SIST EN IEC 60601-2-16:2019

Medical electrical equipment - Part 2-16: Particular requirements for basic safety and essential performance of haemodialysis, haemodiafiltration and haemofiltration equipment (IEC 60601-2-16:2018)

NEW!IEC 60601-2-16:2018 is available as IEC 60601-2-16:2018 RLV which contains the International Standard and its Redline version, showing all changes of the technical content compared to the previous edition.

IEC 60601-2-16:2018 applies to the basic safety and essential performance of haemodialysis, haemodiafiltration and haemofiltration equipment. IEC 60601-2-16:2018 does not take into consideration the dialysis fluid control system of Haemodialysis equipment using regeneration of dialysis fluid and central delivery systems. It does however take into consideration the specific safety requirements of such haemodialysis equipment concerning electrical safety and patient safety. IEC 60601-2-16:2018 specifies the minimum safety requirements for haemodialysis equipment. These devices are intended for use either by medical staff or for use by the patient or other trained personnel under the supervision of medical expertise. IEC 60601-2-16:2018 includes all electromedical equipment that is intended to deliver a haemodialysis, haemodiafiltration and haemofiltration treatment to a patient suffering from kidney failure. This fifth edition cancels and replaces the fourth edition of IEC 60601-2-16, published in 2012. This edition includes the following significant technical changes with respect to the previous edition:
a) update of references to IEC 60601-1:2005 and IEC 60601-1:2005/AMD1:2012, of references and requirements to IEC 60601-1-2:2014, of references to IEC 60601-1-6:2010 and IEC 60601-1-6:2010/AMD1:2013, of references and requirements to IEC 60601-1-8:2006 and IEC 60601-1-8:2006/AMD1:2012, of references to IEC 60601-1-9:2007 and IEC 60601-1-9:2007/AMD1:2013, of references to IEC 60601-1-10:2007 and IEC 60601-1-10:2007/AMD1:2013 and of references to IEC 60601-1-11:2015;
b) widening of the scope;
c) editorial improvements;
d) addition of requirements for anticoagulant delivery means;
e) other few small technical changes.

Medizinische elektrische Geräte - Teil 2-16: Besondere Festlegungen für die Sicherheit einschließlich der wesentlichen Leistungsmerkmale von Hämodialyse-, Hämodiafiltrations- und Hämofiltrationsgeräten (IEC 60601-2-16:2018)

Appareils électromédicaux - Partie 2-16: Exigences particulières pour la sécurité de base et les performances essentielles des appareils d'hémodialyse, d’hémodiafiltration et d’hémofiltration (IEC 60601-2-16:2018)

NEW!IEC 60601-2-16:2018 est disponible sous forme de IEC 60601-2-16:2018 RLV qui contient la Norme internationale et sa version Redline, illustrant les modifications du contenu technique depuis l'édition précédente.

L'IEC 60601-2-16:2018 s'applique à la sécurité de base et aux performances essentielles des appareils d'hémodialyse, d'hémodiafiltration et d'hémofiltration. L'IEC 60601-2-16:2018 ne prend pas en compte le système de contrôle du liquide de dialyse de l'appareil d'hémodialyse utilisant la régénération du liquide de dialyse et les systèmes de transmission centralisés. Toutefois, elle prend en compte les exigences de sécurité spécifiques de l'appareil d'hémodialyse concernant la sécurité électrique et la sécurité du patient. L'IEC 60601-2-16:2018 spécifie les exigences minimales de sécurité relatives aux appareils d'hémodialyse. Ces appareils sont destinés à être utilisés soit par le personnel médical, soit par le patient, soit par d'autres personnes formées, sous le contrôle d'un personnel ayant une bonne compétence médicale. La présente Norme internationale s'applique à tout appareil electromédical destiné à fournir un traitement d'hémodialyse, d'hémodiafiltration et d'hémofiltration à un patient souffrant d'insuffisance rénale. Cette cinquième édition annule et remplace la quatrième édition de l'IEC 60601-2-16 parue en 2012. Cette édition constitue une révision technique. Cette édition inclut les modifications techniques majeures suivantes par rapport à l'édition précédente:
a) actualisation des références à l'IEC 60601-1:2005 et l'IEC 60601-1:2005/AMD1:2012, des références et des exigences à l'IEC 60601-1-2:2014, des références à l'IEC 60601-1-6:2010 et l'IEC 60601-1-6:2010/AMD1:2013, des références et des exigences à l'IEC 60601-1-8:2006 et l'IEC 60601-1-8:2006/AMD1:2012, des références à l'IEC 60601-1-9:2007 et l'IEC 60601-1-9:2007/AMD1:2013, des références à l'IEC 60601-1-10:2007 et l'IEC 60601-1-10:2007/AMD1:2013 ainsi que des références à l'IEC 60601-1-11:2015;
b) élargissement du domaine d'application;
c) améliorations d'ordre rédactionnel;
d) ajout d'exigences concernant les dispositifs de transmission d'anticoagulant;
e) quelques autres modifications techniques limitées.

Medicinska električna oprema - 2-16. del: Posebne zahteve za osnovno varnost in bistvene lastnosti opreme za hemodializo, hemodiafiltracijo in hemofiltracijo (IEC 60601-2-16:2018)

