A 71-year-old Japanese visitor was in critical condition Monday night at the Queen’s Medical Center after falling off an E Noa Tours trolley just outside Ala Moana Center earlier in the day.

Police said the man was standing next to the right side exit at the middle of the vehicle as the trolley was leaving the shopping center.

When the 33-year-old driver made a left turn onto Ala Moana Boulevard toward Waikiki, the man fell onto the roadway 520 feet west of Atkinson Drive, police said.

He suffered head injuries and was taken by ambulance to the hospital, police said.

Police Sgt. Lorenzo Ridela said in his 91⁄ years with the Vehicular Homicide Section, “I don’t recall anyone falling out of a trolley.”

Ridela said the man’s wife was also on the trolley.

Exits on the trolleys have no doors or bars.

A steady stream of trolleys picked up and dropped off visitors at the shopping center Monday evening, and riders said they felt safe.

“Maybe it was the language — he didn’t understand he had to hold on,” said visitor Alan Puckett, 66, of Sydney, who was waiting in line to catch a trolley. “As far as I’m concerned, they are not dangerous,” he said.

Yuko Karatani, 23, of Osaka, Japan, said of the trolleys, “It’s a little scary, a little not safe.”

Her father, Junichiro Karatani, 74, said, putting your legs and arms out “is very dangerous. There is no window.”

Tomo Tani, 61, of Kobe, Japan, said, “Driver tell, ‘Don’t stand up. Sit down. Children standing on the bench, sit down.’”

Eddie Holt, a driver with Hawaii Island Transport Services, a subcontractor for E Noa Tours, said about passengers who are standing, “If they’re not hanging on like they’re supposed to be on handrails and safety straps, then I could see someone fall off.”

“If there aren’t any more seats left, and you are standing, you are advised to hang on, just like the city bus,” Holt said.

He said the turn onto Ala Moana Boulevard is “a fairly sharp turn, but we’re not going that fast.”

Holt called it an “isolated incident which is unfortunate.”