Joan Rivers 'stopped breathing' in surgery

[IndianSummer]

http://www.usmagazine.com/celebrity...er-100-million-of-joan-rivers-estate-20142210
Melissa Rivers Inherits Over $100 Million of Joan Rivers' Estate

 

[BetteDavisEyes]

Melissa Rivers Planning to File Multimillion-Dollar Wrongful Death Lawsuit

Natalie Finn, eonline
10 hours ago

Melissa Rivers is seeking answers—and damages.

A rep for Joan Rivers' daughter confirms to E! News that she is planning to file a multimillion-dollar wrongful death lawsuit against the New York endoscopy clinic where her mother suffered cardiac arrest, as well as all of the doctors involved in peforming the procedure in question...

http://xfinity.comcast.net/articles/entertainment/20141029/Melissa.Rivers.lawsuit/?

 

[Isabelle]

Melissa is rightfully suing. Don't blame her at all. Joan died due to low oxygen or hypoxia and maybe no oxygen (anoxia). The latter, anoxia, could be due to laryngeal spasm (vocal chords closed in spasm). My suspicions are that alarms on the cardiac monitor and pulse oximeter were turned off and it was too late when docs noticed. It's been rumored that ne of the docs took time out for a photo session with the then unconscious Joan. This action is just so distasteful that I have no words to define it. I think the truth of what really happened will come out via the clinic staff who was present. So sad.

 

[nrdsb4]

Melissa is rightfully suing. Don't blame her at all. Joan died due to low oxygen or hypoxia and maybe no oxygen (anoxia). The latter, anoxia, could be due to laryngeal spasm (vocal chords closed in spasm). My suspicions are that alarms on the cardiac monitor and pulse oximeter were turned off and it was too late when docs noticed. It's been rumored that ne of the docs took time out for a photo session with the then unconscious Joan. This action is just so distasteful that I have no words to define it. I think the truth of what really happened will come out via the clinic staff who was present. So sad.

As an RN who works in an endoscopy center, I cannot imagine turning off alarms during a case in which propofol is being administered. It just seems off the charts crazy. But then again, so is administering propofol in a home environment, as was done in Michael Jackson's case. Certainly the best way for Melissa to find out more information is to sue. As much money as she has inherited, I imagine her motivation has much more to do with finding out the truth. The staff will all be deposed under oath and the whole thing will undoubtedly come out. The bad part for those of us who are curious as to what exactly happened in that clinic is that often these cases are settled out of court with strict clauses preventing the parties from discussing the case. I hope that doesn't happen here. I realize I'm not entitled to know anything, but for some reason I would sure like to know if this was negligence or just bad luck for Joan.

 

[BetteDavisEyes]

Joan Rivers Gets Posthumous Women's Image Network Award Nomination for Fashion Police

Brett Malec, eonline
Seconds ago

Joan Rivers is getting a very special posthumous honor.

Almost two months after the legendary 81-year-old comedian passed away from complications of throat surgery, Rivers has been nominated for a Women's Image Network Award for hosting the hit E! show Fashion Police...

http://xfinity.comcast.net/articles/entertainment-eonline/20141030/b593397/

 

[IndianSummer]

http://www.usmagazine.com/celebrity...ivers-doctors-made-a-terrible-mistake-2014511
Donald Trump Sounds Off on Joan Rivers' Death: "I Think The Doctors Made a Terrible Mistake"

 

[Isabelle]

Report released (sorry unable to link): doctors failed to notice Joan Rivers deteriorating condition. Propofol was not accurately documented. And there is more. The state and center for Medicare and Medicated released the information. Clinic has until Jan 7,2015 to straighten up their faults.

Seems doctors clearly wronged Joan Rivers. Melissa has a strong case against the docs and the clinic.

 

[IndianSummer]

Among the major errors CMS found the clinic committed are:
-- Failing to identify deteriorating vital signs and provide timely intervention;
-- Failing to record Rivers' weight, prior to the administration of medication for sedation;
-- Failing to consistently document the dose of Propofol, a sedative, administered;
-- Failing to get Rivers' informed consent for each procedure performed;
-- Failing to ensure that she was cared for only by physicians granted privilege in accordance with the clinic's bylaws;
-- And finally, failing to abide by its own cell phone policy (the report found that a photograph was taken of a surgeon and Rivers while she was under sedation)<----OMG that was TRUE!!!!
http://www.cnn.com/2014/11/10/showbiz/joan-rivers-death/index.html?hpt=hp_t2

 

[K_Z]

Released on Monday, the investigation said that Ms. Rivers&#8217;s blood pressure and pulse decreased precipitously while she was on the operating table on Aug. 28 between 9:12 and 9:26 a.m., yet cardiopulmonary resuscitation began at 9:28 a.m. at the earliest.

The investigation found that the anesthesiologist at the clinic, Yorkville Endoscopy, later changed the medical record to reduce the amount of Propofol, a strong anesthetic whose misuse can be fatal, that Ms. Rivers received. The stated dose was reduced to 120 milligrams from 300 milligrams.

