not concerned with any garden-variety misconduct; rather, “it is a unique cause of action that is concerned

with eradicating organized, long-term habitual criminal activity.” Crest Constr. II, Inc. v. Doe, 660 F.3d 346, 353 (8th Cir. 2011) (citation omitted); see also Craig Outdoor Advert.,

6 In their briefing in opposition to Defendants’ motions to dismiss, Plaintiffs state that their complaint also raises a “failure-to-train” Monell claim. ECF No. 78 at 12. That’s news to the Court, for the second amended complaint contains no hint of a failure-to-train claim. The Court need not address that theory now. Morgan Distrib. Co. v. Unidynamic Corp., 868 F.2d 992, 995 (8th Cir. 1989) (citation omitted) (“[I]t is axiomatic that a complaint may not be amended by the briefs in opposition to a motion to dismiss.”). In any event, a failure-to-train claim would also be destined for dismissal, since that claim also requires “notice of a pattern of unconstitutional acts committed by” a municipal employee. Atkinson, 709 at 1216–17 (citation omitted). As discussed above, the second amended complaint does not plausibly allege either notice or a pattern of unconstitutional conduct. Inc. v. Viacom Outdoor, Inc., 528 F.3d 1001, 1029 (8th Cir. 2008) (noting that courts “reject[] attempts to convert ordinary civil disputes into RICO cases”). To demonstrate a

civil RICO violation, Plaintiffs must plausibly allege “(1) conduct (2) of an enterprise (3) through a pattern (4) of racketeering activity.” Sedima S.P.R.L. v. Imrex Co., 473 U.S. 479, 496 (1985). A RICO claim must be pleaded with particularity under Rule 9(b). Crest Constr. II, 660 F.3d at 353. Dr. Harper and UMP challenge the second element: enterprise. ECF No. 61 at 24– 26. Three elements must be alleged to show that a RICO enterprise existed: (1) a common

purpose that animates the individuals associated with it; (2) an ongoing organization with members who function as a continuing unit; and (3) an ascertainable structure distinct from the conduct of a pattern of racketeering. United States v. Lee, 374 F.3d 637, 647 (8th Cir. 2004). For the third element—a distinct, ascertainable structure—the Court considers “if the enterprise would still exist were the predicate acts removed from the equation.”

Handeen v. Lemaire, 112 F.3d 1339, 1352 (8th Cir. 1997). It is on this third element that Plaintiffs’ RICO claim falters.7 Plaintiffs identify a nebulous collection of medical professionals, hospitals, and institutions, as purported participants in a so-called “child protection enterprise.” ECF

7 That is not to say that this is the only problem with Plaintiffs’ RICO claim. Several other issues jump out to the Court, including whether the alleged amorphous enterprise encompasses an “ongoing organization with members who function as a continuing unit” and whether Plaintiffs have sufficiently alleged a pattern of racketeering activity. Nonetheless, Plaintiffs’ failure to allege an ascertainable structure for the enterprise is the most straightforward basis to dismiss the RICO claim, so the Court will not focus on other potential deficiencies for that claim. No. 45 ¶ 137. This purported child protection enterprise includes Dr. Harper, UMP, Hennepin Healthcare, Hennepin County, the HCAO, I.R.’s foster parents (N.C. and Dr.

Dillman), Dr. Kroupina, and other physicians who purportedly support the diagnostic validity of SBS/AHT. ECF No. 73 at 38; see ECF No. 45 ¶¶ 32, 49, 52, 54, 139, 152–53. The only “common factor that link[s] all these parties together and define[s] them as a distinct group [is] their direct or indirect participation” in the alleged scheme to deprive Plaintiffs of custody over I.R. Stephens, Inc. v. Geldermann, Inc., 962 F.2d 808, 815–16 (8th Cir. 1992) (finding similar allegations against a loosely defined enterprise inadequate

to allege a RICO enterprise). Clearly, then, if the alleged pattern of racketeering is “removed from the equation,” nothing more binds the child protection enterprise together as a common, continuing unit. Handeen, 112 F.3d at 1352. Such allegations are inadequate to plausibly allege a RICO enterprise. See Sebrite Agency, Inc. v. Platt, 884 F. Supp. 2d 912, 919–20 (D. Minn. 2012) (holding that plaintiff fails to allege an enterprise’s distinct,

ascertainable structure when all of the allegations against the enterprise “go directly to the conduct that constitutes the predicate acts of” racketeering); Bucco v. W. Iowa Tech Cmty. Coll., 555 F. Supp. 3d 628, 646–47 (N.D. Iowa 2021) (holding similarly when a complaint lacked “allegations that defendants had any relationship outside the alleged predicate acts”).

