Famous actress and comedian Joan Rivers died of a "therapeutic complication" during a medical procedure, reports citing the New York City medical examiner said.
According to The New York Times, Rivers died last month at the age of 81 after a complication during a procedure that evaluates her voice changes and stomach reflux.
The report, citing a brief report issued by the medical examiner, said that Rivers died from a brain damage caused by low blood oxygen or "anoxic encephalopathy due to hypoxic arrest."
CNN said in a separate report that the arrest took place "during laryngoscopy and upper gastrointestinal endoscopy with propofol sedation for evaluation of voice changes and gastroesophageal reflux disease," citing the data provided by the medical examiner's officer.
On August 28, Rivers went to Manhattan's Yorkville Endoscopy clinic where she was supposed to undergo a routine procedure on her throat after experiencing hoarseness. She then stopped breathing and went into cardiac arrest. She was put on life support at Mount Sinai Hospital in New York but she eventually died a week later.
Pathologist and surgeon Bill Lloyd told CNN that laryngospasm was the complication. Laryngospasm, Lloyd said, makes it difficult for a person to breathe. Since there was no sufficient oxygen to maintain the heart muscle, Rivers "stopped breathing and her heart went into arrhythmia," Lloyd said.
Lloyd, who was not involved in Rivers' autopsy, explained exactly how it happened. First, the vocal cord spasm caused Rivers inability to bring oxygen into her body. Soon, her heart started to beat irregularly or completely stopped. Then, her heart became unable to deliver fresh oxygenated blood to her brain, causing it to shut down.
Although medical error was not cited as the cause of death, The New York Times reported that this may open the possibility of malpractice. It was also noted that the examiner's report did not say anything about the sufficiency of the actions taken by the medical personnel after Rivers stopped breathing. Citing a review from the Journal of Forensic Sciences, The New York Times said that death from therapeutic complications "typically does not address errors of omission, clinical judgment or management or missed diagnosis."
Meanwhile, Dr. Jamie Koufman, an ear, nose and throat specialist in New York City, told The New York Times that Rivers "had brain death before the medics arrived."
Lloyd and Koufman, in separate reports, both questioned why the doctors who were with Rivers at the time of the incident were not able to do a tracheotomy to allow the comedian to breathe. According to reports, Dr. Gwen Korovin was the doctor who conducted Rivers' laryngoscopy to view her vocal cords while gastroenterologist and the clinic's medical director Dr. Lawrence Cohen was the one who performed the endoscopy.
According to the CNN report, Cohen resigned after Rivers' death while Korovin denied "performing an unauthorized procedure."
Meanwhile, a Reuters report said that Melissa Rivers, the comedian's daughter, said in a statement that they are still saddened by their tragic loss and they remain grateful for the continued love and support they get.