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Full text of "NHTSA Special Crash Investigation: Police 1991 Ford LTD Crown Victoria"

© 



400 Seventh Street, S.W. 
Washington, D.C. 20590 



U.S. Department 
of Transportation 

National Highway 
Traffic Safety 
Administration 



Dear Crash Data Researchers/Users: 

Thank you for choosing crash data from the National Highway Traffic Safety 
Administration (NHTSA) for your research or other use. The information contained in 
this motor vehicle crash report is collected, maintained and distributed in accordance with 
Public Law 89-564. In accordance with this Public Law, NHTSA is required not to 
release any case information until completion of quality control procedures. These 
procedures include a review of the case material to extract all names, licenses and 
registration numbers, non-coded interview material, non-research related researcher 
comments in the margins, non-factual data, and the production number portion of the 
vehicle identification number (VIN). 

If you requested NHTSA to query its database files in order to identify a specific crash, 
then that query was made using non-personal descriptors you provided for use in our 
search. This motor vehicle crash may have been identified from a data search and 
matches the general, non-personal descriptors you provided, but we cannot confirm that 
this is the specific crash report you requested. 

If you have any questions with regard to the above procedures, please contact the Field 
Operations Branch, Crash Investigation Division, National Center for Statistics and 
Analysis at 202-366-4820. Again, please be advised that we cannot confirm that this is 
the case that you have specifically requested nor can we certify the information to be 

correct. 

*** ### *** 




O ^^^^^^ AUTO SAFETY HOTLINE 

V --^£t It **•*•* 

SAFETY BELTS SAVE LIVES 



BmtttW** (800)424-9393 

G#l " Wash. D.C. Area 366-01 23 



TRANSPORTATION SCIENCES CENTER 
ACCIDENT RESEARCH GROUP 

Division of Arvin/Calspan 



CALSPAN ON-SITE AIR BAG DEPLOYMENT INVESTIGATION 

CALSPAN CASE NO. 92-12 

VEHICLE - POLICE 1991 FQRILXJP CROWN VICTORIA 

LOCATION -«HMH^|A 

ACCIDENT DATE - JflM i 1992 



Contract No. DTNH22-87-C-27169 



Prepared for: 



U.S. Department of Transportation 

National Highway Traffic Safety Administration 

Washington, D.C. 20590 



DISCLAIMERS 



This document is disseminated under the sponsorship of the 
Department of Transportation in the interest of information 
exchange. The United States Government assumes no responsibility 
for the contents or use thereof. 

The opinions, findings, and conclusions expressed in this 
publication are those of the authors and not necessarily those of 
the National Highway Traffic Safety Administration. 

The crash investigation process is an inexact science which 
requires that physical evidence such as skid marks, vehicular 
damage measurements, and occupant contact points are coupled with 
the investigator's expert knowledge and experience of vehicle 
dynamics and occupant kinematics in order to determine the pre- 
crash, crash, and post-crash movements of involved vehicles and 
occupants . 

Because each crash is a unique sequence of events, generalized 
conclusions cannot be made concerning the crashworthiness 
performance of the involved vehicles (s) or their safety systems. 



TECHNICAL REPORT STANDARD TITLE PAGE 



7. Report No. 
92-12 



2. Government Accession No. 



4. Title and Subtitle 

Calspan On-Site Air Bag Deployment Investigation 
Vehicle - Police 1 991 Ford LTD Crown Victoria 
Location -IB Ifc CA 



7. Authorfs) 

Accident Research Group 



9. Performing Organization Name and Address 
Transportation Sciences Center 
Accident Research Group 
Division of Arvin/Calspan 
P.O. Box 400 



3. Recipient's Catalog No. 



5. Report Date: 



1993 



6. Performing Organization Code 



8. Performing Organization 
Report No. 



10. Work Unit No. 



12. Sponsoring Agency Name and Address 
U.S. Department of Transportation 
National Highway Traffic Safety Administration 
Washington, D.C. 20590 



72. Contract or Grant No. 
DTNH22-87-C-27169 



75. Type of Report and Period Covered 
Technical Report 
Accident DateJ^|/92 



14. Sponsoring Agency Code 



15. Supplementary Notes 

On-site investigation of a single vehicle roadside departure crash that involved a police 1991 Ford LTD Crown Victoria. The 
driver sustained a minor (AIS-1) burn of the left fingers from contact with the inflation module. 



16. Abstract 

This on-site investigation focused on a single vehicle roadside departure crash that occurred on jBHP^* 1992 * The Accident 
Research Group was notified of the crash on 4fl§flfc and ^^^ an on ' site investigation ou^^f/fT A marked police 1991 Ford 
LTD Crown Victoria was in pursuit of a speeding vehicle and was traveling on a rural two lane mountainous road at a police 
reconstructed speed of 119.1 KPH (74 mph). The vehicle drifted onto the right shoulder and broke traction as it exited a moderate 
left curve. The right rear quarter panel area of the vehicle impacted a delineator post located at the outboard edge of the shoulder. 
The Crown Victoria subsequently rotated approximately 80? in counterclockwise direction across the travel lanes before departing 
the left side of the roadway. 

The vehicle became airborne as it exited the shoulder area of the roadway as it traveled down a 45° earth embankment. The 
right side passenger compartment area impacted several trees which resulted in severe vehicle damage. As a result of the impacts, 
the vehicle's supplemental driver air bag system deployed. 

The driver of the vehicle was a 54 year old male, 179.1 cm (70.5') and 99 kg (220 lbs.). He was properly restrained by the 
active 3-point lap and shoulder belt system. In response to the lateral impact forces, the driver's upper torso slid out of the manual 
shoulder belt and impacted the intruding right upper B-pillar, roof, and roof side rail. As a result, he sustained multiple right rib 
fractures with flail chest and hemothorax (AIS-4), multiple fractures of the right upper extremity (AIS-3), and a closed head injury 
with brief loss of consciousness (AIS-2). He rebounded across the interior of the vehicle and came to rest with his left hand 
pressed against the deflated air bag and the inflation module. The heat retained in the inflator assembly melted the air bag and 
produced full thickness burns (AIS-1) of the driver's dorsal left middle, ring, and fifth fingers. 



17. Key Words 

Roadside departure crash 

Right side impacts 

Air bag deployment 

Inflator temperatures of 300°C (578°F) 

Thermal burns of driver's left hand, AIS-1 



79. Security Classif. (of this report) 
Unclassified 



18. Distribution Statement 
General Public 



20. Security Classif. (of this page) 
Unclassified 



27. No. of Pages 
117 



22. Price 



11 



TABLE OF CONTENTS 



Summary 

Accident Schematic 

Accident Data 

Ambience 

Highway 

Traffic Controls 

Vehicle 

Vehicle Damage 

Supplemental Restraint System 

Collision Sequence 

Human Factors/Occupant Data 

Driver Injuries 

Driver Kinematics 

Selected Prints 

Slide Index 



Appendix A 
Appendix B 
Appendix C 
Appendix D 



Police Accident Report 
Air Bag Supplement 
NASS Vehicle Forms 
NASS Occupant Forms 



Page No, 

1 

5 

7 

7 

7 

8 

8 

9 
14 
15 
19 
20 
21 
24 
56 
58 
75 
82 
108 



ill 



CALSPAN ON-SITE AIR BAG DEPLOYMENT INVESTIGATION 

CALSPAN CASE NO. 92-12 

VEHICLE - POLICE 1991 FORD CROHN V ICTORIA 4 DR. SEDAN 

LOCATION -MV m CA 



STJMMARY 



The single vehicle roadside departurg crash occurred on a 
rural two-lane mountainous road on iMHHHN^F/ 1992 during daylight 
hours. The involved vehicle was a marked police 1991 Ford Crown 
Victoria, 4 door sedan (V.I.N. : 4^0JHliliiHMW ^ that was equipped 
with a supplemental driver's air bag system. The crash occurred as 
the vehicle was exiting a moderate left curve with a downgrade of 
5.2%. The dry asphalt road surface was 6.6m (21' 9") wide and was 
bordered by narrow paved and loose cinder shoulders. A steep 
downhill embankment of 45° paralleled the left (south) edge of the 
roadway. The posted speed limit was 88 kph (55 mph) . 

The driver of the Ford Crown Victoria was on routine patrol 
and was traveling in an easterly direction on the state highway. 
He entered the parking lot of a local service station and noted a 
westbound vehicle traveling at a high rate of speed. The officer 
initiated a U-turn and activated the vehicle's emergency equipment 
(flashing lights and siren) and pursued the speeding westbound 
vehicle. During the pursuit, the driver of the Crown Victoria 
entered a moderate left curve at a high rate of speed. The vehicle 
drifted wide onto the right (north) shoulder and broke traction as 
the driver exited the curve. The right rear quarter panel impacted 
a delineator post as the vehicle initiated a counterclockwise yaw. 
The Crown Victoria subsequently deposited four-wheel centrifugal 
tire mar ks on the road surface as it crossed both travel lanes. 
The €NRMNNVNM* Highway Patrol computed an initial speed of 119.1 
kph (74 mph) for the vehicle as it exited the curve using the 
critical curve formula. 

As the vehicle crossed the eastbound travel lane and departed 
the left edge of the roadway, it had rotated approximately 8 0° in 
a counterclockwise direction. The police documented 82.3m (270 ') 
of centrifugal tire marks prior to road departure. During 
Calspan's on-site investigation that occurred nearly three months 
later, 42.7m (140') of tire marks were still visible on the asphalt 
road surface. As the vehicle departed the left (south) edge of the 
roadway, the right front fender area impacted and dislodged a steel 
delineator post from the cinder and earth shoulder. The vehicle 
exited the shoulder area in a near broadside orientation and became 
airborne as it traveled over the earth embankment . The frontal 
area of the Crown Victoria contacted branches of a large tree that 
was located on the embankment 7.62m (25') outboard of the roadedge . 
The vehicle continued in a near broadside orientation and pitched 



slightly to its right. The upper surface of the right front fender 
area of the vehicle impacted a 20.3cm (8") cedar tree that was 
located 9.1m (30') outboard of the roadedge. The 3 o'clock 
direction of force impact fractured the tree 81.3cm (32") above the 
ground and deflected the stump along the vehicle's path of travel. 
The right passenger compartment and roof side rail area of the 
vehicle subsequently impacted a 25.4cm (10") diameter cedar tree 
that was located 2.4m (8") east of the 20.3cm (8") diameter tree 
and 8.7m (28 '6") south of the roadedge. At impact the vehicle was 
pitched approximately 15-20° to its right which resulted in a non- 
horizontal impact force. The impact crushed the side structure of 
the vehicle 69.1cm (27.2") at the beltline and 83.8cm (33") at the 
right roof side rail. Again, the larger diameter tree fractured 
1.9m (6' 3") above the ground and the remaining stump was deflected 
to the ground as the vehicle overrode the struck tree. 

The Ford Crown Victoria rotated approximately 3 0-4 0° in a 
clockwise direction following the latter impact sequence with the 
25.4cm (10") tree. The vehicle came to rest facing in a downhill 
orientation approximately 6.1m (20') west of the 25.4cm (10") 6.1m 
(20') diameter tree. During the crash sequence, the supplemental 
driver's air bag system deployed. 

The driver of the vehicle was a 54 -year-old male with a stated 
height of 179.1cm (70.5") and weight of 99 kg (220 lbs.). He was 
properly wearing the active 3 -point lap and shoulder belt system. 
Belt usage was supported by driver statements, blood stains on the 
upper shoulder belt webbing and by load induced abrasions to the 
inner plastic surface of the system's latchplate. There was no 
loading evidence on the belt webbing or damage to the active 
restraint system. The driver stated that he routinely drove the 
Crown Victoria with the seat adjusted to a mid-track position and 
the seatback set to the most upright position. He stated that ^ the 
tilt steering column was probably adjusted to the center position. 

At impact with the trees, the driver was probably out of 
position to his right due to the pre-crash rotation of the vehicle 
and was further displaced at each tree impact. As the vehicle 
impacted the 25.4cm (10") diameter tree, the driver moved laterally 
to his right as his upper torso slid out of the manual shoulder 
belt webbing, while his pelvic area loaded the lap belt portion of 
the 3 -point belt system. His head impacted the intruding 
headliner and roof 36. 8-50. 8cm (14.5-20") rearward of the right A- 
pillar and 27.9cm (11") above the side rail. The 11.4cm (4.5") 
diameter head contact cracked the backer to the headliner and bowed 
the roof panel approximately 0.6cm (0.25") outward. As a result of 
the contact, the driver sustained a laceration to the top of the 
scalp (AIS-1) , a closed head injury with brief loss of 
consciousness and residual cognitive deficits (AIS-2) , a non- 
displaced fracture of the right zygoma (AIS-2) , a nasal laceration 
(AIS-1) , a displaced nasal fracture (AIS-2) , and four dislocated 



immediately forward of the right B-pillar. The contact resulted in 
a fracture of his right clavicle (AIS-2) . His right forearm 
impacted the right roof side rail 20. 3-29, 2cm (8-11.5") rearward of 
the right upper A-pillar. The contact was evidenced by tissue 
transfers on the headliner fabric that covered the side rail area. 
As a result of the side rail contact, the driver sustained a 
comminuted fracture of the right radial head (AIS-3) and a fracture 
of the right proximal ulna (AIS-2) . 

During the driver's lateral trajectory, his right chest area 
probably contacted the right upper B-pillar as the vehicle crushed 
to maximum engagement . Although no contact evidence was visible to 
the plastic jacket covering the B-pillar, the driver sustained 
fractures of the right ribs 2-9 with flail chest and right 
hemothorax (AIS-4) and a right pulmonary contusion (AIS-3) . 

The driver subsequently rebounded across the interior of the 
vehicle into the left front seatback and/or the left front door 
panel. He sustained a fracture of the spinous process of T 12 from 
the probable rebound contact. The supplemental driver's air bag 
system deployed during the crash sequence; however, due to the 
driver's lateral trajectories, he had minimal involvement with the 
bag. He came to rest with his left hand under the upper module 
cover flap, pressing against the deployed air bag and the inflation 
module. The hot inflation module melted the face of the air bag 
and an internal tether strap of the bag at the 10 o'clock position. 
The heat was transmitted through the bag which resulted in full 
thickness thermal burns of the dorsal aspects of the driver's left 
middle, ring, and fifth fingers (AIS-1) . The thermal burns 
destroyed the tendons of the fingers and required extensive skin 
grafts. The driver came to rest slumped forward over the steering 
assembly and bled profusely from the nasal injuries onto the 
deflated air bag. He was transported by helicopter to a trauma 
center where he was admitted for 24 days for treatment of his 
injuries. Currently he has no ability to move the left ring and 
fifth fingers due to the extensive burn injury. 

During our on-site investigation of this crash, a 
representative from TRW (manufacturer of the air bag module) was 
present to inspect and dismantle the module assembly. During his 
discussion of the deployment process, he stated that the air bag 
material, which consists of woven nylon with a neoprene liner, will 
not support a flame; however, it does have a melting point of 154- 
177° C. (310-350° F.). The inflation module, which is primarily 
stainless steel, reaches deployment temperatures of 3 00° C. (578° 
F.) and cools slowly due to its isolated, non-vented location. 

The melted area of the air bag was located 19.1-26cm (7.5- 
10 25") left of center and 8. 3-9. 5cm (3.25-3.75") above the3 
horizontal centerline. The 1.3 x 7.0cm (0.5 x 2.75") melted area 
of the air bag was located 4. 4 -10. 2cm (1.75-4.0") inboard of the 



horizontal centerline. The 1.3 x 7.0cm (0.5 x 2.75") melted area 
of the air bag was located 4. 4-10. 2cm (1.75-4.0") inboard of the 
peripheral seam. Tissue and blood were visible within the melted 
area. The face of the inflator- contained melted fragments of the 
bag and an internal tether strap that were pressed against the 
inflator by the driver's hand. 

An external inspection of the inflator assembly did not yield 
evidence of filtering screen burnthrough or separation of the 
initiator assembly. The assembly was intact and appeared to have 
performed as designed. Due to the nature of the driver's burn 
injury and the melting of the bag, it was decided that disassembly 
of the inflator was not necessary. The module assembl y was 
identified by the following^ alpha/numerical sequences: 

AND* 



Accident Schematic 
Calspan Case No. 92-12 



Fractured Tree 



10" Diameter 
Struck Tree 



8" Diameter 
Struck Tree 



Struck Tree 
Branches 



f 
\ o 



y 





-^C*#'o 1 

L. - - 



~-h 



-45° 
Embankment 




Area of Struck Delineator 



Paved Shoulder 



rr V - 



IL 





i 

i 

1 


#1 - 








5.2% 




! 



I i 



\ \1 I 



Cinder Shoulder — 



% \\ 



\ 



Vehicle 

1991 Ford LTD Crown 

Victoria Police Vehicle 



Paved Shoulder 



Cinder Shoulder 



h 



tf^ 



V 



Scale 1 M =20' 




Area of Struck Delineator 



/ / 



/■ / 



/ / o ' 

/ / 



CALSPAN ON-SITE AIR BAG DEPLOYMENT INVESTIGATION 

CALSPAN CASE NO. 92-12 

VEHICLE - POLICE 1991 FORD CROWN VICTORIA 

LOCATION - iHfll CA 



ACCIDENT DATA 

Location: 
City/Township : 
Area/Type : 
Accident Date/Time : 



Investigating Police 
Agency : 

Accident Type: 



Air Bag Vehicle Driver 
Injury Severity: 



Rural, two lane state route 

HHHii CA 
Rural /Mountainous 

«tt, 1992, 



daylight hours 



Highway Patrol 



Single vehicle roadside 
departure, multiple tree 
impacts 



Severe (AIS-4) 



AMBIENCE 

Viewing Conditions 
Weather : 
Precipitation : 
Road Surface : 



Daylight 
Clear 
None 
Dry 



HIGHWAY 

Type: 

Number of Lanes 

Width: 

Surface : 

Median: 



State route 

2 

21'9" 

Asphalt 

None 



Edge 



Vertical Alignment: 

Horizontal Alignment: 
Traffic Density: 



North edge - 1.8cm (6') paved 
and loose cinder shoulder 
South edge - 2.5m (8'4") paved 
and loose cinder shoulder 

5.2% grade, negative to the 
west 

Left curve 

Light 



TRAFFIC CONTROLS 

Signals: 
Signs : 
Markings : 

Speed Limit 



None 

No pertinent signs 

Yellow full barrier 
centerlines, solid white 
edgelines 

88 KPH (55 mph) 



VEHICLE 

Description : 

V.I.N. : 

Color: 
Odometer : 
Engine : 
Transmission: 

Steering: 
Brakes : 



1991 Ford Crown Victoria, 4 dr. 
sedan, marked police vehicle 

2FACP72G5MX (production number 
deleted) 

Black and white 

26, 919 miles 

8 cylinder, 5.8 L 

4 -speed automatic overdrive, 
column mounted transmission 
selector lever 

Power 

Power front disc 



Padding ; 



Active Restraints: 



Automatic Restraints; 

Defects: 
Tow Status : 



Upper, mid, and lower 
instrument panel, knee bolster, 
soft edged steering wheel rim 
and air bag module cover, 
sunvisors, adjustable head 
restraints, fold-down center 
armrest, door panels, door 
armrests, headliner 

3 -point lap and shoulder belts 
in the four outboard seated 
positions, center front and 
center rear lap belts 

Supplemental driver's air bag 
system that deployed during the 
crash sequence 

None 

Towed due to damage 



VEHICLE DAMAGE 

Exterior: 



The exterior of the 1991 Ford Crown 
Victoria sustained severe damage from 
multiple impacts with roadside and off- 
road objects. As the vehicle exited a 
left curve, it drifted onto the right 
shoulder and impacted a delineator with 
the right rear quarter panel area. The 
impact produced 12.7cm (5") of crush to 
the panel that was located 86.4cm (34") 
rearward of the right rear axle. The 
deformation to the quarter panel began 
15.3cm (6") rearward of the referenced 
axle and extended 111.8cm (44") to the 
rear bumper. The vehicle rotated across 
the travel lanes in a counterclockwise 
direction and departed the left roadedge 
in a near broadside orientation. As the 
vehicle departed the roadway, the right 
front fender area impacted and dislodged 
a steel delineator post from the cinder 
and earth shoulder. Paint abrasions were 
noted to the fender 20-48cm (8-19") 
rearward of the right front axle position 
and were vertically orientated on the 
fender above the wheel opening. Crush 
damage to the area was masked by 
subsequent impacts . 



