Testifying is a very small percentage of what we do.”

Dr. Andrew M. Baker, Chief Medical Examiner for the Hennepin/Scott/Dakota County Medical Examiner’s Office

When one hears from a medical examiner, it is often in a courtroom or when reading about determining a cause of death.
While those are roles of the medical examiner’s office, it’s “just the tip of the iceberg,” said Dr. Andrew M. Baker, Chief Medical Examiner for the Hennepin/Scott/Dakota County Medical Examiner’s Office.
Dakota, Scott, and Hennepin counties share a medical examiner’s office located in Minnetonka. While that tri-county area is the smallest by geography in the state, it has the highest population served.
In reality, the office has a number of roles ranging from hospice pre-registration, laboratory services, records management and cremation approval.
In fact, last year, only 4% of cases in the tri-county area were homicides, according to the 2024 Medical Examiners Annual Report.
“Testifying is a very small percentage of what we do,” said Baker.
Each year the medical examiner’s office compiles an annual report that breaks down causes of death into great detail from broad categories of vehicular accidents and suicide to specifics like how many died from respiratory causes like asthma to chromic alcoholism.
Baker called this pie chart the “single most important chart I show the public.”
Beyond that 4%, most of the office’s role has to do with public health because it turns out how a population dies has a lot of insight into how it should live.
“Ninety-six percent of what we do is public health,” said Baker.
From that report, Baker highlighted some insights into the tri-county area’s numbers.
In 2024, nearly half of deaths in the tri-county area—47%—were non-vehicular accidents. The highest causes within that category were fatal falls and drug overdoses.
Last year Dakota County had 117 fatal falls. That figure is more than 60% of the total number of non-vehicular accidental deaths in the county and exactly 30% of total deaths countywide. The number of fatal falls in Dakota County has nearly doubled since 2020 where there were 70 fatal falls.
Understanding that 3 in 10 deaths in Dakota County last year came from falls can inform programming and raise awareness about the issue.
The entire category of non-vehicular accidental deaths has continued to grow in the tri-county area over the past five years due to high sustained drug overdose numbers even after the COVID-19 Pandemic. Since 2020, the number of non-traffic accidental deaths has risen 31% to 178 deaths in 2024 from 122 in 2020.
Despite the rise in non-vehicular accidental deaths, in Dakota County the number of fatal falls is still nearly three times higher than drug overdoses and has risen faster than drug overdoses since 2020.
Nearly a third of deaths in 2024 were natural causes of death, many of which were preventable or undiagnosed like heart disease, which is the leading cause of death in the United States and second leading cause of death in Minnesota.
The total number of cases for the medical examiner’s office has risen in recent years, up 13% from 2020 levels.
This rise in caseload comes at a time of staffing shortages for medical examiners, what Baker calls “the perfect storm.”
Baker estimated that across the United States, 1,500 certified forensic pathologists are needed, roughly double the number that are currently practicing.
“It’s constantly a battle to recruit the staff we need,” said Baker.
As caseloads continue to increase, especially the number of drug-related overdose deaths, the issue will only compound.