Alexander Sowinski

RFx

Otsuka America Pharmaceutical, Inc. 02684 Wearable Sensor for Ambulatory Recording X7902684 X7902684 02684

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02684 Wearable Sensor For Ambulatory Recording by Otsuka America Pharmaceutical

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Document DEVICE REPORT02684-RF-Exposure-Info-Otsuka-America-Pharmaceutical-x7902684-ex-1-4
Test Report ­ Products Prüfbericht - Produkte

Test Report No.: Prüfbericht-Nr.:
Client Reference No.: Kunden-Referenz-Nr.:

US225CE4 001 Rev1.0 2361512

Order No.: Auftrags-Nr.:

P00755351 234193356

Order date: Auftragsdatum: 7/6/2022

Page 1 of 7 Seite 1 von 7

Client: Auftraggeber:
Test item: Prüfgegenstand:

Otsuka America Pharmaceutical, Inc. 3956 Point Eden Way Hayward, CA 94545 USA
Otsuka Patch

Identification/ Type No.:

Bezeichnung / Typ-Nr.

D-Tect

Order content: Auftrags-Inhalt:

RF Exposure Report

Test specification: Prüfgrundlage:
Date of sample receipt: Wareneingangsdatum:
Test sample No: Prüfmuster-Nr.:
Testing period: Prüfzeitraum:
Testing laboratory: Prüflaboratorium:

FCC Part 2.1091
10/31/2022
00182, 00196
10/31/2022- 11/2/2022 TUV Rheinland of North America 5015 Brandin Ct. Fremont, CA 94538

See Test Setup Exhibit for Photos

Test result*: Prüfergebnis*:
tested by: geprüft von:

Pass

authorized by: / genehmigt von:

Date: 11/15/2022 Datum:

Issue Date: 11/15/2022 Ausstellungsdatum:

Position / Stellung:
Others / Sonstiges:

Expert

Position / Stellung: Expert

Condition of the test item at delivery: Zustand des Prüfgegenstandes bei Anlieferung:

Test sample complete and undamaged

* Legend: * Legende:

P(ass) = passed a.m. test specification(s) P(ass) = entspricht o.g. Prüfgrundlage(n)

F(ail) = f ailed a.m. test specification(s) F(ail) = entspricht nicht o.g. Prüfgrundlage(n)

N/A = not applicable N/A = nicht anwendbar

N/T = not tested N/T = nicht getestet

This test report only relates to the a. m . test sam ple. Without perm ission of the test center this test report is not perm itted to be duplicated in extracts. This test report does not entitle to carry any test m ark.
Dieser Prüfbericht bezieht sich nur auf das o.g. Prüfmuster und darf ohne Genehmigung der Prüfstelle nicht auszugsweise vervielfältigt werden. Dieser Bericht berechtigt nicht zur Verwendung eines Prüfzeichens.

TÜV Rheinland of North America, Inc., 295 Foster St. Suite 100, Littleton, MA 01460 USA Mail: [email protected] · Web: www.tuv.com

EMC_NAM_Report Template_Rev1.0

FCC ID: X7902684

Test Report - Products Prüfbericht - Produkte
Test report no.: US225CE4 001 Rev1.0 Prüfbericht-Nr.:
Remarks Anmerkungen

