Category Archives: Information

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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Apple Watch is Based on “Planned Obsolescence”

Company breaks open Apple Watch to discover what it says is ‘planned obsolescence’

Tech website iFixit found that Apple had ensured that the technology would eventually fall out of use, forcing customers to buy new products

Jamie Campbell

Saturday 25 April 2015

Tech repair and upgrade website iFixit has claimed that the Apple Watch won’t be a long term option for those hoping to continually upgrade their device.

CEO Kyle Wiens has always been a vocal critic of Apple’s obstructive policies on third parties fixing and upgrading iOS devices and his company provide an online “free repair guide for everything” where methods to repair or improve electronic devices are posted.

Upon the release of the Apple Watch, Wiens’ company immediately got down to the business of (iBuffs look away now) tearing the brand new product open and evaluating it from the inside.

Their prying work has discovered that the “overall device construction limits further repair options”.

“The S1 SiP [internal system in package] is encased in resin, and is further held in place by a mess of glue and soldered ribbon connectors. In short, basic component replacements look nearly impossible.”

The s1SiP is custom-designed Apple technology that integrates a number of subsystems like the chip into one package. It is encased in resin to increase its durability.

Read more:
iFixit: A million little pieces
Apple watch goes on sale
Apple watch: First version unlikely to be a measure of success

Therefore, according to iFixit, the Apple Watch has intentional obsolescence built into it as it will become technologically redundant as processors become faster and apps are supported only by the newest models.

This tactic is known as ‘planned obsolescence’ and has been an accusation levelled at Apple for a number of years.

The current operating system for iPhones, for example, only supports some of the newer models and it appears that the Apple Watch will find itself in a similar position.

This revelation may trouble users, who will have paid £479 for the standard model or even up to £9,500 if they bought the 18-Carat Rose Gold Case edition.

The exploratory work by iFixit revealed that the device includes a 2-5mAh battery, compared to a 300mAh battery found in competing devices, like the Motorola Moto 360 and Samsung Gear Live. The device also includes an ARM Cortex mj3-based touchscreen controller.

The research also interestingly found that, although Apple has promoted the device’s heart rate monitoring feature, it is actually bundled with a plethysmograph that could act as a pulse oximeter. This could allow users to measure their own blood oxygen levels.

Apple has never commented on claims that this is policy that they pursue.

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Are Your Emails Enforceable Contracts?

According to this article from Forbes, email promises are legal.  If your medical equipment salesperson promises something, you can use the email to enforce the delivery of the promise….  Pat

Many people consider email to be an informal form of communication. As a result, offers, counter-offers and terms of proposed agreements are frequently exchanged via email with the hope and expectation that they are for negotiation purposes only. The question is, could such email messages be deemed to be legal, valid and binding agreements that are enforceable against senders in accordance with their terms? The New York Appellate Division in the recent case of Forcelli v Gelco provides some important guidance regarding the answer to this question.

Appellate Division of the New York State Supre...New York Appellate Division  (Photo credit: Wikipedia)

Background

In November 2008, Steven Kuhn drove through a red light and struck a vehicle owned by Gelco Corporation. As a result of the impact, Gelco’s vehicle was thrust forward into a vehicle driven by John Forcelli. A month later, to recover damages for his injuries, Forcelli commenced litigation against Kuhn, Gelco and other related parties.

In May 2011, while the civil procedure of the litigation progressed, Brenda Greene, a representative of Gelco’s insurer, who previously told Forcelli’s counsel that she had authority to settle the case on behalf of Gelco, offered $230,000 to settle the case on behalf of Gelco. Forcelli’s counsel orally accepted the offer on behalf of Forcelli. That same day, Greene sent an email message to Forcelli’s counsel stating the following:

Per our phone conversation today, May 3, 2011, you accepted my offer of $230,000 to settle this case. Please have your client executed [sic] the attached Medicare form as no settlement check can be issued without this form. You also agreed to prepare the release. . .Please forward the release and dismissal for my review. Thanks Brenda Greene.

