Patent Publication Number: US-10780216-B2

Title: Implantable medical device for minimally-invasive insertion

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application is a continuation of U.S. application Ser. No. 14/192,605, filed Feb. 27, 2014, which claims priority to and the benefit of U.S. Application No. 61/770,486, filed Feb. 28, 2013, all of which are incorporated herein by reference. 
    
    
     FIELD 
     The present disclosure relates generally to multi-reservoir containment devices, including but not limited to medical devices, such as implantable medical devices, having containment reservoirs for confining substance or subcomponents for controlled release or exposure thereof. In aspects, the present disclosure relates to improved designs of such devices for minimally invasive implantation and operation. 
     BACKGROUND 
     Implantable medical devices based on microchips that include reservoir arrays containing biosensors or drugs, for example, are known in the art.  FIG. 1  shows a possible conventional approach for assembly of components in an implantable medical device  10 , which includes a microchip assembly  12 . The microchip assembly  12 , which is also referred to as a microchip element, includes microreservoirs, each of which may contain a drug for controlled delivery in vivo or a sensor for controlled exposure in vivo. The microchip assembly  12  is attached to a feedthrough  16  that is welded to the housing  14 . Such microchip assemblies or elements are described, for example, in U.S. Pat. No. 7,510,551 to Uhland et al. and U.S. Pat. No. 7,604,628 to Santini Jr. et al. The feedthrough  16  contains electrically conductive pins that are metallurgically brazed to metallized surfaces on and through an alumina disc. A typical pin count exceeds 100, and in more complex designs, can be over 400. The consequence of such designs is that each pin connection can be a leak point. 
     In addition, each feedthrough pin is electrically connected to an electronic component inside the housing. Some designs utilize a wire from the pin to the circuit, while the illustrated design attaches the feedthrough  16  directly to a conventional plastic circuit board  18 . These electrical connections require testing to ensure continuity. As a result, the pin count impacts the cost of the feedthrough, and that cost increases as the number of feedthrough pins increases in the implantable device. Consequently, due to this complex design requirement, the resulting manufacturing, and the required acceptance tests, the feedthrough is an expensive component. 
     Moreover, conventional implantable device designs based on a feedthrough or header attached to housing components disadvantageously have an overall volume of the resulting device that is larger than desired, because several discrete components make up the assembly. 
     The devices shown in  FIG. 1  contains control electronics, a power source, and wireless communication capabilities. The benefit of these internal functions is that the device can be programmed to automatically release discrete doses at specific time points, and the dosing schedule can be updated or modified wirelessly at any time. The patient therefore can automatically receive his or her medication without having to take any action. A disadvantage to this automatic drug delivery implant is that all of these functions require a finite volume. There is a clear desire, however, to reduce the volume of the device in order to i) reduce the incision required to implant the device under the skin, ii) increase the possible locations in the body that the device can be implanted, and iii) make the device less intrusive for the patient. In particular, it would be desirable to provide a smaller overall device volume without sacrificing functionality, simplicity, and/or hermeticity. 
     SUMMARY 
     Some or all of the above needs and/or problems may be addressed by certain embodiments of the disclosure. In one embodiment, a containment device is provided that includes an elongated microchip element comprising one or more containment reservoirs that are configured to be electrically activated to open. The containment device may also include an elongated electronic printed circuit board (PCB) comprising a biocompatible substrate. The elongated PCB also may include a first side on which one or more electronic components are fixed and an opposed second side on which the elongated microchip element is fixed in electrical connection to the one or more electronic components. Further, the containment device may include an elongated housing fixed to the elongated PCB. The elongated housing is configured to hermetically seal the one or more electronic components of the elongated PCB within the elongated housing. 
     Other embodiments, aspects, and features of the invention will become apparent to those skilled in the art from the following detailed description, the accompanying drawings, and the appended claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Reference will now be made to the accompanying drawings, which are not necessarily drawn to scale. 
         FIG. 1  schematically depicts an exploded perspective view of a prior art containment device including a microchip assembly. 
         FIG. 2A  schematically depicts a cross-sectional view of an assembled containment device including a microchip assembly according to an embodiment. 
         FIG. 2B  schematically depicts an exploded cross-sectional view of the containment device shown in  FIG. 2A . 
         FIG. 2C  schematically depicts a top view of the containment device shown in  FIGS. 2A and 2B . 
         FIG. 3  schematically depicts a perspective view of the containment device illustrated in  FIGS. 2A-2C . 
