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Medicine Build

$42,000 Prosthetic Hand Outperformed By $50 3D Printed Hand 288

An anonymous reader writes "A man named Jose Delgado was so used to using a $42,000 myoelectric prosthetic hand for the last year that he didn't realize that there were other options out there. Although Delgado, born without a left hand, was able to obtain the hand via his insurance, he found that a 3D printed 'Cyborg Beast,' an open source hand which costs just $50 to print, actually was more comfortable and performed better than the device which costs 840 times as much money."
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$42,000 Prosthetic Hand Outperformed By $50 3D Printed Hand

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  • by Anonymous Coward on Sunday April 20, 2014 @07:30PM (#46802267)

    cutting down on the absurb prices for 'prosthetic' devices is great, but someone who is blind has to pay $1000-$2000 for a "Reading Machine" and that's not so great, especially since in the USA this is not covered by Medicare, howoever www.topocr.com has a $5.00 program that does the same job with a $60 scanner or a $95 document camera, I have to say that I'm a happy customer, I wish more people would develop low cost technology that provides an alternative to the big ticket items that "medical" companies charge, mainly to people who can't afford it.

  • Sunk Costs (Score:5, Interesting)

    The additional $41,950 is allocated towards sunk costs including

    • - Cosmetic designs of a hand like-prosthetic to prevent adults staring uncomfortably and children exclaiming "cool"!
    • - Insurance/class action insurance for when the prosthetic ends up injuring/irritating one or more users or people, or things, or otherwise perishable or damageable entities the hand interacts with.
    • - Robustness to last through more than, say, 10,000 cycles before snapping into brittle plastic shards.
    • - Salaries and children's college funds for the scientists, designers, and MBAs running the prosthesis companies
    • - Salaries and children's college funds for the academic and medical researchers involved in prosthetic studies, both mechanical, psychological, and sociological

    Meanwhile, the 3D prosthetic hand has only the following sunk costs to cover.

    • - ~$10,000 investment in quality 3D printer
    • - The time taken find and to add the most saccharinly kitch music to 3D printing application videos on Youtube.

    It's important to remember to keep the background details out of perspective... or in perspective, depending on whichever context you'd prefer to hock.

    • Re:Sunk Costs (Score:5, Insightful)

      by rolfwind ( 528248 ) on Sunday April 20, 2014 @07:45PM (#46802339)

      Cosmetic designs of a hand like-prosthetic to prevent adults staring uncomfortably and children exclaiming "cool"!

      Idk about you, but I'd think an obvious robot hand would be easier to deal with than a fake looking piece of plastic mimicking a human hand.

      • Re:Sunk Costs (Score:5, Interesting)

        by Anonymous Coward on Sunday April 20, 2014 @08:03PM (#46802395)

        I worked with a guy for years, though I only met with him every few weeks at most. Turns out he only had one arm the entire time I knew him, but it was a long time before I realized it, and I wasn't sure about that for quite a few meetings since his prosthetic was so good. Someone later just happened to mention that he'd lost it in a traffic accident years before.

        Being initially inconspicuous might matter to some people.

        If I lost a hand I'd definitely go for the robot look though.

        • This. I've got a birth defect that's left me with only 2 deformed fingers on my left hand. It doesn't bother me, i've never hunted out prosthetics (i like having feeling in my hand!) and no-one really notices. It took my english teacher many months to notice, and i think she's the only teacher to ever pick up on it. Many of my friends don't notice until i point it out too.
        • by PopeRatzo ( 965947 ) on Sunday April 20, 2014 @10:21PM (#46802867) Journal

          I had an uncle with a wooden leg and I thought it was a big deal until I found out my aunt had a cedar chest.

      • by JanneM ( 7445 )

        Idk about you, but I'd think an obvious robot hand would be easier to deal with than a fake looking piece of plastic mimicking a human hand.

        It's probably impossible to know until you are actually in the same situation. There have been highly functional, highly useful hand prosthesis long before robotics - the classical hook is just one example - but the vast majority of patients have always preferred a hand mimic, even when it is completely nonfunctional and even when the mimiry is far from perfect.

        Not gett

        • Re:Sunk Costs (Score:4, Insightful)

          by The123king ( 2395060 ) on Sunday April 20, 2014 @08:58PM (#46802553)

          Not getting stared at, and fitting in, is critically important to people, in this case as in others. Should'nt be too surprising when you think about it in such terms.