Exterior The vehicle exited the left shoulder of 

(Cont'd) : the roadway and traveled down an earth 

embankment, becoming airborne in a 
broadside yaw. The frontal area of the 
vehicle contacted overhanging branches of 
a large tree that was located 7.6m (25') 
outboard of the roadedge . The branches 
probably fractured the header panel and 
scratched the top surface of the 
vehicle's hood. 

As the vehicle continued on its 
trajectory down the embankment, the front 
undercarriage area of the Crown Victoria 
impacted the ground which displaced the 
frontal structure upward. Push bars were 
mounted to the front bumper and frame 
area of the vehicle. As a result of the 
undercarriage impact and subsequent 
contact with small diameter trees on the 
embankment, the right side of the front 
bumper face was dented 40-52cm (16-20.5") 
right of center, to a depth of 1.9cm 

(.75") . The lower right push bar bracket 
was deformed and displaced 12.7cm (5 n ) 
laterally to the left. The bumper energy 
absorbing devices were compressed 3.2cm 

(1.25") on the right side and 1.6cm (.6") 
on the left side. 

Due to the slope of the embankment, the 
broadside trajectory of the vehicle, and 
vehicle contact with the ground, the 
Crown Victoria began to pitch to its 
right. The upper surface of the right 
front fender impacted a 2 0.3cm (8") 
diameter cedar tree that was located 9 . lm 

(30') outboard of the roadedge. The tree 
impact damage began on the fender at 
bumper level and extended vertically onto 
the top of the fender and hood, 
indicating a non-horizontal (00-LFMN-3) ) 
impact force. Direct contact damage 
began 4 0.6cm (16") forward of the axle 
position and extended 2 0.3cm (8") forward 
to the leading edge of the fender. The 
vehicle subsequently impacted a small 
diameter tree with the right front fender 
area. The damage was located 16. 5 -3 0.5cm 

(6.5-12") forward of the referenced axle 
position and involved 7.6cm (3") of crush 
on the lip of the wheel opening. The 

10 



Exterior impacts fractured the 2 0.3cm (8") 

(Cont'd) : diameter tree 81.3cm (32") above ground 

level and displaced the stump to the east 
as the vehicle overrode the remaining 
trunk of the tree. The small diameter 
tree was completely uprooted and 
displaced from its location on the 
embankment . 

The Crown Victoria continued to pitch to 
its right and subsequently impacted a 
25.4cm (10") diameter cedar tree that was 
located 2.4m (8') east of the previously 
struck 8" diameter tree. The impact 
damage extended vertically from the sill 
of the vehicle onto the side rail and 
roof. Due to the slope of the embankment 
and the vehicle's attitude at impact, the 
damage was diagonally orientated on the 
right passenger compartment area. Direct 
contact damage on the right front door 
and sill area began 111.8cm (44") 
rearward of the right front axle and 
extended 35.6cm (14") rearward. The 
direct contact damage on the right roof 
side rail began 162.6cm (64") rearward of 
the axle position and extended 33cm (13") 
rearward. Maximum crush was 83.8cm (33") 
located on the right roof side rail at 
the B-pillar. Crush values at the side 
rail level were as follows: 
C x = 39.4cm (15.5"), C 2 = 78.1cm 
(30.75"), C 3 = 83.8cm (33"), and 
C 4 = 33.3cm (13.1") at the right A-pillar. 
A second set of crush values were 
documented at the beltline area of the 
vehicle which extended from the A- to the 
C-pillars and were as follows: 
Cj = 20.3cm (8") , C2 = 
= 76.7cm (30.2", C 4 = 
20.5cm (8.1") , C 6 = 10. 
crush at the beltline 
located at the B-pillar. The crush 
profile of the right sill area was also 
documented and was as follows: 
Cj = 0cm, C 2 = 26.9cm (10.6"), 
C 3 = 38.1cm (15"), C 4 = 50.8cm (20"), 
C 5 = 54cm (21.25"), C 6 = 19.1cm (7.5"). 

As a result of the multiple impacts, all 
exterior sheetmetal components were 



11 



48. 


. 5cm 


(19 


.1") 


/ 


C 3 


50. 


8 cm 


{20' 


'), 


c 5 


= 


2cm (4" 


') - 


Maximum 


was 


76. 


7 cm 


(30 


.2 


") 



Exterior 
(Cont'd) ; 



damaged from either direct contact or 
induced buckling. The left front door 
was jammed closed due to the deformation 
to the vehicle. Rescue personnel used 
emergency equipment to pry open the door 
and subsequently cut the hinges to remove 
the door from the vehicle. The left rear 
door was jammed closed and again, rescue 
workers pried the door open to treat the 
injured driver. The right side doors 
were jammed due to the severe deformation 
to the passenger compartment area. All 
glazing was damaged by the impacts with 
the exception of the left rear door 
glazing and its quarter window. The 
windshield was removed by rescue 
personnel during extrication of the 
driver. 



CDC; 



Event Number 



Repair 
Cost : 



1 


12-RBEW-l 


2 


02-RFEN-l 


3 


00-FDMW-3 


4 


03-FZLS-l 


5 


00-RFEN-3 


6 


00-RFEN-2 


7 


OO-RPAN-5 


Total 


loss 



Object Contacted 

Delineator post 
Delineator post 
Tree branches 
Small diameter tree 
20.3cm (8") diameter tree 
Small diameter tree 
50.8cm (10") diameter 
tree 



12 



Interior: The interior of the Ford Crown Victoria was 

severely damaged as a result of exterior 
deformation and driver contact. The right 
passenger side impact with the 50.8cm (10") 
diameter tree produced severe intrusion of the 
right side components. Maximum intrusion 
involved 83.8cm (33") of lateral displacement 
of the right roof side rail, the roof and the 
upper B-pillar at the side rail juncture. Due 
to the severe lateral displacement of the side 
rail, the roof was crushed to a near vertical 
surface on the interior of the vehicle. The 
mid right B-pillar and right front door panel 
intruded into the center front occupant space, 
resulting in a lateral displacement of 76.7cm 
(30.2") . 

The driver of the vehicle moved laterally to 
the right in response to the right side tree 
impacts. His knees and lower legs initially 
contacted the fuse box cover and the knee 
bolster. The fuse box cover was scuffed 53- 
61cm (21-24") left of center and 41-46cm (16- 
18") below the top surface of the instrument 
panel. A lower leg scuff was noted to the 
bolster 39-46cm (15.5-18.3") left of center 
and 38-43cm (15-17") below the upper panel. 
The driver's right knee contacted the 
protrusion of the bolster at the base of the 
steering column. A scuff mark and disruption 
of the vinyl covering was noted 38-46cm (15- 
18") left of center. The lateral aspect of 
the driver's right knee contacted the center 
mid instrument panel (scuff) and the center 
mounted police radio equipment. Although the 
radios were removed prior to our inspection of 
the vehicle, a deformed bracket was found in 
the vehicle, indicating contact to the 
components . 

The driver's head and facial areas impacted 
the intruding vertical surface of the roof. 
The 11.4cm (4.5") diameter contact cracked the 
backer panel to the headliner and bowed the 
roof panel outward .6cm (.25"). The contact 
point was located 38-51cm (15-20") rearward of 
the A-pillar and 22-34cm (8.8-13.3") above the 
roof side rail. His right forearm impacted 
the right siderail 20-29cm (8-11.5") rearward 
of the A-pillar, depositing tissue transfers 
on the fabric covering. The driver's thoracic 
area contacted the B-pillar; however, no 

13 



Interior evidence of contact was visible on the vinyl 
(Cont'd) : covering. 

As the driver responded to the lateral impact 
forces, his upper torso slid out of the manual 
shoulder belt webbing. His pelvic area 
subsequently loaded the lap belt webbing which 
pulled the webbing against the crossbar on the 
latchplate. The webbing abraded the plastic 
coating on the crossbar on the back side of 
the component . 

SUPPLEMENTAL RESTRAINT SYSTEM 

The 1991 Ford LTD Crown Victoria was equipped with a 
supplemental driver's air bag system that deployed during the 
multiple impact, off -road crash sequence. The module cover opened 
in the conventional H- configuration at the designated tear points. 
The large upper flap measured 20.3cm (8") in width x 12.4cm 

(4.875") # while the lower flap had respective measurements of 
20.3cm (8") x 3.8cm (1.5") . The air bag was constructed of a woven 
nylon fabric with a neoprene liner and measured approximately 61cm 

(24") in diameter (seam-to-seam) in its deflated state. Two 2.5cm 

(1" ) diameter venting ports were located on the back side of the 
air bag (side away from driver) at the 2 and 8 o'clock positions. 
The bag was tethered by four internal tether straps that were sewn 
to the center face of the bag in a 17.8cm (7") diamet er pattern 
with three rows of orange stitching. Members of the 4RHHHHHH 1 
Highway Patrol's Multi-Disciplinary Accident Investigation Team 

(M.A.I.T.) properly removed the deployed air bag module from the 
involved patrol vehicle. 

The upper center portion of the air bag was heavily stained by. 
blood from the driver as he came to rest slumped against the 
deflated air bag. His left hand came to rest under the upper 
module flap and was pressed against the air bag and the inflator 
housing. As a result of contact with the hot inflator housing, the 
heat was transmitted through the bag which subsequently burned the 
dorsal surface of his left middle, ring, and fifth fingers. The 
contact also melted the face of the bag at the 9:30 o'clock 
position. The melted area measured 1.3 x 7.0cm (0.5 x 2.75") and 
was horizontally located 8. 3 -9. 5cm (3.25-3.75") above the mid point 
of the bag and 19.1-26cm (7.5-10.25") left of the vertical 
centerline. The melted area was also located 4. 4-10. 2cm (1.75- 
4.0") inboard and toward the driver from the peripheral seam. Upon 
magnification of the melted area, tissue fragments and blood were 
found fused to the nylon fabric. 

During Calspan's on-site investigation, a representative from 
TRW (the company that manufactured the air bag module assembly) was 
present to inspect and dismantle the deployed module assembly for 

14 



possible defects. Numerous members of the 4M|IINMNNfti Highway 
Patrol were also present. The TRW representative thoroughly 
discussed the deployment process of the module and used several 
models to identify the internal components. During his discussion, 
he stated that the air bag fabric had a melting point of 154-177° 
C (310-350° F) and that the nylon/neoprene material would not 
support a flame. The inflator housing and its internal filtering 
screens were manufactured from stainless steel . The TRW 
representative stated that the inflator module reaches deployment 
temperatures of 300° C (578° F) and cools slowly due to its 
isolated, non-vented location within the steering assembly. 

The module assembly was transported to a state operated 
laboratory where a machinist drilled and removed the twelve (12) 
retaining rivits that attached the air bag and inflator module to 
the stamped mounting bracket. The air bag and the exterior of the 
inflator module were thoroughly inspected. The internal surface of 
the air bag and a tether strap were melted from contact with the 
hot inflator module. The face of the inflator module above the 
radial inflation ports contained deposits of melted neoprene and 
woven nylon air bag material. These melted transfers, in 
combination with the melted air bag which contained tissue and 
blood deposits, confirmed the source of the burns to the driver's 
left hand. Additional exterior inspection of the inflator assembly 
did not yield evidence of component failure. There was no damage 
or burn- through of the module or filtering screens; therefore, it 
was agreed upon that further dismantling of the inflator assembly 
was not necessary. The involved air bag module was identified by 
the following bar-coded numbers that were affixed to the back side 
of the mQunting bracket: 

id 



COLLISION 
SEQUENCE 

Pre -Crash: 



The driver of the marked police 1991 Ford 
LTD Crown Victoria was on routine patrol 
and was exiting a parking lot of a local 
service station to proceed in an easterly 
direction on the mountainous two- lane 
state route. As he was about to exit the 
parking lot, he observed a westbound 
vehicle traveling at a high rate of 
speed. The driver activated the 
vehicle's emergency equipment (flashing 
lights and siren) and initiated a U-turn 
to pursue the westbound vehicle. 



During the pursuit, the driver of the 
Crown Victoria had negotiated a moderate 
left curve; however, as the vehicle 
exited the curve, it drifted wide onto 



15 



the right (north) shoulder. Based on the 
physical evidence at the crash scene, the 
driver initiated a counterclockwise 
steering input and braked in an attempt 
to maintain control of the vehicle. The 
right side tires of the vehicle departed 
the paved right shoulder onto the loose 
cinder material that bordered the 
shoulder. As a result the vehicle broke 
traction and initiated a counterclockwise 
yaw. The right rear quarter panel 
impacted a delineator post that was 
located at the edge of the shoulder. The 
minor severity impact did not alter the 
trajectory of the vehicle as it crossed 
the travel lanes. The vehicle deposited 
four wheel centrifugal tire marks on the 
asphalt road surface. The investigating 
officer documented approximately 76.2m 
(250') of centrifugal tire marks prior to 
the vehicle crossing the left (south) 
white edgeline. At the time of our 
inspection of the crash scene, which 
occurred nearly 3 months after the crash, 
42.7m (140') of tire marks were still 
visible on the asphalt road surface. As 
the vehicle crossed the south (left) 
edgeline of the roadway, it had rotated 
approximately 8 0° in a CCW direction. 

The HNNHHMNHlte Highway Patrol computed an 
initial speed of 119.1 KPH (74 mph) for 
the vehicle as it exited the curve, using 
the critical curve formula. 

Crash: The right front fender of the Crown 

Victoria impacted and dislodged a steel 
delineator post from the cinder and earth 
south shoulder. The impact resulted in 
minor damage to the vehicle and produced 
an impact force of 2 o'clock. Again, the 
minor severity impact with the delineator 
did not alter the trajectory of the 
vehicle . 

The Crown Victoria exited the shoulder 
area in a near-broadside orientation and 
became airborne as it traversed an earth 
embankment that paralleled the roadway. 
The embankment had a negative slope of 
approximately 45°. As the vehicle 



16 



traveled down the embankment, the frontal 
and hood areas contacted overhanging tree 
branches from a tree that was located 
7.6m (25') outboard of the roadedge . The 
impact produced minor damage to the 
vehicle as it continued on a broadside 
trajectory. The front bumper and right 
push bumper bar impacted several small 
diameter trees as the undercarriage 
subsequently contacted the ground, which 
displaced the front structure upward. 

The vehicle began to pitch to its right 
as its center of gravity continued in a 
southwesterly direction. The upper 
surface of the right front fender and 
hood impacted a 2 0.3cm (8") diameter tree 
that was located 9.1m (30') outboard of 
the roadedge. At impact with the tree, 
the vehicle had traveled approximately 
23m (75') along the embankment. Due to 
the lateral pitching of the vehicle, the 
resultant direction of force was non- 
horizontal (00 o'clock). The vehicle 
fractured the tree 81.3cm (32 ") above 
ground level and overrode the remaining 
trunk, displacing the roots of the tree. 

The right passenger compartment area of 
the vehicle subsequently impacted a 
25.4cm (10") diameter cedar tree that was 
located 2.4m (8') east of the struck 
2 0.3cm (8") diameter tree. At impact 
with the tree, the vehicle was pitched 
slightly to its right and struck the tree 
with its right roof, siderail, door and 
sill areas. Maximum crush was 83.8cm 
(33 " ) located on the siderail at the B- 
pillar area. Again, the vehicle 
fractured the 25.4cm (10") diameter tree 
1.9m ( 6 ' 3 " ) above the ground and 
deflected the remaining stump to the east 
as it overrode the tree trunk. The force 
of the impact hurled the upper portion of 
the tree into a wooded area where it came 
to rest 6.1m (20') to the east of its 
struck location. 

The supplemental driver's air bag system 
deployed during the multiple impact crash 
sequence. Although unconfirmed, the SRS 
probably deployed early in the sequence 

17 



as the front bumper and undercarriage 
impacted the ground and several small 
diameter trees. All impacts involved 
force directions that were primarily 
lateral (within the 2-3 o'clock sector) 
and estimated velocity changes that were 
equivalent to the required threshold of 
13-19 KPH (8-12 mph) necessary for 
deployment . 



Post-Crash: 



Final 
Rest - 



Driver 
Activities 



The Ford Crown Victoria came to rest on 
its wheels at the base of the embankment, 
facing in a southerly direction. At rest 
the vehicle was approximately 6.1m (20') 
east of the struck 25.4cm (10") diameter 
tree. Due to the slope of the 
embankment, the vehicle was barely 
visible from the roadway. 

The driver lost consciousness as a result 
of a head impact with the intruding roof. 
He slumped forward over the steering 
assembly and came to rest with his left 
hand against the air bag inflation 
module. Passing motorists noted the dust 
in the area of the crash and observed the 
vehicle at rest . They rushed down the 
embankment and pushed the driver into the 
seatback as he was bleeding profusely 
from the nose. Another motorist, who 
stopped at the scene, drove to a local 
store and telephoned for police and 
rescue assistance . 



Police 
Activities 



Rescue 
Activities 



Several police units from the County 
Sheriff's Department and the Highway 
Patrol responded to the call and arrived 
on-scene. The investigating officer 
received notification of the crash and 
arrived 4 7 minutes following the crash. 

The local fire department and emergency 
medical personnel responded to the scene. 
They initially treated and evaluated the 
driver in the vehicle. He had regained 
consciousness, but was unaware of what 
had occurred. The fllMfet requested the 
service of a hel icdpt er transport to a 
trauma center in tfl Htt CA. 



18 



The driver was removed from the vehicle 
and carried up the embankment to an 
awaiting ambulance. He was transported 
to a remote helicopter landing site and 
flown to the trauma center where he was 
admitted for treatment of his injuries. 



Scene 
Clearance 



Following the removal and subsequent 
transport of the driver and the on- scene 
police investigation, the vehicle was 
winched up an embankment and towed from 
the scene . 



HUMAN FACTORS /OCCUPANT DATA 

Driver: 

Height : 

Weight : 

Occupation: 

Active Restraint 
System Usage : 

Usage Source : 

Eyeglasses : 

Vehicle Familiarity: 

Route Familiarity: 

Trip Plan: 

Manner of Transport 
From Scene : 



54 year old male 

179.1cm (70.5") 

99kg (220 lbs.) 

