Clinic That Treated Joan Rivers Ignored "Deteriorating Vital Signs," Regulators Say

Joan Rivers Best Looks Horizontal - H 2014
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Joan Rivers Best Looks Horizontal - H 2014

Report reveals numerous mistakes that contributed to the comedienne's death

The outpatient clinic where Joan Rivers underwent a routine, but ultimately fatal procedure, has been cited for many deficiencies by federal regulators.

The doctors at Manhattan's Yorkville Endoscopy "failed to identify deteriorating vital signs and provide timely intervention during the procedure on Aug. 28," as Rivers lay dying from a lack of oxygen to the brain, the New York Department of Health (NYDOH) determined in a survey contracted by the federal Centers for Medicare & Medicaid Services (CMS).

According to a report obtained by The Hollywood Reporter, the violations include not obtaining the patient's consent for a procedure, mistakes in administering the anesthesia Propofol, failing to take Rivers' weight, allowing an unauthorized doctor to perform a procedure at the facility and violating the patient's privacy by taking a cell phone photograph during surgery.

Rivers died Sept. 4 at Mt. Sinai Hospital in Manhattan from surgery complications, according to the medical examiner. The 22-page report released on Monday provides a narrative of the events inside the operating room for the first time. The survey commenced on Sept. 2, two days before Rivers death. "It was determined that the facility failed to ensure that patient care services are provided in a manner that protects the health and safety of all patients," the survey says. On Sept. 3, "As a result of the significant findings that were identified which compromised patient safety, an Immediate Jeopardy was declared."

The Immediate Jeopardy was removed two days later, but the clinic still did not meet CMS standards.

Read more Joan Rivers' NYC Clinic May Lose License After Health Dept. Finds Deficiencies

As a result, Yorkville Endoscopy failed to meet the requirements to receive Medicare funds on Sept. 5. Currently the clinic is on track to have its Medicare funding terminated on Jan. 7, 2015. If the clinic corrects the problems and passes a future unannounced survey, they can return to receiving Medicare funding, a CMS spokeswoman tells THR. It does not force the clinic to cease operations.

Through October of this year, the clinic has received $1,106,847.74 in revenue from Medicare, according to documents provided by CMS in response to a request made by THR under the Freedom of Information Law (FOIL). The clinic opened in 2013, and took in $125, 985.67 last year, according to a 1099 tax form provided by CMS under a FOIL request made by THR.

Melissa Rivers has already hired a malpractice law firm.

In response to the report, her attorneys issued the following statement: "Our client, Melissa Rivers, is terribly disappointed to learn of the multiple failings on the part of medical personnel and the clinic as evidenced by the CMS report. As any of us would be, Ms. Rivers is outraged by the misconduct and mismanagement now shown to have occurred before, during and after the procedure. Moving forward, Ms. Rivers will direct her efforts towards ensuring that what happened to her mother will not occur again with any other patient."

Yorkville Endoscopy said in a statement: “From the outset of the Aug. 28 incident described in the CMS Report, Yorkville has been fully cooperative and collaborative with all regulatory and accreditation agencies. In response to the statement of deficiencies, Yorkville immediately submitted and implemented a plan of correction that addressed all issues raised. The regulatory agencies are currently reviewing the corrective plan of action and have been in regular contact with Yorkville. In addition, the physicians involved in the direct care and treatment referenced in the report no longer practice or provide services at Yorkville. Yorkville will continue its commitment to complying with all standards and accreditation requirements." 

"Yorkville has been and remains open and active and is fully accredited by an independent review organization. The staff and providers are focused on providing the highest quality and most advanced care possible to its patients,” the statement continued.

Oct. 10, 4:34 p.m. Updates with details throughout.