Having done a lot of trauma coverage in my time (although the last time I covered trauma call was nearly eight years ago), I have to admit that, when I first heard of the motor vehicle collision (I never call such crashes "accidents" because they rarely are) in which New Jersey Governor Jon Corzine was seriously injured, the first question that popped into my mind after "How did this happen?" was:
Was the Governor wearing seatbelts?
Of course, I strongly suspected that I already knew the answer, and, indeed, I did. The answer was no. Here's what apparently happened:
Gov. Jon S. Corzine was not wearing a seat belt and was sent hurtling into the back seat when his SUV tore into a guard rail along the Garden State Parkway Thursday night, according to two people who were with the governor in the hours after the crash.
One hospital source also said Corzine is in worse condition than has been publicly acknowledged, and that he could be in a wheelchair for six months.
Corzine's injuries include:
- Large scalp laceration.
- Fractured clavicle.
- Fractured sternum. I point out that it takes a really high-energy hit to the chest to fracture a sternum.
- Fractured ribs, six on each side. It sounds as though this may well have been enough to give Governor Corzine a flail chest, a condition where there is paradoxical movement of the chest wall inward with each breath using the diaphragm, severely compromising respiration. No wonder he's still on a ventilator. Given his sternal fracture and multiple rib fractures, Corzine almost certainly also has a nasty underlying pulmonary contusion that could easily blossom into ARDS, which could kill him if it develops. (If enough force hits you to break your sternum and multiple ribs, it's a good bet that it banged around the underlying lung tissue as well.) Corzine's chest injuries are certainly his most life-threatening injuries at this point.
- Fractured lower vertebrae.
- An open, comminuted femur fracture with a large laceration and muscle damage.
Corzine required seven units of blood and needed to undergo surgery to fix his femur. Even if he does not suffer complications from his chest injury, such as pneumonia and ARDS, he will likely not be able to walk again for months, and will require more surgeries to wash out the damaged and devitalized tissue and to complete the repair of his femur.
Stupid, stupid, stupid, stupid. There's no other word for it.
I'm not saying that Corzine wouldn't have been injured if he had been wearing his seatbelts, but it's very likely that his injuries would have been considerably less severe. Contrary to the myth of "being thrown free" of an accident to survive, those who are thrown, either through the windshield or a window or around the car's interior, suffer more serious injuries by far. They are far more likely to die. Had Corzine been wearing his seatbelts, he might even have walked away from the collision. I note that the only completely uninjured person in the car, an aide, was wearing his seatbelt. The state trooper who was driving suffered relatively minor injuries. He, too, was apparently wearing his seatbelt. In any event, Corzine is incredibly lucky that he didn't suffer any major head trauma and brain damage, which are frequent consequences of being in motor vehicle collisions without a seatbelt.
As a former trauma surgeon, I consider anyone who doesn't wear their seatbelts to be either ignorant, an idiot, or both on this matter, and Corzine set a terrible example by failing to wear his, in the process paying a terrible price for his carelessness. I've seen others pay the same price time and time again, even to the point of paying with their lives or with the destruction of their personalities though brain damage so severe that they're never the same again. Some were made quadriplegic from spinal cord injuries. Here's hoping Corzine recovers as quickly as possible, given his injuries, and that he learns from his foolishness. Here's also hoping that the price he paid serves as a wakeup call to those who think they don't them: Seatbelts save lives.
More like this
I have ridden as a member of a volunteer fire department/heavy rescue team for over 30 years. Just last evening we had a head-on between two cars on a narrow country road. Of the seven people in in the two vehicles, all were wearing seatbelts, and only two had to be transported for relatively minor injuries. The rest were uninjured. We see fewer and fewer serious injuries as more and more people wear seat belts and have air bags. Years ago lots of people ate the windshield; now almost no one does. I have to say Corzine was stupid, as you say.
Sounds almost exactly like what happened to Gen. Patton that caused his death. He was thrown forward and bounced off the roof of the car.
Of course, Patton's car did *not* have seat belts.
About twenty years ago now, I walked away from my obligatory Teenage Male New Driver Car Wreck (TM), uncomfortably aware of how very close I came to very serious injury. About two inches of nylon fabric close, I'd say. The officer who first responded to the scene was taking my statement, and asked me if I'd been wearing my seatbelt. "Yes," I said. He looked at me standing in front of him, then at the twisted wreckage of my dad's van wrapped around the tree behind me. "Yeah, I guess you were," he responded.
