Blueprint
As
filed with the Securities and Exchange Commission on April 18,
2018
Registration
No. 333-213774
UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
AMENDMENT NO. 4 TO
FORM S-1
REGISTRATION
STATEMENT UNDER THE SECURITIES ACT OF 1933
SANUWAVE Health, Inc.
(Exact
name of registrant as specified in its charter)
Nevada
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3841
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20-1176000
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(State
or other Jurisdiction
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(Primary
Standard Industrial
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(I.R.S.
Employer
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of
Incorporation or
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Classification
Code Number)
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Identification
No.)
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Organization)
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3360 Martin Farm Road, Suite 100
Suwanee, Georgia 30024
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(770) 419-7525
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(Address,
including zip code, and telephone number, including area code, of
registrant’s principal executive offices)
Kevin A. Richardson, II
Acting Chief Executive Officer
SANUWAVE Health, Inc.
3360 Martin Farm Road, Suite 100
Suwanee, Georgia 30024
(770) 419-7525
(Name,
address, including zip code, and telephone number, including area
code, of agent for service)
Copies of all communications, including communications sent to
agent for service, should be sent to:
John C. Ethridge, Jr., Esq.Smith, Gambrell & Russell,
LLPPromenade II, Suite 3100
1230 Peachtree Street, N.E.Atlanta, Georgia 30309(404)
815-3500
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Approximate date of commencement of proposed
sale to the public: As soon as practicable after this
registration statement becomes effective.
If any
of the securities being registered on this Form are to be offered
on a delayed or continuous basis pursuant to Rule 415 under the
Securities Act of 1933, check the following
box: ☒
If this
Form is filed to register additional securities for an offering
pursuant to Rule 462(b) under the Securities Act, check the
following box and list the Securities Act registration statement
number of the earlier effective registration statement for the same
offering. ☐
If this
Form is a post-effective amendment filed pursuant to Rule 462(c)
under the Securities Act, check the following box and list the
Securities Act registration statement number of the earlier
effective registration statement for the same
offering. ☐
If this
Form is a post-effective amendment filed pursuant to Rule 462(d)
under the Securities Act, check the following box and list the
Securities Act registration statement number of the earlier
effective registration statement for the same
offering. ☐
Indicate
by check mark whether the registrant is a large accelerated filer,
an accelerated filer, a non-accelerated filer, a smaller reporting
company, or an emerging growth company. See the definitions of
“large accelerated filer,” “accelerated
filer,” “smaller reporting company” and
“emerging growth company” in Rule 12b-2 of the Exchange
Act.
Large accelerated filer ☐
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Accelerated filer
☐
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Non-accelerated filer ☐
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Smaller reporting company
☒
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(Do
not check if a smaller reporting company)
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Emerging growth company ☐
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If an emerging growth company, indicate by check
mark if the registrant has elected not to use the extended
transition period for complying with any new or revised financial
accounting standards provided pursuant to Section 13(a) of the
Exchange Act. ☐
Indicate by check mark whether the registrant is a
shell company (as defined in Rule 12b-2 of the Exchange
Act). ☐
Yes ☒ No
CALCULATION OF REGISTRATION FEE
Title of each
class of securities to be registered (1)
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Proposed
maximum offering price per share (4)
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Proposed
maximum aggregate offering price
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Amount of
registration fee
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Common Stock, $0.001 par value
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28,541,183
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$0.545500
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$15,569,215.33
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$1,804.47
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Common Stock, $0.001 par value (2)
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29,256,668
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$0.545500
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$15,959,512.39
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$1,849.71
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Common Stock, $0.001 par value (3)
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1,839,500
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$0.545500
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$1,003,447.25
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$116.30
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Total (5)
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59,637,351
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$32,532,174.97
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$3,770.48
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(1)
Pursuant to Rule
416, the securities being registered hereunder include such
indeterminate number of additional shares of common stock as may be
issued after the date hereof as a result of stock splits, stock
dividends or similar transactions.
(2)
Represents shares
of common stock issuable upon the exercise of
warrants.
(3)
Represents shares
of common stock issuable upon the exercise of warrants issued to
the placement agent.
(4)
Estimated solely
for the purpose of calculating the registration fee in accordance
with Rule 457(c) under the Securities Act of 1933, as amended,
based on the per share average of the high and low reported prices
for the common stock on the Over the Counter Bulletin Board as of
April 12, 2018.
Pursuant to Rule
429 under the Securities Act, the prospectus contained in this
Registration Statement is a combined prospectus and also relates to
an aggregate of (a) up to 28,483,337 shares of common stock
issuable upon the exercise of warrants that were registered and
sold, 2,051,501 shares of common stock issuable upon the exercise
of warrants that were registered and issued to certain placement
agents described herein and 23,545,114 shares of common stock that
were registered for resale (the "2016 Previously Registered
Securities") under the registrant's Registration Statement on Form
S-1 (File No. 333-208676), which was declared effective on February
17, 2016 (the "2016 Prior Registration Statement"); and (b) up to
1,155,682 shares of common stock issuable upon the exercise of
warrants that were registered (together with the 2016 Previously
Registered Securities, the “Previously Registered
Securities”) under the registrant's Registration Statement on
Form S-1 (File No. 333-195263), which was declared effective on May
6, 2014 (together with the 2016 Prior Registration Statement, the
“Prior Registration Statements"). Upon effectiveness, this
Registration Statement constitutes a post-effective amendment to
each of the Prior Registration Statements, which post-effective
amendments shall hereafter become effective concurrently with the
effectiveness of this Registration Statement in accordance with
Section 8(c) of the Securities Act. If any Previously Registered
Securities under the Prior Registration Statements are offered and
sold before the effective date of this Registration Statement, the
amount of the Previously Registered Securities so sold will not be
included in the prospectus hereunder. The filing fee payable in
connection with each of the Prior Registration Statements was
previously paid at the time of its initial filing. The breakdown of
each of the total share counts in this paragraph corresponding to
each Prior Registration Statement has been provided in the three
additional tables immediately following the Selling
Stockholder’s Table in the section entitled “Selling
Stockholders” of the prospectus contained in this
Registration Statement.
The
registrant hereby amends this registration statement on such date
or dates as may be necessary to delay its effective date until the
registrant shall file a further amendment which specifically states
that this registration statement shall thereafter become effective
in accordance with Section 8(a) of the Securities Act of 1933, or
until the registration statement shall become effective on such
date as the Commission, acting pursuant to said Section 8(a), may
determine.
EXPLANATORY NOTE
Pursuant to Rule
429 under the Securities Act, the prospectus contained in this
Registration Statement is a combined prospectus and also relates to
an aggregate of (a) up to 28,483,337 shares of common stock
issuable upon the exercise of warrants that were registered and
sold, 2,051,501 shares of common stock issuable upon the exercise
of warrants that were registered and issued to certain placement
agents described herein and 23,545,114 shares of common stock that
were registered for resale (the "2016 Previously Registered
Securities") under the registrant's Registration Statement on Form
S-1 (File No. 333-208676), which was declared effective on February
17, 2016 (the "2016 Prior Registration Statement"); and (b) up to
1,155,682 shares of common stock issuable upon the exercise of
warrants that were registered (together with the 2016 Previously
Registered Securities, the “Previously Registered
Securities”) under the registrant's Registration Statement on
Form S-1 (File No. 333-195263), which was declared effective on May
6, 2014 (together with the 2016 Prior Registration Statement, the
“Prior Registration Statements"). Upon effectiveness, this
Registration Statement constitutes a post-effective amendment to
each of the Prior Registration Statements, which post-effective
amendments shall hereafter become effective concurrently with the
effectiveness of this Registration Statement in accordance with
Section 8(c) of the Securities Act. If any Previously Registered
Securities under the Prior Registration Statements are offered and
sold before the effective date of this Registration Statement, the
amount of the Previously Registered Securities so sold will not be
included in the prospectus hereunder. The filing fee payable in
connection with each of the Prior Registration Statements was
previously paid at the time of its initial filing.
This
Registration Statement is also being filed to register 28,541,183
additional shares of the registrant’s common stock for resale
by selling shareholders, 29,256,668 additional shares of the
registrant’s common stock issuable upon the exercise of
warrants that were sold, and 1,839,500 additional shares of the
registrant’s common stock issuable upon the exercise of
warrants that were issued to the placement agent.
The
breakdown of each of the total share counts in this Explanatory
Note corresponding to each Prior Registration Statement has been
provided in the three additional tables immediately following the
Selling Stockholder’s Table in the section entitled
“Selling Stockholders” of the prospectus contained in
this Registration Statement.
The information in this prospectus is not complete and may be
changed. Neither the Company, nor our selling stockholders, may
sell the securities described herein until the registration
statement filed with the Securities and Exchange Commission is
effective. This prospectus is not an offer to sell the securities
and we are not soliciting offers to buy these securities in any
state or jurisdiction where the offer or sale is not
permitted.
Preliminary Prospectus, Subject to Completion, Dated April 18,
2018.
114,872,985 Shares
(Common Stock, $0.001 par value)
This
prospectus relates to the issuance or sale of up to 114,872,985
shares of our Common Stock, consisting of (1) sale by selling
stockholders listed in the prospectus of 52,086,297 outstanding
shares of Common Stock by such selling stockholders, (2) issuance
of 58,895,687 shares of Common Stock upon the exercise of certain
warrants and (3) issuance of 3,891,001 shares of Common Stock upon
exercise of certain warrants held by certain placement agents for
the private placements described herein. The selling stockholder
shares offered by this prospectus may be sold by such selling
stockholders, from time to time, in the over-the-counter market or
other national securities exchange or automated interdealer
quotation system on which our Common Stock is then listed or
quoted, through negotiated transactions or otherwise at market
prices prevailing at the time of sale or at negotiated prices, or
otherwise in compliance with the “Plan of Distribution”
contained herein.
We will
receive none of the proceeds from the sale of the shares by the
selling stockholders. We may receive proceeds upon the exercise of
outstanding warrants for shares of Common Stock covered by this
prospectus if the warrants are exercised for cash. We will bear all
expenses of registration incurred in connection with this offering,
but all selling and other expenses incurred by the selling
stockholders will be borne by them.
We
agreed to pay each Placement Agent described herein a fee of (i)
ten percent (10%) of the aggregate purchase price of the securities
sold in the private placement and (ii) warrants to purchase ten
percent (10%) of the number of shares sold in the private
placement. The Placement Agents, collectively, were initially
issued warrants to purchase 5,831,667 shares of Common Stock
at an exercise price of $0.08 per share, of which warrants relating
to 1,940,666 shares have previously been exercised and such shares
were issued pursuant to an effective registration statement and are
not being offered hereunder. The registration statement of which
this prospectus is a part also covers the shares of Common Stock
issuable from time to time upon the exercise of the placement
agent’s warrants. Certain placement agent’s warrants
and the underlying shares of Common Stock are subject to compliance
with the requirements of the Financial Industry Regulatory
Authority, Inc., or FINRA.
See
“Plan of Distribution” beginning on page 46 of this
prospectus for more information regarding the above compensation
payable to the placement agent.
Our
Common Stock is quoted on the OTC Bulletin Board under the symbol
SNWV.QB. The high and low bid prices for shares of our Common
Stock on April 12, 2018, were $0.511 and $0.58 per share,
respectively, based upon bids that represent prices quoted by
broker-dealers on the OTC Bulletin Board. These quotations
reflect inter-dealer prices, without retail mark-up, mark-down or
commissions, and may not represent actual
transactions.
Investing
in our securities involves a high degree of risk. See
“Risk Factors” beginning on page 3 of this prospectus
for a discussion of information that should be considered in
connection with an investment in our securities.
NEITHER
THE SECURITIES AND EXCHANGE COMMISSION NOR ANY STATE SECURITIES
COMMISSION HAS APPROVED OR DISAPPROVED OF THESE SECURITIES OR
PASSED UPON THE ADEQUACY OR ACCURACY OF THIS PROSPECTUS. ANY
REPRESENTATION TO THE CONTRARY IS A CRIMINAL OFFENSE.
Brokers
or dealers effecting transactions in these securities should
confirm that the securities are registered under the applicable
state law or that an exemption from registration is
available.
The date of this prospectus is_____________,
2018
TABLE OF CONTENTS
PROSPECTUS
SUMMARY
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1
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RISK
FACTORS
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3
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CAUTIONARY
NOTE REGARDING FORWARD-LOOKING STATEMENTS
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20
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USE OF
PROCEEDS
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20
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SELLING
STOCKHOLDERS
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21
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PLAN OF
DISTRIBUTION
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26
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MARKET
FOR OUR COMMON STOCK AND RELATED STOCKHOLDER MATTERS
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28
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MANAGEMENT’S
DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF
OPERATIONS
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30
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BUSINESS
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40
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MANAGEMENT,
EXECUTIVE COMPENSATION AND CORPORATE GOVERNANCE
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55
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CORPORATE
GOVERNANCE AND BOARD MATTERS
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60
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SECURITY
OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT
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64
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CERTAIN
RELATIONSHIPS AND RELATED TRANSACTIONS
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65
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DESCRIPTION
OF SECURITIES TO BE REGISTERED
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66
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SHARES
AVAILABLE FOR FUTURE SALE
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67
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LEGAL
MATTERS
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67
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EXPERTS
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67
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INTEREST
OF NAMED EXPERTS AND COUNSEL
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68
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WHERE
YOU CAN FIND MORE INFORMATION; INCORPORATION OF CERTAIN INFORMATION
BY REFERENCE
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68
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PROSPECTUS SUMMARY
This summary highlights selected information contained in greater
detail elsewhere in this prospectus. This summary may not contain
all of the information that you should consider before investing in
our Common Stock. You should carefully read the entire prospectus,
including ‘‘Risk Factors’’ and the
consolidated financial statements, before making an investment
decision.
Unless the context requires otherwise, the words
‘‘SANUWAVE,’’
‘‘we,’’
‘‘Company,’’
‘‘us,’’ and ‘‘our’’
in this prospectus refer to SANUWAVE Health, Inc. and our
subsidiaries.
About This Prospectus
You may
rely only on the information contained in this prospectus or that
we have referred you to. We have not authorized anyone to provide
you with different information. This prospectus does not constitute
an offer to sell or a solicitation of an offer to buy any
securities other than the securities offered by this prospectus.
This prospectus does not constitute an offer to sell or a
solicitation of an offer to buy any securities in any circumstances
in which such offer or solicitation is unlawful. Neither the
delivery of this prospectus nor any sale made in connection with
this prospectus shall, under any circumstances, create any
implication that there has been no change in our affairs since the
date of this prospectus or that the information contained by
reference to this prospectus is correct as of any time after its
date.
Our Company
We are
a shock wave technology company using a patented system of
noninvasive, high-energy, acoustic shock waves for regenerative
medicine and other applications. Our initial focus is regenerative
medicine – utilizing noninvasive, acoustic shock waves to
produce a biological response resulting in the body healing itself
through the repair and regeneration of tissue, musculoskeletal, and
vascular structures. Our lead regenerative product in the United
States is the dermaPACE® device, used
for treating diabetic foot ulcers, which was subject to two
double-blinded, randomized Phase III clinical studies. On December
28, 2017, the U.S. Food and Drug Administration (the
“FDA”) notified the Company to permit the marketing of
the dermaPACE System for the treatment of diabetic foot ulcers in
the United States.
Our
portfolio of healthcare products and product candidates activate
biologic signaling and angiogenic responses, including new
vascularization and microcirculatory improvement, helping to
restore the body’s normal healing processes and regeneration.
We intend to apply our Pulsed Acoustic Cellular Expression
(PACE®) technology in
wound healing, orthopedic, plastic/cosmetic and cardiac conditions.
In 2018, we have started marketing our dermaPACE System for sale in
the United States and will continue to generate revenue from sales
of the European Conformity Marking (CE Mark) devices and
accessories in Europe, Canada, Asia and Asia/Pacific.
Our
lead product candidate for the global wound care market, dermaPACE,
has received FDA approval for commercial use to treat diabetic foot
ulcers in the United States and the CE Mark allowing for commercial
use on acute and chronic defects of the skin and subcutaneous soft
tissue. We believe we
have demonstrated that our patented technology is safe and
effective in stimulating healing in chronic conditions of the foot
and the elbow through our United States FDA Class III PMA approved
OssaTron® device, and in
the stimulation of bone and chronic tendonitis regeneration in the
musculoskeletal environment through the utilization of our
OssaTron, Evotron®, and
orthoPACE® devices in
Europe and Asia.
Product Overview; Strategy
We are
focused on developing our Pulsed Acoustic Cellular Expression
(PACE) technology to activate healing in:
●
wound conditions,
including diabetic foot ulcers, venous and arterial ulcers,
pressure sores, burns and other skin eruption
conditions;
●
orthopedic
applications, such as eliminating chronic pain in joints from
trauma, arthritis or tendons/ligaments inflammation, speeding the
healing of fractures (including nonunion or delayed-union
conditions), improving bone density in osteoporosis, fusing bones
in the extremities and spine, and other potential sports injury
applications;
●
plastic/cosmetic
applications such as cellulite smoothing, graft and transplant
acceptance, skin tightening, scarring and other potential aesthetic
uses; and
●
cardiac
applications for removing plaque due to atherosclerosis improving
heart muscle performance.
In
addition to healthcare uses, our high-energy, acoustic pressure
shock waves, due to their powerful pressure gradients and localized
cavitational effects, may have applications in secondary and
tertiary oil exploitation, for cleaning industrial waters, for
sterilizing food liquids and finally for maintenance of industrial
installations by disrupting biofilms formation. Our business
approach will be through licensing and/or partnership
opportunities.
For
more information about the Company, see the section entitled
“Business” in this prospectus.
Risks Associated with Our Business
Our
business is subject to numerous risks, as more fully described in
the section entitled ‘‘Risk Factors’’
immediately following this prospectus summary. We have a limited
operating history and have incurred substantial losses since
inception. We expect to continue to incur losses for the
foreseeable future and are unable to predict the extent of future
losses or when we will become profitable, if at all. Our products
are in various stages of research and development, with only the
dermaPACE System having received regulatory approval in the United
States. Our ability to generate revenue in the future will depend
heavily on the successful development and commercialization of our
product candidates. Even if we succeed in developing and
commercializing one or more of our product candidates, we may never
generate sufficient sales revenue to achieve and sustain
profitability. We may be unable to maintain and protect our
intellectual property, which could have a substantial impact on our
ability to generate revenue. Our products are subject to regulation
by governmental authorities in the United States and in other
countries. Failure to comply with such regulations or to receive
the necessary approvals or clearances for our product and product
candidates may have a material adverse effect on our
business.
Trading Market
Our
Common Stock is quoted on the OTCQB under the symbol
“SNWV.”
Corporate Information
We were
incorporated in the State of Nevada on May 6, 2004, under the name
Rub Music Enterprises, Inc. (“RME”). SANUWAVE, Inc. was
incorporated in the State of Delaware on July 21, 2005. In
December 2006, Rub Music Enterprises, Inc. ceased operations and
became a shell corporation.
On
September 25, 2009, RME and RME Delaware Merger Sub, Inc., a Nevada
corporation and wholly-owned subsidiary of RME (the
“Merger Sub”)
entered into a reverse merger agreement with SANUWAVE, Inc.
Pursuant to the Merger Agreement, the Merger Sub merged with and
into SANUWAVE, Inc., with SANUWAVE, Inc. as the surviving entity
(the “Merger”)
and a wholly-owned subsidiary of the Company.
In
November 2009, we changed our name to SANUWAVE Health, Inc. Our
principal executive offices are located at 3360 Martin Farm Road,
Suite 100, Suwanee, Georgia 30024, and our telephone number is
(770) 419-7525. Our website address is www.sanuwave.com. The information on
our website is not a part of this prospectus.
