Guideline 1.4.1 Physical Harm: health app rejected

Guideline 1.4.1 covers health apps that could give inaccurate information or be used to diagnose or treat people. Apple reviews these apps more closely. To pass, your app publishes its sources and methodology, only claims to measure what it actually measures, and reminds users to see a doctor. An app that claims to measure blood pressure using only the iPhone's sensors gets rejected.

This guide is about Apple's review, not medicine. Nothing here is medical advice. I publish my own iOS apps. Further down, a worked example shows how to frame a baby feeding app with 1.4.1 in mind. I read the official text on October 15, 2026. For other rejection reasons, read why Apple rejects an app.

What does guideline 1.4.1 say?

Guideline 1.4, "Physical Harm," is part of the "Safety" section of the App Review Guidelines. It opens like this: "If your app behaves in a way that risks physical harm, we may reject it." Then 1.4.1 targets medical apps: "Medical apps that could provide inaccurate data or information, or that could be used for diagnosing or treating patients may be reviewed with greater scrutiny."

The text sets out four requirements:

• Published data and methodology. "Apps must clearly disclose data and methodology to support accuracy claims relating to health measurements". If the accuracy or methodology can't be validated, the app is rejected.
• No fake sensor readings. Apple rejects apps that claim to take X-rays or measure blood pressure, body temperature, blood glucose levels or blood oxygen levels "using only the sensors on the device".
• A doctor reminder. "Apps should remind users to check with a doctor in addition to using the app and before making medical decisions."
• A link to the clearance. If your app has received regulatory clearance, include a link to that documentation with your submission.

Related rules in section 1.4

A rejection can also cite a neighboring sub-rule.

Rule	What it covers	What Apple expects
1.4.1	Medical apps	Sources, methodology, doctor
1.4.2	Dosage calculators	Approved publisher or clearance
1.4.3	Tobacco, drugs, alcohol	No encouragement
1.4.4	DUI checkpoints	Official sources
1.4.5	Risky challenges	No dangerous challenges

1.4.2 is the strictest. A drug dosage calculator must come from the drug manufacturer, a hospital, a university, a health insurance company, a pharmacy or another approved entity, or be approved by the FDA or its equivalent. So a solo developer without clearance can't publish a dosage calculator. 1.4.3 also covers apps that encourage excessive drinking, like some drinking games.

Is your app a "medical app"?

Apple doesn't give a list. Three official markers help you decide.

The age rating questionnaire. Its definitions separate two families. "Medical or Treatment Information" covers diagnosing and managing a condition, like advice on medication or emergencies. "Health or Wellness Topics" covers lifestyle advice: calorie tracking, diets, exercise. A fitness app offering workouts usually falls in the second one. In Apple's grid, wellness shows up from the 9+ tier, infrequent medical information at 13+, and frequent at 16+.

The medical device declaration. An app available in the European Union, the United Kingdom or the United States must declare whether it's a regulated medical device in two cases. Its primary or secondary category is Health & Fitness or Medical. Or it answered "Frequent" for medical information in the questionnaire. If you have no health feature, you answer no.

The law of the country. In France, the ANSM points out that some software counts as a medical device because it has a medical purpose. It must then carry the CE marking, and its status depends in particular on its intended use. If your app diagnoses, monitors a condition or treats, that's a regulatory question before it's a review question.

On Apple's forums, developers report 1.4.1 rejections for sleep apps, BMI calculators or food tracking apps they considered simple wellness. The reviewer judges what the app shows, not the category you picked.

Measuring with the iPhone: the claim matters more than the sensor

Worked example: an app asks you to put your finger on the camera, then shows a blood pressure reading. The phone alone can't validate that number: it's the textbook case of the rule. The same app also risks 1.1.6, which rejects inaccurate device data.

Two paths remain. Either you read, through HealthKit, measurements taken by a device built for it, and you show their source. Or you publish the methodology and data that prove your accuracy, which means real validation.

With HealthKit, a few more rules apply:

• The HealthKit design guidelines say not to request access to health data without a health feature, and to request it at the moment it's needed.
• Guideline 5.1.3 forbids writing false data to HealthKit, storing personal health data in iCloud and using it for advertising.
• Every access needs its own purpose string in the Info.plist, like the camera: see the ITMS-90683 guide.
• The HealthKit documentation warns that App Review may reject an app that enables clinical records without using them.

Sources, disclaimer, doctor: where to put them

1.4.1 rejection messages posted on Apple's forums ask for citations inside the app, with easy-to-find links to the sources. A disclaimer supports solid sources, it doesn't replace them.

