Fwd: Re: Epstein investigation From ~r- )(6-); (b- )(7- )(C- )----~ To Charisma Edge Date 2019/08/10 16:20 Subject: Fwd: Re: Epstein investigation Attachments: TEXT.htm, mltC634.pdf No problem. Please see attached. r )(6); (b)(7)(C) Supervisory Staff Attorney CLC New York Metropolitan Correctional Center 150 Park Row NewYork, New York 10007 p: (646)836 ;rn;(C) f: (646)836-7665 >>>Charisma Edge 8/10/2019 3:53 PM>>> Can you send me a copy of the death notification letter to the judge. Charisma Edge Associate Warden MCC New York 150 Park Row New York, NY 10007 646-836-6300 exi=ib)=(s>-.,,.: <b=)(7=)(c~; I (b)<s>: (b)(?)(c) bo . ov ov IB/10/2019 3:05 PM >>> ib){?)(A)

Shirley Skipper-Scott Associate Warden MCCNewYork 150 Park Row New York, New 0007 Office: 646-836"'b""")(""'~l""': -,..,.,...--, 'b)(6): Black Ber : 646-423:-.m,n, (b}(6); (b)(7)(C) bop.go .... v~-~ >» Lamine N'Diay4 ~!~%~, fybop.gov> 7/23/2019 12:30 PM»> Can you get this for me. Sent from my Verizon, Samsung Galaxy smartphone -------- Original message -------- From: Ray Onnondfb)(B); @bop.gov> Date: 7/23/19 11 :46 AM (GMT-05:00) To: Lamine N'Diay (b)(6); bop.gov> Sub. R E . (b\(7\(C\ 1ect: e: pstem >» "Ray Onnond" 07/23/2019 11:46 >» Lamine - The memo is very confusing. Please draft an email of his actions and current status. Also include what plans were in motion to move him to a </div><div> Id• 1 • • t·M d. 0 . • 1 /d. d. F .L • N'D. 'b}(S): < 1v><.-- ongma essage -->< 1v>-------- ngma message --------< 1v>< 1v> rom: amme iaye :b)(7)(CJ </div> >» "Lamine N'Diaye'1(b)(6); @bop.gov> 07/23/2019 11: 12 >» Sent from my Verizon, Samsung Galaxy smartphone<div> </div><div> bop.gov> </div><div>Date: 7/23/19 </div><!-- originalMessage --><div>-------- Original message --------</div><div>From: "Shirley V. Skipper-Scott" l(b)(S); (b)(7)(C) ~ bop.gov> </div><div </div> Page 769

-------- Original message•······· From: Ray Ormondkb/(6); ~bop.gov> Date: 7/23/19 11 :46 AM (GMT-05:00) To: Lamine N'Diay i~\~!(,,, Subject: Re: Epstein bop.gov> » > "Ray Ormond" 07/23/2019 11 :46 » > Lamine - The memo is very confusing. Please draft an email of his actions and current status. Also include what plans were in motion to move him to a GP unit. It will nee </div> <div> /d• 1 • • IM d. 0 . . I / d. d. F La • N'D. "b)(S); < Iv> <.-- ongma essage •·> < Iv>-······· ngIna message ----·-··< Iv> < Iv> rom: mine Iay '.bl(7;(C) bop.gov> </div> <div> Date: 7 /23/19 11 :12 AM </div> » > "Lamine N'Diaye' )~l)~;,,,1 bop.gov> 07/23/2019 11:12 » > Sent from my Verizon, Samsung Galaxy smartphone<div> </div> <div> </div> <1-- original Message --> <div>-------- Original message --------</div> <div>From: "Shirley V. Skipper-Scotf b)(6): (b)(7)(C) </div> ~p.gov> </div> <div> Date: 7 /2: Page 863

Shirley Skipper-Scott Associate Warden MCCNewYork 150 Park Row New York, New York 10007 Office: 646-836"'\~...,./\"'~/;,:;: '!'=~---. Black Berry: 646-42 i~1i~Ur, !Cb)(6J: (b)(7)(C) ~ bop.,..o_v __ ~ >» Lamine N'Diay '~)(~((,.,, bop.gov> 7/23/201912:30 PM »> Can you get this for me. Sent from my Verizon, Samsung Galaxy smartphone -------- Original From: Ray Ormon [~;~1,r, bop.gov> Date: 7/23/19 11 :46 AM (GMT-05:00) To: Lamine N"Diayfb)~/;_~ '1l>bop.gov> Subj ect: Re: Epstein » > "Ray Ormond" 07/23/2019 11 :46 » > Lamine - The memo is very confusing. Please draft an email of his actions and current status. Also include what plans were in motion to move him to a GP unit. It will nee </div> <div> </div><!-- originalMessage --> <div>-------- Original message --------</div> <div>From: Lamine N'Diay b)(6): b)(7)(C; </div> ~-~ » > "Lamine N'Diaye"f~~!~~, ~ bop.gov> 07/23/2019 11:12 » > Sent from my Verizon, ~amsung (;alaxy smartphone<div> bop.gov> </div><div>Date:7/23/19 11:12AM </div> <div> </div><!-- original Message --> <div>-------- Original message --------</div> <div> From: "Shirley V. Skipper-Scottf b)(6): (b)(?)(C) [email protected]> </div> <div>Date: 7 /2, </div> Page 930

Fwd: Re: Epstein From To Date Subject: Attachments: t b)(6); (b)(7)(C) f,_ b)<_6l:_<bi_(7)_<cJ __ ___.l amine N'DiayeShirley V. Skipper- Scott 2019/07/25 14:14 Fwd: Re: Epstein TEXT.htm Page 981

Fwd: Re: Epstein investigation From Charisma Edge To Date Subject: r )(6); (b)(?,(C) 2019/08/10 15:53 Fwd: Re: Epstein investigation Attachments: TEXT.htm, Charisma Edge.vcf Can you send me a copy of the death notification letter to the judge. Charisma Edge Associate Warden MCC New York 150 Park Row New York, NY 10007 ..,..,..,.,.,....,,..,..,,~ 646-836-6300 ex :b)(5);(b)(7\(C) l(b)(6); (b)(7)(C)[email protected] NYM/[email protected] > t )(6); (b)(7)(C) ! 8/10/2019 3:05 PM > > > 'b)(7,(A) llb}(6); (b)(7)(C) lb)[7)(A) Supervisory Staff Attorney CLC New York Metropolitan Correctional Center 150 Park Row New York, New York 10007 P. (646)836 :b)(5l; • 'b)[7)(C) f: (646)836-7665

Fwd: Epstein Update From Shirley V. Skipper-Scott To Date Subject: Charisma Edge 2019/07/29 10:30 Fwd: Epstein Update Attachments: TEXT.htm Check this out. Shirley Skipper-Scott Associate Warden MCC New York 150 Park Row New York, New York 10007 Office: 646-83 6 b)(G}; <bl(7)(c) Black Ber : 646-423 b)(G> (b)(7)(c) b)(6); (b)(7)(C) OV > >l(b)(S) (b)(7)(C) V29/2019 10:02 AM > > > Good morning: Same presentation today, but he said he thinks his memory for the incident (injury to his neck) may be impaired because of his sleep apnea. He is supposed to get his CPAP machine today. He is aware he will be returning to SHU, but said he is feeling unwell due to his inability to sleep and numbness in his arm. He requested to have one good night of sleep with his CPAP and will return to SHU with a cell mate tomorrow. tb)(?)(A) I told him he can stay down one more night to receive his CPAP and a good night's sleep, but that he would be returned to SHU tomorrow. It was explained that there is no mental health issues precluding him from returning to SHU tomorrow and t hat we could not house him in the SW/Hospital area becaus~(bX?)(A) lor more comfortable for him (b)(?)(AJ He will remain on psychological observation today and will transition to the SHU tomorrow. Thank you, lml,C) l(b)(6); (b)(7)(C) psy .0. Chief Psychologist U.S. Department of Justice/ Federal Bureau of Prisons Metropolitan Correctional Center 150 Park Row NewYork, New York 10007 Office: (646) 836 ~;[;(lei Fax: (646) 836-7712 E-mail r )(G); lb)(7)(C) p>bop.gov >> r s); (b)(7)(C) ~ /28/2019 7:49 AM > > > AW Skipper-Scott, Inmate Epstein seems psychologically stable. He complained that his right arm was numb and hanging earlier. Nurs~b)CG,; <bKn<c> ~aw him. Page 1120

He again said his right arm still feels somewhat numb and he said he cannot make a fist with that hand. He also said he has numbness on his neck. I informed Nurs b)IB) lbP>(C) He stated the toilet in his cell was running for 45 minutes last night and he could not take the noise. He is going to try the toilet before going to legal today and if it does not shut off, he will be moved to another cell. Thanks, 'b)(6); (b)(7)(C) b)(6); (b)(7)(C) > 'b)(6); (bi{?)(C) Suicide Watch None Psych Observation /28/2019 7:36 AM>>> 1. Epstein #76318-054 Pending Bedspace for SHU r )(6); (b)(7)(C) 1 Thank you, r b)(6); lb)(7)(C) Page 1121

Epstein Update From r b)(6); lb)(7)(C) To ~r....,, )( 5 ...- ); ( ...... b)(7 ...... )(-C)----,,,-...,........,,,..........--=-----------~I Lamine N'Diaye, Shirley V. Skipper-Scott Date 2019/07/29 10:02 Subject: Epstein Update Attachments: TEXT.htm Good morning: Same presentation today, but he said he thinks his memory for the incident (injury to his neck) may be impaired because of his sleep apnea. He is supposed to get his CPAP machine today. He is aware he will be returning to SHU, but said he is feeling unwell due to his inability to sleep and numbness in his arm. He requested to have one good night of sleep with his CPAP and will return to SHU with a cell mate tomorrow. (b)C7)(A> I told him he can stay down one more night to receive his CPAP and a good night's sleep, but that he would be returned to SHU tomorrow. It was explained that there is no mental health issues precluding him from returning to SHU tomorrow and that we could not house him in the SW/Hos ital area because b)(?XA> or more comfortable for him. b)(7)(A> He will remain on psychological observation today and will transition to the SHU tomorrow. Thank you, b)(G); (b)(ncci f b)(6); (b)(7)(C) I Psy .D. Chief Psychologist U.S. Department of Justice/ Federal Bureau of Prisons Metropolitan Correctional Center 150 Park Row NewYork, New York 10007 Office: (646) 836 bJC5>: (b)(7){c) Fax: (646) 836- E-mail :j(b)(G>: (b)(l J(c > ~bop.gov > > i (b){6); (b)(7)(C) 17 /28/2019 7:49 AM>>> AW Skipper-Scott, Inmate Epstein seems psychologically stable. N (b)(6); (b){7)(C) h" He complained that his right arm was numb and hanging earlier. urse~--~saw Im. He again said his right arm still feels somewhat numb and he said he cannot make a fist with that hand. He also said he has numbness on his neck. I informed Nurs (b)C 5 >:(b>< 7>cC> He stated the toilet in his cell was running for 45 minutes last night and he could not take the noise. He is going to try the toilet before going to legal today and if it does not shut off, he will be moved to another cell. Thanks, (b)(6); (b}(7){C) Page 1129

> b)l6); (b)(7)(C) b:(6); (b}(7)(C) Suicide Watch None Psych Observation 28 2019 7:36 AM>>> 1. Epstein #76318-054 Pending Bedspace for SHU r )(6); (b)(l)(C) 1 Thank you, Page 1130

Fwd: Re: Epstein investigation From r b)(6); (b)(7)(C) I To Charisma Edge Date 2019/08/10 16:20 Subject: Fwd: Re: Epstein investigation Attachments: TEXT.htm, mltC634.pdf No problem. Please see attached. P >)(6); {b)(7)(C) Supervisory Staff Attorney CLC New York Metropolitan Correctional Center 150 Park Row NewYork, New York 10007 p: (646)836 (b)(B/ (b)(7)(C) f: (646)836-7665 >>>Charisma Edge 8/10/2019 3:53 PM>>> Can you send me a copy of the death notification letter to the judge. Charisma Edge Associate Warden MCC New York 150 Park Row New York, NY 10007 =~= 646-836-6300 ext (bi(B); (b)(7)(C f b:16);_ @bop.gov :b)(7)(A) NYM/[email protected] r b)(6); (b)(7;(C) >>>1 ~/10/2019 3:05 PM >>>