Standard IEC 60601-2-16:2018 se uporablja za osnovno varnost in bistvene lastnosti opreme za hemodializo, hemodiafiltracijo in hemofiltracijo. Standard IEC 60601-2-16:2018 ne zajema nadzornega sistema za dializno tekočino opreme za hemodializo, ki uporablja regeneracijo dializne tekočine in osrednje sisteme dovajanja. Zajema pa specifične varnostne zahteve opreme za hemodializo v povezavi z električno varnostjo in varnostjo pacienta. Standard IEC 60601-2-16:2018 navaja minimalne varnostne zahteve opreme za hemodializo. Te naprave so namenjene uporabi s strani zdravniškega osebja oziroma pacienta ali drugega usposobljenega osebja pod nadzorom oseb s strokovnim medicinskim znanjem. Standard IEC 60601-2-16:2018 vključuje elektromedicinsko opremo za hemodializo, hemodiafiltracijo in hemofiltracijo, namenjeno pacientom z odpovedjo ledvic. Peta izdaja razveljavlja in nadomešča četrto izdajo standarda IEC 60601-2-16, objavljeno leta 2012. Ta izdaja vključuje naslednje pomembne tehnične spremembe glede na prejšnjo izdajo: a) posodobitev sklicev na standarda IEC 60601-1:2005 in IEC 60601-1:2005/AMD1:2012, sklicev na standard IEC 60601-1-2:2014 in njegovih zahtev, sklicev na standarda IEC 60601-1-6:2010 in IEC 60601-1-6:2010/AMD1:2013, sklicev na standarda IEC 60601-1-8:2006 in IEC 60601-1-8:2006/AMD1:2012 ter njunih zahtev, sklicev na standarda IEC 60601-1-9:2007 in IEC 60601-1-9:2007/AMD1:2013, sklicev na standarda IEC 60601-1-10:2007 in IEC 60601-1-10:2007/AMD1:2013 ter sklicev na standard IEC 60601-1-11:2015; b) razširitev področja uporabe; c) redakcijske izboljšave; d) dodane zahteve za sredstva za dovajanje antikoagulantov; e) drugih nekaj manjših tehničnih sprememb.

General Information

• Status: Published
• Publication Date: 11-Aug-2019
• ICS: 11.040.20 - Transfusion, infusion and injection equipment
• Technical Committee: IEMO - Electrical equipment in medical practice
• Current Stage: 6060 - National Implementation/Publication (Adopted Project)
• Start Date: 30-May-2019
• Due Date: 04-Aug-2019
• Completion Date: 12-Aug-2019
• Directive: 93/42/EEC - Council Directive 93/42/EEC of 14 June 1993 concerning medical devices
• Mandate: M/295 - Standardization mandate to CEN/CENELEC concerning the development of European standards relating to medical devices
• Ref Project: EN IEC 60601-2-16:2019 - Medical electrical equipment - Part 2-16: Particular requirements for the basic safety and essential performance of haemodialysis, haemodiafiltration and haemofiltration equipment

Relations

• Replaces: SIST EN 60601-2-16:2015 - Medical electrical equipment - Part 2-16: Particular requirements for basic safety and essential performance of haemodialysis, haemodiafiltration and haemofiltration equipment
• Effective Date: 28-May-2019
• Replaced By: SIST EN IEC 60601-2-16:2025 - Medical electrical equipment - Part 2-16: Particular requirements for the basic safety and essential performance of haemodialysis, haemodiafiltration and haemofiltration equipment (IEC 60601-2-16:2025)
• Effective Date: 01-Apr-2025
• Revised: SIST EN 60601-2-16:2015 - Medical electrical equipment - Part 2-16: Particular requirements for basic safety and essential performance of haemodialysis, haemodiafiltration and haemofiltration equipment
• Effective Date: 23-Aug-2016

Overview

SIST EN IEC 60601-2-16:2019 (incorporating IEC 60601-2-16:2018) is the fifth-edition particular standard that sets minimum safety and essential performance requirements for medical electrical equipment used to deliver haemodialysis, haemodiafiltration and haemofiltration treatments. The publication is available as IEC 60601-2-16:2018 RLV (Redline Version) showing technical changes versus the previous edition. It replaces the 2012 edition and clarifies requirements for patient and electrical safety specific to dialysis devices.

Key topics and technical requirements

• Scope and device coverage: Applies to all electromedical equipment intended to provide haemodialysis, haemodiafiltration and haemofiltration. It does not address dialysis fluid control systems that use regeneration or central delivery systems, although it includes their electrical and patient safety requirements.
• Basic safety and essential performance: Defines minimum safety limits and performance characteristics designers and manufacturers must meet to prevent hazardous outputs and unsafe operation.
• Risk management integration: Aligns with risk-management approaches (referenced standards such as ISO 14971 are included in the bibliography).
• Alarm systems and prioritization: Specifies requirements for alarm design, tests and guidance tailored to dialysis equipment (linking to IEC 60601-1-8).
• Electromagnetic compatibility (EMC): Incorporates EMC requirements and tests (IEC 60601-1-2) to ensure reliable operation in clinical environments.
• Usability and human factors: References usability collateral standards to address operator and patient interaction (IEC 60601-1-6).
• Anticoagulant delivery: New in this edition - added requirements for anticoagulant delivery means used in extracorporeal treatments.
• Programmable systems and closed-loop controllers: Addresses programmable electrical medical systems (PEMS) and references requirements for physiologic closed-loop controllers (IEC 60601-1-10).
• Identification, marking, documentation and testing: Mandates labeling, user documentation and type/production testing procedures specific to haemodialysis equipment.

Practical applications - who uses this standard

• Device manufacturers - for design, development, and pre-market compliance of dialysis machines and related accessories.
• Test laboratories and conformity assessment bodies - to perform type testing, EMC testing and safety verification.
• Regulatory and quality teams - to demonstrate conformity with harmonized medical-device requirements in Europe and other markets.
• Clinical engineers and hospital procurement - to evaluate equipment safety, alarm strategy and interoperability.
• Product managers and R&D - to scope feature sets such as anticoagulant delivery and closed-loop control while maintaining compliance.

Related standards

• IEC 60601-1 (general safety and essential performance)
• IEC 60601-1-2 (EMC)
• IEC 60601-1-6 (usability)
• IEC 60601-1-8 (alarm systems)
• IEC 60601-1-9 / 1-10 / 1-11 (environmental, closed-loop controllers, home healthcare)
• ISO 14971 (risk management)

Keywords: SIST EN IEC 60601-2-16:2019, IEC 60601-2-16, haemodialysis equipment safety standard, haemodiafiltration, haemofiltration, medical electrical equipment, dialysis machine compliance, anticoagulant delivery, EMC, alarm systems.

