Patient Safety’s First Scandal: The Sad Case of Chuck Denham, CareFusion, and the NQF

In retrospect – always in retrospect – it should have been obvious that, when it came to Dr. Charles Denham, something was not quite right.

In a remarkable number of cases of medical errors, it’s clear – again, in retrospect – that there were signs that something was amiss, but they were ignored. The reasons are manifold: I was just too busy, things are always glitchy around here, I didn’t want to be branded a troublemaker by speaking up…. Part of the work of patient safety has been to alert us to this risk, to get us to trust our internal “spidey-sense.” When something seems wrong, we tell front-line clinicians, speak up!

It’s fitting, then, that the first major scandal in the world of patient safety has a similar subtext. The scandal, which broke two weeks ago, involves a $40 million fine levied by the Department of Justice against a company called CareFusion. The company allegedly paid Denham more than $11 million in an effort to influence the deliberations of a “safe practices” committee of the National Quality Forum co-chaired by Denham. While I was shocked to hear this news, in retrospect there were so many unusual things about the career of Chuck Denham that alarm bells could have, okay, should have, gone off – for many people who knew him, including me. But they didn’t.

Let me say at the outset that while some people feel strongly that leaders in safety and quality should have absolutely no ties with industry, I am not one of them. I serve on a corporate board (of IPC, the largest hospitalist staffing company in the US) and advise several companies working on various safety fixes, mostly technologies. I find this work interesting, enlightening, and fulfilling, and I am compensated for my time and expertise. I report all of these activities to my University and other organizations, and recuse myself from any decision that might possibly relate to one of these companies or their products, or potentially be perceived that way (a fuller description and a list of the companies is here).
Returning to the CareFusion/Denham affair, I first met Chuck Denham about 10 years ago, when he asked me to participate in a session that he was organizing for the National Patient Safety Foundation’s annual conference. The NPSF runs on a shoestring, yet I recall this session as being lavishly staged, our speeches accompanied by a video with Hollywood-like “production values.” I remember asking myself: Where did this person come from? And, more pointedly, where did his resources come from? I looked him up and learned that he ran an organization, called theTexas Medical Institute of Technology. I found precious little information about the Austin-based institute’s structure, staff, or history on the web, and Denham himself was based in Southern California. It all seemed a bit unusual, but not enough so to set off any alarms.

Over the next several years, I ran into Chuck at half a dozen safety meetings. I always found him enthusiastic, cordial, and highly (perhaps too highly?) complimentary of my work. He asked me to do a few things, including speaking in a couple of webinars staged by TMIT. These were quality events, well produced, and they gave me no reason to question his effectiveness or his motives.

Yet over the years, I found myself scratching my head about him on several occasions. A colleague visited him at his home in Laguna Niguel, an affluent beachfront LA suburb, and reported that it was palatial – not something commonly acquired on the salary of a former radiation oncologist. About five years ago, trying not to be too obvious, I asked Chuck where his money came from. He mentioned something about his wife’s family, and that he had decided to leave clinical practice to commit his life to patient safety. On several occasions, he talked about his “research test bed,” saying, “We’re in more than half the hospitals in America.” It wasn’t entirely clear what this meant; having visited many hospitals over the years, I never heard of one that was using the services of TMIT, the way you hear about hospitals that work with Premier or the Advisory Board or the Governance Institute. Very little of this added up, yet still there was no smoking gun.

Over the past few years, I received at least five different calls from colleagues who had been approached by Chuck to work on one project or another – a video to improve radiology safety, an effort to reduce central line infections, and several others I can’t recall. In each case, the question posed by my colleagues was a version of, “Is this guy for real?” In each case I said the same thing: Yes, both he and the situation seem odd, and no, I don’t know where he gets his money. Yet he appeared to be a nice guy, good to his word, and he produced results. I told them that – despite my head scratching – I couldn’t think of a sound reason not to work with him. When I mentioned this yesterday to Peter Pronovost, the Johns Hopkins intensivist who is the world’s leading safety researcher, he told me, “It’s not that five people didn’t understand Chuck… I don’t know anyone whodid understand.”

