e10ksb
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-KSB
Annual
Report Pursuant To Section 13 or 15(d) of the Securities
Exchange Act of 1934
For the Fiscal Year Ended March 31, 2006
Commission File No. 000-20989
UROPLASTY, INC.
(Name of Small Business Issuer in its Charter)
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Minnesota
(State or other jurisdiction of
incorporation or organization)
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41-1719250
(I.R.S. Employer
Identification No.) |
2718 Summer Street NE
Minneapolis, Minnesota 55413-2820
(Address of principal executive offices)
(612) 378-1180
(Issuers telephone number, including area code)
Securities registered under Section 12(g) of the Exchange Act: Common Stock, $.01 par value (Title of class)
Check whether the issuer (1) 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 Company was required to file such reports), and (2) has been
subject to such filing requirements for the past 90 days.
YES þ NOo
Check if disclosure of delinquent filers in response to Item 405 of Regulation S-B is not contained in this form, and no
disclosure will be contained, to the best of Companys knowledge, in definitive proxy or information statements
incorporated by reference in Part III of this Form 10-KSB or any amendment to this Form 10-KSB. þ
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).
YES o NOþ
Issuers revenues for its most recent fiscal year: $6,142,612
The aggregate market value of the voting stock held by non-affiliates computed by reference to the price at which the stock
was sold or the average bid and asked prices of such stock as of June 1, 2006 was $9,514,884.
The number of shares outstanding of the issuers only class of common stock on June 1, 2006 was 6,961,206.
Documents Incorporated By Reference: Portions of the Companys Proxy Statement for its 2006 Annual Meeting of Shareholders
(the Proxy Statement), are incorporated by reference in Part III.
Transitional Small Business Disclosure Format: YES o NO þ
Indicate
by check mark whether the registrant is an accelerated filer (as
defined in Rule 12b-2 of the Exchange Act).
YES o NOþ
TABLE OF CONTENTS
PART I
Uroplasty, Inc. may from time to time make written or oral forward-looking statements, including
our statements contained in this report with the Securities and Exchange Commission and in our
reports to stockholders, as well as elsewhere. Forward-looking statements are statements such as
those contained in projections, plans, objectives, estimates, statements of future economic
performance, and assumptions related to any of the foregoing, and may be identified by the use of
forward-looking terminology, such as may, expect, anticipate, estimate, goal, continue
or other comparable terminology. By their very nature, forward-looking statements are subject to
known and unknown risks and uncertainties relating to our future performance that may cause our
actual results, performance or achievements, or industry results, to differ materially from those
expressed or implied in any such forward-looking statements.
Forward-looking statements are contained in the Managements Discussion and Analysis or Plan of
Operation and other sections of this report. Various factors and risks (not all of which are
identifiable at this time) could cause our results, performance or achievements to differ
materially from that contained in our forward-looking statements. We caution investors that any
forward-looking statement contained herein or elsewhere is qualified by and subject to the warnings
and cautionary statements contained above and in, particular, in the Risk Factors discussion
contained in the Description of Business section of this report.
We do not undertake and assume no obligation to update any forward-looking statement that we may
make from time to time.
ITEM 1. DESCRIPTION OF BUSINESS
Overview
We are a medical device company that develops, manufactures and markets innovative, proprietary
products for the treatment of voiding dysfunctions. Affecting urinary or fecal control, voiding
dysfunctions debilitate millions of adults worldwide and cost billions of healthcare dollars.
Since many of these dysfunctions are highly correlated with age, the aging population will demand
increasingly better, and less invasive, solutions for these conditions.
We have developed, and are developing, products primarily for the treatment of urinary and fecal
incontinence. Our products offer physicians and patients minimally invasive treatment options.
All products we currently market are CE marked for European Union clearance (similar to Food and
Drug administration (FDA) clearance in the U.S.). Our Macroplastique and other implantable tissue
bulking products have not yet been cleared for marketing in the United States.
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Macroplastique® Implants, a proprietary, implantable soft tissue bulking product is used
for the treatment of both male and female urinary incontinence. When Macroplastique is
injected into tissue around the urethra, it stabilizes and bulks tissues close to the
urethra, thereby providing the surrounding tissue with increased capability to control the
release of urine. Macroplastique is also used to treat vesicoureteral reflux,
predominately a pediatric condition in which urine flows backward from the bladder to the
kidney. Macroplastique has been sold, since 1991 in over 40 countries outside of the U.S.,
for urological indications. Our other proprietary, implantable soft tissue bulking agents
that we sell outside the United States include PTQ Implants for fecal incontinence, VOX
Implants for vocal cord rehabilitation and Bioplastique® Implants for dermal augmentation. |
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I-Stop Mid-Urethral Sling is a biocompatible, polypropylene, tension-free sling for the
treatment of female urinary incontinence. We are the exclusive distributor of this product
in the United Kingdom and in the United States. In August 2005 this product received
premarket clearance for sale within the United States. |
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The Urgent® PC neuromodulation system is a minimally invasive neuromodulation device
designed for office-based treatment of overactive bladder symptoms of urge incontinence,
urinary urgency and urinary frequency. Using percutaneous tibial nerve stimulation, the
product delivers an electrical pulse that travels to the sacral nerve plexus, a control
center for bladder function. In April 2005, we acquired the exclusive rights to
manufacture and distribute this product in the U.S., Canada and all countries recognizing
the CE mark. We received regulatory approvals for sale of this product in the United
States and Canada in October 2005, and in Europe in November 2005. Subsequently, we
launched the product for sale in those markets. |
Our goal is to develop and commercialize a portfolio of minimally invasive products for the
treatment of voiding dysfunctions. We believe that, with a suite of innovative products, we can
increasingly garner the attention of key physicians and distributors and enhance market acceptance
of our products. The key elements of our strategy are to:
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Pursue regulatory approval in the U.S. for our Macroplastique; |
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Expand our U.S. marketing and sales organization, using a combination of direct and independent reps; |
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Conduct multi-center, prospective clinical trials for the Urgent PC; |
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Expand distribution of our products outside of the U.S.; and |
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Acquire or license complimentary products if appropriate opportunities arise. |
We concluded a multi-center human clinical trial using Macroplastique Implants in a minimally
invasive, office-based procedure for treating adult female stress urinary incontinence resulting
from intrinsic sphincter deficiency, a weakening of the muscles that control the flow of urine from
the bladder. In December 2004, the FDA accepted for filing our pre-market approval submission
with respect to Macroplastique for the treatment of adult female stress urinary incontinence. This
submission is under review by the FDA and we continue to expect, as we indicated in July 2005, the
possible approval by the FDA in late 2007. We will incur substantial expenses in connection with
these regulatory activities. Even if we obtain regulatory approval, it may be only for limited
uses with specific classes of patients, which may limit the market for our product.
In the United States, we recently staffed our sales organization, consisting of a direct
field sales management team and independent sales representatives, and a marketing organization to
market our products directly to our customers. We anticipate further increasing, as needed, our
sales and marketing organization in the United States to support our sales growth. Outside of the
United States, we sell our products primarily through a direct sales organization in the United
Kingdom and through distributors in other markets.
Voiding Dysfunctions
Voiding dysfunctions affect urinary or fecal control and can result in unwanted leakage (urinary or
fecal incontinence) or uncontrolled sensations (overactive bladder symptoms). We believe we are
uniquely positioned to offer minimally invasive products to treat each of these voiding
dysfunctions.
The Problem of Urinary Incontinence
Urinary incontinence, the uncontrolled leakage of urine, is a problem suffered by millions of
people worldwide in varying degrees of severity. Because of the social stigma associated with this
condition, it is often underreported. It can result in a substantial decrease in a persons
quality of life, and is often the main reason a family moves an elderly person to nursing home
care. The Agency for Health Care Policy and Research (AHCPR), a division of the Public Health
Service, U.S. Department of Health and Human Services, estimates that urinary incontinence affects
about 13 million people in the United States, of which 85% (11 million) are women. The same agency
estimates the total cost of treating all types of incontinence (management and curative approaches)
in the United States to be $15 billion. Researchers at the University of California, Los Angeles
determined a 38% prevalence rate of urinary incontinence among the 23 million adult women surveyed
by the National Center for Health Statistics. We expect the incidence of urinary incontinence will
rise as the percentage of elderly population grows.
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Causes of Urinary Incontinence
The mechanisms of urinary continence are complicated and involve the interaction among several
anatomical structures. In females, urinary continence is controlled by the sphincter muscle and
pelvic floor support structures that maintain proper urethral position. The sphincter muscle
surrounds the urethra and provides constrictive pressure to prevent urine from flowing out of the
bladder. Urination occurs when the sphincter relaxes as the bladder contracts, allowing urine to
flow through the urethra. The urinary sphincter and pelvic floor support are also responsible for
maintaining continence during periods of physical stress. Incontinence may result when any part of
the urinary tract fails to function as intended. Incontinence may be caused by damage during
childbirth, pelvic trauma, spinal cord injuries, neurological diseases (e.g., multiple sclerosis
and poliomyelitis), birth defects (e.g., spina bifida) and degenerative changes associated with
aging.
For men, urinary incontinence is most often associated with prostate conditions or nerve problems,
such as complications arising from diabetes, stroke or Parkinsons disease. Enlargement of the
prostate gland (the gland surrounding the male urethra just below the bladder) may impact urinary
control. Approximately 400,000 prostate surgeries are performed
each year in the United States for prostate enlargement or for prostate cancer. Up to 20% of men
undergoing such surgery develop incontinence following the procedure.
Types of Urinary Incontinence
There are four types of urinary incontinence:
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Stress Urinary Incontinence - Stress urinary incontinence, or SUI, refers to the
involuntary loss of urine due to an increase in intra-abdominal pressure from ordinary
physical activities, such as coughing, sneezing, laughing, straining or lifting. For the
majority of women with SUI (9 million of the 11 million in the U.S.), their incontinence is
caused by urethral hypermobility. Urethral hypermobility abnormal movement of the bladder
neck and urethra occurs when the anatomic supports for the bladder neck and urethra have
weakened. This anatomical change is often the result of childbirth. Stress urinary
incontinence can also be caused by intrinsic sphincter deficiency, or the inability of the
sphincter muscle to function properly. Intrinsic sphincter deficiency can be due to
congenital sphincter weakness or can result from deterioration of the urethral muscular wall
due to changes of aging or damage following trauma, spinal cord lesion or radiation therapy.
The National Association for Continence (NAFC) estimates up to 15% of female stress urinary
incontinence is a result of intrinsic sphincter deficiency. For many women, their SUI is a
combination of urethral hypermobility and ISD. |
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Urge Incontinence - Urge incontinence refers to the involuntary loss of urine associated
with an abrupt, strong desire to urinate. Urge incontinence often occurs when neurological
problems cause the bladder to contract and empty with little or no warning. |
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Overflow Incontinence - Overflow incontinence is associated with an over-distention of
the bladder. This can be the result of an under-active bladder or an obstruction in the
bladder or urethra. |
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Mixed Incontinence - Mixed incontinence is the combination of both urge and stress
incontinence (and, in some cases, overflow). Clinicians estimate that 30% of women
suffering from stress urinary incontinence also exhibit symptoms of urge incontinence.
Since prostate enlargement often obstructs the urethra, older men often have urge
incontinence coupled with overflow incontinence. |
Management and Curative Treatment of Urinary Incontinence
There are two general approaches to dealing with urinary incontinence One approach is to manage
symptoms with products such as pads or diapers. The other approach is to undergo curative
treatments in an attempt to restore continence, such as injection of urethral tissue bulking agents
or by invasive surgeries. We believe the treatment of urinary incontinence should start first with
the least invasive therapy and then move to more invasive therapies only when needed.
Management of Urinary Incontinence
Absorbent Products. Absorbent products are the most common form of management for urinary
incontinence because men and women can use them without consulting a physician. The cost of adult
diapers and pads can be substantial and create a continuous financial burden for patients.
Additionally, this management technique may require frequent changing of diapers and pads to
control patient embarrassment due to odor or soiling.
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Behavior Modification. Techniques used in behavior modification include bladder training,
scheduled voiding and pelvic floor muscle exercises known as Kegels. Some of the tools used in
conjunction with these training regimes are vaginal cones or weights, biofeedback devices and
pelvic floor stimulation. Because these techniques rely on active, frequent participation of the
individual, these techniques are seldom effective.
Occlusion and Compression Devices. Penile clamps, pessaries and urethral occlusion devices are
typically reserved for temporary use. Complications such as tissue erosion, urinary tract
infections, edema, pain and obstruction are associated with extended or improper use.
Urinary Catheters and Collection Devices. The type and severity of incontinence and an
individuals physical and mental condition determine the choice of catheter. Catheters may be
inserted as needed for bladder drainage and may be a closed, indwelling system or an external
collection device.
Drug Therapy. Drug treatment is used to manage multiple types of urinary incontinence.
Therapeutic drug activity is matched to the individuals urinary dysfunction, e.g., activity
targeted to contract muscle tissue of the bladder or bladder neck or to improve the quality of the
bladder neck and urethra mucosal lining. Drugs are most often used to treat
symptoms of overactive bladder but drugs seldom cure stress urinary incontinence. Common side
effects of drugs include dry mouth, constipation and headache. Other potential side effects
include urinary retention, nausea, dizziness, blurred vision and the possibility of unwanted
interactions with other drugs.
Curative Treatment of Urinary Incontinence
Injectable Uretheral Tissue Bulking Agents. Urethral tissue bulking agents are inserted with a
needle into the area around the urethra, augmenting the surrounding tissue for increased capacity
to control the release of urine. Hence, these materials are often called bulking agents or
injectables. Urethral bulking agents may be either synthetic or biologically derived and are an
attractive alternative to surgery because they are considerably less invasive. Active women
benefit from the use of urethral bulking agents since they will often return to normal activities
in a matter of days instead of weeks of recovery following invasive surgical procedures. Bulking
agents also represent a desirable treatment option for the elderly or infirm who may not otherwise
be able to withstand the trauma and morbidity resulting from a fully invasive surgical procedure.
Additionally, the use of a urethral bulking agent does not preclude the use of more invasive
treatments if required.
Biologically derived bulking agents include a patients own fat cells, polysaccharides (not
commercially available in the United States) or bovine collagen. Fat injections involve complex,
invasive harvesting of the patients own fat cells and re-injecting them into the bladder neck.
Collagen injections require pre-treatment allergy skin tests and, since the body absorbs collagen
over time, the patient may require subsequent re-injections.
Synthetic bulking agents include solid silicone elastomers, pyrolytic carbon-coated beads, and DMSO
and polyvinyl alcohol.
Surgery. In women, stress urinary incontinence can be surgically corrected through a procedure in
which the physician elevates and stabilizes the urethra and bladder neck, often with a sling to
support these structures. Market adoption of sling procedures is demonstrated by over 10% annual
growth during the last five years. An estimated 180,000 sling procedures were performed in the
U.S. during 2005, with almost half of these procedures using a tension-free sling product, usually
implanted in an outpatient setting. Numerous publications cite sling procedure efficacy greater
than 85%.
In men, the surgical options for treating urinary incontinence are a male sling or an implanted
artificial urinary sphincter, a patient-controlled device that keeps the urethra closed until the
patient is ready to urinate. Surgery to place the artificial sphincter requires general or spinal
anesthesia.
Uroplasty Solutions for Urinary Incontinence
We believe that we are uniquely positioned with differentiable, minimally invasive products to
address both causes of SUI an injectable bulking agent to treat ISD and a tension-free type sling
to treat urethral hypermobility.
Macroplastique® Implants
Macroplastique® is an injectable soft-tissue bulking agent used to treat stress urinary
incontinence, the most common form of urinary incontinence in women. It is designed to restore the
patients urinary continence immediately following treatment.
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Additionally, men who experience
incontinence as a result of prostate surgery are also candidates for Macroplastique treatment.
Macroplastique is a soft-textured, permanent implant placed endoscopically around the urethra
distal to the bladder neck. It is a proprietary composition of heat vulcanized, solid, soft,
irregularly shaped polydimethylsiloxane (solid silicone) implants suspended in a biocompatible
carrier gel. We believe our compound is better than other commercially available bulking agents
because it does not degrade, is not absorbed into surrounding tissues and does not migrate from the
implant site due to its unique composition, shape and size. This reduces the need for follow-up
treatments. Additionally, there is no need for special storage, cumbersome preparation or mixing
for use or for patient allergy testing.
We currently market Macroplastique outside the U.S. Macroplastique is a outpatient, minimally
invasive treatment that offers lower surgical risk with shorter recovery time, and a less expensive
alternative when compared to invasive procedures. Its safety and efficacy are evidenced by over 14
years of successful use outside the United States with over 50,000 patients treated. We concluded
a multi-center human clinical trial using Macroplastique Implants in a minimally invasive,
office-based procedure for treating adult female stress urinary incontinence resulting from
intrinsic sphincter deficiency, a weakening of the muscles that control the flow of urine from the
bladder. In December 2004, the FDA accepted for filing our pre-market approval submission with
respect to Macroplastique for the treatment of adult female stress urinary incontinence. This
submission is under review by the FDA and we continue to expect, as we indicated in July 2005, the
possible approval by the FDA in late 2007. We will incur substantial expenses in connection with
these
regulatory activities. Even if we obtain regulatory approval, it may be only for limited uses with
specific classes of patients, which may limit the market for our product.
Although Macroplastique is traditionally implanted with the aid of an endoscope, we also market
outside the United States a patented, non-endoscopic product placement kit, or delivery kit, called
the Macroplastique Implantation System, or MIS, for office-based treatment of female stress
urinary incontinence. Our MIS enables easy and consistent product placement without the use of an
endoscope. Following FDA approval of Macroplastique, we intend to seek regulatory approval for the
MIS.
