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More Than 7 Million Incorrect Diagnoses Made in Emergency Rooms Every Year, Government Report Finds

By Wire Service

December 20, 2022Health News

An ambulance drives through Borough Park in New York on Sept. 28, 2020. (Spencer Platt/Getty Images)

A new study finds that nearly 6 percent of the estimated 130 million people who go to emergency rooms every year are misdiagnosed, which translates to about 1 in 18 patients getting the wrong diagnosis.

The report, published on Dec. 15 by the Department of Health and Human Services’ Agency for Healthcare Research and Quality, reviewed nearly 300 studies published between January 2000 and September 2021.

The researchers estimate that 7.4 million misdiagnosis errors are made every year, 2.6 million people receive a harm that could have been prevented, and another 370,000 are permanently disabled or die because of the misdiagnosis. This equates to about 1,400 diagnostic errors every year per emergency room across the country.

The researchers noted that these rates are on par with what is also seen in primary care and hospital inpatient settings.

The top five conditions that were misdiagnosed were:

• stroke
• myocardial infarction
• aortic aneurysm/dissection
• spinal cord compression/injury
• venous thromboembolism

These five conditions accounted for 39 percent of all serious misdiagnosis-related harms.

Stroke was missed 17 percent of the time, often because people reported symptoms of dizziness and vertigo. When they entered the ER, 40 percent of patients who had those two symptoms had their stroke missed initially.

Nonspecific or atypical symptoms were the strongest factor resulting in misdiagnosis, the study found. Women and people of color had a 20 percent to 30 percent increase in risk of being misdiagnosed.

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German court convicts 97-year-old former Nazi camp secretary

20 December 2022, 10:04

Germany Nazi Trial. Picture: PA

In her closing statement, Irmgard Furchner said she was sorry for what had happened and regretted that she had been at Stutthof at the time.

A German court on Tuesday convicted a 97-year-old woman of being an accessory to murder, for her role as a secretary to the SS commander of the Nazis’ Stutthof concentration camp during the Second World War.

Irmgard Furchner was accused of being part of the apparatus that helped the camp function.

The Itzehoe state court in northern Germany gave her a two-year suspended sentence, German news agency dpa reported.

She was alleged to have “aided and abetted those in charge of the camp in the systematic killing of those imprisoned there between June 1943 and April 1945 in her function as a stenographer and typist in the camp commandant’s office”.

The verdict and sentence were in line with prosecutors’ demands.

The wooden main gate leads into the former Nazi Stutthof concentration camp (Czarek Sokolowski/AP)

Defence lawyers had asked for her to be acquitted, saying the evidence had not shown beyond doubt that Furchner knew about the systematic killings at the camp, meaning there was no proof of intent as required for criminal liability.

In her closing statement, Furchner said she was sorry for what had happened and regretted that she had been at Stutthof at the time.

She was tried in a juvenile court because she was under 21 at the time of the alleged crimes.

The defendant tried to skip the start of her trial in September 2021 but was later picked up by police and placed in detention for several days.

Initially a collection point for Jews and non-Jewish Poles removed from Danzig, now the Polish city of Gdansk, Stutthof from about 1940 was used as a Nazi so-called “work education camp” where forced laborers, primarily Polish and Soviet citizens, were sent to serve sentences and often died.

From mid-1944, tens of thousands of Jews from ghettos in the Baltics and from Auschwitz filled the camp along with thousands of Polish civilians swept up in the brutal Nazi suppression of the Warsaw uprising.

A Moral Video Game Industry Requires Regulation

Epic Games allegedly exposed children to predators and ripped off its customers.


BY RYAN COOPER
DECEMBER 20, 2022

JAKUB PORZYCKI/NURPHOTO VIA AP

The Federal Trade Commission recently announced an agreement under which Epic Games will be required to pay more than half a billion dollars over how it has run Fortnite.

The video game Fortnite is one of the most successful entertainment products in history, with something like 400 million registered users, and $9 billion in revenue for its owner Epic Games in just 2018 and 2019. But that success has a dark side. The Federal Trade Commission recently announced an agreement under which Epic will be required to pay more than half a billion dollars over how it has run Fortnite—by allegedly violating the privacy rights of children, including exposing them to adult predators, and tricking its customers with deceptive “dark patterns” billing practices.

It’s a powerful demonstration of the fact that private corporations can’t be trusted to not abuse their customers. If child exploitation or trickery juice a company’s bottom line, they can be relied on to do it, and only the government can stop them.

For those who don’t know, Fortnite is a cartoony first-person shooter that is “free-to-play,” meaning there are no charges for making a character or joining a game. Its most popular mode is called “Battle Royale” (named after a classic Japanese horror film), in which 99 players compete to be the last one standing in an arena that gradually shrinks as time passes. Epic makes its money by charging for cosmetic stuff: clothes, character skins, dances, poses, and so on, as well as selling toys and merchandise. It keeps people playing by regularly updating the game map and mechanics and adding new cosmetics, which keeps it fresh.

Epic has been criticized for years for creating a culture in which kids feel obligated to buy so they aren’t stuck with an uncool default avatar, exploiting the fear of missing out with time-limited items, and similar pressure tactics.

