Patients were left waiting for hours in a hospital A&E department as staff struggled to cope.
NHS Forth Valley failed to meet the four hour waiting time target set by the Scottish Government last month.
They are expected to see 95 per cent of patients in this time and either admit, transfer or discharge them.
But during the week ending October 23, A&E staff at Forth Valley Royal Hospital in Larbert were under so much pressure that only 84 per cent were within the target.
Another 134 patients waited up to eight hours and 33 people waited over eight hours.
The figures come as health board papers show that NHS Forth Valley is also struggling to meet outpatient targets.
Statistics for the 18 week Referral to Treatment, 12 week Treatment Time Guarantee and 12 week Outpatient Wait were all in the red during July and August.
In June 125 patients waited longer than 12 weeks for treatment but in July and August this figure rose to 341 waiting beyond the guarantee.
The majority of these required treatment by doctors in ear, nose and throat, orthopaedics and general surgery.
A spokeswoman for NHS Forth Valley said although the hospital had met its four hour waiting time target for A&E attendances during September, there was a “particularly challenging period” at the end of October.
She added: “This was due to a combination of factors including an increase in the numbers of patients who required to be admitted to hospital and a rise in respiratory illnesses.
“Our performance has improved in the last week and we are continuing to do everything possible to reduce delays for patients.”
Angus MacDonald, Falkirk East MSP, said he hoped the figures were just a “blip”.
He said: “There are always challenges for the NHS over the winter period and we all know that our NHS is put under added strain with winter illnesses and slips and knocks during the cold period. Similar concerns were raised last year however waiting times improved over the busy period.
“The increase in A&E waiting times in October is hopefully just a blip, however we must never be complacent and must always strive to improve how patients are treated in our health service.
“If we are to compare our situation in Scotland to elsewhere in the UK, our NHS is outperforming these regions in every single area.
“There have also been significant improvements in our NHS over the last decade, however more can, and will, be done to further support our hard working NHS staff by the Scottish Government.
“We know how hard our NHS staff work and under additional stress during winter we should appreciate all their efforts.”