CASE PRESENTATION: Patient is an 82-year-old male with significant history of coronary artery disease who presented for chronic chest pain that had recently increased in intensity and become associated with lightheadedness. Patient underwent a coronary catheterization which showed chronic total occlusion and no intervention was performed. Patient was started on heparin drip and guideline based therapy. Patient developed acute blood loss anemia for which all anticoagulants were held. Patient’s course was complicated with acute renal failure requiring continuous renal replacement therapy (CRRT), for which a left FV access was established under ultrasound guidance. Patient complained of left groin pain, and left leg weakness a few hours after placement of catheter. Hemoglobin at that time was noted to be 9.9 gm/dL. Vital signs were within normal limits. Exam was significant for abscence of local hemtoma, weakness of hip adductors and flexors, decreased sensation over medial thigh, absent left patellar reflex consistent with femoral nerve injury. Symptoms persisted over the next 3 days. Patient’s hemoglobin was noted to trend down gradually. On the third day, hemoglobin had dropped to 6.9 gm/dL. A CT scan of the abdomen and pelvis showed an iliopsoas hematoma that was likely causing entrapment/compressive injury of the femoral nerve. There was delay in diagnosis due to patient’s unusual presentation. Patient’s course was fatally complicated with hypovolemic shock and inability to compensate due to his extensive comorbidities.