Form 10-K
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 10-K
(Mark One)
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Annual report pursuant to Section 13 or 15 (d) of the Securities Exchange Act of 1934 |
For the fiscal year ended December 31, 2010
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Transition report pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 |
For the transition period from to
Commission File Number 0-19437
SAFESTITCH MEDICAL, INC.
(Exact name of registrant as specified in its charter)
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Delaware
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11-2962080 |
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(State or other jurisdiction of
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(I.R.S. Employer Identification No.) |
incorporation or organization) |
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4400 Biscayne Blvd., Suite 670, Miami, Florida, 33137
(Address of principal executive offices) (Zip Code)
Registrants telephone number, including area code: (305) 575-4600
Securities registered pursuant to Section 12(b) of the Exchange Act: None
Securities registered pursuant to Section 12(g) of the Exchange Act:
Common Stock, $0.001 par value per share
(Title of Class)
Indicate by check mark whether the registrant is a well-known seasoned issuer, as defined in
Rule 405 of the Securities Act. o
Indicate by check mark whether the registrant is not required to file reports pursuant to
Section 13 or 15(d) of the Exchange Act. o
Indicate by check mark whether the registrant (1) has filed all reports required to be filed
by Section 13 or 15(d) of the Exchange Act during the past 12 months (or for such shorter
period that the registrant was required to file such reports), and (2) has been subject to
the filing requirements for the past 90 days. Yes þ No o
Indicate by check mark whether the registrant has submitted electronically and posted on its
corporate Website, if any, every Interactive Data file required to be submitted and posted
pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12
months (or for such shorter period that the registrant was required to submit and post such
files). Yes o No o
Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation
S-K is not contained herein, and will not be contained, to the best of registrants
knowledge, in definitive proxy or information statements incorporated by reference in Part
III of this Form 10-K or any amendment to this Form 10-K. þ
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated
filer, a non-accelerated filer, or a smaller reporting company See the definitions of large
accelerated filer, accelerated filer and smaller reporting company in Rule 12b-2 of the
Exchange Act.
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Large accelerated filer o
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Accelerated filer o
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Non-accelerated filer o
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Smaller reporting company þ |
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of
the Exchange Act) Yes o No þ
The aggregate market value of the voting and non-voting common equity held by non-affiliates
computed by reference to the average bid and asked price of such common equity, as of June
30, 2010, was: $9.5 million
As of March 28, 2011 there were 28,003,755 shares of Common Stock, $0.001 par value per
share, outstanding.
DOCUMENTS INCORPORATED BY REFERENCE
Part III of this Annual Report on Form 10-K is incorporated by reference to our Definitive
Proxy Statement on Schedule 14A to be filed in respect of our 2011 Annual Meeting of
Stockholders.
SAFESTITCH MEDICAL, INC.
TABLE OF CONTENTS FOR FORM 10-K
2
CAUTIONARY STATEMENT REGARDING FORWARD-LOOKING STATEMENTS
This Annual Report on Form 10-K contains certain forward-looking statements about our
expectations, beliefs or intentions regarding, among other things, our product development and
commercialization efforts, business, financial condition, results of operations, strategies or
prospects. You can identify forward-looking statements by the fact that these statements do not
relate strictly to historical or current matters. Rather, forward-looking statements relate to
anticipated or expected events, activities, trends or results as of the date they are made.
Because forward-looking statements relate to matters that have not yet occurred, these statements
are inherently subject to risks and uncertainties that could cause our actual results to differ
materially from any future results expressed or implied by the forward-looking statements. Many
factors could cause our actual activities or results to differ materially from the activities and
results anticipated in forward-looking statements. These factors include those set forth below as
well as those contained in Item 1A Risk Factors of this Annual Report on Form 10-K. We do not
undertake any obligation to update forward-looking statements, except as required by applicable
law. These forward-looking statements are only predictions and reflect our views as of the date
they are made with respect to future events and financial performance.
Risks and uncertainties, the occurrence of which could adversely affect our business, include
the following:
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We have a history of operating losses and we do not expect to become profitable in the
near future. |
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Healthcare policy changes, including recently enacted legislation reforming the U.S.
healthcare system, may have a material adverse effect on our financial condition and
results of operations. |
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The continuing worldwide economic and market instability may materially and adversely
affect the demand for our products and, if and when approved, our product candidates, as
well as our ability to obtain credit or secure funds through sales of our stock, which may
materially and adversely affect our business, financial condition and ability to fund our
operations. |
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We will require substantial additional funding, which may not be available to us on
acceptable terms, or at all. |
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Some of our technologies are in an early stage of development and are unproven. |
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Our research and development activities may not result in commercially viable products. |
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The results of previous clinical experience with our devices and with devices similar to
those that we are developing may not be predictive of results with our products and product
candidates, and any clinical trials that the U.S. Food and Drug Administration (the FDA)
may require us to undertake may not satisfy FDA requirements or the requirements of other
non-U.S. regulatory authorities. |
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We are highly dependent on the success of our products and product candidates, and we
cannot give any assurance that our product candidates will receive regulatory clearance or
that any of our products and future products will be successfully commercialized. |
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If our competitors develop and market products that are more effective, safer or less
expensive than our products and future products, our commercial opportunities will be
negatively impacted. |
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Our product development activities could be delayed or stopped. |
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The regulatory clearance and approval processes are expensive, time-consuming and
uncertain and may prevent us or our collaboration partners from obtaining clearances or
approvals, as the case may be, for the commercialization of some or all of our product
candidates. |
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Failure to recruit and enroll patients for clinical trials may cause the development of
our product candidates to be delayed. |
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Independent clinical investigators and contract research organizations that we engage to
conduct our clinical trials may not be diligent, careful or timely. |
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Even if we obtain regulatory clearances or approvals for our product candidates, the
terms thereof and ongoing regulation of our products may limit how we manufacture and
market our products and product candidates, which could materially impair our ability to
generate anticipated revenues. |
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Even if we obtain regulatory clearances or approvals to market our product candidates,
the market may not be receptive to our products, or third-party payors, including
government payors, may not provide coverage for our products or for procedures using our
products, which could undermine our financial viability. |
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If we fail to attract and retain key management and scientific personnel, we may be
unable to successfully develop or commercialize our product candidates. |
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As we are evolving from a company primarily involved in development to a company also
involved in commercialization, we may encounter difficulties in managing our growth and
expanding our operations successfully. |
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If we fail to acquire and develop other products or product candidates at all or on
commercially reasonable terms, we may be unable to diversify or grow our business. |
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We rely on third parties to manufacture and supply our products, and we will rely on
third parties to manufacture and supply our product candidates, and an inability to find
additional or alternate sources for our products could materially and adversely affect our
financial condition and results of operations. |
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We currently have a limited sales, marketing and distribution organization. If we are
unable to develop our sales and marketing and distribution capability on our own or through
collaborations with marketing partners, we will not be successful in commercializing our
product candidates. |
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The success of our business may be dependent on the actions of our collaborative
partners. |
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We rely heavily on licenses from third parties, particularly our license with Creighton
University (Creighton), and any loss of our rights under such license agreements could
materially adversely affect our business prospects. |
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Most of our patent rights are licensed to us by Creighton. If we or Creighton do not
properly maintain or enforce the patent applications underlying this license, or if we lose
our rights under this license, our competitive position and results of operations will be
materially adversely affected. |
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If we or our licensors are unable to obtain and enforce patent protection for our
products and product candidates, our business could be materially harmed. |
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If we or our licensors are unable to protect the confidentiality of our proprietary
information and know-how, the value of our technology and products could be adversely
affected. |
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Some jurisdictions may require us or our licensors to grant licenses to third parties.
Such compulsory licenses could be extended to include some of our products and product
candidates, which may limit our potential revenue opportunities. |
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Our commercial success depends significantly on our ability to operate without
infringing the patents and other proprietary rights of third parties. |
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If we become involved in patent litigation or other proceedings related to a
determination of rights, we could incur substantial costs and expenses, substantial
liability for damages or be required to stop our product development and commercialization
efforts, any of which could materially adversely affect our liquidity, business prospects
and results of operations. |
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Medicare legislation and future legislative or regulatory reform of the health care
system may affect our ability to sell our products profitably. |
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Failure to obtain regulatory clearance or approval outside the United States will
prevent us from marketing our product candidates abroad. |
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Non-U.S. governments often impose strict price controls, which may adversely affect our
future profitability. |
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Our business may become subject to economic, political, regulatory and other risks
associated with international operations. |
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The market price of our common stock has been, and may continue to be, highly volatile,
and such volatility could cause the market price of our common stock to decrease and could
cause you to lose some or all of your investment in our common stock. |
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Trading of our common stock is limited, and trading restrictions imposed on us by
applicable regulations may further reduce trading in our common stock, making it difficult
for our stockholders to sell their shares, and future sales of our common stock could
reduce our stock price. |
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Because our common stock may be a penny stock, it may be more difficult for investors
to sell shares of our common stock, and the market price of our common stock may be
adversely affected. |
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Directors, executive officers, principal stockholders and affiliated entities own a
significant percentage of our capital stock, and they may make decisions that you do not
consider to be in your best interests or in the best interests of our stockholders. |
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Compliance with changing regulations concerning corporate governance and public
disclosure may result in additional expenses. |
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PART I
Unless the context otherwise requires, all references in this Annual Report on Form 10-K to
the Company, SafeStitch, we, our, ours, and us refer to SafeStitch Medical, Inc., a
Delaware corporation (formerly Cellular Technical Services Company, Inc.), including our
wholly-owned subsidiaries, SafeStitch LLC, a Virginia limited liability company, and Isis
Tele-Communications, Inc., a Delaware corporation with no operating business.
More
information about us may be found at our website:
www.SafeStitch.com. Information
contained on our website is not incorporated by reference and does not comprise a part of this
Annual Report on Form 10-K. Please refer to page 19 for a glossary of certain medical terms used
in this Annual Report on Form 10-K.
General
We were originally incorporated in August 1988 as NCS Ventures Corp. under the laws of the
State of Delaware, after which our name changed to Cellular Technical Services Company, Inc. On
September 4, 2007, we acquired SafeStitch LLC, and, in January 2008, we changed our name to
SafeStitch Medical, Inc.
Company Overview
We are a developmental stage FDA-registered medical device company focused on the development
of medical devices that manipulate tissues for the treatment of obesity, gastroesophageal reflux
disease (GERD), hernia formation, esophageal obstructions, Barretts Esophagus, upper
gastrointestinal bleeding, and other intraperitoneal abnormalities through endoscopic and minimally
invasive surgery.
We have utilized our expertise in intraperitoneal surgery to test certain of our devices in in
vivo and ex vivo animal trials and ex vivo human trials, and with certain products, in limited in
vivo human trials. Certain of our products did not or may not require clinical trials, including
our AMID Stapler®, SMART DilatorTM, and standard and airway bite blocks. Where
required, we intend to rapidly, efficiently and safely move into clinical trials for certain other
devices, including those utilized in surgery for the treatment of obesity, GERD and for the
treatment and diagnosis of Barretts Esophagus. Preliminary clinical trials for our gastroplasty
product candidates began in the third quarter of 2010 and are expected to continue starting in the
second half of 2011. Sales of our AMID Stapler® are anticipated to begin in the second half of
2011.
Our goal in designing surgical devices is to accomplish one or more of the following surgical
goals:
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Increased effectiveness; |
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Fewer complications; and |
We believe that we can accomplish these goals by developing devices that, among other things,
allow the endoscopic performance of certain types of surgery that are currently performed through
an abdominal incision, including laparoscopically. Devices such as these are expected to reduce
the need for inpatient hospital stay and decrease the likelihood of complications and their
associated costs.
We plan to use our endoscopic, laparoscopic and general surgery experience, our internal
product design expertise and our relationships with third-party product developers to further
develop a pipeline of surgical devices to be utilized in treating intraperitoneal abnormalities
such as gallstones, appendicitis, cancer of the intestinal tract, kidney cancer, trauma,
reproductive disease tumors and liver conditions.
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Dr. Charles J. Filipi, our Chief Medical Officer, has been a pioneer in laparoscopic surgery
and endoluminal surgery at Creighton and is past president of the American Hernia Society. He has
been the lead physician responsible for the development of our product candidates, and he has
relationships with a number of physicians who are experts in these fields. We believe that Dr.
Filipi will be able to utilize his expertise and these relationships to facilitate device
development and the opportunities mentioned above. Some of these experts are part of our medical
advisory board.
Market Opportunities
We believe the market for our products and product candidates is driven by:
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The aging and heavier population; |
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An active and increased life expectancy among the aging baby-boomer generation; |
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Painful and expensive surgical procedures with a moderate to high incidence of
complications; |
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Increasing need to treat obesity, GERD, Barretts Esophagus and other intraperitoneal
abnormalities; and |
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An increased awareness of the benefits of minimally invasive surgery. |
Our lead product candidates are designed for use in operations necessitated in large part by
obesity. The incidence of obesity (defined as 100 pounds over ideal body weight) is increasing,
despite increased public awareness of the health risks associated with obesity and the growth of
the diet and fitness industries. According to recent surveys and medical journal reports, roughly
25% of the U.S. population is considered obese. Some estimates project that 100 million Americans,
or approximately 35% of the anticipated U.S. population, will be obese by the year 2017. The
incidence of obesity is increasing not only in the U.S., but is becoming a problem world-wide,
including in newly industrialized countries such as China and India.
Current treatment options for obesity include exercise and dieting, prescription drugs and
bariatric surgical alternatives. Exercise and dieting are often not successful, and, if
successful, the results are often not permanent. In addition, although there are a number of drug
alternatives currently in the market for treating obesity, they often result in moderate weight
loss (typically no more than 10% of body weight).
As a result of the foregoing, bariatric surgery has become more prevalent as an alternative.
An estimated 350,000 to 400,000 bariatric surgical procedures are performed annually worldwide.
Bariatric surgery is usually recommended for those people with a body mass index (BMI) of 35 or
higher or for those who are approximately 100 pounds overweight. Currently the most common
bariatric surgery methods include gastric bypass, gastric banding and gastroplasty. Gastric bypass
combines the creation of a small stomach pouch to restrict food intake and the construction of
bypasses of the duodenum and other segments of the small intestine, thereby decreasing the bodys
ability to absorb nutrients from food. In gastric banding procedures, a small inflatable/dilatable
band (which allows adjustment to the size of the opening between the pouch and the stomach) is
placed around the upper part of the stomach, creating a small pouch, so that patients feel full
sooner. In vertical banding gastroplasty procedures, or stomach stapling, a band and staples are
used to create a small stomach pouch. These procedures are expensive, require significant
incisions and have a moderate to high level of complications.
Our lead product candidates can also be used to treat GERD and GERD-related complications such
as Barretts Esophagus. In GERD patients, the esophageal junction does not close completely and
acid or bile from the stomach enters the esophagus. Both the hydrochloric acid and bile from the
stomach can damage the esophagus. A significant portion of the adult population in the United
States suffers GERD symptoms. Left untreated for a prolonged period of time, GERD can lead to
complications such as Barretts Esophagus, a precancerous change to the thin layer of tissue lining
the esophagus. Barretts Esophagus can develop into a relatively rare, but often deadly type of
cancer of the esophagus. Worldwide, there are approximately 200,000 250,000 GERD or acid reflux
surgical or transoral procedures performed annually. We believe that none of the currently
available outpatient endoscopic procedures have proven effective in reversing inflammation of the
esophagus or the amount of acid reflux. Another common GERD complication is scar tissue in the
esophagus that inhibits the movement of swallowed food and drink. This and other types of
esophageal restrictions are treated by inserting a dilator tube or
inflatable balloon at the stricture and dilating the esophagus. Approximately 2 million
esophageal dilations are performed annually worldwide, and 20 million endoscopies are performed
annually worldwide. Endoscopies require a bite block to protect both the endoscope and the
patients teeth.
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Our AMID Stapler® is designed for use in open surgical repair of both inguinal (groin) and
ventral (abdominal) hernias. Hernias impact approximately 1% of the worlds population, and
roughly 800,000 inguinal hernias are repaired annually in the United States. Greater than 80% of
the surgeries worldwide for this most common form of hernia are performed using the Lichtenstein
Hernia Repair, whereby a surgeon repairs and reinforces the abdominal wall by affixing mesh through
an open incision. Hernias are also repaired through open incision without affixing mesh, and
laparoscopically either with or without mesh reinforcement.
Products
The AMID Stapler®
We developed the AMID Stapler® in cooperation with Dr. Parviz Amid, a pioneer of and renowned
expert in the Lichtenstein Hernia Repair. This stapler uses non-absorbable titanium staples to
repair inguinal (groin) or ventral (abdominal) hernias. The staples are used to fix mesh in place,
which helps prevent the recurrence of a hernia. In November 2009, we received FDA clearance to
market the AMID Stapler® in the U.S. as a Class II device, and, in February 2010, we received CE
Mark clearance to market the stapler in the European Union and other countries requiring CE
clearance. After we commenced production of the AMID Stapler® in 2010, we voluntarily suspended
sales in order to implement several design improvements and a more robust and reliable commercial
manufacturing process. As a result of these design improvements, we will submit a Special 510(k)
to FDA for clearance prior to marketing the AMID Stapler® in the United States. Additionally, we
will supplement our Technical File prior to marketing the AMID Stapler® in the European Union. We
expect to begin commercial sales of the AMID Stapler® in the second half of 2011.
SMART DilatorTM
Dilators are used when an endoscopy demonstrates the narrowing of the esophagus. Narrowing
may be treated by administering GERD medication or by using a dilator to expand the esophagus.
Approximately 800,000 dilations are performed in the United States each year. Studies have
estimated that approximately 10,000 instances of perforation of the esophagus occur annually as a
result of esophageal dilation. According to peer-reviewed literature, dilation results in a
0.5-1.0% perforation rate. Untreated perforation of the esophagus is fatal, usually within two
days. Research indicates that, during dilation, the physician should place no greater than two
pounds of pressure on the dilator. Our SMART DilatorTM has a handle that changes from
green to yellow and then to red, providing the physician a visual indicator of how close he or she
is to the recommended two pound limit. Additionally, the SMART DilatorTM handle locks
in place when the force applied to the dilator exceeds 2.5 pounds of pressure. While there are
numerous dilators on the market, we believe none include a feedback mechanism similar to that
contained in the SMART DilatorTM.
In February 2009, we received FDA clearance to market the SMART DilatorTM in the
U.S. as a Class II device, and we are currently evaluating commercialization options.
Bite Blocks
A bite block is used to protect the endoscope used in transoral gastrointestinal procedures
and is required in all such procedures. A number of bite blocks are on the market.
Standard Bite Block. Our Standard Bite Block is designed with a bigger lip and slightly
different aperture than other bite blocks on the market. Because this is a Class I device,
significant testing has not been necessary; however, in 2008, Creighton University Medical Center
performed a bite block study to test for comfort during endoscopic procedures in in vivo human
patients. This is a Class I 510(k)-exempt device that requires no preclearance from the FDA prior
to marketing.
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Airway Bite Block. The Airway Bite Block contains a built-in airway that assists breathing in
patients with larger tongues or smaller throats, usually because of obesity, during an endoscopic
procedure. The Airway Bite Block was also tested following Institutional Review Board (IRB)
approval at Creighton University Medical Center in 2008. The Airway Bite Block will come in two
sizes. This is a Class I 510(k)-exempt device that requires no preclearance from the FDA prior to
marketing.
We are currently evaluating commercialization options for the Standard and Airway Bite Blocks.
Product Candidates
We have prioritized our product development efforts on those candidates aimed at opportunities
within gastroenterology, in which attractive markets combine with an emerging understanding of
intraluminal surgery. In that regard, our key product candidates focus on obesity and
obesity-related conditions, as well as other intraperitoneal abnormalities, which often may be
treated by bariatric surgery.
Intraluminal Gastroplasty Device for Obesity and GERD (Gastroplasty Device)
Our Gastroplasty Device consists of a set of instruments designed to perform incision-less,
endoscopic surgery by introduction through the mouth and esophagus. Bariatric and GERD surgeries
are generally performed through an external abdominal incision, and sometimes laparoscopically.
The traditional surgery has the potential for significant complications, requires an in-patient
hospital stay and is expensive.
The Gastroplasty Device is the most tested of our devices, and our testing to date has
demonstrated its effectiveness. In animal tests and ex vivo human testing, the Gastroplasty Device
has been successful in obesity surgeries for suturing and excising tissue and reducing stomach
size. We have tested a prototype in two patients with the approval of the IRB at Creighton
University Medical Center, and we have successfully tested our first investigational devices in
five patients in Hungary, and in which follow up observations were reviewed in March 2011
approximately six months following the initial procedure. At the six month follow-up, we observed,
through endoscopic visualization, that the operative site showed significant scar tissue as
intended with the scar forming a restrictive ring for weight loss for the treatment of obesity or
in the case of GERD, a barrier to prevent acid from refluxing into the esophagus. We also observed
that the weight loss and esophageal monitoring was satisfactory and as expected. We expect to
continue in vivo human testing of this device in the United States during the second half of 2011,
following anticipated FDA review of our clinical trial protocols. We are preparing separate GERD
and obesity clinical trial protocols for this device and anticipate submitting the final
investigational device exemption (IDE) trial plans to the FDA for review by the end of the first
half of 2011. We intend to apply for clearance of the Gastroplasty Device for both GERD and
obesity by the FDA in accordance with all applicable requirements.
Barretts Excision and Ablation Device for Treatment and Diagnosis (Barretts Device)
Barretts Esophagus, which may be caused by GERD, is a condition in which the lining of the
esophagus imitates the stomach mucosa, beginning at the esophageal junction and migrating upward.
Barretts esophageal tissue is pre-cancerous and can result in difficulty in swallowing, malignancy
and death. Our Barretts Device is designed to assist in both the diagnosis of and treatment of
Barretts Esophagus.
Existing treatments include medication, laparoscopic surgery and cauterization. The Barretts
Device allows the mucosa to be suctioned, sliced off and tested. The device also allows for
cauterization of the affected area. No incision will be required, and the procedure will be an
outpatient procedure. We expect this device to be more effective and less costly than existing
procedures.
In more than ten in vivo and ex vivo animal tests and five ex vivo human tests, the Barretts
Device has successfully excised tissue with the desired width, length, depth and contour. We
expect to conduct the first human testing of the Barretts Device in 2012 following submission and
review by FDA of an IDE for trials of this device.
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T Fasteners for Upper GI Bleeding (T Fastener Gun)
The T Fastener Gun delivers small metal fasteners at the end of an endoscope. We believe that
our T Fastener Gun can provide full-thickness stomach wall suturing for control of gastric
bleeding. Existing devices apply energy or clips that are often too superficial, resulting in
rebleeding. The T Fastener suture end is tightened, and because of its full thickness bite, a
larger amount of tissue will compress the bleeding vessel.
The T Fastener Gun is in an early stage of development and has undergone in vivo and ex vivo
animal studies. These tests have established the feasibility of the T Fastener Gun. We believe
this device is a Class II 510(k) device that will require IDE clinical data to support a premarket
notification for FDA clearance.
Novel Devices for Natural Orifice Transluminal Endoscopic Surgery (NOTES)
Natural Orifice Transluminal Endoscopic Surgery or NOTES is a new method of operating in the
abdominal cavity without making an incision in the abdominal wall. This surgery is also referred
to as NO SCAR surgery. The natural orifices used in this type of procedure are the mouth and the
rectum and, in females, the vagina. If the mouth is used, instruments are passed through this
natural orifice out of the stomach and into the abdominal cavity.
NOTES includes surgeries for gallbladder removal, appendectomy, tubal ligation, removal of
intestinal and reproductive organ cancer and hernia repair, all through the gastric, rectal or
vaginal walls. Surgery utilizing the NOTES approach requires stabilization of long flexible
instruments and the organs to be operated upon. We have received a license from Creighton for a
patent application for a magnetic gallbladder retractor that would enable improved operative
exposure for gallbladder removal, as well as other devices to assist in NOTES procedures. We have
not yet begun development of devices utilizing this technology.
Intellectual Property
We have exclusively licensed technology, know-how and patent applications from Creighton for
most of our products and product candidates. These applications include systems and techniques for
minimally invasive gastrointestinal procedures, a dilator for use with an endoscope, bite blocks
for use with an endoscope and for preserving airways of patients during endoscopy and the
T-Fastener Gun. In addition, we have certain rights to other Creighton intellectual property that
we have not yet defined as product candidates. In total, we have seven patent applications pending
in the United States, including six that are exclusively licensed from Creighton. We are also
pursuing several of these applications in other countries, and two such foreign patents have been
issued.
Pursuant to our exclusive license and development agreement with Creighton (the Creighton
Agreement), we own all inventions conceived of and reduced to practice solely by our employees and
agents, and all patent applications and patents claiming such inventions developed without the use
of any licensed patent rights or associated know-how, and Creighton owns all inventions conceived
of and reduced to practice solely by Dr. Filipi, or any university employees or agents who work
directly with Dr. Filipi in the course of performing duties for us, and all patent applications and
patents claiming such inventions, which inventions, patent applications and all resulting licensed
patent rights are subject to the exclusive license and development agreement. Together with the
university, we jointly own all inventions conceived of and reduced to practice jointly by Dr.
Filipi, and/or any university employees or agents who work directly with him and our employees or
agents. Notwithstanding the foregoing, the university owns all inventions conceived of or reduced
to practice under the research and development budget, and all patent applications and patents
claiming such inventions, even if conceived of solely by our employees or agents, and such
inventions, patent applications and all resulting licensed patent rights are subject to the
Creighton Agreement.
