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.

Fatal crash between a car operating with automated control systems and a tractor-semitrailer truck.

OBJECTIVE: The objective of this investigation was to evaluate the interaction between an SAE level 2 automated vehicle and the driver, including the limitations imposed by the vehicle on the driver. METHODS: A case study of the first fatal crash involving a vehicle operating with an automated control system was performed using scene evidence, vehicle damage, and recorded data available from the vehicle, and information from both drivers, including experience, phone records, computer systems, and medical information, was reviewed. RESULTS: System performance data downloaded from the car indicated that the driver was operating it using the Traffic-Aware Cruise Control and Autosteer lane-keeping systems, which are automated vehicle control systems within Tesla's Autopilot suite. As the car crested the hill, a tractor trailer began its left turn onto a crossing roadway. Although reconstruction of the crash determined that there was sufficient sight distance for both drivers to see each other and take action, neither responded to the circumstances leading to the collision. Further, based on the speeds of the vehicles and simulations of the truck's path, the car driver had at least 10.4 s to detect the truck and take evasive action. Neither the car driver nor the Autopilot system changed the vehicle's velocity. At the time of the crash, the system performance data indicated that the last driver interaction with the system was 1 min 51 s prior when the cruise control speed was set to 74 mph. The driver was operating the vehicle using the Autopilot system for 37 of the 41 min in the last trip. During this period, the vehicle detected the driver's hands on the steering wheel for a total of 25 s; each time his hands were detected on the wheel was preceded by a visual alert or auditory warning. CONCLUSIONS: The National Transportation Safety Board (NTSB) determined that the probable cause of the Williston, Florida, crash was the truck driver's failure to yield the right of way to the car, combined with the car driver's inattention due to overreliance on vehicle automation, which resulted in the car driver's lack of reaction to the presence of the truck. Contributing to the car driver's overreliance on the vehicle automation was the car's operational design, which permitted the driver's prolonged disengagement from the driving task and his use of the automation in ways inconsistent with guidance and warnings from the manufacturer.

Medical investigation after a motorcoach strikes the rear of a tractor semitrailer parked on the highway; 13 fatal.

OBJECTIVE: The objective of this study was to examine the medical conditions of 2 commercial drivers and the effects of physical barriers to occupant egress in a crash involving a tractor trailer and a motorcoach in order to assess and identify the factors that caused the crash and had a significant effect on occupant extrication. METHODS: Physical evidence from the scene, video evidence, commercial driver information, phone records, toxicology findings, autopsy results, and personal medical information were reviewed. RESULTS: On October 23, 2016, at 5:16 a.m., a motorcoach carrying a driver and 42 passengers struck the rear of a stopped semitrailer occupied by its driver in the center-right lane of Interstate 10 at highway speed outside Palm Springs, California. The motorcoach driver and 12 passengers died; 11 passengers were seriously injured. All traffic had been stopped on I-10 early that morning to allow electrical lines to be strung over the highway. Security camera footage showed that the truck arrived at the end of a traffic queue 2 min before traffic flow resumed. Physical evidence indicated that the truck's parking brake was still engaged at the time of the collision about 2 min later. The truck driver had a body mass index (BMI) between 45.6 and 50 kg/m2, which placed him at very high risk of moderate to severe obstructive sleep apnea; he also inaccurately recalled that he had been stopped for 20-25 min and had placed the vehicle in gear just before the collision. The motorcoach driver was on the return leg of an overnight trip to a casino. Based on his phone records, known driving time, and security camera footage, at the time of the collision he had had 4 h of sleep opportunity in the preceding 35 h. There was no evidence that the motorcoach driver attempted any evasive action before the collision. In addition, postmortem testing revealed a hemoglobin A1C of 11.4%, indicating poorly controlled diabetes; this was apparently undiagnosed prior to the crash. The motorcoach was equipped with a single loading door at the front of the vehicle; it was rendered inoperable by the collision. Emergency egress was initially carried out through the emergency exit windows, but they repeatedly swung shut, impeding passengers' efforts to exit. Emergency responders eventually cut open the bus wall to create a larger means of egress. Overall, it took almost 3 h to extricate the occupants from the vehicle. CONCLUSIONS: The National Transportation Safety Board (NTSB) determined that the probable cause of the accident was the truck driver's falling asleep, most likely due to undiagnosed moderate-to-severe obstructive sleep apnea, and the motorcoach driver's failure to identify the stopped truck as a hazard requiring evasive action, most likely as the result of fatigue. Additional easy-to-use emergency exits would have decreased the time to extricate the occupants.

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.

A study of general aviation accidents involving children in 2011.

BACKGROUND: General aviation accidents involving children are rare, but when they do happen, little is known about the children involved, including their age, restraint status, and injuries. This lack of information is due to the fact that the National Transportation Safety Board (NTSB) did not always collect detailed data about passengers involved in accidents. METHODS: Consequently, in 2011, NTSB investigators collected detailed information on children involved in general aviation accidents and this report provides a summary of the outcomes. RESULTS: During 2011, 19 general aviation accidents and incidents included 39 children who were 14 yr old and younger. In total, 26 children sustained fatal injuries, 2 sustained serious injuries, 5 sustained minor injuries, and 6 sustained no injuries. All of the children less than 2 yr old were restrained in a child restraint system and sustained no injuries in the accidents. DISCUSSION: At least one 4-yr-old child would have benefited from being restrained in a child restraint system. In addition, in two accidents, it was determined that children were likely sharing a single seat belt. This year-long data collection regarding children involved in general aviation accidents provided substantial information concerning age, restraint status, and injuries. In response to issues identified, the NTSB made improvements to its aviation data management system to routinely collect this information for future investigations and enable subsequent evaluation of the data regarding child passengers involved in general aviation accidents over the long term.