Author Topic: What did we learn from the "open source ventilator" mess.......  (Read 5282 times)

0 Members and 1 Guest are viewing this topic.

Offline filssavi

  • Frequent Contributor
  • **
  • Posts: 433
Re: What did we learn from the "open source ventilator" mess.......
« Reply #25 on: July 07, 2020, 05:05:01 am »

8 ) Raise your hand if you learned that 90% of covid patients who go on ventilators die anyway  :o
https://www.bloomberg.com/news/articles/2020-04-22/almost-9-in-10-covid-19-patients-on-ventilators-died-in-study

Unfortunately those are roughly the statistics for emergency ALS/Emergency ICU in general as well I think.
In my interpretation is that if the patient is in such a bad situation to need such intensive degree of treatment their situation is desperate, and if left to their own devices would have died for sure.

There were also some years ago (Unrelated to Covid) some papers that questioned if ALS is even worth it, or if we should abolish it altogether (in my opinion they were flawed studies but who am I to judge).
 

Offline Berni

  • Super Contributor
  • ***
  • Posts: 5050
  • Country: si
Re: What did we learn from the "open source ventilator" mess.......
« Reply #26 on: July 07, 2020, 05:15:02 am »
I learned the importance of understanding the project specifications before designing the thing.

Pretty much 95% of all the maker built ventilators had no clue of what a ventilator is supposed to do so they ended up building various mechanical contraptions for repeatably squeezing a manual handheld ventilator.

Tesla did a good example of how to do it properly. Granted it was likely more of a PR stunt (I don't have any info on how many they actually made and deployed) but at least it was engineered spot on.
 
The following users thanked this post: Smokey

Offline SmokeyTopic starter

  • Super Contributor
  • ***
  • Posts: 3042
  • Country: us
  • Not An Expert
Re: What did we learn from the "open source ventilator" mess.......
« Reply #27 on: July 07, 2020, 05:57:43 am »
I would not conflate the open source philosophy with makers.
On one hand you have a development method used by thousands of software engineers and programmers, used to develop, most of the software stack that runs the modern world (if all open source software stopped working today, we would be thrown back to the late 1800 basically).

I personally use open source whenever possible, and on the rare occasion have actually tweaked the code to fix/add something, so I get it.  I agree that the world pretty much runs on Linux under the hood.  The open source model works really well in some circumstances.  But I'm not naive enough to believe that everything needs to be open source, or that everything would be better if it was open source.  That's a level of ideology bordering on religious.  The bashing of Medtronic for not meeting the level of full open source purity when they released their design was pretty shocking to me.  As I said elsewhere, if the only thing they had done was release their full specification (which I think they did first), that would have been worthy of sainthood to any capable engineering group wanting to take on the task of making a production ready ventilator.  But instead they got shit on by the open source purists, which incidentally are a big part of the group of people who had delusions that they were capable of doing the job themselves in their garages.  It was pretty obvious no one was going to take the old Medtronic design and start spinning up production, so who cares if you don't have the full CAD models for the injection molds. 

And yes, the PPE and other things the Makers were doing was/is great.  Fully support that.  When I visited the hospital about 6 weeks ago a bunch of the nurses all had 3D printed mask holder bands to save their ears from the elastic, and they loved them.  I'm fully on board for using whatever skills you have to help, but being careful because overextending can be counter productive.
 

Online tggzzz

  • Super Contributor
  • ***
  • Posts: 21225
  • Country: gb
  • Numbers, not adjectives
    • Having fun doing more, with less
Re: What did we learn from the "open source ventilator" mess.......
« Reply #28 on: July 07, 2020, 06:18:35 am »
I learnt that some people would rather die than be put on a ventilator which is not fully medically tested and certified. It kinda surprised me.

Don't be a twat. If they needed a ventilator, they were in no position to be able to give informed consent.

Having built a lung ventilator, over half a lifetime ago, I know there are a lot of subtle ways that it can kill, even if it works correctly and according to specification.

Here we go again.

