Joan Rivers stops breathing during surgery - rushed to hospital

**czb** · September 29th, 2014, 12:22 AM

^^^ actually, that's not true.

for some procedures/treatments, there is NO standard of care. REs doing IVF is an example of this. and that's why that there were issues when the medical board of california did an investigation in the octomom case. at the time (don't know if that is still the case), there was no standard, accepted protocol for the max number of eggs could be transferred. and i'm willing to be there might be parallels for PS. this is why a physician who may not be credentialed, say, a pediatrician, can get away with doing some of the PS procedures in some states.

**MohandasKGanja** · September 29th, 2014, 07:27 AM

Originally Posted by czb

^^^ actually, that's not true.

for some procedures/treatments, there is NO standard of care. REs doing IVF is an example of this. and that's why that there were issues when the medical board of california did an investigation in the octomom case. at the time (don't know if that is still the case), there was no standard, accepted protocol for the max number of eggs could be transferred. and i'm willing to be there might be parallels for PS. this is why a physician who may not be credentialed, say, a pediatrician, can get away with doing some of the PS procedures in some states.

It looks like there is a standard of care for endoscopy, though. The link below (American Society for Gastrointestinal Endoscopy) has a series of documents related to it:

ASGE: Practice Guidelines

And below are standard practices for the elderly:

http://www.asge.org/uploadedFiles/Pu...%20elderly.pdf

**sputnik** · September 29th, 2014, 07:30 AM

i think performing this type of procedure on an eighty-one year-old woman as an outpatient sounds pretty risky to me.

**czb** · September 29th, 2014, 11:15 AM

Originally Posted by MohandasKGanja

It looks like there is a standard of care for endoscopy, though. The link below (American Society for Gastrointestinal Endoscopy) has a series of documents related to it:

ASGE: Practice Guidelines

And below are standard practices for the elderly:

http://www.asge.org/uploadedFiles/Pu...%20elderly.pdf

i agree, there are SoC practices for endoscopy. but i didn't know if it was confirmed that she was having an endo, or some other outpatient procedure. all i've seen (so far) is a bunch of gossip and speculation. it's possible that i missed something, though.

**MohandasKGanja** · September 29th, 2014, 12:10 PM

Originally Posted by czb

i agree, there are SoC practices for endoscopy. but i didn't know if it was confirmed that she was having an endo, or some other outpatient procedure. all i've seen (so far) is a bunch of gossip and speculation. it's possible that i missed something, though.

I admit I'm very confused about the whole thing. People are disputing every single circumstance that has been reported. But because of the huge lawsuit that I'm assuming will ensue, we are probably going to find out, minute by minute, what happened.

**qwerty** · September 29th, 2014, 01:21 PM

Don't HIPAA laws apply here? Or perhaps they've been breached? Why do know about anything that happened in that operating room? A lot of it has to be pure speculation.

**czb** · September 29th, 2014, 01:21 PM

^^^ i think a lot of it has been speculation.

and yes, HIPAA laws apply, thank goodness.

**darksithbunny** · September 29th, 2014, 04:45 PM

So many cool things keep popping up in my personal life about Joan Rivers. I was reading Michael Palin's diary from the 80s and he had a photo of the thank you letter Joan wrote to him for appearing on her TV late night talk show. He said she was the only one who sent him a thank you.

**SoCalMarie** · October 16th, 2014, 03:43 PM

Joan Rivers died after her oxygen supply was cut off: medical examiner

The 81-year-old’s death has been classified as a ‘therapeutic complication.’ The Daily News reported that her death was triggered by a private doctor performing an unplanned biopsy on her vocal cords.

BY THOMAS TRACY , CORKY SIEMASZKO
NEW YORK DAILY NEWS
Published: Thursday, October 16, 2014, 1:53 PM

Comedian Joan Rivers died after her oxygen supply was cut off while she was undergoing a procedure at a private Upper East Side clinic, the Medical Examiner reported Thursday.Rivers's death was classified by the M.E. as a "therapeutic complication."

"That means the death resulted from a predictable complication of medical therapy," spokesman Julie Bolcer said in a statement.
Rivers underwent an endoscopy and was having her throat looked at "for evaluation of voice changes and gastroesophageal reflux disease," the M.E. reported.

The M.E.'s finding comes a month after The Daily News reported that the 81-year-old comic's demise was triggered by a private doctor who performed an unplanned biopsy on her vocal cords.
Rivers died on Sept. 4.
The doctor, Gwen Korovin, was not a staffer at the Yorkville Endoscopy clinic. Rivers' daughter, Melissa, has said she plans to sue her.

Source: http://nydn.us/ZwnRe2

**PaperRain** · October 20th, 2014, 08:41 PM

RIP

**rollo** · November 11th, 2014, 06:47 PM

11 November 2014

Joan Rivers: Clinic cited for multiple failings

Joan Rivers had been sedated during the procedure examining the back of her throat

The New York clinic where Joan Rivers suffered a cardiac arrest during a medical procedure failed to follow standard protocols while treating her, state health investigators have said.
The comedian died on 4 September, aged 81, a week after she stopped breathing at the Yorkville Endoscopy centre.
A report released by the Department of Health cited multiple errors, including failing to detect Rivers' deteriorating vital signs during the procedure.
Negligence has not been alleged.
The New York medical examiner's office ruled Rivers died of brain damage due to lack of oxygen during the procedure examining the back of her throat and vocal cords
The death was classified as a "therapeutic complication", meaning it was a known risk.
The comic had been sedated with the anaesthetic propofol, however the report said there there were inconsistencies recorded in its dosage.
It added there was no record staff at the clinic weighed Rivers before administering the drug.
'Misconduct and mismanagement'
Hypoxia - brain damage caused by lack of oxygen - and cardiac arrest are rare side effects of propofol, but patients usually sign a waiver before surgery to confirm they understand the risks.
But the report said there were no records of medical consent for all the procedures performed.
Investigators said the clinic "failed to identify deteriorating vital signs and provide timely intervention" in Rivers' case.
They also noted a staff member took pictures of the comic without her consent while she was under anaesthesia, in violation of the clinic's mobile phone policy.
Rivers daughter Melissa said she was "outraged by the misconduct and mismanagement" that occurred and wanted to ensure it does not happen again with any other patient.
Her lawyers are investigating the circumstances surrounding her mother's death.
As a result of the state investigation, the Department of Health and Human Services has given Yorkville Endoscopy until 7 January to correct deficiencies to avoid losing accreditation to the government's Medicare programme covering the elderly.
The clinic told NBC it had submitted a plan to officials addressing all the issues raised. It added the physicians referenced in the report no longer provided services there.

BBC News - Joan Rivers: Clinic cited for multiple failings