This case involves a male patient who presented to the emergency room complaining of chest pain and shortness of breath. An EKG, chest x-ray, and other testing was done yielding normal results. After a short time, the patient was discharged from the hospital on and advised to follow up with his primary care physician. A few days later, the patient saw his primary care physician who ordered additional pulmonary function tests. The patient returned to his primary care doctor a few days later, where he was told that his tests had come back and seemed to indicate chronic obstructive pulmonary disease. The doctor ordered a CT chest for the patient, however the patient was found dead in his home before the test could be conducted. An autopsy was later performed which revealed acute pleuritis and empyema and pulmonary emphysema.