I-Stop Sling
We are the exclusive distributor in the United States and the United Kingdom of the I-Stop tape, a
biocompatible, tension-free, mid-urethral sling manufactured by CL Medical SAS of Lyon, France.
The I-Stop tape has received FDA premarket approval and is CE marked for the treatment of female
urinary incontinence due to urethral hypermobility. If the urethra is no longer appropriately
supported by the surrounding tissues and ligaments, the urethra may move too easily and may no
longer properly close. A sling provides a hammock-type support for the urethra to prevent its
downward movement, and associated leakage of urine, during periods of increased abdominal pressure.
I-Stop, the only synthetic, mid-urethral sling made of monofilament knitted polypropylene, has
closed loop edges, which we believe make it non-damaging to surrounding tissue without the need for
a delivery sheath. We also believe that the I-Stop design provides greater strength and controlled
flexibility, and improved resistance to fragmentation, stretching and deformity during the
outpatient implant procedure, than competitive sling devices. For patients, we believe that our
tape design results in less irritation and fewer overall complications. We believe our product is
competitively priced and we offer components to address the retropubic and transobturator surgical
approaches.
In May 2005, we entered into a one-year exclusive agreement with CL Medical to distribute the
I-Stop in the United Kingdom. The agreement is renewable for up to 2 years, subject to certain
performance requirements of us. We are required to purchase a minimum of $266,000 of units in the
12-month period following January 1, 2006, subject to periodic adjustment based on the value of the
euro. The purchase price is payable in euros. If we fail to reach our minimum purchase
requirement, CL Medical has the right to terminate our exclusive distribution rights in the United
Kingdom.
In February 2006 we entered into a six-year exclusive agreement with CL Medical to distribute the
I-Stop in the U.S. The agreement is renewable for successive five-year terms, subject to certain
performance requirements of us. We are required to purchase a minimum of $363,000 of units in the
first 12-month period following January 1, 2006, increasing to approximately $2.6 million of units
in the fifth year, for an aggregate commitment of approximately $6.5 million of units over the
five-year period, subject to periodic adjustment based on the value of the euro. The purchase
price is payable in euros. If we fail to reach our minimum purchase requirement in any 12-month
period, CL Medical has the right to terminate our exclusive distribution rights in the United
States. CL Medical has agreed to provide us, without additional charge, with any improvements or
modifications it makes to the I-Stop sling and has granted us a right of first refusal for
exclusive distribution rights in the United States to any new medical devices or procedures it
develops. We have agreed that during,
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and for one year after, the term of this agreement, we will
not manufacture our own, or market any other partys tension-free vaginal tape product for the
treatment of female stress urinary incontinence. If for some reason CL Medical is prohibited from
exporting the I-Stop into the United States, CL Medical is required to supply us with the
components necessary to manufacture, package and label the I-Stop for the United States market.
The Problem of Overactive Bladder
Overactive bladder (OAB) is a prevalent and challenging urologic problem affecting 16% of the adult
population. An estimated 34 million Americans suffer from overactive bladder, although fewer than
40% seek medical help. A survey of individuals with OAB estimated the total U.S. economic cost of
OAB (direct and indirect costs) to be $12 billion.
For individuals with overactive bladder, the nervous system control for bladder filling and urinary
voiding is incompetent. Signals to indicate a full bladder are sent early and frequently, triggers
to allow the bladder to relax for filling are ineffective and nervous control of the urethral
sphincter, to keep the bladder closed until an appropriate time, is inadequate. An individual with
OAB may exhibit one or all of the symptoms that characterize overactive bladder: urinary
urgency, urinary frequency and urge incontinence. Urgency is the strong, compelling need to
urinate. Frequency is a repetitive need to void. Normal urinary voiding is eight times per day.
Individuals with an overactive bladder may seek to void over 20 times per day and at least two
times during the night, thereby causing significant sleep pattern disturbances. Urge incontinence
is an immediate, compelling need to urinate that typically results in an accident before the
individual can reach the restroom.
Treatment of Overactive Bladder Symptoms
Drug Therapy. The most common treatment for OAB is drug therapy using an anticholinergic agent.
However, for some individuals, the drugs are ineffective or the side effects so bothersome that the
patient discontinues the medications. Common side effects include dry mouth, constipation and
headache.
Biofeedback and Behavioral Modification. Bladder training and scheduled voiding techniques, often
accompanied by the use of voiding diaries, are a non-invasive approach to managing OAB. Because
these techniques rely on the diligence and compliance of the individual, these techniques are
seldom effective. In addition, for OAB symptoms, these techniques may not affect the underlying
cause of the condition.
Neuromodulation. Normal urinary control is dependent upon properly functioning neural pathways and
coordination among the central and peripheral nervous systems, the nerve pathways, bladder and
sphincter. Unwanted, uncoordinated or disrupted signals along these pathways can lead to
overactive bladder symptoms. Therapy using neuromodulation incorporates electrical stimulation to
target specific neural tissue and jam the pathways transmitting unwanted signals. To alter
bladder function, the stimulation must be delivered to the sacral nerve plexus, the neural tissue
affecting bladder activity. Neuromodulation for OAB is presently conducted through sacral nerve
stimulation or percutaneous tibial nerve stimulation.
The sacral nerve stimulator uses a small device, a neurostimulator, to send mild electrical pulses
to the sacral nerve. The sacral nerve is located in the lower back, just above the tailbone. The
surgically implanted neurostimulator contains a battery and electronics to create the electrical
pulses and is connected to a neurostimulation lead (an insulated wire) containing electrodes
through which stimulation is delivered to the nerve. The device is most frequently placed under
the skin of the buttock, with the lead under the skin near the spine.
Alternatively, percutaneous tibial nerve stimulation (PTNS) delivers stimulation to the sacral
nerve plexus by temporarily applying electrical pulses to the tibial nerve. The tibial nerve is an
easily accessed nerve in the lower leg. Neuromodulation using PTNS has a similar therapeutic
effect as the implantable sacral nerve stimulator, but requires no surgery. PTNS is minimally
invasive, has a low risk of complication and is typically performed in a physicians office.
Uroplasty Solutions for Overactive Bladder
Urgent® PC Neuromodulation System
In April 2005, we entered into an exclusive manufacturing and distribution agreement with
CystoMedix, Inc., an Andover, Minnesota medical device company, the exclusive rights to manufacture
and market the Urgent® PC Neuromodulation System for the U.S., Canada and all countries recognizing
the CE mark. The Urgent PC is a minimally invasive nerve stimulation device designed for
office-based treatment of urge incontinence, urinary urgency and urinary frequency
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symptoms of an
overactive bladder. Using percutaneous tibial nerve stimulation near the ankle, the product
delivers an electrical pulse that travels to the sacral nerve plexus, a control center for bladder
function.
We believe that the Urgent PC system is the only non-surgical neuromodulation device in the U.S.
market for treatment of overactive bladder symptoms. Components of the Urgent PC system include a
hair-width needle electrode, a lead set and an external, handheld, battery-powered stimulator. For
each 30-minute office-based therapeutic session, the physician temporarily inserts the needle
electrode in the patients lower leg and connects the electrode to the stimulator. Typically, a
patient undergoes 12 treatment sessions at one-week intervals, with follow up treatments as
required to maintain symptom reduction.
Under our agreement with CystoMedix, we are responsible for regulatory applications and compliance
within all markets outlined in the agreement. Although the Urgent PC as marketed by CystoMedix was
CE marked and 510(k) cleared, following minor revisions to the product, we secured 510(k) clearance
for the device in October 2005 and CE mark in November 2005. Subsequently we launched the product
for sale. We have since then developed a second generation Urgent PC, and in June 2006, received
for it the 510(k) clearance, CE Mark and regulatory approval to sell in Canada.
In connection with the agreement with CystoMedix, we purchased 75% of CystoMedixs inventory of
component parts and subassemblies for $25,000. We paid an initial royalty payment of $225,000 in
May 2005 and paid an additional aggregate of $250,000 in royalties in monthly installments through
May 2006. During the agreements term, we will pay CystoMedix further royalties of 7% of our net
product revenues from the sale of licensed products, offset by payments made against the above
$250,000 royalty amount. We agreed to sell licensed products we manufacture back to CystoMedix, on
a non-exclusive basis, on terms and for such price as we may mutually negotiate for CystoMedixs
own sales outside of the territories exclusively licensed to us.
Our five-year agreement with CystoMedix provides no renewal provision. Between January 2006 and
June 2008, we may elect to purchase all of CystoMedixs assets. The option price is $3,485,000,
reduced by up to $50,000 of liabilities assumed by us. After April 2007 the option price will
increase at a rate of 10% per year. The option price is payable in
shares of our common stock valued at the average of the closing bid price of our shares for the 20
trading days prior to our exercise of the option. If we exercise our option, we also assume up to
$1.4 million of bridge loan advances made to CystoMedix by its Chairman. We would repay up to $1.1
million of the bridge loan advances at closing and would issue our common stock for the balance of
the bridge loan based on the above option price. We also have certain rights of first refusal to
acquire CystoMedixs assets in the event CystoMedix receives a third party offer in advance of any
exercise of our option.
The Problem of Fecal Incontinence
Fecal incontinence, prevalent in 2-6% of the adult population, with women suffering up to four
times more often than men, is an extremely disabling and embarrassing condition. Approximately 25%
of women with stress urinary incontinence are also diagnosed with fecal incontinence.
Fecal continence relies on an intact and functioning anal sphincter. The internal anal sphincter
(IAS) provides most of the resting anal pressure and is the main muscle responsible for the
prevention of anal leakage. Degeneration or disruption of the IAS characteristically leads to
fecal incontinence or soiling. Degeneration can result from childbirth, surgical trauma or
accident.
Treatment of Fecal Incontinence
The internal sphincter cannot be surgically repaired, as it is extremely thin (approximately 2-3
mm) and, as a circular muscle, is under tension. Antidiarrheal drugs and diet modification help
some patients, but this is not a satisfactory, long-term solution for most patients.
Uroplasty Solutions for Fecal Incontinence
We have, and are developing additional, minimally invasive products to address fecal incontinence.
Our PTQ Implants offer a minimally invasive treatment for patients with fecal incontinence. They
are soft-textured, permanent implants. For treatment of fecal incontinence, PTQ Implants are
implanted circumferentially into the submucosa of the anal canal. Injection creates a bulking
and supportive effect similar to that of Macroplastique injection for the treatment of stress
urinary incontinence. The product is CE marked and currently sold outside the U.S. in various
international markets. We also secured CE mark for the application of percutaneous tibial nerve
stimulation for the treatment of fecal incontinence. Our Urgent PC is sold for the treatment of
fecal incontinence in countries recognizing the CE mark.
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Other Uroplasty Products
In addition to urological applications, we market our proprietary tissue bulking material outside
the United States for reconstructive and cosmetic plastic surgery under the trade name
Bioplastique® Implants and for otolaryngology vocal cord rehabilitation applications under the
trade name VOX® Implants.
In The Netherlands and United Kingdom only, we distribute certain wound care products in accordance
with a distributor agreement. Under the terms of the distributor agreement, we are not obligated
to purchase any minimum level of wound care products.
Marketing, Distribution and Sales
We currently sell two products in the United States the I-Stop Sling and the Urgent PC
Neuromodulation System. We received regulatory approvals for sale of our Urgent® PC
Neuromodulation System, the only minimally invasive nerve stimulation device designed for
office-based treatment of overactive bladder symptoms of urge incontinence, urinary urgency and
urinary frequency, in the United States and Canada in October 2005 and in Europe in November 2005.
Subsequently, we launched this product for sale in those markets.
Our U.S. sales organization consists of a direct field-based sales management group and a
nationwide network of independent sales representatives. We anticipate continuing to increase our
sales and marketing organization, as needed, to support the sales growth.
Outside of the United States, in addition to our UrgentÒ PC Neuromodulation system, we market
and sell Macroplastique and related ancillary products, PTQ Implants, VOX Implants and Bioplastique
Implants, and, in the United Kingdom we also sell the I-Stop sling. We sell our products primarily
through a direct sales organization in the United Kingdom. In all other markets we sell our
products primarily through distributors. International sales managers in The Netherlands manage
and train a network of distributors in approximately 40 countries, including Canada, Australia,
countries within Europe and Latin America. Each of our distributors has a territory-specific
distribution
agreement, including requirements indicating they may not sell injectable products that compete
directly with Macroplastique. Collectively, our distributors accounted for approximately 65% and
70% of total net sales for fiscal 2006 and 2005, respectively.
We use clinical studies and scientific community awareness programs to demonstrate the safety and
efficacy of our products. This data is important to obtain regulatory approval and to support our
sales staff and distributors in securing product reimbursement in their territories. Publications
of clinical data in peer-reviewed journals add to the scientific community awareness of our
products, including therapeutic applications, treatment techniques and expected outcomes. Our
clinical research department provides a range of activities designed to support surgeons in their
clinical evaluation study design, abstract preparation, manuscript creation and/or review and
submission. This team works closely with our sales and marketing and regulatory departments in the
area of technical support, submissions, literature review, and analysis and synopsis of technical
presentations and publications.
Researchers have designed clinical trials to provide outcome evidence on products developed by us.
These include randomized controlled trials on our PTQ Implants, Macroplastique Sling Support Kit
(MIS-SK) and a multi-center prospective study on the efficacy of the Urgent PC. Evidence-based
clinical research broadens the surgeons acceptance by providing detailed information related to
product safety and efficacy when applied to patient selection and comparative surgical and
non-surgical treatment regimens. Only by recognition of the complexity of our product,
indications, analysis of the contributing variables and presentation and publication of the
clinical outcomes, will we provide the physicians, patients and reimbursement systems with the
evidence they require to make informed decisions.
Manufacturing and Suppliers
We manufacture our tissue bulking products at our own facilities. We manufacture components in the
United States and finished products in The Netherlands. Our facilities utilize dedicated heating,
ventilation and high efficiency particulate air (HEPA) filtration systems to provide a controlled
working environment. Trained technicians perform all critical manufacturing processes in a
cleanroom environment according to validated written procedures. An outside vendor sterilizes our
products using validated methods and returns the products to us for final inspection and testing.
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Our manufacturing facilities and systems are periodically audited to ensure compliance with ISO
13485 (medical device quality management systems), and applicable European and Canadian medical
device requirements. Our facilities and systems were last audited by AMTAC Certification Services
in January 2005. No major deficiencies were noted, and we were found to be in compliance with all
standards and requirements audited.
Our facilities also need to be compliant with U.S. federal Quality System Regulations (QSR). While
we believe we are compliant with QSR, our facilities have not yet been audited by the FDA for such
compliance, and there can be no guarantee that we will pass the FDA compliance audit. We are also
subject to additional state, local, and U.S. federal government regulations applicable to the
manufacture of our products.
CL Medical designs and manufactures the I-Stop sling. Pursuant to our distribution agreements with
CL Medical, we are the exclusive distributor of the I-Stop sling in the United States and the
United Kingdom. Among other things, we are required to purchase a minimum number of I-Stop product
sets from CL Medical.
Under our manufacturing and distribution agreement with CystoMedix, Inc., we are responsible for
the manufacture of the Urgent PC device. We currently subcontract the manufacture of major
subassemblies for the product.
We purchase medical grade materials for use in our finished products from several single source
suppliers. Our quality department has qualified these suppliers. Although we believe our supply
sources could be replaced if necessary without due disruption, it is possible that the process of
qualifying suppliers for certain raw materials could cause an interruption in our ability to
manufacture our products, which could have a negative impact on sales.
Competition
The market for voiding dysfunction products is intensely competitive. Competitors offer management
and curative treatments, including commercialized tissue bulking agents, urethral sling products
and neurostimulation devices. Indirect and future competitors include drug companies and firms
developing new or improved treatment methods. We believe the principal decision factors among
treatment methods include physician and patient acceptance of the treatment method and cost,
availability of third-party reimbursement, marketing and sales coverage and the existence of
meaningful patent protection. In addition to addressing the decision factors, our ability to
effectively compete in this market will also depend on the consistency of our product quality as
well as delivery and product pricing. Other factors affecting our success include our product
development and innovation capabilities, clinical study results, ability to obtain required
regulatory approvals, ability to protect our proprietary technology, manufacturing and marketing
capabilities and ability to attract and retain skilled employees.
Soft-tissue injectable bulking agents competing directly with Macroplastique®, both outside and in
the U.S. include Contigen® and Tegress®, both FDA-approved bulking agents manufactured by C.R.
Bard, Inc.; Zuidex® and Deflux® (Deflex FDA approved for VUR use only) manufactured by Q-Med AB;
Durasphere® (FDA-approved for female SUI) manufactured by Carbon Medical Technologies; and
Coaptite® manufactured by BioForm, Inc. for Boston Scientific. In contrast to the competitors
products currently approved for sale, Macroplastique, marketed outside the United States since
1991, is a synthetic material that will not degrade, resorb or migrate, has no special preparation
or storage requirements and does not require the patient to have a skin test prior to the
procedure. The silicone-elastomer material has been studied for over 50 years in medical use for
such urological applications as artificial urinary sphincters, penile implants, stents and
catheters. Our patented Macroplastique® Implantation System offers a unique, non-endoscopic,
minimally invasive out-patient procedure that can be performed in the physicians office.