So it's better to let someone die because they haven't given consent to try something that may be risky in order to save their life? Yes, I'm absolutely surprised that people actually think the way you seem to, floored actually. I seriously hope that if I'm going to die and unable to express my wishes that I have a doctor who is willing to be creative and try something novel to save me. If it works, great, if I die, well I was probably going to die anyway, at least they tried. I cannot even fathom why someone would think it better to simply let me (or anyone) die because the lifesaving device/procedure had risk. I'm seriously completely baffled by the attitude : :-//

But what did happen with all this ventilator stuff anyway? My perception is that they managed to scrape up enough machines to get by,t combined with aggressive social distancing reduced the numbers to where we didn't need to take more drastic measures.

Doctors have this Hippocratic oath to contend with;  primum non nocere and all that.

Then they have to contend with lawyers who will convince the corpse's relatives that the doctor did something not sanctioned by the medical profession. However invalid, lawsuits are something doctors try to avoid.
There are lies, damned lies, statistics - and ADC/DAC specs.
Glider pilot's aphorism: "there is no substitute for span". Retort: "There is a substitute: skill+imagination. But you can buy span".
Having fun doing more, with less
 

Online nctnico

  • Super Contributor
  • ***
  • Posts: 28429
  • Country: nl
    • NCT Developments
Re: What did we learn from the "open source ventilator" mess.......
« Reply #29 on: July 07, 2020, 11:07:10 am »
I learnt that some people would rather die than be put on a ventilator which is not fully medically tested and certified. It kinda surprised me.

Don't be a twat. If they needed a ventilator, they were in no position to be able to give informed consent.

Having built a lung ventilator, over half a lifetime ago, I know there are a lot of subtle ways that it can kill, even if it works correctly and according to specification.

Here we go again.

So it's better to let someone die because they haven't given consent to try something that may be risky in order to save their life? Yes, I'm absolutely surprised that people actually think the way you seem to, floored actually. I seriously hope that if I'm going to die and unable to express my wishes that I have a doctor who is willing to be creative and try something novel to save me. If it works, great, if I die, well I was probably going to die anyway, at least they tried. I cannot even fathom why someone would think it better to simply let me (or anyone) die because the lifesaving device/procedure had risk. I'm seriously completely baffled by the attitude : :-//
There are some nuances here. Being put on a ventilator is not like a walk in the park. Chances are extremely high you end up worse with a very low quality of life if you survive (let alone being put on a less than ideal ventilator). Some of my older family members have a 'do not ventilate' card in their wallet for this reason.
Being alive and having quality of life can be very distinct; not all cultures seem to be aware of this.
« Last Edit: July 07, 2020, 11:18:58 am by nctnico »
There are small lies, big lies and then there is what is on the screen of your oscilloscope.
 
The following users thanked this post: wraper

Online tszaboo

  • Super Contributor
  • ***
  • Posts: 8217
  • Country: nl
  • Current job: ATEX product design
Re: What did we learn from the "open source ventilator" mess.......
« Reply #30 on: July 07, 2020, 11:28:55 am »
First Do No Harm. A open source ventilator which is not certified means it is not proven not to cause harm.
But then again, engineers have the equivalent of the Hippocratic Oath, though I've seen people not remembering it.
Engineers shall perform services only in the areas of their competence.
Engineers shall undertake assignments only when qualified by education or experience in the specific technical fields involved.

And learning the difference between "it works" and "it is properly designed, and it should be placed in production, and people can trust their life on it" is somewhat important. Just once, you should design something, that in case of malfunction can kill someone. And go to bed every night after that, and sleep normally.
 

Offline Gyro

  • Super Contributor
  • ***
  • Posts: 10172
  • Country: gb
Re: What did we learn from the "open source ventilator" mess.......
« Reply #31 on: July 07, 2020, 11:50:44 am »
Tesla did a good example of how to do it properly. Granted it was likely more of a PR stunt (I don't have any info on how many they actually made and deployed) but at least it was engineered spot on.

