PORTLAND, Maine (AP) — Three Army Reserve officers were disciplined for dereliction of duty in the aftermath of a rampage in which a reservist killed 18 people in Maine, according to an Army report that cited communication failures within the chain of command, and between military and civilian hospitals, among other shortcomings revealed during an investigation.

The Army review, released Tuesday, unearthed “a series of failures by unit leadership,” said Lt. Gen. Jody Daniels, chief of the Army Reserves, and administrative actions taken against the three officers have the potential to prevent further advancement in the military. Those officers were not identified in the report.

Survivors and victims’ family members have been critical over missed opportunities to stop the 2023 attack, which came after family members and fellow reservists noticed that the gunman had been exhibiting delusional and paranoid behavior.

“My heart and soul goes out to all those families, the folks that were witnesses to what happened,” Daniels told reporters. “We’re doing the best that we can in terms of understanding what did transpire, then make changes for the future.”

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The partially redacted report noted that the gunman, Sgt. 1st Class Robert Card, had previously fallen from a ladder, a potential cause of head injuries uncovered in a post-mortem examination. Daniels said emphatically that there was no tie between his brain injury and his military service, even though the defense department is looking into the potential for damage caused by exposure to repeated blasts.

The 40-year-old Card, who was in the midst of a spiraling mental health crisis, made some alarming statements before the shooting. The investigation indicated Card had a “hit list,” bragged that he could kill 100 people with a rifle scope he’d bought, and told a health care provider that he decided to quit his job “before he ended up killing someone,” the report said. Witnesses said Card answered the door of his Bowdoin home armed with a gun because of his paranoia, the report said.

The shooting happened Oct. 25, 2023, at a bowling alley and at a bar and grill in Lewiston. In addition to the deaths, 13 survived gunshot wounds and 20 others suffered non-shooting injuries during the frenzy.

All told, more than 130 people were present at the bowling alley, which was hosting a youth league, and at the bar, which was hosting a cornhole tournament. Card died by suicide.

An independent commission established by Democratic Gov. Janet Mills is also conducting its own investigation into the tragedy. Its report is expected to be completed later this summer.

Both the Army Reserves and the Army’s Inspector General were asked to provide a full accounting of events. The Army report, which numbered 115 pages, was based on interviews with 43 witnesses, 445 exhibits and visits to relevant locations, including the sites of the shootings and the location where Card’s body was found two days later.

The Army report, which recommends procedural changes and new policies to better manage reservists’ mental health, was so thorough that the Army’s Inspector General, Lt. Gen. Donna Martin, told reporters at the Pentagon that she concluded that her office didn’t need to conduct an independent investigation.

The report cited failures in the Reserve unit’s leadership; communication failures and delays between an Army hospital and a civilian psychiatric hospital where Card was treated in New York; and procedural failures that included an inadequate review of Card’s medical records before his case was closed by the Army Reserve Psychological Health Program.

It also recommended a review of the U.S. Army Reserve’s behavioral health force structure and comprehensive behavioral health retraining across the entire U.S. Army Reserves, which comprises nearly 190,000 soldiers.

People who knew Card reported that his behavior began to change in January 2023, shortly before he purchased hearing aids online. Card’s ex-wife and son had reported their concerns about his paranoia and erratic behavior to police in May, two months before fellow reservists encountered a gaunt Card in New York, where members of his unit were training West Point cadets.

Concerns over his behavior and his attempt to attack a fellow reservist led to him being taken to an Army hospital for evaluation. He was then transferred to a private psychiatric hospital for treatment.

The report said there was enough evidence presented to commanders of Card’s deteriorating health that he shouldn’t have been allowed to attend training at West Point, where he was supposed to work on the machine gun range. And when he was hospitalized, he should’ve retained his on-duty status so the Army could better ensure continuity of care, the report said.

Instead, Card was released after 19 days of treatment in a psychiatric hospital and returned home to Maine where he was no longer on active duty and largely outside the scope of Army rules.

The report said a discharge summary from Four Winds Psychiatric Hospital concluded Card displayed symptoms including psychosis, mood instability and aggression, homicidal ideations, paranoia and auditory hallucinations. It also noted that the hospital sought a court hearing to extend Card’s stay, but the hearing request was rescinded before Card’s discharge.

The report faulted the Army Reserve Psychological Health Program for failing to fully review Card’s medical charts before dismissing the case because of Card’s refusal to cooperate.

The report didn’t resolve a fundamental problem that Army Reservists are under military command only when they’re reporting for drills. Once they return to civilian life, they’re no longer bound by those rules.

An Army nurse practitioner who evaluated Card in New York recommended that Card’s weapons should be removed, but Army officers mistakenly thought they had no options for his personal weapons and relied on Card’s family to handle it, the report said. The same nurse practitioner concluded New York’s red flag law couldn’t be applied to remove Card’s gun because it applied only to New Yorkers.

Back in Maine, Card’s behavior continued to deteriorate, and a reservist who said he was Card’s best friend reported in September to his superiors: “I believe he’s going to snap and do a mass shooting.” That prompted a Maine deputy to attempt to check on Card at his home in Bowdoin, but the deputy declined to initiate proceedings to remove Card’s guns under the state’s yellow flag law, saying he didn’t have legal authority to initiate the process when Card refused to answer the door to his home.

An interim report by Maine’s independent commission concluded that law enforcement had the authority to seize Card’s weapons and shouldn’t have left it up to his family.