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Reporting Medical Errors: What We Learn From Joan Rivers’ Death

December 23, 2014

The unfortunate death of celebrity Joan Rivers from a minor medical procedure revives debate about the need for a national reporting system of medical errors to improve patient safety.  When Joan Rivers underwent a routine endoscopy, death was an unexpected outcome.  Two months after the death, in November 2014, the Centers for Medicare and Medicaid Services (CMS) released findings of its investigation and cited Yorkville Endoscopy for many safety violations in her medical care.

No National System Exists for Reporting Medical Errors

There is no national reporting system for patient safety and medical errors causing death or serious injury. Patient safety experts for years have advocated for a national reporting system of medical errors, but there isn’t one.  A reporting system would collect valuable data about medical errors and prompt corrective action for patient safety.  Only 26 states have a medical error reporting system, and most are poorly funded.

For Medicare beneficiaries like 81-year-old Joan Rivers, the Tax Relief and Health Care Act of 2006 requires the Office of the Inspector General to investigate and report “never events” to Congress.  “Never events” are serious medical errors that “should never occur in a health care setting.”  Common “never events” include:

  • Medication error (including hospital overdose)
  • Unnecessary surgery/diagnostic testing
  • Delay in diagnosis or treatment
  • Inadequate care or treatment
  • Misdiagnosis
  • Inadequate or premature hospital discharge

“Never Event” Medical Errors by Those Operating on Joan Rivers

Medical errors made by Yorkville Endoscopy on Joan Rivers were found to be “never events.”   The New York Department of Health and CMS both investigated Joan’s death because by age she received Medicare benefits.  The CMS investigation found these major errors by Yorkville Endoscopy:

  • Failed to respond to Joan’s deteriorating vital signs or provide timely interventions
  • Failed to record Joan’s weight before selecting, dosing, and giving her sedation drugs
  • Failed to document the dose of Propofol (one of the sedatives given to her, and made known to the world by Michael Jackson’s June 2009 death)
  • Failed to obtain Joan’s consent to procedures performed
  • Failed to ensure only physicians with medical privileges provided Joan’s care
  • Failed to abide by patient privacy laws – healthcare providers took cell phone pictures of Joan under sedation

Protect Your Loved Ones from Medical Errors

Perhaps you or a loved one recently underwent a medical procedure that caused a catastrophic injury or death, like Joan Rivers.  If poor monitoring, medication error, failure to be prepared for an emergency, or other error caused a devastating result, seek legal help immediately.  Ask about filing a complaint online with your state health department.  In Michigan, the Bureau of Health Care Services (BHCS) receives and investigates consumer complaints against state-licensed and federally-certified health facilities, agencies, and programs.  Healthcare providers include nursing homes, hospitals (including psychiatric hospitals and units), hospice agencies and residences, freestanding surgical outpatient facilities, home health agencies, and end-stage renal dialysis centers.

Michigan residents can find more information at:

Department Of Licensing And Regulatory Affairs

It is important to speak to an experienced medical malpractice attorney about your rights.  Michigan law is unfair to people injured by medical professionals and any delay in seeking legal help can mean losing your right to reimbursement. A medical malpractice lawsuit must, typically, be brought within 2 years after the medical error (e.g., surgery date) or be barred forever. In limited instances, a claim may be brought within six months after the patient discovers or should have discovered the error, but the lawsuit must be brought within six years of the original error.

At Buchanan Firm, our combined legal-medical team has decades of experience handling medical malpractice cases, including cases involving failure to monitor or failure to rescue/respond properly to emergency situations. We have medical professionals on staff to talk with you and immediately review your claim. Our team quickly and efficiently assesses the medical facts and takes immediate action to protect your legal rights.  Call the Buchanan Law Firm in Grand Rapids Michigan toll-free at (800) 272-4080.