Author Topic: What did we learn from the "open source ventilator" mess.......  (Read 5276 times)

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Offline SmokeyTopic starter

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Now that the dust has settled and it's not apparently trending anymore...
If you got caught up in the open source ventilator rush and spent any amount of time thinking about that problem seriously, try out these questions.  It's never a total waste of time if you learned something.

1) Raise your hand if... You learned something about being way overconfident in your own functional skills.

2) Raise your hand if... You learned being a "maker" isn't the same as being an engineer.

3) Raise your hand if... You learned that the design of a life critical medical device is more complicated than you thought and deserves more respect than you thought.

4) Raise your hand if... You learned that knowing something about electronics or software does not imply you can design mechanical systems.

5) Raise your hand if... You learned that even if you have a functional design, that does not mean you can successfully manufacture a product.

6) Raise your hand if... You learned that always having 100% "open source" ideological purity isn't really that important and harping on it isn't always helpful.

7) Raise your hand if... After learning how silly the basic idea of open source community designed ventilators are, you volunteered delivering food to old folks in your community or some other useful activity.


It's one thing to have an engineering mindset and be curious about how things work and want to go through the exercise of learning how to do things for it's own sake.  In that case, fine.  Build yourself a ventilator in your garage.  It's another thing entirely to take on the stance that you and your friends on the internet are seriously intending to do what the big companies can't and save the world by becoming functional in the cumulative understanding of a whole handful of distinct engineering careers in a matter of weeks in order to create a reliable life critical medical device for mass production and anyone who thinks that's crazy just needs to shut up and get out of your way.  As it turns out, what we should have all been working on was "open source toilet paper".  We would have been rich!
 
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Offline madires

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #1 on: July 06, 2020, 12:45:50 pm »
Can't you simply 3D print toilet paper? >:D
 
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Offline SmokeyTopic starter

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #2 on: July 06, 2020, 12:47:38 pm »
Can't you simply 3D print toilet paper? >:D

Challenge accepted!
 

Offline Psi

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #3 on: July 06, 2020, 12:51:39 pm »
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.
Greek letter 'Psi' (not Pounds per Square Inch)
 
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Offline GlennSprigg

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #4 on: July 06, 2020, 01:04:08 pm »
Now that the dust has settled and it's not apparently trending anymore...
If you got caught up in the open source ventilator rush and spent any amount of time thinking about that problem seriously, try out these questions.  It's never a total waste of time if you learned something.
1) Raise your hand if... You learned something about being way overconfident in your own functional skills.
2) Raise your hand if... You learned being a "maker" isn't the same as being an engineer.
3) Raise your hand if... You learned that the design of a life critical medical device is more complicated than you thought and deserves more respect than you thought.
4) Raise your hand if... You learned that knowing something about electronics or software does not imply you can design mechanical systems.
5) Raise your hand if... You learned that even if you have a functional design, that does not mean you can successfully manufacture a product.
6) Raise your hand if... You learned that always having 100% "open source" ideological purity isn't really that important and harping on it isn't always helpful.
7) Raise your hand if... After learning how silly the basic idea of open source community designed ventilators are, you volunteered delivering food to old folks in your community or some other useful activity.

It's one thing to have an engineering mindset and be curious about how things work and want to go through the exercise of learning how to do things for it's own sake.  In that case, fine.  Build yourself a ventilator in your garage.  It's another thing entirely to take on the stance that you and your friends on the internet are seriously intending to do what the big companies can't and save the world by becoming functional in the cumulative understanding of a whole handful of distinct engineering careers in a matter of weeks in order to create a reliable life critical medical device for mass production and anyone who thinks that's crazy just needs to shut up and get out of your way.  As it turns out, what we should have all been working on was "open source toilet paper".  We would have been rich!

I really DO understand what you are saying, mate. However, in times like these, we DO have to Bypass the
myriad of normal 'regulations' that authorities/nations would/should 'normally' impinge, on generic products
appearing on the market generally.  It would be quite evident, very early on, which ones are a waste of time,
but there may be many others that may help, and make a difference, where immediate global production is
limited for many reasons. If it 'works', then just do/try it!!  I wouldn't want the life of say my Father or Grand-
Father to rely on some Fabrication/Legal/Govt clause 117.3.b etc to block someone's production, if it HELPS!!   :phew:
Diagonal of 1x1 square = Root-2. Ok.
Diagonal of 1x1x1 cube = Root-3 !!!  Beautiful !!
 

