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

This is VAERS ID 1174531



Case Details

VAERS ID: 1174531 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Foreign  
Vaccinated:2021-02-17
Onset:2021-03-21
   Days after vaccination:32
Submitted: 0000-00-00
Entered: 2021-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP9598 / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Blood potassium, 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: 2021-03-21
   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: APROVEL; ATORVASTATIN; BISOPROLOL; EUPRESSYL [URAPIDIL]; KAYEXALATE; LEVEMIR; LOXEN [NICARDIPINE HYDROCHLORIDE]; PLAVIX; VENOFER
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Arterial hypertension; Blindness; Coronary artery disease; Diabetes; Dialysis (last dialysis on 19Mar2021); Leg amputation; Peripheral obliterative arteriopathy; Retinopathy
Allergies:
Diagnostic Lab Data: Test Name: K; Result Unstructured Data: Test Result:6
CDC Split Type: FRPFIZER INC2021358142

Write-up: Sudden death; This is a spontaneous report from a contactable physician downloaded from the regulatory authority-WEB, regulatory authority number FR-AFSSAPS-MA20211056. A 66-year-old male patient received bnt162b2 (COMIRNATY), first dose via intramuscular on 17Feb2021 (Batch/Lot Number: EP9598) as single dose, then second dose via intramuscular on 17Mar2021 (Batch/Lot Number: ET3620) as single dose for COVID-19 immunization. Medical history included diabetes, coronary artery disease, Arteriopathy obliterans of the lower limbs with amputation of both legs, retinopathy with blindness in one eye, dialysis (last dialysis on 19Mar2021), and arterial hypertension. Concomitant medication included irbesartan (APROVEL); atorvastatin; bisoprolol; urapidil (EUPRESSYL [URAPIDIL]); sodium polystyrene sulfonate (KAYEXALATE); insulin detemir (LEVEMIR); nicardipine hydrochloride (LOXEN [NICARDIPINE HYDROCHLORIDE]); clopidogrel bisulfate (PLAVIX); and saccharated iron oxide (VENOFER), all for unspecified indication. The patient had sudden death following the second vaccination of bnt162b2. The patient underwent lab tests and procedures which included blood potassium: 6 on an unspecified date. The patient died on 21Mar2021. 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: Sudden death


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