         FIG. 4  schematically depicts a close-up, cross-sectional view of a portion of a containment device according to an embodiment. 
         FIG. 5A  schematically depicts a cross-sectional view of a microchip element assembly according to an embodiment. 
         FIG. 5B  schematically depicts an exploded cross-sectional view of the microchip element assembly shown in  FIG. 5A . 
         FIG. 6  schematically depicts a cross-sectional close-up view of a portion of an assembled containment device including a microchip assembly according to an embodiment. 
         FIG. 7  schematically depicts a cross-sectional close-up view of a portion of an assembled containment device including a microchip assembly according to an embodiment. 
         FIG. 8  schematically depicts a cross-sectional close-up view of a portion of an assembled containment device including a microchip assembly according to an embodiment. 
         FIG. 9  schematically depicts an external communicator that may be configured to wirelessly communicate with a containment device according to an embodiment. 
         FIG. 10  schematically depicts an external communicator positioned adjacent to an implanted containment device according to an embodiment. 
     
    
    
     DETAILED DESCRIPTION 
     Illustrative embodiments will now be described more fully hereinafter with reference to the accompanying drawings, in which some, but not all embodiments are shown. The representative embodiments described in the disclosure may be embodied in many different forms and should not be construed as limited to the embodiments set forth herein. Like numbers refer to like elements throughout. 
     The containment devices and assemblies described herein provide, among other advantages, significantly improved space efficiency of the assembled devices. In certain embodiments, the devices and methods advantageously eliminate the need for a costly and complex feedthrough, provide a thinner, sleek implant due to the elimination of the feedthrough, provide improved reliability by eliminating numerous feedthrough pins and electrical connections, provide improved reliability by reducing the number of hermetic interfaces, simplify tests to confirm functionality, and provide a simpler assembly. This can be particularly important in embodiments in which the containment device is an implantable medical device intended for long-term implantation in a human or animal subject via minimally-invasive insertion means, such as through a small incision, trocar, cannula, injector, or similar like medical instrument. 
     The present invention advantageously provides a drug delivery implant with a higher ratio of drug volume to total device volume than previously available for an actively controlled implant device. For example, a theoretical, perfect drug delivery device, with zero device volume could have a ratio of 1000 μL/cc. In practice, conventional drug delivery devices may range from less than 1 μL/cc to about 65 μL/cc. Advantageously, by providing the containment devices described herein and relocating power source and control functions to an external communicator as described herein, a drug delivery implant having a ratio of drug volume to total device volume from about 80 μL/cc to about 120 μL/cc, or higher, is readily achievable. In one embodiment, the implantable drug delivery device has a body housing a drug payload for actively controlled release, which device has a ratio of volume of the drug payload to total volume of the device from about 75 μL/cc to about 150 μL/cc. In one case, for example, the ratio is from about 85 μL/cc to about 120 μL/cc. In one embodiment, the body of the implantable drug delivery device includes a microchip element that has one or more containment reservoirs that are configured to be electrically activated to open; a PCB fixed to the microchip element; and a first inductive coupled device associated with the microchip element or the PCB, wherein the first inductive coupling device is in communication with the one or more electronic components. Nevertheless, essentially any ratio of drug volume to total device volume may be used with the devices and systems described herein. 
     The containment devices provided herein may be further understood with reference to the following exemplary embodiments, including the containment device  110  illustrated in  FIGS. 2A-3 . The containment device  110  includes an elongated microchip element  112  which comprises one or more containment reservoirs  114  that can be electrically activated to open. The containment device  110  also includes an elongated electronic printed circuit board (PCB)  116 . The elongated PCB  116  comprises a biocompatible substrate and has a first side  118  on which one or more electronic components  120  are fixed and an opposed second side  122  on which the microchip element  112  is fixed in electrical connection to the one or more electronic components  120 . As will be explained below with reference to  FIG. 4 , the electronic components  120  on the first side  118  of the PCB  116  are in electrical (i.e., operable) communication with the microchip element  112 . 
     It is understood that the containment device  110  may include any suitable number of microchip elements  112  (e.g., from 1 to 6) and that each microchip element  112  may include a plurality of discrete containment reservoirs  114  (e.g., from 10 to 750 reservoirs). More microchip elements  112 , and fewer or more containment reservoirs  114 , per containment device  110  are also envisioned. Moreover, it is understood that the containment device  110  may include any suitable number of PCBs  116 . 
