EFTA00130065.pdf

• U.S. Department of Justice Federal Elurreau Investgation Bureau File Number 0 (2 Field Office Criminal Investigative and Administrative Files Armed and Dangerous FOIPA ) DO NOT DESTROY NCIC ELSUR OCIS ) Escape Risk Suicidal Financial Privacy Act Other See also Nos. EFTA00130065 Type it Acquired By Date Serial Attachment Type OST Notes Vol 1A 54 2019-08-17 118 Digital and Physical 3 1A 53 2019-09-06 116 Digital and Physical Not Located 3 1A 52 2019-08-28 114 Digital and Physical 3 1A 51 2019-08-12 112 Digital 3 1A 50 a 2019-08-11 103 Digital 3 1A 49 2019-08-10 102 Digital 3 1A 48 2019-08-26 101 Digital 3 1A 47 2019-08-17 100 Physical 3 EFTA00130066 FD-34Oc(4-11.03) File Number q° 4 - 3/s-72z?- Field Office Acquiring Evidence New vorIc Serial # of Originating Document 09 • Date Received fi ? -1 6)/9 From Laser )4, (A) (Name dCostribatorlIntersiewee) eAyro.,64.i , (Address) Sieca O4.f eu VA ( IV( re) B To Be Returned O Yes Erslo Receipt Given ❑ Yes ET-No Grand Jury Material - Disseminate Only Pursuant to Rule 6 (e) Federal Rules of Criminal Procedure O Yes ErNo Federal Taxpayer Information (FIT) O Yes Er-No Reference: (Communkation Endosing Mabilal) Description: O Orienal notes re interview of 0kt. (11 CI) 4 Qutitit46- Cilz• 4 RAO sca.. Ai-o-'; 0,1, (1 ) et c4- Wan*. r~aY f.44.)sw cl4.4_ "Cot' (i) Ct\,t " Am," 4--( "Cat' ; e.-tan 44, 4h 3u4,7"" '14-ir k,41, ell t o cam- (1.3,A1 ttettm 4 sc4.5 t ()LP-- EFTA00130067  3t-64 (tier:Rt.) 1.1-4( - /0 s...1.,nrt /L Soul,- tO (AVMS 4e fi S EFTA00130068 EFTA00130069  ITEM WAS NOT SCANNED DESCRIPTION if)', EFTA00130070  SaNC2 6° (.00-4tVowt Flour ts- (L Ili 10(1 zoo). 08/?_ wy zoi \. - 081;-. 643..mcc Air Gc43_ A4 \FAR° LASER scm cc_ csa N, 6irol ?Poi-ELT ?(w3 09_„T tscr GOY 2°11 _ (1_ NY- GC44Z- µGC Zvi S - 664- NI- Gck3. mu_ cetc. Attrtpoli4,-. 6perec.— k Ate r- So4k, Specie, - Movi Ae, tk.ssi, unit- O n cuhied eel( FAik scAd oirm EFTA00130071  ITEM WAS NOT SCANNED DESCRIPTION EFTA00130072  s EFTA00130073 FD-340c(4-11.03) File Number cto4 - -3l s - Field Office Acquiring Evidence Serial # of Originating Document 11 Li Date Received o - From C E (Name ottoniributerrtgasiewce) (Address) d State) By Tolle Returned El Yes 0 No Receipt Given 0 Yes El No Grand July Material-Disseminate Only Ptusuant to Rule 6 (e) Federal Rules of Criminal Procedure 0 yes Ei No Federal Thapayer Information (FT!) Yes Ei No Title: kfuN Swo Ls) Syek n l e,F+Ve-ti l•C-ip Dec,.-kv1/4 (flute) ts cfrti Reference: (CommmikutionEndesiogMated* Description: 0 Originalnotes re imteniew of Autyt-or5uk Ater+ OP ePsie/ - CO 0 6 p vt-h) (AA s 14/ c,c //45-7 1 •••••••irm. EFTA00130074  OFFICE OF CHIEF MEDICAL EXAMINER OF THE CITY OF NEW YORK STATE OF NEW YORK ) SS.: COUNTY 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 has been ordered to produce certified copies of documents concerning decedent, Jeffrey Edward Epstein ME # M19-19432 OCME is a governmental office organized under the New York City Charter § 557 and the New York City Administrative Code §§17-201 - 17-206. All records contained in its Records Department concerning this matter are maintained in OCME's regular course of business. OCME medical examiner files contain autopsy 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 particular case. The copies provided here represent all the