Bureau of Prisons Health Services Clinical Encounter Inmate Name: EPSTEIN, JEFFREY EDWARD Reg i: ; rh Date of Birth: 01/20/1953 Sex: M__ Race: WHITE Facility: one Encounter Date: 07/12/2019 13:10 Provider: MD Unit: Chronic Care - 14 Day Physician Eval encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Chief Complaint: ENDO/LIPID 66 YR OL HYPERT! 800 , MEDS HX OF O MACHINE. Subjective: STATES TH HITE MALE WITH HX OF ‘CERIDEMIA X 5 YEARS ON VASCEPA FOR 1 YEAR. STATES TRIGL WAS ) STATES HE COULD NOT TOLERATE OTHER ANTI-TRIGLYCERIDE EIR GI SIDE EFFECTS. UVE SLEEP APNEA X 5 YEARS FOR WHICH HE USED A CPAP HAD HIS CPAP MACHINE WITH HIM WHEN HE ARRESTED. Y HAS L4 -L5 SEVERE SIS CASUING NUMBNESS AND SHOOTING PAIN IN THE LOWER EXTREMITIES. SURGICAL HX; NONE MENTAL HEALTH Hx: Yes Pain Assessment Date: Pain: 07/12/2019 13:25 Location: Back-Middle Quality of Pain: Shooting Pain Scale: 5 MEDROL DOSE PACK Q Intervention: Trauma Date/Year: Injury: Mechanism: Onset: Duration: Exacerbating Factors: Relieving Factors: Reason Not Done: Comments: Oo, 5+ Years 5+ Years NO EXERCISE MEDROL DOSE PACK Q & Seen for clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology Added to clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology OBJECTIVE: Exam: General 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, Acutelly Ill Nutrition No: Obese Genorated 07/12/2019 14:20 by I mo Bureau of Prisons - NYM Page lof 3 EFTA00110382

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Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: Encounter Date: 07/12/2019 13:10 Provider: i E MO Reg #: 76318-054 Facility: NYM Unit: 205 Exam: Eyes General Yes: PERRLA, Extraocular Movements Intact Pulmonary Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular Rat No: M/R/G Abdomen Auscultation Yes: Normo-Active B is Palpation Yes: Within Normal Limits Musculoskeletal Tibia / Fibula No: Edema Back Yes: Tenderness Neurologic Cranial Nerves (CN) Yes: Within Normal Limits Motor System-General Yes: Normal Exam ASSESSMENT: Constipation, unspecified, K5900 - Current Hyperlipidemia, unspecified, E785 - Current Low back pain, M545 - Current Neuralgia and neuritis, unspecified, M792 - Current Sleep apnea, G4730 - Current PLAN: New Medication Orders: Rx# Medication Order Date Magnesium Hydroxide Susp Indication: Constipation, unspecified MethylPREDNISolone Tab 4 MG ( Dose Pack 21 tab) Indication: Neuralgia and neuritis, unspecified Disposition: Generated 07/12/2019 14:20 by EEE M10 Bureau of Prisons - NYM Rhythm (RRR), Normal S1 and S2 07/12/2019 13:10 07/12/2019 13:10 © Me Prescriber Order 30 CC Orally - Two Times a Day PRN x 2 day(s) AS DIRECTED Orally - daily x 6 day(s) Page 2 of 3 EFTA00110383

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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: 07/12/2019 13:10 Provider: (© Unit! = Z05 Follow-up at Sick Call as Needed Other: WILL CONTINUE NOTES TO ADDRESS THE NFDR AND FOLLOW-UP. Patient Education Topics: Date Initiated Format Handout/Topic Provider Outcome 07/12/2019 Counseling Diagnosis <b aiizes Understanding Copay Required: No Cosign Required: No Telephone/Verbal Order: Completed by S 07/12/2019 14:20 Generated 07/12/2019 14:20 > MD Bureau of Prisons - NYM Page 3 of 3 EFTA00110384

