Joan Rivers died after a lack of oxygen to her brain caused her to suffocate, her autopsy has revealed.
The comedian who passed away on 4 September 2014, aged 81, had been sedated so that changes in her voice and gastroesophageal reflux disease could be investigated.
Julie Bolcer of the New York City Medical Examiner's Office said in a statement: "OCME [Office of Chief Medical Examiner] has completed its investigation. The cause of Ms Rivers' death is anoxic encephalopathy [brain damage due to lack of oxygen] due to hypoxic arrest during laryngoscopy and upper gastrointestinal endoscopy with Propofol sedation for evaluation of voice changes and gastroesophageal reflux disease.
"The manner of death is therapeutic complication. The classification of a death as a therapeutic complication means that the death resulted from a predictable complication of medical therapy."
Her daughter, Melissa Rivers then released this statement: "We continue to be saddened by our tragic loss and grateful for the enormous outpouring of love and support from around the world."
Joan’s funeral took place on 7 September in Manhattan and was attended by Whoopi Goldberg and Donald Trump, among other celebrities.