Author(s): Kathleen Robinson. Published on January 1, 2012.

Death from Below
In the wake of the 1929 Cleveland Clinic fire, stricter standards for storing hazardous materials

NFPA Journal®, January/February 2012

"One moment, a hundred or more patients . . . were undergoing examination on medical tables. The next instant, death belched from the x-ray room in the basement."

So wrote The New York Times on May 16, 1929, on the deadly fire the day before at the Cleveland Clinic in Cleveland, Ohio.

The fire is believed to have started with an explosion in the clinic’s basement x-ray room, when nitro-cellulose film was exposed to a 100-watt light bulb, releasing smoke and poisonous gas, according to the Encyclopedia of Cleveland History. The gas, which one doctor likened to phosgene gas, "filtered through the four-story brick building slowly at first and then, augmented by a second and greater explosion . . . rushed up from the basement and cut off escape down the stairways and elevators," the Times said.

Most of the 123 victims were asphyxiated by the gas, their faces turning a "sickly yellowish-brown color" within minutes of inhalation. Others appeared uninjured, but dropped dead soon after they were rescued. Some were trampled to death trying to reach the exits.

Firefighters, unable to enter the building through the ground-level entrances, took ladders to the roof and used ropes to lower themselves through a blown-out skylight. "I never hope to have to look at anything so horrifying again," said one firefighter of looking down into the building. "As far down the stairway as you could see were bodies, bodies, bodies." Among the dead were Dr. John Phillips, a cofounder of the clinic.

In the aftermath of the disaster, clinic officials were absolved of responsibility for the fire, and lawsuits amounting to about   $3 million were settled out of court for $45,000. On the national level, the fire spurred the development of stricter standards for storing and labeling hazardous materials, particularly nitro-cellulose film.

The Cleveland Clinic eventually recovered, and today the hospital is among the country’s best medical facilities, placing fourth in a 2011 U.S. News & World Report rating of the 17 best hospitals in the United States.

— Kathleen Robinson