The substantive RICO claims against Dr. Harper and UMP are therefore dismissed. And because no substantive RICO claim remains, the RICO conspiracy claims against Dr. Dillman, Hennepin Healthcare, and UMP must also be dismissed. See Jaworski v. Rollupspacovers, No. 11-cv-1816 (DSD/JSM), 2012 WL 1130684, at *3 (D. Minn. Apr. 3, 2012) (holding that dismissal of a substantive RICO claim requires dismissal of a RICO conspiracy claim).

D. Minn. Stat. § 260E.088 (Count 5) Minnesota Statutes section 260E.08(d) provides that “[a]ny person who knowingly or recklessly makes a false report [of child abuse] shall be liable in a civil suit for any actual damages suffered by the person or persons so reported and for any punitive damages set by the court or jury, plus costs and reasonable attorney fees.” Dr. Harper largely repeats her argument that the second amended complaint does not plausibly allege that she was

aware of I.R.’s medical history, ECF No. 61 at 28, an argument that the Court has rejected in addressing Dr. Harper’s invocation of statutory and qualified immunity. Here, by plausibly alleging that Dr. Harper omitted exculpatory evidence from her report of child abuse, submitted false information to the family court, and was motivated by ulterior motives to report Plaintiffs for child abuse, Plaintiffs have plausibly alleged a claim under

Minn. Stat. § 260E.08 against Dr. Harper.

8 As the Court transitions to Plaintiffs’ state-law claims, a brief interlude on subject- matter jurisdiction is warranted. The Court may consider the merits of those state-law claims under the Court’s supplemental jurisdiction. See 28 U.S.C. § 1367. The federal and state-law claims arise out of a “common nucleus of operative fact” (namely, Defendants’ conduct in reporting Plaintiffs for child abuse), which unlocks the door to the Court’s supplemental jurisdiction. United Mine Workers of Am. v. Gibbs, 383 U.S. 715, 725 (1966). And no party argues that the Court, in its discretion, should decline to exercise jurisdiction over the state-law claims. See Hunter v. Page County, 102 F.4th 853, 869 (8th Cir. 2024). Accordingly, the Court exercises supplemental jurisdiction over Plaintiffs’ state-law claims. E. IIED Claims (Count 6) Dr. Harper, Dr. Dillman, UMP, and Hennepin Healthcare next seek dismissal of the

IIED claims against them. ECF No. 48 at 21–25; ECF No. 53 at 8–9; ECF No. 61 at 29– 32; see ECF No. 45 ¶¶ 161–64. An IIED claim under Minnesota law contains four elements: “(1) the conduct must be extreme and outrageous; (2) the conduct must be intentional or reckless; (3) it must cause emotional distress; and (4) the distress must be severe.” Hubbard v. United Press Int’l, Inc., 330 N.W.2d 428, 438–39 (Minn. 1983). The second amended complaint fails to plausibly allege the first, third, and fourth

elements of an IIED claim. As to the first element, “extreme and outrageous” conduct means conduct “so atrocious that it passes the boundaries of decency and is utterly intolerable to the civilized community.” Id. at 439 (citation omitted). In evaluating a state- law claim, the Court must predict how the Minnesota Supreme Court would evaluate an issue. Cont’l Cas. Co. v. Advance Terrazzo & Tile Co., 462 F.3d 1002, 1007 (8th Cir. 2006).

Decisions from the Minnesota Court of Appeals are “persuasive authority,” and they must be followed “when they are the best evidence of what the state law is.” Id. (citation modified). Highly instructive is the Minnesota Court of Appeals’ decision in Strauss v. Thorne, 490 N.W.2d 908 (Minn. Ct. App. 1992). In that case, the defendant was a physician who

wrote in a patient’s chart that he was concerned about possible child abuse by the plaintiff, who was the patient’s spouse. Id. at 910. That notation caused the family to lose its medical coverage and to be denied coverage by another insurer. Id. at 910–11. The physician freely admitted that he made the notation to “get back” at the plaintiff for talking to him rudely. Id. at 911. The Minnesota Court of Appeals found that, as a matter of law, the physician’s conduct was not “extreme or outrageous,” even if it might have been malicious. Id. at 913.

