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| United States Patent Application |
20060111632
|
| Kind Code
|
A1
|
|
Chen; Richard D.Y.
|
May 25, 2006
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Wireless breach detection
Abstract
Methods and systems for detecting wall breach in inflatable prostheses
rely on intrusion of a body fluid or inflation medium to electrically
alter a signaling circuit. In one embodiment, an open portion of a
circuit is closed to enable or modify a transmitted signal. In another
embodiment, electrical current is generated to power an electrical
transmission.
| Inventors: |
Chen; Richard D.Y.; (Napa, CA)
|
| Correspondence Address:
|
TOWNSEND AND TOWNSEND AND CREW, LLP
TWO EMBARCADERO CENTER
EIGHTH FLOOR
SAN FRANCISCO
CA
94111-3834
US
|
| Assignee: |
Fulfillium, Inc.
Napa
CA
|
| Serial No.:
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282224 |
| Series Code:
|
11
|
| Filed:
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November 18, 2005 |
| Current U.S. Class: |
600/431; 623/23.67 |
| Class at Publication: |
600/431; 623/023.67 |
| International Class: |
A61B 6/12 20060101 A61B006/12; A61F 2/04 20060101 A61F002/04 |
Claims
1. An improved implantable device having an exterior structure, wherein
the improvement comprises a system incorporated into said exterior
structure, which system emits a detectable wireless signal upon breach of
said exterior structure.
2. An improved implantable device as in claim 1, wherein the exterior
structure comprises a wall which at least partially surrounds a
compartment which is fillable with a fluid medium.
3. An improved device as in claim 2, wherein the exterior structure is
inflatable and the liquid medium is an inflation medium.
4. An improved device as in claim 3, wherein the exterior structure is
non-rigid.
5. An improved device as in claim 4, which comprises a breast implant, a
gastric balloon, or a penile implant, or a reservoir.
6. An improved implantable device as in claim 1, wherein the exterior
structure comprises a rigid housing.
7. An improved implantable device as in claim 6, wherein the device
comprises a pacemaker, a defibrillator, a neurostimulator, or an insulin
a biochemical delivery pump, or a reservoir.
8. An improved implantable device as in claim 1, wherein the exterior
structure comprises a covering formed over an electrically conductive
core.
9. An improved implantable device as in claim 8, wherein the device
comprises an electrical cable or an electrical connector.
10. An improved device as in claim 1, wherein the signal emission system
comprises a signaling circuit having one or more components which are
exposed to an exterior or interior environment upon breach of the
exterior structure, wherein exposure of the component energizes the
circuit, closes the circuit or opens the circuit to cause, alter,
disable, or enable signal emission.
11. An improved device as in claim 10, wherein the component generates
electrical current when exposed to body fluid and/or an interior medium
by a wall breach.
12. An improved device as in claim 10, wherein the component includes
spaced-apart conductors which are electrically coupled to close and/or
alter a capacitance or inductance of the signaling circuit when exposed
to a body fluid and/or the fillable medium by a wall breach.
13. An improved device as in claim 10, wherein the signaling circuit
comprises a transponder and an antenna, wherein the transponder is
powered by an external reader which is tuned to the antenna of the
transponder, wherein the transponder and antenna are inactive or
operational in a first mode until a wall breach closes the control or
signaling circuit, wherein closing of the control or signaling circuit
activates or alters the transponder emission.
14. A method for signaling breach of an external structure of an
implantable device, said method comprising emitting an externally
detectable wireless signal when the external structure has been at least
partially breached.
15. A method as in claim 14, wherein the exterior structure is inflatable
and the liquid medium is an inflation medium.
16. A method as in claim 15, wherein the exterior structure is non-rigid.
17. A method as in claim 16, a breast implant, a gastric balloon, or a
penile implant, or a reservoir.
18. A method as in claim 14, wherein the exterior structure comprises a
rigid housing.
19. A method as in claim 18, wherein the device comprises a pacemaker, a
defibrillator, a neurostimulator, a biochemical delivery an insulin pump,
or a reservoir.
20. A method as in claim 14, wherein the exterior structure comprises a
covering formed over an electrically conductive core.
21. A method as in claim 20, wherein the device comprises an electrical
cable or an electrical connector.
22. A method as in claim 14, wherein emitting comprises closing or opening
or signaling circuit when the exterior structure is at least partially
breached.
23. A method as in claim 22, wherein the signaling circuit is unpowered
and comprises an antenna and a transponder, further comprising directing
an interrogation signal to the antenna and detecting a return signal from
the transponder, wherein the returned signal is altered, present or
ceases only when the control or signaling circuit has been closed or
opened by a breach of the exterior structure.