The next day, Forcelli signed a release, notarized by his counsel, stating that he was releasing Gelco from all actions involving the accident in exchange for $230,000. However, just a few days later, on May 10, 2011, the New York Supreme Court (i.e., the trial-level court) issued an order granting a motion for summary judgment in favor of Gelco and dismissing Forcelli’s complaint and all claims asserted against Gelco. Gelco tried to reject the settlement claiming the email message did not constitute a binding written settlement agreement. However, the Supreme Court ruled against Gelco and entered a judgment ordering Gelco to pay Forcelli $230,000. In response, Gelco appealed to the New York Appellate Division.

The Decision

The Appellate Division unanimously upheld the decision of the lower court noting that, in accordance with general contract law, Greene had apparent authority to settle the case on behalf of Gelco, and her email message set forth the material terms of the agreement, contained an expression of mutual assent and was not subject to any conditions such as the outcome of the summary judgment motion. As to whether the email was a subscribed writing sufficient to establish an enforceable settlement agreement, the Appellate Division stated: “given the now widespread use of email as a form of written communication in both personal and business affairs, it would be unreasonable to conclude that email messages are incapable of conforming to the criteria of [New York law] simply because they cannot be physically signed in a traditional fashion.” The Appellate Division focused on the sign-off “Thanks Brenda Greene” at the end of the email concluding it evidenced a “purposeful” signature of the message that is consistent with the reasoning and intent of New York’s Electronic Signatures and Records Act (i.e., the New York version of the Uniform Electronic Transactions Act which governs the validity of electronic contracts and signatures).

Elaine and Karen Mills at 2013 contract signingContract signing (Photo credit: AFGE)

The Lesson For Contracting Parties

This case is a wake-up call to contracting parties to avoid casually negotiating the terms of proposed agreements via email without taking appropriate precautions to avoid having messages unintentionally deemed enforceable and becoming bound by unwanted agreements. In particular, offers, counter-offers and terms of proposed agreements communicated via email should explicitly state that they are subject to any relevant conditions, as well as to the further review and comment of the sender’s clients and/or colleagues. Further, such communications should include appropriate disclaimers such as that the email is not an offer capable of acceptance, does not evidence an intention to enter into an agreement, has no operative effect until a definitive agreement is signed in writing by both parties, and that no party should act in reliance on the email or any representations of the sender until a definitive agreement is signed in writing by both parties. Doing so would help avoid having messages sent for negotiation purposes only unexpectedly become enforceable agreements.

Oliver Herzfeld is the Chief Legal Officer at Beanstalk, a leading global brand licensing agency and part of the Diversified Agency Services division of Omnicom Group.

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HP Fined $3 Million For Misleading Consumers About Their Rights

HP Fined $3 Million For Misleading Consumers About Their Rights

If any business thinks the Australian Competition and Consumer Commission (ACCC) doesn’t take Australian consumer protection seriously, take note of this: the regulator has just fined HP $3 million for misleading consumers over their warranty rights.

Money picture from Shutterstock

The ACCC announced today it had reached an agreed settlement with HP over the case, after launching legal action last October. The behaviour which HP admitted to included:

  • the remedies available to consumers were limited to the remedies available at HP’s discretion;
  • consumers were required to have their product repaired multiple times before they were entitled to a replacement;
  • the warranty period for HP products was limited to a specified express warranty period;
  • consumers were required to pay for remedies outside the express warranty period; and
  • products purchased online could only be returned to HP at HP’s sole discretion.

Under Australian law, all consumers have a right to choose the remedy they want (refund, repair or replacement) in the event of a major flaw, manufacturers can’t unreasonably limit the period a warranty applies for, and consumers don’t have to bear the cost of return if a warranty repair is required. Anyone selling stuff in Australia, take note.

