An Ontario air ambulance on its way to pick up a patient has crashed, killing two pilots and two paramedics.
The helicopter went down at 00:11 EST (04:11 GMT) on Friday as it took off from Moosonee, an isolated community on Canada's James Bay.
Ornge, the province's air ambulance provider, said there was no indication of the cause of the accident.
But the firm has grounded two other Sikorsky S76 helicopters in case mechanical issues were to blame.
The four people killed in the crash were identified as Capt Don Filliter, First Officer Jacques Dupuy, and paramedics Dustin Dagenais and Chris Snowball.
The Transportation Safety Board of Canada has sent investigators to the scene.
"Everybody at Ornge is deeply saddened by this tragic incident, and our hearts go out to the families and friends of those who lost their lives," the company's chief executive Andrew McCallum said in a statement pledging co-operation with investigators.
The company's operating officer Rob Giguere said all crew members aboard were "very well experienced".
Ontario Premier Kathleen Wynne said she was "devastated" to learn of the deaths.
"They lost their lives ensuring the people of this province receive the help they need," she said. "Their service and sacrifice will be honoured and remembered."
And Prime Minister Stephen Harper tweeted his sympathies on Friday: "Condolences to the families of the 4 victims of the Northern Ontario air ambulance crash last night. You are in my thoughts and prayers".
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