24. A method as in claim 22, wherein the signaling circuit is powered and
emitting comprises exposing a component of a signaling circuit to an
internal or external environment when the exterior structure is at least
partially breached wherein the control or signaling circuit is closed and
transmits a signal.
25. A method as in claim 14, wherein emitting comprises exposing a
component of a signaling circuit to an internal or external environmental
when the exterior structure is at least partially breached, wherein the
control or signaling circuit generates energy and transmits a signal.
Description
CROSS-REFERENCES TO RELATED APPLICATIONS
[0001] The present application is a continuation-in-part of application
Ser. No. 11/170,274 (Attorney Docket No. 022209-000400US), filed on Jun.
28, 2005, which was a continuation-in-part of application Ser. No.
11/122,315 (Attorney Docket No. 022209-000230US), filed on May 3, 2005,
and claims the benefit under 35 USC .sctn. 119(e) of prior provisional
application No. 60/629,800 (Attorney Docket No. 02209-000210US), filed on
Nov. 19, 2004, the full disclosures of which are incorporated herein by
reference.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] The present invention relates generally to medical apparatus and
methods. More particularly, the present invention relates to implantable
devices and methods and systems for detecting their malfunction or
failure or impending malfunction or failure.
[0004] All implants of devices, especially those indicated for long term
use, in the human body are highly regulated and must meet certain safety
requirements. One such requirement is biocompatibility of the materials
used in the construction of the device in the event they come into direct
contact with body tissues and fluids. Even if the material is
biocompatible, the contact with body tissues and fluid could result in
diminished performance or malfunction esp. in devices with electronic
components. It is known that when a device is implanted in the body, the
materials forming the cover and structural elements of the device degrade
and fatigue over time. It is also well known that excessive handling
during implantation or even normal, repetitive movements could stress the
structural integrity of the device. Failure of the structural integrity
of the device or its covering, which eventually happens, causes the
contents of the device, which heretofore were confined in the interior of
the device, to be in contact with the surrounding tissues and their
secretions. Therefore, it would be desirable to detect or to predict such
an event before any potentially harmful contents come in contact with the
surrounding tissues, before tissue secretions leak into the interior of
the device resulting in malfunction, or before the content itself suffers
a malfunction.
[0005] Prosthetic devices implanted in numerous locations in the body are
prevalent in medical practice. Many of these prostheses are designed to
assume the structural shape of the body part yet are soft and have
similar flexibility to approximate the look and feel of normal human
tissue. A common use has been for reconstructing the normal contour,
improving the shape, and/or enlarging the size of the human breast. The
most common breast prosthesis is a soft elastomeric container made of
silicone rubber which is filled or "inflated" with a liquid or gel,
typically a saline solution or a silicone gel, or a combination of such
filling materials. Typically such prostheses are surgically implanted to
fit underneath the skin of the body either between the chest wall and the
mammary gland or in place of the mammary gland following a mastectomy.
The ideal result after implantation is to achieve the contours and tissue
characteristics of a natural breast, and prosthetic devices filled with
silicone gel have been found to produce the best cosmetic result. Hence,
silicone gel breast implants are the devices of choice in locations where
they are approved.
[0006] Degradation and fatigue of the silicone rubber container of such
breast implants, however, can lead to perforations, tears, ruptures, and
seam separations, resulting in the leakage of filling materials to the
surrounding tissues. Leakage from a saline filled device is usually
harmless as the solution, if uncontaminated, is absorbed. Leakage from
the preferred silicone gel filled device is much more problematic.
Bleeding of gel at the surface is believed to contribute to the
development of capsular contracture, a scarring condition that compresses
the implanted device from a soft, natural profile into a rigid, spherical
shape. More serious is the migration of leaked silicone gel to other
parts of the body such as the lymph nodes and major organs where it
becomes unremovable. Consequently, silicone gel has been implicated in
many health problems including connective tissue diseases. This risk
increases with the length of time the device is implanted.
[0007] The problem is exacerbated by the fact that leakage of silicone gel
is not easily detected and the rupture of the device cannot be predicted.
Unlike saline filled devices where rupture and leakage results in
deflation over a short period of time and readily discovered by the
patient, silicone gel tends to leak slowly and can go unnoticed for
years. Often the rupture is discovered only upon removal of the device
for another reason. The only noninvasive method currently sensitive
enough to detect such an event reliably is an MRI scan. To monitor the
integrity of a silicone gel device by regularly scheduled MRI scans is
cost prohibitive. Consequently, the use of silicone gel filled breast
prostheses is now highly restricted by regulatory authorities.
