I am finally getting back to you all regarding my experience with the patient that had the bilateral arms that were flexing and extending at the elbows and the hands opening and closing inadvertently.  I will be honest, it was very frustrating for all parties, but there was a happy ending.  To bring you all up to speed, once the patient did go back to work, the problem got worse.  Not only were the same problems reoccurring, but the elbows were turning physically off and on by themselves, and it was happening not only at work, but also at home. Therefore, at that point I requested everything from the tip of the shoulder all the way down to the hand be replaced with brand new hardware on both sides. Otto Bock's customer service was excellent throughout the entire experience and really came through on my request of replacing all electronics.  Once this was completed on Otto Bock's end, and we refitted the arms, everything finally worked perfectly.  Patient returned just last week for his first follow up since receiving the newly replaced prostheses and he was ecstatic.  He stated that his life has become easier to navigate on the tasks that he once was unable to do.  For example, with his old body-powered elbows, he was never able to achieve flexion of his forearm past 90 degrees due to limited excursion.  I can not wait to follow up with him in 3 months to see what he is able to do by then.