Medical Diagnoses in ER: A Comprehensive Review of Medical Conditions in Season 12
- Dec 29, 2025
- 8 min read
Season 12 of ER balances the intimate struggles of its characters with the broader challenges of modern medicine. The season delves into complex metabolic disorders, rare genetic conditions, and the catastrophic consequences of missed diagnoses. From the heart-wrenching search for a diabetic child to the ethical dilemmas of treating a "Munchausen by Proxy" case, the medical narratives are as gripping as they are educational. The season also highlights the dangers of alternative medicine and the critical importance of thorough patient history.
Below is a comprehensive, episode-by-episode review of the medical cases, diagnoses, and treatments presented in Season 12.
Content ⁉️
Episode 1
Diabetic Ketoacidosis (DKA)
Alex Taggart. A 12-year-old diabetic ran away without insulin. Diagnosis: Found lethargic after two days, labs confirmed Diabetic Ketoacidosis (Glucose 375). Treatment: Intravenous saline and insulin infusion stabilized his condition.
Ethylene Glycol Poisoning
Unnamed Patient. A 19-year-old ingested antifreeze. Diagnosis: Ethylene Glycol Toxicity identified via osmolar gap. Treatment: Fomepizole (Alcohol dehydrogenase inhibitor) to prevent toxic metabolite formation, avoiding dialysis.
Theophylline Toxicity
Mr. Canberra. A COPD patient with respiratory distress. Diagnosis: Theophylline Toxicity (Level 53) complicated by PVCs. Treatment: Lidocaine for arrhythmia and cessation of Albuterol.
Infective Endocarditis
Mr. Kingsley. An IV drug user with a deltoid abscess. Diagnosis: A loud murmur and thrill led to the diagnosis of Infective Endocarditis. Treatment: Echocardiogram and IV antibiotics prior to abscess drainage.
Other Medical Diagnoses and Conditions Discussed
Corneal Abrasion: Foreign body removal via slit lamp.
Splenic Laceration: Blunt trauma requiring laparotomy.
Transient Ischemic Attack (TIA): Temporary neurological deficit.
Fever Without Source: Diagnostic challenge.
Traumatic Pneumothorax: Requiring chest tube.
Stellate Facial Laceration: Complex repair.
Subdural Hematoma: Neurosurgical emergency.
Syphilis: Treated with Penicillin G.
Myelomeningocele: Congenital neural tube defect.
Shunt Obstruction: In a patient with hydrocephalus.
Nephrolithiasis: Kidney stone management.
Appendicitis: Ruled out via clinical exam.
Episode 2
Footling Breech and Hypoxic Brain Injury
Claire Jansen. A surrogate mother in labor after an MVA. Diagnosis: Footling Breech Presentation. Complication: Umbilical cord compression and head entrapment during vaginal delivery. Outcome: Severe Hypoxic Brain Injury in the neonate due to prolonged bradycardia.
Hyperammonemic Encephalopathy (Protein Intolerance)
Liam. A vegetarian child found unresponsive after eating cheeseburgers. Diagnosis: Hyperammonemic Encephalopathy (Ammonia 214) due to a metabolic protein intolerance disorder. Treatment: Intubation and Sodium Phenylbutyrate.
Other Medical Diagnoses and Conditions Discussed
Paintball Injuries: Trauma study subject.
Bulimia: Behavioral factor in patient presentation.
Situs Inversus: Congenital organ reversal.
Histoplasmosis: Treated with Amphotericin B.
Ventricular Fibrillation: Cardiac arrest.
Proximal Great Vessel Injury: Vascular trauma.
Myocardial Infarction: Acute "hot" MI.
Episode 3
Chronic Lead Poisoning
Stephanie Lowenstein. A rollerblader with profound anemia (Hemocue 6.9). Diagnosis: Chronic Lead Poisoning from unregulated herbal supplements. Underlying Factor: BRCA1 mutation fear drove her to alternative medicine. Treatment: Chelation therapy (B.A.L.).
LeFort II Fracture
Robbie Beckwith. A scooter crash victim with facial trauma. Diagnosis: LeFort II Fracture and diffuse brain edema. Treatment: Rescue airway (LMA) followed by emergency tracheotomy due to massive nasopharyngeal swelling.
Other Medical Diagnoses and Conditions Discussed
Abscessed Tooth: Dental infection.
Burn Injury: Parkland formula resuscitation.
Acute Alcohol Intoxication: Fluid management.
Sebaceous Cyst Abscess: Infected cyst.
Diffuse Abdominal Pain: Diagnostic imaging required.
Episode 4
Postpartum Depression
Judy Anderson. A mother crashed her car into a wall. Diagnosis: Severe Postpartum Depression; the crash was a suicide attempt. Treatment: Psychiatric admission (voluntary or hold).
