The New York clinic where comedian Joan Rivers stopped breathing a week before her death denied on Wednesday ever administering general anesthesia or conducting a vocal cord biopsy as has been alleged in media reports as contributing to her demise.
It was the first time the Yorkville Endoscopy clinic issued a statement since Aug. 28, when Rivers was rushed to a nearby hospital from the center with cardiac arrest.
She died at age 81 on Sept 4.
The clinic did not mention Rivers by name but issued the statement hours after New York's Daily News newspaper reported that an unplanned vocal cord biopsy at the clinic had left the Brooklyn-born comedian unable to breathe.
"A biopsy of the vocal cords has never been performed at Yorkville Endoscopy," said the clinic, which specializes in gastrointestinal procedures. "General anesthesia has never been administered."
The Daily News said Rivers' doctor, who said he was an ear, nose and throat specialist, asked if he could use the clinic's instruments when another doctor said he had noticed something on Rivers' vocal cords, and he was given the go-ahead.
"A biopsy like that should only be done in hospital," the newspaper quoted the unnamed medical source as saying. "If she had been in a hospital when it happened, she might have been OK."
When asked for further comment, Yorkville Endoscopy said it had nothing more to add.
The cause of Rivers' death is still unknown pending further tests, according to the Office of Chief Medical Examiner.
The State Health Department is reviewing documents and medical records, and interviewing staff and physicians at the clinic, which opened in February 2013.
"The investigation is ongoing," a department official said on Wednesday.
The clinic said its board-certified anesthesiologists use light to moderate sedation and monitor the patient continuously using state-of-the-art equipment. Three to four anesthesiologists are on duty at any given time.
"Yorkville Endoscopy has strict policies in place for the criteria of who gets treated in this center versus in a hospital," it said, adding it also has all the airway equipment needed for emergency intubation.
The clinic said every patient is pre-screened by their gastroenterologist, an anesthesiologist and a nurse before being treated.
Rivers was known for her brash style, numerous cosmetic procedures that she joked about in her comedy routines, and the catchphrase, "Can we talk?"
Her career as a stand-up comedian, author, talk show host and reality TV star spanned five decades.
On Tuesday evening Broadway theaters dimmed their marquees for one minute in honor of Rivers, who was nominated for a Tony award in 1994 for "Sally Marr .. and Her Escorts," which she wrote. She also appeared in two other Broadway shows.
Theater owners reversed an earlier decision not to honor her after friends and fans launched an online petition.