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

This is VAERS ID 1225102



Case Details

VAERS ID: 1225102 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-09
Onset:2021-03-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP9605 / 1 LA / OT

Administered by: Other       Purchased by: ?
Symptoms: Blood pressure measurement, Dyspnoea, Heart rate, Hypertension, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-09
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Breathing difficult; Carotid artery dissection; Hypertension
Allergies:
Diagnostic Lab Data: Test Date: 20210309; Test Name: blood pressure; Result Unstructured Data: Test Result:140/80; Test Date: 20210309; Test Name: heart rate; Result Unstructured Data: Test Result:120; Comments: 120 bpm
CDC Split Type: FRPFIZER INC2021363175

Write-up: Hypertension arterial; Tachycardia; Dyspnoea; This is a spontaneous report from a contactable physician downloaded from a regulatory authority-WEB, regulatory authority number FR-AFSSAPS-PO20211393. An 85-year-old female patient received bnt162b2 (COMIRNATY, Batch/Lot Number: EP9605), dose 1 intramuscular, administered in Arm Left on 09Mar2021 14:30 (at the age of 85years) as single dose for Covid-19 immunization. Medical history included hypertension from an unknown date and unknown if ongoing; and breathing difficult on 07Mar2021. The patient''s concomitant medications were not reported. History: treatment with blood pressure medication (name of medication not given); mention of old carotid dissection according to the medical examiner; the doctor does not want to communicate about the patient''s history. According to the attending physician, he came on Sunday 07Mar2021 at 1 pm to check the patient''s blood pressure, she had breathing difficulties during the weekend. Declaration by a forensic doctor of the death of a patient who received the Comirnaty vaccine the same day: the physician transferred the information because of the ongoing forensic investigation autopsy in progress. On 09Mar2021, the patient was vaccinated with Comirnaty vaccine, lot number: EP9605, left arm, first injection on 09Mar2021 at 2:30 pm. During the pre-vaccination consultation, nothing to report; on 09Mar2021: around 7:50 pm, BP at 140/80 but dyspnea stage II (as since Sunday according to the attending physician) and especially tachycardia at 120 bpm and the attending physician specifies "in this context, there is every reason to look for a latent coronary insufficiency". The doctor writes his letter to the emergency room and contacts a cab to take her to the emergency room; the cab driver discovers the patient face down on the ground, he informed the attending physician who contacts the Emergency medical services; the Emergency medical services takes charge of the patient: he notices traces of blood in the mouth, blood on the internal face of the surgical mask resuscitation gestures carried out: external cardiac massage, intubation, ventilatory maneuvers, infusion of adrenaline 6 mg, thrombolysis 7 ml were given; death noted on 09Mar2021 at 9:13 pm by the doctor of the Emergency medical services. Conclusion: unexplained death within 24 hours after the vaccination, not attributable to the only effects presented on 09Mar2021 and described by the attending physician without precise information on the patient''s medical history. The patient died on 09Mar2021. An autopsy was performed, and results were not available.; Reported Cause(s) of Death: Hypertension arterial; Tachycardia; Dyspnoea


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