| Form 583 Report of Incident | ||
|---|---|---|
| — | — | ----------------------------- |
| Incident ft: NYM-19- Submitted By: 0076 | Date/Time Of Incident 7/23/2019 1:27 AM |
|---|---|
| Section 1: General Information | |
| Staff Aware Date: 7/23/2019 1:27 AM | |
| FBI Notified: No USMS Notified: No | Indicate Where Incident Occurred: Main Facility |
| Location Level 1: SHU | Level 2: Housing Unit, Special (SHU) Level 3: 9 SOUTH SHU |
| TYPOPricilferrt, | Institution Locked Down: No |
| ❑ Assault On Inmate | Modified Operations: No |
| ❑ Assault On Staff | |
| ❑ Assault, Attempted On Inmate | Cause Of Incident Known? No |
| ❑ Assault, Attempted On Staff | Cause Of Incident |
| ❑ Disruptive Behavior | ❑ Alcohol |
| ❑ Escape From Non-secure Facility | ❑ Commissary |
| ❑ Escape From Secure Facility | ❑ Debts |
| ❑ Escape, Attempted From Non-secure Facility | ❑ Disrespect Issue ❑ Drugs |
| ❑ Escape, Attempted From Secure Facility | ❑ Ethnic Conflict |
| ❑ Fight | ❑ Food Issue |
| ❑ Inmate Death | ❑ Geographical Conflict |
| ❑ Institution Disturbance | ❑ Interfering with Staff duties |
| ❑ Introduction Of Contraband | ❑ Property Issue |
| ❑ Lethal Weapons Discharge | ❑ Racial Conflict |
| ❑ Self Mutilation | ❑ Recreation Equipment |
| ❑ Religious Issue | |
| ❑ Setting A Fire | ❑ Security Threat Group Conflict |
| ❑ Sexual Act, Non-consensual On Inmate ❑ Sexual Assault On Staff | ❑ Sexual Pressure |
| ❑ Sexual Contact, Abusive On Inmate | ❑ Sporting Events |
| ❑ Telephone | |
| ❑ Sexual Harassment, Repetitive | ❑ Theft ❑ Visiting |
| ❑ Staff Homicide | ❑ Work Issue |
| ❑ Strike, Food | |
| ❑ Strike, Work | |
| ❑✓ Suicide Attempt | Method: Hanging/Asphyxiation |
| ❑ Use Of Force | |
| ❑ Use Of Force/Applications Of Restraints | |
| ❑ Use of Restraints, Pregnant/Postpartum | |
| Section 2: Inmates Involved |
UNCLASSIFIED/LIMITED OFFICIAL USE ONLY/LAW ENFORCEMENT SENSITIVE¶
This document is marked Unclassified/Limited Official Use Only/Law Enforcement Sensitive and may be disseminated, with proper attribution, to active Law Enforcement, DOD. or U.S. Intelligence Agencies. This document, or any segmenVattachment thereof, may not be released without the approval of the Bureau of Prisons to any media sources, any non-law enforcement entity, the general public or those without a ‘need to know: It contains information that may be exempt from public release under the provisions of the Privacy Act (5 U.S.C. 552).¶
1 of 3¶
CONFIDENTIAL SDNY_000 10632¶
Form 583 Report of Incident¶
| Incident #: NYM-19- Submitted By: 0076 | Date/Time Of Incident: 7/23/20191: AM |
|---|---|
| Reg tt: 76316054 Name: EPSTEIN, JEFFREY Role: Victim Weapon (per inmate): No CIMS: No STG: Yes | Medical Attention Required: No Injury Category: Minor lnju Use of Force (per inmate): No Chemical Used (per Inmate): No |
| Restraints (per inmate): Escort Only | |
| Death (per inmate): No | |
| Reg #: Name: Role: Not Known Weapon (per Inmate): No CIMS: Yes STG: Yes | Medical Attention Required: No Injury Category: No Injury Use of Force (per inmate): No Chemical Used (per inmate): No |
| Restraints (per inmate): No | |
| Death (per inmate): No | |
| Section 3: Others Involved | |
| Name: Medical Attention Required: No Injury Category: No Injury Sexual Assault: No | Person Type: Staff Death: No Staff Injury by Inmate: No |
| Name: Medical Attention Required: No Injury Category: No Injury Sexual Assault: No | Person Type: Staff Death: No Staff Injury by Inmate: No |
| Name: Medical Attention Required: No Injury Category: No Injury Sexual Assault: No | Person Type: Staff Death: No Staff Injury by Inmate: No |
| Name: Medical Attention Required: No Injury Category: No Injury Sexual Assault: No | Person Type: Staff Death: No Staff Injury by Inmate: No |
| Name Medical Attention Required: No Injury Category: No Injury Sexual Assault: No | Person Type: Staff Death: No Staff Injury by Inmate: No |
| Name: Thomas, Michael Medical Attention Required: No | Person Type: Staff Death: No |
| UNCLASSIFIED/LIMITED OFFICIAL USE ONLY/LAW ENFORCEMENT SENSITIVE This document is marked Unclassified/Limited Official Use Only/Law Enforcement Sensitive and may be disseminated, with p ‘per |
attribution, to active Law Enforcement. DOD. or U.S. Intelligence Agencies. This document, or any segment/attachment thereof. may not be released without the approval of the Bureau of Prisons to any media sources, any non-law enforcement entity, the general public or those without a ‘need to know: It contains information that may be exempt from public release under the provision of the Privacy Act (5 U.S.C. 552).¶
2 of 3¶
CONFIDENTIAL SDNY_000 10633¶
Form 583 Report of Incident¶
| Incident | NYM-19- 0076 | Submitted By: | Date/Time Of Incident: 7/23/2019 1:27 AM |
|---|---|---|---|
| Injury Category: No Injury Sexual Assault: No | Staff Injury by Inmate: No | ||
| Section 4: Lethal Weapon Discharge | |||
| No data found. | |||
| Section 5: Use of Force | |||
| No data found. | |||
| Section 6: Description of Incident | |||
DESCRIPTION OF INCIDENT (If Use Of Force, Include details such as name of supervisor applying the chemical agent and/or restraints, masons for use of hard restraints instead of soft restraints, etc.) Please be clear about cause(s) of the incident in your description.¶
