Failing to Disclose

Patient X died after suffering a heart attack. Although the patient had recently visited her primary physician and
presented symptoms of cardiac symptoms including a family history of cardiac trouble. Her primary care
physician did not refer her to a cardiologist. The patient's family sued the HMO (health maintenance
organization) for failing to disclose the financial incentive system it provided to physicians to minimize referrals
to specialists including a cardiologist.
Analyze whether the family has a legitimate claim against the HMO and the primary

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