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Fatal Crash Report

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Crash #2017270271 Crash #2017270271
Fatalities 1
State MINNESOTA
County ANOKA
City HAM LAKE
Date Oct. 15, 2017
Time 12:10 a.m.
Location(45.2165333, -93.2551667) - Fatality Map - Google Maps
Street Name 1 JEFFERSON ST NE
Street Name 2 136TH LA NE
WeatherRain
WeatherCloudy
Number of Vehicles 1
Number of Vehicles in Transport 1
Number of Parked Vehicles 0
Number of Persons in Motor Vehicles 1
Number of Persons in Motor Vehicles in Transport 1
Number of Persons in Parked Vehicles 0
Number of Nonmotorists 1
Route Signing Municipal
Rural / Urban Urban
Functional System Major Collector
Road Owner City or Municipal Highway Agency
National Highway System Not in the National Highway System
Special Jurisdiction No Special Jurisdiction (Includes National Forests Since 2008)
Milepoint 4
First Harmful Event Pedestrian
Manner of Collision First Harmful Event was Not a Collision with Motor Vehicle In-Transport
At Intersection No
Relation to Junction Intersection Related
Type of Intersection T-Intersection
Relation to Road On Roadway
Work Zone None
Light Condition Dark - Not Lighted
Atmospheric Condition Rain
School Bus Related False
Rail Grade Crossing ID 0000000
EMS Notified Hour 0
EMS Notified Minute 10
EMS Arrived Hour 0
EMS Arrived Minute 10
Arrived At Hospital Hour 88
Arrived at Hospital Minute 88
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Persons

Person #1 (Pedestrian) Person #1 (Pedestrian)
Age 65 year(s) old
SexMale
Person TypePedestrian
Injury SeverityFatal Injury (K)
Vehicle which Struck Non MotoristVehicle #1
Seating PositionNot a Motor Vehicle Occupant (2005-Later)
Restraint System UseNot a Motor Vehicle Occupant
Restraint System MisuseNot a Motor Vehicle Occupant
Helmet UseNot Applicable
Helmet MisuseNone Used/Not Applicable
Airbag DeployedNot a Motor Vehicle Occupant
EjectionNot Applicable
Ejection PathEjection Path Not Applicable
ExtricationNot Extricated/Not Applicable
Police Reported Alcohol InvolvementReported as Unknown
Alcohol Test GivenTest Given
Alcohol Test TypeBlood Test
Alcohol Test Result0.105
Police Reported Drug InvolvementReported as Unknown
Drug TestedTest Given
Transported To Medical Facility ByNot Transported for Treatment
Died En RouteDied at Scene
Month of DeathOctober
Day of Death15
Year of Death2017
Hour of Death0
Minute of Death25
Lag Hours0
Lag Minutes15
Non Motorist LocationAt Intersection-Unknown Location
At WorkNo
HispanicNon-Hispanic
Race White
Nonmotorist Bicycle HelmetNo
Nonmotorist PadsNo
Nonmotorist LightsNo
Nonmotorist ReflectorsNo
Nonmotorist Other Protective EquipmentNot Reported
Nonmotorist Other Preventative EquipmentNot Reported
Nonmotorist Marked Crosswalk PresentNone Noted
Nonmotorist Sidewalk PresentNone Noted
Nonmotorist In School ZoneNone Noted
Pedestrian Crash TypeAt Intersection - Other/Unknown
Bicycle Crash TypeNot a Cyclist
Pedestrian LocationAt Intersection
Pedestrian PositionOther/Unknown
Pedestrian DirectionNot Derived/Unknown Initial Direction of Travel
Bicycle LocationNot a Cyclist
Bicycle PositionNot a Cyclist
Bicycle DirectionNot a Cyclist
Motorist DirectionSouthbound
Nonmotorist Prior Action In Roadway-Other (Working, Playing, etc.)
Nonmotorist Impaired Reported as Unknown if Impaired
Nonmotorist Contributing Circumstance Reported as Unknown
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Person #1 in Vehicle #1 Person #1 in Vehicle #1
Age 16 year(s) old
SexMale
Person TypeDriver of a Motor Vehicle In-Transport
Injury SeverityNo Apparent Injury (O)
Seating PositionFront Seat, Left Side (Driver's Side)
Restraint System UseUnknown/Reported as Unknown (Since 2018)
Restraint System MisuseNo Indication of Misuse
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 InvolvementNo (Alcohol Not Involved)
Alcohol Test GivenTest Not Given
Alcohol Test TypeNot Tested for Alcohol
Alcohol Test ResultNone Given
Police Reported Drug InvolvementNo (Drugs Not Involved)
Drug TestedTest Not Given
Transported To Medical Facility ByNot Transported for Treatment
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 0
Number of Occupants 1
Hit and Run No Hit and Run
NCSA Make Ford
Body Type Light Pickup
NCSA Model 481
Registration State Minnesota
Registered Vehicle Owner Driver (in This Crash) Not Registered Owner (Other Private Owner)
VIN 1FTHX26F1VEB
Model Year 1997
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 00000000000
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 30
Travel Speed Unknown
Underride / Override No Underride or Override
Rollover No Rollover
Rollover Location No Rollover
Initial Contact Point Undercarriage
Extent of Damage No Damage
Vehicle Towed Towed
Most Harmful Event Pedestrian
Fire Occurence False
Driver Drinking No Drinking
Driver Present Driver Present
Drivers License State Minnesota
Driver Zip Code 55434
Non CDL License Type Intermediate 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 78
Driver Weight 180
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, Not Divided
Total Lanes in Roadway Two Lanes
Roadway Alignment Straight
Roadway Grade Level
Roadway Surface Type Not Reported
Roadway Surface Condition Wet
Traffic Control Device No Controls
Traffic Control Device Functioning No Controls
Pre Event Movement Going Straight
Critical Precrash Event PEDESTRIAN OR PEDALCYCLIST OR OTHER NON-MOTORIST Pedestrian in Road
Attempted Avoidance Maneuver Braking
Precrash Stability Precrash Stability Unknown
Pre-impact Location Stayed on Roadway, Not Known if Left Original Travel Lane
Crash Type CATEGORY I: SINGLE DRIVER - CONFIGURATION C: FORWARD IMPACT - Pedestrian/Animal
Visibility Obstructions No Obstruction Noted
Moving Violations None
Driver Maneuvered to Avoid Pedestrian, Pedalcyclist or Other Non-Motorist
Vehicle Factors None Noted
Damaged Areas No Damage
Driver Distracted Not Distracted
Driver Impaired None/Apparently Normal
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Crash Events

Event #1 Event #1
VehicleVehicle #1
Area Of ImpactUndercarriage
Sequence of EventsPedestrian

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