Unstable Angina
Lee Rappaport. A patient with chest pain. Diagnosis: Unstable Angina (negative enzymes, positive symptoms). Treatment: Angioplasty.
Prostate Cancer
Dr. Lucien Dubenko. High PSA (6.5) led to biopsy. Diagnosis: Prostate Cancer (T-1). Treatment: Radical bilateral nerve-sparing prostatectomy.
Other Medical Diagnoses and Conditions Discussed
Diverticulitis: Colonic inflammation.
Mandible Fracture: Surgical repair.
Femoral Artery Injury: Ischemic limb.
Cardiac Contusion: Blunt chest trauma.
Epistaxis on Coumadin: Anticoagulated nosebleed.
Episode 5
Anticholinergic Toxicity ("Skittles")
Tommy Bonetti. An agitated fall victim. Diagnosis: Anticholinergic Toxicity from Dextromethorphan (Skittles), identified by a negative anion gap due to bromide interference. Treatment: Physostigmine and sedation.
Idiopathic Intracranial Hypertension (IIH)
Female Patient. A patient with severe headaches. Diagnosis: Idiopathic Intracranial Hypertension. Diagnostic Method: Intraocular pressure measurement correlating to ICP. Treatment: Heparin for sagittal sinus thrombosis.
Other Medical Diagnoses and Conditions Discussed
Nicotine Toxicity: From "Tabaco Gigante" tea.
Coma Recovery: Awakening via experimental drug cocktail.
Prophylactic Mastectomy: Breast cancer prevention.
Zone 2 Neck Injury: Vascular screening required.
Spinal Shock: High thoracic injury complication.
Episode 6
Post-Arrest Hypothermia Protocol
Paul. A cardiac arrest victim with ROSC but poor neurological function (GCS 3). Treatment: Therapeutic Hypothermia (cooling to 33°C) to preserve brain function. Outcome: Significant neurological recovery (GCS 11).
Neonatal Septic Shock (Chimpanzee)
Darwin. A chimp neonate. Diagnosis: Septic Shock progressing to V-tach arrest. Treatment: Aggressive resuscitation failed.
Chlamydia
Zoe Butler. A teen with dysuria. Diagnosis: Chlamydia. Treatment: Doxycycline and STD screening.
Other Medical Diagnoses and Conditions Discussed
Sepsis: Neonatal risk.
Stridor: Laryngeal injury.
Liver Injury: Abdominal trauma.
Displaced Clavicle: Tracheal compression.
Episode 7
Cardiac Tamponade
Sydney Carlyle. A pediatric GSW victim. Diagnosis: Cardiac Tamponade confirmed during emergency thoracotomy. Outcome: Fatal.
Hepatic Injury
Vincent Jansen. An abductor with multiple GSWs. Diagnosis: Grade 4 Liver Laceration ("chopped liver"). Treatment: Emergency ER laparotomy with liver packing.
Other Medical Diagnoses and Conditions Discussed
Ischemia: From wrist restraints.
Penetrating Axillary Trauma: Neurovascular deficit.
Tension Pneumothorax: Decompression required.
Intussusception: Pediatric emergency.
Episode 8
Cardiac Transplant Rejection
Martin Trudeau. A transplant patient stopped meds due to cost. Diagnosis: Acute Rejection. Treatment: Monoclonal antibodies and transfer to Mayo Clinic.
Refractory V-Fib
Adrian. A patient with MI entered V-fib. Treatment: Prolonged resuscitation with multiple shocks and anti-arrhythmics. Outcome: Fatal.
Traumatic Hepatic Laceration
Tony Gates. A paramedic injured in a collapse. Diagnosis: Liver Laceration. Treatment: Field laparotomy and packing by Dr. Rasgotra.
Other Medical Diagnoses and Conditions Discussed
Flail Chest: Respiratory arrest.
Hypotensive Pelvis: Severe fracture.
Ischemic Arm: Vascular emergency.
Foreign Body Aspiration: Alveolar ridge fracture fragment.
Episode 9
Pneumocystis Pneumonia (Pediatric HIV)
Stewy Kenig. A child of an HIV-denialist mother presented with hypoxia. Diagnosis: Pneumocystis Pneumonia (PCP). Treatment: Antibiotics and confrontation of the mother's denial.
Delayed Intracranial Hemorrhage
Glenda Bardelarinski. An intoxicated patient with coagulopathy. Diagnosis: Delayed Intracranial Hemorrhage confirmed on repeat CT. Treatment: Mannitol and neurosurgery.
