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posted by chromas on Saturday July 11 2020, @01:28AM   Printer-friendly
from the tsk-tsk-tsk dept.

Hacking Ventilators With DIY Dongles From Poland:

As COVID-19 surges, hospitals and independent biomedical technicians have turned to a global grey-market for hardware and software to circumvent manufacturer repair locks and keep life-saving ventilators running.

The dongle is handmade, little more than a circuit board encased in plastic with two connectors. One side goes to a ventilator’s patient monitor, another goes to the breath delivery unit. A third cable connects to a computer.

This little dongle—shipped to him by a hacker in Poland—has helped William repair at least 70 broken Puritan Bennett 840 ventilators that he’s bought on eBay and from other secondhand websites. He has sold these refurbished ventilators to hospitals and governments throughout the United States, to help them handle an influx of COVID-19 patients. Motherboard agreed to speak to William anonymously because he was not authorized by his company to talk to the media, but Motherboard verified the specifics of his story with photos and other biomedical technicians.

William is essentially Frankensteining together two broken machines to make one functioning machine. Some of the most common repairs he does on the PB840, made by a company called Medtronic, is replacing broken monitors with new ones. The issue is that, like so many other electronics, medical equipment, including ventilators, increasingly has software that prevents “unauthorized” people from repairing or refurbishing broken devices, and Medtronic will not help him fix them.

[...] Delays in getting equipment running put patients at risk. In the meantime, biomedical technicians will continue to try to make-do with what they can. “If someone has a ventilator and the technology to [update the software], more power to them,” Mackeil said. “Some might say you’re violating copyright, but if you own the machine, who’s to say they couldn’t or they shouldn’t?”

I understand that there is an ongoing debate on the "right to repair". However, many manufacturers increasingly find ways to ensure that "unauthorised" people cannot repair their devices. Where do you stand on this issue? During the ongoing pandemic, do medical device manufacturers have the right to prevent repair by third parties?

Previously (Medtronic):
(2020-04-14) Raspberry Pi to Power Ventilators as Demand for Boards Surges
(2020-03-31) Professional Ventilator Design "Open Sourced" Today by Medtronic
(2019-11-18) US-CERT Warns of Remotely Exploitable Bugs in Medical Devices
(2018-10-17) Medtronic Locks Out Vulnerable Pacemaker Programmer Kit
(2018-08-15) Hack Causes Pacemakers to Deliver Life-Threatening Shocks
(2014-10-28) US Security Agencies Look at Medical Device Security

Previously (right to repair):
(2020-07-06) Fixers Know What "Repairable" Means--Now There's a Standard for It
(2020-04-21) 'Right to Repair' Taken Up by the ACCC in Farmers' Fight to Fix Their Own Tractors
(2020-03-13) Europe Wants a 'Right to Repair' Smartphones and Gadgets
(2020-01-09) Popularity of Older Tractors Boosted by Avoidance of DRM
(2019-06-21) Hackers, Farmers, and Doctors Unite! Support for Right to Repair Laws Slowly Grows
(2019-04-30) Reeducating Legislators on the Right to Repair
(2019-02-22) Right to Repair Legislation Is Officially Being Considered In Canada
(2018-10-13) 45 Out of 50 Electronics Companies Illegally Void Warranties After Independent Repair, Sting Reveals
(2018-09-21) John Deere Just Swindled Farmers Out of Their Right to Repair
(2018-04-17) Apple Sued an Independent iPhone Repair Shop Owner and Lost
(2018-03-08) The Right to Repair Battle Has Come to California
(2018-02-02) Tractor Hacking: The Farmers Breaking Big Tech's Repair Monopoly
(2018-01-28) Washington State Bill Would Make Hard-to-Repair Electronics Illegal
(2017-05-25) Apple, Verizon Join Forces to Lobby Against New York's 'Right to Repair' Law
(2017-03-08) Right to Repair


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  • (Score: 2) by JoeMerchant on Saturday July 11 2020, @03:20AM (4 children)

    by JoeMerchant (3937) on Saturday July 11 2020, @03:20AM (#1019355)

    So, yeah, there's a real problem when you take a design controlled ventilator that has been through "best practices" processes from concept through production and maintenance and then hack a quick fix onto it. Not saying that these 840 ventilators don't have the potential to save lives, they do, and if I were dying of anything and needed a vent, I'd rather use one of these than no vent at all - but, these aren't the circumstances that those ventilators (and so many other medical devices) were designed for.

