An autopsy has found the hyoid bone in Jeffrey Epstein's neck was broken, a person familiar with the matter told NBC News Thursday. Two other sources familiar with the investigation say there's still no indication of foul play.
The hyoid bone is a U-shaped bone in the neck that supports the tongue. An NBC medical expert says a broken hyoid can happen in both strangulation and hanging cases, but occurs more often in strangulations. Studies show it occurs in about a third of strangulations and a quarter of hangings, NBC News Medical Correspondent John Torres said.
The medical examiner's office has not released its final determination on the wealthy financier's death. The autopsy had been completed nearly a week ago, but the medical examiner hadn't ruled on the jailed financier's cause of death, citing the need for further study.
Law enforcement officials have said the convicted sex offender and accused pedophile was found in cardiac arrest in his cell at the federal Metropolitan Correctional Center in Manhattan Saturday morning. He had a bed sheet tied around his neck and died by apparent suicide, an official close to the case said.
The grim discovery came just weeks after an apparent suicide attempt by Epstein at the same facility; that time, he was found in a fetal position, semi-conscious, on the floor of his cell with neck injuries. One of the theories at the time was that Epstein's cellmate, Nicholas Tartaglione, attacked him. However, on Friday, Tartaglione's lawyer told NBC 4 New York that the day before Epstein was found dead, he received a notice from prison officials that his client was cleared and not suspected of having assaulted Epstein in the first incident.
An MCC spokesperson declined to comment.
His death has shined a global spotlight on alleged deficiencies within the federal prison, which houses some of the nation's most notorious inmates, including Joaquin "El Chapo" Guzman and former Trump campaign chair Paul Manafort.
In the days since Epstein's death, a picture has emerged of the MCC as a chronically understaffed jail, with guards working overtime and other employees pressed into service as correctional officers.
Multiple federal investigations have been launched; the center's warden has been temporarily reassigned, and the two guards assigned to watch Epstein the night of his death have been placed on administrative leave.
Investigators are looking into whether those two guards may have been sleeping when the accused sex trafficker apparently hanged himself in his cell, two officials told News 4.
The investigators are questioning if the times recorded for checks on the accused pedophile are accurate or if they were falsified, the sources said. Correction officers at the Manhattan prison were supposed to check on Epstein about every 30 minutes. Investigators have learned those checks weren't done for a "number of hours" before Epstein was found with a bed sheet tied around his neck, according to an official.
Now investigators are reviewing security camera footage to see if it matches up with what was recorded in the guards’ logs, according to sources. If it is not, then federal charges could be filed against the officers.
"If someone did not check in on someone and the log books indicated they had, they could be charged with making a false statement to the federal government — which is a felony,” said former FBI Supervisor Tim Gallagher.
At the time of Epstein's death, he was being held without bail and faced up to 45 years in prison on federal sex trafficking and conspiracy charges. He had pleaded not guilty.
U.S. Attorney General William Barr, who ordered the reassignment of MCC's warden and the leave of the two guards, has pledged a thorough investigation.
"We will get to the bottom of what happened and there will be accountability," Barr said earlier this week.
Federal prosecutors have shifted their focus to possible charges against anyone who assisted or enabled Epstein in his alleged sex crimes. Agents searched his private island home off the coast of St. Thomas in the Caribbean in their quest for evidence, and Barr had a message for any potential accomplices.
"Let me assure you that this case will continue on against anyone who was complicit," Barr said at a law enforcement conference in New Orleans. "The victims deserve justice, and they will get it."