Coronavirus

Hospital Technicians Ignore Copyright Law to Fight COVID-19

They trade tips and manuals through a decentralized information-sharing network. Biomedical technicians say it's the fastest and easiest way to get life-saving information.

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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

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  1. Lets all say it together:

    Thanks, Disney!

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  2. So, are private contracts invalid?

    1. Maybe, maybe not; have you donated to a democrat?

    2. 1. Few (if any) of the medical device sale contracts explicitly included a requirement that all future repairs must be conducted by the manufacturer.
      2. Even if some a contract did exist, it can not be binding upon subsequent buyers (or recipients of donations) who did not consent to the original contract.

      There are only two viable ways to enforce this business model. The mobile phone industry has experimented with both.
      1. Never sell your equipment in the first place. Only lease it.
      2. Make the devices so cheap that people replace rather than attempt repair.

  3. 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 other side of that coin is if the companies do not provide immediate repair, they endanger the lives of patients. A little liability here? I could see a lot of wrongful death cases where the proprietary repair company gets hammered for not keeping a piece of equipment up and running.

    1. That would be interesting. And fun!

  4. If you own something, it is yours to do with as you please, including making (or attempting) repairs or other modifications to function.

    That does not entitle you to illegal use of other peoples property, including intellectual property.

    What is even worse, is that many of these sorts of situations do not involve an actual purchase of property. These are actually licensing arrangements, where the hospital or health system licensed use of the devices.

    Which is really, really stupid. But it is not libertarian to compound their stupidity by violating the rights of others even if it is couched in terms of some nebulous general good.

    Sad to see such a blatantly progressive screed at an ostensibly libertarian publication.

  5. Why is US Law binding in Tanzania?

  6. Funny how Reason tells people “tough shit” when they protest the onerous and often abusive end user agreements and terms of use/service of media and communications companies but then outright champions the violation of entirely equivalent agreements and arrangements applicable to other sorts of goods and services.

    Why, it’s almost as if the principals matter more than the principles.

  7. Reason comes out against property rights. These companies have “fought against DIY repair services in court” because if they don’t they’ll find themselves back in court as the defendants for not controlling their products tightly enough. That’s known in the trade as a disincentive to keep making the shit that’s saving people’s lives.

    1. Auto manufacturers have never been found liable for faulty repairs from third parties. Is there any case law that says manufactures were libel for a defect introduced by a third party?

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  10. I don’t know if I should be happy or not. Don’t worry we will all get through this. Stay strong fellas! Salute to our hospital staffs.

    Now is not the time to visit us, our friends and anybody outside your home.

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