2AAZF-CHB01RFID TRANSCEIVER 3D-HD CAMERA HEAD

DRAFT/PRE-RELEASE/CONFIDENTIAL User Manual PN 550650-09 Rev. A 2014.09 da Vinci ® Si™ ii DRAFT/PRE-RELEASE/CONFIDENTIAL10/9/14 Copyrights © 2014 Intuitive Surgical, Inc. All rights reserved. Portions of this software provided by QNX Software (www.qnx.com). © 2014 QNX Software. All rights reserved. Portions of this software provided by The FreeType Project (www.freetype.org). © 2014 The FreeType Project. All rights reserved. Trademarks Intuitive, Intuitive Surgical, Beyond the Limits of the Human Hand, da Vinci, da Vinci S, da Vinci Si, EndoWrist, OnSite, TilePro and InSite are trademarks or registered trademarks of Intuitive Surgical, Inc. Other parties’ trademarks are the property of their respective owners and should be treated as such. Equipment and Software Version This user manual provides technical information about the use and operation of the IS3000 da Vinci ® Si™ Surgical System. The equipment described herein is designed to work with the da Vinci Si Surgical System operating system version A6.0 P8 and later. Rx only da Vinci ® Si™ iii DRAFT/PRE-RELEASE/CONFIDENTIAL 10/9/14 Terms and Conditions of End User Software License Agreement 1 LICENSE. The software (“Software”) embedded within the da Vinci Si Surgical System (“System”) and the accompanying documentation (“Documentation”) are provided under license and are not sold to buyer. Intuitive Surgical, Inc. (“Intuitive”) grants to buyer a non-exclusive, non-transferable, fully-paid, restricted license to (a) install and use the Software solely as incorporated in the System in machine-executable object code form and solely in connection with the operation of the System as described in the Documentation, and (b) use the Documentation for such Software solely for the purpose of using the Software in compliance with this license. 2 RESTRICTIONS. (a) Buyer shall not (i) use, copy, translate, modify, create derivative works of, or transfer, (ii) merge with any other product, (iii) sublicense, lease, rent, loan, or otherwise transfer, (iv) reverse engineer, decompile, disassemble, attempt to derive the source code for, or otherwise manipulate, or (v) disclose, permit to be disclosed or publicly display or perform, the Software, in whole or in part, or any copy thereof. Notwithstanding the foregoing, manipulation of the Software is permitted if, and then only to the extent that, the foregoing prohibition on manipulation is required to be modified by applicable law; provided, however, that buyer must first request from Intuitive the information to be sought from the Software, and Intuitive may, in its discretion, provide such information to buyer under good faith restrictions, and/or impose reasonable conditions, including but not limited to a reasonable fee, on such use of the Software, to ensure that Intuitive’s and any third party’s proprietary rights in the Software are protected. (b) Buyer may make a reasonable number of backup and archival copies of the Software as necessary to support the use of the Software in connection with the balance of the System, but shall not otherwise copy the Software under any circumstances. Buyer may not alter, obscure or remove any copyright, trademark, proprietary rights, disclaimer, or warning notice included on or embedded in any part of the Software (including those of third parties). 1 OWNERSHIP. The Software is licensed, not sold, to buyer. There is no implied license, right or interest granted in any copyright, patent, trade secret, Trademark, invention or other intellectual property right. 2 TERM. This license will begin on the date the Software is delivered to buyer, and will continue until the end of the useful life of the System. Notwithstanding the foregoing, this license shall terminate immediately upon written notice to buyer by Intuitive if buyer materially breach any term or condition of this license. Buyer agrees upon termination to promptly discontinue all use of and destroy the Software and all copies thereof (whether in tangible form or as installed on buyer equipment). 