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From the 4/30/2021 release of VAERS data:

This is VAERS ID 992734



Case Details

VAERS ID: 992734 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-07
Onset:2021-01-24
   Days after vaccination:17
Submitted: 0000-00-00
Entered: 2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1685 / 1 RA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Chest X-ray, Death, Oxygen saturation decreased, SARS-CoV-2 test positive
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-27
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: alendronate sodium 70 mg 1 time a day every sunday for arthritis aspirin 81 mg q day Buspirone HCL 5 mg 3 times daily Calcitonin solution 200 units 1 spray via nostril Calcium capsule 250 mg 2 times per day Cardedilol 6.25 tab 2 times per
Current Illness: Rheumatoid Arthritis, overactive bladder, glaucoma, major depressive disorder, Alzheimers Disease, polyneuropathy,
Preexisting Conditions: Rheumatoid Arthritis, overactive bladder, glaucoma, major depressive disorder, Alzheimers Disease, polyneuropathy,
Allergies: codeine, penicillin, enbrel, septra, sulfa antibiotics
Diagnostic Lab Data:
CDC Split Type:

Write-up: 1st COVID immunization 1/7/2021, COIVD positive results on 1/16/21, 1/24/21 O2 sats decreased to 78%, 1/24/21 reveived the Bamlanivimab infusion 50 ml/hr. 1/24/20 chest x ray 1/24/21 She was sent to hospital and admitted. 1/27/2021 Expired


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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=992734


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