Iowa State Patrol: Department of Public Safety

Crash Information

L
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C
A
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N 		Date of Accident
3/3/2011		 Time of Accident
05:55 PM 		County
Dubuque - 31		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011014898
Literal Description
NB/EB US 0020 / US 20 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
680798.0
Y-Coordinate
4700961.
U
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1 		Driver's Name - Last
GIBBS		 First
JEFFREY		 Middle
RAY		 Suffix
City
DUBUQUE		 State
IA - Iowa, US		 Zip
52001
Driver's Age
57		 Citation Charge Code 1
321.20B-B		 Citation Charge 1
FINANCIAL LIABILITY-ACCIDENT
Gender
Male		 State
TX - Texas, US		 Class
C - Non-commercial vehicle or commercial Veh w/26000 GVWR or less & either 16 Pass Design or Hazmat		 Endorsements
None		 Restrictions

L - Veh w/o Airbrakes		 Citation Charge Code 2
321.98		 Citation Charge 2
OPERATION W/O REGISTRATION
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:
FINLEY HOSPITAL		 Transported by:
AMBULANCE
Insurance Co. Name
Year
2005		 Make
Ford - FORD		 Model
TAURUS		 Style
4D		 Approximate Cost to Repair or Replace
3000
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
65		 Point of Initial Impact
02 - Right Front		 Most Damaged Area
03 - Right Side		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
01 - No controls present		 Vehicle Config.
01 - Passenger car		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
8 - Other (explain in narrative)		 Vision Obscured
01 - Not obscured		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
04 - Crossed centerline/median		 Second Event
13 - Other non-collision		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
04 - Crossed centerline/median
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?
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Y

D
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E
If Property other than vehicles damaged explain Object Damaged
ROAD SIGN "YIELD" SIGN		 Estimate of Damage
100
Owner's Name - Last
 First
 Middle
 Suffix
Owner Company Name
STATE OF IOWA
City
DUBUQUE		 State
IA - Iowa, US		 Zip
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)
13 - Other non-collision
Manner of Crash/Collision
1 - Non-collision		 Roadway
01 - None apparent		 Type
Light Conditions
2 - Dusk		 Surface Conditions
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
D
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A
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0
NARRATIVE

THE DRIVER OF #1 WAS HAVING A DIABETIC REACTION. #1 CROSSED OVER THE MEDIAN OF HWY 20 NEAR SWISS VALLEY RD AND HIT A YIELD SIGN. # 1 CONTINUED WEST BOUND IN THE EAST BOUND LANES UNTIL HE WAS STOPPED AT COTTINGHAM RD.
Officer
DAUSENER 		Badge No.
144		 Time Officer Notified of Accident
18:01		 Time Officer Arrived At Scene
18:07
Name of Agency
P10		 Date of Report
3/3/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 10 Office
15239 35th St
Oelwein,IA 50662-9446
Phone: (319) 283-5521
Fax: (319) 283-2046