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NEW YORK — Joan Rivers died of brain damage from low blood oxygen during a medical procedure to check out voice changes and reflux, the medical examiner’s office ruled Thursday.

The comedian, who was 81, died Sept. 4. She had been hospitalized for about a week after she went into cardiac arrest during the procedure at a doctor’s office.

Rivers died from “anoxic encephalopathy due to hypoxic arrest” — brain damage due to lack of oxygen — during a procedure to scope her upper gastrointestinal tract and vocal folds, said Julie Bolcer, spokeswoman for the city’s medical examiner.

The death was classified as a therapeutic complication. The classification means the complication was a known risk of the procedure — a risk that patients say they understand when they sign waivers before surgery, a malpractice attorney said.

Rivers had been sedated during the procedure with propofol, the medical examiner said.
The Associated Press

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