From the 12/31/2003 release of VAERS data (an older release, current is 2/26/2021):

This is VAERS ID 113717

Case Details

VAERS ID:	113717 (history)
Form:	Version .0
Age:	53.6
Sex:	Male
Location:	Tennessee

Vaccinated:	1998-05-20
Onset:	1998-05-26
Days after vaccination:	6
Submitted:	1998-06-02
Days after onset:	7
Entered:	1998-09-01
Days after submission:	91

Vaccination / Manufacturer	Lot / Dose	Site / Route
HEP: ENGERIX-B / SMITHKLINE	2186A4 / 1	RA / IM

Administered by: Public Purchased by: Unknown
Symptoms: LIVER FAIL
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 1998-05-26
Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Hep B vax dose 1;
Current Illness: liver failure
Preexisting Conditions: NKA, liver failure
Allergies:
Diagnostic Lab Data: liver failure
CDC Split Type: NKA, liver failure

Write-up: liver failure

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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=113717