The bus was returning the tourists to their hotel when the accident happened Saturday night on a highway on the outskirts of Honolulu.
The 65-year-old driver was in critical condition Sunday at the Queen's Medical Center, and two of the passengers were in serious condition, authorities said. Twenty-two other passengers were treated for minor injuries and released.
Two passengers tried unsuccessfully to take control of the bus after the driver slumped over, police said. The bus ran off the right shoulder, hit an embankment, flipped and then slid before coming to a stop, police said.
Most of the passengers got out through escape hatches through the roof of the bus, Fire Department spokesman Capt. Kenison Tejada said.
The driver's arm was trapped under the bus, Tejada said. ``We were able to use the jaws (Jaws of Life device) to free him up and take him out of the front windshield, which was actually near the ground level.''
Police said the driver may have suffered from medical problems, and that alcohol and speed were not factors in the crash.
