It might not make sense to you if you think about the industry as if it was in the consumer product market, with a wide range of substitutes and a high degree of information. That doesn’t describe the market here.
For a more detailed discussion of how different the market is, you can read the following. One thing to note is how often more expensive higher tech devices don’t produce measurable improvements in outcomes:
The medical device industry doesn’t care about developing the high volume/high quality/low profit per unit model that you see in flour or deck screws. They operate in a world where lobbying to restrict information and using IP lawsuits to constrict competition and decrease supply is standard operating procedure.
For a sense of how just a fraction of their lobbying dollars are spent at the expense of quality, read here:
Overall lobbying spending by the device manufacturing industry is generally aggregated with the phamaceutical industry because companies like Bayer and Johnson and Johnson manufacture large quantities of both. But combined they are the single biggest source of lobbying dollars in DC, spending almost $300 million in 2019.
Note that the lead organization cited (NY Times, Politico for example) as fighting the use of the Defense Production Act is the US Chamber of Commerce, citing fears of government mandates over production. The US Chamber and medical device industry are closely intertwined, with a major percentage of Chamber funding coming from the industry, and detailed histories of the ACA fight in 2009 will spell out how the Chamber was the front for the industry’s efforts to fight Obamacare. The Chamber continued this role of fronting for the industry over the following years, making repeal of a tax on the industry one of its key legislative priorities.
I suppose it’s theoretically possible that the Chamber and the device industry have had a secret divorce in their very expensive relationship over the past year and the Chamber isn’t carrying water for them, I really doubt it, though.
My ex actually works for Medtronic- She’s involved with labeling and user manuals. Every tiny detail needs approval from the FDA and the company’s legal department. They literally once had to do a product recall because an icon on a label was printed in the wrong color.
I mean, I understand that most of these regulations are there to save lives- But there are just so many of them, and so complex, that you find yourself agreeing with the Libertarians. The second the word “medical” gets attached to your product, there’s literally thousands of hoops you need to jump through before it can be sold.
I went 30-some-odd years on this planet thinking the phrase was ‘jerry-rigged’. ‘Jury’ still sounds odd to me, and less evocative of some dude named jerry kludging something together on the fly.
And in an emergency several of them can be waived. Many have. Others … not. Not at all, such as materials used, or wiring. Others, like your example of colors might be OK. OTOH, when people are concentrating on a patient ingrained color coding can be an important error-check. $HERSELF, a former med tech, nearly hit the ceiling just now at the idea of miscoloring labels – her example was a blue stop sign. As picky and bureaucratic as some might seem, most have a story behind them that cost someone life or limb.
It would not in the least surprise me to find that the origin was in the usual wartime propaganda, calling something “Jerry rigged” as an insult to the “Jerrys” (Germans) either in WWI or WWII. After WWII it became disfavored; smears against the Japanese were common when I was a boy but seem to have disappeared.
Is there a process these companies have to follow to ensure that these ventilators and other ad-hoc supplies are free of molds/mildews and chemicals that might hurt already vulnerable patients? I’m assuming the truck parts aren’t stored the same way medical equipment would be.
Yes, here I was impressed that invasive ventilation respirators would have nebulizers, awesome breath cadence monitoring and assist, tubes that went down brachiae and offered air cycling right there, and yes that was also the anesthesia station for growns at the NICU what slays it with an anesthetist, spare headphones, a mainframe rack full o’ mellowness (okay, it’s a dosing station,) and stuff that is a series of tubes.
Also, a mouthpiece that is designed by cybermen is not part. What the hell, Ford? Don’t tell me you never tried the fire PPE in 160 years of originally plan-optional drills.
Why are the HOLO X Circular Economy people f’rexample not blowing up twitter with N95 reusability tutorials? I mean I didn’t either…hm.
The second the word Medical gets added.
Add Apple and Medical though, split the difference with a slide rule.
Agile (mf’g) plant compo! (Underground DISA quarantine distancing edition.)
Aw snap, if they could buy ammo -and- breathing capacity…westerners*, mirite?
Merriam-Webster.com >> Jury-rig comes from the adjective jury, meaning “improvised for temporary use especially in an emergency,” or “makeshift.” It’s a 15th century term that comes from the Middle English jory , as known (back then, anyway) in the phrase “jory sail,” meaning “improvised sail.”
Juri was also a sadistic senior with paper curls in Revolutionary Girl Utena though, and then there’s the fighter character Han Juri…Guilty Gear? So…I just don’t know.
But that would undercut the whole “not a big deal, just like the flu, democratic hoax” meme he’s had going. Plus probably piss off some donors, so nope.
Those points are dead on. Having said that, I would kill for a gross of the PAPR units in our ICU’s. And they don’t have to be pretty, just functional. Unlike a ventilator, those are fairly simple machines married to plastic space suits. So long as the filter and seals work, we’re golden.
Different technology. Iron lungs are negative pressure ventilators, which work great (and are much more natural and less damaging) for normal lungs, where the problem is neurological. The problem with this bastard is ARDS, where the lungs get stiff, fill with fluid and are a bitch to get air into. You need positive pressure for that to happen. Which is too bad, because negative pressure would be technologically way easier.
In the medical field, they are not at all interchangable. But the media is pretty not-savvy to precise language there. Docs wear respirators to care for patients on ventilators.
If you’re thinking of the ones invented for the previous ebola outbreak they also have air conditioning. You might not need that. They were invented by a university student team and should be easy enough to make.
Positive pressure in lungs=negative pressure around the patient; what counts is the difference, although there is less risk of inflating thestomach with negative.
The big gotcha is getting access for everything BUT breathing,
Given that ICU beds with ventialators are expected to be all full by mid april in Australia, we could get the hackerspaces and what not printing these asap.
With negative pressure you are limited to atmospheric pressure. You also have a coffin-sized device vs roughly the size of a shoebox. And your ability to supply PEEP is very limited, since every mmHg of PEEP directly decreases your maximum PIP (or would that be NIP? I’ve never used an iron lung, not sure how the terminology works.) If I had one, I would use it, and I suspect there has never been an evaluation of effectiveness of neg press vent in covid. The other drawback is that there are many thousands of folks very familiar and experienced at using PPV. I suspect it would be very hard to scrape together a handful with experience in iron lungs.