[0008] Gastric balloons are another type of implantable, inflatable
prosthesis which is subject to failure from breach of the wall. Gastric
balloons are typically introduced through the esophagus and inflated in
situ in order to occupy a significant volume within the stomach. While
gastric balloons are typically inflated with saline or other non-toxic
materials which are benign if released into the stomach, the balloon
structure itself is hazardous if accidentally deflated since it can pass
and cause obstruction of the pyloric valve or the intestines distal to
the pyloric valve. Any such obstruction is a medical emergency.
[0009] The problem is not limited to inflatable devices. Many implanted
devices, e.g., cardiac pacemakers, contain electronic circuits and have
insulated wires or leads that sense or deliver signals at certain points
in the body. For example, the covering or insulation could deteriorate
over time or tear in response to normal body movements. Body fluids from
the surrounding could then leak into the circuitry, either as a liquid or
vapor, causing disruption of signals. Or the lead could break at any
point or detach from the connector to the device. Another class of
implanted devices involves a closed vessel system conveying fluids
leading from a part of the device or a part of the body to another part
of the body, such as a shunt conveying blood or cerebrospinal fluid. The
catheter or reservoir in the system could tear or break leading to the
leakage of material out of the catheter to an unintended part of the body
or leakage of body fluids into the catheter causing contamination. Yet
another class of devices, which depend on solid objects for function or
structural support, could fail from fracture or dislocation. These
fractures can start as a hairline from repeated mechanical stress from
use and progress to a complete fracture. Dislocations start with a
loosening of the structure(s) holding an object in place and progress to
a complete dislocation.
[0010] For these reasons, it would be desirable to provide apparatus and
methods to detect or predict an actual or potential wall breach which can
lead to leakage of the filling contents of breast implants, gastric
balloons, catheters, reservoirs, and the like or an actual or potential
disruption of an electronic circuit in cardiac pacemakers or
neurostimulators or the like or an actual or potential stress fracture or
dislocation in the case of solid components in prosthetic devices or the
like. It would desirable further to monitor remotely the structural
integrity and presumed functional status of a device without activating
the function after device implantation in the case of cardiac
defibrillators or without directly applying stress to the monitored part
in the case of solid components. Prompt removal of such devices upon
breach or imminent breach would avert most, if not all, of the ensuing
problems including catastrophes. The methods and apparatus will
preferably be adaptable for use in any structural design of the device
without adversely affecting its structure or, in the case of breast
implants, the final cosmetic result, and further be applicable to solid
and rigid body implants containing electronic components such as
pacemaker and defibrillator canisters and leads and to solid body
implants such as prosthetic heart valves or orthopedic devices. It would
be further desirable if the breach or imminent breach of the device were
detectable to the patient in an easy, rapid, and reliable fashion outside
of a medical facility or at home. Additionally, it would be beneficial if
the system were able to monitor the device non-invasively on a frequent
basis over the life of the device without incurring significant
additional cost for each diagnostic event. At least some of these
objectives will be met by the inventions described hereinafter.
[0011] 2. Description of the Background Art
[0012] Leakage detection is described in U.S. Pat. No. 6,826,948 and
published applications US 2004/0122526 and US 2004/0122527. Breast
implants and methods for their use are described in U.S. Pat. Nos.
6,755,861; 5,383,929; 4,790,848; 4,773,909; 4,651,717; 4,472,226; and
3,934,274; and in U.S. Publ. Appln. 2003/163197. Gastric balloons and
methods for their use in treating obesity are described in U.S. Pat. Nos.
6,746,460; 6,736,793; 6,733,512; 6,656,194; 6,579,301; 6,454,785;
5,993,473; 5,259,399; 5,234,454; 5,084,061; 4,908,011; 4,899,747;
4,739,758; 4,723,893; 4,694,827; 4,648,383; 4,607,618; 4,501,264;
4,485,805; 4,416,267; 4,246,893; 4,133,315; 3,055,371; and 3,046,988 and
in the following publications: US 2005/0137636; US 2004/0215300; US
2004/0186503; US 2004/0186502; US 2004/0162593; US 2004/0106899; US
2004/0059289; US 2003/0171768; US 2002/0099430; US 2002/0055757; WO
03/095015; WO88/00027; WO87/00034; WO83/02888; EP 0103481; EP0246999;
GB2090747; and GB2139902.