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Creighton is obligated to file, prosecute and maintain all licensed patents and all patent
applications and patents disclosing and claiming inventions made in whole or in part by university
employees, agents or contractors resulting from the research and development the university engages
in on our behalf in such countries as we designate. We have the right, but not the obligation, at
our sole expense, to enforce our licensed patent rights and associated know-how under the Creighton
Agreement against any infringer, including the right to file suit for patent
infringement naming Creighton as a party, and the right to settle such suit with the
universitys consent, which shall not be unreasonably withheld. Creighton is entitled to 1.5% of
any amount collected as a result of such judgment or settlement. In the event that we choose not
to file suit for patent infringement within 180 days after becoming aware of infringement,
Creighton has the right, but not the obligation, at its sole expense, to enforce the licensed
patent rights and associated know-how against any infringer, including the right to file suit for
patent infringement naming us as a party, and the right to settle such suit with our consent, which
shall not be unreasonably withheld. The university shall pay us 1.5% of any amount collected as a
result of such judgment or settlement.
We believe that technological innovation is driving breakthroughs in the surgical markets that
we intend to service. We have adopted a comprehensive intellectual property strategy that blends
our efforts toward focused innovation with our business development activities designed to
strategically in-source intellectual property rights.
We intend to develop, protect and defend our own intellectual property rights as dictated by
the developing competitive environment. We value our intellectual property assets and believe we
have benefited from our relationship with Creighton and Dr. Filipi.
Licenses and Collaborative Relationships; Research and Development
Our strategy is to develop a portfolio of product candidates through a combination of internal
development and external partnerships. Collaborations are key to our strategy, and, on May 26,
2006, we entered into the Creighton Agreement, which grants us the right to license and sublicense
most of our product candidates and associated know-how, including the exclusive right to
manufacture, use and sell the product candidates. The foregoing license is exclusive even with
respect to Creighton. Pursuant to the Creighton Agreement, we are obligated to pay Creighton, on a
quarterly basis, a royalty of 1.5% of the revenue collected worldwide from the sale of any product
licensed under the agreement, less certain amounts, including without limitation chargebacks,
credits, taxes, duties and discounts or rebates.
Creighton provides all necessary facilities, including animal research laboratories, to
accommodate Dr. Filipis research and development of licensed products and product candidates, and
we compensate Creighton for the use of such facilities in accordance with the Creighton Agreement.
We recorded expenses for 2010 and 2009 of $52,000 and $41,000, respectively, in satisfaction of the
indirect cost allowance equal to 20% of the direct and personnel costs for services conducted at
the university or company facilities located within 100 miles of Omaha, Nebraska. Also pursuant to
the agreement, the university agreed that Dr. Filipi will devote at least 90% of his working time
during the four-year period that began May 26, 2006, and at least 50% of his time during the two
years thereafter, towards the research and development of any licensed product or product candidate
under the agreement, including the development of any such product to a final design and prototype
as a commercially viable product. The agreement further provides that Dr. Filipi shall assist us
with the prosecution of any and all patent applications related to any such products developed
under the agreement.
We agreed to invest, in the aggregate, at least $2.5 million over 36 months towards
development of any licensed product, not including the first $150,000 of costs related to the
prosecution of patents, which we have done. Through December 31, 2010, we had invested $9.1
million in the licensed products, inclusive of our costs to date relating to prosecution of
patents. Pursuant to the Creighton Agreement, we are entitled to exercise our own business
judgment and sole and absolute discretion over the marketing, sale, distribution, promotion, or
other commercial exploitation of any licensed products, provided that if we have not commercially
exploited or commenced development of a licensed patent and its associated know-how by the seventh
anniversary of the later of the date of the agreement or the date such technology is disclosed to
and accepted by us, then the licensed patent and associated know-how shall revert back to the
university, with no rights retained by us, and the university will have the right to seek a third
party with whom to commercialize such patent and associated know-how, unless we purchase one or
more one-year extensions. In addition to the expenses incurred in connection with the Creighton
Agreement, we have incurred research and development costs and expenses of $2.7 million and $1.2
million for the years ended December 31, 2010 and 2009, respectively.
In January 2007, we signed a consulting agreement with Dr. Parviz Amid to help us develop a
stapler for hernia repair. Dr. Amid is past president of the American Hernia Society and a pioneer
of and renowned expert in the Lichtenstein hernia repair. Under this agreement, we have agreed to
pay Dr. Amid a 4% royalty based on the
worldwide net sales of any product developed by us with his assistance, including the AMID
Stapler®, for a period of ten years from the first commercial sale of each such product.
11
Competition
The market for our products is highly competitive due to the large number of products
competing for market share and significant levels of commercial resources being utilized to promote
those products. The following table sets forth some of the companies whose products we expect to
compete with our products and product candidates:
|
|
|
Product or Product Candidate |
|
Significant Competitor(s) |
|
|
|
Gastroplasty Device
|
|
USGI Medical, Satiety, Endo Gastric
Solutions, Inc. and Medigus, Ltd. |
|
|
|
Barretts Device
|
|
Olympus Medical Equipment Services
America, Inc. and BARRX Medical, Inc. |
|
|
|
AMID Stapler®
|
|
Covidien and Ethicon, Inc. |
|
|
|
SMART DilatorTM
|
|
Boston Scientific Corporation, Cook
Medical Supply, Inc., Miller Medical
Specialties and U.S. Endoscopy |
|
|
|
Standard and Airway Bite Blocks
|
|
Bard, LLC, ConMed Corporation, U.S.
Endoscopy, Omni Medical Supply, Inc. and
Olympus Medical Equipment Services
America, Inc. |
|
|
|
T Fastener Gun
|
|
Cook Medical Supply, Inc. and Olympus
Medical Equipment Services America, Inc. |
In addition, our ability to compete may be affected because of the failure to educate
physicians or the level of physician expertise. This may have the effect of making our products
less attractive to buyers. Among the products with which we will directly compete, we expect to
differentiate on the basis of enhanced safety, effectiveness and efficiency, as well as lower cost,
in most cases. Several medical device companies are actively engaged in research and development
of treatments for gastrointestinal abnormalities similar to the gastrointestinal abnormalities that
are targeted by our product candidates. We cannot predict the basis upon which we will compete
with new products marketed by others. Many of our competitors have substantially greater
financial, operational, sales and marketing and research and development resources than we have.
As indicated, there are also other methods to treat obesity, such as diet, exercise and
medicine. Other competitors have developed products such as medical implants that occupy volume in
the stomach to promote the feeling of satiety (Helioscopie) or gastric sleeves to reduce food
intake.
Government Regulation of our Medical Device Development Activities
Healthcare is heavily regulated by the federal government and by state and local governments.
The federal laws and regulations affecting healthcare change constantly thereby increasing the
uncertainty and risk associated with any healthcare-related venture.
The federal government regulates healthcare through various agencies, including but not
limited to the following: (i) the FDA, which administers the Food, Drug, and Cosmetic Act (FD&C
Act), as well as other relevant laws; (ii) the Centers for Medicare & Medicaid Services (CMS),
which administers the Medicare and Medicaid programs; (iii) the Office of Inspector General
(OIG), which enforces various laws aimed at curtailing fraudulent or abusive practices including,
by way of example, the Anti-Kickback Law, the Anti-Physician Self-Referral Law (commonly referred
to as the Stark Law), the Anti-Inducement Law, the Civil Money Penalty Law, and the laws that
authorize the OIG to exclude health care providers and others from participating in federal
healthcare programs; and (iv) the Office of Civil Rights, which administers the privacy aspects of
the Health Insurance Portability and Accountability Act of 1996 (HIPAA). All of the aforementioned are
agencies within the Department of Health and Human Services (HHS). Healthcare is also provided
or regulated, as the case may be, by the Department of Defense through its TriCare program, by the
Department of Veterans Affairs under, among other laws, the Veterans Health Care Act of 1992, by
the Public Health Service within HHS under the Public Health Service Act, by the Department of
Justice through the Federal False Claims Act and various criminal statutes, and by state
governments under the Medicaid program and their internal laws regulating all healthcare
activities.
12
FDA Regulation of the Design, Manufacture and Distribution of Medical Devices
The testing, manufacture, distribution, advertising and marketing of medical devices are
subject to extensive regulation by federal, state and local governmental authorities in the United
States, including the FDA, and by similar agencies in other countries. Any product that we develop
must receive all relevant regulatory clearances or approvals, as the case may be, before it may be
marketed in a particular country. Under United States law, a medical device (device) is an
article, which, among other things, is intended for use in the diagnosis of disease or other
conditions, or in the cure, mitigation, treatment or prevention of disease, in man or other animals
(see FD&C Act § 201(h)). Substantially all of the devices being developed by SafeStitch are
classified as medical devices and subject to regulation by numerous agencies and legislative
bodies, including the FDA and its foreign counterparts.
Devices are subject to varying levels of regulatory control, the most comprehensive of which
requires that a clinical evaluation be conducted before a device receives clearance or approval for
commercial distribution. The FDA classifies medical devices into one of three classes. Class I
devices are relatively simple and can be manufactured and distributed with general controls. Class
II devices are somewhat more complex and require greater scrutiny. Class III devices are new and
frequently help sustain life.
In the United States, a company generally can obtain permission to distribute a new device in
two ways through a Section 510(k) premarket notification application (510(k) submission), or
through a Section 515 premarket approval (PMA) application. The 510(k) submission applies to any
device that is substantially equivalent to a Predicate Device (a device first marketed prior to
May 28, 1976 or a device marketed after that date which was substantially equivalent to a pre-May
28, 1976 device). These devices are either Class I or Class II devices. Under the 510(k)
submission process, the FDA will issue an order finding substantial equivalence to a Predicate
Device and permitting commercial distribution of that device for its intended use. A 510(k)
submission must provide information supporting its claim of substantial equivalence to the
Predicate Device. The FDA permits certain low risk medical devices to be marketed without
requiring the manufacturer to submit a premarket notification. In other instances, the FDA may not
only require that a premarket notification be submitted, but also that such notification be
accompanied by clinical data. If clinical data from human experience are required to support the
510(k) submission, these data must be gathered in compliance with IDE regulations for
investigations performed in the United States. The FDA review process for premarket notifications
submitted pursuant to section 510(k) should take about 90 days on average, but it can take
substantially longer if the agency has concerns. Furthermore, there is no guarantee that the
agency will clear the device for marketing, in which case the device cannot be distributed in the
United States. There is not any guarantee that the agency will deem the article subject to the
510(k) process, as opposed to the more time-consuming, resource intensive and problematic PMA
process described below.
The more comprehensive PMA approval process applies to a new device that is (a) not
substantially equivalent to a Predicate Device or (b) to be used in supporting or sustaining life
or preventing impairment. These devices are normally Class III devices and can only be marketed
following approval of a PMA. For example, most implantable devices are subject to the PMA approval
process. Two steps of FDA approval generally are required before a company can market a product in
the U.S. that is subject to Section 515 PMA approval, as compared to a Section 510(k) clearance.
First, a company must comply with IDE regulations in connection with any human clinical
investigation of the device; however those regulations permit a company to undertake a clinical
study of a non-significant risk device without formal FDA approval. Prior express FDA approval
is required if the device is a significant risk device. If there is any doubt as to whether a
device is a non-significant risk device, companies normally seek prior approval from the FDA.
Second, the FDA must review a companys PMA application, which contains, among other things,
clinical information acquired under the IDE. The FDA will approve the PMA
application if it finds there is reasonable assurance the device is safe and effective for its
intended use. The PMA process takes substantially longer than the 510(k) process.
13
We are currently in discussions with the FDA regarding the appropriate regulatory approval
pathway for our Gastroplasty Device for the treatment of GERD and for the treatment of obesity. We
have not yet sought final FDA approval to conduct any clinical studies of any of our licensed
products in the United States. There is no assurance that the FDA would permit us to conduct such
clinical studies and no assurance that the FDA would agree with our study design, statistical
methods or endpoints.
Even when a clinical study has been approved or cleared by the FDA or deemed approved, the
study is subject to factors beyond a manufacturers control, including, but not limited to the fact
that the institutional review board at a given clinical site might not approve the study, might
decline to renew approval which is required annually, or might suspend or terminate the study
before the study has been completed. The interim results of a study may also not be satisfactory,
leading the sponsor to terminate or suspend the study on its own initiative or the FDA may
terminate or suspend the study. There is no assurance that a clinical study at any given site will
progress as anticipated; there may be an insufficient number of patients who qualify for or agree
to participate in the study, or the investigator at the site may have priorities other than the
study. Also, there can be no assurance that the clinical study will provide sufficient evidence to
assure the FDA that the product is safe and effective, a prerequisite for FDA approval of a PMA, or
substantially equivalent in terms of safety and effectiveness to a predicate device, a prerequisite
for clearance under 510(k). Even if the FDA approves or clears a device, it may limit its intended
uses in such a way that manufacturing and distributing the device may not be commercially feasible.
After clearance or approval to market is given, the FDA and foreign regulatory agencies, upon
the occurrence of certain events, are authorized under various circumstances to withdraw the
clearance or approval or require changes to a device, its manufacturing process or its labeling or
additional proof that regulatory requirements have been met.
A manufacturer of a device approved through the PMA process is not permitted to make changes
which could affect the devices safety or effectiveness without first submitting a supplement
application to its PMA and obtaining FDA approval for that supplement. In some instances, the FDA
may require clinical trials to support a supplement application. A manufacturer of a device
cleared through a 510(k) submission must submit another premarket notification if it intends to
make a change or modification in the device that could significantly affect the safety or
effectiveness of the device, such as a significant change or modification in design, material,
chemical composition, energy source or manufacturing process. Any change in the intended uses of a
PMA device or a 510(k) device requires an approval supplement or cleared premarket notification.
Exported devices are subject to the regulatory requirements of each country to which the device is
exported, as well as certain FDA and other federal export requirements.
As a company that intends to manufacture medical devices, we are required to register with the
FDA before we begin to manufacture devices for commercial distribution. As a result, we and any
entity that manufactures products on our behalf will be subject to periodic inspection by the FDA
for compliance with the FDAs Quality System Regulation requirements and other regulations. In the
European Union, we will be required to maintain certain International Organization for
Standardization (ISO) certifications in order to sell products and we and/or our manufacturers
must undergo periodic inspections by notified bodies to obtain and maintain these certifications.
These regulations require us and our manufacturers to manufacture products and maintain documents
in a prescribed manner with respect to design, manufacturing, testing and control activities.
Further, we are required to comply with various FDA and other agency requirements for labeling and
promotion. The Medical Device Reporting regulations require that we provide information to the FDA
whenever there is evidence to reasonably suggest that a device may have caused or contributed to a
death or serious injury or, if a malfunction were to occur, could cause or contribute to a death or
serious injury. In addition, the FDA prohibits us from promoting a medical device for unapproved
indications.
The FDA in the course of enforcing the FD&C Act may subject a company to various sanctions for
violating FDA regulations or provisions of the Act, including requiring recalls, issuing Warning
Letters, seeking to impose civil money penalties, seizing devices that the agency believes are
non-compliant, seeking to enjoin
distribution of a specific type of device or other product, seeking to revoke a clearance or
approval, seeking disgorgement of profits and seeking to criminally prosecute a company and its
officers and other responsible parties.
14
Recently Enacted Health Care Reform Legislation
Congress recently passed health care reform legislation that President Obama signed into law
in March 2010. The package signed into law by the President is considered by some to be the most
dramatic change to the countrys health care system in decades.
The principal aim of the law as currently enacted is to expand health insurance coverage to
approximately 32 million Americans who are currently uninsured. The laws most far-reaching
changes do not take effect until 2014, including a requirement that most Americans carry health
insurance. The effect of these significant coverage expansions on the sales of the Companys
products is unknown and speculative at this point.
The enacted legislation contains many provisions designed to generate the revenues necessary
to fund the coverage expansions. The most relevant of these provisions are those that impose fees
or taxes on certain health-related industries, including medical device manufacturers. Beginning
in 2013, each medical device manufacturer will have to pay an excise tax (or sales tax) in an
amount equal to 2.3 percent of the price for which such manufacturer sells its medical devices.
This tax applies to all medical devices, including the Companys products and product candidates.
The legislation as enacted also provides for increased enforcement of the fraud and abuse
regulations discussed below.
Third-Party Payments, Especially Payments by Medicare and Medicaid
A. Medicare and Medicaid Coverage
Because some of the projected patient population that could potentially benefit from our
devices is elderly, Medicare would likely be a potential source of reimbursement. Medicare is a
federal program that provides certain hospital and medical insurance benefits to persons age 65 and
over, certain disabled persons, persons with end-stage renal disease and those suffering from Lou
Gehrigs Disease. In contrast, Medicaid is a medical assistance program jointly funded by federal
and state governments and administered by each state pursuant to which benefits are available to
certain indigent patients. The Medicare and Medicaid statutory framework is subject to
administrative rulings, interpretations and discretion that affect the amount and timing of
reimbursement made under Medicare and Medicaid.
Medicare reimburses for medical devices in a variety of ways depending on where and how the
device is used. However, Medicare only provides reimbursement if CMS determines that the device
should be covered and that the use of the device is consistent with the coverage criteria. A
coverage determination can be made at the local level (Local Coverage Determination) by the
Medicare administrative contractor (formerly called carriers and fiscal intermediaries), a private
contractor that processes and pays claims on behalf of CMS for the geographic area where the
services were rendered, or at the national level by CMS through a National Coverage Determination.
There are statutory provisions intended to facilitate coverage determinations for new technologies
under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) §§ 731 and
942. Coverage presupposes that the device has been cleared or approved by the FDA and, further,
that the coverage will be no broader than the FDA approved intended uses of the device (i.e., the
devices label) as cleared or approved by the FDA, but coverage can be narrower. In that regard, a
narrow Medicare coverage determination may undermine the commercial viability of a device.
CMS has issued a National Coverage Determination with respect to bariatric surgery under which
CMS will cover the surgery only for treatment of co-morbidities associated with morbid obesity, and
only under the following conditions:
|
|
|
Medicare beneficiary has a body-mass index of 35 or greater; |
|
|
|
Medicare beneficiary has at least one co-morbidity related to obesity such as diabetes
or hypertension; |
|
|
|
Medicare beneficiary has been previously unsuccessful with medical treatment for
obesity; and |
|
|
|
Procedure is performed in an approved facility and the surgical procedure is of a type
expressly approved by CMS. |
15
It is unclear whether the type of bariatric surgery that would rely on our primary device
would be covered under the National Coverage Determination noted above.
Seeking to modify a coverage determination, whether local or national, is a time-consuming,
expensive and highly uncertain proposition, especially for a new technology, and inconsistent local
determinations are possible. On average, according to an industry report, Medicare coverage
determinations for medical devices lag 15 months to five years or more behind FDA approval for
respective devices. Moreover, Medicaid programs and private insurers are frequently influenced by
Medicare coverage determinations. Our inability to obtain a favorable coverage determination may
adversely affect our ability to market our products and thus, the commercial viability of our
products.
B. Reimbursement Levels
Even if Medicare and other third-party payor programs cover the procedures that use our
devices, the level of reimbursement may not be sufficient for commercial success. The Medicare
reimbursement levels for covered procedures are determined annually through two sets of
rulemakings, one for outpatient departments of hospitals under the Outpatient Prospective Payment
System (OPPS) and the other, for procedures in physicians offices under the Resource-Based
Relative Value Scales (RBRVS) (the Medicare fee schedule). If the use of a device is covered by
Medicare, a physicians ability to bill a Medicare patient more than the Medicare allowable amount
is significantly constrained by the rules limiting balance billing. For covered services in a
physicians office, Medicare normally pays 80% of the Medicare allowable amount and the beneficiary
pays the remaining 20%, assuming that the beneficiary has met his or her annual Medicare deductible
and is not also a Medicaid beneficiary. For services performed in an outpatient department of a
hospital, the patients co-payment under Medicare may exceed 20%, depending on the service and
depending on whether CMS has set the co-payment at greater than 20%. If a device is used as part
of an in-patient procedure, the hospital where the procedure is performed is reimbursed under the
Inpatient Prospective Payment System (IPPS). In general, IPPS provides a single payment to the
hospital based on the diagnosis at discharge and devices are not separately reimbursed under IPPS.
Usually, Medicaid pays less than Medicare, assuming that the state covers the service. In
addition, private payors, including managed care payors, increasingly are demanding discounted fee
structures and the assumption by healthcare providers of all or a portion of the financial risk.
Efforts to impose greater discounts and more stringent cost controls upon healthcare providers by
private and public payors are expected to continue.
Significant limits on the scope of services covered or on reimbursement rates and fees on
those services that are covered could have a material adverse effect on our ability to
commercialize our devices and therefore, on our liquidity and financial condition.
Anti-Fraud and Abuse Rule
There are extensive federal and state laws and regulations prohibiting fraud and abuse in the
healthcare industry that can result in significant criminal and civil penalties that can materially
affect us. These federal laws include, by way of example, the following:
|
|
|
The anti-kickback statute (Section 1128B(b) of the Social Security Act) prohibits
certain business practices and relationships that might affect the provision and cost of
healthcare services reimbursable under Medicare, Medicaid and other federal healthcare
programs, including the payment or receipt of remuneration for the referral of patients
whose care will be paid by Medicare or other governmental programs; |
|
|
|
The physician self-referral prohibition (Ethics in Patient Referral Act of 1989, as
amended, commonly referred to as the Stark Law, Sections 1877 and 1903(s) of the Social
Security Act), which prohibits referrals by physicians of Medicare or Medicaid patients to
providers of a broad range of designated healthcare services in which the physicians (or
their immediate family members) have ownership interests or with which they have certain
other financial arrangements; |
16
|
|
|
The anti-inducement law (Section 1128A(a)(5) of the Social Security Act), which
prohibits providers from offering anything to a Medicare or Medicaid beneficiary to induce
that beneficiary to use items or services covered by either program; |
|
|
|
The False Claims Act (31 U.S.C. § 3729 et seq.), which prohibits any person from
knowingly presenting or causing to be presented false or fraudulent claims for payment to
the federal government (including the Medicare and Medicaid programs); and |
|
|
|
The Civil Monetary Penalties Law (Section 1128A of the Social Security Act), which
authorizes the United States Department of Health and Human Services to impose civil
penalties administratively for fraudulent or abusive acts. |
Sanctions for violating these federal laws include criminal and civil penalties that range
from punitive sanctions, damage assessments, monetary penalties, imprisonment, denial of Medicare
and/or Medicaid payments or exclusion from the Medicare and/or Medicaid programs. These laws also
impose an affirmative duty on those receiving Medicare or Medicaid funding to ensure that they do
not employ or contract with persons excluded from Medicare and other government programs.
Many states have adopted or are considering legislative proposals similar to the federal fraud
and abuse laws, some of which extend beyond the Medicare and Medicaid programs, to prohibit the
payment or receipt of remuneration for the referral of patients and physician self-referrals
regardless of whether the service was reimbursed by Medicare or Medicaid. Many states have also
adopted or are considering legislative proposals to increase patient protections, such as limiting
the use and disclosure of patient specific health information. These state laws also impose
criminal and civil penalties similar to the federal laws.
In the ordinary course of their business, medical device manufacturers and suppliers have been
and are regularly subject to inquiries, investigations and audits by federal and state agencies
that oversee these laws and regulations. Recent federal and state legislation has greatly
increased funding for investigations and enforcement actions, which have increased dramatically
over the past several years. This trend is expected to continue. Private enforcement of
healthcare fraud also has increased due in large part to amendments to the civil False Claims Act
in 1986 that were designed to encourage private persons to sue on behalf of the government. These
whistleblower suits by private persons, known as qui tam relators, may be filed by almost anyone,
including present and former patients or nurses and other employees, as well as competitors.
HIPAA, in addition to its privacy provisions, created a series of new healthcare-related crimes.
As federal and state budget pressures continue, federal and state administrative agencies may
also continue to escalate investigation and enforcement efforts to root out waste and to control
fraud and abuse in governmental healthcare programs. A violation of any of these federal and state
fraud and abuse laws and regulations could have a material adverse effect on a suppliers liquidity
and financial condition. An investigation into the use of a device by physicians may dissuade
physicians from either purchasing or using the device. This could have a material adverse effect
on our ability to commercialize our devices.
The Privacy Provisions of HIPAA
HIPAA, among other things, protects the privacy and security of individually identifiable
health information by limiting its use and disclosure. HIPAA directly regulates covered
entities, such as healthcare providers, insurers and clearinghouses, and regulates business
associates, with respect to the privacy of patients medical information. All entities that
receive and process protected health information are required to adopt certain procedures to
safeguard the security of that information. It is uncertain whether we would be deemed to be a
covered entity under HIPAA and it is unlikely that we, based on our current business model, would
be a business associate. Nevertheless, we will likely be contractually required to physically
safeguard the integrity and security
17
of any patient information that we receive, store, create or transmit. If we fail to adhere to
our contractual commitments, then our physician or hospital customers may be subject to civil
monetary penalties, which could adversely affect our ability to market our devices. Recent changes
in the law wrought by the HITECH Act provisions of the American Recovery and Reinvestment Act of
2009 increase the duties of business associates and covered entities with respect to protected
health information, thereby subjecting them to direct government regulation, increasing their
compliance costs and their exposure to civil monetary penalties and other government sanctions.
While the new law does not alter the definition of a business associate, it makes it more likely
that covered entities with whom we are likely to do business will require us to enter into business
associate agreements.
Manufacturing
We have no commercial manufacturing facilities, and we do not intend to build our own
commercial manufacturing facilities in the foreseeable future. We have entered into and intend to
enter into agreements with third parties for the contract engineering services and the manufacture
of our products. We make prototypes and non-commercial components, device prototypes and
non-commercial finished devices of certain of our product candidates in our Miami, Florida
facilities for testing, including for limited use in animal or human clinical testing. We have
also entered into agreements with third party manufacturers for the manufacture of prototypes for
certain of our products. These suppliers and their manufacturing facilities must comply with FDA
regulations, current quality system regulations (referred to as QSRs), which include current good
manufacturing practices (cGMPs) or ISO certifications where applicable, and to the extent
laboratory analysis is involved, current good laboratory practices (cGLPs), where applicable.
