Investigators say NYC clinic that treated Joan Rivers made errors that led to her ...

Staff members at the clinic that treated Joan Rivers made multiple errors that led to the comedian's death in September, a government report found Monday.

The U.S Department of Health and Human Services said doctors at the Manhattan-based Yorkville Endoscopy clinic failed to accurately document how much sedative propofol was used on the 81-year-old Rivers, and failed to 'identify deteriorating vital signs and provide timely intervention during the procedure.'

Rivers went into hypoxic arrest -- the result of a lack of oxygen to the brain -- at the clinic on August 28 during a minor operation to treat voice changes and acid reflux. She was rushed to a local hospital and was taken off life support a week later.

The New York State Health Department launched a routine investigation into the clinic, which opened last year, and found multiple violations, including a failure to ensure that patient care services were provided in a manner that protects the health and safety of all patients, a failure to ensure that only authorized personnel were allowed in the operating room and that only credentialed physicians were permitted to execute procedures. The report also said that the clinic failed to ensure that consent was obtained for all surgeries, which compromised Rivers' safety.

In particular, the investigators determined that a staff member took pictures of Rivers with a surgeon who was illegally allowed in the room. Rivers allegedly only consented to an upper endoscopy procedure, but a larger laryngoscopy was instead performed.

Yorkville Endoscopy released its own statement Monday, insisting that it has fully cooperated with officials and has immediately submitted and implemented a 'plan of correction that addressed all issues raised.' The plan remains under review by regulatory agencies.

'The physicians involved in the direct care and treatment referenced in the report no longer practice or provide services at Yorkville,' the statement said. 'Yorkville will continue its commitment to complying with all standards and accreditation requirements.'

Rivers' daughter Melissa has hired her own personal injury lawyers to investigate her mother's death and was 'terribly disappointed' to learn of the multiple failings on the 'part of the medical personnel and the clinic.'

'Ms. Rivers is outraged by the misconduct and mismanagement now shown to have occurred before, during and after the procedure,' Melissa Rivers' attorneys said in a statement issued Monday on her behalf. 'Moving forward, Ms. Rivers will direct her efforts to ensuring that what happened to her mother will not occur again with any other patient.'

Yorkville Endoscopy remains open and active, but will lose its certification if it does not comply and correct the problems cited by state investigators by early January.

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