Flexible wireless patch for physiological monitoring and methods of manufacturing the same

Abstract
Provided herein is an integrated wireless patch comprising a contact layer, an electronics layer, and a battery layer. The contact layer is a substrate having gel cutouts. The electronics layer can be folded into contact with the contact layer. The battery layer can be folded into contact with the electronic layer. Further provided herein is a method of manufacturing a wireless integrated patch comprising folding a substrate comprising at least one cutout, at least one contact disk in communication with a surface of a patient through the cutout, and battery terminals, wherein the at least one cutout, the at least on contact, and the battery terminals are adaptable to be located in different layers after the substrate is folded.
Description
BACKGROUND OF THE INVENTION

Monitoring physiological conditions of the human body is an important component of health care. Although the monitoring can be performed periodically by a health care professional, increasingly the task is being handled by electronics that connect the patient to a computerized system for data storage, presentation and retrieval. These electronic systems consist of sensors, signal conditioners, power sources and other components needed for the specific physiological conditions being monitored. Most sensors used in monitoring physically contact the body, requiring a method for connecting sensors to the rest of the electronic system. In the past, wires were the only option for this connection, but increasingly wireless methods are being employed. One such wireless design, [P1], describes a sensor patch that attaches to the patient during the monitoring period and sends physiological measurement data to the rest of the system over a radio link. This sensor patch includes interface electrodes, signal conditioning circuits, digitizing converters, a wireless data link (radio), support circuits and a power source (battery). Including all of these components in a patch that might be worn on the body for several days presents several design and manufacturing challenges. This patent describes a method for manufacturing such a patch.


SUMMARY OF THE INVENTION

Provided herein is an integrated wireless patch which comprises a contact layer comprising a substrate, an electronic layer folded into contact with the contact layer, and a battery layer folded into contact with the electronic layer. The battery layer comprises battery terminal tabs. Additionally, the battery layer can further comprise at least one antenna. The patch can be adaptable to be assembled by positioning the electronic layer between the contact layer and the battery layer. Furthermore, the patch can comprise an adhesive layer adaptable to be located between the contact layer and the electronic layer. In some embodiments, the patch can further comprise a battery. The contact layer can comprise at least one contact adaptable to be in communication with a surface of a patient. The contact layer can further comprise an adhesive surround positioned around the contact. Additionally, the patch can further comprise at least one antenna. The patch can also comprise at least one application-specific integrated circuit on the electronic layer.


Further provided herein is a method of manufacturing a wireless integrated patch comprising the steps of: folding a substrate comprising at least one cutout, at least one contact disk in communication with a surface of a patient through the cutout, and battery terminals, wherein the at least one cutout, the at least on contact, and the battery terminals are adaptable to be located in different layers after the substrate is folded. Additionally, the method can comprise the step of attaching a battery to the battery terminals. Cutouts can be created in the substrate prior to the folding step. Furthermore, the method can further comprise the step fabricating at least one contact on the substrate prior to the folding step. In some embodiments of the method, the method can further comprise the step of attaching an ASIC to the substrate and further comprising the step of connecting the at least one contact to the ASIC with a trace. An antenna can be connected to the ASIC as part of the method. Additionally, an adhesive spacer can be inserted he between two layers of the folded substrate. The adhesive spacer can be inserted in between the cutout layer and the contact layer. The method can further comprise the step of applying gel to the cutout area on the contact layer. Furthermore, an adhesive washer can be attached to the cutout on the contact layer. In some embodiments, the method further comprises the step of cutting spiral cuts, the spiral cuts adaptable to surround the cutout. The method provided herein can further comprise more than one cutout on the contact layer and more than one contact on the electronics layer corresponding to the cutouts on the contact layer. Further provided herein is a wireless integrated patch produced according to the above described method.


INCORPORATION BY REFERENCE

All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference in their entirety.





BRIEF DESCRIPTION OF THE DRAWINGS

The novel features of the invention are set forth with particularity in the appended claims. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments, in which the principles of the invention are utilized, and the accompanying drawings of which:



FIG. 1 illustrates an expanded view of one embodiment of an integrated patch;



FIGS. 2A-2E illustrate one method for fabricating an integrated patch;



FIGS. 3A-3C illustrate one method for assembling an integrated patch; and



FIG. 4 illustrates a schematic cross-sectional view of one electrode of an integrated patch.





