U
N
I
T
1
|
Driver's Name - Last MCKEAN |
First KEVIN |
Middle MICHAEL |
Suffix
|
City CLOQUET |
State MN - Minnesota, US |
Zip 557200000 |
Driver's Age 32 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State OK - Oklahoma, US |
Class D - Chauffeur |
Endorsements None |
Restrictions
None |
Citation Charge Code 2
|
Citation Charge 2
|
Alcohol Test Given? 1 - None |
Drug Test Given? 1 - None |
Citation Charge Code 3
|
Citation Charge 3
|
Citation Charge Code 4
|
Citation Charge 4
|
Seating Position 01 - Front: Left Side / Motorcycle Driver |
Injury Status 4 - Possible |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 5 - Not deployed |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: MARY GREELEY-AMES |
Transported by: STORY CITY AMBULANCE |
Insurance Co. Name
|
Year 1998 |
Make Ford - FORD |
Model CONTOUR |
Style 4DR |
Approximate Cost to Repair or Replace 1000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 04 - Right Rear |
Most Damaged Area 04 - Right Rear |
Extent of Damage 4 - Disabling damage |
Underride/Override 1 - None |
Total Occupants 4 |
Traffic Controls 01 - No controls present |
Vehicle Config. 01 - Passenger car |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 4 - Illness |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event 13 - Other non-collision |
Second Event 06 - Evasive action (swerve, panic braking, etc.) |
Third Event
|
Fourth Event
|
Most Harmful Event (by vehicle) 22 - Vehicle in/from other roadway |
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?
|
U
N
I
T
2
|
Driver's Name - Last HAVENS |
First MICHAEL |
Middle JAMES |
Suffix
|
City WEST DSM |
State IA - Iowa, US |
Zip 50421 |
Driver's Age 27 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State MN - Minnesota, US |
Class D - Chauffeur |
Endorsements None |
Restrictions
None |
Citation Charge Code 2
|
Citation Charge 2
|
Alcohol Test Given? 1 - None |
Drug Test Given? 1 - None |
Citation Charge Code 3
|
Citation Charge 3
|
Citation Charge Code 4
|
Citation Charge 4
|
Seating Position 01 - Front: Left Side / Motorcycle Driver |
Injury Status 5 - Uninjured |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 1 - Deployed front of person |
Airbag Switch Status 1 - Switch in ON position |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: NA |
Transported by: NA |
Insurance Co. Name
|
Year 2008 |
Make Chevrolet - CHEV |
Model TBZ |
Style SW |
Approximate Cost to Repair or Replace 1000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 70 |
Point of Initial Impact 06 - Left Rear |
Most Damaged Area 06 - Left Rear |
Extent of Damage 2 - Minor damage |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 01 - No controls present |
Vehicle Config. 02 - Four-tire light truck (pick-up, panel) |
Cargo Body Type 10 - Small utility (one axle) |
Vehicle Defect 01 - None |
Driver Condition 1 - Apparently normal |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
| SEQUENCE OF EVENTS |
First Event 06 - Evasive action (swerve, panic braking, etc.) |
Second Event 21 - Vehicle in traffic |
Third Event
|
Fourth Event 08 - Cargo/equipment loss or shift |
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) 05 - Mist |
Environment 1 - None apparent |
Location
|
First Harmful Event of Crash (use codes 11-42 only) 21 - Vehicle in traffic |
Manner of Crash/Collision 6 - Sideswipe, same direction |
Roadway 01 - None apparent |
Type
|
Light Conditions 5 - Dark, roadway not lighted |
Surface Conditions 2 |
Type of Roadway Junction/Feature 01 - No special feature |
Workers Present?
|
D I A G R A M
0 |
|
| NARRATIVE |
UNIT 1 WAS NORTHBOUND I-35 SOUTH OF THE 127 MILE-MARKER ON INTERSTATE 35. THE DRIVER OF UNIT 1; EXPERIENCED A SUDDEN ONSET AND IMMEDIATELY DEBILITATING MEDICAL EPISODE, SLAMMED ON THE BRAKES, WAS IN THE TRAVEL PORTION OF THE ROAD, THE FEMALE PASSENGER WAS ABLE TO MANEUVER THE VEHICLE TOWARD THE SHOULDER OF THE ROAD. THE DRIVER OF UNIT 2 WAS NORTHBOUND I-35 WHEN; IT NOTICED THE SUDDEN BRAKING OF UNIT 1, COULD NOT PASS ON THE LEFT DUE TO THE PRESENCE OF ANOTHER VEHICLE, ATTEMPTED TO LEAVE THE ROADWAY TO THE RIGHT, THE TIRE OF THE TRAILER IT WAS PULLING STRUCK THE RIGHT REAR CORNER OF UNIT 1 AND CAME TO REST IN THE DITCH FACING NORTHBOUND. NO INJURIES WERE REPORTED NOR COMPLAINED OF. THE DRIVER OF UNIT 1 WAS TRANSPORTED FROM THE SCENE TO BE OBSERVED FOR THE INITIAL MEDICAL EPISODE. SEATBELT USAGE PREVENTED INJURY. |
|
Officer
ADES |
Badge No. 098 |
Time Officer Notified of Accident 18:43 |
Time Officer Arrived At Scene 18:55 |
Name of Agency P07 |
Date of Report 2/20/2011 |
Investigation made at scene? Yes |
T.I. #
|
Any questions about this report may be directed to the following address:
Iowa State Patrol District 07 Office
2437 235th St
Ft Dodge,IA 50501-8465
Phone: (515) 972-4213
Fax: (515) 972-4218