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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: Race: WHITE Facility; NYM Encounter Date: 07/12/2019 13:10 Provider: MD Unit: Z05 Chronic Care - 14 Day Physician Eval encounter performed at Health Services. SUBJECTIVE: COMPLAINT 1 Provider: a! “0 Chief Complaint: ENDO/LIPID Subjective: 66 YR OL ITE MALE WITH HX OF HYPERTI CERIDEMIA X 5 YEARS ON VASCEPA FOR 1 YEAR. STATES TRIGL WAS 800 , | STATES HE COULD NOT TOLERATE OTHER ANTI-TRIGLYCERIDE MEDS EIR GI SIDE EFFECTS. HX OF O UVE SLEEP APNEA X 5 YEARS FOR WHICH HE USED A CPAP MACHINE. HAD HIS CPAP MACHINE WITH HIM WHEN HE ARRESTED. STATES TH Y HAS L4-L5 SEVERE SIS CASUING NUMBNESS AND SHOOTING PAIN IN THE LOWER EXTREMITIES. SURGICAL HX: NONE MENTAL HEALTH Hx: Pain: Yes Pain Assessment Date: 07/12/2019 13:25 Location: Back-Middle Quality of Pain: Shooting Pain Scale: 5 Intervention: MEDROL DOSE PACK Trauma Date/Year: Injury: Mechanism: Onset: 5+ Years Duration: 5+ Years Exacerbating Factors: NO EXERCISE Relieving Factors: MEDROL DOSE PACK Reason Not Done: Comments: Cl Seen for clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology Added to clinic(s): Endocrine/Lipid, Pulmonary/Respiratory, Orthopedic/Rheumatology OBJECTIVE: Exam: General 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 Generated 07/12/2019 14:20 by EE mo Bureau of Prisons - NYM Page t of 3 EFTA00110385

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EPSTEIN, JEFFREY EDWARD 01/20/1953 Sex: Inmate Name: Date of Birth: Encounter Date: 07/12/2019 13:10 : E i Reg #: 76318-054 Facility: NYM Unit: Z05 Exam: Eyes General Yes: PERRLA, Extraocular Movements Intact Pulmonary Auscultation Yes: Clear to Auscultation Cardiovascular Auscultation Yes: Regular Rat No: M/R/G Abdomen Auscultation Yes: Normo-Active B s Palpation Yes: Within Normal Limits Musculoskeletal Tibia / Fibula No: Edema Back Yes: Tenderness Neurologic Cranial Nerves (CN) Yes: Within Normal Limits Motor System-General Yes: Normal Exam ASSESSMENT: Constipation, unspecified, K5900 - Current Hyperlipidemia, unspecified, E785 - Current Low back pain, M545 - Current Neuralgia and neuritis, unspecified, M792 - Current Sleep apnea, G4730 - Current PLAN: New Medication Orders: Rx# Medication Magnesium Hydroxide Susp Indication: Constipation, unspecified MethyIPREDNISolone Tab 4 MG ( Dose Pack 21 tab) Indication: Neuralgia and neuritis, unspecified Disposition: Generated 07/12/2019 14:20 by [EEE a0 Rhythm (RRR), Normal S1 and S2 Ay Bureau of Prisons - NYM Oo, Order Date 07/12/2019 13:10 07/12/2019 13:10 ty al Prescriber Order 30 CC Orally - Two Times a Day PRN x 2 day(s) AS DIRECTED Orally - daily x 6 day(s) Page 2 of 3 EFTA00110386

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Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M__ Race: WHITE Encounter Date: 07/12/2019 13:10 Provider: (0 Follow-up at Sick Call as Needed Other: WILL CONTINUE NOTES TO ADDRESS THE NFDR AND FOLLOW-UP. Patient Education Topics: Date Initiated Format Handout/Topic 07/12/2019 Counseling Diagnosis Copay Required: No Telephone/Verbal Order: Cosign Required: No (2) 07/12/2019 14:20 Generated 07/12/2019 14:20 by IE mo Bureau of Prisons - NYM Reg #: 76318-054 Facility: NYM Unit: Z05 Provider a Outcome Verbalizes Understanding Page 3of 3 EFTA00110387

