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kc;:-; INCIDENT REPORT J.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS 1 institution: MCC New York 2. Inmate's Name. Epstein Jeffery 8. Place of Incident SHU Cell 124 9' Inadelt Self-Mutilation . Part I — Incident Roped 3. Register Number 76318-054 7. Assignment Unassigned 10 4. Date of Incident 7/23/2019 Indent Report Numbe 8. Un ZA 1:27am 10. Prohibited Act Code (s): 228 11. Description of Ineklent (Date: 07/23/2019 Time: 1:27AM Staff became aware of incident): On July 23.2019 at approx. 1:27am While working in the Special Housing Unit Myself and S/0 Silva beard noise coming from the M tier cell 124.Upon arrival UM's Epstein.Je(ferya76318.054 cal mate (IN Tartagllone//78514.054)was at the door stating UM Epsten.Jeflerya76318.054 had attempted to hang himself. I kept a visual while S/0 Silva grabbed the door keys and called or assistance. A rSecuring artag ione 4 and removing him from the coll.i entered then placed WM Epstein on his side and removed a orange homemade rope from his neck.UM was breathing at this time But unresponsive. Addition stall and Ops Lt Anderson arrived WM was then removed from SHU 12. typed NamelM klasulb.J rang Employee: 13. Date And Time 14. incident Report to Above Inmate By (Type Name/Sig ). 15. Datelhoc ent Report Delivered: 07/23/2019 3:30am 16. Time Incident Report Delivered Part II - Committee Action 17. Comments of Inmate to Committee Regarding Above Incident: 18. A. It Is the finding of the committee that you: Committed the Prohibited Act as charged: Did not Commit a Prohibited Act. Committed Prohibited Act Code (s). B. r7 The Committee is referring the Charge(s) to the OHO (or further g,ariaan The Committee advised the Inmate of its finding and of the right to file an appeal within 20 calendar days. 19. Committee Decision is Based on Specific Evidence as Follows: 20. Committee action and/Of recommendation if referred to (OHO (Contingent upon DHO finding inmate committ

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