Me, my wife, and most especially my kids are buckled in securely whenever I'm driving, even just for a trip down the block. There's no excuse to refrain from doing something as simple as buckling a belt, when the consequences of inaction are so potentially severe ...
Sort of. Patton's main injury, though, was a cervical spine injury that left him quadriplegic. Back in 1945 we didn't know how to keep such patients alive nearly as well as we do today.
I had a friend long ago who spouted that "thrown safely from the car" nonsense to justify not wearing seatbelts. I pointed out to him that there was no way to be "thrown safely" at 60+ mph into a solid object like a windshield or a guardrail or oncoming traffic.
I won't start my car until everyone's buckled in. I've had a few complaints, but I won't bend on it. Funny, though, how this aspect of our governor's accident hasn't gotten too much publicity. You'd think it would be a great advertisement for seatbelts in a state where driving is considered a competitive sport.
Former EMT here. I've been to a few MVA's and hoo boy does passenger restraint make a difference. Worst accident scenes I've been at involved unrestrained drivers, one dead at scene. This lovely example occurred on Christmas Eve. What a way to ruin a holiday.
Another took place in front of me while I was off-duty. I don't know what happened with that one, but I do know that the patient was in sad shape by the time the ambulance arrived, nearly an hour later (which is *much* too long a response time). Despite the fact that the patient was a good candidate for neck/spine injury, we had to move him because he was downhill from his vehicle in a ditch and the fuel tank had a big hole in it. I remember snarling at someone who wanted to light road flares. (Note to self: pick up safety triangles.) Oh, and "ate the windshield" is a good description of what this guy did.
I've also been in a couple of MVA's, but because I'm a fanatic about wearing seat belts, I walked away from them.
Add me to the "Corzine is a mucking idiot" list.
Oh shoot, I forgot that I wanted to comment on the paradoxical motion thing. IIRC, paradoxical motion is not actually reverse motion of the flail section. It's an illusion of reverse motion caused by the fact that the flail section is staying put while the rest of the rib cage expands. This does not mean that the condition is less serious than Orac was indicating though. Flail chests are something you don't want to have to deal with, either as a patient or a care provider.
And exactly which opening do you think you can be "thrown clear" through?
However, I do have a cousin who *was* thrown clear of a collision. She was with her mother and brother when they hit an embankment at about 100 MPH in a pickup truck. Her mother and brother were killed, but she was found by the first people there face down and unhurt in the grass next to the accident. She was an infant at the time, so I guess she could fit through the window intact.
I smell conspiracy.
Everyone knows that rich people have secret privileges such as underground bypasses to avoid traffic jams. And fancy invisible flying cars. And health care insurance.
The story of the weaving pickup and no seatbelt is convenient indeed. Just proves the media is in on it.
Couple mysteries in that accident. Like why they were going 100mph in a pickup, and why there are any pickups capable of going 100mph.
Amazing to think anyone survived this wreck thought to be around 160mph. Apparently a pretty sturdy cockpit and better-than-average restraint and energy absorption. Or, just "wow".
Maybe the NJ gov will start doing PSA's about seat belts. Or at least his driver should.
Whoops, I was initially referring to Keith B's comment about the cousin who was thrown-clear.
Out of curiosity, how long might it be before Corzine can get back to handling most of his duties? The newspaper article you linked to above quoted acting governor Codey as saying he expected that Corzine would be out of commission for ~10 days? Is this realistic?
From taking taxis about 20 times over the last three years, I can remember only twice seeing a driver buckle their seat belt. And that was only because they saw me buckling mine as soon as I got in the car. Apparently, taxi drivers are exempt from the laws of physics. Or perhaps, because they can't drive fast on busy city streets, they rarely are involved in high impact collisions, and get involved with more of the fender-bender variety.
I've been in exactly one serious car accident in my life. My seat belt saved me from a trip to the hospital, at the very least; it's possible that it saved my life. I always buckle up, and always recommend that others do the same.
There's something weird about the report of the accident. All the reports I've heard agree that Corzine was sitting in the SUV's right front seat, but wound up in the back seat with the described injuries. I haven't seen an accident reconstruction so I don't know just where or how the SUV was hit, but I'd guess that Corzine must have taken a frontal impact, because how else could he wind up with a flailed chest? But then, how did he end up in the back seat? Was he thrown forward against the dash, then backward so hard that the seatback broke? What happened to the passenger-side airbag?