What the FTC alleges, however, is much worse. The complaint—which got unanimous support from both Republican and Democratic commissioners—alleges that Epic intentionally collected personal information on young children without parental consent, in violation of the Children's Online Privacy Protection Act (COPPA) as implemented by the agency. Fortnite is blatantly marketed to children, yet Epic did not require parental consent before collecting data on under-13s, and even “required parents who requested that their children’s personal information be deleted to jump through unreasonable hoops, and sometimes failed to honor such requests,” the FTC alleges.

Worse still, Epic enabled voice chat by default in Fortnite, despite knowing that both adults and children play the game, and despite internal protests from employees that this was a dangerous practice. “Children and teens have been bullied, threatened, harassed, and exposed to dangerous and psychologically traumatizing issues such as suicide while on Fortnite,” said the FTC statement. Republican Commissioner Christine S. Wilson submitted a blistering concurring statement with three specific examples of pedophiles (who were subsequently convicted) sexually abusing children they met on the game.

Epic has agreed to pay a fine of $275 million for this behavior. The Department of Justice has submitted the agreement to a federal judge for sign-off, which is likely just a formality given that Epic has already agreed.

If child exploitation or trickery juice a company’s bottom line, they can be relied on to do it.

The other part of the agreement, which does not go before a judge and includes fines totaling $245 million, is for Epic allegedly tricking people into buying Fortnite items. The FTC alleges that its “counterintuitive, inconsistent, and confusing button configuration led players to incur unwanted charges,” such as “by pressing an adjacent button while attempting simply to preview an item.” Up until 2018, it allowed children to buy items with their parent’s credit card without getting consent first. And the agency alleges that if players disputed charges, the company often retaliated by locking their account, thus causing them to lose access to all their prior purchases. Moreover, even “when Epic agreed to unlock an account, consumers were warned that they could be banned for life if they disputed any future charges.”

Most of this behavior came when Fortnite was still on the Apple Store; it was removed during protracted litigation with Epic about Apple’s extortionate fees. At the time, Apple took 30 percent of all the proceeds of in-app purchases. What liability Apple has for benefiting from that take and failing to protect is users could be the next question the FTC needs to ask.

Epic has promised to implement a number of changes so as to not run afoul of the FTC again. That is all to the good. But if this agreement is any indication, the video game industry could stand more serious regulation. Even this enormous fine barely touches the billions Epic has made on Fortnite over the years, and will continue to make even if it scrupulously adheres to the changes it has promised.

The reason is that, as industry analyses show, it is very easy to make tons of money with this kind of micropayment model by hooking a tiny minority of players (called “whales” in the business) with poor impulse control. It would be worth considering regulations to discourage this kind of inherently abusive business model, perhaps with rules requiring regular disclosure to players of how much they’ve spent, or required warning pop-ups for big spenders, or banning micropayments entirely.

It’s good that COPPA is such a powerful law that it can prevent predatory online conduct that targets children, and it’s great to have an FTC that actually enforces the law. But adults play Fortnite too, and are also susceptible to individual manipulation. The combination of broader legislation and federal regulators signaling that the law matters can really put a dent in Epic’s behavior.

Doing so would have salutary cultural effects as well. By all accounts, Fortnite is a very fun game to play. But fundamentally, it is digital fast food: a flashy, instant-gratification experience with carefully designed hooks to keep you coming back and spending big.

It’s not a coincidence that true works of art like Return of the Obra Dinn, Spec Ops: The Line, Outer Wilds, and Valiant Hearts: The Great War are sold as one-time purchases, instead of as endless, deliberately addicting grind-a-thons that try to colonize as much of your free time as possible. The video game equivalent of the McChicken has its place, but the massive success of Fortnite has already inspired other companies to attempt imitations. It’s easy to imagine a near future in which that is the only kind of game major publishers put out, and that would be a tragedy.

CRIMINAL CAPITALI$M

Epic Forced to Pay Record-Breaking $520 Million Fine for Violating Children's Privacy and Engaging in Dark Pattern Deception


Mack DeGeurin
Mon, December 19, 2022

Photo: Christian Petersen (Getty Images)

Fortnite-maker Epic Games has agreed to pay a massive $520 million fine in settlements with the Federal Trade Commission for allegedly illegally gathering data from children and deploying dark patterns techniques to manipulate users into making unwanted in-game purchases. The fines mark a major regulatory win for the Biden administration’s progressive-minded FTC, who, up until now, had largely failed to deliver on its promise of more robust reinforcement of U.S. tech companies.

The first $275 million fine will settle allegations Epic collected personal information from children under the age of 13 without their parent’s consent when they played the hugely popular battle royale game. The FTC claims that unjustified data collection violates the Children’s Online Privacy Protection Act. Internal Epic surveys and the licensing of Fortnite branded toys, the FTC alleges, show Epic clearly knew at least some of its player base was underage. Worse still, the agency claims Epic forced parents to wade through cumbersome barriers when they requested to have their children’s data deleted.

The FTC additionally took shots at Epic’s default privacy settings, which turn live voice and text communication on by default. That default settling allegedly led to children being linked up with teens and strangers online, who, in some cases then exposed the underage users to bullying, harassment and, “psychologically traumatizing issues,” including suicide. Employees at Epic allegedly expressed concern over harms stemming from that default privacy setting dating back to at least 2017. Despite those concerns, Epic still refused calls to make voice and text communication opt-in.

“No developer creates a game with the intention of ending up here,” Epic said in a statement acknowledging the fines. “The video game industry is a place of fast-moving innovation, where player expectations are high and new ideas are paramount. Statutes written decades ago don’t specify how gaming ecosystems should operate.”