Sales & Marketing
We currently have limited sales, marketing and distribution personnel. In order to
commercialize any products that are approved or cleared for commercial sale, we must either build a
sales and marketing infrastructure, collaborate with third parties possessing sales and marketing
experience or utilize a combination of internal and third party resources. We may build our own
sales and marketing infrastructure to market some of our product candidates, or we may collaborate
with companies established in this industry to market and sell certain of our products, if cleared
or approved, as the case may be. Such collaborations could take the form of joint ventures or
sales, marketing or distribution agreements. We intend to distribute our products, including our
AMID Stapler®, through our own sales and marketing organization; however there can be no assurance
that we will be able to successfully build such an infrastructure. We are also in discussions with
companies possessing established sales and marketing operations in the medical device industry, but
there can be no assurance that we will be able to enter into distribution agreements on terms
acceptable to us or at all.
Employees
As of December 31, 2010, we had 27 full-time employees, six of whom hold advanced degrees. We
plan to add to our headcount in key functional areas as required to commence commercialization
activities and further the development of our product candidates. None of our employees are
represented by a collective bargaining agreement.
Executive Officers of the Registrant
Jeffrey G. Spragens. Mr. Spragens, 69, has served as our President and Chief Executive
Officer and as a member of our Board of Directors since our acquisition of SafeStitch LLC in
September 2007, and he has served as Business Manager of SafeStitch LLC, of which he was a founding
member, since August 2005. From January 2002 to December 2006, Mr. Spragens was a member of Board
of Directors of ETOC, Inc., a privately owned hotel and lodging company based in Minneapolis,
Minnesota. Since April 2002, he has been a Founding Board of Directors Member and Treasurer of the
Foundation for Peace, Washington, D.C. From 1990 to 1995, he was Managing Partner, Gateway
Associates, Inc., a company that secured full subdivision and planning approval for properties
under its control. Prior to that and from 1987 to 1993, he was one of three founding board of
directors members of North American Vaccine, an AMEX company sold to Baxter International in 1999.
Mr. Spragens also has previous experience as a developer and attorney.
18
Charles J. Filipi M.D. Dr. Filipi, 70, has served as our Chief Medical Officer (f/k/a Medical
Director) and a member of our Board of Directors since our acquisition of SafeStitch LLC in
September 2007. Dr. Filipi was a founding member of SafeStitch LLC in August 2005 and has served
as its Medical Director since 2006. He is also Professor of Surgery in the Department of Surgery
at Creighton University School of Medicine in Omaha, Nebraska and has served in this position since
1999. Dr. Filipi has also served as president of the American Hernia Society, editor of the
Journal Hernia and has published approximately 100 peer-reviewed articles and fifty-one book
chapters. He has been the inventor of over twenty provisional or utility patents. His primary
areas of interest are intraluminal surgery for the correction of gastroesophageal reflux disease,
Barretts Esophagus, and obesity.
James J. Martin, C.P.A. Mr. Martin, 44, has served as our Chief Financial Officer since
January 2011 and from July 2010 through January 2011 served as our Controller. Mr. Martin has
served as Vice President, Finance of Aero Pharmaceuticals, Inc. (Aero) a privately-held
pharmaceutical distributor and Chief Financial Officer of Non-Invasive Monitoring Systems,
Inc.(NIMS), a publicly-held medical device company since January 2011. From July 2010 through
January 2011, Mr. Martin served as Controller of NIMS and Aero. Prior to joining SafeStitch, from
2008 through 2010, Mr. Martin served as Controller of AAR Aircraft Services-Miami, a subsidiary of
AAR Corp, an aerospace and defense company in which he was responsible for all financial reporting
and logistics for AAR Aircraft Services-Miami. From 2005-2008, Mr. Martin served as Controller of
Avborne Heavy Maintenance, a commercial aircraft maintenance repair and overhaul company. In
addition to his career in finance and accounting, Mr. Martin served five years in the United States
Navy as an Operations Specialist.
Glossary of Terms
Barretts Esophagus is a complication of severe chronic GERD involving changes in the cells
of the tissue that line the bottom of the esophagus. These cells become irritated when the
contents of the stomach back up (refluxes), resulting in a small, but definite, increased risk of
cancer of the esophagus. The diagnosis results upon seeing (through endoscopy) an orange
esophageal lining (mucosa) that extends a short distance (usually less than 2.5 inches) up the
esophagus from the gastroesophageal junction and findings of intestinal type cells (goblet cells)
seen on histological examinations of biopsy tissue.
Bariatric relates to the branch of medicine that deals with the treatment of obesity and
allied diseases.
Endoscopic is a procedure utilizing an illuminated, usually fiber-optic flexible or rigid
tubular instrument, for visualizing the interior of a hollow organ or part (such as the esophagus)
for diagnostic or therapeutic purposes that typically has one or more channels to enable passage of
instruments.
Ex vivo means outside of a living animal or human.
Gastroplasty is the surgical manipulation of gastric (stomach) tissue.
GERD is gastrointestinal reflux disease, a highly variable chronic condition that is
characterized by periodic episodes of acid reflux usually accompanied by heartburn and that may
result in histopathologic changes in the esophagus.
Histological relates to the tissue changes characteristic of disease or that affect a part
of or accompany a disease.
Inguinal refers to the groin area or lower lateral region of the abdomen.
Intraluminal refers to within the lumen of a hollow organ. Hollow organs include the
esophagus, stomach and small and large intestines, as well as the heart, arteries, veins, ureter
and urethra.
Intraperitoneal refers to within the abdominal cavity.
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In vivo means inside of a living animal or human.
Laparoscopic is surgery utilizing a small incision to examine the abdominal cavity.
Lumen is the central opening in a hollow organ.
Medical device is an article, which, among other things, is intended for use in the
diagnosis of disease or other conditions, or in the cure, mitigation, treatment or prevention of
disease, in man or other animals.
Transoral refers to procedures originating through the mouth.
Transluminal is the egress of instrumentation across the intestinal wall.
Ventral refers to the side of the body opposite the dorsal spine.
An investment in our company involves a significant level of risk. Investors should carefully
consider the risk factors described below together with the other information included in this
Annual Report on Form 10-K. If any of the risks described below occurs, or if other risks not
identified below occur, our business, financial condition, and results of operations could be
materially adversely affected.
Risks Related to our Business
We have a history of operating losses, and we do not expect to become profitable in the near
future.
We are a medical device company with a limited operating history. We are not profitable and
have incurred losses since our inception. We do not anticipate that we will generate revenue from
the sale of products until at least the second half of 2011. Three of our products may currently
be marketed in the United States without further FDA clearance or approval. We continue to incur
research and development and general and administrative expenses related to our operations. Our
net losses for the years ended December 31, 2010 and 2009 were $5.3 million and $2.4 million,
respectively, and we had an accumulated deficit of $17.0 million as of December 31, 2010. We
expect to continue to incur losses for the foreseeable future, and these losses will likely
increase as we prepare for clinical trials of our product candidates and begin to commercialize our
cleared or approved products. If our product candidates fail in clinical trials or do not gain
regulatory clearance or approval, or if our product candidates do not achieve market acceptance, we
may never become profitable. Even if we achieve profitability in the future, we may not be able to
sustain profitability in subsequent periods.
We will require substantial additional funding, which may not be available to us on acceptable
terms, or at all.
We intend to advance multiple additional product candidates through clinical and pre-clinical
development. We will need to raise substantial additional capital to engage in our clinical and
pre-clinical development and commercialization activities.
Our future funding requirements will depend on many factors, including but not limited to:
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our need to expand our research and development activities; |
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the rate of progress and cost of our clinical trials; |
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the costs associated with establishing a sales force and commercialization capabilities; |
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the costs of acquiring, licensing or investing in businesses, products, product
candidates and technologies; |
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the costs and timing of seeking and obtaining FDA and other non-U.S. regulatory
clearances and approvals; |
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the economic and other terms and timing of our existing licensing arrangement and any
collaboration, licensing or other arrangements into which we may enter in the future; |
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our need and ability to hire additional management, scientific, medical and sales and
marketing personnel; |
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the effect of competing technological and market developments; |
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our need to implement additional internal systems and infrastructure, including
financial and reporting systems; and |
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our ability to maintain, expand and defend the scope of our intellectual property
portfolio. |
Until we can generate a sufficient amount of product revenue to finance our cash requirements,
which we may never do, we expect to finance future cash needs primarily through public or private
equity offerings, debt financings or strategic collaborations. We do not know whether additional
funding will be available on acceptable terms, or at all. If we are not able to secure additional
funding when needed, we may have to delay, reduce the scope of or eliminate one or more of our
clinical trials or research and development programs. To the extent that we raise additional funds
by issuing equity securities, our stockholders may experience significant dilution, and debt
financing, if available, may involve restrictive covenants. To the extent that we raise additional
funds through collaboration and licensing arrangements, it may be necessary to relinquish some
rights to our product candidates or grant licenses on terms that may not be favorable to us.
Healthcare policy changes, including recently enacted legislation reforming the U.S.
healthcare system, may have a material adverse effect on our financial condition and results of
operations.
Healthcare costs have risen significantly over the past decade, and there have been and
continue to be proposals by legislators, regulators and third-party payors to keep these costs
down. As noted above, Congress recently passed health care reform legislation that President Obama
signed into law in March 2010. While the most immediate impact on device manufacturers is the
imposition of a 2.3 percent tax beginning in 2013, the other effects of the law on our business and
sector remain uncertain. Over the next few years, the administration can be expected to issue
rules implementing the new reforms and those regulations could have adverse consequences for device
manufacturers.
In addition to the new legislation discussed above, various healthcare reform proposals have
also emerged at the state level. We cannot predict what additional healthcare initiatives, if any,
will be implemented at the federal or state level, or the effect any such future legislation or
regulation will have on us. In addition to the taxes imposed by the new federal legislation, an
expansion in governments role in the U.S. healthcare industry may lower reimbursements for our
products, reduce medical procedure volumes and materially adversely affect our business, financial
condition and results of operations.
Continued worldwide economic and market instability may materially and adversely affect the
demand for our products and, if and when approved, our product candidates, as well as our ability
to obtain credit or secure funds through sales of our stock, which may materially and adversely
affect our business, financial condition and ability to fund our operations.
Worldwide economic conditions may reduce the demand for new and innovative medical devices,
resulting in delayed market acceptance of our products and, if and when approved, our product
candidates. Such a delay could have a material adverse impact on our business, expected cash
flows, results of operations and financial condition.
Additionally, we have funded our operations to date primarily through private sales of our
common and preferred stock and through borrowings under credit facilities available to us from
stockholders and other individuals, including our existing $4.0 million line of credit which will
mature in June 2012. Any economic turmoil and instability in the worlds equity and credit markets
may materially adversely affect our ability to sell additional shares of our stock and/or borrow
cash under existing or new credit facilities. There can be no assurance that we will be able to
raise additional working capital on acceptable terms or at all. Our inability to raise additional
working capital on acceptable terms would materially and adversely affect our liquidity and
could materially adversely affect our ability to continue our operations.
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Some of our technologies are in an early stage of development and are unproven.
We are engaged in the research and development of intraluminal medical devices that manipulate
tissues for the treatment of intraperitoneal abnormalities, including obesity, GERD, hernia
formation, Barretts Esophagus, esophageal obstructions and upper gastrointestinal bleeding. The
effectiveness of our technologies is not well-known in, or accepted generally by, the clinical
medical community. There can be no assurance that we will be able to successfully employ our
technologies as surgical, therapeutic or diagnostic solutions for any intraperitoneal
abnormalities. Our failure to establish the efficacy and safety of our technologies would have a
material adverse effect on our business.
Our product research and development activities may not result in commercially viable
products.
Some of our product candidates are still in early stages of development and are prone to the
risks of failure inherent in medical device product development. We will likely be required to
undertake significant clinical trials to demonstrate to the FDA that our licensed devices are safe
and effective for their intended uses or that they are substantially equivalent in terms of safety
and effectiveness to an existing, lawfully marketed non-PMA device. We may also be required to
undertake clinical trials by non-U.S. regulatory agencies. Clinical trials are expensive and
uncertain processes that may take years to complete. Failure can occur at any point in the
process, and early positive results do not ensure that the entire clinical trial will be
successful. Product candidates in clinical trials may fail to show desired efficacy and safety
traits despite early promising results. A number of companies in the medical device industry have
suffered significant setbacks in advanced clinical trials, even after obtaining promising results
at earlier points.
The results of previous clinical experience with our devices and devices similar to those that
we are developing may not be indicative of future results, and our current and planned clinical
trials may not satisfy the requirements of the FDA or other non-U.S. regulatory authorities.
Positive results from limited in vivo and ex vivo animal trials we have conducted or early
clinical experience with the test articles or with similar devices should not be relied upon as
evidence that later-stage or large-scale clinical trials will succeed. We will be required to
demonstrate with substantial evidence through well-controlled clinical trials that our product
candidates either (i) are safe and effective for their intended uses or (ii) are substantially
equivalent in terms of safety and effectiveness to devices that are already marketed under Section
510(k).
Further, our product candidates may not be cleared or approved, as the case may be, even if
the clinical data are satisfactory and support, in our view, clearance or approval. The FDA or
other non-U.S. regulatory authorities may disagree with our trial design and our interpretation of
the clinical data. In addition, any of these regulatory authorities may change requirements for
the clearance or approval of a product candidate even after reviewing and providing comment on a
protocol for a pivotal clinical trial that has the potential to result in FDA approval. In
addition, any of these regulatory authorities may also clear or approve a product candidate for
fewer or more limited uses than we request or may grant clearance or approval contingent on the
performance of costly post-marketing clinical trials. In addition, the FDA or other non-U.S.
regulatory authorities may not approve or clear the labeling claims necessary or desirable for the
successful commercialization of our product candidates.
We are highly dependent on the success of our products and product candidates, and we cannot
give any assurance that our product candidates will receive regulatory clearance or that any of our
products or future products will be successfully commercialized.
We are highly dependent on the success of our products and product candidates, especially the
Gastroplasty Device and the AMID Stapler®. We cannot give any assurance that the FDA will permit
us to clinically test or grant regulatory clearance for the Gastroplasty Device, nor can we give
any assurance that these products will be successfully commercialized, for a number of reasons,
including without limitation the potential introduction by our
competitors of more clinically-effective or cost-effective alternatives or failure in our
sales and marketing efforts, or our failure to obtain positive coverage determinations or
reimbursement. Any failure to obtain clearance or approval of our products or to successfully
commercialize them would have a material and adverse effect on our business.
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If our competitors develop and market products that are more effective, safer or less
expensive than our products and future products, our commercial opportunities will be negatively
impacted.
The life sciences industry is highly competitive, and we face significant competition from
many medical device companies that are researching and marketing products designed to address the
intraperitoneal abnormalities we are endeavoring to address. We are currently developing and
commercializing medical devices that will compete with other medical devices that currently exist
or are being developed. Products we may develop in the future are also likely to face competition
from other medical devices and therapies. Many of our competitors have significantly greater
financial, manufacturing, marketing and product development resources than we do. Large medical
device companies, in particular, have extensive experience in clinical testing and in obtaining
regulatory clearances or approvals for medical devices. These companies also have significantly
greater research and marketing capabilities than we do. As indicated, there are also other methods
to treat obesity, such as diet, exercise and medicine. Other competitors have developed products
such as medical implants that occupy volume in the stomach to promote the feeling of satiety
(Helioscopie) or gastric sleeves to reduce food intake. Some of the medical device companies we
expect to compete with include USGI Medical, Satiety, EndoGastric Solutions, Inc., Medigus, Ltd.,
Bard, LLC, Olympus Medical Equipment Services America, Inc., BARRX Medical, Inc., Covidien,
Ethicon, Inc., Boston Scientific Corporation, ConMed Corporation, Cook Medical Supply, Inc., Miller
Medical Specialties, U.S. Endoscopy and a number of bite block manufacturers. In addition, many
other universities and private and public research institutions are or may become active in
research involving surgical devices for gastrointestinal abnormalities and minimally invasive
surgery.
We believe that our ability to successfully compete will depend on, among other things:
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the results of our clinical trials; |
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our ability to recruit and enroll patients for our clinical trials; |
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the efficacy, safety and reliability of our product candidates; |
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the speed at which we develop our product candidates; |
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our ability to commercialize and market any of our product candidates that may receive
regulatory clearance or approval; |
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our ability to design and successfully execute appropriate clinical trials; |
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the timing and scope of regulatory clearances or approvals; |
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appropriate coverage and adequate levels of reimbursement under private and governmental
health insurance plans, including Medicare; |
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our ability to protect intellectual property rights related to our products; |
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our ability to have our partners manufacture and sell commercial quantities of any
approved products to the market; and |
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acceptance of future product candidates by physicians and other health care providers. |
If our competitors market products that are more effective, safer, easier to use or less
expensive than our products or future products, or that reach the market sooner than our product
candidates, we may not achieve commercial success. In addition, the medical device industry is
characterized by rapid technological change. It may be difficult for us to stay abreast of the
rapid changes in each technology. If we fail to stay at the forefront of technological change, we
may be unable to compete effectively. Technological advances or products developed by our
competitors may render our technologies or product candidates obsolete or less competitive.
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Our product development activities could be delayed or stopped.
We do not know whether other planned clinical trials will be completed on schedule, or at all,
and we cannot guarantee that our planned clinical trials will begin on time or at all. The
commencement of our planned clinical trials could be substantially delayed or prevented by several
factors, including:
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limited number of, and competition for, suitable patients that meet the protocols
inclusion criteria and do not meet any of the exclusion criteria; |
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limited number of, and competition for, suitable sites to conduct our clinical trials,
and delay or failure to obtain FDA approval, if necessary, to commence a clinical trial; |
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delay or failure to obtain sufficient supplies of the product candidate for our clinical
trials; |
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requirements to provide the medical device required in our clinical trial at cost, which
may require significant expenditures that we are unable or unwilling to make; |
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delay or failure to reach agreement on acceptable clinical trial agreement terms or
clinical trial protocols with prospective sites or investigators; and |
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delay or failure to obtain IRB approval or renewal to conduct a clinical trial at a
prospective or accruing site, respectively. |
The completion of our clinical trials could also be substantially delayed or prevented by
several factors, including:
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slower than expected rates of patient recruitment and enrollment; |
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failure of patients to complete the clinical trial; |
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unforeseen safety issues; |
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lack of efficacy evidenced during clinical trials; |
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termination of our clinical trials by one or more clinical trial sites; |
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inability or unwillingness of patients or medical investigators to follow our clinical
trial protocols; and |
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inability to monitor patients adequately during or after treatment. |
Our clinical trials may be suspended or terminated at any time by us, the FDA, other
regulatory authorities or the IRB for any given site. Any failure or significant delay in
completing clinical trials for our product candidates could materially harm our financial results
and the commercial prospects for our product candidates.
The regulatory approval and clearance processes are expensive, time-consuming and uncertain
and may prevent us or our collaboration partners from obtaining approvals or clearances, as the
case may be, for the commercialization of some or all of our product candidates.
The research, testing, manufacturing, labeling, approval, clearance, selling, marketing and
distribution of medical devices are subject to extensive regulation by the FDA and other non-U.S.
regulatory authorities, which regulations differ from country to country. We are not permitted to
market our product candidates in the United States until we receive a clearance letter under the
510(k) process or approval of a PMA from the FDA, depending on the nature of the device. We are
currently in discussions with the FDA regarding the appropriate regulatory approval for our
Gastroplasty Device for the treatment of GERD and for the treatment of obesity. Obtaining approval
of any PMA can be a lengthy, expensive and uncertain process. While the FDA normally reviews and
clears a premarket notification in 90 days, there is no guarantee that our future product
candidates will qualify for this more expeditious regulatory process, which is reserved for Class I
and II devices, nor is there any assurance, that even if a device is reviewed under the 510(k)
premarket notification process, that the FDA will review it expeditiously or determine that the
device is substantially equivalent to a lawfully marketed non-PMA device. If the
FDA fails to make this finding, then we cannot market the device. In lieu of acting on a
premarket notification, the FDA may seek additional information or additional data which would
further delay our ability to market the product.
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Regulatory approval of a PMA, PMA supplement or clearance pursuant to a 510(k) premarket
notification is not guaranteed, and the approval or clearance process, as the case may be, is
expensive, uncertain and may, especially in the case of the PMA application, take several years.
The FDA also has substantial discretion in the medical device clearance process or approval
process. Despite the time and expense exerted, failure can occur at any stage, and we could
encounter problems that cause us to abandon clinical trials or to repeat or perform additional
pre-clinical studies and clinical trials. The number of pre-clinical studies and clinical trials
that will be required for FDA clearance or approval varies depending on the medical device
candidate, the disease or condition that the medical device candidate is designed to address, and
the regulations applicable to any particular medical device candidate. The FDA can delay, limit or
deny clearance or approval of a medical device candidate for many reasons, including:
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a medical device candidate may not be deemed safe or effective, in the case of a PMA
application; |
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a medical device candidate may not be deemed to be substantially equivalent to a
lawfully marketed non-PMA device in the case of a 510(k) premarket notification; |
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FDA officials may not find the data from pre-clinical studies and clinical trials
sufficient; |
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the FDA might not approve our third-party manufacturers processes or facilities; or |
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the FDA may change its clearance or approval policies or adopt new regulations. |
Failure to recruit and enroll patients for clinical trials may cause the development of our
product candidates to be delayed.
We may encounter delays if we are unable to recruit and enroll and retain enough patients to
complete clinical trials. Patient enrollment depends on many factors, including the size of the
patient population, the nature of the protocol, the proximity of patients to clinical sites and the
eligibility criteria for the trial. Delays in patient enrollment are not unusual. Any such delays
in planned patient enrollment may result in increased costs, which could harm our ability to
develop products.
Independent clinical investigators and contract research organizations that we engage to
conduct our clinical trials may not be diligent, careful or timely.
We will depend on independent clinical investigators to conduct our clinical trials. Contract
research organizations may also assist us in the collection and analysis of data. These
investigators and contract research organizations will not be our employees and we will not be able
to control, other than by contract, the amount of resources, including time that they devote to our
trials. If independent investigators fail to devote sufficient resources to the clinical trials,
or if their performance is substandard, it will delay the approval or clearance and
commercialization of any products that we develop. Further, the FDA requires that we comply with
standards, commonly referred to as good clinical practice, for conducting, recording and reporting
clinical trials to assure that data and reported results are credible and accurate and that the
rights, integrity and confidentiality of trial subjects are protected. If our independent clinical
investigators and contract research organizations fail to comply with good clinical practice, the
results of our clinical trials could be called into question and the clinical development of our
product candidates could be delayed. Failure of clinical investigators or contract research
organizations to meet their obligations to us or comply with federal regulations could adversely
affect the clinical development of our product candidates and harm our business.
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Even if we obtain regulatory clearances or approvals for our product candidates, the terms
thereof and ongoing regulation of our products may limit how we manufacture and market our products
and product candidates, which could materially impair our ability to generate anticipated revenues.
Once regulatory clearance or approval has been granted, the cleared or approved product and
its manufacturer are subject to continual review. Any cleared or approved product may only be
promoted for its
indicated uses. In addition, if the FDA or other non-U.S. regulatory authorities clear or
approve any of our product candidates, the labeling, packaging, adverse event reporting, storage,
advertising and promotion for the product will be subject to extensive regulatory requirements. We
and the manufacturers of our products are also required to comply with the FDAs QSR, which include
requirements relating to quality control and quality assurance, as well as the corresponding
maintenance of records and documentation. Moreover, device manufacturers are required to report
adverse events by filing Medical Device Reports with the FDA, which are publicly available.
Further, regulatory agencies must approve our manufacturing facilities before they can be used to
manufacture our products, and these facilities are subject to ongoing regulatory inspection. If we
fail to comply with the regulatory requirements of the FDA, either before or after clearance or
approval, or other non-U.S. regulatory authorities, or if previously unknown problems with our
products, manufacturers or manufacturing processes are discovered, we could be subject to
administrative or judicially imposed sanctions, including:
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restrictions on the products, manufacturers or manufacturing process; |
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adverse inspectional observations (Form 483), warning letters, non-warning letters
incorporating inspectional observations; |
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civil or criminal penalties or fines; |
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product seizures, detentions or import bans; |
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voluntary or mandatory product recalls and publicity requirements; |
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suspension or withdrawal of regulatory clearances or approvals; |
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total or partial suspension of production; |
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imposition of restrictions on operations, including costly new manufacturing
requirements; and |
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refusal to clear or approve pending applications or premarket notifications. |
In addition, the FDA and other non-U.S. regulatory authorities may change their policies and
additional regulations may be enacted that could prevent or delay regulatory clearance or approval
of our product candidates. We cannot predict the likelihood, nature or extent of government
regulation that may arise from future legislation or administrative action, either in the United
States or abroad. If we are not able to maintain regulatory compliance, we would likely not be
permitted to market our future product candidates and we may not achieve or sustain profitability.
Even if we receive regulatory clearance or approval to market our product candidates, the
market may not be receptive to our products, or third-party payors, including government payors,
may not provide coverage for our products or for procedures using our products, which could
undermine our financial viability.
Even if our product candidates obtain regulatory clearance or approval, resulting products may
not gain market acceptance among physicians, patients, health care payors and/or the medical
community. We believe that the degree of market acceptance will depend on a number of factors,
including:
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timing of market introduction of competitive products; |
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safety and efficacy of our product; |
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prevalence and severity of any side effects; |
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potential advantages or disadvantages over alternative treatments; |
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strength of marketing and distribution support; |
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price of our future product candidates, both in absolute terms and relative to
alternative treatments; and |
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availability of coverage and reimbursement from government and other third-party payors. |
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If our product candidates fail to achieve market acceptance, we may not be able to generate
significant revenue or achieve or sustain profitability.
The coverage and reimbursement status of newly cleared or approved medical devices is
uncertain, and failure to obtain adequate coverage and adequate reimbursement could limit our
ability to market any future product candidates we may develop and decrease our ability to generate
revenue from any of our existing and future product candidates that may be cleared or approved.