          Being that self-conscious about things that have happened or are out of your control is a waste of time, and that's coming from someone with a birth defect. If you're getting a prosthetic for extra freedom and usefulness, great, but getting a fake hand for the sake of a fake hand is just being vain IMHO.

          • by JanneM ( 7445 )

            [...] but getting a fake hand for the sake of a fake hand is just being vain IMHO.

            People are vain. People do care what other people think of them, and people do want to make a good impression on others. And it's completely rational; we are being judged by how we look, what we wear, how we behave. What we think of that is besides the point.

            So yes, it turns out most people care about what their prostheses look like as much or more than how well they function. Any maker that disregards that is setting themselv

          • by artor3 ( 1344997 )

            Great, go tell that to the people who lost a hand. I'm sure it will make them feel better.

            Hurr, stupid idiots, having emotion! Why don't they just stop feeling things!?

            • by sjames ( 1099 )

              Well, he did say a few posts up that he has a deformed left hand. He's not exactly asking people to go where he hasn't been.

              • No, but he is imposing his values on others.

                He might not care about appearances. That's good, it's how it should be.

                But it isn't how it is - some people do care. Some of those people might be potential employers who wouldn't want a "wierdo" or a "flid" around because it might disturb colleagues and customers.

          • Well hell! Your insight has just destroyed the entire multi-billion dollar cosmetics industry! Cad!
        • It's probably impossible to know until you are actually in the same situation.

          It's possible to know because you know how it is from the side of people noticing things. I find artificial hands immediately obvious, as much so as a robotic hand would be.

          I think either would fare just as well in terms of not attracting notice when covered by a glove. Why not, then you would just look a little odd in summer...

      • by laird ( 2705 )

        Interestingly, kids LOVE 3D printed hands. If you go to http://enablingthefuture.org/ [enablingthefuture.org] there are tons of pictures of thrilled kids. It's cool to be like Iron Man!

      • by mwvdlee ( 775178 )

        That's the exact thought I had when I saw the video.
        The "human-like" hand is dead in the middle of the uncanny valley.
        In fact, the 3D printed hand had motion which looked far more "natural", despite looking nothing like a natural object.

        IMHO, trying to make a prostethic look human is like saying "I'm ashamed of not having a hand".
        Adults will stare uncomfortably at both. With the printed hand I think most people will just think "well, he doesn't have a problem with it, why should I?".
        And children will be exc

    • - and since it is a commercial product, a couple of million dollars getting it approved by the FDA.

      It all adds up.

    • Re:Sunk Costs (Score:5, Insightful)

      by im_thatoneguy ( 819432 ) on Sunday April 20, 2014 @08:01PM (#46802393)

      Well, not only that but most people don't know how to operate a 3D printer, nor how to customize the hand to fit the individual. So while the $42,000 hand includes the professional services involved with fitting the device, the 3D printed one depends on a charitable donation from the 3D printing operator to do the work. It won't be much but it's all probably going to be significantly higher ($400-$1,000) for the human being to operate and configure the 3D model for the individual.

      I bet there are only $100 worth of aluminum, gold, silicon and acrylic in the $42,000 hand too.

      This drives me crazy when people don't include the costs of labor. It would be like someone getting a car donated to them and saying "Wow cars only cost $200 for a title and registration! Why do people pay thousands of dollars for a car!?" Because someone gave you one for free!

      I work in film production. I have a $50k camera that I rent out. On most productions your total rental per day will be about $2,000 a day. Now you could say that you could shoot a TV commercial for "only $2,000 in rentals!" But that ignores the fact that cameras don't operate on their own, lights don't just place themselves, actors should be paid for their skills, assistant directors need to keep production on schedule, locations need to be paid for the rights to use their property etc. So yeah it "only costs $2,000" as long as you ignore the $20,000 per day in crew costs for a small production.

      People who say a film only costs $20,000 to make are either productions that somehow shot and finished in 1 day or else they're saying that their crew's time was worth nothing.

      If I spent $10,000 on a 3D printer. I couldn't just open the box and push the "Give me a 3D Prosthetic Hand" button. I would either need to spend a good week or so learning how to print ($100 an hour * 40 hours = $4,000) or else spend $1,000 on a professional to setup and configure the scene/hand for me specifically. /Rant.

