| Age | 20 year(s) old |
| Sex | Male |
| Person Type | Driver of a Motor Vehicle In-Transport |
| Injury Severity | Suspected Serious Injury (A) |
| Seating Position | Front Seat, Left Side (Driver's Side) |
| Restraint System Use | Shoulder and Lap Belt Used |
| Restraint System Misuse | No Indication of Misuse |
| Helmet Use | Not Applicable |
| Helmet Misuse | None Used/Not Applicable |
| Airbag Deployed | Not Deployed |
| Ejection | Not Ejected |
| Ejection Path | Ejection Path Not Applicable |
| Extrication | Not Extricated/Not Applicable |
| Police Reported Alcohol Involvement | No (Alcohol Not Involved) |
| Alcohol Test Given | Not Reported |
| Alcohol Test Type | Not Reported |
| Alcohol Test Result | Not Reported |
| Police Reported Drug Involvement | No (Drugs Not Involved) |
| Drug Tested | Not Reported |
| Transported To Medical Facility By | EMS Ground |
| Died En Route | Not Applicable |
| Non Motorist Device Type | Not Applicable |
| Non Motorist Device Motorization | Not Applicable |
| Non Motorist Location | Occupant of a Motor Vehicle (Includes Railway Train Occupants Since 2006) |
| At Work | Not Aplicable |
| Hispanic | Not a Fatality (Not Applicable) |
| Race | Not a Fatality (Not Applicable) |
| Person Related Factor | None Noted |
| Collapse Table | Collapse Table |
|---|
| Age | 28 year(s) old |
| Sex | Male |
| Person Type | Passenger of a Motor Vehicle In-Transport |
| Injury Severity | Fatal Injury (K) |
| Seating Position | Front Seat, Right Side |
| Restraint System Use | None Used/Not Applicable |
| Restraint System Misuse | None Used/Not Applicable |
| Helmet Use | Not Applicable |
| Helmet Misuse | None Used/Not Applicable |
| Airbag Deployed | Not Deployed |
| Ejection | Not Ejected |
| Ejection Path | Ejection Path Not Applicable |
| Extrication | Extricated |
| Police Reported Alcohol Involvement | No (Alcohol Not Involved) |
| Alcohol Test Given | Test Not Given |
| Alcohol Test Type | Not Tested for Alcohol |
| Alcohol Test Result | None Given |
| Police Reported Drug Involvement | No (Drugs Not Involved) |
| Drug Tested | Test Not Given |
| Transported To Medical Facility By | Not Transported for Treatment |
| Died En Route | Died at Scene |
| Month of Death | October |
| Day of Death | 5 |
| Year of Death | 2023 |
| Hour of Death | 17 |
| Minute of Death | 48 |
| Lag Hours | 0 |
| Lag Minutes | 0 |
| Non Motorist Device Type | Not Applicable |
| Non Motorist Device Motorization | Not Applicable |
| Non Motorist Location | Occupant of a Motor Vehicle (Includes Railway Train Occupants Since 2006) |
| At Work | No |
| Hispanic | Mexican |
| Race | White |
| Person Related Factor | None Noted |
| Collapse Table | Collapse Table |
|---|
| Fatalities | 1 |
| Number of Occupants |
2 |
| Hit and Run | No Hit and Run |
| NCSA Make | Chevrolet |
| Body Type | Large Van - Includes Van-Based Buses |
| NCSA Model | 461 |
| Registration State | Wisconsin |
| Registered Vehicle Owner | Vehicle Registered as Commercial/Business/Company/Government |
| VIN | 1GCWGFCA5B11 |
| Model Year | 2011 |
| VPIC Make ID | 467 |
| VPIC Model ID | 1848 |
| VPIC Body Class | Cargo Van |
| Body Class | Not Applicable |
| Lower Weight Rating | Class 2: 6,001 - 10,000 lbs (2,722 - 4,536 kg) |
| Upper Weight Rating | Class 2: 6,001 - 10,000 lbs (2,722 - 4,536 kg) |
| 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 | 45 |
| Travel Speed | 50 |
| Underride / Override | Not Applicable |
| Rollover | No Rollover |
| Rollover Location | No Rollover |
| Initial Contact Point | 12 O'Clock |
| Extent of Damage | Disabling Damage |
| Vehicle Towed | Towed |
| Most Harmful Event | Tree (Standing Only) |
| Fire Occurence | False |
| Automated Driving System Present | Not Reported |
| Automated Driving System Level | Not Reported |
| Automated Driving System Engaged | Not Reported |
| Driver Drinking | No Drinking |
| Driver Present | Driver Present |
| Drivers License State | Wisconsin |
| Driver Zip Code | 53204 |
| 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 | Restrictions Complied With |
| Driver Height | 70 |
| Driver Weight | 280 |
| Previous Recorded Crashes | 0 |
| Previous BAC Suspensions (Underage) | 0 |
| Previous BAC Suspensions | 0 |
| Previous Other Suspensions | 1 |
| Previous DWI | 0 |
| Previous Speeding Convictions | 1 |
| Previous Other Moving Violations | 4 |
| Month of Oldest Violation | August |
| Year of Oldest Violation | 2020 |
| Month of Newest Violation | April |
| Year of Newest Violation | 2023 |
| Speeding Related | No |
| Trafficway Description | Two-Way, Not Divided |
| 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 | No Controls |
| Traffic Control Device Functioning | No Controls |
| Pre Event Movement | Going Straight |
| Critical Precrash Event | THIS VEHICLE TRAVELING Off the Edge of the Road on the Right Side |
| Attempted Avoidance Maneuver | Steering Left |
| Precrash Stability | Other Vehicle Loss-of-Control |
| Pre-impact Location | Departed Roadway |
| Crash Type | CATEGORY I: SINGLE DRIVER - Right Roadside Departure |
| Vehicle Related Factor | None Noted |
| Driver Related Factor | None Noted |
| Visibility Obstructions | No Obstruction Noted |
| Moving Violations | None |
| Driver Maneuvered to Avoid | Driver Did Not Maneuver to Avoid |
| Vehicle Factors | Reported as Unknown |
| Damaged Areas | 1 O'Clock |
| Damaged Areas | 2 O'Clock |
| Damaged Areas | 3 O'Clock |
| Damaged Areas | 4 O'Clock |
| Damaged Areas | 5 O'Clock |
| Damaged Areas | 6 O'Clock |
| Damaged Areas | 7 O'Clock |
| Damaged Areas | 8 O'Clock |
| Damaged Areas | 9 O'Clock |
| Damaged Areas | 10 O'Clock |
| Damaged Areas | 11 O'Clock |
| Damaged Areas | 12 O'Clock |
| Damaged Areas | Top |
| Damaged Areas | Undercarriage |
| Driver Distracted | Not Reported |
| Driver Impaired | Ill, Blackout |
| Collapse Table | Collapse Table |
|---|