Comedian Joan Rivers, who passed away last month at the age of 81, died of a complication during a medical procedure that caused oxygen deprivation to the brain, the New York Chief Medical Examiner’s Office said on Thursday.

“The cause of Ms. Rivers’ death is anoxic encephalopathy due to hypoxic arrest during laryngoscopy and upper gastrointestinal endoscopy,” it said in a statement, referring to brain damage due to lack oxygen.

“The classification of a death as a therapeutic complication means that the death resulted from a predictable complication of medical therapy,” it added.

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