A fire raced through a hospital in Rio de Janeiro, forcing staff to wheel patients into the streets on beds or in wheelchairs and killing at least 11 people, many of them elderly.
Four firefighters were hospitalized after battling the overnight blaze at Badim Hospital and about 90 patients were transferred to other hospitals, the fire department said.
A rope made from bedsheets and used in an attempt to escape the fire still hung from an upper floor window of the hospital this weekend.
Most victims died from asphyxiation as smoke filled the wards, and some died when life support equipment stopped working in the fire, said Gabriela Graça, director of the state Institute of Forensic Medicine.
Carlos Outerelo, 60, was visiting his sick mother when the fire started Thursday night. Berta Gonçalves Berreiros Sousa, 93, was among the dead.
"They said to stay closed off in the rooms so the smoke couldn't get in, and that it was under control. But in reality, it wasn't under control," he said outside the morgue where his mother's body was brought.
"The smoke started coming from the air conditioning ducts and it turned black and became hard to see," Outerelo said. "It was horrible."
When firefighters arrived, they evacuated people but it was more difficult to move patients who were hooked up to medical equipment, according to reports.
As the fire burned, medical workers in surgical masks rolled equipment in the road as smoke billowed from the building.
Television images showed staff tending to patients sitting in wheelchairs with IV poles beside them in the street, some on sheets and mattresses.
Elderly and intensive care patients were among those rescued.
In the chaos, distraught relatives tried to track down patients, unsure of whether they had perished in the fire or had been transferred to another medical facility.
Authorities released a list of names of 10 of the dead, some in their 80s and 90s.
Marcelo Crivella, the mayor of Rio de Janeiro, said a total of 11 people died.
He declared an official mourning period of three days.