HP issued an apology following the announcement:

We deeply regret that in the instances identified by the ACCC, HP fell short of our core commitment to high standards of service for Australian consumers who purchased our HP-branded desktop computers, notebooks/laptops and printers and of our duties under Australian consumer laws . . . We will provide customer support to assist consumers in resolving concerns with HP products in accordance with the Australian Consumer Law and have established a specific consumer redress program (involving a customer contact centre) to help with past concerns relating to HP-branded desktop computers, notebooks/laptops and printers.

Consumers who purchased goods from HP and feel their warranty rights were misrepresented should contact the company to seek compensation. (There’s also a special email address, consumerclaimsau@hp.com.)

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Are OEM Parts Better than Parts from Elsewhere?

A recent ad in 24×7 Magazine suggests that only Siemens sells real OEM (original equipment manufacturer) parts.   This ad (at the end of this article) is very misleading, as it is intended to be.  Everybody sells original OEM parts.  No one but the OEM make parts for medical equipment.  There is a thriving alternate source for medical equipment components, circuit boards and other parts that break.  The reason that this market exists is because other companies besides the original OEM can repair and resell parts much more inexpensively than the OEM can.

Oh, and another thing – many OEMs would have you believe that the parts they sell are brand new, unlike the old, traded-in parts that other companies would sell you.  Well, not true.  Why do you think that everybody (including the OEMs) require a trade-in of the broken part when you buy a replacement part?  It is so they can repair and resell it, just like the third party independents do.

I know of a hospital system in Milwaukee that tracked out-of-the-box failures of newly received medical parts.  The OEMs parts failed at a higher rate than those parts received from alternate sources.

And let me tell you about the claim of savings of “up to 40%”.  “Up to” means that all parts are not included at the maximum discount.   Additionally, the 40% refers to 40% from the original price of the part – the suggested retail price.  Every biomed and clinical engineer in the US knows that 40% off of list is nothing.  Real OEM parts can be found from many sources at discounts far exceeding the 40% advertised in this ad.

The real message here is that advertisements are full of misleading information.  You have to read everything with a skepticism born of experience.    Have a wonderful day.    Pat

Siemens Ad

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Frank’s Hospital Workshop – Free manuals and education

‘ In some developing countries, up to 50% of the medical equipment is unusable at any given time. In some hospitals, up to 80% of their medical equipment is inoperative… ‘
(World Health Organization, WHO)

Preface
The last ten years I have worked as a biomedical technician, consultant and trainer in five diverse developing countries. All these countries were very different, but the problems in the hospital workshops were similar:

 no spare parts for repairs and maintenance
 no technical manuals
 poorly or no trained biomedical technicians
 no (financial) support by the responsible authorities
 no technical support from the manufacturers
 lack of awareness of the advantages of preventive maintenance

Appropriate training for hospital technicians and simple equipment for hospital workshops would improve the situation easily. But unfortunately most countries still have not recognized the importance of the repair and preventive maintenance of hospital equipment.

I hope that this website can be a little support to all biomedical technicians in developing countries.
Here you find:

 all the documents about biomedical technology I have collected
 all the user and service manuals I have
 all training courses that I have developed and have held

About this site
http://www.frankshospitalworkshop.com is a private and noncommercial website which can be used for self-study. It is a collection of documents, experiences, best-practice procedures and teaching and learning materials about biomedical technology.

Acknowledgement and apologies
Thank you to all who actively support my website by providing documents and information. Special thanks to all the companies who allowed me to provide their equipment manuals. To those companies who do not want their documents to be made public I apologize and I will delete the material immediately upon request.

‘ On the average almost 80% of the medical equipment in government hospitals are not functioning and the number even reaches 98% in dispensaries in some regions. ‘

(Ministry of Health, Tanzania, 2008)

With greetings from Tanzania
Moshi, March 2013

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Intuitive Surgical (DaVinci) – unnecessarily adding cost to healthcare

Fool me once, shame on you; fool me twice, shame on me

The people at Intuitive Surgical, the folks who made a fortune by marketing robotic prostate surgery to men across America, can’t be having much fun right now.  They have been hoping to expand their business in obstetrics and gynecology.  But look at these comments by James T. Breeden, president of ACOG:

Many women today are hearing about the claimed advantages of robotic surgery for hysterectomy, thanks to widespread marketing and advertising. Robotic surgery is not the only or the best minimally invasive approach for hysterectomy. Nor is it the most cost-efficient. It is important to separate the marketing hype from the reality when considering the best surgical approach for hysterectomies.