     As shown in  FIGS. 2A-2C , embodiments particularly suitable for minimally invasive insertion into a patient may have long, narrow microchip elements  112  with elongated arrays of closely spaced containment reservoirs.  FIG. 2C  shows a 2×28 reservoirs array. In one embodiment, the elongated array has from 1 to 4 rows of 20 to 40 reservoirs. In other embodiments, other numbers of rows and reservoirs are envisioned. 
     The “electronic printed circuit board” (PCB) refers to a substrate that mechanically supports and electrically connects electronic components using conductive pathways, tracks, or signal traces as known in the art. In certain embodiments, the PCB includes a biocompatible and hermetic substrate material. Suitable such materials include ceramics, such as alumina and silicon nitride. Multi-layer alumina PCBs have been successfully designed and manufactured. See, for example, U.S. Patent Application Publication No. 2003/0034564. These laminations may be the result of combining conductive layers, dielectric layers, and aluminum oxide (Al 2 O 3 , alumina) in a low temperature co-fired process. The alumina is referred to as low temperature co-fired ceramic (LTCC). These biocompatible ceramics also function as a hermetic barrier, eliminating the need, in some instances, for conventional metallic housing elements. Other materials or combinations of materials capable of performing all or some of the described function may also be used. 
     The term “biocompatible” as used herein generally refers to materials of construction that are suitable for long-term or short-term implantation into a human or animal subject, e.g., a patient. Such materials of constructions are known in the art of implantable medical devices. 
     As used herein, the term “hermetic seal” refers to preventing undesirable ingress or egress of chemicals (e.g., water vapor, water, oxygen, etc.) into or from one or more compartments of the device, such as the device reservoirs our housings, over the useful life of the device. For purposes herein, a material/seal that transmits helium (He) at a rate less than 1×10 −9  atm*cc/sec is termed hermetic. 
     In some instances, the containment device  110  may include an elongated housing  124 . The elongated housing  124  is configured to hermetically seal the one or more electronic components  120  of the elongated PCB  116  within the elongated housing  124 . That is, the elongated housing  124  is configured to surround the first side  118  of the elongated PCB  116 . In this manner, the elongated housing  124  and the elongated PCB  116  collectively form a hermetic enclosure around the one or more electronic components  120 . Desirably, the elongated housing  124  and at least a portion of the outward facing second side  122  of the elongated PCB  114  are formed of a biocompatible material. For example, in some instances, the elongated housing  124  may be made of a biocompatible metal or alloy, such as titanium or stainless steel. In other instances, the elongated housing  124  may be made of a biocompatible polymer. In certain embodiments, at least a portion of the elongated housing  124  may comprise a generally cylindrical body. Moreover, a distal end  136  of the elongated housing  124  may be rounded. 
     The elongated housing  124  may comprises a battery chamber  126  configured to house one or more batteries  128  therein. In some instances, the battery chamber  126  may be a separate area within the elongated housing  124 . In other instances, the battery chamber  126  may be part of a single enclosure formed by the elongated housing  124 . In one embodiment, the battery chamber  126  may be positioned about a proximal end  130  of the elongated housing  124 . However, the battery chamber  126  may be located at any position within the elongated housing  124 . Moreover, in some instances, the battery chamber  126  may be omitted. For example, the device power may be provided by inductive charging. 
     In certain embodiments, the battery chamber  126  may include a cover  132 . The cover  132  may be removable or permanent. The cover  132  may be configured to provide access to the batteries  128  and/or hermetically seal the one or more batteries  128  within the battery chamber  126 . That is, in a preferred embodiment, the cover  132  and the elongated housing  124  form a hermetic seal when affixed to each other. In one example, the cover  132  may be located about the proximal end  130  of the elongated housing  124 . 
     The interface of the elongated housing  124  with the elongated PCB  116 , in a preferred embodiment, forms a hermetic seal to isolate the one or more electronic components  120  within the elongated housing  124 . In some instances, the elongated housing  124  may be welded to the elongated PCB  116 . In other instances, a biocompatible substance  134 , such as a biocompatible epoxy coating (e.g., an epoxy resin) or other biocompatible coating material, may be disposed over at least a portion of the elongated microchip element  112 , the elongated PCB  116 , and the elongated housing  124 . This coating may be multilayered, and it may include a hermetic material so long the material does not interfere with the operation of any of the components, such as the electronic components  120  or the batteries  128 . 