The Dyson one got canned by the NHS before it was ready. I'm not sure if that one was a PR stunt or an attempt to break into the medical devices market. From the pictures I saw, I suspect that their schedule was hampered by having to decide on the colour scheme and how stylish it should look first.

[cynical mode off]
« Last Edit: July 07, 2020, 11:57:11 am by Gyro »
Best Regards, Chris
 

Online tggzzz

  • Super Contributor
  • ***
  • Posts: 21225
  • Country: gb
  • Numbers, not adjectives
    • Having fun doing more, with less
Re: What did we learn from the "open source ventilator" mess.......
« Reply #32 on: July 07, 2020, 02:14:37 pm »
First Do No Harm. A open source ventilator which is not certified means it is not proven not to cause harm.
But then again, engineers have the equivalent of the Hippocratic Oath, though I've seen people not remembering it.
Engineers shall perform services only in the areas of their competence.
Engineers shall undertake assignments only when qualified by education or experience in the specific technical fields involved.

And learning the difference between "it works" and "it is properly designed, and it should be placed in production, and people can trust their life on it" is somewhat important. Just once, you should design something, that in case of malfunction can kill someone. And go to bed every night after that, and sleep normally.

Basically yes.

Exception"... that in case of normal operation as designed can kill someone...".
There are lies, damned lies, statistics - and ADC/DAC specs.
Glider pilot's aphorism: "there is no substitute for span". Retort: "There is a substitute: skill+imagination. But you can buy span".
Having fun doing more, with less
 

Offline donotdespisethesnake

  • Super Contributor
  • ***
  • Posts: 1093
  • Country: gb
  • Embedded stuff
Re: What did we learn from the "open source ventilator" mess.......
« Reply #33 on: July 07, 2020, 04:53:19 pm »
Things that the "Open Source ventilator" saga showed:

1. Most people have no clue what is required to make a medical grade ventilator
2. Most people have no clue that the medical profession are not willing to use unproven devices on patients
3. Most people have no clue what Open Source means

tldr; most people are clueless. But we already knew that.
Bob
"All you said is just a bunch of opinions."
 

Offline james_s

  • Super Contributor
  • ***
  • Posts: 21611
  • Country: us
Re: What did we learn from the "open source ventilator" mess.......
« Reply #34 on: July 07, 2020, 05:10:48 pm »
Doctors have this Hippocratic oath to contend with;  primum non nocere and all that.

Then they have to contend with lawyers who will convince the corpse's relatives that the doctor did something not sanctioned by the medical profession. However invalid, lawsuits are something doctors try to avoid.

Ok, well screw it then, let them die, it's safer than trying to help and helping wrong. I'd like to think that in a really dire situation people would react differently. Maybe it's a cultural thing? I've noticed most of the "OMG it HAS to be properly certified!!  :scared:" people are not in the USA, many of us here have more of a "think outside the box and just get it done" attitude, or used to anyway.
 

Offline james_s

  • Super Contributor
  • ***
  • Posts: 21611
  • Country: us
Re: What did we learn from the "open source ventilator" mess.......
« Reply #35 on: July 07, 2020, 05:24:04 pm »
I personally use open source whenever possible, and on the rare occasion have actually tweaked the code to fix/add something, so I get it.  I agree that the world pretty much runs on Linux under the hood.  The open source model works really well in some circumstances.  But I'm not naive enough to believe that everything needs to be open source, or that everything would be better if it was open source.  That's a level of ideology bordering on religious.  The bashing of Medtronic for not meeting the level of full open source purity when they released their design was pretty shocking to me.  As I said elsewhere, if the only thing they had done was release their full specification (which I think they did first), that would have been worthy of sainthood to any capable engineering group wanting to take on the task of making a production ready ventilator.  But instead they got shit on by the open source purists, which incidentally are a big part of the group of people who had delusions that they were capable of doing the job themselves in their garages.  It was pretty obvious no one was going to take the old Medtronic design and start spinning up production, so who cares if you don't have the full CAD models for the injection molds. 

