HomeMy Public PortalAboutPRR 18-2665COHEN
9414 7266 9904 2106 1250 57
Monday, July 2, 2018
Gulf Stream Police Department
ATTN: Records Department
246 Sea Road
Delray Beach, FL 33483
Our Client: Steven L. Scesa
DOA: 09/25/2016
VSPU Gase No.: 161944
Crash Report No.: 84212026
Dear Records Custodian:
Our office represents Steven L. Scesa regarding injuries he sustained in the above
referenced crash.
Please provide our office with complete copies of all documents in your possession
related to the subject crash, including but not limited to:
1. A complete copy of the crash report;
2. All written and recorded witness statements;
3. Scene investigation photographs;
4. CAD report;
5. Dash Cam or Body Cam videos;
6. All radio transmissions, communications, and 911 calls; and
7. Copies of all property / evidence receipts.
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Sincerely,
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TATUM WHIDDON
twhiddon@cohenmilstein.com
Paralegal
tw
COHEN MILSTEIN SELLERS & TOLL PLLC . 2925 PGA Boulevard • Suite 200 • Palm Beach Gardens, FL 33410
T 561.515.1400 • cohenmilstein.com
TOWN OF GULF STREAM
PALM BEACH COUNTY, FLORIDA
Delivered via e-mail
August 29, 2018
Tatum Whiddon [mail to: twhiddon(i4cohenmilstein. com]
Re: GS #2665 (Crash Report No. 84212026)
Please provide our office with complete copies of all documents in your possession related to
the subject crash, including but not limited to:
1. A complete copy of the crash report;
2. All written and recorded witness statements;
3. Scene investigation photographs;
4. CAD report;
S. Dash Cam or Body Cam videos;
6. All radio transmissions, communications and 911 calls; and
7. Copies of all property/evidence receipts.
Dear Tatum Whiddon [mail to: twhiddon(acohenmilstein.com]:
The Town of Gulf Stream has received your public records request dated July 2, 2018. You should
be able to view your original request and response at the following link:
htlp://www2.gulf-stream.org/weblink/O/doc/I 19920/Paeg l.aspx
We consider this request closed.
Sincerely,
tr� ko'*-�*(
As requested by Rita Taylor
Town Clerk, Custodian of the Records
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P a g e 1 o f 2
N O N C R I M I N A L O F F E N S E R E P O R T
I n c i d e n t T y p e : T R A F F I C C R A S H
L o c a t i o n o f I n c i d e n t : 4 4 0 0 N O C E A N B L V D
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H o m e A d d r e s s :
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R a c e :
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M I C H A E L M A D N I C K
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Z o n e : 4
P r o c e s s e d B y : O F C R W I L S O N
O t h e r U n i t s N o t i f i e d : O F C B O D O N N E L L
O f f i c e r K i l l e d / A s s a u l t e d : N O
V I C T I M
S e x : M A L E
C e l l P h o n e : ( 3 1 2 ) 3 7 1 - 5 2 9 7
I n j u r y : Y E S
R E P O R T E D B Y
W H I T E S e x : M A L E
7 2 9 L A K E S H O R E D R
D E L R A Y B E A C H F L 3 3 4 4 5 C e l l P h o n e : ( 5 6 1 ) 8 4 3 - 5 7 9 3
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F R E D E R I C K B R A D L E Y D E T W I L E R
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0 2 / 2 4 / 1 9 8 6
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D E L R A Y B E A C H F L 3 3 4 4 4
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G U L F S T R E A M F L 3 3 4 8 3
T y p e o f P r e m i s e s :
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T i m e o f C a l l :
1 0 2 8
T i m e o f A r r i v a l :
1 0 2 8
T i m e C o m p l e t e d :
1 2 4 5
O f f i c e r I n j u r e d :
N O
D a t e / T i m e R e p o r t e d :
0 9 / 2 5 / 2 0 1 6 1 0 : 2 8
O c c u r r e d F r o m :
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O F C . R A N D A L L W I L S O N
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3 0 0 S . A U S T R A L I A N A V E
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H o s p i t a l C o n v e y a n c e :
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R a c e :
H o m e A d d r e s s :
N a m e :
J R
R a c e :
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O c c u p a t i o n :
H o m e A d d r e s s :
M I C H A E L M A D N I C K
C o m p l a i n t N u m b e r : 1 6 - 1 9 4 4
Z o n e : 4
P r o c e s s e d B y : O F C R W I L S O N
O t h e r U n i t s N o t i f i e d : O F C B O D O N N E L L
O f f i c e r K i l l e d / A s s a u l t e d : N O
V I C T I M
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C e l l P h o n e : ( 3 1 2 ) 3 7 1 - 5 2 9 7
I n j u r y : Y E S
R E P O R T E D B Y
W H I T E S e x : M A L E
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D E L R A Y B E A C H F L 3 3 4 4 5 C e l l P h o n e : ( 5 6 1 ) 8 4 3 - 5 7 9 3
K N O W N S U S P E C T
F R E D E R I C K B R A D L E Y D E T W I L E R
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2 0 2 5 L A V E R S C I R C L E 4 0 1
D E L R A Y B E A C H F L 3 3 4 4 4
I n j u r y :
N O
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B u i l d : :
T H I N
C o m p l e x i o n :
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C e l l P h o n e : ( 2 4 8 ) 9 9 0 - 1 5 1 6
D r i v e r ' s L i c e n s e : D 3 4 6 2 6 1 0 9 8 1 4 3 M I
H a i r C o l o r :
B R O
H a i r L e n g t h :
S H O R T
H a i r S t y l e :
S T R A I G H T
F a c i a l H a i r :
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Yage 2 of 2
INCIDENT SUMMARY
Complaint Number: 16-1944
THE VICTIM(BICYCLIST) WAS RIDING HIS BICYCLE NORTH IN THE 4400 BLOCK OF N OCEAN BLVD. HE WAS
STAYING ON THE RIGHT SHOULDER OF THE ROADWAY. THE SUSPECT(DRIVER OF V-1) WAS DRIVING
NORTHBOUND IN THE 4400 BLOCK OF N OCEAN BLVD. THE DRIVER OF V-1 INADVERTANTLY DROVE TO THE
TO THE RIGHT SIDE OF THE ROADWAY AND STRUCK THE BICYCLIST IN THE REAR TIRE. THIS KNOCKED THE
BICYCLIST OFF HIS BICYCLE INTO THE GRASSY SWALE AREA. V-1. THE POINT OF IMPACT WAS THE FAR
RIGHT SIDE OF V -1'S BUMPER AND RIGHT FRONT QUARTER PANEL.