There is significant uncertainty related to the third-party coverage and reimbursement of
newly cleared or approved medical devices. Normally, surgical devices are not directly covered;
instead, the procedure using the device is subject to a coverage determination by the insurer. The
commercial success of our existing and future product candidates in both domestic and international
markets will depend in part on the availability of coverage and adequate reimbursement from
third-party payors, including government payors, such as the Medicare and Medicaid programs,
managed care organizations and other third-party payors. Government and other third-party payors
are increasingly attempting to contain health care costs by limiting both coverage and the level of
reimbursement for new products and, as a result, they may not cover or provide adequate payment for
our existing and future product candidates. These payors may conclude that our product candidates
are not as safe or effective as existing devices or that procedures using our devices are not as
safe or effective as the existing procedures using other devices. These payors may also conclude
that the overall cost of the procedure using one of our devices exceeds the overall cost of the
competing procedure using another type of device, and third-party payors may not approve our
product candidates for coverage and adequate reimbursement. The failure to obtain coverage and
adequate reimbursement for our existing and future product candidates or health care cost
containment initiatives that limit or restrict reimbursement for our existing and future product
candidates may reduce any future product revenue.
If we fail to attract and retain key management and scientific personnel, we may be unable to
successfully develop or commercialize our product candidates.
We will need to expand and effectively manage our managerial, operational, financial,
development, marketing and other resources in order to successfully pursue our research,
development and commercialization efforts for our existing and future product candidates. Our
success depends on our continued ability to attract, retain and motivate highly qualified
management and pre-clinical and clinical personnel. The loss of the services of any of our senior
management, particularly Jeffrey G. Spragens and Dr. Charles J. Filipi, could delay or prevent the
development or commercialization of our product candidates. We do not maintain key man insurance
policies on the lives of these individuals or the lives of any of our other employees. We employ
these individuals on an at-will basis and their employment can be terminated by us or them at any
time, for any reason and with or without notice. We will need to hire additional personnel as we
continue to expand our research and development activities and build a sales and marketing
organization.
We have scientific and clinical advisors who assist us in formulating our research,
development and clinical strategies. These advisors are not our employees and may have commitments
to, or consulting or advisory contracts with, other entities that may limit their availability to
us. In addition, our advisors may have arrangements with other companies to assist those companies
in developing products or technologies that may compete with ours.
We may not be able to attract or retain qualified management and scientific personnel in the
future due to the intense competition for qualified personnel among medical device and other
businesses. If we are not able to attract and retain the necessary personnel to accomplish our
business objectives, we may experience constraints that will impede significantly the achievement
of our research and development objectives, our ability to raise additional capital and our ability
to implement our business strategy. In particular, if we lose any members of our senior management
team, we may not be able to find suitable replacements in a timely fashion or at all and our
business may be harmed as a result.
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As we are evolving from a company primarily involved in development to a company also involved
in commercialization, we may encounter difficulties in managing our growth and expanding our
operations successfully.
As we advance our product candidates through research and development and begin
commercializing our products, we will need to expand our development, regulatory, manufacturing,
marketing and sales capabilities or contract with third parties to provide these capabilities for
us. As our operations expand, we expect that we will need to manage additional relationships with
such third parties, as well as additional collaborators and suppliers. Maintaining these
relationships and managing our future growth will impose significant added responsibilities on
members of our management. We must be able to: manage our development efforts effectively; manage
our clinical trials effectively; hire, train and integrate additional management, development,
administrative and sales and marketing personnel; improve our managerial, development, operational
and finance systems; and expand our facilities, all of which may impose a strain on our
administrative and operational infrastructure.
Furthermore, we may acquire additional businesses, products or product candidates that
complement or augment our existing business. Integrating any newly acquired business or product
could be expensive and time-consuming. We may not be able to integrate any acquired business or
product successfully or operate any acquired business profitably. Our future financial performance
will depend, in part, on our ability to manage any future growth effectively and our ability to
integrate any acquired businesses. We may not be able to accomplish these tasks, and our failure
to accomplish any of them could prevent us from successfully growing our company.
If we fail to acquire and develop other products or product candidates at all or on
commercially reasonable terms, we may be unable to diversify or grow our business.
We intend to continue to utilize in-licensing as a source of products and product candidates
for development and commercialization. The success of this strategy depends upon our ability to
identify, select and acquire medical device product candidates. Proposing, negotiating and
implementing an economically viable product acquisition or license is a lengthy and complex
process. We compete for partnering arrangements and license agreements with other medical device
companies and academic research institutions. Our competitors may have stronger relationships with
third parties with whom we are interested in collaborating and/or may have more established
histories of developing and commercializing products. As a result, our competitors may have a
competitive advantage in entering into partnering arrangements with such third parties. In
addition, even if we find promising product candidates, and generate interest in a partnering or
strategic arrangement to acquire such product candidates, we may not be able to acquire rights to
additional product candidates or approved products on commercially reasonable terms that we find
acceptable, or at all.
We expect that any product candidate to which we acquire rights will require additional
development efforts prior to commercial sale, including extensive clinical testing and clearance or
approval by the FDA and other non-U.S. regulatory authorities. All product candidates are subject
to the risks of failure inherent in medical device product development, including the possibility
that the product candidate will not be shown to be sufficiently safe and effective for approval by
regulatory authorities. Even if the product candidates are cleared or approved, we cannot be sure
that they would be capable of economically feasible production or commercial success.
We rely on third parties to manufacture and supply our products, and we will rely on third
parties to manufacture and supply our product candidates, and an inability to find additional or
alternate sources for our products could materially and adversely affect our financial condition
and results of operations.
We do not own or operate manufacturing facilities for clinical or commercial production of our
product candidates, other than a prototype lab and manufacturing facility that can be used for
limited production of devices for clinical trials. We lack the resources and the capability to
manufacture any of our products and product candidates on a commercial scale. If our manufacturing
partners are unable to produce our products in the amounts that we require, we may not be able to
establish a contract and obtain a sufficient alternative supply from another supplier on a timely
basis and in the quantities we require. We expect to depend on third-party contract manufacturers
for the foreseeable future.
28
Our products and product candidates require precise, high quality manufacturing. Any of our
contract manufacturers will be subject to ongoing periodic unannounced inspection by the FDA and
other non-U.S. regulatory authorities to ensure strict compliance with QSR, cGMP and other
applicable government regulations and corresponding standards. If our contract manufacturers fail
to achieve and maintain high manufacturing standards in compliance with QSR, we may experience
manufacturing errors resulting in patient injury or death, product recalls or withdrawals, delays
or interruptions of production or failures in product testing or delivery, delay or prevention of
filing or approval of marketing applications for our products, cost overruns or other problems that
could seriously harm our business.
Any performance failure on the part of our contract manufacturers could delay clinical
development or regulatory clearance or approval of our product candidates or commercialization of
our products and future products, depriving us of potential product revenue and resulting in
additional losses. In addition, our dependence on a third party for manufacturing may adversely
affect our future profit margins. Our ability to replace an existing manufacturer may be difficult
because the number of potential manufacturers is limited and the FDA must approve any replacement
manufacturer before it can begin manufacturing our products. Such approval may require additional
non-clinical testing and compliance inspections. It may be difficult or impossible for us to
identify and engage a replacement manufacturer on acceptable terms in a timely manner, or at all.
We currently have a limited sales, marketing and distribution organization. If we are unable
to develop our sales, marketing and distribution capability on our own or through collaborations
with marketing partners, we will not be successful in commercializing our product candidates.
We currently have minimal marketing, sales and distribution capabilities. We intend to
establish our sales and marketing organization with technical expertise and supporting distribution
capabilities to commercialize our products and product candidates, which will be expensive and
time-consuming. Any failure or delay in the development of our internal sales, marketing and
distribution capabilities would adversely impact the commercialization of these products. We may
choose to collaborate with third parties that have direct sales forces and established distribution
systems, either to augment our own sales force and distribution systems or in lieu of our own sales
force and distribution systems. To the extent that we enter into co-promotion or other licensing
arrangements, our product revenue is likely to be lower than if we directly marketed or sold our
products. In addition, any revenue we receive will depend in whole or in part upon the efforts of
such third parties, which may not be successful and are generally not within our control. If we
are unable to enter into such arrangements on acceptable terms or at all, we may not be able to
successfully commercialize our products and product candidates. If we are not successful in
commercializing our existing and future products, either on our own or through collaborations with
one or more third parties, our future product revenue will suffer and we may incur significant
additional losses.
The success of our business may be dependent on the actions of our collaborative partners.
An element of our strategy may be to enter into collaborative arrangements with established
multinational medical device companies which will finance or otherwise assist in the development,
manufacture and marketing of products incorporating our technology. We anticipate deriving some
revenues from research and development fees, license fees, milestone payments and royalties from
collaborative partners. Our prospects, therefore, may depend to some extent upon our ability to
attract and retain collaborative partners and to develop technologies and products that meet the
requirements of prospective collaborative partners. In addition, our collaborative partners may
have the right to abandon research projects and terminate applicable agreements, including funding
obligations, prior to or upon the expiration of the agreed-upon research terms. There can be no
assurance that we will be successful in establishing collaborative arrangements on acceptable terms
or at all, that collaborative partners will not terminate funding before completion of projects,
that our collaborative arrangements will result in successful product commercialization or that we
will derive any revenues from such arrangements. To the extent that we are not able to develop and
maintain collaborative arrangements, we would need substantial additional capital to undertake
research, development and commercialization activities on our own.
29
We rely heavily on licenses from third parties, particularly our license with Creighton, and
any loss of our rights under such license agreements could materially adversely affect our business
prospects.
Most of the patent applications in our patent portfolio are not owned by us, but are licensed
from Creighton and other third parties. Presently, we rely primarily on licensed technology for
our products and may license additional technology from other third parties in the future. Such
license agreements give us rights for the commercial exploitation of the patents resulting from the
patent applications, subject to certain provisions of the license agreements. Failure to comply
with these provisions could result in the loss of our rights under these license agreements. Our
inability to rely on these patent applications which are the basis of our technology would have a
material adverse effect on our business.
Most of our patent rights are licensed to us from Creighton. If we or Creighton do not
properly maintain or enforce the patent applications underlying this license, or if we lose our
rights under this license, our competitive position, business prospects and results of operations
will be materially adversely affected.
Our success will depend in part on the ability of us or Creighton to obtain, maintain and
enforce patent protection for our licensed intellectual property and, in particular, those patents
to which we have secured exclusive rights. We or Creighton may not successfully prosecute the
patent applications which are licensed to us. Even if patents issue in respect of these patent
applications, we or Creighton may fail to maintain these patents, may determine not to pursue
litigation against other companies that are infringing these patents, or may pursue such litigation
less aggressively than necessary to obtain an acceptable outcome from any such litigation. Without
protection for the intellectual property we have licensed, other companies might be able to offer
substantially identical products for sale, which could materially adversely affect our competitive
business position, business prospects and results of operations.
If we or our licensors are unable to obtain and enforce patent protection for our products and
product candidates, our business could be materially harmed.
Our success depends, in part, on our ability to protect proprietary methods and technologies
that we develop or license under the patent and other intellectual property laws of the United
States and other countries, so that we can prevent others from unlawfully using our inventions and
proprietary information. However, we may not hold proprietary rights to some patents required for
us to commercialize our proposed products. Although numerous patent applications are in process,
we presently do not hold any U.S.-issued patents and none of the technology we license has been
patented in the U.S. Because certain U.S. patent applications are confidential until patents
issue, such as applications filed prior to November 29, 2000, or applications filed after such date
which will not be filed in foreign countries, third parties may have filed patent applications for
technology covered by our pending patent applications without our being aware of those
applications, and our patent applications may not have priority over those applications. For this
and other reasons, we or our third-party collaborators may be unable to secure desired patent
rights, thereby losing desired exclusivity. If licenses are not available to us on acceptable
terms, we will not be able to market the affected products or conduct the desired activities,
unless we challenge the validity, enforceability or infringement of the third party patent or
otherwise circumvent the third party patent.
Our strategy depends on our ability to rapidly identify and seek patent protection for our
discoveries. In addition, we will rely on third-party collaborators to file patent applications
relating to proprietary technology that we develop jointly during certain collaborations. The
process of obtaining patent protection is expensive and time-consuming. If our present or future
collaborators fail to file and prosecute all necessary and desirable patent applications at a
reasonable cost and in a timely manner, our business will be adversely affected. Despite our
efforts and the efforts of our collaborators to protect our proprietary rights, unauthorized
parties may be able to obtain and use information that we regard as proprietary.
The issuance of a patent does not guarantee that it is valid or enforceable. Any patents we
have obtained, or obtain in the future, may be challenged, invalidated, unenforceable or
circumvented. Moreover, the United States Patent and Trademark Office (the USPTO) may commence
interference proceedings involving our patents or patent applications. Any challenge to, finding
of unenforceability or invalidation or circumvention of, our patents or patent applications would
be costly, would require significant time and attention of our management and could have
a material adverse effect on our business. In addition, court decisions may introduce
uncertainty in the enforceability or scope of patents owned by medical device companies.
30
Our pending patent applications may not result in issued patents. The patent position of
medical device companies, including ours, is generally uncertain and involves complex legal and
factual considerations. The standards that the USPTO and its foreign counterparts use to grant
patents are not always applied predictably or uniformly and can change. There is also no uniform,
worldwide policy regarding the subject matter and scope of claims granted or allowable in medical
device patents. Accordingly, we do not know the degree of future protection for our proprietary
rights or the breadth of claims that will be allowed in any patents issued to us or to others. The
legal systems of certain countries do not favor the aggressive enforcement of patents, and the laws
of foreign countries may not protect our rights to the same extent as the laws of the United
States. Therefore, the enforceability or scope of our owned or licensed patents in the United
States or in foreign countries cannot be predicted with certainty, and, as a result, any patents
that we own or license may not provide sufficient protection against competitors. We may not be
able to obtain or maintain patent protection for our pending patent applications, those we may file
in the future, or those we may license from third parties, including Creighton.
We cannot assure you that any patents that will issue, that may issue or that may be licensed
to us will be enforceable or valid or will not expire prior to the commercialization of our product
candidates, thus allowing others to more effectively compete with us. Therefore, any patents that
we own or license may not adequately protect our product candidates or our future products.
If we or our licensors are unable to protect the confidentiality of our proprietary
information and know-how, the value of our technology and products could be adversely affected.
In addition to patent protection, we also rely on other proprietary rights, including
protection of trade secrets, know-how and confidential and proprietary information. To maintain
the confidentiality of trade secrets and proprietary information, we will seek to enter into
confidentiality agreements with our employees, consultants and collaborators upon the commencement
of their relationships with us. These agreements generally require that all confidential
information developed by the individual or made known to the individual by us during the course of
the individuals relationship with us be kept confidential and not disclosed to third parties. Our
agreements with employees also generally provide and will generally provide that any inventions
conceived by the individual in the course of rendering services to us shall be our exclusive
property. However, we may not obtain these agreements in all circumstances, and individuals with
whom we have these agreements may not comply with their terms. In the event of unauthorized use or
disclosure of our trade secrets or proprietary information, these agreements, even if obtained, may
not provide meaningful protection, particularly for our trade secrets or other confidential
information. To the extent that our employees, consultants or contractors use technology or
know-how owned by third parties in their work for us, disputes may arise between us and those third
parties as to the rights in related inventions.
Adequate remedies may not exist in the event of unauthorized use or disclosure of our
confidential information. The disclosure of our trade secrets would impair our competitive
position and may materially harm our business, financial condition and results of operations.
Some jurisdictions may require us or our licensors to grant licenses to third parties. Such
compulsory licenses could be extended to include some of our product candidates, which may limit
our potential revenue opportunities.
Many countries, including certain countries in Europe, have compulsory licensing laws under
which a patent owner may be compelled to grant licenses to third parties. In addition, most
countries limit the enforceability of patents against government agencies or government
contractors. In these countries, the patent owner may be limited to monetary relief and may be
unable to enjoin infringement, which could materially diminish the value of the patent. Compulsory
licensing of life-saving products is also becoming increasingly popular in developing countries,
either through direct legislation or international initiatives. Such compulsory licenses could be
extended to include some of our product candidates, which may limit our potential revenue
opportunities.
31
Our commercial success depends significantly on our ability to operate without infringing the
patents and other proprietary rights of third parties.
Other entities may have or obtain patents or proprietary rights that could limit our ability
to manufacture, use, sell, offer for sale or import products or impair our competitive position.
In addition, to the extent that a third party develops new technology that covers our products, we
may be required to obtain licenses to that technology, which licenses may not be available or may
not be available on commercially reasonable terms, if at all. If licenses are not available to us
on acceptable terms, we will not be able to market the affected products or conduct the desired
activities, unless we challenge the validity, enforceability or infringement of the third party
patent or circumvent the third party patent, which would be costly and would require significant
time and attention of our management. Third parties may have or obtain valid and enforceable
patents or proprietary rights that could block us from developing products using our technology.
Our failure to obtain a license to any technology that we require may materially harm our business,
financial condition and results of operations.
If we become involved in patent litigation or other proceedings related to a determination of
rights, we could incur substantial costs and expenses, substantial liability for damages or be
required to stop our product development and commercialization efforts, any of which could
materially adversely affect our liquidity, business prospects and results of operations.
Third parties may sue us for infringing their patent rights. Likewise, we may need to resort
to litigation to enforce a patent issued or licensed to us or to determine the scope and validity
of proprietary rights of others. In addition, a third party may claim that we have improperly
obtained or used its confidential or proprietary information. Furthermore, in connection with our
third-party license agreements, we generally have agreed to indemnify the licensor for costs
incurred in connection with litigation relating to intellectual property rights. The cost to us of
any litigation or other proceeding relating to intellectual property rights, even if resolved in
our favor, could be substantial, and the litigation would divert our managements efforts. Some of
our competitors may be able to sustain the costs of complex patent litigation more effectively than
we can because they have substantially greater resources. Uncertainties resulting from the
initiation and continuation of any litigation could limit our ability to continue our operations.
If any parties successfully claim that our creation or use of proprietary technologies
infringes upon their intellectual property rights, we might be forced to pay damages, potentially
including treble damages, if we are found to have willfully infringed on such parties patent
rights. In addition to any damages we might have to pay, a court could require us to stop the
infringing activity or obtain a license. Any license required under any patent may not be made
available on commercially acceptable terms, if at all. In addition, such licenses are likely to be
non-exclusive and, therefore, our competitors may have access to the same technology licensed to
us. If we fail to obtain a required license and are unable to design around a patent, we may be
unable to effectively market some of our technology and products, which could limit our ability to
generate revenues or achieve profitability and possibly prevent us from generating revenue
sufficient to sustain our operations.
Medicare legislation and future legislative or regulatory reform of the health care system may
affect our ability to sell our products profitably.
In the United States, there have been a number of legislative and regulatory proposals, at
both the federal and state government levels, to change the healthcare system in ways that could
affect our ability to sell our products profitably, if approved. To the extent that our products
are deemed to be durable medical equipment (DME), they may be subject to distribution under
Medicares Competitive Acquisition regulations, which could adversely affect the amount that we can
seek from payors. Non-DME devices used in surgical procedures are normally paid directly by the
hospital or health care provider and not reimbursed separately by third-party payors. As a result,
these types of devices are subject to intense price competition that can place a small manufacturer
at a competitive disadvantage.
We are unable to predict what additional legislation or regulation, if any, relating to the
health care industry or third-party coverage and reimbursement may be enacted in the future or what
effect such legislation or regulation would have on our business. Any cost containment measures or
other health care system reforms that are adopted
could have a material adverse effect on our ability to commercialize our existing and future
product candidates successfully.
32
Failure to obtain regulatory approval outside the United States will prevent us from marketing
our product candidates abroad.
We intend to market certain of our products and product candidates in non-U.S. markets. In
order to market our existing and future products in the European Union and many other non-U.S.
jurisdictions, we must obtain separate regulatory approvals. We have had limited interactions with
non-U.S. regulatory authorities, the approval procedures vary among countries and can involve
additional testing, and the time required to obtain approval may differ from that required to
obtain FDA approval. Approval or clearance by the FDA does not ensure approval by regulatory
authorities in other countries, and approval by one or more non-U.S. regulatory authorities does
not ensure approval by regulatory authorities in other countries or by the FDA. The non-U.S.
regulatory approval process may include all of the risks associated with obtaining FDA approval or
clearance. We may not obtain non-U.S. regulatory approvals on a timely basis, if at all. We may
not be able to file for non-U.S. regulatory approvals and may not receive necessary approvals to
commercialize our existing and future product candidates in any market.
Non-U.S. governments often impose strict price controls, which may adversely affect our future
profitability.
We intend to seek approval to market certain of our existing and future products in both the
U.S. and in non-U.S. jurisdictions. If we obtain approval in one or more non-U.S. jurisdictions,
we will be subject to rules and regulations in those jurisdictions relating to our products. In
some countries, particularly countries of the European Union, each of which has developed its own
rules and regulations, pricing is subject to governmental control. In these countries, pricing
negotiations with governmental authorities can take considerable time after the receipt of
marketing approval for a medical device candidate. To obtain reimbursement or pricing approval in
some countries, we may be required to conduct a clinical trial that compares the cost-effectiveness
of our existing and future product candidates to other available products. If reimbursement of our
future product candidates is unavailable or limited in scope or amount, or if pricing is set at
unsatisfactory levels, we may be unable to achieve or sustain profitability.
Our business may become subject to economic, political, regulatory and other risks associated
with international operations.
Our business is subject to risks associated with conducting business internationally, in part
due to some of our suppliers being located outside the U.S. Accordingly, our future results could
be harmed by a variety of factors, including:
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difficulties in compliance with non-U.S. laws and regulations; |
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changes in non-U.S. regulations and customs; |
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changes in non-U.S. currency exchange rates and currency controls; |
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changes in a specific countrys or regions political or economic environment; |
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trade protection measures, import or export licensing requirements or other restrictive
actions by U.S. or non-U.S. governments; |
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negative consequences from changes in tax laws; and |
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difficulties associated with staffing and managing foreign operations, including
differing labor relations. |
33
Risks Related to Our Common Stock
The market price of our common stock has been, and may continue to be, highly volatile, and
such volatility could cause the market price of our common stock to decrease and could cause you to
lose some or all of your investment in our common stock.
For the two years ended December 31, 2010, the market price of our common stock has fluctuated
from a high of $2.20 per share to a low of $0.45 per share. The market price of our common stock
may continue to fluctuate significantly in response to numerous factors, some of which are beyond
our control, such as:
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the announcement of new products or product enhancements by us or our competitors; |
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developments concerning intellectual property rights and regulatory approvals; |
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variations in our and our competitors results of operations; |
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changes in earnings estimates or recommendations by securities analysts, if our common
stock is covered by analysts; |
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developments in the medical device industry; |
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the results of product liability or intellectual property lawsuits; |
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future issuances of common stock or other securities; |
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the addition or departure of key personnel; |
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announcements by us or our competitors of acquisitions, investments or strategic
alliances; and |
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general market conditions and other factors, including factors unrelated to our
operating performance. |
Further, the stock market in general, and the market for medical device companies in
particular, has recently experienced extreme price and volume fluctuations. The volatility of our
common stock is further exacerbated due to its low trading volume. Continued market fluctuations
could result in extreme volatility in the price of our common stock, which could cause a decline in
the value of our common stock and the loss of some or all of your investment.
Some or all of the restricted shares of our common stock issued in connection with our
acquisition of SafeStitch LLC, our 2008 and 2010 private placements and the 2010 conversion of all
outstanding shares of our preferred stock and shares of restricted common stock held by other of
our stockholders may be offered from time to time in the open market pursuant to an effective
registration statement under the Securities Act of 1933, as amended, or without registration
pursuant to Rule 144 promulgated thereunder, and these sales may have a depressive effect on the
market price of our common stock.
Trading of our common stock is limited, and trading restrictions imposed on us by applicable
regulations may further reduce trading in our common stock, making it difficult for our
stockholders to sell their shares; and future sales of common stock could reduce our stock price.
Trading of our common stock is currently conducted on the OTCQB. The liquidity of our common
stock is limited, not only in terms of the number of shares that can be bought and sold at a given
price, but also as it may be adversely affected by delays in the timing of transactions and
reduction in security analysts and the medias coverage of us, if at all. Approximately 62% of
the issued and outstanding shares of our common stock are held by officers, directors and
beneficial owners of at least 10% of our outstanding shares, each of whom is subject to certain
restrictions with regard to trading our common stock.
These factors may result in different prices for our common stock than might otherwise be
obtained in a more liquid market and could also result in a larger spread between the bid and asked
prices for our common stock. In addition, without a large public float, our common stock is less
liquid than the stock of companies with broader public ownership, and, as a result, the trading
prices of our common stock may be more volatile. In the absence of an active public trading
market, an investor may be unable to liquidate his investment in our common stock. Trading of a
relatively small volume of our common stock may have a greater impact on the trading price of our
stock than would be the case if our public float were larger. We cannot predict the prices at
which our common stock will trade in the future, if at all.
34
Sales by stockholders of substantial amounts of our shares of common stock, the issuance of
new shares of common stock by us or the perception that these sales may occur in the future could
materially and adversely affect the market price of our common stock, and you may lose all or a
portion of your investment in our common stock.
Because our common stock may be a penny stock, it may be more difficult for investors to
sell shares of our common stock, and the market price of our common stock may be adversely
affected.
Our common stock may be a penny stock if, among other things, the stock price is below $5.00
per share, it is not listed on a national securities exchange or approved for quotation on the
Nasdaq Stock Market or any other national stock exchange or it has not met certain net tangible
asset or average revenue requirements. Broker-dealers who sell penny stocks must provide
purchasers of these stocks with a standardized risk-disclosure document prepared by the Securities
and Exchange Commission (SEC). This risk-disclosure document provides information about penny
stocks and the nature and level of risks involved in investing in the penny-stock market. A broker
must also give a purchaser, orally or in writing, bid and offer quotations and information
regarding broker and salesperson compensation, make a written determination that the penny stock is
a suitable investment for the purchaser and obtain the purchasers written agreement to the
purchase. Broker-dealers must also provide customers that hold penny stock in their accounts with
such broker-dealer a monthly statement containing price and market information relating to the
penny stock. If a penny stock is sold to an investor in violation of the penny stock rules, the
investor may be able to cancel its purchase and get its money back.
