EFTA00063517.pdf

DEPARTMENT OF JUSTICE IOFFICE OF THE INSPECTOR GENERAL March 2. 2022 Office of the Chief Medical Examiner City of New York New York, NY 10016 M19-19432 Dear Office of the Chief Medical Examiner: I am writing to request the complete Medical Examiner's case file associated with the death of inmate Jeffrey Epstein, Metropolitan Correctional Center, New York, Federal Bureau of Prisons. Specifically, please provide the OIG with a copy of the complete Medical Examiners report, digital files including the examiner's notes, any associated reports, photos, evidence, x-rays, and any other documentation utilized by the Medical Examiner to determine Epstein's cause of death. Please provide the documentation digitally to Special Agent Office of the Inspector General, U.S. Department of Justice, a or via digital storage mailed to him at. New York, NY 10004. Thank you, and if you have any questions, please feel free to contact me, or S a Records Photos Sincerely, Xrays D HAI s d by Dale, 20210102 10:1439 -05-0Y APPROVED By ycriMgal at 11:00 am. Mar 02, 2022 Special Agent in Charge OK Per F. Hutner New York Field Office EFTA00063517  OFFICE OF CHIEF MEDICAL EXAMINER OF THE CITY OF NEW YORK CERTIFICATION AS A BUSINESS RECORD I have been delegated by Barbara A. Sampson, M.D.- Ph.D., Chief Medical Examiner, to certify and authenticate records of the Office of Chief Medical Examiner of the City of New York ("OCME") pursuant to Rule 4518 of the New York Civil Practice Law and Rules. OCME is a governmental office organized under the New York City Charter § 557 and the New York City Administrative Code O17-201 - 17-206. All records contained in its Department of Records concerning this matter are maintained in OCME's regular course of business. OCME medical examiner files contain records generated by OCME staff in the regular course of their business, as well as documents received from other sources which are relevant to the case. The copies provided here represent all requested documents which are contained in: OCME medical examiner case file #: M-19-019432 concerning decedent: Jeffrey Edward Epstein ❑ OCME forensic biology case file #: I have examined the original records maintained by OCME's Records and I attest that the records attached to this certification are a true and accurate copy of the original documents and records maintained by the OCME Department of Records. On this date: March 3, 2022, I certify these copies as genuine and as business records of the OCME Department of Records. Yvelisse Matias Electronic Signature Name of Certifier: Yvelisse Matias Title of Certifier: Clerical Accociate IV OCME Business Records Certification Form, rev. 6/2021 EFTA00063518  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: Kristin Roman, 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 APPENDECTOMY (DATE AND INDICATION UNKNOWN) X. SEE TOXICOLOGY REPORT XI. SEE NEUROPATHOLOGY REPORT EFTA00063519 CAUSE OF DEATH: HANGING MANNER OF DEATH: SUICIDE (HANGED SELF) EFTA00063520  OFFICE OF CHIEF MEDICAL EXAMINER CITY OF NEW YORK REPORT OF AUTOPSY CASE NO. I hereby certify that I, Kristin Roman, 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 EFTA00063521  JEFFREY EDWARD EPSTEIN Page 4 surfaces of the intra-abdominal organs, and an oblique, 6.5 cm laceration of the liver to the left of the falciform ligament (artifacts of resuscitative chest