Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
4/15/2011		 Time of Accident
12:33 PM 		County
Polk - 77		 Accident occurred within corporate limits of (city)
Des Moines - 1945		 Law Enforcement Case Number:
2011022827
Literal Description
E GRAND AVE (1000 BLOCK - DRIVEWAY TO I.W.D.) 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
449609.3
Y-Coordinate
4604661.
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1 		Driver's Name - Last
ELLIOTT		 First
LARRY		 Middle
DANIEL		 Suffix
City
DES MOINES		 State
IA - Iowa, US		 Zip
503140000
Driver's Age
45		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 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

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
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
NA		 Transported by:
NA
Insurance Co. Name
Year
1983		 Make
General Motors - GMC		 Model
 Style
PK		 Approximate Cost to Repair or Replace
350
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
30		 Point of Initial Impact
01 - Front		 Most Damaged Area
01 - Front		 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
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?
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N
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2 		Driver's Name - Last
GREEN		 First
CRYSTAL		 Middle
DAWN		 Suffix
City
DES MOINES		 State
IA - Iowa, US		 Zip
503120000
Driver's Age
28		 Citation Charge Code 1
321.20B-B		 Citation Charge 1
NO INSURANCE - ACCIDENT RELATED
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

None		 Citation Charge Code 2
321.306		 Citation Charge 2
IMPROPER USE OF LANES
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
3 - Non-incapacitating		 Occupant Protection
2 - Shoulder and lap belt used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
1 - Switch in ON position		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
MERCY CLINIC		 Transported by:
PRIVATE
Insurance Co. Name
Year
2000		 Make
Chevrolet - CHEV		 Model
IMP		 Style
4D		 Approximate Cost to Repair or Replace
1500
Initial Travel Direction
2 - East		 Vehicle Action
08 - Leaving traffic lane		 Speed Limit
30		 Point of Initial Impact
07 - Left Side		 Most Damaged Area
07 - Left Side		 Extent of Damage
2 - Minor 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
1 - Apparently normal		 Vision Obscured
01 - Not obscured		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
13 - Other non-collision		 Second Event
04 - Crossed centerline/median		 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)
06 - Rain		 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
02 - Road surface condition		 Type
Light Conditions
1 - Daylight		 Surface Conditions
2		 Type of Roadway Junction/Feature
04 - Business drive		 Workers Present?
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NARRATIVE

VEHICLE #1 AND VEHICLE #2 WERE EASTBOUND ON EAST GRAND AVENUE FROM 9TH STREET IN THE 1000 BLOCK. VEHICLE #1 WAS IN THE LEFT LANE AND VEHICLE #2 WAS IN THE RIGHT LANE. VEHICLE #2 PASSED VEHICLE #1, CHANGED FROM THE RIGHT LANE TO THE LEFT LANE, AND THEN SLOWED TO MAKE A LEFT TURN INTO THE EAST DRIVE OF THE IOWA WORK DEVELOPMENT DRIVEWAY WHILE ONLY A FEW CAR LENGTHS AHEAD OF VEHICLE #1. VEHICLE #1'S RIGHT FRONT CORNER STRUCK VEHICLE #2'S DRIVER'S DOOR. DRIVER OF VEHICLE #2 COMPLAINED OF NECK PAIN BUT REFUSED RESCUE.
Officer
OCONNELL 		Badge No.
419		 Time Officer Notified of Accident
12:35		 Time Officer Arrived At Scene
12:39
Name of Agency
P02		 Date of Report
4/15/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 02 Office
1619 Truro Pavement
Osceola,IA 50213-8383
Phone: (641) 342-2108
Fax: (641) 342-4653