documents contained in the above-cited OCME medical examiner case file. I have examined the original records maintained by OCME's Records Department and I have compared the copies provided here to the originals from which they were photocopied, and I attest that the records bearing this certification and authentication are a true and correct copy of the original records so described and are accurate and genuine. I have affixed the official seal of the Office of Chief Medical Examiner of the City of New York to certify these copies as genuine and as business records of the Records Department of the Office of Chief Medical Examiner. Siggfiiure Print Name Clerical Associate IV Title August 28,2019 Date [Seal of the Office of Chief Medical Examiner] OCME Records Certification Form 1 Rev 1/15 EFTA00130075  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: M, 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 EFTA00130076 CAUSE OF DEATH: HANGING MANNER OF DEATH: SUICIDE (HANGED SELF) New York City Office of Chief Medical Examiner I certify the attached are true copies of document(s) in OCME's possession. EFTA00130077 Az. OFFICE OF CHIEF MEDICAL EXAMINER CITY OF NEW YORK REPORT OF AUTOPSY CASE NO. M-19-019432 I hereby certify that I, M, 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 EFTA00130078 M-19-019432 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, 'A 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 EFTA00130079 4 M-19-019432 • JEFFREY EDWARD EPSTEIN Page 5 similar, 1/2 x %", faint, red contusion. Internally, there is a deep muscle hemorrhage of 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 EFTA00130080 M-19-019432 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. EFTA00130081  M-19-019432 JEFFREY EDWARD EPSTEIN Page 7 • LEFT DELTOID MUSCLE x 1 (#1M: 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. First Deputy Chief Medical Examiner. The information provided above is true and correct to the best of my knowledge and belief. Electronically signed by i on Aug 27, 2019 07:38:00 AM EFTA00130082  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 Laborakiry No : FT19-03508 Medical Examiner: ME Case No : M-19-019432 Examination Date : 8/11/2019 Specimen Type: Blood(Femoral): F119-03508-001, Blood(Femoral): FT19-03508-002, Blood Femoral): FT19-03508-003, Blood(Heart): FT19-03508-004, Blood(Heart): FT19-03508-005, Blood(Heart): FT19-03508-006, Bite: FT19-03508-007, Urine: F119-03508.008, Gastric Contents: F119-03508-009, Brain: FT19-03508-010, Liver. FT19-03508-011, Vitreous: FT19-03508-012 Received By : Date Received':. 08/12/2019 Results Blood(Feinoral) : 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 Ms an assfidied kande Toxicology case ie. Cad al= hagasgocmo.nyc.go; If you have questions Salina to the oaten of this repot Si DehNeons of terms used In this mod can be totaled el haelsenvel.hycgcnIsite/ocmeiseMcesrtoxicologyeadinica-raanuals.page Sc (Hons) M PhD. CChem FRSC FHEA or of Forensi Toxicology Date: 4/2019 Page 1 of 1 EFTA00130083  NMS CONFIDENTIAL Phone LI S email: PhD. F-ADFT, DADCC-TC, Laboratory Director Toxicology Report Patient Name FT19-03508 M19-019432 Patient ID NP Report Issued 08/22/2019 17:09 Chain 19244749 Age Not Given DOB Not Given Gender Not Given To: 10074 New York Office of Chief Medical Examiner