      • I see that all the time in IT with people wanting to cowboy up solutions cobbled together from a bunch of random shit. Yes, you can do that, and it can be made to work. However how much time will it take to do and support? Because unless your time is free, you need to factor that in.

        Labour is a big part of the cost of pretty much anything you buy. Software is the ultimate example. The materials and distribution cost of software is minimal even if done on physical media. However that doesn't mean it is free

        • by sjames ( 1099 )

          And people who overcharge are great at exaggerating the cost of labor.

      • If I spent $10,000 on a 3D printer. I couldn't just open the box and push the "Give me a 3D Prosthetic Hand" button

        No shit, you need to print the button first.

      • by sjames ( 1099 )

        Getting from $50 to $42,000 would be a lot of labor. Are you saying it takes 5 months or so full time per hand? Let's be generous and say instead that the labor is $1000. Now to account for the other $41,000

        More likely it's the same MBA math that claims going from the $0.10 part to the more durable but otherwise identical $0.20 part absolutely must add $10 in hard costs to the end product, just because.

      • Re:Sunk Costs (Score:4, Insightful)

        by usuallylost ( 2468686 ) on Monday April 21, 2014 @07:30AM (#46804283)

        In the video that is attached to the article the guy says that in addition to the 3D printed components there are "various bits of hardware, Velcro, padding etc". All of which requires some know how and some assembly. So unless somebody came out with very good instructions or perhaps a kit with all the additional parts I doubt the average person is going to make this at home.

        The other thing that is not really touched on there is that the $42,000 hand hooks onto the entire forearm. It uses the muscles in the forearm to control the actuator. Where the 3D printed hand hooks over the stump of the guy's left hand and uses the muscles in his palm to control movement and to provide the actual strength. A lot of people with missing arms don't have the palm of their hands left to provide that strength and control. For those people the 42K version is going to continue to provide utility where as they wouldn't be able to use the $50 version at all. For this particular type of case the $50 outperforms the 42K version. If you took 500 people with various levels of amputation I suspect that the 42k version would help a lot more of them than the $50 version.

        What is shows me is that there is a tendency in the prosthetic industry to try and go for a one size fits all solution. Where it is clear that for some patients you could use a less expensive solution. It might bare some research to see just how many people are being fitted with 42k prosthetic when much cheaper solutions might work better for them.

    • Re:Sunk Costs (Score:5, Informative)

      by CodeBuster ( 516420 ) on Sunday April 20, 2014 @08:06PM (#46802409)

      To be fair, some of these costs would exist in any business. There are always capital equipment costs, employee costs, administration costs and in some cases research and development costs. However, you are on the right track with your criticism of artificially high medical device costs. Indeed, these high costs can be seen not just in prosthetic hands or limbs but also in more mundane devices such as hearing aids and prescription eyeglasses. In my estimation there are two main reasons for this:

      First, the devices are sold through specialized middlemen who bill your insurance company which in turn bills you and perhaps your employer for premiums. This is the classic third party payer problem that exists throughout the healthcare industry here in the United States and is in no small part responsible for the high costs which are ultimately borne by the consumer in the form of higher premiums and higher out of pocket costs.

      Second, and related to the first point, the market for FDA approved medical devices here in the United States is highly regulated and therefore high cost. There is a great deal of regulatory rigmarole and ceremony required to bring a product to market. This imposes costs of course, but it also results in delays while the product winds it's way through the circuitous approval processes. By the time something is approved for sale as a medical device it's not only expensive but often obsolete or at least several generations behind the state of the art technology.

      Finally, it ought to be remembered that medical devices are now assessed an additional tax under Obamacare, on top of any previous expenses. It's hard to see how this will lower costs, especially for those who find themselves in need of a medical device. Although, I suppose that "reform" is in the eye, or the hand in this case, of the beholder.

      • by sjames ( 1099 )

        It's more that it's poorly regulated than that it is highly regulated. The FDA has no concept of risk assessment. Medicine is highly regulated everywhere in the 1st world, but it is vastly more expensive in the U.S.

