This is a medical record from the Federal Bureau of Prisons documenting Jeffrey Epstein's initial health evaluation on July 12, 2019, at the Metropolitan Correctional Center (MCC) in New York.
This Bureau of Prisons clinical encounter form documents Epstein's 14-day physician evaluation following his July 2019 arrest. The medical record reveals he had a history of hypertriglyceridemia (elevated triglycerides reaching 800), obstructive sleep apnea requiring a CPAP machine, and severe L4-L5 spinal stenosis causing lower extremity numbness and shooting pain. He was being treated with Vascepa for lipid management and had previously used a Medrol dose pack for back pain. Notably, this evaluation occurred just weeks before his death in custody on August 10, 2019.

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Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Race: WHITE Encounter Date: 07/12/2019 13:10 Provider: Reg SI: 76318-054 Facility: NYM Unit: Z05 Chronic Care - 14 Day Physician Eval encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: Chief Complaint: ENDO/LIPID Subjective: 66 YR OL HITE MALE WITH FIX OF HYPERT CERIDEMIA X 5 YEARS ON VASCEPA FOR 1 YEAR. STATES TRIGL WAS 800 , STATES HE COULD NOT TOLERATE OTHER ANTI-TRIGLYCERIDE MEDS • EIR GI SIDE EFFECTS. HX OF O UVE SLEEP APNEA X 5 YEARS FOR WHICH HE USED A CPAP MACHINE. it HAD HIS CPAP MACHINE WITH HIM WHEN HE ARRESTED. STATES THE : Y HAS L4 - LS SEVERE SIS CASUING NUMBNESS AND SHOOTING PAIN IN THE LOWER EXTREMI S SURGICAL HX: NONE MENTAL HEALTH HX: Pain: Yes Pain Assessment Date: 07/12/2019 13:25 Location: Back-Middle Quality of Pain: Shooting Pain Scale: 5 Intervention: MEDROL DOSE PACK Trauma Date/Year: Injury: Mechanism: Onset: 5+ Years Duration: 5+ Years Exacerbating Factors: NO EXERCISE Relieving Factors: MEDROL DOSE PACK Reason Not Done: Comments: Seen for clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology Added to clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology OBJECTIVE: Exam: General Appearance Yes: Appears Well, Alert and Oriented x 3 No: Appears Distressed. Dyspneic. Appears in Pain. Writhing in Pain, Pate. Pallor, Cyanotic, Diaphoretic, Disheveled, Unkempt. Acutely 111 Nutrition No: Appears Obese Generated 07/7212019 14.20 by Bureau of Prisons • NYM Page I of 3 CONFIDENTIAL SDNY_00009419 EFTA00033825
Inmate Name: EPSTEIN. JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Dale: 07/12/2019 13:10 Provider M Race: WHITE Reg #: 76318-054 Facility: NYM Unit: Z05 Exam: Eyes General Yes: PERRLA, Extraocular Movements Intact Pulmonary Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular Rat Rhythm (RRR), Normal S1 and S2 No: M/R/G Abdomen Auscultation Yes: Normo-Active B Palpation Yes: Within Normal Limits Musculoskeletal Tibia / Fibula No: Edema Back Yes: Tenderness ithi Neurologic Cranial Nerves (CN) Yes: W ASSESSMENT: Constipation, unspecified, K5900 - Current 4 7 4 0.1)0 Motor System-General n Normal Limits Yes: Normal Exam Hyperlipidemia, unspecified, E785 - Current Low back pain. M545 - Current Neuralgia and neuritis, unspecified, M792 - Current >e, Sleep apnea, G4730 - Current PLAN: New Medication Orders: Rx# Medication QrtesEpa Magnesium Hydroxide Susp 07/12/2019 13:10 Indication: Constipation, unspecified MethyiPREDNISolone Tab 4 MG ( Dose 07/12/2019 13:10 Pack 21 tab) Indication: Neuralgia and neuritis. unspecified Disposition: Generated 07/122019 14:20 by Prescriber Order" 30 CC Orally - Two Times a Day PRN x 2 day(s) AS DIRECTED Orally - daily x 6 day(s) Bureau of Prisons - NYM Page 2 of 3 CONFIDENTIAL SDNY_00009420 EFTA00033826
