rea MEDICAL TREATMENT REFUSAL CDFRM U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS NEE RE NNN 7-24-2019 Date i, JEFFREY EPSTEIN 76318-054 ___, refuse treatment recommended by the Federal ee enn ee ett bt NI es ee Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: ,. EYE DOCTOR EVALUATION. The following treatment(s) was/were recommended: EYE DOCTOR EVALUATION. Renner eRe mT ST Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accépt treatment: INABILITY TO DIAGNOSE CURRENT OPTHALMOLOGIC DISEASES. {understand the possible consequences and/or complications, listed above, and still refuse recommended treatment. | hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and its employees from any and all liability for respecting and following my expressed wishes and directions. 7-24-2019 Patient's Sign: Date ey ee nF 8 Rte Ee pee a NYM-—NEW YORK MCC EFTA00035180

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BP-S358.060 MEDICAL TREATMENT REFUSAL COFRM SEP 05 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS N.S -10-2019 Date 1, JEFFREY EPSTEIN 76318-054 __, refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: 66 YR OLD MALE WITH NO PMHX , REFERRED FOR ROUITNE CXR. The following treatment(s) was/were recommended: CHEST X-RAY Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment: WORSENING THE CONDITION IF THERE IS ANY FINDINGS l understand the possible consequences and/or complications, listed above, and still refuse . recommended treatment. | hereby assume all responsibility for my physical and/or mental! condition, and release the Bureau of Prisons and its employees from any and all liability for respecting and following my expressed wishes and directions. | RNG 7-10-2019 Counseled by Date ones Stonatire Date “I+ lo -(¢% Date NYM-NEW YORK MCC EFTA00035181

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a MEDICAL TREATMENT REFUSAL CDFRM U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS t 7-24-2019 Date 1, JEFFREY EPSTEIN 76318-054__, refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: EYE DOCTOR EVALUATION The following treatment(s) was/were recommended: EYE DOCTOR EVALUATION Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment: INABILITY TO DIAGNOSE CURRENT OPTHALMOLOGIC DISEASES. | understand the possible consequences and/or complications, listed above, and still refuse recommended treatment. | hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and its employees from any and all liability for respecting and following my expressed wishes and directions. 7-24-2019 = é Counseled by Date Patient's Signa o, til ¢ Date NYM--NEW YORK MCC EFTA00035182

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BP-A0618 A&O DENTAL EXAMINATION JUN 16 {Initial Clinical Dental Findings) U S. DEPARTMENT | OF JUSTICE FEDERAL BUREAU | OF PRISONS. F423 4567 8 8 101 1213 4 15 16 O32 3 30 29 2 7 2M 2D 18 7 mM (ROSS, Observer, Lave onto Crowshin obseed (Approval valid 18 months from examination date) Panorex Patient Name: Der egatie Tike, = | Ds Registfjr Number: Institution: _ ignature Block/Stamp: : > nT MCC New York PDF Prescribed by P6400 ~ Replaces BP-A0618 of JUN 10 EFTA00035183

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BP-A0618 . A&O DENTAL EXAMINATION JUN 16 {Initial Clinical Dental Findings) U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS lusion: $293 4567 6 98 011 1213 14 15 16 32 31 30 29 26 27 2625 2423 22 21 20 18: 18 Ineinicied how to obiain wpent and non-urgent dental care: Yes: _——_ Treatment Priorities: Urgent Referred to Sick Call non-urgent Prophylaxis authorized: Yes WA (Approval valid 18 months from examination date) a Institution: _ ef De MCC New York. PDF Prescribed by P6400 Replaces BP-A0618 of JUN 10 EFTA00035184

