Lawyer Demands Pacemaker Vendor Supply Source Code
oztiks writes "Lawyer Karen Sandler's heart condition means she needs a pacemaker to ward off sudden death. Instead of trusting that the vendor will create a flawless platform for the device to operate, Sandler has demanded to see the device's source code. Sandler's reasoning brings into question the device's reliably, stability, and oddly enough, security."
She could just let her heart regulate itself naturally.
This sort of demand is why lawyers are disliked. The life science industry has to follow the FDA directive to perform a source code review. It is very unlikely that the source code in these devices have any remaining bugs due to the length of time that these devices have been used.
In addition to the source code for the software running the device, which is most likely to be extremely robust given the long time that these devices have been in use (+25 years), she might as well ask for the manufacturing process details for the battery, the casing, the electronic components, and the design of the microprocessor.
This is pointless since any qualified experts on the code are likely to be working for the device manufacturer.
Oh, come on. The source code is not going to tell you a whole lot, it would be only comprehensible to experts and it says nothing about the little hardware bits. Does Mr. Lawyer want Medtronics to go over the schematics with him? Explain the physics?
Sometimes you just have to settle down and let things go. Yes, regulatory agencies should review operations of medical devices closely. No, they don't need to peek inside.
I don't even think the FAA looks at the code for the flight control computers on airliners. They test the planes (or actually they watch the manufacturer test the planes) but they don't get every part off the aircraft and look at it under a microsope.
Faster! Faster! Faster would be better!
A related story on NPR today points out that as a patient you don't have access to the data collected in and about your own body. The story focuses on one man's attempt to see his own data. He's looking for someone with technical skills to help him get at the data. Seems to me that somebody on /. should be able to help. http://www.onthemedia.org/2012/jan/20/who-owns-data-inside-your-body/
Yet I don't demand to audit their code.
Well, if you don't demand that somebody audits their code you are pretty stupid. Unaudited code and code which is proprietary and never shared with outside bodies (this doesn't have to mean the public; just at least someone external) just doesn't have a place in any critical parts of our infrastructure. It is as irresponsible as it would be if Boeing didn't have to hand over the mechanical specifications of their planes, which of course they do. However, If you had read the article you would have seen this quote:
I think you will find that aircraft software, whilst it isn't open source and available to everyone, gets a bit more review than that.
Apart from that, the plane code isn't part of you and is, as a passenger, something you just visit for a short time. I think people have a right to understand fully, to the level of their own ability, things that are made part of their body.
=~ s,(.*),<sarcasm>$1</sarcasm>,g if any_point_you_wish();
It's called software validation and it's a pain in the ass. It's such a pain for medical devices that everyone avoids it unless absolutely needed. Which is why medicine is 10 years behind when it comes to electronics.
For a "quick" overview, here's a start: http://www.fda.gov/RegulatoryInformation/Guidances/ucm126954.htm
The world is made by those who show up for the job.
10 thump
20 thump
30 sleep 1s
40 go to 10
How do we know the software works as advertised? How do we know it's secure?
Well, let's see, what is the failure rate of pacemakers? A quick Google search brought this result (http://www.post-gazette.com/pg/06116/685028-114.stm):
In one study, Dr. Maisel and FDA researchers analyzed reports that pacemaker and ICD manufacturers were required to submit to the federal agency between 1990 and 2002. During that period, more than 17,000 malfunctions resulted in removal and replacement with a new device, researchers found. Battery, capacitor or electrical problems accounted for half the failures. Thirty deaths were attributable to pacemaker malfunction and 31 deaths to malfunctions in ICDs. The annual replacement rate for pacemaker malfunctions decreased during the study period, from 9 per 1,000 implants in 1993 to 1.4 in 2002. But the ICD replacement rate, after decreasing from 38.6 in 1993 to 7.9 in 1996, increased in the latter half of the study, peaking in 2001 at 36.4.
So, there is a failure rate of 1.4 per 1000 in 2002, and half of those were related to hardware issues. Only 30 people ended up dying. This article (http://circ.ahajournals.org/content/105/18/2136.full) claims 3,000,000 people worldwide with pacemakers in 2002, with 600,000 implanted yearly. That means in 2002 .001% of people with pacemakers died. Assuming hardware failure accounted for half of that, then the chances of being killed by a software defect in a pacemaker is extremely small. So, I'd say it's safe to assume that the hardware "works as advertised".
