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of interest |
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If manufacturing or distributing your own
label Class II or higher device, do you have your ISO 13485
QS in place? It has been required since 2006. |
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Life cycle assessment as an
ecodesign tool

Life cycle
assessment is a useful tool for manufacturers as they become more
accountable for the effect they have on the environment.
This column is
based on an article which appeared as
Designing sustainable medical devices
in the July 2009
issue (volume 31, number 7) of MDDI, the magazine of the Medical
Device & Diagnostic Industry.
Stakeholders in
the medical device manufacturing industry are becoming more
concerned about the environmental impact of their products and
processes. These effects range from the potential negative effects
of substances such as phthalate plasticizers leached from plastic
products to emissions resulting from the incineration of disposed
products. In addition, consumers are also becoming more aware of the
negative impact that manufacturers can have on the environment. To
combat such effects, consumer advocacy groups are demanding products
that are more sustainable.
Sustainability
as a competitive advantage
Government
initiatives continue to increase environmental awareness through the
development of new policy and legislation. This in turn is
encouraging industry to become more accountable for the
environmental impact of their products and operations. For example,
the Waste Electrical & Electronic Equipment (WEEE) Directive and the
Producer Responsibility Obligations (Packaging Waste) regulations of
2008 have set precedents regarding end-of-life disposal of products
involved in their industries. It is only a matter of time before
regulatory bodies start initiating changes in policy for other
manufacturing sectors. Such regulations could well make it more
difficult for companies to develop new products, at least in the
short term.
In such
competitive environments, new product development can no longer rely
solely on traditional criteria such as cost, quality and delivery.
Effective environmentally sensitive product design enables
manufacturers to gain a prominent competitive advantage in the
development of “green” products. As a result, more and more
businesses are adopting environmental management systems to organize
and assess environmental effects, and meet the growing demand from
consumers and legislation for green products.
The ISO 14001
standard, “Environmental Management Systems–Requirements with
Guidance for Use” sets guidelines to enable businesses to recognize
the environmental effects of their products and processes. In order
to qualify for ISO 14001 accreditation, a company must identify its
overall environmental impact and determine the significant effects
of its various products, while also demonstrating continual
improvement in its manufacturing processes.
Life cycle assessment
Life cycle
assessment (LCA) is a useful technique to evaluate the environmental
impact of products, identify problem areas, and make improvements at
the most effective stage of a product’s life cycle. Various studies
have shown the benefits of performing a LCA at the product design
stage to effectively lower a product’s overall negative
environmental effect.
One tool used to
make such an assessment is a LCA software packaged called SimaPro.
It uses Eco-Indicator LCA methodology to aid manufacturers in
selecting the most environmentally suitable materials for its
products. The Eco-Indicator method provides impact assessment and
ecodesign scoring. While there is no doubt that a detailed LCA is an
extremely useful method for environmental impact evaluation, it can
be costly and time-consuming, and the results can be difficult to
convey to nonexperts such as consumer and environmental advocacy
groups.
In-house web-based tool
Although there
are various LCA software available, they can be difficult to use on
a large range of products. The user must have prior knowledge of LCA
inventory databases and internal product details before starting an
LCA. The information needs to be entered manually into the program
for each each product. The process is time-consuming and usually
needs to be carried out by an experienced LCA practitioner. In some
cases, materials used in a given product may or may not be present
in the LCA inventory. This means the assessor now has to choose the
closest substitute. This can introduce error into the results of the
assessment.
Some companies
are working their way around these challenges by innovating new
approaches. For instance, a manufacturer of a single-use
respiratory-care device has developed an in-house tool that performs
a streamlined LCA on products using existing company data to obtain
an immediate environmental impact score for any product it
manufactures. Internally, although the tool was developed to aid in
the design process, it also has value in other departments, because
the system provides a baseline score that enables product
comparisons.
Departments can
use the tool to set targets to lower a specific product’s
environmental impact and identify areas of high environmental
concern when designing, purchasing, and marketing products. Once
widespread, such a tool would aid manufacturers in the
decision-making process. The following example is a real-lfie
scenario of how manufacturers can develop a similar tool to aid
designers in developing more sustainable products.
One company
stored information relating to its products in standard structure
query language databases managed by Efacs, an electronic database
and software program. The Efacs system was used to organize the
company’s data and contained features such as the bill of material (BOM)
for each product. Each product BOM provided detailed information on
the product and was organized in a hierachical structure.
Information included all components, subcomponents, and even
specified packaging in terms of weights and materials involved.