If applicable, the penny stock rules may make it difficult for investors to sell their shares
of our common stock. Because of the rules and restrictions applicable to a penny stock, there is
less trading in penny stocks and the market price of our common stock may be adversely affected.
Also, many brokers choose not to participate in penny stock transactions. Accordingly, investors
may not always be able to resell their shares of our common stock publicly at times and prices that
they feel are appropriate.
Directors, executive officers, principal stockholders and affiliated entities own a
significant percentage of our capital stock, and they may make decisions that you do not consider
to be in the best interests of our stockholders.
Our directors, executive officers, principal stockholders and affiliated entities beneficially
own, in the aggregate, over 62% of our outstanding voting securities. As a result, if some or all
of them acted together, they would have the ability to exert substantial influence over the
election of our board of directors and the outcome of issues requiring approval by our
stockholders. This concentration of ownership may also have the effect of delaying or preventing a
change in control of our company that may be favored by other stockholders. This could prevent
transactions in which stockholders might otherwise recover a premium for their shares over current
market prices.
Compliance with changing regulations concerning corporate governance and public disclosure may
result in additional expenses.
There have been changing laws, regulations and standards relating to corporate governance and
public disclosure, including the Sarbanes-Oxley Act, new regulations promulgated by the SEC and
rules promulgated by the national securities exchanges. These new or changed laws, regulations and
standards are subject to varying interpretations in many cases due to their lack of specificity,
and, as a result, their application in practice may evolve over time as new guidance is provided by
regulatory and governing bodies, which could result in continuing uncertainty regarding compliance
matters and higher costs necessitated by ongoing revisions to disclosure and governance practices.
As a result, our efforts to comply with evolving laws, regulations and standards are likely to
continue to result in increased general and administrative expenses and a diversion of management
time and attention from revenue-generating activities to compliance activities. Our board of
directors, Chief Executive Officer and Chief Financial Officer could face an increased risk of
personal liability in connection with the performance of their duties. As a result, we may have
difficulty attracting and retaining qualified board members and executive officers, which could
harm our business. If our efforts to comply with new or changed laws,
regulations and standards differ from the activities intended by regulatory or governing
bodies, we could be subject to liability under applicable laws or our reputation may be harmed.
35
Our principal corporate office is located at 4400 Biscayne Blvd., Miami, Florida. We rent
this space from Frost Real Estate Holdings, LLC, which is a company controlled by Dr. Phillip
Frost, our largest beneficial stockholder. We lease approximately 4,100 square feet under the
lease agreement, which is for a five-year term that began on January 1, 2008.
Additionally, we lease approximately 462 square feet of office space in Omaha, Nebraska. This
facility includes one administrative office used by Dr. Filipi, who is based in Omaha, Nebraska and
is our Chief Medical Officer and one of the members of our Board of Directors. We also lease
approximately 1,200 square feet of warehouse space in Miami, Florida which is used as our prototype
lab.
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Item 3. |
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Legal Proceedings. |
None.
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Item 4. |
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(Removed and Reserved). |
36
PART II
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Item 5. |
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Market for Registrants Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities. |
Since February 22, 2011, our common stock has been quoted on the OTCQB under the symbol
SFES. Prior to such date, our common stock was quoted on the OTCBB under the symbol SFES. The
table below sets forth, for the respective periods indicated, the high and low bid prices for our
common stock in the over-the-counter market as reported on the OTCQB or the OTCBB, as applicable.
The bid prices represent inter-dealer transactions, without adjustments for retail mark-ups,
mark-downs or commissions and may not necessarily represent actual transactions.
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Bid Prices |
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High |
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Low |
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2010 |
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First Quarter |
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1.95 |
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$ |
1.02 |
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Second Quarter |
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1.70 |
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1.02 |
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Third Quarter |
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2.20 |
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1.50 |
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Fourth Quarter |
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2.05 |
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1.14 |
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2009 |
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|
|
|
First Quarter |
|
$ |
1.00 |
|
|
$ |
0.45 |
|
Second Quarter |
|
|
1.06 |
|
|
|
0.50 |
|
Third Quarter |
|
|
1.15 |
|
|
|
0.51 |
|
Fourth Quarter |
|
|
1.25 |
|
|
|
0.53 |
|
As of March 28, 2011, there were approximately 200 record holders of our common stock.
We paid no dividends or made any other distributions in respect of our common stock during our
fiscal years ended December 31, 2010 and 2009, and we have no plans to pay any dividends or make
any other distributions in the future.
In connection with our acquisition of SafeStitch LLC, we entered into a Note and Security
Agreement with both The Frost Group, LLC, a Florida limited liability company whose members include
Frost Gamma Investments Trust, a trust indirectly controlled by Dr. Phillip Frost, the largest
beneficial holder of our common stock, as well as Dr. Jane H. Hsiao and Steven D. Rubin, two of our
directors, and Jeffrey G. Spragens, our Chief Executive Officer and President and a director for
$4.0 million in total available borrowings. Under this credit facility, we may distribute stock
dividends in respect of our common stock, but we may not pay cash dividends in respect of our
common stock.
|
|
|
Item 6. |
|
Selected Financial Data. |
As a smaller reporting company as defined in Rule 12b-2 of the Securities Exchange Act of
1934, as amended (the Exchange Act), we are not required to include information otherwise
required by this item.
37
|
|
|
Item 7. |
|
Managements Discussion and Analysis of Financial Condition and Results of Operations. |
This Annual Report on Form 10-K contains certain forward-looking statements about our
expectations, beliefs or intentions regarding our product development and commercialization
efforts, business, financial condition, results of operations, strategies or prospects. You can
identify forward-looking statements by the fact that these statements do not relate strictly to
historical or current matters. Rather, forward-looking statements relate to anticipated or
expected events, activities, trends or results as of the date they are made. Because
forward-looking statements relate to matters that have not yet occurred, these statements are
inherently subject to risks and uncertainties that could cause our actual results to differ
materially from any future results expressed or implied by the forward-looking statements. Many
factors could cause our actual activities or results to differ materially from the activities and
results anticipated in forward-looking statements. These factors include those set forth below as
well as those contained in Item 1A Risk Factors of this Annual Report on Form 10-K. We do not
undertake any obligation to update forward-looking statements, except as required by applicable
law. These forward-looking statements are only predictions and reflect our views as of the date
they are made with respect to future events and financial performance.
Overview
We are a developmental stage, FDA-registered medical device company focused on the development
of medical devices that manipulate tissues for obesity, GERD, hernia formation, esophageal
obstructions, Barretts Esophagus, upper gastrointestinal bleeding, and other intraperitoneal
abnormalities through endoscopic and minimally invasive surgery.
We have utilized our expertise in intraperitoneal surgery to test certain of our devices in in
vivo and ex vivo animal trials and ex vivo human trials, and with certain products, in limited in
vivo human trials. Certain of our products did not or may not require clinical trials, including
our AMID Stapler®, SMART DilatorTM, and standard and airway bite blocks. Where
required, we intend to rapidly, efficiently and safely move into clinical trials for certain other
devices, including those utilized in surgery for the treatment of obesity, GERD and for the
treatment and diagnosis of Barretts Esophagus. Preliminary clinical trials for our gastroplasty
product candidates began in the third quarter of 2010 and are expected to continue starting in the
second half of 2011. Sales of our AMID Stapler® are anticipated to begin in the second half of
2011.
Critical Accounting Policies and Estimates
Our discussion and analysis of our financial condition and results of operations are based
upon our consolidated financial statements, which have been prepared in accordance with accounting
principles generally accepted in the United States. The preparation of these financial statements
requires us to make estimates and judgments that affect the reported amounts of assets, liabilities
and expenses, and related disclosure of contingent assets and liabilities. On an on-going basis,
we evaluate our estimates, including those related to investments, property and equipment,
intangible assets, contingencies and litigation. We base our estimates on historical experience
and on various other assumptions that are believed to be reasonable under the circumstances, the
results of which form the basis for making judgments about the carrying values of assets and
liabilities that are not readily apparent from other sources. A more detailed discussion on the
application of these and other accounting policies can be found in Note 2 in the Notes to the
Consolidated Financial Statements set forth in Item 8 of this Annual Report on Form 10-K. Actual
results may differ from these estimates under different assumptions or conditions.
Results of Operations
Our net loss totaled $17.0 million from September 15, 2005 (inception) through December 31,
2010. Such losses included $5.3 million and $2.4 million for the years ended December 31, 2010 and
2009, respectively. At December 31, 2010, we had an accumulated deficit of $17.0 million. Since
we do not currently generate revenue from any of our products, including those already cleared for
commercial marketing by the FDA, we expect to continue to generate losses in connection with the
commercial launch of such FDA-cleared products and the continual development of our other products
and technologies. Our research and development activities are budgeted to expand over time and
will require further resources if we are to be successful. As a result, we believe our operating
losses are likely to be substantial over the next several years.
38
Year Ended December 31, 2010 Compared to Year Ended December 31, 2009
Research and Development (R&D) costs and expenses were $2.7 million for the year ended
December 31, 2010, as compared to $1.3 million for the year ended December 31, 2009. This $1.4
million increase resulted primarily from the addition of R&D and manufacturing staff and increased
expenditures for contract engineering services, pre-clinical testing, manufacturing equipment,
controlled environment infrastructure, the manufacturing of devices and components to be used in
clinical trials of our gastroplasty device, and costs associated with monitoring and supporting the
contract manufacturer of the AMID Stapler®.
Selling, General and Administrative (SG&A) costs and expenses were $2.6 million for the year
ended December 31, 2010 as compared to $1.4 million for the year ended December 31, 2009. This $1.2
million increase is primarily related to increased payroll costs from the addition of
administrative, quality, regulation, marketing and sales personnel, increased stock-based
compensation expense and increased advertising, travel and trade show expenses related to the
initial commercialization of the AMID Stapler®, inventory adjustments and engineering and other
costs associated with our efforts to develop a more reliable manufacturing process. These
increases were offset in part by reductions in accounting and legal fees. SG&A costs and expenses
consist primarily of salaries and other related costs, including stock-based compensation expense.
Other SG&A costs and expenses include facility-related costs not otherwise included in R&D costs
and expenses, and professional fees for legal and accounting services. We expect that our SG&A
costs and expenses will remain relatively consistent with 2010 in the short term until such time
as we recommence commercialization activities for the AMID Stapler® in the second half of 2011,
after which we anticipate that SG&A costs and expenses will increase.
Other income of $244,000 for the year ended December 31, 2010 resulted from the awarding of a
tax grant under the U.S. Governments Qualifying Therapeutic Discovery Project (QTDP) program for
research related to development of the AMID Stapler® and the related Simplified Stapled
Lichtenstein Procedure (SSLP) for hernia repair relating to 2009 fiscal year. The QTDP program
was created by Congress on May 21, 2010 under Section 48D of the Internal Revenue Code, as enacted
under the Patient Protection and Affordable Care Act. The QTDP program provides support for
innovative projects that are determined by the U.S. Department of Health and Human Services to have
reasonable potential to result in a new therapy, reduce health care costs, or significantly advance
the goal of curing cancer. The $244,000 grant will not be taxable income for federal tax purposes.
Other income was $903,000 for the year ended December 31, 2009 resulting from a non-recurring gain
recognized upon the disposition of our investment in TruePosition, pursuant to a litigation
settlement.
Interest income was negligible for the year ended December 31, 2010. There was no interest
expense for the year ended December 31, 2010, as compared to $19,000 for the year ended December
31, 2009. The 2009 interest expense was due to outstanding balances under our credit facility.
Liquidity and Capital Resources
As a result of our significant R&D expenditures and the lack of any product sales revenue, we
have generated operating losses since inception. We do not expect to have any source of revenues
before the second half of 2011, and we expect to incur losses from operations for the foreseeable
future. We expect to incur increasing R&D costs and expenses, including expenses related to hiring
new personnel and conducting clinical trials. We expect that SG&A costs and expenses will also
increase as we expand our regulatory compliance and administrative staff and add sales and
marketing personnel and infrastructure.
To date, we have funded our operations primarily with proceeds from the private placement of
stock and credit facilities available to us from our stockholders. Our ability to sell additional
shares of our stock and/or borrow cash under existing or new credit facilities could be materially
adversely affected by any economic turmoil in the worlds equity and credit markets. There can
therefore be no assurance that we will be able to raise funds on acceptable terms or at all, which
may materially adversely affect our ability to continue our operations. Additionally, the current
economic conditions could also reduce the demand for new and innovative medical devices, resulting
in delayed market acceptance of our product candidates. Such delay could have a material adverse
impact on our expected cash flows, liquidity, results of operations and financial position.
39
As a result of these actions, we have received FDA and CE Mark clearance to begin marketing
the AMID Stapler® in the U.S., European Union and certain other countries, and we are preparing to
commence clinical trials of our Gastroplasty Device. We expect to begin commercial sales of the
AMID Stapler® in the second half of 2011. Commencing such commercialization and clinical trial
activities is anticipated to significantly increase our cash requirements for 2011 and into the
foreseeable future. Our management believes that our cash balance as of December 31, 2010 of
approximately $3.0 million, together with the $4.0 million availability under our existing line of
credit, the maturity date of which has been extended from June 2011 to June 2012, is sufficient to
fund our current cash flow requirements through December 31, 2011. However, in order to fund all
planned operations, including the commercialization of certain of our products and the anticipated
expansion in 2011 of clinical trials for certain of our product candidates, we anticipate that
additional external financing will be required. We have based this estimate on assumptions that
are subject to change and may prove to be wrong, and we may be required to use our available
capital resources sooner than we currently expect. Because of the numerous risks and uncertainties
associated with the development and commercialization of our product candidates, we are unable to
estimate the precise amounts of capital outlays and operating expenditures associated with our
current and anticipated commercialization efforts and clinical trials.
Our actual future capital requirements will depend on many factors, including the progress and
results of our clinical trials, the duration and cost of discovery and preclinical development, and
laboratory testing and clinical trials for our product candidates, the timing and outcome of
regulatory review of our product candidates, the costs involved in preparing, filing, prosecuting,
maintaining, defending and enforcing patent claims and other intellectual property rights, the
number and development requirements of other product candidates that we pursue and the costs of
commercialization activities, including product marketing, sales and distribution.
We will need to finance our future cash needs through public or private equity offerings, debt
financings or corporate collaboration and licensing arrangements. We currently do not have any
commitments for future external funding. We may need to raise additional funds more quickly if one
or more of our assumptions prove to be incorrect or if we choose to expand our product development
efforts more rapidly than we presently anticipate. We may also decide to raise additional funds
even before we need them if the conditions for raising capital are favorable. The sale of
additional equity or debt securities will likely result in dilution to our shareholders. The
incurrence of indebtedness would result in increased fixed obligations and could also result in
covenants that would restrict our operations. Additional equity or debt financing, grants or
corporate collaboration and licensing arrangements may not be available on acceptable terms, if at
all. If adequate funds are not available, we may be required to delay, reduce the scope of or
eliminate our R&D programs, reduce our planned commercialization efforts or obtain funds through
arrangements with collaborators or others that may require us to relinquish rights to certain
product candidates that we might otherwise seek to develop or commercialize independently.
|
|
|
Item 7A. |
|
Quantitative and Qualitative Disclosures About Market Risk. |
As a smaller reporting company as defined in Rule 12b-2 of the Exchange Act, we are not
required to include the information otherwise required by this item.
40
|
|
|
Item 8. |
|
Financial Statements and Supplementary Data. |
41
REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
Board of Directors and Stockholders
SafeStitch Medical, Inc.
We have audited the accompanying consolidated balance sheets of SafeStitch Medical, Inc. (a
development stage company) (the Company) as of December 31, 2010 and 2009, and the related
consolidated statements of operations, stockholders equity and cash flows for the years ended
December 31, 2010 and 2009 and for the period from September 15, 2005 (inception) through December
31, 2010. These financial statements are the responsibility of the Companys management. Our
responsibility is to express an opinion on these financial statements based on our audits.
We conducted our audits in accordance with the standards of the Public Company Accounting Oversight
Board (United States). Those standards require that we plan and perform the audit to obtain
reasonable assurance about whether the financial statements are free of material misstatement. We
were not engaged to perform an audit of the Companys internal control over financial reporting.
Our audits include consideration of internal control over financial reporting as a basis for
designing audit procedures that are appropriate in the circumstances, but not for the purpose of
expressing an opinion on the effectiveness of the Companys internal control over financial
reporting. Accordingly, we express no such opinion. An audit includes examining, on a test basis,
evidence supporting the amounts and disclosures in the financial statements. An audit also
includes assessing the accounting principles used and significant estimates made by management, as
well as evaluating the overall financial statement presentation. We believe that our audits
provide a reasonable basis for our opinion.
In our opinion, the financial statements referred to above present fairly, in all material
respects, the consolidated financial position of the Company as of December 31, 2010 and 2009, and
the consolidated results of their operations and cash flows for the years ended December 31, 2010
and 2009 and for the period from September 15, 2005 (inception) through December 31, 2010, in
conformity with accounting principles generally accepted in the United States of America.
/s/
EisnerAmper LLP (formerly known as Eisner LLP)
New York, New York
March 28, 2011
42
SAFESTITCH MEDICAL, INC.
(A Developmental Stage Company)
CONSOLIDATED BALANCE SHEETS
(in 000s, except share and per share data)
|
|
|
|
|
|
|
|
|
|
|
December 31, |
|
|
December 31, |
|
|
|
2010 |
|
|
2009 |
|
ASSETS |
|
|
|
|
|
|
|
|
CURRENT ASSETS |
|
|
|
|
|
|
|
|
Cash and cash equivalents |
|
$ |
3,032 |
|
|
$ |
871 |
|
Other receivable related-party |
|
|
64 |
|
|
|
21 |
|
Prepaid Expenses |
|
|
117 |
|
|
|
131 |
|
Inventory |
|
|
91 |
|
|
|
0 |
|
|
|
|
|
|
|
|
Total Current Assets |
|
|
3,304 |
|
|
|
1,023 |
|
FIXED ASSETS |
|
|
|
|
|
|
|
|
Property and equipment, net |
|
|
337 |
|
|
|
147 |
|
OTHER ASSETS |
|
|
|
|
|
|
|
|
Security deposits |
|
|
2 |
|
|
|
2 |
|
Deferred financing costs, net |
|
|
51 |
|
|
|
255 |
|
|
|
|
|
|
|
|
Total Other Assets |
|
|
53 |
|
|
|
257 |
|
|
|
|
|
|
|
|
TOTAL ASSETS (Note 6) |
|
$ |
3,694 |
|
|
$ |
1,427 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
LIABILITIES AND STOCKHOLDERS EQUITY |
|
|
|
|
|
|
|
|
CURRENT LIABILITIES |
|
|
|
|
|
|
|
|
Accounts payable and accrued liabilities |
|
$ |
221 |
|
|
$ |
93 |
|
Notes payable |
|
|
49 |
|
|
|
50 |
|
|
|
|
|
|
|
|
Total Current Liabilities |
|
|
270 |
|
|
|
143 |
|
Stockholder loans |
|
|
|
|
|
|
|
|
Commitments and contingencies (Note 9) |
|
|
|
|
|
|
|
|
STOCKHOLDERS EQUITY |
|
|
|
|
|
|
|
|
Preferred stock, $0.01 par value per share, 25,000,000 shares authorized |
|
|
|
|
|
|
|
|
10% Series A Cumulative Convertible Preferred Stock, 4,000,000 shares
authorized, 0 and 2,000,000 shares issued and outstanding,
respectively; liquidation preference $0 and $2,088 |
|
|
|
|
|
|
20 |
|
Common stock, $0.001 par value per share, 225,000,000 shares authorized, |
|
|
|
|
|
|
|
|
28,003,755 and 17,962,718 shares issued and outstanding, respectively. |
|
|
28 |
|
|
|
18 |
|
Additional paid-in capital |
|
|
20,427 |
|
|
|
12,974 |
|
Deficit accumulated during the development stage |
|
|
(17,031 |
) |
|
|
(11,728 |
) |
|
|
|
|
|
|
|
Total Stockholders Equity |
|
|
3,424 |
|
|
|
1,284 |
|
|
|
|
|
|
|
|
TOTAL LIABILITIES AND STOCKHOLDERS EQUITY |
|
$ |
3,694 |
|
|
$ |
1,427 |
|
|
|
|
|
|
|
|
The accompanying notes are an integral part of these consolidated financial statements.
43
SAFESTITCH MEDICAL, INC.
(A Developmental Stage Company)
CONSOLIDATED STATEMENTS OF OPERATIONS
(in 000s, except per share amounts)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
September 15, |
|
|
|
Years Ended |
|
|
2005 (Inception) |
|
|
|
December 31, |
|
|
to December 31, |
|
|
|
2010 |
|
|
2009 |
|
|
2010 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Revenues |
|
$ |
|
|
|
$ |
|
|
|
$ |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Costs and expenses |
|
|
|
|
|
|
|
|
|
|
|
|
Research and development |
|
|
2,728 |
|
|
|
1,256 |
|
|
|
9,571 |
|
Selling, General and administrative |
|
|
2,617 |
|
|
|
1,399 |
|
|
|
6,689 |
|
|
|
|
|
|
|
|
|
|
|
Total costs and expenses |
|
|
5,345 |
|
|
|
2,655 |
|
|
|
16,260 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Loss from operations |
|
|
(5,345 |
) |
|
|
(2,655 |
) |
|
|
(16,260 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Other income and (expense) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Other income |
|
|
244 |
|
|
|
903 |
|
|
|
1,147 |
|
Interest income |
|
|
2 |
|
|
|
|
|
|
|
79 |
|
Amortization of deferred financing costs |
|
|
(204 |
) |
|
|
(595 |
) |
|
|
(1,933 |
) |
Interest expense |
|
|
|
|
|
|
(19 |
) |
|
|
(64 |
) |
|
|
|
|
|
|
|
|
|
|
Total Other income and (expense) |
|
|
42 |
|
|
|
289 |
|
|
|
(771 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Loss before income tax |
|
|
(5,303 |
) |
|
|
(2,366 |
) |
|
|
(17,031 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Provision for income tax |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net loss |
|
$ |
(5,303 |
) |
|
$ |
(2,366 |
) |
|
$ |
(17,031 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Loss attributable to common stockholders and loss per
common share: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net loss |
|
$ |
(5,303 |
) |
|
$ |
(2,366 |
) |
|
$ |
(17,031 |
) |
Deemed dividend Series A Preferred Stock Issuance |
|
|
(500 |
) |
|
|
(200 |
) |
|
|
(700 |
) |
Deemed dividend Series A Preferred Stock Conversion |
|
|
(4,301 |
) |
|
|
|
|
|
|
(4,301 |
) |
Declared/Accrued Dividends Series A Preferred Stock |
|
|
(278 |
) |
|
|
(88 |
) |
|
|
(366 |
) |
|
|
|
|
|
|
|
|
|
|
Loss attributable to common stockholders |
|
|
(10,382 |
) |
|
|
(2,654 |
) |
|
|
(22,398 |
) |
Weighted average shares outstanding, basic and diluted |
|
|
22,230 |
|
|
|
17,963 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net loss per basic and diluted share |
|
$ |
(0.47 |
) |
|
$ |
(0.15 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
The accompanying notes are an integral part of these consolidated financial statements.
44
SAFESTITCH MEDICAL, INC.
