NEWPORT — An Upper Valley orthopedic surgeon who is charged with sexually assaulting a patient was refused bail Wednesday and ordered to remain in jail after the prosecutor told the judge that, since police announced the initial charges Tuesday, three other people have contacted law enforcement about the doctor’s behavior.

Dr. Thomas Marks, a 70-year-old resident of Newbury, N.H., who is affiliated with Valley Regional Hospital in Claremont, was charged with multiple counts of sexual assault of a 53-year-old female patient at his office on Elm Street in December, according to court documents.

Marks, who was arrested at his office by Claremont police on Tuesday, appeared via video conference from Sullivan County House of Correction without legal representation and pleaded not guilty at his arraignment in Sullivan Superior Court in Newport on Wednesday.

Marks, formerly affiliated with an orthopedic practice in Windham, N.H., and who joined Valley Regional in 2022, was rebuffed by Judge Martin Honigberg in his request to be released on bail and confined to home detention with an location-monitoring ankle bracelet.

Acknowledging the “record is limited at this time,” Honigberg nonetheless said during the 12½-minute arraignment hearing that he determined there is “clear and convincing evidence that releasing (Marks) into community at this time would pose a threat to the safety of the public.”

The 11-page affidavit, prepared by Claremont Police Detective Richard Bell, alleges that on Dec. 8, 2022, Marks touched the breasts of a female patient, put his hand down her pants, and she performed oral sex on him, at his urging, during an appointment at his office located at 241 Elm St.

The Dec. 8 appointment was approximately the ninth appointment of the patient — who is identified in court materials only by her initials — with Marks, who had hugged the patient during each of her previous visits, the affidavit said.

She subsequently told a friend, her mother and her ex-husband about the alleged assault before reporting it to Claremont police on Dec. 14. (The Valley News generally does not identify the victims of alleged sex crimes.)

At another appointment on Tuesday, the woman was equipped with a hidden recording device and recorded her conversation with Marks, during which he acknowledged they had oral sex on Dec. 8, according to the affidavit. He again touched her breast during an exam and said he wanted her to perform oral sex, officer allege.

Police officers intervened at the patient’s request. They found Marks on his knees in front of the patient, according to the affidavit.

Officers subsequently interviewed Marks, who confirmed he had engaged in flirting, sexual banter, hugging and touching the patient in the “upper chest area” during the Dec. 8 office consultation but denied that she had performed oral sex on him, according to the affidavit.

During the interview, Marks said he had performed surgery on her knees and had been medically treating her for almost a year.

Marks told officers that this was the first time something like this had happened while he was working at Valley Regional. While there had been “some flirtation and banter” with other patients in his career, “he always stopped,” the affidavit quotes him as saying.

The prosecutor, however, during Wednesday’s arraignment hearing, argued that the gravity of the allegation compounded with new information learned in the previous 24 hours warranted denying Marks bail, instead recommending he be held in preventive detention.

“In this instance, particularly when we have more and more people coming forward, this report has not even been out 24 hours and there are three separate individuals making reports to law enforcement. ... I don’t think electronic monitoring ensures the safety of the community (from) the person here who is highly educated and has used that education to manipulate this sort of behavior (and keep it) secret,” said Sullivan County Deputy Attorney Christine Hilliard.

Hilliard did not detail the nature of the reports to law enforcement, or even if they involved allegations of sexual misconduct, other than to say they were reported in Nashua and Derry, N.H., and not in Claremont.

The newer allegations and the current charges were enough to persuade the court.

In granting the state’s preventive detention order, Judge Honigberg said he expected Marks would be engaging an attorney and earlier advised him that he had a right to an evidentiary hearing. An attorney “will know how to make the request and get you back in front of the court and state and we’ll have a more robust discussion about bail.”

The Sullivan County Attorney’s Office assisted Claremont police in their investigation, which is ongoing.

Further charges are anticipated, Claremont police said.

Valley Regional Hospital said it is cooperating with the investigation, and an official report to the New Hampshire Board of Medicine is expected.

Following his arrest on Tuesday, “Dr. Marks was immediately placed on leave, and all privileges have been suspended,” Tim McNulty, a Valley Regional spokesman, said in a Wednesday email.

Marks has an active medical license that is set to expire June 30, 2024, according to the New Hampshire online licensing portal.

He also has an active license in Massachusetts, according to the Massachusetts Board of Registration in Medicine. He is board certified through the American Board of Orthopaedic Surgery.

Marks earned his medical degree in 1979 from the University of Massachusetts, Worcester, and did his internship at Berkshire Medical Center in Pittsfield, Mass., in 1980 and his residency at the University of Massachusetts Medical Center in 1984.

The Massachusetts board has no record of felony or serious misdemeanor convictions, health care facility discipline, Massachusetts Board discipline or out-of-state board discipline for Marks.

The charges against Marks include aggravated felonious sexual assault, attempt to commit aggravated felonious sexual assault and two counts of sexual assault. He told the court he is in the process of obtaining attorney representation.

This is not the first time Valley Regional has been confronted with allegations of a doctor abusing his position to have sex with a patient. In 2021, a family physician at Valley Regional in Claremont pleaded guilty to two counts of second-degree assault in connection with sexual encounters he’d had with a woman during the five months he was her doctor in 2016 and 2017.

Eric Knight, the physician, was sentenced to three to seven years in New Hampshire State Prison on one of the assault charges, with all but 24 months suspended. On the second charge, Knight was sentenced to three to seven years, all suspended as long Knight stays out of trouble.

Knight’s petition for proposed work release was granted on Dec. 7, 2022, by Judge Honigberg, according to state court records.

John Lippman can be reached at jlippman@vnews.com. Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.

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