A total of 13% of device failures are caused by internal pump failure, whereas over 60% are caused by the failure of batteries, the controller and the peripheral cable [416]. Damage to the driveline that interferes with the operation of the pump is a rare, but life-threatening complication. It is often caused by fracture due to accidental mechanical impact. Continuous stress on the cable due to growing body size with weight gain is a risk factor. Moreover, accidental pulling of the cable by dropping the controller bag or by patient falls risks cable damage [417]. Intentional cutting or disconnection of the driveline from the controller has also been described [418]. Treatment of the majority of lead fractures is a simple repair. If the damaged driveline cannot not be repaired, it could require pump explant or exchange, high-urgency HTx, or it could result in patient death.