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Recommendations on Standards for the Design of Medical Diagnostic Equipment for Adults with Disabilities, Advisory Committee Final Report

1.3.1 Overview of NPRM

The U.S. Access Board published a Notice of Proposed Rulemaking (NPRM) proposing MDE accessibility standards (see 77 FR 6916, February 9, 2012). Box 1.3.1 contains the summary of this NPRM. The NPRM requested responses from the public by June 8, 2012, and it announced two hearings to seek public comments: March 14, 2012 in Washington, DC; and May 8, 2012, in Atlanta, GA.

Box 1.3.1

The Architectural and Transportation Barriers Compliance Board (Access Board) is proposing accessibility standards for medical diagnostic equipment. The proposed standards contain minimum technical criteria to ensure that medical diagnostic equipment including examination tables, examination chairs, weight scales, mammography equipment and other imaging equipment used by health care providers for diagnostic purposes are accessible to and usable by individuals with disabilities. The standards will allow independent entry to, use of and exit from the equipment by individuals with disabilities to the maximum extent possible. The standards do not impose any mandatory requirements on health care providers or medical device manufacturers. However other agencies referred to as an enforcing authority in the standards may issue regulations or adopt policies that require health care providers subject to their jurisdiction to acquire accessible medical diagnostic equipment that conforms to the standards.

Summary. Architectural and Transportation Barriers Compliance Board, Notice of Proposed Rulemaking, RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards, February 8, 2012, p. 3.

 The NPRM organized its technical criteria around seven areas, starting with the four basic approaches for positioning patients on MDE (Table 1.3.1(a). Table 1.3.1(b), taken from the NPRM, provides details about equipment features that the technical criteria would address so that patients could achieve proper positioning for diagnostic testing; it also gives illustrative examples of the types of equipment covered.

 

Table 1.3.1(a)

Organization of MDE Accessibility Standards Technical Criteria in
U.S. Access Board 2012 Notice of Proposed Rule Making

 

M301

Diagnostic Equipment Used by Patients in Supine, Prone, or Side-Lying Position

M302

Diagnostic Equipment Used by Patients in a Seated Position

M303

Diagnostic Equipment Used by Patients Seated in a Wheelchair

M304

Diagnostic Equipment Used by Patients in Standing Position

M305

Supports

M306

Communication

M307

Operable Parts

 

Table 1.3.1(b)

Equipment Features by Patient Position and Examples of MDE Types

Patient Positions Equipment Designed to Support

Equipment Features Addressed in Technical Criteria

Types of Equipment to Which Technical Criteria Applies

Diagnostic Equipment Used by Patients in Supine, Prone, or Side-Lying Position (M301)

Transfer surface, including height, size, and transfer sides

Transfer supports, stirrups, and head and back support

Lift compatibility 

Examination tables 

Imaging equipment designed for use with platform beds

Examination chairs designed to recline and be used as examination tables

Diagnostic Equipment Used by Patients in a Seated Position (M302)

Transfer surface, including height, size, and transfer sides

Transfer supports, armrests,
and head and back support

Lift compatibility

Examination chairs

Imaging equipment designed for use with a seat

Weight scales designed for use with a seat

 Diagnostic Equipment Used by Patients Seated in a Wheelchair (M303)

Wheelchair space, including orientation, width, depth, knee and toe clearance, and surface slope

Changes in level at entry to wheelchair space, including ramps

Components capable of examining body parts of patients seated in a wheelchair, including height of breast platforms

Imaging equipment designed for wheelchair use

Weight scales designed for wheelchair use

Diagnostic Equipment Used by Patients in Standing Position (M304)

Slip resistant standing surface

Standing supports

Imaging equipment designed for use in standing position

Weight scales designed for use in standing position

SOURCE: Architectural and Transportation Barriers Compliance Board, Notice of Proposed Rulemaking, RIN 3014-AA40 Medical Diagnostic Equipment Accessibility Standards, February 8, 2012, pp. 10-11.

The NPRM mentioned ANSI/AAMI HE 75, the 2009 report from the Association for the Advancement of Medical Instrumentation that recommends human factors design principles for medical devices. In addition, Chapter 16 of ANSI/AAMI HE 75 recommends practices regarding accessibility for patients and health care personnel with disabilities. The NPRM stated:

The Access Board is committed to using voluntary consensus standards where practical and consistent with the National Technology Transfer and Advancement Act of 1995 (15 U.S.C. 272 note). The Access Board has considered the recommended practices in Chapter 16 of ANSI/AAMI HE 75 in developing the technical criteria for the proposed standards. The technical criteria are generally consistent with and supplement the recommended practices in Chapter 16 of ANSI/AAMI HE 75. The Access Board seeks to promote harmonization of its guidelines and standards with voluntary consensus standards and plans to participate in future revisions to ANSI/AAMI HE 75. (NPRM p. 8)

In addition to seeking general comments on the recommended accessibility standards, the NPRM requested public responses to 46 specific questions.

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