About this Offering
Securities being offered hereunder
Total
Common Stock being offered
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114,872,985 shares
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-
Outstanding Common Stock by the selling
shareholders
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52,086,297 shares
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-
Common Stock issuable upon
exercise of certain warrants
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58,895,687 shares
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-
Common Stock issuable upon
exercise of placement agent warrants
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3,891,001 shares
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Use of Proceeds
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We will
not receive any proceeds from the sale of shares of Common Stock by
selling stockholders in this offering, except cash for the warrant
exercise, which if all such warrants are exercised, would be
approximately $4,969,080. Proceeds, if any, received from the
exercise of such warrants, would be used for working capital
purposes.
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Risk Factors
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See
“Risk Factors” beginning on page 3 of this prospectus
for a discussion of factors you should carefully consider
before deciding to invest in our Common Stock.
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OTCQB
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SNWV
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Summary Financial Information
The
summary financial information set forth below is derived from and
should be read in conjunction with our consolidated financial
statements, including the notes thereto, appearing at the end of
this prospectus.
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Consolidated
Statement of Operations Data
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Revenue
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$738,527
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$1,376,063
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Net
loss
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$(5,537,936)
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$(6,439,040)
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Weighted average
shares outstanding
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138,838,602
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107,619,869
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Net loss per share
- basic and diluted
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$(0.04)
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$(0.06)
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|
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Consolidated
Balance Sheet Data (at end of period)
|
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Working
deficit
|
$(9,955,113)
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$(7,002,324)
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Total
assets
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$1,278,810
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$1,004,870
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Total
liabilities
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$11,159,637
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$7,916,470
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Total stockholders'
deficit
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$(9,880,827)
|
$(6,911,600)
|
Investing in our Common Stock involves a high degree of risk. You
should carefully consider the following risk factors and all other
information contained in this prospectus, including the
consolidated financial statements and the related notes appearing
at the end of this prospectus, before purchasing our Common Stock.
If any of the following risks actually occur, they may materially
harm our business and our financial condition and results of
operations. In any such event, the market price of our Common Stock
could decline and you could lose all or part of your
investment.
Risks Related to our Business
Our recurring losses from operations and dependency upon future
issuances of equity or other financing to fund ongoing operations
have raised substantial doubts as to our ability to continue as a
going concern.
We will be
required to raise additional funds to finance our operations and
remain a going concern; we may not be able to do so, and/or the
terms of any financings may not be advantageous to
us.
The continuation of our business is dependent upon
raising additional capital. We expect to devote substantial
resources for the commercialization of the dermaPACE and will
continue to research and develop the non-medical uses of the PACE
technology, both of which will require additional capital
resources. We incurred a net loss of $5,537,936 and $6,439,040 for
the years ended December 31, 2017 and 2016, respectively. These
operating losses create uncertainty about our ability to continue
as a going concern.
At
December 31, 2017, we had cash and cash equivalents totaling
$730,184 and negative working
capital of $9,955,113. For the years ended December 31, 2017 and
2016, our net cash used by operating activities was $1,528,971 and
$3,199,453, respectively. Management expects the cash used in
operations for the Company will be approximately $225,000 to
$300,000 per month for the first quarter of 2018 and $275,000 to
$350,000 per month for the second quarter of 2018 as
resources are devoted to the expansion of our international
business, preparations for commercialization of the dermaPACE
product including hiring of new employees and continued research
and development of non-medical uses of our technology.
The continuation of our business is dependent upon
raising additional capital during the second quarter of 2018 and
potentially into 2019 to fund operations. Management’s plans
are to obtain additional capital in 2018 through investments by
strategic partners for market opportunities, which may include
strategic partnerships or licensing arrangements, or raise capital
through the conversion of outstanding warrants, the issuance of
common or preferred stock, securities convertible into common
stock, or secured or unsecured debt. These possibilities, to the
extent available, may be on terms that result in significant
dilution to our existing shareholders. Although no
assurances can be given, management believes that potential
additional issuances of equity or other potential financing
transactions as discussed above should provide the necessary
funding for us. If these efforts are
unsuccessful, we may be forced to seek relief through a filing
under the U.S. Bankruptcy Code. Our consolidated financial
statements do not include any adjustments relating to the
recoverability of assets and classification of assets and
liabilities that might be necessary should we be unable to continue
as a going concern.
We have a history of losses and we may continue to incur losses and
may not achieve or maintain profitability.
For
the year ended December 31, 2017, we had a net loss of
$5,537,936 and used $1,528,971 of cash in operations. For the year
ended December 31, 2016, we had a net loss of $6,439,040 and
used $3,199,453 of cash in operations. As of December 31, 2017, we
had an accumulated deficit of $104,971,384 and a total
stockholders' deficit of $9,880,827. As a result of our significant
research, clinical development, regulatory compliance and general
and administrative expenses, we expect to incur losses as we
continue to incur expenses related to commercialization of the
dermaPACE System and research and development of the non-medical
uses of the PACE technology. Even if we succeed in developing and
commercializing the dermaPACE System or any other product
candidates, we may not be able to generate sufficient revenues and
we may never achieve or be able to maintain
profitability.
If we are unable to successfully raise additional capital, our
viability may be threatened; however, if we do raise additional
capital, your percentage ownership as a shareholder could decrease
and constraints could be placed on the operations of our
business.
We
have experienced negative operating cash flows since our inception
and have funded our operations primarily from proceeds received
from sales of our capital stock, the issuance of convertible
promissory notes, the issuance of notes payable to related parties,
the issuance of promissory notes, the sale of our veterinary
division in June 2009 and product sales. We will seek to obtain
additional funds in the future through equity or debt financings,
or strategic alliances with third parties, either alone or in
combination with equity financings. These financings could result
in substantial dilution to the holders of our common stock or
require contractual or other restrictions on our operations or on
alternatives that may be available to us. If we raise additional
funds by issuing debt securities, these debt securities could
impose significant restrictions on our operations. Any such
required financing may not be available in amounts or on terms
acceptable to us, and the failure to procure such required
financing could have a material adverse effect on our business,
financial condition and results of operations, or threaten our
ability to continue as a going concern. Additionally, we will be
required to make mandatory prepayments of principal to
HealthTronics, Inc. on the notes payable, related parties equal to
20% of the proceeds received through the issuance or sale of any
equity securities in cash or through the licensing of our patents
or other intellectual property rights.
A
variety of factors could impact our need to raise additional
capital, the timing of any required financings and the amount of
such financings. Factors that may cause our future capital
requirements to be greater than anticipated or could accelerate our
need for funds include, without limitation:
●
unanticipated
expenditures in research and development or manufacturing
activities;
●
delayed
market acceptance of any approved product;
●
unanticipated
expenditures in the acquisition and defense of intellectual
property rights;
●
the
failure to develop strategic alliances for the marketing of some of
our product candidates;
●
additional
inventory builds to adequately support the launch of new
products;
●
unforeseen
changes in healthcare reimbursement for procedures using any of our
approved products;
●
inability
to train a sufficient number of physicians to create a demand for
any of our approved products;
●
lack
of financial resources to adequately support our
operations;
●
difficulties
in maintaining commercial scale manufacturing capacity and
capability;
●
unforeseen
problems with our third party manufacturers, service providers or
specialty suppliers of certain raw materials;
●
unanticipated
difficulties in operating in international markets;
●
unanticipated
financial resources needed to respond to technological changes and
increased competition;
●
unforeseen
problems in attracting and retaining qualified
personnel;
●
the impact of the
Patient Protection and Affordable Care Act, as amended by the
Health Care and Education Affordability Reconciliation Act
(collectively the PPACA) on our operations;
●
the impact of
changes in U.S. health care law and policy on our
operations;
●
enactment
of new legislation or administrative regulations;
●
the
application to our business of new court decisions and regulatory
interpretations;
●
claims
that might be brought in excess of our insurance
coverage;
●
delays
in timing of receipt of required regulatory approvals;
●
the
failure to comply with regulatory guidelines; and
●
the
uncertainty in industry demand and patient wellness
behavior.
In
addition, although we have no present commitments or understandings
to do so, we may seek to expand our operations and product line
through acquisitions. Any acquisition would likely increase our
capital requirements.
Our product candidates may not be developed or commercialized
successfully.
Our
product candidates are based on a technology that has not been used
previously in the manner we propose and must compete with more
established treatments currently accepted as the standards of care.
Market acceptance of our products will largely depend on our
ability to demonstrate their relative safety, efficacy,
cost-effectiveness and ease of use.
We
are subject to risks that:
●
the
FDA or a foreign regulatory authority finds our product candidates
ineffective or unsafe;
●
we
do not receive necessary regulatory approvals;
●
the
regulatory review and approval process may take much longer than
anticipated, requiring additional time, effort and expense to
respond to regulatory comments and/or directives;
●
the
reimbursement for our products is difficult to obtain or is too
low, which can hinder the introduction and acceptance of our
products in the market;
●
we
are unable to get our product candidates in commercial quantities
at reasonable costs; and
●
the
patient and physician community does not accept our product
candidates.
In
addition, our product development program may be curtailed,
redirected, eliminated or delayed at any time for many reasons,
including:
●
adverse
or ambiguous results;
●
undesirable
side effects that delay or extend the trials;
●
the
inability to locate, recruit, qualify and retain a sufficient
number of clinical investigators or patients for our trials;
and
●
regulatory
delays or other regulatory actions.
We
cannot predict whether we will successfully develop and
commercialize our product candidates. If we fail to do so, we will
not be able to generate substantial revenues, if any.
The medical device/therapeutic product industries are highly
competitive and subject to rapid technological change. If our
competitors are better able to develop and market products that are
safer and more effective than any products we may develop, our
commercial opportunities will be reduced or
eliminated.
Our
success depends, in part, upon our ability to maintain a
competitive position in the development of technologies and
products. We face competition from established medical device,
pharmaceutical and biotechnology companies, as well as from
academic institutions, government agencies, and private and public
research institutions in the United States and abroad. Many of our
principal competitors have significantly greater financial
resources and expertise than we do in research and development,
manufacturing, pre-clinical testing, conducting clinical trials,
obtaining regulatory approvals and marketing approved products.
Smaller or early-stage companies may also prove to be significant
competitors, particularly through collaborative arrangements, or
mergers with, or acquisitions by, large and established companies,
or through the development of novel products and
technologies.
The
industry in which we operate has undergone, and we expect it to
continue to undergo, rapid and significant technological change,
and we expect competition to intensify as technological advances
are made. Our competitors may develop and commercialize
pharmaceutical, biotechnology or medical devices that are safer or
more effective, have fewer side effects or are less expensive than
any products that we may develop. We also compete with our
competitors in recruiting and retaining qualified scientific and
management personnel, in establishing clinical trial sites and
patient registration for clinical trials, and in acquiring
technologies complementary to our programs or advantageous to our
business.
If our products and product candidates do not gain market
acceptance among physicians, patients and the medical community, we
may be unable to generate significant revenues, if
any.
Even
if we obtain regulatory approval for our product candidates, they
may not gain market acceptance among physicians, healthcare payers,
patients and the medical community. Market acceptance will depend
on our ability to demonstrate the benefits of our approved products
in terms of safety, efficacy, convenience, ease of administration
and cost effectiveness. In addition, we believe market acceptance
depends on the effectiveness of our marketing strategy, the pricing
of our approved products and the reimbursement policies of
government and third party payers. Physicians may not utilize our
approved products for a variety of reasons and patients may
determine for any reason that our product is not useful to them. If
any of our approved products fail to achieve market acceptance, our
ability to generate revenues will be limited.
We may not successfully establish and maintain licensing and/or
partnership arrangements for our technology for non-medical uses,
which could adversely affect our ability to develop and
commercialize our non-medical technology.
Our
strategy for the development, testing, manufacturing, and
commercialization of our technology for non-medical uses generally
relies on establishing and maintaining collaborations with
licensors and other third parties. We may not be able to obtain,
maintain or expand these or other licenses and collaborations or
establish additional licensing and collaboration arrangements
necessary to develop and commercialize our product candidates. Even
if we are able to obtain, maintain or establish licensing or
collaboration arrangements, these arrangements may not be on
favorable terms and may contain provisions that will restrict our
ability to develop, test and market our product candidates. Any
failure to obtain, maintain or establish licensing or collaboration
arrangements on favorable terms could adversely affect our business
prospects, financial condition or ability to develop and
commercialize our technology for non-medical uses.
We
expect to rely at least in part on third party collaborators to
perform a number of activities relating to the development and
commercialization of our technology for non-medical uses, including
possibly the design and manufacture of product materials,
potentially the obtaining of regulatory or environmental approvals
and the marketing and distribution of any successfully developed
products. Our collaborators also may have or acquire rights to
control aspects of our product development programs. As a result,
we may not be able to conduct these programs in the manner or on
the time schedule we may contemplate. In addition, if any of these
collaborators withdraw support for our programs or product
candidates or otherwise impair their development, our business
could be negatively affected. To the extent we undertake any of
these activities internally, our expenses may
increase.
We currently purchase most of our product component materials from
single suppliers. If we are unable to obtain product component
materials and other products from our suppliers that we depend on
for our operations, or find suitable replacement suppliers, our
ability to deliver our products to market will likely be impeded,
which could have a material adverse effect on us.
We
depend on suppliers for product component materials and other
components that are subject to stringent regulatory requirements.
We currently purchase most of our product component materials from
single suppliers and the loss of any of these suppliers could
result in a disruption in our production. If this were to occur, it
may be difficult to arrange a replacement supplier because certain
of these materials may only be available from one or a limited
number of sources. Our suppliers may encounter problems during
manufacturing due to a variety of reasons, including failure to
follow specific protocols and procedures, failure to comply with
applicable regulations, equipment malfunction and environmental
factors. In addition, establishing additional or replacement
suppliers for these materials may take a substantial period of
time, as certain of these suppliers must be approved by regulatory
authorities.
If
we are unable to secure, on a timely basis, sufficient quantities
of the materials we depend on to manufacture our products, if we
encounter delays or contractual or other difficulties in our
relationships with these suppliers, or if we cannot find
replacement suppliers at an acceptable cost, then the manufacturing
of our products may be disrupted, which could increase our costs
and have a material adverse effect on our business and results of
operations.
We currently sell our products through three distributors whose
sales account for the majority of our revenues and accounts
receivable. Our business and results of operations could be
adversely affected by any business disruptions or credit or other
financial difficulties experienced by such
distributors.
A
majority of our revenues, and a majority of our accounts
receivable, are from three distributors. Three distributors
accounted for 8%, 38% and 24% of revenues for the year ended
December 31, 2017, and 69%, 17% and 0% of accounts receivable at
December 31, 2017. Two distributors accounted for 50% and 32% of
revenues for the year ended December 31, 2016, and 87% and 10% of
accounts receivable at December 31, 2016. At December 31, 2017, the
Company’s distributor in South Korea accounted for 69% of the
total outstanding accounts receivable. Due to the political climate
and uncertainty in South Korea, this distributor has been unable to
pay the Company in a timely manner. The Company has accounted for
38% of the total outstanding accounts receivable balance as a bad
debt reserve as of December 31, 2017. The Company continues to work
with the distributor representing 69% of the total accounts
receivable on a payment plan to get their account current by April
30, 2018. To the extent that our three distributors experience any
business disruptions or credit or other financial difficulties, our
revenues and the collectability of our accounts receivable could be
negatively impacted. If we are unable to establish, on a timely
basis, relationships with new distributors, our business and
results of operations could be negatively impacted.
We have entered into an agreement with companies owned by a current
board member and stockholder that could delay or prevent an
acquisition of our company and could result in the dilution of our
shareholders in the event of our change of control.
On
February 13, 2018, the Company entered into an Agreement for
Purchase and Sale, Limited Exclusive Distribution and Royalties,
and Servicing and Repairs with Premier Shockwave Wound Care, Inc.
(“PSWC”) and Premier Shockwave, Inc.
(“PS”), each of which is owned by A. Michael Stolarski,
a member of the Company’s board of directors and an existing
shareholder of the Company. Among other terms, the agreement
contains provisions whereby in the event of a change of control of
the Company (as defined in the agreement), the stockholders of PSWC
have the right and option to cause the Company to purchase all of
the stock of PSWC, and whereby the Company has the right and option
to purchase all issued and outstanding shares of PSWC, in each case
based upon certain defined purchase price provisions and other
terms. Such provision may have the effect of delaying or deterring
a change in control of us, and as a result could limit the
opportunity for our stockholders to receive a premium for their
shares of our common stock and could also affect the price that
some investors are willing to pay for our common stock. In
addition, in the event we do experience a change of control, such
provision may cause dilution of our existing shareholders in the
event that PSWC exercises its option to require the Company to
purchase all issued and outstanding shares of PSWC and the Company
finances some or all of such purchase price through equity
issuances.
The loss of our key management would likely hinder our ability to
execute our business plan.
As
a small company with seven employees, our success depends on the
continuing contributions of our management team and qualified
personnel. Our success depends in large part on our ability to
attract and retain highly qualified personnel. We face intense
competition in our hiring efforts from other pharmaceutical,
biotechnology and medical device companies, as well as from
universities and nonprofit research organizations, and we may have
to pay higher salaries to attract and retain qualified personnel.
The loss of one or more of these individuals, or our inability to
attract additional qualified personnel, could substantially impair
our ability to implement our business plan.
We face an inherent risk of liability in the event that the use or
misuse of our product candidates results in personal injury or
death.
The
use of our product candidates in clinical trials and the sale of
any approved products may expose us to product liability claims
which could result in financial loss. Our clinical and commercial
product liability insurance coverage may not be sufficient to cover
claims that may be made against us. In addition, we may not be able
to maintain insurance coverage at a reasonable cost, or in
sufficient amounts or scope, to protect us against losses. Any
claims against us, regardless of their merit, could severely harm
our financial condition, strain our management team and other
resources, and adversely impact or eliminate the prospects for
commercialization of the product candidate, or sale of the product,
which is the subject of any such claim. Although we do not promote
any off-label use, off-label uses of products are common and the
FDA does not regulate a physician’s choice of treatment.
Off-label uses of any product for which we obtain approval may
subject us to additional liability.
We are dependent on information technology and our systems and
infrastructure face certain risks, including from cybersecurity
breaches and data leakage.
We
rely to a large extent upon information technology systems to
operate our businesses, some of which are managed, hosted, provided
and/or used by third parties or their vendors. We collect, store
and transmit large amounts of confidential information, and we
deploy and operate an array of technical and procedural controls to
maintain the confidentiality and integrity of such confidential
information. A significant breakdown, invasion, corruption,
destruction or interruption of critical information technology
systems or infrastructure, by our workforce, others with authorized
access to our systems or unauthorized persons could negatively
impact our operations. The ever-increasing use and evolution of
technology, including cloud-based computing, creates opportunities
for the unintentional dissemination or intentional destruction of
confidential information stored in our or our third-party
providers’ systems, portable media or storage devices. We
could also experience a business interruption, theft of
confidential information or reputational damage from industrial
espionage attacks, malware or other cyber-attacks, which may
compromise our system infrastructure or lead to data leakage,
either internally or at our third-party providers. While we have
invested in the protection of data and information technology,
there can be no assurance that our efforts will prevent service
interruptions or security breaches. Any such interruption or breach
of our systems could adversely affect our business operations
and/or result in the loss of critical or sensitive confidential
information or intellectual property, and could result in
financial, legal, business and reputational harm to
us.
We generate a portion of our revenue internationally and are
subject to various risks relating to our international activities
which could adversely affect our operating results.
A
portion of our revenue comes from international sources, and we
anticipate that we will continue to expand our overseas operations.
Engaging in international business involves a number of
difficulties and risks, including:
●
required
compliance with existing and changing foreign healthcare and other
regulatory requirements and laws, such as those relating to patient
privacy or handling of bio-hazardous waste.
●
required
compliance with anti-bribery laws, data privacy requirements, labor
laws and anti-competition regulations.
●
export
or import restrictions.
●
various
reimbursement and insurance regimes.
●
laws
and business practices favoring local companies.
●
political
and economic instability.
●
potentially
adverse tax consequences, tariffs, customs charges, bureaucratic
requirements and other trade barriers.
●
foreign
exchange controls. and
●
difficulties
protecting or procuring intellectual property rights.
