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Joan Rivers dies at 81 in NYC hospital a week after going into cardiac arrest

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Updated Sept. 7 - Joan Rivers' funeral was like a Hollywood extravaganza fit for an A-lister, as hundreds of fans crowded the sidewalks of Temple Emanu-El on Manhattan’s Upper East Side Sept. 7.

Throngs of celebrities came to pay their last respects to Joan, who died Sept. 4 following complications from throat surgery. Among the attendees were Sarah Jessica Parker, husband Matthew Broderick, Howard Stern, Hoda Kotb, Andy Cohen, Whoopi Goldberg and Diane Sawyer, Ozzy Osbourne and Kathy Griffin, People reported.

Also in attendance were Dr. Mehmet Oz, Rosie O’Donnell, Donald Trump, Joy Behar, Michael Kors, Alan Cumming, Barbara Walters, Hugh Jackman, Kathie Lee Gifford and Rivers’ E! “Fashion Police” co-hosts, Kelly Osbourne and Giuliana Rancic.

The funeral service started with the New York City Gay Men’s Chorus singing the Broadway number “Hey, Big Spender.” Radio shock jock Howard Stern then gave a speech praising Joan as “the best friend in the world … a big sister … a crazy aunt at a bar mitzvah.”

Joan’s only child, daughter Melissa Rivers, spoke briefly, saying she was humbled by the love and support from her mom’s fans around the world. The funeral closed with Hugh Jackman singing the Peter Allen tune, “Quiet Please, There’s a Lady on Stage.”

The star-studded funeral, replete with Broadway show tunes, would have made Rivers very happy. In her 2012 book “I Hate Everyone … Starting With Me,” Joan joked that she wanted her funeral to be like a Hollywood film premiere. “Lights, cameras, action! I want craft services, I want paparazzi and I want publicists making a scene!” she wrote.

Rivers continues to make waves from beyond the grave. Sales of her July 2014 memoir, Diary of a Mad Diva, have increased 90,000% since her death.

Cause of Death Inconclusive: Investigation and Lawsuit Loom

Preliminary results of an autopsy performed on Joan Rivers indicates her cause of death is inconclusive, the New York Daily News reported. The New York City medical examiner's office completed its autopsy a day after Rivers died at Mount Sinai Hospital after being taken off life support.

A rep for the ME's office said further studies will be done to determine the exact "cause and manner" of the legendary comedian's sudden death. New York State Health Department officials have launched their own, separate investigation into Joan's death and are investigating Yorkville Endoscopy clinic, where she went into cardiac arrest Aug. 28 during a routine throat surgery.

Rivers' family is reportedly planning to file a malpractice lawsuit against Yorkville Endoscopy because they don't understand why she stopped breathing during a routine outpatient procedure. For now, the clinic is not accused of any wrongdoing, but is being investigated because of the odd complication that sent Rivers into respiratory arrest. Furious fans have also taken to Yelp to trash the clinic, giving it terrible reviews and blaming its staff for Joan's death.

Rivers was 81 years old when she died, but was said to be in great health, and was repeatedly described by colleagues and friends as "athletic" and energetic. She recently said she walked three miles every day to stay fit.

Had Considered Suicide After Husband Killed Himself

Despite her overall good health, Rivers' history of plastic surgeries may have played a role in her death. Joan said she got her first plastic surgery at age 31. Over the next 50 years, Rivers underwent countless plastic surgeries, including several nose jobs, facelifts, brow lifts and liposuction.

Going under anesthesia carries a risk of death for anyone, no matter what their age, but is especially dangerous for older patients, as they are dramatically more prone to complications. Rivers was under anesthesia when she stopped breathing during her endoscopy on Aug. 28.

Despite her feisty image, Joan confessed that she considered committing suicide after her husband killed himself. At the time, Melissa wasn't speaking to Joan, and Joan had gotten fired from several jobs.

A distraught Rivers said she had a gun in her lap but was pulled out of her suicidal thoughts after her dog abruptly jumped in her lap. Joan said she was worried that if she killed herself, no one would take care of her dog.

Joan has since given lectures on depression and suicide, encouraging depressed people to remember that life goes on, and tough times don't last forever. "I tell people this is a horrible, awful dark moment, but it will change," she said. "You must know it’s going to change and you push forward. I look back and think, 'Life is great, life goes on.'"

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