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

This is VAERS ID 1161342



Case Details

VAERS ID: 1161342 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:2021-03-18
Onset:2021-03-19
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET3620 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiac arrest, Cardio-respiratory arrest, Electrocardiogram, Sudden death
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-19
   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:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Arterial hypertension; COPD; Glaucoma
Allergies:
Diagnostic Lab Data: Test Date: 20210319; Test Name: ECG; Result Unstructured Data: Test Result:asystole
CDC Split Type: ESPFIZER INC2021333412

Write-up: Death sudden/cardiorespiratory arrest; Death sudden/cardiorespiratory arrest; Asystole; This is a spontaneous report from a contactable physician downloaded from the regulatory authority-WEB, regulatory authority number ES-AEMPS-799295. An 87-year-old male patient received bnt162b2 (COMIRNATY), dose 2 via an unspecified route of administration on 18Mar2021 (Batch/Lot Number: ET3620) as SINGLE DOSE for covid-19 immunisation. The patient received first dose of COMIRNATY on 25Feb2021 (lot number: EP2163) for COVID-19 vaccination. Medical history included glaucoma, COPD, Arterial hypertension. The patient''s concomitant medications were not reported. On 19Mar2021, the patient experienced death sudden due cardiorespiratory arrest. The report described that: "We were notified for possible cardiorespiratory arrest. Despite the fact that the son (nurse) began basic CPR maneuvers for 10-15 min until our arrival, the absence of vital signs persisted and the ECG revealed asystole." The patient underwent lab tests and procedures which included ECG: asystole on 19Mar2021. The patient died on 19Mar2021. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Cardiorespiratory arrest; Sudden death; Asystole


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