Sling procedures have become the preferred method for treating urethral hypermobility. The
tension-free sling market is dominated by Gynecares TVT Tension-free Support device. Other
companies competing in this market include American Medical Systems, C.R. Bard, Boston Scientific
and Mentor Corporation. We believe our I-Stop sling offers benefits of multiple surgical
approaches for the physician and a design to resist stretching, deformity and fragmentation.
The Urgent®PC neurostimulation device is an alternative to the more invasive Medtronic InterStim®
device. The Medtronic unit, which stimulates the sacral nerve, requires surgical implantation in
the upper buttocks or abdomen. In contrast, the Urgent PC device allows minimally invasive
stimulation of the sacral nerve plexus in an office-based setting without surgical intervention.
Neotonus markets a non-surgical device to deliver extracorporeal magnetic neuromodulation. In
addition, Boston Scientifics Bion® Microstimulator, a device implanted with a needle-like
instrument to stimulate the pudendal nerve, is CE mark approved for the treatment of urinary urge
incontinence and is undergoing clinical studies in the U.S.
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Many medications treat symptoms of overactive bladder, some by preventing unwanted bladder
contractions, others by tightening the bladder or urethra muscles and some by relaxing bladder
muscles. Sometimes, these drugs have unwanted side effects such as dry mouth, vision problems or
constipation. Among these medications are Detrol® (Pfizer Inc.), Ditropan® (Alza Corporation) and
Flomax® (Abbott Laboratories).
Many of our competitors and potential competitors have significantly greater financial,
manufacturing, marketing and distribution resources and experience than we have. In addition, many
of our competitors offer broader product lines within the urology market, which may give these
competitors the ability to negotiate exclusive, long-term supply contracts and to offer
comprehensive pricing for their products. It is possible other large health care and consumer
products companies may enter this industry in the future. Furthermore, smaller companies, academic
institutions, governmental agencies and other public and private research organizations will
continue to conduct research, seek patent protection and establish arrangements for commercializing
products. These products may compete directly with any products that we may offer in the future.
Government Regulation
The design, testing, manufacturing, promotion, marketing and distribution of our products in the
United States, Europe and other parts of the world are subject to regulation by numerous
governmental authorities, including the U.S. Food and Drug Administration, or FDA, the European
Union and other analogous agencies.
United States
Our products are regulated in the Unites States as medical devices by the FDA under the Food, Drug
and Cosmetic Act. Noncompliance with applicable requirements can result in, among other things:
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fines, injunctions, and civil penalties; |
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recall or seizure of products; |
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operating restrictions, or total or partial suspension of production; |
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denial of requests for 510(k) clearance or pre-market approval of new products; |
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withdrawal of existing approvals; and |
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criminal prosecution. |
Depending on the degree of risk posed by the medical device and the extent of controls needed to
ensure safety and effectiveness, there are two pathways for FDA marketing clearance of medical
devices. For devices deemed by FDA to pose relatively less risk (Class I or Class II devices),
manufacturers, in most instances, may submit a pre-market notification (510(k) clearance)
requesting permission for commercial distribution.. Devices deemed by the FDA to pose the greatest
risk (Class III devices), such as life-sustaining, life-supporting or implantable devices, or a
device deemed not to be substantially equivalent to a previously cleared 510(k) device, require the
submission of a pre-market approval (PMA) application. The FDA can also impose restrictions on the
sale, distribution or use of devices at the time of their clearance or approval, or subsequent to
marketing.
510(k) Clearance. To obtain 510(k) clearance, the pre-market notification must demonstrate that
the proposed device is substantially equivalent in intended use and in safety and effectiveness to
a previously 510(k) cleared device or a device that was commercially distributed before May 28,
1976 and for which FDA has not yet called for submission of a pre-market approval application. The
FDA attempts to respond to a 510(k) pre-market notification within 90 days of submission of the
notification, but the response may be a request for additional information, sometimes including
clinical data. As a practical matter, 510(k) clearance can take significantly longer than 90 days,
including up to one year or more.
After a device receives 510(k) clearance for a specific intended use, modifications or enhancements
that could significantly affect the safety or effectiveness of the device or that would constitute
a major change to the intended use of the device will require a new 510(k) pre-market notification
submission or, depending upon the changes, could require pre-market approval. The FDA requires
each manufacturer to make this determination initially, but the FDA can review any such decision.
If the FDA disagrees with a manufacturers determination that a new clearance or approval is not
required for a particular modification, the FDA can require the manufacturer to cease marketing or
recall the modified device until 510(k) clearance
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or pre-market approval is obtained. Also, in
these circumstances, a company may be subject to significant regulatory fines or penalties.
Pre-market Approval. A pre-market approval application must be submitted if the device cannot be
cleared through the 510(k) process. The pre-market approval process is much more demanding than
the 510(k) notification process. A pre-market approval applicant must provide extensive
preclinical and clinical trial data as well as information about the device and its components
regarding, among other things, device design, manufacturing and labeling. As part of the
pre-market approval process, applicants must file an Investigational Device Exemption, or IDE,
application prior to commencing human clinical trials. If the IDE application is approved by the
FDA, human clinical trials may begin at a specific number of investigational sites with a maximum
number of patients. The results of clinical testing may not be sufficient to obtain approval of
the product.
After the FDA determines that a pre-market approval application is complete, the FDA accepts the
application and begins an in-depth review of the submitted information. The FDA, by statute and
regulation, has 180 days to review an accepted pre-market approval application, although the review
generally occurs over a significantly longer period of time, and can take up to several years.
During this review period, the FDA may request additional information or clarification of
information already provided. Also during this review period, an advisory panel of experts from
outside the FDA may be convened to review and evaluate the application and provide recommendations
to the FDA as to the approvability of the device. In addition, the FDA will conduct a pre-approval
inspection of the manufacturing facility to ensure compliance with the Quality System Regulations.
New pre-market approval applications or supplemental pre-market approval applications are required
for significant modifications to the manufacturing process, labeling, use and design of a device
that is approved through the pre-market approval process. Pre-market approval supplements often
require submission of the same type of information as a pre-market approval, except that the
supplement is limited to information needed to support any device changes not covered by the
original pre-market approval application, and may not require as extensive clinical data as the
original submission or the convening of an advisory panel.
Continuing FDA Regulation. After a device is placed on the market, numerous regulatory
requirements apply. These include:
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Quality System Regulations, which require manufacturers to follow design, testing,
control, documentation and other quality assurance procedures during the manufacturing
process; |
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labeling regulations, which govern product labels and labeling, prohibit the promotion
of products for unapproved or off-label uses and impose other restrictions on labeling
and promotional activities; |
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medical device reporting regulations, which require that manufacturers report to the FDA
if their device may have caused or contributed to a death or serious injury or
malfunctioned in a way that would likely cause or contribute to a death or serous injury if
it were to recur; |
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post-market surveillance activities monitor use of the products placed in the market place; and |
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notices of correction or removal, and recall regulations. |
FDA Approval Status of Our Products. The FDA has determined that urethral tissue bulking agents,
such as Macroplastique, are Class III devices and require FDA clearance of a pre-market approval
application. In 1999, the FDA approved our IDE application for the use of Macroplastique in a
clinical study for the treatment of stress urinary incontinence. In 2000, we commenced human
clinical trials at multiple sites. We concluded the 12-month patient follow up visits for this
study and, in 2004 submitted a pre-market approval application. This submission is under review by
the FDA and we continue to expect, as we indicated in July 2005, the possible approval by the FDA
in late 2007. Even if we obtain regulatory approval, it may be only for limited uses with specific
classes of patients, which may limit the market for our product.
In August 2005, the I-Stop product received premarket clearance for sale within the United States.
The Urgent PC device previously received 510(k) clearance for U.S. marketing by the FDA. However,
following product revisions, we submitted our 510(k) pre-market application in August 2005. We
received 510(k) clearance in October 2005 for our version of the Urgent PC device. Following
development of our second generation of the Urgent PC, in May 2006 we submitted a special 510(k)
pre-market application. With regards to our second generation Urgent PC, in June 2006, we received
the CE mark and approval from Therapeutic Products Directorate of Health to sell in Canada.
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FDA Oversight of Manufacturing Operations. The Food, Drug and Cosmetics Act requires that medical
devices be designed and manufactured in accordance with the FDAs current Quality System
Regulations, which require, among other things, that we:
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regulate our design and manufacturing processes and control them by the use of written procedures; |
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investigate any deficiencies in our manufacturing process or in the products we produce; |
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keep detailed records and maintain a corrective and preventative action plan; and |
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allow the FDA to inspect our manufacturing facilities on a periodic basis to monitor our
compliance with Quality System Regulations. |
Although our manufacturing facilities and processes have been inspected and certified in compliance
with ISO 13485, applicable European medical device directives, and Canadian Medical Device
Requirements, they have not been inspected by the FDA for compliance with Quality System
Regulations. We will be required to have a FDA inspection prior to the pre-market approval of our
Macroplastique product for sale in the U.S. We cannot assure you that our facilities and processes
will be found to comply with Quality System Regulations and there is a risk that approval will,
therefore, be delayed by the FDA until such compliance is achieved.
European Union and Other Regions
The European Union has adopted rules that require that medical products receive the right to affix
the CE mark, which stands for Conformité Européenne. The CE mark demonstrates adherence to quality
assurance standards and compliance with relevant European medical device directives. Products that
bear the CE mark can be imported to, sold or distributed within, the European Union.
We received CE marking approval for Macroplastique in 1996 for the treatment of male and female
stress urinary incontinence and vesicoureteral reflux; for the Urgent PC for the treatment of fecal
incontinence, and overactive bladder symptoms of urinary urgency, urinary frequency and urge
incontinence. In addition, we received CE marking for PTQ Implants in 2002 for the treatment of
fecal incontinence; for VOX Implants in 2000 for vocal cord rehabilitation applications; and for
Bioplastique Implants in 1996 for dermal augmentation applications. The I-Stop sling received CE
marking approval in July 2002. Our European manufacturing facilities and processes have been
inspected and certified by AMTAC Certification Services, a recognized Notified Body, testing and
certification firm based in the United Kingdom.
We currently sell our products in approximately 40 foreign countries, including those within the
European Union. Requirements pertaining to medical devices vary widely from country to country,
ranging from no health regulations to detailed submissions such as those required by the FDA. We
have obtained regulatory approval where required for us to sell our products in the country. We
believe the extent and complexity of regulations for medical devices are increasing worldwide. We
anticipate that this trend will continue and that the cost and time required to obtain approval to
market in any given country will increase.
Third-Party Reimbursement
In both U.S. markets and markets outside the U.S., sales of our products will depend in part on the
availability of reimbursement from third-party payors. Outside of the United States, government
managed health care systems and private insurance control reimbursement for devices and procedures.
Reimbursement systems in international markets vary significantly by country. In the European
Union, reimbursement decision-making is neither regulated nor integrated at the European Union
level. Each country has its own system, often closely protected by its corresponding national
government. Reimbursement for Macroplastique and other tissue bulking products has been successful
in multiple international markets where hospitals and physicians have been able to get budgets
approved by fund-holder trusts or global hospital budgets.
In the U.S., third-party payors consist of government programs, such as Medicare, private health
insurance plans, managed care organizations and other similar programs. For any product, three
factors are critical to reimbursement:
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coding, which ensures uniform descriptions of procedures, diagnoses and medical
products; |
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coverage, which is the payors policy describing the clinical circumstances under which
it will pay for a given treatment; and |
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payment amount. |
Reimbursment for tension-free sling products has been previously addressed by numerous competitors.
As a result coding, coverage and payment for the I-Stop Mid-Urethral Sling is already
well-established.
As a relatively new therapy, nerve simulation using the Urgent PC has not been assigned a
reimbursement code unique to the technology. However, a number of practitioners are using an
existing reimbursement code that closely describes the procedure. In addition, Aetna and Blue
Cross Blue Shield of Minnesota and Maryland have published policies providing coverage for PTNS
under an existing reimbursement code. We will need to continue to work with third-party payers for
coverage policies and the American Medical Association to develop definitive and uniform
reimbursement for the theraphy. In addition, we will need to provide customer reimbursement
support as we market the product and secure medical community acceptance.
We believe, but cannot confirm, that there are appropriate codes available to describe endoscopic
use of Macroplastique to treat female SUI. We expect that, upon FDA approval to market
Macroplastique, we will need to foster coverage policies and payer acceptance to support the U.S.
launch. There is no guarantee that Macroplastique will be reimbursed at the levels expected by
us, if at all.
Patents, Trademarks and Licenses
Our success depends in part on our ability to obtain and maintain patent protection for our
products, preserve our trade secrets and operate without infringing the proprietary rights of third
parties. We seek to protect our technology by filing patent applications for technologies
important to the development of our business following an analysis of the cost of obtaining a
patent, the likely scope of protection, the relative benefits of patent protection compared to
trade secret protection and other business considerations.
We hold multiple patents covering our Macroplastique materials, processes and applications. As of
the date of this report, we have four issued U.S. patents and 19 granted patents in the United
Kingdom, Japan, Germany, France, Spain, Italy, Portugal, The Netherlands and Canada. Our patents
will expire in the U.S. at various times between 2011 and 2016 and in other countries between 2009
and 2017. There can be no assurance any of our issued patents are of sufficient scope or strength
to provide meaningful protection of our products. In addition, there can be no assurance any
current or future U.S. and foreign patents of ours will not be challenged, narrowed, invalidated or
circumvented by competitors or others, or that our patents will provide us with any competitive
advantage. Any legal proceedings to maintain, defend or enforce our patent rights could be lengthy
and costly, with no guarantee of success. CystoMedix and CL Medical also have certain patent
rights which they licensed to us as part of their respective manufacturing and distribution
agreements. We are awaiting prosecution of the patent protection applications we filed in 2006 for
the Urgent PC.
In 1992, we agreed to settle alleged patent infringement claims by Collagen Corporation (now Inamed
Corporation). Under the settlement agreement, we pay Collagen a royalty of 5% of net sales in the
U.S. of Macroplastique products with a minimum, through May 1, 2006, of $50,000 per year.
Although we intend to apply for additional patents and vigorously defend issued patents, management
believes our business success will depend primarily upon our development and sales and marketing
skills, and the quality and economic value of our products rather than on our ability to obtain and
defend patents.
We also seek to protect our trade secrets by requiring employees, consultants, and other parties to
sign confidentiality agreements and noncompetition agreements, and by limiting access by outside
parties to confidential information. There can be no assurance, however, these measures will
prevent the unauthorized disclosure or use of this information or that others will not be able to
independently develop this information.
We have registered Macroplastique®, Uroplasty® and Bioplastique® as trademarks with the U.S. Patent
and Trademark Office. Our non-registered trademarks include VOX and PTQ, for which trademark
registration applications are pending in the U.S. Patent and Trademark Office and in European
countries. In addition, Macroplastique is registered in numerous European countries. CystoMedix
has U.S. registration of the Urgent®PC trademark and has licensed the mark to
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us as part of our
exclusive manufacturing and distribution agreement. In addition, CL Medical has licensed its
non-registered trademark for the I-Stop sling to us as part of our agreement with it.
We have a royalty agreement with three individuals, two of whom are former officers and directors.
Under this royalty agreement, we pay aggregate royalties of three to five percent of net sales of
Macroplastique and Bioplastique, subject to a monthly minimum of $4,500. The royalties payable
under this agreement will continue until the patent referenced in the agreement expires in 2010.
In October 1998, we received an absolute assignment from a British surgeon of a patent relating to
the Macroplastique Implantation System in return for a royalty of £10 for each unit sold during the
life of the patent. We began commercialization of the product outside the U.S. in March 2000.
Research and Development
We have a research and development program to develop new incontinence products. We are also
continually evaluating product potential improvements, and new methods and devices for the
implantation of and new applications for Macroplastique. Research and development expenses also
include the costs of clinical studies and regulatory compliance. Our expenditures for research and
development totaled $3.3 and $2.3 million for fiscal 2006 and 2005, respectively. None of these
costs were borne directly by customers.
Product Liability
The medical device industry is subject to substantial litigation. As a manufacturer of a long-term
implantable device, we face an inherent risk of liability for claims alleging adverse effects to
the patient. We currently carry $2 million of worldwide product liability insurance, plus another
policy specific to the United Kingdom only. There can be no assurance, however, our existing
insurance coverage limits are adequate to protect us from any liabilities we might incur. There
can be no assurance that liability claims will not exceed coverage limits. Product liability
insurance is expensive and in the future may not be available to us on acceptable terms, if at all.
Furthermore, we do not expect to be able to obtain insurance covering our costs and losses as a
result of any product recall. A successful claim in excess of our insurance coverage could
materially deplete our assets. Moreover, any claim against us could generate negative publicity,
which could decrease the demand for our products and our ability to generate revenues.
Compliance with Environmental Laws
Compliance by us with applicable environmental requirements during fiscal years 2006 and 2005 has
not had a material effect upon our capital expenditures, earnings or competitive position.
Dependence on Major Customers
During fiscal 2006, two customers accounted for approximately 14% and 11% of our net sales. During
fiscal 2005, the same two customers accounted for approximately 15% and 11% of our net sales.
Employees
As of March 31, 2006, we had 55 employees, of which 51 were full-time and 4 were part-time. No
employee has a collective bargaining agreement with us. We believe we maintain good relations with
our employees.
Incorporation and Current Subsidiaries
We were incorporated in January 1992 as a Minnesota corporation and a wholly owned subsidiary of
our original parent. In February 1995, we became a stand-alone, privately held company pursuant to
a Plan of Reorganization confirmed by the U.S. Bankruptcy Court. We became a reporting company
pursuant to a registration statement filed with the Securities and Exchange Commission in July
1996.
