Among the people who have watched every single episode of House, and some of them several times, I think I was one of the few who didn't know anything about this episode before watching it. The opening shots made it clear that some violent scene would happen, but I had no idea that one of the ducklings would get hurt.
The whole sequence starting with the struggle down to the OR was excellent. It was intense and credible - in one word - amazing.
I got lucky - I am certain that I would have been much less impressed if I had read the "one of the ducklings will get injured" info before watching it.
Of course the episode has the usual "been-there-done-that" problems, but it deserves a '10' for the atmoshere alone.