Text extracted via OCR from the original document. May contain errors from the scanning process.
Bureau of Prisons
Health Services
Vision Screens
Reg #: 76318-054
Inmate Name: EPSTEIN, JEFFREY EDWARD
Vision Screen on 07/09/2019 12:52
Blindness:
Distance Vision: OD: 20/100
OS: 20/70
OU:
Near Vision:
OD:
OS:
OU:
With Corrective
Distance Vision: OD:
OS:
OU:
Near Vision:
OD:
OS:
OU:
Present Glasses - Distance
Refraction - Distance
Sphere
Cylinder
Axis
Add
Sphere
Cylinder
Axis
Add
R:
R:
L:
L:
Color Test:
Tonometry:
R:
L:
Comments: Needs evaluation with optometrist.
Orig Entered: 07/09/2019 12:54 EST
MLP
Generated 08110/2019 11:02 by
Bureau of Prisons - NVM
Page 1 of 1
CONFIDENTIAL
SDNY_00009458
EFTA00033843
Bureau of Prisons
Health Services
Immunizations
Begin Date: 07/07/2019
End Date:
08/10/2019
Reg #:
76318-054
Inmate Name: EPSTEIN, JEFFREY EDWARD
immunization
immunization Date
Administered
JLocation
Dosaae Drug Mfg
Lai
Axp Date
Hepatitis A and B (TwinRx)
History Unknown
Orig Entered: 07/09/2019 12:51 EST MM.
MLP
Measles/Mumps/Rubeila Series
History Unknown
Orig Entered: 07/09/2019 12:51 EST
. MLP
Smallpox Series
History Unknown
Orig Entered: 07/09/2019 12:51 EST
MLP
Tetanus
History Unknown
Orig Entered: 07/09/2019 12:51 EST
MLP
Varicella Series
History Unknown
Orig Entered: 07/09/2019 12:51 EST
MLP
Total: 5
Generated 09/10/201911:02 by
RN/1OPADC
Bureau of Prisons NYM
Page loll
CONFIDENTIAL
SDNY_00009459
EFTA00033844
Bureau of Prisons
Health Services
Medical Duty Status
Reg #: 76318-054
Inmate Name: EPSTEIN. JEFFREY EDWARD
Housing Status
confined to the living quarters except
meals
pill line
_treatments
Exp. Date:
on complete bed rest:
_bathroom privileges only
Exp. Date:
X cell:
cell on first floor _single cell X lower bunk
airborne infection isolation
Exp. Date:
10/09/2019
other:
Exp. Date:
Physical Limitation/Restriction
all sports
Exp. Date:
weightlifting:
_upper body
lower body
Exp. Date:
cardiovascular exercise:
running _jogging
walking
softball
Exp. Date:
_football _basketball _handball
stationary equipment
other:
Exp. Date:
May have the following equipment in his / her possession:
Equipment
Start Date
End Date
Return Dale
C-Pap
07/30/2019
SERIAL ti: P1131281381ED.
Work Restriction / Limitation:
Cleared for Food Service: Yes
X No Restrictions
Comments: N/A
07/30/2019
Health Services Staff
Date
Inmate Name:
Reg 4:
76318.054
Quarters:
Z04
ALL EXPIRATION DATES ARE AT 24:00
Generated 08/10/2019 11 02 by
Bureau of Prisons • NYM
Page 1 of
CONFIDENTIAL
SDNY 00009460
EFTA00033845
Bureau of Prisons
Health Services
Medical Duty Status
Reg #: 76318-054
Inmate Name: EPSTEIN, JEFFREY EDWARD
Housing Status
confined to the living quarters except _meals
_pill line
_treatments
Exp. Date:
_
___
_
on complete bed rest:
bathroom privileges only
Exp. Date:
X cell:
cell on first floor _single cell X lower bunk
airborne infection isolation
Exp. Date:
10/09/2019
other:
Exp. Date:
Physical Limitation/Restriction
all sports
Exp. Date:
weightlifting:
upper body
lower body
Exp. Date:
cardiovascular exercise:
running _jogging
walking
softball
Exp. Date:
football
basketball
handball
stationary equipment
other:
May have the following equipment in his / her possession:
Work Restriction / Limitation:
Cleared for Food Service: Yes
X No Restrictions
Comments: N/A
Exp. Date:
MLP
07/09/2019
Health Services Staff
Date
Inmate Name:
Reg #:
76318-054
Quarters:
Z04
ALL EXPIRATION DATES ARE AT 24:00
Generated 08/10/2019 11:02 by
bureau of Prisons - NYM
Page 1 of 1
CONFIDENTIAL
SONY 00009461
EFTA00033846
Bureau of Prisons
Health Services
Medication Summary
Historical
Complex: NYM--NEW YORK MCC
Inmate:
Begin Date: 07/07/2019
End Date: 08/10/2019
Reg #:
76318-054
Quarter:
Z04-206LAD
Medications listed reflect prescribed medications from the begin date to end date on this report.