Our wholly owned foreign subsidiaries and their respective principal functions are as follows:
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Uroplasty BV
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Incorporated in The Netherlands, distributes the Urgent PC,
is the manufacturer of Macroplastique, Bioplastique, VOX
Implants, PTQ Implants and of all their accessories,.
Products are sold primarily through distributors. |
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Uroplasty LTD
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Incorporated in the United Kingdom and acts as the sole
distributor of Urgent PC, Macroplastique, Bioplastique, PTQ
Implants, all of their accessories, and wound care products
in the United Kingdom and Ireland. Also distributes the
I-Stop in the United Kingdom. Products are sold primarily
through a direct sales organization. |
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Bioplasty BV
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Incorporated in The Netherlands and is the distributor of
Bioplastique to subdistributors, and distributes wound care
products in The Netherlands. We plan to merge this
subsidiary with Uroplasty BV in fiscal 2007. |
RISK FACTORS
Investing in our common stock involves a high degree of risk. You should carefully consider the
risk factors set forth below and all other information contained in this Annual Report on Form
10-KSB before purchasing our common stock. If the following risks actually occur, our business,
financial condition and results of operations could be seriously harmed, the price of our common
stock could decline and you could lose part or all of your investment.
We continue to incur losses and may never reach profitability
We have incurred net losses in each of the last five fiscal years. As of March 31, 2006, we had an
accumulated deficit of approximately $11 million primarily as a result of costs relating to the
development, including seeking regulatory approvals, and commercialization of our Macroplastique,
I-Stop tape, Urgent® PC neuromodulation system and related products. We expect our operating
expenses relating to sales and marketing activities and product development, including seeking
United States regulatory approval for Macroplastique, will continue to increase during the
foreseeable future. To achieve profitability, we must generate substantially more revenue than we
have in prior years. Our ability to achieve significant revenue growth will depend, in large part,
on our ability to obtain FDA approval to market Macroplastique, and our ability to achieve
widespread market acceptance for our products, which we cannot guarantee will happen. We may never
realize significant revenue from the sale of our products or be profitable.
If we fail to receive or experience a significant delay in receiving regulatory approvals for sale
of our products, our ability to generate revenues will be limited and our business prospects may
suffer.
We cannot sell Macroplastique in the United States until we obtain the requisite FDA approvals. If
we suffer delays in obtaining or fail to receive regulatory approvals, our ability to generate
revenues from the sale of these products will be limited and our future growth may be significantly
hampered.
In the U.S., we have submitted a pre-market approval application with respect to Macroplastique.
The pre-market approval process is very expensive, uncertain and time-consuming and could
materially delay our product coming to market. This submission is under review by the FDA and we
continue to expect, as we indicated in July 2005, the possible approval by the FDA in late 2007.
We will incur substantial expenses in connection with these regulatory activities. Even if we
obtain regulatory approval, it may be only for limited uses with specific classes of patients,
which may limit the market for our product.
We are primarily dependent on sales of one product and our business would suffer if sales of this
product decline.
We are dependent on sales of our products that contain our Macroplastique bulking agent. Our
Macroplastique product line accounted for 67% and 76%, respectively, of total net sales during
fiscal 2006 and 2005. If our Macroplastique products were no longer available for sale in any key
market because of regulatory, intellectual property or any other reason, our net sales from these
products would significantly decline. A significant decline in our net sales could also negatively
impact our product development activities and therefore our business prospects.
We are unable to predict how quickly or how broadly our products will be accepted by the market.
If demand for our products fails to develop as we expect, our revenues will decline or we may be
unable to increase our revenues and be profitable.
Although some our products received FDA approval, market acceptance is uncertain. Our failure to
achieve sufficient market acceptance will significantly limit our ability to generate revenue and
be profitable. Market acceptance of our
products will depend on our ability to demonstrate the safety, clinical efficacy, perceived
benefits and cost-effectiveness of our products
16
compared to products or treatment options of our
competitors, and to train physicians in the proper application of our products. We cannot assure
you that we will be successful in educating the marketplace about the benefits of using our
products. Even if customers accept our products, this acceptance may not translate into sales if
our competitors have developed similar products that our customers prefer. If our products do not
achieve increasing market acceptance in the U.S. and internationally, our revenues will decline or
we may be unable to increase our revenues and be profitable.
Our products and facilities are subject to extensive regulation with which compliance is costly and
which exposes us to penalties for non-compliance. We may not be able to obtain required regulatory
approvals for our products in a cost-effective manner or at all, which could adversely affect our
business and results of operations.
The production and marketing of our products and our ongoing research and development, preclinical
testing and clinical trial activities are subject to extensive regulation and review by numerous
governmental authorities both in the United States and abroad. U.S. and foreign regulations
applicable to medical devices are wide-ranging and govern, among other things, the testing,
marketing and pre-market review of new medical devices, in addition to regulating manufacturing
practices, reporting, advertising, exporting, labeling and record keeping procedures. We are
required to obtain FDA approval or clearance before we can market our products in the United States
and certain foreign countries. The regulatory process requires significant time, effort and
expenditures to bring our products to market, and we cannot assure that any of our products will be
approved for sale. Any failure to obtain regulatory approvals or clearances could prevent us from
successfully marketing our products, which could adversely affect our business and results of
operations. Our failure to comply with applicable regulatory requirements could result in
governmental agencies:
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imposing fines and penalties on us; |
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preventing us from manufacturing or selling our products; |
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bringing civil or criminal charges against us; |
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delaying the introduction of our new products into the market; |
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enforcing operating restrictions; |
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recalling or seizing our products; or |
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withdrawing or denying approvals or clearances for our products. |
If any or all of the foregoing were to occur, we may not be able to meet the demands of our
customers and our customers may cancel orders or purchase products from our competitors, which
could adversely affect our business and results of operations.
Even if we receive regulatory approval or clearance of a product, the approval or clearance could
limit the uses for which we may label and promote the product, which may limit the market for our
products. Further, for a marketed product, its manufacturer and manufacturing facilities are
subject to periodic reviews and inspections by FDA and foreign regulatory authorities. Subsequent
discovery of problems with a product, manufacturer or facility may result in restrictions on the
product, manufacturer or facility, including withdrawal of the product from the market or other
enforcement actions. In addition, regulatory agencies may not agree with the extent or speed of
corrective actions relating to product or manufacturing problems.
If additional regulatory requirements are implemented in the foreign countries in which we sell our
products, the cost of developing or selling our products may increase. In addition, we may rely on
our distributors outside the United States in seeking regulatory approval to market our devices in
particular countries. To the extent we do so, we are dependent on persons outside of our direct
control to make regulatory submissions and secure approvals, and we do or will not have direct
access to health care agencies in those markets to ensure timely regulatory approvals or prompt
resolution of regulatory or compliance matters. If our distributors fail to obtain the required
approvals or do not do so in a timely manner, our net sales from our international operations and
our results of operations may be adversely affected.
In addition, our business and properties are subject to federal, state and local laws and
regulations relating to the protection of the environment, natural resources and worker health and
safety and the use, management, storage, and disposal of hazardous substances, wastes, and other
regulated materials. The costs of complying with these various environmental requirements, as they
now exist or may be altered in the future, could adversely affect our financial condition and
results of operations.
17
If third parties claim that we infringe upon their intellectual property rights, we may incur
liabilities and costs and may have to redesign or discontinue selling the affected product.
The medical device industry is litigious with respect to patents and other intellectual property
rights. Companies operating in our industry routinely seek patent protection for their product
designs, and many of our principal competitors have large patent portfolios. Companies in the
medical device industry have used intellectual property litigation to gain a competitive advantage.
Whether a product infringes a patent involves complex legal and factual issues, the determination
of which is often uncertain. We face the risk of claims that we have infringed on third parties
intellectual property rights. Our efforts to identify and avoid infringing on third parties
intellectual property rights may not always be successful. Any claims of patent or other
intellectual property infringement, even those without merit, could:
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be expensive and time consuming to defend; |
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result in us being required to pay significant damages to third parties; |
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cause us to cease making or selling products that incorporate the challenged intellectual property; |
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require us to redesign, reengineer or rebrand our products, if feasible; |
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require us to enter into royalty or licensing agreements in order to obtain the right to
use a third partys intellectual property, which agreements may not be available on terms
acceptable to us or at all; |
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divert the attention of our management; or |
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result in our customers or potential customers deferring or limiting their purchases or
use of the affected products until resolution of the litigation. |
In addition, new patents obtained by our competitors could threaten a products continued life in
the market even after it has already been introduced.
If we are unable to adequately protect our intellectual property rights, we may not be able to
compete effectively and we may not be profitable.
Our success depends in part on our ability to protect our proprietary rights to the technologies
used in our products. We rely on patent protection, as well as a combination of trademark laws and
confidentiality, noncompetition and other contractual arrangements to protect our proprietary
technology. However, these legal means afford only limited protection and may not adequately
protect our rights or permit us to gain or keep any competitive advantage. Our patents and patent
applications if issued, may not be broad enough to prevent competitors from introducing similar
products into the market. Our patents, if challenged or if we attempt to enforce them, may not
necessarily be upheld by the courts of any jurisdiction. In addition, patent protection in foreign
countries may be different from patent protection under U.S. laws and may not be favorable to us.
As a result, we may not be able to compete effectively.
We also rely on unpatented proprietary technology. We cannot assure you that we can meaningfully
protect all of our rights in our unpatented proprietary technology or that others will not
independently develop substantially equivalent products or processes or otherwise gain access to
our unpatented proprietary technology. We attempt to protect our trade secrets and other
unpatented proprietary technology through the use of confidentiality agreements and noncompetition
agreements with our current employees and with other parties to whom we have divulged trade
secrets. However, these agreements may not be enforceable or may not provide meaningful protection
for our proprietary information in the event of unauthorized use or disclosure or other breaches of
the agreements or in the event competitors discovery or independently develop similar proprietary
information.
Product liability claims could adversely affect our business and results of operations.
The manufacture and sale of medical devices exposes us to significant risk of product liability
claims, some of which may have a negative impact on our business. Our existing products were
developed relatively recently and defects or risks that we have not yet identified may give rise to
product liability claims. Our existing $2 million of worldwide product liability insurance coverage
may be inadequate to protect us from any liabilities we may incur or we may not be able to maintain
adequate product liability insurance at acceptable rates. If a product liability claim or series of
claims is brought against us for
18
uninsured liabilities or in excess of our insurance coverage and
it is ultimately determined that we are liable, our business could suffer. Additionally, we could
experience a material design or manufacturing failure in our products, a quality system failure,
other safety issues or heightened regulatory scrutiny that would warrant a recall of some of our
products. A recall of any of our products likely would be costly, would be uninsured and could
also result in
increased product liability claims. Further, while we train our physician customers on the proper
usage of our products, we cannot ensure that they will implement our instructions accurately. If
our products are used incorrectly by our customers, injury may result and this could give rise to
product liability claims against us. Any losses that we may suffer from any liability claims, and
the effect that any product liability litigation may have upon the reputation and marketability of
our products, may divert managements attention from other matters and may have a negative impact
on our business and our results of operations.
If we are not able to successfully scale-up production of our products, our sales and revenues will
suffer.
In order to commercialize our products in the United States and international markets, we need to
be able to produce, or subcontract the production, of our products in a cost-effective way on a
large scale to meet demand, while maintaining high standards for quality and reliability. If we
fail to successfully commercialize our products, we will not be profitable.
We may experience manufacturing and control problems as we begin to scale-up our future
manufacturing operations, and we may not be able to scale-up manufacturing in a timely manner or at
a reasonable cost to enable production in sufficient quantities. If we experience any of these
problems, we may not be able to have our products manufactured and delivered in a timely manner.
The I-Stop sling is designed and manufactured by CL Medical in France for our distribution in the
United States and the United Kingdom. If CL Medical experiences problems with manufacturing or
control, encounters regulatory or compliance problems, or incurs delays, we may not receive the
I-Stop product in a timely manner. This would limit our ability to generate revenues.
The loss or interruption of materials from any of our key suppliers could slow down the manufacture
of our products, which would limit our ability to generate sales and revenues.
We currently purchase several key materials used in our products from single source suppliers. Our
reliance on a limited number of suppliers subjects us to several risks, including an inability to
obtain an adequate supply of required materials, price increases, untimely delivery and
difficulties in qualifying alternative suppliers. We cannot be sure that acceptable alternative
arrangements could be made on a timely basis. Additionally, the qualification of materials and
processes as a result of a supplier change could be deemed as unacceptable to regulatory
authorities and cause delays and increased costs due to additional test requirements. A
significant interruption in the supply of materials, for any reason, could delay the manufacture
and sale of our products, which would limit our ability to generate revenues.
If we are not able to maintain sufficient quality controls, approval of our products by the
European Union, the FDA or other relevant authorities could be delayed or denied and our sales and
revenues will suffer.
Approval of our products could be delayed by the FDA, European Union or other related authorities
if our manufacturing facilities do not comply with applicable manufacturing requirements. The
FDAs Quality System Regulations impose elaborate testing, control, document and other quality
assurance procedures. Canada and the European Union also impose requirements on quality control
systems of manufacturers, which are inspected and certified on a periodic basis and may be subject
to additional unannounced inspections. Failure by us or CL Medical to comply with these
requirements could prevent us from obtaining FDA approval for our products and from marketing our
products in the United States. We cannot assure you that our manufacturing facilities will comply
with applicable requirements on a timely basis or at all.
Even with approval to market our products in the European Union, the United States and other
countries, we must continue to comply with relevant manufacturing requirements. If violations of
applicable requirements are noted during periodic inspections of our manufacturing facilities, we
may not be able to continue to market our products and our revenues could be materially adversely
affected.
If we are not able to increase our sales force and expand our distribution channels, our sales and
revenues will suffer.
To date, we have sold our products in foreign markets through a network of independent distributors
and our direct sales force. Our ability to increase product sales in foreign markets will largely
depend on our ability to develop and maintain relationships with our existing and additional
distributors and to recruit additional sales personnel. We may not be able to attract distributors
who are willing to commit the necessary resources to market and sell our products to the level of
our
19
expectations. In the United States, we have a sales organization consisting of a direct sales
management group and a nationwide network of independent sales representatives and a marketing
organization to market our products directly and support our distributor organizations. We
anticipate continuing to expand our sales and marketing organization, as needed to support our
growth. We have and will continue to incur significant continued and additional expenses to
support this organization. We will need to raise additional debt or equity financing to expand our
sales and marketing organizations. We have incurred and likely will incur some additional related
expenses in advance of any anticipated
regulatory approval, which we could not recoup if we do not receive such approval. We also may not
be able to hire, train and motivate qualified sales and marketing personnel. Failure to expand our
distribution and sales channels will adversely affect our sales and revenues.
If we are not able to acquire or license other products, our business and future growth prospects
could suffer.
As part of our growth strategy, we intend to acquire or license additional products and product
candidates for development and commercialization. The success of this strategy depends upon our
ability to identify, select and acquire the right products. In fact, we have an option to acquire
the assets of CystoMedix, Inc., the company that has licensed the Urgent® PC technology to us.
Any product candidate we license or acquire may require additional development efforts prior to
sale, including clinical testing and approval by the FDA. Product candidates may fail to receive
or experience a significant delay in receiving FDA approval. In addition, we cannot assure you
that any approved products that we acquire or license will be manufactured economically,
successfully commercialized or widely accepted in the marketplace. Other companies, including
those with greater financial, marketing and sales resources, may compete with us for the
acquisition or license of product candidates or approved products. We may not be able to acquire
or license the right to other products on terms that we find acceptable, or at all.
Even if we complete future acquisitions (including that of CystoMedix, of which there is no
assurance), our business, financial condition and the results of operations could be negatively
affected because:
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we may be unable to integrate the acquired business successfully and realize anticipated
economic, operational and other benefits in a timely manner; and |
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the acquisition may disrupt our ongoing business, distract our management and divert our
resources. |
The loss of our key customers could result in a material loss of revenues.
During fiscal 2006, we had two customers that accounted for approximately 14% and 11% of our net
sales. During fiscal 2005, the same two customers accounted for approximately 15% and 11% of our
net sales. As a result, we face the risk that one or more of our key customers may decrease its or
their business with us or terminate its or their relationships with us. Any decrease in business
from these customers, if we are unable to replace them, could result in a material decrease in our
revenue. This could adversely affect our financial condition.
Negative publicity regarding the use of silicone material in medical devices could harm our
business and result in a material decrease in revenues.
Macroplastique is comprised of medical grade, heat-vulcanized polydimethylsiloxane, which results
in a solid, flexible silicone elastomer. In the early 1990s, the United States breast implant
industry became the subject of significant controversies surrounding the possible effects upon the
human body of the use of silicone gel in breast implants, resulting in product liability litigation
and leading to the bankruptcy of several companies, including our former parent, Bioplasty, Inc.
We use only medical grade solid silicone material in our tissue bulking products and not
semi-liquid silicone gel, as was used in breast implants. Negative publicity regarding the use of
silicone materials in our products or in other medical devices could have a significant adverse
affect on the overall acceptance of our products. We cannot assure you that the use by us and
others of solid silicone in medical devices implanted in the human body will not result in negative
publicity.
The risks inherent in operating internationally and the risks of selling and shipping our products
and of purchasing our components and products internationally may adversely impact our net sales,
results of operations and financial condition.
