Joan Rivers Untimely Death Due to Mishaps

Rivers
Joan Rivers died as the result of a medical staff that failed to put the patient first. Her untimely death is magnified by numerous mishaps that occurred during a botched surgery and reports that the clinic did not have informed consent for several of the procedures performed. Additionally, staff failed to identify deteriorating vital signs, and adding insult to injury, random cell phone pictures were taken during the ordeal.

Investigators from the Centers for Medicare and Medicaid Services (CMS) discovered major errors during their investigation of Yorkville Endoscopy Clinic. For example, (1) the staff failed to follow its cell phone policies; (2) failed to maintain consistent record of Propofol dose; (3) failed to recognize declining vital signs; (4) failed to interject appropriate life saving procedures in a timely manner; (5) failed to document Rivers’ body weight before she was sedated with Propofol; (6) failed to provide only physicians with privileges to treat Rivers according to established clinic bylaws; (7) and finally, the staff failed to obtain Rivers’ consent for each performed procedure during surgery.

The anesthesiologist changed medical records with regards to the amount of anesthesia given. Propofol, the same sedative that killed Michael Jackson in 2009, was said to be administered in a dose of 120 mg, but the initial recorded entry was 300 mg given over too short of a time period. According to Dr. Conrad Murray, the physician accused of the involuntary manslaughter of Michael Jackson, “Joan seems to have received 300 hundred milligrams within one minute and I think that would not be correct.”

Furthermore, the New York City Office of Chief Medical Examiners (OCME) reported the official cause of the comedienne’s death as anoxic encephalopathy resulting from hypoxic arrest. In lay terms, that is brain damage as a result of a lack of oxygen going to the brain. The medical mishaps leading to her untimely death may have been avoided had staff followed the clinic’s pre-existing surgical protocols.

Rivers was admitted into the Manhattan, NY, clinic on Aug. 26 as a precautionary measure to determine the reasons for changes to her voice. She had complained to friends about hoarseness and a sore throat days prior.

At the clinic, she underwent an upper gastrointestinal endoscopy and a laryngoscopy to evaluate the conditions about which she complained. She did have a history of chronic acid reflux disease–an illness that can severely affect the throat over time, but now it may never be determined if this was the actual cause of her vocal changes.

Dr. Lawrence Cohen, then the medical director at the clinic, was reported to have been taking medically unrelated pictures of Rivers, along with Dr. Gwen Korovin, an ear, nose, and throat specialist, while Rivers was under anesthesia and unconscious on the operating table. Reports claim that Dr. Cohen thought Rivers might want to see the pictures after her recovery.

Dr. Korovin, known as the doctor to many celebrities, lacked the credentials to work at Yorkville. Although Dr. Korovin was Rivers’ official ear, nose, and throat doctor, there was no evidence found to indicate consent was given to her for any procedures that day. Later, during the surgery, Rivers ceased breathing and went into cardiac arrest.

A statement released by Yorkville Endoscopy indicated that Dr. Cohen was no longer practicing at the Manhattan clinic and that the clinic was being cooperative with any investigation. They have also issued a plan of correction for each error and misconduct made during the surgery leading to the death of Rivers.

Severe mishaps caused the comedienne never to recover from what should have been a routine surgical procedure. Her untimely death was one week after her admission to Yorkville Endoscopy Clinic. She later died on Sept. 4, 2014 at Mount Sinai Hospital, as a result of “preventable” therapeutic complications. Rivers was 81.

By D’wayne Stanelli

Sources:
The New York Times
CNN Entertainment
US Weekly
ET
Photo by SamirWikimedia

2 Responses to "Joan Rivers Untimely Death Due to Mishaps"

  1. Dwayne Stanelli   November 20, 2014 at 9:03 pm

    …brilliantly state advice Dr. Friedberg. Thank you for sharing your expertise.

    Reply
  2. Barry Friedberg MD   November 16, 2014 at 9:27 am

    As a board certified anesthesiologist, I am saddened by what appears to be another avoidable death, celebrity or not.

    I have been interviewed by CNN during the Conrad Murray trial & asking sociopath Conrad Murray’s opinion about propofol is like asking Jeffrey Daumer about cooking. Absurd.

    Michael Jackson did not die from propofol but from Murray’s reckless abandonment when Murray left the room to carry on a phone call. Unobserved & unmonitored, Jackson lost airway control while receiving propofol & asphyxiated before Murray returned to the room.

    As to Ms. Rivers’ propofol dose:

    Body weight is a standard 20th century method of ‘guesstimating’ propofol dose. Ultimately, it is still guessing.*

    Measuring the direct brain response with a brain monitor is the 21st century approach.

    Watch youtube ‘Going under with Goldilocks anesthesia’ to see how brain monitoring eliminates too much or too little propofol given to achieve numerically reproducible sedation levels.

    Consider signing http://www.change.org/p/prospe

    *Read ‘Getting Over Going Under, 5 things you MUST know before anesthesia’ For a free copy, email [email protected]

    Re: Failure to recognize & treat laryngospasm

    Muscle relaxant, i.e. succinylcholine (Anectine®), might not be readily available in an endoscopy suite but should have been in the crash cart…

    Few dedicated anesthesia providers, much less most surgeons, know that intravenous (or topical) lidocaine (commonly found) will work just as well to relax the vocal cords.

    What is truly disgraceful, IF it can be established Dr. Korovin was indeed present, was that a trained Ears, Nose & Throat (ENT) surgeon would not know this sort of life saving information.

    What is clear is that no dedicated anesthesia provider (anesthesiologist or nurse anesthetist) could have been present or Ms. Rivers would likely still be alive today.

    Reply

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