I worked on similar software that ran on Windows, though the decision was made 18 years ago.  It was driven by:<p>* GUI dev tools were an order of magnitude better than under linux<p>* nidaq (very common daq and dio cards) didn&#x27;t have or had flaky linux drivers.  usb may be a better choice today but was not then available.  Plus it&#x27;s convenient&#x2F;less expensive to push functionality to the computer side and minimize embedded development.<p>* in the beginning (though we fixed this mistake), we shipped software, our machine, and a ni-daq card; users provided a computer.  This was a nightmare.  We ended up shipping whole computers custom built by Dell to our specs with ni-daq cards installed (and later glued in to prevent them slipping out during shipping) plus our custom system images.  At the time, I don&#x27;t think Dell would do this for linux; you could find other vendors that would, but they weren&#x27;t easy to work with or much more expensive.<p>* Nobody is eager to switch OSes because every software update to the machine has to be FDA certified (ie kiss at least $100k goodbye), so the company is <i>very</i> risk averse.  Beyond even the cost to rewrite what has evolved into a relatively complicated gui app.<p>* As mentioned elsewhere, once you leave windows you have to train people to use linux guis that historically had window managers &#x2F; gui toolkits that didn&#x27;t work like windows.<p>All of the above is complicated by the fact most of these medical device companies pay their devs shit and have trouble hiring good devs.  (Engineering shortage, obviously!)