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: 07/31/2019 10:35 Provider: PsyD/DAPC Reg #: 76318-054 Unit Team: 5 Focus of Session Mr. EPSTEIN was seen today by this writer for a follow up appointment after he was removed from Psychological Observation yesterday. Subjective/Objective Presentation Mr. EPSTEIN presented in a pleasant mood and reported he is generally doing well. He stated, "I could be better," but acknowledged he is doing as well as can be expected given his circumstances. He reported he is going to court today for a status hearing. He stated he generally slept well last night and is readjusting to being placed back in SHU. He reported getting along well with his cell mate. He was informed of appropriate procedures for contacting Psychology staff while he is in SHU, if needed. Current Mental Status: Mr. EPSTEIN was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited a neutral affect with appropriate range. Eye contact and hygiene were appropriate. He spoke with normal rate, tone, and volume. His thoughts were organized and coherent, with no loosening of associations or tangential, circumstantial, or irrelevant content. There was no evidence of perceptual disturbance, delusional ideation, or a formal thought disorder. He did not engage in any bizarre or inappropriate behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN explicitly denied recent and current suicidal ideation, planning, and intent. He was future- oriented and expressed a commitment to life and safety, agreeing to contact staff immediately should he experience suicidal ideation or psychological distress. He also denied thoughts of harming others. Intervention(s) Supportive interventions and cognitive behavioral therapeutic techniques were utilized. Mr. EPSTEIN was receptive to all interventions. Progress/Plan Mr. EPSTEIN was educated about both routine and emergency procedures for contacting psychology. There appears to be no need for follow-up at this time and he expressed willingness to self refer to psychology staff if needed. He will continue to be seen during routine SHU rounds and SHU reviews while he is housed in SHU. He was encouraged to reach out for PRN services should he experience any psychological distress. Completed by PsyD/DAPC on 07/31/2019 10:56 Generated 07/31/2019 10:56 by PsyD/DAPC Bureau of Prisons - NYM Page 1 of 1 EFTA00048474

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/30/2019 12:01 Provider: M Facility: NYM PsyD Reg #: 76318-054 Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation He stated he hasn't slept well at MCC-NY because he hasn't had his cpap machine. He stated it is here and he will be able to start using it tonight. He discussed how he does not think he will able to sleep in SHU and how he does not like SHU because of the noise. He discussed issues on not getting some medication with Medical today. The "Eating/Shower Chart" indicated yesterday he ate breakfast and dinner, drank liquids, and took a shower when offered and so far today it noted he ate breakfast and drank liquids. The Psych Observation Log noted he slept, drank water, went to legal, and talked to an Inmate Companion about investments. Current Mental Status: He exhibited a neutral mood with a full range of affect. His speech was logical and coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. There was no indication of disturbed thought process or content. Intellectual ability appeared to be above average. Personal hygiene was adequate. He denied current suicidal or self harm ideation and he agreed to immediately tell staff if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff if he has these thoughts. Intervention(s) Supportive and educative interventions were provided. When asked about the Turning Point handouts for coping in SHU, he stated he already knows these strategies before he read the handouts and had tried them when he was in SHU the last time. He stated with the noise in SHU, he said the strategies will not work. He was encouraged to try them. Progress/Plan The Chief Psychologist was consulted. Psych Observation will be discontinued. Mr. Epstein was educated about both routine and emergency procedures for contacting Psychology staff. He will be seen in follow up by Psychology tomorrow to monitor his mental status and to provide further intervention if needed and he was informed that he will be seen by Psychology tomorrow. In the meantime, he was encouraged to self-refer to Psychology if needed to which he agreed and seems capable of doing. If he remains in SHU, he will be seen by Psychology in SHU Rounds and in SHU Reviews. The SHU Lt. was informed that Mr. Epstein needs to be housed with an appropriate cellmate. Completed by MI, PsyD on 07/30/2019 13:54 Generated 07/30/2019 13:54 by PsyD Bureau of Prisons - NYM Page 1 of 1 EFTA00048475

Bureau of Prisons **SENSITIVE BUT UNCLASSIFIED" Psychology Services Institution Disciplinary Process Report Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/30/2019 12:01 Provider: M Facility: NYM PsyD Reg #: 76318-054 Unit Team: 5 Reason for Referral and Identifying Information Inmate Epstein was referred by Unit Manager Proto for an evaluation of competency to proceed with the disciplinary process for actions resulting in an incident report. On 7/23/19, inmate Epstein was charged with code 228 (Tattooing or Self-Mutilation). These infractions were assigned incident report number 3282555. Background Information According to a Suicide Risk Assessment dated 7/09/19 by "Inmate Epstein denied any history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also denied any acute mental health symptoms at this time." According to a Suicide Risk Assessment dated 7/09/19 by "Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behavior in the past." According to this writers Suicide Risk Assessment dated 7/23/19, "It is unclear at this time if he had placed the string around his neck or if someone else did." Clinical Interview and Mental Status Exam Inmate Epstein still does not remember how he obtained the marks around his neck. Current Mental Status: He exhibited a neutral mood with a full range of affect. His speech was logical and coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. There was no indication of disturbed thought process or content. Intellectual ability appeared to be above average. Personal hygiene was adequate. He denied current suicidal or self harm ideation and he agreed to immediately tell staff if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff if he has these thoughts. Clinical Impression According to his last Diagnostic and Care Level Formulation Note dated 7/09/19 by , "No Diagnosis, No Dx - Current." Findings The determination of whether an inmate is competent to proceed with the disciplinary process is based on a clinical assessment of the inmate's (1) ability to understand the nature of the proceedings, and (2) their ability to assist in their own defense. Depending on the outcome of the assessment, one of three findings can be made: (1) the inmate is COMPETENT to proceed with the disciplinary process; (2) the inmate is NOT PRESENTLY COMPETENT but could be restored to competence with treatment; or (3) the inmate is NOT COMPETENT and is unlikely to become competent. Recommendations Regarding Sanctions In the case of inmate Epstein, after a review of available psychological and psychiatric records as well as information pertaining to the offense conduct, it is determined that this inmate is: (X) COMPETENT to proceed with the disciplinary process. ( ) NOT PRESENTLY COMPETENT, but could become competent with treatment: it is recommended that the inmate for an updated competency assessment in 30 days. ( ) NOT COMPETENT and not likely to become competent. Generated 0713012019 12:33 by PsyD Bureau of Prisons - NYM Page 1 of 2 EFTA00048476

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/30/2019 12:01 Provider: M Facility: NYM PsyD Reg #: 76318-054 Unit Team: 5 Completed by MI, PsyD on 07/30/2019 12:33 Generated 07 30 2019 12'.33 by PsyD Bureau of Prisons NYM Page 2 of 2 EFTA00048477

Bureau of Prisons Psychology Services General Administrative Note "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/30/2019 12:01 Provider: M Facility: NYM PsyD Reg #: 76318-054 Unit Team: 5 Comments Psych Observation Discontinuation Note: Please see "Clinical Contact" dated today. Completed by-, PsyD on 07/30/2019 12:33 Generated 07/30/2019 12:33 by PsyD Bureau of Prisons - NYM Page 1 of 1 EFTA00048478

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: 07/29/2019 10:01 Provider: PhD/Chief Reg #: 76318-054 Unit Team: 5 Focus of Session Inmate Epstein was seen while on psychological observation today in the hospital area. Subjective/Objective Presentation Same presentation today, but he said he thinks his memory for the incident (injury to his neck) may be impaired because of his sleep apnea. He is supposed to get his CPAP machine today. He is aware he will be returning to SHU, but said he is feeling unwell due to his inability to sleep and numbness in his arm. He requested to have one good night of sleep with his CPAP and will return to SHU with a cellmate tomorrow. He then asked if he could remain down here where it is "safe" for the entire week. I told him he can stay down one more night to receive his CPAP and a good nights sleep, but that he would be returned to SHU tomorrow. It was explained that there is no mental health issues precluding him from returning to SHU tomorrow and that we could not house him in the SW/Hospital area because he felt safe or more comfortable for him. It was explained to him that he would be placed in a safe situation in the SHU. According to his log book and eating/shower chart, he has been eating and drinking when not in his legal visits. He has also been writing and attending his legal visits. Intervention(51 Inmate EPSTEIN was provided with brief supportive interventions and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was somewhat receptive to these interventions, but appears more concerned about getting his various needs in the prison (phone calls, recreation, housing placement concerns, etc.) Progress/Plan He will remain on psychological observation today and will transition to the SHU tomorrow. He will be seen by psychology daily to assess his mental status and psychological functioning. Completed by PhD/Chief Psychologist on 07/29/2019 10:26 Generated 07/29/2019 10:26 by PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00048479

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/28/2019 08:33 Provider: M Facility: NYM PsyD Reg #: 76318-054 Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation The "Eating/Shower Chart" noted that yesterday he ate breakfast. He is not in the Psych Observation cell for about 12 hours per day because of being in Attorney Conference with his Attorneys, so the "Eating/Shower Chart" may not reflect all of his meals. He stated he was served one meal in Attorney Conference yesterday. He stated he drinks a lot water at night. The Psych Observation log noted he talked about life in general population and he slept. Earlier he had complained that his right arm was numb and hanging. Nurse from Medical had seen him for this. When this writer was interviewing him, he said his right arm still feels somewhat numb and he said he cannot make a fist with that hand. He also said he has numbness on his neck. This writer notified Nurse He stated last night when he flushed the toilet it kept flushing for 45 minutes. He stated he found it so aversive and upsetting that he said he sat in the corner and held his ears. He said because of this he was agitated for hours and was not able to sleep. The Lt. will be moving him to a different cell and he was informed of this. He stated the feeling he got with the noise of the toilet was similar to when he was in SHU. He said he may have something on the Autism spectrum. He said in the movie "Rain Man," the person with Autism had an aversion to noise. He stated he is also really good with numbers. Current Mental Status: He exhibited a mildly anxious mood with a full range of affect. His speech was logical and coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation and he agreed to immediately tell staff and Inmate Companions if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff and Inmate Companions if he has these thoughts. Intervention(s) Supportive and educative interventions were again provided. He had not been given the Turning Point handouts yesterday that were on his cell door, so they were handed to him by staff today. Progress/Plan He will remain on Psych Observation in an abundance of caution and pending housing arrangements to be made on Monday. While on Psych Observation, he will be seen daily by Psychology. Completed by MI, PsyD on 07/28/2019 09:24 Generated 07/28/2019 09:24 by PsyD Bureau of Prisons - NYM Page 1 of 1 EFTA00048480

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/27/2019 07:14 Provider: M Facility: NYM PsyD Reg #: 76318-054 Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation The "Eating/Shower Chart' indicated yesterday he ate dinner, drank liquids, and took a shower when offered. The Psych Observation Log noted he brushed his teeth, went to a Legal visit, talked about business and investing to an Inmate Companion, ate, and slept. When interviewed, he stated he still cannot remember what happened in SHU that caused the marks on his neck. He stated that for the 5 days before that he had only slept about 30 minutes each night because of noise in SHU. He stated he is anxious about going back to SHU because he stated he is going back to a place where he had gotten marks on his neck and he does not know why it happened. He said he has an appetite and is eating. He said he is waking up every 1 1/2 hours. He stated he feels dehydrated because he is not drinking enough water because he stated he feels he is not given enough bathroom breaks while with his Attorney. Medical was e-mailed with his complaint of feeling dehydrated. He said his Lawyers and friends are all emotionally supportive. Current Mental Status: He exhibited a neutral mood with a full range of affect. His speech was logical and coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation. He stated "I'm a coward." He added he does not like pain and even does not like when he has to give blood. He agreed to immediately tell staff and Inmate Companions if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff and Inmate Companions if he has these thoughts. Interventionist Supportive and educative interventions were provided. Turning Points handouts on stress management, sleep, and building a routine in SHU were placed on his cell door to be given to him when his food slot is opened. He stated he wants it noted in his chart that he is being given a pamphlet on sleep, but that is not going to help because of the noise in SHU that prevents him from sleeping. Progress/Plan He will remain on Psych Observation in an abundance of caution and pending housing arrangements to be made on Monday. While on Psych Observation, he will be seen daily by Psychology. Completed by MI, PsyD on 07/28/2019 09:19 Generated 07/28/2019 09:19 by PsyD Bureau of Prisons - NYM Page 1 of 1 EFTA00048481

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/27/2019 07:14 Provider: M Facility: NYM PsyD Reg #: 76318-054 Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation The "Eating/Shower Chart" indicated yesterday he ate dinner, drank liquids, and took a shower when offered. The Psych Observation Log noted he brushed his teeth, went to a Legal visit, talked about business and investing to an Inmate Companion, ate, an When interviewed, he st stated that for the 5 days b he is anxious about going bac neck and he does not know why II cannot remember what happened in SHU that caused the marks on his neck. He e had only slept about 30 minutes each night because of noise in SHU. He stated ecause he stated he is going back to a place where he had gotten marks on his He said he has an appetite and is eat7R,f He said is waking up every 1 1/2 hours. He stated he feels dehydrated because he is not drinking enough water tated he feels he is not given enough bathroom breaks while with his Attorney. Medical was e-mailed with his f feeling dehydrated. He said his Lawyers and friends are all emotionally supportive. Current Mental Status: He exhibited a neutral mood ly full range of affect. His speech was logical and coherent, with no loosening of associations or tangential ntial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation. He stated " ." He added he does not like pain and even does not like when he has to give blood. He agreed to immedia t aft and Inmate Companions if he starts to have suicidal or self harm thoughts. He was future oriented. He do o be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff and lnmat s if he has these thoughts. Interventionist Supportive and educative interventions were provided. He was given TurninrP douts on stress management, sleep, and building a routine in SHU. He stated he wants it noted in his chart th given a pamphlet on sleep, but that is not going to help because of the noise in SHU that prevents him f r1 n9 Progress/Plan He will remain on Psych Observation in an abundance of caution and pending housing arr be made on Monday. While on Psych Observation, he will be seen daily by Psychology. Completed by-, PsyD on 07/27/2019 08:16 Generated 07/27/2019 08:16 by PsyD Bureau of Prisons - NYM Page 1 of 1 EFTA00048482

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Clinical Intervention - Clinical Contact Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/27/2019 07:14 Provider: M Facility: NYM PsyD Reg #: 76318-054 Unit Team: 5 Focus of Session He was seen by writer while he was on Psych Observation. Subjective/Objective Presentation The "Eating/Shower Chart" indicated yesterday he ate dinner, drank liquids, and took a shower when offered. The Psych Observation Log noted he brushed his teeth, went to a Legal visit, talked about business and investing to an Inmate Companion, ate, an When interviewed, he st stated that for the 5 days b he is anxious about going bac neck and he does not know why II cannot remember what happened in SHU that caused the marks on his neck. He e had only slept about 30 minutes each night because of noise in SHU. He stated ecause he stated he is going back to a place where he had gotten marks on his He said he has an appetite and is eat7R,f He said is waking up every 1 1/2 hours. He stated he feels dehydrated because he is not drinking enough water tated he feels he is not given enough bathroom breaks while with his Attorney. Medical was e-mailed with his f feeling dehydrated. He said his Lawyers and friends are all emotionally supportive. Current Mental Status: He exhibited a neutral mood ly full range of affect. His speech was logical and coherent, with no loosening of associations or tangential ntial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation. He stated " ." He added he does not like pain and even does not like when he has to give blood. He agreed to immedia t aft and Inmate Companions if he starts to have suicidal or self harm thoughts. He was future oriented. He do o be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff and lnmat s if he has these thoughts. Interventionist Supportive and educative interventions were provided. He was given TurninrP douts on stress management, sleep, and building a routine in SHU. He stated he wants it noted in his chart th given a pamphlet on sleep, but that is not going to help because of the noise in SHU that prevents him f r1 n9 Progress/Plan He will remain on Psych Observation in an abundance of caution and pending housing arr be made on Monday. While on Psych Observation, he will be seen daily by Psychology. Completed by-, PsyD on 07/27/2019 08:16 Generated 07/27/2019 08:16 by PsyD Bureau of Prisons - NYM Page 1 of 1 EFTA00048483

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: 07/27/2019 07:14 Facility: NYM Amendment made to this note by PsyD on 07 28 2019 09:19. Bureau of Prisons - NYM EFTA00048484

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: 07/26/2019 09:09 Provider: PhD/Chief Reg #: 76318-054 Unit Team: 5 Focus of Session Inmate Epstein was seen while on psychological observation in our hospital area. Subjective/Objective Presentation Prior to this writer's contact with him, Inmate Epstein showered and dressed himself for his legal visit today. He was smiling and did crack some jokes during the interview. He did elucidate some complaints and suggested being disappointed with this writer as he wants "to trust me and for me to trust him." He stated he remains unhappy with legal visiting procedures as he cannot go to the bathroom as frequently as he would like to since he has a "weak bladder." Inmate Epstein also reported since coming to the psychological observation area, he has felt constipated and needs his Colace. He had self-carry Colace in SHU, but since coming to the observation area, he has not had his medication. This writer immediately notified medical and his pills were being processed during the interview. Inmate Epstein also continues to complain about the conditions of SHU confinement (i.e., feeling punished, smells, noise, and restrictions). With regard to the events which lead to his initial placement on suicide watch, inmate Epstein stated he has no memory of the event. He asked to speak with his old cellmate "Nick" to see if he can tell him what happened or see if his memory could be triggered. He remarked, "I am still trying to figure out how I got this (pointing to the scab around his neck)." Inmate Epstein denies remembering harming himself and/or being harmed by his cellmate. He does not exhibit symptoms of any cognitive disorder, seizure disorder, psychotic disorder, or dissociative disorder at this time or in the past. Inmate Epstein denied any current suicidal ideation, intention, or plan. He reported wanting to be alive to fight his legal case and go back and live life. He referred to himself as "a coward" and "I'm Jewish." He said he is not the type who likes pain or would ever attempt to harm himself. While on psychological observation, inmate Epstein has been eating his meals, sleeping and interacting with the inmate companions. He is in legal visiting the majority of the day and in the evenings. His log book and eating/shower chart reflect the same. He has been speaking to inmate companions about investment strategies and about prison adjustment. Correctional Staff report during his legal visits, he is interacting with his attorney, animated, laughing, and joking. Intervention(s) Inmate Epstein was provided with supportive and coping skills interventions today. He was receptive to them, but mostly wanted to express his complaints about his current prison confinement status and needs. He wanted this writer to address them. Progress/Plan Inmate Epstein will remain on psychological observation in an abundance of caution and pending housing arrangements to be made on Monday. He continues to be vague and reports memory deficits regarding the events which lead to a piece of sheet being placed loosely around his neck and marks with scabs around his neck. Completed by PhD/Chief Psychologist on 07/26/2019 10:05 Generated 07/26/2019 10:05 by PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00048485

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: 07/25/2019 10:14 Provider: PhD/Chief Reg #: 76318-054 Unit Team: 5 Focus of Session Inmate Epstein was seen by this writer this morning while on psychological observation in the hospital area of the prison. Subjective/Objective Presentation Inmate Epstein was in good spirits today and engaged in reciprocal conversation with this writer this morning. He smiled and remarked, "welcome back" when this writer arrived. He continues to assert he does not remember how he received marks around his neck, remarking "I do not remember anything, maybe you can give me some cues." He stated he just remembers going for a drink of water and the next thing he knew he woke up to the sound of his own snoring. When this writer attempted to get a more detailed account from him, indicating that it would be rare to have such impairments in memory as he does not suffer from an acute cognitive disorder, he smiled and said he understood my position. Inmate Epstein did reveal he is unhappy with his current confinement in Special Housing (SHU) as he considers it "a punishment cell? He said he finds the restrictions up there unfair as he has not done anything wrong. Inmate Epstein stated he feels it is dangerous in the SHU, he cannot sleep well up there due to noise from the other inmates, it smells, and it is difficult for him to work on his legal case up there. He stated he has not received the phone calls he was promised nor has he been able to receive recreation. It was explained to him that he spends the entire day in the attorney conference room and it is likely that he has missed the times when staff members have attempted to give him phone calls and recreation. Inmate Epstein also reported complaints about the attorney conference room, stating they do not take him to the bathroom frequently enough. Inmate Epstein adamantly denied any suicidality at this time, stating "I am too vested in my case to fight it, I have a life and I want to go back to living my life." He denied any acute symptoms at this time. According to his log book, he has been eating, drinking, sleeping, and interacting with the inmate companions. He has also been attending his daily legal visits. Intervention(s) Inmate EPSTEIN was provided with brief supportive interventions and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was mostly receptive to these interventions. He requested to be housed in general population rather than the SHU and stated he wanted to remain on psychological observation due to his concerns with being in the SHU. Progress/Plan In an abundance of caution, inmate Epstein will remain on psychological observation. He has yet to give an account of how he sustained the marks around his neck, is not revealing much about his mental status, and there are concerns about his adjustment at this time to being housed in the SHU. Inmate Epstein will be seen daily by psychology while on psychological observation. Completed by PhD/Chief Psychologist on 07/25/2019 10:43 Generated 07/25/2019 10:43 by PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00048486

Bureau of Prisons Psychology Services Post Suicide Watch Report "SENSITIVE BUT UNCLASSIFIED— Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: 5 Date: 07/24/2019 09:23 Provider: Ph.D. Watch Start Date: 07/23/2019 01:40 Total Time on Watch: 31 hrs 5 minutes Watch Conducted By: Both inmates and staff Current Mental Status Watch Stop Date: 07/24/2019 08:45 Transfered to Medical Center: No Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Current Mental Status: Mr. EPSTEIN was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited a neutral affect with appropriate range. Eye contact and hygiene were appropriate. The inmate spoke with normal rate, tone, and volume. His thoughts were organized and coherent, with no loosening of associations or tangential, circumstantial, or irrelevant content. There was no evidence of perceptual disturbance, delusional ideation, or a formal thought disorder. He did not engage in any bizarre or inappropriate behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN explicitly denied recent and current suicidal ideation, planning, and intent. He was future-oriented and expressed a commitment to life and safety, agreeing to contact staff immediately should he experience suicidal ideation or psychological distress. He also denied thoughts of harming others. Risk Factors Assessed. This writer screened the inmate for a variety of empirically validated factors commonly associated with risk for self harm. The following STATIC risk factors were assessed to be present and increase the inmate's risk for engaging in suicide related behaviors: High Profile Crime, Lack of family connections, Sex offender status The following DYNAMIC risk factors were assessed to be present and increase the inmate's risk for engaging in suicide related behaviors: Current physical pain, Fear for own safety The following PROTECTIVE factors were assessed to be present and may decrease the inmate's risk of suicide:Able to identify reasons to live, Adequate problem solving skills, Denial of suicidal ideation/intention/plans, Future orientation, View of death as negative, Willingness to engage in treatment Risk Factors: Mr. EPSTEIN has a significant scar around his neck, which is now scabbing over. He reported swelling in this area but denied experiencing any related pain. Mr. EPSTEIN continues to claim a lack of memory for the incident resulting in this scar. The story he provided was vague, such that this writer challenged him a couple of times, but he insisted he was being honest about his lapse in memory. The nature of the incident remain unclear. Mr. EPSTEIN is incarcerated for a very high profile crime with media attention. He was recently denied bail. He also reported difficulty managing his time in the SHU. He reported being fearful for his safety if he is to return to the cell with his previous cell mate. Protective Factors: Mr. EPSTEIN adamantly denied current suicidal ideation or intent or a history of suicide attempts. He stated, "I have no interest in killing myself? He explained, although his situation is "not perfect" due to his being incarcerated, he noted he has "lots to do for [his) legal case: He described having a "wonderful life," to include interactions with "interesting people and projects." He said "it would be crazy" to take his life. He furthered, "I would not do that to myself." He denied feelings of hopelessness, although did report being "depressed" and "unhappy" about his current legal situation. He previously denied a history of childhood abuse. He reported he is sleeping adequately now that he is no longer in the SHU. He appear future-oriented as he endorsed an interest in being housed in general population. Weighing of Risk and Protective Factors: Mr. EPSTEIN adamantly denied sucidality. However, in light of his vague self-report regarding the incident which precipitated his placement on Suicide Watch, combined with his fear for his own safety, reported Generated 07/24/2019 12:09 by Ph.D. Bureau of Prisons • NYM Page 1 of 3 EFTA00048487

