Document M-19-019432

M-19-019432 JEFFREY EDWARD EPSTEIN Page 7 LEFT DELTOID MUSCLE x 1 (#10): Intramuscular and fascial hemorrhages consisting of intact erythrocytes. TOXICOLOGY: Specimens are submitted for toxicologic analysis. A separate report will be issued. FORENSIC BIOLOGY: Blood spot card, clippings from right and left fingernails, and swabs of the back and front of neck and right and left hands are submitted. NEUROPATHOLOGY: A separate report will be issued. ANTHROPOLOGY: A separate report will be issued. EVIDENCE: Received separately are a ligature and clothing. The items are examined, photographed, and submitted to Evidence. See also "Additional Autopsy Notes". RADIOGRAPHY: Post-mortem radiographs are taken. PHOTOGRAPHY: Autopsy photos are taken. This report is reviewed by First Deputy Chief Medical Examiner. The information provided above is true and correct to the best of my knowledge and belief. Electronically signed by on Aug 27, 2019 07:38:00 AM DOJ-OGR-00026828 --- PAGE BREAK --- OFFICE OF CHIEF MEDICAL EXAMINER CITY OF NEW YORK REPORT OF AUTOPSY Name of Decedent: Jeffrey Edward Epstein M.E. #: M-19-019432 Autopsy Performed by: [redacted] M.D. Date of Autopsy: 08/11/2019 FINAL DIAGNOSES: I. HANGING: A. LIGATURE FURROW OF NECK B. PETECHIAL HEMORRHAGES OF BILATERAL PALPEBRAL CONJUNCTIVAE AND OF ORAL MUCOSA C. CONFLUENT HEMORRHAGES OF RIGHT BULBAR CONJUNCTIVA D. PLETHORA OF FACE AND HEAD WITH PETECHIAL HEMORRHAGES OF FACE E. FRACTURES OF BILATERAL THYROID CARTILAGE CORNUAE AND LEFT HYOID CORNUA WITH ACCOMPANYING SOFT TISSUE HEMORRHAGES 1. SEE ANTHROPOLOGY REPORT F. RESUSCITATION ATTEMPTED 1. ABRASIONS OF MOUTH 2. ANTERIOR PARASTERNAL RIB FRACTURES 3. HEPATIC LACERATION WITH THIN HEMOPERITONEUM II. ABRASIONS OF LEFT FOREARM III. CUTANEOUS CONTUSIONS OF WRISTS IV. SUBCUTANEOUS HEMORRHAGE OF LEFT DELTOID MUSCLE V. HYPERTENSIVE AND ATHEROSCLEROTIC CARDIOVASCULAR DISEASE A. CARDIAC HYPERTROPHY (440 GM) B. LEFT VENTRICLE HYPERTROPHY (1.9 CM) C. RENAL ARTERIOLAR SCLEROSIS D. SLIGHT CORONARY ATHEROSCLEROSIS E. SLIGHT TO MODERATE AORTIC ATHEROSCLEROSIS VI. HEPATIC STEATOSIS (2480 GM) VII. CERVICAL LYMPHADENOPATHY VIII. REMOTE FRACTURE OF RIGHT FIRST RIB IX. REMOTE APPENDICECTOMY (DATE AND INDICATION UNKNOWN) X. SEE TOXICOLOGY REPORT XI. SEE NEUROPATHOLOGY REPORT DOJ-OGR-00026822 --- PAGE BREAK --- OFFICE OF CHIEF MEDICAL EXAMINER CITY OF NEW YORK REPORT OF AUTOPSY CASE NO.: M-19-019432 I hereby certify that I, [redacted] M.D., City Medical Examiner - II, have performed an autopsy on the body of Jeffrey Edward Epstein, on the 11 of August 2019, commencing at 9:21 AM in the Manhattan Mortuary of the Office of Chief Medical Examiner of the City of New York. EXTERNAL EXAMINATION: The body is received in a sealed, labeled, plastic body bag (seal #152384). The body is of a well-developed, thin, muscular, light skinned, 5'10", 196 lb man whose appearance is consistent with the given age of 66 years. The scalp hair is wavy, predominantly grey with interspersed dark hairs, has slight male pattern balding, and measures up to 3". The facial hair is cleanly shaven. The eyes have light irides. The oral cavity has intact teeth in good repair. The tongue is free of natural disease. The finger and toenails are well groomed and free of polish. Striae are on the shoulders. The genitalia are atraumatic and of a normal, circumcised man. The anus is atraumatic. POSTMORTEM CHANGES: There is moderate, symmetric rigor mortis of the upper and lower extremities and the jaw. Lividity is fixed, purple, and unevenly distributed on the posterior surfaces of the body. The body is cool. SCARS: On the back of the left shoulder is an oblique, 1-1/2", well healed, linear scar. On the right lower quadrant of the abdomen is an oblique, 2", well healed, linear appendectomy scar. THERAPEUTIC PROCEDURES: An endotracheal tube is in the mouth, extending into the upper airway. On the lips are multiple, focal, red abrasions. A cervical collar encircles the neck. Electrocardiogram electrodes are on the torso. An intravascular catheter is in the left antecubital fossa. An intraosseous line is in the right shin. A blood pressure cuff encircles the upper, right arm. On the chest between the nipples is a 3" x 3", irregular, yellow abrasion. Internally, there are minimally hemorrhagic, parasternal, rib fractures of right ribs #4-6 and left ribs # 5-6, approximately 60 ml of liquid blood thinly coating the serosal DOJ-OGR-00026824 --- PAGE BREAK --- Page 3243 THE CITY OF NEW YORK OFFICE OF CHIEF MEDICAL EXAMINER NEUROPATHOLOGY REPORT CASE NUMBER: M-19-019432 NAME OF DECEDENT: EPSTEIN, JEFFREY EDWARD (AUTOPSY PERFORMED BY [redacted] ON 8/11/2019) MACROSCOPIC EXAMINATION (PERFORMED BY [redacted] WITH [redacted] IN ATTENDANCE, ON 8/20/2019): The unfixed brain weighs 1520g (expected, 1200-1500g). Examination of the fixed brain (minus the left occipital pole, removed at the time of autopsy for possible toxicology) shows normal leptomeninges. No contusions, stigmata of herniation, or other surface abnormalities are seen. External brainstem landmarks and cranial nerves are normal. Vessels at the base are distributed normally, and have no atherosclerosis. The cerebellum is normal. Coronal sections of the cerebral hemispheres reveal normal cortical ribbon, white matter, and deep gray nuclei. There is no midline shift. Hippocampi are symmetrical and of normal volume. Ventricles are normal in size and appearance. Axial sections of the brainstem and cerebellum en bloc show the substantia nigra and locus ceruleus to be well-pigmented. The aqueduct and fourth ventricle are normal. Cerebellar cortex, white matter, and dentate are normal. Cranial dura from the convexities, tentorium, and base shows falcine ossification (comment: common age-related finding). The venous sinuses and tributary (bridging) veins are patent. Spinal cord and dura from upper cervical to cauda equina levels show no abnormality, externally or on midsagittal section. PHOTOGRAPHS: YES MICROSCOPIC EXAMINATION: NO FINAL NEUROPATHOLOGIC DIAGNOSIS: I. NORMAL BRAIN AND SPINAL CORD [redacted] MD The information provided above is true and correct to the best of my knowledge and belief. Electronically signed by [redacted] on Aug 20, 2019 05:41:27 PM DOJ-OGR-00026832