EFTA00123116.pdf

BP, (02/18 INCIDENT REPORT JAN i 7 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS Part I - Incident Report Indent Report Number I. instlubm- MCC New York 2. Inmate's- Name: 3. Register Number: 4. Date of Incitenl: j 5. Time: Epstein . Jeffery 76318-054 07/23/2019 1:27am 6. Place of Incident. 7. Assignment: 8. U SHU M-Tier Cell 124 Unassigned ZA 9. Incident: 10. Prohibited Ad Code (a): 228 Self-Mutilation 11. Description of incident (Date: 07/23/2019 Time: 1:27AM Staff became aware of Incident): On July 23.2019 al approx. 1:27am While working in the S. eclat Housin Unit Myself and heard noise coming from the M tier cell 124.Upon arrival IfM's E tow...teff 7631 to (li at the door stating l/P4 Epstein,Jeff 76318-054 had attem ted to ang mse . op a v sus io gra the door keys an ca crass ante. r cunng n removing rom se end en p ein on is s a rerno a orange rope rom s n .fffi./Was rest. rig at 1 s me But unresponsive. Addition staff and Ops arrived UM was then removed from SHU ng Employee: 13. Date And Time: (Type Name/S ve Inmat y 15. Date f J 07/23/2019 3:30am ent Report Delivered: 7''a -7f 16. Time Indent Report Delivered - Part - Committee Action 17. Comments of Inmate to Committee Reganfing Above Incident: I icn n‘ 5 t k 34/5 (111 re (T Qn.Q9 18. A. It is the finding of the committee that you: is B.Be The Committee is referring the Charge(s) to the DHO for further Committed the Prohibited Act as charged: C. I 1 The Committee advised the inmate of its finding and of the right Did not Commit a Prohibited Act. to file an appeal within 20 calendar days. Committed Prohibited Act Code (s). 19. Committee Decision is Based on Specific Evidence as Follows: 20. mittee action and or recommendation tf referred to 0110 (Contingent upon DH finding inmate committed prohibited act): 61 %kt ' tin C., ;A -ate— tniRSIN...aca (l Orr L); i n \—$4- CtreisJL, ttRos, 06, -31 4/4 --A" riNLAA 0,44‘ 0,41 • 21. Dale and Time of Action: S till (The UDC Chairman=s signature certifies o sat on the UDC and that the completed reynie accurately risked the UDC o9 Member (Typed Name): Member (Typed Name) it° i [IONS: AB items outside of heavy rule are for staff use only. Begin entries with the number 1 and work up. Entries not completed wit be voided by staff. Distribute: OrIgInalCentral File Record; COPY-1-DHO: COPY-2-Inmate after UDC Action: COPY 3-Inmate within 24 hours of Part I Preparation PDF Prescribed by PS270 Replaces BP-A0288 of AUG 11 CONFIDENTIAL SDNY_00010597 EFTA00123116  Part III - Investigation 22. Date And Time Investigation Began 7/30/2019 12:40PM 23. Inmate Advised Of Right To Remain Silent: You Are Advised Of Your Right To Remain Silent At All Stages Of The Disciplinary Process But Are In rmed That Your Silence May Be Used To Draw An Adverse Inference Against You At Any St ge Of The Institutional Disciplinary Process. You Are Also Informed That Your S' ence Alone May Not Be Used To Support A Finding That You Have Committed A Prohibited ct. The Inmate Was Advised Of The Above Right By enant (Date/time)?/30/2019 12:40PM 24. Inmate Statement And Attitude: Inmate Epstein, Jeffery #76318-054 was advised of his rights and understood his rights as read. Inmate Epstein stated "I no comment at this time". Inmate Epstein had a poor attitude. Inmate Epstein was furnished a copy of this report. 25. Other Facts About The Incident, Statements Of Those Persons Present At Scene, Disposition Of Evidence, Etc. No witnesses requested. Please see attached staff memorandum, photograph and medical assessment. This incident report was served late due to inmate on suicide watch. 26. Investigator's Comments And Conclusions: Based on the writer's description of the incident in block #l1, of the incident report, This investigator concludes the report to be accurate as written and the charge warranted. 27. Action Taken: Inmate Epstein is in his special housing unit status, this report referred to UDC for further disposition. Date and Time Investig- ion Completed 7/30/2019 12:45PM Printed Name/si•na re Of InvestigatoJ. Signature Title Lieutenant CONFIDENTIAL SD Y_00010598 EFTA00123117