Joan Rivers suffered complications during a routine throat surgery at a private clinic called Yorkville Endoscopy which led to her coma and eventual death on Thursday, Sept. 4, but the reasons why Rivers was having the surgery remain unclear.

Officials have decided to investigate the clinic and have opened a review on Rivers’ case, though it may take months for the review to be completed and publicized. However, it should be noted that while a formal inquest of Yorkville Endoscopy (which has been receiving an unending list of threats since yesterday) it underway, officials do not believe that any wrongdoing leading to Rivers’ death had gone on.

Possibilities for Joan Rivers’ Throat Surgery

Endoscopies are the clinic’s specialty so it’s likely Rivers was the subject of one. An endoscopy involves an imager called an endscope being placed into the organ in question—in this case Rivers’ throat. Endoscopies are often utilized in investigating a patients suffering from gastrointestinal or esophageal maladies.

Stenosis or Polyps to Blame?

Given that Rivers was a comedian with multiple shows and a working performer, it is likely that the procedure was done in regards to something called laryngotracheal stenosis, which often affects singers and those who use—or overuse—their voice which leads to the narrowing of the windpipe.

At 81, Rivers could also have been suffering from an esophageal deterioration which is a natural eroding of the esophagus that happens as people age.

Rivers was also—at least for a time—an avid smoker. Either one of these things can also easily lend itself to the growth of throat polyps or engorged lymph nodes. While it is possible the growths could be cancerous, given the reportedly “routine” nature of the procedure, it’s more likely that the endoscopy was a preliminary search for a larger problem or a way of treating ongoing stenosis, which in itself, can also be treated easily.

Doctors may wish, in extreme circumstances, in induce a coma in their patient. This is done usually as a stalling, temporary method, while they attempt to discover what went wrong, why, and how to fix it. Unfortunately, in the case with Rivers, it may have been done as a palliative measure.