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ep.ssse 060 MEDICAL TREATMENT REFUSAL CDFRM SEP U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS | 7-24-2019 Date { 1, JEFFREY EPSTEIN 76318-054 __, refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: EYE DOCTOR EVALUATION. The following treatment(s) was/were recommended: EYE DOCTOR EVALUATION. Federal Bureau of Prisons Medical staff members have carefully explained to me that the following 5 possible consequences and/or complications may result because of my refusal to accept treatment: | | INABILITY TO DIAGNOSE CURRENT OPTHALMOLOGIC DISEASES ! understand the possible consequences and/or complications, listed above, and still refuse recommended treatment. | hereby assume all responsibility for my physical and/or mental condition, and H release the Bureau of Prisons and its employees from any and all liability for respecting and following my | expressed wishes and directions. | 7-24-2019 = 4 Date Patient's Signe : Date NYM-—NEW YORK MCC EFTA00035185

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Federal U.S. Medical Center for Federal Prisons Ou of 1900 W. Sunshine Street Prisons Springfield, MO 65807 417-874-1621 *** Sensitive But Unclassified *** Name EPSTEIN, JEFFREY Facility MCC New York Collected 07/09/2019 13:34 Reg # 76318-054 Order Un Received 07/10/2019 10:44 DOB 01/20/1953 Provider MD Reported 07/10/2019 14:46 Sex _ M LIS ID 188191004 HIV 1/2 Negative Negative Screening test - See confirmatory testing for Reactive results FLAG LEGEND L=Low L!=Low Critical H=High H!=High Critical A=Abnormal A! =Abnormal Critical Page 3 of 3 EFTA00035186

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Bureau of Prisons Health Services Cosign/Review Inmate Name; EPSTEIN, JEFFREY EDWARD Reg#: § 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/10/2019 16:58 Provider; Lab Result Receive Facility: NYM Cosigned by EE on 07/14/2019 18:12. Bureau of Prisons - NYM EFTA00035187

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BP.S368,060 MEDICAL TREATMENT REFUSAL COFRM U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS SS 7-24-201 Date 1, JEFFREY EPSTEIN 76318-054 _, refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: EYE DOCTOR EVALUATION. Sn eee een ey a The following treatment(s) was/were recommended: EYE DOCTOR EVALUATION. Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment: INABILITY TO DIAGNOSE CURRENT OPTHALMOLOGIC DISEASES. t t | understand the possible consequences and/or complications, listed above, and still refuse i recommended treatment. | hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and its employees from any and all liability for respecting and following my expressed wishes and directions. 7-24-2019 2 epee a, Patient's Sign; Date CH 5 Date NYM--NEW YORK MCC EFTA00035188

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BP-A0618 A&O DENTAL EXAMINATION JUN 16 (Initial Clinical Dental Findings) ; U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS ey 2 3 4567 6 9 011 1213 ox 31 30 29 28 27 26252423 22 21.20 19° D ignature Block/Stamp: Sos. ef Dental! Officer MCC New York Re oo Institution: Date: POF Prescribed by P6400 Replaces BP-A0616 of JUN 10 EFTA00035189

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— MEDICAL TREATMENT REFUSAL COFRM U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS SS 7-24-2019 Date i, JEFFREY EPSTEIN 76318-054 __, refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: 7 e-2 ERP EEDA RRC ee net EYE DOCTOR EVALUATION. The following treatment(s) was/were recommended: EYE DOCTOR EVALUATION. 2 ee ee SRS me ee TE Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment: INABILITY TO DIAGNOSE CURRENT OPTHALMOLOGIC DISEASES. Se re pee te ! understand the possible consequences and/or complications, listed above, and still refuse recommended treatment. | hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and its employees from any and all liability for respecting and following my expressed wishes and directions. D 7-24-2019 Date Patient's Sig Date Citi 5 Date NYM—NEW YORK MCC EFTA00035190

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BP-S358.060 MEDICAL TREATMENT REFUSAL COFRM SEP 05 . U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS a, 7-10-2019 Date 1, JEFFREY EPSTEIN 76318-054 _, refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s): DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY: 66 YR OLD MALE WITH NO PMHX , REFERRED FOR ROUITNE CXR. The following treatment(s) was/were recommended: CHEST X-RAY Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment: WORSENING THE CONDITION IF THERE IS ANY FINDINGS l understand the possible consequences and/or complications, listed above, and still refuse recommended treatment. | hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and its employees from any and all liability for respecting and following my a xnav 7-10-2019 expressed wishes and directions. Counseled by Date Patinys Sanat nature “2 EFTA00035191

