[Updating] Why we need ventilators and why it is so hard to make them

And how the industrial AM community can help by making parts, not systems

The main issue, as explained in a detailed New York Times article, is that, to put it plainly, “there aren’t enough ventilators to cope with the coronavirus“. The reason why there aren’t enough is that they are extremely difficult to produce and so it takes a long time, even for those companies that have been making these machines for decades. That’s why it’s not about making 3D printed ventilators but 3D printing parts to address ventilator supply chain issues.

Right now, the NYT reports that “while the acute shortages are global, not just in the United States, some European governments are deploying wartime-mobilization tactics to get factories churning out more ventilators — and to stop domestic companies from exporting them. In one dramatic example, the article cites Andreas Wieland, the chief executive of Hamilton Medical in Switzerland, one of the world’s largest makers of ventilators, who says that they are seeing the same desperate situation in Italy as they saw in China and are now starting to see in France. And while they are producing and shipping machines as fast as they can, when Italy ordered 4000, they were only able to deliver 400.

Ventilators, which deliver air to the lungs through a tube placed in the windpipe, are a crucial tool to keep COVID-19 patients alive, and computerized, bedside machines can cost as much as $50,000. Altogether most industrialized nations have several tens of thousands of ventilators in their hospitals. However, the risk is that hundreds of thousands will be needed.

A document published by OSCMS cites a 2009 survey indicating that US hospitals could use both existing machines and pull older devices from storage, as well as the 8,900 sitting in emergency stockpiles. This adds up to roughly 200,000 devices, but the number of available medical staff able to operate them at any one time would lower that number significantly. And some worse-case estimates show that more than 900,000 people could need ventilators, according to the American Hospital Association (ABC News, 3/14/20).

Companies that make ventilators include Hamilton Medical mentioned above as well as Dräger in Germany and Getinge in Sweden. In the US, there are giants like General Electric and Medtronic – as well as smaller firms such as Ventec – and they are scrambling to accelerate production but production involves hundreds of small parts produced by companies all over the world. Which brings us back to the issue of local vs global supply chains.

No type of company can switch production lines faster than additive manufacturing service providers. Not only that, but the kind of automation that only industrial additive manufacturing technologies can already provide today is of paramount importance at a time when people are asked to stay home and avoid social contacts as much as possible.

Additive manufacturing service providers need to connect with both ventilator manufacturers and governmental institutions that are leading the effort in converting production lines. 3dpbm has created a Forum section where industrial additive manufacturing companies are able to highlight their production capabilities and connect with institutions that need them.

In Europe CECIMO, as the European association for additive manufacturing, was requested by the European Commission to address its membership and query if it would be able to aid in producing equipment (for instance, valves or ventilators) that hospitals are lacking due to the COVID19 outbreak in Europe. However, from a regulatory point of view, it has been highlighted that some legal constraints can hamper the full implementation of such solutions. Member States should consider temporarily waiving some of the Medical Device Directive requirements for strategical goods during this period of crisis.

In this regard, CECIMO welcomed Commissioner Breton’s statement, claiming that the EC will facilitate all companies helping in this time, also protecting them from potential legal issues. The Commissioner also highlighted that technologies such as 3D printing should be included in the scope of a new fund aiming to sustain different sectors, such as healthcare, in this time of need.

If AM companies will be able to rapidly connect with manufacturers and scale up production of needed ventilator parts, the next challenge will be the need to produce and install more industrial additive manufacturing machines, which are also made of thousands of parts, and very complex and lengthy to make. These also rely, at least in part, on global supply chains. However, most industrial 3D printers are manufactured locally. Europe, North America, and Asia all have local 3D printer manufacturers and material manufacturers catering to the local markets. Some components, especially electronics, could be relying on global suppliers however intercontinental transportation has not been halted and electronic components can still be obtained. The same goes for materials. Material refinery into 3D printable form – filaments, powders, and resins – takes place locally, so that only the raw materials, in some cases, will need to be obtained from remote suppliers.

[Update 3-21-2020]

As reported by the Financial Times, three industrial consortia (one made up of aerospace companies led by Meggitt and two from the automotive sector steered respectively by Nissan and McLaren) are aiming to develop a basic ventilator prototype by next week. The target is to manufacture 5,000 ventilators as soon as possible, with a goal of a further 30,000 eventually. Manufacturing is expected to start within a month. The aerospace consortium includes GKN, Airbus, Thales and Renishaw, which makes medical devices, among other high-tech products. Meggitt makes oxygen systems for aircraft, while Airbus, Renishaw and GKN can bring their expertise in 3D printing for components.

[Update 3-24-2020]

A letter published by the US Food and Drug Administration (FDA) provides recommendations for health care providers and facilities, based on the recently issued guidance, regarding the use of devices with patients who develop respiratory compromise from COVID-19 or other respiratory disorders. These are important guidelines to follow in order to implement ventilator supply mitigation strategies in the US but can be useful for healthcare institutions, product suppliers and government institutions in other parts of the world affected by the COVID-19 outbreak.

Please add/discuss anything useful related to this in the dedicated forum.

Davide Sher

Since 2002, I have built up extensive experience as a technology journalist, market analyst and consultant for the additive manufacturing industry. Born in Milan, Italy, I spent 12 years in the United States, where I received my Bachelor of Arts undergraduate degree. As a journalist covering the tech industry - especially the videogame industry - for over 10 years, I began covering the AM industry specifically in 2013, as blogger. In 2016 I co-founded London-based 3D Printing Business Media Ltd. (now 3dpbm) which operates in marketing, editorial, and market analysis & consultancy services for the additive manufacturing industry. 3dpbm publishes 3D Printing Business Directory, the largest global directory of companies related to 3DP, and leading news and insights websites 3D Printing Media Network and Replicatore. I am also a Senior Analyst for leading US-based firm SmarTech Analysis focusing on the additive manufacturing industry and relative vertical markets.

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