EFTA00073873

# Bureau of Prisons
Health Services
Health Screen

Sex:

Provider:

| Carcinoma/Lymphoma: | Denied |

| :--- | :--- |

PPD Administration:



Date/Time: 07/06/2019 21:39





Provider: PA-C



Location: Right Forearm



Drug Mfg: Sanofi Pasteur



Page 043 of 148

Lot Number: C5474BA

Withheld pursuant to exemption

Dosage: 0.1mL

(b) (6) ; (b)(7)(A) ; (b)(7)(C)



Route: ID



of the Freedom of Information and Privacy Act

| Exp Dt: | 10/2020 |

| :--- | :--- |

Comments:

Tuberculosis:

Hx of Previous Disease: No

Blood-tinged Sputum: No

Night Sweats: No

Weight Loss: No

Fever: No

Cough: No

Comments:

Generated 07/06/2019 21:56 by

Page 1 of 6



PA-C


Bureau of Prisons - NYM

EFTA00073874

<table border="1"><tr><td>Inmate Name:</td><td>EPSTEIN, JEFFREY EDWARD</td></tr><tr><td>Date of Birth:</td><td>01/20/1953</td></tr><tr><td>Encounter Date:</td><td>07/06/2019 21:38</td></tr></table>

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

# Infectious Disease Risk Factors:

IV Drug Use: No

IV Drug Use Needles:

Sexual Partner IV Drug Use: No

Sexual Partner IV Drug Use Needles:

Female Sexual Partners (Last 5 Yrs): 10+

Male Sexual Partners (Last 5 Yrs): 0

Condom Use: Sometimes

Sexual Contact With HIV+ Individual: No

Blood Product Transfusion: No

Travel Outside US: Yes

Tattoos: No

Comments: Born in US

High school diploma

Banker

Traveled to Paris x 3 weeks up until arrest



Comments: Denies



Generated 07/06/2019 21:56 by

Page 2 of 6

Bureau of Prisons - NYM

EFTA00073875

<table border="1"><tr><td>Inmate Name:</td><td>EPSTEIN, JEFFREY EDWARD</td></tr><tr><td>Date of Birth:</td><td>01/20/1953</td></tr><tr><td>Encounter Date:</td><td>07/06/2019 21:38</td></tr></table>

Sex:

Provider:



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

Mental Health:

Level of Consciousness: Alert and Oriented

Psychomotor Activity: Normal

Current Mental Health Treatment: No

Current Mental Health Complaint: No

Page 045 of 148

Withheld pursuant to exemption

Substance Use History: Denied

Other Health Issues:

Current Medical Conditions:

Other Current Treatments:

<table><tr><td>Pregnant:</td><td>N/A</td></tr></table>

Dental Condition: Denied

Generated 07/06/2019 21:56 by



PA-C


Page 3 of 6

Bureau of Prisons - NYM

EFTA00073876

<table border="1"><tr><td>Inmate Name:</td><td>EPSTEIN, JEFFREY EDWARD</td></tr><tr><td>Date of Birth:</td><td>01/20/1953</td></tr><tr><td>Encounter Date:</td><td>07/06/2019 21:38</td></tr></table>

Sex:

Provider:

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

## Observations:

<table border="1"><tr><td>Draining Skin Lesions: No</td></tr><tr><td>Signs of Lice: No</td></tr><tr><td>Signs of Scabies: No</td></tr><tr><td>Signs of Recent Trauma: No</td></tr><tr><td>Recent Tattoos: No</td></tr><tr><td>Needle Marks: No</td></tr><tr><td>Signs of Rash: No</td></tr><tr><td>Open Sores: No</td></tr><tr><td>Wounds: No</td></tr><tr><td>Body Deformities: No</td></tr><tr><td>Tremors: No</td></tr><tr><td>Sweating: No</td></tr><tr><td>Comments:</td></tr></table>

Comments:

<table><thead><tr><th colspan="2">Respirations:</th><th colspan="2">Withheld pursuant to exemption</th></tr><tr><th>Date</th><th>Time</th><th>Rate Per Minute</th><th>Provider</th></tr></thead><tbody><tr><td>07/06/2019</td><td>21:43 NYM</td><td>(b)(6) ; (b)(7)(A) ; (b)(7)(C)</td><td>15 Kang, Yoon PA-C</td></tr></tbody></table>

of the Freedom of Information and Privacy Act

<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>07/06/2019</td><td>21:45 NYM</td><td>164/90</td><td>Right Arm</td><td>Sitting</td><td>Adult-regular</td><td>PA-C</td></tr><tr><td>07/06/2019</td><td>21:43 NYM</td><td>155/83</td><td>Left Arm</td><td>Sitting</td><td>Adult-regular</td><td>PA-C</td></tr></tbody></table>

Potential Items For Follow-up:

Prosthetic Devices/Equipment: Denied

Page 4 of 6

EFTA00073877

| Inmate Name: | EPSTEIN, JEFFREY EDWARD |
| :--- | :--- |
| Date of Birth: | 01/20/1953 |
| Encounter Date: | 07/06/2019 21:38 |

| | | | | Reg #: | 76318-054 |
| :--- | :--- | :--- | :--- | :--- | :--- |
| | Sex: | M | | Race: | WHITE |
| | Provider: | PA-C | | Facility: | NYM |



Health Problems Newly Identified During This Encounter: Health Problem

Medication Reconciliation.

The patient's known medication list including OTC items was compiled and compared to new and changed BOP orders.

Reconciled Medications:

<table border="1"><tr><td>Type</td><td>Rx#</td></tr><tr><td>OTC</td><td></td></tr></table>

<table><tr><td>Medication</td></tr><tr><td>No known OTCs</td></tr></table>

Order Detail

# New Laboratory Requests:

## Details

Lab Tests-H-Hemoglobin A1C

Lab Tests-C-CBC w/diff

Lab Tests-L-Lipid Profile

Lab Tests-C-Comprehensive Metabolic Profile (CMP)

Lab Tests-U-Urinalysis w/Reflex to Microscopic

**Additional Information:**

66 y/o male, elevated BP

**Labs requested to be reviewed by:**

<table><tr><td>Frequency</td></tr><tr><td>One Time</td></tr></table>

<table><thead><tr><th>Due Date</th></tr></thead><tbody><tr><td>08/05/2019 00:00</td></tr></tbody></table>



Priority

Routine



New Non-Medication Orders:

<table><thead><tr><th>Order</th></tr></thead><tbody><tr><td>EKG</td></tr></tbody></table>

<table><thead><tr><th>Frequency</th></tr></thead><tbody><tr><td>One Time</td></tr></tbody></table>

<table border="1"><tr><td>Duration</td><td>Details</td></tr><tr><td>Withheld pursuant to exemption</td><td>66 y/o male</td></tr></table>

<table border="1"><tr><td rowspan="3">Fecal Occult Blood</td><td>Order Date:</td><td>07/06/2019(g)(6);(b)(7)(A);(b)(7)(C)</td></tr><tr><td>One Time</td><td>3 different stools of the Freedom of Information and Privacy Act</td></tr><tr><td>Order Date:</td><td>07/06/2019</td></tr></table>

## Schedule:

# Activity

Vision Screen

66 y/o male

PPD Reading

Follow-up

BP check

<table border="1"><tr><td>Date Scheduled</td><td>Scheduled Provider</td></tr><tr><td>07/06/2019 00:00</td><td>Optometrist</td></tr></table>

<table border="1"><tr><td>07/08/2019 00:00</td><td>Nurse</td></tr><tr><td>07/09/2019 00:00</td><td>Mid-Level Provider</td></tr></table>

BP noticed to be elevated.

IM denies Hx of HTN or any significant chronic medical conditions.

He is currently asymptomatic and denies any bodily complaints at this time.

Will recheck BP in 2-3 days.

Follow-up at Sick Call as Needed To be Evaluated by Provider

## Disposition:

Instructed inmate how to obtain medical, dental, and mental health care.

<table><tr><td>Copay Required: No</td></tr><tr><td>Telephone/Verbal Order: No</td></tr></table>

Cosign Required: Yes

Generated 07/06/2019 21:56 by

Bureau of Prisons - NYM

PA-C

Page 5 of 6