     In certain embodiments, the containment device  110  may include a sleek, tubular profile. For example, some or all of the components associated with the containment device  110  may be elongated. That is, some or all of the components of the containment device  110 , such as the elongated microchip element  112 , the elongated PCB  116 , and the elongated housing  124 , may have a greater length than width. Furthermore, the biocompatible coating substance  134 , the elongated microchip element  112 , and the elongated housing  124  may collectively form a generally circular cross-section and rounded distal end  136  of the containment device  110 . The components may collectively fit together to form a sleek, tube-like structure or assembly that may be inserted in a human or animal subject in a minimally invasive manner. In other instances, some or all of the components associated with the containment device  110  may not be elongated. 
     The biocompatible coating substance  134  may create an atraumatic surface about the containment device  110 . In embodiments, the surface of the containment device is formed of or coated with a lubricious substance to facilitate passage of the device to the intended tissue site. 
     The containment device  110  may be implanted in a human or animal subject, such as a patient in need of treatment, diagnosis, or prophylaxis, by a variety of techniques known in the art. In a preferred embodiment, the device is inserted into the patient at a subcutaneous tissue site. A variety of insertion tools and systems may be used depending on the particular size of the implant and the particular site of implantation desired for a particular medical purpose. The containment device  110  may be inserted, injected, or otherwise placed into the human or animal subject via one or a combination of minimally invasive medical instruments, including a cannula, trocar, subcutaneous insert, or a gun-like injector device or assembly. In one embodiment, a small (few millimeter) incision is made in the patient&#39;s skin, and the containment device is passed through the incision and into the patient just under the skin using a long, narrow inserter tool that can grasp an end of the containment device in a linear low profile arrangement. The containment device would be released from the inserter tool, the end of the inserter tool would be removed from the incision, and then the incision would be closed, for example with one or a few stitches. In some instances, one or more suture loops may be provided with the housing  124  and/or the cap  132 . The suture loops may be configured to anchor the containment device  110  in a subcutaneous space. 
     The electronic components  120  provide any of a number of functions for the containment device  110 . Examples include, but are not limited to, a controller (e.g., microprocessor) and power source (e.g., a battery or capacitor) for electrically activating the reservoir  114  to cause it to become opened and/to communicate with a sensor, for example, located within the reservoir  114  or with another device remotely located from the containment device  110 . Other electronic components may include, for example, telemetry hardware, capacitors, transistors, and diodes, as well as the control means for actuating the reservoir caps. The control means may include an input source, a microprocessor, a timer, a demultiplexer (or multiplexer). In an embodiment, the electronic components include components for wirelessly receiving energy for charging an on-board storage capacitor, which may further reduce the space requirements for the electronic components on-board the containment device. In some instances, the electronic components may include an antenna. 
     The containment reservoir  114  of the microchip element  112  may be configured to open/activate in a variety of ways, which may be known in the art. In one embodiment, the containment reservoir  114  is structured and configured to be electrically activated to open as described in U.S. Pat. Nos. 7,510,551 and 7,604,628, which are incorporated herein by reference. 
     One embodiment of the electrical connection between a PCB/electronic components and a microchip element is illustrated in  FIG. 4 . The figure shows part of the microchip element  312  including two containment reservoirs  344 . Each containment reservoir  344  has an opening closed off by a reservoir cap  348 . The containment reservoir  344 , which is formed at least in part in a substrate  343 , has a closed end opposed to the opening and a sidewall therebetween. The microchip element  312  is secured to a side of a PCB  314 , and electronic component  318  is secured on the opposed side of the PCB  314 . The PCB  314  includes a via  330  which electrically connects electronic component  318  to the microchip element  312 . Via  330  is mechanically and electrically connected to metallized conductive surfaces  332 A,  332 B on the PCB  314 , and the microchip element  312  is wirebonded  334  to the metallized conductive surface  332 A. A biocompatible coating substance  336  is applied over the wire bond to secure and protect the connection, and typically will coat part of the surface of the PCB  314 , part of the microchip element  312 , and part of the housing  320  but not the reservoir caps  348 . The coating substance  336  may be a polymer, such as an epoxy or other resin. 
     In one embodiment, the reservoir caps  348  are structured and configured to be electrically activated to open as described in U.S. Pat. Nos. 7,510,551 and 7,604,628, which are incorporated herein by reference. The reservoir caps  348  may be formed of a metal film, which may comprise a single layer or a laminate structure. For example, the reservoir cap  348  may comprise gold, platinum, titanium, or a combination thereof. In other embodiments, the reservoir cap  348  can be configured to be activated or opened by a mechanical or electrochemical mechanism. 
