Bureau of Prisons Health Services Medication Summary Historical Complex: NYM--NEW YORK MCC Inmate: EPSTEIN. JEFFREYU Begin Date: 07/02/2019 End Date: 07/30/2019 Reg #: 76318-054 Quarter: Z04-206LAD Medications listed reflect prescribed medications from the begin date to end date on this report. Allergies: Denied Active Prescriptions Bisacodyl E.C. 5 MG TAB Take one tablet (5 MG) by mouth at bedtime AS NEEDED for 10 days Rx#: 121757-NYM Doctor: Joaquin, Y. MLP Start: 07/09/19 Exp: 07/19/19 WC: 07/12/19 Pharmacy Dispensings: 10 TAB in 22 days Docusate Sodium 100 MG Cap Take one capsule (100 MG) by mouth twice daily for 30 days Rx#: 121823-NYM Doctor: Beaudouin, Robert MD Start: 07/12/19 Exp: 08/11/19 Pharmacy Dlspensings: 60 CAP in 19 days Docusate Sodium 100 MG Cap Take one capsule (100 MG) twice daily by mouth with plenty of water Rx#: 122084-NYM Doctor: Beaudouin, Robert MD Start: 07/26/19 Exp: 01/22/20 Pharmacy Dispensings: 30 CAP in 5 days Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML shake well take 2 tablespoonful twice daily by mouth Rx#: 121835-NYM Doctor: Beaudouin, Robert MD Start: 07/12/19 Exp: 07/14/19 Pharmacy Dispensings: 473 ML in 19 days Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML shake well take 10ml by mouth twice daily AS NEEDED Rx#: 122150-NYM Doctor: Beaudouin, Robert MD Start: 07/30/19 Exp: 10/28/19 methylPREDNISolone 4 MG Tab ( 21 count Pack) Take the tablet by mouth as directed Rx#: 121836-NYM Doctor: Beaudouin, Robert MD Start: 07/12/19 Pharmacy Dispensings: 473 ML in 1 day Exp: 07/18/19 Pharmacy Dispensings: 21 tab in 19 days methylPREDNISolone 4 MG Tab ( 21 count Pack) Take the tablet by mouth as directed Rx#: 122149-NYM Doctor: Beaudouin, Robert MD Start: 07/30/19 Exp: 08/05/19 Pharmacy Dispensings: 21 tab in 1 day Generated 07/30/2019 15:33 by Aassiddaa, Joy FOIA Bureau of Prisons - NYM Page 1 of 2 EFTA00045568

Complex: NYM--NEW YORK MCC Begin Date: 07/02/2019 Inmate: EPSTEIN, JEFFREY Reg #: 76318-054 End Date: 07/30/2019 Quarter: Z04-206LAD Active Prescriptions Omega 3 (Vascepa) 1 GM Capsule Take two capsules (2 GM) twice daily by mouth with food Rx#: 121885-NYM Doctor: Beaudouin, Robert MD Start: 07/17/19 Exp: 01/13/20 Pharmacy Dispensings: 120 Cap in 14 days Insulin Reg (10 ML) 100 UNITS/ML Inj Inject regular insulin subcutaneously per sliding scale: twice daily "'pill Mem for 7 days "'pill line*" Rx#: 122148-NYM Doctor: Beaudouin, Robert MD Start: 07/30/19 Exp: 08/06/19 Pharmacy Dispensings: 0 ML in 1 day Generated 07/30/2019 15:33 by Aassiddaa, Joy FOIA Bureau of Prisons - NYM Page 2 of 2 EFTA00045569

Bureau of Prisons Health Services Dental Health History Screen Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Encounter Date: 07/26/2019 07:54 Reg #: 76318-054 Sex: M Race: WHITE Facility: NYM Provider: Ancrum, Cheryl DDS Unit: H01 ASSESSMENTS: Health Problems as of Dental Health History Encounter date: 07/26/2019 07:54 Health Problems Health Problem Status Hyperlipidemia, unspecified Current HYPERTRIGLYCERIDEMIA Sleep apnea Current Constipation, unspecified Current Low back pain Current Neuralgia and neuritis, unspecified Current No Diagnosis Current Injury, unspecified Current RIO self inflicted injuries. Medical History as of Dental Health History Encounter date: 07/26/2019 07:54 Medical History: Allergies: Denied Seizures: Denied Diabetes: Denied Cardiovascular: Denied CVA: Denied Hypertension: Denied Respiratory: Denied Sickle Cell Anemia: Denied Carcinoma/Lymphoma: Denied HIV History: When Tested: 2019 Test Result: Negative When Diagnosed AIDS: Last CD4: Comments: Hepatitis: Denied Generated 07/26/2019 07:59 by Ancrum. Cheryl DDS Bureau of Prisons - NYM Page 1 of 3 EFTA00045570

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Encounter Date: 07/26/2019 07:54 Reg #: 76318-054 Sex: M Race: WHITE Facility: NYM Provider: Ancrum, Cheryl DDS Unit: H01 Other Infectious Diseases: Syphilis: No Syphilis Last Treatment: N/A Genital Warts: No Chlamydia: Yes Gonorrhea: No Herpes: No Chicken Pox: Yes Other: No Comments: Chlamydia in 2015, treated Chicken pox in childhood Other Health Issues: Other Medical Conditions And Treatment: sleep apnea Current Medical Conditions: Other Current Treatments: Pregnant: N/A Dental Observations as of Dental Health History Encounter date: 07/26/2019 07:54 History: Alcohol: No Methamphetamine: No Tobacco products: No Other drugs: No Sensitive teeth: No Bleeding gums: Yes Food impaction: Yes Pain around ear: No Toothache: No Wear partial dentures: No Unusual sounds while eating: No Snoring: Yes Blisters on lips or mouth: No Clenching or grinding: Yes Swelling or lumps in mouth/throat: No Burning tongue: No Bad breath: No Decayed teeth: No Loose teeth: No Wear dentures: No None: No Comments: Generated 07)26:2019 07:59 by Ancrum. Cheryl DDS Bureau of Prisons - NYM Page 2 of 3 EFTA00045571

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Encounter Date: 07/26/2019 07:54 Reg #: 76318-054 Sex: M Race: WHITE Facility: NYM Provider: Ancrum, Cheryl DDS Unit: H01 Cardiac Condition Requiring Prophylaxis: No Prosthetic joint(s): No Radiation history of head or neck: No Excessive bleeding: No Bisphosphonates: No Comments: Medications as of Dental Health History Encounter date: 07/26/2019 07:54 Medications: Docusate Sodium 100 MG Cap Exp: 08/11/2019 SIG: Take one capsule (100 MG) by mouth twice daily for 30 days Omega 3 (Vascepa) 1 GM Capsule Exp: 01/13/2020 SIG: Take two capsules (2 GM) twice daily by mouth with food OTCs: Listing of all known OTCs this inmate is currently taking. Instructed inmate how to obtain medical, dental, and mental health care. Copay Required:No Cosign Required: No Telephone/Verbal Order: No Completed by Ancrum, Cheryl DDS on 07/26/2019 07:59 Generated 07/26/2019 07:59 by Ancrum. Cheryl DDS Bureau of Prisons - NYM Page 3 of 3 EFTA00045572

Bureau of Prisons Health Services Dental A&O Exam Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/26/2019 07:47 Provider: Ancrum, Cheryl DDS Unit: H01 Reviewed Health Status: Yes Occlusion: Class I Oral Hygiene: Fair CPITN: 3 2 3 3 1 2 3 Hard and soft tissue examination performed and documented on BP618 form: Yes Head & Neck/Soft Tissue within normal limits? No Comments: moderate to advanced upper posterior gingival recession Decayed: Missing: Filled: 0 1 14 Comments: Lower anterior crowding Approved for hygiene appointment and radiographs: Yes Instructed inmate how to obtain routine and emergency dental care. Oral hygiene instructions given: Yes Dental A8O Screening Exam findings entered on EPSTEIN, JEFFREY by Ancrum, Cheryl DDS on 07/26/2019 07:47. Generated 07/26/2019 08:00 by Ancrum. Cheryl DDS Bureau of Prisons - NYM Page 1 of 1 EFTA00045573

Bureau of Prisons Health Services Dental Soap/Admin Encounter Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/18/2019 13:48 Provider: DeBruce, Juanita Dental Asst Unit: Z05 Screening encounter at Dental Clinic. Reason Not Done: Unavailable Comments: Patient has had several call outs for his Dental A & O screening but has not been escorted to the dental clinic. Cosign Required: No Completed by DeBruce, Juanita Dental Asst on 07/19/2019 13:49. Generated 07/19/2019 13:49 by DeBruce. Juanita Dental Bureau of Prisons • NYM Page 1 of 1 EFTA00045574

Bureau of Prisons Psychology Services General Administrative Note "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/30/2019 12:01 Provider: Imeri, Darlene PsyD Reg #: 76318-054 Unit Team: 5 Comments Psych Observation Discontinuation Note: Please see "Clinical Contact" dated today. Completed by Imeri, Darlene PsyD on 07/30/2019 12:33 Generated 07/30/2019 12:33 by Imeri. Darlene PsyD Bureau of Prisons - NYM Page 1 of 1 EFTA00045575

Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED" Psychology Services Institution Disciplinary Process Report Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/30/2019 12:01 Provider: lmeri, Darlene PsyD Reg #: 76318-054 Unit Team: 5 Reason for Referral and Identifying Information Inmate Epstein was referred by Unit Manager Proto 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 by Dr. Miller, "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 by Dr. Miller, "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." According to this writers Suicide Risk Assessment dated 7/23/19, "It is unclear at this time if he had placed the string around his neck or if someone else did." Clinical Interview and Mental Status Exam Inmate Epstein still does not remember how he obtained the marks around his neck. 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 by Dr. Miller, "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 by linen. Darlene PsyD Bureau of Prisons - NYM Page 1 of 2 EFTA00045576

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/30/2019 12:01 Provider: Imeri, Darlene PsyD Reg #: 76318-054 Unit Team: 5 Completed by 'men, Darlene PsyD on 07/30/2019 12:33 Generated 07:30,2019 12:33 by Imeri. Darlene PsyD Bureau of Prisons NYM Page 2 of 2 EFTA00045577

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/30/2019 12:01 Provider: Imeri, Darlene PsyD Reg #: 76318-054 Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation He stated he hasn't slept well at MCC-NY because he hasn't had his cpap machine. He stated it is here and he will be able to start using it tonight. He discussed how he does not think he will able to sleep in SHU and how he does not like SHU because of the noise. He discussed issues on not getting some medication with Medical today. The "Eating/Shower Chart" indicated yesterday he ate breakfast and dinner, drank liquids, and took a shower when offered and so far today it noted he ate breakfast and drank liquids. The Psych Observation Log noted he slept, drank water, went to legal, and talked to an Inmate Companion about investments. 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. Intervention(s) Supportive and educative interventions were provided. When asked about the Turning Point handouts for coping in SHU, he stated he already knows these strategies before he read the handouts and had tried them when he was in SHU the last time. He stated with the noise in SHU, he said the strategies will not work. He was encouraged to try them. Progress/Plan The Chief Psychologist was consulted. Psych Observation will be discontinued. Mr. Epstein was educated about both routine and emergency procedures for contacting Psychology staff. He will be seen in follow up by Psychology tomorrow to monitor his mental status and to provide further intervention if needed and he was informed that he will be seen by Psychology tomorrow. In the meantime, he was encouraged to self-refer to Psychology if needed to which he agreed and seems capable of doing. If he remains in SHU, he will be seen by Psychology in SHU Rounds and in SHU Reviews. The SHU Lt. was informed that Mr. Epstein needs to be housed with an appropriate cellmate. Completed by Imeri, Darlene PsyD on 07/30/2019 13:54 Generated 07/30/2019 13:54 by Imeri. Darlene PsyD Bureau of Prisons - NYM Page 1 of 1 EFTA00045578

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/29/2019 10:01 Provider: Miller, Elissa PhD/Chief Reg #: 76318-054 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. He then asked if he could remain down here where it is "safe" for the entire week. 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 he felt safe or more comfortable for him. It was explained to him that he would be placed in a safe situation in the SHU. 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. Intervention(51 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 by Miller, Elissa PhD/Chief Psychologist on 07/29/2019 10:26 Generated 07/29/2019 10:26 by Miller. Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00045579

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/28/2019 08:33 Provider: Imeri, Darlene PsyD Reg #: 76318-054 Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation The "Eating/Shower Chart" noted that yesterday he ate breakfast. He is not in the Psych Observation cell for about 12 hours per day because of being in Attorney Conference with his Attorneys, so the "Eating/Shower Chart" may not reflect all of his meals. He stated he was served one meal in Attorney Conference yesterday. He stated he drinks a lot water at night. The Psych Observation log noted he talked about life in general population and he slept. Earlier he had complained that his right arm was numb and hanging. Nurse Columba from Medical had seen him for this. When this writer was interviewing him, he 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. This writer notified Nurse Columba. He stated last night when he flushed the toilet it kept flushing for 45 minutes. He stated he found it so aversive and upsetting that he said he sat in the corner and held his ears. He said because of this he was agitated for hours and was not able to sleep. The Lt. will be moving him to a different cell and he was informed of this. He stated the feeling he got with the noise of the toilet was similar to when he was in SHU. He said he may have something on the Autism spectrum. He said in the movie "Rain Man," the person with Autism had an aversion to noise. He stated he is also really good with numbers. Current Mental Status: He exhibited a mildly anxious 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 and 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. Intervention(s) Supportive and educative interventions were again provided. He had not been given the Turning Point handouts yesterday that were on his cell door, so they were handed to him by staff today. 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 by Imeri, Darlene PsyD on 07/28/2019 09:24 Generated 07/28/2019 09:24 by Imeri. Darlene PsyD Bureau of Prisons - NYM Page 1 of 1 EFTA00045580

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/27/2019 07:14 Provider: Imeri, Darlene PsyD Reg #: 76318-054 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 When interviewed, he st stated that for the 5 days b he is anxious about going bac neck and he does not know why II cannot remember what happened in SHU that caused the marks on his neck. He e had only slept about 30 minutes each night because of noise in SHU. He stated ecause he stated he is going back to a place where he had gotten marks on his He said he has an appetite and is eat7R,f He said is waking up every 1 1/2 hours. He stated he feels dehydrated because he is not drinking enough water tated he feels he is not given enough bathroom breaks while with his Attorney. Medical was e-mailed with his f feeling dehydrated. He said his Lawyers and friends are all emotionally supportive. Current Mental Status: He exhibited a neutral mood ly full range of affect. His speech was logical and coherent, with no loosening of associations or tangential ntial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. 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 s if he has these thoughts. Interventionist Supportive and educative interventions were provided. He was given TurninrP 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 r1 n9 Progress/Plan He will remain on Psych Observation in an abundance of caution and pending housing arr be made on Monday. While on Psych Observation, he will be seen daily by Psychology. Completed by Imeri, Darlene PsyD on 07/27/2019 08:16 Generated 07/27/2019 08:16 by Imeri. Darlene PsyD Bureau of Prisons - NYM Page 1 of 1 EFTA00045581

Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/27/2019 07:14 Facility: NYM Amendment made to this note by lmeri, Darlene PsyD on 07 28 2019 09:19. Bureau of Prisons - NYM EFTA00045582

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/27/2019 07:14 Provider: Imeri, Darlene PsyD Reg #: 76318-054 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. When interviewed, he stated he still cannot remember what happened in SHU that caused the marks on his neck. He stated that for the 5 days before that he had only slept about 30 minutes each night because of noise in SHU. He stated he is anxious about going back to SHU because he stated he is going back to a place where he had gotten marks on his neck and he does not know why it happened. 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. Interventionist 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 by Imeri, Darlene PsyD on 07/28/2019 09:19 Generated 07/28/2019 09:19 by Imeri. Darlene PsyD Bureau of Prisons - NYM Page 1 of 1 EFTA00045583

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/27/2019 07:14 Provider: Imeri, Darlene PsyD Reg #: 76318-054 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 When interviewed, he st stated that for the 5 days b he is anxious about going bac neck and he does not know why II cannot remember what happened in SHU that caused the marks on his neck. He e had only slept about 30 minutes each night because of noise in SHU. He stated ecause he stated he is going back to a place where he had gotten marks on his He said he has an appetite and is eat7R,f He said is waking up every 1 1/2 hours. He stated he feels dehydrated because he is not drinking enough water tated he feels he is not given enough bathroom breaks while with his Attorney. Medical was e-mailed with his f feeling dehydrated. He said his Lawyers and friends are all emotionally supportive. Current Mental Status: He exhibited a neutral mood ly full range of affect. His speech was logical and coherent, with no loosening of associations or tangential ntial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. 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 s if he has these thoughts. Interventionist Supportive and educative interventions were provided. He was given TurninrP 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 r1 n9 Progress/Plan He will remain on Psych Observation in an abundance of caution and pending housing arr be made on Monday. While on Psych Observation, he will be seen daily by Psychology. Completed by Imeri, Darlene PsyD on 07/27/2019 08:16 Generated 07/27/2019 08:16 by Imeri. Darlene PsyD Bureau of Prisons - NYM Page 1 of 1 EFTA00045584

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/26/2019 09:09 Provider: Miller, Elissa PhD/Chief Reg #: 76318-054 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). With regard to the events which lead to his initial placement on suicide watch, inmate Epstein stated he has no memory of the event. He asked to speak with his old cellmate "Nick" to see if he can tell him what happened or see if his memory could be triggered. He remarked, "I am still trying to figure out how I got this (pointing to the scab around his neck)." Inmate Epstein denies remembering harming himself and/or being harmed by his cellmate. 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. Intervention(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. He continues to be vague and reports memory deficits regarding the events which lead to a piece of sheet being placed loosely around his neck and marks with scabs around his neck. Completed by Miller, Elissa PhD/Chief Psychologist on 07/26/2019 10:05 Generated 07/26/2019 10:05 by Miller. Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00045585

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/25/2019 10:14 Provider: Miller, Elissa PhD/Chief Reg #: 76318-054 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. He continues to assert he does not remember how he received marks around his neck, remarking "I do not remember anything, maybe you can give me some cues." He stated he just remembers going for a drink of water and the next thing he knew he woke up to the sound of his own snoring. When this writer attempted to get a more detailed account from him, indicating that it would be rare to have 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. Intervention(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. He has yet to give an account of how he sustained the marks around his neck, is not revealing much about his mental status, and there are concerns about his adjustment at this time to being housed in the SHU. Inmate Epstein will be seen daily by psychology while on psychological observation. Completed by Miller, Elissa PhD/Chief Psychologist on 07/25/2019 10:43 Generated 07/25/2019 10:43 by Miller. Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00045586

Bureau of Prisons Psychology Services Post Suicide Watch Report "SENSITIVE BUT UNCLASSIFIED— Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 ex: M Facility: NYM Unit Team: 5 Date: 07/24/2019 09:23 Provider: DiMisa, Samantha Ph.D. 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 Watch Stop Date: 07/24/2019 08:45 Transfered to Medical Center: No 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: 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. There 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 Risk Factors: Mr. EPSTEIN has a significant scar around his neck, which is now scabbing over. He reported swelling in this area but denied experiencing any related pain. Mr. EPSTEIN continues to claim a lack of memory for the incident resulting in this scar. The story he provided was vague, such that this writer challenged him a couple of times, but he insisted he was being honest about his lapse in memory. The nature of the incident remain unclear. Mr. EPSTEIN is incarcerated for a very high profile crime with media attention. He was recently denied bail. He also reported difficulty managing his time in the SHU. He reported being fearful for his safety if he is to return to the cell with his previous cell mate. 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, in light of his vague self-report regarding the incident which precipitated his placement on Suicide Watch, combined with his fear for his own safety, reported Generated 07/24/2019 12:09 by DiMisa. Samantha Ph.D. Bureau of Prisons • NYM Page 1 of 3 EFTA00045587

Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 ex: M Facility: NYM Unit Team: 5 Date: 07/24/2019 09:23 Provider: DiMisa, Samantha Ph.D. difficulty managing his time in the SHIJ, and 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. Asked about the alleged incident which transpired yesterday resulting in his placement on Suicide Watch, Mr. EPSTEIN said he is frustrated he has been placed in a "punishment cell for no reason." Specifically, Mr. EPSTEIN was referring to his placement in the SHU. Asked to recall the events surrounding the alleged incident, Mr. EPSTEIN said his cell mate was "playing with a bed sheet" and he claimed he does not recall the events thereafter. He said he recalled eating meat and drinking water and claimed the next event for which he has memory is his hearing himself snore and waking up on a stretcher. Mr. EPSTEIN claimed he does not recall himself or his cell mate tying a string or rope around his neck. He said he has "been trying to remember" and "wracking his mind." Asked if he experienced any interpersonal issues with his cell mate, Mr. EPSTEIN described his cell mate as "agitated" and claimed his cell mate called him a "pedophile" for the first time yesterday. His cell mate was also reportedly reading a newspaper article about Mr. EPSTEIN, which bothered him and it was something he believed to be "strange" for their to be an article about him in his cell. Mr. EPSTEIN recalled throwing away the newspaper photograph of himself by crumpling it and flushing it down the toilet. Asked if his cell mate ever threatened to harm him, he denied this to be the case. Asked why he told the inmate companions yesterday his cell mate tried to kill him, while also claiming no memory of the incident, Mr. EPSTEIN again said he did not recall the incident and further stated, "I don't know if he put it there as a joke." Mr. EPSTEIN explained he had been experiencing difficulty sleeping in his SHU cell due to his inmate peers banging on the cell door and window, but has not been experiencing any other acute issues other than this. 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 Dx - Current Conclusions The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent Recommendations 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 by DiMisa. Samantha Ph.D. Bureau of Prisons • NYM Page 2 of 3 EFTA00045588

Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 ex: M Facility: NYM Unit Team: 5 Date: 07/24/2019 09:23 Provider: DiMisa, Samantha Ph.D. Observation. 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 by DiMisa, Samantha Ph.D. on 07/24/2019 12:09 Generated 07/24/2019 12:09 by DiMisa. Samantha Ph.D. Bureau of Prisons • NYM Page 3 of 3 EFTA00045589

Bureau of Prisons Psychology Services Suicide Risk Assessment "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/23/2019 10:09 Provider: lmeri, Darlene PsyD Reg #: 76318-054 Unit Team: 5 Type of Housing: SHU- Administrative Segregation Cell Accommodation: Double-Cell FINDINGS 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 The On Call Psychologist, Dr. Miller, had been contacted by the Operations Lt. at about 2 AM on 7/23/19 to inform her that Mr. Epstein was being placed on Suicide Watch because he was found with a string around his neck. Mr. Epstein was seen by this writer for a Suicide Risk Assessment at about 9:10 AM on 7/23/19. This note is being entered at about 3:35 PM on 7/23/19. Mental Health History According to a Suicide Risk Assessment dated 7/09/19 by Dr. Miller, "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 7/09/19 by Dr. Miller, "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." Substance Abuse History According to a Suicide Risk Assessment dated 7/09/19 by Dr. Miller, "Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol." Current Problem Earlier this morning Mr. Epstein was found by SHU staff in his cell with a string loosely tied around his neck. It is unclear at this time if Mr. Epstein had placed the string around his own neck. When Mr. Epstein was asked by this writer how he ended up on Suicide Watch, he denied remembering. He stated he got a drink of water last night in his cell and went back to bed. He said the next thing he remembered is hearing himself snore. He said he wants to know why he is on Suicide Watch. He was informed that staff stated he was found in his cell with a string on his neck. According to Medical records, he had been seen by Medical for this and had a rule out of self inflicted injuries. When this writer reviewed the Staff Suicide Watch Log, it noted that Mr. Epstein told the staff watching him that his cellmate tried to kill him, which Mr. Epstein did not tell this writer when this writer had interviewed Mr. Epstein. This writer was not able to ask Mr. Epstein about this, since Mr. Epstein was now in Legal. The Captain was notified about this notation and the Captain stated they were already aware of this statement. Current Mental Status Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Generated 07/23/2019 15:38 by Imeri, Darlene PsyD Bureau of Prisons - NYM Page 1 of 3 EFTA00045590

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/23/2019 10:09 Provider: Imeri, Darlene PsyD Reg #: 76318-054 Unit Team: 5 Thought Process: Goal Directed Thought Content: Normal 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 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 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 Risk Factors: He was found by staff in his cell in SHU with a string loosely tied around his neck, which Mr. Epstein stated he did not remember anything about. It is unclear at this time if Mr. Epstein had placed the string around his own neck or if someone else did. According to Medical, he had a circular line around the base of his neck, which he denied knowing how he obtained. He stated his throat hurts which was reported to Medical. He has a high profile sex offense case and recently was denied bail. When asked if he has any friends or family that are emotionally supportive, he stated he does not know what that means. When emotional supports were explained to him and then again asked if he as any family or friends that are emotionally supportive, he was vague and said he has a lot of people. Protective Factors: He denied current suicidal or self harm thoughts or ever having these thoughts. He denied a history of self harm and suicide attempts. He denied a family history of suicidal and self harm attempts. He denied having any chronic medical conditions. He denied feeling hopeless. He denied a history of childhood abuse. He denied fearing for his safety. He denied feeling like a burden to anyone. He reported he is sleeping adequately. He stated he lives to have fun, to enjoy life, and to learn. He said his future plans include fighting his case and going back to his normal life. Whereas, he is denying suicidal and self harm thoughts and has a lot of protective factors, he is denying that he remembers how he ended up on Suicide Watch and has marks encircling his neck. It is unclear at this time if he had placed the string around his neck or if someone else did. He will remain on Suicide Watch for further observation and safekeeping. DIAGNOSIS; No Diagnosis, No Dx - Current CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Moderate Overall Chronic Suicide Risk for this Inmate is: Absent RECOMMENDATIONS 1. Mr. Epstein will remain on Suicide Watch for further observation and safekeeping. 2. While on Suicide Watch, he will be continuously observed by Inmate Companions. 3. While on Suicide Watch, he will be seen daily by Psychology. 4. Supportive and educative interventions were provided. 5. Medical was informed that he reported his throat hurts. Suicide Watch: A suicide watch was initiated by non-clinical staff and continues to be warranted Suicide Watch was initiated on: 07/23/2019 01:40 Generated 07/23/2019 15:38 by Imeri, Darlene PsyD Bureau of Prisons - NYM Page 2 of 3 EFTA00045591

Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: 5 Date: 07/23/2019 10:09 Provider: Imeri, Darlene PsyD Completed by 'men, Darlene PsyD on 07/23/2019 15:38 Generated 07/23/2019 15:38 by Imeri, Darlene PsyD Bureau of Prisons - NYM Page 3 of 3 EFTA00045592

Bureau of Prisons Psychology Services General Administrative Note "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/23/2019 07:56 Provider: Miller, Elissa PhD/Chief Reg #: 76318-054 Unit Team: 5 Comments This On-Call Psychologist was contacted by the Operations Lt. at about 2 AM on 7/23/19 to inform Mr. Epstein was being placed on Suicide Watch because he was found with a string loosely hanging around his neck. Mr. Epstein will be seen today by the duty psychologist for a Suicide Risk Assessment. Completed by Miller, Elissa PhD/Chief Psychologist on 07/24/2019 07:59 Generated 07/24/2019 07:59 by Miller. Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00045593

Bureau of Prisons Psychology Services SHU Review "SENSITIVE BUT UNCLASSIFIED— Inmate Name: Date of Birth: Date: EPSTEIN, JEFFREY 01/20/1953 Sex: M Facility NYM 07/18/2019 07:21 Provider: Miller, Elissa PhD/Chief Reg #: 76318-054 Unit Team: A&O Placed in SHU: Status: Basis of Review: Mental Status: 07/10/2019 ADMIN.DETENTION Inmate was interviewed No significant mental health issues. Type: Threat to Self: Adjustment: Threat to Others: SHU Low Satisfactory, segregation not detrimental Low Comments Monthly SHU Review Note Inmate Epstein was meeting with his legal team today and has a court hearing. He was not able to be seen for a SHU review. Another attempt to interview him for a SHU review will be done in the near future. Completed by Miller, Elissa PhD/Chief Psychologist on 07/18/2019 12:06 Generated 07/18/2019 12:06 by Miller. Elissa PhD/Chief Bureau of Prisons • NYM Page 1 of 1 EFTA00045594

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/16/2019 12:48 Provider: Miller, Elissa PhD/Chief Reg #: 76318-054 Unit Team: A&O Focus of Session Inmate Epstein called for this writer in attorney conference today. The officer in attorney conference notified this writer that he was asking to be seen. Subjective/Objective Presentation Inmate Epstein reported he has not received a spoon or soap in SHU, nor did he receive the phone calls that were "promised to him: He told this writer we need to have mutual trust that his needs are met in the prison. This writer told inmate Epstein that she would address his concerns. On the way out, a staff member told this writer she witnessed inmate Epstein receive two phone calls from the Lt. Nonetheless, this writer informed the SHU lieutenant of his concerns and he said he would ensure that he had soap, a spoon, and his initial SHU phone call. Inmate Epstein did not have any psychological concerns today. He denied any mental health symptoms or suicidality. He has been eating as best as he can and has requested a Kosher diet. tntervention(s) Inmate EPSTEIN was provided with brief supportive and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was receptive to these interventions. He continued with his legal visit. 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. There appears to be no need for follow up at this time. He will be seen in SHU for rounds and monthly SHU reviews. Completed by Miller, Elissa PhD/Chief Psychologist on 07/18/2019 13:05 Generated 07/18/2019 13:05 by Miller. Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00045595

