Questions 4-5: Did the recipient experience a complication of infusion requiring a transfer to an intensive care unit?

Report whether the recipient required a transfer to the intensive care unit due to a complication directly related to the infusion. If “yes” report the date of transfer to the intensive care unit in question 5. Otherwise, report “no” and continue to question 6.

Question 6: Did the patient develop sepsis requiring pressor support?

Report whether the patient developed sepsis and required pressor support. If “yes” report the date pressor support started in question 7. Otherwise, report “no” and continue to question 8.

Question 7: Date pressor support required:

Indicate date pressor support was required.

Question 8: Did the recipient die as a result of organ failure?

If the recipient died as a result of organ failure, select “yes” and submit the form.

If the recipient did not die as a result of organ failure, select “no” and submit the form.

Last modified: Jan 27, 2020

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