And yes, the PPE and other things the Makers were doing was/is great.  Fully support that.  When I visited the hospital about 6 weeks ago a bunch of the nurses all had 3D printed mask holder bands to save their ears from the elastic, and they loved them.  I'm fully on board for using whatever skills you have to help, but being careful because overextending can be counter productive.


The Medtronic thing was obviously targeted at companies capable of producing devices of that nature already. If you are already manufacturing equipment and there is a dire enough need, having that design available greatly reduces the amount of reinventing the wheel that needs to be done. Also it was fascinating to be able to look at the design and see just how these things work.

The PPE is a great example of hospitals using equipment made by non-traditional suppliers, I remember people stating flat out that would never happen, that hospitals would never buy any sort of gear from random suppliers like that and yet they did. While I agree that some people are overconfident, pie in the sky types, I'm equally annoyed at the "it will never work, it's a stupid idea, don't even bother trying" crowd. That group will always sit around and accomplish nothing, while the group attempting the impossible will occasionally succeed. There's something that all very successful people have in common, they had the audacity to try and keep trying to pull off something. Look at SpaceX and Blue Origin for example, how would people 40 years ago react if you told them that in just a few decades private companies started by tech billionaires would be sending rockets into space? It's preposterous! That could never happen! Yet it has happened, and governments of superpowers are paying them for their services. A vastly larger number of people with big ideas have failed to get anywhere, but a few succeeded. 100% of those who decided not to try because it was futile failed.
« Last Edit: July 07, 2020, 05:25:41 pm by james_s »
 

Online tggzzz

  • Super Contributor
  • ***
  • Posts: 21225
  • Country: gb
  • Numbers, not adjectives
    • Having fun doing more, with less
Re: What did we learn from the "open source ventilator" mess.......
« Reply #36 on: July 07, 2020, 06:19:08 pm »
While I agree that some people are overconfident, pie in the sky types, I'm equally annoyed at the "it will never work, it's a stupid idea, don't even bother trying" crowd.

That is a false dichotomy that you have invented.

I will tell people why their ideas won't work, and also be receptive to new possibilities. That's what I've been doing my whole professional career in R&D. I sometimes get it wrong, but I've learned to trust my inderstanding and intuition.
There are lies, damned lies, statistics - and ADC/DAC specs.
Glider pilot's aphorism: "there is no substitute for span". Retort: "There is a substitute: skill+imagination. But you can buy span".
Having fun doing more, with less
 
The following users thanked this post: Smokey

Offline Berni

  • Super Contributor
  • ***
  • Posts: 5050
  • Country: si
Re: What did we learn from the "open source ventilator" mess.......
« Reply #37 on: July 07, 2020, 07:13:24 pm »
That is a false dichotomy that you have invented.

I will tell people why their ideas won't work, and also be receptive to new possibilities. That's what I've been doing my whole professional career in R&D. I sometimes get it wrong, but I've learned to trust my inderstanding and intuition.

I think that was more meant at the stubborn kind of people that are fully and wholly convinced that the way they do something is the only correct way to do it. That kind of person who knows how to use a hammer and sees every problem as some variation of a nail. So when a very non nail-like problem pops up and the said hammer doesn't work the answer is "This is not possible to do". Yet it is perfectly possible if a screwdriver was used instead of a hammer, but too bad that he refuses to listen to any screwdriver related solutions because the hammer is clearly the superior tool because he has been using it for the last 25 years.

The issue is that it can be hard to tell the difference between this narrow minded hammer aficionado and an actual competent expert that is trying to tell you that this indeed will not work.

But yes people often don't like being told that there silly idea won't work, even if this is being explained by an actual expert that knows how badly the idea will indeed fail.
 

Offline daqq

  • Super Contributor
  • ***
  • Posts: 2321
  • Country: sk
    • My site
Re: What did we learn from the "open source ventilator" mess.......
« Reply #38 on: July 07, 2020, 08:28:52 pm »
Copying my response from a previous thread ( https://www.eevblog.com/forum/dodgy-technology/sars-ncov-2covid-fueled-hype-enabled-ventilators/ ):
Quote
This is mostly a classic media reporting issue.