“We accepted this agreement because we want Epic to be at the forefront of consumer protection and provide the best experience for our players.”

Though bad enough on its own, the child privacy violations were only part of Epic’s problem. The game-maker additionally agreed to pay $245 million to refund customers who the FTC says fell victim to manipulative, unfair billing practices that fall under the category, “dark patterns.” Fortnite allegedly deployed a, “counterintuitive, inconsistent, and confusing button configuration,” that led players to incur unwanted charges with a single press of a button. In some cases, the FTC claims that single press button meant users were charged while sitting in a loading screen or while trying to wake the game from sleep mode. Users, the complaint alleges, collectively lost hundreds of millions of dollars to those shady practices. Epic allegedly “ignored more than one million user complaints,” suggesting a high number of users were being wrongly charged. Now that $245 million payout from Epic will be used to refund customers who lost money.

“All game developers should rethink steps they’ve taken to simplify payment flows in favor of practices that provide the largest amount of clarity to players when they make purchase decisions,” Epic said in response to the dark patterns fine. “Saving payment information by default is a common way to streamline the checkout process, so players do not have to re-enter their payment method every time they make a purchase. We’ve agreed with the FTC to change this practice, and we now offer an explicit yes or no choice to save payment information.”

In a statement, FTC chair Lina Khan said she wanted the fines, some of the largest in the agency’s 108 year history, to make clear the agency’s intent to vigorously pursue violations.


“Protecting the public, and especially children, from online privacy invasions and dark patterns is a top priority for the Commission, and these enforcement actions,” Khan said.

And though the FTC’s latest fine is far cry from the $5 billion penalty the agency issued against Facebook in 2019 and represents just a portion of the billions Fortnite reportedly rakes in each year, supporters said it nonetheless represents more than a mere slap on the wrist.

“This agreement is not a parking ticket—it’s a clear demonstration of the FTC’s full-throated commitment to protecting children online and ending the use of dark patterns,” American Economic Liberties Project Executive Director Sarah Miller said in a statement. “By securing both the largest fine and refund in the Commission’s history, the agency is showing once again that laws are not suggestions—especially when kids’ well-being is on the line.”

 

Epic Games will pay $520 million to settle FTC's 'Fortnite' case

The agency said Epic violated child privacy rules and used deceptive design choices.


Kris Holt
·Contributing Reporter
Mon, December 19, 2022

Fortnite maker Epic Games will pay $520 million to settle allegations that it violated the Children’s Online Privacy Protection Act (COPPA) and "tricked millions of players into making unintentional purchases," using deceptive design strategies called dark patterns, the Federal Trade Commission said. The agency notes that there are two separate settlements, each of which broke FTC records.

Epic will pay $275 million for allegedly violating the COPPA rule as part of a proposed federal court order. The agency says that's the largest penalty it has obtained to date over a rule violation. Epic will also refund customers $245 million over its billing practices and use of dark patterns. The FTC claims that's the largest refund in a gaming-related case and its biggest administrative order to date. It will decide whether to finalize the consent order after a 30-day public comment period.

"As our complaints note, Epic used privacy-invasive default settings and deceptive interfaces that tricked Fortnite users, including teenagers and children," FTC chair Lina M. Khan said in a statement. "Protecting the public, and especially children, from online privacy invasions and dark patterns is a top priority for the Commission, and these enforcement actions make clear to businesses that the FTC is cracking down on these unlawful practices.”

Fortnite Chapter 4 Season 1

Fortnite has been a colossal success for Epic. The game generated $9 billion in profit between 2018 and 2019, and $5.1 billion in gross revenue in 2020.

The FTC claimed that Epic violated the COPPA rule by collecting personal data from Fortnite players aged under 13 without notifying or seeking consent from their parents. In its complaint, the FTC said parents who wanted Epic to delete personal information on their kids had to "jump through extraordinary hoops" and even then the company sometimes didn't honor those requests.

The agency also accused Epic of engaging in "unfair practices" and harming children and teens by enabling voice and text chat by default. "Children and teens have been bullied, threatened, harassed and exposed to dangerous and psychologically traumatizing issues such as suicide while on Fortnite," the FTC claimed.

As part of the COPPA settlement, the FTC says there's a first-of-its-kind provision that forces Epic to have more stringent default privacy settings for kids and teens, including making sure that voice and text chat are off by default. The company also needs to delete personal data it has collected on Fortnite players unless a player says they're 13 or over or it gets parental consent to retain the information.

Earlier this month, Epic rolled out "cabined accounts" for young Fortnite, Fall Guys and Rocket League players. It said at the time these accounts provided a safe way for kids to play its games. Without parental consent, users with cabined accounts are locked out of features like using voice chat or buying items from in-game stores with real money.

Fortnite Chapter 4 Season 1

The second complaint accused Epic of using "dark patterns to trick players into making unwanted purchases and [letting] children rack up unauthorized charges without any parental involvement." The FTC claimed that players could be charged when resuming Fortnite from sleep mode, when it was on a loading screen or by accidentally clicking a button next to an item preview option. The agency said these design decisions led consumers to pay "hundreds of millions of dollars in unauthorized charges."

The FTC said children were able to buy V-Bucks, Fortnite's in-game currency, without parental consent until 2018. "Some parents complained that their children had racked up hundreds of dollars in charges before they realized Epic had charged their credit card without their consent," the agency noted. The FTC has targeted the likes of Amazon, Google and Apple for similar reasons in the past.