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: 5 Date: 07/24/2019 09:23 Provider: Ph.D. difficulty managing his time in the SHU, and the high profile nature of his alleged offense, Mr. EPSTEIN will be stepped down from Suicide Watch to Psychological Observation. Changes in Risk Factors Assessed Upon a review of the log book, it was indicated Mr. EPSTEIN has been speaking to the inmate companions about having previously taught mathematics and physics. He has been observed pacing the cell as well as sleeping, eating. and drinking within normal limits. Upon interview today, Mr. EPSTEIN requested he be provided a toothbrush as well as a shower. His requests were made known to the lieutenants and he was provided a shower prior to attending his legal visit. This writer also provided him a toothbrush, toothpaste, and hygiene products. Asked about the alleged incident which transpired yesterday resulting in his placement on Suicide Watch, Mr. EPSTEIN said he is frustrated he has been placed in a "punishment cell for no reason." Specifically, Mr. EPSTEIN was referring to his placement in the SHU. Asked to recall the events surrounding the alleged incident, Mr. EPSTEIN said his cell mate was "playing with a bed sheet" and he claimed he does not recall the events thereafter. He said he recalled eating meat and drinking water and claimed the next event for which he has memory is his hearing himself snore and waking up on a stretcher. Mr. EPSTEIN claimed he does not recall himself or his cell mate tying a string or rope around his neck. He said he has "been trying to remember" and "wracking his mind." Asked if he experienced any interpersonal issues with his cell mate, Mr. EPSTEIN described his cell mate as "agitated" and claimed his cell mate called him a "pedophile" for the first time yesterday. His cell mate was also reportedly reading a newspaper article about Mr. EPSTEIN, which bothered him and it was something he believed to be "strange" for their to be an article about him in his cell. Mr. EPSTEIN recalled throwing away the newspaper photograph of himself by crumpling it and flushing it down the toilet. Asked if his cell mate ever threatened to harm him, he denied this to be the case. Asked why he told the inmate companions yesterday his cell mate tried to kill him, while also claiming no memory of the incident, Mr. EPSTEIN again said he did not recall the incident and further stated, "I don't know if he put it there as a joke." Mr. EPSTEIN explained he had been experiencing difficulty sleeping in his SHU cell due to his inmate peers banging on the cell door and window, but has not been experiencing any other acute issues other than this. Reason for Removal from Watch Mr. EPSTEIN stated, "I have no interest in killing myself." He explained although his situation is "not perfect" due to his being incarcerated, he noted he has "lots to do for [his] legal case." He described having a "wonderful life," to include interactions with "interesting people and projects." He said "it would be crazy" to take his life. He furthered, "I would not do that to myself." Mr. EPSTEIN did express a feeling of safety being housed on Psychological Observation rather than in the SHU. He asked if he could remain on this status for a couple of days, he was advised his housing situation will be re-evaluated on a day-to-day basis. He expressed a desire to be housed in general population rather than in the SHU and asked if there were a "safer" unit for him to be housed in comparison to the one where he was initially placed. Mr. EPSTEIN claimed there were many MS-13 gang members on the initial unit. He was advised he will be maintained on Psychological Observation in the near future, but his long-term housing situation will be revisited, as it is not ideal for one to remain in isolation on Psychological Observation for extended periods of time. Mr. EPSTEIN acknowledged this information and thanked this writer for her explanation and time. Diagnosis• No Diagnosis, No Dx - Current Conclusions The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent Recommendations 1. Mr. EPSTEIN will be removed from Suicide Watch and stepped down to Psychological Observation. 2. While on Psychological Observation, he will be continuously observed by Inmate Companions. 3. While on Psychological Observation, he will be seen daily by Psychology. 4. Supportive and educative interventions were provided. 5. Mr. EPSTEIN was provided novels and a request was made for his legal paperwork to be provided to him on Psychological Generated 07/24/2019 12:09 by Ph.D. Bureau of Prisons • NYM Page 2 of 3 EFTA00048488

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facility: NYM Unit Team: 5 Date: 07/24/2019 09:23 Provider: Ph.D. Observation. 6. This writer contacted the Pharmacy to indicate Mr. EPSTEIN has not been receiving his medication used to alleviate his constipation. 7. Mr. EPSTEIN attended a legal visit today, after having been provided a shower. 8. Mr. EPSTEIN was educated about both routine and emergency procedures for contacting psychology. 9. The inmate was encouraged to reach out for PRN services should he experience any psychological distress. Completed by Ph.D. on 07/24/2019 12:09 Generated 07/24/2019 12:09 by Ph.D. Bureau of Prisons • NYM Page 3 of 3 EFTA00048489

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: 07/23/2019 10:09 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 The On Call Psychologist, had been contacted by the Operations Lt. at about 2 AM on 7/23/19 to inform her that Mr. Epstein was being placed on Suicide Watch because he was found with a string around his neck. Mr. Epstein was seen by this writer for a Suicide Risk Assessment at about 9:10 AM on 7/23/19. This note is being entered at about 3:35 PM on 7/23/19. Mental Health History According to a Suicide Risk Assessment dated 7/09/19 by "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." Substance Abuse History According to a Suicide Risk Assessment dated 7/09/19 by "Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol." Current Problem Earlier this morning Mr. Epstein was found by SHU staff in his cell with a string loosely tied around his neck. It is unclear at this time if Mr. Epstein had placed the string around his own neck. When Mr. Epstein was asked by this writer how he ended up on Suicide Watch, he denied remembering. He stated he got a drink of water last night in his cell and went back to bed. He said the next thing he remembered is hearing himself snore. He said he wants to know why he is on Suicide Watch. He was informed that staff stated he was found in his cell with a string on his neck. According to Medical records, he had been seen by Medical for this and had a rule out of self inflicted injuries. When this writer reviewed the Staff Suicide Watch Log, it noted that Mr. Epstein told the staff watching him that his cellmate tried to kill him, which Mr. Epstein did not tell this writer when this writer had interviewed Mr. Epstein. This writer was not able to ask Mr. Epstein about this, since Mr. Epstein was now in Legal. The Captain was notified about this notation and the Captain stated they were already aware of this statement. Current Mental Status Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Generated 07/23/2019 15:38 by M, PsyD Bureau of Prisons - NYM Page 1 of 3 EFTA00048490

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Date: 07/23/2019 10:09 Provider: M, PsyD Thought Process: Goal Directed Thought Content: Normal Current Mental Status: He exhibited a neutral mood with a full range of affect. His speech was logical and coherent, with no loosening of associations or tangential, circumstantial or irrelevant speech. Auditory and visual hallucinations were denied, and delusions were not elicited. He did not engage in any bizarre or inappropriate behavior. He denied current suicidal or self harm ideation and he agreed to immediately tell staff if he starts to have suicidal or self harm thoughts. He was future oriented. He does not appear to be an immediate danger to self. He denied thoughts of hurting others and he agreed to tell staff if he has these thoughts. RISK AND PROTECTIVE FACTORS ASSESSED• This writer screened the inmate for a variety of empirically validated factors commonly associated with risk for self-harm and suicide. The following STATIC risk factors were assessed to be present and increase the inmate's risk for engaging in suicide related behaviors: High Profile Crime, Lack of family connections, Sex offender status The following DYNAMIC risk factors were assessed to be present and increase the inmate's risk for engaging in suicide related behaviors: Current physical pain The following PROTECTIVE factors were assessed to be present and may decrease the inmate's risk of suicide:Able to identify reasons to live, Adequate problem solving skills, Denial of suicidal ideation/intention/plans, Future orientation, View of death as negative, Willingness to engage in treatment Risk Factors: He was found by staff in his cell in SHU with a string loosely tied around his neck, which Mr. Epstein stated he did not remember anything about. It is unclear at this time if Mr. Epstein had placed the string around his own neck or if someone else did. According to Medical, he had a circular line around the base of his neck, which he denied knowing how he obtained. He stated his throat hurts which was reported to Medical. He has a high profile sex offense case and recently was denied bail. When asked if he has any friends or family that are emotionally supportive, he stated he does not know what that means. When emotional supports were explained to him and then again asked if he as any family or friends that are emotionally supportive, he was vague and said he has a lot of people. Reg #: 76318-054 Unit Team: 5 Protective Factors: He denied current suicidal or self harm thoughts or ever having these thoughts. He denied a history of self harm and suicide attempts. He denied a family history of suicidal and self harm attempts. He denied having any chronic medical conditions. He denied feeling hopeless. He denied a history of childhood abuse. He denied fearing for his safety. He denied feeling like a burden to anyone. He reported he is sleeping adequately. He stated he lives to have fun, to enjoy life, and to learn. He said his future plans include fighting his case and going back to his normal life. Whereas, he is denying suicidal and self harm thoughts and has a lot of protective factors, he is denying that he remembers how he ended up on Suicide Watch and has marks encircling his neck. It is unclear at this time if he had placed the string around his neck or if someone else did. He will remain on Suicide Watch for further observation and safekeeping. DIAGNOSIS; No Diagnosis, No Dx - Current CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Moderate Overall Chronic Suicide Risk for this Inmate is: Absent RECOMMENDATIONS 1. Mr. Epstein will remain on Suicide Watch for further observation and safekeeping. 2. While on Suicide Watch, he will be continuously observed by Inmate Companions. 3. While on Suicide Watch, he will be seen daily by Psychology. 4. Supportive and educative interventions were provided. 5. Medical was informed that he reported his throat hurts. Suicide Watch: A suicide watch was initiated by non-clinical staff and continues to be warranted Suicide Watch was initiated on: 07/23/2019 01:40 Generated 07/23/2019 15:38 by MI, PsyD Bureau of Prisons - NYM Page 2 of 3 EFTA00048491

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M FaliNYM Date: 07 232019 10:09 Provider: PsyD Completed by El. PsyD on 07/23/2019 15:38 Reg #: 76318-054 Unit Team: 5 Generated 07/23/2019 15:38 by M, PsyD Bureau of Prisons - NYM Page 3 of 3 EFTA00048492

Bureau of Prisons Psychology Services General Administrative Note "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/23/2019 07:56 Provider: PhD/Chief Reg #: 76318-054 Unit Team: 5 Comments This On-Call Psychologist was contacted by the Operations Lt. at about 2 AM on 7/23/19 to inform Mr. Epstein was being placed on Suicide Watch because he was found with a string loosely hanging around his neck. Mr. Epstein will be seen today by the duty psychologist for a Suicide Risk Assessment. Completed by PhD/Chief Psychologist on 07/24/2019 07:59 Generated 07/24/2019 07:59 by PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00048493

Bureau of Prisons Psychology Services SHU Review "SENSITIVE BUT UNCLASSIFIED— Inmate Name: Date of Birth: Date: EPSTEIN, JEFFREY EDWARD 01/20/1953 Sex: M 07/18/2019 07:21 Provider: Facility NYM PhD/Chief Reg #: 76318-054 Unit Team: A&O Placed in SHU: Status: Basis of Review: Mental Status: 07/10/2019 ADMIN.DETENTION Inmate was interviewed No significant mental health issues. Type: Threat to Self: Adjustment: Threat to Others: SHU Low Satisfactory, segregation not detrimental Low Comments Monthly SHU Review Note Inmate Epstein was meeting with his legal team today and has a court hearing. He was not able to be seen for a SHU review. Another attempt to interview him for a SHU review will be done in the near future. Completed by PhD/Chief Psychologist on 07/18/2019 12:06 Generated 07/1812019 12:06 by PhD/Chief Bureau of Prisons NYM Page 1 of 1 EFTA00048494

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: 07/16/2019 12:48 Provider: PhD/Chief Reg #: 76318-054 Unit Team: A&O Focus of Session Inmate Epstein called for this writer in attorney conference today. The officer in attorney conference notified this writer that he was asking to be seen. Subjective/objective Presentation Inmate Epstein reported he has not received a spoon or soap in SHU, nor did he receive the phone calls that were "promised to him: He told this writer we need to have mutual trust that his needs are met in the prison. This writer told inmate Epstein that she would address his concerns. On the way out, a staff member told this writer she witnessed inmate Epstein receive two phone calls from the Lt. Nonetheless, this writer informed the SHU lieutenant of his concerns and he said he would ensure that he had soap, a spoon, and his initial SHU phone call. Inmate Epstein did not have any psychological concerns today. He denied any mental health symptoms or suicidality. He has been eating as best as he can and has requested a Kosher diet. tntervention(s) Inmate EPSTEIN was provided with brief supportive and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was receptive to these interventions. He continued with his legal visit. Progress/Plan Inmate EPSTEIN was educated about both routine and emergency procedures for contacting Psychology staff. He was reminded of the self-help books and audiotapes available through the Psychology department. There appears to be no need for follow up at this time. He will be seen in SHU for rounds and monthly SHU reviews. Completed by PhD/Chief Psychologist on 07/18/2019 13:05 Generated 07118,2019 13:05 by PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00048495

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: 07/11/2019 15:21 Provider: PhD/Chief Reg #: 76318-054 Unit Team: A&O Focus of Session Inmate Epstein was seen for his psychological observation follow-up in attorney conference this afternoon. Subjective/Objective Presentation Inmate Epstein reported he has been consulting with his attorney most of the day. He elucidated concerns about his incarceration including not receiving his property yet in SHU, feeling cold in his cell, not receiving his Colace, not having enough water in attorney conference, and a desire to recreate in SHU.' Inmate Epstein was also upset about wearing an orange jumpsuit and being treated like "a bad guy" when he did not do anything wrong in the prison. Custody and security concerns were addressed with inmate Epstein including why he has to wear his orange jumpsuit (due to his being housed in SHU). He requested that he be placed in a brown uniform during his legal visits. He was told his concerns would be addressed in the SHU meeting. Inmate Epstein stated he is not having any current problems with his cellmate and indicated he at bran cereal for breakfast and took a shower yesterday. He did not sleep well last night. Inmate Epstein continues to deny any suicidal ideation, intention or plan. He did not appear to be in any distress at this time. fnterventionisi Inmate EPSTEIN was provided with brief supportive interventions, CBT-based interventions, and psychoeducation regarding additional coping strategies. Inmate EPSTEIN was receptive to these interventions. Progress/Plan Inmate EPSTEIN was educated about both routine and emergency procedures for contacting Psychology staff. He was reminded of the self-help books and audiotapes available through the Psychology department. He will be seen next week after his bail hearing to assess his mental status and psychological stability. Completed by PhD/Chief Psychologist on 07/12/2019 07:51 Generated 07/12/2019 07:51 by PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00048496

Bureau of Prisons Psychology Services General Administrative Note "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/11/2019 14:28 Provider: M Facility: NYM PsyD Reg #: 76318-054 Unit Team: A&O Comments This writer attempted to see Mr. Epstein in the morning and then again in the afternoon for a Psych Observation Follow Up, but he was in Attorney Conference. Completed by M, PsyD on 07/11/2019 15:51 Generated 07/11/2019 15:51 by PsyD Bureau of Prisons - NYM Page 1 of 1 EFTA00048497

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: 07/10/2019 08:38 Provider: PhD/Chief Reg #: 76318-054 Unit Team: A&O Focus of Session Inmate Epstein was seen today for a psychological observation contact in the hospital area by this writer. Subjective/Objective Presentation Inmate Epstein appeared well and it was noted in his log book and eating/sleeping chart that he has been eating his meals, sleeping, interacting with the inmate companions, and pacing in his cell. Today, he presented this writer with numerous concerns and requests. He stated he does not want to be housed in the SHU because he is not comfortable there; he wants to be single-celled if he goes to the SHU; he wants Colace, not the Ducolex he received from medical yesterday; he wants to be able to walk around and go to recreation: he does not want to wear an orange uniform to his legal visits because he is treated "like a punished inmate;" he wants a phone call before he leaves the psychological observation area; he wants a shower and towel; he would like to be housed in the cadre (5S) unit; and would like his property, paper, and a pen. Inmate Epstein's concerns were addressed by this writer and it was explained to him he will not be single-celled or placed in a housing unit for safety and security concerns. His medical concerns (constipation) were discussed with health services as well as his desire to be placed on Colace. Inmate Epstein was provided a shower this morning. intervention(s) Inmate Epstein was provided with supportive intervention and coping skills strategies today. He was receptive to interventions and was able to elucidate his various needs. He did not present with any acute psychopathology and continues to deny any suicidal ideation, intention, or plan. He is looking forward to his bail hearing on Monday but stated he is aware that even if he gets bail, it will take at least two weeks to sort things out so he can leave the jail. Progress/Plan Inmate Epstein is not in any psychological distress, does not present with any mental health symptoms or complaints, and is denying any suicidality. He appears psychologically stable at this time and can be released from the psychological observation area. Inmate Epstein will be housed in the 9S area with a cellmate. He will be seen again tomorrow by psychology to evaluate his mental status and psychological stability. Completed by PhD/Chief Psychologist on 07/10/2019 09:09 Generated 07/10/2019 09:09 by PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00048498

Bureau of Prisons "SENSITIVE BUT UNCLASSIFIED" Psychology Services Diagnostic and Care Level Formulation Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/09/2019 10:13 Provider: PhD/Chief Reg #: 76318-054 Unit Team: A&O Relevant Historical Information Inmate Epstein is a 66-year-old Caucasian male, currently incarcerated on sex trafficking charges. He denied any history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also denied any acute mental health symptoms at this time. Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behavior in the past. Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol. Presenting Problem/Symptom Inmate Epstein was seen by this writer for suicide risk assessment today, 7/9/19 at 7:30 a.m. for precautionary reasons. He returned from court yesterday evening. He did not mark any mental health items or symptoms on his Psychology Questionnaire (PSIQ) when he entered the institution. Nonetheless, Inmate Epstein has various risk factors for suicidality including a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court proceeding yesterday which could have given him bad news regarding his legal situation. Inmate Epstein returned from court after duty hours yesterday evening and staff notified the on•call psychologist. Inmate Epstein was placed on a precautionary psychological observation status until psychology could interview him this morning to conduct a formal suicide risk assessment in order to determine whether he is currently at-risk for suicidality. Diagnostic Formulation Inmate Epstein has no history of mental health problems and does not exhibit suicidality at this time. He has never received inpatient or outpatient mental health treatment and denied any history of suicidality. Currently, he does not exhibit any acute psychopathology, is currently psychologically stable and is in no psychological distress. As such, he is being classified as a CC1-MH inmate at this time. CARE1-MH is indicative of an inmate who either has no identifiable mental illness (Axis I 'No Diagnosis") or is mildly ill and requires clinical intervention on an as-needed basis. Care Level Formulation CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Diagnosis: No Diagnosis, No Dx - Current Completed by PhD/Chief Psychologist on 07/09/2019 10:40 Generated 07/0912019 10:40 by PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00048499

Bureau of Prisons Psychology Services Diagnostic and Care Level Formulation **SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/09/2019 10:13 Provider: M Facility: NYM PhD/Chief Reg #: 76318-054 Unit Team: A&O Relevant Historical Information Inmate Epstein is a 66-year-old Caucasian male, currently incarcerated on sex trafficking charges. He denied any history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also denied any acute mental health symptoms at this time. Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behavior in thgpast. Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink Inmate Epstein was seen health items or symptoms on h Epstein has various risk factors charges, pre-trial status, and he had legal situation. Inmate Epstein return psychologist. Inmate Epstein was placed on interview him this morning to conduct a tor suicidality. Diagnostic Formulation Inmate Epstein has no history of mental health proble s not exhibit suicidality at this time. He has never received inpatient or outpatient mental health treatment any history of suicidality. Currently, he does not exhibit any acute psychopathology, is currently psychologic nd is in no psychological distress. As such, he is being classified as a CC1-MH inmate at this time. CARE1-M e of an inmate who either has no identifiable mental illness (Axis I 'No Diagnosis") or is mildly ill and requires ention on an as-needed basis. Care Level Formulation 'sk assessment today for precautionary reasons. He did not mark any mental ology Questionnaire (PSI()) when he entered the institution. Nonetheless, Inmate y including a high profile case with media attention, sex offense/trafficking proceeding yesterday which could have given him bad news regarding his om court er duty hours yesterday evening and staff notified the on-call onary psychological observation status until psychology could risk assessment to determine whether he is currently at-risk for CARE1-MH is indicative of an inmate who shows no significant level of illness and demonstrates no need for regular mental health intervention. Diagnosis: No Diagnosis, No Dx - Current Completed by PhD/Chief Psychologist on 07/09/2019 10:32 airment associated with a mental Generated 0710912019 10:32 by PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00048500

Bureau of Prisons Psychology Services Diagnostic and Care Level Formulation **SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Date: 07/09/2019 10:13 Provider: M Facility: NYM PhD/Chief Reg #: 76318-054 Unit Team: A&O Relevant Historical Information Inmate Epstein is a 66-year-old Caucasian male, currently incarcerated on sex trafficking charges. He denied any history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also denied any acute mental health symptoms at this time. Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behavior in thgpast. Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink Inmate Epstein was seen health items or symptoms on h Epstein has various risk factors charges, pre-trial status, and he had legal situation. Inmate Epstein return psychologist. Inmate Epstein was placed on interview him this morning to conduct a tor suicidality. Diagnostic Formulation Inmate Epstein has no history of mental health proble s not exhibit suicidality at this time. He has never received inpatient or outpatient mental health treatment any history of suicidality. Currently, he does not exhibit any acute psychopathology, is currently psychologic nd is in no psychological distress. As such, he is being classified as a CC1-MH inmate at this time. CARE1-M e of an inmate who either has no identifiable mental illness (Axis I 'No Diagnosis") or is mildly ill and requires ention on an as-needed basis. Care Level Formulation 'sk assessment today for precautionary reasons. He did not mark any mental ology Questionnaire (PSI()) when he entered the institution. Nonetheless, Inmate y including a high profile case with media attention, sex offense/trafficking proceeding yesterday which could have given him bad news regarding his om court er duty hours yesterday evening and staff notified the on-call onary psychological observation status until psychology could risk assessment to determine whether he is currently at-risk for CARE1-MH is indicative of an inmate who shows no significant level of illness and demonstrates no need for regular mental health intervention. Diagnosis: No Diagnosis, No Dx - Current Completed by PhD/Chief Psychologist on 07/09/2019 10:32 airment associated with a mental Generated 0710912019 10:32 by PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00048501

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: 07/09/2019 10:13 Facility: NYM Amendment made to this note by PhD/Chief Psychologist on 07/09/2019 10:40. Bureau of Prisons - NYM EFTA00048502

Bureau of Prisons Psychology Services Suicide Risk Assessment "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facilit : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/Chief Psychologist Type of Housing: Other Psychological Observation Cell Accommodation: Single Cell FINDINGS This assessment and the resulting recommendations are based on the following sources of information: Medical Record, Clinical Interview Inmate Epstein was placed on psychological observation when he returned from court yesterday evening 7/8/19 for precautionary reasons. He is not on a suicide watch at this time. He was seen this morning for a psychological observation contact and suicide risk assessment this morning, 7/9/19, at 7:30 a.m. as it was determined he possessed some at-risk factors for suicidality. Reason for Referral Inmate Epstein is being seen for suicide risk assessment today for precautionary reasons. Inmate Epstein has various risk factors for suicidality at this time including a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court proceeding yesterday which could have given him bad news regarding his legal situation. As such, this writer instructed R&D staff, as well as the Lieutenant's Office, to immediately notify the psychology department when he returned from court. Inmate Epstein returned from court after duty hours and denied suicidality. The aforementioned staff notified the on-call psychologist and inmate Epstein was placed on a precautionary psychological observation status until psychology could interview him this morning to conduct a suicide risk assessment. Developmental History Inmate Epstein denied any history of being the victim and/or perpetrator of physical or sexual abuse. Educational History/Cognitive Impairment Inmate Epstein reported he obtained his high school diploma and attended some graduate classes in the area of mathematics. Arrest History and Experience of Incarceration Inmate Epstein reported he has served time in Palm Beach County jail on sex offense charges (soliciting prostitution) in the past. He is now being charged with sex trafficking, on a federal level. Mental Health History Inmate Epstein denied any history of mental health treatment, either on an inpatient or outpatient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also denied any acute mental health symptoms at this time. Self-Harm History Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever engaging in any suicide attempts or self-injurious behavior in the past. Substance Abuse History Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol. Medical Concerns Inmate Epstein denied any significant medical problems, other than a history of high triglycerides. He reported feeling constipated at this time. Current Problem Inmate Epstein is currently on psychological observation due to his having multiple risk factors associated with suicidality. He denies any suicidality at this time and has no mental health or suicide history. He is being seen for a suicide risk assessment in an abundance of caution. Current Mental Status Generated 07/10/2019 09:20 by PhD/Chiel Bureau of Prisons - NYM Page 1 of 3 EFTA00048503

