Megan,
Great question! And you are correct; I deal with surgical risks on a daily basis. Most of the details of the demise of Joan Rivers during “simple” outpatient surgery are currently hidden due to pending legal action. Much of what information did get out is sketchy at best. This is partly what forced the press to speculate. So lets deal with the basics, and stick to known facts. No surgery is without risk, no matter how simple. We do surgery only when the potential benefits outweigh the risks. There are three problems that happen during surgery: human error, equipment failure, and medical complications.

Human error includes poor training or preparation, failure to recognize or correct common problems, and violation of established protocols. The high reliability of critical medical equipment can lull providers into a false sense of security, because no one is expecting equipment failure. Advanced medical technology creates miracles, but is also a crutch. Bad physical reactions to the manipulations and stresses of surgery can lead to catastrophic outcomes.

Rumor has it that both human error and adverse physical reaction to surgery may have contributed to the death of Joan Rivers. A vocal cord biopsy, a procedure not normally done at that institution, done by a visiting doctor, not authorized to practice at that institution, may have caused irritation and spasm of the airway. This spasm may have progressed to complete airway closure and suffocation, in spite of attempts to reopen her airway. My explanation is based on innuendo and hearsay. The truth will eventually come out.

To keep it real, weight the fictional risks vs. the benefits of surgery in your stories, and do what would make sense in the real world. Make sure that any surgical complication is due to some combination of human error, equipment failure, or bad medical condition. If all else fails, obscure the surgical details in the name of legal action and patient privacy. After all, that’s what the real media does.

H.S. Clark, MD