EFTA00139318.pdf

BP-S358.060 SEP 05 MEDICAL TREATMENT REFUSAL CDFRM 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: The following treatment(s) was/were recommended: 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: 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. 7-24-2019 Date s Sign Date NYM-NEW YORK MCC 3 1 CONFIDENTIAL SDNY 00009374 EFTA00139318 BP-S358.C60 MEDICAL TREATMENT REFUSAL COMM SEP 05 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-10-2019 Date I, JEFFREY EPSTEIN 76318-054 , refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: The following treatment(s) was/were recommended: 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: 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. 7-10-2019 Date Paten Signature Date NW-NEW YORK MCC Signature of Witness CONFIDENTIAL SDNY 00009375 EFTA00139319 BP-S358 060 MEDICAL TREATMENT REFUSAL C0FRkl 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: The following treatment(s) was/were recommended: 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: i• I 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 as Sign Date NYM--NEW YORK MCC CONFIDENTIAL SDNY_00009376 EFTA00139320 BP-A0618 A&O DENTAL EXAMINATION JUN 16 (Initial Clinical Dental Findings) U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS (Approval valid 18 months from examination date) re en icer MCC New York POF Ptescdbod by P6400 Replaces BP.A0618 of JUN 10 CONFIDENTIAL SDNY_00009377 EFTA00139321 BP-A0618 A&O DENTAL EXAMINATION JUN 16 (Initial Clinical Dental Findings) U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS PM: (Approval valid 18 months from examination date) BWs: Panorex: PeentName: Den' • &kin gi pNumber: eSirity r I Institution: / Date: Signature Block/Stamp: 7‘31(C-os- I MCC NEW YORK PDF Piesalbed by P6400 Replaces BP-A0616 c4JUN 10 CONFIDENTIAL SDNY_00009378 EFTA00139322  BP-5358 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: The following treatment(s) was/were recommended: 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: 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. 7-24-2019 Counseled by Dale Pa as Sign Date NYM--NEW YORK MCC CONFIDENTIAL SDNY_00009379 EFTA00139323  Federal U.S. Medical Center for Federal Prisons Bureau of Prisons ••• Sensitive But Unclassified ••• Name EPSTEIN, JEFFREY Facility MCC New York Collected 07/09/2019 13:34 Reg # 76318-054 Order Unit E06-547U Received 07/10/2019 10:44 DOB 01/20/1953 Provider Reported 07/10/2019 14:46 Sex M LIS ID 188191004 HIV FLAG LEGEND L=Low L!=Low Critical H=High H!=High Critical A=Abnorrnal A! =Abnormal Critical Page 3 of 3 CONFIDENTIAL SDNY_00009380 EFTA00139324  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 byl on 07/14/2019 18:12. Bureau of Prisons - NYM CONFIDENTIAL SDNY_00009381 EFTA00139325 BP-S358 C50 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: The following treatment(s) was/were recommended: 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: 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. 7-24-2019 Counseled by Date NYM--NEW YORK MCC CONFIDENTIAL SDNY_00009382 EFTA00139326 BP-A0618 A&O DENTAL EXAMINATION JUN 18 (initial Clinical Dental Findings) U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS • Instructed how to obtain urgent and non-urgent dental care: Yes: i No: Treatment Priorities: None: Non-urgent Urgent Referred to Sick Call: non-urgent Radiographs authorized: . Prophylaxis authorized: Yes I No PM: (Approval valid 18 months from examination date) 8Ws: Panorex: Patient Name: . Den' c s --c4 n 1 --)C_M -Q t1 E FAT4Number. I Institution: / Date: ins -7G 3 1Sf- D.S-\ MCC NEW YORK 7- zo -1 Q. PDF Prescribed by P64C0 Replaces BP.A0618 ofJON 10 CONFIDENTIAL SDNY_00009383 EFTA00139327 Ell:14358.0W 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: The following treatment(s) was/were recommended: 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 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. 7-24-2019 Counseled by Date NYM-NEW YORK MCC CONFIDENTIAL SDNY_00009384 EFTA00139328 BP-S358.C60 MEDICAL TREATMENT REFUSAL CDFRM SEP 05 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 7-10-2019 Date I, JEFFREY EPSTEIN 76318-054 , refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: The following treatment(s) was/were recommended: 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: 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. 