3 EXPORT LAW. The Software and related technology are subject to U.S. export control laws and may be subject to export or import regulations in other countries. Buyer agrees to strictly comply with all such laws and regulations and acknowledge that buyer have the responsibility to obtain such licenses to export, re-export or import as may be required. 4 U.S. GOVERNMENT BUYERS. The Software is a “commercial item” as that term is defined at 48 C.F.R. 2.101, consisting of “commercial computer software” and “commercial computer software documentation” as such terms are used in 48 C.F.R. 12.212. Consistent with 48 C.F.R. 12.212 and 48 C.F.R. 227.7202-1 through 227.7202-4, all U.S. Government end users acquire the Software with only those rights set forth therein. _________________________________End of section______________________________ da Vinci ® Si™ iv DRAFT/PRE-RELEASE/CONFIDENTIAL10/9/14 Contents 1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1 •1.1 User Manual Organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1 • Chapters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1 • Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2 •1.2 General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1- 2 • Contact Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2 • Compliance and Classifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1- 3 • System Labels. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .…

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da Vinci ® Si™ Vision System Use 7-6 DRAFT/PRE-RELEASE/CONFIDENTIAL 10/9/14 Install Endoscope on Camera Head Before you can install the endoscope on the camera head, you must install the camera head sterile adapter, as described in 6.5 Camera Head Draping Procedure on page 6-15. Endoscope Orientation on the Camera Head and Calibration The endoscope has pins in its base that help you to align it easily with the corresponding channels on the camera head sterile adapter. Figure 7.5 Installing endoscope in camera head The pins support installing the endoscope on the camera head in two orientations 180 de grees opposite. The calibration process is sensitive to the orientation of the endoscope with respect to the camera head. You must successfully calibrate the endoscope in each orientation in which you will use it. For an angled endoscope, you must calibrate the scope in both orientations to make sure it is ready for use as a 30 degrees up scope and as a 30 degrees down scope. •For angled endoscopes, the orientation with which you install it determines whether the scope is 30 degrees up or down. (The syste m automatically detects and displays it, whichever way it is installed.) For 30 degrees up, orient the scope so that the angled tip is on the same side as the camera head buttons; do the opposite for 30 degrees down. The scope base also indicates which side is which with marking that says 30º on one side and 30 º on the other. •For flat endoscopes (0 degrees), we recommend you install the endoscope on the camera head consistently in the same orientation: with the “Intuitive Surgical” logo on the base of endoscope on the same side as the camera head buttons, as shown above in Figure 7.5. Sterile adapter (drape removed for clarity) Camera head Endoscope Guide pin Channel to accept guide pin Intuitive logo Installation: Detail of pin entering channel 30º 30º Vision System Use da Vinci ® Si™ 7-7 DRAFT/PRE-RELEASE/CONFIDENTIAL10/9/14 Follow these steps to install the scope: 1. Hold the endoscope and camera head with attached sterile adapter firmly in each hand – avoid dropping either part. 2. Place the endoscope base over the sterile adapter, turning the scope as necessary until the scope slides down over the camera head sterile adapter. 