EFTA00130099

Medico-Legal Investigations

@ocme.nyc.gov

421 E 26th Street,
New York, New York 10016


www:nyc.gov/ocme


Barbara A. Sampson, M.D.-Ph.D.
Chief Medical Examiner

# Investigation Report

| Name of Decedent: | Epstein, Jeffery |

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Case No: M-19-019432



Report Date & Time: August 11, 2019 00:31



Disposition: ME Case



| Place of Death: | 170 William Street, New York, NY, 10038 |

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Date & Time of Death: August 10, 2019 07:36

## Case Synopsis

The decedent is a 66-year-old White male prison inmate who was found hung by the neck within his cell and was later pronounced dead at the hospital ED despite resuscitative efforts. The NOK does not object to an autopsy. PMH information is pending on receipt of the correction facility medical health services records.

## Subjective Findings

As per Dr. of the ED at New York Presbyterian Lower Manhattan Hospital on 08/10/2019 EMS found the decedent to be in cardiac arrest and with ligature markings of the neck following an unknown “down” time at the Metropolitan Correction Center (MCC). The decedent was intubated and was given epinephrine x 4 and bicarbonate x2 along with CPR. ACLS was continued at the ED. The decedent was given an additional epinephrine x 1 and bicarbonate x 1. However, the decedent was in asystole by cardiac monitor and in cardiac standstill by ultrasound. He was pronounced dead at 07:36 hours. Ligature markings of the neck were observed by Dr. in the ED as well as by EMS. However, no ligature material was observed by either EMS or by Dr. in the ED. No bloods were drawn and no fentanyl was administered in the ED or by EMS.

Dr. was instructed to submit to OCME a completed ME Clinical Summary Worksheet the EMS ACR, and the ED Notes. These were received except the ACR. An email was sent to Evidence Request with cc's to Evidence Pickups and OCME Tour Commanders requesting that the ACR be obtained.

The undersigned was accompanied by Deputy Director of Forensic Investigations and Operations, for a MLI scene investigation. FBI Special Agents

were also present at the scene conducting their investigation.

(unknown contact info.),

As per Lieutenant of Corrections at MCC the decedent was detained at MCC since 07/06/2019 on charges of sex trafficking conspiracy and sex trafficking of minors as inmate # 76318054. He was placed in a cell on 07/07/2019, but was moved for psycholoag evaluation

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07/08/2019 – 07/10/2019. His psychologist was (unknown contact). He was then moved to the Special Housing Unit (SHU) from 07/10/2019 – 07/23/2019. However, on 07/23/2019 the decedent attempted suicide by

hanging. In the early morning hours this date the decedent's cellmate, inmate Tartaglione, was awakened by a sound and saw the decedent. He started banging on the cell door to alert the corrections officers responded at 01:27 hours and observed the decedent to be either seated or laying in a fetal position on the cell floor (unclear history) with a "loose homemade noose" around his neck made from a torn orange bedsheet. At this time the decedent was found to have erythema around two-thirds of the circumference of his neck, two inches wide, with sparing of the back of the neck. There were also some "friction marks". The decedent was transferred to Suicide Watch from 07/23/2019 – 07/29/2019. He was transferred to the SHU again on 07/29/2019 where he remained until the DOD. He was in cell # 206 originally this last time in SHU, but was switched to cell # 220 at an unknown date and time. The decedent had a cellmate, inmate Reyes. However, on the morning of 08/09/2019 inmate Reyes went to court and was released through the court. No cell mate was present at the time of the incident leading to the decedent's death.

Information was taken from and Captain regarding this incident. Regular rounds of the inmate cells are conducted by the corrections officers every 30 minutes, but no longer than at 40-minute intervals. It is unknown when the decedent was last seen alive pending interview of MCC personnel. On the morning of 08/10/2019 at 06:33 hours during these regular rounds Officer Michael Thomas found the decedent hung by the neck within his cell # 220. However, the location within the cell and the position of the decedent are unknown pending interview of MCC personnel. Office removed" the decedent from an unknown fixed object and placed him on the cell floor. The officer started CPR. In the meantime Operations Lt. and RN entered the cell. took over performing CPR and the decedent was taken to the Medical Health Services area. EMS arrived and took over care for the decedent there.