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/11/2019 15:21 Provider: Miller, Elissa PhD/Chief Reg #: 76318-054 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. Inmate Epstein stated he is not having any current problems with his cellmate and indicated he at bran cereal for breakfast and took a shower yesterday. 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. fnterventionisi 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 by Miller, Elissa PhD/Chief Psychologist on 07/12/2019 07:51 Generated 07/12/2019 07:51 by Miller. Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00045596

Bureau of Prisons Psychology Services General Administrative Note "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/11/2019 14:28 Provider: Imeri, Darlene PsyD Reg #: 76318-054 Unit Team: A&O Comments This writer attempted to see Mr. Epstein in the morning and then again in the afternoon for a Psych Observation Follow Up, but he was in Attorney Conference. Completed by Imeri, Darlene PsyD on 07/11/2019 15:51 Generated 07/11/2019 15:51 by Imeri, Darlene PsyD Bureau of Prisons - NYM Page 1 of 1 EFTA00045597

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/10/2019 08:38 Provider: Miller, Elissa PhD/Chief Reg #: 76318-054 Unit Team: A&O Focus of Session Inmate Epstein was seen today for a psychological observation contact in the hospital area by this writer. Subjective/Objective Presentation Inmate Epstein appeared well and it was noted in his log book and eating/sleeping chart that he has been eating his meals, sleeping, interacting with the inmate companions, and pacing in his cell. Today, he presented this writer with numerous concerns and requests. He stated he does not want to be housed in the SHU because he is not comfortable there; he wants to be single-celled if he goes to the SHU; he wants Colace, not the Ducolex he received from medical yesterday; he wants to be able to walk around and go to recreation: he does not want to wear an orange uniform to his legal visits because he is treated "like a punished inmate;" he wants a phone call before he leaves the psychological observation area; he wants a shower and towel; he would like to be housed in the cadre (5S) unit; and would like his property, paper, and a pen. Inmate Epstein's concerns were addressed by this writer and it was explained to him he will not be single-celled or placed in a housing unit for safety and security concerns. His medical concerns (constipation) were discussed with health services as well as his desire to be placed on Colace. Inmate Epstein was provided a shower this morning. intervention(s) Inmate Epstein was provided with supportive intervention and coping skills strategies today. He was receptive to interventions and was able to elucidate his various needs. He did not present with any acute psychopathology and continues to deny any suicidal ideation, intention, or plan. He is looking forward to his bail hearing on Monday but stated he is aware that even if he gets bail, it will take at least two weeks to sort things out so he can leave the jail. afigfeaSfliffi Inmate Epstein is not in any psychological distress, does not present with any mental health symptoms or complaints, and is denying any suicidality. He appears psychologically stable at this time and can be released from the psychological observation area. Inmate Epstein will be housed in the 9S area with a cellmate. He will be seen again tomorrow by psychology to evaluate his mental status and psychological stability. Completed by Miller, Elissa PhD/Chief Psychologist on 07/10/2019 09:09 Generated 07/10/2019 09:09 by Miller. Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00045598

Bureau of Prisons Psychology Services Diagnostic and Care Level Formulation **SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Date: 07/09/2019 10:13 Sex: M Facility: NYM Provider: Miller, Elissa PhD/Chief Reg #: 76318-054 Unit Team: A&O Relevant Historical Information Inmate Epstein is a 66-year-old Caucasian male, currently incarcerated on sex trafficking charges. He 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. 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 thgpast. Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink Inmate Epstein was seen health items or symptoms on h Epstein has various risk factors charges, pre-trial status, and he had legal situation. Inmate Epstein return psychologist. Inmate Epstein was placed on interview him this morning to conduct a tor suicidality. Diagnostic Formulation Inmate Epstein has no history of mental health proble s not exhibit suicidality at this time. He has never received inpatient or outpatient mental health treatment any history of suicidality. Currently, he does not exhibit any acute psychopathology, is currently psychologic nd is in no psychological distress. As such, he is being classified as a CC1-MH inmate at this time. CARE1-M e of an inmate who either has no identifiable mental illness (Axis I 'No Diagnosis") or is mildly ill and requires ention on an as-needed basis. Care Level Formulation 'sk assessment today for precautionary reasons. He did not mark any mental ology Questionnaire (PSI()) when he entered the institution. Nonetheless, Inmate y including a high profile case with media attention, sex offense/trafficking proceeding yesterday which could have given him bad news regarding his om court er duty hours yesterday evening and staff notified the on-call onary psychological observation status until psychology could risk assessment to determine whether he is currently at-risk for CARE1-MH is indicative of an inmate who shows no significant level of illness and demonstrates no need for regular mental health intervention. Diagnosis: No Diagnosis, No Dx - Current Completed by Miller, Elissa PhD/Chief Psychologist on 07/09/2019 10:32 airment associated with a mental Generated 07/09/2019 10:32 by Miller. Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00045599

Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 10:13 Facility: NYM Amendment made to this note by Miller, Elissa PhD Chief Psychologist on 07'09 2019 10:40. Bureau of Prisons - NYM EFTA00045600

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Diagnostic and Care Level Formulation Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/09/2019 10:13 Provider: Miller, Elissa PhD/Chief Reg #: 76318-054 Unit Team: A&O Relevant Historical Information Inmate Epstein is a 66-year-old Caucasian male, currently incarcerated on sex trafficking charges. He 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. 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. Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol. Presenting Problem/Symptom Inmate Epstein was seen by this writer for suicide risk assessment today, 7/9/19 at 7:30 a.m. for precautionary reasons. He returned from court yesterday evening. He did not mark any mental health items or symptoms on his Psychology Questionnaire (PSIQ) when he entered the institution. Nonetheless, Inmate Epstein has various risk factors for suicidality including a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court proceeding yesterday which could have given him bad news regarding his legal situation. Inmate Epstein returned from court after duty hours yesterday evening and staff notified the on•call psychologist. Inmate Epstein was placed on a precautionary psychological observation status until psychology could interview him this morning to conduct a formal suicide risk assessment in order to determine whether he is currently at-risk for suicidality. Diagnostic Formulation Inmate Epstein has no history of mental health problems and does not exhibit suicidality at this time. He has never received inpatient or outpatient mental health treatment and denied any history of suicidality. Currently, he does not exhibit any acute psychopathology, is currently psychologically stable and is in no psychological distress. As such, he is being classified as a CC1-MH inmate at this time. CARE1-MH is indicative of an inmate who either has no identifiable mental illness (Axis I 'No Diagnosis") or is mildly ill and requires clinical intervention on an as-needed basis. Care Level Formulation CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Diagnosis: No Diagnosis, No Dx - Current Completed by Miller, Elissa PhD/Chief Psychologist on 07/09/2019 10:40 Generated 07/09/2019 10:40 by Miller. Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00045601

Bureau of Prisons Psychology Services Diagnostic and Care Level Formulation **SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Date: 07/09/2019 10:13 Sex: M Facility: NYM Provider: Miller, Elissa PhD/Chief Reg #: 76318-054 Unit Team: A&O Relevant Historical Information Inmate Epstein is a 66-year-old Caucasian male, currently incarcerated on sex trafficking charges. He 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. 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 thgpast. Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink Inmate Epstein was seen health items or symptoms on h Epstein has various risk factors charges, pre-trial status, and he had legal situation. Inmate Epstein return psychologist. Inmate Epstein was placed on interview him this morning to conduct a tor suicidality. Diagnostic Formulation Inmate Epstein has no history of mental health proble s not exhibit suicidality at this time. He has never received inpatient or outpatient mental health treatment any history of suicidality. Currently, he does not exhibit any acute psychopathology, is currently psychologic nd is in no psychological distress. As such, he is being classified as a CC1-MH inmate at this time. CARE1-M e of an inmate who either has no identifiable mental illness (Axis I 'No Diagnosis") or is mildly ill and requires ention on an as-needed basis. Care Level Formulation 'sk assessment today for precautionary reasons. He did not mark any mental ology Questionnaire (PSI()) when he entered the institution. Nonetheless, Inmate y including a high profile case with media attention, sex offense/trafficking proceeding yesterday which could have given him bad news regarding his om court er duty hours yesterday evening and staff notified the on-call onary psychological observation status until psychology could risk assessment to determine whether he is currently at-risk for CARE1-MH is indicative of an inmate who shows no significant level of illness and demonstrates no need for regular mental health intervention. Diagnosis: No Diagnosis, No Dx - Current Completed by Miller, Elissa PhD/Chief Psychologist on 07/09/2019 10:32 airment associated with a mental Generated 07/09/2019 10:32 by Miller. Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00045602

Bureau of Prisons Psychology Services Suicide Risk Assessment "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: Miller, Elissa PhD/Chief Psychologist Type of Housing: Other Psychological Observation Cell Accommodation: Single Cell FINDINGS This assessment and the resulting recommendations are based on the following sources of information: Clinical Interview, Medical Record Inmate Epstein was placed on chological observation when he returned from court yesterday evening 7/8/19 for precautionary reasons. He i a suicide watch at this time. Reason for Referral Inmate Epstein is being seen e risk assessment today for precautionary reasons. Inmate Epstein has various risk factors for suicidality at thi • ing a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court o ing yesterday which could have given him bad news regarding his legal situation. As such, this writer instruc &D staff s well as the Lieutenant's Office, to immediately notify the psychology department when he returned fro Inmate Epstein returned from court after duty hours and denied suicidality. The aforementioned staff notifi -call psychologist and inmate Epstein was placed on a precautionary psychological observation status until psycho/.. o ' .terview him this morning to conduct a suicide risk assessment. Developmental History Inmate Epstein denied any history of being the victim •etrator of physical or sexual abuse. Educational History/Cognitive Impairment Inmate Epstein reported he obtained his high school diplom d some graduate classes in the area of mathematics. Arrest History and Exoerience of Incarceration Inmate Epstein reported he has served time in Palm Beach County jail se charges (soliciting prostitution) in the past. He is now being charged with sex trafficking, on a federal level. Mental Health History le Inmate Epstein denied any history of mental health treatment, either on an inpat tient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also d ljyacute mental health symptoms at this time. Self-Harm History Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever ging in any suicide attempts or self-injurious behavior in the past. Substance Abuse History Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol. Medical Concerns Inmate Epstein denied any significant medical problems, other than a history of high triglycerides. He reported feeling constipated at this time. Current Problem Inmate Epstein is currently on psychological observation due to his having multiple risk factors associated with suicidality. He denies any suicidality at this time and has no mental health or suicide history. He is being seen for a suicide risk assessment in an abundance of caution. Current Mental Status Level of Consciousness: Alert and Oriented Generated 07/09/2019 10:36 by Miller, Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 3 EFTA00045603

Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: Miller, Elissa PhD/Chief Psychologist Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Inmate Epstein did not exhibit any acute psychopathology and exhibited a clear mental status. Current Mental Status: Mr. EP a neutral affect with appropri and volume. His thoughts irrelevant content. There not engage in any bizarre or ina explicitly denied recent and curre commitment to life and safety, agree' IN was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited e. Eye contact and hygiene were appropriate. The inmate spoke with normal rate, tone, nized and coherent, with no loosening of associations or tangential, circumstantial, or e of perceptual disturbance, delusional ideation, or a formal thought disorder. He did e behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN eation, planning, and intent. He was future-oriented and expressed a act staff immediately should he experience suicidal ideation. RISK AND PROTECTIVE FACTORS SSED• This writer screened the inmate for a variety of suicide. The following STATIC risk factors were assessed t behaviors: High Profile Crime, Lack of family connect' Of the DYNAMIC risk factors assessed, none were foun validated factors commonly associated with risk for self-harm and and increase the inmate's risk for engaging in suicide related ender status st. The following PROTECTIVE factors were assessed to be pres m y decrease the inmate's risk of suicide:Able to identify reasons to live, Adequate problem solving skills, Denial of suici ention/plans, Future orientation, View of death as negative, Willingness to engage in treatment As noted above, Inmate Epstein is a 66-year-old Caucasian male. He tVr k factors for suicidality at this time including a high profile case with extensive media attention, sex offense/tr c rges, pre-trial status, and he had a court proceeding yesterday which may have given him bad news regarding his leg l Inmate Epstein also informed this writer that his only family at this time is his brother, with whom he does not hay cl tionship with. Despite these risk factors, inmate Epstein possesses a number of protective factors atRfi Inmate Epstein adamantly denied any suicidal ideation, intention or plan. He was very future oriented and requeste all, to meet with his attorney, to take a shower, and to brush his teeth. He was eating his cereal when this writ r d said "I have my paper spoon here." He reported he is going to have a bail hearing on Monday and believes he is go g t sed from jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "bei fun." He also revealed he enjoys learning and teaching. He has confidence in his attorney and described him as mpetent." Inmate Epstein denied any mental health history or history of suicidality. He also reported none of his family members have mental health histories. Inmate Epstein stated he is a mathematician and took post graduate classes in this area of study. Inmate Epstein stated he has a support system in the community, including friends and other associates. Finally, inmate Epstein demonstrated a good sense of humor and did not appear dysphoric, agitated or anxious. No acute psychopathology was noted. Overall, inmate Epstein has numerous protective factors at this time that outweigh his risk factors for suicidality. He has a positive outlook regarding his legal case, demonstrates no psychiatric symptoms, has no psychiatric or suicide history, and verbalized a desire to be alive at this time and future orientation. DIAGNOSIS* No Diagnosis, No Dx - Current CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent Generated 07/09/2019 10:36 by Miller, Elissa PhD/Chiel Bureau of Prisons - NYM Page 2 of 3 EFTA00045604

Inmate Name: EPSTEIN, JEFFREY Reg ff: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: Miller, Elissa PhD/Chief Psychologist RECOMMENDATIONS Inmate Epstein is currently on psychological observation pending suitable housing placement. In light of his current sex offense charges and extensive media coverage on the television, he will need to be confined in a suitable housing unit. Inmate Epstein will be seen daily while on psychological observation and will be seen for a psychological observation follow-up session once he is released from observation. Inmate Epstein denied the need for psychological intervention, self-help materials, or follow-up. He has been classified as a CC1-MH inmate at this time. CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Suicide Watch: A suicide watch is not warranted at this time Completed by Miller, Elissa PhD/Chief Psychologist on 07/09/2019 10:36 Generated 07/09/2019 10:36 by Miller, Elissa PhD/Chief Bureau of Prisons - NYM Page 3 of 3 EFTA00045605

Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 08:41 Facility: NYM Amendment made to this note by Miller, Elissa PhD Chief Psychologist on 07'10 2019 09:20. Bureau of Prisons - NYM EFTA00045606

Bureau of Prisons Psychology Services Suicide Risk Assessment "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: Miller, Elissa PhD/Chief Psychologist Type of Housing: Other Psychological Observation Cell Accommodation: Single Cell FINDINGS This assessment and the resulting recommendations are based on the following sources of information: Medical Record, Clinical Interview Inmate Epstein was placed on psychological observation when he returned from court yesterday evening 7/8/19 for precautionary reasons. He is not on a suicide watch at this time. He was seen this morning for a psychological observation contact and suicide risk assessment this morning, 7/9/19, at 7:30 a.m. as it was determined he possessed some at-risk factors for suicidality. Reason for Referral Inmate Epstein is being seen for suicide risk assessment today for precautionary reasons. Inmate Epstein has various risk factors for suicidality at this time including a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court proceeding yesterday which could have given him bad news regarding his legal situation. As such, this writer instructed R&D staff, as well as the Lieutenant's Office, to immediately notify the psychology department when he returned from court. Inmate Epstein returned from court after duty hours and denied suicidality. The aforementioned staff notified the on-call psychologist and inmate Epstein was placed on a precautionary psychological observation status until psychology could interview him this morning to conduct a suicide risk assessment. Developmental History Inmate Epstein denied any history of being the victim and/or perpetrator of physical or sexual abuse. Educational History/Cognitive Impairment Inmate Epstein reported he obtained his high school diploma and attended some graduate classes in the area of mathematics. Arrest History and Experience of Incarceration Inmate Epstein reported he has served time in Palm Beach County jail on sex offense charges (soliciting prostitution) in the past. He is now being charged with sex trafficking, on a federal level. Mental Health History 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 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. Substance Abuse History Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol. Medical Concerns Inmate Epstein denied any significant medical problems, other than a history of high triglycerides. He reported feeling constipated at this time. Current Problem Inmate Epstein is currently on psychological observation due to his having multiple risk factors associated with suicidality. He denies any suicidality at this time and has no mental health or suicide history. He is being seen for a suicide risk assessment in an abundance of caution. Current Mental Status Generated 07/10/2019 09:20 by Miller, Elissa PhD/Chiel Bureau of Prisons - NYM Page 1 of 3 EFTA00045607

Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: Miller, Elissa PhD/Chief Psychologist 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 Inmate Epstein did not exhibit any acute psychopathology and exhibited a clear mental status. 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. There 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. 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: Sex offender status, Lack of family connections, High Profile Crime Of the DYNAMIC risk factors assessed, none were found to be present. The following PROTECTIVE factors were assessed to be present and may decrease the inmate's risk of suicide:Willingness to engage in treatment, View of death as negative, Future orientation, Denial of suicidal ideationAntentiorVplans, Adequate problem solving skills, Able to identify reasons to live As noted above, Inmate Epstein is a 66-year-old Caucasian male. He has various risk factors for suicidality at this time including a high profile case with extensive media attention, sex offense/trafficking charges, pre-trial status, and he had a court proceeding yesterday which may have given him bad news regarding his legal situation. Inmate Epstein also informed this writer that his only family at this time is his brother, with whom he does not have a close relationship with. Despite these risk factors, inmate Epstein possesses a number of protective factors at this time. Inmate Epstein adamantly denied any suicidal ideation, intention or plan. He was very future oriented and requested a phone call, to meet with his attorney, to take a shower, and to brush his teeth. He was eating his cereal when this writer arrived and said "I have my paper spoon here." He reported he is going to have a bail hearing on Monday and believes he is going to be released from jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "being alive is fun." He also revealed he enjoys learning and teaching. He has confidence in his attorney and described him as "competent." Inmate Epstein denied any mental health history or history of suicidality. He also reported none of his family members have mental health histories. Inmate Epstein stated he is a mathematician and took post graduate classes in this area of study. Inmate Epstein stated he has a support system in the community, including friends and other associates. Finally, inmate Epstein demonstrated a good sense of humor and did not appear dysphoric, agitated or anxious. No acute psychopathology was noted. Overall, inmate Epstein has numerous protective factors at this time that outweigh his risk factors for suicidality. He has a positive outlook regarding his legal case, demonstrates no psychiatric symptoms, has no psychiatric or suicide history, and verbalized a desire to be alive at this time and future orientation. DIAGNOSIS: No Diagnosis, No Dx - Current Generated 07/10/2019 09:20 by Miller, Elissa PhD/Chiel Bureau of Prisons - NYM Page 2 of 3 EFTA00045608

Inmate Name: EPSTEIN, JEFFREY Reg ff: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: Miller, Elissa PhD/Chief Psychologist CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent FIECOMMENDATIONS Inmate Epstein is currently on psychological observation pending suitable housing placement. In light of his current sex offense charges and extensive media coverage on the television, he will need to be confined in a suitable housing unit. Inmate Epstein will be seen daily while on psychological observation and will be seen for a psychological observation follow-up session once he is released from observation. Inmate Epstein denied the need for psychological intervention, self-help materials, or follow-up. He has been classified as a CC1-MH inmate at this time. CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Suicide Watch: A suicide watch is not warranted at this time Completed by Miller, Elissa PhD/Chief Psychologist on 07/10/2019 09:20 Generated 07/10/2019 09:20 by Miller, Elissa PhD/Chief Bureau of Prisons - NYM Page 3 of 3 EFTA00045609

Bureau of Prisons Psychology Services Suicide Risk Assessment "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: Miller, Elissa PhD/Chief Psychologist Type of Housing: Other Psychological Observation Cell Accommodation: Single Cell FINDINGS This assessment and the resulting recommendations are based on the following sources of information: Clinical Interview, Medical Record Inmate Epstein was placed on chological observation when he returned from court yesterday evening 7/8/19 for precautionary reasons. He i a suicide watch at this time. Reason for Referral Inmate Epstein is being seen e risk assessment today for precautionary reasons. Inmate Epstein has various risk factors for suicidality at thi • ing a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court o ing yesterday which could have given him bad news regarding his legal situation. As such, this writer instruc &D staff s well as the Lieutenant's Office, to immediately notify the psychology department when he returned fro Inmate Epstein returned from court after duty hours and denied suicidality. The aforementioned staff notifi -call psychologist and inmate Epstein was placed on a precautionary psychological observation status until psycho/.. o ' .terview him this morning to conduct a suicide risk assessment. Developmental History Inmate Epstein denied any history of being the victim •etrator of physical or sexual abuse. Educational History/Cognitive Impairment Inmate Epstein reported he obtained his high school diplom d some graduate classes in the area of mathematics. Arrest History and Exoerience of Incarceration Inmate Epstein reported he has served time in Palm Beach County jail se charges (soliciting prostitution) in the past. He is now being charged with sex trafficking, on a federal level. Mental Health History le Inmate Epstein denied any history of mental health treatment, either on an inpat tient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also d ljyacute mental health symptoms at this time. Self-Harm History Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever ging in any suicide attempts or self-injurious behavior in the past. Substance Abuse History Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol. Medical Concerns Inmate Epstein denied any significant medical problems, other than a history of high triglycerides. He reported feeling constipated at this time. Current Problem Inmate Epstein is currently on psychological observation due to his having multiple risk factors associated with suicidality. He denies any suicidality at this time and has no mental health or suicide history. He is being seen for a suicide risk assessment in an abundance of caution. Current Mental Status Level of Consciousness: Alert and Oriented Generated 07/09/2019 10:36 by Miller, Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 3 EFTA00045610

Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: Miller, Elissa PhD/Chief Psychologist Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Inmate Epstein did not exhibit any acute psychopathology and exhibited a clear mental status. Current Mental Status: Mr. EP a neutral affect with appropri and volume. His thoughts irrelevant content. There not engage in any bizarre or ina explicitly denied recent and curre commitment to life and safety, agree' IN was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited e. Eye contact and hygiene were appropriate. The inmate spoke with normal rate, tone, nized and coherent, with no loosening of associations or tangential, circumstantial, or e of perceptual disturbance, delusional ideation, or a formal thought disorder. He did e behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN eation, planning, and intent. He was future-oriented and expressed a act staff immediately should he experience suicidal ideation. RISK AND PROTECTIVE FACTORS SSED• This writer screened the inmate for a variety of suicide. The following STATIC risk factors were assessed t behaviors: High Profile Crime, Lack of family connect' Of the DYNAMIC risk factors assessed, none were foun validated factors commonly associated with risk for self-harm and and increase the inmate's risk for engaging in suicide related ender status st. The following PROTECTIVE factors were assessed to be pres m y decrease the inmate's risk of suicide:Able to identify reasons to live, Adequate problem solving skills, Denial of suici ention/plans, Future orientation, View of death as negative, Willingness to engage in treatment As noted above, Inmate Epstein is a 66-year-old Caucasian male. He tVr k factors for suicidality at this time including a high profile case with extensive media attention, sex offense/tr c rges, pre-trial status, and he had a court proceeding yesterday which may have given him bad news regarding his leg l Inmate Epstein also informed this writer that his only family at this time is his brother, with whom he does not hay cl tionship with. Despite these risk factors, inmate Epstein possesses a number of protective factors atRfi Inmate Epstein adamantly denied any suicidal ideation, intention or plan. He was very future oriented and requeste all, to meet with his attorney, to take a shower, and to brush his teeth. He was eating his cereal when this writ r d said "I have my paper spoon here." He reported he is going to have a bail hearing on Monday and believes he is go g t sed from jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "bei fun." He also revealed he enjoys learning and teaching. He has confidence in his attorney and described him as mpetent." Inmate Epstein denied any mental health history or history of suicidality. He also reported none of his family members have mental health histories. Inmate Epstein stated he is a mathematician and took post graduate classes in this area of study. Inmate Epstein stated he has a support system in the community, including friends and other associates. Finally, inmate Epstein demonstrated a good sense of humor and did not appear dysphoric, agitated or anxious. No acute psychopathology was noted. Overall, inmate Epstein has numerous protective factors at this time that outweigh his risk factors for suicidality. He has a positive outlook regarding his legal case, demonstrates no psychiatric symptoms, has no psychiatric or suicide history, and verbalized a desire to be alive at this time and future orientation. DIAGNOSIS* No Diagnosis, No Dx - Current CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent Generated 07/09/2019 10:36 by Miller, Elissa PhD/Chiel Bureau of Prisons - NYM Page 2 of 3 EFTA00045611

Inmate Name: EPSTEIN, JEFFREY Reg ff: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: Miller, Elissa PhD/Chief Psychologist RECOMMENDATIONS Inmate Epstein is currently on psychological observation pending suitable housing placement. In light of his current sex offense charges and extensive media coverage on the television, he will need to be confined in a suitable housing unit. Inmate Epstein will be seen daily while on psychological observation and will be seen for a psychological observation follow-up session once he is released from observation. Inmate Epstein denied the need for psychological intervention, self-help materials, or follow-up. He has been classified as a CC1-MH inmate at this time. CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Suicide Watch: A suicide watch is not warranted at this time Completed by Miller, Elissa PhD/Chief Psychologist on 07/09/2019 10:36 Generated 07/09/2019 10:36 by Miller, Elissa PhD/Chief Bureau of Prisons - NYM Page 3 of 3 EFTA00045612

Bureau of Prisons Psychology Services General Administrative Note "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/08/2019 10:41 Provider: Miller, Elissa PhD/Chief Reg #: 76318-054 Unit Team: A&O Comments This writer consulted with Dr. Robert Nagle, Central Office, regarding inmate Epstein. Inmate Epstein has various risk factors for suicidality including a high profile case with media attention, sex offense charges, pre-trial status, and a court proceeding today which could potentially be giving him bad news regarding his legal situation. As such, when inmate Epstein returns from court, R&D staff as well as Lieutenant's have been informed to immediately notify the psychology department. If he returns after duty hours, the aforementioned staff were instructed to notify the on-call psychologist and to place inmate Epstein on a watch status until psychology can conduct a thorough suicide risk assessment. Completed by Miller, Elissa PhD/Chief Psychologist on 07/08/2019 10:49 Generated 07/08/2019 10:49 by Miller. Elissa PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00045613

Bureau of Prisons Psychology Services Risk of Sexual Abusiveness "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/08/2019 09:35 Provider: Schtessinger, K. PsyD/PhD Reg #: 76318-054 Unit Team: A&O Comments Risk of Sexual Abusiveness During the intake screening process, for Inmate Epstein, based on the documentation available at the time of the screening, and Inmate Epstein's self-report, he was identified as being at risk for sexual abusiveness due to previous perpetration of sexual abuse in the community or in an institutional setting, as evidenced by the following objective criteria: ( ) Having a history of prior institutional violence or sexual abuse perpetration (X ) Having a history of prior sexual abuse perpetration in the community (X ) Having prior convictions of violent offenses As required by P5324.11, Sexually Abusive Behavior Prevention and Intervention, Inmate Epstein was seen by Psychology on today's date to assess his risk factors for sexual abusiveness. At the onset of this clinical contact, the inmate was informed about the BOP requirements regarding PREA. Inmate Epstein indicated he understands the institution's policy against engaging in sexual behavior. His risk factors for sexual abusiveness were assessed and include: ( ) History of prior sexual victimization in prison ( X ) History of prior prison sexual predation ( ) History of head injury with loss of consciousness ( ) History of childhood psychological, physical, sexual abuse ( ) Witnessed family violence ( ) Antisocial Personality Disorder traits of irritability/aggressiveness and recklessness ( ) Hypersexuality (defined by eight or more orgasms a week prior to prison) ( ) Hypermasculinity ( ) Other: Based on this clinical assessment, the inmate is considered to be at: (X ) Low Risk of Abusiveness at this facility (Note: Even though this inmate is judged to be at low risk of sexual abusiveness, an unforeseen change in risk factors may significantly alter his risk level.). Programming recommendations included sex offender treatment. Inmate Epstein declined programming recommendations.The inmate understands the procedure for contacting Psychology for routine or emergent services. ( ) Moderate Risk of Abusiveness. The Unit Team and Correctional Staff have been notified regarding Psychology staff's recommendation that he not be housed in a cell with any inmates identified as at increased risk for sexual victimization. Psychology also recommends a greater level of supervision regarding his work and education assignments. Programming recommendations include XXXXX. Inmate =inmateLastName is agreeable to/ declined programming recommendations. ( ) High Risk of Abusiveness. It is recommended this inmate be housed in the Special Housing Unit in accordance with P5324.11 to "keep separate those inmates at high risk of being sexually victimized from those at high risk of being sexually abusive" until Correctional Services and Correctional Programs staff can assess his appropriateness for general population at this facility. This inmate should not be housed with any inmates judged to be at an increased risk for sexual victimization. Programming recommendations include XXXXX. Inmate =inmateLastName is agreeable to/ declined programming recommendations. Generated 07/08/2019 09:41 by Schlessinger. K. PsyD/PhD Bureau of Prisons - NYM Page 1 of 2 EFTA00045614

