Officers identified the victim as James Vern Banister of Zebulon, who they said was driving the 1991 Nissan Pathfinder that ran off the left side of East Haywood Street and smashed into a tree about 4:45 p.m.
His son, James Scott Bannister of Zebulon, was a passenger and was seriously hurt, police reported.
Eastern Wake EMS took both men to WakeMed, police Chief J.A. Privette said.
The car was coming to the intersection of Haywood and South Pine Street when the elder Bannister lost control "due to a medical condition," Privette said. The car accelerated, went off the road, struck a mailbox and then hit the tree.
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