IEC TR 60601-4-3:2018

IEC TR 60601-4-3 ®
Edition 2.0 2018-12
TECHNICAL
REPORT
colour
inside
Medical electrical equipment –
Part 4-3: Guidance and interpretation – Considerations of unaddressed safety
aspects in the third edition of IEC 60601-1 and proposals for new requirements

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IEC TR 60601-4-3 ®
Edition 2.0 2018-12
TECHNICAL
REPORT
colour
inside
Medical electrical equipment –

Part 4-3: Guidance and interpretation – Considerations of unaddressed safety

aspects in the third edition of IEC 60601-1 and proposals for new requirements

INTERNATIONAL
ELECTROTECHNICAL
COMMISSION
ICS 11.040.01 ISBN 978-2-8322-6278-8

– 2 – IEC TR 60601-4-3:2018  IEC 2018
CONTENTS
FOREWORD . 6
INTRODUCTION . 8
1 Scope . 9
2 Normative references . 9
3 Terms and definitions . 11
4 Recommendations . 11
4.1 Template used for recommendations prepared by SC 62A . 11
4.2 Recommendation sheets . 12
4.2.101 Total PATIENT LEAKAGE CURRENT of a ME SYSTEM . 12
4.2.102 Pollution degree for MOPP . 13
4.2.103 Transients on DC mains . 13
4.2.104 Altitude factor for DEFIBRILLATION-PROOF APPLIED PARTS . 14
4.2.105 Defibrillation energy protection for MOOP/MOPP . 15
4.2.106 Overvoltage categories III and IV . 15
4.2.107 Pollution degree related to different micro/macro environments . 15
4.2.108 Warnings versus ALARM SIGNALS . 16
4.2.109 Single Y1 capacitor for MOPP . 16
4.2.110 WORKING VOLTAGE > 14 140 V peak . 17
4.2.111 CREEPAGE DISTANCE and AIR CLEARANCE for dental equipment . 18
4.2.112 Short-circuiting of one constituent part of DOUBLE INSULATION . 19
4.2.113 Instability in transport position . 19
4.2.114 Delay time for conducting leakage current tests after humidity
preconditioning treatment . 20
4.2.115 DEFIBRILLATION-PROOF TYPE B APPLIED PARTS . 20
4.2.116 Instability excluding transport position . 21
4.2.117 DIELECTRIC STRENGTH of two serial MOPP barrier parts . 21
4.2.118 Overheating transformer . 22
4.2.119 Test equipment for recurrent tests according to IEC 62353 testing used
within IEC 60601-1 type approval testing . 23
4.2.120 Tolerances of apparatus . 25
4.2.121 FUNCTIONAL EARTH CONDUCTOR and ESSENTIAL PERFORMANCE. 26
4.2.122 AC motors . 27
4.2.123 Operational insulation . 28
4.2.124 WORKING VOLTAGE measurement . 28
4.2.125 Defibrillation test. 29
4.2.126 Oil containers for moving parts . 30
4.2.127 PERMANENTLY INSTALLED ME EQUIPMENT in the HOME HEALTHCARE
ENVIRONMENT . 30
4.2.128 Polystyrene plate for LEAKAGE CURRENT tests . 32
4.2.129 Push buttons . 33
4.2.130 Temperature limit at the ENCLOSURE in SINGLE FAULT CONDITION . 34
4.2.131 Optic coupler requirements . 35
4.2.132 Eye-verification of tester before legibility test . 37
4.2.133 End stops to prevent overtravel . 38
4.2.134 MOPP barrier with low WORKING VOLTAGE RMS and high
WORKING VOLTAGE peak . 39
4.2.135 Labeling: spare parts vs. detachable parts vs. ACCESSORIES . 40