compressions). CLOTHING: The body is received clad in a hospital gown. INJURIES, EXTERNAL AND INTERNAL: These injuries are described in reference to standard anatomic planes. These injuries are grouped and labeled for descriptive purposes only; no sequence is implied. A. HANGING: There is a depressed, focally dried and abraded, noncircumferential ligature furrow of the neck that peaks slightly on both sides of the neck, more steeply on the right side than on the left. On the right side of the neck, the furrow bifurcates anterior to the ear, with one arm that peaks behind the right ear and one arm that extends to the right side of the back of the neck. On the back of the right side of the neck at the end of the lower arm of the furrow is a 1/2" x 1", irregular, red abrasion. The furrow ranges from 13-3/4" to 15" long (measured from both ends of the furrow on the right), and ranges from 1/8" to 1/2" wide. Anteriorly, the furrow passes over the thyroid cartilage. On the upper edge of the right side of the furrow beneath the chin is an adjacent, % x 1", inverted V-shaped, linear abrasion that ranges in width from 1/8" to 1/4". Beneath the left side of the mandible is a faint, 1/2" x 1-3/4". irregular, red abrasion with multiple, interspersed, deeper, red abrasions that measure up to % x 3/8". The face and head are plethoric above the furrow, with petechial hemorrhages of the face that are most marked within the eyebrows. There are multiple, petechial hemorrhages of the palpebral conjunctivae of both eyes, and confluent hemorrhages on the periphery of the right bulbar conjunctiva. There are faint petechial hemorrhages on the mucosal surfaces of the upper and lower lips. Within the parenchyma of the tongue are multiple, focal, spotty, purple hemorrhages. There is diffuse, purple hemorrhage at the base of the tongue. There are no hemorrhages of the anterior strap muscles of the neck. Posteriorly, there is a single hemorrhage in the left, deep, paraspinal muscles. Both thyroid cartilage cornuae are fractured, and the left cornua of the hyoid bone is fractured, all with accompanying soft tissue hemorrhages. See also "Anthropology Report." There are no fractures of the cervical vertebrae. B. OTHER INJURIES: On the back of the left forearm is an oblique, 1", linear, red, abrasion with an adjacent, 1/2" x 1-1/4", faint, red abrasion. On the medial aspect of the back of the right wrist is a 1/8" x 1/2", faint, red contusion, and on the medial aspect of the back of the left wrist is a EFTA00063522  JEFFREY EDWARD EPSTEIN Page 5 / x %", faint, red contusion. Internally, there is a deep muscle hemorrhage of similar, 12 the left deltoid muscle. INTERNAL EXAMINATION: HEAD: The scalp is without contusion or laceration. The skull is without fracture. There is no epidural, subdural or subarachnoid hemorrhage. The brain weighs 1520 gm. The brain, spinal cord, and dura mater are submitted for neuropathologic evaluation. NECK: See "Injuries." BODY HABITUS: The abdominal pannus is 1-1/4" thick. The body mass index is 27. BODY CAVITIES: The pleural and pericardial cavities are free of abnormal fluid accumulations or adhesions. See also 'Therapeutic Procedures." CARDIOVASCULAR SYSTEM: The heart weighs 440 gm and has a normal distribution of right dominant coronary arteries with slight atherosclerosis (left main and left circumflex arteries, no stenoses; left anterior descending