EFTA00045995

# Bureau of Prisons Health Services Clinical Encounter

| Inmate Name: | EPSTEIN, JEFFREY EDWARD |

| :--- | :--- |

| Date of Birth: | 01/20/1953 |

| Encounter Date: | 07/23/2019 06:20 |

<table border="1"><tr><td>Sex:</td><td>M</td><td>Race:</td><td>WHITE</td></tr><tr><td>Provider:</td><td colspan="3">Joaquin, Y. MLP</td></tr></table>

<table border="1"><tr><td>Reg #:</td><td>76318-054</td></tr><tr><td>Facility:</td><td>NYM</td></tr><tr><td>Unit:</td><td>H01</td></tr></table>

Injury Assessment - Non-work related encounter performed at Health Services.

## SUBJECTIVE:

# JURY 1 Provider: Joaquin, Y. MLP

**Date of Injury:** 07/23/2019 01:27 **Date Reported for Treatment:** 07/23/2019 08:25

**Work Related:** No **Work Assignment:** 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):**

- "I do not know. Just went to drink a little water and wake up snorting."

**Symptoms (as reported by inmate):**

- None

## OBJECTIVE:

## Temperature:

<table><thead><tr><th>Date</th><th>Time</th><th>Fahrenheit</th><th>Celsius</th><th>Location</th><th>Provider</th></tr></thead><tbody><tr><td>07/23/2019</td><td>06:30 NYM</td><td>97.5</td><td>36.4</td><td>Oral</td><td>Joaquin, Y. MLP</td></tr></tbody></table>

## Pulse:

<table border="1"><tr><td>Date</td><td>Time</td><td>Rate Per Minute</td><td>Location</td><td>Rhythm</td><td>Provider</td></tr><tr><td>07/23/2019</td><td>06:30</td><td>92</td><td>Via Machine</td><td>Regular</td><td>Joaquin, Y. MLP</td></tr></table>

## Respirations:

<table><thead><tr><th>Date</th><th>Time</th><th>Rate Per Minute</th><th>Provider</th></tr></thead><tbody><tr><td>07/23/2019</td><td>06:30 NYM</td><td>16</td><td>Joaquin, Y. MLP</td></tr></tbody></table>

## Blood Pressure:

<table><thead><tr><th>Date</th><th>Time</th><th>Value</th><th>Location</th><th>Position</th><th>Cuff Size</th><th>Provider</th></tr></thead><tbody><tr><td>07/23/2019</td><td>06:30 NYM</td><td>140/85</td><td>Right Arm</td><td>Sitting</td><td>Adult-regular</td><td>Joaquin, Y. MLP</td></tr></tbody></table>



SaO2:


<table><thead><tr><th>Date</th><th>Time</th><th>Value(%)</th><th>Air</th><th>Provider</th></tr></thead><tbody><tr><td>07/23/2019</td><td>06:30 NYM</td><td>96</td><td>Room Air</td><td>Joaquin, Y. MLP</td></tr></tbody></table>

## 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 07/23/2019 09:05 by Joaquin, Y. MLP

Page 1 of 2

Bureau of Prisons - NYM

EFTA00045996

| Inmate Name: | EPSTEIN, JEFFREY EDWARD |
| :--- | :--- |
| Date of Birth: | 01/20/1953 |
| Encounter Date: | 07/23/2019 06:20 |

Exam:
Acutely III

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: "I 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 - R/O 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 | Format | Handout/Topic | Provider | Outcome |
| :--- | :--- | :--- | :--- | :--- |
| 07/23/2019 | Counseling | Access to Care | Joaquin, Y. | Verbalizes Understanding |
| 07/23/2019 | Counseling | Plan of Care | Joaquin, Y. | Verbalizes Understanding |

Copay Required: No
Cosign Required: Yes

Telephone/Verbal Order: No

Completed by Joaquin, Y. MLP on 07/23/2019 09:05

<table><tr><td>Telephone/Verbal Order:</td><td>No</td></tr><tr><td colspan="2">Completed by Joaquin, Y. MLP on 07/23/2019 09:05</td></tr><tr><td colspan="2">Requested to be cosigned by Beaudouin, Robert MD.</td></tr><tr><td colspan="2">Cosign documentation will be displayed on the following page.</td></tr></table>

Generated 07/23/2019 09:05 by Joaquin, Y. MLP

Bureau of Prisons - NYM

Page 2 of 2

EFTA00045997

Epstein, Jeffrey Edward, Reg. No. 76318-054X

<table border="1"><tr><td>From</td><td>Lee Plourde</td></tr></table>

Adam Johnson, Charisma Edge, Elissa Miller, Jermaine Darden,

<table><tr><td>To</td><td>Lamine N'Diaye, Lee Plourde, NYM/Executive Staff, Shirley V.</td></tr></table>

