[Gregor Herz] caught wind of a problem that neuropediatric clinics in Germany have been facing recently. Orfiril, a seizure-preventing medication used in those clinics for treating children, is normally prescribed to adults, and the usual dosages are too high for kids. Orfiril comes in regular pill-shaped capsules, each capsule containing a bunch of small medication-soaked pellets, and you only need a certain amount of these pellets if you want to achieve a lower dose.
It used to be that you could get a special spoon helping you to get a proper dosage — but sadly, the original supplier has quit making these. So, our hacker designed a 3D printable model instead.
[Gregor] tells us that a lot of clinics in Germany are facing this exact issue right now, so sharing this model may mean that more hospitals can work around the supply issue. Provided a friendly hobbyist has food-grade 3D printing conditions available, anyway. He tells about some suitable filaments models you can buy, as well as research on food-grade printing requirements — a topic we’ve talked about in detail, and just this month have seen someone revisit with reassuring results. Are you interested in printing some of these? If so, there might be a clinic nearby that’d be thankful.
We’ve seen a surge of 3D printing for medical uses two years ago, back when supply chain issues had doctors face PPE shortages, and some critical parts for equipment were in short supply. Before that, we’d sometimes see medical purpose 3D printing done in dire circumstances, when no other choices were available. Now 3D printing of medical devices is more accepted, and we can’t wait for more research and hacking on this front!
Thank you Gregor!!!
+1
It’s all great until somebody makes a print with the wrong scale and something goes horribly wrong in hospitals. Don’t get me wrong, it’s a great thing this guy did, but in my opinion there is quite a big risk involved. I wonder if those hospitals don’t have a precise scale to simply weight the needed amount of medication? Of course thats slower than using a 3D printed device made on purpose. At least this should be done once to check if a newly 3D printed spoon is correctly sized.
It isn’t being used to measure powder so sizing isn’t too critical. The spoon is only being used to help count the number of balls needed for a given dose with 1 ball per hole.
And then a Follow Up Documented Calibration Check each Month kept on file..
It would have to be an extremely wrong scale. There is supposed to be one pellet per divot, so that not happening would be pretty staggeringly obvious.
Uh ok, sorry, i got it wrong. I thought it was one dose == multiple pellets in each hole. I apologize (but i am still worried this guy could get in trouble in some way if something goes wrong. Medical is a lot of paperwork and certification from what i know.)
By the same token, the hackaday web site is putting itself in the same legal jeopardy by publishing the details. If someone reads this article and then proceeds to make themselves a defective spoon. Nobody even has to get hurt, the lawsuits will fly, and lawyers will collect their fees.
not how it works lol
It’s Germany. Not the USA.
The right to free speech does not give you the right to dispense bad medical advice.
1) mind that this website is not USA-exclusive and the laws around the world vary 2) are you sure about that? did you actually check?
Taking medical advice from anyone other than a doctor is done at your OWN risk.
and really, even medical advice from a doctor is your own risk first and foremost, malpractice insurance is only an after-the-fact compensation for bodily harm and doesn’t cover everything that IRL a doctor can cause.
…there’ll be someone who doesn’t understand. Printing the instructions clearly on there would help.
On the plus side, I suspect that food grade maybe isn’t relevant here as it’s all dry stuff.
This is a copy of an existing spoon design afaiu, I’d wager the medical personnel and patients involved are already trained to use these spoons. I’d also bet that the original design didn’t print instructions either.
Maybe a scale could be incorporated in the print so the staff can quickly verify the spoon has been printed to size with a ruler (“this line 1cm long”)
The scale doesn’t matter that much tbh. It’s for the granulates to drop in the divets and this mechanism is quite forgiving regarding the dimensions. I did a sensitivity analysis of the divet-diameter and unless values were unreasonable, it didn’t really matter much.
Hey, the idea is, that one pellet falls into one divot. Also the dosage is spelled out in the spoon. So you’d have to be way off with you scaling. An even then a simple visual inspection will show, that something has gone wrong. It’s been in use for a few weeks with several iterations of the design and we’ve not seen any misdosing.
The capacity of people to screw up simple things is enormous. For example the nurse convicted of manslaughter after giving a patient a paralytic drug instead of an antianxiety med and leaving her alone. She ignored multiple warnings from the dispensing machine as well as the red labels on the box and vial, which were in place to prevent what occurred.
Will the print survive an autoclave? I find a lot of things with medical applications in mind need to survive an autoclave.
I’d bet not! I also wonder if like, Just Printing Another One and discarding is a viable alternative. Given that a clinic is already successfully using these printed spoons, it gotta be that they find a viable workflow – I’d like to learn more!
