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As first responders arrived at the Bristol Health & Rehab Center on Tuesday afternoon, they were faced with a nightmarish scene: A nursing facility that housed 120 people had exploded, and dozens were trapped.

Shards of wood, glass, and paneling littered the lawn. The smell of gas hung thick in the air — and flames were spreading.

“Send everybody,” an officer immediately radioed, according to the Bristol Township police chief.

Police, firefighters, and even neighbors and a utility worker rushed into the blaze and began pulling people to safety — hoisting them through busted windows and missing doors, from stairwells and the basement flooding with water.

Then a second explosion erupted, sparking another fire and raising uncertainty about how many people were stuck beneath the rubble.

By Wednesday, the scale of the damage and its toll on the Lower Bucks County town had come into focus. Two women had died: Muthoni Nduthu, 52, of Bristol, who worked at the facility as a nurse for over a decade, and a resident whose name had not been released.

Nduthu had emigrated from Mombasa, Kenya, to the Philadelphia area about two decades ago, and earned her nursing degree from Jersey College, said Rose Muema, a friend who spoke on behalf of Nduthu’s family Wednesday.

“She came here to work,” Muema said. “She came here to make a difference.”

Nduthu, a devout Catholic, had three sons — Clinton, 30; Joseph, 24; and K.K., 18 — and a 4-year-old granddaughter. She was bubbly, hardworking, and committed to the people she loved, her friend said. On the night before she died, she cooked her famous spiced chicken for her family to enjoy.

As Nduthu’s family grieved on the eve of Christmas, others poured through the doors of area hospitals, visiting with the 19 people who remained hospitalized from their injuries from the blast. One person was in critical condition, police said.

All other residents and employees of the facility have been accounted for.

The cause of the explosion remained under investigation, Bristol Township Fire Chief Kevin Dippolito said Wednesday, though bystanders speculated that it could be connected to a gas leak that utility officials had responded to earlier Tuesday.

The National Transportation Safety Board, which helps investigate explosions, said it could take days to clear the wreckage to allow investigators to safely reach and evaluate the natural gas service line.

The tragedy has also brought new scrutiny to the facility’s long history of safety and care violations.

The nursing home, a collection of brick buildings on a two-acre campus in Lower Bucks County, was previously known as Silver Lake and was acquired by Saber Healthcare Group earlier this month. Previously, it was owned by CommuniCare Health Services, a privately run for-profit nursing home operator based in Cincinnati.

Just two months ago, state inspectors cited the facility for lacking a fire safety plan, failing to maintain extinguishers, and having hallways and doors that could not contain smoke. Corrections were ordered to be made by the end of November.

Federal inspections also flagged substandard healthcare, poor infection control, and mismanaged medical records, earning the facility a one-star rating. Operators were fined more than $418,000 in 2024, records show, due to ongoing violations.

It remains unclear whether the fire safety deficiencies were addressed.

Peco crews had responded to the nursing home earlier Tuesday on reports of a gas odor, a spokesperson for the utility said, adding that “it is not known at this time if Peco’s equipment, or natural gas, was involved in this incident.”

One Peco employee who was on site working to stop the gas leak was seriously injured, said Larry Anastasi, president of IBEW Local 614, the union that represents Peco workers.

The technician was working alone in the basement of the nursing home, then left to get more tools from his truck. As the worker was walking back into the building, Anastasi said, it erupted.

The worker then rushed into the building to help others escape, Anastasi said.

“He was trying to go in and get more people,” the union chief said. “[First responders] had to grab him and said, ‘Brother, you need to stop and go in the ambulance.’”

The technician, whom Anastasi declined to name to protect his privacy, suffered burns to his face and hands, as well as injuries caused by shrapnel, he said. He remained hospitalized at Thomas Jefferson University Hospital’s Burn Center but was expected to be released later Wednesday.

Also among the wounded was a 35-year-old certified nursing assistant who was nearly finished with her shift when the building she had worked at for five years suddenly exploded.

Andrea Taylor said her daughter Natalie remained hospitalized Wednesday and had suffered a punctured lung and severe bruising throughout her body. She asked that her daughter be identified only by her first name to protect her privacy.

Taylor said her daughter initially did not remember anything about the explosion, but as Wednesday wore on, her memory started to return.

Natalie, she said, had gone into the cafeteria to heat up some soup when she said she smelled something strange.

“What’s that smell?” Taylor said her daughter asked a colleague just before the floor fell out from under them.

The explosion appeared to come from the basement, she said, collapsing the floor of the kitchen and cafeteria. Natalie and a colleague fell into the basement, she said, and hoisted themselves out over debris with the help of first responders. She said Natalie helped pull out her coworker, who suffered a fractured leg.

She said her daughter is in pain, with bruising across her face and back, but lucky to be alive.

“We’re lucky to have her,” she said. “We’re not asking for anything, just for prayers.”

Throughout Wednesday, cranes continued to lift debris from the wreckage as local, state, and federal investigators worked to make sense of the disaster.

Donna Straiton, 67, watched from behind a line of yellow caution tape, staring at what remained of the nursing home where she had worked for 20 years.

Straiton worked in the dementia unit, she said, before retiring in February 2024. In her final years working there, fire alarms routinely went off, she said. She estimated the facility locked down no less than twice a month as the smell of gas wafted in the air.

Most often, she said, the alarm system indicated the issue was in the basement, but she never saw a fire.

“The fire department would come and we’d get an all clear, and then it would be back to business as usual,” she said.

In a statement, Saber Health called the explosion devastating and said the company was determining the extent of the damage. Staff at the nursing facility had reported a gas smell to Peco, and the utility company had been investigating prior to the explosion, Saber said.

“Just 24 days ago, Saber Healthcare Group became affiliated with Bristol Health and Rehab Center,” the company said. “We have worked to improve and fix prior issues, and we will continue that work in the wake of this event.”

Bristol Township Police Chief Charles “CJ” Winik lauded the first responders who he said sprinted toward danger, through collapsing walls and ongoing explosions. Initial officers were overwhelmed, he said, and it was a team effort to pull injured residents, including those who could not walk or used wheelchairs, from the wreckage.

“I’ve never seen such heroism,” he said.