Things got odder still. Zelig-like, Chuck kept popping up in extraordinary places. After Dennis Quaid’s twin newborns nearly died of a heparin overdose at Cedars-Sinai Medical Center, I wondered whether Quaid would become a spokesperson for patient safety. The next thing I know, Quaid is holding a news conference, and standing beside him is Chuck Denham. And soon, a very slick video, Chasing Zero, was released and distributed gratis to hospitals everywhere. The producer: Chuck Denham.

And there’s more. The Journal of Patient Safety launched early in the safety field, co-sponsored by the National Patient Safety Foundation. To me, JPS has never been very good or particularly influential, and by all accounts it struggled to make ends meet. Then in 2011, I learned that it hadnamed a new editor. You guessed it: Denham. The change had been made so precipitously that the NPSF, a founding sponsor, claimed it had been blindsided and removed its sponsorship in protest. I looked back to see whether Denham’s pedigree could justify his being named the editor of an academic journal. A PubMed search revealed that, before 2009, he had not had a single first-author publication in a 20-year career. Since then he has had 12, 11 of them in JPS.

Which brings us to the National Quality Forum. The NQF was founded in 1999 to vet and endorse quality measures. After the safety field launched, NQF added several safety-related products, most famously an NQF-endorsed list of “safe practices” and another of “serious reportable events,” the latter more commonly known as the “never events” list. Two individuals shared the job of chairing the NQF Safe Practices committee. One, Gregg Meyer, is a respected academician and safety leader, whose career has included stints at AHRQ, Mass General, and now Dartmouth. The other: Chuck Denham.

All of this is preamble to the announcement earlier this month that the U.S. Department of Justice had fined CareFusion, a manufacturer of safety-related products (market cap: $8.5 billion), $40 million for having given Chuck Denham’s company $11.6 million to try to influence the NQF’s endorsement of safety practices. It should be noted that, although Denham is specifically named in the Justice Department documents, no formal charges have been filed against him and both he and his attorney have denied that the payments were kickbacks designed to manipulate the NQF process. Denham’s statement, in which he calls the allegations “blatantly false,” is here.

The picture has become clearer with reports from several NQF insiders that Denham lobbied the Safe Practices committee to insert a new recommendation to “use chlorhexidine gluconate 2% and isopropyl alcohol solution as skin antiseptic preparation…” (Safe Practice 22). Though committee members did not realize it at the time, such specificity would have been a home run for CareFusion, since its product ChloraPrep was the only one on the market containing that formulation. In addition, Denham changed a previous general recommendation to use chlorhexidine to prevent central line-associated blood stream infections (CLABSI, Safe Practice 21) into one that specified the ChloraPrep formulation. Several committee members, including Pronovost and Patrick Romano of UC Davis, have described being completely unaware of Denham’s CareFusion relationship. In the case of Safe Practice 22, the NQF meeting transcript, posted by ProPublica, shows Denham twice referencing a still-unpublished New England Journal of Medicine article that touted the effectiveness of the 2% formulation.

This is troubling on several levels. First, questions have been raised about potential conflicts in theNEJM article, since all of the study’s investigators received funding from Cardinal Health, CareFusion’s parent company. Second, there was no evidence, then and now, that the 2% formulation works any better than other chlorhexidine formulations. Finally, how did Denham, who was not an author, gain access to the NEJM findings prior to the paper’s publication?

