EFTA00131467¶
BP-A0288 JUN 10¶
INCIDENT REPORT CDFRM¶
U.S. DEPARTMENT OF JUSTICE¶
FEDERAL BUREAU OF PRISONS¶
Part I - Incident Report¶
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Institution: MCC New York
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Inmate’s Name Epstein , Jeffery
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Register Number 76318-054
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Date of Incident 07/23/2019
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Time 1:30 am
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Place of Incident SHU M-Tier Cell 124
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Assignment Unassigned
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Unit ZA
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Incident Self-Mutilation
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Prohibited Act Code(s) 228
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Description Of Incident (Date: 07/23/2019 Time: 1:27 am Staff became aware of incident) On July 23, 2019 at approx. 1:27am 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 (I/M #78514-054) was at the door stating I/M Epstein #76318-054 had attempted to hang himself. I kept 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. I/M was breathing at this time.But unresponsive.Addition staff and Ops Lt arrived I/M was then removed from the SHU.
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Typed Name/Signature of Reporting Employee
13.Date And Time 7/23/2019 1:30 am¶
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Incident Report Delivered to Above Inmate By (Type Name/Signature)
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Date Incident Report Delivered
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Time Incident Report Delivered
Part II - Committee Action¶
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Comments of Inmate to Committee Regarding Above Incident
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A. It is the finding of the committee that you: ___ Committed the Prohibited Act as charged. ___ Did not Commit a Prohibited Act. ___ Committed Prohibited Act Code(s)
B. ___ The Committee is referring the Charge(s) to the DHO for further Hearing. C. ___ The Committee advised the inmate of its finding and of the right to file an appeal within 20 calendar days.¶
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Committee Decision Is Based on Specific Evidence as Follows:
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Committee action and/or recommendation if referred to DHO (Contingent upon DHO finding inmate committed prohibited act)
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Date And Time Of Action ___ (The UDC Chairman’s signature certifies who sat on the UDC and that the completed report accurately reflects the UDC proceedings.)
Prescribed by P5270¶
Replaces BBPBBBBB(H2-S24A/052-Of MAY 94¶
PDF¶