Monday, July 22, 2019

Joan Rivers died at 81.  Some people surmise her death to be the result of medical malpractice.  New York state health officials took a look at the Upper East Side clinic where she stopped breathing.

The clinic, Yorkville Endoscopy, on E. 93rd St. in Manhattan, NY, opened in February 2013 as a state-of-the-art surgical center founded by doctors at New York Gastroenterology.  The mission of the clinic, as promoted on its website, was to serve as a community resource for digestive disorders staffed by endoscopists with a commitment to patient safety.

The clinic announced when the facility opened:  "We recognized that a growing proportion of health care services are moving out of the hospital environment and into ambulatory facilities…," according to Dr. Lawrence B. Cohen, medical director and board member of Yorkville, as reported by the NYDailyNews.

Joan Rivers’ family considered a lawsuit against the clinic for alleged mistakes during surgery, which might have led to Rivers’ cardiac arrest.  Rivers was reportedly undergoing an endoscopy of her vocal cords.

The Health Department investigation could have been triggered by the complaints of a family member, publicity, or Rivers' autopsy report.  Hospitals are better equipped to handle patients who might need emergency intubation to prevent brain injury or death.  The clinic, an outpatient facility may not have had certain medications and staff trained for such an emergency.

Outcomes of health investigations often include findings mandating risk reduction strategies and corrective actions the facility must agree to.  Types of medical misconduct include practicing fraudulently, gross negligence, alcohol impairment, crime conviction. 

In October 2014, the medical examiner’s office ruled Joan Rivers died of brain damage from low blood oxygen during a medical procedure.  Her death was classified as a therapeutic complication, a known risk where a patient signs a waiver before surgery.  Negligence was not listed as a contributing cause.

The medical examiner's ruling doesn't preclude Rivers' family from filing a lawsuit.  Another doctor may give a different opinion.  At trial in a medical malpractice case, if Rivers’ family sues, the investigation findings of fact can be used, but the family cannot use the conclusions.  In medical malpractice, if a state concludes there were departures from the standard of care, the investigations won't assist the doctors in defense.