U
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I
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1
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Driver's Name - Last SUMMERS |
First EDITH |
Middle MARLENE |
Suffix
|
City IOWA CITY |
State IA - Iowa, US |
Zip 522450000 |
Driver's Age 75 |
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 3 - Non-incapacitating |
Occupant Protection 2 - Shoulder and lap belt used |
Airbag Deployment 1 - Deployed front of person |
Airbag Switch Status 3 - No ON/OFF switch present |
Ejection 1 - Not ejected |
Ejection Path
|
Trapped 2 - Freed by non-mechanical means |
Transported to: UNIVERSITY OF IOWA HOSPITAL |
Transported by: WEST BRANCH AMBULANCE |
Insurance Co. Name
|
Year 1999 |
Make
|
Model TL |
Style 4D |
Approximate Cost to Repair or Replace 8000 |
Initial Travel Direction 4 - West |
Vehicle Action 06 - Changing lanes |
Speed Limit 70 |
Point of Initial Impact 01 - Front |
Most Damaged Area 01 - Front |
Extent of Damage 5 - Severe, vehicle totaled |
Underride/Override 1 - None |
Total Occupants 2 |
Traffic Controls 01 - No controls present |
Vehicle Config. 01 - Passenger car |
Cargo Body Type 01 - Not applicable |
Vehicle Defect 01 - None |
Driver Condition 5 - Asleep, fainted, fatigued, etc |
Vision Obscured 01 - Not obscured |
Contributing Circumstances, Driver (up to 2)
|
SEQUENCE OF EVENTS |
First Event 21 - Vehicle in traffic |
Second Event 01 - Ran off road, right |
Third Event
|
Fourth Event 36 - Concrete barrier (median or right side) |
Most Harmful Event (by vehicle) 26 - Other non-fixed object (explain in narrative) |
Emergency Vehicle Type 1 - Not applicable |
Emergency Status 3 - Not Applicable |
Carrier Name
|
City
|
State
|
Zip
|
Number of Axles
|
Gross Vehicle Weight Rating
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Placard #
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Hazardous Materials Released?
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