this post was submitted on 26 Sep 2024
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Apologies for posting a pay walled article. Consider subscribing to 404. They’re a journalist-founded org, so you could do worse for supporting quality journalism.

Trained repair professionals at hospitals are regularly unable to fix medical devices because of manufacturer lockout codes or the inability to obtain repair parts. During the early days of the COVID-19 pandemic, broken ventilators sat unrepaired for weeks or months as manufacturers were overwhelmed with repair requests and independent repair professionals were locked out of them. At the time, I reported that independent repair techs had resorted to creating DIY dongles loaded with jailbroken Ukrainian firmware to fix ventilators without manufacturer permission. Medical device manufacturers also threatened iFixit because it posted ventilator repair manuals on its website. I have also written about people with sleep apnea who have hacked their CPAP machines to improve their basic functionality and to repair them.

PS: he got it repaired.

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[–] [email protected] 2 points 2 months ago (2 children)

As its paywalled I can’t see the article and any pictures clearer, but from the image shown isn’t that those tiny battery packs you can use for RC drones etc? Because those things are dirty fucking cheap, I would be furious if that was a $100,000 charge.

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[–] [email protected] 8 points 2 months ago

I agree, 404 is legit journalism. No org is perfect, but they're as good as it gets.

[–] [email protected] 13 points 2 months ago (2 children)

Medical devices are required to comply with 21 CFR 820 in the United States, which establishes quality management standards. This includes minimum standards for the software development lifecycle, including software verification and validation testing.

In the EU, broadly equivalent standards include ISO 13485 and IEC 62304.

If an OEM wants to do a software update, they at minimum need to perform and document a change impact analysis, verification testing, and regression testing. Bigger changes can involve a new FDA submission process.

If you go around hacking new software features into your medical device, you are almost certainly not doing all of that stuff. That doesn't mean that your software changes are low quality--maybe, maybe not. But it would be completely unfair to hold your device to the standard that the FDA holds them to--that medical devices in the United States are safe and effective treatments for diseases.

This may be okay if you want to hack your own CPAP (usually a class II device) and never sell it to someone else. But I think we all need to acknowledge that there are some serious risks here.

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[–] [email protected] 10 points 2 months ago (1 children)

repair techs had resorted to creating DIY dongles loaded with jailbroken Ukrainian firmware to fix ventilators without manufacturer permission

How many jailbreaks are done by Ukrainian hackers? Wasn't the John Deere firmware from Ukraine as well? Nice job 💖

[–] [email protected] 6 points 2 months ago* (last edited 2 months ago) (1 children)

Ukraine produces more than its fair share of excellent programmers.

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[–] [email protected] 36 points 2 months ago (6 children)

The right to repair is such an obvious good in the world that those opposed to it should be publicly shamed.

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[–] [email protected] 16 points 2 months ago* (last edited 2 months ago) (2 children)

The CPAP lockout is something I went through. The company behind my CPAP does not allow you to get ANYTHING off the device. But there is an SD Card that you can get all the info you want from your old system. Its arbitrarily locked out.

You are also unable to repair anything on the device without insurance getting involved. And insurance is often at OEM prices (think 200+ for a basic mask). Thankfully, people have illegally added STLs/chips/parts/etc... online that you can basically reverse engineer the entire device nowadays. As long as you use medical safe materials, it saves you literally thousands of dollars. Ive replaced quite a few parts and the device is still working after many years of usage.

[–] [email protected] 7 points 2 months ago* (last edited 2 months ago)

Like anything medically related in the US, it's our time to crack open our wallets and do our patriotic duty of paying half the nation.

Like, if I want to talk to a doctor for 5 minutes, then it's my time to pay the all the insurance industry workers, and I have to pay my part of those 3 minutes long drug commercials you see on TV every ad break and before every YouTube video, and I have to pay all those people locking down the medical devices so that the users can't use their own data. This is my time to shine, I got to pay for all this because I talked to the doctor for 5 minutes. Also, hopefully in the end I have a few cents left over to give to the doctor.

Fucking rent seekers...

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[–] [email protected] 159 points 2 months ago (2 children)

This is what Louis Rossmann has been screaming and fighting about for years. It's the most fucked up shit ever. It is affecting our food supplies and we are not paying attention to it.

[–] [email protected] 15 points 2 months ago (3 children)

Do you have a source on the food supply angle? Sounds interesting and enraging.