Allergies:
Denied
Active Prescriptions
Bisacodyl E.C. 5 MG TAB
Take one tablet (5 MG) by mouth at bedtime AS NEEDED for 10 days
Rx#: 121757-NYM
Doctor:
MLP
Start: 07/09/19
Exp: 07/19/19
D/C: 07/12/19
Pharmacy Dispensings: 10 TAB in 32 days
Docusate Sodium 100 MG Cap
Take one capsule (100 MG) by mouth twice daily for 30 days
Rx#: 121823-NYM
Doctor:
Start: 07/12/19
Exp: 08/11/19
Pharmacy Dispensings: 60 CAP in 29 days
Docusate Sodium 100 MG Cap
Take one capsule (100 MG) twice daily by mouth with plenty of water
Rx#: 122084-NYM
Doctor:
Start: 07/26/19
Exp: 01/22/20
Pharmacy DIspensIngs: 30 CAP in 15 days
Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML
shake well take 2 tablespoonful twice daily by mouth
Rx#: 121835-NYM
Doctor:
Start: 07/12/19
Exp: 07/14/19
Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML
shake well take 10mi by mouth twice daily AS NEEDED
Rx#: 122150-NYM
Doctor:
Start: 07/30/19
Exp: 10/28/19
methylPREDNISolone 4 MG Tab ( 21 count Pack)
Take the tablet by mouth as directed
Rx#: 121836-NYM
Doctor:
Start: 07/12/19
Exp: 07/18/19
methylPREDNISolone 4 MG Tab ( 21 count Pack)
Take the tablet by mouth as directed
Rx#: 122149-NYM
Doctor:
Start: 07/30/19
Exp: 08/05/19
Generated 08/10/2019 11:02 by
Pharmacy Dispensings: 473 ML in 29 days
Pharmacy Dispensings: 473 ML in 11 days
Pharmacy Dispensings: 21 tab in 29 days
Pharmacy Dispensings: 21 tab in 11 days
Bureau of Prisons - NYM
Page 1 of 2
CONFIDENTIAL
SDNY_00009462
EFTA00033847
Complex: NYM—NEW YORK MCC
Inmate:
Begin Date: 07/07/2019
End Date: 08/10/2019
Reg #:
76318-054
Quarter:
204-206LAD
Active Prescriptions
Omega 3 (Vascepa) 1 GM Capsule
Take two capsules (2 GM) twice daily by mouth with food
Rx#: 121885-NYM
Doctor:
Start: 07/17/19
Exp: 01/13/20
Pharmacy Dispensings: 180 Cap in 24 days
Insulin Reg (10 ML) 100 UNITS/ML Inj
Inject regular insulin subcutaneously per sliding scale: twice daily '"pill linen' for 7 days "'pill linen'
Rx#: 122148-NYM
Doctor:
Start: 07/30/19
Exp: 08/06/19
D/C: 07/31/19
Pharmacy Dispensings: 0 ML in 11 days
Insulin Reg (10 ML) 100 UNITS/ML lnj
Inject regular insulin subcutaneously per sliding scale: each morning for 7 days "'pill linen' "'pill linen'
Rx#: 122160-NYM
Doctor:
Start: 07/31/19
Exp: 08/07/19
Pharmacy Dispensings: 0 ML in 10 days
Generated 08/10/2019 11:02 by
Bureau of Prisons - NYM
Page 2 of 2
CONFIDENTIAL
SDNY_00009463
EFTA00033848
Bureau of Prisons
Health Services
Dental Health History Screen
Inmate Name:
Reg #:
76318-054
Date of Birth:
01/20/1953
Sex:
M
Race.
WHITE
Facility: NYM
Encounter Date: 07/26/2019 07:54
Provider:
DDS
Unit:
H01
ASSESSMENTS:
Health Problems as of Dental Health History Encounter date: 07/26/2019 07:54
Health Problems
hen
Status
Hyperlipidemia, unspecified
Current
Sleep apnea
Current
Constipation, unspecified
Current
Low back pain
Current
Neuralgia and neuritis, unspecified
Current
No Diagnosis
Current
Injury, unspecified
Current
R/O self inflicted injuries.
