A nonvolatile semiconductor memory device and a method of fabricating the device are provided that allow the use of dry etching when removing the ONO film and that eliminate the danger of etching the silicon substrate in the gate oxide film formation areas even in the event of over-etching. The ceramic substrate has an internal conductor layer, which is connected to a test pad. This device may be used to assist in the treatment of congestive heart failure. The damping element may exhibit an elongate configuration that extends along at least a portion of the shaft, and the damping element may have the configuration of either a fluid-filled chamber or a foam structure. The machine may modify itself according to interaction with its authorized authenticated users with self-modification via learning within application-specific, user-specific constraints hardwired into the original machine, eliminating configuration management and computer programming.