- Clinic: "A biopsy of the vocal cords has never been performed at Yorkville Endoscopy"
- Federal privacy laws limit what medical providers can make public about patients
- The clinic has state-of-the-art equipment and well-qualified doctors, nurses, clinic says
- Joan Rivers died a week after suffering cardiac arrest at the Manhattan clinic
The Manhattan clinic where Joan Rivers suffered cardiac arrest disputed a report that it happened during a biopsy of her vocal cords.
A spokesman for the Yorkville Endoscopy clinic gave CNN its first public statement since Rivers fell ill during a procedure.
While federal privacy laws limit what medical providers can make public, the statement counters a New York newspaper report quoting an unidentified source saying a doctor made a "spur-of-the-moment" decision "to take a scalpel to a polyp-like growth on her vocal cord."
"A biopsy of the vocal cords has never been performed at Yorkville Endoscopy," the clinic's statement said.
Rivers, 81, died last Thursday in New York's Mount Sinai Hospital, where she was rushed a week earlier after she stopped breathing and her heart stopped beating during treatment at Yorkville Endoscopy.
Many questions have been raised about what that treatment was given and what might have gone wrong that led to the comedian's death. Few answers have been made public because of medical privacy rules, but the New York State Health Department confirmed the agency is investigating.
The clinic statement also seemed to address speculation that her cardiac arrest could have been related to the anesthesia used to sedate Rivers while an endoscope, which is a long, flexible camera, was used to examine her throat.
"General anesthesia has never been administered at Yorkville Endoscopy," the statement said. "The type of sedation used at Yorkville Endoscopy is monitored anesthesia care. Our anesthesiologists utilize light to moderate sedation."
Only licensed medical doctors who are board-certified anesthesiologists administer anesthesia at the clinic, the statement said.
"Our anesthesiologists monitor the patient continuously utilizing state-of-the-art monitoring equipment, and remain at the bedside throughout the procedure and into recovery," it said.
The clinic's statement also appeared to address criticism that Rivers should have been treated in a hospital and not a clinic because of her advanced age.
"Yorkville Endoscopy has strict policies in place for the criteria of who gets treated in this center versus in a hospital," the statement said. "Every patient is pre-screened by their gastroenterologist, an anesthesiologist and a nurse for appropriateness to be treated at Yorkville Endoscopy. Some patients are also pre-screened by their personal physicians."
The clinic is also well-equipped and staffed to handle emergencies, including for tracheal intubation when a patient stops breathing, the statement said.
"Yorkville Endoscopy has all necessary airway equipment, including a fiber optic scope available for emergency intubation," it said. "Three to four board certified anesthesiologists are on duty at Yorkville Endoscopy at any given time."
All of its doctors are certified for advance cardiac life support and many of the nurses also work in hospital intensive care units and emergency rooms, it said.
Rivers was undergoing an apparently minor elective procedure at the clinic when she suffered cardiac and respiratory arrest, according to the New York Fire Department.
Paramedics took her by ambulance to Mount Sinai Hospital, about a mile from the clinic, where she was initially listed in critical condition. Rivers spent a week on life support before she was pronounced dead on September 4.
The outpatient clinic is now being investigated by the New York State Department of Health, spokesman James O'Hara said.
Rivers' death also has triggered an investigation by the New York medical examiner's office, its spokeswoman, Julie Bolcer, told CNN. "The cause and manner of death will be announced at some point," she said.