Inmate Name: Date of Birth: Date: Bureau of Prisons Psychology Services Suicide Risk Assessment EPSTEIN, JEFFREY EDWARD 01/20/1953 Sex: M Facilit 08/01/2019 13:29 Provider: b)(5>: (b)(7><c> NYM PsyD Type of Housing: SHU- Administrative Segregation Cell Accommodation: Double-Cell FINDINGS **SENSITIVE BUT UNCLASSIFIED** Reg #: 76318-054 Unit Team: 5 This assessment and the resulting recommendations are based on the following sources of information: Clinical Interview, Medical Record, Psychology Data System, Sentry Reason for Referral R & D staff reported to this writer this morning at about 8:30 AM on 8/01/19 that yesterday when Mr. Epstein was brought back from court the US Marshals asked him to sign a form that noted Mr. Epstein has "suicidal tendencies." Mr. Epstein was seen for a Suicide Risk Assessment at about 1 :00 PM on 8/01 /19 in Attorney Conference. This note is being entered at about 4:20 PM on 8/01 /19. Mental Health History According to a Suicide Risk Assessment dated 7/09/1 9 b{bJts:: (b/(7)tcJ I, "Inmate Epstein denied any history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also denied any acute mental health symptoms at this time." Self-Harm History According to a Suicide Risk Assessment dated 7/09/1 9 by j<b)(5>: (bK?,(Cl I "Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behavior in the past." 'b)(7i(A) Current Problem R & D staff reported to this writer this morning at about 8:30 AM on 8/01/19 that yesterday when Mr. Epstein was brought back from court the US Marshals asked him to sign a form that noted Mr. Epstein has "suicidal tendencies." This is likely due to the incident on 7 /23/19, but as a precaution another Suicide Risk Assessment was conducted. Mr. Epstein seemed surprised that there was a form noting suicidal tendencies. He denied stating he was suicidal. He said he saw the OHO today and he said his incident report for the marks on his neck was expunged. He stated even though he has his cpap machine now, he said his cellmate talks at night and he stated this keeps him up. This writer offered to talk to the SHU Lt. to have him housed with a different cellmate, but he stated he wants to give it 3 to 4 days to see if he wants a different cellmate. He complained about the noise in SHU. Current Mental Status 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 Current Mental Status: He exhibited a neutral mood with a mildly restricted range of affect. His speech was logical and Generated 08/01/2019 16:21 b ~ b)(6): (b)(7)(C) f syD Bureau of Prisons • NYM Page 1 of 3

Inmate Name: Date of Birth: Date: EPSTEIN, JEFFREY EDWARD 01/20/1953 Sex: 08/01/2019 13 :29 Provider :bJC5J: Cb)(7)CCJ Reg #: 76318-054 Unit Team: 5 coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation and he agreed to immediately tell staff if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff if he has these thoughts. RISK AND PROTECTIVE FACTORS ASSESSED: This writer screened the inmate for a variety of empirically validated factors commonly associated with risk for self-harm and suicide. The following STATIC risk factors were assessed to be present and increase the inmate's risk for engaging in suicide related behaviors: High Profile Crime, Lack of family connections, Sex offender status The following DYNAMIC risk factors were assessed to be present and increase the inmate's risk for engaging in suicide related behaviors: Current physical pain, Sleep problems The following PROTECTIVE factors were assessed to be present and may decrease the inmate's risk of suicide:Able to identify reasons to live, Denial of suicidal ideation/intention/plans, Future orientation, Religious beliefs against suicide, Supportive family relationships, View of death as negative, Willingness to engage in treatment Risk Factors lbX7JCA) (b)(7)(A) ,b)(7)(A) e sex o ense case. Ica Is aware o e 1 Icu y s eepmg even with his cpap machine because he stated his cell mate talks at night. Protective Factors: He denied current suicidal or self harm thoughts and agreed to tell staff if he starts to have these thoughts. He had denied a history of self harm and suicide attempts. He had denied a family history of suicidal and self harm attempts. He had denied having any chronic medical conditions. He denied feeling hopeless. He had denied a history of childhood abuse. He denied fearing for his safety at this time. He denied feeling like a burden to anyone. He stated he lives for and plans to finish this case and to go back to his normal life. He said his friends and Lawyers are emotionally supportive. He said he is Jewish and he said in his religion suicide is against the religion. Overall, his current protective factors override his risk factors for suicidality. He is currently psychologically stable. He denied feeling hopeless. He is reporting positive future plans and reasons to live for. He said he has social supports in the community and his Lawyers visit him often. He denied any current suicidal or self harm ideation, intention or plan. Suicide Watch is not indicated at this time. DIAGNOSIS: No Diagnosis, No Dx - Current CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Overall Chronic Suicide Risk for this Inmate is: RECOMMENDATIONS 1. Suicide Watch is not indicated at this time. Low Absent 2. Supportive and educative interventions were provided. 3. He was educated about both routine and emergency procedures for contacting Psychology staff. 4. He will be seen in follow up by Psychology next week to monitor his mental status and to provide further intervention if needed. 5. In the meantime, he was encouraged to self-refer to Psychology if needed to which he agreed and seems capable of doing. 6. If he remains in SHU, he will be seen by Psychology in SHU Rounds and in SHU Reviews. Suicide Watch: A suicide watch is not warranted at this time Generated 08/01/2019 16:21 byf bl(5i: (b)(?JCCJ f syD Bureau of Prisons • NYM Page 2 of 3

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M F acil it Date: 08/01/2019 13 :29 Provider: _bJ(BJ; (bl<7)(CJ Completed b b)(B;; (bJmcc J syD on 08/01/2019 16:21 NYM syD Generated 08/01/2019 16:21 b~(bXB); (b)(7i(C) IPsyD Bureau of Prisons • NYM Reg #: 76318-054 Unit Team: 5 Page 3 of 3

Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/27/2019 07:14 Provider: ,..,..,..,,,M.,....,,..,.=,---F--c,aci lity: NYM lb)(6); (b)(7)(c) IPsyD Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation The "Eating/Shower Chart" indicated yesterday he ate dinner, drank liquids, and took a shower when offered. The Psych Observation Log noted he brushed his teeth, went to a Legal visit, talked about business and investing to an Inmate Companion, ate, and slept. lb)(7)(A: He stated that for the 5 da s before that he had onl sle t about 30 minutes each ni ht because of noise in SHU. Cb}(7)(A> :b)(7)(A) He said he has an appetite and is eating. He said he is waking up every 1 1 /2 hours. He stated he feels dehydrated because he is not drinking enough water because he stated he feels he is not given enough bathroom breaks while with his Attorney. Medical was e-mailed with his complaint of feeling dehydrated. He said his Lawyers and friends are all emotionally supportive. Current Mental Status: He exhibited a neutral mood with a full range of affect. His speech was logical and coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation. He stated "I'm a coward." He added he does not like pain and even does not like when he has to give blood. He agreed to immediately tell staff and Inmate Companions if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff and Inmate Companions if he has these thoughts. lntervention(s) Supportive and educative interventions were provided. Turning Points handouts on stress management, sleep, and building a routine in SHU were placed on his cell door to be given to him when his food slot is opened. He stated he wants it noted in his chart that he is being given a pamphlet on sleep, but that is not going to help because of the noise in SHU that prevents him from sleeping. Progress/Plan He will remain on Psych Observation in an abundance of caution and pending housing arrangements to be made on Monday. While on Psych Observation, he will be seen daily by Psychology. Completed bl(blC5>: Cbl(7J(c> I PsyD on 07/28/2019 09:19 Generated 07/28/2019 09:19 b 'b)(BJ: lblC7llC) PsyD Bureau of Prisons - NYM Page 1 of 1

(b)(7)(A) '.b)(7)(A) (b)(7)(A) 9. Attorney Log Books Please provide a copy of the log book audit. Institution Response: The audit revealed the Random Visitor Log Book did not reflect visitor pat searches after May 19, 2019. In addition, the Jog book does not offer a column to annotate a staff witness. The ContractorN olunteer Log Book was not always filled in properly. The Law Enforcement Log Book was up to date; however, the time of departure was not always documented. The Attorney Log was missing inmate register numbers and more often than not was legible. There was no Visitor Denial Log created. The audit conducted on September 25, 2019, is attached for your review. 3

Additional corrective measures will now include the Activities Lieutenant checking all Front Lobby log books. The Captain will ensure these checks are included in the Lieutenant's Daily Log for Day Watch and Evening Watch. In addition, the Activities Lieutenant will address any discrepancies immediately through on the spot training and/or performance log entries. 13. Sex Offense Risk Factors Psychologists are subject matter experts in sex offender risk factors and they play a crucial role in sharing this knowledge through traditional settings such as ICT, AT, and institutional meetings. However, Executive Staff play a pivotal role in establishing and addressing institutional culture and promoting and participating in training. A lack of a broad understanding of sex offender specific risk factors requires an intentional training approach led by Executive Staff. They must be out front talking about inmates with a sex offense, expressing an understanding of sex offender dynamics, modeling agency condoned expectations for the understanding and treatment of inmates with a sex offenses, and assisting with institutional trainings. These practices encourage a broader acceptance by line staff. Institution Response: The MCC New York Executive Staff are out front talking about inmates with sex offenses, and expressing an understanding of sex offender dynamics, modeling agency expectations for the understanding and treatment of inmates with sex offenses. This is done through departmental meetings, trainings, staff recalls and walking and talking throughout the institution. (b)(7)(A) 4

b)(7)(A) (b}(7)(A) :b}(7)(A) :b)(7)(A) (b)(7)(A) (b)(7)(A) 9. Attorney Log Books: Four log books were not secured following Mr. Epstein's death. Specifically, three Attorney Log Books located in the Attorney Visiting and Front Lobby areas and an Inmate Search Log Book located in the Attorney Visiting area were not secured. All four books were still in use at the outset of tbe reconstruction and after the reconstruction team advised staff to secure them. P5324.08 states, "In the event of a suicide, institutjon staff, particularly CoITectional Services staff, and other law enforcement personnel, will handle the site with the same level of protection as any crime scene in which a death has occu1Ted." This policy further states, "All possible 10

evidence and documentation will be preserved to provide data and support for subsequent investigators doing a psychological reconstruction." Further, a review of the attorney log books identified many errors and signify a systemic concern. For example, there were two concurrently open attorney log books in the Attorney Visiting area. Further, the different purposes of the two attorney log books, one in the Attorney Visit area and one in the Front Lobby, could not be explained. BOP staff were unable to articulate a system of control for the Jog books, and during the reconstruction, some of the log books could not be accounted for. Within the log books, entries were made out of chronologicaJ order, attorneys did not consistently sign in and out, significant information was illegible or missing, columns were not consistently labeled, log book opening and closing dates were inconsistent, and the cover had been tom off of several books. At the cmTent time, these log books are not functioning as an adequate system of control and monitoring. Institution Response: 9. Attorney Log Books: On August l 0, 2019. log books deemed relevant to the investigation were removed from various locations throughout the facility. The Reconstruction Team did identify pertinent logbooks that had not been secured. At this time, all relevant logbooks have been removed and replaced. ln addition. a logbook audit was conducted to ensure accuracy of the documentation and compliance with policy. Measures are being taken lo ensure in the future that all relevant logbooks are identified, secured immediately and replaced with new ones to ensure the institution can continue to run efficiently. 10. Automatic External Defibrillators: A review of available AEDs in the institution revealed that the list used for accountability and inspection purposes was inaccurate and incomplete. Institution Response: I 0: Automatic External Defibrillators: A review of the Automatic External Defibrillators (AED) report presented by Great Lakes Biomedical Services dated July 22.2019. revealed that all AEDS were accounted for and were placed in the correct respective areas. The report was accurate and complete. New AEDs have been purchased and wjll be inspected Great Lakes Biomedical Services upon their arrival. The list reviewed by the reconstruction team was an old and outdated list from January 8. • 2018. Medical staff provides training and conducts monthly inspections of all AEDs in the institution. Great Lakes Biomedical Services. an outside contractor, conducts a bi-annual inspection and provides a report. Procedures on inspecting all AEDS in the institution have been prepared and are awaiting approval. These procedures are at1ached hereto. 11. Post Orders & SHU Training: SHU Post Orders Sign-In Sheets were reviewed for the 3rd Quarter, spanning June 9, 2019, to September 7, 2019. Office b)(5>;(b><7)(c> failed to sign post orders for SHU #3 post. Quarterly SHU Training Sign-Tn Sheets were reviewed. The 2019 3rd Quarter SHU Training was conducted on June 6, 2019. Three staff assigned to the 3rd Quarter SHU Roster in SHU did not atrtend or receive the SHU Training: Officerfb!<5>; <b>a>cci IOffice1bK5>; (bi{7)(C} land Officer[°><5>; (b>C7)cc> f Institution Response: 11 . Post Orders & SITU Training: The Suicide Watch Post Orders arc located in the Lieutenant's Office and SHU with a quarterly sign-in sheet. A copy of the Suicide Watch Post Orders will also be placed in a secure container outside of the suicide watch cells on Tier H in SIIU. This container will also hold signature sheets and additional Staff Suicide Watch Log Books. 11

