A Fatal Supplement Form is required whenever there is a traffic crash resulting in a fatality. The death must occur within 30 days of the crash to be considered a traffic fatality. A fetus must be 28 weeks developed to be counted as a traffic fatality. This form replaces the paper and electronic MV3480 Fatal Supplement Form when submitted as part of a TraCS electronic crash report and is necessary to comply with the requirements of the federal Fatality Analysis Reporting System (FARS). This form is transmitted when validated.
If an electronic DT4000 (Crash report) has been completed for the crash but has not yet been end shifted, open the Crash report and click “Replicate” button on the menu bar, then select “Fatal Supplement”. Using the Replicate button sets up the Fatal Supplement correctly. The following must be added and entered on the Fatal Supplement.
Every unit
Every unit has at least one individual (usually the driver)
Every individual that died as a result of the crash
Every individual that was transported to the hospital
If the Fatal Supplement Form is submitted after the electronic crash is sent (e.g., a critically injured person dies two weeks after the crash), the original crash needs to be amended to reflect this information.
Creating the Fatal Supplement Form |
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To create a fatal supplement.
Go to an Office Workstation
Note: Can use a mobile computer if using Web Services.
Find Original Crash Form
Note: The original might be in the Archive
If the Original form is in Archive then Unarchive it.
Replicate from Original. To Replicate
Either Highlight form and click Replicate from the Forms Manager
Or Highlight form, right click choose Open Form (Ctrl_O), then click Replicate from the Forms Viewer. Note: this option is better for Web Services Clients.
Choose Fatal Supplement
A new Fatal Supplement form will be opened and placed in Edit mode. Quite a few fields have been disabled, these fields match the Crash form. Note: if you need to change them, see updating date of death.
Fill out the empty fields
Validate
Verify
Transmit to the DOT
Updating date of death |
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If one of the following instances happen
One or more the grayed out fields needs updating
An individual died within the 30 day crash window
It was found that someone was transported to the hospital
To update this items on the fatal supplement do the following
Create an amended crash report (See working with 2017 amended crash form)
Transmit the crash form
Open the Fatal supplement you are working on.
Place the fatal supplement form in Edit mode, by Clicking Edit Form
Click the Update button in the Crash ribbon.
The grayed out fields will update to the latest amended form.
Finish the report
Validate
Transmit.