Iowa State Patrol: Department of Public Safety

Crash Information

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N 		Date of Accident
03/04/2014		 Time of Accident
01:57 PM 		County
Warren - 91		 Accident occurred within corporate limits of (city)
 Law Enforcement Case Number:
2014015380
Literal Description
US 65 MEASURING 1610 FEET WEST FROM US 65 AND 150TH AVE 		Legal Intervention?
No		 Private Property?
No
X-Coordinate:
455987.1
Y-Coordinate
4570497.
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1 		Driver's Name - Last
SAFFELL		 First
JENNIFER		 Middle
LUANNE		 Suffix
City
LACONA		 State
IA - Iowa, US		 Zip
501390000
Driver's Age
31		 Citation Charge Code 1
 Citation Charge 1
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:
METHODIST MEDICAL CENTER		 Transported by:
LIFE FLIGHT
Insurance Co. Name
Year
2002		 Make
Chevrolet - CHEV		 Model
VEN		 Style
VN		 Approximate Cost to Repair or Replace
4000
Initial Travel Direction
2 - East		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
07 - Left Side		 Most Damaged Area
07 - Left Side		 Extent of Damage
5 - Severe, vehicle totaled		 Underride/Override
1 - None
Total Occupants
02		 Traffic Controls
01 - No controls present		 Vehicle Config.
03 - Van or mini-van		 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
04 - Crossed centerline/median		 Second Event
06 - Evasive action (swerve, panic braking, etc.)		 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
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2 		Driver's Name - Last
QUEZADA AVITIA		 First
MANUEL		 Middle
 Suffix
City
MILWAUKEE		 State
WI - Wisconsin, US		 Zip
532150000
Driver's Age
33		 Citation Charge Code 1
 Citation Charge 1
Gender
Male		 State
WI - Wisconsin, US		 Class
A - Veh w/26001 GVWR or more Towed unit is 10001 GVWR or more		 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
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
 Trapped
1 - Not trapped
Transported to:
N/A		 Transported by:
N/A
Insurance Co. Name
CAINE TRANSFER INC
Year
2002		 Make
 Model
 Style
TT		 Approximate Cost to Repair or Replace
1500
Initial Travel Direction
4 - West		 Vehicle Action
01 - Movement essentially straight		 Speed Limit
55		 Point of Initial Impact
10 - Under Carriage		 Most Damaged Area
10 - Under Carriage		 Extent of Damage
3 - Functional damage		 Underride/Override
1 - None
Total Occupants
01		 Traffic Controls
01 - No controls present		 Vehicle Config.
09 - Tractor/semi-trailer		 Cargo Body Type
02 - Van/enclosed box		 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
CAINE TRANSFER INC		 City
LOWELL		 State
WI - Wisconsin, US		 Zip
53557
Number of Axles
5		 Gross Vehicle Weight Rating
80000		 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)
01 - Clear		 Environment
1 - None apparent		 Location
 First Harmful Event of Crash (use codes 11-42 only)
21 - Vehicle in traffic
Manner of Crash/Collision
7 - Sideswipe, opposite direction		 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
SAFFELL		 First
JACOB		 Middle
MATHEW		 Suffix
City
 State
 Zip Code
Age
2		 Sex
Male		 Unit No.
01		 Seating Position
07 - Rear: Left Side		 Injury Status
1 - Fatal		 Occupant Protection
5 - Child safety seat used		 Airbag Deployment
6 - Not applicable		 Airbag Switch Status
3 - No ON/OFF switch present		 Ejection
1 - Not ejected		 Ejection Path
1 - Not ejected/not applicable		 Trapped
2 - Freed by non-mechanical means
Transported to:
STATE MED EXAMINER		 Transported by:
FRAISER AMBULANCE
NON-MOTORIST Type
 Location
 Action
 Condition
 Safety Equipment
 Contributing Circumstances
 Unit No. of Vehicle Striking
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0
NARRATIVE

Unit 1 was traveling east when the driver crossed the centerline and struck Unit 2 which was traveling west on Highway 65. Unit 1 came to rest on the south shoulder and Unit 2 came to rest on the north shoulder after impact.
Officer
Spencer 		Badge No.
387		 Time Officer Notified of Accident
14:20		 Time Officer Arrived At Scene
15:23
Name of Agency
P02		 Date of Report
03/04/2014		 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