artery, multiple, focal, less than 50% stenoses; right coronary artery, multiple, focal, less than 50 to 60% stenoses). The myocardium is brown and diffusely fibrous. There is no focal fibrosis, hemorrhage, or pallor. The free wall of the left ventricle and the interventricular septum are each 1.9 cm thick, and the free wall of the right ventricle is 0.5 cm thick. The four valves and endocardial surfaces are unremarkable. The pulmonary vessels and the venae cavae are free of thrombus and embolus. The aorta has moderate atherosclerosis. RESPIRATORY SYSTEM: The right lung weighs 560 gm and the left weighs 510 gm. Both lungs have spongy, maroon and pink parenchyma that is free of masses. The distribution of bronchi and vasculature are unremarkable. The bronchi are empty. LIVER, GALLBLADDER, PANCREAS: The liver weighs 2480 gm and has soft, brown parenchyma. The gallbladder is unremarkable and contains approximately 30 ml of brown bile without stones. The pancreas is tan, lobular, and free of hemorrhage and mineralization. HEMIC AND LYMPHATIC SYSTEMS: The spleen weighs 270 gm and has an intact, purple capsule and an unremarkable distribution of red and white pulp. There are multiple, enlarged, cervical lymph nodes, measuring up to 1.5 cm in greatest dimension. The remainder of the lymph nodes is unremarkable. There is no thymus. The bone marrow is unremarkable. GENITOURINARY SYSTEM: The right kidney weighs 180 gm and the left weighs 160 gm. Both kidneys have granular, brown surfaces and otherwise unremarkable architecture and vasculature. The ureters maintain uniform caliber into an unremarkable EFTA00063523  JEFFREY EDWARD EPSTEIN Page 6 bladder that contains approximately 5 ml of cloudy, yellow urine. The prostate is slightly and diffusely enlarged, with marked enlargement of the verumontanum. The testes are unremarkable. ENDOCRINE SYSTEM: The pituitary, thyroid, and adrenal glands are unremarkable. DIGESTIVE SYSTEM: The esophagus and gastroesophageal junction are unremarkable. The stomach contains approximately 5 ml of opaque, brown fluid without recognizable food or pills. The gastric mucosa is unremarkable. The small intestine and large intestines and rectum are unremarkable. The vermiform appendix is surgically absent. MUSCULOSKELETAL SYSTEM: See "Therapeutic Procedures." On the anterior, inner surface of the right, first rib is a slightly displaced, healed, fracture callus. The vertebrae, clavicles, remainder of ribs, and pelvis are without fracture. The musculature is well developed and normally distributed. MICROSCOPIC DESCRIPTIONS: Tissue or Organ x # of fragments and/or levels (#= slide ID number) Histology # HT19-003396 HEART x 2 (#2): Myocardial and perivascular fibrosis. Slightly hypertrophied myocytes. LUNG x 5 (#3,4): Slight patchy emphysema. LIVER x 1 (#1): Steatosis involving approximately 50% of hepatic parenchyma. Slight periportal fibrosis. Marked congestion. KIDNEY x 1 (#1): Arteriolar sclerosis. Congestion. TESTES x 2 (#5,6): No pathologic abnormality. TONGUE x 1 (#7): Intramuscular and fascial hemorrhages consisting of intact erythrocytes. MUSCLE ADJACENT TO HYOID BONE x 1 (#8): Intramuscular and fascial hemorrhages consisting of intact erythrocytes. LEFT POSTERIOR NECK MUSCLE x 1 (#9): Intramuscular and fascial hemorrhages consisting of intact erythrocytes. EFTA00063524  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 