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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1579983

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Case Details

VAERS ID: 1579983 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Cardiac arrest, Hallucination
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
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? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: PLPFIZER INC202100990208

Write-up: hallucinations; cardiac arrest; died as a result of cardiac arrest; This is a spontaneous report from a contactable physician. This report was received via a sales representative. A 35-year-old male patient received bnt162b2 (COMIRNATY), via an unspecified route of administration on an unspecified date (Batch/Lot Number: unknown) as dose 2, single for covid-19 immunisation. The patient''s medical history and concomitant medications were not reported. In a patient with a massive physique, a few days after receiving 2 doses of Comirnaty, hallucinations appeared. The patient was taken to the hospital, where he died as a result of cardiac arrest. The reporting person claims that the patient was healthy. The patient died on an unspecified date. It was not reported if an autopsy was performed. Outcome cardiac arrest was fatal while for hallucinatons was unknown. No follow-up attempts are possible. No further information is expected. Information on batch/lot number cannot be obtained.; Reported Cause(s) of Death: cardiac arrest


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