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From the 5/7/2021 release of VAERS data:

This is VAERS ID 1142674

Case Details

VAERS ID: 1142674 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Female  
Location: Minnesota  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-03-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Autopsy, Chills, Death, Fatigue, Feeling abnormal, Feeling cold, Hypersomnia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-27
   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: 5 mg prednisone, apixaban, metoprol, simvastatin 20 mg, oxygen 3L
Current Illness: Covid (January 20-30th)
Preexisting Conditions: Heart Failure, COPD, Myositis, resolved pulmonary embolism, possible lung cancer - undetermined
Allergies: None
Diagnostic Lab Data: Her body is at the medical examiner''s for a partial autopsy
CDC Split Type:

Write-up: She developed chills she couldn''t control and fell asleep all afternoon, evening and through the night. I spoke with her twice and my uncle and aunt checked on her three times, all three she was freezing cold and too tired to get up. In the morning, she was dazed, cold and walked to the bathroom, where she collapsed to her death. Paramedics could not revive her. My mom died Saturday morning - within the 24-hour period of her vaccine. She was feeling so great leading up to it, active, stripping the guest bedroom sheets, bubbly, and excited for us to be able to finally visit her soon.

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