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: 97/23/2019 Time: 1:27 am Staff became aware of i On July 23,2019 at approx. 1:27am While working in the e q heard noise coming 9. Incident Self -Mutilation himself. I kept a visual while Officer rabbed door securil I/M Tartaglione and removi him from the cell, I entered then placed I/M Epstein on his side and removed an orange homemade rope from his neck. I/M was breathing at this time, B f arrived I/M was then removed from the SHU. 13.Date And Time 7/23/2019 1:30 am 12. Typed Name/Signature of Reporting Employee 14. Incident Report Delivered to Above Inmate By (Type Name/Signature) 15, Date Incident . ncident Report Delivered 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: ee ee U UU EE UE SE SISSIES 20. Committee action and/or recommendation if referred to DHO (Contingent upon DHO finding inmate committed prohibited act) ee SS a 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 ere for staff use only. Begin entrics with the number | and 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 BP pR2ats GR2-G2 4062-01 MAY 94 SDNY_00006510 EFTA_00000595 EFTA00135007