(A Developmental Stage Company)
CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS EQUITY (DEFICIT)
FOR THE PERIOD SEPTEMBER 15, 2005 (INCEPTION) THROUGH DECEMBER 31, 2010
(in 000s, except per share amounts)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Deficit |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Accumulated |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Additional |
|
|
During the |
|
|
|
|
|
|
|
Preferred Stock |
|
|
Common Stock |
|
|
Paid-in |
|
|
Development |
|
|
|
|
|
|
|
Shares |
|
|
Amount |
|
|
Shares |
|
|
Amount |
|
|
Capital |
|
|
Stage |
|
|
Total |
|
Inception September 15, 2005 |
|
|
|
|
|
$ |
|
|
|
|
|
|
|
$ |
|
|
|
$ |
|
|
|
$ |
|
|
|
$ |
|
|
Capital contributed |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1 |
|
|
|
|
|
|
|
1 |
|
Net loss |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(76 |
) |
|
|
(76 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Balance at December 31, 2005 |
|
|
|
|
|
$ |
|
|
|
|
|
|
|
$ |
|
|
|
$ |
1 |
|
|
$ |
(76 |
) |
|
$ |
(75 |
) |
Capital contributed |
|
|
|
|
|
|
|
|
|
|
11,256 |
|
|
|
11 |
|
|
|
1,493 |
|
|
|
|
|
|
|
1,504 |
|
Net loss |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(1,060 |
) |
|
|
(1,060 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Balance at December 31, 2006 |
|
|
|
|
|
$ |
|
|
|
|
11,256 |
|
|
$ |
11 |
|
|
$ |
1,494 |
|
|
$ |
(1,136 |
) |
|
$ |
369 |
|
Exercise of options (CTS)-September 23, 2007 at
$0.79 per share |
|
|
|
|
|
|
|
|
|
|
42 |
|
|
|
|
|
|
|
35 |
|
|
|
|
|
|
|
35 |
|
Stock-based compensation-September 4, 2007 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
77 |
|
|
|
|
|
|
|
77 |
|
Issuance of shares in recapitalization September
4, 2007 at $0.64 per share |
|
|
|
|
|
|
|
|
|
|
4,795 |
|
|
|
5 |
|
|
|
3,078 |
|
|
|
|
|
|
|
3,083 |
|
SafeStitch expenses associated with recapitalization |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(156 |
) |
|
|
|
|
|
|
(156 |
) |
Stock-based compensation |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
65 |
|
|
|
|
|
|
|
65 |
|
Warrants issued in connection with credit
facility-September 4, 2007 at $2.46 per share |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1,985 |
|
|
|
|
|
|
|
1,985 |
|
Rule 16 payment received |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
4 |
|
|
|
|
|
|
|
4 |
|
Net loss |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(3,041 |
) |
|
|
(3,041 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Balance at December 31, 2007 |
|
|
|
|
|
$ |
|
|
|
|
16,093 |
|
|
$ |
16 |
|
|
$ |
6,582 |
|
|
$ |
(4,177 |
) |
|
$ |
2,421 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Issuance of common shares in private offering
May 2008 at $2.15 per share, net of offering costs |
|
|
|
|
|
|
|
|
|
|
1,862 |
|
|
|
2 |
|
|
|
3,986 |
|
|
|
|
|
|
|
3,988 |
|
Issuance of common shares as repayment of
stockholder note-December 30, 2008 at $1.22 per
share |
|
|
|
|
|
|
|
|
|
|
8 |
|
|
|
|
|
|
|
10 |
|
|
|
|
|
|
|
10 |
|
Stock-based compensation |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
239 |
|
|
|
|
|
|
|
239 |
|
Net loss |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(5,185 |
) |
|
|
(5,185 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Balance at December 31, 2008 |
|
|
|
|
|
$ |
|
|
|
|
17,963 |
|
|
$ |
18 |
|
|
$ |
10,817 |
|
|
$ |
(9,362 |
) |
|
$ |
1,473 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Issuance of Series A Preferred Stock in July 2009
at $1.00 per share, net of offering costs |
|
|
2,000 |
|
|
|
20 |
|
|
|
|
|
|
|
|
|
|
|
1,962 |
|
|
|
|
|
|
|
1,982 |
|
Fair value of beneficial conversion feature of
Series A Preferred Stock |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
200 |
|
|
|
|
|
|
|
200 |
|
Deemed dividend to Series A Preferred Stockholders,
charged to additional paid-in capital in the
absence of retained earnings |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(200 |
) |
|
|
|
|
|
|
(200 |
) |
Stock-based compensation |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
195 |
|
|
|
|
|
|
|
195 |
|
Net loss |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(2,366 |
) |
|
|
(2,366 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Balance at December 31, 2009 |
|
|
2,000 |
|
|
$ |
20 |
|
|
|
17,963 |
|
|
$ |
18 |
|
|
$ |
12,974 |
|
|
$ |
(11,728 |
) |
|
$ |
1,284 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Issuance of Series A Preferred Stock in January
2010 at $1.00 per share, net of offering costs |
|
|
2,000 |
|
|
|
20 |
|
|
|
|
|
|
|
|
|
|
|
1,978 |
|
|
|
|
|
|
|
1,998 |
|
Fair value of beneficial conversion feature of
Series A Preferred Stock |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
500 |
|
|
|
|
|
|
|
500 |
|
Deemed dividend to Series A Preferred Stockholders,
charged to additional paid-in capital in the
absence of retained earnings |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(500 |
) |
|
|
|
|
|
|
(500 |
) |
Issuance of common shares in private offering
June 2010 at $1.00 per share, net of offering costs |
|
|
|
|
|
|
|
|
|
|
4,978 |
|
|
|
5 |
|
|
|
4,969 |
|
|
|
|
|
|
|
4,974 |
|
Conversion of 4,000 shares of Series A Preferred
Stock and accumulated dividends into 4,366 shares
of Common Stock in September 2010 |
|
|
(4,000 |
) |
|
|
(40 |
) |
|
|
4,366 |
|
|
|
4 |
|
|
|
36 |
|
|
|
|
|
|
|
|
|
Issuance of 697 shares of Common Stock as
Consideration Shares in September 2010 |
|
|
|
|
|
|
|
|
|
|
697 |
|
|
|
1 |
|
|
|
(1 |
) |
|
|
|
|
|
|
|
|
Intrinsic value of 5,063 aggregate shares of Common
Stock issued on conversion of Series A Preferred
Stock |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
4,301 |
|
|
|
|
|
|
|
4,301 |
|
Dividend paid to Series A Preferred Stockholders on
conversion, charged to additional paid-in capital
in the absence of retained earnings |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(4,301 |
) |
|
|
|
|
|
|
(4,301 |
) |
Stock-based compensation |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
471 |
|
|
|
|
|
|
|
471 |
|
Net loss |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(5,303 |
) |
|
|
(5,303 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Balance at December 31, 2010 |
|
|
|
|
|
$ |
|
|
|
|
28,004 |
|
|
$ |
28 |
|
|
$ |
20,427 |
|
|
$ |
(17,031 |
) |
|
$ |
3,424 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
The
accompanying notes are an integral part of these unaudited condensed consolidated financial
statements.
45
SAFESTITCH MEDICAL, INC.
(A Developmental Stage Company)
CONSOLIDATED STATEMENTS OF CASH FLOWS
(in 000s)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
September 15, |
|
|
|
|
|
|
|
|
|
|
|
2005 (Inception) |
|
|
|
Years Ended December 31, |
|
|
to December 31, |
|
|
|
2010 |
|
|
2009 |
|
|
2010 |
|
OPERATING ACTIVITIES |
|
|
|
|
|
|
|
|
|
|
|
|
Net loss |
|
$ |
(5,303 |
) |
|
$ |
(2,366 |
) |
|
$ |
(17,031 |
) |
Adjustments to reconcile net loss to net cash used in operating activities: |
|
|
|
|
|
|
|
|
|
|
|
|
Amortization of deferred finance costs |
|
|
204 |
|
|
|
595 |
|
|
|
1,933 |
|
Stock-based compensation expense |
|
|
471 |
|
|
|
195 |
|
|
|
970 |
|
Stock-based compensation expense related to Share Exchange |
|
|
|
|
|
|
|
|
|
|
77 |
|
Depreciation and amortization |
|
|
87 |
|
|
|
56 |
|
|
|
202 |
|
Gain on sale of TruePosition investment |
|
|
|
|
|
|
(903 |
) |
|
|
(903 |
) |
Inventory adjustments |
|
|
53 |
|
|
|
|
|
|
|
53 |
|
Changes in operating assets and liabilities |
|
|
|
|
|
|
|
|
|
|
|
|
Other current assets |
|
|
(29 |
) |
|
|
12 |
|
|
|
(161 |
) |
Inventory |
|
|
(144 |
) |
|
|
|
|
|
|
(144 |
) |
Other assets |
|
|
|
|
|
|
|
|
|
|
(2 |
) |
Accounts payable and accrued liabilities |
|
|
128 |
|
|
|
(179 |
) |
|
|
(63 |
) |
|
|
|
|
|
|
|
|
|
|
NET CASH USED IN OPERATING ACTIVITIES |
|
|
(4,533 |
) |
|
|
(2,590 |
) |
|
|
(15,069 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
INVESTING ACTIVITIES |
|
|
|
|
|
|
|
|
|
|
|
|
Purchase of equipment |
|
|
(277 |
) |
|
|
(35 |
) |
|
|
(539 |
) |
Proceeds from sale of TruePosition investment |
|
|
|
|
|
|
903 |
|
|
|
903 |
|
Payment received under Rule 16b |
|
|
|
|
|
|
|
|
|
|
4 |
|
|
|
|
|
|
|
|
|
|
|
NET CASH (USED IN) PROVIDED BY INVESTING ACTIVITIES |
|
|
(277 |
) |
|
|
868 |
|
|
|
368 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
FINANCING ACTIVITIES |
|
|
|
|
|
|
|
|
|
|
|
|
Net cash provided in connection with the acquisition of SafeStitch LLC |
|
|
|
|
|
|
|
|
|
|
3,192 |
|
Issuance of Common Stock, net of offering costs |
|
|
4,974 |
|
|
|
|
|
|
|
8,962 |
|
Issuance of Preferred Stock, net of offering costs |
|
|
1,998 |
|
|
|
1,982 |
|
|
|
3,980 |
|
Capital Contributions |
|
|
|
|
|
|
|
|
|
|
1,431 |
|
Proceeds from notes payable |
|
|
70 |
|
|
|
71 |
|
|
|
141 |
|
Repayment of notes payable |
|
|
(71 |
) |
|
|
(21 |
) |
|
|
(92 |
) |
Proceeds from stockholder loans |
|
|
|
|
|
|
900 |
|
|
|
2,860 |
|
Repayment of stockholder loans |
|
|
|
|
|
|
(900 |
) |
|
|
(2,776 |
) |
Exercise of options |
|
|
|
|
|
|
|
|
|
|
35 |
|
|
|
|
|
|
|
|
|
|
|
NET CASH PROVIDED BY FINANCING ACTIVITIES |
|
|
6,971 |
|
|
|
2,032 |
|
|
|
17,733 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
NET INCREASE IN CASH AND CASH EQUIVALENTS |
|
|
2,161 |
|
|
|
310 |
|
|
|
3,032 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
CASH AND CASH EQUIVALENTS AT BEGINNING OF PERIOD |
|
|
871 |
|
|
|
561 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
CASH AND CASH EQUIVALENTS AT END OF PERIOD |
|
$ |
3,032 |
|
|
$ |
871 |
|
|
$ |
3,032 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Supplemental disclosures: |
|
|
|
|
|
|
|
|
|
|
|
|
Cash paid for interest |
|
$ |
|
|
|
$ |
19 |
|
|
$ |
64 |
|
Non cash activities: |
|
|
|
|
|
|
|
|
|
|
|
|
Non-cash dividend upon issuance and conversion of Preferred Stock |
|
$ |
4,801 |
|
|
$ |
200 |
|
|
$ |
5,001 |
|
Dividends |
|
$ |
366 |
|
|
$ |
|
|
|
$ |
366 |
|
Stockholder loans contributed to capital |
|
$ |
|
|
|
$ |
|
|
|
$ |
84 |
|
Warrants issued in connection with credit facility |
|
$ |
|
|
|
$ |
|
|
|
$ |
1,985 |
|
The accompanying notes are an integral part of these consolidated financial statements.
46
SAFESTITCH MEDICAL, INC.
(A Developmental Stage Company)
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
NOTE 1 BASIS OF PRESENTATION AND LIQUIDITY
SafeStitch Medical, Inc. (together with its consolidated subsidiaries, SafeStitch or the
Company) is a developmental stage medical device company focused on the development of medical
devices that manipulate tissues for endoscopic and minimally invasive surgery for the treatment of
obesity, gastroesophageal reflux disease (GERD), Barretts Esophagus, esophageal obstructions,
upper gastrointestinal bleeding, hernia formation and other intraperitoneal abnormalities.
Cellular Technical Services Company, Inc. (Cellular), a non-operating public company, was
incorporated in 1988 as NCS Ventures Corp. under the laws of the State of Delaware. On July 25,
2007 Cellular entered into a Share Transfer, Exchange and Contribution Agreement (the Share
Exchange) with SafeStitch LLC, a Virginia limited liability company. On September 4, 2007,
Cellular acquired all of the members equity interests in SafeStitch LLC in exchange for 11,256,369
shares of Cellulars common stock, which represented a majority of Cellulars outstanding shares
immediately following the Share Exchange. Effective January 8, 2008, Cellular changed its name to
SafeStitch Medical, Inc. and increased the aggregate number of shares of capital stock that may be
issued from 35,000,000 to 250,000,000, comprising 225,000,000 shares of common stock, par value
$0.001 per share (the Common Stock), and 25,000,000 shares of preferred stock, par value $0.01
per share. For accounting purposes, the acquisition has been treated as a recapitalization of
SafeStitch LLC, with SafeStitch LLC as the acquirer (reverse acquisition). The historical
financial statements prior to September 4, 2007 are those of SafeStitch LLC, which began operations
on September 15, 2005. The accompanying financial statements give retroactive effect to the
recapitalization as if it had occurred on September 15, 2005 (inception).
The accompanying financial statements have been prepared assuming that the Company will
continue as a going concern. For the period from September 15, 2005 (inception) through December
31, 2010, the Company has accumulated a deficit of $17.0 million, including a net loss of $5.3
million for the year ended December 31, 2010, and has not generated revenue or positive cash flows
from operations. The Company has been dependent upon equity financing and loans from stockholders
to meet its obligations and sustain operations. The Companys efforts have been principally
devoted to developing its technologies and commercializing its products. Based upon its current
cash position, availability under the extended term of its $4.0 million line of credit from The
Frost Group LLC (The Frost Group) and the Companys President and CEO, Jeffrey G. Spragens (the
Credit Facility), and by monitoring its discretionary expenditures, management believes that the
Company will be able to fund its existing operations through December 31, 2011. However, in order
to fund all planned operations, including the commercialization of certain of the Companys
products and the anticipated expansion in 2011 of clinical trials for certain of the Companys
product candidates, the Company anticipates that additional external financing will be required. If
adequate funds are not available, the Company may be required to delay, reduce the scope of or
eliminate its research and development programs, reduce its planned commercialization efforts or
obtain funds through arrangements with collaborators or others that may require the Company to
relinquish rights to certain product candidates that it might otherwise seek to develop or
commercialize independently. Although the Company plans to secure additional funds through the
issuance of equity and/or debt, no assurance can be given that additional financing will be
available to the Company on acceptable terms, or at all. The Companys ability to continue as a
going concern is ultimately dependent upon generating revenues from those products that do not
require further marketing clearance by the U.S. Food and Drug Administration (FDA), obtaining FDA
clearance to market its other product candidates, and achieving profitable operations and
generating sufficient cash flows from operations to meet future obligations.
47
NOTE 2 SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Consolidation. The consolidated financial statements include the accounts of the Company and its
wholly-owned subsidiaries, Isis Tele-Communications, Inc., which has no current operations, and
SafeStitch LLC. All inter-company accounts and transactions have been eliminated in consolidation.
Use of estimates. The preparation of financial statements in conformity with accounting principles
generally accepted in the United States (GAAP) requires management to make estimates and
assumptions, such as useful lives of property and equipment, that affect the reported amounts of
assets and liabilities and disclosure of contingent assets and liabilities at the date of the
financial statements and the reported amounts of expenses during the reporting period. Actual
results could differ from those estimates.
Cash and cash equivalents. We consider all highly liquid investments with a maturity of three
months or less when purchased to be cash equivalents. The Company holds cash and cash equivalent
balances in banks and other financial institutions, and includes overnight repurchase agreements
collateralizing its depository bank accounts (sweep accounts) in its cash balances. Balances in
excess of Federal Deposit Insurance Corporation (FDIC) limitations may not be insured.
Allowances for Doubtful Accounts. The Company provides an allowance for receivables it believes it
may not collect in full. Receivables are written off when they are deemed to be uncollectible and
all collection attempts have ceased. The amount of bad debt recorded each period and the resulting
adequacy of the allowance for doubtful accounts at the end of each period are determined using a
combination of customer-by-customer analysis of the Companys accounts receivable each period and
subjective assessments of the Companys future bad debt exposure.
Inventories. Inventories are stated at lower of cost or market using the weighted average cost
method and are evaluated at least annually for impairment. The $91,000 inventory balance at
December 31, 2010 consists of reinforcing mesh used for hernia surgery. Provisions for potentially
obsolete or slow-moving inventory are made based on managements analysis of inventory levels,
obsolescence and future sales forecasts.
Property and equipment. Property and equipment are carried at cost less accumulated depreciation.
Major additions and improvements are capitalized, while maintenance and repairs that do not extend
the lives of assets are expensed. Gain or loss, if any, on the disposition of fixed assets is
recognized currently in operations. Depreciation is calculated primarily on a straight-line basis
over estimated useful lives of the assets.
Revenue Recognition. Revenue from product sales is recognized when persuasive evidence of an
arrangement exists, the goods are shipped and title has transferred, the price is fixed or
determinable, and the collection of the sales proceeds is reasonably assured.
Advertising Costs. The Company expenses all costs of advertising as incurred. Advertising and
promotional costs are included in selling, general and administrative (SG&A) costs and expenses
for all periods presented, and totaled $61,000 and $5,000, respectively, for the years ended
December 31, 2010 and 2009.
Research and development. Research and development costs principally represent salaries of the
Companys medical and biomechanical engineering professionals, material and shop costs associated
with manufacturing product prototypes and payments to third parties for clinical trials and
additional product development and testing. All research and development costs are charged to
expense as incurred.
Patent costs. Costs incurred in connection with acquiring patent rights and the protection of
proprietary technologies are charged to expense as incurred.
Stock-based compensation. The Company accounts for all share-based payments, including grants of
stock options, as operating expenses, based on their grant date fair values. The fair value of the
Companys stock option awards is expensed over the vesting life of the underlying stock options
using the graded vesting method, with each tranche of vesting options valued separately.
Stock-based compensation is included in general and administrative costs and expenses for all
periods presented.
48
Therapeutic discovery project tax credit. The Company records the therapeutic discovery project
tax credit on the accrual basis when approved by the government agency which is reported as other
income in the accompanying statements.
Fair value of financial instruments. The carrying amounts of cash and cash equivalents, accounts
payable, and accrued expenses approximate fair value based on their short-term maturity. Related
party receivables and stockholder loans are carried at cost.
Long-lived assets. The Company reviews the carrying values of its long-lived assets, including
long-term investments, for possible impairment whenever events or changes in circumstances indicate
that the carrying amounts of the assets may not be recoverable. Any long-lived assets held for
disposal are reported at the lower of their carrying amounts or fair value less costs to sell.
Income taxes. The Company follows the liability method of accounting for income taxes, which
requires the recognition of deferred tax liabilities and assets for the expected future tax
consequences of temporary differences between the carrying amounts and the tax bases of the assets
and liabilities. The Companys policy is to record a valuation allowance against deferred tax
assets, when the deferred tax asset is not recoverable. The Company considers estimated future
taxable income or loss and other available evidence when assessing the need for its deferred tax
valuation allowance.
Comprehensive income (loss). Comprehensive income (loss) is defined as the change in equity of a
business enterprise during a period from transactions and other events and circumstances from
non-owner sources. The Companys comprehensive net loss is equal to its net loss for all periods
presented.
NOTE 3 PROPERTY AND EQUIPMENT
Property and equipment consists of the following:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Estimated Useful lives |
|
|
December 31, 2010 |
|
|
December 31, 2009 |
|
Machinery and equipment |
|
5 years |
|
$ |
452,000 |
|
|
$ |
190,000 |
|
Furniture, fixtures and leasehold
improvements |
|
3-5 years |
|
|
50,000 |
|
|
|
35,000 |
|
Software |
|
3-5 years |
|
|
37,000 |
|
|
|
37,000 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
539,000 |
|
|
|
262,000 |
|
Accumulated depreciation and
amortization |
|
|
|
|
|
|
(202,000 |
) |
|
|
(115,000 |
) |
|
|
|
|
|
|
|
|
|
|
|
Property and equipment, net |
|
|
|
|
|
$ |
337,000 |
|
|
$ |
147,000 |
|
|
|
|
|
|
|
|
|
|
|
|
Depreciation of fixed assets utilized in research and development activities is included in
research and development expense. All other depreciation is included in general and administrative
expense. Depreciation and amortization expense was $87,000 and $56,000, respectively, for the
years ended December 31, 2010 and 2009.
NOTE 4 LONG-TERM INVESTMENT
In November 1999, Cellular invested in a one-year, $1.0 million 10% convertible note of KSI, Inc.
(KSI) and also received warrants to purchase KSI common stock. All of the outstanding stock of
KSI was acquired in August 2000 by TruePosition, Inc. (TruePosition), a majority owned subsidiary
of Liberty Media Corporation (Liberty Media). Prior to the acquisition, the convertible note was
exchanged for KSI common stock. Cellular exercised the KSI warrants and purchased additional KSI
common stock for approximately $754,000. Cellulars investment in KSI common stock was exchanged
for 191,118 shares of TruePosition common stock on the date of the acquisition. The Company
accounted for the $1,754,000 investment in TruePosition using the cost method. In December 2002,
based upon its review of available information and communications with Liberty Media, Cellular
concluded there had been an other-than-temporary decline in the estimated fair value of its
investment and reduced the recorded carrying value of this investment from its cost basis of
$1,754,000 to zero, representing its best estimate of the then-current fair value of Cellulars
investment in the net equity of TruePosition. In August 2007, the Company was informed that Liberty
TP Acquisition, Inc. was being merged into TruePosition. Pursuant to the terms of the merger,
TruePositions minority stockholders, including the Company, were entitled to receive $3.5116 in
cash in exchange for each share held. The Company exercised its statutory appraisal rights in
respect of this merger, and became a party to both an appraisal action and a securities fraud
litigation. The appraisal action and securities fraud litigation were terminated in December 2009
pursuant to settlement agreements under which each litigating stockholder received a total of
$4.7247 in cash for each TruePosition share held. The Company recorded a $903,000 gain on the
disposition of its 191,118 shares, and received cash proceeds of approximately $816,000, net of
estimated litigation-related costs.
49
NOTE 5 STOCK-BASED COMPENSATION
Cellulars 1996 Stock Option Plan (the 1996 Plan) authorized the grant of both incentive
(ISO) and non-qualified stock options, up to a maximum of 335,000 shares of Common Stock, to
employees of and consultants to the Company. The exercise price, term and vesting provision of
each option grant was fixed by the compensation committee of the Board of Directors (the
Compensation Committee) with the provision that the exercise price of an ISO may not be less than
the fair market value of the Common Stock on the date of grant, and the term of an ISO may not
exceed ten years. The Company has not granted any options under the 1996 Plan since December 31,
2005. The 1996 Plan has been terminated and no new options may be granted under the 1996 Plan.
As of the date of the Share Exchange, all options issued to former officers and directors
under the 1996 Plan with exercise prices in excess of the then-current share price of the Common
Stock were cancelled in exchange for the issuance of 2,000 shares of Common Stock per person, for
an aggregate issuance of 6,000 shares of Common Stock. The Company recognized compensation expense
of $77,000 on the date of the Share Exchange relating to the intrinsic value of the options
outstanding on that date.
The Company granted 88,667 options outside of plans in September 2007 at an exercise price of
$2.60 per share. The Company determined the estimated aggregate fair value of these options on the
grant date to be $196,000, or approximately $2.21 per option. For the years ended December 31,
2010 and 2009, the Company recorded stock-based compensation expense of $34,000 and $49,000,
respectively, for these options, which is included in general and administrative expense.
On November 13, 2007, the Board of Directors and a majority of the Companys stockholders
approved the SafeStitch Medical, Inc. 2007 Incentive Compensation Plan (the 2007 Plan). Under
the 2007 Plan, which is administered by the Compensation Committee, the Company may grant stock
options, stock appreciation rights, restricted stock and/or deferred stock to employees, officers,
directors, consultants and vendors up to an aggregate of 2,000,000 shares of Common Stock, which
are fully reserved for future issuance. The exercise price of stock options or stock appreciation
rights may not be less than the fair market value of the Common Stock at the date of grant and,
within any twelve month period, no person may receive stock options or stock appreciation rights
for more than one million shares of Common Stock. Additionally, no stock options or stock
appreciation rights granted under the 2007 Plan may have a term exceeding ten years.
The Company granted 750,000 and 358,500 stock options under the 2007 Plan during the years ended
December 31, 2010 and 2009, respectively. The options granted during 2009 were issued at an
exercise price of $0.80 per share and had an estimated aggregate grant date fair value of $180,000.
The options granted during 2010 were issued at exercise prices between $1.10 and $2.00 per share
and had an estimated aggregate grant date fair value of $697,000. The weighted average grant date
fair value of the options granted during 2010 and 2009 was $0.93 per share and $0.50 per share,
respectively. At December 31, 2010, a total of 665,000 shares of Common Stock remained available
for issuance under the 2007 Plan.
Total stock-based compensation recorded for the years ended December 31, 2010 and 2009 was
$471,000 and $195,000, respectively, and is included in general and administrative expense. The
fair value of the Companys stock option awards is expensed over the vesting life of the underlying
stock options using the graded vesting method, with each tranche of vesting options valued
separately. Expected volatility is based on the historical volatility of the Companys stock. The
risk-free interest rate for periods within the contractual life of the stock option award is based
on the yield of U.S. Treasury bonds on the grant date with a maturity equal to the expected term of
the stock option. The expected life of stock option awards is based upon the simplified method
for plain vanilla options described in the United States Securities and Exchange Commission
(SEC) Staff Accounting Bulletin No. 107, as amended by SEC Staff Accounting Bulletin No. 110.
Forfeiture rates are based on managements estimates. The fair value of each option granted are
estimated on the date of their grant using the Black-Scholes option pricing model using the
following assumptions.
50
|
|
|
|
|
|
|
Year ended |
|
Year ended |
|
|
December 31, 2010 |
|
December 31, 2009 |
Expected volatility |
|
87.09% 108.28% |
|
74.59% 86.43% |
Expected dividend yield |
|
0.00% |
|
0.00% |
Risk-free interest rate |
|
.88% 3.11% |
|
1.39% 1.79% |
Expected life |
|
4.0 7.0 years |
|
4.0 5.5 years |
Forfeiture rate |
|
0% 5% |
|
2.50% |
The following summarizes the Companys stock option activity for the year ended December 31,
2010:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted |
|
|
|
|
|
|
|
|
|
|
Weighted |
|
|
Average |
|
|
|
|
|
|
|
|
|
|
Average |
|
|
Remaining |
|
|
Aggregate |
|
|
|
|
|
|
|
Exercise |
|
|
Contractual |
|
|
Intrinsic |
|
|
|
Shares |
|
|
Price |
|
|
Term (Years) |
|
|
Value |
|
Outstanding at December 31, 2009 |
|
|
615,167 |
|
|
$ |
1.63 |
|
|
|
5.98 |
|
|
|
|
|
Granted |
|
|
750,000 |
|
|
$ |
1.26 |
|
|
|
6.22 |
|
|
|
|
|
Exercised |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Canceled or expired |
|
|
30,500 |
|
|
$ |
2.24 |
|
|
|
2.11 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Outstanding at December 31, 2010 |
|
|
1,334,667 |
|
|
$ |
1.41 |
|
|
|
5.74 |
|
|
$ |
674,570 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Exercisable at December 31, 2010 |
|
|
427,667 |
|
|
$ |
1.78 |
|
|
|
5.38 |
|
|
$ |
183,520 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Vested and expected to vest at December 31, 2010 |
|
|
1,283,198 |
|
|
$ |
1.42 |
|
|
|
5.74 |
|
|
$ |
646,056 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
62,000 of the 750,000 options granted during the year ended December 31, 2010, were vested as
of December 31, 2010. At December 31, 2010, there was $331,000 of total unrecognized compensation
cost related to non-vested employee and director share-based compensation arrangements. That cost
is expected to be recognized over a weighted-average period of 1.96 years.
