Subpar conditions at a Washington, D.C., VA medical center have prompted a scathing report from the agency’s inspector general and the dismissal of the hospital’s director.

The report, signed by Inspector General Michael Massie, says inspectors “identified a number of serious and troubling deficiencies at the Medical Center that place patients at unnecessary risk.” Although the report said the inspector general’s office had not yet found any “adverse patient outcomes,” it goes on to detail unsanitary conditions, poor management by administrators, and a lack of critical supplies.

“Since January 1, 2014, the Medical Center has recorded 194 patient safety reports relating to the unavailability of equipment or supplies,” the report states. At times the hospital borrowed equipment from a nearby private hospital, although sometimes operations proceeded despite basic materials not being in the medical center’s possession.

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Inspectors also found that 18 of the 25 sterile storage areas they looked at were dirty. The hospital serves some 98,000 veterans in the Washington, D.C. area.

It is rare for the VA inspector general to release such a report, but the IG did so in this case to alert the public to conditions at the medical center.

“Although our work is continuing, we believed it appropriate to publish this Interim Summary Report given the exigent nature of the issues we have preliminarily identified and the lack of confidence in VHA adequately and timely fixing the root causes of these issues,” the report states.

The director of the medical center has now “temporarily been assigned to administrative duties,” and a new acting director has been named. The report cautions, however, that “there are numerous and critical open senior staff positions that will make prompt remediation of these issues very challenging.”

The VA system has come under fire over the last several years after numerous deficiencies were found in medical centers nationwide. In 2014, for example, it was found that dozens of veterans had died in the Phoenix area while awaiting care.

“Our inspection is continuing and we will publish a final report with any additional recommendations when our work is completed,” the report concludes.