MEMORANDUM FOR ALL CONCERNED FROM: SUBJECT: UNITEL ,TATES GOVERNMENT Memorandum FEDERAL BUREAU OF PRISONS Metropolitan Correctional Center July 23, 2019 oill , Material Handler Supervis Possible Suicide Attempt On July 23, 2019 at approx. 1:27 a.m., the Control Center announced a call for assistance on the Special Housing Unit. Upon my arrival to 9-South, I/M Epstein, Jeffrey #76318-054 was lying on the floor of his cell handcuffed. I assisted with carrying inmate Epstein to HA-Unit on a stretcher, where he was dressed in a suicide smock and placed on Suicide Watch observation with staff. ASensitiee Limited Official Use Onlya EFTA00048374

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I/N1 Epstein #76318-054 From To Lieutenants Date 2019/07/23 22:17 Subject: 1/M Epstein #76318-054 Attachments: TEXT.htm The purpose of this email is to inquire as to whether or not inmate Epstein, Jeffrey #76318-054 is mentally capable of proceeding with the disciplinary process. Thanks in advance. Page 1408 EFTA00048376

Properties Propens Value NlessagelD 5D378786.NYMDOM LNYMADM1.100.1696E30.1.6 06A5.1 Message Path xniFTrash/5D378786.NYMDOMLNYMADMI.100.1 696E30.3606A5.1.xinl From Moho Name Email LA ID 4271 I 5200DA7-0000431004384E7305411F5 Reply To Text To Ce NYWLieutenants Subject PM Epsteii #76318-054 Scheduled date 2019-07-23 22:17:42 Creation date 2019-07-23 22:17:42 Modified date 2019-07-24 0737:03 Delivered date 2019-07-2322:17:43 Message size 185 Attachments sin 450 Total size 646 Attachments 1 Attachment TEXT.Iim Name TEXT.htm Content ID 5D378786.NYMOMLNYMADM1.20020018BB.1.3 F535.1k#45:5D378786.NYMDOMLNYMADM1100.1 696E30.1.606A5.419.NYMDOMLNYMADMI.100 .0.1.0.1€318 Is Inline fake Type file Size 450 Date 2019-07-23 18:17:41 CA d76afa40096edd0929f9a6be23547de3 Hash 9E1D3AD78B01461043B33BE4251292F 1622695749 F41C2AAA21:2423963DD8BF5I041 I 11:96 Recipients 2 Recipient Display Name Email WAD -01 Dinxx0XIX'-0000-8B6E-1B003A002D00 Distribution Type 30 Recipient Type User Recipient NYM/Licutenam. Display Name NYM La:utounts Email NYM/Lictacnantsttfibop.gov UU1D 4137666E0-17D8-0000-977I-000000I 00002 Distribution Type CC Recipient Type SysterriGroup Expire 0 Delis delivery until 0 Delegated fake Archived fake Read true Deleted WC Opened true Completed fake Security Normal Box type Inbox Return notification when opened fake Return notification when deleted fake Return notification when completed fake Return notification when declined fake Return notification when accepted fake Archive Version 5.3 Internal ID 5D378786.NYMDOMLNYMADM1.100.1696E30.1.606A5.16t19.NYMDCIMLNYMADMI.100.0.1.0.1@l 8 Source received Class Pubic Account aBOP19019.NYMADMLNYMOOMI Location II) 1540843105474 Class Name GW.MESSAGE.MAIL Page 1409 EFTA00048377

Enclosing Folders I Folder Trash ID 9.NYMDOMLNYMADM U.100.01.01(08 Name Trash T.pe Trash System true Share Type NotShared Page 1410 EFTA00048378

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Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M R e: WHITE Facility: NYM Encounter Date: 08/10/2019 07:25 Provider: RN Unit: Z04 Emergency Code - Resuscitation Event encounter performed at Special Housing Unit. SUBJECTIVE: Emergency Note Provider: Team Members: Provider RN Bole Team/Code Leader RN Code Events: Type Value Date CPR Compressions 08/10/2019 06:35 EKG/Monitor Lifepak 08/10/2019 06:39 No shock advised CPR Compressions 08/10/2019 06:40 Oxygen 15 L 08/10/2019 06:47 IV Access Peripheral IV 08/10/2019 06:48 18 g Left AC Airway Endotracheal Tube ET Tube 7.5 24CM to L Lip line Placed by Paramedics 08/10/2019 07:08 Medications Epinephrine 1mg IV 08/10/2019 07:10 Epinephrine 3 doses and Sodium bicarb 2 doses administered by paramedics CPR Compressions 08/10/2019 07:11 Medications Sodium Bicarbonate 1 mEa/kg IV 08/10/2019 07:11 IV Fluids Normal Saline 0.9% 1000 ml 08/10/2019 07:12 Medications Epinephrine 1mg IV 08/10/2019 07:13 CPR Compressions 08/10/2019 07:14 Medications Sodium Bicarbonate 1 mEa/kg IV 08/10/2019 07:14 Medications Epinephrine 1mg IV 08/10/2019 07:16 CPR Compressions 08/10/2019 07:17 Comments: Responded to a body alarm at 0635 for medical emergency on 9S, Upon arrival Inmate was received on the floor of his cell unresponsive with CPR in progress by correctional officers, Inmate was Cold, with circumferential Bruising around the neck and posterior mottling, Pupils Fixed and dilated, No Palpable pulses, Call place for EMS, CPR Continued, AED Placed No shock advised, CPR Continued, inmate transported to HSU treatment room with CPR in progress, 18g hep lock to L AC, O2 15 Lt ViA BVM, Pulse Check NO SHOCK advised. EMS and Paramedics arrived 0656, Placed on cardiac monitor asystole Resumed CPR, Inmate was intubated by Medics, 3 Rounds of Epinephrine administered, Pulse Check asystole, Inmate was transported to Local ER with CPR in progress. OBJECTIVE: Exam: General Appearance Yes: Unconscious Generated 08'102019 08:10 by RN Bureau of Prisons - NYM Page 1 of 2 EFTA00048380

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M R e: WHITE Facility: NYM Encounter Date: 08/10/2019 07:25 Provider: RN Unit: Z04 Exam: ASSESSMENT: Cardiac Arrest PLAN: New Consultation Requests: Consultation/Procedure Target Date Scheduled Target Date Priority Translator Language Emergency Room 08/10/2019 08/10/2019 Emergent No Subtype: AMBULANCE Reason for Request: Cardiac arrest with CPR in progress Copay Required:No Cosign Required: Yes Telephone/Verbal Order: No Completed by RN on 08/10/2019 08:10 Requested to be cosigned by MD. Cosign documentation will be displayed on the following page. Generated 08/10/2019 08:10 by RN Bureau of Prisons - NYM Page 2 of 2 EFTA00048381

Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 08/10/2019 07:25 Provider: RN Facility: NYM Cosigned by MD on 08/12:2019 08:09. Bureau of Prisons - NYM EFTA00048382

Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/30/2019 15:58 Provider: MD Unit: 201 Chronic Care - Chronic Care Clinic encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: MD Chief Complaint: Other Problem Subjective: PATIENT WAS REFERRED BY THE WARDEN FOR EVALUATION. PATIENT REPORTS HE HAS BEEN WITHOUT HIS MEDS FOR ABOUT 1 WEEK. HE ALSO REPORTS NUMBNESS IN HIS RIGHT ARM FOR A FEW MINUTES 3 DAYS AGO. STATES THE NUMBNESS WENT AWAY ON ITS OWN, BUT WAS VERY CONCERNING. HE DENIES RIGHT SIDED WEAKNESS, DIPLOPIA, FACIAL DROOP, DIFFICULTY SPEAKING OR SWALLOWING. HE REPORTS NOCTURIA OF ABOUT 5 TIMES,. HE DENIES DYSURIA. HE REPORTS H OF KIDNEY STONES, HX OF HTN FOR WHICH HE WAS TAKING TOPROL. HE AHS A HX OF SLEEP APNEA AND STATED HE HAS NOT SLEPT FOR 3 WEEKS ISNCE HE HASB EEN HERE SINCE HE DIE NOT HAVE ACCESS T HI CPAP MACHINE. I INFORME DHIM THAT WE RECEIVED HIS CPAP MACHINE AND IT WILL BE GIVEN TO HIM TONIGHT.. HE REPORT OTHER NON-MEDICAL ISSUES. STATES HE FEELS OTHERWISE FINE. Pain: Not Applicable Seen for clinic(s): Pulmonary/Respiratory, Orthopedic/Rheumatology, Endocrine/Lipid OBJECTIVE: Exam: General Affect Yes: Cooperative 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 Pulmonary Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular Rate and Rhythm (RRR), Normal S1 and S2 No: M/R/G Musculoskeletal Tibia / Fibula No: Edema Neurologic Generated 07)302019 16:12 by MD Bureau of Prisons - NYM Page 1 of 2 EFTA00048383

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M R : WHITE Encounter Date: 07/30/2019 15:58 Provider: MD Reg #: 76318-054 Facility: NYM Unit: Z01 Exam: Cranial Nerves (CN) Yes: Within Normal Limits Motor System-General Yes: Normal Exam Motor System-Strength Yes: Normal Muscular Strength ASSESSMENT: Body mass index (BMI) 27.0-27.9, adult, Z6827 - Current Constipation, unspecified, K5900 - Current Essential (primary) hypertension, 110 - Current - BY HX. Hyperlipidemia, unspecified, E785 - Current Low back pain, M545 - Current Neuralgia and neuritis, unspecified, M792 - Current Prediabetes, R7303 - Current Sleep apnea, G4730 - Current PLAN: New Medication Orders: Ettl Medication INsulin REG - Human Indication: Prediabetes Discontinued Medication Orders: Siff Medication 122148-NYM Insulin Reg (10 ML) 100 UNITS/ML Inj Order Date 07/30/2019 15:58 Order Date 07/30/2019 15:58 Discontinue Type: When Pharmacy Processes Discontinue Reason:new order written Indication: Copay Required:No Telephone/Verbal Order: No Completed by Cosign Required: No MD on 07/30/2019 16:12 Prescriber Order SLIDING SCALE Subcutaneously each morning x 7 day(s) Pill Line Only Prescriber Order Inject regular insulin subcutaneously per sliding scale: twice daily "pill linen* for 7 days Generated 07230,2019 16:12 by Bureau of Prisons - NYM Page 2 of 2 EFTA00048384

Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/30/2019 11:12 Provider: MD Reg #: 76318-054 Facility: NYM Unit: Z01 Chronic Care - Chronic Care Clinic encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: Chief Complaint: Other Problem Subjective: PATIENT PATIE ALS STAT HE DEN SPEAKING HE REPORT HE REPORTS TOPROL. HE AHS A HX OF SLEEP ISNCE HE HASB EEN INFORME DHIM THAT WE HIM TONIGHT.. HE REPORT OTHER NON-ME STATES HE FEELS OTHERWISE Pain: Not Applicable MD REFERRED BY THE WARDEN FOR EVALUATION. RTS HE HAS BEEN WITHOUT HIS MEDS FOR ABOUT 1 WEEK. HE S NUMBNESS IN HIS RIGHT ARM FOR A FEW MINUTES 3 DAYS AGO. BNESS WENT AWAY ON ITS OWN, BUT WAS VERY CONCERNING. SIDED WEAKNESS, DIPLOPIA, FACIAL DROOP, DIFFICULTY OWING. IA OF ABOUT 5 TIMES,. HE DENIES DYSURIA. NEY STONES, HX OF HTN FOR WHICH HE WAS TAKING AND STATED HE HAS NOT SLEPT FOR 3 WEEKS E HE DIE NOT HAVE ACCESS T HI CPAP MACHINE. I HIS CPAP MACHINE AND IT WILL BE GIVEN TO ES. Seen for clinic(s): Endocrine/Lipid, Orthopedic.JRheumatologyC Respiratory IP O OBJECTIVE: Pulse: Date Time Rate Per Minute Location 07/30/2019 13:02 94 07/30/2019 09:40 88 Via Machine 07/30/2019 09:30 87 Via Machine Respirations: Date Time Rate Per Minute Provider 07/30/2019 09:30 NYM 12 Blood Pressure: Date lime Value Location Position 07/30/2019 13:02 NYM 114/84 Left Arm Standing 07/30/2019 09:40 NYM 125/60 Right Arm Standing 07/30/2019 09:30 NYM 108/86 Left Arm Sitting SaO2: Dale lime Value(%) Air 07/30/2019 09:30 NYM 98 Room Air Weight: Date Time as Kg Waist Circum Provider MD Provider eaudouin, Robert MD ouin, Robert MD Robert MD Cuff Size Provider Provider MD MD MD MD Generated 07/30/2019 14:05 by MD Bureau of Prisons - NYM Page 1 of 3 EFTA00048385

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: fivniku.: WHITE Facility: NYM Encounter Date: 07/30/2019 11:12 Provider: MD Unit: Z01 Date Time 07/30/2019 09:30 NYM 194.2 88.1 MD Lbs Kg Waist Circum Provider Exam: General Affect Yes: Cooperative Appearance Yes: Appears Well, Alert and Oriented x 3 No: Appears Distre ed, Dyspneic, Appears in Pain, Writhing in Pain, Pale, Pallor, Cyanotic, Diaphoretic, Disheveled, Unk cutely III Nutrition No: Appears O Pulmonary Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular Rate and Rhythm (RRR No: M/R/G Musculoskeletal Tibia / Fibula No: Edema Neurologic Cranial Nerves (CN) Yes: Within Normal Limits Motor System-General Yes: Normal Exam Motor System-Strength Yes: Normal Muscular Strength ASSESSMENT: Body mass index (BMI) 27.0.27.9, adult, Z6827 - Current Constipation, unspecified, K5900 - Current Essential (primary) hypertension, 110 - Current - BY HX. Hyperlipidemia, unspecified, E785 - Current Low back pain, M545 - Current Neuralgia and neuritis, unspecified, M792 - Current Prediabetes, 87303 - Current Sleep apnea, G4730 - Current 1 and S2 PLAN: New Medication Orders: 13x# Medication Order Date Prescriber Order Generated 07/30/2019 14:05 by MD Bureau of Prisons - NYM Page 2 of 3 EFTA00048386

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M R Encounter Date: 07/30/2019 11:12 Provider: Reg St: 76318-054 Facility: NYM MD Unit: Z01 New Medication Orders: Exit Medication Magnesium Hydroxide Susp conc 800 MG/5ML Indication: Constipation, unspecified INsulin REG - Human Indication: Renew Medication Orders: Eixf Medication 121836-NYM methylP Pack) Indication: New Laboratory Requests: Details Frequency Lab Tests Short List-General-CBC w cliff Sne Time Lab Tests-P-PSA, Total Lab Tests-U-Uric Acid Lab Tests - Short List-General-Comprehensiv Metabolic Profile (CMP) Lab Tests-U-Urinalysis w/Reflex to Microscopic New Radiology Request Orders: Details General Radiology-Spine / Cervical- General Specific reason(s) for request (Complaints and findings): 66 YR OLD MALE WITH COMPLAITN OF RIGHT ARM NU PLEASE PERFORM C SPINE SERIES Order Date 07/30/2019 11:12 07/30/2019 11:12 Prediabetes Disposition: Follow-up at Sick Call as Needed ne 4 MG Tab ( 21 count Order Date 07/30/2019 11:12 a and neuritis, unspecified Frequency One Time Patient Education Topics: Date Initiated Format Handout/Topic 07/30/2019 Counseling Access to Care 07/30/2019 Counseling Copay Required:No Telephone/Verbal Order: No Completed by Plan of Care Cosign Required: No MD on 07/30/2019 14:05 Prescriber Order 10 CC Orally - Two Times a Day PRN x 90 day(s) SLIDING SCALE Subcutaneously Two Times a Day x 7 day(s) Pill Line Only Prescriber Order Take the tablet by mouth as directed x 6 day(s) Due Date 08/01/2019 00:00 Due Date 08/29/2019 Priority Routine Priority Routine R 2-3 MINUTES 3 DAYS AGO. te Beaudo Robert Outcome Verbalizes Understanding Verbalizes Understanding Generated 07/30/2019 14:05 by MD Bureau of Prisons - NYM Page 3 of 3 EFTA00048387

Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/30/2019 11:12 Provider: MD Reg #: 76318-054 Facility: NYM Unit: Z01 Chronic Care - Chronic Care Clinic encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: Chief Complaint: Other Problem Subjective: PATIENT PATIE ALS STAT HE DEN SPEAKING HE REPORT HE REPORTS TOPROL. HE AHS A HX OF SLEEP ISNCE HE HASB EEN INFORME DHIM THAT WE HIM TONIGHT.. HE REPORT OTHER NON-ME STATES HE FEELS OTHERWISE Pain: Not Applicable MD REFERRED BY THE WARDEN FOR EVALUATION. RTS HE HAS BEEN WITHOUT HIS MEDS FOR ABOUT 1 WEEK. HE S NUMBNESS IN HIS RIGHT ARM FOR A FEW MINUTES 3 DAYS AGO. BNESS WENT AWAY ON ITS OWN, BUT WAS VERY CONCERNING. SIDED WEAKNESS, DIPLOPIA, FACIAL DROOP, DIFFICULTY OWING. IA OF ABOUT 5 TIMES,. HE DENIES DYSURIA. NEY STONES, HX OF HTN FOR WHICH HE WAS TAKING AND STATED HE HAS NOT SLEPT FOR 3 WEEKS E HE DIE NOT HAVE ACCESS T HI CPAP MACHINE. I HIS CPAP MACHINE AND IT WILL BE GIVEN TO ES. Seen for clinic(s): Endocrine/Lipid, Orthopedic.JRheumatologyC Respiratory IP O OBJECTIVE: Pulse: Date Time Rate Per Minute Location 07/30/2019 13:02 94 07/30/2019 09:40 88 Via Machine 07/30/2019 09:30 87 Via Machine Respirations: Date Time Rate Per Minute Provider 07/30/2019 09:30 NYM 12 Blood Pressure: Date lime Value Location Position 07/30/2019 13:02 NYM 114/84 Left Arm Standing 07/30/2019 09:40 NYM 125/60 Right Arm Standing 07/30/2019 09:30 NYM 108/86 Left Arm Sitting SaO2: Dale lime Value(%) Air 07/30/2019 09:30 NYM 98 Room Air Weight: Date Time as Kg Waist Circum Provider MD Provider eaudouin, Robert MD ouin, Robert MD Robert MD Cuff Size Provider Provider MD MD MD MD Generated 07/30/2019 14:05 by MD Bureau of Prisons - NYM Page 1 of 3 EFTA00048388

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: fivniku.: WHITE Facility: NYM Encounter Date: 07/30/2019 11:12 Provider: MD Unit: Z01 Date Time 07/30/2019 09:30 NYM 194.2 88.1 MD Lbs Kg Waist Circum Provider Exam: General Affect Yes: Cooperative Appearance Yes: Appears Well, Alert and Oriented x 3 No: Appears Distre ed, Dyspneic, Appears in Pain, Writhing in Pain, Pale, Pallor, Cyanotic, Diaphoretic, Disheveled, Unk cutely III Nutrition No: Appears O Pulmonary Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular Rate and Rhythm (RRR No: M/R/G Musculoskeletal Tibia / Fibula No: Edema Neurologic Cranial Nerves (CN) Yes: Within Normal Limits Motor System-General Yes: Normal Exam Motor System-Strength Yes: Normal Muscular Strength ASSESSMENT: Body mass index (BMI) 27.0.27.9, adult, Z6827 - Current Constipation, unspecified, K5900 - Current Essential (primary) hypertension, 110 - Current - BY HX. Hyperlipidemia, unspecified, E785 - Current Low back pain, M545 - Current Neuralgia and neuritis, unspecified, M792 - Current Prediabetes, 87303 - Current Sleep apnea, G4730 - Current 1 and S2 PLAN: New Medication Orders: 13x# Medication Order Date Prescriber Order Generated 07/30/2019 14:05 by MD Bureau of Prisons - NYM Page 2 of 3 EFTA00048389

