Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
5/28/2011		 Time of Accident
09:30 PM 		County
O'Brien - 71		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011031055
Literal Description
0.7 M W OF M12 ON 400TH ST 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
296340.3
Y-Coordinate
4771462.
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1 		Driver's Name - Last
WILLIAMS		 First
MACIE		 Middle
JEAN MARIE		 Suffix
City
PAULINA		 State
IA - Iowa, US		 Zip
51046
Driver's Age
16		 Citation Charge Code 1
321.288		 Citation Charge 1
FAIL TO MAINTAIN CONTROL
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
 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
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
PRIMGHAR HOSPITAL		 Transported by:
PRIVATE PARTY (MOTHER).
Insurance Co. Name
Year
1997		 Make
Chevrolet - CHEV		 Model
CAMARO		 Style
2D		 Approximate Cost to Repair or Replace
3000
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
02 - Right Front		 Most Damaged Area
09 - Top		 Extent of Damage
4 - Disabling damage		 Underride/Override
1 - None
Total Occupants
3		 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
05 - Animal or object in roadway		 Second Event
01 - Ran off road, right		 Third Event
 Fourth Event
 Most Harmful Event (by vehicle)
11 - Overturn/rollover
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

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E
If Property other than vehicles damaged explain Object Damaged
NONE		 Estimate of Damage
Owner's Name - Last
 First
 Middle
 Suffix
Owner Company Name
City
 State
 Zip
ACCIDENT ENVIRONMENT ROADWAY CHARACTERISTICS
Major Contributing Circumstances:		 WORKZONE RELATED? SEQUENCE OF EVENTS
Location of First Harmful Event
2 - Shoulder		 Weather Conditions (up to two)
02 - Partly cloudy		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
11 - Overturn/rollover
Manner of Crash/Collision
1 - Non-collision		 Roadway
01 - None apparent		 Type
Light Conditions
5 - Dark, roadway not lighted		 Surface Conditions
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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0
NARRATIVE

VEH #1 WAS WESTBOUND ON 400TH ST (A GRAVEL ROAD), THE DRIVER SWERVED TO MISS A DEER AND SUBSUQUENTLY LOST CONTROL. SHE FIRST STRUCK THE RIGHT SHOULDER, SWERVED TO THE MIDDLE, AND THEN OVER CORRECTED CAUSING HER TO ENTER THE NORTH DITCH. THE VEHICLE THEN DID ROLL OVER AND COME TO REST ON ITS TOP.
Officer
CHRISTIANS 		Badge No.
163		 Time Officer Notified of Accident
22:41		 Time Officer Arrived At Scene
23:13
Name of Agency
P06		 Date of Report
5/28/2011		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 06 Office
503 W 44th St
Spencer,IA 51301-2089
Phone: (712) 262-1424
Fax: (712) 262-3222