Office of Professional Responsibility U.S. Department of Homeland Security 950 L’ Enfant Plaza Washington, DC 20024 DETAINEE DEATH REVIEW Case Number Detainee Alien Number Citizenship Date of Death Detention Facility Facility Type 201111495 Irene BAMENGA (b)(6), (b)(7)c France July 27, 2011 Albany County Jail – Albany, New York IGSA OVERVIEW The U.S. Immigration and Customs Enforcement, Office of Professional Responsibility, Office of Detention Oversight, initiated this review after receiving information that ICE Detainee Irene BAMENGA, a citizen and national of France, died at the Albany Memorial Hospital located in Albany, New York. At the time of her death, Detainee BAMENGA was in ICE custody at the Albany County Jail (ACJ) pending removal proceedings. Detainee BAMENGA died on July 27, 2011, due to cardiomyopathy. This review found that Detainee BAMENGA was admitted into the United States on July 22, 2005, as a visitor for pleasure under the Visa Waiver Pilot Program. On July 15, 2011, US Customs and Border Protection (CBP) officers encountered BAMENGA at the Lewiston Bridge Port of Entry in Lewiston, NY, after Canadian Immigration officials denied BAMENGA entry into Canada. On the same date, CBP officers issued BAMENGA a Notice to Alien Ordered Removed/Departure Verification, Form I-296, charging removability pursuant to § 212(a) of the Immigration and Nationality Act (INA) or deportable under the provisions of § 237 of the INA as a Visa Waiver Pilot Program violator. On July 15, 2011, BAMENGA entered ICE custody at the Allegany County Jail in Belmont, NY. On July 21, 2011, ERO FOD Buffalo officers transferred BAMENGA to the Albany County Jail for staging, as she was scheduled for removal through the John F. Kennedy International Airport in New York, NY, on July 28, 2011. On July 27, 2011, Detainee BAMENGA was found unresponsive in her cell and transported to the Albany Memorial Hospital. Albany Memorial Hospital medical staff pronounced Detainee BAMENGA dead at 1:15 am. A New York State Department of Health Certi?cate of Death was generated regarding BAMENGA. According to the Certi?cate of Death report, inrrnediate cause of death was cardiomyopathy and the time of death is listed as 1:17 am. The death certi?cate indicates an autopsy was performed on BAMENGA. Coroner Timothy Cavanaugh and signed the Certi?cate of Death pertaining to BAMENGA. ICE has been denied access to the BAMENGA autopsy report by the Albany County Department of Law based on New York State County Law 677. The ICE Of?ce of Principal Legal Advisor (OPLA) has made efforts to obtain the autopsy report without success. According to information supplied by Albany County Attorney w: . martin the autopsy report cannot be disclosed at the request of the Department of Homeland Security. MGT of America, a national management and consultant ?rm, contracted by ICE to provide subject matter expertise in detention management including health care, reviewed the medical care of Detainee BAMENGA while housed at the ACCF and the ACJ. MGT of America found that the ACCF and the ACJ were not compliant with the ICE NDS for medical care. Speci?cally, MGT determined that the ACCF and ACJ failed to dispense ordered medications, delayed in starting medications, failed to verify medications, and provided incorrect dosing of medications. A mortality review was conducted by Dr. a clinical consultant medical doctor contracted by ICE to evaluate the medical care provided to Detainee BAMENGA while in ICE custody. Dr. 72c assessed the care provided by the ACCF as inadequate. Speci?cally, Dr. documented in her report that both the ACCF and the ACJ were remiss in not conducting a thorough clinical evaluation and assessment of BAMENGA whose congestive heart failure would deteriorate when poorly managed. According to Dr. report, BAMENGA should have been placed on a restricted sodium diet. Additionally, an electrocardiogram should have been done and a chest x-ray should have been completed. According to Dr. mm? mm: laboratory testing should have been done to include digoxin levels, electrolytes, a complete blood count, and thyroid function studies. Of?ce of Professional Responsibility Department of Homeland Security 950 Enfant Plaza SW Washington, DC 20536 U.S. Immigration 9 and Customs Enforcement c? \Nbg/ 0? a; 4 MEMORANDUM FOR: Gary Mead Executive Associate Director Enforcement and Removal Operations FROM: Timothy M. Assistant Director SUBJECT: Investigative Findings Death ot?lCE Detainee Irene BAMENGA (JICMS Case 201111495) The Of?ce of Professional Responsibility, Of?ce of Detention Oversight (ODO), has completed the Detainee Death Review regarding ICE Detainee Irene BAMENGA. Detainee BAMENGA died on July 27. 201 l. at the Albany Memorial Hospital in Albany. New York due to cardiomyOpathy. Prior to her death, Detainee BAMENGA was housed by ICE at the Albany County Jail. The ?ndings of the review are in the attached report. If you have any questions, please contact me or have a member of your staff contact ODO Deputy Division Director?at (202) 732- Attachment cc: Kumar Kibble Beth Gibson Kevin Landy Dr. Jon Krohmer OFFICIAL USE ONLY SENSITIVE Page 1 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 Immigration and Customs Enforcement Office of Professional Responsibility PREPARED BY (b)(6), (b)(7)c REPORT OF INVESTIGATION 2. REPORT NUMBER 002 HB 4200-01 (37), Special Agent Handbook 3. TITLE Bamenga, Irene/Unknown/0108 Death-Detainee/Alien (Unknown Cause)/ALBANY, ALBANY, NY 4. FINAL RESOLUTION 5. STATUS Closing Report 6. TYPE OF REPORT Detainee Death Review 7. RELATED CASES 8. TOPIC Closing Report for Detainee Death Review of Irene BAMENGA (b)(6), (b)(7)c 9. SYNOPSIS On July 27, 2011, the Joint Intake Center (JIC), Washington D.C., received notification regarding the death of U.S. Immigration and Customs Enforcement (ICE) Detainee Irene BAMENGA. Detainee BAMENGA, a citizen of France, died on July 27, 2011, at the Albany Memorial Hospital in Albany, New York. The New York State Medical Examiner reported Detainee BAMENGA died due cardiomyopathy. On August 15, 2011, the ICE Office of Professional Responsibility (OPR), Office of Detention Oversight (ODO) initiated a Detainee Death Review (DDR) of Irene BAMENGA's death. This report documents the findings of the review. 10. CASE OFFICER (Print Name & Title) (b)(6), (b)(7)c Agent Supervisor 12. APPROVED BY(Print Name & Title) (b)(6), (b)(7)c 11. COMPLETION DATE 14. ORIGIN OFFICE - ICE-OPR Special 12-JAN-2012 ICE OPR Office of Detention Oversight (ODO) 13. APPROVED DATE 15. TELEPHONE NUMBER 12-JAN-2012 No Phone Number - ICE-OPR Special Agent Supervisor THIS DOCUMENT IS LOANED TO YOU FOR OFFICIAL USE ONLY AND REMA NS THE PROPERTY OF THE DEPARTMENT OF HOMELAND SECURITY. ANY FURTHER REQUEST FOR DISCLOSURE OF THIS DOCUMENT OR INFORMATION CONTA NED HEREIN SHOULD BE REFERRED TO HEADQUARTERS, DEPARTMENT OF HOMELAND SECURITY, TOGETHER WITH A COPY OF THE DOCUMENT. THIS DOCUMENT CONTA NS INFORMATION REGARD NG CURRENT AND ON-GO NG ACTIVITIES OF A SENSITIVE NATURE. IT IS FOR THE EXCLUSIVE USE OF OFFICIAL U.S. GOVERNMENT AGENCIES AND REMAINS THE PROPERTY OF THE DEPARTMENT OF HOMELAND SECURITY IT CONTAINS NEITHER RECOMMENDATIONS NOR CONCLUSIONS OF THE DEPARTMENT OF HOMELAND SECURITY. DISTRIBUTION OF THIS DOCUMENT HAS BEEN LIMITED AND FURTHER DISSEM NATION OR EXTRACTS FROM THE DOCUMENT MAY NOT BE MADE WITHOUT PRIOR WRITTEN AUTHORIZATION OF THE ORIGINATOR. OFFICIAL USE ONLY SENSITIVE OFFICIAL USE ONLY SENSITIVE Page 2 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 PREPARED BY (b)(6), (b)(7)c REPORT OF INVESTIGATION CONTINUATION HB 4200-01 (37), Special Agent Handbook 2. REPORT NUMBER 002 10. NARRATIVE On July 27, 2011, the JIC was notified of the death of Detainee Irene BAMENGA (Alien Number (b)(6), (b)(7)c ). Detainee BAMENGA, a citizen of France was born on November 10, 1981 and died on July 27, 2011 at the Albany Memorial Hospital located at 600 Northern Boulevard, Albany, New York. Detainee BAMENGA was 29 years old at the time of her death. Detainee BAMENGA was in ICE custody at the Albany County Correctional Facility (ACCF) on the date of her death. The Albany County Sheriff's Office (ACSO) owns and operates the ACCF. The ACCF is a mixed-use facility that houses inmates received from area law enforcement jurisdictions, as well as adult male and female federal detainees over 72 hours. The ACCF is an intergovernmental service agreement (IGSA) facility contracted by the United States Marshals Service (USMS) to house federal detainees. ICE is an Authorized User in accordance with the contract. (b)(6), (b)(7)c During the week of August 22, 2011, OPR ODO Special Agent (SA) and (b)(6), (b)(7)c Supervisory Special Agent (SSA) conducted the on-site segment of the ODO (b)(6), (b)(7)c DDR. The agents were assisted by Program Manager (PM) PM (b)(6), (b)(7)c is employed by MGT of America Inc. (MGT), a national management and consultant firm, contracted by ICE to provide subject matter expertise in detention management and correctional health care. As part of the review, agents interviewed staff at the ACCF, the Allegany County Jail (ACJ), U.S. Customs and Border Protection (CBP), and the ICE Office of Enforcement and Removal Operations (ERO). Additionally, agents reviewed immigration, medical, and detention records pertaining to Detainee BAMENGA. The following is a time-line of the events regarding Detainee BAMENGA while she was in ICE custody. (b)(6), (b)(7)c On July 15, 2011, at approximately 5:35 p.m., CBP Officer (CBPO) encountered Irene BAMENGA at the Lewiston Bridge Port of Entry (POE) in Lewiston, New York. Irene (b)(6), (b)(7)c (b)(6), (b)(7)c BAMENGA, her husband and attempted to enter Canada from the United States. BAMENGA was denied entry into Canada due to lack of a valid I-94 (Arrival-Departure Record) from the United States. All three individuals attempted to re-enter the United States and were detained by CBP officers at the Lewiston Bridge POE. CBP officers researched BAMENGA's immigration status and learned that she entered the United States as a Visa Waiver Pilot Program participant in 2005. BAMENGA was authorized to remain in the United States until October 21, 2005. SSA (b)(6), (b)(7)c and CBP Internal Affairs (IA) SA OFFICIAL USE ONLY (b)(6), (b)(7)c SENSITIVE interviewed CBPO (b)(6), (b)(7)c on August 45mm Page 3 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 PREPARED BY REPORT OF INVESTIGATION CONTINUATION 2. REPORT NUMBER HB 4200?01 (37), Special Agent Handbook 002 10. NARRATIVE 23, 2011, at the CBP Internal Affairs Of?ce in Buffalo, New York. CBP Of?cer va uel remembered BAMENGA due to the volume of people he encounters daily. CBP Of?cer? stated that on the day of the encounter he received a radio transmission alert from the radio console of?cer regarding a vehicle that was denied access to Canada and was directed back to the United States. CBPO observed the vehicle and stopped it at the POE. CBPO stated he observed two black males and one black female in the vehicle. CBPO obtained identification from the three individuals and scanned the identification into the Vehicle Primary Client (VPC) system. The VPC system veri?es the validity of travel documents and performs various CBP-related database inquiries. The VPC inquiry revealed BAMENGA - referred BAMENGA, . to the Document Control unit in the Lewiston Operations Building located at the Lewiston Bridge POE. CBP of?cers escorted all three individuals into the building and seated them in a secure location. Acting CBPO supervisor encountered BAMENGA in the secure area of the Lewiston Operations Building. SSA and CBP IA SA interviewed CBPO on August 23, 2011, at the Rainbow Bridge POE. CBPO I. - stated she examined BAMENGA's passport and observed the most recent CBP admission stamp was documented in 2005. CBPO - stated she knew BAMENGA entered the United States as a Visa Waiver Program Tourist in 2005 and the visa waiver was only valid for 90 days from entry. CBPO determined that BAMENGA was subject to administrative removal from the United States. During the encounter, BAMENGA advised that she had congestive heart failure (CHF), which re uired daily medications. CBPO notified CBP Chief ?of the situation. interviewed BAMENGA regarding her immigration status and determined she was subject to removal from the United States. CBPO arrested and charged Detainee BAMENGA with violations of the Immigration and Nationality Act (INA) Section relating to remaining in the United States after admission for a time longer than permitted (Exhibit 01interviewed CBPW on August 24, 2011, at the CBP Internal Affairs Of?ce in Buffalo, New York. CBPO stated Acting CBPO supervisor noti?ed him regarding immigration status. CBPO interviewed BAMENGA regarding her immigration status and learned that BAMENGA entered the United States in 2005 as part of the Visa Waiver Program to visit her husband. BAMENGA did not depart the United States as required per the Visa Waiver Program. (Agent's note: the l-94 Page 4 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 PREPARED BY REPORT OF INVESTIGATION CONTINUATION 2. REPORT NUMBER HB 4200-01 (37), Special Agent Handbook 002 10. NARRATIVE arrival/departure record related to BAMENGA indicates she was admitted into the United States in accordance with the Visa Waiver Program on July 22, 2005. BAMENGA's admittance into the United States was valid until October 21, 2005 [Exhibit During the course of the immigration queries, CBPO bserved that Mr. ?led an l-130 petition on behalf of BAMENGA to adjust her immigration status. CBPO explained to Mr. and BAMENGA that the M30 was not valid for adjustment of status based on the fact that Mr. is not a United States citizen and BAMENGA was in violation of her immigration status. During the course of their conversation, BAMENGA advised CBPO rt a that she was diagnosed with CHF and that she needs to take medication daily. BAMENGA added that she had taken her required medication that day. CBPO i BAMENGA declined medical treatment and stated she was ?ne. At approximately 5:21 pm, CBPO ICE ERO Immigration Enforcement Agent ?regarding BAMENGA. IEA authorized BAMENGA to be housed at the Allegany County Jail (ACJ). CBPO ?informed IEA that BAMENGA was diagnosed with CHF, possessed six (6) different medications, and appeared to be in good health at that time. No discrepancies were discovered re arding the travel documents or immigration status for Mr. CBPO informed Mr hat BAMENGA would be housed at the ACJ and provided him the address and telephone number to the facility. All of BAMENGA's property, except for her medications, was released to Mr. Mr. . were allowed to enter the United States through the Lewiston Bridge POE. At approximately 7:58 pm, CBPOMauthorized a pat down search of BAMENGA and performed the pat down search. CBPO the search which produced negative results for contraband. ZLI CBPO on August 22, 2011, at the CBP Internal Affairs Of?ce in Buffalo, New York. CBPO uwu i=2. stated that she performed a pat down search on BAMENGA. According to CBPO - her husband. Upon completion of the pat down search, BAMENGA was placed in handcuffs and a belly chain in preparation for transport. (Agent?s note: a belly chain is a restraint device that is placed around the subject's waistline. The handcuffs are attached to the belly chain to restrict Page 5 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 PREPARED BY REPORT OF INVESTIGATION CONTINUATION HB 4200-01 (37), Special Agent Handbook 2. REPORT NUMBER 10. NARRATIVE directed CBPO At approximately 8:00 pm, CBP Of?cers . and took custody of Detainee BAMENGA and transported her from the Lewiston Bridge POE in Lewiston, New York to the ACJ (Exhibit 03). interviewed CBP Enforcement O?ic?on August 23, stated she was an evidence bag containing medication and booking documentation for the jail. According to CBPO she monitored the temperature in the transport van to ensure a moderate climate was maintained and activated the microphone to hear any comments by BAMENGA. normal upon arrival to the ACJ. According to CBPO booking documentation and medications to the jail. on August 22, 2011, at the CBP . stated he and CBPO CBPO did not converse with BAMENGA durini the transport but BAMENGA requested more heat on several occasions. CBPO advised that the transport to the ACJ lasted approximately 2.5 hours. CBPO met Ir? ru- stated that upon arrival to the ACJ, he transferred custody of BAMENGA and a Ziploc bag of her medication to the ACJ staff. On July 15, 2011, at approximately 10:30 pm, BAMENGA arrived at the ACJ in the transport van (Exhibit 04). ACJ Of?cer signed the Form l-203 (Order to Detain or Release Alien) acknowledging custody of BAMENGA (Exhibit 05). The Form I-203 indicates BAMENGA has congestive heart failure that is controlled by medication she had with her. At approximately 11:19 pm, BAMENGA was processed into the jail by Sergeant Page 6 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 PREPARED BY REPORT OF INVESTIGATION CONTINUATION 2. REPORT NUMBER HB 4200?01 (37), Special Agent Handbook 002 10. NARRATIVE During the intake screening, BAMENGA was asked booking observation questions listed on the Booking Observation Report (Exhibit 06). BAMENGA answered yes to being allergic to food or medication, testing positive for tuberculosis, and having medication. Question 12 of the Booking Observation Report is "Are you on any medication?" The response to question 12 is listed as "lots of them." The booking data sheet shows the booking end time as 11:23 pm. SSAmand PM interviewed Sergeant. the ACJ on August 23, 2011. Sergeant stated he recalled processing BAMENGA. Sergeant stated BAMENGA spoke English and was able to respond to his questions at intake. Sergeant stated there was a large quantity of medication that accompanied BAMENGA to the facility. Upon receipt in the intake processing area, Sergeant stated he walked the medication to the medical unit and placed the medication on Nurse Practitioner (NP) desk. Sergeant stated that due to the hour of night that BAMENGA arrived at ACJ, no medical personnel were available to receive the medication. Sergeant stated BAMENGA joked with him and was friendly during the booking process. BAMENGA did not request any medication or medical care while being processed. Upon completion of the booking process, BAMENGA was ?ngerprinted, photographed, and was provided facility clothing. BAMENGA was assigned to housing unit after booking. On July 16, 2011, Registered Nurse (RN) we. conducted an initial medical screening of PM interviewed RN at the ACJ on August 23, 2011. RN stated that the medication BAMENGA arrived with on July 15, 2011, consisted of two large medication organizers containing various medications. BAMENGA advised that she had taken her medication the day prior (July 14, 2011). RN stated BAMENGA knew the names of the medication she was taking but did not know the dosages. RN -. stated the only medical concern BAMENGA expressed during the initial medical screening was that she was unable to have the medicine she had during her arrest. RN stated BAMENGA's screening was unremarkable thus no further medical action was necessary before Monday (July 18, 2011). The initial medical screening was hand written by RN and documented on the Booking Observation Report (Exhibit 06). On July 18, 2011, NP ?we- a-w: conducted a physical examination of BAMENGA. The examination is documented in the ACJ History and Physical Examination report (Exhibit 07). According to the report, BAMENGA was ordered the following medications with start date of July 18, 2011: - ASA 81 mg daily Page 7 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 PREPARED BY REPORT OF INVESTIGATION CONTINUATION 2. REPORT NUMBER HB 4200-01 (37), Special Agent Handbook 002 10. NARRATIVE - Spironalactone 25 mg twice daily - Lasix 20 mg daily Digoxin 0.25 mg daily - Carvedilol 20 mg daily - Lisinopril 20 mg daily The report additionally states BAMENGA is allergic to Tramadol. A review of the ACJ Medication Record (MR) for BAMENGA indicates she did not receive medication until July 19, 2011 (Exhibit 08). ACJ Sergeant classi?ed BAMEGNA for general population and assigned her to housing unit D08. On July 19, 2011, at approximately 10:10 am, IEA visited the ACJ. SAM and CBP lA SA interviewed on August 23, 2011, at the CBP Internal Affairs Of?ce in Buffalo, New York. IEA stated he conducts weekly visits to ICE detention facilities in order to conduct detainee interviews. IEA stated he inquires about any problems, questions, or concerns on behalf of the detainee during the detainee interviews. IEA stated that on July 19, 2011, BAMENGA was 1 of 15 detainees whom he interviewed at the ACJ (Exhibit 09). Prior to the interview with BAMENGA, issued a Detainee Handbook speci?c to the ACJ. IEA explained personal property procedures (Exhibit 11) and also completed a Detainee InterviewNisitation Worksheet (Exhibit 12). The interview worksheet indicates BAMENGA did not have any questions during the interview. According to IEA BAMENGA appeared healthy during her interview. A review of grievance records revealed no grievances were ?led by BAMENGA while housed at the ACJ (Exhibit 13). On July 21, 2011, at approximately 9:20 am, ICE IEAs arrived at ACJ and took custody of BAMENGA and Detainee (Exhibit 14). Page 8 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 PREPARED BY REPORT OF INVESTIGATION CONTINUATION 2. REPORT NUMBER HB 4200-01 (37), Special Agent Handbook 002 10. NARRATIVE were required to transport two detainees from the ACJ to exit 36 on Interstate 90 (Exhibit 15). Additionally, the lEAs were required to cash the detainee's checks from the ACJ. IEA mm mm stated the purpose of the trip was to meet with ERO of?cers from Alban NY, at exit 36 to exchange detainees. According to IEA he and IEA arrived at the ACJ at medications, and sealed health transfer summaries for the two detainees. According to IEA I asked both detainees if they received their medications that day and both detainees responded, "Yes." tated they departed the ACJ with the detainees at approximately 9:20 am, and proceeded to the Steuban Trust Bank located at 11 Schuyler street Belmont, New York. IEA ?entered the bank and cashed the checks for the detainees while IEAmremained with the detainees in the transport van. IEA mm cashed Allegany County Sheriff's Of?ce check in the amount of $12.70 for BAMENGA (Exhibit 17). Upon completion of the ?nancial transactions, the transport continued towards their destination. IEA mm: contacted mm of the Albany, New York office while traveling to the meeting location. IEA advised IEAmheir estimated time of arrival to exit 36 was approximately 12:00 pm. lEAs a and stated that BAMENGA appeared normal during the trip. They also stated that they did not converse with either detainee during the transport. At approximately 12:00 pm, the IEAs from ERO Buffalo and Albany arrived at exit 36 on Property 'n?n Jun; Ilvi..?i he recived approximately ?ve different medications as part of property. The medication was labeled with name, the types of medications, and the respective dosage amounts. Page 9 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 PREPARED BY REPORT OF INVESTIGATION CONTINUATION HB 4200?01 (37), Special Agent Handbook 002 2. REPORT NUMBER 10. NARRATIVE BAMENGA and 4' from exit 36 on Interstate 90 in Syracuse, New York, to the ACCF located in Albany, New York. According to w: uz-m- at approximately 1:15 pm, the transport stopped at exit 31 on Interstate 90 and allowed both detainees to use the restroom at an unknown gas station. At approximately 1:25 pm, both were secured in the van and the transport continued to the ACCF. While traveling to the ACCF, IEA contacted an unknown medical staff member at the ACCF regarding BAMENGA's medication. The staff member agreed to accept BAMENGA at the ACCF. According to IEA conversed brie?y with BAMENGA regarding her heart condition. lEAs -r and indicated BAMENGA appeared healthy and did not request medical care while in their custody. On July 21, 2011, at approximately 2:30 pm, the transport van arrived at the ACCF. Upon arrival at the ACCF, lEAs mm and mm escorted BAMENGA and the facility. All property, medications, and documents were turned over to booking of?cers at the ACCF. and SSA interviewed ACCF Of?cer on August 25, 2011, at the ACCF. Of?cermplained the booking process at the ACCF. According to Of?cer detainees are interviewed by booking of?cers, who obtain basic biographical data. Detainees are issued yellow jumpsuits, bedding, and granted access to telephones. Officers in the booking area perform mental health screening and issue color-coded wristbands. Of?cer advised that booking of?cers are not aware of the ICE National Detention Standards (S). Upon completion in the booking process, detainees are screened by medical personnel. Of?cer stated the medical screening is performed in a private area in the medical unit. The detainees are interviewed by the Inmate Services Unit, and then housed with other arriving detainees until classi?ed. Upon completion of the classification process, detainees are housed according to their classi?cation levels. At approximately 5:58 pm, ACCF Of?cer booked BAMENGA into the ACCF via the Offender Management System (OMS) (Exhibit 20). SSA a interviewed ACCF Of?cer um um August 26, 2011, at the ACCF. Of?cer '1 stated he did not recall processing BAMENGA due to the large number of inmates he encounters on a daily basis. Of?cer ?was presented with the ACCF OMS data related to BAMENGA and con?rmed he entered BAMENGA's information into the computer system during the booking process. Of?cer . - stated BAMENGA was referred to the medical department due to her medications and her responses to medical questions. Page 10 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 PREPARED BY REPORT OF INVESTIGATION CONTINUATION 2. REPORT NUMBER HB 4200?01 (37), Special Agent Handbook 002 10. NARRATIVE On July 21, 2011, at approximately 6:30 pm, ACCF RN completed a Correctional Medical Services Medical and Mental Health History and Screening form pertaining to BAMENGA (Exhibit 21). The form documents that BAMENGA responded af?rmatively when asked if