New information suggests the US deliberately targeted the Kunduz hospital, killing 22 patients and staff, despite knowing it was a protected medical site.

US special operations analysts investigated the hospital for days prior to the deadly October 3 attack, describing the hospital as a base of operations for a Pakistani agent coordinating Taliban activities, AP has learned from a former intelligence official familiar with the documents.

The site, operated by Doctors Without Borders (Medecins Sans Frontieres, MSF), was attacked five times in the span of an hour by a C-130 gunship, despite repeated pleas by the MSF to US forces. MSF officials described repeated strafing runs against the main hospital building, which housed the emergency room and the intensive care unit. No surrounding buildings were hit, they say.

The new details suggest “that the hospital was intentionally targeted,” Meinie Nicolai of MSF told the AP by email. “This would amount to a premeditated massacre,” she added.

According to AP’s source, intelligence reports suggested the hospital was being used as a Taliban command and control center and a repository for heavy weapons. MSF insists that no weapons were allowed in the hospital. While the US military has claimed that US and Afghan forces came under fire from the hospital, Afghan hospital employees told AP that no one had fired from the building

MSF staff “reported a calm night and that there were no armed combatants, nor active fighting in or from the compound prior to the airstrikes,” Nicolai told AP.

The US military initially reported the air strike was conducted “in the vicinity” of the MSF medical facility, targeting the Taliban who were fighting US and Afghan forces, and that the strike “may have resulted in collateral damage “ to the hospital.

Two days later, General John F. Campbell, commander of the US forces in Afghanistan, said the Afghan forces had requested air support because “they were taking fire from enemy positions” and said that “several civilians were accidentally struck” in the air strike.

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US forces in Afghanistan have been authorized to make “condolence payments” to the victims’ families and payments to MSF in order to repair the hospital, the Pentagon said on October 11. The US and Afghan governments have also launched internal investigations into the deadly attack. However, MSF insists on an independent investigation, and has described the hospital bombing as a war crime.

Pentagon officials declined to comment on the AP report.