Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
4/5/2011		 Time of Accident
04:13 PM 		County
Clayton - 22		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011021069
Literal Description
X026 / FALCON AVE and US 0018 / US 18 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
631117.0
Y-Coordinate
4766574.
U
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1 		Driver's Name - Last
KIESAU		 First
BETTY		 Middle
EILEEN		 Suffix
City
MONONA		 State
IA - Iowa, US		 Zip
521590964
Driver's Age
71		 Citation Charge Code 1
321.322		 Citation Charge 1
FAIL TO YIELD FROM STOP SIGN
Gender
Female		 State
IA - Iowa, US		 Class
C - Non-commercial vehicle or commercial Veh w/26000 GVWR or less & either 16 Pass Design or Hazmat		 Endorsements
None		 Restrictions

B - Cor Lenses		 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
5 - Not deployed		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2006		 Make
Buick - BUIC		 Model
RDV		 Style
SW		 Approximate Cost to Repair or Replace
4000
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
25		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 Extent of Damage
4 - Disabling damage		 Underride/Override
1 - None
Total Occupants
1		 Traffic Controls
04 - Stop signs		 Vehicle Config.
04 - Sport utility vehicle		 Cargo Body Type
01 - Not applicable		 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
21 - Vehicle in traffic		 Second Event
01 - Ran off road, right		 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?
U
N
I
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2 		Driver's Name - Last
WEIPERT		 First
PAUL		 Middle
SAMUEL		 Suffix
City
FARMERSBURG		 State
IA - Iowa, US		 Zip
52047
Driver's Age
41		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 State
IA - Iowa, US		 Class
A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more		 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
2 - Incapacitating		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
1 - Deployed front of person		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
PDC MEMORIAL HOSP		 Transported by:
MONONA AMBUALNCE
Insurance Co. Name
Year
1997		 Make
Chevrolet - CHEV		 Model
CAV		 Style
4D		 Approximate Cost to Repair or Replace
2500
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
03 - Right Side		 Most Damaged Area
03 - Right Side		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
2		 Traffic Controls
01 - No controls present		 Vehicle Config.
01 - Passenger car		 Cargo Body Type
01 - Not applicable		 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
 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)
02 - Partly cloudy		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
Manner of Crash/Collision
5 - Broadside		 Roadway
01 - None apparent		 Type
Light Conditions
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
11 - Four-way intersection		 Workers Present?
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D 		Name- Last
DUNDEE		 First
JORDAN		 Middle
 Suffix
City
 State
 Zip Code
Age
7		 Sex
Male		 Unit No.
2		 Seating Position
08 - Rear: Center		 Injury Status
2 - Incapacitating		 Occupant Protection
3 - Lap belt only used		 Airbag Deployment
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
1 - Not trapped
Transported to:
PDC MEMORIAL HOSP		 Transported by:
MONONA AMBULANCE
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
D
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NARRATIVE

VEHICLE #1 WAS STOPPED AT THE POSTED STOP SIGN AT THE NORTH SIDE OF THE INTERSECTION OF HWY 18/52 AND FALCON AVE. (X28). VEHICLE #2 WAS TRAVELING WEST ON US HWY 18/52. VEHICLE #1 PULLED OUT INTO THE INTERSECTION AND STRUCK VEHICLE #2 IN THE PASSENGER SIDE. DRIVER AND PASSENGER OF VEHICLE #2 WERE INJURED AND TRANSPORTED BY AMBULANCE TO PRAIRIE DU CHIEN MEMORIAL HOSPITAL. PASSENGER IN VEHICLE #2 WAS LATER AIR-LIFTED TO LACROSSE. DRIVER OF VEHICLE #1 REPORTED NO INJURIES AT THE SCENE.
Officer
MOMMER 		Badge No.
189		 Time Officer Notified of Accident
16:17		 Time Officer Arrived At Scene
16:25
Name of Agency
P10		 Date of Report
4/5/2011		 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