20190704 olson19070412
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0HWRB03 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Secondary
CrashAmendedCrash Type
DT4000 (STANDARD CRASH)Reportable
TagsSchool Bus Related
NOActive School ZoneGovernment
Property
Reporting
ThresholdTrailer or TowedWork ZoneLane ClosureHit and RunOn Emergency
Total Killed
00
Total Injured
02
Total Units
01
Time Notified
02:02 PM
Date Notified
07/04/2019
Time Arrived
02:14 PM
Date Arrived
07/04/2019
Crash Time
02:01 PM
Crash Date
07/04/2019
Investigating Officer/Deputy
DEPUTY DARIN JENSEN
Agency Crash NumberPrimary Crash Document #Document Number Override
6VL0HWRB03Additional InformationPHOTOS
Photos ByD. JENSEN
Reconstruction ByDiagram
Description
I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON JULY 4TH, MR. WAS OPERATING A MOTORCYCLE SOUTHBOUND ON HIGHWAY C. MR. SUFFERS FROM EPILEPSY AND SUFFERED
A SEIZURE WHILE DRIVING CAUSING MR. TO LOSE CONTROL OF THE MOTORCYCLE GOING STRAIGHT INTO A DITCH INSTEAD OF
NAVIGATING A CURVE. MR. MOTORCYCLE STRUCK SEVERAL TREES THEN ROLLED DOWN THE HILL TURNING NORTHBOUND. MR.
AND THE PASSENGER, MS. , WERE TRANSPORTED TO , WISCONSIN.
Crash Time 02:01 PM
Crash Date 07/04/2019Wisconsin Motor Vehicle Crash
Form DT4000 1 of 5
This report does not include any CJIS data.
19070412
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0HWRB03 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Structure Type
Y CoordinateX Coordinate
LongitudeLatitudeON CTHC SB
0.24 MI S
OF ORTWIG LN
IN THE TOWN OF COUDERAY
IN SAWYER COUNTY
Location
Special StudyAccess Control
NO CONTROL
Tribal Land
Crash Classification - Jurisdiction
NO SPECIAL JURISDICTION
Crash Classification - Location
PUBLIC PROPERTY
Relation To Trafficway
TRAFFICWAY - ON ROAD
Animal Type
Weather Condition(s)
CLEAR
Environment Factor(s)
NONE
Roadway Factor(s)
NONE
Road Surface Condition(s)
DRY
Light Condition
DAYLIGHT
Manner of Collision
NO COLLISION W/VEHICLE IN TRANSPORT
First Harmful Event Location
ROADSIDE
First Harmful Event
DITCH
Crash Scene
Intersection Type
NOT AN INTERSECTION
Junction Location
NON-JUNCTION
Within Interchange Area
NO
Truck Bus or HazMat
NO
Road Grade
LEVEL
Road Curvature
CURVE RIGHT
Surface Type
BLACKTOP (BITUMINOUS)
Traffic Control Inoperative/Missing
NO
Traffic Control
NO CONTROL
Traffic Way
TWO-WAY, NOT DIVIDED
Emergency Motor Vehicle Use
NOT APPLICABLE
Special Function
NO SPECIAL FUNCTION
Most Harmful Event: Collision With
TREE
Total Lanes
2
Speed Limit
45
Pre CrashTire
Mark
Direction Of Travel
SOUTHBOUND
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
2
Operating As EndorsementsVehicle Type
MOTORCYCLE01 Unit Type
MOTORCYCLE
Vehicle Operating As Classification
M CLASS
Unit Status
IN TRANSIT
Unit Summary
UNITExtent Of Damage
FUNCTIONAL DAMAGE
Vehicle Damage
12--FRONT
Initial Contact Point
12--FRONT
Bus Use
NOT A BUS
Body Style
MC - MOTORCYCLE
Color
GRY - GRAY
Model
FLHXS STRE
Year
2014
Make
HARLEY DAVIDSON
Vehicle Identification Number
60640101 Country of Issuance
UNITED STATES
St
WI
Plate Type
CYC - CYCLE
License Plate Number
VEHICLEUNIT Vehicle
Crash Time 02:01 PM
Crash Date 07/04/2019Wisconsin Motor Vehicle Crash
Form DT4000 2 of 5
This report does not include any CJIS data.
