So she brought her own doctor with her, who forced his way into the routine procedure to do something unscheduled that wasn't originally agreed to, and should never have been done in an out-patient environment.
First, who is this doctor (Michael Jackson comes to mind here) and wouldn't he/she be the culpable one?
Before she died, Rivers was allegedly "afraid of anesthesia." Perhaps she brought her own doctor to do the biopsy to avoid anesthesia for two separate procedures. This makes sense to me, as I am extremely sensitive to anesthetics and getting more sensitive with age.
Anyway, both of Rivers' physicians agreed to do this deadly twofer -- one doc hardly "forced" his way in. Too bad they couldn't have agreed to do them in the hospital. Both are to blame for things going wrong.
But what, exactly, is cause of death?