ANNAPOLIS, Md. (AP) — State agencies and panels consistently missed red flags in the case of a pediatrician charged with sexually abusing more than 100 children over a decade, a Delaware law school dean reported Tuesday.

Linda Ammons, dean of the Widener University Law School, said the case of Dr. Earl Bradley should send a message to communities about how people in positions of trust can exploit children. Her report examined the state's handling of complaints in the case.

"Many flags were missed," Ammons said at a news conference also carried on a conference call. "Opportunities were missed. People weren't careful. People didn't check as they should have, and the end result is this went on for much too long."

Ammons released her report after an independent review over about four months. She sent a list of 73 recommendations to Delaware Gov. Jack Markell on Tuesday, including proposed changes in the law, and Markell pledged to work with lawmakers on them.

"The Department of Justice will be releasing our own report soon, and we look forward to working with the governor and the General Assembly on the recommendations dean Ammons has made and on the recommendations that will be included in our report as well," said Chief Deputy Attorney General, Charles Butler.

Some of the recommendations include:

—Making sure that licensing boards have access to criminal reports.

—Opening Delaware's Board of Medical Practice hearings to the public and making hearing outcomes public record.

—Conducting an evaluation on whether deputy attorneys general are too risk averse to take on tough cases.

The dean concluded in the report that no one could fairly predict whether the alleged crimes could have been prevented.

"However, a tragedy of this magnitude may have been pre-empted if the individuals directly involved had been more focused and alert, less willing to give Bradley the benefit of the doubt, and if they had scrupulously followed the law," Ammons wrote.

Ammons said the state had been on notice since the mid-1990s that there may have been problems with Bradley, but she said people weren't talking to each other in ways that would have brought the doctor closer scrutiny.

In June 1994, just before he began practicing at Beebe Hospital in Lewes, Del., he was accused by a mother of improperly touching her child at his office in Philadelphia. That case was dismissed.

"People could not believe that Bradley could be involved in anything like this," Ammons said.

Bradley pleaded not guilty in March to charges outlined in a 471-count indictment accusing him of sexually abusing 103 children. The crimes in that indictment were based on videotapes seized by investigators. Last month, he was indicted on 58 new counts alleging sexual assaults on additional children.

The crimes alleged in the indictment date from 1999 to December 2009, when Bradley was arrested.

Ammons also said children aren't believed often enough, and she noted that people shouldn't necessarily discount what very young children say.

"From these tragic circumstances, we must learn that just because an allegation is shocking does not mean it can't be true," Ammons said.

Markell, who commissioned the independent review, said in a statement that his administration will work with the Delaware General Assembly and the attorney general's office to implement recommendations in the report.

While systems were in place to catch a perpetrator, Ammons wrote that they were either not properly accessed or human or mechanical error prevented appropriate actions from being taken.

"I hope that this is a lesson for the nation," Ammons told reporters.

She also noted that Bradley was extremely cunning based on the allegations, and she described him as a master manipulator.

"Based on the allegations, he groomed the parents and the patients to make the children his prey," Ammons wrote.

Ammons also concluded that while the criminal justice system may not have been able to stop him sooner because of his methods, the civil process should have been employed to protect the public.

"An over-reliance on the criminal justice system alone prolonged the abuse and terror experienced by innocent children," she wrote.

On the Net: www.governor.delaware.gov