Fire, explosion, and electrocution become companions to patient care with increasing dependence on mechanical and electrical devices. The expertise with which each new item is introduced gradually yields to operation by superficially trained personnel as successful application makes the device indispensable. Complicated design, structure, and circuitry are not necessarily the components of disaster. Rather, appreciation of the context in which appliances are used, as an overriding criterion for design, is imperative for safety. Indeed, in the bizarre and near-fatal accident described here, equipment and furnishings were ordinary to any patient-care unit; security in their use was bred of familiarity rather than knowledge. A double room was plunged into darkness as an oxygen-powered respirator in use on a critically ill patient suddenly erupted sparks and thick, black, acrid smoke. The accident is reported in detail to warn of the hazards of fire, explosion, and electrocution that accompany the use of appliances.