At least 60 children have died over five days at a government hospital in northern India that suffered oxygen shortages, officials said amid fears the toll could rise.
Authorities said they have launched an inquiry but denied reports that a lack of oxygen had caused the deaths at the Baba Raghav Das Hospital in Gorakhpur district in Uttar Pradesh state.
Indian media said 30 children died on Thursday and yesterday after oxygen supply was disrupted in wards housing the sick, allegedly because the suppliers' bills were not paid.
Gorakhpur's divisional commissioner said a preliminary report should be out today.
"Yes, sixty patients have died at the hospital in the last five days but we don't think it's linked to reports of oxygen shortage," he added.
A statement issued by the office of state chief minister Yogi Adityanath, which has ordered the inquiry, said that all 60 deaths had occurred at the hospital's paediatric ward over a five-day period starting Monday.
Twenty-three children died on Thursday, when, according to the statement, "the pressure of the liquid oxygen supply became low and 52 reserve oxygen cylinders were pressed into service".
India's Nobel Peace laureate Kailash Satyarthi, a campaigner for children's rights, described the deaths as "a massacre" on Twitter.
30 kids died in hospital without oxygen. This is not a tragedy. It's a massacre. Is this what 70 years of freedom means for our children?— Kailash Satyarthi (@k_satyarthi) August 11, 2017
"Thirty kids died in hospital without oxygen. This is not a tragedy. It's a massacre. Is this what 70 years of freedom means for our children?," he said.
The region is one of India's poorest and registers hundreds of child deaths each year from Japanese Encephalitis and Acute Encephalitis Syndrome, which is rife in parts of eastern and northern India.
"We will be getting more liquid oxygen cylinders tonight or tomorrow, and have also cleared the dues of the supplier," a district official said.
He added that the deaths "could be (due to) natural (causes), as many patients admitted at the hospital are serious".