A man driving a pickup complained of chest pains minutes before his vehicle crossed the center line of State Route 7 and struck another pickup.
The driver, 48-year-old Glenn Fitting, died and six people from the other car were injured in the collision, which closed both lanes of SR 7 at 316th Street East near Eatonville.
Two adults were taken to MultiCare Tacoma General Hospital and are listed in serious condition.
Four children were also injured in the crash and are at MultiCare Mary Bridge Children's Hospital. A 7-year-old girl is in critical condition and three children, 3, 4 and 8, are listed in satisfactory condition.
Fitting had called his girlfriend saying he was having chest pains about ten minutes before the crash.
According to investigators she told him to call 911, but he said he was going to drive himself to the hospital.
WSP spokesperson Trooper Guy Gill said no one should be driving if they fear they are having serious health problems.
"If you get going on the road at speeds and something changes," said Trooper Gill, "These things can happen."
Investigators do not know if the health problems caused the wreck.
Other drivers told police Fitting had been speeding and passing other cars prior to crashing into the other pickup.