Kristin Roman: The Medical Examiner Who Performed Jeffrey Epstein’s Autopsy

PostedSeptember 29, 2026

UpdatedSeptember 29, 2026

ByEpsteinWiki

Snapshot

Dr. Kristin Roman was the New York City medical examiner who performed Jeffrey Epstein’s autopsy on August 11, 2019. The autopsy report identifies the cause of death as hanging and the manner of death as suicide. Roman initially left the determination pending while seeking more information about the scene. In a sworn May 2022 interview with the U.S. Department of Justice Office of the Inspector General, she explained the physical findings behind her conclusion and described an unresolved question about which bedsheet ligature had been used. Read the autopsy packet and Roman’s interview. Epstein Files

Key Takeaways

Roman performed the autopsy. Her report records an examination beginning at 9:21 a.m. on August 11, 2019, at the Manhattan mortuary of the New York City Office of Chief Medical Examiner.
The final findings were hanging and suicide. Hanging is the cause of death. Suicide is the manner of death. Roman made that distinction explicitly in her sworn interview.
Her initial pending classification was deliberate. Roman wanted more information about how Epstein was found and where he had been hanging. She said the case’s profile led her to seek a particularly thorough review.
She considered the neck fractures consistent with hanging. Roman described the location and pattern of the hyoid bone and thyroid cartilage fractures, as well as the neck mark, facial discoloration, pinpoint hemorrhages, and lack of injuries suggesting a struggle.
She could not confidently identify the exact ligature. A bedsheet noose accompanied the body, but Roman later said a different possible noose shown to her in photographs looked more likely to have made the mark. She said this uncertainty did not change her conclusion about hanging.
Michael Baden observed the examination and disagreed. The forensic pathologist retained by Epstein’s family argued that the neck injuries favored homicidal strangulation. His interpretation should be distinguished from Roman’s findings and the official ruling.
There was one physical autopsy in the records reviewed here. Baden attended Roman’s examination as an observer. The available records do not document a second examination of the body.

Who Is Kristin Roman?

Roman was a city medical examiner with the New York City Office of Chief Medical Examiner when she examined Epstein. In her sworn interview, she said she earned a medical degree from SUNY Downstate in 1999. She described earlier fine arts and premedical studies, followed by residency training at Kings County Hospital and a forensic pathology fellowship at the New York City medical examiner’s office. Yirah.fi

Roman told investigators she had performed approximately a couple thousand autopsies before Epstein’s case. She estimated that more than one hundred, and perhaps several hundred, involved suicide. She also described a break in her New York City service from 2013 to 2014, when she worked at the Dane County Medical Examiner’s Office in Wisconsin. These are Roman’s own estimates and account of her career, rather than an independently audited case count. Read her professional background in the sworn interview. Yirah.fi

Roman’s Role in the Epstein Case

Epstein was found in his cell at the Metropolitan Correctional Center in Manhattan on August 10, 2019. Roman said the medical examiner’s office learned of the death that day and initially expected the body to arrive on August 10. Another examiner had originally been assigned, but Roman was selected when the examination took place on August 11. She said Epstein was her only autopsy case that day. Morgue technicians and a photographer assisted her. Yirah.fi

Roman was the examiner who performed the autopsy. Dr. Barbara Sampson was New York City’s chief medical examiner and announced the office’s suicide ruling on August 16. Dr. Michael Baden, retained by Epstein’s family, observed Roman’s examination. Those roles matter because later accounts sometimes blur who examined the body, who announced the ruling, and who offered an opposing interpretation. Read the autopsy packet, Roman’s interview, and the companion EpsteinWiki article on Michael Baden. Epstein Files

What the Autopsy Documented

The official autopsy packet records a ligature mark on Epstein’s neck and findings Roman associated with neck compression. It documents fractures involving the left greater horn of the hyoid bone and the superior horns of the thyroid cartilage. The packet also contains associated examination material, including toxicology and neuropathology records. The signed report gives the final cause and manner of death as hanging and suicide. Read the complete autopsy packet. Epstein Files

