A stinging internal investigation finds “failed leadership at multiple levels” at the Veterans Administration during the Obama administration that put patients at a major hospital at risk. It’s another blow to current Secretary David Shulkin, who also served at the agency then and now is fighting to keep his job.

The 150-page report released Wednesday by the VA internal watchdog offers new details to its preliminary finding last April of patient safety issues at the Washington, D.C., medical center.