Investigators are uncovering shocking details of the events on Aug. 28 that lead to the comedienne Joan River's death a week later at Mount Sinai Hospital.

Rivers had originally gone to the Yorkville Endoscopy clinic to undergo a scheduled procedure under Dr. Lawrence Cohen to locate any digestive tract issues. At some point during the procedure, an anomaly was detected in Rivers' throat, prompting an unplanned and unauthorized biopsy on her vocal chords as she was sedated.

The staff at the clinic told investigators that Rivers did not sign a consent form for the biopsy and was not made aware that an additional procedure would be performed on her while under anesthesia.

Moreover, River's personal ENT specialist, who has not been publicly identified, was in the clinic's operating room without authorization as well, and was the one who performed the procedure without clearance at the facility.

According to Dr. Arthur Caplan of New York University's Langone Medical Center, many red flags should have been raised that day.

"Even though you are a licensed physician, you still should have, if you will, the checks and balances to get your approval to practice in that particular place," Caplan said.

The biopsy on Rivers' vocal chords was not completed as her vocal chords began to swell, cutting off the oxygen and blood circulation to her lungs and brain, putting her into cardiac arrest.

The clinic called 911 and two fire rescue services and an ambulance from Mount Sinai arrived on the scene within 10 minutes to attempt to revive Rivers via CPR and with a defibrillator.

Rivers never regained consciousness and died on Sept. 4.

One of the most shocking details to arise so far from the investigation is, allegedly, Rivers' personal ENT specialist paused during the unauthorized biopsy procedure to take a selfie of herself with the unconscious comedienne. 

As the investigation continues, Yorkville Endoscopy clinic denies that any throat biopsy procedure occurred in its facility at any time. Dr. Cohen has since stepped down from his position as medical director of the clinic.

Neither Cohen nor the unidentified ENT doctor has been charged with any wrongdoing in relation to the case. 

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