For months family members, lawyers and doctors of Vera V. Trifonova pleaded with officials to grant her furlough from prison to seek medical help. Suffering from severe diabetes, the businesswoman, in jail awaiting trial on fraud charges, had only one working kidney, and her lungs were filled with so much liquid that there was a danger she could drown in her sleep, her lawyers said. With her body quickly shutting down, Trifonova, 53, was finally granted permission to go to the hospital last Thursday, but it was too late. The next day she died of heart failure in the medical ward of a Moscow pretrial detention center. The death is only the latest case to highlight the poor conditions in Russian prisons. President Dmitry Medvedev called for a major overhaul of the country's penal system after the death last November of a prominent lawyer under circumstances that mirrored Trifonova's. After Medvedev ordered an investigation into Trifonova's death on Saturday, officials moved quickly. On Tuesday, the lead investigator in the fraud case against Trifonova, Sergei Pysin, was charged with negligence. At least two other officials at the department that oversaw the case were fired. Officials admitted to similar violations in the case of Sergei L. Magnitsky, a 37-year-old lawyer who died of toxic shock and heart failure last November. His lawyers say that prison officials ignored repeated requests for medical care after he was jailed on a tax evasion charge. His death set off outrage in Russia. In response, Medvedev fired around 20 prison officials and ordered prosecutors to open an inquiry into the case. He also signed a law easing punishments for economic crimes. It allows, among other things, for suspects to post bail rather than remain in prison in certain cases. Still, no charges have been brought in the death of Magnitsky and little more has been done to reform Russia's penal system, said Valery V. Borshchev, who leads a nongovernmental group that monitors prison conditions. One of the biggest flaws, Borshchev says, is that investigators have the ability to set pretrial restrictions. These include whether or not a defendant is imprisoned or granted medical care. Though judges can reject investigators' decisions, he said, they rarely do. When Trifonova, the head of a real estate company, was arrested Dec. 16, Pysin, the investigator, tried to set such pretrial restrictions, her lawyer, Vladimir A. Zherebenkov, said. Though Trifonova's health problems should have prevented her from being imprisoned, Zherebenkov said, 'Pysin said that he would only release her if she confessed.' Trifonova refused to acquiesce, denying charges that she and a senator were involved in a plan to sell a seat in Russia's upper house of parliament to the head of a Russian bank for $1.5 million. 