The only thing necessary for evil to triumph is for it to be pitted against a slightly greater evil
It is very unlikely that the source code in these devices have any remaining bugs due to the length of time that these devices have been used
hahahahaahaha ahaahah.
you spoke like someone who has zero experience in software development.
Read radical news here
GP lives in their flight path. Around here it's difficult to impossible to find a place to live where a rather large plane doesn't fly overhead on a regular basis.
If you read the article or ones on the same topic from last year, you'll find that the reason she is making the request is that not even the FDA has audited the code. It's just there.
Other embedded hardware has been found to be easily crackable and able to deliver fatal doses of medication. Someone has to audit the code, since the FDA is not doing it, Karen is making an issue of it. In these cases, there is no excuse for the code not being 100% open. People's lives hang in the balance.
Beta is broken and the link to classic doesn't work. Stop wasting our time or there won't be anybody left here.
It she weren't a lawyer, we wouldn't even be speaking about it.
It's funny how lawyers seem to have extra rights in our society. They can make demands, we cannot.
I thought they had their hearts removed when they passed the bar at the same place that performs MBA lobotomies.
I love Jesus, except for his foreign policy.
The summary is pretty bad, but one of the more salient points is that modern pacemaker/debrillators have Wi-Fi in them. Yes, WiFi. According the the recording, someone at defcon has already managed to hack into an insulin pump equipped with WiFi and been abe to manipulate the delivery rate (which could kill the patient). So the security concerns aren't completely unwarranted.
Demanding the source code is a bit silly. How many people are really going to be able to review the source code for a pacemaker/debriliator? Very very few. Even if they do, there's a hell of a lot more to a pacemaer/debrillator than the software, so why is it just the software that's her concern?
A more sane approach would be demanding the software follow basic security rules like not allowing the wi-fi connection to ever change anything in the medical device. (It's supposed to be a reporting mechanism so the doctor can follow the progress of the patient). I can't believe she has anylegal grounds to demand source code, so this is a fight for the minds of the public rather than a legal one. Demanding source code is a bit silly since most of the public doesn't even understand that there is such a thing as source code. The public is by now very aware of security problems and hackers, so ensuring that the wi-fi is read-only would be an easier battle to win.
AccountKiller
The MBA lobotomy is a very precise operation, they only remove the parts of the brain that remember to pay taxes and how to truthfully report corp. earnings.
Actually, people do that sort of thing *all the time*.
I have a coworker who can't have wheat or dairy, and it takes a lot of questioning for her to get a meal at a restaurant. My mom is allergic to soy (including soybean oil), and since soy pops up in the darndest places that means it also takes a lot of questioning for her to get a meal at a restaurant. No, they don't audit the cooks, but they do demand information about what they're about to put in their body, up to a point required to ensure their own health to the best of their own knowledge and abilities.
What were you saying about fantasies? I think you have a few.
Porquoi?
You're in luck, I know a lawyer who wants one.
We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
The MBA lobotomy is a very precise operation, they only remove the parts of the brain that remember to pay taxes and how to truthfully report corp. earnings.
You forgot empathy.
If God forks the Universe every time you roll a die, he'd better have a damned good memory.
The MBA lobotomy is a very precise operation, they only remove the parts of the brain that remember to pay taxes and how to truthfully report corp. earnings.
You forgot empathy.
If you had measurable empathy in the first place, they wouldn't have let you in.
If Slashdot were chemistry it would look like this:Cadaverine
I am TheRaven on Soylent News
My heart rate is controlled by a pacemaker at this moment. I do not have access to the specifications, so I cannot determine directly whether it contains a real-time clock. But the behavior seems to require one. The pacemaker stores records of its behavior and its sensor readings, and transmits them whenever its short-range radio can reach a satellite/cellular interface. It is extremely likely that a real-time clock in the pacemaker is used to time-stamp the data that are transmitted at unpredictable times hours after they are recorded.
Mike O'Donnell http://people.cs.uchicago.edu/~odonnell/
*facepalm*
Of course! Curse this properly formed brain of mine.
If God forks the Universe every time you roll a die, he'd better have a damned good memory.
...and incidentally every time one of their products flies over my house to land at the DC area airport I live close to.
Yet I don't demand to audit their code.
There is also a pilot and co-pilot in command of the aircraft. Most of the time they're sober enough to recover any software glitches before a crash, and they're usually awake during takeoffs and landings.
Last year at OSCON. Sadly the line was too long for me to shake her hand and say thanks for starting this.
There's a few points I'd like to add, many already covered.
