The controversy surrounding the death of George Washington was immediate, intense, and continues today. After a horse ride in sleet and snow, Washington developed fulminant acute epiglottitis that rapidly claimed his life within 24 hours. In treatment, he endured phlebotomy of over 2500 mL as well as various other painful therapies that were the standard practice of the day. Over the years, numerous criticisms have been lodged against the care his three physicians rendered. Although the marked bloodletting has been most heavily scrutinized, others have argued that Washington could have survived had a tracheostomy been performed. Delayed presentation, prolonged Class IV hemorrhagic shock, acute respiratory failure, and probable septic shock in a 67 year old with preexisting medical comorbidities has a high mortality rate today and would have been irreversible in 1799. George Washington's inevitable death was assured by his own initial actions compounded by the treatments initiated by his physicians.