New questions about the cause of death of Jeffrey Epstein, who was found dead in his cell in August 2019 while awaiting trial on charges of child sex trafficking, are being raised by pathologist Michael Baden, who attended the autopsy as an observer on behalf of the financier's family. Dr. Michael Baden says he is "still not convinced" by the New York Medical Examiner's Office's conclusion that Epstein committed suicide by hanging. As he emphasized in an interview with The Telegraph, "in my opinion, his death was most likely caused by strangulation, asphyxiation, and not by hanging."

He added that “based on all the information now available, further investigation into the cause and manner of death is warranted.” Dr. Baden did not perform the August 11, 2019, autopsy himself, but was present as an observer. According to him, at that time both he and the medical examiner agreed that more data were needed to definitively determine the cause of death. In a declassified version of the autopsy report, released in December as part of the first release of the so-called “Epstein files” by the U.S. Department of Justice, the “manner of death” is listed as “pending,” while the “suicide” and “homicide” fields are blank.

According to Baden, five days after the death certificate was released with the note “pending further investigation,” the then-New York City medical examiner, Dr. Barbara Sampson, ruled the death a result of hanging and classified the manner as “suicide.” He claims that Dr. Sampson was not present at the autopsy, and she has publicly denied his claims, stating that she supports her conclusion. Epstein’s lawyers said at the time that Baden’s reservations matched theirs and that they were “not satisfied” with the forensic findings. The pathologist himself says he has seen no evidence that further investigation was conducted before the final decision.

The official report mentions three fractures in the neck, one in the left hyoid bone and two in the thyroid cartilage, right and left. According to Baden, in 50 years of experience reviewing the deaths of prisoners, he has not encountered a single case of suicide by hanging with three fractures in the neck. “Even one fracture requires investigation for the possibility of homicide. Two certainly require a full investigation,” he emphasizes. On the other hand, Dr. Sampson has argued that fractures of the hyoid bone and cartilage can be observed in both suicide and homicide cases.

DOJ surveillance footage shows an orange figure walking up the stairs to Jeffrey Epstein's cell—the last movement seen before his body was found the next morning.

The figure is believed to be someone wearing an orange inmate jumpsuit.

Their identity and exact answers remain... pic.twitter.com/fwTRKpxlAE

— Shadow of Ezra (@ShadowofEzra) July 30, 2025

Further questions have been raised after government documents and security camera footage were released. A video from the night of his death showed a “missing minute,” prompting speculation that a third person had entered the cell. Another image shows an orange “spark” on the stairs leading to the solitary confinement cell, with authorities saying it was “probably” a prisoner.

Meanwhile, guards allegedly failed to check on Epstein for hours, despite being required to do so every half hour, while two cameras near the cell either did not work or did not record footage. Dr. Baden also expressed doubts about the rope found at the scene, made from an orange sheet, saying it “did not match the marks on the neck.” He also claims that the removal of the body and its transport to the prison infirmary were “highly unusual” actions, which may have led to the loss of critical evidence, and also mentions the loss of an accurate determination of the time of death.