THE BICYCLIST REQUESTED FIRE RESCUE FOR POSSIBLE INJURIES. HE WAS SUBSEQUENTLY TRANSPORTED
TO BETHESDA HOSPITAL BY BOYNTON BEACH FD FOR A CHECKUP. THE DRIVER OF V-1 WAS ON SCENE AND
COMFORTING THE BICYCLIST WHEN I ARRIVED ON SCENE. SEE BOYNTON BEACH FD RUN #1610349. THIS RUN
NUMBER WAS PROVIDED BY BOYNTON FIRE PARAMEDIC PERSON.
THE BICYCLE HAD MAJOR DAMAGE (INOPERABLE) AND V-1 HAD MINOR DAMAGE. THE DRIVER OF V-1 WAS
ISSUED NUMEROUS CITATIONS AND LISTED AT FAULT IN THE ACCIDENT REPORT. SEE ACCIDENT REPORT
NUMBER/DHSMV NUMBER 84212026.
FLORIDA TRAFFIC CRASH REPORT
LONG FORM ® SHORT FORM UPDATE
(Shaded Areas)
MAIL TO: DEPARTMENT OF HIGHWAY SAFETY & MOTOR VEHICLES
TRAFFIC CRASH RECORDS, NEIL KIRKMAN BUILDING
TALLAHASSEE, FL 32399-0537
TOTAL # OF VEHICLE SECTION(S)
TOTAL # OF PERSON SECTION(S)
TOTAL # OF NARRATIVE SECTION(S)
2
CRASH DATE TIME OF CRASH DATE OF REPORT REPORTING AGENCY CASE NUMBER HSMV CRASH REPORT NUMBER
09/25/2016 10:28 AM 09/25/2016 161944 84212026
CRASH IDENTIFIERS
COUNTY CODE CITY CODE COUNTY OF CRASH PLACE OR CITY OF CRASH CHECK IF WITHIN TIME REPORTED TIME DISPATCHED
06 44 'PALM BEACH GULF STREAM CITY LIMITS 10:28 AM 10:28 AM
TIME ON SCENE TIME CLEARED SCENE CHECK IF REASON (If Investigation NOT Complete) Notified By: 1 Motorist
X 2 Law Enforcement
%28 AM 12:45 PM COMPLETED
ROADWAY INFORMATION (CHOOSE ONLY I OF 4 OPTIONS)
CRASH OCCURRED ON STREET, ROAD, HIGHWAYAT STREET ADDRESS # AT LATITUDE AND LONGITUDE
®
S.R.A1A(N OCEAN BLVD) 4400
FEET MILES N S E W AT/ FROM INTERSECTION WITH STREET, ROAD, HIGHWAY O OR FROM MILEPOST#
50.00 X 1:1 [:] 1:10 COUNTY RD
Road System Identifier 7 Forest Road Type of Shoulder Type of Intersection s Traffic circle
1 Interstate 4 County 8 Private Roadway 1 Not at Intersection 6 Roundabout
1 Paved
2 Unpaved
111 2 U.S. 5 Local 9 Parking Lot 2 Four -Way Intersection 7Five-Point, or More
3 T-Intersectionp P 77 Other, Explain in Narrative
3 State 6Turn ike/Toll 77 Other, Ex Iain in
2 3 Curb 1
Narrative 4 Y -Intersection
INFORMATION (CHECK IF PICTURES TAKEN)
Light Condition Weather Condition Roadway Surface Condition School Bus Related Manner of Collision/Impact
1 Daylight 5 Dark -Not Lighted 4 Fog, rn Smoke 5 Oil 1 No
2 Dusk 6 Dark -Unknown 5 Sleet/Hai 6 Mud, Dirt, Gravel 2 Yes, School Bus 4 Sideswipe, Same Direction
Lighting Freezing Rain 7 Sand Directly Involved 5 Sideswipe, Opposite Direction
[:21
3 Dawn
111 4 Dark -Lighted 77 Other, Explain in 6 Blowing Sand, Soil, 2 8 Water (standing/ 1 3 Yes, School Bus 1 6 Rear to Side
Narrative Dirt moving) Indirectly Involved 1 Front to Rear 7 Rear to Rear
1 Clear 7 Severe Crosswinds 1 Dry 77 Other, Explain 77 Other, Explain in Narrative
88 Unknown Front to Front
2 Cloud 2 Wet2
3 Rainy 77 Other, Explain in 41ce/Frost in Narrative 3 Angle 88 Unknown
Narrative 88 Unknown
First Harmful Event Non -Collision Collision Non -Fixed Object Collision with Fixed Object
First Harmful Event
1 Overturn/Rollover 30 Pedestrian 19 Impact Attenuator/Crash 30 Concrete Traffic Barrier
Location 1 On Roadway
2 Fire/Explosion 11 Pedalcycle Cushion 31 Other Traffic Barrier
11 3 Immersion 12 Railway Vehicle (train, 20 Bridge Overhead Structure 32 Tree (standing)
2 Off Roadway
4 Jackknife engine) 21 Bridge Pier or Support 33 Utility Pole/Light Support
3 Shoulder
5 Cargo/Equipment 13 Animal 22 Bridge Rail 34 Traffic Sign Support
4 Median
First Harmful Event Loss or Shlft 14 Motor Vehicle in Transport 23 Culvert 35 Traffic Signal Support
1 6 Gore
within Interchange 6 Fell/Jumped From 1S Parked Motor Vehicle 24 Curb 36 Other Post, Pole or Support
7 Separator
Motor Vehicle 16 Work Zone/Maintenance 25 Ditch 37 Fence
I No 7 Thrown or Falling Equipment 26 Embankment 38 Mailbox
2 Yes Object 17 Struck By Falling, Shifting 27 Guardrail Face 39 Other Fixed Object (wall,
81n Parking Lane or Zone
9 Outside Right-of-way
30 Roadside
1 88 Unknown 8 Ran into Water/Canal Cargo 28 Guardrail End building, tunnel, etc.)
