MEDICAL EXAMINER PUBLIC DATA FORM Data Classified as “Public” in Accordance with Minnesota Statute §13.83 Medical Examiner Data

NAME: Collins, Barway Edwin CASE #: 2015-2071

DATE OF BIRTH: 11/10/2004 DATE OF DEATH: 04/11/2015

ADDRESS: 5450 Douglas Dr #129, Crystal, MN 55429

SEX: Male AGE: 10 HEIGHT: 58 inches WEIGHT: 108 pounds

RACE: (DC)* Black CITIZENSHIP: (DC)* Ghana

HAIR COLOR: Black EYE COLOR: Brown

BUILD: No record COMPLEXION: No record

IDENTIFYING MARKS, SCARS, AMPUTATIONS: None

DESCRIPTION OF CLOTHING: Short sleeved t-shirt with “Wave Rider” surfboards logo, black belt, Wrangler

black denim jeans, underwear, Shaq brand gray, black and red sneakers, socks

MARITAL STATUS: Never Married NAME OF SPOUSE: None

LOCATION OF DEATH: Mississippi River close to 53rd

Ave N/Lyndale Ave N, Minneapolis, MN 55430

SERVED IN THE ARMED FORCES: (DC)* No

OCCUPATION: (DC)* None BUSINESS: (DC)* None

FATHER’S NAME: Pierre Barlee Collins MOTHER’S NAME: (DC)* Sylvia Mamie Kromah

BIRTHPLACE OF DECEDENT: (DC)* Ghana

BIRTHPLACE OF PARENTS: No record

MANNER OF DEATH: Homicide CAUSE OF DEATH: Homicide by unspecified means

CAUSES OF CAUSE OF DEATH: N/A

OTHER SIGNIFICANT CONDITIONS: N/A

AUTOPSY PERFORMED: Yes CONCLUSIVE: N/A DATE OF INJURY: Unknown

PLACE OF INJURY: Unknown

HOW INJURY OCCURRED: Deceased was injured by another person or persons

ATTENDANCE OF PHYSICIAN: No

PHYSICIAN NAME AND ADDRESS: None

CERTIFICATION BY CORONER OR MEDICAL EXAMINER: Yes

NAME OF CORONER OR MEDICAL EXAMINER: Andrew Baker, M.D.

TYPE OF DISPOSITION OF BODY: DC* Burial DATE OF DISPOSITION: DC*

PLACE OF BURIAL: DC* Glen Haven Memorial Gardens

FUNERAL HOME: Estes Funeral Home

LOCAL FUNERAL DIRECTOR: DC* Tracy Wesley Sr.

DC* Data from Death Certificate in MDH Minnesota Registration & Certification System (MR&C)

*Form Updated by MDR June 2013