But when he asked the manufacturer to send him a replacement part, he was surprised to receive the manufacturer’s response: “ ‘Absolutely no.’ ”

“I had just expected, ‘Oh, no problem. Where can we send it?’ ” he said. “I wasn’t expecting them to dig their heels in.”

Mackeil was well aware of what’s become a common obstacle for hospitals: Manufacturers not only have a monopoly over even simple replacement parts, but they also often allow only their authorized service technicians to repair equipment.