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M R : WHITE Encounter Date: 07/30/2019 11:12 Provider: MD Reg it: 76318-054 Facility: NYM Unit: Z01 New Medication Orders: Exit Medication Order Date Magnesium Hydroxide Susp conc 800 07/30/2019 11:12 MG/5ML Indication: Constipation, unspecified INsulin REG - Human 07/30/2019 11:12 Indication: Renew Medication Orders: Eixf Medication 121836-NYM methylP Pack) Indication: New Laboratory Requests: Details Frequency Lab Tests Short List-General-CBC w cliff Sne Time Lab Tests-P-PSA, Total Lab Tests-U-Uric Acid Lab Tests - Short List-General-Comprehensiv Metabolic Profile (CMP) Lab Tests-U-Urinalysis w/Reflex to Microscopic New Radiology Request Orders: Details General Radiology-Spine / Cervical- General Specific reason(s) for request (Complaints and findings): 66 YR OLD MALE WITH COMPLAITN OF RIGHT ARM NU PLEASE PERFORM C SPINE SERIES Prediabetes Disposition: Follow-up at Sick Call as Needed ne 4 MG Tab ( 21 count Order Date 07/30/2019 11:12 a and neuritis, unspecified Frequency One Time Patient Education Topics: Date Initiated Format Handout/Topic 07/30/2019 Counseling Access to Care 07/30/2019 Counseling Copay Required:No Telephone/Verbal Order: No Completed by Plan of Care Cosign Required: No MD on 07/30/2019 14:05 Prescriber Order 10 CC Orally - Two Times a Day PRN x 90 day(s) SLIDING SCALE Subcutaneously Two Times a Day x 7 day(s) Pill Line Only Prescriber Order Take the tablet by mouth as directed x 6 day(s) Due Date 08/01/2019 00:00 Due Date 08/29/2019 Priority Routine Priority Routine R 2-3 MINUTES 3 DAYS AGO. te Beaudo Robert Outcome Verbalizes Understanding Verbalizes Understanding Generated 07/30/2019 14:05 by MD Bureau of Prisons - NYM Page 3 of 3 EFTA00048390

Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/30/2019 15:58 Facility: NYM Amendment made to this note by MD on 07/30/2019 16:12. Bureau of Prisons - NYM EFTA00048391

Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M R e: WHITE Facility: NYM Encounter Date: 07/28/2019 20:25 Provider: RN Unit: H01 Nursing - Follow up encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: RN Chief Complaint: Neuropathy - Tingling/Numbness of Extremity(ies) Subjective: Inmate seen for F/U after returning from attorney conference offers no new complaints or worsening S/S stats My R hand still has pins and needles sometimes" No change in appearance from previous exam. Pain: No OBJECTIVE: Pulse: Date lime Rate Per Minute Location Rhythm Provider 07/28/2019 20:28 81 RN Respirations: Date Time Rate Per Minute Provider 07/28/2019 20:28 NYM 14 RN Blood Pressure: Date lime Value Location Position Cuff Size Provider 07/28/2019 20:28 NYM 157/91 RN SaO2: Data Time Value(%) Al! Provider 07/28/2019 20:28 NYM 98 RN Exam: General Affect Yes: Cooperative Appearance Yes: Appears Well, Alert and Oriented x 3 Nutrition Yes: Within Normal Limits Skin General Yes: Within Normal Limits, Dry, Skin Intact ASSESSMENT: No Significant Findings/No Apparent Distress PLAN: Disposition: To be Evaluated by Provider Generated 07)28.2019 20:30 by RN Bureau of Prisons - NYM Page 1 of 2 EFTA00048392

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: ty" E.Ac TE Facility: NYM Encounter Date: 07/28/2019 20:25 Provider: RN Unit: H01 Follow-up in 12-24 Hours Patient Education Topics: Date Initiated Format 07/28/2019 Counseling HandoutLT_opic Plan of Care Copay Required:No Cosign Required: Yes Telephoner Verbal Order: No Completed by RN on 07/28/2019 20:30 Requested to be cosigned by MD. Cosign documentation will be displayed on the following page. Outcome Verbalizes Understanding Generated 07/28/2019 20:30 by RN Bureau of Prisons - NYM Page 2 of 2 EFTA00048393

Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/28/2019 20:25 Provider: RN Facility: NYM Cosigned by MD on 07/28:2019 20:50. Bureau of Prisons - NYM EFTA00048394

Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M R e: WHITE Facility: NYM Encounter Date: 07/28/2019 06:51 Provider: RN Unit: H01 Nursing - Triage Note encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: RN Chief Complaint: Neuropathy - Tingling/Numbness of Extremity(ies) Subjective: " I woke up and I had no control over my Right arm for a few minutes it was just doing what it wanted to do" Pain: No OBJECTIVE: Pulse: Dale Time Rate Per Minute Location Rhythm Provider 07/28/2019 06:57 82 RN Respirations: Dale Time Rate Per Minute Provider 07/28/2019 06:57 NYM 14 RN Blood Pressure: Dale Time Value Location Position Cuff Size Provider 07/28/2019 06:57 NYM 138/80 RN SaO2: Date Time Valuer/O1 Air Provider 07/28/2019 06:57 NYM 98 RN Exam: General Affect Yes: Cooperative Appearance Yes: Appears Well, Alert and Oriented x 3 Skin General Yes: Within Normal Limits, Dry, Skin Intact Head General Yes: Symmetry of Motor Function, Atraumatic/Normocephalic No: Facial Asymmetry, Battle's Sign, Raccoon Eyes, Deformity Eyes General Yes: PERRLA, Extraocular Movements Intact Face General Yes: Symmetric Generated 07/2812019 07:22 by RN Bureau of Prisons - NYM Page 1 of 3 EFTA00048395

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M R : WHITE Facility: NYM Encounter Date: 07/28/2019 06:51 Provider: RN Unit: H01 Exam: No: Ecchymosis, Numbness, Swelling, Periorbital Edema Neck General Yes: Abrasion(s) Pulmonary Observation/Inspection Yes: Within Normal Limits No: Respiratory Distress, Tachypnea, Hyperventilation Cardiovascular Observation Yes: Normal Rate Musculoskeletal Shoulder Yes: Full Range of Motion R, Symmetric R No: Swelling R, Inflammation R Humerus Yes: Within Normal Limits R Elbow Yes: Normal Exam R, Full Range of Motion R, Non-Tender on Palpation R Radius / Ulna Yes: Normal Exam R, Full Range of Motion R WrisVHand/Fingers Yes: Full Range of Motion R, Non-Tender on Palpation R, Swelling R No: Inflammation R, Ecchymosis R, Erythema R, Tenderness R, Laceration(s) R, Abrasion(s) R, Contusion(s) R ROS Comments Received inmate AAOX3 in no acute distress, speaking in full sentenced ambulating independently CIO Right arm numbness after waking up from "sleeping on my side" that has since subsided. inmate interviewed in psyc obs through the slot. V/S noted WNL, RR even and unlabored, no neurological deficits noted, no facial droop slurred speech or dysphagia, Inmate with Full ROM to all extremities with 4/4 strength bilaterally, slight swelling noted to right phalanges when compared to left, no edema, erythema or ecchymosis noted. Denies any pain numbness or tingling at this time. Denies any Chest pain, Headache, Dizziness, SOB or Blurred vision. Eyes PERRLA. MD on Call notified, Re-evaluate this evening or sooner if S/S persist. ASSESSMENT: Alteration in comfort PLAN: Disposition: Follow-up at Sick Call as Needed Notify Medical Duty Officer Patient Education Topics: Date Initiated Format Handout/Topic Provider Outcome 07/28/2019 Counseling Plan of Care Verbalizes Understanding Generated 07/28/2019 07:22 by RN Bureau of Prisons - NYM Page 2 of 3 EFTA00048396

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/28/2019 06:51 Provider: RN Unit: H01 Date Initiated Format Handout/Topic Provider Outcome Copay Required:No Telephone/Verbal Order: No Completed by i RN on 07/28/2019 07:22 Requested to be cosigned by MD. Cosign documentation will be displayed on the following page. Cosign Required: Yes Generated 07/28/2019 07:22 by RN Bureau of Prisons - NYM Page 3 of 3 EFTA00048397

Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/28/2019 06:51 Provider: RN Facility: NYM Cosigned by MD on 07/28/2019 20:51. Bureau of Prisons - NYM EFTA00048398

Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: Date of Birth: Note Date: EPSTEIN, JEFFREY EDWARD 01/20/1953 07/26/2019 08:57 Sex: Provider: M MD Reg #: Facility: Unit: 76318-054 NYM H01 Cosign Note - Clinical Encounter Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider: MD THE MLP NOTIFIED THE OP LT OF THE INMATE STATEMENT REGARDING WHAT HAPPENED TO HIM 2 NIGHTS AGO. New Medication Orders: Batt Medication Docusate Sodium Capsule Indication: Copay Required:No TelephoneNerbal Order: No Completed by Constipation, unspecified Cosign Required: No MD on 07/26/2019 08:58 Order Date 07/26/2019 08:57 Prescriber Order TAKE ONE 100 MG CAP Orally - Two Times a Day x 180 day(s) Generated 07/26/2019 08:58 by MD Bureau of Prisons - NYM Page 1 of 1 EFTA00048399

Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: Facility: NYM Note Date: 07/24/2019 16:10 Provider: MD Unit: H01 Cosign Note - Clinical Encounter Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider: MD THE MLP NOTIFIED THE OP LT OF THE INMATE STATEMENT REGARDING WHAT HAPPENED TO HIM 2 NIGHTS AGO. Copay Required:No TelephoneNerbal Order: No Completed by Beaudouin, Robe Cosign Required: No 0 24/2019 16:12 Generated 07/24/2019 16:12 by MD Bureau of Prisons - NYM Page 1 of 1 EFTA00048400

Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: Facility: NYM Note Date: 07/24/2019 16:10 Provider: MD Unit: H01 Cosign Note - Clinical Encounter Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider: MD THE MLP NOTIFIED THE OP LT OF THE INMATE STATEMENT REGARDING WHAT HAPPENED TO HIM 2 NIGHTS AGO. Copay Required:No TelephoneNerbal Order: No Completed by Beaudouin, Robe Cosign Required: No 0 24/2019 16:12 Generated 07/24/2019 16:12 by MD Bureau of Prisons - NYM Page 1 of 1 EFTA00048401

Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: Encounter Date: 07/26/2019 08:57 Facility: NYM Amendment made to this note by MD on 07/26/2019 08:58. Bureau of Prisons - NYM EFTA00048402

Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: Facility: NYM Note Date: 07/24/2019 15:10 Provider: MD Unit: H01 Admin Note - General Administrative Note encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider: MD PATIENT WAS OFFERED TO HAVE AN OPTOMETRIST EVALUATION. HE REFUSED. REFUSAL FORM SIGNED. Copay Required:No TelephoneNerbal Order: No Completed by Cosign Required: No MD on 07/24/2019 15:17 Generated 07/24/2019 15:17 by MD Bureau of Prisons - NYM Page 1 of 1 EFTA00048403

Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M R : WHITE Facility: NYM Encounter Date: 07/24/2019 13:08 Provider: Unit: H01 Mid Level Provider - Follow up Visit encounter performed at Receiving & Discharge. SUBJECTIVE: COMPLAINT 1 Provider: Chief Complaint: Other Problem Subjective: I still do not want to talk about. But, between you and me. I think my room mate had to do with what happened to me. Do not ask me. I am not going to say anything. Pain: No OBJECTIVE: Temperature: Date Time Fahrenheit Celsius Location Provider 07/24/2019 13:12 NYM 97.8 36.6 Oral Pulse: Date Time Rate Per Minute Location Rhythm Provider 07/24/2019 13:12 83 Via Machine Regular Blood Pressure: Date Time Value Location Position Cuff Size Provider 07/24/2019 13:12 NYM 132/89 Right Arm Sitting Adult-regular SaO2: Date Time Value(%) Ak Provider 07/24/2019 13:12 NYM 96 Room Air Exam: General Affect Yes: Cooperative Appearance Yes: Appears Well, Alert and Oriented x 3 No: Appears Distressed, Appears in Pain Exam Comments Follow up evaluation done for inmate Epstein. He does not look in any pain or distress. He still has the erythema around his neck. Central part of this erythema has some abrasion. Patient does not complaint of any respiratory problem or distress. He still does not want to explain how the skin injury on his neck happed. he insinuates that injuries on his neck have to do with his room mate. But does not want to talk about it. ASSESSMENT: Injury, unspecified, T1490 - Current PLAN: Disposition: Generated 07/24/2019 13:24 by Bureau of Prisons - NYM Page 1 of 2 EFTA00048404

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: .I Riii.NHITE Facility: NYM Encounter Date: 07/24/2019 13:08 Provider: Unit: H01 Follow-up at Sick Call as Needed Patient Education Topics: Date Initiated Format Handout/Topic . Outcome 07/24/2019 Counseling Access to Care Verbalizes Understanding 07/24/2019 Counseling Preventive Health Verbalizes Understanding Copay Required:No Cosign Required: Yes Telephone Verbal Order: No Completed by on 07'24 2019 13:24 Requested to be cosigned by MD. Cosign documentation will be displayed on the following page. Generated 07/24/2019 13:24 by Bureau of Prisons - NYM Page 2 of 2 EFTA00048405

Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/24/2019 13:08 Provider Facility: NYM Cosigned with New Encounter Note by MD on 07.24.2019 16:10. Bureau of Prisons - NYM EFTA00048406

Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M R : WHITE Facility: NYM Encounter Date: 07/23/2019 06:20 Provider: Unit: H01 Injury Assessment - Non-work related encounter performed at Health Services. SUBJECTIVE: INJURY 1 Provider: 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 Pulse: pate Time Rate Per Minute Location Rhythm Provider 07/23/2019 06:30 92 Via Machine Regular Respirations: Date Time Rate Per Minute Provider 07/23/2019 06:30 NYM 16 Blood Pressure: Date Time Value Location Position Cuff Size Provider 07/23/2019 06:30 NYM 140/85 Right Arm Sitting Adult-regular SaO2: Dale Time Value(%) Air Provider 07/23/2019 06:30 NYM 96 Room Air 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 Bureau of Prisons - NYM Page 1 of 2 EFTA00048407

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M R : WHITE Facility: NYM Encounter Date: 07/23/2019 06:20 Provider: 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 Verbalizes Understanding 07/23/2019 Counseling Plan of Care Verbalizes Understanding Copay Required:No Cosign Required: Yes Telephone/Verbal Order: No Completed by on 07/23/2019 09:05 Requested to be cosigned by MD. Cosign documentation will be displayed on the following page. Generated 07/23/2019 09:05 by Bureau of Prisons - NYM Page 2 of 2 EFTA00048408

Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/23/2019 06:20 Provider: Facility: NYM Cosigned by MD on 07/23/2019 15:44. Bureau of Prisons - NYM EFTA00048409

Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/14/2019 17:36 Provider: MD Unit: Z05 Chronic Care - 14 Day Physician Eval encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: 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 MD Bureau of Prisons - NYM Page 1 of 3 EFTA00048410

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M R : WHITE Encounter Date: 07/14/2019 17:36 Provider: MD Reg #: 76318-054 Facility: NYM Unit: 205 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: &It 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 MD Bureau of Prisons - NYM 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 Page 2 of 3 EFTA00048411

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M R : WHITE Encounter Date: 07/14/2019 17:36 Provider: MD Reg #: 76318-054 Facility: NYM Unit: 205 FASTING. Lab Tests-H-Hep B surface Ab Lab Tests-H-Hep B surface Ag Lab Tests-H-Hep C Ab Lab Tests-H-Hepatic Profile Schedule: One Time Activity Date Scheduled Clinical Encounter 07/24/2019 00:00 66 YR OLD MALE FOR ROUTINE SCREENING. Chronic Care Visit 01/07/2020 00:00 6 MONTH F/U. Chronic Care Visit 07/01/2020 00:00 Other: PENDING EKG AND FOBT. CXR WAS REFUSED. Patient Education Topics: Date Initiated Format 07/14/2019 Counseling Copay Required:No Telephone/Verbal Order: No Completed by Handout/Topic Diagnosis Cosign Required: No MD on 07/14/2019 18:11 08/08/2019 00:00 Routine Scheduled Provider Optometrist Mid-Level Provider Physician 01 Provider Outcome Verbalizes Understanding Generated 07/14/2019 18:11 by MD Bureau of Prisons - NYM Page 3 of 3 EFTA00048412

Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/12/2019 13:10 Provider: MD Unit: Z05 Chronic Care - 14 Day Physician Eval encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: 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: MD 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 MD Bureau of Prisons - NYM Page 1 of 3 EFTA00048413

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M R : WHITE Facility: NYM Encounter Date: 07/12/2019 13:10 Provider: 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 MD Bureau of Prisons - NYM Page 2 of 3 EFTA00048414

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/12/2019 13:10 Provider: 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 07/12/2019 Counseling Diagnosis Copay Required: No Telephone/Verbal Order: Completed by Beaudouin, Cosign Required: No 07/12/2019 14:20 0 Provider Outcome Verbalizes Understanding Generated 07/12/2019 14:20 by MD Bureau of Prisons - NYM Page 3 of 3 EFTA00048415

Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/12/2019 13:10 Provider: MD Unit: Z05 Chronic Care - 14 Day Physician Eval encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: 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: MD 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 MD Bureau of Prisons - NYM Page 1 of 3 EFTA00048416

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M R : WHITE Facility: NYM Encounter Date: 07/12/2019 13:10 Provider: 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 MD Bureau of Prisons - NYM Page 2 of 3 EFTA00048417

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/12/2019 13:10 Provider: 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 07/12/2019 Counseling Diagnosis Copay Required: No Telephone/Verbal Order: Completed by Beaudouin, Cosign Required: No 07/12/2019 14:20 0 Provider Outcome Verbalizes Understanding Generated 07/12/2019 14:20 by MD Bureau of Prisons - NYM Page 3 of 3 EFTA00048418

Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/14/2019 17:36 Facility: NYM Amendment made to this note by MD on 07 14 2019 18:11. Bureau of Prisons - NYM EFTA00048419

Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: Date of Birth: Note Date: EPSTEIN, JEFFREY EDWARD 01/20/1953 07/12/2019 09:06 Sex: Provider: M MD Reg #: Facility: Unit: 76318-054 NYM Z05 Admin Note - Orders encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider: MD PATIENT REQUESTED TO HAVE A COLACE RX , INSTEAD OF TEH BISACODYL FOR CONSTIPATION. New Medication Orders: 1324 Medication Docusate Sodium Capsule Indication: Constipation, unspecified Discontinued Medication Orders: Hist/ 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 Cosign Required: No MD on 07/12/2019 09:10 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 MD Bureau of Prisons - NYM Page 1 of 1 EFTA00048420

Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: Facility: NYM Note Date: 07/07/2019 00:17 Provider: MD Unit: E06 Cosign Note - Intake Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider: MED CL:1 NO CCC APPT. MD Discontinued Laboratory Requests: Details 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: 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 TelephoneNerbal Order: No Completed by Cosign Required: No MD on 07/07/2019 00:30 Generated 07107/2019 00:30 by MD Bureau of Prisons - NYM Page 1 of 1 EFTA00048421

Bureau of Prisons Health Services Health Screen Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: Race: WHITE Encounter Date: 07/06/2019 21:38 Provider: NM= 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: 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 Bureau of Prisons - NYM Page 1 of 6 EFTA00048422

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/06/2019 21:38 Provider: 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 Bureau of Prisons - NYM Page 2 of 6 EFTA00048423

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/06/2019 21:38 Provider: 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 Bureau of Prisons - NYM Page 3 of 6 EFTA00048424