No options were exercised during the years ended December 31, 2010 and 2009. The $195,000 of
stock-based compensation recorded for the year ended December 31, 2009 is net of an approximately
$15,000 credit related to the modification of stock option awards for certain former employees. On
the modification date, the Companys Compensation Committee accelerated and fully vested the former
employees options, which were originally scheduled to vest on various dates through 2012.
Additionally, the Compensation Committee extended the term of these options to one year following
the modification date. All 17,000 modified options expired during the year ended December 31, 2010.
No tax benefits were attributed to the stock-based compensation expense because a valuation
allowance was maintained for substantially all net deferred tax assets.
NOTE 6 DEBT
The $49,000 notes payable balance at December 31, 2010 relates to the third-party financing of
certain of the Companys insurance policies. This note is a self-amortizing, 5.94% installment
loan which matures in October 2011.
Credit Facility. In connection with the acquisition of SafeStitch LLC, the Company entered
into the Credit Facility with The Frost Group and Jeffrey G. Spragens, the Companys Chief
Executive Officer and President and a director. The Frost Group is a Florida limited liability
company whose members include Frost Gamma Investments Trust, a trust controlled by Dr. Phillip
Frost, the largest beneficial holder of the issued and outstanding shares of the Companys common
stock, Dr. Jane H. Hsiao, the Companys Chairman of the Board and Steven D. Rubin, a director. The
Credit Facility provides for $4.0 million in total available borrowings, consisting of $3.9 million
from the Frost Group and $100,000 from Mr. Spragens. The Company has granted a security interest
in all present and subsequently acquired collateral in order to secure prompt, full and complete
payment of the amounts due under the Credit Facility. The collateral includes all assets of the
Company, inclusive of intellectual property (patents, patent rights, trademarks, service marks,
etc.). Outstanding borrowings under the Credit Facility accrue interest at a 10% annual rate. The
Credit Facility had an initial term of 28 months, expiring in December 2009, and was amended on
three occasions to extend the Maturity Date, which is now June 30, 2012 (see Note 15).
51
In connection with the Credit Facility, the Company granted warrants to purchase an aggregate
of 805,521 shares of its Common Stock to the Frost Group and Mr. Spragens at an assumed exercise
price of $0.25 per share. The fair value of the warrants was determined to be approximately $2.0
million on the grant date based on the Black-Scholes valuation model using the following
assumptions: expected volatility of 82%, dividend yield of 0%, risk-free interest rate of 4.88% and
expected life of 10 years. The fair value of the warrants was recorded as deferred financing costs
and is being amortized over the life of the Credit Facility. The Company recorded amortization
expense of $204,000 and $595,000 related to these deferred financing costs for the years ended
December 31, 2010 and 2009, respectively.
The Company borrowed $900,000 under the Credit Facility during the year ended December 31,
2009 and repaid the entire outstanding balance in July 2009 using the proceeds from a sale of
preferred stock from 2008. The Company recognized interest expense related to the outstanding
borrowings under the Credit Facility for the years ended December 31, 2010 and 2009 of $0 and
$19,000, respectively. As of December 31, 2010 and 2009, there was no balance outstanding under
the Credit Facility.
NOTE 7 CAPITAL TRANSACTIONS
2010 Private Placement of Common Stock. On June 15, 2010, the Company entered into a stock
purchase agreement (the Stock Purchase Agreement) with 20 investors (the PIPE Investors)
pursuant to which the PIPE Investors agreed to purchase an aggregate of 4,978,000 shares of Common
Stock (the PIPE Shares) at a price of $1.00 per share for aggregate consideration of $4,978,000.
Among the PIPE Investors who purchased a portion of the PIPE Shares were Hsu Gamma Investments,
L.P. (Hsu Gamma), an entity of which Dr. Jane Hsiao, the Companys Chairman of the Board, is
general partner, Frost Gamma, as well as Grandtime Associates Limited (Grandtime), a Taiwan-based
investment company. Each of Hsu Gamma, Frost Gamma and Grandtime purchased 1,300,000 PIPE Shares.
The Company issued the PIPE Shares in reliance upon the exemption from registration under Section
4(2) of the Securities Act of 1933, as amended (the Securities Act), and Rule 506 of Regulation D
promulgated thereunder.
10.0% Series A Cumulative Convertible Preferred Stock. In June 2009, the Company authorized a
new series of preferred stock, designated as 10.0% Series A Cumulative Convertible Preferred Stock,
par value $0.01 per share (Series A Preferred Stock). Holders of the Series A Preferred Stock
are entitled to receive, when, as and if declared by the Companys Board of Directors, dividends on
each share of Series A Preferred Stock at a rate per annum equal to 10.0% of the sum of (a) $1.00,
plus (b) any and all declared and unpaid and accrued dividends thereon, subject to adjustment for
any stock split, combination, recapitalization or other similar corporate action (the Liquidation
Amount). Holders of the Series A Preferred Stock also have the right to receive notice of any
meeting of holders of Common Stock or Series A Preferred Stock and to vote (on an as-converted into
Common Stock basis) upon any matter submitted to a vote of the holders of Common Stock or Series A
Preferred Stock. With respect to dividend distributions and distributions upon liquidation,
winding up or dissolution of the Company, the Series A Preferred Stock ranks senior to all classes
of Common Stock and to each other class of the Companys capital stock existing now or hereafter
created that are not specifically designated as ranking senior to or pari passu with the Series A
Preferred Stock. The Company may not issue any capital stock that is senior to or pari passu with
the Series A Preferred Stock unless such issuance is approved by the holders of at least 66 2/3% of
the issued and outstanding Series A Preferred Stock voting separately as a class.
Upon the occurrence of a Liquidation Event (as defined in the Series A Preferred Stocks
Certificate of Designation, which is referred to as the Certificate of Designation), holders of
Series A Preferred Stock are entitled to be paid, subject to applicable law, out of the assets of
the Company available for distribution to its stockholders, an amount in cash (the Liquidation
Payment) for each share of Series A Preferred Stock equal to the greater of (x) the Liquidation
Amount for each share of Series A Preferred Stock outstanding, or (y) the amount for each share of
Series A Preferred Stock the holders would be entitled to receive pursuant to the Liquidation Event
if all of the shares of Series A Preferred Stock had been converted into Common Stock as of the
date immediately prior to the date fixed for determination of stockholders entitled to receive a
distribution in such Liquidation Event. Such Liquidation Payment will be paid before any cash
distribution will be made or any other assets distributed in respect of any class of securities
junior to the Series A Preferred Stock, including, without limitation, Common Stock. The holder of
any share of Series A Preferred Stock may at any time and from time to time convert such share into
such number of fully paid and nonassessable shares of Common Stock as is determined by dividing (A)
the Liquidation Amount of the share by (B) the conversion price, which was initially $1.00, subject
to adjustment as
provided in the Certificate of Designation. To the extent it is lawfully able to do so, the
Company may redeem all of the then outstanding shares of Series A Preferred Stock by paying in cash
an amount per share equal to $1.00 plus all declared or accrued unpaid dividends on such shares,
subject to adjustment for any stock dividends or distributions, splits, subdivisions, combinations,
reclassifications, stock issuances or similar events with respect to the Common Stock.
52
2009 Issuance of Series A Preferred Stock. On July 21, 2009, the Company entered into a
securities purchase agreement with a private investor (the 2009 Investor), pursuant to which the
2009 Investor agreed to purchase an aggregate of up to 2,000,000 shares (the 2009 Shares) of the
Series A Preferred Stock at a purchase price of $1.00 per share. On July 22, 2009, the Company
closed on the issuance of the 2009 Shares for aggregate consideration of $2.0 million. A portion
of the proceeds from the issuance was used to repay all principal and interest outstanding under
the Credit Facility described in Note 6.
2010 Issuance of Series A Preferred Stock. On July 21, 2009, the Company entered into a second
securities purchase agreement (the Future Purchase Agreement) with certain private investors (the
Future Investors, together with the 2009 Investor, the Preferred Investors), pursuant to which
the Future Investors agreed to purchase, at the Companys election upon ten days written notice
delivered to the Future Investors by the Company, an aggregate of up to 2,000,000 shares of Series
A Preferred Stock (the Future Shares, together with the 2009 Shares, the Preferred Shares) at a
purchase price of $1.00 per share. On December 30, 2009, the Company provided notice to the Future
Investors that the Company intended to consummate the sale of the Future Shares on January 12,
2010, and on January 12, 2010, the Company closed on the issuance of 2,000,000 Future Shares under
the Future Purchase Agreement for aggregate consideration of $2.0 million. Among the Future
Investors who purchased an aggregate of 995,000 Future Shares were Hsu Gamma, Frost Gamma and Mr.
Spragens, each of whom is the beneficial owner of more than 10% of the Common Stock.
The Company issued the Preferred Shares in reliance upon the exemption from registration under
Section 4(2) of the Securities Act. On July 22, 2009 and January 12, 2010, the closing prices of
the Common Stock on the OTCBB were $1.10 and $1.25, respectively, resulting in beneficial
conversion features of $0.10 and $0.25 per share of Series A Preferred Stock on the respective
issue dates. The $200,000 and $500,000 aggregate beneficial conversion features of the Series A
Preferred Stock on the issue dates were deemed discounts on the issuance of the Preferred Shares
and were recorded as increases to additional paid-in capital in the consolidated financial
statements. Because the Series A Preferred Stock was immediately convertible by the holders
thereof into Common Stock, the $200,000 and $500,000 aggregate intrinsic value was deemed a
dividend paid to the Preferred Investors on the relevant closing date. In the absence of retained
earnings, such deemed dividends were recorded as reductions of additional paid-in capital and, for
calculating net loss per common share, as increases in losses attributable to common stockholders
(see Note 8).
2010 Conversion of Series A Preferred Stock. Effective September 10, 2010 (the Conversion
Date), the Preferred Investors elected to convert an aggregate of 4.0 million shares of the Series
A Preferred Stock pursuant to the terms of the Certificate of Designation. Following conversion of
the Series A Preferred Stock, the Company had no issued and outstanding shares of any class of
preferred stock. On the Conversion Date, for each converted share of Series A Preferred Stock, the
holder thereof became entitled to receive one share of Common Stock, plus all accrued and unpaid
dividends (Unpaid Dividends) thereon through the Conversion Date, which Unpaid Dividends were
paid in shares of Common Stock in accordance with the Certificate of Designation. Approximately
$366,000 of Unpaid Dividends had accumulated through the Conversion Date and an aggregate of
365,575 shares of Common Stock were issued as a result of the Unpaid Dividends (the Dividend
Shares), of which 29,709 Dividend Shares were issued to each of Hsu Gamma and Frost Gamma, and
6,638 Dividend Shares were issued to Mr. Spragens.
53
To encourage the Preferred Investors to voluntarily convert their respective shares of Series
A Preferred Stock, the Company offered to each Preferred Investor who converted his or her shares
of Series A Preferred Stock on or prior to the Conversion Date the number of shares of Common Stock
(the Consideration Shares) equal to the difference between (a) the number of shares of Common
Stock issuable pursuant to a holder-initiated conversion of Series A Preferred Stock on March 31,
2012 and (b) the number of shares of Common Stock issuable pursuant to a holder-initiated
conversion of Series A Preferred Stock on the Conversion Date, each as calculated in accordance
with the Certificate of Designation. The Preferred Investors voluntarily elected to convert all of
their respective shares of Series A Preferred Stock, and an aggregate of 697,462 Consideration
Shares were issued, of which 76,261
Consideration Shares were issued to each of Hsu Gamma and Frost Gamma, and 17,042
Consideration Shares were issued to Mr. Spragens.
On September 10, 2010, the closing price of the Common Stock on the OTCBB was $1.85, resulting
in an intrinsic value of $0.85 per share for the 4,000,000 shares of Common Stock issued upon
conversion of the Series A Preferred Stock and the 365,575 shares of Common Stock issued as
Dividend Shares. These 4,365,575 shares of Common Stock had an aggregate intrinsic value of $3.7
million on the Conversion Date, which was considered a deemed dividend. The 697,462 Consideration
Shares issued on the Conversion Date had an aggregate market value of approximately $1.3 million,
which was also considered a deemed dividend on the Conversion Date. In the absence of retained
earnings, the $366,000 accumulated dividends and the $5.0 million aggregate deemed dividends were
recorded as reductions of additional paid-in capital and, for calculating net loss per common
share, as increases in losses attributable to common stockholders (see Note 8).
NOTE 8 BASIC AND DILUTED NET LOSS PER SHARE
Basic net loss per common share is computed by dividing net loss attributable to common
stockholders by the weighted average number of common shares outstanding during the period.
Diluted net loss per common share is computed giving effect to all dilutive potential common shares
that were outstanding during the period. Diluted potential common shares consist of incremental
shares issuable upon exercise of stock options and warrants and conversion of preferred stock. In
computing diluted net loss per share for the years ended December 31, 2010 and 2009, no adjustment
has been made to the weighted average outstanding common shares as the assumed exercise of
outstanding options and warrants and conversion of preferred stock would be anti-dilutive.
Potential common shares not included in calculating diluted net loss per share are as follows:
|
|
|
|
|
|
|
|
|
|
|
December 31, 2010 |
|
|
December 31, 2009 |
|
|
Stock options |
|
|
1,334,667 |
|
|
|
615,167 |
|
Stock warrants |
|
|
805,521 |
|
|
|
805,521 |
|
Series A Preferred Stock |
|
|
0 |
|
|
|
2,088,333 |
|
|
|
|
|
|
|
|
Total |
|
|
2,140,188 |
|
|
|
3,509,021 |
|
|
|
|
|
|
|
|
Under SEC accounting guidance, the difference between (a) the fair value of the consideration
transferred to the Preferred Investors upon conversion of the Series A Preferred Stock and (b) the
carrying amount of the Series A Preferred Stock on the Companys balance sheet is required to be
added to the Companys net loss to arrive at loss available to common stockholders in the
calculation of loss per share. As discussed in Note 7 above, the Preferred Investors received an
aggregate dividend of $5.4 million, consisting of $366,000 accumulated dividends and $5.0 million
aggregate deemed dividends. This $5.4 million aggregate dividend was recorded as a $4.4 million
increase in losses attributable to common stockholders on the Conversion Date, after giving effect
to the $700,000 beneficial conversion feature and $286,000 cumulative dividends recorded as
increases in losses attributable to common stockholders in prior periods.
54
NOTE 9 COMMITMENTS AND CONTINGENCIES
The Company is obligated under various operating lease agreements for office space expiring in
2012. Generally, the lease agreements require the payment of base rent plus escalations for
increases in building operating costs and real estate taxes. Rental expense under operating leases
amounted to $164,000 and $105,000 for the years ended December 31, 2010 and 2009, respectively. At
December 31, 2010, the Company was obligated under non-cancellable operating leases to make future
minimum lease payments (excluding sales taxes) as follows:
|
|
|
|
|
Year Ending December 31, |
|
|
|
|
2011 |
|
$ |
174,000 |
|
2012 |
|
|
182,000 |
|
|
|
|
|
|
|
$ |
356,000 |
|
|
|
|
|
The Company is obligated to pay royalties to Creighton University (Creighton) on the sales
of products licensed from Creighton pursuant to an exclusive license and development agreement (see
Note 10). The Company is also obligated under an agreement with Dr. Parviz Amid to pay a 4%
royalty to Dr. Amid on the net sales of any product developed with Dr. Amids assistance, including the
AMID Stapler®, for a period of ten years from the first commercial sale of such product. No
royalties have been incurred or paid in the years ended December 31, 2010 and 2009.
The Company has placed orders with various suppliers for the purchase of certain tooling,
inventory and contract engineering and research services. Each of these orders has a duration or
expected completion within the next twelve months. The Company currently has no material
commitments with terms beyond twelve months.
In late July 2010, the Company voluntarily suspended sales of the AMID Stapler® in order to
implement a more robust and reliable commercial manufacturing process. The Company intends to
recommence stapler sales in the second half of 2011. The costs associated with evaluating the
existing manufacturing process and developing and implementing any necessary design or process
modifications are expensed as incurred and are included in SG&A costs and expenses. Management
expects that the implementation of design and process modifications will delay anticipated revenues
associated with the sale of the staplers and result in increased expenses through 2011.
NOTE 10 AGREEMENT WITH CREIGHTON UNIVERSITY
On May 26, 2006, SafeStitch entered into an exclusive license and development agreement (the
Creighton Agreement) with Creighton, granting the Company a worldwide exclusive (even as to the
university) license, with rights to sublicense, to all the Companys product candidates and
associated know-how based on Creighton technology, including the exclusive right to manufacture,
use and sell the product candidates.
Pursuant to the Creighton Agreement, the Company is obligated to pay Creighton, on a quarterly
basis, a royalty of 1.5% of the revenue collected worldwide from the sale of any product licensed
under the Creighton Agreement, less certain amounts including, without limitation, chargebacks,
credits, taxes, duties and discounts or rebates. Also pursuant to the Creighton Agreement, the
Company agreed to invest, in the aggregate, at least $2.5 million over 36 months, beginning May 26,
2006, towards development of any licensed product. This $2.5 million investment obligation
excluded the first $150,000 of costs related to the prosecution of patents, which the Company
invested outside of the Creighton Agreement. The Company is further obligated to pay to Creighton
an amount equal to 20% of certain of the Companys research and development expenditures as
reimbursement for the use of Creightons facilities. Failure to comply with the payment
obligations above will result in all rights in the licensed patents and know-how reverting back to
Creighton. As of December 31, 2007, the Company had satisfied the $2.5 million investment
obligation described above. For the years ended December 31, 2010 and 2009, the Company paid
Creighton $52,000 and $41,000, respectively, in satisfaction of the 20% facility reimbursement
obligation.
Pursuant to the Creighton Agreement, SafeStitch is entitled to exercise its own business
judgment and sole and absolute discretion over the marketing, sale, distribution, promotion and
other commercial exploitation of any licensed products, provided that, if the Company has not
commercially exploited or commenced development of a licensed patent and its associated know-how by
the seventh anniversary of the later of the date of the Creighton Agreement or the date such
technology is disclosed to and accepted by SafeStitch, then the licensed patent and associated
know-how shall revert back to the university, with no rights retained by the Company, and the
university will have the right to seek a third party with whom to commercialize such patent and
associated know-how, unless the Company purchases one or more one-year extensions.
55
NOTE 11 INCOME TAXES
The Company accounts for income taxes using the asset and liability method, the objective of
which is to establish deferred tax assets and liabilities for the temporary differences between the
financial reporting and the tax bases of the Companys assets and liabilities at enacted tax rates
expected to be in effect when such amounts are
realized or settled. A valuation allowance related to deferred tax assets is recorded when it
is more likely than not that some portion or all of the deferred tax assets will not be realized.
At December 31, 2010, we have approximately $8.4 million of federal net operating loss
carryforwards to offset future taxable income and $5.1 million of certain operating expenses which
have been deferred as start up costs under Sec. 195 for federal income tax purposes, subject to
limitations for alternative minimum tax. Start-up costs will continue to be capitalized until the
month in which active business begins, at which time the costs may be amortized over 15 years. In
addition, at December 31, 2010 we have approximately $290,000 of research and development tax
credit carryforwards. The net operating loss and research and development credit carryforwards
expire through 2030.
The difference between income taxes at the statutory federal income tax rate and income taxes
reported in the statements of operations are attributable to the following:
|
|
|
|
|
|
|
|
|
|
|
December 31, |
|
|
December 31, |
|
|
|
2010 |
|
|
2009 |
|
|
Income tax benefit at the federal statutory rate |
|
|
34.00 |
% |
|
|
34.00 |
% |
State income taxes, net of effect on federal taxes |
|
|
3.49 |
% |
|
|
3.51 |
% |
Research and development credit |
|
|
2.71 |
% |
|
|
1.57 |
% |
Other |
|
|
0.25 |
% |
|
|
(0.20 |
%) |
Increase in valuation allowance |
|
|
(40.45 |
%) |
|
|
(38.88 |
%) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Provision for income tax |
|
|
0 |
% |
|
|
0 |
% |
|
|
|
|
|
|
|
The deferred tax asset at December 31, 2010 and 2009 consists of the following:
|
|
|
|
|
|
|
|
|
|
|
2010 |
|
|
2009 |
|
|
Net operating loss carryforward |
|
$ |
3,121,000 |
|
|
$ |
2,121,000 |
|
Deferred start up costs |
|
|
1,916,000 |
|
|
|
1,115,000 |
|
Research and development credit carryforward |
|
|
290,000 |
|
|
|
129,000 |
|
Stock-based compensation |
|
|
394,000 |
|
|
|
217,000 |
|
Other |
|
|
(16,000 |
) |
|
|
(22,000 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5,705,000 |
|
|
|
3,560,000 |
|
Less: Valuation allowance |
|
|
(5,705,000 |
) |
|
|
(3,560,000 |
) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net deferred tax asset |
|
$ |
|
|
|
$ |
|
|
|
|
|
|
|
|
|
The change in the valuation allowance from December 31, 2009 to December 31, 2010 amounted to
approximately $2,145,000. At December 31, 2006, Cellular had available for federal income tax
purposes, net operating loss carryforwards of approximately $54.1 million which expire through
2026, and research and development tax credits of approximately $1.2 million that will expire
through 2024. The Company had provided a valuation allowance of 100% of the net deferred tax asset
related to the operating loss carryforwards and tax credits. Upon consummation of the share
exchange with SafeStitch LLC, these net deferred tax assets along with net operating losses for
2007 were forfeited in accordance with Section 382 of the Internal Revenue Code.
The Company recognizes interest and penalties related to uncertain tax positions in general
and administrative expense. As of December 31, 2010, the Company has no unrecognized tax benefit,
including interest and penalties.
The tax years 2007-2009 remain open to examination by the major tax jurisdictions in which the
Company operates.
56
NOTE 12 CERTAIN RELATIONSHIPS AND RELATED PARTY TRANSACTIONS
In connection with the acquisition of SafeStitch LLC, the Company entered into the Credit
Facility with The Frost Group and Jeffrey G. Spragens, the Companys Chief Executive Officer and
President and a director. The
Frost Group is a Florida limited liability company whose members include Frost Gamma
Investments Trust, a trust controlled by Dr. Phillip Frost, the largest beneficial holder of the
issued and outstanding shares of the Companys common stock, Dr. Jane H. Hsiao, the Companys
Chairman of the Board and Steven D. Rubin, a director. There were no amounts outstanding as of
December 31, 2010 and 2009. (See Note 6).
The Company entered into a five-year lease for office space in Miami, Florida with a company
controlled by Dr. Frost. The non-cancelable lease, which commenced January 1, 2008, provides for a
4.5% annual rent increase over the life of the lease. The Miami office lease was amended in July
2010 to include additional office space in the same building, and current rental payments under the
lease are approximately $14,000 per month. The Company recorded $127,000 and $79,000 of rent
expense related to the Miami lease for the years ended December 31, 2010 and 2009, respectively.
Dr. Jane Hsiao, the Companys Chairman of the Board, served as a director of Great Eastern
Bank of Florida until August 2009, a bank where the Company maintains a bank account in the normal
course of business.
Dr. Hsiao, Dr. Frost and director Steven Rubin are each significant stockholders and/or
directors of Non-Invasive Monitoring Systems, Inc. (NIMS), a publicly-traded medical device
company, Aero Pharmaceuticals, Inc. (Aero), a privately-held pharmaceutical distribution company,
Cardo Medical, Inc. (Cardo), a publicly-traded medical device company, and SearchMedia Holdings
Limited (SearchMedia), a publicly-traded media company operating primarily in China. Commencing
in March 2008, the Companys then-Chief Financial Officer also served as the Chief Financial
Officer and supervised the accounting staffs of NIMS and Aero under a board-approved cost sharing
arrangement whereby the total salaries of the accounting staffs of the three companies are shared.
The Company has recorded reductions to General and Administrative costs and expenses for the years
ended December 31, 2010 and 2009 of $114,000 and $73,000, respectively, to account for the sharing
of costs under this arrangement. Upon Mr. Martins appointment as CFO in January 2011, this shared
sevices relationship continues. Commencing in December 2009, the Companys Chief Legal Officer also
serves under a similar board-approved cost sharing arrangement as Corporate Counsel of SearchMedia
and as the Chief Legal Officer of each of NIMS and Cardo. The Company has recorded $186,000 of
reductions to General and Administrative costs and expenses for the year ended December 31, 2010 to
account for the sharing of costs under this arrangement. Aggregate accounts receivable from NIMS,
Aero, Cardo and SearchMedia were approximately $64,000 as of December 31, 2010.
NOTE 13 EMPLOYEE BENEFIT PLANS
Effective May 1, 2008, the SafeStitch 401(k) Plan (the 401k Plan) permits employees to
contribute up to 100% of qualified annual compensation up to annual statutory limitations.
Employee contributions may be made on a pre-tax basis to a regular 401(k) account, or on an
after-tax basis to a Roth 401(k) account. The Company will contribute to the 401k Plan a safe
harbor match of 100% of each participants contributions to the 401k Plan up to a maximum of 4% of
the participants qualified annual earnings. The Companys matching contributions to the plan were
approximately $39,000 and $22,000, respectively, for the years ended December 31, 2010 and 2009.
NOTE 14 CONCENTRATION OF RISK
The Companys financial instruments that are exposed to concentrations of credit risk consist
primarily of cash. The Company maintains its cash at banks and financial institutions it considers
to be of high credit quality; however the Companys cash deposits may at times exceed the FDIC
insured limit. The Companys deposits at banks in excess of the FDIC insured limit are maintained
in sweep accounts that are collateralized by overnight repurchase agreements. The Company has not
experienced losses on these accounts, and management believes that the Company is not exposed to
significant risks on such accounts.