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1 The equipment used during the specified testing period was calibrated according to our test laboratory calibration program. The equipment fulfils the requirements included in the relevant standards. The traceability of the test equipment used is ensured by compliance with the regulations of our management system. Detailed information regarding test conditions, equipment and measurement uncertainty is available in the test laboratory and could be provided on request.
Alle eingesetzten Prüfmittel waren zum angegebenen Prüfzeitraum gemäß eines festgelegten Kalibierungsprogramms unseres Prüfhauses kalibriert. Sie entsprechen den in den Prüfprogrammen hinterlegten Anforderungen. Die Rückverfolgbarkeit der eingesetzten Prüfmittel ist durch die Einhaltung der Regelungen unseres Managementsystems gegeben. Detaillierte Informationen bezüglich Prüfkonditionen, Prüfequipment und Messunsicherheiten sind im Prüflabor vorhanden und k önnen auf Wunsch bereitgestellt werden.
2 As contractually agreed, this document has been signed digitally only. TUV Rheinland has not verified and unable to verify which legal or other pertaining requirements are applicable for this document. Such verification is within the responsibility of the user of this document. Upon request by its client, TUV Rheinland can confirm the validity of the digital signature by a separate document. Such request shall be addressed to our Sales department. An environmental fee for such additional service will be charged.
Wie vertraglich vereinbart, wurde dieses Dokument nur digital unterzeichnet. Der TÜV Rheinland hat nicht überprüft, welche rechtlichen oder sonstigen diesbezüglichen Anforderungen für dieses Dokument gelten. Diese Überprüfung liegt in der Verantwortung des Benutzers dieses Dokuments. Auf Verlangen des Kunden k ann der TÜV Rheinland die Gültigkeit der digitalen Signatur durch ein gesondertes Dokument bestätigen. Diese Anfrage ist an unseren Vertrieb zu richten. Eine Umweltgebühr für einen solchen zusätzlichen Service wird erhoben.
3 Test clauses with remark of * are subcontracted to qualified subcontractors and descripted under the respective test clause in the report. Deviations of testing specification(s) or customer requirements are listed in specific test clause in the report.
Prüfk lausel mit der Note * wurden an qualifizierte Unterauftragnehmer vergeben und sind unter der jeweiligen Prüfk lausel des Berichts beschrieben. Abweichungen von Prüfspezifikation(en) oder Kundenanforderungen sind in der jeweiligen Prüfklausel im Bericht aufgeführt.
4 The test results contained in this report refer exclusively to the product(s) presented for testing. No liability may be assumed for models or products not referred to herein. This test report may not be published or duplicated in part without permission of the testing body. This test report by itself does not constitute authorization for the use of any TÜV Rheinland test mark. The report must not be used by the client to claim product certification, approval, or endorsement by A2LA.
5 Radio Compliance Emissions Test Report. The above product was found to be Compliant to the above test standard(s).

EMC_NAM_Report Template_Rev1.0

FCC ID: X7902684

Test Report - Products Prüfbericht - Produkte
Test report no .: US225CE4 001 Rev1.0 Prüfbericht-Nr.:
Product description Produktbeschreibung

Page 3 of 7 Seite 3 von 7

1 Product details: Produk tdetails:

The Patch device is a component of the Core Medical Device (CMD) that gathers ingestion, physiological and behavioral metrics from a user.This data is then
transmitted to a BLE-enabled gateway device. The data can be accessed by external applications for further processing or displayed directly to a user via a display.

2 Dimensions / Weight: Maße / Gewicht:

11.3cm x 4.52cm x 0.68cm / 0.011 kg

3 Operating elements: Bedienelemente:

2.9VDC Battery Operated, Transmit bands 2.402-2.480GHz.

4 Equipment / Accessories: Ausstattung / Zubehör:

N/A

5 Used materials: Verwendete Materialien:

None.

6 Other: Sonstiges:
7 Test sample obtaining: Prüfmusterbereitstellung:

Test sample(s), as well sample information, description, product details and intended usage was provided by customer.

 Sending by customer  others:

 Sampling by TÜV Rheinland Group

EMC_NAM_Report Template_Rev1.0

FCC ID: X7902684

Test Report - Products Prüfbericht - Produkte

Test report no.: US225CE4 001 Rev1.0 Prüfbericht-Nr.:

Date mm/dd/yy
11/15/2022

Name Rev. 1

Revisions
Page Number of Change
N/A

Page 4 of 7 Seite 4 von 7
Describe Change Original Document

EMC_NAM_Report Template_Rev1.0

FCC ID: X7902684

Test Report - Products Prüfbericht - Produkte
Test report no.: US225CE4 001 Rev1.0 Prüfbericht-Nr.:

Page 5 of 7 Seite 5 von 7

TABLE OF CONTENTS

1 Product Information.................................................................................................................. 6 1.1 Product Description........................................................................................................... 6 1.2 Product Specifications ....................................................................................................... 6
2 RF Exposure Test Exemption.................................................................................................... 7 2.1 Purpose .......................................................................................................................... 7 2.2 RF Exposure Limit ............................................................................................................ 7 2.3 Assessment Calculation..................................................................................................... 7 2.4 Conclusion....................................................................................................................... 7

EMC_NAM_Report Template_Rev1.0

FCC ID: X7902684

Test Report - Products Prüfbericht - Produkte
Test report no.: US225CE4 001 Rev1.0 Prüfbericht-Nr.:

Page 6 of 7 Seite 6 von 7

1 Product Information

1.1 Product Description
The Patch device is a component of the Core Medical Device (CMD) that gathers ingestion, physiological and behavioral metrics froma user. This data is then transmitted to a BLE-enabled gateway device. The data can be accessed by external applications f or further processing or displayed directly to a user via a display.

1.2 Product Specifications

The information provided in the following table should be listed as it should appear in the final report.

Table 1 ­ EUT Specifications*

EUT Specification

Exposure Type DC Power Input

 General Population / Uncontrolled  Occupational / Controlled
2.9VDC

Environment Operating Temperature Range: Multiple Feeds:
Product Marketing Name (PMN)

Indoor/Outdoor +5 to +40 degrees C
Yes and how many No Otsuka Patch

Hardware Version Identification Number (HVIN)
Firmware Version Identification Number (FVIN)
Operating Mode

DT3.0 FIRMWARE_VERSION,17,v0.1.4.0 GIT:733 Bluetooth Low Energy

Transmitter Frequency Band 2402 - 2480 MHz

Power Setting @ Operating Channel
Antenna Type

-8 dBm (max) Patch

Data Rate

1Mbps and 2Mbps

Antenna Gain (dBi)

-10.1 dBi

Modulation Type TX/RX Chain (s)

AM

FM

Other describe: GFSK

1

DSSS

OFDM

Note: *All EUT specifications are provided by the manufacturer or the TUV direct customer. Information supplied by the customer and can affect the validity of results.

EMC_NAM_Report Template_Rev1.0

FCC ID: X7902684

Test Report - Products Prüfbericht - Produkte
Test report no.: US225CE4 001 Rev1.0 Prüfbericht-Nr.:
2 RF Exposure Test Exemption

Page 7 of 7 Seite 7 von 7

2.1 Purpose
In this document, we evaluate the RF Exposure to human body due the intentional transmission from the transmitter (EUT). The limit for RF Exposure Test Exemption specified in FCC 1.1307 is followed.

2.2 RF Exposure Limit
1-mW Test Exemption limit per § 1.1307(b)(3)(i)(A), a single RF source is exempt RF device if the available maximum time-averaged (matched conducted) output power is no more than 1 mW, regardless of separation distance. This exemption applies to all operating configurations and exposure conditions, for the frequency range 100 kHz to 100 GHz, regardless of fixed, mobile, or portable device exposure conditions. This is a standalone exemption, and it cannot be applied in conjunction with any other test exemption.

2.3 Assessment Calculation The maximum output power and antenna gain is declared by the manufacturer and used in this assessment. The minimum RF exposure distance during normal operation is 5mm.

Stand Alone Analysis ,

Frequency Band (MHz)
2402-2480

Operating Freq (MHz) 2402

Max. Conducted
Power (dBm) -8.21

Antenna Gain (dBi) -10.1

Max. Conducted
Power (mW) 0.151

Exemption Limit (mW) 1

Result (Pass/Fail)
Pass

2.4 Conclusion
The above result had shown that the device complied with RF Exposure test ememption requirement.

EMC_NAM_Report Template_Rev1.0

FCC ID: X7902684



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