Police officer 

3 -point lap and shoulder belt system 

Vehicle inspection, police report 

None 

Not assigned patrol vehicle, has 
driven similar vehicles daily over 
the past year 

Daily, routine patrol area 

In pursuit of a speeding vehicle 

Ambulanced from the scene to an 

emergency heliport then flown by 

helicopter to a trauma center in 
t, CA 



Type of 
Treatment : 



Medical 



Admitted to the hospital for 24 days 
for treatment of his injuries, 
readmitted for follow-up surgeries 



19 



DRIVER INJURIES 



Injury 

Fractured right 
ribs 2-9 with flail 
chest and right 
hemothorax 

Right pulmonary 
contusion 

Full thickness 
thermal burns of 
the dorsal aspect 
of the left middle, 
ring, and 5th 
fingers with loss 
of the extensor 
tendons and 
devascularization 
of part of the 
bones within the 
digits 

Comminuted fracture 
of the right radial 
head 

Fracture of the 
right proximal ulna 

Closed head injury 
with loss of 
consciousness and 
residual cognitive 
deficits (amnesia) , 
negative head CT 

Non-displaced 
fracture of the 
right zygoma 

T 12 spinous process 
fracture 



Severity (OIC/AIS) 
Severe (CRFS-4) 

Serious (CRCP-3) 
Minor (WLBI-1) 



Serious (RRFS-3) 



Moderate (RRFS-2) 



Moderate (HWKB-2) 



Moderate (FRFS-2) 



Moderate (BSFS-2) 



Source 

Intruding right B- 
pillar 



Intruding right B- 
pillar 

Contact against the 
air bag inflator 
module 



Intruding right 
roof side rail 



Intruding right 
roof side rail 



Intruding 
panel 



roof 



Intruding 
panel 



roof 



Right 
fracture 



clavicle 



Moderate (SRFS-2) 



Probable rebound 
contact into left 
front door panel or 
seatback 

Intruding right 
roof side rail 



20 



Injury 



nasal 
Nasal laceration 



Displaced 
fracture 



Right earlobe 

laceration 

Superior scalp 

laceration 

Dislocated 
(loosened) teeth 

nos . 5-8 



Severity (OIC/AIS) 
Moderate (FCFS-2) 

Minor (FCLI-1) 

Minor (HRLE-1) 

Minor (HSLI-1) 

Minor (FIDS-1) 



Source 
Intruding roof 



Intruding roof and 
headliner 

Intruding roof and 
headliner 

Intruding roof and 
headliner 



Intruding 
panel 



roof 



DRIVER KINEMATICS 

The driver of the Ford Crown Victoria was in a normal seated 
position pre-crash with both hands on the steering wheel while in 
pursuit of the speeding vehicle. He was properly wearing the 
manual 3 -point lap and shoulder belt system. Rstraint usage was 
supported by driver interview data, blood stains on the upper 
shoulder belt webbing, and from load induced abrasions on the inner 
plastic surface of the latchplate. The driver stated that he 
routinely drove the Crown Victoria with the seat adjusted to a mid- 
track position and the seatback set to the most vertical position. 
He added that the tilt steering wheel was adjusted to the center 
position. 

At impact with the trees, the supplemental driver's air bag 
system deployed. The driver was probably slightly out of position 
to his right due to the pre-crash counterclockwise rotation of the 
vehicle. He was further displaced to his right by each tree impact 
as he responded to the lateral impact forces. The driver's upper 
torso slid out of the manual shoulder belt webbing while his pelvic 
area loaded the lap belt portion of the 3 -point system. His 
loading force against the lap belt pulled the webbing through the 
latchplate which abraded the inner plastic surface of the 
latchplate' s fixed crossbar. The driver's knees contacted the fuse 
box cover and the knee bolster which scuffed the contacted 
components. His right knee contacted the bolster at the protrusion 
for the steering column and disrupted the vinyl covering of the 
bolster. These contacts did not result in injury to the driver's 
lower extremities. The lateral aspect of the driver's right knee 
impacted the left edge of the lower mid instrument panel (scuff 
mark) and the center mounted police radio equipment. The radio 
equipment was removed from the vehicle prior to our inspection; 
however, a bracket for the equipment was deformed to the right, 



21 



indicating driver contact. Again, no injury resulted from the 
lower extremity contact . 

The driver's right forearm flailed upward with respect to his 
seated position and impacted the intruding right roof siderail 
20. 3-29. 2cm (8-11.5") rearward of the upper A-pillar. Tissue 
transfers evidenced the contact which resulted in a comminuted 
fracture of the right radial head and a fracture of the right 
proximal ulna. The driver's right shoulder subsequently impacted 
and scuffed the intruding right roof side rail immediately forward 
of the B-pillar. The contact fractured the mid-portion of the 
driver's right clavicle. His right lateral chest area impacted the 
intruding right upper B-pillar and possibly the struck tree as the 
vehicle crushed to maximum engagement . Although no contact 
evidence was visible on the vinyl jacket covering the B-pillar, the 
driver sustained fractured right ribs 2-9 with flail chest, right 
pneumothorax, and a right pulmonary contusion. 

The driver's head impacted the intruding headliner and roof 
panel on the right side of the vehicle. Due to the non-horizontal 
impact with the tree, the roof was displaced to a vertical 
orientation over the right front seated position. The head contact 
was located 36. 8-50. 8cm (14.5-20") rearward of the upper right A- 
pillar and 27.9cm (11") above the side rail. The driver's head 
cracked the backer to the headliner and bowed the roof panel 
approximately 0.6cm (.25") outward. Faint tissue transfers were 
visible on the headliner material that surrounded the 11.4cm (4.5") 
diameter contact. As a result of the impact, the driver sustained 
a laceration of the superior scalp, a right earlobe laceration, a 
nasal laceration with a displaced fracture of the nasal bone, a 
fracture of the right zygoma, and a closed head injury with loss of 
consciousness and residual cognitive deficits (amnesia) . In 
addition to the head and facial injuries that were identified on 
the medical reports, the driver stated that he sustained minor 
dislocations (loosened) of the right upper teeth, nos . 5-8. The 
dislocated teeth were attributed to the head and facial contact 
with the intruding roof . 

The driver subsequently rebounded across the interior of the 
vehicle into the left front seatback and/or left front door panel. 
He sustained a fracture of the spinous process of T 12 from the 
probable rebound contact . There was no contact evidence to the 
components from his rebound trajectory. Prior to coming to rest 
within the vehicle, the driver's left hand moved under the upper 
air bag module cover flap as the driver slumped forward in an 
unconscious state against the steering wheel and the air bag module 
assembly. The dorsal aspect of his left middle, ring, and fifth 
fingers were pressed against the deflated air bag and the hot 
inflation module. The heat from the stainless steel inflation 
module melted the face of the bag and an internal tether strap at 
the 10 o'clock position and was transmitted into the driver's 

22 



fingers, which resulted in full thickness thermal burns with loss 
of the extensor tendons and devascularization of part of the bones 
within the digits. 

Several passing motorists noted the dust from the crash and 
observed the vehicle at final rest. They rushed to the vehicle and 
found the driver slumped against the steering wheel, bleeding 
profusely from the nasal injuries onto the deflated air bag. The 
motorists pulled the driver back into the seatback which disengaged 
his hand from the air bag module assembly. 



23 



SELECTED PRINTS 





Pre -crash Trajectory Of The Ford Crown Victoria. 

24 





Vehicle's Rotational Trajectory Across The Travel Lanes, 
Beginning Of The Right Side Centrifugal Tire Marks. 



25 





Beginning Of The Left Side Centrifugal Tire Marks 

26 




Vehicle Departs Left Roadedge In A Near Broadside Orientation, 




Vehicle Travels Down Earth Embankment 

27 




Struck Tree Branches 
And 20.3cm (8") and 25.4cm (10") Diameter Cedar Trees 







; 



M 



Remainder of Struck Trees . 
28 




Final Impact Sequence Against The 25.4cm (10") Diameter Tree, 




Struck And Displaced Delineator Post 

29 







Mid Section Of The Struck 
And Fractured 25.4cm (10") Diameter Tree. 




Lookback View Of The Crash Scene , 

30 




Lookback View Up The Earth Embankment . 




Lookback View Of The Vehicle's Roadway Departure, 

31 




Frontal View Of The Ford Crown Victoria. 




Tree Impact Damage To The Right Bumper Push Bar, 

32 




Left Front Three-Quarter View. 







Left Side View. 
33 




Left Rear Three-Quarter View. 




Rear View, 
34 




Right Rear Three -Quarter View. 




Right Side View, 
35 




Primary Impact Damage To The Right Passenger Compartment Area, 




Overhead View Showing The Extent Of Crush. 

36 




Tree Impact Damage To The Right Front Fender Area, 




Right Front Three-Quarter View, 
37 




Overall View Of The Deployed Air Bag, 




Melted Area Of The Deployed Air Bag, 

38 



BEST AVAILABLE 





Additional Views Of The Melted Area Of The Air Bag. 

39 




Upper Air Bag Module Flap, 




Perpendicular View Of The Module Flaps , 

40 



BEST AVAILABLE 




Interior View With The Air Bag Module Assembly Removed. 




Driver's Trajectory And Contact Points. 

41 



BEST AVAILABLE 





Knee And Lower Leg Contact Points 
To The Knee Bolster And The Lower Panel 



42 



BEST AVAILABLE 




Driver's Active 3-Point Belt System. 




Belt Loading Abrasions To The Plastic Coating On The Latchplate. 

43 



BESTAVAILABLE 




Probable Right Leg Contact To The 
Center Mounted Radio Equipment (Removed) 




Head, Arm, And Shoulder Contact Points 
To The Intruding Roof And Side Rail . 



44 



BESTAVAILABLE 




Head Contact To Headliner And Roof. 




Right Shoulder And Arm Contacts To The Roof Side Rail . 

45 



BESTAVAILABLE 




Apparent Tissue Transfer From Right Forearm Contact 

To Roof Side Rail. 




Location Of Burn With Respect To The Center Of The Air Bag, 

46 



BESTAVAILABLE 





Closeup Views Of The Burned Area. 

47 



BESTAVAILABLE 




Location Of Burn With Respect To The Peripheral Seam. 




View Of A Melted Internal Tether Strap 
Through The Left Venting Port, 



48 




w^mmm 




Backside Of The Removed Module Assembly, 



49 




Removed Inflator Assembly From The Retaining Plate. 




Melted Bag Material On The Face Of The Inflator, 

50 





Views Of The Radial Inflation Ports 
Of The Inflator Assembly. 



51 





Additional Views Of The Radial Inflation Ports 

52 








Internal Views Of The Melted Areas Of The Air Bag, 

53 



"GRAPHIC" 
PHOTOGRAPHS AND IMAGES 

The following "GRAPHIC" Photographs and Images have been removed from this case. 

If you would like a copy of these photographs and/or images please write to: 

MARJORIE SACCOCCIO 
VOLPE NATIONAL TRANSPORTATION SYSTEMS CENTER 

55 BROADWAY 
CAMBRIDGE, MA 02142 

In the body of your request please include the case, photograph and image number(s). 




Sectional View Of A Similar TRW Inflator. 



55 



SLIDE INDEX 

Slide No (s) . Description 

1 Accident schematic \ 

) KtM0)/E$ FOR SAjJiT\lAT\Q4/ 

2 Driver injury mannequin 

3,4 Pre-crash trajectory of the police vehicle 

5 Right rear tire begins to mark 

6 Right front and left rear tires begin to mark 

7 Left front tire begins to mark 

8 Vehicle departs left roadedge in a near 
broadside orientation 

9 Vehicle traverses embankment and contacts tree 
branches 

10 Struck trees 

11 Struck tree that resulted in severe right side 

damage to vehicle 

12 Final rest position of vehicle 

13 Section of struck tree, impacted tree in 

foreground 

14 Lookback view of vehicle's trajectory 

15 Frontal view of the Ford Crown Victoria 

16 Left front three-quarter view 

17 Left side view, LF door removed by rescue 

personnel 

18 Left rear three-quarter view 

19 Rear view 

20 Right rear three-quarter view 

21 Right side view 

22 Primary impact damage to right side area 

23 Longitudinal view showing the extent of crush 

56 



SI: 


ide No (s) . 




24 




25 




26 




27 




28 



SLIDE INDEX (CONT'D.) 

Description 

Right front three-quarter view 

Overall interior view of the driver's 
trajectory and contact points 

Deployed driver's air bag 

Steering wheel assembly with module removed 

Burned (melted) area of air bag with tissue 
from driver's hand contact 

2 9 Location of burn mark with respect to 

peripheral seam and vent port 

3 Perpendicular view of the module flaps 

31,32 Driver's knee/lower leg contacts to the knee 

bolster 

33,34 Driver's head, right shoulder and forearm 

contacts to the intruding side rail and 
headliner 

35 Tissue transfer from right forearm contact 

3 6 Right shoulder fabric transfer/impression on 

headliner 

37 Driver's head contact to headliner 

3 8 Slight deformation to upper steering wheel rim 

3 9 Blood stain on shoulder belt webbing 

40 Belt abrasions to the latchplate 



57 



CASE NUMBER CA VM* 



MISSING 
SLIDES 



THE FOLLOWING SLIDES ARE NOT INCLUDED IN THIS CASE: 
SLIDE NUMBER(S) 

-M2* 




CA9212 #6 



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APPENDIX A 
Police Accident Report 



58 



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STATION LINES 

A station line was established by laying a 100 ft. tapa 

parallel to tha oenter of 8R-f*. station o+oo was 
established at a point approximately 380 feet East of Kile 
Foat A AHA 44.00 



STATION LOO 


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LOCATION: 


DESCRIPTION: 






0+00 


R-8PT.3IN. 


START OP SKID #1 


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LINE CENTRIFUGAL 


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0+10 


R-8FT.8IN. 


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SKID CONTINUES 






0+30 


R-9FT.8IN. 


SKID CONTINUES 






0+40 


• R-9FT 10 IN. 


SKID CONTINUES 






0+50 


R-10PT.0IH. 


SKID CONTINUES 






+ 60 


R'lOPT: 31N 


, SKID CONTINUES 






0+70 


R-10PT. 4 in 


SKID CONTINUES 






0+80 


R-10FT. 8 IN 


SKID CONTINUES 






0+90 


R-10FT. 7 IN 


SKID CONTINUES 






1+10 


R-10FT. 6IH 


SKID CONTINUES 






1+20 


R-10FT. 5 IN 


SKID CONTINUES 






1+30 


R-10FT. 4IN 


SKID CONTINUES 




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1+40 


R-10FT. 2 IN 


. " SKID CONTINUES 


• 


. 


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• 




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1+70 


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1+60 


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1+90 


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2+00 


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2+10 


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SKID CONTINUES 






2+20 


R-3FT. 7IH. 


SKID CONTINUES 






. 2+30 


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SKID CONTINUES 






2 + 40 


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2+50 


.R-2PT. 2IN, 


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2+80 
3+10 
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3+48 



R-0FT 6IN. 
L-l FT OIN. 
LOCATION I 

L-4FT 8IN. 
L-9FT. 0IN. 
L 13 FT. 
L 18FT 2 IN. 



SKID CONTINUE! 
SKID CONTINUES 
DESCRIPTION: 

SKID 11 CONTINUES 
SKID CONTINUES 
SKID LEAVES ASPHALT 
8KID GOES OVER EMBANK- 
MENT. 



0+60 
0+70 
0+80 



0+90 
1+00 
1+20 
1+40 
1+60 
1+80 
2+00 
2+20 



2+40 
2+60 
2+80 
3+00 
3+10 
3+30 

3+50 
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R-11FT. 6IN. 
R-11FT. 8IN. 



R-11FT.10IN. 
R-12FT. 4IN. . 
R-12FT 8ZN. 
R-12FT. 9IN. 
R-12FT. 8IN. 
R-12FT. 51N. 
R-11FT. 10IN. 
R-10FT. 9IN. 



R-9FT. 4 IN. 
R-7FT. 1 IN. 
R-4FT. 6 IN. 
R-1FT. OIN. 
L-1FT. UN. 
L-5FT. 8IN. 

L-10FT.5IN. 
L-16FT. 4IN. 



START OF SKID #2 

SKID CONTINUES 

SKID CONTINUES (EDGE OF 

ASPHALT, WHICH IS 

COVERED WITH DIRT) 

SKID CONTINUES. 

SKID CONTINUES IH DIRT. 

SKID CONTINUES 

SKID CONTINUES 

SKID CONTINUES 

SKID CONTINUES 

SKID CONTINUES 

SKID CONTINUES (HIDE 

SKID AND AT THE RT. 

EDGE LINE). 

SKID CONTINUES 

SKID CONTINUES 

SKID CONTINUES 

SKID CONTINUES 

SKID CONTINUES 

SKID CONTINUES, A THICK 

SIDE SKID. 

SKID ON EDGE LINE 

SKID ENDS OVER THE 

EMBANKMENT. 



2+10 
2+30 

2+40 
2+60 



R-1FT 10 IN. 
CENTER LINE 

L-1FT. OIN. 
L-3FT. SIN. 



START OF SKID #3. 
SKID CONTINUES ACROSS 
CENTER LINE, 
SKID CONTINUES 
8KID CONTINUES 




u« •diiona until depleted. 
63 



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3+00 


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STATION : 


LOCATION* 


3+20 


L-14FT. SIN. 


3+40 


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L-39FT 

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L-43FT. 

L-45PT. 

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•TATf MttHWAY MLATID 



SKID CONTINUES 
SKID CONTINUES 
DESCRIPTION* 

SKID #3 CONTINUES 
RND OF SKID, OVER 
THE EMBANKMENT. 

START OF SKID 14 
8KID CONTINUES . 
SKID CONTINUES .. 
SKID CONTINUES 
8KID CONTINUES 
SKID CONTINUES 
SKID CONTINUE8 
SKID CONTINUES 
SKID CONTINUES 
SKID CONTINUES 
SKID CONTINUES 
END OF SKID THAT HAS 
VISIBLE. 

LOWER LIMBS OF FINE 
TREE DAMAGED TO A HEIGHT 
OF 8FT 2 INCHES ABOVE 
GROUND LEVEL. 
MARKS IN THE DIRT ft 
BRUSH LEFT BT V-l. . 
STUMP OF FINE TREE, 
DOWNED TREE S. OF 
STUMP . 

STUMP OF PINE TRSfe* 
DOWNED TREE IN THE 
SAME AREA. 

POINT OF REST OF V-l AT 
REST IN AN UP RIGHT 
POSITION. 





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75 




/ 



APPENDIX B 



Air Bag Supplement 



76 



Dup. Cols. 1-8 
from prior card 



Modu le A £ 



Format Q. 1 



AIRBAG SUPPLEMENT AB-1 



ACCIDENT SUMMARY 

ACCIDENT DATE 



/ ^ 



POLICE INVESTIGATED (1,2,9)* 



City 



County:! 



GENERAL LOCALITY 

(1) Freeway, Limited Access 

(2) Urban (City) 

(3) Urban-Rural (mixed) 

(4) Rural, Fields 

CONFIGURATION (First Harm) 

(0) Struck Object or Pedestrian 

(1) Rear-End OxKvrt*^. 

(2) Head-On 

(3) Rear-to-Rear 

(4) Angle 

(5) S Idesw Ipe-Same Direction 

(6) Sideswipe-Opposite Direct. 

(7) NonCollteg Fell frOm Veh 

(8) Nonimpact Deployment 

(9) Unknown 

FIRE INVOLVED (0) None 

(1 ) AlrBag Vehicle 

(2) Other Vehicle 

(3) Both Vehicles 
(9) Unknown 

NUMBER: VEHICLES INVOLVED 
(8)=8 or more 
PERSONS INVOLVED 

INJURED PERSONS 

MAXIMUM AIS IN ACCIDENT 



OTHER VEHICLE: MAXIMUM AIS 

PRIME/DEPLOY IMPACT w AB VEH: 
EVENT NUMBER / 

CDC - 'Zi- 

TOTAL DELTA-V 

Model Year, Make, Model, Body Ty 



ii. 