     The containment reservoir of the microchip element may be a “microreservoir” which generally refers to a reservoir having a volume equal to or less than 500 μL (e.g., less than 250 μL, less than 100 μL, less than 50 μL, less than 25 μL, less than 10 μL, etc.). In another embodiment, the containment reservoirs may be a “macroreservoir” which generally refers to a reservoir having a volume greater than 500 μL (e.g., greater than 600 μL, greater than 750 μL, greater than 900 μL, greater than 1 mL, etc.) and less than 5 mL (e.g., less than 4 mL, less than 3 mL, less than 2 mL, less than 1 mL, etc.). The terms “reservoir” and “containment reservoir” are intended to encompass both microreservoirs and macroreservoirs unless explicitly indicated to be limited to either one or the other. 
     In a second aspect, improved microchip elements and methods for their manufacture are provided. In a preferred embodiment, the microchip device element includes a relatively thin silicon substrate bonded to a relatively thicker primary substrate formed of a polymer or a glass or other ceramic material. Advantageously, by defining the reservoirs in the primary substrate rather than the silicon substrate, the reservoirs may be formed using processes other than dry reactive ion etching (DRIE). This is important, not just because DRIE processes are expensive, but also because under the conventional process, the DRIE processes occurred after deposition of the reservoir cap film, unnecessarily exposing the reservoir cap film to subsequent processing, which can negatively impact the yield of acceptable (e.g., hermetic) reservoir caps. 
     In addition, by adding the positive sealing features (e.g., gold sealing rings) to the silicon substrate, this keeps all of the high tolerance microfeatures to only the silicon substrate, which in turn frees up the primary substrate to be made by other, potentially lower tolerance, manufacturing processes. In this way, the reservoir can be made much deeper and thereby increase the unit reservoir payload. In one embodiment, the primary substrate is made by a casting or molding process using ceramic or polymeric materials that allows for formation of reservoirs that are deeper than conventional reservoirs and have smoother side walls than would be readily possible using DRIE. This cast or molded substrate then may be gold plated in and about sealing grooves formed therein for bonding with the positive sealing features on the silicon substrate. 
     An exemplary embodiment of the elongated microchip element is illustrated in  FIG. 5A  and  FIG. 5B . The elongated microchip element  412  includes a primary substrate  440  and a silicon substrate  442 , which are bonded together. The silicon substrate  442  has a first side, an opposed second side, and apertures  446  extending therethrough. Three apertures  446  are shown for each reservoir  444 . The first side of the silicon substrate  442  includes reservoir caps  448  which close off the apertures until the reservoir needs to be opened. In a preferred embodiment, the reservoir caps  448  are electrically conductive. For example, the reservoir caps  448  may be in the form of a metal film. The silicon substrate  442 , apertures  446 , and reservoir caps  448  can be made using microfabrication techniques known in the art. For example, the photolithography, etching, and deposition techniques described in U.S. Pat. No. 7,604,628 may be used to form the apertures  446  in a polysilicon substrate closed off by metal reservoir caps  448 . 
     The primary substrate  440  includes two reservoirs  444  in this illustration, although more or less reservoirs may be included. Each reservoir  444  is defined by a closed end wall, an open end, and at least one sidewall extending between the closed end wall and the open end. As mentioned above, the primary substrate  440  may be formed of silicon. In other embodiments, the substrate may be formed of a metaloid, polymer, glass, or other ceramic material. The substrate and reservoirs may be made by any suitable process, including but not limited to molding, casting, micromachining, and build-up or lamination techniques known in the art. In one embodiment, the primary substrate  440  is made of/by low temperature co-fired ceramics (LTCC). It may further include a coating layer on all or a portion of the substrate, for example to provide or improve hermeticity, biocompatibility, bonding, and/or reservoir content compatibility, stability, or release. Depending on the purpose of the coating layer, it may be applied inside the reservoirs  444 , outside of the reservoirs  444 , or both. Examples of possible coating materials include biocompatible metals, such as gold, and polymers, such as parylene. 
     The primary substrate  440  and the silicon substrate  442  are bonded together using any suitable method, to hermetically seal the reservoirs  444 . In this way, the open end of the reservoir  444  is in fluid communication with the apertures  446  for controlled release or exposure of reservoir contents. In a preferred embodiment, the substrates are hermetically sealed together using a compression cold welding process, such as described in U.S. Pat. No. 8,191,756, which is incorporated herein by reference. 
