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strained vocal cords. Like dry cleaning, she'd be in by 9 and out by
noon. Nobody foresaw a need for defibrillators, breathing tubes or
sirens wailing on the ride to Mount Sinai Hospital, a mile away, where
Ms. Rivers was kept on life support until she died a week later, on
Sept. 4. But things went wrong inside Yorkville Endoscopy. Horribly
wrong.
Callous and cavalier?
Routine endoscopy? Hardly. From privileges and propofol to selfies and
safety standards, the 81-year-old comedienne's death leaves a trail of
unanswered questions about what took place at the freestanding surgery
center in midtown Manhattan and puts the safety of outpatient surgery
once again under scrutiny.
"When death occurs to someone who is well-known, it seems like
the roof's falling in," says anesthesiologist David Shapiro, MD, the for-
mer president of the Ambulatory Surgery Center Association. "That's
not the case. Outpatient surgery in accredited facilities is safe. Not
perfect, but safe. It's sad to me that the whole model of delivery of
care has been questioned."
At press time, the New York City medical examiner hadn't yet
reached a conclusion on what caused the death of Ms. Rivers, but he
might want to list a callous disregard for safety and a cavalier attitude
as contributing factors.
If we are to believe widespread reports and speculation about what
happened on the morning of Aug. 28, Ms. Rivers, after sailing through
many age-defying cosmetic surgeries without incident — "I've had so
much plastic surgery, when I die, they will donate my body to
Tupperware," she once joked — didn't die from the scheduled
endoscopy. Gastro-enterologist Lawrence Cohen, MD, who was the
medical director of the clinic until resigning after Ms. Rivers's death,
C O V E R S T O R Y