On top of that, Epic allegedly locked the accounts of users who disputed unauthorized payments with their credit card companies. The FTC said Epic ignored more than a million user complaints and employee concerns over wrongful charges.

Along with the $245 million Epic will pay to cover refunds, the proposed consent order seeks to block it from using dark patterns to charge users or otherwise charge them without obtaining explicit consent. Epic will also agree not to enact blanket bans for accounts that perform chargebacks, only disabling those it suspects of actual fraud. The FTC will send emails to those who made Fortnite in-game purchases when it has more details to share about the refund program.

Epic said in a lengthy statement that, among other things, it has "restored thousands of accounts that were banned due to reported chargebacks under our previous policy." Payment information will no longer be saved by default, with users offered the chance to opt out. This will add more friction to the checkout process and perhaps help to avoid unintended purchases. "We accepted this agreement because we want Epic to be at the forefront of consumer protection and provide the best experience for our players," the company said.

This isn't the end of Epic Games' legal troubles when it comes to Fortnite, which the FTC notes has more than 400 million players. Earlier this month, a judge ruled that a Quebec class action suit claiming the game is addictive (leading one child to reportedly spend more than $6,000 CAD on skins) could move forward.

Gaming Industry shows zero improvement on conflict minerals sourcing

While Apple, Google, and Nintendo maintained standards, Sony, Microsoft, Facebook and more saw concerning declines in responsible sourcing numbers

Feature by Brendan Sinclair 

 Managing Editor

GamesIndustry International
Published on Dec. 8, 2022



It's time for our eighth annual look at the games industry's conflict minerals sourcing practices and what companies are doing to ensure that the video game hardware we buy isn't funding armed conflict, slave labor, extortion and other human rights violations.

If this is your first time reading one of these, be sure to check out "The Basics" for the quick background on what conflict minerals are and where the information we're looking at is coming from, then brush up on the "Common Terms" we'll refer to throughout this piece.

If you're familiar with those bits and just want to know how the industry did, we discuss the broader results and larger trends around responsible mineral sourcing starting in The Year in Review section.

Finally, we have the individual company performances, which are linked just below. We looked at 14 different companies this year, and not a single one showed improvements over last year.

To be fair, in some cases, there's really not much in the way of room for improvement, and companies like Apple and Google have been as close to perfect as these disclosures allow for.

On the other hand, companies like Microsoft and Sony that had made significant strides since the beginning of conflict minerals reporting gave up a chunk of that progress this year, while outfits like Amazon and Valve continue to demonstrate little or no regard for transparency around ethical mineral sourcing.

One thing to note is that each year's disclosures around conflict minerals cover companies' supply chains from the previous year, so the most recent data we have will be for 2021.

Background

The Basics
Common Terms
Company-by-company performanceMicrosoft
Sony
Nintendo
Amazon
Apple
Google/Alphabet
Meta/Facebook
Other Companies in Brief
The Year in Review

In the early days of conflict minerals reporting, it was in many cases impossible to tell how much of a company's supply chain was conformant because major companies had plenty of suppliers that wouldn't even answer the conflict minerals surveys about the upstream businesses from which they obtained raw materials. For example, only 31% of Disney's suppliers bothered returning a survey in 2013.

Those numbers improved over the years, and the latest round of disclosures we looked at had most companies that reported survey return rates seeing that figure at 100% (or so close as to be explained by special circumstances). At least on that front, the improvement seems to have been sustained.

Like the supplier survey return rates, the percentage of conformant smelters or refiners (SORs) suppliers sourced materials from likewise trended up over the years in most cases, but this year a number of companies showed significant backsliding on that front.

It fits with something we were told for last year's article by Raphael Deberdt of the Responsible Sourcing Network (RSN), a charitable organization dedicated to ending human rights abuses associated with raw material supply chains. He had said that concern over conflict minerals was "in fashion" for a few years but of late that concern had switched toward cobalt, which is more closely associated with child labor than armed conflict. As a result, he had seen improvement in 3TG sourcing plateau.
"[Conflict minerals] was very much in the news from 2010 until about 2016, and then cobalt really appeared as the new mineral to be interested in"Raphael Deberdt

We check in with Deberdt again this year, and he says even the RSN has been mostly working on cobalt and other minerals besides 3TGs. Just to make certain, we ask if that suggests the conflict minerals problem has been solved.

"No, not at all," he admits. "It goes back to the 'fashionable' aspect of conflict minerals. It was very much in the news from 2010 until about 2016, and then cobalt really appeared as the new mineral to be interested in."

The RSN's focus now is on the European Union regulations around disclosure of 3TG supply chains that went into effect last year. The law requires the EU to review the law every three years, which provides an opportunity to expand the requirements to cover additional minerals like cobalt.

Even in its current state, Deberdt believes there are benefits to the EU regulations, but there's no standardized template for reporting and the law leaves it up to individual countries to determine how (or if) the findings are reported. For example, Deberdt says some countries will publish all the reports they receive, but others won't.

"It's a bit of a tricky situation where we don't have a centralized or common approach to all the issues, so that makes it extremely difficult to measure," he says.

Thankfully there are parties working to address the issue above and beyond government regulation. Last month the Responsible Minerals Initiative formally debuted a Minerals Agnostic Standard and Pilot Reporting Template that had been developed in cooperation with major companies like Microsoft.