Dr. Jason K. Graham, First Deputy Chief Medical Examiner. The information provided above is true and correct to the best of my knowledge and belief Electronically signed by Kristin Roman on Aug 27, 2019 07:38:00 AM EFTA00063525  FORENSIC TOXICOLOGY LABORATORY THE CITY OF NEW YORK OFFICE OF CHIEF MEDICAL EXAMINER 520 FIRST AVE NEW YORK, NY 10016 Decedent Name : Jeffrey Edward Epstein Laboratory No : F719.03508 Medical Examiner : Kristin Roman ME Case No : M-19-019432 Examination Date : 8/11/2019 Specimen Type : Blood(Femoral): FT19-03508-001, Blood(Femoraff: FT19-03508-002, Blood Femoral): FT19-03508-003, Blood(Heart): F719-03508-004, Blood(Heart): FT19-03508-005, Blood(Heart): FT19.03508-006, Bile: F719-03508-007, Urine: F719.03508.008, Gastric Contents: FT19-03508.009, Brain: FT19-03508-010, Liver. FT19-03508-011, Vitreous: FT19-03508-012 Received By : April Galindez Date Received : 08/12/2019 Results Blood(Femoral) : FT19-03508-001 Ethanol Not Detected HSGC Benzoylecgonine, barbiturates, oxycodone, opiates, amphetamines, Not Detected IA benzodiazepines, methadone, cannabinoids, fentanyl Gabapentin, pregabalin Not Detected LC- TOF/MS Basic Drugs Not Detected GC/MS Blood(Femoral) : FT19-03508-002 Synthetic cannabinoids Pending Report NMS Vitreous : FT19-03508-012 Ethanol Not Detected HSGC This Report has en assoclatc4 Forensic TocCOna7f rase No. Contact FrOX_Ihp-eggoone recopy If you have quoilices named to act content of this report. Sign Delsellons of tams used In this repel can be located al htift/Wwwl flYc Odetattiocmolennowtoncology-tethrscal-manuals cage Dr. Gat oo er c ons c CChem FRSC FHEA Director of Forensic Toxicology / Date: 8 4/2019 Page 1 of 1 EFTA00063526  NMS Labs CONFIDENTIAL 200 Vttibh Road. Horsham. PA 19044-2208 NMS Phone: Robert A. PAIddlebem. PhD. F-ABFT, DABCC-TC, Laboratory Director Toxicology Report Patient Name FT19-03508 M19-019432 Patient ID NP Report Issued 08722/2019 17:09 Chain 19244749 Age Not Given DOB Not Given Gender Not Given To: 10074 Workorder 1924 47 49 New York Office of Chief Medical Examiner of Toxicology 0016 Pago 1 of 2 Positive Findings: None Detected See Detailed Findings section for additional information Testing Requested: Analysis Codo Description 95508 Synthetic Cannabinoids Screen (2019 Scope), Blood Specimens Received: ID Tube/Container Volume/ Collection Matrix Source Miscellaneous Mass DatoMmo Information 001 Gray Top Tube 4.25 mL Not Given Femoral Blood All sample volumes/weights are approximations. Specimens received on 08/14/2019 NMS v.18.0 EFTA00063527  CONFIDENTIAL Workorder 19244749 *NMS Chain Patient ID 19244749 NP Page 2 of 2 Detailed Findings: Examination of the specimen(s) submitted did not reveal any positive findings of toxicological significance by procedures outlined in the accompanying Analysis Summary. Unless alternate arrangements are made by you, the remainder of the submitted specimens will be discarded one (1) year from the date of this report; and generated data will be discarded five (5) years from the date the analyses were perforated. CERTIFICATION: Pursuant to New York Criminal Procedure Law Section 190.30(2), I certify that this report was made by me or is a true copy thereof for testing conducted at NMS Laboratories. I further certify that I am authorized by NMS Laboratories to make this certification. Workorder 19244749 was electronically signed on 08/22/2019 