EFTA00113054.pdf

LIMITED OFFICIAL USE 1 DIGITALLY RECORDED SWORN STATEMENT OF OIG CASE #: 2019-010614 DEPARTMENT OF JUSTICE OFFICE OF THE INSPECTOR GENERAL MAY 31, 2022 RESOLUTE DOCUMENTATION SERVICES 28632 Roadside Dr., Suite 285 Agoura Hills, CA 91301 Phone: EFTA00113054  2 APPEARANCES: OFFICE OF THE INSPECTOR GENERAL BY: BY: WITNESS: OTHER APPEARANCES: EFTA00113055  3 1 MR. : This is Special Agent Lyeson 2 Today is May 31st, 2022. The time is 3 3:33 p.m., and the recording is now on. 4 My name is . I am a Special 5 Agent with the U.S. Department of Justice, 6 Office of the Inspector General, New York Field 7 Office, and these are my credentials. You 8 should be able to see. This interview with New 9 York City Medical Examiner Dr. . 10 Did I say that right? 11 MS. : Yes. 12 MR. : Is being conducted as part of 13 an official U.S. Department of Justice, Office 14 of the Inspector General investigation. 15 Today's date is May 31st, 2022. The time is 16 3:34 p.m. This interview is being conducted 17 via Microsoft Teams Video Conferencing. Also 18 present is DOJ/OIG Special Agent-in-Charge Ryan 19 , and Office of Chief Medical Examiner 20 General Counsel, . For this 21 interview be recorded by me, Special Agent 22 . Could everyone please identify 23 themselves for the record and spell your last 24 name? To start, again, I am DOJ/OIG Special 25 Agent and that's spelled - EFTA00113056  4 1 . SAC ? You're on mute. Sorry. 2 MR. : My name is . I'm a Special Agent-in-Charge for the New 4 York Field Office. 5 MR. : Ms. . 6 MS. : Oh, . General Counsel from the New York City 8 Office of Chief Medical Examiner. 9 MR. : Dr. . 10 MS. : I'm . . 11 And I'm a city medical examiner at Office of 12 the Chief Medical Examiner in New York. 13 MR. : Thank you, everyone. This is 14 an official DOJ/OIG investigation into the 15 events surrounding the death of inmate Jeffrey 16 Epstein. And you are being asked to 17 voluntarily provide answers to our questions. 18 Will you agree to a voluntary interview with 19 the DOJ/OIG? 20 MS. : Yes. 21 MR. : Before starting the 22 interview, I would like to place you under 23 oath. Dr. , can you please raise your 24 right hand? Do you swear to tell the truth and 25 nothing but the truth during this interview? EFTA00113057  5 1 MS. : I swear. 2 MR. : Thank you. Please let me 3 know if you don't understand any questions that 4 I ask. I'll try to repeat it or try to 5 rephrase it for you. 6 MS. : Okay. 7 MR. : We're going to start with 8 your background, and then get into the details 9 of the autopsy itself. Can you provide us with 10 a summary of your college level education, 11 starting with your bachelor's degree? 12 MS. : Sure. My bachelor's degree is 13 in Fine Art, and I completed that at Cooper 14 Union School of Art (Phonetic Sp. *00:02:45). 15 I then went back to school for pre-medical 16 studies only, to Columbia University School of 17 Graduate Studies, and completed the requisites, 18 the pre-requisite courses for applying to 19 medical school. 20 I then went to medical school at SUNY 21 downstate in Brooklyn, completed that, and I 22 earned an MD. I did a year of residency 23 training in obstetrics and gynecology. Found 24 that that wasn't the right field for me, so I 25 switched. EFTA00113058  6 1 I did three years of training in 2 pathology. And then, I did a final year of 3 fellowship training in forensic pathology. All 4 of my residency training was done at King's 5 County Hospital in Brooklyn, and the fellowship 6 training was done here at the Office of the 7 Chief Medical Examiner. 8 MR. : Okay. And the three years in 9 pathology, that was done at the Office of Chief 10 Medical Examiner? 11 MS. : No. That was also done at 12 King's County, and not Brooklyn. 13 MR. : Okay. Now, once you do the 14 three years in pathology, and you come over. 15 Did you start with the office of chief Medical 16 Examiner right after that? 17 MS. : After completing the 18 fellowship year, yes. 19 MR. : Okay. And then, once you 20 started at the Office of Chief Medical 21 Examiner, is there specialized training that 22 they sent you in for also, or -? 23 MS. : We do, to maintain our 24 licenses, we do training on a weekly basis. 25 And in order to be board certified, you have to EFTA00113059  7 1 recertify every ten years, and every year, show 2 that you've done a certain amount of credits of 3 training. So, I've been undergoing 4 supplementary training my entire life since 5 coming to the Office of the Chief Medical 6 Examiner. 7 MR. : Okay. And what year did you 8 earn your doctor? Did you become a doctor? 9 MS. : It was 1999 when I graduated 10 from medical school. 11 MR. : Okay. And your three years 12 in pathology? When did you complete that? 13 MS. : So, I did, from '99 to 2001 14 was OB. And then, from 2001 to 2003 was the 15 pathology training. And then, '03 to '04 was 16 the fellowship training. 17 MR. : '03 to '04. So, you've been 18 with the Medical Examiner's Officer for almost 19 20 years now? 20 MS. : Yes. I did leave for one year 21 briefly. I took a job elsewhere to be second 22 in command. Didn't like it. Came back. So, 23 there has been a year break in service. 