USA Gymnastics released an apology letter and an internal report Tuesday detailing a cultural shift after the organization was rocked by a sexual abuse scandal. The scandal centers on Dr. Larry Nassar, a former Michigan State University and USA Gymnastics doctor accused of dozens of cases of sexual abuse.

“Even one instance of child abuse is one too many. USA Gymnastics is very sorry that anyone has been harmed during his or her gymnastics career, and we offer our deepest regrets to any athlete who suffered abuse or mistreatment while participating in the sport. By working together, we can move the sport forward to better prevent the opportunity for abuse to occur,” the statement from USA Gymnastics read.

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The statement did not mention Nassar by name.

Nassar was a faculty member of Michigan State’s College of Osteopathic Medicine and a practitioner at the college’s sports-medicine clinic according to Michigan Live in March. Nassar worked there from 1997 until he was fired in 2016. Nassar, 53, attended the University of Michigan for undergrad and got his doctorate from Michigan State.

USA Gymnastics is the oversight body for America’s Olympic gymnastics team. Nassar went to four Olympics as the team doctor for the U.S. gymnasts starting with the 1996 Olympics in Atlanta. Nassar also served as a volunteer doctor for Holt, Michigan’s athletic teams, the suburb where Nassar lived.

Nassar is currently standing trial for 12 first degree counts of criminal sexual conduct in Michigan. Four of the charges are for victims under the age of 13. Nassar also faces federal charges for possessing child pornography NBC reported in May. In addition to the criminal trial, Nassar faces 10 lawsuits with over 84 former patients as plaintiffs Michigan Live reported. The suits also list Michigan State, USA Gymnastic and a Lansing-area gymnastics club as codefendants in the suits.

In August 2016 the Indianapolis Star published a story detailing how USA Gymnastics had mishandled sexual abuse allegations. This prompted two former athletes of the program Rachael Denhollander and Jamie Dantzscher to come forward with their allegations, thou Nassar was not mentioned by name in the story.

 USA Gymnastics commissioned a report by ex-prosecutor Deborah Daniels to examines its protocol to protect athletes.

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“A number of troubling reports have surfaced of young women allegedly abused by persons affiliated with USA Gymnastics as members or contractors over a lengthy period of time, including allegations that USA Gymnastics was not sufficiently responsive in disciplining offenders and terminating their access to young gymnasts,” the report reads. “Practices of USA Gymnastics have not kept up with best practices in the field of child abuse protection, allowing for significant gaps and exposures regarding the prevention and reporting of child sexual abuse within the sport.”

The report details a lack of reporting mechanism, safety measures, training and slow response to allegations of abuse. USA Gymnastics’ Board of Directors voted unanimously to accept the recommendations in the report.