she had any medical problems. CHF is recorded as the explanatory response in the comments section of the form. RN recorded BAMENGA's weight as 194 lbs. and blood pressure (BP) as 140/88. BAMENGA signed a statement at the bottom of the screening form consenting to routine care and acknowledging she was told how to access health care services. A review of the Interdisciplinary Progress Notes prepared by RN muE. indicates BAMENGA was screened without difficulty. The Progress Notes document that BAMENGA had a history of positive PPD (tuberculosis) and was ordered a chest x-ray. Additionally, the Progress Notes indicate BAMENGA had a history of hypertension (HTN), CHF, and anemia (Exhibit 22). - I w- interviewed RN Mon August 25, 2011, at the Mir-:- stated she did not recall BAMENGA or any complaints made by her. RN I stated she documented BAMENGA's health problems reported during the medical screening process. RN stated she documented BAMENGA had a history of congestive heart failure (CHF), hypertension (HTN), and anemia. BAMENGA did not make any comments concerning her medications and did not express any concerns or complaints. RN advised that Dr. I, .: approved BAMENGA's medications and she documented BAMENGA's medications in the Physicians' Orders. A review of the ACCF Progress Notes related to BAMENGA indicates, "Call placed to MD. orders received" (Exhibit 22). A review of the Physician Orders documented the following prescriptions, all with start dates of July 21, 2011, and stop dates of August 20, 2011 (Exhibit 23): - ASA 81 mg daily - Spironalactone 25 mg twice daily - Lasix 20 mg daily - Digoxin 0.25 mg daily - Lisinopril 20 mg daily - Coreg (same medication as Carvedilol) 20 mg daily A review of the ACCF Medication Administration Record (MAR) revealed BAMENGA received her medications on July 21, 2011, except for Digoxin which was started on July 25, 2011, and Coreg which was started on July 26, 2011 (Exhibit 24). Page 11 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 PREPARED BY REPORT OF INVESTIGATION CONTINUATION 2. REPORT NUMBER HB 42mm (37), Special Agent Handbook 002 10. NARRATIVE .r on August 25, tractor employed by the stated he never interacted with Is advised the medical staff to continue her medications. Upon completion of the booking process and medical evaluation, BAMENGA was assigned to housing unit 8 West, Left Block, cell 6, bed 2 at the ACCF (Exhibit 25). On July 25, 2011, BAMENGA completed two Correctional Medical Services Health Services Request Forms (Exhibit 26). The ?rst health services request form documents that BAMENGA alleged she was not provided her complete dosage of her medications. in the second health services request form BAMENGA wrote she had shortness of breath, palpitations when lying down, and dizziness upon standing. On July 26, 2011, at approximatel 9:40 am, Nurse Practitioner (NP) examined BAMEGNA. SA SSA and PM interviewed NP on August 25, 2011, at the ACCF. NP stated she reviewed BAMENGA's intake screening form medical history, surgical history, and medication. During the exam, BAMENGA advised NP that she had congestive heart failure and hypertension. NPMlistened to BAMENGA's heart and lungs, examined her eyes and ears, and obtained BAMENGA's body temperature, blood pressure, and pulse rate. According to NP mm: all measurements were within normal limits. I stated that BAMENGA was well-versed in her medication requirements. According to BAMENGA stated she was not receiving two types of medication. NP [nut-c reviewed BAMENGA's medication record and observed that the medication Coreg was provided to BAMENGA once a day. NP increased the dosage of Coreg to twice a day and documented the action in the Physician's Orders (Exhibit 23). NP advised BAMENGA that her Spironalactone medication was ordered for twice a day and that she would need to ensure she obtained the medication during medical pass. . stated she consistently documented her actions on the health services request forms and signed her initials on the health services request form related to BAMENGA. NP stated she was not aware of the second health services request form ?led by BAMENGA. According to NP BAMENGA's physical exam was normal and she appeared healthy. BAMENGA did not complain about shortness of breath or chest pain during her exam with NP Page 12 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 PREPARED BY REPORT OF INVESTIGATION CONTINUATION HB 4200?01 (37), Special Agent Handbook 002 2. REPORT NUMBER 10. NARRATIVE :1 advised that She is not familiar with the ICE NDS. On July 26, 2011, BAMENGA was interviewed by ACCF Inmate Services Specialist (ISS) I . 38AM and PM v: interviewed ACCF ISS on August 25, 2011, at the ACCF. ISS stated she usually sees new detainees within 24 hours of their arrival to the ACCF. ISS um. stated her role as an Inmate Services Specialist requires her to interview detainees and advise them of various services offered at the ACCF. ISS In In provides detainees with an Incoming Package Form (IPF) that instructs the detainee how to receive various items at the facility from family or friends. ISS also provides detainees with a Program Request Form (PRF) that instructs detainees how to join self-improvement programs within the facility. According to ISS BAMENGA stated during her interview on July 26, 2011, that she had not been receiving her medication. ISS II 1 we asked BAMENGA if she spoke with someone in the medical department about receiving her medication and she stated "Yes." ISS ?mu: provided BAMENGA the IPF and PRF documents and informed her how to obtain medical services at the facility. ISS advised that BAMENGA was calm and cooperative during her interview and BAMENGA for normal classi?cation. ISS 4 a completed an Inmate Service Unit Intake Interview packet regarding her interaction with BAMENGA (Exhibit 27). stated she is not familiar with the ICE NDS. According to ISS classi?cation process is the final stage for detainees to be housed at the facility. On July 26, 2011, at approximately 1:10 pm, ICE ERO IEAwsited BAMENGA at the ACCF (Exhibit 28). SA mm: and SSA interviewed IEA at the Albany, New York ERO of?ce on August 24, 2011. IEA stated he went to the ACCF on July 26, 2011, to interview approximately 10 detainees regarding their immigration status and verify telephones available to detainees were in proper working order. IEA he conducts weekly visits to facilities that house ICE detainees and interviews them regarding their immigration status. During his interview of detainees, stated he inquires about any problems, questions, or concerns on behalf of the detainee. completed a Detainee InterviewNisitation Worksheet regarding his interview with BAMENGA (Exhibit 29). During the interview, BAMENGA requested to know the disposition of her case and when she could return to France. IEA advised BAMENGA he would provide her answers to her questions after speaking with her case of?cer. IEAmstated the interview lasted approximately 5 minutes and BAMENGA appeared healthy during the encounter. According to IEA BAMENGA did not ask any questions regarding her medication or her illness. Page 13 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 PREPARED BY REPORT OF INVESTIGATION CONTINUATION HB 4200?01 (37), Special Agent Handbook 002 2. REPORT NUMBER 10. NARRATIVE On July 26, 2011, at approximately 2:30 pm, BAMENGA was classi?ed by ACCF as a level 3 detainee based on the ACCF Inmate Classi?cation Test results (Exhibit 30). . - and PMinterviewed Sergeant on August 25, 2011, at the ACCF. Sergeant stated the ACCF uses ?ve different classi?cation levels when classifying detainees. [Agent's note: the ACCF policy indicates six levels of classi?cation (Exhibit Sergeant mated each classi?cation level is segregated from other classification levels. Sergeant advised that she inputs data into the computer-based Inmate Classi?cation Test and the computer provides a classi?cation level. Sergeant a . she did not have any direct contact with BAMENGA but generally uses information from the Inmate Services Unit, interviews with detainees, and medical information to determine classi?cations. Sergeant stated a level 3 classi?cation was applied to BAMENGA based on the fact that BAMEGNA was detained without the ability for release on bond. Sergeant advised that she is not familiar with the ICE NDS and does not use information from ICE to classify detainees. Upon completion of the classi?cation process, BAMENGA was reassigned to housing unit 6 West, Left 3, Cell 9, Bed 1 at the ACCF. On July 27, 2011, ACCF Corrections Of?cer was the of?cer on duty for post 6 West. A review of post log information indicates that at approximately 12:15 am, inmates in Left Bay #3 noti?ed CO tum. a that BAMENGA was sick (Exhibit 32). .. on August 25, 2011, at the ACCF. Of?cer stated that at approximately 12:15 am, he noti?ed the relief of?cer so that BAMENGA could be escorted to the medical unit. At approximately 12:19 am, CO noti?ed Sergeant At approximately 12:23 am, CO entered Left Bay #3 and observed that BAMENG ?1 approximately 12:24 am, ACCF medical staff entered the cell and cardiopulmonary re uscitation (CPR) was performed on BAMENGA. CO stated he administered chest compressions to BAMENGA while Nurse operated the ambu bag. [Agent's note: the ambu bag is a trademark for a self-rein?ating bag used during resuscitation At approximately 12:32 am, Colonie Emergency Medical Services (EMS) arrived at the ACCF and assumed care for BAMENGA. A Colonie EMS Prehospital Care Report was generated regarding the care provided to BAMENGA (Exhibit 33). According to the report, Advanced Emergency Medical Technician Paramedics (AEMT-P) W. Page 14 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 PREPARED BY REPORT OF INVESTIGATION CONTINUATION 2. REPORT NUMBER HB 4200-01 (37), Special Agent Handbook 002 10. NARRATIVE - provided care to BAMENGA. At approximately 12:55 am, Colonie EMS personnel departed the ACCF with BAMENGA and transported her to the Albany Memorial Hospital. The care report indicates the EMS personnel and BAMENGA arrived at the Albany Memorial Hospital at 1:08 am. ACCF COs and lncident Report 11-106 docume interviewed CO on August 25 2011, at the ACCF. CO stated that on Jul 27, 2011, he was instructed by ACCF Captain to prepare for a hospital escort. CO was sitting in his vehicle when he observed EMS personnel exit the ACCF with BAMENGA. CO observed CPR equipment on BAMENGA and observed EMS personnel place her in the Mr followed the ambulance to the hospital while CO ?r rode in the ambulance with BAMENGA. .. interviewed CO .I- on August 25, 2011, at the ACCF. CO stated that on July 27, 2011, he was instructed by an unknown ACCF Sergeant to prepare for a hospital escort. co stated that at approximately 12:50 am, he and co ?were located in the ACCF exterior booking area. CO 2 rw-c observed Colonie EMS personnel exit the ACCF with BAMENGA and place her in the ambulance. CO stated he occupied the front passenger seat of the ambulance and observed paramedics administer medications intravenously. CO stated that upon arrival to the hospital, BAMENGA was transferred to the emergency room and hospital staff assumed care for BAMENGA. CO advised that emergency room personnel were unable to revive BAMENGA and she was pronounced dead by the emergency room physician at 1:15 am. CO :r w: departed the hospital at approximately 5:30 am. According to CO I: i he remained with BAMENGA until 8:00 am. until he was relieved by ACCF CO I- reviewed the Albany Memorial Hospital Emergency Department Report regarding BAMENGA (Exhibit 35). According to the report, CPR was continued in the Emergency Department under the supervision of Dr.? The report indicates "At 01:15, her total downtime was in excess of 45 minutes with at least 35 minutes of documented asystole and no perfusing during that entire time." Dr. ?determined further resuscitative efforts were futile and pronounced BAMENGA dead. The report documents that BAMENGA's husband, was noti?ed. According to the report, "The coroner was noti?ed, and will be taking the body for autopsy." On August 15, 2011, SAMreceived the New York State Department of Health Certi?cate of OFFICIAL USE ONLY SENSITIVE DEPARTMENT OF HOMELAND SECURITY Page 15 of 20 1. CASE NUMBER 201111495 PREPARED BY (b)(6), (b)(7)c REPORT OF INVESTIGATION CONTINUATION HB 4200-01 (37), Special Agent Handbook 2. REPORT NUMBER 002 10. NARRATIVE Death regarding BAMENGA (Exhibit 36). According to the Certificate of Death report, BAMENGA' s immediate cause of death was cardiomyopathy and the time of death is listed as 1:17 a.m. The death certificate indicates an autopsy was performed on BAMENGA. Coroner (b)(6), (b)(7)c (b)(6), (b)(7)c (b)(6), (b)(7)c and M.D., signed the Certificate of Death pertaining to BAMENGA. ICE has been denied access to the BAMENGA autopsy report by the Albany County Department of Law based on New York State County Law 677. The ICE Office of Principal Legal Advisor (OPLA) has made efforts to obtain the autopsy report without success. According to (b)(6), (b)(7)c information supplied by Albany County Attorney the autopsy report cannot be disclosed at the request of the Department of Homeland Security (Exhibit 37). MEDICAL COMPLIANCE REVIEW: MGT of America, a national management and consultant firm, contracted by ICE to provide subject matter expertise in detention management including health care, reviewed the medical care of Detainee BAMENGA while housed at the ACCF and the ACJ. MGT of America found that the ACCF and the ACJ were not compliant with the ICE NDS for medical care. Specifically, MGT determined that the ACCF and ACJ failed to dispense ordered medications, delayed in starting medications, failed to verify medications, and provided incorrect dosing of medications. The MGT of America report is attached to this ROI (Exhibit 38). MORTALITY REVIEW: (b)(6), (b)(7)c A mortality review was conducted by Dr. , a clinical consultant medical doctor contracted by ICE to evaluate the medical care provided to Detainee BAMENGA while in ICE custody. Dr. (b)(6), (b)(7)c assessed the care provided by the ACCF as inadequate. Specifically, Dr. (b)(6), (b)(7)c documented in her report that both the ACCF and the ACJ were remiss in not conducting a thorough clinical evaluation and assessment of BAMENGA whose congestive heart failure would deteriorate when poorly managed. According to Dr. (b)(6), (b)(7)c report, BAMENGA should have been placed on a restricted sodium diet. Additionally, an electrocardiogram should have been done and a chest x-ray should have been completed. According to Dr. (b)(6), (b)(7)c laboratory testing should have been done to include digoxin levels, electrolytes, a complete blood count, and thyroid function studies. Dr. (b)(6), (b)(7)c Mortality Review Report is attached to this report (Exhibit 39). IMMIGRATION AND DETENTION HISTORY: Irene BAMENGA, a native of Angola and citizen of France, entered the United States as a visitor OFFICIAL USE ONLY SENSITIVE OFFICIAL USE ONLY SENSITIVE DEPARTMENT OF HOMELAND SECURITY Page 16 of 20 1. CASE NUMBER 201111495 PREPARED BY (b)(6), (b)(7)c REPORT OF INVESTIGATION CONTINUATION HB 4200-01 (37), Special Agent Handbook 2. REPORT NUMBER 002 10. NARRATIVE under the Visa Waiver Program (VWP) at Boston, Massachusetts on July 22, 2005. Detainee BAMENGA was authorized to remain in the United States until October 21, 2005. On July 15, 2011, BAMENGA was encountered by CBP at the Lewiston Bridge, Lewiston, New York, after having been refused entry into Canada for failure to provide a valid I-94, Nonimmigrant (b)(6), (b)(7)c Visa Waiver Arrival/Departure Form. CBP Assistant Port Director issued an Order of Removal for Detainee BAMENGA in accordance with Section 217 of the Immigration and Naturalization Act (INA). From July 15, 2011 to July 21, 2011, Detainee BAMENGA was housed at the Allegany County Jail, located in Belmont, New York pending removal from the United States. On July 21, 2011, Detainee BAMENGA was transferred to Albany County Correctional Facility, located in Albany, New York. Detainee BAMENGA was scheduled for removal from the United States on July 28, 2011. CRIMINAL HISTORY: According to the National Crime Information Center (NCIC), Detainee BAMENGA was assigned (b)(7)e the FBI # NCIC records indicate Detainee BAMENGA has no additional arrests prior to her encounter with CBP on July 15, 2011. INVESTIGATIVE FINDINGS: Detainee BAMENGA came into ICE custody on July 15, 2011, and her congestive heart failure was documented consistently while in ICE custody. The New York State Department of Health Certificate of Death documents that Detainee BAMENGA's immediate cause of death was cardiomyopathy. A review of the Medical Administration Records (MAR) pertaining to BAMENGA revealed the ACCF and ACJ failed to dispense ordered medications, delayed in starting medications, failed to verify medications, and provided incorrect dosing of medications. According to information provided by Dr. (b)(6), (b)(7)c "missed medication dosing as well as incorrect medication dosing were significant factors that contributed to the decompensation of her congestive heart failure." [Agent's note: decompensation is failure of the heart to maintain adequate blood circulation, marked by labored breathing, engorged blood vessels, and edema (www. medical-dictionary.thefreedictionary.com.)] This review revealed the ACJ and the ACCF were not in compliance with the ICE NDS Medical Care Standard. The ICE NDS, Medical Care, Section (I), Policy, indicates all detainees shall have access to medical services that promote detainee health and general well-being. MGT of America reviewed Medical Administration Records (MAR) and determined that the ACCF and ACJ failed to OFFICIAL USE ONLY SENSITIVE Page 17 of 20 DEPARTMENT OF HOMELAND SECURITY 1. CASE NUMBER 201111495 PREPARED BY REPORT OF INVESTIGATION CONTINUATION 2. REPORT NUMBER HB 4200?01 (37), Special Agent Handbook 002 10. NARRATIVE dispense ordered medications, delayed in starting medications, failed to verify medications, and provided incorrect dosing of medications. The ACJ and the ACCF were not in compliance with the ICE NDS, Medical Care, Section (D), General, indicates all new arrivals shall receive TB screening by PPD (mantoux method) or chest x-ray. The PPD shall be the primary screening method unless this diagnostic test is contraindicated; then a chest x-ray is obtained. The ACJ took appropriate action to request authorization for a chest x-ray, though it was not completed rior to her transfer to the ACCF on July 21, 2011. ACCF Health Services Administrator (HSA)hstated Detainee BAMENGA did not receive a chest x-ray and that RN we? weir-- failed to write the order for the x-ray. The ACCF was not in compliance with the ICE NDS, Medical Care, Section (F), Sick Call, which indicates the health care provider will review the request slips and determine when the detainee will be seen. BAMENGA alleged in a health services request form dated July 25, 2011, that she had shortness of breath, palpitations when lying down, and dizziness upon standing. BAMENGA's complaints in this document were not reviewed by medical staff. NP during her interview that she was not aware of this health service request form and did not address this complaint during her exam of BAMENGA. This review revealed the ACCF and the ACJ were not in compliance with the ICE NDS regarding the Detainee Handbook and Classi?cation. Detainee BAMENGA was not provided an Inmate Handbook upon admission into the ACCF in accordance with the ICE NDS. In addition, Detainee BAMENGA was not classi?ed upon arrival at either facility as required by the ICE NDS. Also, the ICE NDS classi?cation levels range from a level 1 (lowest threat) to a level 3 (highest threat). The ACCF uses a classi?cation system that ranges from level 1 to level 6 and the ACJ uses a classi?cation system that separates detainees by general population or maximum population. AREAS OF CONCERN: Based on interviews and documents reviewed during this review, the ACCF correctional staff and the ACCF medical staff are not aware of the requirements of the ICE NDS. The medical staff at the ACJ and the ACCF failed to obtain BAMENGA's previous medical records. Additionally, the ACJ failed to order medications in a timely manner. The order for medication was made three days following arrival at the ACJ. ACJ NPM stated the medications ordered, including dosage, were as reported by detainee BAMENGA. NPdid not attempt to verify the medications before ordering them. NP stated she did not consider pursuing OFFICIAL USE ONLY SENSITIVE DEPARTMENT OF HOMELAND SECURITY Page 18 of 20 1. CASE NUMBER 201111495 PREPARED BY (b)(6), (b)(7)c REPORT OF INVESTIGATION CONTINUATION HB 4200-01 (37), Special Agent Handbook 2. REPORT NUMBER 002 10. NARRATIVE the BAMENGA's medical records from her community provider, or ordering laboratory tests. ACJ policy does not address handling of medications received with new detainees, including documenting receipt, inventory, disposal or release by either booking or medical staff. Interviews with ACJ medical staff revealed that in ACJ practice, medications are turned over to the medical unit when received, and returned to ICE detainees upon release or transfer. A review of the contract between the United States Marshals Service (USMS) and the ACCF for housing detainees at the ACCF revealed ICE is listed as an "Other Authorized Agency User" (Exhibit 40). According to the contract, "Detainees shall also be housed in a manner that is consistent with federal law and the Federal Performance-based Detention Standards." ICE does not have a separate and independent contract with the ACCF that specifies requirements of the ICE NDS for housing ICE detainees. OFFICIAL USE ONLY SENSITIVE OFFICIAL USE ONLY SENSITIVE DEPARTMENT OF HOMELAND SECURITY Page 19 of 20 1. CASE NUMBER 201111495 PREPARED BY (b)(6), (b)(7)c REPORT OF INVESTIGATION Exhibit List HB 4200-01 (37), Special Agent Handbook 2. REPORT NUMBER 002 01 - Form I-213, Record of Deportable/Inadmissible Alien (7/15/2011) 02 - I-94 Arrival/Departure information related to BAMENGA 03 - CBP Vehicle Utilization Log (7/15/2011) 04 - ACJ Vehicle Log used to document activity at the facility (7/15/2011) 05 - Homeland Security Form I-203 Order to Detain or Release Alien (7/15/2011) 06 - ACJ Booking Observation Report (7/15/2011) 07 - ACJ History and Physical Examination (7/18/2011) 08 - ACJ Medication Record 09 - ICE Detainee Interview Log (7/19/2011) 10 - Certificate of Issuance of Immigration Detainee Handbook (7/19/2011) 11 - ICE Personal Property Notice (7/19/2011) 12 - Detainee Interview /Visitation Worksheet (7/19/2011) 13 - ACJ Grievance Records 14 - ACJ Vehicle Log used to document activity at the facility (7/21/2011) (b)(6), (b)(7)c 15 - Email from SDDO (7/20/2011) 16 - Homeland Security Form I-203 Order to Detain or Release Alien (7/21/2011) 17 - Copy of Allegany County Sheriff's Office check number (b)(6), (b)(7)c (7/20/2011) 18 - Memorandums pertaining to Detainee Transfer Sheets 19 - Form I-216 Record of Persons and Property Transferred (7/21/2011) 20 - ACCF Offender Management System (OMS) data (7/21/2011) 21 - Correctional Medical Services Medical and Mental Health History and Screening form (7/21/2011) 22 - ACCF Interdisciplinary Progress Notes 23 - Correctional Medical Services Physician Orders 24 - ACCF Medication Administration Record 25 - ACCF Housing Assignments for BAMENGA 26 - Correctional Medical Services Health Services Request Forms (7/25/2011) 27 - ACCF Inmate Service Unit Intake Interview packet (7/26/2011) 28 - ACCF Register Log (7/26/2011) 29 - Detainee Interview/Visitation Worksheet (7/26/2011) 30 - ACCF Inmate Classification Test results (7/26/2011) 31 - ACCF Classification Policy 32 - ACCF Post Log for 6 West (7/27/2011) 33 - Colonie EMS Prehospital Care Report 34 - ACCF Incident Report # 11-106 35 - Albany Memorial Hospital Emergency Department Report (7/27/2011) 36 - New York State Department of Health Certificate of Death (7/27/2011) OFFICIAL USE ONLY SENSITIVE OFFICIAL USE ONLY SENSITIVE DEPARTMENT OF HOMELAND SECURITY Page 20 of 20 1. CASE NUMBER 201111495 PREPARED BY (b)(6), (b)(7)c REPORT OF INVESTIGATION Exhibit List HB 4200-01 (37), Special Agent Handbook (b)(6), (b)(7)c 37 - Albany County Attorney Email (8/11/2011) 38 - MGT of America Medical Compliance Review (6/29/2011) (b)(6), (b)(7)c 39 - Mortality Review by Dr. 40 - U.S. Marshals Service IGSA Detention Contract with ACCF OFFICIAL USE ONLY SENSITIVE 2. REPORT NUMBER 002 U.5. Dugunmont ofHomolund Securig' Bubjuct ID Record of Allen I?mme Nam Fm! Muldl: Sn ?yc- {ml-n WM. Inna an: (?uunuy ?hum:de Puma Numhtr ml Camry of Lane I Hum . Waigm Ouml rmcu 67 190 In Wm Sun m1 BELMONT. NEW YORK, 1f813 . SCAR BACK . um mv. um "mm of Entry Pm?! Baudch DJ. Numb" raw! I i vomnl um ?Vi 1'7" was I Gas-Co? MAI QIWIMI Numb". rm. Cur. Hum ml Country of Pam-mm Imam HIM qr 189 Mm: MIME or Auim Imam Code x?A'Ia'wm Danwt 11/10/1001 Ago: 07/15/2011 07/15/2011 17:15 l'cly. l'wvim- mum ol?illn? AR Form [Tyne and No.) Lincd Cl Non Linn! LUMDA. ANGOLA NW 1mm Von ml Numb" Sun-15mm, Acumt Nam: Sun: In Em 8mm When WM A n! In mun [Saw mil Soci-I Secun'ly N- bu Lenph omm- In US A 2% ovzn 1 Inmuumlm I Criminal Recon] (rag None Know: Nun . Maw. mum-lay us ?no mum Rm. If Apmdm) Numb" n?lomhy or Mliov Cull-lam CONGO 7a I .Iml AMr-u. If Known uwh .md Mm?. CONGO 107151;??! I YWCI Monlw Wmeny In 0.5. Hal In Punk). Yes No 3mm Ouch Chm} Cab Wad-m Non. Claimed Nat. my. 213 Rum and ?mm 0.3? amnluyg: Type Sal-y Empbyod from/m NM Ht 6m: um" mom: an IIKIMDM 13m ?comm canon!) My . .ICONTINUID 0N 1?831) 0 n- nto.? Namuvv IOu?lnu [umuulnn undn whluh allcn wu Includt dmil: unl shown above reg-rain] vlomms wluvh mull." vlulnliun. Indium: mum: and mule of Io interior.) Lott Index fingerprint n, Imc. place and mun-m oflul any. at Illy "my. ml Right Index ting-rpriht Ann M. m? uh Iml nr cummumumn nmllun ova/5230? 6%elloimm (Slum-Ing Ipd of lnmi Dnmlumunt Rectivcd: (Suhjcu and Docummll) "(upon at 71?! Of?ccr. you on: ?13? 15' 2?11 mm? Dino-Ilium WPP Removal r? .m U.S. Department of Homeland Security - - Continuation Page for Form . 