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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1210642



Case Details

VAERS ID: 1210642 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-26
Onset:2021-03-27
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET3620 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: 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: 2021-03-27
   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: METFORMINE [METFORMIN]; CARDENSIEL; ALPRAZOLAM; ZOLOFT
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Depression; Hypertension; Overweight; Type 2 diabetes mellitus
Allergies:
Diagnostic Lab Data:
CDC Split Type: FRPFIZER INC2021380165

Write-up: Sudden death; This is a spontaneous report from a contactable Physician downloaded from the Agency Regulatory Authority-WEB. The Regulatory Authority report number is FR-AFSSAPS-BX20212598. An 89-year-old female patient received the first dose of BNT162B2 (COMIRNATY, Lot Number: ET3620 and expiration date not reported), intramuscular, administered in the left arm on 26Mar2021 as a single dose for COVID-19 immunisation. Medical history included Type 2 diabetes mellitus, Depression, Overweight, Hypertension; all from an unknown date and unknown if ongoing. Concomitant medications included metformin (METFORMINE), bisoprolol fumarate (CARDENSIEL), alprazolam, and sertraline hydrochloride (ZOLOFT). The patient is autonomous at home and went to bed around 8:30 pm to 9 p.m. On 27Mar2021, the patient experienced sudden death. Presence of a basin next to the bed and there was no sign of struggle. The patient died on 27Mar2021. 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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