_Ql 



O 



pe: 




AIRBAG VEHICLE INSPECTION 

DATE VEH. INSPECTED 

REASON VEHICLE NOT INSPECTED 

(0) Not Required 

(1) Inspection Completed 

(2) Cannot be Located** 

(3) Repaired or Destroyed** 
(5) Refual or Impounded** 
(7) Other* 

••Specify: 



/±^ 



IMPACT DATA OBTAINED 

(0) No Data Obtained 

(1) CDC Only 

(2) Crush Prof I le Only 

(3) Trajectory Data Only 

(4) CDC and Crush Profile 

(5) CDC and Trajectory 

(6) Crush and Trajectory 

(7) CDC, Crush & Trajectory 

BASIS OF DELTA-V 

(0) Not Computed (Unknown Why) 

(1) CRASH - Damage Only 

(2) CRASH - Damage+Trajectory 

(3) Missing Vehicle Algorithm 

(4) Yielding Object Algorithm 

(5) Unknown Basis 

(6) One Vehicle Beyond Scope 

(7) Collision Beyond Scope 

(8? Insu fficient Data 



-3- 



VEHICLE HISTORY 

HAS AIRBAG VEHICLE BEEN IN 
ANY PRIOR IMPACTS (1,2,9)* 

HAS ANY PRIOR MAINTENANCE/SERVICE 
BEEN PERFORMED ON SYSTEM ( 1 , 2,9 ) * 

*Descr I be: 



o2- 



"AIRBAG VEHICLE: FLEET f oucC 



VlN^LA.Qe.2^ £>.£.KX_ _ 
MILEAGE Jbflrt 



* (1)=Yes, (2)=No, (9)=Unknown 



DRAFT - 



77 



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READINESS LAMP, FIRST HARM 



AIRBA6 SUPPLEMENT AB-2 



SYSTEM READINESS LAMP 

(In Instrument Cluster) 

PRE- IMPACT LAMP CONDITION 

(1) Funct Ion Ing/ProvedOut 

(2) Inoperative 
(9) Unknown 



DRIVER'S REPORT OF 
PRE-IMPACT FLASHING 



No Flashing Reported 
Continuous Flashing 



of Flashes 



(00) 
(01 ) 
(02) 
— >Number 
(11 ) 

(12) Constant Light 
(19) Flashing, Unkn Number 
(88) Not App (system removed) 
(99) Unknown 



PERIOD OF PRE-IMPACT FLASHING 

(0) No Flashing 

(1) Same Day as Impact 

(2) Prior Day 

(3) Pr ior Two Days 

(4) Prior Week 

(5) Prior Month 

(6) Over One Month 
(9) Unknown 



POST-IMPACT LAMP CONDITION 

(1) Funct Ion I ng/ProvedOut 
(2 ) I noperat I ve 
(9) Unknown 



POST-IMPACT FLASHING 



_0 o. 



No Flashing 
Continuous F 



(00) 

(01) Continuous Flashing 
(02) 
-- >Number of Flashes 
(11 ) 

(12) Constant Light 

(19) Flashing, Unkn Number 

(86) Not Appl (removed) 

(99) Unknown i^oPee/srit^ 



_2^_ 



AIRBAG VEHICLE 

FIRST HARMFUL EVENT 



,i4_ 



(01) Firt or explosion 

(02) Immersion 

(03) Gas Inhalation 

(04) Fell from vehicle 

(05) Injured in vehicle 

(06) Other •oocollision (specify): 

(07) Overturn 

(08) Jackknife with intraunit damage 
Collision With: I 

(09) Pedestrian J 

(10) Pedalcyclist | 

(11) Railway train j 

(12) Animal 

(13) Motor vehicle in transport (same 
roadway) 

(14) Motor vehicle in transport (other 
roadway) 

(15) Parked motor vehicle 

(16) Other type nonmotorist (specify): 

(17) Thrown or falling object 

(18) Boulder 

Collision with Fixed Object: 

(20) Building 

(21) Impact attenuator /Crash Cushion 

(22) Bridge pier or abutment 

(23) Bridge parapet end 

(24) Bridge rail 

(25) Guardrail 

(26) Concrete traffic barrier 

(27) Median barrier 

(28) Other longitudinal barrier (specify): 

(29) Highway/Traffic sign post i 

(30) Overhead sign support 
(33) Luminaire 'Light support 

(32) Utility pole 

(33) Other post, pole, or support (specif)): CDEUA*^^ ^ 

(34) Culvert 

(35) Curb 

(36) Ditch 

(3^) Embankment-earth 

(38) Embankment -rock, stone or concrete 

(39) Fence (wooden, wire, chain link, etc ) 

(40 ) Wall (stone, rock, meta], etc.) 

(41) Fire hydrant 

(42) Shrubbery 

(43) Tree 

(44; Other fixed object (specify): 

(45) Pavement surface irregularity (pothole, 

grooved, grates) 
(99 ) Unknown 



78 



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URBAG VEHICLE IMPACT-DAMAGE 



AIRBAG SUPPLEMENT AB-3 



URBAG VEHICLE IMPACT SUMMARY 




FIRST AIRBAG VEHICLE IMPACT: 




VEHICLE ROLE 


J_ 


CONFIGURATION 





0) Non-col 1 Is Ion 




(0) Struck Object or Pedestrian 




il) Striking Unit 




(1 ) Rear-End 




(2) Struck Unit 




(2) Head-On 

(3) Rear-to-Rear 




13) Both Striking and Struck 




19) Unknown 




(4) Angle 






JL 


(5) Sideswipe - Same Direction 




MANNER OF LEAVING SCENE 


(6) Sideswipe-Opposite Direct. 








(7) NonColl:eg Fell from Veh 




( 1 ) Dr I ven 




(6) Nonimpact Deployment 




(2) Towed-due to damage 




(9) Unknown 




[3) Towed - not for damage 








(4) Towed - details unknown 




CDC _DA--JLJL-£J0--L 




(5) Abandoned 




, 




[9) Unknown 




OBJECT CONTACTED: DeuMXTOtL 




NUMBER OF IMPACT EVENTS 


Ji_ 










(8) 8 or more, (9) Unknown 




PRIMARY/DEPLOYMENT. IMPACT: 




ROLLOVER (0) No Rollover 


Q 




A 


(1 ) First Event 




EVENT NUMBER 


(2) Subsequent Event 








(3) Yes,UnknownEvent 




TOTAL DELTA-V 




(9) Unknown 










J_ 


LONGITUDINAL DELTA-V 




)VERRIDE/UNDERRIDE 










CONFIGURATION 




{ 1 ) No over/underrlde 








(1 ) Override - 1st CDC 




(0) Struck Object or Pedestrian 




(3) - Other CDC 




( 1 ) Rear-End 




(4) Underrlde - 1st CDC 




(2) Head-On 

(3) Reai — to-Rear 




[6) - Other CDC 




(9) Unknown 




(4) Angle 

(5) Sideswipe - Same Direction 










MRBAG VEHICLE DAMAGE 




(6) Sideswipe-Opposite Direct. 

(7) NonColl:eg Fell from Veh 




CODES: (1 ) Yes, DAMAGED 




(8) Nonimpact Deployment 




(2) No Damage 




(9) Unkonwn 




(9) Unknown 




CDC - - 




LEFT FRONT FENDER DAMAGE 


i 


OBJECT CONTACTED: -p^fff 




^IGHT FRONT FENDER DAMAGE 


I 
1 






CENTER TOP OF GRILLE DAMAGE 


NOTES: 








fcASH ; 


r R0NT BUMPER E.A. STATUS: Left 


JL 


SP£c\f'ic eoe^T °°^^ ua>ka>ooimj 


(1) Normal Right 


_3_ 






(2) Extended 








(3) Partial Compression 








(4) Complete Compression 








(5) Not Appl Icable 








19) Unknown 









79 



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SYSTEM DAMAGE 



AIRBAG SUPPLEMENT AB-4 



MRBAG SYSTEM DAMAGE 

CODES: (1) Yes, Damaged* 
(2) No, Intact 

(8) Not App. (Removed) 

(9) Unknown 

AIRBAG MODULE 

SENSORS: Left Front 
Center Front 
Right Front 
Rear, Cowl 

DIAGNOSTIC MODULE 

WIRING 

KNEE DIVERTER 

INDICATION OF DISCONNECTED 
OR LOOSE ELECTRICAL 
CONNECTORS 



a. 
x 

a. 



CONDITION OF DEPLOYED BAG 

(1) Bag Intact 

(2) Spl It or Torn* 

(3) Cut by Object In Impact* 

(4) Cut after Accident* 

(5) Other (e.g., burned)* 

(8) N/A (not deployed) 

(9) Unknown 



S- 



•DESCRIBE System and Bag Damage: 



NOTE DAMAGE AND CONTACT MARKS ON AIRBAG DIAGRAMS BELOW 
&->£a> o*j f/vc<r of G«6 




TOP 



BOTTOM 




FRONT 



80 



BACK 



BEST fiv'fllLABLE COPY 



BEST AVAILABLE COPY 



OCCUPANTS/DRIVER 



AIRBAG SUPPLEMENT AB-5 



OCCUPANTS of AIRBAG CAR 

DUMBER OF OCCUPANTS IN VEHICLE 

(8) 8 or more 
NUMBER OF INJURED PERSONS 

MAXIMUM AIS IN AIRBAG VEHICLE 

(0) No Injury 
(1-6) AIS Severity 

(7) Injured, Unknown Severity 

(9) Unknown 



DRIVER AGE SH SEX MftLC 

NUMBER OF DRIVER INJURIES 
SOURCE OF BEST INJURY DATA 

(0) Not Injured 

(1) Autopsy */*o med. records 

(2) Hospital Medical Records 

(3) Emergency Room only 

(4) Private phys Ic I an ,C I In Ic 

(5) Ley Coroner Report 

(6) EMS Personnel 
(7 ) I nterv lewee 

(8) Pol Ice 

(9) Unknown 



NOTES: 



MAXIMUM AIS BY BODY REGION 

REGION MAX AIS 

Head/Neck/Face 3> 

Dhest H 

Abdomen 

Leg/Hips 

Other (Arms) 3> 

DRIVER MAXIMUM H 



CONTACT 



±15 
3 3> 



EJECTION: Extent AJftOgT 
Portal a /a 



81 



, j 

DRIVER-PASSENGER AIRBAG SUPPLEMENT AB-6 



DRIVER BELT USAGE; (1) Used (2) Not Used (9) Unknown _J 

Evidence; Pot-icg teflagr iLorroESA. CT/rrg/feXT^ f /^AfA-Siao^ Q*J atXSing 

DRIVER POSTURE; Any Comments Recorded (1) Yes, (2) No _J_ 

Describe drlver*s posture and position on seat Including specific comments 
on head, torso, buttocks, legs and feet. Also note hand and arm position. 
Did driver brace before crash? Describe: 



DRIVER FOREIGN OBJECTS; Comments Recorded (1) Yes, (2) No _JL 

Was driver wearing contact lenses or eyeglasses? Or holding any foreign 
object at the time of the Impact (packages on lap, pipe, food, bottle, 
cigarette, etc.)? Did any lenses, objects, or jewelry play any role?: 



DRIVER COMMENTS; Comments Recorded (1) Yes, (2) No 3. 

Was the driver aware that the vehicle was equipped with a supplemental 
restraint system? Did driver offer any comments on smoke, noise, etc.? 
Did the driver comment on the alrbag as a restraint system? Describe: 



PFm&&£& ^K£ i&X. QE 3%£ CW>ti 



PASSENGER-AIRBAfi C ON TACT (1) Yes, (2) No, (9) Unknown iL_ 

Describe: A3 O faaeOfcgfc, 



._J 



Irbag. supp/Jcm 9/4/85 

82 



APPENDIX C 



NASS Vehicle Forms 



83 



U.S. D#p«rtm#nt of Transportation 

.National Highway Traffic Saf aty 

t Admtnbtratton 



GENERAL VEHICLE FORM 



NATIONAL ACCIDENT SAMPLING SYSTEM 
CRASHWORTHINESS DATA SYSTEN 



1 . Prim a ry S a mpl i n g Un i t Numb e r 

2. Case Number - S tr a tum 3- 3~~ L -A= 

3. Vehicle Number O i 



VEHICLE IDENTIFICATION 



4. Vehicle Model Year 



Code the last two digits of the model year 
(99) Unknown 



Vehicle Make (specify): 

Eo*h 

Applicable codes are found in your 
NASS Data Collection, Coding and 
Editing Manual. 
(99) Unknown 



i_L 



i L 



6. 



Vehicle Model (specifylj 

/■T/V CftS""^ UlCTQfttfit 



o I G 



1 1 . Police Reported Alcohol Presence O 

(0) No alcohol present 

(1) Yes (alcohol present) 

(7) Not reported 

(8) No driver present 

(9) Unknown 

Note: See variables 37 through 55 

(Page 4) for information on Other Drugs 

12. Alcohol Test Result For Driver °\ b 

Code actual value (decimal implied 

before first digit— O.xx) 

(95) Test refused 

(96) None given 

(97) AC test performed, results unknown 

(98) No driver present 

(99) Unknown 

Source: 



Applicable codes are found in your 
NASS Data Collection, Coding and 
Editing Manual. 
(999) Unknown 



A*-(Cg uem ece* 



7. Body Type OH 

Note: Applicable codes may be found on 
the back of this page. 



8. Vehicle Identification Number 

Left justify; Slash zeros and letter Z (0 and Z) 
No VIN— Code all zeros 
Unknown —Code all nine's 



OFFICIAL RECORDS 



9. Police Reported Vehicle Disposition 

(0) Not towed due to vehicle damage 

(1) Towed due to vehicle damage 
(9) Unknown 



10. Police Reported Travel Speed 7 H 

Code to the nearest mph (NOTE: 00 means 

less than 0.5 mph) 

(97) 96.5 mph and above 

(99) Unknown 



ACCIDENT RELATED 



1 3. Speed Limit S *> 
(00) No statutory limit 

Code posted or statutory speed limit 
(99) Unknown 

14. Attempted Avoidance Maneuver O 3 

(00) No impact 

(01 ) No avoidance actions 

(02) Braking (no lockup) 

(03) Braking (lockup) 

(04) Braking (lockup unknown) 

(05) Releasing brakes 

(06) Steering left 

(07) Steering right 

(08) Braking and steering left 

(09) Braking and steering right 

(10) Accelerating 

(11) Accelerating and steering left 

(12) Accelerating and steering right 

(97) No driver present 

(98) Other action (specify): 

(99) Unknown 

15. Accident Type QJX- 

Applicable codes may be found on the 

back of page two of this field form 
(00) No impact 

Code the number of the diagram that 
best describes the accident circumstance 

(98) Other accident type (specify): 

(99) Unknown 



#### SKIP TO VARIABLE GV37 IF GV07 DOES NOT EQUAL 01-49 * ## * 



HS Form 435 <Rav. 1/92) 



84 



CODES FOR BODY TYPE 



CDS APPLICABLE VEHICLES 

Automobiles 

(01) Convertible (excludes sun-roof, t-bar) 

(02) 2-door sedan, hardtop, coupe 

(03) 3-door/2-door hatchback 

(04) 4-door sedan, hardtop 

(05) 5-door/4-door hatchback 

(06) Station wagon (excluding van and truck based) 

(07) Hatchback, number of doors unknown 

(08) Other automobile type (specify): 

(09) Unknown automobile type 

Automobile Derivatives 

(10) Auto based pickup (includes El Camino, Caballero, 
Ranchero, Brat, and Rabbit pickup) 

(11) Auto based panel (cargo station wagon, auto based 
ambulance/hearse) 

( 1 2) Large limousine - more than four side doors or stretched 
chassis 

(13) Three-wheel automobile or automobile derivative 

Utility Vehicles (x 10,000 lbs GVWRI 

(14) Compact utility (Jeep CJ-2 • CJ-7, Scrambler, Golden 
: Eagle, Renegade, Laredo, Wrangler, Cherokee [84 and 

after]. Dispatcher, Raider, Bronco II, Bronco [76 and 
before]. Explorer, S-10 Blazer, Geo Tracker, Bravado, 
S-16 Jimmy, Thing, Pathfinder, Trooper, Trooper II, 
Rodeo, Amigo, Navajo, 4-Runner, Montero, Samurai, 
Sidekick, Rocky) 

(15) Large utility (includes Jeep Cherokee [83 and before], 
Ramcharger, Trailduster, Bronco-fullsize [78 and after], 
fullsize Blazer, fullsize Jimmy, Landcruiser, Rover, 
Scout) 

(16) Utility station wagon (Chevy Suburban, GMC Suburban, 
Traveled, Grand Wagoneer, includes suburban 
limousine) 

(1 9) Utility, unknown body type 

Van Based Light Trucks (* 10,000 lbs GVWRI 

(20) Minivan (Chrysler Town and Country, Caravan, Grand 
Caravan, Voyager, Grand Voyager, Mini-Ram, 
Dodge/Plymouth Vista, Aerostar, Lumina APV, Trans 
Sport, Silhouette, Astro, Safari, Toyota Van, Toyota 
Minivan, Previa, Nissan Minivan, Mitsubishi Minivan, 
Vanagon/Camper.) 

Large van (B150-B360, Sportsman, Royal, Maxiwagon, 
Ram, Tradesman, Voyager [83 and before], E150-E350, 
Econoline, Clubwagon, Chateau, G10-G30, Chevy Van, 
Beauville, Sport Van, G15-G35, Rally Van, Vandura.) 
Step van or walk-in van (£ 10,000 lbs GVWR) 
Van based motorhome (£ 10,000 lbs GVWR) 
Other van type (Hi-Cube Van, Kary) (specify): 

(29) Unknown van type ~ ~ 

Light Conventional Trucks (Pickup style cab, 
<, 10,000 lbs GVWR) 

(30) Compact pickup (D50, Colt P/U, Ram 50, Dakota, 
Arrow Pickup [foreign], Ranger, Courier, S-10 , T-10, 
LUV, S-15, T-15, Sonoma, Datsun/Nissan Pickup, P'up, 
Mazda Pickup, Toyota Pickup, Mitsubishi Pickup) 

(31) Large Pickup (Jeep Pickup, Comanche, Ram Pickup, 
D100-D350, W100-W3B0, F100-F350, C10-C35, K10- 
K36, R10-R35, V10-V35, Silverado, Sierra, R100- 
R500,) 

(32) Pickup with slide-in camper 

(33) Convertible pickup 

(39) Unknown pickup style light conventional truck type 



(21) 



(22) 
(23) 
(28) 



Other Light Trucks {* 10,000 lbs GVWR) 

(40) Cab chassis based (includes rescue vehicles, light 
stake, dump, and tow truck) 

(41) Truck based panel 

(42) Light truck based motorhome (chassis mounted) 
(45) Other light conventional truck type 

(48) Unknown light truck type 

(49) Unknown light vehicle type (automobile, utility, van, or 
light truck) 



OTHER VEHICLES 

Buses (Excludes Van Based) 
(50) School bus (designed to carry students, not 
cross country or transit) 

(58) Other bus type (e.g., transit, intercity, bus based 
motorhome) (specify): 

(59) Unknown bus type 

Medium/Heavy Trucks (> 10,000 lbs GVWR) 

(60) Step van (> 10,000 lbs GVWR) 

(61) Single unit straight truck (10,000 lbs < GVWR £ 
19,600 lbs) 

(62) Single unit straight truck (19,500 lbs < GVWR £ 
26,000 lbs) 

(63) Single unit straight truck (> 26,000 lbs 
GVWR) 

(64) Single unit straight truck, GVWR unknown 

(65) Medium/heavy truck based motorhome 

(67) Truck-tractor with no cargo trailer 

(68) Truck-tractor pulling one trailer 

(69) Truck-tractor pulling two or more trailers 

(70) Truck-tractor (unknown if pulling trailer) 

(78) Unknown medium/heavy truck type 

(79) Unknown truck type (light/medium/heavy) 

Motored Cycles (Does Not Include Alt-Terrain 
Vehicles/Cycles) 

(80) Motorcycle 

(81 ) Moped (motorized bicycle) 

(82) Three-wheel motorcycle or moped 

(88) Other motored cycle (minibike, motorscooter) 
(specify) : 

(89) Unknown motored cycle type 

Other Vehicles 

(90) ATV (All-Terrain Vehicle) and ATC (All-Terrain Cycle) 

(91) Snowmobile 

(92) Farm equipment other than trucks 

(93) Construction equipment other than trucks 
(97) Other vehicle type 

(99) Unknown body type 



85 



National Accident Sampling System-Crashworthiness Data System: General Vehicle Form 



Page 2 



OCCUPANT RELATED 



16. 