The students/hobbyists etc. meant the ventilators mostly as a desperate last means, when the alternative would be for the doctors to hook up a patient to a vacuum cleaner they borrowed from the cleaning staff or let them die. Everyone knows it, the makers know it, the doctors know it. And only a few of the projects (there's actually a very good list of open source projects on this here: https://docs.google.com/spreadsheets/d/1inYw5H4RiL0AC_J9vPWzJxXCdlkMLPBRdPgEVKF8DZw/edit?usp=sharing , mind you, given the numbers it's incomplete and only the most serious projects are even mentioned) are actually really serious, most of them were just "huh, wonder how it works.".

The media reported this as "These brave local* lads created a device that is the same as a 10kUSD device that's being sold by the large corporations. All they needed was this balloon, a motor and a lot of duct tape."
It's really the fault of the way that the media prechew and dumb down the information. Instead of:
"This device, provided a lot more time and development is done, could be used, in the worst case scenario, to help in a very specific set of cases."
we got:
"This cheap fully working device can easily replace this 10kUSD machine! Rejoice, we are saved!"

* - this happened in many countries - here (Slovakia) as well, we had a report of at least 3 independent ideas.
Believe it or not, pointy haired people do exist!
+++Divide By Cucumber Error. Please Reinstall Universe And Reboot +++
 

Offline Gyro

  • Super Contributor
  • ***
  • Posts: 10172
  • Country: gb
Re: What did we learn from the "open source ventilator" mess.......
« Reply #39 on: July 07, 2020, 09:24:13 pm »
Doctors have this Hippocratic oath to contend with;  primum non nocere and all that.

Then they have to contend with lawyers who will convince the corpse's relatives that the doctor did something not sanctioned by the medical profession. However invalid, lawsuits are something doctors try to avoid.

Ok, well screw it then, let them die, it's safer than trying to help and helping wrong. I'd like to think that in a really dire situation people would react differently. Maybe it's a cultural thing? I've noticed most of the "OMG it HAS to be properly certified!!  :scared:" people are not in the USA, many of us here have more of a "think outside the box and just get it done" attitude, or used to anyway.

You're kidding right? You have the most litigious society in the world.  ::)

Mind you, buying up the world production of Remdesvir for the next few months is certainly a "just get it done attitude" (not to mention a 'screw them' one)!
« Last Edit: July 07, 2020, 09:43:56 pm by Gyro »
Best Regards, Chris
 
The following users thanked this post: GlennSprigg

Offline free_electron

  • Super Contributor
  • ***
  • Posts: 8550
  • Country: us
    • SiliconValleyGarage
Re: What did we learn from the "open source ventilator" mess.......
« Reply #40 on: July 07, 2020, 09:36:15 pm »
What i learned is the following :

- the medical world had no clue how to treat this novel virus. They applied time-proven procedures, only to find out they don't work with new diseases. ( note : this is not a blame. nobody know how this thing behaves, even now much of it is still an unknown)
- 90% of people ending up on ventilators , died ... because the ventilators cause massive damage to the lungs in case of covid.
- the reason the demand for ventilators has gone away is because they do not work for covid. It is better to feed to patient 100% oxygen using a demand mask , or a 'hood' than using intubation and forced ventilation. Some hospitals adapted a simple full-face snorkeling mask and hooked it to a 100% oxygen supply or a cpap machine. it worked way better than ventilators. less load on the patient.

if you end up on a true ventilator with covid you are essentially dying with very little hope of recovery ...

Stay safe !
Professional Electron Wrangler.
Any comments, or points of view expressed, are my own and not endorsed , induced or compensated by my employer(s).
 
The following users thanked this post: Smokey

Online tggzzz

  • Super Contributor
  • ***
  • Posts: 21225
  • Country: gb
  • Numbers, not adjectives
    • Having fun doing more, with less
Re: What did we learn from the "open source ventilator" mess.......
« Reply #41 on: July 07, 2020, 09:50:30 pm »
What i learned is the following :

- the medical world had no clue how to treat this novel virus. They applied time-proven procedures, only to find out they don't work with new diseases. ( note : this is not a blame. nobody know how this thing behaves, even now much of it is still an unknown)

Not quite.

