A review of 208 cases involving injuries sustained by vehicle occupants was extracted from the computer storage at the Highway Safety Research Institute. In addition, 157 new car crashes investigated by the authors were separately analysed. Data analysis indicates injuries are sustained by direct occupant-to-occupant contact and by one occupant forcing another into or against one or more interior car structures. All body areas can be involved in this previously unreported injury mechanism, with the upper portion of the body being more susceptible to injury. Case histories from field accident investigations dramatically document a variety of these injury mechanisms.