On August 28, 2014, legendary comedian Joan Rivers went in for a scheduled appointment at Yorkville Endoscopy in New York — and entered cardiac arrest while in surgery.
David Shankbone/Wikimedia CommonsAfter Joan Rivers’ death at the age of 81, an investigation discovered evidence of medical malpractice.
For anyone who enjoyed comedy or award shows, Joan Rivers seemed ever-present. The sharp-tongued comedian had been a looming presence in American pop culture since the 1960s, and never ceased to delight — and scandalize — audiences with her quick, acerbic wit. So it was a huge shock to many when Joan Rivers died on September 4, 2014.
Though Rivers was 81 years old, her death came out of the blue. The legendary comedian had booked a routine endoscopy at Yorkville Endoscopy in New York City after noticing a change in her voice. She also wanted to investigate the cause of her stomach reflux. But during her appointment on August 28, 2014, a number of things went terribly wrong.
For starters, though Rivers had planned to undergo an upper endoscopy, her medical team also performed a laryngoscopy. It’s unclear whether or not Rivers gave consent for this procedure, which involved the doctors examining her vocal folds and glottis. But what is clear is that things took a dangerous turn for Rivers during the unscheduled procedure.
As doctors performed the laryngoscopy, Rivers’ oxygen saturation level started to drop. Her doctors were able to stabilize her, but her oxygen level dropped again when they moved on to the planned upper endoscopy. From that point on, the comedian started to deteriorate quickly.
She was briefly resuscitated, and was soon rushed to a hospital and put on life support. But Joan Rivers died several days later, on September 4, 2014. And it would take months for the truth of what happened to come to light.
Joan Rivers, Comedienne Extraordinaire
Born Joan Alexandra Molinsky on June 8, 1933, in Brooklyn, New York, Joan Rivers arguably got her comedy chops from her father, a Russian immigrant physician who often did impersonations of his patients.
Rivers’ parents, however, did not approve of her interest in acting. So she forged her own path as she found small roles in Off-Broadway shows and performed stand-up in clubs. Her profile grew, and Rivers made her breakthrough when she appeared on Johnny Carson’s The Tonight Show in 1965. Carson loved her and invited her to come sit on his couch.
Public DomainJoan Rivers in 1966.
“God, you’re funny,” he said. “You’re going to be a star.”
From there, Rivers did become a star. Though she and Carson eventually had a falling out, Rivers made a name for herself as his guest host, as the host of her own daytime talk show, as a Las Vegas headliner, and as a writer, producer, and director. Rivers became a mainstay of award show red carpets, where she offered biting evaluations of celebrities’ outfits.
She also experienced considerable tragedy along the way. Her second husband, Edgar Rosenberg, died by suicide in 1987, Rivers had a falling out with her daughter, Melissa, and Rivers even contemplated suicide herself.
Los Angeles Times Photographic CollectionJoan Rivers and her daughter Melissa in 1973.
But things were going well for her by the 2010s. Not only had she reconciled with Melissa, but she also continued to book acting roles and write books, and she was co-hosting the E! show Fashion Police.
Then, in 2014, Rivers made an appointment for a routine endoscopy.
The Death Of Joan Rivers In 2014
On August 28, 2014, Joan Rivers went to Yorkville Endoscopy in New York City for an endoscopy. The procedure was meant to investigate what was causing her stomach reflux, and whether or not her voice changes could be a reason for concern (throat cancer could be a possible cause).
But — as a lawsuit filed by Joan Rivers’ estate after her death alleged — several things went wrong during the comedian’s appointment.
Public DomainJoan Rivers in 2001. Though her life had ups and downs, things were going well for the comedian by the 2010s.
For starters, Rivers had gone to Yorkville Endoscopy for an upper endoscopy and a possible biopsy if there were any potential signs of throat cancer. But while she was sedated, her doctors started things off by performing a laryngoscopy. (Rivers had not given consent for this in writing, though it’s possible she gave verbal consent.) During the laryngoscopy, which involves examining a patient’s vocal cords and glottis, doctors had “difficulty maintaining” Rivers’ oxygen saturation, according to the lawsuit.