     As shown in  FIGS. 5A and 5B , the second side of the silicon substrate  442  includes ring structures  452  formed thereon, and the first side of the primary substrate  440  includes grooves  450 . These bonding features are compressed together to form a cold weld bond hermetic seal surrounding the individual reservoirs  444 . The ring structures  452  may be formed by a depositing gold or another metal layer on the silicon substrate  442 . The grooves  450  may be etched in the silicon and then coated with a metallized layer of the same material as the metal ring. Variations of this embodiment are envisioned, for example, where other positive and negative bonding features are provided in/on either or both interfacing surfaces of the silicon substrate  442  and the primary substrate  440 . 
     The primary substrate  440  is generally relatively thicker than the silicon substrate  442 , and all or at least a majority (greater than 50%) of the reservoir sidewall height (or depth) is defined by the primary substrate  440 . In an embodiment, the silicon substrate  442  has thickness that is between 5% and 50% of the thickness of the primary substrate  440  at the bonded interfaces of the substrates. 
     Although not shown in the  FIG. 4  or  FIG. 5A , the reservoirs  344  and  444 , respectively, include reservoir contents positioned therewithin. The reservoirs can be configured to store essentially any substance or device component in need hermetic containment and subsequent release or exposure at a selected time. The reservoir content may be, for example, a chemical reagent, a drug formulation, or sensor or component thereof, such as an electrode. In an embodiment, a single device includes at least one containment reservoir containing a biosensor and at least one reservoir containing a drug formulation. Examples of various reservoir contents are described for example in U.S. Pat. Nos. 7,510,551; 7,497,855; 7,604,628; 7,488,316; and PCT WO 2012/027137. 
     An exemplary embodiment of a containment device  600  including a microchip element  612  is illustrated in  FIG. 6 . The containment device  600  includes a ceramic PCB  614  which has via  630  electrically connecting electronic component  618  to the microchip element  612 . The electronic component  618  is secured on a first side of the ceramic PCB  614 , and the microchip element  612  is secured on the opposing second side of the PCB  614 . The via  630  electrically connects to a metallized conductive surface  632  on the first side of the PCB  614 . The electrical circuitry  635  of the microchip element  612  is electrically connected to the metallized surface  632  by a wirebond  634 . An epoxy  633  coats the wirebond  634  and at least a portion of the microchip element  612 , the ceramic PCB  614 , and a housing  620 . In this manner, the epoxy  633  ensures that the containment device  600  is void of any atramatic surfaces. The second side of the ceramic PCB  614  also includes a metallized conductive surface  637 , which is electrically connected to the electronic component  618 . Although not shown in this illustration, the containment device  600  may include multiple microchip elements, as well as multiple vias, electronic components, and wirebonds. Moreover, the containment device  600  may be completely or partially coated by the epoxy  633 . 
     The microchip element  612  includes a primary substrate  640  and a silicon substrate  642 . The primary substrate  640  and silicon substrate  642  are bonded together by compression cold welding at/adjacent the interface of a ring structure and groove structure tongue  650 / 652 . Reservoirs  644  are defined in the primary substrate  640  with the open end in fluid communication with apertures  646  defined through the silicon substrate  612 . Electrically conductive reservoir caps  648  sealingly cover the apertures  646  and reservoirs  644 . 
     An exemplary embodiment of a containment device  700  is illustrated in  FIG. 7 . The containment device  700  includes a microchip element  712  and a ceramic PCB  714 , which is fixed to the microchip element  712 . Electrical circuitry  735  of the microchip element  712  is electrically connected to the metallized surface  732  by a wirebond  734 . An epoxy  733  coats the wirebond  734  and at least a portion of the microchip element  712 , the ceramic PCB  714 , and/or the metallized surface  732 . In this manner, the epoxy  733  ensures that the containment device  700  is void of any atramatic surfaces. Although not shown in this illustration, the containment device  700  may include multiple microchip elements, as well as multiple vias, electronic components, and wirebonds. Moreover, the containment device  700  may be completely or partially coated by the epoxy  733 . In some instances, the containment device  700  may be relatively thin and the epoxy coating may be omitted. The containment device  700  may include any length, to width, to thickness ratio. That is, the containment device  700  may be any suitable size. 
     In some instances, the PCB  714  may comprise a silicon material that is manufactured using a MEMS manufacturing process. In other instances, the PCB  714  may comprise a multilayer low temperature co-fired ceramic (LTCC). In yet other instances, the PCB  714  may comprise a substrate other than a printed circuit board that is capable of performing the functionality described herein. For example, element  714  may comprise a silicon substrate or the like that is configured to house one or more electric components  718  therein. In turn, the electrical components  718  may be in communication with the microchip element  712 . 
