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Fatal Crash Report

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Crash #2004250441 Crash #2004250441
Fatalities 2
State MASSACHUSETTS
County WORCESTER
City GARDNER
Date Oct. 12, 2004
Time 10:36 a.m.
Location(42.5637861, -71.9969194) - Fatality Map - Google Maps
Street Name 1 SR-2A
Street Name 2 MANCA DR
WeatherClear
Number of Vehicles 0
Number of Vehicles in Transport 3
Number of Parked Vehicles 0
Number of Persons in Motor Vehicles 6
Number of Persons in Motor Vehicles in Transport 0
Number of Persons in Parked Vehicles 6
Number of Nonmotorists 0
Route Signing State Highway
Rural / Urban Urban
Functional System Minor Arterial
Road Owner Unknown
National Highway System Not in the National Highway System
Special Jurisdiction No Special Jurisdiction (Includes National Forests Since 2008)
Milepoint 0
First Harmful Event Motor Vehicle In-Transport
Manner of Collision Angle
At Intersection No
Relation to Junction Intersection
Type of Intersection Not Reported
Relation to Road On Roadway
Work Zone None
Light Condition Daylight
Atmospheric Condition Clear
School Bus Related False
Rail Grade Crossing ID 0000000
EMS Notified Hour 10
EMS Notified Minute 35
EMS Arrived Hour 10
EMS Arrived Minute 40
Arrived At Hospital Hour 11
Arrived at Hospital Minute 5
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Persons

Person #1 in Vehicle #1 Person #1 in Vehicle #1
Age 49 year(s) old
SexMale
Person TypeDriver of a Motor Vehicle In-Transport
Injury SeverityFatal Injury (K)
Seating PositionFront Seat, Left Side (Driver's Side)
Restraint System UseNone Used/Not Applicable
Restraint System MisuseNone Used/Not Applicable
Helmet UseNot Applicable
Helmet MisuseNone Used/Not Applicable
Airbag DeployedNot Deployed
EjectionNot Ejected
Ejection PathEjection Path Not Applicable
ExtricationExtricated
Police Reported Alcohol InvolvementNot Reported
Alcohol Test GivenNot Reported
Alcohol Test TypeBlood Test
Alcohol Test ResultAC Test Performed, Results Unknown
Police Reported Drug InvolvementNot Reported
Drug TestedNot Reported
Transported To Medical Facility ByTransported Unknown Source
Died En RouteNot Applicable
Month of DeathOctober
Day of Death12
Year of Death2004
Hour of Death15
Minute of Death12
Lag Hours4
Lag Minutes36
Non Motorist LocationOccupant of a Motor Vehicle (Includes Railway Train Occupants Since 2006)
At WorkNo
HispanicPuerto Rican
Race White
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Person #2 in Vehicle #1 Person #2 in Vehicle #1
Age 54 year(s) old
SexMale
Person TypePassenger of a Motor Vehicle In-Transport
Injury SeverityFatal Injury (K)
Seating PositionFront Seat, Right Side
Restraint System UseNone Used/Not Applicable
Restraint System MisuseNone Used/Not Applicable
Helmet UseNot Applicable
Helmet MisuseNone Used/Not Applicable
Airbag DeployedNot Deployed
EjectionNot Ejected
Ejection PathEjection Path Not Applicable
ExtricationExtricated
Police Reported Alcohol InvolvementNot Reported
Alcohol Test GivenNot Reported
Alcohol Test TypeNot Tested for Alcohol
Alcohol Test ResultNone Given
Police Reported Drug InvolvementNot Reported
Drug TestedNot Reported
Transported To Medical Facility ByTransported Unknown Source
Died En RouteNot Applicable
Month of DeathOctober
Day of Death28
Year of Death2004
Hour of Death15
Minute of Death34
Lag Hours388
Lag Minutes58
Non Motorist LocationOccupant of a Motor Vehicle (Includes Railway Train Occupants Since 2006)
At WorkNo
HispanicPuerto Rican
Race White
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Person #3 in Vehicle #1 Person #3 in Vehicle #1
Age 34 year(s) old
SexMale
Person TypePassenger of a Motor Vehicle In-Transport
Injury SeverityPossible Injury (C)
Seating PositionSecond Seat, Unknown
Restraint System UseUnknown/Reported as Unknown (Since 2018)
Restraint System MisuseNone Used/Not Applicable
Helmet UseNot Applicable
Helmet MisuseNone Used/Not Applicable
Airbag DeployedNot Deployed
EjectionNot Ejected
Ejection PathEjection Path Not Applicable
ExtricationNot Extricated/Not Applicable
Police Reported Alcohol InvolvementNot Reported
Alcohol Test GivenNot Reported
