Kamila Valieva left the ice in tears after performing her routine in the women's figure skating short program at the Winter Olympics on Tuesday.
The immense pressure and scrutiny appeared to get the better of the 15-year-old Russian, who is at the centre of the latest Olympic doping scandal.
'PERVASIVE DISREGARD': USA lashes Russian teen's doping decision
She stumbled on her opening triple axel and left the ice in tears after her routine, barely holding it together while she awaited her scores.
However she wound up earning 82.16 points, more than eight off her own world record but more than enough to top the field.
Russian teammate Anna Shcherbakova, the reigning world champion, was second with 80.60 points followed by Japan's Kaori Sakamoto (79.89pts).
Valieva and Shcherbakova's compatriot Alexandra Trusova (74.60pts) was fourth, with the three Russians trying to deliver the second podium sweep in Olympic figure skating and the first in the women's competition.
The free skate, which will decide the medals, is on Thursday night in Beijing.
Valieva is the clear favourite to win her second gold in Beijing, but there will be no medal ceremony if she finishes in the top three.
The podium ceremony will be put on hold until the full investigations into the Russian's doping case have concluded.
The International Olympic Committee, concerned that she could still be banned after a full doping case, said it would instead "organise dignified medal ceremonies" in the future.
The 15-year-old, who was cleared to compete by sport's top court despite testing positive for a banned heart drug, will not have her case resolved before the conclusion of the Beijing Games.
Uproar after Kamila Valieva allowed to keep competing
Valieva tested positive at her national championships on December 25 but the result was not revealed until February 8 - after she had already won gold at the Beijing Games in the team event.
An Olympic official said on Tuesday that Valieva's defence was that there had been a mix up with her grandfather's heart medication.
The teenager's case has prompted uncomfortable questions about figure skating, and whether or not the minimum age for competitors (15) needs to be raised.
"I absolutely believe that there should be an age limit," said American Mariah Bell who skated in the women's singles on Tuesday.
The nine skaters who featured for the US and the seven who competed for Japan in the team event will go home without receiving their medals because of Valieva's drug case.
The US finished behind the Russian Olympic Committee (ROC), with Japan third.
"My heart goes out to the rest of my teammates and hopefully we'll find some way to celebrate together," US ice dancer Madison Hubbell said.
The Court of Arbitration for Sport ruled that Valieva should be allowed to compete while anti-doping officials conduct a full investigation, in part because she is a minor and is subject to different rules from an adult athlete.
"I wish it was a level playing field and it's not, but they've made a decision they've made and I can't do anything about that," British skater Natasha McKay said.
NBC commentators Johnny Weir and Tara Lipinski were almost silent during Valieve's performance on Tuesday, seemingly protesting her participation.
“All I feel I can say is that was the short program of Kamila Valieva at the Olympics,” Weir said.
Lipinski added: “She had a positive test. We should not have seen this skate."
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