this post was submitted on 26 Sep 2024
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Apologies for posting a pay walled article. Consider subscribing to 404. They’re a journalist-founded org, so you could do worse for supporting quality journalism.

Trained repair professionals at hospitals are regularly unable to fix medical devices because of manufacturer lockout codes or the inability to obtain repair parts. During the early days of the COVID-19 pandemic, broken ventilators sat unrepaired for weeks or months as manufacturers were overwhelmed with repair requests and independent repair professionals were locked out of them. At the time, I reported that independent repair techs had resorted to creating DIY dongles loaded with jailbroken Ukrainian firmware to fix ventilators without manufacturer permission. Medical device manufacturers also threatened iFixit because it posted ventilator repair manuals on its website. I have also written about people with sleep apnea who have hacked their CPAP machines to improve their basic functionality and to repair them.

PS: he got it repaired.

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[–] tabular 385 points 2 months ago* (last edited 2 months ago) (2 children)

The manufacture should have zero say if their product gets repaired or not. The only person who can give permission to repair it is the owner. It should be illegal to implement tying to lockout parts being used as a replacement. Right to repair

They call it jailbreak because this is an issue of freedom: software freedom

[–] dgmib 125 points 2 months ago (2 children)

They call it jailbreak because this is an issue of freedom

I support your position and the right to repair, but that’s not the origin of the term jailbreak in the context of computing.

The term jailbreaking predates its modern understanding relating to smartphones, and dates back to the introduction of “protected modes” in early 80s CPU designs such as the intel 80286.

With the introduction of protected mode it became possible for programs to run in isolated memory spaces where they are unable to impact other programs running on the same CPU. These programs were said to be running “in a jail” that limited their access to the rest of the computer. A software exploit that allowed a program running inside the “jail” to gain root access / run code outside of protected mode was a “jailbreak”.

The first “jailbreak” for iOS allowed users to run software applications outside of protected modes and instead run in the kernel.

But as is common for the English language, jailbreak became to be synonymous with freedom from manufacture imposed limits and now has this additional definition.

[–] tabular 47 points 2 months ago* (last edited 2 months ago) (1 children)

Thanks for the history and technical explanation. I didn't mean to imply that was the origin (for computing) and was only talking about a specific usage of the word.

I think most people say it to refer to manufacture imposed limits but I wanted to promote a broader usage. That using proprietary software is like being in a jail because your software freedoms are denied.

[–] [email protected] 22 points 2 months ago (1 children)

Oooo healthy online discourse. Where's my popcorn...

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[–] meco03211 17 points 2 months ago (4 children)

I'd temper that by saying a manufacturer would need to provide a reasonable option. Some things could become dangerous or even deadly if repaired incorrectly. Or it could be dangerous or deadly to even attempt to repair it.

[–] tabular 42 points 2 months ago* (last edited 2 months ago) (19 children)

In the medical field when a device can only be repaired by the manufacturer then you can expect long wait times, bad repair jobs and having your own equipment sent in for repair destroyed for "safety".

We let people repair their own car's brake pads.. we shouldn't give up ownership rights for a unwarranted claim to safety. If something is potentially dangerous then making it more difficult to repair is a bad idea.

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[–] orclev 15 points 2 months ago (5 children)

It's OK for manufacturers to say using aftermarket parts voids the warranty, it's not OK for them to prevent using them entirely. Likewise if there's a safety concern that should be handled by regulation and things like safety inspections, not by forcing all repairs to go through the manufacturer. If whatever it is is that critical to the safe operation it should be publicly documented so that third parties can manufacture it correctly to the needed tolerances.

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[–] [email protected] 159 points 2 months ago (2 children)

This is what Louis Rossmann has been screaming and fighting about for years. It's the most fucked up shit ever. It is affecting our food supplies and we are not paying attention to it.

[–] ivanafterall 15 points 2 months ago (3 children)

Do you have a source on the food supply angle? Sounds interesting and enraging.

[–] [email protected] 91 points 2 months ago (2 children)

Short of it is that John Deere is preventing farmers from repairing their own tractors. How much it threatens the food supply, I'm not sure, but there is an obvious connection.

