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Interviews: Ask Dr. Tarek Loubani About Creating Ultra-Low Cost Medical Devices
Tarek Loubani is an emergency medicine physician who works as a
consultant doctor in the emergency departments in London, Canada and Shifa Hospital in Gaza. He is also an assistant
professor at the Department of Medicine at the University of Western
Ontario. Tarek has been working in Gaza for the past 5 years, where he made news recently by creating a 3D-printable, 30-cent stethoscope that is better than the world's best $200 equivalent. The need to develop free and open medical devices due to the lack of medical supplies resulting from the blockade, inspired Loubani who hopes the stethoscope is just the beginning of replacing expensive proprietary medical tools. Tarek has agreed to answer any questions you might have. As usual, ask as many as you'd like, but please, one question per post.
We're working on getting smartphones to detect bone fractures. Who do I give this to? https://www.youtube.com/watch?... very preliminary
Liberty - Security - Laziness - Pick any two.
A significant amount of the effort on a medical device is the 510k submission
What is the market value of a person who is familiar with this process?
Normally it is looked at as a niche market with little demand, but it seems to me that an independent group that does 510k submission for multiple device developers would have an opportunity
Wherever You Go, There You Are
Most activities that can be performed commercially but which can also be performed non-commercially are either exempt from patents or never get prosecuted. Fixing other people's bicycles, writing a book, and performing music come to mind. (Software development is a grey area.) But 3D printing is taking an activity where efficient production on any reasonable scale was pretty much the exclusive domain of businesses, and making it accessible to DIY-ers and people who would do it while doing their job or performing some task at home, without any direct commercial aspect. Any idea what stage the debate is at regarding patent restrictions on printing or distributing designs for things more complicated or more modern than stethoscopes?
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You think the wonderful developers could set up a filter for AC posts containing "moo" and "cow."
Yes it's an anecdote! Were you expecting original research in a Slashdot comment?
It seems there are a lot of restrictions on what can be imported into gaza as there is a risk technologies might fall into terrorist hands and used for nefarious purpose. Under this, is it really possible to import a 3D printer into gaza for such tasks?
Your 30-cent stethoscope seems to be an excellent example of "Intermediate Technology" (or "Appropriate Technology") as popularized by Dr Hans Schumacher in his influential book, Small is Beautiful.
https://en.wikipedia.org/wiki/Appropriate_technology
Do you think that 3D printing will become increasingly important in the third world with regards to improving basic medicine, agriculture etc?
I am guessing this technology can be used to print needles as well. Well... everything but the actual metal needle part. Maybe that will be printable in the near future? Or is there something other than steel that can be used for the needle to do injections?
"Never give up, for that is just the time and place when the tide will change." -Harriet Beecher Stowe ^_^
Go take a nap on some railroad tracks, Bernie shill!
Sure... because Israel is rich. And it's rich because it steals the land (and water) of Palestinians. And because it bombs them and then forces them to work for low wages serving Israelis. And because the US gives them massive amounts of money.
I was pro-Israeli for most of my life. Until I saw Israeli bulldozers tearing down houses in Gaza before they pulled out and built the wall. Why did they do that? For "internal security"? No, this was not on Israeli land. They did it for reasons of hate and vengeance. Why should I (or the US) support that?
Israel has become a state sponsor of terrorism. Instead of explosive vests, they use jets and missiles.
"He took a duck in the face at 250 knots." -- William Gibson, Pattern Recognition
Ultra-Low Cost Medical Devices*
*for entertainment purposes only, in the USA.
systemd is Roko's Basilisk.
Even in the so-called first world, we can't afford the ridiculous prices of frames and lenses. The protection racket of the optometrists (they don't give out the PD) and the monopoly of Luxottica (25 "different" brands all made in the same Chinese sweatshop) needs to be broken ASAP.
The benefit would be that I would buy glasses more often and send the old ones to developping countries.
I see lots of stuff blamed on the import restrictions, but are medical devices actually blockaded, or are they stopped because they're used as a cover to smuggle in other things?
While reviewing the online repository for the stethoscope design, I saw that mainly it's the sound gathering part that is 3D printed. The rest is - reasonably - made out of regular stuff. So then, with some regular stuff, can't local people figure out how to make stethoscopes? They really can't figure out that one sound gathering piece? It takes a doctor/hacker to come from some land far away bearing the URL to a 3D printable part to solve the problem?