Standards Content (Sample)

SLOVENSKI STANDARD
01-september-2019
Nadomešča:
SIST EN 60601-2-16:2015
Medicinska električna oprema - 2-16. del: Posebne zahteve za osnovno varnost in
bistvene lastnosti opreme za hemodializo, hemodiafiltracijo in hemofiltracijo (IEC
60601-2-16:2018)
Medical electrical equipment - Part 2-16: Particular requirements for basic safety and
essential performance of haemodialysis, haemodiafiltration and haemofiltration
equipment (IEC 60601-2-16:2018)
Medizinische elektrische Geräte - Teil 2-16: Besondere Festlegungen für die Sicherheit
einschließlich der wesentlichen Leistungsmerkmale von Hämodialyse-,
Hämodiafiltrations- und Hämofiltrationsgeräten (IEC 60601-2-16:2018)
Appareils électromédicaux - Partie 2-16: Exigences particulières pour la sécurité de base
et les performances essentielles des appareils d'hémodialyse, d’hémodiafiltration et
d’hémofiltration (IEC 60601-2-16:2018)
Ta slovenski standard je istoveten z: EN IEC 60601-2-16:2019
ICS:
11.040.20 Transfuzijska, infuzijska in Transfusion, infusion and
injekcijska oprema injection equipment
2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.

EUROPEAN STANDARD EN IEC 60601-2-16

NORME EUROPÉENNE
EUROPÄISCHE NORM
May 2019
ICS 11.040.20; 11.040.25 Supersedes EN 60601-2-16:2015
English Version
Medical electrical equipment - Part 2-16: Particular requirements
for the basic safety and essential performance of haemodialysis,
haemodiafiltration and haemofiltration equipment
(IEC 60601-2-16:2018)
Appareils électromédicaux - Partie 2-16: Exigences Medizinische elektrische Geräte - Teil 2-16: Besondere
particulières pour la sécurité de base et les performances Festlegungen für die Sicherheit einschließlich der
essentielles des appareils d'hémodialyse, wesentlichen Leistungsmerkmale von Hämodialyse-,
d'hémodiafiltration et d'hémofiltration Hämodiafiltrations- und Hämofiltrationsgeräten
(IEC 60601-2-16:2018) (IEC 60601-2-16:2018)
This European Standard was approved by CENELEC on 2018-05-25. CENELEC members are bound to comply with the CEN/CENELEC
Internal Regulations which stipulate the conditions for giving this European Standard the status of a national standard without any alteration.
Up-to-date lists and bibliographical references concerning such national standards may be obtained on application to the CEN-CENELEC
Management Centre or to any CENELEC member.
This European Standard exists in three official versions (English, French, German). A version in any other language made by translation
under the responsibility of a CENELEC member into its own language and notified to the CEN-CENELEC Management Centre has the
same status as the official versions.
CENELEC members are the national electrotechnical committees of Austria, Belgium, Bulgaria, Croatia, Cyprus, the Czech Republic,
Denmark, Estonia, Finland, Former Yugoslav Republic of Macedonia, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia,
Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden,
Switzerland, Turkey and the United Kingdom.

European Committee for Electrotechnical Standardization
Comité Européen de Normalisation Electrotechnique
Europäisches Komitee für Elektrotechnische Normung
CEN-CENELEC Management Centre: Rue de la Science 23, B-1040 Brussels
© 2019 CENELEC All rights of exploitation in any form and by any means reserved worldwide for CENELEC Members.
Ref. No. EN IEC 60601-2-16:2019 E

European foreword
The text of document 62D/1557/FDIS, future edition 5 of IEC 60601-2-16, prepared by SC 62D
"Electromedical equipment" of IEC/TC 62 "Electrical equipment in medical practice" was submitted to
the IEC-CENELEC parallel vote and approved by CENELEC as EN IEC 60601-2-16:2019.
The following dates are fixed:
• latest date by which the document has to be implemented at national (dop) 2019-11-24
level by publication of an identical national standard or by endorsement
• latest date by which the national standards conflicting with the (dow) 2022-05-24
document have to be withdrawn
This document supersedes EN 60601-2-16:2015.
Attention is drawn to the possibility that some of the elements of this document may be the subject of
patent rights. CENELEC shall not be held responsible for identifying any or all such patent rights.
Endorsement notice
The text of the International Standard IEC 60601-2-16:2018 was approved by CENELEC as a
European Standard without any modification.
In the official version, for Bibliography, the following notes have to be added for the standards
indicated:
IEC 60601-2-24 NOTE Harmonized as EN 60601-2-24
IEC 60601-2-39 NOTE Harmonized as EN 60601-2-39
IEC 80001-1:2010 NOTE Harmonized as EN 80001-1:2011 (not modified)
ISO 8637-2 NOTE Harmonized as EN ISO 8637-2
ISO 11197 NOTE Harmonized as EN ISO 11197
ISO 23500-1 NOTE Harmonized as EN ISO 23500-1
ISO 23500-2 NOTE Harmonized as EN ISO 23500-2
ISO 23500-3 NOTE Harmonized as EN ISO 23500-3
ISO 23500-4 NOTE Harmonized as EN ISO 23500-4
ISO 23500-5 NOTE Harmonized as EN ISO 23500-5
ISO 14971:2007 NOTE Harmonized as EN ISO 14971:2012 (not modified)

Annex ZA
(normative)
Normative references to international publications
with their corresponding European publications
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 1  Where an International Publication has been modified by common modifications, indicated by (mod), the relevant
EN/HD applies.
NOTE 2  Up-to-date information on the latest versions of the European Standards listed in this annex is available here:
www.cenelec.eu.
Annex ZA of EN 60601-1:2006 applies, except as follows:
Publication Year Title EN/HD Year