Plaintiffs essentially allege the same wrongful conduct: making a false report of child abuse for an improper purpose. See ECF No. 73 at 41 (explaining that the IIED claim is based on the allegations that Defendants “fabricat[ed] an abuse diagnosis of a newborn” and pursued termination of parental rights on a “false pretense”). While the false reporting of child abuse may have been more sustained in this case, Strauss suggests that, as a matter of law, that conduct is not extreme or outrageous enough to plausibly allege an IIED claim.

490 N.W.2d at 913.9 Even if Plaintiffs had plausibly alleged sufficiently “extreme or outrageous” conduct, Plaintiffs still fall short of plausibly alleging the third and fourth elements of an IIED claim: severe emotional distress. That emotional distress must be “so severe that no reasonable [person] could be expected to endure it.” Hubbard, 330 N.W.2d at 439 (citation

omitted). Even at the pleading stage, “generalized complaints of distress” do not suffice to plausibly allege severe emotional distress. Albert v. Ind. Sch. Dist. No. 709, No. A12-1516, 2013 WL 1500986, at *4 (Minn. Ct. App. Apr. 15, 2013) (affirming dismissal of IIED claim when the plaintiff alleged that she experiences “general anxiety, depression, and embarrassment”); see Hickman v. Ellison, A23-0127, 2023 WL 4199139, at *3 (Minn. Ct.

9 At oral argument, Plaintiffs suggested that N.C.’s conduct in secretly discarding Ramirez Rodriguez’s breast milk constitutes “extreme or outrageous.” See id. ¶ 84. But the IIED claim is not brought against N.C. And even if the Court credited the vague allegation that Dr. Harper “knew about and/or participated in” the dumping of breast milk, the Court disagrees that this conduct, although hurtful, “passes the boundaries of decency and is utterly intolerable to the civilized community.” Hubbard, 330 N.W.2d at 439. App. June 26, 2023) (affirming dismissal of IIED claim when the plaintiff made “conclusory allegations” of “ongoing mental, emotional and financial distress”); Clemons

v. MRCI WorkSource, No. A13-1994, 2014 WL 2178938, at *3 (Minn. Ct. App. May 27, 2014) (affirming dismissal of IIED claim when the plaintiff made “conclusory” allegations that he suffered “mental anguish, humiliation, embarrassment, and other damages”). Here, all Plaintiffs offer is the conclusory allegation that they have suffered “immeasurable emotional harm,” ECF No. 45 ¶ 105, which is inadequate to plausibly allege severe emotional distress, see Hickman, 2023 WL 4199139, at *3. Plaintiffs note

that they also allege that they felt “horror” at Defendants’ actions, ECF No. 73 at 42 (citing ECF No. 45 ¶ 105), but again, this conclusory allegation tells the Court nothing about how this “horror” amounts to “distress beyond what a reasonable person could be expected to endure.” Clemons, 2014 WL 2178938, at *3. Although Plaintiffs list a variety of harms they allegedly suffered because of Defendants’ conduct—such as losing custody of I.R.,

losing their employment, expending money to meet the requirements of the family-court proceedings, and losing eligibility for benefits, see ECF No. 45 ¶¶ 105–07—never do they explain how these harms impacted them emotionally beyond invoking conclusory buzzwords like “horror” and “immeasurable emotional harm.” Id. ¶ 105. Without such allegations, Plaintiffs’ IIED claims must be dismissed.10

10 The Court need not address Defendants’ alternative argument that Plaintiffs’ IIED claims are time-barred. F. Private Attorney General Statute Claims (Count 7) Plaintiffs next allege claims against Hennepin Healthcare and UMP under

Minnesota’s Private Attorney General Statute, see Minn. Stat. § 8.31, subd. 3a, seeking to remedy “the sort of egregious, fraudulent conduct Minnesota’s consumer protection legislation, including Minn. Stat. § 325D is designed to remedy.” ECF No. 45 ¶¶ 165–73. This claim is riddled with pleading problems, but three independently dispositive ones suffice to dismiss this claim. First, the Private Attorney General Statute grants a right of action to private

plaintiffs injured by violations of statutes involving “unfair, discriminatory, and other unlawful practices in business, commerce, or trade.” Minn. Stat. § 8.31, subd. 1. There are numerous such statutes on which an action under the Private Attorney General Statute may be based, including the Nonprofit Corporation Act, the Act Against Unfair Discrimination and Competition, the Unlawful Trade Practices Act, the Antitrust Act, the