All staff members assigned to a suicide watch post are responsible for signing the post orders prior to performing the staff suicide watch. Attached please !ind a copy or the NERO Waiver permitting staff monitored suicide watches in SHU. With regard to SHU Suicide Prevention training, this continues to be conducted on a quaiterly basis. However, the sign-in sheets for this training arc now be examined by the SHU Lieutenant for accuracy. If a staff member who is assigned to SHU misses the training, the sign-in sheet will be routed to the Captain, who will coordinate with the Chief Psychologist and schedule a time to receive a make-up session for the SI [U Suicide Prevention Training. SHU training is conducted quarterly two weeks from the beginning of the new quarter. A representative from Psychology will provide the required suicide prevention training. In addition. the SHU training on BOPLEARN will be completed by all staff assigned to SHU that day of training. SHU staff will be allotted time during that day to complete all prescribed web-based training as identified on the agenda. Staff who are assigned to SHU but have not received the mandatory training before assuming the post will be roster-adjusted to attend another training day as assigned by the Captain. Staff assigned to suicide watch shall maintain a chronological log of the inmate's behavior. Blank log books will be maintained in the Lieutenants office and on the 2 nd Floor. A chronological record or events will commence immediately upon the initiation of watch. It is the responsibility of the staff member initiating the watch to obtain a blank log book prior to initiating the watch. Different log books will be used for each inmate on suicide watch; each log book wi II contain entries for one suicide watch only. The name and register number of the inmate on watch shall be clearly printed on the front cover of the log book and at the top of each page in the log book in which entries are made. During some suicide watches. staff observers may cover some shills and inmate companions may cover others. In this instance, two separate log books must be used: one for the shifts during which staff are maintaining constant visual observation (blue) and another for shifis during which inmate companions are providing constant visual observation (yellow). When separate inmate companion log books are used. staff must sign the inmate companion log book every 60 minutes. Lights will remain on inside the cell 24 hours day to ensure the inmate on watch can be seen. A Lieutenant will make rounds every shift and remove the inmate from the cell and perform a cursory search. No food items, trays. eating utensils. milk cartons. toilet paper, plastic bags, reading materials. pens, pencils, or anything else not prescribed by Psychology staff should be in the cell. The inmate will be outfitted in a suicide preventive smock, suicide preventive blanket, suicide preventive mattress and if necessary a suicide preventive helmet. Inmate Companions will be searched prior to assuming duties. Inmate Companions are not allowed to have radios, mp3 players, magazines, books or anything that would distract them from maintaining constant supervision. Inmate Companions will not have direct or physical contact with inmates on suicide watch. 12. Staffing: The Drug Abuse Program Coordinator positon at MCC New York was abolished during Phase l of the staff realignment during fiscal year 2018. Re-establishing the Drug Abuse Program Coordinator position would provide the institution with an additional supervisory psychologist to provide critical clinical services. Staffing in the Correctional Services department is relevant to the reconstruction. However, the details about this topic are provided in an After Action Review completed separately from this report. 12

Institution Response: 12. Stafling: The Drug Abuse Coordinator position is currently a shared position. The Warden has re-established the Drug Abuse Coordinator position as a full-time position to provide the Psychology Department with an additional supervisory psychologist to perform critical clinical services. At the current time, the posi tion is pending selection. We are currently in the process of requesting to hire a Staff Psychologist position to provide additional psychological services to inmates in the SI IU, including therapy sessions with PSY ALERT, CC2-MH and CC3-MH inmates who arc currently housed there. An additional psychologist could also monitor I lot List inmates arriving to the SIIU and ensure they are housed with appropriate cell mates. This psychologist could conduct daily rounds to look for signs of psychological distress and address the concerns of om Long Term SHU inmates. Finally, an additional Staff Psychologist could assist with our daily crisis interventions and suicide risk assessments. 13. Sex Offense Risk Factors: A broad understanding of risk factors associated with sex offenders, by staff at MCC New York. did not annear to be oresent in all staff but was vital to his adiustment and safetv in orison. A more (b)(S) Institution Response: 13. Sex Offense Risk Factors: The Chief Psychologist is a member of the Executive Staff. The Chief Psychologist or her designee continues to be present at all Executive Staff meetings, Department Head meetings, and SHU meetings. During these meetings. the Chief Psychologist offers feedback regarding the treatment and management or sex offender inmates. Additionally, the Chief Psychologist continues to educate all staff during Introduction to Correctional Techniques (ICT) and Annual Training (AT) about the sex offender specific risk factors and suicidal ity. b)(7)(A)

Form 583 Report of Incident Incident#: NYM-19- 0076 Submitted By: Skipper-Sott, S. Date/Time Of Incident: 7/23/2019 1 :27 AM Section 1: General Information Staff Aware Date: 7/23/2019 1 :27 AM FBI Notified: No USMS Notified: No Indicate Where Incident Occurred: Main Facility Location Level 1: SHU Type Of Incident Level 2: Housing Unit, Special (SHU) Level 3: 9 SOUTH SHU D Assault On Inmate D Assault On Staff D Assault, Attempted On Inmate D Assault, Attempted On Staff D Disruptive Behavior D Escape From Non-secure Facility D Escape From Secure Facility D Escape, Attempted From Non-secure Facility D Escape, Attempted From Secure Facility 0 Fight D Inmate Death D Institution Disturbance D Introduction Of Contraband D Lethal Weapons Discharge IZl Self Mutilation D Setting A Fire D Sexual Act, Non-consensual On Inmate D Sexual Assault On Staff D Sexual Contact, Abusive On Inmate D Sexual Harassment, Repetitive D Staff Homicide D Strike, Food D Strike, Work Method: Laceration IZ) Suicide Attempt D Use Of Force Method: Hanging/Asphyxiation D Use Of Force/Applications Of Restraints D Use of Restraints, Pregnant/Postpartum (b)(7)(A) Institution Locked Down: No Modified Operations: No Cause Of Incident Known? No Cause Of Incident 0 Alcohol D Commissary D Debts D Disrespect Issue D Drugs D Ethnic Conflict D Food Issue D Geographical Conflict D Interfering with Staff duties D Property Issue D Racial Conflict D Recreation Equipment D Religious Issue D Security Threat Group Conflict D Sexual Pressure D Sporting Events D Telephone 0 Theft D Visiting D Work Issue 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). 1 of 4

Form 583 Report of Incident Incident#: NYM-19- 0076 Submitted By: Skipper-Sott, S. Date/Time Of Incident: 7/23/2019 1 :27 AM (b)(7)(A) Section 3: Others Involved Name: l(b)(6>: (blC7l(C> I Person Type: Staff Medical Attention Required : No Death: No Injury Category: No Injury Staff Injury by Inmate: No Sexual Assault: No Name: [ b><6>: (bl(7l(C> I Person Type: Staff Medical Attention Required: No Death: No Injury Category: No Injury Staff Injury by Inmate: No Sexual Assault: No Name: r b)(6); ib)(7)(C) Person Type: Staff Medical Attention Required : No Death: No Injury Category: No Injury Staff Injury by Inmate: No Sexual Assault: No Name: [ b)(6): (b)(7)(C) I Person Type: Staff Medical Attention Required: No Death: No Injury Category: No Injury Staff Injury by Inmate: No Sexual Assault: No Name: [ b)C6) (b)C7)(Cl I Person Type: Staff Medical Attention Required: No Death: No Injury Category: No Injury Staff Injury by Inmate: No Sexual Assault: No N l(bX6); (b)(7)(C) ame: 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). 2 of 4

Form 583 Report of Incident Incident#: NYM-19- 0076 Submitted By: Skipper-Sott, S. Date/Time Of Incident: 7/23/2019 1 :27 AM Injury Category: No Injury Sexual Assault: No No data found. No data found. Staff Injury by Inmate: No Section 4: Lethal Weapon Discharge Section 5: Use of Force 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 vour descriotion. File Date 7/24/2019 7/24/2019 7/24/2019 7/24/2019 7/24/2019 7/24/2019 7/24/2019 7/24/2019 7/24/2019 7/24/2019 7/24/2019 7/24/2019 Section 7: Attachments File Name ST AFF} =!9,§J:,ER.pdf ,b)(7)(A) r b)1.6/, (b)(7)(A), (b)\7)(C) INMATE EPSTEIN PHOTOS.pdf INMATE EPSTEIN IR.pdf ADO.pdf Original Entered By (b)(6): (b)(7)(C) Original Loe. Code NYM NYM NYM NYM NYM NYM NYM NYM NYM NYM NYM NYM 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). 3 of 4

Form 583 Report of Incident Incident#: NYM-19- 0076 Submitted By : Skipper-Sott, S. Approved By: SUBMITTED ----------------- Skipper-Sot!, S. Date/Time Of Incident: 7/23/2019 1 :27 AM 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). 4 of 4

Fwd: Re: Epstein From To Date Subject: Attachments: ~~~------, amine N'DiayeShirley V. Skipper- 2019/07/25 14:14 Fwd: Re: Epstein TEXT.htm Page 1557

Fwd: Epstein Update From Shirley V. Skipper-Scott To Date Subject: Charisma Edge 2019/07/29 10:30 Fwd: Epstein Update Attachments: TEXT.htm Check this out. Shirley Skipper-Scott Associate Warden MCC New York 150 Park Row New York, New York 10007 Office: 646-836 b)(6); Cb)[7)(c> (b)(6); (b)[7)(C) Black Berry: 646-423 ~-~ r )(6); (b)(7)(C) ~ bop.gov > > ! b)<5>; tbJ<7l<C) Ir 7/29/2019 10:02 AM > > > Good morning: Same presentation today, but he said he thinks his memory for the incident (injury to his neck) may be impaired because of his sleep apnea. He is supposed to get his CPAP machine today. He is aware he will be returning to SHU, but said he is feeling unwell due to his inability to sleep and numbness in his arm. He re uested to have one ood ni ht of slee with his CPAP and will return to SHU with a cell mate tomorrow. b)(7)(A> I told him he can stay down one more nig t to receive is CPAP an a goo nig t's seep, ut t at e wou d be returned to SHU tomorrow. It was explained that there is no mental health issues precluding him from returning to SHU tomorrow and that we could not house him in the SW/Hos ital area becaus (bHn(A) r more comfortable for him tb)[7)<A> He will remain on psychological observation today and will transition to the SHU tomorrow. Thank you, bJ(7)(c) r :b)(6); (b;[7)(C) I p Q ~----~ sy .. Chief Psychologist U.S. Department of Justice/ Federal Bureau of Prisons Metropolitan Correctional Center 150 Park Row NewYork, New York 10007 Office: (646) 83 bl<5>; tb)[7)tc) Fax: (646) 836-7712 E-mail ~rb:c5i tb)[7)(cJ @bop.gov V /28/2019 7:49 AM > > > AW Skipper-Scott, Inmate Epstein seems psychologically stable. He complained that his right arm was numb and hanging earlier. Nurs b)<5>; (bl<71<c> aw him. Page 1562

He again said his right arm still feels somewhat numb and he said he cannot make a fist with that hand. He also said he has numbness on his neck. I informed Nurs1:b)C5> Cb>a)cc) I He stated the toilet in his cell was running for 45 minutes last night and he could not take the noise. He is going to try the toilet before going to legal today and if it does not shut off, he will be moved to another cell. Thanks, > (b)(6); (b)(7)(C) (b)(6); (b)(7)(C) Suicide Watch None 7/28/2019 7:36 AM>>> Psych Observation 1. Epstein #76318-054 Pending Bedspace for SHU [ b)(6); (b)(7)(C) I Thank you, r /(6); (b)(7)(C) Page 1563

-------- Original message•······· From: Ray Ormond l o)(6l; Pbop.gov> Date: 7/23/19 11 :46 AM (GMT-05:00) To: Lamine N'Diay~ j1h;,s, Pbop.gov> Subject: Re: Epstein » > "Ray Ormond" 07/23/2019 11 :46 » > Lamine - The memo is very confusing. Please draft an email of his actions and current status. Also include what plans were in motion to move him to a GP unit. It will nee </div> <div> </div><!-- original Message•·> <div>-······· Original message --------</div> <div> From: Lamine N'Diay )~((~)(,.,, bop.gov> </div> <div> Date: 7 /23/19 11 :12 AM </div> » > "Lamine N'Diaye" !(b)(~J~~- k;>bop.gov> 07/23/2019 11:12 » > Sent from my Verizon, Samsung Galaxy smartphone<div> </div> <div> /d• 1 • • IM d. 0 • • I /d. d. F "Sh. I V Sk. S J b)(5): (b)(7)(C) L b / d. d. D 7/2" < Iv><.-- ongma essage -->< Iv>-------- ngIna message --------< Iv>< Iv> rom: Irey . Ipper- cotq.._ ____ __,12' op.gov>< Iv>< Iv> ate: , </div> Page 1604

Inmate Epstein #76318-054 (Suicide Watch) To From f b)(6); (b)(7)cc> I l:=. ii)== (6)=: (b:::::: )(7== )(C=) ===~-----------------~ )(6): (b)(7)(C) Date Subject: Attachments: b)(7)(A) 2019/07/23 13 :07 Inmate Epstein #76318-054 (Suicide Watch) TEXT.htm Page 1955

