Millions of people are still driving vehicles with Takata air bags that may pose a lethal danger because they have not been repaired or, in some cases, even recalled.

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ROCK HILL, S.C. — The shrapnel from the Ford Ranger air bag punctured Joel Knight’s neck with so much force that investigators initially did not rule out a fatal shooting.

Knight’s truck hit a stray cow on a South Carolina highway last month, an accident that should have left Knight, 52, a welder, shaken up but not dead.

Instead, Knight bled to death, not knowing that the air bag in his truck had ever posed a risk, because it had never been recalled.

He most likely did not even know his air bag had been manufactured by Takata, the Japanese supplier whose faulty air bags have been linked to 10 deaths and more than 100 injuries, said his widow, Ann Knight.

“If he’d have known, he’d have gotten it fixed,” said Ann Knight, 50. “He took good care of that truck.” She added: “Now something that was supposed to save him killed him.”

More than a decade after the first confirmed rupture of a Takata air bag in Alabama, and despite a vast recall spanning 14 automakers, a reality remains: Tens of millions of people drive vehicles that may pose a lethal danger but have not been repaired or, as in Joel Knight’s case, have not even been recalled.

Since 2000, Takata has sold as many as 54 million metal “inflaters” in the United States containing ammonium nitrate, an explosive compound that regulators believe is at the center of the problem, according to an estimate by Valient Market Research and provided to The New York Times. About 28 million inflaters in 24 million vehicles have been recalled. And of the 28 million recalled inflaters, about 30 percent have been repaired. The rest of the inflaters, about 26 million, have not been recalled.

The National Highway Traffic Safety Administration (NHTSA) has stepped up its scrutiny of the problem, after a series of missteps over nearly a decade, but has stopped short of an immediate recall of all Takata air bags containing the compound. The agency does not have the authority to order people to stop driving the cars and has not advised people to avoid driving them.

Gordon Trowbridge, a spokesman for the safety agency, said that not knowing the exact cause of the ruptures prevented broader recalls.

“It is unknown why some inflaters perform better than others,” he said. “It is unknown why the same inflater, with the same propellant formulation, performs better in some vehicles than in other vehicles.”

Still, he added, “If NHTSA believes a vehicle presents an unreasonable risk to safety, the agency would seek a recall.”

Car manufacturers, at the same time, have been reluctant to sound alarms. They would face huge costs if they needed to provide loaner cars for millions of owners. Of the 14 manufacturers affected by the Takata recalls, not one has offered a blanket policy of supplying loaners.

Regulators have no authority to order automakers to make loaner cars available, but Trowbridge said his agency had encouraged them to consider doing so and had encouraged car owners to ask for loaners.

Chris Rouen of South Carolina is one such owner. He was turned down by Ford when he asked for a loaner while waiting for the recalled air bag in his Ford Mustang to be replaced.

“That’s wrong,” Rouen, 63, said. “That is just wrong.”

Drivers like Rouen report monthslong delays in getting their vehicles serviced at dealerships, for lack of replacement parts. Slightly less than 30 percent of recalled inflaters had been fixed as of Jan. 15, according to the safety agency. That was before regulators added 5 million more inflaters to the 23 million under recall.

And it may be years before regulators have any firm understanding of the scope of the problem. The safety agency, which has barred Takata from using ammonium nitrate for new orders, has given the supplier until the end of 2018 to prove that ammonium nitrate is safe in existing air bags. Takata has even longer, until the end of 2019, to show that inflaters with a more advanced version of the compound are safe.

In recent months, the depth of Takata’s deception has become clear. Takata has admitted that its engineers manipulated test data, and it faces a criminal investigation into its handling of the defect.

But Takata’s client automakers, and regulators, also played big roles.

Honda, the automaker most affected by the recalls, learned of an air-bag rupture in one of its cars as early as 2004, and alerted Takata. But the companies deemed the incident an anomaly, and did not alert regulators. Only in 2008, after three more ruptures, did Honda issue its first recall, for 4,000 cars.

During that time, regulators were slow to investigate. An initial inquiry into Honda’s early recalls, in 2009, was closed after the two companies assured investigators that any quality issues were under control.

Even as the ruptures continued, automakers worked to minimize the scope of the recalls. In mid-2014, many automakers compromised with regulators and issued regional recalls limited to humid areas. Ammonium nitrate is sensitive to high temperatures and moisture, and can become unstable over time.

But only in May did Takata admit that its air bags were, in fact, defective, prompting more nationwide recalls.

All the while, the human toll has mounted.

In July 2014, a pregnant Malaysian woman was killed when the air bag in her 2003 Honda City ruptured. The inflater model was the same as the one that ruptured in Joel Knight’s 2006 Ford Ranger, though Takata said the two inflaters had different configurations. Yet Ford chose not to recall the Ranger until that November when, at regulators’ request, it issued a recall for the driver’s-side inflaters, but only for 2004 and 2005 Rangers.

Regulators tested 1,900 inflaters retrieved from the recalled vehicles. They could find no anomalies, Trowbridge said.

A month after Knight’s death, Ford recalled 391,000 vehicles with inflaters similar to the one from the Malaysian death.

Globally, Takata has shipped 80 million to 100 million inflaters with ammonium nitrate to 14 of the world’s largest automakers, according to Valient. The recall has become one of the largest and most complex in history.

“We are cooperating fully with regulators and our automotive customers and continue to support all actions that advance vehicle safety,” Takata said in a statement.

For Knight, the recall came too late. It was three days before Christmas; he and his wife, his 31-year-old son Jason, and four grandchildren planned a feast.

A metal chunk hurtled out from his ruptured air bag and punched a 1-inch hole in his neck, breaking his vertebra.

He also had wounds on his right arm. They show that he tried to brace himself from the air bag before he died.