Jeffrey Epstein Autopsy Findings

Five days after Jeffrey Epstein was discovered dead in his Metropolitan Correctional Center cell, New York City pathologists opened his body and documented a mix of ligature marks, bone fractures and soft-tissue bruising unlike anything seen in a routine low-drop jail hanging.

Their official conclusion—suicide by hanging—was accepted by the Department of Justice and later repeated in the 2023 OIG report, yet alternative opinions from prominent forensic experts and public polling show the country remains sharply split on whether Epstein killed himself or was killed.

Primary report — the one-page OCME "Final Pathological Diagnosis" signed by Dr. Kristin Roman and dated 11 Aug 2019 is circulating online in scanned form.¹
Official position — Chief Medical Examiner Dr. Barbara Sampson upgraded the manner of death from "pending" to suicide on 16 Aug 2019 after "additional investigative information."²
Media release — 60 Minutes obtained the full photographic set and published selected autopsy stills in January 2020.³

Core Autopsy Findings

Body area / specimen	Observed injury	Immediate forensic meaning
Neck skin	8 mm wide ligature furrow running left-ear to behind right-ear	Position is high-mid neck, a pattern more typical of manual pressure than low-drop suspension.⁴
Hyoid bone	Left greater horn fracture	Hyoid breaks appear in 6–25 % of suicidal hangings but far more often in throttling.⁵
Thyroid cartilage	Bilateral fractures of superior cornu	Triple combined fractures (hyoid + both thyroid horns) are "extremely unusual" in suicidal hangings per Dr. Michael Baden.⁶
Eyes / face	Petechial hemorrhages	Burst capillaries are routine in strangulation, less so in hangings without a drop.⁷
Wrists	Recent contusions both sides	Suggest struggle or restraint; no jail documentation explains them.⁸
Left shoulder	Deep trapezius hemorrhage	Requires compressive force, not produced by hanging posture alone.⁹
Toxicology	No intoxicants detected	Removes drugs as a contributory factor.¹⁰

Interpretations

New York City OCME

Dr. Sampson stated that when all scene evidence, witness interviews and medical data were combined, hanging remained the most consistent explanation, adding that individual fractures "cannot be evaluated in a vacuum."¹¹ The DOJ inspector-general report echoed that assessment and found no sign of outside involvement.¹²

Independent Pathologist

Michael Baden, hired by Epstein's brother and present at the autopsy, Baden argues that the triad of fractures, extensive hemorrhage and facial petechiae "fit homicidal strangulation far better than suicide."¹³ He notes reviewing more than a thousand New York State jail hangings without seeing the same injury constellation.¹⁴

Other Forensic Voices

Source	Statement/Interpretation
Jonathan Arden	Former President of the National Association of Medical Examiners; agrees that a broken hyoid raises red flags but stresses it is not definitive alone¹⁵
Deutsche Welle	Reported the OCME's suicide ruling while noting worldwide skepticism fueled by the injury list¹⁶
Reuters (sources)	Obtained confirmation from two law-enforcement sources that multiple neck bones were broken, a finding they acknowledged could occur in either mechanism¹⁷

Public Sentiment

A YouGov survey of 7,392 U.S. adults (5 Jan 2024) found only 20% believe Epstein committed suicide, 37% believe he was murdered and 40% remain unsure.¹⁸

National press coverage continues to reflect that divide—Axios summarized Baden's homicide assertions the day they were Made, while GQ chronicled how the meme "Epstein didn't kill himself" became cultural shorthand for institutional distrust.¹⁹²⁰

Unresolved Gaps

No photograph was taken of the body as discovered in the cell, eliminating a baseline for body position, noose angle and drop distance.²¹

Two separate orange-sheet ligatures were collected — at least one shows hemmed ends inconsistent with being cut down.²²

Surveillance footage outside the tier had camera failures documented in the FBI case file, leaving a blank interval around the time of death.²³