Online tggzzz

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There are lies, damned lies, statistics - and ADC/DAC specs.
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Online tggzzz

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #6 on: July 06, 2020, 01:09:59 pm »
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.
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
 
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Offline Psi

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #7 on: July 06, 2020, 01:12:51 pm »
That was kind-of my point, i was surprised so many people were being twats about it.
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Online tggzzz

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #8 on: July 06, 2020, 01:17:19 pm »
That was kind-of my point, i was surprised so many people were being twats about it.

Really? I can't see how your statement can be interpreted that way...

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.
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 Rerouter

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #9 on: July 06, 2020, 01:19:01 pm »
I learned that biologists researching other options can really be divided into lazy, incompetent, career chasers and actual good people like any work place, and that scares the crap out of me more than the few thousand half hearted attempts at accidentally killing people over misunderstanding all the requirements.
 

Offline SmokeyTopic starter

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #10 on: July 06, 2020, 01:29:05 pm »
I really DO understand what you are saying, mate. However, in times like these, we DO have to Bypass the
myriad of normal 'regulations' that authorities/nations would/should 'normally' impinge, on generic products
appearing on the market generally.  It would be quite evident, very early on, which ones are a waste of time,
but there may be many others that may help, and make a difference, where immediate global production is
limited for many reasons. If it 'works', then just do/try it!!  I wouldn't want the life of say my Father or Grand-
Father to rely on some Fabrication/Legal/Govt clause 117.3.b etc to block someone's production, if it HELPS!!   :phew:

I fully support the people who are out there working their asses off to make the things that people need right now.  That includes all the professionals and engineering companies and groups working on ventilators.  Those aren't the people I have issues with though.
The family of the dude who's lungs you pop with your "device" won't care about how many other lives you may have saved.
 

Offline DrG

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #11 on: July 06, 2020, 02:19:44 pm »
Now that the dust has settled and it's not apparently trending anymore...
If you got caught up in the open source ventilator rush and spent any amount of time thinking about that problem seriously, try out these questions.  It's never a total waste of time if you learned something.

1) Raise your hand if... You learned something about being way overconfident in your own functional skills.

2) Raise your hand if... You learned being a "maker" isn't the same as being an engineer.

3) Raise your hand if... You learned that the design of a life critical medical device is more complicated than you thought and deserves more respect than you thought.

4) Raise your hand if... You learned that knowing something about electronics or software does not imply you can design mechanical systems.

5) Raise your hand if... You learned that even if you have a functional design, that does not mean you can successfully manufacture a product.

6) Raise your hand if... You learned that always having 100% "open source" ideological purity isn't really that important and harping on it isn't always helpful.

7) Raise your hand if... After learning how silly the basic idea of open source community designed ventilators are, you volunteered delivering food to old folks in your community or some other useful activity.


It's one thing to have an engineering mindset and be curious about how things work and want to go through the exercise of learning how to do things for it's own sake.  In that case, fine.  Build yourself a ventilator in your garage.  It's another thing entirely to take on the stance that you and your friends on the internet are seriously intending to do what the big companies can't and save the world by becoming functional in the cumulative understanding of a whole handful of distinct engineering careers in a matter of weeks in order to create a reliable life critical medical device for mass production and anyone who thinks that's crazy just needs to shut up and get out of your way.  As it turns out, what we should have all been working on was "open source toilet paper".  We would have been rich!

Can't say you have not made some good points, because I think you have.

I just want to offer, what I think is a successful example, of a successful open source ventilator project...
https://www.jpl.nasa.gov/news/news.php?feature=7661
https://www.techbriefs.com/component/content/article/tb/stories/blog/36790
https://www.nasa.gov/press-release/eight-us-manufacturers-selected-to-make-nasa-covid-19-ventilator

No, it was most-definitely NOT made in a single person's garage. It is a story that, I think, complements the issues that you raised.

It is open source (at least insofar as I think of open source).

