Joan Rivers 2009
Rivers' endoscopy clinic in the spotlight
02:21 - Source: CNN

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Joan Rivers suffered complications during minor elective surgery

Any kind of surgery comes with risk

Age can be a complicating factor for surgery; Rivers was 81

CNN  — 

Comedian Joan Rivers lost her life after having an apparently minor elective procedure at a Manhattan medical clinic last week.

The routine surgery was on her throat, according to the New York Fire Department. She apparently suffered cardiac and respiratory arrest during the procedure at Yorkville Endoscopy. She was transferred by ambulance to Mount Sinai Hospital and died on Thursday.

The outpatient clinic is now being investigated by the New York State Department of Health, according to its spokesperson, James O’Hara.

No criminal investigation is under way, according to several New York law enforcement officials. The state health department is investigating whether there was any malpractice by the doctors and their staff, the same officials said.

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Rivers’ autopsy was inconclusive, the medical examiner’s office said.

The routine nature of the surgery has left some asking how it could have killed her.

Doctors say just because a surgery is called routine or elective doesn’t necessarily mean it is simple.

“Elective typically just means it is something you can plan ahead of time, as opposed to emergency surgery where you need to get someone in right away,” said Dr. John Sweeney, chairman of the department of surgery at Emory University in Atlanta.

When Sweeney talks to his patients about surgery he explains that there are always risks involved.

There could be complications due to bleeding or infection during the procedure. Or there could be specific risks related to the type of operation.

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Endoscopy usually refers to an evaluation of the esophagus or GI tract, according to Dr. Joel Zivot. Zivot is an assistant professor of anesthesiology and surgery at Emory University School of Medicine.

He said sometimes patients will have these procedures so doctors can evaluate their vocal cords.

Endoscopy is normally done under general anesthetic. Operating on the vocal cords is trickier, because a tube that would normally help someone breathe during such a procedure couldn’t go across the vocal cords. To tolerate that kind of evaluation, Zivot said, someone would need to be in a deep unconscious state.