Epstein #76318-054 From To l(b)(6); (b)(?XC) Date Subject: Attachments: 2019/07/24 11 :41 Epstein #76318-054 TEXT.htm SIS, (bP)(A) l(b)(6); (b)(?)(C) Very respectfully, :b)(6:; (b)(7)(C) Ph.D. ~------~ Forensic Psychologist LT, U.S. Public Health Service U.S. Department of Justice Federal Bureau of Prisons Metropolitan Correctional Center 150 Park Row NewYork, New York 10007 Office: 646.83 l~lm(C) Fax: 646.836.7712 E-mailfb:15>; (b)Cn <c , ~ bop.gov !Cb)(6); (b)(7)(C) ,b)(6); (b)(7)(C) "This message is intended for official use and may contain SENSITIVE information. If this message contains SENSITIVE informat ion, it should be properly delivered, labeled, stored, and disposed of according to policy." Page 1972

'.b)(7)(A) (b)(7)(A) bi(7)(A) Shirley Skipper-Scott Associate Warden MCCNewYork 150 Park Row New York, New York 10007 Office: 646-836.._(b~)(=~>_: -.,,.,.,.,,,...._..., Black Be 646-42 '.~;\~(;~, (b)(6); (b)(?)(C) bop,gov Shirley Skipper-Scott Associate Warden MCCNewYork 150 Park Row New York, New York 10007 Office:646-83. '...,b) __ (~ ___ r -,;-·~,-----, Black Be : 646-42 b)~) _, b)(6); (bl(7)(Cl , bop.go..,.\.,.,' ,.,--~ >» Lamine N'Diayej:b)(6); _ fi}bop.gov> 7/23/2019 12:30 PM >» Can you get this for me. Sent from my Verizon, Samsung Galaxy smartphone ------- Original messa e •······· From: Ray Om1011 lei(~\;~, bop.gov> Date: 7/23/ 19 11 :46 AM GMT-05:00) To: Lamine N'Diay \~;)~\ic\ bop.gov> Subject: Re: Epstein 'b)(?)(A) Page 2053

>>> "Ray Ormond" 07/23/2019 11 :46 >>> Lamine -TI1e memo is very confusing. Please draft an email of his actions and cuffent status. Also include what plans were in motion to move him to a </div><div> </div><!-- originalMessage --><div>-------- Original message --·-····</div><div>From: Lamine N'Diaye ;gl(~Uci bop.gov> </div><div>Date: 7/23/19 </div> »> "Lamine N'Diaye'1\~/\~!~~- @bop.gov> 07/23/2019 11:12 »> Sent from my Verizon, Samsm1g Galaxy smartphone<div> </div><div> </ctiv><!•- originalMessage •• ><div>-··-···· Original message •••••••• </div><div>From: "Shirley V. Skipper.Scott"fbl(6); (b)(?)(C) @bop.gov></div><div </div> Page 2054

Media inquiry - Washington Post - re: health status of Jeffrey Epstein From To Date Subject: Attachments: (b)(6): (b)(7)(C) (b)(6): (b)(7)(C) (b)(6): (b)(7)(C) xec Assistant~ NYM/Exec Assistant~ 2019/07/23 18:05 Media inquiry - Washington Post - re: health status of Jeffrey Epstein TEXT.htm If you happen to get this tonight, maybe you can call me on my cell at 202-32.~lmir.1 My boss may want to answer this reporter tonight, but before we send an answer perhaps like the one below we wanted to see for our own internal awareness what you may know about this if any of it is true in regard to Epstein. My mobile Samsung is not always receiving emails and leaving work now, so my personal cell by calling the number above is best if you get this. Thanks so much, (b)(6); (b)(7)(C) Public Information Office Federal Bureau of Prisons (202) 35 b)(6): (b)(7)(C) > > b)(S); (b)\?)(Cl 7/23/2019 5:57 PM > > > ~(b-)(6-); l-b)(~7)(-C)----~ While I will probably reply to this reporter with something like my draft below which doesn't reveal much if anything, nonetheless we want to be sure we understand from you or the institution what if anything may have happened with inmate Epstein. Could you see if the institution can look into this and provide us with what they may know for our internal purposes (not for release to media)? We will reply to media inquiries about Epstein (not the institution) since stories about him are national news (unless we finalize an answer that we could give to the institution to use as well if media ask about this tomorrow). Thanks, lb/16); (b)(7)(C) (b)(6); (b)(7)(C) Pu ic In ormation Office Federal Bureau of Prisons (202) 353 b)(G); (b)(7)(C) Page 2103

,;, ,;, ,;, l(bi(6); (b>(7}(C) 1,wwc:1~1 IJ.,IU~L.LUI I 1-> / / L:J( LU I J :J.""t:J l"IVI ,;, ,;, Hi, b)(7)(A) We are seeking any information and comment you can offer on this subject. My number is 202 617 l(b)(6); (b)(7)(C) I Thanks, f b)(6); (b)[?)(C) Washington Post Page 2104

> > uperv1sory ta ttomey > CLC New York > Metropolitan Correctional Center > 150 Park Row > New York, New York 10007 > P: ( 646)8 3 6-:b)(G); (b)(7)(C) > f: (646)836-7665 > > Page 2145

Re: Epstein From To f b)(6); (b)(?}(C) r )(6); (b)(7)(C) Date 2019/07/25 15:17 Subject: Re: Epstein Attachments: TEXT.htm, EPphotos.pdf, EP.staffmemos.pdf Page 2152

Re: Epstein #76318-054 From l(b)(6>: (b)(7)(c> ~. ,,,.-,.,,,-,....,,-..,.,,-,,,..,,-~---_-_-_-_-_~---, To (b)(6): (b)(7)(C ) Date 2019 07 24 12:00 Subject: Re: Epstein #76318-054 Attachments: TEXT.htm Page 2218

AW SS just called regarding his competency .... I said yes, do you agree? l (b)(6); (b)(7)(Ci I ~- ----~Psy.D. Chief Psychologist U.S. Department of Justice/ Federal Bureau of Prisons Metropolitan Correctional Center 150 Park Row NewYork, New York 10007 Office: (646) 836 b)(G); CbK7)<c ) Fax: (646) 836-7712 E-mail r (6); (b)(? )(C ) r bop.goy > > 1 b)(6); (b)(7)(C) SIS, f/24/201911:41 AM>>> b)(7)(A) Very respectfully, l(b)(6); (b)(7)(C) I l (b)(6); (b)(7)(C) I h ~- ----~ p .D. Forensic Psychologist LT, U.S. Public Health Service U.S. Department of Justice Federal Bureau of Prisons Metropolitan Correctional Center 150 Park Row NewYork, New York 10007 Office: 646.83 ig~!tq Fax: 646.836.7 E-mailr G);(b)(7i(C) bop.gov l(b)(6); (b)(7)(C) "This message is intended for official use and may contain SENSITIVE information. If this message contains SENSITIVE information, it should be properly delivered, labeled, stored, and disposed of according to policy." Page 2219

Inmate Epstein #76318-054 (Suicide Watch) From To Date Subject: Attachments: b)(7)(!1) l(b)(6 ); (b)(7)(C) I llb)(6); (b)(7)(C) 2019/07/23 13 :07 Inmate Epstein #76318-054 (Suicide Watch) TEXT.htm Page 2311

' BP-, 1021!8' JAN,1F ' .. U.S. DEPARTMENT OF JUSTICE SHU M-Tier Cell 124 11. Description of Incident (Date: 07/23/2019 (b)(7)(A) f b)(6); (b)(7)(C) re): (b)(6); (b)(7)(C) INCIDENT REPORT 1gnmen : Unassigned FEDERAL BUREAU OF PRISONS . 1me: 1:27am Time: 1 :27 AM Staff became aware of Incident): (b)(6); (h\f7\f("' 17. Comments of Inmate to Committee Regarding Above Incident: ~:_1_._1m __ ,_k_1a_._?~ ! ~ n~ s l,fff,h mi& r )(7)(A) J :::J: 18. A. II ls the finding of the committee that you: Committed the Prohibited Ad as charged: Did not Commit a Prohibited Act. Committed Prohibited Act Code (s). B. ~ The Committee Is refen1ng the Charge(s) to the OHO for further He C. The Committee advised the inmate of Its finding and of the right to e an appeal within 20 calendar days. 19. Committee Decision is Based on Specific Evidence as Follows: ;:4ht~.i_¾I~ "lib '44,e.; 011-0 barn .d on. '-Iha: @1-cdj :~-_f ... ?2mm .... ,,. ,..,._,. OHO (C<>"'o,ge,uupon OHO - inmoW oommm.d '""'""' "°' ,b)(6); (b)(7)(C) Member (Typed Name): Member (Typed Name): tNSfRDcTIONS: All Hems outside of heavy rule are for staff use only. Begin entries with the number 1 and woi'k up. Entrles not completed wlll be voided by staff. Distribute: Original-Central Fife Record: COPY-1-0HO: COPY-2-lnmate after UDC Action: COPY 3-tnmate within 24 hours of Part I Preparation PDF Presaibed by P5270 Replaces BP-A0288 of AUG 11

Part III - Investigation 22. Date And Time Investigation Began 7/30/2019 12:40PM · 23. Inmate Advised Of Right To Remain Silent: You Are Advised Of Your Right To Remain Silent At All Stages Of The Disciplinary Process But Are In rmed That Your Silence May Be Used To Draw An Adverse Inference Against You At Any St ge Of The Institutional Disciplinary Process . You Are Also Informed That Yours · ence Alone May Not Be Used To Support A Finding That You Have Committed A Prohibit= -~ • The Inmate Was Advised Of The Above Right 12:40PM nant (Date/time)?/30/2019 24. Inmate Statement And Attitude: Inmate Epstein, Jeffery #76318- 054 was advised of his rights and understood his rights as read. Inmate Epstein stated "I no comment at this timen, Inmate Epstein had a poor attitude . Inmate Epstein was furnished a copy of this report. 25. Other Facts About The Incident, Statements Of Those Persons Present At Scene, Disposition Of Evidence, Etc. No witnesses requested . Please see attached staff memorandum, photograph and medical assessment. This incident report was served late due to inmate on suicide watch. 26. Investigator's Comments And Conclusions: Based on the writer's description of the incident in block #11, of the incident report, This investigator concludes the report to be accurate as written and the charge warranted. 27 . Action Taken: Inmate Epstein is in his special housing unit status, this report referred to UDC for further disposition. ion Completed 7/30/2019 12:45PM Signature Title Lieutenant

Re: Epstein #76318-054 From To Date Subject: r b)(6); (b)(7)(C) 2019/07/24 12:01 Re: Epstein #7 6318-054 Attachments: TEXT.htm Page 2640

yes > > ~b)(6) (b)(7)(C) 17 /24/2019 12:00 PM > > > AW SS just called regarding his competency .... I said yes, do you agree? fb)(6); (b)(l)(C) I Psy.D. Chief Psychologist U.S. Department of Justice/ Federal Bureau of Prisons Metropolitan Correctional Center 150 Park Row NewYork, New York 10007 Office: (646) 836 f~;~!ir.i Fax: (646) 836-7712 E-mail:fb>(5>;<b)<7><c> ~ bop.gov > > ~ :b)(6); (b)(7)(C) 17/24/201911:41 AM>>> SIS, (b)(7)(A) r b)(6); (b)(7)(C) Very respectfully, l(b)(6); (b)(7)(C) I r )(6); (b)(7)(C) i Ph.D. Forensic Psychologist LT, U.S. Public Health Service U.S. Department of Justice Federal Bureau of Prisons Metropolitan Correctional Center 150 Park Row NewYork, New York 10007 Office: 646.83 (b)(G); (b)(?)(c Fax: 646.836.7712 E-mail :fb>C5>: (b)(7><c1~ bop.gov "This message is intended for official use and may contain SENSITIVE information. If this message contains SENSITIVE information, it should be properly delivered, labeled, stored, and disposed of according to policy." Page 2641

BP-A0563 JUN 10 MUL Tl-LEVEL MORTALITY REVIEW U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS Date: To: From: Subject: Inst: 09/09/2019 Office of Quality Management MCC New York Health Services Mortality Review for Inmate Epstein #76318-054 MCC-NY Name: Epstein, Jeffrey Reg. #: 76318-054 DOD : 08/10/2019 DOB: 01/20/1953 Age: -~66 __ Sex: Male Place of Death: _ Inst. :L Community Hospital _ OTHER Name of community hospital: New York Presbyterian Lower Manhattan Hospital Nature 1:>f Death: _ Natural (chronic) _ Natural (Acute) _ Accidental: _______________ _ _ Homicide .L Suicide (Method) Hangjng Cause(s) of Death: Ax h iation NARRATIVE SUMMARY: (Should include components below) Date of admission to the 07/06/2019 Race: ...L.New commit __ Transfer from ______ _ Holdover Status: __ Inpatient at: __ Inst. __ Community Hospital __ Outpatient AdmlttinR 1. Sleep Apnea 2. Hypertriglyceridemia 3. L4 - LS Lumbar Stenosis 4. ------------------------ --------- (Pis. continue on supplementary page if necessary) Past diaRnosls: 1. Sleep Apnea 2. HyPertriglyceridemia 3. L4 - LS Lumbar Stenosis 4. --------------------------------- (PI s. continue on supplementary page if necessary) Significant mental health __ (Yes) _L(No) _ (NA) Include specific information as relevant to death: PDF Presaibed by P6013 White