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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: 07/14/2019 17:36 Facility: NYM Amendment made to this note by EEE MD on 07/14/2019 18:11, Bureau of Prisons - NYM EFTA00110388

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Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: : Facility: © NYM Note Date: 07/12/2019 09:06 Provider: ‘iii MD Unit: 205 Admin Note - Orders encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider: A M0 PATIENT REQUESTED TO HAVE A COLACE RX, INSTEAD OF TEH BISACODYL FOR CONSTIPATION. New Medication Orders: Rx# Medication Order Date Prescriber Order Docusate Sodium Capsule 07/12/2019 09:06 TAKE ONE 100 MG CAP Orally - Two Times a Day x 30 day(s) Indication: Constipation, unspecified Discontinued Medication Orders: Rx# Medication Order Date Prescriber Order 121757-NYM _— Bisacodyl E.C. 5 MG TAB 07/12/2019 09:06 Take one tablet (5 MG) by mouth at bedtime AS NEEDED for 10 days Discontinue Type: When Pharmacy Processes Discontinue Reason: discontinue Indication: Copay Required: No Cosign Required: No Telephone/Verbal Order: No Completed by EE MD on 07/12/2019 09:10 Generated 07/12/2019 09:10 by AE “0 Bureau of Prisons - NYM Page tof 1 EFTA00110389

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Bureau of Prisons Health Services Clinical Encounter - Administrative Note Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: ‘iii Facility: © NYM Note Date: 07/07/2019 00:17 Provider: MD Unit: E06 Cosign Note - Intake Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 14 Provider: iy Mo MED CL:1 NO CCC APPT. Discontinued Laboratory Requests: Details Frequency Due Date Priority Lab Tests-H-Hemogiobin A1C One Time 08/05/2019 00:00 Routine Lab Tests-C-CBC w/diff Lab Tests-L-Lipid Profile Lab Tests-C-Comprehensive Metabolic Profile (CMP) Lab Tests-U-Urinalysis w/Reflex to Microscopic Additional Information: 66 y/o male, elevated BP Labs requested to be reviewed by: 10 New Laboratory Requests: Details Frequency Due Date Priority Chronic Care Clinics-Diabetic-CBC widiff One Time 07/25/2019 00:00 Routine Chronic Care Clinics-Diabetic-Lipid Profile Chronic Care Clinics-Diabetic-Hemoglobin A1C Lab Tests-H-HIV 1/2 Lab Tests-R-RPR Chronic Care Clinics-Diabetic-Comprehensive Metabolic Profile (CMP) New Radiology Request Orders: General Radiology-Chest-2 Views One Time 07/25/2019 Routine Specific reason(s) for request (Complaints and findings): 66 YR OLD MALE WITH NO PMHX , REFERRED FOR ROUITNE CXR. Copay Required: No Cosign Required: No Telephone/Verbal Order: No Completed by EEE M0 on 07/07/2019 00:30 Generated 07/07/2019 00:30 by SEN 110 Bureau of Prisons - NYM Page 1of 1 EFTA00110390

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Bureau of Prisons Health Services History & Physical Inmate Name: EPSTEIN, JEFFREY EDWARD Ra WHITE Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: M ice: Facility: NYM Encounter Date: 07/09/2019 12:35 Provider: [NM me Unit: HO1 Seizures: Denied Diabetes: Denied Cardiovascular: Denied CVA: Denied Hypertension: Denied Respiratory: Denied Sickle Cell Anemia: Denied Carcinoma/Lymphoma: Denied Allergies: Denied Tuberculosis: Hx of Previous Disease: No Blood-tinged Sputum: No Night Sweats: No Weight Loss: No Fever: No Cough: No Comments: Infectious Disease Risk Factors: IV Drug Use: No IV Drug Use Needles: Sexual Partner IV Drug Use: No Sexual Partner IV Drug Use Needles: Female Sexual Partners (Last 5 Yrs): 10+ Male Sexual Partners (Last 5 Yrs): 0 Condom Use: Sometimes Sexual Contact With HIV+ Individual: No Blood Product Transfusion: No Travel Outside US: Yes Tattoos: No Comments: Born in US High school diploma Banker Traveled to Paris x 3 weeks up until arrest No tattoos Generated 07/09/2019 13:03 by [EE up Bureau of Prisons - NYM Page 1 of 13 EFTA00110391

