The U.S. military on Saturday acknowledged it may have bombed a hospital run by medical aid group Medecins Sans Frontieres in the Afghan city of Kunduz in an air strike that killed at least nine people and wounded 37.

The incident could renew concerns about the use of U.S. air power in Afghanistan, a controversial issue in America’s longest war. Former President Hamid Karzai fell out with his backers in Washington over the number of civilians killed by bombs.

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U.S. forces launched an air strike at 2.15 a.m. (1745 ET), the spokesman, Col. Brian Tribus, said in a statement. “The strike may have resulted in collateral damage to a nearby medical facility,” he added. “This incident is under investigation.”

At the aid group’s bombed-out hospital, one wall of a building had collapsed, scattering fragments of glass and wooden door frames, and three rooms were ablaze, said Saad Mukhtar, director of public health in Kunduz.

“Thick black smoke could be seen rising from some of the rooms,” Mukhtar said after a visit to the hospital. “The fighting is still going on, so we had to leave.”

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