88 Unknown
9 Other Non -Collision 18 Other Non -Fixed Object 29 Cable Barrier
First Harmful Event Relation to
Contributing Circumstances: Road
Contributing Circumstances:
Junction
5 Railway Grade Crossing
❑ 9 Worn, Travel -Polished Surface
10 Road Surface Condition (wet,
icy,
11-1
Environment
14 Entrance/Exit Ramp
1 15 Crossover - Related
snow, slush, etc.)
11 Obstruction in Roadway
1 Non -Junction 16 Shared -Use Path or Trail
2 Intersection 17 Acceleration/Deceleration Lane
1 None 12 Debris
4 Work Zone (construction/ 13 Traffic Control Device
Inoperative, Missing or Obscured
1
1 None 5 Animal(s) in Roadway
3lntersection-Related 18 Through Roadway
4 Driveway/Alley Access 77 Other, Explain in Narrative
/
maintenance utility) 14 Non -Highway Work
6 Shoulders (none, low, soft, high) 77 Other, Explain in Narrative
2 Weather Conditions 77 Other, Explain in
3 Physical Obstruction(s) Narrative
Related 88 Unknown
7 Rut, Holes, Bumps 88 Unknown
4 Glare 88 Unknown
Work Zone Related Crash in Work Zone Type of Work Zone Workers in Work Zone Law Enforcement in
1 No 1 Before the First Work Zone 1 Lane Closure 1 No Work Zone
gn 2 Lane Shift/Crossover 2 Yes
2 Yes Warning Si1 No
88
❑ ❑ ❑
88 Unknown 2 Advance Warning Area 3 Work on Shoulder or Median Unknown 2 Officer Present
1 3 Transition Area 4 Intermittent or Moving Work 3 Law Enforcement Vehicle
4 Activity Area 77 Other, Explain in Narrative Only Present
5 Termination Area
WITNESSES
NAME ADDRESS CITY & STATE ZIP CODE
MICHAEL MADNICK 729 LAKESHORE DR DELRAY BEACH FL 33444
NAME ADDRESS CITY & STATE ZIP CODE
NAME ADDRESS CITY & STATE ZIP CODE
NON VEHICLE PROPERTYDAMAGE
VEHICLE # PERSON # PROPERTY DAMAGE — OTHER THAN VEHICLE EST. AMOUNT OWNER'S NAMED (Check if Business) ADDRESS CITY & STATE ZIP CODE
VEHICLE #
PERSON #
PROPERTY DAMAGE —OTHER THAN VEHICLE
EST. AMOUNT
OWNER'S NAMED (Check if Business) ADDRESS CITY & STATE ZIP CODE
J
HSMV 90010 S (E) (rev 10/10) Page 1 of 6
REPORTING AGENCY CASE NUMBER
HSMV CRASH REPORT NUMBER
1 161944
84212026
VEHICLE LICENSE NUMBER
ST10�ATE REGISTRATION EXPIRES
Check if Permanent
VIN
1 Vehicle in Transport
2 Parked Motor Vehicle
1
DCF -4061
MI 02/24/2017
Registration
5J6TF2H56CL011279
3WorkingVehicle
Hit and Run YEAR MAKE MODEL STYLE COLOR DAMAGE: EST. AMOUNT
1 No 1 Disabling 4 Minor
zves 2Functional ss Unknown �
] �RO
1 2012 HONDA ROSSTOUR GRY
1000known3 None
INSURANCE COMPANY FINSURPAN(E POLICY NUMBER Towed due VEHICLE REMOVED BY IRotation
to Damage: Owner Request
[:�]
OAKLAND INS. CO. 103030 1No 2Yes
PD Driver 3
Other, Ex Iain in Narrative
NAME OF VEHICLE OWNER ❑ (Check if Business) CURRENT ADDRESS CITY & STATE ZIP CODE
FREDERICK BRADLEY DETWILER
2025 LAVERS CIRCLE APT 401 DELRAY BEACH FL 33445
Trailer #
LICENSE NUMBER
STATE
REGISTRATION EXPIRES Check
if Permanent
VIN
YEAR
MAKE
LENGTH
AXLES
Registration
❑
1
Trailer #
LICENSE NUMBER
STATE
REGISTRATION EXPIRES Check
if Permanent
VIN
YEAR
MAKE
LENGTH
AXLES
Registration
❑
2
VEHICLE N S E W Off -Road Unknown ON STREET, ROAD, HIGHWAY
AT EST. SPEED POSTED
SPEED
TOTAL LANES
TRAVELING
®❑
�35
S.R. A1A 4400 BLOCK N OCEAN BLVD)
35
02
HAZ. MAT. RELEASED HAZ. MAT. PLACARD HAZ. MAT. NUMBER HAZ. MAT. CLASS
1 N 1No
Area of Initial Impact � Most Damaged Area
2Yes 2Yes
1 88 Unknown 1
88 Unknown ❑ ❑
O I 3 I+ s e 18 Undercarriage 18
MOTOR CARRIER NAME US DOT NUMBER
s e r e 19 Overturn 19 ,
/ \ 20 Windshield 20 / \
1 13 12 11 b 1 9 21 Trailer 21 a 13 12 I1 le 9
