Ventilator Companies Finally Make the Life Saving Devices Easier to Repair (vice.com) 32
America needs ventilators. The coronavirus has spread far enough that Donald Trump used the Defense Production Act on April 2 to make it easier to produce more. There's also broken ventilators on the market that could work with some repairs, but manufacturers spent weeks making it hard to get basic information needed for technicians to repair the machines. From a report: U.S. PIRG and other groups had been pressuring the manufacturers to release the ventilator information for weeks. On April 14, the States Treasurer of Pennsylvania, Delaware, Illinois, Rhode Island, and Colorado called on the manufacturers to release the documents in an open letter. Now, ventilator manufacturers GE, Fisher & Paykal, and Medtronic have made it easier to access the repair manuals and other service information hospitals need to repair broken ventilators. GE opened a web portal where people can download the repair information for its Carescape R860 and Engstrom ventilators. GE typically requires a 4-day in-person training class to learn to repair ventilators but is making the information available to the public "to help navigate this crisis and ensure ventilators are maintained as quickly as possible to get these vital systems back into patient care."
Medtronic, who makes a number of ventilators, has posted a portal to register for the design and repair information of its ventilators. Meaning that the savvy user could do more than repair a broken machine -- they may be able to build a whole new ventilator. But it's not enough, according to Kyle Wiens of iFixit, a company that advocates for the right-to-repair and teaches people how to fix their own stuff. "Medtronic only released the manual for the PB560, which they don't sell in the U.S," Wiens told Motherboard in a Twitter DM. "We don't have the manual for the PB980, their flagship model and the one used by our hospitals in San Luis Obispo."
Medtronic, who makes a number of ventilators, has posted a portal to register for the design and repair information of its ventilators. Meaning that the savvy user could do more than repair a broken machine -- they may be able to build a whole new ventilator. But it's not enough, according to Kyle Wiens of iFixit, a company that advocates for the right-to-repair and teaches people how to fix their own stuff. "Medtronic only released the manual for the PB560, which they don't sell in the U.S," Wiens told Motherboard in a Twitter DM. "We don't have the manual for the PB980, their flagship model and the one used by our hospitals in San Luis Obispo."
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How savvy do you need to be? (Score:2)
Genuine question from someone who doesn't know much about ventilators: aren't those machines essentially simple displacement pumps with some control electronics to maintain positive pressure and adjust the flow rate depending on blood oxygen levels?
Or said another way: how hard can it be to maintain or repair those things? What the hell requires 4 days of training and a manual that you can't do without to work on them - apart of course the fear of lawsuits, which should essentially be lifted in time of cris
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No, what you're describing is a CPAP machine. Those don't even necessarily have blood-O2 feedback. They just create a steady breeze. BiPAPs lower the pressure when you exhale.
I don't know how hard xPAPs are to repair, or how my Medical Equipment vendor handles that. I've never had one break in over 20 years. Ontario pays 75% of the cost every 5 years, so I just move up. Like most devices, they get smaller, lighter, and quieter each product cycle. Those suckers ... er blowers... are the among most reliable m
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It depends on your contract. You may well be prohibited from repairing them by contract, and availability of warranty and support may be void if you do.
Remember, the customers are hospitals, and the qualifications of the people who work there are not in electronics and mechanical repair, but in medicine.
Re: How savvy do you need to be? (Score:2)
Apart from the service department (generally part of medical physics) for medical devices where suitably personnel are employed. Bit like the IT department which also employs none medics, or finance which again does not employ medics.
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It's not whether you're savvy, but will anyone indemnify you for doing repairs. Hospitals have clinical engineering departments that repair old and new devices, even those without support contracts. They have a limited amount of things they can do and it typically voids FDA approval to use a 'duct tape' approach to fixing stuff.
Re:How savvy do you need to be? (Score:4, Interesting)
I look through the service manual for one. There's a displacement pump at the core, yes - but it's got a lot of complicated mechanisms around it. Pressure monitoring, pressure regulation, temperature regulation, humidity control, and lots of bits I just can't figure out the purpose for. If the air isn't going in through the nose, it needs pre-heating and -humdifying or prolonged use could damage the lungs.
Ventilators for Covid-19 treatment (Score:2, Insightful)
Re:Ventilators for Covid-19 treatment (Score:4, Informative)
What you are saying is true. You don't deserve to moderated as "troll." I'd mod you higher if I had points. But I don't so this is the best I can do.
To anyone else reading: medical researchers have indeed begun questioning the use of ventilators for many COVID-19 patients. They are recommending that patients not be ventilated unless they are physically struggling to breathe, rather then when their O2 blood saturation drops below a certain level. For reason we don't yet understand, COVID-19 patients can better tolerate low O2 saturation levels than non-infected people can.
Therefore, to avoid negative ventilator side effects like lung injury that could worsen their prognosis, researchers are recommending that ventilators be eschewed until patients are in physical distress.
Comment removed (Score:5, Interesting)
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The British government has just told Dyson not to bother getting its design approved and starting manufacturing because they are simply not needed.
I thought this would happen. All these companies saying we will have a few thousand ventilators by June. If it was that bad by June we would be in real dire straights.
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The British government has their own scandals around ventilators right now. By all appearances, they deliberately excluded the country from an EU-wide supply scheme for equipment distribution, because admitting a dependence upon EU support would undermine the party's position regarding Brexit negotiations. Hard to keep talking about a strong and independent Britain while also using EU-supplied ventilators.
