EFTA00123113.pdf

Form 583 Report of Incident Incident NYM-19- Submitted By: Date/Time Of Incident: 7/23/2019 1:27 AM 0076 Section 1: General Information Staff Aware Date: 7/23/2019 1:27 AM FBI Notified: No USMS Notified: No Indicate Whore Incident Occurred: Main Facility Location Level 1: SHU Level 2: Housing Unit, Special (SHU) Level 3: 9 SOUTH SHU TypeOfincldent Institution Locked Down: No ❑ Assault On Inmate Modified Operations: No ❑ Assault On Staff Cause Of Incident Known? No ❑ Assault, Attempted On Inmate ❑ Assault, Attempted On Staff Cause Of Incident ❑ Disruptive Behavior ❑ Alcohol ❑ Commissary ❑ Escape From Non-secure Facility • Debts ❑ Escape From Secure Facility ❑ Disrespect Issue ❑ Escape, Attempted From Non-secure Facility ❑ Drugs ❑ Escape, Attempted From Secure Facility ❑ Ethnic Conflict ❑ Fight ❑ Food Issue ❑ Inmate Death ❑ Geographical Conflict ❑ Institution Disturbance ❑ Interfering with Staff duties ❑ Introduction Of Contraband ❑ Property Issue ❑ Lethal Weapons Discharge ❑ Racial Conflict ❑ Recreation Equipment ❑ Self Mutilation ❑ Religious Issue El Setting A Fire ❑ Security Threat Group Conflict ❑ Sexual Act, Non-consensual On Inmate ❑ Sexual Pressure ❑ Sexual Assault On Staff ❑ Sporting Events ❑ Sexual Contact, Abusive On Inmate ❑ Telephone ❑ Sexual Harassment, Repetitive ❑ Theft ❑ Staff Homicide ❑ Visiting ❑ Strike, Food ❑ Work Issue ❑ Strike, Work ❑✓ Suicide Attempt Method: Hanging/Asphyxiation ❑ Use Of Force ❑ Use Of Force/Applications Of Restraints ❑ Use of Restraints, Pregnant/Postpartum Section 2: Inmates Involved UNCLASSIFIED/LIMITED OFFICIAL USE ONLY/LAW ENFORCEMENT SENSITIVE This document is marked Unclassified/Limited Official Use Only/Law Enforcement Sensitive and may be disseminated, with proper attribution, to active Law Enforcement, DOD, or U.S. Intelligence Agencies. This document, or any segment/attachment thereof, may not be released without the approval of the Bureau of Prisons to any media sources, any non-law enforcement entity, the general public or those without a 'need to know.' It contains information that may be exempt from public release under the provisions of the Privacy Act (5 U.S.C. 552). 1 of 3 CONFIDENTIAL SDNY_00010632 EFTA00123113  Form 583 Report of Incident Incident #: NYM-19- Submitted By: Date/Time Of Incident: 7/23/2019 1:27 AM 0076 Reg #: 76318054 Name: EPSTEIN, JEFFREY Role: Victim Medical Attention Required: No Injury Category: Minor Injury Weapon (per inmate): No Use of Force (per inmate): No Chemical Used (per inmate): No CIMS: No STG: Yes Restraints (per inmate): Escort Only Death (per inmate): No Reg #: 78514054 Name: TARTAGLIONE, NICHOLAS Role: Not Known Medical Attention Required: No Injury Category: No Injury Weapon (per inmate): No Use of Force (per inmate): No Chemical Used (per inmate): No CIMS: Yes STG: Yes Restraints (per Inmate): No Death (per inmate): No Section 3: Others Involved Name: Person Type: Staff Medical Attention Required: No Death: No Injury Category: No Injury Staff Injury by Inmate: No Sexual Assault: No Name: Person Type: Staff Medical Attention Required: No Death: No Injury Category: No Injury Staff Injury by Inmate: No Sexual Assault: No Name: Person Type: Staff Medical Attention Required: No Death: No Injury Category: No Injury Staff Injury by Inmate: No Sexual Assault: No Name: Person Type: Staff Medical Attention Required: No Death: No Injury Category: No Injury Staff Injury by Inmate: No Sexual Assault: No Name: Person Type: Staff Medical Attention Required: No Death: No Injury Category: No Injury Staff Injury by Inmate: No Sexual Assault: No Name: Thomas, Michael Person Type: Staff Medical Attention Required: No Death: No UNCLASSIFIED/LIMITED OFFICIAL USE ONLY/LAW ENFORCEMENT SENSITIVE This document is marked Unclassified/Limited Official Use Only/Law Enforcement Sensitive and may be disseminated, with per attribution, to active Law Enforcement, DOD. or U.S. Intelligence Agencies. This document, or any segment/attachment the may not be released without the approval of the Bureau of Prisons to any media sources, any non•law enforcement entity, the ge ral public or those without a 'need to know.' It contains information that may be exempt from public release under the provisional of the Privacy Act (5 U.S.C. 552). 2 of 3 CONFIDENTIAL SDNY_00010633 EFTA00123114  Form 583 Report of Incident Incident NYM-19- Submitted By: Date/Time Of Incident: 7/23/2019 1:7 AM 0076 Injury Category: No Injury Staff Injury by Inmate: No Sexual Assault: No Section 4: Lethal Weapon Discharge No data found. Section 5: Use of Force No data found. Section 6: Description of Incident DESCRIPTION OF INCIDENT (If Use Of Force, Include details such as name of supervisor applying the chemical agent and/or restraints, reasons for use of hard restraints instead of soft restraints, etc.) Please be clear about cause(s) of the Incident In your description. On July 23, 2019 at approx. 1:27 a.m., a call for assistance on the Special Housing Unit was announced by the Control Center. Upon my snivel I was informed that an inmate had attempted suicide and proceeded to cell, Z05-124LAO. I observed inmate Epstein, Jeffrey #76318-054 lying In the fetal position on the floor of his cell wearing a t-shirt anc boxers. He was breathing heavily and was snoring. I called out to inmate Epstein and observed him flicker his eyes and continue snoring. His neck was red with no abrasions. I observed no further injuries to his person. An attempt was made rttto get the inmate to stand on his own with negative results. The inmate was placed in hand restraints and staff was di ed to retrieve the stretcher. As inmate Epstein was being placed on the stretcher by responding staff, he would open h s eyes and observe staff. When staff made eye contact with him, he would hurriedly shut his eyes. The inmate was tak@n to HA-Unit, dressed in the suicide smock and placed on suicide watch. Upon the arrival of medical staff, inmate Epstein was examined and treated by, MLP M. for a circular line of erythema at the base of the neck, one section on the front with marks of friction and a smal erythema on his left knee. Section 7: Attachments :Arettiate proniu Entailei 7 TtgAikt0.*-.= No data found. Approved By: NOT COMPLETED UNCLASSIFIEDfLIMITED OFFICIAL USE ONLY/LAW ENFORCEMENT SENSITIVE This document is marked Unclassified/Limited Official Use Only/Law Enforcement Sensitive and may be disseminated, with attribution, to active Law Enforcement, DOD. or U.S. Intelligence Agencies. This document, or any segment/attachment may not be released without the approval of the Bureau of Prisons to any media sources. any non-law enforcement entity, the general public or those without a 'need to know.' It contains information that may be exempt from public release under the provisioniof the Privacy Act (5 U.S.C. 552). 3 of 3 CONFIDENTIAL SDNY_00010634 EFTA00123115