The Navy increased medical surveillance and added performance-enhancing drug testing during Navy SEAL training after a candidate died of pneumonia in 2022, according to an inspector general report. However, the report noted a lack of policies guiding the Navy’s approach to sleep deprivation during SEAL training.

The report, released this week, discussed the Navy’s notoriously rigorous SEAL training and looked at the policies, staffing and medical procedures that drew attention after SEAL candidate Kyle Mullen died in February 2022, at the end of Hell Week – a six-athlete. -day log of 108.5 consecutive training hours in which candidates get less than four hours of sleep.

The IG did not question the need for SEAL candidates to get little sleep, noting that such conditions are “operationally relevant” in determining how candidates perform individually and as a team and in exposing them to an environment that is likely to would experience during combat. However, the report said the four hours of sleep candidates now get during Hell Week was not based on official policy. Navy officials, the report said, were “unable to provide a specific rationale for the timing, length, or number of sleep periods, and we were unable to identify (DoD) policies that provided purpose, applicability, and guidance for the deliberate deprivation of sleep of candidates.”

Capt. Jodie Cornell, spokesperson for the Naval Special Warfare Command, said a study is underway to develop a corresponding policy.

The report also noted a number of positive new policies at the school, known as Basic Underwater Demolition/SEAL training, or BUD/S, and a culture shift toward safety.

Improvements after class 352

Mullen, a 6-foot-4 former college football player who was a member of Class 352, pushed himself to his limits to be “on the edge” at the end of Hell Week. By mid-week he began to fall behind the events and coughed brown and pink fluid from his lungs before developing pneumonia. At one point, a fellow BUD/S student discovered Mullen coughing up dark fluids in the bathroom just hours after finishing the week with the lung infection, when Mullen said, “I’m such a wuss.”

“Kyle died largely because he is so incredibly strong, because he is one of the few people who is actually able to push his body to the death line. That doesn’t excuse all the opportunities for intervention that were there,” said Mark Hardman, a former Navy captain and Navy lieutenant, senior medical officer and attorney who studied bioethics at Harvard University. “But nevertheless, Kyle’s strength was a problem and that’s why there needs to be a medical professional in the room saying, ‘No more.’”

After Mullen spent the last hour of Hell Week in the back of an ambulance breathing from an oxygen tank, BUD/S medics and instructors sent him to the barracks without further medical attention. There, the Hell Week survivors were followed by junior BUD/S students without medical training. On February 4, 2022, Mullen was found unconscious in the barracks by his classmates and was pronounced dead at a local hospital.

The new IG report highlighted a number of changes in SEAL training since Mullen’s death, including new policies to prevent infectious diseases. A new practice the Navy has implemented is to give candidates an injection of Bicillin the week before the Phase 1 assessment and crucible events. Before Class 352, there was an average of 2.2 cases of pneumonia during Hell Week. Since the new injections, there have been 0.94 cases per class, according to the war center.

The Navy is also now looking at testing the province’s ocean waters for disease-causing pathogens to determine if the waters are safe enough for training. If beaches are closed due to transboundary pollution in the Tijuana River Valley and the Pacific Ocean, officials will cancel or reschedule the training. Between January 2022 and December 2023, the center moved almost 32% of its events into the water due to contamination.

The Navy’s investigation found that medical coverage during the tough training week was inadequate due to the high levels of illness and injury common among trainees during that phase. Only one clinician was assigned to each training course, and the training of those clinicians was described as ‘poorly organised, poorly integrated and poorly managed’. Most were active duty service members and contractors with competent training, but the report found that none had completed the mandatory BUD/S-specific training, even though some had already served at the school for two years.

The Navy has since assigned two medics to each BUD/S evolution, according to the service’s May 2023 report. However, with 108.5 consecutive hours of Hell Week training, the war center staff told the IG that manpower is a “major concern.” Therefore, the report recommended that the Department of Defense and the Navy assess the center’s staffing capabilities to ensure they are meeting clinical demand and potentially reduce the center’s staffing capabilities. burnout in a doctor.

The War Center has also added medical screenings every 24 hours, including post-TOUR and Hell Week evaluations, with medical providers remaining on site until candidates complete medical checks on Saturday morning. High-risk candidates will be observed at a medical center until a healthcare provider determines them to be low risk. If they need follow-up care, they will be sent to a hospital, according to a Navy document on the updated policy.

One of the most intensive training courses in the army

Before Hell Week, SEAL candidates train for months before attending a class and are required to swim in the ocean, run sand, and obstacle courses. Candidates then enter Phase 1 of Basic Underwater Demolition/SEAL training for seven weeks, where they are pushed to their limits. Hell Week takes place at the end of Phase 1.

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Typically, fewer than half of SEAL candidates drop out before Hell Week, but Mullen’s early 2022 class lost nearly 80% of its candidates, according to a months-long Navy study. The safety investigation found that the school’s culture of “no slack” training and lax supervision led officials to miss the warning signs of Mullen’s deteriorating condition, despite numerous medical checks.

Hardman praised the changes the Navy has made in the wake of Mullen’s death, but he also pointed to a larger structural problem not addressed in the IG report: the tension between medications, medical diagnosis and treatment at special operations and other high-value operations. valuing military specialty units.

“How on earth were people treated for pulmonary edema with high flow oxygen during Hell Week when it wasn’t documented in MHS Genesis?” Hardman said. “Because you lose control over that information and its implications for someone’s future qualification.”

Hardman also said the lack of qualified, experienced medical professionals increases the difficulty of challenging senior officials with their own medical advice.

“I’ve had conversations with senior physicians who just don’t believe they are wanted at a place like BUD/S because they would put their foot down too much,” he said. “You can’t have someone who puts his foot down too much. You have to have someone who puts the right foot on the ground.”

While monitoring candidates, Hardman also noted a section in the IG report that he believes is representative of a cultural change. During an evolution in September 2023, a tired and disoriented candidate indicated to management that he wanted to quit, but an instructor encouraged him to consult medical personnel rather than give up. That’s the “positive change” people want, he said.

“Anytime you have a tragedy like this, which is very public, it can be the catalyst for very positive cultural shifts. What people want is rigorous training with reasonable safety measures that ensure warfighters can go further and further down,” Hardman said. “I don’t want Navy SEALs to be soft and I don’t want their training to be easy. What I want is appropriate medical risk management.”