Replacement
IEC 60601-1-2 2014 Medical electrical equipment - Part 1-2: EN 60601-1-2 2015
General requirements for basic safety and
essential performance - Collateral
Standard: Electromagnetic disturbances -
Requirements and tests
IEC 60601-1-6 2010 Medical electrical equipment - Part 1-6: EN 60601-1-6 2010
General requirements for basic safety and
essential performance - Collateral
standard: Usability
+ A1 2013  + A1 2015
IEC 60601-1-8 2006 Medical electrical equipment - Part 1-8: EN 60601-1-8 2007
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
- -  + corrigendum Mar. 2010
+ A1 2012  + A1 2013
- -  + AC 2014
- -  + A11 2017
Addition
IEC 60601-1-10 2007 Medical electrical equipment - Part 1-10: EN 60601-1-10 2008
General requirements for basic safety and
essential performance - Collateral
Standard: Requirements for the
development of physiologic closed-loop
controllers
+ A1 2013  + A1 2015
IEC 60601-1-11 2015 Medical electrical equipment - Part 1-11: EN 60601-1-11 2015
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 61672-1 -  Electroacoustics - Sound level meters - EN 61672-1 -
Part 1: Specifications
ISO 3744 -  Acoustics - Determination of sound power EN ISO 3744 -
levels and sound energy levels of noise
sources using sound pressure -
Engineering methods for an essentially
free field over a reflecting plane

IEC 60601-2-16 ®
Edition 5.0 2018-04
INTERNATIONAL
STANDARD
NORME
INTERNATIONALE
colour
inside
Medical electrical equipment –

Part 2-16: Particular requirements for the basic safety and essential performance

of haemodialysis, haemodiafiltration and haemofiltration equipment

Appareils électromédicaux –
Partie 2-16: Exigences particulières pour la sécurité de base et les performances

essentielles des appareils d'hémodialyse, d'hémodiafiltration et d'hémofiltration

INTERNATIONAL
ELECTROTECHNICAL
COMMISSION
COMMISSION
ELECTROTECHNIQUE
INTERNATIONALE
ICS 11.040.20; 11.040.25 ISBN 978-2-8322-5549-0

– 2 – IEC 60601-2-16:2018 © IEC 2018
CONTENTS
FOREWORD . 4
INTRODUCTION . 7
201.1 Scope, object and related standards . 8
201.2 Normative references . 10
201.3 Terms and definitions . 11
201.4 General requirements . 14
201.5 General requirements for testing ME EQUIPMENT . 17
201.6 Classification of ME EQUIPMENT and ME SYSTEMS . 17
201.7 ME EQUIPMENT identification, marking and documents . 17
201.8 Protection against electrical HAZARDS from ME EQUIPMENT . 22
201.9 Protection against MECHANICAL HAZARDS of ME EQUIPMENT and ME SYSTEMS . 23
201.10 Protection against unwanted and excessive radiation HAZARDS . 23
201.11 Protection against excessive temperatures and other HAZARDS . 23
201.12 * Accuracy of controls and instruments and protection against hazardous
outputs . 24
201.13 HAZARDOUS SITUATIONS and fault conditions for ME EQUIPMENT . 34
201.14 PROGRAMMABLE ELECTRICAL MEDICAL SYSTEMS (PEMS) . 34
201.15 Construction of ME EQUIPMENT . 35
201.16 * ME SYSTEMS . 35
201.17 ELECTROMAGNETIC COMPATIBILITY of ME EQUIPMENT and ME SYSTEMS . 36
202 Electromagnetic disturbances – Requirements and tests . 36
208 General requirements, tests and guidance for ALARM SYSTEMS in MEDICAL
ELECTRICAL EQUIPMENT and MEDICAL ELECTRICAL SYSTEMS . 37
209 Requirements for environmentally conscious design . 39
210 Requirements for the development of PHYSIOLOGIC CLOSED-LOOP
CONTROLLERS . 39
211 * Requirements for MEDICAL ELECTRICAL EQUIPMENT and MEDICAL ELECTRICAL
SYSTEMS used in the HOME HEALTHCARE ENVIRONMENT . 39
Annexes . 41
Annex G (normative) Protection against HAZARDS of ignition of flammable anaesthetic
mixtures . 42
Annex AA (informative) Particular guidance and rationale . 43
Annex BB (informative) Examples of HAZARDS, foreseeable sequences of events, and
HAZARDOUS SITUATIONS in HAEMODIALYSIS EQUIPMENT . 62
Bibliography . 71
Index of defined terms used in this particular standard. 74

Figure 201.101 – Continuous air infusion test setup with example dimensions . 30
Figure AA.1 – Example of a HAEMODIALYSIS ME SYSTEM . 58

Table 201.101 – ESSENTIAL PERFORMANCE requirements . 14

IEC 60601-2-16:2018 © IEC 2018 – 3 –
Table AA.1 – Example of ALARM CONDITION priorities according to 6.1.2
of IEC 60601-1-8:2006 and IEC 60601-1-8:2006/AMD1:2012, adapted for
HAEMODIALYSIS EQUIPMENT needs . 60
Table BB.1 – HAZARDOUS SITUATION list following ISO 14971:2007, Annex E . 62

– 4 – IEC 60601-2-16:2018 © IEC 2018
INTERNATIONAL ELECTROTECHNICAL COMMISSION
____________
MEDICAL ELECTRICAL EQUIPMENT –

Part 2-16: Particular requirements for the basic safety and
essential performance of haemodialysis, haemodiafiltration
and haemofiltration equipment
FOREWORD
1) The International Electrotechnical Commission (IEC) is a worldwide organization for standardization comprising
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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.
International standard IEC 60601-2-16 has been prepared by IEC subcommittee 62D:
Electromedical equipment, of IEC technical committee 62: Electrical equipment in medical
practice.
This fifth edition cancels and replaces the fourth edition of IEC 60601-2-16 published in 2012.
This edition constitutes a technical revision.
This edition includes the following significant technical changes with respect to the previous
edition:
a) update of references to IEC 60601-1:2005 and IEC 60601-1:2005/AMD1:2012, of
references and requirements to IEC 60601-1-2:2014, of references to IEC 60601-1-6:2010
and IEC 60601-1-6:2010/AMD1:2013, of references and requirements to
IEC 60601-1-8:2006 and IEC 60601-1-8:2006/AMD1:2012, of references to

