CCTV footage showed arsonist Lefter Canaj, 57, dousing a male patient in gasoline before engulfing the room in flames at a private American hospital in Tirana, Albania.
The savage attack killed Canaj and two female patients, Sanije Sulaj, and Hani Mal, both 55, and left Dashamir Saraci – who Canaj allegedly argued with – fighting for his life.
The patients are seen flailing in agony as the room fills with black smoke and flames. Ms Sulaj, and Ms Mal died from asphyxiation, according to Albanian news site Albeu.
Local media reported that Canaj died on Tuesday, several hours after he was arrested.
It is thought that Canaj carried out the attack following an argument with Mr Saraci earlier that day while waiting to use the kidney dialysis machine.
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In a post on Facebook the hospital praised the actions of the nurses, who helped extinguish the fire before firefighters attended the scene.