Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
10/19/2011		 Time of Accident
11:55 AM 		County
Mills - 65		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2011059231
Literal Description
21218 ELLINGTON AVE. 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
266555.2
Y-Coordinate
4552193.
U
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1 		Driver's Name - Last
MAHAN		 First
TIMOTHY		 Middle
S		 Suffix
City
COUNCIL BLUFFS		 State
IA - Iowa, US		 Zip
51501
Driver's Age
21		 Citation Charge Code 1
707.6A(1)		 Citation Charge 1
VEHICULAR HOMICIDE
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
707.6A(4)		 Citation Charge 2
SERIOUS INJURY BY VEHICLE
Alcohol Test Given?
1 - None		 Drug Test Given?
3 - Urine		 Citation Charge Code 3
321J.2		 Citation Charge 3
OWI - DRUG
Citation Charge Code 4
 Citation Charge 4
Seating Position
01 - Front: Left Side / Motorcycle Driver		 Injury Status
4 - Possible		 Occupant Protection
9 - Unknown		 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:
CREIGHTON		 Transported by:
GLENWOOD FIRE
Insurance Co. Name
Year
2002		 Make
 Model
LIBERTY		 Style
SUV		 Approximate Cost to Repair or Replace
10000
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
01 - Front		 Most Damaged Area
09 - Top		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
9 - Unknown
Total Occupants
4		 Traffic Controls
01 - No controls present		 Vehicle Config.
04 - Sport utility vehicle		 Cargo Body Type
01 - Not applicable		 Vehicle Defect
01 - None		 Driver Condition
8 - Other (explain in narrative)		 Vision Obscured
01 - Not obscured		 Contributing Circumstances, Driver (up to 2)
SEQUENCE OF EVENTS First Event
03 - Ran off road, left		 Second Event
11 - Overturn/rollover		 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?
ACCIDENT ENVIRONMENT ROADWAY CHARACTERISTICS
Major Contributing Circumstances:		 WORKZONE RELATED? SEQUENCE OF EVENTS
Location of First Harmful Event
4 - Roadside		 Weather Conditions (up to two)
01 - Clear		 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
1 - Daylight		 Surface Conditions
1		 Type of Roadway Junction/Feature
01 - No special feature		 Workers Present?
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D 		Name- Last
GUNDERSON		 First
CHANCE		 Middle
E		 Suffix
City
 State
 Zip Code
Age
19		 Sex
Male		 Unit No.
1		 Seating Position
03 - Front: Right Side		 Injury Status
1 - Fatal		 Occupant Protection
1 - None used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
3 - Totally ejected		 Ejection Path
9 - Unknown		 Trapped
1 - Not trapped
Transported to:
CREIGHTON		 Transported by:
PTERSON FUNERAL
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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D 		Name- Last
HANSEN		 First
FELICIA		 Middle
M		 Suffix
City
 State
 Zip Code
Age
23		 Sex
Female		 Unit No.
1		 Seating Position
09 - Rear: Right Side		 Injury Status
2 - Incapacitating		 Occupant Protection
1 - None used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
3 - Totally ejected		 Ejection Path
9 - Unknown		 Trapped
1 - Not trapped
Transported to:
CREIGHTON		 Transported by:
GLENWOOD RESCUE
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
P
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S
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N 		I
N
J
U
R
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D 		Name- Last
WAHLE		 First
JACOB		 Middle
A		 Suffix
City
 State
 Zip Code
Age
19		 Sex
Male		 Unit No.
1		 Seating Position
07 - Rear: Left Side		 Injury Status
2 - Incapacitating		 Occupant Protection
1 - None used		 Airbag Deployment
5 - Not deployed		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
3 - Totally ejected		 Ejection Path
9 - Unknown		 Trapped
1 - Not trapped
Transported to:
CREIGHTON		 Transported by:
GLENWOOD RESCUE
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
D
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NARRATIVE

VEHICLE 1 WAS WESTBOUND ON ELLINGTON IN MILLLS COUNTY. VEHICLE 1 LOST CONTROL AND ENTERED THE SOUTH DITCH. VEHICLE 1 ROLLED SEVERAL TIMES, THREE OF THE PASSENGERS WERE EJECTED. VEHICLE 1 ROLLED ONTO ONE OF THE PASSENGERS AND THAT PERSON WAS DELARED DEAD AT THE SCENE. AMENDED 6/6/12 TO ADD URINE/DRUG TEST RESULTS OF POSITIVE TO THE DRIVER OF UNIT #1. ALSO, CHARGES HAVE BEEN FILED AND ARE LISTED UNDER UNIT #1.
Officer
MILLER 		Badge No.
199		 Time Officer Notified of Accident
12:11		 Time Officer Arrived At Scene
12:22
Name of Agency
P03		 Date of Report
10/19/2011		 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