(Russian fire fighter/Creative Commons, Cavin)

Most of the patients were confined to the one-story brick-and-wood facility and died in their beds as firefighters rushed from the nearest fire station almost an hour away, the New York Times reported. Of the 41 people in the building, only three survived.

The state news agency RIA Novosti says it has been told by a "police source" that most of the victims "died in their sleep [from] inhaling the fumes as they were likely sedated by prescribed medicine," NPR reported.

Investigators working at the scene of the fire, which started at about 2 a.m. and was put out almost three hours later, are considering several possible causes, including a short-circuit, violation of fire safety regulations and even arson, RIA Novosti reported.

At least 29 people were burned alive, said Irina Gumennaya, a spokeswoman for the Russian Investigative Committee.

The fire highlights Russia's poor safety record, which has high rates of alcoholism, smoking, dilapidated fire equipment, old electrical and heating systems, and widespread violations of safety codes, said the New York Times.

Russia's rate of death from fire, more than 8 per 100,000, greatly exceeds rates in Greece, Denmark, the United States and the United Kingdom, where only 1 per 100,000 die from fires, according to a report by the Geneva Association.

A nurse tried to extinguish the fire and evacuate patients, but it spread so quickly that she was only able to get one out the building before the whole building was consumed in flames, said the Times.

Moscow region governor Andrei Vorobyev said some of the hospital windows were barred.

Officials from the Russian Investigative Committee said they are looking at poor fire regulations and a short circuit as possible causes of the blaze that engulfed the hospital in the Ramenskiy settlement, some 53 miles north of Moscow, according to CBS News.

A January fire in an underground parking lot killed 10 migrant workers, and a similar incident in September killed 14 Vietnamese workers who were working at a clothing factory near Moscow. in 2009, more than 150 people died in a night club fire after a pyrotechnic show caused a wooden ceiling to collapse.

Read more at RIA Novosti.

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