4.2.136 Protective earth impedance of ME SYSTEM > 200 mΩ . 43
4.2.137 Ball pressure test . 44
4.2.138 Magnesium alloy ENCLOSURE. 45
4.2.139 Instability with initial movement . 46
4.2.140 Ball pressure test . 47
4.2.141 DIELECTRIC STRENGTH test values . 49
4.2.142 SECONDARY CIRCUITS . 50
4.2.143 LEAKAGE CURRENTS in SINGLE FAULT CONDITION and during component
faults . 50
4.2.144 Impedance of a PROTECTIVE EARTH CONDUCTOR within a DETACHABLE
POWER SUPPLY CORD . 51
4.2.145 Time delay of the 100 VA limit . 52
4.2.146 Test voltage multiplied by factor 1,6 . 53
4.2.147 Overflow and spillage . 53
4.2.148 DIELECTRIC STRENGTH test of transformers without accessible frame . 54
4.2.149 Expected voltage on SIP/SOPs . 54
4.2.150 Flammability rating for transformer bobbin . 55
4.2.151 COMPONENT WITH HIGH-INTEGRITY CHARACTERISTICS . 55
4.2.152 Peak and RMS WORKING VOLTAGES . 56
4.2.153 Critical components . 57
4.2.154 LEAKAGE CURRENT test for ME EQUIPMENT with multiple APPLIED PARTS . 57
4.2.155 DIELECTRIC STRENGTH test value for extruded and spirally wrapped multi-
layer wires . 58
4.2.156 DIELECTRIC STRENGTH test after thermal cycling test . 58
4.2.157 Required MOOP values higher than MOPP values . 59
4.2.158 Optocouplers . 59
4.2.159 Impact test . 60
4.2.160 Spillage test in NORMAL CONDITION and in SINGLE FAULT CONDITION . 61
4.2.161 TYPE B APPLIED PART connected to ACCESSIBLE PARTS . 62
4.2.162 Current/power labeling . 62
4.2.163 Separate power supply part of ME EQUIPMENT or ME SYSTEM . 63
4.2.164 Specification of the allowed power supply . 63
4.2.165 Mains transients for opposite polarity on the secondary side or battery
pole to pole barrier . 64
4.2.166 Keep dry and umbrella symbol . 65
4.2.167 MOBILE and STATIONARY ME EQUIPMENT with wheels . 66
4.2.168 Varistors installed in the MAINS PART . 67
4.2.169 Using Y2 capacitors for MOPP . 67
4.2.170 Overtravel end stops – Specification of the speed. 68
4.2.171 CREEPAGE DISTANCE and AIR CLEARANCE between input and output of
fuse contacts . 69
4.2.172 Examples of SINGLE FAULT CONDITION . 70
4.2.173 Examples of ME SYSTEMS . 70
4.2.174 Cross sectional area of POWER SUPPLY CORD for rated input current
> 63 A . 71
4.2.175 Biocompatibility for quasi APPLIED PARTS . 71
4.2.176 Floating reference earth. 72
4.2.177 SINGLE FAULT CONDITION in OXYGEN RICH ENVIRONMENT . 73
4.2.178 Laser requirements . 75
4.2.179 Flammability rating of insulated wires . 75

