This case involves a 13-year-old male who presented to the emergency department complaining of lower abdominal pain. He was assessed by a nurse practitioner and diagnosed with a viral illness. The patient was subsequently discharged. Two days later, the patient presented to the same emergency department complaining of severe abdominal pain along with testicular pain. An ultrasound showed testicular tortion, and it was decided that the patient would undergo correctional surgery immediately. Despite the operation being critical and time sensitive, the patient was not taken to the operating room until 7pm that evening — over 8 hours after the decision was made to operate. The patient suffered from testicular atrophy and required an orchiectomy to remove his right testicle the following week.