We still derive substantially all of our net sales from operations in international markets. We
expect non-United States sales to continue to represent a significant portion of our revenues until
we achieve sufficient market acceptance from United
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States customers of the already FDA-approved
products and we obtain requisite FDA approvals for the remaining products. The sale and shipping
of our products and services across international borders, as well as the purchase of components
and products from international sources, subject us to extensive U.S. and foreign governmental
trade regulations. Compliance with such regulations is costly and exposes us to penalties for
non-compliance. Any failure to comply with applicable legal and regulatory obligations could
impact us in a variety of ways that include, but are not limited to, significant criminal, civil
and administrative penalties, including imprisonment of individuals, fines and penalties, denial of
export privileges, seizure of shipments, restrictions on certain business activities, and exclusion
or debarment from government contracting. Also, the failure to comply with applicable legal and
regulatory obligations could result in the disruption of our shipping and sales activities.
In addition, most of the countries in which we sell our products are, to some degree, subject to
political, economic and/or social instability. Our international sales operations expose us and
our representatives, agents and distributors to risks inherent in operating in foreign
jurisdictions. These risks include:
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the imposition of additional U.S. and foreign governmental controls or regulations; |
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the imposition of costly and lengthy new export licensing requirements; |
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the imposition of U.S. and/or international sanctions against a country, company, person
or entity with whom the company does business that would restrict or prohibit continued
business with the sanctioned country, company, person or entity; |
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political and economic instability; |
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fluctuations in the value of the U.S. dollar relative to foreign currencies; |
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a shortage of high-quality sales people and distributors; |
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loss of any key personnel that possess proprietary knowledge, or who are otherwise
important to our success in certain international markets; |
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changes in third-party reimbursement policies that may require some of the patients who
receive our products to directly absorb medical costs or that may necessitate the reduction
of the selling prices of our products; |
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changes in duties and tariffs, license obligations and other non-tariff barriers to trade; |
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the imposition of new trade restrictions; |
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the imposition of restrictions on the activities of foreign agents, representatives and distributors; |
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scrutiny of foreign tax authorities which could result in significant fines, penalties
and additional taxes being imposed on us; |
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pricing pressure that we may experience internationally; |
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laws and business practices favoring local companies; |
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longer payment cycles; |
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difficulties in enforcing agreements and collecting receivables through certain foreign legal systems; |
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difficulties in enforcing or defending intellectual property rights; and |
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exposure to different legal and political standards due to our conducting business in
approximately 40 countries. |
We cannot assure you that one or more of these factors will not harm our business. Any material
decrease in our international sales would adversely impact our net sales, results of operations and
financial condition. Our international sales
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are predominately in Europe. In Europe, health care
regulation and reimbursement for medical devices vary significantly from country to country. This
changing environment could adversely affect our ability to sell our products in some European
countries.
Fluctuations in foreign exchange rates could negatively impact our results of operations.
Because our international sales are denominated primarily in euros, currency fluctuations in
countries where we do business may render our products less price competitive than those of
competing companies whose sales are denominated in weaker currencies. We report our financial
results in U.S. dollars, and fluctuations in the value of either the dollar or the currencies in
which we transact business can have a negative impact on our results of operations and financial
condition. Consequently, we have exposure to foreign currency exchange risks. We do not hedge any
of our foreign currency risk.
If we are unable to continue to develop and market new products and technologies, we may experience
a decrease in demand for our products or our products could become obsolete, and our business would
suffer.
We are continually engaged in product development and improvement programs, and we expect new
products to represent a significant component of our future business. We may not be able to
compete effectively with our competitors unless we can keep up with existing or new products and
technologies in the urinary and fecal incontinence market. If we do not continue to introduce new
products and technologies, or if those products and technologies are not accepted, we may not be
successful and our business would suffer. Moreover, our clinical trials have durations of several
years and it is possible that competing therapies, such as drug therapies, may be introduced while
our products are still undergoing clinical trials. This could reduce the potential demand for our
products and negatively impact our business prospects. Additionally, our competitors new products
and technologies may beat our products to market, may be more effective or less expensive than our
products or render our products obsolete.
The marketing of our products requires a significant amount of time and expense and we may not have
the resources to successfully market our products, which would adversely affect our business and
results of operations.
The marketing of our products requires a significant amount of time and expense in order to
identify the physicians who may use our products, invest in training and education and employ a
sales force that is large enough to interact with the targeted physicians. We may not have
adequate resources to market our products successfully against larger competitors which have more
resources than we do. If we cannot market our products successfully, our business and results of
operations would be adversely affected.
The size and resources of our competitors may allow them to compete more effectively than we can,
which could adversely affect our potential profitability.
Our products compete against similar medical devices and other treatment methods, including drugs,
for treating urinary and fecal voiding dysfunctions. Many of our competitors have significantly
greater financial, research and development, manufacturing and marketing resources than we have.
Our competitors could use these resources to develop or acquire products that are safer, more
effective, less invasive, less expensive or more readily accepted than our products. Their
products could make our technology and products obsolete or noncompetitive. Our competitors could
also devote greater resources to the marketing and sale of their products and adopt more aggressive
pricing policies than we can. If we are not able to compete effectively, then we may not be
profitable.
We are dependent on the availability of third-party reimbursement for our revenues.
Our success depends on the availability of reimbursement for the cost of our products from
third-party payors, such as government health authorities, private health insurance plans and
managed care organizations. There is no uniform policy for reimbursement in the United States and
foreign countries. We believe that the ease of obtaining, and the amount of, reimbursement for
urinary incontinence treatment has a significant impact on the decisions of health care providers
regarding treatment methods and products. Accordingly, changes in the extent of coverage or a
reduction in reimbursement rates under any or all third-party reimbursement programs may cause a
decline in purchases of our products, which would materially adversely affect the market for our
products. Alternatively, we might respond to reduced reimbursement rates by reducing the prices of
our products, which could also reduce our revenues.
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If physicians do not recommend and endorse our products, our sales may decline or we may be unable
to increase our sales and profits.
In order for us to sell our products, physicians must recommend and endorse them. We may not
obtain the necessary recommendations or endorsements from physicians. Acceptance of our products
depends on educating the medical community as to the distinctive characteristics, perceived
benefits, safety, clinical efficacy, cost-effectiveness and reimburseability of our products
compared to products of our competitors, and on training physicians in the proper application of
our products. If we are not successful in obtaining the recommendations or endorsements of
physicians for our products, our sales may decline or we may be unable to increase our sales and
profits.
Our business strategy relies on assumptions about the market for our products, which, if incorrect,
would adversely affect our business prospects and profitability.
We are focused on the market for minimally invasive therapies used to treat voiding dysfunctions.
We believe that the aging of the general population will continue and that these trends will
increase the need for our products. However, the projected demand for our products could
materially differ from actual demand if our assumptions regarding these trends and acceptance of
our products by the medical community prove to be incorrect or do not materialize. Actual demand
for
our products could also be affected if drug therapies gain more widespread acceptance as a viable
alternative treatment, which in each case would adversely affect our business prospects and
profitability.
Proposals to modify the health care system in the U.S. or other countries could affect the pricing
of our products. If we cannot sell our products at the prices we plan to, our margins and
profitability could be adversely affected.
Proposals to modify the current health care system in the United States to improve access to health
care and control its costs are continually being considered by the federal and state governments.
We anticipate that the U.S. Congress and state legislatures will continue to review and assess
alternative health care reform proposals. We cannot predict whether these reform proposals will be
adopted, when they may be adopted or what impact they may have on us if they are adopted. Any
spending decreases or other significant changes in government programs such as Medicare could
adversely affect the pricing of our products.
Like the United States, foreign countries have considered health care reform proposals and could
materially alter their government-sponsored health care programs by reducing reimbursement rates.
Any reduction in reimbursement rates under United States or foreign health care programs could
negatively affect the pricing of our products. If we are not able to charge a sufficient amount
for our products, our margins and our profitability will be adversely affected.
If our information systems fail or if we experience an interruption in their operation, our
business and results of operations could be adversely affected.
The efficient operation of our business is dependent on our management information systems. We
rely on our management information systems to effectively manage accounting and financial
functions, order entry, order fulfillment and inventory replenishment processes, and to maintain
our research and development and clinical data. The failure of our management information systems
to perform as we anticipate could disrupt our business and product development and could result in
decreased sales, increased overhead costs, excess inventory and product shortages, causing our
business and results of operations to suffer. In addition, our management information systems are
vulnerable to damage or interruption from:
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earthquake, fire, flood and other natural disasters; |
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terrorist attacks and attacks by computer viruses or hackers; and |
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power loss or computer systems, Internet, telecommunications or data network failure. |
Any such interruption could adversely affect our business and results of operations.
If we lose the services of our chief executive officer or other key personnel, we may not be able
to manage our operations and meet our strategic objectives.
Our future success depends, in large part, on the continued service of our senior management. We
have no key person insurance with respect to any of our senior managers, and any loss or
interruption of their services could significantly reduce our ability to effectively manage our
operations and implement our strategy. Also, we depend on the continued service of key managerial,
scientific, sales and technical personnel, as well as our ability to continue to attract and retain
additional highly qualified personnel. We compete for such personnel with other companies,
academic institutions, government entities and other organizations. Any loss or interruption of
the services of our other key personnel could also significantly reduce
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our ability to effectively
manage our operations and meet our strategic objectives because we cannot assure you that we would
be able to find an appropriate replacement should the need arise.
We also compete for experienced medical device sales personnel. If we are unable to hire and
retain qualified sales personnel, our sales could be negatively impacted.
We will require additional financing in the future which may not be available to us when required,
or may be available only on unfavorable terms.
Our future liquidity and capital requirements will depend on numerous factors, including:
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the timing and cost associated with obtaining FDA approval of Macroplastique; |
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the timing and cost involved in manufacturing scale-up and in expanding our sales,
marketing and distribution capabilities in the U.S. market; |
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the cost and effectiveness of our marketing and sales efforts with respect to our
existing products in international markets; |
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the effect of competing technologies and market and regulatory developments; and |
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the cost involved in protecting our proprietary rights. |
We will need to raise additional debt or equity financing to continue funding for product
development and continued expansion of our sales and marketing activities, and ultimately, we will
need to achieve profitability and generate positive cash flows from operations to fund our
operations and grow our business. As such we plan to raise additional equity capital in fiscal
2007, but there can be no guarantee that we will be successful. We currently have no committed
sources of, or other arrangements with respect to, additional financing except for the recently
established credit lines for $1.3 million and a term loan of $100,000 as described in Note 9,
Subsequent Events, to the financial statements. We cannot assure you that we will be able to
obtain additional financing on acceptable terms or at all. Our failure to obtain financing when
needed could have a material adverse effect on us. Any equity financing could substantially dilute
your equity interests in our company and any debt financing could impose significant financial and
operational restrictions on us.
You may be unable to sell your investment.
There is only a limited trading market for our common stock, which is quoted on the AMEX.
Transactions in our common stock may lack the volume, liquidity and orderliness necessary to
maintain a liquid and active trading market. Accordingly, an investor should consider the
potential lack of liquidity before investing in our common stock.
Further, our common stock is subject to the penny stock rules under The Securities and Exchange
Act of 1934. The penny stock rules require brokers who sell penny stocks to persons other than
established customers and institutional accredited investors to complete required documentation,
make suitability inquiries and provide investors with information concerning the risks of trading
in the security. The additional burdens imposed on brokers by these requirements could discourage
brokers from effecting transactions in our common stock. Consequently, an investor is likely to
find it more difficult to sell our common stock.
Our stock price may fluctuate and be volatile.
The market price of our common stock may be subject to significant fluctuation due to the following
factors, among others:
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variations in our quarterly financial results; |
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developments regarding FDA approval of Macroplastique; |
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market acceptance of our products; |
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the success of our efforts to acquire or license additional products;
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announcements of new products or technologies by us or our competitors; |
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developments regarding our patents and proprietary rights or those of our competitors; |
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developments in U.S. or international reimbursement systems; |
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changes in accounting standards, policies, guidance or interpretations; |
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sales of substantial amounts of our stock by existing shareholders; and |
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general economic conditions. |
The stock market in recent years has experienced extreme price and volume fluctuations that have
often been unrelated or disproportionate to the operating performance of affected companies. These
broad market fluctuations may cause the price of our common stock to fall abruptly or remain
significantly depressed.
Future sales of our common stock in the public market could lower our share price.
The market price of our common stock could decline due to sales by our existing shareholders of a
large number of shares of our common stock or the perception that these sales could occur. These
sales could also make it more difficult for us to raise capital through the sale of common stock at
a time and price we deem appropriate.
We have filed a registration statement under the Securities Act covering the issuance of up to
806,218 shares of common stock that certain existing security holders may acquire upon the exercise
of outstanding warrants. The registration statement has not yet been declared effective therefore
these shares are currently not freely tradeable. As of May 31, 2006, we have outstanding 1,180,928
shares of registered common stock issuable upon exercise of warrants granted to the security
holders in connection with our April 2005 private placement.
As of May 31, 2006, we had 949,327 shares of common stock subject to outstanding options granted
under our former 1995, 1997 and 2002 Stock Option Plans. These shares are registered for public
resale by the holders of those options. As of May 31, 2006 we had 38,000 shares of common stock
subject to outstanding options granted under our 2006 Stock and Incentive Plan. In addition, as of
May 31, 2006 we had 1,240,000 shares of common stock subject to outstanding options granted from
various stock option plans. Further, if we exercise our option to acquire the assets of
CystoMedix, we will need to issue our common stock to CystoMedix for the purchase price. As of May
31, 2006, 1,832,643 outstanding options are immediately exercisable.
We will be exposed to risks relating to evaluations of controls required by Section 404 of the
Sarbanes-Oxley Act.
Changing laws, regulations and standards relating to corporate governance and public disclosure,
including the Sarbanes-Oxley Act and related regulations implemented by the SEC, are creating
uncertainty for public companies, increasing legal and financial compliance costs and making some
activities more time consuming. We will be evaluating our internal controls systems to allow
management to report on, and our independent auditors to attest to, our internal controls. We will
be performing the system and process evaluation and testing (and any necessary remediation)
required to comply with the management certification and auditor attestation requirements of
Section 404 of the Sarbanes-Oxley Act. While we anticipate being able to fully implement the
requirements relating to internal controls and all other aspects of Section 404 by our March 31,
2008 deadline, we cannot be certain as to the timing of completion of our evaluation, testing and
remediation actions or the impact of the same on our operations. If we are not able to implement
the requirements of Section 404 in a timely manner or with adequate compliance, we may be subject
to sanctions or investigation by regulatory authorities, including the SEC. This type of action
could adversely affect our financial results or investors confidence in our company and our
ability to access capital markets and could cause our stock price to decline. In addition, the
controls and procedures that we will implement may not comply with all of the relevant rules and
regulations of the SEC. If we fail to develop and maintain effective controls and procedures, we
may be unable to provide the required financial information in a timely and reliable manner.
Further, if we acquire any company in the future, we may incur substantial additional costs to
bring the acquired companys systems into compliance with Section 404.
25
Changes in accounting standards regarding stock option plans could limit the desirability of
granting stock options, which could harm our ability to attract and retain employees, and would
also negatively impact our results of operations.
The Financial Accounting Standards Board has issued Statement No. 123(R), Share-Based Payments,
SFAS 123(R), which requires all companies to treat the fair value of stock options granted to
employees as an expense, beginning in the first fiscal year that begins after December 15, 2005,
for small business issuers. Accordingly, SFAS 123(R) is effective for us beginning in fiscal 2007.
For fiscal 2006 and prior years, we generally have not recorded compensation expense in connection
with stock option grants to employees. Because in the future we will expense the fair value of
employee stock option grants, granting stock options is less attractive because of the additional
expense recognized associated with these grants, which will negatively impact our results of
operations. If we had adopted the fair value method for fiscal 2006 and 2005, our net loss for the
respective fiscal years would have been $3,062,324, and $2,321,745 higher than reported and net
loss per share would have increased by $0.46, and $0.50 per common share, respectively.
Nevertheless, stock options are an important employee recruitment and retention tool, and we may
not be able to attract and retain key personnel if we reduce the scope of our employee stock option
program.
In February 2006, our Board of Directors approved a plan to accelerate, effective February 2, 2006,
the vesting of out-of-the-money, unvested stock options previously granted to our employees,
officers and directors. An option was considered out-of-the-money if the stated exercise price
exceeded $2.85, the then closing price of our common stock. Pursuant to this action, options to
purchase approximately 0.4 million shares of our common stock with a weighted average exercise
price of $4.49 per share became exercisable immediately.
We accelerated the vesting of these options to minimize the amount of compensation expense we must
recognize upon adoption of SFAS No. 123(R). None of these options had intrinsic value at the
acceleration date under APB 25. We expect that the acceleration of the vesting of these options
reduced the pre-tax stock option expense by approximately $1.4 million, in the aggregate, calculated using the Black-Scholes option valuation model, that we
would have otherwise recognized over the next three fiscal years, upon adoption of SFAS No. 123(R).
We have included the charge attributed to the accelerated vesting of the options in the pro forma
disclosures to our consolidated financial statements for the fiscal year ended March 31, 2006.
However, certain outstanding options, with a cashless exercise provision, and certain outstanding
options classified as liabilities, could result in a significant charge to compensation expense in
future periods, as we will mark those options to fair value at each reporting period until
settlement. Also, additional options as granted to attract or retain new employees could result in
significant charge to compensation expense.
Our corporate documents and Minnesota law contain provisions that could discourage, delay or
prevent a change in control of our company.