On July 23. 2019 at approx. 1:27 a.m., a call for assistance on the Special Housing Unit was announced by the Control Center. Upon my arrival I was informed that an inmate had attempted suicide and proceeded to cell, Z05-124LA 4 ). I observed inmate Epstein, Jeffrey #76318-054 lying in the fetal position on the floor of his cell wearing a t-shirt an boxers. He was breathing heavily and was snoring. I called out to inmate Epstein and observed him flicker his eyes and continue snoring. His neck was red with no abrasions. I observed no further injuries to his person. An attempt was made to get the inmate to stand on his own with negative results. The inmate was placed in hand restraints and staff was di ed to retrieve the stretcher. As inmate Epstein was being placed on the stretcher by responding staff, he would open h s eyes and observe staff. When staff made eye contact with him, he would hurriedly shut his eyes. The inmate was lak n to HA-Unit, dressed in the suicide smock and placed on suicide watch.¶
Upon the arrival of medical staff, inmate Epstein was examined and treated by, MLP for a circular line of erythema at the base of the neck, one section on the front with marks of friction and a sma e hema on his left nee.¶
Section 7: Attachments¶
iftenarde* No data found. Orfalnal.Entered By¶
Approved By: NOT COMPLETED¶
UNCLASSIFIED/LIMITED OFFICIAL USE ONLY/LAW ENFORCEMENT SENSITIVE¶
This document is marked Unclassified/Limited Official Use Only/Law Enforcement Sensitive and may be disseminated, with p r attribution, to active Law Enforcement. DOD, or U.S. Intelligence Agencies. This document. or any segmenVattachment there f. may not be released without the approval of the Bureau of Prisons to any media sources, any non4aw enforcement entity, the general public or those without a *need to know.’ It contains information that may be exempt from public release under the provisions of the Privacy Act (5 U.S.C. 552).¶
3 of 3¶
CONFIDENTIAL SDNY_000 10634¶
UNITEL TATES GOVERNMENT Memorandum¶
FEDERAL BUREAU OF PRISONS Metropolitan Correctional Center¶
150 Park Row¶
New York New York 10007¶
July 23, 2019¶
MEMORANDUM FO¶
FROM:¶
SUBJECT: Possible Suicide Attempt¶
On July 23, 2019 at approx. 1:27 a.m., a call for assistance on the Special Housing Unit was announced by the Control Center. Upon my arrival I was informed that an inmate had attempted suicide and proceeded to cell, Z05-124LAD. I observed inmate Epstein, Jeffrey #76318-054 lying in the fetal position on the floor of his cell wearing a t-shirt and boxers. He was breathing heavily and was snoring. I called out to inmate Epstein and observed him flicker his eyes and continue snoring. His neck was red with no abrasions. I observed no further injuries to his person. An attempt was made to get the inmate to stand on his own with negative results. The inmate was placed in hand restraints and staff was directed to retrieve the stretcher. As inmate Epstein was being placed on the stretcher by responding staff, he would open his eyes and observe staff. When staff made eye contact with him, he would hurriedly shut his eyes. The inmate was taken to HA-Unit, dressed in the suicide smock and placed on suicide watch. While awaiting the arrival of an inmate companion, inmate Epstein sat on the edge of the bed and began moving forward as if he was attempting to fall over head first. When I looked away, he straightened up. As I turned to look at him again, he attempted the same act. I laid him down on the bed and directed him to cease his action or he would be placed in restraints for his safety. At that moment, he stated, “Okay, I won’t do it again,” and gave the thumbs up. Because of his unpredictable behavior, the decision was made to have a staff member observe inmate Epstein. I left HA-Unit in order to make staff notifications. Moments later, I spoke with Officer Clark- wh sta tein was alert and had indicated that his cellmate, had attempted to kill him and had been harassing¶
im e state e inmate had indicated that he’d informed his attorney of this matter.¶
I photographed and spoke with inmate who stated that he was asleep with his headphones on when he felt something hit his legs and said, “Jeff, what you’re doing?” He didn’t answer, so he got up, turned on the light and saw him with a string around his neck. He stated that he then called the guards and¶
ASensilive Limited Official Use Onlvir.¶
CONFIDENTIAL SDNY_00010636¶
they ran down. Upon f,…ner questioning, inmate ..fated that he sleeps on the bottom bunk, but gave it to inmate Epstein because he’s old. He stated that he sleeps on the floor on a mattress. He stated that when he got up, he couldn’t remember if he sat up or stood up to check on Epstein. He stated that Epstein was sitting on the floor leaning to the side with his eyes opened, but wasn’t responding. He stated that the last time he saw him he was snoring really loud.¶
Inmate Epstein stated that he came in fricau legal visit at approx. 8:00PM and staff handed him a copy of the Daily News. “M” was on the floor reading the Daily News. He stated that he had given it to him. He stated that mentioned that he’d been in court all day in Westchester and was carrying on. At that point, inmate paused as if he was making the story up as he went along, and stated that stated, “These fucking niggers. This place is inhumane, I wish I could report it. (Officer), that nigger hobbit mother fucker.” He then turned to a page in the Daily News that had his picture on it and stated that Epstein was worth seventy seven million dollars. Epstein stated that he took his picture, balled it up and threw it in the garbage. I asked inmate Epstein what happened prior to staffs arrival. He stated that at approx. 1:00 AM, he’d gotten up to get a drink of water, as he gets up every thirty minutes. He remember walking back to his bunk and waking up with staff there in his cell. I asked if he’d waken up and seen staff, why didn’t he respond when we were calling out to him? He stated that he only remembered hearing himself making a noise like snoring. When asked about the allegations against his cellmate, he stated that he was told, if he hurt him, staff wouldn’t care.¶