MOTOR CARRIER ADDRESS CITY & STATE ZIP CODE
PHONE NUMBER
Vehicle Body Type Trafficway Commercial Motor Vehicle Configuration
15 Low Speed Vehicle ❑1 Two -Way, Not Divided 1 Vehicle 10,000 lbs or less Placarded 8 Tractor/Triple
2 Two Not Divided,
16 (Sport) Utility Vehicle -Way, with a for Hazardous Materials 9 Truck more than 10,000 lbs (4,536
17 Cargo Van (10,000 lbs 1 Continuous Left Turn Lane 2 Single -Unit Truck (2 -axle and GVWR kg), Cannot Classi
1 kg) less) 3 Two -Way, Divided, Unprotected
(4,536 or more than 10,000 lbs (4,536 kg)) SO Bus/Large Van seats for 9-15
1 Passenger Car 18 Motor Coach (painted >4 feet) Median 3 Single -Unit Truck (3 or more axles) occupants, including driver)
2 Passenger Van 19 Other Light Trucks (10,000 lbs 4 Two -Way, Divided, Positive Median 4 Truck Pulling Trailer(s� 11 Bus (seats for more than 15
3 Pickup (4,536 kg) or less) Barrier 5 Truck Tractor bobtail occupants, including driver)
20 Medium/Heavy Trucks more than 5 One -Way Trafficway - 6 Truck Tractor/Semi-Trailer 77 Other, Explain in Narrative
7 Motor Home vy ( 88 Unknown � Trailer Typ@ 7 Truck Tractor/Double Truck 88 Unknown
8 Bus 10,000 lbs 14,536 kg))
11 Motorcycle 21 Farm Labor Vehicle TRAILER 1 TRAILER 2 1 Single Semi Trailer Cargo Body Type
12 Moped 77 Other, Explain in Narrative 2 Tandem Semi Trailer 8 Pole Trailer 13 Intermodal
13 All Terrain Vehicle (ATV) 88 Unknown 3 Tank Trailer 9 Towed Vehicle 3 Van/Enclosed Box Container Chassis
4 Saddle Mount/Trailer 10 Auto Transport11 4 Hopper 14 Vehicle Towing
Comm/Non-Commercial 5 Boat Trailer 77 Other, Explain in 5 Pole -Trailer Another Vehicle
i Interstate Carrier 6 Utility Trailer Narrative 6 Cargo Tank 15 Not Applicable
Carrier 88 Unknown 1 No Cargo 7 Flatbed
2 Intrastate 7 House Trailer vehicle 10,000 lbs
❑
3 Not in Commerce/Government 2 Bus 8 Dump (4,536kg) or less not
4 Not in Commerce/Other Truck 110,000 lbs (4,536 kg) or less 9 Concrete Mixer displaying HM placard)
Comm 10 Auto Transport
210,001-26,000 lbs 4,536-11,793 kg) 77 Other, Explain in
Most Harmful Event Non -Collision GVWR/GCWR 3 More than 26,000 lbs (11,793 kg) 11 Garbage/Refuse Narrative
1 Overturn/Rollover 4 Not Applicable 12 Log 88 Unknown
2 Fire/Explosion
3 Immersion Collision with Non -Fixed Object Collision Fixed Object 29 Cable Barrier Emergency
41ackknife 10 Pedestrian30 Concrete Traffic Barrier
11 5 Cargo/Equipment Loss or Shift 19 Impact Attenuator/Crash Cushion
11 Pedalcycle 31 Other Traffic Barrier Vehicle Use
20 Bridge Overhead Structure
6 Fell/Jumped From Motor Vehicle 12 Railway Vehicle (train, engine) 21 Bridge Pier or Support 32 Tree (standing)
Sequence of Events 7 Thrown or Falling Object 13 Animal 33 Utili Pole/Light Su ort
8 Ran into Water/ Canal 22 Bridge Rail tYPP
14 Motor Vehicle in Transport 34 Traffic Sign Support
23 Culvert
9 Other Non -Collision 15 Parked Motor Vehicle 24 Curb 35 Traffic Signal Support 1[40-06
Sequence of Events only]16 Work Zone/Maintenance 25 Ditch 36 Other Post, Pole, or Support 1No
n42
40 Equipment Failure (blown tire, Equipment 26 Embankment 37 Fence 2Yes
3rd brake failure, etc.) 17 Struck By Falling, Shifting Cargo or 27 Guardrail Face 38 Mailbox 88 Unknown
4th 41 Separation of Units Anything Set in Motion by Motor 28 Guardrail End 39 Other Fixed Object (wall,
43 Ran Off Roadway, Left 18 Other Non -fixed Object
❑ ❑ 42 Ran Off Roadway, Right Vehicle building, tunnel, etc.)