Equally concerning, the NQF has also acknowledged that much of the staff work for the Safe Practices committee was supplied, gratis, by Denham’s company, Health Care Concepts. Denham was removed from his NQF position after concerns were raised by both staff and committee members, and a competitor, 3M Health Care, objected to the specific recommendation of the CareFusion product in the draft of Safe Practice 22. An ad hoc committee quickly convened by NQF reviewed the 2% recommendation and voted to replace it with a more generic one, which is what appeared in the final report. On the other hand, according to Romano, the 2% recommendation for CLABSI was not discussed in committee meetings, yet it did appear in the final report for Safe Practice 21. Moreover, Denham hosted webinars, under the NQF banner, that cited the CareFusion product as the one endorsed by NQF.

Several recent articles (in Modern Healthcare, WBUR’s CommonHealth blog, and ProPublica) have described the relationships between Denham’s companies and NQF in more detail; the chronology is well summarized by Roy Poses on his Health Care Renewal blog. Despite Denham’s protestation, I can’t come up with any other interpretation than that he was being paid by at least one company (CareFusion) to infiltrate at least one (NQF) and potentially other patient safety organizations (he also chaired an influential committee of the Leapfrog Group – he resigned from it earlier today – and has collaborated with the World Health Organization) and influence their work on behalf of corporate sponsors, while withholding information about these corporate links.

And CareFusion was far from TMIT’s only corporate partner. Here’s another, from TMIT’s website: “The documentary Surfing the Healthcare Tsunami: Bring Your Best Board was partially funded by General Electric Corporation and the Denham Family Fund with some in-kind support by HCC Corporation, an affiliate of TMIT that is a contractor to General Electric.” Interesting.

The NQF, whose CEO is now Dr. Chris Cassel, who was CEO at ABIM when I was board chair last year, has approached this scandal as a mortal threat, which of course it is. Cassel is relatively new to the NQF (Denham was long gone by the time she assumed her role) and she and her senior staff are in crisis mode, pledging to review all of the Safe Practices and to markedly strengthen their conflict-of-interest policies. Cassel is not mincing words when she describes Denham: “He clearly lied,” she told Marshall Allen of ProPublica. “He just didn’t say anything about any of his business relationships.” According to the NQF, Denham was asked on several occasions about potential conflicts and never mentioned the multi-million dollar CareFusion contract.

It’s hard to protect our institutions completely against a lie. But in retrospect, all sorts of alarm bells should have gone off when it came to Chuck Denham. Who was this person, who seemingly came out of nowhere to a position atop the patient safety universe? Where did his resources come from? Why was he lobbying NQF for a particular product? Why was his company willing to donate what must have been hundreds of thousands of dollars of in-kind services to NQF? (According to ProPublica and confirmed by NQF, TMIT staffers conducted NQF evidence reviews and produced multimedia presentations on the Safe Practices.) “It was all a bit of a mystery to us that Chuck Denham was so generous with his time and his staff time to support this process,” Patrick Romano told ProPublica.

And I can’t help but wonder: What was the process by which the Journal of Patient Safety became yet another Denham franchise. To its credit, the journal has reportedly released Denham and installed the highly respected David Bates of Harvard as interim editor (he was associate editor). But the journal needs to go further, describing any financial relationship that might have existed between it and Denham or his companies.

What are the lessons from this sorry affair? For me, a personal one is to trust my spidey-sense: when something seems odd, nearly inexplicable, perhaps things really are not right. In Denham’s case, there’s a related lesson, reminiscent of a saying one frequently hears in Silicon Valley: if a product is being given to you for free, then there’s a good chance that you are the product.

Organizations like the NQF must have potent conflict-of-interest policies and enforce them strenuously. Though others may disagree, I don’t believe that individuals participating in such organizations need have absolutely no corporate ties – we’ll lose too many good people, and academic-industry partnerships can be good for patient safety. But these relationships have to be transparent and well structured. This means that the disclosure process must be rigorous and strictly enforced. Conflicts should be presented at the start of every committee meeting, and the culture has to be one in which individuals with even close call relationships err on the side of recusal, and colleagues feel comfortable “speaking up” when they’re concerned about potential conflicts. Would this have caught the Denham issue earlier? I’m not sure. But we must try.

