The ambulance rushing to the aid of the injured is a staple of any action show, a sign of hope or a proof that everything is "going to be okay", civilization is working.
So, what's more ironic than getting killed by one? When an ambulance runs down a pedestrian, it's a sign that things have fallen apart or whatever God in charge has taken a darkly comedic turn.
As a Death Trope, all Spoilers will be unmarked ahead. Beware.
- On the climax of the final battle of JoJo's Bizarre Adventure: Diamond is Unbreakable, Jotaro stops time and crushes Yoshikage Kira's arms and hands with punches to keep him from activating his time-resetting ability. When time resumes, Kira falls on the path of an ambulance and gets his head crushed (the anime arguably makes it worse by showing his head being rotated 180° before cutting away). Note that he often boasted that fate was on his side.
- Dawn of the Dead (2004), when the heroine's gun-toting neighbor is run down by a passing ambulance.
- Final Destination 4, when the security guard is mentioning a feeling of 'déjà vu' and is run down by a careening ambulance twice.
- Hot Shots!: Dead Meat survives a plane crash only to be hit by an ambulance. Whether that or the Trauma Conga Line he endured afterward was the cause of his death is uncertain.
- In the 1980s nuclear Brit Com Whoops Apocalypse, there's a scene where U.S. President Johnny Cyclops, up for re-election, has been advised to fake an injury to gain sympathy and votes. The ambulance rushing him to hospital runs down and kills his political rival.
- Run Lola Run, by the same ambulance that destroys the Sheet of Glass.
- An ambulance is used to abduct people and steal their organs in the 1990 thriller The Ambulance. The same scenario takes place in the 1979 German film Fleisch.
- In Avalanche, the rescue workers cause more on-screen deaths than the avalanche does, including several caused by poor ambulance driving.
- Happens to Victoria in When Evil Calls. As a result of her wish, her mother loses control of her wheelchair as they are leaving the hospital. The chair rolls out into the road where it gets struck by a speeding ambulance.
- In Han Nolan's Dancing on the Edge, the mother of protagonist Miracle was hit by an ambulance while pregnant, and while they were unable to save her mother they were able to save Miracle herself. Later on we learn her mother was actually trying to commit suicide and jumped in front of the ambulance.
- Downplayed, played for laughs, and justified in The Bartimaeus Trilogy. When Bartimaeus was working for a military during a war in the early 1900's, he was tasked with infiltrating an enemy base. He took the form of an enemy medic and stole an ambulance. Because he's a demon (and therefore incompatible with technology) he accidentally ran over several people on the way there. Luckily, this meant that the soldiers at their HQ were so busy tending to his casualties they they didn't notice him sneaking inside.
- One episode of the live-action adaptation of Hell Girl has a hell banishment where a nurse who left a patient to die is run over by an ambulance and similarly left to rot.
- Barely averted at least once on Casualty, albeit with a motorcyclist instead of a pedestrian who got away with a few bruises and a stern reminder to look both ways before crossing a junction in future.
- A BBC docu-drama following Real Life ambulance crews opens one episode with some young idiot crashing his blinged-up shitbox into an ambulance as it crosses a junction.
- Played for Drama in season 4 of London's Burning after a collision between a fire engine and a car that left one civilian badly injured and resulted in Sicknote facing serious criminal charges. He's ultimately acquitted.
- On one episode of Top Gear, Hammond, May, and Clarkson were tasked with creating their own ambulances and "saving" dummies that were rigged with timers. Every time the body was bumped while on the way to the hospital, the victim got ten seconds closer to dying. May's fell out of the back of his ambulance, while Hammond's ended up through a window of the hospital.
- M*A*S*H: In "Dear Sigmund", Col. Potter has to write a letter to the parents of an ambulance driver who was killed when he overturned the ambulance while driving at unsafe speeds. He turns the duty over to Radar, who writes a touching letter about how their son died trying to save others' lives.
- Deconstructed on 9-1-1 by showing the effect it has on the ambulance driver. One episode has the crew respond to an industrial accident and have to take the victim to the hospital. After Hen turns on the siren, a young woman in a compact car pulls into the intersection in front of her and Hen rams into the side of her car. Hen is frantic when she sees that she's severely injured an innocent person and completely falls apart when the victim dies.
- The Widget Series Zombies Vs The Ambulance kind of zig-zags this trope, as you do use the ambulance to run down zombies, but you can also rescue people who haven't quite passed over into un-death.
- Grand Theft Auto
- The ambulance has a tendency to run you over if you stand too close to a wounded pedestrian. The first couple of times this happens you chalk it up to coincidence, but eventually you get the feeling it's driven by Laser-Guided Karma. Of course, none of this is a patch on the carnage that can result if you're behind the ambulance's wheel yourself..
- In the side missions where you use the ambulance to do emergency runs picking people up and taking them to the hospital, only the patient actually matters. You can kill as many other people as you'd like along the way with no consequences beyond the potential inconvenience of trying to pick up patients with a wanted level.
- Players doing the ambulance missions are often foiled by overeager patients sprinting towards your oncoming vehicle. If you're moving really fast (as you will be more often than not), you're gonna squash your patient and fail the mission.
- A variant occurs in The Incredible Hulk: Ultimate Destruction: there are side-missions where you must pick up an ambulance, and rush the wounded occupant to a hospital. You do this by sprinting across the city, through busy traffic and pedestrians, likely causing more loss of life than you actually saved.
- This clip from DayZ shows that just because there's a red cross on the side doesn't mean its coming to heal you...
- John Madden Football '92 includes a feature where when an athlete is injured, an ambulance drives onto the field. Athletes standing in the ambulance's path are run over and knocked off screen. This actually caused a minor controversy from Moral Guardians.
- Some abilities in Nexus War games allow players to throw ambulances, among other vehicles. In the first game, this was a purely Angelic power, but the sequel expanded it to all three moral sides.
- Danganronpa: Trigger Happy Havoc used a slight variation for Celestia Ludenberg's execution: it's not an ambulance that runs her over, but a fire truck. However, the spirit of the trope is very much in effect, since the fire truck arrived to extinguish the massive bonfire that was about to engulf her.
- The now-defunct blog "Random Acts of Reality", by British emergency medical technician Tom Reynolds, contained frequent rants about pedestrians who seem to be actively trying to make this Truth In Television.
- The Amazing World of Gumball:
- In "The Mystery", Principal Brown opens a door into Ms. Simian, knocking her out the window, whereupon she is slowly run over by the ambulance that was called for her (which is the same thing she caused to happen to Brown, but with a school bus).
- Mrs. Robinson's Laser-Guided Karma at the end of "The Wicked" culminates (after many other injuries) with her being run over by the ambulance—which is shot identically to the previous scene.
- In an especially cruel variant, "The Advise" has Banana Joe's gurney roll down a flight of steps into an ambulance, but then it keeps rolling through the windshield, plopping Joe in front of it as it drives off, siren blazing.
- The possibility of this was raised following the crash of Asiana Flight 214 in San Francisco, when a victim who had been ejected from the aircraft during the crash sequence was run over by an emergency vehicle. However, investigators later determined that the victim was already dead before she was run over, having likely died on impact when she was ejected.