3.Push down the scope until it bottoms and turn until it locks into place. You will hear a click when the endoscope is locked into the sterile adapter. Icons on the endoscope base (sh own at left) indicate the direction you must turn to lock or unlock the scope over the sterile adapter. Camera / Scope Setup from the Camera Head The da Vinci Si System supports camera / scope setup, including white balance and automatic 3D calibration, completely via the camera head buttons. Using only the camera head buttons as explained below, a single sterile person can select options presented on the touchscreen. There is no need to touch the touchscreen, although it is still possible to perform manual calibration at the touchscreen, as described under Manual 3D Calibration, page 7-13. Three buttons are provided on the camera head for quick vision system setup. Control Adjustment Description Vision SetupUse the Vision Setup button to open and make selections within the Camera/Scope Setup menu. Focus In & Out / Navigate menu Press the Focus In or Out buttons to adjust the focus of the surgical image, and to navigate the Camera/Scope Setup menu. Lamp On/OffPress and hold Lamp On/Off for 1 second to turn the lamp on or off. da Vinci ® Si™ Vision System Use 7-8 DRAFT/PRE-RELEASE/CONFIDENTIAL 10/9/14 Figure 7.6 shows the camera head buttons. Figure 7.6 Camera head buttons, shown draped on right Invoke Camera / Scope Setup and Navigate As long as no instruments are in following mode, you can open the Camera / Scope Setup menu on the touchscreen by pressing and holding for 1 second the Vision Setup button on the camera head. When you do, the following menu appears. Figure 7.7 Camera / Scope Setup on touchscreen via camera head This menu is navigable only by means of the Focus In and Out arrow buttons on the camera head. You cannot select these options by touching them directly on the touchscreen (except for the X button to close the menu). For orientation, the up arrow is the one nearer the Lamp On/Off button. Press up or down to move up or down the list. Press the Vision Setup button to “click” your selection like a mouse button. Vision SetupFocus In & OutLamp On/Off Press and hold 1 s to open menu Navigate Select Vision System Use da Vinci ® Si™ 7-9 DRAFT/PRE-RELEASE/CONFIDENTIAL10/9/14 The message “Auto-calibration in progress...” appears continually in the stereo viewer until you exit the menu. Figure 7.8 Auto-calibration in progress (appears in stereo viewer only) To exit the C amera / Scope Setup menu completely, select Exit in the menu (see Figure 7.7 above) or touch the X button on the touchscreen. The surgeon cannot enter following mode until calibration is complete and you exit this menu. Setting the White Balance You must white balance the camera at the start of each procedure and any time a camera head, endoscope, lamp module, or Illuminator is changed. White balance sets a white color benchmark for the vision system. To set the white balance, follow these steps: 1.Turn on the lamp by pressing the Lam p On/Off button on the camera head or Illuminator front panel. (The Illuminator must be powered on. When Illuminator power is on but la mp is off, the display reads “OFF” and the LED on the front panel is lit amber.) The display flashes “ OFF” while the lamp ignites. When the lamp is on, the LED on the front panel turns blue, and the display indicates intensity as a percentage of maximum. Use the – and + buttons to adjust intensity in 10% increments. Make sure the intensity is set to 100% before proceeding. 2. Point the endoscope at a white object so the object covers the entire field of view. The wh ite object should be 4 in. (10 cm) from the endoscope tip. Figure 7.9 Using…

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da Vinci ® Si™ Appendix A: Error Handling A-3 DRAFT/PRE-RELEASE/CONFIDENTIAL 10/9/14 After Disabling an Instrument Arm After you disable an instrument arm, you still can use the arm clutch and port clutch buttons to move the arm out of the way. Disabling the Instrument Control Box (ICB) In the event of an error specific to the ICB, the system presents the option to disable the ICB on the touchscreen and touchpad. Once the ICB has been disabled, it can not be re-enabled until the next power cycle. Intuitive Surgical designed this feature to allow a user to complete a procedure without use of the EndoWrist instruments that employ the ICB, such as the Vessel Sealer. Non-Recoverable Faults If a fault is non-recoverable, the system must be restarted. The following message is displayed: Non-recoverable fault: XXXX Restart System to continue. Restarting the System During a Procedure If a non-recoverable fault occurs during a procedure, you must completely remove all instruments from the system. The endoscope does not need to be removed. Follow these steps to restart the system: 1. Completely remove all instruments from the system. The endoscope does not need to be removed. If an instrument is grasping tissue, follow the grip release instructions in Chapter 9, Grip Release, on page 9-13. WAR NI NG : If it is not clinically possible to remove an instrument, closely monitor the instrument arm during restart to ensure that no motion occurs. 