Shocking Allegations in Joan Rivers Death

As the investigation into the death of comedienne Joan Rivers continues, shocking new allegations have come to light.

CNN is reporting that River’s personal ENT (Ears, Nose, and Throat) physician, who was reportedly present during her procedure, may have taken a “selfie” while Rivers was under anesthesia.

Rivers had gone to the Yorkville Endoscopy Center to have gastroenterologist Dr. Lawrence Cohen perform an endoscopy as part of a evaluation for hoarseness of her voice. Acid reflux is one cause of vocal hoarseness.  Her person physician, an ENT doctor, who was not authorized to perform procedures at that clinic, attended the procedure, and inspected Rivers’ vocal cords.

Sources are saying that this physician began to perform a biopsy of something that was seen on the vocal cords, however the cords began to swell and the respiratory arrest ensued.

Yorkville Endoscopy Center asserts that “A biopsy of the vocal cords has never been performed at Yorkville Endoscopy,” although it did confirm that Dr. Cohen “is not currently performing procedures…nor is he currently serving as medical director.”

Joan Rivers consent for the procedure did not specifically include a vocal cord biopsy.

Here is CNN’s report:

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

3 Comments

  1. Jordan Bley

    September 25, 2014 at 10:19 am

    “…The health of my patient will be my first consideration;… I will maintain the utmost respect for human life;…”
    -Declaration of Geneva (A Revision of the Hippocratic Oath)

    Amid the shocking demise of Joan Rivers, personal responsibility and professionalism must be called into question. As an individual interested in medicine, what good are ethics if they’re only there to look pretty? Surely, in the midst of the massive overhaul the health care system is undergoing, physicians aren’t developing the audacity to skirt the rules in favor of convenience, are they?

    As a student that has closely followed both ethics and policy within surgical practices for several years, this astonishes me. Not because I’m so naïve to think that things like this never happen, but rather because of the nature of the situation. I’ve never wanted to be a celebrity, probably because I’m naturally introverted and enjoy living a simple, “easy” life. To me, celebrities attempt to live closed off lives by hiring anything from personal chefs and stylists to trainers and physicians to keep themselves from over-exposure while in public (thank you, media and paparazzi). It is within this realm that the ethics of medicine become complicated. Naturally, people tend to want their trusted advisors in close proximity when they’re undergoing a procedure (case in point- the personal ENT “observing” the endoscopy). I’m not questioning the ENT’s qualifications- in fact- in order to reach a prominent position such as, “personal ENT for Ms. Joan Rivers”, I’m sure that he/she is an extraordinarily gifted physician. I also understand that mistakes, regardless of whether they occurred out of carelessness or happenstance, occur in life. The underlying issue, however, is not of competency as a physician in the physical sense, but rather in the moral sense. However, a lack of surgical privilege at the Yorkville Endoscopy Center does not bode well for Ms. Rivers’ physician (or Dr. Cohen for allowing the procedure to continue).

    It should be of the utmost importance that patients understand exactly what could/will occur every time they go under the knife. It doesn’t appear that Ms. Rivers expecting a biopsy while receiving in the midst her endoscopy (I know this is not uncommon, nor is it logistically safer to put her under anesthesia two times for separate, small procedures, but there is no plausible proof that this was communicated to the patient). Ultimately, it’s entirely possible that she was aware that a biopsy would occur if something suspicious was found during the endoscopy, but the documentation doesn’t suggest that. While EHR’s and dictation are typically the bane of a physicians’ existence, it does play a vital role in confirming that all parties are on the same page. Ultimately, it is the responsibility of anyone possessing a medical license to ensure that the patient’s well being is not compromised. By nature, this is an extraordinarily difficult topic to discuss, but the legality and ethics surrounding medicine are becoming more and more functionally necessary to prevent unsafe practices.

    • Armybeef68

      August 25, 2015 at 8:15 pm

      “Amid the shocking demise of Joan Rivers”

      They PULLED THE PLUG, what did you think was going to happen, she’d get up and start dancing around?

  2. Delaram Abaei

    November 6, 2014 at 12:53 pm

    Celebrity patients present a number of unique challenges for medical practices and require additional supervision of staff and compliance measures to protect all the parties involved- the practice, the patients and staff. This increased attention from the media, the public, and regulators comes regardless of any question of negligence on behalf of the doctor or facility. But in the case of Joan River’s death, a variety of allegations have apparently emerged. Such claims include significant HIPPA violations alleged against the treating physician for taking one or more “selfies” with Rivers during her treatment, potential claims about lack of supervision by a properly credentialed anesthesiologist, and an allegation of an unapproved procedure consisting of a throat biopsy.
    Many such medical care allegations involving celebrities involve negligence in ensuring patient compliance and the lack of written processes on the part of the ASC’s and facilities. It is in cases like this where the proper use of secured EHR’s can be taken advantage of by healthcare facilities in the recording of medical procedures performed and the care given to the patient. As discussed in class, there are many potential risks that are involved with the use of electronic records and maintaining patients’ information securely is more difficult than in the paper world due to the volume and mutable nature of electronic patient information – such records can often easily be revised, altered, and lost easily. While all patients deserve the same high-level of care, some certainly present additional challenges, such as professional athletes, government officials, and celebrities have a higher than average level of interest from the media. And in many cases, physicians must deal with a long list of people who are actively trying to discover and reveal what they have to keep private when it comes to celebrity patients. Some of these media sources have even come to hire hackers, and even use private detectives to perform a variety of discovery operations in order to obtain such electronic records. As such, when EHR security is properly addressed and ensured, such technology can have a myriad of advantages. In the case of becoming entangled in lawsuits, physicians and ASC’s can present such properly recorded documents as electronic evidence to a jury or judge. In the case of Joan River, negligence with regards to patient compliance in receiving a throat biopsy may or may not have occurred, but regardless, robust and detailed electronic records of the services provided and received can make for a much more transparent situation.

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