Brant, NY (WKBW) - A one-month-old boy and two adults are dead after a crash on the Thruway near the Town of Brant.
Now, authorities are asking why were ten people, including seven children, packed into a minivan.
Some of the children, first responders say, were not properly restrained -- sitting and sleeping in the vehicle's floor.
Trooper Douglas Montijo says that "children need to be in safety restraints. They save lives. It's very important and they are only helpful if they are used properly and installed properly."
Police are now blaming a deadly combination of suspected driver fatigue and a lack of safety seats for the severity of the crash.
Three people were killed in the accident, which happened at about 7:30 in the morning.
Six kids in the accident are at Women and Children's Hospital in Buffalo. As of early Wednesday afternoon, three other children were in the Intensive Care Unit on ventilators.
"People forget they are traveling at the same speed and they have the momentum of that speed when they travel and they continue to travel once the vehicle stops and they strike the vehicle," says Douglas Montijo with the New York State Police. "That either being another passenger, the seat, a door pillar or something along those lives."
Investigators say there were 10 people inside the 2003 MPZ Mazda Minivan, which seats seven people.
However, Montijo says the second row of seating had been ripped out. Some of the children were left sitting on the floor during their trip back from Florida.
In addition to the one-month-old in the vehicle, the children were ages two, four, six, eight, ten and thirteen.
Montijo says "We see one infant style seat and a booster seat ... And possibly another child seat, we were rummaging through the remains at the scene."
Investigators believe the driver, 27-year-old Luis Arroyo of Buffalo, drifted off the road, hitting a Thruway Maintenance vehicle.
Arroyo and his one-month-old infant, Luis Arroyo, Jr. were pronounced dead the scene.
29-year-old Christieanne Gonzalez was pronounced dead at Lakeshore Hospital. Police say she talked to investigators before being transported from the scene.
The children who survived still face a tough fight.
Three are stable with moderate injuries. Three others are in the Intensive Care Unit.
Wednesday afternoon, Dr. Kathryn Eass, the Director of Trauma and Women and Children's Hospital, said "Three of them are on ventilators right now because of head injuries, chest injuries and many of them also have long bone injuries and several of them also have abdominal injuries."
Doctors say the next 24 to 48 hours will be critical for their recovery.
A third adult in the minivan was also the hospital. 24-year-old Jessica Gonzalez was taken to Erie County Medical Center for surgery.
The other children injured in the accident are two-year-old Jaicob Gonzalez (stable condition), four-year-old Jaiden Gonzalez (stable condition), six-year-old Adrianna Arroyo (critical condition), eight-year-old Yamaris Rodriguez (critical condition), 10-year-old Alexis Rodriguez (stable condition), and 13-year-old Alexandra Rodriguez (critical condition).
Doctors say Alexandra Rodriguez had to undergo an hour-and-a-half surgery on head and neck injuries.
A Thruway Maintenance worker was sustained wrist injuries in the crash.
State Police believe driver fatigue was the reason of the accident. However, they are also looking into the possibility of a medical condition. They are also awaiting toxicology results from Arroyo's autopsy.