A 47 year old Michigan man with a history of hypertension presented to the ER with acute abdominal pain. A chest X-ray revealed mediastinal widening. A surgery consult was called as cholecystitis was suspected. That night the patient complained of severe chest pain and subsequently died from a ruptured aortic aneurysm. A medQuest general surgeon/osteopath reported that the mediastinal widening and pain, the primary indications of an aortic aneurysm, were negligently misdiagnosed. Timely surgery would have prevented the patient's death.