TIMOTHY STAPLETON ORIGINAL

• Document Type: FOIA
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 06775865
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 3
• Document Creation Date: March 8, 2023
• Document Release Date: May 28, 2019
• Case Number: F-2015-02478
• Publication Date: June 18, 2013

Approved for Release: 2019/02/26 C06775865
Rage of
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Central Intelligence Agency
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MEDINT
Thimary Oftense
Location Type i
Data ReoOrtad
06/18/2013
Dine Reported
12:13
MEDICAL INCIDENT
Othor Oftenso
Other Offense
COO,, ClInton
Reponin � Officer
Distnct/Zone
Cue $tatO
SS
SPECIAL SERVICES
t. mown mummer:co
00930 DOLLEY MADISON BL PR
Can Soaped Be Identified
Y" Ej No C:3
Offense Begin Date
06/18/2013
Offense Begin
08:02
Time
Offense End Date
06/18(2013
Offense End Time
08:39
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I.'
T
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c
0
SC
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'.'1.
Nam
Sex
Race
o
'hen
Date of Birth
Social Secunly Number
Address
Horne Phone
Employer Nem /Address
Employer Phone
complainant
Sax
Race
Age
Date of Birth
Social Stoutly Number
Home Phone
Add'oSiT
-Employer Name / Address
Employer Phone
arrative',"-. -
..
OFFICER NARRATIVE:
On 18 June 2013, at approximately 0802 hours, I, SPS
(b)(3)
I I Team Specialist, was alerted by the Security
Operations Center (SOC) to a medical emergency in we outside air intake for mechanical room
GUS of the Imaging Publishing Services ) Building located on the George Bush Center for
Intelligence (GBCI) compound. Team Chief, Team Specialist,
and I responded to the scene arriving at approximately 0805 hours. Upon arrival to the
scene, I
shaft adjacent
approximately
to determine
and began
placed on
found the patient, Timothy Stapleton, lying unconscious and unresponsive in a concrete
to the IPS Building. Witnesses on scene stated that the patient had fallen �
15 to 20 feet landing on the floor below. Once I reached the patient I was able
there was no pulse present, called for an Automated External Defibrillator (AED)
Cardio Pulmonary Resuscitation (CPR) starting with chest compressions. The AED was
the patient and after anal zing the heart rhythm it stated no shock advised and
to resume
CPR. Specialist Itook over chest compressions while I provided ventilations
utilizing
a Bag Valve Mask (BVM). Team Chief handed me the suction unit since there was
;r
blood coming
Pharyngeal
from the patient's nose and mouth suctioning, I inserted an Oral
Airwa Cr_Gif2,4 in attempt to create a better airway for the patient. During that
time, Team
Chief was preparing the King LT - D to be inserted into the patient's airway.
While Specialist
continued chest compressions, I inserted the King LT - D. Team Chief
took
over ventilations after the insertion of the King LT - D. Personnel from the
.'of
CPR efforts.
after confirming
Medical Services (OMS) arrived on scene at approximately 0814 hours and assisted with
I inserted a 20 gauge intravenous catheter into the patient's left forearm and
a proper saline flow, I administered 1 mg of epinephrine. Personnel from
,. .. �-VEHICLE INFORMATION
Stolen 0 Recovered 0 Victimized fl Suspect El ' Towed El ATL E)
Year
Make
Model
Style
Color
License
Number
License Year
State �
VIN
veans
Towed By / Towed To
Stolen 0 Recovered 0 Victimized 0 Suspect El Towed M ATL CI
Year
Make
Model
Style
Color
1-1.1090
Number
License Year
Slate
VIN
Value
Towed By / Towed To
' ''.WITNESSES..- ..' .� .-,:�-:
Witness No. I
Addams �
930 DOLLEY MADISON BL
Su
Race
Age
TX
0 -
Witness No. 2
Address
930 DOLLEY MADISON BL
....
Sex
Race
Aga
TX
0 -
Lighting
Weather
Means at Entry
Point ol Entry
Point of Exit
Toots used
Evil Direction
Entry Direction
Signature of Reporting Officer:
Approved for Release: 2019/02/26 C06775865
Approved for Release: 2019/02/26 C06775865
Page
2 of
3
Central Intelligence Agency
Narrative Continued
Fairfax County Fire and Rescue Department (FCFRD) arrived at
hours and assumed patient care. We assisted FCFRD with placing
placing him on a cot, and transporting him to the ambulance. CPR
this process. The ' t was placed the in the back of the medic
the patient at approximately 0822 �
the patient on a backboard,
was continued throughout
unit at approximately 0827
�
hours, and all units cleared the scene without further incident.
,
Electronic Signature of Reporting Officer Date
06/18/2013
Pending Ell Arrest Adult El ExcepOonal Adulf I= Aohnin Close ED
Status
Unfounded 1=I Perest Juvenile 127:1 Exceptional Juvenile CI
Approving Supervisors Signature
P.N
This Report
Has Been Approved By:
Approved for Release: 2019/02/26 C06775865
Approved for Release: 2019/02/26 C06775865
P3 '3
Central Intelligence Agency.--
1
,
Suspect' . �� � . � '� ,, . ,
Name
STAPLETON, TIMOTHY
Name
Address
Address
Home Phone
Date of Birth
09/22/1955
Social Security Number
Homo Phone
Dale of Birth
Social Security Number
Sex
M
Rena
W
Age
057
Build
See
Rase
. AP*
Build
Height
508
Weight
195
Her
BRO
Eyes
BRO
Haight
Weight
Hair
Eyes
Place Employed! School'
.
Place Employed / School
Weapons
Weapons
.SeepecliNbterted, '7- .,,
:NNStit:::t;Ne :CM
Arrest #
Artest Date
Arras( Tiers
fitesPeci Melded ;:',
Arrest #
Arrest Date
Arrest Time
Arrest Location
Arrest Location
Arrest Charges
Arrest Charges
Injury Type
Injury Type
Name
Name .
Address
Address
Homo Phone
Defeat Birth
Sector Sammy Number
Homo Henna
Date of Birth
Social Security Number
Sex
Roos
Ago
Build
sok
Roca
Ago
Build
Height
Weight
Hair
Eyes
'Height
Weight
Hair
Eyes
Place S111000'1' SCh.'
Place Employed / School
Weapons
Weapons/
Saxe! AlieSbed ,
Yes .0 ISO [:::1
Arrest fl
Arrest Date
Arrest time
ArteSSed:
Yea.t1-'NO
Arrest #
Arrest Date
Arrest Time
Arrest theatres
Arrest Location
Arrest Charges
Arms! Charges
InlorY TYPo
Injury Type
This Report Has Been Approved By:
Approved for Release: 2019/02/26 C06775865