HomeMy WebLinkAbout22-13442 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 3 27c
COLLISION REP FIT 1591971
CASE 22-13442 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 6 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑
COLLISION.. 12 - 19 - 2022 1737 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
MONSTER ROAD SW BLOCK NO. e✓ 501
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 0 ,❑ FEET e S B W eEACON COA MILES BL MINE RD
1 9 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2067725482 0 11
30
6� LAST NAME KOBUKI FIRSTNAME FRANK MIDDLE K 1 1 2 31
INITIAL
STREET ❑, 6630 S 128TH ST CITY SEATTLE ST WA ZIP 98178 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/iNTERLOCKYEs NO INTERLOCKYEs Z/NO YES 1/ NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES 2❑
USE CLASS UNKNOWN MEDICAL EVENT-POSSIBLY HEART
3
10 9❑ PI AT 14 DP47495 STATE WA VIN#' 2T18U4EE4CC878128
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
TRLR. TRLR 5 1 33
12 3 5 VIN#' VIN#
ROM TO
❑ VEH.YEAR 2012 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 34
13 4 TOYT COROL SD DAMAGE YES NO �MEYER 1 5 YES❑ No✓
REGISTERED OWNER INFO YOSHIKOKOBUKI6630S128THST SEATTLEWA98178 D:2067725482 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14LIABILI INSURANCE INSURANCE CO UNKNOWN UNKNOWN 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE
L
15 CHARGE 5 36
EGALLY YES❑NO❑ CITATION# NONE NIA I o BOTTOM
❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES�/ NO D:2067241898
16 a
LAST NAME KAHIKINA FIRST NAME CHRISTINE MIDDLE IS
INITIAL
17❑ NEW ADDRE_ 32213 1STREET 94TH AVE SE CITY KENT ST WA ZIP 98042 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER # STATE WA SEX F M D.C.B. 01 30 _ 1975 39
20 ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 HE 2 INJURY 7 NATURE of INJURIES 40
USE CLASS CHEST PAIN
❑ILICENSE 21❑ PLA E# BTW8832 TATE 41
WA VIN# JTEBU14R268061318 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2006 MAKE TOYT MODEL 4 STYLE UT VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24 DAMAGE YES 1/ NO (,ENE MEYER YES NO
REGISTERED OWNER INFO CHRISTINE KAHIKINA 32213194TH AVE SE KENT WA 98042 D:2067241898 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO USAA 014783581 7103IN 9TOP
- 5
VEHICLE ❑ ,.I—I CITATION# CHARGE �BOTTOM
LEGALLY YES N
25 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
J.CHR/STIANSEN 10437 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED17044
COLLISION REPORT III III III III III 111
1591972 CASE# 22-13442
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
PM USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Please see subsequent narrative pages
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.CHRISTIANSEN 12-19-22 09:47 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1212112022 5:47:09 PM
BADGE OR ID# 10437 OR]#' WA0171300 TIME POLICE DISPATCHED I` 5:41 PM TIME POLICE ARRIVED',5:45 PM
PART I PAGE IT]OF
REPORT NO. ED17044 CASE# 22-13442 OF COLLISION
12/19/22 17:37
OF CbLLI510N
NARRATIVE
RPD CASE#: 22-13442
RECORDED ON AXON
*This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized. *
On 12.19.2022, at approximately 1741 hours, I dispatched to a two-vehicle, injury, blocking collision
in the area of 501 Monster Road SW, in the City of Renton, WA, the County of King.
I was assigned to uniformed marked patrol in the City of Renton, WA, the County of King. I was
operating a fully marked Renton Police Tahoe #277, equipped with "POLICE" markings, overhead
exterior lights, and audible siren. I was wearing my department-issued uniform, including a fully
equipped duty belt, exterior ballistic vest with "POLICE" stenciled on the front and back and Renton
Police badge affixed to the left breast. I was also wearing my department-issued jumpsuit with
"POLICE" patches on both shoulders and across the rear shoulders. It would be immediately obvious
to any reasonable person I was a police officer. I was assigned as 3r22.
