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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1045458



Case Details

VAERS ID: 1045458 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-28
Onset:2021-01-29
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM0477 / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Glomerular filtration rate, Sudden death
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-29
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OMEPRAZOL; ZOLPIDEM; LOPERAMIDE; FOLIUMZUUR; SOTALOL; CITALOPRAM; FUROSEMIDE
Current Illness: Cardiac disorder; Vascular dementia
Preexisting Conditions: Medical History/Concurrent Conditions: Tuberculosis
Allergies:
Diagnostic Lab Data: Test Name: lab; Result Unstructured Data: Test Result:55
CDC Split Type: NLPFIZER INC2021158439

Write-up: Sudden death; This is a spontaneous report received from a contactable Physician, downloaded from the regulatory authority NL-LRB-00441531. An 82-year-old female patient received bnt162b2 (COMIRNATY, lot number EM0477), via an unspecified route of administration on 28Jan2021 at single dose for covid-19 immunisation. Medical history included tuberculosis, ongoing cardiac disorder, ongoing vascular dementia. Concomitant medication included omeprazole (OMEPRAZOL), zolpidem, loperamide, folic acid (FOLIUMZUUR), sotalol, citalopram and furosemide. The patient experienced sudden death on 29Jan2021. The patient underwent lab tests and procedures which included eGFR (glomerular filtration rate): 55 on unknown date. The patient was found deceased on the toilet the day after vaccination. Reported other possible cause was suspicion of colon malignity. The patient died on 29Jan2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Sudden death; suspicion of colon malignity


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1045458

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