[–] [email protected] 49 points 2 months ago

I've also read about the John Deere issue as a leading instigator of right-to-repair laws. They weren't able to provide authorized local repair techs when a tractor breaks down, so farmers were stuck waiting 1-2 weeks for someone to show up while crops were rotting in the fields (think of how fast your fresh fruit rots in your kitchen and then imagine dozens of fields of that crop going to waste). And the biggest insult was when the repair tech drove into town for a $5 part that the farmer had already identified but couldn't replace because of manufacturer lockouts.

[–] [email protected] 24 points 2 months ago* (last edited 2 months ago)

This is correct. And the connection is major. I, as a former farmer, can tell you that repairing my own equipments is a matter of life or death (for my crops). Rice for example, required a constant stream of cold(~~riger~~ river temp cold) and fresh water for 6 months straight. Non-stop. If my diesel powered water pump breaks and I can't fix it, I only have a couple of days (if at all) to fix it, otherwise, all that rice is just dead. So, I always had parts available at my house for just in case. I'd also had two diesel water pumps at the river, in case one broke and took a while to fix, so I can fire up the second one. Same thing with my harvesting machine..... the list goes on and on. It's absolutely essential that farmers fix their own equipments. What John Deere is doing should make every human being angry, because this is our food they're messing with.

[–] [email protected] 15 points 2 months ago* (last edited 2 months ago)

Yeah, just search up right to repair farm equipment, just linking one or two articles won't give you the scope of the problem the way seeing how much it has been covered, but not changed.

I got family that farms independent, and it's pretty much the single biggest factor in profitability over time. Those machines can cost as much, or more, than a nice house, and you're locked in to inflated service and parts costs.

Enraging doesn't honestly do the problem justice.

This isn't a "google it" thing, it's really about actually seeing the search results first hand. We're talking pages of hits going back decades.

[–] [email protected] 11 points 2 months ago

Here is one video of many he has made about John Deere and how they're being absolute scums of the earth. Louis actually helped the farmers win some cases in several states. A lot of people on the internet love to shit on Rossmann (mostly about his personality), but the man has been tremendous work. He's a fucking fighter.

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[–] Wilzax 120 points 2 months ago (6 children)

Medical device manufacturers also threatened iFixit because it posted ventilator repair manuals on its website.

What the fuck is wrong with people. Anyone who opposes the right to repair for MEDICAL DEVICES is irredeemable.

[–] A7thStone 47 points 2 months ago (1 children)

Education and healthcare should never be for profit.

[–] [email protected] 16 points 2 months ago (2 children)

Please read this next line as if it had alternating/random caps:

"But capitalism improves efficiency!"

Tap for spoilerI'm on mobile and would rather not deal with my spellcheck "learning" anything today.

[–] [email protected] 9 points 2 months ago

There's this app, I don't use it often but leave it installed for this

https://github.com/MobileFirstLLC/irregular-expressions

The option spongemock LeTs YoU wRiTe LiKe ThIs

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[–] cmrn 112 points 2 months ago (3 children)

Keeping repairs locked into your system of parts/techs can at least feign “safety” or “quality”.

But essentially just refusing to repair is an absolute fuck you.

I’ve started choosing the companies I use based much more on the experience offered when their product/service DOESN’T work, rather than when it does.

[–] [email protected] 51 points 2 months ago (5 children)

I’ve started choosing the companies I use based much more on the experience offered when their product/service DOESN’T work, rather than when it does.

Easy to do for a cell phone or a toaster, but I can't imagine there's a ton of options for exosuits that correct your condition, covered by your insurance, that your doctor is familiar enough with to prescribe (for lack of a better term).

Some things are annoying to make abandonware, and some things should be criminal.

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[–] [email protected] 11 points 2 months ago (2 children)

For me it's a mix of what you said and how they treat their employees/where they're making the product.

I spend extra time trying to find higher priced, higher quality, more fairly manufactured products.

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[–] [email protected] 10 points 2 months ago

Right it begs the question.

Is me not receiving care or having access to care REALLY better for me?

If the answer can't clearly be yes, then they are just choosing to make me ill or kill me for their perceived interests.

[–] BrightCandle 81 points 2 months ago

A right to repair is long overdue but more than that when it comes to medical devices it's obvious battery replacement is going to be necessary and should be user accessible.

[–] omarfw 75 points 2 months ago (1 children)

corporations are a problem we need to solve as a society.

[–] Dead_or_Alive 13 points 2 months ago (12 children)

Orrrr and hear me out. We just pass a national right to repair law.