2.Power off the system: Press the Powe r button on any system component. The system takes several seconds to shut down . When complete, all system Power but- tons will be lit amber, indicating standby mode, and readiness for restart. 3. Restart the system: Press the Pow er button on any system component. 4. After the system has restarted successfully, then the instrument s can be reinserted. Note: During system restart, video is temporarily unavailable at the Surgeon Console view er and touchscreen monitor. Note: If the fault cannot be cleared by a system restart, call Intuitive Surgical Technical Support. Emergency Stop Press the red Emergency Stop button should it be necessary to stop system operation at any time. The Emergency Stop button will cease robotic control of the instruments and endoscope. The instruments and endoscope will stay in their last commanded position. If the instrument grips are closed when the Emergency Stop button is pressed, the grips will remain closed. However, the gripping force of the instrument may decrease. Pressing Emergency Stop initiates a recoverable fault, which you can override by pressing Recover on the touchscreen or touchpad. The Emergency Stop button illuminates when pressed and remains illuminated until the fault is recovered. Appendix A: Error Handling da Vinci ® Si™ A-4 DRAFT/PRE-RELEASE/CONFIDENTIAL10/9/14 EPO (Emergency Power Off) Figure A.3 EPO button on rear of Patient Cart The Emergency Power Off (EPO) button is on the back of the Patient Cart. Press this button to c ompletely remove power to the Patient Cart. The system classifies this a non-recoverable fault. The system must be restarted. Battery Backup Should the Patient Cart be unplugged, the system will generate a recoverable fault that must be addressed to continue a procedure. System operation will be allowed to continue on reserve power, but with basic functionality only. Note: Battery backup is only intended for safe removal of the system components from the patient and is not intended for continuing the procedure. Battery Low Condition If there is insufficient battery backup power on the Patient Cart, cart drive is disabled and the user will have to wait for the battery backup to charge. •To move the cart manually, move the shift switc h es on the base of the cart to the neutral position. When finished moving the cart, be sure to move the shift switches back to the drive position. Note: The backup battery is not user-serviceable , and must be r eplaced by authorized personnel only. Contact Intuitive Surgical Technical Support for details. Note: The Patient Cart battery should be adequately charged. If not, an error message appears on the monitors. You can override the error if the Patient Cart is plugged into AC power. da Vinci ® Si™ Appendix A: Error Handling A-5 DRAFT/PRE-RELEASE/CONFIDENTIAL 10/9/14 A.3 Conversion to Open Surgery If a situation arises where a conversion to open surgery is required, perform the following steps to remove the system from the patient: 1. Remove the instruments and endoscope fr om the patient. Note the following: Note: Whenever possible, use Surgeon Console c ontrol to release the instrument grips. a. In case of system failure while the instrument i s grasping tissue, the grips can be manually opened by following the grip release instructions, see Grip Release on page 9-13 (Chapter 9, Patient Cart Use). WAR NI NG : Do not p er form grip release on a non-faulted system without first pressing the Emergency Stop button. Failure to observe this warning may result in unintended instrument motion or damage to the grip release mechanism. WAR NI NG : Rotating the grip release tool too far and/or in the incorrect direction can cause unintended instrument motion or damage to the grip release mechanism. 