Accident Investigation Report of a Fatal Collision Between an Ambulance and a Motorcycle: A Case Study of Vehicle-Related Risk Factors and Vulnerable Road Users in Nakhon Ratchasima Province, December 2025

Abstract

On December 18, 2025, the Situation Awareness Team (SAT) of the Office of Disease Prevention and Control 9, Nakhon Ratchasima, was notified by the Nakhon Ratchasima Provincial Public Health Office regarding a fatal collision between an ambulance and a motorcycle, resulting in one fatality. This accident event directly impacted the safety of medical personnel and patients, reflecting safety gaps within the referral system regarding the utilization of aging vehicles. The Joint Investigation Team (JIT) and the Road Traffic Injury (RTI) Team jointly collaborated to investigate the incident. The study was descriptive epidemiological research. This study aimed to: 1) describe the epidemiology of the injuries and fatality resulting from the accident, 2) investigate the causes and contributing factors of this accident, and 3) identify preventive measures to mitigate the severity of ambulance-related road traffic injuries. Data were collected through interviews with involved individuals, as well as physical inspections of the vehicles and the environmental conditions at the crash site. Data were subsequently analyzed using the Haddon Matrix and Swiss Cheese Model. The results revealed that the collision occurred on a narrow community road when the motorcycle suddenly cut in front of the ambulance. The ambulance, which had been in service for more than 10 years, was traveling at a speed of 81 km/h. The motorcycle rider was a 74-year-old male with a hearing impairment who was not wearing a safety helmet, and he sustained severe injuries and subsequently died. The three occupants of the ambulance comprised the driver, an ophthalmic patient, and the patient’s relative. All of them sustained no injuries due to strict adherence to seatbelt utilization. The findings of this study indicated that the incident was driven by three primary dimensions of vulnerability: 1) human factors (the opposing party was an older adult with a hearing impairment), 2) vehicle factors (the ambulance was over 10 years old), and 3) environmental factors (a narrow community road with limited visibility). Therefore, greater emphasis should be placed on implementing a safe speed for conditions in community areas. Furthermore, policies should be established to limit long-distance patient transfer missions for ambulances with extended service life in order to mitigate systemic risks.