Aditionally, Apple writes: Regarding 1.4.1 issue, though your app is used for training purpose, your app connects to external medical hardware to provide medical services, it still need to be compliant with App Store Review Guideline 1.4.1, you must: Demonstrate regulatory clearence for your app's use of medical hardware with documentation from the appropriate regulatory organization Provide documentation of a report or peer-reviewd study that demonstrates your app'Äs use of medical hardware works as described