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Objective and background: Violence necessitating legal intervention is a common occurrence in the USA. Such legal intervention may include the use of firearms by law enforcement personnel. However, very little is known about such firearm related injuries necessitating medical care. The objective of the present study is to characterize the burden in terms of mortality and emergency department charges of firearm related interventions requiring ED care in USA. Further we sought to identify high-risk cohorts for such injuries. Methods: A nationwide (USA) emergency department sample for the year 2008 through 2010 was used for the present study. All patients treated in an emergency department (ED) due to firearm injuries by law enforcement personnel were selected for analysis. Outcomes examined including mortality in the ED and ED charges. Findings: There were 6144 ED visits due to firearm injuries caused by law enforcement. The mean age was 33 years. Most patients (69.1%) resided in geographic regions designated as low income areas, and the vast majority were males (91.8%). Many patients (39%) were uninsured. For those with insurance, payers included Medicare (5%), Medicaid (13.5%), private (26.5%), and other insurance (15.6%). Following an ED visit 56.9% were discharged as routine, 25.5% were admitted as inpatients, 3.5% were transferred to another short-term hospital, and 2.8% were transferred to a long-term facility. 338 patients died in the ED and 102 patients died following admission as an inpatient. The mean ED charge was US$3631 and total ED charges across the USA was US$12.8 million. Hospitalization and rehabilitation charges were not assessed in this study. Young adults, males, uninsured, and those residing in low-income areas were identified as the high-risk groups involved in firearm related injuries delivered by legal personnel. Nearly 390 children were involved in such injuries. Discussion: Our study offers initial insights into a complex, important, and not an uncommon problem facing the public. Preventive measures and alternative protective strategies should be considered in the high risk cohorts, especially for children. Language: en