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#1

Why Joan Rivers Died

According to the title of this article, Doctor Who performed the surgery. You always take your life in your hands when a British science fiction character does the surgery.
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If anyone ever tells you that you put too much Parmesan cheese on your pasta, stop talking to them. You don't need that kind of negativity in your life.
#2

Why Joan Rivers Died

LOL, I thought the exact same thing when i read that article in Hufpo over the weekend!

Those Blocked: SueStorm. N2N Nate. Good riddence to stupid! Rad-Z, shill begone!
#3

Why Joan Rivers Died



You buried the lede, as they say in newspaper circles. It was the title of the article, which could be read as being about the TV character "Doctor Who": "Doctor Who Performed Joan Rivers' Procedure Steps Down"

The real story has three potentially criminal aspects:

One is that Dr. Lawrence Cohen is a notorious rogue advocate for the de-regulation of hospital services. For several years he has been writing articles saying that Propofol, the powerful anesthetic that killed Michael Jackson, should be administered by doctors and nurses without the presence of a anesthesiologist. If Joan died of a Propofol overdose, he is to blame.

Two is that he allowed an as-yet-unidentified ENT doctor in to the operating room, without any authorization. This ENT was not only allowed to observe but also to examine Joan's throat.

Finally, he performed an unauthorized biopsy of the vocal cord, which then "seized," which caused her to stop breathing. Joan had only signed forms consenting to the endoscopy, not a biopsy.

If the third possibility proves true, he could be tried and found guilty of criminally negligent homicide, which is a Grade-B felony with a potential 10-year sentence.



#4

Why Joan Rivers Died

Pal Joey-I read somewhere that she was asked for permission to perform the biopsy and said no. If they can prove that these doctors took it upon themselves to do this without her consent (she did sign off on an endoscopy I read-but that doesn't include a biopsy), then they're looking at the negligent homicide (which is what I tend to think happened). Why they couldn't leave well enough alone I will never understand. (She may have had a reason for saying no.)

PJ-Also-not only would the doctor be found guilty in that instance, but wouldn't the CLINIC? They allowed him (or one of their physicians did) to perform the unauthorized procedure.

Updated On: 9/15/14 at 12:48 PM

#5

Why Joan Rivers Died

I don't understand why he's not in jail. The procedure he performed was unauthorized outside of a hospital setting. That means illegal, right? What am I missing?
#6

Why Joan Rivers Died

I was wondering that, too, Cats. (I was talking to a lawyer about this as a what if and he said it's not necessarily negligent homicide. I'd sure like to know what it is then-not only was this guy NOT supposed to be there, but I daresay had he not performed a procedure that she didn't authorize, she might still be alive. It wasn't his decision to make. Period.)
#7

Why Joan Rivers Died

Why would a doctor ever perform a biopsy if the patient explicitly disapproved prior to going under? That is negligence, if not worse. Assuming dreaming's claims are true.
#8

Why Joan Rivers Died



A hospital is not necessary for an endoscopy. (It's a licensed endoscopy clinic.) These outpatient clinics are common all over the country, but they're fairly new in New York State. They are licensed and follow procedures but their procedures are not as stringent as hospital procedures. It's part of the "new medicine"--doctors can open clinics and make a lot more money doing procedures that used to be done in hospitals only.

I don't believe Joan said "no" to the biopsy. (She was under anesthesia.) It's that she signed on for the endoscopy and a biopsy was not authorized. The doctor--APPARENTLY--made an on-the-spot decision to do the biopsy and that--or the Propofol--killed her.

The board of directors of the clinic removed him fairly quickly, given that he was the head of the clinic. No criminal charges will be filed until the investigations are complete.

But the more you read about this doctor, the more he seems like Dr. Mengele.





Updated On: 9/15/14 at 01:42 PM

#9

Why Joan Rivers Died

I hope they find some way to give him the death penalty.
#10

Why Joan Rivers Died

The thing about her saying no is that they asked before the procedure whether she would consent to the biopsy-and she would not consent (is that not the same as saying no?).

I think that what was done is very suspect-endoscopies are very routine procedures and can easily be done without hurting the patient.
#11

Why Joan Rivers Died



I haven't seen that reported anywhere. Where did you see it?
#12

Why Joan Rivers Died

There is often some boiler plate in there about"if during the course the the procedure a situation occurs/is found where in the opinion of the physicians a specific action is necessary the action can be take w/out the express consent." U can cross it out and refuse but often the MD's will refuse the whole procedure then.

"without the presence of a anesthesiologist" now is that anesthesiologist or anesthetist ?
Both have specialized training but only the anesthesiologist is a board certified specialist.
I personally have no issue w the deregulation of services, over the course of my professional career I have seen dozens upon dozens of procedures being successfully and safely done on an out pt basis at considerable savings of time and resources (as well as cash)

Oh and Propofol w/out anesthesia specialists being present( at least in a supervisory capacity) will not happen- too many anesthesiologists/anesthetists will fight it w the medical boards of licensure.
#13

Why Joan Rivers Died

They were "present" at the clinic--but whether or not they were in the operating room supervising the administration of the Propofol is under investigation. And the arrogant Dr. Cohen has apparently written papers saying doctors and nurses are sufficient to administer it.
#14

Why Joan Rivers Died

Anesthesia is not generally required- a sedative like Versed w or w/out Fentynal is used along w a lidocaine local anesthesia spray to the throat to suppress the gag reflex ( oh just write your own damn joke here.) People come out quicker w/out the side effects. Propofol puts u right out and u need vital sign monitoring and is usually not used in clinics. IF anesthesia was on site and they had appropriate resuscitative equipment there shouldn't have been an issue.

#15

Why Joan Rivers Died




That's the point. Dr. Cohen was too arrogant to follow standard procedures. He followed his own procedures.

That's why she's dead. And that's why they fired him. And that's why he's being investigated by the New York State Department of Health, the New York City Office of Chief Medical Examiner, and local law-enforcement authorities.



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