– 4 – IEC TR 60601-4-3:2018  IEC 2018
4.2.180 Infrared lamps . 76
4.2.181 Identification of internal fuses . 77
4.2.182 Chargers for ME EQUIPMENT used at home . 78
4.2.183 CLASS II ME EQUIPMENT with FUNCTIONAL EARTH CONDUCTOR . 79
4.2.184 Symbol ISO 7010-W001 (2011-05) on a MULTIPLE SOCKET-OUTLET (MSO) . 80
4.2.185 PATIENT leads connectors . 81
4.2.186 Rationale for IP2X . 82
4.2.187 Battery – Limited power . 83
4.2.188 TYPE B APPLIED PART separated from ACCESSIBLE PARTS . 83
4.2.189 Protective earth test > 25A . 84
4.2.190 Reference to IEC 62304:2006 . 85
4.2.191 The SIP/SOP pin to earth TOUCH CURRENT . 85
4.2.192 Overbalancing . 87
4.2.193 MAINS VOLTAGE on APPLIED PART . 88
4.2.194 TYPE B vs TYPE BF SFC limits . 88
4.2.195 Split up of BI, SI, DI, RI barriers . 90
4.2.196 ALARM PULSE RISE TIME . 92
4.2.197 Non-frequency-weighted measurement . 93
4.2.198 Printed circuit boards meeting UL 796 . 94
4.2.199 Y1 caps bridging 2 MOPP . 94
4.2.200 PORTABLE, STATIONARY and TRANSPORTABLE ME EQUIPMENT . 95
4.2.201 Opposite polarity and philosophy of IEC 60601-1 . 96
4.2.202 Separation device . 97
4.2.203 Consult ACCOMPANYING DOCUMENTS . 98
4.2.204 AP-ENCLOSURE requirements. 100
4.2.205 Guidewire . 101
4.2.206 H or L mains fuses . 102
4.2.207 APPLIED PART temperature . 103
4.2.208 Cecon plug as permanently installed MEE . 103
4.2.209 Biocompatibility for enclosures and other parts . 104
4.2.210 Safety relevant LEDs . 105
4.2.211 Lithium coin cells . 105
4.2.212 Motor capacitors . 106
4.2.213 Warning, caution, safety notice . 106
4.2.214 ESSENTIAL PERFORMANCE related to RM (P1 and P2) . 107
4.2.215 IEC 60601-1-8 symbol color . 109
4.2.216 Indicator lights for standby switch . 109
4.2.217 CLASS II symbol . 110
4.2.218 Authorized SERVICE PERSONNEL . 111
4.2.219 Scope of IEC 62133 and requirement in 15.4.3.4 related to PORTABLE
batteries . 112
4.2.220 IT-NETWORK requirements . 112
4.2.221 Non-lithium batteries . 113
4.2.222 AP and APG . 114
4.2.223 Non-weighted 10 mA PATIENT AUXILIARY CURRENT . 115
4.2.224 IPX test and test criteria . 116
4.2.225 ALARM SETTINGS, alarm presets, default alarm presets . 117
4.2.226 AUDIBLE ALARM SIGNALS . 119
4.2.227 ISO 8820-3 fuses . 120

4.2.228 Luminous colour of ambient light . 121
4.2.229 WITHDRAWN . 121
4.2.230 WITHDRAWN . 121
4.2.231 Assumed typing errors in several clauses . 122
4.2.232 Indicator lights . 123
4.2.233 PEMS . 124
4.2.234 PEMS validation . 126
4.2.235 Instability excluding transport . 127
4.2.236 Separating transformer output voltage accuracy . 127
4.2.237 CLASS I ME EQUIPMENT in EMS environment . 128
4.2.238 Fire ENCLOSURE top cover . 129
4.2.239 Unacceptable RISK – Mechanical strength . 130
4.2.240 PE plus 1 MOP for non-medical components . 130
4.2.241 Resistance temperature method for non-copper windings . 132
4.2.242 DUPLICATE / WITHDRAWN . 132
4.2.243 Drop test during INTENDED USE . 133
Annex A (informative) Overview of the recommendations developed by SC 62A . 134
Bibliography . 141

Figure 1 – WORKING VOLTAGE measuremnent . 29
Figure 2 – Example of creepage measurement . 92
Figure 3 – Same severity could result in an acceptable or unacceptable RISK,
depending on the probability factor . 108

Table A.1 – Cross-references to IEC 60601-1:2005 and IEC 60601:2005/AMD1:2012 in
numerical order . 134
Table A.2 – Cross-references to IEC 60601-1-8:2006 and IEC 60601-1-
8:2006/AMD1:2012 in numerical order . 139
Table A.3 – Cross-references to IEC 60601-1-11:2010 and IEC 60601-1-11:2015 in

numerical order . 140
Table A.4 – Cross-references to IEC 60601-1-12:2014 in numerical order . 140