16:36 by: Sherri L. Kacinko, Ph.D., F-ABFT Forensic Toxicologist Analysis Summary and Reporting Limits: All of the following tests were performed for this case. For each test, the compounds listed were included in the scope. The Reporting Limit listed for each compound represents the lowest concentration of the compound that will be reported as being positive. If the compound is listed as None Detected, it is not present above the Reporting LM'iit. Please refer to the Positive Findings section of the report for those compounds that were identified as being present. Acode 9560B - Synthetic Cannabinotds Screen (2019 Scope), Blood - Femoral Blood -Analysis by High Performance Liquid Chromatography/Tandem Mass Spectrometry QTRAP (LC-MS/MS QTRAP) for aaranstuad Ret Limit COOMBS' Rot—Limit 4-cyano-CUMYL-BINACA 0.10 ng/mL AMB-FUBINACA 1.0 ng/mL 4-fluoro-MDMB-BINACA 0.10 ng/mL CUMYL-THPINACA 0.10 ng/mL 5-fluoro-EDMB-PINACA 0.10 ng/mL MDMB-CHMCZCA 0.10 nghnL 5-fluoro-MDMB-PICA 0.10 ng/mL MDMB-CHMICA 0.10 nghnL 5-rtuoro-MDMB-PINACA/ 5-Ituoro- 0.20 ng/ml MDMB-CHMINAC 0.10 ng/mL EMB-PINACA MDMB-FUBICA 0.10 ng/na. 5-fluoro-MMB-PINACA 0.050 ng/mL MDMB-FUBINACA I EMB- 0.10 ng/mL 5-fluoro-NA-PIC 0.10 ng/mL FUBINACA 5-fluoro-QU-PINAC 0.10 ng/mL MMB-CHMICA 0.10 ng/mL ADAMANTYL-FUBINACA 0.20 ng/mL MMB-CHMINACA 0.20 ng/mL ADMB-CHMINACA 0.10 ng/mL MMB-FUBICA 1.0 ng/mL ADMB-FUBICA 1.0 rig/mt. MMB-FUBINACA 0.10 ng/mL ADMB-FUBINACA 1.0 ng/mL NA-FUBIC 1.0 ng/mL AMB-CHMINACA 1.0 ng/mL NA•FUBIM 0.20 ng/mL NMS v.18.0 EFTA00063528  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 DR. ROMAN ON 8/11/2019) MACROSCOPIC EXAMINATION (PERFORMED BY DR. FOLKERTH, WITH DR. ROMAN IN ATTENDANCE, ON 8/20/2019): The unfixed brain weighs 15209 (expected, 1200-1500g). Examination of the fixed brain (minus the left occipital pole. removed at the time of autopsy for possible toxicology) shows normal leptorneninges. 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. Coronet 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 equine levels show no abnormality, externally or on midsagittal section. PHOTOGRAPHS: YES MICROSCOPIC EXAMINATION: NO FINAL NEUROPATHOLOGIC DIAGNOSIS: I. NORMAL BRAIN AND SPINAL CORD REBECCA FOLKERTH, MD The information provided above is true and correct to the best of my knowledge and belief. Electronically signed by Rebecca Folkerth on Aug 20, 2019 05:41:27 PM EFTA00063529  OFFICE OF CHIEF MEDICAL EXAMINER 520 First Avenue, New York, NY 10016 Barbara A. Sampson, MD-Ph.D., Chief Medical Examiner Department of Forensic Pathology Forensic Anthropology Unit M-19-19432 (212) 447-2763 ANTHROPOLOGY BACKGROUND: On 12 August 2019. the Forensic Anthropology Unit received a hyoid and larynx that were removed by Dr. Kristin Roman during the autopsy of a 66-year-old male and submitted for a trauma analysis. The hyoid was cleaned in warm water and a combination of sodium bicarbonate and enzyme detergent. The larynx was placed in formalin and the soft tissues of the thyroid and cricoid were manually removed to facilitate examination. The specimens were examined radiographically. macroscopically and microscopically. Hyoid Thyroid Cricoid Figure I. Diagram of the submitted hyoid Figure 2. Overview of the submitted hyoid and larynx (anterior view) showing the hone exhibiting a fracture to the left greater approximate fracture locations (red lines). horn (white arrow). FINDINGS: Hyoid The greater horns of the hyoid arc bilaterally fused to the hyoid body. There is a fracture of the left greater horn (Figures I and 2). The Forensic Anthropology Unit is accredited in Forensic Inspection under ISO/IEC /7020 issued by ANSI National Accreditation Board. Refer to certificate and scope ofaccreditation Fb0014. EFTA00063530  M-I9-19432 Larynx The thyroid cartilage is almost entirely ossified and the cricoid cartilage is partially ossified. The thyroid exhibits two fractures: one to the left superior horn and one to the right superior horn (Figures 1 and 3). The fractures to both the left and right superior horns occur just superior to the junction with the lamina. The cricoid does not exhibit any fractures. Figure 3. Microscopic (10x) posterior views of fractures (white circles) to the left and right superior horns of the thyroid. SUMMARY: The hyoid bone exhibits a fracture of the left greater horn. The thyroid exhibits two fractures: one to the right superior horn and one to the left superior horn. Date: 21 August 2019 'Ang(tla Sofa/. PhD, D-ABFA Forensic Anthropologist Page 2 of 2 EFTA00063531  M.E. CASE CASE WORKSHEET M-19-019432 NAME OF DECEDEN Race SEX x AUTOPSY X M _ NO AUTOPSY (Exam) Epstein, Jeffery 66 Years White F PURSUANT TO LAW MEDICAL EXAMINER DA i TIME U AM U PM DR.Roman, Kristin 08/11/2019 PART I: NAM WAS CAUSED BY: ' P inc. -.Int- tr.:: es a immediate cause b. Due to or as a consequence at C. Due to or as a consequence el PART II: Other significant conditions contributing to death but not resulting Is the underlying cause given In pan 1: d. MANNER OF DEATH: i LinNDING STUDIES _ NATURAL _, THERAPEUTIC COMPLICATION _ ACCIDENT ...i SuICIDE 1.1 hOMIODE _ UNDETERMINED PLACE OF DEATH: (Name of hospital, far, ity or street address) Any HOSpee TYPE OF PLACE: care in last 30 Now York Presbyterian Lower Manhattan days U Hospital in.pstient U Nursing hcene/long wan ewe Hospital, 170 William Street New York, NY '36 I-Capita/ ED/ ail:patient U Hospice facility 10038, United States yes f ti Hasp WA U Decedent's residence X3 No C Other, specify: DATE AND HOUR OF DEATH: 08/10/2019 7:36 AM Jnk INJURY: Cote Time: AN AT wOR< TYPE OF PLACE:IN:me, Stmet, etc./ PM YES _ NO LOCATION: HOW INJURY OCCURRED: IF TRANSPORTATION INJURY: 0 DRIVE VOPERATOR 0 PEDESTRIAN C PASSENGER J OTHER, SPECIFY IF FEMALE: If within one year of death, outwore of pregnarcy • Uve birth U Not pregnant within one year of death LI Soo-Wane= termination U Pregnant at time of death U Induced termination • Noce U No: pregnant at time of death, but pregnant within42 days of death U Not pregnant at time of death, but pregnant 43 days to 1 year before death U Unknown if pregnant within one year of death Did tobacco use contribute to death? For infant under 1 year: Name and address of hospital or ether place of beth U Yes J No ..i Probst* ),O Unk. EFTA00063532  • NAMEOF DECEDENT: Epstein, Jeffery M.E. CASE #: M-19-019432 MEDICAL OTAA4NER DR ROMRIT, Kristin DATE OF DEATit 08/10/7019 U HOMICIDE U PRISONER U MVA(Droor/Operator) U OTHER RUSH TODAY'S DATE: 08/11/2019 COMPONENTS OF MEDICOLEGAL CASE RECORD NEEDED FOR CERTRCATION FOR FILE COMPLETION TOXICOLOGY REPORT t'f\C3 HSTO I9C -- --- , C) 40;IRIOPAT RCARC4AC PATHOLOGY / ..1° REPORT(S): p POLICE U FIRE MARSHAL IC MU CULTURES: U BLOOD U TB U OTHER: CONSULTANTS )50 AN11030 J RADIOLOGY U OTHER HOSPITµ OR MEDICAL RECORDS -) Q INFANT OWN SCENE INVESTIGATION OTHER frItbeTrUi VVAILA (../ I\ 0—{ ..