Three-dimensional printing technology may be taking the science and computing worlds by storm, and turning heads in distribution, logistics, manufacturing and supply chain management, but this new equipment may do more than disrupt standard business practices and production.
John Hornick, technology expert and lawyer, posits in his book, 3D Printing Will Rock the World, that terrorists will begin using 3-D printers to fabricate everything from bombs and nuclear weapons to bacteria and viruses. Hornick wonders how governments, law enforcement, homeland security and the military will handle this new threat.
What will – and should – healthcare organizations do? In an exclusive interview with Healthcare Purchasing News Senior Editor Rick Dana Barlow, Hornick expounds on some of his ideas and offers a healthcare-centric perspective on specific possibilities suggested to him, particularly if a hospital or healthcare facility has and operates a 3-D printer onsite.
HPN: How might 3-D printers be used to create explosive devices, loaded guns and other hand-held weapons for use in hospitals?
HORNICK: I don’t want to suggest that 3-D printing technology is inherently dangerous or to give the bad guys any ideas. 3-D printing has important and disruptive benefits for healthcare. But as I explain in my book, 3D Printing Will Rock the World, relatively inexpensive industrial 3-D printers have been used to 3D print a variety of undetectable guns. Initially, the quality was poor, but the results have improved and will continue to do so. However, loaded 3-D printed guns should be detectable because the live rounds are detectable. Other types of handheld weapons can be 3-D printed with consumer-grade or industrial machines. I am not aware of 3-D printers being used to make IEDs, but there is no reason this can’t happen. In fact, the FBI set up a unit to study how 3-D printers might be used to make explosive devices.
How might 3-D printers be used to create security access cards/IDs for illegal entry in various areas of the hospital?
I am not aware that this has happened. Also, I question whether it is a substantial threat. 3-D printers do not provide a fundamentally different or better way to counterfeit most ID cards, versus traditional methods of counterfeiting such cards. But one illegal application could be to use certain types of 3-D printers to counterfeit ID cards that have images or data embedded throughout the entire thickness of the card. 3-D printers have been used to make false façades for bank machines, which illegally skim user information. Such technology probably could be used to skim ID card information.
How might 3-D printers allow someone to print bacteria and viruses, say, to place in air ducts, on surfaces or even on recently sterilized instruments within the sterile field in the operating room during surgery?
Bioprinting is a growing area of 3-D printing. It may be used for regenerative medicine and customized pharmaceuticals. The same technology could be used for illegal purposes, such as to bioprint bacteria and viruses.
How might 3-D printers be used to create flaws in organ fabrication and other inorganic implantable devices or even medical/surgical devices and instruments used in invasive surgical procedures?
The key to 3-D printing any object, such as a surgical device, or to bioprinting organs or implants, is the digital blueprint. If such digital blueprints are corrupted, intentionally or unintentionally, the object, organ, or implant could fail, with potentially catastrophic results. Perfecting and securing such blueprints, and being sure they are genuine and have not been corrupted, is therefore paramount.
Your comment about cybersecurity brings hacking to mind. We’ve learned that even biometric authentication is not nearly as safe as we believed because the scanning system makes a digital copy of your face, fingerprints, retina and vein mapping that can be illegally obtained. How can healthcare organizations protect their 3-D printers from hacking, particularly if they’re interfaced or integrated with any or all hospital systems?
Whether digital blueprints are stored inside a healthcare organization’s servers or in the cloud, protection against hacking depends on IT protection. These organizations need to assess their IT risks related to 3-D printing and take steps to secure their machines, digital blueprints, and 3-D printing related data, and adopt strict physical and digital controls. They should identify the data and control who has access to it and how it can be used and transmitted. They should monitor and log such uses and maintain an audit trail. File integrity must also be controlled. Although legal recourse may be the last line of defense against such hacking, IT is the first.
In this emerging age of “Internet of Things” connectivity, how could you program 3-D printers to use some type of A.I. to identify and prevent the printing of bacteria, viruses, explosives, device flaws, etc.?
This is an interesting idea. I hope someone is working on it. Others have proposed other safeguards, such as using DNA marking or chemical marking, or microdots, to provide assurance that 3-D printed objects are authentic and safe. But it is inherently difficult to prevent a 3-D printer from printing whatever digital blueprint is loaded into it.
How would a 3-D-printer-free hospital or other healthcare facility be able to detect any problematic 3-D-printed products and prevent them from being brought into the facility and used on patients?
Again, this is an inherently difficult problem. Maybe authenticity could be assured by the use of DNA or chemical marking, microdots, or other safety measures, dealing with a trusted supply chain, and obtaining warranties from each link in the chain. But work in this area is just beginning and best practices are just starting to be developed. At this point, it is important that law enforcement agencies and stakeholders become educated on the risks of potential illegal uses of 3-D printing.
Rick Dana Barlow | Senior Editor
Rick Dana Barlow is Senior Editor for Healthcare Purchasing News, an Endeavor Business Media publication. He can be reached at [email protected].