Alcohol Test TypeNot Tested for Alcohol
Alcohol Test ResultNone Given
Police Reported Drug InvolvementNot Reported
Drug TestedNot Reported
Transported To Medical Facility ByTransported Unknown Source
Died En RouteNot Applicable
Non Motorist LocationOccupant of a Motor Vehicle (Includes Railway Train Occupants Since 2006)
At WorkNot Aplicable
HispanicNot a Fatality (Not Applicable)
Race Not a Fatality (Not Applicable)
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Person #4 in Vehicle #1 Person #4 in Vehicle #1
Age 9 year(s) old
SexMale
Person TypePassenger of a Motor Vehicle In-Transport
Injury SeverityPossible Injury (C)
Seating PositionSecond Seat, Unknown
Restraint System UseNone Used/Not Applicable
Restraint System MisuseNone Used/Not Applicable
Helmet UseNot Applicable
Helmet MisuseNone Used/Not Applicable
Airbag DeployedNot Deployed
EjectionNot Ejected
Ejection PathEjection Path Not Applicable
ExtricationNot Extricated/Not Applicable
Police Reported Alcohol InvolvementNot Reported
Alcohol Test GivenNot Reported
Alcohol Test TypeNot Tested for Alcohol
Alcohol Test ResultNone Given
Police Reported Drug InvolvementNot Reported
Drug TestedNot Reported
Transported To Medical Facility ByTransported Unknown Source
Died En RouteNot Applicable
Non Motorist LocationOccupant of a Motor Vehicle (Includes Railway Train Occupants Since 2006)
At WorkNot Aplicable
HispanicNot a Fatality (Not Applicable)
Race Not a Fatality (Not Applicable)
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Person #1 in Vehicle #2 Person #1 in Vehicle #2
Age 40 year(s) old
SexMale
Person TypeDriver of a Motor Vehicle In-Transport
Injury SeverityPossible Injury (C)
Seating PositionFront Seat, Left Side (Driver's Side)
Restraint System UseUnknown/Reported as Unknown (Since 2018)
Restraint System MisuseNone Used/Not Applicable
Helmet UseNot Applicable
Helmet MisuseNone Used/Not Applicable
Airbag DeployedNot Deployed
EjectionNot Ejected
Ejection PathEjection Path Not Applicable
ExtricationNot Extricated/Not Applicable
Police Reported Alcohol InvolvementNot Reported
Alcohol Test GivenNot Reported
Alcohol Test TypeNot Tested for Alcohol
Alcohol Test ResultNone Given
Police Reported Drug InvolvementNot Reported
Drug TestedNot Reported
Transported To Medical Facility ByTransported Unknown Source
Died En RouteNot Applicable
Non Motorist LocationOccupant of a Motor Vehicle (Includes Railway Train Occupants Since 2006)
At WorkNot Aplicable
HispanicNot a Fatality (Not Applicable)
Race Not a Fatality (Not Applicable)
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Person #1 in Vehicle #3 Person #1 in Vehicle #3
Age 39 year(s) old
SexMale
Person TypeDriver of a Motor Vehicle In-Transport
Injury SeverityPossible Injury (C)
Seating PositionFront Seat, Left Side (Driver's Side)
Restraint System UseUnknown/Reported as Unknown (Since 2018)
Restraint System MisuseNone Used/Not Applicable
Helmet UseNot Applicable
Helmet MisuseNone Used/Not Applicable
Airbag DeployedNot Deployed
EjectionNot Ejected
Ejection PathEjection Path Not Applicable
ExtricationNot Extricated/Not Applicable
Police Reported Alcohol InvolvementNot Reported
Alcohol Test GivenNot Reported
Alcohol Test TypeNot Tested for Alcohol
Alcohol Test ResultNone Given
Police Reported Drug InvolvementNot Reported
Drug TestedNot Reported
Transported To Medical Facility ByTransported Unknown Source
Died En RouteNot Applicable
Non Motorist LocationOccupant of a Motor Vehicle (Includes Railway Train Occupants Since 2006)
At WorkNot Aplicable
HispanicNot a Fatality (Not Applicable)
Race Not a Fatality (Not Applicable)
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Moving Vehicles

Vehicle #1 Vehicle #1
Fatalities 2
Number of Occupants 4
Hit and Run No Hit and Run
NCSA Make Chevrolet
Body Type Station Wagon (Excluding Van- and Truck-Based)
NCSA Model 17
Registration State Massachusetts
Registered Vehicle Owner Driver (in This Crash) Not Registered Owner (Other Private Owner)
VIN 1G1AW81W2K61
Model Year 1989
VPIC Make ID None
VPIC Model ID None
VPIC Body Class Unknown
Body Class Unknown
Lower Weight Rating Not Reported
Upper Weight Rating Not Reported
Vehicle Trailing No Trailers