19070412
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0HWRB03 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Owner Address
ALTOONA, WI 54720 , US
Owner Name01Driver DistractionsNOT DISTRACTED
01Driver Actions
OTHER CONTRIBUTING ACTION
Driver Prior Action Other
Vehicle Factors
NOT APPLICABLE
What Driver Was Doing
NEGOTIATING CURVE
Vehicle Removed ByTowed Due To Damage
TOWED BUT NOT DUE TO DISABLING DAMAG
UNITVEHICLE Sequence Of Events
Event
MOTOR VEH IN TRANSPORT01
Event
02Event
03Event
04IndividualInsurance Company
PROGRESSIVE-ADVANCED-INSURANCE-CO
Policy Holder
UNITInjury
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT APPLICABLE
Airbag
NOT APPLICABLE
Injury Severity
SUSPECTED SERIOUS INJUR00101 Tint Compliance
YES
Eye Protection
YES: WORN
Helmet Compliance
UNKNOWN
Helmet Use
NO
Seat Position
1--FRONT SEAT-LEFT SIDE (DRIVER/MOTORCY
Protective Gear
NONE
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
ALTOONA, WI 54720 , US
Race
WHITE
Date of Birth
05/01/
Sex
MALE
Citations Issued
0
Driver
ITEquipment
Individual
UNINDIVIDUALCrash Time 02:01 PM
Crash Date 07/04/2019Wisconsin Motor Vehicle Crash
Form DT4000 3 of 5
This report does not include any CJIS data.
19070412
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0HWRB03 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
CONFUSED OR DISORIENTED (NON LUCID)
Drug Type
00101Drug Test ResultsDrug Test TypeDrug Test Given
TEST NOT GIVEN
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
TEST NOT GIVEN
Suspected Drug Use
NO
Suspected Alcohol Use
NO
Action Other
Action
To/From SchoolLocationPrior ActionStriking Unit #
Time of DeathDate of DeathHospital
LAKEVIEW MED CTR
EMS Run #EMS Agency Identifier
6000954
Medical Transport
EMS GROUND
UNIT Non Motorist
INDIVIDUALInjury
To/From SchoolLocationPrior ActionStriking Unit #
Time of DeathDate of DeathHospital
LAKEVIEW MED CTR
EMS Run #EMS Agency Identifier
6000954
Medical Transport
EMS GROUND
Trapped/Extricated
NOT TRAPPED
Ejection Path
NOT EJECTED/NOT APPLICABL
Ejected
NOT APPLICABLE
Airbag
NOT APPLICABLE
Injury Severity
SUSPECTED MINOR INJURY00201 Tint Compliance
YES
Eye Protection
YES: WORN
Helmet Compliance
UNKNOWN
Helmet Use
NO
Seat Position
4--SECOND SEAT-LEFT SIDE(MOTORCYCLE/BI
Protective Gear
NONE
On Duty Crash
Driver License Number
STATE: WISCONSIN COUNTRY: UNITED STATES
Address
ALTOONA, WI 54720 , US
Race
WHITE
Date of Birth
10/07/
Sex
FEMALE
Citations Issued
0
Passenger
ITEquipment
Non Motorist
Individual
UNINDIVIDUALCrash Time 02:01 PM
Crash Date 07/04/2019Wisconsin Motor Vehicle Crash
Form DT4000 4 of 5
This report does not include any CJIS data.
19070412
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL0HWRB03 WISCONSIN MOTOR VEHICLE
CRASH REPORT
Drug & Alcohol
Individual Condition
APPEARED NORMAL
Drug Type
00201Drug Test ResultsDrug Test TypeDrug Test Given
TEST NOT GIVEN
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
TEST NOT GIVEN
Suspected Drug Use
NO
Suspected Alcohol Use
NO
Action Other
Action
UNITINDIVIDUALCrash Time 02:01 PM
Crash Date 07/04/2019Wisconsin Motor Vehicle Crash
Form DT4000 5 of 5
This report does not include any CJIS data.