The surgeon who performed the throat procedure on Joan Rivers the day she went into cardiac arrest wrote an article telling his fellow doctors it's not cost-effective to have an anesthesiologist present for procedures like the one that killed Joan.
Dr. Lawrence Cohen -- who was also the Medical Director of the Yorkville Endoscopy Center -- wrote in 2012 ... it was not always COST-EFFECTIVE to have an anesthesiologist on board for outpatient endoscopic procedures.
Dr. Cohen writes, "Although we can all agree that [monitored anesthesia care] is a highly effective and safe method of sedation, the question is whether it is worth the extra cost to our health care system."
Dr. Cohen then answers his question: "The answer is clearly no."
Dr. Cohen crunches the number in his article, saying the average cost for an anesthesiologist is $400 per procedure, but the risk of death is 1 out of 100,000. Cohen therefore concludes it costs $40,000,000 to save one life, adding that cost "far exceeds ... an acceptable level of cost-effectiveness."
There was an anesthesiologist present at the beginning of the procedure, but our sources say it's unclear if she was there when Joan's vital signs plummeted. A scathing report blamed the doctors for being inattentive and not noticing her vital signs were in the danger zone.