Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
12/4/2010		 Time of Accident
05:30 AM 		County
Polk - 77		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2010068535
Literal Description
144MM I80 EB 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
467073.5
Y-Coordinate
4614376.
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1 		Driver's Name - Last
BUSICK		 First
SHAWN		 Middle
MICHAEL		 Suffix
City
DES MOINES		 State
IA - Iowa, US		 Zip
503100000
Driver's Age
40		 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

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
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
1997		 Make
Chevrolet - CHEV		 Model
SUB		 Style
SW		 Approximate Cost to Repair or Replace
900
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
70		 Point of Initial Impact
06 - Left Rear		 Most Damaged Area
06 - Left Rear		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
01		 Traffic Controls
01 - No controls present		 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
 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
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2 		Driver's Name - Last
HILL		 First
VICKI		 Middle
MAE		 Suffix
City
BARSTOW		 State
IL - Illinois, US		 Zip
61236
Driver's Age
47		 Citation Charge Code 1
321.288		 Citation Charge 1
CONTROL OF VEHICLE
Gender
Female		 State
IL - Illinois, US		 Class
D - Chauffeur		 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
5 - Not deployed		 Airbag Switch Status
9 - Unknown		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
 Transported by:
Insurance Co. Name
Year
2001		 Make
Ford - FORD		 Model
F150		 Style
TRK		 Approximate Cost to Repair or Replace
2500
Initial Travel Direction
2 - East		 Vehicle Action
05 - Overtaking/passing		 Speed Limit
70		 Point of Initial Impact
03 - Right Side		 Most Damaged Area
03 - Right Side		 Extent of Damage
2 - Minor damage		 Underride/Override
1 - None
Total Occupants
04		 Traffic Controls
01 - No controls present		 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
03 - Ran off road, left		 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)
05 - Mist		 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
5 - Dark, roadway not lighted		 Surface Conditions
3		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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NARRATIVE

VEHICLE #1 IS EASTBOUND AT THE 144 MM I80 DRIVING IN THE OUTSIDE OF TWO LANES OF TRAVEL. VEHICLE #2 IS AT THE SAME LOCATION DRIVING IN THE INSIDE LANE OF TRAVEL AND PASSING VEHICLE #1. AS VEHICLE #2 IS PASSING VEHICLE #1 THE DRIVER OF VEHICLE #2 LOOSES CONTROL OF THE VEHICLE AND SLIDES INTO THE LEFT SIDE OF VEHICLE #1 TO THE RIGHT SIDE OF VEHICLE #2. THIS CONTACT OCCURS IN THE RIGHT LANE OF TRAVEL. AFTER IMPACT VEHICLE #1 COMES TO REST IN THE MEDIAN FACING SOUTHWEST. AFTER IMPACT VEHICLE #2 CROSSES THE MEDIAN AND COMES TO REST ON THE TRAVELED PORTION OF ROADWAY ON THE WESTBOUND SIDE OF TRAVEL.
Officer
BATTLES 		Badge No.
392		 Time Officer Notified of Accident
05:32		 Time Officer Arrived At Scene
05:42
Name of Agency
P01		 Date of Report
12/4/2010		 Investigation made at scene?
Yes		 T.I. #


Any questions about this report may be directed to the following address:
Iowa State Patrol District 01 Office
260 NW 48th Place
Des Moines,IA 50313-2299
Phone: (515) 725-0010
Fax: (515) 725-0011