7-10-2019 Counseled by Date Patien Signature Date Signature of Witness NYM-NEW YORK MCC Date CONFIDENTIAL SDNY_00009385 EFTA00139329 BP-A0618 A&O DENTAL EXAMINATION JUN 16 (Initial Clinical Dental Findings) U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 1 / non-urgent Prophylaxis authorized: No (Approval valid 18 months from examination date) r Number: 3-c.c.city Institution: / £ Date: 76 3 RP- US-14/i MCC NEW YORK 7-2-6 -19. POE Prescribed by P8400 Replaces 8P-A0618 of JUN 10 CONFIDENTIAL SDNY_00009386 EFTA00139330  Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Reg 76318-054 Date of Birth: 01/20/1953 Sex: Facility: NYM Encounter Date: 08/10/2019 07:25 Provider: Unit: Z04 Emergency Code - Resuscitation Event encounter performed at Special Housing Unit. SUBJECTIVE: Emergency Note Provider: Team Members: Provider Bak Team/Code Leader Code Events: Tvoe Value Data CPR Compressions 08/10/2019 06:35 EKG/Monitor Lifepak 08/10/2019 06:39 No shock advised CPR Compressions 08/10/2019 06:40 Oxygen 15 L 08/10/2019 06:47 IV Access Peripheral IV 08/10/2019 06:48 18 g Left AC Airway Endotracheal Tube 08/10/2019 07:08 ET Tube 7.5 24CM to L Lip line Placed by Paramedics Medications Epinephrine 1mg IV 08/10/2019 07:10 Epinephrine 3 doses and Sodium bicarb 2 doses administered by paramedics CPR Compressions 08/10/2019 07:11 Medications Sodium Bicarbonate 1 mEa/kg IV 08/10/2019 07:11 IV Fluids Normal Saline 0.9% 1000 ml 08/10/2019 07:12 Medications Epinephrine 1mg IV 08/10/2019 07:13 CPR Compressions 08/10/2019 07:14 Medications Sodium Bicarbonate 1 mEa/kg IV 08/10/2019 07:14 Medications Epinephrine 1mg IV 08/10/2019 07:16 CPR Compressions 08/10/2019 07:17 Comments: Responded to a body alarm at 0635 for medical emergency on 9S, Upon arrival Inmate was received on the floor of his cell unresponsive with CPR in progress by correctional officers, Inmate was Cold, with circumferential Bruising around the neck and posterior mottling, Pupils Fixed and dilated, No Palpable pulses, Call place for EMS, CPR Continued, AED Placed No shock advised, CPR Continued, inmate transported to HSU treatment room with CPR in progress, 18g hep lock to L AC, O2 15 Lt ViA BVM, Pulse Check NO SHOCK advised. EMS and Paramedics arrived 0656, Placed on cardiac monitor asystole Resumed CPR, Inmate was intubated by Medics, 3 Rounds of Epinephrine administered, Pulse Check asystole, Inmate was transported to Local ER with CPR in progress. OBJECTIVE: Exam: General Appearance Yes: Unconscious Generated 08/1012019 08:10 by Bureau of Prisons - NYM Page 1 of 2 CONFIDENTIAL SDNY_00009387 EFTA00139331 Inmate Name: EPSTEIN. JEFFREY EDWARD Reg #: 76318.054 Date of Birth: 01/20/1953 Sex: M Rare: WHITF Facility: NYM Encounter Date: 08/10/2019 07:25 Provider: Unit: Z04 Exam: ASSESSMENT: Cardiac Arrest PLAN: New Consultation Requests: Consultation/Procedure Target Date Scheduled Target Date Priority Translator Language Emergency Room 08/10/2019 08/10/2019 Emergent No Subtype: AMBULANCE Reason for Request: Cardiac arrest with CPR in progress Copay Required:No Cosign Required: Yes TelephoneNerbal Order: No Completed b n 08/10/2019 08:10 Requested to be cosigned by Cosign documentation will be displayed on the following page. Generated 0811012019 08:10 by Bureau of Prisons • NYM Page 2 of 2 CONFIDENTIAL SDNY_00009388 EFTA00139332  Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: • Facility: NYM Encounter Date: 07/30/2019 15:58 Provider: Unit: 201 Chronic Care - Chronic Care Clinic encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: CONFIDENTIAL SDNY_00009389 EFTA00139333 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/30/2019 15:58 Provider: Unit: 201 Generated 07/30/2019 16:12 by Bureau of Prisons • NYM Page 2 of 2 CONFIDENTIAL SDNY_00009390 EFTA00139334  Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Reg ft 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/30/2019 11:12 Provider: Unit: 201 Generated 07/302019 14A5 by Bureau of Prisons NYM Page 7 of 3 CONFIDENTIAL SDNY_00009391 EFTA00139335 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE NYM Encounter Date: 07/30/2019 11:12 Provider: Unit: 201 CONFIDENTIAL SDNY_00009392 EFTA00139336 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/30/2019 11:12 Provider Unit: 201 Generated 07/30/2019 14:05 by Bureau of Prisons • NYM Page 3 of 3 CONFIDENTIAL SDNY_00009393 EFTA00139337  Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN. JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/30/2019 11:12 Provider: Unit: Z01 CONFIDENTIAL SDNY_00009394 EFTA00139338 Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/30/2019 11:12 Provider: Unit: ZO1 CONFIDENTIAL SDNY 00009395 EFTA00139339 Inmate Name: EPSTEIN. JEFFREY EDWARD Reg 8: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/30/2019 11:12 Provider: Unit: 201 Generated 07/30/2019 14.05 by Bureau of Prisons • NYM Page 3 of 3 CONFIDENTIAL SDNY_00009396 EFTA00139340  Bureau of Prisons Health Services See Amendment Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/30/2019 15:58 Facility: NYM Amendment made to this note by on 07/30/2019 16:12. Bureau of Prisons - NYM CONFIDENTIAL SDNY_00009397 EFTA00139341