SANTO DOMINGO, Dominican Republic (AP) — A government-appointed commission in the Dominican Republic released a report Friday recommending sanctions against a team of doctors following the hospital deaths of 11 children.

The commission found their actions caused the death of at least four children over the weekend at the Caribbean country’s main children’s hospital. Commission member Dr. Altagracia Guzman said the children were seen by residents, when specialists should have been caring for them.

The commission also found the other seven children died because of bacteria contracted at the hospital and a breakdown of the hospital’s oxygen system. Guzman said problems with the oxygen system accelerated the deaths of at least two children who were in critical condition. Eight of the children who died were less than a year old.

Rosa Nieves, director of the Robert Reid Cabral Children’s Hospital, had said earlier that the deaths coincided with a breakdown of the hospital’s ventilation system but denied that was to blame.

The Ministry of Health said it was analyzing the report and would soon decide whether to sanction the doctors.

Dr. Radhames Ovalles, a member of a committee created to improve the hospital’s infrastructure and services, criticized the report and said it fails to hold the government accountable. He and other doctors have complained for months about a lack of equipment and supplies and warned of an excessive number of patients being treated at a hospital built in the 1950s.