As
we expand internationally, our results of operations and cash flows
will become increasingly subject to fluctuations due to changes in
foreign currency exchange rates. Our expenses are generally
denominated in the currencies in which our operations are located,
which is in the United States. If the value of the U.S. dollar
increases relative to foreign currencies in the future, in the
absence of a corresponding change in local currency prices, our
future revenue could be adversely affected as we convert future
revenue from local currencies to U.S. dollars.
Provisions in our Articles of Incorporation, Bylaws and Nevada law
might decrease the chances of an acquisition.
Provisions
of our Articles of Incorporation and Bylaws and applicable
provisions of Nevada law may delay or discourage transactions
involving an actual or potential change in control or change in our
management, including transactions in which stockholders might
otherwise receive a premium for their shares, or transactions that
our stockholders might otherwise deem to be in their best
interests. Some of the following provisions in our Articles of
Incorporation and Bylaws that implement these are:
●
stockholders
may not vote by written consent;
●
advance
notice of business to be brought is required for a meeting of the
Company’s stockholders;
●
no
cumulative voting rights for the holders of common stock in the
election of directors; and
●
vacancies
in the board of directors may be filled by the affirmative vote of
a majority of directors then in office, even if less than a
quorum.
In
addition, Section 78.438 of the Nevada Revised Statutes prohibits a
publicly-held Nevada corporation from engaging in a business
combination with an interested stockholder (generally defined as a
person which together with its affiliates owns, or within the last
three years has owned, 10% of our voting stock, for a period of
three years after the date of the transaction in which the person
became an interested stockholder) unless the business combination
is approved in a prescribed manner. The existence of the foregoing
provisions and other potential anti-takeover measures could limit
the price that investors might be willing to pay in the future for
shares of our common stock. They could also deter potential
acquirers of our Company, thereby reducing the likelihood that you
could receive a premium for your common stock in an
acquisition.
Regulatory Risks
The results of our clinical trials may be insufficient to obtain
regulatory approval for our product candidates.
We
will only receive regulatory approval to commercialize a product
candidate if we can demonstrate to the satisfaction of the FDA or
the applicable foreign regulatory agency, in well designed and
conducted clinical trials, that the product candidate is safe and
effective. If we are unable to demonstrate that a product candidate
is safe and effective in advanced clinical trials involving large
numbers of patients, we will be unable to submit the necessary
application to receive regulatory approval to commercialize the
product candidate. We face risks that:
●
the
product candidate may not prove to be safe or
effective;
●
the
product candidate’s benefits may not outweigh its
risks;
●
the
results from advanced clinical trials may not confirm the positive
results from pre-clinical studies and early clinical
trials;
●
the
FDA or comparable foreign regulatory authorities may interpret data
from pre-clinical and clinical testing in different ways than us;
and
●
the
FDA or other regulatory agencies may require additional or expanded
trials and data.
We are subject to extensive governmental regulation, including the
requirement of FDA approval or clearance, before our product
candidates may be marketed.
The
process of obtaining FDA approval is lengthy, expensive and
uncertain, and we cannot be sure that our product candidates will
be approved in a timely fashion, or at all. If the FDA does not
approve or clear our product candidates in a timely fashion, or at
all, our business and financial condition would likely be adversely
affected. The FDA has determined that our technology and product
candidates constitute “medical devices”, and are thus
subject to review by the Center for Devices and Radiological
Health. However, we cannot be sure that the FDA will not select a
different center and/or legal authority for one or more of our
other product candidates, in which case applicable governmental
review requirements could vary in some respects and be more lengthy
and costly.
Both
before and after approval or clearance of our product candidates,
we and our product candidates, our suppliers and our contract
manufacturers are subject to extensive regulation by governmental
authorities in the United States and other countries. Failure to
comply with applicable requirements could result in, among other
things, any of the following actions:
●
fines
and other monetary penalties;
●
unanticipated
expenditures;
●
delays
in FDA approval and clearance, or FDA refusal to approve or clear a
product candidate;
●
product
recall or seizure;
●
interruption
of manufacturing or clinical trials;
●
operating
restrictions;
In
addition to the approval and clearance requirements, numerous other
regulatory requirements apply, both before and after approval or
clearance, to us and our products and product candidates, our
suppliers and contract manufacturers. These include requirements
related to the following:
●
reporting
to the FDA certain adverse experiences associated with the use of
the products; and
●
obtaining
additional approvals or clearances for certain modifications to the
products or their labeling or claims.
We
are also subject to inspection by the FDA and other international
regulatory bodies to determine our compliance with regulatory
requirements, as are our suppliers and contract manufacturers, and
we cannot be sure that the FDA and other international regulatory
bodies will not identify compliance issues that may disrupt
production or distribution or require substantial resources to
correct.
The
FDA’s requirements and international regulatory body
requirements may change and additional regulations may be
promulgated that could affect us, our product candidates, and our
suppliers and contract manufacturers. We cannot predict the
likelihood, nature or extent of government regulation that may
arise from future legislation or administrative action. There can
be no assurance that we will not be required to incur significant
costs to comply with such laws and regulations in the future, or
that such laws or regulations will not have a material adverse
effect upon our business.
Patients may discontinue their participation in our clinical
studies, which may negatively impact the results of these studies
and extend the timeline for completion of our development
programs.
Clinical
trials for our product candidates require sufficient patient
enrollment. We may not be able to enroll a sufficient number of
patients in a timely or cost-effective manner. Patients enrolled in
our clinical studies may discontinue their participation at any
time during the study as a result of a number of factors, including
withdrawing their consent or experiencing adverse clinical events,
which may or may not be judged to be related to our product
candidates under evaluation. If a large number of patients in a
study discontinue their participation in the study, the results
from that study may not be positive or may not support a filing for
regulatory approval of the product candidate.
In
addition, the time required to complete clinical trials is
dependent upon, among other factors, the rate of patient
enrollment. Patient enrollment is a function of many factors,
including the following:
●
the
size of the patient population;
●
the
nature of the clinical protocol requirements;
●
the
availability of other treatments or marketed therapies (whether
approved or experimental);
●
our
ability to recruit and manage clinical centers and associated
trials;
●
the
proximity of patients to clinical sites; and
●
the
patient eligibility criteria for the study.
We rely on third parties to conduct our clinical trials, and their
failure to perform their obligations in a timely or competent
manner may delay development and commercialization of our
device.
We
engage a clinical research organization (CRO) and other third party
vendors to assist in the conduct of our clinical trials. There are
numerous sources that are capable of providing these services.
However, we may face delays outside of our control if these parties
do not perform their obligations in a timely or competent fashion
or if we are forced to change service providers. Any third party
that we hire to conduct clinical trials may also provide services
to our competitors, which could compromise the performance of their
obligations to us. If we experience significant delays in the
progress of our clinical trials, the commercial prospects for the
product could be harmed and our ability to generate product
revenues would be delayed or prevented. Any failure of the CRO and
other third party vendors to successfully accomplish clinical trial
monitoring, data collection, safety monitoring and data management
and the other services they provide for us in a timely manner and
in compliance with regulatory requirements could have a material
adverse effect on our ability to complete clinical development of
our product and obtain regulatory approval. Problems with the
timeliness or quality of the work of the CRO may lead us to seek to
terminate the relationship and use an alternate service provider.
However, making such changes may be costly and may delay our
clinical trials, and contractual restrictions may make such a
change difficult or impossible. Additionally, it may be difficult
to find a replacement organization that can conduct our trials in
an acceptable manner and at an acceptable cost.
We may be required to suspend or discontinue clinical trials due to
unexpected side effects or other safety risks that could preclude
approval of our product candidates.
Our
clinical trials may be suspended at any time for a number of
reasons. For example, we may voluntarily suspend or terminate our
clinical trials if at any time we believe that they present an
unacceptable risk to the clinical trial patients. In addition, the
FDA or other regulatory agencies may order the temporary or
permanent discontinuation of our clinical trials at any time if
they believe that the clinical trials are not being conducted in
accordance with applicable regulatory requirements or that they
present an unacceptable safety risk to the clinical trial
patients.
Administering any
product candidate to humans may produce undesirable side effects.
These side effects could interrupt, delay or halt clinical trials
of our product candidates and could result in the FDA or other
regulatory authorities denying further development or approval of
our product candidates for any or all targeted indications.
Ultimately, some or all of our product candidates may prove to be
unsafe for human use. Moreover, we could be subject to significant
liability if any patient suffers, or appears to suffer, adverse
health effects as a result of participating in our clinical
trials.
Regulatory approval of our product candidates may be withdrawn at
any time.
After
regulatory approval has been obtained for medical device products,
the product and the manufacturer are subject to continual review,
including the review of adverse experiences and clinical results
that are reported after our products are made available to
patients, and there can be no assurance that such approval will not
be withdrawn or restricted. Regulators may also subject approvals
to restrictions or conditions or impose post-approval obligations
on the holders of these approvals, and the regulatory status of
such products may be jeopardized if such obligations are not
fulfilled. If post-approval studies are required, such studies may
involve significant time and expense.
The
manufacturing facilities we use to make any of our products will
also be subject to periodic review and inspection by the FDA or
other regulatory authorities, as applicable. The discovery of any
new or previously unknown problems with the product or facility may
result in restrictions on the product or facility, including
withdrawal of the product from the market. We will continue to be
subject to the FDA or other regulatory authority requirements, as
applicable, governing the labeling, packaging, storage,
advertising, promotion, recordkeeping, and submission of safety and
other post-market information for all of our product candidates,
even those that the FDA or other regulatory authority, as
applicable, had approved. If we fail to comply with applicable
continuing regulatory requirements, we may be subject to fines,
suspension or withdrawal of regulatory approval, product recalls
and seizures, operating restrictions and other adverse
consequences.
Federal regulatory reforms may adversely affect our ability to sell
our products profitably.
From
time to time, legislation is drafted and introduced in the United
States Congress that could significantly change the statutory
provisions governing the clearance or approval, manufacture and
marketing of a medical device. In addition, FDA regulations and
guidance are often revised or reinterpreted by the agency in ways
that may significantly affect our business and our products. It is
impossible to predict whether legislative changes will be enacted
or FDA regulations, guidance or interpretations changed, and what
the impact of such changes on us, if any, may be.
Failure to obtain regulatory approval in foreign jurisdictions will
prevent us from marketing our products abroad.
International
sales of our products and any of our product candidates that we
commercialize are subject to the regulatory requirements of each
country in which the products are sold. Accordingly, the
introduction of our product candidates in markets outside the
United States will be subject to regulatory approvals in those
jurisdictions. The regulatory review process varies from country to
country. Many countries impose product standards, packaging and
labeling requirements, and import restrictions on medical devices.
In addition, each country has its own tariff regulations, duties
and tax requirements. The approval by foreign government
authorities is unpredictable and uncertain and can be expensive.
Our ability to market our approved products could be substantially
limited due to delays in receipt of, or failure to receive, the
necessary approvals or clearances.
Prior
to marketing our products in any country outside the United States,
we must obtain marketing approval in that country. Approval and
other regulatory requirements vary by jurisdiction and differ from
the United States’ requirements. We may be required to
perform additional pre-clinical or clinical studies even if FDA
approval has been obtained.
If we fail to obtain an adequate level of reimbursement for our
approved products by third party payers, there may be no
commercially viable markets for our approved products or the
markets may be much smaller than expected.
The
availability and levels of reimbursement by governmental and other
third party payers affect the market for our approved products. The
efficacy, safety, performance and cost-effectiveness of our product
and product candidates, and of any competing products, will
determine the availability and level of reimbursement.
Reimbursement and healthcare payment systems in international
markets vary significantly by country and include both government
sponsored healthcare and private insurance. To obtain reimbursement
or pricing approval in some countries, we may be required to
produce clinical data, which may involve one or more clinical
trials, that compares the cost-effectiveness of our approved
products to other available therapies. We may not obtain
international reimbursement or pricing approvals in a timely
manner, if at all. Our failure to receive international
reimbursement or pricing approvals would negatively impact market
acceptance of our approved products in the international markets in
which those pricing approvals are sought.
We
believe that, in the future, reimbursement for any of our products
or product candidates may be subject to increased restrictions both
in the United States and in international markets. Future
legislation, regulation or reimbursement policies of third party
payers may adversely affect the demand for our products currently
under development and limit our ability to sell our products on a
profitable basis. In addition, third party payers continually
attempt to contain or reduce the costs of healthcare by challenging
the prices charged for healthcare products and services. If
reimbursement for our approved products is unavailable or limited
in scope or amount, or if pricing is set at unsatisfactory levels,
market acceptance of our approved products would be impaired and
our future revenues, if any, would be adversely
affected.
Uncertainty surrounding and future changes to healthcare law in the
United States may have a material adverse effect on
us.
The
healthcare regulatory environment in the United States is currently
subject to significant uncertainty and the industry may in the
future continue to experience fundamental change as a result of
regulatory reform. In March 2010, the former U.S. President signed
into law the Patient Protection and Affordable Care Act, as amended
by the Health Care and Education Affordability Reconciliation Act
(collectively the PPACA), which substantially changes the way
healthcare is financed by both governmental and private insurers,
encourages improvements in the quality of healthcare items and
services, and significantly impacts the biotechnology and medical
device industries. The PPACA includes, among other things, the
following measures:
●
a 2.3% excise
tax on any entity that manufactures or imports medical devices
offered for sale in the United States, with limited exceptions,
began in 2013 but a two year moratorium has been issued for sales
during 2016 and 2017, and new legislation was passed in January
2018 such that the tax will be delayed until January 1,
2020;
●
a new
Patient-Centered Outcomes Research Institute to oversee, identify
priorities and conduct comparative clinical effectiveness
research;
●
payment system
reforms including a national pilot program on payment bundling to
encourage hospitals, physicians and other providers to improve the
coordination, quality and efficiency of certain healthcare services
through bundled payment models;
●
an independent
payment advisory board that will submit recommendations to reduce
Medicare spending if projected Medicare spending exceeds a
specified growth rate; and
●
a new
abbreviated pathway for the licensure of biological products that
are demonstrated to be biosimilar or interchangeable with a
licensed biological product.
However, some of
the provisions of the PPACA have yet to be fully implemented and
certain provisions have been subject to judicial and Congressional
challenges. Furthermore, President Trump has vowed to repeal the
PPACA, and it is uncertain whether new legislation will be enacted
to replace the PPACA. On January 20, 2017, President Trump signed
an executive order stating that the administration intended to seek
prompt repeal of the healthcare reform law, and, pending repeal,
directed the U.S. Department of Health and Human Services and other
executive departments and agencies to take all steps necessary to
limit any fiscal or regulatory burdens of the healthcare reform
law. On October 12, 2017, President Trump signed another executive
order directing certain federal agencies to propose regulations or
guidelines to permit small businesses to form association health
plans, expand the availability of short-term, limited duration
insurance, and expand the use of health reimbursement arrangements,
which may circumvent some of the requirements for health insurance
mandated by the healthcare reform law. The U.S. Congress has also
made several attempts to repeal or modify the healthcare reform
law. In the coming years, there may continue to be additional
proposals relating to the reform of the United States healthcare
system. Certain of these proposals could limit the prices we are
able to charge for our products or the amounts of reimbursement
available for our products and could limit the acceptance and
availability of our products. The adoption of some or all of these
proposals could have a material adverse effect on our business,
results of operations and financial condition.
Additionally,
initiatives sponsored by government agencies, legislative bodies
and the private sector to limit the growth of healthcare costs,
including price regulation and competitive pricing, are ongoing in
the United States and other markets. We could experience an adverse
impact on our operating results due to increased pricing pressure
these markets. Governments, hospitals and other third party payors
could reduce the amount of approved reimbursement for our products
or deny coverage altogether. Reductions in reimbursement levels or
coverage or other cost-containment measures could adversely affect
our future operating results.
If we fail to comply with the United States Federal Anti-Kickback
Statute, False Claims Act and similar state laws, we could be
subject to criminal and civil penalties and exclusion from the
Medicare and Medicaid programs, which would have a material adverse
effect on our business and results of operations.
A
provision of the Social Security Act, commonly referred to as the
Federal Anti-Kickback Statute, prohibits the offer, payment,
solicitation or receipt of any form of remuneration in return for
referring, ordering, leasing, purchasing or arranging for, or
recommending the ordering, purchasing or leasing of, items or
services payable by Medicare, Medicaid or any other Federal
healthcare program. The Federal Anti-Kickback Statute is very broad
in scope and many of its provisions have not been uniformly or
definitively interpreted by existing case law or regulations. In
addition, most of the states have adopted laws similar to the
Federal Anti-Kickback Statute, and some of these laws are even
broader than the Federal Anti-Kickback Statute in that their
prohibitions are not limited to items or services paid for by
Federal healthcare programs, but instead apply regardless of the
source of payment. Violations of the Federal Anti-Kickback Statute
may result in substantial civil or criminal penalties and exclusion
from participation in Federal healthcare programs.
Our
operations may also implicate the False Claims Act. If we fail to
comply with federal and state documentation, coding and billing
rules, we could be subject to liability under the federal False
Claims Act, including criminal and/or civil penalties, loss of
licenses and exclusion from the Medicare and Medicaid programs. The
False Claims Act prohibits individuals and companies from knowingly
submitting false claims for payments to, or improperly retaining
overpayments from, the government.
All
of our financial relationships with healthcare providers and others
who provide products or services to Federal healthcare program
beneficiaries are potentially governed by the Federal Anti-Kickback
Statute, False Claims Act and similar state laws. We believe our
operations are in compliance with the Federal Anti-Kickback
Statute, False Claims Act and similar state laws. However, we
cannot be certain that we will not be subject to investigations or
litigation alleging violations of these laws, which could be
time-consuming and costly to us and could divert management’s
attention from operating our business, which in turn could have a
material adverse effect on our business. In addition, if our
arrangements were found to violate the Federal Anti-Kickback
Statute, False Claims Act or similar state laws, the consequences
of such violations would likely have a material adverse effect on
our business, results of operations and financial
condition.
Failure to comply with the HIPAA Privacy, Security and Breach
Notification Regulations, as such rules become applicable to our
business, may increase our operational costs.
The
HIPAA privacy and security regulations establish comprehensive
federal standards with respect to the uses and disclosures of PHI
by certain entities including health plans and health care
providers, and set standards to protect the confidentiality,
integrity and availability of electronic PHI. The regulations
establish a complex regulatory framework on a variety of subjects,
including, for example: the circumstances under which uses and
disclosures of PHI are permitted or required without a specific
authorization by the patient. a patient’s right to access,
amend and receive an accounting of certain disclosures of PHI. the
content of notices of privacy practices describing how PHI is used
and disclosed and individuals’ rights with respect to their
PHI. and implementation of administrative, technical and physical
safeguards to protect privacy and security of PHI. We anticipate
that, as we expand our dermaPACE business, we will in the future be
a covered entity under HIPAA. We intend to adopt policies and
procedures to comply with the Privacy Rule, the Security Rule and
the HIPAA statute as such regulations become applicable to our
business and as such regulations are in effect at such time;
however, there can be no assurance that our policies and procedures
will be adequate or will prevent all incidents of non-compliance
with such regulations.
The
privacy regulations establish a uniform federal standard but do not
supersede state laws that may be more stringent. Therefore, as we
expand our deramPACE business, we may also be required to comply
with both federal privacy and security regulations and varying
state privacy and security laws and regulations. The federal
privacy regulations restrict the ability to use or disclose certain
individually identifiable patient health information, without
patient authorization, for purposes other than payment, treatment
or health care operations (as defined by HIPAA), except for
disclosures for various public policy purposes and other permitted
purposes outlined in the privacy regulations.
The
HITECH Act and its implementing regulations also require healthcare
providers to notify affected individuals, the Secretary of the U.S.
