The Navy has increased medical monitoring and added performance-enhancing drug tests 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 policy driving the Navy’s approach to sleep deprivation during SEAL training.
The report, released this week, reviewed the Navy’s infamously rigorous SEAL training and took a look at policies, staffing, and medical procedures which garnered attention after SEAL-candidate Kyle Mullen who died in February 2022, at the end of Hell Week – a six-day slog 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 face low amounts of sleep, noting such conditions are “operationally relevant” to determine how candidates perform individually and as a team and to expose them to an environment they would likely experience during combat. However, the report said that the four hours of sleep that candidates now get during Hell Week was not grounded in an official policy. Navy officials, the report said, were “unable to provide specific rationale for the timing, length, or number of sleep periods, and we were unable to identify [Department of Defense] policies providing purpose, applicability, and guidance for intentionally depriving candidates of sleep.”
Capt. Jodie Cornell, spokesperson for the Naval Special Warfare Command said a study is underway to develop a corresponding policy.
The report also noted several 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-3, former college football player who was part of Class 352, pushed himself to the limits in order to be “on the berm” at the end of Hell Week. Halfway through the week, he began to fall behind on events and cough up brown and pink fluids from his lungs before he developed pneumonia. At one point, a fellow BUD/S student found Mullen coughing up dark fluids in the bathroom, just hours after finishing the week with the lung infection when Mullen said: “I am such a pussy.”
“Kyle died in large part because he’s so incredibly strong because he’s one of the few people who is actually capable of pushing his body to the line of death. That does not excuse all of the opportunities for intervention that existed,” Mark Hardman, a retired lieutenant, senior medical officer and lawyer studying bioethics at Harvard University said. “But nonetheless, Kyle’s strength was a problem and so there has to be a medical professional in the room that says, ‘No more.’”
After Mullen spent the final 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 with no further medical attention. There, Hell Week survivors were monitored by junior BUD/S students with no medical training. On Feb. 4, 2022, Mullen was found unresponsive in the barracks by his classmates and was pronounced dead at a local hospital.
The new IG report highlighted a number of changes to SEAL training since Mullen’s death, including new infectious disease prevention policies. One new practice that the Navy has implemented is to give candidates an injection of Bicillin the week before Phase 1 assessment and crucible events. Before class 352, there were an average of 2.2 pneumonia cases during Hell Week. Since the new injections, there have been 0.94 cases per class, according to the warfare center.
The Navy also now looks at county ocean water tests for disease-producing pathogens to determine whether the waters are safe enough for training. If beaches are closed because of cross-border pollution in the Tijuana River Valley and Pacific Ocean, officials will cancel or relocate training. Between January 2022 and December 2023, the center relocated nearly 32% of its in-water events because of contamination.
The Navy investigation found that medical coverage during the rigorous week of training was not sufficient for the high levels of sickness and injuries that are common among trainees during that phase. Only one medic was assigned to each training event, and the training of those medics was described as “poorly organized, poorly integrated, and poorly led.” Most were active duty and contractors with competent training, but the report found none completed mandatory BUD/S-specific training, even though some were on duty at the school for two years.
The Navy has since assigned two medics to every BUD/S evolution, the service’s May 2023 report said. However, with 108.5 consecutive hours of Hell Week training, warfare center staff told the IG that manpower is a “major concern” so the report recommended that the Defense Department and Navy assess the center’s staffing capabilities to make sure they meet clinical demand and potentially reduce clinician burnout.
The warfare center has also added medical screenings every 24 hours including evaluations post-TOUR and Hell Week 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 provider determines they are “low risk” or if they need follow-on care, they will be sent to a hospital, according to a Navy document of its updated policies.
Among the military’s most intensive training
Ahead of Hell Week, SEAL candidates train for months before joining a class and are put through ocean swims, sand running, and obstacle courses. Then, candidates go on to Phase 1 of Basic Underwater Demolition/SEAL training for seven weeks where they are pushed to their mental and physical limits. Hell Week occurs at the end of Phase 1.
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Typically, less than half SEAL candidates drop out before Hell Week, but Mullen’s early 2022 class lost nearly 80% of its candidates, according to a months-long investigation by the Navy. The safety inquiry found that the school’s culture of “no slack” training and lax supervision led officials to miss warning signs of Mullen’s deteriorating condition, despite numerous medical checks.
Hardman commended the changes that the Navy has made in the wake of Mullen’s death but he also pointed out a larger structural problem that wasn’t addressed in the IG report; that is the tension between medicine, medical diagnosis and treatment in special operations and other high value military specialty units.
“How in God’s name were people being treated for pulmonary edema with high flow oxygen during Hell Week and that wasn’t being documented in MHS Genesis?,” Hardman said. “Because you lose control of that information and its implications for someone’s future qualification.”
Hardman also called said that the lack of qualified, experienced medical professionals adds to the difficulty of challenging high-ranking officials with their own medical advice.
“I’ve had conversations with senior physicians who just don’t believe that they’re 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 their foot down too much. You have to have someone who puts their foot down the right amount.”
With the monitoring of candidates, Hardman also noted a section in the IG report which he said is representative of a cultural change. During a September 2023 evolution, one fatigued and disoriented candidate indicated to leadership that he wanted to quit but an instructor encouraged him to see medical personnel instead of giving up. That’s the “positive change” people want, he said.
“Any time you go through a tragedy, like this that is very public, that can be the impetus for very positive cultural shifts. What people want is hard as hell training with reasonable safety precautions that continue to deliver war fighters to go down range,” 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.”