The contentious case surrounding Philadelphia teacher Ellen Greenberg’s death, which was labeled a suicide despite 23 stab wounds in 2011, has once again been deemed a suicide following an extensive review. However, some experts continue to argue that the evidence points to a different conclusion.

Dr. Lindsay Simon, who currently serves as the city’s chief medical examiner, was assigned to re-evaluate the work conducted by Dr. Marlon Osbourne, the assistant medical examiner responsible for the initial autopsy.

Initially, Dr. Osbourne classified Greenberg’s death as a “homicide” due to “multiple stab wounds.” Subsequently, he revised the manner of death to “suicide.” Yet, earlier this year, Dr. Osbourne altered his stance once more, stating in a letter to the court that, in his professional view, Ellen’s manner of death should be classified as something other than suicide.

A split image juxtaposes a family photo of Ellen Greenberg smiling with a computer-generated graphic from the autopsy report, illustrating the locations where she was stabbed. (Courtesy of the Greenberg family)

This latest review follows persistent legal efforts by Greenberg’s parents, Dr. Josh Greenberg and Sandee Greenberg, who have been advocating for the Philadelphia Medical Examiner’s Office to change the official cause of death from suicide to undetermined.

“The key stab wounds to the base of the brain and deeper into the upper spinal column are inconsistent with being self-inflicted because of the location and associated injuries,” said Dr. Priya Banerjee, a board-certified forensic pathologist who reviewed Dr. Simon’s report.

Based on that wound, she told Fox News Digital that she believes Greenberg’s death was a homicide.

Read Dr. Simon’s report:

“While the distribution of injuries is admittedly unusual, the fact remains that Ellen would be capable of inflicting these injuries herself,” Dr. Simon wrote.

Joe Podraza, a lawyer for Greenberg’s parents, has said that this wound was inflicted after Greenberg’s heart stopped beating. But Dr. Simon suggested that the wound came during the autopsy and not in her apartment.

“It still sounds undetermined to me at this point,” said Joseph Giacalone, a former NYPD cold case investigator and a criminal justice professor at Penn State Lehigh Valley. “[Dr. Simon] is trying to piece together something from 14 years ago with paperwork, slides and photographs.”

She also had to rely on a Philadelphia investigation that has been problematic from the start, he said. A cleanup crew destroyed the crime scene before police showed up with a search warrant.

Dr. Josh and Sandee Greenberg in Philadelphia after a settlement was reached with the city in their daughter Ellen’s case. (Gavin Fish )

Fingerprint testing on a knife found in her chest returned only “two non-usable prints,” according to Dr. Simon’s report. She also identified three additional stab wounds and 20 more bruises that were not mentioned in Dr. Osbourne’s earlier findings.

Although Greenberg was found with bruises on various parts of her body in addition to the stab wounds, Dr. Simon said she showed no signs of defensive injuries. She also discounted marks on her wrists as evidence she may have been held or bound while being stabbed.

Ellen Greenberg with her parents Dr. Josh and Sandee Greenberg. (Greenberg family)

“While the absence of ‘defensive injuries’ does not eliminate the possibility of homicide, the lack of defensive injuries must be explained,” Dr. Simon wrote.

She identified and ruled out four potential explanations: the attack was over before the victim could defend herself, she was intoxicated and unable to defend herself, she was physically restrained or she suffered an incapacitating injury at the beginning of the attack.

A prior review by Dr. Wayne Ross on behalf of Greenberg’s parents found evidence that the victim could have been strangled and had her wrists restrained, rendering her defenseless, but Dr. Simon disagreed with his findings.

A computer illustration showing two of Ellen Greenberg’s knife wounds to the back of her neck and skull. (Tom Brennan)

“While the shape of the contusions on Ellen’s forearms could hypothetically be caused by fingers, the undersigned only identified three contusions on Ellen’s right forearm and three contusions on Ellen’s left forearm,” Dr. Simon wrote. “This would indicate an incomplete grip on the forearms if the contusions were indeed caused by fingers. Also, the contusions on the right forearm appeared to the undersigned to be of different ages.”

Identifying the age of the bruises visually can be problematic and inaccurate, however, according to Dr. Banerjee.

“So [they] could be from that one incident, or multiple or unrelated matters,” she said.

Ellen Greenberg, left, in an undated family photo with her then-fiance, Sam Goldberg.  (Greenberg family)

A contributing factor to Dr. Simon’s findings was multiple reports that Greenberg was suffering from anxiety and stress, primarily due to her work as a school teacher. According to text messages sent on the day of her death, she told a friend that grades were due that night and she was struggling to have them done by the deadline.

“I wanna scream,” she wrote.

The grading process was apparently a major problem for her, according to Dr. Simon’s report, and she told friends and her therapist that she was considering quitting her job.

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“Let’s face it, millions of people have anxiety or depression at one time or another and never kill themselves,” said John Kelly, a New Jersey-based criminal profiler and psychotherapist who has been following the case for years.

Severe depression can be a factor in suicides — but not always, he said. Greenberg had been seeking treatment for anxiety, which is cited in Dr. Simon’s report, but she was not diagnosed with depression. For stress, she had been prescribed Zoloft and then Klonopin.

Sandee Greenberg in Philadelphia after a settlement was reached with the city in her daughter Ellen’s case (Gavin Fish)

According to a 2025 study from the Centers for Disease Control and Prevention, about 49% of suicide victims have a documented mental health condition. Of those, 71.7% have been diagnosed with depression, compared to 24% with anxiety disorder.

The same CDC analysis also examined undetermined deaths, finding 75% involved precipitating circumstances, such as a mental health issue, and 27.5% of those included an anxiety disorder diagnosis.

Multiple outside experts, including the late and renowned forensic pathologist Dr. Cyril Wecht, have reviewed Greenberg’s death over the years. While Dr. Simon included analyses from Dr. Wecht and others in her report, she disagreed with their conclusions that suicide was unlikely or inconsistent with the evidence.

She also included the findings of Dr. Jonathan Arden, who agreed with the suicide designation, citing the locations of the injuries as well as internet searches found on Greenberg’s laptop related to the phrase “suicide.”