     The microchip element  712  includes a primary substrate  740  and a silicon substrate  742 . The primary substrate  740  and silicon substrate  742  are bonded together by compression cold welding at/adjacent the interface of a ring structure and groove structure tongue  750 / 752 . The reservoirs  744  are defined in the primary substrate  740  with the open end in fluid communication with the apertures  746  defined through the silicon substrate  742 . Electrically conductive reservoir caps  748  sealingly cover the apertures  746  and reservoirs  744 . In some instances, the PCB  714  and the primary substrate  740  may comprise a single silicon substrate or separate silicon substrates. In this manner, the PCB  714  and the primary substrate  740  may be manufactured together as part of a MEMS process or manufactured separately and assembled together. 
     In certain embodiments, in order to provide a smaller and less intrusive containment device  700 , the housing is omitted. In this manner, the electronic components  718  are integrated into the microchip element  712  and/or the ceramic PCB  714 . That is, the electronic components  718  may be disposed within or about the microchip element  712  and/or the ceramic PCB  714 . In some instances, the electronic components  718  include components and/or functionality for wirelessly receiving energy for charging an on-board storage capacitor, which may further reduce the space requirements for the electronic components on-board the containment device  700 . In some instances, the electronic components  718  may include an antenna or the like. In addition, an inductive coupling device  760 , such as a coil or the like, may be incorporated into the microchip element  712  and/or the ceramic PCB  714 . In certain embodiments, the electronic components  718  and the inductive coupling device  760  may be integrated. In other embodiments, the electronic components  718  and the inductive coupling device  760  may be separate components in electrical (i.e., operable) communication with one another. The inductive coupling device  760  may form an inductive coupling circuit between the implanted containment device  700  and an external communicator, such as a power source and/or computing device or the like. The electronic components  718  and/or the inductive coupling device  760  provide, for example, functionality to receive wireless power transmission from the external communicator, capacitors to store the required energy to open the caps  748 , and/or other electronics and circuitry to manage the flow of current to the appropriate reservoirs  744 . Other functionality also may be provided by the electronic components  718  and/or the inductive coupling device  760 . 
     An exemplary embodiment of a containment device  800  is illustrated in  FIG. 8 . The containment device  800  includes a microchip element  812  and a ceramic PCB  814 , similar to those described above. That is, the ceramic PCB  814  is fixed to the microchip element  812 . A via  830  electrically connects electronic components  818  to portions of the microchip element  812 . For example, the electrical circuitry  835  of the microchip element  812  is electrically connected to the electronic components  818  by way of the via  830 . Although not shown in this illustration, the containment device  800  may include multiple microchip elements, as well as multiple vias, electronic components, wirebonds, and/or epoxy coatings that ensure the containment device  800  is void of any atramatic surfaces (i.e., the containment device  800  may be completely or partially coated by an epoxy). In some instances, the containment device is relatively thin and the epoxy coating may be omitted. The containment device  800  may include any length, to width, to thickness ratio. That is, the containment device  800  may be any suitable size. 
     In certain embodiments, the PCB  814  may comprise a silicon material that is manufactured using a MEMS manufacturing process. In other instances, the PCB  814  may include a multilayer low temperature co-fired ceramic (LTCC). In yet other instances, the PCB  814  may include a substrate other than a printed circuit board that is capable of performing the functionality described herein. For example, element  814  may include a silicon substrate or the like that is configured to house one or more electric components  818  therein. In turn, the electrical components  818  may be in communication with the microchip element  812 . 
     The microchip element  812  includes a primary substrate  840  and a silicon substrate  842 . The primary substrate  840  and silicon substrate  842  are bonded together by compression cold welding at/adjacent the interface of a ring structure and groove structure tongue  850 / 852 . The reservoirs  844  are defined in the primary substrate  840  with the open end in fluid communication with the apertures  846  defined through the silicon substrate  842 . Electrically conductive reservoir caps  848  sealingly cover the apertures  846  and reservoirs  844 . In some instances, the PCB  814  and the primary substrate  840  may comprise a single silicon substrate or separate silicon substrates. In this manner, the PCB  814  and the primary substrate  840  may be manufactured together as part of a MEMS process or manufactured separately and assembled together. 