Inmate Name: EPSTEIN. JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/12/2019 13:10 Provider: I Reg #: 76318-054 Facility: NYM Unit: Z05 Follow-up at Sick Call as Needed Other: WILL CONTINUE NOTES TO ADDRESS THE NFDR AND FOLLOW-UP. Patient Education Topics: Pate Initiates'. Format Han ~UTop! 07/12/2019 Counseling Diagnosis Copay Required: No Cosign Required: No TelephoneNerbal Order: Completed by Beaudouin. n 07/12/2019 14:20 Generated 07/12/2019 14 20 by Provider Outcome Verbalizes Understanding Bureau of Prisons NYM Page 3 of 3 CONFIDENTIAL SDNY 00009421 EFTA00033827
Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN. JEFFREY EDWARD Reg tit: 76318.054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/12/2019 13:10 Provider: Unit: Z05 Chronic Care - 14 Day Physician Eval encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: Chief Complaint: ENDO/LIPID Subjective: 66 YR OL HITE MALE WITH HX OF HYPERT; CERIDEMIA X 5 YEARS ON VASCEPA FOR 1 YEAR. STATES TRIGL WAS 800 , STATES HE COULD NOT TOLERATE OTHER ANTI-TRIGLYCERIDE MEDS • EIR GI SIDE EFFECTS. HX OF O 4 UVE SLEEP APNEA X 5 YEARS FOR WHICH HE USED A CPAP MACHINE. -I, 1-Nr* HAD HIS CPAP MACHINE WITH HIM WHEN HE ARRESTED. STATES THE a Y HAS L4 - L5 SEVERE SIS CASUING NUMBNESS AND SHOOTING PAIN IN THE LOWER EXTREMI SURGICAL FIX: NONE MENTAL HEALTH FIX: Pain: Yes Pain Assessment Date: 07/12/2019 13:25 Location: Back-Middle Quality of Pain: Shooting Pain Scale: 5 Intervention: MEDROL DOSE PACK Trauma Date/Year: Injury: Mechanism: Onset: 5+ Years Duration: 5+ Years Exacerbating Factors: NO EXERCISE Relieving Factors: MEDROL DOSE PACK Reason Not Done: Comments: Seen for clinic(s): Endocrine/Lipid, Pulmonary/Respiratory. Orthopedic/Rheumatology Added to clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology OBJECTIVE: Exam: General Appearance Yes: Appears Well, Alert and Oriented x 3 No: Appears Distressed, Dyspneic. Appears in Pain, Writhing in Pain, Pale. Pallor. Cyanotic. Diaphoretic, Disheveled, Unkempt, Acutely III Nutrition No: Appears Obese Generated 07112,2019 14 20 by Bureau of Prisons - NYM Page 1 of 3 CONFIDENTIAL SDNY 00009422 EFTA00033828
Inmate Name: EPSTEIN, JEFFREY EDWARD Dale of Birth: 01/20/1953 Sex: Encounter Date: 07/12/2019 13:10 Provider M Race: WHITE Reg #: 76318-054 Facility: NYM Unit: 205 Exam: Eyes General Yes: PERRLA, Exlraocular Movements Intact Pulmonary Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular Rat Rhythm (RRR), Normal S1 and S2 No: WR/G Abdomen Auscultation Yes: Normo-Active B Palpation Yes: Within Normal Limits Musculoskeletal Tibia / Fibula No: Edema Back Yes: Tenderness Neurologic Cranial Nerves (CN) Yes: Within Normal Limits Motor System-General Yes: Normal Exam ASSESSMENT: Constipation, unspecified, K5900 - Current Hyperlipidemia, unspecified, E785 - Current Low back pain, M545 - Current Neuralgia and neuritis, unspecified, M792 - Current Sleep apnea, G4730 - Current PLAN: New Medication Orders: Rx# Medication Magnesium Hydroxide Susp Indication: Constipation, unspecified MethyIPREDNISolone Tab 4 MG ( Dose Pack 21 tab) Indication: Neuralgia and neuritis, unspecified Disposition: Corer:nod 01:17,2019 1420 by Order Date 07/12/2019 13:10 07/12/2019 13:10 Bureau of Prisons - NYM aescriber Order 30 CC Orally - Two Times a Day PRN x 2 day(s) AS DIRECTED Orally - daily x 6 day(s) Page 2 of 3 CONFIDENTIAL SDNY 00009423 EFTA00033829
