What is the test for a claim for negligence in a medical malpractice case?

"A complaint in an action for negligence must allege (1) the defendant's legal duty of care towards the plaintiff, (2) the defendant's breach of that duty, (3) injury to the plaintiff as a proximate result of the breach, and (4) damage to the plaintiff. [Citation.] A complaint which lacks facts to show that a duty of care was owed is fatally defective. [Citation.]" (Jones v. Grewe (1987) 189 Cal.App.3d 950, 954.) "[T]he threshold question in an action for negligence is whether the defendant owed the plaintiff a duty to use care [citation], and the '[r]ecognition of a duty to manage business affairs so as to prevent purely economic loss to third parties in their financial transactions is the exception, not the rule, in negligence law' [citation]." (Summit, supra, 27 Cal.4th at p. 715.) "Whether a duty of care exists is a question of law for the court. [Citations.]" (Jones v. Grewe, supra, at p. 954.)