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Page 514 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: 07/23/2019 06:20 Provider: [OX: ee) Unit: HO1 Injury Assessment - Non-work related encounter performed at Health Services. SUBJECTIVE: INJURY 1 Provider: ("| MLP Date of Injury: 07/23/2019 01:27 Date Reported for Treatment: 07/23/2019 08:25 Work Related: No Work Assignment: UNASSG Pain Location: Pain Scale: 0 Pain Qualities: Where Did Injury Happen (Be specific as to location): Special Housing Unit Z05-Cell 124 L Cause of Injury (Inmate's Statement of how injury occurred): MT (7A Symptoms (as reported by inmate): None OBJECTIVE: Temperature: Date Time Fahrenheit Celsius Location Provider 07/23/2019 06:30 NYM 97.5 36.4 Oral MLP Pulse: Date Time Rate Per Minute Location Rhythm Provider 07/23/2019 06:30 92 Via Machine Regular MLP Respirations: Date Time Rate Per Minute Provider 07/23/2019 06:30 NYM 1 MEP Blood Pressure: Date Time Value Location Position Cuff Size Provider 07/23/2019 06:30 NYM 140/85 Right Arm Sitting Adult-regulany?’) ore SaQ2: Date Time Value(%) Air 07/23/2019 06:30 NYM 96 Room Air Exam: General Affect Yes: Cooperative Appearance Yes: Appears Well, Alert and Oriented x 3 No: Appears Distressed, Lethargic, Dyspneic, Appears in Pain, Pallor, Cyanotic, Diaphoretic, Disheveled, biG}; (br MC} Generated 07/23/2019 09:05 by LP Bureau of Prisons - NYM Page 1 of 2 DOJ-OGR- 00024971