Medical History as of Dental Health History Encounter date
Medical History:
Allergies:
Denied
Seizures:
Denied
Diabetes:
Denied
Cardiovascular:
Denied
CVA:
Denied
Hypertension:
Denied
Respiratory:
Denied
Sickle Cell Anemia:
Denied
Carcinoma/Lymphoma:
Denied
HIV History:
When Tested:
2019
Test Result:
Negative
When Diagnosed AIDS:
Last CD4:
Comments:
Hepatitis:
Denied
Generated 07/26/2019 07:59 by
07/26/2019 07:54
DOS
Bureau of Prisons - NYM
Page 1 of 3
CONFIDENTIAL
SDNY_00009464
EFTA00033849
Inmate Name:
Reg #:
76318-054
Date of Birth:
01/20/1953
Sex:
M Race:
WHITE
Facility: NYM
Encounter Date: 07/26/2019 07:54
Provider:
DDS
Unit:
H01
Other Infectious Diseases:
Syphilis:
No
Syphilis Last Treatment:
N/A
Genital Wads:
No
Chlamydia:
Yes
Gonorrhea:
No
Herpes:
No
Chicken Pox:
Yes
Other:
No
Comments: Chlamydia in 2015, treated
Chicken pox in childhood
Other Health Issues:
Other Medical Conditions And Treatment: sleep apnea
Current Medical Conditions:
Other Current Treatments:
Pregnant: N/A
Dental Observations as of Dental Health History Encounter date: 07/26/2019 07:54
History:
Alcohol:
No
Methamphetamine:
No
Tobacco products:
No
Other drugs:
No
Sensitive teeth:
No
Bleeding gums:
Yes
Food impaction:
Yes
Pain around ear:
No
Toothache:
No
Wear partial dentures:
No
Unusual sounds while eating:
No
Snoring:
Yes
Blisters on lips or mouth:
No
Clenching or grinding:
Yes
Swelling or lumps in mouth/throat:
No
Burning tongue:
No
Bad breath:
No
Decayed teeth:
No
Loose teeth:
No
Wear dentures:
No
None:
No
Comments:
Generated 0712612019 07.59 by
DOS
Bureau of Prisons - NYM
Page 2 of 3
CONFIDENTIAL
SDNY_00009465
EFTA00033850
Inmate Name:
Reg #:
76318-054
Date of Birth:
01/20/1953
Sex:
M
Race:
WHITE
Facility: NYM
Encounter Date: 07/26/2019 07:54
Provider:
DDS
Unit:
H01
Cardiac Condition Requiring Prophylaxis: No
Prosthetic joint(s):
No
Radiation history of head or neck:
No
Excessive bleeding:
No
Bisphosphonates:
No
Comments:
Medications as of Dental Health History Encounter date:
07/26/2019 07:54
Medications:
Docusate Sodium 100 MG Cap Exp: 08/11/2019 SIG: Take one capsule (100 MG) by mouth twice daily for 30 days
Omega 3 (Vascepa) 1 GM Capsule Exp: 01/13/2020 SIG: Take two capsules (2 GM) twice daily by mouth with food
OTCs: Listing of all known OTCs this inmate is currently taking.
Instructed inmate how to obtain medical, dental, and mental health care.
Copay Required:No
Cosign Required: No
TelephoneNerbal Order: No
Completed by
DDS on 07/26/2019 07:59
Generated 07/26/2019 07:59 by
DOS
Bureau of Prisons - NYM
Page 3 or 3
CONFIDENTIAL
SDNY_00009466
EFTA00033851
Bureau of Prisons
Health Services
Dental A&O Exam
Inmate Name:
Date of Birth:
01/20/1953
Sex: M
Race: WHITE
Encounter Date: 07/26/2019 07:47
Provider:
Reg #:
76318-054
Facility:
NYM
DDS
Unit:
H01
Reviewed Health Status:
Yes
Occlusion:
Class I
Oral Hygiene: Fair
CPITN:
3
2
3
3
1
2
1
3
Hard and soft tissue examination performed and documented on BP618 form: Yes
Head & Neck/Soft Tissue within normal limits?