They tried and are still trying remedies in the cupboard. Not procedures.

The procedures used to discover and assess the remedies continue to be valid.

Quote
- 90% of people ending up on ventilators , died ... because the ventilators cause massive damage to the lungs in case of covid.
- the reason the demand for ventilators has gone away is because they do not work for covid. It is better to feed to patient 100% oxygen using a demand mask , or a 'hood' than using intubation and forced ventilation. Some hospitals adapted a simple full-face snorkeling mask and hooked it to a 100% oxygen supply or a cpap machine. it worked way better than ventilators. less load on the patient.

AIUI that is too much of a simplification.

Quote
if you end up on a true ventilator with covid you are essentially dying with very little hope of recovery ...

Stay safe !

Very little is too strong.
There are lies, damned lies, statistics - and ADC/DAC specs.
Glider pilot's aphorism: "there is no substitute for span". Retort: "There is a substitute: skill+imagination. But you can buy span".
Having fun doing more, with less
 

Offline EEVblog

  • Administrator
  • *****
  • Posts: 39025
  • Country: au
    • EEVblog
Re: What did we learn from the "open source ventilator" mess.......
« Reply #42 on: July 08, 2020, 02:19:44 am »
The Medtronic thing was obviously targeted at companies capable of producing devices of that nature already. If you are already manufacturing equipment and there is a dire enough need, having that design available greatly reduces the amount of reinventing the wheel that needs to be done. Also it was fascinating to be able to look at the design and see just how these things work.

I don't understand why Medtronic couldn't just ramp up existing production and pump out all the ventilators needed?
 

Online rsjsouza

  • Super Contributor
  • ***
  • Posts: 6105
  • Country: us
  • Eternally curious
    • Vbe - vídeo blog eletrônico
Re: What did we learn from the "open source ventilator" mess.......
« Reply #43 on: July 08, 2020, 02:34:59 am »
The Medtronic thing was obviously targeted at companies capable of producing devices of that nature already. If you are already manufacturing equipment and there is a dire enough need, having that design available greatly reduces the amount of reinventing the wheel that needs to be done. Also it was fascinating to be able to look at the design and see just how these things work.

I don't understand why Medtronic couldn't just ramp up existing production and pump out all the ventilators needed?

Perhaps because they may have been burned in the past, just like Prestige Ameritech here in DFW area:

Quote
Learning from the company’s reaction to the 2009 swine flu pandemic, Bowen says he isn’t hiring additional staff or increasing production times because if/when the outbreak subsides his businesses would be forced to downsize.

“Everybody said they’d stay with us. The day after the [swine flu] pandemic they forgot who we were. We nearly went out of business,” Bowen said during a recent podcast.

Source: https://dfw.cbslocal.com/2020/02/26/north-texas-face-mask-manufacturer-coronavirus-demand/
Vbe - vídeo blog eletrônico http://videos.vbeletronico.com

Oh, the "whys" of the datasheets... The information is there not to be an axiomatic truth, but instead each speck of data must be slowly inhaled while carefully performing a deep search inside oneself to find the true metaphysical sense...
 

Offline EEVblog

  • Administrator
  • *****
  • Posts: 39025
  • Country: au
    • EEVblog
Re: What did we learn from the "open source ventilator" mess.......
« Reply #44 on: July 08, 2020, 03:07:30 am »
The Medtronic thing was obviously targeted at companies capable of producing devices of that nature already. If you are already manufacturing equipment and there is a dire enough need, having that design available greatly reduces the amount of reinventing the wheel that needs to be done. Also it was fascinating to be able to look at the design and see just how these things work.

I don't understand why Medtronic couldn't just ramp up existing production and pump out all the ventilators needed?

