TvDx
ER

ERNBC

Season 9, Episode 20

10 medical diagnoses portrayed

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Also known as: TOF

Hypercyanotic spellPulmonary edemaCardiac arrest

A Croatian boy with tetralogy of Fallot arrives on a plane in critical condition with severe cyanosis and respiratory distress. He experiences cardiac arrest during transport and requires emergency unifocalization and tet repair surgery, which becomes the central plot as Kovac fights to get approval for the surgery at County General.

ER — S09E20Patient: Ante
Recurring storyline
SyncopeRisk of cardiac arrest

A minor league baseball player experiences a syncopal episode after wind sprints and is diagnosed with Long QT syndrome. The diagnosis creates conflict as the patient and his mother want to pursue his baseball career despite the cardiac risks.

ER — S09E20Patient: Lucia Perez's son (baseball player)

Also known as: GSW to chest

Pneumothorax

A mother shot during a drive-by shooting sustains a through-and-through chest wound requiring chest tube placement for pneumothorax as part of a major storyline involving gang violence affecting an entire family.

ER — S09E20Patient: Mrs. Mitchell

Also known as: GSW to abdomen

Splenic injuryInternal bleeding

A young boy injured in the same drive-by shooting sustains an abdominal gunshot wound causing splenic injury requiring exploratory surgery and possible splenectomy.

ER — S09E20Patient: Turner Mitchell

Also known as: Broken neck with paralysis

Spinal shockParalysis below C-5Respiratory compromise

A 9-year-old girl injured when a bookcase fell on her during the shooting sustains complete cervical spinal cord transection at C-5 level with paralysis and no motor or sensory function below the injury. The tragic nature of her injury - caused by her mother's attempt to protect her - drives emotional weight in the episode.

ER — S09E20Patient: Noelle Mitchell

Also known as: Third-degree burn

Full-thickness burnsVascular compromiseRisk of compartment syndrome

Romano sustains a severe burn to his prosthetic arm when his sling catches fire on a stove burner, which he doesn't realize due to lack of sensation. The injury requires débridement and eventual skin grafting, but Romano ultimately decides to pursue amputation, marking a major character development moment.

ER — S09E20Patient: Robert Romano
Recurring storyline

Also known as: Manic depression

Medication non-complianceManic episodeErratic behavior

Abby's brother Eric, who has been in a treatment program, skips out after reducing his medications by 'cheeking' them, leading to a manic episode. He disrupts Carter's grandmother's funeral, highlighting the ongoing struggle with his mental illness.

ER — S09E20Patient: Eric Wyczenski
Recurring storyline
Concussionsupporting

Also known as: Mild traumatic brain injury

The baseball player initially presents with head trauma after syncopal episode, though the underlying Long QT syndrome is the more significant diagnosis.

ER — S09E20Patient: Minor league baseball player

Also known as: Botox complication

Dysphagia

A woman who attended a Botox party develops difficulty swallowing from botulism toxicity, requiring nasogastric tube feeding.

Also known as: GSW to chest

Cardiac arrestExsanguination

The older brother who left gang life returns and is later brought in with a gunshot wound to the chest requiring emergency thoracotomy after he goes into cardiac arrest, representing the tragic continuation of the gang violence cycle.

ER — S09E20Patient: Curtis Mitchell