JOAN RIVERS Physicians failed to administer succinylcholine or perform a cricothyrotomy that might have saved her, according to the malpractice suit.

The lawsuit against 5 physicians and the New York endoscopy clinic where Joan Rivers slipped into a coma in 2014 has been settled, and her daughter, Melissa Rivers, says going forward she will "work towards ensuring higher safety standards in outpatient surgical clinics."

The amount of the settlement wasn't released, but lawyers for the Rivers family tell The New York Times that it was "substantial."

Ms. Rivers died in September 2014, a week after undergoing a laryngoscopy and endoscopy at Yorkville Endoscopy in Manhattan. According to the malpractice suit that followed, physicians at the clinic violated several safety protocols and failed to respond properly when Ms. Rivers suffered a laryngospasm and eventually went into cardiac arrest. She died 7 days later at Mount Sinai Hospital in New York after being taken off life support.

In addition to the clinic, the suit named gastroenterologist Lawrence Cohen, MD, who later stepped down as the clinic's medical director, Gwen Korovin, MD, an ENT specialist and Ms. Rivers's personal physician, and anesthesiologists Renuka Bankulla, MD, Robert Koiuta, MD and Suzanne Scarola, MD.

Dr. Bankulla, worried that she would be blamed for the death, wrote out 5 pages of notes after the chaotic scene at the clinic unfolded — details that lawyers for the Rivers family say they found very helpful.

According to Dr. Bankulla's notes, she warned Dr. Cohen during the procedure that Ms. Rivers's vocal cords were in danger of seizing, but was told she was being "paranoid." Later, she failed to ask for a crash cart that might have contained succinylcholine, and instead sought Dr. Korovin, in the hope that she could perform a cricothyrotomy. But, according to Dr. Bankulla's notes, Dr. Korovin had fled the scene.

By accepting the settlement, Melissa Rivers says she is "able to … ensure that those culpable for her death have accepted responsibility for their actions quickly and without equivocation."

Yorkville Endoscopy released a statement saying, "The parties agreed to settle this case to avoid protracted litigation. We remain committed to providing quality, compassionate health care services."

Jim Burger