– 6 – IEC TR 60601-4-3:2018  IEC 2018
INTERNATIONAL ELECTROTECHNICAL COMMISSION
____________
MEDICAL ELECTRICAL EQUIPMENT –

Part 4-3: Guidance and interpretation – Considerations
of unaddressed safety aspects in the third edition of IEC 60601-1
and proposals for new requirements

FOREWORD
1) The International Electrotechnical Commission (IEC) is a worldwide organization for standardization comprising
all national electrotechnical committees (IEC National Committees). The object of IEC is to promote
international co-operation on all questions concerning standardization in the electrical and electronic fields. To
this end and in addition to other activities, IEC publishes International Standards, Technical Specifications,
Technical Reports, Publicly Available Specifications (PAS) and Guides (hereafter referred to as “IEC
Publication(s)”). Their preparation is entrusted to technical committees; any IEC National Committee interested
in the subject dealt with may participate in this preparatory work. International, governmental and non-
governmental organizations liaising with the IEC also participate in this preparation. IEC collaborates closely
with the International Organization for Standardization (ISO) in accordance with conditions determined by
agreement between the two organizations.
2) The formal decisions or agreements of IEC on technical matters express, as nearly as possible, an international
consensus of opinion on the relevant subjects since each technical committee has representation from all
interested IEC National Committees.
3) IEC Publications have the form of recommendations for international use and are accepted by IEC National
Committees in that sense. While all reasonable efforts are made to ensure that the technical content of IEC
Publications is accurate, IEC cannot be held responsible for the way in which they are used or for any
misinterpretation by any end user.
4) In order to promote international uniformity, IEC National Committees undertake to apply IEC Publications
transparently to the maximum extent possible in their national and regional publications. Any divergence
between any IEC Publication and the corresponding national or regional publication shall be clearly indicated in
the latter.
5) IEC itself does not provide any attestation of conformity. Independent certification bodies provide conformity
assessment services and, in some areas, access to IEC marks of conformity. IEC is not responsible for any
services carried out by independent certification bodies.
6) All users should ensure that they have the latest edition of this publication.
7) No liability shall attach to IEC or its directors, employees, servants or agents including individual experts and
members of its technical committees and IEC National Committees for any personal injury, property damage or
other damage of any nature whatsoever, whether direct or indirect, or for costs (including legal fees) and
expenses arising out of the publication, use of, or reliance upon, this IEC Publication or any other IEC
Publications.
8) Attention is drawn to the Normative references cited in this publication. Use of the referenced publications is
indispensable for the correct application of this publication.
9) Attention is drawn to the possibility that some of the elements of this IEC Publication may be the subject of
patent rights. IEC shall not be held responsible for identifying any or all such patent rights.
The main task of IEC technical committees is to prepare International Standards. However, a
technical committee may propose the publication of a technical report when it has collected
data of a different kind from that which is normally published as an International Standard, for
example "state of the art".
IEC TR 60601-4-3, which is a technical report, has been prepared by subcommittee 62A:
Common aspects of electrical equipment used in medical practice, of IEC technical
committee 62: Electrical equipment in medical practice.
This second edition cancels and replaces the first edition of IEC 60601-4-3 published in 2015.
This edition constitutes a technical revision.
This edition includes the following significant technical changes with respect to the previous
edition: addition of 47 new recommendations.

The text of this document is based on the following documents:
Enquiry draft Report on voting
62A/1236/DTR 62A/1258A/RVDTR
Full information on the voting for the approval of this technical report can be found in the
report on voting indicated in the above table.
This document has been drafted in accordance with the ISO/IEC Directives, Part 2.
Terms used throughout this document that have been defined in Clause 3 of
IEC 60601-1:2005 and IEC 60601-1:2005/AMD 1:2012, IEC 60601-1-8:2006 and
IEC 60601-1-8:2006/AMD1:2012, IEC 60601-1-11:2010, IEC 60601-1-11:2015 and
IEC 60601-1-12:2014 are printed in SMALL CAPITALS.
A list of all parts in the IEC 60601 series, published under the general title Medical electrical
equipment, can be found on the IEC website.
The committee has decided that the contents of this document will remain unchanged until the
stability date indicated on the IEC website under "http://webstore.iec.ch" in the data related to
the specific document. At this date, the document will be
• reconfirmed,
• withdrawn,
• replaced by a revised edition, or
• amended.
A bilingual version of this document may be issued at a later date.