57
NOTE 15 SUBSEQUENT EVENTS
On
March 10, 2011, the Company granted to directors, officers, existing employees and
consultants an aggregate of 562,500 options to purchase the Companys common stock under the 2007
Plan. Each such option was granted at an exercise price of $1.12 per share.
On March 28, 2011, the Company, the Frost Group and Mr. Spragens amended the Credit Facility
discussed in Note 6 above to further extend the Credit Facilitys Maturity Date from June 30, 2011
to June 30, 2012. All other terms and conditions of the Credit Facility remain unchanged.
58
|
|
|
Item 9. |
|
Changes in and Disagreements with Accountants on Accounting and Financial
Disclosure. |
None.
|
|
|
Item 9A. |
|
Controls and Procedures. |
Disclosure Controls and Procedures
The Companys management, with the participation of its Chief Executive Officer and Chief
Financial Officer, evaluated the effectiveness of the design and operation of the Companys
disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) or 15d-15(e)) as of
December 31, 2010. Based upon that evaluation, the Chief Executive Officer and Chief Financial
Officer concluded that, as of that date, the Companys disclosure controls and procedures were
effective.
Managements Report on Internal Control over Financial Reporting
Management is responsible for establishing and maintaining adequate internal control over
financial reporting. Internal control over financial reporting is a process designed to provide
reasonable assurance regarding the reliability of financial reporting and the preparation of
financial statements for external purposes in accordance with generally accepted accounting
principles. Internal control over financial reporting includes those policies and procedures that:
(i) pertain to the maintenance of records that in reasonable detail accurately and fairly reflect
the transactions and dispositions of the assets of the Company; (ii) provide reasonable assurance
that transactions are recorded as necessary to permit preparation of financial statements in
accordance with generally accepted accounting principles, and that receipts and expenditures of the
Company are being made only in accordance with authorizations of management and directors of the
Company; and (iii) provide reasonable assurance regarding prevention or timely detection of
unauthorized acquisition, use or disposition of the Companys assets that could have a material
effect on the financial statements.
Because of its inherent limitations, internal control over financial reporting may not prevent
or detect misstatements. Also, projections of any evaluation of effectiveness to future periods
are subject to the risk that controls may become inadequate because of changes in conditions, or
that the degree of compliance with the policies or procedures may deteriorate.
For the period ended December 31, 2010, pursuant to Section 404 of the Sarbanes-Oxley Act of
2002, management (with the participation of our principal executive officer and principal financial
officer) conducted an evaluation of the effectiveness of our internal control over financial
reporting based on the framework established in Internal ControlIntegrated Framework issued by
the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Based on this
evaluation, management concluded that, as of December 31, 2010, our internal control over financial
reporting was effective.
Changes in Internal Controls Over Financial Reporting
There were no changes in the Companys internal control over financial reporting during the
last quarter that have materially affected, or are reasonably likely to materially affect, the
Companys internal control over financial reporting.
|
|
|
Item 9B. |
|
Other Information. |
On March 28, 2011, we entered into the Third Amendment (the Third Amendment) to the Credit
Facility. The Third Amendment extended the Maturity Date of the Credit Facility from June 30, 2011
to June 30, 2012. The description of the Credit Facility set forth in Note 6 to our consolidated
financial statements contained in this Annual Report on Form 10-K is incorporated by reference in
this Item 9B.
The foregoing description of the Third Amendment is only a summary and is qualified in its
entirety by reference to the full text of the Third Amendment, which is attached as Exhibit 10.20
to this Annual Report on Form 10-K and incorporated in this Item 9B by reference.
59
PART III
|
|
|
Item 10. |
|
Directors, Executive Officers and Corporate Governance. |
The information required by this Item is incorporated by reference to the definitive proxy
statement for our 2010 Annual Meeting of Stockholders to be filed with the SEC within 120 days of
December 31, 2010.
|
|
|
Item 11. |
|
Executive Compensation. |
The information required by this Item is incorporated by reference to the definitive proxy
statement for our 2010 Annual Meeting of Stockholders to be filed with the SEC within 120 days of
December 31, 2010.
|
|
|
Item 12. |
|
Security Ownership of Certain Beneficial Owners and Management and Related Stockholder
Matters. |
The information required by this Item is incorporated by reference to the definitive proxy
statement for our 2010 Annual Meeting of Stockholders to be filed with the SEC within 120 days of
December 31, 2010.
|
|
|
Item 13. |
|
Certain Relationships and Related Transactions, and Director Independence. |
The information required by this Item is incorporated by reference to the definitive proxy
statement for our 2010 Annual Meeting of Stockholders to be filed with the SEC within 120 days of
December 31, 2010.
|
|
|
Item 14. |
|
Principal Accounting Fees and Services. |
The information required by this Item is incorporated by reference to the definitive proxy
statement for our 2010 Annual Meeting of Stockholders to be filed with the SEC within 120 days of
December 31, 2010.
60
PART IV
|
|
|
Item 15. |
|
Exhibits, Financial Statement Schedules |
(a) List of documents filed as part of this report:
1. Financial Statements: The information required by this item is contained in Item 8 of this
Annual Report on Form 10-K.
2. Financial Statement Schedules: The information required by this item is included in the
consolidated financial statements contained in Item 8 of this Annual Report on Form 10-K.
3. Exhibits: The following exhibits are filed as part of, or incorporated by reference into, this
Annual Report on Form 10-K.
|
|
|
|
|
|
|
|
|
Exhibits: |
|
|
|
|
|
|
3.1 |
|
|
Restated Certificate of Incorporation of the Registrant, as amended, filed as Annex A to our
Definitive Information Statement on Schedule 14C filed with the SEC on December 7, 2007 and
incorporated by reference herein. |
|
|
|
|
|
|
3.2 |
|
|
Amended and Restated Bylaws of SafeStitch Medical, Inc., filed as Exhibit 3.2 to our Annual
Report on Form 10-KSB, as amended, filed with the SEC on March 29, 2008 and incorporated by
reference herein. |
|
|
|
|
|
|
3.3 |
|
|
Certificate of Designation of Series A Preferred Stock, filed as Exhibit 3.1 to our Current
Report on Form 8-K filed with the SEC on July 23, 2009 and incorporated by reference herein. |
|
|
|
|
|
|
4.1 |
|
|
Specimen Certificate for Common Stock of Registrant, filed as Exhibit 4.1 to our Annual Report on
Form 10-KSB, as amended, filed with the SEC on March 29, 2008 and incorporated by reference
herein. |
|
|
|
|
|
|
4.2 |
|
|
Form of Common Stock Warrant, filed as Exhibit 4.1 to our Current Report on Form 8-K filed with
the SEC on September 10, 2007 and incorporated by reference herein. |
|
|
|
|
|
|
4.3 |
|
|
Specimen Certificate for Series A Preferred Stock, filed as Exhibit 4.2 to our Current Report on
Form 8-K filed with the SEC on July 23, 2009 and incorporated by reference herein. |
|
|
|
|
|
|
10.1 |
|
|
Form of Lockup Agreement, filed as Exhibit 2.4 to our Current Report on Form 8-K filed with the
SEC on July 31, 2007 and incorporated by reference herein. |
|
|
|
|
|
|
10.2 |
|
|
Note and Security Agreement, dated as of September 4, 2007, by and among the Company, SafeStitch
LLC, The Frost Group, LLC and Jeffrey G. Spragens, filed as Exhibit 10.2 to our Current Report on
Form 8-K filed with the SEC on September 10, 2007 and incorporated by reference herein. |
|
|
|
|
|
|
10.3 |
|
|
Exclusive License and Development Agreement, dated as of May 26, 2006, by and between Creighton
University and SafeStitch LLC, filed as Exhibit 10.5 to our Annual Report on Form 10-KSB, as
amended, filed with the SEC on March 29, 2008 and incorporated by reference herein. |
|
|
|
|
|
|
10.4 |
+ |
|
Letter Agreement for Terms of Employment between SafeStitch LLC and Stewart B. Davis, M.D., dated
May 16, 2007, filed as Exhibit 10.4 to our Current Report on Form 8-K filed with the SEC on
September 10, 2007 and incorporated by reference herein. |
|
|
|
|
|
|
10.5 |
+ |
|
SafeStitch Medical, Inc. 2007 Incentive Compensation Plan, filed as Annex B to our Definitive
Information Statement on Schedule 14C, filed with the SEC on December 7, 2007 and incorporated by
reference herein. |
|
|
|
|
|
|
10.6 |
+ |
|
Offer Letter from SafeStitch Medical, Inc. to Adam S. Jackson, dated March 11, 2008, filed as
Exhibit 10.1 to our Current Report on Form 8-K filed with the SEC on April 3, 2008 and
incorporated by reference herein. |
61
|
|
|
|
|
|
|
|
|
Exhibits: |
|
|
|
|
|
|
10.7 |
|
|
Form of Subscription Agreement, filed as Exhibit 10.1 to our Current Report on Form 8-K filed
with the SEC on May 29, 2008 and incorporated by reference herein. |
|
|
|
|
|
|
10.8 |
|
|
First Amendment to Note and Security Agreement, dated March 25, 2009, by and among the Company,
SafeStitch LLC, The Frost Group, LLC and Jeffrey G. Spragens, filed as Exhibit 10.8 to our Annual
Report on Form 10-K filed with the SEC on March 27, 2009 and incorporated by reference herein. |
|
|
|
|
|
|
10.9 |
|
|
Form of Current Securities Purchase Agreement, filed as Exhibit 10.1 to our Current Report on
Form 8-K filed with the SEC on July 23, 2009 and incorporated by reference herein. |
|
|
|
|
|
|
10.10 |
|
|
Form of Future Securities Purchase Agreement, filed as Exhibit 10.2 to our Current Report on Form
8-K filed with the SEC on July 23, 2009 and incorporated by reference herein. |
|
|
|
|
|
|
10.11 |
|
|
Form of Subscription Agreement, filed as Exhibit 10.1 to our Current Report on Form 8-K filed
with the SEC on May 29, 2008 and incorporated by reference herein. |
|
|
|
|
|
|
10.12 |
+ |
|
Form of Employee Stock Option Agreement pursuant to the SafeStitch Medical, Inc. 2007 Incentive
Compensation Plan, filed as Exhibit 10.12 to our Annual Report on Form 10-K filed with the SEC on
March 31, 2010 and incorporated by reference herein. |
|
|
|
|
|
|
10.13 |
+ |
|
Form of Non-Employee Stock Option Agreement pursuant to the SafeStitch Medical, Inc. 2007
Incentive Compensation Plan, filed as Exhibit 10.13 to our Annual Report on Form 10-K filed with
the SEC on March 31, 2010 and incorporated by reference herein. |
|
|
|
|
|
|
10.14 |
|
|
Second Amendment to Note and Security Agreement, dated March 29, 2010, by and among the Company,
SafeStitch LLC, The Frost Group, LLC and Jeffrey G. Spragens, filed as Exhibit 10.14 to our
Annual Report on Form 10-K filed with the SEC on March 31, 2010 and incorporated by reference
herein. |
|
|
|
|
|
|
10.15 |
|
|
Stock Purchase Agreement, dated as of June 15, 2010, by and between SafeStitch Medical, Inc. and
the purchasers party thereto, filed as Exhibit 10.1 to our Current Report on Form 8-K filed on
June 17, 2010 and incorporated by reference herein. |
|
|
|
|
|
|
10.16 |
|
|
Confidential General Release of All Claims, dated November 24, 2010, by and between Stewart Davis
and SafeStitch Medical, Inc., filed as Exhibit 10.1 to our Current Report on Form 8-K filed on
December 1, 2010 and incorporated by reference herein. |
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10.17 |
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Consulting Agreement, dated November 24, 2010 and effective November 12, 2010, by and between
Stewart Davis and SafeStitch Medical, Inc., filed as Exhibit 10.2 to our Current Report on Form
8-K filed on December 1, 2010 and incorporated by reference herein. |
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10.18 |
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Confidential General Release of All Claims, dated January 14, 2011, by and between Adam Jackson
and SafeStitch Medical, Inc., filed as Exhibit 10.1 to our Current Report on Form 8-K filed on
January 14, 2011 and incorporated by reference herein. |
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10.19 |
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Consulting Agreement, effective January 10, 2011, by and between Adam Jackson and SafeStitch Medical, Inc., filed as Exhibit 10.2 to our Current Report on Form 8-K filed on January 14, 2011
and incorporated by reference herein. |
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10.20 |
* |
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Third Amendment to Note and Security Agreement, dated March 28,
2011, by and among the Company,
SafeStitch LLC, The Frost Group, LLC and Jeffrey G. Spragens, filed as Exhibit 10.20 to our
Annual Report on Form 10-K filed with the SEC on March 30, 2011 and incorporated by reference
herein. |
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14.1 |
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Code of Ethics Pursuant to Section 406 of the Sarbanes-Oxley Act of 2002 filed as Exhibit 14.1 to
our Annual Report on Form 10-K filed with the SEC on March 31, 2010 and incorporated by reference
herein. |
62
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Exhibits: |
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21.1* |
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Subsidiaries of the Registrant |
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23.1* |
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Consent of EisnerAmper LLP (formerly known as Eisner LLP) |
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31.1* |
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Certification of Chief Executive Officer pursuant to Rule 13a-14(a)/15d-14(a) |
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31.2* |
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Certification of Chief Financial Officer pursuant to Rule 13a-14(a)/15d-14(a) |
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32.1* |
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Certification of Chief Executive Officer pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 |
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32.2* |
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Certification of Chief Financial Officer pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 |
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* |
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Filed herewith |
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+ |
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Compensation Plan or Arrangement or Management Contract |
63
SIGNATURES
Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934,
the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto
duly authorized.
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SAFESTITCH MEDICAL, INC. |
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Date: March 30, 2011 |
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By:
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/s/ Jeffrey G. Spragens
Jeffrey G. Spragens
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Chief Executive Officer and President |
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Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been
signed below by the following persons on behalf of the registrant and in the capacities and on the
dates indicated.
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Signature |
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Title |
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Date |
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/s/ Jeffrey G. Spragens
Jeffrey G. Spragens
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Chief Executive Officer, President
and Director
(Principal
Executive Officer)
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March 30, 2011 |
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/s/ Jane H. Hsiao, Ph.D.
Jane H. Hsiao, Ph.D.
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Chairman of the Board of Directors
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March 30, 2011 |
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/s/ Dr. Charles J. Filipi
Dr. Charles J. Filipi
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Chief Medical Officer and Director
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March 30, 2011 |
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/s/ Dr. Chao C. Chen
Dr. Chao C. Chen
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Director
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March 30, 2011 |
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/s/ Steven D. Rubin
Steven D. Rubin
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Director
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March 30, 2011 |
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/s/ Richard C. Pfenniger, Jr.
Richard C. Pfenniger, Jr.
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Director
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March 30, 2011 |
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/s/ Kevin T. Wayne
Kevin T. Wayne
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Director
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March 30, 2011 |
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/s/ James J. Martin
James J. Martin
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Chief Financial Officer (Principal
Financial and
Accounting Officer)
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March 30, 2011 |
Exhibit 10.20
EXHIBIT 10.20
THIRD AMENDMENT TO NOTE AND SECURITY AGREEMENT
THIS THIRD AMENDMENT (THE THIRD AMENDMENT) DATED MARCH 28, 2011 TO THE NOTE AND SECURITY AGREEMENT (THE
AGREEMENT) DATED AS OF SEPTEMBER 4, 2007 AMONG SAFESTICH MEDICAL, INC., SAFESTITCH, LLC (COLLECTIVELY THE BORROWER)
AND THE UNDERSIGNED LENDERS (LENDERS).
RECITALS
WHEREAS, Borrower and Lenders (collectively, the Parties) are parties to the Agreement which became effective on
September 4, 2007; and
WHEREAS, the Borrowers and Lenders previously amended the Agreement to extend the Maturity Date (as defined in the
Agreement) from June 30, 2010 until June 30, 2011, and
WHEREAS, the Borrowers and Lenders desire to again amend the Agreement to extend the Maturity Date from June 30,
2011 until June 30, 2012.
NOW THEREFORE, in consideration of the mutual covenants and promises contained in the Agreement and this Third
Amendment and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged,
Borrower and Lenders agree as follows:
AMENDMENT
1. Extension of Maturity Date. Section 3 of the Agreement is hereby amended and restated in its entirety as
follows:
Payments of Obligations, including Principal and Interest. The principal amount of the
Loan evidenced hereby, together with any accrued and unpaid interest, and any and all the
Obligations, including unpaid costs, fees and expenses accrued, such as Lenders Expenses, shall be
due and payable in full on June 30, 2012 (the Maturity Date).
2. Governing Law. This Third Amendment shall be governed by the laws of the State of Florida without regard to
its conflict of laws rules or principles.
3. Amendments. Except as expressly amended hereby, the Agreement shall remain unmodified and in full force and
effect.
4. Entire Agreement. This Third Amendment and the Agreement and any schedules or exhibits attached to the
Agreement constitute the entire agreement of the Parties with respect to the subject matter hereof and supersede all
prior understandings and writings between the Parties relating thereto.
5. Interpretation. Any capitalized terms used in this Third Amendment but not otherwise defined shall have the
meaning provided in the Agreement.
Page 1 of 2
1
6. Counterparts. This Third Amendment may be executed manually, electronically in Adobe® PDF file format, or by
facsimile by the Parties, in any number of counterparts, each of which shall be considered one and the same amendment
and shall become effective when a counterpart hereof shall have been signed by each of the Parties and delivered to the
other Party.
IN WITNESS WHEREOF, the Parties hereto have caused this Third Amendment to be executed in their names as of the
date first written above.
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SAFESTITCH MEDICAL, INC.
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By:/s/ James J. Martin |
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Name: James J. Martin
Title: Chief Financial Officer |
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SAFESTITCH LLC
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By:/s/ James J. Martin |
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Name: James J. Martin
Title: Chief Financial Officer |
THE FROST GROUP, LLC
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By: /s/ Jane H. Hsiao
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Name: Jane H. Hsiao
Title: Member
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JEFFREY G. SPRAGENS
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By: /s/ Jeffrey Spragens
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Page 2 of 2
2
Exhibit 21.1
Exhibit 21.1
SUBSIDIARIES
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Name Under Which Subsidiary Is Doing |
Name of Subsidiary |
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State of Incorporation |
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Business |
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Isis Tele-Communications, Inc.
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Delaware
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Isis Tele-Communications, Inc. |
SafeStitch LLC
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Virginia
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SafeStitch LLC |
Exhibit 23.1
Exhibit 23.1
CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
We hereby consent to the incorporation by reference in the Registration Statement on Form S-8 (No
333-161291) of our report dated March 28, 2011 with respect to our audits of the consolidated
financial statements of SafeStitch Medical, Inc. (a development stage company) as of December 31,
2010 and 2009 and for the years then ended and for the period from September 15, 2005 (inception)
through December 31, 2010 included in its Annual Report on Form 10-K for the year ended December
31, 2010 filed with the Securities and Exchange Commission.
/s/
EisnerAmper LLP (formerly known as Eisner LLP)
New York, New York
March 28, 2011
Exhibit 31.1
Exhibit 31.1
CERTIFICATIONS
I, Jeffrey G. Spragens, certify that:
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(1) |
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I have reviewed this Annual Report on Form 10-K of SafeStitch Medical, Inc.; |
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(2) |
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Based on my knowledge, this report does not contain any untrue
statement of a material fact or omit to state a material fact
necessary to make the statements made, in light of the circumstances
under which such statements were made, not misleading with respect to
the period covered by this report; |
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(3) |
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Based on my knowledge, the financial statements, and other financial
information included in this report, fairly present in all material
respects the financial condition, results of operations and cash flows
of the registrant as of, and for, the periods presented in this
report; |
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(4) |
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The registrants other certifying officer(s) and I are responsible for
establishing and maintaining disclosure controls and procedures (as
defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal
control over financial reporting (as defined in Exchange Act Rules
13a-15(f) and 15d-15(f)) for the registrant and have: |
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(a) |
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Designed such disclosure controls and procedures, or caused such
disclosure controls and procedures to be designed under our
supervision, to ensure that material information relating to the
registrant, including its consolidated subsidiaries, is made known to
us by others within those entities, particularly during the period in
which this report is being prepared; |
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(b) |
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Designed such internal control over financial reporting, or caused
such internal control over financial reporting to be designed under
our supervision, to provide reasonable assurance regarding the
reliability of financial reporting and the preparation of financial
statements for external purposes in accordance with generally accepted
accounting principles; |
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(c) |
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Evaluated the effectiveness of the registrants disclosure controls
and procedures and presented in this report our conclusions about the
effectiveness of the disclosure controls and procedures, as of the end
of the period covered by this report based on such evaluation; and |
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(d) |
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Disclosed in this report any change in the registrants internal
control over financial reporting that occurred during the registrants
most recent fiscal quarter (the registrants fourth fiscal quarter in
the case of an annual report) that has materially affected, or is
reasonably likely to materially affect, the registrants internal
control over financial reporting; and |
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(5) |
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The registrants other certifying officer(s) and I have disclosed,
based on our most recent evaluation of internal control over financial
reporting, to the registrants auditors and the audit committee of the
registrants board of directors (or persons performing the equivalent
functions): |
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(a) |
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All significant deficiencies and material weaknesses in the design or
operation of internal control over financial reporting which are
reasonably likely to adversely affect the registrants ability to
record, process, summarize and report financial information; and |
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(b) |
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Any fraud, whether or not material, that involves management or other
employees who have a significant role in the registrants internal
control over financial reporting. |
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By:
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/s/ Jeffrey G. Spragens
Jeffrey G. Spragens
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Chief Executive Officer (Principal Executive Officer) |
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March 30, 2011 |
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Exhibit 31.2
Exhibit 31.2
CERTIFICATIONS
I, James J. Martin, certify that:
(1) |
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I have reviewed this Annual Report on Form 10-K of SafeStitch Medical, Inc.; |
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(2) |
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Based on my knowledge, this report does not contain any untrue
statement of a material fact or omit to state a material fact
necessary to make the statements made, in light of the circumstances
under which such statements were made, not misleading with respect to
the period covered by this report; |
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(3) |
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Based on my knowledge, the financial statements, and other financial
information included in this report, fairly present in all material
respects the financial condition, results of operations and cash flows
of the registrant as of, and for, the periods presented in this
report; |
|
(4) |
|
The registrants other certifying officer(s) and I are responsible for
establishing and maintaining disclosure controls and procedures (as
defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal
control over financial reporting (as defined in Exchange Act Rules
13a-15(f) and 15d-15(f)) for the registrant and have: |
|
(a) |
|
Designed such disclosure controls and procedures, or caused such
disclosure controls and procedures to be designed under our
supervision, to ensure that material information relating to the
registrant, including its consolidated subsidiaries, is made known to
us by others within those entities, particularly during the period in
which this report is being prepared; |
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(b) |
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Designed such internal control over financial reporting, or caused
such internal control over financial reporting to be designed under
our supervision, to provide reasonable assurance regarding the
reliability of financial reporting and the preparation of financial
statements for external purposes in accordance with generally accepted
accounting principles; |
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(c) |
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Evaluated the effectiveness of the registrants disclosure controls
and procedures and presented in this report our conclusions about the
effectiveness of the disclosure controls and procedures, as of the end
of the period covered by this report based on such evaluation; and |
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(d) |
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Disclosed in this report any change in the registrants internal
control over financial reporting that occurred during the registrants
most recent fiscal quarter (the registrants fourth fiscal quarter in
the case of an annual report) that has materially affected, or is
reasonably likely to materially affect, the registrants internal
control over financial reporting; and |
(5) |
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The registrants other certifying officer(s) and I have disclosed,
based on our most recent evaluation of internal control over financial
reporting, to the registrants auditors and the audit committee of the
registrants board of directors (or persons performing the equivalent
functions): |
|
(a) |
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All significant deficiencies and material weaknesses in the design or
operation of internal control over financial reporting which are
reasonably likely to adversely affect the registrants ability to
record, process, summarize and report financial information; and |
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(b) |
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Any fraud, whether or not material, that involves management or other
employees who have a significant role in the registrants internal
control over financial reporting. |
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By:
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/s/ James J. Martin
James J. Martin
|
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Chief Financial Officer |
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March 30, 2011 |
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Exhibit 32.1
Exhibit 32.1
CERTIFICATION PURSUANT
TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002
In connection with the accompanying Annual Report on Form 10-K of SafeStitch Medical, Inc. for
the fiscal year ended December 31, 2010 (the Report), the undersigned hereby certifies pursuant
to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, to
the best of my knowledge and belief, that:
(1) |
|
the Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities
Exchange Act of 1934; and |
(2) |
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the information contained in the Report fairly presents, in all material respects, the
financial condition and results of operations of SafeStitch Medical, Inc. |
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By:
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/s/ Jeffrey G. Spragens
Jeffrey G. Spragens
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Chief Executive Officer and President |
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March 30, 2011 |
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The certification set forth above is being furnished as an Exhibit solely pursuant to Section
906 of the SarbanesOxley Act of 2002 and is not being filed as part of the Report or as a
separate disclosure document of SafeStitch Medical, Inc. or the certifying officers
Exhibit 32.2
Exhibit 32.2
CERTIFICATION PURSUANT
TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002
In connection with the accompanying Annual Report on Form 10-K of SafeStitch Medical, Inc. for
the fiscal year ended December 31, 2010 (the Report), the undersigned hereby certifies pursuant
to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, to
the best of my knowledge and belief, that:
(1) |
|
the Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities
Exchange Act of 1934; and |
(2) |
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the information contained in the Report fairly presents, in all material respects, the
financial condition and results of operations of SafeStitch Medical, Inc. |
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By:
|
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/s/ James J. Martin
James J. Martin
|
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Chief Financial Officer |
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March 30, 2011 |
|
|
The certification set forth above is being furnished as an Exhibit solely pursuant to Section
906 of the SarbanesOxley Act of 2002 and is not being filed as part of the Report or as a
separate disclosure document of SafeStitch Medical, Inc. or the certifying officers