Duty medical, was notified and briefed. It was determined no further medical attention was needed. A medical assessment was not conducted at the time¶
of this incident, due to the fact, there was no medical staff available after 10:00 PM. iU on the arrival of medical staff, inmate Epstein was examined and treated by, MLP I for a circular line of erythema at the base of the neck, one section on the front wit marks of friction and a small erythema on his left knee.¶
ASensitive Limited Official Use Only=¶
CONFIDENTIAL SDNY_00010637¶
CONFIDENTIAL SDNY_00010638¶
UNITED STATES GOVERNMENT MEMORANDUM¶
Metropolitan Correctional Center, New York, New York¶
SUBJECT: Suicide Attempt Inmate Epstein#76318-054¶
On the above date at approx. I :27am While working in the Special Housing Unit Myself and S/O heard noise coming from the M tier Cell 124. Upon arrival inmate Epstein’s cell mate (Um was at the door stating I/M Epstein 476318-054 had attempted to hang himself. I ke t a visual while Officer grabbed door keys and called for assistance. After securing I/M and removing him from the cell, I entered then placed I/M Epstein on his side and removed an orange homemade rope from his neck. IIM was breathing at this time, But unresponsive. As I began chest compressions addition staff and Ops arrived, IIM was then removed from the Special I-lousing Unit without further incident.¶
CONFIDENTIAL SDNY_000 10639¶
CONFIDENTIAL SDNY_00010640¶
UNITED STATES GOVERNMENT MEMORANDUM¶
Metropolitan Correctional Center, New York, New York¶
SUBJECT: Inmate Epstein reg# 76318-054¶
On July 23, 2019 at approximately 1:27 AM while assigned to the Special Housing Unit, myself and Senior Officer Specialist heard some noises coming from M Tier. Upon checking cell Z05-124 I observed inmate Epstein reg# 76318-054 laying down near his bunk with what appeared to be a piece of handmade orange cloth around his neck. I immediately called Control Center for staff assistance. Officer kept a visual of inmate Epstein while I proceeded to retrieve the door keys and the cutter from the main cabinet located in the MPA. Officer applied restraints to his cell mate inmate . I secured inmate inside the bathroom while Officer provided assistance to inmate Epstein. When additional staffarrived inmate Epstein was removed from his cell without further incident.¶
CONFIDENTIAL SDNY_00010641¶
CONFIDENTIAL SDNY_00010642¶
UNITED STATES GOVERNMENT MEMORANDUM¶
Metropolitan Correctional Center, New York, New York¶
July 23, 2019¶
On July 23, 2019 at approximately 1:27, I. responded to a body alarm on the Special Housing Unit. While the 9-South officer was conducted rounds inmate Epstein, Jeffrey #76318-054 was found in his cell with a noose around his neck and appeared to be unresponsive. I assisted with taking inmate Epstein #76318-054 from his cell and putting him on a stretcher. The inmate was taken to the second floor and placed on suicide watch, where he was monitored by staff. Moments afterwards, inmate Epstein became responsive. While observing inmate E stein he sat u on the bed and began telling me that he think his Bunkie,¶
tried to kill him. Inmate Epstein also stated that his Bunkie also tried to extort money from him and stated that if he didn’t pay him that he would beat him up. He stated that this has been going on for a week. I asked inmate Epstein if he told staff about this and he told me no, that he’d only told his lawyer. He went on to say that his Bunkie told him that if he beat him up, because of his charges, the officers would not report it and because of this he was not comfortable telling the officers about the prolong threats and alleged attempts to extort him. I immediately reported this to the lieutenant.¶
CONFIDENTIAL SDNY_00010643¶
At approximately 1:27AM, I responded to a radio transmission asking for staff assistance on 9 South (Special Housing Unit). Once I was granted access to said unit I made my way to the location (M Tier) in which the disturbance stemmed from. I was told by Officer that Epstein, Jeffrey I/M# 76318-054 has attempted to hang himself. Upon arrival to cel!” 124 in which he was housed, I noticed J. Epstein I/M# 76318-054 on the floor and OfficerS placing restraints on him. Officer and I entered said cell attempting to assist in said process.¶
Now that I am inside of the cell I notice that J. Epstein I/M# 76318-054 was snoring on the floor of his cell, he appeared to be asleep. We made several verbal commands for him to wake up and attempted to get him to his feet but they were all unsuccessful. After said attempts a asked for a stretcher to be retrieve to safely remove him out of his cell. Once stretcher arrived, Officer…, Officer.M and I lifted J. Epstein I/M# 76318-054 off the floor and placed him on the stretcher. Once we secured him safely on the stretcher, Officers IM and I lifted J. Epstein I/M# 76318-054 who is now on the stretcher safely out of 9 SouTh (Special Housing Unit) and into the awaiting elevator.¶