24 MR. : Was that recently, or going 25 back a while? EFTA00113060  8 1 MS. : 2013 to 2014. 2 MR. : Okay. Where did you go? 3 MS. : I went to Madison, Wisconsin 4 to work at the Dane County Medical Examiner's 5 Officer. 6 MR. : That's a big jump from New 7 York City to Madison. 8 MS. : Oh, you aren't kidding. It's 9 very different. 10 MR. : SAC , do you have any 11 questions about background? 12 MR. : Nothing from me. Thanks. 13 MR. : No problem. Prior to 14 conducting -. So, are you familiar with MCC 15 inmate - the Metropolitan Correctional Center 16 in New York - inmate Jeffrey Epstein? 17 MS. : After his death, yes. 18 MR. : So, prior to conducting 19 Did you conduct his autopsy? 20 MS. : I did. 21 MR. : Okay. Prior to conducting 22 Jeffrey Epstein's autopsy, how many autopsies 23 had you conducted? If you can give me a rough 24 estimate. 25 MS. : Oh. I don't know exactly. It EFTA00113061  9 1 was a couple thousand. 2 MR. : Oh, okay. And do you know 3 how many -? An estimate of how many of those 4 autopsies resulted in the conclusion of 5 suicide? 6 MS. : Again, I don't have an exact 7 number, but I will say that there were an awful 8 lot of suicides in Staten Island where I worked 9 in Dane County. So, I've done plenty. 10 Certainly more than a hundred, probably several 11 hundred. 12 MR. : Wow. Okay. And did you ever 13 deal with any prisoner deaths that you 14 conducted autopsies for, prior to Mr. Epstein? 15 MS. : Oh, yes. 16 MR. : Okay. And how many of those 17 autopsies, if you can give an estimate, 18 resulted in the determination of cause of death 19 by suicide? 20 MS. : So, I can remember a couple 21 actually. Maybe two or three. 22 MR. : Okay. I'll come back to 23 that. Anything else, SAC , on that? 24 MR. : No. And now, doctor, these 25 were deaths at the MDC, Metropolitan Detention EFTA00113062  10 1 Center, or was this the MCC, or what facility 2 were these autopsies conducted in reference to 3 their deaths? 4 MS. : I honestly don't remember. 5 I'd have to look that up. 6 MR. : But they were local here in 7 New York? 8 MS. : They were New York cases. 9 Yes. 10 MR. : Okay. 11 MS. : I didn't do any custody cases 12 at all when I was in Dane County. 13 MR. : Thanks. 14 MS. : Just to clarify, it is 15 (Indiscernible *00:07:30) City Department of 16 Correction -- 17 MR. : Okay. 18 MS. : -- you're asking about 19 federal deaths. 20 MR. : Yes, we are. 21 MR. : Okay. So, yeah. 22 MR. : Thank you for that. Dr. 23 , do you recall when and where you 24 conducted the autopsy of Jeffrey Epstein? 25 MS. : I did the autopsy on the 11th EFTA00113063  11 1 of August, 2019, and I actually have my notes 2 in front of me, so I will check the -- 3 MR. : Okay. 4 MS. : -- time, if you'd bear with 5 me. Oh, let's see. I mean, actually, maybe I 6 don't have that particular note. I don't 7 remember exactly, but I know he was my only 8 case that day. So, I started in the morning, 9 and worked steadily through the day on him. 10 MR. : Okay. So, that was the only 11 case for the day. 12 MS. : Yes. 13 MR. : And when did you become aware 14 of his death? 15 MS. : We were made aware of the 16 death the day prior, and we were expecting him 17 to arrive the day prior, actually, on the 10th. 18 MR. : Okay. How do you get 19 assigned to do Mr. Epstein's autopsy? Is that 20 like a rotation? Or was it assigned to you by 21 somebody? 22 MS. : It was assigned to me by 23 somebody. We had initially thought he would 24 come in on the 10th, and I wasn't the person 25 assigned, but that person wasn't working on the EFTA00113064  12 1 11th, and I was chosen to do the autopsy on the 2 11th. 3 MR. : Okay. Do you know who it was 4 that was chosen initially? 5 MS. : Yes. 6 MR. : Do you know the name? 7 MS. : Sure. It was Dr. 8 (Phonetic Sp. *00:09:00). 9 MR. : . Okay. No problem. 10 MS. : Yup. 11 MR. : Did anyone else assist you 12 with the autopsy? 13 MS. : Yes. I had morgue technicians 14 and photographers assisting me with the 15 autopsy. 16 MR. : Do you know the names off 17 hand? 18 MS. : I remember the photographer is 19 (Phonetic Sp. *00:09:17). And there 20 were a couple of morgue techs, but the one that 21 I recall is -. Gosh, what's her last 22 name? It's blanking. I'm blanking on 23 last name. But . 24 MR. : Okay. No problem. And you 25 said -- EFTA00113065  13 1 MS. : Yeah. 2 MR. : -- there's , and there's 3 one other person. Right? 4 MS. : Yeah. And there was another 5 morgue tech who sort of rotated in and out, and 6 I don't remember which one that was. 7 MR. : Okay. 8 MS. : We usually don't keep track of 9 that. 10 MR. : No problem. 11 MS. : . That's her last name. 12 . I know a couple (Indiscernible 13 *00:09:49), and she . Mm-hmm. 14 MR. : Thank you. Based on your 15 recollection of the autopsy, is there anything 16 that stood out in your mind, based on your 17 examination? 18 MS. : Yeah. Definitely. 19 MR. : Do -? 20 MS. : Do you want me to 21 MR. : Yes. 22 MS. : -- recount it for you? 23 MR. : Yes, please. 