As care standards increasingly drive payment and public reporting policies, and as electronic health records allow us to “hard wire” certain practice standards and monitor them in real time, the stakes will grow ever larger. Brian Johnson, publisher of Massdevice.com, told WBUR’s CommonHealth blog, “Large legal settlements involving kickback payments to doctors happen quite frequently. The Justice Department is very aggressive in prosecuting companies for kickbacks, off-label promotions, these types of alleged wrongdoings. This case is unique because in essence, it appears to be an attempt to influence an entire health care system by paying a key member of a very influential patient safety organization.” Such influence was never possible before. It is now.

This means that the fields of patient safety and quality are no longer sleepy mom-and-pop affairs fueled by the passion of a handful of true believers. There is now big money involved. “It’s an enormous business,” Pronovost told ProPublica’s Allen. “Hundreds of millions or billions of dollars are at stake, but our transparency procedures haven’t matured.” It is up to the field’s leaders to ensure that decisions are based on evidence, that our processes and structures are fair and transparent, and that individuals and organizations that violate the trust of our patients and clinicians are dealt with swiftly and sternly.

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Olympus Agrees to Pay $646 Million Fine for Kickback Violations In US and Latin America

 

Endoscopes distributor Olympus Corp of the Americas has agreed to pay a $623.2 million fine to settle criminal charges and civil claims related to the company’s illegal payment of kickbacks to doctors and hospitals. The settlement is the largest amount in United States history involving violations of the Anti-Kickback Statute by a medical device company. The company’s Latin American division will also pay $22.8 million to resolve criminal charges in Latin America.
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Supportability Forum Addresses Medical Device Maintenance and Repair

On November 2 and 3, a group of 30 industry leaders got together in Arlington, Virginia.  AAMI hosts (and footed a large part of the bill for) this meeting to bring manufacturers, HTM, ISOs, GPOs, regulators, and educators together to address the issues surrounding the practices of making medical equipment difficult (or expensive) to maintain for the owner of the equipment.  This is the first face-to-face meeting since the task force started at AAMI 2012 in Charlotte, NC.

More details will be forthcoming from AAMI, but in this blog, I want to recognize the outstanding manufacturers who are obviously enlightened and chose to be a part of this groundbreaking initiative.  The medical equipment manufacturers represented are:

Steris

Getinge

Medtronic

Philips

Baxter

I really want to hand it to these companies who are taking an active interest in making the active effort to evolve and do the right thing for healthcare by exploring more openness and transparency in their medical equipment life cycle service plans.

Patrick Lynch

Chief Do-Gooder

Biomeds Without Borders

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The 5 Most Overpaid Medtech CEOs

Public interest in ballooning CEO pay spiked recently, after the billionaire Republican presidential candidate Donald Trump called it “disgraceful” and “a total and complete joke.” Speaking to his populist base, he stressed the need for reinvigorating U.S. manufacturing but essentially argued that CEOs are already overpaid: “I know companies very well and the CEO puts in all his friends…and they get whatever they want you know because their friends love sitting on the board.”

Here at Qmed, we delved into corporate SEC filings to figure out which CEOs arguably get paid more than they should, comparing their pay to their company’s financial performance.

We ranked overall compensation for CEOs at 18 of the largest medical device companies publicly traded in the U.S. We then compared the compensation rank with a company performance ranking based on four factors: revenue growth, five-year stock performance compared to the S&P 500, earnings growth, and total revenue (as a control for size).

Here are the five CEOs whose compensation ranking was much larger than the company performance ranking .

1. Stephen MacMillan, Hologic

Compensation Rank: 4

Company Performance Rank: 18

Hologic provided MacMillan with generous awards to recruit him in December 2013, during the first quarter of Hologic’s fiscal year ended September 27, 2014. Much of the $24.5 million compensation the former Stryker CEO received came from $15.3 million in stock awards under MacMillan’s employment agreement.