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BP-A0618 A&O DENTAL EXAMINATION JUN 16 (Initial Clinical Dental Findings) ; U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS a] 2.3 4567 6 98 1011 1213 14 15 16 eo 31 30 29 26 27 2625 2423 22 21.20 18° 18 17 A rid ~ aged ROSS Sune FESS 00, Ob Crosbing obsested Instructed how to obtain urgent and non-urgent dental care: Yes: v Non-urgent: Urgent Referred to Sick Call: ° Prophylaxis authorized: Yes / No (Approval valid 18 months from examination date) cin, DeCiey = | Ms Reaist] Be institution: Date: Signature Block/Stamp: IL ZITO MCC NEW YORK T-26-19. ME 0s. McC New York POF Prescribed by P6400 Replaces BP-A0618 of JUN 10 EFTA00035192

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Inmate Name: EPSTEIN, JEFFREY EDWARD Bureau of Prisons Health Services Clinical Encounter Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M_ Race: WHITE Facility: NYM Encounter Date: 08/10/2019 07:25 Provider: RN Unit: Z04 Emergency Code - Resuscitation Event encounter performed at Special Housing Unit. SUBJECTIVE: Emergency Note Provider: | RN Team Members: Provider Role a Team/Code Leader Code Events: Type Value Date CPR Compressions 08/10/2019 06:35 EKG/Monitor Lifepak 08/10/2019 06:39 No shock advised CPR Compressions 08/10/2019 06:40 Oxygen 15L 08/10/2019 06:47 IV Access Peripheral IV 08/10/2019 06:48 18 g Left AC Airway Endotracheal Tube 08/10/2019 07:08 ET Tube 7.5 24CM to L Lip line Placed by Paramedics Medications Epinephrine 1mg IV 08/10/2019 07:10 Epinephrine 3 doses and Sodium bicarb 2 doses administered by paramedics CPR Compressions 08/10/2019 07:11 Medications Sodium Bicarbonate 1 mEa/kg IV 08/10/2019 07:11 IV Fluids Normal Saline 0.9% 1000 mi 08/10/2019 07:12 Medications Epinephrine img IV 08/10/2019 07:13 CPR Compressions 08/10/2019 07:14 Medications Sodium Bicarbonate 1 mEa/kg IV 08/10/2019 07:14 Medications Epinephrine img IV 08/10/2019 07:16 CPR Compressions 08/10/2019 07:17 Comments: Responded to a body alarm at 0635 for medical emergency on 9S, Upon arrival Inmate was received on the floor of his cell unresponsive with CPR in progress by correctional officers, Inmate was Cold, with circumferential Bruising around the neck and posterior mottling, Pupils Fixed and dilated, No Palpable pulses, Call place for EMS, CPR Continued, AED Placed No shock advised, CPR Continued, inmate transported to HSU treatment room with CPR in progress, 18g hep lock to LAC, 02 15 Lt VIA BVM, Pulse Check NO SHOCK advised. EMS and Paramedics arrived 0656, Placed on cardiac monitor asystole Resumed CPR, Inmate was intubated by Medics, 3 Rounds of Epinephrine administered, Pulse Check asystole, Inmate was transported to Local ER with CPR in progress. OBJECTIVE: Exam: General App Generated 08/10/2019 08:10 by SS Rn earance Yes: Unconscious Bureau of Prisons - NYM Page 1 of 2 EFTA00035193

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Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M » WHITE Facility: NYM Encounter Date: 08/10/2019 07:25 Provider: RN Unit: Z04 Exam: ASSESSMENT: Cardiac Arrest PLAN: New Consultation Requests: Consultation/Procedure Target Date Scheduled Target Date Priority Translator Language Emergency Room 08/10/2019 08/10/2019 Emergent No Subtype: AMBULANCE Reason for Request: Cardiac arrest with CPR in progress Copay Required: No Cosign Required: Yes Telephone/Verbal Order: No Completed by RN on 08/10/2019 08:10 Requested to be cosigned by Cosign documentation will be displayed on the following page. Generated 08/10/2019 08:10 by SE RN Bureau of Prisons - NYM Page 2 of 2 EFTA00035194

