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Medicine Databases Technology

A Medical Device Maker Threatens iFixit Over Ventilator Repair Project (vice.com) 69

STERIS Corporation, a company that makes sterilization and other medical equipment, sent a letter to iFixit claiming their online database of repair manuals for ventilators and medical equipment violates their copyrights. Motherboard reports: "It has come to my attention that you have been reproducing certain installation and maintenance manuals relating to our products, documentation which is protected by copyright law," the letter said. The letter then went on to tell [Kyle Wiens, CEO of iFixit] to remove all Steris copyrighted material from the iFixit website within 10 days of the letter. As Motherboard reported in March, major manufacturers of medical devices have long made it difficult for their devices to be repaired through third party repair professionals. Manufacturers have often lobbied against right to repair legislation and many medical devices are controlled by artificial "software locks" that allow only those with authorization to make modifications.

"I'm disappointed that Steris is resorting to legal threats to stop hospitals from having access to information about how to maintain critical sterilization equipment during a pandemic," Wiens told Motherboard in an email. "No manufacturer should be stopping hospitals from repairing their equipment," Wiens said. "The best way to ensure patient safety is to make sure that equipment is being maintained regularly using the manufacturer's recommended procedures. The only way to do that is if hospitals have up to date manuals." With regards to the letter sent by Steris, Wiens said iFixit has not removed any material from its website. "We explained to Steris that what we did is a lawful and protected fair use under the U.S. Copyright act," Wiens said.
"iFixit is protected by Section 512 of the Digital Millennium Copyright Act, which allows online platforms to host content contributed by users provided they comply with the Act's requirements, which iFixit does," a letter to Steris from the Electronic Frontier Foundation on behalf of iFixit said.
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A Medical Device Maker Threatens iFixit Over Ventilator Repair Project

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  • Good. (Score:4, Informative)

    by Gravis Zero ( 934156 ) on Wednesday June 17, 2020 @06:08PM (#60194932)

    Now the world can see what STERIS Corporation actually cares about and it's not patients.

    • But but but, think about their ROI. No one thinks about the ROI...
    • They are a corporation, not a non-profit. Of course they put money before patients, the law requires that. The interests of the people are supposed to be protected by the government- but both Republican parties (D and R) have chosen to priortize profits.
      • Re:Good. (Score:5, Informative)

        by Stolovaya ( 1019922 ) <skingiii AT gmail DOT com> on Wednesday June 17, 2020 @07:02PM (#60195112)

        Of course they put money before patients, the law requires that.

        No. No it doesn't. See: https://www.nytimes.com/roomfo... [nytimes.com]

        • It's bizarre how many people think that though. It's just a way for people to be scumbags and not feel bad about it. For some reason, it's hard for people to admit that if some people have to suffer and die for them to make money, then people need to suffer and die. Instead, just blame the made up law that says they have to make money, and blame that very same law when others suffer and die.
          • Thats good to know. I always took it as more a "The laws an ass and should be ignored or defied" thing.

          • It is. Some people probably just genuinely think that, based on what they've seen around us (how a lot of people put profit over all). And then some, yeah, are just kind of assholes and use that "not law" to justify profits above all else.
        • That's a NYTimes OPINION piece.
          • Okay. You can always counter that with a citation of the law that says profits are to be gained above all else.
      • Re:Good. (Score:4, Informative)

        by sjames ( 1099 ) on Wednesday June 17, 2020 @08:26PM (#60195342) Homepage Journal

        the law requires that

        Absolutely not. Please quit helping unethical people cover their tracks. It is nothing more or less than a poor excuse for people who want to put their monetary gain above and beyond all other concerns but don't want to pay the social price for that.

        Although little enforced, any corporation's existence is required first and foremost to be in the public interest. The Rs and the Ds have made the enforcement lax, but profit uber alles is still not required.

      • by ufgrat ( 6245202 )

        Except of course, Steris moved their HQ to Dublin, so as to not pay American taxes.

        Screw 'em.

