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From the 1/14/2022 release of VAERS data:

This is VAERS ID 986948

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Case Details

VAERS ID: 986948 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Georgia  
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Cardiac arrest, Death
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-25
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Diltiazem CD, Gabapentin, Hydroxychloroquine, Levothyroxine, Omeprazole, Oritavancin, Potassium Chloride, Propylene Glycol Eye Drops, Sertraline
Current Illness: alcoholic cirrhosis, thrombocytopenia, anemia, lymphedema
Preexisting Conditions: hypertension, hypothyroid, rheumatoid arthritis, depression, GERD
Allergies: acetaminophen, atorvastatin, belsomra, benadryl, benzoin, cefazolin, cephalosporins, codeine, cymbalta, darvocet, dilaudid, duragesic, floxin, guaifenesin, hydrocodone, indocin, lovenox, morphine, nafcillin, oxycodone, paxil, sudafed, sulfa, vancomycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Cardiac arrest on 1/24/21 in the early morning hours then passed away on 1/25/21 around 1:51am in the hospital

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