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

This is VAERS ID 1055869

Case Details

VAERS ID: 1055869 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Foreign  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: ?
Symptoms: Diarrhoea, Malaise, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-12
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic liver disease; Psychiatric disorder NOS
Diagnostic Lab Data:
CDC Split Type: ESPFIZER INC2021181693

Write-up: Diarrhea; Malaise; Muscular weakness; This is a spontaneous report from a contactable physician downloaded from the Agency ES-AEMPS-750879. A 68-year-old male patient received bnt162b2 (COMIRNATY) via an unspecified route of administration on 11Feb2021 at single dose for COVID-19 immunisation. Medical history included neuro-psychiatric disorders and chronic liver disease. Concomitant medications were unknown. The patient experienced diarrhea, malaise, muscular weakness on 11Feb2021. The patient was stable but 4 hours after vaccination he begins to complain, muscle weakness, at 6 hours there were 4 liquid stools until he died on 12Feb2021 at 18 hours after vaccination. It was unknown if autopsy was performed. Outcome of all events was fatal. No follow-up attempts are possible, information on lot/batch number cannot be obtained.; Reported Cause(s) of Death: diarrhea; malaise; muscular weakness

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