The template lays out a standardized process for companies to collect data on all the minerals used in their work, which will hopefully make it easier for them to perform effective due diligence on their minerals supply chains.

Many of the challenges around responsible minerals sourcing extend far beyond 3TGs and the funding of armed militias

Another area that a number of companies are experimenting with for improved conflict minerals tracking is blockchain, with Apple and Google (two companies with comparatively strong track records on conflict minerals reporting) among those embracing it.

While the companies experimenting with blockchain solutions say it could improve transparency in the conflict minerals tracking process, Deberdy says it has unclear benefits at the moment.

"As of now, the context and the available data we can access in the conflict minerals and cobalt sector kind of prevents us from having an efficient and effective blockchain system in place," Deberdt says. "I don't think it's really feasible at this time."

Speaking with Deberdt, it's clear that many of the challenges around responsible minerals sourcing extend far beyond 3TGs and the funding of armed militias.
"I think we'll also see a push from the West to really develop rare earth minerals deposits in the West or in countries that are more friendly to the West."Raphael Deberdt

For example, pandemic lockdowns across the Southern region of Africa slowed down cobalt export routes from the DRC, and the small-scale artisanal mining sector has been hurt by the wider economic slowdown (although Deberdt adds the mining industry in general is doing fairly well at the moment).

He says the Russian invasion of Ukraine had a particularly significant impact on nickel, and a less notable impact on cobalt.

Russia has considerable amounts of high-grade nickel that's important for electric vehicle batteries, and the price effectively doubled at the beginning of the war amid fears of shortages. While the price has since come back down to earth, it is still trading significantly above where it was prior to the invasion.

Perhaps more than the actual impact on nickel, the war in Ukraine has served as a reminder to many countries that political tensions can prevent access to essential materials for various industries.

"It's something we should keep in mind in the future in terms of how we source minerals and from where," Deberdt says. "I think we'll also see a push from the West to really develop rare earth minerals deposits in the West or in countries that are more friendly to the West."

According to the US Geological Survey, Chinese mines produced 60% of the world's rare earth last year, and accounted for 78% of rare earth compounds and metals imported into the US between 2017 and 2020.
"At some point we need to just recognize that we use too much minerals..."Raphael Deberdt

That could spur the 'Next Big Thing' for the mineral extraction industry: deep sea mining.

Deberdt says various outfits are exploring the idea right now, and thinking through the impact it would have on minerals sourcing as well as the environment and potentially various communities of people.

A number of companies, Razer for example, have called for a moratorium on deep sea mining, but Deberdt says the parties embracing such measures seem to split between those who think we don't know enough about deep sea mining to do it just yet, and those who think we should never attempt it.

"I think at some point we need to just recognize that we use too much minerals, and maybe the main focus should be on recycling and decreasing the amount of minerals we use," Deberdt says.

Before we get into the company-by-company breakdown, a reminder that we have a helpful glossary of all the common terms used in the write-ups.

Microsoft 

Microsoft's conflict minerals report has some concerning flags. The one area of improvement was with CMRT surveys, where it managed to achieve a 100% response rate from its 193 suppliers. (In 2020, there was a single supplier that did not return a survey, making for a 99.5% return rate.)

However, 2021 also saw the continuation of a concerning dip in conformant SORs in Microsoft's supply chain. In 2019, Microsoft had 99.6% conformant SORs, with just a single non-conformant SOR out of the 233 in its supply chain. In 2020, we noted that figure dipping to 78.7%, or 237 out of 301 SORs.

For 2021, that percentage continued sinking, with the company reporting 238 conformant SORs out of the 322 eligible for a 3TG audit program, or 73.9%. Another 25 SORs (7.8%) were in the process of becoming conformant, but the remaining portion of SORs – almost one-fifth of the SORs in the supply chain – had a potpourri of problems.

A total of 9 SORs (2.8%) either failed their audits or didn't renew their participation in the audit programs. 5 SORs (1.6%) were listed as "communication suspended," with the SOR having "strongly communicated a lack of interest in participation."

Another 36 SORs (11.2%) were listed as "Outreach required," with the next step being to have companies in the Responsible Mining Assurance Program reach out to "encourage" participation in an audit.

Then there were 5 SORs (1.6%) in communication with RMAP or its members about auditing, but which hadn't begun the process yet.

Finally, 4 SORs (1.2%) had "not met the threshold for due diligence vetting."

Despite all that, Microsoft did not in 2021 see any nonconformance that it felt justified terminating its business with any of its suppliers.

As for how it hopes to improve those figures, Microsoft said it would require in-scope suppliers to find alternative upstream suppliers if they're sourcing from non-conformant SORs.

Sony

Sony has traditionally been the worst performing of the major companies we look at in this report. Or at least it was until we started looking at Amazon.

And while the company made steps to improve conflict minerals sourcing in 2020, 2021 saw it headed in the opposite direction. The best we can say about Sony is that it once again managed a 100% response rate from its suppliers, marking just the second time that has happened.

Unfortunately, the news from the suppliers was not good. Only 75% of Sony's 339 identified SORs were conformant, down from 80% of the 305 SORs in its supply chain for 2020.

Of the remaining 84 non-conformant SORs, Sony doesn't know where 47 of them are located, or where their 3TGs are sourced from.

As for how it will improve on these figures, it has asked its suppliers to work with their SORs to undergo audits, and to remove non-conformant SORs unwilling to go through the audit process from the supply chain, much as it has in previous years.