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/06/2019 21:38 Provider: 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 Respirations: Date lime 07/06/2019 21:43 NYM Blood Pressure: Date Time Value Location Position Cuff Size Provider 07/06/2019 21:45 NYM 164/90 Right Arm Sitting Adult-regular 07/06/2019 21:43 NYM 155/83 Left Arm Sitting Adult-regular Rate Per Minute Provider 15 SaO2: Date lime Value(%) Air Provider 07/06/2019 21:43 NYM 95 Room Air Height: Date lime Inches Cm Provider 07/06/2019 21:43 NYM 72.0 182.9 Weight: Date Time Liza Kg Waist Circum Provider 07/06/2019 21:43 NYM 200.0 90.7 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 Bureau of Prisons - NYM Page 4 of 6 EFTA00048425

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/06/2019 21:38 Provider: 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 Detail New Laboratory Requests: Details Frequency Due Date Priority Lab Tests-H-Hemoglobin A1G 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: MD New Non-Medication Orders: Order Frequency Duration Details EKG One Time 66 y/o male Order Date: 07/06/2019 Fecal Occult Blood One Time 3 different stools 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 Ordered By Generated 07/06/2019 21:56 by Bureau of Prisons - NYM Page 5 of 6 EFTA00048426

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/06/2019 21:38 Provider: Facility: NYM Completed by on 07/06/2019 21:56 Requested to be cosigned by MD. Cosign documentation will be displayed on the following page. Generated 07/06/2019 21:56 by Bureau of Prisons - NYM Page 6 of 6 EFTA00048427

Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/062019 21:38 Provider: Facility: NYM Cosigned with New Encounter Note by MD on 07/07/2019 00:17. Bureau of Prisons - NYM EFTA00048428

Bureau of Prisons Health Services History & Physical Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 07/09/2019 12:35 Provider: HITE 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: I-Ix of Previous Disease: No Blood-tinged Sputum: No Night Sweats: No Weight Loss:No Fever: No Cough:No Comments: Infectious Disease Risk Factors: IV Drug Use: No IV Drug Use Needles: Sexual Partner IV Drug Use: No Sexual Partner IV Drug Use Needles: Female Sexual Partners (Last 5 Yrs): 10+ Male Sexual Partners (Last 5 Yrs): 0 Condom Use: Sometimes Sexual Contact With HIV+ Individual: No Blood Product Transfusion: No Travel Outside US: Yes Tattoos: No Comments: Born in US High school diploma Banker Traveled to Paris x 3 weeks up until arrest No tattoos Generated 07/09/2019 13:03 by Bureau of Prisons • NYM Page 1 of 13 EFTA00048429

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Reg #: 76318-054 Facility: NYM Unit: H01 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 07'092019 13:03 by Bureau of Prisons • NYM Page 2 of 13 EFTA00048430

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Rac HITE Encounter Date: 07/09/2019 12:35 Provider: Reg #: 76318-054 Facility: NYM Unit: H01 Mental Health: Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Hx of Mental Health Treatment: None Hx of Head Injury: None Current Mental Health Treatment: No Current Mental Health Complaint: No Hx of Loss of Consciousness: No Hx of Hearing Voices: No Past History of Suicide Attempt: No Current Suicide Ideation: No Suicide Prevention Initiated:No Comments: Substance Use History: Denied Current Painful Condition: Denied Other Health Issues: Current Medical Conditions: Other Current Treatments: Pregnant: Dental Condition: Denied N/A Generated 07/0912019 13:03 by Bureau of Prisons • NYM Page 3 of 13 EFTA00048431

Inmate Name: EPSTEIN. JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Reg #: 76318-054 Facility: NYM Unit: H01 Observations: Draining Skin Lesions: No Signs of Lice: No Signs of Scabies: No Signs of Recent Trauma: No Recent Tattoos: No Needle Marks: No Signs of Rash: No Open Sores: No Wounds: No Body Deformities: No Tremors: No Sweating: No Comments: Generated 07,09,2019 13:03 by Bureau of Prisons NYM Page 4 of 13 EFTA00048432

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M R : WHITE Encounter Date: 07/09/2019 12:35 Provider: Reg #: 76318-054 Facility: NYM Unit: H01 Immunizations: Hepatitis A and B (TwinRx) Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Measles/Mumps/Rubella Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Tetanus Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Generated 07/09/2019 13:03 by Bureau of Prisons • NYM Page 5 of 13 EFTA00048433

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Reg #: 76318-054 Facility: NYM Unit: H01 Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Varicella Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Temperature: Date Time Fahrenheit Celsius Location Provider 07/09/2019 12:49 NYM 97.3 36.3 Oral Pulse: Date Time Rate Per Minute Location Rhythm Provider 07/09/2019 12:49 82 Via Machine Regular Respirations: Date Time Rate Per Minute Provider 07/09/2019 12:49 NYM 16 Blood Pressure: pate Time Value Location Position Cuff Size Provider 07/09/2019 12:49 NYM 117/66 Right Arm Sitting Adult-regular SaO2: Date Time Value(%) Air Provider 07/09/2019 12:49 NYM 97 Room Air Height: Date Time Inches am Provider 07/09/2019 12:49 NYM 70.0 177.8 Generated 07/0912019 13:03 by Bureau of Prisons Page 6 of 13 EFTA00048434

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 07/09/2019 12:35 Provider: M R : WHITE Reg #: 76318-054 Facility: NYM Unit: H01 Date lime inches Om Provider Weight: Date Time Lbs Kg Waist Circum. Provider 07/09/2019 12:49 NYM 194.4 88.2 Prosthetic Devices/Equipment: Denied Tobacco Usage: Denied General Social History: Foreign Travel: Born in USA: Yes Country of Birth: USA Patient Education Assessments: Date Ed Yrs Occupation Learns Best By Primary Language Barriers to Education 07/09/2019 12 Banker Speaking/Listening English None Family History - Father: Age at Death: 74 Cause of Death: Diabetes complications Significant Illnesses: Diabetes Heart Disease Comments: Family History - Mother: Age at Death: 81 Cause of Death: Kidney Failure Significant Illnesses: Heart Disease Comments: Family History - Sibling: Number of Siblings: 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 Bureau of Prisons • NYM Page 7 of 13 EFTA00048435

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M R : WHITE Encounter Date: 07/09/2019 12:35 Provider: 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 Bureau of Prisons • NYM Page 8 of 13 EFTA00048436

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: li m aSHITE Facility: NYM Encounter Date: 07/09/2019 12:35 Provider: 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 0710912019 13:03 by Bureau of Prisons • NYM Page 9 of 13 EFTA00048437

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: HITE Encounter Date: 07/09/2019 12:35 Provider: Reg #: 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: Right Left Radial: Femoral: Dorsalis Pedis: Post. Tibialis: Comments: Generated OW0912019 13:03 by Bureau of Prisons • MIA Page 10 of 13 EFTA00048438

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: i m lifeHITE Facility: NYM Encounter Date: 07/09/2019 12:35 Provider: 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 Bureau of Prisons • MIA Page 11 of 13 EFTA00048439

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 07/09/2019 12:35 Provider: HITE Reg #: 76318-054 Facility: NYM Unit: H01 Reflexes: Bight Lan Biceps: Patellar: Brachioradialis: 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 Bureau of Prisons • NYM Page 12 of 13 EFTA00048440

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Rac HITE Encounter Date: 07/09/2019 12:35 Provider: 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 on 07/09/2019 13:03 Requested to be cosigned by MD. Cosign documentation will be displayed on the following page. Generated 07/0912019 13:03 by Bureau of Prisons • NYM Page 13 of 13 EFTA00048441

Bureau of Prisons Health Services Cosign/Review Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/09/2019 12:35 Provider: Facility: NYM Cosigned by MD on 07 11:2019 22:41. Bureau of Prisons - NYM EFTA00048442

Bureau of Prisons Health Services Inmate Local Hospital Reg #: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD SENSITIVE BUT UNCLASSIFIED — This information is confidential and must be appropriately safeguarded. Transfer To: Transfer Date: 08/10/2019 Health Problems Health Problem Status Hyperlipidemia, unspecified Current HYPERTRIGLYCERIDEMIA Sleep apnea Current Essential (primary) hypertension Current BY HX. Constipation, unspecified Current Low back pain Current Neuralgia and neuritis, unspecified Current No Diagnosis Current Prediabetes Current Injury, unspecified Current R/O self inflicted injuries. Body mass index (BMI) 27.0-27.9, adult Current Medications: All medications to be continued until evaluated by a physician unless otherwise indicated. Bolded drugs required for transport. Docusate Sodium 100 MG Cap Exp: 08/11/2019 SIG: Take one capsule (100 MG) by mouth twice daily for 30 days Docusate Sodium 100 MG Cap Exp: 01/22/2020 SIG: Take one capsule (100 MG) twice daily by mouth with plenty of water Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML Exp: 10/28/2019 SIG: shake well take 10ml by mouth twice daily AS NEEDED 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. None Pending Appointments Date Time Activity Provider 07/24/2019 00:00 Clinical Encounter Optometrist 01/07/2020 00:00 Chronic Care Visit Mid-Level Provider 07/01/2020 00:00 Chronic Care Visit Physician 01 07/09/2020 00:00 PRO Administration Nurse Pending Non-Medication Orders: Order Order Date Freauencv Duration Details EKG 07/06/2019 One Time 66 y/o male Fecal Occult Blood 07/06/2019 One Time 3 different stools TB Clearance: Yes Last PPD Date: 07/09/2019 Induration: 0mm Last Chest X-Ray Date: TB Treatment: TB Follow-up Recommended: No Sickle Cell: Sickle Cell Trait/Disease: No Results: Sx free for 30 days: Yes Generated 08/1012019 07:00 by RN Bureau of Prisons - NYM Page 1 of 2 EFTA00048443

