Marine One prepares to land at Walter Reed National Military Medical Center in July 2021. Susan Walsh/Associated Press

A heavily redacted Department of Defense report includes some new details about the Lewiston mass shooter’s time in a New York psychiatric hospital, but does not clarify whether military officials believe his brain injuries were related to his service in the Army Reserve.

The conclusions of Walter Reed National Military Center’s forensic autopsy of Robert Card are largely redacted because they are “deliberative in nature and part of the decision-making process, containing opinions and recommendations,” according to a letter released with the 22-page document Friday morning in response to a public records request filed last October.

It’s not clear whether the unredacted version of the document includes commentary on the few questions that remain unanswered since Card killed 18 people on Oct. 25, 2023, including whether he sustained any brain injuries during routine military service that contributed to his mental health deterioration.

Jody Daniels, the former head of the Army Reserve, raised some eyebrows last July when she told reporters that injuries found in the shooter’s brain were probably not related to the grenade blasts he was frequently exposed to as a weapons instructor. The Boston University researchers who analyzed the shooter’s brain had previously determined that grenade blasts had most likely contributed to the injuries.

Daniels’ explanation that the shooter was probably injured during civilian life met skepticism from both the Card family and members of Maine’s congressional delegation. Sen. Susan Collins told the Press Herald in December that she hoped the Walter Reed report might offer more clarity. But the only unredacted discussion of Card’s brain is a summary of the Boston University findings.

Collins’ office said the senator had not yet received a copy of the report and therefore could not comment. It was unclear Friday whether Sen. Angus King, who had also pressured the military to investigate how the Army handled Card’s mental deterioration, had received a copy of the report.

Both senators have also pushed for legislation intended to better protect the brains of service members. 

The analysis does include some personal details about Card beyond what his friends, family and fellow reservists have shared with the public.

Card sometimes felt that he did not fit in as a child, the report says, and he was diagnosed with dyslexia and struggled in school before improving as a student as he got older. While some information is redacted on the basis of “personal privacy,” the document’s description of Card largely matches public testimony from the people who knew him: He was a normal if private man with no obvious signs of serious substance abuse, mental illness, or behavioral problems until he began experiencing paranoid delusions several months before the shooting.

The analysis also brings to light some new details about Card’s two-week stay in Four Winds Hospital last summer, including that he refused to take several medications his doctors recommended. On July 28, Card’s doctors noted that he remained paranoid and lacked “insight into his illness,” and the hospital was prepared to seek a court order to keep him in treatment against his will, according to the report. But just four days later, after he agreed to up the dosage of his medication and stopped threatening to refuse treatment, doctors decided it was safe to discharge him.

It’s not clear whether the unredacted report analyzes whether the hospital was right to let Card leave. Three lengthy paragraphs that immediately follow the description of Card’s discharge are entirely blacked out both for privacy reasons and because “medical quality assurance records” are privileged.

Attorney Travis Brennan speaks at a press conference outside of the Sagadahoc County Superior Courthouse in October after a probate hearing. Brianna Soukup/Portland Press Herald

Travis Brennan, who is one of the attorneys representing family members of victims and survivors of the Lewiston shootings, wasn’t surprised by what he read — and couldn’t read — in the analysis.

“I think this report highlights many things that we have already known in this case, which is that Mr. Card had serious mental health issues that were new in 2023, he had serious and concerning warning signs that everyone saw, and there were multiple missed opportunities on the part of the U.S. Army to intervene and prevent this tragedy from occurring,” Brennan said.

He believes the information contained in them will come out during the court process.

Attorneys preparing a lawsuit against the military have been gathering documents for months. Those include Card’s medical records from Four Winds and Keller Community Army Hospital as well as the Boston University lab’s analysis of Card’s brain tissue. Brennan said the Walter Reed report’s findings are “consistent” with what they’ve seen so far.

“One of the continued concerns that we have is about whether the repeated blast exposure that Mr. Card had during the time that he was in the Army … contributed to his mental health deterioration in 2023,” Brennan said. “This report suggests there may be a connection. But certainly, in this redacted form, it doesn’t answer that.”