Gbenga Akinnagbe, Raquel Nave, Kali Reis, Michael Pitt, Katherine Waterston, and Mike Tyson appear in supporting roles.

Rookie New York City Fire Department (FDNY) paramedic Ollie Cross arrives in the chaotic aftermath of a gang shooting.

Later, Cross suffers incessant verbal abuse from a junkie being transported to hospital, and helps to perform a difficult tracheal intubation in a butchers.

Cross explains to Rutkovsky that he's living in a tiny apartment with two roommates to save money while studying to retake the Medical College Admission Test (MCAT).

Cross turns it back on, and Lafontaine protests that the drug dealer deserves to die and they can decide who survives transport, implying that Rutkovsky feels the same way.

[3] In February 2021, Sean Penn replaced Gibson in one of the lead roles and was reported that Open Road Films had acquired the U.S. distribution rights.

[14] In January 2024, Vertical and Roadside Attractions acquired North American rights to the film, which was renamed Asphalt City, and released it exclusively in theaters on March 29.

The website's consensus reads: "Asphalt City can be commended for trying to highlight the unforgiving nature of EMT work, but the unrelentingly grim end results prove a punishing watch.

[17] Eric Ortiz Garcia of Screen Anarchy wrote that the film "finds its power reflecting the brutal level of stress inherent in this profession ... Sauvaire makes his mission explicit: to raise awareness about those paramedics who are completely overwhelmed.

"[18] Tori Brazier of Metro wrote, "Black Flies is a grim tale, and not a recommended watch for the more delicate cinema fan, but its message and lack of subtlety certainly hit home.

"[19] Pete Hammond of Deadline wrote that the film had a "game cast and nice mostly handheld camera work by David Ungaro" but that it failed to offer anything new, and repeated plot points already covered in Martin Scorsese's Bringing Out the Dead (1999).

[20] David Ehrlich of IndieWire wrote, "Black Flies is such an unrelentingly bleak look inside the busted gut of the American healthcare system that its posturing honesty soon curdles into something that's hard to believe.