Gathering environmental data
The
company used LCA software to collect the environmental data for the
scoring tool and chose the EcoIndicator 99 methodology. The process
involved creating a project within the scoring tool that calculated
an environmental impact score for all materials and processes. It
also incorporated the required disposal scenarios of landfill or
incineration. The figures were stored in a separate material scores
table.
The first step
involved collecting a list of all the materials and finding them (or
the most appropriate substitutes) within the scoring tool databases.
The next step involved calculating the environmental impact using
Edo-Indicator 99 methodology.
Because the scoring tool is Web based, users have easy access to the
data. The user can type any component part or product code that the
company manufactures into the tool. Once the part code is entered,
the scoring tool must read data from the BOM. The results of the BOM
is dsiplayed in the table, showing part number, description of the
part, material number, description of the material, generic material
type, and weight of the material. The system then calculates the
total quantity of each material used for each part (if more than one
is used). The tool displays a dropdown menu for each material so
that materials can be changed, and the button to calculate the score
is activated only once all the fields are completed.
When calculating
the score, the tool gets information from the populated scores table
by multiplying quantities with score values. The results are then
summed for each selected product and displayed in a report for
landfill and incineration disposal scenarios.
The
simple-to-use Web-based tool enables the streamlined LCA of a
product to be carried out in as little as two steps. This is
important, because in order to design a more sustainable product,
the designer needs to benchmark the existing product. New product
designs are usually based on products already in production. The
first use of the tool is to score the existing product to provide a
benchmark. Once a benchmark is set, targets can be determined and
improvements can be recognized. Because the products are made of
components and subcomponents, the tool can change the materials and
weights based on these. Any changes are reflected in the scores that
can be compared side-by-side with the benchmark.
The tool also
has dynamic features that allow designers to change and compare
products in five steps. The designer can also view product BOMs, add
new components or remove existing components, change materials alter
the weights involved, and compare the environmental impact of
designs side-by-side. All the design ideas can be saved to a file
for future reference.
Challenges remain but the course
is set
The
environmental scoring tool achieved the objective of quick and
accurate impact scores for existing products, setting the benchmark
to design more-sustainable products. Error is greatly reduced when
comparing products because the environmental impact scores for
selected materials have already been decided. Having access to such
data precludes the need for the user to have prior knowledge of the
environmental effects of different materials and products. These
features mean the tool can be used by nonexperts of environmental
LCA and provide accurate results, unlike traditional LCA software.
The scoring tool also runs from a live database that eliminates
error associated with incorrect data input, and products can be
scored in seconds rather than hours.
As is often the
case when it comes to manufacturing considerations, the medical
device industry poses special challenges with regards to
environmental issues. Medical devices involve additional
environmental factors that have not yet been taken into account in
generating an environmental impact score at this early assessment
stage. For example, the additional environmental impact associated
with the leaching of phthalate plasticizers from plastics. There are
also the effects of product sterilization (of which a variety of
techniques are used) before and after use, which have not yet been
included. These processes and others like them will have to be added
at a later stage
Another important
limitation is the lack of available environmental data for
thermoplastics elastomers and biopolymer materials, which may end up
being used in future products. Estimates, however can be made by
manually performing an LCA using existing data on raw materials and
processes. Research in these areas will be used to develop the
environmental scoring tool to aid in designing future sustainable
medical devices. The process has really only just begun. A whole new
generation of greener, more environmentally benign products will
definitely see the light of day.
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That crunching
noise you hear is the sound of endoscopes shrinking. Medical
diagnostic and therapeutic procedures are growing smaller, from
neurology to podiatry. Minimally invasive surgery (MIS) is shrinking
to the point that incisions can heal without sutures, and the new
words of the day are “endoluminal” and “NOTES” (natural orifice
transluminal endoscopic surgery), both implying procedures done via
natural body openings, with no external incisions.
Endoscope remains
the workhorse
But
how do the doctors performing these miracles see inside their
patients? Various new and experimental technologies seek to five
doctors with now direct visual access the equivalent of x-ray
vision. But for most of these new procedures, the workhorse of
visualization remains the endoscope.
Direct
visualization via endoscopy provides the clearest image for doctors.
It is the gold standard against which other technologies are
weighted for effectiveness. For example, in comparison between MRS
and spectroscopy systems, arthroscopy has been used to judge the
performance of each. According to the literature available,
endoscopy demonstrates the following attributes:
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Offers a track record of procedural success.
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Enables real-time visualization to precisely guide placement, as
well as use of intruments, vastly reducing potential for
malpositioning or damage.
