EBME Forums Forums Maintenance Technical Assistance When do you decide a unit must be switched out?

When do you decide a unit must be switched out? I am an employee of a medical devices company and we have a diathermy device that in all honesty as long as it is taken care of will go on for at least 10 years. We have been asked by some hospitals what the lifespan of the product is, when should they replace it?

Obviously our company would like it if a new unit was purchased on a more regular basis and shorter time period as we would make more money. e.g. new unit every 5 years rather than a view of if it is properly maintained and is functioning safely then it doesn't need to be switched for potentially twice that amount of time, especially if it still works and does so safely.

Has anyone come across a situation where they are being encouraged to switch out units due to their age alone despite still being fit for purpose? Is so, how did they handle it and what were the biggest obstacles they faced? I'm loathed to put my name to anything which says a unit must be changed after a certain time for any reason if I am sure that with proper care and maintenance it will be fine for a longer period of time.

You have to take into consideration changes to medical practices and the introduction of different consultants year on year.

It has to also be considered that a life cyle can be costed (not that it is done in most circumstances), cost per treatment, down time for maintenance, cost of service parts, specialist service equipment, specialist software.

At the end of the day if some thing is costing a fortune to keep going and use, then it has to be replaced.

So in total it is all really down to cost.

Ten years is our usual term.

Hello

We have an Eschmann DS301 from 1981 sat in Obstetric theatre as backup.

I will not be removing it from service; it still works to its' original specification, consumables are available and it hasn't gone wrong in over 20 years.

However I will happily support the clinical staff when they say this equipment is not up to date, cannot do what modern diathermies do, and should be replaced.

Lee

We have a notional 7 year replacement programme, but use things for longer if there's no reason to replace them.

Seven years is I suppose the least we expect, to get our money's worth and keep the accountants happy. After that, it's down to whether the thing can still be serviced, and whether new, better technology is available.

In "proper" Maintenance Management records are kept of all maintenance activity, and all new work is costed (cost forecasted).

Then we have the well-known (we hope) concept of "Beyond Economic Repair" (BER). That is, the sad point in the life of a piece of equipment when any further expenditure on it is deemed to be uneconomic (that is, unjustifiable from the bean-counting point of view).

I have always used 60% as the magic BER level (or trigger point). That is, once accumulated maintenance expenditure on an item exceeds (or is set to exceed) 60% of the cost of buying a new one.

So two figures need to be known:-

1) Accumulated maintenance expenditure
2) Cost of like-for-like replacement

In my experience this state of affairs is rarely actually reached for (what I call) decent* kit. In fact, life-times in excess of twenty years are achievable for well-maintained equipment. And that has always been my default "planned equipment lifetime":- twenty years.

Any decent Maintenance Management (computer) System will also be able to forecast the anticipated "BER Date" based upon historic maintenance expenditure on each item.

But (as Billy has mentioned) perfectly good - from the engineering point of view - is often scrapped for what we might call "clinical reasons". That is, because some Consultant or other has been shown the latest wussorama "must have" piece of kit.

Personally, I don't mind "progress" like that, just as long as the medics condemn the equipment themselves, rather than bringing pressure to bear on the biomed(s) to do the dirty deed for them.

* Well designed, quality medical equipment, such as that typically found in operating theatres; and imaging equipment, most laboratory equipment and the like (rather than the plastic junk that often passes for medical equipment out on the Wards).

If you are a supplier then you should be saying at least 5 years from last production of the device, this should tie in with the availability of spares. We wouldn't replace a device if you can still purchase it on the open market

obviously if it's old and fails regularly then get rid, but diathermy rarely falls into this category unless made by a particular supplier

See also this thread on spare parts availability.

When do you replace something?
Either the technology is too old to be useful - when that is depends on an opinion of a clinician (i.e. what new toys their friends have, or what they saw at a show) or the thing no longer works or cannot be supported. You cannot put a date on this as it varies widely from device type to device type.
Robert

But you can put an anticipated retirement date on every piece of kit. Or at least make an estimate (during acceptance and commissioning) of the likely life in service for each equipment type.

And don't forget that overall condition is (or should be) assessed and recorded at each PM visit. Unpleasant surprises can be largely avoided if the inventory is properly managed and maintained.

I would have thought that ten years (fifteen, perhaps) would be a reasonable planned lifetime for electrosurgical units. After that (as has been mentioned) it would be time to consider looking around for a replacement.

In a word:- planning. That's what databases are for.

Geoff comments about database use...
Equipment purchase cost can be included & then use depreciation (used 7%) as a baseline, but this could be adjusted, library equipment had a higher %, specialist kit with a lower use level a lower %. The BER was set at 70% for devices as a default, again it could be adjusted. A background script ran each time a maintenance/repair was performed for a device - print a list...

Example, kit £10,000 @ 7%; ~14.5 year life or operational life to a £7,000 cost - requires good evauation of kit prior to purchase...

Yes. I reckon that these four are the figures that always need to be available for each piece of kit:-

1) Purchase cost
2) Estimated current market value
3) Cumulative maintenance expenditure
4) Cost of like-for-like replacement

But I agree that item 2) presents a bit of a "problem" as someone would need to actually estimate it and enter the figure from time to time.

So your comment about depreciation is ... er, appreciated as it presents the possibility of automatically re-evaluating the current value based upon the initial purchase and then depreciation per annum. Nice one!

Yes. I have heard 7% being mentioned before. So I'll get on it straight away! But as a strictly "nerdy" point:- should we also factor-in annual inflation (ie, the falling value of money in real terms)? That way we could automatically keep on top of an estimated cost of replacement as well.

I note your comment about the BER level of 70%. But am I right in assuming that you're basing that solely on depreciation over passage of time (the years taken for the item to fall to 30% of its original cost); rather that accumulated maintenance expenditure? If so, I would argue that is a "consider for replacement" indicator, rather than "beyond economic repair" per se. Otherwise I can't immediately see how you arrived at fourteen plus years.

Meanwhile, it would be interesting to hear what figures others use.