Department of Health and Human Services, and in some cases, the
media, when PHI has been breached as defined under and following
the requirements of HIPAA. Many states have similar breach
notification laws. In the event of a breach, to the extent such
regulations are applicable to our business, we could incur
operational and financial costs related to remediation as well as
preparation and delivery of the notices, which costs could be
substantial. Additionally, HIPAA, the HITECH Act, and their
implementing regulations provide for significant civil fines,
criminal penalties, and other sanctions for failure to comply with
the privacy, security, and breach notification rules, including for
wrongful or impermissible use or disclosure of PHI. Although the
HIPAA statute and regulations do not expressly provide for a
private right of action for damages, private parties may also seek
damages under state laws for the wrongful or impermissible use or
disclosure of confidential health information or other private
personal information. Additionally, amendments to HIPAA provide
that the state Attorneys General may bring an action against a
covered entity for a violation of HIPAA. As we expand our business
such that federal and state laws regarding PHI and privacy apply to
our operations, any noncompliance with such regulations could have
a material adverse effect on our business, results of operations
and financial condition.
We face periodic reviews and billing audits from governmental and
private payors and these audits could have adverse results that may
negatively impact our business.
As
a result of our participation in the Medicare and Medicaid
programs, we are subject to various governmental reviews and audits
to verify our compliance with these programs and applicable laws
and regulations. We also are subject to audits under various
government programs in which third-party firms engaged by the
Centers for Medicare & Medicaid Services conduct extensive
reviews of claims data and medical and other records to identify
potential improper payments under the Medicare program. Private pay
sources also reserve the right to conduct audits. If billing errors
are identified in the sample of reviewed claims, the billing error
can be extrapolated to all claims filed which could result in a
larger overpayment than originally identified in the sample of
reviewed claims. Our costs to respond to and defend reviews and
audits may be significant and could have a material adverse effect
on our business, financial condition, results of operations and
cash flows. Moreover, an adverse review or audit could result
in:
●
required
refunding or retroactive adjustment of amounts we have been paid by
governmental or private payors.
●
state
or Federal agencies imposing fines, penalties and other sanctions
on us.
●
loss
of our right to participate in the Medicare program, state
programs, or one or more private payor networks. or
●
damage
to our business and reputation in various markets.
Any
one of these results could have a material adverse effect on our
business, financial condition, results of operations and cash
flows.
Product quality or performance issues may be discovered through
ongoing regulation by the FDA and by comparable international
agencies, as well as through our internal standard quality
process.
The
medical device industry is subject to substantial regulation by the
FDA and by comparable international agencies. In addition to
requiring clearance or approval to market new or improved devices,
we are subject to ongoing regulation as a device manufacturer.
Governmental regulations cover many aspects of our operations,
including quality systems, marketing and device reporting. As a
result, we continually collect and analyze information about our
product quality and product performance through field observations,
customer feedback and other quality metrics. If we fail to comply
with applicable regulations or if post market safety issues arise,
we could be subject to enforcement sanctions, our promotional
practices may be restricted, and our marketed products could be
subject to recall or otherwise impacted. Each of these potential
actions could result in a material adverse effect on our business,
operating results and financial condition.
The use of hazardous materials in our operations may subject us to
environmental claims or liability.
We
conduct research and development and manufacturing operations in
our facility. Our research and development process may, at times,
involve the controlled use of hazardous materials and chemicals. We
may conduct experiments in which we may use small quantities of
chemicals, including those that are corrosive, toxic and flammable.
The risk of accidental injury or contamination from these materials
cannot be eliminated. We do not maintain a separate insurance
policy for these types of risks. In the event of an accident or
environmental discharge or contamination, we may be held liable for
any resulting damages, and any liability could exceed our
resources. We are subject to Federal, state and local laws and
regulations governing the use, storage, handling and disposal of
these materials and specified waste products. The cost of
compliance with these laws and regulations could be
significant.
Risks Related to Intellectual Property
The protection of our intellectual property is critical to our
success and any failure on our part to adequately protect those
rights could materially adversely affect our business.
Our
commercial success depends to a significant degree on our ability
to:
●
obtain
and/or maintain protection for our product candidates under the
patent laws of the United States and other countries;
●
defend
and enforce our patents once obtained;
●
obtain
and/or maintain appropriate licenses to patents, patent
applications or other proprietary rights held by others with
respect to our technology, both in the United States and other
countries;
●
maintain
trade secrets and other intellectual property rights relating to
our product candidates; and
●
operate
without infringing upon the patents, trademarks, copyrights and
proprietary rights of third parties.
The
degree of intellectual property protection for our technology is
uncertain, and only limited intellectual property protection may be
available for our product candidates, which may prevent us from
gaining or keeping any competitive advantage against our
competitors. Although we believe the patents that we own or
license, and the patent applications that we own, generally provide
us a competitive advantage, the patent positions of biotechnology,
biopharmaceutical and medical device companies are generally highly
uncertain, involve complex legal and factual questions and have
been the subject of much litigation. Neither the United States
Patent & Trademark Office nor the courts have a consistent
policy regarding the breadth of claims allowed or the degree of
protection afforded under many biotechnology patents. Even if
issued, patents may be challenged, narrowed, invalidated or
circumvented, which could limit our ability to stop competitors
from marketing similar products or limit the length of term of
patent protection we may have for our products. Further, a court or
other government agency could interpret our patents in a way such
that the patents do not adequately cover our current or future
product candidates. Changes in either patent laws or in
interpretations of patent laws in the United States and other
countries may diminish the value of our intellectual property or
narrow the scope of our patent protection.
We
also rely upon trade secrets and unpatented proprietary know-how
and continuing technological innovation in developing our products,
especially where we do not believe patent protection is appropriate
or obtainable. We seek to protect this intellectual property, in
part, by generally requiring our employees, consultants, and
current and prospective business partners to enter into
confidentiality agreements in connection with their employment,
consulting or advisory relationships with us, where appropriate. We
also require our employees, consultants, researchers, and advisors
who we expect to work on our products and product candidates to
agree to disclose and assign to us all inventions conceived during
the work day, developed using our property or which relate to our
business. We may lack the financial or other resources to
successfully monitor and detect, or to enforce our rights in
respect of, infringement of our rights or breaches of these
confidentiality agreements. In the case of any such undetected or
unchallenged infringements or breaches, these confidentiality
agreements may not provide us with meaningful protection of our
trade secrets and unpatented proprietary know-how or adequate
remedies. In addition, others may independently develop technology
that is similar or equivalent to our trade secrets or know-how. If
any of our trade secrets, unpatented know-how or other confidential
or proprietary information is divulged to third parties, including
our competitors, our competitive position in the marketplace could
be harmed and our ability to sell our products successfully could
be severely compromised. Enforcing a claim that a party illegally
obtained and is using trade secrets that have been licensed to us
or that we own is also difficult, expensive and time consuming, and
the outcome is unpredictable. In addition, courts outside the
United States may be less willing to protect trade secrets. Costly
and time consuming litigation could be necessary to seek to enforce
and determine the scope of our proprietary rights, and failure to
obtain or maintain trade secret protection could have a material
adverse effect on our business. Moreover, some of our academic
institution licensees, evaluators, collaborators and scientific
advisors have rights to publish data and information to which we
have rights. If we cannot maintain the confidentiality of our
technologies and other confidential information in connection with
our collaborations, our ability to protect our proprietary
information or obtain patent protection in the future may be
impaired, which could have a material adverse effect on our
business.
In
particular, we cannot assure you that:
●
we
or the owners or other inventors of the patents that we own or that
have been licensed to us, or that may be issued or licensed to us
in the future, were the first to file patent applications or to
invent the subject matter claimed in patent applications relating
to the technologies upon which we rely;
●
others
will not independently develop similar or alternative technologies
or duplicate any of our technologies;
●
any
of our patent applications will result in issued
patents;
●
the
patents and patent applications that we own or that have been
licensed to us, or that may be issued or licensed to us in the
future, will provide a basis for commercially viable products or
will provide us with any competitive advantages, or will not be
challenged by third parties;
●
the
patents and patent applications that have been licensed to us are
valid and enforceable;
●
we
will develop additional proprietary technologies that are
patentable;
●
we
will be successful in enforcing the patents that we own or license
and any patents that may be issued or licensed to us in the future
against third parties;
●
the
patents of third parties will not have an adverse effect on our
ability to do business; or
●
our
trade secrets and proprietary rights will remain
confidential.
Accordingly,
we may fail to secure meaningful patent protection relating to any
of our existing or future product candidates or discoveries despite
the expenditure of considerable resources. Further, there may be
widespread patent infringement in countries in which we may seek
patent protection, including countries in Europe and Asia, which
may instigate expensive and time consuming litigation that could
adversely affect the scope of our patent protection. In addition,
others may attempt to commercialize products similar to our product
candidates in countries where we do not have adequate patent
protection. Failure to obtain adequate patent protection for our
product candidates, or the failure by particular countries to
enforce patent laws or allow prosecution for alleged patent
infringement, may impair our ability to be competitive. The
availability of infringing products in markets where we have patent
protection, or the availability of competing products in markets
where we do not have adequate patent protection, could erode the
market for our product candidates, negatively impact the prices we
can charge for our product candidates, and harm our reputation if
infringing or competing products are manufactured to inferior
standards.
Patent applications owned by us or licensed to us may not result in
issued patents, and our competitors may commercialize the
discoveries we attempt to patent.
The
patent applications that we own and that have been licensed to us,
and any future patent applications that we may own or that may be
licensed to us, may not result in the issuance of any patents. The
standards that the United States Patent & Trademark Office and
foreign patent agencies use to grant patents are not always applied
predictably or uniformly and can change. Consequently, we cannot be
certain as to the type and scope of patent claims to which we may
in the future be entitled under our license agreements or that may
be issued to us in the future. These applications may not be
sufficient to meet the statutory requirements for patentability
and, therefore, may not result in enforceable patents covering the
product candidates we want to commercialize. Further, patent
applications in the United States that are not filed in other
countries may not be published or generally are not published until
at least 18 months after they are first filed, and patent
applications in certain foreign countries generally are not
published until many months after they are filed. Scientific and
patent publication often occurs long after the date of the
scientific developments disclosed in those publications. As a
result, we cannot be certain that we will be the first creator of
inventions covered by our patents or applications, or the first to
file such patent applications. As a result, our issued patents and
our patent applications could become subject to challenge by third
parties that created such inventions or filed patent applications
before us or our licensors, resulting in, among other things,
interference proceedings in the United States Patent &
Trademark Office to determine priority of discovery or invention.
Interference proceedings, if resolved adversely to us, could result
in the loss of or significant limitations on patent protection for
our products or technologies. Even in the absence of interference
proceedings, patent applications now pending or in the future filed
by third parties may prevail over the patent applications that may
be owned by us or licensed to us or that we may file in the future,
or may result in patents that issue alongside patents issued to us
or our licensors or that may be issued or licensed to us in the
future, leading to uncertainty over the scope of the patents owned
by us or licensed to us or that may in the future be owned by us or
impede our freedom to practice the claimed inventions.
Our patents may not be valid or enforceable and may be challenged
by third parties.
We
cannot assure you that the patents that have been issued or
licensed to us would be held valid by a court or administrative
body or that we would be able to successfully enforce our patents
against infringers, including our competitors. The issuance of a
patent is not conclusive as to its validity or enforceability, and
the validity and enforceability of a patent is susceptible to
challenge on numerous legal grounds, including the possibility of
reexamination proceedings brought by third parties in the United
States Patent & Trademark Office against issued patents and
similar validity challenges under foreign patent laws. Challenges
raised in patent infringement litigation brought by us or against
us may result in determinations that patents that have been issued
to us or licensed to us or any patents that may be issued to us or
our licensors in the future are invalid, unenforceable or otherwise
subject to limitations. In the event of any such determinations,
third parties may be able to use the discoveries or technologies
claimed in these patents without paying licensing fees or royalties
to us, which could significantly diminish the value of our
intellectual property and our competitive advantage. Even if our
patents are held to be enforceable, others may be able to design
around our patents or develop products similar to our products that
are not within the scope of any of our patents.
In
addition, enforcing the patents that we own or license and any
patents that may be issued to us in the future against third
parties may require significant expenditures regardless of the
outcome of such efforts. Our inability to enforce our patents
against infringers and competitors may impair our ability to be
competitive and could have a material adverse effect on our
business.
Issued patents and patent licenses may not provide us with any
competitive advantage or provide meaningful protection against
competitors.
The
discoveries or technologies covered by issued patents we own or
license may not have any value or provide us with a competitive
advantage, and many of these discoveries or technologies may not be
applicable to our product candidates at all. We have devoted
limited resources to identifying competing technologies that may
have a competitive advantage relative to ours, especially those
competing technologies that are not perceived as infringing on our
intellectual property rights. In addition, the standards that
courts use to interpret and enforce patent rights are not always
applied predictably or uniformly and can change, particularly as
new technologies develop. Consequently, we cannot be certain as to
how much protection, if any, will be afforded by these patents with
respect to our products if we, our licensees or our licensors
attempt to enforce these patent rights and those rights are
challenged in court.
The
existence of third party patent applications and patents could
significantly limit our ability to obtain meaningful patent
protection. If patents containing competitive or conflicting claims
are issued to third parties, we may be enjoined from pursuing
research, development or commercialization of product candidates or
may be required to obtain licenses, if available, to these patents
or to develop or obtain alternative technology. If another party
controls patents or patent applications covering our product
candidates, we may not be able to obtain the rights we need to
those patents or patent applications in order to commercialize our
product candidates or we may be required to pay royalties, which
could be substantial, to obtain licenses to use those patents or
patent applications.
In
addition, issued patents may not provide commercially meaningful
protection against competitors. Other parties may seek and/or be
able to duplicate, design around or independently develop products
having effects similar or identical to our patented product
candidates that are not within the scope of our
patents.
Limitations
on patent protection in some countries outside the United States,
and the differences in what constitutes patentable subject matter
in these countries, may limit the protection we have under patents
issued outside of the United States. We do not have patent
protection for our product candidates in a number of our target
markets. The failure to obtain adequate patent protection for our
product candidates in any country would impair our ability to be
commercially competitive in that country.
The ability to market the products we develop is subject to the
intellectual property rights of third parties.
The
biotechnology, biopharmaceutical and medical device industries are
characterized by a large number of patents and patent filings and
frequent litigation based on allegations of patent infringement.
Competitors may have filed patent applications or have been issued
patents and may obtain additional patents and proprietary rights
related to products or processes that compete with or are similar
to ours. We may not be aware of all of the patents potentially
adverse to our interests that may have been issued to others.
Because patent applications can take many years to issue, there may
be currently pending applications, unknown to us, which may later
result in issued patents that our product candidates or proprietary
technologies may infringe. Third parties may claim that our
products or related technologies infringe their patents or may
claim that the products of our suppliers, manufacturers or contract
service providers that produce our devices infringe on their
intellectual property. Further, we, our licensees or our licensors,
may need to participate in interference, opposition, protest,
reexamination or other potentially adverse proceedings in the
United States Patent & Trademark Office or in similar agencies
of foreign governments with regards to our patents, patent
applications, and intellectual property rights. In addition, we,
our licensees or our licensors may need to initiate suits to
protect our intellectual property rights.
Litigation or any
other proceeding relating to intellectual property rights, even if
resolved in our favor, may cause us to incur significant expenses,
divert the attention of our management and key personnel from other
business concerns and, in certain cases, result in substantial
additional expenses to license technologies from third parties.
Some of our competitors may be able to sustain the costs of complex
patent litigation more effectively than we can because they have
substantially greater resources. An unfavorable outcome in any
patent infringement suit or other adverse intellectual property
proceeding could require us to pay substantial damages, including
possible treble damages and attorneys’ fees, cease using our
technology or developing or marketing our products, or require us
to seek licenses, if available, of the disputed rights from other
parties and potentially make significant payments to those parties.
There is no guarantee that any prevailing party would offer us a
license or that we could acquire any license made available to us
on commercially acceptable terms. Even if we are able to obtain
rights to a third party’s patented intellectual property,
those rights may be nonexclusive and, therefore, our competitors
may obtain access to the same intellectual property. Ultimately, we
may be unable to commercialize our product candidates or may have
to cease some of our business operations as a result of patent
infringement claims, which could materially harm our business. We
cannot guarantee that our products or technologies will not
conflict with the intellectual property rights of
others.
If we
need to redesign our products to avoid third party patents, we may
suffer significant regulatory delays associated with conducting
additional clinical studies or submitting technical, clinical,
manufacturing or other information related to any redesigned
product and, ultimately, in obtaining regulatory approval. Further,
any such redesigns may result in less effective and/or less
commercially desirable products, if the redesigns are possible at
all.
Additionally, any
involvement in litigation in which we, our licensees or our
licensors are accused of infringement may result in negative
publicity about us or our products, injure our relations with any
then-current or prospective customers and marketing partners, and
cause delays in the commercialization of our products.
Risks Related to our Common Stock
Our stock price is volatile.
The
market price of our common stock is volatile and could fluctuate
widely in response to various factors, many of which are beyond our
control, including the following:
●
our
ability to obtain additional financing and, if available, the terms
and conditions of the financing;
●
changes
in the timing of on-going clinical trial enrollment, the results of
our clinical trials and regulatory approvals for our product
candidates or failure to obtain such regulatory
approvals;
●
changes
in our industry;
●
additions
or departures of key personnel;
●
sales
of our common stock;
●
our
ability to execute our business plan;
●
operating
results that fall below expectations;
●
period-to-period
fluctuations in our operating results;
●
new
regulatory requirements and changes in the existing regulatory
environment; and
●
general
economic conditions and other external factors.
In
addition, the securities markets have from time to time experienced
significant price and volume fluctuations that are unrelated to the
operating performance of particular companies. These market
fluctuations may also materially and adversely affect the market
price of our common stock.
There is currently a limited trading market for our common stock
and we cannot predict how liquid the market might
become.
To
date, there has been a limited trading market for our common stock
and we cannot predict how liquid the market for our common stock
might become. Our common stock is quoted on the Over-the-Counter
market (OTCQB), which is an inter-dealer market that provides
significantly less liquidity than the New York Stock Exchange or
the NASDAQ Stock Market. The quotation of our common stock on the
OTCQB does not assure that a meaningful, consistent and liquid
trading market exists. The market price for our common stock is
subject to volatility and holders of our common stock may be unable
to resell their shares at or near their original purchase price, or
at any price. In the absence of an active trading
market:
●
investors
may have difficulty buying and selling, or obtaining market
quotations for our common stock;
●
market
visibility for our common stock may be limited; and
●
a
lack of visibility for our common stock may have a depressive
effect on the market for our common stock.
Trading for our common stock is limited under the SEC’s penny
stock regulations, which has an adverse effect on the liquidity of
our common stock.
The
trading price of our common stock is less than $5.00 per share and,
as a result, our common stock is considered a “penny
stock,” and trading in our common stock is subject to the
requirements of Rule 15g-9 under the Securities Exchange Act of
1934, as amended (the Exchange Act). Under this rule,
broker-dealers who recommend low-priced securities to persons other
than established customers and accredited investors must satisfy
special sales practice requirements. Generally, the broker-dealer
must make an individualized written suitability determination for
the purchaser and receive the purchaser’s written consent
prior to the transaction.
Regulations of the Securities and Exchange
Commission (the “SEC”) also require additional disclosure in
connection with any trades involving a “penny stock,”
including the delivery, prior to any penny stock transaction, of a
disclosure schedule explaining the penny stock market and its
associated risks. These requirements severely limit the liquidity
of securities in the secondary market because only a few brokers or
dealers are likely to undertake these compliance activities.
Compliance with these requirements may make it more difficult for
holders of our Common Stock to resell their shares to third parties
or to otherwise dispose of them in the market.
As an issuer of “penny stock”, the protection provided
by the federal securities laws relating to forward looking
statements does not apply to us.
Although federal
securities laws provide a safe harbor for forward-looking
statements made by a public company that files reports under the
federal securities laws, this safe harbor is not available to
issuers of penny stocks. As a result, we will not have the benefit
of this safe harbor protection in the event of any legal action
based upon a claim that the material provided by us contained a
material misstatement of fact or was misleading in any material
respect because of our failure to include any statements necessary
to make the statements not misleading. Such an action could hurt
our financial condition.
We have not paid dividends in the past and do not expect to pay
dividends in the future. Any return on investment may be limited to
the value of our common stock.
