Overcrowding in Tallaght Hospital is posing a "grave risk", with patients enduring two nights on a trolley waiting for a bed recently, it has been claimed.
The stark warning emerged in a confidential memo from the hospital's emergency consultant Dr James Gray to Health Minister Simon Harris and other members of the Oireachtas.
The memo, seen by the Herald, was written on Wednesday and reveals there were 21 patients who needed a hospital bed in the emergency department at that time.
"There are further trolleys in other parts of the hospital," wrote Dr Gray.
"Fourteen patients are languishing 24 hours or more in the emergency department, two for two days or more. Ten patients are occupying cubicles that deny ambulance arrivals and waiting room patients access into the service.
"Seven patients are occupying conduits/corridors which are clearly not designated patient areas and are an evacuation hazard.
"Six patients needed isolation for infection and only one was in an isolation room. The oldest patient is 77 years of age."
Dr Gray told Mr Harris: "It is only a matter of time before we have our next untimely trolley-related death here due to overcrowding.
"Hospital overcrowding and the 350 related deaths annually constitutes an ongoing State institutional scandal that will come back to haunt us all.
"Admitted boarder patients have very poor or no dignity, privacy, confidentiality, suffer constant light and regular noise, resulting in sleep deprivation, which amounts to sensory torture."
The memo continued: "They are offered poor standards of infection control and constitute an evacuation hazard, especially when warehoused on conduits and corridors.
"We have a five-hour wait to get to see an a doctor currently. There is no space to see them due to the overcrowding situation," Dr Gray added.
In response, Fianna Fail deputy Billy Kelleher said: "It sets out the crisis that is engulfing the hospital. It's simply not good enough."
Mr Harris said more funding will be in the Budget for a winter plan to ease the worst of the crisis.