Number 51 was an item on The List.
Slept with Ralph's MomEdit
After performing as Phish Tahko the first time, as everyone was getting settled in after the party, Earl's groupie was too drunk on jello shots and was unconscious. Loraine Mariano saw this as a chance to feel loved. After getting the band back together to cross off list item number 50, Ralph heard "Slept with Ralph's Mom" mentioned by Tom Sparks, (the former lead singer of their rock band "Phish Tahko" who was then voted out by the other members of the group: Earl, Randy and Ralph) and grew furious with Earl. Ralph was threatening to kill Earl, then in order to avoid killing his friend, attempted to sleep with Earl's mom, Kay Hickey. After that attempt failed, Ralph saw the only way to make this right was for Earl to marry Loraine.
Earl was unable to bring himself to consummate the marriage, so he kept on making excuses. Eventually the gig for Phish Tahko arrived, and as Earl passed out from trying to make himself drunk enough to consummate the marriage, Earl passed out. Once he returned to Loraine's house, he discovered Loraine and Tom Sparks slept together. They annulled the marriage shortly after and Tom began a relationship with Loraine and became Ralph's father figure.