24 MS. : So, he had a really marked 25 (Phonetic Sp. *00:10:07) and obvious ligature EFTA00113066  14 1 furrow (Phonetic Sp. *00:10:10), very 2 consistent with what I typically see in a 3 hanging. And he, above the furrow, had fluride 4 (Phonetic Sp. *00:10:16) petechial hemorrhages 5 of his facial skin, his conjunctiva, and in his 6 mouth, all things that I see very frequently in 7 hangings. 8 MR. : I'm going to ask you a favor. 9 So, some of the terminology is going to go 10 right over my head. So, and especially for 11 reporting everything. Is it possible -? I 12 don't know if you can, how do I say? To dumb it 13 down. 14 MS. : Say it in English? 15 MR. : Yes. 16 MS. : I could do that. I'm pretty 17 sure you know what ligature furrow -- 18 MR. : Yes. 19 MS. : -- means. 20 MR. : I do. 21 MS. : It's just a deep -- 22 MR. : Yes. 23 MS. : -- abraded sort of abrasion of 24 the skin. The petechiae that I'm referring to, 25 and the plethora. So, plethora is purple EFTA00113067  15 1 discoloration of the skin from back up of 2 circulation. Petechiae are pinpoint 3 hemorrhages that occur with a similar 4 mechanism. If the blood is cut off, and the 5 small capillaries burst, you get petechial 6 hemorrhages, which, they're just like pinpoint 7 bleeds in the skin. So, he had them in his 8 skin, in his eyes, and in his mouth. 9 MR. : Okay. 10 MS. : Yeah. 11 MR. : And is that consistent with 12 suicides? 13 MS. : It's consistent with a suicide 14 by hanging. Yes. 15 MR. : Right. Hanging. Can that 16 also be associated with anything else, like 17 strangulation, anything like that? 18 MS. : So, the petechiae can be. The 19 plethora, usually not. 20 MR. : Okay. And why not the 21 plethora? 22 MS. : Because the plethora really 23 involves having a sustained steady pressure, 24 and you usually don't get that in a 25 strangulation because very rarely is a person EFTA00113068  16 1 going to be still for that, or submit to it, 2 without struggling. So, with a struggle, the 3 pressure is not even, and you really don't get 4 the plethora, and the petechiae aren't quite 5 distributed like his were. His were, like, 6 just all the way from the neck up, he had 7 petechiae. In strangulations, it's usually 8 just the eyes and mouth, not all of the skin. 9 So, even though they can be seen in homicidal 10 strangulations, they usually have a different 11 pattern then I saw in Mr. Epstein. 12 MR. : Got it. Thank you. So, what 13 made you come to the conclusion that Jeffrey 14 Epstein's death was a suicide? Can you walk us 15 through that? I know you mentioned the 16 plethora, the petechiae, and also the ligature 17 itself. What all did you see that made you 18 come to the conclusion as suicide? Sorry. 19 MS. : So, the autopsy didn't show 20 really any signs of a struggle. And every 21 single strangulation case I've had, even people 22 who were really impaired by intoxicants, they 23 struggled. So, he didn't have any marks on his 24 hands. He had one abrasion on his arm, which 25 probably was from convulsing when being EFTA00113069  17 1 hanging. But nothing that suggested a 2 struggle. No broken fingernails. No other 3 bruising anywhere. 4 He was pretty much pristine, other than 5 the neck and face findings. He also internally 6 didn't have strap muscle hemorrhages of the 7 neck. That's bleeding in the lung muscles, in 8 the front of your neck. Nor did he have 9 hemorrhaging in the muscles of the back of his 10 neck. That you see when it's been an 11 incomplete compression, not a sustained 12 compression like a hanging. So, when I don't 13 see those, I'm more likely to think hanging 14 than manual strangulation, or even ligature 15 strangulation. 16 And then, lastly, he did have fractures of 17 his thyroid cartilage and one side of his hyoid 18 bone. These are structures inside your neck. 19 Then the pattern of these fractures was 20 consistent with a hanging. You see a very 21 different pattern of fracturing if there has 22 been a manual compression of the neck versus a 23 sustained pressure of a hanging. And the 24 pattern of his fractures was that of a hanging. 25 So, even without an investigation, and EFTA00113070  18 1 although I wanted one, just because of the 2 nature of the case, even without an 3 investigation, this case, autopsy wise, looked 4 like a very clear-cut hanging. 5 MR. : Okay. I'm going to break 6 that down just a little bit. The hyoid -- 7 MS. : Sure. 8 MR. : -- the hyoid bone. What is 9 that? 10 MS. : So - there's a little worm in 11 my office, sorry - it's a U-shaped bone that 12 sits between your tongue and your larynx. Sort 13 of horseshoed like this, shaped like this, 14 right here. And its function is to aid in 15 swallowing and phonation, speaking. 16 Because it's almost like a little 17 wishbone, when somebody squeezes your neck, it 18 snaps. And if somebody squeezes your neck in a 19 homicidal fashion with un-sustained pressure, 20 it'll snap near the joints where it was 21 centrally. If your hyoid bone is pressed 22 against your spine by hanging, it fractures at 23 the tips. Maybe one. Maybe both. His is 24 fractured on the tip, on the left. So, that's 25 why I think his hyoid bone is fractured from EFTA00113071  19 1 hanging and not manual strangulation. 