DETAILED DESCRIPTION OF THE INVENTION

Provided herein is an integrated wireless patch which comprises a contact layer comprising a substrate, an electronic layer folded into contact with the contact layer, and a battery layer folded into contact with the electronic layer. The battery layer comprises battery terminal tabs. Additionally, the battery layer can further comprise at least one antenna. The patch can be adaptable to be assembled by positioning the electronic layer between the contact layer and the battery layer. Furthermore, the patch can comprise an adhesive layer adaptable to be located between the contact layer and the electronic layer. In some embodiments, the patch can further comprise a battery. The contact layer can comprise at least one contact adaptable to be in communication with a surface of a patient. The contact layer can further comprise an adhesive surround positioned around the contact. Additionally, the patch can further comprise at least one antenna. The patch can also comprise at least one application specific integrated circuit (ASIC) on the electronic layer.


I. Devices



FIG. 1 illustrates the components of a wireless patch. The wireless patch can use a multi-chip module or ASIC to integrate most of the needed functions into a single module. The ASIC can be a single chip device. In some embodiments, additional components can be added to the ASIC as needed. The FIG. 1 illustrates a substrate comprising a contact layer 1A, an electronics layer 1B, and a battery layer 1C. The contact layer 1A can come in contact with the surface of a patient. The contact layer can have gel cutouts 9. The gel cutouts 9 can be filled with a gel 11 that conducts an electrical signal from the surface of the patient. In some embodiments, the gel cutouts 9 can be surrounded by spiral cutouts 8. The spiral cutout 8 can provide flexibility between the contact layer and the skin of the patient and can serve to reduce strain between the contact layer and the skin surface. In some embodiments, the cutouts 9 of the contact layer 1A can have adhesive washers 10 that surround the cutouts 9. An electrode gel 11 can be used in conjunction with the adhesive washers 10 and the cutouts 9 to facilitate communication between the surface of the patient and the contacts 6 on the electronics layer 1B.


The electronics layer 1B comprises at least one contact pad 6. In some embodiments, multiple contact pads 6 can be fabricated on the electronics layer 1B, as shown in FIG. 1. The contact pads 6 can have conducting traces 7 that relay the signal sensed by the contact pads 6 to an application specific integrated circuit (ASIC) 3 located on the electronics layer 1B. The ASIC can be mounted directly on the substrate, with no additional support.


A battery can be used to power the patch. The battery can be in communication with the patch through the battery layer. In some embodiments, the battery layer 1C is a truncated circle, as shown in FIG. 1. In some embodiments, the battery layer can be substantially circular. The battery layer 1C, as shown in FIG. 1, can have battery terminals 5 that come in contact with a battery 2. The battery terminals can be spot welded or conductive glued to the battery layer. A cover or insulating film can be put over the top, with holes left for air access in the case of the battery is a zinc-air battery. The battery 2 powers the ASIC 3 through traces 7 between the battery terminals 5 and the ASIC 3. Additional support can be provided to the battery. The battery layer can further be adaptable to be used with a flat battery such as, for example purposes only, a watch battery, where the flat battery is mounted directly onto the battery layer.


In some embodiments, the battery layer 1C further comprises an antenna 4 that is in communication with the ASIC 3. Additionally, an input/output (I/O) used to communicate information from the patch to a user can be included on the battery layer. Input/outputs include, but are not limited to, light emitting diodes (LEDs), switches, or any other suitable indicator or actuator.


Additionally shown in FIG. 1 is an adhesive spacer 12. The adhesive spacer 12 can be located between the contact layer 1A and the electronics layer 1B, in order to prevent signal leakage between electrodes. The adhesive spacer can also be used to add a bit of thickness to keep the application specific integrated circuit projecting out too far from the electronics layer. A cutout 13 can be located on the adhesive spacer 12 to accommodate the ASIC 3 on the electronics layer 1B. Furthermore gel cutouts 14 of the adhesive spacer 12 can correspond to the gel cutouts 9 and contacts 6 of the contact layer 1A and the electronics layer 1B, respectively.


