Systems and methods for imaging communication and control

Information

  • Patent Grant
  • 12165538
  • Patent Number
    12,165,538
  • Date Filed
    Friday, November 4, 2022
    2 years ago
  • Date Issued
    Tuesday, December 10, 2024
    12 days ago
  • Inventors
  • Original Assignees
    • MENDAERA, INC. (San Mateo, CA, US)
  • Examiners
    • Volentine; Rebecca A
    • Lee; Jimmy S
    Agents
    • Goodwin Procter LLP
Abstract
A telesurgical mentoring platform with a wheeled base, a lower rack mounted on the base, an upper rack extending vertically from the lower rack, a compactly foldable articulated arm that is configured to extend horizontally outward away from the upper rack and configured to connect to a connector piece holding an end effectuator at its distal end, a tablet personal computer; the console configured to be readily mobilized on the floor of an existing operating room and is capable of providing a connectivity point for communication, audiovisual, and data transfer services in an operating room.
Description
FIELD

The invention relates to the field of telesurgical mentoring platforms for surgeons and/or medical device representatives.


BACKGROUND

Telesurgical mentoring platforms have evolved as an important subset of telemedicine, yet has remained an underutilized technique in the operating room.


Telesurgical mentoring typically allows a more experienced surgeon to assist or direct another less experienced surgeon while is operating at a remote location. The benefit is that the more experienced surgeon can assist in a morning surgery in Miami and an afternoon surgery in Los Angeles, while never leaving his practice in New York.


Doctors can also benefit from the advice of device manufacturers representatives during surgery. For example, a doctor that is installing a new type of stent may need some installation guidance from the manufacturer. The manufacturer's representative can provide this guidance without having to travel to the medical room.


One of the primary requirements for conferring telesurgical mentoring is the availability of a clear view of the site of incision on the patient's body for a remote surgeon. When the local surgeon is working, the camera should be easy to adjust and the platform on which it sits must be very mobile to remotely position the camera in various position via controlling the articulated arms.


The art in this field demonstrates a need for the continuous improvement on systems that can provide telesurgical mentoring. For example, U.S. Pat. No. 4,753,473 issued to Arnett describes about a telesurgical gripper for robotic apparatus used for various applications. Also, U.S. Pat. No. 5,872,892 issued to Brown et al. describes a process and apparatus for imparting linear motion to tooling. The tooling is attached to a manipulator device having two different length arms. U.S. Pat. No. 6,343,601 issued to Kiske et al. describes a mobile medical supply device with an anesthesia apparatus, with a plurality of supply and drain lines. U.S. Pat. No. 4,778,329 issued to Phillips describes a robot with an arm and the movement of the arm defined in XY plane.


U.S. Pat. No. 5,971,572 issued to Rouchan a device for the angular positioning of a mass with respect to a horizontal support axis which includes a support arm intended to carry the mass and mounted such that it can be angularly displaced about the support axis.


Most of the articulated arms described in the prior art may be able to do the job of positioning the camera at various positions. But none of the above described articulated arms can move the camera dexterously by infinitely incremental positions. Even if they do so, they would require repeated manual adjustment which would become a labor-intensive task and would be cumbersome.


Accordingly, there exists a need for an articulated arm for a medical mobile cart which can be easily maneuvered to infinitival location displacements and controlled efficiently from a remote location.


SUMMARY

The present invention describes an articulated arm connected to a telesurgical mentoring platform which includes a wheeled base, a lower rack mounted on the base, an upper rack extending vertically upwards from the lower rack, display screens attached to the upper rack and a articulated arm extending from the upper portion of the upper rack.


The telesurgical mentoring platform with an articulated arm as disclosed provides a number of advantages, including perioperative medical device support in the operating room, improved viewing angles and better image quality for doctors and others who are viewing remotely via the electronic display.


In addition, the articulated arm would help in fine controlling of the position of the end effectuator (for example the end effectuator could be a pan tilt zoom camera, special surgery lighting device or the like)


Since the portable platform can be maneuvered around the operating table there is no need for the use of ceiling booms to suspend equipment or the ceiling booms can be reserved for larger equipment that is otherwise too heavy to be supported by a floor standing unit.