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/08/2019 09:35 Provider: Schlessinger. K. PsyD.PhD Reg #: 76318-054 Unit Team: A&O Completed by Schlessinger, K. PsyD/PhD on 07/08/2019 09:41 Generated 07108/2019 09:41 by Schlessinger. K. PsyD:PhD Bureau of Prisons NYM Page 2 of 2 EFTA00045615

Bureau of Prisons Psychology Services Intake Screening **SENSITIVE BUT UNCLASSIFIED•• Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/08/2019 09:24 Provider: Schlessinger, K. PsyD/PhD Limits of Confidentiality Limits of confidentiality were reviewed with inmate EPSTEIN. He expressed an understanding of the limits of confidentiality and consented to be interviewed accordingly. Data Source(s) The following data sources were reviewed in conjunction with this Initial Intake Evaluation: Self-Report, SENTRY, Staff Observation. Inmate Epstein is a 66-year-old, Black male who was seen by Psychology Services due to newly arriving at MCC-NY. He denied a history of mental health treatment on his Psychology Services Intake Questionnaire. Mental Health History and Current Symptoms No history of mental health issues was noted. No history of prior mental health treatment was noted. No current mental health symptoms were noted. No suicidal ideation, attempts, or self-harm were noted. Substance Abuse No history of substance abuse was noted. No history of substance abuse treatment was noted. Sex Offenses No sexual offense convictions were noted. No history of sexual predation in a correctional setting was noted. Relevant Psychosocial History Noteworthy psychosocial issues: Other. Inmate Epstein is currently incarcerated for a Sex Trafficking. He stated he was previously incarcerated three months f or prostitution. Inmate Epstein stated he is single and does not have any children. He revealed he was living in New York. He stated he completed high school. He stated he was employed in banking work prior to his incarceration. Adjustment to Incarceration Adjustment to incarceration concerns were identified: Other. SEXUAL ABUSE HISTORY Inmate Epstein denied being the victim of physical or sexual abuse. He is currently charged with sex trafficking and has previously been charged with prostitution. He was informed of the programs offered by MCC-NY as well as the Bureau of Prisons. Additionally, he was informed of this institutions self-help program. Inmate Epstein reported he was not currently interested in any treatment programs. MENTAL STATUS: Inmate Epstein appeared calm, controlled, without signs of psychomotor agitation or retardation. He was fully cooperative, maintained good eye-contact, and related in an interpersonally appropriate manner with interviewer. Speech and thought processes were organized, coherent, logical, and goal-directed. Based on informal assessment during this interview, this inmate's cognitive functioning appeared within normal limits, as reflected by adequate long and short-term memory, good attention, and appropriate concentration during interview, as well as adequate receptive and expressive language skills. Inmate denied any current sleep disturbances and described his appetite as adequate. This inmate denied recent or present morbid thoughts, passive or active suicidal ideation, intent or plan and contracted for safety. This inmate's verbalizations were optimistic, future oriented, and without indications of helpless or hopeless thinking. Inmate Brown denied any familial history of suicide behaviors or attempts. This inmate was provided with supportive psychotherapy, and psycho-education to strengthen coping skills and facilitate adjustment to incarceration. Findings Care Level: CARE1-MH Generated 07/08/2019 09:30 by Schlessinger, K. PsyD/PhD Bureau of Prisons - NYM Page 1 of 2 EFTA00045616

Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: A&O Date: 07/08/2019 09:24 Provider: Schlessinger, K. PsyD/PhD Inmate EPSTEIN denied any history of mental health symptoms or treatment. He denied any current mental health symptoms. He does not meet criteria for any current psychological diagnosis. He meets criteria for Mental Health Care Code 1. CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Recommendations The following psychological services are recommended: Other. Inmate EPSTEIN was educated about both routine and emergency procedures for contacting Psychology staff. He does not appear to be in distress at this time. He agreed to contact psychology if he feels he needs psychology services in the future. He meets criteria for CC1 and does not require scheduled follow up at this time. Completed by Schlessinger, K. PsyD/PhD on 07/08/2019 09:30 Generated 07/08/2019 09:30 by Schlessinger, K. PsyD/PhD Bureau of Prisons - NYM Page 2 of 2 EFTA00045617

Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 "' Sensitive But Unclassified Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Order Unit E06-547U Provider Robert Beaudouin, MD Collected 07/09/2019 13:34 Received 07/10/2019 10:44 Reported 07/10/2019 14:46 LIS ID 188191004 CHEMISTRY Sodium Potassium Chloride CO2 BUN Creatinine eGFR (IDMS) 137 4.7 99 27 17 1.05 >60 137-148 3.5.5.0 99.114 22-30 7.22 0.66.1.25 mmol/L mmol/L mmol/L mmol/L mg/dL mg/dL GFR units measured as mUmin/1.73 m^2. If African American multiply by 1.210. A calculated GFR <60 suggests chronic kidney disease if found over a 3 month period. Calcium 9.8 8.5-10.9 mg/dL Glucose 102 70-110 mg/dL AST H 57 11.55 U/L ALT 62 11-66 U/L Alkaline Phosphatase 64 41.133 U/L Bilirubin, Total 1.1 0.2.1.3 mg/dL Total Protein 7.3 6.0-8.2 g/dL Albumin 4.4 3.6.5.1 g/dL Globulin 2.9 2.0.3.7 g/dL Alb/Glob Ratio 1.50 1.00-2.30 Anion Gap 10.2 9.0.19.0 BUN/Creat Ratio 16.1 5.0.30.0 Cholesterol H 216 <200 mg/dL Triglycerides H 413 10.150 mg/dL Calculation of LDL is not appropriate for samples with a triglyceride greater than 400 mg/dL. Therefore the LDL is not calculated. HDL Cholesterol L 31 40.60 mg/dL Chol/HDL Ratio H 6.9 0.0.4.0 HEMATOLOGY WBC 7.6 4.3-11.1 K/uL NRBC% 0.0 RBC 5.42 4.46-5.78 M/uL Hemoglobin 15.6 13.6-17.6 g/dL Hematocrit 47.8 40.2-51.4 MCV 88.2 82.5-96.5 fL MCH 28.8 27.1-34.9 Pg MCHC L 32.6 33.0-37.0 g/dL RDW-CV 12.8 12.0-14.0 Platelet 338 130-374 K/uL FLAG LEGEND L=Low L!=Low Critical H=High H!=High Critical A=Abnormal A! =Abnormal Critical Page 1 of 3 EFTA00045618

Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 a' Sensitive But Unclassified*** Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Order Unit E06-547U Provider Robert Beaudouin, MD Collected 07/09/2019 13:34 Received 07/10/2019 10:44 Reported 07/10/2019 14:46 LIS ID 188191004 HEMATOLOGY MPV Neutrophils Therapeutic decision making should be based on absolute values, rather than percentages Lymphocytes °A) Monocytes Eosinophils % Basophils Immature Granulocytes % Neutrophils # Lymphocytes # Monocytes # Eosinophils # Basophils # Immature Granulocytes # 10.4 58.7 25.0 11.1 4.1 0.8 0.3 4.4 1.9 0.8 0.3 0.1 0.02 6.9-10.5 0.0-5.0 1.9.6.7 1.3.3.7 0.3-1.1 0.0.0.5 0.0.0.1 0.00-0.50 fL K/uL K/uL K/uL K/uL K/uL 10^3/uL HEMOGLOBIN A1C Hemoglobin A1C 5.7 - 6.4 Increased Risk > 6.4 Diabetes H 6.3 <5.7 SEROLOGY RPR Non-Reactive Results may be affected in patients with severely advanced immunosuppression. Non-Reactive FLAG LEGEND L=Low L!=Low Critical H=High H!=High Critical A=Abnormal A! =Abnormal Critical Page 2 of 3 EFTA00045619

Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 "' Sensitive But Unclassified Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Order Unit E06-547U Provider Robert Beaudouin, MD Collected 07/09/2019 13:34 Received 07/10/2019 10:44 Reported 07/10/2019 14:46 LIS ID 188191004 HIV HIV 1/2 Negative Screening test • See confirmatory testing for Reactive results Negative FLAG LEGEND L=Low L!=Low Critical H=High H!=High Critical A=Abnormal A! =Abnormal Critical Page 3 of 3 EFTA00045620

Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/10/2019 16:58 Provider: Lab Result Receive Facility: NYM Cosigned by Beaudouin. Robert MD on 0714:2019 18:12. Bureau of Prisons - NYM EFTA00045621

BP-S358.060 MEDICAL TREATMENT REFUSAL CDFRM SEP 05 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-24-2019 Date JEFFREY EPSTEIN 76318-054 , refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: EYE DOCTOR EVALUATION. The following treatment(s) was/were recommended: EYE DOCTOR EVALUATION. Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment: INABILITY TO DIAGNOSE CURRENT OPTHALMOLOGIC DISEASES. I understand the possible consequences and/or complications, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and its employees from any and all liability for respecting and following my expressed wishes and directions. BEAUDOUI , ROBERT MD 7-24-2019 Counseled by Date - C.- 7Z:so< C7kl ef e Signature of Witn s Date 725,Aidca 71eae-tcri4<cr NYM--NEW YORK MCC Date EFTA00045622

BP-A0618 A&O DENTAL EXAMINATION JUN 16 (Initial Clinical Dental Findings) U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS Occlusion: rs 1 2 3 ♦ 5 6 7 6 9 1011 00 14 15 11 6ItilM 32 31 30 29 28 27 2525 2423 22 21 20 19 18 17 14„ • Oral Hygiene: Good Fair oor CPITN: 3 3 3 2- 9 Head 8 Neck / Soft Tissue: D M: Classification: C1- 7 - Pain Scale: /10 Dental Prostheses at Intake: Yes Type: e l Age: Condition: Comnat eto R 62 65 / Lc."—Xe--4- C.--‘4e/t at i r ti )2.5 R/c4.1 Or) 019 Setu-e. or Ceb-L3JJA 5 0 .19SeiLle4 Intra-oral Photos Taken: Yes 0 Radiographs Taken: (Document findings on A80 encounter) Yes 9 Instructed how to obtain urgent and non-urgent dental care: Yes: 1 No: Treatment Priorities: None: Non-urgent non-urgent Urgent Referred to Sick Call: Radiographs authorized: PM: Prophylaxis authorized: Yes 1 No (Approval valid 18 months from examination date) BWs: Panorer. Pagan Name:, S -1-C4 -3 —Cc-PR.-ti E n Dentist Signature: 0 - L1-44014LAA.4— >DS st r Number. f -7(, 31Se- USN Institution: / MCC NEW YORK Date: 7- z6. ---/ 9. Signature Block/Stamp: C. Ancrum DDS. PDF Prescribed by P6400 let L)ental Umcer MCC New York Replaces BP-A0618 of JUN 10 EFTA00045623

BP-5358.060 MEDICAL TREATMENT REFUSAL CDFRM SEP 05 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-24-2019 Date JEFFREY EPSTEIN 76318-054 , refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: EYE DOCTOR EVALUATION. The following treatment(s) was/were recommended: EYE DOCTOR EVALUATION. Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment: INABILITY TO DIAGNOSE CURRENT OPTHALMOLOGIC DISEASES. I understand the possible consequences and/or complications, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and its employees from any and all liability for respecting and following my expressed wishes and directions. BEAUDOUI , ROBERT MD 7-24-2019 Counseled by Date Signature of Witn s Date cG 7 -4;c6e6 tej- NYM-NEW YORK MCC EFTA00045624

BP-S358.060 SLP 05 MEDICAL TREATMENT REFUSAL CDFRM U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-10-2019 Date I, JEFFREY EPSTEIN 76318-054 , refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: 66 YR OLD MALE WITH NO PIVIHX , REFERRED FOR ROUITNE CXR. The following treatment(s) was/were recommended: CHEST X-RAY Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment: WORSENING THE CONDITION IF THERE IS ANY FINDINGS I understand the possible consequences and/or complications, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and its employees from any and all liability for respecting and following my expressed wishes and directions. ESGUERRA, S. X-RAY 7-10-2019 Counseled by Date Patien Signature Signature of Witness Date NYM-NEW YORK MCC Date EFTA00045625

Medical Records request Tor Inmate Jeffrey Epstein, Reg. No. 76318-054 07/01/19 - 07/24/19 From Joy Aassiddaa To Adam Johnson, Stephanie Scannell Date 20I 9/07/24 10:38 Subject: Medical Records request for Inmate Jeffrey Epstein, Reg. No. 76318- 054 07/01/19 - 07/24/19 Attachments: TEXT.htm, PrintChartGetReport.faces.pdf Please see attached. Thank You!! Joy Aossiddoo, Legal Assistant CLC New York Metropolitan Correctional Center 150 Park Row New York, NY 10007 (P) 646-836-6458 (F) 646-836-7665 Page 16115 EFTA00045626