Jackknife Not an Articulated Vehicle
Motor Carrier ID 0.0
Vehicle Configuration Not Applicable
Cargo Body Type Not Applicable
Bus Use Not a Bus
Special Vehicle Use No Special Use Noted
Emergency Vehicle Use Not Applicable
Speed Limit Unknown
Travel Speed Unknown
Underride / Override No Underride or Override
Rollover No Rollover
Rollover Location Unknown
Initial Contact Point 9 O'Clock
Extent of Damage Disabling Damage
Vehicle Towed Towed
Most Harmful Event Motor Vehicle In-Transport
Fire Occurence False
Driver Drinking No Drinking
Driver Present Driver Present
Drivers License State Massachusetts
Driver Zip Code 1331
Non CDL License Type Full Driver License
Non CDL License Status Valid
CDL License Status No Commercial Driver's License (CDL)
CDL Endorsements No Endorsements Required for This Vehicle
License Compliance With Class of Vehicle Valid License for This Class Vehicle
Compliance with LIcense Restrictions No Restrictions or Not Applicable
Driver Height 63
Driver Weight 999
Previous Recorded Crashes 2
Previous BAC Suspensions (Underage) None
Previous BAC Suspensions None
Previous Other Suspensions None
Previous DWI 0
Previous Speeding Convictions 0
Previous Other Moving Violations 1
Month of Oldest Violation November
Year of Oldest Violation 2001
Month of Newest Violation January
Year of Newest Violation 2004
Speeding Related No
Trafficway Description Two-Way, Divided, Unprotected Median
Total Lanes in Roadway Two Lanes
Roadway Alignment Straight
Roadway Grade Level
Roadway Surface Type Blacktop, Bituminous, or Asphalt
Roadway Surface Condition Dry
Traffic Control Device Stop Sign
Traffic Control Device Functioning Device Functioning Properly
Pre Event Movement Unknown
Critical Precrash Event OTHER Unknown
Attempted Avoidance Maneuver Unknown/Not Reported
Precrash Stability Precrash Stability Unknown
Pre-impact Location Unknown
Crash Type CATEGORY VI: MISCELLANEOUS - Other Crash Type
Driver Related Factor Failure to Obey Actual Traffic Signs, Traffic Control Devices or Traffic Officers, Failure to Observe Safety Zone Traffic Laws
Driver Related Factor Failure to Yield Right-of-Way
Damaged Areas 9 O'Clock
Vehicle Event 1 Motor Vehicle In-Transport
Vehicle Event 2 Unknown/Reported as Unknown (Since 2018)
Vehicle Event 3 Unknown/Reported as Unknown (Since 2018)
Vehicle Event 4 Unknown/Reported as Unknown (Since 2018)
Vehicle Event 5 Unknown/Reported as Unknown (Since 2018)
Vehicle Event 6 Unknown/Reported as Unknown (Since 2018)
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Vehicle #2 Vehicle #2
Fatalities 0
Number of Occupants 1
Hit and Run No Hit and Run
NCSA Make Peterbilt
Body Type Truck/Tractor (Cab Only, or With Any Number of Trailing Units: Any Weight)
NCSA Model 884
Registration State Massachusetts
Registered Vehicle Owner Vehicle Registered as Commercial/Business/Company/Government
VIN 1XP5DB9X9RN3
Model Year 1994
VPIC Make ID None
VPIC Model ID None
VPIC Body Class Unknown
Body Class Unknown
Lower Weight Rating Not Reported
Upper Weight Rating Not Reported
Vehicle Trailing One Trailer
Trailer VIN 1 None
Trailer VIN 2 None
Trailer VIN 3 None
Trailer Weight Rating 1 Not Reported
Trailer Weight Rating 2 Not Reported
Trailer Weight Rating 3 Not Reported
Jackknife No
Motor Carrier ID 5700654327.0
Vehicle Configuration Truck Tractor/Semi-Trailer
Cargo Body Type Van/Enclosed Box
Bus Use Not a Bus
Special Vehicle Use No Special Use Noted
Emergency Vehicle Use Not Applicable
Speed Limit Unknown
Travel Speed 89
Underride / Override No Underride or Override
Rollover No Rollover
Rollover Location Unknown
Initial Contact Point 12 O'Clock
Extent of Damage Reported as Unknown
Vehicle Towed Reported as Unknown
Most Harmful Event Motor Vehicle In-Transport
Fire Occurence False
Driver Drinking No Drinking
Driver Present Driver Present
Drivers License State Massachusetts
Driver Zip Code 1331
Non CDL License Type Full Driver License
Non CDL License Status Valid
CDL License Status Valid
CDL Endorsements No Endorsements Required for This Vehicle
License Compliance With Class of Vehicle Valid License for This Class Vehicle
Compliance with LIcense Restrictions Restrictions Complied With
Driver Height 71