Inmate Name: EPSTEIN. JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/12/2019 13:10 Reg #: 76318.054 Sex: M Race: WHITE Facility: NYM Provider: El Unit: Z05 Follow-up at Sick Call as Needed Other: WILL CONTINUE NOTES TO ADDRESS THE NFDR AND FOLLOW-UP. Patient Education Topics: Date Initiated Format Handout/Tonic 07/12/2019 Counseling Diagnosis Copay Required: No TelephoneNerbal Order: Cornpteled CI Generated 07/12/2019 14 20 by Cosign Required: No n 07/12/2019 14:20 Bureau of Prisons NYM Provider Outcome Verbalizes Understanding Page 3 of 3 CONFIDENTIAL SDNY_00 009424 EFTA00033830
Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/14/2019 17:36 Facility: NYM Amendment made to this note by on 07114/2019 18:11. &mftwoflhiumis.NYM CONFIDENTIAL SDNY_00009425 EFTA00033831
Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: Date of Birth: Note Date: EPSTEIN, JEFFREY EDWARD 01/20/1953 Sex: 07/12/2019 09:06 Provider: Reg #: Facility: Unit: 76318-054 NYM 205 Admin Note - Orders encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider: PATIENT REQUESTED TO HAVE A COLACE RX , INSTEAD OF TEH BISACODYL FOR CONSTIPATION. New Medication Orders: B.24 Medication Order Date Docusate Sodium Capsule 07/12/2019 09:06 Indication: Constipation, unspecified Discontinued Medication Orders: Bit# Medication. Order Data 121757-NYM Bisacodyl E.C. 5 MG TAB 07/12/2019 09:06 Discontinue Type: When Pharmacy Processes Discontinue Reason:discontinue Indication: Copay Required: No TelephoneNerbal Order: No Completed by Cosign Required: No on 07/12/2019 09:10 Generated 07/12/2019 09:10 by Bureau of Prisons • NYM Prescriber Order TAKE ONE 100 MG CAP Orally - Two Times a Day x 30 day(s) prescriber Order Take one tablet (5 MG) by mouth at bedtime AS NEEDED for 10 days Paget& 1 CONFIDENTIAL SONY 00009426 EFTA00033832
Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Facility: NYM Note Date: 07/07/2019 00:17 Provider: Sex: Unit: E06 Cosign Note - Intake Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider: MED CL:1 NO CCC APPT. Discontinued Laboratory Requests: Details Frequency Due Date Priority Lab Tests-H-Hemoglobin A1C One Time 08/05/2019 00:00 Routine Lab Tests-C-CBC w/diff Lab Tests-L-Lipid Profile Lab Tests-C-Comprehensive Metabolic Profile (CMP) Lab Tests-U-Urinalysis w/Rellex to Microscopic Additional Information: 66 y/o male, elevated BP Labs requested to be reviewed by: New Laboratory Requests: Details Freauency DUG Date Priority Chronic Care Clinics-Diabetic-CBC w/diff One Time 07/25/2019 00:00 Routine Chronic Care Clinics-Diabetic-Lipid Profile Chronic Care Clinics-Diabetic-Hemoglobin A1C Lab Tests-H-HIV 1/2 Lab Tests-R-RPR Chronic Care Clinics-Diabetic-Comprehensive Metabolic Profile (CMP) New Radiology Request Orders: Details Frequency End Date Due Date Priority General Radiology-Chest-2 Views One Time 07/25/2019 Routine Specific reason(s) for request (Complaints and findings): 66 YR OLD MALE WITH NO PMHX , REFERRED FOR ROUITNE CXR. Copay Required: No TelephoneNerbal Order: No Completed by Generated 07/07/2019 00:30 by Cosign Required: No on 07/07/2019 00:30 Bureau of Prisons - NYM Page 1 of 1 CONFIDENTIAL SDNY_00009427 EFTA00033833
