Learning Objectives:

1.  Use medical information learned to impact and improve patient care.

2.  Apply medical knowledge gained to target and care for complex patients.

3.  Effect changes to improve quality of care and reduce or avoid medical errors.

4.  Discuss patient with refractory ITP who ultimately passed away from complications of her disease.

5.  Brief review of ITP management guidelines and recommendations for refractory disease.

6.  Discuss what could have been done differently or any clinical practice changes that could been enacted.