In her later interview, Roman highlighted several findings:

Ligature furrow: She described a pronounced mark on the neck that, in her experience, looked consistent with hanging.
Plethora: She described purple discoloration above the neck mark associated with backed up circulation during sustained compression.
Petechiae: She described pinpoint hemorrhages in the facial skin, eyes, and mouth. She said their distribution supported her interpretation of hanging.
Other injuries: She said she did not see the hand injuries, broken fingernails, or broader bruising she would expect in a struggle. She acknowledged an abrasion on an arm and offered a possible explanation for it.
Internal neck findings: She discussed the absence of significant anterior neck muscle hemorrhage as part of her reasoning. The precise wording of her interview should be read alongside the written autopsy findings, which document the internal examination in greater detail.
Fractures: She acknowledged the hyoid and thyroid cartilage fractures and argued that their locations and pattern were consistent with pressure from hanging.

These observations are evidence that Roman used to reach a forensic opinion. No single finding, considered by itself, establishes the manner of death. Read Roman’s explanation beginning in her interview transcript. Yirah.fi

Why the Initial Determination Was Pending

Roman did not immediately select suicide or homicide on the initial death certification. She said she wanted to learn how Epstein had been found, whether he had been fully suspended, where the suspension occurred, and whether the ligature delivered to the mortuary was the one used. She also wanted to see the cell and speak with the correctional officer who found him. Business Insider

In her interview, Roman said she was not allowed to visit the cell or speak with the officers. She reviewed scene material, including photographs, but did not obtain every form of access she requested. She explained that the unusually prominent case and the possibility that someone might have wanted Epstein dead made her especially careful before formally classifying the manner of death. She nevertheless described the autopsy findings as clear evidence of hanging and said the additional requests were largely about completeness. Read the interview passages on the delayed ruling. Business Insider

The distinction is consequential: pending described the status of an unfinished determination at that point in the process. It was not a final finding of homicide, nor did Roman later describe it as a rejection of hanging.

The Hyoid and Thyroid Cartilage Fractures

The three commonly discussed fracture sites are one side of the hyoid bone and both superior horns of the thyroid cartilage. Baden has argued that this combination favored homicidal strangulation. Roman agreed that the fractures existed but disputed what they meant. Her analysis focused on their positions and the surrounding findings rather than the number of fractures alone. Epstein Files

Roman said the hyoid break occurred at a location she associated with pressure against the spine during hanging. She said the thyroid cartilage fractures also fit the direction of pressure she inferred. In her account, manual strangulation would tend to produce a different and less even pattern, often with other evidence of a struggle. These are Roman’s forensic interpretations, not rules that allow readers to determine manner of death by counting fractures. Read the autopsy packet and her sworn explanation. Business Insider

Baden continued to disagree after Roman’s interview became public. In March 2026, he told Business Insider that he still considered the injuries more consistent with homicide. Read that account of the competing interpretations. Business Insider

The Bedsheet Ligatures and the Unresolved Identification

The identity of the precise ligature is one of the most important limits in Roman’s account. She said a bedsheet noose accompanied Epstein’s body to the medical examiner’s office. She questioned whether that particular item was the one that had made the neck mark. In the 2022 interview, investigators showed her photographs of other possible bedsheet ligatures from the cell. She said either of two pictured items could have caused the mark, while the second appeared a more likely candidate than the one brought to her. Business Insider

Roman also rejected the suggestion that the cord of a CPAP machine matched the injury. She said the furrow was too broad for such a cord and appeared to have been made by fabric. This was her assessment of the mark, not a laboratory identification of a particular bedsheet strip. Read the ligature discussion in the sworn interview. Yirah.fi

The careful conclusion is therefore narrow: Roman supported hanging but did not establish with confidence which individual bedsheet ligature was used. The uncertainty about the item should be preserved when summarizing her testimony.

