Medical Examiner: Joan Rivers Died of Low Blood Oxygen

Joan Rivers died from low blood oxygen during a routine medical procedure to check out voice changes and reflux, the medical examiner’s office ruled Thursday.

The comedian, who was 81, died Sept. 4 after she’d been hospitalized for about a week when she went into cardiac arrest during the procedure at a doctor’s office.

Rivers died from “anoxic encephalopathy due to hypoxic arrest” — brain damage due to lack of oxygen — during a procedure to scope her upper gastrointestinal tract and vocal folds, a spokeswoman for the city’s medical examiner said.

The death was classified as a complication of a medical procedure. The classification is not commonly used; more deaths are certified as homicides, suicides or natural causes.

Rivers had been sedated during the procedure with propofol, the medical examiner said.

The state Health Department also is investigating.

Rivers’ daughter and TV partner, Melissa Rivers, said they had no comment on the ruling.