It was slow going, however, under MacMillan’s initial leadership of the Bedford, MA–based diagnostic and medical imaging equipment maker. Revenue only grew 1.5% during the 2014 fiscal year, 14th among the 18 companies analyzed, and earnings of $17.3 million were less than 1% of revenue from the previous year—though it did mark a turnaround from the nearly $1.2 billion that Hologic lost during the 2013 fiscal year.

MacMillan, however, appears to be more than earning his keep this year. Hologic had the best performing stock among large medical device companies during the first nine months of 2015. Its stock value was up more than 45% during the time period. Hologic says it has been seeing accelerated adoption of its FDA-approved Genius 3D mammography systems. 3-D imaging is able to detect 41% more invasive cancers than standard 2-D imaging, according to Hologic.

2. Michael Mahoney, Boston Scientific

Compensation Rank: 11

Company Performance Rank: 16

While Michael Mahoney has helped turn around the performance of Boston Scientific, it comes as a cost. Mahoney is one of the best paid CEOs in the medical device industry. In 2014, he made $10,527,884—only slightly less than the tenth-highest paid medtech CEO Timothy Ring of C.R. Bard, who made $10,840,935.

Mahoney’s annual compensation has hovered in the $10–$12 million range since he took over the Boston Sci’s CEO post in late 2012.

In 2012, the Minneapolis/St. Paul Business Journal explained that Mahoney brought in nearly $12 million after working only 76 days after replacing retiring the then CEO Hank Kucheman. Most of the money from then until now comes from stock options.

For the company’s most recent fiscal year, he received total compensation of more than $10.5 million. Meanwhile, the company saw revenue grow 3.3% the same year, placing the company in the middle of the pack.

A person investing $100 in Boston Scientific stock at the end of 2009 would have had $147.22-worth of stock five years later—$57.92 less than if they had simply invested it in the S&P 500. It was one of the worst rankings for stock performance.

However, Boston Scientific stock has been showing improvement this year, up more than 26% in value for the first nine months of 2015. In fact, a report from Evaluate Medtech found that the company’s share price rose 34% in the first six months of the year—the biggest increase of any medtech company with $15 billion or more in revenue. Boston Scientific’s interventional cardiology business has played an important role helping to drive the company forward.

3. Miles White, Abbott Labs

Compensation Rank: 6

Company Performance Rank: 11

White’s $17.3 million in total compensation was actually down a bit during the fiscal year ended December 31, 2014; he received $20.9 million the year before. White’s option awards were valued at $4.6 million, a little more than half what he received the year before.

Company performance, however, does not seem to have kept up. Revenue was up only 3% during the year, and profits were down 11%. Abbott Labs comes in 11th for five-year stock performance compared to the S&P 500; it’s stock price was only slightly up during the first nine months of 2015.

4. Jeffrey Immelt, GE

Compensation Rank: 2

Company Performance Rank: 6

It makes sense that Immelt’s $37.3 million annual compensation would place him near the top of the list, especially since the industrial conglomerate General Electric is one of the largest companies in the world with $148.6 billion in annual revenues. Only $18.3 billion of that revenue came from GE Healthcare, but the amount still makes GE one of the largest medical device companies in the world.

Qmed controlled for revenue size in its company performance rankings, and yet GE still came in sixth. It was 13th for revenue growth and 13th for earnings growth, measured as a percentage of the previous year’s revenue.

GE Healthcare revenue in 2014 was only up 1%, to $18.3 billion, amid slow growth in developed markets outside the U.S.

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Dishonest Company from Colombia

 From Dotmed.com

September 15, 2015 06:19

If you receive an inquiry from a company Teknopolis in Bogota Colombia beware because it is a scam. They inquire about 3M Littman Stethoscopes and ask to pay with credit cards and ship next day. The person who will contact you is Wiston Tobon. Below find the info:

TEKNOPOLIS S.A
C.C. CALIMA
carrera 30 # 19 – 38 local 155
tel 57301 5394674
whatsapp 57300 2923659
Bogota Colombia
e_mail.teknopolisw@hotmail.com

Beware of these scammers!