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Also enable doctors to see as a patient is manipulated (e.g. as a
shoulder is rotated during surgery, via arthroscopy)
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Provides greater portability than other similar technologies.
Together, these
factors mean endoscopy offers accuracy, flexibility, and breadth of
use, particularly in therapeutic applications, Many studies bear out
this claim. Magnetic resonance images (MRI) of musculoskeletal
joints including soft tissue, for instance, are notoriously
problematic. Estimates of false positives for pathological knee MRIs
reach as high as 20%, creating complications for patients and adding
costs for insurance providers. In some studies, MRIS barely
outperformed clinical examinations. In other areas, such as
diagnosis of scapholunate ligament injury, MRI failures have been
severe enough that studies have concluded they simply should not be
used.
Despite these
studies, endoscoppy has historically been underused in many
applications. MRIs still dominate advance diagnosis of knee and
shoulder pain. Why? Because traditional arthroscopy has been
perceived as highly invasive, requiring fairly large scopes
(2.7-4mm. diameter), and thus full anesthesia in a hospital or
surgical centre. Conversely, MRIs are noninvasive. Given the
perception that arthroscopy requires hospitalization or at least an
advanced surgical centre, doctors have not traditionally viewed
arthroscopy as a comparable potential of office revenue.
The perception of
endoscopy as highly invasive is changing as technology improves.
However, there are still challenges that must be met.
Nonsurgical
endoscopy has been hampered somewhat by technological challenges.
When endoscopic systems are shrunk beyond traditional endoscopy
(say, to sizes below 1.5 mm OD) pixelization and brittleness can
occur. Microdiameters limit fiber size and the ability to carry
light. Smaller systems mean less room for everything: light fiber,
image fiber, coatings, and other materials that increase durability.
There are also
challenges in trying to connect microendoscopes to the cameras that
doctors use, and ultimately to the endscope tower that offer video
image display and capture options. Working with scopes in the 1mm
range has been likened to trying to control a strand of cooked
spaghetti.
In addition,
microendoscope systems can be difficult to manufacture reliably and
with cost stability. Making a small number of experimental prototype
microendoscopes that sell in the $7,000 range is one thing. Finding
reliable, repeatable manufacturing technologies that allow
production runs in the thousands and affordable scope prices is a
challenge. But it’s the mass-produced scoope that can benefit
doctors, patients and insurance companies.
All the
difficulties associated with designing and manufacturing
microendoscope systems must be resolved in an integrated way that
provides seamlesss end-to-end imaging and service.
Several
visualization options other than traditional endoscopy are in use or
under development to support minimally invasive procedures. Some of
the most promising include the following.
Capsule endoscopy:
This integrated endoscopic camera, relay lenses, and transmission
system is the size of a large multi-vitamin. Patients swallow the
device, which enables clear and continuous transmission of images
that, in many cases, can replace gastroscopy and colonoscopy. There
have been issues with capsules not being eliminated requiring
further medical attention. A limitation of capsule endoscopy is that
the doctor cannot control the capsule’s movement. Nonetheless,
capsule endoscopes have been used in diagnostic procedures.
Nanotechnology cameras:
Several nanotechnology camera systems exist or are under
development, including some potentially small enough to travel
through the circulatory system. These exciting systems are for
diagnostics, but they do not yet enable manipulation and thus have
no immediate therapeutic value.
Single-fiber
endoscopes:
Hair-thin single-fiber endoscopes break out visible light by color
and use spectrographs to generate virtual 3-D images. These offer
interesting possibilities for extremely small incisions, if inherent
issues of fragility and brittleness can be addressed. The clarity
and procedural usefulness of images generated via spectrography also
require further study.
Robotic
image-guided systems:
Robotic image guidance systems use microcameras isnerted with
surgical instruments and electromagnetic devices to track location,
overlaying the information using fast 3-D visualization to generate
real-time live images, some in high definition. Such systems are
being used in pioneering forms, for example, Intuitive Surgical’s
daVinci robotic surgical system.
Virtual imaging:
Potential real-time visualization systems are emerging from virtual
image technologies. These devices fuse images generated by different
noninvasive technologies (such as MRI and ultrasound) to form
composites that combine the best of each technology.
The new
procedures enabled by non-surgical endoscopy offer the potential for
a paradign shift away from large traditional glass endoscopes.
Innovative diagnostic and therapeutic applications will reduce costs
for insurers, ease patient pain, and speed healing, while also
increasing revenue for doctors and device manufacturers alike.
This text is
based on an article which appeared in the July 2009 issue (volume
31, number 7) of MDDI, the magazine of the Medical Device &
Diagnostic Industry
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