A Step Too Far is the seventeenth episode of the fourth season and the 71st overall episode of Private Practice.

Short SummaryEdit

At the launch party for Violet's book, Sheldon falls for the smart, beautiful Dr. Marla Thomkins, even though she's the critic who panned Violet's tome. Meanwhile, Addison's and Pete's patient is caught in a love triangle with her brother-in-law and sister, for whom she is a surrogate, and Cooper and Sam try to convince a family to make their son's health a priority over his successful wrestling career.

Full SummaryEdit

Episode in detail.


  • Addison Montgomery
  • Pete Wilder
  • Cooper Freedman
  • Charlotte King
  • Sheldon Wallace
  • Amelia Shepherd
  • Sam Bennett
  • Violet Turner
  • Marla Thomkins
  • Randy Hatcher
  • Stacy Hatcher
  • Elliott
  • Lorraine
  • Claudine
  • Tyler Hatcher
  • Anesthesiologist
  • Coach Patterson

Main CastEdit

Guest StarsEdit


Medical NotesEdit

Addison Forbes MontgomeryEdit

  • Diagnosis:
  • Doctors:
  • Treatment:
    • Antacid

Addison woke up and vomited. When she got to work, she used an antacid to treat herself. Amelia suspected that Addison might be pregnant. Addison took a pregnancy test and it came back negative.


  • Diagnosis:
    • Cancer
  • Doctors:
    • Pete Wilder (alternative medicine practitioner)
    • Oncologist
  • Treatment:
    • Radiation

Lorraine was examined by Pete, who asked if it hurt. She said it didn't and was surprised that she was cancer- and pain-free.


  • Diagnosis:
    • Pregnancy
    • Uterine tear
  • Treatment:
    • C-section delivery
    • Hysterectomy

Claudine was acting as a surrogate for her sister, Lorraine, and her husband, Elliott. While her sister was being examined, she had a pain in her abdomen. Pete called Addison for a consult. Addison told her she was in labor. Her regular OB was gone for the week, so Claudine asked Addison to deliver her baby. The baby went into distress and Claudine had to be taken in for a c-section. After Addison delivered the baby, there was bleeding. Addison said she had lacerated one of the uterine arteries. In order to control the bleeding, Addison had to perform an emergency hysterectomy. Despite this, Claudine handed the baby over to Lorraine.

Tyler HatcherEdit

  • Diagnosis:
    • Hypertrophic cardiomyopathy
    • Cardiac arrest
  • Treatment:
    • Medically induced coma

Tyler, 17, came in to see Cooper after getting dizzy while wrestling. Cooper heard a heart murmur and wanted them to get a consult from Sam. Sam diagnosed hypertrophic cardiomyopathy, but said it was probably safe for Tyler to continue wrestling, since his only symptom was dizziness. Despite that, Cooper said he couldn't recommend that he continue to wrestle. He ordered a cardiac MRI. His father agreed to have him stop wrestling, but his mother took him to the match anyway, with a forged medical consent. Cooper and Sam went to the match, which Tyler won. Shortly after the end of the match, Tyler went into cardiac arrest. They were able to get his heart re-started, but they had to put him into a medically induced coma in order to let his brain recover from the time of prolonged oxygen deprivation.


Song Performer Scene
"Everything She Wants" Wham!
  • Pete reads reviews of Violet's book to her. She finds a negative review.
  • Addison vomits into a toilet. Sam checks on her and she gets angry with him.
  • Pete examines his patient.
"I'm Your Life" Chrisette Michele
  • The doctors mill around Violet's book party.
  • Amelia asks Addison about her drink.
  • They toast to Violet's book.
  • Violet worries about Marla's review. Pete tells her not to let Marla ruin the party for her.
  • Sheldon eyes Marla from across the room. Sam encourages him to go for it.
  • She comes over and introduces herself to him. Marla knows who he is from his work.
  • Violet and Pete thank Sheldon for standing up for Violet.
"Second Wind" Trent Dabbs
  • Addison does a c-section on Claudine. Claudine has come bleeding after delivery.
  • Tyler's dad says he agrees with the doctors, but Stacy hasn't brought Tyler in.
  • Sheldon and Marla have dinner together. Sheldon defends Violet, but Marla stands strong.
  • Addison tells Claudine she had to do a hysterectomy.
  • Claudine and Elliot decide to keep the baby.
  • Sam and Cooper tell Tyler's coach to stop the match.
  • Tyler wins, but collapses shortly afterward.
"Miss Previously Loved" Gareth Dunlop
  • Pete and Lorraine talk about Claudine.
  • Lorraine feels like she's lost everything, but Pete encourages her to fight.
  • Sheldon asks Cooper if he can date Marla. Cooper says he can't.
  • Addison brings the baby to Claudine and tells her she can't have her sister's husband and baby.
"Always Remember Me" Ry Cuming
  • Tyler's parents sit by his bedside and cry.
  • Addison tells Amelia she's not pregnant.
  • Cooper vents to Charlotte about Tyler. Charlotte reassures him.
  • Sheldon goes to Marla's hotel room.
  • Violet starts to believe what Marla said was true. Pete reassures her and they start kissing.
  • Addison tells Sam she's not pregnant. She asks him for a firm answer on whether or not he'll have a child with her.

Notes and TriviaEdit

Private Practice 4x17 - PROMO - A Step Too Far

Private Practice 4x17 - PROMO - A Step Too Far

  • This episode scored 7.93 million viewers.
  • The episode was filmed in early February, 2011.


Episode StillsEdit


See AlsoEdit

A complete overview of this episode's crew can be found here.

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