Brain bleed patient made to wait nine hours at Belfast's Royal Victoria Hospital
A patient with a bleed on the brain waited almost nine hours to see a neurosurgeon at the Royal Victoria Hospital, a health watchdog has found.
It was one of a series of startling failings that are putting patients at risk at the hospital.
The Regulation and Quality Improvement Authority (RQIA) carried out a number of unannounced inspections at wards at the hospital last December.
The team spent time visiting surgical and acute medical wards and the emergency department from December 14 to 16 last year.
In ward 6c, a surgical ward, the inspectors were told of a "recent incident where a patient with a sub-dural bleed waited eight hours 40 minutes to be seen by a neurosurgeon".
The report said: "The situation was only resolved following escalation to a co-director."
The team also found a do not resuscitate order on a patient had not been signed by a senior doctor and there was no next of kin named on the document.
During their visit, they observed staff not responding properly when a confused patient exposed himself.
They were also told that band-three healthcare assistants were being used in place of band-five nurses.
Meanwhile, some patients in the ward waited more than eight days for an MRI scan and said a patient call bell system had the potential to be unsafe.
Dirty equipment was discovered and the inspectors branded the storage of some medication "unsafe".
The report also highlighted the fact that the hospital's recently opened £150m emergency unit was not fit for purpose. Staff at the unit complained it was cold overnight, while the inspection team found that there were not enough toilets and raised repeated concerns about overcrowding.
The report said: "At busy times, we observed that the number of patients occupying the majors area was beyond the capacity for which it was designed to manage at any one time.
"This made it challenging for staff to provide basic nursing care and maintain the dignity and privacy of patients."
Joe McCusker, of union Unison said the findings were "alarming" and called for an investigation.
A Belfast Heath and Social Care Trust spokesman said: "As a learning organisation, we accept there are areas that would benefit from improvement.
"The RQIA gave us verbal feedback at the time of the inspection regarding improvements. Staff moved to put them in place and we are confident we will meet all the recommendations within the trust's control."