A federal report in the Joan Rivers death investigation said the New York City outpatient clinic where the 81-year-old comedian suffered cardiac arrest during a throat procedure didn't follow all the standard protocols, such as weighing her before administering the sedative Propofol.
Rivers died on Sept. 4 in a New York City hospital a week after her heart stopped during the outpatient procedure at the Yorkville Endoscopy center on Manhattan's Upper East Side.
Reuters reported the Centers for Medicare & Medicare Services, the agency that released the report, as saying there was no record that staff at the center weighed Rivers before administering Propofol on Aug. 28 and there were inconsistencies recorded in the dosage of the drug.
It also said there were no records of medical consent for all the procedures performed. The report added that a doctor who was in the operating room was there without authorization and said physicians also failed to detect Rivers' deteriorating vital signs during the procedures.
Melissa Rivers, the comedian's only child, said in a statement on Monday that she is "outraged by the misconduct and mismanagement" that occurred and will ensure it does not happen again with any other patient.
Her lawyers are investigating the circumstances surrounding her mother's death.
The CMS released the report following an investigation by the New York State Department of Health, which questioned doctors and staff and examined records at the clinic.
"The Centers for Medicare & Medicaid Services (CMS) does not comment on information contained in a facility's statement of deficiencies," it said it a statement after releasing its report.
No one was immediately available at Yorkville Endoscopy to comment on the report.
The New York Chief Medical Examiner's Office said Rivers died of a predictable complication during a medical procedure and lack of oxygen to the brain.
The CMS said another unannounced survey will be conducted at the clinic and if corrections are made and it is in substantial compliance it will not face termination of federal Medicare and Medicaid funding.
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