If anything, the process of engineering is most difficult in that answering most questions tends to be straightforward (not easy, but straightforward once you know the right methods to apply), while figuring out if you've asked all the right questions is the thing that keeps me awake at night. If you don't ask and dig in until you've answered it fully, it's easy to get blind sided.
I have difficulty believing it could have gone so horribly wrong now, but I can't deny that just from the information available, even if MCAS isn't the root cause of the Ethiopian Air crash, there is some egregious failures in sound practice going on with Boeing to have slipped up this badly.
That's the thing with sound Engineering, when you do it, it just verks. When you don't...
So while yes, runaway trim is a thing, the circumstances under which an error could happen are substantially different.
For instance, a pilot could check the maintenance log book and see some work or inspection was done on the auto-trim subsystem. This would prime the pilot to be more on the alert for the possibility of trim misbehavior during the flight. Crisis averted, right?
But no pilot would look at an entry for an AoA sensor being off or worked on, and would think, "Boy, better look out for that safety system I never knew existed that could cause a trim runaway because my previously airworthyness agnostic AoA sensor is unreliable."
Flying and complex system diagnosis in time sensitive conditions requires extensive ahead of time mental model creation ahead of time.