IMPORTANT – The 'colour inside' logo on the cover page of this publication indicates
that it contains colours which are considered to be useful for the correct
understanding of its contents. Users should therefore print this document using a
colour printer.
– 8 – IEC TR 60601-4-3:2018  IEC 2018
INTRODUCTION
At the Sydney meeting in November 1993, IEC subcommittee (SC) 62A established a
procedure under which working group (WG) 14 would develop recommendations regarding
problems of interpretation or application of IEC 60601-1. WG 14 is made up of experts with
particular expertise in testing according to the requirements of IEC 60601-1. Many of the
experts on WG 14 are employed by test laboratories with a long history of applying
IEC 60601-1 to MEDICAL ELECTRICAL EQUIPMENT. While the National Committee members of
SC 62A nominate these experts, their recommendations were not to be formally adopted
through any official voting procedure. To reinforce this process, the subcommittee specifically
directed that the following note appear on every page of the resulting informational circular:
IMPORTANT NOTE: Per the 62A decision at Sydney (see RM3755/SC62A, August 1994), the
62A Secretary is circulating this recommendation, prepared by 62A/WG 14, regarding
problems of interpretation or application of IEC 60601-1 to all P-Member NCs.
This recommendation/interpretation is the result of considerations by a group of nominated
experts and has not been formally adopted through any National Committee voting procedure.
Distribution is only for information.
At the November 2000 meeting of SC 62A in Tokyo, the subcommittee discussed ways and
means for achieving a wider distribution of the WG 14 recommendations. At the conclusion of
this discussion, the subcommittee instructed the Secretariat to develop a technical report (TR)
based on the published recommendations of WG 14. This technical report is intended to
convey the results of WG 14's work to interested parties such as MANUFACTURERS and test
laboratories while retaining the informative nature of the material.
This second edition of IEC TR 60601-4-3 contains 143 recommendations, numbered 101 to
243. All these recommendations are based upon IEC 60601-1:2005 and
IEC 60601-1:2005/AMD1:2012, and IEC 60601-1-8:2006 and
IEC 60601-1-8:2006/AMD1:2012, IEC 60601-1-11:2010, IEC 60601-1-11:2015 and
IEC 60601-1-12:2014.
The numbering starts with 101 instead of just 1 to ensure that these WG 14 recommendations
(101 to 243) will not accidentally be confused with previous issued WG 14 recommendations
1 to 63, which are based on IEC 60601-1:1998 and published in IEC TR 62296:2009.
This document may be amended from time to time as WG 14 prepares additional
recommendations.
MEDICAL ELECTRICAL EQUIPMENT –

Part 4-3: Guidance and interpretation – Considerations
of unaddressed safety aspects in the third edition of IEC 60601-1
and proposals for new requirements