No
Comments:
moderate to advanced upper posterior gingival recession
Decayed:
Missing:
Filled:
0
1
14
Comments:
Lower anterior crowding
Approved for hygiene appointment and radiographs:
Yes
Instructed inmate how to obtain routine and emergency dental care. Oral hygiene Instructions given: Yes
Dental A&O Screening Exam findings entered on EPSTEIN. JEFFREY EDWARD by
DDS on
07/26/2019 07:47.
Generated 07/26/2019 08:00 by
DOS
Bureau of Prisons - NYM
Page 1 of 1
CONFIDENTIAL
SDNY_00009467
EFTA00033852
Bureau of Prisons
Health Services
Dental Soap/Admin Encounter
Inmate Name:
Reg #:
76318-054
Date of Birth:
01/20/1953
Sex:
M
Race: WHITE
Facility:
NYM
Encounter Date: 07/18/2019 13:48
Provider:
Dental Asst
Unit:
205
Screening encounter at Dental Clinic.
Reason Not Done: Unavailable
Comments: Patient has had several call outs for his Dental A & O screening but has not been escorted to the dental clinic.
Cosign Required: No
Completed by
Dental Asst on 07/19/2019 13:49.
Consumed 07/19/2019 13:49 by
Denial
Bureau of Prisons • NYM
Page 1 of 1
CONFIDENTIAL
SDNY_00009468
EFTA00033853
Federal
Bureau of
Prisons
U.S. Medical Center for Federal Prisons
1900 W. Sunshine Street
Springfield, MO 65807
417-874-1621
"' Sensitive But Unclassified 1"
Name EPSTEIN, JEFFREY
Reg # 76318-054
DOB 01/20/1953
Sex
M
Facility
MCC New York
Order Unit E06-547U
Provider
Collected 07/09/2019 13:34
Received 07/10/2019 10:44
MD
Reported 07/10/2019 14:46
LIS ID
188191004
CHEMISTRY
Sodium
Potassium
Chloride
CO2
BUN
Creatinine
eGFR (IDMS)
137
4.7
99
27
17
1.05
>60
137-148
3.5-5.0
99-114
22-30
7-22
0.66-1.25
mmol/L
mmoUL
mmol/L
mmoUL
mg/dL
mg/dL
GFR units measured as mUmin/1.73 mA2. If African American multiply by 1.210.
A calculated GFR <60 suggests chronic kidney disease if found over a 3 month period.
Calcium
9.8
8.5-10.9
mg/dL
Glucose
102
70-110
mg/dL
AST
H
57
11-55
U/L
ALT
62
11-66
U/L
Alkaline Phosphatase
64
41-133
U/L
Bilirubin, Total
1.1
0.2-1.3
mg/dL
Total Protein
7.3
6.0-8.2
g/dL
Albumin
4.4
3.6-5.1
g/dL
Globulin
2.9
2.0-3.7
g/dL
Alb/Glob Ratio
1.50
1.00-2.30
Anion Gap
10.2
9.0-19.0
BUN/Creat Ratio
16.1
5.0-30.0
Cholesterol
H
216
<200
mg/dL
Trighicerides
H
413
10-150
mg/dL
Calculation of LOL is not appropriate for samples with a triglyceride greater than 400 mg/dL. Therefore the LDL Is not calculated.
HDL Cholesterol
L
31
40-60
mg/dL
Chol/HDL Ratio
H
6.9
0.0-4.0
HEMATOLOGY
WBC
7.6
4.3-11.1
K/uL
NRBC%
0.0
RBC
5.42
4.46-5.78
M/ut.
Hemoglobin
15.6
13.6-17.6
g/dL
Hematocsit
47.8
40.2-51.4
MCV
88.2
82.5-96.5
iL
MCH
28.8
27.1-34.9
P9
MCHC
L
32.6
33.0-37.0
g/dL
RDW-CV
12.8
12.0-14.0
Platelet
338
130-374
K/uL
FLAG LEGEND
L=Low L!=Low Critical H=High HI=High Critical A=Abnormal Al =Abnormal Critical
Page 1 of 3
CONFIDENTIAL
SDNY_00009469
EFTA00033854
Federal
Bureau of
Prisons
U.S. Medical Center for Federal Prisons
1900 W. Sunshine Street
Springfield, MO 65807
417-874-1621
••• Sensitive But Unclassified •••
Name EPSTEIN, JEFFREY
Reg # 76318-054
DOB 01/20/1953
Sex
M
Facility MCC New York
Order Unit E06-547U
Provider
Collected 07/09/2019 13:34
Received 07/10/2019 10:44
MD
Reported 07/10/2019 14:46
LIS ID
188191004
HEMATOLOGY
MPV
10.4
6.9-10.5
fL
Neutrophils %
58.7
Therapeutic decision making should be based on absolute values, rather than percentages
Lymphocytes %
25.0
Monocytes %
11.1
ok
Eosinophils %
4.1
Basophils %
0.8
Immature Granulocytes %
0.3
0.0-5.0
Neutrophils #
4.4
1.9-6.7
K/uL
Lymphocytes #
1.9
1.3-3.7
K/uL
Monocytes #
0.8
0.3-1.1
K/uL
Eosinophils #
0.3
0.0-0.5
K/uL
Basophils #
0.1
0.0-0.1
K/uL
Immature Granulocytes #
0.02
0.00-0.50
10^3/uL
HEMOGLOBIN A1C
Hemoglobin A1C
H
6.3
<5.7
5.7 - 6.4 Increased Risk
6.4 Diabetes
SEROLOGY
RPR
Non-Reactive
Results may be affected in patients with severely advanced immunosuppression.