## Scene Investigations/ Details

The scene was within the decedent's cell, # 220 on Tier L of the SHU within the MCC. Of the scene photos INV-Scene 003 depicts the sealed cell door to # 220. Photo 004 depicts a straight-ahead view from the now opened cell door. Photo 005 represents the left side of the room. Beyond the right-sided wall of Photo 004 the right side of the room can be viewed in Photo 009. There is bedding material strewn in the middle of the floor including a mattress, presumably from the top bunk, and orange blanket and sheets. There was a CPAP machine on the floor with an electric cord reportedly provided by the MCC staff at bedtime ~ 22:00 hours and plugged into an outlet to the right outside of the cell door. Adjacent to the toilet and sink is a small table and stool on the right side of the cell. There was a handwritten note. It was not a suicide note, but it's content vented frustration about conditions and experiences at the facility. There was a bunk bed. The mattress was removed and personal items were kept on the top bunk. Amongst these were medications and supplements including Vitamin C 500 mg, Tolnaftate Cream 1%, Vascepa Omega 3, two boxes of Acetaminophen 500 mg which were both sealed closed, Multivitamins, a sealed container of Milk of Magnesia, Methylprednisolone 4 mg Dosepak also sealed, and Docusate Sodium 100 mg. The bottom bunk had rumpled up orange bedding. There were strips of orange cloth presumably from the bedding located in different spots in the room. Included amongst these was what appeared to be a makeshift clothesline tied between the bunk bed

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posts with a pair of orange underpants hung from it. Measurements of the bunk bed set are as follows: The height from the floor to the top bunk was ~ 58.5 inches. The length of the bed set was ~ 79.5 inches. The width across each bed (Photo 052 depicts the bottom bunk mattress) was ~ 25 inches. Photo 049 shows the heights of the rungs of the ladder to the top bunk.

RN of the Medical Health Services arrived to the scene and presented the AED with defibrillator pads used on the decedent along with the “ligature”, which appears to be a stripped piece of an orange bed sheet.

As per RN the AED revealed no shockable rhythm on the decedent. The ligature was collected by the undersigned and entered into the evidence locker cage at 421 E. 26th Street in Manhattan.

As per he was made aware by MCC staff that when the decedent's cellmate Reyes left it is believed that some of the items in the cell may have been his which were not removed.

## Examination of Body

N/A

## Additional Information

As per Nick confirmed that the decedent's NOK, his brother, Mark Epstein was notified of the decedent's death. The undersigned called the brother and discussed OCME policy and procedure with regard to a ME case. He does not object to an autopsy, however, he has requested to have present a private independent physician (pathologist) as a second opinion for the findings at the OCME autopsy. Dr. has agreed to allow this as a courtesy to the family with the following conditions: The physician must be a Forensic Pathologist. He/She must arrive to OCME at 520 First Avenue in Manhattan before or by 09:00 on 08/11/2019. He/She must sign observer disclaimer paperwork and provide a DNA sample. Mark Epstein was made aware of this and he understood. He was instructed to call OCME with his choice of the private pathologist beforehand. He was provided with the Manhattan OCME office address, telephone number, and the decedent's OCME case number. He expressed that following completion of the autopsy he intends to have the decedent's body shipped to Florida. The visual identification process was also discussed with the brother.

Note: The decedent's cell at MCC is being held pending the preliminary autopsy results. It is requested that the assigned ME discuss the preliminary autopsy findings with FBI Special Agent

Disposition: ME Case/Hospital with MLI Scene Investigation.

NOK Does Not Object to Autopsy.

NOK Plans to Retain an Independent Forensic Pathologist to Observe Autopsy.

The information provided above is true and correct to the best of my knowledge and belief. Electronically signed by on August 11, 2019 00:31.

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