The comedian, who was 81, died Sept. 4. She had been hospitalized since Aug. 28 when she went into
cardiac arrest during a routine medical procedure at a doctor’s office to check out voice changes and
reflux.

Medical examiner spokeswoman Julie Bolcer said Thursday that the cause was brain damage due to lack of
oxygen. It is classified as a therapeutic complication, meaning that the death resulted from a
predictable complication of surgery.

The New York state health department is investigating the circumstances.

Her daughter Melissa Rivers says in a statement that the family continued to be saddened by the tragic
loss.