Frank Bleischmidt

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BEWARE OF JOHN GEBHARDT- HEALTHCARE SYSTEMS


The following post was discovered on Dotmed.com as an advisory regarding some alleged dirty dealing regarding an PET/CT sale/purchase.   The original poster is iodentifieds at the end of this blog, if you wish further details.  Pat

BEWARE OF JOHN GEBHARDT- HEALTHCARE SYSTEMS

August 01, 2015 12:44

John Gebhardt signed a contract and agreed to sell us a PET/CT for $335,000.

We sent him a $51,367 deposit in January of this year and he disappeared refusing to answer emails or return phone calls.

Not only has he not returned our deposit but he was trying to sell the same unit to other dealers.

Be careful of him and John, if you see this, please return our deposit.

Nationwide Imaging Services Inc

Robert Manetta, Manager
DOTmed user since November 2012

2301 Atlantic Avenue
Manasquan, NJ 08736 USA
Phone: +1 (732) 262-3115
http://www.nationwideimaging.com

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Apple Doesn’t Want You To Be Able To Fix Your iPhone—Here’s Why

This applies to consumer goods from Apple, but it also applies to many medical devices.   Pat

 

The cure for planned Apple-escence

BY Kendra Pierre-Louis

 “It’s not just Apple,” says Gordon-Byrne. “Any manufacturer that doesn’t want to provide parts and tools can instantly, without any difficulty, refuse to repair equipment and say that your only choice is to buy a new product.”

Twenty-five years ago, my family’s television, a sturdy mass of wood and tubes, went on the fritz. The curved glass screen had taken to displaying everything from the Smurfs to Peter Jennings in shades of green. Shipping the massive box to the manufacturer was out of the question. Instead, a call to a local, independent repairperson was placed. For a fraction of the cost of replacement, he restored our set to its Technicolor glory.

Just 20 years later, when an errant elbow cracked my family’s three-year-old flat-screen, no repair calls were made. What was the point? Replacing it would be cheaper, so that TV joined the 41.8 million tons of e-waste discarded around the world in 2014— much of it toxic.

A generation ago, the idea of tossing out a broken television would have seemed wasteful, or just plain stupid. Conventional wisdom suggests that rapid advances in technology—your average smartphone, after all, has more computing power than NASA used for the original Apollo missions—combined with the declining costs of offshore labor, means the culture of repair is losing the free-market battle against cheap replacement costs. Right?

Wrong, says Gay Gordon-Byrne, executive director of the Digital Right to Repair Coalition. The coalition of tinkerers, used-equipment sellers, e-waste reduction groups and concerned individuals came together in 2013 to serve as the public voice on issues of the digital aftermarket: what we’re allowed— and increasingly not allowed—to do with our products.

“The lack of repairability is deliberate on the part of manufacturers,” says Gordon-Byrne. It takes proper construction to create devices that can be repaired, as well as basic support to allow those repairs to happen. Many items are unfixable by design, like Apple’s 2015 Retina Macbook, which uses proprietary screws, and solders and glues components in place. But many items could be repaired, with the right parts and knowledge. The local repairperson of my childhood was aided by manufacturers’ providing manuals and selling parts. Those are two things that, for the most part, no longer happen.

“Their business model now,” says Gordon-Byrne, “is: You ship the TV back to them. They fix it, but they charge you whatever they want. They don’t allow Mr. Bob’s TV repair to buy the parts, the tools, or to get the manuals.”