Name: ____ E ... ps=te...,in""', J.,.e,..ffre~y ___ _ Reg.#: ___ ___:7.:.63:;.:1..::.8-.:.0.::..S4:...... __ _ DOB: 01/20/1953 Admitting dlagnosis:(continue) Past diagnosis: (Continue) PDF Prescribed by P6013

Description of course of illness (past and present) and cause of the death in sufficient detail to indicate circumstances of death, including treatment, medications, diagnostic testing, etc. Give findings of diagnostic exams. Insert pages in this section as required. Intake Screeninq History and Physical present? Date of most recent History and Physical Timeliness of Diaqnostic and Treatment reqimes? Discharge summary from Attending M.D. on chart Institution Community Hospital Autopsy Toxicology Death Certificate Available INSTITUTION MEDICAL CARE REVIEW: Severity of illness at time of admission to hospital / Health Services Unit Proqnosis on admission to hospital / health Services Unit Were diagnostic procedures appropriate and timely _:/_Yes 07/09/2019 .-LYes __ Yes __ Yes __ Yes __ Yes __ Yes -- Critical . _L __ Poor _L _LYes _:/_Yes _____No _NA _No _.NA _L_No _NA _L_No _NA _LNo _NA LNo -----NA _L_No _NA Stable Unknown Good NA __ No __ No Was treatment appropriate to diagnosis and instituted timely Proqnosis with treatment -- Poor _L_ Good __ Unknown Any complications adversely affecting outcome: Describe briefly Asphvxiation Secondary to Hanging. Was treatment appropriate to complication Surgical Procedures (list) Appropriate pre-operative evaluation completed, including lab, physical exam, updated history Complications related to surgical procedures (describe) _____________________ _ Prognosis following surgical procedure Patient compliant with treatment / medications PDF Prescribed by P6013 __ Yes _LYes __ Yes __ Yes __ Yes __ Poor __ Yes ...L_No __ No __ No __ No __ No ...:L_NA Good ....L... Unknown __ No _:{_NA 3

Discussion with patient or patient's family regarding prognosis DNRorder Advance Directive / Living Will LOCAL COMMUNITY HOSPITAUZA TIONS ONLY: __ Yes __ Yes __ Yes Date _No ...L...NA .L.No LNA Type of admission __Routine 1-.Emergent __ Other Method of transportation appropriate to patient condition Severitv of condition at time of admission to local hospital ProAnosis on admission to local hospital Were diagnostic procedures appropriate and timely Was treatment appropriate to diagnosis and instituted timely ProAnosis with treatment Any complications adversely affecting outcome: (describe briefly) Asphyxiation Secondary to Hangjng. Was treatment appropriate to complication _..:f.._Yes _:{__ Critical _L__ Poor .LYes _:/_Yes _:I_ Poor LYes Surgical Procedures (list) ________________ _ LYes __ Yes Appropriate pre-operative evaluation completed, including lab, physical exam, updated history Complications related to surgical procedures Describe ------------------------ __ Yes __ Yes _No -- Stable -- Good _No _No -- Good _No _No _:L_).Jo Prognosis following surgical procedure -- Poor __ Good Patient compliant with treatment / medications Discussion with patient or patient's family regarding patient prognosis PDF Prescribed by P6013 __ Yes __ Yes _No __ No _NA -- Unknown --Unknown -- Unknown _L Unknown ...LJ.JA LNA 4

DNRorder Advance Directive / Living Will REVIEW OF EMERGENCY MEDICAL CARE: Was death related to a medical emergency Response to medical emerQencv notification timely Physician Physician Assistant Nurse Practitioner Nurse(s) EmerQencv Medical Techs Others CPR ACLS List protocol (s) used (if appropriate) B EMS. Problems encountered during medical emergency, e.g., equipment, communications, transportation. Describe briefly: Providers responding maintain current certification / credentials in BCLS, ACLS (if required) SUMMARY REVIEW: (b)(7)(A) .bi(7)(A) PDF Prescribed by P6013 __ Yes __ Yes ....:f.._Yes ....:f.._Yes _L_Yes ....:f_yes __ Yes __ Yes __ Yes ....:f.._Yes ....L_Yes __ Yes ....:L._ves Date Date _No _No _No __No _No _No _No __No _No ....L_No __No ....i.....No ...L.No _NA _NA __:l___NA ...LM _NA ...:L.J.JA _NA _NA _NA

Documentation in medical record reviewed by Mortality Review Committee and found to be within acceptable limits. If no, describe ______________ ________ ___; __ Did patient receive appropriate and adequate health care, consistent with community standards, during his incarceration in the Federal Bureau of Prisons? If no, explain State any strengths and weaknesses that existed: _:/_Yes ....LYes _No __NA _No __NA I. The Mortality Review Committee reviewed the Medical Record. The patient received timely and appropriate medical and psychological care. 27. Recommendation(s) if any. The Mortality Review Committee reviewed the Medical Record. No recommendations at this time. 6 PDF Prescribed by P6013

28. Attachments: 1. Medical Record __ 2. Narrative Summary __ 3. Death Certificate __ 4. Autopsy Report __ 5. Other Documents as appropriate (list) ALL INFORMATION CONTAINED IN THIS REPORT IS EXEMPT AND TO BE CONSIDERED FOR REVIEWNIEWING ON A NEED TO KNOW BASIS ONLY. 'b)(6); (b)(7)(C) PDF REVIEW COMMITTEE: A-W, (M) , HSA DofN (b)(6); (b)(7)(C) Prescribed by P6013 PA 7

OFFICE OF THE REGIONAL DIRECTOR Comments: - Agree with Institution MRC _ Disagree with Inst. MRC Recommendations or Action taken: Regional HSA Date Regional Director Date 8 PDF Prescribed by P6013

OFFICE OF QUALITY MANAGEMENT Comments: Signature of Review Committee Member 9 PDF Prescribed by P6013

Suicide Watch Chronological Log Inmate Companions Log t ·- ..::. s: c ~ " W CU bO 2 s ~(O ~ ·o := CC Cl _. v, b.0~ a -' -....... C CU - <( ~,. ·- '- t .,.. u ..:: C. +' (I VI 0 (U +' '- ~-= E.s!~ 9- ~-1 UJ \V V) V') C:::: - C: (' !::~ CJJ C1J QJU oV Date Watch Began I Ended , ~ ~ :g =g =8 i g- E j I 1 Z u ·- .... ·- ro :l ::s :::s ro o nJ < 72311 ·o V) V) V') Cl) o. Cl) t- IJ Name of Inmate on watch: Register#: il, ~\[ . csy Institution: To be completed by Chief Psychologist at conclusion of watch: Booklet __ of __ SWCL - INMATE

STAPLE LOCAL PROCEDURES HERE Check one of the following: D This is the initial log book for this suicide watch. Enter date and time watch began: D This is a continuation log book for this watch._ Enter date and time this watch book was initiated: Instructions to Observer: Document your observations every minutes. Legibly print and sign your name at the beginning of your shift.

Name of Inmate on watch: Time cL, k}Vt Suicide Watch Observation Log Date: , 2.5 19 Observations: Briefly note your observations. Initial all entries. Initials '.b)(6); (b)(7)(C ) ' M - Note to all observers: Legibly print and sign your name at the beginning of your shift. 1

' . r i ·: l .. , ,.··.•,.• ! . i I I• f:' I ,: •, I •. I ' .. .... . . : ... ,.·;,·):•//· • • . , Suicide Watch Chronol ogical .-·,· ... ,1, . .. ·. . •• ./•~~ ..... r• .. · . • .. ·' \ \ ·.' · •·,. .. .·•·· :•:/ • ;'._~!:iY\ ; .• ,;·- • : . . :s<·_ · .. t./a ~~:.:_,-·~f:·_·- _:_::,·.·s>·::._.,u:.-/: .• ·.:.c,·· ... • ..• ~·a ~i.<e\)_·w '._.:-:: .. '.a·)'t/.:c;:k~.·h;':::·.::;_·_:.·.,.:· __ ;_i;_:;;~_i}:;._ :_~i<_' ·_;,_. . ·,· _.;.·•·.·'. <:,.-:/:/ :::-.- . .:: ::'.~: • .: i?>_:j:~_}\ .. ·,: ',/:;~·:.,:-. A ,-• • • ' j • . ,,,:·· ., . . . ~: . ~. . ... :: ?:~; ·:·. ·.1,: ' . ·• . ~:. ~ ,•• . . ..: ... : . ~--. •-·. :_ .. :: .. i,;_· •• _:_ .. ::. . . -•. -.- ,• • .... ,·: ... :·J:, ...... ~-~-,.~-~-:/p·~::.·_ .. _· ·f-;,.<· •• ~: ·: .•·· .-·1 :-. • ·-- :~ •.~:..•:!-. ': ... -· • -,.J • • _,. '· ...... ,• -::. •_,. . ·::,'• .. ~ . .; • • .. t• ~ ' '· • .• _..-_.:, i'' .:- . : ,..,, • . ~. ·- ·"-_AM . ·,_-_:;~ - :w• ·.,_;_,_;:, k __ , ... ~-.. ,. _ : · . .,,. •. ·7 ·- • ,. ,_ .-::,: !.,::.i · I YI~ ~ ·-]~ -~-·-_ • -·:;./--·:~ : • . _ :b~;~:w1ii~ .~~~~~;i~~~~~ ;,:'.,::.:.:~r . : _ •.. •• :rz, '</•,f:~v, 23,2.oit{::.i ·..:~::.1 / .· .. ' ~-~y?,·? oiq ... , 1,' .>:.,l, •' i •·' . '; ~ .. .. ,, ,. To be.completed ·by Chief__Psyqhologist at:c'om~l_usion ~f_wa'tch·: . ' . ' . • t ' . . • ,, . .. ' .': ' ' •• ." . • • • ..,: . • . :•· •·; . • • • I • • • I Booklet ot_· _ SWCL - STAFF

STAPLE LOCAL PROCEDURES HERE • F~ec~ otie of the following: Enter dat_e .and time watch· began: • . ~,!..\'.'. . . . - . ' . ,.,.,: l .' ,, '• : .·i • • • .. - t .. • :•,t:• .... .,···. ,, ,,; . " ·:-~ •. lnstn.fotion·s ·to ·observ·er:· ., •. . . -~·· ·l :•. ·•··- Legibly pr.int .and sign your name at the begi'nning of _your shift.:-

Suicide Watch Observation Log on watch: Reg#: i(o Date: 7 2. Time Observations: Briefly note your observations. Initial all entries. Initials ttll-H4 ,b)(6); (b)(7)(C) 2·.15 2·. 4·,.30AM 5·, 00AM oor doov Note to all observers: Legibly print and sign your name at the beginning of your shift. 1

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/24/2019 13:08 Bureau of Prisons Health Services Clinical Encounter Sex: M Race: WHITE Provider: (bl(6>; Cb)(7)(C> LP Mid Level Provider - Follow up Visit encounter performed at Receiving & Discharge. SUBJECTIVE: COMPLAINT 1 Provider: ib)(G); CbJ(7)(Cl MLP Chief Complaint: Other Problem Subjective: ,b)(7)(A) Pain: No OBJECTIVE: Temperature: .D.a1!t. Iim§. Fahrenheit Celsius Location Provider Reg#: 76318-054 Facility: NYM Unit: H01 07/24/2019 13:12 NYM 97.8 36.6 Oral b)(6); (b)(7)(C ) M LP Pulse: ~ Ii.rm 07/24/2019 13:12 Rate Per Minute 83 Location Via Machine Blood Pressure: Qm .Ii!M 07/24/2019 13:12 NYM SaO2: Value 132/89 Locatjon Right Arm nm 07/24/2019 Iim§. Value(%) Air Exam: General Affect 13:12 NYM Yes: Cooperative Appearance 96 Room Air Yes: Appears Well, Alert and Oriented x 3 No: Appears Distressed, Appears in Pain Exam Comments Follow up evaluation done for inmate Epstein. He does not look in any pain or distress. ASSESSMENT: Injury, unspecified, T1490 - Current PLAN: Disposition: Position Sitting Rhythm Provider Regular tb)t5i; (b)(7)(C) MLP Cuff Size Provider Adult-regula{bX5>; (b)(7lrc> IMLP Provider (b)(6); (b)(7)(C) MLP Generated 07/24/201913:24 b (b)(G); (b)(? )(C) MLP Bureau of Prisons - NYM Page 1 of 2

