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\ ht r b. * ,,,tv,NT 07: 4,0 .II '1r lga I I * Jeffrey Epstein Death Investigation New York Field Office EFTA00161494 • July 6, 2019 Epstein was arrested on federal sex trafficking charges in New York • July 8, 2019 Epstein was detained at Metropolitan Correctional Center (MCC) in downtown Manhattan • At this time a psych elevation and observations took place • July 9, 2019 was placed in a cell at MCC with cellmate Nicholas Tartaglione • July 23, 2019 Epstein's first suicide attempted • July 24-29 2019 Epstein was placed on suicide watch • July 29, 2019 MCC Chief Psychologist approved Epstein to be removed from suicide watch • August 9, 2019 Cellmate was released from cell • Aiiniist 10 201g Fnstp!in Miiiiihifk"'CreirMEM?Isk'nrnnnininpri ripari EFTA00161495 Date Time Details 7/6/2019 21:34 7/6/2019 21:36 7/7/2019 19:20 7/8/2019 9:24 7/8/2019 10:41 7/8/2019 18:03 Epstein admitted to Metropolitan Detention Center (MCC) in downtown Manhattan Epstein assigned to House E, Range 6, Bed 547 Epstein assigned to the Secure Housing Unit (SHU) Epstein underwent a psychological intake screening. He reported no suicidal ideation or attempts and denied any mental health symptoms or treatment. Chief psychologist consulted with doctor from Central Office, regarding Epstein. Given Epstein's risk factors for suicidality, including a high profile case with media attention, sex offense charges, pre-trial status, and a "court proceeding today which would potentially be giving him bad news regarding his legal situation," staff and lieutenants were instructed to "notify the on-call psychologist and place inmate Epstein on a watch status until psychology can conduct a thorough suicide risk assessment." Epstein assigned to House H, Range 1, Bed 001L (psychological observation) UNCLASSIFIED EFTA00161496 .AMEN? * * Sr (U) Timeline Continued Date Time 7/9/2019 7/10/2019 8:41 15:26 7/11/2019 15:21 7/23/2019 1:27 7/23/2019 1:40 tg$ Ili 147e .440, Ah. '"AU OF .° Details Chief Psychologist conducted a suicide risk assessment of Epstein. Epstein denied any suicidality and had no mental health or suicide history. He will be seen daily while on psychological observation and will be seen for a follow-up session once he was released from observation. Epstein is assigned a cellmate Nicholas Tartaglione Chief Psychologist saw Epstein for a psychological observation contact. He denied suicidality and "did not appear to be in any distress at this time." Call for assistance initiated by control center. Arriving officer was told that Epstein had attempted suicide and officer observed Epstein laying in the fetal position on the floor of his cell snoring. His neck was red with no abrasions. Epstein was placed on the stretcher and appeared to open eyes to watch staff then quickly shut them. Placed on suicide watch. Epstein told officer that Tartaglione(cellmate) had tried to kill him and had been harassing him. Tartaglione claimed he had been asleep and woke up to see Epstein with a string around his neck. Officer assessed transporting Epstein to suicide watch. Epstein initiated on suicide watch. UNCLASSIFIED EFTA00161497 , t4ty,NT Op (U) Timeline Continued Date Time 7/23/2019 7/24/2019 10:09 8:45 7/24/2019 9:23 7/25/2019 10:14 7/26/2019 9:09 • '4 '7.7 .4r OF lti Details Psych conducted a suicide risk assessment. Epstein denied remembering how he ended up on suicide watch and denied current suicidal thoughts or ideation. "It was unclear at this time if he had placed the string around his neck or if someone else did." He was deemed a "moderate" risk of suicide. Epstein taken off suicide watch (total time was 31 hours, 5 minutes) Psych conducted a post-suicide watch report. Epstein denied suicidality and stated "I have no interest in killing myself" and that it "would be crazy" to take his life, although he was "depressed" and "unhappy" about his current legal situation. He was told he will remain on psychological observation in the near term. Clinical contact: Epstein asserted that he did not recall how he got the marks on his neck, and complained about the conditions in the ShU. He denied suicidality and said that he was "too vested in my case to fight it, I have a life and I want to go back to living my life." Epstein