2. Disconnect the cannulae from the instrument and camera arms. 3. Move the instrument and camera a r ms away from the patient. Note: If the system is in a fault state while converting to open surgery, the Patient Cart will still allow use of the port clutch buttons. If the system loses all power, the arms and setup joints may be overpowered to move the arms as necessary. _________________________________End of section______________________________ Appendix B: da Vinci Si-e Surgical System da Vinci ® Si™ B-1 DRAFT/PRE-RELEASE/CONFIDENTIAL10/9/14 BAppendix B: da Vinci Si-e Surgical System This appendix provides detailed information and specifications for the da Vinci Si-e Surgical System, an upgradable configuration of the da Vinci Si…

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da Vinci ® Si™ Index K-5 DRAFT/PRE-RELEASE/CONFIDENTIAL 10/9/14 Video Patch Panel H-2 Video Settings Tab 7-17 Video Source Tab 7-17 Video tab on touchpad 10-12 Viewer Mode 10-16 Vision Cart 2-4 Vision Cart Overview 2-11 Vision Cart Positioning 3-6 Vision Cart Wheel Locks 3-7 Vision System Overview 7-1 Vision System Use 7-1 Voltage 1-6 Volume Adjustment 7-19 W Warnings 1-9 Wheel Lock 3-7 White Balance 10-14 white balance 7-9 Working with EndoWrist Instruments 9-5 Working with the Endoscope at the Patient Side 9-14 Working with the Illuminator Controls 7-14 Working with the Touchscreen Vision Controls 7-15 Y Ye l l o w 7-18 yellow energy pedal 10-25, 10-32 Z Zoom 10-15

Taking surgery beyond the limits of the human hand. ™ Intuitive Surgical, Inc. Ph: 408.523.2100 1266 Kifer Road Fax: 408.523.1390 Sunnyvale, California 94086 www.intuitivesurgical.com April 20, 2015 Federal Communications Commission Equipment Authorization branch 7435 Oakland Mills Road Columbia, MD 21046 To whom it may concern: I, the undersigned, hereby authorize UL Verification Services Inc. to act on our behalf in all manners relating to application for equipment authorization, including signing of all documents relating to these matters. Any and all acts carried out by UL Verification Services Inc. on our behalf shall have the same effect as acts of our own. I, the undersigned, hereby certify that we are not subject to a denial of federal benefits, that includes FCC benefits, pursuant to Section 5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C. 853(a). In authorizing UL Verification Services Inc. as our representative, we still recognize that we are responsible to: a) comply with the relevant provisions of the certification program; b) make all necessary arrangements for the conduct of the evaluation, including provision for examining documentation and access to all areas, records (including internal audit reports) and personnel for the purposes of evaluation (e.g. testing, inspection, assessment, surveillance, reassessment) and resolution of complaints; c) make claims regarding certification only in respect of the scope for which certification has been granted; d) do not use our product certification in such a manner as to bring the Certification Division into disrepute and not make any statement regarding our product certification which the Certification Division may consider misleading or unauthorized; e) upon suspension or cancellation of certification, discontinue use of all advertising matter that contains any reference thereto and return any certification documents as required by the Certification Division;

(FOR REPRESENTATION ONLY) PLEASE PRINT FROM .AI FILE VER-REVZONEDESCRIPTION OF CHANGE (SEE ACCS FOR APPROVALS)DRFTDATE 01-AALLINITIAL RELEASEBJM4/17/15 D C B A B C D 123 45 6 7 8 8 7 6 5 4 3 2 1 E F E F INTUITIVE SURGICAL CONFIDENTIAL . THIS DOCUMENT CONTAINS CONFIDENTIAL AND PROPRIETARY INFORMATION. UNLESS GRANTED WRITTEN PERMISSION FROM INTUITIVE SURGICAL, SUCH INFORMATION SHALL NOT BE PUBLISHED OR DISCLOSED TO OTHERS OR USED FOR ANY PURPOSE OTHER THAN ON BEHALF OF INTUITIVE SURGICAL. 