Another advantage includes gesture-based control of the pan-tilt-zoom camera for both the users in the operating room and the remote users can manipulate through the use of the tablet device. In addition, the platform provides the ability for users in the operating room and remote user to manipulate the flow of video, audio and data by toggling of video sources, selection of audio output source and selection of data sources.


Further, the stand portion of the unit can be used to store electronic equipment and it provides a centralized-on board computer that can be readily accessed by the surgeon and medical staff. The floor standing console can also be configured to deliver power and electronic connectivity to equipment.


It should be understood that the summary above is provided to introduce in simplified form a selection of examples that are further described in the detailed description. It is not meant to identify key or essential features of any claimed subject matter that may later claim priority to the present description. Furthermore, the scope of any such claimed subject matter would not be limited to implementations that solve any disadvantages noted above or contained herein.


These and other embodiments are described in more detail in the following detailed descriptions and the figures. The foregoing is not intended to be an exhaustive list of embodiments and features of the present invention. Persons skilled in the art are capable of appreciating other embodiments and features from the following detailed description in conjunction with the drawings.





BRIEF DESCRIPTION OF THE DRAWINGS

Many aspects of the present invention can be better understood with reference to the following drawings. The components in the drawings are not necessarily to scale, emphasis instead being placed upon clearly illustrating the principles of the present invention. Moreover, in the drawings like reference numerals designate corresponding parts throughout several views.



FIG. 1 is a front side, isometric view of a telesurgical mentoring platform with an articulated arm, according to embodiments of the present invention.



FIG. 2 is a top plan view of the unit shown in FIG. 1, according to embodiments of the present invention.



FIG. 3 is a left side view of the unit shown in FIG. 1, the right-side view being a mirror image thereof, according to embodiments of the present invention.



FIG. 4 is a left side view of the unit shown in FIG. 1 and the articulated arm in a folded configuration.



FIG. 5 is a system diagram of the unit shown in FIG. 1.





SELECTED REFERENCE CHARACTERS






    • 100 Illustrates a perspective view of the telesurgical mentoring platform.


    • 110 Wheeled Base


    • 112, 114, 116, 118 Lockable swivel caster wheels


    • 120 Lower rack


    • 130 Upper rack


    • 145 Electronic display


    • 150 Articulated arm base


    • 155 Electronic display with control capabilities


    • 160 Articulated arm


    • 170 Articulated head


    • 175 Stationary Camera


    • 180 Connecting piece


    • 185 Control handle


    • 190 End effectuator


    • 200 Illustrates a top view of the telesurgical mentoring platform.


    • 300 Illustrates a side view of the telesurgical mentoring platform.


    • 400 Illustrates a side view of the telesurgical mentoring platform with a compactly folded articulated arm.


    • 500 Illustrates a system diagram for the telesurgical mentoring platform.


    • 510A and B Imaging Systems


    • 520 Video Mixer


    • 530A and B Cameras


    • 540 Video Frame Grabber


    • 550 Computer


    • 560A and B Blue Tooth headsets


    • 570 Monitor


    • 580 Power Supply


    • 590 Power mains





DETAILED DESCRIPTION

The embodiments in this disclosure, as illustrated in FIGS. 1 through 4 and described in the text below, are adapted for telesurgical mentoring of operating room surgical procedures, including, but not limited to, orthopedic, spinal, interventional cardiology, peripheral vascular, Neuromodulation, orthopedic, urology and cardiac rhythm management procedures. The different components described in the invention may be made with tube metal or any other suitable material that can be used in a sterile environment such as an operating room.


The term electronic display shall mean an electronic visual display, informally a screen, and a display device for presentation of images, text, or video transmitted electronically, without producing a permanent record. Electronic visual displays may include television sets, computer monitors, tablet computers, smartphones, and information appliances.


The term on-board computer shall mean and represent practically any type of computer, computer system or other programmable electronic device having mobile computing capabilities, including a personal computer, a tablet computer, Personal Digital Assistant (PDA), Personal Information Manager (PIM), cellular telephone, smartphone, and the like.


In a preferred embodiment, referring to FIG. 1, reference numeral label 100 designates a telesurgical mentoring platform with an articulated arm. Unit 100 has a wheeled base 110 with lockable swivel caster-wheels 112, 114, 116, and 118, a lower rack 120, an upper rack 130, electronic display 145, electronic display with control capabilities 155, articulated arm base 150, articulated arm 160, articulated head 170, a first camera 175, connector piece 180, a handle 185 on the articulated arm and an end effectuator 190.


