This is a level 40 Talisman. Since Death can never reach level 40, he is unable to equip it as its in-game description states, "A sacrificial artifact of unknown origins." The purpose of this item is to be sacrificed into one of Death's possessed weapons. Since this item has no abilities, it will not affect the number of choices for the abilities available when sacrificed. If sacrificed alone, it will only upgrade the abilities on the possessed weapon and will not let Death pick another ability.