Apollo Theatre, one of the popular venues in the city's West End theatre district, was packed with about 720 people for last evening's show of 'The Curious Incident of the Dog in the Night-Time', when plaster and masonry from a section of the ceiling tumbled down with a "crackling" sound and left many wounded, including some with head injuries.
Paramedics initially said 88 people were injured but later they revised the number to 76, seven of whom were seriously wounded. Another 51 "walking wounded" were taken to hospital with minor injuries.
Police and officials said it was too soon to say what was the cause of the partial collapse of the ceiling. They said a full probe was being carried out in the matter.
"A section of the theatre's ceiling collapsed onto the audience who were watching the show. The ceiling took parts of the balconies down with it," Kingsland Fire Brigade station manager Nick Harding said.
"Firefighters worked really hard in very difficult conditions and I'd like to pay tribute to them. They rescued people from the theatre, made the area safe and then helped ambulance crews with the injured. In my time as a fire officer, I've never seen an incident like this," he said.
The historic theatre, named after the Greek and Roman god of the arts, opened in 1901. It seats 755 on four levels and the balcony on the third tier is considered the steepest in London.
Martin Bostock, who was in the theatre, told 'Sky News': "I was in the stalls with my family in the early stages of the show. I think the front part of the balcony fell down. At first we thought it was part of the show, it was very dramatic."
An Indian-origin theatre-goer Khalil Anjarwalla told the BBC that his heavily pregnant wife and her parents managed to escape from the theatre safely after "kilos of concrete plummeted from the ceiling."
The Apollo's owner described it as a "shocking and upsetting" incident and said an investigation was under way.
A spokesman for the company, Nimax Theatres, said "thoughts are with the audience and staff".
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