Wolfwalker, the SUV was hit on the side and then hit the guardrail on the side... the airbag would deploy for an impact on the front. Also, as stated above in the first sentence of the blockquote "Gov. Jon S. Corzine was not wearing a seat belt."
One of the reasons my father actually *installed* seatbelts into the cars he bought before they were standard was because he survived a vehicle that left the highway and went down an embackment... where he found himself flung into the backseat (and covered with the contents of a broken bottle of whiskey). They had fallen asleep, and the car was easily pulled out the next day. It was not at high speed, and not that far down the hillside, though it was fortunage that someone saw the tiremarks in the snow and found them.
Another reason was that as an MP (military police) he responded to one very bad accident that left a few teenagers from the local high school dead.
I have heard snide comments from passengers about putting on seatbelts. That is when I get to tell them of how big the dash seemed as my face propelled towards it, only to be pulled back by the seatbelt. Since it was just a lapbelt I did break a rib. But I'll take a broken rib over a smashed forehead anytime. Oh, and boyfriend (now hubby) was much more cautious about driving from then on. That was his Teenage Male Newish Driver Crash (he was 19).
Much the same happened with Diana and Dodi, I understand: Diana actually survived the accident and died later; Dodi and the driver died at the scene or on impact; and the security guard (reported as the only seatbelt wearer) came through.
Now I believe that their car hit at a pretty high speed, and the situation might have been unsurvivable for her anyway, but given that she lived to be extracted from the car and for some time afterwards, who knows what might have happened if she'd been properly restrained?
Pickup trucks need to haul heavy loads, sometimes on highways. Without a truly heavy load they're going to be able to haul ass. The transmission could probably be rigged to keep it from going too fast, but the need to haul a heavy load at highway speeds probably places a limit on what can be accomplished in that regard.
thanks for the medical summary. i would go with "careless" instead of "stupid" though, sounds a bit less judgemental. we all do careless things as intelligent people. the ARDS possibility is quite scary, and not one you're hearing from the media. good blogging. hope the doctors are able to fix him. did you hear Cody asking the world to pray for corzine? that's fine, but how about giving the EMT's, nurses, and doctors some credit for patching him together?
I wouldn't. Maybe it's just because I've seen the consequences too often.
I hadn't heard the "thrown clear" thing before. Crazy.
A girl I went to college with was in an accident a few weeks after graduation. She was thrown clear of the car - and right into oncoming traffic. She did not survive.
I do insurance investigations and all of you seatbelt wearers are bad for business.
All the reports I've heard agree that Corzine was sitting in the SUV's right front seat, but wound up in the back seat with the described injuries.
You fly towards the point of impact. So if he flew towards the backseat, he was rear ended.
Seat belt crash.
Perhaps this is a demonstration of political Darwinism?
Here's a good diagram of how the collision happened.
Kevin: A friend of mine from high school (we graduated the same year) was killed in a car crash the same week he graduated from college in a way similar to what you describe. He wasn't that close a friend, but it was still a major shock to me.
My husband survived a crash in which he sustained a broken left femur, broken ribs, ruptured spleen, and a collapsed lung (hit by a logging truck; what can I say?). And he WAS wearing a seat belt. He's never doubted that without a seat belt, he'd have been dead at the scene. As it was, he had no head or spinal injuries, and the damage, as extensive as it was, was confined to his left side (where the truck hit the car).
Not to minimize here, because I too have survived a crash, and lived only because of my seatbelt... BUT
I blame this on Don Imus. Indirectly.
Okay thats a stretch, but that's actually the key to the seatbelt, it STRETCHES. The key is that it is stitched, like a fine sweater. Not just to hold you in place, but allow your body's "change in momentum"/impulse to occur over a LONGER time period and distance.
Latest description of the accident from the NYTs. I'm wondering if this could mean that the end of the guardrail shoved him into the backseat, as it crushed into his chest from the front?
The Suburban slid into the end of a guardrail, which "penetrated the vehicle, and struck both Rasinski and Governor Corzine," according to a police report.
