NYC Office of Chief Medical Examiner — Autopsy of Jeffrey Edward Epstein (M-19-019432)

On August 10, 2019, Jeffrey Edward Epstein was discovered unresponsive in his Special Housing Unit cell at the Metropolitan Correctional Center, 150 Park Row, New York, NY at approximately 6:30 a.m. He was pronounced dead at New York Downtown Hospital (170 William Street) at 6:36 a.m. The same morning, OCME Manhattan opened case M-19-019432 with a 'Notice of Death' recording an initial 'Apparent Manner: Undetermined' (EFTA00109940; EFTA00242699). The decedent was a federal pretrial detainee charged in United States v. Epstein, 19-cr-00490 (S.D.N.Y., Judge Richard Berman), held under BOP register number 76318-054.

The autopsy was performed on August 11, 2019, commencing at 9:21 a.m. in the Manhattan Mortuary by Dr. Kristin Roman, City Medical Examiner II, with the decedent's brother Mark Epstein in attendance and Dr. Michael Baden present as a privately retained observer at the family's request. The body was received clad in a hospital gown; ligature and clothing were received separately as evidence. Following standard OCME protocol, specimens were taken for forensic toxicology (Lab No. FT19-03508), forensic biology, neuropathology (macroscopic examination by Dr. Rebecca Folkerth, August 20, 2019), and anthropology (Forensic Anthropology Unit, dated August 21, 2019, examining the hyoid bone and larynx for trauma analysis).

The FINAL DIAGNOSES recorded in the certified Report of Autopsy (EFTA00063517 page 4 / EFTA00063519) list: HANGING with ligature furrow of neck, petechial hemorrhages of bilateral palpebral conjunctivae and oral mucosa, confluent hemorrhages of right bulbar conjunctiva, plethora of face and head with petechial hemorrhages of face, fractures of bilateral thyroid cartilage cornuae and left hyoid cornua with accompanying soft-tissue hemorrhages, and resuscitation injuries (mouth abrasions, anterior parasternal rib fractures, hepatic laceration with thin hemoperitoneum). The anthropology report describes one fracture to the left greater horn of the hyoid and two fractures to the thyroid cartilage — to the right and left superior horns, just superior to the junction with the lamina (EFTA00137978 pages 7–8, anthropology Pages 1–2). The toxicology workup by NMS Labs (issued August 22, 2019) reported no positive findings of toxicological significance and 'None Detected' for ethanol, benzoylecgonine, barbiturates, oxycodone, opiates, amphetamines, and the synthetic-cannabinoids screen.

CAUSE OF DEATH was certified as HANGING. MANNER OF DEATH was certified as SUICIDE (HANGED SELF) (EFTA00063517 page 3; EFTA00063520). On October 30, 2019, Dr. Michael Baden gave a public Fox News interview opining that injuries to the neck — specifically the multiple cartilage fractures — were 'more indicative of homicidal strangulation than suicidal hanging.' OCME and Chief Medical Examiner Dr. Barbara Sampson publicly reaffirmed the suicide ruling and stood by Dr. Roman's findings.

The OCME case file became part of the federal investigative record through two channels: an initial production via subpoena to FBI New York during 90A-NY-3151227 (the SDNY-bates'd portion of the autopsy report appears at EFTA00137978–EFTA00137986 with internal Bates 'SDNY_00014097' through 'SDNY_00014098'); and a March 2, 2022 OIG records request from the FBI Special Agent in Charge, New York Field Office, to OCME for the 'complete Medical Examiner's case file,' returned on March 3, 2022 with a Rule 4518 New York CPLR business-records certification by OCME Records Clerk Yvelisse Matias acting for Dr. Sampson (EFTA00063517 pages 0–3). The OIG's 2023 published report and the FBI's case-closing communication of December 6, 2022 each adopted OCME's suicide-by-hanging determination.

