Please also add the information from the HS.FHIRServer.API.Data.Request message.
The question posted is a copy-and-paste of source code.
In order to obtain diagnostic help, please state the FHIR resource content that you are trying to send to the database, as well as the information from the relevant HS.FHIRServer.Interop.Request message object.
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David,
It appears that in discussion with our Worldwide Response Center support you identified the root cause of the problem to be an erroneous example on the HL7 FHIR website at: http://hl7.org/fhir/searchparameter-example-extension.json.html
The example lacks the "url=" text that should precede the specific extension url text.
Best regards,
Paul Lomayesva
InterSystems Corporation