EFTA00034288¶
CONFIDENTIAL SDNY_00010645¶
CONFIDENTIAL SONY_00010646¶
UNITEL ‘TATES GOVERNMENT Memorandum¶
FEDERAL BUREAU OF PRISONS Metropolitan Correctional Center¶
150 Park Row¶
New York New Ynrk 10007¶
July 23, 2019¶
MEMORANDUM FOR ALL CONCERNED¶
FROM:¶
Material Handler Supervis¶
SUBJECT: Possible Suicide Attempt¶
On July 23, 2019 at approx. 1:27 a.m., the Control Center announced a call for assistance on the Special Housing Unit. Upon my arrival to 9-South, I/M Epstein, Jeffrey #76318-054 was lying on the floor of his cell handcuffed. I assisted with carrying inmate Epstein to HA-Unit on a stretcher, where he was dressed in a suicide smock and placed on Suicide Watch observation with staff.¶
ASensitive Limited Official Use Only=¶
CONFIDENTIAL SDNY_00010649¶
7/23/2019 7.02.27 AM¶
| Post | Split Shift | 2 00:00 - 08:00 | 3 06:00 - 14:00 | 8 08:00 - 16:00 | 10 14:00 -22:00 | 12 16:00 00:00 |
|---|---|---|---|---|---|---|
| CAPTAIN | 6 $ | |||||
| CAPTAIN SEC | 6tC | |||||
| OPS LT | 2 | -6=s | 12 | |||
| ACT LT | 3 | ”10S IS OT | ||||
| ADMIN LT | 6 | |||||
| SHU LT | ••10 | |||||
| SIS LT | 6 | |||||
| SIS LT #2 | 6 | |||||
| SIA | 8 | |||||
| SIS TECH #1 | 8 | |||||
| SIS TECH #2 | 3 | |||||
| PHONE MONITOR | 8 | |||||
| SEC OFFICER #1 | 3 | |||||
| SEC OFFICER #2 | 8 Reyes, d $ | |||||
| TOOL ROOM | ’16 | |||||
| SEARCH OFFICER | ||||||
| 2 SALLY OFF | ||||||
| 3 SALLY OFF | ||||||
| LOBBY CONTROL #1 | 3 | 10 | ||||
| CONTROL #2 | a$ | 8 | 12 | |||
| INTERNAL | ”2 | 10 | ”12 | |||
| OT IMO 01:30 | ||||||
| INTERNAL #2 | CT | ”12 | ||||
| ATTY CONF | “‘8 OT | I 12 | ||||
| UNIT 2 | 2 | 8_$ | 12 IIII | |||
| UNIT 3 | $ OT | 8 | 12 5 | |||
| 5 NORTH | OT | *-8 | 12 | |||
| 5 SOUTm | $ OT | 8 | 12 | |||
| 7 NORTH | ”2 OT | B | 12 | |||
| 7 SOUTH | 2 $ | 5 ”ES OT | / | 12 | ||
| 9 NORTH | ”8 OT | 12 | ||||
| SHU 01 | ”2 W OT | I | ||||
| SHU #2 | OT | OT | 12 | |||
| SHU #3 | (NCI | 10 | ||||
| SHU #4 | $ OT | ”12 | ||||
| 10 SOUTH #1 | 2 | 12 | ||||
| 10 SOUTH #2 | 3 | “10 OT |
6 07:00 .15:00 9 12:00 - 20:00¶
Tuesday July 23. 2019¶
Page 1¶
CONFIDENTIAL SDNY_000 10650¶
| REC OFFICER #1 | |||
|---|---|---|---|
| MC OFFICER 02 | |||
| 11 NORTH | I=I a o | -a WM | 12 |
| 11 SOUTH | ;Sy | ’1 | i |
| 11 SOUTH #2 | 12 | ||
| REAR GATE | |||
| OSP 01 | $ | $ | $ I |
| SANITATION OFF | $ | ||
| VISIT #1 | |||
| VISIT 02 | OT | ||
| VISIT 03 | |||
| ****Special Assignments’ | |||
| EPO OFFICE | |||
| ESCORT OFF Al | |||
| ESCORT OFF #2 | |||
| LOBBY #2 | $ D g | ||
| PHONE RM | ai | ||
| TOWN DRIVER | 10MID | ||
| SUICIDE WATCH | OT (NC) 01:30 08:00 | 8 | 12 |
| ***Back Page Categorise” | |||
| DAY OFF | |||
| a | t so | ||
| SICK LEAVE | |||
| ANNUAL LEAVE | |||
| LWOP | |||
| LWOP(M) | |||
| AWOL | |||
| SUSPENSION | |||
| OFFICIAL TIME | |||
| 7/23/2019 7:02:34 AM | |||
SDNY_00010651 EFTA00034294¶
| Tuesday July A ale Pare3 | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| COP | |||||||||
| WM , | |||||||||
| IF TRAINING | |||||||||
| Change Records"" - | |||||||||
| Post | Spit Shit Officer | Relieved Officer’s Now Status | Relieving Officer | Relieving Officer’s Provious Status | Ret | Shit Changed By | |||
| TOOL ROOM | 8 | [Sick / Annual] | 7/14 13:31 | ||||||
| [Sick/ Annual] | (Removed) | 7/14 13:52 | |||||||
| CONTROL #2 | 3 | Annual Leave | 7/16 07:54 | ||||||
| (sp)PHONE RM 2 | 8 | 3 CONTROL *2 | S 7/16 07:54 | ||||||
| SHU #1 | 8 | LWOP(M) | S 7/16 09:22 | ||||||
| INTERNAL | 8 | Annual Leave | S 7/180929 | ||||||
| INTERNAL | 8 | 87 SOUTH | 7/1612:07 | ||||||
| UNIT 3 | 2 | EM 5 | Annual Leave | Y | W 7/1718:58 | ||||
| Shift UNIT 3 | ill S | T/CT | Stan End | ||||||
| Annual Leave | $ | ||||||||
| ATTY CONF | 8 | MM $ | Annual Leave | Y | 7/18 08,00 | ||||
| Shift ATTY CONF | III $ | /CT T | Start | End | |||||
| 7 SOUTH | 8 | Annual Leave | 2 9 NORTH | 7/18 10:11 | |||||
| Shift 7 SOUTH 9 NORTH | is s $ | T/CT | Start | End | |||||
| SHU LT | 10 | Sick Leave | 7/1810:19 | ||||||
| LWOP | 8 PHONE RM 2(sp) | 7/1611:35 | |||||||
| 5 SOUTH | 2 | 810 SOUTH #1 | Y | 7/18 12:10 | |||||
| Shift 5 SOUTH 10 SOUTH N1 | OT/CT Start DT | End | |||||||
| (Inserted NCS) | (Sick/Annual) | 7/19 10:19 | |||||||
| INTERNAL | 2 | [Sick / Annual] | IIIN 7/1910:19 | ||||||
| 10 SOUTH #2 | 10 | $ | Annual Leave | `V | 7/19 12:15 | ||||
| Shift 10 SOUTH #2 | IS $ | FrT/CT QT | Start | End | |||||
| Annual Leave | |||||||||
| ACT LT | 10 | I S | 8 OPS LT | Y Jr7/21 14:10 | |||||
| Shift | ii | MT Stan •T | End | ||||||
| ACT LT OPS LT | J$ ,J$ | ||||||||
| SHU #2 | 2 | 12 SHU 04 | 7/22 08 21 | ||||||
| Shift | •T/CT | Start | End | ||||||
| SHU #2 | T | ||||||||
| SHU *4 | IIIIIII $ 3 REC OFFICER #1 | Y RAN 7/22 08:28 | |||||||
| VISIT #2 | 9 | Dubenerie, D $ Shift | OT/CT | Start | End | ||||
| MISR 102 | OT | ||||||||
| REC OFFICER #1 |
CONFIDENTIAL SDNY_000 10652¶
| Page 4 | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Post | Spit Shft Officer | Relieved Officers New Status | Relieving Officer | Relieving Officer’s Previous Status | Ret | Shft Changed By | |||
| VISIT #2 | 9 | $ | (Sick / Annual) | RW 72208:27 | |||||
| [Sick / Annual) | $ | [Removed] | RW 7/22 08:27 | ||||||
| 7 NORTH | 2 | 12 7 NORTH | Y RW 72208:34 | ||||||
| Shift 7 NORTH 7 NORTH | Staff | prim’ Start OT | End | ||||||