1213 Aliqn?s Name File Number Date BANENGA. Irene 07/15/2011 mime Event No: .Iarzs Neg . Previous admission number: I-94W 'Buttalo JTTF was not contacted. DISCRETION: No emergent circumstances in this case. COD Neg Neg Neg CLAIM Pos CPIC Neg Neg race Neg SECTION CODES 237elB Recerd'o! Deportahle/Bxcludable Alien: . . - ENTRY: Service-records and/or admission stamp in passport indicate that the subject was admitted to the 08 at Boston, us under the on July 22. 2005. The subject was authorised to remain in the 08 until October 21, 2005. BAMMNGA. Irene DOB: 11/10/1381 COB: Angola coc: France with French passport number was encountered at the Lewiston Bridge in Lewiston, NY on July 15; 2011 after having been retused entry into Canada. The subject had been refused entry into Canada - because she was not in possession of a yalid 1-94 from the united States and the last united States entry stamp in her passport was from 2005. The primary officer retained the vehicle keys.'deployed the stop stick and called for back-up. CBP Officers escorted the subject'tc the secure area. The traveler remained under CBP dontrol'until the inspection process was complete. . - . Parana! oversea: case Iljuzri; CRIMINIL RECORDI None found FBI was not contacted for record checks. raven/crass. The subject attempted to go to Canada to catch a tlight tron Toronto, Ontario to Amsterdam. She had remained in the US in violation o?.her status. The subject?s most recent entry to the 08 was on July'22. 2005 at Boston, MA under the (WT) with authorisation to remain until October 21. 2005. Subject had been staying with'her?nusbend 1?C?t.d .t Lynn, . I61. rrn#: 1024301956;; ed in 18318: YES 931#: .vI . -. .. .. hurl; Good ON PAGE) Signature Title I can nnlorcement gttiggr 2 Page; Pom Continuation Page (Rev. 08/0llo7) .. ?e vs. Dopartmontof Homeland Security Continuation Page for Form 1513 - - . (an Alion?a Name File Number Date amen, Irene 07/15/2011 Event No: - Medical issueet Congestive Heart Failure she takes medications to control her medical problcn.', . A current condition: Good - . Medications with the aliens: Subject stated_thst she has 6 bodicetions with her that she neods'to take every morning for her congestive.heart failure condition. .Pregnant at the tine ct encounter: ?no Previous treatment for mental illness: no. Telephcnio privileges provided: Inc. Subject was traveling with her husband and did not went to cell anyone at this time. . . . comm . 3-. . - COUNTRY: The Consulate was not contacted at the request of July 15 3011 by Detentioni Detention Renove1(BRO) was contacted at 1721 hours by CBPBO ammIMFn Deportation (Juicer [In-2r:- muzm contacted who authorized detention Spece?nt- the Allegeny County Jail 48? State Route 19 Belmont, NY 14813. Deportation attics: .mmunnm =dvised ISA would not ssaist in the transport to Allegeny County jail because it was after hours. capo CBPO transported_BAMBNGA to Allegeny County Jail at ZOQO hours. is and Petdownl lpbjeot wee given PATDOWN Search prior to transport to Allegsny_County J?ilr This search was authorised by SCBPO {nu conducted by CBPO end witnessed by case anaimvn The search began at 1958 hrs, ended at 1959 and returnsd,with negative results. . . AUTHORIZING OFFICER: CBP Chief rs. subject issued Rencvel. under Section. 217 or the 1m. 'm subject was Sound to be.renevable iron the United States under Section 237(c)(1)(3) of the run. The' I subject was detsined st Allegheny?Ccunty Jail pending France. ., worcmt Olticer i .. ,l 3 ?Pages. l?onn H) I. Continuation Page (Rev. 08/0l/01)' . - Record of Sworn Statement In (m 0.8. Depertmentef?omelend Amati? Proceedings onlceanmsrou, NY (gunmst aumi pos Statement 5y: 1m BAMENGA In the 13m BWOA neuron: . Date: July 15, Before: Enforcement Officer In the ENGLISH leaguege. (Rene end . Interpreter: - Interpreter employed by: a I ot?eer of the United State: Department of Homeland Securlty, authorized by law to admleleter eetht end take tettlmony In cennectloe the enforcement otthe Immigration and Nationality lm otthe United-States. ldetlre to ?it your were YOUR STATUS IN THE UNIT BEES. Q. Are you contortable conducting this interview in the English Languageyou understand what I've seid to you? -A. Yes. - . 0. Do you have any questions? A. NO. Q. Are you willing to answer my questions at this time? to no you eweer or attire that all statements you are about to make are true and (A - complete? A. Yea. a. What ie your true and correct name? A. Irene Bimnge. O. neve you ever used .any other names? A. By husbands name Zikianda. Q. Where were you born? A. Luanda Angola. . Q. What is your date orbirth? 11/10/1981. . . Q. Have you ever used a ditrerent date of birthwhet country or countries are you a citizen A. Frence. . . - .0. Do you claim to be a United States citizenlewrul permanent resident of the United States, also known as a, green card holder? . A. No. - What is your marital status A. hurried. Q. Where 'was your nether born? A: Angola. 0. me ie your mother's citizenship? A. French. - - . 9. Does your another have any claim to United states, citizenship(CONTINUED ON 1-831) . Page I off_ - . 1-877 (kw. 08/01/07) -1 f. Allen '8 Name Continuation Page for ?Fonn 0.8. Department of Homeland Security IRENE BWNGA File Number . Date . - July 15, 2011 Event No: . a; Doee your tether have any claim to unitedstatea citizenship? - 0. no you remember. where you entered the Unitedstates on yourlast entry? . A. I came to see my husband and be with him to see his family because we just got married.' Q. Where was your tether born? A. Democratic Republic of Congo. . I 4 9. What is your father's citizenship? A., CongoDoes your tether have Immigration status in the United~8tatesyou have any childrenWere you retueed entry into Canada today? A. Yea. 9.,What has your mode or transportation? be Our. . I Q. Why were you refused entry into Canada? A. heceuee I_overetayed in the united States.? 0. Who is traveling with you today? my cousin and husband. - - - Q. Why were you all attempting to enter-Canada? . - A. I wanted to visit and depart from there to Amsterdam. 0. how long have you'been in the united States since your last entry? A. Since 2005. 6 years. . - Q. Do you remember the date you last entered the united States? ?0e . . Q. Do you remember how long you were authorized to remain in the united States on your last entry? . . - ?e 3119251183 A. Boston. MA. 9. According to our records, -you last entered the' United States by air at Boston, In on July I 32. 3008. You were?edmitted on that data into the me. with authorization to remain until October 21, .3005 as a Visa Waiver Visitor tor "Does this sound correct? - A., Yes. . 9. What was your purpose for entry into the united States on July 22, .2005?? Q. Did you plan on leaving the United State's after you entered on.July 22, 2005? A. I did. .. - . I 0. have you ever traveled outside the United States after you entered on July 22, 3005? Re . . . 9. have you ever applied for any benefits with the Department of Homeland Security or the - . Agency tormerly known as the Immigration and Naturalization Service that would allow you te' live and/or work in the United States? . . I applied to extend my stay in the united States. 0. Was that application approvedHow come you did not leave the Unitedstatea after .that application was denied? A. I wanted to try another option and ask tor a different vise. . . Bee anyone ever filed any applications with the Department of Homeland Security or the Agency tormerly known as the Immigration and Naturalization Service that would allow you to live and/or work in the United States? . - A. Yes my hueband i'iled an application for me to live here. 9. Wu that application approved? . . . ON me PAGE) . 6 Title L. .. . A Slgnature .. can mtorc?t orgigg I . _v Page: Perm 1-831 Continuation-hie (Rev. M1107) . the united States within these 10 years you'can'be charged criminally pureuant_to a use, initialised each page of this statement (and the corrections noted on page(e) I to on us. Department of Homeland Security - Continuation Page for Form 1' ?77 Allen's Nome IRENE BMNGA Duo . July 15.? 2011 F?oNun?wr A. Yep. . . . - a. ?ave'you ever received authorization to live and work in the United States at any time eince your entry into the united States on July 22, 2005? 0 no. I . Q. Did you work while you were in the United States? I NO. I . 0. How did you eupport?youreelt while you were in the United States? a. My hueband eupported'me. Q. Do you understand'that by not departing the united States on October 21, 2005, you violated the terme- of your entry and are removable from the United States? I A. Yea. - Q. Have you ever heen_arreeted tor any crime, anywhere in the world? . No. i D. Becauee-you appear to have'overetayed your authorization to be in the united states for a? period ed 6 years, you appear to be removable from the U.B. pursuant to Section 217 o: the Immigration and Nationality not. Because you applied for entry and were admitted into the v.9. on July 22, 2005 under the Visa Waiver program, you are not entitled to a hearing or a review. no you~underetand-thie? - . a. Yea. . you underotand that.YDu will require a United states visa in order to enter the united Staten at any tine in the tuturet - reeult or your removal tron the united States under the Visa waiver program, you are barred from re-entry into.the united Staten-for the next ten years. If you attempt re-enter. 1326. a. Yee'. - - . 9. Why did you leave 'your home ccuntry and'move to the United States? a. I wanted to he with my husband. - .. 0. no you have? any tear or concern about being returned to your homecountry or being removed tron the united StatesWould you be-harmed reaidencet I A. No. 0. no you have Do you underetand_thie? i it you are returned to your home country or country or last any ?uootione or is there anything else you would like'to add? I have read (or have had read to me).the foregoing statement concieting o: -4 paged. 1? attire that the anewere attributed to no herein are true and correct to the-SEaE-Et-ny- knowledge and beliet'and that this statement is a full. true. and correct record o: my guertidning by the above-nhmed officer of the Immigration and naturalization Service. I have . .- .- . . .ue-ee . . . (comment on were men). can ?adamant Onion: 3 . Pages ?I'orm 1-83.! Continuation Page (Removal/07) U.S. Homeland Security Continuation Page for Form 1'8? Allen's Name File Number . Date IRENE July 15, 2011 _v . Event No: Bignntun of alien: Lawi L?ewiston, NY on July 15, 2011_ Bub-crib?! and sworn (Signature 0! Immigration Officer) Signature Title Chile-r 4 of _4 Pages Form 1-83l Continuation Page (Rev. 08/0l/07) Statement 1: When Consular Noti?tion is at the Foreign National?s Option As a non-US. citizen who is being arrested or detained, youare entitled to have us notify your country's consular representatives here in the United States. A conSUIar of?cial from your country may be able to help you obtain legal counsel, and may contact your family and-visit you in detention, among other things. If you want us to notify your country's consular of?cials, you can request this noti?cation now, or at any time in the future. After your consular of?cials are noti?ed, they I may call or visit you. Do you want 'us to notify your cOuntry's consular of?cials? Please Ciro/e one: "yes" . Date: July 15, 2011' Date: July 15, 2011 Signature of Witness Discretionary Authority Checklist for Alien Applicants Applicant?s Name: ?Tens Bamenga . Port E901 . Date of 3mm [11t1ot1ssr . A Date of Action; [07/16/2011 - I Citizenship: . Passport] 1) Identity I Citizenship: 1 2) Age, Health and Notoriety of Applicant: Identity suf?ciently determined: Yes No Are age or health relevant factors? Yes Ne .Citiaenship suf?ciently determined:Yes No Is the applicant a public ?gureCongressional or media interest? Yes No Discretionaty authority should generally not beexerct'sed Ifidentit?y or citizenship can not be established. REMARKS (to Include origin, destination and intended length of stay): Subject was refused entry into Canada was processed for visa' waiver removal because she is an overstey. . 3) Intended Purpose 4) Database queries: Emergency: - Yes BN0 TECS (Subject Query): POS NEG- . Medical: - - Yes Nam NCIC (Match to subject): POS NEG (m I Pleasure: . Yes No CIS CLAIMS: POS NEG Business/Official: Yes No a CCDI: I POS NEG - 1 Other(Super query): POS NBG- . in the rentarln sectionbelow: indicate the speci?c violation?r) or'grounds for inadmissibility. The queries listed in number 4 represent the minimumqueries that. should be conducted. (to include ENFORCE Event ti and FIN If applicable): EVEN - I . - - 5) Previous Immigration Violations.orlnadmissibility: 6) Nature of lnadrnisslbility: . Previous Immigration Violation(s): YesDNo Minor Technical: Yes No Previous Inadmissibility: . Yes No Criminal: . Yes No Previous. Bene?ciary? of Discretion: Yes No National I Homeland SecuritySubject has been living In USA tor the past 6 years as an overstay 7) Threat posed to the United States: Discretionary authority should generally not be Terrorist Af?liations or Ties: Yes No exercised (fa threat is posed to the United States. Criminal History; No REMARKS: . . I ,1 . .,ReoentlSigni?cant Criminal Threai:Yes No . . . LR Likely to Add to Illegal Population?Other Credible Threat: Yes (Last Updated 05/08) 2 8) Other Factors to Consider: Legitimate reason for entering the United States: .Yes No Documentary (Passport I Visa) de?ciency only: Yes No Credible claim ofo?icial misinformation: Yes No Relationship to a U.S. employer or resident: Yes No Intent to circumvent admissibility requirements: Yes No Misrepresentations made during processing: Yes No Minor children accompanying or already in the United States: Yes No Unaware of Visa voidanee or consequences of VWP overstay: Yes No Relief available through the parole or waiver process: . Yes No REMARKS: Visa waiver removal Examining car Of?cer: I Applicablc_0round(s) of inadmisslbility: .Applicablc Discretionary Action(s): Withdrawal of Application for Admission: -Yes - - . . Parole to Depart Foreign lVoiuntary Reium: . Yes Length of parole sought: Humanitarian Parole: Yes Length of parole sought: Waiver of Passport Requirement: - Yes Period of admission sought:_ Waiver ofNon-lmmigrant Visa Requirement: Yes - - Classi?cation: . - Period of admission sought: Waiver of immigrant Visa Requirement: Yes No - Waiver of processing fee (if applicable): .- Yes No - .. Deferred inspection: . Yes No a Deferral Period and Location: Supervisory CBP Recommendation: Approve: I Yes No Disapprove: Yes No uni?cation for recommendation (to include alternatives, if disapproval is recommended): Reviewing 2? Line Manager: - - I Decision: . Approved:m . Disapproved:D - Justi?cation for decision (to Inciude?iinal dispositioni ii? disapprovedi.(Lsst Updated 05/08) use. 102.3013? and.? In U.S. Department of Homeland Security Withdrawal of Application for Admission/Consular Notification Basis for Aciiomchack all that apply) - File I Date: 07/15/2011 Application for Admission Withdrawn - Canceled VWPP Refusal Ordered removed (inadmissible) by Immigration Judge -Section 235(b)(2)(order attached) [3 Ordered removed (inadmissible) by DHS - Section 235(b)(1)(order attached) Waiver revoked (order attached) Departure required (8 CFR 240.25) (Form 1-213 attached) Notice 10: American Consul vans, rwca From: anon emu, try as 1030:. (Lamllon) (loco/Ion) Name (FAMILY. Given. Middle) names, Irene I Chintan Count'rx of birth pate of birth . 11/10/19ai Complete foreign addrm Address Airlinale?l of arer Date of arrival 07/15/2011 1729 Vila numBor. type Date. place of visa issuance Social Security Number I martini iinciudc all pertinent facts concerning denial of application for admission. including use ot?eltered. counterfeit or fraudulent documenu): Right index Finger ENTRY: Service records and/or admission stamp in passport indicate, that the subject was admitted to the US at Boston, MA under the on July 22. -2005. The subject was authorized to remain in the US until October 21, 2005. - BAMENGA, Irene DOB: 11/10/1981 COB: Angola COC: France with French number? was~ encountered at the Lewiston Bridge in ?Lewietoni. NY ori"Udly? 15, 2011 after hav ng een refused entry into Canada. The subject had been refused entry into Canada'because she was not in possession of a valid 1-94 trout theUnited States and the last United States entry stamp in her passport was trout 2005. The primary otticer retained the vehicle keys, deployed the stop stick and called tor beck-up. CBP Officers escorted the subject to the secure area. The traveler remained under control until the inspection process was complete. . . . (GOMTNUED ON 7-831) Continue on reverse or attach aanareta sheet II needed. .: CBP Enforcement Office Name and Title of O?'tcer (Print) Signature 0 Of?cer Form l-275 (Rev. (Will/07) TO BE COMPLETED BY ALIEN WHEN APPLICATION FOR ADMISSION l?underatand that my- admissibility is questioned for the above reasons., which i have read or which have been read to me in the ENGLISH language. 1 request that i be permitted to withdraw my application for admission and return abroad. -I understand that my Voluntary withdrawal of my application for admission is.in_lieu of a formal determination concerning my admissibility: . [El by an immigration of?cer . in removal proceedings before an immigration judge Data - . . INSTRUCTIONS For withdrawal procedures. ace inspections Field Manual Chapters 17.2 and 17.15. Aliens who appear inadmissible pursuant to of thelNA who elect to withdraw application for admission may choose at anytime to appear before an judge for a hearing in removal proceedings. Aliens who appear in admissible pursuant to section 235(b)( l) or inadmissible puisuant.to.8 CFR 217.4 arenot entitled to a hearing before an immigrationjudge._ . - a vlsa is canceled pursuant consular-iasued Border Crossing Card is voided under authority CFR forward original of 1-275 to consular post which issued the canceled or voided document. . Any lifted document. - Relating form .1 -2l3 or 1-862 (Notice to Appear) Relating removal or waiver revocation order A ny relating memorandum report or sworn statement -..-. . .- -..-. . -..--. Form 1-2'1slnev. Will/07) A U.S. Department of Homeland Security . Continuation Page for Form ?75 Alisn'a' Name . Date Irene I I. . July. 15, PRIMARY CBPO ?rCV?uou. Admission marl (huh: CRIKINAL RECORD: None found . . - - Buttelo ms was not contacted.- . 1'31 was not contacted for record checks. mesa/omen: The subject attempted to go to Canada to catch a flight tron Toronto, Ontario to Amsterdam. the had remained in the US in violation of her status. The subject's most to the US was on July 22, 2005 at Boston. MA under the WP (WT) with authorisation to remain until October 21,_ 2005. Subject had been staying with her Husband located at ,Lynn. MA. DISCRETION: No emergent circumstances in this case'. Alien booked in nus. res ears; - . slut: 1024301856 HEALTH: Good . . .. ,Nedicelissuesu Congestive Heart Failure she takes 'medications to control her medical problem. I . . current condition: -Gccd . . . . - . Medications with'the aliens: Subject stated that she has 6, medications with her that she, needs ?to. take every morning for her congestive heart failure'condition. - Pregnant at the time ct encounter: no - Previous treatment tor mental illness: no. - Telephonic privileges provided: no. Subject was traveling vith her husband and did not want to call anyone at.this tine. .. . . comma NON-mgropy son by cease: Detention: Detention RenovaMBRO) was contacted at 1721 hours by CBPBO we. mam Deportation Otticer contacted who authorized detention space at the Allegany County Jail 4004 State Route 19 Belmont. NY 14813. Deportation Officer advised In would not the transport to Allegany'County jail because it was atter hours. (3390 - transported semen to Allegany County Jail at 2000 hours. . The Consulate was not contacted at the-request cf amen on July 1.3 mu?n, Petdowna .Bubjeot was given a panacea Search prior to transport to Allegany County sail. - This search was authorized by BCBPO conducted by CBPO mm;- Ime and witnessed by - csroM The search beganat 1958 me, ended at 1959 hrs'and returned with negative .u-n?nu - O'uvmm - . . .. caucus esp can: The subject issued a WP Removal. under Section 21.7 of the INA. The subject w'aa. .. (commas on mar Pace) . . - . Tide. . .I - can engagement Guisg . . . - 3 Pages Form [-831 Conlinuslion Page (Rev. 08/01/07) 0.8. Dopartmonl of Homeland Security Continuation Page for Form 1375 (m Allen's Name Date Irena July 15; 2011 sound to be removable grow the United Staten under Sectioh 237(a)(1)(B) o: the INA. subject was detained at Alleghany County Jail pending removal to France. The - rm?_?mo~ u-o-p.--onc I Signature Title cm" intercom?: 0:21.60: 4 Pagoo' Continuation Pose (Rov. 08/01/07)? m-l INFORMATION FOR TRAVEL DOCUMENT OR PASSPORT 07 1.5mow" BY . - . ?mam a. mm o. mormm 11/10/1981 - 1.11m. 11/; moon 7. Halal-tr mo HAIR 00me mason some 67. I 190 81.: amt BACK NIMIIT moi any TO PLAOI 011mm . o. ammo: mo ammo? op or= sum-c FROM THIS man om 10. IF I. DIFFERENT FROM WUNTRY OF BIRTH. WM. IF NAM IN ANY WUNTRY. SHOW DAT-E AND PLAOB OP NUM 81' ATE HOW WAD AGIUIREJ. - u'moo 11. LOCATIONS AND DATE. (Yams) OP ATTENDANCE 1a.. NAMES. ?uc?r AND Amuomcl . OF FOREIGN INOUJDE DA AND ATURB OF ANY OF FOREIGN OOHOOLB . - REUGDUB OEREMONY WHICH MAY HAVE BEEN 11 a1 No .0 0 Not; Applicable - II. FIRMANINT OP unusual-1w madman) 4 OOUNTRYOPWTFOREION RESIDENCE ?hadn?t-u. dblmuhmhn) 1'5. mm on mo main - I am; 0? 3mm wro uurrao cram 1/15/2011 1729 W?egme 32m .. ?Wow?mmw I . m"vn." was rm 1::211'0 'ga' 65 em' "o'nTl?vas?Umuvg. new? as . I 51'? 'Al'mngouum" no no. arm: Haw?. wu" m3 ?wuss-153mm '11- we sonata 'A'maouzumumf' m' 6! 0633mmmoo Appltooble - 2 mm: ma okra op awn-1 runs or 3mm IIJI173C I mac AODHIOO 19. MAIOIN BIRTH - PLACE OF BIRTH mama-.1on I N. NAME. HILATIONBNIP. AND ADme RELATIVES ABROAD 5 lot: Applicable PREVIOUSLY. mono ammo . not. 3,91,16,31. ON .7 VIA (M (M (emu . - a. OI TI IN PRISON OR APUBLIO IN THE COUNTRY OF A NATIO SUDPLaes - w" .r I Not Applicable II. M. am. AND ADDRESSES OF ALL MILDREN 38. IF NONOANADIAN TO CANADA ONE DATE AND PORT OF ARRIVAL IN AND WE OF VBOBBL I'om (aw. 0144-01103. Duponmgm of H??chnd Security 11 15 TECS II - 1-94 DISPLAY 090611 DETAIL VIEW ADMN REC 001 OF 001 NBR :1 ADMISSION CODE WT VALID TO 10212005 NAME (LAST, FIRST) EAMENGA, IRENE DITIZENSHIP DOB 11101981 GENDER MISC KSSPORT NBR ER mr1 COUNTRY OF RESIDENCE FR FRANCE ALIAS LN ALIAS DOB ALIAS FN ALIAS COC ARRIVAL INFORMATION AIRLINE AA AMERICAN AIRLINES FLIGHT NBR 00147 ARRIVAL DATE 07222005 VISA ISSUE CITY VISA ISSUE DATE PORT OF ENTRY BOS U.S. ADDRESS- CITY LYNN STATE MA INSPECTOR TRAVEL MODE AIR COMMENTS STATUS CODE A DEPARTURE INFORMATION PORT DEPARTURE DATE STATUS CARRIER FLIGHT NAME NO MORE DATA AVAILABLE J. arm. .- Security De? - Vehide Ut?in?on Log Wand-Bmdal?mtcc?om Maka?Mcda-l: (5,25 Magi?; Program; Ending Date Time (100 i 0'7 [12: 3300 /PFZIL Tr~r5o-1 337G911 I37QLS- 9c 132.194930 1 . 004 lict ?01 "saws 'zzyz- l71r?l 16:. 3Q km??xk I - -33. MIL: 17. {gm 1310 13BEST COPY AVAILABLE Vehicle Log Date Time 7.61; Gila/9, 1505? {520 ?I?L-Zpii 0190 0309 0342'? 053?0 ?(905 0954?? o7_ r120 (:25 /l 3 L9 to ~u [[029 Ito} 411' my nix BEST COPY AVAILABLE Visitor Name (First Middle Initial. Last; Badge Number A Vehicle Remarks S. ture a geney Plate NO- (Name oflnmate etc.) {3/0 1 0% ugl?f 77? r. acq- OHK OFF (-1.) DHS Pl,? 36?; OIL Cal/Vol 196.- IbHs aux/{LT (zen-mo wLSo u? 1103 WLSD '25 FR ORDER TO DETAIN OR RELEASE ALIEN TD: (NAME and Person In Charged . . can, m? - 1.4813 hr Flouo Detaln Balsam . Date 11m. . - 07/15/2011 01:30pm Nm Nlon Fl 1:03Evan: No: A90 Duo! BlM?Mo.Day.Yr.) Sax Mummy '20 13/10/1931 ANGOLA Nltun o! Danton 211 mu mm: 60min? 8oue Minn uh. uh.- nidicpuona .cont'rol' hot. prubicn. lubjut hu nae-non with hot. 11:19 . O?lco car max-omen: qtucor- sw/m - . UNITED STATES DEPARTMENT OF HOMELAND SECURITY In?! I. i A 0? In dat- 1.non-?im- II Booking Obsewetlon Report Alienany County Jail day's Date: 071102011 nmnte Middie At?x Sex Race Birth Date RAMENGA IRENE 0?45. 05-15797 . Pomean oelli Security. County! 11-804 A check merit indicate. 0 response. while unchecked mom NO Order 0 10 ?1 Booking Observation Questions AnmnareY-Yee. ti orBIenk-No, R-RefmedtoAnewer smug/HF FOLLOWING HEALTH pkg? - [?2an 9am enema - . ,y p.3\ Emu? wigsng 7 I JIEB-FOOD OR MEDICATION ANY OF THE FOLLOWING WITHIN 0 M03. Regen 2 NIGHT SWEATB. FEVER. WEIGHT LOSS OOUOHINO UP BLOOD HAVE YOU TESTED POSITIVE FOR BEEN IN LAST 8 MONTHS ANY INJURIES DURING ARREST EVER CONSIDERED OOMMITTING SUICIDE Jul.28. 20? Allegany County Sheriffs Office Booking Observation Report Allegany County Jail Today's om: 0711612011 rinmm infatuation Lu! First Middle Mint 89:: Race Birth Date i BAMENGA IRENE I Booking! 08-16707 Permanonw Booini 800mm? Gouniyu 11-604 No?: A check man: Indicates a YES mponoo, while unchecked man: No Booking Observation Questions Answers are ?You, or Blank 9 No. a Refund to Ansmr Ordor Question YINIR Brief N009 oovou HAVEOREVERHADANYOFTHE FOLLOWING HEALTH commons? 1 DIABETES a EPILEPSY 3 memes-moo on MEDICATION iramadona 4 museum on ANXIETY 5 ANY OF THE FOLLOWING WITHIN 0 M08. 0 NIGHT swans. FEVER. WEIGHT LOSS 7 UP HAVE YOU TESTED POSITIVE FOR 118.? 12 390 BEEN HOSPITALIZED IN um 3 MONTHS Io ANY ounma ARREST 11 EVER CONSIDERED COMMITTING SUICIDE No. 95I6 P. 28 ?1.28. 2011 Allegany County Sheriffs Office Booking Observation Repatt Allegany County Juli Today'c Date: (if/1812011 -inmnb information-- I Ln! Flu! A?ix Sex Race Birth Date i Name BAMENGA IRENE 3 1111011931 i Booking! 05-10797 Penn-non? Buouniya Count? 1. Note: A check mark lndicaioo 3 YES maponso. while unchecked moans N0 Order Booking Observation Questions Answers are Who. or Blank - No, to Annular Question ARE YOU ON ANY MEDICAL-RELIGIOUS DIET BODY DEFORMITIES-PROSTHESIS DRUGS OR ALOOHOL WITHIN 48 HRS OFFICER OBSERVATION AN ASSESSMENT UNDER INFLUENCE ALCOHOL OR DRUGS INJURIES OBVIOUB PAIN BLEEDING RISK OF SUICIDE OR ASSAULT NEED TO BE ISOLATED-SEPARATED ILLNESS OR NEED FOR MED REFERML NEEDs SPECIAL WATCH B?af Note lots of them No. 9516 P. 29 Ju .28. 