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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: 07/30/2019 15:58 Provider: PY Unit: 04 Chronic Care - Chronic Care Clinic encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: as Chief Complaint: Other Problem Subjective: PATIENT WAS REFERRED BY THE WARDEN FOR EVALUATION. PATIENT REPORTS HE HAS BEEN WITHOUT HIS MEDS FOR ABOUT 1 WEEK. HE ALSO REPORTS NUMBNESS IN HIS RIGHT ARM FOR A FEW MINUTES 3 DAYS AGO. STATES THE NUMBNESS WENT AWAY ON ITS OWN, BUT WAS VERY CONCERNING. HE DENIES RIGHT SIDED WEAKNESS, DIPLOPIA, FACIAL DROOP, DIFFICULTY SPEAKING OR SWALLOWING. HE REPORTS NOCTURIA OF ABOUT 5 TIMES,. HE DENIES DYSURIA. HE REPORTS H OF KIDNEY STONES, HX OF HTN FOR WHICH HE WAS TAKING TOPROL. HE AHS A HX OF SLEEP APNEA AND STATED HE HAS NOT SLEPT FOR 3 WEEKS ISNCE HE HASB EEN HERE SINCE HE DIE NOT HAVE ACCESS T HI CPAP MACHINE. | INFORME DHIM THAT WE RECEIVED HIS CPAP MACHINE AND IT WILL BE GIVEN TO HIM TONIGHT.. HE REPORT OTHER NON-MEDICAL ISSUES. STATES HE FEELS OTHERWISE FINE. Pain: Not Applicable Seen for clinic(s): Pulmonary/Respiratory, Orthopedic/Rheumatology, Endocrine/Lipid OBJECTIVE: Exam: General Affect Yes: Cooperative Appearance Yes: Appears Well, Alert and Oriented x 3 No: Appears Distressed, Dyspneic, Appears in Pain, Writhing in Pain, Pale, Pallor, Cyanotic, Diaphoretic, Disheveled, Unkempt, Acutely Ill Nutrition No: Appears Obese Pulmonary Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular Rate and Rhythm (RRR), Normal S1 and S2 No; M/R/G Musculoskeletal Tibia / Fibula No: Edema Neurologic Generated 07/30/2019 16:12 by Si Bureau of Prisons - NYM Page 1 of 2 EFTA00035195

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Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M_ Race: WHITE Encounter Date: 07/30/2019 15:58 Provider: Reg#: 76318-054 Facility: NYM Unit: —_Z01 Exam: Cranial Nerves (CN) Yes: Within Normal Limits Motor System-General Yes: Normal Exam Motor System-Strength Yes: Normal Muscular Strength ASSESSMENT: Body mass index (BMI) 27.0-27.9, adult, 26827 - Current Constipation, unspecified, K5900 - Current Essential (primary) hypertension, 110 - Current - BY HX. Hyperlipidemia, unspecified, E785 - Current Low back pain, M545 - Current Neuralgia and neuritis, unspecified, M792 - Current Prediabetes, R7303 - Current Sleep apnea, G4730 - Current PLAN: New Medication Orders: Ret Medication Order Date INsulin REG - Human 07/30/2019 15:58 Indication: Prediabetes Discontinued Medication Orders: Medication Order Date 122148-NYM Insulin Reg (10 ML) 100 UNITS/ML Inj 07/30/2019 15:58 E Discontinue Type: When Pharmacy Processes Discontinue Reason: new order written Indication: Copay Required: No Cosign Required: No Telephone/Verbal Order: No Completed by EN on 07/30/2019 16:12 Generated 07/30/2019 16:12 by [in Bureau of Prisons - NYM Prescriber Order SLIDING SCALE Subcutaneously each morning x 7 day(s) Pill Line Only Prescriber Order Inject regular insulin subcutaneously per sliding scale: twice daily ***pill line*** for 7 days Page 2 of 2 EFTA00035196

