More Questions Than Answers in Psych Ward Fire

President Vladimir Putin called Friday morning's deadly blaze at a Moscow region psychiatric hospital a "major tragedy" and ordered government ministries and the region's governor to conduct a thorough investigation into the incident, which killed 38.

Investigators have opened a criminal case into possible fire safety violations at the facility, Psychiatric Hospital No. 14, located about 85 kilometers north of Moscow, the Investigative Committee said in a statement. The charge carries a maximum penalty of seven years in prison.

It's still unclear what caused the fire, which broke out at about 2 a.m. and quickly engulfed the wooden building, burning it to the ground and leaving rows of twisted, metal bed frames amid the?  ruins. Investigators said a short circuit and arson are among the potential culprits.

The fire likely began on a couch in the hospital's recreation room, and one surviving patient said a chain-smoking, recovering drug addict was checked into the clinic the day before and defied staff orders not to smoke inside, according to the investigators' statement.

It's also not yet clear why only three people — two patients and a nurse — were able to escape the inferno. Media reported that patients might have been strapped to their beds or unable to climb out of the windows due to the metal lattices that covered them, a claim officials disputed.

Moscow region acting-Governor Andrei Vorobyov told Rossia 24 TV that some, but not all of the windows had lattices, and a spokeswoman for the regional Investigative Committee told Interfax that there were not any physical obstacles to prevent patients from getting up and fleeing.

"The ward didn't have any doors; the patients could have left the building on their own. The dead were all found in their beds," spokeswoman Irina Gumennaya said, adding that investigators had not yet determined whether any patients were tied down.

Investigators are also looking into whether drugs or other substances might have hindered patients' ability to escape on their own. The ward was for newly arrived patients and reportedly included those suffering from severe psychosis, alcoholism, drug addiction and schizophrenia.

Survivors included nurse Viktoria Volkova, 30, who was awakened at 2:20 a.m. to the clanging of the fire alarm. She led one patient outside and shouted to others to follow, investigators said.

Another surviving patient said he tried in vain to put the fire out with water and a fire extinguisher, but then had to grope blindly through the smoke-filled building to get out.

Most of the dead, ages 19 to 73, were found in their beds. They were likely knocked unconscious by the noxious gas before they suffocated and burned to death, a law enforcement source told Interfax.

Video footage posted by investigators showed a scene of utter destruction: The charred wreckage of the building looked barely knee-high, and only part of a wall was left standing. Nine of the 38 victims had been identified as of Sunday afternoon, a grim testament to the intensity of the blaze.

Their families will receive 500,000 rubles ($16,000) from the regional government, and their funerals will be free, said Vorobyov, the acting governor. ? 

In the coming days, attention also seems likely to focus on the performance of fire brigades, which took about an hour to make the 40-minute trip because a river crossing was closed, Vorobyov said.

But an eyewitness told LifeNews.ru that firefighters arrived at 4:30 a.m., not 3:20 a.m. as officials claim, and that the first two firetrucks to arrive did not bring water. The fire was extinguished by 5 a.m., about three hours after it broke out, the Emergency Situations Ministry said.

Deadly fires periodically break out in Russian institutions, where fire-safety regulations are often violated. Many hospital buildings are built of wood and lack proper fire exits. A 2009 blaze in a nursing home in the Komi republic killed 23 people. More recently, two were killed in December in a fire at a psychiatric hospital in the Tula region.

Inspectors from the Emergency Situations Ministry checked Psychiatric Hospital No. 14 in August and January. They discovered three violations and one person was held accountable, investigators said. Vorobyov ordered inspections of a range of health institutions in the Moscow region in the wake of Friday's fire.

Sergei Kalashnikov, head of the State Duma's Public Health Committee, told Kommersant FM that the tragedy was a reminder of systemic problems with Russia's social services infrastructure, which he described as "extremely worn-out" and neglected by regional officials.

And, he said, "The level of organization at these institutions is, forgive me for saying, stone-age."? 

Staff writer Ivan Nechepurenko contributed reporting.