IEC 60601-2-16:2018 © IEC 2018 – 5 –
IEC 60601-1-9:2007 and IEC 60601-1-9:2007/AMD1:2013, of references to
IEC 60601-1-10:2007 and IEC 60601-1-10:2007/AMD1:2013 and of references to
IEC 60601-1-11:2015;
b) widening of the scope;
c) editorial improvements;
d) addition of requirements for anticoagulant delivery means;
e) other few small technical changes.
The text of this particular standard is based on the following documents:
FDIS Report on voting
62D/1557/FDIS 62D/1585/RVD
Full information on the voting for the approval of this particular standard can be found in the
report on voting indicated in the above table.
This publication has been drafted in accordance with the ISO/IEC Directives, Part 2.
In this document, the following print types are used:
– requirements and definitions: roman type;
– test specifications: italic type;
– informative material appearing outside of tables, such as notes, examples and references: in smaller type.
Normative text of tables is also in a smaller type;
– TERMS DEFINED IN CLAUSE 3 OF THE GENERAL STANDARD, IN THIS PARTICULAR STANDARD OR AS
NOTED: SMALL CAPITALS.
In referring to the structure of this document, the term
– "clause" means one of the seventeen numbered divisions within the table of contents,
inclusive of all subdivisions (e.g. Clause 7 includes subclauses 7.1, 7.2, etc.);
– "subclause" means a numbered subdivision of a clause (e.g. 7.1, 7.2 and 7.2.1 are all
subclauses of Clause 7).
References to clauses within this document are preceded by the term "Clause" followed by
the clause number. References to subclauses within this particular standard are by number
only.
In this document, the conjunctive "or" is used as an "inclusive or" so a statement is true if any
combination of the conditions is true.
The verbal forms used in this document conform to usage described in Clause 7 of the
ISO/IEC Directives, Part 2. For the purposes of this document, the auxiliary verb:
– "shall" means that compliance with a requirement or a test is mandatory for compliance
with this document;
– "should" means that compliance with a requirement or a test is recommended but is not
mandatory for compliance with this document;
– "may" is used to describe a permissible way to achieve compliance with a requirement or
test.
An asterisk (*) as the first character of a title or at the beginning of a paragraph or table title
indicates that there is guidance or rationale related to that item in Annex AA.

– 6 – IEC 60601-2-16:2018 © IEC 2018
A list of all parts of 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 publication will remain unchanged until
the stability date indicated on the IEC website under "http://webstore.iec.ch" in the data
related to the specific publication. At this date, the publication will be
• reconfirmed,
• withdrawn,
• replaced by a revised edition, or
• amended.
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.
NOTE The attention of users of this document is drawn to the fact that equipment manufacturers and testing
organizations may need a transitional period following publication of a new, amended or revised IEC publication in
which to make products in accordance with the new requirements and to equip themselves for conducting new or
revised tests. It is the recommendation of the committees that the content of this publication be adopted for
implementation nationally not earlier than 3 years from the date of publication.

IEC 60601-2-16:2018 © IEC 2018 – 7 –
INTRODUCTION
The minimum safety requirements specified in this particular standard are considered to
provide for a practical degree of safety in the operation of HAEMODIALYSIS,
HAEMODIAFILTRATION and HAEMOFILTRATION EQUIPMENT.

– 8 – IEC 60601-2-16:2018 © IEC 2018
MEDICAL ELECTRICAL EQUIPMENT –

Part 2-16: Particular requirements for the basic safety and
essential performance of haemodialysis, haemodiafiltration
and haemofiltration equipment
201.1 Scope, object and related standards
Clause 1 of the general standard applies, except as follows:
201.1.1 * Scope
Replacement:
This part of IEC 60601 applies to the BASIC SAFETY and ESSENTIAL PERFORMANCE of
HAEMODIALYSIS, HAEMODIAFILTRATION and HAEMOFILTRATION EQUIPMENT, hereafter referred to as
HAEMODIALYSIS EQUIPMENT.
This document does not take into consideration specific safety details of the DIALYSIS FLUID
control system of HAEMODIALYSIS EQUIPMENT using regeneration of DIALYSIS FLUID or CENTRAL
DELIVERY SYSTEMS for DIALYSIS FLUID. It does, however, take into consideration the specific
HAEMODIALYSIS EQUIPMENT concerning electrical safety and
safety requirements of such
PATIENT safety.
This document specifies the minimum safety requirements for HAEMODIALYSIS EQUIPMENT.
These HAEMODIALYSIS EQUIPMENT are intended for use either by medical staff or for use by the
PATIENT or other trained personnel under medical supervision.
This document includes all ME EQUIPMENT that is intended to deliver a HAEMODIALYSIS,
HAEMODIAFILTRATION and HAEMOFILTRATION treatment to a PATIENT, independent of the
treatment duration and location.
If applicable, this document applies to the relevant parts of ME EQUIPMENT intended for other
extracorporeal blood purification treatments.
The particular requirements in this document do not apply to:
– EXTRACORPOREAL CIRCUITS (see ISO 8637-2, [12] );
– DIALYSERS (see ISO 8637-1, [11]);
– DIALYSIS FLUID CONCENTRATES (see ISO 23500-4, [18]);
– DIALYSIS WATER supply systems (see ISO 23500-2, [16]);
– CENTRAL DELIVERY SYSTEMS for DIALYSIS FLUID CONCENTRATES (see ISO 23500-4, [18]),
described as systems for bulk mixing concentrate at a dialysis facility;
– equipment used to perform PERITONEAL DIALYSIS (see IEC 60601-2-39, [8]).
___________
The general standard is IEC 60601-1:2005 and IEC 60601-1:2005/AMD1:2012, Medical electrical equipment –
Part 1: General requirements for basic safety and essential performance.
Numbers in square brackets refer to the Bibliography.

