A composition comprising a functionalized substrate in the form of a medical device containing lumens, cavities, porous structures, or combinations thereof, the functionalized substrate having a polymeric undercoat immobilized thereon and a non-fouling polymeric topcoat copolymer covalently bound to the polymeric undercoat, the polymeric undercoat being between the functionalized substrate and the non-fouling polymeric topcoat copolymer, wherein more than 35 mole % of the polymerized monomers comprised by the non-fouling polymeric topcoat copolymer are polyether moieties or phosphorylcholine, sulfobetaine or carboxybetaine zwitterionic moieties, the polymeric undercoat and the non-fouling polymeric topcoat copolymer comprising complementary reactive functional groups wherein the non-fouling polymeric topcoat copolymer is covalently bound to the polymeric undercoat via covalent bonds formed by the complementary reactive functional groups.