We
have never paid cash dividends on our common stock and do not
anticipate doing so in the foreseeable future. The payment of
dividends on our common stock will depend on earnings, financial
condition and other business and economic factors affecting us at
such time as our board of directors may consider relevant. If we do
not pay dividends, our common stock may be less valuable because a
return on your investment will only occur if our stock price
appreciates.
The rights of the holders of common stock may be impaired by the
potential issuance of preferred stock.
Our
board of directors has the right, without stockholder approval, to
issue preferred stock with voting, dividend, conversion,
liquidation or other rights which could adversely affect the voting
power and equity interest of the holders of common stock, which
could be issued with the right to more than one vote per share, and
could be utilized as a method of discouraging, delaying or
preventing a change of control. The possible negative impact on
takeover attempts could adversely affect the price of our common
stock.
On
January 12, 2016, the Company filed a Certificate of Designation of
Preferences, Right and Limitations of Series B Convertible
Preferred Stock of the Company with the Nevada Secretary of State
which amended our Articles of Incorporation to designate 293 shares
of our preferred stock as Series B Convertible Preferred Stock. The
holders of Series B Convertible Preferred Stock will participate on
an equal basis per-share with holders of our common stock in any
distribution upon winding up, dissolution, or liquidation. Holders
of Series B Convertible Preferred Stock are entitled to convert
each share of Series B Preferred Stock into 2,000 shares of common
stock. Holders of the Series B Preferred Stock are entitled to vote
on all matters affecting the holders of the common stock of the
Company on an “as converted” basis, provided that the
holder of such Series B Preferred Stock does not hold in excess of
9.99% of our common stock at the time of measurement.
Although
we have no present intention to issue any additional shares of
preferred stock or to create any additional series of preferred
stock, we may issue such shares in the future.
We have never held an annual meeting for the election of
directors.
Pursuant
to the provisions of the Nevada Revised Statutes (the
“NRS”), directors are to be elected at the annual
meeting of the stockholders. Pursuant to the NRS and our
bylaws, our board of directors is granted the authority to fix the
date, time and place for annual stockholder meetings. No date, time
or place has yet been fixed by our board for the holding of an
annual stockholder meeting. Pursuant to the NRS and our bylaws,
each of our directors holds office after the expiration of his term
until a successor is elected and qualified, or until the director
resigns or is removed. Under the provisions of the NRS, if an
election of our directors has not been made by our stockholders
within 18 months of the last such election, then an application may
be made to the Nevada district court by stockholders holding a
minimum of 15% of our outstanding stockholder voting power for an
order for the election of directors in the manner provided in the
NRS.
We have not sought an advisory stockholder vote to approve the
compensation of our named executive officers.
Rule
14a-21 under the Exchange Act requires us to seek a separate
stockholder advisory vote at our annual meeting at which
directors are elected to approve the compensation of our named
executive officers, not less frequently than once every three years
(say-on-pay vote), and, at least once every six years, to seek a
separate stockholder advisory vote on the frequency with which we
will submit advisory say-on-pay votes to our stockholders
(say-on-frequency vote). In 2013, the year in which Rule 14a-21
became applicable to smaller reporting companies, and in 2014, we
did not submit to our stockholders a say-on-pay vote to approve an
advisory resolution regarding our compensation program for our
named executive officers, or a say-on-frequency vote. Consequently,
the board of directors has not considered the outcome of our
say-on-pay vote results when determining future compensation
policies and pay levels for our named executive
officers.
CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS
This
prospectus, including the sections titled ‘‘Prospectus
Summary,’’ ‘‘Risk Factors,’’
‘‘Management’s Discussion and Analysis of
Financial Condition and Results of Operations’’ and
‘‘Business,’’ contains forward-looking
statements within the meaning of the Private Securities Litigation
Reform Act of 1995 and Section 27A of the Securities Act of
1933. Statements in this prospectus that are not historical facts
are hereby identified as ‘‘forward-looking
statements’’ for the purpose of the safe harbor
provided by Section 21E of the Exchange Act and Section 27A of the
Securities Act of 1933, as amended (the “Securities
Act”). Forward-looking statements convey our current
expectations or forecasts of future events. All statements in this
prospectus, including those made by the management of the Company,
other than statements of historical fact, are forward-looking
statements. Examples of forward-looking statements include
statements regarding the Company’s future financial results,
operating results, business strategies, projected costs, products,
competitive positions, management’s plans and objectives for
future operations, and industry trends. These forward-looking
statements are based on management’s estimates, projections
and assumptions as of the date hereof and include the assumptions
that underlie such statements. Forward-looking statements may
contain words such as “may,” “will,”
“should,” “could,” “would,”
“expect,” “plan,” “anticipate,”
“believe,” “estimate,”
“predict,” “potential” and
“continue,” the negative of these terms, or other
comparable terminology. These forward-looking statements include,
among other things, statements about:
●
market acceptance
of and demand for dermaPACE and our product
candidates;
●
regulatory actions
that could adversely affect the price of or demand for our approved
products;
●
our intellectual
property portfolio;
●
our marketing and
manufacturing capacity and strategy;
●
estimates regarding
our capital requirements, and anticipated timing of the need for
additional funds;
●
product liability
claims;
●
economic conditions
that could adversely affect the level of demand for our
products;
●
timing of clinical
studies and eventual FDA approval of our products;
●
the competitive
environment.
Any or
all of our forward-looking statements in this prospectus may turn
out to be inaccurate. We have based these forward-looking
statements largely on our current expectations and projections
about future events and financial trends that we believe may affect
our financial condition, results of operations, business strategy
and financial needs. They may be affected by inaccurate assumptions
we might make or by known or unknown risks and uncertainties,
including the risks, uncertainties and assumptions described in the
section titled ‘‘Risk Factors.’’ In light
of these risks, uncertainties and assumptions, the forward-looking
events and circumstances discussed in this prospectus may not occur
as contemplated, and actual results could differ materially from
those anticipated or implied by the forward-looking
statements.
You
should read this prospectus and the registration statement of which
this prospectus is a part completely and with the understanding
that our actual future results may be materially different from
what we expect. We qualify all of the forward-looking statements in
this prospectus by these cautionary statements.
You
should not unduly rely on these forward-looking statements, which
speak only as of the date of this prospectus. Unless required by
law, we undertake no obligation to publicly update or revise any
forward-looking statements to reflect new information or future
events or otherwise. You should, however, review the factors and
risks we describe in the reports we will file from time to time
with the SEC after the date of this prospectus.
USE OF PROCEEDS
This
prospectus relates to (1) shares of our Common Stock that may be
offered and sold from time to time by the selling stockholders who
will receive all of the proceeds from the sale of the shares and
(2) shares issuable upon the exercise of warrants. We will not
receive any proceeds from the sale of shares of Common Stock by
selling stockholders in this offering, but we may receive cash for
the warrant exercise, which if all such warrants are exercised,
would be approximately $4,969,080. Proceeds, if any, received
from the exercise of such warrants, would be used for working
capital purposes.
We will
bear all expenses of registration incurred in connection with this
offering, but all commissions, selling and other expenses incurred
by the selling stockholders to underwriters, agents, brokers and
dealers will be borne by them. We estimate that our expenses
in connection with the filing of the registration statement of
which this prospectus is a part will be approximately
$43,770.
SELLING STOCKHOLDERS
Description of Transactions Related to Securities Initially
Registered Herewith:
Registration of Restricted Stock Acquired in Private Transactions
from the Company Over Three Years Ago
The
Company is registering for the first time 241,182 shares of
restricted Common Stock owned by A. Michael Stolarski acquired in
private transactions from the Company over three years
ago.
August 2016 Private Placement
On
August 24, 2016, the Company entered into a Securities Purchase
Agreement with certain “accredited investors” (as that
term is defined in the Commission’s Regulation D) (the
“Purchasers”) for the issuance of an aggregate
total 28,300,001 shares of the Company’s common stock,
par value $0.001 per share (the “Common Stock”) for an
aggregate total purchase price of $1,698,000. The Company intends
to use the proceeds from the private placement for working capital
and general corporate purposes.
In
addition, the Company, in connection with the private placement,
issued to the Purchasers an aggregate total of 28,300,001
warrants (the “Class L Warrants”) to purchase shares of
Common Stock at an exercise price of $0.08 per warrant. Each Class
L Warrant represents the right to purchase one share of Common
Stock. The warrants vested upon issuance and expire on March 17,
2019.
Pursuant to the
terms of a Registration Rights Agreement that the Company entered
with the Purchasers in connection with the private placement, the
Company is required to file a registration statement or
registration statements with the Commission that cover the resale
by the Purchasers in the private placement of the shares of Common
Stock and the shares of Common Stock issuable upon exercise of the
Class L Warrants. The failure on the part of the Company to satisfy
certain deadlines described in the Registration Rights Agreement
may subject the Company to payment of certain monetary
penalties.
Anthony
M. Stolarski, a member of our board of directors and an existing
shareholder of the Company and Michael Nemelka, the brother of a
member of our board of directors and an existing shareholder of the
Company, were purchasers in this private placement.
At the
closing of the private placement, we paid WestPark Capital, Inc.,
the placement agent for the private placement, a fee of (i) ten
percent (10%) of the aggregate purchase price of the securities
sold in the private placement and (ii) warrants to purchase ten
percent (10%) of the number of shares sold in the private
placement. Accordingly, the Placement Agent was issued warrants to
purchase 2,830,000 shares of Common Stock at an exercise price
of $0.08 per share.
In a
cashless exercise, the Purchasers exercised 1,683,333, and the
Placement Agent exercised 990,500 Class L Warrants to purchase
shares of Common Stock at an exercise price of $0.08 per share and
subsequently sold such shares pursuant to Rule 144 and Section
3(a)(9); therefore, such shares are not being registered hereunder
and are not reflected in the fee table, prospectus cover or Exhibit
5.1 hereto. The total shares being registered hereunder related to
this August 2016 Private Placement are (1) 28,300,001 shares of
Common Stock, (2) 26,616,668 shares of Common Stock underlying the
Class L Warrants and (3) 1,839,500 shares of Common Stock
underlying the Class L Warrants that were issued to the Placment
Agent.
Warrants issued for consulting
services
The
Company is also registering the issuance by the Company of common
stock upon exercise of certain warrants that were provided to
service providers in consideration of consulting
services.
In
June 2016, the Company issued 500,000 warrants to purchase shares
of Common Stock at an exercise price of $0.08 per warrant to
Millennium Park Capital LLC. Each Class L Warrant represents
the right to purchase one share of Common Stock. The warrants
vested upon issuance and expire March 17, 2019. In August
2016, the Company issued 2,140,000 warrants to purchase shares of
Common Stock at an exercise price of $0.08 per warrant to
Millennium Park Capital LLC. Each Class L Warrant represents
the right to purchase one share of Common Stock. The warrants
vested upon issuance and expire March 17, 2019.
The
issuance of the warrants was made pursuant to the exemption from
registration provided by Section 4(a)(2) of the Act and Rule 506 of
Regulation D thereunder. The Company did not utilize any form
of general solicitation or general advertising in connection with
the issuance.
Description of Transactions Related to Securities Previously
Registered Under File Nos. 333-208676 and 333-195263:
Series A Warrants
On
March 17, 2014, we completed a private placement to ten
institutional and individual accredited investors for the issuance
of an aggregate total of 6,210,000 shares of Common Stock and 6,175
shares of Series A Convertible Preferred Stock for an aggregate
total purchase price of $9,280,000. Each share of Series A
Convertible Preferred Stock is convertible into 2,000 shares of
Common Stock at the option of the holder. The net proceeds received
by the Company were $8,562,500, net of offering costs of
$717,500.
As part
of the private placement, the investors were issued an aggregate
total of 23,200,000 Series A Warrants to purchase shares of Common
Stock at an exercise price of $0.50 per share. The warrants vested
upon issuance and expire after five years. In addition, the
investors were issued an aggregate total of 13,920,000 Series B
Warrants to purchase shares of Common Stock at an exercise price of
$1.50 per share. The warrants vested upon issuance and expire after
one year. For each of the warrants, the holder will be able
to exercise the warrant on a cashless basis, if at the time of
exercise, a registration statement covering the shares of our
Common Stock underlying such warrants is not
effective.
There
are currently 1,155,682 Series A Warrants outstanding as of the
filing of this prospectus at an exercise price of $0.0334 per
share.
Series A Warrant Conversion
On
January 13, 2016, the Company entered into an Exchange Agreement
(the “Exchange Agreement”) with certain beneficial
owners (the “Investors”) of Series A warrants (the
“Warrants”) to purchase shares of the Company’s
common stock, $0.001 par value per share (the “Common
Stock”), pursuant to which the Investors exchanged (the
“Exchange”) all of their respective Warrants for either
(i) shares of Common Stock or (ii) shares of Common Stock and
shares of the Company’s Series B Convertible Preferred Stock,
$0.001 par value (the “Preferred Stock”).
The
Exchange was based on the following exchange ratio (the
“Exchange Ratio”): 1 Series A Warrant = 0.4685 shares
of capital stock. Investors who, as a result of the Exchange, owned
in excess of 9.99% (the “Ownership Threshold”) of the
outstanding Common Stock, received a mixture of Common Stock and
shares of Preferred Stock. They received Common Stock up to the
Ownership Threshold and received shares of Preferred Stock beyond
the Ownership Threshold (but the total shares of Common Stock and
Preferred Stock issued to such holders was still based on the same
Exchange Ratio). The relative rights, preferences, privileges and
limitations of the Preferred Stock are as set forth in the
Company’s Certificate of Designation of Series B Convertible
Preferred Stock, which was filed with the Secretary of State of the
State of Nevada on January 12, 2016 (the “Series B
Certificate of Designation”).
In the
Exchange an aggregate number of 23,701,428 Warrants were exchanged
for 7,447,954 shares of Common Stock and 293 shares of Preferred
Stock. Pursuant to the Series B Certificate of Designation, each of
the Preferred Stock shares is convertible into shares of Common
Stock at an initial rate of 1 Preferred Stock share for 12,500
Common Stock shares, which conversion rate is subject to further
adjustment as set forth in the Series B Certificate of Designation.
Pursuant to the terms of the Series B Certificate of Designation,
the holders of the Preferred Stock shares will generally be
entitled to that number of votes as is equal to the number of
shares of Common Stock into which the Preferred Stock may be
converted as of the record date of such vote or consent, subject to
the Beneficial Ownership Limitation.
In
connection with entering into the Exchange Agreement, the Company
also entered into a Registration Rights Agreement, dated January
13, 2016, with the Investors. The Registration Rights Agreement
requires that the Company file with the SEC a registration
statement to register for resale the shares of the Common Stock
issued in connection with the Exchange and the Common Stock
issuable upon conversion of the Preferred Stock shares (the
“Preferred Stock Conversion Shares”). The registration
statement was declared effective by the SEC on February 16,
2016.
2016 Equity Offering
On
March 11, 2016, April 6, 2016, and April 15, 2016, pursuant to an
effective registration statement filed with the SEC on Form S-1
(Registration No. 333-208676) pursuant to the Act, in conjunction
with an equity offering of securities (the “2016 Equity
Offering”) with select accredited investors, the Company
issued an aggregate of 25,495,835, 3,083,334 and 1,437,501,
respectively, “units” for an aggregate purchase price
of $1,529,750, $185,000, and $86,200, respectively. Each unit
consisted of one share of Common Stock and one warrant (the
“Class L Warrants”) to purchase one share of Common
Stock at an exercise price of $0.08 per share. The warrants vested
upon issuance and expire on March 17, 2019.
The
mandatory prepayment of principal on the notes payable equal to 20%
of the proceeds received by the Company was waived by
HealthTronics, Inc. for this 2016 Equity Offering.
Michael
N. Nemelka, the brother of a member of the Company’s board of
directors and an existing shareholder of the Company, was a
purchaser in the 2016 Equity Offering of $100,000. A. Michael
Stolarski, a member of the Company's board of directors and an
existing shareholder of the Company, was a purchaser in the 2016
Equity Offering of $75,000.
At the
closing of the 2016 Equity
Offering, the Company paid Newport Coast Securities, Inc.,
the placement agent for the equity offering, cash compensation
based on the gross proceeds of the private placement and 3,001,667
Class L Warrants.
The
Purchasers have previously exercised 1,533,333 Class L Warrants to
purchase shares of Common Stock at an exercise price of $0.08 per
share, and the Placement Agent previously exercised 950,166 Class L
Warrants to purchase shares of Common Stock at an exercise price of
$0.08 per share. Such shares were either issued pursuant to the
previous registration statement or were issued in cashless
exercises and resold pursuant to Rule 144 and Section 3(a)(9), are
not being registered or offered hereunder and are not reflected in
the fee table, prospectus cover or Exhibit 5.1 hereto.
Distribution of Prides Capital Fund I, L.P. and NightWatch Capital
Partners II, L.P.
In
September 2015, Prides Capital Fund I, L.P. distributed 9,220,771
of Common Stock of the Company to the partners as a part of the
liquidation of the fund. In December 2015, NightWatch Capital
Partners II, L.P. distributed 1,904,145 of Common Stock of the
Company to the partners as a part of the liquidation of the
fund.
Selling Stockholder Table
The
table set forth below lists the selling stockholders and other
information regarding the beneficial ownership (as determined under
Section 13(d) of the Securities Exchange Act of 1934, as amended,
and the rules and regulations thereunder) of the shares of Common
Stock held by each of the selling stockholders. Following this
table are three additional tables that detail which of each selling
stockholder’s offered securities were previously registered
for sale on the registration statements under File Numbers
333-195263, 333-208676 and 333-213774.
The
selling stockholders identified in this prospectus may offer the
shares of our common stock at prevailing market prices at the time
of sale, at prices related to the prevailing market price, at
varying prices determined at the time of sale or at negotiated
prices. See “Plan of Distribution” for additional
information.
Unless
otherwise indicated, we believe, based on information supplied by
the following persons, that the persons named in the table below
have sole voting and investment power with respect to all shares of
common stock that they beneficially own. The registration of the
offered shares does not mean that any or all of the selling
stockholders will offer or sell any of the shares of common stock
upon any such exchange.
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Name of Beneficial Owner
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Directors and Executive Officers:
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(2)
|
Kevin
A. Richardson, II
|
9,559,216
|
6.7%
|
406,244
|
*
|
9,152,972
|
6.4%
|
(6)
|
A.