Perhaps because they may have been burned in the past, just like Prestige Ameritech here in DFW area:

Or perhaps, just perhaps, they needed some good publicity:
https://www.nytimes.com/2020/03/29/business/coronavirus-us-ventilator-shortage.html
 

Offline Berni

  • Super Contributor
  • ***
  • Posts: 5050
  • Country: si
Re: What did we learn from the "open source ventilator" mess.......
« Reply #45 on: July 08, 2020, 05:27:54 am »
Or perhaps, just perhaps, they needed some good publicity:
https://www.nytimes.com/2020/03/29/business/coronavirus-us-ventilator-shortage.html

So the medical equipment vendors are also all greedy unethical capitalists like the pharmaceutical industry.

Then again this is how most big companies do business. That big board of directors does whatever it takes to please the shareholders and investors. They don't care who they piss off as long as the numbers are going up and up.
 

Offline CatalinaWOW

  • Super Contributor
  • ***
  • Posts: 5569
  • Country: us
Re: What did we learn from the "open source ventilator" mess.......
« Reply #46 on: July 08, 2020, 05:38:14 am »
The Medtronic thing was obviously targeted at companies capable of producing devices of that nature already. If you are already manufacturing equipment and there is a dire enough need, having that design available greatly reduces the amount of reinventing the wheel that needs to be done. Also it was fascinating to be able to look at the design and see just how these things work.

I don't understand why Medtronic couldn't just ramp up existing production and pump out all the ventilators needed?

This question cuts to the heart of one of the issues.  Medtronic has a design.  And a supply chain that is tooled up and certified at a production rate.  Ramping up production requires either shortening process steps (No you don't have to do a 10 hour burn in on part Z before test.....) or increasing parallelism (adding new suppliers, etc.).  Both choices involve going outside the approved design box, with unknown risks.  Adding parallel lines doesn't churn stuff out faster for a while, it depends on how long it takes to buy and install machinery and the like.  Often all of these steps require certification from some agency which has its own staffing and scheduling problems.

There was a public evaluation of production increases at one vendor of PPE.  His normal rate involved two shifts of production on his line, the third shift being used for repairs and preventative maintenance on the line.  He increased production in the short term by 50% by running production all three shifts.  But was aware that maintenance was going to cause issues sooner or later.  He had his older production line in storage and was bringing it out of mothballs, but there was setup time (measured in weeks as I recall) and it wasn't going to double capacity because the old line had been designed for a lower rate.  He also had to find and train operators for the line as his workforce overtime was already saturated by running three shifts.  Going up beyond that on production was going to require buying all new machinery, hiring and training more people, and was going to require developing suppliers capacity also.  The machinery was all custom stuff, so it wasn't just a matter of opening the appropriate catalog and buying it, it was buying pieces, arranging for fabrication of other pieces, then assembling, tuning and testing the result.

Over multiple months increasing production is realistic.  Doing it in days or weeks is limited.
 
The following users thanked this post: Smokey

Offline EEVblog

  • Administrator
  • *****
  • Posts: 39025
  • Country: au
    • EEVblog
Re: What did we learn from the "open source ventilator" mess.......
« Reply #47 on: July 08, 2020, 06:39:52 am »
The Medtronic thing was obviously targeted at companies capable of producing devices of that nature already. If you are already manufacturing equipment and there is a dire enough need, having that design available greatly reduces the amount of reinventing the wheel that needs to be done. Also it was fascinating to be able to look at the design and see just how these things work.

I don't understand why Medtronic couldn't just ramp up existing production and pump out all the ventilators needed?

This question cuts to the heart of one of the issues.  Medtronic has a design.  And a supply chain that is tooled up and certified at a production rate.  Ramping up production requires either shortening process steps (No you don't have to do a 10 hour burn in on part Z before test.....) or increasing parallelism (adding new suppliers, etc.).  Both choices involve going outside the approved design box, with unknown risks.  Adding parallel lines doesn't churn stuff out faster for a while, it depends on how long it takes to buy and install machinery and the like.  Often all of these steps require certification from some agency which has its own staffing and scheduling problems.

