At least 38 people died in a fire at a psychiatric hospital outside Moscow early Friday, according to Russian media reports.
Forty-one people were believed to have been in the Ramensky hospital when the fire started, but a nurse managed to lead two patients to safety, according to early reports.
The building housed patients with severe mental disorders, according to Russian Health Ministry officials.
The fire is believed to have been caused by a short circuit that occurred in a wooden annex of the wood-and-brick hospital building shortly after 2am.
The closest fire station was over 50km away, and it took firefighters an hour to respond to an emergency call.
Most of the fire's victims were local patients, many of whom were sedated at the time.
All of the building's windows had metal bars, according to a BBC report citing a local official.