Driver Presence in Vehicle 

(0) Driver not present 

(1) Driver present 
(9) Unknown 



1 7. Number of Occupants This Vehicle 

(00-96) Code actual number of occupants" 

for this vehicle 
(97) 97 or more 
(99) Unknown 



n± 



18. Number of Occupant Forms Submitted Q { 



VEHICLE WEIGHT ITEMS 



19. Vehicle Curb Weight 

3jB*Q. Code weight to nearest 
1 100 pounds. 

(010) Less than 1050 pounds 
(1 35) 1 3,500 pounds or more 
(999) Unknown 

Source: 



O 3 , 8 00 



20. Vehicle Cargo Weight 

( O Code weight to nearest 



O . 100 



(00, uSSSw,™* PeWp^faH" 5 * 
(97) 9,650 pounds or more 
(99) Unknown 



24. Rollover J 

(0) No rollover (no overturning) 

Rollover (primarily about the longitudinal axis) 

(1) Rollover, 1 quarter turn only 

(2) Rollover, 2 quarter turns 

(3) Rollover, 3 quarter turns 

(4) Rollover, 4 or more quarter turns (specify): 



(5) Kollover-end-over-end (i.e., primarily 

about the lateral axis) 
(9) Rollover (overturn), details unknown 



25. Front Override/Underride (this Vehicle) Q 

26. Rear Override/Underride (this Vehicle) Q 

(0) No override/underride, or 
not an end-to-end impact 

Override fsee specific CDC) 

(1) 1st CDC 

(2) 2nd CDC 

(3) Other not automated CDC (specify): 



RECONSTRUCTION DATA 



21. Towed Trailing Unit 

(0) No towed unit 

(1) Yes— towed trailing unit 
(9) Unknown 



22. Documentation of Trajectory Data 
for This Vehicle 

(0) No 

(1) Yes 



23. Post Collision Condition of Tree or Pole 
(For Highest Delta V) 

(0) Not collision (for highest delta V) with 
tree or pole 

(1) Not damaj ^ 

(2) Crackedtfsheared 

(3) Tilted <45TJBgfees 

(4) Tilted ^45 degrees 

(5) Uprooted tree 

(6) Separated pole from base 

(7) Pole replaced 

(8) Other (specify): 

(9) Unknown 



O 



Underride (see specific CDC) 

(4) 1st CDC 

(5) 2nd CDC 

(6) Other not automated CDC (specify): 



(7) Medium/heavy truck or bus override 
(9) Unknown 



HEADING ANGLE AT IMPACT FOR 
HIGHEST DELTA V 



Values: (000M359) Code actual value 

(997) Noncollision 

(998) Impact with object 

(999) Unknown 

27. Heading Angle For This Vehicle J 

28. Heading Angle For Other Vehicle *\ *\ % 



S 



86 



BEST AVAILABLE COPY 



Cate- 
gory 



Configur- 



ation 



ACCIDENT TYPES (includes Intent) 



A. 

Right 
Roadside 
Departure 



DRIVE OFF 
ROAD 




CONTROL/ 
TRACTION LOSS 



03 r "_~i 



AVOID COLLISION 
WITH VEH.. PED.. ANIM. 



04 

SPECIFICS 
OTHER 



06 

SPECIFICS 
UNKNOWN 



Mi 



B 
Left 

Roadside 
Departure 



DRIVE OFF 
ROAD * 



CONTROL/ 
TRACTION LOSS 



AVOID COLLISION 
WITH VEH.. PED.. ANIM. 



09 

SPECIFICS 
OTHER 



10 

SPECIFICS 
UNKNOWN 



C 

Forward 
Impact 



11 



12 






13 



14 



PARKED VEH. STA. OBJECT PEDESTRIAN/ 

ANIMAL 



1 — 

END 
DEPARTURE 



15 

SPECIFICS 
OTHER 



16 

SPECIFICS 
UNKNOWN 



to t- 

c E 



n r* 

£ 5 



D 
Rear-End 



20 -^22 

— ^23 

STOPPED SLOWER 

21. 22. 23 », 26. 27 




28 



DECEL. 

2S.30. H 



30 
► 2 
31 



-C^ 29 



(EACH • 32) (EACH • 33) 



SPECIFICS 
OTHER 



SPECIFICS 
UNKNOWN 



E 

Foruard 
Impact 



O 36 /y»» c:> 

36 » -37 



\ZV> (EACH • 42) (EACH • 43) 
41 



CONTROL/ 
TRACTION LOSS 



CONTROL/ 
TRACTION LOSS 



AVOID COLLISION 
WITH VEH. 



AVOID COLLISION SPECIFICS 
WITH OBJECT OTHER 



SPECIFICS 
UNKNOWN 



F 
Sideswipe 

Angle 



44 



46 



46- 

45- 
47. 




(EACH • 48) 

SPECIFICS 
OTHER 



(EACH • 49) 
SPECIFICS UNKNOWN 



G 

Head-On 



60 ♦^L- (EACH •52) 

* 0000 '^ SPECIFICS 

LATERAL MOVE OTHER 



(EACH • 63) 
SPECIFICS UNKNOWN 



H 

Forward 
impact 



CONTROL/ 
TRACTION LOSS 



CONTROL/ 
TRACTION LOSS 



CJ (EACH • 62KEACH • 63) 
61 

AVOID COLLISION AVOID COLLISION SPECIFICS SPECIFICS 

WITH VEH. WITH OBJECT OTHER UNKNOWN 



I 

Sideswipe 7 

Angle 




(EACH • 66) 

SPECIFICS 
OTHER 



(EACH • 67) 
SPECIFICS UNKNOWN 



* Ob 

o c 

i! 

I- H 
%j o 

£3 

CO JZ 
JZ C 

u > 



J. 

Turn 

Across 

Path 



x/~ 



68 

INITIAL OPPOSITE 
DIRECTIONS 



INITIAL SAME DIRECTIONS 



<EACH»74)(EACH«75) 

SPECIFICS SPECIFICS 
OTHER UNKNOWN 



K 

Turn Into 

Path 



79 _ » ^ + 



TURN INTO SAME DIRECTION 



TURN INTO OPPOSITE DIRECTIONS 



(EACH • 84) (EACH • 85) 

SPECIFICS SPECIFICS 
OTHER UNKNOWN 



jz v i> 

2? 3 8P 

5 .E iO 



L 

Straight 

Paths 



r -i- 



(EACH • 90) 

SPECIFICS 
OTHER 



(EACH • 91) 
SPECIFICS UNKNOWN 



8 8 



M 

Backing 
Etc. * 



92 



BACKINO 
VEH. 



93 

OTHER VEH. 
OR OBJECT 



98 Other Accident Type 

99 Unknown Accident Type 
00 No Impact 



87 



National Accident Sampling System-Crashworthiness Data System: General Vehicle Form 



Page 3 



£. 



29. Basis for Total Delta V (highest) 

Delta V Calculated 

(1) CRASH program— damage only routine 

(2) CRASH program— damage and trajectory 
routine 

(3) Missing vehicle algorithm 



Delta V Not Calculated 

(4) At least one vehicle (which may be this 
vehicle) is beyond the scope of an acceptable 
reconstruction program, regardless of 
collision conditions. 

(5) All vehicles within scope (CDC applicable) 
of CRASH program but one of the collision 
conditions is beyond the scope of the CRASH 
program or other acceptable reconstruction 
technique, regardless of adequacy of damage 
data. 

(6) All vehicle and collision conditions are within 
scope of one of the acceptable reconstruction 
programs, but there is insufficient data 
available. 



COMPUTER GENERATED DELTA V 



Secondary Highest 

+ 



32. Lateral Component of Delta V 
Nearest mph 



3_a. 



34, 



30. Total Delta V 



Secondary Highest 

^3_ 



Nearest mph 



31. 



(NOTE: 00 means less than 
0.5 mph) 

(97) 96.5 mph and above 
(99) Unknown 



Longitudinal Component of 
Delta V 



^A_a. 



Nearest mph 



(NOTE: 00 means greater than 

-0.5 and less than +0.5 mph) 
(±97) ±96.5 mph and above 
( 99) Unknown 



36. 



(NOTE: 00 means greater than 

-0.5 and less than +0.5 mph) 
(±97) ±96.5 mph and above 
(_99) Unknown 

33. Energy Absorption \ _\ \ , a 

Nearest 1 00 foot-lbs 

(NOTE: 0000 means Irss than 50 foot-lbs) 
(9997) 999,650 for . tbs or more 
(9999) Unknown 



Confidence In Reconstruction Program 

Results (For Highest Delta V) Q 

(0) No reconstruction 

(1) Collision fits model — results appear 
reasonable 

(2) Collision fits model — results appear high 

(3) Collision fits model — results appear low 

(4) Borderline reconstruction — results appear 
reasonable 



35. Type of Vehicle Inspection 

(0) No inspection 

(1) Complete inspection 

(2) Partial inspection (specify): 



Is this an AOPS Vehicle? 

(0) No 

(1) Yes 



IS OLDMISS APPLICABLE FOR THIS VEHICLE? [ ] YES [ ] NO 
IF YES: IS A COMPLETED OLDMISS PROGRAM SUMMARY INCLUDED? [ ] YES [ ] NO 



88 



National Accident Sampling System-Crashworthiness Data System: General Vehicle Form 



Page 4 



37. Police Reported Other Drug Presence 

(0) No other drugs present 

(1) Yes (other drug present) 

(7) Not reported 

(8) No driver present 

(9) Unknown 



38. Police Reported Observation/Perception 
Test Type For Driver 

(0) No observation/perception test given 

(1) Drug recognition technician (DRT) 
determination using DEC process 

(2) Behavioral 

(3) Other physical observation/perception 
determination (specify): 

(4) DEC process available, unknown if 
determination made 

(5) DEC process not available, unknown if 
other observation/perception test given 

(7) Other observation/perception test 
(specify) : 

(8) No driver present 



39. Other Drug Specimen Test Type For Driver 

(0) No specimen test given 

(1) Blood test 

(2) Urine test 

(3) Other specimen tests (specify): 

(7) Unspecified specimen test 

(8) No driver present 

(9) Unknown if specimen test given 



JL 



DRUG EVALUATION CLASSIFICATION 

OTHER DRUGS TEST RESULTS FOR DRIVER 



_Q 



DEC 




Observation/ 


Specimen 


Perception 


Test 


Test Results 


Results 


40. O 


41. O 


42. O 


43. a 


44. O 


45. O 


46. O 


47. D 


48. o 


49. o 


50. o 


51. a 


52. o 


53. q 


54. n 


55. O 



Narcotic Drug 

Depressant Drug 

Stimulant Drug 

Hallucinogen Drug 

Cannabinoid Drug 

Phencyclidine (PCP) 

Inhalant Drug 

Other Drug (Excluding 
Nicotine, Aspirin, Alcohol, 
Drugs Administered Post-Crash) 



Codes For Observation/Perception Test Results 

(0) No DEC observation/perception test given 

(1) Passed DEC observation/perception test 

(2) Failed DEC observation/perception test 

(3) DEC observation/perception test given— 
results unknown 

(8) No driver present 

(9) Unknown if DEC observation/perception 
test given 

Codes for Specimen Test Results 

(0) No specimen test given 

(1) Drug not found in specimen 

(2) Drug found in specimen 

(7) Specimen test given, results unknown or 
not obtained 

(8) No driver present 

(9) Unknown if specimen test given 



89 



National Accident Sampling System-Crashworthiness Data System: General Vehicle Form 



Page 5 



OTHER DATA 


61 . Rollover Initiation Object Contacted O O 

62. Location on Vehicle Where Initial Principal O 
Tripping Force Is Applied 

(0) No rollover 

(1) Wheels/tires 

(2) Side plane 

(3) End plane 

(4) Undercarriage 

(5) Other location on vehicle (specify): 


56. Driver's Zip Code m W 

(00000) Driver not present 

(00001) Driver not a resident of U.S. or territories 
Code actual 5-digit zip code 


(99999) Unknown 

57. Driver's Race/Ethnic Origin I 

(0) Driver not present 

(1) White (non-Hispanic) 

(2) Black (non-Hispanic) 

(3) White (Hispanic) 

(4) Black (Hispanic) 

(5) American Indian, Eskimo or Aleut 

(6) Asian or Pacific Islander 
(8) Other (specify): 


(8) Non-contact rollover forces (specify): 


(9) Unknown 

63. Direction of Initial Roll O 

(0) No rollover 

(1) Roll right - primarily about the longitudinal axis 

(2) Roll left - primarily about the longitudinal axis 

(5) End-over-end (i.e., primarily about the lateral 

axis) 
(9) Unknown roll direction 


(9) Unknown 

58. Vehicle Special Use (This Trip) iT 
10) No special use 

(1) Taxi 

(2) Vehicle used as school bus 

(3) Vehicle used as other bus 

(4) Military 

(5) Police 

(6) Ambulance 

(7) Hearse 

(8) Fire truck or car 

(9) Unknown 


PRECRASH DATA 


64. Pre-Event Movement (Prior to ( o 
Recognition of Critical Event) 

(01) Going straight 

(02) Slowing or stopping in traffic lane 

(03) Starting in traffic lane 

(04) Stopped in traffic lane 

(05) Passing or overtaking another vehicle 

(06) Disabled or parked in travel lane 

(07) Leaving a parking position 

(08) Entering a parking position 

(09) Turning right 

(10) Turning left 

(11) Making a U-turn 

(12) Backing up (other than for parking position) 

(13) Negotiating a curve 

(14) Changing lanes 

(15) Merging 

(16) Successful avoidance maneuver to a previous 
critical event 

(97) Other (specify): 


ROLLOVER DATA 


If GV07 (Body Type) * 1-49, leave GV59-GV63 blank. 
If GV24 (Rollover) = 0, then GV59-GV63 must equal 0. 
If GV24 = 9, then GV59-GV63 must equal 9. 


59. Rollover Initiation Type Q 

(0) No rollover 

(1) Trip-over 

(2) Flip-over 

(3) Turn-over 

(4) Climb-over 

(5) Fall-over 

(6) Bounce-over 

(7) Collision with another vehicle 

(8) Other rollover initiation type specify): 


(9) Unknown rollover initiation type 

60. Location of Rollover Initiation Q 

(0) No rollover 

(1) On roadway 

(2) On shoulder— paved 

(3) On shoulder— unpaved 

(4) On roadside or divided trafficway median 
(9) Unknown 


(98) No driver present 

(99) Unknown 



90 



CODES FOR ROLLOVER INITIATION OBJECT CONTACTED 



(00) No rollover 

(01-30) - Vehicle Number 

Noncollision 

(31) Turn-over — fall-over 
(33) Jackknife 

Collision With Fixed Object 

(41) Tree (£ 4 inches in diameter) 

(42) Tree (> 4 inches in diameter) 

(43) Shrubbery or bush 

(44) Embankment 

(45) Breakaway pole or post (any diameter) 

Nonbreakaway Pole or Post 

(50) Pole or post (as 4 inches in diameter) 

(51) Pole or post (> 4 inches but s 12 inches in 
diameter) 

(52) Pole 6r post (> 12 inches in diameter) 

(53) Pole or post (diameter unknown) 

(54) Concrete traffic barrier 

(55) Impact attenuator 

(56) Other traffic barrier (includes guardrail) 
(specify) : 



(57) Fence 

(58) Wall 

(59) Building 

(60) Ditch or culvert 

(61) Ground 

(62) Fire hydrant 

(63) Curb 

(64) Bridge 

(68) Other fixed object (specify): 

(69) Unknown fixed object 

Collision with Nonfixed Object 
(71) Motor vehicle not in-transport 

(76) Animal 

(77) Train 

(78) Trailer, disconnected in transport 

(88) Other nonfixed object (specify): 

(89) Unknown nonfixed object 

(98) Other event (specify): 

(99) Unknown event or object 



91 



National Accident Sampling System-Crashworthiness Data System: General Vehicle Form 



Page 6 



PRECRASH DATA (Continued) 



65. 



Critical Precrash Event 



Oh. 



This Vehicle Loss of Control Due To: 

(01 ) Blow out or flat tire 

(02) Stalled engine 

(03) Disabling vehicle failure (e.g., wheel fell off) 
(specify): 

(04) Non-disabling vehicle problem (e.g., hood flew 
up) (specify): 

(05) Poor road conditions (puddle, pot hole, ice, etc.) 
(specify): 

(06) Traveling too fast for conditions 

(08) Other cause of control loss (specify): 

(09) Unknown cause of control loss 

This Vehicle Traveling 

(10) Over the lane line on left side of travel lane 

(11) Over the lane line on right side of travel lane 

(1 2) Off the edge of the road on the left side 

(13) Off the edge of the road on the right side 

(14) End departure 

(15) Turning left at intersection 

(16) Turningjright at intersection 

(17) Crossing over (passing through) intersection 
(19) Unknown travel direction 

Other Motor Vehicle In Lane 

(50) Stopped 

(51) Traveling in same direction with lower speed 
(i.e., lower steady speed or decelerating) 

(52) Traveling in same direction with higher speed 

(53) Traveling in opposite direction 

(54) In crossover 

(55) Backing 

(59) Unknown travel direction of other motor vehicle 
in lane 

Other Motor Vehicle Encroaching Into Lane 

(60) From adjacent lane (same direction)— over left 
lane line 

(61) From adjacent lane (same direction)— over right 
lane line 

(62) From opposite direction— over left lane line 

(63) From opposite direction— over right lane line 

(64) From parking lane 

(65) From crossing street, turning into same 
direction 

(66) From crossing street, across path 

(67) From crossing street, turning into opposite 
direction 

(68) From crossing street, intended path not known 

(70) From driveway, turning into same direction 

(71) From driveway, across path 

(72) From driveway, turning into opposite direction 

(73) From driveway, intended path not known 

(74) From entrance to limited access highway 
(78) Encroachment by other vehicle— details 

unknown 



Pedestrian or Pedalcyclist, or Other Nonmotorist 
Pedestrian in roadway 
Pedestrian approaching roadway 
Pedestrian - unknown location 
Pedalcyclist or other nonmotorist in roadway 
(specify) 



(80) 
(81) 
(82) 
(83) 

(84) 

(85) 



Pedalcyclist or other nonmotorist approaching 

roadway (specify): 

Pedalcyclist or other nonmotorist— unknown 
location (specify) i 



Object or Animal 

(87) Animal in roadway 

(88) Animal approaching roadway 

(89) Animal— unknown location 

(90) Object in roadway 

(91) Object approaching roadway 

(92) Object— unknown location 

(98) Other critical precrash event (specify): 

(99) Unknown — 



For Corrective Actions Attempted see variable GV14 
(Attemped Avoidance Manuever) 



66. Precrash Stability After Avoidance Maneuver *-f 

(0) No avoidance maneuver 

(1) Tracking 

(2) Skidding longitudinally— rotation less than 30 
degrees 

(3) Skidding laterally— clockwise rotation 

(4) Skidding laterally— counterclockwise rotation 

(7) Other vehicle loss-of -control (specify): 

(8) No driver present 

(9) Precrash stability unknown 



67. Precrash Directional Consequences of _l 

Avoidance Maneuver (Corrective Action) 

(0) No avoidance maneuver 

(1) Vehicle stayed in travel lane where avoidance 
maneuver was initiated 

(2) Vehicle stayed on roadway but left travel lane 
where avoidance maneuver was initiated 

(3) Vehicle stayed on roadway, not known if left 
travel lane where avoidance maneuver was 
initiated 

(4) Vehicle departed roadway 

(5) Avoidance maneuver initiated off roadway 

(8) No driver present 

(9) Directional consequences unknown 



♦♦♦IF THE CDS APPLICABLE VEHICLE WAS NOT INSPECTED (I.E., GV35 = 0), ♦♦♦ 
DO NOT COMPLETE THE EXTERIOR AND INTERIOR VEHICLE FORMS. 

