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For example, on January 17, 1994, at 4:31 AM Pacific Standard Time, an earthquake registering 6.8 on the Richter scale occurred in a previously unrecognized fault in Los Angeles County's San Fernando Valley, killing at least 60 people.  The earthquake caused considerable damage to health facilities and significant health service disruption.  Immediately after the shaking stopped, structural and nonstructural damage forced several hospitals to evacuate patients and move operations outside (9,10).  Structural damage forced several older hospitals and medical buildings to cease or reduce operations.  During the 1985 Mexico City earthquake, which killed an estimated 7,000 people, a total of 4,397 hospital beds were lost--about one in four of those available in the metropolitan Mexico City area (119).  Hospital emergency plans in earthquake areas should provide for the contingency of evacuating patients from the wards; safely removing critical equipment from operating theaters, radiology departments, and other parts of the hospital; and re-establishing routine patient-care services (120).