Critical Medical Examiner Choice for Flagler’s District Down to Chief of Palm Beach Office and One of Her Assistants

On December 6, Sneed and Miller will be vying for the same job: Chief medical Examiner for District 23, which covers Flagler, St. Johns and Putnam counties. The two finalists will be interviewed–Miller at 10 a.m., Sneed at 1:30 p.m.–by a three-county panel chaired by R.J. Larizza, the state attorney for the Seventh Judicial District, which includes all three counties plus Volusia. Volusia has its own medical examiner.

The search for a new medical examiner in a profession with its own near-critical dearth of qualified pathologists was precipitated by the unexpected death of Dr. Predrag Bulic, who’d been the district’s medical examiner for 12 years when he died in July after a severe stroke. He was 63. Dr. Jon R. Thogmartin, a highly regarded pathologist and former chief medical examiner in Pinellas and Pasco counties, has been the interim. He is not interested in the permanent post.

The medical examiner’s job likely has the greatest low-profile to high-impact ratio in the criminal justice system. Few people ever see the medical examiner, considering that the chief portion of their clientele is dead. They’re responsible for autopsies of victims of homicide, car crashes, untimely, suspicious and unexplained deaths. They work closely with detectives and state investigators, and answer to families’ anxieties about their loved ones’ cause of death, at times being the final word on whether a person died accidentally, by suicide or by foul means.




When medical examiners are seen in public, the few times they are, it’s to testify at trials, usually for the prosecution, as their testimony plays a key role in determining a victim’s manner of death and a perpetrator’s means of culpability. That’s why both the state attorney and the public defender consider the appointment of a chief medical examiner to be a crucial link in their cases.

That’s why Larizza and Public Defender Matt Metz have been at the table as the panel first culled candidates from eight to five on Nov. 1, then, on Nov. 21, down to Miller and Sneed, with one candidate withdrawing on his own. The three others had been Kent Harshbarger, the Montgomery County, Ohio, coroner, who was the one to withdraw; Keng-Chih Su, a forensic pathologist at the coroner’s office in Sacramento, Calif. and Stacey Simons, an associate medical examiner in Florida’s District 18 in Rockledge. St. Johns County Human Resources Director Lilian Hutchinson had conducted pre-interviews with all the candidates.

The panel also includes the St. Augustine police chief, the St. Johns County sheriff, the public defender for the Seventh Judicial Circuit, a Palm Coast physician, a Palatka funeral director, and, representing Flagler County, Andy Dance, the county commissioner. It’s a scaled down committee, compared to its last edition in 2011, when Bulic was hired. The group has been meeting at the St. Johns County administration complex. The meetings are open to the public. It will meet again before the day of the interviews to go over questions that will be asked the candidates.




One of the questions is certain to be this (the panel alluded to it when it met in early November): why would the chief medical examiner of a county with a population of 1.5 million choose to leave a job she fought for just three years ago–after the retirement of Chief Medical Examiner Michael Bell–and won out of a pool of 11 candidates, overseeing a significant capital expansion, to come to a district where the combined population of Flagler, St. Johns and Putnam counties is a third that of Palm Beach County at most?

Sneed oversaw a staff of 26 when she took over. The office grew to 28 by 2022, on a budget just shy of $5 million. Her office saw pathologists perform on average 225 autopsies a year, per pathologist. The profession’s best practice is 225 a year, plus or minus 50 cases.

The Medical Examiner’s office for the 23rd district is smaller in every respect. It has a current budget of $1.34 million. St. Johns county share is $757,000, with Putnam and Flagler contributing $872,000 (Flagler’s share is 24 percent, Putnam’s 30 percent.) In 2021, the office conducted 560 autopsies for the three counties combined, and gave approval for 4,100 cremations for a total of 4,660 cases. The case estimate for 2022 is about 5,500.

Pay may not be an issue. The starting base salary in West Palm Beach was advertised as $260,000 in 2019 (the retiring medical examiner was making $286,000). The 23rd District wants to be competitive: it is offering a non-negotiable salary of $320,000, or $120,000 more than Bulic’s starting salary a little over a decade ago. (Associate medical examiners’ pay starts at $200,000, depending on experience).

St. Johns also has a chief attraction, if the candidates have school-age children: year after year it is the best school system in the state, often by far, and the envy of counties like Flagler and Putnam. Panelists are barred by law from asking a candidate’s age, but not whether the candidate has school-age children.




Miller graduated Tulane University with an undergraduate degree in 2009 and became a doctor of medicine with a degree from Meharry Medical College in Nashville in 2015. She trained in Miami-Dade and at the University of Texas, and has been an associate medical examiner in Palm Beach since July 2020, also performing similar services (what’s referred to with the Latin phrase lucum tenens) for the medical examiner offices in Miami Dade and Galveston County, Texas. She remains a clinical assistant professor in the department of pathology at the university of Texas Medical Branch, but without a salary. She’s widely published despite a young career.

Sneed is not quite a generation older. She graduated from the University of Vermont in Burlington with a B.S. in 1993 and graduated medical school from Ponce School of Medicine in Puerto Rico in 1999, going on to a residency at Mount Sinai in Miami Beach. She was Resident of the Year there in 2003. Between 2005 and 2019, she was an assistant medical examiner in Miami Dade, Fort Myers, Maricopa County, Ariz., and Broward County. She then won the job in Palm Beach County.

The highest-profile case she has testified in was in the recent sentencing trial of Nicholas Cruz, the man responsible for the massacre of 17 people, most of them students, at Marjory Stoneman Douglas High School in February 2018. As an associated medical examiner in Broward County at the time, she had performed autopsies on two of the victims, Christopher Hixon , who died of two gunshot wounds, and Peter Wang, who was struck with 12 gunshots wounds, including four to the head, impacts the medical examiner described on the stand.