AN: Why should an anesthesiology department or group practice consider buying a piece of used equipment?
PJ: The main reason to buy used is fundamental—buyers want to save money—but there are other reasons, such as availability. There might be a waiting list to receive new equipment and used equipment is simply more readily available and makes more sense to acquire. In other instances, buyers acquire a used anesthesia machine just to get the parts that can keep their current equipment up and running. This also might be done because a group of clinicians know a particular machine and are accustomed to using it. They might not wish to train for a new machine, but instead keep what they have in top condition to extend its life. Having spare parts can be an important part of that. I know of some anesthesiology departments that have bought used machines to bridge between today and next year when they buy all new machines. Having parts on demand also can decrease downtime; anesthesiology and biomedical engineering departments like to have spare parts for this reason as well. In addition, hospitals with a large research section should think about going with used equipment, including anesthesia machines and monitors. This will make their funds stretch much farther.
AN: Has any study found a risk to patients from used equipment?
PJ: To my knowledge, there is no study that demonstrates that used equipment is a risk to patients. I’m actually frequently asked if I’m aware of specific instances where a piece of equipment has, as the result of being used or having been refurbished, caused harm to a patient and I have never heard of such an instance. That does not mean that it has not happened, but suggests that it is not an inherent or prevalent problem.
AN: From a buyer’s perspective, what anesthesia equipment makes the most sense to consider buying used?
PJ: It makes most sense to buy the equipment you already have trained on because there is no downtime or learning curve. This also would mean that you probably have spare parts and your biomedical engineers already know how to service it. Everyone knows about a doctor who interned at a U.S. hospital and learned how to use a specific anesthesia machine. We often get calls from anesthesiologists around the world exploring various equipment options, and we always advise them to buy the machine they are familiar with. It makes it easier to know how to use it and that is a big plus.
AN: From a seller’s perspective, what devices are easiest to move?
PJ: If you are selling an anesthesia machine, never assume that what you have is unsaleable. Most people believe that newer equipment is more saleable than older equipment but that is not necessarily true. Obviously, newer equipment is more valuable but in some cases, older equipment is in higher demand because it is easier to use and less software-driven. In short, there is a buyer for almost everything in different places in the world. Dräger is a well-known brand; so is Ohmeda, which became Datex- Ohmeda and today is part of GE Healthcare. These anesthesia machines that are more than 20 years old sell. Machines with more vaporizers and ventilators will sell for more money than if they are missing the vaporizers and ventilators. In Europe, Engström was a well-known name in this category. It also is easier to sell a machine that is in service than it is to sell a machine that has been taken out of service.
AN: What about manufacturer support? If a department or group buys a piece of used equipment, can it expect the same level of service as if it had been a new device?
PJ: In terms of manufacturer support, in some cases the manufacturer will refuse to service the machine that it did not sell. In other cases, the manufacturer will service the machine without a problem and sometimes will charge a fee to evaluate the machine to make sure that it qualifies for service.
Fortunately, in the United States, supply and demand has created an environment where there are third-party service companies for anesthesia machines so even if the original equipment manufacturer refuses support, you can go to a third party for service.
AN: How does a buyer go about inspecting a used machine? What warranties are available?
PJ: Like buying anything that is an investment, it’s important for careful due diligence, and that means having someone qualified inspect and test the equipment. Some are qualified to do it themselves, but in most cases it’s better to have a qualified engineer instead. It is worth spending extra money to have the machine evaluated and in most cases cost-justified, especially if the equipment is in the tens of thousands of dollars. It’s certainly worth spending $1,000 to $1,200—which is a typical inspection cost—to have the machine inspected, otherwise your entire investment could be at risk. Many companies that sell anesthesia machines sell them with warranties and we estimate that approximately 40% of service on these machines is performed in-house. Purchasing a used anesthesia machine is not for everyone, but it has its place.