IEC 60601-2-16:2018 © IEC 2018 – 9 –
201.1.2 Object
Replacement:
The object of this particular standard is to establish BASIC SAFETY and ESSENTIAL PERFORMANCE
requirements for HAEMODIALYSIS EQUIPMENT.
201.1.3 Collateral standards
Addition:
This particular standard refers to those applicable collateral standards that are listed in
Clause 2 of the general standard and Clause 201.2 of this particular standard.
IEC 60601-1-2:2014, IEC 60601-1-8:2006 and IEC 60601-1-8:2006/AMD1:2012,
IEC 60601-1-10:2007 and IEC 60601-1-10:2007/AMD1:2013 and IEC 60601-1-11:2015 apply
as modified in Clauses 202, 208, 210 and 211. IEC 60601-1-3 and IEC 60601-1-12 do not
apply. IEC 60601-1-9:2007 and IEC 60601-1-9:2007/AMD1:2013 does not apply as noted in
Clause 209. All other published collateral standards in the IEC 60601-1 series apply as
published.
201.1.4 Particular standards
Replacement:
In the IEC 60601 series, particular standards may modify, replace or delete requirements
contained in the general standard and collateral standards as appropriate for the particular
ME EQUIPMENT under consideration, and may add other BASIC SAFETY and ESSENTIAL
PERFORMANCE requirements.
A requirement of a particular standard takes priority over the general standard.
For brevity, IEC 60601-1:2005 and IEC 60601-1:2005/AMD1:2012 are referred to in this
particular standard as the general standard. Collateral standards are referred to by their
document number.
The numbering of clauses and subclauses of this particular standard corresponds to that of
the general standard with the prefix "201" (e.g. 201.1 in this document addresses the content
of Clause 1 of the general standard) or applicable collateral standard with the prefix "20x"
where x is the final digit(s) of the collateral standard document number (e.g. 202.4 in this
particular standard addresses the content of Clause 4 of the IEC 60601-1-2 collateral
standard, 203.4 in this particular standard addresses the content of Clause 4 of the
IEC 60601-1-3 collateral standard, etc.). The changes to the text of the general standard are
specified by the use of the following words:
"Replacement" means that the clause or subclause of the general standard or applicable
collateral standard is replaced completely by the text of this particular standard.
"Addition" means that the text of this particular standard is additional to the requirements of
the general standard or applicable collateral standard.
"Amendment" means that the clause or subclause of the general standard or applicable
collateral standard is amended as indicated by the text of this particular standard.
Subclauses, figures or tables which are additional to those of the general standard are
numbered starting from 201.101. However, due to the fact that definitions in the general
standard are numbered 3.1 through 3.147, additional definitions in this document are

– 10 – IEC 60601-2-16:2018 © IEC 2018
numbered beginning from 201.3.201. Additional annexes are lettered AA, BB, etc., and
additional items aa), bb), etc.
Subclauses, figures or tables which are additional to those of a collateral standard are
numbered starting from 20x, where "x" is the number of the collateral standard, for example
202 for IEC 60601-1-2, 203 for IEC 60601-1-3, etc.
The term "this document" is used to make reference to the general standard, any applicable
collateral standards and this particular standard taken together.
Where there is no corresponding clause or subclause in this particular standard, the clause or
subclause of the general standard or applicable collateral standard, although possibly not
relevant, applies without modification; where it is intended that any part of the general
standard or applicable collateral standard, although possibly relevant, is not to be applied, a
statement to that effect is given in this particular standard.
201.2 Normative references
NOTE Informative references are listed in the bibliography.
Clause 2 of the general standard applies, except as follows:
Replacement:
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 60601-1-6:2010, Medical electrical equipment – Part 1-6: General requirements for basic
safety and essential performance – Collateral standard: Usability
IEC 60601-1-6:2010/AMD1:2013
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
Addition:
IEC 60601-1-10:2007, Medical electrical equipment – Part 1-10: General requirements for
basic safety and essential performance – Collateral Standard: Requirements for the
development of physiologic closed-loop controllers
IEC 60601-1-10:2007/AMD1:2013
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 61672-1, Electroacoustics – Sound level meters – Part 1: Specifications
ISO 3744, Acoustics – Determination of sound power levels and sound energy levels of noise
sources using sound pressure – Engineering method in an essentially free field over a
reflecting plane
IEC 60601-2-16:2018 © IEC 2018 – 11 –
201.3 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 60601-1-2:2014, IEC 60601-1-8:2006 and IEC 60601-1-
8:2006/AMD1:2012, IEC 60601-1-10:2007 and IEC 60601-1-10:2007/AMD1:2013, IEC 60601-
1-11:2015 and the following 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
NOTE An index of defined terms is found beginning on page 74.
201.3.8
* APPLIED PART
Replacement:
EXTRACORPOREAL CIRCUIT and all parts permanently and conductively connected to it (e.g.
DIALYSIS FLUID circuit)
Note 1 to entry: See Figure AA.1.
201.3.78
PATIENT CONNECTION
Addition:
Note 1 to entry: The PATIENT blood lines connectors are the individual points on the APPLIED PART through which a
current can flow between the PATIENT and the HAEMODIALYSIS EQUIPMENT in NORMAL CONDITION or SINGLE FAULT
CONDITION.
Additional terms and definitions:
201.3.201
ARTERIAL PRESSURE
pressure measured in the blood withdrawal line of the EXTRACORPOREAL CIRCUIT between the
PATIENT CONNECTION and DIALYSER connection
Note 1 to entry: A difference can be made between the pre-pump pressure, which is upstream of the blood pump,
and post-pump pressure, which is downstream of the blood pump.
201.3.202
* BLOOD LEAK
leakage of blood from the blood compartment to the DIALYSIS FLUID compartment of the
DIALYSER
Note 1 to entry: When performing an HF PROCESS, this involves the filtration fluid section.
201.3.203
CENTRAL DELIVERY SYSTEM
part of a ME SYSTEM which proportions DIALYSIS FLUID CONCENTRATE and DIALYSIS WATER for
distribution as DIALYSIS FLUID to the HAEMODIALYSIS EQUIPMENT or distributes DIALYSIS FLUID
CONCENTRATE
201.3.204
DIALYSER
device containing a semi-permeable membrane that is used to perform HD, HDF or HF