1 Scope
This part of IEC 60601, which is a Technical Report, contains a series of recommendations
developed by an expert working group of IEC subcommittee 62A in response to questions of
interpretation of IEC 60601-1:2005 and related collateral standards in the IEC 60601 series.
This document is primarily intended to be used by:
– MANUFACTURERS of MEDICAL ELECTRICAL EQUIPMENT;
– test laboratories and others responsible for assessment of compliance with
IEC 60601-1:2005, IEC 60601-1:2005/AMD1:2012, IEC 60601-1-8:2006,
IEC 60601-1-8:2006/AMD1:2012, IEC 60601-1-11:2010, IEC 60601-1-11:2015 and
IEC 60601-1-12:2014;
– those developing subsequent editions of IEC 60601-1.
The recommendations in the first edition of IEC TR 62296 were considered in preparing the
third edition of IEC 60601-1. Similarly, it is expected that these recommendations within
IEC 60601-4-3 will be considered when preparing future revisions of IEC 60601-1 and related
collateral standards in the IEC 60601 series.
The object of this document is to make the recommendations/interpretations available to
those interested in the application of the third edition of IEC 60601-1 and applicable collateral
standards.
NOTE There might be other acceptable solutions which are not reflected in this document. The reader is reminded
that, although a majority of the National Committee members of IEC/SC 62A have approved publication of this
document, the contents remain the opinion of the expert members having participated in the drafting of the
document. These recommendations/interpretations are the result of considerations by this group of nominated
experts and have not been formally adopted through any National Committee voting procedure. Distribution is only
for information.
2 Normative references
The following documents are referred to in the text in such a way that some or all of their
content constitutes requirements of this document. For dated references, only the edition
cited applies. For undated references, the latest edition of the referenced document (including
any amendments) applies.
NOTE For improved reading and easy understanding of the recommendation section of each issue, the
referenced standards are written as follows:
a) Written IEC 60601-1:2005, meant only Edition 3.0 from 2005.
b) Written IEC 60601-1:2005/AMD1:2012, meant only Amendment 1:2012.
c) Written IEC 60601-1:2005 and IEC 60601-1:2005/AMD1:2012, meant Edition 3.0 and Amendment 1:2012
combined.
d) Written IEC 60601-1 (in undated form), meant IEC 60601-1:2005 and IEC 60601-1:2005/AMD1:2012 (in the
year 2018 the latest edition of IEC 60601-1).
If an edition is not explicitly specified, all editions referenced in this normative references clause applies.

– 10 – IEC TR 60601-4-3:2018  IEC 2018
IEC 60332-1-2, Tests on electric and optical fibre cables under fire conditions – Part 1-2: Test
for vertical flame propagation for a single insulated wire or cable – Procedure for 1 kW pre-
mixed flame
IEC 60332-2-2, Tests on electric and optical fibre cables under fire conditions – Part 2-2: Test
for vertical flame propagation for a single small insulated wire or cable – Procedure for
diffusion flame
IEC 60529:1989, Degrees of protection provided by enclosures (IP Code)
IEC 60529:1989/AMD1:1999
IEC 60529:1989/AMD2:2013
IEC 60601-1:2005, Medical electrical equipment – Part 1: General requirements for basic
safety and essential performance
IEC 60601-1:2005/AMD1:2012
IEC 60601-1-2:2014, Medical electrical equipment – Part 1-2: General requirements for basic
safety and essential performance – Collateral Standard: Electromagnetic disturbances –
Requirements and tests
IEC 60601-1-8:2006, Medical electrical equipment – Part 1-8: General requirements for basic
safety and essential performance – Collateral Standard: General requirements, tests and
guidance for alarm systems in medical electrical equipment and medical electrical systems
IEC 60601-1-8:2006/AMD1:2012
IEC 60601-1-11:2010, Medical electrical equipment – Part 1-11: General requirements for
basic safety and essential performance – Collateral Standard: Requirements for medical
electrical equipment and medical electrical systems used in the home healthcare
environment
IEC 60601-1-11:2015, Medical electrical equipment – Part 1-11: General requirements for
basic safety and essential performance – Collateral Standard: Requirements for medical
electrical equipment and medical electrical systems used in the home healthcare environment
IEC 60601-1-12:2014, Medical electrical equipment – Part 1-12: General requirements for
basic safety and essential performance – Collateral Standard: Requirements for medical
electrical equipment and medical electrical systems intended for use in the emergency
medical services environment
IEC 60747-5-5:2007, Semiconductor devices – Discrete devices – Part 5-5: Optoelectronic
devices – Photocouplers
IEC 60950-1:2005, Information technology equipment – Safety – Part 1: General requirements
IEC 62133, Secondary cells and batteries containing alkaline or other non-acid electrolytes –
Safety requirements for portable sealed secondary cells, and for batteries made from them,
for use in portable applications
IEC 62304:2006, Medical device software – Software life cycle processes
IEC 62304:2006/AMD1:2015
ISO 8820-3:2010, Road vehicles – Fuse-links – Part 3: Fuse-links with tabs (blade type) Type
C (medium), Type E (high current) and Type F (miniature)
___________
This publication was withdrawn and replaced by IEC 60601-1-11:2015.
This publication was withdrawn and replaced by IEC 62366-1:2015.