BRIEF SUMMARY OF THE INVENTION
[0013] The present invention provides systems and methods for detecting
partial or complete breach in the exterior wall of an implantable device,
such as an inflatable, implantable prosthesis of the type where a wall at
least partially surrounds a fluid medium, liquid or air, in one or more
inflatable compartments. The walls of inflatable devices will usually be
non-rigid, either elastic or non-elastic. Other implantable devices
subject to exterior structure breach include metal and plastic (polymer)
devices which may comprise rigid-walled casings or housings, such as
pacemakers, implantable defibrillators, neurostimulators, insulin pumps,
reservoirs, devices having flexible housings such as elastomeric
reservoirs containing with naturally collected or pre-filled fluids or
insulation or other coverings formed over the electrically conductive
core of electrical leads, electrical connectors (e.g., plugs), and the
like. Implantable devices subject to stress fracture in solid functional
components include artificial joints, prosthetic heart valves, and the
like. These and other devices may contain potentially bioincompatible
materials, such as batteries, circuitry, synthetic chemicals, and the
like. While the implementation of these systems and methods will be
described in detail in connection with inflatable devices such as breast
implants and gastric balloons and with solid core devices such as
electrical leads, it will be appreciated that the principles may be
applied to other inflatable prostheses, such as penile implants, to
vessel systems containing or conveying fluids, to electronic and other
devices having solid internal structural or functional components. The
systems of the present invention are incorporated into at least a portion
of the wall of the wall or covering of the inflatable prosthesis or other
device or coupled to the electronic circuitry or embedded in the solid
component itself and provide for or enable the emission or transmission
of a detectable radio-frequency or other electronic signal upon breach or
partial breach of the wall or the structural integrity of the component.
As used hereinafter, the term "breach" will refer to any partial or full
penetration of the structure of the wall or covering as well as to other
mechanical disruption of a solid part of the device which could initiate
or lead to the contact of materials inside the wall or covering or the
solid component itself with tissues or body fluids outside the device.
Such breach signifies a compromise or a threatening compromise to the
integrity of the device.
[0014] The signal emission system of the present invention preferably
comprises a signaling circuit having one or more components which become
exposed to an exterior or interior environment surrounding or within the
prosthesis or other implantable device upon breach or partial breach of
the wall or covering, wherein such exposure enables, disables, energizes,
and/or changes a signal which is emitted by the system. In particular,
the breach may act like a switch to close or open a region within the
signaling circuit to cause, enable, disable, or alter the signal
emission. Alternatively, the exposure of the circuit and/or internal
structure to the interior or exterior environment may result in a change
in impedance, capacitance, inductance or other detectable circuit
characteristics that can trigger or modify the signal emitted.
[0015] In a first embodiment, the component of the signaling circuit will
generate electrical current when exposed to a body fluid and/or an
interior medium within the device upon breach or failure of the exterior
structure. Body fluids such as blood, cerebrospinal fluid, lymph fluid,
and the like, are naturally conductive, i.e., contain electrolytes. The
interior medium, such as an inflation medium, can be selected to be
electrically conductive, e.g., comprise or consist of saline or other
biologically compatible electrolytes and salt solutions. In such cases,
the generated electrical current can power an unpowered transmission
component to emit the signal. Alternatively, the power can alter a signal
which has already been continuously or periodically emitted by the
signaling circuit. In the latter case, the signaling circuit may require
a separate source of energy, such as a battery or circuit components
which are placed on the exterior or interior of the wall so that they are
always exposed to fluids to provide for current generation.
[0016] Alternatively, the circuit components may include spaced-apart
conductors which are electrically coupled to the signaling circuit to
"close" the signaling circuit to permit current flow when exposed to a
body fluid and/or device contents by a wall breach. Alternatively, the
circuit may be altered, enabled or otherwise modified by a sufficient
flow of electrolytes to enable, interpret, disrupt, or modify a signal
emission. The circuit components may include spaced apart conductors
which are coupled to the signaling circuit to detect a change in
resistance, capacitance, impedance, or voltage. Since the breach could be
small and intermittent as it starts, it can be difficult to detect as a
flow but the cumulative gain or loss of the electrolytes from the
contents or surrounding body fluids could cause a change in the
resistance, capacitance, or impedance across the conductors.
Alternatively, the detection circuit is closed and the contact of the
contents or the body fluids with the conductors could cause a break,
disruption, or change in the functioning of the circuit. In the exemplary
embodiments described below, the conductors may comprise meshes, films,
or other relatively large surface areas covering most or all of the wall
so that breach at any point in the wall will provide the intended
electrically conductive bridging between the conductors. The coupling of
the conductors may also cause, alter, or enable a signal emission to
alert the patient of the breach or potential breach. The spaced-apart
conductors can have any one of a variety of shapes or configurations,
continuous configurations, such as plates and films, or discontinuous
configurations, such as lattices, meshes, and the like, can be placed in
various locations, preferably near interior portions of the device where
body fluids will pool to enhance sensitivity and reliability of the
detection.