Deceptive Trade Practices Act, the Consumer Fraud Act, and false advertising laws. See id. Incredibly, though, Plaintiffs do not identify any statute under which they seek to proceed. Instead, they only vaguely state that they challenge purported illegal conduct under “Minnesota’s consumer protection legislation, including [but not limited to] Minn. Stat. § 325D.” ECF No. 45 ¶ 171. Broadly gesturing at the entirety of “Minnesota’s

consumer protection legislation” does nothing to inform the Court (or Defendants) of the legal theory on which Plaintiffs are relying. “[N]either Defendant[s] nor the Court should be left to assume or guess at the legal basis under which Plaintiff[s] seek[] relief.” Bush v. Duncan Aviation, Inc., No. 4:24CV3057, 2025 WL 304785, at *2 (D. Neb. Jan. 27, 2025). Plaintiffs’ claims under the Private Attorney General Statute are subject to dismissal on that basis alone.

Second, even if the Court were to liberally construe the second amended complaint to raise claims under the Consumer Fraud Act, the Deceptive Trade Practices Act, or the False Statement in Advertisement Act (that is, the laws that seem most applicable to Plaintiffs’ allegations, as Plaintiffs’ counsel stated at oral argument that this case is about “false advertising”), pleading a violation of each of those laws requires satisfying the heightened pleading standard of Rule 9(b). See Bhatia v. 3M Co., 323 F. Supp. 3d 1082,

1091–92 (D. Minn. 2018). That means that Plaintiffs must plead with particularity the “who, what, where, when, and how” of Hennepin Healthcare’s and UMP’s wrongful conduct. Drobnak v. Andersen Corp., 561 F.3d 778, 783 (8th Cir. 2009) (citation omitted). Here, Plaintiffs allege that “Defendants” promised in “advertising and marketing” “teamwork and collaboration to respectfully address the physical, emotional, cultural and

spiritual needs of pediatric patients and their families,” that they “are dedicated to meeting the physical, developmental, and emotional needs of the children in [their] care,” that they are “dedicated to making sure families are involved in and understand the hospital care being provided,” and that they “take pride in knowing that you and your child fully understand what is happening during your hospital stay.” ECF No. 45 ¶ 167. This fails to

allege, with particularity, the who, when, and where of Hennepin Healthcare’s and UMP’s purported misconduct. As to the “when” and “where,” Plaintiffs never allege when or where these statements were made in Hennepin Healthcare’s and UMP’s “advertising and marketing.” Id. As for the “who,” Plaintiffs do not differentiate between statements purportedly made by Hennepin Healthcare and statements made by UMP. That’s a problem because when “multiple defendants are asked to respond to allegations of fraud, the

complaint should inform each defendant of the nature of [its] alleged participation in the fraud.” Streambend Props. II, LLC v. Ivy Tower Minneapolis, LLC, 781 F.3d 1003, 1013 (8th Cir. 2015) (citation omitted). Rule 9(b) does not allow Plaintiffs to do what they have done here: “cluster all the Defendants together without the required specificity to discern the respective roles of the individual defendants in the alleged fraud scheme.” Moua v. Jani-King of Minn., Inc., 613 F. Supp. 2d 1103, 1111 (D. Minn. 2009).

Third, even if Plaintiffs had sufficiently alleged the above statements with the requisite particularity under Rule 9(b), the statements would likely constitute non- actionable puffery under the Consumer Fraud Act, the Deceptive Trade Practices Act, and the False Statement in Advertisement Act. See Bernstein v. Extendicare Health Servs., Inc., 607 F. Supp. 2d 1027, 1031 (D. Minn. 2009) (holding statements were inactionable puffery

under the Consumer Fraud Act, the Deceptive Trade Practices Act, and the False Statement in Advertisement Act); Browe v. Evenflo Co., No. 14-cv-4690 (ADM/JJK), 2015 WL 3915868, at *5–6 (D. Minn. June 15, 2015) (same). Non-actionable puffery includes “vague or highly subjective claims of product superiority.” Am. Italian Pasta Co. v. New World Pasta Co., 371 F.3d 387, 390–91 (8th Cir. 2004). More specifically, statements by

a healthcare provider that it will provide “high quality care” are puffery. See Bernstein, 607 F. Supp. 2d at 1032 (statements that a nursing home would provide “high quality care” through “rigorous standards” that would “comply with or exceed applicable law” were puffery). All of the statements that Plaintiffs cite—that Defendants would use teamwork to meet the needs of patients, that Defendants would dedicate themselves to helping patients understand their care, and that Defendants take pride in helping patients understand