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M F ili : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/Chief Psychologist Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Inmate Epstein did not exhibit any acute psychopathology and exhibited a clear mental status. Current Mental Status: Mr. EPSTEIN was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited a neutral affect with appropriate range. Eye contact and hygiene were appropriate. The inmate spoke with normal rate, tone, and volume. His thoughts were organized and coherent, with no loosening of associations or tangential, circumstantial, or irrelevant content. There was no evidence of perceptual disturbance, delusional ideation, or a formal thought disorder. He did not engage in any bizarre or inappropriate behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN explicitly denied recent and current suicidal ideation, planning, and intent. He was future-oriented and expressed a commitment to life and safety, agreeing to contact staff immediately should he experience suicidal ideation. RISK AND PROTECTIVE FACTORS ASSESSED• This writer screened the inmate for a variety of empirically validated factors commonly associated with risk for self-harm and suicide. The following STATIC risk factors were assessed to be present and increase the inmate's risk for engaging in suicide related behaviors: Sex offender status, Lack of family connections, High Profile Crime Of the DYNAMIC risk factors assessed, none were found to be present. The following PROTECTIVE factors were assessed to be present and may decrease the inmate's risk of suicide:Willingness to engage in treatment, View of death as negative, Future orientation, Denial of suicidal ideationAntentiorVplans, Adequate problem solving skills, Able to identify reasons to live As noted above, Inmate Epstein is a 66-year-old Caucasian male. He has various risk factors for suicidality at this time including a high profile case with extensive media attention, sex offense/trafficking charges, pre-trial status, and he had a court proceeding yesterday which may have given him bad news regarding his legal situation. Inmate Epstein also informed this writer that his only family at this time is his brother, with whom he does not have a close relationship with. Despite these risk factors, inmate Epstein possesses a number of protective factors at this time. Inmate Epstein adamantly denied any suicidal ideation, intention or plan. He was very future oriented and requested a phone call, to meet with his attorney, to take a shower, and to brush his teeth. He was eating his cereal when this writer arrived and said "I have my paper spoon here." He reported he is going to have a bail hearing on Monday and believes he is going to be released from jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "being alive is fun." He also revealed he enjoys learning and teaching. He has confidence in his attorney and described him as "competent." Inmate Epstein denied any mental health history or history of suicidality. He also reported none of his family members have mental health histories. Inmate Epstein stated he is a mathematician and took post graduate classes in this area of study. Inmate Epstein stated he has a support system in the community, including friends and other associates. Finally, inmate Epstein demonstrated a good sense of humor and did not appear dysphoric, agitated or anxious. No acute psychopathology was noted. Overall, inmate Epstein has numerous protective factors at this time that outweigh his risk factors for suicidality. He has a positive outlook regarding his legal case, demonstrates no psychiatric symptoms, has no psychiatric or suicide history, and verbalized a desire to be alive at this time and future orientation. DIAGNOSIS: No Diagnosis, No Dx - Current Generated 07/10/2019 09:20 by PhD/Chiel Bureau of Prisons - NYM Page 2 of 3 EFTA00048504

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg ff: 76318-054 Date of Birth: 01/20/1953 Sex: M F ili : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/Chief Psychologist CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent FIECOMMENDATIONS Inmate Epstein is currently on psychological observation pending suitable housing placement. In light of his current sex offense charges and extensive media coverage on the television, he will need to be confined in a suitable housing unit. Inmate Epstein will be seen daily while on psychological observation and will be seen for a psychological observation follow-up session once he is released from observation. Inmate Epstein denied the need for psychological intervention, self-help materials, or follow-up. He has been classified as a CC1-MH inmate at this time. CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Suicide Watch: A suicide watch is not warranted at this time Completed by PhD/Chief Psychologist on 07/10/2019 09:20 Generated 07/10/2019 09:20 by PhD/Chief Bureau of Prisons - NYM Page 3 of 3 EFTA00048505

Bureau of Prisons Psychology Services Suicide Risk Assessment "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facilit : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/Chief Psychologist Type of Housing: Other Psychological Observation Cell Accommodation: Single Cell FINDINGS This assessment and the resulting recommendations are based on the following sources of information: Clinical Interview, Medical Record Inmate Epstein was placed on chological observation when he returned from court yesterday evening 7/8/19 for precautionary reasons. He i a suicide watch at this time. Reason for Referral Inmate Epstein is being seen e risk assessment today for precautionary reasons. Inmate Epstein has various risk factors for suicidality at thi • ing a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court o ing yesterday which could have given him bad news regarding his legal situation. As such, this writer instruc &D staff s well as the Lieutenant's Office, to immediately notify the psychology department when he returned fro Inmate Epstein returned from court after duty hours and denied suicidality. The aforementioned staff notifi -call psychologist and inmate Epstein was placed on a precautionary psychological observation status until psycho/.. o ' .terview him this morning to conduct a suicide risk assessment. Developmental History Inmate Epstein denied any history of being the victim . . . - .etrator of physical or sexual abuse. Educational History/Cognitive Impairment Inmate Epstein reported he obtained his high school diplom d some graduate classes in the area of mathematics. Arrest History and Exoerience of Incarceration Inmate Epstein reported he has served time in Palm Beach County jail se charges (soliciting prostitution) in the past. He is now being charged with sex trafficking, on a federal level. Mental Health History re Inmate Epstein denied any history of mental health treatment, either on an inpat tient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also d tjyacute mental health symptoms at this time. Self-Harm History Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever ging in any suicide attempts or self-injurious behavior in the past. Substance Abuse History Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol. Medical Concerns Inmate Epstein denied any significant medical problems, other than a history of high triglycerides. He reported feeling constipated at this time. Current Problem Inmate Epstein is currently on psychological observation due to his having multiple risk factors associated with suicidality. He denies any suicidality at this time and has no mental health or suicide history. He is being seen for a suicide risk assessment in an abundance of caution. Current Mental Status Level of Consciousness: Alert and Oriented Generated 07/09/2019 10:36 by PhDiChiel Bureau of Prisons - NYM Page 1 of 3 EFTA00048506

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M F ili : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/Chief Psychologist Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Inmate Epstein did not exhibit any acute psychopathology and exhibited a clear mental status. Current Mental Status: Mr. EP a neutral affect with appropri and volume. His thoughts irrelevant content. There not engage in any bizarre or ina explicitly denied recent and curre commitment to life and safety, agree' IN was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited e. Eye contact and hygiene were appropriate. The inmate spoke with normal rate, tone, nized and coherent, with no loosening of associations or tangential, circumstantial, or e of perceptual disturbance, delusional ideation, or a formal thought disorder. He did e behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN eation, planning, and intent. He was future-oriented and expressed a act staff immediately should he experience suicidal ideation. RISK AND PROTECTIVE FACTORS SSED• This writer screened the inmate for a variety of suicide. The following STATIC risk factors were assessed t behaviors: High Profile Crime, Lack of family connect' Of the DYNAMIC risk factors assessed, none were foun validated factors commonly associated with risk for self-harm and and increase the inmate's risk for engaging in suicide related ender status st. The following PROTECTIVE factors were assessed to be pres m y decrease the inmate's risk of suicide:Able to identify reasons to live, Adequate problem solving skills, Denial of suici ention/plans, Future orientation, View of death as negative, Willingness to engage in treatment As noted above, Inmate Epstein is a 66-year-old Caucasian male. He tVr k factors for suicidality at this time including a high profile case with extensive media attention, sex offense/tr c rges, pre-trial status, and he had a court proceeding yesterday which may have given him bad news regarding his leg i Inmate Epstein also informed this writer that his only family at this time is his brother, with whom he does not hay cl tionship with. Despite these risk factors, inmate Epstein possesses a number of protective factors atRfi Inmate Epstein adamantly denied any suicidal ideation, intention or plan. He was very future oriented and requeste all, to meet with his attorney, to take a shower, and to brush his teeth. He was eating his cereal when this writ r d said "I have my paper spoon here." He reported he is going to have a bail hearing on Monday and believes he is go g t sed from jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "bei fun." He also revealed he enjoys learning and teaching. He has confidence in his attorney and described him as mpetent." Inmate Epstein denied any mental health history or history of suicidality. He also reported none of his family members have mental health histories. Inmate Epstein stated he is a mathematician and took post graduate classes in this area of study. Inmate Epstein stated he has a support system in the community, including friends and other associates. Finally, inmate Epstein demonstrated a good sense of humor and did not appear dysphoric, agitated or anxious. No acute psychopathology was noted. Overall, inmate Epstein has numerous protective factors at this time that outweigh his risk factors for suicidality. He has a positive outlook regarding his legal case, demonstrates no psychiatric symptoms, has no psychiatric or suicide history, and verbalized a desire to be alive at this time and future orientation. DIAGNOSIS* No Diagnosis, No Dx - Current CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent Generated 07/09/2019 10:36 by PhD/Chiel Bureau of Prisons - NYM Page 2 of 3 EFTA00048507

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg ff: 76318-054 Date of Birth: 01/20/1953 Sex: M F ili : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/Chief Psychologist RECOMMENDATIONS Inmate Epstein is currently on psychological observation pending suitable housing placement. In light of his current sex offense charges and extensive media coverage on the television, he will need to be confined in a suitable housing unit. Inmate Epstein will be seen daily while on psychological observation and will be seen for a psychological observation follow-up session once he is released from observation. Inmate Epstein denied the need for psychological intervention, self-help materials, or follow-up. He has been classified as a CC1-MH inmate at this time. CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Suicide Watch: A suicide watch is not warranted at this time Completed by PhD/Chief Psychologist on 07/09/2019 10:36 0 5 1 ) ) 6 0 d ) , Generated 07/09/2019 10:36 by PhD/Chief Bureau of Prisons - NYM Page 3 of 3 EFTA00048508

Bureau of Prisons Psychology Services Suicide Risk Assessment "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Facilit : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/Chief Psychologist Type of Housing: Other Psychological Observation Cell Accommodation: Single Cell FINDINGS This assessment and the resulting recommendations are based on the following sources of information: Clinical Interview, Medical Record Inmate Epstein was placed on chological observation when he returned from court yesterday evening 7/8/19 for precautionary reasons. He i a suicide watch at this time. Reason for Referral Inmate Epstein is being seen e risk assessment today for precautionary reasons. Inmate Epstein has various risk factors for suicidality at thi • ing a high profile case with media attention, sex offense/trafficking charges, pre-trial status, and he had a court o ing yesterday which could have given him bad news regarding his legal situation. As such, this writer instruc &D staff s well as the Lieutenant's Office, to immediately notify the psychology department when he returned fro Inmate Epstein returned from court after duty hours and denied suicidality. The aforementioned staff notifi -call psychologist and inmate Epstein was placed on a precautionary psychological observation status until psycho/.. o ' .terview him this morning to conduct a suicide risk assessment. Developmental History Inmate Epstein denied any history of being the victim . . . - .etrator of physical or sexual abuse. Educational History/Cognitive Impairment Inmate Epstein reported he obtained his high school diplom d some graduate classes in the area of mathematics. Arrest History and Exoerience of Incarceration Inmate Epstein reported he has served time in Palm Beach County jail se charges (soliciting prostitution) in the past. He is now being charged with sex trafficking, on a federal level. Mental Health History re Inmate Epstein denied any history of mental health treatment, either on an inpat tient basis. Inmate Epstein denied any treatment in the past or present with psychotropic medication. He also d tjyacute mental health symptoms at this time. Self-Harm History Inmate Epstein denied any past or present suicidal ideation, intention or plan. He denied ever ging in any suicide attempts or self-injurious behavior in the past. Substance Abuse History Inmate Epstein denied any alcohol or substance abuse. He said it is well-known that he does not even drink alcohol. Medical Concerns Inmate Epstein denied any significant medical problems, other than a history of high triglycerides. He reported feeling constipated at this time. Current Problem Inmate Epstein is currently on psychological observation due to his having multiple risk factors associated with suicidality. He denies any suicidality at this time and has no mental health or suicide history. He is being seen for a suicide risk assessment in an abundance of caution. Current Mental Status Level of Consciousness: Alert and Oriented Generated 07/09/2019 10:36 by PhDiChiel Bureau of Prisons - NYM Page 1 of 3 EFTA00048509

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M F ili : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/Chief Psychologist Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Inmate Epstein did not exhibit any acute psychopathology and exhibited a clear mental status. Current Mental Status: Mr. EP a neutral affect with appropri and volume. His thoughts irrelevant content. There not engage in any bizarre or ina explicitly denied recent and curre commitment to life and safety, agree' IN was alert and oriented. He was polite, calm, and cooperative in demeanor. He exhibited e. Eye contact and hygiene were appropriate. The inmate spoke with normal rate, tone, nized and coherent, with no loosening of associations or tangential, circumstantial, or e of perceptual disturbance, delusional ideation, or a formal thought disorder. He did e behavior. He noted having normal sleeping and eating habits. Mr. EPSTEIN eation, planning, and intent. He was future-oriented and expressed a act staff immediately should he experience suicidal ideation. RISK AND PROTECTIVE FACTORS SSED• This writer screened the inmate for a variety of suicide. The following STATIC risk factors were assessed t behaviors: High Profile Crime, Lack of family connect' Of the DYNAMIC risk factors assessed, none were foun validated factors commonly associated with risk for self-harm and and increase the inmate's risk for engaging in suicide related ender status st. The following PROTECTIVE factors were assessed to be pres m y decrease the inmate's risk of suicide:Able to identify reasons to live, Adequate problem solving skills, Denial of suici ention/plans, Future orientation, View of death as negative, Willingness to engage in treatment As noted above, Inmate Epstein is a 66-year-old Caucasian male. He tVr k factors for suicidality at this time including a high profile case with extensive media attention, sex offense/tr c rges, pre-trial status, and he had a court proceeding yesterday which may have given him bad news regarding his leg i Inmate Epstein also informed this writer that his only family at this time is his brother, with whom he does not hay cl tionship with. Despite these risk factors, inmate Epstein possesses a number of protective factors atRfi Inmate Epstein adamantly denied any suicidal ideation, intention or plan. He was very future oriented and requeste all, to meet with his attorney, to take a shower, and to brush his teeth. He was eating his cereal when this writ r d said "I have my paper spoon here." He reported he is going to have a bail hearing on Monday and believes he is go g t sed from jail. Inmate Epstein reported he is a Banker and has a "big business" in the community and that "bei fun." He also revealed he enjoys learning and teaching. He has confidence in his attorney and described him as mpetent." Inmate Epstein denied any mental health history or history of suicidality. He also reported none of his family members have mental health histories. Inmate Epstein stated he is a mathematician and took post graduate classes in this area of study. Inmate Epstein stated he has a support system in the community, including friends and other associates. Finally, inmate Epstein demonstrated a good sense of humor and did not appear dysphoric, agitated or anxious. No acute psychopathology was noted. Overall, inmate Epstein has numerous protective factors at this time that outweigh his risk factors for suicidality. He has a positive outlook regarding his legal case, demonstrates no psychiatric symptoms, has no psychiatric or suicide history, and verbalized a desire to be alive at this time and future orientation. DIAGNOSIS* No Diagnosis, No Dx - Current CONCLUSIONS The Overall Acute Suicide Risk for this Inmate is: Low Overall Chronic Suicide Risk for this Inmate is: Absent Generated 07/09/2019 10:36 by PhD/Chiel Bureau of Prisons - NYM Page 2 of 3 EFTA00048510

Inmate Name: EPSTEIN, JEFFREY EDWARD Reg ff: 76318-054 Date of Birth: 01/20/1953 Sex: M F ili : NYM Unit Team: A&O Date: 07/09/2019 08:41 Provider: PhD/Chief Psychologist RECOMMENDATIONS Inmate Epstein is currently on psychological observation pending suitable housing placement. In light of his current sex offense charges and extensive media coverage on the television, he will need to be confined in a suitable housing unit. Inmate Epstein will be seen daily while on psychological observation and will be seen for a psychological observation follow-up session once he is released from observation. Inmate Epstein denied the need for psychological intervention, self-help materials, or follow-up. He has been classified as a CC1-MH inmate at this time. CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Suicide Watch: A suicide watch is not warranted at this time Completed by PhD/Chief Psychologist on 07/09/2019 10:36 0 5 1 ) ) 6 0 d ) , Generated 07/09/2019 10:36 by PhD/Chief Bureau of Prisons - NYM Page 3 of 3 EFTA00048511

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: 07/09/2019 08:41 Facility: NYM Amendment made to this note by PhD/Chief Psychologist on 07/10/2019 09:20. Bureau of Prisons - NYM EFTA00048512

Bureau of Prisons Psychology Services General Administrative Note "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/08/2019 10:41 Provider: PhD/Chief Reg #: 76318-054 Unit Team: A&O Comments This writer consulted with Dr. , Central Office, regarding inmate Epstein. Inmate Epstein has various risk factors for suicidality including a high profile case with media attention, sex offense charges, pre-trial status, and a court proceeding today which could potentially be giving him bad news regarding his legal situation. As such, when inmate Epstein returns from court, R&D staff as well as Lieutenant's have been informed to immediately notify the psychology department. If he returns after duty hours, the aforementioned staff were instructed to notify the on-call psychologist and to place inmate Epstein on a watch status until psychology can conduct a thorough suicide risk assessment. Completed by PhD/Chief Psychologist on 07/08/2019 10:49 Generated 07/08/2019 10:49 by PhD/Chief Bureau of Prisons - NYM Page 1 of 1 EFTA00048513

Bureau of Prisons Psychology Services Risk of Sexual Abusiveness "SENSITIVE BUT UNCLASSIFIED" Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/08/2019 09:35 Provider: PsyD/PhD Reg #: 76318-054 Unit Team: A&O Comments Risk of Sexual Abusiveness During the intake screening process, for Inmate Epstein, based on the documentation available at the time of the screening, and Inmate Epstein's self-report, he was identified as being at risk for sexual abusiveness due to previous perpetration of sexual abuse in the community or in an institutional setting, as evidenced by the following objective criteria: ( ) Having a history of prior institutional violence or sexual abuse perpetration (X ) Having a history of prior sexual abuse perpetration in the community (X ) Having prior convictions of violent offenses As required by P5324.11, Sexually Abusive Behavior Prevention and Intervention, Inmate Epstein was seen by Psychology on today's date to assess his risk factors for sexual abusiveness. At the onset of this clinical contact, the inmate was informed about the BOP requirements regarding PREA. Inmate Epstein indicated he understands the institution's policy against engaging in sexual behavior. His risk factors for sexual abusiveness were assessed and include: ( ) History of prior sexual victimization in prison ( X ) History of prior prison sexual predation ( ) History of head injury with loss of consciousness ( ) History of childhood psychological, physical, sexual abuse ( ) Witnessed family violence ( ) Antisocial Personality Disorder traits of irritability/aggressiveness and recklessness ( ) Hypersexuality (defined by eight or more orgasms a week prior to prison) ( ) Hypermasculinity ( ) Other: Based on this clinical assessment, the inmate is considered to be at: (X ) Low Risk of Abusiveness at this facility (Note: Even though this inmate is judged to be at low risk of sexual abusiveness, an unforeseen change in risk factors may significantly alter his risk level.). Programming recommendations included sex offender treatment. Inmate Epstein declined programming recommendations.The inmate understands the procedure for contacting Psychology for routine or emergent services. ( ) Moderate Risk of Abusiveness. The Unit Team and Correctional Staff have been notified regarding Psychology staff's recommendation that he not be housed in a cell with any inmates identified as at increased risk for sexual victimization. Psychology also recommends a greater level of supervision regarding his work and education assignments. Programming recommendations include XXXXX. Inmate =inmateLastName is agreeable to/ declined programming recommendations. ( ) High Risk of Abusiveness. It is recommended this inmate be housed in the Special Housing Unit in accordance with P5324.11 to "keep separate those inmates at high risk of being sexually victimized from those at high risk of being sexually abusive" until Correctional Services and Correctional Programs staff can assess his appropriateness for general population at this facility. This inmate should not be housed with any inmates judged to be at an increased risk for sexual victimization. Programming recommendations include XXXXX. Inmate =inmateLastName is agreeable to/ declined programming recommendations. Generated 07/08/2019 09:41 by PsyD/PhD Bureau of Prisons - NYM Page 1 of 2 EFTA00048514

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Facility: NYM Date: 07/08/2019 09:35 Provider: PsyD.PhD Reg #: 76318-054 Unit Team: A&O Completed by PsyalPhD on 07.88'2019 09:41 Generated 0710812019 09:41 by PsyD:PhD Bureau of Prisons NYM Page 2 of 2 EFTA00048515

Bureau of Prisons Psychology Services Intake Screening **SENSITIVE BUT UNCLASSIFIED•• Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M NYM Date: 07/08/2019 09:24 Provider: . PsyD/PhD Reg #: 76318-054 Unit Team: A&O Limits of Confidentiality Limits of confidentiality were reviewed with inmate EPSTEIN. He expressed an understanding of the limits of confidentiality and consented to be interviewed accordingly. Data Source(s) The following data sources were reviewed in conjunction with this Initial Intake Evaluation: Self-Report, SENTRY, Staff Observation. Inmate Epstein is a 66-year-old, Black male who was seen by Psychology Services due to newly arriving at MCC-NY. He denied a history of mental health treatment on his Psychology Services Intake Questionnaire. Mental Health History and Current Symptoms No history of mental health issues was noted. No history of prior mental health treatment was noted. No current mental health symptoms were noted. No suicidal ideation, attempts, or self-harm were noted. Substance Abuse No history of substance abuse was noted. No history of substance abuse treatment was noted. Sex Offenses No sexual offense convictions were noted. No history of sexual predation in a correctional setting was noted. Relevant Psychosocial History Noteworthy psychosocial issues: Other. Inmate Epstein is currently incarcerated for a Sex Trafficking. He stated he was previously incarcerated three months f or prostitution. Inmate Epstein stated he is single and does not have any children. He revealed he was living in New York. He stated he completed high school. He stated he was employed in banking work prior to his incarceration. Adjustment to Incarceration Adjustment to incarceration concerns were identified: Other. SEXUAL ABUSE HISTORY Inmate Epstein denied being the victim of physical or sexual abuse. He is currently charged with sex trafficking and has previously been charged with prostitution. He was informed of the programs offered by MCC-NY as well as the Bureau of Prisons. Additionally, he was informed of this institutions self-help program. Inmate Epstein reported he was not currently interested in any treatment programs. MENTAL STATUS: Inmate Epstein appeared calm, controlled, without signs of psychomotor agitation or retardation. He was fully cooperative, maintained good eye-contact, and related in an interpersonally appropriate manner with interviewer. Speech and thought processes were organized, coherent, logical, and goal-directed. Based on informal assessment during this interview, this inmate's cognitive functioning appeared within normal limits, as reflected by adequate long and short-term memory, good attention, and appropriate concentration during interview, as well as adequate receptive and expressive language skills. Inmate denied any current sleep disturbances and described his appetite as adequate. This inmate denied recent or present morbid thoughts, passive or active suicidal ideation, intent or plan and contracted for safety. This inmate's verbalizations were optimistic, future oriented, and without indications of helpless or hopeless thinking. Inmate Brown denied any familial history of suicide behaviors or attempts. This inmate was provided with supportive psychotherapy, and psycho-education to strengthen coping skills and facilitate adjustment to incarceration. Findings Care Level: CARE1-MH Generated 07/08/2019 09:30 by PsyD/PhD Bureau of Prisons - NYM Page 1 of 2 EFTA00048516

Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M F ili : NYM Date: 07/08/2019 09:24 Provider: . PsyD/PhD Reg #: 76318-054 Unit Team: A&O Inmate EPSTEIN denied any history of mental health symptoms or treatment. He denied any current mental health symptoms. He does not meet criteria for any current psychological diagnosis. He meets criteria for Mental Health Care Code 1. CARE1-MH is indicative of an inmate who shows no significant level of functional impairment associated with a mental illness and demonstrates no need for regular mental health intervention. Recommendations The following psychological services are recommended: Other. Inmate EPSTEIN was educated about both routine and emergency procedures for contacting Psychology staff. He does not appear to be in distress at this time. He agreed to contact psychology if he feels he needs psychology services in the future. He meets criteria for CC1 and does not require scheduled follow up at this time. Completed by . PsyD/PhD on 07/08/2019 09:30 Generated 07/0812019 09:30 by PsyD/PhD Bureau of Prisons - NYM Page 2 of 2 EFTA00048517

Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 "' Sensitive But Unclassified Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Collected 07/09/2019 13:34 Order Unit E06-547U Received 07/10/2019 10:44 Provider MD Reported 07/10/2019 14:46 LIS ID 188191004 CHEMISTRY Sodium Potassium Chloride CO2 BUN Creatinine eGFR (IDMS) 137 4.7 99 27 17 1.05 >60 137-148 3.5.5.0 99.114 22-30 7.22 0.66.1.25 mmol/L mmol/L mmol/L mmol/L mg/dL mg/dL GFR units measured as mUmin/1.73 m^2. If African American multiply by 1.210. A calculated GFR <60 suggests chronic kidney disease if found over a 3 month period. Calcium 9.8 8.5-10.9 mg/dL Glucose 102 70-110 mg/dL AST H 57 11.55 U/L ALT 62 11-66 U/L Alkaline Phosphatase 64 41.133 U/L Bilirubin, Total 1.1 0.2.1.3 mg/dL Total Protein 7.3 6.0-8.2 g/dL Albumin 4.4 3.6.5.1 g/dL Globulin 2.9 2.0.3.7 g/dL Alb/Glob Ratio 1.50 1.00-2.30 Anion Gap 10.2 9.0.19.0 BUN/Creat Ratio 16.1 5.0.30.0 Cholesterol H 216 <200 mg/dL Triglycerides H 413 10.150 mg/dL Calculation of LDL is not appropriate for samples with a triglyceride greater than 400 mg/dL. Therefore the LDL is not calculated. HDL Cholesterol L 31 40.60 mg/dL Chol/HDL Ratio H 6.9 0.0.4.0 HEMATOLOGY WBC 7.6 4.3-11.1 K/uL NRBC% 0.0 RBC 5.42 4.46-5.78 M/uL Hemoglobin 15.6 13.6-17.6 g/dL Hematocrit 47.8 40.2-51.4 MCV 88.2 82.5-96.5 fL MCH 28.8 27.1-34.9 Pg MCHC L 32.6 33.0-37.0 g/dL RDW-CV 12.8 12.0-14.0 Platelet 338 130-374 K/uL FLAG LEGEND L=Low L!=Low Critical H=High H!=High Critical A=Abnormal A! =Abnormal Critical Page 1 of 3 EFTA00048518

Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 a' Sensitive But Unclassified*** Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Order Unit E06-547U Provider MD Collected 07/09/2019 13:34 Received 07/10/2019 10:44 Reported 07/10/2019 14:46 LIS ID 188191004 HEMATOLOGY MPV Neutrophils Therapeutic decision making should be based on absolute values, rather than percentages Lymphocytes °A) Monocytes Eosinophils % Basophils Immature Granulocytes % Neutrophils # Lymphocytes # Monocytes # Eosinophils # Basophils # Immature Granulocytes # 10.4 58.7 25.0 11.1 4.1 0.8 0.3 4.4 1.9 0.8 0.3 0.1 0.02 6.9-10.5 0.0-5.0 1.9.6.7 1.3.3.7 0.3-1.1 0.0.0.5 0.0.0.1 0.00-0.50 fL K/uL K/uL K/uL K/uL K/uL 10^3/uL HEMOGLOBIN A1C Hemoglobin A1C 5.7 - 6.4 Increased Risk > 6.4 Diabetes H 6.3 <5.7 SEROLOGY RPR Non-Reactive Results may be affected in patients with severely advanced immunosuppression. Non-Reactive FLAG LEGEND L=Low L!=Low Critical H=High H!=High Critical A=Abnormal A! =Abnormal Critical Page 2 of 3 EFTA00048519

Federal Bureau of l'risons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 "' Sensitive But Unclassified*" Name EPSTEIN. JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Order Unit E06-547U Provider MD Collected 07/09/2019 13:34 Received 07/10/2019 10:44 Reported 07/10/201914:46 LIS ID 188191004 HIV HIV 1/2 Negative Screening test • See confirmatory testing for Reactive results Negative FLAG LEGEND L=Low L!=Low Critical H=High H!=High Critical A=Abnormal A! =Abnormal Critical Page 3 of 3 EFTA00048520

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: 07/10/2019 16:58 Provider: Lab Result Receive Facility: NYM Cosigned by MD on 07 14:2019 18:12. Bureau of Prisons - NYM EFTA00048521

, BP410489 JUN 10 HIV COUNSELING DOCUMENTATION • U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS Directions: Use the folloWing criteria to counsel the patient who Is tested for the HIV anibody. Che• ck off each item as they are discussed. Write NA beside any item that is inappropriate to the situation. Thercverse side of this form will be utilized to .docuritent seronegative and inconclusive test result. Then file to the patient's record, documenting in progreis notes that counseling was completed. PRETEST: ▪ 1, Explain purpose of session. 2. Explain:contidentiality.. ▪ 3. Explain HIV antibody test. a. What HIV is b. What the test is Test Procedure Meaning of test results _~__e. Inability of detecting early infection (false negatives) f. Potential need for additional testing Significance of a positive test. Ust risk factors/clinical signs: (check all that apply) a. Injecting drug use, sharing drug or tattoo equipment b. Unprotected or multiple sex partners No. Treated for sexually transmitted Infections, hepatitis, or TB : Pregnant female Other. Clinical sus: fever or illness of unknown cause, symptoms of AIDS opportunistic infecfions. Exposure: recent occupational or non-occupational exposafincident, ..e. Obtain Informed consent (when applicable). . Risk Reduction Behaviors. Educational material given. /7, Patient Reactions/Comments. Explain how the patient will be notified of the result. The above information has been explained to me in a language 1 can understand. Signatiao of Inmate Date: Al, rile in thischgedicat Record: Section 6. r Prescribed by P6190 Replaces BP-5489.061 olAPR EFTA00048522

BP-S355.060 SEP 05 r MEDICAL TREATMENT R FUSAL CDFRM U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-9-2019 Date 1, JEFFREY EPSTEIN 76318-054 , refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: Rectal and genital examination The following treatments) waslwere recommended: Rectal and genital examination Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result becauSe of my refusal to accept treatment: Undetected and untreated medical condition. I understand the possible consequences and/or complications listed above, and still refuse recommended treatment. f hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and its employees from any and allnability for respecting and following my expressed wishes and directions. Counseled by -9-2019 Date Patient's Signa Date it'. di Office : j MCC NY 7 11/(5 Signature of Witness Date NYM-NEW YORK MCC EFTA00048523

BP-S358.060 MEDICAL TREATMENT REFUSAL CDFRM SEP 05 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-24-2019 Date I, JEFFREY EPSTEIN 76318-054 , refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: EYE DOCTOR EVALUATION. The following treatment(s) was/were recommended: EYE DOCTOR EVALUATION. Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment: INABILITY TO DIAGNOSE CURRENT OPTHALMOLOGIC DISEASES. I understand the possible consequences and/or complications, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and Its employees from any and all liability for respecting and following my expressed wishes and directions. Counseled by Date Signature of Witne ^ Date NYM-NEW YORK MCC EFTA00048524

BP A0518 JUN 16 U.S. DEPARTMENT OF JUSTICE A&O DENTAL EXAMINATION (Initial Clinical Dental Findings) FEDERAL. BUREAU OF PRISONS Occlusion: r- 1 2 1 4 5 0 7 8 0 10 11 12 13 14 15 16 m rc 32 31 10 29 28 27 26 25 24 23 22 21 20 19 18 17 (514 (AL 411 Oat Oral Hygiene: CPITN: Good Fair Poor 3 2_ Head & Neck i Soft Tissue: M: I F /9 Classification: OLT- Pain Sea /10 Dental Prostheses at Intake: Yes No Type: Age: Condition: C =wit 4O ad rilt, r-cuss, on Ola 14,Xed- C--% 404 an Sen.)-e-J or Idea y,15, Cieb-O1/AC OkStAked Infra-oral Photos Taken: Yes 0 Radiographs Taken: (Document findings on MO encounter) Yes 9 Instructed how to obtain urgent and non-urgent dental care: Yes: If No: Treatment Priorities: None: Non-urgent: non-urgent Urgent Referred to Sick Cat Radiographs authorized: PAs: Prophylaxis authorized: Yes I No (Approval valid 18 months from examination date) EF/Vs: Panoror P ' nt Name: S -0 CC: PR- E Dentst &gnat.; re: IMINNIMIkDs is( Number: -7‘, 3 i (C: os-m Institution: MCC NEW YORK Date: -7-24 -1 9 . Signature Block/Stamp: DDS. PDF Prescribed by P6400 ief Dental cer MCC New York Replaces BP-A0018 of JUN 10 EFTA00048525

BP-S358 060 MEDICAL TREATMENT REFUSAL CDFRM SEP 05 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-24-2019 Date I, JEFFREY EPSTEIN 76318-054 refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: EYE DOCTOR EVALUATION. The following treatment(s) was/were recommended: EYE DOCTOR EVALUATION. Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment: INABILITY TO DIAGNOSE CURRENT OPTHALMOLOGIC DISEASES. I understand the possible consequences and/or complications, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and its employees from any and all liability for respecting and following my expressed wishes and directions. MD 7-24-2019 Counseled by Date Patient's Sign Date ElMille! t 4 Si nature of VVitne j fe ," r NYM--NEW YORK MCC f/re-cie- EFTA00048526

BP-5353.0€0 Sit, C5 MEDICAL TREATMENT REFUSAL CDFRM U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-10-2019 Date I, JEFFREY EPSTEIN 76318-054 , refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following conditionfs): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: 66 YR OLD MALE WITH NO PMHX , REFERRED FOR ROUITNE CXR. The following treatment(s) was/were recommended: CHEST X-RAY Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment: WORSENING THE CONDITION IF THERE IS ANY FINDINGS I understand the possible consequences and/or complications, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and its employees from any and all liability for respecting and following my expressed wishes and directions. X-RAY 7-10-2019 Counseled by Date Patient Signature (Cc Signature of Witness Date NYM-NEW YORK MCC Date EFTA00048527

U.S. Department of Justice Federal Bureau of Prisons Reentry Services Division Washington, DC 20534 May 14, 2020 MEMORANDUM FOR REGIONAL DIRECTOR NORTHEAST REGION Digitally signed by Date: 2020.05.14 11:36:21 -04'00' FROM: , Assistant Director SUBJECT: Reentry Services Division Institution Response Psychological Reconstruction Inmate Epstein, Jeffrey (Reg. No. 76318-054) I have reviewed your Institution Response, dated January 27, 2020, to the Psychological Reconstruction of an inmate suicide at MCC New York. The corrective actions and plans for implementation in your response are appropriate. Please thank your staff for their efforts in addressing the recommendations outlined in the Psychological Reconstruction Report. If you have questions or concerns, please feel free to contact me at cc: Warden, MCC New York EFTA00048528

PSYCHOLOGICAL RECONSTRUCTION OF INMATE DEATH This is an interim report, due to an inability to gather all necessary data. Formal interviews were not conducted as a part of this reconstruction to avoid interference with pending investigations by other Department of Justice components. A copy of the video is normally made by Special Investigative Staff following a significant incident, but there was no such video in this case since the original video was confiscated by the Federal Bureau of Investigation (FBI) prior to the beginning of this reconstruction. The absence of these two sources of information severely limited the ability to establish accurate timelines, confum subjective reports, establish converging and diverging lines of facts, or discover new areas of inquiry. As a result, information typically gathered, reviewed and consolidated during a reconstruction to support actionable findings and recommendations is limited. Name: Jeffrey Epstein Register Number: 76318-054 Date of Death: 08-10-2019 Prepared by: National Suicide Prevention Coordinator, Psychology Services Branch, Central Office BACKGROI IND INFORMATION Mr. Jeffrey Epstein was a 66-year-old, White male who died on August 10, 2019. while housed at the Metropolitan Correctional Complex (MCC), in New York, New York. former Acting Assistant Director, Reentry Services Division a inted a team to conduct a psychological reconstruction. The team consisted of National Suicide Prevention Coordinator, Central Office; Sex Offender Treatment Programs Coordinator, Central Office; Mental Health Treatment Coordinator, Central Office; and Correctional Services Administrator, Northeast Regional Office. This reconstruction was established in accordance with Bureau of Prisons' (BOP) Program Statement 5324.08 Suicide Prevention Program, Social History: Mr. Epstein did not have a Pre-Sentence Report (PSR) available at the time of the reconstruction; therefore, no official information regarding social history was accessible. The following was gathered from publicly available documents. Mr. Epstein was born in 1953 and grew up in a middle-class family in the neighborhood of Sea Gate on Coney Island, Brooklyn, New York, with one brother. After early promotion in two grades, Mr. Epstein graduated from Lafayette High School in 1969, at the age of 16. He attended Cooper Union and New York University but did not graduate from either. Mr. Epstein taught at the Dalton School, a private school on the Upper East Side of Manhattan from September 1974 until he was 1 EFTA00048529

dismissed in June 1976 for inadequate development as a teacher. Following that, he held a number of positions in the financial industry to include a position as a limited partner at Bear Steams until he was dismissed for unknown policy violations in 1981. He also worked as a financial consultant and founded at least two separate companies. Mr. Epstein had two significant periods of employment. The first of these was his position as a consultant with Steven Jude Hoffenberg in the late 1980s. Mr. Hoffenberg was described as his first mentor. Mr. Hoffenberg was later convicted and incarcerated for running a large Ponzi scheme. He implicated Mr. E stein in fraudulently diverting company funds for his own personal use. Years later, Mr. Epstein's sole client at J. Epstein and Com an , granted him power of attorney over his affairs. Despite also being identified as Mr. mentee, Mr. Epstein was again accused of misappropriating funds-more than 46 million dollars. These large sums are believed to be the seed money Mr. Epstein used to establish his considerable fortune. These events are indicative of Mr. Epstein's highly-regarded intelligence and charismatic personality. Legal History: Mr. Epstein had a history of adult criminal charges and convictions. In June 2008, he entered into a non-prosecution agreement and pleaded guilty to one count Solicitation of Prostitution and one count Procuring a Person Under the Age of 18 for Prostitution in the state of Florida. He was sentenced to 30 months: 18 months of incarceration and 12 months of probation. He was also mandated to register as a sex offender under the National Sex Offender Registration and Notification Act. Mr. Epstein served 13 of his 18-month incarceration and then successfully completed 12 months of probation. It is unclear whether he followed the sex offender registration guidelines in each place he owned a residence. In regard to pending charges, Mr. Epstein was formally charged with Sex Trafficking Conspiracy in violation of 18 U.S.C. § 371 and Sex Trafficking in violation of 18 U.S.C. § 1591(a), (b) (2), 2 on July 2, 2019. Specifically, he was accused of sexually exploiting and abusing minor females over the course of several years. Charging documents allege Mr. Epstein enticed and recruited minor females to engage in sexual activity. The minor females were reportedly compensated with cash following the sexual encounters and some were encouraged to find other minor females to accompany them to Mr. Epstein's residences in New York or Florida. He pleaded not guilty to these charges and was in pretrial status at the time of his death. In a 37-page Decision & Order Remanding the Defendant, signed by Judge Richard M. Berman on July 18, 2019, 18 pages were dedicated to detailing the danger Mr. Epstein posed to others and the community. The document also alleged he was a flight risk. As a result, Mr. Epstein's proposed bail package was determined to be inadequate. He was denied pretrial release and held on remand. 2 EFTA00048530

Institutional History: On July 6, 2019, Mr. Epstein was arrested at Teterboro Airport in New Jersey upon his return from Paris, France. It is unknown whether he was anticipating this arrest. He was transported to MCC New York and keyed into SENTRY at 9:24 p.m. that evening. Mr. Epstein was placed in a general population housing unit for approximately 22 hours. On July 7, 2019, at approximately 7:20 p.m. he was moved to the Special Housing Unit (SHU) pending reclassification due to the significant increase in media coverage and awareness of his notoriety among the inmate population. With regard to his adjustment to a correctional setting, Mr. Epstein received one incident report while in BOP custody for Self-Mutilation on July 23, 2019. As of August 15, 2019, the incident report had been expunged though it is unclear why it had been expunged and whether Mr. Epstein knew this. Also, a review of financial transactions associated with Mr. Epstein's prison account revealed one of his attorneys was depositing funds into his cellmate's (inmate Reyes) commissary account for unknown reasons. BEALTH CARE AND PERSONALITY DESCRIPTION BOP Electronic Medical Records (BEMR) indicate Mr. Epstein was diagnosed with hyperlipidemia, sleep apnea, hypertension, constipation, prediabetes, neuralgia, and neuritis unspecified. He was prescribed the following mediations: docusate sodium, milk of magnesia, omega 3, methylprednisone, and bisacodyl. Mr. Epstein was also prescribed insulin, and the prescription required him to go to the institution pharmacy for administration of this medication. However, the dates for which it was prescribed have a notation indicating "dose not indicated," thus it does not appear insulin was routinely medically necessary. The rest of the medications prescribed were self-carry. He also had a continuous positive airway pressure (CPAP) machine which is typically used to treat sleep apnea. Mr. Epstein was provided with his personal CPAP machine on July 30, 2019, per BEMR. In regard to mental health history and treatment, there are no known available records. Any records that may have been maintained relating to Mr. Epstein's incarceration in Florida were not available for review as of the date of this re rt. With regard to Psychology Data System records in BEMR (PDS-BEMR), Dr. Forensic Psychologist at MCC New York completed a routine Intake Screening on July 8, 2019. During this screening, Mr. Epstein denied any history of mental health problems, substance abuse, and treatment. No symptoms of mental illness were observed. He was classified as Mental Health Care Level 1 and was not diagnosed with a mental illness. Following a consultation with Dr. , National Suicide Prevention Coordinator on July 8, 2019, Dr. Chief Psychologist at MCC New York determined Mr. Epstein should be pre-emptively evaluated for suicide risk upon his return from court. Primary consideration was given to his various risk factors for suicide such as his high profile case and media attention, pending sex offense charges, pre-trial status, and an ongoing court proceeding. Mr. Epstein returned from court on July 8, 2019, after normal business hours. He denied suicidal 3 EFTA00048531

thoughts at that time, but due to the potential for other risk factors listed above, the on-call psychologist placed Mr. Epstein on Psychological Observation in one of the suicide watch cells until he could be assessed in person by a BOP psychologist. Psychological Observation is a form of individual monitoring that is less restrictive than Suicide Watch. It is used for inmates who are stabilizing and not yet prepared for placement in general population or restrictive housing. It is often used to transition inmates off of Suicide Watch in order to monitor their transition and safety after an acute suicidal crisis. On Jul 9, 2019, Mr. Epstein underwent a formal, in-person suicide risk assessment with . She determined that, while suicide watch was not warranted at that time, Mr. Epstein should remain on Psychological Observation status out of an abundance of caution. He was removed from Psychological Observation on July 10, 2019. On July 23, 2019, the on-call psychologist was notified Mr. Epstein had been found in his cell with a piece of orange cloth around his neck. Reportedly, he was observed lying in the fetal position on the floor with a noose around his neck. Medical staff evaluated Mr. Epstein and found friction marks and superficial reddening of the neck skin and one knee. He was placed on suicide watch by the Operations Lieutenant at approximately 1:40 a.m. pending a formal in- person suicide risk assessment. Dr. Staff Psychologist at MCC New York, assessed Mr. Epstein for risk of suicide later in the morning of July 23, 2019, and determined he should remain on suicide watch. Mr. Epstein denied any knowledge of how he received marks on his neck and initially informed staff he believed his cellmate,Nicholas Tartaglione, had attempted to kill him. Special Investigative Services (SIS) staff opened an investigation to assess Mr. Epstein's safety and collect facts surrounding the episode. Despite this investigation, staff was unable to determine whether he was assaulted or engaged in self-directed violence. Mr. Epstein was removed from suicide watch on July 24, 2019, after 31 hours and 5 minutes. Thereafter, he remained in the suicide watch cell and was placed on Psychological Observation, where he remained housed until July 30, 2019, according to PDS-BEMR records. A discrepancy exists regarding when he was removed from Psychological Observation. His cell assignment, per SENTRY, indicates he was transferred back to the Special Housing Unit (SHU)on July 29,2019, whereas PDS-BEMR indicates he was removed from Psychological Observation on July 30, 2019, at approximately 8:15 a.m. Mr. Epstein attended a court hearing on July 31, 2019, and, upon his return, the United States Marshals Service (USMS) provided aperwork to Receiving and Discharge (R&D) staff that noted "suicidal tendencies." was notified on August 1, 2019, about this paperwork. She consulted with and then met with Mr. Epstein to conduct a suicide risk assessment. She determined suicide watch was not warranted at that time. Mr. Epstein remained classified as a Mental Health Care Level 1 throughout his time at MCC New York. During his contacts with psychologists, Mr. Epstein routinely denied current mental health symptoms to include suicidal ideation, and he did not exhibit symptoms of a serious mental illness. However, there was evidence Mr. Epstein was experiencing challenges 4 EFTA00048532

adjusting to his environment and changes in his lifestyle. He reported frequent complaints of difficulty sleeping. He did not have access to his CPAP machine until it was reportedly provided to him on July 30, 2019. Mr. Epstein also reported he was bothered by noise in the SHU. At times, he noted concerns related to his safety in SHU or on a general population housing unit. On two occasions, July 26, 2019, and July 27, 2019, he described himself as a coward and as someone who does not like pain. On July 28, 2019, he told the toilet in his cell would not stop flushing for an extended period of time, and he then took to sitting in the corner with his hands over his ears. Mr. Epstein indicated he was agitated following this incident and was unable to sleep that night. ANTECEDENT CIRCUMSTANCES Mr. Epstein entered BOP custody on July 6, 2019, with a history of convictions for sexual offenses and allegations comprised of more serious charges. The current indictment alleged sexual crimes against minors, and he was facing up to 45 years in prison. On July 18, 2019, Mr. Epstein's request for bail and pretrial release was denied. On July 23, 2019, Mr. Epstein was found unresponsive in his cell. The motivation and context were never fully determined. After 31 hours and 5 minutes on Suicide Watch, he was then placed on Psychological Observation. On July 30, 2019, Mr. Epstein was removed from Psychological Observation. sent an e-mail reporting Mr. Epstein had been removed from Psychological Observation and needed to be housed with an appropriate cellmate. This e-m ail was sent to 71 MCC New York staff and, as of August 13, 2019, only 27 staff members had opened the message. On August 9, 2019, a federal court unsealed approximately 2,000 pages of documents into the public domain. These included graphic allegations against Mr. Epstein. Included was a book order receipt for titles such as SM 101: A Realistic Introduction; SlaveCraft: Roadmaps for Erotic Servitude; and Training with Miss Abernathy: A Workbook for Erotic Slaves and Their Owners. Additional high profile public figures were also named in the released documents. The documents were part of a defamation lawsuit filed by a woman who alleged Mr. Epstein had victimized her, against a British socialite, Ghislaine Maxwell, who was Mr. Epstein's ex-girlfriend, associate, and alleged to have assisted with his criminal activities. According to staff report, Mr. Epstein was afforded telephone calls on two different days although it is unknown whether they were legal or social calls. No recording of the calls exist and it is not known with whom he was speaking. One occurred on or around July 16, 2019, and the other on August 9, 2019. Legal calls are not monitored, and would not be recorded. A social call would be recorded; given the limited information known about Mr. Epstein, knowledge of the content of any social calls would have been crucial to helping staff work with him. Following his final telephone call on the evening of August 9, 2019, Mr. Epstein was moved into his SHU cell. He was single-celled at that time because his cellmate (Efrain Reyes #85993-054) 5 EFTA00048533

did not return from court. The need for a cellmate was communicated between Day Watch (DW) and Evening Watch (EW) shifts in the SHU, but no cellmate was laced with him by the EW staff. According to a memorandum from Senior Officer Specialist , SHU staff were informed at approximately 1:50 m. Mr. Epstein's cellmate would likely not return from court. Furthermore, Officer noted Mr. Epstein would need a cellmate upon arrival from his attorney visit. A review of the 30-minute rounds forms indicate unit rounds were corn leted for the entire MW shift on August 10, 2019. However, a memorandum from Lieutenant indicates Officer Tova Noel and Material Handler Supervisor Michael Thomas made a statement after Mr. Epstein's death that they did not complete proper 30-minute rounds at 3:00 a.m. or 5:00 a.m. DESCRIPTION OF SCF.NFt A detailed description of the scene was unavailable because the officers who discovered Mr. Epstein did not write memorandums and could not be interviewed. According to the Report of Incident, on August 10, 2019, at approximately 6:33 a.m., while serving the breakfast meal in the SHU, Range 9 South, Mr. Epstein was found unresponsive in his cell. Staff reportedly called for medical assistance, activated the body alarm, and began life-saving measures. Arriving staff stated they brought an automated external defibrillator (AED) and stretcher. Cardiopulmonary resuscitation (CPR) reportedly continued while the AED was placed on Mr. Epstein. The AED reportedly indicated no shock advised and CPR was continued. Mr. Epstein was escorted to Health Services at approximately 6:39 a.m., and Emergency Medical Services (EMS) arrived at 6:43 a.m. He was transported to the local hospital at approximately 7:10 a.m. Mr. Epstein was pronounced deceased at 7:36 am. It was not possible to confirm this timeline without viewing video footage. CONCLUSIONS/RECOIVIMENDATIONS A general appreciation of risk factors for suicide specific to sex offenders is necessary when reviewing Mr. Epstein's death. These factors, as well as more general risk factors for suicide, were likely present. There are several common factors that increase risk for suicide in individuals with a history of a sexual offense. These include stigma due to the nature of sexually-based crimes (both within society and the prison system), a disruption of the ability to utilize sex as a coping mechanism (which can lead to increased levels of distress and negative affect), and grief about loss experienced in regards to arrest. This grief may be secondary to the loss of former lifestyle, loss of physical items or collections related to sexual offenses, and/or the loss of perceived relationships with victims. Other factors that may increase risk for suicide among individuals accused of a sex offense include safety concerns, potentially long sentences, and lack of skills necessary to navigate social relationships in prison. Mr. Epstein was a high-profile, pretrial detainee awaiting trial on sex trafficking offenses. He had been a successful, wealthy businessman with a number of high-profile acquaintances that he accumulated through a combination of charisma, charm, and intelligence. Despite his many associates, he had limited significant or deep interpersonal ties. Although Mr. Epstein appeared 6 EFTA00048534

to cultivate a large social and professional network, he was estranged from his only brother. Indeed, his identity appeared to be based on his wealth, power, and association with other high- profile individuals. Approximately two-and-a-half weeks before his death, Mr. Epstein appeared to attempt suicide, but ultimately denied it was a suicide attempt. He was convincing in his denial. On that occasion, he was saved because his cellmate notified BOP staff. In the weeks before his death, he made statements that he was "a coward" and was having difficulty adapting to his diminished circumstances. He also frequently referenced poor sleep and an inability to tolerate the noise of prison. On the day before his death, a number of documents in his case were unsealed, further eroding his previously- enjoyed elevated status and potentially implicating some of his associates. The lack of significant interpersonal connections, a complete loss of his status in both the community and among associates, and the idea of potentially spending his life in prison were likely factors contributing to Mr. Epstein's suicide. The following recommendations concern institution operations: Corr Svc/ Psych 1. Single Tilling. It is recommended that all inmates be double-celled unless safety concerns or an odd number of inmates precludes this. Priority should be given to inmates with a history of mental illness, self-directed violence, recent stressors (e.g., losses, newly sentenced, etc.) It is recommended that a system of control be implemented explaining who will be notified when a Suicide Watch or Psychological Observation ends and how that communication will take place. Because this is a life safety issue, the system of control, once approved by the warden, should be reviewed in formal meetings such as staff recalls, department head meetings, and lieutenants meetings. 1. Single Cell Placement A system has been put in place to ensure inmates are not single celled. A single cell report is completed during each shift by the SHU Lieutenant during Day Watch and the Operations Lieutenant during the Morning Watch and Evening Watch. Notifications are made to the Institution Duty Officer (IDO) and Executive Staff. Psychology discusses the status of inmates who are at-risk for suicidality, their housing needs, as well as their needs for cellmates during staff meetings, department head meetings, SHU meetings, morning meetings, and close out meetings. When inmates are placed on and off suicide watch, the Warden is notified verbally, regardless of the time of day. The Warden then determines which suicide watch area a suicidal inmate will be housed and if they will be observed with an inmate companions or a staff member. 7 EFTA00048535

