The 2011 Ford F-450 SD has 5 recalls, the most serious being multiple fire risks: a body control module electrical short that can overheat and ignite the vehicle, and oil leaking from a power take-off pressure switch onto the exhaust's thermal blanket, which can catch fire.
The fire risk from the PTO pressure switch appears across vehicles modified by different upfitters, but the underlying hazard is the same in each case. There is also a drivetrain concern specific to trucks equipped with ambulance or fire engine preparation packages: a transmission control issue can cause the engine to shut down unexpectedly, requiring a cool-down period before restart, which can delay emergency response.