It happened because he refused to take his medication for Epilepsy, but he won't spend a single day in prison.
Despite cries for Afzal to say he was sorry, there was nothing Judge Roger Hays could do or say in Manhattan Supreme Court, that could take away a family's pain.
It was nearly 4 years ago when rookie cabbie, Hassan Afzal, failed to take his seizure medication, and failed to admit he was a person with Epilepsy when he applied for his cabbie license.
He literally gave his 4 passengers the ride from hell.
First, he blasted rap music, and when they asked him to lower it, "You made it louder, you laughed," said one of his victims.
Then, he was speeding nearly 90 miles an hour they say on the West Side Highway.
All while putting his right leg on top of his front-seat passenger, Danielle Ricco, a 21-year-old Sophomore at Pace University.
She was thrown from Afzal's cab as it crashed, and then, struck and killed by another cab on the highway.
"How did you do that? Drive your taxi with your left foot, and put your right leg on my daughter, how dare you touch our daughter," said Richard Ricco, the victim's father.
24-year-old Amy Vallarelli, who survived the crash, choked back the tears in court as she described her shattered leg and pelvis.
"So I had to walk around, in excruciating horrible pain for years, because of your reckless, irresponsible driving!" exclaimed Vallarelli.
It was the kind of driving that makes anyone hailing a cab in the city cringe.
Emotions in court, were obviously still very raw.
"You won't say your sorry? You're a monster!" yelled a family member at Afzal.
Afzal will serve no time behind bars because proving he actually had a seizure while driving would have been so hard, prosecutors could have lost the conviction.
In court, while Afzal's lawyer said his client was remorseful, Danielle Ricco's grieving mother said, "I'm sorry, I'm a grieving parent, I have no forgiveness."
Outside the courtroom, it was clear their haunting questions will go unanswered forever.
"You don't even care you killed somebody! What kind of human being are you!" yelled the victim's family.