| 11 NORTH | 2 | $ | Day Off | Y RW 7/22 08:45 | |||||
| Shift 11 NORTH Day Off | Staff S I | OT/CT OT | Start | End | |||||
| (sp}PHONE RM 2 | 8 | Sick Leave | KR 7/22 09:05 | ||||||
| SHU #1 | 2 | 12 SHU #1 | Y PJAI 7/22 09:20 | ||||||
| Shift SHU #1 SHU #1 | Staff | pT/CT | Start | End | |||||
| [Inserted NCS] | (Sick/Annual) | 7/22 09:39 | |||||||
| SHU #3 | 3 | [Sink / Annual) | 7/22 09:39 | ||||||
| SHU #4 | 8 | 2 SANITATION OFF | Y R.N 7/22 10:04 | ||||||
| Shift SHU #4 SANITATION OFF | Staff | OT/CT OT | Start | End | |||||
| SHU #1 | 8 | $ | 8 SHU #2 | RW 72210:19 | |||||
| SHU #2 | 8 | Day Off | Y | 7/22 10:19 | |||||
| Shift SHU #2 Day Off | Staff | T TICT T | Start | End | |||||
| 7 NORTH | 2 | pick /Annual] | RW 722 10:43 | ||||||
| (Sick / Annual) | [Removed) | RW 7722 10:43 | |||||||
| 9 NORTH | 8 | 2 UNIT 2 | Y | RW 7/22 11.04 | |||||
| Shift 9 NORTH UNIT 2 | Staff $ | OT/CT OT | Start | End | |||||
| 11 NORTH | 8 | 2 11 SOUTH | AIR 722 14:34 | ||||||
| 5 NORTH | 8 | r | 2 5 NORTH | MR 7/22 14:37 | |||||
| INTERNAL #2 | 2 | Annual Leave | V | RW7/22 14:45 | |||||
| Shift INTERNAL #2 Annual Leave | Staff | OT/CT CT | Start | End | |||||
| 7 NORTH | 2 | Day Off | Y | 7/22 14:58 | |||||
| Shift 7 NORTH Day Off | Staff | T/CT T | Start | End | |||||
| VISIT #2 | 9 | $ | 3 REC OFFICER #1 | Y | W 7/22 15:28 | ||||
| Shift VISIT #2 REC OFFICER #1 | Staff | OT/CT OT | Start | End | |||||
| 5 NORTH | 2 | $ | 12 UNIT 3 | Y MR 7/22 18:12 | |||||
| Shift 5 NORTH UNIT 3 | Staff $ ■ $ | OT/CT OT | Start | End |
CONFIDENTIAL SDNY_00010653¶
EFTA00034296¶
Tuesday July 23, 2019¶
| Tuesday July 23, 2019 | Pago 5 | |||||||
|---|---|---|---|---|---|---|---|---|
| Post | Spit Shft Officer | New Status | Relieving Officer | r - - - Previous Status | Shft C41811Qed By | |||
| 11 SOUTH | 2 | 12 UNIT 2 | Y SJ 7/22 1921 | |||||
| Shift 11 SOUTH UNIT 2 | if | 07/C7 Start OT | End | |||||
| INTERNAL | 12 | $ | 12 SHU 04 | SJ 7221922 | ||||
| SHU 02 | 2 | $ | (Sick / Annual) | & 7/2221:14 | ||||
| [Sick / Annual) | $ | (Removed) | & 7/22 21:14 | |||||
| SHU 02 | 2 | Shift SHU 02 INTERNAL 02 | 12 INTERNAL 02 11 | Y S, 7/2221:14 OT/Cr Start 01 | End | |||
| 5 SOUTH | 2 | Echandi. M | (Sick /Annual) | 11 7/22 22:08 | ||||
| [Sick / Annual) | [Removed] | 11722 22:08 | ||||||
| 5 SOUTH | 2 | Shift 5 SOUTH INTERNAL | 12 INTERNAL tall $ $ | Y | 7/22 22:12 Start OT/CT OT | End | ||
| Unsoiled NCS) | (Sick/Annual] | 7/23 04:30 | ||||||
| (ap)Suickle Watch | 2 | [Sick / Annual) | 7/23 C4:31 | |||||
| (sp)Suicide Watch | 2 | (Time Change] | Shift Suicide Watch | l’ i | el 7/23 04:31 Start OT/CT OT 01:30 | End 08:00 | ||
| INTERNAL | 2 | (Time Change] | Shift INTERNAL | Staff | k | 7/23 04:32 Start 0T/CT QT 00:00 | End 01:30 | |
| 11 SOUTH | 8 | Sick Leave | 7/23 05:05 | |||||
| Evening Watch | Morning Watch 8 AM Watch 7 Day Watch 23 PM Watch 6 17 —Back Pago Categories” Sick Leave 4 Day Off 20 Annual Leave 7 1 LWOP LWOP(M) 4 AWOL 9 1 SUSPENSION 1 OFFICIAL TIME COP 2 IF TRAINING 3 Total Correctional Svcs. Staff: 113 Non Correctional Svcs. Staff: 2 Overtime Occurrences: 18 Comptlme Occurrences: I | |||||||
| Ops Lt. Evening Watch Signature: | ||||||||
| Captain’s Signature: | ||||||||
| 7/23/2019 7:02:36 AM | ||||||||
| CONFIDENTIAL | SDNY_000 10654 |
Bureau of Prisons Health Services Clinical Encounter¶
| Clinical Encounter | |
|---|---|
| Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: Encounter Date: 07/23/2019 06:20 Provider: | Reg #: 76318-054 WHITE Facility: NYM H01 Unit: |
| Injury Assessment - Non-work related encounter performed at Health Services. SUBJECTIVE: | |
| INJURY 1 Provider: | |
| MLP Date of Injury: Date Reported for Treatment: 07/23/2019 01:27 | 07/23/2019 08:25 |
| Work Related: Work Assignment: No | UNASSG |
| Pain Location: | |
| Pain Scale: 0 | |
| Pain Qualities: | |
| Where Did Injury Happen (Be specific as to location): | |
| Special Housing Unit Z05-Cell 124 L | |
| Cause of Injury (Inmate’s Statement of how injury occurred): | |
| 1 do not know. Just went to drink a little water and wake up snorting’. | |
| Symptoms (as reported by inmate): | |
| None | |
| OBJECTIVE: Temperature: ade Fahrenheit Location Time Celsius 07/23/2019 06:30 NYM 36.4 Oral 97.5 | Provider MLP |
| Pulse: | |
| Location Time Rate Per Minute DAM | Provider .BMttlam |
| 07/23/2019 06:30 92 Via Machine | Regular MLP |
| Respirations: | |
| Date Rate Per Minute Provider Time . MLP 07/23/2019 06:30 NYM 16 | |
| Blood Pressure: | |
| Position Date Time Value Location 07/23/2019 06:30 NYM 140/85 Right Arm Sitting | Cuff Size Provider MLP Adult-regular |
| SaO2: | |
| Air t Time Valuer/id Provider S[ 07/23/2019 06:30 NYM 96 Room Air | MLP |
| Exam: | |
| General | |
| Affect | |
| Yes: Cooperative | |
| Appearance | |
| Yes: Appears Well, Alert and Oriented x 3 | |
| No: Appears Distressed, Lethargic, Dyspneic, Appears in Pain. Pallor, Cyanotic, Diaphoretic, Disheveled, | |
| Generated 0723/201909 05 by MM. MLP Bureau of Prisons - NYM | Page 1 of 2 |
CONFIDENTIAL SDNY_00010655¶
CONFIDENTIAL SDNY_00010656¶
| Inmate Name: | EPSTEIN. JEFFREY EDWARD | Reg #: | 76318.054 | |||
|---|---|---|---|---|---|---|
| Date of Birth: | 01/20/1953 | Sex: | M | Race: WHITE | Facility: NYM | |
| Encounter Date: 07/23/2019 06:20 | Provider: | MLP | Unit: | H01 |
Exam:¶
Acutely Ill¶
Pulmonary¶
Auscultation¶
Yes: Clear to Auscultation, Vesicular Breath Sounds Bilaterally¶