2 MR. : Okay. And what about the 3 thyroid -? What is the thyroid? 4 MS. : So, the thyroid cartilage, I 5 think that's what you mean -- 6 MR. : Yes. 7 MS. : -- is what we refer to as, 8 like, the larynx, or the voice box. And it's 9 sort of a -. It's almost shaped like a 10 butterfly inside of your throat. And it has 11 two horns at the top, which be almost like the 12 tops of butterfly wings. And those sit next to 13 the end points of the hyoid bone. 14 MR. : Okay. 15 MS. : So, that structure also gets 16 pressed against the spine when you hang, and 17 the tips break, and that's exactly where his 18 thyroid cartilage is fractured, on both of the 19 tips. 20 MR. : Okay. 21 MS. : And if it's fractured during a 22 manual strangulation, whether it's a bar type 23 or a pincher type, it usually fractures, again, 24 centrally or unevenly, not in this even 25 fashion. EFTA00113072  20 1 MR. : And because there was 2 consistent - you're saying - because there was 3 consistent pressure -- 4 MS. : Yes. 5 MR. : -- pressure on the neck, it's 6 a different type of damage that happens to the 7 hyoid bone, and also the thyroid cartilage 8 itself, and that's what you saw in Epstein - 9 Jeffrey Epstein -- 10 MS. : Yes. 11 MR. : -- and that's why you came to 12 the determination of suicide? 13 MS. : Yes. All of these things 14 combined, lack of other trauma, beautiful 15 ligature furrow that actually peaked. You 16 know, if it's a ligature strangulation, they 17 usually don't peak upward. They're either 18 straight across, or they peak downward. His 19 peak is upward slightly. He's got the 20 plethora, the petechiae, the patterns of 21 fracturing, and no other trauma. So, all of 22 that together made this autopsy very, very 23 consistent with a suicidal hanging. 24 MR. : When you say peak, you mean 25 the back of the actual ligature itself, on the EFTA00113073  21 1 back of the neck, going up? 2 MS. : Yeah. I can -. Let me see. 3 I'm going to use my phone cord to show you. 4 When you hang yourself, it hangs, and it 5 actually will sometimes make like a peak at the 6 back, right? And sometimes it isn't fully 7 circumferential. That's really classic for 8 hanging. So, Mr. Epstein had a peak, it was 9 sort of to the right and behind the ear, and it 10 was not fully circumferential. Totally 11 consistent with a hanging. 12 MR. : And if it was circumstantial, 13 that means someone strangled him? 14 MS. : It can, or it can mean that if 15 he has - if you are really good, if what they 16 showed me was his ligature, he didn't tie a 17 good slip knot, i.e., he didn't tie a good 18 hangman's knot. If you tie a good hangman's 19 knot, it will sometimes be circumferential just 20 because it tightens with your weight. If you 21 don't, if you have a fixed knot, you slump into 22 the ligature, and it doesn't -. It isn't 23 circumferential. So, it depends on the 24 ligature. I have a feeling he wasn't well 25 versed in the tying of hangman's knots or good EFTA00113074  22 1 slip knots, and that's why his isn't 2 circumferential. 3 MR. : So, what type of knot did you 4 see on the noose? 5 MS. : So, they showed me a noose 6 with what looked like a fixed sort of granny 7 knot. And I'm not convinced that's even a 8 noose because they told me they thought this 9 was the ligature, but there was a lot of 10 confusion about what the ligature - which thing 11 was actually the ligature. And there was a lot 12 of stuff in that room. But the thing that they 13 said, this is the ligature, it had a fixed 14 knot. Not a slip knot. 15 MR. : Okay. I kind of jumped, but 16 I'll come back to the noose part. That's later 17 on in the interview. You said there was no 18 defensive wounds. So, if someone was to - if 19 there was possibly an attack - me just putting 20 it out there - if it was an attack, there would 21 have been defensive wounds. Where else? Where 22 would you have seen the defensive wounds? 23 MS. : So, what I tend to see in 24 victims of strangulation is they have lots of 25 debris under their fingernails from fighting, EFTA00113075  23 1 and from trying to pull the strangling person 2 off their own neck. So, you'll see a bunch of 3 linear abrasions usually on the neck itself, 4 and chin, and you'll see a lot of debris under 5 the nails. He didn't have either of those 6 things. Those are usually women. 7 Being that he's a man, I would have also 8 expected more of sort of the pugilistic type of 9 injuries, because I can't imagine somebody 10 strangling a man easily without him trying to 11 punch them out. So, I would think there would 12 be some, you know, punch-type things, too, or 13 sort of contusions on the knuckles and stuff. 14 But he didn't have any of that. None of that 15 stuff. 