Who/What Killed my friend Joan Rivers ?

Erica, my wife and I were honored to attend the funeral of Joan Rivers Sunday, watching as the NYPD bagpipers played, and with tears mixed with laughter, New York and the Nation said good bye to our beloved X-Rated court jester. The whole town turned out. Howard Stern, Barbara Walters, Diane Sawyer, Donald Trump, Hugh Jackman and a list of notables remembered her outrageous wit. Joan and I were in the daytime talk show business together. She was a brilliant comic who made the world a happier place. Irreverent and energetic, she could make a sphinx laugh. She was feisty, side-splittingly funny and filled with piss and vinegar.She had boundless love for daughter Melissa and grandson Cooper. She loved New York and she could make a car crash funny. We'll all miss her. I miss her. She made me laugh and she was always a loyal, trustworthy friend through thick and thin. But even before the grieving for Joan Rivers is over, all who knew her are insisting that there be an aggressive investigation of the store-front clinic where her fatal encounter began. How could they administer the powerful sedative Propofol to an 81-year old woman without the expertise or equipment on site to resuscitate her in the event of cardiac and/or respiratory failure?  This seems to mirror the fate of Michael Jackson, who died in his home from an overdose of Propofol administered with gross negligence by Dr. Conrad Murray. Murray went to jail, which may be the fate of the owner/operator of Yorkville Endoscopy Clinic. Donald Trump shares my sentiments. He told me Sunday, that her passing, “...was shocking because I spoke to her a week ago and she phoned me on something else and she was in such great spirits and such great health and she was going to go on forever and all of a sudden we read the story with probably some bad doctor or whatever the hell happened, but something bad happened.”Dr. Marc Siegel of the Fox News Medical “A” Team was more specific,  “It was some kind of an endoscope,” Dr. Siegel said, “And the key with someone of that age is that what you use for anesthesia can be problematic. How much anesthesia you use, whether it’s monitored carefully enough, you got to use a lower dose, and often times what is used in this setting is Propofol which is what killed Michael Jackson.”Aside from the issue of whether the sedative used on the frail 81-year old was too strong, why was this procedure done in a clinic rather than a hospital? Again, here is what Dr. Siegel says, “I think it’s problematic to have someone, anyone that’s over the age of 80 years old have a procedure like this done in a walk-in clinic situation because it all happens so fast and you know what? The amount of oxygen to the brain being cut off, irreversible brain damage occurs much more quickly in an 81 yr old than it would in someone younger and that could actually recover. It’s very risky in my opinion to do it that way. I would have taken an elderly patient and put them in the hospital for this.”Once the crisis started with Joan, did the clinic do enough to resuscitate the stricken woman? Summoned by a frantic 911 call, precious minutes were wasted until Joan was taken to nearby Mt. Sinai Hospital and placed in a medically-induced coma. She was on life-support, but really, she was already dead. As famed forensic pathologist Dr. Michael Baden told my brother Craig when asked how long before the human brain is damaged as a result of oxygen deprivation,  “Within 10 seconds if the brain doesn’t get enough oxygen, the person will pass out. And within a minute or so, there will be extensive brain damage, individual cells will die if oxygen isn’t immediately resupplied by giving oxygen and the whole CPR process becomes an important factor to look into in determining what happened to Joan Rivers and what was done that could have stopped the process from getting worse.” Investigators for the New York Department of Health as well as other agencies have begun intensive probes, gathering medical records, searching for video tapes of the incident, and interviewing doctors and staff at the only one-year old facility. My guess is that it will not be around for much longer.

Rest in Peace Joan Rivers. We’ll track down what ended your brilliant, well-lived life.