People familiar with the autopsy report told the newspaper the bones broken in Epstein’s neck included the hyoid bone, which is near the Adam’s apple.
This sort of break can happen when a person hangs themselves or dies by strangulation, forensics experts told the Post.
Epstein, 66, was found dead in the special housing unit of the federal Metropolitan Correctional Center in New York on Saturday. He was in a cell by himself.
Officials have cautioned to CNN that they don’t know what the staff members were doing during that time and are still trying to pin that down.
Representatives for Epstein are not disputing preliminary findings of FBI investigators and the New York City medical examiner that Epstein died by suicide, according to a source briefed on the matter.
The medical examiner is awaiting toxicology reports before officially ruling on Epstein’s death.
Epstein’s family hired its own pathologist, Michael Baden, who was present during the autopsy, according to the source, and he is also not disputing preliminary findings from the medical examiner that Epstein killed himself.
Fractured hyoid occurs in both suicides and homicides, experts say
While a break in the hyoid bone is common in victims of homicide by strangulation, Epstein’s autopsy also showed signs of other neck fractures, the Washington Post reported.
CNN Chief Medical Correspondent Dr. Sanjay Gupta said, “With multiple neck fractures, that is less likely to be strangulation alone.”
“In strangulation, while you can break the hyoid bone, it is less likely to actually break bones in the neck,” Gupta said. “By hanging, someone can break both the hyoid bone and other bones in the neck. None of these factors in isolation give you a complete story.”
Dr. Lawrence Kobilinsky, a professor of forensic science at John Jay College of Criminal Justice, noted the hyoid bone is a weak, fragile structure, and it can break from a hanging. A fractured hyoid bone does not necessarily indicate a homicide, Kobilinsky said.
To make a determination about a death, medical examiners look at other factors in addition to the autopsy, like a person’s psychological history and video surveillance.
“A lot of pieces have to come together in order to make the final determination,” Kobilisnky said.
One staffer was not currently a regular guard; both were on overtime
The second staff member on Epstein duty, a woman, was a fully trained guard, according to the person briefed on the matter.
The FBI, one of the agencies investigating Epstein’s suicide, is looking into what the guards were doing during their shift. The two guards aren’t talking to investigators and have hired lawyers, people briefed on the matter have told CNN.
Most of the staff on duty early Saturday were on overtime, according to numbers provided by a Department of Justice official. From midnight until 8 a.m. ET, 10 of the 18 people there were working extra hours. One other person was scheduled to work but didn’t.
On the shift from 4 p.m. Friday until midnight, six of 20 people present were on overtime and one person scheduled to work was absent.
Epstein was no longer on suicide watch
It’s protocol for detainees coming off suicide watch not to be placed alone in a cell, according to the source.
The FBI and Justice Department’s inspector general are investigating the earlier incident as part of the broader probe into Epstein’s death, it was revealed Wednesday in letters between the judge overseeing the Epstein case and the former warden of the jail where he died.
In the letters dated August 12, US District Court Judge Richard Berman wrote to the warden to inquire about the July 23 incident, saying “to my knowledge, it has never been definitively explained what the BOP (Bureau of Prisons) concluded about that incident.”
The warden at the time, Lamine N’Diaye, replied that an internal investigation into the incident had been completed, and that the matter would be reinvestigated as part of the investigations into Epstein’s death. N’Diaye said he couldn’t divulge any information about the original investigation.
Prison warden has been temporarily reassigned
CNN’s Shimon Prokupecz, Erica Orden, Evan Perez, David Shortell, Mark Morales, Mary Kay Mallonee, Jacqueline Howard and Brynn Gingras contributed to this report.