In 2021, Sony reported 31 suppliers who worked with non-conformant SORs, only 18 of which agreed to take the above steps.

If suppliers don't cooperate, Sony said it may take further actions that could include cancelling a supplier's contract or "implementing a phased-in termination of the business relationship."

Sony did not say if it actually took such actions in 2021.

It wasn't all bad for Sony though. In an annual sustainability report on its corporate site, Sony addressed its cobalt sourcing, saying it had eight suppliers drawing materials from 23 cobalt refineries, all of which were either conformant or in the process of a third-party audit to become conformant.

Nintendo

Nintendo isn't subject to the Dodd-Frank Act's disclosure requirements, but it does release comparable details on its corporate social responsibility page each year.

Just like in 2020, Nintendo saw a 100% response rate from suppliers in 2021, and it confirmed that 100% of the 282 SORs in its supply chain were conformant.

Nintendo has also gone a bit above and beyond its peers by including cobalt SORs in its disclosures as well as those that handle 3TGs, and still maintaining its perfect conformant rate.

However, that rate appeared to be obtained in part by cutting entire countries out of its supply chains against the guidance of the Organisation for Economic Co-operation and Development, which created the standards most companies use in their conflict minerals disclosures. If everybody were to avoid sourcing from conflict-affected countries entirely, there would be no reason to adopt above-board best practices, and the countries would lose out on legitimate economic activity that might help bring stability rather than fuel instability.

Nintendo previously said on its site that it has a policy that "prohibits the use of minerals from Conflict-Affected and High-Risk Areas." That straight-forward declaration is gone now, but footnotes on the site suggest the policy remains in place.

Just like last year, Nintendo only lists a single SOR in one of the countries covered by Dodd-Frank, a tin smelter in Rwanda.

Amazon

I'll cut and paste a chunk of last year's write-up of Amazon because that's more or less what the Fire tablet and Luna maker did in its reporting. Again.

Ever since Amazon first had to file a minerals disclosure on its supply chain in 2014, it has said the same thing: that "a majority" of its suppliers had certified that their supply chain was clean, either because they didn't use 3TGs, didn't source them from the Covered Countries, or used only conformant SORs.

As for what the situation is with the suppliers who might be funding war crimes – which, given its vague disclosures, could be almost 50% of the 1,900 suppliers it works with – Amazon only said, "The remaining suppliers are still completing investigations of their supply chains."

That was word-for-word what the company reported last year. And the year before that. And every year since 2014.

In nine years of filings, Amazon has never given an indication as to how large a majority of its suppliers filled out their CMRT surveys or how many are still investigating their supply chains. There's no telling how many SORs they might collectively source from, much less whether those SORs would be funding militias and/or human rights abuses.

Amazon has shown zero demonstrable progress on conflict minerals since reporting began.

Apple

If Amazon's reporting is mockery of the push to detail responsible sourcing procedures, Apple's reporting is a model of it.

Apple was among the first big tech firms to prioritize conflict minerals sourcing and reporting, and it continued to lead the way in 2021. For the seventh straight year, 100% of the 253 smelters or refiners in Apple's 3TG supply chains were participating in independent audits. Apple said the same about its cobalt and lithium supply chains, neither of which it is required to report on.

One of the ways Apple has kept its unblemished record is by removing from its supply chain anyone who either won't go through the audit process or goes through it but falls short of requirements. In 2021, that meant scratching a dozen SORs from the supply chain. Since 2009, the company has removed a total 163 SORs from its chain.

A little more than half of those removed suppliers over the years have been dealing in gold, so it's worth noting that Apple has made particular strides in its sourcing there. The company has set a goal to use recycled gold exclusively in its supply chain, and 2021 was the first year it achieved that in a single Apple product. That product was the iPhone 13, which used recycled gold for the front and rear camera wiring, as well as the main logic board plating.

Apple said it eventually wants to use exclusively recycled and renewable minerals and materials in all of its products.

Alphabet/Google

Google's a lot like Apple, it turns out.

Like Apple, Google had its bases mostly covered in 2021.

Like Apple, every SOR in Google's supply chain is compliant, in the process of becoming compliant, or not sourcing 3TGs from the covered countries. Google received a 100% response rate from its suppliers, who collectively identified 266 SORs in the supply chain. 89% of them were conformant and another 5% were going through the auditing process. The remaining 6% were at least confirmed to not be sourcing their 3TGs from the covered countries.

Like Apple, Google has been doing this for a while now. 2021 was the company's fourth straight year where 100% of its 3TG supply chain fell into those three categories.

Like Apple, Google is also paying attention to its cobalt supply chain, funding Responsible Sourcing Network research into the challenges of ethical cobalt sourcing and funding Responsible Minerals Initiative efforts to aid cooperation between stakeholders to understand what effect investments and efforts to mitigate issues with cobalt supply chains have been having.

Like Apple, Google also wants to increase its reliance on recycled materials. Unlike Apple's future 100% recycled commitment, Google set a more modest near-term goal, aiming to have 100% of Google consumer hardware products contain at least some recycled materials in them starting this year.

Meta/Facebook

Meta is less significant in the hardware space, with its Portal video calling device as well as Quest VR headsets and controllers being the only 3TG products of note that it makes. Despite that, the supply chain is similarly sprawling, with Meta identifying 255 SORs in its supply chain.

Almost 91% of those were conformant, with another 4% being active in a third-party audit program. That left 13 SORs – about 5% of the total – in question.

