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From the 5/14/2021 release of VAERS data (an older release, current is 11/26/2021):

This is VAERS ID 1180145

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Case Details

VAERS ID: 1180145 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Illinois  
Vaccinated:2021-03-04
Onset:2021-03-26
   Days after vaccination:22
Submitted: 0000-00-00
Entered: 2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 2 AR / IM

Administered by: Other       Purchased by: ?
Symptoms: Blood magnesium normal, Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-26
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: 1/21/2021 Acute diarrhea negative for C.diff; 2/4/21 labs WBC 2.83, RDW-CV 15.3, Platelet Count 437, Neut # 1.50; Labs obtained from Hosiptal.
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Low Magnesium levels 2/24 Mag 1.5, 3/4 received 4gm Mag Sulfate, 3/8 Mag 1.6 (obtained from Hospital. Death within 30 days of vaccination


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20210514&IDNUMBER=1180145


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