Companies often simply urge customers to purchase a new device. “I heard this story recently,” says Gordon-Byrne. “A teenager’s headphone jack on his iPhone didn’t work, so he took it to the Apple Store for repair. The store told him that his phone was off warranty and, regardless, they don’t repair headphone jacks.” Instead, he was given the option to trade in for a new phone at a hefty cost of $275. In this case he was lucky: The headphone jack is a common component across smartphones and can be purchased in bulk for as little as 10 cents. A tinkerer was able to fix the supposedly irreparable phone for $25. In 2014, however, new manufacturer guidelines released by Apple prompted rumors that the company may phase out this standard connector for its own proprietary “lightning” port. (Apple did not respond to a request for comment.)

“It’s not just Apple,” says Gordon-Byrne. “Any manufacturer that doesn’t want to provide parts and tools can instantly, without any difficulty, refuse to repair equipment and say that your only choice is to buy a new product.”

That doesn’t mean repair is impossible—just difficult. For parts, one must typically turn to Asian suppliers that skirt intellectual property laws and often lack quality control. For information, one must depend on individuals who dissect devices on YouTube and websites like iFixit, a crowdsourced part of the Right to Repair Coalition that provides instruction manuals and ranks products by ease of repair.

Increasingly, companies create barriers in the form of proprietary black box software. Gordon-Byrne tells the story of a woman with a broken refrigerator who was able to identify which part had broken, procure the digital part, and successfully replace it—despite a lack of official documentation—only to be stymied by the need for a reset code. The only way to get the code? Paying for a technician to come out and enter it. Gordon-Byrne calls such practices “abusive.”

 The tractor company John Deere has said that owning its products is little more than a license to use them. It argues that any modification of their software—say, to fix a broken harvester in a rural place where a technician may not arrive for days, but crops can spoil in hours—would violate copyright law.

Such policies mean that the next generation of engineers won’t be able to tinker as children without risking a lawsuit. Imagine if the Wright Brothers had been prevented from reengineering the bike.

In addition, the net result of such restrictions is higher repair costs, fewer jobs and more toxic waste. As of 2011, Americans were generating 3.4 million tons of electronic waste annually, 75 percent of which wound up in incinerators, according to the EPA. Electronic waste is a toxic stew of more than 1,000 materials. A typical tube television includes up to 8 pounds of lead, according to the Electronics TakeBack Coalition. Newer flat screens have less lead, but more mercury. These chemicals contaminate soil and drinking water. If burned, they foul the air.

Recycling is not the answer, either. We ship about 40 percent of electronics earmarked for recycling to countries like China, India, Ghana and Nigeria. Because so many electronics are not designed to be repaired, taking apart these products is hazardous. It frequently involves burning them or using corrosive acids to melt away the plastic and extract the gold, silver, copper and other precious metals that, combined with low wages, make electronics recycling profitable. In Xiejia, China, with more than 3,000 registered recycling businesses, the money comes at a cost: Lead levels in children’s bloodstreams have been high enough to cause irreversible brain damage.

In New York and Minnesota, the coalition has gotten legislation introduced—though not yet passed—that would require manufacturers to provide service information, security updates and replacement parts. It’s based on a Massachusetts auto repair bill, passed in 2012, that requires auto companies to standardize their diagnostic codes and repair data by 2018. The bills in New York and Minnesota, however, are more expansive, encompassing anything that contains a microchip, from medical equipment to tractors to cellphones.

“We’re losing jobs in the state of New York because these large corporations are mandating repair work be done by their own companies,” says Republican state Sen. Phil Boyle, who introduced the bill in New York. “The more vertical integration there is, the less free market there is. The small repair shop down the street needs to stay in business.”

Kendra Pierre-Louis

Kendra Pierre-Louis is a member of the Rural America In These Times’ Board of Editors. Kendra is a Queens, New York-based journalist. Her work has appeared in, Newsweek, Earth Island Journal and Modern Farmer. She is the author of Green Washed: Why We Can’t Buy Our Way to a Green Planet (Ig Publishing 2012).

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