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/24/2019 13:08 Follow-up at Sick Call as Needed Patient Education Topics: Date Initiated Format 07/24/2019 Counseling 07/24/2019 Counseling Copay Required: No TelephoneNerbal Order: No Provider: :bJC5>; Cbl<ncc> MLP Handout/Topic Access to Care Preventive Health Cosign Required: Yes Completed b~ibJi5J;tbJ(?XC> IMLP on 07/24/2019 13:24 Requested to be cosigned byfb)(G); (b)(?J<c> IMD. Cosign documentation will be displayed on the following page. Generated 07/24/2019 13:24 b~ b)(6); (b)(?)(C) ~ LP Bureau of Prisons - NYM Reg #: 76318-054 Facility: NYM Unit: H01 Provider (b)(6); (bX7){C) Outcome Verbalizes Understanding Verbalizes Understanding Page 2of 2

Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M ,,,..,.,.,.,...,..,.=""'""'"""""' Encounter Date: 07/24/2019 13:08 Provider: (b)<5>; (b)(7)(C) MLP Cosigned with New Encounter Note bi,_b_l( 6 _); <_bl<_ 7l(_c> ___ __,IMD on 07/24/201916:10. Bureau of Prisons • NYM Reg#: Race: Facility: 76318-054 WHITE NYM

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/23/2019 06:20 Bureau of Prisons Health Services Clinical Encounter Sex: M Race: WHITE Provider: bJl5>; (b)(?)(C) LP Injury Assessment - Non-work related encounter performed at Health Services. SUBJECTIVE: INJURY 1 Provider: fb)(S); lblC7>cc> ~ LP Reg#: 76318-054 Facility: NYM Unit: H01 Date of Injury: 07/23/2019 01 :27 Date Reported for Treatment: 07/23/2019 08:25 Work Related: No Work Assignment: UNASSG Pain Location: Pain Scale: 0 Pain Qualities: Where Did Injury Happen (Be specific as to location): Special Housing Unit Z05-Cell 124 L Cause of Injury (Inmate's Statement of how injury occurred): r )(?)IA) Symptoms (as reported by inmate): None OBJECTIVE: Temperature: Time Fahrenheit Celsius Location Provider Date 07/23/2019 06:30 NYM 97.5 36.4 Oral b)(6) (b)(?)(C) MLP Pulse: Date Time 07/23/2019 06:30 Respirations: Rate Per Minute 92 Location Via Machine Date 07/23/2019 Time 06:30 NYM Rate Per Minute Provider 16 (b)(6); (b)(7)(C) Blood Pressure: Date Tjme Value 07/23/2019 06:30 NYM 140/85 Sa02: Locatjon Right Arm Date Time Value(%) Air Position Sitting LP Rhythm Regular Cuff Size Provider b)(6): /b)(?)(C) Provider Adult-regular b)ts); <blcn cc J Provider 07/23/2019 06:30 NYM 96 Room Air l(b)(6); (b)l?)(C) ~ LP Exam: General Affect Yes: Cooperative Appearance Yes: Appears Well, Alert and Oriented x 3 MLP MLP No: Appears Distressed, Lethargic, Dyspneic, Appears in Pain, Pallor, Cyanotic, Diaphoretic, Disheveled, Generated 07/23/2019 09;05 b 1 b)(6): (b)(?)(C) ~ LP Bureau of Prisons - NYM Page 1 of 2

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/23/2019 06:20 Exam: Acutely Ill Pulmonary Auscultation Provider: b)(5>; (b)(l)(Cl MLP Yes: Clear to Auscultation, Vesicular Breath Sounds Bilaterally No: Crackles, Rhonchi, Wheezing Exam Comments (b)(7:(A) 'b)(7)(A) ASSESSMENT: Injury, unspecified, T1490 - Current - RIO self inflicted injuries. PLAN: Disposition: Follow-up at Sick Call as Needed Placed on Suicide Watch Follow-up in 2-4 Hours Other: For follow up with psychology service. Patient Education Topics: Date Initiated Format 07/23/2019 Counseling 07/23/2019 Counseling Copay Required:No TelephoneNerbal Order: No HandouVJopic Access to Care Plan of Care Cosign Required: Yes Completed b~Cbl(5l:(b><7><c> I MLP on 07/23/2019 09:05 Requested to be cosigned b~tb:C6); (b)(?)(Cl ~ D. qosign documentation will be displayed on the following page. b)(6); Generated 07/23/2019 09:05 b :b)(7)(C) MLP Bureau of Prisons - NYM Reg#: 76318-054 Facility: NYM Unit: H01 Provider 'b)(6): (b)(7)(C) Outcome Verbalizes Understanding Verbalizes Understanding Page 2 of 2

Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M ---- Encounter Date: 07/23/2019 06:20 Provider: b)(6); (b)C7>cc > MLP Cosigned by~l'0_)l5_i; <-bi(_7ic_c > ___ __.~ o on 07/23/201915:44. Bureau or Prisons - NYM Reg#: Race: Facility: 76318-054 WHITE NYM

Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: Date of Birth: EPSTEIN, JEFFREY EDWARD 01/20/1953 Sex: M Bace-WHIIF Provider: r6); lo)(?)(C) ~ D Note Date: 07/26/2019 08:57 Cosign Note - Clinical Encounter Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider~lb)(6); (b)(7)(c ; 'o)(7)(A) New Medication Orders: Rx# Medication Docusate Sodium Capsule Indication: Constipation, unspecified Copay Required: No TelephoneNerbal Order: No Cosign Required: No Completed by! .... 'b)_(6_H _bi17_i_,cl ___ __.lMD on 07/26/2019 08:58 Order Date 07/26/2019 08:57 Generated 07/26/2019 08:58 byfblt6i; (b)(?)(C) Bureau of Prisons - NYM Reg#: Facility: Unit: 76318-054 NYM H01 Prescriber Order TAKE ONE 100 MG CAP Orally - Two Times a Day x 180 day(s) Page 1 of 1

Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: Date of Birth: Note Date: EPSTEIN, JEFFREY EDWARD 01/20/1953 07/24/2019 16:10 Sex: M Race:WHITE Provider: f0lC5l;<olC7)cc> I MD Cosign Note - Clinical Encounter Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 ,b)(7)(A) Copay Required: No Telephone/Verbal Order: Provider: ·o)(5); <oJc7>(c) D Cosign Required: No Completed by=bl:cs)=; co=)(:nc:c)=====:::•.._.~24/2019 16:12 (9~ ~ Generated 07/24/2019 16:12 byl(b)(6); <b)(7)(C) Bureau of Prisons - NYM Reg#: Facility: Unit: 76318-054 NYM H01 Page 1 of 1

Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Encounter Date: 07/26/2019 08:57 Amendment made to this note by .... f bl-(5-);<b- )(7- )(c _ ) ___ _.I MD on 07/26/2019 08:58. Bureau of Prisons - NYM Reg#: Race: Facility: 76318-054 WHITE NYM

Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Institution Disciplinary Process Report Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/30/2019 12:01 Provider: M Facility: NYM ~lrb=)c6~J~Cb1=a=)1c~i ----,I PsyD Unit Team: 5 Reason for Referral and Identifying Information Inmate Epstein was referred by Unit Manag :~!(~\:.,.,, for an evaluation of competency to proceed with the disciplinary process for actions resulting in an incident report. On 7/23/19, inmate Epstein was charged with code 228 (Tattooing or Self-Mutilation). These infractions were assigned incident report number 3282555. Background Information According to a Suicide Risk Assessment dated 7/09/19 b~(b)C5>: (bl(7KcJ !"Inmate Epstein denied any history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also denied any acute mental health symptoms at this time." According to a Suicide Risk Assessment dated 7 /09/19 b 1b 1161 lb)miCJ "Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behavior in the past." b)(7)(A) Clinical Interview and Mental Status Exam b)(7)iA) Current Mental Status: He exhibited a neutral mood with a full range of affect. His speech was logical and coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. There was no indication of disturbed thought process or content. Intellectual ability appeared to be above average. Personal hygiene was adequate. He denied current suicidal or self harm ideation and he agreed to immediately tell staff if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff if he has these thoughts. Clinical Impression According to his last Diagnostic and Care Level Formulation Note dated 7/09/19 b (b)( 6>: (b)i?Jtc> 'No Diagnosis, No Dx - Current." Findings The determination of whether an inmate is competent to proceed with the disciplinary process is based on a clinical assessment of the inmate's (1) ability to understand the nature of the proceedings, and (2) their ability to assist in their own defense. Depending on the outcome of the assessment, one of three findings can be made: (1) the inmate is COMPETENT to proceed with the disciplinary process; (2) the inmate is NOT PRESENTLY COMPETENT but could be restored to competence with treatment; or (3) the inmate is NOT COMPETENT and is unlikely to become competent. Recommendations Regarding Sanctions In the case of inmate Epstein, after a review of available psychological and psychiatric records as well as information pertaining to the offense conduct, it is determined that this inmate is: (X) COMPETENT to proceed with the disciplinary process. ( ) NOT PRESENTLY COMPETENT, but could become competent with treatment; it is recommended that the inmate for an updated competency assessment in 30 days. () NOT COMPETENT and not likely to become competent. Generated 07/30/2019 12:33 b~lbi(5J; lbl(7>cc) ~syD Bureau of Prisons - NYM Page 1 of 2

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: 5 Date: 07/30/2019 12:01 Provider: "'" ·b'"" )<6.,.... ); <~b)=rn..,. (c.,.... > --...... syD Completed by I mer :b)<6>; {b){7)(c ) on 07/30/2019 12:33 Generated 07/30/2019 12:33 b r (G); (b)(7)(C) jPsyD Bureau of Prisons - NYM Page 2 of 2

Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/29/2019 10:01 Provider: M Facility: NYM "'"f b""' >t5,,... U ,,..., b)=(7i"" tc,,... ) --.IP h D/C h ief Unit Team: 5 Focus of Session Inmate Epstein was seen while on psychological observation today in the hospital area. Subjective/Objective Presentation Same presentation today, but he said he thinks his memory for the incident (injury to his neck) may be impaired because of his sleep apnea. He is supposed to get his CPAP machine today. He is aware he will be returning to SHU, but said he is feeling unwell due to his inability to sleep and numbness in his arm. He requested to have one good night of sleep with his CPAP and will return to SHU with a cellmate tomorrow. l(b)(7)(Al I fbiITiCA> I I told him he can stay down one more night to receive his CPAP and a good night's sleep, but that he would be returned to SHU tomorrow. It was explained that there is no mental health issues precluding him from returning to SHU tomorrow and that we could not house him in the SW/Hospital area because~ ICb)t7i(A> lor more comfortable for him ..... b_,IT_>cA_> ___________________________ __, According to his log book and eating/shower chart, he has been eating and drinking when not in his legal visits. He has also been writing and attending his legal visits. lntervention(s) Inmate EPSTEIN was provided with brief supportive interventions and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was somewhat receptive to these interventions, but appears more concerned about getting his various needs in the prison (phone calls, recreation, housing placement concerns, etc.) Progress/Plan He will remain on psychological observation today and will transition to the SHU tomorrow. He will be seen by psychology daily to assess his mental status and psychological functioning. Completed b (b)(G); (bJ(?)(c> PhD/Chief Psychologist on 07/29/2019 10:26 Generated 07/29/2019 10:26 by b,(G); (bl(7)(C) PhD/Chief Bureau of Prisons - NYM Page 1 of 1

Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/27/2019 07:14 Provider: =M~=--F--.-acility: NYM (b)(6); (b)(7)(C) I PsyD Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation The "Eating/Shower Chart" indicated yesterday he ate dinner, drank liquids, and took a shower when offered. The Psych Observation Log noted he brushed his teeth, went to a Legal visit, talked about business and investing to an Inmate Companion, ate, an 'b)(7)(A) He stated that for the 5 da s 15 e had onl sle t about 30 minutes each ni ht because of noise in SHU. (b)(?)(A> (b)(l)(A) (b)(7XA) He said he has an appetite and is eatI because he is not drinking enough water bee his Attorney. Medical was e-mailed with his o is waking up every 1 1 /2 hours. He stated he feels dehydrated tated he feels he is not given enough bathroom breaks while with t f feeling dehydrated. He said his Lawyers and friends are all emotionally supportive. Current Mental Status: He exhibited a neutral mo ly full range of affect. His speech was logical and coherent, with no loosening of associations or tange ntial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. e ~- n engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation. He stated" ." He added he does not like pain and even does not like when he has to give blood. He agreed to immedia t aft and Inmate Companions if he starts to have suicidal or self harm thoughts. He was future oriented. He do o be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff and lnmat o I ns if he has these thoughts. lntervention(s) Supportive and educative interventions were provided, He was given Turnin P douts on stress management, sleep, and building a routine in SHU. He stated he wants it noted in his chart th ~ given a pamphlet on sleep, but that is not going to help because of the noise in SHU that prevents him f g. Progress/Plan ~ He will remain on Psych Observation in an abundance of caution and pending housing arr ge "Jibe made on Monday. While on Psych Observation, he will be seen daily by Psychology. ' Completed bf biC5>: Cb)C?J<c) IPsyD on 07/27/2019 08:16 Generated 07/27/2019 08:16 bf blC6>:CbiC7J(cJ jPsyD Bureau of Prisons - NYM Page 1 of 1

Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Encounter Date: 07/27/2019 07:14 , J b'(6)· (b'(7)(C) I Amendment made to this note byi._' '_ · _' __ ___. PsyD on 07/28/2019 09:19. Bureau of Prisons - NYM Reg#: Race: Facility: 76318-054 WHITE NYM

Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/26/2019 09:09 Provider: ,,,M""'""'~,,,.,...-____., acility: NYM 'b)(6>; (b)(7)(c> PhD/Chief Unit Team: 5 Focus of Session Inmate Epstein was seen while on psychological observation in our hospital area. Subjective/Objective Presentation Prior to this writer's contact with him, Inmate Epstein showered and dressed himself for his legal visit today. He was smiling and did crack some jokes during the interview. He did elucidate some complaints and suggested being disappointed with this writer as he wants "to trust me and for me to trust him." He stated he remains unhappy with legal visiting procedures as he cannot go to the bathroom as frequently as he would like to since he has a "weak bladder." Inmate Epstein also reported since coming to the psychological observation area, he has felt constipated and needs his Colace. He had self-carry Colace in SHU, but since coming to the observation area, he has not had his medication. This writer immediately notified medical and his pills were being processed during the interview. Inmate Epstein also continues to complain about the conditions of SHU confinement (i.e., feeling punished, smells, noise, and restrictions). l(blf?)IA) I He does not exhibit symptoms of any cognitive disorder, seizure disorder, psychotic disorder, or dissociative disorder at this time or in the past. Inmate Epstein denied any current suicidal ideation, intention, or plan. He reported wanting to be alive to fight his legal case and go back and live life. He referred to himself as "a coward" and "I'm Jewish." He said he is not the type who likes pain or would ever attempt to harm himself. While on psychological observation, inmate Epstein has been eating his meals, sleeping and interacting with the inmate companions. He is in legal visiting the majority of the day and in the evenings. His log book and eating/shower chart reflect the same. He has been speaking to inmate companions about investment strategies and about prison adjustment. Correctional Staff report during his legal visits, he is interacting with his attorney, animated, laughing, and joking. lntervention(s) Inmate Epstein was provided with supportive and coping skills interventions today. He was receptive to them, but mostly wanted to express his complaints about his current prison confinement status and needs. He wanted this writer to address them. Progress/Plan Inmate Epstein will remain on psychological observation in an abundance of caution and pending housing arrangements to be made on Monday. (bJIT)(A> lb)(7)(A) Completed b~bl(6); (b><7>rC> f hD/Chief Psychologist on 07/26/2019 10:05 Generated 07/26/2019 10:05 b (b)(6): (b)(7)(C) PhD/Chief Bureau of Prisons - NYM Page 1 of 1

Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/25/2019 10:14 Provider: ..,...,.,,,M.,....,,..,.= .,...-------1 acility: NYM :bH5>;<b:mrc> PhD/Chief Unit Team: 5 Focus of Session Inmate Epstein was seen by this writer this morning while on psychological observation in the hospital area of the prison. Subjective/Objective Presentation Inmate Epstein was in good spirits today and engaged in reciprocal conversation with this writer this morning. He smiled and remarked, "welcome back" when this writer arrived. (blt7:tA> b)(7)(A) 'b)(7)(A) (b}(7)CA> Is wn er a emp e o ge a more ave such impairments in memory as he does not suffer from an acute cognitive disorder, he smiled and said he understood my position. Inmate Epstein did reveal he is unhappy with his current confinement in Special Housing (SHU) as he considers it "a punishment cell." He said he finds the restrictions up there unfair as he has not done anything wrong. Inmate Epstein stated he feels it is dangerous in the SHU, he cannot sleep well up there due to noise from the other inmates, it smells, and it is difficult for him to work on his legal case up there. He stated he has not received the phone calls he was promised nor has he been able to receive recreation. It was explained to him that he spends the entire day in the attorney conference room and it is likely that he has missed the times when staff members have attempted to give him phone calls and recreation. Inmate Epstein also reported complaints about the attorney conference room, stating they do not take him to the bathroom frequently enough. Inmate Epstein adamantly denied any suicidality at this time, stating "I am too vested in my case to fight it, I have a life and I want to go back to living my life." He denied any acute symptoms at this time. According to his log book, he has been eating, drinking, sleeping, and interacting with the inmate companions. He has also been attending his daily legal visits. lntervention(s) Inmate EPSTEIN was provided with brief supportive interventions and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was mostly receptive to these interventions. He requested to be housed in general population rather than the SHU and stated he wanted to remain on psychological observation due to his concerns with being in the SHU. Progress/Plan In an abundance of caution, inmate Epstein will remain on psychological observation. (b)(?)(A) b)(7)(A) Inmate Epstein will be seen daily by psychology while on Completed b~b>C5l; <b)(?)(c> I PhD/Chief Psychologist on 07/25/2019 10:43 Generated 07/25/2019 10:43 b f b)(6); (b)(7)(C) r hD/Chief Bureau of Prisons - NYM Page 1 of 1

Bureau of Prisons Psychology Services Post Suicide Watch Report **SENSITIVE BUT UNCLASSIFIED** Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: Date: 07/24/2019 09:23 Provider: Watch Start Date: 07/23/2019 01 :40 Total Time on Watch: 31 hrs 5 minutes Watch Conducted By: Both inmates and staff Current Mental Status 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 M Facility: NYM ~t b)(_6_): (-b)(7_ )_(C_) ---~f h.D. Watch Stop Date: Unit Team: 5 07/24/2019 08:45 Transfered to Medical Center: No Current Mental Status: Mr. EPSTEIN was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited a neutral affect with appropriate range. Eye contact and hygiene were appropriate. The inmate spoke with normal rate, tone, and volume. His thoughts were organized and coherent, with no loosening of associations or tangential, circumstantial, or irrelevant content. Ttiere was no evidence of perceptual disturbance, delusional ideation, or a formal thought disorder. He did not engage in any bizarre or inappropriate behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN explicitly denied recent and current suicidal ideation, planning, and intent. He was future-oriented and expressed a commitment to life and safety, agreeing to contact staff immediately should he experience suicidal ideation or psychological distress. He also denied thoughts of harming others. Risk Factors Assessed: This writer screened the inmate for a variety of empirically validated factors commonly associated with risk for self harm. The following STATIC risk factors were assessed to be present and increase the inmate's risk for engaging in suicide related behaviors: High Profile Crime, Lack of family connections, Sex offender status The following DYNAMIC risk factors were assessed to be present and increase the inmate's risk for engaging in suicide related behaviors: Current physical pain, Fear for own safety The following PROTECTIVE factors were assessed to be present and may decrease the inmate's risk of suicide:Able to identify reasons to live, Adequate problem solving skills, Denial of suicidal ideation/intention/plans, Future orientation, View of death as negative, Willingness to engage in treatment . J b)(7)(A) Risk Factors:, (b)(7)(A) Protective Factors: Mr. EPSTEIN adamantly denied current suicidal ideation or intent or a history of suicide attempts. He stated, "I have no interest in killing myself." He explained, although his situation is "not perfect" due to his being incarcerated, he noted he has "lots to do for [his] legal case." He described having a "wonderful life," to include interactions with "interesting people and projects." He said "it would be crazy" to take his life. He furthered, "I would not do that to myself." He denied feelings of hopelessness, although did report being "depressed" and "unhappy" about his current legal situation. He previously denied a history of childhood abuse. He reported he is sleeping adequately now that he is no longer in the SHU. He appear future-oriented as he endorsed an interest in being housed in general population. Weighing of Risk and Protective Factors: Mr. EPSTEIN adamantly denied sucidality. However rbt(7>(A) (b)(7KA) Generated 07/24/2019 12:09 b :bXG): (b)(7)(CJ Ph.D. Bureau of Prisons - NYM Page 1 of 3

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: 5 Date: 07/24/2019 09:23 Provider: l(bl(5>: Cb)(7)CCJ f h.D. llb)(7)CA> land the high profile nature of his alleged offense, Mr. EPSTEIN will be stepped down from Suicide Watch to Psychological Observation. Changes in Risk Factors Assessed Upon a review of the log book, it was indicated Mr. EPSTEIN has been speaking to the inmate companions about having previously taught mathematics and physics. He has been observed pacing the cell as well as sleeping, eating, and drinking within normal limits. Upon interview today, Mr. EPSTEIN requested he be provided a toothbrush as well as a shower. His requests were made known to the lieutenants and he was provided a shower prior to attending his legal visit. This writer also provided him a toothbrush, toothpaste, and hygiene products. b)(7)(A) Reason for Removal from Watch Mr. EPSTEIN stated, "I have no interest in killing myself." He explained although his situation is "not perfect" due to his being incarcerated, he noted he has "lots to do for [his] legal case." He described having a "wonderful life," to include interactions with "interesting people and projects." He said "it would be crazy" to take his life. He furthered, "I would not do that to myself." Mr. EPSTEIN did express a feeling of safety being housed on Psychological Observation rather than in the SHU. He asked if he could remain on this status for a couple of days, he was advised his housing situation will be re-evaluated on a day-to-day basis. He expressed a desire to be housed in general population rather than in the SHU and asked if there were a "safer" unit for him to be housed in comparison to the one where he was initially placed. Mr. EPSTEIN claimed there were many MS-13 gang members on the initial unit. He was advised he will be maintained on Psychological Observation in the near future, but his long-term housing situation will be revisited, as it is not ideal for one to remain in isolation on Psychological Observation for extended periods of time. Mr. EPSTEIN acknowledged this information and thanked this writer for her explanation and time. Diagnosis: No Diagnosis, No Ox - Current Conclusions The Overall Acute Suicide Risk for this Inmate is: Overall Chronic Suicide Risk for this Inmate is: Recommendations Low Absent 1. Mr. EPSTEIN will be removed from Suicide Watch and stepped down to Psychological Observation. 2. While on Psychological Observation, he will be continuously observed by Inmate Companions. 3. While on Psychological Observation, he will be seen daily by Psychology. 4. Supportive and educative interventions were provided. 5. Mr. EPSTEIN was provided novels and a request was made for his legal paperwork to be provided to him on Psychological Generated 07/24/2019 12:09 b f bl(6); (b)(?)(C) I Ph.D. Bureau of Prisons - NYM Page 2 of 3

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: Date: 07/24/2019 09:23 Provider: Observation. M Facility: NYM ~,(b-)(6-);(-b)-(7-)(C-) ---~, Ph.D. Unit Team: 5 6. This writer contacted the Pharmacy to indicate Mr. EPSTEIN has not been receiving his medication used to alleviate his constipation. 7. Mr. EPSTEIN attended a legal visit today, after having been provided a shower. 8. Mr. EPSTEIN was educated about both routine and emergency procedures for contacting psychology. 9. The inmate was encouraged to reach out for PRN services should he experience any psychological distress. Completed b ~ lb/ts,; tb/mtc > !Ph.D. on 07/24/2019 12:09 Generated 07/24/2019 12:09 br )(S); (b)(?)(C) I Ph.D. Bureau of Prisons - NYM Page 3 of 3

Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED** Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: Date: 01/20/1953 Sex: 07/11/2019 15:21 Provider: ..,...M,.,,,.,..,~=,----,Facility: NYM rb){6): (b)(7;(C) t hD/Chief Unit Team: A&O Focus of Session Inmate Epstein was seen for his psychological observation follow-up in attorney conference this afternoon. Subjective/Objective Presentation Inmate Epstein reported he has been consulting with his attorney most of the day. He elucidated concerns about his incarceration including not receiving his property yet in SHU, feeling cold in his cell, not receiving his Colace, not having enough water in attorney conference, and a desire to recreate in SHU." Inmate Epstein was also upset about wearing an orange jumpsuit and being treated like "a bad guy" when he did not do anything wrong in the prison. Custody and security concerns were addressed with inmate Epstein including why he has to wear his orange jumpsuit (due to his being housed in SHU). He requested that he be placed in a brown uniform during his legal visits. He was told his concerns would be addressed in the SHU meeting. (b)(7)(A) 'bK7l<A> He did not sleep well last night. Inmate Epstein continues to deny any suicidal ideation, intention or plan. He did not appear to be in any distress at this time. lntervention(s) Inmate EPSTEIN was provided with brief supportive interventions, CBT-based interventions, and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was receptive to these interventions. Progress/Plan Inmate EPSTEIN was educated about both routine and emergency procedures for contacting Psychology staff. He was reminded of the self-help books and audiotapes available through the Psychology department. He will be seen next week after his bail hearing to assess his mental status and psychological stability. Completed b~(bll5l: <o)(?)(c) !PhD/Chief Psychologist on 07/12/2019 07:51 Generated 07/12/2019 07:51 bt bHGJ: fb~7)(CJ FhD/Chief Bureau of Prisons - NYM Page 1 of 1