would remain on psychological observation out of an abundance of caution given that he had yet to give an account of how he got the marks on his neck. Clinical contact: Epstein denied suicidal ideation, intention, or plan, and referred to himself as "a coward" and "I'm Jewish" and said that he was not someone who liked pain or would ever attempt to harm himself. UNCLASSIFIED EFTA00161498 (U) Timeline Continued Date Time 7/27/2019 7/28/2019 7:14 8:33 7/29/2019 10:01 7/29/2019 12:21 7/30/2019 12:01 7/31/2019 10:35 8/1/2019 13:29 4- • S * i! * •r? t * • 111'7 -• k'dix ov, lti Details Clinical contact: Epstein said he could not remember what happened in SHU. He denied suicidal ideation and said "I'm a coward." He would remain on pscyh observation in an abundance of caution pending housing arrangements to be made on Monday (7/29) Clinical contact: Epstein complained about noises and conditions in his cell. He denied suicidal ideation. Clinical contact: Epstein asked to remain in the hospital unit for one more week where it is "safe." He could stay for one more night to receive his CPAP and get a good night's sleep, but that he would be returned to SHU tomorrow (7/29). There was "no mental health issues precluding him from returning to SHU" and "we could not house him in the SW/hospital area because he felt safe or more comfortable for him." Epstein assigned to House Z, Range 4, Bed 206L (SHU) Clinical contact: Epstein denied suicidal ideations and "does not appear to be an immediate danger to self. Psych observation was discontinued. Clinical contact: Epstein denied suicidal ideation. Suicide Risk assessment. Staff reported that when Epstein came back from court the USM asked him to sign a form that noted he had "suicidal tendencies." He was seen for a suicide risk assessment. Epstein "seemed surprised that there was a form noting suicidal tendencies. He denied stating that he was suicidal." He denied any suicidal frInr-Inrininc, nrirl ,nine rin+ EFTA00161499 (U) Timeline Continued Date Time 8/9/2019 8/9/2019 8:00 8:30 8/9/2019 13:50 8/9/2019 18:45 8/9/2019 19:17 8/10/2019 12:00 8/10/2019 12:35 8/10/2019 3:06 8/10/2019 5:00 8/10/2019 5:30 ♦ ,stii.y.,NT Op JL • 4- * 44 4f * Sli * i !r • '4 7 -• (.4 LI OF 1.1'.‘1 Details Epstein's departs for court (WAB-USMS-SDNY). Epstein arrives in Attorney Conference. Officer said Epstein's cellmate was going WAB and possibly may not return, so Epstein would need a cellmate upon arrival from his attorney visit. Epstein departs Attorney Conference and returns to SHU. Epstein places an approximately-20 minute call. Officer 1 allowed him to make the call in the shower area and dialed the number on a legal line because Epstein did not have his PAC and PIN set up. Officer 1 left Officer 2 and another male officer with Epstein. Officer 2 and 3 start their shift, supervised. Both are working OT. They work until 8am and are replaced by two other officers SHU Count corrected -1 (Fernandez in Dry Cell R-A) per Lt. Log completed by Lt. ). Good verbal count announced at 12:36. Officer 2 and 3 certify there are 72 inmates present for the official count for ZA. Officer 2 and 3 certify there are 72 inmates present for the official count for ZA. Lt. I= arrives and relives Lt. UNCLASSIFIED EFTA00161500 (U) Timeline Continued • 4t, ~ RE4IU of Date Time Details E- Body alarm activated in SHU. Officer 2 announced by radio a medical emergency on 9 South. Lt. arrived on 9 South, and waited for control to buzz him in. He saw Officer 1, who said "Epstein hung himself." When Lt. arrived at the cell, Officer 3 was performing 8/10/2019 6:33 CPR on Epstein. Lt. began performing CPR. Lt. notified control center to call emergency services. During the situation, Officer 2 stated "we did not complete the 3am nor 5am rounds." Officer 3 appeared distraught 8/10/2019 6:35 and said "we messed up," "I messed up, she's not to blame, we didn't do any rounds." Epstein is moved to the 2nd floor medical area, and Nurse performed CPR until EMT 8/10/2019 6:43 staff arrived. No pulse found. Epstein is transferred into ambulance with an Officer and followed by another Officer to 8/10/2019 7:10 Beekman hospital. 