[–] [email protected] 15 points 2 months ago* (last edited 2 months ago)

Yeah, just search up right to repair farm equipment, just linking one or two articles won't give you the scope of the problem the way seeing how much it has been covered, but not changed.

I got family that farms independent, and it's pretty much the single biggest factor in profitability over time. Those machines can cost as much, or more, than a nice house, and you're locked in to inflated service and parts costs.

Enraging doesn't honestly do the problem justice.

This isn't a "google it" thing, it's really about actually seeing the search results first hand. We're talking pages of hits going back decades.

[–] [email protected] 91 points 2 months ago (2 children)

Short of it is that John Deere is preventing farmers from repairing their own tractors. How much it threatens the food supply, I'm not sure, but there is an obvious connection.

[–] [email protected] 49 points 2 months ago

I've also read about the John Deere issue as a leading instigator of right-to-repair laws. They weren't able to provide authorized local repair techs when a tractor breaks down, so farmers were stuck waiting 1-2 weeks for someone to show up while crops were rotting in the fields (think of how fast your fresh fruit rots in your kitchen and then imagine dozens of fields of that crop going to waste). And the biggest insult was when the repair tech drove into town for a $5 part that the farmer had already identified but couldn't replace because of manufacturer lockouts.

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[–] [email protected] 120 points 2 months ago (6 children)

Medical device manufacturers also threatened iFixit because it posted ventilator repair manuals on its website.

What the fuck is wrong with people. Anyone who opposes the right to repair for MEDICAL DEVICES is irredeemable.

[–] [email protected] 47 points 2 months ago (3 children)

Education and healthcare should never be for profit.

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[–] [email protected] 384 points 2 months ago* (last edited 2 months ago) (2 children)

The manufacture should have zero say if their product gets repaired or not. The only person who can give permission to repair it is the owner. It should be illegal to implement tying to lockout parts being used as a replacement. Right to repair

They call it jailbreak because this is an issue of freedom: software freedom

[–] [email protected] 17 points 2 months ago (9 children)

I'd temper that by saying a manufacturer would need to provide a reasonable option. Some things could become dangerous or even deadly if repaired incorrectly. Or it could be dangerous or deadly to even attempt to repair it.

[–] [email protected] 42 points 2 months ago* (last edited 2 months ago) (19 children)

In the medical field when a device can only be repaired by the manufacturer then you can expect long wait times, bad repair jobs and having your own equipment sent in for repair destroyed for "safety".

We let people repair their own car's brake pads.. we shouldn't give up ownership rights for a unwarranted claim to safety. If something is potentially dangerous then making it more difficult to repair is a bad idea.

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[–] [email protected] 124 points 2 months ago (2 children)

They call it jailbreak because this is an issue of freedom

I support your position and the right to repair, but that’s not the origin of the term jailbreak in the context of computing.

The term jailbreaking predates its modern understanding relating to smartphones, and dates back to the introduction of “protected modes” in early 80s CPU designs such as the intel 80286.

With the introduction of protected mode it became possible for programs to run in isolated memory spaces where they are unable to impact other programs running on the same CPU. These programs were said to be running “in a jail” that limited their access to the rest of the computer. A software exploit that allowed a program running inside the “jail” to gain root access / run code outside of protected mode was a “jailbreak”.

The first “jailbreak” for iOS allowed users to run software applications outside of protected modes and instead run in the kernel.

But as is common for the English language, jailbreak became to be synonymous with freedom from manufacture imposed limits and now has this additional definition.

[–] [email protected] 46 points 2 months ago* (last edited 2 months ago) (2 children)

Thanks for the history and technical explanation. I didn't mean to imply that was the origin (for computing) and was only talking about a specific usage of the word.

I think most people say it to refer to manufacture imposed limits but I wanted to promote a broader usage. That using proprietary software is like being in a jail because your software freedoms are denied.

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[–] [email protected] 4 points 2 months ago (1 children)

Where are the horse exoskeletons for horses that fall and get injured in completely unnecessary horse races?

[–] [email protected] 42 points 2 months ago (5 children)

Absolutely hate this shit.

[–] [email protected] 14 points 2 months ago (2 children)

It’s definitely annoying, but they have a provided decent explanation of why, imo

[–] [email protected] 8 points 2 months ago (1 children)

The reason why is that they need my email address?

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[–] [email protected] 5 points 2 months ago

Exactly why I'm using an email proxy..

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