Mr. Corzine's left thigh bone, or femur, was fractured, and it punched two holes through his skin. He lost about half of the blood in his body, requiring seven units during surgery Thursday night, and broke six ribs on each side, along with his sternum, collarbone and a lower vertebra. [more here...]
And as a practical question, does anybody know who is the responsible party for passenger seatbelt compliance -- the driver or would an individual passenger get the ticket?? I once got into a terrific argument with a passenger who refused my request to buckle up. We sat in the parked car and yelled a lot about responsibility and danger [not just to him but his flying around the car as a danger to the other occupants if there was an accident].
I did prevail after about 20 minutes, but it was really unpleasant at the time, and the temptation was to just let it go [he was my respected "elder," so to speak].
Orac, nice to have your take on things. As with any "accident" there are many factors involved and "fault" may be in the eye of the beholder. Just seems curious that the picture shows the governor's vehicle in front of the white bronco at the point of impact. In legal terms that would imply that the governor's vehicle was not at fault. However, I am putting my chips that the governor's vehicle was speeding, probably travelling over 75 MPH, based on what you have described. In addition, I would be willing to bet that the governor's car ran into the white bronco, in the legal sense that at the point of impact the white bronco was STILL AHEAD. Just speculation of course.
Question: My (drunk) friends often tell me that it's MUCH better to be drunk if you are in an accident. Something about the blood clotting or body being relaxed. Is it a wives tale like "getting thrown and being safer"?
About the taxidriver comment, they seem to have a 6th sense about when to slow down and when it is okay to accelerate. It is an acquired talent to really bully the roadway, accelerate when you see somebody approaching a stop sign at the same time as you, judge whether they are going to run the stop sign, before you do...
The cop driving was probably feeling undue pressure to drive quickly and aggressively if necessary. A small thing like a car in the shoulder would be reason for a good, wary, driver to slow down. A cab driver would (probably)have avoided the accident, in my opinion.
well, I guess part of his fine for not wearing a seat belt will go to spinal cord research, since this happened in New Jersey?
Coming from the UK, I always find it funny that americans even talk about this issue. We all just take it for granted that you wear a seatbelt because you don't want to die.
Renee: I asked a taxi driver about seatbelts, and at least in this country, they're allowed to not wear seatbelts because they might be assaulted by passengers and need to leave the car quickly.
I survived an accident because of a seatbelt and sholder restraint. So did my father. My mother didn't survive that same accident and probably wouldn't have even if her seat had had a shoulder belt. But the injuries to her body and face would certainly have been less severe with a shoulder harness as part of the seat belt. I've heard people say that wearing a seatbelt is too confining. I think of it as one of my parents hugging me to keep me safe. But whatever perception measures I use to keep me wearing the belt are better than the alternative.
You can add my wife to the list to "seatbelt-wearing survivors." A few years ago, she slid our little car across an icy 2-lane road at 35 mph and hit a stout telephone pole head on. The car was totaled instantly, but her only injury was a vivid diagonal bruise across her torso from the belt. The state trooper that came along afterwards said to her, "Yep, I can see you were wearing your seatbelt, otherwise I'd be scraping your remains off the dashboard."
I guess you can add me to the list of seatbelt-wearing survivors as well. Unexplainably lost control of the car while driving about 55 miles per hour on a parkway, still going over in my mind trying to figure it out - nice summer day, no traffic, normal speed, car suddenly goes to the right. Either got complacent after 20 years of accident-free driving and lost attention for a moment or the right front tire hit something, it looked blown up thereafter (could be from the impact too). The car hit the rail on the right, then turned from the impact, crossed the left lane and hit the middle rail. Total loss. But we (one passenger) walked away without a scratch. My first reaction was "oh, my car, my car"; only some days later I realized how lucky I was. A little more traffic and another car could've hit me or I could've hit somebody else.
I've had some arguments with some guys I met about seatbelts in the past. Some people are really stupid - "if I break very hard it is still doesn't throw me around", "if the car falls into a river, I have to be able to get out quickly". I guess the idea that he cannot swim away if he is unconscious doesn't cross his mind. One of these arguments came from a guy right out of medical school, an intern - shows that those who learn physics in college can still be stupid.
On the subject of taxi drivers, perhaps they don't wear safety belts because most of their driving is on busy city streets, where they can't go very fast, so they generally are only involved in low impact accidents.