♦♦♦IF GV07 DOES NOT EQUAL 01-49, DO NOT COMPLETE ♦♦♦ 

THE EXTERIOR VEHICLE, INTERIOR VEHICLE, 

OCCUPANT ASSESSMENT, AND OCCUPANT INJURY FORMS. 



92 



© 

U.S. Department of Transportation 

National Highway Traffic Safety 
\dmtnbtratk>n 



EXTERIOR VEHICLE FORM 



NATIONAL ACCIDENT SAMPLING SYSTEM 
CRASHWORTHINESS DATA SYSTEM 



1 . Primary B ompling Unit Number 

2. Case Number - Strotum - 



_i_aj__L_a^ 



3. Vehicle Number 



0_L 



VEHICLE IDENTIFICATION 



Vehicle Make (specify): fo&SS 



Model Year ^ ( 
Vehicle Model (specify): ltj\ r^ouu * UiCTfcfciA 



LOCATOR 



Locate the end of the damage with respect to the vehicle longitudinal center line or bumper corner for end impacts 
or an undamaged axle for side impacts. , 



Specific Impact No. 



Location of Direct Damage 



£<3T joAfcg.Arrn/C 



Location of Field L 



CRUSH PROFILE | 


NOTES: Identify the plane at which the C-measurements are taken (e.g., at bumper, above bumper, at sill, above 
sill, etc.) and label adjustments (e.g., free space). 

Measure and document on the vehicle diagram the location of maximum crush. 

Measure C1 to C6 from driver to passenger side in front or rear impacts and rear to front in side 
impacts. 

Free space value is defined as the distance between the baseline and the original body contour taken at 
the individual C locations. This may include the following: bumper lead, bumper taper, side protrusion, 
side taper, etc. Record the value for each C-measurement and maximum crush. 

Use as many lines/columns as necessary to describe each damage profile. 


Specific 
Impact 
Number 


Plane of impact 
C-Measurements 


Direct Damaae 


Field 

L 


c, 


c 2 


c 3 


c 4 


c 6 


C e 


±D 


Width 
(CDC) 


Max 
Crush 


7 


Sr<~C 


IM" 


21.15'' 


bo 


o 


JO.fc> 


tS.o" 


rXO.D 


A<»S 


?'§" 


+ 5.i 


























7 


(Ittrrci/ae 


!*<" 


2o.St M 


6o 




\1>f 


3o.il" 


At>. P 


s.r 


^°" 


■*s.a> 


























7 


S>(bC£Ai(. 


t3.o" 


11. o" 


S"H 


iz.s: 


10.-7% 


!Z.i> 


tU* 


— 


— 




















































































































































































- 

































































HS Form 435A (Rev. 1/92) 



93 



National Accident Sampling System-Crashworthiness Data System: Exterior Vehicle Form 



Page 2 



TIRE-WHEEL DAMAGE 
a. Rotation physically b. Tire 
restricted deflated 



RF 
LF 

RR~3- 
LR x. 



1_ 

A. 



RF _J_ 
LF Z 
RR ?L 

LR 5L 



(1) Yes (2) No (8JNA (9) Unk. 



TYPE OF TRANSMISSION 



D Manual 



IS Automatic 



VEHICLE DAMAGE SKETCH 



ORIGINAL SPECIFICATIONS 



Wheelbase 
Overall Length 
Maximum Width 
Curb Weight 
Average Track 
Front Overhang 
Rear Overhang 



tt«>r 






7?>S r 



33^ 



6*.?s" 



Engine Size: cyl./displ. 2/uJ£, / S.%l/db A 
Undeformed End Width 



WHEEL STEER ANGLES 
(For locked front wheels or 
displaced rear axles only) 



RF ± 
LF ± 
RR ± 
LR ± 



o 
o 
o 
o 



Within ± 5 degrees 



DRIVE WHEELS 
□ FWD pi RWD D 4WD 



Approximate 

Cargo. Weight tooiJLs 

PDUOL gQm&MEATT 




F£Q*JT £A6 4T&QKC 



"TO fHAiH 



T 



Original 
Bumper height 



_L 

T 



(? *-a 





, , i 



Bumper corner 
Stringline 



Bumper corner_ 
Stringline . 




d£ovc/rro^ 



_Bumper corner 
Stringline 



Q£UA>£ATOfc- ZfvPACT 
1 Of *- p AXlX 



__ Bumper corner 
_1 Stringline 



NOTES: Sketch new perimeter end cross hatch direct damage and single hatch induced damage on all views. Annotate observations which might be useful 
in reconstructingthe accident (e.g., grass in tire bead, direction of striations, scuff on sidewalls, etc.). If pulling trailer, sketch type of trailer and 
damage received on the back of this page. 
Annotate any damage caused by extrication such as component removal by torching, prying, or hydraulic shears. 



94 



National Accident Sampling System-Crashworthiness Data System: Exterior Vehicle Form 



CDC WORKSHEET 



Page 3 



CODES FOR OBJECT CONTACTED 



(01-30) — Vehicle Number 



Noncollision 

(31) Overturn — rollover 

(32) Fire or explosion 

(33) Jackknife 

(34) Other intraunit damage (specify): 



(35) Noncollision injury 

(38) Other noncollision (specify): 



(57) Fence 

(58) Wall 

(59) Building 

(60) Ditch or culvert 

(61) Ground 

(62) Fire hydrant 

(63) Curb 

(64) Bridge 

(68) Other fixed object (specify): 



(39) Noncollision — details unknown 

Collision With Fixed Object 

(41) Tree (as 4 inches in diameter) 

(42) Tree (> 4 inches in diameter) 

(43) Shrubbery or bush 

(44) Embankment 

(45) Breakaway pole or post (any diameter) 

Nonbreakaway Pole or Post 

(50) Pole or post (£ 4 inches in diameter) 

(51) Pole or post (> 4 inches but £ 12 inches in 
diameter) 

(52) Pole or post (> 12 inches in diameter) 

(53) Pole or post (diameter unknown) 

(54) Concrete traffic barrier 

(55) Impact attenuator 

(56) Other traffic barrier (includes guardrail) 
(specify) : 



(69) Unknown fixed object 

Collision with Nonfixed Object 

(71 ) Motor vehicle not in-transport 

(72) Pedestrian 

(73) Cyclist or cycle 

(74) Other nonmotorist or conveyance 

(75) Vehicle occupant 

(76) Animal 

(77) Train 

(78) Trailer, disconnected in transport 

(88) Other nonfixed object (specify): 

(89) Unknown nonfixed object 

(98) Other event (specify): 

(99) Unknown event or object 



DEFORMATION CLASSIFICATION BY EVENT NUMBER 



Accident 

Event 

Sequence 

Number 



Object 
Contacted 



(1M2) 
Direction 
of Force 
(degrees) 



Incremental 

Value of 

Shift 



o \ 


oj±_ 




O.S- 


OL 


o-7 









s-o 


s~o 


43 


4 I 


H2 


HI 


M 1 












J 


S" 


O 





O 


4 


o 


o 

o 
o 

o 

o 




o 





o 


o 


o 


o 


<\ 


o 


o 





o 


n 





o 











o 


o 


o 


6 









(3) 

Deformation 

Location 

ft. 

_^ 

JL 

X- 



(4) 

Specific 

Longitudinal 

or Lateral 

Location 



(6) 

Specific 

Vertical or 

Lateral 

Location 



G> 



P 



e 



(6) 

Type of 

Damage 

Distribution 



±±2_ 

s 

JO 
JO 



(7) 

Deformation 

Extent 



o \ 


O 1 


_qS 


o l 


o3 


6 a. 


o <T 









95 



National Accident Sampling System-Crashworthiness Data System: Exterior Vehicle Form 



COLLISION DEFORMATION CLASSIFICATION 



Page 4 



HIGHEST DELTA "V 

Accident 

Event 
Sequence Object 
Number Contacted 


(1X2) 
Direction 
of Force 


(3) 

Deformation 

Location 


(4) 

Longitudinal 

or Lateral 

Location 


(5) 

Vertical or 

Lateral 

Location 


(6) 

Type of 

Damage 

Distribution 


(7) 

Deformation 

Extent 


4. O 7 


5. M 3L 


6. OO 


7._B^ 


s._e_ 


9.^. 


10. K> 


11._Ql.£1 



Second Highest Delta "V 



12._Q_iT 13. H 3L 14. OO 15. R, 



16._£_ 



17. £ 



18. Al 19. O 3 



CRUSH PROFILE 



The crush profile for the damage described in the CDC(s) above should be documented 
in the appropriate space below. (ALL MEASUREMENTS ARE IN INCHES.) 



HIGHEST DELTA "V" 



20. 



21. 



22. 



C, 



C 4 



C 6 



±D 



•SlDCRA/c CJto^U 

_D_£iL J-L. 

Smm+ Highest Delta "V" 

23. 24. 

L C, 



_2_L _J_1 _l2_ _. 



25. 



C. 



C 6 



±D 



&Ecto*>£ cAO&H 



_Q_6 o _q&_ _Li_ _3.o_ 



^L-CL 



_o£_ _DiL 






26. Are CDCs Documented 
but Not Coded on The 
Automated File? 

(0) No 

(1) Yes 



27. Researcher's Assessment 
of Vehicle Disposition 

(0) Not towed due to 
vehicle damage 

(1) Towed due to 
vehicle damage 

(9) Unknown 



28. Original Wheelbase 
ltH,% Code to the 
nearest tenth 
of an inch 
(9999) Unknown 



_LJ_iL--i 



96 



National Accident Sampling System-Crashworthiness Data System: Exterior Vehicle Form 



Page 5 



29. Is This A Multi-Stage Manufactured Vehicle 
And/Or A Certified Altered Vehicle? 

(0) No post manufacturer modifications 

(1) Yes - post manufacturer modifications 
(specify): 



30. 



(Include photograph of CERTIFICATION 
PLACARD in case report) 
(9) Unknown if vehicle is modified 



Fire Occurrence 

(0) No fire 

Yes, fire occurred 

(1) Minor 

(2) Major 

(9) Unknown 



O 



31. Origin of Fire 

(0) No fire 

(1) Vehicle exterior (front side, back, top) 

(2) Exhaust system 

(3) Fuel tank (and other fuel retention 
system parts) 

(4) Engine compartment 

(5) Cargo/trunk compartment 

(6) Instrument panel 

(7) Passenger compartment area 

(8) Other location (specify): 

(9) Unknown 



32. Type of Fuel Tank 

(0) No fuel tank (electrical vehicle) 

(1) Metallic 

(2) Non-metallic 
(9) Unknown 



* STOP: IF THE CDS APPLICABLE VEHICLE WAS NOT TOWED AND WAS NOT AN AOPS ### 
(I.E., GV09 = OR 9 AND GV36 = 0), DO NOT COMPLETE THE INTERIOR VEHICLE FORM. 



97 




BEST AVAILABLE COPY 



• U^pepartmenj^^ 



: National H Trafflo Safety 

Administration 






:'■■■ vV- 



;4 \t V^^HSS® 



f ^ 4f rimary S a m p lin g i Unft W 
:^, Case Tslumbe r Strotum 
p ^3. Vehicle Number ^^^ 






GLAZING 




INTEGRITY 






£^&fc 



P4 



isSengef ; 

»"«toor*.tohi 









i' 



dahield end door I 
_ dihield •^';w||f 
J) Side and rear windov 

dtWeld and tkJa wiftdc 
and side WindoWl 
) ^IftKer combination oFi 




w . jfjnknown >t/^^jjl*if|$ 



fe^^^M^ 



i^oic^^ht^ 

l^ezNreontaeted by occupant but no glazing djamafM^^jd: 
glazing in place *nd cracked by occupant ^nttie^^^^l ! ^ 



poor, Tailgate or Hatch ppenii 

^^^) |fe!^i^ati| _ 

^^^M^^o^/pataAort^ 
^ . ^Door/gate7hatch * 

^ili&^^ ^ . , 1MBWW .^ 



f|jS ^%$) #lozing^^ £y occupy 

* "^"^j^iezing "•■■■■**• 
r*S^^#iccupai 

IfySfclazing disintogra 



rP 



•'.--: 's^.i^a/feaSias 



, : i^>::;i;W^^^- 







Damage/Failure Associat 

Opening in Collision. « IV05-IV09,** 2, Then code U ^/ J 

10. LF_C>1 1. RF_Ol2. LR_Ol3. RR $~>U. TG/H Q 

(0) No door/gat or door not opened ,.*£ ^"' ! ; 'k; /: /^k. ^^-^ 

- - * *•"**-,*. * i f - ;■ J* I . Mt^ 1 * % V 3W ^TO'* 3 

Door, Tailgate or Hatch Came Open During Cotlieion ^%f^j^ 

(1) Door operational tno damageK^^^'-V^i-^St^^^^^ 

(2) Latch/striker failure duetodai^geT^^^p, , 

(3) Hinge failure due to damage JZ&¥*L ^*S$b&& 
; r J4) Door structure failure due t» dairagef^^^^^^j 
r : 3*.fl5) '^>oor support (i,a. t .pUlar, .'atlrv oof. side naV^^^^^P^B 

. ;'- . '.etc) failure due to damage h^^^^r^$^:^&^^^ 4 
16) Latch/striker and hinge failure due to ^damage ^al^ff^f 
(8) Other failure (specify): ^.ir i^,;^!;^ f^i ^: ,, ^^, 



36,SUl 37/i\oQOOj38,©therJe ,l;:^i 



t >c »T|0) 4io glazing contact janoTjio damage, *r no glazing ^C'^ ::.-;- ; 



:'&t2) ^%^ : f(^aniparad ; 



s^d#r¥ 



V^ndowPrecrashCiazihg Status 






(9) Unknown 



'■- <r»,^i-»;«f**"v; 




ft JW? 



1) Closed 
13) Partially opened 
> 44) Fully opened ;: 
(9) Unknown 



*. ?.%" " ' .! - .. * l ?". Js^t'J?' ...»:**a-!l''- .43b&I»£' .*.... ■: . * 



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HS Form 435C (Rev. 1/92) 



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lent Bar 






1st?! 



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OCCUPANT AREA INTRUSION 



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•;;«=s.I42) Middle,^ 



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••••-Second S«^i*^ 497) Catastrophic v-*. 5 *- . 
. ; :fc*2l J Liift jSSSf&t'S^fW) -Other enclosed ivsfc^ 

" **23)?Rii 




^WhlraSeat-^i^^ 
.- ,i(31i -Left -v-*-*-- .^ r-.: \^r;3stea» - &'3a~- -:-,. ^ , 



133) Rioht C^y 






i 



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MAeNHm>E©F 1NTRMSIOI 
31 ) Jfc # inch but *c "43 ** 
.^•M2)";fc^_4hches but' 4"^B _ „_ 

■:M4yM$i inches biit 4 v f$afridtikf 
4:^(5)^8 jnchesbui J 
6)^34 Inches 
)JDatastr6| 



JL* «!«awKE." Aft* M i^SSHMf *1 






!M7f Catastrophic 
:\$) Unknown 




-• ^2)"Xohoitudinal" '%&& 

^3(3) '.lateral .„ :- *^£3C$§ 

sWph]c:H^!|pl^^^-i; W . 



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System:' 





92. Steering Kim/Spoke Defor 

10) '^No steering \ftfa deformation 

H^SM value M" 

*6) >« ^ampr.^pt^^^,^ ^--i 
(8) Observed deformation cannot be nw 



4^»*^y!5^L 



m 
\mtm 



$|05)^i»periia^Mfim/8poke ^-^ -^^ 
*5i06) J&wer half of rim/spoke 
!it07)|IMt liiilf Jdf rim/$poke 

^409) ; Complete steering wheel collapse ^ 

1 410) Undetermined location r, ', > *•& 

"499) Unknown - *-' ** • * • '->'**~#*w^ 




INSTRUMENT PANEL 



94. Odometer Reading 7 



&^*Lmil 



afiaia-miles-Code mileage to the s--*$M 

nearest 1*000 miles' ?:i<d>^&f$30%s0™ 
3000) --No odometerU",^ >i^#\&.1l 
4001) "iess than 1,500 miles X ^| ^?? 
1300) 299,500 miles '-or^morejg^Pfl 
J999) Unknown ;^;, T^Jl_ -•ffffi ^g 

;Source^tf**-¥*- JV ' ^ " 






95/tnstrufrterit1*anel Damage from 
Occupant Contact? 

10) No . ■'.:';.',: 






* ,-,1 -V-, ^.^^V?^ rj " - ^-.^ ^ 



rjk&j&l 



96. Knee Bolster s Deformed from 
Occupant Contact? 

10) No ^ r. 

it) Y«->v^-^*ivr^'^ •■> 
. (8) IJot present ^;^%;^; 



.1:^4;.: 



:**S ; 



t9)aUnknovvri ^M^p 

97, Did Glove Compartment Door Open ; :ZY^f; 

During Cbllision(s)? ^ - ^-^^^?>^7--r^^»i 

; <0) NO \?W** /'>'' -"^^ ?^4^W'^ 

ID Yes '-r v _ . -:, : /;\JVC ': 

<8) Not present " Mt>- 

(9) Unknown VTJ 




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VEHICLE INTERIOR SKETCHES 












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Sketch windshield contact(s) and She damaged areata) *h the instrument panel outline .<e,fl., 

seompartment. damage tolbstrumenj panel ;l m^n^^M^ > ^^fl^^^.$W% 

Cross hatch contact points; ffraw spider wobs *r lis* other enhotatioh^ae may fce appropriate. 








<$ 



; W^ ,-.-./ .£.':.■ 






^Siifift^WvtaBa***^^ * I »>4-^&foft. 



Annotate the contacted area with aletter (bedin With A) irid fist on the Points of Occupant pontact : >ape. f 

■ ' ' " "-r — ^'" ' M ' ' ' ' " : ' . .'_' "•"— 7"— "' . ' " ," ' . " ' " ' "." ' . ""' " 

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National Accident SamplhiQ Syttam-Crathworthinass Data Syi Interior Vahicla Form 





'2*1$ 






126) Left side window (lass Including 

Jf^§||fame,; window ifli, A pillar, t^> 
'*$ pillar, or roof side rail. 