Non-Reactive
FLAG LEGEND
L=Low L!=Low Critical H=High Fil=High Critical A=Abnormal A! =Abnormal Critical
Page 2 of 3
CONFIDENTIAL
SDNY_00009470
EFTA00033855
it
apE)Federal
Bureau of
Prisons
U.S. Medical Center for Federal Prisons
1900 W. Sunshine Street
Springfield, MO 65807
417.874-1621
••• Sensitive But Unclassified '•'
Name EPSTEIN, JEFFREY
Reg # 76318-054
DOB 01/20/1953
Sex
M
Facility MCC New York
Order Unit E06-547U
Provider
MD
Collected 07/09/2019 13:34
Received 07/10/2019 10:44
Reported 07/10/2019 14:46
LIS ID
188191004
HIV
HIV 1/2
Negative
Screening lest - See confirmatory testing for Reactive results
Negative
FLAG LEGEND
L=Low LI=Low Critical H=High H!=High Critical A=Abnonnal A! =Abnormal Critical
Page 3 of 3
CONFIDENTIAL
SCINY_00009471
EFTA00033856
Bureau of Prisons
Health Services
Cosign/Review
Inmate Name:
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
on 07/141201918:12.
Bureau of Prisons NYM
CONFIDENTIAL
SDNY_00009472
EFTA00033857
BP-S358.060
SEP 05
CDFRM
7-24-2019
Date
76318-054 refuse treatment recommended by the Federal
Bureau of Prisons Medical staff for the following condition(s):
DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY:
The following treatment(s) was/were recommended:
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:
I understand the possible consequences and/or complications, listed above, and still refuse
recommended treatment. I 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
ions.
7-24-2019
Counseled by
Date
Signature
of VVitne s
Date
Date
I
CONFIDENTIAL
SDNY_00009473
1
EFTA00033858
BP-A0618
JUN 16
(Initial Clinical Dental Findings)
Occlusion:
• MN
x 1 2
3
4
5 0
7
8
0 1011 12 13 14 15 18 WI
-
32 31
30 2D 28 27 28 25 24 23 22 21 20 ID
18
17
7
054
Oral Hygiene:
Good
E
Fair
00r
CP:TN:
3
3
3
2-
3
Head & Neck / Soft Tissue:
cAk, p
Classification:
CL -7—
Pain Scale:
/10
Dental Prostheses at Intake:
Yes
No
Type:
Age:
Condition:
Comrant
.1O :44
0.*
75 / V41
r ie. 02 SS/ on 017 Serum
Lat-ste--r C+N. AC1 or
catsliAc
0.10w
Intra-oral Photos Taken:
Yes
0
Radiographs Taken: (Document findings on ASO encounter)
Yes
9
Instructed how to obtain urgent and non-urgent dental care:
Yes: I
No:
Treatment Priorities:
None:
Non-urgent
non-urgent
Urgent Referred to Sick Call:
Radiographs authorized:
PM:
Prophylaxis authorized:
Yes i
No
(Approval valid 18 months from examination date)
BWs:
Panorer
Patient Name:
s—terni
.
- ) C-C1PW-v E
-
-
•
-1 9.
DS
Fiegsti: Number
,
76 3 ISE; ock-\
Institution: /
MCC NEW YORK
a e:
--7- z6
gnature Block/Stamp:
IDS.
PDF
Mescal:it'd by PeAci0
ief DentalOfficer
MCC New York
Replaces BP-A0618 of JUN 10
CONFIDENTIAL
SDNY_00009474
EFTA00033859