What Roman Said About Outside Influence

Investigators directly asked whether anyone had attempted to coerce or bribe Roman into ruling the death a suicide. She answered no. She said she had avoided much of the media attention and had difficult conversations with family members who disagreed with the determination. Her sworn answer is relevant evidence about her own experience; it does not replace the broader review of the investigation or scene records. Read the closing portion of her interview. Yirah.fi

Roman, Sampson, and Baden: Distinct Positions

Person	Role	Documented position
Kristin Roman	Performed the August 11 autopsy	Found the physical evidence consistent with hanging and affirmed suicide as the manner of death.
Barbara Sampson	New York City chief medical examiner	Announced the office’s suicide ruling on August 16 after reviewing investigative information.
Michael Baden	Family retained forensic pathologist who observed the examination	Publicly disputed the suicide conclusion and argued that the neck injuries favored homicide.

Their disagreement concerns the interpretation of a shared examination and related scene evidence. It does not establish that a second autopsy occurred. A separate sworn interview with Mark Epstein says the family did not seek a second autopsy after Baden attended the first. Read Mark Epstein’s interview. Business Insider

What the Inspector General Found

The Justice Department inspector general’s report documented serious failures in the Metropolitan Correctional Center’s supervision, staffing, required checks, and recordkeeping before Epstein’s death. Its review did not find evidence contradicting the FBI’s determination that there was no criminal act associated with how Epstein died. That institutional finding and Roman’s medical findings answer different questions: one examines the prison’s conduct and investigative record; the other concerns what the body and associated forensic evidence showed. 0 8 5

For the wider chronology, see Death of Jeffrey Epstein. Roman’s interview is especially useful because it explains the reasoning behind the medical examiner’s conclusion while preserving the limits of her knowledge about the scene and exact ligature.

Evidence Appearances and Associated Records

EFTA00063517: New York City autopsy packet. The central record identifying Roman as the examiner and documenting the examination, final cause and manner of death, and associated forensic material.
EFTA00063459: Roman’s May 31, 2022, sworn interview. Her account of her training, assignment, examination, fracture interpretation, pending decision, scene requests, and uncertainty about the ligature.
EFTA00063395: Inspector general interview memorandum and related material. A companion investigative record for the interview and its referenced materials.
EFTA00023982: Communications concerning pending studies and scene information. Related correspondence bearing on information sought while the death investigation was being completed.
EFTA00035810: Request concerning physical ligature evidence. A later inspector general evidence request relevant to tracing the noose evidence.
EFTA00113460: Mark Epstein’s sworn interview. Relevant to Baden’s attendance and the family’s decision about a possible second autopsy.
EFTA00039025: Inspector general investigative material. A further record connected to the federal review of the death.
Justice Department inspector general report, June 2023. The published investigation of the prison failures and circumstances surrounding Epstein’s death.

The autopsy packet and the interview are the primary records for Roman’s own work and explanations. The other items supply context about the scene, evidence handling, family response, and federal investigation.

Questions the Records Leave Open

Which exact bedsheet ligature made the neck mark? Roman did not identify one with certainty and thought an item shown later in photographs looked more likely than the item delivered with the body.
What additional detail would Roman have obtained from a direct cell visit or interview with the discovering officer? She sought both, but said she could not conduct them.
Can the competing fracture interpretations be reconciled from the released materials? Roman and Baden reached different opinions. Readers can compare their stated reasoning with the autopsy findings, but the existence of disagreement does not itself resolve it.
Where are the photographs and physical items discussed in the interview within the released evidence? The interview identifies material shown to Roman. Its descriptions should be checked against the underlying exhibits before treating any pictured item as the proven ligature.

These questions concern the precision and completeness of the evidentiary record. Roman’s stated conclusion remained hanging as the cause of death and suicide as the manner.

Sources

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