II. Methods of Manufacturing


Further provided herein is a method of manufacturing a wireless integrated patch comprising the steps of: folding a substrate comprising at least one cutout, at least one contact disk in communication with a surface of a patient through the cutout, and battery terminals, wherein the at least one cutout, the at least on contact, and the battery terminals are adaptable to be located in different layers after the substrate is folded. Additionally, the method can comprise the step of attaching a battery to the battery terminals. Cutouts can be created in the substrate prior to the folding step. Furthermore, the method can further comprise the step fabricating at least one contact on the substrate prior to the folding step. In some embodiments of the method, the method can further comprise the step of attaching an ASIC to the substrate and further comprising the step of connecting the at least one contact to the ASIC with a trace. An antenna can be connected to the ASIC as part of the method. Additionally, an adhesive spacer can be inserted he between two layers of the folded substrate. The adhesive spacer can be inserted in between the cutout layer and the contact layer. The method can further comprise the step of applying gel to the cutout area on the contact layer. Furthermore, an adhesive washer can be attached to the cutout on the contact layer. In some embodiments, the method further comprises the step of cutting spiral cuts, the spiral cuts adaptable to surround the cutout. The method provided herein can further comprise more than one cutout on the contact layer and more than one contact on the electronics layer corresponding to the cutouts on the contact layer. Further provided herein is a wireless integrated patch produced according to the above described method.


Provided herein is a method of manufacturing a wireless patch with integrated circuits and a battery. The patch can be manufactured using materials that are disposable or recyclable, while still meeting the technical requirements of the market for example purposes only, size, weight, battery life, functionality, comfort, among others. The process for manufacturing one embodiment of a wireless patch with integrated circuits is described below. While the steps of manufacturing such a wireless patch are outlined in one order, it should be noted that the steps for manufacturing the device can be done in any suitable order.



FIGS. 2A-2E illustrate one method for fabricating a wireless integrate patch. FIG. 2A illustrates a patch outline that has been cut from a piece of substrate material 1. In some embodiments, the substrate 1 is cut such that three separate sections are defined creating a first section 1A, a middle section 1B, and an end section 1C, as shown in FIG. 2A. The beginning section 1A corresponds to the contact layer, as described in FIG. 1. The middle section 1B and end section 1C correspond to the electronics layer and the battery layer, respectively. In some embodiments, the substrate is cut in one continuous strip. The substrate 1 can be cut so that the beginning section 1A and middle section 1B are cut in substantially the same shape, as seen in FIG. 2A. The end section 1C can be cut so that is only partially the size as the beginning and middle sections, as shown in FIG. 2A. Alternatively, the end section 1C can be cut so that the end section is the substantially the same shape as the beginning and middle sections.


After the substrate has been cut to the desired shape and/or size, at least one cutout 9 can be formed in the beginning part 1A of the substrate 1. The cutout 9 can provide access between a contact disk 6 and the patient's skin. In some embodiments, multiple cutouts 9 are provided are shown in FIG. 2B. Additionally, spiral slots 8 can be cut in the substrate 1 surrounding the cutout 9. The spiral slot 8 can help to alleviate tension between the substrate and the surface of the skin, wherein the tension is caused by slight changes in the surface characteristics of the skin. The spiral slot surrounding the cutout has been previously described in U.S. Ser. No. 60/982,233 filed Oct. 24, 2007, entitled Multi-Electrode Sensing Patch for Long-term Physiological Monitoring with Swappable Electronics, Radio and Battery (Beck).


After the cutouts 9 have been formed, at least one contact disk 9 can be fabricated on the surface of the middle section 1B of the substrate. The contact can be fabricated from metal, polymer, or composite or any suitable combination thereof. The contact can be fabricated by any suitable method including, but not limited to, microfabrication, printing, chemical deposition or other techniques. Multiple contacts can be fabricated on the substrate, as shown in FIG. 2C. Any suitable number of contacts can be fabricated on the substrate. Traces 7 from the contacts 6 can also be fabricated. In addition to the contacts, battery contact points can be fabricated on the end section of the substrate.


After the contacts and traces from the contact have been fabricated, an application specific integrated circuit 3 can be mounted on the substrate 1 as shown in FIG. 2D. Additionally, an antenna 4 can be mounted on the substrate 1. Before the device is folded into its final configuration a battery 2 can be attached to the substrate 1 at the battery terminals 5. The device can be folded after the battery has been attached. Alternatively, the device can be folded and then the battery attached.



