Manufacturers are making it impossible for hospitals to fix broken ventilators

Artificial lung ventilation monitor in the intensive care unit. Nurse with medical equipment. Ventilation of the lungs with oxygen. COVID-19 and coronavirus identification. Pandemic.This post is by Olivia Webb, iFixit‘s outreach coordinator.

If you bought it, you own it. That means you should be able to open it and fix it without retribution from the manufacturer. Right?

Wrong. Most manufacturers make it pretty tough to maintain products, which is why Right to Repair legislation exists. John Deere won’t let anyone else under the hood of its tractors except its repair fleet. As of last week, Nikon ended its authorised repair programme.

Right to Repair is simply the idea that individuals have the right to fix their things – from toys to electronic devices to tractors – and that manufacturers should make the necessary parts, tools and information available for them to do so.

Manufacturers don’t make repair details available 
Repair is big business for manufacturers. Since they’ve seized full control of the repair market, we’re forced to play by their rules. It’s in their best interest that you bring your broken devices to their service desk (or, for bigger machines, call one of their technicians to your location) so that they can perform the repair. They can then charge you exorbitant prices, or – since they only offer a fraction of the repairs that independent technicians can perform – they may try to upsell you the newest model (which you don’t necessarily need). Either way, they’re determined to make the most money possible from your repair.

But what is stopping you from doing the repair yourself, or using an independent repair shop? Well nothing, except, as the manufacturers will tell you, third party shops probably don’t have access to the official repair documentation. The manufacturers keep that very close to their chests. For example, it’s very difficult to become an Apple-authorised Independent Repair Provider. You have to spend several months jumping through hoops, and then sign a non-disclosure agreement. Most repair shops aren’t using Apple’s official repair documentation, they’re relying either on their own knowledge and expertise, or they’re using resources like iFixit.

Hospital technicians can’t get training or information
We’ve heard stories for years from hospital repair technicians – called biomedical technicians, or ‘biomeds’ for short – about how medical device manufacturers make it difficult for them to fix their machines. They refuse to train the biomeds, and make their repair manuals difficult (or impossible) to find and access. They want hospitals to pay to bring out their technicians. In the current circumstances, with ventilators in short supply, biomeds and hospitals do not have time to wait for these technicians. They need the repair resources and manuals now.

What will happen when biomeds become overwhelmed with broken ventilators that need to get back out onto the wards? And what if they get sick, or there are too many broken machines, and they need help? Their time is precious, they should be spending it on repairing hardware that saves lives, not be searching the internet for the manuals, or waiting around for manufacturers’ technicians, who will also be in high demand.

Crowdsourcing manuals is making them available
To help, iFixit is creating a central resource for hospital technicians. We’ve crowdsourced thousands of repair documents and manuals for hundreds of device models, from ventilators to respiratory analysers to anesthesia systems. Our army of volunteers is organising the manuals on our site and helping to identify common machines and problems. Soon, we’ll turn these manuals into easy-to-read guides, which more volunteers will translate into other languages so that biomeds can use them all over the world.

We don’t know how much our resources are being used by biomeds. Now is not the time to be harassing them to find out, but we have done our best to find manuals for ventilators that are most commonly used across hospitals.  We have received the occasional anecdote to inspire us and spur us on, for example, our CEO Kyle Wiens and the Restart Project were able to find a manual in our repair database that was needed by one hospital clinical engineer.

Maybe when this crisis comes to an end we will hear if our resources helped biomeds to weather the storm. In the meantime, we’re going to keep gathering repair manuals and turning them into accessible guides on our site.

In the end, though, workers on the frontline will definitely remember who it was who made their jobs much harder. In a better world, manufacturers would step up to the plate at such a difficult time and freely offer up their closely guarded information to those who need it most, instead of keeping it locked up. Most Right to Repair bills have specifically excluded medical devices from proposed legislation, but maybe now lawmakers will see that needs to be changed. Then, if we are unfortunate enough to find ourselves in this situation again in future, we can spend time fixing broken ventilators instead of fixing a broken process.

One comment

  • An excellent article highlighting the difficult balance that needs to be struck between after sales support revenue that an OEM needs to recover design and production R&D and tooling costs, provide an assured product quality and performance, approved calibration performance, software upgrades, and support itself with continuous cashflow from repair and maintenance, versus, the right and need for the customer to have a choice with its own asset maintenance and support needs, but understanding the consequence of warranty invalidation, technical support training, document control, calibration, potentially compromising safety cases for the equipment, software and hardware reliability, spares availability of obsolete models, etc.

    Given some of the emergency ventilator and PPE adaptation designs are now open sourced, no IPR restrictions, and made available by governments for companies to bid to produce, will this ease the matter somewhat, or will medical procurement return to the old comfortable, but expensive, procure and support contracts that generate this problem?

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