Officials said a car driving on East 229th Street in the Williamsbridge section struck 37-year-old Irene Espinal's van, causing it to roll over and land on top of her.
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Neighbors came running to the scene after hearing the startling noise of the crash, and they frantically tried to save the woman pinned under the van.
"Her neck and her shoulder, they were cut with their wheel, so i guess it cut her respiration," witness Maureen Cani said.
Another witness, Bryanna Glassford, heard the screams, ran outside and called 911.
"She was breathing when I came outside, but five minutes into the conversation she stopped," Glassford said.
They said they could not pull Espinal out from under the vehicle because she was under the wheel.
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Espinal was pronounced dead at the scene. She worked for IAHD and was in the process of bringing a resident of a group home to an appointment at Montefiore Medical Center when the crash happened.
"We are devastated to learn of the death of a cherished employee of IAHD," said Kerry Brady, director of residential services at IAHD. "This is a terrible tragedy and our heartfelt condolences go out to Irene's family. We are working closely with police as we await the results of their investigation."
Espinal started working for the company earlier this year.
Police said the driver of the vehicle that struck the ambulette fled the scene after the crash. They're now looking for the driver and vehicle involved.
No passengers in the ambulette were injured.