The 2018 Ford E-450 has 4 recalls, the most serious involving rear axle U-bolts on transit bus conversions that can loosen further or break, allowing the axle to separate from the vehicle and causing a sudden loss of control.
All four recalls affect vehicles that have been modified by third-party upfitters rather than the factory, so each applies to specific ambulance, transit bus, or shuttle bus conversions rather than the base chassis broadly. On ambulance builds from two separate converters, Whelen-brand brake lights can illuminate even when the driver has not pressed the brake pedal, sending a false signal to drivers behind and creating confusion that raises the risk of a rear-end collision. There is also a backup camera concern on E-450-based shuttle buses equipped with ASA Electronics Voyager monitors: the monitor can revert to factory default settings and display the camera image in a mirrored or reversed orientation, meaning a driver steering away from an obstacle they see on screen may actually be steering toward it.