Starstruck clinic in malpractice suit

The anesthesiologist was getting nervous. Joan Rivers, the comic known for her sassy wit and raspy voice, had been complaining of more than the usual hoarseness.

Now Rivers was on the operating table at an Upper East Side clinic and her private doctor, Gwen Korovin, wanted to send a small instrument into her windpipe to take a second look at her vocal cords, according to a malpractice lawsuit filed on Monday in State Supreme Court in Manhattan.

The anesthesiologist warned that the cords were extremely swollen, and that they could seize up and Rivers would not be able to breathe.

“You’re such a curious cat,” Dr Lawrence Cohen, the medical director of the clinic, Yorkville Endoscopy, scolded the anesthesiologist, according to the suit, which was filed by Rivers’s daughter, Melissa.

Dr Cohen dismissed the anesthesiologist’s concern as “paranoid” and let Dr Korovin proceed, the suit said, with disastrous results.

Rivers went into cardiac and respiratory arrest during the procedure on August 28 and died several days later. There has been no official determination of exactly what it was that killed her, though federal health investigators found a number of errors, including a failure by those treating Rivers to notice that her vital signs were dropping, which the lawsuit said contributed to the death. The lawsuit also said the closing of Rivers’s vocal cords was a cause.

The defendants include Dr Korovin; the clinic; Renuka Bankulla, the anesthesiologist; and Dr Cohen, who stepped down as the clinic’s medical director. The clinic, in an emailed statement, said it was “not appropriate to comment publicly regarding the lawsuit” but that “the Rivers family has, as it has always had, our deepest sympathies and condolences.”

Bruce Brady, a lawyer for Dr Bankulla, said, “The claims of malpractice against her are unfounded.” None of the others responded to requests for comment on Monday.

The doctors who treated  Rivers were so oblivious, the lawsuit says, that Dr Cohen pulled out his cellphone and took pictures of Rivers lying on the operating table as her brain was being damaged by lack of oxygen.

Eventually, Dr Bankulla realised that Rivers was “suffering from an airway obstruction and/or laryngospasm,” a closing of the vocal cords.

But, the court papers say, Dr Bankulla did not demand a “crash cart,” which might have had a drug like succinylcholine to relax her muscles and allow insertion of a breathing tube, then waited several minutes before calling for help.

When she did, two other anesthesiologists arrived, and one of them tried to administer oxygen through a mask, to no avail.

Dr Bankulla looked around for Dr Korovin to punch a hole in Rivers’s throat – an emergency cricothyrotomy that she should have been trained to do as an ear, nose and throat doctor – but Dr Korovin had fled the clinic, according to the suit.

Serious allegations

The lawsuit drew its allegations from as-yet-unreleased documents including a five-page statement written by Dr Bankulla, and interviews conducted by the medical examiner.

Melissa Rivers’s lawyers said they would seek “significant damages,” which could range in the millions considering that Joan Rivers, at 81, was still performing regularly as a comedian.

“Not only did my mother deserve better, every patient deserves better,” Melissa Rivers said in a statement issued by her lawyers, Jeffrey Bloom and Ben Rubinowitz.

The federal government said this month that the clinic, on East 93rd Street, had until March 2 to correct problems discovered by health investigators, or it would lose its ability to receive Medicare and Medicaid payments.

The lawsuit says that Rivers was in part a victim of her own celebrity, receiving treatment that violated protocol because her doctors were star-struck and trying to please her.

Dr Korovin, an ear, nose and throat doctor to a number of well-known actors and singers, was  Rivers’s personal physician, and did not have privileges at the clinic.

But Dr Cohen, the medical director, allowed her in,  Bloom, the lawyer, said on Monday. The court papers say Dr Korovin fled the clinic when it became clear that Rivers was in trouble because she knew she was not supposed to be there, and “wanted to avoid getting caught.”“Joan Rivers needed a doctor, not a groupie,” Bloom said.