Dr. Oz: Joan Rivers’s Tragic Death
Dr. Oz kicked off his episode by talking about the troubling new revelations surrounding the investigation of Joan Rivers’s death. It’s been two weeks since Joan Rivers stopped breathing and went into cardiac arrest while undergoing a routine endoscopy. An investigation of the surgical center where she had the procedure has been underway for days.
Dr. Oz: Unauthorized Procedure
CNN correspondent Susan Candiotti spoke to a source inside that surgery center, giving us possible insight into what really happened to Joan Rivers. It seems an unauthorized procedure, a biopsy on Joan Rivers’s vocal cords, was performed on the comedian while she was sedated. Staffers found no consent form from Rivers.
The source said that Joan Rivers was undergoing a scheduled endoscopy by the clinic’s gastroenterologist. An endoscopy is when they send a tiny camera down the throat to look for digestive issues. While Rivers was under anesthesia, the doctor saw something.
Dr. Oz: Joan Rivers Biopsy
Rivers’s personal ear, nose, and throat specialist then examined her vocal cords and began a biopsy. It turns out that not only was this unauthorized, the doctor wasn’t certified to operate there.
During the biopsy, Joan Rivers’s vocal cords began to swell, cutting off her oxygen and putting her in cardiac arrest. From then on, it seems the clinic did everything right to get emergency personnel there. However, the clinic has released a statement saying the gasterenterologist who performed the endoscopy, then serving as medical director, released a statement saying he’s “not currently performing procedures at Yorkville Endoscopy; nor is he currently serving as medical director.”
Dr. Oz: Anesthesia Vs. Sedation
Dr. Oz then talked to anesthesiologist Dr. Mike Roizen and ear, nose, and throat expert Dr. Jamie Koufman. Dr. Roizen said that it seems they did a sedation, rather than general anesthesia for Joan Rivers. This is a problem because when the patient is under sedation, the vocal cords can go into spasm, making what happened a predictable event.
Joan Rivers told Dr. Oz the last time she was on the show how nervous she got when she went under anesthesia. Her dad was a doctor and he warned her to be careful. In her appearance, she said that she always asks the doctors to be careful.
Dr. Oz: No Consent Form For Biopsy
Dr. Koufman said that without a consent form, she would never do a biopsy. She said if the lesion on Joan Rivers’s vocal cords looked malignant or dangerous, then the biopsy should be done in a controlled environment in an operating room so that airway problems like this could not occur.
During the biopsy, Joan Rivers’s vocal cords started to swell, causing them to shut tightly and prevent breathing. This caused the cardiac arrest. Dr. Koufman said that there were 8 million sedated endoscopies performed last year and the reported death rate is one per 10,000, meaning that about 800 people died during endoscopy last year.
Dr. Roizen said there should have been a team to discuss what would happen if a breathing issue occurred. He said they would have put a tube in just to make sure breathing continued and paralyzed the vocal cords so they wouldn’t swell. These kind of elaborate preventative measures should be done in a controlled environment and it’s important the anesthesiologist and the ear, nose, and throat surgeon should’ve worked together before.
Dr. Roizen also pointed out that by the time they called for emergency personnel to come in, they had to have examined the problem enough to know they needed emergency personnel. This means that the actual time between her stopping breathing and them calling could have been too long.
Dr. Oz: Did Joan Rivers’s Doctor Take A Selfie While She Was Knocked Out?
It turns out there’s also reports that one doctor had taken a selfie with Rivers during the procedure. Dr. Koufman said that was incredibly unprofessional.
Dr. Oz: Did She Need This Procedure?
Dr. Koufman also said she wouldn’t have recommended this procedure or this facility. She said that Joan Rivers likely had acid reflux and this procedure had needless risks. There are low risk procedures with an awake patient with an ultra thin instrument. The greatest risk to the airway is when the patient is sedated like this. The ultra thin, awake procedure has been done since the 1990s. Dr. Koufman said she should have had one of those or this procedure in a controlled environment. But she also said one of the most egregious things was the biopsy done without permission and without foresight of what could have happened if the vocal cords spasms or swelled.