On April 27, 2011, the City of Tuscaloosa, Alabama, suffered the worst natural disaster in its history. A mile-wide F5 tornado with 200 mile an hour winds damaged or completely destroyed a significant portion of Tuscaloosa. There were 43 casualties and more than 1,000 injuries. Hospitals prepare for disasters of all types but often not the large number of injuries sustained in this disaster. Well-developed disaster plans can be adapted to much larger numbers of injuries. A previously well-thought disaster plan, although not rehearsed for a thousand patients, was able to be expanded to that number and implemented quickly. At the time of the tornado, no one had any idea of the number of injuries or casualties. The hospital received only a single complaint during this disaster.