    • by Anonymous Coward

      The additional $41,950 is allocated towards sunk costs including

      • - Cosmetic designs of a hand like-prosthetic to prevent adults staring uncomfortably and children exclaiming "cool"!
      • - Insurance/class action insurance for when the prosthetic ends up injuring/irritating one or more users or people, or things, or otherwise perishable or damageable entities the hand interacts with.
      • - Robustness to last through more than, say, 10,000 cycles before snapping into brittle plastic shards.
      • - Salaries and children's college funds for the scientists, designers, and MBAs running the prosthesis companies
      • - Salaries and children's college funds for the academic and medical researchers involved in prosthetic studies, both mechanical, psychological, and sociological

      When I see the actual books - not what the PR people say or what is reported to the SEC* - then I'll believe it.

      The CEO class - actually they are MDs in the medical industry sometimes with a MBA on top of that - usually gets the spoils.

      And the insurance on the lawsuits is exaggerated.

      *They don't have to nor do they volunteer to report the most of the above costs. All you will see is overall insurance costs, R&D, and lump sums of ALL the salaries. To get an actual product cost (indirect and direct) is i

    • This is really the point. The $40K+ prosthetic is simply over engineered. It's a poor argument saying that we should support engineers, their families, their companies, etc so that they can charge a disabled person $40K when we could have a single developer make a much simpler product that can be produced at a local 3D fab shop or in the garage of an enterprising neighbor.

      Clearly this is an early version, though fully functional. Improving aesthetics can certainly be an optional component. Today, a blac

      • by ruir ( 2709173 )
        This comments are rather naive. The prosthetic costs 40K+ because the system is designed to rip off insurance companies, and inflate the bill 3 or 5 times more when dealing with insurance claims. The same as with a car accident... someone hit my car a couple of years ago, signed a term of responsibility and neither did she not care to deal with me in human terms, nor she replied to my emails. So down the line, two months were gone, and by the time I had it being repaired, her insurance company received a b
    • There's also the concept of "Price the Market will bear," which gets convoluted in the mire of health insurance companies. No one really knows what the market will bear, cuz it's always just payed whatever price was asked.

      $42,000 for a prosthetic hand? Sure, if that's what it costs.
      $1000 for an MRI? OK, if you say so.
      $500 per pill to treat my hypochondria? Seems reasonable... etc.

      Right now, the market will bear a 42,000 hand. And these guys could probably sell their $50 version for 45,000 on the clai

    • Re:Sunk Costs (Score:5, Insightful)

      by laird ( 2705 ) <lairdp@gmai[ ]om ['l.c' in gap]> on Sunday April 20, 2014 @10:18PM (#46802847) Journal

      You're coming very much from the prospective of a wealthy American/European, where a $42K prosthetic is an option.

      But if you're not covered by very good insurance, which is the case for the majority of humanity, an affordable 3D printed hand is much better than nothing.

      And a free/open innovative community working on prosthetics can move much faster than the commercial options, and perhaps innovate past them the way home 3D printing exploded past the commercial 3D printing companies. The commercial guys were too concerned with the expensive/subtle issues, when what people may well care more about is being able to cheaply and easily solve their problem.

      You're right that the $42K prosthetic isn't the same as the $50 one. A major difference, which you missed, is that it's myoelectric and active, while the $50 one is mechanical. It turns out that for this patient, the simple, mechanical solution worked better than the sophisticated, computerized one. So it's fundamentally a cheaper, simpler solution.

      The rest of the costs pretty much come down to the traditional business model vs. FOSS. If you want to buy a product from a company that you can sue, with MBAs and lawyers and on-staff researchers, etc., you get to pay the big bucks for the product. If you don't have the money for that, or you prefer free/open source solutions for other reasons (such as the ability to modify the designs to suit your personal needs), you can go the Free Open Source Software route, and print your own.

      Yes, this relies on volunteer labor to do the printing, assembly, fitting, etc. There are 600+ people registered at http://enablingthefuture.org/ [enablingthefuture.org] (mainly in the Google+ group). That's the point - by empowering people with FOSS designs and documentation, they can help each other, at much lower cost than paying professionals with all of the overhead that you mention. And it turns out that many of the volunteers work professionally in the field - this is just a new way for them to apply their skills to help patients.

      And I'll also point out that your comments reveal some misunderstandings of how rapidly 3D printing has progressed.