[0017] Alternatively, the detection and signaling circuit may comprise at
least two conductors coupled to a third conductor which is part of the
functional circuitry or is embedded in the solid component of the device
or is the solid component itself. In the event any of the conductors, and
the third, functional conductor in particular, is fractured, even
intermittently, a circuit is broken thereby causing a signal alteration
by the signaling circuit to alert the patient of the breach or potential
breach. The detecting conductors can have any one of a variety of shapes
or configurations, including continuous configurations, such as plates
and films, or discontinuous configurations, such as lattices, meshes,
braids, fabrics, and the like, and can be placed in various locations,
preferably spanning parts of the device where fractures are prone in
order to enhance sensitivity and reliability of the detection. More than
one of these couplings could be made in any configuration or location on
a device to determine the site of the breach.
[0018] The signaling circuit can be active or passive. In a preferred
embodiment, the signaling circuit will comprise a passive transponder and
antenna which are adapted to be powered and interrogated by an external
reader. Such transponder circuitry may conveniently be provided by using
common radiofrequency identification (RFID) circuitry where the
transponder and tuned antenna are disposed on or within a protected area
in the prosthesis and connected to remaining portions of the signaling
circuit. Passively powered circuitry is particularly preferred in devices
with on board batteries where the amount of energy stored in the battery
generally determines the functional product life. The antenna and
transponder could be located in close proximity to the detection
circuitry or placed elsewhere in the device or another part of the body.
For example, by connecting the transponder circuitry to "open" conductors
which is closed in the presence of body fluids and/or inflation medium,
the signal emitted by the transponder upon interrogation by an external
reader may be altered. Thus, the patient or medical professional may
interrogate the prosthesis and determine whether or not the prosthesis
remains intact or the threat of an impending breach exists. This is a
particularly preferred approach since it allows the user to determine
that the transponder circuitry is functional even when a breach has not
occurred.
[0019] The present invention further provides methods for signaling breach
of a wall or covering of an inflatable prosthesis, electronic prosthesis,
solid prosthesis, electrical cable, or the like. Usually, signaling
comprises generating an emission by closing a signaling circuit when the
wall or part of the device is at least partially breached. Usually a flow
of electrolytes occurs when the wall or part of the device is at least
partially breached, thereby closing the signaling circuit. To detect a
near complete or complete fracture in solid components, generating an
emission may comprise opening a signaling circuit when the wall,
covering, or other part is substantially breached or generating an
electrical current when the part is substantially breached. The
particular signaling circuits and transmission modes have been described
above in connection with the methods of the present invention.
[0020] The signaling system of the present invention can be designed to
function using any one of a variety of algorithms to notify the patient
in a simple, unequivocal fashion. For example, in a toggle algorithm, the
transmitter is either on in the static state or preferably off in order
to reduce the need for power. Upon direct contact between the conductors
and the body fluids and or device contents, the now closed circuit cause
the transmitter to turn the signal off or preferably on to be able to
send a wireless signal on a continuous basis. The wireless signal or lack
thereof depending on the algorithm is recognized by the detector to
notify the patient that the integrity of the device is compromised.
[0021] Alternatively, the algorithm could be based on time, amplitude,
frequency, or some other parameter. For example, the transmitter may send
a wireless signal at a predetermined time interval in its static state.
The detector recognizes the length of the interval as normal and the
existence of the signal as the system in working order. Upon direct
contact with the body fluids or device contents by the probes, the
transmitter is enabled to send the same signal at different time
intervals or a different signal, which is recognized by the detector to
notify the patient that the integrity of the device is compromised. The
lack of a signal is recognized by the detector to notify the patient of a
detection system malfunction and potential compromise of the integrity of
the device.
[0022] Optionally, more than one probe or more than one type of probe may
be placed internally in different parts or components in the device so
that the particular part or component which failed may be identified
based on which probe was activated. The transmitter would send different
signals for the receiver to display the source of the failure.
[0023] The internal probe could be of any shape and is disposed in the
interior or preferably in the wall or covering of the device. The
preferred configuration is a fine lattice or continuous film of the
detection material embedded in the wall or in between layers of the wall
covering the entire device, thereby conforming to the shape of the
device. Such a configuration optimizes the performance of the system in
detecting failures early. As the site of the tear or rupture cannot be
predicted, the probe would be unlikely to miss detecting the breach by
covering the entire device.
[0024] Compromise of the device typically starts with a somewhat linear
split or tear in surface of the device wall or covering from mechanical
fatigue or handling damage. As the split propagates, it will expose more
and more lines of the lattice or area of the film to the body fluids and
or device contents. Consequently, as the size and seriousness of the
breach increases, the probability of detection increases. Embedding the
detection material in the covering such as the wall of the balloon
further enables detection before a full breach of the entire thickness of
the device wall.