Robotic hysterectomy generally provides women with a shorter hospitalization, less discomfort, and a faster return to full recovery compared with the traditional total abdominal hysterectomy (TAH) which requires a large incision. However, both vaginal and laparoscopic approaches also require fewer days of hospitalization and a far shorter recovery than TAH. These two established methods also have proven track records for outstanding patient outcomes and cost efficiencies.

At a time when there is a demand for more fiscal responsibility and transparency in health care, the use of expensive medical technology should be questioned when less-costly alternatives provide equal or better patient outcomes. 

At a price of more than $1.7 million per robot, $125,000 in annual maintenance costs, and up to $2,000 per surgery for the cost of single-use instruments, robotic surgery is the most expensive approach. A recent Journal of the American Medical Association study found that the percentage of hysterectomies performed robotically has jumped from less than 0.5% to nearly 10% over the past three years. A study of over 264,000 hysterectomy patients in 441 hospitals also found that robotics added an average of $2,000 per procedure without any demonstrable benefit.  

[A]n estimated $960 million to $1.9 billion will be added to the health care system if robotic surgery is used for all hysterectomies each year.

Aggressive direct-to-consumer marketing of the latest medical technologies may mislead the public into believing that they are the best choice. Our patients deserve and need factual information about all of their treatment options, including costs, so that they can make truly informed health care decisions. Patients should be advised that robotic hysterectomy is best used for unusual and complex clinical conditions in which improved outcomes over standard minimally invasive approaches have been demonstrated.

The stock market seems to be noticing:

6 comments:

nana said…

I remember when you were agonizing over whether/having to invest in robotic prostate equipment at the hospital because it was “all the rage” and the men would demand it and go elsewhere if not provided. Wonder if the outcomes are the same.

March 14, 2013 10:48 PM

e-Patient Dave deBronkart said…

From Facebook:

My extremely awesome urologist/surgeon Drew Wagner, who removed my kidney and adrenal gland laparoscopically *with bare hands*, says he does use robots sometimes. They’re extremely precise, not shaky, etc, for very fine work. The problem as Paul’s wording suggests, is that their marketing *increases* the amount of surgery, instead of just improving the quality of existing surgery. And since all surgery involves risk of harm, such marketing causes harm, IMO.

March 15, 2013 7:16 AM

Bill Reenstra said…

From Facebook:

It is my understanding that robotic procedures are always longer than comparable human (non-robotic) procedures. This increases the risk of infection of the open incision and risks associated with anesthesia.

March 15, 2013 7:17 AM

Beverly H Rogers said…

From Facebook:

Not only that you’ve got the learning curve for the surgeons learning to use the robot. Laparoscopic gyn surgery has been around for a long time.

March 15, 2013 7:17 AM

Barry Carol said…

This is another classic example of why doctors need to embrace knowing and caring about costs as an important part of their job. We need robust, user friendly price and quality transparency tools to help them do that with as little incremental demand on their time as possible.

March 15, 2013 7:43 AM

Jesse said…

Too bad unnecessary robotic surgery is not part of the choosing wisely campaign. Given the track record with Prostate surgery this (hysterectomy by robot) may become the norm as people vote with their feet based on the marketing hype. At our hospital we lost nearly all our prostatectomies to other institutions when we decided not to get a robot because there was no proven clinical advantage. Plus more and more residents are being trained primarily on the robot so if you don’t have one it becomes harder to recruit surgeons. Needless to say we now own a robot for surgeries.

March 15, 2013 8:05 AM

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