Investigators with the N.C. Highway Patrol said the accident was one of the worst they have seen.
They said a white Buick driven by Marcia Gorham Smart, of Havelock, was headed north on I-95 at about 2:30 p.m. when it veered off the road, flipped over several times, and landed upside down in a ditch.
"When she ran off the road and realized it -- whether she fell asleep or whatever -- when she tried to correct it, that's when she started to roll over," Trooper David Whitley said.
Five people were pinned inside the car. Four of those passengers died, and a fifth person -- 16-year-old Jamal Bush -- was flown by helicopter to Pitt County Memorial Hospital.
Smart, 59, was killed, along with New Bern residents Bonnie Herring, 47; Robert Allen, 70; and Sheila Allen, 54, troopers said.
An official at Pitt County Memorial Hospital said Sunday that Bush was treated and released.
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