The design engineers, who were not in the ventilator business, learned what it was supposed to do by asking the medical profession what it was supposed to do and working with them.

The "team" included engineers from many different areas ( e.g., https://hackaday.com/2020/06/08/rapid-prototyping-hack-chat/#more-415947).

The team implemented rapid prototyping that exemplifies to me, what 'rapid prototyping" means (again, my opinion). " It was designed, prototyped, and tested on an incredibly ambitious timetable: 37 days total." - that is the usual quote...not going to stick my neck out on that one, but the point is, when an eclectic approach is used (one that involves expertise in many different areas), the chance of success is increased.

The team understood and worked with regulatory folks (see FDA faciltation).

It is an impressive story and one that does not refute what you are saying, it elaborates upon what you are saying.

It does not nullify the role of the individual, it realizes the role of the individual.
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Offline SmokeyTopic starter

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #12 on: July 06, 2020, 11:52:58 pm »
Can't say you have not made some good points, because I think you have.
I just want to offer, what I think is a successful example, of a successful open source ventilator project...
https://www.jpl.nasa.gov/news/news.php?feature=7661
https://www.techbriefs.com/component/content/article/tb/stories/blog/36790
https://www.nasa.gov/press-release/eight-us-manufacturers-selected-to-make-nasa-covid-19-ventilator
No, it was most-definitely NOT made in a single person's garage. It is a story that, I think, complements the issues that you raised.
It is open source (at least insofar as I think of open source).
The design engineers, who were not in the ventilator business, learned what it was supposed to do by asking the medical profession what it was supposed to do and working with them.
The "team" included engineers from many different areas ( e.g., https://hackaday.com/2020/06/08/rapid-prototyping-hack-chat/#more-415947).
The team implemented rapid prototyping that exemplifies to me, what 'rapid prototyping" means (again, my opinion). " It was designed, prototyped, and tested on an incredibly ambitious timetable: 37 days total." - that is the usual quote...not going to stick my neck out on that one, but the point is, when an eclectic approach is used (one that involves expertise in many different areas), the chance of success is increased.
The team understood and worked with regulatory folks (see FDA faciltation).
It is an impressive story and one that does not refute what you are saying, it elaborates upon what you are saying.
It does not nullify the role of the individual, it realizes the role of the individual.

Yes!  What the JPL team did was pretty cool.  There is always a place for the skunkworks mentality, where you get the best people together and just get out of their way.  And I fully recognize and appreciate the individual contributions of the engineers.  When it comes down to it, it's all about the individual engineers.  Good managers really only exist to remove roadblocks for the engineers.

I think it's really telling that the team that succeeded came from JPL.  We are already talking about some of the best of the best.  If you needed more qualifications, that organization made the mars rovers which had a spec for a minimum 90 days of operation but continued working for 15 years!!!!!  I can guarantee these guys weren't soliciting help from the hackaday community for design reviews.  They weren't monitoring the community spreadsheet which kept an opensource purity score for all the worldwide hacker projects.  They weren't putting up fiverr listing for Arduino code.  They just got to work.  When they needed help they pulled in the experts they knew already had the skills they needed.  They didn't ask some super excited dude on the internet to catch up on years of technical understand and experience and wait for him to maybe contribute.

The JPL team (and I'm sure some other teams like them) are exactly what the world needed.  The experts were on it.  Everything else was just noise.  All of the media attention of high school kids and their garage projects was just a distraction.  You want an experienced pilot flying the plane, not a student on the first day or some dude who played a flight simulator once. 

It's an important skill to be able to take a step back and say to yourself, "Self, This is actually important and I'm not qualified to be here right now".
 
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Offline james_s

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #13 on: July 07, 2020, 12:04:28 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.
 

Offline james_s

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #14 on: July 07, 2020, 12:07:29 am »
The family of the dude who's lungs you pop with your "device" won't care about how many other lives you may have saved.

Perhaps that is a reflection of just how incredibly self centered many people are. They don't care about lives saved, they only care about the life of their person.
 

Offline sokoloff

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #15 on: July 07, 2020, 12:40:13 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.
On the other hand, if someone needs a ventilator and doesn't get one, there's not a lot of variety in how that story ends.
 

