EBME Forums Forums Free discussion Free discussion life duration of medical devices in a medical emergency unit

Hello,

i am presently working as a biomedical engineer in a medical emergency unit for the fire department of isere. would you know if there are similar positions in england?
I would be very interested to share experiences
and am looking for assesmment of the average life duration of medical devices such as monitoring units, defibrillators, ECG and so on. All of these itemps working in mobile units( ambulances).

Thanks for your answers.

In the UK, Ambulance Services are run entirely separately from Fire Services. As far as I know no ambulance service in the UK employ EBME technicians directly but have a contract with the EBME department at the nearest major hospital, eg Lincolnshire Ambulance have a contract with Lincoln Clinical Engineering to maintain their defibs, pulse oximeters and sphygmomanometers. I personally do a lot of the PPM work on Lincs ambulance gear. If you have any specific questions - I may be able to answer them ( within reason ) but I don't want to breach confidentiallity as far as the contractual relationship between Lincs Amb and Lincoln CEng is concerned.

Hello Philippe, and welcome to the forum. As Jonathan points out, things are done a little differently in the UK. But, of course, the fact remains that the equipment still has to be maintained. I would say that Fire Service medical equipment is likely to be “heavily used”, and would suggest a reduction of planned life by 50% (as compared to “normal” hospital use). Ten years tops, I would have thought. Personally, I would put greatest emphasis in asserting the actual condition of the equipment during inspection/PM which, I would suggest, should be carried out at least every six-months (quarterly would be better) for life-saving equipment of this type.

I once came across a trio of ambulances in supposed “front-line service” (not in the UK, I hasten to add) in which all defibs failed to light up (dead batteries, of course), and oxygen cylinders were empty in all the gas-powered resuscitation outfits. Obviously, then, we should not rely too heavily on “user checks”!

Dear Phil

I have never worked with ambulance or fire equipment so can only give an educated estimate.

The roughest usage medical devices get in hospitals is usually in the Accident & Emergency department. That's where "crash" trolleys really crash! (I once went to test a "broken" defibrillator & found a crash trolley shaped hole in a partition wall. It was just like Tom & Jerry. The staff complained the trolley "had no brakes".)
Some A & E staff believe an ECG machine is a device made for knocking a swing door open when a major trauma comes in.

Case parts can be replaced with relative ease and at reasonable cost, but I've found that in general items can only be expected to last about 8 years in the A & E environment before the accumulated punishment begins to take a toll on the internals of machines and then it all becomes very expensive.

Consequently I would expect ambulance & fire service equipment to last about 6 years before it becomes a liability.

In military applications the standard of equipment build is on an entirely different level and stuff is expected to get thrown, splattered with mud, cooked & frozen.

Unfortunately despite their ridiculous cost and critical application medical devices are generally far too lightly built for longterm reliable transport / roadside use.

Marc

Phil,

As part of my remit in the Armed forces I look after all the south west Search and Rescue helicopter emergency equipment and all the airfield fire stations and ambulance equipment.

Quick one for Marcel Eve, medical equipment in use with the Armed Forces is exactly the same as the stuff in use in the NHS, as is all the equipment we use on operations overseas or at sea. The emphasis is very much upon the Biomedical Engineer to ensure that equipment "survives" the environments that is was very much not designed to be used in, and to that end the life expectancy is not normally more than 5 years, although this very much depends on who's paying the bill for the replacements and what's going on in the military environment (i.e. January 2003 I got in excess on £1M of equipment in one splash for use in a front line field hospital - S/5s, Zolls etc etc). If only the training budget was so lavish!

Richie.

From my experience looking after Lincs Amb equipment, the crews always took good care of their gear since there is no spare gear available in the middle of a field! So their equipment have lasted nearly 10 years including defibs!

