Dressed in his blue medical mask and scrubs, Justin Barbour looks like a doctor on a break from treating COVID-19 patients. He's actually a biomedical technician, or BMET—someone who fixes medical devices. He's on staff at a Houston hospital that he asked that we keep anonymous.
Barbour's job has suddenly become dangerous. "If one of us gets sick, then, obviously, multiple technicians in a room, somebody else is probably gonna get sick, and you could take down a whole hospital just by taking down your biomed staff," he tells Reason.
Barbour, who has been working as a BMET for over a decade, often uses service manuals when repairing equipment, but he lacks a lot of essential documentation. So he turns to online forums and relies on his intuition. During the COVID-19 pandemic, BMETs have turned especially often to this decentralized information-sharing network to repair essential hospital equipment. But they've been using it for years, trading information on Reddit, Facebook, and websites like MedWrench and DotMed.
Medical device manufacturers have responded by imposing software locks, proprietary code, and requirements that users obtain special authorizations. They've also fought against DIY repair services in court. So biomedical technicians have had to think especially creatively—because in a pandemic, one broken machine could be the difference between life and death.
Kyle Wiens, the CEO and founder of the third-party repair company iFixIt, says medical device companies have adopted certain tactics pioneered by Apple.
"Well, we'll sell it to you, but we're not going to let you service it," he says. "We want to be the ones to service it."
Manufacturers frequently claim that the information in manuals is their intellectual property—a result of broadly written copyright laws that date back to the 1990s. These were intended to protect the music and film industries from pirates, which were taking their work and sharing it first through physical bootlegs and then online.
But in the 2000s, software began to get integrated into phones, household items, cars, farming equipment, and medical devices too. Manufacturers claimed that copyright laws established that they're the only ones the law permits to repair consumer devices.
"There [are] some manufacturers that won't even sell us parts. It's proprietary and we have no access to it," says Barbour.
BMETs around the world began to rely on Frankshospitalworkshop.com, a website started by a technician in Tanzania named Frank. Frank (who kept his last name private) was having trouble servicing medical devices that had been donated to hospitals in Africa, since he lacked the proprietary keys to make them useable. He figured other people might be in his same position, so he started a website where he posted manuals and wrote about how the equipment worked.
Frank's site was, "from my experience, the most comprehensive, most used resource for medical service information," says Wiens.
Then manufacturers started sending Frank takedown requests. Now, when businesses forbid certain downloads of manuals, his site is limited to featuring the companies' names.
A right-to-repair movement has been fighting to change federal copyright law—or to pass state-level laws that let people fix their own devices. But medical device companies fought back with letters to lawmakers, saying right-to-repair laws could endanger the lives of patients if devices were fixed improperly by untrained personnel.
The trade association AdvaMed, which represents medical device companies, has even lobbied the Food and Drug Administration to regulate third-party device repairs. But after the agency did an assessment in 2018, it concluded that third parties provide high-quality, safe, and effective servicing of medical devices.
iFixit recently announced an initiative to begin collecting service manuals and information about medical devices on its website. They are looking for more info, as well as for people to help organize the information for BMETs.
Produced by Paul Detrick
Watercolor paper: ID 126796034 © Dmytro Synelnychenko | Dreamstime.com; Architect blueprint; Credit: ID 177025853 © Jelena Okjan | Dreamstime.com