Crash Information

L O C A T I O N	Date of Accident 9/18/2011	Time of Accident 06:50 PM	County Pottawattamie - 78	Accident occurred within corporate limits of (city)	Law Enforcement Case Number: 2011054127
	Literal Description EB INTERSTATE 0080 34.5 MM				Legal Intervention? No	Private Property? No
					X-Coordinate: 295663.8
					Y-Coordinate 4597012.

U N I T 1	Driver's Name - Last THIES			First DAVID			Middle LEE		Suffix
	City AMES			State IA - Iowa, US				Zip 500109137
	Driver's Age 43					Citation Charge Code 1 321.98		Citation Charge 1 OPERATION WITHOUT REGISTRATION
	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	Restrictions None	Citation Charge Code 2		Citation Charge 2
	Alcohol Test Given? 2 - Blood			Drug Test Given? 2 - Blood		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: JENNY EDMUNDSON					Transported by: AVOCA RESCUE
	Insurance Co. Name
	Year 2001		Make Honda - HOND		Model ACC		Style 4D		Approximate Cost to Repair or Replace 6000
	Initial Travel Direction 2 - East	Vehicle Action 06 - Changing lanes	Speed Limit 70	Point of Initial Impact 08 - Left Front	Most Damaged Area 09 - Top	Extent of Damage 3 - Functional damage	Underride/Override 1 - None
	Total Occupants 01	Traffic Controls 01 - No controls present	Vehicle Config. 01 - Passenger car	Cargo Body Type 01 - Not applicable	Vehicle Defect 01 - None	Driver Condition 9 - Unknown	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 20 - Non-motorist (see non-motorist type)	Third Event	Fourth Event	Most Harmful Event (by vehicle) 20 - Non-motorist (see non-motorist type)
	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) 20 - Non-motorist (see non-motorist type)
Manner of Crash/Collision 1 - Non-collision	Weather Conditions (up to two) 02 - Partly cloudy	Roadway 01 - None apparent	Type
Light Conditions 1 - Daylight	Surface Conditions 2	Type of Roadway Junction/Feature 01 - No special feature	Workers Present?

P
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S
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J
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Name- Last
COLLINS

First
MICHAEL

Middle
BENJAMIN

Suffix

City

State

Zip Code

Age
41

Sex
Male

Unit No.

Seating Position
15 - Pedestrian

Injury Status
1 - Fatal

Occupant Protection

Airbag Deployment

Airbag Switch Status

Ejection

Ejection Path

Trapped

Transported to:
STATE MEDICAL EXAMIER

Transported by:
PAULEY JONES FUNERAL HOME

NON-MOTORIST

Type
8 - Other (wheelchair, etc.)

Location
9 - Unknown

Action
8 - Other (explain in narrative)

Condition
1 - Apparently normal

Safety Equipment
2 - Reflective clothing

Contributing Circumstances
88 - Other (explain in narrative)

Unit No. of Vehicle Striking
1

D
I
A
G
R
A
M

0

NARRATIVE

VEHICLE #1 WAS TRAVELING EB ON I-80 AND APPROACHING THE 34.50 MM. THE DRIVER OF VEHICLE #1 NOTICED THAT TRAFFIC IN FRONT OF HIM HAD SLAMMED ON THEIR BRAKES FOR UNKNOWN REASONS. OPPOSED TO COLLIDING INTO THE REAR OF ANOTHER VEHICLE, THE DRIVER OF VEHICLE #1 SWERVED INTO THE LEFT LANE AND STRUCK THE VICTIM, WHO WAS STANDING IN THE LEFT LANE DIRECTING TRAFFIC. VEHICLE #1 ENTERED THE MEDIAN AND CAME TO A STOP. AMENDED 1/4/12 - CHANGED NARRATIVE, ADDED CHARGES, AND BLOOD TEST RESULTS.

Officer HITCHCOCK	Badge No. 423	Time Officer Notified of Accident 18:50	Time Officer Arrived At Scene 18:50
Name of Agency P03	Date of Report 9/18/2011	Investigation made at scene? Yes	T.I. #

Any questions about this report may be directed to the following address:
Iowa State Patrol District 03 Office
2025 Hunt Ave
Council Bluffs,IA 51503-4254
Phone: (712) 328-8001
Fax: (712) 328-1504