Arthrographis kalrae

Record number: 
186
Adverse Occurrence type: 
MPHO Type: 
Time to detection: 
months
Alerting signals, symptoms, evidence of occurrence: 
Young woman developed fungal infection and heart valve was explanted at 7 months. She died of infection at 13 months after allografting. Same yeast was found on heart valves processed from a different donor on the same day.
Demonstration of imputability or root cause: 
Disputed in court and settled out of court. Possible contamination during processing highly probable that it was donor derived due to cause of death.
Imputability grade: 
2 Probable
Suggest references: 
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