Reg #: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD SENSITIVE BUT UNCLASSIFIED — This information is confidential and must be appropriately safeguarded. Limitations/Restrictions/Diets: Cell: lower bunk --- 10/09/2019 Cleared for Food Service: Yes Other diet restrictions: FISH ALLERGIES. --- 07/30/2020 Comments: Allergies No Known Allergies Devices / Equipment C-Pap Travel: Direct Travel: No Travel Restrictions: None UNIVERSAL PRECAUTIONS OBSERVED WHEN TRANSPORTING ANY INMATE: Transfer From Institution: NEW YORK MCC Address 1: 150 PARK ROW Address 2: City/State/Zip: NEW YORK, New York 10007 Name/Title of Person Completing Form: Phone Number: 6468366300 RN Date: 08/10/2019 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 DOB: 01/20/1953 Sex: M Generated 08/10/2019 07:00 by RN Bureau of Prisons - NYM Page 2 of 2 EFTA00048444

Bureau of Prisons Health Services Vitals All Begin Date: 07/06/2019 Reg #: 76318-054 End Date: 05/11/2020 Inmate Name: EPSTEIN, JEFFREY EDWARD Temperature: Date Time Fahrenheit Celsius Location 07/24/2019 13:12 NYM 97.8 36.6 Oral Orig Entered: 07/24/2019 13:14 EST 07/23/2019 06:30 NYM 97.5 36.4 Oral Orig Entered: 07/23/2019 08:33 EST 07/09/2019 12:49 NYM 97.3 36.3 Oral Orig Entered: 07/09/2019 12:51 EST Pulse: Date Time 07/30/2019 13:02 Rate Per Minute Location 94 Orig Entered: 07/30/2019 13:04 EST 07/30/2019 09:40 Orig Entered: 07/30/2019 09:30 Orig Entered: 07/28/2019 20:28 Orig Entered: 07/28/2019 06:57 Orig Entered: 07/24/2019 13:12 Orig Entered: 07/23/2019 06:30 88 Via Machine 07/30/2019 13:04 EST 87 Via Machine 07/30/2019 12:59 EST 81 07/28/2019 20:29 EST 82 07/28/2019 06:58 EST 83 07/24/2019 13:14 EST 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 07/30/2019 09:30 NYM Provider Rhythm Provider MD MD MD RN RN Via Machine Regular Via Machine Regular Via Machine Regular Via Machine Rate Per Minute Provider 12 Orig Entered: 07/30/2019 12:59 EST 07/28/2019 20:28 NYM Orig Entered: 07/28/2019 20:29 EST 07/28/2019 06:57 NYM Orig Entered: 07/28/2019 06:58 EST 07/23/2019 06:30 NYM Orig Entered: 07/23/2019 08:33 EST 07/09/2019 12:49 NYM MD MD 14 RN RN 14 RN 16 16 RN lMD IMD IMO RN RN Generated 05/11/2020 09:57 by Allen. Tamara OGC Bureau of Prisons - DAN Page 1 of 3 EFTA00048445

Begin Date: 07/06/2019 Reg #: 76318.054 End Date: 05/11/2020 Inmate Name: EPSTEIN, JEFFREY EDWARD Data Time Rate Per Minute Provider Orig Entered: 07/09/2019 12:51 EST 07/06/2019 21:43 NYM 15 Orig Entered: 07/06/2019 21:48 EST Blood Pressure: Date Lime Value 07/30/2019 13:02 NYM 114/84 Location Left Arm Orig Entered: 07/30/2019 13:04 EST 07/30/2019 09:40 NYM 125/60 Right Arm Orig Entered: 07/30/2019 13:04 EST 07/30/2019 09:30 NYM 108/86 Left Arm Orig Entered: 07/30/2019 12:59 EST 07/28/2019 20:28 NYM 157/91 Orig Entered: 07/28/2019 20:29 EST 07/28/2019 06:57 NYM 138/80 Orig Entered: 07/28/2019 06:58 EST 07/24/2019 13:12 NYM 132/89 Right Arm Orig Entered: 07/24/2019 13:14 EST 07/23/2019 06:30 NYM 140/85 Right Arm Orig Entered: 07/23/2019 08:33 EST 07/09/2019 12:49 NYM 117/66 Right Arm Orig Entered: 07/09/2019 12:51 EST 07/06/2019 21:45 NYM 164/90 Right Arm Orig Entered: 07/06/2019 21:48 EST 07/06/2019 21:43 NYM 155/83 Left Arm Orig Entered: 07/06/2019 21:48 EST Blood Glucose: Date Time 08/04/2019 08:30 Orig Entered: 08/02/2019 06:30 Orig Entered: 08/01/2019 06:30 Orig Entered: 07/31/2019 06:15 Orig Entered: SaO2: Date 07/30/2019 Value (mg/WI Type Position Standing Standing Sitting Sitting Sitting Sitting Sitting Sitting 156 Non-Fasting 08/04/2019 09:08 EST 97 Non-Fasting 08/02/2019 08:16 EST 103 Non-Fasting 08/01/2019 09:00 EST 108 Non-Fasting 07/31/2019 08:36 EST Time Value(°/O) Air 09:30 NYM 98 Room Air Orig Entered: 07/30/2019 12:59 EST 07/28/2019 20:28 NYM 98 Orig Entered: 07/28/2019 20:29 EST 07/28/2019 06:57 NYM 98 Generated 05/11/2020 09:57 by Allen. Tamara OGC Cuff Size Provider MD MD MD RN RN Adult-regular Adult-regular Adult-regular Adult-regular Adult-regular Regular Insulin Provider RN Provider MD RN Bureau of Prisons - DAN MD RN RN MD MD MD RN RN RN Page 2 of 3 EFTA00048446

Begin Date: 07/06/2019 End Date: 05/11/2020 Reg #: 76318.054 Inmate Name: EPSTEIN, JEFFREY EDWARD Date Time Value(%1 Air Provider Orig Entered: 07/28/2019 06:58 EST RN 07/24/2019 13:12 NYM 96 Room Air Orig Entered: 07/24/2019 13:14 EST • 07/23/2019 06:30 NYM 96 Room Air Orig Entered: 07/23/2019 08:33 EST 07/09/2019 12:49 NYM 97 Room Air Orig Entered: 07/09/2019 12:51 EST 07/06/2019 21:43 NYM 95 Room Air Orig Entered: 07/06/2019 21:48 EST Height: Date Time inches Cm Provider 07/09/2019 12:49 NYM 70.0 177.8 Orig Entered: 07/09/2019 12:51 EST 07/06/2019 21:43 NYM 72.0 182.9 Orig Entered: 07/06/2019 21:48 EST Weight: Date Time uts Kg Waist Circum Provider 07/30/2019 09:30 NYM 194.2 88.1 MD Orig Entered: 07/30/2019 12:59 EST MD 07/09/2019 12:49 NYM 194.4 88.2 Orig Entered: 07/09/2019 12:51 EST 07/06/2019 21:43 NYM 200.0 90.7 Orig Entered: 07/06/2019 21:48 EST Generated 05/11/2020 09:57 by Allen. Tamara OGC Bureau of Prisons - DAN Page 3 of 3 EFTA00048447

Bureau of Prisons Health Services PPDs Reg #: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD Admin: Location 07/06/2019 21:39 Right Forearm Orig Entered: 07/06/2019 21:43 EST Total: 1 Provider Reading; Induration Provider 07/09/2019 12:47 0 mm Orig Entered: 07/09/2019 12:47 EST Generated 05,1112020 09:57 by Allen. Tamara OGC Bureau of Prisons DAN Page 1 of 1 EFTA00048448

76318-054 EPSTEIN. JEFFREY Medication Orders Medication Administration Record JULY 2019 Time 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Ord. Date 07/30/19 1421 Exp. Dale 07/31/19 1001 NY11 122148- NY1A MD Inject regular Insulin subcutaneously per sliding scale: twice daily —pill line*" for 7 days InWill R49 (10 ML) 100 UNITS ML Inj PAN OW. Date 07/31/19 1000 Exp. Date 08O7/19 0959 NM 122160- NYM MD Inject regular insulin subcutaneously per sliding scale: each morning for 7 days —pill line"' 'WWII Deg (10 ML) 100 UNITSML In PAN Providers: YJ - Documentation Codes: ORD = Order I NI = Dose Not Indicated Registration N: 76318-054 Pt. Name: EPSTEIN. JEFFREY DOB: 01/20/53 Report information is current as of the date and time of printing: 05/11/202009:57 EST EFTA00048449

76318-054 EPSTEIN. JEFFREY Medication Administration Record AUGUST 2019 Medication Orders Tune 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Ord. Date MD 07/31/19 1000 Inject regular insulin subcutaneously per Exp. Dale sliding scale: each morning for 7 days "'pill 0807/19 line—• 09$9 NYM 122160- NYM Mites, Reg (10 MI.) 100 UNITS/ML Iry PRN Providers: YJ - Documentation Codes: ORD = Order I NI = Dose Not Indicated Registration N: 76318-054 Pt. Name: EPSTEIN. JEFFREY DOB: 01/20/53 Report information is current as of the date and time of printing: 05/11/2020 09:57 EST EFTA00048450

Bureau of Prisons Health Services Devices and Equipment Stan Date: 07/06/2019 Stop Date: 05/11/2020 Reg #: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD Device/Equipment Stan Date Stop Date Date Returned Obtained From Comments C-Pap 07/30/2019 14:05 EST MD 07/30/2019 Personal PHILIPS RESPIRONICS SYSTEM ONE CPAP MACHINE. SERIAL #: P11312813B1ED. Total: 1 Generated 05/11/2020 09:57 by Allen, Tamara OGC Bureau of Prisons - DAN Page 1 of 1 EFTA00048451

Bureau of Prisons Health Services Pain Management Begin Date: 07/06/2019 End Date: 05/11/2020 Reg #: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD Date Intervention Pain Quality Location Pig Post Provider 07/12,2019 13:25 MEDROL DOSE PACK Shooting Back-Middle 5 MD Orig Entered: 07:12/2019 13:28 EST MD Generated 05111;2020 09:57 by Allen. Tamara OGC Bureau of Prisons DAN Page 1 of 1 EFTA00048452

