The crash involved a utility service vehicle and happened on a state highway in Meigs County in eastern Tennessee, said Lt. Bill Miller of the Tennessee Highway Patrol.
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There were 22 children on the bus when the crash happened. Five were airlifted to a regional hospital, and two were taken by ambulance, officials said.
The bus driver, a woman, had no opportunity to stop, the THP said at a Tuesday evening news conference at Meigs South Elementary School in Decatur, according to the Chattanooga Times Free Press.
One student, a boy, was in critical condition and was undergoing surgery as of late Tuesday night. No names were released pending notification of family.
"My sincere condolences to this community and to the family of the school bus driver and the family of the 7-year-old who was killed tonight in this crash," Lt. Miller said.
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Tennessee Education Commissioner Penny Schwinn said in a statement that she and the entire staff at the Tennessee Department of Education are "deeply saddened" to hear about the crash.
The driver of the utility vehicle, from Service Electric, was being treated for minor injuries.
Authorities are investigating the crash. No charges have been filed as of Wednesday morning.