Properties Property Value Message ID 5D38352B.NYMDOMI.NYMADM1.100.1373875.1.7 9803.1 Message Path xmVMaibeed5D38352B.NYMDOMI.NYMADM1,100.1373875.1.798Clilacml From Joy Aassiddaa Display Name Joy Aassiddaa Entail jaassildall@bollgov U CI D 263DFECO-05FA-0000-B8E9-E3DDF99F0ABB Reply To jaassiddaa(i/bop.gov Text Joy Aassiddaa To Adam Johnson; Stephanie Scannell Subject Medical Records request for Inmate Jeffrey Epsteix Reg. No. 76318-054 07/01/19 - 07/24/19 Scheduled date 2019-07-24 1038:35 Creation date 2019-07-24 10835 Modified date 2019-07-24 12:1029 Delivered date 201947-24 10836 Message sift 177 Attachments size 220622 Total size 220810 Attachments 2 Attachment TEXT.htm Name TEXT.htm Content ID 5D38352B.NYMDOMI.NYMADMI.200.203000F.1.1 04FD&103455D38352B.NYMDOMI.NYMADM1.100. 1373875.1.N/3CD. 1 @1:7.NYMDOMI.NYMADMI.10 0.0.1.0. I@ 16 Is Inline fake Type file Size 631 Date 2019-07-24 063832 CA ab66443I84887e997blal07362114960 DM h 50O57100CCA7E672DEDF090A I I4DA054BE247904 231I4A36979IAABC2B4B98226F23C0C6 Attachment PritChartGetReport.faces.pdf Name PrixClunGetRepon.faces.pdf Content ID 5D38352B.NYMDOMI.NYMADMI.200.200000F.I. I 041129.1@45$O383528.NYMDOMI.NYMADMI.100. 1373875.1.798CB.1@1:7.NYMDOMI.NYMADMI.10 0.0.1.0. l@l6 Is Inline false Type fat Size 219991 Date 2019-07-24 0637:47 CA c82161f414683f4edlbedb5a4cd9Obec Hash 0223176DE32CBA7a 0IE3409994D0F5A31D25905B1337F651DF42C534F22D41F65104C Recipients 2 Recipient Adam Johnson Display Name Adam Johnson Email a lOjahnsoKabop.gov COD 2750CADD-09CA-00004X8F4-IACF3lEA7575 Distribution Type TO Recipient "fype User Recipient Stephanie Scannell Display Name Stephanie Scannell Email sscannelka,bup.gov CUM I5A65E10-0C33-0000•A3E7-68A6064I5CAD Distribution Type TO Recipient Type User Expire 0 Delay deli ery until 0 Delegated fake Arehked fake Read trot Deleted fake Opened INC Completed fake Security Normal Box type Inbax Return notification alien opened fake Return notification ..hen deleted false Page 16116 EFTA00045627

Return notification ..hen completed fake Return notification ..hen declined false Return notification ..hen accepted false Archive Version 5.3 Internal ID 5D38352B.NYMDOM I.NYMADM 1 .100.1373875.1.7 98CB.1@1:7.NYMDOMLNYMADMI.100.0.1.0. I@I 6 Source received Class Public Account Adam lehrocitgBOP18939.NYMADM INYMDOM I Location ID 1540842683886 Class Name OW.ME-SSAGF-MAIL Enclosing Folders I Folder Malbox ID 7.NYNIDOMLNYMADM1.100.0.1.0.1@l6 Name Maas). Type Maabio System true Share Type NotSharcd Page 16117 EFTA00045628

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Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/23/2019 06:20 Provider: Joaquin, Y. MLP Unit: H01 Injury Assessment - Non-work related encounter performed at Health Services. SUBJECTIVE: INJURY 1 Provider: Joaquin, Y. MLP 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): "I do not know. Just went to drink a little water and wake up snorting". Symptoms (as reported by inmate): None OBJECTIVE: Temperature: Date Time Fahrenheit Celsius Location Provider 07/23/2019 06:30 NYM 97.5 36.4 Oral Joaquin, Y. MLP Pulse: pate Time Rate Per Minute Location Rhythm Provider 07/23/2019 06:30 92 Via Machine Regular Joaquin, Y. MLP Respirations: Date lime Rate Per Minute Provider 07/23/2019 06:30 NYM 16 Joaquin, Y. MLP Blood Pressure: Date Time Value Location Position Cuff Size Provider 07/23/2019 06:30 NYM 140/85 Right Arm Sitting Adult-regular Joaquin, Y. MLP SaO2: Date Time Value(%) Air Provider 07/23/2019 06:30 NYM 96 Room Air Joaquin, Y. MLP Exam: General Affect Yes: Cooperative Appearance Yes: Appears Well, Alert and Oriented x 3 No: Appears Distressed, Lethargic, Dyspneic, Appears in Pain, Pallor, Cyanotic, Diaphoretic, Disheveled, Generated 07/2312019 09:05 by Joaquin, Y. MLP Bureau of Prisons - NYM Page 1 of 2 EFTA00045631

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Encounter Date: 07/23/2019 06:20 Reg #: 76318-054 Sex: M Race: WHITE Facility: NYM Provider: Joaquin, Y. MLP Unit: H01 Exam: Acutely III Pulmonary Auscultation Yes: Clear to Auscultation, Vesicular Breath Sounds Bilaterally No: Crackles, Rhonchi, Wheezing Exam Comments Inmate for injury report as requested by Operational Lt. He is ambulatory, oriented x 3. In not apparent distress, smiling during this clinical encounter. Alleges, that he does not know what happened. Can not explain the marks on his neck. Responded: "I don't know". He does not want to talk of the events leading to the marks on his neck. He does not look in any distress or pain. Has an circular line of erythema at the base of the neck. Reaching 2/3 of the neck circumference, 2 inches wide, sparing the back of the neck. Has one section of this erythema in the front with marks of friction. No inflammation, no deformities, no hematomas, no lacerations, no tenderness. Patient moving his neck without any restriction. Denies having any pain or discomfort. Denies any respiratory problem. Has another small erythema on left knee about 2cm in diameter(mild). As per information from custody staff inmate Epstein was found in his cell with a rope around his neck and sitting on the floor. Inmate is currently placed on suicide watch. 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 Flandout/Topic Provider Outcome 07/23/2019 Counseling Access to Care Joaquin, Y. Verbalizes Understanding 07/23/2019 Counseling Plan of Care Joaquin, Y. Verbalizes Understanding Copay Required:No Cosign Required: Yes Telephone/Verbal Order: No Completed by Joaquin, Y. MLP on 07/23/2019 09:05 Requested to be cosigned by Beaudouin, Robert MD. Cosign documentation will be displayed on the following page. Generated 07/23/2019 09:05 by Joaquin, Y. MLP Bureau of Prisons - NYM Page 2 of 2 EFTA00045632

Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/23/2019 06:20 Provider: Joaquin, Y. MLP Facility: NYM Cosigned by Beaudouin. Robert MD on 07 23x2019 15:44. Bureau of Prisons - NYM EFTA00045633

Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/14/2019 17:36 Provider: Beaudouin, Robert MD Unit: Z05 Chronic Care - 14 Day Physician Eval encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: Beaudouin, Robert MD Chief Complaint: ENDO/LIPID Subjective: 66 YR OLD WHITE MALE WITH HX OF HYPERTRIGLYCERIDEMIA X 5 YEARS ON VASCEPA FOR 1 YEAR. STATES TRIGL WAS 800 , NOW 431. STATES HE COULD NOT TOLERATE OTHER ANTI-TRIGLYCERIDE MEDS DUE TO THEIR GI SIDE EFFECTS. HX OF OBSTRUCTUVE SLEEP APNEA X 5 YEARS FOR WHICH HE USED A CPAP MACHINE. STATES HE HAD HIS CPAP MACHINE WITH HIM WHEN HE ARRESTED. STATES THE FBI LOKELY HAS L4 - L5 SEVERE STENOSIS CASUING NUMBNESS AND SHOOTING PAIN IN THE LOWER EXTREMITIES. SURGICAL HX: NONE MENTAL HEALTH HX: NONE Pain: Yes Pain Assessment Date: 07/12/2019 13:25 Location: Back-Middle Quality of Pain: Shooting Pain Scale: 5 Intervention: MEDROL DOSE PACK Trauma Date/Year: Injury: Mechanism: Onset: 5+ Years Duration: 5+ Years Exacerbating Factors: NO EXERCISE Relieving Factors: MEDROL DOSE PACK Reason Not Done: Comments: Seen for clinic(s): Orthopedic/Rheumatology, Pulmonary/Respiratory, Endocrine/Lipid Added to clinic(s): Orthopedic/Rheumatology, Pulmonary/Respiratory, Endocrine/Lipid OBJECTIVE: Exam: General Appearance Yes: Appears Well, Alert and Oriented x 3 No: Appears Distressed, Dyspneic, Appears in Pain, Writhing in Pain, Pale, Pallor, Cyanotic, Diaphoretic, Disheveled, Unkempt, Acutely III Nutrition No: Appears Obese Generated 07/14/2019 18:11 by Beaudouin, Robert MD Bureau of Prisons - NYM Page 1 of 3 EFTA00045634

Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/14/2019 17:36 Provider: Beaudouin, Robert MD Unit: Z0S Exam: Eyes General Yes: PERRLA, Extraocular Movements Intact Pulmonary Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular Rate and Rhythm (RRR), Normal S1 and S2 No: M/R/G Abdomen Auscultation Yes: Normo-Active Bowel Sounds Palpation Yes: Within Normal Limits Musculoskeletal Tibia / Fibula No: Edema Back Yes: Tenderness Neurologic Cranial Nerves (CN) Yes: Within Normal Limits Motor System-General Yes: Normal Exam ASSESSMENT: Constipation, unspecified, K5900 - Current Hyperlipidemia, unspecified, E785 - Current Low back pain, M545 - Current Neuralgia and neuritis, unspecified, M792 - Current Sleep apnea, G4730 - Current PLAN: New Medication Orders: EXtf Medication Omega 3 ( Vascepa) 1 GM Capsule Order Date 07/14/2019 17:36 Indication: Hyperlipidemia, unspecified New Laboratory Requests: Details Frequency Lab Tests-H-Hemoglobin A1C One Time Lab Tests-L-Lipid Profile Additional Information: Generated 07/14/2019 18:11 by Beaudouin, Robert MD Prescriber Order TAKE 2 CAPS Orally - Two Times a Day x 180 day(s) -- TAKE WITH FOOD. Due Date Priority 10/10/2019 00:00 Routine Bureau of Prisons - NYM Page 2 of 3 EFTA00045635

Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/14/2019 17:36 Provider: Beaudouin, Robert MD Unit: Z05 FASTING. Lab Tests-H-Hep B surface Ab One Time 08/08/2019 00:00 Routine Lab Tests-H-Hep B surface Ag Lab Tests-H-Hep C Ab Lab Tests-H-Hepatic Profile Schedule: Activity Date Scheduled Scheduled Provider Clinical Encounter 07/24/2019 00:00 Optometrist 66 YR OLD MALE FOR ROUTINE SCREENING. Chronic Care Visit 01/07/2020 00:00 Mid-Level Provider 6 MONTH F/U. Chronic Care Visit 07/01/2020 00:00 Physician 01 Other: PENDING EKG AND FOBT. CXR WAS REFUSED. Patient Education Topics: Date Initiated Format Handout/Topic Provider Outcome 07/14/2019 Counseling Diagnosis Beaudouin, Robert Verbalizes Understanding Copay Required:No Cosign Required: No Telephone/Verbal Order: No Completed by Beaudouin, Robert MD on 07/14/2019 18:11 Generated 07/14/2019 18:11 by Beaudouin, Robert MD Bureau of Prisons - NYM Page 3 of 3 EFTA00045636

Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/12/2019 13:10 Provider: Beaudouin, Robert MD Unit: Z05 Chronic Care - 14 Day Physician Eval encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: Beaudouin, Robert MD Chief Complaint: ENDO/LIPID Subjective: 66 YR O HITE MALE WITH HX OF HYPER CERIDEMIA X 5 YEARS ON VASCEPA FOR 1 YEAR. STATES TRIGL WAS 800 , STATES HE COULD NOT TOLERATE OTHER ANTI-TRIGLYCERIDE MED • EIR GI SIDE EFFECTS. HX OF IL UVE SLEEP APNEA X 5 YEARS FOR WHICH HE USED A CPAP MACHINE. HAD HIS CPAP MACHINE WITH HIM WHEN HE ARRESTED. STATES TH Y HAS L4 - L5 SEVERE iSIS CASUING NUMBNESS AND SHOOTING PAIN IN THE LOWER EXTREM SURGICAL HX: NONE MENTAL HEALTH HX: Pain: Yes Pain Assessment Date: 07/12/2019 13:25 Location: Back-Middle Quality of Pain: Shooting Pain Scale: 5 Intervention: MEDROL DOSE PACK Trauma Date/Year: Injury: Mechanism: Onset: 5+ Years Duration: 5+ Years Exacerbating Factors: NO EXERCISE Relieving Factors: MEDROL DOSE PACK Reason Not Done: Comments: Seen for clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology Added to clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology OBJECTIVE: Exam: General Appearance Yes: Appears Well, Alert and Oriented x 3 No: Appears Distressed, Dyspneic, Appears in Pain, Writhing in Pain, Pale, Pallor, Cyanotic, Diaphoretic, Disheveled, Unkempt, Acutely III Nutrition No: Appears Obese Generated 07/12/2019 14:20 by Beaudouin, Robert MD Bureau of Prisons - NYM Page 1 of 3 EFTA00045637

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Encounter Date: 07/12/2019 13:10 Reg #: 76318-054 Sex: M Race: WHITE Facility: NYM Provider: Beaudouin, Robert MD Unit: Z0S Exam: Eyes General Yes: PERRLA, Extraocular Movements Intact Pulmonary Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular Rat Rhythm (RRR), Normal S1 and S2 No: M/R/G Abdomen Auscultation Yes: Normo-Active Palpation Yes: Within Normal Limits Musculoskeletal Tibia / Fibula No: Edema Back Yes: Tenderness Neurologic Crania O l Nerves (CN) Yes: Within Normal Limits Motor System-General ASSESSMENT: Constipation, unspecified, K5900 - Current 05 1 ) )60 Yes: Normal Exam Hyperlipidemia, unspecified, E785 - Current Low back pain, M545 - Current Neuralgia and neuritis, unspecified, M792 - Current d ), Sleep apnea, G4730 - Current PLAN: New Medication Orders: EXtt Medication Order Date Prescriber Order Magnesium Hydroxide Susp 07/12/2019 13:10 30 CC Orally - Two Times a Day PRN x 2 day(s) Indication: Constipation, unspecified MethyIPREDNISolone Tab 4 MG ( Dose 07/12/2019 13:10 AS DIRECTED Orally - daily x Pack 21 tab) 6 day(s) Indication: Neuralgia and neuritis, unspecified Disposition: Generated 07/12/2019 14:20 by Beaudouin, Robert MD Bureau of Prisons - NYM Page 2 of 3 EFTA00045638

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Encounter Date: 07/12/2019 13:10 Reg #: 76318-054 Sex: M Race: WHITE Facility: NYM Provider: Beaudouin, Robert MD Unit: Z05 Follow-up at Sick Call as Needed Other: WILL CONTINUE NOTES TO ADDRESS THE NFDR AND FOLLOW-UP. Patient Education Topics: Date Initiated Format Handout/Topic Provider Outcome 07/12/2019 Counseling Diagnosis Beaudouin, Robert Verbalizes Understanding Copay Required: No Telephone/Verbal Order: Completed by Beaudouin, Cosign Required: No 07/12/2019 14:20 0 Generated 07/12/2019 14:20 by Beaudouin, Robert MD Bureau of Prisons - NYM Page 3 of 3 EFTA00045639

Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/12/2019 13:10 Provider: Beaudouin, Robert MD Unit: Z05 Chronic Care - 14 Day Physician Eval encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: Beaudouin, Robert MD Chief Complaint: ENDO/LIPID Subjective: 66 YR O HITE MALE WITH HX OF HYPER CERIDEMIA X 5 YEARS ON VASCEPA FOR 1 YEAR. STATES TRIGL WAS 800 , STATES HE COULD NOT TOLERATE OTHER ANTI-TRIGLYCERIDE MED • EIR GI SIDE EFFECTS. HX OF IL UVE SLEEP APNEA X 5 YEARS FOR WHICH HE USED A CPAP MACHINE. HAD HIS CPAP MACHINE WITH HIM WHEN HE ARRESTED. STATES TH Y HAS L4 - L5 SEVERE iSIS CASUING NUMBNESS AND SHOOTING PAIN IN THE LOWER EXTREM SURGICAL HX: NONE MENTAL HEALTH HX: Pain: Yes Pain Assessment Date: 07/12/2019 13:25 Location: Back-Middle Quality of Pain: Shooting Pain Scale: 5 Intervention: MEDROL DOSE PACK Trauma Date/Year: Injury: Mechanism: Onset: 5+ Years Duration: 5+ Years Exacerbating Factors: NO EXERCISE Relieving Factors: MEDROL DOSE PACK Reason Not Done: Comments: Seen for clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology Added to clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology OBJECTIVE: Exam: General Appearance Yes: Appears Well, Alert and Oriented x 3 No: Appears Distressed, Dyspneic, Appears in Pain, Writhing in Pain, Pale, Pallor, Cyanotic, Diaphoretic, Disheveled, Unkempt, Acutely III Nutrition No: Appears Obese Generated 07/12/2019 14:20 by Beaudouin, Robert MD Bureau of Prisons - NYM Page 1 of 3 EFTA00045640

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Encounter Date: 07/12/2019 13:10 Reg #: 76318-054 Sex: M Race: WHITE Facility: NYM Provider: Beaudouin, Robert MD Unit: Z0S Exam: Eyes General Yes: PERRLA, Extraocular Movements Intact Pulmonary Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular Rat Rhythm (RRR), Normal S1 and S2 No: M/R/G Abdomen Auscultation Yes: Normo-Active Palpation Yes: Within Normal Limits Musculoskeletal Tibia / Fibula No: Edema Back Yes: Tenderness Neurologic Crania O l Nerves (CN) Yes: Within Normal Limits Motor System-General ASSESSMENT: Constipation, unspecified, K5900 - Current 05 1 ) )60 Yes: Normal Exam Hyperlipidemia, unspecified, E785 - Current Low back pain, M545 - Current Neuralgia and neuritis, unspecified, M792 - Current d ), Sleep apnea, G4730 - Current PLAN: New Medication Orders: EXtt Medication Order Date Prescriber Order Magnesium Hydroxide Susp 07/12/2019 13:10 30 CC Orally - Two Times a Day PRN x 2 day(s) Indication: Constipation, unspecified MethyIPREDNISolone Tab 4 MG ( Dose 07/12/2019 13:10 AS DIRECTED Orally - daily x Pack 21 tab) 6 day(s) Indication: Neuralgia and neuritis, unspecified Disposition: Generated 07/12/2019 14:20 by Beaudouin, Robert MD Bureau of Prisons - NYM Page 2 of 3 EFTA00045641

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Encounter Date: 07/12/2019 13:10 Reg #: 76318-054 Sex: M Race: WHITE Facility: NYM Provider: Beaudouin, Robert MD Unit: Z05 Follow-up at Sick Call as Needed Other: WILL CONTINUE NOTES TO ADDRESS THE NFDR AND FOLLOW-UP. Patient Education Topics: Date Initiated Format Handout/Topic Provider Outcome 07/12/2019 Counseling Diagnosis Beaudouin, Robert Verbalizes Understanding Copay Required: No Telephone/Verbal Order: Completed by Beaudouin, Cosign Required: No 07/12/2019 14:20 0 Generated 07/12/2019 14:20 by Beaudouin, Robert MD Bureau of Prisons - NYM Page 3 of 3 EFTA00045642

Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/14/2019 17:36 Facility: NYM Amendment made to this note by Beaudouin, Robert MD on 07 14 2019 18:11. Bureau of Prisons - NYM EFTA00045643

Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: Date of Birth: Note Date: EPSTEIN, JEFFREY 01/20/1953 07/12/2019 09:06 Reg #: Sex: M Race:WHITE Facility: Provider: Beaudouin, Robert MD Unit: 76318-054 NYM Z05 Admin Note - Orders encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider: Beaudouin, Robert MD PATIENT REQUESTED TO HAVE A COLACE RX , INSTEAD OF TEH BISACODYL FOR CONSTIPATION. New Medication Orders: I3x# Medication Docusate Sodium Capsule Indication: Constipation, unspecified Discontinued Medication Orders: Eta Medication 121757-NYM Bisacodyl E.C. 5 MG TAB Order Date 07/12/2019 09:06 Order Date 07/12/2019 09:06 Discontinue Type: When Pharmacy Processes Discontinue Reason:discontinue Indication: Copay Required:No TelephoneNerbal Order: No Completed by Beaudouin. Robert MD on 07/12/2019 09:10 Cosign Required: No Prescriber Order TAKE ONE 100 MG CAP Orally - Two Times a Day x 30 day(s) Prescriber Order Take one tablet (5 MG) by mouth at bedtime AS NEEDED for 10 days Generated 07/12/2019 09:10 by Beaudouin. Robert MD Bureau of Prisons - NYM Page 1 of 1 EFTA00045644

Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race:WHITE Facility: NYM Note Date: 07/07/2019 00:17 Provider: Beaudouin, Robert MD Unit: E06 Cosign Note - Intake Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider: MED CL:1 NO CCC APPT. Discontinued Laboratory Requests: Details Beaudouin, Robert MD Frequency Due Date Priority Lab Tests-H-Hemoglobin AlC One Time 08/05/2019 00:00 Routine Lab Tests-C-CBC w/diff Lab Tests-L-Lipid Profile Lab Tests-C-Comprehensive Metabolic Profile (CMP) Lab Tests-U-Urinalysis w/Rellex to Microscopic Additional Information: 66 y/o male, elevated BP Labs requested to be reviewed by: Beaudouin, Robert MD New Laboratory Requests: Details Frequency Due Date Priority Chronic Care Clinics-Diabetic-CBC w/diff One Time 07/25/2019 00:00 Routine Chronic Care Clinics-Diabetic-Lipid Profile Chronic Care Clinics-Diabetic-Hemoglobin Al C Lab Tests-H-HIV 1/2 Lab Tests-R-RPR Chronic Care Clinics-Diabetic-Comprehensive Metabolic Profile (CMP) New Radiology Request Orders: Details Frequency End Date Due Date Priority General Radiology-Chest-2 Views One Time 07/25/2019 Routine Specific reason(s) for request (Complaints and findings): 66 YR OLD MALE WITH NO PMHX REFERRED FOR ROUITNE CXR. Copay Required:No Cosign Required: No TelephoneNerbal Order: No Completed by Beaudouin, Robert MD on 07/07/2019 00:30 Generated 07107/2019 00:30 by Beaudouin. Robert MD Bureau of Prisons - NYM Page 1 of 1 EFTA00045645

Bureau of Prisons Health Services Health Screen Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/06/2019 21:38 Provider: Kang, Yoon PA-C Facility: NYM Seizures: Denied Diabetes: Denied Cardiovascular: Denied CVA: Denied Hypertension: Denied Respiratory: Denied Sickle Cell Anemia: Denied Carcinoma/Lymphoma: Denied Allergies: Denied PPD Administration: Date/Time: 07/06/2019 21:39 Provider: Kang, Yoon PA-C Location: Right Forearm Drug Mfg: Sanofi Pasteur Lot Number: C5474BA Dosage: 0.1mL Route: ID Exp Dt: 10/2020 Comments: Tuberculosis: Hx of Previous Disease: No Blood-tinged Sputum: No Night Sweats: No Weight Loss:No Fever: No Cough:No Comments: Generated 07/06/2019 21:56 by Kang. Yoon PA•C Bureau of Prisons - NYM Page 1 of 6 EFTA00045646

Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/06/2019 21:38 Provider: Kang, Yoon PA-C Facility: NYM Infectious Disease Risk Factors: IV Drug Use: No IV Drug Use Needles: Sexual Partner IV Drug Use: No Sexual Partner IV Drug Use Needles: Female Sexual Partners (Last 5 Yrs): 10+ Male Sexual Partners (Last 5 Yrs): 0 Condom Use: Sometimes Sexual Contact With HIV+ Individual: No Blood Product Transfusion: No Travel Outside US: Yes Tattoos: No Comments: Born in US High school diploma Banker Traveled to Paris x 3 weeks up until arrest No tattoos HIV History: When Tested: 2019 Test Result: Negative When Diagnosed AIDS: Last CD4: Comments: Hepatitis: Denied Other Infectious Diseases: Syphilis: No Syphilis Last Treatment: N/A Genital Warts: No Chlamydia: Yes Gonorrhea: No Herpes: No Chicken Pox: Yes Other: No Comments: Chlamydia in 2015, treated Chicken pox in childhood Abuse History: Denied Physical: No Emotional: No Sexual: No Comments: Denies Generated 07/06/2019 21:56 by Kang. Yoon PA•C Bureau of Prisons - NYM Page 2 of 6 EFTA00045647

Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/06/2019 21:38 Provider: Kang, Yoon PA-C Facility: NYM Mental Health: Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Hx of Mental Health Treatment: None Hx of Head Injury: None Current Mental Health Treatment: No Current Mental Health Complaint: No Hx of Loss of Consciousness: No Hx of Hearing Voices: No Past History of Suicide Attempt: No Current Suicide Ideation: No Suicide Prevention Initiated:No Comments: Substance Use History: Denied Current Painful Condition: Denied Other Health Issues: Current Medical Conditions: Other Current Treatments: Pregnant: Dental Condition: Denied N/A Generated 07/06/2019 21:56 by Kong. Yoon PA•C Bureau of Prisons - NYM Page 3 of 6 EFTA00045648

Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/06/2019 21:38 Provider: Kang, Yoon PA-C Facility: NYM Observations: Draining Skin Lesions: No Signs of Lice: No Signs of Scabies: No Signs of Recent Trauma: No Recent Tattoos: No Needle Marks: No Signs of Rash: No Open Sores: No Wounds: No Body Deformities: No Tremors: No Sweating: No Comments: Pulse: Date Time Rate Per Minute Location Rhythm Provider 07/06/2019 21:43 90 Via Machine Kang, Yoon PA-C Respirations: Date Time Rate Per Minute Provider 07/06/2019 21:43 NYM 15 Kang, Yoon PA-C Blood Pressure: Date Time Value Location Position Cuff Size Provider 07/06/2019 21:45 NYM 164/90 Right Arm Sitting Adult-regular Kang, Yoon PA-C 07/06/2019 21:43 NYM 155/83 Left Arm Sitting Adult-regular Kang, Yoon PA-C SaO2: Date 07/06/2019 lime 21:43 NYM Value(%) Air Provider 95 Room Air Kang, Yoon PA-C Height: Date lime Inches Cm Provider 07/06/2019 Weight: 21:43 NYM 72.0 182.9 Kang, Yoon PA-C Date Time Uzi Kg. Waist Cireums Provider 07/06/2019 21:43 NYM 200.0 90.7 Kang, Yoon PA-C Prosthetic Devices/Equipment: Denied Potential Items For Follow-up: Item Travel Outside US Other Infectious Disease History Comments: I have reviewed 0 pages of intake paperworks Generated 07/06/2019 21:56 by Kang. Yoon PA-C Bureau of Prisons - NYM Page 4 of 6 EFTA00045649

Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/06/2019 21:38 Provider: Kang, Yoon PA-C Facility: NYM Health Problems Newly Identified During This Encounter: Health Problem Medication Reconciliation. The patient's known medication list including OTC items was compiled and compared to new and changed BOP orders. Reconciled Medications: Source Action JyRe Bit Medication OTC No known OTCs Order Detali New Laboratory Requests: Details Frequency Due Date Priority Lab Tests-H-Hemoglobin Al C One Time 08/05/2019 00:00 Routine Lab Tests-C-CBC w/diff Lab Tests-L-Lipid Profile Lab Tests-C-Comprehensive Metabolic Profile (CMP) Lab Tests-U-Urinalysis w/Reflex to Microscopic Additional Information: 66 y/o male, elevated BP Labs requested to be reviewed by: Beaudouin, Robert MD New Non-Medication Orders: Order Frequency Duration Details Ordered By EKG One Time 66 y/o male Kang, Yoon PA-C Order Date: 07/06/2019 Fecal Occult Blood One Time 3 different stools Kang, Yoon PA-C Order Date: 07/06/2019 Schedule: Activity Date Scheduled Scheduled Provider Vision Screen 07/06/2019 00:00 Optometrist 66 y/o male PPD Reading 07/08/2019 00:00 Nurse Follow-up 07/09/2019 00:00 Mid-Level Provider BP check Other: BP noticed to be elevated. IM denies Hx of HTN or any significant chronic medical conditions. He is currently asymptomatic and denies any bodily complaints at this time. Will recheck BP in 2-3 days. Disposition: Follow-up at Sick Call as Needed To be Evaluated by Provider Instructed inmate how to obtain medical, dental, and mental health care. Copay Required:No Cosign Required: Yes Telephone/Verbal Order: No Generated 07/06/2019 21:56 by Kang. Yoon PA-C Bureau of Prisons - NYM Page 5 of 6 EFTA00045650

Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/06/2019 21:38 Provider: Kang, Yoon PA-C Facility: NYM Completed by Kang, Yoon PA-C on 07/06/2019 21:56 Requested to be cosigned by Beaudouin, Robert MD. Cosign documentation will be displayed on the following page. Generated 07/06/2019 21:56 by Kang. Yoon PA•C Bureau of Prisons - NYM Page 6 of 6 EFTA00045651

Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/062019 21:38 Provider: Kang, Yoon PA-C Facility: NYM Cosigned with New Encounter Note by Beaudouin, Robert MD on 07 .07.2019 00:17. Bureau of Prisons - NYM EFTA00045652

