BACKGROUND:An 11-year-old girl had undergone posterior spinal fusion surgery for scoliosis. The surgery was complicated by intraoperative bleeding, and hemostasis was achieved by topically applying gelatin sponges. CASE DESCRIPTION:She developed acute pulmonary embolism and cardiac arrest during the surgery, which was confirmed by transesophageal echocardiography. CONCLUSIONS:Autopsy shortly after revealed that her death was associated with unintended intravascular entry of gelatin sponge fragments, resulting in an embolic event and secondary cardiopulmonary collapse.