– 12 – IEC 60601-2-16:2018 © IEC 2018
201.3.205
DIALYSIS FLUID
DIALYSATE
DIALYSIS SOLUTION
DIALYSING FLUID
aqueous fluid containing electrolytes and, usually, buffer and glucose, which is intended to
exchange solutes with blood during HAEMODIALYSIS
[SOURCE: ISO 23500-1:— [15], 3.15, modified – The word "dialysing fluid" has been added as
synonym, and the notes have been deleted.]
201.3.206
DIALYSIS FLUID CONCENTRATE
substances which, when appropriately diluted or dissolved with DIALYSIS WATER, produce the
DIALYSIS FLUID
201.3.207
EXTRACORPOREAL CIRCUIT
blood lines, DIALYSER and any integral ACCESSORY
Note 1 to entry: An alternative for DIALYSER could be a HF-filter, adsorber or other device.
201.3.208
HAEMODIAFILTRATION
HDF
PROCESS whereby concentrations of water-soluble substances in a PATIENT'S blood and an
excess of fluid of a PATIENT are corrected by a simultaneous combination of HD and HF
201.3.209
HAEMODIALYSIS
HD
PROCESS whereby concentrations of water-soluble substances in a PATIENT'S blood and an
excess of fluid of a PATIENT are corrected by bidirectional diffusive transport and
ULTRAFILTRATION across a semi-permeable membrane separating the blood from the DIALYSIS
FLUID
Note 1 to entry: This PROCESS typically includes fluid removal by filtration. This PROCESS is usually also
accompanied by diffusion of substances from the DIALYSIS FLUID into the blood.
201.3.210
* HAEMODIALYSIS EQUIPMENT
ME EQUIPMENT or ME SYSTEM used to perform HAEMODIALYSIS, HAEMODIAFILTRATION and/or
HAEMOFILTRATION
Note 1 to entry: When the term ME EQUIPMENT is used in headings, it is equivalent to HAEMODIALYSIS EQUIPMENT.
When the term ME EQUIPMENT is used in the text, it is referring to a general ME EQUIPMENT.
201.3.211
HAEMOFILTRATION
HF
PROCESS whereby concentrations of water-soluble substances in a PATIENT'S blood and an
excess of fluid of a PATIENT are corrected by convective transport via ULTRAFILTRATION and
partial replacement by a SUBSTITUTION FLUID resulting in the required NET FLUID REMOVAL
201.3.212
NET FLUID REMOVAL
fluid loss from the PATIENT
Note 1 to entry: Historically, this term was "weight loss".

IEC 60601-2-16:2018 © IEC 2018 – 13 –
201.3.213
* ONLINE HDF
HAEMODIAFILTRATION PROCEDURE where the HAEMODIALYSIS EQUIPMENT produces SUBSTITUTION
FLUID for infusion from DIALYSIS FLUID for the HAEMODIAFILTRATION treatment
201.3.214
* ONLINE HF
HAEMOFILTRATION PROCEDURE where the HAEMODIALYSIS EQUIPMENT produces the SUBSTITUTION
FLUID for infusion from DIALYSIS FLUID for the HAEMOFILTRATION treatment
201.3.215
* PROTECTIVE SYSTEM
automatic system, or a constructional feature, specifically designed to protect the PATIENT
HAZARDOUS SITUATIONS
against
201.3.216
SUBSTITUTION FLUID
fluid used in HF and HDF treatments which is directly infused into the EXTRACORPOREAL CIRCUIT
as a replacement for the fluid that is removed from the blood by filtration
[SOURCE:ISO 23500-1:—[15], 3.40, modified – The words "patient's blood" and
"ultrafiltration" have been replaced respectively by "EXTRACORPOREAL CIRCUIT" and "filtration"
in the definition, and the notes have been deleted.]
201.3.217
TRANSMEMBRANE PRESSURE
TMP
fluid pressure difference exerted across the semi-permeable membrane of the DIALYSER
Note 1 to entry: Generally the mean TMP is used. In practice, the displayed TRANSMEMBRANE PRESSURE is usually
estimated from the measured EXTRACORPOREAL CIRCUIT pressure minus the measured DIALYSIS FLUID pressure,
each obtained at a single point.
Note 2 to entry: This note applies to the French language only.
201.3.218
* ULTRAFILTRATION
PROCESS of fluid removal from the PATIENT'S blood across the semi-permeable membrane of
the DIALYSER
201.3.219
VENOUS PRESSURE
pressure measured in the blood return line of the EXTRACORPOREAL CIRCUIT between the
DIALYSER connection and PATIENT CONNECTION
201.3.220
DIALYSIS WATER
water that has been treated to meet the requirements of ISO 23500-3 [17] and which is
suitable for use in HAEMODIALYSIS applications, including the preparation of DIALYSIS FLUID,
reprocessing of DIALYSERS, preparation of concentrates and preparation of SUBSTITUTION FLUID
for online convective therapies
Note 1 to entry: The words "water for dialysis", "permeate", "reverse osmosis water" and "purified water" are
commonly used as synonyms of DIALYSIS WATER.
[SOURCE: ISO 23500-1:—[15], 3.17, modified – The reference number "[17]" has been added
in the definition, as well as the note.]

– 14 – IEC 60601-2-16:2018 © IEC 2018
201.4 General requirements
Clause 4 of the general standard applies, except as follows:
201.4.3 * ESSENTIAL PERFORMANCE
Addition:
201.4.3.101 * Additional ESSENTIAL PERFORMANCE requirements
ESSENTIAL PERFORMANCE of HAEMODIALYSIS EQUIPMENT includes, but is not
If applicable, the
limited to, the functions found in the subclauses listed in Table 201.101, which shall be met
within the tolerances specified by the MANUFACTURER under NORMAL CONDITION.
Table 201.101 – ESSENTIAL PERFORMANCE requirements
Requirement Subclause
Blood flow rate 201.4.3.102
DIALYSIS FLUID flow rate 201.4.3.103
NET FLUID REMOVAL 201.4.3.104
SUBSTITUTION FLUID flow rate 201.4.3.105
Dialysis time 201.4.3.106
DIALYSIS FLUID composition 201.4.3.107
DIALYSIS FLUID temperature 201.4.3.108
SUBSTITUTION FLUID temperature 201.4.3.109