There, problem fixed and we don’t need to burn anything!

[–] omarfw 9 points 2 months ago (5 children)

aaaww but I already got my gas can and matches out

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[–] Ensign_Crab 64 points 2 months ago

Corporations are a fucking curse.

[–] iAvicenna 62 points 2 months ago

any company who locks medical device repair should be burned to the ground. and dont bullshit me about liabilities bla it is more likely cash grab which they get in the form of "extra care packages" or exorbitant repair prices charged after the guarantee period ends.

[–] [email protected] 57 points 2 months ago (3 children)

For a $100k device, I would expect better long term support.

[–] douglasg14b 21 points 2 months ago

You would, but if there's no reason for them to spend the money on it why?

This is what regulation is for, and it needs to have teeth.

[–] exanime 13 points 2 months ago

They just want him to get a new one... Why repair a $20 battery on a perfectly functioning device when you can force him to get a new $100,000 exoskeleton?

This is just more capitalist ghouls doing the only thing they know

[–] [email protected] 8 points 2 months ago

Remember when people unironically said "you get what you pay for"?

[–] UnderpantsWeevil 42 points 2 months ago (7 children)

Absolutely hate this shit.

[–] NOT_RICK 14 points 2 months ago (2 children)

It’s definitely annoying, but they have a provided decent explanation of why, imo

[–] [email protected] 8 points 2 months ago (1 children)

The reason why is that they need my email address?

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[–] [email protected] 40 points 2 months ago

Update: He temporarily gained the ability to walk again after touching a spinning steel ball, despite the recovery not lasting he will still be competing in upcoming cross country horse race.

[–] [email protected] 37 points 2 months ago

there is absolutely no excuse for this

[–] [email protected] 36 points 2 months ago (1 children)

The right to repair is such an obvious good in the world that those opposed to it should be publicly shamed.

[–] exanime 21 points 2 months ago* (last edited 2 months ago)

Right to repair NOW!

Medical devices should be either supported for life (with money on escrow to support it) or provided with all schematics, manuals and spare parts

Non paywalled article

https://www.theverge.com/2024/9/26/24255074/former-jockey-michael-straight-exoskeleton-repair-battery

[–] orl0pl 19 points 2 months ago

Line must go 🆙

[–] mesamunefire 16 points 2 months ago* (last edited 2 months ago) (2 children)

The CPAP lockout is something I went through. The company behind my CPAP does not allow you to get ANYTHING off the device. But there is an SD Card that you can get all the info you want from your old system. Its arbitrarily locked out.

You are also unable to repair anything on the device without insurance getting involved. And insurance is often at OEM prices (think 200+ for a basic mask). Thankfully, people have illegally added STLs/chips/parts/etc... online that you can basically reverse engineer the entire device nowadays. As long as you use medical safe materials, it saves you literally thousands of dollars. Ive replaced quite a few parts and the device is still working after many years of usage.

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[–] mkwt 13 points 2 months ago (2 children)

Medical devices are required to comply with 21 CFR 820 in the United States, which establishes quality management standards. This includes minimum standards for the software development lifecycle, including software verification and validation testing.

In the EU, broadly equivalent standards include ISO 13485 and IEC 62304.

If an OEM wants to do a software update, they at minimum need to perform and document a change impact analysis, verification testing, and regression testing. Bigger changes can involve a new FDA submission process.

If you go around hacking new software features into your medical device, you are almost certainly not doing all of that stuff. That doesn't mean that your software changes are low quality--maybe, maybe not. But it would be completely unfair to hold your device to the standard that the FDA holds them to--that medical devices in the United States are safe and effective treatments for diseases.

This may be okay if you want to hack your own CPAP (usually a class II device) and never sell it to someone else. But I think we all need to acknowledge that there are some serious risks here.

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[–] fne8w2ah 10 points 2 months ago* (last edited 2 months ago)

Louis Rossmann should definitely get right on this case ASAP.

[–] [email protected] 10 points 2 months ago (2 children)

repair techs had resorted to creating DIY dongles loaded with jailbroken Ukrainian firmware to fix ventilators without manufacturer permission

How many jailbreaks are done by Ukrainian hackers? Wasn't the John Deere firmware from Ukraine as well? Nice job 💖

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[–] [email protected] 8 points 2 months ago

I agree, 404 is legit journalism. No org is perfect, but they're as good as it gets.

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