DOJ-OGR-00025134.pdf

Page 816 Form 583 Report of Incident Incident #: NYM-19-0076 Submitted By: Date/Time Of Incident: 7/23/2019 1:27 AM Section 1: General Information Staff Aware Date: 7/23/2019 1:27 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 Type of Incident Institution Locked Down: No Modified Operations: No Cause Of Incident Known? No Cause Of Incident Assault On Inmate Alcohol Assault On Staff Commissary Assault, Attempted On Inmate Debts Assault, Attempted On Staff Disrespect Issue Disruptive Behavior Drugs Escape From Non-secure Facility Ethnic Conflict Escape From Secure Facility Food Issue Escape, Attempted From Non-secure Facility Geographical Conflict Escape, Attempted From Secure Facility Interfering with Staff duties Fight Property Issue Inmate Death Racial Conflict Institution Disturbance Recreation Equipment Introduction Of Contraband Religious Issue Lethal Weapons Discharge Security Threat Group Conflict Self Mutilation Sexual Pressure Setting A Fire Sporting Events Sexual Act, Non-consensual On Inmate Telephone Sexual Assault On Staff Theft Sexual Contact, Abusive On Inmate Visiting Sexual Harassment, Repetitive Work Issue Staff Homicide Strike, Food Strike, Work Suicide Attempt Use Of Force Use Of Force/Applications Of Restraints Use of Restraints, Pregnant/Postpartum Method: Hanging/Asphyxiation 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 DOJ-OGR-00025134