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article imageDeath of comic Joan Rivers blamed on anesthesia drug propofol

By Nathan Salant     Oct 17, 2014 in Entertainment
New York - Acerbic comedian Joan Rivers died after suffering cardiac arrest during an outpatient medical procedure, a known potential side effect of the anesthesia drug propofol — the same drug implicated in the death of Michael Jackson.
Rivers, 81, died in a hospital Sept. 4 — a week after being administered propofol to undergo a upper gastrointestinal endoscopy to determine the cause of voice changes and reflux, according to the Associated Press.
The famous comedian, widely admired for becoming a commanding presence in the formerly male-dominated world of standup comedy, had been hospitalized since suffering the complications at an upper East Side medical clinic.
The New York City Medical Examiner's Office made the cause of death determination on Thursday, the AP said.
The official cause of death was "anoxic encephalopathy due to hypoxic arrest" — brain damage due to lack of oxygen, a spokeswoman for the medical examiner, Julie Bolcer, told the AP.
Rivers' death was classified as a "therapeutic complication," a rarely used category, since most deaths are certified as accidents, homicides, suicides or natural causes, but which indicates that negligence is not suspected.
Because cardiac arrest and hypoxia are known risks from the use of propofol, Rivers would have signed a waiver before the drug would have been used, Manhattan medical malpractice attorney Steven R. Harris told the AP.
"I always tell my clients when they come through here, every time you have surgery you're playing Russian Roulette," Harris said.
"The more surgery, the more the numbers can catch up with you and, as we know, Ms. Rivers had a lot of surgery," he said.
Medical experts told the AP that propofol can be used safely the type of procedure Rivers underwent, but that it should only be administered by a doctor or nurse trained in using it.
Elderly patients should be given the drug gradually at lower doses than younger ones and, while being treated, patients should be closely monitored by someone not involved in doing the procedure, the experts said, and breathing support equipment should be immediately available in case of problems, the medical experts said.
The medical examiner's report did not say whether those precautions were taken.
Rivers' daughter, Melissa, declined to comment on the report.
"We continue to be saddened by our tragic loss and grateful for the enormous outpouring of love and support from around the world," she said in a written statement.
Rivers was a regular on late-night talk shows — she even hosted her own for a short time, leading to a infamous falling out with Johnny Carson in 1983 — and became a cable television regular with snarky commentaries, often accompanied by her daughter, beginning in 1994.
Pop megastar Jackson died of an overdose of propofol at age 50 in 2009 and his personal physician, Conrad Murray, was convicted of voluntary manslaughter two years later for administering the fatal dose.
Murray served two years of a four-year jail sentence and was released from custody in 2013.
Despite the conviction, Murray has always denied responsibility for Jackson's death.
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