I was contacted by news reporter Sheila Feeny at AM New York yesterday, shortly after Joan Rivers died after being removed from life support, to help answer questions about how the New York State Department of Health investigation is conducted in light of suspected medical wrongdoing.
Here is one quote that was used...
While hospitals are better equipped to handle patients who might need emergency intubation to prevent brain damage or death, Oginski observed that even outpatient facilities "are supposed to have crash carts and certain medications and staff trained to use them in an emergency. Were they prepared?" he said.
There has been a dramatic sudden interest by the New York State Department of health with the events surrounding Joan Rivers' cardiac arrest following her throat surgery procedure at an upper East side endoscopy facility. The speed at which the Department of Health has sprung into action is astounding.
Normally, it takes months for them to (1) assign an investigator, (2) go to the medical facility, (3) interview nurses and doctors and (4) review the records. It then takes weeks or months for them to prepare a report and conclusions about their findings.
Today's news reports also indicate that an autopsy done by the New York City medical examiner was also completed. This too is a surprisingly swift clinical and pathological examination of a patient who died under questionable circumstances.
According to news reports, the initial autopsy reveals it was inconclusive. The medical examiner took body fluid samples and will send that off for evaluation, which can take weeks.
AM New York was trying to determine what the Department of Health looks for when investigating a doctor or healthcare facility.
Here's what I told Ms. Feeny...
First, they look to see whether the medical facility's own protocol and procedures were violated. Then they look to see if any state law, rules or regulations were violated. If they determine that there were violations, they then the issue a “statement of deficiencies.”
The overall purpose of issuing a statement is not to point fingers and point blame at the doctor or healthcare facility. Rather, the DOH claims it is for the purposes of preventing further injury to any patients in the future. If a statement of deficiencies is issued, then the doctor or health care facility must prepare a plan of correction in order to make sure that this type of event does not happen again in the future.
At the present time, the public does not know the details surrounding the procedure that was done, whether the doctor was qualified, whether the patient was a candidate for the procedure, at what point before, during or after the procedure she suffered her cardiac arrest.
We also don't know what triggered the cardiac arrest and why she lapsed into a coma. Was there an anesthesiologist providing sedation? Did someone not recognize that she was either in respiratory arrest or cardiac arrest?
The Department of Health will also look to determine whether the staff was trained and qualified in treating patients who have medical emergencies. They will look to see what type of crash cart was available and what type of medications on the crash cart were available.
This type of Department of Health investigation is separate and apart from any type of medical malpractice wrongful death lawsuit that her family may choose to bring.
The issue of whether the Department of Health findings of fact or conclusions can be used at trial are a great topic for a separate article that I've commented on previously here on my website.