As the number of medically complex children increases, pediatricians and emergency physicians face challenges in evaluating complications from devices placed to treat their underlying conditions. We present a child with spina bifida who developed a perforation of his vesicostomy leading to peritonitis, septic shock, and urgent externalization of his ventriculoperitoneal shunt. Multiple consultants may need to be promptly involved in the management of children with underlying medical problems. Because procedural complications are often reported only in the surgical specialty literature, pediatricians and emergency physicians should seek information from their patients' specialists about potential problems.