What Risk Managers Should Consider When Employing Tactical Medical Support in SWAT Operations

By all accounts, it appears that the number of medical personnel participating in heavily armed raids is on the rise.

In the mid-1960s, major police departments around the U.S. began employing Special Weapons and Tactics (SWAT) teams: heavily armed, specially trained officers who can act swiftly and decisively in volatile situations. Although the exact figure is unknown, it's safe to say that today a majority of municipalities use SWAT teams.

Growing need for medical personnel due to drug raids

Despite the potential hazards, most SWAT operations end without shots fired. However, SWAT teams have been increasingly used to conduct drug raids, which can present unique risks because drug labs and large caches of hazardous substances pose enormous health threats to responding officers. Of particular concern is fentanyl, which can be fatal on contact or through inhalation.

As a result, SWAT teams have increasingly included medical personnel during drug raids. An in-depth study conducted in 2008 found that 78 percent of SWAT operations had an ambulance on standby, 43 percent of SWAT teams included paramedics and 8 percent had a doctor on location.

What to consider when adding medical personnel to the team

Who employs the doctors? If the doctors are in the city’s employ, the city needs to consider purchasing malpractice insurance. The city also should determine if law enforcement liability coverage includes what an on-scene doctor does or does not do. For instance, if doctors are volunteers and employed by a nearby hospital, will their malpractice insurance apply in the SWAT situation?

Are doctors screened and trained? Medics in quasi-combat environments require the ability to make quick decisions and work without additional medical oversight. How much operational planning includes medical response? How much tactical training are doctors provided?

Are doctors identified on the scene? Doctors in SWAT gear, including those who may be armed, could be targeted by suspects. Doctors should participate in all SWAT training exercises to ensure that all team members are aware of their expected activities during an upcoming operation.

Are policies and procedures updated? Many police departments have lost civil cases because they couldn’t produce relevant policies or failed to operate within those policies. It is important to ensure that policies are updated before deploying doctors or medics.

Can this risk be transferred? If the doctor is not a city employee, the police department must ensure the city is protected under an agreement that outlines all of the necessary requirements to satisfy a municipality’s risk appetite.

Who insures the doctors? Most municipalities do not employ doctors, therefore, they do not have medical malpractice insurance for employees. This raises the need for errors and omissions coverage for doctors accompanying SWAT teams. Any nonmedical action taken by doctors acting as members of a SWAT team could trigger general and law enforcement liability exposures. For example, if an armed doctor uses a weapon and injures or kills someone, claims will most likely follow. The SWAT team then has to defend its decision to employ the doctor and show that the doctor was appropriately trained.

What if doctors get injured? If doctors are employed by the municipality and act within the course and scope of their employment, workers’ compensation coverage would apply. But if the doctors are volunteering their services, that coverage can become fuzzy depending on the jurisdiction. Some states have separate, injured-on-duty programs outside of workers’ compensation for police officers. If doctors are sworn officers or otherwise deputized, this coverage may come into play, which can be significantly more expensive in some instances for the municipality.

What about reputational risk? As police departments continue to be scrutinized with respect to militarization, the use of doctors can have pros and cons and can raise these questions: Does having doctors on the scene increase the expectation that violence and injury will result? Or does the presence of doctors show that the municipality is taking precautions to minimize injury?

What next? Although agencies approach medical services differently, governments should work together toward standardizing guidelines, including having ongoing discussions at the national level to build a consensus on best practices.