»ii«tf4'wwtiw^-^ CODES fOR INTERIOR COMPONENTS 

; ;^01 ) Windshield ^ j3H^g&; * 
l kjji02\ Mirror -vf ,.-': ^^^^^^ 

: 404) Steering whsrtfifc '& ! ^t ; ; ' fe 127) Other left aide object Specify): i 

i wheel i v|fe : v|y^ "•■:•-: ■ - ^ ■: ■ 

Left side window sill - v . * 

*!*>*'-" ; '*' V'" ; -* -C'V; ; 
|£30) flight side interior surface, - y X \v < 

: ft?!^^i^c1uding;1iardware"'or armrestr!^^ 



(48) Child safety seat (specify) : 



it^'*^'< 



.^|0$) Steering 

>406) gwhee ; ; |; *,;£V<28) i*f 

#1^ #« $ode* 04 end ^)#>-f* - <" ' **; -V.«^ v * 
^07) Steering cokjmr,, jtransmis sion ; ? RIGMT«DE 
'^1 ./>" E C -selector Jever, jothsr attachment J 
IfJ^W ie.g.rCB, tape 

;;? * : deck, air conditioner) V • ' . : " r 
J, T 1(09) Left instrument panel and below 

(10) Center instrument panel and below 

(11) Right instrument panel end below 

(12) Glove compartment door 
Knee bolster a ■-» 4 , 
Windshield including one or more 
of the following: "front header, A- 
pillar. Instrument panel, mirror, or 
steering assembly (driver side only) 
Windshield including one or more 
of the following: front header, A- 
pillar, instrument panel, or mirror 
(passenger side only) 
Other front object (specify): 



149) 



ROOF 
\ (BO) 

,;;^B2) 

#aB53): 
^B4) 



131) Right side hardware or armrest 

(32) Bight A pillar /, - : ^1 £i < * ? SFLOOR 

' -^"■ ± -*?r? - 1 * ~-~ Pfy~f** T.r-5fr*T. jeer 



(33) *ight B.pillar , w 
434) Other right pillar (specify): 



(13) 
(14) 



(15) 



(36) 
(36) 



«7) 



Right side window glass or frame 
Right side window glass including 
one or more of the following: ! s 
frame, window sill, A pillar, ^ ■ 
B pillar, or roof side reil. 
Other right side object (specify):: 



*56) 
(67) 



5(68) 
169) 



Other interior object (specify): 

front header W^&j-^* >k - ' ^; 
Rear header ,>32#€W :-' ^ '■"•" 
Roof left. side tal.^^ V--« ' ^ 
JRodf right side >a¥ '^"j^&^-r x 
Roof or convertible ~tbp "Tj^F ' ^ 

Floor (including toe pen) 
Floor or console mounted : ^ / 
transmission lever, including 
console --- 

Parking brake handle .■■•-->^'.,. 
Foot controls including parking 
torake' <>•*: ;, v, V. f "> ' 



(38) Right side window sill 



REAR 
(60) 
(61) 

"(62) 



(16) 



S3fe- : 



LEFTSIDE 

(20) Left side interior surface/ 
excluding hardware or armrests 

(21 ) Left side hardware or ermrest 

(22) Left A pillar 

(23) Left B pillar 

(24) Other left pillar (specify): 

(25) Left side window glass or frame 



INTERIOR 

(40) Seat, back support V .^ < "J, 

(41) Belt restraint webbing/buckle ; -^5 

(42) Belt restraint B-pillar , r 
;;*i attachment point 

(43) Other restraint system component 
(specify): ^___ 

(44) Head restraint system 

(45) Air bag 

(46) Other occupants (specify): 

(47) Interior loose objects 



Backlight (rear window) ; 

Backlight storage r 

Other ■rear, object ; ; (spe^fy);^^^H 









CONFIDENCE LEVEL OF ; ;-: „ l 
CONTACT POINT I; 

(1) Certain - 

(2) Probeble r 

(3) Possible 
(9) Unknown 



102 



BEST AVAILABLE COPY 



BEST AVAILABLE COPY 



AUTOMATIC RESTRAINTS 



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^^^(0) ^|ot equipped/not 
^?fl| -4 point automatic belt* <*§ 
V = iZ) & point automatic belts '^^ 



ly*t»i 



liNotS 






^ 






/not used 
^ ^1 ) Automatic b«tt used property 
U) ^Automa^c^t used pr#>er1y^itn 

undtr 

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__„_ . . jlwtiattraluwirtottaa/ w 

** i^etaJippedfodtavaHaU ' 4^ ~ 

f automatic tMalt failure!*) V^^fj -?p 
>rn tabbing (stretched webbing not '* u 

'jpcbprage,.«oparat«d;7f^^S :l 
anchorage separated {specify): , ,* 



Automatic (Passive) Salt System ^ 



|5)^uio^at8^^^ 



40) ;j*et^ppeato^^^^ t #|Nan^na>araoii,.^^^v^^^ 






^irtbir rendered inoparatl^|^^^1J 

^^iRAutoinalic bolt in vee^^'fcffey 

M2) Automatic bait not fa use (menu 

^ ;lS^fdiacbhnactad # motorized track 
u "^^^oparatival y^^^faj^|gL 
"!T??3} ! Automatic bait use unknown _*. 

Automatic (Paaalval Bait Syafam Typa 



^.^'. K6) 4ap.|>ortion of automatic bait ^btn 

f|r?^- r v^n^bdo>naJi i^aife!/^^ 
k T ^n^7) ■ Automatic tap and shoulder belt 

^"^iPM^t'pparl^ 
*■ lH*- wih child !" 

;^t8i} .jbthar ;l^ 



^y: :><5fwagji?;' *£*,'• rf,;^ v v - ^ j j 



^(0) Not aqutppad/not available , vr' ^ ;?£-' 
(1 ) Non-motorized system ^ - ^ -^ "M^ 




system ; % 
(specify) 
(9) Unknown :^&i^ 



T'.-;!!) Non-motorized system ,^ ,"-,i '** -^ - * 8 ' Unknown ;^H^*¥t|%#-^ -*" . .- T ~w^?i^^ 






^sfr#?i 



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MANUAL RESTRAINTS 



* ,.•.-•*.-■• 



: 'j&g&i, found >w*;Bestraint systems sd during 

! ^p^-;.Ocupant Assessment Form^i^fe^^^^^P 

$?$fcito a Child aif^fiiaf Is prtWfigtf^* 1 - tjS - 









sTs^sss^rsss 






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5^sL*S41 Aapjandshoui 

45) fcelt avaBabte;?ti^;UHlai6wni 

H6) Shoulder belt <lapfeett 

destroyed/removed) 
(7) Lap belt (shoulder 

destroyed/removed) 






fipfr^ffei 









»(08) ^theV'beltB^ <Bpecify1r;fl: &?# : : / ' ;J 



/■fe 






Shoulder belt used with child safety seat 
p J^^ safety)seat :,^ 

14) ^Lap *n# f hpulder belt used with ctiild 

$5) Belt used with child safety seat - ? t ; 



HIS) seat 



:.-?t*Fi 




5J8) Other belt {specify) 



eltl8DeclM:>;v'.-^:^^i\-;^.,,C.-J-- 



^v^n'-v#;-^ 






5<9) Unknoyyh - 



Manual (A< System Use 

^;:*:;; <00) None used, not available, or belt 
^w^^- v removed/d^stipyed ,-:, A %i^} :L& )-A%W^^^^yw 
- ^r-(OI) Inoperable lepeclfy): >Tx^'^' •-^^*W-^t' 



Manual {Active) Belt failure Modes During Accident 
{0) No manual belt used or not available 
(1 )'|jp'ii ^^^Svff r ^ ; : - 

^2) Torn i^bftl|[ (stretched webbing not v 

J3) Broken buckle or latchplate t„ k>;> 

, ^ ^v« * /A; : ^ * (*) Upper anchorage separated ^ ^^.j„ 
u~i* r l ; v^ ^ ; : ^j other anchorage separated (specify): ii „ 












(02) Shoulder belt 
103) Lap belt! 

(04) Lap and shoulder belt 

(05) Belt used -type unknown 



K<**-- : -?>* &K^'C5|>||i^v-(6) Broken retractor ^f^^^^r^^^4-^- ^-. 
Si£^ of above {specify):^ ;tf& -\- 



A- *% *A* -$.'?$ in "^ip'-^L^v 4 l X--*^ 1 ** . v* *■ t r '' * i r '.. i .'■'".. i. ■ ".' i i i 

;.il;7XiSWll« v : ; '.: :; (8) -Other manual belt failure {specify): 






(9) Unknown 



^..^irti^^irtiiBa 



BEST AVAILABLE COPY 






0*sL 



CHILD SAFETY SEAT FIELD ASSESSMENT 



3 



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: \I-^i'f| 



ItVVhen ;• child safety seat Is present ei 



: the occupant's $mperMi 



codes listed b«lov 




pant Number 



ffl&Wi* 













fri-^#%: 









ti 



iisAgeVWejght 

sfttte) ^>r«*aro facing:, 
;^08) ^Other orientatior 

' '' ' ' ¥&*■$&$ ' Unknown orientation .Wm&fr 











3) Child $af city 

s/shield/te _ 



BsignedlAfith 






ess/Shield/Tether * *«** *^*si--< 






Jnknown 



™ , ji JMk&ear facing ^ 

f|I|p.2| forward facing 
^<^(18) ^thwjirie^atipn 

'•^|,^19V Unknown prienta 



. . /*ised^f!|ip; 
iroess/Shieldnether ■$&* 




...¥2£?^ iS5'i^^^?) Unknown if harness/shield/tether used ' ^ 

'~*~' *"~ Chiid^af^y^eatWlakL _ _ . 

^Specify make/imode f nd £ecup 






pherrfSfi 





S^ rf-^i r * - ^ *_ "--.."'i i f L1 iti J , | -T*-'' ■•**""--*' ~- -t ■"i7 'if^:"^-' J f - I'll' °" =*-.-*#-><>---' •;»*-«• T-r#r- 

■T29) ■ Unknbwn orientation ^i^^/^J^&T&Pw.,^ 

(99) unknown if child safety ^eat used i M\ r "^^^'¥^:^'^' -^ ^>i^ r % 




JiM^i; v .... 















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National Accident Sampling System-Cras hworthiness Data System 



worthiness Data System: Interior Vehicle Form X^^^^^4'^ t H9Bf^JM. 



m. 



HEAD RESTRAINTS/SEAT EVALUATION 



NOTES: Encode the applicable data for each seat position in the vehicle- ^he attrlbi 

be found at the bottom of the page. Head restraint type/damage and seat type/perf ormance should be 
assessed during the vehicle inspection then coded on the Occupant Assessment Form, ^ % ;;;V 



1m; 



#1 '.; 



Head Restraint Type/Damage 



Seat Type , *>...'» J f>w^^ft^% 



■&»**$&< 



Seat Pert on ' ; f.|>#^#^ 



^Seat Orientati ^ &i^ 



Left 



./< '^"^SV* • 



•©£1 



£«#»' 



■^^MCis^ 









Center 



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IE 






Right 



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8! 2 






jHead Restraint Type/Damage 



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Seat Orientation 






S4# M 



||!ead Bestrairit Type/Damage 



r 



I- 



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If 



$Beat Type ; 



■■*.->:#£- 



$3 



it performance - 






^Seat Orientation 




T 
H 
E 
R 



Head Restraint Type/Damage 



Seat Type 



Seat Performance 



Seat Orientation 




Head Restraint Type/Damage by Occupant at This , 

Occupant Position vi , , 

■ . ■" , . "/\<„-' : .- . - - --,- v j^. '■ 

-■'f-^-^fOK'^o'head.r^rairits --• - v,> ; "' : 

(1) Integral — no damage ' ,1 ><■ » a 

{2 J Integral — damaged during accident ~=^j^ : 

(3) Adjustable — no damage 

(4) Adjustable — damaged during accident 

(5) Add-on — no damage - 

(6) Add-on — damaged during accident 

(8) Other Specify): 

(9) Unknown ~ — 

Seat Type (this Occupant Position) 

(00) No seat 

(01) Bucket 

(02) Bucket with folding back 

(03) Bench 

(04) Bench with separate back cushions 

(05) Bench with folding back(s) 

(06) Split bench with separate back cushions 

(07) Split bench with folding back(s) 

(08) Pedestal (i.e., column supported) 

(09) Other seat type (specify): 

(10) Box mounted seat (i.e., van type) " 
(99) Unknown 



Seat Performance (this Occupant Position) 

11(0) No seat = 

(1) No seat performance failure(s) ' 

(2) Seat adjusters failed 

7^3) Seat back folding locks or "seat back* bailed 

specify:_ '' ■• ■--'•:? - "--r 

(4) Seat tracks/anchors failed 

15) Deformed by impact of occupant ' 

(6) Deformed by passenger compartment 
intrusion (specify): 

(7) Combination of above (specify): 

(8) Other (specify): ~ ~" 

(9) Unknown " - ~ 

Seat Orientation (this Occupant Position) 

(0) No seat 

(1) Forward facing seat 

(2) Rear facing seat 

(3) Side facing seat (inward) 

(4) Side facing seat (outward) 

(8) Other (specify): < f '^:-* ? :?; -T^:-' 



(9) Unknown 



DESCRIBE ANY INDICATION OF ABNORMAL OCCUPANT POSTURE (I.E., UNUSUAL OCCUPANT 
CONTACT PATTERN) 



BEST AVAILABLE COPY 



106 



^'fpjM^lllljlp 



EJECTION/ENTRAPMENT DATA 









*w* 










jj&jfj=* '.-'^ 



^■'4 _'^| 






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antrapment rnc 



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S40^ 



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(Note Jn.yeh.cle interior^ia^rrta^^ygiil^i^^ 



s4*S*#& 



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BEST AVAILABLE COPY 



ferfiilliifnfHf&tli 







a^^i^gi^ 



APPENDIX D 



NASS Occupant Forms 



108 



© 



U.S. Department of Transportation 



OCCUPANT ASSESSMENT FORM 



Form Approved 
O.M.B. No. 2127-0021 



National Highway Traffic Safety 
Administration 






NATIONAL ACCIDENT SAMPLING SYSTEM 
CRASHWORTHINESS DATA SYSTEM 


1. Primary Sampling Unit Number 

2. Case Number - Stratum 

3. Vehicle Number 

4. Occupant Number 


1 *.- 




1 1 . Occupant Posture O 

(0) Normal posture 

(1) Abnormal posture (specify): 


l 3l 
O I 
O l 


(9) Unknown 


EJECTION/ENTRAPMENT 



OCCUPANT'S CHARACTERISTICS 



S-JL 



Occupant's Age 

Code actual age at time of accident. 

(00) Less than one year old (specify by month): 

(97) 97 years and older 
(99) Unknown 



6. Occupant's Sex 

(1) Male 

(2) Female 
(9) Unknown 



Occupant's Height 70.S" '_5_L 

Code actual height to the nearest inch. 
(99) Unknown 



8. Occupant's Weight ^oJNU* 3L 3l O 



Code actual weight to the nearest pounds. 
(999) Unknown 



9. Occupant's Role 

(1) Driver 

(2) Passenger 
(9) Unknown 



10. Occupant's Seat Position 
Front Seat 

(11) Leftside 

(12) Middle 

(13) Right side 

(14) Other (specify): 

(15) On or in the lap of another occupant 



12. Ejection 

(0) No ejection 

(1) Complete ejection 

(2) Partial ejection 

(3) Ejection, unknown degree 
(9) Unknown 



13. Ejection Area 

(0) No ejection 

(1) Windshield 

(2) Left front 

(3) Right front 

(4) Left rear 

(5) Right rear 

(6) Rear 

(7) Roof 

(8) Other area (e.g., back of pickup, etc.) 
(specify) : 

(9) Unknown 



o 



-L_L 



Second Seat 

(21) Leftside 

(22) Middle 

(23) Right side 

(24) Other (specify): 

(25) On or in the lap ot another occupant 

Third Seat 

(31) Leftside 

(32) Middle 

(33) Right side 

(34) Other (specify): 

(35) On or in the lap of another occupant 



Fourth Seat 
(41) Leftside 

Middle 

Right side 

Other (specify): 



(42) 
(43) 
(44) 
(45) 



14. Ejection Medium 

(0) No ejection 

(1) Door/hatch/tailgate 

(2) Nonfixed roof structure 

(3) Fixed glazing 

(4) Nonfixed glazing (specify): 

(5) Integral structure 

(8) Other medium (specify): 



On or in the lap of another occupant 



(97) In or on unenclosed area 

(98) Other seat (specify): 

(99) Unknown 



(9) Unknown 



15. Medium Status (Immediately Prior To Impact) O 

(0) No ejection 

(1) Open 

(2) Closed 

(3) Integral structure 
(9) Unknown 



16. Entrapment _ 

(NOTE: Entrapped means that part of the 
person was in the vehicle and mechanically 
restrained; jammed doors and immobilizing 
injuries by themselves are not sufficient to 
constitute entrapment.) 

(0) Not entrapped 

(1) Entrapped 
(9) Unknown 



109 



HS Form 433 A (1/92) 



This report is authorized by P.L. 69-563, Title 1, Section 106, 108, and 112. nin» T vu *re not required to respond, 
your cooperation is needed to make the results of this data collection effort comprehensive, accurate, and timely. 



National Accident Sampling System-Crashworthiness Data System: Occupant Assessment Form 



Page 2 



RESTRAINT SYSTEM AND SEAT EVALUATION 



17. Manual (Active) Belt System Availability 



(0) None available 

( 1 ) Belt removed/destroyed 

(2) Shoulder belt 

(3) Lap belt 

(4) Lap and shoulder belt 

(5) Belt available— type unknown 

Integral Belt Partially Destroyed 

(6) Shoulder belt (lap belt destroyed/removed) 

(7) Lap belt (shoulder belt destroyed/removed) 

(8) Other belt (specify): 

(9) Unknown 



OH 



18. Manual (Active) Belt System Use 

(00) None used, not available, or belt 
removed/destroyed 

(01) Inoperative (specify): 



(02) Shoulder belt 

(03) Lap belt 

(04) Lap and shoulder belt 

(05) Belt used— type unknown 
(08) Other belt used (specify): 

(12) Shoulder belt used with child safety seat 

(13) Lap belt used with child safety seat 

(14) Lap and shoulder belt used with child 
safety seat 

(15) Belt used with child safety seat— type unknown 
(18) Other belt used with child safety seat 

(specify) : 

(99) Unknown if belt used 



21. Air Bag System Availability /Function 

(0) Not equipped/not available 

(1) Air bag 

Non-functional 

(2) Air bag disconnected (specify): 

(3) Air bag not reinstalled 
(9) Unknown 



22. Air Bag System Deployment 



( 



19. Proper Use of Manual (Active) Belts 

(0) None used or not available 

(1 ) Belt used properly 

(2) Belt used properly with child safety seat 

Belt Used Improperly 

(3) Shoulder belt worn under arm 

(4) Shoulder belt worn behind back or seat 

(5) Belt worn around more than one person 

(6) Lap belt worn on abdomen 

(7) Lap belt or lap and shoulder belt used 
improperly with child safety seat (specify): 

(8) Other improper use of manual belt system 
(specify): 

(9) Unknown 



20. Manual (Active) Belt Failure Modes 
During Accident 

(0) No manual belt used 

(1) No manual belt failure(s) 

(2) Torn webbing (stretched webbing not 
included) 

(3) Broken buckle or latchplate 

(4) Upper anchorage separated 

(5) Other anchorage separated (specify): 

(6) Broken retractor 

(7) Combination of above (specify): 

(8) Other manual belt failure (specify): 

(9) Unknown 



1 



(0) 
(1) 

(2) 

(3) 

(4) 
(5) 
(6) 



(9) 



Not equipped/not available 

Air bag deployed during accident (as a 

result of impact) 

Air bag deployed inadvertently just 

prior to accident 

Air bag deployed, accident sequence 

undetermined 

Nondeployed 

Unknown if deployed 

Air bag deployed as a result of a noncolHsion 

event during accident sequence (e.g., fire, 

explosion, electrical) 

Unknown 



23. Did Air Bag System Fail? 

(0) Not equipped/not available 

(1) No 

(2) Yes (specify): 



(9) Unknown 



Note: See Variables 44 through 48 (Page 5) 
for Information on Automatic Belts 



24. Police Reported Restraint Use 

(0) None used 

(1) Police did not indicate restraint use 

(2) Shoulder belt 

(3) Lap belt 

(4) Lap and shoulder belt 

(5) Belt used, type not specified 

(6) Child safety seat 

(7) Other or automatic restraint (specify): 

