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A. SHU INMate COUNTS... eeessssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssssseseessesess 61 B. Staif ROUMGS IA TAS: SHY sescccscoseeswerssenwueees mevenes wereses weueen emecemaremnnieemeemnme eeneE ene REE mes 67 Vi. Epstein’s Déath OA AUSUSE 10 «seis acme mena arma eee aro meen Arn A on a re aE 70 A. Discovery of Epstein Hanged in Cell and Emergency ReSponse...........sesseeceeeseseeeceeeerseetseeeeeeeeees 70 B. Items Found in Epstein’s Cell on August 10 Following His Death... eeeeeseeceeeeeeeeeeeeeeeeeees 76 C. AUTOPSY RESUIES «0... ceeeeseeeseeseeeeereseeseeeceeesessesecseeseesesaesessessesesecscesesseeaesesersaesacsesenseesaeeaeenseesaeeaeeaeetees 79 Chapter 6: The Availability of Limited Recorded Video Evidence Due to the Security Camera RECOrding SYStEM FailUle wcoicccaseseccascancaseseancascsnsesnersnsenvexcasaaxexcaseanensnscaneeseaeancaseansacneeanseavexcasascexcancanexenacanenseas 81 |. Background on the Security Camera System at MCC NeW York... esseseceeeresesseeeeeeeseeseeeeeeceeseeeaceeseeeeres 81 II. Discovery of Security Camera System Recording Issues in AUSUSt 2019... eee eeeeeeeeeeeeeeeeeeeeees 82 A Discovery on August 8 of the DVR 2 Failure that Occurred on JULY 29.0... ee eeseeeeeeeeeeeeeeeeeeeeeeees 82 B. Response on August 8 and 9 to Discovery of the Recording Failure «00.0.0... eessesceceeeeeseeeeeeeeees 83 C SHU Camera Locations and Operational Status ON AUGUST 10.0... ee eeeeeeeeeeeeeseeceeeeeeeeeeseeeeeeeees 84 D. FBI Forensic Analysis of the DVR Syste .........ccsssseseseessseeceeeersseeseeeeseesesaeeseeeeesaesaeeceesensateaceeseneeees 92 Chapter 7: Conclusions and REcOMMendation............cccsssccssscceccesssseccesssscecessscceecesscceecessceeecessseeeeessseeeees 94 I. COMCIUSIONS oo. ee ceeesceeesceeescseeeesseescsesscsssacsseeescsesscesacsssaeseossscsssassesasscsesscsssacsseasssoesasessacsssassceasseeseacateasaseesaees 94 A. MCC New York Staff Failed to Ensure that Epstein Had a Cellmate on August 9 as Instructed by the Psycholosy Department Of JULY 30 scmsusnsesecmmmnemnmnens wanrnraennen arama ereememess 98 B. MCC New York Staff Failed to Conduct Mandatory Rounds and Inmate Counts Resulting in Epstein Being Unobserved for Hours Before His Death... ee eeeeeseesseeceeeeeeseeeceeceeeseesceecseeeetaceeeeeeenees 102 C. MCC New York Staff Allowed Epstein to Place an Unmonitored Telephone Call on August 9 107 D. MCC New York Staff Failed to Conduct and Document Cell Searches and Eliminate Safety Hazards in Epstein’s Cell on August 9 Leaving Epstein with Excessive Linens in His Cell... 108 E. MCC New York Staff Failed to Ensure that the Institution’s Security Camera System was Fully Functional Resulting in Limited Recorded Video Evidence... ee eessesssseeeeeeseeeceeceesseeeceeceeseeeaeeaeeneenees 109 Il. RECOMMENCATIONS .......eeeessssceeeeeeeeseesceeceteseeseeecenssesseeccseesesssssesaesessesseeaesessessseaseaeeeseesaseaceasenseteaceaseneerens 110 Appendix A: The BOP’s Response to the Draft Report ..............ccccssssscccssscceccesscseecesscceecssscceceesscceeeessscceees 115 Appendix B: OIG Analysis of the BOP’s ReSponse.............ccccssssseccesscseccessscceceesscseecesssceeecassceeeesscceeeessseeeees 118 DOJ-OGR- 00023367