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From the 5/14/2021 release of VAERS data (an older release, current is 11/19/2021):

This is VAERS ID 973957

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Case Details

VAERS ID: 973957 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: North Carolina  
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-01-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: ?
Symptoms: Activated partial thromboplastin time shortened, Blood pressure increased, Computerised tomogram head abnormal, Death, International normalised ratio increased, Platelet count normal, Prothrombin time prolonged, Subarachnoid haemorrhage, Subdural haemorrhage
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Haemorrhagic central nervous system vascular conditions (narrow), Accidents and injuries (broad), Hypertension (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-26
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pantoprazole 40 mg daily potassium chloride 10 meq daily sotalol 120mg BID warfarin 2.5mg daily warfarin 5mg weekly furosemide 40mg daily allopurinol 200 mg daily donepezil 10mg daily lisinopril 5mg daily
Current Illness: none
Preexisting Conditions: atrial fibrillation, hypertension, GERD, prostate cancer
Allergies: penicillin
Diagnostic Lab Data: PT 36.0 PTT 39.0 INR 3.1 platelets 195 Head CT - Large Geographic left parietal/occipital parenchymal hemorrhage with 12mm rightward shift. Subarachnoid and subdural hemorrhage of the left hemisphere.
CDC Split Type:

Write-up: 5 days after receiving his COVID vaccination the patient had a spontaneous (nontraumatic) subarachnoid hemorrhage which was fatal. The patient had previously been stable on his coumadin dosing with therapeutic INRs for the past several months per his wife. At time of presentation his blood pressure in the ER was elevated to 223/94 and his INR was risen to 3.1

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