Provisions in our articles of incorporation may discourage, delay or prevent a merger or
acquisition involving us that our stockholders may consider favorable. For example, our articles
of incorporation authorize our board of directors to issue up to 20 million shares of stock which,
without stockholder approval, the board of directors has the authority to attach special rights,
including voting and dividend rights. With these rights, the holders of such shares could make it
more difficult for a third party to acquire us. In addition, our articles of incorporation
provides for a staggered board of directors, whereby directors serve for three year terms, with
approximately one third of the directors coming up for reelection each year. Having a staggered
board will make it more difficult for a third party to obtain control of our board of directors
through a proxy contest, which may be a necessary step in an acquisition of us that is not favored
by our board of directors.
We are also subject to the anti-takeover provisions of Section 302A.673 of the Minnesota Business
Corporation Act. Under these provisions, if anyone becomes an interested shareholder, we may not
enter into a business combination with that person for four years without special approval, which
could discourage a third party from making a takeover offer and could delay or prevent a change of
control. For purposes of Section 302A.673, interested shareholder means, generally, someone
owning 10% or more of our outstanding voting stock or an affiliate of ours that owned 10% or more
of our outstanding voting stock during the past four years, subject to certain exceptions.
We do not intend to declare dividends on our stock in the foreseeable future.
We have never declared or paid cash dividends on our common stock. We currently intend to retain
all future earnings, if any, for the operation and expansion of our business and, therefore, do not
anticipate declaring or paying cash dividends on our common stock in the foreseeable future. Any
payment of cash dividends on our common stock will be at the discretion of our board of directors
and will depend upon our results of operations, earnings, capital requirements, financial
condition, future prospects, contractual restrictions and other factors deemed relevant by our
board of directors. Therefore, you should not expect to receive dividend income from shares of our
common stock.
26
ITEM 2. DESCRIPTION OF PROPERTY
We currently lease on a month-to-month basis a 13,705 square-foot (reduced to 6,205 square feet in
July 2006) office, warehouse, laboratory and production facility for our corporate headquarter in
Minneapolis, Minnesota. Effective May 2006 we entered into an eight-year lease for an 18,259
square foot facility in Minnetonka, Minnesota for our new corporate headquarter. We expect to
fully relocate to our new corporate headquarter in the third calendar quarter of 2006. We own
9,774 square feet of office and warehouse space in Geleen, The Netherlands and lease 2,330 square
feet of office, warehouse, laboratory and manufacturing space through June 2007 in Eindhoven, The
Netherlands. In addition, we lease 5,230 square feet of office and warehouse space through
September 2011 (subject to our right to terminate the lease in September 2006) in Reading, United
Kingdom. We intend to terminate this lease in September 2006 and consolidate our operations in
Geleen, The Netherlands.
ITEM 3. LEGAL PROCEEDINGS
There are no material pending legal proceedings other than ordinary routine litigation incidental
to our business.
ITEM 4. SUBMISSION OF MATTERS TO A VOTE OF SECURITY HOLDERS
We did not submit any matter to a vote of our security holders during the fourth quarter of our
recently completed fiscal year.
27
PART II
ITEM 5. MARKET FOR COMMON EQUITY AND RELATED STOCKHOLDER MATTERS
Market Information. As of the date hereof, there is only a limited public trading market for our
Common Stock.
In October 2005, we listed our common stock on the American stock Exchange under the symbol UPI.
Previously, our common stock was quoted on the OTC Bulletin Board under the symbol UPST.OB.
The following table sets forth the high and low closing prices for our common stock for our fiscal
year ended March 31, 2006, as reported on the American Stock Exchange and the high and low bid
prices for our common stock as reported by the OTC Bulletin Board, as applicable, for the periods
indicated. The OTC quotations represent interdealer prices, without retail markup, mark down or
commission, and do not necessarily represent actual transactions.
|
|
|
|
|
|
|
|
|
Fiscal Quarters |
|
Low |
|
|
High |
|
First Quarter |
|
$ |
3.91 |
|
|
$ |
4.90 |
|
Second Quarter |
|
|
2.60 |
|
|
|
5.80 |
|
Third Quarter |
|
|
2.60 |
|
|
|
3.80 |
|
Fourth Quarter |
|
|
2.30 |
|
|
|
3.14 |
|
As of March 31, 2006, approximately 523 holders held our Common Stock of record. Registered
ownership includes nominees who may hold securities on behalf of multiple beneficial owners.
Securities Authorized for Issuance Under Equity Compensation Plans. The following table provides
particular information regarding our equity compensation plans as of March 31, 2006.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Number of Securities |
|
|
|
|
|
|
|
|
|
|
Remaining Available for |
|
|
|
|
|
|
|
|
|
|
Future Issuance Under |
|
|
Number of Securities to |
|
Weighted-Average |
|
Equity Compensation |
|
|
be Issued Upon Exercise |
|
Exercise Price of |
|
Plans (Excluding |
|
|
of Outstanding Options, |
|
Outstanding Options, |
|
Securities Reflected |
|
|
Warrants and Rights |
|
Warrants and Rights |
|
in the First Column) |
Equity Compensation
Plans Approved by
Security Holders |
|
|
624,993 |
|
|
$ |
3.25 |
|
|
|
39,100 |
(2) |
|
|
|
|
|
|
|
|
|
|
|
|
|
Equity Compensation
Plans Not Approved
by Security Holders
(1) |
|
|
1,363,334 |
|
|
$ |
4.07 |
|
|
|
10,431 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total |
|
|
1,988,327 |
|
|
$ |
3.81 |
|
|
|
49,531 |
|
|
|
|
(1) |
|
The following is a brief description of the various equity compensation plans not
approved by our stockholders. |
|
|
|
Our 1995 Stock Option Plan provides for the grant only of non-qualified stock options to
our employees, directors, non-employees and consultants. At March 31, 2006, 340,000
unexercised options were outstanding, and we have not granted additional options
subsequently under this plan. This plan was terminated on May 3, 2006 and no new option
grants may be awarded from this plan. |
|
|
|
We have also granted options from outside of our 1995 Stock Option Plan. In January
2005, we granted options to acquire 400,000 and 100,000 shares of our common stock at an
exercise price of $5.19 per share, respectively, to Sam B. Humphries, our former
President and Chief Executive Officer, pursuant to an employment agreement, and Daniel
G. Holman, our former Chairman, for his service as a member of the Board, pursuant to an
employment and consulting agreement. The options for both executives are fully
vested and have a term of 10 years. In April 2003, we entered into a consulting
agreement with Executive Advisory Group (EAG) for general business advisory services
and assistance. Mr. Humphries is President of EAG. We granted EAG a five-year option
to purchase up to 50,000 shares of our Common Stock, exercisable at $2.80 per share. In
April 2003, we entered into a consulting agreement with C.C.R.I. Corporation for
investor relations services and issued five-year warrants to purchase 100,000 of our
shares. Half of these warrants are exercisable at $3.00 per share and the other half
are exercisable at $5.00 per share. In November 2005, we granted options to acquire
100,000 shares of our common stock at an exercise price of $3.00 per share to Mahedi A.
Jiwani, our Chief Financial Officer, pursuant to an employment agreement. These options
are fully vested and have a term of 10 years. In May 2006, we granted options to
acquire 300,000 shares of our common stock (of which 100,000 are vested as of May 31,
2006) at an exercise price of $2.50 per share to David B. Kaysen, our President and
Chief Executive Officer, pursuant to an employment agreement. These options have a term
of 10 years. In addition, we have outstanding an aggregate of 850,000 stock options (of
which 778,665 are vested as of May 31, 2006) to our directors and executive officers for
their services, generally exercisable for five years from the date of grant at exercise
prices ranging between $1.10 and $10.50. |
|
(2) |
|
All option plans previously approved by our shareholders were terminated, and no new
option grants may be awarded from those plans, upon adoption on May 3, 2006 of our 2006
Stock and Incentive Plan at a special meeting of our shareholders. As of May 31, 2006,
1,162,000 securities remain available for future issuance under our 2006 plan. |
28
ITEM 6. MANAGEMENTS DISCUSSION AND ANALYSIS OR PLAN OF OPERATION
THIS DISCUSSION OF THE FINANCIAL CONDITION AND THE RESULTS OF OPERATIONS OF THE COMPANY SHOULD BE
READ IN CONJUNCTION WITH, AND IS QUALIFIED IN ITS ENTIRETY BY, THE CONSOLIDATED FINANCIAL
STATEMENTS AND NOTES THERETO INCLUDED ELSEWHERE WITHIN THIS ANNUAL REPORT, THE MATERIAL CONTAINED
IN THE RISK FACTORS AND DESCRIPTION OF BUSINESS SECTIONS OF THIS ANNUAL REPORT, AND THE
CAUTIONARY DISCLOSURE ABOUT FORWARD-LOOKING STATEMENTS AT THE FRONT OF PART I OF THIS ANNUAL
REPORT.
Overview
We are a medical device company that develops, manufactures and markets innovative, proprietary
products for the treatment of voiding dysfunctions. We have developed, and are developing,
minimally invasive products primarily for the treatment of urinary and fecal incontinence and
overactive bladder symptoms. All products we currently sell have received CE marking and are being
sold outside the United States in approximately 40 countries, including Europe, Canada, Australia
and Latin America. In the U.S. we have received 510(k) clearance for two of our products (I-Stop
and Urgent PC). Our Macroplastique and other implantable tissue bulking products have not been
cleared for marketing in the United States. We are pursuing FDA approval (PMA) for our
Macroplastique product.
Our goal is to develop and commercialize a portfolio of minimally invasive products for the
treatment of voiding dysfunctions. We believe that, with a suite of innovative products, we can
increasingly garner the attention of key physicians and distributors and enhance market acceptance
of our products. The key elements of our strategy are to:
|
|
|
Pursue regulatory approval in the U.S. for our Macroplastique products. |
|
|
|
|
Expand our U.S. marketing and sales organization, using a combination of direct and independent reps; |
|
|
|
|
Conduct multi-center, prospective clinical trials for the Urgent PC; |
|
|
|
|
Expand distribution of our products outside of the U.S.; and |
|
|
|
|
Acquire or license complimentary products if appropriate opportunities arise. |
We concluded a multi-center human clinical trial using Macroplastique Implants in a minimally
invasive, office-based procedure for treating adult female stress urinary incontinence resulting
from intrinsic sphincter deficiency, a weakening of the muscles that control the flow of urine from
the bladder. In December 2004, the FDA accepted for filing our pre-market approval submission with
respect to Macroplastique for the treatment of female stress urinary incontinence. This submission
is under review by the FDA and we continue to expect, as we indicated in July 2005, the possible
approval by the FDA in late 2007. We will incur substantial expenses in connection with these
regulatory activities. Even if we obtain regulatory approval, it may be only for limited uses with
specific classes of patients, which may limit the market for our product.
In the United States, we recently staffed our sales organization, consisting of a direct field
sales management team and independent sales representatives, and a marketing organization to market
our products directly to our customers. We anticipate further increasing, as needed, our sales
and marketing organization in the United States to support our sales growth. Outside of the United
States, we sell our products primarily through a direct sales organization in the United Kingdom
and primarily through distributors in other markets.
Critical Accounting Policies
We prepare our consolidated financial statements in accordance with U.S. generally accepted
accounting principles, which require us to make estimates and assumptions in certain circumstances
that affect amounts reported. In preparing these consolidated financial statements, we have made
our best estimates and judgments of certain amounts, giving due consideration to materiality. We
believe that of our significant accounting policies, the following are particularly important to
the portrayal of our results of operations and financial position. They may require the
application of a higher level of judgment by Uroplasty management, and as a result are subject to
an inherent degree of uncertainty.
Revenue Recognition. The Securities and Exchange Commissions Staff Accounting Bulletin (SAB) No.
104, Revenue Recognition in Financial Statements, provides guidance on the application of
generally accepted accounting principles to selected revenue recognition issues. We believe our
revenue recognition policies comply with SAB 104. We market and distribute our products through a
network of distributors and through direct sales to end-users in the United Kingdom and The
Netherlands. We recognize revenue upon shipment of product to our distributors and direct
customers. We have no customer acceptance provisions or installation obligations. Our sales terms
to our distributors and customers provide no right of return outside of our standard warranty, and
payment terms consistent with industry standards apply. Sales terms and pricing to our distributors
are governed by the respective distribution agreements. Our distribution partners purchase the
Uroplasty products to meet sales demand of their end-user customers as well as to fulfill their
internal requirements associated with the sales process and, if applicable, contractual purchase
requirements under the respective distribution agreements. Internal and other requirements include
purchases of products for training, demonstration and evaluation purposes, clinical evaluations,
product support, establishing inventories, and meeting minimum purchase commitments. As a result,
the level of our net sales during any period is not necessarily indicative of our distributors
sales to end-user customers during that period, which we estimate
29
are not substantially different
than our sales to those distributors in each of the last two years. Our distributors level of
inventories of our products, their sales to end-user customers and their internal product
requirements may impact our future revenue growth.
Accounts Receivable. We carry our accounts receivable at the original invoice amount less an
estimate made for doubtful receivables based on a periodic review of all outstanding amounts. We
determine the allowance for doubtful accounts based on customer health, and both historical and
expected credit loss experience. We write off our accounts receivable when we deem them
uncollectible. We record recoveries of accounts receivable previously written off when received.
Inventories. We state inventories at the lower of cost or market using the first-in, first-out
method. We provide lower of cost or market reserves for slow moving and obsolete inventories based
upon current and expected future product sales and the expected impact of product transitions or
modifications. While we expect our sales to grow, a reduction in sales could reduce the demand for
our products and may require additional inventory reserves.
Foreign Currency Translation/Transactions. The financial statements of our foreign
subsidiaries were translated in accordance with the provisions of SFAS No. 52 Foreign Currency
Translation. Under this Statement, we translate all assets and liabilities using period-end
exchange rates, and we translate statements of operations items using average exchange rates for
the period. We record the resulting translation adjustment within accumulated other comprehensive
loss, a separate component of shareholders equity. We recognize foreign currency transaction gains
and losses in the statement of operations, including unrealized gains and losses on short-term
intercompany obligations using period-end exchange rates, resulting in an increase in the
volatility of our consolidated statements of operations. We recognize unrealized gains and losses
on long-term intercompany obligations within accumulated other comprehensive loss, a separate
component of shareholders equity.
Impairment of Long-Lived Assets. Long-lived assets at March 31, 2006 consist of property, plant and
equipment and intangible assets. We review our long-lived assets for impairment whenever events or
business circumstances indicate that the carrying amount of an asset may not be recoverable. We
measure the recoverability of assets to be held and used by a comparison of the carrying amount of
an asset to future undiscounted net cash flows expected to be generated by the asset. If we
consider such assets impaired, we measure the impairment to be recognized by the amount by which
the carrying amount of the assets exceeds the fair value of the assets. We report assets to be
disposed of at the lower of the carrying amount or fair value less costs to sell.
Stock Based Compensation and Accelerated Vesting. We accounted for our stock option grants under
APB Opinion No. 25 (APB 25), Accounting for Stock Issued to Employees, and related interpretations.
No stock-based compensation cost is reflected in net loss, as all options granted under these
plans had an exercise price equal to the market value of the
underlying common stock on the date of grant. We also grant options to non-employees for goods and
services and in conjunction with certain agreements. These grants are accounted for under
Financial Accounting Standards Board (FASB) Statement No. 123 based on the grant date fair
values.
In December 2004, FASB published Statement No. 123 (revised 2004), Share-Based Payment (FAS
123(R) or the Statement).
FAS 123(R) requires that the compensation cost relating to share-based
payment transactions, including grants of employee stock options, be recognized in financial
statements. That cost will be measured based on the fair value of the equity or liability
instruments issued. FAS 123(R) covers a wide range of share-based compensation arrangements
including stock options, restricted share plans, performance-based awards, share appreciation
rights, and employee share purchase plans. FAS 123(R) is a replacement of Statement No. 123,
Accounting for Stock-Based Compensation, and supersedes APB 25, and its related interpretive
guidance.
This Statement will require entities to measure the cost of employee services received in exchange
for stock options based on the grant-date fair value of the award, and to recognize the cost over
the period the employee is required to provide services for the award. FAS 123(R) permits entities
to use any option-pricing model that meets the fair value objective in the Statement. We will be
required to apply FAS 123(R) beginning in the first quarter of fiscal year 2007. FAS 123(R) allows
two methods for determining the effects of the transition: the modified prospective and the
modified retrospective. We have adopted the modified prospective transition method beginning April
1, 2006. The pro forma compensation costs presented previously and in our prior filings have been
calculated using a Black-Scholes option pricing model and may not be indicative of amounts which
should be expected in future years.
In February 2006, our Board of Directors approved a plan to accelerate, effective February 2, 2006,
the vesting of out-of-the-money, unvested stock options previously granted to our employees,
officers and directors. An option was considered out-of-
30
the-money if the stated exercise price
exceeded $2.85, the then closing price of our common stock. We accelerated the vesting of these
options to minimize the amount of compensation expense we must recognize upon adoption of SFAS No.
123(R). None of these options had intrinsic value at the acceleration date under APB 25. We
expect that the acceleration of the vesting of these options reduced our pre-tax stock option
expense by approximately $1.4 million, in the aggregate, calculated using the Black-Scholes option
valuation model, that we would otherwise have recognized over the next three fiscal years, upon
adoption of SFAS No. 123(R). We do not expect the remaining options, to result in a significant
charge to compensation expense upon adoption of SFAS 123(R) under the modified prospective
application method. However, certain outstanding options that permit cashless exercise and certain
options classified as liabilities could result in a significant charge to compensation expense, as
we will mark those options to fair value at each reporting period until settlement. Also,
additional options as granted to attract or retain new employees could result in a significant
charge to compensation expense.
