When the Thinklabs One's output volume is higher than what the receiving device can handle, it causes clipping or digital distortion. Digital distortion In a recording or transmitted audio signal in telemedicine sounds like scratchy clicks when mild to moderate. When it's extreme, your whole recording can sound like perpetual scratchy fuzzy clicks and the stethoscope sounds are completely masked by the distortion.
You can avoid this recording error by carefully setting your input volume using the visual display of the sounds as a guide. See the below pictures for examples.
Good ( No Clipping or Distortion ) * Do this
Bad ( Moderate Clipping and Distortion ) * Definitely don't do this
Very Bad ( Extreme Clipping and Extreme Near Constant Distortion ) * Most definitely don't do this