      • by rtb61 ( 674572 )

        As a corporation, they have to prioritise the interest of the board and their major investors, what ever those board members and major investors choose it to be ie this company https://www.sanitarium.com.au/ [sanitarium.com.au]. They have been routinely attacked by loobyists from American cereal company, their responce to those US corporations, hey want the economic advantages we have, become a NON-profit just like us (I do enjoy the cereal, https://www.sanitarium.com.au/... [sanitarium.com.au] with cocoa made with water and a dash of milk, (oh a

      • They are a corporation, not a non-profit. Of course they put money before patients, the law requires that.

        You might want to take that up with the Supreme Court [cornell.edu]:

        While it is certainly true that a central objective of for-profit corporations is to make money, modern corporate law does not require for-profit corporations to pursue profit at the expense of everything else, and many do not do so.

    • Liability, man. Somebody fucks up, the company gets sued.

      • by sjames ( 1099 )

        FUD. FUD put out as a weak argument for doing the thing that "just happens" to make them a few extra barrels of cash.

        • Doesn't matter if it's "weak". The threat only has to exist.

          • by sjames ( 1099 )

            You can get sued for wearing a solid colored tee shirt that someone doesn't like. The argument is weak in the sense that I (and many others) aren't buying it.

            • The argument is weak in the sense that I (and many others) aren't buying it.

              That only matters if you are on the jury

            • ....getting sued still takes time and money even if the case is baseless....injunctions and legal triplines are the bread and butter of corporations to stifle competition, maintain profits or just to be downright annoying.
      • Bullshit, if the ventilator breaks down because some install guy broke it, a judge isn't even going to even hear it beyond the initial conference. Its a "whats the actual legal theory here?" thing.

      • It's their manuals! If they are publishing wrong shit then they deserve to get sued. If their manual says to remove the widget from the henway valve exposing the fluberflix so it can be flushed with cleaner then so be it. If you have a replacement widget and there is a procedure to follow as outlined in the manual to properly replace it, then what's the problem? You're following the same procedure that a "factory qualified" technician is doing.
        • by Cederic ( 9623 )

          You're assuming that the manuals haven't changed, and that iFixit is offering the correct manual for the specific device.

          That may be the case but Steris can't properly validate that, and that could indeed put lives at risk.

          While I welcome most companies opting against enforcing their copyrights on product manuals (although I do prefer to go to the manufacturer's site anyway) for medical equipment there is a reasonable argument that stronger controls are beneficial.

    • Ifixit should just pay a few grand and have a mob of protesters outside of STERIS hq. Have them put it on social media to look 100x a bigger issue than it actually is, and STERIS's image will be lower than Trump's.
    • Now the world can see what STERIS Corporation actually cares about and it's not patients.

      More importantly, its current and potential future customers can see what STERIS thinks of its customers.

      Smooth move, outing yourself as short-sighted a-holes.

  • Grey area (Score:5, Insightful)

    by Rick Schumann ( 4662797 ) on Wednesday June 17, 2020 @06:18PM (#60194968) Journal
    Having worked previously for a medical device manufacturer (ophthalmic ultrasound machines), I can say that since they're regulated by the FDA, even repair of them is a touchy subject since unauthorized repairs, if done incorrectly, might cause a malfunction that could harm a patient either directly or indirectly, therefore medical device manufacturers are generally speaking going to do whatever they can to discourage unauthorized persons from repairing their products.
    That being said the current circumstances are way out of the ordinary and in some places rather dire, therefore this becomes a less clear-cut matter.
    The smart thing for this manufacturer to do is to step up in some way or other to close the 'repair gap' if there are damaged machines of theirs out there that are standing in the way of patient care. Getting litigious about it isn't helping anyone.
    • by raymorris ( 2726007 ) on Wednesday June 17, 2020 @06:30PM (#60195008) Journal

      I can certainly understand they don't want the liability when someone who has never worked on one of these machines screws up. (They can't prove who worked on it.) They do have a legitimate interest in having only properly trained people mess with the medical equipment they make and are liable for.

      But as you said the right response to that would be to put out free training material or something. Maybe offer training videos and after you complete the free videos you can save a copy of the manual. Something that solves the need.