Workorder 1924 4 74 9 Attn: Department of Toxicology 520 First Avenue New York, NY 10016 Page 1 of 2 Positive Findings: None Detected See Detailed Findings section for additional information Testing Requested: Analysis Code Description 95606 Synthetic Cannabinoids Screen (2019 Scope). Blood Specimens Received: ID Tube/Container Volume/ Collection Matrix Source Miscellaneous Mass Date/Time Information 001 Gray Top Tube 4.25 mL Not Given Femoral Blood All sample volumes/weights are approximations. Speemens received on 08/14/2019. NMS v.18.0 EFTA00130084  CONFIDENTIAL Workorder 19244749 Chain 19244749 -NMS Patient ID NP LABS 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 performed. 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: 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 Limit. Please refer to the Positive Findings section of the report for those compounds that were identified as being present. Acode 9560B - Synthetic Cannabinoids Screen (2019 Scope), Blood - Femoral Blood -Analysis by High Performance Liquid Chromatography/Tandem Mass Spectrometry QTRAP (LC-MS/MS QTRAP) for. Compound Rot. Limit Compound 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 ng/mL 5-fluoro-M0MB-PICA 0.10 nglmL MDMB-CHMICA 0.10 ng/mL 5-fluoro-MDMB-PINACA/ 5-fluoro- 0.20 ng/mL MDMB-CHMINAC 0.10 ng/mL EMB-PINACA MDMB-FUBICA 0.10 ng/mL 5-fluoro-MMB-PINACA 0.050 ng/mL MDMB-FUBINACA/ EMB- 0.10 ng/mL 5-fluoro-NA-PIC 0.10 ng/mL FUBINACA 5-fluoro-QU-PINAC 0.10 nglmL 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 ng/mL MMB-FUBINACA 0.10 ng/mL ADMB-FUBINACA 1.0 nglmL NA-FUBIC 1.0 ng/mL AMB-CHMINACA 1.0 nglmL NA-FUBIM 0.20 ng/mL NMS v.18.0 EFTA00130085  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. ON 811112019) MACROSCOPIC EXAMINATION (PERFORMED BY DR. WITH DR. IN ATTENDANCE, ON 8120/2019): 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 equine levels show no abnormality, externally or on midsagittal section. PHOTOGRAPHS: YES MICROSCOPIC EXAMINATION: NO FINAL NEUROPATHOLOGIC DIAGNOSIS: I. NORMAL BRAIN AND SPINAL CORD ,MD The information provided above is true and correct to the best of my knowledge and belief. Electronically signed by on Aug 20, 2019 05:41:27 PM EFTA00130086  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 anthronologv@ocme.nvc.2ov BACKGROUND: On 12 August 2019, the Forensic Anthropology Unit received a hyoid and larynx that were removed by Dr. 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 •Or Thyroid Cricoid 2 cm 1 in Figure 1. Diagram of the submitted hyoid Figure 2. Overview of the submitted hyoid and larynx (anterior view) showing the bone 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. Them is a fracture of the left greater horn (Figures 1 and 2). The Forensic Anthropology Unit is accredited in Forensic Inspection under ISO/EC 17020 issued by ANSI National Accreditation Board. Refer to certificate and scope ofaccreditation F1-0014. EFTA00130087  M-19-19432 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 (I0x) 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 PhD, D-ABFA Forensic Anthropologist Page 2 of 2 EFTA00130088  OFFICE OF CHIEF MEDICAL EXAMINER CITY OF NEW YORK ADDITIONAL AUTOPSY NOTES M.E. CASE # - EXAMINED BY DR. DATE /20 EFTA00130089  OFFICE OF CHIEF MEDICAL EXAMINER CITY OF NEW YORK ADDITIONAL AUTOPSY NOTES NAME OF DECEDENT: (Ti griz -or? se„v. M.E. CASE # -( - /C1C-f EXAMINED BY DR. DATE 41_120 17 EFTA00130090  OFFICE OF CHIEF MEDICAL EXAMINER CITY OF NEW YORK ADDITIONAL AUTOPSY NOTES NAME OF DECEDENT:5 /-CEV-11 M.E. CASE # /V1- - 1- 1 } 0A-ti, 'tqaft.e-/bash,e1- nmkogi OA I °I- ZICI-b, EXAMINED By DR. DATE / / 20r1 EFTA00130091  OFFICE OF CHIEF MEDICAL EXAMINER 4r-ri- 17‘ lk CITY OF NEW YORK ADDITIONAL AUTOPSY NOTES NAME OF DECEDENT: (ri Cz M.. CAsE # - - Crt .3? V)A•k k t\k-1. 