EBME Forums Forums Management Medical Equipment Management obsolescence guides

Hi everyone. I am new to the field and to this group. Just took a job as biomedical engineering manager less than a month ago.

I have read somewhere that there is an American Hospital Association Guide on the approved life of different biomedical devices. However, I couldn't find that guide.

Is there any standard that, for example, prevents the use of a CT more than 10 years old? or a fibroscope more than 20 years old?

Welcome to the forum, Gustavo.

Here's one from 2004.

Also, you may find this site* to be a useful reference when deciding upon equipment status as you review your equipment dependency (inventory of maintainable items).

Note that the UMDNS codes at the first link and the Type Codes at the second should correspond (more or less) - as both appear to stem from the old ECRI codes.

In my experience, medical equipment gets replaced when it becomes unreliable, or (more often) unwanted - by the medics. Unless, of course, you work for a private hospital owned by a wealthy benefactor, or perhaps one influenced by pushy surgeons or other specialists - then the "latest" gear often turns up (and older kit can be let go - sometimes well before any planned lifetime has expired).

Equipment in government hospitals (or better still, charity-based organisations) tends to stay in beneficial use until parts (or more likely, biomed man-hours) are no longer available. On a personal note, it's situations like that that I "enjoyed" the most.

Good Luck with your new job.

* Posted by a forum member in Malaysia - and therefore most pertinent to that part of the world - but still very useful as a starting point for building (and maintaining) a similar database focused on your own area.

That was incredibly useful. Thank you very much.

There is a wealth of good information at the HTMC site (which is maintained by some well-known - and prolific - biomeds in the USA). I would point you especially towards the "Database Tables".

Meanwhile, if you can provide an email address (include in your Profile, for example), I can send you some other files (.pdf, .xls) that may help when making your plans.

End of life for Lorad Mammo
https://mega.nz/file/nY8EGZYJ#DH3hYaPIBKxyB34sD-o1BKT4Y0PRrXwutqXzGux41lk

End of Support /EOL X Ray Siemens
https://mega.nz/file/bUtkhLgQ#4mqCFYK5ACXk2km7iwHAoyJRcMkC5RYMQaWuO0JD1P8

LIFECYCLE GUIDANCE
FOR MEDICAL IMAGING EQUIPMENT IN CANADA
https://mega.nz/file/bQsSlbha#YtpgWoxtjuUBLR4bSddJ9Ux-J-F7SkPF91VkfL0FrPg

Interesting. Thanks for sharing, Pablo.

I notice a useful chart at Appendix 3 at your third link:- "2013 Life Expectancy Guide Compared with Other Guidelines". It displays life expectancy for common imaging equipment according to various sources.

To my mind, those life expectancy years are a little on the low side. For instance, it seems that the US Army only expects an MRI Scanner to last five years.

The table on page 13 is also interesting, as it indicates life expectancies set against equipment utilisation (number of patient examinations, etc.).

The trade organisation COCIR have a guide to Medical Imaging Equipment Age Profile & Density that has recommendations for the age of medical imaging equipment.

Aha - the famous "Golden Rules". But what are these based on? Apart from wishful thinking, or (more likely) anticipated new equipment sales, that is

They mention "obsolete" but do not offer any definition of that word.

Otherwise, yes, that's an interesting document, and worthy of adding to our list of references. The figures for density (the number of systems in use per million inhabitants) for various countries are worthy of study.

This is the quote I like the best (regarding MRI in this case):-
Read into that whatever you like.

The "Golden Rules" are not just plucked out of thin air.

They are based on multiple considerations, including the regulatory requirements to specify a design life for the product (see medical device regulations) and the current "state of the art". For example an X-ray system form 10-years ago will require a higher dose rate to get same image quality than a current system using considerably less dose can achieve. The images from an MRI scanner that is 15 years old are simply terrible by comparison to a current system, similar for a CT.

Given a growing number of medical devices are software based and network connected (Ethernet, Bluetooth, etc.), once the manufacturers support has ended (typically after 10-years) they will be vulnerable to cybersecurity issues, and therefore unsafe.

Just because you can keep something working does not mean it is as safe, reliable, or clinically effective as a new "state of the art" device! The COCIR "Golden Rules" are therefore a very good guide.

All good points. But it may be worth mentioning in passing how few (according to charts in the report cited) areas of the world have met the "Golden Rules" - many failing to do so by quite a wide margin.

To my mind that indicates that - perhaps - the Rules are a bit on the optimistic side.

In the Real World (including that of Private Hospitals, hospitals in the "Developing World" and what-have-you), other factors weigh heavily when decisions are made about replacing capital equipment. For instance, the availability (or otherwise) of large amounts of money, and the ongoing serviceability (or otherwise) of existing equipment. Sometimes it may be deemed more prudent simply to carry on on supporting (servicing, repairing - or even upgrading) old equipment whilst saving-up (hopefully) for the latest innovations.

Don't forget also that in some parts of the world the latest "high tech" systems may not actually be appropriate (for all of the reasons that we may guess at). I have worked on old systems (Happy Days) that were more or less indestructible (they were repairable "in the field", and laptops - and the internet - had yet to be invented) - whilst noticing modern systems that (whilst generally looking very nice) did not appear to be actually "built to last".

Meanwhile, I am interested in the matter of x-ray exposure dose. Myself, I doubt that dose for equivalent examinations have decreased that much over the last ten, twenty (or perhaps even thirty) years. I know that early CT blasted out hefty doses of the "magic rays", but I reckon they improved quite quickly (maybe as far back as thirty years ago). But I am more interested in traditional (conventional) radiography (the sort of thing that Dr.Röntgen would instantly recognise). Does anyone have any documentation (charts etc.) about exposure dose-rates over the years?

In my experience, the highest risk of unnecessary patients doses arose from "repeat" exposures due (in the main) to what we might call "operator error" (bad patient positioning, incorrect selection of factors, etc.).

Aren't we really talking about the welcome change from film cassettes (and wet-processing) to Computerised Radiography? And won't most (almost all) exposures these days be terminated by AEC techniques such as (Siemens) Iontomat? Has anyone we know had a go at retro-fitting CR to old x-ray systems? Was it a cost-effective solution? And (perhaps most importantly) did patient doses decrease - or even increase?

Lastly, and by the way, image quality of modern diagnostic ultrasound is also noticeably better than in times gone by. "Image quality" can be a bit subjective ... but having machines from different eras operating side-by-side should convince most observers. But whether such an improvement would warrant immediately binning the old machine (or rushing out to buy a new one) is something I would doubt. It would probably be better to "let nature take its course" and simply purchase a new unit when the old one can no longer be supported (unreliable, lacks of spares or whatever).