Rivers was stabilized and doctors continued with the planned upper endoscopy, which they had to stop and start again when Rivers’ oxygen level dropped once more. At some point, one of the doctors allegedly took a selfie with Rivers while she was under anesthesia, and another doctor suggested that they perform a second laryngoscopy, despite the earlier issues.
By the time the doctors noticed that her vital signs and oxygen level had deteriorated, it was too late. Efforts to revive Rivers with ambu bagging did not work, and the doctors failed to perform either a cricothyrotomy or tracheotomy, procedures meant to relieve obstruction in the airways.
YouTubeDoctors performed two laryngoscopies on Rivers, who may or may not have verbally consented to the procedure. An investigation later found that Joan Rivers died of brain damage due to lack of oxygen during a laryngoscopy.
The lawsuit filed by Rivers’ estate alleged that doctors should have performed an emergency tracheotomy, but one of the doctors, who “did not have privileges to perform surgical procedures” at Yorkville Endoscopy, had allegedly left the room to avoid getting into trouble.
Though the comedian was rushed to a nearby hospital, where she was put in a medically induced coma, Joan Rivers died a week later on September 4, 2014. Her estate later alleged that Rivers’ doctors had been “reckless, grossly negligent, and wanton” during what should have been a routine procedure.
Joan Rivers’ Cause Of Death — And The Settlement Reached By Her Family
In the aftermath of Joan Rivers’ death, tributes from her fans, friends, and even some of the people she mocked poured in. Though Rivers was 81 at the time she died, many asked the same question — how did Joan Rivers die?
Peter T./Wikimedia CommonsJoan Rivers and her daughter, Melissa, at New York Fashion Week in 2012.
The New York medical examiner stated in October 2014 that her cause of death was brain damage that occurred due to a lack of oxygen. This happened “during laryngoscopy and upper gastrointestinal endoscopy with propofol sedation for evaluation of voice changes and gastroesophageal reflux disease.” The medical examiner’s investigation also determined that Rivers had a “laryngospasm,” a spasm of the vocal cords, which can make it difficult to breathe. Without enough oxygen, Rivers’ brain shut down.
A month later, in November, a federal investigation found that Rivers’ treatment involved numerous violations. “The physicians in charge of the care of the patient failed to identify deteriorating vital signs and provide timely intervention during the procedure,” the report stated.
Rivers’ estate soon filed a medical malpractice lawsuit in January 2015, alleging that Rivers’ doctors had made a number of medical missteps while she was under their care that resulted in her death.
“The level of medical mismanagement, incompetency, disrespect, and outrageous behavior is shocking and, frankly, almost incomprehensible,” Rivers’ daughter, Melissa, said in a statement. “Not only did my mother deserve better, every patient deserves better.”
In May 2016, a settlement was reached between Joan Rivers’ estate and Yorkville Endoscopy for an undisclosed amount.
“In accepting this settlement, I am able to put the legal aspects of my mother’s death behind me and ensure that those culpable for her death have accepted responsibility for their actions quickly and without equivocation,” Melissa Rivers said in a statement. “Moving forward, my focus will be to ensure that no one ever has to go through what my mother, [my son] Cooper, and I went through and I will work towards ensuring higher safety standards in out-patient surgical clinics.”
David Shankbone/Wikimedia CommonsJoan Rivers died in 2014, about four years after this photo was taken.
In the end, however, most people don’t remember Joan Rivers because of her tragic death, but because of her sparkling life. From the start, the comedian used her wit to climb her way to the top. She was blunt about every topic, even death. In a March 2014 appearance on The Tonight Show, just months before she died, Rivers told Jimmy Fallon:
“I’m not afraid of death. My father was a doctor, so I was around death all my life, I was very used to it… because he was a sh*tty doctor.”
After reading about Joan Rivers’ death, go inside the tragic death of comedian John Candy at the age of 43. Or see how comedian John Belushi died of a lethal overdose when he was just 33 years old.
