UNITED STATES GOVERNMENT MEMORANDUM Metropolitan Correctional Center, New York, New York DATE: August 10, 2019 TO: Po FROM: HE Ciiica Nurse SUBJECT: Medical Emergency Unit (CA) On Saturday, Aug 10, 2019, at approximately 0633 a.m., I responded to a medical emergency 9S, upon arrival Inmate (EPSTEIN, J. Reg #: 76318-054) 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 were felt, At this time 0635 a call placed for EMS, CPR Continued, an AED was Placed with No shock advised, CPR was continued. Inmate was transported to HSU treatment room with CPR in progress, where a 18g hep lock to L AC was placed and, 02 15 Lt ViA BVM. Pulse Check NO SHOCK advised. EMS and Paramedics arrived 0656, Placed on cardiac Monitor shows asystole Resumed CPR, Inmate was intubated by Medics, 3 Rounds of Epinephrine administered, and Pulse Check asystole, Inmate was transported to Local ER with CPR in progress at approximately 0710. EFTA00075366

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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: 08/10/2019 07:25 Provider: mummy Unit! 204 Exam: ASSESSMENT: Cardiac Arrest PLAN: New Consultation Requests: Consultation/Procedure Target Date Scheduled Target Date Priority Emergency Room 08/10/2019 08/10/2019 Emergent Subtype: AMBULANCE Reason for Request: Cardiac arrest with CPR in progress Copay Required: No Cosign Required: Yes Telephone/Verbal Order: No Requested to be cosigned by MD. Cosign documentation will be displayed on the following page. Generated 08/10/2019 08:10 by Columbo, Joseph RN Bureau of Prisons -NYM Translator | Language No Page 2 of 2 EFTA00075367

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Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 08/10/2019 07:25 Provider: M_ Race: WHITE Reg #: 76318-054 Facility: NYM Unit: Z04 Emergency Code - Resuscitation Event encounter performed at Special Housing Unit. SUBJECTIVE: a Team Members: i. res 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 1mg 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 1mg IV 08/10/2019 07:16 CPR Compressions 08/10/2019 07:17 Comments: cell unresponsive with CPR in progress by correctional officers, Inmate was Cold, with circumferential Brui neck and posterior mottling, Pupils Fixed and dilated, No Palpable pulses, Call place for EMS, CPR C Placed No shock advised, CPR Continued, inmate transported to HSU treatment room with CPR in to LAC, 02 15 Lt VIA BVM, Pulse Check NO SHOCK advised. EMS and Paramedics arrived 0656, Placed monitor asystole Resumed CPR, Inmate was intubated by Medics, 3 Rounds of Epinephrine administered, ulse Check asystole, Inmate was transported to Local ER with CPR in progress. OBJECTIVE: Exam: General Appearance Yes: Unconscious Generated 08/10/2019 08:10 by Bureau of Prisons - NYM Page 1 of 2 EFTA00075368