Referring to FIG. 2 and FIGS. 3, 200 and 300 represent the top plan view and side view respectively of the telesurgical platform. Referring to FIG. 4, 400 represents a side view of the telesurgical platform with a compactly folded articulated arm.


Referring to FIG. 5, 500 represents a network diagram overview of the components of the telesurgical platform including various components. Imaging systems 510A and 510B are connected to a video mixer 520. The two medical imaging inputs 510A and 510B allows for the ability to directly include the inputs from one or more medical imaging systems in the operating room (e.g., Fluoroscopy, Echocardiogram, Endoscope), encrypt their real-time view and transmit the view out to the remote user. The connection inputs can be DVI, HDMI or SDI. Cameras 530A and 530B also input their recordings into the video mixer 520 which is in turn is connected to a Video Frame Grabber 540. The video mixer 520 allows the unit to toggle various video sources and provide multi-screen functionality (like full screen, split screen, tri-view, quad-view).


A computer 550 takes input from video frame grabber 540 and the videos can be processed on a monitor 570 or a tablet 590. The output of monitor 570 can be in the form of a HDMI monitor output, which allows for the monitor of the unit to be mirrored to existing monitors in the operating room.


The computer 550 is also connected to a blue tooth headsets 560A and 560B. An ethernet connection 555 is linked to the computer, which allows for connecting to the internet. All the above components are powered by a power supply 580 connected to a main power supply 590. The medical power supply 580 and 590 allows the unit to operate without being plugged in for a specified period of time without disruption.


In a non-limiting embodiment, four rolling lockable caster wheels are used with the base 110. Three wheels 112, 114, and 116 are shown in FIG. 1, while the fourth wheel 118 can be visualized in FIG. 2. It should be appreciated by those of ordinary skill that the specific structural and material configurations of the base 110 and caster wheels 112, 114, 116, and 118 are exemplary only. Other design configurations and any number of caster wheels may be used that generally fall within the spirit and scope of the present invention.


With continuing reference to FIG. 1-4, base 110 is connected to lower rack 120 which is in turn connected to the upper rack 130. In a non-limiting embodiment, an articulated arm 160 is attached to the upper rack of the telesurgical platform as shown in shown in FIGS. 1-4. The lower rack 120 can be of hollow construction resembling a lockable cabinet to accommodate a medical power supply, a quad core computer or a video input converter. Optionally the lower rack 120 may also host accessories required for Bluetooth technology headsets (560A and 560B), keyboards, mouse and the like. A handle or hook can be attached to the lower rack 120 for holding on to single use sterile covers for the different electronic accessories.


It should be appreciated by those of ordinary skill that the specific structural and material configurations of articulated arm 160 is exemplary only. Other design configurations and any number of arms may be used that generally fall within the spirit and scope of the present disclosure.


The articulated arm 160 is capable of swinging in a horizontal plane extending from the articulated arm base 150 at the top portion of the upper rack. The articulated arm head 170 is connected to a connector piece 180 of varying length which has an end effectuator 190 connected at the distal end. The articulated arm head 170 is also equipped with the capability of swinging the articulated arm 160 and the connector piece 180 in a horizontal plane extending from the articulated head. The freedom for swinging the articulated arm and the connector piece in a horizontal plane makes way for the compact folding feature of the articulated arm as shown in FIG. 4. The end effectuator can be a pan tilt zoom camera or a special surgery lighting device or the like. By controlling the position of the articulated arm and articulated head the position of the end effectuator can be maneuvered easily to infinitival incremental desired positions for focusing the end effectuator to the area of interest.


In a non-limiting embodiment, the lower rack hosts the control unit, which includes an on-board computer, power supply and control lines junction, with the control lines further connecting the electronic display with control capabilities to the articulated arm and articulated head components. Venting interfaces are provided on specific areas to allow airflow, circulation and prevent overheating. The fixed camera 175 on the unit directly below 150 assists in a 360-degree visualization of the operating room and camera 190 on an articulating arm 180 allows for a direct view of the surgical site and/or procedural back-table of medical instruments.


In another embodiment, the telesurgical platform includes an electronic display 145 and electronic display with control capabilities 155. In one exemplary embodiment, the electronic display 145 and 155 is a tablet computer with a mobile application installed for connection to the Internet over Wi-Fi or 4G, allowing operating room personnel to communicate securely with personnel who are in a remote location.