At the time of this incident, it was snowing/sleeting, approximately 36 degrees, the roadways were
wet, and it was dark, streetlights were illuminated. Monster Road SW, is a two-lane roadway running
north/southbound and the posted speed limit is 35 mph.
At approximately 1740:38 hours, dispatched updated the call notes with the following:
"Name: OLSON, MATT/PSRBY Phone: 425/273-5864 RPCon?: O IDCCode: 25R4 Comment:
BLOCKING BOTH DOTS, OCCUPANTS ARE UNABLE TO GET OUT OF VEHS."
I arrived on scene at 1745 hours and observed both vehicles were heavily damaged, the roadway
was blocked in both directions and neither involved driver could exit their respective vehicles. I
updated dispatch and asked for additional units for traffic control and asked Renton Fire Authority to
expedite.
Unit 01 was identified as a white in color Toyota Corolla bearing WA/DP47495. Unit 01 had
extensive damage to the driver's side front tire, front bumper, '/ panel, undercarriage and had a
combination of airbag deployments. Unit 01 was operable -Gene Meyer towing was notified.
Unit 01's driver was identified by his WADL as Kobuki, Frank Kunio (DOB: 01.01.1938; 206/772-
5482). Kobuki matched the photo shown on his WADL. Kobuki appeared to have suffered from a
medical emergency or event; he was extremely slow to answer questions, stated he had a multitude
of medical issues, was currently taking several prescription medications and had dialysis yesterday.
Further, Kobuki said his chest hurt and he was medically transported to Valley Medical Center for
additional medical evaluation and treatment. Kobuki could not tell me what happened leading up to
the collision; he stated he had insurance but could not answer any further questions.
Unit 02 was identified as a black in color Toyota 4Runner bearing WA/ BTW8832. Unit 02 had
extensive damage to the front driver's side, the front driver's side tire and axle were ripped from the
vehicle and laying in the roadway. Unit 02 had damage to the front bumper and undercarriage and
was inoperable. Gene Meyer towing was notified to send an additional flatbed tow.
Unit 02's driver was identified by her WADL as Kahikina, Christine S. (DOB: 01.30.1975; 206/724-
1898). Kahikina matched the photo shown on her WADL. Kahikina was complaining of chest pain
and had front airbag deployment. Kahikina's husband arrived on scene and transported her to Valley
Medical Center for additional medical evaluation and treatment.
Kahikina stated she was traveling southbound on Monster Road SW, following in a line of cars when
Unit 01, who was traveling northbound on Monster Road SW, crossed over the yellow line, veered
into her lane of travel and struck her vehicle on the front driver's side.
Unit 01's driver, Kobuki, appeared to have a medical event proceeding this collision.
Both Unit 01 and 02 were towed by Gene Meyer towing, privately. Both drivers' were transported to
Valley Medical Center for additional medical evaluation.
No citations were issued.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
PAGE 3 OF 5
REPORT NO. ED17044 CASE# 22-13442 OF COLLISION
12/19/22 17:37
OF CbLLI510N
NARRATIVE
Electronically signed by Officer J. Christiansen #10437, on December 19, 2022, at approximately
2132 hours, in Renton, WA.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Location Character: CITY STREET
Motor Vehicle Unit 1
Action Code: VEERED INTO ONCOMING LANES
**** END OF AUTO-POPULATED SECTION ****
PAGE 4 OF 5
REPORT NO.! ED17044 CASE# ' 22-13442 DATE AND TIME 12/19/22 17:37
OF COLLISION
*NOT TO SCALE*
Renton. D4: 2 -1 442
12.19.2022
Officer J. Christiansen 410437
0
Renton Concrete Recyclers
a
a
PAGE 5 OF 5