DOJ-OGR-00026084.json 4.1 KB

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  1. {
  2. "document_metadata": {
  3. "page_number": "2408",
  4. "document_number": "BP-S358.060",
  5. "date": "7-10-2019",
  6. "document_type": "Medical Treatment Refusal",
  7. "has_handwriting": true,
  8. "has_stamps": false
  9. },
  10. "full_text": "Page 2408\nBP-S358.060 SEP 05 MEDICAL TREATMENT REFUSAL CDFRM\nU.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS\n7-10-2019 Date\nI, JEFFREY EPSTEIN 76318-054 , refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s):\nDESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY:\n66 YR OLD MALE WITH NO PMHX, REFERRED FOR ROUITNE CXR.\nThe following treatment(s) was/were recommended:\nCHEST X-RAY\nFederal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment:\nWORSENING THE CONDITION IF THERE IS ANY FINDINGS\nI understand the possible consequences and/or complications, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and its employees from any and all liability for respecting and following my expressed wishes and directions.\n(b)(6); (b)(7)(C) 7-10-2019 X-RAY Date\nCounseled by\nPatient's Signature\n(b)(6); (b)(7)(C) 7-10-19 NYM-NEW YORK MCC Date\nSignature of Witness\nDOJ-OGR-00026084",
  11. "text_blocks": [
  12. {
  13. "type": "printed",
  14. "content": "MEDICAL TREATMENT REFUSAL",
  15. "position": "header"
  16. },
  17. {
  18. "type": "printed",
  19. "content": "U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS",
  20. "position": "header"
  21. },
  22. {
  23. "type": "handwritten",
  24. "content": "7-10-2019",
  25. "position": "middle"
  26. },
  27. {
  28. "type": "printed",
  29. "content": "I, JEFFREY EPSTEIN 76318-054 , refuse treatment recommended by the Federal Bureau of Prisons Medical staff for the following condition(s):",
  30. "position": "middle"
  31. },
  32. {
  33. "type": "printed",
  34. "content": "DESCRIBE CONDITION IN LAYMAN'S TERMINOLOGY:",
  35. "position": "middle"
  36. },
  37. {
  38. "type": "printed",
  39. "content": "66 YR OLD MALE WITH NO PMHX, REFERRED FOR ROUITNE CXR.",
  40. "position": "middle"
  41. },
  42. {
  43. "type": "printed",
  44. "content": "The following treatment(s) was/were recommended:",
  45. "position": "middle"
  46. },
  47. {
  48. "type": "printed",
  49. "content": "CHEST X-RAY",
  50. "position": "middle"
  51. },
  52. {
  53. "type": "printed",
  54. "content": "Federal Bureau of Prisons Medical staff members have carefully explained to me that the following possible consequences and/or complications may result because of my refusal to accept treatment:",
  55. "position": "middle"
  56. },
  57. {
  58. "type": "printed",
  59. "content": "WORSENING THE CONDITION IF THERE IS ANY FINDINGS",
  60. "position": "middle"
  61. },
  62. {
  63. "type": "printed",
  64. "content": "I understand the possible consequences and/or complications, listed above, and still refuse recommended treatment. I hereby assume all responsibility for my physical and/or mental condition, and release the Bureau of Prisons and its employees from any and all liability for respecting and following my expressed wishes and directions.",
  65. "position": "middle"
  66. },
  67. {
  68. "type": "handwritten",
  69. "content": "7-10-2019",
  70. "position": "middle"
  71. },
  72. {
  73. "type": "handwritten",
  74. "content": "7-10-19",
  75. "position": "bottom"
  76. },
  77. {
  78. "type": "signature",
  79. "content": "",
  80. "position": "bottom"
  81. }
  82. ],
  83. "entities": {
  84. "people": [
  85. "JEFFREY EPSTEIN"
  86. ],
  87. "organizations": [
  88. "U.S. DEPARTMENT OF JUSTICE",
  89. "FEDERAL BUREAU OF PRISONS"
  90. ],
  91. "locations": [
  92. "NEW YORK MCC"
  93. ],
  94. "dates": [
  95. "7-10-2019",
  96. "7-10-19"
  97. ],
  98. "reference_numbers": [
  99. "76318-054",
  100. "BP-S358.060",
  101. "DOJ-OGR-00026084"
  102. ]
  103. },
  104. "additional_notes": "The document is a medical treatment refusal form signed by Jeffrey Epstein. The form indicates that Epstein refused a recommended chest X-ray treatment. The document contains some redacted information."
  105. }