Psychology verbally notifies the Lieutenant when inmates are removed from suicide watch and communicates to the Lieutenant that they will need to be placed with a cellmate (Providing direct communication and instructions). Cellmates are recommended not only for SHU inmates being removed from suicide watch, but also for inmates returning to the general population setting. Once an inmate is removed from suicide watch, psychology staff sends an e-mail to the Executive Staff, IDO, and Lieutenants informing them the inmate is being removed from suicide watch and can return to a cell with a cellmate. The e-mail contains the name of the staff member whom psychology verbally spoke with. This recommendation for a cellmate and conversation with the Lieutenant is also documented in the Post Suicide Watch Report and placed in BEMR/PDS. Psychology Services has eliminated the use of Psychological Observation to avoid any confusion as to the needs of inmates on a watch status. Exec/IDO 2. Rounds: 30-minute rounds are required by P5500.14 correctional Services Procedures Manual. Corr Svc / Legal 3. f climate Assignments; When Mr. Epstein was placed in SHU on July 7, 2019, Executive Staff decided Mr. Tartaglione would be his cellmate. As explained by input was not sought from Psychology Services and it is not clear if or how sex offender-specific needs and associated risk were incorporated into the housing plan. Mr. Tartaglione was also a high profile inmate-an ex-police officer charged in multiple murders. However, he and Mr. Epstein did not share the risk associated with being a sex offender and their pairing may have aggravated Mr. Epstein's risk for self-directed violence. In an effort to treat Mr. Epstein the same as other inmates, a statement repeated by multiple staff, Executive Staff may have inadvertently overlooked the need to consider unique risk factors associated with individuals who have been charged with and convicted of a sex offense. On July 25, 2019, sent an e-mail to Associate Warden explaining a consultation between and Dr. , National Suicide Prevention Coordinator. In the e-mail, 3. Cellmate Assignments: The psychological reconstruction suggests MCC New York Executive Staff did not take into account Mr. Epstein's sex offender-specific needs in assigning him a cellmate in SHU. However, that is not correct. MCC New York Executive Staff considered a variety of factors in determining the most appropriate cellmate for Mr. Epstein, including but not limited to history of sex offenses, nature of the inmate, cooperation status, etc. 8 EFTA00048536

MCC New York administrators initially housed Mr. Epstein with Mr. Tartaglione as both had high profile cases. Mr. Tartaglione is also a certified death penalty eligible inmate and, thus, based on correctional judgment, less likely to assault or otherwise try to extort Mr. Epstein. Indeed, Mr. Tartaglione notified staff immediately when he realized Mr. Epstein first made a possible suicide attempt/gesture on July 23, 2019. Prior to Mr. Epstein being taken off suicide watch, MCC New York Executive Staff, with input from psychology staff, assessed all the inmates in SHU at that time and narrowed the list down to the most appropriate candidates. Mr. Tartaglione was not chosen as the investigation at the time had not yet cleared him of any wrongdoing. Most of the other inmates in SHU at the time were there for disciplinary reasons and were otherwise not appropriate to be housed with Mr. Epstein. The other notable inmate in SHU with a history of sex offenses, Mr. Hoyt, was deemed dangerous to Mr. Epstein due to his threatening nature. Accordingly, MCC New York Executive Staff narrowed the possibilities to cooperators. Specifically, Efrain Reyes, reg. no. 85993-054, was placed in SHU for claims he was being threatened and extorted on his unit, and he was confirmed as proffering with the U.S. Attorney's Office. As both he and Mr. Epstein were in SHU for safety reasons, Mr. Reyes was deemed an appropriate cellmate. Based on the above, consideration was made for Mr. Epstein's sex-offender-specific needs in choosing his cellmate in SHU. His charged crime was just one of the factors reviewed in making the determination. MCC New York Executive Staff also considered high publicity inmates with ample reasons not to hurt Mr. Epstein, and cooperators who are not only vulnerable themselves, but also had a lot to lose should they harm Mr. Epstein. 3. Cellmate Assignments Inmates with serious mental illness and those at-risk for suicidality are discussed during staff meetings, department head meetings, SHU meetings, morning meetings, and close out meetings. The Captain, Associate Wardens, Warden and Psychology discuss the inmate's needs. The Staff Attorney also assists when the inmate's attorney or court are concerned about an inmate's mental health. Psychology Services are involved in making recommendations regarding the types of cellmates that inmates at- risk for suicidality should celled with. Psychology Services takes into consideration the suicide risk factors involved with a particular inmate and share their knowledge with Executive Staff. Legal reviewed the consult and recommendation from the Psychology Services Branch, Central Office that Mr. Epstein be housed with another inmate who had also been accused of 9 EFTA00048537

committing a sex offense. There is no evidence this information was considered beyond this e-mail, and Mr. Epstein was never housed with another inmate charged or convicted of a sexual offense. Exec Staff It is recommended Executive Staff and Correctional Services staff include a psychologist in decisions about cellmates as a means of incorporating expertise about suicide risk, mental health needs, and interventions for psychological stability. Psvc Svc 4. Documentation Accuracy On July 23, 2019, Mr. Epstein was found unresponsive in his cell. He had abrasions on his neck and knee. There are inconsistencies between documents describing the circumstances of the scene. In a General Administrative Note in PDS-BEMR documented information received from Operations Lieutenant that Mr. E stein. "was found with a string loosely hanging around his neck." In contrast, Officer who responded to this emer ency, wrote a memorandum dated July 23, 2019. In that memorandum, Officer wrote he saw Mr. Epstein "laying down near his bunk with what appeared to be a piece of handmade orange cloth around his neck." It is critical that all descriptions of the incident accurately reflect objective evidence. Officer wrote Mr. Epstein an incident report for Self-Mutilation on July 23, 2019, after he was found unresponsive in his cell but prior to having the necessary facts to determine whether he likely engaged in a Bureau violation. BOP policy expects staff to write an incident report within 24 hours of having the information that an inmate likely violated BOP rules but without making a presumptive decision about guilt. A Special Investigative Services Threat Assessment was completed August 2, 2019, but results were inconclusive as to whether Mr. Epstein engaged in self- directed violence, willingly fought with his cellmate, or was assaulted by his cellmate. It is recommended that staff remain open to all reasonable explanations for a behavior and take the appropriate actions when a final determination is made. Although the incident report was later expunged, inmates frequently experience significant stress when they contemplate the potential consequences associated with findings of guilt. entered a Psychology Services Intake Screening into PDS-BEMR on July 8, 2010. The document has three typographical errors. She selected the No Sexual Offense Convictions check box when, in fact, Mr. Epstein was previously convicted of S9licitation of Prostitution and Procuring a Person Under the Age of 18 for Prostitution. Second, Mr. Epstein was erroneously identified as a Black male in this document. Finally, there is one instance where he was mistakenly referred to as Mr. Brown. 4. Documentation Accuracy I EFTA00048538

Psychology considers the information from more than one source when making decisions about suicide watch placement. Clinical judgment is used to make determinations taking into consideration each person's self-report of a situation as they may be perceived differently. The Chief Psychologist has spoken to all psychology staff members concerning proof reading all documents entered to reduce typos and to improve information accuracy. Additionally, there is a second Staff Psychologist in the department which helps reduce the workload on current psychologists, allowing more time for documentation review. The Chief Psychologist and Drug Abuse Coordinator counseled the Drug Treatment Specialist (DTS) concerning her documentation in the suicide watch log book. There was no ill-intent on the part of the DTS as all log books were maintained; the original log book written by the officer and the one documented by the DTS. The DTS indicated a desire to assist the officer as he had written in the wrong log book. Specifically, he wrote in the inmate companion log book rather than the staff log book. However, she was informed that this is not her role and she is not to document in a log book for anyone else observing an inmate on suicide watch. In the future, only the staff member watching the inmate on suicide watch documents in the suicide watch log book. Log books are now being closely monitored on a daily basis by the Chief Psychologist. The Psychology Department has eliminated Psychology Observation at MCC-NY. Both Staff and the Lieutenants received additional training on when they are required to complete rounds and sign Suicide Watch log books. With regard to suicide watch log books signatures, Correctional Staff arc required to perform routine rounds every hour. The 2 Sally Officer on Monday- Friday during Day Watch is required to perform rounds on suicide or observation watch inmates as prescribed by the Captain. After-hours, the Unit 2 Officer will be responsible for making rounds, feeding meals, collecting trash in the area, and performing the count with the Internal I or Internal 2 assisting with duties as assigned by the Captain. Additionally, Psychology staff check the suicide watch logs daily when they interview the inmates on suicide watch. If it is noted hourly rounds are not being conducted by the Unit Officer and/or the Lieutenants are not rounding and signing the books each shift, the Associate Warden over Programs and the Captain are notified immediately and enforce accountability. EFTA00048539

completed a Risk of Sexual Abusiveness document on July 8, 2019. She marked "History of prior prison sexual predation" in the affirmative. This is not accurate. Mid-Level Practitioner, completed a History and Physical on July 9, 2019. An Intake Screening should have been conducted within 24 hours of his entry into Bureau custody which was on July 6, 2019, according to P6031.04, Patient Care. 4: Inmate Jeffery Epstein #76318-05, arrived in the Receiving and Discharge (R&D), area, on July 6, 2019, at approximately 9:24 p.m. His medical Intake Screening was conducted at approximately 9:38 p.m., by Health Services staff, Physician Assistant (PA) on July 6, 2019, the same night he arrived in R&D. On July 9, 2019, he was placed on Psychological Observation and at approximately 12:38 p.m., he was escorted from Psychological Observation to Health Services for a Medical Assessment and a History and Physical, which was performed by PA . According to P6031.04, Patient Care, a provider must perform a History and Physical within 14 days of the inmate arriving at BOP facility. The History and Physical and Intake Screening was conducted timely and in accordance to policy. ays was responsible for observing Mr. E stein and documenting his behavior while on suicide watch on July 23, 2019. mistakenly used a Suicide Watch Log Book intended for inmate companion documentation between Suicide Watch Log Book. 1:40 a.m. and 6:00 a.m. on Jul 23, 2019, when he should have been using the Staff Drug Treatment S ecialist, reportedly noticed this error and subsequently hand copied all of entries from 1:40 a.m. to 6:00 a.m. into a Staff Suicide Watch Log Book. She then initialed these entries, and this makes it appear as if she was the one conducting the watch. This information was discovered and conveyed in an e-mail from Ms. Associate Warden to with a carbon copy to Warden on August 12, 2019. Of note, did not make an entry explaining why she was making the log book changes. Additionally, then wrote entries for 6:15, 6:30, 6:45 and 7:00 a.m. in the Staff Suicide Watch Log Book. These were not a part of the original entries made by nor was assigned to work the Suicide Watch post. Due to the inabilit to interview staff at this time, it is unknown why attempted to correct error, or made any of the subsequent log entries. It is recommended that if a staff member makes an entry error (e.g., writes in the incorrect suicide watch log book), the staff member should describe the error in the correct log book, to include indicating when they became aware of the error. The staff member should then notify the Chief Psychologist. Corr Svc 9 EFTA00048540

A review of Special Housing Unit Records (BP-A0292) revealed a number of incomplete entries. This document is used to monitor provision and receipt of basic services such as recreation, medical rounds, showers, meal consumption, etc. The Officer in Charge signature is missing on 10 occasions and a medical provider's signature is missing in seven instances. There are six instances in which it is not clear if Mr. Epstein ate his meal. There are nine instances in which it is not clear if Mr. Epstein took a shower. There are ten instances in which it is not clear if Mr. Epstein was offered recreation. P5500.15, Correctional Services Manua requires accurate and complete information on the BP-A0292. A review of Psychology Observation Log Books revealed significant discrepancies from the approved Psychological Observation Procedural Memorandum, dated April 15, 2019. A Correctional Officer is required to complete hourly rounds and sign the log book; 179 10 EFTA00048541

out of 183 round signatures were missing. The lieutenant is required to sign the log book one time per shift and signatures were missing in 10 of 23 instances. A Physician Assistant is required to sign one time per shift and 16 of 16 instances were missing. It is recommended that a further review of Psychological Observation procedures be conducted. fl = 5. Telephone Calls• In a PDS-BEMR note written by on July 16, 2019, she was informed by an unnamed staff member that a lieutenant facilitated two telephone calls for Mr. Epstein. It is unknown when and to whom these calls were placed and no evidence that they took place on a monitored telephone. According to a memorandum from Unit Manager on August 10, 2019, Mr. Epstein terminated his le al visit early on August 9, 2019, in order to place a telephone call to his family. (who was the Institutional Duty Officer that week) escorted Mr. Epstein to SHU around 7:00 p.m. that evening and he was placed in the shower area on G tier. While there, he was provided the telephone to make a call. Since Mr. Epstein reportedly did not have his PAC or PIN number, which is required to use the inmate telephone system, the Unit Manager placed the call, dialing a number that reportedly began with area code 347. Mr. Epstein told he was calling his mother who, according to public records, has been deceased since 2004. It is recommended that all telephone calls, other than legal calls, be made on monitored lines to be available for post-call review or on a speaker phone so staff can monitor what is discussed. Section 5: There is no documentation to substantiate that a Lieutenant facilitated two telephone calls to Mr. Epstein. However, there is documented evidence that Unit Manager Proto provided a call to Mr. Epstein on July 30, 2019, at 5:15 p.m., to a Karina Shaliak, friend, on a monitored telephone/speaker phone. The call was documented in a log that is maintained in the Correctional Systems Department. Mr. Epstein was provided a call because he had not been able to conduct voice recording on the inmate telephone. This is standard procedure by the Unit Team at MCC New York, to occasionally provide a call to new arrivals, when necessary. 6. Direct Observation; Mr. Epstein was on suicide watch from July 23, 2019, until July 24, 2019. While on suicide watch on July 23, 2019, Mr. Epstein attended an attorney visit from approximately 12:40 p.m. until 7:15 p.m. During this time, he was without "direct, continuous observation" by a dedicated BOP staff member as required by P5324.08. While on Psychological Observation, he attended attorney visits on July 24, 2019, for 11.25 hours; on July 25, 2019, for 11.25 hours; on July 26, 2019, for 9.25 hours; on July 27, 2019, for 11.33 hours; on July 28, 2019, for 10.5 hours; and on July 29, 2019, for 8 hours. On July 30, 2019, Psychology Observation was terminated. 11 EFTA00048542

During these visits, continuous observation by a dedicated BOP staff member was not maintained as required by MCC New York's Procedural Memorandum for Psychological Observation. 6. Direct Observation The Psychology Department has eliminated Psychology Observation at MCC-NY. Inmates on Suicide Watch are only provided legal visits under special circumstances as deemed by the Court. 7. Follow-Um Mr. Epstein arrived at MCC New York on Saturda July 6, 2019. While conducting the 10:00 p.m. institution count that evening, Facilities Assistant reported she observed Mr. E stein in his cell. In an e-mail she sent to and and Lieutenant later that evening, she described Mr. Epstein as "distraught, sad and a little confused." She said she then asked Mr. Epstein if he was 7. Follow Uo Staff have been trained when they have concerns for an inmate's mental health, they need to make verbal contact with either Psychology Staff or a Lieutenant. If Psychology is not in the institution, an inmate is placed on suicide watch, and the on-call psychologist and Warden is notified. All Psychology Staff added a response to their incoming emails. This automatic replay states, "If you are emailing about an inmate that may be at risk for suicide or self-harm, this is an emergency situation. Please make sure that you make contact (verbally) to Psychology Staff or the on-call psychologist. Please ensure to maintain constant visual observation of the inmate until formal steps can be taken to ensure his/her safety pending a formal assessment by a Psychologist." The Psychology Department uses PSY ALERT codes more frequently with high profile cases and with inmates with a history or charge of a sex offense. The PSY ALERT code is applied more immediately and not just when an inmate is about to leave the institution. If an inmate is moved in and out of our institution for court, etc., the inmate is assessed more immediately prior to being released to a unit. R&D staff have been reminded of the Marshall and Court alert notices. Psychology Staff are notified immediately if there are suicidal concerns noted by the Courts. If Psychology is not in the institution, an inmate that enters the institution with an alert notice is placed on suicide watch, and the on-call psychologist and Warden is notified. These inmates receive a suicide risk assessment by a psychologist before being released to the general population. 12 EFTA00048543

Psvc Svc okay, and he reportedly said he was. However, noted in her e-mail she was not convinced of this, adding, "He seems dazed and withdrawn." She went on to say, "So just to be on the safe side and prevent any suicidal thoughts can someone from Psychology come and talk with him." Despite the fact that Lieutenant opened the e-mail there is no evidence that he contacted the on-call s chologist as is required by P5324.08, Suicide Prevention Prozram, Additionally, if was concerned about suicide risk, P5324.08, Suicide Prevention Pro re tyres her to maintain direct, continuous observation of Mr. Epstein. When o ened the e-mail the following Monday morning, Mr. Epstein was evaluated by at approximately 9:30 a.m. Psvc Svc Mr. Epstein was denied bail on Thursday, July 18, 2019. This was a significant disappointment for Mr. Epstein and likely challenged his ability and willingness to adapt to incarceration. Given the potential impact of the judge's decision, a psychologist should have assessed Mr. Epstein's mental status upon his return to the institution. The BOP developed a SENTRY assignment of PSY ALERT for purposes such as this. Specifically PSY ALERT is used "to ensure, if movement occurs, that all staff consider the special psychological and management-related risks associated with the inmate." Furthermore, P5324.07 SENTRY Psvcholozv Alert Function states, "When a decision to move [any PSY ALERT] inmate occurs, any special psychological needs of the inmate are reviewed and considered by Psychology Services staff [and] any safety and security concerns are highlighted for non-Psychology Services staff." Psychologists should use the PSY ALERT assignment more frequently with high profile cases and with inmates who have a history or charge of sex offense. Both of these groups of inmates are susceptible to exaggerated or unrealistic fears about correctional settings and experience stress associated during movement and periods of transition (e.g., cell/unit changes, movement to and from court, institutional movement, and release of information through the media). PP-63 Func Mr. Epstein was reportedly in court on July 31, 2019. It is unknown what time he departed or returned to MCC New York because this information was not entered in SENTRY. Regardless, upon his return, the United States Marshals Service (USMS) provided R&D staff with a Prisoner Custody Alert Notice regarding Mr. Epstein. The notice indicated Mr. Epstein had "MTL Mental Concerns Suicidal Tendencies." The USMS requested R&D staff sign the form and the then departed with the signed copy. On August 1, 2019, at 8:46 a.m., sent an e-mail reporting she had just become aware of the above information. In the absence of additional information about this notation, this should have been considered a referral to Psychology Services about a potentially suicidal inmate and procedures should have been followed as outlined in P5324.08, Suicide Prevention Program, Specifically, when a staff member becomes aware an inmate may be thinking about suicide during normal working hours, that staff 13 EFTA00048544

member must contact Psychology Services and maintain the inmate under direct,continuous observation until he is placed on Suicide Watch or seen by a psychologist. There is no evidence Mr. Epstein was monitored under these conditions from the time he returned from court until he was seen by for a suicide risk assessment on August 1, 2019, at approximately 1:30 p.m. Exec 8. Jnmate Accountability and Assignment Accuracy. According to a SENTRY quarters roster generated on August 10, 2019, at 12:51 a.m., there were three inmates assigned to Mr. Epstein's SHU cell, Z04-206LAD, including him, at the time of his death. However, his SHU cell was only a double occupancy cell. Inmate Patrick Avila (#86710-054), inmate Gregory Ferrer (#79793-054), and Mr. Epstein were all assigned to the same cell. On August 13, 2019, at 12:06 p.m. and 12:08 p.m., a quarters history roster was generated for inmate Avila and Ferrer, respectively. Inmate Avila's cell assignment was Z04-206LAD from August 5, 2019, until August 11, 2019, when he was moved to cell Z04-212UAD. Inmate Ferrer's cell assignment was Z04-206UAD from August 1, 2019, until August 11, 2019, when he was moved to cell Z04-207LAD. A quarters history roster was generated for Mr. Epstein on August 13, 2019, at 9:07 a.m. His cell assignment was Z04-206LAD from July 29, 2019, until August 10, 2019. On Monday, August 12, 2019, photographs ofnametags on SHU cell doors and SHU locator forms were sent to the Correctional Service Department in the Northeast Region. The SHU locator form is dated August 9, 2019. It shows inmate Ferrer in cell 207L (SENTRY states he was moved to this cell on August 11, 2019), inmate Avila in cell 212U (SENTRY states he was moved to this cell on August 11, 2019), inmate Epstein in cell 220L (SENTRY never shows him in this cell) along with inmate Reyes (#85993- 054). The locator shows inmate Copper (#92299-054) and inmate Dockery (#60685-050) in cell 206. The photo sheets show the cell being 220 with inmates Epstein and Reyes' identification cards on the door. Inmate Reyes, Efrain, Reg. No. 85993-054 was in cell Z06-220U from August 5, 2019 to August 9, 2019. Psvc Svc MCC New York has four suicide watch cells and each is for single occupancy use. The suicide watch cells are located in Health Services. Each cell is abbreviated with the unit code HOI in SENTRY followed by the four-digit cell number. The doors are identified by a painted number from one to four. Two reviews were conducted. The first revealed Mr. Epstein was in H01-001L according to SENTRY but the Suicide Watch Log Books indicate he was in cell 4. A second review was conducted on August 13, 2019, while there were four inmates on in these cells. SENTRY showed two inmates assigned to HO1-001L, one assigned to H01-002L, and the fourth inmate assigned to a general population housing unit. Through physical observation of the dedicated suicide watch cells there were four H0I cells, however a review of the BOPWARE Inmate Housing Format, only shows three cells. 14 EFTA00048545

Exec Inmate movement and assignments are not accurately reflected in SENTRY as required by P5500.14 Correctional Service Procedures Manual 8. Inmate Accountability and Assignment Accuracy With regard to the accuracy and accountability of inmates placed on suicide watch status in the hospital area, Psychology Services now runs a daily Sentry roster of all the inmates on suicide watch in the hospital area. The roster is examined to ensure that the inmates placed on suicide watch in a suicide watch cell are keyed into SENTRY with the correct cell assignment noted. The Associate Warden, Programs, is notified if there are any inconsistencies. Moreover, the four suicide watch cells now all have Sentry Assignments of H01-001L - H01-004L. Exec Staff 9. Attorney Log Books: Four log books were not secured following Mr. Epstein's death. Specifically, three Attorney Log Books located in the Attorney Visiting and Front Lobby areas and an Inmate Search Log Book located in the Attorney Visiting area were not secured. All four books were still in use at the outset of the reconstruction and after the reconstruction team advised staff to secure them. P5324.08 states, "In the event of a suicide, institution staff, particularly Correctional Services staff, and other law enforcement personnel, will handle the site with the same level of protection as any crime scene in which a death has occurred." This policy further states, "All possible evidence and documentation will be preserved to provide data and support for subsequent investigators doing a psychological reconstruction." Further, a review of the attorney log books identified many errors and signify a systemic concern. For example, there were two concurrently open attorney log books in the Attorney Visiting area. Further, the different purposes of the two attorney log books, one in the Attorney Visit area and one in the Front Lobby, could not be explained. BOP staff were unable to articulate a system of control for the log books, and during the reconstruction, some of the log books could not be accounted for. Within the log books, entries were made out of chronological order, attorneys did not consistently sign in and out, significant information was illegible or missing, columns were not consistently labeled, log book opening and closing dates were inconsistent, and the cover had been tom off of several books. At the current time, these log books are not functioning as an adequate system of control and monitoring. 15 EFTA00048546