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The UK government has even bigger issues than not joining the EU procurement scheme on ideological grounds. It was more more than ventilators, BTW, it includes PPE that we desperately need.
The government was warned back in 2016 that it needed to stockpile. It was warned repeatedly in 2019 and early this year that it wasn't acting fast enough. It's likely going to miss its 100,000 tests/day target.
Matt Hancock is being set up as the scapegoat for all this but really it's a much bigger failure than just him.
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A PC in a Box (Score:1)
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Capitalism (Score:1)
While capitalism is good to have layered on top of the basics (shelter, food and health care), this is exactly what happens when you think capitalism is the be all and end all.
It isn't, those who can't get a job (as they don't exist) are boned. Capitalism says "buy cheap" so China etc do your work for you and this is exactly what happens.
Hopefully a mixed approach is seen to be the answer..
(in case someone says "relevance?", the point is that companies are encouraged to make as much money as possible, hence
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While capitalism is good to have layered on top of the basics (shelter, food and health care), this is exactly what happens when you think capitalism is the be all and end all.
You get to blame capitalism when the barrier to entry isnt a hundred million in testing, and changing requirements just as patents are about to expire.
Problem here is regulation (Score:5, Insightful)
I'm curious how the liability works for a FDA-approved medical device which is repaired. If a part breaks, is repaired by a third party, then a failure in the repair leads to a patient death, who is liable? The only other industry I know of which is as highly regulated is aerospace. There, the only ones allowed to do repairs are either the original manufacturer, or a maintenance company which goes through a training program approved by the manufacturer and is certified to make repairs so long as they strictly follow the instructions published by the manufacturer. You do not allow anyone out there with a 3D printer to print out a compatible part, and stick it into a plane to make a repair. All the parts used in repairs also have to be certified as meeting regulated standards as well.
So the situation is actually the reverse of what you're saying - the problem is caused by regulation, and capitalistic pressure is what's causing all these people to try to repair these devices. If it's anything like the FAA, these people would normally be prohibited by the FDA from making these repairs (without training and certification). But the extremely unusual circumstances we're living in - where badly repaired ventilators which work will save more lives than badly repaired ventilators which fail will kill - are getting the FDA to look the other way as untrained and uncertified people make these repairs.
Re:Capitalism (Score:4)
>"While capitalism is good to have layered on top of the basics (shelter, food and health care), this is exactly what happens when you think capitalism is the be all and end all. It isn't, those who can't get a job (as they don't exist) are boned."
Um, the only reason the economy is screwed right now (and will be for a long time) is that the government interfered with "capitalism" and forced businesses to stop. Using the current crisis to criticize capitalism is very disingenuous.
And the deal with ventilator availability is, again, the result of government interference in the form of extreme regulation by the government in the past AND the present. The past with so many rules that few could make them or repair them, making availability low and prices high. And the present with the "forced" demand, which turned out to be totally out of proportion with actual need.
This is not to say that some regulation is important, or that extraordinary emergencies don't need some government intervention. But let's not pretend that "capitalism" is a fault factor.
Protectionism (Score:3)
You could also make the case that layers of regulation and backwards trade policy make it nearly impossible for regular market forces to operate properly in the ventilator market. Companies were falling over themselves to try to make ventilators, but had to get special permission from the FDA to do so. It's even more of a pressing concern in the market for COVID-19 test kits. Initially the CDC said nobody else could produce them, then the first batch the CDC produced were faulty.
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You could indeed, and you would be correct. Any conversation about how to make things better for everyone is a step in the right direction.
Ventilators are killing some patients (Score:4)
https://www.statnews.com/2020/... [statnews.com]
By using ventilators more sparingly on Covid-19 patients, physicians could reduce the more-than-50% death rate for those put on the machines, according to an analysis published Tuesday in the American Journal of Tropical Medicine and Hygiene.
But does America really need (more) ventilators? (Score:3)
So far there have been no shortages of ventilators. Granted, the situation may change, but a jump from a handful needed to tens of thousands strikes as unlikely. The media has certainly stopped worrying about it.
"America needs ventilators"? Do we? (Score:4)
Does it?
I know the meme that a number of people are trying to communicate is need/desperation/misery but are we in such desperate need?
First, the increasing messages from the medical field is that we should stop using them so much in coping with covid19:
Ventilators are overused: https://www.statnews.com/2020/... [statnews.com]
Reduce reliance on ventilators: https://www.statnews.com/2020/... [statnews.com]
Dr's rethink rush to ventilate: https://www.reuters.com/articl... [reuters.com]
And at the same time, Britain's NHS has advised Dyson that need for ventilators has been far lower than expected and they don't need the Dyson versions currently in testing.
Dyson Covid-19 ventilators are 'no longer required' https://www.bbc.com/news/busin... [bbc.com]
I rather suspect some of the messaging is inertial - we NEEDED ventilators so we keep saying we do like the cancer kid asking for get-well cards who got better or died or whatever decades ago. I suspect some of it is political: by continuing to amp the misery, amp the crisis, it's all a non-subtle attack on the preparedness of the US government and in parallel Trump (which is always in style for most of the media).
I'd be curious to find out if we really, objectively, do need ventilators today.