No: Crackles, Rhonchi, Wheezing¶
Exam Comments¶
Inmate for injury report as requested by Operational Lt.¶
He is ambulatory, oriented x 3. In not apparent distress, smiling during this clinical encounter. Alleges, that he does not know what happened. Can not explain the marks on his neck. Responded: 1 don’t know”.¶
He does not want to talk of the events leading to the marks on his neck.¶
He does not look in any distress or pain.¶
Has an circular line of erythema at the base of the neck. Reaching 2/3 of the neck circumference, 2 inches wide, sparing the back of the neck. Has one section of this erythema in the front with marks of friction.¶
No inflammation, no deformities, no hematomas, no lacerations, no tenderness. Patient moving his neck without any restriction. Denies having any pain or discomfort. Denies any respiratory problem.¶
Has another small erythema on left knee about 2cm in diameter(mild).¶
As per information from custody staff inmate Epstein was found in his cell with a rope around his neck and sitting on the floor.¶
Inmate is currently placed on suicide watch.¶
ASSESSMENT:¶
Injury, unspecified. T1490 - Current - RIO self inflicted injuries.¶
PLAN:¶
Disposition:¶
Follow-up at Sick Call as Needed Placed on Suicide Watch Follow-up in 2-4 Hours¶
Other:¶
For follow up with psychology service.¶
Patient Education Topics:¶
| Date Initiated 07/23/2019 07/23/2019 | Format Counseling Counseling | Handout/Topic Access to Care Plan of Care | provider | Outcome Verbalizes Understanding Verbalizes Understanding |
|---|---|---|---|---|
| Copay Required: No TelephoneNerbal Order: No | Cosign Required: Yes | |||
| Completed by | MLP on 07/23/2019 09:05 | |||
| Requested to be cosigned by | MD. Cosign documentation will be displayed on the following page. | |||
Generated 07/23/2019 09:05 by MLP Bureau of Prisons - NYM Page 2 of 2¶
CONFIDENTIAL SDNY 00010657¶
Metropolitan Correctional Center New York, N.Y. Photo Sheet Special Investigative Section¶
| Type of Incident | Possible Suicide Attempt |
|---|---|
| Date and Time of Incident | 07/23/19 - 1:27 AM |
| Inmate Name/Register Number | Epstein, Jeffrey #76318-054 |
| Location of Incident | Special Housing Unit |
| 1 Photograph(s) by | a , Lieutenant |
| Date and Time of Photo | 07/23/19 -1:45 AM |
CONFIDENTIAL SDNY_00010658¶
Lieutenant’s Office¶
Metropolitan Correctional Center New York, N.Y. Photo Sheet Special Investigative Section¶
| Type of Incident | Possible Suicide Attempt |
|---|---|
| Date and Time of Incident | 07/23.779- 1:27 All |
| Inmate Name/Register Number | Epstein, Jeffrey #76318-054 |
| Location of Incident | Special Housing Unit |
| Photograph(s) by | Lieutenant |
| Date and *lime of Photo | 07;23:19-1:45 Adl |
CONFIDENTIAL SDNY_000 10659¶
Metropolitan Correctional Center New York, N.Y. Photo Sheet Special Investigative Section¶
| Type of Incident | Possible Suicide Attempt |
|---|---|
| Date and Tune of Incident | 07/23/19- 1:27 AM |
| Inmate Name/Register Number | Epstein, Jeffrey #76318-054 |
| Location of Incident | Special Housing Unit |
| Photograph(s) by | . Lieutenant |
| Date and Time of Photo | 07/23/19 -1:45 AM |
CONFIDENTIAL SDNY_000 10660¶
reittenatil .s Office¶
Metropolitan Correctional Center New York, N.Y. Photo Sheet Special Investigative Section¶
CONFIDENTIAL SONY_00010661¶
Metropolitan Correctional Center New York, N.Y. Photo Sheet Special Investigative Section¶
| Type of Incident | Possible Suicide Attempt | |
|---|---|---|
| Date and Time of Incident | 1:2’ Al! 07723 19 | |
| Inmate Name/Register Number | Epstein, Jeffrey #76318-0.5-1 | |
| Location of Incident | Special Housing Unit | |
| Photograph(s) by | ||
| Date and Timc of Photo | 07/23.19 -1:.15.4.11 |
CONFIDENTIAL SDNY_000 10662¶
Lieutenant’s Office¶
Metropolitan Correctional Center New York, N.Y. Photo Sheet Special Investigative Section¶
| — | ||
|---|---|---|
| Type of Incident r | Possible Suicide Attempt | |
| Date and Time of Incident | 1:27,4A/ 07/23/19 | |
| Inmate Name/Register Number | Epstein. Jeffrey 1176318-054 | |
| Location of Incident | Special Housing Unit | |
| Photograph(s) by | ||
| Date and Time of Photo | 23;19 -1:45 AM 07 |
CONFIDENTIAL SDNY_000 10663¶
Lieutenant’s Office¶
Metropolitan Correctional Center New York, N.Y. Photo Sheet Special Investigative Section¶
| Type of Incident | Possible Suicide Attempt | |
|---|---|---|
| I)atc and Time of Incident | O23/9 1:27A,11 | |
| Inmate Name/Register Number | Epstein, Jeffrey #76318-054 | |
| Location of Incident | Special Housing Unit | |
| Photograph(s) by | . Lieutenant | |
| Date and Time of Photo | OT 23 • 19 -1:45 AM |
.O,0 L.,:¶
CONFIDENTIAL SDNY_00010664¶
N lite¶
Metropolitan Correctional Center New York, N.Y. Photo Sheet Special Investigative Section¶
| Type of Incident | Possible Suicide Attempt | |
|---|---|---|
| Date and Time of Incident | 07/23/19 — 1:27 AAtt | |
| Inmate Name/Register Number | Epstein, Jeffrey #76318-054 | |
| Location of Incident | Special Housing Unit | |
| Photograph(s) by | I , Lieutenant | |
| Date and Time of Photo _ |
CONFIDENTIAL SDNY_000 10665¶
Metropolitan Correctional Center New York, N.Y. Photo Sheet Special Investigative Section¶
CONFIDENTIAL SDNY_000 10666¶
Lieutenant’s Office¶
Metropolitan Correctional Center New York, N.Y. Photo Sheet Special Investigative Section¶
| Type of Incident | Possible Suicide Attempt(Celltnate) |
|---|---|
| Date and Time of Incident | 07/23/19 1:27 AM |