17'1 LaufW-es-ivv) \Yer artot\i - ) clA14 I r.,19 OA , V (..a4,, ki,y(ukik, Y, "; _ _ S rt gt5T GO- MSS— EXAMINED ay DR. DATE <6- AI. /20(c) EFTA00130092  esm ice chi Cztr- , wsitc\tie keiticufri Mde d Diadem Epstein, Jeffery ILLS: M-19-019432 El•Idge Din: EFTA00130093  OFFICE OF CHIEF MEDICAL EXAMINER THE CITY OF NEW YORK AUTOPSY NOTES (51W-f- 0 Nr or Demean: Epste Jeffery - MEI M-19-019432 e l sm coLon: WWII, TIMM' Pr OR Weintri TI lei t IA ClitEI TES: AMES Ti_ Virki Torso: Ara Gamma&J r ) 1 ..„... MAWR lame roans: LAVA oroirre&F TEMPERATURE: Scars: 6.). Tattoos: 0 Clothing: TherapeuticProcedures: Injuries: ur) Heady Brain Neck - Cavities Vessels 1W L.V. 1 4.A .) R•Lung 1:-Lu Iv f ll'', BIN- C.<31 Pancreas Ge- Sli Spleen Lymph M g"t• Ai v. I/L SO -LSO '' -' S1 \ ' .c. , Thyme: R•rf We bc— . L-Kidneya4L0 Urine • Gonads Endocrl Digestive Tr Gastric • ml c...17 ("-- ' (2-4- 40 ) cgt."Q—, App RI Nusc-S , Examined by: kik EFTA00130094  FT19-03508-001 NYC Office of Chief FORENSIC TOXICOLOGY REQUEST FORM „mosaic Type: Source: Bid Femoral Medical Examiner M.E. CASE M: DATE OF DEATH: M-19-019432 08/10/2019 7:36 AM NAME OF DECEDENT: Age Race AUTOPSY • a CI Epstein, Jeffery a 66 Years White Mx J NO AUTOPSY (Exam) F M19019432 U PURSUANT TO LAW MEDICAL EXAMINER: ME EXAM DATE: Dr. 0 08/11/2019 INDICATED: U NO L YES K) YES BASIC COMPREHENSIVE MANNER HOMIODE J SUIODE . , ACCIDENT NATURAL THERAPELOIC COMPLICATION UNDETERMINED OF DEATH COI I: 109 COT l a•A coc SAMPLES SUBMITTED: BLOOD (k FEMORA!) (%ilAll iE :F.) _CAVITY _ SUBDURAL U OTHER 6 ,3 LII• i (-1(4 B LE URINE TRI BRAIN L., VER U DECOMP U OTHER: CONTE FLUID iTREOUS ._! CHEMISTRY REQUEST t ' CIPAL.. Na K a VUN/Cr Glucose Other: Id irrOsfA BRIEFCASE DETAILS j/ 3itk f tntAl o ljAk VN Lij2142' ir —re{ -r (414 .1 a de .Ths l ( frlir U PRISONER DECOMP U MOTOR VEHICLE COWSION DRIVER DURATION OF HOSPITALIZATION: 1 CYLA&T Bil , ari SUSPECT DRUGS/M TI ED EDI S: a_113:k__Litti_ 01: A 0 fri..151:1 1CS SIGNATURE: EFTA00130095  NAME OF DECEDENT: Epstein, Jeffery PA.E.ust a: M-19-019432 MEENCAL DUMMER: DR DATE OF DEATH- 08/10/20144 - HOMICIDE _ PRISONER Z MVA (Orrver/Operator) _ OTHER RUSH TODAY'S DATE: 08/11/2019 COMPONENTS OF MEDICOLEGAL CASE RECORD NEEDED FOR CIRIIF/CATION FOR FILE COMPLETION TOXCOLOGY REPORT .>CI HISTOLOG2,r___ ) -alEVROPATHO R CARDIAC PATHOLOGY 0 2 ° REPORT(S): / >C1 POLK( '- FIRE MARSHAL X MLI ? C) CULTURES: _ BLOOD _ TB _ OTHER: CONSULTANTS X) ANTHRO - RADDLOGY - OTHER: HOSPITAL OR MEDICAL RECORDS l.-- \ C INFANT DEATHSCENE iNVESTIGAT:CN OTHER: 'It %Wl ikil .CL III 1.(-, 1-- ( 14 For Pete lair% Casts: Is there suspicion of abuse at this time? YES NO If ye ,CaU 1 (Sw) 635,1522 AUTOPSY INVENTORY CONSULT SERVICE (ky RAIN HEART THRO X-RAYS: 4 YES NO PHOTOS: T)0 YES - NO BOTTLE(S) REQUESTING hN HISTOLOGY: STOCK JAR(S)- 1 2 3 4 YES NO CO2 3