I simply cannot recall any news reports of people being killed in car accidents on crowded city streets, unless they are pedestrians or bike riders. Is it the low speeds that account for this? It seems most of the news reports of car fatalities or serious injuries happen on highways.
From reading other blogs, there is wild speculation about how fast the governer's SUV was traveling. I've read anywhere from 80 to 100 mph. From my experience driving here in NJ, even in the right lane on a highway, drivers are usually going 70-75 mph. If you drive 65, you will constantly be passed. So maybe 80 mph is not unrealistic.
Yes, it's ironic that Corzine was traveling back to the governer's residence for the Don Imus-Rutgers basketball team meeting.
Renee,
I expect there are a few reasons you don't hear about fatalities on city streets. First, many of the accidents likely don't make the news for more than a brief paragraph, if at all. Second, city streets carry many fewer cars than freeways and interstates, so there are fewer vehicles to be involved in accidents (interstates are the safest roads in the country). Third, the speeds on city streets are generally lower (especially if the road is over capacity and all jammed up) so the severity of accidents is less. I suspect that if you went to city hall and got all the police reports for traffic accidents, you'd find out just how dangerous city roads can be.
I should also point out that speed doesn't cause accidents--it worsens them. Accidents are generally caused by differentials in speed. Research shows that accidents occur when cars differ in speed by more than 20 mph--in either direction. That means that if everyone on the road is going 70 mph, the idiot going 90 is just as likely to cause a wreck as the jerk going 50. Obviously the 90 mph car has more energy with which to inflict injury, but the 50 mph guy can still cause sudden avoidance maneuvers and other actions that lead to wrecks. Crashes on the interstate will be more severe than those on local roads, but there are fewer crashes on the interstates than local streets.
In addition to wearing seat belts, another less I see in this incident is that people should never pull straight into traffic from the shoulder. While you should avoid stopping on the shoulder if at all possible (even if that means ruining a rim by driving to the next exit on a flat tire), re-entering the flow of traffic must be done properly. Accelerate to around the same speed as traffic and rejoin traffic flow by pulling off the shoulder as if making a lane change. No one will have to slam on the breaks and/or swerve into other cars to avoid you. If your right wheels go off the pavement into the grass (as may have happened in the Corzine incident), slow down and gently move left until you are fully back on the paved surface. Sudden movements can kill.
Ah yes, the "I'm not moving this car until you're buckled up" argument. I've had that a few times. As I tell my passengers, I may be a grown woman long since out on my own, but I do not ever, EVER want to have to tell my father the occasional ER physician that someone died in my car because he or she wasn't wearing a seat belt. (And yes, I am belted in at all times.) Seatbelts: Far less restrictive and confining than wheelchairs.
I've had a few people try that, "I want to be thrown clear" thing with me. My response is to ask them what exactly they think is going to occur when they are stopped - by a tree, another car, the ground, whatever - and the momentum of their movement is transferred to their flesh and bone (I'm sure I'm butchering the expression of the physics here, but I think you all get my meaning). Unless they're followed around by Spider-Man, who can spin a strong but flexible web designed to catch then safely, they're pretty much hosed.
One thing to include in all this is that seat belts can be damaged in a wreck. If you ever have a vehicle that has been in a wreck, yours, or you find out about it by carfax, replace the belts. They may not work as well in a second crash.
As Scholar mentioned above, seat belts stretch, and if they have been stretched once before, they might not stretch as well the next time.
Frayed belts should be replaced ASAP, as they can tear under the extreme stresses of holding back a body during rapid deceleration.
My crash experiece involved sliding off the road after the worst weather that Kentucky has to offer. Freezing rain followed by snow, then warm air. The snow becomes slush, and the least miscalculation will teach a lasting lesson about inertia. I had just gotten my driver's license, and my wise mother, realizing that these were not conditions under which an inexperienced driver should be out in, took the wheel. Before we made it off the quarter mile driveway, we went straight where the road made a turn and hit a tree. The car that would be mine through high school, college and part of grad school was already wrecked.
Thanks to wearing a seatbelt, and the mid eighties solid frame of an oldsmobile... I only had a bruise, and the car only needed to have its frame straightened and a couple of body panels replaced. And a radiator. And a fan...
Side note, other drivers cede right of way to two tone cars more than you might expect.
