The locked gates and barred windows that kept 45 women from escaping a fire at a drug treatment center pointed to conditions now common in post-Soviet Russia's state-run institutions.
An official described a scene that hinted at horrific panic early Saturday as patients struggled to escape the fire - Moscow's deadliest in decades.
"Judging by the placement of the bodies, they really tried to get out," said Deputy Emergency Situations Minister Alexander Chupriyan. He said all 45 victims - reportedly 43 patients and two staffers - were dead by the time firefighters arrived.
Inspectors who visited the hospital in February and March had recommended its temporary closure because of safety violations, said Russia' chief fire inspector Yuri Nenashev.