2011 Allegany County Sheriffs Office No.9516 P. 30 . Booking Observation Report Allegany County Joli Today's Date: ammo" -inmaioinformaiion-? Loot Middle Af?x 89): Race Birth Date Name BAMENGA - 1111011981 . Booklng? 0515797 i i Social homily! I Now: A chock mark lndloahl 0 YES response. whllo unchecked moons NO Booking Observation Questions Amara aro YaYoa, or Blank No, a Remand to Answer Couruyo 11-804 Order Question YINIR Brief Note 20 ANY FURTHER ACTION TAKEN 27 ANY HEALTH 23 ANY MEDICAL ALERTS ?uh nun-nun - urncso Inrirmare 5852599752 HISTORY AND PHYSICAL EXAMINATION PATIENT NAME: Irene Bamenga INMATE NUMBER: 11-604 - i 3 DATE: 07/1311 1:03: 11mm . REASON FOR VISIT: HERE FOR A HISTORY AND PHYSICAL. PutNIodIcal History: CHF, HTN, anemIa PAST SURGICAL HISTORY: rrIght lung MEDICATIONS: ASA: spironmactone. IIsInoprIl, laslx. dIgaxIn. carved?ol ALLEROIES: hamadol . SOOIAL HISTORYTOBACCO: denloo ALCOHOL denies ILucerRues: donIoo A1118: Marrlod - REUGIOUS AFFILIATION: CathoIIo LEVEL OF EDUCATION: - PCP: None - SUICIDE . . - MENTAL HEALTH REFERRAL: No OBJECTIVE: GENERAL APPEARANCE: 29ylo black female appears statedage . NQ V8: Wolght: 208} SKIN: with good color and tumor. 'No rashes. lesions, or soars noted HEAD: NCIAT EARS: Bilateral TM poorly gray good re?ex noted EYES: Roporlo normal vIolon PERL. EOMI. Salem and conjunctivao cl?oar . MOUTH 8THROAT: - . No orthoma or'oxudatos noted - - - Supple and aymmotrlcal. Trachea Io mIdlIno. Thyroid Is smooth, non-enlarged and wItI'Iout nodules. No oervloal Iymphadenopathy appreciated. No carotid bruIta aucultatad. Thorax Io symmetrical. Breath sounds clear . 1?00 and Normal 31152. PMLatSth No 83/84. murmurs. lube, oIIoks or gallops appreciated I Flat, soft. non-under active howelsounds No organemegaly appreclated - EXTREMETIES: - Upper and lower extremities WNL - OUIRECTAL: Defomd . NomlcarvIcaI,moraeIc, and normal lumbar splna of motlon. No aoolloaIa or kyphosls noted. - . General .Bohavlor..levol ofconsciouoness, thought content and emotional sta'tus WNL .CranIaI nerves are grosst Intact Jul 27 11 ovzsaa - HCSO?InPirmara -.- 5552559752 -p;1 MEDICATION LIST Inmate Namarlrend Bamenga Allergies: Traniadol DOB: 11/10/1081 . DATE - START STOP 7/18/2011 ASA 81mg daily 7118/2011 Splronalactone 25mg BID - 7/18/2011 Last): 20mg dally - . 7/18/2011 Dlgoxln 0.25mg daily 711322011 Carvedllol 20mg daily 7118/2011 Llainoprn 20mg daI/y 7/18/2011 ??mx?wiimiin? Ivfw - ?Lu? you-- I . nun-no'to-onn-u? I I 1 I Jul 27,11 07:59a HCSO Infirmara 5352589752 p.2 PROBLEM LIST I Inmate Name: Irene Bamahga . .- DOB: 11I10181 tramadol lnmate?: 11-604 HTIWT: who? PPD: Previous positive Social Security Number: PCP: Nonfs'e Insurance: Ncno . - Special Needs: None DATE PROBLEM TREATMENT . 7/7/2011 . HTN ASA 81mg daily' CHF 25mg BID Anemla .Laslx 20mg daily Digoxin 0.25mg daily Carvednol 20mg daily Lislnopr? 20mg daily .1: "Jul a7,i1 cameo acso Infirmary 5952689752 MEDICATION RECORD Pagolof . (See Instructions on mass) Burt! Mutilation Ordn- Itop. Tylenol to 61:13 pm Only give unequemd BC ASA 81MB . IPO DAILY Time 1 PO BID PO daily powiy P0 daily 20mg . PO daily 71819202122 718192021 718192021? mm:ng BEST COPY AVAILABLE nl? Homeland Security O?ice and Removal US. Immigration and Customs Enforcement Facility Liaison Visit Checklist Local IGSA CDF "name $1133)? ?(Ev-Viv VLJ - Nani. Oate A w. V. Arrival at c, - Departure Tune 'Total Facility Count ICE Facility Count DFTS Count - ICE Detainees in SMU's Admin. Seg. (-3 K25 Detainees in SMU's Disc Seg I TIEE'bhi?inEcs in lnlirmary . lT BMW "m . .. _s Was DETS Count Verified I Reconcrled? Comments: tLIst nn bact- ol checklist) Yes No . "512' Good Avg Poor Cortiriienls: General Facility Sanitation oil-?: Conmen?s. Observations Salted ?001 auc- ubiu kl i (Check Content lrlunnea Valium Detainee Observations [3 (Check all that apply) . was ow?x?m? can?mats; Medical Stall Observations sun? [m uh i (Check lg Forwarded to tour - . 3 "m Comments. ?Hammond. tout-cm Phone oystem F. and whorm (Cempuinls IRosolutncnExc Good Alla. Poor Comments ?memes-S -. D. I 690d Ayg Poo: Conunents. SMU Observations l} . '_(rnettls served?recrealionyis?crs,etc) mun? Exc Good Avg Poor Comments 2 General Grievance Observations 7- 9, (Procedures Doing lollowed. etc i 135;}; "i . Total Number of Scheduled Interwews? (Us! all names onback . S, .1 s- _Cagd??th .. Interviews? (Us! names on back of checklist) Total Number of Unscheduled and lnlormat BEST COPY AVAI LABLE BEST COPY AVAILABLE (\{bu-?val u' ?hwy - - ?1 ., (cwk a- 112(ail I ri?aut) wM?m fr. ?my; rmqi ?r?.ll Souk?3me Lon?; abuts 74 2? 3 3. twiluzij? p?Lo; \w I . I C?CERTIFICATE OF ISSUANCE OF IMMIGRATION DETAINEE HANDBOOK On ire?me Date Name? did receive an immigration beating Immigration Alien Number Detainee book while detained at the?jeqa . Falzility Nanle I understand that if I have any questions concerning my immigration case that I may direct them to the immigration of?cers who visit the facility each week, or by writing directly to my assigned deportation of?cer. Date 7 ~Lj?tl Date Certi?cation to be ?led in detention file. Immigration and Customs Enforcement Personal Propertv Notice You are currently being housed at an Immigration and Customs Enforcement Non- Service Detention facility. Any personal property and/or valuables in your possession at the time of arrest will be secured at this facility. In the event the facility is not willing to accept your prOpert it will be secured by Immigration and Customs Enforcement While in custody your pr0perty is subject to the following rules: - will secure a maximum of one bag not to exceed forty pounds. 0 will secure your prOperty and/or valuables for thirty (30) days after you are released ?om custody. If your property and/or valuables have not been picked up within thirty days of your release from custody, they will be declared abandoned and disposed of in accordance with the ICE Detention Standards. 0 You may designate a third party to receive your property and/or valuables in the event that you are removed from the United States or released from the custody of ICE. In the event that the third party wants to pick up your property, they may contact the District Of?ce at (716) 551-474] and ask to speak to the Property Of?cer in order to make the appropriate arrangetnents. I, e, bearing Alien Number - - acknowledge receipt of this notice and designate the following third party to receive my prOperty in the event I am removed from the United States or released from ICE custody: Name: Address: 747-? Date 7~l7~ll Date ?73 DETAINEE I SITATI ON WORKSHEET Pursnant to the Detention Standards of the Bureau of Immigration and Customs Enforcement (ICE) of the Department of omeland Security, ?Federal detainees must have the ability to communicate with ICE personnel and/or make written requests to ICE stafT and receive an answer in an acceptable time frame?. In an efTort to comply with the above mentioned standard, we are requesting that facilities housing ICE detainees supply said detainees with this form in order to initiate communication With ICE staff. 'lhe standard further requires ICE stafT to make weekly visits to facilities housing ICE detainees. DATE OFREQUEST: 74614 FACILITY IAiiQ/Qoen??It Gee/n+7 tier NAME :?Am 8va Irene. Fl FILE A anneal REQUEST Que-54w 5 DATE OF REPLY RESPONSE VISITING OFFICER DATE: Forms should be collecte rom ia011ity when performing the visit and forwarded to the case of?cer in the event that an .answer cannot be supplied by the visiting ICE staff member. Wheii completed forward this form to the Buffalo Field Of?ce for ?ling. ALLEGANY COUNTY GRIEVANCE RECORD FOR GRIEVANCE DATE INMATE WHO DATE WHO NOTES NUMBER GIVEN A PICKED UP (7/103/ Cy/d/H par 70 3:10 6 ?11- ?f/mm {Wu Gil-03? 6/93/11 ?an-?d or) 6799/? 611- a? ?1 .f?Z/a/u 752.2 35? 7I/9/u on 7/4/0 67M 1% 1? 6mm! 7/ "7/13/11 F5044 (/1-022' O4 7/30/11 G'xl'oQG? Erma; an 37qu 6?4"6 37 Emu a? '7/21/u C77. (34/ I 3770/? BEST COPY AVAILABLE Vehicle Log T. . . - Remarks . Date lm Name Badge Agency Veh'CIe '?l'g'nature IN OUT Number Plate N0. (Nameoflnmateetc:03; 30 00 7h 7/12/ 1/ mo g, [luff-1r [lnmc BEST COPY AVAILABLE Page 1 of 2 From: ., Sent: Wednesda Jul 20 2011 12:53 PM To: Cc: Subject: FW: females for removal by ALB next week Importance: High Attachments: image003.jpg; image001.jpg Pick both females up at Allegany on Thursday 7/21, cash checks, meet ALB at exit 36 (1200hrs). Start at 070hrs. !uperv sory Enforcement Agent Department of Homeland Security (DHS) Immigration and Customs Enforcement (ICE) Enforcement and Removal Operation (ERO) Buffalo Field Office (0) 718-843 v10 3. {i3 From: [innit thuT-c Sent: Wednesda Jul 20 2011 11:19 AM me Subject: females for remova AL next week Importance: High Guys. We have two detained females out your way that we?re going to need to move east for removal next week (Tue. the 26th and Thu. the 28m): co. JAIL Mcase) ALLEGANY co. JAIL 7/26 removal: 7/28 removal: lrene BAMENGA, If possible I'd like to get them transferred with cash for their removals. I?m not sure if the jail accounts of?ce can do this at release. or if the iEA's picking them up can go through a drive-through at the bank the jail uses after release to get their checks cashed. i've got no problem with backing the meet up a couple of hours if we know ahead of time and that?s the plan. Let me know if you can help us out with this and when we can get the bodies moved on/before Monday. Thanks, Supervisory Detention and Deportation Of?cer ll Senior Firearms Instructor Enforcement and Removal Operations Buffalo Field Office/Albany sub-of?ce Ph. (518) 43l :Iiflx. :m Fax (5l8) 431 new The mission of 's Enforcement and Removal Operations (ERO) is to identify. arrest. and remove aliens who present a danger to national security or are a risk to public safety. as well as those who enter the United States illegally or otherwise defy the integrity of our immigration laws and our border control efforts. ERO upholds America 's immigration laws at. within and beyond our borders through 8/23/20] 1 Page 2 of 2 efficient enforcement and removal operations. Warning: us i . -- OFFICIAL USE ONLY It contains infor I . -- . exempt from public release under . a flnformation Act (5 U.S.C. 552 . ro ed, stored, handled, transmitted. distributed. and disposed of in accordance . m; --snu relating to FOUO information and is not to be released to the public or other personnel . - - . - a valid "need-to-know" withou - . a - lof an authorized DHS of?cial. No or - - ould be furnished to the media, either in written or verbal form. 8/23/20] 1 . - - - ?mm?"mun - ORDER TO DETAIN OR RELEASE ALIEN To: (NAME and TITLE of Person in Charge of Facility) one (Name of Facility) Allegany Please nmiu Date Time 7/21/11 '_Name of Alien BAMENGA, liene [Tye Date of Birth (MoJDay/Yr.) Sex Naiionality Foreign Address 29 11/10/1981 France Nature of Proceedings Removal REMARKS: Being removed via Albany Of?ce -. Title Office BUF STATES DEPARTMENT OFJUS?I?ICE-lmmigration and Naturalization Service Ju .28. 2011 f?\gany County Shariffs Office No.9515 9. 11 Release Receipt 'Ihxifl Max:718 Mogany County Jail 07002011 14:00:37 1 Ilillifl IlilliTIC BAMENGA, IRENE Booking Number 11604 oneotmnh: 1 Location Cash Amount $0.00 Check Amaum $12.70 Tomi Released $12.70 Check lnfonnatlon: jlli)? jL?u? Memo 'z ele ICE Common! Released to ICE Deb! Balance $0.00 Commissary Balance: $0.00 my 20, 2011 14:03 $12.70 IRENE BAMENGA Released to ICE EMENGA, IRENE 1 1 RELEASE . a I Date Amount Check Twpe Checkbook Station Operator Reside?t ALLEGANY COUNTY omce INMATE FUND ACCOUNT Payee Memo . (Mice and Removal )pt'rmium Department of Homeland Securit) l3? Delaware Ateuue Buffalo. New York I-thD US. Immigration and Customs Enforcement July 28, 2011 MEMORANDUM FOR: Michael T. Phillips Field Of?ce Director THROUGH: .. Supcrvisory Immigration Enforcement Agent FROM: Immigration *ntorcement gent SUBJECT: Detainee Transfer Sheet On July 2] 2011, Of?cermand I were assigned to transport two Detainees from Alleghany County Jail who were being removed from the United States. We were assigned to do a meet and greet with Albany ERO at exit 36. At the time it was unaware to us where the detainees would be going. Of?cemzmd I Did not know if the detainees were going to be staged at a facility or transferred l?urther downstate for removal. Due to these Circumstances Detainee Transfer Sheets were not completed. Statement by wuwicegov Um tit/Quinn awn/.01.! Rt'mn.'m? .5. Department of Homeland hecuril) 130 \wnue ltut'l?alu. \eu York an", . . U.S. and Customs 414?,? ?5 Enforcement gi 4?1) t? July 28. 2011 MEMORANDUM FOR: Michael T. Phillips Field Of?ce Director THROUGH: Ot'tieial (.?hannels FROM: immigration orcement Agent SUBJECT: Detainee Transfer Sheet 011 Jul) 21. 201 I and Agent ?were assigned to conduct a transport from Allegany (?ounty Jail to 13in 36 for a meet and greet ol'two l'emale detainees for removal. At the time oftransport we were did not know il'they were being staged at a speci?c Facility for removal. Due to heing unaware ot?what facility they were going to. we did not complete the Detainee 'l'runsl'er sheet. The Alhnn) Agents transported the two subjects from exit 36. Form l-216 u.s. DEPARTMENT OF HOMELAND SECURITY IMMIGRATION a CUSTOMS ENFORCEMENT Sheet No. 1 (Rev.5l22/O7) Transfer Date: 07/21/11 . RECORD OF PERSONS AND PROPERTY TRANSFERRED FROM: Alleganx VIA (1) Exit 36 TO: Albany MODE: Origin F0: - VIA (2) Best. F0: Other: File No. Status (1) Sex Convictions Lava 6-58? Comments (2) 11/10/81 France certify compliance with all ICE Detention and Transfer Standards and JPATS Boarding Requirements for this. JPA TS/Charter movement and Title: Ol?ce: Contact (1) - Show whether transfer or removal. For translem show whether NTA or Final Order Reoelvedthe above! .- - ge checks (2) - Show medical conditions, high risk. ?ight risk. epileptic. insane. etc. Signature: Use a separate line lor each person transferred. This term is to be executed in sufficient number of copies to allow receiving Title: of?cer to retain one copy of his personal expense voucher and two additional copies fOl? station of ?nal delivery. Place and Date: 3 (If a L. bonandur Management System for Windows Version 7.2.1. You ate lagged In as 'jlu- Inmat; Offloq Reports Iudmdua! Reports gHelp Inna: MI Al I IN Namm - ll Adm! Cc" - Bed - 1000mm 171.!- um: Sex Ruu.? Release Hum 55!! Booking? Permanent? Booked Date 11/10/1981 Iv. ?I'vll Sccnon Block .Il?rll' i RENE Ihlzf-u. (huh: AMENOA 0/1 981 70100111768 'Iruu' 1-03216 FEDERAL NMATE HOMELAND SECURITY (INS) US IMMIGRATION 8: NATURAUZATION 1- u: BEST COPY AVAI LABLE Chimes Chum CUM: Delmar: EdchIon Homing Ion lnc'dom Manama: Physical Proan Questions Romeo Schoduo septum Social Stu: I?V?O?andet Nanagemonl System for Win?om Version 7.2.1. You are tagged in a 741-" i'n'flug Lecvruls iryi: 3" .Z'H?tu a - season mock I m, mum Cell - nun - LOCGIIOD Sex Race Release: Iypl: $sz Bookmg? Eamon?! Hooked Date Classllucamm Una/1981 arm in "21/2011 Chums Gus"? Cidhm Dumas 1 OOKINGCONDITIOMNORMAL Yes PEARS OK median Grime: ?3 BOOKING common: . OTHER Incidonts Ll EOAL DRUG USE . Wenduc?ls . 5 Yes AKES MEDS meofty Ouu?onu 6 LLNESS WHEN BOOKED . Rm sanmn 2 pt; EXAMINAYION ORDERED BY COURT EXAMINATION ORDERED BY BOOKING Yes sum l?f'af'} ?13] ?8Vt I hid-'1 I hm Heady BEST COPY AVAI LABLE i" "O?ondnr System for Windows Ver?ion 7.2.1. You are logged in cg "e Emmi: L'ffl'u Etc-mt; Igdraudxdhep-mta ch-ip lmln. AIIRIS a .Booklng "mm AWNOA RENE Suctlon Block - 1' Adult cu" - nod - L?W?mm' Sex In?: Release Bookings! Petmanenm Booked Date Classi?cation 1111011981 mmon 11-03215 2m.? 701.9011 1! Chum? . MW uhxz?l. cum un?t;- AME AS INMATE MW. so mm mm tum Grievance(mi "its-.21." chin ?gm Lu ,u J-Zg'fj FRANCE ?mm RANGE Macmillan FRANCE phw?cai Property Gumbo: CATHOLIC Rolom Schodulo Su?sm-Jog Separates Social sum l; Er? lSearcnl I My)? lug-QM needy 7 BEST COPY AVAILABLE ?ironwmm System for Windows Version 7.2.1 . You are logged In as we; Imuslc ywduiec Eeports 5 Pvt-parts thk? aoomna AIM 50cm" Block mum Cell - Bud - Location 3m- 512x Ram: Release WIN: 55f: Booking? Pennanenw Booked Date Classmcauon :1 many Wm - . . . . Dame's Edmdlon - - - Grievance: . W?s I mm, Miscnducts myucnl Pron moment Rob?. Sch.? Summing 5mm? Soda! Slaw: PI iI?lf BEST COPY AVAI LALBE O?ondar Monagunant System for Winildws Version 7.2.1 Yod are logg'o?d in as we, mac: 'n duh: get-Orti- 10:11.1ual Lap-nu. anir. MI Al I RIS Booking sect-on mock [mun Cell - - Location Sex Ram: lurluasc NIH: SSW Booking? Permanenw Booked Date Classmcation a? I I I an revit- Eli!- - .. 13-51.: Ii?- Cluclty ?a mm mm- Educ-?an 010010000 Grievance: Zia-1H. u' ?mm woman woo/noon omomono moo/noon "cw" omomoo omomoo onperty Question: Release smou- Separate: Sochl Sinus Add ligelet'J BIN I WOW. 55"" I M?m- Tia-9M HOW BEST COPY AVAILABLE - - 67/27/2611 87:47 ALBANY CD PAGE 10/31 CORRECTIONAL MEDICAL MEDICAL AND MENTAL HEALTH HISTORY ANL Institution DOB: lnntelo Namo: Skin lnlectlon Restricted Mobility 81th Rash Unconscious Dtoottunled such as bloodlng or dfenllon? 1 Have fanned or had a head in the 6 months? 3 Have been seen a doctor In the Loslons Jaunde 4 or contact Obvlouo Porn Needle marks 6 Do you crutchou. ant or bmco Bruch Swollen Glands need whlle here? Fever Active Cough 6 Do you or whiskey? Nausea mumme am How often ?How Much Uses Tobacco Hoadlbody lloe Last limo 7 Have had colzuros or blackouts When Arthritis Frequent 8 Do you use drugs? Type Diabetes Genital Solos HOW Lost Tlmo: Solzuro Disorder VD. Asthma Spodal Dlet Heart Condition 5 Tuberculosis Sore Throat Stomach Ulnar Dental Problems Cancer Surgeries Slotdo 10 Are you currently dotoxtnp? If yes. from what we should know oboul? bolero? 11 Do have In lhlo medical tn or a Jaundlca MW or 18 Havo consumed or am treated with TB drugs 17 Are sad? Previous PPD toot? No l8 Do to or someone also? Pruvloun Poaltlva Reaction? No 18 Am whntore ll po??lfe mutt: of sex When Chronlo Fever or ml assault? vlotenl behavior? 21 at 2 Recent Wolght Loos Sweat: Loss do you had dose. lrequency and (complete ROI If on mediation to wnly) Wu/?y 8P Temp wr Resp Nona 'Placornohl Room Obwvatlon Modlcauon Allomloo No I Mental Henllh Infirmary Mm Sotung ac, General Population OthcrAllergles: Yes #9 Other Type: Md? 3" muons trule and have been bid the waylo obtaln health ?Mono and moat to voutlno cam provldod by?:le 531w. lundnrohmd that my madlcatlons not plowed up 48 hours or release m: be destroyed. to! mum shoots gtvon to Inmate Signatum: . DATE: 9/97/17 1mg; I BEST COPY AVAILABLE 0,810. 1! lm? 2110 SEER BY: A 67/27/2811 87:47 518853.1?323 ALBANY CD FAC PAGE 04/31 - ZORRECTIONAL MEDICAL SERVICES - . INTERDISCIPUNAHY PROGRESS NOTES 5?neni . i I . Jame I 1 i LD, if [h SIGNATQRE DATE Z/?z/Iz vim? A6560 9w;- ?5727 . 3? . rmwiqurlmm 0 ?0 . Ws?mMm *??fo?mvm .T - 6, han 9 my? 'Nores Macs/?Efm??cswz ?pm-5L4", ISL .. - . - Liam 45W 7/7?5?1? [hum-1mm: 1? .107 19m 4, In ?l BEST COPY AVAI LABLE ,0 67/27/2811 87:47 5138635923 ALBANY CU CORK FAC PAGE 63/31 '5 All (Dow a T'lmb CORRECTIONAL MEDICAL SERVICES . PHYSICIANS ORDERS . 0-0.8- LOCATION .. ALLERGIES Dispense As Wrillen Sun a. Tlmo we 11am,le 0.0.9. HALLERGIES 4 Dispense As Illull?on Perm! A NAME 447 0.0.8. 2 I 7 -. 2 LOCATION ?14 spense 31. Submilulion Permllied 32- NAME . . - '1 0.0.3. an. 35. LOCATION .. ,5 ALLERGIES a? .4 .0 Dispense Substitution Permmed BEST COPY AVAI LABLE MEDICATION ADMINISTRATION RECORD Bunny(Dita . - - 3725449 #0 n? #30, Mac-7w Sun 3! Jana I Cc, [9:179 IQ zJo?ybd mauve- BEST COPY AVAILABLE MEDICATION ADMINISTRATIOK RECORD 1.12345 13, ?25?ssee BEST COPY AVAI LABLE hi i .l a. . "mayWk! and; ?93?0 EZSESSBBIS man- 1 lmluwon: BEST COPY AVAILABLE lnmate: BAMENGA, IRENE Booking 11-03216 Permanent airy-z? BEST COPY AVAILABLE A A ALBANY CD CURH FAG PAGE 14/31 37/27/2811 67CORRECTIONAL MEDICAL SERVICES 22:: - ?Aw HEALTH SERVICES REQUEST FORM . . Print Name: QRMEN {Quirk Date of Reciuest: . ID Date Ome?h: . Housing Location: 2&4" um! Hm ma Nature of problem or request?EAMW - I . grind! Tanlc? NIde a 795%: 9:522 may CA7th if?Ln-15:. cm: mgti?m?a?h?, muffs} I consent to be treated 5y health staff for the condition described. "awn-Lyn . SIGNATURE . . "a sur TO THE NURSE ON MEISICAIION ROUNOS DO NOT WRITE BELOW nus AREA Mid-level SC Physician SC MH Dental I. Other: HEAIIH CARE DOCUMENIATION Subjective: Objective: BP Assessment: Inmate education handom reviewed with and given to patient. Refer (Circle any applicable) Mid-level Physician MH Dental Other: Signatme Tltle: Date: Time; BEST COPY AVAILABLE 37/27/2611 PAGE 12/31 ALBANY CO FAC 67:47 518863u923 CORRECTIONAL MEDICAL SERVICES HEALTH SERVICES REQUEST FORM i r. . Lg?a-z?u - I?Mbnew?mami?'khza i I Date of Request: Housing Location: A Print Name: I - Nature of problem or request: f'ihcg?jr 314: 741351;?" 0&4: th?-?align? Muf?n Lukas?. Ni?- at; 4.41335!? gay 3} 5m; Man-I L. a; ?i'J?Iichg .- a" I consent to be treated by health staff for the condition desaibed. SIGNATURE - . I. x9}. ..M 5:11:- GIVE SLIP TO THE NURSE 0N MEDICATION Rovas no NOT WRITE BELOW nus AREA Referred to: (Cixcle One) MW I?riaged by: NSC Mid-level SC Physician SC MH Dental Other. HEALTH CARE DOCUMENTATION Subjective: I Objective: 13p . W: Assessment: Plan: Inmate education handout Reviewed with and given to patient. Refer to: (Chde any applicable) Mid-level Physician MH Dental Other: Signature {it Title: Date: Time: Rev 04m BEST COPY AVAI LABLE r" A man: SERVICE UNIT INTAKE FORM I Race 183 880M if Marital Status (Z 2 a 6/ PhonoM Length Employed mmloyer Length Address A Position . Salary Source of incone (if not employed) Veteran; 2 Service Dates Discharge Education ?oats completed.) Wh rem us no College A I) 9 0f (m RoligionM?here/Clergy FAMILY mm no the: rather was: Contact Pox-so Re?ltionohip I 2 QE 9 4d Address lv %e Phonelmm Work Phone! Joann-23 (4/03) Judge . Charges/Convictions IVY) ?acid BailQ Arr. Att . Phone Probation ?o_?es P.O Court Date sent. Sentence Conviction Time left Parole P.O. Court Date sent. Sentence . Conviction Date paroled time left Violated Re Yes Why Other Pending Court Actions 0 Yes What PRIOR OFFENSES Date Court offense Digsition ?ee-9? a t; *Escape/Attenpted Escapegz?fes If yes, describe PRIOR INCARCERATIONS Date Facility Manse Length of Stay Any inmate you should have no contact with ?110 235 If yes, list I Any problems during present/ prior incarcerations ?/No Yes if yes, (4/03) CASE HISTORY Code l=daily 3=several times a week 5=doesn't use 2=once a week 4=several times a month 6=other Substance Freonencv/Quagtity Substance Freoue cv uantitv -lcohol Crack 4/ Marihuana Hallucinogen Heroin Tranquilizer 7 5 Cocaine Methadone I I ther drug usage Alcohol Dru Treatment Histo Date Where Length Finish Date Where Length Finish Date_/ Where Length He tal ealth Concerns Finish Depression Suicide attempts/thoughts If yes, describe Suicide in family ental Health eatment isto Date Where [10 Reason Reason Date__/__/_Where ?edicgi Any major medical concerns 5 If yes, describe [Gear?- age/mm On any medicationmC?J?VW 9 Seen by medical 2.5 Inform Medical of above NO YES, Medical Staff bu inforgned of above. Who is youJ Primary Care i>hysicen Oommw ?ream What type of Health Care coverage do you have I) I7 NOTE: Information as noted on pages 1 through 3, as stated by inmate. JGADM-ZB 03) 564567 51/19 /v?j J: Mflta??f -. 09-24-03 Inmate Service Unit Staff Notes ruwmxug ?aw/cm! QCLK V?oshm Qa?Quc-S?i?fv?r- IQ: Hp Date Date Intake conducted by Updated by JGADM-ZS (4/03) 87/26/2611 13:36 51. ms PAGE 81 Albany County Correctional Facility INMA CLASSIFICATI A (Form C-2) Date: 2 To: Classi?cation Unit From: Medical Departm Sta?? :7 g; a DOA. 7 Ac D.O.B. 20 Age: Inmate: Sex: Assessment: Recommendation: For usage by: Medical Department Mental Health Unit Inmate Service Unit Albany County Correctional Facility INMATE RECOMMENDATION (Form 0-2) To: Classification Unit From: inmate Service Unit Staff - Date: 2 1? Inmate/L Kane ?ll/n 6/1 Qing D-O-A- 3/46? Sex: 00.8. ?ll 10/ 3t Age: Assessment: Recommendation: For usage by: Inmate Service Unit Medical Department Mental Health BEST COPY AVAILABLE Chm?an "kWh \jldoh? 3 \bey . UNYC :1 u/L/ 4 021/17 .2 41 my . ag/M"/6557 7le ,I?gyzt; lf? -1 1&5; bur/2% AIL L-d?cl 2415 8/0 ?ns; N13, 725?; s" . Axb +51 [34/10 7 UL I 3' 752' A H307 cm 7% Ma ?ow 1) [(529] . W1: DETAINEE WORKSHEET Pursuant to the Detention Standards of the Bureau of Immigration and Customs Enforcement (ICE) of the Department of Homeland Security, ?Federal detainees must have the ability to communicate with ICE personnel and/or make written requests to ICE staff and receive an answer in an acceptable time frame". In an effort to comply with the above mentioned standard, we are requesting that facilities housing ICE detainees supply said detainees with this form in order to initiate communication with ICE staff. The standard further requires ICE staff to make weekly visits to facilities housing ICE detainees. DATE OF REQUEST FACILITY Albany County NAME lrene__ REQUEST: [5 THE DISPOSITION or PM CASE 7 :woeld LIKE To Know CASE OFFICER DATE OF REPLY RESPONSE VISITING OFFICER DATE: 07-26- 20] I Forms should be collected from the facility when performing the visit and forwarded to the ease of?cer in the event that an answer A A. 