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Inmate Name: EPSTEIN, JEFFREY EDWARD 76318-054 Date of Birth: 01/20/1953 Sex: NYM Encounter Date: 07/09/2019 12:35 Provider: H01 HIV History: When Tested: 2019 Test Result: Negative When Diagnosed AIDS: - Last CD4: Comments: Hepatitis: Denied Other Infectious Diseases: Syphilis: No Syphilis Last Treatment: N/A Genital Warts: No Chlamydia: Yes Gonorrhea: No Herpes: No Chicken Pox: Yes Other: No Comments: Chlamydia in 2015, treated Chicken pox in childhood Abuse History: Denied Physical: No Emotional: No Sexual: No Comments: Denies Generated 07/09/2019 13:03 by EEE mip Bureau of Prisons - NYM Page 2 of 13 EFTA00110392

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Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: : WHITE Facility: NYM Encounter Date: 07/09/2019 12:35 Provider: . MLP Unit: HO1 Mental Health: Level of Consciousness: Alert and Oriented Psychomotor Activity: Normal General Appearance: Normal Behavior: Cooperative Mood: Appropriate to Content Thought Process: Goal Directed Thought Content: Normal Hx of Mental Health Treatment: None Hx of Head Injury: None Current Mental Health Treatment: No Current Mental Health Complaint: No Hx of Loss of Consciousness: No Hx of Hearing Voices: No Past History of Suicide Attempt: No Current Suicide ideation: No Suicide Prevention Initiated:No Comments: Substance Use History: Denied Current Painful Condition: Denied Other Health Issues: Current Medical Conditions: Other Current Treatments: Pregnant: NIA Dental Condition: Denied Generated 07/09/2019 13:03 by EEE mip Bureau of Prisons - NYM Page 3of 13 EFTA00110393

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Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: : WHITE Facility: NYM Encounter Date: 07/09/2019 12:35 Provider: . MLP Unit: HO1 Observations: Draining Skin Lesions: No Signs of Lice: No Signs of Scabies: No Signs of Recent Trauma: No Recent Tattoos: No Needle Marks: No Signs of Rash: No Open Sores: No Wounds: No Body Deformities: No Tremors: No Sweating: No Comments: Generated 07/09/2019 13:03 by ENN. MLP Bureau of Prisons - NYM Page 4 of 13 EFTA00110394

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inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: : WHITE Facility: NYM Encounter Date: 07/09/2019 12:35 Provider: MLP Unit: H01 immunizations: Hepatitis A and B (TwinRx) Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Sip Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Measles/Mumps/Rubella Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST immunization Date: Provider: SE ip Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Smallpox Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST immunization Date: Provider: a. MLP Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments; Tetanus Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Generated 07/09/2019 13:03 by [EES ur Bureau of Prisons - NYM Page S of 13 EFTA00110395

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Inmate Name: EPSTEIN, JEFFREY EDWARD Reg#: 76318-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: wy Encounter Date: 07/09/2019 12:35 Provider: {NN MLP Unit: immunization Date: Provider: J mvp Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Varicella Series Administration: History Unknown, Not Administered Documented Date: 07/09/2019 12:51 EST Immunization Date: Provider: Hill MLP Location: Drug Mfg: Lot Number: Dosage: Route: Exp Dt: Comments: Temperature: Date Time Fahrenheit Celsius Location Provider 07/09/2019 12:49NYM 97.3 36.3 Oral a vie Pulse: Date Time Rate Per Minute — Location Rhythm Provider 07/09/2019 12:49 82 Via Machine Regular I MiP Respirations: Date Time Rate Per Minute Provider 07/09/2019 12:49 NYM 16 SR vie Blood Pressure: Date Time Value — Location Position Cuff Size = Provider 07/09/2019 12:49NYM 117/66 Right Arm Sitting Adult-regular Poll | MLP Sa02: Date Time Value(%) Air Provider 07/09/2019 12:49NYM 97 Room Air Hl MLP Height: Date Time Inches Cm Provider 07/09/2019 12:49 NYM 70.0 177.8 hin MLP Generated 07/09/2019 13:03 by SRS mur Bureau of Prisons - NYM Page 6 of 13 EFTA00110396

