(AP) — The Kansas Highway Patrol says a school bus driver’s medical condition directly impacted the cause of a crash that injured the driver and 22 middle school students.

The Aug. 21 accident outside Bonner Springs injured the driver and 22 sixth-grade girls from the Pembroke Hill School in Kansas City. The injuries included broken collar bones and concussions.

The patrol investigation says video shows the 66-year-old driver’s hands weren’t on the steering wheel and his head was dropped down as the bus took a highway exit curve too fast and overturned.

Investigators said the driver was taking medication for high blood pressure and diabetes, and his condition had a direct impact on the crash.

The report was sent to the Wyandotte County District Attorney’s office.