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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: 07/30/2019 11:12 Provider: NM unit: 201 Chronic Care - Chronic Care Clinic encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: Chief Complaint: Other Problem Subjective: PATIENT WAS REFERRED BY THE WARDEN FOR EVALUATION. PATIE RTS HE HAS BEEN WITHOUT HIS MEDS FOR ABOUT 1 WEEK. HE ALSO: S NUMBNESS IN HIS RIGHT ARM FOR A FEW MINUTES 3 DAYS AGO. STAT IBNESS WENT AWAY ON ITS OWN, BUT WAS VERY CONCERNING. HE DENI SIDED WEAKNESS, DIPLOPIA, FACIAL DROOP, DIFFICULTY SPEAKING OWING. HE REPORT: 1A OF ABOUT 5 TIMES,. HE DENIES DYSURIA. HE REPORTS H NEY STONES, HX OF HTN FOR WHICH HE WAS TAKING TOPROL. HE AHS A HX OF SLEEP. AND STATED HE HAS NOT SLEPT FOR 3 WEEKS ISNCE HE HASB EEN (CE HE DIE NOT HAVE ACCESS T HI CPAP MACHINE. | INFORME DHIM THAT WE REG@E HIS CPAP MACHINE AND IT WILL BE GIVEN TO HIM TONIGHT.. HE REPORT OTHER NON-MEDI UES. STATES HE FEELS OTHERWISE FIN Pain: Not Applicable Seen for clinic(s): Endocrine/Lipid, Orthopedic/Rheumatology, OBJECTIVE: Pulse: Date Time Rate Per Minute _—_Location Provider 07/30/2019 13:02 94 eaudouin, Robert MD 07/30/2019 09:40 88 Via Machine O- Robert MD 07/30/2019 09:30 87 ‘Via Machine if Robert MD Respirations: Date Time Rate Per Minute Provider 07/30/2019 09:30 NYM 2 iii Blood Pressure: Date Time Value Location Position Cuff Size Provider 07/30/2019 13:02NYM 114/84 Left Arm Standing FP 07/30/2019 09:40NYM 125/60 RightArm —_ Standing Po 07/30/2019 09:30NYM 108/86 Left Arm Sitting Po $Sa02: Date Time Value(%) Air Provider 07/30/2019 09:30 NYM 98 Room Air Po Weight: Date Time Lbs Kg Waist Circum. Provider Generated 07/30/2019 14:05 by Fs Bureau of Prisons - NYM Page 1 of 3 EFTA00035197

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Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M_ Race: WHITE Facility: NYM Encounter Date: 07/30/2019 11:12 Provider: Unit: Z01 Date Time Lbs. Kg Waist Circum, Provider 07/30/2019 09:30 NYM 194.2 88.1 Exam: General Affect Yes: Cooperative Appearance Yes: Appears Well, Alert and Oriented x 3 No: Appears Distressed, Dyspneic, Appears in Pain, Writhing in Pain, Pale, Pallor, Cyanotic, Diaphoretic, Disheveled, Unk cutely Ill Nutrition No: Appears Ob Pulmonary Auscultation Yes: Clear to ee Cardiovascular Auscultation Yes: Regular Rate and Rhythm (RRR 1 and S2 No: M/R/G Musculoskeletal Tibia / Fibula Q No: Edema Neurologic Cranial Nerves (CN) Yes: Within Normal Limits Motor System-General Yes: Normal Exam Motor System-Strength Yes: Normal Muscular Strength ASSESSMENT: Body mass index (BMI) 27.0-27.9, adult, 26827 - Current & Constipation, unspecified, KS900 - Current Essential (primary) hypertension, 110 - Current - BY HX. Hyperlipidemia, unspecified, E785 - Current Low back pain, M545 - Current Neuralgia and neuritis, unspecified, M792 - Current Prediabetes, R7303 - Current Sleep apnea, G4730 - Current PLAN: New Medication Orders: Rxit Medication Order Date Prescriber Order Generated 07/30/2019 14:05 by Bureau of Prisons - NYM Page 2 of 3 EFTA00035198

