Year after Joan Rivers' death, what changed?
On the first anniversary of the death of Joan Rivers following what was supposed to be an ordinary outpatient procedure, nothing much of consequence — except for bad publicity — has happened to the clinic where she was treated and to the doctors who were treating her.
There's a multi-million-dollar lawsuit pending from Rivers' daughter, Melissa Rivers. The damaging headlines, blaring daily a year ago, have diminished to a few stories here and there about such things as where Melissa spread her mother's ashes (in Wyoming).
The media and the public have moved on. Even Melissa Rivers has moved on, replacing her mother as host on Fashion Police.
Meanwhile, it's been no easy task prying any intelligible information out of lawyers, government agencies and medical professionals for a status report about what happened to Rivers and why, and whether anyone did anything wrong that led her death.
Here's what we know:
The autopsy report: Rivers died Sept. 4 in New York's Mount Sinai Hospital, one week after she stopped breathing during a routine procedure on a hoarse throat. She never regained consciousness. The city Medical Examiner's Office ruled that she died due to lack of oxygen to the brain during the throat surgery, or what it called a "therapeutic complication." She was 81.
The clinic: Yorkville Endoscopy on Manhattan's Upper East Side, where Rivers was being treated when she suffered a medical crisis on Aug. 28, 2014, is still open, still taking patients and still thriving.
A report on the clinic by health authorities was released in November and found a long list of errors by the clinic, including "failing to identify deteriorating vital signs and provide timely intervention."
But it appears the only consequence was a brief blip in the clinic's Medicare certification.
After the federal Centers for Medicare & Medicaid Services, acting for the New York Department of Health, inspected the clinic and found errors and deficiencies, the clinic's certification was pulled in January, meaning it could no longer receive payments from Medicare and Medicaid for patients 65 or older. That could have been a big problem for the clinic's bottom line had it lasted.
But it didn't last. By March, the certification was reinstated because the clinic was back in compliance with Medicare regulations, according to Reina Becnel, a public-affairs official for the agency. She did not explain how or why, or how it was related to the Joan Rivers case.
Also, the clinic's state accreditation for "office-based surgery" has switched from the American Association for Accreditation of Ambulatory Surgery Facilities, to the Accreditation Association for Ambulatory Health Care. The distinction is apparently legal rather than medical and it's not clear whether it has to do with Joan Rivers.
On Thursday, Yorkville issued a statement through its new media manager, Jane Hardey, in response to questions about the one-year anniversary.
"The physicians of Yorkville Endoscopy continue to serve their patients. Yorkville is fully licensed by the New York State Department of Health, Medicare-approved, and accredited by the Accreditation Association for Ambulatory Health Care. The physicians directly responsible for Ms. Rivers' care are no longer affiliated with Yorkville in any way."
Hardy added, "At no time did the (clinic) cease receiving payment from Medicare nor did any termination of Medicare participation ever become effective."
The clinic doctor: Dr. Lawrence Cohen resigned from Yorkville during the uproar following Rivers' death. Cohen conducted the endoscopy procedure on Rivers and, according to the negligence lawsuit by Melissa Rivers, also took cellphone pictures of Rivers while she was unconscious on the operating table.
"It wasn't a selfie in the sense that it was a picture of himself," says one of Melissa Rivers' lawyers, Jeffrey Bloom. "It was a picture of Joan on the table, while she was crashing, by the way."
Cohen's lawyer, Jay Rappaport, says Cohen is still in New York and is still a practicing gastroenterologist — "He never stopped practicing" — although he wouldn't say where or otherwise comment. In response to the Melissa Rivers lawsuit, Cohen has denied he took a cellphone picture of Joan Rivers.
The personal doctor: Dr. Gwen Korovin, Rivers' personal doctor, is still practicing in New York.
Korovin was not authorized to practice at Yorkville but she was there anyway and, according to the lawsuit, conducted an unauthorized laryngoscopy on Rivers. The lawsuit also asserts that Korovin left the operating room while other medical personnel were trying to revive her.
Before the Rivers tragedy, Korovin was beloved by celebrities and stars, known as "Broadway's throat doc and keeper of high-profile pipes," as the New York Daily News put it in April 2013. And even after Rivers died, her celebrity patients, such as Joel Grey, were effusive about her.
"I only know her to be prudent and careful and loving, and there was no hour of the day I couldn't call her," said Grey, Korovin's patient for 20 years, in the New York Times. "I never saw her do anything that was less than caring and considered."
Initial reports after Rivers' death suggested it was Korovin who took the infamous cellphone photo. But she denied this during a July hearing for the Melissa Rivers lawsuit, and Rivers' lawyers, Bloom and Ben Rubinowitz, confirmed to USA TODAY they believe it was Cohen who took the picture.
The lawsuit: Like all lawsuits, it's plodding through the legal system, says Bloom, and is still in the discovery phase.
The lawsuit, which Bloom says "seeks compensation for the loss of Joan" targets Yorkville, its parent company, Frontier Healthcare, and Cohen and Korovin.
Melissa made clear her intent at the time it was filed in late January.
"The level of medical mismanagement, incompetency, disrespect and outrageous behavior is shocking and frankly, almost incomprehensible, " she said in a statement.
