Lindsey was the primary nurse for a 16-year-old male that presented with a complaint of left rib pain/back pain for 1 month. This patient had been seen previously by PMD without a definitive diagnosis. Initial thoughts were patient's pain was muscular in origin, but neither Nurse Lindsey nor the MD were convinced. Discussion led to an EKG prior to discharge; something seemed not right. EKG showed minimal changes but enough concern led to a cardiology consult. Further testing showed a positive D-dimer which led to a CT angio diagnosing multiple PE's. He was transferred to an ICU and further care which involved an extended stay and consult of transplant team.