[0025] The detection material could be any metal, polymer, fiber,
ingredient, or combination thereof, with or without any coating that can
generate an electrical charge or enable flow of electric current when in
contact with the body fluids or device contents. For example, an
electrical charge could be generated from a non-toxic chemical reaction
when the lattice exposed underneath a tear comes in contact with the body
secretions. Flow of electric current could be enabled when two ends of an
electric circuit hitherto physically separated by electrically
non-conductive material in the covering or a structural element of the
device are in contact with electrolytes in the body secretions when the
electrically non-conductive material is compromised. For example, a
charged lattice is embedded in the wall separated by silicone rubber from
the ground probe on the external surface of the device. When the lattice
is exposed to the electrolytes in the body fluids in the event of a tear,
the circuit is closed. Alternatively, the lattice and ground could be
separate from each other but interlaced in the wall of the device.
Preferred materials include non-corrosive, biocompatible metals and
elastomers, inks, or the like which contain electrically conductive
particles.
[0026] The transmitter can be a simple wireless signal generator triggered
by an electric current or preferably a transponder using the
well-established RFID technology, i.e., produces a wireless signal when
triggered by an interrogating signal. The electric charge generated or
the electric current enabled by the probe in contact with the body fluids
or device contents changes the logic state thereby enabling the
transmitter to emit or causes it to emit a wireless signal. Typically,
the transponder is powered by the interrogating radio frequency signal so
that no power source of its own is required. Alternatively, the
transmitter could be powered by a micro battery or by the electrical
power generated by a chemical reaction. For protection from degradation
by an acidic and electrolyte solution and become potentially toxic, the
transmitter or transponder circuit is encased in a highly resistant
material, such as silicone rubber or stainless steel. The transmitter or
transponder circuit can be placed on the exterior, embedded in the wall,
or preferably in the interior of the device for shielding from chemical
degradation and mechanical stress. It can be placed in any orientation,
preferably in the plane where the antenna is most sensitive and the
transmitter is most effective in sending and receiving signals through
body tissue overlying the device.
[0027] The wireless signal from the transmitter is recognized by a
separate detector, typically external to the body. The detector could be
simply a receiver tuned to the transmitter's signal or, preferably, a
combination of both a transmitter of a signal to interrogate the
transponder and a receiver to distinguish the different signals from the
transponder. The detector is preferably powered by batteries and portable
enough to be worn on a wristband, necklace, or belt or can be placed
conveniently near a place where the patient spends most of his time. Upon
receiving a signal that a breach has occurred, the detector will alert
the patient to seek medical assistance or alert medical professionals
directly through other devices, such as Bluetooth linked to an autodial
telephone. The alarm could be auditory, such as beeping sounds, visual,
such as flashing LED's or a LCD display, sensory, such as vibrations, or
preferably a combination of any or all of the above.
[0028] Optionally, the detector could have different auditory, visual,
sensory, or different combinations to identify the source of the detected
breach, especially with more than one probe or more than one type of
probe. For example, LED's of different colors or different sounds could
be used. The alarm could further indicate the seriousness of the breach.
For example, when multiple probes detect a breach, the volume of the
alarm would increase to a higher level.
[0029] In the case of electronic implantable devices, such as pacemakers
and defibrillators, the devices will be subject to failure due to
intrusion of body fluids through breaches, particularly at the seams and
lead connections. Thus, the detector circuit components described above
could be located within the device canister near those seams and
connectors at risk of failure so that initial penetration of fluids could
be detected before sufficient amount of fluids, liquid or vapor, has
entered to cause failure of the device.
[0030] In the case of electrical leads used in electronic stimulation
devices, a breach in the insulation and a breach in the conductor can
both be detected. The embodiments described above are particularly
suitable for detecting a breach in the covering insulation from wear and
tear. Usually this breach will precede and can serve as a sentry for a
breach in the conductor. A breach in the conductor without a breach in
the insulation can be detected by a closed circuit formed by two
conducting probes, one coupled to the conductor near its proximal end and
the other at its distal end. Any fracture or disruption of the current
flow in the conductor, whether made of a metal, elastomer, or gel,
between the two points will result in "opening" the circuit. An opening
will change the logic state of the detection circuit and enable the
transmitter to emit or causes it to emit a wireless signal. The detection
and transmitting circuitry could be attached to any part of the lead or
is in its own separate housing connected to the lead by the conducting
probes. Thus, the detection and transmitting circuitry could be placed in
a preferred orientation where normal body movements would not cause any
sharp angles in the conductors and an area away from sites where wear and
tear are more prone.
[0031] In the case where electrical leads are coupled to another conductor
such as the connector outside the canister containing the functioning
hardware and software, the principles and methods can detect detachment
of the lead. In this embodiment, one probe is electrically coupled to the
male and another probe to the female side of the connection. When the
lead is detached from the connector, the circuit is thereby "opened" and
detected as a breach.
