Impaired driving: A case report. Pickup truck centerline crossover collision with medium-size bus on U.S. Highway 83, Concan, Texas, United States.

Objective: The objective of this communication is to describe a crash involving an impaired pickup truck driver who crossed the centerline and struck a medium-size bus carrying senior adults restrained with lap-only belts that resulted in 13 fatalities.Methods: Document review of the National Transportation Safety Board investigation was performed. Documents are available at: https://dms.ntsb.gov/pubdms/search/hitlist.cfm?docketID=61581&CFID=2452299&CFTOKEN=9e7f5cd49ac23dc3-47A7BE1A-B81A-1A8F-7B1554A90617B722.Results: Prior to the crash, the erratic movement of the pickup truck being driven by a 20-year-old man was videotaped by witnesses in a following vehicle (https://www.youtube.com/watch?v=jsGsbYTwWbM). The 14.5-min cell phone recording demonstrated the pickup truck swerving repeatedly over the double yellow center line and onto the shoulder. The recording ended before the crash. While rounding a curve in the roadway, the pickup crossed the centerline and struck a medium-size bus with 14 occupants. All but one of the rearmost bus occupants were fatally injured in the collision. The pickup driver survived with serious injuries. Following the crash, toxicology testing found that the pickup truck driver had used marijuana in combination with a prescription benzodiazepine, clonazepam. The bus occupants ranged in age from 64 to 87 years old and all were wearing the available restraints, which included lap-shoulder belts and air bags (both of which deployed) for the driver and front seat passenger. Of the 12 rear passenger seats, 8 were equipped with traveling retractor lap belt assemblies and the 2-person bench seats in the last row on each side of the bus were equipped with manually adjustable lap belt assemblies.Conclusions: The failure of the truck driver to maintain control of his vehicle was due to impairment stemming from his use of marijuana in combination with misuse of a prescribed medication, clonazepam. Following the crash, the pickup driver was sentenced to 55 years in prison. Improved countermeasures including guidance and access to improved roadside testing methods, expanded law enforcement training to detect impaired drivers, enhanced enforcement regarding impairment by combinations of drugs or drugs and alcohol, as well an evaluation and implementation of data-driven strategies are needed to reduce fatalities, injuries, and crashes involving drivers impaired by alcohol and other drugs. The lap belts provided insufficient protection for the passengers seated in the rear of the bus aft of the intrusion zone; standard installation by vehicle manufacturers of lap-shoulder belts on medium-size as well as larger buses (now required) could mitigate the risk of injury in the event of a crash.

Changes in baseline concussion assessment scores following a school bus crash.

OBJECTIVE: The objective of this article is to present concussion assessment data for 30 male athletes prior to and after being involved in a large school bus crash. The athletes on the bus, all male and aged 14-18 years, were participants in their school's concussion management program that included baseline and postinjury testing using Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). METHODS: This case study described changes in concussion assessment scores for 30 male athletes following a primarily frontal school bus crash. Data from the school's concussion management program, including baseline test data and postinjury assessment data, were reviewed. Athletes who required multiple postinjury assessments by the program were identified as having had significant cognitive changes as a result of the bus crash. RESULTS: Twenty-nine of 30 athletes were injured. One had lumbar compression fractures; others had various lacerations, abrasions, contusions, sprains, and nasal fractures. ImPACT data (postcrash) were available for all 30 athletes and 28 had available precrash baseline data. A total of 16 athletes (53.3%) had significant cognitive changes indicated by changes in their concussion assessment scores, some of which took months to improve. CONCLUSION: This case study highlights a unique opportunity to evaluate concussion assessment data from 30 male athletes involved in a high-speed school bus crash. Further, these data provide additional insight into assessing the effectiveness of current school bus occupant protection systems.