Legendary comedian and TV personality Joan Rivers was recently hospitalized following an apparent cardiac arrest during the course of an endoscopic procedure at an outpatient facility on the Upper East Side in Manhattan, New York. The 81, year old was brought to Mount Sinai Hospital and placed in a medically induced coma. She passed away yesterday. Were there departures from accepted medical practices in the treatment of Ms. Rivers?

Upper endoscopic procedures are usually administered in order to evaluate gastrointestinal (GI) issues such as ulcers or tumors, esophageal and vocal cord issues and symptoms like heartburn or swallowing difficulties. The procedure involves the placement of a scope into the mouth and advanced to visualize the throat, esophagus, stomach and portions of the small intestines. Performing such a procedure on an elderly patient requires special consideration to ensure that the patient is able to undergo the procedure. One of the main risks of performing endoscopy in an elderly patient is the effects of sedatives or anesthesia utilized during the procedure. Studies suggest that there are increased risks such as arrhythmias, hypoxia and hypotension, associated with the sedation. Over-sedation can increase respiratory depression and impair recovery in elderly patients.

Mr. Steven E. North, Esq. a noted New York City medical malpractice attorney states that there are numerous issues to evaluate in determining the propriety of the medical treatment rendered to Ms. Rivers – Was the procedure indicated? Was the patient medically cleared for the procedure? Was the procedure performed properly? Were the arrest circumstances timely and properly managed? Was the anesthesia properly provided and monitored?

Physicians performing endoscopic procedures must be fully familiar with the patient’s history and understand that procedures used in younger patients may not be suitable for older ones. If a physician exposes a patient to an unacceptable risk, he or she can face substantial medical malpractice claims.