[0032] In the case of solid devices, such as artificial joints or heart
valves, the conductors are embedded in the device components prone to
failure. The detection and transmitting circuitry could also be embedded
in the device or placed in an area away from sites where wear and tear
are more prone or signal transmission could be adversely affected.
BRIEF DESCRIPTION OF THE DRAWINGS
[0033] FIG. 1 illustrates a gastric balloon having the wall breach
detections system of the present invention incorporated therein.
[0034] FIG. 2 illustrates a breast implant having the wall breach
detection system of the present invention incorporated therein.
[0035] FIG. 3 illustrates a multi-layer wall structure useful for the
prostheses of the present invention.
[0036] FIG. 4 illustrates a passive transponder system which may be
utilized in the wall breach detection systems of the present invention.
[0037] FIG. 5 illustrates a hand-held interrogation unit useful with the
systems of the present invention.
[0038] FIG. 6 illustrate leads and connectors used in electronic
stimulators having the covering breach detection system of the present
invention incorporated therein.
[0039] FIG. 7 illustrate solid device components having the wall breach
detection system of the present invention incorporated therein.
DETAILED DESCRIPTION OF THE INVENTION
[0040] Referring now to FIG. 1, the gastric balloon 100 includes two
electric probes. Probe 130 is on the external surface in contact with the
surrounding tissues, body fluids, and contents of the stomach. Probes 130
and 110 can have any of a variety of shapes or configurations, including
circular plates, lattices, films, and the like, cover all or a portion of
the balloon or other device. Probe 110, shown here in a lattice
configuration, provides the second probe incorporated in the wall of the
balloon. The probe material could be any metal, polymer, fiber, or
combination thereof, with or without any coating that can generate an
electrical charge or enable flow of electric current when in contact with
the stomach contents. The probes are connected electronically to the
wireless transmitter 140, but are separated from each other by at least
one layer of non-conductive material in the balloon wall. The transmitter
can be a simple wireless signal generator triggered by an electric
current or preferably is an unpowered transponder using well-established
RFID technology which produces a wireless signal in response to an
interrogating signal. In the intact state when the wall is not breached,
components 130, 110, and 140 comprise an open electrical circuit and the
transmitter is inactive, disabled, or enabled to transmit a base signal.
[0041] Referring now to FIG. 2, a breast implant 200 may be similarly
formed with a lattice 210 formed within the breast wall, an external
electrically conductive probe 230 formed on or over the exterior surface
of the implant, and a transmitter 240 connected to both the lattice and
exterior probe. In the case of breast implants filled with low
conductivity materials, such as silicone gel, it may be desirable to
provide conductive materials to enhance conductivity upon leakage.
[0042] As magnified in FIG. 3, the second internal probe comprises both a
fine lattice 110 and a thin film configuration 112 in the wall of the
balloon in between, at the minimum two layers, an outermost layer 102 and
innermost layer 104. The second internal probe can be also disposed in
any enclosed space in the device (not shown). In the configuration
described in FIG. 1, probes 130 and 110 and transponder 140 represent one
open circuit and probes 130 and 112 and transponder 140 represent a
second open circuit. Each open circuit is available to power or enable
the transmitter or may enable the transponder to alter a base signal.
[0043] After the balloon is deployed in the stomach, the external probe
130 is in contact with the surrounding tissue and body fluids and stomach
contents. Upon a breach in the integrity of the wall, such as a tear in
the outermost layer 102, the leakage of physiologic fluid or stomach
contents with electrolytes into the tear forms a salt bridge that closes
the circuit formed probes 130 and 112 and transponder 140. Once the
circuit is closed, a toggle is switched in the transponder, which will be
enabled to transmit a "layer 102 breach" signal. Tears through layer 106
in the balloon wall will allow leakage of physiologic fluid or stomach
contents with electrolytes into the tear forming a salt bridge that
closes the circuit formed probes 130 and 110 and transmitter 140. Closing
this circuit switches another toggle in the transponder, which will be
enabled to transmit a "layer 106 breach" signal.
[0044] The preferred radiofrequency identification circuit is shown
schematically in FIG. 4. The circuit comprises a transmitter component
300 which includes transponder circuitry 302, typically formed as an
integrated circuit, and a tuned antenna-capacitor circuit 304. An
interrogator reader 310 comprises circuitry 312 including the power
supply (typically a battery) demodulator circuitry, decoder circuitry,
and the like. An antenna 314 is tuned so that it can communicate
wirelessly with the antenna 304 of the transponder 300. Operation of this
circuitry is generally conventional and provides for energizing,
demodulating, and decoding signals between the external and implanted
components. The transponder circuitry, however, will be modified so that
the conductive elements implanted in the wall, such as film 320 and
lattice 330 may enable or alter the signal emitted by the transponder
when the conductive elements are bridged by body fluids or inflation
medium. In the preferred embodiments described above, electrical coupling
of the conductors 320 and 330 will alter the signal that is produced by
the transponder 302. In that way, the patient or other user will be able
to interrogate the transponder and receive a base or "normal" response
signal when no wall breach has occurred. In the event of a wall breach,
the signal emitted by the transponder will be altered so that the breach
will be made evident.