44 cross Median Vehicle Maneuver Action Traffic Control Device For Vehicle Defects
45 Cross Centerline 1 Straight Ahead
46 Downhill Runaway 13 Stopped in Traffic This Vehicle
Roadway Grade ❑ 3 Turning Left 14 Slowing
1 Level RoadwayAlignment 15 Negotiating a Curve 8 Flashing Signal 1
9
16 5 Turning Right
2 Hillcrest 16 Leaving Traffic Lane 1 12 Suspension
1 Strai ht 6 Changing Lanes 9 Railway Crossing
3 Uphill g 17 Entering Traffic Lane Device 1 None 13 Wheels
El
8 Parked
4 Downhill 2 Curve Right SO Making U -Turn 77 Other, Explain in 1 No Controls 10 Person (including 2 Brakes 14 Windows/
5 Sag (bottom) 1 3 Curve Left 11 Overtaking/ Narrative 4 School Zone Sign/ Flagman, Officer, 3 Tires Windshield
❑
Passing 88 Unknown Device Guard, etc.) 4 Lights (head, 15 Mirrors
5 Traffic Control 13 Warning Sign signal, tail) 16 Truck Coupling/
Special Function 1 No Special Function 9 Ambulance 14 Intercity Bus Signal 77 Other, Explain in 6 Steering Trailer Hitch/
2 Farm Vehicle 10 Fire Truck 15 Charter/Tour Bus 6 Stop Sign Narrative 7 Wipers Safety Chains
of Motor Vehicle 3 Police 11 Farm Labor Transport 16 Shuttle Bus 7 Yield Sign 88 Unknown 9 Exhaust System 77 Other, Explain in
1 7 Taxi 12 School Bus 17 Farm Labor Bus 10 Body, Doors Narrative
8 Military 13 Transit/Commuter Bus 88 Unknown 11 Power Train 88 Unknown
VIOLATIONS
PERSON # NAME OF VIOLATOR FL STATUTE NUMBER CHARGE CITATION NUMBER
1 FREDERICK BRADLEY DETWILER 316.1925(1) CARELESS DRIVING A1PKX2P
PERSON #
NAME OF VIOLATOR
FL STATUTE NUMBER
CHARGE
CITATION NUMBER
1
FREDERICK BRADLEY DETWILER
322.15(1)
FAILED TO EXHIBIT D.L. UPON COMMAND
Al PKX3P
PERSON #
NAME OF VIOLATOR
FL STATUTE NUMBER
CHARGE
CITATION NUMBER
1
FREDERICK BRADLEY DETWILER
316.066(3)(C)
DID NOT SUPPLY CURRENT INS CARD
Al PKX5P
HSMV 90010 S (V) (rev 10/10) Page ? of 6
REPORTING AGENCY CASE NUMBER
HSMV CRASH REPORT NUMBER
1 161944
84212026
11D ver VEHICLE# NAME PHONE NUMBER Check if
n-Motoristsenger � Recommend
1 FREDERICK BRADLEY DETWILER 248-990-1516 Driver Re-exam
CURRENT ADDRESS (Number and Street) CITY & STATE ZIP CODE
2025 LAVERS CIRCLE APT 401 DELRAY BEACH FL 33445
DATE OF BIRTH SEX ]DRIVER LICENSE NUMBER ��SrATE EXPIRES INJURYSEVERITY(INJ)
1Mle 1None 4lncapacitating
2 Female 261098143 02!28/2020 2 Possible 5 Fatal within 30 dys) 1
02/24/1986
88 Unknown 3 Non-incapacitating6 Non-1(raffic Fatality
DRIVER
DL Type Required Endorsements Driver's Actions at Time of Crash
IA 2B 3C tat 26 Ran off Roadway 3rd Condition At
1 Yes 1 No Contributing Action 27 Disregarded other Traffic
4 D/Chauffeur 2 No 2 Operated MV in Careless or Sing Time of Crash
5 E/Operator 3 No Re Endorsement 8
5 6 E O er -Rest 3 9' Negligent Manner 28 Disregarded Other Road 1 Apparently Normal
E2 1 3
3 Failed to Yield Right -of- Way Markings 3 Asleep or Fatigued
7 None 4Improper Backing 29 Over-Correcting/Over- S III (sick) or Fainted
Driver Distracted By 4 Other Inside the Vehicle 2nd 6 Improper Turn Steering 4th 6 Seizure, Epilepsy, Blackout
in narrative) 10 Followed too Close! 7 Physical) Im aired
1 Not Distracted (explain y 30 Swerved or Avoided :Due y P
2 Electronic Communication 5 External Distraction 11 Ran Red Light to Wind, Slippery Surface, 8 Emotional (depression,
1 Devices (cell phone, etc.) (outside the vehicle, 12 Drove too Fast for Conditions MV, Object, Non -Motorist in angry, disturbed, etc.)
C ❑
3 Other Electronic Device explain in narrative) 13 Ran Stop Sign Roadway, etc. 9 Under the Influence of
6 Texting 15 Improper Passin
(navigation device, DVD player) g 31 Operated MV in Erratic, Medications/Drugs/Alcohol
7 Inattentive 17 Exceeded Posted Speed Reckless or Aggressive Manner 77 Other, Explain in Narrative
Driver Vision Obstructions 88 Unknown 21 Wrong Side or Wrong Way 77 Other Contributing Action 88 Unknown
25 Failed to Keep in Proper Lane
1 Vision Not Obscured 5 Load on Vehicle 9 Smoke
DRIVER • , PASSENGER
2 Inclement Weather 6 Building/Fixed Object 10 Glare
3 Parked/Stopped Vehicle 7 Signs/Billboards 77 All Other, Explain
4 Trees/Crops/Bushes 8 Fog in Narrative Helmet Use (HU) Eye Protection (EP)Restraint Systems
• • • • 1 DOT -Compliant 1 Yes (RS)
Motorcycle Helmet 2 No 3
Motor Vehicle Seating Position: LOCATION: SEAT ROW OTHER 2 Other Helmet 3 Not Applicable 1 Not Applicable
3 No Helmet1:1 2 None U sed -Motor Vehicle Occupant
Seat Row Other (LOC) 3 Shoulder and Lap Belt Used
1 1 Air Bag Deployed
5 Deployed -Other 4 Shoulder Belt Only Used
1 Left 1 Front 1 Not ApplicableY
2 Middle 2 Second 2 Sleeper Section of Truck Cab (ABD) (knee, air belt, etc.) 5 Lap Belt Only Used
3 Right 3 Third 3 Other Enclosed Cargo Area Ejection (EJECT) 6 Deployed- 6 Restraint Used -Type Unknown
77 Other 4 Fourth 4 Unenclosed Cargo Area 1 Not Ejected ❑ 1 Not Applicable Combination 7 Child Restraint System - Forward Facing
(explain in 77 Other Row 5 Trailing Unit 2 E'ected, Totally 2 Not Deployed 7 Deployed -Curtain 8 Child Restraint System - Rear Facing
3 Deployed -Front 88 Deployment 9 Booster Seat
