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

This is VAERS ID 1189311



Case Details

VAERS ID: 1189311 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-12
Onset:2021-03-13
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP 2166 / 2 RA / OT

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Cardiac failure, Heart rate
SMQs:, Cardiac failure (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-13
   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: FURADANTIN; OMEPRAZOL SANDOZ [OMEPRAZOLE]; NITROLINGUAL; ALVEDON; UREA; IMPUGAN [FUROSEMIDE]; ENALAPRIL SANDOZ; BISOPROLOL SANDOZ; OXASCAND; ISONOVA; ALLOPURINOL SANDOZ; WARAN; ZOPICLONE ACTAVIS
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Atrial fibrillation; Cardiac failure
Allergies:
Diagnostic Lab Data: Test Date: 20210312; Test Name: blood pressure; Result Unstructured Data: Test Result:without remark; Test Date: 20210312; Test Name: pulse; Result Unstructured Data: Test Result:without remark
CDC Split Type: SEPFIZER INC2021371022

Write-up: death/Cause of death: cardiac failure; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority SE-MPA-2021-020843, Safety Report Unique Identifier SE-MPA-1615988685350. A 92-year-old female patient received bnt162b2 (COMIRNATY, lot number EP 2166 and expiration date not provided), intramuscular, administered in Arm Right second dose on 12Mar2021 at 0.3 mL, single for covid-19 immunisation. The patient''s medical history included atrial fibrillation and cardiac failure. The patient''s concomitant medications included nitrofurantoin (FURADANTIN) from 13Aug2020 at 150 mg, 1x/day; omeprazole (OMEPRAZOL SANDOZ [OMEPRAZOLE]) from 22Jun2020 at 20 mg, 1x/day; glyceryl trinitrate (NITROLINGUAL) from 22Jun2020 at 0.4 mg, as needed; paracetamol (ALVEDON) at 1000 mg, as needed; urea from 16Jul2020 at Lubricate as needed; furosemide (IMPUGAN [FUROSEMIDE]) from 16Jul2020 at 80 mg, 1x/day; enalapril maleate (ENALAPRIL SANDOZ) from 22Jun2020 at 10 mg, 1x/day; bisoprolol fumarate (BISOPROLOL SANDOZ) from 22Jun2020 at 5 mg, 1x/day; oxazepam (OXASCAND) from 22Jun2020 at 5 mg, 1x/day; isosorbide mononitrate (ISONOVA) from 22Jun2020 at 30 mg, 1x/day; allopurinol (ALLOPURINOL SANDOZ) from 07May2020 at 300 mg, 1x/day; warfarin sodium (WARAN) from 07May2020 at according to special prescription; and zopiclone (ZOPICLONE ACTAVIS) from 22Jun2020 at 5 mg, 1x/day. The patient historical vaccine includes bnt162b2 (COMIRNATY) first dose on Jan2021 for COVID-19 immunization. It was reported that patient received the second dose on 12Mar2021, the patient appeared to be as usual. No fever. Pulse and blood pressure without remark. The next day on 13Mar2021, the patient was found dead in her bed. The cause of death was cardiac failure. The patient died on 13Mar2021. An autopsy was not performed. No follow-up attempts are possible, information on batch number cannot be obtained.; Reported Cause(s) of Death: death/Cause of death: cardiac failure


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