A German woman has died after she lost her arm in a shark attack last week in Maui, Hawaii.
Jana Lutteropp, 20, who had been on life support, died at Maui Memorial Medical Centre, a hospital spokesperson said.
Ms Lutteropp was snorkeling off the coast of the Big Island when she was attacked by the animal.
She is just one of the victims in a recent spike in attacks in the island's surrounding waters.
"Jana fought hard to stay alive," her mother and sister said in a statement. "However, we are sad to say that she lost her fight today."
Ms Lutteropp was snorkeling 100 yards off Palauea Beach at the resort community of Makena when the shark swam toward her and bit off her arm.
An American school teacher on holiday jumped into the water to rescue the 20-year-old after hearing her scream and seeing blood in the water. Rick Moore, 57, said Ms Lutteropp went in and out of consciousness and kept repeating that she was going to die.
It it not known what type of shark bit her but state officials are beginning an investigation into the movements of tiger sharks in the area,
"Jana was a very beautiful, strong, young woman who was always laughing, and we will forever remember her that way," continued the statement.
"We appreciate all the support from the Maui community, as well as the prayers and thoughts from around the world and in Germany."
The head of the state Department of Land and Natural Resources, the agency responsible for Hawaii's waters, added that he was sorry for the family's loss.
"As an island state, we are aware that we are all visitors in the natural environment that surrounds us, and that unfortunate incidents such as this one can occur," William Aila said.
"We are committed to furthering research efforts that will help guide effective management actions in the interest of safety."
Mr Aila said earlier this week that Hawaii waters are safe if swimmers take safety precautions.
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The prevailing opinion in Hawaii, however, is that there are more sharks and more people in Hawaiian waters, resulting in a higher ratio of attacks.
He added: "We know that the impression is that there is an inordinate amount of shark attacks that have happened recently."
"We just want to make it clear that within the history of the state of Hawaii, the number of shark attacks have gone up, and they've gone down, and there have been some years we've actually had no shark attacks."
