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From the 10/8/2021 release of VAERS data:

This is VAERS ID 1104931



Case Details

VAERS ID: 1104931 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-02-07
Onset:2021-02-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8723 / 2 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Death, Incorrect route of product administration
SMQs:, Drug abuse and dependence (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-13
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Atrial fibrillation; Dyspnoea exertional; Primary hyperthyroidism
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DEPFIZER INC2021266972

Write-up: Unknown cause of death; intravenous; This is a spontaneous report from a non-contactable consumer downloaded from the regulatory authority-WEB DE-PEI-CADR2021017125. An 82-year-old female patient received second dose of BNT162B2 (COMIRNATY), intravenous on 07Feb2021 (Lot Number: EL8723) at single dose for COVID-19 immunisation. Medical history included ongoing primary hyperthyroidism, ongoing atrial fibrillation and ongoing dyspnoea exertional. The patient''s concomitant medications were not reported. The patient previously received first dose of BNT162B2 (COMIRNATY) on 17Jan2021 for COVID-19 immunization. The patient death occurred on 13Feb2021, unknown cause of death. It was not reported if an autopsy was performed. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Unknown cause of death


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1104931

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