10. Automatic External Defibrillators: A review of available AEDs in the institution revealed that the list used for accountability and inspection purposes was inaccurate and incomplete. 10: A review of the Automatic External Defibrillators (AED) report presented by Great Lakes Biomedical Services dated July 22, 2019, revealed that all AEDS were accounted for and were placed in the correct perspective areas. The report was accurate and complete. New AEDs have been purchased and will be inspected Great Lakes Biomedical Services, upon their arrival. It must be noted that the list reviewed by the reconstruction team was an old and outdated list (January 8, 2018). II. Post Orders & SHU Training. SHU Post Orders Sign-In Sheets were reviewed for the 3" Quarter. spanning June 9, 2019, to September 7, 2019. Officer failed to sign post orders for SHU #3 post. Quarterly SHU Training Sign-In Sheets were reviewed. The 2019 3" Quarter SHU • Training was conducted on June 6, 2019. Three staff assigned to the 3"Quarter SHU Roster in SHU did not attend or receive the SHU Trainin : Officer . Officer and Officer 11. Post Orders & SHU Training The Suicide Watch Post Orders is located in the Lieutenant's Office with a quarterly sign-in sheet. All staff members assigned to a suicide watch post are responsible for signing the post orders prior to performing the staff suicide watch. With regard to SHU Suicide Prevention training, this continues to be carried out on a quarterly basis. However, the sign-in sheets for this training are now be examined by the SHU Lieutenant for accuracy. If a staff member who is assigned to SHU misses the training, they see the Chief Psychologist and schedule a time to receive a make-up session for the SHU Suicide Prevention Training. Psvc Svc 12. Staffing: The Drug Abuse Program Coordinator positon at MCC New York was abolished during Phase I of the staff realignment during fiscal year 2018. Re- establishing the Drug Abuse Program Coordinator position would provide the institution with an additional supervisory psychologist to provide critical clinical services. Staffing in the Correctional Services department is relevant to the reconstruction. However, the details about this topic are provided in an After Action Review completed separately from this report. 16 EFTA00048547

12. Staffing The current Drug Abuse Coordinator position is currently a shared position. The Warden is currently working on re-establishing the Drug Abuse Coordinator position as a full-time position to provide the Psychology Department with an additional supervisory psychologist to perform critical clinical services. At the current time, the position has been formally announced. Psvc Svc 13. Sex Offense Risk Factors: A broad understanding of risk factors associated with sex offenders, by staff at MCC New York, did not appear to be present in all staff but was vital to his adjustment and safety in prison. A more focused management strategy is recommended, particularly in complex and high profile cases. Supplemental training on sex-offender specific risk factors is recommended for all staff and should be provided by Executive Staff and Psychology Services. 13. Sex Offense Risk Factors The Chief Psychologist or her representative continues to be present at all Executive Staff Meetings, Department Head Meetings, and SHU meetings. During these meetings, the Chief Psychologist offers feedback regarding the treatment and management of sex offender inmates. Additionally, the Chief Psychologist continues to educate all staff during Institution Familiarization (IF) and Annual Training (AT), about the sex offender specific risk factors and suicidality. 17 EFTA00048548

DOCUMENTS EXAMINED TRU-INTEL Download Report of Incident (583), 586, & Global Report TRUVIEW - Money Exchanged; Phone, Email, & Visitor Lists; Calls; Messages; Visits; Timeline TRU-SCOPE - Logs, High Risk Inmates, Inmates Lists, etc. Staff Memorandums Staff E-Mail Photographs of Scene; Deceased, Autopsy Video Showing Scene and Staff Response Sentry Documentation SIS Case File Index Psychology File PDS-BEMR Psychological Observation Procedural Memorandum Post Orders Lieutenant Logs Attorney Logs Staff Roster Medical Information/Records (BEMR) BOP Twenty-Four Hour Death Report he-Sentence Report Note(s) Left Behind by Deceased Time Line Autopsy Request & Report Inmate Central File Court Return Screening Form Prisoner Remand Form (If applicable) USM 129 Individual Custody/Detention Report (If applicable) Prisoner Custody Alert Notice Staff Sign-In Log 1 Week Prior to Suicide (If applicable) Detention Orders (If applicable) 30 minute SI-IU rounds BP 292's & 295's 18 EFTA00048549

PSYCHOLOGICAL RECONSTRUCTION OF INMATE DEATH This is an interim report, due to an inability to gather all necessary data. Formal interviews were not conducted as a part of this reconstruction to avoid interference with pending investigations by other Department of Justice components. A copy of the video is normally made by Special Investigative Staff following a significant incident, but there was no such video in this case since the original video was confiscated by the Federal Bureau of Investigation (FBI) prior to the beginning of this reconstruction. The absence of these two sources of information severely limited the ability to establish accurate timelines, confum subjective reports, establish converging and diverging lines of facts, or discover new areas of inquiry. As a result, information typically gathered, reviewed and consolidated during a reconstruction to support actionable findings and recommendations is limited. Name: Jeffrey Epstein Register Number: 76318-054 Date of Death: 08-10-2019 Prepared by: National Suicide Prevention Coordinator, Psychology Services Branch, Central Office BACKGROI IND INFORMATION Mr. Jeffrey Epstein was a 66-year-old, White male who died on August 10, 2019. while housed at the Metropolitan Correctional Complex (MCC), in New York, New York. former Acting Assistant Director, Reentry Services Division a inted a team to conduct a psychological reconstruction. The team consisted of National Suicide Prevention Coordinator, Central Office; Sex Offender Treatment Programs Coordinator, Central Office; Mental Health Treatment Coordinator, Central Office; and Correctional Services Administrator, Northeast Regional Office. This reconstruction was established in accordance with Bureau of Prisons' (BOP) Program Statement 5324.08 Suicide Prevention Program, Social History: Mr. Epstein did not have a Pre-Sentence Report (PSR) available at the time of the reconstruction; therefore, no official information regarding social history was accessible. The following was gathered from publicly available documents. Mr. Epstein was born in 1953 and grew up in a middle-class family in the neighborhood of Sea Gate on Coney Island, Brooklyn, New York, with one brother. After early promotion in two grades, Mr. Epstein graduated from Lafayette High School in 1969, at the age of 16. He attended Cooper Union and New York University but did not graduate from either. Mr. Epstein taught at the Dalton School, a private school on the Upper East Side of Manhattan from September 1974 until he was 1 EFTA00048550

dismissed in June 1976 for inadequate development as a teacher. Following that, he held a number of positions in the financial industry to include a position as a limited partner at Bear Steams until he was dismissed for unknown policy violations in 1981. He also worked as a financial consultant and founded at least two separate companies. Mr. Epstein had two significant periods of employment. The first of these was his position as a consultant with Steven Jude Hoffenberg in the late 1980s. Mr. Hoffenberg was described as his first mentor. Mr. Hoffenberg was later convicted and incarcerated for running a large Ponzi scheme. He implicated Mr. E stein in fraudulently diverting company funds for his own personal use. Years later, Mr. Epstein's sole client at J. Epstein and Com an , granted him power of attorney over his affairs. Despite also being identified as Mr. mentee, Mr. Epstein was again accused of misappropriating funds-more than 46 million dollars. These large sums are believed to be the seed money Mr. Epstein used to establish his considerable fortune. These events are indicative of Mr. Epstein's highly-regarded intelligence and charismatic personality. Legal History: Mr. Epstein had a history of adult criminal charges and convictions. In June 2008, he entered into a non-prosecution agreement and pleaded guilty to one count Solicitation of Prostitution and one count Procuring a Person Under the Age of 18 for Prostitution in the state of Florida. He was sentenced to 30 months: 18 months of incarceration and 12 months of probation. He was also mandated to register as a sex offender under the National Sex Offender Registration and Notification Act. Mr. Epstein served 13 of his 18-month incarceration and then successfully completed 12 months of probation. It is unclear whether he followed the sex offender registration guidelines in each place he owned a residence. In regard to pending charges, Mr. Epstein was formally charged with Sex Trafficking Conspiracy in violation of 18 U.S.C. § 371 and Sex Trafficking in violation of 18 U.S.C. § 1591(a), (b) (2), 2 on July 2, 2019. Specifically, he was accused of sexually exploiting and abusing minor females over the course of several years. Charging documents allege Mr. Epstein enticed and recruited minor females to engage in sexual activity. The minor females were reportedly compensated with cash following the sexual encounters and some were encouraged to find other minor females to accompany them to Mr. Epstein's residences in New York or Florida. He pleaded not guilty to these charges and was in pretrial status at the time of his death. In a 37-page Decision & Order Remanding the Defendant, signed by Judge Richard M. Berman on July 18, 2019, 18 pages were dedicated to detailing the danger Mr. Epstein posed to others and the community. The document also alleged he was a flight risk. As a result, Mr. Epstein's proposed bail package was determined to be inadequate. He was denied pretrial release and held on remand. 2 EFTA00048551

Institutional History: On July 6, 2019, Mr. Epstein was arrested at Teterboro Airport in New Jersey upon his return from Paris, France. It is unknown whether he was anticipating this arrest. He was transported to MCC New York and keyed into SENTRY at 9:24 p.m. that evening. Mr. Epstein was placed in a general population housing unit for approximately 22 hours. On July 7, 2019, at approximately 7:20 p.m. he was moved to the Special Housing Unit (SHU) pending reclassification due to the significant increase in media coverage and awareness of his notoriety among the inmate population. With regard to his adjustment to a correctional setting, Mr. Epstein received one incident report while in BOP custody for Self-Mutilation on July 23, 2019. As of August 15, 2019, the incident report had been expunged though it is unclear why it had been expunged and whether Mr. Epstein knew this. Also, a review of financial transactions associated with Mr. Epstein's prison account revealed one of his attorneys was depositing funds into his cellmate's (inmate Reyes) commissary account for unknown reasons. BEALTH CARE AND PERSONALITY DESCRIPTION BOP Electronic Medical Records (BEMR) indicate Mr. Epstein was diagnosed with hyperlipidemia, sleep apnea, hypertension, constipation, prediabetes, neuralgia, and neuritis unspecified. He was prescribed the following mediations: docusate sodium, milk of magnesia, omega 3, methylprednisone, and bisacodyl. Mr. Epstein was also prescribed insulin, and the prescription required him to go to the institution pharmacy for administration of this medication. However, the dates for which it was prescribed have a notation indicating "dose not indicated," thus it does not appear insulin was routinely medically necessary. The rest of the medications prescribed were self-carry. He also had a continuous positive airway pressure (CPAP) machine which is typically used to treat sleep apnea. Mr. Epstein was provided with his personal CPAP machine on July 30, 2019, per BEMR. In regard to mental health history and treatment, there are no known available records. Any records that may have been maintained relating to Mr. Epstein's incarceration in Florida were not available for review as of the date of this re rt. With regard to Psychology Data System records in BEMR (PDS-BEMR), Dr. Forensic Psychologist at MCC New York completed a routine Intake Screening on July 8, 2019. During this screening, Mr. Epstein denied any history of mental health problems, substance abuse, and treatment. No symptoms of mental illness were observed. He was classified as Mental Health Care Level 1 and was not diagnosed with a mental illness. Following a consultation with Dr. , National Suicide Prevention Coordinator on July 8, 2019, Dr. Chief Psychologist at MCC New York determined Mr. Epstein should be pre-emptively evaluated for suicide risk upon his return from court. Primary consideration was given to his various risk factors for suicide such as his high profile case and media attention, pending sex offense charges, pre-trial status, and an ongoing court proceeding. Mr. Epstein returned from court on July 8, 2019, after normal business hours. He denied suicidal 3 EFTA00048552

thoughts at that time, but due to the potential for other risk factors listed above, the on-call psychologist placed Mr. Epstein on Psychological Observation in one of the suicide watch cells until he could be assessed in person by a BOP psychologist. Psychological Observation is a form of individual monitoring that is less restrictive than Suicide Watch. It is used for inmates who are stabilizing and not yet prepared for placement in general population or restrictive housing. It is often used to transition inmates off of Suicide Watch in order to monitor their transition and safety after an acute suicidal crisis. On Jul 9, 2019, Mr. Epstein underwent a formal, in-person suicide risk assessment with . She determined that, while suicide watch was not warranted at that time, Mr. Epstein should remain on Psychological Observation status out of an abundance of caution. He was removed from Psychological Observation on July 10, 2019. On July 23, 2019, the on-call psychologist was notified Mr. Epstein had been found in his cell with a piece of orange cloth around his neck. Reportedly, he was observed lying in the fetal position on the floor with a noose around his neck. Medical staff evaluated Mr. Epstein and found friction marks and superficial reddening of the neck skin and one knee. He was placed on suicide watch by the Operations Lieutenant at approximately 1:40 a.m. pending a formal in- person suicide risk assessment. Dr. Staff Psychologist at MCC New York, assessed Mr. Epstein for risk of suicide later in the morning of July 23, 2019, and determined he should remain on suicide watch. Mr. Epstein denied any knowledge of how he received marks on his neck and initially informed staff he believed his cellmate,Nicholas Tartaglione, had attempted to kill him. Special Investigative Services (SIS) staff opened an investigation to assess Mr. Epstein's safety and collect facts surrounding the episode. Despite this investigation, staff was unable to determine whether he was assaulted or engaged in self-directed violence. Mr. Epstein was removed from suicide watch on July 24, 2019, after 31 hours and 5 minutes. Thereafter, he remained in the suicide watch cell and was placed on Psychological Observation, where he remained housed until July 30, 2019, according to PDS-BEMR records. A discrepancy exists regarding when he was removed from Psychological Observation. His cell assignment, per SENTRY, indicates he was transferred back to the Special Housing Unit (SHU)on July 29,2019, whereas PDS-BEMR indicates he was removed from Psychological Observation on July 30, 2019, at approximately 8:15 a.m. Mr. Epstein attended a court hearing on July 31, 2019, and, upon his return, the United States Marshals Service (USMS) provided aperwork to Receiving and Discharge (R&D) staff that noted "suicidal tendencies." was notified on August 1, 2019, about this paperwork. She consulted with and then met with Mr. Epstein to conduct a suicide risk assessment. She determined suicide watch was not warranted at that time. Mr. Epstein remained classified as a Mental Health Care Level 1 throughout his time at MCC New York. During his contacts with psychologists, Mr. Epstein routinely denied current mental health symptoms to include suicidal ideation, and he did not exhibit symptoms of a serious mental illness. However, there was evidence Mr. Epstein was experiencing challenges 4 EFTA00048553

adjusting to his environment and changes in his lifestyle. He reported frequent complaints of difficulty sleeping. He did not have access to his CPAP machine until it was reportedly provided to him on July 30, 2019. Mr. Epstein also reported he was bothered by noise in the SHU. At times, he noted concerns related to his safety in SHU or on a general population housing unit. On two occasions, July 26, 2019, and July 27, 2019, he described himself as a coward and as someone who does not like pain. On July 28, 2019, he told the toilet in his cell would not stop flushing for an extended period of time, and he then took to sitting in the corner with his hands over his ears. Mr. Epstein indicated he was agitated following this incident and was unable to sleep that night. ANTECEDENT CIRCUMSTANCES Mr. Epstein entered BOP custody on July 6, 2019, with a history of convictions for sexual offenses and allegations comprised of more serious charges. The current indictment alleged sexual crimes against minors, and he was facing up to 45 years in prison. On July 18, 2019, Mr. Epstein's request for bail and pretrial release was denied. On July 23, 2019, Mr. Epstein was found unresponsive in his cell. The motivation and context were never fully determined. After 31 hours and 5 minutes on Suicide Watch, he was then placed on Psychological Observation. On July 30, 2019, Mr. Epstein was removed from Psychological Observation. sent an e-mail reporting Mr. Epstein had been removed from Psychological Observation and needed to be housed with an appropriate cellmate. This e-m ail was sent to 71 MCC New York staff and, as of August 13, 2019, only 27 staff members had opened the message. On August 9, 2019, a federal court unsealed approximately 2,000 pages of documents into the public domain. These included graphic allegations against Mr. Epstein. Included was a book order receipt for titles such as SM 101: A Realistic Introduction; SlaveCraft: Roadmaps for Erotic Servitude; and Training with Miss Abernathy: A Workbook for Erotic Slaves and Their Owners. Additional high profile public figures were also named in the released documents. The documents were part of a defamation lawsuit filed by a woman who alleged Mr. Epstein had victimized her, against a British socialite, Ghislaine Maxwell, who was Mr. Epstein's ex-girlfriend, associate, and alleged to have assisted with his criminal activities. According to staff report, Mr. Epstein was afforded telephone calls on two different days although it is unknown whether they were legal or social calls. No recording of the calls exist and it is not known with whom he was speaking. One occurred on or around July 16, 2019, and the other on August 9, 2019. Legal calls are not monitored, and would not be recorded. A social call would be recorded; given the limited information known about Mr. Epstein, knowledge of the content of any social calls would have been crucial to helping staff work with him. Following his final telephone call on the evening of August 9, 2019, Mr. Epstein was moved into his SHU cell. He was single-celled at that time because his cellmate (Efrain Reyes #85993-054) 5 EFTA00048554

did not return from court. The need for a cellmate was communicated between Day Watch (DW) and Evening Watch (EW) shifts in the SHU, but no cellmate was laced with him by the EW staff. According to a memorandum from Senior Officer Specialist , SHU staff were informed at approximately 1:50 m. Mr. Epstein's cellmate would likely not return from court. Furthermore, Officer noted Mr. Epstein would need a cellmate upon arrival from his attorney visit. A review of the 30-minute rounds forms indicate unit rounds were corn leted for the entire MW shift on August 10, 2019. However, a memorandum from Lieutenant indicates Officer Tova Noel and Material Handler Supervisor Michael Thomas made a statement after Mr. Epstein's death that they did not complete proper 30-minute rounds at 3:00 a.m. or 5:00 a.m. DESCRIPTION OF SCF.NFt A detailed description of the scene was unavailable because the officers who discovered Mr. Epstein did not write memorandums and could not be interviewed. According to the Report of Incident, on August 10, 2019, at approximately 6:33 a.m., while serving the breakfast meal in the SHU, Range 9 South, Mr. Epstein was found unresponsive in his cell. Staff reportedly called for medical assistance, activated the body alarm, and began life-saving measures. Arriving staff stated they brought an automated external defibrillator (AED) and stretcher. Cardiopulmonary resuscitation (CPR) reportedly continued while the AED was placed on Mr. Epstein. The AED reportedly indicated no shock advised and CPR was continued. Mr. Epstein was escorted to Health Services at approximately 6:39 a.m., and Emergency Medical Services (EMS) arrived at 6:43 a.m. He was transported to the local hospital at approximately 7:10 a.m. Mr. Epstein was pronounced deceased at 7:36 am. It was not possible to confirm this timeline without viewing video footage. CONCLUSIONS/RECOIVIMENDATIONS A general appreciation of risk factors for suicide specific to sex offenders is necessary when reviewing Mr. Epstein's death. These factors, as well as more general risk factors for suicide, were likely present. There are several common factors that increase risk for suicide in individuals with a history of a sexual offense. These include stigma due to the nature of sexually-based crimes (both within society and the prison system), a disruption of the ability to utilize sex as a coping mechanism (which can lead to increased levels of distress and negative affect), and grief about loss experienced in regards to arrest. This grief may be secondary to the loss of former lifestyle, loss of physical items or collections related to sexual offenses, and/or the loss of perceived relationships with victims. Other factors that may increase risk for suicide among individuals accused of a sex offense include safety concerns, potentially long sentences, and lack of skills necessary to navigate social relationships in prison. Mr. Epstein was a high-profile, pretrial detainee awaiting trial on sex trafficking offenses. He had been a successful, wealthy businessman with a number of high-profile acquaintances that he accumulated through a combination of charisma, charm, and intelligence. Despite his many associates, he had limited significant or deep interpersonal ties. Although Mr. Epstein appeared 6 EFTA00048555

to cultivate a large social and professional network, he was estranged from his only brother. Indeed, his identity appeared to be based on his wealth, power, and association with other high- profile individuals. Approximately two-and-a-half weeks before his death, Mr. Epstein appeared to attempt suicide, but ultimately denied it was a suicide attempt. He was convincing in his denial. On that occasion, he was saved because his cellmate notified BOP staff. In the weeks before his death, he made statements that he was "a coward" and was having difficulty adapting to his diminished circumstances. He also frequently referenced poor sleep and an inability to tolerate the noise of prison. On the day before his death, a number of documents in his case were unsealed, further eroding his previously-enjoyed elevated status and potentially implicating some of his associates. The lack of significant interpersonal connections, a complete loss of his status in both the community and among associates, and the idea of potentially spending his life in prison were likely factors contributing to Mr. Epstein's suicide. The following recommendations concern institution operations: Corr Svc/ Psych I. 5inele Ceiling: It is recommended that all inmates be double-celled unless safety concerns or an odd number of inmates precludes this. Priority should be given to inmates with a history of mental illness, self-directed violence, recent stressors (e.g., losses, newly sentenced, etc.) It is recommended that a system of control be implemented explaining who will be notified when a Suicide Watch or Psychological Observation ends and how that communication will take place. Because this is a life safety issue, the system of control, once approved by the warden, should be reviewed in formal meetings such as staff recalls, department head meetings, and lieutenants meetings. Exec/IDO 2. Rounds- 30-minute rounds are required by P5500.14, Correctional Services Procedures Manual. Corr Svc / Legal 3. Cellmate Assignments; When Mr. Epstein was placed in SHU on July 7, 2019, Executive Staff decided Mr. Tartaglione would be his cellmate. As explained by input was not sought from Psychology Services and it is not clear if or how sex offender-specific needs and associated risk were incorporated into the housing plan. Mr. Tartaglione was also a high profile inmate-an ex-police officer charged in multiple murders. However, he and Mr. Epstein did not share the risk associated with being a sex offender and their pairing may have aggravated Mr. Epstein's risk for self-directed violence. In an effort to treat Mr. Epstein the same as other inmates, a statement repeated by multiple staff, Executive Staff may have inadvertently overlooked the need to consider unique risk factors associated with individuals who have been charged with and convicted of a sex offense. On July 25, 2019, sent an e-mail to 7 EFTA00048556

