OBJECTIVES: Exposure to topical bovine-derived thrombin has been associated with post-operative immune-mediated coagulopathy (IMC). Although rare, IMC has been associated with poor outcomes and additional clinical and financial burden. Formal economic analyses of IMC events have not been performed, in part due to the lack of specific diagnostic codes. The goal of this descriptive study was to develop a novel approach to estimate the economic burden and resource utilization in patients where the presence of this adverse event was suspected. METHODS: Data for bovine thrombin-exposed patients discharged between January 2005 and March 2009 were extracted from Premier’s Perspective™ database. Coagulopathies were identified utilizing a clinical algorithm based on laboratory tests and/or consultations consistent with investigation of suspected coagulopathies, including IMC. The index hospitalization was the first observed use of bovine thrombin and suspected IMC in the study period. Length of stay (LOS), ICU LOS, total, and departmental costs per patient were calculated for the index hospitalization and any subsequent hospitalization with suspected coagulopathy. Costs were adjusted to 2009 dollars. RESULTS: A total of 450 patients exposed to bovine thrombin met the defined criteria for a suspected coagulopathy during their index hospitalization. Five of these patients had suspected coagulopathy during a subsequent hospitalization. The estimated total cost [median (range)] associated with the index and subsequent hospitalizations was $62,373 ($1,385‑$1,368,706), including costs in pharmacy $7,404 ($237-$990,267), laboratory $6,098 ($247‑$250,718), and blood bank $3,019 ($15-$264,943). Total hospital LOS [median (range)] was 21 days (1-1,027), with a median ICU LOS of 13 days (2-161). CONCLUSIONS: The approach used in this study may be useful in quantifying the medical resources utilized by patients developing IMC after exposure to bovine thrombin. Further evaluation of the cost of IMC is warranted because these iatrogenic events may be preventable.