8/10/2019 7:36 Official time of death, as reported by ER physician. Epstein's body released to Office of Chief Medical Examiner 8/10/2019 12:15 (OCME) OCME transports remains from New York Presbyterian to city morgue. Officer 8/10/2019 12:57 accompanies the remains. 8/11/2019 OCME performed an autopsy Indictment OF OFFICERS EFTA00161501 (U) Epstein Housing Unit Details :a-, j.x EFTA00161502 (U) Epstein Housing Unit Details EFTA00161503 (U) Epstein Housing Unit Details Orit7 EFTA00161504 (U) Epstein Housing Unit EFTA00161505 (U) Epstein Housing Unit UNCLASSIFIED EFTA00161506 (U) Epstein Cell Area EFTA00161507 Type of Incident INMATE SUICIDE Date and Time of Incident Inmate Name Rcg. No. Location of Incident Photograph(s) by 08/10/2019 6:33 A Al EPSTEIN, JEFFERY REG:;"6318-054 Date and Time of Photo 08102019 6:49 All I pe of Incident IN llA11. 5(.1011)1 Rae and Time of Incident (is 10 2019 6 33 AI Inmate Name. Reg. No. EPSTEIN. JEFFERY REGP76311(054 [meat ion of Incident Photograph(s) by Date and Time of Photo ofP-0,1s. EMT /1 tt c 10 2019 6:49 Alf UNCLASSIFIED//LAW ENFORCEMENT SENSITIVE EFTA00161508 Type of Incident Date and Time of Incident Inmate Name ! Reg. No. Location of Incident Photograph(s) by Date and Time of Photo INMATE SUICIDE 08/1012019 6:33 AM EPSTEIN. JEFFERY REG#76318-0.54 ZA 08/10/2019 6:49 AM Type of Incident INMATE SUICIDE Date and Time of Incident 08./10/2019 6.33 AA/ Inmate Name !Reg. No. EPSTEIN JEFFERY REG;76318-054 Location of Incident ZA Photograph(s) by Date and Time of Photo Os' 10 2019 6.49 AM IlL r .----7-7- ) — Ca ..... - ..-,--- IK . -.4. ,,. 0 ,.. UNCLASSIFIED EFTA00161509 Type of Incident Date and Time of Incident Inmate Name / Reg. No. Location of Incident Photographs) by Date and Time of Photo INMATE SUICIDE 08'10/2019 6:33 :Ill EPSTEIN, JEFFERY REG#76318-054 0N/10 2019 6:49..11 UNCLASSIFIED Date and Time of Incident II W10'2019 a 6:33 AM Inmate Name(s) / Reg. No. ocation of Incident Photograph(s) by Jeffrey, Epstein #76318-054 photographs taken at outside hospital D. Nlebane/CMC EFTA00161510 Type of Incident N/A pe of In:ident N A Date and Tint(' of Incident 8/10/2019 &Jr 6:33 AM Date and Time of Incident 8:10/2019 .)/ 6:33 AM Inmate Name(s) / keg. No. Jeffrey. Epstein 476318-054 Inmate Name(s) / Reg. No Jeffrey, Epstein 476318-054 Location of Incident photographs taken at outside hospital Location of Incident photographs taken at outside hospital Photograph(s) by D. Mebane 'CMC. Photograph(s) by D. Nlebane/CMC UNCLASSIFIED EFTA00161511 (U) Inside Epstein's Cell UNCLASSIFIED//LAW ENFORCEMENT SENSITIVE EFTA00161512 (V) Image EFTA00161513 (U) OCME Epstein Autopsy Report 4 * Sis . m vi e, re, AI /A7 , • e4 -4( 4- 40 • ?k'diu ov VI 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 CAUSE OF DEATH: MANNER Of DEATH: HANGING SUICIDE (HANGED SELF) Nronvotetedbe of CAW4WIS Etrits I omelets ached frau, Copes of occurramfmn OCAElommiefen. p.,Oca: thr:ZZ/7 j gjoiltare Marko UNCLASSIFIED EFTA00161514 (U) OCME Epstein Autopsy Report Continued CLOTHING: The body is received clad in a hospital gown. tr'tta r l it * errs* * IN SST lit4 11 e s • ,44cu * • 2 ? nF 0 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 11, 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. Anteriorty, 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 comuae are fractured, and the left comua 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 UNCLASSIFIED EFTA00161515 (U) OCME Epstein Autopsy Report Continued ; g ♦ 4.6. b y c-IIU OF 1.• Laryn.r 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 I 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 virus of fractures to bite 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. Figure I. Diagram of the submitted hyoid and larpn (anterior slew) showing the approximate fracture locations I red lint"). 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-yearsold 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. 2cm flin 1 igure 2. Oscars tea of the submitted hyoid bone exhibiting a fracture to the kit greater horn tw Ink arrow 1. FINDINGS: Hyoid The greater horns of the hyoid are bilaterally fused to the hyoid body. There is a fracture of the left greater horn (Figures I and 2). The Forensic Anthropekty (hut is atentliled in totemic Investor, ,...In ISO/IEC 17020 Ettore! hi 4NNLVarsoc Accreditation Rnard. Refer to cerhfinsie and wipe of arrtrthrishon Fl-0014 UNCLASSIFIED EFTA00161516