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

Posted by timothy
from the chop-off-your-hand-to-check dept.
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, 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.

  • 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.

  • 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.
  • by laird (2705) <lairdp AT gmail DOT com> on Sunday April 20, 2014 @10:54PM (#46802987) Journal

    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 prosthetics, just that they're more accessible. Particularly outside of the US and Europe, the cost is a huge barrier, and we're excited that we are producing designs, documentation, etc., empowering people to help each other if they don't have a viable commercial option.

  • by Bryan Ischo (893) * on Sunday April 20, 2014 @11:53PM (#46803173) Homepage

    It would be more accurate to say that when the service is free, as it more or less is for poor people, then the service is used by those people without consideration for the cost of providing that service.

    My wife is a doctor, and has worked in the Bronx and also in low income areas of San Jose. In the Bronx it was not uncommon for people to call an ambulance when they had a cold and wanted to see a doctor to get some cough medicine prescribed, because they didn't have to pay for the ambulance and it was a free ride to a free doctor's visit for a condition that doesn't need an ambulance or a doctor.

    In San Jose, she sees tons of drunks and drug users who end up returning to the hospital over and over again because it's the easiest way to milk the system for some attention (I suppose drunks don't get much out of it, but drug users can often badger the system into providing some pills; when presented with a persistent patient with unverifiable claims of pain, after a while the doctors have to prescribe something just to get the person out of the way so that patients with real needs can be seen.

    Making everyone pay a nominal amount for every visit is not possible because hospitals cannot refuse anyone, even if they can't pay. But forcing people to get insurance, so that they pay ahead of time, seems like the next best thing.

    Also virtually nobody in the USA chooses between a $90 doctor's visit and feeding their family. The choice is usually between a $90 doctor's visit and a $90 cable or cell phone bill.

  • by silanea (1241518) on Monday April 21, 2014 @05:24AM (#46803819)

    Could you define "not uncommon" please? Daily? Monthly? She saw this herself, or 'heard about it'? And the ambulance crews just waved them onboard, like wide-eyed innocents who could be duped that way? [...]

    Some input from a medic from Munich, southern Germany. Depending on which part of town you get assigned to you the number of frequent flyers varies considerably. From experience - no statistics to back that up, sorry - our gold card members are most frequent

    1. in the poorest quarters where half the calls turn out to be drunks, junkies (who usually did not intend to see us) and socially isolated, but not necessarily homeless people looking for someone to talk to, and
    2. in the older, still not so fully urbanized incorporated villages where elderly people of modest wealth abound who cannot properly care for themselves anymore, whose children have moved too far away to provide constant care but who are too proud to move into a dedicated care facility.

    What keeps amazing me is that in spite of my - and other medics' - prediction after the banking crisis and the ensuing wave of unemployment the number of FFs type a seems to be more or less constant but type b has been climbing steadily. So this is only partly an issue of poverty. It has more to do with social isolation, with the increasing difficulty of maintaining a robust social network (not Facebook, the family-and-friends variety) that can catch people when they face difficult phases in their life so that they do not hit rock bottom.

    Medical care has long transitioned into social care that along the way can also give you a pill or sew up a cut.

    And as to whether the medics are duped: Someone wants to see a doctor, you take them to a doctor. That is what the law says. That is what our job description says. We try to avoid it, believe me. We sweet-talk, we bribe, we threaten. But if the patient is adamant, there is no way we are going to assume the legal risk of refusing transportation. The ER staff is not naive, they know their devoted customers. They will make them go through hell, put them through every annoying and time-consuming test they can think of. But guess what: Because of this practice with increasing regularity they actually find a legitimate medical issue that had gone undiagnosed by doctors who just saw the addict or the annoying elderly or the lonesome hypochondriac and treated that instead of the complaints and symptoms.

    In medicine there is no easy answer, no magical solution.

  • by Anonymous Coward on Monday April 21, 2014 @05:35AM (#46803859)

    Nice to see an informed post, though really what you have said for me only reinforce the subtext of the video, that the medical industry overcharges for products that often do not meet the needs of the patient but are in the practitioners interest. From what you have said it sounds like the patient was originally provided with a product that didn't meet their needs when other less expensive products would, and equally that the product provided was poorly fitted. It sounds like someone made alot of money out of this patient without the patient receiving real benefit for it.

    Of course the patient may have originally asked for the more expensive type that didn't do what he wanted and would provide the highest commission for the doctor.

  • by nbauman (624611) on Monday April 21, 2014 @06:15AM (#46803991) Homepage Journal

    Obamacare exists because the poor can't be bothered to pay $90 for a doctors visit. Instead they rack up a $900 bill at the local hospital (because hospitals are required to see you, doctors aren't) and they never pay it.

    this makes no sense. so, does the doctor's visit cost $90 or $900?

    One of the most common problems is:

    1. Patient has asthma.

    2. Asthma gets worse.

    3. Doctor prescribes drugs to control the asthma (~$60/month).

    4. Patient can't afford $60/month for the controller medication, so he doesn't get it.

    5. Patient gets an asthma attack, can't breathe.

    6. Family calls an ambulance, patient goes to hospital, spends a night in the hospital breathing oxygen and maybe gets a steroid shot. Total cost: $3,000

    Medicare saves: $720/year in asthma controller medication.

    Medicare loses: $3,000 in one hospital visit.

    I saw a printout of the admissions at Montifiore Hospital in the Bronx, and the most common one was an asthma attack. This is what happens to real people, in typical situations. No Ronald Reagan stories.

  • by Anonymous Coward on Monday April 21, 2014 @11:27AM (#46806557)

    Out of curiosity, what part of the medical industry would you like more regulation in? I work for a company trying to assist the medicaid management groups in various states meet the state and federally mandated goals and measurements to continue serving the patients. As part of this, we need to contact the patients by phone. In addition to getting a script for this phone call approved by my own company's directors and legal eagles, we have to get it approved by the management group. This was all done in January, it's now almost the end of April, the state has yet to approve the script in question (and has no feedback for why it's not approved, or when we should expect approval, just that "it's pending"). These goals and measurements need to be hit by December. We're ready to go, the regulators are not. And this is just one of many bottle necks in the "medical industry" that is a result of over used and ineffective regulation.

    Don't get me wrong, there are certainly reasons to have certain regulations in the medical industry. But we're long past the "helpful" regulation point.

    captcha: inhuman
    Pretty much the whole medical regulation industry.

That does not compute.

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