Bureau of Prisons Health Services Modified Diet Request Types of Diets: Clear Liquid Exp Date: Low Fat Exp Date: Mechanical Soft Exp Date: Low Cholesterol Exp Date: Low Triglyceride Exp Date: Renal Exp Date: Full Liquid Exp Date: Sodium Controlled Exp Date: Snack Exp Date: Diabetic Exp Date: Calorie Controlled Exp Date: X Other: FISH ALLERGIES. Exp Date: 07/30/2020 Comments: MD Health Service Staff EPSTEIN, JEFFREY EDWARD Inmate Name 76318-054 07/30/2019 Reg# Date Generated 07/30/2019 14:57 by MD Bureau of Prisons - NYM Page 1 of 1 EFTA00048453

Bureau of Prisons Health Services Allergies Reg #: 76318-054 Inmate Name: EPSTEIN. JEFFREY EDWARD Alleray Date Noted Reaction No Known Allergies 07/06/2019 Orig Entered: 07/06/2019 21:40 EST Total: 1 Generated 05/11/2020 09:57 by Allen. Tamara OGC Bureau of Prisons - DAN Page 1 of 1 EFTA00048454

Bureau of Prisons Health Services Patient Education Assessments & Topics Reg #: 76318-054 Inmate Name: EPSTEIN. JEFFREY EDWARD Assessments Assessment Learns Best By Primary Language Years of Education Barriers To Education 07/09/2019 Speaking/Listening English 12 None Orig Entered: 07/09/2019 12:52 EST Total: 1 Date Initiated Format NandouVTopic 07/30/2019 Counseling Access to Care Orig Entered: 07/30/2019 13:33 EST 07/30/2019 Counseling Plan of Care Orig Entered: 07/30/2019 13:34 EST 07/28/2019 Counseling Plan of Care Orig Entered: 07/28/2019 07:22 EST 07/28/2019 Counseling Plan of Care Orig Entered: 07/28/2019 20:30 EST 07/24/2019 Counseling Access to Care Orig Entered: 07/24/2019 13:23 EST 07/24/2019 Counseling Preventive Health Orig Entered: 07/24/2019 13:23 EST 07/23/2019 Counseling Access to Care Orig Entered: 07/23/2019 09:04 EST 07/23/2019 Counseling Plan of Care Orig Entered: 07/23/2019 09:04 EST 07/14/2019 Counseling Diagnosis Orig Entered: 07/14/2019 18:11 EST 07/12/2019 Counseling Diagnosis Generated 05/11/2020 09:57 by Allen, Tamara OGC Topics Provider Outcome Provider Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Verbalizes Understanding Bureau of Prisons • DAN Page 1 of 2 EFTA00048455

Reg #: 76318-054 Inmate Name: EPSTEIN. JEFFREY EDWARD Topics Date Initiated Format NandouVTopic Outcome Provider Orig Entered: 07/12/2019 13:33 EST Total: 10 Generated 05,11;2020 09:57 by Allen, Tamara OGC Bureau of Prisons DAN Page 2 of 2 EFTA00048456

Bureau of Prisons Health Services Blood Glucose Begin Date: 07/06/2019 End Date: 05/11/2020 Reg #: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD (Reference Range: Random or Fasting 70 - 100, 2 hour post-prandial 70 - 140) Date lime Value Type 08/04/2019 08:30 NYM 156 Non-Fasting Orig Entered: 08/04/2019 09:08 EST RN 08/02/2019 06:30 NYM 97 Non-Fasting Orig Entered: 08/02/2019 08:16 EST 08/01/2019 06:30 NYM 103 Non-Fasting Orig Entered: 08/01/2019 09:00 EST 07/31/2019 06:15 NYM 108 Non-Fasting Orig Entered: 07/31/2019 08:36 EST Total: 4 Comments Generated 05/11/2020 09:57 by Allen, Tamara OGC Bureau of Prisons • DAN Page 1 of 1 EFTA00048457

Bureau of Prisons Health Services Health Problems Reg #: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD Description SA Code Type Code Diag. Date Status Status Date Current HyperlIpidemia, unspecified 07/12/2019 13:48 EST MD ICD-10 E785 07/12/2019 Current HYPERTRIGLYCERIDEMIA Sleep apnea 07/12/2019 13:56 EST MD ICD-10 G4730 07/12/2019 Current Essential (primary) hypertension 07/30/2019 13:13 EST MD ICD-10 110 07/30/2019 Current BY HX. Constipation, unspecified 07/09/2019 12:58 EST ICD-10 K5900 07/09/2019 Current Low back pain 07/12/2019 13:30 EST MD ICD-10 M545 07/12/2019 Current Neuralgia and neuritis, unspecified 07/12/2019 13:30 EST MD ICD-10 M792 07/12/2019 Current No Diagnosis 07/09/2019 10:28 EST PhD/Chief I DSM-IV No Dx 07/09/2019 Current Psychologist Prediabetes 07/30/2019 13:26 EST MD ICD-10 R7303 07/30/2019 Current Injury, unspecified 07/23/2019 09:04 EST ICD-10 T1490 07/23/2019 Current R/O self inflicted injuries. Body mass index (BMI) 27.0-27.9, adult 07/30/2019 13:14 EST MD 1CD-10 Z6827 07/30/2019 Current Total: 10 Generated 05/11/2020 09:57 by Allen, Tamara OGC Bureau of Prisons • DAN Page 1 of 1 EFTA00048458

Bureau of Prisons Health Services Vision Screens Reg #: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD Vision Screen on 07/09/2019 12:52 Blindness: Distance Vision: OD: 20/100 OS: 20/70 OU: Near Vision: OD: OS: OU: With Corrective Distance Vision: OD: OS: OU: Near Vision: OD: OS: OU: Present Glasses - Distance Refraction - Distance Sphere Cylinder Axis Add Sphere Cylinder Axis Add R: R: L: L: Color Test: Tonometry: R: L: Comments: Needs evaluation with optometrist. Orig Entered: 07/09/2019 12:54 EST Generated 05/11/2020 09:57 by Allen. Tamara OGC Bureau of Prisons - DAN Page 1 of 1 EFTA00048459

Bureau of Prisons Health Services Immunizations Begin Date: 07/06/2019 End Date: 05/11/2020 Reg #: 76318-054 Inmate Name: EPSTEIN, JEFFREY EDWARD Immunization immunization Date Administered Location Dosage Drug Mfg Lot l Exp Date Hepatitis A and B (TwinRx) History Unknown Orig Entered: 07/09/2019 12:51 EST Measles/Mumps/Rubella Series History Unknown Orig Entered: 07/09/2019 12:51 EST Smallpox Series History Unknown Orig Entered: 07/09/2019 12:51 EST Tetanus History Unknown Orig Entered: 07/09/2019 12:51 EST Varicella Series History Unknown Orig Entered: 07/09/2019 12:51 EST Total: 5 Generated 05/11/2020 09:57 by Allen, Tamara OGC Bureau of Prisons • DAN Page 1 of 1 EFTA00048460

Burc i of Prisons Heatth Services Med7cal Duty Status Reg #: 76318-054 in.late Name: EPSTEIN. JEFFREY EDWARD Housing Status confined to the living quarters except _meals pill line _treatments on complete bed rest: _bathroom privileges only X cell: cell on first floor single cell X lower bunk airborne infection isolation other: Physical Limitation/Restriction all sports weightlifting: upper body _lower body cardiovascular exercise: _running _jogging _walking _softball _football _basketball _handball _stationary equipment other: Equipment May have the following equipment In his / her possession: Start Date C-Pap 07/30/249 PHILIPS RESPIRONICS SYSTEM ONE CPAP MACHINE. .%i% SERIAL #: P11312813B1ED. Work Restriction I Cleared for Food Service: Yes X No Restrictions Comments: N/A Beaudouin. Robert MD Health Services Staff Inmate Name: EPSTEIN, JEFFREY EDWARD ALL EXPIRATION DATES ARE AT 24:00 Reg #: 76318-054 Exp. Date: Exp. Date: Exp. Date: Exp. Date: Exp. Date: Exp. Date: Exp. Date: Exp. Date: End Date 07/30/2019 10;09/2019 JIM Return Date Date Quarters: null eze Generated 05/11/2020 09:57 by Allen. Tamara OGC bureau otPneons - DAN Page 1 ell EFTA00048461

Bur )iili of Prisons Heatth Services Med7cai Duty Status Reg #: 76318-054 in.late Name: EPSTEIN. JEFFREY EDWARD Housing Status confined to the living quarters except _meals pill line _ _treatments Exp. Date: _ on complete bed rest: _bathroom privileges only Exp. Date: X cell: cell on first floor single cell X lower bunk airborne infection isolation Exp. Date: 10;09/2019 other: Exp. Date: Physical Limitation/Restriction all sports Exp. Date: _ weightlifting: _upper body _lower body Exp. Date: _ cardiovascular exercise: _running _jogging _walking _softball Exp. Date: _football _basketball _handball _stationary equipment — other: Exp. Date: May have the following equipment in his / her possession: Work Restriction / Limitation: Cleared for Food Service: Yes X No Restrictions Comments: N/A 07/09/2019 Health Services Staff Date Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318.054 Quarters: null < 9: ALL EXPIRATION DATES ARE AT 24:00 SZO . # fp ket ke 45) Q e, Generated 05/11/2020 09:57 by Allen. Tamara OGC bureau otPneons - DAN Page 1 ell EFTA00048462