Investigators also reported that Dr. Lawrence Cohen, then medical director of the clinic, took cellphone pictures of Ms. Rivers and her ear, nose and throat doctor, Gwen Korovin, while Ms. Rivers was lying on the operating table unconscious from anesthesia.

http://www.msn.com/en-us/news/us/jo...g-vital-signs-federal-inquiry-says/ar-AA7vsYw

As I predicted, a cascade of staggering screw ups, and colossally bad decisions, by more than one person. Take out the checkbook-- this will be a huge win or settlement. And the un-credentialed provider wasn't even mentioned-- that's really, really significant. It sounds like little to nothing was done according to proper procedures.

This just did NOT have to happen. This tragedy was 100% avoidable, IMO.

More links:

http://www.foxnews.com/entertainmen...-treated-joan-rivers-made-errors-that-led-to/

http://edition.cnn.com/2014/11/10/showbiz/joan-rivers-death/index.html

http://news.yahoo.com/ny-agency-notes-clinic-errors-rivers-treatment-013150068.html

http://entertainment.suntimes.com/t...se/?utm_medium=twitter&utm_source=twitterfeed

 

[SStarr33]

I knew all along it was going to turn out this way. I bet Melissa is PISSED because I am royally pissed and I am not even a Joan Rivers fan.

 

[CHERIE.T]

I'm shocked at the lack of professionalism shown by this medical team.....just shocked. Joan did not have to die that day. wow
I feel so badly for Joan's daughter.

 

[jjenny]

I knew all along it was going to turn out this way. I bet Melissa is PISSED because I am royally pissed and I am not even a Joan Rivers fan.

Exactly. Joan was very active. She likely had many more years ahead of her.
It was taken away.

 

[K_Z]

I knew all along it was going to turn out this way. I bet Melissa is PISSED because I am royally pissed and I am not even a Joan Rivers fan.

I'm pretty pissed off, too. I'm always pissed off when I hear about anesthetic mishaps that did not have to happen.

 

[SStarr33]

The freaking anesthesiologist changed the record and reduced the amount of propofol used. Just lovely.

I know of a couple anesthesiologists who shorted patients on their drugs and kept the extra for their personal use. Pretty pathetic that they can witness a surgery patient bucking on the table and continue the behavior.

 

[K_Z]

The propofol thing again-- the article that says she was "Michael Jackson-ed" to death-- I don't know if I can agree with that.

There is no hard and fast "dosage" for propofol used as sedation/ "deep sedation-pretending-not-to-be-general-anesthesia."

The issue is how was it dosed-- by little "bumps" from a hand held syringe, or in a drip on a pump? And we have no idea how long they diddled around in that endo suite.

The issue of not weighing her was an omission, for sure-- but professionals have to guesstimate weight every day of the week, especially in emergency situations (and for sure, this was an elective procedure). I'm not as worried about the lack of weight documented-- the anesthesiologist should have been able to guesstimate within 10-15 pounds of her actual weight. She wasn't that big.

 

[K_Z]

The bigger issue, as I see it, was "why" couldn't they secure her airway, once it was clear she wasn't breathing? FTLOG, cut a hole in her neck and trach her if necessary-- there was an ENT standing RIGHT there!

 

[SStarr33]

The propofol thing again-- the article that says she was "Michael Jackson-ed" to death-- I don't know if I can agree with that.

There is no hard and fast "dosage" for propofol used as sedation/ "deep sedation-pretending-not-to-be-general-anesthesia."

The issue is how was it dosed-- by little "bumps" from a hand held syringe, or in a drip on a pump? And we have no idea how long they diddled around in that endo suite.

The issue of not weighing her was an omission, for sure-- but professionals have to guesstimate weight every day of the week, especially in emergency situations (and for sure, this was an elective procedure). I'm not as worried about the lack of weight documented-- the anesthesiologist should have been able to guesstimate within 10-15 pounds of her actual weight. She wasn't that big.

Don't you think he/she must have been worried about the dose if they changed the record?

 

[K_Z]

Don't you think he/she must have been worried about the dose if they changed the record?

Who knows why he/ she changed the record? Was it a paper record, or an electronic one, I wonder?

And again, depends on how the provider was dosing the propofol, and how they were documenting it minute to minute. Could be a real mess in there with the cardiac arrest, and the transfer.

 

[K_Z]

Have to also keep in mind that it's likely other drugs were given, as well. They all potentiate one another. It's likely she was also being given some kind of opioid (fentanyl, sufenta, etc).

I have to wonder if alarms were silenced?

 

[K_Z]

I hate to say this, but it sounds like there was a "celebrity gawking party" in that endo suite. Everyone was so "excited" to be involved with the care of a big-deal celebrity that they left half their brains and common sense outside the room. They violated sooooo many standards of care, and institutional standards, it's truly staggering. And that's just what can be pieced together from the news reports. IMO, her celebrity status caused pretty much everyone there to abandon their professionalism.

I hate to make judgments without all the information, but I just can't imagine WHAT that anesthesiologist was doing in there? I have a ton of questions, now that it's confirmed an actual anesthesiologist was in attendance. His/ her attention was majorly distracted, IMO. Too busy watching the procedure on the video monitor and noshing with the other docs?