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

This is VAERS ID 1202941



Case Details

VAERS ID: 1202941 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-01-01
Onset:2021-02-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / OT

Administered by: Other       Purchased by: ?
Symptoms: Peripheral embolism
SMQs:, Embolic and thrombotic events, arterial (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PRIMPERAN; FURIX [FUROSEMIDE]; FRAGMIN; OXYCONTIN; ALVEDON
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Abdominal aortic aneurysm; Deep vein thrombosis; Diabetes mellitus; Hypertension; Lung cancer metastatic
Allergies:
Diagnostic Lab Data:
CDC Split Type: SEPFIZER INC2021380341

Write-up: arterial embolism in the leg; This is a spontaneous report from a contactable physician downloaded from the regulatory authority, regulatory authority number SE-MPA-2021-021667. An 86-year-old female patient received bnt162b2 (COMIRNATY), dose 1 intramuscular in Jan2021 (Batch/Lot Number: not reported) as single dose for Covid-19 immunization. Medical history included lung cancer metastatic, diabetes mellitus, hypertension, abdominal aortic aneurysm, and deep vein thrombosis; all from an unknown date and unknown if ongoing. Concomitant medications included metoclopramide hydrochloride (PRIMPERAN), furosemide (FURIX), dalteparin sodium (FRAGMIN), oxycodone hydrochloride (OXYCONTIN), and paracetamol (ALVEDON); all taken for an unspecified indication, start and stop date were not reported. The patient got an arterial embolism in the leg 12 days after dose 1 of Comirnaty, which was treated acutely and despite the ongoing high dose low molecular treatment with Fragmin (dalteparin) as treatment for deep vein thrombosis the patient had a new thrombosis shortly afterwards and had to amputate her leg. The patient got slightly better but did not recover and died 36 days after the vaccination. The cause of death was reported as "lung cancer metastatic". The patient died on an unspecified date (36 days after the vaccination). An autopsy was not performed (Autopsy will not be performed). The report was assessed as serious, death, life threatening by health authority. No follow-up attempts are possible, information on batch number cannot be obtained.; Reported Cause(s) of Death: Lung cancer metastatic


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