This picture tells the story https://www.the-sun.com/wp-content/uploads/sites/6/2020/01/dk-comp-epstein-cell-v2.jpg

Firstly the multiple prison uniforms on the floor, secondly the thin ligature marks on his neck and his severed earlobe, thirdly the top bunk matress on the floor, fourthly the orange uniform cloth he was hung from is tied to the 2nd rung of the ladder. Here is what that says happened; Multiple assailants dressed in orange prison uniforms entered his cell while he was sleeping. They dragged him off the top bunk so the matress came with him onto the floor then they held him down and garotted him with a wire garotte that cut into his neck and severed his earlobe. When he was unconsious or dead they slumped his body up against the bunk's ladder and tied the strip of prison uniform cloth around his neck and then while some of them lifted his weight off the floor one of them wrapped the cloth strip tight around and around the rung of the ladder to make it look like a hanging. That is why it was tied so low down on the 2nd rung. Then the assailants all threw off their prison uniforms and left them on the floor before leaving.