narrative) 88 Unknown 6 Riding on Motor Vehicle Exterior (non- 3 Ejected, Partially 2
1 4 Deployed -Side Unknown 10 Child Restraint Type Unknown
88 Unknown trailing unit) 4 Not Applicable
88 Unknown 88 Unknown 77 Other, Explain in Narrative
NON -MOTORIST
Non -Motorist Description Non -Motorist Location At Time of Crash Action Prior to Crash
1 Pedestrian 1 Intersection - Marked Crosswalk 8 Sidewalk 1:15 Walking/Cycling on Sidewalk
2 Other Pedestrian (wheelchair, person in a 2 Intersection - Unmarked Crosswalk 9 Median/Crossing Island 6 In Roadway -- Other (working,
building, skater, pedestrian conveyance, etc.) 3Intersection–Other 10 Driveway Access playing, etc.)3
Bicyclist 4 Midblock - Marked Crosswalk 11 Shared -Use Path or Trail 7 Adjacent to Roadway (e.g.,
1-14
Other Cyclist 5 Travel Lane -Other Location 12 Non-Trafflcway Area 1 Crossing Roadway shoulder, median)
S Occupant of Motor Vehicle Not in Transport 6 Bitycle Lane 77 Other, Explain in Narrative 2 Waiting to Cross Roadway 8 Going to or from School (K-12)
(parked, etc.) 7 Shoulder/Roadside 88 Unknown 3 Walking/Cyclmg Along 9 Working in Trafficway
6 Occupant of a Non -Motor Vehicle Non -Motorist Actions/Circumstances Roadway with Traffic (in or (incident response)
Transportation Device adjacent to travel lane) 10 None
7 Unknown Type of Non -Motorist 1 No Improper Action 4 Walking/Cycling Along 77 Other, Explain in Narrative
2 Dart/Dash Roadway Against Traffic (in 88 Unknown
Safety Equipment tst 3 Failure to Yield Right -of -Way
or adjacent to travel lane)
1 None S Lighting 4 Failure to Obey Traffic Signs,
2 Helmet 6 Not ApplicableSignals, or Officer 7 Entering/Exiting Parked/Standing 10 Improper Turn/Merge
3 Protective Pads Used 77 Other, Explain 5 In Roadway Improper! (standing, Vehicle 21 Improper Passing
(elbows, knees, shins, etc.) in Narrative 2nd lying, working, 8Inattentive eating, etc) 12 Wrong -Way Riding or Walking
❑
playing Italking,
4 Reflective Clothing Qacket, 88 Unknown 6 Disabled Vehicle Related (working9 Not Visible dark cllothing, no 77 Other, Explain in Narrative
backpack, etc.) on, pushing, leaving/approaching) lighting, etc.) 88 Unknown
ALCOHOL/DRUG/EMS
SUSPECTED ALCOHOL TESTED: ALCOHOLTESTTYPE: ALCOHOL gpC SUSPECTED DRUG TESTED: DRUG TEST TYPE: DRUG TEST RESULT:
ALCOHOL USE: 1 Test Not Given❑ 1 Blood TEST RESULT: DRUG USE: 1 Test Not Given ❑ 1 Blood 1 Positive
1 2 Test Refused 2 Breath 1 Pending 1 No 2 Test Refused 3 Urine 2 Negative
❑ ❑ ❑ ❑
2 Yes 3 Test Given 3 Urine 2 Completed 2 Yes 1 3 Test Given 77 Other, 3 Pending
Ye
88 Unknown 1 88 Unknown, if Tested 77 Other, Explain in 88 Unknown 88 Unknown 88 Unknown, if Tested Explain in Narrative 88 Unknown
Narrative
SOURCE OF TRANSPORT TO MEDICAL FACILITY EMS AGENCY NAME OR ID EMS RUN NUMBER MEDICAL
FACILITY TRANSPORTED TO
1 Not Transported
❑
2 EMS 3 Law Enforcement 1
77 Other, Ex Iain in Narrative 88 Unknown
ADDITIONAL
PERSON # VEHICLE # NAME DATE OF BIRTH IN1
SEX LOC: S R O EJECT HU EP ABD RS
CURRENT ADDRESS (Number and Street) CITY & STATE ZIP CODE
SOURCE OF TRANSPORT TO MEDICAL FACILITY
EMS AGENCY NAME OR ID
EMS RUN NUMBER MEDICAL
FACILITY TRANSPORTED TO
1 Not Transported
❑
2 EMS 3 Law Enforcement
77 Other Ex Iain in Narrative 88 Unknown
PERSON #
VEHICLE #NAME
DATE OF BIRTH
�INJ
SEX
LOC: S
R
1 0
EJECT
I HU
EP
ABD
RS
CURRENT ADDRESS (Number and Street) CITY & STATE ZIP CODE
SOURCE OF TRANSPORT TO MEDICAL FACILITY
EMS AGENCY NAME OR ID
EMS RUN NUMBER MEDICAL
FACILITY TRANSPORTED TO
1 Not Transported
❑
2 EMS 3 Law Enforcement
77 Other, Explain in Narrative 88 Unknown
HSMV 90010 S (P) (rev 10/10) Page 3 of 6
REPORTING AGENCY CASE NUMBER HSMV CRASH REPORT NUMBER
161944 84212026
D
VEHICLE# NAME PHONE NUMBER Checkif
7N..-M.Wd. Recommend
STEVEN SCESA 312-371-9527 Driver Re exam
CURRENT ADDRESS (Number and Street) CITY & STATE ZIP CODE
300 S AUSTRALIAN AVE WEST PALM BEACH FL 33446
DATE OF BIRTH SEX DRIVER LICENSE NUMBER STATE EXPIRESINJURY SEVERITY (INJ)
1 Male 1 None 4lnca acitating
m
10/01 /1968 2 Fen 2 Possible 5 Fatal (within 30 days) 2
88 Unknown 3 Non -Incapacitating 6 Non -Traffic Fatality
•M=
DL Type Required Endorsements Driver's Actions at Time of Crash
- 1A 2B 3C 1 Yes 1st 26 Ran off Roadway 3rd Condition At
1 No Contributing Action g Time of Crash
4 D/Chauffeur 2 No 2 Operated MV in Careless or 27 Disregarded arded other Traffic
5 E/Operator 3 No Re Endorsement
Q• Negligent Manner 1 Apparently Normal
❑ ❑
28 Disregarded Other Road
Noneer -Rest 3 Failed to Yield Right -of- Way 3 Asleep or Fatigued
7 Markings
4Improper Backing 29 Over-Correcting/Over- 5 III (sick) or Fainted
Driver Distracted By 4 Other Inside the Vehicle 2nd 6 Improper Turn Steering 4th 6 Seizure, Epilepsy, Blackout
1 Not Distracted (explain in narrative) 10 Followed too Closely 30 Swerved or Avoided :Due 7 Physically Impaired
2 Electronic Communication to Wind, Slippery Surface, 8 Emotional (depression,
(outside the vehicle, 12 Drove too Fast for Conditions angry, disturbed, etc.)