Offline John B

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #16 on: July 07, 2020, 01:22:20 am »
The ventilators would itself have to operate within an existing system of people, institutions and regulations, with responsibilities and liabilities. So the idea of of a patient giving consent to try a piece of untested/unregulated equipment, then someone actually administering treatment on hospital grounds is unrealistic.
 

Offline james_s

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #17 on: July 07, 2020, 02:27:55 am »
So I guess in that situation we should just throw up our hands and let people die because otherwise we might kill some of them? I swear some people live in a completely different reality than I do.  :o

Imagine what WWII would have been like if people had insisted that all new aircraft go through the full certification process before they were allowed to carry people and be flown into battle because "what if" one of those uncertified and hastily designed and assembled aircraft failed in flight and people died. :scared: We'd have to get the informed consent of every soldier, official or civillian who might fly on one and everyone who might be on the ground underneath one. Meanwhile you get pummeled by the axis forces who aren't bothered by such details. Personally I'm glad we threw caution into the wind and got the job done rather than sit mired in bureaucracy that peacetime allows for. Some of these aircraft did fail due to flaws in their design and/or construction, people died as a result, but overall vastly more people were saved.
 

Offline helius

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #18 on: July 07, 2020, 02:51:54 am »
You don't have to imagine: that's what in fact happened.

The P-51 Mustang, probably the most iconic US warbird, had "an uncommonly short development period, even during the war"; it first flew 149 days after the contract was drawn up. Its first deployment was over a year later when it entered service in the RAF.
http://en.wikipedia.org/wiki/North_American_P-51_Mustang

The operational history of Axis planes shows similarly long programmes of testing and refinement.
(The Me-262 took over three years from its first flight until deployment in the Luftwaffe)
« Last Edit: July 07, 2020, 02:55:18 am by helius »
 

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #19 on: July 07, 2020, 02:54:33 am »
So I guess in that situation we should just throw up our hands and let people die because otherwise we might kill some of them? I swear some people live in a completely different reality than I do.  :o

Imagine what WWII would have been like if people had insisted that (...)
James, unfortunately in those days people and society were vastly different and a comparison has become quite difficult to fathom. I mentioned this in another thread, but the expectation of "safety at all costs" warped societies into thinking that we can protect or safeguard ourselves and risk has become a tainted concept with the general public. The conundrum nowadays regarding masks and infections with a 1% kill ratio tells us something about how people would react boarding an airplane or an LCV where chances of returning were quite unfavourable. 

Regarding the ventilators, their need was severely reduced as initially the reported death rates were astonishingly high and they were being used more indiscriminately. Nowadays it seems they are being used more selectively and therefore the demand for makeshift equipment is not severe.

https://www.washingtonpost.com/health/more-covid-19-patients-are-surviving-ventilators-in-the-icu/2020/07/03/2e3c3534-bbca-11ea-8cf5-9c1b8d7f84c6_story.html
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Offline SmokeyTopic starter

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #20 on: July 07, 2020, 03:20:48 am »
Why argue about if we should allow garage shop ventilators to be used in hospitals when there is a better solution to the problem?  This is sort of the mentality I'm trying to point out is stupid here.

The choices aren't garage shop ventilator or die. 

The third option is...... Let professional engineers who solve problems for a living make a professional quality ventilator to a reasonable spec, get that thing certified quickly, and then use that!  As pointed out, the JPL team finished their design AND got it certified in 37 days.  Because that's what they do.  Respect.  The "makers" on the internet were still trying to figure out what the little triangle symbol on the schematic meant at 37 days and making mechanical death traps out of stuff they found in their garage.
 

Offline james_s

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #21 on: July 07, 2020, 04:07:06 am »
You don't have to imagine: that's what in fact happened.

The P-51 Mustang, probably the most iconic US warbird, had "an uncommonly short development period, even during the war"; it first flew 149 days after the contract was drawn up. Its first deployment was over a year later when it entered service in the RAF.
http://en.wikipedia.org/wiki/North_American_P-51_Mustang

The operational history of Axis planes shows similarly long programmes of testing and refinement.
(The Me-262 took over three years from its first flight until deployment in the Luftwaffe)

That's crazy fast, just over a year from the contract being drawn up to deployment? The development and certification time for something like a civilian airliner is more like 4-8 years. The Me-262 was a bit of a special case since it was an entirely new type of aircraft, metallurgy was not yet up to the needs of producing a reliable axial flow jet engine and IIRC even the very last production models had engines that could last approximately 25 hours of flight time. It was held back by limitations of the technology available at the time, not by bureaucracy.

