ALBANY, N.Y. (AP) - State health investigators say the Manhattan clinic where Joan Rivers suffered a fatal complication during a medical procedure made several errors, including failing to identify deteriorating vital signs and provide timely intervention.

The comedian, who was 81, died Sept. 4. New York City's medical examiner found she died of brain damage due to lack of oxygen after she stopped breathing during an endoscopy on Aug. 28.

A report released by the state Department of Health cites Yorkville Endoscopy for numerous deficiencies related to the Rivers case, although negligence is not alleged.

Investigators found conflicting information in Rivers' medical records regarding the amount of the sedation drug Propofol (PROH'-puh-fahl) she was administered and the time resuscitation was initiated. They also faulted the clinic for allowing a surgeon who was not a member of the medical staff to perform two nose and throat scoping procedures and noted that a staff member took cellphone photos of Rivers and a surgeon while she was under anesthesia.

The federal Department of Health and Human Services has given Yorkville Endoscopy until Jan. 7 to correct deficiencies to avoid losing Medicare accreditation.

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