An electro static discharge protection element being formed by a diode including a well region of a first conductivity type on a surface of a semiconductor substrate, and a first diffusion layer of a second conductivity type in the well region. Nurse case managers working with physician consultants who have experience in dealing with complex non-cancerous chronic pain diagnoses, substance abuse, mental health conditions, and drug diversion are employed. At least two wheels of the plurality of wheels are each mounted on the chassis via a respective wheel suspension. The local device, voice applications rendering agent and management system may be interconnected via a communications network.