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Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 763 18-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Facility: NYM Encounter Date: 07/09/2019 12:35 Provider: [ce Unit: HO1 Date Time Inches Cm = Provider Weight: Date Time Lbs Kg Waist Circum. Provider 07/09/2019 12:49NYM 194.4 88.2 ve Prosthetic Devices/Equipment: Denied Tobacco Usage: Denied General Social History: Foreign Travel: Born in USA: Yes Country of Birth: USA Patient Education Assessments: Date Ed Yrs Occupation Learns BestBy Primary Language Barriers to Education 07/09/2019 12 Banker Speaking/Listening English None Family History - Father: Age at Death: 74 Cause of Death: Diabetes complications Significant llinesses: Diabetes Heart Disease Comments: Family History - Mother: Age at Death: 81 Cause of Death: Kidney Failure Significant llinesses: Heart Disease Comments: Family History - Sibling: Number of Siblings: 1 Significant Ilinesses: Comments: Past Hospitalization: Reason Location When Acute Appendicitis Mount Sinai Hospital 1990 Complications: None Comments: Head: Normal: Yes Comments: Generated 07/09/2019 13.03 by SEE. mu Bureau of Prisons - NYM Page 7 of 13 EFTA00110397

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Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: : WHITE Facility: NYM Encounter Date: 07/09/2019 12:35 Provider: . MLP Unit: H01 Eyes: EOMI: Yes Icterus:No Conjunctival Inflammation: No Pupils PERRLA: Yes Pupil Size Rt: Pupil Size Lt: Pupils Comments: Fundi Vessels Nicking: No Fundi Vessels Discs Flat:Yes Fundi Vessels Discs Sharp Margins: Yes Fundi Vessels Grounds Abnormal: No Eyes Comments: Vision Screen 07/09/2019 12:52 . Blindness: With Corrective Distance Vision: OD: 100 OS: 70 Ou: Near Vision: OD: Os: OU: tshihara Color Test: Tonometry: L: R: Comments: Needs evaluation with optometrist. Ears: Right Ear: Canal patent Left Ear: Canal patent Ears Comments: Nose: Nares Patent: Yes Septum Midline:Yes Septum Intact: Yes Drainage/Discharge:No Polyps: No Nose Comments: Generated 07/09/2019 13:03 by I. mip Bureau of Prisons - NYM Page 8 of 13 EFTA00110398

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Inmate Name: EPSTEIN, JEFFREY EDWARD Reg #: 76318-054 Date of Birth: 01/20/1953 Sex: : WHITE Facility: NYM Encounter Date: 07/09/2019 12:35 Provider: MLP Unit: HO1 Mouth Lesions:No Oral/Buccal Mucosa:Yes Gums Normal: Yes Tonsils Present: Yes Tonsils Normal: Yes Pharynx: Normal Color Teeth Poor Dentition: No Teeth Count:Mostly Present Dentures: No Mouth Comments: Cranial Nerves: Intact II-XII: Yes Cranial Nerves Comments: Neck: Full ROM: Yes Masses/Nodes: No Trachea: Midline Thyroid: Normal Size Comments: Breasts: Normal: Yes Masses:No Tenderness:No Scars: No Dimpling:No Nipple Discharge: No Nipple Retraction: No Instructions for Self Breast Exam Given: No Comments: Generated 07/09/2019 13:03 by J mip Bureau of Prisons - NYM Page 9 of 13 EFTA00110399