A patient came to our cardiovascular invasive lab for a procedure for management of peripheral arterial disease (PAD). Another of his co-morbidities is renal disease with hemodialysis (HD) dependency, but he was NOT here for management of his HD access, a left forearm loop arteriovenous graft (AVG). However, Sheila noted during the recovery phase after his peripheral vascular procedure that there was no thrill or even bruit in his graft; this despite the fact that no part of our care placed the AVG at any risk or specifically warranted checking its status post-procedure. Sheila immediately communicated this to me by Secure Chat, and by exam I absolutely agreed that the AVG had clearly clotted since his last HD two days prior. Thanks to Sheila's early catch and timely message we had ample time to take the patient back to the lab then and there and were able to successfully declot the graft. The patient had already missed one day of HD for his procedure with me; had Sheila not identified that his graft was non-functional, it would not have been discovered until he presented to his dialysis center for HD the next day, which would have necessitated his return to us or another center for the declot procedure and most likely resulted in ANOTHER missed day of dialysis.