Skipper-Scott

<table><thead><tr><th>Date</th><th>2019/08/13 14:11</th></tr></thead></table>

Subject: Epstein, Jeffrey Edward, Reg. No. 76318-054X

Attachments: Epstein, Jeffrey Edward, Reg. No. 76318-054X.docx

Page 16487

EFTA00045998

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Page 16488

EFTA00045999

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Page 16489

EFTA00046000

<table border="1"><tr><td colspan="4">Audits</td></tr><tr><td>Date</td><td>Action</td><td>Auditor</td><td>Note</td></tr><tr><td>2019-08-20 18:16:56 EDT</td><td>Created</td><td>cn=Archive Agent_2-Zero Day Archive5.cn=Jobs.cn=GWOpenNode.cn=archiving.o=netmail</td><td>Generated by Netmail Inc.[cn=Archive Agent_2-Zero Day Archive5.cn=Jobs.cn=GWOpenNode.cn=archiving.o=netmail]</td></tr><tr><td>2019-08-21 10:32:45 EDT</td><td>Exported</td><td>netmail.netmail.netmail</td><td>Exported by netmail.netmail.netmail</td></tr><tr><td>2019-09-20 08:44:56 EDT</td><td>Exported</td><td>netmail.netmail.netmail</td><td>Exported by netmail.netmail.netmail</td></tr><tr><td>2020-05-19 14:34:35 EDT</td><td>Tag</td><td>BOP01703.MXRADM1.MXRDOM1</td><td>Flagged</td></tr><tr><td>2020-05-19 15:28:59 EDT</td><td>Tag</td><td>BOP01703.MXRADM1.MXRDOM1</td><td>Responsive</td></tr><tr><td>2020-05-19 15:17:06 EDT</td><td>Tag</td><td>BOP01703.MXRADM1.MXRDOM1</td><td>Responsive</td></tr></table>

Page 16490

EFTA00046001

Mail Attachment

Epstein, Jeffrey Edward, Reg. No. 76318-054X.docx

Page 16491

EFTA00046002

# Suicide Timeline:

## RE: Epstein, Jeffrey Edward, Reg. No. 76318-054

## Friday, August 9, 2019

8:00 am: inmate Reyes Efrain, Reg. No. 85993-054 departs for court (WAB-USMS-SDNY). Reyes is Epstein's cellmate.

8:30 am: inmate Epstein arrives in Attorney Conference. He is visited by several attorneys throughout the day.

6:45 pm: inmate Epstein departs attorney conference and returns to SHU.

7:00 pm: inmate Epstein provided a social call by IDO. IDO reports inmate Epstein was in good spirits, nothing unusual.

## Saturday, August 10, 2019

6:33 am: Body alarm activated in SHU. Staff found inmate Epstein unresponsive in cell. Staff reported to bedside of inmate and attempted to wake him. Control announced medical emergency. CPR initiated

6:35 am: Medical staff (on duty PA) on site, CPR already in progress medical staff continues CPR and AED applied on inmate. Control called for ambulance

6:40 am: S. Skipper-Scott, AW notified

6:45 am: EMS arrives, paramedics continue CPR. Inmate Epstein remains unresponsive. Inmate Epstein is intubated, given three rounds of Epinephrine, IV access started, IO initiated. No pulse found, no shock advised, inmate prepared for transport to local hospital.

7:00 am: Institution placed on modified operations

7:10 am: EMS departs institution enroute to Beekman Hospital.

7:19 am: USMS notified of incident.



EFTA00046003


7:20 am: SIS Lt notified.

7:30 am: L. N'Diaye, Warden arrives at institution. C.Edge, AW notified.

7:32 am: PIO notified of incident by the Warden.

7:36 am: Official time of death reported by ER physician.

7:40 am: Acting Chief Psychologist notified.

8:00 am: S.Skipper-Scott, AW and J. Darden, Captain arrives at institution.

8:10 am: SIS Lt arrives at institution.

8:10 am: CMC and SCSS notified.

8:34 am: FBI notified.

9:00 am: AUSA notified.

9:00 am: C. Edge arrives at institution.

## Cont. Saturday, August 10, 2019

9:00 am: SIS Lt. Reports to SHU. Interviews will be conducted with inmates assigned to tier.

9:15 am: CMC arrives at institution.

9:30 am: Acting Chief Psychologist arrived to the institution.

9:50 am: SCSS arrives at institution.

9:55 am: CMC and IDO depart institution En route to Beekman Hospital.

10:00 am: CMC and IDO arrive at Beekman Hospital, fingerprints and photographs taken of inmate Epstein. Inmate clothing secured and brought back to institution.

10:00 am: Judge Berman notified.

10:15 am: CMC returns to institution.

EFTA00046004

Cont. Saturday, August 10, 2019

10:45 am: PIO arrived to the institution.

11:00 am: Next of kin (brother) notified by Case Management Coordinator.

11:12 am: Press Release released to media.

11:15 am: Crisis Support Team activated.

11:15 am: Press Release provided to Judge Berman.

12:15 pm: Body released to Medical Examiner (ME) for autopsy



12:19 pm: FBI arrives.



1:35 pm: FBI arrives in Special Housing Unit.

1:40 pm: OIG notified by the Warden and they will be sending an Agent to NYM.

2:15 pm: Crisis Support Team debrief conducted.

2:45 pm: OIG arrived in Special Housing Unit (SHU)

3:45 pm: OIG and FBI departed from SHU.

5:05 pm: OIG/FBI departed MCC New York.

5:30 pm: CST departed MCC New York.

10:15 pm: Computer Services Manager arrives at institution to remove hard drives (Computers) from SHU. And replaced with new ones.

## Sunday, August 11, 2019

8:00 am: Resumed normal operations. Attorney conference visits and social visits (Unit 3) resume.

12:15 am: Computer Services Manager departs the institution.

EFTA00046005

Cont. Sunday, August 11, 2019

10:40 am: OIG Agent Kerwin, John and Agent Guido Modano arrives at institution.

11:15 am: OIG Agent Kerwin John, departs institution with two computers FPS 021407270 and FPS 0214207268.

2:00 pm: OIG Agent Guido Modano departs the institution.

## Monday, August 12, 2019

1:00 pm: Staff recall conducted

3:14 pm: FBI arrives



7:56 pm: FBI departs



9:45 pm: FBI returns



10:30 pm: FBI departs



## Tuesday August 13, 2019

7:15 am: Mr. Hollingsworth, NER Correctional Services Administrator arrives to the institution

7:25 am: Dr. Robert Negle National suicide prevention coordinator, and Dr. Kristin Willert, National Sex offender program coordinator arrives to the institution.

8:40 am: Northeast Regional Director R. Ormond arrives to the institution.