Ted Kaczynski, the imprisoned domestic terrorist known as the “Unabomber,” was diagnosed with rectal cancer in March 2021, and a month prior to killing himself in June 2023, “was noted to be depressed and sent for psychiatric evaluation,” according to his autopsy report obtained by NBC News.
Kaczynski was 81, and a senior law enforcement official had said at the time that he had been diagnosed with cancer, although its type and severity were unclear.
Now, 10 months after Kaczynski died and NBC News first filed a Freedom of Information Act request related to his case, his autopsy report offers new details into the health and final months of a man who, for two decades, waged a deadly bombing spree that killed three people and injured 23 others. It ended with his capture in the Montana wilderness in 1996; he was sentenced to life in prison without the possibility of parole.
The Office of the Chief Medical Examiner in North Carolina lists the cause of death as hanging, with a shoelace used as a ligature, at Kaczynski’s solitary cell at the Federal Medical Center in Butner, northeast of Durham.
Kaczynski’s death by suicide raises questions about whether it was preventable and why he had access to a shoelace, said Jack Donson, a retired longtime Federal Bureau of Prisons case manager and executive director of the Federal Prison Education and Reform Alliance, a nonprofit organization.
It’s unclear whether Kaczynski’s depression resulted in a suicide watch, which Donson said would include 24/7 direct supervision and removal of objects that could allow inmates to harm themselves. “It’s virtually impossible to stop anyone from harming themselves other than somebody on formal suicide watch,” he added.
But, he said, given Kaczynski’s status within the BOP, “it’s somewhat surprising a high-profile inmate coming out of maximum-security was able to obtain shoelaces in a hospital environment to kill themselves — especially him.”
The 2019 suicide of wealthy financier and convicted sex offender Jeffrey Epstein in his BOP jail cell in New York resulted in an investigation that found a failure to monitor and other lapses, including ensuring that he had a cellmate as recommended.
In response to Kaczynski’s death and whether it was avoidable, BOP officials declined to comment specifically about his case or the conditions of his confinement for “safety and security reasons.” In general, the agency said, in cases of deaths by homicide or suicide, the BOP follows a protocol to preserve and document evidence “needed to support subsequent investigation,” and there are also guidelines for suicide prevention and training at each facility.
The policy notes that inmates in detention or disciplinary segregation “often may be at higher risk for suicidal behavior” and are “monitored for signs of potential suicide risk.” It’s unclear if Kaczynski had ever been monitored for suicide risk during his time at Butner.
A Justice Department inspector general report in February found that the BOP had failed to prevent the deaths of 187 inmates who died by suicide over eight years, with “numerous operational and managerial deficiencies” creating unsafe conditions. The report focused on deaths that appeared to likely be preventable and not ones that involved inmates who had more complex questions of medical care.
Aside from Kaczynski’s rectal cancer diagnosis, which medical examiners said was at stage 4, his autopsy notes that he had a history of mental health disorders and was feeling depressed about a month before his death.
“At around midnight on June 10, 2023, he was found to have hung himself from a handicap rail in his room with shoelaces,” the report says. “He was initially pulseless, and resuscitation was initiated.”
There was a “return of spontaneous circulation” before he was transferred to Duke University Hospital in Durham where his blood pressure remained low, according to the report. He was pronounced dead at 8:07 a.m.
“The decedent was not on any prescription medications and had no prior suicidal ideations or attempts,” the report added. “Federal Law Enforcement had no concern for foul play.”
The autopsy also noted that there was “extensive injury” to Kaczynski’s rib cage due to chest compressions and that his rectal cancer had spread to the liver and both lungs. He suffered “massive blood loss” as the chest compressions caused “lacerations of his severely diseased liver,” but the report said that was only caused by “his own inciting actions of hanging himself, and thus the manner is appropriately suicide.”
Kaczynski, a Harvard-educated mathematician who railed against technology, planted homemade pipe bombs — targeting universities, an American Airlines flight and others — in a campaign from 1978 to 1995 that included three deaths and multiple maimings, federal prosecutors said. His notoriety as the “Unabomber” came from an FBI code name stemming from his university and airline bombing targets.
Kaczynski had taunted officials with a rambling manifesto and was captured following one of the longest FBI manhunts in history. In 1998, while awaiting trial, authorities said Kaczynski had attempted to hang himself with his underwear and was placed on 24-hour suicide watch in jail. He insisted, however, that he wasn’t mentally ill despite being diagnosed as a paranoid schizophrenic.
To avoid the death penalty, Kaczynski pleaded guilty to his crimes and was placed into the federal Supermax prison in Florence, Colorado, a high-security facility that has held some of the nation’s most wanted terrorists and criminal kingpins.
In March 2021, Kaczynski complained of rectal bleeding. He was transferred that fall from Florence to the Federal Medical Center in Butner for treatment for cancer, medical examiners said. He began biweekly chemotherapy until March 2023, “when he refused any further treatments due to negative side effects and his poor prognosis,” they added.
An oncologist noted that he “appeared depressed” about a month before his death.
If you or someone you know is in crisis, call 988 to reach the Suicide and Crisis Lifeline. You can also call the network, previously known as the National Suicide Prevention Lifeline, at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.
This article was originally published on NBCNews.com