Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
10/9/2010		 Time of Accident
01:38 PM 		County
Jasper - 50		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010058323
Literal Description
16.85 MM WB ON HWY 163 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
477015.4
Y-Coordinate
4605551.
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1 		Driver's Name - Last
ROBERSTON		 First
DOUGLAS		 Middle
EMERY		 Suffix
City
OTTUMWA		 State
IA - Iowa, US		 Zip
52501
Driver's Age
71		 Citation Charge Code 1
321J.2A		 Citation Charge 1
OWI (1ST OFFENSE)
Gender
Male		 State
IA - Iowa, US		 Class
D - Chauffeur		 Endorsements
3 - Pass Veh less than 16 Pass Design		 Restrictions

None		 Citation Charge Code 2
 Citation Charge 2
Alcohol Test Given?
4 - Breath		 Drug Test Given?
1 - None		 Citation Charge Code 3
 Citation Charge 3
Citation Charge Code 4
 Citation Charge 4
Seating Position
10 - Sleeper Section		 Injury Status
4 - Possible		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
2 - Deployed side of person		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
METHODIST HOSPITAL		 Transported by:
PRARIE CITY
Insurance Co. Name
Year
2007		 Make
Ford - FORD		 Model
FSL		 Style
VN		 Approximate Cost to Repair or Replace
10000
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
65		 Point of Initial Impact
07 - Left Side		 Most Damaged Area
07 - Left Side		 Extent of Damage
4 - Disabling damage		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
01 - No controls present		 Vehicle Config.
04 - Sport utility vehicle		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
6 - Under the influence of alcohol/drugs/medications		 Vision Obscured
01 - Not obscured		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
21 - Vehicle in traffic		 Second Event
 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
21 - Vehicle in traffic
Emergency Vehicle Type
1 - Not applicable		 Emergency Status
3 - Not Applicable
Carrier Name
 City
 State
 Zip
Number of Axles
 Gross Vehicle Weight Rating
 Placard #
 Hazardous Materials Released?
ACCIDENT ENVIRONMENT ROADWAY CHARACTERISTICS
Major Contributing Circumstances:		 WORKZONE RELATED? SEQUENCE OF EVENTS
Location of First Harmful Event
1 - On Roadway		 Weather Conditions (up to two)
01 - Clear		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
Manner of Crash/Collision
1 - Non-collision		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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NARRATIVE

UNIT #1 WAS TRAVELING WEST BOUND ON HWY 163 WHEN HE LOST CONTROL OF HIS VEHICLE AND WENT INTO THE DITCH. THE VEHICLE ROLLED ONE TIME COMING TO A REST ON ALL FOUR TIRES. THE DRIVER WAS TRANSPORTED TO METHODIST HOSPITAL AND THE VEHICLE WAS TOWED BY HEWITTS TOWING.
Officer
STARRETT 		Badge No.
248		 Time Officer Notified of Accident
13:38		 Time Officer Arrived At Scene
13:54
Name of Agency
P01		 Date of Report
10/9/2010		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 01 Office
260 NW 48th Place
Des Moines,IA 50313-2299
Phone: (515) 725-0010
Fax: (515) 725-0011