EFTA00104956.pdf

Form 583 Report of Incident Incident NYM-19- Submitted By: Date/Time Of Incident: 7/23/2019 1 7 AM 0076 Section 1: General Information Staff Aware Date: 7/23/2019 127 AM FBI Notified: No USMS Notified: No Indicate Where Incident Occurred: Main Facility Location Level 1: SHU Level 2: Housing Unit, Special (SHU) Level 3: 9 SOUTH SHU Typs,Ofh 1N: 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 ❑ Alcohol ❑ Disruptive Behavior ❑ 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 ❑ Racial Conflict ❑ Lethal Weapons Discharge ❑ Recreation Equipment ❑ Self Mutilation ❑ Religious Issue ❑ Setting A Fire ❑ Security Threat Group Conflict ❑ Sexual Ad, 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 EI Suicide Attempt Method: Hanging/Asphyxiation ❑ Use Of Force ❑ Use Of Force/Applications Of Restraints ❑ Use of Restraints, PregnanUPostpartum Section 2 Inmates Involved UNCLASSIFIEDILIMITED OFFICIAL USE ONLY/LAW ENFORCEMENT SENSITIVE This document is marked Unclassirvd/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.' If contains information that may be exempt from public release under the provisions of the Pnvacy Act (5 U.S.C. 552). 1 of 3 EFTA00104956  Form 583 Report of Incident Incident a: NYM-19- Submitted By: Date/Time Of Incident: 723/20191 AM 0076 Reg It 76318054 Name: EPSTEIN, JEFFREY Role: Victim Medical Attention Required: No Injury Category: Minor inj 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 a: 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: 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 proper attribution, to active Law Enforcement, DOD. or U.S. Intelligence Agencies. This document or any segment/attachment thereof. may not be re:eased without Me 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 provision1of the Privacy Act (5 U.S.C. 552). 2 of 3 EFTA00104957  Form 583 Report of Incident Incident #: NYM-19- Submitted By: Date/Time Of Incident: 7/23/2019 127AM 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 arrival I was informed that an inmate had attempted suicide and proceeded to cell, Z05-124LAD. I observed inmate Epstein, Jeffrey #76318-054 lying in the fetal position on the floor of his cell wearing a t-shirt and 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 to get the inmate to stand on his own with negative results. The inmate was placed in hand restraints and staff was directed to retrieve the stretcher. As inmate Epstein was being placed on the stretcher by responding staff, he would open hii eyes and observe staff. When staff made eye contact with him, he would huniedly shut his eyes. The inmate was taker) 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 Y. Joaquin for a circular line of erythema at the base of the neck, one section on the front with marks of friction and a small erythema on his left knee. Section 7: Attachments pMDafa Pile NiteTe. No date found. Approved By: NOT COMPLETED UNCLASSIFIED/LIMITED OFFICIAL USE ONLY/LAW ENFORCEMENT SENSITIVE This document is marked Undassined/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/attachrrent thereof. riay not be released without the approval of the Bureau of Prisons to any media sources, any non-law enforcement entity, the genera 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). 3 of 3 EFTA00104958