Many years after he left ER as a regular, Noah Wyle admitted he had not enjoyed the final few seasons he'd done the show full-time. He also said that he'd treated newcomers to the series such as Kellie Martin, Erik Palladino, and especially Goran Visjnic badly, and apologized to them in interviews. He also admitted he hated Visjnic because it was clear the Croatian was a much better actor than Wyle himself was.
The balcony collapse in this episode is similar to the deadliest balcony collapse in United States history which occurred two years prior on June 29, 2003, in Chicago; killing 13 and seriously injuring 57 others.
This episode is Noah Wyle's final appearance as a cast member, although he guest-starred in 2006 and 2009. Wyle was the last original cast member remaining in season 11. Sherry Stringfield was also an original cast member, but left between 1996 and 2001- Wyle was on the show for a continuous 11 years from the pilot in 1994 to the 11th season finale.
When Carter leaves the ER, he says "You set the tone" to Morris. Mark Greene said the same thing to Carter when he left the ER three years earlier. Before that, the phrase was originated by Dr. David Morgenstern when he was leaving for the last time and said it to Dr. Mark Greene.
During the brief "You set the tone" conversation Carter has with Morris in the ambulance bay, Morris has exactly the same posture that Carter had when Mark Greene had the same conversation with Carter. The only difference is that Carter had his stethoscope in hand, where Morris' hands are empty. The conversation between Carter and Greene is the source of a brief clip in the opening credits montage.