Michael Stolarski
|
6,848,423
|
4.8%
|
2,474,626
|
1.7%
|
4,373,797
|
3.1%
|
|
Lisa
E. Sundstrom
|
1,514,500
|
1.1%
|
-
|
-
|
-
|
-
|
(3)
|
John
F. Nemelka
|
746,503
|
*
|
46
|
*
|
746,457
|
*
|
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Alan
Rubino
|
719,800
|
*
|
-
|
-
|
-
|
-
|
|
All
directors and executive officers as a group (5
persons)
|
19,888,442
|
14.0%
|
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Principal and/or Selling Shareholders:
|
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(4)
|
RA
Capital Healthcare Fund, L.P.
|
9,956,624
|
7.0%
|
9,956,624
|
7.0%
|
-
|
-
|
(2)
|
Prides
Capital Fund I, LP
|
5,514,081
|
3.9%
|
4,851,719
|
3.4%
|
662,362
|
*
|
(5)(7)
|
John
McDermott
|
9,999,999
|
7.0%
|
4,166,666
|
2.9%
|
-
|
-
|
(5)(8)
|
Nainoor
Thakore
|
5,833,334
|
4.1%
|
2,916,667
|
2.1%
|
-
|
-
|
(5)(9)
|
James
McGraw
|
2,500,000
|
5.0%
|
2,500,000
|
1.8%
|
-
|
-
|
(5)(10)
|
Todd
W Arbiture
|
2,083,333
|
4.1%
|
2,083,333
|
1.5%
|
-
|
-
|
(5)(11)
|
Nicholas
Carosi III
|
6,000,000
|
4.2%
|
2,000,000
|
1.4%
|
-
|
-
|
(5)(12)
|
Lynn
A. Anderson
|
3,800,000
|
2.7%
|
1,900,000
|
1.3%
|
-
|
-
|
(5)(13)
|
Horberg
Enterprises LP
|
5,000,001
|
3.5%
|
1,666,667
|
1.2%
|
-
|
-
|
(5)(14)
|
Ian
Miller
|
3,916,667
|
2.8%
|
1,666,667
|
1.2%
|
-
|
-
|
(2)
|
Tudor
BVI Global Portfolio Ltd.
|
1,494,552
|
1.1%
|
1,494,552
|
1.1%
|
-
|
-
|
(5)(15)
|
Michael
Nemelka
|
4,505,336
|
3.2%
|
1,250,000
|
*
|
-
|
-
|
(5)(16)
|
Union
Square Energy Advisors Ltd
|
2,400,000
|
1.7%
|
1,200,000
|
*
|
-
|
-
|
(5)(17)
|
Kerri
Johnson
|
2,333,334
|
1.6%
|
1,166,667
|
*
|
-
|
-
|
(3)
|
NightWatch
Capital Partners, LP
|
1,020,446
|
*
|
1,020,446
|
*
|
-
|
-
|
(5)(18)
|
Tyler
J. Anderson
|
2,250,001
|
1.6%
|
916,667
|
*
|
-
|
-
|
(5)(19)
|
Debra
L. Miller
|
1,666,666
|
1.2%
|
833,333
|
*
|
-
|
-
|
(5)(20)
|
Howard
Bialick
|
1,666,666
|
1.2%
|
833,333
|
*
|
-
|
-
|
(2)
|
The
Trustees of Columbia University in City of New York
|
656,074
|
*
|
656,074
|
*
|
-
|
-
|
(5)
|
Lucas
Hoppel
|
583,333
|
*
|
583,333
|
*
|
-
|
-
|
(3)
|
NightWatch
Capital Partners (Cayman) Ltd.
|
454,101
|
*
|
454,101
|
*
|
-
|
-
|
(5)(21)
|
John
F. Willis
|
833,334
|
*
|
416,667
|
*
|
-
|
-
|
(5)(22)
|
Scott
Hodges
|
833,334
|
*
|
416,667
|
*
|
-
|
-
|
(5)(23)
|
Siltstone
Capital Partners LP
|
833,334
|
*
|
416,667
|
*
|
-
|
-
|
(2)
|
Crown
Investment Fund
|
238,585
|
*
|
238,585
|
*
|
-
|
-
|
(4)
|
MAZ
Partners LP
|
201,085
|
*
|
201,085
|
*
|
-
|
-
|
(5)(24)
|
Roberto
Nascinento
|
400,000
|
*
|
200,000
|
*
|
-
|
-
|
(3)
|
AMA
U.S. Equity Opportunity Fund (QP) LP
|
182,296
|
*
|
182,296
|
*
|
-
|
-
|
(5)(25)
|
Jeramy
Fisher
|
750,001
|
*
|
166,667
|
*
|
-
|
-
|
(4)
|
Brenda
Hall
|
163,991
|
*
|
163,991
|
*
|
-
|
-
|
(2)
|
Hallador
Alternative Assets Fund,LLC
|
158,649
|
*
|
158,649
|
*
|
-
|
-
|
(2)
|
Palladian
Partners IV, LLC
|
152,244
|
*
|
152,244
|
*
|
-
|
-
|
(4)
|
Oppenheimer
& Co., Inc.
|
149,349
|
*
|
149,349
|
*
|
-
|
-
|
(2)
|
HealthTronics,
Inc.
|
138,782
|
*
|
138,782
|
*
|
-
|
-
|
(4)
|
Michael
S. Barish
|
129,867
|
*
|
129,867
|
*
|
-
|
-
|
(4)
|
Frederick
Wahl
|
117,137
|
*
|
117,137
|
*
|
-
|
-
|
(4)
|
John
S. Irish
|
117,137
|
*
|
117,137
|
*
|
-
|
-
|
(4)
|
Dassity,
Inc.
|
106,209
|
*
|
106,209
|
*
|
-
|
-
|
(2)
|
Palladian
Partners V, LLC
|
88,756
|
*
|
88,756
|
*
|
-
|
-
|
(4)
|
Fred
Bohlander
|
88,618
|
*
|
88,618
|
*
|
-
|
-
|
(4)
|
Sharon
Borg Wall
|
88,286
|
*
|
88,286
|
*
|
-
|
-
|
(2)
|
Echelon
Partners LP
|
82,055
|
*
|
82,055
|
*
|
-
|
-
|
(2)
|
El
Coronado Holdings, LLC
|
71,517
|
*
|
71,517
|
*
|
-
|
-
|
(3)
|
Thunder
Basin Corporation
|
65,800
|
*
|
65,800
|
*
|
-
|
-
|
(3)
|
Taylor
Waypoint Fund, LP
|
61,359
|
*
|
61,359
|
*
|
-
|
-
|
(2)
|
Nortrust
Nominees Ltd Leperq Amcur Sicav FIS
|
61,020
|
*
|
61,020
|
*
|
-
|
-
|
(4)
|
John
M. Fay
|
59,666
|
*
|
59,666
|
*
|
-
|
-
|
(2)
|
Palladian
Partners V-A, LLC
|
59,170
|
*
|
59,170
|
*
|
-
|
-
|
(2)
|
Hallador
Balance Fund LLC
|
58,019
|
*
|
58,019
|
*
|
-
|
-
|
(2)
|
Belfer
Investment Partners, LP
|
49,380
|
*
|
49,380
|
*
|
-
|
-
|
(2)
|
Lime
Partners, LLC
|
49,380
|
*
|
49,380
|
*
|
-
|
-
|
(2)
|
Robert
A. Belfer Descendants' Trust
|
49,380
|
*
|
49,380
|
*
|
-
|
-
|
(3)
|
Stacy
Family Trust
|
47,710
|
*
|
47,710
|
*
|
-
|
-
|
(2)
|
Nortrust
Nominees A/C Leperq-Lynx Partner
|
44,700
|
*
|
44,700
|
*
|
-
|
-
|
(2)
|
The
Indick/Lachman Revocable Trust
|
44,262
|
*
|
44,262
|
*
|
-
|
-
|
(3)
|
Nightwatch
Capital Management, LLC
|
40,025
|
*
|
40,025
|
*
|
-
|
-
|
(2)
|
Lynx
Managed Equity Master Fund, LP
|
36,833
|
*
|
36,833
|
*
|
-
|
-
|
(2)
|
P.
Paul and Assocaites
|
31,495
|
*
|
31,495
|
*
|
-
|
-
|
(2)
|
Taylor
Insurance Series LP - Series G
|
30,916
|
*
|
30,916
|
*
|
-
|
-
|
(2)
|
Carlson
Capital, LP
|
29,712
|
*
|
29,712
|
*
|
-
|
-
|
(2)
|
Charlie
McCarthy
|
27,081
|
*
|
27,081
|
*
|
-
|
-
|
(2)
|
Booth
and Company, Nominee A/C Lepercq Partners Fund, L.P.
|
25,984
|
*
|
25,984
|
*
|
-
|
-
|
(2)
|
Peter
T. Paul Living Trust
|
25,792
|
*
|
25,792
|
*
|
-
|
-
|
(2)
|
KMS
Opportunity Fund
|
25,212
|
*
|
25,212
|
*
|
-
|
-
|
(2)
|
Renee
Holdings Partnership, LP
|
24,689
|
*
|
24,689
|
*
|
-
|
-
|
(2)
|
2006
Paul Partnership, LP
|
24,445
|
*
|
24,445
|
*
|
-
|
-
|
(2)
|
Elizabeth
Rice Grossman Family Trust
|
23,839
|
*
|
23,839
|
*
|
-
|
-
|
(2)
|
Elizabeth
Grossman IRA
|
23,802
|
*
|
23,802
|
*
|
-
|
-
|
(2)
|
Hank
Lawlor
|
16,658
|
*
|
16,658
|
*
|
-
|
-
|
(3)
|
Nadel
& Gussman Combined Funds, LLC
|
16,141
|
*
|
16,141
|
*
|
-
|
-
|
(2)
|
Berkowitz
Trust U/A/D 9/01/95
|
15,470
|
*
|
15,470
|
*
|
-
|
-
|
(2)
|
Taylor
Investments Class F
|
14,924
|
*
|
14,924
|
*
|
-
|
-
|
(2)
|
Christian
Puscasiu
|
12,108
|
*
|
12,108
|
*
|
-
|
-
|
(2)
|
Murray
Indick, IRA / RO
|
11,306
|
*
|
11,306
|
*
|
-
|
-
|
(2)
|
Michael
Weinberg
|
9,760
|
*
|
9,760
|
*
|
-
|
-
|
(4)
|
George
Johnson
|
7,450
|
*
|
7,450
|
*
|
-
|
-
|
(2)
|
Nicholas
A Halaby
|
5,954
|
*
|
5,954
|
*
|
-
|
-
|
(2)
|
Rob
Santangelo, IRA
|
5,954
|
*
|
5,954
|
*
|
-
|
-
|
(2)
|
Jeff
and Janice Mondry
|
5,554
|
*
|
5,554
|
*
|
-
|
-
|
(2)
|
Stephen
E. Cootey
|
5,244
|
*
|
5,244
|
*
|
-
|
-
|
(3)
|
Lawrence
Becerra
|
5,014
|
*
|
5,014
|
*
|
-
|
-
|
(2)
|
KCS
|
4,986
|
*
|
4,986
|
*
|
-
|
-
|
(2)
|
Roy
Trice
|
4,814
|
*
|
4,814
|
*
|
-
|
-
|
(3)
|
Demar-Collins
Children's Trust
|
4,712
|
*
|
4,712
|
*
|
-
|
-
|
(2)
|
Robert
J. Leerink
|
4,061
|
*
|
4,061
|
*
|
-
|
-
|
(2)
|
Intellivestor,
LLC
|
3,519
|
*
|
3,519
|
*
|
-
|
-
|
(2)
|
Christian
Puscasiu Roth
|
3,096
|
*
|
3,096
|
*
|
-
|
-
|
(2)
|
Charlie
McCarthy, IRA
|
3,011
|
*
|
3,011
|
*
|
-
|
-
|
(3)
|
Paul
Harris
|
2,761
|
*
|
2,761
|
*
|
-
|
-
|
(3)
|
Stuart
Harris
|
2,761
|
*
|
2,761
|
*
|
-
|
-
|
(2)
|
Brad
and Kelly Eichler
|
2,391
|
*
|
2,391
|
*
|
-
|
-
|
(2)
|
Charles
Jobson
|
2,382
|
*
|
2,382
|
*
|
-
|
-
|
(2)
|
Michael
McCarthy
|
2,368
|
*
|
2,368
|
*
|
-
|
-
|
(2)
|
Peter
Zecca, Jr.
|
2,353
|
*
|
2,353
|
*
|
-
|
-
|
(4)
|
Christopher
Wynne
|
1,335
|
*
|
1,335
|
*
|
-
|
-
|
(3)
|
Ameriprise
Financial, FBO Paul V. Burgon IRA
|
744
|
*
|
744
|
*
|
-
|
-
|
(2)
|
Youghiogheny
Holdings
|
518
|
*
|
518
|
*
|
-
|
-
|
(3)
|
Paul
Burgon
|
229
|
*
|
229
|
*
|
-
|
-
|
(2)
|
Asagard
investment Corporation
|
52
|
*
|
52
|
*
|
-
|
-
|
|
|
|
|
|
|
|
|
|
|
|
|
52,086,297
|
|
14,935,588
|
|
(1)
Applicable percentage ownership is based on 142,012,979 shares of
common stock outstanding as of April 12, 2018. "Beneficial
ownership" includes shares for which an individual, directly or
indirectly, has or shares voting or investment power, or both, and
also includes options that are exercisable within 60 days of April
12, 2018. Unless otherwise indicated, all of the listed persons
have sole voting and investment power over the shares listed
opposite their names. Beneficial ownership as reported in the above
table has been determined in accordance with Rule 13d-3 of the
Exchange Act.
(2)
Shares issued pursuant to distribution of shares of Prides Capital
Fund I, L.P. Shares previously registered with Registration No.
333-208676 on February 17, 2016.
(3)
Shares issued pursuant to distribution of shares of NightWatch
Capital Partners II, L.P. Shares previously registered with
Registration No. 333-208676 on February 17, 2016.
(4)
Shares issued pursuant to Series A Warrant Conversion. Shares
previously registered with Registration No. 333-195263 on May 6,
2014.
(5)
Shares pursuant to August 2016 Private Placement. Shares being
registered with current Registration No. 333-213774.
(6)
Number of shares being offered includes: 1,000,000 shares pursuant
to August 2016 Private Placement and 241,182 shares acquired over
three years ago based on the records of the Company (collectively
being registered with current Registration No. 333-213774), and
119,563 shares issued pursuant to Series A Warrant Conversion and
1,113,881 shares acquired over three years ago based on records of
the Company (collectively previously registered with Registration
No. 333-208676 on February 17, 2016).
(7)
Number of shares beneficially owned includes 5,833,333 shares
underlying warrants.
(8)
Number of shares beneficially owned includes 2,916,667 shares
underlying warrants.
(9)
Number of shares beneficially owned includes 4,579,167 shares
underlying warrants.
(10)
Number of shares beneficially owned includes 3,750,000 shares
underlying warrants.
(11)
Number of shares beneficially owned includes 4,000,000 shares
underlying warrants.
(12)
Number of shares beneficially owned includes 1,900,000 shares
underlying warrants.
(13)
Number of shares beneficially owned includes 3,333,334 shares
underlying warrants.
(14)
Number of shares beneficially owned includes 2,250,000 shares
underlying warrants.
(15)
Number of shares beneficially owned includes 3,255,336 shares
underlying warrants.
(16)
Number of shares beneficially owned includes 1,200,000 shares
underlying warrants.
(17)
Number of shares beneficially owned includes 1,116,667 shares
underlying warrants.
(18)
Number of shares beneficially owned includes 1,333,334 shares
underlying warrants.
(19)
Number of shares beneficially owned includes 833,333 shares
underlying warrants.
(20)
Number of shares beneficially owned includes 833,333 shares
underlying warrants.
(21)
Number of shares beneficially owned includes 416,667 shares
underlying warrants.
(22)
Number of shares beneficially owned includes 416,667 shares
underlying warrants.
(23)
Number of shares beneficially owned includes 416,667 shares
underlying warrants.
(24)
Number of shares beneficially owned includes 200,000 shares
underlying warrants.
(25)
Number of shares beneficially owned includes 583,334 shares
underlying warrants.
Breakdown of Offered Securities Previously Registered Under File
No. 333-208676
|
|
|
Name of
Beneficial Owner
|
|
|
RA Capital
Healthcare Fund, L.P.
|
9,956,624
|
9,956,624
|
Prides Capital Fund
I, LP
|
4,851,719
|
4,851,719
|
Tudor
BVI Global Portfolio Ltd.
|
1,494,552
|
1,494,552
|
A. Michael
Stolarski
|
1,233,444
|
1,233,444
|
NightWatch Capital
Partners, LP
|
1,020,446
|
1,020,446
|
The
Trustees of Columbia University in City of New York
|
656,074
|
656,074
|
NightWatch Capital
Partners (Cayman) Ltd.
|
454,101
|
454,101
|
Kevin A.
Richardson, II
|
406,244
|
406,244
|
Crown
Investment Fund
|
238,585
|
238,585
|
MAZ Partners
LP
|
201,085
|
201,085
|
AMA U.S. Equity
Opportunity Fund (QP) LP
|
182,296
|
182,296
|
Brenda
Hall
|
163,991
|
163,991
|
Hallador
Alternative Assets Fund,LLC
|
158,649
|
158,649
|
Palladian
Partners IV, LLC
|
152,244
|
152,244
|
Oppenheimer &
Co., Inc.
|
149,349
|
149,349
|
HealthTronics,
Inc.
|
138,782
|
138,782
|
Michael S.
Barish
|
129,867
|
129,867
|
Frederick
Wahl
|
117,137
|
117,137
|
John S.
Irish
|
117,137
|
117,137
|
Dassity,
Inc.
|
106,209
|
106,209
|
Palladian
Partners V, LLC
|
88,756
|
88,756
|
Fred
Bohlander
|
88,618
|
88,618
|
Sharon Borg
Wall
|
88,286
|
88,286
|
Echelon
Partners LP
|
82,055
|
82,055
|
El
Coronado Holdings, LLC
|
71,517
|
71,517
|
Thunder Basin
Corporation
|
65,800
|
65,800
|
Taylor Waypoint
Fund, LP
|
61,359
|
61,359
|
Nortrust
Nominees Ltd Leperq Amcur Sicav FIS
|
61,020
|
61,020
|
John M.
Fay
|
59,666
|
59,666
|
Palladian
Partners V-A, LLC
|
59,170
|
59,170
|
Hallador
Balance Fund LLC
|
58,019
|
58,019
|
Lime
Partners, LLC
|
49,380
|
49,380
|
Belfer
Investment Partners, LP
|
49,380
|
49,380
|
Robert
A. Belfer Descendants' Trust
|
49,380
|
49,380
|
Stacy Family
Trust
|
47,710
|
47,710
|
Nortrust
Nominees A/C Leperq-Lynx Partner
|
44,700
|
44,700
|
The
Indick/Lachman Revocable Trust
|
44,262
|
44,262
|
Nightwatch Capital
Management, LLC
|
40,025
|
40,025
|
Lynx
Managed Equity Master Fund, LP
|
36,833
|
36,833
|
P.
Paul and Associates
|
31,495
|
31,495
|
Taylor
Insurance Series LP - Series G
|
30,916
|
30,916
|
Carlson
Capital, LP
|
29,712
|
29,712
|
Charlie
McCarthy
|
27,081
|
27,081
|
Booth
and Company, Nominee A/C Lepercq Partners Fund, L.P.
|
25,984
|
25,984
|
Peter
T. Paul Living Trust
|
25,792
|
25,792
|
KMS
Opportunity Fund
|
25,212
|
25,212
|
Renee
Holdings Partnership, LP
|
24,689
|
24,689
|
2006
Paul Partnership, LP
|
24,445
|
24,445
|
Elizabeth
Rice Grossman Family Trust
|
23,839
|
23,839
|
Elizabeth
Grossman IRA
|
23,802
|
23,802
|
Hank
Lawlor
|
16,658
|
16,658
|
Nadel & Gussman
Combined Funds, LLC
|
16,141
|
16,141
|
Berkowitz
Trust U/A/D 9/01/95
|
15,470
|
15,470
|
Taylor
Investments Class F
|
14,924
|
14,924
|
Christian
Puscasiu
|
12,108
|
12,108
|
Murray
Indick, IRA / RO
|
11,306
|
11,306
|
Michael
Weinberg
|
9,760
|
9,760
|
George
Johnson
|
7,450
|
7,450
|
Nicholas
A Halaby
|
5,954
|
5,954
|
Rob
Santangelo, IRA
|
5,954
|
5,954
|
Jeff
and Janice Mondry
|
5,554
|
5,554
|
Stephen
E. Cootey
|
5,244
|
5,244
|
Lawrence
Becerra
|
5,014
|
5,014
|
KCS
|
4,986
|
4,986
|
Roy
Trice
|
4,814
|
4,814
|
Demar-Collins
Children's Trust
|
4,712
|
4,712
|
Robert
J. Leerink
|
4,061
|
4,061
|
Intellivestor,
LLC
|
3,519
|
3,519
|
Christian
Puscasiu Roth
|
3,096
|
3,096
|
Charlie
McCarthy, IRA
|
3,011
|
3,011
|
Paul
Harris
|
2,761
|
2,761
|
Stuart
Harris
|
2,761
|
2,761
|
Brad
and Kelly Eichler
|
2,391
|
2,391
|
Charles
Jobson
|
2,382
|
2,382
|
Michael
McCarthy
|
2,368
|
2,368
|
Peter
Zecca, Jr.
|
2,353
|
2,353
|
Christopher
Wynne
|
1,335
|
1,335
|
Ameriprise
Financial, FBO Paul V. Burgon IRA
|
744
|
744
|
Youghiogheny
Holdings
|
518
|
518
|
Paul
Burgon
|
229
|
229
|
Asagard
investment Corporation
|
52
|
52
|
John
F. Nemelka
|
46
|
46
|
Shareholder Shares
|
23,545,114
|
23,545,114
|
Breakdown of Offered Securities Initially Being Registered Herewith
(File No. 333-213774)
Name of
Beneficial Owner
|
|
Principal
and/or Selling Shareholders:
|
|
John
McDermott
|
4,166,666
|
Nainoor
Thakore
|
2,916,667
|
James
McGraw
|
2,500,000
|
Todd
Arbiture
|
2,083,333
|
Nicholas
Carosi, III
|
2,000,000
|
Lynn
A. Anderson
|
1,900,000
|
Ian
Miller
|
1,666,667
|
Horberg
Enterprises LP
|
1,666,667
|
Michael
Nemelka
|
1,250,000
|
Union
Square Energy Advisors Ltd
|
1,200,000
|
Kerri
Johnson
|
1,166,667
|
Anthony M.
