U
N
I
T
1
|
Driver's Name - Last BRADLEY |
First MICHAEL |
Middle BRUCE |
Suffix
|
City CENTERVILLE |
State IA - Iowa, US |
Zip 525440000 |
Driver's Age 58 |
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? 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 2 - Incapacitating |
Occupant Protection 1 - None used |
Airbag Deployment 1 - Deployed front of person |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 3 - Totally ejected |
Ejection Path
|
Trapped 1 - Not trapped |
Transported to: STATE MEDICAL EXAMINER'S LAB |
Transported by: FIELDING FUNERAL HOME |
Insurance Co. Name
|
Year 1998 |
Make Chevrolet - CHEV |
Model TAHOE |
Style SW |
Approximate Cost to Repair or Replace 5000 |
Initial Travel Direction 1 - North |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 1 |
Traffic Controls 01 - No controls present |
Vehicle Config. 04 - Sport utility vehicle |
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 04 - Crossed centerline/median |
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?
|
U
N
I
T
2
|
Driver's Name - Last PAGE |
First HOWARD |
Middle LEROY |
Suffix
|
City HUMESTON |
State IA - Iowa, US |
Zip 501230000 |
Driver's Age 59 |
Citation Charge Code 1
|
Citation Charge 1
|
Gender Male |
State IA - Iowa, US |
Class B - Veh w/26001 GVWR or more Towed unit is less than 10001 GVWR |
Endorsements
|
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 2 - Incapacitating |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 3 - Deployed both front/side |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 3 - Extricated by mechanical means |
Transported to: MERCY HOSPITAL, DSM |
Transported by: LIFEFLIGHT |
Insurance Co. Name
|
Year 2003 |
Make Ford - FORD |
Model F150 |
Style PK |
Approximate Cost to Repair or Replace 7000 |
Initial Travel Direction 3 - South |
Vehicle Action 01 - Movement essentially straight |
Speed Limit 55 |
Point of Initial Impact 02 - Right Front |
Most Damaged Area 02 - Right Front |
Extent of Damage 5 - Severe, vehicle totaled |
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?
|
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 2 - Head-on |
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?
|
D I A G R A M
0 |
|
NARRATIVE |
VEHICLE 1 WAS NORTHBOUND ON HWY 65, WHEN IT CROSSED THE CENTERLINE INTO THE SOUTHBOUND LANE AND SHOULDER. VEHICLE 2 WAS SOUTHBOUND ON HWY 65 WHEN IT MET VEHICLE 1. , VEHICLE 2 SWERVED TO THE LEFT TRYING TO AVOID A COLLISION, BUT VEHICLE 1 STRUCK VEHICLE 2 IN THE RIGHT FRONT. THE DRIVER OF VEHICLE 1 WAS EJECTED FROM THE VEHICLE AND LANDED IN THE SOUTHBOUND LANE OF TRAFFIC, HIS VEHICLE CAME TO REST IN THE WEST DITCH. VEHICLE 2 CAME TO REST ON THE EAST SHOULDER AND ROLLED ONTO THE DRIVER'S SIDE. DRIVER OF VEHICLE #2 WAS TRAPPED. AFTER THIS ACCIDENT A SECOND ACCIDENT OCCURED INVOLVING A SEMI TRUCK AND THE DRIVER OF VEHICLE #1 AS HE WAS LAYING IN THE ROADWAY AND ANOTHER VEHICLE THAT HAD PARKED ON THE SOUTHBOUND SHOULDER TO RENDER ASSISTANCE. THE SECOND ACCIDENT WAS COVERED BY TRP. CHRISTENSEN, CASE # 2010072532. |
|
Officer
TUCKER |
Badge No. 487 |
Time Officer Notified of Accident 19:32 |
Time Officer Arrived At Scene 19:50 |
Name of Agency P02 |
Date of Report 12/22/2010 |
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