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Federal agency accepts planned fixes at clinic where Joan Rivers was treated before she died

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NEW YORK — The clinic where Joan Rivers suffered a fatal complication during a medical procedure has submitted an acceptable plan to correct problems uncovered during an investigation after her death, a federal health agency said Tuesday.

The investigation, ordered by the federal Centers for Medicare and Medicaid Services, found the Yorkville Endoscopy clinic made several errors, including failing to keep proper medication records and snapping cellphone photos of Rivers while she was unconscious. It also found the Manhattan clinic failed to get informed consent for every procedure performed and failed to record Rivers' weight before the administration of sedation medication.

Rivers, an acid-tongued comedienne who crashed the male-dominated realm of late-night talk shows and starred with her daughter on E! in "Fashion Police," died Sept. 4 at age 81. The city's medical examiner found she died of brain damage due to lack of oxygen after she stopped breathing during an endoscopy days earlier. Her death was classified as a therapeutic complication, and no negligence was alleged in the federal report.

The clinic submitted a lengthy plan for fixes including a visitor safety log that states employees must show badges and a procedure room quality log that states a list of credentialed physicians must be posted, according to the paperwork. The plan also includes and a code blue policy update, which details how the clinic responds when a patient is in a sudden life-threatening situation. Four drills on the policy must be performed annually.

PHOTO: FILE - This Oct. 5, 2009 file photo shows Joan Rivers posing as she presents "Comedy Roast with Joan Rivers " during the 25th MIPCOM (International Film and Programme Market for TV, Video, Cable and Satellite) in Cannes, southeastern France. A federal agency has accepted planned fixes at the New York City clinic where Joan Rivers suffered a fatal complication during a medical procedure. The federal Centers for Medicare and Medicaid Services on Tuesday, Dec. 16, 2014, released the Manhattan clinic's plan to fix deficiencies. The clinic has until Jan. 7 to comply or lose Medicare accreditation. Rivers died Sept. 4, 2014. Rivers, 81, was hospitalized Aug. 28, after going into cardiac arrest at a doctor's office. (AP Photo/Lionel Cironneau, File)
FILE - This Oct. 5, 2009 file photo shows Joan Rivers posing as she presents "Comedy Roast with Joan Rivers " during the 25th MIPCOM (International Film and Programme Market for TV, Video, Cable and Satellite) in Cannes, southeastern France. A federal agency has accepted planned fixes at the New York City clinic where Joan Rivers suffered a fatal complication during a medical procedure. The federal Centers for Medicare and Medicaid Services on Tuesday, Dec. 16, 2014, released the Manhattan clinic's plan to fix deficiencies. The clinic has until Jan. 7 to comply or lose Medicare accreditation. Rivers died Sept. 4, 2014. Rivers, 81, was hospitalized Aug. 28, after going into cardiac arrest at a doctor's office. (AP Photo/Lionel Cironneau, File)

The plan also clarifies the procedures for the use of the anesthesia drug propofol, which was administered to Rivers and was implicated in pop star Michael Jackson's death.

The Centers for Medicare and Medicaid Services will make an unannounced visit to ensure procedures are in place, and, if so, the clinic will not lose its Medicare accreditation. The clinic has until Jan. 7 to comply.

Representatives for the clinic didn't return a call seeking comment Tuesday. The clinic said in November, after it submitted the plan to state and federal accreditation agencies, that the plan addressed all issues raised and that the physicians referenced in the report no longer provide services there.

Rivers' daughter, Melissa Rivers, has said she was outraged by the report's findings. She has hired a prominent malpractice attorney to investigate.

The Medicare probe was done on behalf of the federal agency by the state Department of Health. The clinic's plan was accepted Monday and released Tuesday.

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