FIGS. 3A-3C illustrate a wireless integrated patch being assembled. FIG. 3A illustrates a fabricated wireless integrated patch before being assembled. The patch can then be assembled by folding the patch using a z-fold as shown in FIG. 3B, wherein the contact layer 1A is in contact with the electronics layer 1B, and the electronics layer 1B is in contact with the battery layer 1C. An adhesive spacer 12 can be inserted in between the contact layer 1B and the electronics layer 1C. Once the device is folded as shown in FIG. 3C, the adhesive washers 10 and gel 11 can be applied to the contact layer 1A.


A schematic cross section of a portion of the patch is shown in FIG. 4, in particular the contact layer 1A and electronics layer 1B and related structures. As shown in FIG. 4, the contact layer 1A can be stacked on the electronics layer 1B with an adhesive spacer 12 located in between the contact layer 1A and the electronics layer 1B. The contact 6 on the electronics layer 1B is in communication with the surface of a patient through the gel cutout 9 on the contact layer 1A and electrode gel 11. In some embodiments, the contact layer 1A can be adhered to the skin of a patient using adhesive washers 10 surrounding the get cutout 9 of the contact layer 1A. Spiral cutouts 8 surrounding the gel cutout 9 can help alleviate any tension between the patch and the skin surface.


While preferred embodiments of the present invention have been shown and described herein, it will be obvious to those skilled in the art that such embodiments are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the invention. It should be understood that various alternatives to the embodiments of the invention described herein may be employed in practicing the invention. It is intended that the following claims define the scope of the invention and that methods and structures within the scope of these claims and their equivalents be covered thereby.

Claims
  • 1. An integrated wireless patch comprising different layers, the patch comprising: a contact layer comprising a substrate configured to come into contact with a surface of a user, wherein the contact layer comprises one or more cutouts configured to provide flexibility and reduce strain between the contact layer and the surface of the user;a battery layer disposed over the contact layer, wherein the battery layer comprises a battery;an electronic layer disposed above the contact layer and adjacent to the battery layer, wherein the electronic layer comprises at least one contact pad configured to sense an electrical signal from the surface of the user; andan adhesive spacer adaptable to be located adjacent to the contact layer and the electronic layer, wherein the adhesive spacer is configured to prevent signal leakage from the at least one contact pad.
  • 2. The patch of claim 1 wherein the battery layer comprises battery terminal tabs.
  • 3. The patch of claim 1 wherein the patch is adaptable to be assembled by positioning the electronic layer between the contact layer and the battery layer.
  • 4. The patch of claim 1 wherein the contact layer comprises an electrode gel configured to facilitate communication between the surface of the user and the at least one contact pad.
  • 5. The patch of claim 1 wherein the one or more cutouts are one or more spiral cutouts.
  • 6. The patch of claim 1 further comprising at least one antenna powered by the battery.
  • 7. The patch of claim 1 further comprising at least one application-specific integrated circuit on the electronic layer.
  • 8. The patch of claim 1 wherein the adhesive spacer is configured to add thickness to the patch, thereby protecting components on the electronics layer.
  • 9. The patch of claim 1 wherein the electronic layer comprises conducting traces that relay the signal from the user sensed by the contact pads to an application-specific integrated circuit on the electronic layer.
  • 10. The patch of claim 1 wherein each of the different layers are configured to be stacked above or below a different layer.
  • 11. The patch of claim 1 wherein each of the different layers comprise a similar shape or size.
  • 12. The patch of claim 1 wherein a center of each of the different layers substantially align.
  • 13. The patch of claim 1 wherein prevention of signal leakage improves a quality of the signal sensed from each of the contact pad.
  • 14. An integrated wireless patch comprising different layers, the patch comprising: a contact layer comprising a substrate, wherein the contact layer is configured to come into contact with a surface of a user, wherein the contact layer comprises one or more cutouts configured to provide flexibility and reduce strain between the contact layer and the surface of the user, and wherein the contact layer comprises an electrode gel configured to facilitate communication between the surface of the user and the at least one contact pad;a battery layer disposed over the contact layer, wherein the battery layer comprises a battery; andan electronic layer disposed above the contact layer and adjacent to the battery layer, wherein the electronic layer comprises at least one contact pad configured to sense an electrical signal from the surface of the user,wherein each of the different layers are configured to be stacked above or below a different layer.
  • 15. The patch of claim 14 wherein the battery layer comprises battery terminal tabs.
  • 16. The patch of claim 14 wherein the patch is adaptable to be assembled by positioning the electronic layer between the contact layer and the battery layer.
  • 17. The patch of claim 14 wherein the one or more cutouts are one or more spiral cutouts.
  • 18. The patch of claim 14 further comprising at least one antenna powered by the battery.
  • 19. The patch of claim 14 further comprising at least one application-specific integrated circuit on the electronic layer.
  • 20. The patch of claim 14 wherein the electronic layer comprises conducting traces that relay the signal from the user sensed by the contact pads to an application-specific integrated circuit on the electronic layer.
  • 21. The patch of claim 14 wherein each of the different layers comprise a similar shape or size.
  • 22. The patch of claim 14 wherein a center of each of the different layers are substantially aligned.
CROSS-REFERENCE

