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Page 3317 Form 583 Report of Incident Incident #: NYM-19- Submitted By: N' Diaye, L. Date/Time Of Incident: 8/10/2019 6:33 AM HEN) Person Type: Staff Medical Attention Required: No Death: No Injury Category: No Injury Staff Injury by inmate: No Sexual Assault: No err 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 August 10, 2019, at approximately 6:33 a.m., while serving the breakfast meal inmate Epstein, Jeffrey, Reg. No. 76318-054 was found unresponsive in his cell. Staff called for assistance and began life saving measures, He wa: escorted to Health Services at approximately 6:39 a.m., and EMS arrived at 6:43 a.m. He was transported to the Kgcal hospital at approximately 7:10 a.m. Inmate Epstein was pronounced deceased at 7:36 am. Section 7: Attachments 8/10/2019 8/10/2019 Unit Roster.pdf 8/10/2019 Staff Roster.pdf NY¥M 8/10/2019 Medical Assessment.pdf NYM 8/10/2019 Staff Memorandum. pdf NYM Approved By: SUBMITTED N‘ Diaye, L. UNCLASSIFIED/LIMITED OFFICIAL USE ONLY/LAW ENFORCEMENT SENSITIVE This decument is marked Unclassified/Limited Official Use Only/Law Enforcement Sensitive and may be disseminated, with proper altribution, ta active Law Enforcemant, OOD, or U.S. Intelligence Agencias. This document, or any segment/attachment thergof, may eral nol be released without the approval of the Bureau of Prisons to any media sources, any non-law enforcement entity, he ge public or those without a “need to know.” {t contains information that may ba exempt from public relaase under the provisions of the Privacy Act (5 U.S.C. 552). 3 of 3 DOJ-OGR-00026906