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There are devices known as simulators. They work by simulating a human finger but fail to reproduce the optical properties of blood. These devices are mainly used for testing the entire pulse oximeter system, that is the sensor and monitor. Their main use is in testing the software within the monitor and in detecting broken wires in the pulse oximeter sensor. They have been used as a basis for comparing the performance of systems from different manufacturers with the assumption that all sensors are perfect.

It is assumed that there is no wavelength error in the sensor and that all sensors are perfect in this respect. All of the sensors that have been identified by The Lightman as being inaccurate and not suitable for use would have been passed as fit for use by a simulator. This is backed up in The ISO Pulse Oximetry Standard 9919 where it is said that no simulator has the spectral resolution to enable it to be used for calibration purposes.

The main source of error confronting any user of pulse oximetry is that due to variability between pulse oximeter sensors, the performance of the monitors is less questionable. Thus The LightmanŽ is unique in its ability to assess the accuracy of a pulse oximeter sensor.