While 95% compliance is better than a lot of companies we looked at, it's still down from 99% last year. Given Meta's various hardware offerings will likely ramp up if it continues its massive push into the metaverse, it's worrying to see any backsliding on this front.

It's also unclear what Meta will do to improve its numbers from here, as its disclosure form was substantially identical to last year, with little difference beyond the updated numbers.

Other Companies in Brief

● For the fourth straight year, Valve didn't answer our inquiries about conflict minerals. The company's continued refusal to even acknowledge responsible minerals sourcing as a concern, its growing hardware presence with the Steamdeck, and its well-demonstrated disdain for basing decisions on morality continue to be a deeply concerning combination of factors.

● Logitech saw its percentage of conformant SORs drop from 98.4% (247 out of 251) in 2020 to 92.5% (234 out of 253) in 2021. In both years, all non-conformant SORs were either in the audit process or confirmed to not source their 3TGs from the DRC or neighboring countries.

● Turtle Beach also dropped in 2021, going from having 94% of its SORs conformant (232 out of 246) to 85% (225 out of 264). The company says it works with partners "to provide awareness of Turtle Beach's goal to only source from conformant smelters or refiners," but did not describes steps it will take to get closer to that goal instead of falling further away from it as it did in 2021.

● Razer is not subject to Dodd-Frank requirements, so it didn't file with the SEC. It did point us to its Go Green with Razer initiative though, saying it is requiring suppliers to conduct due diligence for responsible sourcing of minerals, and that it is participating in a moratorium on deep sea mining. It also states that it does not purchase materials from high-risk areas.

● We haven't covered GameStop previously, but the retailer does use 3TGs in parts for its refurbishments business as well as some of its merchandise. It reported a 100% response rate on surveys, with 16 SORs in its supply chain, two of which could not be confirmed as conflict-free. On top of that, some of its suppliers did not identify their sources for raw materials.

● HTC once again referred us to the corporate responsibility page on its website, which affirms that the company continues to avoid sourcing materials from Central Africa and takes steps to ensure no child labor is used by its manufacturing suppliers.

● Activision Blizzard was only in last year's report because of a single product, a World of Warcraft beer stein it made. The company confirmed for us that it didn't make any products using 3TGs in 2021, so it didn't need to file a disclosure form with the SEC.
The Basics

In the 2000s, the United Nations identified connections between the mining of 3TGs (the collective shorthand for tin, tantalum, tungsten, and gold) and the funding of non-state armed militias in the Democratic Republic of Congo (DRC). In some cases, those militias controlled the mines and forced civilians to work them. In others, they extorted money from the mines or taxed the trade routes they used. In short, the money companies paid for minerals in their supply chains was funding the militias that were committing an array of crimes and human rights abuses.

Concern around the subject led to the inclusion of regulations around conflict minerals in the US' Dodd-Frank Wall Street Reform and Consumer Protection Act, which became federal law in 2010. One small part of the law – Section 1502 – explains legislators' concern that the trade of 3TGs was funding "extreme levels of violence in the eastern Democratic Republic of the Congo, particularly sexual- and gender-based violence, and contributing to an emergency humanitarian situation therein..."

Section 1502 requires companies that are publicly traded in the US and use 3TGs from the DRC or neighboring countries to have independent audits of their supply chains to ensure they weren't funding armed groups, and to make public disclosure of their findings.

The way it normally works is that the company assesses the products it makes to see if any of them use 3TGs. If so, they ask their suppliers to fill out surveys to help identify where the 3TGs in their products come from.

But the suppliers aren't digging these things out of the ground themselves. They're getting the minerals from smelters or refiners (SORs), who in turn should have an idea as to which mines produced the minerals they smelt or refine.

So the industry decided that the best way so ensure an ethical supply chain was to have a variety of audit programs for SORs where independent parties could assess SOR operations and ensure they were keeping to established best practices in order to ensure the minerals they dealt with were ethically sourced and not going to fund armed conflict or other human rights violations. SORs that get that stamp of approval are called "conformant."

Companies began making those disclosures in 2014. We've reported on them since 2015. You can read our previous reports here:2015
2016
2017
2018
2019
2020
2021

Click here to return to the top of the article.

Common Terms

There are a handful of terms and acronyms that we are leaning on across the article. Here are a few of the big ones and what they mean:3TG - This means tin, tungsten, tantalum, and gold, collectively the four substances US conflict minerals laws require publicly traded companies to report on the use of in their supply chains.
SORs - Smelters and refiners, one of the furthest upstream elements in supply chains for minerals, and well-positioned to have visibility into which mines produced their minerals. Companies typically do not do business directly with SORs, so they exert their influence on their suppliers, who may in turn have additional suppliers in between themselves and the SORs.
DRC - The Democratic Republic of Congo, one of the first countries where the financial ties between the mining of conflict minerals and armed groups was established.
Covered Country - As defined by the Dodd-Frank Act, this includes the Democratic Republic of Congo and adjoining countries: Angola, Burundi, Central African Republic, Rwanda, South Sudan, Tanzania, Uganda, and Zambia. Some companies base their disclosures around 3TGs from these areas.
Conformant - A catch-all description used for smelters and refiners who have passed an audit process to ensure responsible sourcing. These programs are overseen by a number of outfits, including the London Bullion Market Association, the Responsible Jewellery Council, or the Responsible Minerals Initiative.
RMAP - Responsible Minerals Assurance Process, a program created by the Responsible Minerals Initiative to help companies responsibly source minerals in their supply chains.
CMRT - Conflict Minerals Reporting Template, a standardized reporting measure developed by the Responsible Minerals Initiative to allow companies to gather and submit information about the upstream elements of their supply chains and every link between them and a mineral's smelter or refiner.