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Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M_ Race: WHITE Facility: NYM Encounter Date: 07/30/2019 11:12 Provider: Unit: Z01 New Medication Orders: Magnesium Hydroxide Susp conc 800 07/30/2019 11:12 10 CC Orally - Two Times a MG/SML Day PRN x 90 day(s) Indication: Constipation, unspecified INsulin REG - Human 07/30/2019 11:12 Indication: Prediabetes Renew Medication Orders: Rx# Medication 121836-NYM methylPR| Pack) Indication: Goh and neuritis, unspecified New Laboratory Requests: Details Frequency Lab Tests - Short List-General-CBC widiff ne Time Lab Tests-P-PSA, Total Lab Tests-U-Uric Acid Lab Tests - Short List-General-Comprehensiv Metabolic Profile (CMP) Lab Tests-U-Urinalysis w/Reflex to Microscopic New Radiology Request Orders: Details General Radiology-Spine / Cervical- General Specific reason(s) for request (Complaints and findings): 66 YR OLD MALE WITH COMPLAITN OF RIGHT ARM NUI PLEASE PERFORM C SPINE SERIES Order Date ne 4MGTab(21 count 07/30/2019 11:12 Frequency One Time Disposition: Follow-up at Sick Call as Needed Patient Education Topics: Date Initiated Format Handout/Topic 07/30/2019 Counseling Access to Care 07/30/2019 Counseling Plan of Care Copay Required: No Telephone/Verbal Order: No Completed by [EEE on 07/30/2019 14:05 Cosign Required: No Generated 07/30/2019 14:05 by Bureau of Prisons - NYM Due Date 08/29/2019 SLIDING SCALE Subcutaneously - Two Times a Day x 7 day(s) Pill Line Only Prescriber Order Take the tablet by mouth as directed x 6 day(s) Due Date 08/01/2019 00:00 Routine - Routine R 2-3 MINUTES 3 DAYS AGO. Outcome Verbalizes Understanding Verbalizes Understanding Q “4 on Page 3 of 3 EFTA00035199

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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: 07/30/2019 11:12 Provider: Unit: Z01 Chronic Care - Chronic Care Clinic encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Chief Complaint: Other Problem Subjective: PATIENT PATIE! ALSO: STATI HE DENI SPEAKING HE REPORT: HE REPORTS H S REFERRED BY THE WARDEN FOR EVALUATION. RTS HE HAS BEEN WITHOUT HIS MEDS FOR ABOUT 1 WEEK. HE S NUMBNESS IN HIS RIGHT ARM FOR A FEW MINUTES 3 DAYS AGO. (re WENT AWAY ON ITS OWN, BUT WAS VERY CONCERNING. SIDED WEAKNESS, DIPLOPIA, FACIAL DROOP, DIFFICULTY OWING. 1A OF ABOUT 5 TIMES,. HE DENIES DYSURIA. NEY STONES, HX OF HTN FOR WHICH HE WAS TAKING TOPROL. HE AHS A HX OF SLEEP. AND STATED HE HAS NOT SLEPT FOR 3 WEEKS ISNCE HE HASB EEN CE HE DIE NOT HAVE ACCESS T HI CPAP MACHINE. | INFORME DHIM THAT WE REG@E: HIS CPAP MACHINE AND IT WILL BE GIVEN TO HIM TONIGHT.. HE REPORT OTHER NON-MEDI UES. STATES HE FEELS OTHERWISE FIN, Pain: Not Applicable Seen for clinic(s): Endocrine/Lipid, Orthopedic/Rheumatology, OBJECTIVE: Pulse: Date Time Rate Per Minute —_Location 07/30/2019 13:02 94 07/30/2019 09:40 88 Via Machine 07/30/2019 09:30 87 Via Machine Respirations: Date Time Rate Per Minute Provider fej 07/30/2019 09:30 NYM 2 iii Blood Pressure: Date Time Value Location Position Cuff Size Provider 07/30/2019 13:02NYM 114/84 Left Arm Standing 07/30/2019 09:40NYM 125/60 RightArm _ Standing fF 07/30/2019 09:30NYM 108/86 —_Left Arm Sitting PF Sa02: Date Time Value(%) Air Provider 07/30/2019 09:30 NYM 98 Room Air Weight: Date Time Lbs Kg Waist Circum. Provider Generated 07/30/2019 14:05 by iy Bureau of Prisons - NYM EFTA00035200

