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 Rivers, who was 81, suffered a loss of oxygen to her brain on Aug.
28 while physicians at the Yorkville Endoscopy center in Manhattan
were performing procedures to examine her throat and vocal cords,
and she died a week later at a New York hospital.
The lawsuit said the doctors were not adequately trained to
recognize and deal with the type of emergency airway obstruction
suffered by Rivers and that they failed to detect her deteriorating
vital signs while she was in their care.
Moreover, the complaint says, the outpatient clinic allowed a doctor
whose presence was unauthorized to twice conduct a procedure that
Rivers had not consented to, a trans-nasal laryngoscopy, in which a
scope is passed through sinus passages into the larynx.
It was during a repeat of that procedure, according to the lawsuit,
that Rivers' already dangerously low blood pressure and heart rate
fell further as her airway became so constricted that she could no
longer breathe.
 Apparently unaware at that point of Rivers' declining condition, one
doctor took out his cell phone and snapped photos of himself with
the doctor performing the laryngoscopy on Rivers while she was
sedated, the lawsuit said.
As Rivers' condition grew dire and doctors struggled to restore her
breathing, the physician who conducted the laryngoscopy left the
room because she knew she was not permitted to be there "and wanted
to avoid getting caught," the complaint alleged. It also said clinic
staff were slow in calling 911 for emergency help.
The malpractice case was filed by Rivers' only child, her daughter
Melissa, in New York state Supreme Court seeking unspecified
compensatory and punitive damages. It names Yorkville, its parent
company and five physicians as defendants.
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"The level of medical mismanagement, incompetence, disrespect and
outrageous behavior is shocking and frankly, almost
incomprehensible," Melissa Rivers said in a statement.
Yorkville Endoscopy declined comment on the lawsuit.
Earlier this month a government health agency, the Centers for
Medicare & Medicaid Services, cited the Yorkville clinic for failing
to follow standard protocols during its treatment of Rivers,
including some lapses alleged by the lawsuit.
The clinic was given until March to correct its deficiencies or face
revocation of its federal accreditation and funding.
(Additional reporting by Jonathan Stempel in New York; Writing by
Steve Gorman; Editing by Cynthia Johnston and Eric Walsh)
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