A Pennsylvania couple died and nine others were injured after a van rolled over at least five times on Interstate 95 in Colleton County Wednesday night.

The van was carrying 11 people northbound on I-95 when at 7:27 p.m. the van ran off the right side of the road near the 42 mile marker, littering the area with injured people and debris, authorities said.

Four people were ejected from the van, including a husband and wife, 49 and 48, respectively, who died at the scene, according to Colleton County Fire and Rescue Director Barry McRoy.

Two sisters, ages 11 and 14, were also ejected from the van.

All of the passengers were from Pennsylvania, McRoy said. It appears as though none of them were wearing seatbelts.

McRoy said three other patients sustained critical injuries, including a 3-year-old boy who was near-death and barely breathing when Colleton County firefighter-paramedics arrived. The boy was treated at the scene and taken to Colleton Medical Center and later taken by helicopter to the Medical University Hospital, where he survived the night, McRoy said.

Volunteer firefighters from various areas of the county and Yemassee responded to the scene, as well as many bystanders.

Two medical helicopters landed at the scene and took the 11-year-old girl to the Memorial Medical Center in Savannah and a 22-year-old male to MUSC.

The remaining patients were all taken by ambulance to Colleton Medical Center in Walterboro, which was alerted ahead of time about the large number of incoming patients, McRoy said.

The 14-year-old girl ejected from the car was later taken to MUSC.

In total, five ambulances, three fire engines, four paramedic first response units and three helicopters responded to the scene, McRoy said.

S.C. Highway Patrol Cpl. Paul Brouthers said they are investigating what caused the van to run off the side of the road.

McRoy said several good Samaritans arrived at Colleton Medical Center later that evening. One man brought some of the patients clean clothing to wear and money to help them while another family brought children's clothes.