A fire at a dilapidated Russian psychiatric facility that broke out early Friday morning has killed at least 37 people, including a nurse who tried to guide patients to safety, officials say.

The fire in the town of Luka, about 120 miles southeast of St. Petersburg, was the second such blaze in recent months. In April, a similar blaze at a psychiatric hospital near Moscow killed 38 people.

In the latest incident, authorities had long warned that the mostly wooden building dating to the 19th century was unsafe, according to The Associated Press.

Reuters says that a female orderly died while trying to save patients at the hospital, however the AP identifies the woman as "a 44-year-old nurse."

The news agency said that investigators and the chief doctor at the hospital "suspected a patient started the fire, Russian news agencies reported, but regional governor Sergei Mitin said it might have been accidental." Reuters continues:

" 'Medical personnel saw a patient who was shrouded in flames. ... It's possible that he was smoking in bed and the mattress caught fire,' Mitin said, according to Interfax. He said the ward that caught fire housed severely ill patients.

" 'Sedatives were given to patients for whom they had been prescribed,' Interfax quoted the chief doctor, Gusein Magomedov, as saying, but it was unclear how many were sedated when the blaze broke out."

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