The 2018 Ford E-450 has 4 recalls, the most serious involving loose U-bolts on the rear axle of transit bus conversions that can loosen further or break, allowing the axle to separate and causing a loss of vehicle control.
Two recalls affect ambulance conversions equipped with Whelen brake lights: the lights can illuminate without the brake pedal being pressed, which may confuse following drivers. On shuttle bus conversions equipped with ASA Electronics Voyager backup monitors, the screen can revert to factory default settings and display a mirror-reversed camera image, causing the driver to steer the wrong direction when backing up. All four recalls stem from third-party upfitters rather than the base Ford chassis, so applicability depends on how a specific vehicle was converted.