MedStar Washington Central Hospital— they see plenty of gunshots. A femoral bleed would not be hidden. Femoral arterial bleeds pretty evident, and surgically corrected.
What could be going on is if bone chips went into abdominal/gut and sepsis is happening. Temp spikes and blood bacterial count up. In the Civil War, such a hip strike by a much larger and slower minie ball mean shattered bone and death by sepsis.
Dr. Paul tended to him as he could- there are no details as to what that was or could do with ... nothing but their hands for pressure. He was on plasma in the video to the medevac helo, 4 minutes to the Level 3 Trauma center on their helo deck.
Prayers.
During the time of surgery, yes they would notice, but you can bleed a gallon into your upper leg and hip before you go for surgery. IOWs the extent of damage may not have been so apparent until they got in there. I agree, it’s got to be more likely the extent of injuries that may have caused ischemia. The bullet (s) may have hit the femoral head causing havoc. Still, I would think compared to your worse case military trauma, he was seen quickly and stabilized. Sepsis takes around 72 hours. REmember with Reagan, it was by lucky chance that they picked up his pneumothorax. Scalise may have been hit in other areas as well.