      After reading the EFF's legal arguments, I find them not entirely convincing as a matter of *law*. This putting aside the issue of "doing the right thing" and just looking at it as a legal argument. I'm not saying their argument is garbage, but it's also not a particularly strong legal position. They took the entire manual, not snippets. They are distributing it for the same purpose as the manufacturer distributes it; it's not like they cut it up and made it into a work of art or something.

      • I don't necessarily disagree with you, but my experience at the ultrasound company taught me one thing: you can document something to the Nth degree, and in many case it still won't be enough to do the job properly. The people working in the probe department needed years of training in assembling, setting up, and calibrating the probes, which were very precise instruments. From the docs alone you could put one together, but it wouldn't be anywhere near the quality of a probe constructed by someone experienc
      • "I can certainly understand they don't want the liability when someone who has never worked on one of these machines screws up. (They can't prove who worked on it.)"

        They can use seals, just like on scales or gas pumps.

        • > > "I can certainly understand they don't want the liability when someone who has never worked on one of these machines screws up. (They can't prove who worked on it.)"

          > They can use seals,

          I pictured a sea lion and a seal trying to work on a ventilator, struggling because they have flippers instead of hands. :)

          But seriously, I'm also thinking I'm on the jury and your expert shows that a Steris ventilator killed your kid because it had a safety valve installed upside down. Steris says "the sticker

      • by uncqual ( 836337 )

        If a medical devices company were to put out free training materials as you suggest they could be liable for even misuse of that information which may result in injury or death to a patient.

        Due to deep pockets laws the manufacturer could be liable for 100% of damages if the injured party can convince a jury that the training materials were not clear enough about some small thing and that contributed, even a tiny amount, to an "unauthorized repairer" failing to repair the machine correctly and that resulted

    • Re:Grey area (Score:5, Interesting)

      by NoNonAlphaCharsHere ( 2201864 ) on Wednesday June 17, 2020 @06:42PM (#60195040)
      I would tend to agree with you, were it not for the fact that STERIS is acting exactly like (and using the same legal tools) that John Deere is using to prevent farmers from changing the oil on tractors they (the farmers) OWN. Somehow, the FAA has come up with a method for airplane owners to change their own oil, or even replace their engines without paying an exclusive tribute to Cessna as the original manufacturer. Perhaps, in the midst of a pandemic, we could find a way to say to the STERIS lawyers and their ilk: "Fuck you! Shut the fuck up!".
    • If the brakes in your car fail because of "Repairs" by some back yard mechanic, it's not the car company at fault. Putting tamper seals on the ventilator will show if unauthorized repairs occured.
    • Re:Grey area (Score:5, Insightful)

      by jbeaupre ( 752124 ) on Wednesday June 17, 2020 @08:21PM (#60195318)

      Coincidentally, I design ultrasonic surgical equipment. There's a huge difference between maintenance, field repair, and factory repair. There is no one-size-fits-all solution. Any comparison to fixing your phone or a tractor or planes needs to factor in many things unique to medical equipment

      We'd be happy to let hospitals do as much maintenance as possible. We make money with the disposable product used with it. But between having custom power components and surface mount electronics, it's all to likely a repair can make things worse. Sort of like trying to repair a motherboard ... with injury or death possible if you screw it up. Same with modifying software.

      Simply put, I design them and even I wouldn't dare repair them. Too risky. There are a few company technicians I might trust, because they build them and have the special test equipment and procedures. They can certify it was done right. But it would never make sense to train and certify a hospital technician. Why spend weeks learning to fix a $5,000 piece of equipment that have a failure rate of 5% over 10 years (and no hazardous failure that I'm aware of).

      So we offer cheap/free "repair" service. In reality, we do some testing and replace the faulty subsystem. New motherboard or power supply or LED screen. Or just a whole new unit.

      And to anyone who thinks "well, just put a tamper seal": that's not going to protect the manufacturer from a lawsuit. Lawyers sue everyone with deep pockets in any way affiliated with an injury or death regardless of cause. Totally innocent companies will still pay tens of thousands of dollars in settlement to avoid legal bills 10X as much. And if they go to trial, juries often will still give the plaintiff money because, hey, the company can afford it and these people deserve something.