Stolarski
|
1,241,182
|
Tyler
J. Anderson
|
916,667
|
Debra
L. Miller
|
833,333
|
Howard
Bialick
|
833,333
|
Lucas
Hoppel
|
583,333
|
Scott
Hodges
|
416,667
|
John
F. Willis
|
416,667
|
Siltstone
Capital Partners LP
|
416,667
|
Roberto
Nascinento
|
200,000
|
Jeramy
Fisher
|
166,667
|
Total Selling Shareholder
Shares
|
28,541,183
|
PLAN OF DISTRIBUTION
Offering of Shares by Selling Stockholders and Upon Exercise of
Warrants
We are
registering the shares of Common Stock initially issued to the
selling stockholders in the August 2016 private placement to permit
the resale of these shares of Common Stock by the selling
stockholders, from time to time, after the date of this prospectus.
See “Selling Stockholders” for additional information.
We will not receive any proceeds from the sale of shares of Common
Stock by selling stockholders in this offering, except cash for the
warrant exercise, which if all such warrants are exercised, would
be approximately $4,969,080. Proceeds, if any, received from
the exercise of such warrants, would be used for working capital
purposes.
In
connection with the private placement described under
“SELLING STOCKHOLDERS – August 2016 Private
Placement,” we engaged WestPark Capital, Inc., as Placement
Agent, and in connection with the registered offering described
under “SELLING STOCKHOLDERS – 2016 Equity
Offering,” we engaged Newport Coast Securities, Inc. as
Placement Agent. We agreed to pay each Placement Agent a fee of (i)
ten percent (10%) of the aggregate purchase price of the securities
sold in the respective placement and (ii) warrants to purchase ten
percent (10%) of the number of shares sold in the respective
placement. The Placement Agents, collectively, were issued warrants
to purchase 5,831,667 shares of Common Stock at an exercise
price of $0.08 per share. The registration statement of which this
prospectus is a part also covers the shares of Common Stock
issuable from time to time upon the exercise of the placement
agent’s warrants.
As
required by FINRA pursuant to Rule 5110(g)(1), neither WestPark
Capital, Inc.’s Warrants nor any shares of common stock
issued upon exercise of such Warrants may be sold, transferred,
assigned, pledged, or hypothecated, or be the subject of any
hedging, short sale, derivative, put, or call transaction that
would result in the effective economic disposition of such
securities by any person for a period of 180 days immediately
following the date hereof, except the transfer of any
security:
●
by operation of law
or by reason of our reorganization;
●
to any FINRA member
firm participating in the offering and the officers or partners
thereof, if all securities so transferred remain subject to the
lock-up restriction described above for the remainder of the time
period;
●
if the aggregate
amount of our securities held by the placement agent or related
person do not exceed 1% of the securities being
offered;
●
that is
beneficially owned on a pro-rata basis by all equity owners of an
investment fund, provided that no participating member manages or
otherwise directs investments by the fund, and participating
members in the aggregate do not own more than 10% of the equity in
the fund; or
●
the exercise or
conversion of any security, if all securities received remain
subject to the lock-up restriction set forth above for the
remainder of the time period.
The
selling stockholders may sell all or a portion of the shares of
Common Stock held by them and offered hereby from time to time
directly or through one or more underwriters, broker-dealers or
agents. If the shares of Common Stock are sold through underwriters
or broker-dealers, the selling stockholders will be responsible for
underwriting discounts or commissions or agent’s commissions.
The shares of Common Stock may be sold in one or more transactions
at fixed prices, at prevailing market prices at the time of the
sale, at varying prices determined at the time of sale or at
negotiated prices. These sales may be effected in transactions,
which may involve crosses or block transactions, pursuant to one or
more of the following methods:
●
on any national
securities exchange or quotation service on which the securities
may be listed or quoted at the time of sale;
●
in the
over-the-counter market;
●
in transactions
otherwise than on these exchanges or systems or in the
over-the-counter market;
●
through the writing
or settlement of options, whether such options are listed on an
options exchange or otherwise;
●
ordinary brokerage
transactions and transactions in which the broker-dealer solicits
purchasers;
●
block trades in
which the broker-dealer will attempt to sell the shares as agent
but may position and resell a portion of the block as principal to
facilitate the transaction;
●
purchases by a
broker-dealer as principal and resale by the broker-dealer for its
account;
●
an exchange
distribution in accordance with the rules of the applicable
exchange;
●
privately
negotiated transactions;
●
short sales made
after the date the Registration Statement is declared effective by
the SEC;
●
broker-dealers may
agree with a selling security holder to sell a specified number of
such shares at a stipulated price per share;
●
a combination of
any such methods of sale; and
●
any other method
permitted pursuant to applicable law.
The
selling stockholders may also sell shares of Common Stock under
Rule 144 promulgated under the Securities Act of 1933, as amended,
if available, rather than under this prospectus. In addition, the
selling stockholders may transfer the shares of Common Stock by
other means not described in this prospectus. If the selling
stockholders effect such transactions by selling shares of Common
Stock to or through underwriters, broker-dealers or agents, such
underwriters, broker-dealers or agents may receive commissions in
the form of discounts, concessions or commissions from the selling
stockholders or commissions from purchasers of the shares of Common
Stock for whom they may act as agent or to whom they may sell as
principal (which discounts, concessions or commissions as to
particular underwriters, broker-dealers or agents may be in excess
of those customary in the types of transactions involved). In
connection with sales of the shares of Common Stock or otherwise,
the selling stockholders may enter into hedging transactions with
broker-dealers, which may in turn engage in short sales of the
shares of Common Stock in the course of hedging in positions they
assume. The selling stockholders may also sell shares of Common
Stock short and deliver shares of Common Stock covered by this
prospectus to close out short positions and to return borrowed
shares in connection with such short sales. The selling
stockholders may also loan or pledge shares of Common Stock to
broker-dealers that in turn may sell such shares.
The
selling stockholders may pledge or grant a security interest in
some or all of the shares of Common Stock owned by them and, if
they default in the performance of their secured obligations, the
pledgees or secured parties may offer and sell the shares of Common
Stock from time to time pursuant to this prospectus or any
amendment to this prospectus under Rule 424(b)(3) or other
applicable provision of the Securities Act amending, if necessary,
the list of selling stockholders to include the pledgee, transferee
or other successors in interest as selling stockholders under this
prospectus. The selling stockholders also may transfer and donate
the shares of Common Stock in other circumstances in which case the
transferees, donees, pledgees or other successors in interest will
be the selling beneficial owners for purposes of this
prospectus.
To the
extent required by the Securities Act and the rules and regulations
thereunder, the selling stockholders and any broker-dealer
participating in the distribution of the shares of Common Stock may
be deemed to be “underwriters” within the meaning of
the Securities Act, and any commission paid, or any discounts or
concessions allowed to, any such broker-dealer may be deemed to be
underwriting commissions or discounts under the Securities Act. At
the time a particular offering of the shares of Common Stock is
made, a prospectus supplement, if required, will be distributed,
which will set forth the aggregate amount of shares of Common Stock
being offered and the terms of the offering, including the name or
names of any broker-dealers or agents, any discounts, commissions
and other terms constituting compensation from the selling
stockholders and any discounts, commissions or concessions allowed
or re-allowed or paid to broker-dealers. Each selling stockholder
has informed us that it does not have any written or oral agreement
or understanding, directly or indirectly, with any person to
distribute the shares of Common Stock in violation of any
applicable securities laws. In no event shall any broker-dealer
receive fees, commissions and markups which, in the aggregate,
would exceed eight percent (8%).
Under
the securities laws of some states, the shares of Common Stock may
be sold in such states only through registered or licensed brokers
or dealers. In addition, in some states the shares of Common Stock
may not be sold unless such shares have been registered or
qualified for sale in such state or an exemption from registration
or qualification is available and is complied with.
There
can be no assurance that any selling stockholder will sell any or
all of the shares of Common Stock registered pursuant to the
registration statement, of which this prospectus forms a
part.
The
selling stockholders and any other person participating in such
distribution will be subject to applicable provisions of the
Exchange Act, and the rules and regulations thereunder, including,
without limitation, to the extent applicable, Regulation M of the
Exchange Act, which may limit the timing of purchases and sales of
any of the shares of common stock by the selling stockholders and
any other participating person. To the extent applicable,
Regulation M may also restrict the ability of any person engaged in
the distribution of the shares of Common Stock to engage in
market-making activities with respect to the shares of Common
Stock. All of the foregoing may affect the marketability of the
shares of Common Stock and the ability of any person or entity to
engage in market-making activities with respect to the shares of
Common Stock.
Once
sold under the registration statement, of which this prospectus
forms a part, the shares of Common Stock will be freely tradable in
the hands of persons other than our affiliates.
MARKET FOR OUR COMMON STOCK AND RELATED STOCKHOLDER
MATTERS
Market Information
The
Company’s Common Stock is quoted on the OTCQB under the
symbol “SNWV”.
The
following table sets forth, for the periods indicated, the high and
low sales prices per share of our Common Stock, as reported on the
OTCQB. The quotations reflect inter-dealer prices, without mark-up,
mark-down or commissions, and may not represent actual
transactions:
|
|
|
|
|
2018
|
|
|
First
Quarter
|
$0.57
|
$0.16
|
Second Quarter
(thru April 12, 2018)
|
$0.64
|
$0.47
|
|
|
|
|
|
2017
|
|
|
First
Quarter
|
$0.19
|
$0.11
|
Second
Quarter
|
$0.14
|
$0.08
|
Third
Quarter
|
$0.18
|
$0.09
|
Fourth
Quarter
|
$0.28
|
$0.10
|
See the
cover page of this prospectus for a recent bid price of our Common
Stock as reported by the OTC Bulletin Board.
As of
April 12, 2018, there were 142,012,979 shares of our Common Stock
outstanding and approximately 135 holders of record of our Common
Stock. However, we believe that there are more beneficial
holders of our Common Stock as many beneficial holders hold their
stock in “street name.”
Dividend Policy
We have
never declared or paid any cash dividends on our capital stock. We
currently intend to retain future earnings, if any, to finance the
expansion of our business. As a result, we do not anticipate paying
any cash dividends in the foreseeable future.
Securities Authorized for Issuance under Equity Compensation
Plans
Plan
Category
|
Number of
securities to be issued upon exercise of outstanding options and
rights
|
Weighted-average
exercise price of outstanding options and rights
|
Number of
securities remaining available for future issuance under equity
compensation plans (excluding securities reflected in column
(a))
|
|
|
|
|
Equity
compensation plans approved by security holders
|
-
|
$0.00
|
-
|
Equity
compensation plans not approved by security holders
|
21,593,385
|
$0.31
|
2,238,281
|
Total
|
21,593,385
|
$0.31
|
2,238,281
|
Stock Incentive Plans
During
2006, SANUWAVE, Inc.’s board of directors adopted the 2006
Stock Incentive Plan of SANUWAVE, Inc., and certain non-statutory
stock option agreements with key employees outside of the 2006
Stock Incentive Plan. The non-statutory stock option agreements
have terms substantially the same as the 2006 Stock Incentive Plan.
The stock options granted under the plans were nonstatutory options
which vest over a period of up to four years and have a ten year
term. The options were granted at an exercise price equal to the
fair market value of the common stock on the date of the grant,
which was approved by the board of directors of the
Company.
On
November 1, 2010, the Company approved the Amended and Restated
2006 Stock Incentive Plan of SANUWAVE Health, Inc. effective as of
January 1, 2010 (the “Stock
Incentive Plan”). The Stock Incentive Plan permits
grants of awards to selected employees, directors and advisors of
the Company in the form of restricted stock or options to purchase
shares of common stock. Options granted may include nonstatutory
options as well as qualified incentive stock options. The Stock
Incentive Plan is currently administered by the board of directors
of the Company. The Stock Incentive Plan gives broad powers to the
board of directors of the Company to administer and interpret the
particular form and conditions of each option. The stock options
granted under the Stock Incentive Plan are nonstatutory options
which vest over a period of up to three years and have a ten year
term. The options are granted at an exercise price equal to the
fair market value of the common stock on the date of the grant
which is approved by the board of directors of the
Company.
MANAGEMENT’S DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The following Management’s Discussion and Analysis of
Financial Condition and Results of Operations contains
forward-looking statements regarding our business development
plans, clinical trials, regulatory reviews, timing, strategies,
expectations, anticipated expenses levels, projected profits,
business prospects and positioning with respect to market,
demographic and pricing trends, business outlook, technology
spending and various other matters (including contingent
liabilities and obligations and changes in accounting policies,
standards and interpretations) and express our current intentions,
beliefs, expectations, strategies or predictions. These
forward-looking statements are based on a number of assumptions and
currently available information and are subject to a number of
risks and uncertainties. Our actual results could differ materially
from those anticipated in these forward-looking statements as a
result of various factors, including those set forth under the
sections titled “Cautionary Note Regarding Forward-Looking
Statements” and “Risk Factors” and elsewhere in
this prospectus. The following discussion should be read in
conjunction with our consolidated financial statements and related
notes thereto included elsewhere in this prospectus.
Overview
We are
a shock wave technology company using a patented system of
noninvasive, high-energy, acoustic shock waves for regenerative
medicine and other applications. Our initial focus is regenerative
medicine – utilizing noninvasive, acoustic shock waves to
produce a biological response resulting in the body healing itself
through the repair and regeneration of tissue, musculoskeletal, and
vascular structures. Our lead regenerative product in the United
States is the dermaPACE® device, used
for treating diabetic foot ulcers, which was subject to two
double-blinded, randomized Phase III clinical studies and cleared
by the U.S. Food and Drug Administration (FDA) on December 28,
2017.
Our
portfolio of healthcare products and product candidates activate
biologic signaling and angiogenic responses, including new
vascularization and microcirculatory improvement, helping to
restore the body’s normal healing processes and regeneration.
We intend to apply our Pulsed Acoustic Cellular Expression
(PACE®) technology in
wound healing, orthopedic, plastic/cosmetic and cardiac conditions.
In 2018, we have started marketing our dermaPACE System for sale in
the United States and will continue to generate revenue from sales
of the European Conformity Marking (CE Mark) devices and
accessories in Europe, Canada, Asia and Asia/Pacific.
Our
lead product candidate for the global wound care market, dermaPACE,
has received FDA approval for commercial use to treat diabetic foot
ulcers in the United States and the CE Mark allowing for commercial
use on acute and chronic defects of the skin and subcutaneous soft
tissue. We believe we
have demonstrated that our patented technology is safe and
effective in stimulating healing in chronic conditions of the foot
and the elbow through our United States FDA Class III PMA approved
OssaTron® device, and in
the stimulation of bone and chronic tendonitis regeneration in the
musculoskeletal environment through the utilization of our
OssaTron, Evotron®, and
orthoPACE® devices in
Europe and Asia.
We are
focused on developing our Pulsed Acoustic Cellular Expression
(PACE) technology to activate healing in:
●
wound conditions,
including diabetic foot ulcers, venous and arterial ulcers,
pressure sores, burns and other skin eruption
conditions;
●
orthopedic
applications, such as eliminating chronic pain in joints from
trauma, arthritis or tendons/ligaments inflammation, speeding the
healing of fractures (including nonunion or delayed-union
conditions), improving bone density in osteoporosis, fusing bones
in the extremities and spine, and other potential sports injury
applications;
●
plastic/cosmetic
applications such as cellulite smoothing, graft and transplant
acceptance, skin tightening, scarring and other potential aesthetic
uses; and
●
cardiac
applications for removing plaque due to atherosclerosis improving
heart muscle performance.
In
addition to healthcare uses, our high-energy, acoustic pressure
shockwaves, due to their powerful pressure gradients and localized
cavitational effects, may have applications in secondary and
tertiary oil exploitation, for cleaning industrial waters and food
liquids and finally for maintenance of industrial installations by
disrupting biofilms formation. Our business approach will be
through licensing and/or partnership opportunities.
Recent Developments
On
December 28, 2017, the U.S. Food and Drug Administration (the
“FDA”) notified the Company to permit the marketing of
the dermaPACE system for the treatment of diabetic foot ulcers in
the United States.
On September 27, 2017, we entered into a binding
term sheet with MundiMed Distribuidora Hospitalar LTDA
(“MundiMed”), effective as
of September 25, 2017, for a joint venture for the manufacture,
sale and distribution of our dermaPACE device. Under the binding
term sheet, MundiMed will pay the Company an upfront distribution
fee, with monthly upfront distribution fees payable thereafter over
the following eighteen months. Profits from the joint venture are
distributed as follows: 45% to the Company, 45% to MundiMed and 5%
each to LHS Latina Health Solutions Gestão Empresarial Ltda.
and Universus Global Advisors LLC, who acted as advisors in the
transaction. The initial upfront distribution fee was received on
October 6, 2017.
On
February 13, 2018, the Company entered into an Agreement for
Purchase and Sale, Limited Exclusive Distribution and Royalties,
and Servicing and Repairs with Premier Shockwave Wound Care, Inc.,
a Georgia Corporation (“PSWC”), and Premier Shockwave,
Inc., a Georgia Corporation (“PS”). The agreement
provides for the purchase by PSWC and PS of dermaPACE System and
related equipment sold by the Company and includes a minimum
purchase of 100 units over 3 years. The agreement grants PSWC and
PS limited but exclusive distribution rights to provide dermaPACE
Systems to certain governmental healthcare facilities in exchange
for the payment of certain royalties to the Company. Under the
agreement, the Company is responsible for the servicing and repairs
of such dermaPACE Systems and equipment. The agreement also
contains provisions whereby in the event of a change of control of
the Company (as defined in the agreement), the stockholders of PSWC
have the right and option to cause the Company to purchase all of
the stock of PSWC, and whereby the Company has the right and option
to purchase all issued and outstanding shares of PSWC, in each case
based upon certain defined purchase price provisions and other
terms. The agreement also contains certain transfer restrictions on
the stock of PSWC. Each of PS and PSWC is owned by A. Michael
Stolarski, a member of the Company’s board of directors and
an existing shareholder of the Company.
Clinical Trials and Marketing
The FDA
granted approval of our Investigational Device Exemption (IDE) to
conduct two double-blinded, randomized clinical trials utilizing
our lead device product for the global wound care market, the
dermaPACE device, in the treatment of diabetic foot
ulcers.
The
dermaPACE system was evaluated using two studies under IDE G070103.
The studies were designed as prospective, randomized, double-blind,
parallel-group, sham-controlled, multi-center 24-week studies at 39
centers. A total of 336 subjects were enrolled and treated with
either dermaPACE plus conventional therapy or conventional therapy
(a.k.a. standard of care) alone. Conventional therapy included, but
was not limited to, debridement, saline-moistened gauze, and
pressure reducing footwear. The objective of the studies was to
compare the safety and efficacy of the dermaPACE device to
sham-control application. The prospectively defined primary
efficacy endpoint for the dermaPACE studies was the incidence of
complete wound closure at 12 weeks post-initial application of the
dermaPACE system (active or sham). Complete wound closure was
defined as skin re-epithelialization without drainage or dressing
requirements, confirmed over two consecutive visits within
12-weeks. If the wound was considered closed for the first time at
the 12 week visit, then the next visit was used to confirm closure.
