The Association of Healthcare Technology Providers for Imaging, Radiotherapy and Care (AXREM) has released two documents related to medical device installation safety, following a report into the death of a patient.
Issued in response to a formal review written by Ian Chell and reported by the Society of Radiographers last year, the documents outline what healthcare professionals, policy makers, suppliers or stakeholders must know about medical device installation safety. The documents mainly apply to permanently installed medical radiological equipment.
Mr Chell’s formal review provided recommendations to enhance patient safety in relation to a death that took place during a diagnostic coronary angiogram in 2020.
In response, AXREM has published a document titled ‘Medical Device Installation Safety’, which lists rules for installing medical electrical equipment - also known as medical electrical systems - to allow them to operate safely. The second document is a significant update to the ‘Electrical installation checklist’ designed to ensure medical equipment - like X-ray, CT and MRI – can be installed with compliant room electrical wiring.
Collaboration, patient safety and training
The first guidance document spans installation, maintenance and monitoring of Medical Electrical Equipment and new advice on Contactor controls and indicator lamps. It encourages:
- Collaboration between healthcare estates, designers, clinical staff and the device supplier/manufacturer from the earliest possible stages when it comes to commissioning new or replacement medical equipment
- Ensuring Estates Departments take responsibility for contactor control circuits
- Ensuring that the wiring complies with the latest wiring guidance, which is crucial for patient safety
- The replacement of contactor switchgear (e.g. Emergency Power Off buttons) with new medical radiological equipment and making sure the location is appropriate
- Operators are trained in the use of contactor controls
Read the Medical Device Installation Safety document in full here.
AXREM’s updated electrical installation checklist will be used in the future by medical device suppliers to check the room wiring is compliant before they set up permanently installed equipment. It is therefore recommended that hospitals are aware of the form to ensure the room is prepared correctly. The in-depth checklist asks questions such as whether the physical, environmental and required services meet the medical device specifications, and if all documentation related to the installation has been provided. A significant checkpoint is that it asks for the hospital to justify - in writing - why the room wiring is not compliant with the latest wiring guidance (currently April 2026).
The checklist was first published in April 2020 and was updated last week (16 April). The updated version can be accessed here. It is suggested that this form be passed to the estates department.
Recommendations from the formal review
Ian Chell is an independent expert in ‘medical locations’ - the term used to refer to mains supply wiring in medical rooms - and runs occasional training courses for trusts mainly on the governance process. These two forms and the new wiring guidance will help to cement that process.
In the formal review, which he shared with the SoR and was reported by SoR News in November 2025, a coroner found that the death took place after a power disconnection resulted in the loss of X-ray capability, which prevented the commencement of a stenting procedure until mains power was restored. The incident occurred as the radiographer was moving the C-arm and patient table into the CPR position, at which point the X-ray equipment mains power was disconnected. Mr Chell was an expert witness at the inquest.
The full details can be found in the report. One recommendation in the coroner’s report is that training is undertaken (for operators) on the operation of mains contactor controls and the meaning of indicator lamps. The AXREM guidance explains the standards for such control equipment.
‘Pragmatic guidance’
Richard Evans, CEO of the SoR, praised AXREM’s willingness to emphasise the role of radiographers in patient safety by publishing guidance off the back of the formal review.
“Ian Chell’s long-standing connection with the SoR and his knowledge of the importance of radiographers to patient safety is evident in the way he contacted us to help him publicise his important work on this tragic incident,” he said. “It is brilliant that industry partners are providing pragmatic guidance that will help to ensure high standards of safety for the future.”
Click here to read the Medical Device Installation Safety document. Read the updated electrical installation checklist here.
(Image credit: Comezora via Getty Images)