This application is a Continuation Application of U.S. application Ser. No. 14/091,252, filed on Nov. 26, 2013, which is a Continuation Application of U.S. application Ser. No. 12/739,561, filed on Nov. 3, 2010, now U.S. Pat. No. 8,628,020, which is a National Stage Entry of PCT/US08/80695, filed Oct. 22, 2008, which claims the benefit of U.S. Provisional Application Nos. 60/982,402, filed Oct. 24, 2007 and 60/982,233, filed Oct. 24, 2007, which applications are incorporated herein by reference in their entirety. This application is related to U.S. Provisional Application No. 60/943,539, filed Jun. 12, 2007; and to PCT/US08/64800, filed on May 23, 2008 which claimed priority to U.S. Provisional Application No. 60/940,072, filed on May 24, 2007, which applications are incorporated herein by reference in their entirety.

US Referenced Citations (75)
Number Name Date Kind
3786391 Mathauser Jan 1974 A
3808577 Mathauser Apr 1974 A
4067342 Burton Jan 1978 A
4082086 Page et al. Apr 1978 A
4084583 Hjort Apr 1978 A
4121573 Crovella et al. Oct 1978 A
4365634 Bare et al. Dec 1982 A
4398545 Wilson Aug 1983 A
4653503 Heath Mar 1987 A
5372125 Lyons Dec 1994 A
5483967 Ohtake Jan 1996 A
5578065 Hattori et al. Nov 1996 A
5634468 Platt et al. Jun 1997 A
5895369 Flower Apr 1999 A
5948006 Mann Sep 1999 A
6104306 Hogue et al. Aug 2000 A
6117077 Del Mar et al. Sep 2000 A
6168568 Gavriely Jan 2001 B1
6441747 Khair et al. Aug 2002 B1
6453186 Lovejoy et al. Sep 2002 B1
6456720 Brimhall et al. Sep 2002 B1
6814706 Barton Nov 2004 B2
6897788 Khair et al. May 2005 B2
6965794 Brody Nov 2005 B2
7156301 Bonalle et al. Jan 2007 B1
7257438 Kinast Aug 2007 B2
7400298 Fogg et al. Jul 2008 B2
7486977 Sweitzer Feb 2009 B2
7499739 Sweitzer Mar 2009 B2
7668580 Shin et al. Feb 2010 B2
7796042 Walther et al. Sep 2010 B2
7920096 Fogg et al. Apr 2011 B2
7969307 Peeters Jun 2011 B2
7970450 Kroecker et al. Jun 2011 B2
8150502 Kumar et al. Apr 2012 B2
8287386 Miller et al. Oct 2012 B2
8315687 Cross et al. Nov 2012 B2
8611980 Choe et al. Dec 2013 B2
8628020 Beck Jan 2014 B2
8688189 Shennib Apr 2014 B2
8718742 Beck et al. May 2014 B2
8926509 Magar et al. Jan 2015 B2
9019934 Yun et al. Apr 2015 B2
9265435 Beck Feb 2016 B2
20020037756 Jacobs Mar 2002 A1
20020045836 Alkawwas Apr 2002 A1
20030040305 Ng et al. Feb 2003 A1
20030069510 Semler Apr 2003 A1
20040131897 Jenson Jul 2004 A1
20060009691 Yeo et al. Jan 2006 A1
20060155183 Kroecker et al. Jul 2006 A1
20060264767 Shennib Nov 2006 A1
20070060832 Levin Mar 2007 A1
20070072443 Rohrbach et al. Mar 2007 A1
20070093705 Shin et al. Apr 2007 A1
20070179376 Gerder Aug 2007 A1
20070293781 Sims et al. Dec 2007 A1
20080055045 Swan et al. Mar 2008 A1
20080186241 Christensen Aug 2008 A1