    One element of risk management is called "reasonably foreseeable misuse" - and this includes hacky fixes that customers will use to do things like: reuse single use disposables, band-aid field fixes to devices instead of returning them for proper service and repair, etc. Believe it or not, most medical device "lock out" design elements are put there for patient safety, profit is an incidental concern in this area - generally speaking, you don't want to piss off the customers and being a jerk about lockout (like printer ink cartridge refills do) blatant lockout is a good way to drive your customers to competitors who don't do those things.

    Offtopic: All in all, I still think I'd prefer to die before I ever need a ventilator, but I suppose I'm not going to say "DNR if a vent is needed," not yet at least, maybe when I'm 70 and/or can't walk anymore.

    Ontopic: if there's truly a crisis, hackavator is better than no vent at all, but there's a lot of knowledge and experience that gets folded into a modern "advanced" ventilator design, and when you switch to a simple, cheaper hackavator - you're running lots of risks that have been managed in the more advanced designs. When the alternative is certain death, those risks are clearly preferable in most cases, but... in ordinary circumstances you would prefer not to take the additional risks associated with hackavator designs / patches, etc.

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  • (Score: 4, Insightful) by c0lo on Saturday July 11 2020, @03:51AM (3 children)

    by c0lo (156) Subscriber Badge on Saturday July 11 2020, @03:51AM (#1019371) Journal

    Ontopic: if there's truly a crisis, hackavator is better than no vent at all

    Not such a clear cut, unfortunately.

    E.g. slightly higher pressure of delivered oxygen may make the prognostic worse but rupturing the alveolae already weakened by covid
    This can happen in various circumstances:
    - an improperly restored "hackavator"
    - an overused ventilator which just happen to have a dying pressure sensor - a pity the ventilators shortage in time of crisis doesn't allow for the recommended periodic calibration time for the equipment. Maybe if those ventilators wouldn't be so expensive, the hospitals could afford to stock more to mitigate occasional shortages?
    - a perfectly tuned ventilator which a dumb (or just overworked) medical personnel maladjusted for the conditions of the patient.

    This being said, I'll let you ponder on the "simple, clear solution to complex problems"

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    • (Score: 2) by JoeMerchant on Saturday July 11 2020, @12:31PM (2 children)

      by JoeMerchant (3937) on Saturday July 11 2020, @12:31PM (#1019471)

      As you imply, there is no simple clear solution to complex problems - if there were, they wouldn't be complex problems would they?

      I strongly believe in the principle of "first do no harm" and people using hackavators should understand the risks before using them - otherwise you get the 737 MAX effect of reasonably competent pilots being misled by their equipment and people being injured or dying basically due to a lack of training on the equipment in use. As demonstrated by the aircraft, this is a very real risk with very real consequences (the risk of operators not understanding the risks - compounded by the devices not undergoing proper risk identification/management and operator training...)

      As for: if those ventilators weren't so expensive... thank your capitalists and their "free market" for that one. I've worked in medical device development for 30 years now, I've seen a number of innovative ideas that could have been saving lives for decades already - not developed because the resources required could be applied to making more money in other endeavors. If you want to be nice about it you can say that "making more money is saving more lives, or at least benefiting more people" but, the correlation is imperfect at best. Why doesn't the "free market" make cheaper ventilators? Very simply, because there is more money to be made in making expensive ventilators. Changing that simple fact is... a complex problem.

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      • (Score: 2) by c0lo on Saturday July 11 2020, @12:47PM (1 child)

        by c0lo (156) Subscriber Badge on Saturday July 11 2020, @12:47PM (#1019473) Journal

        As for: if those ventilators weren't so expensive... thank your capitalists and their "free market" for that one.

        It's more than that. It's confusing a mean (market/economy) with and end.
        Further aggravated by the picking poor metrics to use in the measure the economy - money (I know no other science that is trying to express the realities it supposedly describes using just two units - money and time - hell of a reductionist vision of this world).
        Even more complicated by the fact that there's no a clear/accepted image of what that end (for the market mean) should be.

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        • (Score: 2) by JoeMerchant on Saturday July 11 2020, @01:02PM

          by JoeMerchant (3937) on Saturday July 11 2020, @01:02PM (#1019474)

          complicated by the fact that there's no a clear/accepted image of what that end (for the market mean) should be

          If you want to take a simple, humanist, view of it - it's a 7.8 billion dimensional problem, but in reality it's more complex as people's opinions and actual needs morph over time.

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