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Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: 01/20/1953 Sex: M_ Race: WHITE Facility: NYM Encounter Date: 07/30/2019 11:12 Provider: Unit: Z01 07/30/2019 09:30 NYM 194.2 88.1 Exam: General Affect Yes: Cooperative Appearance Yes: Appears Well, Alert and Oriented x 3 No: Appears Distressed, Dyspneic, Appears in Pain, Writhing in Pain, Pale, Pallor, Cyanotic, Diaphoretic, Disheveled, Unk: cutely Ill Nutrition No: Appears Obi Pulmonary e Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular Rate and Rhythm (RRR 1 and S2 No: M/R/G Musculoskeletal Tibia / Fibula E No: Edema Neurologic Cranial Nerves (CN) Yes: Within Normal Limits Motor System-General Yes: Normal Exam Motor System-Strength Yes: Normal Muscular Strength ASSESSMENT: Body mass index (BMI) 27.0-27.9, adult, 26827 - Current & Constipation, unspecified, K5900 - Current Essential (primary) hypertension, 110 - Current - BY HX. Hyperlipidemia, unspecified, E785 - Current Low back pain, M545 - Current Neuralgia and neuritis, unspecified, M792 - Current Prediabetes, R7303 - Current Sleep apnea, G4730 - Current PLAN: New Medication Orders: Ret Medication Order Date Prescriber Order Generated 07/30/2019 14:05 by Bureau of Prisons - NYM Page 2 of 3 ~ EFTA00035201

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Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M__ Race: WHITE Facility; NYM Encounter Date: 07/30/2019 11:12 Provider: Unit: Z01 New Medication Orders: Rx# Medication Order Date Prescriber Order Magnesium Hydroxide Susp conc 800 07/30/2019 11:12 10 CC Orally - Two Times a MG/S5ML Day PRN x 90 day(s) Indication: Constipation, unspecified INsulin REG - Human 07/30/2019 11:12 Indication: Prediabetes Renew Medication Orders: Rx#t Medication Order Date 121836-NYM methyiPR ne 4MGTab(21 count 07/30/2019 11:12 Pack) Indication: Goh: and neuritis, unspecified New Laboratory Requests: SLIDING SCALE Subcutaneously - Two Times a Day x 7 day(s) Pill Line Only Prescriber Order Take the tablet by mouth as directed x 6 day(s) Details Frequency Due Date Priority Lab Tests - Short List-General-CBC widiff e Time 08/01/2019 00:00 Routine Lab Tests-P-PSA, Total Lab Tests-U-Uric Acid Lab Tests - Short List-General-Comprehensiv Metabolic Profile (CMP) Lab Tests-U-Urinalysis w/Reflex to Microscopic New Radiology Request Orders: Details Frequency le Due Date Priority General Radiology-Spine / Cervical- One Time 08/29/2019 Routine General Specific reason(s) for request (Complaints and findings): 66 YR OLD MALE WITH COMPLAITN OF RIGHT ARM NUI PLEASE PERFORM C SPINE SERIES Disposition: Follow-up at Sick Call as Needed Patient Education Topics: Date Initiated Format Handout/Topic 07/30/2019 Counseling Access to Care 07/30/2019 Counseling Plan of Care Copay Required: No Telephone/Verbal Order: No Completed by NY on 07/30/2019 14:05 Cosign Required: No Generated 07/30/2019 14:05 by Bureau of Prisons - NYM R 2-3 MINUTES 3 DAYS AGO. Q Outcome Verbalizes Understanding Verbalizes Understanding Page 3of 3 EFTA00035202

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Bureau of Prisons Health Services See Amendment inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/30/2019 15:58 Facility: © NYM Amendment made to this note by AE on 07/30/2019 16:12. Bureau of Prisons - NYM EFTA00035203