Waste Not Want Not
A Christchurch engineer considered whether single-use medical devices could be sterilised and sold back to hospitals, then set out to make it happen.
It’s a unique business model that seemingly breaks the rules of simple
economics: put discarded products back into the supply chain multiple times, each
time selling them back to the very buyer who threw them away. Yet engineering
entrepreneur Oliver Hunt’s company, Medsalv, does that while providing a
solution to New Zealand’s hospital waste challenges.
Throwing more money at health isn’t necessarily the best solution, as it’s more about finding ways to improve efficiencies in the health sector.
Oliver says hospitals around the country discard huge amounts of medical devices every year, using them once before disposing of them for good. Although difficult to quantify, the volume of this type of equipment ending up in landfills every year is thought to be in the tens of thousands of tonnes. Not only does that mean a substantial footprint on the environment, it translates to a large cost for the health budget.
Medsalv partners with hospitals to reprocess non-invasive, single-use devices that would otherwise have gone to a landfill, and returns them to hospitals to re-use. And it’s all at a lower cost than hospitals would have paid to replenish their stocks with brand new devices,
The idea for Medsalv came to him one night in a conversation with his uncle
James Burn, an orthopaedic surgeon. “We were talking about the healthcare budget. My uncle told me throwing more money at health isn’t necessarily the best solution, as it’s more about finding ways to improve efficiencies in the health sector,” Oliver says.
“He showed me his garage where he had all these unused single-use medical devices that couldn’t be used because the packaging had expired yet they were probably fine. He reckoned he had about $400,000 worth of devices sitting on the garage floor.
“He said I should gamma irradiate these to sterilise them and sell them back to the
hospital. That’s pretty much what led to the idea behind Medsalv.”
James says the orthopaedic industry promotes single-use items and specifies this on many products, even though they can be made re-useable, and hospitals pass on the costs to the public.
“The waste created by this process goes to landfills and incineration. Products whose sterilisation date is passed are scrapped rather than re-processed. Meanwhile, the hard-earned export-generated currency to purchase the products is sucked back out of the
country; and currently competition from within New Zealand is negligible,” James says.
He says New Zealand is “being held to ransom” by the orthopaedic companies, but there are solutions.
Oliver researched how others had approached reprocessing medical devices in New Zealand, and their challenges. He started his company as part of a project for his Masters of
Engineering in Management at the University of Canterbury. In early 2018, aged 24, he won the $100,000 Dream Believe Succeed Award, which helped make the concept commercially viable.
Oliver says Medsalv is the only company that reprocesses medical devices in
New Zealand, describing the work as “reverse engineering”.
“When we sell something back to the hospital, we become the manufacturer of record, standing behind that device as any manufacturer would. We have robust quality systems in place that give us the ability to do this, and we are currently implementing ISO 13485 [the internationally recognised quality standard for the design and manufacture of medical devices] to build on our quality standards and the integrity of our processes.”
As the manufacturer of record, Medsalv needs to know everything about the device – how it formed, what’s inside it, what might go wrong with it – to create the company’s own design file for the device.
For commercial reasons he won't talk about specifics around the reprocessing techniques his company uses. However, he says they can include anything from using special machines like hydrogen peroxide gasifiers to sterilise the equipment, to simply removing debrisor reassembling broken parts by hand.
“We do visual inspections on every single device multiple times, which is more than you’d expect for a brand new, batch- manufactured, single-use device. We look at them many times over to see if there’s any contamination or damaged parts – anything that could cause discomfort to patients or prevent the device from performing its intended function.”
Currently, Medsalv provides services to DHBs that comprise about a quarter of New Zealand’s population, and to some private hospitals. That’s expected to grow, with plans to expand into a larger reprocessing plant in Woolston, Christchurch.
Oliver says the company saves hospitals at both ends of the device lifecycle, because it sells to hospitals for a lower price and removes waste.
In time, he says, Medsalv could shave up to $100 million off the amount spent on health every year, adding that it's a very "back-of-envelope figure", based on what’s already being done in the United States "and extrapolating it to the New Zealand
context". Nonetheless, Oliver believes Medsalv is extremely well placed to make a difference one way or another, “given the current political climate and focus on sustainability and lifecycle cost”.
This article was first published in Engineering New Zealand’s EG magazine Issue 7/2019.