Elderly female suspected of necrotic at pfn site for left it fracture fixation was on higher antibiotics ( tidezolid, teicoplanin, meropenem, aztreonam) pt underwent nail removal and debridement intra op 500ml blood loss after recieving pt in icu on norad ds of 4ml/hr had around 200ml of blood loss, pts shock further worsens and soakage of dressing was there, over night pt went on mech support, vasopressin @3.6ml/hr,dobutamine@3.4ml/hr, norad @22ml/hr, adrenaline @ 4