We have had patients break out of the asylum films before The Incident/Asylum Breakout could be a less comedic version of Alone in the Dark (1982) and a host of ones where the patients take over the asylum and impersonate the doctors a bunch of adaptations of Edgar Allan Poes The System of Dr Tarr and Professor Fether (1845). The Incident/Asylum Breakout is more of a prison riot film than an asylum film and deals with the harsh brutality of a group of criminally insane being accidentally released and going amok.
Courtes paces much emphasis on harsh realism. That and the 1989 setting suggests that the film is telling a true story although you suspect that this is more because they needed to set everything in the pre-cellular era as this is a film where the entire situation would have been solved in about two minutes flat had any of the staff had access to a cellphone. Rupert Evans is the only recognisable name present but with a grunge look that casts him as something quite different to any of the pretty face roles we have seen him in before.
Alexandre Courtes succeeds in winding up the tension and terror within a very short space of time as soon as the lights go off. The sheer brutality of the film is one that few horror films in their constant theatrics and cliches rarely manage to achieve. Some of the scenes as the film escalates are incredibly raw the sheer nastiness of the scene where the inmates throw Kenny Doughty on a kitchen stove burner and incinerate him while still alive. There are not many films that give you this kind of tension and emotional workout by the end.