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Let me start by stating that the elbows are one part of the body that can do a considerable amount of damage and are considered dangerous with good reason. Also, acknowledging that player safety is of paramount importance to sports officials, it seems unlikely that you will ever get knocked for committing an error if your concern on a play was for the well being of a player.
That being said it is my humble opinion that contact which doesn't inhibit normal defense would have to be considered incidental (4-27 is the best rule reference), even in the specific case you describe (initiated by the ballholder and with the elbow).
So, just as with contact caused by any other part of the body, the official has to make a judgment call here whether the contact inhibits the defender or not.
I would put the example you give (the defender was struck in the face and fell backwards and sideways) in the definitely inhibits column and thus have a foul.
While in a couple of other cases, I find it hard to deem that a foul occurred:
1. A1's elbow hitting B1's forearm while A1 is pivoting and attempting to prevent B1 from causing a held ball.
2. A1's elbow hitting the side of B1's torso and not causing any displacement as A1 steps around B1 to throw a pass.
And how about a gray area just for fun:
1. A1's elbow clips the nose or chin of B1 after B1 took a defensive position just short of contact. Let's say the contact doesn't cause the defender to back off or fall backwards, but he could be momentarily stunned.
Perhaps this is analogous to when a player gets poked in the eye. Frequently, this is not a foul.
Lastly, consider what you think of A1 pivoting and colliding knee-to-knee with B1 while B1 is stationary.
Of course, all of this is only my individual opinion and you will need to follow the instructions of those in your area who give the orders. We seem to allow a fair amount of contact here.
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