Income Taxes. Deferred tax assets and liabilities are recognized for future tax consequences
attributable to differences between the financial carrying amounts of existing assets and
liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using
enacted tax rates expected to be applied to taxable income in the years in which those temporary
differences are expected to be recovered or settled. We have generated approximately $15,423,000
in U.S. net operating loss carryforwards that cannot be used to offset taxable income in foreign
jurisdictions. We recognize a valuation allowance when it is more likely than not a portion of the
deferred tax asset will not be realized. We have established a valuation allowance for U.S. and
certain foreign deferred tax assets due to the uncertainty that enough income will be generated in
those taxing jurisdictions to utilize the assets.
In addition, U..S. tax rules impose limitations on the use of net operating loss following certain
changes in ownership change. Such a change in ownership may limit the amount of these benefits
that would be available to offset future taxable income each year, starting with the year of
ownership change.
Set forth below is managements discussion and analysis of the financial condition and results of
operations for the fiscal years ended March 31, 2006 and 2005. See Note 7 to our Consolidated
Financial Statements for business segment information.
Results of Operations
Net Sales. In fiscal 2006, net sales of all products were $6.1 million, representing an 8%
decrease when compared to net sales of $6.7 million for fiscal 2005. Excluding fluctuations in
foreign currency exchange rates, we had a sales decrease of approximately 5% primarily due to a
$0.8 million decline in sales of our Macroplastique products offset by a $0.5 million net increase
in all of our other products. We attribute this decline primarily to adverse changes in
reimbursement policies of the insurers and the increase in pricing competition. We expect these
reimbursement changes and the increase in price competition to adversely impact our future sales in
those markets. In these markets we have launched a strategy to increase sales of our existing
products, and to expand our platform of products for the treatment of voiding dysfunctions. We are
conducting training workshops targeted to our sales personnel, distributors and key incontinence
surgeons, and we are sponsoring scientific podium presentations and seminars at key international
incontinence
congresses. We are also seeking to broaden our patient base to include Urgent PC treatment for
symptoms of overactive bladder (OAB), the I-Stop sling procedure for treatment of female stress
urinary incontinence (SUI) and hypermobility and PTQ Implants and Urgent PC treatments for fecal
incontinence. We cannot assure that these initiatives will increase sales.
Gross Profit. Gross profit was $4.3 million and $4.9 million for the fiscal years ended March 31,
2006 and 2005, respectively, or 70% and 74% of net sales. The decline in gross profit percent is
attributed primarily to the decline in sales of the above-average gross margin Macroplastique
product, and certain one-time costs related to updating our manufacturing quality systems. Gross
profit as a percentage of net sales between periods fluctuates based on the following factors: our
unit sales, our utilization of manufacturing capacity, the mix of products sold with different
gross margins, the mix of customers (and different discounts to them), the mix of direct sales
versus sales through distributors (with higher margins on direct sales), and currency fluctuations.
Historically, our gross margin has ranged from approximately 70-80% of net sales.
General and Administrative Expenses. General and administrative (G&A) expenses increased from
$2.3 million during fiscal 2005 to $3.0 million during fiscal 2006. The increase in expense is
attributed to: $590,000 increase in salary costs, including $150,000 for severance pay and $100,000
option expense for former executives, $170,000 increase in information (IT) expense, $100,000
increase in legal and accounting fees, $80,000 increase in recruiting costs, $50,000 of expenses
related to listing the company on the American Stock exchange, $110,000 increase in depreciation
and amortization expense, general price increases and fluctuations in foreign currency exchange
rates, offset by a decrease in bad debt expense of $330,000. The IT consulting expense relates to
the implementation of a new computer software system, including training and post-implementation
support.
31
Research and Development Expenses. Research and development expenses increased 47% from $2.3
million during fiscal 2005 to $3.3 million during fiscal 2006. The increase in expense is
attributed to a $350,000 increase in salary costs, including $170,000 for severance pay to a former
executive, and $770,000 for consulting expense for product development and regulatory approvals,
offset by a $130,000 reduction in costs for clinical trials and testing.
Selling and Marketing Expenses. Selling and marketing expenses increased 69% from $2.0 million
during fiscal 2005 to $3.4 million during fiscal 2006. The increase in expenses is attributed to
$940,000 for expansion of our direct sales force and marketing organizations in the U.S., $190,000
for increase in costs for travel, trade-shows and conventions, $90,000 for increase in consulting
expense, and general price increases and fluctuations in foreign currency exchange rates.
Other Income (Expense). Other income (expense) includes interest income, interest expense, warrant
expense or benefit, foreign currency exchange gains and losses and other non-operating costs when
incurred. Our financial results are subject to material fluctuations based on changes in currency
exchange rates. Other income (expense) was $788,597 and $(11,510) for fiscal 2006 and fiscal 2005,
respectively.
In July 2002, we conducted a rights offering pursuant to which our stockholders purchased certain
units consisting of shares of our common stock and common stock purchase warrants exercisable for
two years at $2.00 per share. However, we suspended the exercise of the warrants when we delayed
the filing of our annual report on Form 10-KSB for the fiscal year ended March 31, 2004. As a
result, 706,218 of the warrants lapsed unexercised at July 31, 2004. In April 2005, we granted a
like number of new common stock purchase warrants to the holders of the expired warrants. The new
warrants will be exercisable at $2.00 per share for 90 days after the effective date of a new
registration statement covering the resale of the shares underlying these warrants. We have filed
a registration statement covering such warrants on Form SB-2 with the Securities and Exchange
Commission (SEC). In April 2005, we recognized a liability and equity charge of $1.4 million
associated with the grant of these warrants. A net warrant benefit of $707,320 for fiscal 2006 is
included in the statement or operations which represents the change in the fair value of the
warrants since their issuance due to the change in value of the common stock which may be acquired
by the exercise of these warrants.
We recognize exchange gains and losses primarily as a result of fluctuations in currency rates
between the U.S. dollar (the functional reporting currency) and the euro and British pound
(currencies of our subsidiaries), as well as their effect on the dollar denominated short-term
intercompany obligations between us and our foreign subsidiaries. We recognized foreign currency
losses of $31,195 and $15,744 for fiscal 2006 and fiscal 2005, respectively.
Income Tax Expense. Our Dutch subsidiaries recorded income tax expense (benefit) of $(46,873) and
$91,503 for fiscal 2006 and fiscal 2005, respectively. We cannot use the U.S. net operating loss
carry forwards to offset taxable income in foreign jurisdictions. For fiscal 2006, the Dutch income
tax rate was 25.5% for 22,689 (approximately $27,500) of profit and 29.6% for amounts above
22,689 compared to 27% and 31.5% in fiscal 2005, respectively.
Liquidity and Capital Resources
Cash Flows. As of March 31, 2006, our cash and cash equivalent and short-term investments balances
totaled $2.7 million.
At March 31, 2006, we had working capital of approximately $2.7 million. In fiscal 2006, we used
$4.6 million of cash in operating activities, compared to $1.3 million of cash used in the same
period of fiscal 2005. The usage of cash was primarily attributable to the net loss incurred of
$4.5 million. Inventory increased by $280,000, due to production planning requirements,
manufacturing lead times and the introduction of additional products. Accounts receivable, other
current assets, accounts payable and accrued expenses fluctuated due to the timing of payments and
fluctuations in foreign currency exchange rates.
Fluctuations in foreign currency exchange rates, weak economic conditions in foreign markets where
we sell and distribute our products, changes in regulatory environment and changes in third-party
reimbursement polices could materially affect our financial condition and results of operations.
The effects of these conditions could include reduced unit sales and reduced sales in dollars when
converted from foreign currency amounts and material gains and losses on transactions denominated
in foreign currencies. Furthermore, because our U.S. operations are funded by sales denominated in
foreign currency, strengthening of the U.S. dollar against the euro and/or the British pound could
have an adverse effect on our cash flow and results of operations.
32
Sources of Liquidity. In April 2005, we conducted a private placement of common stock in which we
sold 2,147,142 shares of our common stock at a price per share of $3.50, together with warrants to
purchase 1,180,928 shares of common stock, for an aggregate purchase price of approximately $7.5
million. The stock sale proceeds are offset by costs of approximately $935,000, resulting in net
proceeds of approximately $6.6 million. The warrants are exercisable for five years at an exercise
price of $4.75 per share.
In connection with our April 2005 private placement, we agreed to file a registration statement
with the SEC covering the resale of the shares (including those underlying the warrants) that we
sold. We also agreed that, for each month after May 21, 2005, that we failed to file this
registration statement, and for each month after July 20, 2005 that the SEC did not declare it
effective, we would pay liquidated damages at a rate of 1% of the aggregate investment. We filed
the registration statement on July 20, 2005 and the SEC declared it effective on July 29, 2005.
Accordingly, in January 2006, as settlement of liquidated damages and interest in the amount of
$174,054, we issued 57,381 shares of our common stock and paid cash in the amount of $23,077.
Commitments and Contingencies. We believe that our current resources, funds generated from sale of
our products and remaining proceeds from the private placement completed earlier this year together
with the recent credit facilities (see Note 9, Subsequent Events, to the financial statements) will
be adequate to meet our cash flow needs, including regulatory activities associated with existing
products, through the end of the next fiscal year. We will need to raise additional debt or equity
financing to continue funding for product development and continued expansion of our sales and
marketing activities, and ultimately, we will need to achieve profitability and generate positive
cash flows from operations to fund our operations and grow our business. As such we plan to raise
additional equity capital in fiscal 2007, but there can be no
guarantee that we will be successful. In the event that such required financing is not immediately available, management is prepared
to curtail planned product development activities and other expenditures to ensure adequate working
capital is available through fiscal 2007.
We expect to continue to incur significant costs for regulatory activities associated with
obtaining regulatory approval in the United States for Macroplastique. For fiscal 2007, we expect
to incur significant research and development expenses, including those in connection with the
regulatory approval activities for Macroplastique. We also expect that during fiscal 2007, we will
continue to incur significant expenses as we expand our selling and marketing organization in the
U.S. to market our products. In addition, we expect general and administrative expenses in fiscal
2007 to increase as we increasingly prepare to implement the provisions of Section 404 of the
Sarbanes-Oxley Act of 2002.
In April 2005, we entered into an exclusive manufacturing and distribution agreement with
CystoMedix for the Urgent PC product. The agreement required us to pay CystoMedix an initial
payment of $225,000 and an additional payment of $250,000 in 12 monthly installments of $20,833.
We capitalized the aggregate amount as licensed technology and are amortizing it over the term of
the agreement. We will also pay CystoMedix a 7% royalty on product sales. However, the 7% royalty
is first offset against the monthly royalty installments.
CystoMedix has also granted us an exclusive option to acquire its assets. The purchase price is
$3,485,000, reduced by up to $50,000 of liabilities assumed by us. However, the $3,485,000 amount
used to compute the purchase price will increase at a rate of 10% per year after April 2007. The
purchase price is payable in shares of our common stock valued at the average of the closing bid
price of our shares for the 20 trading days prior to our exercise of the option. We may exercise
the option between January 2006 and June 2008. If we exercise the option, we will also assume up
to $1.4 million of bridge loan advances made to CystoMedix by its Chairman. We would repay up to
$1.1 million of the bridge loan advances at closing and would issue our common stock for the
balance of the bridge loan based on the above option
price. We also have certain rights of first refusal to acquire CystoMedixs assets in the event
CystoMedix receives a third party offer in advance of any exercise of our option. We will need to
raise additional equity or debt funds in order to consummate the CystoMedix acquisition, should we
elect to do so.
We have two exclusive distribution agreements with CL Medical allowing us to market and sell the
I-Stop urethral sling: effective February 2006, a six-year agreement, with a right to renew it for
successive five-year terms, for distribution in the United States and, effective May 2005, a
one-year agreement with automatic renewal for up to two years, for distribution the in United
Kingdom. Under the agreements, we are required to purchase a minimum of $630,000 of units in the
first 12-month period following January 1, 2006, increasing to $2.6 million of units in the fifth
year of the agreement, for an aggregate commitment of approximately $6.7 million of units over the
five-year period, subject to periodic adjustment based on the value of the euro.
We are obligated to pay royalties of 5% of net sales of Macroplastique products in the U.S. with a
minimum of $50,000 per year. The duration of this royalty agreement is through May 1, 2006. Under
another royalty agreement we pay royalties, in the aggregate, of three to five percent of net sales
of Macroplastique, Bioplastique, and PTQ Implants subject to a monthly minimum of $4,500. The
royalties payable under this agreement will continue until the patent referenced in the agreement
33
expires in 2010. Under a license agreement for the Macroplastique Implantation System, we pay a
royalty of 10 British pounds for each unit sold during the life of the patent.
We have a pension plan covering 16 employees in The Netherlands, reported as a defined benefit
plan. We pay premiums to an insurance company to fund annuities for these employees. However, we
are responsible for funding additional annuities based on continued service and future salary
increases. We closed this defined benefit plan for new employees in April 2005. As of that date,
the Dutch subsidiary established a defined contribution plan that now covers new employees. We also
closed our UK subsidiarys defined benefit plan to further accrual for all employees effective
December 31, 2004. In March 2005, the UK subsidiary established a defined contribution plan that
now covers new employees.
In January 2006, we entered into a long-term lease with Liberty Property Limited Partnership for an
18,258 square foot facility for our U.S. headquarters located at 5420 Feltl Road, Minnetonka,
Minnesota. The lease effective date was May 1, 2006, has a term of 96 months, requires average
annual minimum rent payments of approximately $140,000 and requires payments for operating expenses
estimated to be approximately $82,000 in the first 12 months.
On May 31, 2006, we entered into a promissory note with Venture Bank with a principal amount of
$100,000, interest rate of 8.25% per annum, and a maturity date of May 31, 2009. The amount is
used for certain capital expenditures relating to the relocation of our facility to our Minnetonka,
Minnesota location.
Repayments of our contractual obligations as of March 31, 2006, consisting of royalties, notes
payable (inclusive of interest), and operating leases, including the January 20, 2006 lease noted
above, are summarized below:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Payments Due by Period |
|
|
|
|
|
|
|
|
|
|
|
Fiscal |
|
|
Fiscal |
|
|
Fiscal |
|
|
|
|
|
|
|
|
|
|
|
2008 and |
|
|
2010 and |
|
|
2012 and |
|
|
|
Total |
|
|
Fiscal 2007 |
|
|
2009 |
|
|
2011 |
|
|
thereafter |
|
Minimum royalty payments |
|
$ |
318,333 |
|
|
$ |
124,833 |
|
|
$ |
108,000 |
|
|
$ |
85,500 |
|
|
$ |
|
|
Minimum purchase agreement |
|
|
6,676,416 |
|
|
|
735,283 |
|
|
|
2,016,715 |
|
|
|
3,924,418 |
|
|
|
|
|
Notes payable |
|
|
655,665 |
|
|
|
92,087 |
|
|
|
187,212 |
|
|
|
102,468 |
|
|
|
273,898 |
|
Operating lease commitments |
|
|
1,445,492 |
|
|
|
327,768 |
|
|
|
394,824 |
|
|
|
285,773 |
|
|
|
437,127 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total contractual obligations |
|
$ |
9,095,906 |
|
|
$ |
1,279,971 |
|
|
$ |
2,706,751 |
|
|
$ |
4,398,159 |
|
|
$ |
711,025 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Recent Accounting Pronouncements
Statement of Financial Accounting Standards 154, Accounting Changes and Error Corrections
In May 2005, the Financial Accounting Standards Board, or FASB, issued Statement of Financial
Accounting Standards, or SFAS, 154, Accounting Changes and Error Corrections. This new standard
replaces APB Opinion No. 20, Accounting Changes, and FASB Statement No. 3, Reporting Accounting
Changes in Interim Financial Statements. Among other changes, Statement 154 requires retrospective
application of a voluntary change in accounting principle with all prior period financial
statements presented on the new accounting principle, unless it is
impracticable to do so. Statement 154 also requires accounting for a change in method of depreciating or amortizing a
long-lived nonfinancial asset as a change in estimate (prospectively) affected by a change in
accounting principle. Further, the Statement requires that correction of errors in previously
issued financial statements be termed a restatement. The new standard is effective for
accounting changes and correction of errors made in fiscal years beginning after December 15, 2005.
Early adoption of this standard is permitted for accounting changes and correction of errors made
in fiscal years beginning after June 1, 2005. We do not believe the adoption of FASB Statement 154
will have a material effect on our financial position or results of operations.
Statement of Financial Accounting Standards 151, Inventory Costs
In November 2004, the FASB, issued SFAS 151, Inventory Costs, An Amendment of Accounting Research
Bulletin No. 43, Chapter 4, which adopts wording from the International Accounting Standards
Boards, or IASB, IAS 2 Inventories in an effort to improve the comparability of cross-border
financial reporting. The new standard requires us to treat abnormal freight, handling costs and
wasted materials (spoilage) as current period charges rather than as a portion of inventory cost.
Additionally, the standard clarifies that we should allocate fixed production overhead based on the
normal capacity of a
34
production facility. The statement is effective for us beginning in fiscal
2007. We do not expect adoption to have a material impact on our consolidated financial
statements.
Statement of Financial Accounting Standards 123(R), Share-Based Payment
In December 2004, the FASB issued SFAS 123(R), Share-Based Payment, which is a revision of SFAS
123, Accounting for Stock-Based Compensation, and supersedes APB Opinion 25, Accounting for Stock
Issued to Employees. SFAS 123(R) requires all share-based payments to employees, including grants
of employee stock options, to be valued at fair value on the date of grant, and to be expensed over
the applicable vesting period. SFAS 123(R) is effective for us beginning on April 1, 2006. Please
refer to discussion in Stock Based Compensation and Accelerated Vesting under critical account
policies.