      - It doesn't cost $10K for a quality 3D printer. You can get a fine 3D printer for $1K, or a cheap one for $300, and the most expensive home 3D printer is $3K. There are some great industrial printers, but it would be stupid to buy an industrial printer to print one thing - there are plenty of people and Maker spaces who already have 3D printers. See http://enablingthefuture.org/c... [enablingthefuture.org] and register if you're interested. And of course there are service bureaus such as ShapeWays if you really want a high-end printed version.
      - The materials aren't as fragile as you think. There are 100+ people happily using ABS prosthetics now, and we're finding that printing in Nylon is amazingly durable. You can hammer on Nylon, and just bounces back. Amazing stuff. Hospitals and medical researchers are using 3D printed Nylon now, so using it for prosthetics is pretty reasonable.
      - If you can print a replacement for the raw cost of materials, that changes the economics. If you can print your own replacements for $1, it doesn't make sense to spend $millions in R&D, and spend vastly more for the prosthetic's materials, because the cost of avoiding breakage far outstrips the cost of the breakage.

      All of the designs are published, and open source. So there's nothing being hidden in the video - you can download the models and inspect them to your heart's desire.

      If you don't like the music that someone selected, feel free to make a better video!

    • by gl4ss ( 559668 )

      make it 1000 for the printer.

      10 000$ bucks printer(mojo) doesn't print in taulman nylon(which is what he is now printing another version in for him). ..part of the reason why the commercial hand option is so high is that the person isn't expected to pay from his own money at all, but from insurance.

    • Yeah, but not since the original days of Libraries has there been a chance for Library/Staples option to "rent a 3d printer".

      That could bring down the price to print something to say $100 + materials and Bring Your Own Design.

    • "Sunk costs"... you're not using it right. Perhaps you mean "hidden costs" or "unaccounted for costs".

    • by sjames ( 1099 )

      So what you're saying is that the conventional prosthetic is made by a horribly inefficient company that should have been washed out by the market but the market failed (as is typical for anything vaguely medical).

      The 3D printed prosthetic had to be designed as well and apparently it was designed better. It could probably be stronger and even cheaper if it was mass produced.

  • A different beast (Score:5, Informative)

    by Sarten-X ( 1102295 ) on Sunday April 20, 2014 @07:44PM (#46802333) Homepage

    I'm no expert in prothetics, but it seems the printed Cyborg Beast [thingiverse.com] hand is a completely passive device, relying on wrist movements to control the fingers. On the other hand, the $42,000 device was a "myoelectric prosthetic device, which took signals from the muscle fibers in his forearm, translated those signal, and then used them to mechanically move the fingers of the prosthetic, which looks pretty close to an actual hand."

    This guy prefers the less-realistic device. Good for him. A direct comparison is somewhat unreasonable, though.

    • More importantly it ignores labor costs. Simply listing the price of the materials isn't an apples to apples comparison to the robotic hand which needs someone to setup the 3D printer, and then actually assemble the hand (Probably takes someone with a working hand to perform the threading of the cables etc.)

      • by laird ( 2705 )

        Typically the first one is assembled by the volunteer working with the family, as a training session, and after that they can print replacements and do the assembly themselves.

        this approach does require a parent/relative/friend with some dedicated to get started. There's a map of volunteers http://enablingthefuture.org/c... [enablingthefuture.org] . If you don't have anyone around that wants to help, you'd better have insurance to cover paying a professional to help you out.

  • $50 3D printed hand preferred over $42,000 prosthetic hand by particular guy

    This is great news for this particular guy, but it doesn't necessarily follow that the 3D printed hand is therefore objectively better than the other.

  • by Theovon ( 109752 ) on Sunday April 20, 2014 @08:32PM (#46802471)

    When you buy a medical prosthetic from a medical company, almost none of the sticker price covers materials or basic engineering. Most of the money is split between liability insurance and extra R&D and testing overhead to make damn sure that someone won’t misuse the device, thereby generating a law suit. In Law, products liability is a huge area; big companies have deep pockets and often lose in suits where the user of their product was clearly doing something really stupid. (Chain saw instructions: Do not use hands to stop chain!) The fact is, people are sue-happy, and that’s the primary reason why all medical devices cost so damn much.

    If someone is selling 3D printed prosthetics, they are GOING to get sued, and they’ll get put out of business very quickly by some moron who found a way to hurt themselves in a heretofor never conceived of manner. It’s just inevitable.

    If someone were to make open source designs avaiable for prosthetics so that people could print them themselves, you’d think that the user would be taking all the liabilty into their own hands right? Ha! When something goes wrong, the maker of the 3D printer will get sued. And no matter what kind of disclaimer they put on it, the maker of the 3D schematics will get sued too. All because people find amazing ways to hurt themselves and sue over it. Especially with medical devices.