Associate Warden explaining a consultation between and Dr. , National Suicide Prevention Coordinator. In the e-mail, Legal reviewed the consult and recommendation from the Psychology Services Branch, Central Office that Mr. Epstein be housed with another inmate who had also been accused of committing a sex offense. There is no evidence this information was considered beyond this e-mail, and Mr. Epstein was never housed with another inmate charged or convicted of a sexual offense. Exec Staff It is recommended Executive Staff and Correctional Services staff include a psychologist in decisions about cellmates as a means of incorporating expertise about suicide risk, mental health needs, and interventions for psychological stability. Psvc Svc 4. Documentation Accuracy On July 23, 2019, Mr. Epstein was found unresponsive in his cell. He had abrasions on his neck and knee. There are inconsistencies between documents describing the circumstances of the scene. In a General Administrative Note in PDS-BEMR, documented information received from Operations Lieutenant that Mr. E stein. "was found with a string loosely hanging around his neck." In contrast, Officer who responded to this emer ency, wrote a memorandum dated July 23, 2019. In that memorandum, Officer wrote he saw Mr. Epstein "laying down near his bunk with what appeared to be a piece of handmade orange cloth around his neck." It is critical that all descriptions of the incident accurately reflect objective evidence. Officer wrote Mr. Epstein an incident report for Self-Mutilation on July 23, 2019, after he was found unresponsive in his cell but prior to having the necessary facts to determine whether he likely engaged in a Bureau violation. BOP policy expects staff to write an incident report within 24 hours of having the information that an inmate likely violated BOP rules but without making a presumptive decision about guilt. A Special Investigative Services Threat Assessment was completed August 2, 2019, but results were inconclusive as to whether Mr. Epstein engaged in self- directed violence, willingly fought with his cellmate, or was assaulted by his cellmate. It is recommended that staff remain open to all reasonable explanations for a behavior and take the appropriate actions when a final determination is made. Although the incident report was later expunged, inmates frequently experience significant stress when they contemplate the potential consequences associated with findings of guilt. entered a Psychology Services Intake Screening into PDS-BEMR on July 8, 2010. The document has three typographical errors. She selected the No Sexual Offense Convictions check box when, in fact, Mr. Epstein was previously convicted of S9licitation of Prostitution and Procuring a Person Under the Age of 18 for Prostitution. Second, Mr. Epstein was erroneously identified as a Black male in this document. Finally, there is one instance where he was mistakenly referred to as Mr. Brown. 8 EFTA00048557

completed a Risk of Sexual Abusiveness document on July 8, 2019. She marked "History of prior prison sexual predation" in the affirmative. This is not accurate. Mid-Level Practitioner, completed a History and Physical on July 9, 2019. An Intake Screening should have been conducted within 24 hours of his entry into Bureau custody which was on July 6, 2019, according to P6031.04, Patient Care. Psvc was responsible for observing Mr. E stein and documenting his behavior while on suicide watch on July 23, 2019. mistakenly used a Suicide Watch Log Book intended for inmate companion documentation between 1:40 a.m. and 6:00 a.m. on Jul 23. 2019. when he should have been using the Staff Suicide Watch Log Book. Drug Treatment S ecialist, reportedly noticed this error and subsequently hand copied all of entries from 1:40 a.m. to 6:00 a.m. into a Staff Suicide Watch Log Book. She then initialed these entries, and this makes it appear as if she was the one conducting the watch. This information was discovered and conveyed in an e-mail from Ms. Associate Warden to with a carbon copy to Warden on August 12, 2019. Of note, did not make an entry explaining why she was making the log book changes. Additionally, then wrote entries for 6:15, 6:30, 6:45 and 7:00 a.m. in the Staff Suicide Watch Log Book. These were not a part of the original entries made by nor was assigned to work the Suicide Watch post. Due to the inabilit to interview staff at this time, it is unknown why attempted to correct error, or made any of the subsequent log entries. It is recommended that if a staff member makes an entry error (e.g., writes in the incorrect suicide watch log book), the staff member should describe the error in the correct log book, to include indicating when they became aware of the error. The staff member should then notify the Chief Psychologist. Corr Svc A review of Special Housing Unit Records (BP-A0292) revealed a number of incomplete entries. This document is used to monitor provision and receipt of basic services such as recreation, medical rounds, showers, meal consumption, etc. The Officer in Charge signature is missing on 10 occasions and a medical provider's signature is missing in seven instances. There are six instances in which it is not clear if Mr. Epstein ate his meal. There are nine instances in which it is not clear if Mr. Epstein took a shower. There are ten instances in which it is not clear if Mr. Epstein was offered recreation. P5500.15 Correctional Services Manual requires accurate and complete information on the BP-A0292. A review of Psychology Observation Log Books revealed significant discrepancies from the approved Psychological Observation Procedural Memorandum, dated April 15, 2019. A Correctional Officer is required to complete hourly rounds and sign the log book; 179 9 EFTA00048558

out of 183 round signatures were missing. The lieutenant is required to sign the log book one time per shift and signatures were missing in 10 of 23 instances. A Physician Assistant is required to sign one time per shift and 16 of 16 instances were missing. It is recommended that a further review of Psychological Observation procedures be conducted. fl = 5. j'elenhone Calls. In a PDS-BEMR note written by on July 16, 2019, she was informed by an unnamed staff member that a lieutenant facilitated two telephone calls for Mr. Epstein. It is unknown when and to whom these calls were placed and no evidence that they took place on a monitored telephone. According to a memorandum from Unit Manager on August 10, 2019, Mr. Epstein terminated his le al visit early on August 9, 2019, in order to place a telephone call to his family. (who was the Institutional Duty Officer that week) escorted Mr. Epstein to SHU around 7:00 p.m. that evening and he was placed in the shower area on G tier. While there, he was provided the telephone to make a call. Since Mr. Epstein reportedly did not have his PAC or PIN number, which is required to use the inmate telephone system, the Unit Manager placed the call, dialing a number that reportedly began with area code 347. Mr. Epstein told he was calling his mother who, according to public records, has been deceased since 2004. It is recommended that all telephone calls, other than legal calls, be made on monitored lines to be available for post-call review or on a speaker phone so staff can monitor what is discussed. 6. Direct Observatiotu Mr. Epstein was on suicide watch from July 23, 2019, until July 24, 2019. While on suicide watch on July 23, 2019, Mr. Epstein attended an attorney visit from approximately 12:40 p.m. until 7:15 p.m. During this time, he was without "direct, continuous observation" by a dedicated BOP staff member as required by P5324.08. While on Psychological Observation, he attended attorney visits on July 24, 2019, for 11.25 hours; on July 25, 2019, for 11.25 hours; on July 26, 2019, for 9.25 hours; on July 27, 2019, for 11.33 hours; on July 28, 2019, for 10.5 hours; and on July 29, 2019, for 8 hours. On July 30, 2019, Psychology Observation was terminated. During these visits, continuous observation by a dedicated BOP staff member was not maintained as required by MCC New York's Procedural Memorandum for Psychological Observation. 7. Follow-Um Mr. Epstein arrived at MCC New York on Saturda July 6, 2019. While conducting the 10:00 p.m. institution count that evening, Facilities Assistant reported she observed Mr. E stein in his cell. In an e-mail she sent to and and Lieutenant later that evening, she described Mr. Epstein as "distraught, sad and a little confused." She said she then asked Mr. Epstein if he was 10 EFTA00048559

Psvc Svc okay, and he reportedly said he was. However, noted in her e-mail she was not convinced of this, adding, "He seems dazed and withdrawn." She went on to say, "So just to be on the safe side and prevent any suicidal thoughts can someone from Psychology come and talk with him." Despite the fact that Lieutenant opened the e-mail there is no evidence that he contacted the on-call s chologist as is required by P5324.08, Suicide Prevention Prozram, Additionally, if was concerned about suicide risk, P5324.08, Suicide Prevention Pro re tyres her to maintain direct, continuous observation of Mr. Epstein. When o ened the e-mail the following Monday morning, Mr. Epstein was evaluated by at approximately 9:30 a.m. Psvc Svc Mr. Epstein was denied bail on Thursday, July 18, 2019. This was a significant disappointment for Mr. Epstein and likely challenged his ability and willingness to adapt to incarceration. Given the potential impact of the judge's decision, a psychologist should have assessed Mr. Epstein's mental status upon his return to the institution. The BOP developed a SENTRY assignment of PSY ALERT for purposes such as this. Specifically PSY ALERT is used "to ensure, if movement occurs, that all staff consider the special psychological and management-related risks associated with the inmate." Furthermore, P5324.07 SENTRY Psycholozv Alert Function states, "When a decision to move [any PSY ALERT] inmate occurs, any special psychological needs of the inmate are reviewed and considered by Psychology Services staff [and] any safety and security concerns are highlighted for non-Psychology Services staff." Psychologists should use the PSY ALERT assignment more frequently with high profile cases and with inmates who have a history or charge of sex offense. Both of these groups of inmates are susceptible to exaggerated or unrealistic fears about correctional settings and experience stress associated during movement and periods of transition (e.g., cell/unit changes, movement to and from court, institutional movement, and release of information through the media). PP-63 Func Mr. Epstein was reportedly in court on July 31, 2019. It is unknown what time he departed or returned to MCC New York because this information was not entered in SENTRY. Regardless, upon his return, the United States Marshals Service (USMS) provided R&D staff with a Prisoner Custody Alert Notice regarding Mr. Epstein. The notice indicated Mr. Epstein had "MTL Mental Concerns Suicidal Tendencies." The USMS requested R&D staff sign the form and the then departed with the signed copy. On August 1, 2019, at 8:46 a.m., sent an e-mail reporting she had just become aware of the above information. In the absence of additional information about this notation, this should have been considered a referral to Psychology Services about a potentially suicidal inmate and procedures should have been followed as outlined in P5324.08, Suicide Prevention Program, Specifically, when a staff member becomes aware an inmate may be thinking about suicide during normal working hours, that staff 11 EFTA00048560

member must contact Psychology Services and maintain the inmate under direct,continuous observation until he is placed on Suicide Watch or seen by a psychologist. There is no evidence Mr. Epstein was monitored under these conditions from the time he returned from court until he was seen by for a suicide risk assessment on August 1, 2019, at approximately 1:30 p.m. Exec 8. Jnmate Accountability and Assignment Accuracy. According to a SENTRY quarters roster generated on August 10, 2019, at 12:51 a.m., there were three inmates assigned to Mr. Epstein's SHU cell, Z04-206LAD, including him, at the time of his death. However, his SHU cell was only a double occupancy cell. Inmate Patrick Avila (#86710-054), inmate Gregory Ferrer (#79793-054), and Mr. Epstein were all assigned to the same cell. On August 13, 2019, at 12:06 p.m. and 12:08 p.m., a quarters history roster was generated for inmate Avila and Ferrer, respectively. Inmate Avila's cell assignment was Z04-206LAD from August 5, 2019, until August 11, 2019, when he was moved to cell Z04-212UAD. Inmate Ferrer's cell assignment was Z04-206UAD from August 1, 2019, until August 11, 2019, when he was moved to cell Z04-207LAD. A quarters history roster was generated for Mr. Epstein on August 13, 2019, at 9:07 a.m. His cell assignment was Z04-206LAD from July 29, 2019, until August 10, 2019. On Monday, August 12, 2019, photographs ofnametags on SHU cell doors and SHU locator forms were sent to the Correctional Service Department in the Northeast Region. The SHU locator form is dated August 9, 2019. It shows inmate Ferrer in cell 207L (SENTRY states he was moved to this cell on August 11, 2019), inmate Avila in cell 212U (SENTRY states he was moved to this cell on August 11, 2019), inmate Epstein in cell 220L (SENTRY never shows him in this cell) along with inmate Reyes (#85993- 054). The locator shows inmate Copper (#92299-054) and inmate Dockery (#60685-050) in cell 206. The photo sheets show the cell being 220 with inmates Epstein and Reyes' identification cards on the door. Inmate Reyes, Efrain, Reg. No. 85993-054 was in cell Z06-220U from August 5, 2019 to August 9, 2019. Psvc Svc MCC New York has four suicide watch cells and each is for single occupancy use. The suicide watch cells are located in Health Services. Each cell is abbreviated with the unit code HOI in SENTRY followed by the four-digit cell number. The doors are identified by a painted number from one to four. Two reviews were conducted. The first revealed Mr. Epstein was in H01-001L according to SENTRY but the Suicide Watch Log Books indicate he was in cell 4. A second review was conducted on August 13, 2019, while there were four inmates on in these cells. SENTRY showed two inmates assigned to HO1-001L, one assigned to H01-002L, and the fourth inmate assigned to a general population housing unit. Through physical observation of the dedicated suicide watch cells there were four H0I cells, however a review of the BOPWARE Inmate Housing Format, only shows three cells. 12 EFTA00048561

Exec Inmate movement and assignments are not accurately reflected in SENTRY as required by P5500.14, Correctional Service Procedures Manual, Exec Staff 9. Attorney Loe Books-, Four log books were not secured following Mr. Epstein's death. Specifically, three Attorney Log Books located in the Attorney Visiting and Front Lobby areas and an Inmate Search Log Book located in the Attorney Visiting area were not secured. All four books were still in use at the outset of the reconstruction and after the reconstruction team advised staff to secure them. P5324.08 states, "In the event of a suicide, institution staff, particularly Correctional Services staff, and other law enforcement personnel, will handle the site with the same level of protection as any crime scene in which a death has occurred." This policy further states, "All possible evidence and documentation will be preserved to provide data and support for subsequent investigators doing a psychological reconstruction." Further, a review of the attorney log books identified many errors and signify a systemic concern. For example, there were two concurrently open attorney log books in the Attorney Visiting area. Further, the different purposes of the two attorney log books, one in the Attorney Visit area and one in the Front Lobby, could not be explained. BOP staff were unable to articulate a system of control for the log books, and during the reconstruction, some of the log books could not be accounted for. Within the log books, entries were made out of chronological order, attorneys did not consistently sign in and out, significant information was illegible or missing, columns were not consistently labeled, log book opening and closing dates were inconsistent, and the cover had been tom off of several books. At the current time, these log books are not functioning as an adequate system of control and monitoring. 10. Automatic External Defibrillators: A review of available AEDs in the institution revealed that the list used for accountability and inspection purposes was inaccurate and incomplete. Corr/Svc py ic 11. Post Orders & SHIJ Training• SHU Post Orders Sign-In Sheets were reviewed for the 3 Quarter, spanning June 9, 2019, to September 7, 2019. Officer failed to sign post orders for SHU #3 post. Quarterly SHU Training Sign-In Sheets were reviewed. The 2019 3rd Quarter SHU Training was conducted on June 6, 2019. Three staff assigned to the 314 after SHU Roster in SHU did not attend or receive the SHU Training: Officer Officer and Officer Psvc Svc 12. Staffing: The Drug Abuse Program Coordinator positon at MCC New York was 13 EFTA00048562

abolished during Phase 1 of the staff realignment during fiscal year 2018. Re-establishing the Drug Abuse Program Coordinator position would provide the institution with an additional supervisory psychologist to provide critical clinical services. Staffing in the Correctional Services department is relevant to the reconstruction. However, the details about this topic are provided in an After Action Review completed separately from this report. PSYc Svc 13. ,Sex Offense Risk Factors; A broad understanding of risk factors associated with sex offenders, by staff at MCC New York, did not appear to be present in all staff but was vital to his adjustment and safety in prison. A more focused management strategy is recommended, particularly in complex and high profile cases. Supplemental training on sex-offender specific risk factors is recommended for all staff and should be provided by Executive Staff and Psychology Services. Corr Svc/ Leeal 14 EFTA00048563

DOCUMENTS EXAMINED TRU-INTEL Download Report of Incident (583), 586, & Global Report TRUVIEW - Money Exchanged; Phone, Email, & Visitor Lists; Calls; Messages; Visits; Timeline TRU-SCOPE - Logs, High Risk Inmates, Inmates Lists, etc. Staff Memorandums Staff E-Mail Photographs of Scene; Deceased, Autopsy Video Showing Scene and Staff Response Sentry Documentation SIS Case File Index Psychology File PDS-BEMR Psychological Observation Procedural Memorandum Post Orders Lieutenant Logs Attorney Logs Staff Roster Medical Information/Records (BEMR) BOP Twenty-Four Hour Death Report he-Sentence Report Note(s) Left Behind by Deceased Time Line Autopsy Request & Report Inmate Central File Court Return Screening Form Prisoner Remand Form (If applicable) USM 129 Individual Custody/Detention Report (If applicable) Prisoner Custody Alert Notice Staff Sign-In Log 1 Week Prior to Suicide (If applicable) Detention Orders (If applicable) 30 minute SI-IU rounds BP 292's & 295's 15 EFTA00048564

MCC NEW YORK NEW YORK, NY Overtime Log - 5/19/2020 Criteria: Log Date between 7/22/2019 and 7/23/2019 Log Dale/Time Parr Action 07/21/19 21:36 Doh51989 Quarterly Shift Preference • QUARTERLY PREFERENCE MADE FOR 4TH QTR 2019 07/23/19 20:47 BOP1899 mandate 07/23/19 20:46 BOP1899 worked 16 07/23/19 20:35 BOP1899 staff canceled o 07/23/1919:41 BOP4936 Selected Lists BPT ARMED ESCORT 07/23/1919:24 BOP1899 OT Assigned MANDATE 07/23/19 19:24 BOP1899 OT Bypassed WORKED 16 07/23/1919:23 BOP1899 OT Assigned MANDATE 07/23/19 19:23 BOP1899 OT By-passed WORKED 16 07/23/19 18:54 BOP1879 OT Assgned EXHAUST 07/23/19 18:51 BOP4408 Quarterly Shift Preference QUARTERLY PREFERENCE MADE FOR 4TH QTR 2019 OT Assigned OT By-passed OT Removed - Staff Cancelled Signed Up for OT I would like to be on EW sick and annual, if my picks are not choose thank you 07/23/19 18:20 BOP1901 Signed Uo for OT Selected Lists (Air, 07/23/19 18:20 BOP1901 Signed Up for OT Selected Lists (All] 07/23/19 18:20 BOP1901 Signed Up for OT Selected Lists (An] 07/23119 18:19 BOP1901 Signed Up for OT Selected Lists (MI 07/23/19 18:19 BOP1931 Quarterly Shift Preference QUARTERLY PREFERENCE MADE FOR. 4TH QTR 2019 07/23/19 16:52 BOP4408 Deleted OT Sign tin - Day 07/23/19 16:52 BOP4408 Quarterly Shift Preference QUARTERLY PREFERENCE MADE FOR 4TH QTR 2019 Lt-. I would like to be on EW sick and annual, if my picks are not choose thank you 07/23/19 16:50 BOP5797 Signed Up for OT Selected Lists BPT UNARMED ESCORT Png N/A 1st VAR F Sa ER-4 2nd E/W S Sa UNIT 2 3rd VAR Th F 10 SOUTH 01 4th ENV Th F ER-2 5th ENV W Th INTERNAL #2 07/24/19 WIN 5 SOUTH Shift date %Smith N/A 5 SOUTH 07/24/19 WIN 5 SOUTH 07/24/19 M/W REMOVED FROM [Sick / Annual) N/A 07/26/19 N/A Selected Shifts MNJ SHU N2 07/24/19 WW SHU 02 SHU 01 SHU 01 10 SOUTH N2 07/24/19 WW 07/24/19 MNV 07/24/19 M/W 07/24/19 NM N/A 1M: EAN S Sa 7 NORTH 2nd EMI W Th.F ER-3 3rd ENV F Sa 11 SOUTH 4th: EAN Th F 11 SOUTH #2 5th ENV S M 11 NORTH N/A 08/02/19 Selected Shifts DNV N/A Selected Shifts D/W N/A Selected Shifts DAN N/A Selected Shifts D/W N/A 1st EMI S Sa UNIT 2 2nd: E/W S Sa S SOUTH 3rd &IN S M OSP /11 4th ENV F Sa CONTROL 01 5th P/M Th F 10 SOUTH 02 N/A 07/23/19 N/A N/A N/A N/A N/A N/A 08/01/19 N/A N/A 07/31/19 N/A N/A 07/29/19 N/A N/A N/A N/A N/A N/A N/A 1st ENV S Sa 7 NORTH 2nd. EAN W Th.F ER-3 3rd. E/W S Sa 5 NORTH 4th ENV S M 11 NORTH 5th ENV F Sa 11 SOUTH N/A 07/27/19 N/A N/A Selected Shifts DAN wignment ) Pr N/A Page 1 kIndiry Mandtry List Mandtry List List Exempt K N/A K Mandtry List Mandtry List Mandtry List Mandtry List List Exempt 0 0 5/19/2020 10:35:50 AM EFTA00048565

log Date/lime I yr Action 07/23/19 16:37 BOP4408 Deleted OT Sign Up - Day 07/23/19 16:36 BOP4408 Deleted OT Sign Up - Day 07/23/19 16:36 BOP1899 OT Removed Mgmt Cancelle 07/23/19 16:35 BOPI899 OT Assigned cpd adjustment 07/23/19 16:33 B0P1899 OT Removed - Mgmt Cancelle clad adjustment 07/23/19 16:33 BOPI 899 OT Assigned CO adjustment 07/23/19 16:28 B0P4526 Deleted OT Sign Up - Day Min 07/23/19 14:48 BOP1884 Quarterly Shift Preference QUARTERLY PREFERENCE MADE FOR 4TH QTR 2019 07/23/19 14:41 BOP1888 Signed Up for OT Selected Lists BPT UNARMED ESCORT 07/23/19 14:41 B0P1888 Signed Up for OT Selected Lists BPT UNARMED ESCORT 07123/19 14:41 80P1888 Deleted OT Sign Up Day 07/23/19 14:41 BOP1888 Deleted OT Sign Up - Day 07/23/19 14:34 BOP1881 OT Assigned agreed 07/23/19 14:34 BOP1881 OT By-passed n/a message left 07/23/19 14:34 BOP1881 OT By-passed coo 07/23/19 14:34 BOP1881 OT By-passed ria message left 07/23/19 14:33 BOP1881 OT By-passed n/a message left 07/23/19 14:25 BOP4270 Quarterly Shift Preference QUARTERLY PREFERENCE MADE FOR 4TH OTR 2019 07/23/19 12:32 BOP1879 OT Assigned EXEMPT 0723/1912:30 bop17345 Quarterly Shift Preference QUARTERLY PREFERENCE MADE FOR 4TH QTR 2019 07/23/1911:47 BOP1505 OT Assigned agreed to work overtime 07/23/19 11:47 BOP1505 OT By-passed ■ The staff member is already working this watch Post N/A N/A Shift date A% meth 07/24/19 N/A 0703/19 N/A SHU #2 07/24/19 DAN - REMOVED FROM (Sick / Annual) SHU #3 07/24/19 NM Assignment Type N/A N/A List Exempt List Exempt Page 2 NIndtry SHU #3 07/24/19 NM Signup List -LAST OT DATE SET TO 7/22/2019 1249.57 PM - REMOVED FROM [Sick / Annual) SHU #2 07/24/19 DAN List Exempt N/A 07/24/19 N/A N/A N/A 1st VAR S M ER-10 2nd 3rd 4th 5th N/A Selected Shifts MAN NM DAN P/M E/VV N/A Selected Shifts MAN NM DAN P/M E/VV N/A N/A UNIT 2 List Selected (All) UNIT 2 List Selected (All) UNIT 2 List Selected (All) UNIT 2 List Selected [NI) UNIT 2 List Selected: [All) N/A 1st 2nd 3rd 4th 5th 5 NORTH N/A N/A 08/04/19 N/A N/A 08/03/19 N/A N/A 0708/19 N/A N/A 07/27/19 N/A N/A 0708/19 DAN Signup List 07/28/19 DAN Signup List 07/28/19 DAN Signup List 07/28/19 DAN Signup List 07/28/19 DAN Signup List N/A N/A MAN S M UNIT 2 MW S M 9 NORTH MAN S M OSP S1 MAN Sa S SANITATION OFF 07/23/19 EAN List Exempt N/A N/A N/A 1st MAN S M OSP WI 2nd VAR S M PHONE MONITOR 3rd DAN S Sa UNIT 3 4th 5th SHU #2 0723/19 ENV Signup List List Selected (NI) SHU #2 07/23/19 EMI Signup List Lis! Selected (All( K 0 K 5/19/2020 10.35 50 AM EFTA00048566

