When the 3rd edition of IEC 60601-1 was published, it marked the beginning of a new era. The standard now incorporates the concept and application of risk management in the design and production of devices. Implementation of risk management has implications for not only the end-product manufacturer, but component providers as well, and further cascades through the entire supply chain. All parties now face a series of choices and opportunities in determining how best to ensure, for the entire lifetime of a device, that basic safety and essential performance are preserved. This article explores some of those choices and their consequences.