The advocate
In the summer of 2021, Meredith Koch ’12 stood inside an operating room at the Pacifica Salud Hospital in Panama City watching the future of healthcare unfold. Seated at a surgeon console nearby, Dr. Salomón Zebede was performing a robot-assisted hysterectomy using a system designed by global healthcare technology leader Medtronic. As one of the company’s clinical systems engineers, Koch was there to support the procedure, which made international news and attracted a visit from the country’s president and first lady.
Looking back, “It’s one of the highlights of my career,” said Koch, who now manages the clinical systems engineering team from Medtronic’s Boston office. “To be able to see the work I had done coming to life in an operating room to treat a patient and improve their life was incredible.”
To those who know Koch well, her involvement in such a momentous event should have come as no surprise, despite the hurdles she had to overcome to get there. The Norwalk, Connecticut native showed a keen interest in healthcare from a young age, joining the Darien EMS team at 14. She took pre-med courses at Boston College and discovered a passion for biomedical engineering during a junior-year internship. In 2015, after earning a master's degree in mechanical engineering from the University of Vermont, she accepted her first job at Medtronic as a clinical specialist in their cardiac rhythm management division, providing technical support to surgeons implanting pacemakers and defibrillators.
“I got to nerd out on the technology while also working in a hospital environment,” she recalled. “I remember saying to myself, ‘This is my dream job.’”
But three months into that job, Koch’s world turned upside down. The week of her 25th birthday, she was helping friends unload a piano from the back of a pickup truck when “gravity took over,” and the 850-pound instrument slammed into her back, shattering her vertebrae and paralyzing her from the waist down. She was rushed to the hospital by the same team of paramedics she volunteered with, where she underwent emergency spinal cord surgery. When she woke up, the realization that she might never walk again was almost as painful as her physical injuries.
“I had run a half-marathon five days before the accident,” she said. “I was dancing six-plus hours a week en pointe, I was skiing black diamonds—I loved being active. It seemed like everything had been taken away from me when I got hurt.”
From patient to advocate
Koch was transferred to Spaulding Rehabilitation Hospital in Boston, where she began learning how to live with a spinal cord injury. A team of physical therapists helped her regain strength in her limbs, and introduced her to the world of adaptive sports, which became a lifeline. The first time Koch pedaled an adaptive bicycle, she broke down in tears.
“Everyone was asking, ‘What’s wrong? Are you in pain?’ and I said, ‘No, I finally feel like myself again,” she said. “It just set off this fire and opened this world to me of pushing my boundaries and trying new things.”
Koch began swimming regularly for exercise, joining a local master swim group and eventually making the U.S. Paralympic Swimming Emerging Team. She went rock climbing and skiing, and got a recumbent tricycle to use on the bike paths near her home. The physical exercise helped her mind and body heal—she went from being on eight prescription medications to zero in less than two years—and introduced her to a community of adaptive athletes who became some of her closest friends. When she needed help figuring things out, like how to dress professionally or transfer from her wheelchair to a barstool, she could turn to her network for answers.
Fifteen weeks after her accident, Koch went back to work at Medtronic, scared that if she didn’t return quickly, she wouldn’t return at all. By then, she had regained the ability to walk using leg braces and a walker, but her confidence was still shaky. For the next two years, she avoided using her wheelchair in hospital settings, afraid that doctors and patients would question her ability to do her job. It took a severe pain flare-up and a sprained ankle for her to finally break her silence, and she never looked back.
“It was such a game-changing moment for me to say, ‘I’m confident enough in my skills that whatever underlying stigma they might have, I can overcome it and I’m willing to fight it,’” she recalled. “And it was a really encouraging experience because where I thought there would be resistance or pushback, people didn’t care.”
Engineering for impact
In 2019, after nearly five years as a clinical specialist, Koch accepted a new position within Medtronic as a clinical systems engineer, joining a small team working on a potentially groundbreaking project—a surgical robot called the Hugo™ robotic-assisted surgery system.
With Hugo™, a clinician could perform soft tissue surgery like prostate removal without touching a patient, precisely controlling instruments from an open surgeon console with a high definition 3D display of the patient’s anatomy. The surgical instruments and a state-of-the-art camera entered the patient through tiny incisions in the body, reducing pain and recovery time compared to open surgery.
Koch working on a training exercise in one of Medtronic's mock operating rooms. Photo by Ariana Cho.
Over the next two years, Koch helped her company ready the Hugo™ RAS system for market—overseeing rigorous testing in preclinical settings, writing reports, and developing clinical set-up guides for surgeons to use in the operating room. After her experience in Panama City, she was promoted to principal, then a year later, to manager, overseeing a team that has quadrupled in size since she took over leading it.
Working on a device as complex as Hugo™ requires Koch to juggle multiple projects and draw on a myriad of different skills every day. Her team addresses technical, engineering, and clinical challenges, taking into account feedback from both doctors and patients. They interview stakeholders and run user-facing labs to evaluate clinical performance, and test new tools and procedural set-up guides in a mock operating room within the Medtronic office.
“It’s not enough that a product performs as intended,” explained Koch. “It also needs to be able to be used correctly.”
Last summer, the Hugo™ system was used in a partial nephrectomy (kidney removal) at a research hospital in Toronto, Canada, marking its North American debut, and it is currently in clinical use in more than 25 countries across five continents. (In the U.S., the Hugo™ RAS system is an investigational device not for sale.) As technology advances, robotic surgery is becoming more common in operating rooms worldwide, providing patients with the benefits of minimally invasive surgery while giving surgeons greater precision and flexibility in their movements, 3D visualization, and a chance to sit comfortably at a console instead of standing hunched over an operating table.
Being at the forefront of healthcare technology as an incomplete paraplegic is a position Koch could have never envisioned while driving ambulances at the age of 17, but it's one she’s happy to occupy. She speaks openly about her accident, often while wearing a t-shirt emblazoned with the hashtag “#EndPianoViolence,” and has delivered a TEDx talk advocating for the inclusion of people with disabilities. At Medtronic, she feels a personal connection with the patients who rely on devices her team has engineered, tested, and trained doctors how to use, and a responsibility to serve them well.
“As an engineer, I’ve been able to impact thousands of lives with the work that I've done,” she said. “When someone comes out of a scary health situation, they’ll know that the technology that was used to operate on them was designed to the highest possible standard—and I got to play a part in that."