5 External Distraction 11 Ran Red Light 1:1
El
Devices (cell phone, etc.) MV, Object, Non -Motorist in
3 Other Electronic Device explain in narrative) 13 Ran Stop Sign Roadway, etc. 9 Under the Influence of
6 Texting 15 Improper Pas" 31 Operated MV in Erratic, Medications/Drugs/Alcohol
(navigation device, DVD player) ng
7 Inattentive 17 Exceeded Posted Speed Reckless or Aggressive Manner 77 Other, Explain in Narrative
Driver Vision Obstructions 1 88 Unknown 21 Wrong Side or Wrong Way 77 Other Contributing Action 88 Unknown
25 Failed to Keep in Proper Lane
Not Obscured 5 Load on Vehicle 9 Smoke DRIVER • , PASSENGER
lnclement Weather 6 Building/Fixed Object 10 Glare
AVision
Parked/Stopped Vehicle 7 Signs/Billboards 77 All Other, Explain Helmet Use HU
Trees/crops/Bushes 8 Fog in Narrative ( ) Eye Protection (EP) Restraint Systems
• . • . . 1 DOTor yc eiant ❑ 1 Yes (RS)
Motorcycle Helmet 2 No ❑
Motor Vehicle Seating Position: LOCATION: SEAT ROW OTHER 2 Other Helmet 3 Not Applicable 1 Not Applicable
(LOC) 3 No Helmet 2 None Used - Motor Vehicle Occupant
3 Shoulder and Lap Belt Used
Seat Row Other1:1El El Air Bag Deployed
5 l0
1 Left 1 Front 1 Not Applicable Deployed -Other 4 Shoulder Belt Only Used
2 Middle 2 Second 2 Sleeper Section of Truck Cab (ABD) (knee, air belt, etc.) 5 Lap Belt Only Used
3 Right 3 Third 3 Other Enclosed Cargo Area Ejection (EJECT) 6 Deployed- 6 Restraint Used - Type Unknown
77 Other 4 Fourth 4 Unenclosed Cargo Area ❑ 1 Not Ejected a 1 Not Applicable Combination 7 Child Restraint System - Forward Facing
(explain in 77 Other Row 5 Trailing Unit 2 E'ected, Totally, 2 Not Deployed 7 Deployed -Curtain 8 Child Restraint System - Rear Facing
narcative) 88 Unknown 6 Riding on Motor Vehicle Exterior (non- 3 Ejected, Partially 3 Deployed -Front 88 Deployment 9 Booster Seat
4 Not Applicable 4 Deployed -Side Unknown 10 Child Restraint Type Unknown
88 Unknown trailing unit)
88 Unknown 88 Unknown 77 Other, Explain in Narrative
NON -MOTORIST
Non -Motorist Description Non -Motorist Location At Time of Crash Action Prior to Crash
1 Pedestrian 1 Intersection - Marked Crosswalk 8 Sidewalk ❑5 WalkineCycling on Sidewalk
2 Other Pedestrian (wheelchair, person in a 2 Intersection - Unmarked Crosswalk 9 Median/Crossing Island 61n Roaddway — Other (working,
building, skater, pedestrian conveyance, etc.) 3 Intersection — Other 10 Driveway Access 3 playing, etc.)
3 Bicyclist 4 Midblock - Marked Crosswalk 11 Shared -Use Path or Trail 7 Adjacent to Roadway (e.g.,
❑
3 4 Other Cyclist 7 5 Travel Lane - Other Location 12 Non-Trafficway Area 1 Crossing Roadway shoulder, median)
5 Occupant of Motor Vehicle Not in Transport 6 Bicycle Lane 77 Other, Explain in Narrative 2 Waiting to Cross Roadway 8 Going to or from School (K-12)
(parked, etc.) 7 Shoulder/Roadside 88 Unknown 3 Walking/Cycling Alongg 9 Working in Trafficway
6 Occupant of a Non -Motor Vehicle Non -Motorist Actions/Circumstances Roadway with Traffic+in or (incident response)
Transportation Device adjacent to travel lane) 10 None
7 Unknown Type of Non-Motorist1 No Improper Action 4 Walking/Cycling Along 77 Other, Explain in Narrative
2 Dart/Dash Roadway Against Traffic 88 Unknown
(in
Safety Equipment 1st 3 Failure to Yield Right -of -Way or adjacent to travel lane)
1 None 5 Lighting 1 4 Failure to Obey Traffic Signs,
2 Helmet 6 Not Applicable 2 Signals, or Officer 7 Entering/Exiting Parked/Standing 10 Improper Turn/Merge
3 Protective Pads Used 77 Other, Explain 5 In Roadway Improperly (standing, Vehicle 11 Improper Passing
(elbows, knees, shins, etc.) in Narrative 2nd lying, working, 8 Inattentive talking, eating, etc) 12 Wrong Way Riding or Walking
[:]
playing)
4 Reflective Clothing (jacket, 88 Unknown 6 Disabled Vehicle Related (workingble 9 Not Visit dark clothing, no 77 Other, Explain in Narrative
❑
backpack, etc.) on, pushing, leaving/approaching) lighting, etc.) 88 Unknown
ALCOHOL/DRUG/EMS
SUSPECTED
ALCOHOL USE:
ALCOHOLTESTED:
1 Test Not Given