With the clinic that helped design them and has been active in testing, we found that just replacing them every once in a while is the most viable alternative. So as of now they just drop me a message, when they’ve run out. It’s a couple of prints a month, so nothing to time and resource consuming. So if you have a clinic nearby, maybe join in the fun:)
I’d bet the original spoon won’t be autoclaved lol.
The comment section is hilarious tbh.
It’s a damn dosing spoon. It doesn’t need to be sterile, nor won’t the hands be sterile which hand you the pill/s.
I thought everything I ingested had to be sterile to be safe. /s
Especially prebiotic!
B^)
The plastic thingy that the pharmacist uses to count the pills and put them in the jar, never goes in the autoclave. The pharmacist uses it over and over again without even cleaning it. However it was made in a factory and the design has no doubt passed many tests, no tiny plastic bits in your pills or.anything like that
No it certainly won’t. But since it is used to dose orally administered, dry granulates, sterility isn’t necessary. We’ve decided to just go with new spoon every once in a while. Another reason why we’d be very thankful for more community-printed spoons
“OMG 3D PRINT IT!!!!!111” is not the answer to everything.
Did we not learn anything from “OMG OPEN SOURCE VENTILATORS!!!111”
Don’t screw around with medical devices (and yes this is a medical device).
🤣
what specifically did we learn from open source ventilators, pray tell?
I’m a doctor (MD, and also rather relevantly in this case a PhD in biomedical engineering) and have no problem with this because it’s made in a “quantum” way – one pellet per hole – that minimizes the effect of shrinking, wrong scaling, etc. Quite clever. Of course, someone who is very familiar with how it’s supposed to work should be checking it and educating the patient’s family if it’s their first time using the device.
Making it food grade is a good thought as well (though not so critical as if it were a liquid medication with unknown excipients that might leach who-knows-what plasticizers and dyes out of the plastic and into the daily medication.) You could also just 3D print a mould and cast the spoons out of a stiff medical-grade silicone. There are also food-safe coatings that could be applied to it (probably with adjustment of the underlying geometry of the model.)
I think 3D printing can have a very big role in cost-effective and individualized medical care, but our regulatory frameworks need to catch up and adapt to these sorts of technologies.
Conflicts of interest: I own a medical device prototyping company and I guess I am favorably disposed to innovation in this space?
ooh that’s cool! and yes, casting in medical-grade silicon sounds like a very viable idea, likely scales way better than printing, too!
Whenever the terms “medical ” and “3d printed” show up in the same articule, folks will reliably wet themselves in the comment section.
This is a good idea and will very likely work well and never once harm anybody in the slightest.
Indeed. Did you know that some people take cough syrup (for example) with a teaspoon? A teaspoon! Because they’ve lost or misplaced the measuring spoon.
If we 3D-printed a teaspoon all hell would break loose.
Yepp, got a good chuckle out of all those “it’s not foid safe”, “you’ll get sued” and “ppl gonna die because someone will print it at a wrong scale” comments.
It’s seriously mind blowing what problems some folks come up with in their heads.
careful, that’s a cornerstone principle of modern day political discussions! 😝
Medicine should be taken with the seriousness it deserves.
https://hackaday.com/2015/10/26/killed-by-a-machine-the-therac-25/
..we’re talking about a spoon!
And I’m talking about an attitude.
don’t bring radiation therapy machine attitude to a spoon fight
As I read the picture this dosing spoon can be personalized as the imprint reads “Leo’s spoon” in German, where I assume that “Leo” is the name of the kid. So this device is apparently tailored to an individual’s dose, and therefore makes it even more safe than a generalized counting spoon.
A very clever, versatile, and safe design!
It was originally designed for my cousin, because they forgot theirs on vacation and couldn’t find a replacement. The clinic showed interest in the design I came up with so I made various versions with different dosages. We’ve been testing them for a couple of months without issues, before we decide to publish the models. The medical professionals did not have any problems and with a minimal introduction this design is safe for personal use as well. Usually, the patients are on other medications as well and parents are very proficient with medication at that point.
Love the design and work you did here. In another comment you said you just print off a new batch as needed, now you have the design done would it be better to get some machined out of stainless? They wouldn’t have to dispose of them and could be easily cleaned, yes up front cost would be a lot but then they have them forever.
Or since this is Leos spoon do they need different dosages for different patients which doesn’t make this as viable?
What if we used a CNC machine to mill the shape and dimples from wood? Would some commenters here still freak out?
Or aluminium! It would last forever!