ISO 14971:2000, Medical devices – Application of risk management to medical devices
ISO 14971:2007, Medical devices – Application of risk management to medical devices
UL 1642:2012, Standard for lithium batteries
3 Terms and definitions
For the purposes of this document, the terms and definitions given in IEC 60601-1:2005 and
IEC 60601-1:2005/AMD1:2012, IEC 60601-1-8:2006 and IEC 60601-1-8:2006/AMD1:2012,
IEC 60601-1-11:2010, IEC 60601-1-11:2015 and IEC 60601-1-12:2014 apply.
ISO and IEC maintain terminological databases for use in standardization at the following
addresses:
• IEC Electropedia: available at http://www.electropedia.org/
• ISO Online browsing platform: available at http://www.iso.org/obp
4 Recommendations
4.1 Template used for recommendations prepared by SC 62A
The recommendations in this document are presented in tabular form using the following table
structure.
a
Recommendation number NNN
b
Clause(s) number (only)
c
Source/problem
d
Discussion/comment
e
Submitter proposed recommendation
f
Recommendation
a
The numbering of the recommendations in the Technical Report starts with 101 instead of just 1 to ensure
that these recommendations will not accidentally be confused with previously issued recommendations 1 to
63, which are based on the second edition of IEC 60601-1.
b
The clause, subclause or requirement to which the question is related. If no standard is listed, the reference
is to IEC 60601-1:2005 and IEC 60601-1:2005/AMD1:2012. In case of a collateral standard, please specify:
IEC 60601-1-8:2006, IEC 60601-1-8:2006/AMD1:2012, IEC 60601-1-11:2010, IEC 60601-1-11:2015 and
IEC 60601-1-12:2014.
c
A description of the problem as submitted to SC 62A.
d
Additional discussion or commentary provided by the submitter.
e
The submitter's proposed resolution to the problem, if one exists.
f
The final recommendation developed by SC 62A.

___________
This publication was withdrawn and replaced by ISO 14971:2007.

– 12 – IEC TR 60601-4-3:2018  IEC 2018
4.2 Recommendation sheets
PATIENT LEAKAGE CURRENT of a ME SYSTEM
4.2.101 Total
Recommendation number 101
Clause(s) number (only) 16.6.3
Source/problem There is no measuring circuit or measurement method given in
IEC 60601-1 for measurement of the total PATIENT LEAKAGE CURRENT
of ME SYSTEMS.
Input: PATIENT can be simultaneously monitored for a physiological
parameter by the ME EQUIPMENT "1" and for other physiological
parameter by the ME EQUIPMENT "2". The ME EQUIPMENT "1" and "2"
belong to the same ME SYSTEM. The total PATIENT LEAKAGE CURRENT
of the ME SYSTEM in question should be measured, but how should
the measurement be performed?
Discussion/comment –
Submitter proposed recommendation –
SC 62A recommendation Q1:
Shall the total PATIENT LEAKAGE CURRENT of the ME SYSTEM be
measured "from" and "to" all PATIENT CONNECTIONS of all APPLIED
PARTS (in the ME SYSTEM) of the same type connected together?
NOTE Those APPLIED PARTS belong to several individual
ME EQUIPMENTS of the ME SYSTEM.
SC 62A answer to Q1:
No, measure only "from" (i.e. to earth) not "to" all PATIENT
CONNECTIONS of the same type of APPLIED PARTS of the ME SYSTEM
connected together. Reason: SINGLE FAULT CONDITION tests with
SUPPLY MAINS on APPLIED PART or with SUPPLY MAINS on SIP/SOP
(represent "to" measurement) are N/A for a ME SYSTEM (see 16.1 and
16.6.3).
Q2:
Is it adequate that the total PATIENT LEAKAGE CURRENT of the
ME SYSTEM in question is measured according to 8.7.4.7 h)
separately for each individual ME EQUIPMENT belonging to the
ME SYSTEM?
SC 62A answer to Q2:
No, this is not adequate. Individual tests of each item of
ME EQUIPMENT or non-ME EQUIPMENT is anyway required and those
individual measurements do not replace the ME SYSTEM tests of the
total PATIENT LEAKAGE CURRENT.
In addition:
It is not explicitly written in IEC 60601-1:2005 and IEC 60601-
1:2005/AMD1:2012, but SC 62A recommends measuring the total
PATIENT LEAKAGE CURRENT in an ME SYSTEM by combining all APPLIED
PARTS of the same type of the whole ME SYSTEM together and
measuring against earth. See also Annex A, subclause 16.6.3.