In another preferred embodiment, referring to FIGS. 1 and 3, the electronic display 145 or 155 may have touch-screen control or joy stick or any other form of controlling technique which falls in the scope of the invention.


The on-board computer also typically receives a number of inputs and outputs for communicating information externally. For interface with a user or operator, including doctors and medical staff, the on-board computer typically includes one or more user-input devices (e.g.; a keyboard (not shown), a mouse (not shown), a microphone, or a tablet and an output unit or display (e.g.; an LCD display panel).


In a preferred embodiment, with respect to FIGS. 1 through 3, a setup for the telesurgical mentoring platform can be described as follows. The end effectuator camera 190 can be connected to the on-board computer for transmitting a video stream to the on-board computer. In addition, the on-board computer can be capable of converting the video stream to an encrypted stream that may consist of, for example, 128-bit advanced encryption standard. The video stream may be communicated from the on-board computer through the Internet to a remote user via the electronic display 145 or 155.


The many aspects and benefits of the invention are apparent from the detailed description, and thus, it is intended for the following claims to cover all such aspects and benefits of the invention which fall within the scope and spirit of the invention. In addition, because numerous modifications and variations will be obvious and readily occur to those skilled in the art, the claims should not be construed to limit the invention to the exact construction and operation illustrated and described herein. Accordingly, all suitable modifications and equivalents should be understood to fall within the scope of the invention as claimed herein.

Claims
  • 1. An imaging system comprising: a pan-tilt-zoom camera supported by a distal end of an articulated arm supported by one or more racks on a base, wherein the articulated arm comprises at least a plurality of pieces configured for movement relative to one another about a vertical axis within a limited horizontal plane, thereby permitting the pan-tilt-zoom-camera to move within the limited horizontal plane relative to the one or more racks;an additional camera disposed on an upper portion of the one or more racks, wherein the upper portion of the one or more racks comprises a vertical portion and a lateral portion extending horizontally from the vertical portion, wherein the articulated arm and the additional camera are coupled to the lateral portion;one or more video inputs configured to receive video inputs from additional video sources;one or more processors configured to receive images from the pan-tilt-zoom camera, the additional camera, and the one or more video inputs; andone or more communication systems configured to receive the images from the one or more processors, and configured to deliver the images to (1) an electronic display supported by the rack and (2) a remote device at a different location from the imaging system, wherein the additional camera is (i) independently movable relative to the electronic display and (ii) positioned in front of the electronic display,wherein the remote device is configured to receive controls from a user to control movement of the pan-tilt-zoom camera.
  • 2. The imaging system of claim 1, wherein the electronic display comprises a touchscreen display coupled to a computer.
  • 3. The imaging system of claim 2, wherein the computer comprises an application installed that is configured to deliver the images to the remote device.
  • 4. The imaging system of claim 1, wherein the pan-tilt-zoom camera is angled via the articulating arm to produce live video images on the electronic display.
  • 5. The imaging system of claim 1, wherein the articulating arm is connected to an upper rack of the one or more racks via an articulated arm base, which allows for free-swinging movement of the articulated arm in the limited horizontal plane.
  • 6. The imaging system of claim 1, wherein the articulating arm and a connector piece of the plurality of pieces are connected by an articulated arm base joint allowing for free-swinging movement of the articulated arm and the connector piece in a horizontal plane.
  • 7. The imaging system of claim 1, wherein the imaging system is movable to a convenient location in an operating room or near a patient or a surgical environment.
  • 8. The imaging system of claim 1, wherein the electronic display is configured to display one or more image or video outputs from the pan-tilt-zoom camera.
  • 9. The imaging system of claim 1, further comprising: an ethernet input for establishing an Internet connection;an HDMI monitor output for mirroring existing monitors in the imaging system; andone or more imaging system inputs to directly input the imaging system, encrypt a real-time view obtained using the imaging system, and transmit the real-time view to a remote user.
  • 10. The imaging system of claim 1, further comprising: a video mixer which allows for toggling of various video sources to provide multi-screen functionality which enables a display to show a full screen view or be split into multiple different views.
  • 11. The imaging system of claim 10, wherein the multi-screen functionality is displayed on the electronic display.
  • 12. The imaging system of claim 10, wherein the multi-screen functionality is displayed on the remote device.
  • 13. The imaging system of claim 1, wherein the additional video sources comprise at least one medical imaging system.
  • 14. The imaging system of claim 1, further comprising a stand-alone speaker and a microphone.
  • 15. The imaging system of claim 1, further comprising an on-board computer in communication with the electronic display and an audiovisual component for network conferencing of video content and audio content in real time to a remote user.
  • 16. The imaging system of claim 1, wherein at least one of the pan-tilt-zoom camera or the additional camera is configured to provide up to a 360-degree visualization of an operating room in which the imaging system is located.
  • 17. The imaging system of claim 1, wherein the articulated arm and the additional camera are coupled to different surfaces or sides of the lateral portion.
  • 18. The imaging system of claim 1, wherein the articulated arm and the additional camera are coupled to opposing surfaces or sides of the lateral portion.
  • 19. The imaging system of claim 1, wherein the images delivered to the electronic display and the remote device are manipulable, togglable, or selectable by a remote user and a local user of the imaging system.
  • 20. The imaging system of claim 1, wherein the pan-tilt-zoom camera is configured for gesture-based control by both a remote user and a local user of the imaging system.
CROSS-REFERENCE