16 MR. : Is it possible, I mean, in 17 cases of suicide, like, once someone tries to 18 hang themselves, do they just sit there? I 19 mean, is it possible that they -? Normally 20 with a person trying, you know, last second, 21 change their mind, and try to dig in, and try 22 to stop themselves from dying? 23 MS. : Well, that really rarely 24 happens. I've yet to see that happen. I've 25 seen hangings where people simply tie a EFTA00113076  24 1 ligature and slump forward in a chair. It 2 happens pretty quickly. You lose consciousness 3 in, like, less than a minute. And then, at 4 that point, there's really no intentional 5 activity, and you start to seize pretty 6 quickly. 7 So, there is a very small sort of envelope S of time, and most people are able to not fight 9 that. I mean, I rarely -. I actually can't 10 think of any case where I've seen the clawing 11 things in a hanging, even a non-complete 12 suspension hanging, which I suspect this is. 13 MR. : No problem. SAC , any 14 questions on that? 15 MR. : Yes, doctor. So, the broken 16 hyoid bone and the fractured thyroid. Was 17 there any indication that these bones were 18 damaged -- 19 MS. : Mm-hmm. 20 MR. : -- before the possible - well, 21 I guess the break, right? - but could you be 22 able to tell if there was some kind of damage 23 to those bones before you actually conducted 24 your atop? 25 MS. : So, I had an anthropologist EFTA00113077  25 1 look at those to determine exactly that, if 2 they were fractured superimposed on old trauma, 3 or if they were just recent fractures. And 4 their opinion was that they were recent 5 fractures. It was no superimposed trauma. 6 MR. : So, I'm guessing you were 7 familiar with the July 23rd incident where Mr. 8 Epstein tried to take his life initially? 9 MS. : Yes. I was. 10 MR. : And there was a noose found 11 around his neck. We were just trying to get an 12 idea if it's possible that he sustained 13 injuries during that attempt, that could have 14 also assisted, or made things, you know, the 15 broken hyoid and the thyroid cartilage could 16 have also been because of the fact of the 17 initial attempt? Could it have been broken 18 because of the damage already caused by the 19 July 23rd incident? 20 MS. : I think probably not, just 21 based on how they appeared. They don't 22 describe any - the anthropologist - doesn't 23 describe any healing. So, there would have 24 been, if three is a refracture from a prior 25 fracture, there probably would have been some EFTA00113078  26 1 healing visible, and they didn't see that. 2 Also, if he had sustained that kind of 3 trauma the first time, he would have had 4 symptoms. He would have, you know, had 5 difficulty talking and swallowing, and they 6 probably would have noted that clinically. So, 7 that might be a question you direct the people 8 who took care of him after the first attempt. 9 MR. : Okay. 10 MR. : And just a follow up, doctor. 11 You said that people lose consciousness within 12 a minute. Is that pretty standard, you know, 13 when they attempt to hang themselves? Is that, 14 in your practice, a pretty standard time frame? 15 MS. : So, where I'm getting that 16 information from isn't so much my practice as 17 there is a woman in Canada who researched this 18 extensively, and actually had a collection of 19 films of people hanging themselves. 20 They were judicial hangings. They were 21 in-custody hangings where there were actual 22 cameras on prisoners who had managed to hang 23 themselves. And there were people who actually 24 filmed their own hangings. 25 And on those films, there is a really EFTA00113079  27 1 consistent pattern of they hang, in about a 2 minute or less, they become limp, and then they 3 start to seize violently. And it's almost a 4 hundred percent reproducible. So, it's based 5 on sort of evidence that other people have 6 gathered as opposed to anything I've done or 7 researched on my own. 8 MR. : Sure. Okay. No. Thank you. 9 MR. : Is there anything else you 10 observed during the autopsy examination that 11 you thought might seem suspicious or out of 12 place? Like bruising, cuts, things like that? 13 MS. : Nothing at all. 14 MR. : I'm going to show you -. I'm 15 going to share a picture with you. This is 16 part of your -. Bear with me. Can you see 17 this? 18 MS. : Yes. 19 MR. : Do you see the cut above the 20 lip? 21 MS. : Yeah. 22 MR. : On him. 23 MS. : Yeah. I do. 24 MR. : Do you know where -? Do you 25 know what the cause of that? Is that something EFTA00113080  28 1 from the resuscitation, or was that -? 2 MS. : So, there were other photos 3 that will also show cuts on the other side of 4 the lip, inside, and I think that these are 5 from resuscitative efforts. They're pretty 6 commonly seen when there is a mixture of 7 different types of resuscitation, particularly 8 if they've used a mask, or if it's somebody who 9 is - if there was any bystander resuscitation, 10 as well. So, these, to me, appeared 11 resuscitative. 