EFTA00073894

Bureau of Prisons
Health Services
Inmate Local Hospital

<table border="1"><tr><td colspan="2">SENSITIVE BUT UNCLASSIFIED – This information is confidential and must be appropriately safeguarded.</td></tr><tr><td colspan="2">Transfer To:  Transfer Date:08/10/2019</td></tr><tr><td>Health Problems</td><td></td></tr><tr><td>Health Problem</td><td>Status</td></tr><tr><td>Hyperlipidemia, unspecified HYPERTRIGLYCERIDEMIA</td><td>Current</td></tr><tr><td>Sleep apnea</td><td>Current</td></tr><tr><td>Essential(primary)hypertension BY HX.</td><td>Current</td></tr><tr><td>Constipation, unspecified</td><td>Current</td></tr><tr><td>Low back pain</td><td>Current</td></tr><tr><td>Neuralgia and neuritis, unspecified</td><td>Current</td></tr><tr><td>No Diagnosis</td><td>Current</td></tr><tr><td>Prediabetes</td><td>Current</td></tr><tr><td>Injury, unspecified R/O self inflicted injuries.</td><td>Current</td></tr><tr><td>Body mass index(BMI)27.0-27.9, adult</td><td>Current</td></tr></table>

Medications: All medications to be continued until evaluated by a physician unless otherwise indicated.

Bolded drugs required for transport.

<table><tr><td>Docusate Sodium 100 MG Cap</td><td>Exp: 08/11/2020</td><td>SIG: Take one capsule (100 MG) by mouth twice daily for 30 days</td></tr><tr><td>Docusate Sodium 100 MG Cap</td><td>Exp: 01/22/2020</td><td>SIG: Take one capsule (100 MG) twice daily by mouth with plenty of water</td></tr></table>

Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML Exp: 10/28/2019 SIG: shake well take 10ml by mouth twice daily AS NEEDED of the Freedom of Information and Privacy Act

<table><tr><td>Omega 3 (Vascepa) 1 GM Capsule</td><td>Exp: 01/13/2020</td><td>SIG: Take two capsules (2 GM) twice daily by mouth with food</td></tr></table>

OTCs: Listing of all known OTCs this inmate is currently taking.

None

## Pending Appointments

<table border="1"><tr><td>Date</td><td>Time</td><td>Activity</td><td>Provider</td></tr><tr><td>07/24/2019</td><td>00:00</td><td>Clinical Encounter</td><td>Optometrist</td></tr><tr><td>01/07/2020</td><td>00:00</td><td>Chronic Care Visit</td><td>Mid-Level Provid</td></tr><tr><td>07/01/2020</td><td>00:00</td><td>Chronic Care Visit</td><td>Physician 01</td></tr><tr><td>07/09/2020</td><td>00:00</td><td>PPD Administration</td><td>Nurse</td></tr></table>

## Pending Non-Medication Orders:

<table><thead><tr><th>Order</th><th>Order Date</th><th>Frequency</th></tr></thead></table>

| Duration | Details |

| :--- | :--- |

| EKG | 07/06/2019 | One Time |

| :--- | :--- | :--- |

| Fecal Occult Blood | 07/06/2019 | One Time |

| :--- | :--- | :--- |

TB Clearance: Yes

Last PPD Date: 07/09/2019

TB Treatment:

Induration: 0mm

TB Follow-up Recommended: No

Last Chest X-Ray Date:___

Results:

## Sickle Cell:

Sx free for 30 days: Yes

Sickle Cell Trait/Disease: No

Generated 08/10/2019 07:00 by

RN

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Bureau of Prisons - NYM

EFTA00073895

<table><tr><td>Reg #: 76318-054</td><td>Inmate Name: EPSTEIN, JEFFREY EDWARD</td></tr></table>

SENSITIVE BUT UNCLASSIFIED – This information is confidential and must be appropriately safeguarded.

<table><tr><td>Limitations/Restrictions/Diets:</td></tr><tr><td>Cell: lower bunk --- 10/09/2019</td></tr><tr><td>Cleared for Food Service: Yes</td></tr><tr><td>Other diet restrictions: FISH ALLERGIES. --- 07/30/2020</td></tr></table>

Comments:

Allergies

No Known Allergies



Devices / Equipment

C-Pap



# Travel:

Direct Travel: No

Travel Restrictions: None

UNIVERSAL PRECAUTIONS OBSERVED WHEN TRANSPORTING ANY INMATE:

<table border="1"><tr><td>Transfer From Institution:</td><td>NEW YORK MCC</td></tr><tr><td>Address 1:</td><td></td></tr><tr><td>Address 2:</td><td></td></tr><tr><td>City/State/Zip:</td><td>NEW YORK, New York 10007</td></tr></table>

Name/Title of Person Completing Form: RN

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg.#: 76318-054 DOB: 01/20/1953 Sex: M

Withheld pursuant to exemption

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

of the Freedom of Information and Privacy Act

Generated 08/10/2019 07:00 by

RN

Bureau of Prisons - NYM

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