Doctor builds dialysis machine in his garage

There's always a first for everything. New equipment is being developed constantly. But this generally being a commercial enterprise, usually the investment of time and money is directed to the most common (and therefore most profitable) urgent health problems. Babies requiring dialysis are fairly rare, so they are bottom of the pile. It is left to enterprising medical geniuses like this doctor to take the initiative.

I think that you and chrisb2e9 don't realise how far and wide resources in the NHS have to be spread to save lives on a daily basis. Even if these machines already existed, they would cost --not because they are built by "money grabbing companies" but because they are hideously complex machines that have to be hand-built by experts to a high standard, and to last. You can buy a machine that will save ten lives a week for £10,000,--, or you can spend the same on a device that will save a baby once every three to six months. What would you buy? I thought so.

As long as the parents give informed consent, the doctor would be in the clear. Baby is dying anyway, remember? You and chrisb2e9 also don't seem to realise that medical staff make ethical and professional decisions on the knife-edge of life, death, law and taxes (it all costs money) on a daily basis. We only second-guess them and start moaning if we don't like the outcome. I'm sure the baby's parents however, are appreciative.

 

Nexxo is right, the doctor puts the paitent first, even if it did go badly i would be surprised if the parents would blame him or any of the other medical staff. this doctor tried his best, and he pulled it off.

there is nothing more complex than designing for the medical trade, i should know as thats what i do!

 

Well said. Agree with it all.

 

I do have an understanding of how the system works. spend some money to save a lot or spend some many to save a few. pretty easy decision to make there. so dont assume that I "dont realise".
My complaint was that money is the reason that there wasn't a machine like this available at a hospital. Because it wouldn't be used very often and therefor would not be cost effective. And that I think is an utter load of crap. Money should not be the deciding factor when it comes to saving lives. Even if its just one life.

 

Hm, perhaps I have too much faith in the laws of supply and demand, and not enough in the limits of the health system. You have a point about other machines being higher priority for the hospital, but when a few people can put one together in a garage in a week, it still makes me wonder.

I'm glad to hear that the doctor is legally in the clear. I didn't expect that family or other staff would blame him if it went wrong, it's more that the press and various activists would crucify him. In case I wasn't clear earlier, I think this guy is awesome for trying, and would be even if it hadn't worked. My point was more about the amount of red tape I'm assuming he had to cut to get there, and that this story could have gone terribly wrong. Brave guy to take the risk.

I respect the ethical and professional choices that doctors have to make, you say they have to play with legal limits as well? Eeek. News to me.

 

What a wonderful fellow human being!

 

Welcome to the real world, where money is always a deciding factor. I agree that our tax money could be spent less on nuclear submarines or state dinners (£50,000,-- to have Brown visit the G8 conference on the world food crisis where the highlight, ironically, was an 18-course dinner. The government thinks it was "value for money". Yes, our tax money at work, right there...) and more on the NHS. But the reality is that the pot of money allocated to the NHS is finite, and hard decisions have to be made. I talk to the people who make them, and they are hard decisions indeed.

Next time you vote, go for the party that promises more spending on the NHS rather than lower taxes. It has to come from somewhere.

The previous absence of this machine was a product of supply and demand. And you can bet that the doctor funded this machine out of his own pocket, made it from spare and improvised parts, and that it was a lot cheaper because it did not come with expensive insurance and long-term warranties attached. It only had to work once, not every time, all the time, without fail over the next five years.

Yup. There are informed consent issues, capacity and refusal of treatment issues; issues in treating uninsured illegal immigrants and patients engaged in illegal drug use...

 

To quote a film "If life was fair, we wouldn't need a justice department". Noble sentiments, but how many people die needlessly from hunger and other such easily preventable life threatening issues. Where there's a will there's a way. Unfortunately the people with real power to change aren't interested in saving the average Joe.

 

Cool guy

props to him

 

Neat stuff! To bad this is coming about just now, obviously the demand has been there for quite a while acording to the article. I wonder how many of these cases he saw before he went ahead and did this? Makes me think of that show "american inventor" this guy is going to be rich if this wasn't simply a smaller dialasis machine.

 

The world needs more people like that. Today, a lot of people only care about themselves, especially when they have money. What he did was more than most, he saved a life, and because of what he did, many more lives can be saved. It doesn't mention him asking for funding or anything else, which really is amazing. I tip my hat to him.

 

Well I do wonder why conventional dialysis machines aren't more adaptable...

But if you are looking for an NHS scandal there are far easier ones to uncover. Just speak to any clinician (and many patients) and you find endless tales of missing or substandard equipment, bureaucratic and economic shortcuts, and postcode lotteries. The NHS has been abused for the last 30+ years, and from what I hear, it's a minor miracle that it manages to do what it does.

 

After all the threads we get on here about people getting killed on busses, or tazered a rediculas number of times... its really nice to see that there are people like still around. An amazing man.

 

i don't mean to rain on everyone's parades.. but dialysis machines aren't exactly high tech. a pump, some tubing. Amazing.

 

Thanks for that, do you work in medicine then? At least if your kidneys ever fail you'll have the know-how to just hook yourself up to a fish-tank and negate the need to go to hospital .

 

Don't dialysis machines have to do the work of the kidneys and filter out the crap?

 

Yeah, because you've worked on a dialysis ward, have you?

Yes, and that is more complicated than it sounds.

• The machine has to be sterile and clean. That means that every trace of blood of the previous patient has to be flushed out.
• The machine has to reroute a significant part of the blood stream of the patient through a set of filters. This means:
  • keeping extraction pressure witin a narrow range of arterial pressure;
  • keeping the blood at exactly the right temperature;
  • keeping the blood from coagulating by constant addition and regulation of heparine;
  • pumping the blood through the dialyser without macerating the blood cells or (more significantly) blood platelets, at the right speed and pressure, balancing this with the dialysate (cleaning fluid) passing through the dialyser at exactly the right speed, (lower) pressure and temperature as well to facilitate filtration across the semipermeable dialyser membrane;
  • keeping air bubbles out with an air trap;
  • reintroducing the blood into the patient at the right venous pressure and temperature.

But wait, there's more. Because dialysis patients' kidneys are shot, they have no efficient way to get rid of excess fluids. So they need to be weighed before dialysis so an estimate can be made of how much needs to be drained. Of course, dialysis can lose more water and salts in the process than intended, so sometimes a substitution fluid has to be introduced as well to compensate for salts and water unintentionally lost during the filtration process. Again, at the correct pressure and temperature.

Wait, not done yet. Rerouting a significant part of someone's blood supply through a machine causes a blood pressure drop which can trigger sympathetic vagal responses such as tachycardia, vasoconstriction and a sense of breathlessness. You need to keep an eye on that. Then there is fistula infection risk, risk of leakage (in terms of blood loss and air bubbles) and making sure that the power does not fail or the machine conks out. this is not a process you can simply stop and unplug from at the drop of a hat.

Yup. Just a pump and some tubing. Amazing.

 

aw. that's cool. my uncle struggled with kidney problems for years. nice to see there's still doctors out there to help ppl, not just milk there money.

 

Haha, nice high horse. most of what you talk about are valid considerations concerning care of patients undergoing dialysis. not what the dialysis machine is doing. a dialysis machine consists of a peristaltic pump which runs blood through dialysis tubing in a bath of salt/glucose solution and back into the patient.

it's a pump and some tubing dude. sorry.

 

Yep... thats right... no filters... no temperature monitors/regulators... just some old piping and a pump...