--13 For Pediatric Cases: is there suspicion of abuse at this time? YES 0 NO If ye e Call (600)635-1522 AUTOPSY INVENTORY CONSULT SERVICE (QUIN U HEW _ HRO X-RAYS: A YES U NO PHOTOS: )O YES U NO BOTTIETS) REQUESTING HISTOLOGY: STOCK JAR(S): 1 2 3 4 \ ye, YES U NO CD 2 3 SUMS: MICROBIOLOGY J YES 2( 0 SPECIMEN SOURCE OTHER STUDIES: PERSONAL U YES NO U CLOTHING U BALLISTICS X (0) U PROPERTY OTHER: EEVIDENCE LI HAIR SCALP- U SWABS URNA LATER FBIO U BONE ?L0FINGERNAILS LI OTHER PUBIC t°°D ORµ SWABS/SMEAR BUCCAL SPECIMEN TRACE EVIDENCE CLOTHING/UNDERWEAR DEBRIS FBIO DRIED SECRETIONS FINGERNAIL SEXUAL ASSAULT PULLED HEAD HAIRS PUBIC HAIR COMBINGS PULLED PUBIC HAIRS AND/OR BITE MARKS SCRAPINGS/O.IPPINGS KIT PERIANAL AND ANµ VULVAR OR PENILE VAGINAL SWABS AND CERVICAL SWABS AND OTHER SWABS AND SMEAR SWABS AND SMEAR SMEAR '1 SMEAR SIGNATURE Roman, Kristin EFTA00063533  .FT19-03508-001 NYC • Office of Chief Medical Examiner FORENSIC TOXICOLOGY REQUEST FORM W FT'R43334:600 Typo: Source: Bid PamOral a M.E. DATE OF DEATIt CAS"' M-19-019432 08/10/2019 7:36 AM NAME OF DECEDENT: Ape Race N AUTOPSY • Epstein, Jeffery hoc 86 Years White U NOAUTOPSY (Exam} F U PURSUANT TO UAW MEOICAL EXAMINER: ME EXAM DATE: Dr. Roman, Kristin 08/11/2019 INDICATED: U NO U YES )Q YES BASIC COMPREHENSIVE MANNER J HOMIODE j SUICIDE U ACCIDENT U NATURAL U THERAPEURCCOMPIKATON I I UNDETERMINED DING OF DEATH la4 COI I. 01 co4 I. SAMPLES SUBMITTED: COF:0.0 BLOOD q;4 FEMORAL) THE L CAVITY • U SUBDURAL L ,3 OTHER 6 Lit• i(44 8 LE RINE RI _ BRAIN J VER U DECOMP U OTHER: CONTE a FLUID 7REous) U CHEMISTRY REQUEST NS K a VUN/Cr Glucose Other: BRIEF Eli AILS 1) CAMV1/11 60 141\1"‘ (1/21,112, kerfpc Atlitel . C.) K s U PRISONER ❑ DECOMP U MOTOR VEHICLE COWSION DRIVER DURATION OF HOSPITALIZATION: . .y lak,TkL It! SUSPECTED DRUGS/MEDI TI S: OCkAllet..1 cOrLA Caltirivvb;-SP SIGNATURE: Roman, Krlst EFTA00063534  OFFICE OF CHIEF MEDICAL EXAMINER THE CITY OF NEW YORK AUTOPSY NOTES i5V;i5/-1 aF Decasegr: Epstei Jeffery M-19-019432 P Clj Ig1 Mot* Tomo: Am Gearratue ri Flume ewes: Uvon reorms(F)IF Scars:6--). Tattoos: Clothing: l Therapeutic Procedures: Inhales: \Th lissdt Brain' ' Meek Cavities Vessels Heart He - Pancreas Spleen Lymph Thymus: R-Kidne L-KIdoey Urine - Gonads Podocri Digestive Tr Gasffic AP.. Mane Skeoava—• Examined by: Roman, Kristin p ,_ 4 — tate: .K•ILI Time4_41AAti atm EFTA00063535  • ) Epstein, Jeffery ki.e.e; M-19-0194p2 Roman, ristin (W. 'AO IL-_ EFTA00063536  OFFICE OF CHIEF MEDICAL EXAMINER CITY OF NEW YORK ADDITIONAL AUTOPSY NOTES NAME OF DECEDENT: (pm slot- m.E.c.e# AAA - EXAMINED BY DR. DATE Is EFTA00063537  OFFICE OF CHIEF MEDICAL EXAMINER CITY OF NEW YORK ADDITIONAL AUTOPSY NOTES NAME OF DECEDENT: M.E. CASE # - EXAMINED BY DR. DATE / /20 EFTA00063538  OFFICE OF CHIEF MEDICAL EXAMINER CITY OF NEW YORK ADDITIONAL AUTOPSY NOTES NAME OF DECEDEIZt M.E. CAsE# . L fyr. 0A-te-, ', 1qatAielbaskad- grA alS I 4 EXAMINED BY DR. 61,1AA1---- DATE If /L t c . /20n EFTA00063539  OFFICE OF CHIEF MEDICAL EXAMINER CITY OF NEW YORK ADDITIONAL AUTOPSY NOTES M.E. CASE # ._11.1.3? wiA, 1,_ Net 17.-K , --4\m) Owvvv, \Yer nA -2506 51,A - `` Ikkult9 1.3(,2>vc_ C11-44 ( ( \oeh-y. v4JAK- fl_a4,, I>uA 0,44, 100*T _ te, 4* xccs- EXAMINED eyDR. DarE___5,4 /20(`) EFTA00063540  DEPARTMENT OF HEALTH AND MENTAL HYGIENE NYC Office of Chief