I think that everyone here is all about safety. If not we wouldn't be discussing all of these issues. However, I believe that we can "try" to worry about the "What If" scene, but we can't always be able to take care of it. By that I mean, if I inspect a job and it meets the present NEC, then I must pass that job. I can't always worry about, "WHAT IF" someone adds, blah, blah, blah. If someone does add a large piece of equipment and the work he does, doesn't meet the code, then I would fail the job. Too many times though, people add stuff to the house and office and don't get permits, and since there are no permits, we can not inspect the job. If I had to worry about the "What IF" problem, then all buildings I inspect would have to be able to withstand a crash from a 747 airplane, with stand earthquakes and hurricanes of very large sizes.
So bringing it back to an eye care place, if the doctor decides to operate on eyes a few years after I inspect his office, then it is his responsability to make sure that it meets all of the proper codes. This is my opinion only mind you.