Bureau of Prisons Health Services History & Physical Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/09/2019 12:35 Sex: M Race: WHITE Provider: Reg #: Facility: Unit: 76318-054 NYM H01 Seizures: Diabetes: Cardiovascular: CVA: Hypertension: Respiratory: Sickle Cell Anemia: Carcinoma/Lymphoma: Allergies: Tuberculosis: Denied Denied Denied Denied Denied Denied Denied Denied Denied Hx of Previous Disease: No Blood-tinged Sputum: No Night Sweats: No Weight Loss: No Fever: No Cough:No Comments: 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 Pans x 3 weeks up until arrest No tattoos Generated 07/09/2019 13:03 by Bureau of Prisons - NYM Page 1 of 13 CONFIDENTIAL SDNY_00009428 EFTA00033834
Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 07/09/2019 12:35 Provider: i m ilfaHITS Reg #: 76318-054 Facility: NYM Unit: H01 HIV History: When Tested: 2019 Test Result: Negative When Diagnosed AIDS: Last CD4: Comments: Hepatitis: Denied Other Infectious Diseases: Syphilis: No Syphilis Last Treatment: N/A Genital Warts: No Chlamydia: Yes Gonorrhea: No Herpes: No Chicken Pox: Yes Other: No Comments: Chlamydia in 2015, treated Chicken pox in childhood Abuse History: Denied Physical: No Emotional: No Sexual: No Comments: Denies Generated 07/09/2019 13:03 by Bureau of Prisons - NYM Page 2 of 13 CONFIDENTIAL SDNY_00009429 EFTA00033835
Inmate Name: EPSTEIN. JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 07/09/2019 12:35 Provider: Reg #: 76318-054 Facility: NYM Unit: H01 Mental Health: Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Hx of Mental Health Treatment: None Hx of Head Injury: None Current Mental Health Treatment: No Current Mental Health Complaint: No Hx of Loss of Consciousness: No Hx of Hearing Voices: No Past History of Suicide Attempt: No Current Suicide Ideation: No Suicide Prevention Initiated:No Comments: Substance Use History: Denied Current Painful Condition: Denied Other Health Issues: Current Medical Conditions: Other Current Treatments: Pregnant: N/A Dental Condition: Denied Generated 07/09/2019 13:03 by Bureau of Prisons • NYM Page 3 of 13 CONFIDENTIAL SDNY_00009430 EFTA00033836
Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 07/09/2019 12:35 Provider: 1.1../HITS Reg #: 76318-054 Facility: NYM Unit H01 Observations: Draining Skin Lesions: No Signs of Lice: No Signs of Scabies: No Signs of Recent Trauma: No Recent Tattoos: No Needle Marks: No Signs of Rash: No Open Sores: No Wounds: No Body Deformities: No Tremors: No Sweating: No Comments: Generated 07/09/2019 13:03 by Bureau of Prisons - NYM Pardo( 13 CONFIDENTIAL SDNY_00009431 EFTA00033837
Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 07/09/2019 12:35 Provider: Race: WHITE Reg #: 76318-054 Facility: NYM Unit: H01 Immunizations: Hepatitis A and B (TwinRx) Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Measles/Mumps/Rubella Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number Dosage: Route: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Tetanus Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Generated 07/09f2019 13:03 by Bureau of Prisons - NYM Page 5 of 13 CONFIDENTIAL SDNY_00009432 EFTA00033838
Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 07/09/2019 Sex: • ITE Encounter Date: 07/09/2019 12:35 Provider. Reg #: 76318-054 Facility: NYM Unit: H01 Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Varicella Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Temperature: pate Time Fahrenheit Celsius Location provider 07/09/2019 12:49 NYM 97.3 36.3 Oral Pulse: DAM Time Rate Per Minute Location Rhythm Provider 07/09/2019 12:49 82 Via Machine Regular Respirations: Date Time Rate Per Minute Provider 07/09/2019 12:49 NYM 16 Blood Pressure: DAM Time Yarn Location Position Cuff Slut Provider 07/09/2019 12:49 NYM 117/66 Right Arm Sitting Adult-regular SaO2: Data Time Valuee4). Air Provider 07/09/2019 12:49 NYM 97 Room Air Height: DatS lima Inches fa Provider 07/09/2019 12:49 NYM 70.0 177.8 Generated 07,09/2019 13:03 by Bureau of Prisons • NYM Page a of 13 CONFIDENTIAL SDNY_00009433 EFTA00033839
Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Reg #: 76318-054 Facility: NYM Unit: H01 Date Time inches Cm Provider Weight: Mt Int Lbs. hg Waist Circum. Provider 07/09/2019 12:49 NYM 194.4 88.2 Prosthetic Devices/Equipment: Denied Tobacco Usage: Denied General Social History: Foreign Travel: Born in USA: Yes Country of Birth: USA Patient Education Assessments: Date Ed Yrs Occupation Learns Best By Primary Language Barriers to Education 07/09/2019 12 Banker Speaking/Listening English None Family History - Father: Age at Death: 74 Cause of Death: Diabetes complications Significant Illnesses: Diabetes Heart Disease Comments: Family History - Mother: Age at Death: 81 Cause of Death: Kidney Failure Significant Illnesses: Heart Disease Comments: Family History - Sibling: Number of Siblings: 1 Significant Illnesses: Comments: Past Hospitalization: Reason Location When Acute Appendicitis Mount Sinai Hospital 1990 Complications: None Comments: Head: Normal: Yes Comments: Generated 07/09/2019 13:03 by Bureau of Prisons NYM Page 7 of 13 CONFIDENTIAL SDNY_00009434 EFTA00033840
Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race. WHITE Encounter Date: 07/09/2019 12:35 Provider: Reg #: 76318-054 Facility: NYM Unit: H01 Eyes: EOMI: Yes lcterus:No Conjunctival Inflammation: No Pupils PERRLA: Yes Pupil Size Rt: Pupil Size Lt: Pupils Comments: Fundi Vessels Nicking: No Fundi Vessels Discs Flat:Yes Fundi Vessels Discs Sharp Margins: Yes Fundi Vessels Grounds Abnormal: No Eyes Comments: Vision Screen 07/09/2019 12:52 Blindness: With Corrective Distance Vision: OD: 100 OS: 70 OU: OD: Near Vision: OD: OS: OU: OD: lshihara Color Test: Tonometry: L: R: Comments: Needs evaluation with optometrist. Ears: Right Ear: Canal patent Left Ear: Canal patent Ears Comments: Nose: Nares Patent: Yes Septum Midline:Yes Septum Intact: Yes Drainage/Discharge:No Polyps: No Nose Comments: Generated 07/09/2019 13:03 by OS OS: OU: OU: Bureau of Prisons • NYM Page 8 of 13 CONFIDENTIAL SDNY_00009435 EFTA00033841
Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 07/09/201912:35 Provider: Reg #: 76318-054 Facility: NYM Unit: H01 Mouth Lesions:No Oral/Buccal Mucosa:Yes Gums Normal: Yes Tonsils Present:Yes Tonsils Normal: Yes Pharynx: Normal Color Teeth Poor Dentition: No Teeth Count:Mostly Present Dentures:No Mouth Comments: Cranial Nerves: Intact Yes Cranial Nerves Comments: Neck: Full ROM:Yes Masses/Nodes: No Trachea: Midline Thyroid: Normal Size Comments: Breasts: Normal: Yes Masses:No Tenderness:No Scars: No Dimpling:No Nipple Discharge: No Nipple Retraction: No Instructions for Self Breast Exam Given: No Comments: Generated 07/092019 13:03 by Bureau of Prisons - NYM Page 9 of 13 CONFIDENTIAL SDNY_00009436 EFTA00033842