Monday, December 1, 2014

Doctors Delayed CPR to Joan Rivers

Shocking report claims doctors delayed giving resuscitation to Joan Rivers during botched medical procedure.

Joan Rivers might still be alive if the two throat specialists who performed her ill-fated August procedure had simply started CPR and called 911 when the 81-year-old comedienne first went into shock, according to medical sources with knowledge of the case.
But a shocking new play-by-play — pieced together from interviews, confidential EMT records and a federal report — shows that Yorkville Endoscopy’s now-former medical director, Dr. Lawrence Cohen, and Rivers’ own Ear, Nose and Throat specialist, celebrity ENT Dr. Gwen Korovin, continued to perform scoping procedures on her larynx and trachea for 14 minutes even as her pulse and blood pressure plummeted.
Even when Rivers went into cardiac arrest, Cohen and Korovin squandered an additional 10 minutes on their own unsuccessful resuscitation attempts before calling 911, according to EMT records obtained by The Post and a federal report released this month.
By then, it was too late.
“She had no heartbeat, no pulse, she wasn’t breathing,” one insider said of Rivers’ condition when medics finally reached the Upper East Side clinic at 9:47 a.m Aug. 28.
“She had cyanosis around the lips and the mouth — that’s when your lips turn blue from lack of oxygen,” said the source, who spoke on condition of anonymity. “That takes several minutes without oxygen.”
The two medics and two emergency medical technicians who worked on Rivers managed to restart her heart and get precious oxygen into her lungs using the tracheal tube and bag-valve-mask ventilator that Yorkville’s medical staff had been plying unsuccessfully, according to records and insider accounts.
But by then, Rivers’ brain had been deprived of oxygen for significantly longer than the 5-minute cut-off for brain damage.
“They should have stopped the procedure and started resuscitation right away and done an emergency tracheotomy if there was any obstruction,” the insider said. “Maybe she would still be alive.”
Rivers made her appointment at Yorkville in hopes that camera scopings of her sinus, larynx and trachea would uncover the cause of her raspy voice. Doctors believed that her chronic acid reflux might be to blame, but something new — a polyp near her larynx, for example — also could have been responsible.
Rivers arrived at the East 93rd Street clinic with the gowned Korovin, who has treated such Broadway and recording luminaries as Hugh Jackman, Julie Andrews and Celine Dion.
Korovin was not authorized to practice at the clinic, and Rivers never signed a consent form for the two laryngoscopies that Korovin would conduct, according to a federal Department of Health and Human Services report. Rivers and Korovin were joined in the procedure room by an unnamed female anesthesiologist and an unnamed female endoscopy technician.
When she was put under at 9 a.m., Rivers’ blood pressure, pulse and other vital signs were normal, the report says. That would change dramatically in just 15 minutes, when Rivers went into shock, possibly from a reaction to anesthesia or her vocal cords seizing up in what’s known as a laryngospasm.
According to medical reports and expert and insider accounts, it was at that point that the three physicians in the room — Korovin, Cohen and the anaesthesiologist — made several critical missteps.
They failed to immediately stop their scoping and begin resuscitation at 9:16 a.m., when Rivers’ blood pressure first dropped to 92/54 and her pulse to 56 — indications of shock.
“At this point, something has gone wrong, the procedure must come to an end, and she needs to be resuscitated,” said one veteran paramedic who was not involved in the Rivers case but reviewed her records.
But Korovin and Cohen still hadn’t stopped their scoping and begun resuscitation 5 minutes later, at 9:21 a.m., when Rivers’ blood pressure dropped still further to 89/44, and her pulse fell to 54.
“She is now in decompensated shock,” said the paramedic. “If they interceded then”– stopping the procedure, starting CPR and calling 911 — “she would probably still be on TV today making fun of what people are wearing.” Instead, at 9:21 a.m., the anesthesiologist administered 120 milligrams of Propofol, the same strong sedative that Michael Jackson OD’d on.
“That doesn’t make any sense,” said the paramedic. “You’re sedating someone who’s going into shock.” By 9:26 a.m., Rivers’ blood pressure plunged to 84/40, and her pulse was 47. “This is what you call ‘coding,’ ”the paramedic said. “That’s where, in the hospital, all the doctors come running.”
But the examination continued.
By 9:28 a.m. Cohen withdrew from Rivers’ trachea a flexible scoping device called an EGD, for “Esophagogastroduodenoscope.”
Korovin then took her second turn at examining Rivers, inserting a nasolaryngoscope.
There was still no CPR, no treatment for Rivers’ shock and no 911 call, according to HHS and EMT records. Instead, according to the HHS report, the anaesthesiologist merely increased Rivers’ oxygen flow.
At some point during Korovin’s examination of Rivers, Cohen took his cell phone and snapped a humorous photograph of the doctor and her patient, according to the HHS report.
“She’s going down the tubes, and they’re taking a selfie,” said the paramedic.
Korovin would continue scoping Rivers for another 2 minutes, until 9:30 a.m. according to the HHS report. At that point, her blood pressure was at 85/49, and there was “no pulse recorded,” the report said.
Only then, at 9:30 a.m., do the doctors stop their scoping, start CPR and administer epinephrine and atropine — though 911 would not be called for another 10 minutes, at 9:40 a.m.
According to EMT records obtained by The Post, the doctors stopped giving CPR as they waited for the ambulances to arrive.
“AIDED FEM 80 YRS—- CPR IS NOT BEING GIVEN,” reads one record logged at 9:42 a.m.
“That’s just terrible,” the veteran paramedic said of the Yorkville doctors’ apparent lack of continuous CPR. “The physicians in charge of the care of the patient failed to identify deteriorating vital signs and provide timely intervention,” the HHS report states.
“Based on their own notes [as recorded in the HHS report], this is very ugly,” the paramedic said of the Yorkville staff’s actions.
Korovin and Cohen did not respond to requests for comment.
Howard Bragman, a spokesman for Rivers’ daughter, Melissa, declined comment.
Jacked from Page Six  


Anonymous said...

Hmmmm, what did she say?

NBA is fixed said...

Even more proof that the PTB (Powers That Be) murdered Joan Rivers!

WTF???!!!!! said...

^^^co-sign @ NBA is fixed

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