| Inmate Name/Register Number | |
| Location of Incident | Special Housing Unit |
| Photograph(s) by | I , Lieutenant |
| Date and Time of Photo | 07 23/19 -2:25 A.11 |
CONFIDENTIAL SDNY_00010667¶
Lieutenant’. (1ilice¶
Metropolitan Correctional Center New York, N.Y. Photo Sheet Special Investigative Section¶
| Type of Incident | Possible Suicide Aueinpt(Cellmate) |
|---|---|
| Date and Time of Incident | 07/23/19 - 1:27 AM |
| Inmate Name/Register Number | #78514-054 |
| Location of Incident | Special Housing Unit |
| Photograph(s) by | I. . Lie:dentin! |
| Date and Time of Photo | rr 23 /9 -2:25 AM |
1-v v¶
Lieutenant’s Office¶
Metropolitan Correctional Center New York, N.Y. Photo Sheet Special Investigative Section¶
| Type of Incident | Possible Suicide Attempt(Cellmate) |
|---|---|
| Date and Time of Incident | 07/23/19 - 1:27 AM |
| Inmate Name/Register Number | |
| Location of Incident | Special housing 11th/! |
| Photograph(s) by | , Lieutenant |
| Date and Time of Photo | 07/23/19 -2:25 AM |
CONFIDENTIAL SONY_00010669¶
Lieurenatult Office¶
Metropolitan Correctional Center New York, N.Y. Photo Sheet Special Investigative Section¶
| Type of Incident | Possible Suicide Attempt(Cellmate) |
|---|---|
| Date and Time of Incident | 1:27 A.11 07/23/19 |
| Inmate Name/Register Number | 478514-054 |
| Location of Incident | Special Housing Unit |
| Photograph(s) by | a Lieutenant |
| Date and Time of Photo | 07:23; 19 -2:25 All |
CONFIDENTIAL SDNY_000 10670¶
Lieutenant’s Office¶
Metropolitan Correctional Center New York, N.Y. Photo Sheet Special Investigative Section¶
| Type of Incident | Possible Suicide Attempt(Cellmate) |
|---|---|
| Date and ‘lime of Incident | 07/23/19 - 1:27 AM |
| Inmate Name/Register Number | |
| Location of Incident | Special Housing Unit |
| Photograph(s) by | Lieutenant |
| Date and Time of Photo | 07/23/19 -2:25 AM |
CONFIDENTIAL SDNY_000 10671¶
ADMINISTRATIVE DETENTION ORDER U.S. DEPARTMENT OF JUSTICE¶
FEDERAL BUREAU OF PRISONS¶
| NEWYORK MCC | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| InstitutOn | |||||||||
| asiomme 07-10-2019 | |||||||||
| TO Speommonmin humaffires_ | |||||||||
| FROM | (Name/Title) | ||||||||
| SUBJECT Placement of | EPSTEIN. JEFFERY | . Reg. No. | 7-10-2019 | in Administrative Detention | |||||
| (a) Is pending an investigation for a violation of Bureau regulations; | |||||||||
| (b) Is pending an SIS investigation | |||||||||
| (c) Is pending investigation or trial for a criminal act: | |||||||||
| (d) Is to be admitted to Administrative Detention | |||||||||
| (I) Since the urinate has requested admission for protection. | |||||||||
| I hereby request placement in Adminstrative Detention for my own protection | |||||||||
| Inmate Signature/Register No.: | |||||||||
| Staff Witness Printed Name Signature’ | |||||||||
| (2) Since a serious threat exists to indmduars safety as perceived by staff. although person has not requested admission. referral of the necessary information will be forwarded for an appropriate hearing by the SRO | |||||||||
| (e) | Is pending transfer or is in holdover status during transfer | ||||||||
| it (I) | Is pending classification or | ||||||||
| designee. | Is terminating confinement in Disciplinary Segregation and has been ordered into Administrative Detention by the Warden’s | ||||||||
| PENDING CLASSIFICATION | Kis this Correctional Supervisors decision based on all the circumstances that the above named inmates continued presence in the general population poses a serious threat to life. properly. self, staff. other inmates. or to the secunty or orderly running of the institution because | ||||||||
| Therefore, the above named inmate is to be placed In Administrative Detention until further notice. The inmate received a copy of Iris Order on | |||||||||
| (dale/ time) | - t | ||||||||
| StallWitness Signature/Printed Name | Date | / C5 ? ” | |||||||
| Supervisor 24 hour review of placement: Signature/Printed name | |||||||||
| documented here. | ’ In the case of OHO anon, reference to that order is sufficient. In other cases. the Correctional supervisor wit make an independent review and decision, wnich is | ||||||||
| Record Copy • Inmate Concerned (not necessary if placement is a result of holdover status): Copy • Captain. Copy - Unit Manager: Copy - Oper - Administrative Detention Unit: Copy — Psychology. Copy - Central File | ’COPY | ||||||||
| Prescribed by P5270 | (Replaces BP-A0308 of JAN 88) | Isli et 6 1 |
CONFIDENTIAL SDNY_000 10672¶
| INCIDENT REPORT | ||||||||
|---|---|---|---|---|---|---|---|---|
| J.S. DEPARTMENT OF JUSTICE | FEDERAL BUREAU OF PRISONS | |||||||
| 1. institution’ ‘ MCC New York | Part I — Incident Report | Incident Report Numbe | ||||||
| 27Inmates Name: | 3. Register Number: | 4. Date of Inciden | ||||||
| Epstein , Jeffery | 76318-054 | 07/23/2019 | 1:27am | |||||
| S. Place of Incident: | 7. Assignment | . Unit: | ||||||
| SEW M-Tier Cell 124 | Unassigned | ZA | ||||||
| 9. Incident: Self-Mutilation | 1 10. Prohibited Act Code (S)r 228 | |||||||
| 11. Desaiption of Incident (Date: 07/23/2019 | Time: 1:27AM | Stall became aware of incident): | ||||||
