FILE - This March 28, 2017, file photo, provided by the New York State Sex Offender Registry shows Jeffrey Epstein.  Epstein has died by suicide while awaiting trial on sex-trafficking charges, says person briefed on the matter, Saturday, Aug. 10, 2019. (New York State Sex Offender Registry via AP, File)
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(CNN) —  

New York City’s chief medical examiner said her office stands by its conclusion that Jeffrey Epstein’s cause of death was suicide by hanging.

Chief Medical Examiner Dr. Barbara Sampson’s statement follows claims made by a doctor paid by the Epstein family challenging that conclusion.

“Our investigation concluded that the cause of Mr. Epstein’s death was hanging and the manner of death was suicide. We stand by that determination,” Sampson said.

“We continue to share information around the medical investigation with Mr. Epstein’s family, their representatives, and their pathology consultant. The original medical investigation was thorough and complete. There is no reason for a second medical investigation by our office.”

The comments come after Dr. Michael Baden, a former NYC medical examiner, claimed on “Fox & Friends” on Wednesday morning that findings in Epstein’s autopsy were “more consistent with ligature homicidal strangulation.”

Baden echoed remarks from Epstein’s attorneys in August in which the legal team said it had received opinions that Epstein suffered injuries consistent with a fatal assault. Baden was present at the official autopsy on August 11.

On “Fox & Friends” on Wednesday, Baden specifically noted that Epstein had broken several bones in his neck, which he said was more consistent with strangulation than with hanging.

However, CNN Chief Medical Correspondent Dr. Sanjay Gupta said in August that multiple neck fractures means the cause is less likely to be strangulation alone.

“In strangulation, while you can break the hyoid bone, it is less likely to actually break bones in the neck,” Gupta said. “By hanging, someone can break both the hyoid bone and other bones in the neck. None of these factors in isolation give you a complete story.”

Dr. Lawrence Kobilinsky, a professor of forensic science at John Jay College of Criminal Justice, also said the hyoid bone is a weak, fragile structure, and it can break from a hanging. A fractured hyoid bone does not necessarily indicate a homicide, Kobilinsky said.

The medical examiner’s initial determination on his cause of death came almost a week after the multimillionaire was found dead in his cell at the Metropolitan Correctional Center, where the 66-year-old was awaiting trial on federal charges accusing him of sexually abusing underage girls and running a sex trafficking ring. He had pleaded not guilty to the charges.

US Attorney General William Barr has said there were “serious irregularities” at the facility where Epstein was held.