Only once did I end up with an unbuckled passenger - my mother-in-law and her boyfriend. Each time I insisted on them buckling up, they pretended they hadn't heard, and finally my husband got peeved - if we didn't take them home, we'd never get home, either. I told him that next time, I'd tell them to not even get in, we'd even pay for a cab. If they wanted to drive around unbuckled in their own car, let 'em kill themselves. But when they're potential missiles in my backseat, taking me with them on their way out the windshield, the decision is not up to them.
It is unlikely that Corzine's vehicle was traveling less than 75 mph, being in the left lane of the parkway. And he was hit by the car to his right in the center lane, which was swerving to avoid the car that was passing it on the right - certainly in excess of 80, I'd wager as a regular parkway driver, myself. Several state troopers, who are the drivers of the governor's cars, have said they tried to get him to buckle up without success. They're trying to remain anonymous, because they're the officers who are supposed to be issuing summonses to unbuckled drivers on roads like the Parkway. It's worse than driving your MIL home by a longshot - issue a summons to your own passenger, when he's your boss? Not too easy.
Many thanks, Good Doctor, for detailing Corzine's injuries and their relative risk to his long-term well-being. One of the reasons I'm an Orac fan is because you put medical issues like Corzine's accident and Eliz Edwards' breast cancer in understandable medical detail that you won't find in any other media outlet.
Just one observation of a very telling statement from today's AP piece by Kathy Matheson, quoting Corzine's chief of staff, Tom Shea:
Unlike many in the current presidential administration, this sad case is one where the politician himself is now paying for not being "amenable to suggestion."
I was almost in an interesting wreck in '75.
Two lanes in each direction with a turn lane in the middle; 55mph.
A cold night in Iowa.
Two cars were drag racing in East bound lanes; I (MG - they didn't really have brakes) was West bound. One of the racers lost control and came swerving across the path of the car in front of me (something large and American). They slammed on the breaks but still plowed into the side of the swerving car.
I did some incredible steering and swerved around them both; coming to a stop ahead of them in the turn lane. The seat belt held me in place so I could steer.
The car ahead of me had two adults and a child in the front seat, belted in; they were all right but stunned. The engine was still running, my passenger told them to turn it off.
People were stopping to help. The car that was racing was hit at high speed on the passenger's side; the engine was still running; there was no one in the car. He was 20 or so feet away on the pavement (no seatbelt); he didn't look too good.
=======================
Being "thrown clear" often includes not only smashing into the pavement, but also having the vehicle land on top of you.
Scholar, I've also heard the thing about drunks getting less-severe injuries in collisions - from my Driver's Ed. instructor in high school. She was NOT advocating drunk driving, obviously, but telling us about the frequent occurence of a drunk-on-sober collision where the innocent party (sober) dies but the drunk survives. The logic ran along the lines of inebriation leading to relaxation, which can be beneficial in some collisions.
As far as I recall, alcohol interferes with blood clotting, meaning a drunk person might be more likely to bleed to death than a sober person with similar injuries. Not sure about that one.
My parents drilled it into me since before I could speak that the car doesn't move unless everybody is belted. Putting on a belt is now a habit for me - I've actually gotten into my car to look for something in the glove compartment, or pop the hood release, or some other non-driving-related thing, and realized I'm belted in when I try to get out.
DecrepitOldFool:
We don't talk about it much, the accident was bout 40 years ago, but I think suicide might have been involved - possibly post-natal depression.
Add my Dad to the list of survivors who was wearing a seatbelt. He swerved to miss a couch between two lanes and hit everything else (the median barrier, the car in the other lane, a lamp post and then the hill on the other side of the motorway). Car wound up totalled on its side, he had a cut on his cheek that healed without medical attention or a scar and a bad tear in his suit. He lifted himself out of the car door.
The people in the other car were wearing seatbelts and fine but their unconstrained dog died.
I should also point out that speed doesn't cause accidents--it worsens them.
Really? How often have you heard of a collision between two stationary objects? :)
I had a friend who didn't like to wear his seat belt, but he did believe in them. His theory was that in the event of a crash he would quickly buckle up.
I pointed out that in the event of a crash, he would either be fighting the wheel with both hands and have no opportunity to buckle up, or, it would be over before he could move.
That is beyond ignorant.