      So medical device companies figure "Screw That!" and avoid putting their fate in the hands of some hospital technician, no matter how competent.

      • > So we offer cheap/free "repair" service. In reality, we do some testing and replace the faulty subsystem.

        This makes total sense. Normally.

        But now say there's some major even happening where every patient needs ultrasonic surgical equipment and there's not enough and you don't have a supply chain that can keep up with components, even if equipment is FedEx'ed overnight back and forth, and if these things aren't working, people are dying.

        So, do you want somebody near the hospital who is competent with m

        • > So we offer cheap/free "repair" service. In reality, we do some testing and replace the faulty subsystem.

          This makes total sense. Normally.

          But now say there's some major even happening where every patient needs ultrasonic surgical equipment and there's not enough and you don't have a supply chain that can keep up with components, even if equipment is FedEx'ed overnight back and forth, and if these things aren't working, people are dying.

          I guess if it's a national emergency and this is required they can pass a law indemnifying the medical device manufacturers against lawsuits. Otherwise the lawyers will sue no matter what the circumstances.

      • "And to anyone who thinks "well, just put a tamper seal": that's not going to protect the manufacturer from a lawsuit."

        Neither is a prohibition on user service. But a seal would make it much easier to win the lawsuit.

        If the user actually owns the equipment then they have a legal right to repair it. In the US we have the Magnuson-Moss act to guarantee it. That's why JD uses DRM to prevent it. You may have the right to work on it, but it refuses to work if you do. And a contract can't override the law.

  • https://www.youtube.com/watch?... [youtube.com] That already been said, people working on these machines need to be specifically qualified. This has nothing to do with publishing maintenance manuals.
  • Same thing. You can't fix your own stuff. You must wait for and "authorized" repair person to show up, even if alot of the fixes can be done by the farmer.

    What would it be like if you couldn't fix your own car, or home appliance?

    • by caseih ( 160668 ) on Wednesday June 17, 2020 @07:02PM (#60195110)

      Not quite. John Deere doesn't have any problems with farmers fixing their own machines physically, and selling them parts. For some reason, however, they have it in their mind that the digital, electrical domain is different, though. Intellectual property. And all companies seem to not want to sell service manuals. John Deere really thinks it is the Apple of heavy machinery companies. I don't think this all about protecting dealer networks. I'm really at a loss as to explain John Deere's paranoia and insecurity.

      But this is different from the medical device world. Medical device manufacturers, for a variety of liability and legal reasons, don't want customers to even crack the box open.

      A few companies have tried to DRM common household appliances, but they've been rebuffed pretty strongly by consumers. Besides, they've already managed to convince us to buy disposable appliances that never need to be repaired.

    • by quonset ( 4839537 ) on Wednesday June 17, 2020 @07:08PM (#60195136)

      What would it be like if you couldn't fix your own car, or home appliance?

      Don't worry, at the rate things are going, that's exactly what will happen. Remember how easy it used to be to change your oil or replace a headlight bulb? Manufacturers have now made it difficult, if not impossible, for you to change your oil without specialized equipment. And forget about bulbs. More and more are moving to led lights which require the entire assembly be replaced (at high cost no less).

      Sure, you can change your wiper blades or rotate your tires, but more and more it's becoming difficult to do much more. There was an article on here a while back about a car manufacturer which was considering making a car whose hood you could never open. It would have been one giant sheet of metal and the only way to service the car would have been to take it to a dealer. Don't be surprised if that doesn't happen in your lifetime. Can't find the article, but someone with a bit more search foo should be able to bring it up.

      • Remember how easy it used to be to change your oil or replace a headlight bulb? Manufacturers have now made it difficult, if not impossible, for you to change your oil without specialized equipment... Don't be surprised if that doesn't happen in your lifetime.

