I'm sure all of you here have either worked with the fellas at Smart Tap or at least heard of their process.  If not a quick google search will explain.....

I'd be willing to bet there are mixed opinions of the process.  However you may feel concerning their specific process and the liability it incurs isn't the question I have today.....

I wanted to reach out to the community to get some opinions on something new (to me):

I recently heard about a local installation utilizing "Axially Swaged, Elastic Strain Preload Fittings".  The process involved cutting into a live (not isolated) medical gas line (pressure gas), sliding a Medlok slip coupling and an open valve onto the live pipe, crimping the coupling then closing the valve.  After the valve addition the patient side connection was made.

I know the plumbing community has been repairing water pipes with Pro-Press utilizing this process for years.  I don't believe there is anything in the NFPA code preventing this installation procedure for medical gas (unless I'm missing something).

My questions to the community is:

1. Is this an installation method that should be allowed or disallowed?
2. Does the community think this is a good, safe, and acceptable procedure?
3. Does this procedure safeguard patients from hazards?

Awesome topic of discussion! Here are my thoughts, specific to the questions you asked (and not the smart tap procedure in general). 

1. That installation method is not discussed when you do the training for ML or Lokring. The big issue as a verifier, is you have to have the inspection marks to confirm proper installation. I don't think that there would be time to use the proper marking gauge on the pipe if 50 psi is shooting out of it. Pre-marking the pipe could be an option, but it isn't covered in the manufacturer instructions that I know of. 

2. My personal opinion is it doesn't seem like a safe activity.

Assuming it is a category 1 Facility, the Facility needs to take into account 5.1.1.2 

The loss of the piped gas or piped vacuum systems is likely to cause major injury or death of patients, staff, or visitors.

There will be a temporary loss of pressure (or drop), is that acceptable? The bigger question for me is, what happens if this process doesn't work as anticipated? If there are leaks at the end, do we need a shutdown anyway? If a tool breaks, or fitting, or whatever (and now 50psi is escaping the pipe), what is the backup plan? Also with all of these questions, assuming there is a back up plan, will the Safety dept or the AHJ sign off on the process, after being educated to the risks involved?

3. Not necessarily that I can think of. See #2, 

4. Could the AHJ approve this install? For sure. Will they? Not in my neck of the woods. Just to restate, the Facility needs to be aware of the inherent risks of this procedure and draw their own conclusions.

5. Good for you for advocating and asking questions for you Facility and their patients!   

YES WITH THE PRIOR WRITTEN APPROVAL FROM THE AHJ:

Below From: The NFPA 99 Code - The 2012 Edition

(As a whole this is not the hospital)

3.3.65  Governing Body. The person or persons who have the overall legal responsibility for the operation of a health care facility. (FUN)

(This is the hospital, in most states the CEO and / or The Safety Director of the facility)  

Please review the newer 2021 Edition of The NFPA 99 Code.

ANNEX: A.3.2.2 + A3.3.74 / In doing this you can get a clearer picture.