    Why do you think airline food is so damn expensive? When something goes wrong with a plane, everyone gets named in the suit. The airline, the airplane manufacturer, all subcontractors of said manufacturer, including the company that made the rivets, the supplyer of the airline food, the pilot, you name it.

    • by laird ( 2705 )

      The designs are open source, and freely shared, very specifically with no warranty or guarantee. Just like open source software. People who release open source software don't get sued over the software, because they're not selling and supporting it, they're giving it away specifically with no guarantees or support.

      I've worked in the airplane business. As screwed up as liability law is, there still has to be actual liability to award damages. So unless someone can prove that food was a cause of a crash, I do

      • Re: (Score:2, Informative)

        by Anonymous Coward

        You have no idea what you're talking about. We're dealing with a medical device in this situation, not some open source piece of software that jerks off Linux penguins. You cannot simply release specifications for a medical device and think that because you made them free and said you're not liable that you won't get pounded into the ground by a lawyer who is much, much smarter than you. Grow up and face the real world some time.

        • by laird ( 2705 )

          As I said, I used to work in the airplane business. And if you bought a kit for an airplane and built it yourself, you can't sue the company that sold you the kit because you assumed the liability. That's why most innovation in airplanes in the US is in kit planes - commercial manufactures fall under liability, which complicates their lives quite a bit, which (perversely) discourages innovation, so many people are flying airplanes with engine designs from the 1950s.

          Hand prosthetics are "prosthetic devices c

        • Yeah, face the real world: in the real world, we have things like books and libraries. They are full of ways describing how to build things you can use to hurt yourself. If you build those things and hurt yourself, it's your problem.

  • This shouldn't come as a big surprise.

    You'll routinely pay 10x or 100x markup for all that lovely FDA "protection". If only the mafia were providing health care, I'm sure their "protection" wouldn't be quite so pricey.

    Medicine is all about information technology and customization. The prices of these things have been coming done exponentially, but medical prices still go up. Why? Because fuck you, that's why. Because they can. Because with medicine, the link between your money and your life is more direct t

    • What kind of idiot fails to understand that all those nasty government regulations came about because people were getting fleeced left right and centre by quacks, confidence men, grifters, Republicans and other thieves.?

      • "all those nasty government regulations came about because people were getting fleeced..."

        Are you really enough of a buffoon to believe that?

        I'd note that if the concern were really about getting fleeced, fraud has been both criminally and civilly actionable for a long long time.

      • What kind of idiot fails to understand that all those nasty government regulations came about because people were getting fleeced left right and centre by quacks, confidence men, grifters, Republicans and other thieves.?

        Quite right, that's why they came about. And now, instead of just a small number of stupid people getting fleeced because they believed some snake oil salesman, the entire nation gets fleeced, and it gets fleeced by many of the same companies. And the irony is: the regulations don't even wor

      • You forgot Democrats and the Independents. Include them, and I partly agree with you.

  • One of the big advantages that big corporations bring to bare is the ability to finance big long term product development all the way through to manufacturing and distribution. One of the ways they do this is through shear scale of infrastructure. So if a washing machine company comes up with a new washing machine it is easy for them to put it in front of the consumer; easy that is compared to your average schmoe. But what happens in a world where either some guy tinkering in his basement in Northern Manito
    • 3D printing right now tends to scratch an itch for somebody. Recently the GF had a part break on a brand new lamp. Nothing fancy just a utility light for her crafting room. 30 seconds of searching on thingverse to find that multiple people have come up with a better replacement. Mind you I'm a wood guy a few minutes with a scrap of hardwood and a shop full of tools would be my normal response but had a new toy to try out.

  • 49% of the population.
  • As I recall, it was Dr Strangelove. But the ones they had back then had glitches that caused the hand to attempt to strangle the person to whom it was attached. I am sure that they have this problem corrected by now..