The entire war spanned just 6 years and within that period many dozens of different aircraft went from the drawing board to large scale deployment. Technological development went from fabric covered biplanes to early jet powered fighters, the speed at which all of this happened was unlike anything we have seen before or since. Almost none of those aircraft were certified the way they would have had to be in peacetime, that was bypassed and they were rushed into service. Practically overnight we had companies transition from building things like cars and washing machines to airplanes and engines, there wasn't time to worry about regulations and red tape, we just did it.
 

Offline james_s

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #22 on: July 07, 2020, 04:18:32 am »
Why argue about if we should allow garage shop ventilators to be used in hospitals when there is a better solution to the problem?  This is sort of the mentality I'm trying to point out is stupid here.

The choices aren't garage shop ventilator or die. 

We know that now, we didn't know that at the time.

When the open source stuff was being developed it was a response to dire predictions of tens of thousands of people dying due to a lack of available ventilators. We can hardly blame people for making efforts to solve this problem, it's easy with the benefit of hindsight to point it out as a wasted effort, but had things panned out differently that may not have been the case. If we'd had hundreds of people dying every day, people being rejected from hospitals due to lack of available space, equipment and staff and it had turned out that ventilators were critical to patient survival I don't think it's unreasonable to imagine makeshift clinics operated by loosely trained volunteers using whatever equipment they could get their hands on, or creative people taking care of their family and neighbors. There are plenty of real world examples of this sort of thing in war-torn third world countries.

The open source projects were abandoned due to lack of necessity as the predicted acute shortage of proper certified machines never materialized, not because an amateur or volunteer constructed machine couldn't have saved lives.
 

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #23 on: July 07, 2020, 04:49:24 am »
Now that the dust has settled and it's not apparently trending anymore...
If you got caught up in the open source ventilator rush and spent any amount of time thinking about that problem seriously, try out these questions.  It's never a total waste of time if you learned something.

1) Raise your hand if... You learned something about being way overconfident in your own functional skills.

2) Raise your hand if... You learned being a "maker" isn't the same as being an engineer.

3) Raise your hand if... You learned that the design of a life critical medical device is more complicated than you thought and deserves more respect than you thought.

4) Raise your hand if... You learned that knowing something about electronics or software does not imply you can design mechanical systems.

5) Raise your hand if... You learned that even if you have a functional design, that does not mean you can successfully manufacture a product.

6) Raise your hand if... You learned that always having 100% "open source" ideological purity isn't really that important and harping on it isn't always helpful.

7) Raise your hand if... After learning how silly the basic idea of open source community designed ventilators are, you volunteered delivering food to old folks in your community or some other useful activity.

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
« Last Edit: July 07, 2020, 04:52:34 am by EEVblog »
 

Offline filssavi

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Re: What did we learn from the "open source ventilator" mess.......
« Reply #24 on: July 07, 2020, 04:53:12 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).

On the other you have a bunch of donning Kruger know it all “makers”. Who, strong of their experience building led lighting and crappy second year undergraduate control systems, think that in a matter of weeks you can go from not knowing anything about a subject to mass production (which in itself for a maker is almost risible); only taking care of posting each brain fart on some blog/YouTube/website for publicity

The JPL team, on the other hand, for which I have massive respect, did the design, I’m shure with the help of life support specialists at NASA and their institutional knowledge in the field, got it certified, and then posted online for publicity. That is a much different attitude.

As for certification, the regulators know full well that doing a full blown year+ certification in those conditions of need was unthinkable, they started doing emergency certifications, which were both much faster and much easier to get.

To end on a hopeful note, not all makers are so hopelessly full of themselves, a bunch of people’s (the majority I hope) rightfully identified an area where they could indeed help, and started 3D printing face shield components. PPEs are just as important and lifesaving as ventilators (actually they might even be more important) and are a much easier target, since a malfunction will not result in life altering injuries or death
 
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