Bureau of Prisons Health Services History & Physical Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Joaquin, Y. MLP Reg #: 76318-054 Facility: NYM Unit: H01 Seizures: Denied Diabetes: Denied Cardiovascular: Denied CVA: Denied Hypertension: Denied Respiratory: Denied Sickle Cell Anemia: Denied Carcinoma/Lymphoma: Denied Allergies: Denied Tuberculosis: Fix of Previous Disease: No Blood-tinged Sputum: No Night Sweats: No Weight Loss:No Fever: No Cough:No Comments: Infectious Disease Risk Factors: IV Drug Use: No IV Drug Use Needles: Sexual Partner IV Drug Use: No Sexual Partner IV Drug Use Needles: Female Sexual Partners (Last 5 Yrs): 10+ Male Sexual Partners (Last 5 Yrs): Condom Use: Sometimes Sexual Contact With HIV+ Individual: No Blood Product Transfusion: No Travel Outside US: Yes Tattoos: No Comments: Born in US High school diploma Banker Traveled to Paris x 3 weeks up until arrest No tattoos Generated 07/09/2019 13:03 by Joaquin. Y. MLP Bureau of Prisons • NYM Page 1 of 13 EFTA00045653

Inmate Name: EPSTEIN. JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/09/2019 12:35 Provider: Joaquin, Y. MLP Unit: H01 HIV History: When Tested: 2019 Test Result: Negative When Diagnosed AIDS: Last CD4: Comments: Hepatitis: Denied Other Infectious Diseases: Syphilis: No Syphilis Last Treatment: N/A Genital Warts: No Chlamydia: Yes Gonorrhea: No Herpes: No Chicken Pox: Yes Other: No Comments: Chlamydia in 2015. treated Chicken pox in childhood Abuse History: Denied Physical: No Emotional: No Sexual: No Comments: Denies Generated 07,09,2019 13:03 by Joaquin. Y. MLP Bureau of Prisons NYM Page 2 of 13 EFTA00045654

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Joaquin, Y. MLP Reg #: 76318-054 Facility: NYM Unit: H01 Mental Health: Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Hx of Mental Health Treatment: None Hx of Head Injury: None Current Mental Health Treatment: No Current Mental Health Complaint: No Hx of Loss of Consciousness: No Hx of Hearing Voices: No Past History of Suicide Attempt: No Current Suicide Ideation: No Suicide Prevention Initiated:No Comments: Substance Use History: Denied Current Painful Condition: Denied Other Health Issues: Current Medical Conditions: Other Current Treatments: Pregnant: Dental Condition: Denied N/A Generated 07/0912019 13:03 by Joaquin. Y. MUD Bureau of Prisons • NYM Page 3 of 13 EFTA00045655

Inmate Name: EPSTEIN. JEFFREY Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Joaquin, Y. MLP Reg #: 76318-054 Facility: NYM Unit: H01 Observations: Draining Skin Lesions: No Signs of Lice: No Signs of Scabies: No Signs of Recent Trauma: No Recent Tattoos: No Needle Marks: No Signs of Rash: No Open Sores: No Wounds: No Body Deformities: No Tremors: No Sweating: No Comments: Generated 07.09:2019 13:03 by Joaquin. Y. MLP Bureau of Prisons NYM Page 4 of 13 EFTA00045656

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Joaquin, Y. MLP Reg #: 76318-054 Facility: NYM Unit: H01 Immunizations: Hepatitis A and B (TwinRx) Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Joaquin, Y. MLP Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Measles/Mumps/Rubella Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Joaquin, Y. MLP Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Joaquin, Y. MLP Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Tetanus Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Generated 07/09/2019 13:03 by Joaquin. Y. MLP Bureau of Prisons • NYM Page 5 of 13 EFTA00045657

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Joaquin, Y. MLP Reg #: 76318-054 Facility: NYM Unit: H01 Immunization Date: Provider: Joaquin, Y. MLP Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Varicella Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Joaquin, Y. MLP Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Temperature: Date Time Fahrenheit Celsius Location Provider 07/09/2019 12:49 NYM 97.3 36.3 Oral Joaquin, Y. MLP Pulse: Date Time Rate Per Minute Location Rhythm Provider 07/09/2019 12:49 82 Via Machine Regular Joaquin, Y. MLP Respirations: Date Time Hate Per Minute Provider 07/09/2019 12:49 NYM 16 Joaquin, Y. MLP Blood Pressure: Date Time Value Location Position Cuff Size Provider 07/09/2019 12:49 NYM 117/66 Right Arm Sitting Adult-regular Joaquin, Y. MLP SaO2: Date Time Value(%) Air Provider 07/09/2019 12:49 NYM 97 Room Air Joaquin, Y. MLP Height: Date Time Mahal Cm Provider 07/09/2019 12:49 NYM 70.0 177.8 Joaquin, Y. MLP Generated 07/09/2019 13:03 by Joaquin, Y. MLP Bureau of Prisons NYM Page 6 of 13 EFTA00045658

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Joaquin, Y. MLP Reg #: 76318-054 Facility: NYM Unit: H01 Date lime inches Om Provider Weight: Date Time the Kg Waist Circum. Provider 07/09/2019 12:49 NYM 194.4 88.2 Joaquin, Y. MLP Prosthetic Devices/Equipment: Denied Tobacco Usage: Denied General Social History: Foreign Travel: Born in USA: Yes Country of Birth: USA Patient Education Assessments: Date Ed Yrs Occupation Learns Best By Primary Language Barriers to Education 07/09/2019 12 Banker Speaking/Listening English None Family History - Father: Age at Death: 74 Cause of Death: Diabetes complications Significant Illnesses: Diabetes Heart Disease Comments: Family History - Mother: Age at Death: 81 Cause of Death: Kidney Failure Significant illnesses: Heart Disease Comments: Family History - Sibling: Number of Siblings: I Significant Illnesses: Comments: Past Hospitalization: Reason Location When Acute Appendicitis Mount Sinai Hospital 1990 Complications: None Comments: Head: Normal: Yes Comments: Generated 07/0912019 13:03 by Joaquin. Y. MUD Bureau of Prisons • NYM Page 7 of 13 EFTA00045659

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Joaquin, Y. MLP Reg #: 76318-054 Facility: NYM Unit: H01 Eyes: EOMI: Yes Icterus:No Conjunctival Inflammation: No Pupils PERRLA: Yes Pupil Size Rt: Pupil Size Lt: Pupils Comments: Fundi Vessels Nicking: No Fundi Vessels Discs Flat:Yes Fundi Vessels Discs Sharp Margins: Yes Fundi Vessels Grounds Abnormal: No Eyes Comments: Vision Screen 07/09/2019 12:52 Blindness: With Corrective Distance Vision: OD: 100 OS: 70 OU: OD: OS OU: Near Vision: OD: OS: OU: OD: OS: OU: Ishihara Color Test: Tonometry: L: R: Comments: Needs evaluation with optometrist. Ears: Right Ear: Canal patent Left Ear: Canal patent Ears Comments: Nose: Nares Patent: Yes Septum Midline:Yes Septum Intact: Yes Drainage/Discharge:No Polyps: No Nose Comments: Generated 07/0912019 13:03 by Joaquin. Y. MUD Bureau of Prisons • NYM Page 8 of 13 EFTA00045660

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Joaquin, Y. MLP Reg #: 76318-054 Facility: NYM Unit: H01 Mouth Lesions: No Oral/Buccal Mucosa:Yes Gums Normal: Yes Tonsils Present:Yes Tonsils Normal: Yes Pharynx: Normal Color Teeth Poor Dentition: No Teeth Count:Mostly Present Dentures: No Mouth Comments: Cranial Nerves: Intact II-XII: Yes Cranial Nerves Comments: Neck: Full ROM:Yes Masses/Nodes: No Trachea: Midline Thyroid: Normal Size Comments: Breasts: Normal: Yes Masses:No Tenderness:No Scars: No Dimpling:No Nipple Discharge: No Nipple Retraction: No Instructions for Self Breast Exam Given: Comments: No Generated 07/09/2019 13:03 by Joaquin, Y. MLP Bureau of Prisons • NYM Page 9 of 13 EFTA00045661

Inmate Name: EPSTEIN. JEFFRE Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Joaquin, Y. MLP Reg 4: 76318-054 Facility: NYM Unit: H01 Thorax: Contour Normal:Yes Increased AP Diameter: No Asymmetrical Expansion:No Lungs Clear: Yes Wheezes: No Crackles: No Rhonchi: No Rales: No Accessory Muscle Use: No Comments: Spine: Deformity: No Full ROM:Yes Tenderness:No Comments: Cardiovascular: RRR: Yes Normal S1 /S2: Yes Murmurs: No Carotid Bruits:No JVD: No Arteries: Hight Leh Radial: Femoral: Dorsalis Pedls: Post. Tibialis: Comments: Generated 07,09,2019 13:03 by Joaquin. Y. MLP Bureau of Prisons NYM Page 10 of 13 EFTA00045662

Inmate Name: VS- JEFFI ) 3E Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Joaquin, Y. MLP Reg #: 76318-054 Facility: NYM Unit: H01 Abdomen: Normal Contour:Yes Scaphoid: No Obese: No Gravid: No Hernias: No Bruits: No Masses:No Scars: No Tenderness: No Organomegaly: No Active Bowel Sounds: Yes Comments: Extremities: Nails Clubbing: No Nails Cyanosis: No Lower Extremity Edema - Right: None Lower Extremity Edema - Lett: None Atrophy: No Amputations: No Other Deformities: No Varicosities: No Calf Tenderness:No Pulse Deficit: No Strength: Bight Left Arm: Leg: Full ROM: Hight Left Arm: Yes Yes Leg: Yes Yes Comments: Generated 07/0912019 13:03 by Joaquin. Y. MLP Bureau of Prisons • NYM Page 11 of 13 EFTA00045663

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Joaquin, Y. MLP Reg #: 76318-054 Facility: NYM Unit: H01 Reflexes: Ri ght Biceps: Patellar: Brachioradialls: Achilles: Sensation: Vibratory: Yes Light Touch: Yes Pin Prick: Yes Comments: GU: Chaperoned By: Rectum: Not Done Comments: Refused. Male Genitalia: Not Done Comments: Refused. Skin: Normal: Yes Rash: No Redness:No Abnormal Pigmentation: No Abnormal Lesions/Growths: No Comments: Lymphatics: Adenopathy: No Comments: Potential Items For Follow-up: Item Travel Outside US Other Infectious Disease History Rectum Not Done Male Genitalia Not Done PPD Administration Not Performed Comments: Patient has a history of constipation. Generated 07/09/2019 13:03 by Joaquin. Y. MLP Bureau of Prisons • NYM Page 12 of 13 EFTA00045664

Inmate Name: EPSTEIN, JEFFREY Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Joaquin, Y. MLP Reg #: 76318-054 Facility: NYM Unit: H01 Cleared For Food Services: Yes Health Problems Newly Identified During This Encounter: Health Problem Constipation, unspecified - Current - New Medication Orders: f3X# Medication Order Date Prescriber Order Bisacodyl E.C. Tablet 07/09/2019 12:35 5 mg Orally at bedtime PRN x 10 day(s) Indication: Constipation, unspecified Disposition: Follow-up at Sick Call as Needed Instructed inmate how to obtain medical, dental, and mental health care. Copay Required:No Cosign Required: Yes Telephone/Verbal Order: No Completed by Joaquin, Y. MLP on 07/09/2019 13:03 Requested to be cosigned by Beaudouin, Robert MD. Cosign documentation will be displayed on the following page. Generated 07/0912019 13:03 by Joaquin. Y. MUD Bureau of Prisons • NYM Page 13 of 13 EFTA00045665

Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Joaquin, Y. MLP Facility: NYM Cosigned by Beaudouin. Robert MD on 07 11:2019 22:41. Bureau of Prisons - NYM EFTA00045666

Bureau of Prisons Health Services Vitals All Begin Date: 07/01/2019 Reg #: 76318-054 End Date: 07/24/2019 Inmate Name: EPSTEIN, JEFFREY Temperature: Date Time Fahrenheit Celsius Location 07/23/2019 06:30 NYM 97.5 36.4 Oral Orig Entered: 07/23/2019 08:33 EST Joaquin, Y. MLP 07/09/2019 12:49 NYM 97.3 36.3 Oral Orig Entered: 07/09/2019 12:51 EST Joaquin, Y. MLP Pulse: Date Time Rate Per Minute 07/23/2019 06:30 92 Orig Entered: 07/23/2019 08:33 EST 07/09/2019 12:49 82 Orig Entered: 07/09/2019 12:51 EST 07/06/2019 21:43 90 Orig Entered: 07/06/2019 21:48 EST Respirations: Date Time 07/23/2019 06:30 NYM Orig Entered: 07/23/2019 08:33 EST 07/09/2019 12:49 NYM Orig Entered: 07/09/2019 12:51 EST 07/06/2019 21:43 NYM Orig Entered: 07/06/2019 21:48 EST Blood Pressure: Date Time 07/23/2019 06:30 NYM Orig Entered: 07/09/2019 12:49 NYM Orig Entered: 07/06/2019 21:45 NYM Orig Entered: 07/06/2019 21:43 NYM Orig Entered: Value Lamaism 140/85 Right Arm 07/23/2019 08:33 EST 117/66 Right Arm 07/09/2019 12:51 EST 164/90 Right Arm 07/06/2019 21:48 EST 155/83 Left Arm 07/06/2019 21:48 EST SaO2: Date Time 07/23/2019 06:30 NYM Location Via Machine Joaquin, Y. MLP Via Machine Joaquin, Y. MLP Via Machine Kang, Yoon PA-C Rate Per Minute Provider 16 Joaquin, Y. MLP Joaquin, Y. MLP 16 Joaquin, Y. MLP Joaquin, Y. MLP 15 Kang, Yoon PA-C Kang, Yoon PA-C Position Sitting Joaquin, Y. MLP Sitting Joaquin, Y. MLP Sitting Kang, Yoon PA-C Sitting Kang, Yoon PA-C Provider Joaquin, Y. MLP Joaquin, Y. MLP Rhythm Provider Regular Joaquin, Y. MLP Regular Joaquin, Y. MLP Kang, Yoon PA-C Cuff Size Adult-regular Adult-regular Adult-regular Adult-regular Value(%) Air Provider 96 Room Air Joaquin, Y. MLP Orig Entered: 07/23/2019 08:33 EST Joaquin, Y. MLP 07/09/2019 12:49 NYM 97 Room Air Joaquin, Y. MLP Orig Entered: 07/09/2019 12:51 EST Joaquin, Y. MLP Provider Joaquin, Y. MLP Joaquin, Y. MLP Kang, Yoon PA-C Kang, Yoon PA-C Generated 07/24/2019 10:37 by Aassiddaa, Joy FOIA Bureau of Prisons - NYM Page 1 of 2 EFTA00045667