What I'd do:

• A "Sources" link under each piece of advice, pointing to the organization behind it: WHO, the country's health authority, a medical society.
• The doctor reminder right where people read the advice, not just in the terms of use.
• The same caution on the product page: no promise to cure, diagnose or replace a professional.

Example: framing a baby feeding app

If you're building a baby food introduction app, here's an example of how to frame it. This isn't an Apple approval. A food app isn't necessarily medical. But talking to parents about age, allergens and choking risk quickly gets close to 1.4.1.

Here's how to frame it:

• No medical promise. The app helps you cook and track meals. It diagnoses nothing and doesn't replace the pediatrician.
• Official sources, cited in the app. Start from the WHO recommendations on complementary feeding, then each country's own. In France, Santé publique France publishes the brochure Pas à pas, votre enfant mange comme un grand.
• A human review. Write the content from those sources, then have a dietitian or a pediatrician review it before publishing. No fake experts.
• A visible disclaimer: "for informational purposes only," with a reminder to ask the pediatrician.
• First aid through an official link, rather than instructions you wrote yourself.
• Allergies treated as health data: explicit consent, minimal collection, export, deletion and an accurate declaration in App Privacy.

You can pick the Food & Drink category if that's what the app does. But the category won't protect you: if a screen gives health advice, 1.4.1 applies.

"Health or food app" checklist before submitting

• The app doesn't diagnose, treat or calculate doses, or you have the clearance that goes with it.
• Every piece of health advice links to an official source that's easy to find.
• A "Sources and methodology" screen lists every reference.
• The reminder to see a doctor appears next to the advice.
• No measurement comes from the iPhone's sensors alone without a validated, published methodology.
• Calculations (age, quantities, scores) are covered by tests with edge cases.
• HealthKit is only requested for a health feature, at the right moment.
• No health data goes to iCloud, to advertising or into the text of a notification.
• The medical device declaration is filled in if your category or questionnaire requires it.
• The age rating questionnaire describes your actual medical content.
• An app that provides a health service is submitted by an organization: guideline 5.1.1(ix) requires it. You choose that status when you enroll in the developer program.
• The review notes say where to find the sources, the disclaimer and, if you have one, the link to the clearance.

Responding to a 1.4.1 rejection

1. Spot what the reviewer cites: a measurement, advice without a source, a diagnostic feature.
2. Fix it in the build: visible sources, doctor reminder, feature removed if it can't be validated.
3. Align the product page: description, subtitle and screenshots with no medical promise.
4. Reply with the locations, as explained in responding to App Review.

A template in English to adapt, keeping only what's true:

Hello,

Thank you for your feedback regarding Guideline 1.4.1.

In build [X]:
- every health recommendation links to its source
  ([organization]); see [screen] > "Sources";
- a reminder to consult a doctor appears on [screens];
- [feature] no longer claims to measure [value].

Best regards,
[Your name]

If the app has regulatory clearance, attach the link to the document. If not, don't make one up: Apple asks for proof.

Pass 1.4.1 on your next submission

The Review Kit gathers everything I check before each submission, with two skills that review your project in Claude Code and draft your reply if Apple rejects you. If you want a human look, book an hour with me: we'll go over your advice screens and your product page together. The full process is on the app rejected by Apple page.

If you're preparing your first release, take the free diagnostic: it tells you which step to tackle first and sends you my Apple anti-rejection checklist.

Nobody can guarantee Apple will accept your app. Visible sources and measured claims at least take this reason off the list.

Frequently asked questions

What does "Guideline 1.4.1 - Safety - Physical Harm" mean?

It's the rejection title in Apple's message. The reviewer thinks some health information in your app could be inaccurate, or could be used to diagnose, without the expected safeguards: sources, methodology, a doctor reminder or clearance.

Is a disclaimer enough to pass guideline 1.4.1?

No. The reminder to see a doctor is one of the requirements, but it doesn't replace sources or methodology. A measurement that can't be validated still gets rejected, even with a disclaimer at the top of the screen.

Can an app measure blood pressure with the iPhone camera?

No. 1.4.1 lists blood pressure, body temperature, blood glucose and blood oxygen among the measurements you can't take with the phone's sensors alone. For any other measurement, you have to publish the data and methodology that prove its accuracy.

Do you need a company to publish a health app?

For a health service, yes: guideline 5.1.1(ix) requires apps in highly regulated fields, including healthcare, to be submitted by the entity that provides the service. A recipe or wellness app isn't necessarily a health service.

What age rating does a health app get?

It depends on your answers to the questionnaire. In Apple's grid, wellness topics show up from the 9+ tier, infrequent medical information at 13+ and frequent at 16+. Answer based on your actual content, not the tier you're aiming for.