S13 caused two external arm collisions by moving the endoscope.The endoscope arm collided with working Arm 2 and produced two high- priority alarms.The second alarm caused a chain of 9 unintended system alarms in the next 45 seconds.The surgeon had to wait for study staff to clear the repeated alarms.S13 thought the arms were too close to each other and should have been on opposing sides of the endoscope.Normally, they would have a plan for their procedure and be able to tell right away that there was a problem.