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Published Study Results Demonstrate Substantial Length of Stay and Hospital Cost Reductions with Use of CoapTech's PUMA-G System™ for Gastrostomy When Compared to Usual Care Methods

Wednesday, May 11, 2022

  • Ventilator-dependent patients at UM BWMC whose feeding tubes were placed using the Percutaneous Ultrasound Gastrostomy (PUG) procedure had shorter lengths of stay both in the intensive care unit (ICU) and hospital, by 5 and 8.7 days respectively, compared to usual care.
  • Total hospital costs were reduced by more than $26,000 per patient when utilizing the PUMA-G System.

BALTIMORE, May 11, 2022 /PRNewswire/ -- CoapTech, Inc, a medical device company focused on delivering transformative solutions for minimally-invasive surgery, announced today publication of study results conducted at the University of Maryland Baltimore Washington Medical Center (UM BWMC) comparing percutaneous gastrostomies placed with the PUMA-G System™ to those placed with usual care methods. This peer-reviewed study, published in the May issue of the Journal of Intensive Care Medicine, confirms and quantifies cost and length of stay reductions with use of the PUMA-G System.

Unnecessary hospital costs were hypothesized to result from workflow inefficiencies and delays in patient care. Today, the majority of gastrostomy tubes for ICU patients are placed by specialists either in an operating suite, or at the bedside with a mobile endoscopy tower. Both approaches require coordination of multiple consulting services, often require patient transport, and ultimately result in increased ICU and hospital lengths of stay (LOS). CoapTech's PUG procedure allows front-line ICU intensivists to place gastrostomy tubes at the bedside using point-of-care ultrasound at the time of indication, thereby reducing costly delays and improving workflow.

"The PUG program has positively impacted our ICU providers by making care more efficient, helped patients and families by reducing ICU and hospital length of stay, and benefited the hospital bottom line by substantially reducing total costs of care," stated Kathy McCollum, President and CEO of UM BWMC, the Glen Burnie, Maryland hospital where the research was conducted and a member organization of the University of Maryland Medical System.

This single-center retrospective cohort study was conducted in a 36-bed, mixed medical/surgical ICU at UM BWMC. Between July 2020 and March 2021, 88 patients with ventilatory dependent respiratory failure received either PUG (45 patients) or usual care (43 patients) gastrostomies. Whether the patient received PUG or usual care was determined solely by whether the presiding attending physician was trained in PUG. The primary outcomes were intensive care unit length of stay (ICULOS) and total hospital costs. Patient demographic and clinical characteristics thought to potentially influence ICULOS and hospital costs were compared and no differences were observed. Patients who received PUG were found to have significantly shorter mean ICULOS and hospital LOS than those who received usual care, with reductions of 5.0 and 8.7 days respectively. Total hospital costs per patient were reduced by an average of $26,621 in the PUG group. Secondary outcomes were mortality and discharge disposition, of which no differences between the PUG and usual care groups were observed (as expected). 

"PUG is a simple, safe, and broadly accessible procedure that can be performed by intensivists at the bedside," said Jeffrey Marshall, MD, a pulmonary and critical care physician at UM BWMC and an investigator in the study. "Our study demonstrated significant reductions in LOS and total hospital costs when the PUG procedure was performed versus usual care."

Other notable findings of the study include:

  • 70% of PUG patients received concomitant percutaneous tracheostomy compared to 0% of usual care patients
  • 54.5% of PUG patients received the gastrostomy procedure off-hours compared to 4.6% in the usual care group
  • PUG procedures were postponed far less often than usual care (16% vs 44%)

"This study confirms the economic value of the PUMA-G System to hospitals," remarked CoapTech Co-Founder and CEO Howard Carolan. "Extrapolating the $26,000 cost savings per patient to the entire study group would translate to an annualized $2.5 million cost reduction for the hospital."

CoapTech spun out of the University of Maryland, Baltimore (UMB) where the technology was developed. UMB's technology transfer arm, UM Ventures, Baltimore, also provided direct investment in the company.

"We're excited to see CoapTech's study results. They provide additional support for a hospital to use CoapTech's PUMA-G System for patient care," said Phil Robilotto, associate vice president for the Office of Technology Transfer at UMB, and director of UM Ventures, Baltimore. "The findings are an important addition to the growing body of clinical and economic evidence for PUG."

Research reported in this publication was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award 2R44DK115325.  The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The peer-reviewed study is published in the May issue of the Journal of Intensive Care Medicine

About CoapTech
CoapTech is a Baltimore-based medical device company commercializing a new platform called the PUMA System, which allows ultrasound to be utilized in hollow organ cavities. The PUMA (Point-of-care Ultrasound Magnet Aligned) System enables several new minimally invasive, bedside medical procedures, substantially reducing costs while improving patient safety and experience. The platform's first product application, PUMA-G for ultrasound gastrostomy in adults, has been cleared for use in the U.S. by the FDA via the 510(k) pathway and has received a CE mark. CoapTech was selected as a Medtech Innovator 2019 Best-in-Class Startup company and was named 2018 Maryland Incubator Company of the Year for Best Medical Device Company. Visit for more information or connect via Twitter at @coaptech.

About the University of Maryland Baltimore Washington Medical Center
Located in Glen Burnie, Maryland, UM BWMC is an acute-care facility that is part of the University of Maryland Medical System. The medical center has 285 beds and more than 3,500 team members. It also has 1,000 medical providers on staff in over 50 specialties. For more information, visit

About the University of Maryland Medical System
The University of Maryland Medical System (UMMS) is a university-based regional health care system focused on serving the health care needs of Maryland, bringing innovation, discovery and research to the care we provide and educating the state's future physician and health care professionals through our partnership with the University of Maryland School of Medicine and the UM Schools of Nursing, Pharmacy, Social Work and Dentistry in Baltimore. As one of the largest private employers in the State, the health system's 28,000 employees and 4,000 affiliated physicians provide primary and specialty care in more than 150 locations and at 12 hospitals. UMMS' flagship academic campus, the University of Maryland Medical Center in Baltimore is partnered with the University of Maryland School of Medicine and is recognized regionally and nationally for excellence and innovation in specialized care. Our acute care and specialty rehabilitation hospitals serve urban, suburban and rural communities and are located in 13 counties across the State. For more information, visit

About the University of Maryland, Baltimore and UM Ventures
A leading academic medical research institution, the University of Maryland, Baltimore (UMB) was awarded more than $692 million in sponsored biomedical research in Fiscal Year 2021. The six nationally ranked professional schools – medicine, law, nursing, pharmacy, law, and social work -- and an interprofessional graduate school produce more than 200 new inventions each year, resulting in 8 to 10 new startups and nearly 50 license agreements with industry partners annually. UM Ventures commercializes UMB's breakthrough therapies, diagnostics and devices, fueling the creation of innovative start-up companies, and attracting industry leaders and entrepreneurs to its thriving campus. For more information, visit and