# Form 583 Report of Incident

| Incident #: NYM-19-0076 | Submitted By: |

| :--- | :--- |

Date/Time Of Incident: 7/23/2019 1:27 AM

<table border="1"><tr><td colspan="3">Section 1: General Information</td></tr><tr><td colspan="3">Staff Aware Date:7/23/2019 1:27 AM</td></tr><tr><td colspan="3">FBI Notified:NoUSMS Notified:NoIndicate Where Incident Occurred:Main Facility</td></tr><tr><td>Location Level 1:SHU</td><td>Level 2:Housing Unit, Special(SHU)</td><td>Level 3:9 SOUTH SHU</td></tr><tr><td>Type Of Incident</td><td></td><td>Institution Locked Down:No</td></tr><tr><td>□Assault On Inmate</td><td></td><td>Modified Operations:No</td></tr><tr><td>□Assault On Staff</td><td></td><td>Cause Of Incident Known? No</td></tr><tr><td>□Assault, Attempted On Inmate</td><td></td><td>Cause Of Incident</td></tr><tr><td>□Assault, Attempted On Staff</td><td></td><td>Alcohol</td></tr><tr><td>□Disruptive Behavior</td><td></td><td>Commissary</td></tr><tr><td>□Escape From Non-secure Facility</td><td></td><td>Debts</td></tr><tr><td>□Escape From Secure Facility</td><td></td><td>Disrespect Issue</td></tr><tr><td>□Escape, Attempted From Non-secure Facility</td><td></td><td>Drugs</td></tr><tr><td>□Escape, Attempted From Secure Facility</td><td></td><td>Ethnic Conflict</td></tr><tr><td>□Fight</td><td></td><td>Food Issue</td></tr><tr><td>□Inmate Death</td><td></td><td>Geographical Conflict</td></tr><tr><td>□Institution Disturbance</td><td></td><td>Interfering with Staff duties</td></tr><tr><td>□Introduction Of Contraband</td><td></td><td>Property Issue</td></tr><tr><td>□Lethal Weapons Discharge</td><td></td><td>Racial Conflict</td></tr><tr><td>□Self Mutilation</td><td></td><td>Recreation Equipment</td></tr><tr><td>□Setting A Fire</td><td></td><td>Religious Issue</td></tr><tr><td>□Sexual Act, Non-consensual On Inmate</td><td></td><td>Security Threat Group Conflict</td></tr><tr><td>□Sexual Assault On Staff</td><td></td><td>Sexual Pressure</td></tr><tr><td>□Sexual Contact, Abusive On Inmate</td><td></td><td>Sporting Events</td></tr><tr><td>□Sexual Harassment, Repetitive</td><td></td><td>Telephone</td></tr><tr><td>□Staff Homicide</td><td></td><td>Theft</td></tr><tr><td>□Strike, Food</td><td></td><td>Visiting</td></tr><tr><td>□Strike, Work</td><td></td><td>Work Issue</td></tr><tr><td>Suicide Attempt</td><td colspan="2">Method: Hanging/Asphyxiation</td></tr><tr><td>Use Of Force</td><td></td><td></td></tr><tr><td>Use Of Force/Applications Of Restraints</td><td></td><td></td></tr><tr><td>Use Of Restraints, Pregnant/Postpartum</td><td></td><td></td></tr></table>

## 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 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 provisions of the Privacy Act (5 U.S.C. 552).



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SDNY_00010632
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Form 583 Report of Incident

<table><thead><tr><th>Incident #: NYM-19-0076</th><th colspan="2">Submitted By:</th><th>Date/Time Of Incident: 7/23/2014</th></tr></thead><tbody><tr><td>Reg #: 76318054</td><td colspan="2">Name: EPSTEIN, JEFFREY</td><td></td></tr><tr><td>Role: Victim</td><td colspan="2">Medical Attention Required: No</td><td>Injury Category: Minor Injury</td></tr><tr><td>Weapon (per inmate): No</td><td colspan="2">Use of Force (per inmate): No</td><td>Chemical Used (per inmate): No</td></tr><tr><td>CIMS: No</td><td colspan="2">STG: Yes</td><td></td></tr><tr><td>Restraints (per inmate):</td><td colspan="2">Escort Only</td><td></td></tr><tr><td>Death (per inmate):</td><td colspan="2">No</td><td></td></tr><tr><td>Reg #: 78514054</td><td colspan="2">Name: TARTAGLIONE, NICHOLAS</td><td></td></tr><tr><td>Role: Not Known</td><td colspan="2">Medical Attention Required: No</td><td>Injury Category: No Injury</td></tr><tr><td>Weapon (per inmate): No</td><td colspan="2">Use of Force (per inmate): No</td><td>Chemical Used (per inmate): No</td></tr><tr><td>CIMS: Yes</td><td colspan="2">STG: Yes</td><td></td></tr><tr><td>Restraints (per inmate):</td><td colspan="2">No</td><td></td></tr><tr><td>Death (per inmate):</td><td colspan="2">No</td><td></td></tr></tbody></table>

# Section 3: Others Involved

| Name: | Person Type: Staff |
| :--- | :--- |
| Medical Attention Required: No | Death: No |
| Injury Category: No Injury | Staff Injury by Inmate: No |
| Sexual Assault: No | |

| Name: | Person Type: Staff |
| :--- | :--- |
| Medical Attention Required: No | Death: No |
| Injury Category: No Injury | Staff Injury by Inmate: No |
| Sexual Assault: No | |

| Name: | Person Type: Staff |
| :--- | :--- |
| Medical Attention Required: No | Death: No |
| Injury Category: No Injury | Staff Injury by Inmate: No |
| Sexual Assault: No | |

| Name: | Person Type: Staff |
| :--- | :--- |
| Medical Attention Required: No | Death: No |
| Injury Category: No Injury | Staff Injury by Inmate: No |
| Sexual Assault: No | |

| Name: | Person Type: Staff |
| :--- | :--- |
| Medical Attention Required: No | Death: No |
| Injury Category: No Injury | Staff Injury by Inmate: No |
| Sexual Assault: No | |

| Name: Thomas, Michael | Person Type: Staff |
| :--- | :--- |
| Medical Attention Required: No | 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 proper 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 provisions of the Privacy Act (5 U.S.C. 552).

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SDNY_00010633
EFTA00123114


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 Staff Injury by Inmate: No
Sexual Assault: 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, reasons 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, Z05-124LAD. 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.

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 small erythema on his left knee.

# Section 7: Attachments

| File Date | File Name | Original Entered By | Original Loc. Code |
| :--- | :--- | :--- | :--- |
| No data found. | | | |

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 proper 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 provisions of the Privacy Act (5 U.S.C. 552).

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SDNY_00010634
EFTA00123115