Patients at a British hospital were left to lie in filthy, soiled bedding, without food or water and little or no basic nursing care, a report found.
Evidence collected from nearly 1,000 patients and their families found that appalling standards at Stafford hospital led to hundreds more deaths than might normally have been expected over a period of three years.
The independent report, which took two months to compile, examined events at the hospital between January 2005 and March 2009 and found that between 400 and 1,200 people more had died than would have been expected.
An inquiry was launched after a damning report last March revealed a catalogue of failings at the hospital which is run by the Mid Staffordshire NHS Foundation Trust.
At the time, some patients told of being so thirsty they were forced to drink the water from flower vases, while others were left screaming in pain.
Wednesday's report found numerous instances of patients being not being able to get to the bathroom and being left to lie in their own filth, causing great distress and embarrassment.
"Requests for assistance to use a bedpan or to get to and from the toilet were not responded to," the report said.
"Patients were often left on commodes or in the toilet for far too long.
"They were also often left in sheets soiled with urine and faeces for considerable periods of time ... Considerable suffering, distress and embarrassment were caused to patients as a result."
Other patients were left unwashed, sometimes for up to a month, and food and drink were placed out of reach, the report said.
It also detailed a severe lack of basic hygiene, with razors being used on more than one person, patients being admitted to filthy rooms where the previous occupant had suffered from diarrhoea, and others not having their teeth cleaned.
"I heard so many stories of shocking care," said inquiry chairman Robert Francis QC, a specialist in legal medical issues.
"These patients ... were people who entered Stafford Hospital and rightly expected to be well cared for and treated.
"Instead many suffered horrific experiences that will haunt them and their loved ones for the rest of their lives."
Frances said the lack of care was largely due to a chronic shortage of staff, particularly nurses.
A&E was "chronically understaffed in terms of consultants and nurses" and the NHS trust managing the hospital was found to be "disconnected" from what was actually taking place on the premises, preferring to focus on meeting waiting-time targets, the report said.