Outrage Over Last Operation on Joan Rivers

     (CN) – The doctor who let an unqualified specialist operate on Joan Rivers and ignored her fading vital signs also photographed the legendary comedian in surgery, her family claims in court.
     The executors of Joan Rivers’ estate – her daughter, Melissa Rivers; business manager, Michael Karlin; and interior designer, Robert Higdon – sued Frontier Healthcare LLC and its facility, Yorkville Endoscopy LLC; Acquista Medical Services PLLC dba Comprehensive Anesthesia Specialists; and five medical providers in New York Supreme Court on Monday.
     When Rivers went to Yorkville Endoscopy in New York on Aug. 28, 2014, she allegedly signed informed consent documents solely for “an upper endoscopy (EGD), with possible biopsy/possible polypectomy, possible dilatation of the esophagus” with anesthesia.
     After Rivers was sedated, however, gastroenterologist Lawrence Cohen, M.D., allegedly asked otolaryngology specialist Gwen Korovin, M.D., to perform a transnasal laryngoscopy, even though the patient never agreed to that procedure and “even though he was aware that [Korovin] was not credentialed by the defendants, Yorkville Endoscopy or Frontier Healthcare.”
     Anesthesiologist Renuka Bankulla “raised questions,” but Cohen and Korovin ignored her, knowing Rivers had not consented to a laryngoscopy, according to the complaint.
     When Bankulla pointed out “the possibility of airway compromise” because of edema, or swelling, resulting from a second laryngoscopy, Cohen called her paranoid, the Rivers estate claim.
     Bankulla wanted to reinsert the EGD scope to visualize the vocal cords in light of the plans for the new procedure, but that request also met with refusal, according to the complaint, which says Cohen called her “a curious cat. You always want to know what’s going on.”
     Cohen then used his cellphone to take “photos of Joan Rivers while under sedation and with the defendant, Korovin,” in violation of HIPAA, the complaint states. The Rivers estate says no one objected.
     The doctors allegedly “failed to recognize that Joan Rivers was hypotensive and bradycardic before attempting a second laryngoscopy and failed to provide timely intervention” by requesting a crash cart, administering a muscle relaxant, or intubating her.
     Bankulla noticed Rivers’ vital signs deteriorating at about 9:29 a.m., but still “waited minutes before stating that she needed help,” the complaint states.
     Neither Robert Koniuta nor Suzanne Scarola, the two anesthesiologists who answered Bankulla’s call, “ordered, performed, or recommended the appropriate emergency treatment that the situation required,” according to the complaint.
     Instead Koniuta handed cardiac medicines to Bankulla while Scarola “took over the unsuccessful attempts at mask ventilation via ambu bagging,” the complaint alleges.
     Minutes later, Scarola “made an unsuccessful attempt to intubate Joan Rivers,” the comedian’s estate says.
     Bankulla then wanted Korovin to perform a cricothyrotomy – an emergency incision to make way for air flow – but Korovin had “left the procedure room because she knew she was not permitted to perform medical services or procedures at the defendant, Yorkville Endoscopy, and wanted to avoid getting caught,” according to the complaint.
     Though Bankulla had called a “code blue” at 9:28 a.m., “it was not until 9:40 a.m. that someone from the defendant, Yorkville Endoscopy, called 911,” the complaint states.
     The plaintiffs say that Rivers therefore “suffered hypoventilation, airway obstruction, hypoxemia, and severe and prolonged hypoxia which caused cerebral anoxia and eventual death” on Sept. 4, 2014, harming her daughter, Melissa, and her grandson, Cooper.
     The two-count, 281-paragraph complaint seeks punitive damages for failure to train and negligent hiring and policymaking.
     Cohen’s failure to “even mention the laryngoscopies performed by the defendant, Korovin, at his request and with his permission or even that defendant, Korovin, was present at any time during the procedure,” violated New York state law, the complaint alleges.
     The plaintiffs are represented by Jeffrey Bloom and Ben Rubinowitz of Gair, Gair, Conason, Steigman, MacKauf, Bloom & Rubinowitz in New York.

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