LF5-M333688D001RFID MODULE FOR USE WITH A RF GENERATOR FOR IDENTIFICATION OF COMPATIBILITY PURPOSES

Medtronic Confidential CS0049 RFID_User_Manual_FCV.fm 10/1/13 10:18 am 8.5 in x 11 in (215.9 mm x 279.4 mm) 10116967DOCRev. 1A RFID Module MODEL NUMBER: M333688D001 Medtronic Confidential CS0049 RFID_User_Manual_FCV.fm 10/1/13 10:18 am 8.5 in x 11 in (215.9 mm x 279.4 mm) 10116967DOCRev. 1A FEDERAL COMMUNICATIONS COMMISSION (FCC) COMPLIANCE: FCC ID: LF5-M333688D001 ■ This device complies with Part 15 of the FCC Rules. Operation is subject to the following two conditions: (1) this device may not cause harmful interference, and (2) this device must accept any interference received, including interference that may cause undesired operation. ■ The FCC regulates marketing, sale and importation of radio frequency (RF) devices. When importing an RF device the importer or ultimate consignee, or their designated broker, may be required to declare that the RF device meets the FCC importation conditions under Title 47 of the Code of Federal Regulation (CFR) Section 2.1204. See KDB 997198 Importation Guidelines for more details. ■ The host product manufacturer is responsible for ensuring that the final product with the module installed and fully operational complies with all applicable FCC equipment authorizations regulations, requirements and equipment functions. Refer to CFR Title 47 Part 2 Subpart J Equipment Authorization Procedures, and KDB 784748 D01 V07 Labeling Guidelines. ■ The antenna must not transmit simultaneously with any other antenna or transmitter, except in accordance with FCC multi transmitter product codes. ■ Separate approval is required for all other operating configurations, including portable configurations with respect to CFR Title 47 Part 2.1093 and different antenna configuration. ■ Any changes or modifications of this product, not approved by manufacturer will void the user's authority to operate the equipment. ■ The antenna must be installed such that it is a distance of at least 20 cm (7.9 in) between the antenna and users. ■ The module will only be installed in mobile applications as defined by part 2.1091(b). INDUSTRY CANADA COMPLIANCE: IC: 3408D-M333688D001 ■ This device complies with Industry Canada license-exempt RSS standard(s). Operation is subject to the following two conditions: (1) this device may not cause interference, and (2) this device must accept any interference, including interference that may cause undesired operation of the device. ■ Le présent appareil est conforme aux CNR d'Industrie Canada applicables aux appareils radio exempts de licence. L'exploitation est autorisée aux deux conditions suivantes : (1) l'appareil ne doit pas produire de brouillage, et (2) l'utilisateur de l'appareil doit accepter tout brouillage radioélectrique subi, même si le brouillage est susceptible d'en compromettre le fonctionnement. Medtronic Confidential CS0049 RFID_User_Manual_EN_CH.fm 10/1/13 10:18 am 8.5 in x 11 in (215.9 mm x 279.4 mm) 10116967DOCRev. 1A The following statements must be on the label or the manual of the host device: ■ “This equipment complies with FCC radiation exposure limits set forth for an uncontrolled environment. This equipment should be installed and operated with a distance of at least 20 cm between the radiator and your body. This transmitter must not be co-located or operating in conjunction with any other antenna or transmitter.” ■ “This device complies with Industry Canada license-exempt RSS standard(s). Operation is subject to the following two conditions: (1) this device may not cause interference, and (2) this device must accept any interference, including interference that may cause undesired operation of the device.” ■ “Le présent appareil est conforme aux CNR d'Industrie Canada applicables aux appareils radio exempts de licence. L'exploitation est autorisée aux deux conditions suivantes: (1) l'appareil ne doit pas produire de brouillage, et (2) l'utilisateur de l'appareil doit accepter tout brouillage radioélectrique subi, même si le brouillage est susceptible d'en compromettre le fonctionnement.” The following statements must be on the label of the host device: ■ “Contains FCC ID: LF5-M333688D001” ■ “Contains IC: 3408D-M333688D001” Medtronic Confidential CS0049 RFID_User_Manual_CST_bcv.fm 10/1/13 10:18 am 8.5 in x 11 in (215.9 mm x 279.4 mm) 10116967DOCRev. 1A *10116967DOC* © Medtronic, Inc. 2013 All Rights Reserved 10116967DOC Rev. 1A Manufacturer: Medtronic, Inc. 710 Medtronic Parkway Minneapolis, MN 55432 USA Tel. +1 763 514 4000 Fax +1 763 514 4879 www.medtronic.com

Label location FCC ID: LF5-M333688D001 IC ID: 3408D-M333688D001 Underside of unit shown. Pins Label Location

Prediction of MPE limit at a given distance Exposure limit according to FCC CFR 47part 1, §1.1307, §1.1310 Equation from Section 2of OET Bulletin 65, Edition 97-01 or Where: S = power density P = power input to the antenna G = power gain of the antenna in the direction of interest relative to an isotropic radiator EIRP = Equivalent (or effective) isotropically radiated power R = distance to the center of radiation of the antenna Max emission at 3m: 69.0 dBuV EIRP: 69.0 – 95.2 = -26.2 dBm = 0.0024 mW Time averaging: 100% Prediction distance: 10 cm Prediction frequency: 13.56 MHz MPE limit at prediction frequency: 0.97 mW/cm 2 Power density at prediction frequency: 0.000001909 mW/cm 2 PASS Margin of compliance: -57 dB This equates to: 0.00001909 W/m 2 = 0.0848 V/m 2 4R PG S   2 4R EIRP S  