There was a public evaluation of production increases at one vendor of PPE.  His normal rate involved two shifts of production on his line, the third shift being used for repairs and preventative maintenance on the line.  He increased production in the short term by 50% by running production all three shifts.  But was aware that maintenance was going to cause issues sooner or later.  He had his older production line in storage and was bringing it out of mothballs, but there was setup time (measured in weeks as I recall) and it wasn't going to double capacity because the old line had been designed for a lower rate.  He also had to find and train operators for the line as his workforce overtime was already saturated by running three shifts.  Going up beyond that on production was going to require buying all new machinery, hiring and training more people, and was going to require developing suppliers capacity also.  The machinery was all custom stuff, so it wasn't just a matter of opening the appropriate catalog and buying it, it was buying pieces, arranging for fabrication of other pieces, then assembling, tuning and testing the result.

Over multiple months increasing production is realistic.  Doing it in days or weeks is limited.

Yes, but it's vastly easier and quicker than having other people/companies take their existing design docs and do it all from scratch using new suppliers and processes and personnel etc.
If the government wanted to they could have requested (and paid for) companies like Medtronics to ramp up their output.
Open sourcing their design docs under a very restrictive license was little more than a dog and pony show, and they know it.
 
The following users thanked this post: sokoloff

Offline Berni

  • Super Contributor
  • ***
  • Posts: 5050
  • Country: si
Re: What did we learn from the "open source ventilator" mess.......
« Reply #48 on: July 08, 2020, 07:03:31 am »
The difficulty of ramping up production can vary a lot.

Yes a heavily automated high volume production line (such as one that spits out multiple facial masks per second) has no room for speed up. All you can do is make sure it keeps running 24/7 while setting up a second parallel one takes a long time.

But production lines for complex low volume products are not like that (such as a line making high end oscilloscopes or heck medical ventilators). Those are not the same perfectly timed clockwork operations. They might normally make production runs of 100s to 1000s of units where they order the plastic cases, boards, PSUs etc... Once the stuff arrives they get a bunch of people together to assemble it, test it and put it into boxes that go in the warehouse to be sold. Once the warehouse starts running low they push the button for another production run. The same people that put together those oscilloscopes this week might be putting together signal generators the next week.

So on these low volume manual production lines you can ramp up production a lot. The plastic injection moldering supplier just stamps out more ventilator plastic housings rather than washing machine control housings that costumer canceled the order for because there factory is shut down. The people assembling them are not a terribly high skilled force and in a large company you can find workers to move into an extra production shift, you can reduce the production of other products to free up more time on the shared production floor.. etc The only issue might be any specialized test rigs in quality control, they might only have one test rig that is not designed to handle such a volume and a second one would have to be custom built from scratch. But perhaps you can run the test rig now 24/7 while before it might have been run on a single normal 8 hour shift.
 
The following users thanked this post: EEVblog

Online tom66

  • Super Contributor
  • ***
  • Posts: 7334
  • Country: gb
  • Electronics Hobbyist & FPGA/Embedded Systems EE
Re: What did we learn from the "open source ventilator" mess.......
« Reply #49 on: July 08, 2020, 07:21:35 am »
At the early stages of the disease there was strong evidence to suggest a 10 million+ worldwide death toll; ultimately it looks like it will peter out below 1 million, depending on how the USA and Brazil behave over the next 3 months. 

If the death toll continued to increase, an open source ventilator designed to a minimum, fair standard (certainly not one of those 'bag-squeezing' machines) may have been worthwhile, IF it could be spun up quickly.  But, I think ultimately, it would have been better to take an existing design and mass produce it.   The secondary issue that no one seemed to mention is that nurses, doctors, etc are all trained on a set of specific machines that they'd find in their hospital.  They may need to be retrained to use new equipment, which could take days. Existing equipment is also pre-certified and likely to be safe by design, or at least its limitations are understood.
 


Share me

Digg  Facebook  SlashDot  Delicious  Technorati  Twitter  Google  Yahoo
Smf