20080309287 Reed Dec 2008 A1
20090036792 Deluca et al. Feb 2009 A1
20100049006 Magar et al. Feb 2010 A1
20100081913 Cross et al. Apr 2010 A1
20100317958 Beck et al. Dec 2010 A1
20100326703 Gilad et al. Dec 2010 A1
20110021937 Hugh et al. Jan 2011 A1
20110028822 Beck Feb 2011 A1
20110062241 Beck Mar 2011 A1
20110065476 Hsiao et al. Mar 2011 A1
20110299713 Moeller Dec 2011 A1
20120088999 Bishay et al. Apr 2012 A1
20140088398 Beck Mar 2014 A1
20150073231 Beck et al. Mar 2015 A1
20160015962 Shokoueinejad Maragheh Jan 2016 A1
20160029906 Tompkins et al. Feb 2016 A1
Foreign Referenced Citations (9)
Number Date Country
WO-0178594 Oct 2001 WO
WO-02089667 Nov 2002 WO
WO-03065926 Aug 2003 WO
WO-03065926 Jun 2004 WO
WO-2005094674 Oct 2005 WO
WO-2006061354 Jun 2006 WO
WO-2007060609 May 2007 WO
WO-2007060609 Oct 2007 WO
WO-2008006150 Jan 2008 WO
Non-Patent Literature Citations (21)
Entry
International search report and written opinion dated May 28, 2009 for PCT Application No. US08/80695.
International search report and written opinion dated Jul. 20, 2009 for PCT Application No. US08/80659.
International search report and written opinion dated Sep. 29, 2008 for PCT Application No. US08/64800.
Notice of allowance dated Feb. 4, 2013 for U.S. Appl. No. 12/739,561.
Notice of allowance dated Mar. 14, 2014 for U.S. Appl. No. 12/601,373.
Notice of allowance dated Sep. 12, 2013 for U.S. Appl. No. 12/739,561.
Notice of allowance dated Dec. 19, 2013 for U.S. Appl. No. 12/601,373.
Office action dated Jan. 22, 2015 for U.S. Appl. No. 14/091,252.
Office action dated Feb. 27, 2015 for U.S. Appl. No. 14/244,760.
Office action dated Apr. 15, 2013 for U.S. Appl. No. 12/601,373.
Office action dated Jun. 26, 2012 for U.S. Appl. No. 12/739,561.
Office action dated Jul. 30, 2013 for U.S. Appl. No. 12/739,553.
Office action dated Aug. 31, 2012 for U.S. Appl. No. 12/601,373.
Office action dated Oct. 29, 2013 for U.S. Appl. No. 12/601,373.
Office action dated Nov. 21, 2012 for U.S. Appl. No. 12/739,553.
Office action dated Dec. 29, 2014 for U.S. Appl. No. 12/739,553.
Notice of allowance dated Oct. 7, 2015 for U.S. Appl. No. 12/739,553.
Co-pending U.S. Appl. No. 14/814,436, filed Jul. 30, 2015.
Co-pending U.S. Appl. No. 14/997,401, filed Jan. 15, 2016.
International search report and written opinion dated Jan. 7, 2016 for PCT/US2015/042989.
Notice of allowance dated Nov. 3, 2015 for U.S. Appl. No. 12/739,553.
Related Publications (1)
Number Date Country
20150374294 A1 Dec 2015 US
Provisional Applications (2)
Number Date Country
60982233 Oct 2007 US
60982402 Oct 2007 US
Continuations (2)
Number Date Country
Parent 14091252 Nov 2013 US
Child 14805389 US
Parent 12739561 US
Child 14091252 US