Accidental Hypothermia
Harry Royman. A hockey player fell through ice. Diagnosis: Profound Hypothermia (86°F) and V-fib arrest. Treatment: Pleural irrigation and peritoneal dialysis rewarming. Outcome: Survival.
Other Medical Diagnoses and Conditions Discussed
SMA Laceration: Massive abdominal hemorrhage.
Intestinal Malrotation: Volvulus risk.
Tracheoesophageal Fistula: Aspiration pneumonia.
Episode 10
Hyponatremia (Ovarian Cancer)
Tamara Gordon. An MVA victim seized. Diagnosis: Severe Hyponatremia secondary to metastatic Ovarian Cancer. Outcome: Left AMA to be with family.
Traumatic Arrest (GSW)
Danielle Hopkins. A 6-year-old GSW victim. Diagnosis: Traumatic Arrest from massive hemorrhage. Treatment: Emergency thoracotomy, aortic cross-clamping, and chest tube for tension pneumothorax.
Other Medical Diagnoses and Conditions Discussed
Munchausen ("Systemic Ponderosa"): Factitious disorder.
Central Pontine Myelinolysis: Risk of rapid sodium correction.
Diabetic Ulcer: Maggot infestation.
Episode 11
Advanced Hip Degeneration
Kerry Weaver. A fall revealed chronic pathology. Diagnosis: End-Stage Hip Degeneration with a cartilaginous flap. Treatment: Total hip replacement recommended.
Pregnancy (Sexual Assault)
Amanda Ramsey. A teen with abdominal pain. Diagnosis: Pregnancy resulting from rape. Treatment: Termination via laminaria insertion.
Other Medical Diagnoses and Conditions Discussed
Acetaminophen Overdose: Mucomyst treatment.
Ovarian Torsion: Surgical emergency.
CML: Philadelphia chromosome leukemia.
Episode 12
Urosepsis
Mrs. Venema. A vegetative patient presented with "pea soup" urine. Diagnosis: Urosepsis. Treatment: Early goal-directed therapy vs. palliative care debate.
Nightstick Fracture
Zoe Butler. A teen with a forearm fracture. Diagnosis: Nightstick Fracture (Ulnar fracture), a defensive injury indicating physical abuse. Outcome: Social services intervention.
Supernumerary Thelium
Archie Morris. Diagnosis: Supernumerary Thelium (Extra nipples).
Other Medical Diagnoses and Conditions Discussed
Foreign Body Inhalation: Roach clip aspiration.
Diverticular Abscess: Complicated diverticulitis.
Polydactyly: Extra digits.
Episode 13
ALS and Pneumonia
Nate Lennox. A professor with Amyotrophic Lateral Sclerosis (ALS) presented with Pneumonia. Treatment: Tracheostomy for assisted ventilation to extend life.
Other Medical Diagnoses and Conditions Discussed
Pseudobulbar Affect: Emotional incontinence.
Multiple Sclerosis: MRI diagnosis.
Heat Stroke: Hemolyzed labs.
Episode 14
Renal Pedicle Injury
Jodie Kenyon. A GSW victim with hemodynamic instability. Diagnosis: Renal Pedicle Injury. Treatment: Renal artery repair using an omental patch during a 45-minute ischemia window.
Other Medical Diagnoses and Conditions Discussed
Nail Gun Injury: Psychiatric consult needed.
Infected Branchial Cyst: Neck mass.
Polysubstance Toxicity: Anesthesia complication.
Episode 15
Mesenteric Artery Tear
Jose Rodriguez. A pediatric pedestrian struck by a car. Diagnosis: Mesenteric Artery Tear confirmed by CT. Treatment: Emergency surgery.
Schistosomiasis Cirrhosis
Stephen (Dakarai). A patient on a medical mission. Diagnosis: Cirrhosis secondary to chronic Schistosomiasis.
Other Medical Diagnoses and Conditions Discussed
Cholera: Oral rehydration.
Crohn’s Obstruction: Surgical emergency.
Sexual Assault: Traumatic injuries in a conflict zone.
Episode 16
Meningococcemia
Donna and Katie. MVA victims with fever and purpura. Diagnosis: Meningococcemia. Treatment: Isolation, antibiotics, and prophylaxis for contacts.
Myelodysplastic Syndrome (MDS)
Mr. Elliot. A wealthy patient with anemia. Diagnosis: Myelodysplastic Syndrome. Treatment: Chronic transfusions and iron chelation therapy.
Other Medical Diagnoses and Conditions Discussed
End-Stage Arthrosis: Dr. Weaver's hip condition.
Laryngospasm: Airway obstruction.
Foreign Body Ingestion: Light bulb in duodenum.