     Similar to the embodiments described in  FIG. 7 , in order to provide a smaller and less intrusive containment device  800 , the housing is omitted. As a result, the electronic components  818  are integrated into the microchip element  812  and/or the ceramic PCB  814 . That is, the electronic components  818  may be disposed within or about the microchip element  812  and/or the ceramic PCB  814 . In some instances, the electronic components  818  include components and/or functionality for wirelessly receiving energy for charging an on-board storage capacitor, which may further reduce the space requirements for the electronic components on-board the containment device  800 . In some instances, the electronic components  818  may include an antenna or the like. In addition, an inductive coupling device  860 , such as a coil or the like, may be incorporated into the microchip element  812  and/or the ceramic PCB  814 . In certain embodiments, the electronic components  818  and the inductive coupling device  860  may be integrated. In other embodiments, the electronic components  818  and the inductive coupling device  860  may be separate components in electrical (i.e., operable) communication with one another. The inductive coupling device  860  may form an inductive coupling circuit between the implanted containment device  800  and an external communicator, such as a power source and/or computing device or the like. The electronic components  818  and/or the inductive coupling device  860  provide, for example, functionality to receive wireless power transmission from the external communicator, capacitors to store the required energy to open the caps  848 , and/or other electronics and circuitry to manage the flow of current to the appropriate reservoirs  844 . Other functionality also may be provided by the electronic components  818  and/or the inductive coupling device  860 . 
     An exemplary embodiment of an external communicator  900  (or controller) is illustrated in  FIG. 9 . In certain embodiments, the external communicator  900  includes a display  902 , a battery  904  (or other power supply), a power management module  906 , a multiplexer  908 , a microcontroller  910 , an input/output module  912 , and/or an electromagnetic modulation module  914 . In addition, the external communicator  900  includes one or more processors coupled to at least one memory. In this manner, various instructions, methods, and techniques described herein may be considered in the general context of computer-executable instructions, such as program modules, executed by one or more computers or other devices. Additional components and/or modules may be included. Moreover, the external communicator  900  includes an inductive coupling device  916 . The inductive coupling device  916  forms an inductive coupling circuit between the implanted containment device and the external communicator  900  when brought within proximity of one another. 
     In some instances, the external communicator  900  may be a hand held device. In other instances, the external communicator  900  may be associated with a computer or the like. In yet other instances, the external communicator  900  may be wireless. The external communicator  900  may include any number of interfaces so that a user may interact therewith. Moreover, the external communicator  900  may include any number of interfaces and/or functionality so that the external communicator  900  may wirelessly interact with a containment device. 
     As depicted in  FIG. 10 , in some instances, an external communicator  1000  may be positioned on or about the surface of the skin  1004  adjacent to a containment device  1002  that is implanted within a patient. For example, in one embodiment the site of implantation is subcutaneous and near to the skin of the patient. The external communicator  1000  includes an inductive coupling device  1006  or the like, and the containment device  1002  includes an inductive coupling device  1008  or the like. In this manner, the external communicator  1000  may be configured to transmit both control instructions and the necessary power to release the required dose or doses by way of an inductive coupling between the inductive coupling device  1006  and the inductive coupling device  1008 . In certain embodiments, the external communicator  1000  may query the implanted containment device  1002  to obtain diagnostic information or confirmation information, such as specific doses released and doses remaining. 
     The use of the external communicator  1000  advantageously significantly reduces the overall size of the containment device  1002  by relocating the power source and several of the control functions from the containment device  1002  to the external communicator  1000 . For example, both power and control signals can be transferred across the skin  1004  via electromagnetic coupling, such as inductive charging or the like. Other wireless communications and connections may also be incorporated between the external communicator  1000  and the containment device  1002 . In this manner, the external communicator  1000  may control one or more aspects of the containment device  1002  remotely. 
     The reduction in the size (i.e., volume) of the containment device  1002  beneficially leads to reductions in the incision required to implant the containment device  1002  under the skin  1004 . The reduction in the size of the containment device  1002  also beneficially increases the possible locations in the body that the containment device  1002  can be implanted, which may be important for local or regional delivery of therapeutic agents and/or may reduce the amount of drug required to be delivered for a particular therapy. Moreover, the reduction in the size of the containment device  1002  makes the containment device  1002  less intrusive for the patient. As a result, the containment device  1002  may comprise a drug delivery implant with a higher ratio of drug volume to total device volume. 
     Modifications and variations of the methods and devices described herein will be obvious to those skilled in the art from the foregoing detailed description. Such modifications and variations are intended to come within the scope of the appended claims.