Neck Fractures, Noose Evidence: Epstein Autopsy Doctor Explains Why She Hesitated to Call His Death 'Suicide'

The doctor who examined Jeffrey Epstein's body after he died in a New York prison has explained why she did not immediately rule his death a suicide.

In newly released testimony, forensic pathologist Kristin Roman said she delayed making a final decision because the case was highly sensitive and closely watched. She also pointed to fractures in Epstein's neck and said she initially did not have full information about what happened inside his prison cell.

Although officials later ruled the death a suicide, Roman said she wanted to review more details before confirming the cause.

Epstein was found dead in his cell at Manhattan Correctional Center on 10 August 2019 while awaiting trial on sex-trafficking charges involving underage girls.

The next day, Roman, a medical examiner with New York City's Office of the Chief Medical Examiner, carried out the autopsy. Michael Baden, a forensic pathologist hired by Epstein's brother, Mark Epstein, was also present during the examination.

The two doctors quickly reached different views about what the evidence suggested.

Baden later argued that Epstein's injuries pointed to homicide rather than suicide. Roman, however, decided not to make a final judgement straight away.

Instead, she left both the 'suicide' and 'homicide' boxes blank on the death certificate and marked the cause of death as 'pending studies', meaning further review was needed.

At the time, the decision was simply part of the medical process. But the delay later fuelled widespread conspiracy theories about Epstein's death, as critics questioned why the cause had not been confirmed immediately.

Why The 'Suicide' Rule Was Delayed

Roman's reasoning has now emerged in a transcript of her sworn interview with investigators from the US Justice Department inspector general's office. The interview was released this year under the Epstein Files Transparency Act.

In the transcript reported by Business Insider, Roman described her initial hesitation as a matter of professional caution.

She explained that Epstein's notoriety changed how she approached the case. Given his connections to powerful figures in politics, finance, and business, Roman recognised that speculation about foul play would be unavoidable. Because of that, she felt a stronger obligation to ensure every detail had been reviewed before reaching a conclusion.

Roman told investigators that had the deceased been less prominent, she likely would have ruled the death a hanging immediately after the autopsy.

Instead, she wanted additional context. This means access to Epstein's prison cell and the opportunity to speak with the correctional officer who discovered his body. Such information, she said, helps forensic examiners understand whether injuries align with how a body was found.

Those requests were never granted. Roman said she was not allowed to enter the cell or interview the staff directly. Investigators instead showed her photographs of the scene.

Despite those limitations, Roman eventually concluded that Epstein had hanged himself.

Neck Fractures and Competing Interpretations

One reason the case attracted so much attention was the discovery of several fractures in Epstein's neck.

Baden has repeatedly argued that these injuries—including breaks in the hyoid bone and thyroid cartilage—are more consistent with strangulation than with suicide by hanging. Drawing on his decades of experience examining prison deaths, Baden said seeing this combination of fractures in a suicide case is extremely rare.

Roman, however, interpreted the same evidence differently.

In her testimony, she said the location of the fractures actually supported the conclusion that Epstein died by hanging. According to Roman, the hyoid bone was broken near the tip, an area that would press against the spine if someone were suspended by the neck.

She explained that if someone had been strangled by another person, the bone would likely break closer to the joints, where pressure is typically applied during manual strangulation.

Roman also pointed to fractures in the thyroid cartilage. She said the pattern of damage matched what doctors usually see in hangings. In cases of manual strangulation, she explained, the cartilage tends to break in a more uneven way.

Based on these findings, Roman told investigators that the medical evidence was 'pretty clear cut'.

Missing Noose Evidence Added Another Layer Of Doubt

However, another detail made the investigation more complicated: the noose itself.

Roman said Epstein's body arrived at the medical examiner's office with a noose made from a torn bedsheet that prison officers said they had found in his cell.

But Baden later said he did not see that noose during the autopsy. Instead, he only saw photographs showing several makeshift nooses on the floor of Epstein's cell.

When investigators later showed Roman photos of two possible nooses, she said she had not seen them before. She told investigators that both of the bedsheet ligatures could have caused the marks seen on Epstein's neck. However, she said one of them appeared more likely to match the injuries.

Even so, Roman admitted she could not be completely certain which noose had been used.

For critics of the official ruling, that uncertainty remains troubling.

Mark Epstein, the financier's brother, continues to believe his brother did not take his own life. After reading Roman's interview transcript, he rejected the explanation from investigators, arguing that officials were either wrong, incompetent, or not telling the truth.

Seven years after Epstein's death, the case still divides opinion, especially as more files are being released.

Originally published on IBTimes UK