While an anguished nation slept in the hours after the assassination of US president John F Kennedy, flames tore through a nursing home in rural northern Ohio, killing 63 people in what remains one of the worst such fires in that country's history.
Many victims had been restrained to their beds or trapped behind wheelchairs too wide for the exits.
Investigators blamed faulty wiring and found the nursing home didn't have an evacuation plan.
Overshadowed by the shooting in Dallas 50 years ago and largely forgotten now, that deadly fire - along with a string of other nursing home fires in the 1960s - helped bring about better US federal and state oversight and uniform safety rules for the industry.
Until then, inspections and regulations were inconsistent, and there were no requirements for sprinklers, fire drills or safety plans.
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The result was a series of nursing home fires that killed an average of 15 people a year during the 1960s and early 1970s, said Tom Jaeger of Virginia, a long-time consultant to the nursing home industry.
Now the number killed in multiple-death nursing home fires is less than two each year, he said.
The industry has made great strides in reducing those fires, but US health experts and regulators warned just this year that many nursing homes were ill-prepared for natural disasters after examining responses to hurricanes Sandy and Katrina.
The fire on November 23, 1963, at the Golden Age Nursing Home in Fitchville, a village between Toledo and Cleveland, killed all but 21 of the home's residents.
The fire began just before 5am in the attic of the one-storey building, burned through the phone lines and spread before anyone knew what was happening.
By the time firefighters arrived 10 minutes later, the building was burning from one end to the other.
Passers-by and employees managed to get a few residents out.
Jerry Earl, who was 18 at the time, arrived with his father, a fire chief in a neighbouring village.
He said he found one of the exits blocked by a wheelchair with a charred mass behind it.
After the fire, which wasn't carried on the covers of many major US newspapers, Ohio's governor ordered beefed-up inspections of wiring in nursing homes.
State lawmakers later established regulations that required sprinklers, fire exits and extinguishers.
US Congress instituted safety codes that went into effect in 1970 and spelled out rules for building construction and fire safety.
But it wasn't until this year that all nursing homes were required to have automatic sprinklers if they wanted to qualify for Medicare and Medicaid reimbursements.