Renee wrote:
I guess it depends on just how crowded is "crowded", and whether you're limiting the question to the especially crowded hours. We've had plenty of automobile deaths on city streets here in Baltimore. You might be surprised what speeds some of these jokers can attain on surface streets, especially when trying to outrun the police. Every so often I hear about a fatal crash in the city on the news, most often police-related (some idiot killing himself trying to get away, or occasionally some other driver in the wrong place at the wrong time getting rammed by either cop or fugitive, or in one case someone failing to yield right of way to a cop running with lights and sirens, and getting between the police car and the car it had been chasing).
A block from my house, a cop died when a felon in a stolen SUV deliberately rammed his cruiser -- which was stationary, facing him, lights flashing. It took two tow trucks pulling in opposite directions, tires smoking, to separate the vehicles. And right at my corner I watched a car that had been sliced in half by a tree getting hauled away on two separate flatbeds, though I've no idea how the driver of that one fared.
Then there's the occasional car going through a brick wall into somebody's bedroom or living room, though I can't recall any deaths from that off the top of my head, just near misses.
And then, of course, there are the illegal dirt bikes weaving through traffic, at least one rider having gotten killed when he hit something. I'm not sure whether that counts ...
It may not be as common as highway deaths, but city street smashups can be fatal as well.
A common cause of city street smashups are the red-light runners: http://www.citynews.ca/news/news_2573.aspx
Another thing are those who make left turns without adequately looking. At the busy corner two blocks from my house I almost hit someone who turned left right in front of me (and he only had a blinking yellow while I had a green light). Finally last year the city changed that light so that they get a green arrow, while the direction I was coming from is now a red light.
Though last week while my light was green, and that particular left turning lane had a red light... some fool still made the left hand turn through the red light. Sigh.
Then there are the folks who drive while talking on their cellphones. I was rear-ended when I was the SECOND car at a stop-light by a guy talking on a cellphone. Fortunately it was at low speed. I can just imagine his conversation: "yada yada yada... oh shit!" followed by SCREEECH!!!... Crunch!
Oh this is cute: The SUV that the governor of NJ was in was going 30 mph over the speed limit:
http://www.reuters.com/article/bondsNews/idUSN1720648420070418
Anyone who took some physics knows that the force of impact is the SQUARE of the velocity! It does not take a genius that fragrant disregard of speed AND seatbelt laws is not just bad for your political future... especially when the gov hears of the relevations from a hospital bed!
(personal note: I have a 16 year old son who is learning how to drive. We are spending lots of energy trying to impress upon this high school honor student the minor points of driving a car. This includes how to turn around a corner without getting into an oncoming lane... or even how going 40mph in a 25mph zone is a bad idea. But at least he knows enough to put on his seatbelt!!!... oh, the driver's ed class we used is run by cops:
http://www.911drivingschool.com/ !!!)
I do not recall why, but I visited a junkyard years ago. In the junkyard was a car that had just arrived, and had obviously been in a high-speed head-on collision. There was a head-sized hole in the windshield, directly above the steering wheel, with a big red ring around it for emphasis. I cannot imagine how that could have gotten there without the driver not wearing a seat belt.
I have always been a fanatic about seat belts. Even before that visit to the junkyard, I put on my seatbelt even if just moving the car in a parking lot. To me, it is just part of being in the car: it feels wrong not to be buckled in. I do not know why others cannot figure this out as well.
"It does not take a genius that fragrant disregard of speed"
I too have experience driving with people who have fragrant disregard.
This controversy would not have been an issue had the call been placed to 9-1-2 in the first place.
Dear Scholar, while I do wear seatbelts and never ever drive under the influence of alcohol...
I confess I wrote "fragrant" (flagrant!) while under the influence of my second glass of wine.
A few years back, Ontario was running a buckle-up TV commercial which showed a slow-motion sequence of a pumpkin flying through the air, turning gently end over end, while the voice-over talks about the "thrown clear" excuse. Then the pumpkin hits a telephone pole, with predictable results.
I recall my Dad buying and installing belts in about 1965, before they came standard, and I've worn them ever since. They undoubtedly saved us from serious injury when I (stupidly, totally my fault) rear-ended someone a couple of years back. As it was, we walked away without a scratch (except the bruises to my ego). Likewise, my parents -- in my Dad's only accident in 57 years of driving -- came away with a few bruises, in an accident that would otherwise have been serious for a pair of fragile octogenarians.