their care—boil down to the nonspecific and immeasurable promise of “high quality care.” See ECF No. 45 ¶ 167. For these three reasons (at minimum), Plaintiffs’ claims under the Private Attorney General Statute are dismissed. G. Civil Conspiracy (Count 8) The amended complaint finally alleges a civil conspiracy claim against all Defendants. ECF No. 45 ¶¶ 174–81. A civil conspiracy claim under Minnesota law

requires (1) a combination of two or more people (2) to commit an unlawful act or a lawful act by unlawful means. Harding v. Ohio Cas. Ins. Co., 41 N.W.2d 818, 824 (Minn. 1950); see Hong Chen v. Mar, No. A10-1908, 2011 WL 2119406, at *5 (Minn. Ct. App. May 31, 2011). At this point, however, the only Defendant against whom Plaintiffs have pleaded a plausible claim for relief is Dr. Harper. Because the second amended complaint does not

plausibly allege that two or more people conspired to commit an underlying tort, the civil conspiracy claim fails as a matter of law. See Reynolds, 2026 WL 622283, at *28. III. Dismissal With or Without Prejudice Defendants ask for any dismissal of Plaintiffs’ claims to be with prejudice, see ECF No. 48 at 29; ECF No. 61 at 36, while Plaintiffs request the opportunity for leave to amend

to cure any defects in the second amended complaint, see ECF No. 73 at 44. “Courts ultimately have discretion to decide between a dismissal with prejudice and one without prejudice.” Harris v. Medtronic Inc., 729 F. Supp. 3d 869, 883 (D. Minn. 2024). Although a dismissal without prejudice is favored at the pleading stage, “a dismissal with prejudice is appropriate when a plaintiff has shown persistent pleading failures despite one or more opportunities to amend or when the record makes clear that amendment would be futile.”

Id. (citation omitted) (internal quotation marks omitted). For four reasons, the Court elects to dismiss Plaintiffs’ claims with prejudice. First, Plaintiffs have had three opportunities to file a complaint in this case, ECF Nos. 1, 9, 45, which demonstrates “persistent pleading failures despite one or more opportunities to amend.” Harris, 729 F. Supp. 3d at 883. Second, Plaintiffs are represented by the same counsel as the plaintiff in Reynolds, and in Reynolds, the Court pointed out

several identical pleading deficiencies in that plaintiff’s Monell and IIED claims. See 2026 WL 622283, at *17–19, 27. The fact that Plaintiffs’ counsel, with the benefit of the Court’s guidance in Reynolds, could not plausibly allege these same claims here suggests to the Court that those claims will likely never be plausibly alleged. Third, the pleading deficiencies here are not slight; the Monell, RICO, IIED, and Private Attorney General

Statute claims suffer from multiple independently fatal flaws, which confirms the Court’s suspicion that further amendment of these claims is likely futile. Fourth, in requesting leave to amend the second amended complaint, Plaintiffs did not submit a proposed third amended complaint or otherwise explain what allegations a third amended complaint might contain. “Absent some indication as to what might be added to the complaint to make it

viable, [Plaintiffs are] not entitled to leave to amend.” Wolgin v. Simon, 722 F.2d 389, 394– 95 (8th Cir. 1983). What will remain in this case, then, is Plaintiffs’ Section 1983 (Count 1) and Minn. Stat. § 260E.08 (Count 5) claims against Dr. Harper. CONCLUSION For these reasons and based on the files, records, and proceedings herein, IT IS

HEREBY ORDERED that: 1. Hennepin Healthcare System’s Motion To Dismiss (ECF No. 47) is GRANTED; 2. Dr. Megan Dillman’s Motion To Dismiss (ECF No. 52) is GRANTED;

3. Dr. Nancy Sanders Harper’s and University of Minnesota Physicians’ Motion To Dismiss (ECF No. 59) is GRANTED in part and DENIED in part;

4. Hennepin County’s Motion To Dismiss (ECF No. 65) is GRANTED; and

5. Counts 2, 3, 4, 6, 7, and 8 of the second amended complaint (ECF No. 45) are DISMISSED WITH PREJUDICE.

Dated: August 28, 2026 s/Laura M. Provinzino Laura M. Provinzino United States District Judge