The autopsy conducted on the body of pedophile and rapist Jeffrey Epstein revealed he had multiple breaks in his neck. Epstein's hyoid bone, which is near the Adam's apple in men, was broken along with other bones. That injury is more common in strangulation homicides than in hanging, forensic experts told The Washington Post, but can occur in hanging suicides as well, particularly in older people.
Jonathan L. Arden, president of the National Association of Medical Examiners, told the Post that in general a broken hyoid in a death requires a more extensive investigation by pathologists. "If, hypothetically, the hyoid bone is broken, that would generally raise questions about strangulation, but it is not definitive and does not exclude suicidal hanging," he said.
Epstein died early Saturday when guards at the Metropolitan Correctional Center in Manhattan found him hanging and could not revive him. The autopsy was completed on Sunday, and New York City’s chief medical examiner, Barbara Sampson, has listed the cause of his death as pending. She emphasized that a single factor in an autopsy isn't conclusive. "In all forensic investigations, all information must be synthesized to determine the cause and manner of death. Everything must be consistent; no single finding can be evaluated in a vacuum," she said in a statement. Her office is "seeking additional information on Epstein’s condition in the hours before his death" according to the Post's sources. That includes any video from his cell and the hallways near it, a toxicology report, and interviews with the guards.