A woman in her 70s with a history of dementia, congestive heart failure, and COPD was admitted to the hospital after a mechanical fall. A CT scan of the pelvis revealed a right superior and inferior pubic rami fracture. Orthopedics recommended pain control and nonoperative intervention. Subsequently, the patient developed acute kidney injury requiring dialysis. During her first dialysis session, she developed hypotension, hypoxemia, and an altered mental status. A rapid response team was activated, and the patient was transferred to the ICU. Upon ICU transfer, her vital signs revealed a BP of 105/77 mm Hg, a heart rate of 100 beats/min, and a respiratory rate of 26 breaths/min; pulse oximeter oxygen saturation was 94% on 4 L of oxygen. Her physical examination revealed pale, cool skin and coarse crackles on lung auscultation. Her vital signs initially improved with fluid resuscitation; however, 4 hours after the transfer, she became increasingly confused and hypotensive, and vasopressor agents were started.