1) She's qualified to do this. Not to review the software. But she has plenty of good colleagues for that.
She's a director of GNOME (I know, I know...), former GC of the SFLC, an attorney... and ... from listening to her talk, she either genuinely gets software -- or someone that did wrote her whole speech for her.
2) This is a real, not a hypothetical problem.
People commenting without RTFA need to understand--These devices are 802.11 enabled. Remote exploits /have/ been demonstrated.
This is not a wholly uncommon situation -- one of my coworkers has a daughter with a computerized glucose pump that has also had remote compromise demonstrated.
And even a trivial interest in breathatlizers reveals there has been...myriad incidences of these devices not just being a total failure of design, but having rollover and similar bugs in their implementations.
3) People may be correct that it would be hard to get people to understand the code. That is wholly irrelevant and a false front of an argument. I don't care what your medical experience is in your industry or company. What your experience with regulators or lawsuits are. There's companies that commit fraud, lie, cheat, steal. They exist. This is indisputable. There's places where MBA's and biologists that can barely write a hello world by themselves compose pointer arithmetic, hit compile, hit test, and go home at the end of the day. I've worked at places like that on applications that could kill if they failed. It is why I do not as of two years ago.
I presently work with a woman that could not compose a CSV in a basic ETL from another filetype without help. She has the language being used using on her resume. Her workflow involved copy/paste off of the internet, and then changing one line at a time, saving it as file.### and trying to run it. If it didn't crash, she'd examine the output and try to put in what she thought would fix it. If it did, she'd try to find the error. When I offered a hand, she was currently at over her 500th revision.
So let me be damend clear -- even an unqualified person can do a basic code review just by running a fucking linter on it and looking at the warnings. Because if it generates one or a million -- that says something about the quality right there.
Why? Because unless you're in a business whose core business *IS* software, my personal experience is that 80% plus of the developers have never heard of one, and 95% don't know how to use it if they have. And that is why my code has less bugs than my colleagues.
Now -- even if my experiences are anecdotal, and "invalid" -- I've just proven the existence of the problem.
This is her life we're talking about. Her life entrusted to a piece of cybernetics that has had a demonstrated remote exploit.
Please /., have a little bit of humanity for once. This isn't about corporate profits, NDAs, lawsuits. This is about someone asking to read something to make an informed choice about their continued existence.
In the 90s, the FDA realized that even if it could see the could, there was no way it could realistically audit code for all the devices it is required to review annually. So they switch from attempting to verify devices directly to insisting that devices be design and developed under a very high quality engineering paradigm.
So instead of looking at code trying to find problems, what they do is demand artifacts of a very disciplined design development and test process, reasoning that if people are in fact actually writing out test cases, doing internal code reviews with documented changes arising from them, maintaining requirements traceability matrices linking each line of code to a user requirement and then a lower level system requirement, then that process will result in better code than the FDA could accomplish by their own audit or that of a 3rd party. So the woman should be asking to see the details of the company's FDA submission, presumably under NDA from the company.
Now, whether the FDA is employing Design Control in a strict enough way is definitely a fair question - in particular the 510k (predicate device) submission process has left a lot of loopholes (due to its risk class, a pacemaker does not go through 510k, it goes through the more demanding PMA process). But to suggest that she or someone she hires will just be able to wade through the code to decide if she thinks it's high quality seems to me more like grandstanding than anything else.
Actually, people do that sort of thing *all the time*.
They do... and restaurants often say "we can't be sure, so you'll have to eat elsewhere" because they can't be bothered with it. So by your analogy (which I like) there is a risk that pacemaker manufacturers will do the same.
"... and more and more now there are all kinds of electronic goodies available" -- Pink Floyd 1972
That's really rude. The lawyer this store is about, Karen Sandler, worked pro bono for the Software Freedom Law Center helping to protect people's software freedoms. Which would normally be considered a very good and moral thing around here, would it not? She currently works for the GNOME foundation.
http://www.youtube.com/watch?v=nFZGpES-St8 OSCON 2011
http://www.youtube.com/watch?v=5_pRH8lzaQo Freedom: From my heart to the desktop
http://www.youtube.com/watch?v=GcWlD2Y6HNM OSCON 2010 Free Software on Medical Devices: Unchain My Heart
Karen Sandler, the lawyer this article is about is also a programmer and has an engineering degree. She works for the GNOME foundation and before that the Software Freedom Law Center...I think she can find a few people who are also programmers to help her as well.