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This case study outlines MedViron's comprehensive four-year development process of the Sotto Overbed Table, designed specifically for compatibility with 5th wheel motorized hospital beds and Big Wheel stretchers. Addressing a significant gap in existing products, MedViron's Sotto table uniquely fits under the motorized 5th wheel, rectifying positioning challenges other tables face. Beginning the project in November 2020, MedViron's design journey involved extensive prototyping and testing of various steel base designs, ensuring stability, durability, and ease of movement. The collaborative process incorporated feedback from clinical professionals, focusing on ergonomics, ease of cleaning, and user safety. Key features of the Sotto Overbed Table include a patented aluminum column tested for remarkable durability, a user-friendly one-handed height adjustment lever, and a seamless KYDEX top emphasizing patient comfort and infection control. Notably, it is the only table designed for optimal alignment with critical care motorized beds, ensuring enhanced safety and comfort for patients. The Sotto Overbed Table exemplifies MedViron's dedication to innovation and adherence to ISO 13485 protocols. Its robust design and user-centric features make it a valuable long-term asset for hospitals and healthcare environments.