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A commercially sold hospital stethoscope is a legally marketed medical device made under a manufacturer quality system, with labeling/instructions, device listing/registration obligations, adverse-event/complaint processes, cleanability expectations, liability, warranty, consistent materials, and repeatable acoustic performance.

An open-source 3D-printed stethoscope is a cool project, but unless it is produced and controlled as a medical device, it is not equivalent to what hospitals are buying for daily patient care.

Personally, if I was a hospital or a doctor, it would be a no-brainer for me to go with the commercially sold stethoscopes. All those factors I listed above, if neglected, can end up costing a lot more in terms of consequences. I would rather pay a fixed extra overhead price per unit to sleep well, knowing I don't have to worry or think about those factors at all. And, I would assume, most of the patients would be in favor of that as well.

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What standard exactly, for a stethoscope?

I know nothing of this, but it looks like stethoscopes are Class 1 medical devices with 501(k) exemption, and fall under the "Good manufacturing practices" guidelines of Quality System Regulation (21 CFR 820), but that seems pretty squishy.

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CFR 21 being labeled squishy is a first for me.
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CFR 21 is the whole thing. I'm specifically referring to Part 820, within the context of a stethoscope.
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In the UK it would be Class Im - so low risk device that sits outside the body, with a measuring functionality.
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To get an idea for required rigor, this is also what eye glasses fall under, in the UK.
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