511037-01 SHEET: LABEL,FCC ID, CANADA 4/17/15 B. BLAIR M. Quillopo B. MAY REV: UNLESS OTHERWISE SPECIFIED: DRW SCALE:DRAWING NUMBER - VERSION:DRW SIZE:DATE: MFG ENGINEER: DESIGN ENGINEER: DRAWN BY: DRW UNITS: INCHES LINEAR: X.XX = 0.02 X.XXX = NOT USED . ANGLES: 0.5 Intuitive Surgical 1:1C A 1 OF 1 A DRAWING TITLE: NOTES: 1. MATERIAL: .010" FINE TEXTURED LEXAN (MAY ALSO BE CALLED VELVET/MATTE). 2. ADHESIVE: .005 THK. 3M #9672 PERMANENT ADHESIVE, 83# KRAFT PAPER LINER 3. USE AI FILE FOR ARTWORK. COLORS AND ARTWORK SHOWN HERE ARE FOR REPRESENTATION ONLY. 4. BACKGROUND ISI CARBON GRAY (MATCH PANTONE COOL GRAY 11 C, TEXT WHITE. 5. SUPPLIER TO APPLY UL RECOGNITION LABEL IDENTIFYING CONTENTS AS "SUBSURFACE POLYCARBONATE 2". 6. PACKAGE PARTS IN CLEAR PLASTIC BAGS. LABEL EACH BAG WITH INTUITIVE PART NUMBER, REVISION, QUANTITY, SUPPLIER LOT NUMBER, SHELF LIFE DURATION AND PURCHASE ORDER NUMBER. 7. IQC NOTE THAT TOLERANCES ARE INTENTIONALLY LOOSELY SPECIFIED  0.02. CORNER RADIUS IS NOT CRITICAL. CORNERS NEED ONLY BE ROUNDED. 2.0" .375" .125" R. (4X)

PROPOSED FCC and IC ID LABEL AND LOCATION Label: Label Location - Back of Camera Body: FCC /IC Label Location

FCC 47 CFR PART 15 SUBPART C INDUSTRY CANADA RSS-GEN ISSUE 4 CERTIFICATION TEST REPORT FOR RFID TRANSCEIVER 3D-HD CAMERA HEAD MODEL NUMBER: HD-3 REPORT NUMBER: 14U19050-E1, REVISION B FCC ID: 2AAZF-CHB01 IC: 11508A-CHB01 ISSUE DATE: MAY 02, 2015 Prepared for INTUITIVE SURGICAL INC. 1266 KIFER ROAD SUNNYVALE CA, 94086, U.S.A Prepared by UL VERIFICATION SERVICES INC. 47173 BENICIA STREET FREMONT, CA 94538, U.S.A. TEL: (510) 771-1000 FAX: (510) 661-0888 REPORT NO: 14U19050-E1B DATE: MAY 02, 2015 FCC ID: 2AAZF-CHB01 IC: 11508A-CHB01 Page 2 of 23 UL VERIFICATION SERVICES INC. FORM NO: CCSUP4701I 47173 BENICIA STREET, FREMONT, CA 94538, USA TEL: (510) 771-1000 FAX: (510) 661-0888 This report shall not be reproduced except in full, without the written approval of UL Verification Services Inc. Revision History Rev. Issue Date Revisions Revised By -- 02/24/2015 Initial Issue T. Chu A 04/22/2015 Add power table on Section 5.2 and 99% BW C. Pang B 05/2/2015 Address TCB’s Questions C. Pang REPORT NO: 14U19050-E1B DATE: MAY 02, 2015 FCC ID: 2AAZF-CHB01 IC: 11508A-CHB01 Page 3 of 23 UL VERIFICATION SERVICES INC. FORM NO: CCSUP4701I 47173 BENICIA STREET, FREMONT, CA 94538, USA TEL: (510) 771-1000 FAX: (510) 661-0888 This report shall not be reproduced except in full, without the written approval of UL Verification Services Inc. TABLE OF CONTENTS 1. ATTESTATION OF TEST RESULTS ................................................................................. 4 2. TEST METHODOLOGY ..................................................................................................... 5 3. FACILITIES AND ACCREDITATION ................................................................................. 5 4. CALIBRATION AND UNCERTAINTY ................................................................................ 5 4.1. MEASURING INSTRUMENT CALIBRATION .............................................................. 5 4.2. SAMPLE CALCULATION ............................................................................................ 5 4.3. MEASUREMENT UNCERTAINTY ............................................................................... 6 5. EQUIPMENT UNDER TEST ............................................................................................... 7 5.1. DESCRIPTION OF EUT .............................................................................................. 7 5.2. MAXIMUM OUTPUT POWER...................................................................................... 7 5.3. DESCRIPTION OF AVAILABLE ANTENNAS .............................................................. 7 5.4. SOFTWARE AND FIRMWARE .................................................................................... 7 5.5. WORST-CASE CONFIGURATION AND MODE .......................................................... 7 5.6. MODIFICATIONS ........................................................................................................ 7 5.7. DESCRIPTION OF TEST SETUP ................................................................................ 