This application is a continuation of U.S. Ser. No. 16/789,255, filed Feb. 12, 2020, which is a continuation of U.S. Ser. No. 15/498,273, filed Apr. 26, 2017, which claims priority to U.S. Provisional Ser. No. 62/328,366, filed on Apr. 27, 2016, each of which is incorporated by reference herein in its entirety.

US Referenced Citations (111)
Number Name Date Kind
4473074 Vassiliadis Sep 1984 A
4585436 Davis et al. Apr 1986 A
D285001 Denis et al. Aug 1986 S
4625731 Quedens et al. Dec 1986 A
4695271 Goethel Sep 1987 A
4753473 Arnett et al. Jun 1988 A
4778329 Phillips et al. Oct 1988 A
D387168 Edelman et al. Dec 1997 S
5701904 Simmons et al. Dec 1997 A
5872892 Brown et al. Feb 1999 A
5872922 Hogan et al. Feb 1999 A
5971572 Rouchon et al. Oct 1999 A
D447567 Murphy et al. Sep 2001 S
6292713 Jouppi et al. Sep 2001 B1
6343601 Kiske et al. Feb 2002 B1
D467001 Buczek et al. Dec 2002 S
6641039 Southard Nov 2003 B2
D486915 Warschewske et al. Feb 2004 S
D518267 Arceta Mar 2006 S
7133062 Castles et al. Nov 2006 B2
7164969 Wang et al. Jan 2007 B2
7199817 Mottur et al. Apr 2007 B2
D550362 Olivera et al. Sep 2007 S
7289883 Wang et al. Oct 2007 B2
D567381 Olivera et al. Apr 2008 S
7411509 Rosenfeld et al. Aug 2008 B2
7432949 Remy et al. Oct 2008 B2
7562883 Livengood et al. Jul 2009 B2
D613866 Tanaka et al. Apr 2010 S
D613867 Tanaka et al. Apr 2010 S
7761185 Wang et al. Jul 2010 B2
7949616 Levy et al. May 2011 B2
8069420 Plummer Nov 2011 B2
D652521 Ross et al. Jan 2012 S
D652936 Ross et al. Jan 2012 S
8092426 Molnar Jan 2012 B2
8179418 Wright et al. May 2012 B2
D692563 Naef et al. Oct 2013 S
8670017 Stuart et al. Mar 2014 B2
8780165 Wang et al. Jul 2014 B2
D712833 George et al. Sep 2014 S
8849679 Wang et al. Sep 2014 B2
8849680 Wright et al. Sep 2014 B2
8872879 Saleh et al. Oct 2014 B2
8897920 Wang et al. Nov 2014 B2
D726324 Duncan et al. Apr 2015 S
D734475 Ross Jul 2015 S
D735342 Asad et al. Jul 2015 S
9089972 Stuart et al. Jul 2015 B2
9129054 Nawana et al. Sep 2015 B2
9160783 Pinter Oct 2015 B2
D743036 Boukhny et al. Nov 2015 S
D746475 Mongin et al. Dec 2015 S
9198728 Wang et al. Dec 2015 B2
D750787 Asad et al. Mar 2016 S
D751209 DiMino et al. Mar 2016 S
D767423 Choudhary Sep 2016 S
D776279 Newman et al. Jan 2017 S
9600631 Stuart et al. Mar 2017 B2
9602765 Wang et al. Mar 2017 B2
D792974 Roth Jul 2017 S
D807510 Newman et al. Jan 2018 S
D816232 Asad et al. Apr 2018 S
10315312 Wang et al. Jun 2019 B2
10404939 Wang et al. Sep 2019 B2
10483007 Celmins et al. Nov 2019 B2
D871588 Schultz et al. Dec 2019 S