The corpus contains 35 EFTA-stamped pages and 150 emails linked to OCME case M-19-019432, drawn predominantly from DS9 with one DS12/DS99 cross-reference (DOJ-OGR-00026495 / EFTA02853705 — the same MCC SHU 30-Minute Check Sheet for August 8, 2019 produced through House Oversight). Many of the 35 EFTAs are single-page item photographs and post-mortem radiograph captures stamped with M-19-019432 — e.g., AP Skull and AP Chest radiographs taken at 'NYC OCME Bronx CR30' (EFTA00109981, EFTA00109995, EFTA00109996, EFTA00109998, EFTA00109999, EFTA00109975, EFTA00109993), evidence-bag tags and chain-of-custody forms (EFTA00109947, EFTA00109950, EFTA00109948), clothing-tag scans (EFTA00109964, EFTA00109972, EFTA00109973, EFTA00109966), and ruler-scale evidence photos (EFTA00063516, EFTA00063606, EFTA00109953, EFTA00109968, EFTA00113454, EFTA00125458, EFTA00109952, EFTA00109954, EFTA00109965, EFTA00109967).

The substantive medical record is concentrated in two complementary EFTAs. EFTA00063517 is the 89-page certified OCME case file produced to the OIG on March 3, 2022 in response to the FBI New York SAC's March 2, 2022 records request: it begins with the OIG records-request letter (page 0), the Rule 4518 OCME business-records certification (page 1), and then the complete Report of Autopsy by Dr. Kristin Roman (case number M-19-019432; autopsy commenced 9:21 a.m. August 11, 2019, Manhattan Mortuary), the FT19-03508 Forensic Toxicology Laboratory report, the NMS Labs synthetic-cannabinoids screen reporting 'None Detected,' the OCME Neuropathology Report by Dr. Rebecca Folkerth, and the Forensic Anthropology Unit report describing the hyoid and thyroid-cartilage fractures (EFTA00063517 pages 0–9ff). EFTA00137978 is an 84-page parallel production stamped with internal SDNY Bates numbers (SDNY_00014097 onward) that reproduces the autopsy narrative starting at Page 5 (external/internal examination) through the toxicology, neuropathology, and anthropology reports, plus appended BOP records that include the August 10, 2019 MCC psychology memorandum on Mr. Epstein's three psychology contacts (intake screening July 8, 2019 with Epstein denying any psychology history; suicide watch July 8–9, 2019 after Central Office consultation; suicide-risk assessment July 9, 2019; psychology observation; July 11, 2019 attorney conference) (EFTA00137978 page 79), the Suicide Watch Observation Logs from July 23, 2019 (EFTA00137978 pages 52–55), the MCC Daily Lieutenant's Logs for August 9 and 10, 2019 (EFTA00137978 pages 72–73), and the BP-S358.060 Medical Treatment Refusal forms Mr. Epstein executed on July 10 and July 24, 2019 declining a routine chest x-ray and an ophthalmologic evaluation (also reproduced at EFTA00132684 pages 1–3, FBI 90A-NY-3151227 Serial 98).

Notice-of-Death documentation is preserved at EFTA00109940 and EFTA00242699 (08/10/2019 08:31 OCME report; place of death 170 William Street, New York, NY 10038; reporter from medical facility; 'App. Manner: Undetermined' as the initial classification before autopsy). The corpus also captures the FBI investigative use of the autopsy file: an FBI Import Form (FD-1036) under 90A-NY-3151227 Serial 98, dated September 6, 2019, titled 'Medical Notes Regarding Jeffrey Epstein,' attaches BOP medical records covering the July 10 and July 24, 2019 treatment refusals (EFTA00132684), and an FD-302 under 90A-NY-3151227 Serial 180 documents the August 23, 2019 joint FBI/OIG/SDNY interview of an MCC corrections officer who responded to the body alarm at approximately 06:38–06:40 a.m. on August 10, 2019 (EFTA00131726). MCC SHU 30-Minute Check Sheets for August 8, 2019 (Tier-J and Tier-K) appear at EFTA02853705 / DOJ-OGR-00026495 and contemporaneous BOP Count Sheets at EFTA00048963.

The corpus does not include autopsy color photographs, video of the autopsy, the unredacted neuropathology slides, or any independent post-mortem examination by Dr. Michael Baden; it likewise does not contain primary correspondence between the OCME and Dr. Baden, between the OCME and Mark Epstein, or any retraction or amendment of the certified suicide ruling. The October 2019 Baden Fox News commentary disputing the suicide ruling is referenced in adjacent FBI/OIG investigative files, not in the OCME case file itself.