Bureau of Prisons Health Services Medication Summary Historical Complex: NYM--NEW YORK MCC Inmate: EPSTEIN, JEFFREY EDWARD Begin Date: 07/06/2019 End Date: 05/11/2020 Reg #: 76318-054 Quarter: ???-???? 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: Start: 07/09/19 Exp: 07/19/19 D/C: 07/12/19 Pharmacy Dispensings: 10 TAB in 307 days Docusate Sodium 100 MG Cap Take one capsule (100 MG) by mouth twice daily for 30 days Rx#: 121823-NYM Doctor: MD Start: 07/12/19 Exp: 08/11/19 D/C: 08/10/19 Pharmacy Dispensings: 60 CAP in 304 days Docusate Sodium 100 MG Cap Take one capsule (100 MG) twice daily by mouth with plenty of water Rx#: 122084•NYM Doctor: MD Start: 07/26/19 Exp: 01/22/20 D/C: 08/10/19 Pharmacy Dispensings: 30 CAP in 290 days Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML shake well take 2 tablespoonful twice daily by mouth Rx#: 121835-NYM Doctor: MD Start: 07/12/19 Exp: 07/14/19 Pharmacy Dispensings: 473 ML in 304 days Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML shake well take 10ml by mouth twice daily AS NEEDED Rx#: 122150-NYM Doctor: MD Start: 07/30/19 Exp: 10/28/19 D/C: 08/10/19 Pharmacy Dispensings: 473 ML in 286 days methylPREDNISolone 4 MG Tab [ 21 count Pack) Take the tablet by mouth as directed Rx#: 121836-NYM Doctor: MD Start: 07/12/19 Exp: 07/18/19 Pharmacy Dispensings: 21 tab in 304 days methylPREDNISolone 4 MG Tab [ 21 count Pack) Take the tablet by mouth as directed Rx#: 122149-NYM Doctor: MD Start: 07/30/19 Exp: 08/05/19 Pharmacy Dispensings: 21 tab in 286 days Generated 05/11/2020 09:57 by Allen, Tamara OGC Bureau of Prisons • DAN Page 1 of 2 EFTA00048463

Complex: NYM--NEW YORK MCC Inmate: EPSTEIN, JEFFREY EDWARD Begin Date: 07/06/2019 End Date: 05/11/2020 Reg #: 76318-054 Quarter: ???-???? Active Prescriptions Omega 3 (Vascepa) 1 GM Capsule Take two capsules (2 GM) twice daily by mouth with food Rx#: 121885-NYM Doctor: MD Start: 07/17/19 Exp: 01/13/20 D/C: 08/10/19 Pharmacy Dispensings: 180 Cap in 299 days Insulin Reg (10 ML) 100 UNITS/ML Inj Inject regular insulin subcutaneously per sliding scale: twice daily —*pill line— for 7 days Rx#: 122148-NYM Doctor: MD Start: 07/30/19 Exp: 08/06/19 D/C: 07/31/19 Pharmacy Dispensings: 0 ML in 286 days Insulin Reg (10 ML) 100 UNITS/ML lnj Inject regular insulin subcutaneously per sliding scale: each morning for 7 days "'pill lines" lines" Rx#: 122160-NYM Doctor: MD Start: 07/31/19 Exp: 08/07/19 Pharmacy Dispensings: 0 ML in 285 days Generated 05/11/2020 09:57 by Allen, Tamara OGC Bureau of Prisons • DAN Page 2 of 2 EFTA00048464

Bureau of Prisons Health Services Dental Health History Screen Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M R : WHITE Facility: NYM Encounter Date: 07/26/2019 07:54 Provider: 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 07e26,2019 07:59 by DDS Bureau of Prisons - NYM Page 1 of 3 EFTA00048465

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M R : WHITE Facility: NYM Encounter Date: 07/26/2019 07:54 Provider: 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 DDS Bureau of Prisons - NYM Page 2 of 3 EFTA00048466

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M R : WHITE Facility: NYM Encounter Date: 07/26/2019 07:54 Provider: 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 DDS on 07/26/2019 07:59 Generated 07/262019 07:59 by DDS Bureau of Prisons-NYM Page 3 of 3 EFTA00048467

Bureau of Prisons Health Services Dental A&O Exam Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/26/2019 07:47 Provider: Reg #: 76318-054 Facility: NYM 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 EDWARD by DDS on 07/26/2019 07:47. Generated 07/26/2019 08:00 by DDS Bureau of Prisons - NYM Page 1 of 1 EFTA00048468

Bureau of Prisons Health Services Dental Soap/Admin Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/18/2019 13:48 Provider: 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 Dental Asst on 07/19/2019 13:49. Generated 07/19/2019 13:49 by Dental Bureau of Prisons • NYM Page 1 of 1 EFTA00048469

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 08/08/2019 10:02 Provider: PhD/Chief Reg #: 76318-054 Unit Team: 5 Focus of Session Inmate Epstein was seen today for a follow-up session in SHU. Subjective/Objective Presentation Inmate Epstein stated he is feeling okay and has been eating his meals. He reported his sleep as "fair" and would like to go the general population. He denied any mental health symptoms at this time and denied any feelings of depression and/or anxiety. Inmate Epstein denied any suicidal ideation, intention, or plan. He currently has a cellmate and appears to interact with him. Inmate Epstein continues to spend his days and evening with his attorney's in the attorney conference room. He told this writer he received his PAC number to make phone calls. Inmate Epstein indicated he has only had a couple of phone calls over the speaker phone and wondered "if that counted" as his monthly phone contact. He also reported he his missing some books he was reading in the suicide watch area prior to returning to the SHU. Other than complaints about the prison and concerns regarding his housing, he had no mental health concerns today. He did not appear to be in any distress and the SHU Staff have not reported any unusual behaviors on his part. interventionisi Inmate EPSTEIN was provided with brief supportive 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. There appears to be no need for follow up at this time. He will be seen in weekly rounds and monthly for SHU reviews. Completed by PhD/Chief Psychologist on 08/08/2019 10:09 Generated 08/08/2019 10:09 by PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00048470

Bureau of Prisons Psychology Services Suicide Risk Assessment "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M FaafiNYM Date: 08/01/2019 13:29 Provider: M, 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 R & D staff reported to this writer this morning at about 8:30 AM on 8/01/19 that yesterday when Mr. Epstein was brought back from court the US Marshals asked him to sign a form that noted Mr. Epstein has "suicidal tendencies." Mr. Epstein was seen for a Suicide Risk Assessment at about 1:00 PM on 8/01/19 in Attorney Conference. This note is being entered at about 4:20 PM on 8/01/19. Mental Health History According to a Suicide Risk Assessment dated 7/09/19 by "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 "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 writer's 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." Current Problem R & D staff reported to this writer this morning at about 8:30 AM on 8/01/19 that yesterday when Mr. Epstein was brought back from court the US Marshals asked him to sign a form that noted Mr. Epstein has 'suicidal tendencies." This is likely due to the incident on 7/23/19, but as a precaution another Suicide Risk Assessment was conducted. Mr. Epstein seemed surprised that there was a form noting suicidal tendencies. He denied stating he was suicidal. He said he saw the DHO today and he said his incident report for the marks on his neck was expunged. He stated even though he has his cpap machine now, he said his cellmate talks at night and he stated this keeps him up. This writer offered to talk to the SHU Lt. to have him housed with a different cellmate, but he stated he wants to give it 3 to 4 days to see if he wants a different cellmate. He complained about the noise in SHU. Current Mental Status Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Current Mental Status: He exhibited a neutral mood with a mildly restricted range of affect. His speech was logical and Generated 08/01/2019 16:21 by PsyD Bureau of Prisons - NYM Page 1 of 3 EFTA00048471

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Date: 08/01/2019 13:29 Provider: M, PsyD coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation and he agreed to immediately tell staff if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff if he has these thoughts. RISK AND PROTECTIVE FACTORS ASSESSED• This writer screened the inmate for a variety of empirically validated factors commonly associated with risk for self-harm and suicide. The following STATIC risk factors were assessed to be present and increase the inmate's risk for engaging in suicide related behaviors: High Profile Crime, Lack of family connections. Sex offender status The following DYNAMIC risk factors were assessed to be present and increase the inmate's risk for engaging in suicide related behaviors: Current physical pain, Sleep problems The following PROTECTIVE factors were assessed to be present and may decrease the inmate's risk of suicide:Able to identify reasons to live, Denial of suicidal ideation/intention/plans, Future orientation, Religious beliefs against suicide, Supportive family relationships, View of death as negative, Willingness to engage in treatment Risk Factors: He was found by staff in his cell in SHU on 7/23/19 with a string loosely tied around his neck, which Mr. Epstein stated he did not remember anything about. It is still unclear at this time if Mr. Epstein had placed the string around his own neck or if someone else did. He has a high profile sex offense case. He stated his lower back hurts and he stated Medical is aware of this. He stated he has difficulty sleeping even with his cpap machine because he stated his cellmate talks at night. Reg #: 76318-054 Unit Team: 5 Protective Factors: He denied current suicidal or self harm thoughts and agreed to tell staff if he starts to have these thoughts. He had denied a history of self harm and suicide attempts. He had denied a family history of suicidal and self harm attempts. He had denied having any chronic medical conditions. He denied feeling hopeless. He had denied a history of childhood abuse. He denied fearing for his safety at this time. He denied feeling like a burden to anyone. He stated he lives for and plans to finish this case and to go back to his normal life. He said his friends and Lawyers are emotionally supportive. He said he is Jewish and he said in his religion suicide is against the religion. Overall, his current protective factors override his risk factors for suicidality. He is currently psychologically stable. He denied feeling hopeless. He is reporting positive future plans and reasons to live for. He said he has social supports in the community and his Lawyers visit him often. He denied any current suicidal or self harm ideation, intention or plan. Suicide Watch is not indicated at this time. DIAGNOSIS- No Diagnosis, No Dx - Current CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent RECOMMENDATIONS 1. Suicide Watch is not indicated at this time. 2. Supportive and educative interventions were provided. 3. He was educated about both routine and emergency procedures for contacting Psychology staff. 4. He will be seen in follow up by Psychology next week to monitor his mental status and to provide further intervention if needed. 5. In the meantime, he was encouraged to self-refer to Psychology if needed to which he agreed and seems capable of doing. 6. If he remains in SHU, he will be seen by Psychology in SHU Rounds and in SHU Reviews. Suicide Watch: A suicide watch is not warranted at this time Generated 08/01/2019 16:21 by M, PsyD Bureau of Prisons - NYM Page 2 of 3 EFTA00048472

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M FaliNYM Date: 08 01 2019 13:29 Provider: PsyD Completed by El. PsyD on 08/01/2019 16:21 Reg #: 76318-054 Unit Team: 5 Generated 08/01/2019 16:21 by M, PsyD Bureau of Prisons - NYM Page 3 of 3 EFTA00048473