External Consultant Review Date of Review Inmate Name/Number DOD - AGE COD FACILITY/RGN Consultant's Sig Medications: Docusate Sodium 100 MG Cap, Take one capsule (100 MG) by mouth twice daily for 30 days Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML, shake well take 10ml by mouth twice daily AS NEEDED methylPREDNISolone 4 MG Tab ( 21 count Pack), Take the tablet by mouth as directed Omega 3 (Vascepa) 1 GM Capsule, Take two capsules (2 GM) twice daily by mouth with food Insulin Reg (10 ML) 100 UNITS/ML lnj, Inject regular insulin subcutaneously per sliding scale: each morning 9/19/2019 Epstein, Jeffrey #76318-054 8/10/2019 66 Hanging/Suicide MCC New York/NER Consultant Comments: Although there were no medical issues that contributed to this patient's death. The following is offered to strengthen and improve our medical processes: 1. Review Tracking system for diagnostic and screening tests when ordered. An FORT and ECG were ordered for this patient on 7/6/19, date of admission to the institution. However, there is no documentation of results and no follow-up noted addressing lack thereof even though this patient was seen on 7/9/19 (History and Physical) and 7/14/19 (Chronic Care clinic). 2. Review roles and responsibilities of staff responsible for inspecting, testing and maintaining your AED at all institutions. This is considered life support equipment requiring implementation of a process that assures that the AED is available and accessible on the event of a life threatening emergency. The suicide reconstruction review report noted that documentation of AED inspections in the institution was often incomplete. 3. Page 9 of the Suicide Reconstruction Report inaccurately reported that the patient's History and Physical was performed outside the required BOP policy. The BOP policy requires this to be done within 14 days of admission. This patient's History and Physical was conducted on 7/9/19. He entered the institution on 7/6/19.