Life duration of medical devices - seems like such a simple question. However, many factors need to be taken into consideration:

1. Can you still get spares? - If the device is no longer supported by the manufacturer, then its life is about to end.

2. Is it still clinically current? - AED's & biphasic defibs are the latest "trend". Resus Policy may also dictate a change in technology.

3.PPM's/Breakdowns? - Do you experience lots of problems when performing PPM? Is the device unreliable?

4. Usage? - Heavy usage may indicate a shorter life expectancy, however regular usage may lead to a longer life. Which one of these 2 similar camps does your equipment fall into? In a hospital it is possible to rotate the defib from a heavily used emergency department to a quieter ward environment.

Being a professional who possesses experience you can take into account the above factors (& the many others that I couldn't think of at short notice) & use your professional judgement guided by information relating to failure rate etc to determine the useful life of devices.


We had some defibs here many years ago that were used both by the Trust & the ambulance service that were 22 years old!! They performed well, were reliable, & we could still get the spares. However, I do not feel that this is the norm with most devices, especially nowadays - obsolescence of technology seems to be the overriding factor.

The following can be applied to determine when equipment has reached the end of it's life:

Worn out, beyond economical repair (Estimate for repair cost attached)

Damaged, beyond economical repair (Estimate for repair cost attached)

Unreliable (Service history report attached)

Clinical or technically obsolete (report attached)

Spare parts no longer available (Supplier’s statement attached)

More cost-effective or clinically effective device has become available (report attached)

Unable to clean effectively prior to disinfection and/or sterilisation (report attached)

Hi Folks,

To add more feathers to the hat, I would like to share my experience with you by saying that general trend for life time of medical equipment is between 7 - 10 years. Again, class and type of equipment are considered while making such derivation. Critical care equipment, anesthesia equipment and OR equipment are slated for 7 years and rest of them fall within the range. Manufacturers make equipment obsolete for various reasons to sustain in the market due to technological advances, competition and the like and stop production initially and support spare parts for 7 years before they wind up complete support for any given obsolete product. Having worked both in medical equipment companies and hospitals, I could make such differentiations. As explained very well by others that there are a lot of factors which come into picture before we make decision to condemn/ make medical equipment obsolete in a healthcare environment. Cost, usage, technically and clinically unaccepted, better technology equipment, depreciation, cost Vs benefit, risk of using the equipment, etc. We enter 10 years by default on our dbase for all medical equipment and analyse and monitor case by case basis.

Hope this helps.

Hi folks,
As an aside to the issue of spare parts, I copy this from Actameds parent company in America.
. . . . . . . . . . . . . . . . .
Dear Mr. Millitt:

Thank you for your recent inquiry with Actamed Limited regarding the Pre-Purchasing Questionnaire. From my understanding, you have a question about section 10 on the form as to why we have not provided a time period for guaranteeing spare parts availability and I wish to explain why.

As you may be aware, medical devices in the United Kingdom are regulated by the European Medical Device Directive 93/42/EEC. Under the guidelines of this directive, there are no defined requirements for providing spare parts for a set period of time after the manufactured date nor are there requirements for providing or guaranteeing spare parts. Since there are no defined requirements within the directive, we as a manufacturer are not obligated to define a set period for spare parts availability. We have typically handled the issue of spare parts availability through warranty terms, service contracts or general business terms within contract negotiation and tenders.

While the Medical Device Directive does not require guaranteeing spare parts, it is my understanding that there may be a national regulation or hospital specific guideline that dictates spare parts availability in the UK. Arizant Healthcare and Actamed are interested in learning more about any specific guidelines that cover spare parts requirements. With this in mind, we would like to request if you could please provide us with the name of the guidance document that defines spare parts requirements and how we may obtain it for further review. If you have this document, could you please send it to my attention? We would like to understand your need and how we can best meet it. By doing so, we can resolve this issue to our mutual benefit.

If you believe there is additional information related to this issue that may be relevant for us to be aware of, please feel free to provide us with that information as well.

I look forward to your cooperation.
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Any comments would be welcome, Pete