        It's already impossible for me to change the oil in my car, because it doesn't have any to change. Electric vehicles have almost no routine maintenance other than replacing wipers and tires. Electric motors have basically no regular maintenance and no user-repairable parts... but they're a couple of orders of magnitude more durable and reliable than internal combustion engines. Batteries are also not really user-repairable. Basically the whole drivetrain is non-repairable but extremely reliable and not like

        • they're a couple of orders of magnitude more durable and reliable than internal combustion engines

          I just re-read this and cringed at this exaggeration. I think I meant to say either "a couple of times" or "an order of magnitude" and mooshed them together. An order of magnitude is probably about right. Two orders of magnitude, not so much.

      • by jwdb ( 526327 )

        I wish you hadn't picked headlights as an example, because considering the number of badly-adjusted headlights I encounter on the roads here, I wish people would stop trying to replace their own headlight bulbs. That, or instead the state should require an annual inspection of bulb alignment.

        While I don't do my own car maintenance, in general I do agree with you that people should be able to do it themselves. However, that means we also need to hold anyone who does so to certain quality standards where it m

    • by toddz ( 697874 )
      Dare I say a majority of people can't fix their own car or home appliance. And the person hired to fix them may not be qualified either.
      • by sjames ( 1099 )

        OTOH, going to the dealer doesn't guarantee that the person working on it has a clue either.

  • by yakatz ( 1176317 ) on Wednesday June 17, 2020 @07:19PM (#60195176) Homepage Journal
    This letter loses all credibility when in the first paragraph they refer to Marketplace as an NPR program. Marketplace is played on many NPR affiliated radio stations, but is actually produced and distributed by American Public Media (not to be confused with the TV program Marketplace from the Canadian Broadcasting Company). If the lawyers can't get simple things like that right, why would the reader be confident that they got complicated legal precedent right.
    • by cusco ( 717999 )

      They don't have to get it right, they just need to be able to bill for their time. And hey, if they do it wrong the first time they can always bill again to fix it!

  • by rsilvergun ( 571051 ) on Wednesday June 17, 2020 @10:46PM (#60195844)
    not sure if it was this supplier (I've lost track of the names) but during the Obama administration there were plans for increasing the national stockpile of ventilators in preparation for a pandemic like the one we're in now.

    The plan was to buy them cheaply at around $3k/each from a newer supplier. One of the established players (who sold them for $10k/each) didn't like this. They bought up the new guy on the block and shut down the program. And, well, here we are.
    • by cusco ( 717999 )

      Clinton Administration tried to do the same, not only with equipment but PPE, antibiotics, anti-virals, pretty much everything that they could think of to stop a pandemic or a bio-terror attack. The program was killed in the first year of the Shrub Madministration, but some things are too stupid even for a Bush so it was brought back in a dramatically reduced form a few years later. Then they moved it from the CDC to FEMA, where "great job Brownie" mismanaged it pretty thoroughly.

  • I wonder how they sleep at night?

    Oh yeah, on a mattress stuffed with $100 bills. >:(

    One day, something really bad will happen because of all of this reckless disregard for human lives, profits over people, and thousands will die.

    Then we may see a violent revolition.

    • One day, something really bad will happen because of all of this reckless disregard for human lives, profits over people, and thousands will die.

      Look around you, Ozymandias, and despair.

  • Section 512 of the DMCA doesn't allow sites to host infringing material provided by users. It allows sites to avoid being held liable for such material.

    In return they must remove such material when properly notified. I'm really not sure what Steris are doing wrong here; they're enforcing a legal right that they've been granted, and doing so through polite notification and request.

    The copyright system has many flaws but this is hardly an exemplar case for any of them.

    • If only an artist would make a collage with the manuals, then the work would be "transformative", and no longer protected by copyright. It would be rather difficult to argue that repair manuals were created for their aesthetic appeal.

  • Full disclosure: I design Class IIb medical equipment for a living and our (really old) manuals are on the site as well. I really love ifixit when it comes down to tear-downs of phones or game consoles, but when I noticed last month they published these service manuals I just thought: "this is insane and really dangerous". I know due to COVID-19, repairs were difficult since access to facilities were blocked and exemptions should be made, but publishing these service manuals online so that your average wash

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