Yesterday at GEH I actually got to lay eyes on an old Kodak perforater. Unfortunately it's in the collection so that means it'll never be used again, but, I agree with AgX that it should be a relatively simple task for anyone who is good at milling and machining.
In fact, although not for making perfs, in the labs down here I've come across these two little film splitters with stickers that say RIT on them. They are for splitting 4" film down to 35mm, and the other is for splitting 35mm down to 16mm. The bigger is driven by a motor and the smaller by hand crank. My point in mentioning these is that the construction of them is very simple, but they are also incredibly well made, with very high tolerances, and they work like a charm.
If somebody at a technical university can put these things together, a film perforater for medium quantity production would be easy enough me thinks.