Driver Weight 999
Previous Recorded Crashes 0
Previous BAC Suspensions (Underage) None
Previous BAC Suspensions None
Previous Other Suspensions None
Previous DWI 0
Previous Speeding Convictions 0
Previous Other Moving Violations 0
Month of Oldest Violation No Record
Year of Oldest Violation 0
Month of Newest Violation No Record
Year of Newest Violation 0
Speeding Related No
Trafficway Description Two-Way, Divided, Unprotected Median
Total Lanes in Roadway Two Lanes
Roadway Alignment Straight
Roadway Grade Level
Roadway Surface Type Blacktop, Bituminous, or Asphalt
Roadway Surface Condition Dry
Traffic Control Device Stop Sign
Traffic Control Device Functioning Device Functioning Properly
Pre Event Movement Unknown
Critical Precrash Event OTHER Unknown
Attempted Avoidance Maneuver Unknown/Not Reported
Precrash Stability Precrash Stability Unknown
Pre-impact Location Unknown
Crash Type CATEGORY VI: MISCELLANEOUS - Other Crash Type
Damaged Areas 12 O'Clock
Vehicle Event 1 Motor Vehicle In-Transport
Vehicle Event 2 Motor Vehicle In-Transport
Vehicle Event 3 Unknown/Reported as Unknown (Since 2018)
Vehicle Event 4 Unknown/Reported as Unknown (Since 2018)
Vehicle Event 5 Unknown/Reported as Unknown (Since 2018)
Vehicle Event 6 Unknown/Reported as Unknown (Since 2018)
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Vehicle #3 Vehicle #3
Fatalities 0
Number of Occupants 1
Hit and Run No Hit and Run
NCSA Make Other Make
Body Type Unknown Bus Type
NCSA Model 988
Registration State Massachusetts
Registered Vehicle Owner Vehicle Registered as Commercial/Business/Company/Government
VIN 4RKNDTGA9TR8
Model Year 1996
VPIC Make ID None
VPIC Model ID None
VPIC Body Class Unknown
Body Class Unknown
Lower Weight Rating Not Reported
Upper Weight Rating Not Reported
Vehicle Trailing No Trailers
Jackknife Not an Articulated Vehicle
Motor Carrier ID 88888888888.0
Vehicle Configuration Bus (Seats for More Than 15 Occupants, Including Driver, 2010-Later)
Cargo Body Type Bus
Bus Use Bus, Unknown Use
Special Vehicle Use No Special Use Noted
Emergency Vehicle Use Not Applicable
Speed Limit Unknown
Travel Speed Unknown
Underride / Override No Underride or Override
Rollover No Rollover
Rollover Location Unknown
Initial Contact Point 11 O'Clock
Extent of Damage Reported as Unknown
Vehicle Towed Reported as Unknown
Most Harmful Event Motor Vehicle In-Transport
Fire Occurence False
Driver Drinking No Drinking
Driver Present Driver Present
Drivers License State Massachusetts
Driver Zip Code 1468
Non CDL License Type Full Driver License
Non CDL License Status Valid
CDL License Status Valid
CDL Endorsements No Endorsements Required for This Vehicle
License Compliance With Class of Vehicle Valid License for This Class Vehicle
Compliance with LIcense Restrictions Restrictions Complied With
Driver Height 70
Driver Weight 999
Previous Recorded Crashes 0
Previous BAC Suspensions (Underage) None
Previous BAC Suspensions None
Previous Other Suspensions None
Previous DWI 0
Previous Speeding Convictions 0
Previous Other Moving Violations 0
Month of Oldest Violation No Record
Year of Oldest Violation 0
Month of Newest Violation No Record
Year of Newest Violation 0
Speeding Related No
Trafficway Description Two-Way, Divided, Unprotected Median
Total Lanes in Roadway Two Lanes
Roadway Alignment Straight
Roadway Grade Level
Roadway Surface Type Blacktop, Bituminous, or Asphalt
Roadway Surface Condition Dry
Traffic Control Device Stop Sign
Traffic Control Device Functioning Device Functioning Properly
Pre Event Movement Unknown
Critical Precrash Event OTHER Unknown
Attempted Avoidance Maneuver Unknown/Not Reported
Precrash Stability Precrash Stability Unknown
Pre-impact Location Unknown
Crash Type CATEGORY VI: MISCELLANEOUS - Other Crash Type
Damaged Areas 11 O'Clock
Vehicle Event 1 Motor Vehicle In-Transport
Vehicle Event 2 Unknown/Reported as Unknown (Since 2018)
Vehicle Event 3 Unknown/Reported as Unknown (Since 2018)
Vehicle Event 4 Unknown/Reported as Unknown (Since 2018)
Vehicle Event 5 Unknown/Reported as Unknown (Since 2018)
Vehicle Event 6 Unknown/Reported as Unknown (Since 2018)
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