'nmate Classification Test Result ALBANY COUNTY CORRECTIONAL FACILITY Today's Date: 07/26/2011 Initial Classification Page 1 of 7 Inmate Name Inmate Housing Area Laet Name First Name Middle Name Affix Section Block Cell Bed Booking! SNGA IRENE 6 WEST L3 09 1 11-03216 DateofBinhz11I1ll/1981 Sex: Race:B Booking Date: 07/21/2011 9cm; 55mm Date of initial 07,26,20" initial Omcer Classi?cation Classi?cation Result LEVEL 3 Date of mus/2011 Overide own.? Of?cer let Review Classification Result ?23::Rfviaw 07/25/2011 Reason for Override Notes Category LENGTH OF STAY FACTORS (BAIL CATEGORY) Logical Answer: Numeric Answer: 4 1. SENTENCED 8- S1 - $499 2. $500 - $2499 3. $2500 - 59999 $10,000 8. ABOVE 5. NO BAIL Notes Category RISK ASSESSMENT (ADDITIONAL) Logical Answer: Numeric Answer: 0 1 ADDITIONAL CHARGE 2 ADDITIONAL CHARGES 3 ADDTIONAL CHARGES 4 OR GREATE ADDITIONAL CHARGES Inmate Classification Test Result COUNTY CORRECTIONAL FACILITN Today?s Date: 07I2612011 Initial Classi?cation Page 2 ol 7 .Inmate Name Inmate Housing Area Name First Name Middle Name Alfix Section Block Cell Bed Booking! . IRENE 6 WEST L3 09 1 11.03216 Date at Birth: 11/1 on 931 Sex: Race: 8 Booking Date: 0712112011 Pcm;_ ssa: Date of Initial amaze" Initial OfIicer Classi?cation Classi?cation Result LEVEL 3 Date ol Overide Override Of?cer Isl Review own/2?11 Classificatmn Result Data at 07/2612011 Reason lor Override 2nd Revrew Notes Category RISK ASSESSMENT (PRESENT LY CHARGED OR SENT Logical Answer: Numeric Answer: 5 1. VIOLATION 2. MISDEMEANOR 3. MISDEMEANOR (VIOLENT) FELONY (NON VIOLENT) 6. FELONY (VIOLENT) 6. FED I IMMIGRATION Notes Category ESCAPE RISK Logical Answer; Numeric Answer: 0 6. ESCAPE 3RD CURRENT CHARGE 7. ESCAPE OR 2ND CURRENT Notes -A iory IN-CUSTODY DISCIPLINARY Logical Answer: Numeric Answer: 0 .. COOPERATIVE I NO HISTORY A Inmate Classification Test Result ALBANY COUNTY CORRECTIONAL FACILITY Today's Date; 07!2612011 Initial Classi?cation Page 3 of 1 ?Inmate Name Inmate Housing Area 'Name First Name Middle Name Aflix Section Block Cell Bed Booking! .NGA IRENE 6 WEST L3 09 1 11-03216 Date olBirth: 11/10/1981 Sex: Race:8 Booking Date; 07/21/2011 Date of Initial ammo" Initial Officer Classi?cation Classification Result LEVEL 3 on. of ovum; Override Officer Review Classification Result :3ng 0712612011 Reason for Ovemde Notes Category ASSAULT I DISCIPLINARY Logical Answer: Numeric Answer: 0 2. DIS. HISTORY 3. NO HISTORY OF DIS. 4. HISTORY OF DIS. Notes Category CRIMINAL HISTORY Logical Answer: Numeric Answer: 3 N0 RECORD 0-3 PRIOR CONVICTIONS 4-6 PRIOR CONVICTIONS 7-11 PRIOR CONVICTIONS 12 OR GREATER PRIOR CONVICTION Notes J. qory SENTENCED STATUS Logical Answer: Numeric Answer: 0 1. IS THE INMATE Inmate Classi?cation Test Result ALBANY COUNTY CORRECTIONAL Today?s Date: 07/26/2011 Initial Classi?cation Page 4 ol 7 Inmate Name Inmate Housing Area Name First Name Middle Name Af?x Section Block Cell Bed Booking! I IRENE 6 WEST L3 09 1 11-03216 Date ofBIrth: 11/10/1901 Sex: Race:8 Booking Date: 07/21/2011 Pcwz? ssa: Date of Initial Initial Of?cer Classi?cation Classi?cation Result LEVEL 3 Date 01 Ovoride Override Officer lat Review (mu/20" Classi?cation Result 2::Rfvim 07/25/2011 Reason Ior Override Notes Category SENT ENCED STATUS Logical Answer: Numeric Answer: 0 US SENTENCED TO COUNTY Notes Category CLEARANCE LogicaiAnswer: Numeric Answer: 0 1. MEDICAL 2. MENTAL HEALTH Notes Category ESCAPE RISK Logical Answer: Numeric Answer: 0 1. NONE 2. ABSCONDING WORK RELEASE 3. ESCAPE THREAT (UNVERIFIED) 4. PREVIOUS ESCAPE (10 YRS) 5. PREVIOUS ESCAPE 10YRS) Inmate Classification Test Result ALBANY COUNTY CORRECTIONAL FACILITV Today's Date: 07/26/2011 Initial Classi?cation Page 5 ol 7 Inmate Name Inmate Housing Area a' Name First Name Middle Name Atfix Section Block Cell Bed Booking! .. NGA IRENE 6 WEST L3 09 1 11-03216 01111101311111: 1111011901 Sex: Race:B Booking Date: 0712112011 Poem" 3511:? Oate oi Initial oms?m? Initial Of? Classi?cation Classi?cation Result LEVEL 3 Data at Overide Override Ot?cer ist Review 07/26/2011 Classi?cation Result 07?25/2011 Reason lor Override Notes Category DRUG OR ALCOHOL USE I ABUSE Logical Answer: Numeric Answer: 1 1. N0 DRUG 0R ALCOHOL USE 2. OCCASIONAL ALCOHOL 3. PAST DRUG I ALCOHOL ABUSE PRESENT ABUSE Notes Category WARRANTS I DETAINERS Logical Answer: Numeric Answer: 0 1. NONE 2. 1 OETAINER 3. VIOLENT FELONY WARRANTS Notes Category EDUCATION FACTOR Logical Answer: Numeric Answer: 2 1. COLLEGE -. HIGH SCHOOL I GED A Inmate Classification Test Result ALBANY COUNTY CORRECTIONAL FACILITY Today?s Date: 0712612011 initial Classi?cation Page 6 or 7 "lnmele Name inmate Housing Area 3 Name First Name Middle Name Affix Section Block Cell Bed Booking: NGA IRENE 6 WEST L3 09 1 11-03216 Dale of em: 11/10/1931 Sex: Race: 8 Booking Date: 0712112011 Dale of Initial initial Officer Classification Classi?cation Result LEVEL 3 t? 7' i Date oi overide Override Officer let Review 07?26?20" Classi?cation Result 071260011 Reason for Override Notes Celegory EDUCATION FACTOR Logical Answer: Numeric Answer. 2 3. 8TH - 11 GRADE COMPLETED 4. LESS THAN 8TH GRADE Notes Category EMPLOYMENT FACTOR (LAST 2 YEARS) Logical Answer: Numeric Answer: 3 1. 1 YR CONTINUOUS EMPLOYMENT 2. 6 MONTHS CONTINUOUS 3. LESS THAN 6 MONTHS 4. NO EMPLOYMENT Notes Category ADDITIONAL WARRANTS Logical Answer: Numeric Answer: 0 1. 1 ADDITIONAL WARRENT 2. 2 ADDITIONAL WARRANTS .1. 3 ADDITIONAL WARRANT Today?s Date: 'lnmala Name ?Iame .. JGA Date of Birth: Date of Initial Classification Dale oI Ist Review Date at 2nd Review Category ADDITIONAL WARRANTS Inmate Classi?cation Test Result ALBANY COUNTY CORRECTIONAL FACILITI 07l26!2011 initial Classi?cation Page 7 cl 7 Inmate Housing Area First Name Middle Name Nil: Section Block Cell Bed Booking! IRENE 6 WEST L3 09 1 11-03216 1111011901 Sex: Race: 8 Booking Date: 07/21/2011 8? 11 initial Of?cer 2? Classi?cation Result LEVEL 3 ovedde Override Officer 07,28,20? Classification Result 07?2812011 Reason for Override Notes Logical Answer: Numeric Answer: 0 4. 4 ADDITIONAL WARRANTS 5. 5 ADDITIONAL WARRANTS General Notes Total Score ALBANY COUNTY OFFICE GENERAL DATE ISSUED EFFECTIVE DATE ORDER NUMBER ORDER 07-16-07 09-16-85 51-CF-00 SUBJECT: DISTRIBUTION: Classi?cation All Staff AUTHORITY: ISSUED BY: Sheriff Superintendent REFERENCE: New York State Commission of Correction, Minimum Standards Section 7013, 7003 New York State Sheriff's Association Standard #33, 46 REVIEWED: 01-21-11 REVISED: 04-21-11 Number of Pages: 9 This date of issue supercedes all prior issues. Policy: It is the policy of the Albany County Correctional Facility to Standards. The instructions and guidelines contained in this directive are not intended to be all- inclusive. There may be circumstances that are not speci?cally addressed within. In these circumstances the staff involved must seek assistance and guidance from their supervisor immediately. The contents herein DO NOT supercede any law, statute or regulatory authority. ll. Procedure: A. Classi?cation System: 1. De?nitions: designated categories for the classi?cation and assignment of inmates to housing units The Albany County Correctional Facility has established a system of and programs. a. Classi?cation for Housing Units: Assignment of inmates to appropriate housing units for the purpose of achieving maximum compatibility and safety of inmates. b. Classi?cation for Programs: conjunction with the classi?cation process will determine program approval. 1 provide a safe and secure environment for the effective management of inmate populations to include inmate housing and inmate work details, in accordance with all applicable local, New York State and Federal Law, New York State Commission of Corrections Regulations and New York State Sheriff?s Association Accreditation To determine which inmates can best be facilitated and served by programs made available to them by the facility. The Inmate Service Unit in c. Classi?cation Plan: A formal and objective system designed to appropriately classify, house and effectively manage the inmate population in a safe and secure manner. B. Initial Reception: 1. Upon admission, each inmate shall undergo an initial screening and risk assessment, which shall consist of: a. Review of commitment document(s) b. Visual assessment of each inmate, and screening interview, including completion of the Suicide Prevention Screening Form. 2. Prior to determining each inmate?s primary housing assignment, each inmate shall be placed in a housing area designated for classi?cation purposes. Such housing shall be temporary pending completion of the classi?cation process. C. Classi?cation and Housing Assignment: 1. The classi?cation process including the determination of appropriate housing shall be completed within ?ve (5) business days of each inmate?s admission to the facility. The Chief Administrative Of?cer may extend the time to complete the classi?cation process for a particular inmate up to an additional ten (10) business days if he Ishe concludes that additional time is necessary to make determination of appropriate housing. 2. The following information shall be utilized to assist in the classi?cation determination if such information is available and accessible: Criminal history Propensity for victimization History of Medical I Mental Illness History of sex offenses History of hostile relationship(s) with other inmates Prior attempts at self-injury or suicide Prior escapes and attempted escapes Attitude and behavior during present and prior incarceration(s) including any history of assaultive behavior during incarceration. (Records made available to such of?cer from the court or delivering jurisdiction) Information obtained during an inmates initial screening and risk assessment j. Any records from the department of correctional services, any local correctional facility k. Any information, which may affect the safety and welfare of the inmate or the facility staff I. Any other relevant information concerning an inmate?s condition brought to the attention of any facility staff person. meow-1.0 .69) 3. The following departments will assist in the classi?cation process in the prescribed manner: a. Medical Unit: Staff will conduct a medical screening of each inmate and complete an Inmate Classi?cation Assessment Form (C-2 Form). Completed forms are forwarded to the Inmate Service Unit. 2 b. Mental Health Unit: Whenever commitments or referrals deem appropriate, mental health staff will interview inmate(s) to determine mental status. Staff will note their assessment, and recommendations on the C-2 Form. Completed forms will be fonNarded to the Inmate Service Unit. c. Inmate Service Unit: Staff will conduct a fact ?nding intake interview, which will include: personal information, criminal history, incarceration history, substance abuse information, and medical and mental health information. Inmate Service Unit Staff will note their assessment and recommendation(s) on the C-2 Form. 4. The Classi?cation Evaluator: Will utilize the formal and objective Albany County Correctional Facility Initial Inmate Classi?cation Form/Program to appropriately determine classi?cation levels and designate primary housing. 5. Override: This process is used as a tool to alter an inmates classi?cation based on extenuating circumstances not described in the classi?cation point scale. Whenever an override is exercised, a written justi?cation must be recorded on the Initial Inmate Classi?cation Fonn/Program. 6. Classi?cation Decision Noti?cations: Within one (1) business day after each classi?cation determination is made, facility staff shall notify the inmate in writing utilizing the Notice of Classi?cation Decision Form (C-6 Form), and explain the classi?cation implications. 7. Classi?cation Review: The following procedures are designed to ensure each inmate the right to due process. The classi?cation Evaluator shall review and revise as necessary utilizing the Albany County Correctional Facility Inmate Classi?cation Review Form an inmate?s classi?cation status when one or more of the following conditions occur: 1. The inmate is involved in a serious unusual incident or exhibits adjustment problems, which threatens his/her safety, or the safety, security or good order of the facility. 2. A written request, including justi?cation(s) made by facility staff to alter or review the inmates classi?cation status based on new information or exhibited positive or negative behavior; and/or; 3. The facility medical or mental health director discloses relevant information about the inmate, which has not already been considered in determining the inmate?s classi?cation status: 4. If an inmate?s classi?cation status is changed pursuant to a review, facility staff shall notify the inmate in writing within one (1) business day, utilizing the Reclassi?cation Decision Form (C-5 Form), and explain the classi?cation implications. Levels of Classi?cation: Levels of classi?cation have been designated for effective management of inmate population and housing units in accordance with New York State Minimum Standard Section #7013, Classi?cation, Supervision and Security is in accordance with New York State Minimum Standard Section #7003 and facility guidelines. The levels of classi?cation are denoted as follows: A. Level One: Inmate Worker/Trustee/Workers In Waiting 1. Inmate General Workers perform work assignments within the facility. 2. Inmate Trustee perform work assignments within the exterior premises. 3. Workers in Waiting inmates cleared to work awaiting assignment. Inmates classi?ed as Level One shall be housed in area designated for Level One Classi?cation. B. Level Two: Inmates classi?ed as Level Two have scored between 0-15 points on the Initial Inmate Classi?cation Form, have had their initial classi?cation level overridden, or have been reclassi?ed as the result of a Classi?cation Review. Inmates classi?ed as Level Two shall be housed in areas designated for Level Two classi?cation. C. Level Three: Inmates classi?ed as Level Three have scored between 16-23 points on Initial Inmate Classi?cation Form, have had their initial classi?cation level overridden, or have been reclassi?ed as the result of a Classi?cation Review. Inmates classi?ed as Level Three shall be housed in areas designated for Level Three classi?cation. D. Level Four: Inmates classi?ed as Level Four have scored 24 or greater on the Initial Inmate Classi?cation Form, have had their initial classi?cation level overridden, or have been reclassi?ed as the result of a Classi?cation Review. Inmates classi?ed as Level Four shall be housed in areas designated for Level Four classi?cation. E. Level Five: Inmates shall be classi?ed as Level Five upon written recommendation of the Medical and/or Mental Health Departments. Inmates classi?ed as Level Five shall be housed in areas designated for Level Five classi?cation. F. Level Six: Program Designation Inmates classi?ed as Level Six are those approved to be housed in a Program Housing Unit. Inmates Classi?ed at Level Six shall be housed in areas designated for Level Six classi?cation. IV. Work Assignments: A. General Worker 1. Only county sentenced inmates who are free of holds will be considered for work details. 4 A review of Inmates Service Unit records is conducted by the Classi?cation Evaluator to ascertain if inmate is appropriate for work. If deemed appropriate, the Classi?cation Evaluator forwards a Reclassi?cation Request Form (C-4Form) to the Medical Department for review. The Medical Department will indicate on the C-4 Form whether or not the inmate is appropriate for work, and fon/vard the C-4 Form back to the Classi?cation Evaluator. lf deemed appropriate by the Medical Department, the inmate is reclassi?ed, and moved to a housing unit designated for workers. The receiving tier is noti?ed of inmate classi?cation and job assignment and the inmate?s wristband is changed appropriately. B. Trustee Trustees should have no history of extensive drug use, drug related convictions, crime(s) of violence, or sex offenses(s). 1. Steps 1, 2, 3, and 4 described under General Worker shall apply in the processing of trustees. If appropriate, the inmate is movedto a housing unit designated for trustees. Receiving tier is noti?ed of inmate classi?cation and job assignment. The supervisor in charge of trustees is noti?ed of inmate job assignment. The identi?cation Bureau is noti?ed of inmate assignment and the inmate is issued a Trustee ID. card as well as an appropriate colored wristband. V. Quarterly Classi?cation Report 1. Part 7013.13 of NYSCOC minimum standards requires, that on or before the 15th day of February, May, August and November of each year, an Administrator will forward a quarterly report relative to the housing and classi?cation of inmates to the commission which re?ects information pertaining to the preceding three-month period. INMATE CLASSIFICATION ASSESSMENT (Form 0-2) To: Classi?cation Unit From: Unit Date: Inmate; D.O.A. Sex: 00.8. Age Assessment: Staff Comments: For Usage By: Inmate Service Unit Medical Department Mental Health Unit RECLASSIFICATION REQUEST FORM (Form C-4) ame Date 003 Sex Tier Cell Reason for Reclassi?cation Request: Inmate Signature: Staff Signature: Classi?cation Unit Use Only Reclassi?cation Request Approved Disapproved Reclassi?cation to Level Housing Unit Assignment Tier Cell Reason(s) for Disapproval: Classi?cation Unit Staff Date Reclassi?cation Decision (Form C-5) Name Tier On the following decision was made on your reclassi?cation. Reclassi?ed from level to level Housing Unit tier cell Classi?cation Unit Staff Date Note: If the decision of the classi?cation unit is not acceptable, you may request a complaint form, as indicated in the Rules and Regulations Booklet. (Inmate?s Signature) (Date) (Staff?s Signature) (Date) CC: Admission Discharge Inmate File WHITE COPY Inmate File YELLOW COPY - Inmate 8 Albany County Correctional Facility Notice of Classi?cation Decision (Form C-6) To: Date: On a decision was rendered by the Classi?cation Unit as to your Classification Level, as noted below: Classification Level: Housed on Tier NOTIFICATION EXPLANATION: (Inmate?s Signature) (Date) (Stast Signature) (Date) Your classi?cation status is based on your past and present criminal history, the amount of your bail, escape attempts, disciplinary reports, wants, warrants or detainers logged against you, medical and mental health status and any other pertinent information. Your classi?cation status determines your housing in this facility. WHITE COPY - Inmate File YELLOW COPY Inmate AGADM-26 (5/96) 9 9) 1" (Pi/Jag ?ll-22'! A -- ma BEST COPY AVAILABLE Eli-q we @ng Jane Am?: we Am (a west m. 63?; .0 wqdkeA aw waxy; Mame .Vweoua 9C _.quweAeL?0r?, bo-W @4355:an a?cka? bars, duox?, mats, (599%; an appear Sew, a 5. I 5=j?poke Wag hm aems, I I 21 9.39%: 1-. p. a" 1 rm 5'7 :nmr/,L?gbw . .. 177. _:??amaya p5 (Kids- ?14? 1/719 I - 44 il?fm/A??ia/z?m/za/A/Mgmaao/crr/ My an . i . ?7 6 was Mg 5w: yum; 579? . 5/475 .. I 74?? BEST COPY AVAILABLE 102112011 15221 (FAX) P.002I006 mammal/[13-25} I -- "Alf F3 . 1 AT SCENE AC 3- 31/0 #(Soj-Mca? - Emmi; 7' 0 7 FROM SCENE k: a W. 1 Aroesnmnou I I I i Oman INSERVICE :gagmsmas om . ONONEMEBGENCY ?a one. - 0mm Om Com: Oran/unwaqu Com-rams 0mm QWMW Sdb?usod? Swat! OM OWVleum-d Ohm an em WI Um 09ch Gamma?m: 8m. WBYOW 00M E4- 3? gjuc 2 AU Dbt?ql PROBLEM 0 Annie Radian om Caller 1mm con/Head mm 0 Mum-um! lam 0 mm mummy" 0 0 ?mm 0mm" 0 Sum] Inlay OTraum-Ponauwnn Euvhlmemll a 1mm ms: 0 ?Em' 0 SWIM (Minna!) mewmsnomm and Time Inlay 0mm 0 0mm: named (Mona-I) OHnardealorlm Nadine Arm! 0 0 mm - 0 china: DullUnra 8 mm ?m 0 Alan 0 D?alnd 0 Cool 5mm ?e 8qu 0 Wm OVo?ce - Const?clcd 0 69mm ocymouc 00 Hypertensr'on' 0 m5 . ?smnaw 8 mm Pah Molst 0 a1st 0 8 gages 80 rd. :es Lama Irregular map. 8 "Wn 8 aoryo 0 mm :1 ac . . 8mm? 08$;L18mm 85 Sham 0 ?If? 8mmOlatod we 0 Ragnls 0 90.508 Comt! 0 arm 0 05mm 8mm OPan 0 5mm: 0 om 0mm OP Laborrd lmgulu Urnsp. No-Roacmn 0 Dry 0 damned 1/0 I UAQth?ulzyt Pabokus /A?ne.L AST Lf and me. In $71.44: Hg pA Mr E?ic?r mm tk?dmeww?L 9- 9 Wheel on Mug- CPR. SGML OPP. ?5 mt. FAMEJA mm 5?13? TREATMENT GIVEN FILL IN CIRCLE Moved mm? on gm?charfba?mm to I CMedlca?on AWHISMIW 58 Continuation Form) 0 Walked to ambulance ,4 soda 0 N351 ?m9 Airway cleared Btaedlng/ Hemorrhage Commned (Method Used: om Nasal Airway 1w. and Immobilization Neck and Back 0 Esophageal ammo: Airway! ?30ng83] Gastric Tube Alrway ?79 1 Umb Immobilized by muon_0 Tiacdon andomcnaal Tube (EH) 1'53 0 (Heat) or (Gold) Appllad 90mm Administered LEM. Method L) Vomiting Induced lime Method 0 Sucbon Used A, Restraints Applied. Type Wl?clal Ventilation Method ?49 0 [my gamma Time In Conny GORE. In pmgress on arrival by cmzen Alive 0 3mm 0 Mae 0 Female 0 in lmndalenburg Salon 6 cm. Stancd (9 Time umu cm. mums 0 in [an Wm, mm?:wa mm EKG Momma (Attach Tracing) (Emma) mm head elevated De?bt?la?mvCardioverslon No. ?mes 0 Manual 0 Send-automatic Other: nunmumnou (Sea List) . - anm usrn BEST COPY AVAILABLE ?turn .. ., . 1. I. in . 'C-i -- ?k?hn ?l vv?i A . -v BEST COPY AVAILABLE .1 Hats?. n. i 1.541.- . {7553? hr?; Prehospital Care Report commumou Pom mm USE BALL mm; FEM (mu . Dov-.11 PRINT 7 7 v/ are/we ?32: - Pmemsm anemia mm mm Ilene game?? A an 7 - :3 TIME RESP SOUNDS PULSE EKG BP. 2.3. DOSE ROUTE ?Elm Dumm Rome-J onlynumb- nkwho DFW DNW am noonElmo?4 246 92! Wk! a?hgg i[ 79? mg?msg 1 5* - 54;: Ere?, g; LL 69m {Ma gL/Js @Ac'?'zagk 3 My. if ?2 f1" 5M3.) @3294 am; a6 pathway $9.4.er (3) 9-14; QLM le?w?L r? . a! 4446; (our fa? mac/1?4 EM 4? My;ng ?c 733 mm Mm! (lbs! 5/1; fl?: 1,?@531. (My {2?4 Mi ?czen NARRATIVE: 4 Adm: ism. ?e MEDICAI- WWOLFW Dam QTY . ?lm? W. mm - Madam -mm- gnu VWIM mam BEST COPY AVAI LABLE 10121.00? 15:22 Pfehospital Care (FAX) Report Page DATE USE BALL worm qu ONLY 55mm Erna(Owe em 9 rep pea 'namwua nazwwa gmeh?n We Morcd P.004I006 CONTINUATION FORM men 0043 3% cm wk ?32: 0050 NARRATIVE: CONTROL FAGLHY 0045?? . -Aw we ?21 tuned mun rauum @8885. cab 003. .32: 3 0203.0 039332: a. mam mwnm? 38:92 BEST COPY AVAI LABLE RWSIOOG (FAX) 523 1 101212011 ?0 unamuedao eluoloo lo umol mac] BEST COPY AVAILABLE wound ALBANY COUNTY CORRECTIONAL FACILITY Quick Reference Report - Incident Information: Investigative Report Subject: 0 cl INMATE DEATH Date: Time:, Location: 07/27/l 6 WEST L-3 Investigative Report on File: 00ch I (XchS )No Video (5) Reviewed: If no. Why not: 00 Yes I CONSISTENT WITH REPORT Inmate (2): Housing Area Assigned: IRENE BAMENGA 6 WEST L-3 Inmate (3): Housing Area Assigned: Inmate (I). Housing Ana Assigned; Inmate (5): Housing Area Assigned: Inmate (6): Housing Area Assigned: Employee (I): Employee (2): OFFICE Employee (3): Employee (4): SGT. Synopsis: ALARM SOUNDED FOR 6 WEST WITH A REQUEST FOR MEDICAL ASSISTANCE FOR INMATE BAMENGA WHO WAS LAYING IN HER BED UNRESPONSIVE. STA FF RESPONDED, INMATE WAS PLACED ON THE FLOOR AND CPR WAS INITIATED. EMS WAS CALLED AND RESPONDED. FNMATE BAMENGA WAS TRANSPORTED TO MEMORIAL HOSPITAL BY AMBULANCE SUPERVISED BY OFFICERS AT WAS PRONOUNCED DEAD AT MEMORIAL HOSPITAL. Continuation of synopsis on backside Yes No Notifications Made: Administrator: Investi ator: CHIEF NOTE: Attach COpy to Daily Activity Sheet Attach copy to Investigative Report Incident Report No; L.R.I. ALBANY COUNTY CORRECTIONAL I 'Inaracter oI Incident; 3 :35 FACILITY 1406 INCIDENT REPORT INMATE DEATH gccuued Day Late Time Speci?c Location 11: WED 07 27 20 I 0023 6 WEST LEFT 3 BAY Log Entry 8y Wno- Day Date Time 8 Yes No (3.0 43115143117": WEDNESDAY 07 27 .20I I 0023 INVOLVED PERSONS: (EM) Employee (5) Suspect (0) Complainant (W) Witness (V) Victim (or) Other Code Last. First: DOB: Address: v-1 BAMENGA, 1115111: Code Last. First DOB: ress: ACCF DOB: AddTess: ACCF DOB Address: 1 :1116; ili11:7;c MEDICAL INFORMATION (Use Codes from above to reference speci?c persons) Code Nature of Injuries Hospital Run (Name) 0mm 1@ooss ALBANY I SEE ATTACHED Detemme: MEMORIAL HOSP. Code Nature of Injuries Hospital Run (Name) Detel Time: Code Nature of Injuries Hospital Run (Name) Datel Time: PROPERTY (L) Lost (8) Stolen (U) Used in Crime (E) Evidence (OT) Olhel' Item number Property Code Description Location I Item number Property Code LocatTon 2 MISCELLANEOUS Photos: Who: Statements taken Other AttachmentsMISC. REPORT AND MED. NOTES NARRATIVE: (brief statement of facts) ON JULY 27 20I I. I WAS WORKING ON THE 6 WEST HOUSING UNIT I TO 7 SHIFT. AT APPROXIMATELY IZIS AM I WAS NOTIFIED BY INMATES IN BAY L3 THAT INMATE BAMENGA WAS SICK. I THEN CALLED FOR A RELIEF OFFICER SO THE INMATE COULD BE TAKEN TO MEDICAL. AT APPROXIMATELY I2I9 NOTIFIED THE UNIT SUPERVISOR BECAUSE INMATE BAMENGA WOULD NOT ANSWER ME. AT I223 I ENTERED L3 BAY TO ROUSE BAMENGA. INMATE BAMENGA DID NOT RESPOND. I THEN NOTIFIED MEDICAL VIA MY PORTABLE RADIO TO RESPOND IMMEDIATELY WHILE INSIDE L3 BAY. THEN LEFT THE BAY TO ACTIVATE THE UNITS ALARM SYSTEM. AT I224 MEDICAL STAFF ENTERED THE BAY AND CPR WAS COMMENCED. ADMINISTERED CHEST conic WORKED THE AMBU BAG. EMS ARRIVED AT IZJS AND TOOK COMPRESSIONS FOR INMATE BAMENGA WHILE NURSE OVER CARE FOR INMATE BAMENOA. AT I253 EMS TRANSPORTED INMATE BAMENGA FROM THE UNIT . ID: Reporting Otficer: (Print) Date I Time 335m ur Commander STgneture I Date Reports /3 Reports 8 a? 7 0?7 [3 See Misc. Report 0 See Misc. Report 12-02) .n I Inc dent Reparl NO ALBANY COUNTY CORRECTIONAL FACILITY 3 Supplemental Report I 1"!th SUPPLEMENTAL I CONTINUATION REPORT Raw? FDate oI Origrnal Incident Date of thus Report Character 0! IncIdent [07/27/11 07/27/11 DEATH A. SUPERVISOR NARRATIVE: ON 07/2721 I REPORTING ME AND STATED THAT HE HAD AN UNRESPONSIVE INMATE ON HIS HOUSING UNIT TN LEFT 3 BAYWEST HOUSING UNIT, SECURITY ALARM SOUNDED. I AND WERE ALREADY ENRODTE TO THE I- WEST HOUSING UNIT. I ARRIVED ON THE TIER AT 0023, WHILE OTHER OFFICERS AND IAND NURSE WERE RESPONDING. I ENTERED THE LEFT 3 BAY ON THE 6 WEST AND IWIINESSED OFFICER ORR. ON INMATE BAMENGA AT 0024. INURSE ADVISED ME OF THE NEED FOR AN AMBULANCE. I ORDERED MAIN AND MEDICAL CONTINUED ICONTROL OFFICER TO CALL FOR AN AMBULANCE AT 0025. OFFICER -Ir II: TO PERFORM CPR ON INMATE BAMENGA UNTIL EMS ARRIVED ON THE TIER AT 0035. EMS TOOK OVER I IFOR THE CARE OF INMATE BAMENGA. EMS EXITED THE 6 WEST HOUSING UNIT WITH INMATE BAMENGA IAT 0053 TO BOOKING. EMS EXITED OUR BOOKING COMPOUND AT 0055 ENROUTE TO MEMORIAL IHOSPITAL. A SEARCH OF THE AREA WHERE INMATE BAMENGA WAS SLEEPING WAS CHECKED, INMATE HAD NO PROPERTY ON THE HOUSING UNIT. INTERVIEWED THE OTHER 8 TNMATES IN THE BAY. ALL .DECLTNED TO GIVE A WRITTEN STATEMENT AT THIS TIME. INMATE BAMENGA WAS PRONOUNCED DEAD ATOI IS. INVESTIGATO . r- WAS NOTIFIED OF THE INCIDENT AT 0I40. NYSCOC, WAS AND CONTACTED AT 0159. IMMIGRATION AGENT WAS NOTIFIED AND AT OISS. DEPORTATION OFFICER WAS NOTIFIED AND CONTACTED AT 0138. I epomng Of?cer (punt) Date Superwsor evrewe eport (Print) Date 4.. Eur Commander Rev-awed Report, (PrInl) Dale CAPT. 07/27/l I Tage ol r? Albany County Correctional Facility Miscellaneous Report Form Date of Incident: I Date of Report?aml Start Time of Report:3:3o AM. End Time of Report: 3:45 ,Subject: alarm reSponse Re.6 west Irene Barnen a) Du Submitted On 7/27/20? at 12:23 AM. I responded an alarm on the 6th West housing unit. Upon