A military investigation into the bombing of a Doctors Without Borders Hospital in Afghanistan in October found that human errors, fatigue, process and equipment failures were at fault in the deadly airstrike, defense officials said Friday.
"These factors contributed to the 'fog of war,' which is the uncertainty often encountered during combat operations," U.S. Central Command said in a statement.
Sixteen U.S. military personnel have been disciplined for their roles in the bombing.
The punishments are all non-judicial. No one will be court-martialed and there are no criminal charges pending. Some of the punishments, however, will be career-ending. A general officer will be the only person named while other lower-ranking service members will remain unnamed.
“The trauma center was a protected facility, but was misidentified,” Gen. Joseph Votel, head of U.S. Central Command told reporters on Friday.
The Department of Defense does not consider the act “a war crime,” Votel said and the investigation concluded that the personnel involved didn’t know they were striking hospital.
"The label “war crimes” is typically reserved for intentional acts — intentionally targeting civilians or intentionally targeting protected objects. The investigation found that the tragic incident resulted from a combination of unintentional human errors and equipment failures, and that none of the personnel knew that they were striking a medical facility," U.S. Central Command said in a statement.
The hospital was on a no strike list — critical information that was missed. According to the report, air crew observed the trauma center and personnel for 68 minutes prior to firing 211 rounds and never saw fire coming from or going to the compound.
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The air crew questioned the request for offensive fire multiple times and verified the target multiple times with the ground commander. They also questioned how this strike was appropriate under the rules of engagement — the ground commander gave a physical description of the compound without being able to see it — he relied on the Afghans for the physical description and that is ultimately what the air crew relied on.
They fired for for roughly 30 minutes. Eleven minutes after the firing began, Doctors Without Borders/Médecins Sans Frontières notified multiple military commands they were under attack
The U.S. airstrike against the trauma center killed at least 42 people including 14 hospital staff members and at least 24 patients. Doctors Without Borders called the airstrikes a war crime.
"Patients burned in their beds, medical staff were decapitated and lost limbs, and others were shot by the circling AC-130 gunship while fleeing the burning building," Doctors Without Borders said in its report of the attacks released in November.
President Obama apologized for the airstrike, which took place when Afghan troops tried to reclaim Kunduz from the Taliban. The top U.S. commander in Afghanistan called it a "tragic mistake" and the military promised to investigate.
Initially the military gave shifting accounts of the airstrike, and had at first claimed the attacks were aimed at "insurgents who were directly firing upon U.S. service members." The military later backed away from those claims.
Doctors Without Borders/Médecins Sans Frontières said Friday that the administrative punishments of the 16 military personnel at the center of the deadly attack "lack of meaningful accountability."
Votel and his team briefed the organization on the report's findings on Thursday and that the group is weighing the U.S. account fully answers outstanding questions about the attack. The organization also expressed disappointment that, so far, there has been no independent investigation by the International Humanitarian Fact Finding Commission.
Some members of Congress said Friday that they will continue to press for an independent investigation.
"The victims and their families deserve justice and I will continue to call on President Obama and Secretary Carter to allow an independent investigation to be conducted to ensure that all who are responsible are held accountable and that this never happens again,” Rep. Jim McGovern, D-Massachusetts and co-chair of a bipartisan congressional human rights commission said in a statement.
The White House on Friday said it was satisfied that the investigation is complete.
"I think the passion of the arguments that are being made by MSF are understandable," White House press secretary Josh Earnest told reporters on Friday and lauded the organization's heroic international work.
However, Earnest added, the military has done due diligence.
Doctors Without Borders also worries about putting health care teams in harm's way in Afghanistan.
“We can’t put our teams — including our colleagues who survived the traumatic attack — back to work in Kunduz without first having strong and unambiguous assurances from all parties to the conflict in Afghanistan that this will not happen again,” Meinie Nicolai, Médecins Sans Frontières president said in a statement. "
Advocacy groups were also troubled by the Pentagon's report.
“The decision to dole out only administrative punishments and forego a thorough criminal investigation of October’s deadly strike in Kunduz is an affront to the families of the more than 40 men, women, and children who died that night, punished merely for being in a hospital, a supposed safe haven in a time of war," Donna McKay, executive director of Physicians for Human Rights said in a statement. "When justice is served, it provides a modicum of accountability, an example for others to follow. But today, justice for the patients who died in their beds, the doctors and nurses and hospital staff killed while doing their jobs, was denied.”
Halimah Abdullah is a digital editor and writer for NBC News and is responsible for reporting, writing, editing and web producing federal policy news for NBCNews.com. Prior to joining the site in April 2015, Abdullah worked at CNN.com, where she reported, edited and web produced stories on federal politics and policy. In that role, Abdullah was responsible for helping cover Congress, the White House, federal agencies, and national political races.
A veteran politics and policy reporter and editor, Abdullah has worked for Bloomberg Government, McClatchy Newspapers' Washington Bureau, the Memphis Commercial Appeal, Newsday, and the Dallas Morning News. Her work has also appeared in the New York Times and TODAY.com, among other publications. Her journalism and creative writing have won awards, been published in several anthologies, and earned her invitations to attend several writing colonies. Abdullah is also a writing professor who has taught at the University of Maryland and the University of the District of Columbia and John Jay College and Brooklyn College in New York.
Abdullah lives in the Washington D.C. metro area.
Courtney Kube is a correspondent covering national security and the military for the NBC News Investigative Unit.