What is #1 candidate declines appointment?

Hello- so DS applied to big 3 SAs and MOC (Rep) gave him nom to all 3. He rec’d medical waiver right away from AF, but others are still pending ( so not looking great at this late date for that to change, but not over til the TWE). A local student received appointments to all 3 and accepted to USNA. Does this “possibly” mean that #2 or #3 on the list might receive appointment? I am aware that this student may have several other noms from other sources. I’m just curious if on any slate, if #2 get the opportunity or does that SA get to choose from NWL. Thank you in advance for sharing any insight.

The SAs want to fill the class with at least one person from each MOC. They are obligated to offer an appoint to at least one. They are not obligated to select #2 on the list, but they may.