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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1194600



Case Details

VAERS ID: 1194600 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Female  
Location: Virginia  
Vaccinated:2021-04-08
Onset:2021-04-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 RA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Acute cardiac event, Death, Malaise, Somnolence
SMQs:, Myocardial infarction (narrow), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Other ischaemic heart disease (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-08
   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: Lisinopril We think High Blood pressure medicine as well She had been prescribed Sertraline but do not believe she was taking it
Current Illness:
Preexisting Conditions: Asthma High Blood Pressure High Cholesterol
Allergies: Penicillin and Shellfish
Diagnostic Lab Data: Medical Examiner suspects cardiac event, however, she left work early not feeling well Thursday evening (falling asleep at work) and no one heard from her after that. No time of death has been given but we are assuming Thursday evening since no one heard from her. They are going to cremate her tomorrow and we want to make sure if any tests need to be done, we can have them hold off. We feel it necessary for you to do an autopsy to confirm cause of death.
CDC Split Type:

Write-up: Death She was found Saturday Apr 10th deceased at her home.


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