... DATE: TO: FROM: August I 0, 2019 UNITED STATES GOVERNMENT MEMORANDUM Metropolitan Correctional Center, New York, New York Charisma Edge, Associate Warden Programs l (b)(6); (b)(7)(C ) I ;b)(6); (b)(?)(C) 0 p.•D' O _..__ ______ ___, Psy.D., Ph.D., Forensic Psychologis I'~ ,,- 1 .__ ___ ___, SUBJECT: Epstein #76301-054 This memo summarizes the psychology contacts with Mr. Epstein. Mr. Epstein arrived on July 8, 2019, and was seen by psychology services for an intake screening in SHU. He denied any psychology history or symptoms. The Chief Psychologist spoke with Central Office on July 8, 2019, and it was determined he should be placed on suicide watch and seen for a suicide risk assessment after he returns from court due to his increased suicide risk factors. Mr. Epstein was seen on July 9, 2019, for a suicide risk assessment where he denied any suicide ideation, intention, or plan. Despite his risk factors of his sex offence charge, high profile case with media attention, and pretrial status housed in SHU, his protective factors outweighed his risk factors. He was future oriented, wanted to fight his case, and denied any mental health history or suicidality. He was removed from suicide watch and placed on psychology observation. He was seen the following day at which time he requested to be celled alone if housed in SHU and was told he could not. Mr. Epstein was released from psychology observation and seen on July 11, 2019, in attorney conference. He expressed concerns such as wearing an orange jumpsuit, not receiving medication, and not having enough water during attorney visits. Mr. Epstein was seen one week later, July 16, 2019, for follow up and because he was asking to be seen. He did not express any psychological concerns, rather correctional issues such as not getting a phone call and needing a spoon. An attempt at a SHU review was made on, July 18, 2019; however, Mr. Epstein was with his legal team. (b)(?)(A) l(b)(6); (b)(7)(C) I CblC7XA> I Mr. Epstein was seen daily while on psychology observation, each day denying he was suicidal. During one interview, he claimed he could not remember what happened because of his "sleep apnea." On July 30, 2019, Mr. Epstein was removed from psychology observation and returned to SHU. He reported he did not think he could sleep in SHU because of the noise. He denied any psychological concerns. lt was noted he would be placed with a cellmate.

.. On July 3 1, 2019, Mr. Epstein was seen for a psychology observation follow up. He stated he was doing as well as can be expected given his circumstances and reported he was going to court for a status hearing. He also reported he slept well. Mr. Epstein was seen for another suicide risk assessment on August I, 2019, at approximately I pm, as he returned from court with a note from the court indicatin "suicidal tendencies." Mr. Epstein denied he was suicidal. b)f?KA> r ;(7)(A) I He comp l'La-m-e~ a~ o-u-t -,th_e_n_o~i~se~ in----=s=HU ~ .----:M-=-r _....,E=-p-s-te-.i,...n-=-· s- pr-o-te_c_t.,...iv_e_f::::-a-c-to_r_s _o_u_tw_e--;i-gh;-e-d,...,....h1,--, s-' nsk factors and he was not placed on suicide watch. He denied suicidal ideation, reported fighting his case, stated he has emotional support, and stated suicide is against his religion. On August 8, 2019, Mr. Epstein was seen for a follow up session. He stated he was feeling ok and his sleep was fair. He again requested to go to general population. He denied any mental health symptoms. He denied any suicide ideation, intention or plan. He had a cellmate. He spends his days with his attorney. It was noted he would continue to be seen for weekly rounds.

,n I tVJ011fA 7.6.19- Epstein Ar;ives and is placed in GP (on a Saturday) 7 .8.19-[bi(6i (b)(7)<C> • ~ake Screening - Monday (No endorsements on PSIQ and had just returned from court)- clear mental status, no hx of mental health treatment or symptoms, no suicide history, nothing significant noted, CCl-MH assignment. 7 .s.19r )(fi); (b)[?)(C ) !consults with Central Office regarding Epstein and Risk Factors and R&D was instructed to place him on psychological observation when he returns from court pending a SRA. He is placed on psychological observation at 6:00 p.m. Log book reflects he was asking 1/C about how life is in GP and the crazy things he has seen as an 1/C., about prison life, sleeping, pacing 7 .9.19-fbl(6i (blf?HC) I Suicide Risk Assessment ( placement on Psych Obs after court proceeding as a precaution/precautionary SRA)- No mental health history, no substance abuse history, no suicide history, no suicidal thoughts. Clear mental status. Denies suicidality, future oriented, wants to make phone calls and speak with his lawyer, enjoys life, learning and teaching, has a business in the community, spoke about being a mathematician and about his post graduate studies, good sense of humor, no acute sxs, Was eating when I arrived (ce"eal) and his log book was not significant for any symptoms. Recommended that he remain on psychological observation pending a suitable housing arrangement. (This writer spend 45 minutes interviewing him) - Log Book: he 1·eaves for his legal visit at 8:20 am, returns at 2:00 pm and eats as well as goes to medical. .. leaves again _around 3 pm and returns to cell around 8 pm from attorney visit. Talks to companion about the escort business, how to handle prison, about celebrities he knows, about prison food 7 .10.19 b)(5>; (b)(?J(C) Psychological Observation Contact (remained on psy obs pending suitable [ housin_g placement with a ~ellmate)- indicated he did not like SHU because he.is not comfortable th~re and said he wanted to be single celled. He expressed numerous needs: Colace instead of Ducolax, being able to walk around, no orange uniform, phone call, shower and towel, placement on the cadre unit, ~ pen, and property. Log book indicated he has been eating, sleeping and interacting with companions, went to his leg_al ~it. Looking forward to bail hearing, realizes he will be here for a couple of weeks even if he gets baiVinmate Epstein is to return to SHU with a cellmate (this is documented). V - 7 .11.1~Cb>(5>; <bl(7>cc > ~ Psychological Observation Follow-up - Saw him in Attorney Conference area- he listed numerous concerns related to his confinement including receiving his property, feeling cold in his cell, not getting Colace, not having enough water in the attorney conference area and desire for more recreation, dislike of orange jumper and wanted brown one. This writer told him she would address in the SHU meeting. (I did not put in clinical note but It is worth noting he was kind of mocking me in t he atty conference area about being placed on watch ... he was smirking and said, "why would you ever think I would be suicidal, I am not suicidal and I would never be." - he said it in front of his attorney (palm beach one) ... ) 7 .18.19~(bH5>; ibl<7><c , I Attempted SHU Review but he was in legal visit. (b)[?i(A)

] .24.19rb)(6); (b:(7i(C: ,b)(7)(A) b)(7)(A) !Post Suicide Watch Report _b)(7/(A> ~-:----:---:---:--:---:-~~=======.-__J I Recently, was denied bail. l(blC7KA) eating and drinking and that waking up to hear himself snore up on a stretcher. ( J Epstein adamantly denied suicidality, "lots to do for legal case, wonderful life, interesting people and projects in life, it would be crazy to take my life, I would not do that to myself." He did rep0rt feeling depressed and unhappy with his situation. He reported he slept wel! last night and was future oriented. Talked to companions about having taught math ard physics and has been eating, sleeping, drinking. He wanted hygiene products and to shower. Log book: talking about ja ii to 1/C, sleeping, brushes teeth, drinking. Goes to lega I visit all morning. Discussing investment strategies, inmate safety, and prison adjustment with the 1/C. He washes his face, rests, and sleeps. 7 .25.1 ,b)i6); (b)(7)(C) Psychological Observation Contact - Smiled "welcome back"; good spirits.lCbK7XAJ I ,b)(7)(A) .b)(7)(A) ,b)(7)(A) Reported being unhappy with SHU due to ~he restrictions and noise and he said his requests '--------' have not been granted for phone calls and recreation. He is unhappy that he is not taken to the bathroom enough during attorney/conference visits. Denied suicidality, stated he is too vested in case to fight it and I have a life and I want to go back living my life." No acute mental health symptoms were noted. Log Book: He had been eating, drinking, and sleeping. Also showers, brushes teeth, and goes to legal visit. Talks to 1/C about business and investing, life-lessons, and tells 1/C he does not want to go to SHU in lieu of GP and wants to know about the conditions of various housing units. 7.26.19l(b)IG,;(b)(7Xc> I Psychological Observation Contact- Smiling and cracking some jokes. Disappointed in writer that his various requests in the prison have not been ad he red to. "I have to trust you if you I _ want to trust me" He elucidated many complaints with legal visiting procedures, his constipation L-/"-medication, and conditions of SHU confinement and prison restrictions. fb)(7JCA> / bl(7XA) He '----:""--:--:-------=------:-----:-~---------:---:------:---::-----,-,----,-,_J denied any symptoms of psychosis, depression, or anxiety. Denied suicidality; He stated he would never harm himself as he wants to be alive to fight his legal case and go back to live his life. He remarked he is "a coward ... I am Jewish." He said he does not like pain and never attempt to harm himself.

Loe Book: sleeping, talks to 1/C about BOP policy including phone visits and usage, Talks to 1/C about business and investing, life lessons, and tells 1/C he does not want to go to SHU in lieu of GP and wants to know about the conditions of various housing units. 7 .27 .19- b)(6): (b)(7)(C) sychological Observation Contact b)(?:IA) rb)(7(A) and interacted with the inmate companions talking a out usmess and investing topics. support from friends and lawyers, denied mental health sxs or suicidality, said he felt dehydrated and medical was notified. Provided with self-help handouts. log book: eating, sleeping, sitting on bed, legal visit, asking for toilet tissue, talking about life in GP 7,28.1~ b:<5J: (b){7)(c) psychological Observation Contact - noted he is in attorney visits 12 hours a day, lo·gs indicate he speaks about life in general population; reported his right arm felt numb and he had been seen by medica I. Flushing of the toilet in his cell was aversive; told writer maybe he has Autism . ./ because sounds/noise are aversive to him like "the Rain Man." Mildly anxious mood; provided with i::v: Turning point handouts and supportive interventions. Eating when in the cell, but otherwise, eating in Attorney conference. Log Book: Upset about non-stop flushing of toilet, goes to legal visit most of day, talks to 1/C later about who is best cook on 11N, investments, driving a taxi in NY, sleeping. 7 .29.19l'b)(eJ: (bir7><CJ !Psychological Observation Contact - continues to report no memory of the event which lead up to him being placed on SW/Psych Obs. He requested to stay on psychological observation another day so that he could get a good night's sleep. NO mental health sxs or suicidality was reported or noted, he ate and has been attending legal visits. Wanted to remain on psychological observation V because it is more comfortable and not noisy like SHU. It was explained that psychological observation cannot be continued long-term for the purposes of being more comfortable and that the purpose of psych obs is to stabilize mental health problems. His only concerns are getting his various needs met in the prison including more phone calls, recreation, and being placed in a comfortable and safe place. He was informed he would be housed in a safe situation in the SHU. • Log Book: showers, eats, writes in note pad, drinks water, legal visit, talks to 1/C about investment options, his jail appeal, sleeps . ... - .......... 7.30.19, bk61 <bmc !Psychological Observation Contact and Discontinuation - waiting to go to SHU to get ~machine as he did not sleep well without it. ~aid SHU is noisy and he is concerned about sleeping well there and he said he did not get one of h. edications yet that day. He ate meals, drank liquids, showered, no mental health sxs, no suicida i . SHU L . • formed inmate Epstein needs to be h d • h • II h"I • SHU b,161 lb)(7)(C, , d • h ·1) I ouse wit an appropriate ce mate w I e tn ._ __ ___. we up wit an e-ma1 . nmate remained on observation until brought to his attorney conference visit. Log book: Sleeping, eats breakfast, talks about jail life, taken off of psych obs status at 8:15 a.m., goes to his legal visit, and later to SHU. 7 .31.19~(bXGJ; (b)(7;(CJ !Psychological Observation Follow-up Session - denied suicidality, no mental health sxs, slelpt well and was getting reading for court hearing. Reported getting along with cell mate in SHU.

8.1.1 b,1s, ,b a.(C) SRA was conducted- Court sent a form "suicidal tendencies" Denied any suicidality; ortive; Jewish-a a inst his religion bJ(7 >CA1 b),7)(A) His cell mate is ta kative but he will give it a c ...._ ___________ __J lives for fighting this case and going back to his nomal life. 8.s.19jcbHS;; lb;(?Jrci lfor a follow-up session to assess adjustment in SHU~...af;ute symptoms, distress or mental health concerns; denied suicidality, some concerns with slee~?P~ .. ~e received his PAC# to make phone calls and requested to speak with someone without it being on as peakerphone. Wanting his books he left in the suicide watch area. Interacting and getting along with his cellmate. Getting ready of this attorney visit. 8.10.19 - Found Unresponsive and Hanging in SHU at 6:30 a.m. (10 days after his removal from a constant observation}

AFTER HOURS. (1>)(7)!A) (b j(6); (1>)(7)(C )