"[11][12] The USCENTCOM 15-6 report stated that General Campbell's own lack of strategic guidance and dissemination of certain Rules of Engagement were major contributing factors that led to the command and control breakdown prior to the airstrike.

[14] On 7 October 2015, President Barack Obama issued an apology and announced the United States would be making condolence payments of $6,000 to the families of those killed in the airstrike.

However, fighting continued, and on 3 October, a US-led airstrike struck and practically destroyed Kunduz Trauma Centre operated by Médecins Sans Frontières (MSF), killing doctors, staff members and patients.

[18] Two days prior to the attack Carter Malkasian, adviser to the Joint Chiefs of Staff, emailed MSF asking if the facility had Taliban militants "holed up" inside.

[19][20] Médecins Sans Frontières reported that between 02:08 and 03:15 local time (UTC+04:30) on the night of 3 October, the organization's Kunduz hospital was struck by "a series of aerial bombing raids".

[22] On 15 October NBC Nightly News reported that according to Defense Department sources, cockpit recordings from the attacking AC-130 gunship "reveal that the crew actually questioned whether the airstrike was legal".

[14] U.S. and NATO Commander John F. Campbell later confirmed that a U.S. AC-130 gunship made the attack on the hospital and that it was a US decision, contrary to earlier reports that the strike had been requested by local Afghan forces under Taliban fire.

"[28] White House spokesman Josh Earnest defended U.S. forces, saying the U.S. Department of Defense "goes to greater lengths and places a higher premium on avoiding civilian casualties" than any other military in the world, and hinted the U.S. may compensate victims and their families.

[32] The Afghan Ministry of Defense and a representative of the police chief in Kunduz also said that Taliban fighters were hiding in the hospital compound at the time of the attack, the latter claiming that they were using it as a human shield.

These statements imply that Afghan and U.S. forces working together decided to raze to the ground a fully functioning hospital – with more than 180 staff and patients inside – because they claim that members of the Taliban were present.

[38] Article 11 of Additional Protocol II of the 1949 Geneva Conventions protects hospitals in a non-international armed conflict (which the NATO war in Afghanistan was since 19 June 2002).

[41] Previous to 12 December when new figures were released, casualty reports listed 30 dead including 13 MSF staff (three of them doctors[42]), ten patients, and seven burned beyond recognition and as yet unidentified.

[45] A review of the incident released on 7 November by MSF reported that some medical staff were decapitated and lost limbs to shrapnel and others were shot from the air as they tried to flee the burning building.

[47] Glenn Greenwald of The Intercept accused CNN and The New York Times of "deliberately obscuring who perpetrated the Afghan hospital attack" during the first thirty-six hours after the airstrike, stating that their reporting was "designed to obfuscate who carried out this atrocity.

[51] Eleven days after the attack, MSF said an American tank forcibly entered the hospital: "Their unannounced and forced entry damaged property, destroyed potential evidence and caused stress and fear."

[57] The American gunship had identified the building based on a visual description from Afghan troops, and did not consult their no-strike list, which included the coordinates of the hospital as provided by MSF.

[58] The internal report states the aircraft fired 211 shells at the building in 29 minutes, before American commanders realized the mistake and ordered the attack to stop.

[66] Secretary-General of the United Nations Ban Ki-moon said "hospitals and medical personnel are explicitly protected under international humanitarian law" and called for an independent investigation.

Nicholas Haysom, the Secretary-General's Special Representative for Afghanistan called "on all parties to the conflict to respect and protect medical and humanitarian personnel and facilities".

UN High Commissioner for Human Rights, Zeid Ra'ad Al Hussein responded that “This event is utterly tragic, inexcusable, and possibly even criminal” and likewise called for an independent investigation.

[67][68] Human Rights Watch (HRW) called the attack a "shocking development" and said "All forces are obligated to do their utmost to avoid causing civilian harm."