The Manhattan clinic where Joan Rivers suffered cardiac arrest disputed a report that it happened during a biopsy of her vocal cords . A spokesman for the Yorkville Endoscopy clinic gave CNN its first public statement since Rivers fell ill during a procedure . While federal privacy laws limit what medical providers can make public , the statement counters a New York newspaper report quoting an unidentified source saying a doctor made a `` spur-of-the-moment '' decision `` to take a scalpel to a polyp-like growth on her vocal cord . '' `` A biopsy of the vocal cords has never been performed at Yorkville Endoscopy , '' the clinic 's statement said . Rivers , 81 , died last Thursday in New York 's Mount Sinai Hospital , where she was rushed a week earlier after she stopped breathing and her heart stopped beating during treatment at Yorkville Endoscopy . Many questions have been raised about what that treatment was given and what might have gone wrong that led to the comedian 's death . Few answers have been made public because of medical privacy rules , but the New York State Health Department confirmed the agency is investigating . The clinic statement also seemed to address speculation that her cardiac arrest could have been related to the anesthesia used to sedate Rivers while an endoscope , which is a long , flexible camera , was used to examine her throat . `` General anesthesia has never been administered at Yorkville Endoscopy , '' the statement said . `` The type of sedation used at Yorkville Endoscopy is monitored anesthesia care . Our anesthesiologists utilize light to moderate sedation . '' Only licensed medical doctors who are board-certified anesthesiologists administer anesthesia at the clinic , the statement said . `` Our anesthesiologists monitor the patient continuously utilizing state-of-the-art monitoring equipment , and remain at the bedside throughout the procedure and into recovery , '' it said . The clinic 's statement also appeared to address criticism that Rivers should have been treated in a hospital and not a clinic because of her advanced age . `` Yorkville Endoscopy has strict policies in place for the criteria of who gets treated in this center versus in a hospital , '' the statement said . `` Every patient is pre-screened by their gastroenterologist , an anesthesiologist and a nurse for appropriateness to be treated at Yorkville Endoscopy . Some patients are also pre-screened by their personal physicians . '' The clinic is also well-equipped and staffed to handle emergencies , including for tracheal intubation when a patient stops breathing , the statement said . `` Yorkville Endoscopy has all necessary airway equipment , including a fiber optic scope available for emergency intubation , '' it said . `` Three to four board certified anesthesiologists are on duty at Yorkville Endoscopy at any given time . '' All of its doctors are certified for advance cardiac life support and many of the nurses also work in hospital intensive care units and emergency rooms , it said . Rivers was a pointed , pioneering comedian . Rivers was undergoing an apparently minor elective procedure at the clinic when she suffered cardiac and respiratory arrest , according to the New York Fire Department . Paramedics took her by ambulance to Mount Sinai Hospital , about a mile from the clinic , where she was initially listed in critical condition . Rivers spent a week on life support before she was pronounced dead on September 4 . 25 of Joan Rivers ' best jokes . The outpatient clinic is now being investigated by the New York State Department of Health , spokesman James O'Hara said . Rivers ' death also has triggered an investigation by the New York medical examiner 's office , its spokeswoman , Julie Bolcer , told CNN . `` The cause and manner of death will be announced at some point , '' she said . Howard Stern : I cried 'like a baby ' at Rivers ' funeral .
Clinic : `` A biopsy of the vocal cords has never been performed at Yorkville Endoscopy '' Federal privacy laws limit what medical providers can make public about patients . The clinic has state-of-the-art equipment and well-qualified doctors , nurses , clinic says . But it is not a hospital or even an outpatient facility ; its primary purpose is to provide free health care for people who cannot afford it.