On 11 Oct 2023, a pickup truck crashed into a roadside tree in Narathiwat Province, southern Thailand after overtaking another vehicle. We conducted a descriptive study by reviewing medical records and interviewing rescuers, officers, survivors, and witnesses. We surveyed the collision site, reviewed video records, and used Haddon’s matrix to assist with the analysis. A pickup truck carrying 11 passengers (including the driver) overtook another pickup truck on a stretch of road. The driver of the first pickup truck lost control due to tire deflation and crashed into a tree resulting in eight deaths (72.7%) and three hospitalizations (27.3%). All deaths were caused by severe head injuries. Multiple factors during pre-crash (vehicle unfamiliarity leading to improper passing sight distance and speeding), the crash (overloaded truck and a roadside tree), and post-crash such as poor communication, contributed to the severity of this event. The driver of the truck had no driving license and was unfamiliar with the vehicle. Six passengers were sitting in the truck’s cab and three were in the cargo bed. Pre-crash and crash speeds were determined to be 80 and 100 kilometers per hour, respectively. The passing sight distance was grossly insufficient. Poor communication in the rescue process and the crowd of people at the scene resulted in improper emergency management. Strengthening law enforcement, increasing the number of speed limit signs, felling roadside trees, and practicing mass casualty incidents should be implemented.
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