12 Also, there is no, like, real bruising 13 under these. If I had thought these were from 14 some kind of impact to his face, there would be 15 bruising, and if you look at the rest of the 16 autopsy, I have the inside of his mouth 17 photographed really well, and all you see are 18 the petechiae. There is no big bruising. So, 19 these aren't impacts. These are consistent 20 with him probably being already dead when they 21 were trying to resuscitate him. 22 MR. : Okay. And this is, this 23 picture is labeled, "Photos, I.D., Visual 001". 24 This is the picture that was taken by your 25 office. Right? EFTA00113081  29 1 MS. : Yes. It's taken by the 2 mortuary technicians for the purpose of showing 3 it to a family so they can identify the 4 deceased formally for us. 5 MR. : Okay. (Indiscernible 6 *00:25:21). 7 MS. : In the next picture, you can 8 see the petechiae really well on his face, 9 actually. 10 MR. : Yeah. Doctor, that was going 11 to be my question. Is this a good depiction of 12 the petechiae, was you described earlier to us? 13 The blonchyness (Phonetic Sp. *00:25:29) red in 14 his face. Is that what you typically see? The 15 petechiae. 16 MS. : Yeah. 17 MR. : Okay. 18 MS. : Yeah. You can see it's 19 blotchy, and almost sort of -. It looks almost 20 like a measles rash, but it's small pinpoint 21 hemorrhages. Yeah. 22 MR. : Okay. 23 MR. : And you mentioned that's from 24 sustained pressure on the neck. 25 MS. : Yes. EFTA00113082  30 1 MR. : All right. I'm going to show 2 you a couple other pictures from the same -. 3 Tell me if you recognize this picture. It was 4 also labeled, "INV scene 004." It was provided 5 by your office. Do you recognize this? 6 MS. : I do. 7 MR. : Okay. So, just to give an 8 explanation. Did you have a chance to go by 9 the cell, see the cell itself? 10 MS. : No. They wouldn't let me go 11 in and see the cell itself. I had to rely on 12 photographs. 13 MR. : Yeah. So, it's a little 14 tough. So, just to give an explanation. Where 15 the picture, the person's point of view, 16 whoever is standing there, that's where the 17 door is, the cell door is. Now, if you look 18 in, there is a little window on the door. So, 19 when we got a chance to interview the 20 correctional officer who found Mr. Epstein, he 21 was basically doing feeding, just to give you 22 an understanding, he was coming there early 23 morning, he was doing the feeding time, and he 24 knocked on the cell, and you see the mattress 25 on the floor? EFTA00113083  31 1 MS. : Yes. 2 MR. : Mr. Epstein's legs were 3 sticking out. So, he was actually - and not, 4 like, to (Indiscernible *00:26:53) - I mean, 5 the mattress sticking out. Mr. Epstein was to 6 the right itself. So, he couldn't see anything 7 to the right. He called out to Mr. Epstein. 8 He didn't answer. So, he walked in. 9 And when he walked in, he couldn't explain 10 it for us, a mess like this, he explained there 11 was a lot of linens, a lot of different stuff, 12 but the mattress was there. And when he found 13 Mr. Epstein - and I'm going to show you another 14 picture - Mr. Epstein was to the right, the 15 part that we can't see in the initial picture. 16 MS. : Yup. 17 MR. : And he was hanging from the 18 corner over here. So, you see then, he 19 mentioned that's part of the noose. And he was 20 hanging low with his bottom, with his buttocks 21 off the ground. So, his feet was out, and his 22 buttocks was off the ground. So -- 23 MS. : Okay. 24 MR. : -- that's how he found him. 25 So, basically, he didn't use a cutter. He EFTA00113084  32 1 actually pulled. So, I think he used all his 2 might, he panicked, so the C.O. kind of pulled 3 the noose, and the noose broke, and Mr. Epstein 4 fell to the ground, and then he wrapped his 5 arms around Mr. Epstein and dragged him out to 6 the outer area. I don't know if I have a 7 picture. Let me go back. He dragged him out 8 here. Can you see where my mouse is? 9 MS. : Yup. 10 MR. : He dragged him out here so he 11 could perform CPR on it, or on Mr. Epstein. 12 MS. : Can I ask you a question 13 quickly? 14 MR. : Yeah. 15 MS. : So, I see that piece of stuff 16 hanging in the corner there. That is not what 17 they brought to me and called the ligature. 18 When this correction officer pulled Jeffrey 19 Epstein out to start CPR, did something remain 20 around his neck? 21 MR. : So, he doesn't recall. He 22 thinks he took it -- 23 MS. : Ah. 24 MR. : -- took it off. He was not a 25 hundred percent sure. Everything happened in EFTA00113085  33 1 the moment in time. One of the questions we 2 were going to ask you is, who provided you with 3 that noose? 4 MS. : I believe -. So, I think that 5 it was given to the investigators by the EMS 6 crew who took over the -. Yeah, that's the 7 picture of how it came to us. It was in the 8 bag. And this is what they brought me. 9 MR. : So, this is labeled, "Path 10 evidence 006." And the picture prior to this 11 was, "INV scene 009." So, this is what they 12 provided to you. And you said this didn't seem 13 -. This was like a -. You didn't think this 14 was the piece that cost - that was the noose 15 around his neck? 16 MS. : Well, I'm asking because in 17 the photo you showed me a piece of stuff 18 hanging, and you tell me that the correction 19 officer pulled and ripped. This thing that 20 they gave me isn't ripped at all like it would 21 be ripped off of something. It's ripped to 22 create the strip, but it's not ripped off. So 23 -- 24 MR. : Okay. 25 MS. : -- I'm -. EFTA00113086  34 1 MR. : That's the same question we 2 had. 3 MS. : It's making me wonder if this 4 is even the ligature that they gave me. 5 MR. : All right. So, I'm going to 6 show you another picture. This is in the same 7 set of pictures that you had to -. Sorry. 