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Joan Rivers Died From Lack of Oxygen: Medical Examiner

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Joan Rivers died as a result of complications of low blood oxygen during a medical procedure she underwent at a Manhattan clinic, the New York City Office of Chief Medical Examiner said Thursday.

The comedian suffered brain damage due to lack of oxygen during an exam, a “predictable complication of medical therapy,” medical examiner's office said.

Rivers, 81, was undergoing a laryngoscopy — where the back of the throat is examined — and an upper gastrointestinal endoscopy — a procedure in which an instrument is used to look at the esophagus, stomach and small intestine — at Yorkville Endoscopy on Aug. 28 when she went into hypoxic arrest, which occurs when the brain lacks oxygen. She was rushed to a hospital where she died on Sept. 4 after being removed from life support. Rivers’ manner of death was “therapeutic complication,” meaning “the death resulted from a predictable complication of medical therapy,” the medical examiner’s office said in a statement. The drug propofol, an anesthetic, was administered to Rivers, who was being evaluated for voice changes and gastroesophageal reflux disease.

When asked how the low blood oxygen complications arose during the procedure, the medical examiner's office said its findings were not more specific. Calls placed seeking comment from the New York State Department of Health, which had previously said it was investigating Rivers’ death, and to Yorkville Endoscopy were not immediately returned.

"We continue to be saddened by our tragic loss and grateful for the enormous outpouring of love and support from around the world," Rivers daughter, Melissa, said in a statement. "We have no further comment at this time."

The therapeutic complication manner of death “is used for fatalities due to predictable complications of appropriate medical therapy,” officials with the New York City medical examiner’s office said in a 2006 research paper. Analyses of such deaths provide “important quality of care information for medical providers,” they said, and noted that the "certification of TC usually does not address errors of omission, clinical judgement/management, or missed diagnoses."

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