LAB REGISTRATION #6844A-3 FCC REGISTRATION #377448 Testing Laboratory Certificate #2555.01 Page 1 of 32 Report issue date: 9/16/2013 GEMC File #:GEMC-FCC-21213R1 © Global EMC Inc. This test report shall not be reproduced except in full, without written approval of Global EMC Inc. This report is based on GEMC Template “FCC 15 247 Rev2.” Global EMC Inc. Labs EMC & RF Test Report As per RSS 210 Issue 8:2010 & FCC Part 15 Subpart C:2011 Unlicensed Intentional Radiators on the M333688D001 RFID Module Raymond Lee Au Project Engineer Global EMC Inc. 11 Gordon Collins Dr. Gormley, ON L0H 1G0, Canada Ph: (905) 883-8189 Testing produced for See Appendix A for full customer & EUT details. Client Medtronic Inc. Product M333688D001 Standard(s) RSS 210 Issue 8:2010 / FCC Part 15 Subpart C 15:2011 Page 2 of 32 Report issue date: 9/16/2013 GEMC File #: GEMC-FCC-21213R1 © Global EMC Inc. This test report shall not be reproduced except in full, without written approval of Global EMC Inc. Table of Contents Table of Contents ................................................................................................................... 2 Report Scope .......................................................................................................................... 3 Summary ................................................................................................................................ 4 Test Results Summary ....................................................................................................... 4 Test Notes .......................................................................................................................... 5 Applicable Standards, Specifications and Methods ........................................................... 6 Sample calculation(s) ......................................................................................................... 7 Document Revision Status ................................................................................................. 7 Definitions and Acronyms ..................................................................................................... 8 Testing Facility ...................................................................................................................... 9 Calibrations and Accreditations ......................................................................................... 9 Testing Environmental Conditions and Dates ................................................................. 10 Detailed Test Results Section .............................................................................................. 11 Radiated Emissions .......................................................................................................... 12 Power Line Conducted Emissions ................................................................................... 21 Appendix A – EUT Summary .............................................................................................. 31 Client Medtronic Inc. Product M333688D001 Standard(s) RSS 210 Issue 8:2010 / FCC Part 15 Subpart C 15:2011 Page 3 of 32 Report issue date: 9/16/2013 GEMC File #: GEMC-FCC-21213R1 © Global EMC Inc. This test report shall not be reproduced except in full, without written approval of Global EMC Inc. Report Scope This report addresses the EMC verification testing and test results of the M333688D001 RFID module from Medtronic Inc. This unit is herein referred to as EUT (Equipment Under Test). Testing is performed at Global EMC Labs. The EUT was tested for compliance against the following standards: RSS 210 Issue 8:2010 / FCC Part 15 Subpart C 15:2011 Test procedures, results, justifications, and engineering considerations, if any, follow later in this report. The results contained in this report relate only to the item(s) tested. This report does not imply product endorsement by A2LA or any other accreditation agency, any government, or Global EMC Inc. Opinions/interpretations expressed in this report, if any, are outside the scope of Global EMC Inc accreditation. Any opinions expressed do not necessarily reflect the opinions of Global EMC Inc, unless otherwise stated. Client Medtronic Inc. Product M333688D001 Standard(s) RSS 210 Issue 8:2010 / FCC Part 15 Subpart C 15:2011 Page 4 of 32 Report issue date: 9/16/2013 GEMC File #: GEMC-FCC-21213R1 © Global EMC Inc. This test report shall not be reproduced except in full, without written approval of Global EMC Inc. Summary The results contained in this report relate only to the item(s) tested. EUT FCC Certification #, FCC ID: LF5-M333688D001 EUT Industry Canada Certification #, IC: 3408D-M333688D001 EUT Passed all tests performed. Yes (see test results summary) Tests conducted by Raymond Lee Au Test Results Summary Standard/Method Description Class/Limit Result FCC 15.203 Antenna Requirement Unique Pass See Test Notes FCC 15.205 RSS 210 (Table 1) Restricted Bands for intentional operation QuasiPeak Average Pass FCC 15.207 Power line conducted emissions QuasiPeak Average Pass FCC 15.209 RSS-210 (Table 2) Spurious Radiated emissions QuasiPeak Average Pass Overall Result PASS Client Medtronic Inc. Product M333688D001 Standard(s) RSS 210 Issue 8:2010 / FCC Part 15 Subpart C 15:2011 Page 5 of 32 Report issue date: 9/16/2013 GEMC File #: GEMC-FCC-21213R1 © Global EMC Inc. This test report shall not be reproduced except in full, without written approval of Global EMC Inc. All tests were performed by Raymond Lee Au. If the product as tested or otherwise complies with the specification, the EUT is deemed to comply with the requirement and is deemed a ‘PASS’ grade. If not ‘FAIL’ grade will be issued. Note that ‘PASS’ / ‘FAIL’ grade is independent of any measurement uncertainties. A ‘PASS’ / ‘FAIL’ grade within measurement uncertainty is marked with a ‘*’. Test Notes This section contains notes regarding testing, procedures, justifications, deviations, or other general n…

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Radiated Emissions – 9 kHz – 30 MHz Radiated Emissions – 30 MHz – 1 GHz Conducted Emissions