Episode 17
Fatal HIT and Air Embolism
Nimet. A stabbing victim. Treatment: Emergency bypass. Complication: Fatal Heparin-Induced Thrombocytopenia (HIT) causing intracranial hemorrhage. Note: The summary mentions Air Embolism in Episode 21, but HIT is specific here.
Delusional Parasitosis
Female Patient. Complained of "Morgellons" fibers. Diagnosis: Delusional Parasitosis.
Factitious Overdose
Mr. Sadler. Claimed Tylenol overdose. Diagnosis: Factitious Disorder (Malingering) to avoid a social event.
Other Medical Diagnoses and Conditions Discussed
TORCH Infection: Congenital risk.
Abdominal Aortic Aneurysm: Critical vascular condition.
Thalassemia: Hereditary anemia.
Episode 18
Subclinical Seizures (Toxin Induced)
Brook Sawyer. An MVA victim with masseter spasm after succinylcholine. Diagnosis: Subclinical Seizures from MDMA/GHB toxicity. Treatment: Anticonvulsants.
Acute Mitral Regurgitation
Jim Coker. An assault victim with a prosthetic valve. Diagnosis: Acute Mitral Regurgitation due to blown porcine valve. Treatment: Emergency replacement.
Other Medical Diagnoses and Conditions Discussed
Anoxic Brain Injury: Airway compromise outcome.
Epididymitis: Scrotal pain differential.
Boxer's Fracture: Hand injury.
Episode 19
Nephrotic Syndrome (Lithium Induced)
Lenore Bee. A fall victim with abdominal fluid. Diagnosis: Fluid was ascites from Nephrotic Syndrome caused by Lithium, not blood. Outcome: Spared unnecessary surgery.
Perforated Appendicitis
Steve Curtis. A prisoner with "resolved" pain. Diagnosis: Perforated Appendicitis (pain relief from rupture). Treatment: Emergency surgery.
Other Medical Diagnoses and Conditions Discussed
Bilateral Lacunar Infarcts: Vascular dementia.
Coin Ingestion: Pediatric foreign body.
Gallbladder Disease: Lap chole indication.
Episode 20
Conversion Disorder (Psychogenic Seizures)
Jordan Dunn. A pregnant patient with "status epilepticus." Diagnosis: Psychogenic Non-Epileptic Seizures (Conversion Disorder). Treatment: Sodium Amytal interview revealed repressed trauma (SIDS death).
Other Medical Diagnoses and Conditions Discussed
Wolff-Parkinson-White Syndrome: Arrhythmia risk.
Sudden Infant Death Syndrome: Historical context.
White Coat Hypertension: Anxiety response.
Episode 21
Hypertensive Heart Failure (Adolescent)
Elgin. A teen with untreated hypertension. Diagnosis: Congestive Heart Failure secondary to Left Ventricular Hypertrophy (LVH). Treatment: Diuretics, nitrates, and ACE inhibitors.
Other Medical Diagnoses and Conditions Discussed
True Knot: Umbilical cord accident causing stillbirth.
Mesenteric Occlusion: Surgical emergency.
Preeclampsia: Pregnancy complication.
Episode 22
Catastrophic Trauma (Bilateral Amputation)
Linda. An MVA victim wedged between cars. Injuries: Massive hepatic laceration and crush injury. Treatment: Emergency Bilateral Lower Extremity Amputation to extricate and control hemorrhage.
Bronchial Transection
Michael. A 7-year-old with tension pneumothorax and persistent air leak. Diagnosis: Transected Left Mainstem Bronchus. Treatment: Surgical repair.
Other Medical Diagnoses and Conditions Discussed
Opiate Overdose: Driver toxicology.
End-Stage Colon Cancer: Terminal illness presentation.
🔖 Key Takeaways
🗝️ Diagnostic Vigilance: The season emphasizes the danger of assuming common diagnoses, as seen in the lead poisoning case masquerading as anemia and the "stomach flu" that was actually a perforated appendix.
🗝️ Pediatric Emergencies: High-stakes pediatric cases were central, including metabolic disorders like hyperammonemia, non-accidental trauma investigations, and the tragic consequences of unvaccinated children (Pertussis).
🗝️ Surgical Innovation: The show featured field procedures like Dr. Rasgotra's roadside laparotomy and complex ER interventions like the emergency tracheotomy for a LeFort fracture.
🗝️ Chronic Disease Consequences: The long-term impact of conditions like diabetes (DKA), hypertension (teen heart failure), and alcoholism (variceal bleeding) was starkly portrayed.
🗝️ Ethical Dilemmas: The season tackled complex issues such as HIV-positive organ transplantation, the management of hunger strikes, and the treatment of patients with factitious disorders.
Keywords: Medical Diagnoses ER Season 12
Medical Diagnoses ER Season 12
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