Sorry it wasn't perfect but this look back, with 20/20 hindsight, seeking perfection, and assigning blame is out of place IMHO.
How do you improve SAR if you refuse to examine either the mistakes of the past or the performance of the key management individuals?
Everyone involved should go through a mandatory performace review.
Oh, no performace reviews? A family almost dies, one man did...and no performance reviews?
Even those who were part of the search admit to problems. That makes it an ideal time to make changes.