4.2.102 Pollution degree for MOPP
Recommendation number 102
Clause(s) number (only) 8.9,
8.9.1.1
Source/problem IEC 60601-1 does not include requirements for MOPP in regards to
pollution degrees 1 and 3.
Discussion/comment There are no clear requirements in regards to pollution degree
relative to MOPP.
Submitter proposed recommendation Use Table 12 for MOPP as provided for pollution degrees 1, 2 and 3.
NOTE Pollution degree 4 is not allowed as a MOP.
SC 62A recommendation It is recommended to use Table 12 for MOPP for pollution degrees 1,
2 and 3.
NOTE Pollution degree 4 is not allowed.

4.2.103 Transients on DC mains
Recommendation number 103
Clause(s) number (only) 8.9,
8.9.1.1
Source/problem Transients on DC mains (e.g. ambulance power source).
Discussion/comment The tables are based on AC mains transients. What about ME
EQUIPMENT that operates from a DC mains such as an ambulance?
Submitter proposed recommendation Apply Tables 12 through 16 as provided for ME EQUIPMENT connected
to the DC mains.
SC 62A recommendation It is recommended to apply Tables 12 through 16 for ME EQUIPMENT
connected to the DC mains.
Examples:
a) pure external battery power: no MAINS TRANSIENT VOLTAGE exists;
b) if the external DC power is derived out of an AC MAINS VOLTAGE
(e.g. 230 V AC), use the concept already described in
IEC 60601-1;
c) if the external DC power is locally generated by a local generator
(i.e. not derived out of MAINS VOLTAGE 230 V AC), for example by
a generator of the ambulance, then use transient level Table 10,
line 50 V RMS for primary DC circuit.

– 14 – IEC TR 60601-4-3:2018  IEC 2018
4.2.104 Altitude factor for DEFIBRILLATION-PROOF APPLIED PARTS
Recommendation number 104
Clause(s) number (only) 8.9,
8.9.1.1
Source/problem Use of AIR CLEARANCE altitude multiplication factor for
DEFIBRILLATION-PROOF APPLIED PARTS
Discussion/comment Should the AIR CLEARANCE multiplication factor based on altitude
(reference Table 8) be used for 8.9.1.15?
It was mentioned that IEC 60601-2-4 could be referenced, but many
APPLIED PARTS marked DEFIBRILLATION-PROOF are not in themselves
defibrillators. The group felt that since the AIR CLEARANCE
multiplication factor pertains to transients, it should apply.
DEFIBRILLATION-PROOF TYPE CF APPLIED PARTS testing is conducted in
IEC 60601-1 for three primary reasons, which include:
1) to ensure that the defibrillator energy at APPLIED PARTS does not
transfer excessive energy to parts of ME EQUIPMENT that
OPERATORS or other persons could touch during cardiac
defibrillation;
2) to ensure t
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