I pg Oate'lirne ner Action :sliss 07/23/19 11:47 BOP1505 OT By-passed called teft message 07/23/19 11:47 BOP1505 OT By-passed calied teft message 07/23/19 11:47 BOP1505 OT By-passed unable to work overtime 07/23/19 11:46 BOP1505 OT By-passed called lett message 07/23/19 11:46 BOP1505 OT By-passed called teft message 07/23/19 11:46 BOP1505 OT By-passed The staff member MK is already working this watch. 07/23/19 11:46 BOP1505 OT By-passed called lett message 07/23/1911:46 BOP1505 OT Btoassed unable to work overtime 07/23/19 11:46 BOP1505 OT Ely•passed unable to work overtime 07/23/19 11:46 BOP1505 OT By•passed unable to work overtime 07/2311911:45 BOP1505 OT By-passed unable to work overtime 07/23/1911:45 BOP1505 OT By.passed unable to work overtime 07/23/19 11:45 BOP1505 OT By•passed called lett message 07/23/19 11:45 BOP1505 OT By-passed called lett message 07/23/19 11:45 BOP1505 OT By-passed called lett message 07/23/19 11:45 8OP1505 OT By-passed ffi unable to work overtime 07/23/1911:21 BOP1881 OT Assigned PROPERTY DISTRIBUTION 07/23/19 11:06 BOP1881 OT Assigned agreed 07/23/19 10:40 BOP1903 Ouarterly Shift Preference OUARTERLY PREFERENCE MADE FOR 4TH OTR 2019 my Ist is hosp escort 07/23/19 10:39 BOP1888 Ouarterly Shift Preference OUARTERLY PREFERENCE MADE FOR 4TH OTR 2019 Assignment Page 3 Post Shift date Watch Type Mndiry SNU I:2 07/23/19 EAN Signup List I0 List Selefed- [All] SHU #2 07/23/19 ENN Signup List CI List Selected [All] SHU #2 07/23/19 ENN Signup List El List Selected [All] SNU #2 07/23/19 EAN Signup List (0 List Selected [Al SHU #2 07/23/19 EN/ Signup List D List Selefed [All) SNU #2 07/23/19 EAN Signup List CI List Selected [Al SNU #2 07/23/19 EAN Signup List D List Selected [Al SHU #2 07/23/19 ENN Signue List D List Selected [All) SNU #2 07/23/19 ENN Signup List 0 List Selected [All] SNU #2 07/23/19 ENN Signup List Li List Selected [All) SHU N2 07/23/19 EAN Signup List D List Selected [Al SHU #2 07/23/19 EAN Sirup List CI List Selected [All) SHU #2 07/23/19 EAN Signup List CI List Selected [All) SNU #2 07/23/19 ENN Signup List CI List Selected [Al SHU #2 07/23/19 EM/ Signup List CI List Selected [All) SHU N2 07/23/19 ENN Signup List D List Selected (All) SHU PROPERTY 07/23/19 ENV List Exempt D 5 NORTH 07/28/19 MAN Signup List El List Selected [NI) N/A N/A N/A 0 Ist DAN Sa 5 [Sick/Annuall 2nd DAN Sa S UNIT 3 3rd DAN Sa S 3 SALLY OFF 4th: DAN Sa S INTERNAL 5th DAN Sa S 11 SOUTH N/A N/A N/A (3 Ist NM S Sa CONTROL #2 2nd NM Th F LOBBY 3rd NM T W 10 SOUTH #2 4th NM F Sa SHU #3 5th 07/23/19 10:32 BOP1881 OT Removed - Mgmt Cancelle 10 SOUTH #2 07/24/19 P/M List Exempt cancelled - REMOVED FROM (Sick / Annual) 07/2311910:32 BOP1881 OT Removed - Mgmt Cancelle SHU #4 07/23/19 EAN Signup List cancelled -LAST OT DATE SET TO 7/22/2019 10 22 47 AM - REMOVED FROM [Slok / Annual) 07/2311910:30 BOP1881 OT Assigned 3 SALLY OFF 07/25/19 DAN Signup List agreed List Selected. [Al 0721/1910:29 BOP1881 OT By-passed 3 SALLY OFF 07/25/19 DAN Signup List n/a message lett List Selected [All) 07/2311910:29 BOP1881 OT By-passed 3 SALLY OFF 07/25/19 DAN Siam» List nia message lett List Selected [All) 07123/19 10:29 BOP1881 OT By-passed 3 SALLY OFF 07/25/19 DAN Signup List The stall member il is already working this watch List Selected (All) 07/23/19 10:29 BOP1881 OT By-passed 3 SALLY OFF 07/25/19 DAN Signup List nia message lett List Selected o 5/19/2020 10 35 50 AM EFTA00048567

ling Assignment Dateil ime t ser Action Alias Post Shift dale %%well Type 07/23/19 10:29 BOP1881 OT By-passed 3 SALLY OFF 07/25/19 DAN Signup List Na message left List Selected [AN 07/23/19 10:04 BOP1897 Quarterly Shift Preference N/A N/A N/A QUARTERLY PREFERENCE MADE FOR 4TH QTR 2019 1st 0/W [Sick/Annual) 2nd 0/W S Sa 2 SALLY OFF 1 ST hosp I a ore 2 rf beat out of everything KS DW and weeking off 3rd D/W S Sa 3 SALLY OFF DW 4th DAN S Sa REAR GATE 5th D/W S Sa INTERNAL 07/23/19 10:01 BOP1881 OT Assigned SHU #4 07/25/19 ENV List Exempt sgrf 07/23/19 9:58 80P1879 OT Assigned SIS LT 02 07/23/19 D/W List Exempt 07/23/19 9:58 80P1881 OT Assigned LOBBY #2 07/23/19 PRA List Exempt iisdt 07/23/199:52 BOP1879 OT Assigned 11 NORTH 07/23/19 D/W List Exempt RELIEF 07/23/19 9:43 BOP1881 OT Assigned OSP 081 07/27/19 ENV Sqnup List agreed List Selected (All) 07/23/19 9:40 BOP1898 Signed Up for OT N/A 07/27/19 N/A N/A Selected Lists Selected Shifts (Ail) ENV 07/23/19 9:37 bop17345 Quarterly Shift Preference N/A N/A N/A QUARTERLY PREFERENCE MADE FOR 4TH QTR 2019 1st WW S M OSP #1 2nd VAR S M PHONE MONITOR 3rd DNV S Sa UNIT 3 4th ENV 5th 07/23/19 9:32 bop17345 Quarterly Shift Preference N/A N/A N/A QUARTERLY PREFERENCE MADE FOR 4TH QTR 2019 1st MNV S M OSP #1 2nd VAR S M PHONE MONITOR 3rd 4th 5th: 07/23!199:31 BOP1881 OT Assigned agreed SHU a1 List Selected (All) 07/26/19 D/VV Signup List 07/23/19 9:31 BOP1881 OT By-passed cop SHU e1 List Selected [All) 07/26/19 DAN Signup List 07/23/19 9:30 BOP1881 OT By-passed n/a message left SHU #1 List Selected (All) 07/26/19 DAN Signup List 07/23/19 9:30 BOP1881 OT By-passed nia message left SHU #1 List Selected [All) 0726/19 DAN Skanup List 07/23/19 9:27 BOP1881 OT Assigned rghjk 5 SOUTH 07/27/19 EAN List Exempt 07/23/19 9:26 BOP1881 OT Assigned agreed 9 NORTH List Selected (All) 07/28/19 MNV Signup List 07/23/19 9:26 BOP1881 OT By-passed n/a n/a message left 9 NORTH List Selected (All) 07 WW lis Signut) ist t 07/23/19 9:26 BOP1881 OT By-passed nia message left 9 NORTH List Selected [All] 07/28/19 MAN Sirup List 07/23/19 9:23 BOP5770 Deleted OT Sign Up - Day N/A 07/24/19 N/A N/A 07/23/19 9:23 BOP5770 Signed Up for OT N/A 07/24/19 N/A N/A Selected Lists (AN) Selected Shifts MNV 07/23/19 9:23 BOP5770 Deleted OT Sign Up Watch N/A 07/25/19 ENV N/A 07/23/19 9:18 BOP1881 OT Assigned agreed SHU #4 List Selected (AN 07/24/19 DAN Signup List 07/23/19 9:18 BOP1881 OT By-passed SHU 04 07/24/19 ONV Sirup List The staff member I I is already working this watch List Selected (All) 07/23/19 9:18 BOP1881 OT By-passed SHU #4 07/24/19 D/VV Signup List The staff member i is already working this watch List Selected (All) 07/23/19 9:18 BOP1881 OT By-passed n/a message left SHU ft4 List Selected (All) 07/24/19 D/W Signup List Page 4 Mndtry 0 5/19/2020 10 35 50 AM EFTA00048568

Page 5 Log Assignment Date/Time I cer Action Alias Post Shift date Notch Type %Anew". 07/21/19 9:18 BOP1881 OT By-passed SHU 04 07/24/19 DAN Slipup List K The staff member I ) is already working this watch List Selected (All] 07/23/19 9:18 BOP1881 OT Bypassed S SHU *4 07724/19 DAN Signup List K cop List Selected (All] 07/23/19 9:18 BOP1881 OT Bypassed SHU #T4 07/24/19 DAN Signup List K The staff member is already working this watch List Selected. (All] 07/23/19 9:18 BOP1881 OT By-passed SHU N4 07/24/19 DAN Signup List K n/a message left List Selected. (All] 07/23/19 9:18 BOP1881 OT Bypassed SHU $14 07/24/19 DAN Signup List K n/a message left List Selected (All] 07/23/19 9:09 BOP1881 OT Assigned SHU 03 07/24/19 NM Sginup List K agreed List Selected- [All] 07/23/19 9:09 BOP1881 OT By-passed SHU *3 07/24/19 A/M Signup List K 16 List Selected (All] 07/23/19 9:09 BOP1881 OT By-passed SHU #3 07/24/19 A/M Slipup List K n/a message left List Selected (All] 07/23/19 9:09 BOP1881 OT By-passed SHU #3 07/24119 NM Signup List K cop List Selected (All] 07/23/19 9:08 BOP1881 OT By-passed SHU *3 0724119 A/M Signup List K 16 List Selected (All) 07/23/19 9:08 BOP1881 OT By-passed SHV /13 07/24/19 A/M Sgnup List K n/a message lett List Selected (All] 07/23/19 9:08 BOP1881 OT By-passed SHU 03 07/24/19 AIM Signup List K n/a message left List Selected (All] 07/23/19 9:07 BOP1881 OT Assigned SHU #4 07/23/19 EAN Signup List K agreed List Selected: [AN 07/23/19 9:07 BOP1881 OT By-passed SHU OM 07/23/19 ENV Signup List K 16 List Selected. (AN 07/23/19 9:07 BOP1881 OT By-passed SHU OM 07/23/19 ENV Signup List K n/a message left List Selected. (All) 07/23/19 9:07 BOP1881 OT By-passed SHU tt4 07/23/19 ENV Signup List K COP List Selected [All] 07/23/19 9:06 BOP1881 OT By-passed SHU #4 07/23/19 EMI Signup List K Na message left List Selected [All] 07/23/19 9:06 BOP1881 OT By-passed SHU *4 07723/19 ENV Signup List K n/a message left List Selected (All] 07/23/19 9:06 BOP1881 OT By-passed SHU 114 07/23/19 EMI Signup List K n/a message left List Selected (All] 07/23/19 9:06 BOP1881 OT By-passed = SHU 04 07/23/19 ENV Signup List K unable List Selected (All] 07/23/19 8:14 BOP1881 OT Assigned INTERNAL 07/27/19 DAN List Exempt K fggt 07/23/19 8:28 BOP1881 OT Assigned ATTY CONF 07/23/19 ENV Signup List K agreed List Selected [All] 07/23/19 8:28 BOP1881 OT By-passed ATTY CONF 07/23/19 ENV Signup List K nia message left List Selected (All] 07/23/19 8:28 BOP1881 OT By-passed ATTY CONF 07/23/19 EAN $ignup List K Na message left List Selected. [All] 07/23/19 8:28 BOP1881 OT By-passed ATTY CONF 07/23/19 ENV Signup List K 16 List Selected (All] 07/23/19 8:28 BOP1881 OT By-passed ATTY CONF 07/23/19 ENV Signup List K n/a message left List Selected. (AM 07/23/19 8:28 BOP1881 OT By-passed ATTY CONF 07/23/19 ENV Signup List K n/a message left List Selected (All) 07/23/19 8:28 BOP1881 OT By-passed ATTY CONF 07/23/19 EM/ Signup List K 16 List Selected (All] 07/21/19 8:28 BOP1881 OT By-passed ATTY CONF 07/23/19 ENV Signup List K Na message left List Selected (All] 07/23/19 8:27 BOP1881 OT By-passed S ATTY CONF 07/23/19 ENV Signup List K cop List Selected (All) 07/23/19 8:27 BOP1881 OT By-passed ATTY CONF 07/23/19 EM! Signup List K Na message left List Selected (All] 5/19/2020 10 35 50 AM EFTA00048569

Log Bate/Thor l'ser Action 07/23/19 8:27 BOP1881 OT Bypassed n/a message left 07/23/19 8:27 BOP1881 OT By-passed n/a message left 07/23/19 8:27 BOP1881 OT By-passed unable 07/23/19 7:55 80P4489 Quarterly Shift Preference QUARTERLY PREFERENCE MADE FOR 4TH QTR 2019 Alias DUE TO CHILD CARE ISSUES I RESPECTFULLY ASK TO BE PLACED ON MAN WITH SUMMON OFF. PLEASE NO S H U 07/231197:17 60P1879 CANCELLED 07/23/19 7:17 BOP1879 CPO ADJUSTMENT 07/23/19 7:07 BOP1894 Selected Lists BPT ARMED ESCORT 07/23/19 7:07 BOP1894 Selected Lists BPT ARMED ESCORT 07/23/19 7:06 BOP1894 Selected Lists BPT ARMED ESCORT 07/23/19 7:06 BOP1894 Selected Lists BPT ARMED ESCORT 07/23/19 6:10 BOP1881 OT Removed - Mgmt Cancelle OT Assigned Signed Up for OT Signed Up tot OT Signed Up for OT Signed Up for OT Deleted OT Sign Up - Day 07/23/19 4:31 80P2824 OT Assigned cont of duty 07/23/19 1:23 BOP4270 Signed Up for OT Selected Lists [NI] 07/23/19 1:22 BOP4270 Signed Up for OT Selected Lists (AN 07/23/19 1:22 BOP4270 Signed Up for OT Selected Lists (AllJ 07/22/19 23:51 BOP1896 Quarterly Shift Preference QUARTERLY PREFERENCE MADE FOR 4TH QTR 2019 07/22./19 23:07 BOP4490 Quarterly Shift Preference QUARTERLY PREFERENCE MADE FOR 4TH QTR 2019 07/22/19 22:25 BOP4117 Signed Up for OT Selected Lists (All) 07/22./19 22:25 BOP4117 Signed Up for OT Selected Lists (Alt] 07/22/19 22:25 BOP4117 Signed Up for OT Selected Lists (AV( 07/22/19 22:24 BOP4117 Signed Up for OT Selected Lists (All) Post Shift date Watch ATTY CONE 07/23/19 EM! List Selected [All) ATTY CONF 07/23/19 ENV List Selected (Au] ATTY CONF 07/23119 EM! List Selected [AN N/A N/A 1st MAN S M UNIT 2 2nd MM/ S M 9 NORTH 3rd MM! M T 11 NORTH 4th MM! M T MR-7 5th EMI S Sa UNIT 2 7 SOUTH 07/23/19 D/W List Exempt - REMOVED FROM (Sick / Annual) 7 NORTH 07/23/19 DAN List Exempt Assignment Type Signup List Signup List Signup List N/A N/A Selected Shifts PAM N/A Selected Shifts P/M WA Selected Shifts P/M N/A Selected Shifts P/M N/A 08/01/19 N/A N/A 07/31/19 N/A N/A 07/30/19 N/A N/A 07/25/19 N/A N/A 07/23/19 N/A N/A Suicide Watch 07/23/19 MM! Let Exempt N/A Selected Shifts WV/ N/A Selected Shifts DAN N/A Selected Shifts MM/ N/A 1st- ENV S M OSP al 2nd: E/W S M 10 SOUTH NI 3rd: 4th: 5th: VAR Th F DR-1 NIA N/A N/A 1st EAN S Sa S SOUTH 2nd VAR S F.Sa VISIT 11 3rd VAR S Th.F VISIT I/3 4th VAR S W.Th VISIT N2 5th ENV F Sa 11 SOUTH N/A 08/06/19 N/A N/A Selected Shrfts ACM N/A 08/06/19 N/A N/A Selected Shifts DM1 N/A 08/06/19 N/A N/A Selected Shifts P/M N/A 08/06/19 N/A N/A Selected Shifts- EAN 08/05/19 N/A N/A 08/02/19 N/A N/A 07/31/19 N/A N/A N/A WA Page 6 Mndtry 0 o 5/19/2020 10 35 50 AM EFTA00048570

Page 7 Io Assignment Date/Time l'aCT Action :Alias Post Shift date Watch Type Mndtry 07/22/19 22:24 BOP4117 Stoned Up for OT N/A 08/07/19 N/A N/A Selected Lists Selected Shifts [Ali] 07/22/19 22:24 BOP4117 Signed Up for OT N/A 08/07/19 N/A N/A Selected Lists Selected Shifts [All] DNV 07/22/19 22:24 BOP4117 Signed Up for OT N/A 08/07/19 N/A N/A Selected Lists Selected Shifts (All) P/M 07/22/19 22:24 BOP4117 Signed Up for OT N/A 08/07/19 N/A N/A Selected Lists Selected Shifts [At] ENV 07/22/19 22:24 BOP4117 Signed Up for OT N/A 08/08/19 N/A N/A Selected Lists Selected Shifts [All] NM 07/22/19 22:24 BOP4117 Signed Up for OT N/A 08/08/19 N/A N/A Selected Lists Selected Shifts. (Ail] D/W 07/22/19 22:24 BOP4117 Signed Up for OT WA 08/08/19 N/A N/A Selected Lists Selected Shifts (All] P/M 07/22/19 22:23 BOP4117 Signed Up for OT N/A 08/08/19 N/A N/A Selected Lists Selected Shins (Al!] ENV 07/22/19 22:23 BOP4117 Signed Up for OT N/A 08/09/19 N/A N/A Selected Lists Selected Shifts AMI 07/22/19 22:23 BOP4117 Signed Up for OT N/A 08/09/19 N/A N/A Selected Lists Selected Shifts. [All] DAN 07/22/19 22:23 60P4117 Signed Up for OT N/A 08/09/19 N/A N/A K Selected Lists Selected Shifts [All] P/M 07/22/19 22:23 BOP4117 Signed Up for OT N/A 08/09/19 N/A N/A 0 Selected Lists Selected Shifts (All] ENV 07/22/19 22:23 BOP4117 Signed Up for OT N/A 08/10/19 N/A N/A Selected Lists Selected Shifts (All] NM 07/22/19 22:23 BOP4117 Signed Up for OT N/A 08/10/19 N/A WA Selected Lists Selected Shifts (All] P/M 07/22/19 22:22 BOP4117 Signed Up for OT N/A 08/11/19 N/A N/A Selected Lists Selected Stuns (All] NM 07/22/19 22:22 BOP4117 Signed Up for OT N/A 08/11/19 N/A WA K Selected Lists Selected Shifts (All] P/M 07/22/19 22:22 BOP4117 Signed Up for OT N/A 08/12/19 N/A WA Selected Lists Selected Shifts [NI] P/M 07/22/19 22:22 BOP4117 Signed Up for OT N/A 08/12/19 N/A N/A Selected Lists Selected Shifts [All] ENV 07/22/19 22:22 BOP4117 Signed Up for OT NIA 08/13/19 N/A N/A Selected Lists Selected Shifts. [All] NM 07/22/19 22:22 BOP4117 Signed Up for OT N/A 08/13/19 N/A N/A Selected Lists Selected Shifts (All] D/VV 07/22/19 22:22 BOP4117 Signed Up for OT N/A 08/13/19 N/A N/A Selected Lists Selected Shifts [Ail] P/M 07/22/19 22:22 BOP4117 Signed Up for OT N/A 08/13/19 N/A N/A Selected Lists Selected Shifts [All] ENV 5/19/2020 10 3551 AM EFTA00048571

Page 8 I log Anignintnl Dateline tier Action Alin Peat Shift date Watch Tipe Mader) 07/22/19 22:21 BOP4117 Signed Up for OT N/A 08/14/19 N/A N/A K Selected Lists Selected Shifts (All] AAA 07/22/19 22:21 BOP4117 Signed Up for OT N/A 08/14/19 N/A NIA K Selected Lists Selected Shifts (Ali] DAN 07/22/19 22:21 BOP4117 Signed Up for OT N/A 08/14/19 N/A N/A K Selected Lists Selected Shifts (All] PAA 07/22/19 22:21 8OP4117 Signed Up for OT N/A 08/14/19 N/A N/A K Selected Lists Selected Shifts (All) EM/ 07/22/19 22:21 BOP4117 Signed Up for OT N/A 08/15/19 N/A N/A K Selected Lists Selected Shifts (All) NM 07/22/19 22:21 BOP4117 Signed Up for OT N/A 08/15/19 N/A N/A K Selected Lists Selected Shifts (All) DNV 07/22/19 22:21 BOP4117 Signed Up for OT N/A 08/15/19 N/A N/A K Selected Lists Selected Shifts (All) P/M 07/22/19 22:21 BOP4117 Signed Up for OT N/A 08/15/19 N/A N/A K Selected Lists Selected Shifts (Ain EMI 07/22/19 22:20 BOP4117 Signed Up for OT N/A 08/05/19 N/A N/A K Selected Lists Selected Shifts (All) EM/ 07/22/19 22:20 BOP4117 Signed Up for OT N/A 08/05/19 N/A N/A K Selected Lists Selected Shifts [API P/M 07/22/19 22:20 8OP4117 Signed Up for OT N/A 08/04/19 N/A N/A K Selected Lists. Selected Shifts [All) P/M 07/22/19 22:20 8OP4117 Signed Up for OT N/A 08/04/19 N/A N/A K Selected Lists Selected Shifts (Aft) NM 07/22/19 22:19 BOP4117 Signed Up for OT N/A 08/03/19 N/A N/A K Selected Lists Selected Shifts [All) NM 07/22/19 22:19 8OP4117 Signed Up for OT N/A 08/03/19 N/A N/A K Selected Lists Selected Shifts (All] P/M 07/22/19 22:19 8OP4117 Signed Up for OT N/A 08/16/19 N/A N/A K Selected Lists Selected Shifts (All] NM 07/22/19 22:19 BOP4117 Signed Up for OT N/A 08/16/19 N/A N/A K Selected Lists. Selected Shifts (All] DAN 07/22/19 22:19 BOP4117 Signed Up for OT N/A 08/16/19 N/A N/A K Selected Lists Selected Shifts (All] P/M 07/22/19 22:19 BOP4117 Signed Up for OT N/A 08/16/19 N/A N/A K Selected Lists Selected Shifts [All] UN 07/22/19 22:19 BOP4117 Signed Up for OT N/A 08/17/19 N/A N/A K Selected Lists Selected Shifts [All) NM 07/22/19 22:19 BOP4117 Signed Up for OT N/A 08/17/19 N/A N/A K Selected Lists Selected Shifts [Ali] P/M 07/22/19 22:18 BOP4117 Signed Up for OT N/A 08/18/19 N/A N/A K Selected Lists Selected Shifts (All] NM 07/22/19 22:18 BOP4117 Signed Up for OT N/A 08/18/19 N/A N/A K Selected Lists Selected Shifts. [Ail] P/M 5/19/2020 10 35 51 AM EFTA00048572

I „g Assignment Page 9 Datell imc l'ser Mann Alias Poll Shift date Watch Type Medtry 07/22/19 22:14 BOP4117 Signed Up for OT N/A 08/02/19 N/A N/A O Selected Lists Selected Shifts [Ali] NM 07/22/19 22:14 80P4117 Signed Up for OT N/A 08/02/19 N/A N/A O Selected Lists Selected Shifts [All] DAV 07/22/19 22:14 BOP4117 Signed Up for OT N/A 08/02/19 N/A N/A O Selected Lists Selected Shifts [All] P/M 07/22/19 22:14 BOP4117 Signed Up for OT N/A 08/02/19 N/A N/A O Selected Lists Selected Shirts [Ali] EAN 07/22/19 22:13 BOP4117 Signed Up for OT N/A 08/01/19 N/A N/A O Selected Lists Selected Shifts (All] NM 07/22/19 22:13 BOP4117 Signed Up for OT N/A 08/01/19 N/A N/A O Selected Lists Selected Shifts [All] DM/ 0722/19 22:13 BOP/1117 Signed Up for OT N/A 08/01/19 N/A N/A O Selected Lists Selected Shifts (All] P/M 07/22/19 22:13 BOP4117 Signed Up for OT N/A 08/01/19 N/A N/A O Selected Lists Selected Shifts [All] E/W 07/22/19 22:13 B0P4117 Signed Up for OT N/A 07/31/19 N/A N/A O Selected Lists Selected Shifts (All] NM 07/22/19 22:12 80134117 Signed Up for OT N/A 07/31/19 N/A N/A O Selected Lists Selected Shifts (All] DNV 07/22/19 22:12 BOP4117 Signed Up for OT N/A 07/31/19 N/A N/A O Selected Lists Selected Shifts (All] P/M 07/22/19 22:12 BOP4117 Signed Up for OT N/A 07/31/19 N/A NIA O Selected Lists Selected Shifts (All] ENd 07/22/19 22:12 80134117 Signed Up for OT N/A 08/19/19 N/A N/A O Selected Lists Selected Shifts (All] P/M 07/22/19 22:12 BOP4117 Signed Up for OT N/A 08/19/19 N/A N/A O Selected Lists Selected Shifts [Ali] E/W 07/22/19 22:12 BOP2824 OT Assigned staff accept MOT 5 SOUTH 07/23/19 MAN Mandtry List 07/22/19 22:11 80134117 Signed Up for OT N/A 08/20/19 N/A N/A O Selected Lists- Selected Shifts (All] NM 07/22/19 22:11 80132824 OT By-passed 5 SOUTH 07/23119 MAN Mandtry List The staff member (al) is already working this watch. 07/22/19 22:11 80134117 Signed Up for OT N/A 08/20/19 N/A N/A O Selected Lists Selected Shifts' [All] D/W 07/22/19 22:11 BOP2824 OT By-passed unv 5 SOUTH 07/23/19 MM/ Mandtry List g 07/22/19 22:11 80134117 Signed Up for OT N/A 08/20/19 N/A N/A O Selected Lists Selected Shifts [AN PM 07/22/19 22:11 80134117 Signed Up for OT N/A 08/20/19 N/A N/A O Selected Lists Selected Shifts- (All] VW 07/22/19 22:11 80134117 Signed Up for ()T N/A 08/21/19 N/A N/A O Selected Lists Selected Shifts IAII] MA 07/22/19 22:11 BOP4117 Signed Up for 07 N/A 08/21/19 N/A N/A O Selected Lists Selected Shifts [AT DAN 5/19/2020 10 35 51 AM EFTA00048573