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I see "wireless", but not "WiFi" or "802.11*" in the PDF.

For what it's worth, devices I work on have a few wireless interfaces while guaranteeing 20-year life time: one interface is long-range (on the order of 10km), two are short range (on the order of a few mm). There is no way we can get to 20-year life time with doing WiFi (maintaining current battery size/capacity) for long'ish range and maybe not even BT for shorter range.

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yes - but this means there is more than a simple OS operating in those devices.

and just like any other IoT, using generic chips and stacks is cheaper.

run QNX or Linux on it and walk away.

there are DYI insulin pump monitors out there already that use Linux on RaspberryPi - see here: https://openaps.org/

The microcontrollers on these devices don't have MMUs. There is typically not even a USB interface. The microcontroller is in deep sleep mode saving power 99.9% of the time. During that time only essential peripherals are powered on and no code is executing.

A RasPi has no chance of running for 20 years off a single A-size non-rechargeable non-serviceable battery.

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