8 6. TEST AND MEASUREMENT EQUIPMENT ......................................................................10 7. OCCUPIED BANDWIDTH .................................................................................................11 8. RADIATED EMISSION TEST RESULTS...........................................................................13 8.1. LIMITS AND PROCEDURE ........................................................................................13 8.2. TX SPURIOUS EMISSIONS 0.15 TO 30 MHz ............................................................14 8.3. TX SPURIOUS EMISSION 30 TO 1000 MHz .............................................................16 9. AC MAINS LINE CONDUCTED EMISSIONS ....................................................................17 10. SETUP PHOTOS ...........................................................................................................21 REPORT NO: 14U19050-E1B DATE: MAY 02, 2015 FCC ID: 2AAZF-CHB01 IC: 11508A-CHB01 Page 4 of 23 UL VERIFICATION SERVICES INC. FORM NO: CCSUP4701I 47173 BENICIA STREET, FREMONT, CA 94538, USA TEL: (510) 771-1000 FAX: (510) 661-0888 This report shall not be reproduced except in full, without the written approval of UL Verification Services Inc. 1. ATTESTATION OF TEST RESULTS COMPANY NAME: INTUITIVE SURGICAL INC. 1266 KIFER ROAD SUNNYVALE CA, 94086, U.S.A EUT DESCRIPTION: RFID TRANSCEIVER 3D-HD CAMERA HEAD MODEL: HD-3 SERIAL NUMBER: SF0929009 DATE TESTED: JANUARY 12 TO JANUARY 27, 2015 APPLICABLE STANDARDS STANDARD TEST RESULTS FCC PART 15 SUBPART C Pass INDUSTRY CANADA RSS-GEN Issue 4 Pass UL Verification Services Inc. tested the above equipment in accordance with the requirements set forth in the above standards. All indications of Pass/Fail in this report are opinions expressed by UL Verification Services Inc. based on interpretations and/or observations of test results. Measurement Uncertainties were not taken into account and are published for informational purposes only. The test results show that the equipment tested is capable of demonstrating compliance with the requirements as documented in this report. Note: The results documented in this report apply only to the tested sample, under the conditions and modes of operation as described herein. This document may not be altered or revised in any way unless done so by UL Verification Services Inc. and all revisions are duly noted in the revisions section. Any alteration of this document not carried out by UL Verification Services Inc. will constitute fraud and shall nullify the document. This report must not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST, any agency of the Federal Government, or any agency of any government. Approved & Released For UL Verification Services Inc. By: Tested By: CHIN PANG TINA CHU SENIOR ENGINEER LAB TECHNICIAN UL VERIFICATION SERVICES INC. UL VERIFICATION SERVICES I…

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REPORT NO: 14U19050-E1B DATE: MAY 02, 2015 FCC ID: 2AAZF-CHB01 IC: 11508A-CHB01 Page 21 of 23 UL VERIFICATION SERVICES INC. FORM NO: CCSUP4701I 47173 BENICIA STREET, FREMONT, CA 94538, USA TEL: (510) 771-1000 FAX: (510) 661-0888 This report shall not be reproduced except in full, without the written approval of UL Verification Services Inc. 10. SETUP PHOTOS RADIATED EMISSION BELOW 30 MHz RADIATED EMISSIONS BELOW 30MHz (FRONT) RADIATED EMISSIONS BELOW 30MHz (BACK) REPORT NO: 14U19050-E1B DATE: MAY 02, 2015 FCC ID: 2AAZF-CHB01 IC: 11508A-CHB01 Page 22 of 23 UL VERIFICATION SERVICES INC. FORM NO: CCSUP4701I 47173 BENICIA STREET, FREMONT, CA 94538, USA TEL: (510) 771-1000 FAX: (510) 661-0888 This report shall not be reproduced except in full, without the written approval of UL Verification Services Inc. RADIATED EMISSION ABOVE 30 MHz RADIATED EMISSIONS ABOVE 30 MHz (FRONT) RADIATED EMISSIONS ABOVE 30 MHz (BACK) REPORT NO: 14U19050-E1B DATE: MAY 02, 2015 FCC ID: 2AAZF-CHB01 IC: 11508A-CHB01 Page 23 of 23 UL VERIFICATION SERVICES INC. FORM NO: CCSUP4701I 47173 BENICIA STREET, FREMONT, CA 94538, USA TEL: (510) 771-1000 FAX: (510) 661-0888 This report shall not be reproduced except in full, without the written approval of UL Verification Services Inc. AC MAINS LINE CONDUCTED EMISSION END OF REPORT LINE CONDUCTED EMISSION (FRONT) LINE CONDUCTED EMISSION (BACK)