Medical Examiner Public Data Form
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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 53 rd 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
description
A medical examiner’s report released Tuesday says 10-year-old Barway Collins’ death was a homicide, but the cause of death is still unknown.
Transcript of Medical Examiner Public Data Form
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
