Six people are dead and one in a critical condition in hospital after an early morning pile up near Edgbaston in Birmingham.
Six vehicles were involved in the crash including a black cab whose driver was killed in the carnage. A woman in the back seat was confirmed dead at the scene and a man she was with later died in hospital.
Four men were thrown from the third car, three of whom were confirmed dead at the scene and the fourth was taken to Queen Elizabeth Hospital Birmingham.
However, there were stories of survival as a man and woman travelling in the first car were able to get out the car with only minor injuries.
A West Midlands Ambulance Service spokesman said: "There were six vehicles involved in the crash scene, which was extensive.
"In the first car there were a man and a woman. The vehicle had suffered very extensive damage but astonishingly, despite the damage, the pair had managed to get out and had suffered relatively minor injuries. They were taken to Heartlands Hospital by ambulance for further assessment.
"The second vehicle, a 'black cab' was on its side. Sadly, there was nothing that could be done to save the driver and he was confirmed dead at the scene. The man and woman in the back were rapidly extricated.
"Unfortunately, it was not possible to save the woman and she was also confirmed dead at the scene. The man was taken on blue lights to the major trauma centre at the Queen Elizabeth Hospital Birmingham with [a] trauma doctor travelling with the crew. Sadly, he died at hospital.
"There were four men from the third car. All had been ejected. Tragically, three of them were confirmed dead at the scene. The fourth was also taken on blue lights to the major trauma centre at the Queen Elizabeth Hospital Birmingham with the Critical Care Car doctor travelling with the crew. He was said to be in a critical condition on arrival.
"There were three further cars involved in the crash which had tried to avoid the crash scene. "Ambulance staff did not see anyone from the first vehicle. A man and a woman from the second vehicle suffered minor injuries and were taken by ambulance to Heartlands Hospital for further assessment.
Very upsetting scenes
"There were two men in the third vehicle. One was discharged on scene after assessment; the other said he didn't require any assistance. This was an extremely complex and distressing crash scene that required excellent multi-agency teamwork.
"The ambulance service has already debriefed all of the staff involved and will be providing on-going support as required due to the nature of the incident."
Emergency services rushed to the scene after the crash, which happened just after 1am on Sunday (17 December).
They were confronted with "very upsetting" scenes with photos from the scene showing at least three destroyed cars and debris strewn across the road.
West Midlands Police said on Twitter: "We are continuing to investigate a serious collision this morning involving three cars on Belgrave and Lee Bank Middleway in Birmingham. Six people have sadly been confirmed dead. Please avoid the area."
The stretch of road from Islington Row to Bristol Street has been closed and is expected to remain shut for some time as investigators look for clues on how the crash happened.
Birmingham Police tweeted: "All first responders at the scene are doing their very best in very difficult and upsetting circumstances. This is a very serious incident. If you saw the crash happen or the circumstances leading up to it, please call us now on 101.
"All emergency services are responding to a very serious crash near the tunnel on Lee Bank Middleway close to Bristol Street, Edgbaston. Avoid the area. Road likely to be closed for a very long time."