The facility houses a large number of people who were convicted of crimes in Washington, D.C. due to the National Capital Revitalization and Self-Government Improvement Act of 1997, which gave the Federal Bureau of Prisons custody of sentenced DC felons.

[8] On November 4, 2007, USP Big Sandy inmate Eric Eymard (17628-045) repeatedly stabbed his cellmate in the neck with a shank.

After the assault, Eymard told correctional officers that he had intended to kill his cellmate, who required surgery and hospitalization.

On May 21, 2009, while being prepared for transportation from USP Big Sandy to a hearing in Federal District Court in Ashland, Kentucky, Eymard stabbed two correctional officers with a sharp weapon which he had shaped from plexiglas.

In early 2008, inmate Steven Michael Reid (11728-018) threw scalding water on a prison unit manager's face and neck.

As a result of Reid's assault, the unit manager suffered first and second degree burns to the face, neck, and chest.

John Travis Millner (32011-007) stabbed fellow inmate Vincent Earl Smith Jr. at USP Big Sandy with a prison-made ice pick before strangling him to death in January 2009.

Millner was already serving a life sentence for shooting and killing a person using a high-powered rifle on New Year's Eve 2002.

Steven Michael Reid, who had already been sentenced to 20 additional years in prison connection with a 2008 assault on staff (see above), stabbed a correctional officer in the stomach on June 24, 2010, with a two-foot-long (60 cm) spear-type object made of two rolled up magazines and a sharpened piece of plexiglas.