Form 583 Report of Incident Type Of Incident K Assault On Inmate K Assault On Staff K Assault, Attempted On Inmate K Assault, Attempted On Staff K Disruptive Behavior K Escape From Non-secure Facility K Escape From Secure Facility K Escape, Attempted From Non-secure Facility K Escape, Attempted From Secure Facility K Fight K Inmate Death K Institution Disturbance K Introduction Of Contraband K Lethal Weapons Discharge K Self Mutilation K Setting A Fire K Sexual Act, Non-consensual On Inmate K Sexual Assault On Staff K Sexual Contact, Abusive On Inmate K Sexual Harassment, Repetitive K Staff Homicide K Strike, Food K Strike, Work K Suicide Attempt K Use Of Force K Use Of Force/Applications Of Restraints K Use of Restraints, Pregnant/Postpartum Method: Hanging/Asphyxiation Incident #: NYM-19- Submitted By: 0082 Date/Time Of Incident: 8/10/2019 6:33 AM Section 1: General Information Staff Aware Date: 8/10/2019 6:33 AM FBI Notified: Yes USMS Notified: Yes Indicate Where Incident Occurred: Main Facility Location Level 1: SHU Level 2: Housing Unit, Special (SHU) Level 3: 9 SOUTH SHU Institution Locked Down: Yes Modified Operations: No Cause Of Incident Known? No Cause Of Incident K Alcohol K Commissary K Debts K Disrespect Issue K Drugs K Ethnic Conflict K Food Issue K Geographical Conflict K Interfering with Staff duties K Property Issue K Racial Conflict K Recreation Equipment K Religious Issue K Security Threat Group Conflict K Sexual Pressure K Sporting Events K Telephone K Theft K Visiting K Work Issue Section 2: Inmates Involved UNCLASSIFIED/LIMITED OFFICIAL USE ONLY/LAW ENFORCEMENT SENSITIVE This document is marked Unclassified/Limited Official Use Only/Law Enforcement Sensitive and may be disseminated, with proper attribution, to active Law Enforcement, DOD. or U.S. Intelligence Agencies. This document, or any segmenUattachment thereof, may not be released without the approval of the Bureau o