entering the unit I went to left 3 bay. There I assisted the medical staff removing inmate Bamenga from her bunk and placing her on the ?oor. Then I secured the area while the medical staff performed CPR. Distribution: . White: Administrative Captain Yellow; Daily Activity' Sheets #5 Albany County Correctional Facility Miscellaneous Report Form Date of Incident: 07/27? I Date of Repon?zm I Start Time of Report:6AM End Time of Rep0r126205AM Subject: INMATE DEATH IRENE BAMENOA Submitted *3st ON JULY 27TH AT APPROXIMATELY I WAS ADVISED BY REPORT TO BOOKING TO TRANSPORT AN TO THE HOSPITAL. DROVE THE CHASE CAR AND OFFICER WAS IN THE AMBULANCE WITH THE INMATE. WE ARRIVED AT ALBANY MEMORIAL AN BAMENOA WAS BROUGHT To THE EMERGENCY ROOM. ATTEM PTS BY HOSPITAL STAPP WERE MADE TO RECESITATE. SHE WAS PRONOUNCED DEAD AT Distribution: White: Administrative Captain Yellow: Daily Activity' Sheets Albany Memorial Hosp Emergency Department Reports Acct: >1 7 3 Mad Rec Num' Name: BAMENGAJRENE Phys: Age: 29 DOB: 11 10 81 Arrival Date: 07/27111 Sex: Statue: DEF ER Loc: M-ER DICTATED an" MD DATE OF SERVICE: 07/27/11 CHIEF COMPLAINT: Cardiac arrest. HISTORY OF PRESENT ILLNESS: This Is a 29 -year-cld female who arrives from the Albany County Jail In full cardiopulmonary arrest. History is obtained from EMS providers. and some history from her family when I had called them. She is a 29 -year-old with a hlalory of anemia and congestive heart failure who has been taking multiple medications. apparently recently started digoxin. nd per the family has been feeling Increasingly unwell recently. She was apparently laying In bed. not terrible responsive for several houre. but her estimates were not initially concerned because her eyes were open and they thought she was simply not communicative. However. when the tried to reuse her. they were unable to. At that point. the guards were summoned. Jail medical staff responded and started CPR. EMS was called simultaneously. On EMS arrival. the guards had performed approximately ten minutes of CPR. EMS found her to be in aeyetole. She was lntubated with a 7.0 endotrachaaltube atteren apparently challenging intubetion. IV access was established. She was given four rounds of epinephrine. three rounds of atropine. and 2 mg of Narcan without any change In her status. CPR was continued during her transport to the Emergency Department. No further history is obtainable. REVIEW OF SYSTEMS: Unobtainabie. PAST MEDICAL HISTORY Includes anemia and congestive heart failure. MEDICATIONS include Coreg. Ilelnoprtl. dlgoxln. Lasix. epironolactone and aspirin. SOCIAL HISTORY: She is at the jail in immigration hold. She was married. PHYSICAL EXAMINATION: Pulseiass female in full cardiac aneet. Eyes are without injection. Pupils are midpoint and mixed. Nose patent. Moull?l haa an andotrachaai tube In place. Neck has no tracheal deviation or JVD. Lungs have diminished air entry bilaterally but symmetric breath sounds Name BAMENGA, IRENE Acct: page Number: 1 231hreh27 1246 9? Lloany Mero'z' resctzi518-44'-359? DOB: 11/10/81 Acct: Nome: IRENE bilaterally. No roles or rhonchl. The diminished breath sounds are due to body hebltue. Heert has no heart tonee. Abdomen Io distended with some increased tympeny to peroueelon. GU: No overt biedder distention. Musouiosireietei: No cords. She has some mottiing or the extremities. Neuroioplo: 008 is 31'. EMERGENCY DEPARTMENT COURSE: CPR was continued in the Emergency Department under my supervision. She was given on additional dose or epinephrine. Cerdleo ultreeound demonstrated no evidence of cardiac activity. For EMS apparently she did have one brief nm of potential tine V-tib while being transported. She was shocked once and converted to eeyetoie. At 01:16. her totel downtime was in excess at 45 minutes with at least 85 minutes of documented eeyetoie end no pertusing during that entire time. At this point. further resuscitative efforts were deemed futile. and the petient was pronounced deed. PROVISIONAL DIAGNOSES: 1. Cardiopulmonary emet. 2. History of congestive heart failure. 3. History of anemia. Next at iti patients huebend. 887-234 was notified. Records had been faxed down from the jail medloei un and had been reviewed. The ooronerwee noti?ed. and will be taking the body for eutopey. at phone number D: 07127/2011 03:28:26 T: 07l27/2011 09:69:11 DTH Job Date end Time of Signature: Name: mart, IRENE Acct: page Number: 2 (A w; 12 46 Mama" Hcspitz'. name: mm, mm DOB: 11/10/81 page Numer: 3 Acct: Acct: k? mullqm ncw?ls?r new vonx sure DEPARTMENT OF MUN ?rmer!? CERTIFICATE OF DEATH 5"?5 NUVBER um: us' 25:: nomaomn ?Im mm . Irene Bamenga 21' >01: 7 727 2011 An mm noihm noon uuksac Wm: um out: In hum. (pump out (A oumuw mum mama mgurv .Saxl'l Kuhn-alum {40 mm (Mm-rum} . cm nuor tom . if A .0 [s MMm.mana-u.mum . I W's: innatan 71A Human-1981 29 4 i {Lua a. Anoola I lmvlulwl wkw?tm au-a-nru-nnuha?I?u-uunn gin-m lum?lumuwm (hum. .Qwuwm a 0' 20m GDIJ- tar?lb? 10mm law-?Imam IDS- II wanna-?unnumou maIu-uvul IDshw IDhmImmtn-u 3 lewam'um?m? I ?Uumma~~n SUIma-naw a Ian-mm 'Umum? 'Um?unm? 10mm?. 1 I mausmus ammi'fm an." a, 0' as W4 i?muwm Lynn, MA 01902 In mun-~- .ma man In?! at 10th::- an Goodrich Funeral Home 128 Washi .uuMW. cum oculde mm mm and mm mums 93W 1w? Qua-Ann 3" I. "i Mum 1 (may 1 wwm'mmtwu I imam ?mmw tho ManI?m msuy wraps?W I it mama ans: mun! ?cum sum mumm- .0 magma mo I Us LJ: oLluo 18115 [10 [32 n?ng ?Him almmvumnaunvmu mums?; . - ?Ileaurz canvas commune "N'eru?' A'ts'nv I vc mama IWIMU um S?cn 3: us uaom mun on ul?lw Ihm mm'no'" "5 a war-Mum- 'l hon-urn? hmmO-nl- cm ?minim [.731 I umumummnv?n - WARNING THE ABOVE RED NEW YORK SEAL IS PRINTED IN A HEAT REACTIVE SECURITY INK THAT SHOULD DISAPPEAR WHEN ROBBED. 67/28/2811 18:54 5184:475699 CORDNER PAGE OF ALBANY OFFXCE or CORONERS 112 STATE Smear - Sum: 735 ALBANY, New YORK 12207 CORONERS PHYSICMNS CORONERS (518) 445-7604 mxt518H47-5699 CONFIDENTIAL SECRETARY July28.201 I RN. MSN. CCHP. CPHM LC DR. United States Public Health Service Health Service Corps/ERO Field Medical Coordinator US. Immigration and Customs Enforcement 130 Delaware Avenue. ?2"d Floor Buffalo. New York 1-3202 Re: Irene Bamenga DOD - 07/27/2011 Please be advised that I received )our request for Autopsy and Toxicology reports on the above referenced decedent. As we spoke on the phone. the immediate Cause 0 eath was (I diom ath and 1 will forward the reports to you as soon as they are available. If you have any further questions. please do not hesitate to contact me at (518) 445. Sincerely. From? Sent: Thursda Au ust11 2011 8:27 AM To: Subje menga NYS County Law Sec. 677 Ms.nThis office represents Albany County, New York, and specifically regarding the captioned matter, the Office of the Coroner. i read with interest the position articulated by your office in the email below. For clarification, without an express federal statute authorizing disclosure in this context there is no conflict of law/preemption issue regarding New York's privacy act. That also holds in the instance of any DHS administrative regulation. (Similarly, Mr. . July 28th HIPAAjustification is off point.) There is no authority permitting the County to violate a NY statute in order to comply with a mere administrative procedure of OHS. Documentation ofthe death or medical condition of an ICE detainee, if required, may be accomplished by complying with Sec. 677 or employing methods other than asking a municipal agency to violate state law. Kindly advise if you require assistance in this regard. All future correspondence and/or communication on this matter, if any, from your of?ce shall be directed to the undersigned. Thank you. !l!any !ounty Attorney Albany County Department of Law 112 State Street, . .. Albany, New York 12207 sue-44%" Washington DC Office OF AMERICA, INC. Washington DC 20005 202-824?0752 October 13, 2011 TO: Section Chief ICE Of?ce of Professional Responsibility Of?ce of Detention Oversight FROM: rune) mm ssistant Project Manager Of?ce of Detention Oversight Support SUBJECT: Medical Compliance Review, Detainee Death Detainee Irene BAMENGA, we), As you are aware, MGT was asked to conduct a medical compliance review in support investigation into Detainee Irene death by while in ICE custody. Because of my experience dealing with medical issues and deaths in jails, I ersonall conducted the compliance review, which included joining you and Special Agentmin visiting the site and participating in interviews of staff at the Allegany and Albany County, NY detention facilities. Attached please ?nd my report. As you will see, in Section 1 I summarized the contents of detainee medical record and information provided by sta? in tirneline format, offering therein observations and findings on compliance with the ICE National Detention Standard on medical care. Section 2 is a table summarizing missed medications. For your information, review of the medical record was supported by health care subject matter expert who agreed with report content from a medical perspective and concurred with the ?ndings. Please note qualitative assessment of care against comrnrurity standards of practice is beyond the scope of contract and is not addressed in this, or any, MGT report. Should you have any questions or require additional information, please feel free to contact me. Pagell Review of Detainee Death (b)(6), (b)(7)c Irene Bamenga, A-Number Medical Record Review Findings Allegany County Jail, Belmont, New York Albany County Correctional Facility, Albany, New York Section 1: Timeline As requested by the ICE Office of Professional Responsibility, Office of Detention Oversight, MGT of America, Inc. participated in a review of detainee Irene BAMENGA’s death while in (b)(6), (b)(7)c (b)(6), (b)(7)c ICE custody. MGT accompanied Special Agents and for site visits to the Allegany County Jail and Albany County Correctional Center August 23 – 25 2011, and participated in interviews of correctional and medical staff at both facilities. Additionally, MGT reviewed the medical record of detainee BAMENGA and inspected documentation of staff training in emergency response and distribution of medication. MGT’s participation was requested to determine compliance with ICE National Detention Standards (NDS) governing medical services. The following chronicles detainee BAMENGA’s period of detention at the Allegany and Albany County facilities based on documented and reported information. Italicized text in parenthesis defines or explains medical terminology and abbreviations. MGT’s findings with respect to compliance with ICE NDS and general observations for which there are no applicable NDS components are documented in commentary. Background ICE Significant Event Notification – Significant Incident Report documents that on July 15, 2011 detainee Irene BAMENGA was issued a Notice to Alien Ordered Removed/Departure Verification by Customs and Border Protection (CBP) officers after being denied entry into Canada by Canadian immigration officials. An Order to Detain or Release Alien signed by CBP Enforcement Officer (b)(6), (b)(7)c directed her detention at the Allegany County Jail (ACJ) pending removal proceedings. In the Remarks section of the form was documented, “Congestive Heart Failure she takes medications to control her medical problem. Subject has medication with her.” Friday, July 15, 2011 ALLEGANY COUNTY JAIL Allegany County Sheriff’s Office Inmate Personal Property Receipt documents detainee BAMENGA’s personal property as $20 in currency, white sneakers, yellow brazil shirt, and shorts. Suicide Prevention Screening Questionnaire completed by Deputy (b)(6), (b)(7)c Saturday, July 16, 2011 Allegany County Jail Booking Observation Report completed by Deputy( )(6), (b)(7)cdocuments detainee BAMENGA responded affirmatively when asked if she was on medication, stating “lots of them.” In addition, she reported an allergy to Tramadol (treats moderate to severe pain) and DDR Medical Compliance Review: Detainee Irene BAMENGA Section 1: Timeline Page 1 positive tuberculosis (TB) test 12 years ago. No medical conditions or special needs documented. COMMENT: The Booking Observation Report includes health-related observation and interview questions intended to identify immediate medical or special housing needs. Facility policy J-3.10 assigns responsibility for completion of the report to booking officers and includes provisions for referral for immediate medical attention if required. ICE NDS, Medical Care, section (III)(D) requires that all new arrivals receive initial medical and mental health screening by a health care provider or an officer trained to perform this function. MGT verified officers are trained in the intake screening function. Compliance is met. According to Deputy(b)(6), (b)(7 cdetainee BAMENGA was received with a large bag of medications which he took directly to the Medical Unit. Because of the hour, medical staff was not present to directly receive the medications. COMMENT: ACJ policy does not address handling of medications received with new detainees, including documenting receipt, inventory, disposal or release by either booking or medical staff. MGT was informed that in practice, medications are turned over to the Medical unit when received, and returned to ICE detainees upon release or transfer. (b)(6), (b)(7)c Registered Nurse (RN), per interview. Detainee BAMENGA was screened by RN (b)(6), (b)(7)c stated she reported to the facility on a Saturday because she was on-call for the purpose of performing TB testing and follow-up medical screening on new prisoners. RN (b)(6), (b)(7)c documented the encounter by noting the following on the Booking Observation Report completed by Deputy(b)(6), (b)(7) Congestive Heart Failure (CHF) and high blood pressure; ASA (aspirin to reduce risk of heart attack), Digoxin (heart medication), Lisinopril (hypertension), and Furosemide (diuretic) on a daily basis; Spironalactone (diuretic) twice a day; and Carvedilol (HTN, heart failure, and angina/chest pain), dosage frequency documented as “?”. In addition, RN (b)(6), (b)(7)c documented a previous positive TB test in 2002, “was treated;” and blood pressure of 138/92 (slightly elevated). During interview, RN (b)(6), (b)(7)c stated detainee BAMENGA was not certain of Carvedilol dosing. She reported the detainee’s lungs were clear, her heart rate was regular, and she observed no swelling. A TB test by PPD was not planted because the detainee previously tested positive; instead, authorization for chest x-ray was to be requested. RN (b)(6), (b)(7)c stated detainee BAMENGA voiced no medical complaints, and was not asked for information on her private provider or when she was last seen. RN (b)(6), (b)(7)c reported there were two large medication organizers belonging to the detainee “stuffed” with various medications. The detainee informed her she had taken her medications the day before and asked why she could not have them. RN (b)(6), (b)(7)c stated she informed detainee BAMENGA the facility does not allow prisoners to take their own medications because they are not verified. She instructed the detainee to obtain information on dosages from her husband. Upon inquiry, RN (b)(6), (b)(7)c stated procedures are in place for off-hours consultation with a provider concerning medications or other matters; however, because BAMENGA’s screening was normal, she did not believe action before Monday was necessary. DDR Medical Compliance Review: Detainee Irene BAMENGA Section 1: Timeline Page 2 (b)(6), (b)(7)c COMMENT: According to RN (b)(6), (b)(7)c and Nurse Practitioner (NP) The ACJ Medical Unit does not document encounters or actions in Progress Notes or other chronological record. RN (b)(6), (b)(7)c she typically makes a note in the SOAP format (Subjective, Objective, Assessment, Plan) if there are findings of significance. MGT was informed detainee BAMENGA’s medications were placed in her personal property. Monday, July 18, 2011 “Informed Consent – Consent for Detainees” form signed. COMMENT: ICE NDS, Medical Care, section (III)(L) requires health care providers to obtain signed and dated consent forms from all detainees before any medical examination or treatment, except in emergency circumstances. Compliance is met. NP (b)(6), (b)(7)c conducted a physical examination, making hand-written notes on the same Booking Observation Report used by RN Harrington to document the medical screening, and generating a type-written “History and Physical Examination” report. Findings were documented as follows: History and Physical Examination • Past medical history: CHF (congestive heart failure- excessive amount of fluid in lungs), HTN (hypertension/high blood pressure), and anemia (reduction of circulating red blood cells) • Past surgical history: right lung • Medications: ASA daily, Spironalactone twice a day, Lasix (diuretic) daily, Digoxin daily, Carvedilol daily, and Lisinopril daily. • Allergies: Tramadol (pain medication) • Denies tobacco, alcohol and illicit drug use • Suicide and mental health referral: negative • General appearance: 29 year-old black female, “appears as stated age;” alert and oriented. • Vital signs: temperature 99.8, pulse 88, respirations 20, blood pressure (BP) 128/84 (slightly elevated), weight 206 lbs. • Cardiac: Regular rate and rhythm. COMMENT: ICE NDS, Medical Care, section (III)(D) requires that health care providers conduct a health appraisal and physical examination on each detainee within 14 days of arrival. Compliance is met. COMMENT: Detainee BAMENGA was not placed on a restricted diet despite her weight and history of hypertension. NP (b)(6), (b)(7)c generated the following: Problem List • Height, 67 inches; weight, 206 lbs. • Previous positive PPD DDR Medical Compliance Review: Detainee Irene BAMENGA Section 1: Timeline Page 3 • • • Problems: HTN, CHF, and Anemia Treatment: ASA 81 mg daily, Spironalactone 25 mg twice daily, Lasix 20 mg daily, Digoxin 0.25 mg daily, Carvedilol 20 mg daily, and Lisinopril 20 mg daily. Date documented for listed problems and treatment: 7/7/2011. During interview, NP Ralyea, the incorrect date was a typographical error. Medication List • Allergies: Tramadol • Medications (start date July18, 2011) o ASA 81 mg daily o Spironalactone 25 mg twice daily o Lasix 20 mg o Digoxin 0.25 mg daily o Carvedilol 20 mg daily o Lisinopril 20 mg daily Orders • Diagnosis: CHF, HTN, anemia • Allergies: Tramadol • Date order of 7/18/2011 and Date Stop of 10/18/2011 for the following: o Tylenol 2 tablets by mouth as needed for fever or pain o ASA 81mg daily o Spironalactone 25mg twice daily o Lasix 20 mg daily o Digoxin 0.25mg daily o Lisinopril 20mg daily o Carvedilol 20mg daily COMMENT: The order for medications was made three days following the detainee’s arrival. During interview, NP b)(6), (b)(7)c stated the medications ordered, including dosage, were as reported by detainee BAMENGA. She did not attempt to verify the medications before ordering them. According to the Nursing 2010 Drug Handbook, Carvedilol is to be administered twice daily, and according to WebMD, pulse should be taken when Digoxin is administered to ensure it is not too slow. The order for Digoxin did not include this provision. NP (b)(6), (b)(7)c stated she did not consider pursuing the detainee’s medical records from her community provider, or ordering laboratory tests. Treatment Authorization Request approved for chest x-ray due to positive PPD history. Approved July 19, 2011. COMMENT: ICE NDS, Medical Care, section (III)(D) requires that all new arrivals receive TB screening by PPD (mantoux method) or chest x-ray. PPD is to be the primary screening method unless contraindicated, as was the case with detainee BAMENGA. ACJ took appropriate action to request authorization for a chest x-ray, though it was not completed prior to her transfer on July 21, 2011. NP b)(6), (b)(7)c stated that though not DDR Medical Compliance Review: Detainee Irene BAMENGA Section 1: Timeline Page 4 documented, detainee BAMENGA was screened for, but did not exhibit signs or symptoms of TB. Medication Administration Record (MAR) documents Officer BAMENGA her evening dose of Spironalactone. (b)(6), (b)(7)c gave detainee COMMENT: MGT was informed medications are distributed by officers trained in the function when medical staff is not on site. MGT verified Officer(b)(6), (b)(7)ccompleted training. ICE NDS, Section (III)(I) requires that written records be maintained of all medications given to detainees. Compliance is met for the term of detainee BAMENGA’s detention in the ACJ. Tuesday, July 19, 2011 MAR documents detainee BAMENGA was given ASA, Lasix, Digoxin, Lisinopril, Carvedilol, and Spironalactone by RN (b)(6), (b)(7)c in the morning, and her evening dose of Spironalactone in by Officer (b)(6), (b)(7)c COMMENT: There was no documentation supporting Officer training in distribution of medication. (b)(6), (b)(7)c completed Wednesday, July 20, 2011 MAR documents detainee BAMENGA was given ASA, Lasix, Digoxin, Lisinopril, Carvedilol, and Spironalactone by RN (b)(6), (b)(7)c in the morning, and her evening dose of Spironalactone in by Officer (b)(6), (b)(7)c NP (b)(6), (b)(7)c stated she was notified by Intake that detainee BAMENGA was being transferred. She prepared a Medical Summary of Federal Prisoner/Alien in Transit form documenting the detainee had a previous positive PPD and treatment in 2000; chest x-ray “not done yet.” Departure date was recorded as July 20, 2011; “Destination” and “Reason for Transfer” left blank. Current Medical Problems were documented as HTN, CHF, and anemia; recorded medications, dosage, and “Medication Requirements for Care En Route” were consistent with Medication List, Orders and MAR. No special needs affecting transportation noted. NP (b)(6), (b)(7)c stated the transfer summary was placed in a sealed envelope bearing the detainee’s name and marked, “CONFIDENTIAL.” She stated the envelope and blister packs containing detainee BAMENGA’s remaining medications were forwarded for transfer. COMMENT: ICE NDS, Detainee Transfers, section (III)(D)(6) requires that health care providers be given advance notice prior to the release, transfer or removal of a detainee so that medical staff may determine and provide for any medical needs. Section (III)(D)(6) further requires IGSA facilities to prepare transfer summaries documenting TB clearance, current mental and physical health status, medications, and contact information for the transferring medical official. In addition, ICE NDS, Medical Care, section (III)(N) requires placement of medical information in sealed envelopes marked “MEDICAL CONFIDENTIAL.” Compliance with all requirements is met. DDR Medical Compliance Review: Detainee Irene BAMENGA Section 1: Timeline Page 5 Thursday, July 21, 2011 ICE Signi?cant Event Noti?cation Signi?cant Incident Report documents, FOD Buffalo of?cers transferred detainee to the Albany County Jail for staging, as she was scheduled for removal 011 July 28, 2011.? ALBANY COUNTY CORRECTIONAL FACILITY Suicide Prevention Screening Guidelines form documents ?Yes? to ?Detainee is very worried about major problems other than legal situation serious ?nancial or family problems, a medical condition or fear of losing job,? noting, ?medical issues? as the corresponding comment. Impressions recorded as ?Alert and cooperative. Appears Referred to medical. Albany County Correctional Facility (ACCF)/Correctional Medical Services Medical and Mental History and Screening completed by RN Form documents detainee responded affnmatively when asked if she had current medical problems; CHF recorded as the explanatory response. As medical history, detainee reported a heart condition and anemia, chickenpox, and previous positive allergy to Tramadol. Denied being pregnant. ?See List? recorded in Current Medications section of the form. RNM documented detainee was oriented to person, place and time, and ?not happy? about being incarcerated. Weight recorded as 194 lbs., BP 140/88 elevated), other vital signs Within normal limits. Placement: general population. Detainee BAMENGA signed a statement at the bottom of the screening form consenting to routine care and acknowledging she was told how to access health care services. COMMENT: ACCF complied with ICE NDS, Medical Care, section requiring that medical intake screening be conducted, and section requiring that consent be obtained prior to examination or treatment. Interdisciplinary Progress Note by RN ml. "tum documents detainee screened without dif?culty; history of positive chest x-ray ordered; history of HTN, CHF, anemia. ?Call placed to MD. orders received.? During interview, Health Services Administrator (HSA) . stated detainee BAMENGA did not receive a chest x-ray. She stated though documented, RN failed to write the order for the x-ray. COMNIENT: ACCF is not in compliance with ICE NDS, Medical Care, section requiring that all newly arriving detainees be tested for TB. Physician Orders documented the following prescriptions, all with start dates of July 21, 2011 and stop dates of August 20, 2011: ECASA 81 mg daily Spironalactone 25 mg twice daily Lasix 20 mg dailiy Digoxin 0.25 mg daily Lisinopril 20 mg daily Coreg (same medication as Carvedilol) 20 mg daily DDR Medical Compliance Review: Detainee Irene BAMENGA Page 6 Section 1: Timeline COMMENT: Facility physician Dr. (b)(6), (b)(7)c did not increase Coreg to twice daily, and did not order that detainee BAMENGA’s pulse be taken before giving Digoxin. Problem List documented chronic problems as CHF, HTN, and anemia. Detainee signed Informed Consent for urine pregnancy test and consent for HIV testing. COMMENT: No documentation of pregnancy or HIV testing. It is noted, however, RN documented negative in the “Pregnancy Test Results” of the intake screening form. (b)(6), (b)(7)c During interview, RN b)(6), (b)(7)cstated the medications were received with the detainee in blister packs; further, that medications received from another facility in this manner may be administered upon physician approval. RN b)(6), (b)(7)cstated detainee BAMENGA made no comments concerning her medications and expressed no concerns or complaints. MAR documents detainee BAMENGA was given all medications this date as ordered. MGT was informed only medical personnel distribute medications. Friday, July 22, 2011 MAR documents detainee BAMENGA was given morning doses of all medications; “NS” (No Show) recorded for evening dose of Spironolactone. COMMENT: HSA (b)(6), (b)(7)c provided policy J-D-02.06, “Medication Administration Record,” which states “Absent” is to be documented if the prisoner is “not present, and no reason for the absence was given.” She stated the expectation is that the nurse goes to the cell to determine the reason for the absence or refusal; further, that the prisoner be referred to the ordering practitioner following three missed doses. She provided the Medication Administration Documentation lesson plan supporting nurses are trained accordingly. HSA (b)(6), (b)(7)c stated she reviewed nursing staff’s medication distribution practices in light of the fact “NS” was recorded on detainee BAMENGA’s MAR on July 22, 24, 25 and 26, 2011. On none of the days “NS” was recorded did the nurse seek out the detainee, and no action taken to notify the provider after the third dose was missed. HSA (b)(6), (b)(7)c stated failure to follow policy was addressed with three specific staff members who recorded “NS,” and correct procedures have been reviewed with all staff. Saturday, July 23, 2011 MAR documents detainee BAMENGA was given all medications as ordered. Sunday, July 24, 2011 MAR documents detainee BAMENGA was given morning doses of all medications; “NS” recorded for evening dose of Spironolactone. Monday, July 25, 2011 MAR documents detainee BAMENGA was given morning doses of all medications; “NS” recorded for evening dose of Spironolactone. DDR Medical Compliance Review: Detainee Irene BAMENGA Section 1: Timeline Page 7 MAR documents a new entry for Digoxin: “Digoxin to be given daily and to hold dose if apical pulse is [less than] 60 and notify MD.” MAR documents apical pulse was 88 and Digoxin given. COMMENT: As noted previously, checking pulse prior to giving Digoxin is expected practice, however, there is no corresponding Physician’s Order or other documentation reflecting what precipitated the instruction. Tuesday, July 26, 2011 Health Services Request Form: “I am not being given the full dosage of my medications. Two of the six different meds are meant to be take twice a day and so far I have only be given 1 dosage in the morning. The two medecines are spironolactone and carvedilol [sic].” Date and time received illegible, as are the initials of the individual who conducted triage and referred the detainee for nurse’s sick call. Documented in the “Health Care Documentation” section of the form are, “Seen on 7-26” and “Coreg ordered [twice per day].” Health Services Request Form submitted by detainee: “Shortness of breath at night especially when laying down, palpitations when laying down. Dizziness upon standing up when palpitation and shortness of breath occur.” “FOR MEDICAL USE ONLY” section of form for documenting date and time received are blank, as are sections for recording triage and “Health Care Documentation.” According to HSA (b)(6), (b)(7)c the “FOR MEDICAL USE ONLY” section is to be completed when a medical staff person is handed a request form directly by a detainee. It is not completed if received through another source. HSA (b)(6), (b)(7)c further stated both the triage and Health Care Documentation sections should have been completed. COMMENT: ICE NDS, Medical Care, section (III)(F), Sick Call, requires facilities to have a mechanism that allows detainees the opportunity to request health care services. Facility policy J-E-07.00 supports compliance with the standard. In addition, section (III)(F) requires health care providers to review request slips to determine when the detainee will be seen. Compliance is supported with respect to one of detainee BAMENGA’s sick call requests. 