diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/OperationOutcomeUtil.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/OperationOutcomeUtil.java
index c910e4ce4758..8905dd2f06cd 100644
--- a/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/OperationOutcomeUtil.java
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/OperationOutcomeUtil.java
@@ -36,6 +36,7 @@
 import org.hl7.fhir.instance.model.api.ICompositeType;
 import org.hl7.fhir.instance.model.api.IPrimitiveType;
 
+import java.util.ArrayList;
 import java.util.List;
 
 import static org.apache.commons.lang3.StringUtils.isNotBlank;
@@ -114,6 +115,18 @@ public static String getFirstIssueDiagnostics(FhirContext theCtx, IBaseOperation
 		return getIssueStringPart(theCtx, theOutcome, "diagnostics", 0);
 	}
 
+	public static List<String> getAllIssueDiagnostics(FhirContext theCtx, IBaseOperationOutcome theOutcome) {
+		int nIssues = OperationOutcomeUtil.getIssueCount(theCtx, theOutcome);
+
+		List<String> issueStrings = new ArrayList<>();
+		for (int i = 0; i < nIssues; i++) {
+			String diag = OperationOutcomeUtil.getIssueDiagnostics(theCtx, theOutcome, i);
+			issueStrings.add(diag);
+		}
+
+		return issueStrings;
+	}
+
 	public static String getIssueDiagnostics(FhirContext theCtx, IBaseOperationOutcome theOutcome, int theIndex) {
 		return getIssueStringPart(theCtx, theOutcome, "diagnostics", theIndex);
 	}
diff --git a/hapi-fhir-base/src/test/java/ca/uhn/fhir/util/OperationOutcomeUtilTest.java b/hapi-fhir-base/src/test/java/ca/uhn/fhir/util/OperationOutcomeUtilTest.java
new file mode 100644
index 000000000000..aa7e119a9b0c
--- /dev/null
+++ b/hapi-fhir-base/src/test/java/ca/uhn/fhir/util/OperationOutcomeUtilTest.java
@@ -0,0 +1,41 @@
+package ca.uhn.fhir.util;
+
+import ca.uhn.fhir.context.FhirContext;
+import org.hl7.fhir.instance.model.api.IBaseOperationOutcome;
+import org.mockito.MockedStatic;
+import org.mockito.Mockito;
+
+import java.util.List;
+
+import static org.junit.jupiter.api.Assertions.*;
+import static org.mockito.ArgumentMatchers.any;
+import static org.mockito.ArgumentMatchers.anyInt;
+import static org.mockito.Mockito.CALLS_REAL_METHODS;
+
+class OperationOutcomeUtilTest {
+	@org.junit.jupiter.params.ParameterizedTest
+	@org.junit.jupiter.params.provider.ValueSource(ints = {0, 1, 2})
+	void testGetAllIssueDiagnostics_various_items(int numDiagnostics) {
+		// Arrange
+		FhirContext ctx = Mockito.mock(FhirContext.class);
+		IBaseOperationOutcome outcome = Mockito.mock(IBaseOperationOutcome.class);
+		List<String> knownDiagnostics = java.util.stream.IntStream.range(0, numDiagnostics)
+			.mapToObj(i -> "diag" + i)
+			.collect(java.util.stream.Collectors.toList());
+
+		try (MockedStatic<OperationOutcomeUtil> operationUtils = Mockito.mockStatic(OperationOutcomeUtil.class, CALLS_REAL_METHODS)) {
+			operationUtils.when(() -> OperationOutcomeUtil.getIssueCount(any(), any())).thenReturn(knownDiagnostics.size());
+			operationUtils.when(() -> OperationOutcomeUtil.getIssueDiagnostics(any(), any(), anyInt()))
+				.thenAnswer(invocation -> {
+					int idx = invocation.getArgument(2);
+					return knownDiagnostics.get(idx);
+				});
+
+			// Act
+			List<String> resultDiagnostics = OperationOutcomeUtil.getAllIssueDiagnostics(ctx, outcome);
+
+			// Assert
+			assertEquals(knownDiagnostics, resultDiagnostics);
+		}
+	}
+}
diff --git a/hapi-fhir-storage/src/main/java/ca/uhn/fhir/jpa/interceptor/validation/RepositoryValidatingInterceptor.java b/hapi-fhir-storage/src/main/java/ca/uhn/fhir/jpa/interceptor/validation/RepositoryValidatingInterceptor.java
index 31f928669154..41b9db9fecc9 100644
--- a/hapi-fhir-storage/src/main/java/ca/uhn/fhir/jpa/interceptor/validation/RepositoryValidatingInterceptor.java
+++ b/hapi-fhir-storage/src/main/java/ca/uhn/fhir/jpa/interceptor/validation/RepositoryValidatingInterceptor.java
@@ -153,9 +153,10 @@ private boolean isPlaceholderResource(IBaseResource theNewResource) {
 
 	protected void handleFailure(IRepositoryValidatingRule.RuleEvaluation theOutcome) {
 		if (theOutcome.getOperationOutcome() != null) {
-			String firstIssue =
-					OperationOutcomeUtil.getFirstIssueDiagnostics(myFhirContext, theOutcome.getOperationOutcome());
-			throw new PreconditionFailedException(Msg.code(574) + firstIssue, theOutcome.getOperationOutcome());
+			List<String> allIssues =
+					OperationOutcomeUtil.getAllIssueDiagnostics(myFhirContext, theOutcome.getOperationOutcome());
+			String concatenatedIssues = String.join("\n", allIssues);
+			throw new PreconditionFailedException(Msg.code(574) + concatenatedIssues, theOutcome.getOperationOutcome());
 		}
 		throw new PreconditionFailedException(Msg.code(575) + theOutcome.getFailureDescription());
 	}