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McClellan v. Health Maintenance Organization of Pennsylvania

Pennsylvania Superior Court

604 A.2d 1053 (1992)

Facts

In 1985 Marilyn McClellan (plaintiff) enrolled in healthcare coverage with the Health Maintenance Organization of Pennsylvania (HMO PA) (defendant). The HMO PA was an individual-practice-association health-maintenance organization that contracted with independent private physicians. Individuals who enrolled in HMO PA’s coverage plan were given a list of primary-care physicians with whom HMO PA contracted. Marilyn selected Joseph A. Hempsey as her family’s primary-care physician. In October 1985, Hempsey removed a mole on Marilyn’s back and failed to obtain a biopsy. On January 1, 1988, Marilyn died from melanoma. Marilyn’s husband, Ronald M. McClellan (plaintiff), sued Hempsey for malpractice. Ronald also filed a negligence action in Pennsylvania trial court against HMO PA on ostensible-agency and corporate-negligence theories. The trial court dismissed the complaint against HMO PA for failure to state a cause of action. The matter was appealed to the Pennsylvania Superior Court.

Rule of Law

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Issue

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Holding and Reasoning (McEwen, J.)

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