9:40 AM Physical Assessment completed by NP (b)(6), (b)(7)c Weight documented as 200 lbs; BP 110/80 (normal range); other vital signs within normal limits. History of positive PPD; treated in 2000 in Paris, France. Past medical history of HTN, CHF for five years; past surgical history of right lobectomy (surgical removal of lobe of any organ or gland). Current medications recorded. Described as cooperative and alert and oriented to person, place & time; denied chest pain and shortness of breath. COMMENT: Compliance with ICE NDS, Section (III)(D) requiring physical examination within 14 days of arrival is met. COMMENT: Detainee BAMENGA was not placed on a restricted diet despite weight and history of hypertension. DDR Medical Compliance Review: Detainee Irene BAMENGA Section 1: Timeline Page 8 Chronic Disease Clinic - Initial Baseline Medical Data form completed by NP Personal risk factors documented as high blood pressure and alcohol (1-2 glasses wine 6 months ago). Family history of heart disease and high blood pressure (mother). History of HTN and CHF since 2006. No other signi?cant ?ndings. BP 110/80 (normal range, weight 200 lbs., other vital signs within normal limits. Assessment: HTN and CHF. Documented detainee received education and verbalized understanding of instructions. Plan: medication change: Carvedilol twice a day; detainee to return to clinic in 90 days. During interview, NP rm: stated initiation of Chronic Care Clinic is protocol for any prisoners with identi?ed chronic conditions. Physician Orders: Coreg/Carvedilol twice a day. COMNIENT: During interview, NP mm: reported she increased Coreg based on detainee ?adamant? insistence she should receive the medication twice daily. It is noted the detainee did not previously complain of incorrect dosing; further, Allegany County RN . documented detainee BAMENGA was unsure of Coreg/Carvedilol dosing and NP tw-GI- 'bs-TI documented the detainee reported taking it once per day. As previously noted, no attempt was made to verify the Coreg/Carvedilol or any prescription. stated Spironolactone was already ordered twice per day, therefore, no change was necessary. Because the MAR was not available for her review, . mm was not aware evening doses of Spironolactone were missed on July 22, 24 and 25. She stated the detainee was ?well-versed? on her medications and reported she took them as ordered. NP rtm?r. ?We stated she did not recall seeing the sick call request wherein detainee BAMENGA claimed of shortness of breath and dizziness. Upon inquiry, NP mm indicated that if she had seen it, she would not necessarily have queried the detainee concerning these complaints. She stated the detainee denied shortness of breath, she noted no signs of swelling, and the detainee had no dif?culty walking. The examination was ?routine? with ?nothing was out of range.? For these reasons, she did not consider pursuing detainee prior medical records or ordering lab tests. MAR documents all detainee BAMENGA was given morning doses of all medications; pulse 82; recorded for evening doses of Spironolactone and Coreg. July 27, 2011 12:23 AM Interdisciplinary Progress Notes documents, ?Called to GW [regarding patient] being umesponsive. This writer [and] arrived on the scene to witness C.O. mm mm hakirrg [patient?s left] arm. This writer immediately assisted in taking [patient] from top bunk. [No] signs of life noted. [No] pulse, [no respirations], pupils ?xed and dilated. CPR [with] ambu bag immediately instituted. Airway patent [open], eyes (sclera) dry, extremities cold and stiff, skin color cyanotic lacking oxygen]. C.O. mu. ?p.71: ook over compressions while this writer [checked patient?s temperature] 91.2 and began to apply AED pads. [Illegible] EMS was in route [per] noti?cation of emergency. CPR continued until EMS arrived 0042. [No changes] noted.? DDR Medical Compliance Review: Detainee Irene BAMENGA Page 9 Section 1: Timeline ACCF Incident Report by Officer (b)(6), (b)(7)c documents the following: “On July 27, 2011 I was working on the 6 West Housing Unit 11 to 7 shift. At approximately 12:15 AM I was notified by inmates in Bay L3 that inmate Bamenga was sick. I then called for a relief officer so the inmate could be taken to medical. At approximately 1219 I notified the Unit Supervisor because inmate would not answer me. At 1223 I entered L3 Bay to rouse Bamenga. Inmate Bamenga did not respond. I then notified Medical via my portable radio to respond immediately while inside L3 Bay. I then left the bay to activate the units alarm system At 1224 Medical staff entered the bay and CPR was commenced. I administered chest compressions for inmate Bamenga while nurse (b)(6), (b)(7)c worked the ambu bag. EMS arrived at 1235 and took over care for inmate Bamenga. At 1253 EMS transported inmate Bamenga from the unit.” During interview Officer b)(6), (b)(7)creported that when he conducted count at 11:00 PM, detainee BAMENGA was lying in bed. He stated she appeared to be awake because her eyes were open. He stated that when first notified by her dorm-mates that she was ill, he followed standard operating procedure by calling for an escort officer. While waiting, inmates stated “she is really sick,” so he decided to walk from his station to her housing area. From outside, he called her name a few times and asked if she was OK. Receiving no reply, he returned to his station to verify escort was on its way. He then walked back to the housing area and decided to enter. He stated detainee BAMENGA looked “really sick,” so he grabbed her arm and finding her nonresponsive, notified Medical via his radio and returned to his station to hit the alarm. Nurse (b)(6), (b)(7)c (b)(6), (b)(7)c and Nurse arrived “quickly” and together, they removed detainee BAMENGA from her upper bunk. Once she was on the floor, Nurse (b)(6), (b)(7)c applied the ambu-bag and Nurse (b)(6), (b)(7)c initiated CPR, subsequently being relieved by Officer (b)(6), (b)(7)c and Nurse (b)(6), (b)(7)c COMMENT: Asked why he did not enter the housing unit when he called for detainee BAMENGA and did not receive a reply, he stated that as a male, he did not want to enter a female unit; further, he did not feel it was necessary because he could see everyone. He further stated, “They tell us not to go in because it could be a trap and you don’t want to go in alone.” During interview, Captain (b)(6), (b)(7)c stated officers are trained not to enter cells by themselves except in medical emergency. It is noted Officer (b)(6), (b)(7)c report documents four minutes elapsed between being alerted detainee BAMENGA was sick and finding her unresponsive upon calling to her from outside the housing unit. Instead of returning to his station to notify his supervisor as documented in his report, or to check on escort as reported during interview, Officer b)(6), (b)(7)ccould legitimately have called medical emergency by radio and entered the unit. Another four minutes elapsed before he entered and attempted to wake detainee BAMENGA, whereupon he called Medical by radio and again returned to his station to activate the alarm system. A total of nine minutes elapsed between notification the detainee was ill and commencement of CPR. COMMENT: MGT was provided with a memorandum on Albany County Sheriff’s Office letterhead stating Officer b)(6), (b)(7)ccompleted cardio-pulmonary resuscitation (CPR) re-certification training March 1, 2011. In addition, CPR certification cards expiring in (b)(6), (b)(7)c (b)(6), (b)(7)c 2012 were produced for Nurse and Nurse ICE DDR Medical Compliance Review: Detainee Irene BAMENGA Section 1: Timeline Page 10 NDS, Medical Care, section (III)(H) states detention staff must be trained to respond to health-related emergencies within a four-minute timeframe. Compliance with training requirements is met. 12:58 AM Interdisciplinary Progress Notes documents, “EMS [with patient] to Memorial Hospital, life support machines on [patient].” 1:00 AM Interdisciplinary Progress Notes documents, “Health Services Administrator of situation.” 1:05 AM Interdisciplinary Progress Notes documents, “MD (b)(6), (b)(7)c (b)(6), (b)(7)c informed notified of incident. 1:20 AM Interdisciplinary Progress Notes documents, “Dr. (b)(6), (b)(7)c from Memorial Hospital stated the [patient] was pronounced dead at 0115.” Albany Memorial Hospital Emergency Department Reports dictated by Doctor documented the following: (b)(6), (b)(7)c “Chief Complaint: cardiac arrest. History of Present Illness: This is a 29-year-old female who arrives from the Albany County Jail in full cardiopulmonary arrest. History obtained from EMS providers, and some history from her family when I had called them. She is a 29-year-old with a history of anemia and congestive heart failure who has been taking multiple medications, apparently laying in bed, not terrible [sic] responsive for several hours, but her cellmates were not initially concerned because her eyes were open and they thought she was simply not communicative. However, when the [sic] tried to rouse her, they were unable to. At that point, the guards were summoned. Jail medical staff responded and started CPR. EMS was called simultaneously. On EMS arrival, the guards had performed approximately ten minutes of CPR. EMS found her to be asystole…” Certificate of Death documents manner of death as natural cause; cased referred to coroner; autopsy performed. Immediate cause of death: cardiomyopathy (disease that affects heart muscle, diminishing cardiac performance). DDR Medical Compliance Review: Detainee Irene BAMENGA Section 1: Timeline Page 11 MEDICAL COMPLIANCE REVIEW Section 2: Missed Medication Summary Detainee Irene BAMENGA Following are medications detainee BAMENGA reported she was taking at the time of her arrest, subsequently ordered by Allegany and Albany County providers. Column A summarizes doses not given as ordered by the providers. Column B summarizes doses missed pending provider order at Allegany County, failure to distribute ordered medications at Albany, and incorrect dosing of Carvedilol. * A B EC ASA None 3 Lasix None 3 Lisinopril None 3 Digoxin* None 3 Pulse taken for Digoxin 2 9 Carvedilol/Coreg 1 15 Spironalactone 2 9 MORTALITY REVIEW REPORT NAME: Bamenga, Irene ID#: (b)(6), (b)(7)c DATE OF BIRTH: November 10th, 1981 FACILITY: Albany County Correctional Facility DATE OF DEATH: July 27th, 2011 The preliminary autopsy report and certificate of death indicated that 29 year old Irene Bamenga, a citizen of France, died of cardiomyopathy. This mortality review was conducted based on a review of booking, classification, investigative reports and statements, as well as medical records from Allegany County Jail, Albany County Correctional Facility and Albany Memorial Hospital Emergency Room. Narrative Summary: 7/15/2011: Bamenga was brought to the Allegany County Jail with documentation indicating she had congestive heart failure and was on several medications which she had on her person. The booking officer conducted a booking observation and a suicide screening questionnaire which indicated no special circumstances that required immediate intervention. 7/18/2011: The nurse practitioner conducted a medical history and physical examination on Bamenga. No information regarding a chief complaint was elicited from the patient. A past medical history of treatment for latent tuberculosis infection, hypertension, congestive heart failure and anemia was noted and her current medications were as follows: aspirin 81 mg daily, spironolactone 25 mg twice daily, lasix 20mg daily, digoxin 0.25mg daily, carvedilol 20mg daily and lisinopril 20mg daily. On examination, Bamenga’s vital signs indicated a low grade fever with a temp of 99.8, pulse=88, respirations=20 and blood pressure=128/84. Her cardiac and respiratory examination was documented as normal with no signs of congestive heart failure. Her medications were ordered by the nurse practitioner. A review of the medication administration records only documented administration of her medications on 7/19 and 7/20/2011. It is not clear whether she received her medications from the evening of 7/15/2011 to 7/18/2011 as well as on the morning of 7/21/2011. She was transferred to the Albany County Correctional Facility on 7/21/2011 early that morning. 7/21/2011: Bamenga arrived at the Albany County Correctional Facility at approximately 6:00pm. She received a medical and mental health history. The history of anemia, congestive heart failure, hypertension and positive PPD was given including medications listed on transfer sheet. However, no further medical history was elicited at that time to determine the severity of her medical conditions that might have triggered an earlier than scheduled evaluation by the nurse practitioner or physician. A call was placed to the physician who gave verbal orders for her current medications. A chest xray was ordered to rule out active tuberculosis and Bamenga was placed in general population. 7/25/2011: Bamenga completed two health services request forms. In her own words, she wrote, “Shortness of breath at night especially when laying down; palpitations when laying down; dizziness 1 upon standing when palpitations and shortness of breath occur.” “I am not being given the full dosages of my medication. Two of the six different medications are meant to be taken twice a day and so far I have only been given one dosage in the morning. The two medications are spironolactone and carvedilol.” Sometime on or after 7/26/2011, the triage nurse wrote on the slip that Bamenga was seen on 7/26 and that coreg 25mg twice daily had been ordered. Legibility of the medication administration record was poor in some instances; however, it appears that the nursing staff documented with “NS” that Bamenga did not show for her 9pm spironolactone dosages on 7/22, 24 and 26. 7/26/2011: The nurse practitioner conducted a physical assessment of Bamenga. Her vital signs were temp=97.9, pulse=82, resp=16, B/P=110/80. She documented that Bamenga denied pain/discomfort and also denied chest pain or shortness of breath. She found no abnormalities in the cardiovascular and respiratory evaluation and no edema in the lower extremities. She did increase the carvedilol (coreg) to 25mg twice daily. I could find no documentation indicating that the nurse practitioner had appropriately explored the patient’s symptoms of shortness of breath at night, of palpitations when lying down and of dizziness upon standing. On completion of the examination, there was no indication as to status of Bamenga’s chronic medical conditions nor were any tests ordered to make that determination. 7/27/2011: At approximately 12:15am inmates in the housing unit notified the correctional officer that Bamenga was sick. The officer responded but was unable to arouse Bamenga and at 12:23am, he activated the medical response system and the unit’s alarm system.CPR as instituted with chest compressions and the ambu bag. There was no documentation that an automatic external defibrillator was applied by the facility’s staff. At 12:35am, the community emergency medical system/ambulance arrived, took over care and transported the patient to Albany Memorial Hospital. Efforts to resuscitate this patient were unsuccessful and the patient was pronounced dead at 1:15am. Conclusions and Recommendations: If we are to believe the physical assessments conducted by the two nurse practitioners at the Allegany County Jail and the Albany County Correctional Facility on July 18th and July 26th respectively, then, it is highly unlikely that this patient’s immediate cause of death would be cardiomyopathy due to her congestive heart failure. The clinical course of congestive heart failure is usually slowly progressive with symptoms of worsening shortness of breath that becomes visible, swelling of the lower extremities known as peripheral edema, and lung findings such as a productive cough and rales in the lungs on auscultation. None of these findings were documented. Based on the patient’s complaints on 7/25/2011, we can conclude that this patient’s congestive heart failure was worsening; this may have been due to the combination of incorrect dosing of carvedilol, missed doses of spironolactone, a diuretic, and increase in dietary sodium. Carvedilol should be prescribed at a twice daily dosage and in her case, the initial dose should have been documented as 25mg and not 20mg. The formulation does not exist in a 20mg form. I am not clear as to why she was a “no show” for some of her 9pm spironolactone doses. Was she sleeping and not aroused for those doses? Did the nursing staff 2 recognize the severity of her disease and make any attempts to ensure medication compliance? I saw no documentation of such efforts. Because this patient’s congestive heart failure did not appear to have worsened severely, I believe that we must look at other causes of her death. Based on her symptoms of palpitations on July 26th, she may have died from a cardiac arrhythmia which would not be found on autopsy. What would cause a cardiac arrhythmia in this patient? Digoxin toxicity and alterations in potassium level can both cause fatal cardiac arrhythmias. Digoxin concentrations are increased by about 15% when digoxin and carvedilol are administered concomitantly. Therefore, increased monitoring of digoxin is recommended when initiating, adjusting, or discontinuing carvedilol. Was this patient hyperthyroid? We do not know because we did not investigate the complaint of palpitations. Did this patient have a myocardial infarction due to her cardiomyopathy? Did this patient throw a pulmonary embolus? Toxicology studies will be crucial in helping to determine the final cause of death. However, regardless of this patient’s final cause of death, both facilities were remiss in not conducting a thorough clinical evaluation and assessment of this patient whose congestive heart failure would deteriorate when poorly managed. The assessments by both nurse practitioners did not include whether Bamenga’s congestive heart failure and hypertension were controlled. There was no plan to determine what type of anemia this patient suffered from. This patient should have been placed on a restricted sodium diet, an electrocardiogram should have been done, the chest x-ray should have been completed and laboratory testing should have been done to include digoxin levels, electrolytes, a complete blood count and thyroid function studies. Previous medical records were being sent by Bamenga’s attorney but there was no documentation that the records had been received. The physician should have been consulted for guidance in initial management of this young cardiac patient and this did not occur in either facility. Subsequent early follow up by the physician would have been appropriate. Finally the early use of an automatic external defibrillator (AED) is standard practice in responding to a life threatening emergency and it is recommended that an AED be obtained and the facility’s medical as well as correctional staff be trained in its use. Submitted by: (b)(6), (b)(7)c MD, Clinical Consultant Diplomate of the American Board of Family Medicine Date of Review: September 4, 2011 3 From: To: Subject: Date: (b)(6), (b)(7)c Re: BAMENGA mortality review follow up questions Thursday, September 29, 2011 2:52:50 PM QUESTION 1: What bearing, if any, may have missed medications had on detainee BAMENGA’s death? For example, Coreg is usually prescribed twice a day but BAMENGA only received it once a day. Did receiving it once a day instead of twice a day make a difference in her health? ANSWER 1: This patient suffered from a chronic cardiac condition namely, congestive heart failure. Appropriate medication management including appropriate dosing and patient compliance is critical in controlling this condition. Based on Banenga's medical complaints on her sick call request forms on July 25th, it is clear that her congestive heart failure which was stable on entry, had now decompensated. Yes, missed medication dosing as well as incorrect medication dosing were significant factors that contributed to the decompensation of her congestive heart failure. Other factors were increased sodium intake through dietary intake. QUESTION 2: To what degree did failure to take the actions referenced in the final paragraph of the Mortality Review Report have relevance to detainee BAMENGA’s death; i.e., had they been taken, could the death have been prevented? ANSWER 2:  If this patient's death was indeed cardiomyopathy due to congestive heart failure, then this death could have been prevented if the appropriate steps were taken to determine the severity of her congestive heart failure followed by an appropriate treatment plan to control her cardiac condition. QUESTION 3: Should nurse practitioners/medical personnel at both facilities have known that Coreg is usually prescribed twice a day? ANSWER 3:  If nurse practitioners in New York State have prescriptive authority (can order medications), then the expectation is that they would have the training, knowledge and skills to prescribe medications appropriately. Yes, we providers do make errors in prescribing if we are not using electronic prescribing systems. However, our health care system's check and balance is the pharmacist who has electronic drug pharmacy systems. Normally, when a dose of medication that does not follow the drug manufacturer's prescribing recommendations, is prescribed, the pharmacist will contact the prescribing practitioner to determine if this was an error. I could not determine if this communication occurred nor whether the practitioners had access to electronic prescribing systems. Dr.(b)(6), (b)(7)c we are unable to obtain the autopsy report for this case due to New York state privacy laws.  