| On July 23.2019 at approx. 1:27am While working in the S arrival um’s Epstein.Jefferylt76318.054 cell mate (UM hang himself I kept a visual while 5/0 him from the calif entered-then placed But unresponsive. Addition staff and 0 s | rabbed I ie oor teys an ca pstein on his side and removed a orange homemade rope rrived UM was then removed from SHU | ecial Housing Unit Myself and 5/0 lEheard noise corning from the M tier cell as at the door slating UM Epstein.Jeff for assistance. After Sec—urine- 9M from his n | wasbreathing at thus | 124 Upon 76318-054 had attempted to wand removing | ||||
| 12. Typed Name | ||||||||
| Employee: | 07/23/2019 3:30am | 13. Date And Time | ||||||
| 14. Incident Repot | Inmate by | 15. Date InJ ent Repon Delivered: | 18. Time Incident Report Delivered: | |||||
| (Type Name | ||||||||
| Part II — Committee Action | ||||||||
| 18. A. It is the finding of the committee that you: Did not Commit a Prohibited Act. | Committed the Prohibited Act as charged: Committed Prohibited Act Code (s). | B. 1 Heargia_, C I I | The Committee is referring the Charge(s) to the OHO for further The Committee advised the inmate of its finding and of the right to Me an appeal within 20 calendar days. | |||||
| 19. Committee Decision is Based on Specific Evidence | as Follows: | |||||||
| 20. Committee action and/or recommendation if referred to OHO (Contingent | upon DHO finding inmate committed proNbited act): | |||||||
| 21. Date and Time of Action: | ||||||||
| accurately reflects the UDC proceedings). | (The UDC Chairmanws signature certifies who sat on the UDC and that | the completed report | ||||||
| airman (Typed Name/Signature). | Member (Typed Name): | Member ( fyped Name): | ||||||
| INS1RUCT | IONS: All items outside of heavy rule are for staff use only. Begin | entries with the number 1 and work up. Entnes not completed | wilt be | |||||
| voided by staff. | ||||||||
| DisInbule: Onginal.Central File Record: COPY-WHO | COPY.2-Inniate after UDC Action. COPY 3.Inniale | within 24 hours of Part I Preparation |
PDF¶
CONFIDENTIAL¶
Presuibed by P5270 Replaces BP-A0288 of AUG 11¶
SONY_000 10673 EFTA00034316¶
| Part III - Investigation | 22. Date And Time Investigation Began |
|---|---|
| 23. Inmate Advised Of Right To Remain Silent: You are advised of your right to remain silent at all stages of the discipline process. Your silence may be used to draw an adverse inference against you at any stage of the discipline process. Your silence alone may not be used to support a finding that you have committed a prohibited act. | |
| The Inmate Was Advised Of The Above Right By | At (Date/time) |
| 24. Inmate statement and attitude | |
| 25. Other facts about the incident, statements of those persons present at scene, disposition of evidence, etc. | |
| 26. investigator’s comments and conclusions | |
| 27. Action taken | |
| Date and Time Investigation Completed | |
| Printed Name/Signature Of Investigator | 7ith: |
| PDF Prescribed by P5270 | Replaces BP-S288 052 Of MAY 94 |
CONFIDENTIAL¶
SDNY_00010674 EFTA00034317¶
~oP _ Air /e9 / a..// IA/ k i k et, 7-43/4 CONFIDENTIAL SDNY_00010675¶
Bureau of Prisons Health Services Clinical Encounter¶
| Clinical Encounter | |||||||
|---|---|---|---|---|---|---|---|
| Inmate Name: WHITE M Race: Sex: Date of Birth: PA-C Encounter Date: 07/31/2019 14:11 Provider: | Reg tt: Facility: NYM Unit: | 78514-054 Z06 | |||||
| Mid Level Provider - Evaluation encounter performed at Special Housing Unit. | |||||||
| SUBJECTIVE: | |||||||
| PA-C Provider: COMPLAINT 1 | |||||||
| Chief Complaint: No Complaint(s) “I feel good today, can’t complain. My anxiety is getting better and I have no side effect from Subjective: the new anxiety medication” IM being seen in the SHU as per the request of lieutenants. States he’s been doing well and has no acute complaints. For what happened to his previous cell mate about a week ago, states “I have no idea what was going on. I didn’t do anything and I have no injury” Pain: No | |||||||
| OBJECTIVE: | |||||||
| Pulse: | |||||||
| &Winn Rate Per Minute Location Time pate Via Machine 71 07/31/2019 14:19 | Provider | PA-C | |||||
| Respirations: | |||||||
| Rate Per Minute ProvideC Date Time PA-C 15 14:19 NYM 07/31/2019 | |||||||
| Blood Pressure: | |||||||
| Cuff Size Position Value Location lime Date Adult-regular Sitting Left Arm 118/70 07/31/2019 14:19 NYM | Provider | PA-C | |||||
| SaO2: | |||||||
| Provider Time ValuefToi Air Date PA-C 98 Room Air 14:19 NYM 07/31/2019 | |||||||
| Exam Comments | |||||||
| General: AAOx3. NAD HEENT: PERRLA. EOMI. Nares patent. Neck: Supple Heart: S1, S2. RRR Lungs: CTAB EXT: No edema. Neuro: Grossly normal CN | |||||||
| ASSESSMENT: | |||||||
| Encounter for general adult medical exam without abnormal findings, Z0000 - Current | |||||||
| PLAN: | |||||||
| Disposition: | |||||||
| Follow-up at Sick Call as Needed |
Other:¶
Generated 07/31/2019 14:39 by PA-C Bureau of Prisons- NYM Page 1 of 2¶
CONFIDENTIAL SONY_00010676 EFTA00034319¶
| Inmate Name: 1 10110/1967 Date of Birth: Encounter Date: 07/31/2019 14:11 | Race: WHITE M Provider: | 78514.054 Reg #: Facility: NYM Z06 Unit: | |||
|---|---|---|---|---|---|
| IM states he feels as himself and denies being in acute distress. | |||||
| Patient Education Topics: Date Initiated Format Counseling 07/31/2019 | Handout/Topic Access to Care | Outcome Provider Verbalizes MEM Understanding | |||
| Copay Required: No TelephoneNerbal Order: No | Cosign Required: Yes | ||||
| Completed by -PA-C Requested to be cosigned by | on 07/31/2019 14:39 MD. | ||||
| Cosign documentation will be displayed on the following page. |
Generated 07/31/2019 14:39 by PA•C¶
Bureau of Prisons • NYM Page 2 of 2¶