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Specific details of Joan Rivers death will remain a mystery after her daughter Melissa Rivers decided not order a further autopsy, according to TMZ.

Joan passed away due to a lack of oxygen to her brain during an impromptu throat surgery in September. New York law doesn’t require an autopsy unless criminal activity is suspected in the cause of death.

TMZ reports:

We may never know exactly what killed Joan Rivers … because a decision was made NOT to do an autopsy … TMZ has learned.

The Medical Examiner has concluded the cause of death was deprivation of oxygen which caused irreversible brain damage. We’re told they determined the “predictable” complication involved the procedure itself and not Propofol.

Here’s the problem … we’re told without an autopsy it’s impossible to pinpoint the nature of the problem. As one source said, an autopsy might reveal a puncture in the throat or other trauma.

The doctor that treated Rivers has left the Yorkville Endoscopy LLC while it remains under investigation for the procedure. The clinic is in jeopardy of losing its license, as the Medicare and Medicaid subsidiaries announced it will no longer be listed as a supplier to the clinic.

ABC reports:

The New York City clinic where Joan Rivers underwent the procedures that led to her death could lose its federal accreditation in a matter of months, according to state authorities.

ABC News has obtained the results of the New York State Health Department investigation into Yorkville Endoscopy. The investigation, which was routine, started the day after Rivers died and ended Oct. 9.

It found lapses in four categories required for accreditation: governing body and management, surgical services, medical staff and patient rights. Specifics were not immediately disclosed.

The Centers for Medicare and Medicaid Services, the federal subsidiary of the Department of Health and Human Services that certifies ambulatory surgery facilities, notified the clinic that “Yorkville Endoscopy LLC no longer meets the requirements for participation as a supplier of services in the Medicare program.”

As of today, the clinic remains open to the public.

SOURCE: TMZ | VIDEO CREDIT: News Inc. 

Joan Rivers Through The Years (PHOTOS)
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