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A dramatic video of Sunday's crash shows a woman hitting the driver in the head with an object, prompting him to retaliate with one hand. The woman is unleashed once again.
The driver then abruptly pulls the steering wheel to the left and the bus starts, hitting a car before breaking the rails of the bridge crossing the Yangtze River in Chongqing City (southwest).
Thirteen bodies have been removed from the river, but two are still missing. In total, 15 people were on the bus.
Local police said that the passenger involved in the fight, a 48 year old, approached the driver and asked to be released after missing his stop.
When the driver refused, the two men started screaming and using an "aggressive language," police said on their Weibo account, the Chinese equivalent of Twitter.
The search and rescue teams have dispatched more than 70 boats, as well as a team of divers and underwater robots, to find the wreckage and recover the bodies in the water.
"The lessons to be learned are very painful," police said.
Fatal road accidents are common in China, where traffic rules are often flouted or not enforced.
According to the authorities, in 2015 alone, 58,000 people were killed in accidents that occurred throughout the country.
Road traffic offenses were attributed to almost 90% of accidents resulting in death or injury that year.
Thirteen bodies have been removed from the river, but two are still missing.