(8) Restrained, type unknown 

(9) Police indicated "unknown" 



25. Head Restraint Type/Damage by Occupant 
at This Occupant Position 

(0) No head restraints 

(1) Integral— no damage 

(2) Integral— damaged during accident 

(3) Adjustable— no damage 

(4) Adjustable— damaged during accident 

(5) Add-on— no damage 

(6) Add-on— damaged during accident 

(8) Other (specify): 

(9) Unknown 



110 



National Accident Sampling System-Crashworthiness Data System: Occupant Assessment Form 



Page 3 



26. Seat Type (this Occupant Position) 



o 6 



(00) Occupant not seated or no seat 

(01) Bucket 

(02) Bucket with folding back 

(03) Bench 

(04) Bench with separate back cushions 

(05) Bench with folding back(s) 

(06) Split bench with separate back cushions 

(07) Split bench with folding back(s) p0t» eft > 

(08) Pedestal (i.e., column supported) 

(09) Other seat type (specify): 

(10) Box mounted seat (i.e., van type) 
(99) Unknown 



27. Seat Performance (this Occupant Position) 

(0) Occupant not seated or no seat 

(1) No seat performance failure(s) 

(2) Seat adjusters failed 

(3) Seat back folding locks or "seat back" failed 

(4) Seat track/anchors failed 

(5) Deformed by impact of occupant 

(6) Deformed by passenger compartment intrusion 
(specify) : 



30. Child Safety Seat Orientation 
(00) No child safety seat 



O O 



(7) Combination of above (specify): 

(8) Other (specify): 



(9) Unknown 



Designed for Rear Facing for This Age/Weight 

(01) Rear facing 

(02) Forward facing 

(08) Other orientation (specify): 

(09) Unknown orientation 

Designed For Forward Facing for This Age/Weight 

(11) Rear facing 

(12) Forward facing 

(18) Other orientation (specify): 

(19) Unknown orientation 

Unknown Design or Orientation For This 
Age/Weight, or Unknown Age/Weight 

(21) Rear facing 

(22) Forward facing 

(28) Other orientation (specify): 



o o 


oo 


Od 



CHILD SAFETY SEAT 



o o 



28. Child Safety Seat Make/Model 
(000) No child safety seat 
Applicable codes are found in your NASS CDS 
Data Collection, Coding and Editing 
(950) Built-in child safety seat 

(997) Other make/model (specify): 

(998) Unknown make/model 

(999) Unknown if child safety seat used 



29. Type of Child Safety Seat 



(0) No child safety seat 

(1) Infant seat 

(2) Toddler seat 

(3) Convertible seat 

(4) Booster seat 

(7) Other type child safety seat (specify): 

(8) Unknown child safety seat type 

(9) Unknown if child safety seat used 



(29) Unknown orientation 

(99) Unknown if child safety seat used 

31 . Child Safety Seat Harness Usage 

32. Child Safety Seat Shield Usage 

33. Child Safety Seat Tether Usage 
Note: Options below applicable to 
Variables OA31-OA33. 

(00) No child safety seat 



Not Designed With Harness/Shield/Tether 

(01) After market harness/shield/tether 
added, not used 

(02) After market harness/shield/tether used 

(03) Child safety seat used, but no after market 
harness/shield/tether added 

(09) Unknown if harness/shield/tether 
added or used 

Designed With Harness/Shield/Tether 

(11) Harness/shield/tether not used 

(12) Harness/shield/tether used 

(19) Unknown if harness/shield/tether used 

Unknown if Designed With Harness/Shield/Tether 

(21) Harness/shield/tether not used 

(22) Harness/shield/tether used 

(29) Unknown if harness/shield/tether used 

(99) Unknown if child safety seat used 



111 



National Accident Sampling System-Crash worthiness Data System: Occupant Assessment Form 



Page 4 



INJURY CONSEQUENCES 


38. Working Days Lost 6 I 

Code the number of days 
(up through 60) that the occupant 
lost from work due to the accident 
(00) No working days lost 

(61) 61 days or more 

(62) Fatally injured 

(97) Not working prior to accident 
(99) Unknown 

39. Time to Death O O 

Code number of hours from time of 
accident to time of death up through 24 
hours. If time of death is greater than 24 
hours, code number of days. (Note: 1 day = 
31, 2 days - 32, ... n days = 30 +n up through 
30 days = 60) 
(00) Not fatal 

(96) Fatal - ruled disease 
(99) Unknown 

40. 1st Medically Reported Cause of Death O O 

41. 2nd Medically Reported Cause of Death O O 

42. 3rd Medically Reported Cause of Death O O 

Code the Occupant Injury from line 
number(s) for the medically reported 
injury(s) which reportedly contributed to 
this occupant's death 
(00) Not fatal or no additional causes 

(97) Other result (specify): 


34. Injury Severity (Police Rating) 2l 

(0) - No injury 
(DC- Possible injury 

(2) B - Nonincapacitating injury 

(3) A - Incapacitating injury 

(4) K - Killed 

(5) U - Injury, severity unknown 

(6) Died prior to accident 
(9) Unknown 

35. Treatment - Mortality 3 

(0) No treatment 

(1) Fatal 

(2) Fatal - ruled disease 

Nonfatal 

(3) Hospitalization 

(4) Transported and released 

(5) Treatment at scene - nontransported 
(6>) Treatment later 

(8) Treatment - other (specify): 


(9) Unknown 

36. Type Of Medical Facility (for Initial Treatment) ( 

(0) Not treated at a medical facility 

(1) Trauma center 

(2) Hospital 

(3) Medical clinic 

(4) Physician's office 

(5) Treatment later at medical facility 
(8) Other (specify): 


(99) Unknown 

43. Number of Recorded Injuries for 

This Occupant | ^j 

Code the actual number of 
injuries recorded for this occupant. 
(00) No recorded injuries 
(97) Injured, details unknown 
(99) Unknown if injured 


(9) Unknown 

37. Hospital Stay 3L 3 
(00) Not Hospitalized 

Code the number of davs (up through 60) 
that the occupant stayed in hospital. 
(61) 61 days or more 
(99) Unknown 





112 



National Accident Sampling System-Crash worthiness Data System: Occupant Assessment Form 



Page 5 



AUTOMATIC BELT SYSTEM 


48. Automatic (Passive) Belt Failure Modes O 
During Accident 

(0) Not equipped/not available/not in use 

(1) No automatic belt failure(s) 

(2) Torn webbing (stretched webbing not included) 

(3) Broken buckle or latchplate 

(4) Upper anchorage separated 

(5) Other anchorage separated (specify): 


44. Automatic (Passive) Belt System Availability/ O 
Function 

(0) Not equipped/not available 
(1)2 point automatic belts 

(2) 3 point automatic belts 

(3) Automatic belts - type unknown 

Non-functional 

(4) Automatic belts destroyed or rendered 
inoperative 

(9) Unknown 

45. Automatic (Passive) Belt System Use O 

(0) Not equipped/not available/destroyed or 
rendered inoperative 

(1) Automatic belt in use 

(2) Automatic belt not in use (manually 
disconnected, motorized track inoperative) 
(specify): 


(6) Broken retractor 

(7) Combination of above (specify): 

(8) Other automatic belt failure (specify): 


(9) Unknown 


49. Seat Orientation (this Occupant Position) \ 

(0) Occupant not seated or no seat 

(1) Forward facing seat 

(2) Rear facing seat 

(3) Side facing seat (inward) 

(4) Side facing seat (outward) 
(8) Other (specify): 


(3) Automatic belt use unknown 
(9) Unknown 

46. Automatic (Passive) Belt System Type O 

(0) Not equipped/not available 

(1) Non-motorized system 

(2) Motorized system 
(9) Unknown 

47. Proper Use of Automatic (Passive Q 
Belt System 

(0) Not equipped/not available/not used 

(1) Automatic belt used properly 

(2) Automatic belt used properly with 
child safety seat 

Automatic Belt Used Improperly 

(3) Automatic shoulder belt worn under arm 

(4) Automatic shoulder belt worn behind back 

(5) Automatic belt worn around more than 
one person 

(6) Lap portion of automatic belt worn 
on abdomen 

(7) Automatic lap and shoulder belt or 
automatic shoulder belt used improperly 
with child safety seat (specify): 


(9) Unknown 


TRAUMA DATA 


50. Glasgow Coma Scale (GCS) Score Q 1_ 

(at Medical Facility) 

(00) Not injured 

(01) Injured - not treated at medical facility 

(02) No GCS Score at medical facility 
(03-1 5) Code the actual value of the 

initial GCS Score recorded at medical 

facility. 
(97) Injured, details unknown 
(99) Unknown if injured 

51 . Was the Occupant Given Blood? 9 

(1) No - blood not given 

(2) Yes - blood given 
(specify units): 


(9) unknown it blood given 

52. Arterial Blood Gases (ABG) - HCO-* O [ 

(00) Not injured 

(01) Injured, ABGs not measured or reported 
(02-50) Code the actual value of theHCOQ 

(96) ABGs reported , HCO3 unknown 

(97) Injured, details unknown 
(99) Unknown if injured 


(8) Other improper use of automatic belt system 
(specify): 


(9) Unknown 


UPDATE CANDIDATE? NO [uT YES [ ] 
OCCUPANT INJURY FORM INCLUDED WITH INITIAL SUBMISSION? NO W YES [ ] 


*** STOP HERE *** 

IF THERE ARE NO RECORDED INJURIES 

(I.E., OA43 = 00,97,99) 



113 



© 



U.S. Department of Transportation 

National Highway Traffic Safety 
Administration 



Form Approved 
O.M.B. No. 2127-0021 

OCCUPANT INJURY FORM NATIONAL ACCIDENT SAMPLING SYSTEM 

wwwwi --,■- i i.-wwit i wiiivi CRASHWORTHINESS DATA SYSTEM 



1 . Primary Sampling Unit Number 

2. Case Number - Stratum 






3. Vehicle Number 

4. Occupant Number 


o \ 


<\ A- ( 


Z 







INJURY DATA 



Record below the actual injuries sustained by this occupant that were identified from the official and unofficial data 
sources. Remember not to double count an injury just because it was identified from two different sources. If 
greater than ten injuries have been documented, encode the balance on the Occupant Injury Supplement. 



O.I.C.-A.I.S 



Source _____ 
of Injury Body 
Data Region 



Aspect Lesion 



System A.I.S. 

Organ Severity 



Injury 

Source Direct/ 

Injury Confidence Indirect Occupant Area 

Source Level injury Intrusion No. 



1st 5 



WS^^^^^^^^^^M^^M^^^^^S^^^^^^mi 



2nd '"^j^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ 



II 



3rd 



i^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^M 



«h "^^^^^^^^^^^^^S^^^^^^^^^^^^^^^^^^S^ 



5th 



' 46 lill : l*lfi 



eth ™§M^ 



HS Form433B (1/92) 



Thia report « authorized by P.L. 89-563, Title 1, Section 106, 108, and 112. While you are not required to respond, 
your cooperation is needed to make the results of this data collection effort comprehensive, accurate, and timely. 



114 



OCCUPANT INJURY DATA 



O.I.C.-A.I.S 

Source ____^ 

of Injury Body System A.I.S. 

Data Region Aspect Lesion Organ Severity 



Injury 
Source 



Injury 

Source Direct/ 

Confidence Indirect Occupant Area 
Level Injury Intrusion No. 



11th 



£. C, L_ -I. 1- £± 



.L jD± 



12th _2_ jy_ 



SH I \ O 



13th ^2 tL 4. JL T j_ 5ll_ _L 



O I 



14th _^ 



.a £ i_ s± _l ± _g± 



15th 



16th 



17th 



18th 



19th 



20th 



21st 



22nd 



23rd 



24th 



25th 



115 



AGE..&4.... 

SEX mLE 

WT.1220..1bs, 
»j T 179. lcm 

H T. ^jza^sLi) 



Right earlobe laceration 
(AIS-1), intruding roof 



Superior scalp laceration 
(AIS-1), intruding roof 



Closed head injury with 
brief loss of consciousness 
and residual cognitive deficits 



Dislocated teeth, #D5-8 
(AIS-1) , intruding roof 

Non-displaced fracture of the 
right zygoma (AIS-2) , 
intruding roof 

Right clavicle fracture 
(AIS-2) , intruding 
right roof side rail 

Fractured right ribs 2-g, 
with flail chest and 
right hemothorax 
(AIS-4) , right B-pillar 



Right pulmonary 
contusion (AIS-3)', 
right B-pillar 



Comminuted fracture 
of the right radial 
head (AIS-3) , right 
roof side rail 



Fracture of the right 
proximal ulna (AIS-2) , 
right roof side rail 




Displaced nasal fracture (AIS-2) , 
intruding roof 

Nasal laceration (AIS-1) , 
intruding roof 



T-12 spinous process fracture 
(AIS-2) , rebound contact into 
seatback/door 



Full thickness thermal burn 
of the dorsal left middle, 
ring and fifth fingers 
(AIS-l ) air bag inf lator . 
odule 



116 



SOURCE OF INJURY DATA 

OFFICIAL 

(1) Autopsy records with or without hospital 
medical records 

(2) Hospital medical records other than 
emergency room (e.g., dishcarge 
summary) 

(3) Emergency room records only (including 
associated X-rays or other lab reports) 

(4) Private physician, walk-in or emergency 
clinic 

UNOFFICIAL 



(5) 
(6) 
(7) 
(8) 



Lay coroner report 

E.M.S. personnel 

Interviewee 

Other source (specify): 



(9) Police 



INJURY SOURCE 

FRONT 

(01) Windshield 

(02) Mirror 

(03) Sunvisor 

(04) Steering wheel rim 

(05) Steering wheel hub/spoke 

(06) Steering wheel (combination 
of codes 04 and 05) 

(07) Steering column, transmission 
selector lever, other attachment 

(08) Add on equipment (e.g., CB, tape 
deck, air conditioner) 

(09) Left instrument panel and below 

(10) Center instrument panel and below 

(1 1 ) Right instrument panel and below 

(12) Glove compartment door 

(13) Knee bolster 

(14) Windshield including one or more 
of the following: front header. A- 
pillar, instrument panel, mirror, or 
steering assembly (driver side only) 

(15) Windshield including one or more 
of the following: front header, A- 
pillar, instrument panel, or mirror 
(passenger side only) 

(1 6) Other front object (specify): 



LEFT SIDE 

(20) Left side interior surface, 
excluding hardware or armrests 

(21 ) Left side hardware or armrest 

(22) Left A pillar 

(23) Left B pillar 

(24) Other left pillar (specify): 

(25) Left side window glass or frame 



(26) Left side window glass including 
one or more of the following: 
frame, window sill, A-piller, 
B-pillar, or roof side rail. 

(27) Other left side object (specify): 

(28) Left side window sill 

RIGHT SIDE 

(30) Right side interior surface, 
excluding hardware or armrests 

(31) Right side hardware or armrest 

(32) Right A pillar 

(33) Right B pillar 

(34) Other right pillar (specify): 

(35) Right side window glass or frame 

(36) Right side window glass including 
one or more of the following: 
frame, window sill, A pillar, 

B pillar, or roof side rail. 

(37) Other right aide object (specify): 

(38) Right side window sill 

INTERIOR 

(40) Seat, back support 

(41) Bert restraint webbing/buckle 

(42) Belt restraint B-pillar 
attachment point 

(43) Other restraint system component 
(specify): 



(44) Head restraint system 

(45) Air bag 

(46) Other occupants (specify): 



(47) Interior loose objects 

(48) Child safety seat (specify): 



(49) Other interior object (specify): 



ROOF 

(50) Front header 

(51) Rear header 

(52) Roof left side rail 

(53) Roof right side rail 

(54) Roof or convertible top 

FLOOR 

(56) Floor (including toe pan) 

(57) Floor or console mounted 
transmission lever, including 
console 

(58) Parking brake handle 

(59) Foot controls including parking 
brake 

REAR 

(60) Backlight (rear window) 



O.I.C. Body Region 

(M) Abdomen 

(Q) Ankle-foot 

(A) Arm (upper) 

(B) Back-thoracolumbar spine 

(C) Chest 

(E) Elbow 

(F) Face 
(R) Forearm 
(H) Head-skull 

(U) Injured, unknown region 

(K) Knee 

(L) Leg (lower) 

(Y) Lower Kmbs(s) (whole or 

unknown part) 

(N) Neck— cervical spine 

(P) Pelvic-hip 

(S) Shoulder 

(T) Thigh 

(X) Upper Kmb(s) (whole or 

unknown part) 

(0) Whole body 

(W) Wrist-hand 



(61) Backlight storage rack, door, etc. 

(62) Other rear object (specify): 



EXTERIOR of OCCUPANTS VEHICLE 

(65) Hood 

(66) Outside hardware (e.g., outside 
mirror, antenna) 

(67) Other exterior surface or tires 
(specify) :_ 



(68) Unknown exterior objects 

EXTERIOR OF OTHER MOTOR VEHICLE 

(70) Front bumper 

(71) Hood edge 

(72) Other front of vehicle (specify): 

(73) Hood ~~ 

(74) Hood ornament 

(75) Windshield, roof rail, A-pillar 

(76) Side surface 

(77) Side mirrors 

(78) Other side protrusions (specify) 

(79) Rear surface 

(80) Undercarriage 

(81 ) Tires and wheels 

(82) Other exterior of other motor vehicle 
(specify): 

(83) Unknown exterior of other motor vehicle 

OTHER VEHICLE OR OBJECT IN THE 
ENVIRONMENT 

(84) Ground 

(85) Other vehicle or object (specify) 

(86) Unknown vehicle or object 

NONCONTACT INJURY 

(90) Fire in vehicle 

(91) Flying glass 

(92) Other noncontact injury source 
(specify): 



(93) Air bag exhaust gases 
(97) Injured, unknown source 



INJURY SOURCE CONFIDENCE 

(1) Certain 

(2) Probable 

(3) Possible 
(9) Unknown 



DIRECT/INDIRECT INJURY 

(1 ) Direct contact injury 

(2) Indirect contact injury 

(3) Noncontact injury 

(7) Injured, unknown source 



OCCUPANT INJURY CLASSIFICATION 



Aspect of Injury 

(A) Anterior— front 

(B) Bilateral (rib fracture only) 

(C) Central 

(I) Inferior— lower 

(U) Injured, unknown aspect 

(L) Left 

(P) Posterior-back 

(R) Right 

(S) Superior— upper 

(W) Whole region 

Lesion 

(A) Abrasion 
(M) Amputation 
(V) Avulsion 

(B) Bum 

(K) Concussion 

(C) Contusion 
(N) Crush 

(G) Detachment, separation 

(D) Dislocation 



(F) Fracture 

(Z) Fracture end dislocation 

(U) Injured, unknown lesion 

(L) Laceration 

(0) Other 

(P) Perforation, puncture 

(R) Rupture 

(S) Sprain 

(T) Strain 

(E) Total severance, transection 

System/Organ 

(W) All systems in region 

(A) Arteries— veins 

(B) Brain 

(D) Digestive 

(E) Ears 

(0) Eye 
(H) Heart 

(U) Injured, unknown system 

(1) Integumentary 
(J) Joints 

(K) Kidneys 



(L) Liver 

(M) Muscles 

(N) Nervous system 

(P) Pulmonary— lungs 

(R) Respiratory 

(S) Skeletal 

(C) Spinal cord 

(Q) Spleen 

CO Thyroid, other endocrine 

gland 

(V) Vertebrae 

Abbreviated Injury Seals 

(1) Minor injury 

(2) Moderate injury 

(3) Seriour Injury 

(4) Severe injury 

(5) Critical injury 

(6) Maximum (untreatable) 

(7) Injured, unknown severity 



117