A medical emergency may have contributed to a Tuesday morning fatal crash in Wise County. Virginia State Police say a 55-year-old man was driving a pickup truck on Route 23 near Route 634 when for some reason he went off the road and hit an embankment. He was taken to a hospital where he later died. VSP says the crash remains under investigation but they are looking at a possible medical issue as a cause. There were no other vehicles involved and no one else was hurt.