ALCOHOL TEST TYPE:
1 Blood
TEST RESULT:
ALCOHOLf7]2
SUSPECTED
DRUG USE:
DRUG TESTED:
1 Test Not Given
DRUG TEST TYPE: DRUG
1 Blood 1
TEST RESULT:
Positive
1 No
2 Yes
2 Test Refused ❑
3 Test Given
2 Breath 111
3 Urine
Pending F-11
2 Completed
No ❑
Yes 1
2 Test Refused
3 Test Given
3 Urine ❑ 2
77 Other, 3
Negative
Pending
88 Unknown 1
88 Unknown, if Tested
77 Other, Explain in
88 Unknown
88 Unknown
88 Unknown, if Tested
Explain in Narrative 88
Unknown
Narrative
SOURCE OF TRANSPORT TO MEDICAL FACILITY EMS AGENCY NAME OR ID EMS RUN NUMBER MEDICAL FACILITY TRANSPORTED TO
1 Not Transported
❑ �BCIYNTON �BETHESDA
La Enforcement
2EM5 3LawinNarati2 BEACH FD 1610349 HOSPITAL ER
77 Other. Iain Narrative 88 Unknown
DD •
PERSON # VEHICLE #'NAME DATE OF BIRTH [NJ SEX LOC: 5 R 0
EJECT
HU
EP A80
RS
CURRENT ADDRESS (Number and Street) CITY & STATE ZIP CODE
SOURCE OF TRANSPORT TO MEDICAL FACILITY
EMS AGENCY NAME OR ID
EMS RUN NUMBER
MEDICAL FACILITY TRANSPORTED TO
1 Not Transported
❑
2 EMS 3 Law Enforcement
77 Other Explain in Narrative 88 Unknown
PERSON #VEHICLE
#NAME
DATE OF BIRTH
1 N
SEX
LOC: 5 1
R
0
EJECT
HU
EP
ABD
RS
CURRENT ADDRESS (Number and Street) CITY & STATE ZIP CODE
SOURCE OF TRANSPORT TO MEDICAL FACILITY
EMS AGENCY NAME OR ID
EMS RUN NUMBER
MEDICAL FACILITY TRANSPORTED TO
1 Not Transported
171
2 EMS 3 Law Enforcement
77 Other, Ex Iain in Narrative 88 Unknown
HSMV 90010 S (P) (rev 10/10) Page 4 of 6
REPORTING AGENCY CASE NUMBER HSMV CRASH REPORT NUMBER
161944 84212026
BICYCLIST WAS RIDING HIS BICYCLE NORTH BOUND IN THE 4400 BLOCK OF N. OCEAN BLVD. HE WAS MAINTAINING THE RIGHT SHOULDER AND
NOT DISRUPTING TRAFFIC. DRIVER OF V-1 WAS ALSO DRIVING NORTH BOUND IN THE 4400 BLOCK OF N. OCEAN BLVD. BEHIND THE BICYCLIST.
AS V-1 APPROACHED THE BICYCLIST HE INADVERTANTLY DROVE TO THE RIGHT AND STRUCK THE REAR TIRE OF THE BICYCLIST. THIS SENT
THE BICYCLIST FALLING OFF HIS BICYCLE INTO A GRASSY SWALE AREA ADJACENT TO THE ROADWAY. BOYNTON BEACH FIRE DEPARTMENT
RESPONDED AND TRANSPORTED BICYCLIST TO BETHESDA HOSPITAL FOR A CHECKUP. DRIVER OF V-1 CITED FOR CARELESS DRIVING.
ADDITIONAL
PERSON TEHICLE # NAME DATE OF BIRTH INJ SEX LOC: S EJECT HU EP ABD RS
CURRENT ADDRESS (Number and Street) CITY & STATE ZIP CODE
SOURCE OF TRANSPORT TO MEDICAL FACILITY
EMS AGENCY NAME OR ID EMS
RUN NUMBER
MEDICAL FACILITY TRANSPORTED TO
1 Not Transported
❑
2 EMS 3 Law Enforcement
77 Other Explain in Narrative 88 Unknown
PERSON #VEHICLE
#
NAME
DATE OF BIRTH
INJ
SEX
LOC: S
I R
1 0
EJECT
HU
EP
ABD
RS
CURRENT ADDRESS (Number and Street) CITY & STATE ZIP CODE
SOURCE OF TRANSPORTTO MEDICAL FACILITY EMS AGENCY NAME OR ID EMS
RUN NUMBER MEDICAL FACILITY TRANSPORTED TO
1 Not Transported
❑
2 EMS 3 Law Enforcement
77 Other, Ex Iain in Narrative 88 Unknown
ADDITIONAL VIOLATIONS
PERSON #
NAME OF VIOLATOR FLSTATUTE NUMBER
CHARGE CITATION NUMBER
PERSON #
NAME OF VIOLATOR FL STATUTE NUMBER
CHARGE CITATION NUMBER
;REPORTINGOFFICER
ID/BADGE NUMBER RANK & NAME DEPARTMENT FHP SO PD OTHER
755 OFFICER WILSON GULF STREAM POLICE DEPARTMENT ❑ ❑ X ❑
HSMV 90010 S (N) (rev 10/10) Page 5 of 6
REPORTING AGENCY CASE NUMBER HSMV CRASH REPORT NUMBER
161944 84212026
S.R. A1A North Ocean Bv.
Double Yellow Markings
CZ
Not To Scale
HSMV 90010 S (D) (rev 10/10) Page 6 of 6
GULF STREAM POLICE DEPT.
246 Sea Road
PROPERTY RECEIPT
Gulf Stream, Florida 33483
❑ STOLEN ❑ FOUND PROPERTY ❑ PROPERTY OF DECEASED
❑ RECOVERED ❑ EVIDENCE ❑ EVIDENCE SENT TO LAB
Case No. Date Time Officer 1. D.
Ir
Address where property impounded (Giveee,ct location where property was located)
I hereby acknowledge that the above list represents all I hereby acknowledge that the above list represents all property impounded by me in the
property taken fro my po ession and that I have official performance of duty as a Police cer.
received a cop thi hh
Signature _ Signature v� ID ��
RECEIVED BY
REASON
DATE & TIME
f
/ ./
IV
Final Disposition
Authority
Date & Time
WHITE/CANARY — EVIDENCE PINK — REPORT GOLD — RECEIPT
P��