BP-A0288 INCIDENT REPORT corrm JUN 10 U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU : PRISONS 1. Institution: MCC New York 2. Inmate’s Name Epstein , Jeffery 6. Place of Incident SHU M-Tier Cell 124 7. Assignment Unassigned ll. Description Of Incident (Date: 07/23/2019 Time: On July 23,2019 at rox. 1:27am While working in the heard noise comi from the M tier Cell 124. Tartaglione #78514-054) was at the door stati himself. I kept a visual while Officer rrabbed door s and called for assistance.After securing I/M Tartaglione and removing him from the cell, I entered then placed I/M tein on his side and removed an orange homemade rope from his neck. I/M was breathing at this time, B unresponsive .Addition staff and Ops Lt f arrived I/M was then removed from the SHU. 13.Date And Time 7/23/2019 1:30 am 9. Incident Self -Mutilation 12. Typed Name/Signature of Reporting Employee LE | 14. Incident Report Delivered to Above Inmate By (Type Name/Signature) ncident Delivered 15, Date Incident Report Delivered Part II - Committee Action 17. Comments of Inmate to Committee Regarding Above Incident The Committee is referri Charge(s) to the DHO for Hearing. c. ____ The Committee advised the) inmate of its finding and of the right to file an appeal within 20 calendar days. 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) 19. Committee Decision is Based on Specific Evidence as Follows: 20. Committee action and/or recommendation if referred to DHO (Contingent upon DHO finding inmate committed prohibited act) a SS SE EEE SEE 21. Date And Time Of Action (The UDC Chairman's signature certifies who sat on the UDC and that the completed report accurately reflects the UDC proceedings.) Chairman (Typed Name/Signature) Member (Typed Name) Member (Typed Namie) INSTRUCTIONS: Alll items outside heavy rule are for staff ese only. Begin entries with the number | end work up. Entries not completed will be voided DISTRIBUTE; ORIGINAL-Cenwal File record; COPY-t- DHO; COPY-2- Inmate After UDC Action; COPY -3- inmate withia 24 hours of Part I Pi PDF Prescribed by P5270 Replaces B&piakts G2-G248053-0f MAY 94 EFTA00119513