Dr. Baden, a former New York City medical examiner and a Fox News contributor, added, “I’ve not seen in 50 years where that occurred in a suicidal hanging case.”

The findings by Dr. Baden were strongly disputed by the city’s chief medical examiner, Dr. Barbara Sampson, who previously ruled that Mr. Epstein’s death on Aug. 10 in the Metropolitan Correctional Center was a suicide.

“I stand firmly behind our determination of the cause and manner of death in this case,” Dr. Sampson said in an interview on Wednesday. She added: “In general, fractures of the hyoid bone and the cartilage can be seen in suicides and homicides.”

The hyoid is a bone near the Adam’s apple.

Dr. Sampson also dismissed Dr. Baden’s contention that the circumstances around Mr. Epstein’s death suggested other people may have been involved. She said her office had done a “complete investigation,” taking into consideration information gathered by law enforcement in making the determination.

“No one finding can be taken in isolation,” she said.

Dr. Baden served briefly as New York City’s medical examiner. He was provisionally appointed to the position in 1978 and dismissed just a year later, by Mayor Edward I. Koch. In later years, he went on to work as a consultant on a number of high-profile cases.