8 (Indiscernible *00:29:50). 9 MS. : Oh, no, don't do that. 10 MR. : This is labeled "INV scene 11 055." Right? And this is when you -. Let me 12 show you the initial picture again. You 13 notice, there's the entrance when we walk in. 14 This is the little table, stool area right 15 there. 16 MS. : Yes. 17 MR. : This is INV picture 005. 18 There is a toilet here. There is a stool 19 there. Now, we're going to go back to the 20 other picture. You'll notice this to the left 21 of the stool. You see that? 22 MS. : Yes. 23 MR. : You see that little noose 24 laying there? 25 MS. : Yeah. EFTA00113087  35 1 MR. : Now I'm going to give you a 2 close up over here. This is INV scene 015. 3 This seems like there was another noose that 4 was laying at the scene. I don't know if you 5 can see that a little bit better. 6 MS. : Yeah. 7 MR. : And this seems to have a 8 tear. 9 MS. : It does. 10 MR. : And if you compare it to the 11 other picture that we saw, if he pulled, if 12 this was around Mr. Epstein's neck, to me, it 13 seems like there should have been more - 14 Like, it should have been tight, tightened up a 15 lot more. Like, he should have been more 16 wrinkled up because it was wrapped around his 17 neck. Right? As a noose. But it doesn't seem 18 like there was much. It looks like -. Can you 19 explain the difference? By looking at it, what 20 do you think? 21 MS. : Well, what it looks like to me 22 is that it's too tidy. And if you tell me that 23 somebody tore him off of the corner -. Like, 24 when you look at that thing that they showed 25 me, it was never clear to me how that suspended EFTA00113088  36 1 him from anything. All right? I could see him 2 putting the looped part around his neck, but I 3 can't see how this suspended him from anything. 4 There is no knot hanging anywhere or anything 5 like this. 6 And then, that other thing you showed me 7 that's by the desk apparatus, that is torn, it 8 makes more sense to me because that's got the 9 tearing that the correction officer remembers. 10 Either one of these, in terms of its shape, 11 could have caused the markings on Mr. Epstein, 12 but this one, this second one that you're 13 showing me that was never brought to me, looks 14 like a more likely candidate. 15 MR. : Okay. Do you recall -? Do 16 you know if the initial noose that was brought 17 to you, was there any DNA testing, or any kind 18 of testing done on that noose? 19 MS. : I didn't swab it or anything. 20 We're instructed not to do that just to submit 21 it. So, I am not sure what happened to it 22 after I bagged it up and gave it to evidence. 23 MR. : When you say submit it, what 24 does that mean? 25 MS. : It means that I bag it up EFTA00113089  37 1 again, and submit it as evidence, and then 2 whoever is investigating, the cops, you guys, 3 whoever it is, they decide whether or not to do 4 DNA testing. I don't actually order that. 5 MR. : Okay. 6 MS. : Because it's irrelevant to me, 7 really. 8 MR. : SAC , do you have any 9 questions on the pictures before -? 10 MR. : Yes. I do. Just a follow up. 11 And I think you said this earlier. You said 12 this cloth material could have caused those 13 marks. So, regardless of what noose was used 14 here, we have several in the pictures, but what 15 you're saying is that, this type of material 16 could have caused the marks consistent of what 17 you noticed in your autopsy? 18 MS. : Correct. 19 MR. : Okay. 20 MR. : And your office doesn't have 21 the second noose, you said. Right? 22 MS. : I don't think I ever received 23 this piece of stuff that you're showing me. 24 No. 25 MR. : Okay. And this knot. I EFTA00113090  38 1 know, since you mentioned hangman's noose, and 2 different nooses, do you -- 3 MS. : Mm-hmm. 4 MR. : -- can you tell what kind of 5 knot this is? 6 MS. : Those look like fixed knots, 7 as well. They actually look like granny knots 8 to me. They don't look like knots that will 9 slide and tighten, which is one of the reasons 10 why I said that this could have just as easily 11 caused the markings. 12 MR. : Okay. And based on the knot, 13 this was - as SAC asked - this could have 14 been the one that - this or the other one - 15 could be the one that caused Mr. Epstein's 16 death/ 17 MS. : Yes. 18 MR. : Okay. And this is, what kind 19 of knot is this one? 20 MS. : That looks like another kind 21 of -. It's either a granny knot, or it's an 22 overhand knot, but it's a fixed knot. It's not 23 a sliding knot, like a slip knot or a hangman's 24 knot, which is really just a series of slip 25 knots. EFTA00113091  39 1 MR. : So, this is in reference to 2 packed evidence, picture 006, and the other one 3 was the initial reference about the knot was 4 for INV scene 015. Okay. Anything else, SAC 5 ? 