(Updates with mayor's comment, prosecutor's office statement, details, quotes)

By Oleg Shchedrov

MOSCOW, Dec 9 (Reuters) - A fire at a Moscow drug clinic on Saturday killed 45 women patients and staff who were prevented from escaping by metal grilles, emergency services said.

Arson was the likely cause of the fire, officials said.

Hospital psychologist Olga Rudakova told NTV television the dead were mostly women under 35, addicts infected with HIV and many with psychological disorders.

"The lights went out and panic started," she said. "Everyone could have left, there were no patients that could not walk."

Crying relatives of the dead arrived at the brick building with white grilles on the windows as ambulances hurried to and fro in the yard. The glass of some windows had been smashed, but the grilles were intact.

"The number of victims has reached 45," Deputy Emergencies Minister Alexander Chupriyan told reporters outside Drug Treatment Hospital No. 17 in southwest Moscow.

"Judging by the position of the bodies, people tried to get out but there was only one fire exit available."

The Emergencies Ministry said it applied to a court in March to close the hospital because of fire safety violations including grilles on windows and staircases. The court turned down the request.

All the victims were women and two were clinic staff.

"The personnel did not undertake any rescue measures," Chupriyan said. "When they discovered the fire, they simply left the building."

Inside the building, poorly furnished wards and corridors were darkened by fire and flooded with water.

Moscow Mayor Yuri Luzhkov called the fire "a tragedy".

"There was nothing there that could catch fire on its own. This is either arson or negligence (when) using highly inflammable material," he told NTV television station.

CRIMINAL INVESTIGATION

The Prosecutor's Office said in a statement on its site www.genproc.gov.ru it had started a criminal investigation into a case of breaking fire safety rules and intentional ruin of property. The statement said 12 people were taken to hospital.

"Preliminary investigation showed that the focus of the fire was located on the second floor of a five-storey building, where repair works had taken place the previous day," it said.

Emergency officials say the victims were killed by fume inhalation. The alarm in the hospital was not designed to react to smoke but only to fire and high temperatures.

"There is a 90 percent probability that it was arson," said Yuri Nenashev, head of the Emergencies Ministry fire safety directorate.

Moscow Emergency Ministry spokesman Yevgeny Bobylov said the hospital personnel had called fire services 30 minutes too late, allowing dense smoke to spread and stifle patients.

"They did not use keys to open grilles for evacuation. As a result, people were caught in a trap," he said.

Ministry spokeswoman Irina Andrianova told Reuters: "One staircase was blocked by the fire and the other was blocked by a metal grille that firefighters had to remove."

The alarm was raised at 0142 on Saturday morning (2242 Friday GMT). Fire crews arrived within 4 minutes and took only 20 minutes to extinguish the fire, officials said.

Several fatal fires have occurred at secure hospitals in Russia where drug addicts or mentally ill people are treated. They are often in old, neglected buildings.

In December last year, seven people died when a fire broke out in the night at a hospital near Moscow treating people for nervous disorders.

Nineteen people died in 1999 in a fire at a hospital for people with mental illnesses in the Leningrad region near Russia's second city of St Petersburg, the agency said.

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