Epstein's death raises a baffling question: How did a prison inmate on 24/7 suicide watch kill himself?
Millionaire investor and registered sex offender, Jeffrey Epstein, allegedly hanged himself at the Manhattan Correctional Center on early Saturday morning, despite previous reports that Wall Street financier was on suicide watch.
Epstein was arrested by federal agents July 6 in New Jersey after his return from a Paris trip and was charged with child sex trafficking in violation of Title 18, United States Code, Section 1591.
He is suspected of sex trafficking minors in Florida and New York.
The new charges against the billionaire suggest the Department of Justice's attempt to redeem its 2008 decision where a top federal prosecutor cut a questionable plea deal with the investor accused of engaging in sex with dozens of underage girls.
Although police found evidence suggesting he had regularly molested and trafficked dozens of underage girls, he was handed a sentence of just 13 months of part-time custody in county jail.
The financier was found unconscious in the Manhattan prison with marks on his neck last month, a week after being denied bail.
Authorities, suspecting a suicide attempt, had launched an investigation with reports of Epstein being under constant watch since the July 23 incident.
The suspicious circumstances surrounding the 66-year-old's sudden demise has everyone asking how a high-profile prison inmate under suicide watch was able to kill himself?
"The actual operation of 'suicide watch' in any facility may depend on facilities, staffing, diligence, and risk assessment. Effectiveness of suicide watch depends on several elements. Has the detained individual been deprived of possible means of suicide?" Christopher E. Smith, Professor, School of Criminal Justice, Michigan State University told MEA Worldwide.
Christine Tartaro, an expert on suicide in correctional facilities, said it is very difficult to kill oneself when there is constant personal vigilance.
"It's very difficult to kill oneself when somebody's right there," Tartaro, a professor of criminal justice at Stockton University, told CNN.
It is not yet known whether Epstein was under digital surveillance or a guard was keeping an eye on him after his last suicide attempt, with reports suggesting that the sexual offender had likely attempted to hang himself.
"Ideally there should be constant, one-on-one eyes on (suicidal) inmates. It is so easy to get distracted and walk away from the TV set," Tartaro added.
An inmate under suicide watch traditionally is locked in a bare prison cell by themselves, with many given paper gowns or tear-proof clothes to prevent them from using the material as a noose to hang themselves. A bare cell and isolation generally take a toll on the inmate's mental health, making them fixated on one thing.
"In extreme instances, an individual may be held naked in a cell or given only a paper gown--but that extreme approach is often balanced against privacy/humiliation interests, so that depends on risk assessment. Of course, suicide is possible even with a paper gown if a person tries to swallow/choke themselves on the paper gown. Does the facility have cameras to monitor cell continuously and staff to watch the monitor continuously? Obviously, this approach takes resources," Smith added.
Therefore, some correction facilities are attempting to try new approaches, with some allowing the prisoners access to possessions like books, and not keeping them in isolation and allowing them to remain in a cell with a more stable inmate, but under surveillance, Tartaro said.
A Federal Bureau of Prisons research stated that trained inmate "observers" could assist in reducing the amount of time suicidal prisoners remained on watch by almost 45 hours on average.
A report released by the National Institute of Corrections in 2010 stated that nearly two-thirds of prisons surveyed in the study did not regularly assign suicidal inmates to "suicide-resistant" rooms.
The report states that a majority of inmate suicide are hangings, similar to that of Epstein, which suggest that despite being a high profile inmate who had already allegedly attempted to take his life, the financier was not given a "suicide-resistant" cell and had easy access to an anchor on the ceiling and a fabric to make a noose.
The 2010 report, which analyzed nearly 700 jail suicides in 2005 and 2006, around 8 percent of inmates in local jails were on suicide watch when they took their own lives.
Assuming Epstein was under constant observation, considering the immediate danger to his life, the enormity of his case and high profile connections like Donald Trump, and Bill Clinton, not keeping an eye on the prisoner for even a minute could turn fatal for the inmate. According to a report by the World Health Organization's Department of Mental Health, it takes just three minutes after hanging oneself to cause permanent brain damage and 5-7 minutes to die from it.
"Suicide watch may be coming by to look into the cell every 15 minutes or other short period. In such instances, a determined individual can figure out the timing and perhaps succeed with suicide anyway. Everything hinges on the diligence of staff in following procedures. If they are busy or uncaring, they may not check the cell with required regularity or only give a cursory glance that does not recognize what is really happening, "E. Smith said.
With details of Epstein's circumstances of death still coming in, it is for certain that the Metropolitan Correctional Center in Manhattan is set to come under heavy scrutiny, with many critics already beginning to suspect the sexual offender's sudden hanging.