10617299 Sanchez et al. Apr 2020 B2
10682763 Pinter Jun 2020 B2
10768668 Herzog et al. Sep 2020 B2
10887545 Stuart et al. Jan 2021 B2
11553160 Schultz et al. Jan 2023 B1
20020015296 Howell et al. Feb 2002 A1
20060052676 Wang et al. Mar 2006 A1
20060119701 King Jun 2006 A1
20060122482 Mariotti et al. Jun 2006 A1
20060136703 Wisecup et al. Jun 2006 A1
20070122783 Habashi May 2007 A1
20070192910 Vu et al. Aug 2007 A1
20090240371 Wang et al. Sep 2009 A1
20090318770 Marka et al. Dec 2009 A1
20100115418 Wang et al. May 2010 A1
20110187875 Sanchez et al. Aug 2011 A1
20110190930 Hanrahan et al. Aug 2011 A1
20110213210 Temby et al. Sep 2011 A1
20110288684 Farlow et al. Nov 2011 A1
20120072024 Wang et al. Mar 2012 A1
20120098927 Sablak Apr 2012 A1
20120126503 Butler et al. May 2012 A1
20120191464 Stuart et al. Jul 2012 A1
20120303476 Krzyzanowski et al. Nov 2012 A1
20120306994 Schwartz et al. Dec 2012 A1
20130248598 Dehnadi et al. Sep 2013 A1
20130339039 Roman et al. Dec 2013 A1
20140095890 Mangalore et al. Apr 2014 A1
20140135990 Stuart May 2014 A1
20140204190 Rosenblatt, III et al. Jul 2014 A1
20140218282 Hung et al. Aug 2014 A1
20140263674 Cerveny Sep 2014 A1
20150104013 Holman et al. Apr 2015 A1
20150339452 Wright et al. Nov 2015 A1
20160119593 Schultz et al. Apr 2016 A1
20170020627 Tesar Jan 2017 A1
20170316705 Schultz et al. Nov 2017 A1
20190147141 Kahn May 2019 A9
20190342520 Wang et al. Nov 2019 A1
20200101615 Pinter et al. Apr 2020 A1
20200203025 Kaira et al. Jun 2020 A1
20200215683 Wright et al. Jul 2020 A1
20200237224 Sanchez et al. Jul 2020 A1
20200265961 Celmins et al. Aug 2020 A1
Foreign Referenced Citations (1)
Number Date Country
200421149 Oct 2004 TW
Non-Patent Literature Citations (10)
Entry
U.S. Appl. No. 15/498,273 Office Action dated Jan. 30, 2019.
U.S. Appl. No. 16/789,255 Final Office Action dated Feb. 22, 2022.
U.S. Appl. No. 16/789,255 Notice of Allowance dated Sep. 28, 2022.
U.S. Appl. No. 16/789,255 Office Action dated Jun. 17, 2021.
U.S. Appl. No. 16/789,255 Office Action dated Sep. 15, 2020.
U.S. Appl. No. 29/562,031 Notice of Allowance dated Nov. 8, 2019.
U.S. Appl. No. 29/562,031 Office Action dated Feb. 4, 2019.
U.S. Appl. No. 29/562,031 Office Action dated Jul. 23, 2018.
U.S. Appl. No. 15/498,273 Office Action dated Aug. 14, 2019.
U.S. Appl. No. 29/562,031 Notice of Allowance dated Aug. 29, 2019.
Provisional Applications (1)
Number Date Country
62328366 Apr 2016 US
Continuations (2)
Number Date Country
Parent 16789255 Feb 2020 US
Child 18052657 US
Parent 15498273 Apr 2017 US
Child 16789255 US