  • I see them as having different purposes. Rather than go into details about the hands and their obvious/not so obvious differences or the minutia of when which performs better and how to define PKI for those metrics, it can bes implified into: At least poorer people have options now, that is ALL that matters.
  • by joeshmoo ( 1221826 ) on Sunday April 20, 2014 @10:12PM (#46802821)

    I am a prosthetist, and I regularly fit and bill for these devices as a result. Sure it sounds great that this particular patient can get a hand made for $50, but it’s not a fair comparison and doesn’t necessarily apply for every amputee. Also, as several others have pointed out, that does not take into account the labor or other overhead costs. (Cost estimates that follow are just some ballpark figures)

    First off, the patient has part of his hand, and has opposition capabilities at his wrist. If his amputation level was directly through the wrist, or higher, the 3D-printed hand would need a harness or some other element to provide the body power. He’s also lucky enough that he can get away without having an extensive socket to suspend the 3D printed hand on his arm as a result.

    Based on the myoelectric prosthesis shown, the $42,000 cost is likely “Usual and Customary” cost. At a contracted rate with insurance on a device like this, you’re probably best case looking at about $16,000 actually being billed to the insurance company. Looks like a Sensorhand Speed (or similar) hand being used, which has a parts cost upwards of $4000 from the manufacturer. The electrodes, battery unit, and custom made socket probably cost an additional $3000 in parts. The billed amount to the insurance company includes the prosthetist’s evaluation, casting, manufacturing, fitting, and subsequent follow-up and adjustment appointments for 6 months.

    All that said, the patient probably shouldn’t have been fit with the system shown; most of the benefits he’s stating (such as holding a box at work) are more related to him having a proper limb length with the 3D printed hand! The myoelectric prosthesis shown has thrown off the alignment of the hands for performing bimanual tasks, placing his prosthetic hand way further from his elbow than his sound side hand. He would probably benefit from an M-finger prosthesis which would probably have only run about $5,000 to the insurance company, even being custom made to match the patient. Probably $1500 in parts.

    .... but if they said a $1500 prosthetic hand was outperformed by $50 3D printed hand, people wouldn’t get as hyped up.

    • Re: (Score:2, Interesting)

      by laird ( 2705 )

      Wow, nice to see someone with an informed post. The amusing thing to me is that we've got tons of videos, and this is the one that made Slashdot. But we're happy with any of the patent's stories. They're pretty cool, actually - patients talking about their prosthetics, shot by either the patients, their parents, or the "maker", and a few videos of people giving presentations (e.g. at TED). Check out http://enablingthefuture.org/m... [enablingthefuture.org] .

      We're not claiming that 3D printed prosthetics are better than commercial

    • -sigh- bad day not to have any mod points

      Thanks for posting an informed, reasonable response.

  • by kheldan ( 1460303 ) on Sunday April 20, 2014 @10:19PM (#46802855) Journal
    If it's any sort of 'medical device' then the FDA must approve it before allowing you to sell it in the U.S., and in order for it to be approved by them you must do testing the FDA mandates. The testing is complicated and very often expensive, and if your device can't pass the testing then you have to go back to the drawing board and fix whatever it is that causes it to fail the test. Additionally the FDA demands certain manufacturing standards. They can come in and inspect your production facilities, personnel, methods, procedures, tools used, etc. If they don't like the way the communal kitchen looks or whether the communal refrigerator is clean enough for them, or any number of other nit-picky things, they can prevent you from selling or even producing your device; they can shut your company down completely. Sometimes the cost of all the testing and jumping through the hoops the FDA requires you to jump through will cost more than your device costs to produce. The end result is the costs are all tacked on to the final price of the device being manufactured. The 3D-printed prosthetic obviously wasn't FDA approved and couldn't be mass-produced and sold without going through the same process that everyone else has to. Since 3D-printing is relatively new and there hasn't been much if any legislation to govern it's use, what will likely happen at some point in the future is that anyone offering the CAD/CAM files to produce something like this prosthetic hand on a 3D-printer will be jumped on by the FDA and required to do the requisite testing of the finished product or face legal action against them. Furthermore I wouldn't put it past the FDA to require only 'authorized' 3D-printers to produce such things. Of course if it's all open-source and people are building their own 3D printers then the FDA can more or less go fuck themselves, but there'll be a shitstorm over the whole subject, guaranteed.

    Source of my information: Personal experience from working for a medical device manufacturer for 5 years.
  • Do you think you can use adamantium in a 3D printer?

    Asking for a friend.

  • Well, $41,950 of that $42,000 is government medical approval, licensing, paperwork, other assorted lawyer and FDA crap, etc.
  • Comment removed based on user account deletion

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