However, regarding the mortality review you provided in this case, can you please answer the following 3 questions. QUESTION 1: What bearing, if any, may have missed medications had on detainee BAMENGA’s death? For example, Coreg is usually prescribed twice a day but BAMENGA only received it once a day. Did receiving it once a day instead of twice a day make a difference in her health? Detainee BAMENGA reported she took her medications the day she was taken into custody, July 15, 2011. Based on documentation and interviews, the following summarizes medications received and missed July 16 – 26, 2011. Detainee BAMENGA was found unresponsive shortly after midnight on July 27, 2011. ASA · Physical exam July 18, 2011: detainee reported taking daily · Ordered July 18, 2011: 81 mg daily · Received July 19 – 26, 2011 · Missed doses: 3 (July 16, 17, 18) Lasix · Physical exam July 18, 2011: detainee reported taking daily · Ordered July 18, 2011: 20 mg daily · Received July 19 – 26, 2011 · Missed doses: 3 (July 16, 17, 18) Lisinopril · Physical exam July 18, 2011: detainee reported taking daily · Ordered July 18, 2011: 20 mg daily · Received July 19 – 26, 2011 · Missed doses: 3 (July 16, 17, 18) Digoxin · Physical exam July 18, 2011: detainee reported taking daily · Ordered July 18, 2011: 0.25 mg daily · Received July 19 – 26, 2011 · Missed doses: 3 (July 16, 17, 18) · Order amended July 25, 2011: dose to be held if apical pulse is less than 60. Recorded pulse July 26: 88; July 26: 82 Carvedilol/Coreg · Physical exam July 18, 2011: detainee reported taking daily · Ordered July 18, 2011: 20 mg daily · Received one dose per day July 19 – 25, 2011 · Ordered July 26, 2011: 25 mg twice daily in response to detainee report she should receive the medication twice per day. Detainee did not receive second dose July 26, 2011. · Missed doses: 14, based on Dr (b)(6), (b)(7)(C) statement concerning twice per day administration (none received July 16, 17, 18; received one per day July 19 – 26, 2011) Spironalactone · Physical exam July 18, 2011: detainee reported ordered twice per day · Ordered July 18, 2011: 25 mg twice per day · July 25. Received twice per day starting evening, July 18 – July 21, 2011; July 23; · Missed doses: 9 (two per day July 16, 17, 18; evening July 22, 24, 26) QUESTION 2: To what degree did failure to take the actions referenced in the final paragraph of the Mortality Review Report have relevance to detainee BAMENGA’s death; i.e., had they been taken, could the death have been prevented? QUESTION 3: Should nurse practitioners/medical personnel at both facilities have known that Coreg is usually prescribed twice a day? (O) 202-732-(b)(6), (b)(7)c 2- . rut? at}: Mr Im'um??f US. Department of Justice United States Marshals Service Prisoner Operations Division Washington. DC 20530-[000 July 14,2009 MEMORANDUM TO: m: Chief Deputy United States Marshal Northern District of New York t1. in: Senior Grants Specra Prisoner Operations Division SUBJECT: Albany County Correctional Facility The above mentioned certi?ed IGA is attached. A copy should also be sent to the appropriate Bureau of Prisons (BOP) Community Corrections Manager and Immigration and Customs Enforcement (ICE) regional of?ce, if included in the IGA. Please make sure that the Administrative Of?cer and Criminal Clerk has a copy of the executed documents so that they are aware of the current jail day rate and any special terms and conditions guard/transportation services, mileage, etc.). If you have questions, please contact Senior Grants Specialist at (202) 616-? Cc: Albany County Correctional Facility 1. Agreement Number 2. Effective Date 3. Facility Code(s) 4. DUNS Number 52-03-0023 See Block 19. 2EE 958498644 5. Issuing Federal Agency 6. Local Government United States Marshals Service Albany County Correctional Facility Prisoner Operations Division 840 Albany Shaker Road Detention Operations - East Albany, NY 12211 Washington, DC 20530-1000 Tax 14-6002563 8. Local Contact Person 9. Tel (518)869- A ,7 Fax: (518 862 Etna": il:n:7,uc 11. 7. Appropriation Data 15X1020 10. This agreement is for the housing, safekeeping, and subsistence of federal prisoners, in accordance with content set forth Male: 20 Female: 0 $119.30 herein. (Estimated Federal Beds) 13. Optional Guard/Transportation Services: 14. 8 Medical Services Guard Hour Rate: $36.42 U.S. Courthouse Mileage shall be reimbursed by the Federal Government at the GSA Federal Travel Regulation Mileage Rate. 15. Local Government Certi?cation 16. Signature of Person Authorized to Sign (Local) To the best of my knowledge and belief, information submitted in support of this agreement is true and correct, this document Signal; has been duly authorized by the governing of the Department or Agency and the Department or Agency will comply with all provisions set forth herein. Name . ?fjl/Ff? 6 /3 :44 Title Date 17.Prisoner and 18. Other Authorized 19. Signature of Person Authorized to Sign (Federal) Detainee Type Agency User Authorized 8 Adult Male IE BOP igna ure 8 Adult Female 8 ICE Juvenile Male Senior Grants Specialist I 7 I Juvenile Fema Title Dite ICE Detainees Page 1 of 12 Agreement Number 52?03-0023 Authority .. 3 Purpose of Agreement and Security Provided .. 3 Period of Performance .. 4 Assignment and Outsourcing of Jail Operations .. 4 Medical Services .. 4 Receiving and Discharge of Federal Detainees .. 6 Optional Guard/Transportation Services to Medical Facility .. 6 Optional Guard/Transportation Services to US. Courthouse .. 7 Special Notifications .. 7 Prisoner Rape Elimination Act (PREA) .. 8 Service Contract Act .. 8 Per-Diem Rate .. 8 Billing and Financial Provisions .. 9 Payment Procedures ..10 Modifications and Disputes ..10 Inspection of Services ..11 Litigation . .1 1 Prisoner Rape Elimination Act Reporting Information ..12 Page 2 of 12 Agreement Number 52?03-0023 Authority Pursuant to the authority of Section 119 of the Department of Justice Appropriations Acts of 2001 (Public Law 106-553), this Agreement is entered into between the United States Marshals Service (hereinafter referred to as the ?Federal Government?) and the Albany County Correctional Facility (hereinafter referred to as ?Local Government?), who hereby agree as follows: Purpose of Agreement and Security Provided The Federal Government and the Local Government establish this Agreement that allows the United States Marshals Service (USMS) to house federal detainees with the Local Government at the Albany County Correctional Facility 840 Albany Shaker Road Albany, NY 12211 (hereinafter referred to as ?the facility?). The population, hereinafter referred to as ?federal detainees," will include individuals charged with federal offenses and detained while awaiting trial, individuals who have been sentenced and are awaiting designation and transport to a BOP facility, and individuals who are awaiting a hearing on their immigration status or deportation. The Local Government shall accept and provide for the secure custody, safekeeping, housing, subsistence and care of federal detainees in accordance with all state and local laws, standards, regulations, policies and court orders applicable to the operation of the facility. Detainees shall also be housed in a manner that is consistent with federal law and the Federal Performance-based Detention Standards. The USMS ensures the secure custody, care, and safekeeping of USMS detainees. Accordingly, all housing or work assignments, and recreation or other activlties for USMS detainees are permitted only within secure areas of the building or within the secure external recreational/exercise areas. At all times, the Federal Government shall have access to the facility and to the federal detainees housed there, and to all records pertaining to this Agreement, including financial records, for a period going back 3 years from the date of request by the Federal Government. Page 3 of 12 Agreement Number 52-03-0023 Period of Performance This Agreement is effective upon the date of signature of both parties, and remains in effect unless terminated by either party with written notice. The Local Government shall provide no less than 120 calendar days notice of their intent to terminate. Where the Local Government has received a Cooperative Agreement Program (CAP) award, the termination provisions of the CAP prevail. Assignment and Outsourcing of Jail Operations Overall management and operation of the facility housing federal detainees may not be contracted out without the prior express written consent of the Federal Government. Medical Services The Local Government shall provide federal detainees with the full range of medical care inside the detention facility. The level of care inside the facility should be the same as that provided to state and local detainees. The Local Government is ?nancially responsible for all medical care provided inside the facility to federal detainees. This includes the cost of all medical, dental, and mental health care as well as the cost of medical supplies, over the counter prescriptions and, any prescription medications routinely stocked by the facility which are provided to federal detainees. The cost of all of the above referenced medical care is covered by the federal per diem rate. However, if dialysis is provided within the facility, the Federal Government will pay for the cost of that service. The Federal Government is financially responsible for all medical care provided outside the facility to federal detainees. The Federal Government must be billed directly by the medical care provider not the Local Government. In order to ensure that Medicare rates are properly applied, medical claims for federal detainees must be on Centers for Medicare and Medicaid (CMS) Forms in order to be re- priced at Medicare rates in accordance with Title 18, USC Section 4006. The Local Government is required to immediately forward all medical claims for federal detainees to the Federal Government for processing. All outside medical care provided to federal detainees must be pre- approved by the Federal Government. In the event of an emergency, the Local Government shall proceed immediately with necessary medical treatment. In such an event, the Local Government shall notify the Federal Government immediately regarding the nature of Page 4 of 12 Agreement Number 52-03-0023 the federal detainee's illness or injury as well as the types of treatment provided. Medical care for federal detainees shall be provided by the Local Government in accordance with the provisions of USMS, Publication loo-Prisoner Health Care Standards and in compliance with USMS Inspection Guidelines, USM 218 Detention Facility Investigative Report. The Local Government is responsible for all associated medical record keeping. The facility shall have in place an adequate infectious disease control program which includes testing of all federal detainees for Tuberculosis (TB) as soon as possible after intake (not to exceed 14 days). When Purified Protein Derivative (PPD) skin tests are utilized, they shall be read between 48 and 72 hours after placement. TB testing shall be accomplished in accordance with the latest Centers for Disease Control (CDC) Guidelines and the result documented in the federal detainee?s medical record. Special requests for expedited TB testing and clearance (to include time sensitive moves) will be accomplished through advance coordination by the Federal Government and Local Government. The Local Government shall immediately notify the Federal Government of any cases of suspected or active TB or any other highly communicable disease such as Severe Acute Respiratory (SARS), Avian Flu, Methicillin-resistant Staphylococcus Aureus (MRSA), Chicken Pox, etc., which might affect scheduled transports or productions so that protective measures can be taken by the Federal Government. When a federal detainee is being transferred and/or released from the facility, they will be provided with seven days of prescription medication which will be dispensed from the facility. When possible, generic medications should be prescribed. Medical records must travel with the federal detainee. If the records are maintained at a medical contractor?s facility, it is the Local Government?s responsibility to obtain them before a federal detainee is moved. Federal detainees may be charged a medical co?payment by the Local Government in accordance with the provisions of Title 18, USC Section 4013(d). The Federal Government is not responsible for medical co- payments and cannot be billed for these costs even for indigent federal prisoners. Page 5 of 12 Agreement Number 52-03-0023 Receiving and Discharge of Federal Detainees The Local Government agrees to accept federal detainees only upon presentation by a law enforcement of?cer of the Federal Government with proper agency credentials. The Local Government shall not relocate a federal detainee from one facility under its control to another facility not described in this Agreement without permission of the Federal Government. The Local Government agrees to release federal detainees only to law enforcement officers of the Federal Government agency initially committing the federal detainee Drug Enforcement Administration, Bureau of Immigration and Customs Enforcement, etc.) or to a Deputy United States Marshal (DUSM). Those federal detainees who are remanded to custody by a DUSM may only be released to a DUSM or an agent specified by the DUSM of the Judicial District. USMS federal detainees sought for a state or local court proceeding must be acquired through a Writ of Habeas Corpus or the Interstate Agreement on Detainers and then only with the concurrence of the district United States Marshal (USM). Optional Guard/Transportation Services to Medical Facility If Medical Services in block 13 on page (1) of this Agreement is checked, the Local Government agrees, subject to the availability of its personnel, to provide transportation and escort guard services for federal detainees housed at their facility to and from a medical facility for outpatient care, and transportation and stationary guard services for federal detainees admitted to a medical facility. These services should be performed by at least two armed quali?ed law enforcement or correctional officer personnel. If the Local Government is unable to meet this requirement, the Local Government may seek a waiver of this requirement from the local U.S. Marshal. The Local Government agrees to augment this security escort if requested by the USM to enhance specific requirement for security, prisoner monitoring, visitation, and contraband control. If an hourly rate for these services has been agreed upon to reimburse the Local Government it will be stipulated on page (1) of this Agreement. After 36 months, if a rate adjustment is desired, the Local Page 6 of 12 Agreement Number 52-03-0023 Government shall submit a request. Mileage shall be reimbursed in accordance with the current GSA mileage rate. Optional Guard/Transportation Services to U.S. Courthouse If U.S. Courthouse in block 13 on page (1) of this Agreement is checked, the Local Government agrees, subject to the availability of its personnel, to provide transportation and escort guard services for federal detainees housed at its facility to and from the U.S. Courthouse. These services should be performed by at least two armed qualified law enforcement or correctional of?cer personnel. If the Local Government is unable to meet this requirement, the Local Government may seek a waiver of this requirement from the local U.S. Marshal. The Local-Government agrees to augment this security escort if requested by the USM to enhance specific requirements for security, detainee monitoring, and contraband control. Upon arrival at the courthouse, the Local Government?s transportation and escort guard will turn federal detainees over to a DUSM only upon presentation by the deputy of proper law enforcement credentials. The Local Government will not transport federal detainees to any U.S. Courthouse without a speci?c request from the USM who will provide the detainee's name, the U.S. Courthouse, and the date the detainee is to be transported. Each detainee will be restrained in handcuffs, waist chains, and leg irons during transportation. If an hourly rate for these services has been agreed upon to reimburse the Local Government it will be stipulated on page (1) of this Agreement. After 36 months, if a rate adjustment is desired, the Local Government shall submit a request. Mileage shall be reimbursed in accordance with the current GSA mileage rate. Special Notifications The Local Government shall notify the Federal Government of any activity by a federal detainee which would likely result in litigation or alleged criminal activity. The Local Government shall immediately notify the Federal Government of an escape of a federal detainee. The Local Government shall use all reasonable means to apprehend the escaped Page 7 of 12 Agreement Number 52-03-0023 federal detainee and all reasonable costs in connection therewith shall be borne by the Local Government. The Federal Government shall have primary responsibility and authority to direct the pursuit and capture of such escaped federal detainees. Additionally, the Local Government shall notify the Federal Government as soon as possible when a federal detainee is involved in an attempted escape or conspiracy to escape from the facility. In the event of the death or assault of a federal detainee, the Local Government shall immediately notify the Federal Government. Prisoner Rape Elimination Act (PREA) The detention facility is requested to post the Prisoner Rape Elimination Act brochure/bulletin in each housing unit of the facility. All detainees have a right to be safe and free from sexual harassment and sexual assaults. (See Page 11) Service Contract Act This Agreement incorporates the following clause by reference, with the same force and effect as if it was given in full text. Upon request, the full text will be made available. The full text of this provision may be accessed electronically at this address: Federal Acquisition Regulation Clause(s): 52.222-41 Service Contract Act of 1965, as Amended (July 2005) 52.222-42 Statement of Equivalent Rates for Federal Hires (May 1989) 52.222-43 Fair Lab0r Standards Act and the Service Contract Act Price Adjustment (Multiyear and Option Contracts) (May 1989) The current Local Government wage rates shall be the prevailing wages unless notified by the Federal Government. Per-Diem Rate The Federal Government will use various price analysis techniques and procedures to ensure the per-diem rate established by this Agreement is considered a fair and reasonable price. Examples of such techniques include, but are not limited to, the following: 1. Comparison of the requested per~diem rate with the independent government estimate for detention services, otherwise known has the Core Rate; Page 8 of 12 Agreement Number 52-03-0023 2. Comparison with per-diem rates at other state or local facilities of similar size and economic conditions; 3. Comparison of previously proposed prices and previous Federal Government and commercial contract prices with current proposed prices for the same or similar items; 4. Evaluation of the provided jail operating expense information; The ?rm-fixed per-diem rate for services is $119.30, and shall not be subject to adjustment on the basis of Albany County Correctional Facility actual cost experience in providing the service. The per-diem rate shall be ?xed for a period from the effective date of the Agreement forward for 36 months. The per-diem rate covers the support of one federal detainee per ?federal detainee day?, which shall include the day of arrival, but not the day of departure. After 36 months, if a rate adjustment is desired, the Local Government shall submit a request through the Electronic Intergovernmental Agreements area of the Detention Services Network (DSNetwork). All information pertaining to the jail on DSNetwork will be required before a new per-diem rate can be considered. Billing and Financial Provisions The Local Government shall prepare and submit for certi?cation and payment, original and separate invoices each month to each Federal Government component responsible for federal detainees housed at the facility. Addresses for the components are: United States Marshals Service Northern District of New York 213 Federal Building - 10 Broad Street Utica, New York 13501 (315) 793-8109 Bureau of Prisons Community Corrections Office 411 7th Avenue, Room 1204 Pittsburg, PA. 15319 (412) 644?6560 Page 9 of 12 Agreement Number 52-03?0023 Immigration Customs Enforcement Northern Regional Office 70 Kimball Avenue S. Burlington, VT. 05403 (802) 660-1134 To constitute a proper invoice, the name and address of the facility, the name of each federal detainee, their speci?c dates of confinement, the total days to be paid, the appropriate per diem rate as approved in the Agreement, and the total amount billed (total days multiplied by the rate per day) shall be listed, along with the name, title, complete address and telephone number of the Local Government official responsible for invoice preparation. Nothing contained herein shall be construed to obligate the Federal Government to any expenditure or obligation of funds in excess of, or in advance of, appropriations in accordance with the Anti-Deficiency Act, 31 U.S.C. 1341. Payment Procedures The Federal Government will make payments to the Local Government on a basis, after receipt of an appropriate invoice. The Local Government shall provide a remittance address below: Albany County Correctional Facility 840 Albany Shaker Road Albany, NY 12211 Modifications and Disputes Either party may initiate a request for modification to this Agreement in writing. All modi?cations negotiated will be effective only upon written approval of both parties. Disputes, questions, or concerns pertaining to this Agreement will be resolved between appropriate of?cials of each party. Both the parties agree that they will use their best efforts to resolve the dispute in an informal fashion through consultation and communication, or other forms of non-binding alternative dispute resolution mutually acceptable to the parties. Page 10 of 12 Agreement Number 52-03-0023 Inspection of Services The Local Government agrees to allow periodic inspections of the facility by Federal Government inspectors. Findings of the inspection will be shared with the facility administrator in order to promote improvements to facility operations, conditions of confinement, and levels of services. Litigation The Federal Government shall be notified, in writing, of all litigation pertaining to this Agreement and provided copies of any pleadings filed or said litigation within 5 working days of the filing. The Local Government shall cooperate with the Federal Government legal staff and/or the United States Attorney regarding any requests pertaining to Federal Government or Local Government litigation. Page 11 of 12 Prigoner Rage Elimination Act Reggrting Informatign SEXUAL ASSA LT AWARENE This document is requested to be posted in each Housing Unit Bulletin Board at all Contract Detention Facilities. This document may be used and adapted by Intergovernmental Service Agreement Providers. W?hile detained by the Department of justice, United States Marshals Service, you have a right to be safe and free from sexual harassment and sexual assaults. mm A. Detainee-on-Detainee Sexual One or more detainees engaging in or attempting to engage in a sexual act with another detainee or the use of threats, intimidation, inappropriate touching or other actions and/ or communications by one or more detainees aimed at coercing and or pressuring another detainee to engage in a sexual act. B. -on-D tain Sex Ab As ult Staff member engaging in, or attempting to engage in a sexual act with any detainee or the intentional touching of a detainee?s genitalia, anus, groin, breast, inner thigh, or buttocks with the intent to abuse, humiliate, harass, degrade, arouse, or gratify the sexual desires of any person. Sexual abuse/ assault of detainees by sta?' or other detainees is an inappropriate use of power and is prohibited by policy and the law. C. Staff Sexual is: Sexual behavior between a staff member and detainee which can include, but is not limited to indecent, profane or abusive language or gestures and inappropriate visual surveillance of detainees. Prohibited Acts A detainee, who engages in inappropriate sexual behavior with or directs it at others, can be charged with the following Prohibited Acts under the Detainee Disciplinary Policy. Using Abusive or Obscene Language Sexual Assault Making a Sexual Proposal Indecent Exposure Engaging in Sex Act Detenm as a Safe Environment While you are detained, no one has the right to pressure you to engage in sexual acts or engage in unwanted sexual behavior regardless of your age, size, race, or ethnicity. Regardless of your sexual orientation, you have the right to be safe from unwanted sexual advances and acts. Con?dentiality Information concerning the identity of a detainee victim reporting a sexual assault, and the facts of the report itself, shall be limited to those who have the need to know in order to make decisions concerning the detainee-victim?s welfare and for law enforcement investigative purposes. Report All Assaults! If you become a victim of a sexual assault, you should report it immediately to any staff person you trust, to include housing of?cers, chaplains, medical staff, supervisors or Deputy US. Page 12 of 12 Marshals. Staff members keep the reported information con?dential and only discuss it with the appropriate of?cials on a need to know basis. If you are not comfortable reporting the assault to staff, you have other options: 0 Write a letter reporting the sexual misconduct to the person in charge or the United States Marshal. To ensure con?dentiality, use special (Legal) mail procedures. 0 File an Emergency Detainee Grievance If you decide your complaint is too sensitive to ?le with the Of?cer in Charge, you can ?le your Grievance directly with the Field Of?ce Director. You can get the forms from your housing unit of?cer, or a facility supervisor. 0 Write to the Of?ce of Inspector General (OIG), which investigates allegations of staff misconduct. The address is: Of?ce of Inspector General, US. Department of Justice, 950 Ave. Room 4706, Washington, DC. 20530 0 Call, at no expense to you, the Of?ce of Inspector General (OIG). The phone number is 1?800-869?4499. Individuals who sexually abuse or assault detainees can only be disciplined or prosecuted if the abuse is reported. A publication of the Of?ce of the Federal Detmtion Trustee Published February 2008