NOTE Some ESSENTIAL PERFORMANCE requirements listed in Table 201.101 are dependent on the characteristics
of the disposables used (e.g. blood flow rate is dependent upon the pump segment inner diameter in rotary
peristaltic pumps).
201.4.3.102 Blood flow rate
The blood flow rate of the HAEMODIALYSIS EQUIPMENT shall be delivered as specified by the
MANUFACTURER. The specification shall include the pump segment fatigue for the maximum
specified usage life of the EXTRACORPOREAL CIRCUIT.
* NOTE 1 A blood flow rate lower than the set value is considered detrimental for a typical treatment. Therefore,
the goal of testing is to find the highest negative blood flow rate error.
Compliance is checked under the following test conditions for typical peristaltic pumps:
– apply an unused pump segment to the HAEMODIALYSIS EQUIPMENT according to the
instructions for use and let it run for at least 30 min;
– apply a fluid (e.g. water) with a temperature of 37 °C in the EXTRACORPOREAL CIRCUIT;
– set the blood flow rate of the HAEMODIALYSIS EQUIPMENT to 400 ml/min or – if not possible –
to the highest possible blood flow rate;
– set the pre-pump ARTERIAL PRESSURE to –200 mmHg;
– measure the blood flow rate.
The value of the measured blood flow rate shall be within the tolerances specified by the
MANUFACTURER in the instructions for use.
NOTE 2 Pump segment fatigue can reduce the blood flow rate.
NOTE 3 The blood flow rate in peristaltic pumps can be affected by negative input pressures.

IEC 60601-2-16:2018 © IEC 2018 – 15 –
201.4.3.103 DIALYSIS FLUID flow rate
The DIALYSIS FLUID flow rate of the HAEMODIALYSIS EQUIPMENT shall be delivered as specified
by the MANUFACTURER.
NOTE A DIALYSIS FLUID flow rate lower than the set value is considered detrimental for a typical treatment.
Compliance is checked under the following test conditions:
– set the HAEMODIALYSIS EQUIPMENT to the HAEMODIALYSIS mode as specified by the
MANUFACTURER;
– set the HAEMODIALYSIS EQUIPMENT to maximum DIALYSIS FLUID flow rate;
DIALYSIS FLUID flow rate over a period of 30 min;
– measure the
– set the HAEMODIALYSIS EQUIPMENT to minimum DIALYSIS FLUID flow rate;
DIALYSIS FLUID flow rate over a period of 30 min.
– measure the
The values of the DIALYSIS FLUID flow rate shall be within the tolerances specified by the
MANUFACTURER in the instructions for use.
201.4.3.104 NET FLUID REMOVAL
The NET FLUID REMOVAL of the HAEMODIALYSIS EQUIPMENT shall be achieved as specified by the
MANUFACTURER.
Compliance is checked under the following test conditions.
Test 1 for the balancing part of the HAEMODIALYSIS EQUIPMENT only:
– set the HAEMODIALYSIS EQUIPMENT in the HAEMODIALYSIS mode, if applicable, with a
DIALYSER according to the MANUFACTURER’S recommendation;
– apply fluid (e.g. water) in THE EXTRACORPOREAL CIRCUIT;
– set the highest DIALYSIS FLUID flow rate, if applicable;
– set the DIALYSIS FLUID temperature to 37 °C, if applicable;
– set the NET FLUID REMOVAL rate to 0 ml/h or the lowest adjustable value;
– create a DIALYSER blood outlet pressure of 50 mmHg below the highest operating pressure
specified by the MANUFACTURER;
– measure the NET FLUID REMOVAL during an appropriate time interval.
Continue with test 2:
– set the NET FLUID REMOVAL rate to the maximum value;
– measure the NET FLUID REMOVAL during an appropriate time interval.
Continue with test 3:
– create a DIALYSER blood outlet pressure of 20 mmHg above the lowest operating pressure
specified by the MANUFACTURER;
– measure the NET FLUID REMOVAL during an appropriate time interval.
NET FLUID REMOVAL shall be within the tolerances specified by the
The values of the
MANUFACTURER in the instructions for use.
201.4.3.105 SUBSTITUTION FLUID flow rate
For HAEMOFILTRATION and HAEMODIAFILTRATION EQUIPMENT only.

– 16 – IEC 60601-2-16:2018 © IEC 2018
The SUBSTITUTION FLUID flow rate of the HAEMODIALYSIS EQUIPMENT shall be delivered as
specified by the MANUFACTURER.
NOTE A SUBSTITUTION FLUID flow rate lower than the set value is considered detrimental for a typical treatment.
Compliance is checked under the following test conditions.
Test 1 for the balancing part of the HAEMODIALYSIS EQUIPMENT and of the therapeutic relevant
SUBSTITUTION FLUID flow rate:
– set the HAEMODIALYSIS EQUIPMENT to the HDF or HF mode with a DIALYSER according to the
MANUFACTURER’s recommendation;
EXTRACORPOREAL CIRCUIT;
– apply fluid (e.g. water) in the
– set the NET FLUID REMOVAL flow rate to 0 ml/h, or – if not possible – to the minimum;
SUBSTITUTION FLUID flow rate;
– set the maximum
– set the temperature of the SUBSTITUTION FLUID to 37 °C, if applicable;
– measure the SUBSTITUTION FLUID flow rate and the NET FLUID REMOVAL.
Continue with test 2:
– set the minimum SUBSTITUTION FLUID flow rate;
– measure the SUBSTITUTION FLUID flow rate and the NET FLUID REMOVAL.
SUBSTITUTION FLUID flow rate and NET FLUID REMOVAL shall be within the
The values of
tolerances specified by the MANUFACTURER in the instructions for use.
201.4.3.106 Dialysis time
The accuracy of the dialysis treatment time for the HAEMODIALYSIS EQUIPMENT shall be as
specified by the MANUFACTURER.
Compliance is checked by functional tests relevant for the definition of dialysis treatment time
specified by the MANUFACTURER.
201.4.3.107 * DIALYSIS FLUID composition
The test method for accuracy of the composition of the DIALYSIS FLUID shall be specified by the
MANUFACTURER and compliance checked accordingly.
IALYSIS FLUID temperature
201.4.3.108 D
The temperature of the DIALYSIS FLUID shall be achieved as specified by the MANUFACTURER.
NOTE This test applies only to HAEMODIALYSIS EQUIPMENT having a heater for the DIALYSIS FLUID.
Complia
...