With all the allergies to various materials, such as nickle and latex, what materials can be 3d-printed that are medically inert? Surgical instruments are stainless steel, implants are titanium, how do you print these? It seems another whole line of questions to find proper materials that can be printed.
Too bad the $200 saved is trivial compared to the dominant cost of using a stethoscope, which is the cost of the long process of learning how to properly listen to it, under guidance of an expert.
What do you see as the main challenges in getting your devices to the regions that need them?
Just wondering... How accurate/sensitive do electrocardiogram's need to be? Could you use an off-the-shelf Op-Amp & an analog-to-digital converter?
Hearing aids seem to be very expensive. How difficult would it be to write up a simple program on, like, a Raspberry Pi to produce sound as particular frequencies and measure an individuals hearing loss at each frequency? How hard would it be to rig up converter software to map frequencies that cannot be heard to frequencies that can be heard? (Basically just a fast-fourier transform (FFT) & remapping. Open Source software does most of this already, and very computationally efficient.) The whole think looks like a Raspberry Pi would be overkill computationally. You could run the output to conventional $9 stereo headphones.
It wouldn't look as nice as the expensive hearing aids, or be as inconspicuous, or as low-powered. But you could build it for a tiny fraction of the cost...
I've read there are other 3D-printed stethoscopes. Is yours (the Gila 3D stethoscope) attracting attention because it's better, or cheaper, or because it's actually getting used? Or is the Gila 3D stethoscope getting attention not for what it is but for it being an example from a domain where 3D seems set to bring radical change?
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This question didn't spring to mind at first. Seems a bit basic. But I wrote it because a lot of the comments so far indicate that people (myself included) don't know a hell of a lot about this project other than that it exists.
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Because I don't want anyone to tell me how to live my life.
I love firing guns, but don't currently own any.
I'm also about to lose my company provided health insurance, and will be paying the fine next year (or the year after) at tax time. WHen I get tired of living, I'm going to offer my body to medical sciense, probably Emory University.
I have ideas for several medical devices.
But what is the most cost effective way to get them in hands of Doctors ?
Does the exist an doctor equivalent of Slashdot where you can post a story about it or buy ads ?
I printed one in Germany, as cheap as possible. Here is my feedback and my questions.
- the 3D printed parts costed 23 EUR (incl shipment)
- One tube as badly printed, because the tube shape is a bit difficult to get right for a 3D printer. The printer re-did it for free though.
- I ordered all non 3D printed parts as cheap as possible. It came to 21 EUR (incl shipment).
- The instructions state the following "... Attach the silicone tube to the T-Piece". However, the T-Piece is neither 3D printed, nor in the BoM of things to buy in addition. This would add to the total cost, but also at this stage prevents me to complete the stethoscope. Where is the T-piece suppose to come from ?
Also, where is the ring to hold the diaphragm supposed to come from ? What are the dimensions of the diaphragm and of the ring ? Seems that a few important steps are missing...
Assuming the T-piece would cost me 7 EUR and the ring 4 EUR, the total cost of producing one stethoscope in my region would come to ca 55 EUR. Of course, I will have enjoyed building it, testing it and if all is fine I will have a stethoscope which is "as good as the best ones". That is not negligible.
A significant portion of the costs is due to shipment or having to order much larger quantity of material than needed (example : 1 meter silicone tubes instead of 40 cm). If I would have produced, say, 100 stethoscopes, my estimation would be that the total cost for one unit could be reduced from 55 EUR to approximately 25 - 30 EUR. It is difficult to imagine reducing the unit cost further.
So maybe another question is this one: how confident are you to achieve the goals of producing one for a few USDs ?
What other devices would you like and what do you think is attainable during these methods?
I personally work in (research) MRI and regularly create custom solutions and thus I know the difference in cost between creating a device (eg. AV presentation, stimulus response, infant tactile stimulus) vs. buying the commercial model(s). Usually, even if you factor in labor, the difference is one to several orders of magnitude different.
What are countries/regions missing desperately simply due to their retail cost that are apparently easily manufactured (given your experience with these methods and the regions in question)
Custom electronics and digital signage for your business: www.evcircuits.com