[2] A teaching hospital, it maintains links with the University of Galway, ATU Letterkenny and the Royal College of Surgeons.

[8][9] The emergency department of the hospital was closed for nine months when it was destroyed by flooding in July 2013 which caused €40 million worth of damage.

[15] The hospital has its origins in the Letterkenny Union Workhouse and Infirmary which was designed by George Wilkinson and opened in Kilmacrennan Road in 1844.

[22][23] In November 2008, it was confirmed that work would begin on a new emergency department and medical wards at the hospital, of about 6,600 square metres.

[26][27] Following a heatwave across Ireland on 26 July 2013,[28] a thunderstorm brought heavy rain, causing a nearby river to burst its banks.

The resulting flood "completely destroyed" the new emergency department, swept much of the rest of the hospital away and led to the evacuation of patients.

[32] Blame for the scale of the damage was laid on cutbacks at Donegal County Council which led to drains outside the hospital going uncleaned for seven months.

[34][35] In August 2013, nurses at the hospital were told they would have to travel to Derry, across the border in Northern Ireland, to help deal with the overflow of patients there.

[13][38] Taoiseach Enda Kenny remarked that the floods had "destroyed a first class medical facility" and called the damage "very substantial – records lost, MRI machine, diagnostics laboratory, walls to be stripped and decontaminated.

Fianna Fáil leader Micheál Martin, himself a former Minister for Health who had announced the new emergency department almost exactly ten years previously,[39] visited the hospital on 31 July.

This level of damage is unprecedented for any Irish hospital in living memory, and there are serious implications for health service provision right across the North West.

[43] Meanwhile, consultant oncologist and senator John Crown was critical of the lack of media interest in the events outside the area affected.

A Donegal County councillor demanded an independent inquiry into the building of the new wing of the hospital which was built in a hollow.