6 MR. : Nothing further. Thank you. 7 MR. : All right. So, a witness, 8 basically an inmate, told the guard man that he 9 saw the C.O. who entered Epstein's cell fall to 10 the ground with Epstein when he attempted to 11 move him, or when he pulled him, whatever, he 12 couldn't describe -. He didn't give us an 13 exact explanation. But he said that he 14 actually saw the C.O. and Epstein fall to the 15 ground. In your examination, did you see any 16 bruising or anything consistent with any falls 17 that Mr. Epstein might have taken? 18 MS. : Nope. 19 MR. : Okay. 20 MS. : But if he landed on top of the 21 guy, I wouldn't have seen much. 22 MR. : Okay. And if he didn't, if 23 he landed on the floor, would there have been 24 bruising being the fact that he was already - 25 if he was already dead at this point. Would EFTA00113092  40 1 there have been bruising on his body? 2 MS. : There might not have been 3 bruising, but what I might have seen might have 4 been sort of dried, not hemorrhagic abrasions. 5 Particularly if the guy pulling him was a big 6 guy and landed on top of him. That could -. 7 Even a dead body, if you scrape it across a 8 concrete floor like that, you're going to get 9 some scraping on the skin. I wouldn't see 10 bruising, but I would see scraping most likely. 11 MR. : And he mentioned that he 12 didn't use a cutter. Normal practices, if you 13 see somebody hanging, they use a cutter to cut 14 the rope. 15 MS. : Mm-hmm. 16 MR. : He didn't use a cutter. He 17 just yanked on it. Is it possible why him 18 yanking on the rope, trying to yank the rope 19 off, he could have caused - the C.O. - could 20 have caused any of the damage on Mr. Epstein's 21 neck? 22 MS. : He certainly could have 23 augmented it. I see it in hangings without 24 that, but if he was pulling Epstein against the 25 ligature, and it snapped, that could have EFTA00113093  41 1 augmented any damage that was already there, or 2 even created some of it. Particularly, if he 3 did a short, sharp pull. It could have. 4 MR. : Okay. And as far as you 5 recall, there was no bruising, cuts, or 6 anything else that stood out on his body, that 7 could have possibly been, like, defensive or 8 suspicious to you? 9 MS. : Not at all. 10 MR. : Okay. Sorry. I asked a lot 11 of questions, and I'm just making sure I'm not 12 (Indiscernible *00:36:30). SAC , you can 13 ask anything else. 14 MR. : Yeah. Lyeson, I don't know if 15 you want to move on to toxicology. 16 MR. : Yes. 17 MR. : I know there was a toxicology 18 test done, and, you know, you know, I guess the 19 question is, was there anything found in his 20 system? 21 MS. : Let me double check that. 22 Hang on. I have the case in front of me. As I 23 recall, absolutely nothing, but let me be sure, 24 sure, sure. Since I'm under oath and all. 25 Here we go. Yup. Nothing detected. EFTA00113094  42 1 MR. : And that's, and obviously, 2 contraband substances, but also anything 3 prescribed to him. Any medications that he 4 would have been on? But there was nothing in 5 his system at all? 6 MS. : Nothing in his system at all. 7 Now, our testing doesn't cover every single 8 prescription medication -- 9 MR. : All right. 10 MS. : -- out there. Those are often 11 targeted testing that I need to request. I saw 12 what was in the cell. There were vitamins. 13 There was Tylenol that was not opened. Those 14 things, the Tylenol will show up on our regular 15 testing. As well as, like, the other stuff he 16 was taking. I think he was taking, like, a 17 steroid, as well. None of that showed up. 18 MR. : And in those substances, is it 19 safe to say that it would not have contributed 20 to his death? 21 MS. : Correct. 22 MR. : Yeah. 23 MR. : I just have a few more 24 questions. And before I go. All right. Do 25 you recall that Mark Epstein -? Did you ever EFTA00113095  43 1 deal with a Mark Epstein? Jeffrey Epstein's 2 brother. 3 MS. : I did. 4 MR. : Okay. Do you recall that he 5 hired his own medical examiner to be also 6 present for the autopsy? 7 MS. : Oh, yeah. Yup. 8 MR. : Do you remember the name of 9 that medical examiner? 10 MS. : Yeah. So, that was Dr. 11 Michael Bodin (Phonetic Sp. *00:38:39). 12 MR. : Okay. And they mentioned, 13 they told the OIG that, when they spoke with 14 you, that you needed information from the 15 correctional officer who found Jeffrey Epstein, 16 before you could make the determination on 17 cause of death, and instead of waiting on that 18 information, you actually moved forward and 19 made a determination anyway as suicide. 20 MS. : So, what I did was, we 21 attempted to get the information from the 22 correctional officer, and I also, I wanted to 23 go and see the cell. They wouldn't allow that. 24 I wanted to see some film footage. I was 25 allowed to do that. EFTA00113096  44 1 So, there were a couple of different 2 things I wanted to do before I could ascertain 3 whether