[0045] An exemplary reader module 120 is shown in FIG. 5 and includes LEDs
to indicate normal or "on" function, failure, and emergency failure. An
audible the alarm 126 could also be provided to alert with beeping
sounds, or sensory, such as vibrations, or preferably a combination of
any or all of the above. Optionally, the detector could have different
auditory, visual, sensory, or different combinations to identify the
source of the detected breach, especially with more than one chemical
substance used. The alarm could further indicate the seriousness of the
breach. For example, when breaches are detected, the volume of the alarm
would increase to a higher level.
[0046] Referring now to FIG. 6A, an electrical lead 600 with a functional
conductor 650 which is useful for cardiac or neuro stimulators may be
similarly formed with an electrically conductive lattice 610 embedded
within an insulating covering 605, an external electrically conductive
cable coil 630 attached to the exterior surface of the implant, and a
transmitter 640 connected to both the lattice 610 and external coil 630.
As shown in the cross section FIG. 6B, the lattice 610 is preferably
formed coaxial to the conductor 650 and separated from the conductor and
the surrounding environment by inner and outer annular portions of the
cover 605. The cross section of FIG. 6C shows conductive probes 610 and
620 in lattice form both embedded in the covering. The cross section of
FIG. 6D shows a plurality of conducting probes 610 and 620 which are
embedded coaxially in the insulating covering 605. In this embodiment, a
current flow enabled by electrolytes between external probe 630 and 610
or 620 or the functional conductor 650 could indicate the extent of the
breach. An alternative configuration is shown as lead 601 in FIG. 6E and
FIG. 6F with two functional conductors 650a and 650b connected at their
ends but electrically isolated from each other along their length so that
each can serve as a backup for the other. In this configuration, the
probes 610 and 620 do not have to be separated from but are in contact
with the functional conductors.
[0047] In the case of detecting a breach of the functional conductor, a
lead 602 is shown with two electrically conductive probes 660 and 670
coupled to two ends of the functional conductor 650, as shown in FIG. 6G.
[0048] In the case where the functional conductor 650 is connected to
another functional electrical conductor 680, as shown in FIG. 6H, a lead
603 is shown with a transmitter 640 with two probes, 660 and 670. Probe
660 is coupled to the functional conductor 650 and 670 to the other
functional conductor 680, in this embodiment an electrical connector. One
or both of the probes 660 and 670 are attached after the connection is
made. Both probes 660 and 670 can be embedded in the functional conductor
connection housing in either the male or female side, as shown in FIG.
61. In this embodiment of a female connector 604, functional conductor
650 passes through and is electrically coupled to functional conductor
680. In this embodiment as electrically isolated rings inside the female
connector 604, probe 670 is coupled to 680 and probes 660a and 660b
coupled to 650. Such a configuration would enable detection of a partial
detachment of the male member 649 when the circuit between 670 and 660b
is closed but that between 660a and 660b is open and a possible complete
lead detachment when all the detection circuits are open. The placement
and physical length of the probes 660a and 660b would determine the
amount of detachment necessary to open the circuit and enable the system
to signal a breach.
[0049] While the leads and connectors incorporating the detection system
are illustrated independently above, they may be configured independent
to each other in a device system or together in any combination using one
or more common detecting or signaling circuits.
[0050] Referring now to FIG. 7, two solid prosthetic device forms are
shown. Cylindrical shaped 701 and a flat triangular shaped 702 are shown
with a transmitter 740, an electrically conductive lattice 710, and an
external electrically conductive probe 730. 701a and 702a are cross
sections of each respectively. Any wear and tear or fracture deep to the
lattice 710 is detected as a breach. It can be appreciated that the
principle can be applied to a solid object of any shape. In the case of
an object holding other parts of the device in place or within a range of
motion (not shown), such as functioning like a ligamentous or
cartilagecartilaginous structure in the body, respectively, detecting a
breach of the object would indicate a potential dislocation of the other
parts.
[0051] While the above is a complete description of the preferred
embodiments of the invention, various alternatives, modifications, and
equivalents may be used. Therefore, the above description should not be
taken as limiting the scope of the invention which is defined by the
appended claims.
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