Financial Accounting Standards Board Interpretation No. 47
In March 2005, the FASB issued FASB Interpretation No.47, or FIN 47, which clarifies terminology
in FASB Statement No. 143, Accounting for Asset Retirement Obligations. FIN 47 clarifies when an
entity has sufficient information to reasonably estimate the fair value of an asset retirement
obligation. FIN 47 was effective for us in fiscal 2006. Adoption of FIN 47 did not have a
material impact on our consolidated financial statements.
ITEM 7. FINANCIAL STATEMENTS
The information contained under the headings Consolidated Statements of Operations, Consolidated
Balance Sheets, Consolidated Statements of Shareholders Equity and Comprehensive Income (Loss),
Consolidated Statements of Cash Flows, Notes to Consolidated Financial Statements and Reports
of Independent Registered Public Accounting Firms is incorporated herein by reference.
ITEM 8. CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE
None.
ITEM 8A. CONTROLS & PROCEDURES
Disclosure Controls and Procedures. As of the end of the period covered by this report, we
conducted an evaluation, under the supervision and with the participation of our principal
executive officer and principal financial officer, of our disclosure controls and procedures as
defined in Rules 13(a)-15(e) under the Securities Exchange Act of 1934 (the Exchange Act). Based
on this evaluation, the principal executive officer and principal financial officer concluded that
our disclosure controls and procedures are effective to ensure that information required to be
disclosed by us in the reports we file or submit under the Exchange Act is recorded, processed,
summarized and reported within the time periods specified in Securities and Exchange Commission
rules and forms.
Internal Control Matters. We also maintain a system of internal accounting controls designed to
provide reasonable assurance that our books and records accurately reflect our transactions and
that our policies and procedures are followed. There have been no changes in our internal control
over financial reporting during the fiscal quarter ended March 31, 2006, or thereafter, that have
materially affected, or are reasonably likely to materially affect, our internal control over
financial reporting.
In connection with our review of our consolidated financial statements for the year ended March 31,
2005 and the audit of those statements by our independent registered public accounting firm, we
determined that our year-end financial
statement closing process did not ensure our adequate review of all significant elements of our
consolidated financial statements. In our post-closing and audit processes, we and our independent
registered public accounting firm discovered certain issues that resulted in adjustments to our
consolidated financial statements, specifically with respect to our inventory valuation and income
tax provision. We discovered these matters before our consolidated financial statements were
completed, and they are properly accounted for in our financial statements. However, we have
concluded that the failure to discover these items in our regular closing process is a result of a
significant deficiency, resulting primarily from a lack of segregation of duties due to the size of
our company and the geographic distance between our key financial personnel, that constitutes a
material weakness in the design or operation of our internal controls over financial reporting.
|
|
|
A significant deficiency is defined as a control deficiency, or combination of
deficiencies, that adversely affects a companys ability to initiate, authorize, record,
process or report external financial data reliably in accordance with |
35
|
|
|
generally accepted
accounting principles such that there is more than a remote likelihood that a misstatement
of the companys financial statements that is more than inconsequential will not be
prevented or detected. |
|
|
|
|
A material weakness is a significant deficiency, or combination of significant
deficiencies, that result in more than a remote likelihood that a material misstatement of
the financial statements will not be prevented or detected. |
Although the items described above were properly accounted for before completing our consolidated
financial statements for fiscal year 2005, we have concluded that the failure to discover these
items in our regular closing process was a material weakness because the elements of our
consolidated financial statements that were not adequately reviewed are material to our
consolidated financial statements and there is more than a remote likelihood that a material
misstatement of our consolidated financial statements would not be prevented or detected.
We discussed the material weakness described above with our Audit Committee. We have implemented
corrective actions where required to improve the effectiveness of our internal controls, including
the enhancement of our systems and procedures. Specifically, we have enhanced and formalized our
period-end closing processes to ensure we adequately review all significant elements of our
consolidated financial statements.
Any control system, no matter how well conceived and operated, can provide only reasonable, not
absolute, assurance that the objectives of the control system are met. The design of a control
system inherently has limitations, and the benefits of controls must be weighed against their
costs. Additionally, controls can be circumvented by the individual acts of some persons, by
collusion of two or more people, or by management override of the control. Therefore, no
evaluation of a cost-effective system of controls can provide absolute assurance that all control
issues and instances of fraud, if any, will be detected.
ITEM 8B. OTHER INFORMATION
None.
36
PART III
ITEM 9. DIRECTORS, EXECUTIVE OFFICERS, PROMOTERS AND CONTROL PERSONS; COMPLIANCE WITH SECTION
16(a) OF THE EXCHANGE ACT
The information contained under the heading Management in the Proxy Statement is incorporated
herein by reference.
ITEM 10. EXECUTIVE COMPENSATION
The information contained under the heading Executive Compensation in the Proxy Statement is
incorporated herein by reference.
ITEM 11. SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND RELATED STOCKHOLDER
MATTERS
The information contained under the heading Principal Shareholders in the Proxy Statement is
incorporated herein by reference.
ITEM 12. CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS
The information contained under the heading Certain Transactions in the Proxy Statement is
incorporated herein by reference.
ITEM 13. EXHIBITS AND REPORTS
(a) Exhibits incorporated by reference.
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|
|
|
|
Number |
|
Description |
|
2.1
|
|
First Amended Joint Plan of Reorganization (Modified) dated
January 31, 1994 (Incorporated by reference to Exhibit 8.1 to
Registrants Registration Statement on Form 10SB) |
|
|
|
|
|
3.1
|
|
Articles of Incorporation of Uroplasty, Inc. (Incorporated by
reference to Exhibit 2.1 to Registrants Registration
Statement on Form 10SB) |
|
|
|
|
|
3.2
|
|
Bylaws of Uroplasty, Inc. (Incorporated by reference to
Exhibit 2.2 to Registrants Registration Statement on Form
10SB) |
|
|
|
|
|
4.1
|
|
Form of Stock Certificate representing shares of our Common
Stock (Incorporated by reference to Exhibit 3.1 to
Registrants Registration Statement on Form 10SB) |
|
|
|
|
|
4.2
|
|
Form of Warrant (Incorporated by reference to Exhibit 4.2 to
Registrants Registration Statement on Form SB-2, Registration
No. 333-128313) |
|
|
|
|
|
10.1
|
|
Settlement Agreement and Release dated November 30, 1993 by
and between Bioplasty, Inc., Bio-Manufacturing, Inc.,
Uroplasty, Inc., Arthur A. Beisang, Arthur A. Beisang III, MD
and Robert A. Ersek, MD (Incorporated by reference to Exhibit
6.1 to Registrants Registration Statement on Form 10SB) |
|
|
|
|
|
10.2
|
|
Purchase and Sale Agreement dated December 1, 1995 by and
among Bio-Vascular, Inc., Bioplasty, Inc., and Uroplasty, Inc.
(Incorporated by reference to Exhibit 6.2 to Registrants
Registration Statement on Form 10SB) |
|
|
|
|
|
10.3
|
|
License Agreement dated December 1, 1995 by and between
Bio-Vascular, Inc. and Uroplasty, Inc. (Incorporated by
reference to Exhibit 6.3 to Registrants Registration
Statement on Form 10SB) |
|
|
|
|
|
10.4
|
|
Lease Agreement dated January 10, 1995 between Summer Business
Center Partnership and Uroplasty, Inc. (Incorporated by
reference to Exhibit 6.4 to Registrants Registration
Statement on Form 10SB) |
|
|
|
|
|
10.5
|
|
Unsecured $640,000 Promissory Note dated March 30, 1994 by and
between Bioplasty, Inc., Uroplasty, Inc. and Bioplasty Product
Claimants Trust (Incorporated by reference to Exhibit 6.5 to
Registrants Registration |
37
|
|
|
|
|
Number |
|
Description |
|
|
|
Statement on Form 10SB) |
|
|
|
|
|
10.6
|
|
Agreement and Satisfaction dated January 30, 1995 by and
between Bioplasty Product Claimants Trust and Bioplasty, Inc.
(Incorporated by reference to Exhibit 6.6 to Registrants
Registration Statement on Form 10SB) |
|
|
|
|
|
10.7
|
|
Asset Sale and Satisfaction of Debt Agreement dated June 23,
1995 by and between Bioplasty, Inc. and Uroplasty, Inc.
(Incorporated by reference to Exhibit 6.7 to Registrants
Registration Statement on Form 10SB) |
|
|
|
|
|
10.8
|
|
Executory Contract Assumption Stipulation dated December 28,
1993 by and between Bioplasty, Inc., Uroplasty, Inc., and
Collagen Corporation (Incorporated by reference to Exhibit 6.8
to Registrants Registration Statement on Form 10SB) |
|
|
|
|
|
10.9
|
|
Settlement and License Agreement dated July 23, 1992 by and
between Collagen Corporation, Bioplasty, Inc., and Uroplasty,
Inc. (Incorporated by reference to Exhibit 6.9 to Registrants
Registration Statement on Form 10SB) |
|
|
|
|
|
10.10
|
|
Employment Agreement between Uroplasty, Inc. and Christopher
Harris dated December 7, 1999. (Incorporated by reference to
Exhibit 10.11 to Registrants Form 10-KSB for the year ended
03-31-2000.) |
|
|
|
|
|
10.11
|
|
Employment Agreement between Uroplasty, Inc. and Susan Holman
dated December 7, 1999. (Incorporated by reference to Exhibit
10.13 to Registrants Form 10-KSB for the year ended
03-31-2000.) |
|
|
|
|
|
10.12
|
|
Employment Agreement between Uroplasty, Inc. and Larry
Heinemann dated December 7, 1999. (Incorporated by reference
to Exhibit 10.14 to Registrants Form 10-KSB for the year
ended 03-31-2000.) |
|
|
|
|
|
10.13
|
|
Agreement, dated October 14, 1998, by and between Uroplasty,
Inc. and Samir M. Henalla (pertaining to Macroplastique
Implantation System). (Incorporated by reference to Exhibit
10.15 to Registrants Form 10-KSB/A for the year ended
03-31-2001) |
|
|
|
|
|
10.14
|
|
Employment Agreement between Uroplasty, Inc. and Mr. Marc
Herregraven dated November 15, 2002. (Incorporated by
reference to Exhibit 10.15 to Registrants Form 10-KSB for the
year ended 03-31-2003) |
|
|
|
|
|
10.15
|
|
Consulting Agreement between Uroplasty, Inc. and CCRI
Corporation dated April 1, 2003. (Incorporated by reference to
Exhibit 10.18 to Registrants Form 10-KSB for the year ended
03-31-2003) |
|
|
|
|
|
10.16
|
|
Form of Manufacturing and Distribution Agreement with CL
Medical SAS (Incorporated by reference to Exhibit 10.19 to
Registrants Form 10-QSB for the period ended September 30,
2004) |
|
|
|
|
|
10.17
|
|
Employment Agreement between Uroplasty, Inc. and Sam B.
Humphries dated January 1, 2005 (Incorporated by reference to
Exhibit 10.1 to Registrants Form 10-QSB for the period ended
December 31, 2004) |
|
|
|
|
|
10.18
|
|
Employment and Consulting Agreement between Uroplasty, Inc.
and Daniel G. Holman dated January 1, 2005 (Incorporated by
reference to Exhibit 10.2 to Registrants Form 10-QSB for the
period ended December 31, 2004) |
|
|
|
|
|
10.19
|
|
Exclusive Manufacturing and Distribution Agreement, dated as
of April 18, 2005, by and between Uroplasty, Inc. and
CystoMedix, Inc. (Incorporated by reference to Exhibit 10.19
to Registrants Form 8-K dated April 18, 2005) |
|
|
|
|
|
10.20
|
|
Form of Securities Purchase Agreement, dated as of April 21,
2005, by and among Uroplasty, Inc., and the investors
identified on the signature pages thereto (Incorporated by
reference to Exhibit 10.20 to Registrants Form 8-K dated
April 21, 2005) |
|
|
|
|
|
10.21
|
|
Form of Warrant (Incorporated by reference to Exhibit 10.21 to
Registrants Form 8-K dated April 21, 2005) |
|
|
|
|
|
10.22
|
|
Form of Registration Rights Agreement dated as of April 21,
2005, by and among Uroplasty, Inc., and the investors named
therein (Incorporated by reference to Exhibit 10.22 to
Registrants Form 8-K dated April 21, 2005) |
|
|
|
|
|
10.23
|
|
Business Loan Agreement and related Promissory Note dated
March 24, 2005 with Venture Bank (Incorporated by reference to
Exhibit 10.26 to Registrants Form 10-KSB for the year ended
March 31, 2005) |
38
|
|
|
|
|
Number |
|
Description |
|
10.24
|
|
Employment Agreement between Uroplasty, Inc. and Mahedi A.
Jiwani dated November 14, 2005 (Incorporated by reference to
Exhibit 10.24 to Registrants Form 10-QSB for the period ended
September 30, 2005) |
|
|
|
|
|
10.25
|
|
Lease Agreement between Uroplasty, Inc. and Liberty Property
Limited Partnership dated January 20, 2006 (Incorporated by
reference to Exhibit 10.25 to Registrants Form 8-K dated
January 24, 2006) |
|
|
|
|
|
10.26
|
|
Form of Distribution Agreement between Uroplasty, Inc. and CL
Medical SARL, dated February 15, 2006 (Incorporated by
reference to Exhibit 10.26 to Registrants Form SB-2/A dated
February 21, 2006 |
|
|
|
|
|
10.27
|
|
Letter Agreement between Daniel G. Holman and Uroplasty, Inc.,
amending terms of Employment Agreement dated January 1, 2005
(Incorporated by reference to Exhibit 10.26 to Registrants
Form 8-K dated March 27, 2006) |
|
|
|
|
|
10.28
|
|
Letter Agreement pursuant to separation arrangements between
Sam B. Humphries and Uroplasty, Inc., dated April 26, 2006
(Incorporated by reference to Exhibit 10.28 to Registrants
Amendment No. 1 to Form SB-2 dated April 27, 2006). |
|
|
|
|
|
10.29
|
|
Letter Agreement between Uroplasty, Inc. and Daniel G. Holman
dated April 26, 2006 (Incorporated by reference to Exhibit
10.29 to Registrants Amendment No. 1 to Form SB-2 dated April
27, 2006). |
(b) The following exhibits are filed as part of this report:
|
|
|
|
|
Number |
|
Description |
|
10.30
|
|
Employment Agreement between Uroplasty, Inc. and David B.
Kaysen dated May 17, 2006. |
|
|
|
|
|
10.31
|
|
Business Loan Agreement and related Promissory Note dated May
31, 2006 with Venture Bank |
|
|
|
|
|
13
|
|
Financial Statements |
|
|
|
|
|
21.0
|
|
List of Subsidiaries |
|
|
|
|
|
23.1
|
|
Consent of Independent Registered Public Accounting Firm
McGladrey & Pullen, LLP |
|
|
|
|
|
31
|
|
Certifications by the CEO and CFO pursuant to Section 302 of
the Sarbanes-Oxley Act of 2002 |
|
|
|
|
|
32
|
|
Certifications by the CEO and CFO pursuant to 18 USC Section
1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley
Act of 2002 |
ITEM 14. PRINCIPAL ACCOUNTANT FEES AND SERVICES
The information contained under the heading Independent Registered Public Accounting Firm in the
Proxy Statement is incorporated herein by reference.
39
SIGNATURES
In accordance with Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant
caused this Report to be signed on its behalf by the undersigned, thereunto duly authorized.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Dated: June 29, 2006 |
|
UROPLASTY, INC. |
|
|
|
|
|
|
|
|
|
|
|
By
|
|
/s/ David B. Kaysen |
|
|
|
|
|
|
|
|
|
|
|
David B. Kaysen |
|
|
|
|
President and Chief Executive Officer |
|
|
In accordance with 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.
|
|
|
|
|
Name |
|
Title / Capacity |
|
Date |
|
/s/ David B. Kaysen
|
|
President, Chief Executive
Officer and Director |
|
|
|
|
|
|
|
David B. Kaysen
|
|
(Principal Executive Officer)
|
|
June 29, 2006 |
|
|
|
|
|
/s/ Mahedi A. Jiwani
|
|
Vice President, Chief Financial Officer |
|
|
|
|
|
|
|
Mahedi A. Jiwani
|
|
and Treasurer
(Principal Financial and
Accounting Officer)
|
|
June 29, 2006 |
|
|
|
|
|
/s/ Arie J. Koole |
|
|
|
|
|
|
|
|
|
Arie J. Koole
|
|
Controller
|
|
June 29, 2006 |
|
|
|
|
|
/s/ Sam B. Humphries |
|
|
|
|
|
|
|
|
|
Sam B. Humphries
|
|
Director
|
|
June 29, 2006 |
|
|
|
|
|
/s/ Joel R. Pitlor |
|
|
|
|
|
|
|
|
|
Joel R. Pitlor
|
|
Director
|
|
June 29, 2006 |
|
|
|
|
|
/s/ R. Patrick Maxwell |
|
|
|
|
|
|
|
|
|
R. Patrick Maxwell
|
|
Director
|
|
June 29, 2006 |
|
|
|
|
|
/s/ Thomas E. Jamison |
|
|
|
|
|
|
|
|
|
Thomas E. Jamison
|
|
Director
|
|
June 29, 2006 |
40