Author

Brendan Sinclair
Managing Editor
Brendan joined GamesIndustry International in 2012. Based in Toronto, Ontario, he was previously senior news editor at CBS-owned GameSpot in the US.

Fewer abortions, more vasectomies: Why the procedure may be getting more popular

December 20, 2022
SARAH MCCAMMON

Dr. Esgar Guarín with his mobile vasectomy clinic parked at a Planned Parenthood in St. Louis, Mo.Sarah McCammon/NPR

Restrictions on abortion in many states are prompting some men to rethink their reproductive health decisions. Since this summer's U.S. Supreme Court ruling overturning Roe v. Wade, some doctors say they're hearing from a growing number of male patients asking for vasectomies.

"It shouldn't just be on women to step up and not have kids, you know?" says Dustin May, of St. Louis, shortly after his vasectomy procedure at a Planned Parenthood clinic. Vasecomies are outpatient permanent sterilization procedures that block sperm from being released in semen.

May and his girlfriend, Courtney Price, have known for years that they don't want children.

"If she got pregnant, an abortion would be something that we would consider... This is a step to prevent that."

Price says she's tried several types of birth control, all with unpleasant side effects. May and Price are both still in their 20's, but Price says they knew from their first date more than three years ago that neither one of them wanted to become parents.

"I'm like, 'Kids?' And he's like, 'No.' I'm like, 'Thank God!' "

Few other options in restrictive abortion states

As of the Dobbs v. Jackson Women's Health decision in June, abortion is illegal in Missouri and roughly a dozen other states, with Republican lawmakers in many states pushing to pass more restrictions in the future.

Book by mom of six puts onus on men to stop unwanted pregnancies

The Planned Parenthood clinic in St. Louis used to provide abortions, but on a recent day NPR visited, the health center was hosting a free vasectomy clinic at three different locations around Missouri over three days. Normally, if not covered by a patient's insurance, Planned Parenthood charges up to $1,000 for the procedure, including follow-up care.

As soon as the Dobbs decision was released, Dr. Esgar Guarín says his Iowa-based vasectomy practice saw a surge in website traffic, and the number of patients coming for procedures nearly doubled from June to July.

"What has happened is that since Roe v. Wade was overturned, many men have realized that they perhaps have been absent in contraception, particularly in contraceptive decisions," says Guarín, who assisted with the vasectomy clinic in Missouri.

Guarín's practice isn't alone. A spokesperson for the American Urological Association told NPR that while national data isn't available yet, healthcare providers around the country have anecdotally reported seeing increased demand for vasectomies in recent months.

Dr. Esgar Guarín's mobile vasectomy clinic, pictured here parked at a Planned Parenthood in St. Louis, Mo., features images of sperm.Sarah McCammon/NPR

Permanent with little risk

In addition to being permanent, Guarín says vasectomies are relatively quick - about 10 minutes for a skilled surgeon. They're also less invasive than tubal ligation, a sterilization procedure that involves cutting or blocking the fallopian tubes to prevent pregnancy. They have a far lower failure rate than many other types of birth control including condoms and are more effective than some other types of contraceptives including the pill.

Dr. Sarah Vij, assistant professor of urology at the Cleveland Clinic, says vasectomies are "at sky-high, record rates" since Dobbs. At Planned Parenthood North Central States in the Midwest, CEO Ruth Richardson says the organization received a "surge of calls" after the decision.
Sponsor Message

In New York, Dr. Meera Shah, chief medical officer at Planned Parenthood Hudson Peconic, is getting similar calls from patients who've decided that now is the time for a vasectomy.

"They've been thinking about getting it for a really long time, and then what's happening in this country has motivated them that much more to get the vasectomy," Shah says.
Some downsides

There can be downsides, though. Shah tells patients that vasectomy reversals are sometimes possible but never guaranteed.

"If somebody is going into a vasectomy saying, 'Oh, it can be reversed,' then I say that they may not be a candidate for it."

Shah says some patients choose to freeze their sperm before the procedure in an effort to keep more options open should they decide to try to have a child in the future.

Another patient at the Planned Parenthood in St. Louis, Collin Mack, says he's been wanting a vasectomy for several years, "but I waited because I don't like making rash decisions."

Now, Mack says he worries about the lack of access to abortion. And he likes the idea of being in control of his fertility, rather than relying on a female partner's contraceptive decisions.

In the hunt for a male contraceptive, scientists look to stop sperm in their tracks

At 24, Mack says he felt confident in his decision, but he persuaded his grandparents to help fund the cost of freezing some sperm as a "backup option" in case he ever changes his mind. Storing sperm typically costs several hundred dollars a year.

"I kind of played the card of like, 'Do you guys want me to have kids? Because you guys seem the most upset about this procedure, you guys should invest some money in me freezing the sperm,' " Mack says. "I'm not too worried about it. I'd prefer not to have kids - I think that's the choice that I'm going to stick with."

Dr. Guarín says many of his recent patients have been younger men, often in their 30s, as well as couples. Many had been relying on female partners for contraception and no longer feel confident doing so.

"I hope this is an inflection point in reproductive rights in America for the participation of men," he says.