Investigators continued to follow subjects and evaluate wound
closure through 24 weeks.
The dermaPACE device completed its initial Phase
III, IDE clinical trial in the United States for the treatment of
diabetic foot ulcers in 2011 and a PMA application was filed with
the FDA in July 2011. The patient enrollment for the second,
supplemental clinical trial began in June 2013. We completed
enrollment for the 130 patients in this second trial in November
2014 and suspended further enrollment at that time.
The
only significant difference between the two studies was the number
of applications of the dermaPACE device. Study one (DERM01; n=206)
prescribed four (4) device applications/treatments over a two-week
period, whereas, study two (DERM02; n=130) prescribed up to eight
(8) device applications (4 within the first two weeks of
randomization, and 1 treatment every two weeks thereafter up to a
total of 8 treatments over a 10-week period). If the wound was
determined closed by the PI during the treatment regimen, any
further planned applications were not performed.
Between
the two studies there were over 336 patients evaluated, with 172
patients treated with dermaPACE and 164 control group subjects with
use of a non-functional device (sham). Both treatment groups
received wound care consistent with the standard of care in
addition to device application. Study subjects were enrolled using
pre-determined inclusion/exclusion criteria in order to obtain a
homogenous study population with chronic diabetes and a diabetic
foot ulcer that has persisted a minimum of 30 days and its area is
between 1cm2 and 16cm2, inclusive. Subjects
were enrolled at Visit 1 and followed for a run-in period of two
weeks. At two weeks (Visit 2 – Day 0), the first treatment
was applied (either dermaPACE or Sham Control application).
Applications with either dermaPACE or Sham Control were then made
at Day 3 (Visit 3), Day 6 (Visit 4), and Day 9 (Visit 5) with the
potential for 4 additional treatments in Study 2. Subject progress
including wound size was then observed on a bi-weekly basis for up
to 24 weeks at a total of 12 visits (Weeks 2-24; Visits
6-17).
A total
of 336 patients were enrolled in the dermaPACE studies at 37 sites.
The patients in the studies were followed for a total of 24 weeks.
The studies’ primary endpoint, wound closure, was defined as
“successful” if the skin was 100% re-epithelialized at
12 weeks without drainage or dressing requirements confirmed at two
consecutive study visits.
A
summary of the key study findings were as follows:
●
Patients treated
with dermaPACE showed a strong positive trend in the primary
endpoint of 100% wound closure. Treatment with dermaPACE increased
the proportion of diabetic foot ulcers that closed within 12 weeks,
although the rate of complete wound closure between dermaPACE and
sham-control at 12 weeks in the intention-to-treat (ITT) population
was not statistically significant at the 95% confidence level used
throughout the study (p=0.320). There were 39 out of 172 (22.67%)
dermaPACE subjects who achieved complete wound closure at 12 weeks
compared with 30 out of 164 (18.29%) sham-control
subjects.
●
In addition to the
originally proposed 12-week efficacy analysis, and in conjunction
with the FDA agreement to analyze the efficacy analysis carried
over the full 24 weeks of the study, we conducted a series of
secondary analyses of the primary endpoint of complete wound
closure at 12 weeks and at each subsequent study visit out to 24
weeks. The primary efficacy endpoint of complete wound closure
reached statistical significance at 20 weeks in the ITT population
with 61 (35.47%) dermaPACE subjects achieving complete wound
closure compared with 40 (24.39%) of sham-control subjects
(p=0.027). At the 24 week endpoint, the rate of wound closure in
the dermaPACE® cohort was 37.8% compared to 26.2% for the
control group, resulting in a p-value of 0.023.
●
Within 6 weeks
following the initial dermaPACE treatment, and consistently
throughout the 24-week period, dermaPACE significantly reduced the
size of the target ulcer compared with subjects randomized to
receive sham-control (p<0.05).
●
The proportion of
patients with wound closure indicate a statistically significant
difference between the dermaPACE and the control group in the
proportion of subjects with the target-ulcer not closed over the
course of the study (p-value=0.0346). Approximately 25% of
dermaPACE® subjects reached wound closure per the study
definition by day 84 (week 12). The same percentage in the control
group (25%) did not reach wound closure until day 112 (week 16).
These data indicate that in addition to the proportion of subjects
reaching wound closure being higher in the dermaPACE® group,
subjects are also reaching wound closure at a faster rate when
dermaPACE is applied.
●
dermaPACE
demonstrated superior results in the prevention of wound expansion
(≥ 10% increase in wound size), when compared to the control,
over the course of the study at 12 weeks (18.0% versus 31.1%;
p=0.005, respectively).
●
At 12 and 24 weeks,
the dermaPACE group had a higher percentage of subjects with a 50%
wound reduction compared to the control (p=0.0554 and p=0.0899,
respectively). Both time points demonstrate a trend towards
statistical significance.
●
The mean wound
reduction for dermaPACE subjects at 24 weeks was 2.10cm2 compared
to 0.83cm2 in the control group. There was a statistically
significant difference between the wound area reductions of the two
cohorts from the 6 week follow-up visit through the end of the
study.
●
Of the subjects who
achieved complete wound closure at 12 weeks, the recurrence rate at
24 weeks was only 7.7% in the dermaPACE group compared with 11.6%
in the sham-control group.
●
Importantly, there
were no meaningful statistical differences in the adverse event
rates between the dermaPACE treated patients and the sham-control
group. There were no issues regarding the tolerability of the
treatment which suggests that a second course of treatment, if
needed, is a clinically viable option.
We
retained Musculoskeletal Clinical Regulatory Advisers, LLC (MCRA)
in January 2015 to lead the Company’s interactions and
correspondence with the FDA for the dermaPACE, which have already
commenced. MCRA has successfully worked with the FDA on numerous
Premarket Approvals (PMAs) for various musculoskeletal, restorative
and general surgical devices since 2006.
Working
with MCRA, we submitted to FDA a de novo petition on July 23, 2016. Due
to the strong safety profile of our device and the efficacy of the
data showing statistical significance for wound closure for
dermaPACE subjects at 20 weeks, we believe that the dermaPACE
device should be considered for classification into Class II as
there is no legally marketed predicate device and there is not an
existing Class III classification regulation or one or more
approved PMAs (which would have required a reclassification under
Section 513(e) or (f)(3) of the FD&C Act). On December 28,
2017, the FDA determined that the criteria at section 513(a)(1)(A)
of (B) of the FD&C Act were met and granted the de novo clearance classifying dermaPACE
as Class II and available to be marketed immediately.
Finally, our
dermaPACE device has received the European CE Mark approval to
treat acute and chronic defects of the skin and subcutaneous soft
tissue, such as in the treatment of pressure ulcers, diabetic foot
ulcers, burns, and traumatic and surgical wounds. The dermaPACE is
also licensed for sale in Canada, Australia, New Zealand and South
Korea.
We are
actively marketing the dermaPACE to the European Community, Canada
and Asia/Pacific, utilizing distributors in select
countries.
Financial Overview
Since
inception in 2005, our operations have primarily been funded from
the sale of capital stock and convertible debt securities. We
expect to devote substantial resources for the commercialization of
the dermaPACE System and will continue to research and develop the
non-medical uses of the PACE technology, both of which will require
additional capital resources. We incurred a net loss of $5,537,936
and $6,439,040 for the years ended December 31, 2017 and 2016,
respectively. These operating losses create uncertainty about our
ability to continue as a going concern.
The continuation of our business is dependent upon
raising additional capital during the second quarter of 2018 to
fund operations. Management’s plans are to obtain additional
capital in 2018 through investments by strategic partners for
market opportunities, which may include strategic partnerships or
licensing arrangements, or raise capital through the conversion of
outstanding warrants, the issuance of common or preferred stock,
securities convertible into common stock, or secured or unsecured
debt. These possibilities, to the extent available, may be on terms
that result in significant dilution to our existing
shareholders. Although no assurances can be given,
management believes that potential additional issuances of equity
or other potential financing transactions as discussed above should
provide the necessary funding for us. If these efforts are unsuccessful, we may be
forced to seek relief through a filing under the U.S. Bankruptcy
Code. Our consolidated financial statements do not include any
adjustments relating to the recoverability of assets and
classification of assets and liabilities that might be necessary
should we be unable to continue as a going
concern.
Since
our inception, we have incurred losses from operations each year.
As of December 31, 2017, we had an accumulated deficit of
$104,971,384. Although the size and timing of our future operating
losses are subject to significant uncertainty, we expect that
operating losses may continue over the next few years as we prepare
for the commercialization of the dermaPACE System for the treatment
of diabetic foot ulcers but if we are able to successfully
commercialize, market and distribute the dermaPACE System, then we
hope to partially or completely offset these losses within the next
few years. Although no assurances can be given, we believe that
potential additional issuances of equity, debt or other potential
financing, as discussed above, will provide the necessary funding
for us to continue as a going concern for the next
year.
We
cannot reasonably estimate the nature, timing and costs of the
efforts necessary to complete the development and approval of, or
the period in which material net cash flows are expected to be
generated from, any of our products, due to the numerous risks and
uncertainties associated with developing products, including the
uncertainty of:
●
the scope, rate of
progress and cost of our clinical trials;
●
future clinical
trial results;
●
the cost and timing
of regulatory approvals;
●
the establishment
of successful marketing, sales and distribution;
●
the cost and timing
associated with establishing reimbursement for our
products;
●
the effects of
competing technologies and market developments; and
●
the industry demand
and patient wellness behavior.
Any
failure to complete the development of our product candidates in a
timely manner, or any failure to successfully market and
commercialize our product candidates, would have a material adverse
effect on our operations, financial position and liquidity. A
discussion of the risks and uncertainties associated with us and
our business are set forth under the section entitled “Risk
Factors – Risks Related to Our Business”.
Critical Accounting Policies and Estimates
The
discussion and analysis of our financial condition and results of
operations are based on our consolidated financial statements,
which have been prepared in accordance with United States generally
accepted accounting principles. The preparation of our consolidated
financial statements requires us to make estimates and assumptions
that affect the reported amounts of assets, liabilities, revenues
and expenses.
On an
ongoing basis, we evaluate our estimates and judgments, including
those related to the recording of the allowances for doubtful
accounts, estimated reserves for inventory, estimated useful life
of property and equipment, the determination of the valuation
allowance for deferred taxes, the estimated fair value of warrants
and warrant liability, and the estimated fair value of stock-based
compensation. We base our estimates on authoritative literature and
pronouncements, historical experience and on various other
assumptions that we believe are reasonable under the circumstances,
the results of which form the basis for making judgments about the
carrying value of assets and liabilities that are not readily
apparent from other sources. Our actual results may differ from
these estimates under different assumptions or conditions. The
results of our operations for any historical period are not
necessarily indicative of the results of our operations for any
future period.
While
our significant accounting policies are more fully described in
Note 2 to our consolidated financial statements filed with this
registration statement on Form S-1, we believe that the following
accounting policies relating to revenue recognition, research and
development costs, inventory valuation, intangible assets,
liabilities related to warrants issued, stock-based compensation
and income taxes are significant and; therefore, they are important
to aid you in fully understanding and evaluating our reported
financial results.
Revenue Recognition
Sales
of medical devices, including related applicators and applicator
kits, are recognized when shipped to the customer. Shipments under
agreements with distributors are invoiced at a fixed price, are not
subject to return, and payment for these shipments is not
contingent on sales by the distributor. We recognize revenue on
shipments to distributors in the same manner as with other
customers. We recognize fees from services performed when the
service is performed. Fees for upfront distribution license
agreements will be recognized as identified performance obligations
are satisfied.
Research and Development Costs
We
expense costs associated with research and development activities
as incurred. We evaluate payments made to suppliers and other
vendors and determine the appropriate accounting treatment based on
the nature of the services provided, the contractual terms, and the
timing of the obligation. Research and development costs include
payments to third parties that specifically relate to our products
in clinical development, such as payments to contract research
organizations, clinical investigators, clinical monitors, clinical
related consultants and insurance premiums for clinical studies. In
addition, employee costs (salaries, payroll taxes, benefits and
travel) for employees of the regulatory affairs, clinical affairs,
quality assurance, quality control, and research and development
departments are classified as research and development
costs.
Inventory Valuation
We
value our inventory at the lower of our actual cost or the current
estimated market value, which is valued using the first in, first
out (FIFO) method, and consists primarily of devices and the
component material for assembly of finished products, less reserves
for obsolescence. We regularly review existing inventory quantities
and expiration dates of existing inventory to evaluate a provision
for excess, expired, obsolete and scrapped inventory based
primarily on our historical usage and anticipated future usage.
Although we make every effort to ensure the accuracy of our
forecasts of future product demand, any significant unanticipated
change in demand or technological developments could have an impact
on the value of our inventory and our reported operating
results.
Intangible Assets
Intangible assets
subject to amortization consist of patents which are recorded at
cost. Patents are amortized on a straight-line basis over the
average life of 11.4 years. We regularly review intangible assets
to determine if facts and circumstances indicate that the useful
life is shorter than we originally estimated or that the carrying
amount of the assets may not be recoverable. If such facts and
circumstances exist, we assess the recoverability of the intangible
assets by comparing the projected undiscounted net cash flows
associated with the related asset or group of assets over their
remaining lives against their respective carrying amounts. If
recognition of an impairment charge is necessary, it is measured as
the amount by which the carrying amount of the intangible asset
exceeds the fair value of the intangible asset.
Liabilities related to Warrants Issued
We
record certain common stock warrants we issued at fair value and
recognize the change in the fair value of such warrants as a gain
or loss, which we report in the Other Income (Expense) section in
our Consolidated Statements of Comprehensive Loss. We report the
warrants that we record at fair value as liabilities because they
contain certain down-round provisions allowing for reduction of
their exercise price. We estimate the fair value of these warrants
using a binomial options pricing model.
Warrants Related to Debt Issued
We
record a warrant discount related to warrants issued with debt at
fair value and recognize the cost using theeffective interest
method over the term of the related debt as interest expense, which
we report in the Other Income (Expense) section in our Consolidated
Statements of Comprehensive Loss. We report this warrant discount
as a reduction of the related debt liability.
Beneficial Conversion Feature on Convertible Debt
We
record a beneficial conversion feature related convertible debt at
fair value and recognize the cost using the effective interest
method over the term of the related debt as interest expense, which
we report in the Other Income (Expense) section in our Consolidated
Statements of Comprehensive Loss. We report this beneficial
conversion feature as a reduction of the related debt
liability.
Stock-based Compensation
The
Stock Incentive Plan provides that stock options, and other equity
interests or equity-based incentives, may be granted to key
personnel, directors and advisors at the fair value of the common
stock at the time the option is granted, which is approved by our
board of directors. The maximum term of any option granted pursuant
to the Stock Incentive Plan is ten years from the date of
grant.
In
accordance with ASC 718, Compensation – Stock Compensation
(formerly SFAS No. 123(R), Accounting for Stock-Based
Compensation), the fair value of each option award is estimated on
the date of grant using the Black-Scholes option pricing model. The
expected terms of options granted represent the period of time that
options granted are estimated to be outstanding and are derived
from the contractual terms of the options granted. We amortize the
fair value of each option over each option’s vesting
period.
Income Taxes
We
account for income taxes utilizing the asset and liability method
prescribed by the provisions of ASC 740, Income Taxes (formerly SFAS
No. 109, Accounting for Income Taxes). Deferred tax assets and
liabilities are determined based on differences between the
financial reporting and tax basis of assets and liabilities and are
measured using the enacted tax rates and laws that will be in
effect when the differences are expected to reverse. A valuation
allowance is provided for the deferred tax assets, including loss
carryforwards, when it is more likely than not that some portion or
all of a deferred tax asset will not be realized.
We
account for uncertain tax positions in accordance with the related
provisions of ASC 740, Income
Taxes (formerly FASB Interpretation No. 48, Accounting for
Uncertainty in Income Taxes (FIN 48)). ASC 740 specifies the way
public companies are to account for uncertainties in income tax
reporting, and prescribes a methodology for recognizing, reversing,
and measuring the tax benefits of a tax position taken, or expected
to be taken, in a tax return. ASC 740 requires the evaluation of
tax positions taken or expected to be taken in the course of
preparing our tax returns to determine whether the tax positions
would “more-likely-than-not” be sustained if challenged
by the applicable tax authority. Tax positions not deemed to meet
the more-likely-than-not threshold would be recorded as a tax
benefit or expense in the current year.
Results of Operations for the Years ended December 31, 2017 and
2016
Revenues and Cost of Revenues
Revenues for the
year ended December 31, 2017 were $738,527, compared to $1,376,063
for the same period in 2016, a decrease of $637,536, or 46%.
Revenue resulted primarily from sales in Europe, Asia, and
Asia/Pacific of our orthoPACE devices and related applicators and
upfront distribution fee from our Brazilian distribution agreement
with MundiMed. The decrease in revenue for 2017 is primarily due to
a decrease in sales of orthoPACE devices in Asia/Pacific and the
European Community, as compared to the prior year, as well as lower
sales of new and refurbished applicators.
Cost of
revenues for the year ended December 31, 2017 were $241,970,
compared to $565,129 for the same period in 2016. Gross profit as a
percentage of revenues was 67% for the year ended December 31,
2017, compared to 59% for the same period in 2016. The increase in
gross profit as a percentage of revenues in 2017 was primarily due
to higher revenue for refurbishment license and upfront
distribution fee which have little or no related cost, as compared
to 2016. Gross profit as a percentage of revenues excluding
refurbishment license and upfront distribution fee revenue
decreased for the year ended December 31, 2017, compared to the
same period in 2016 due to reduced pricing to customers for
refurbishments and higher shipping costs.
Research and Development Expenses
Research and
development expenses for the year ended December 31, 2017 were
$1,292,531, compared to $1,128,640 for the same period in
2016, an increase of $163,891, or 15%. Research and development
expenses include the costs associated with the dermaPACE submission
to the FDA, which incurred costs related to responses to questions
from the FDA including the hiring of an independent consultant to
perform software updates. In addition, a medical device and
separate technical audit was performed related to our ISO
certification in 2017.
General and Administrative Expenses
General
and administrative expenses for the year ended December 31, 2017
were $3,004,803, as compared to $2,673,773 for the same period in
2016, an increase of $331,030, or 12%. The increase in general and
administrative expenses in 2017, as compared to 2016, was due to an
increase in board of director’s fees related to adding a
member to the board, costs associated with symposium hosted in
December 2017, increased costs associated with investor relations
consultants, and increased non-cash stock based compensation
related to stock option and stock warrants issued in
2017.
Depreciation and Amortization
Depreciation for
the year ended December 31, 2017 was $24,069, compared to $19,858
for the same period in 2016, an increase of $4,211, or 21%. The
increase was due to the full year of depreciation related to
devices added to fixed assets in the prior year.
Amortization for
the years ended December 31, 2017 and 2016 was $0 and $306,756,
respectively. The decrease is due to the intangible assets being
fully amortized as of December 31, 2016.
Other Income (Expense)
Other
income (expense) was a net expense of $1,713,490 for the year ended
December 31, 2017 as compared to a net expense of
$3,122,541 for the same period in 2016, a decrease of
$1,409,051 in the net expense. The net expense in 2017 included a
non-cash loss of $568,729 for a valuation adjustment on outstanding
warrants, as compared to a net expense in 2016 included a non-cash
loss of $2,223,718 for a valuation adjustment on outstanding
warrants and conversion of Series A Warrants. The is partially
offset by increased interest expense, beneficial conversion
discount and debt discount in 2017, as compared to 2016, mainly due
to convertible promissory notes issued in the fourth quarter of
2017.
Provision for Income Taxes
At
December 31, 2017, we had federal net operating loss carryforwards
of $78,455,234 that will begin to expire in 2025. Our ability to
use these net operating loss carryforwards to reduce our future
federal income tax liabilities could be subject to annual
limitations. In connection with possible future equity offerings,
we may realize a “more than 50% change in ownership”
which could further limit our ability to use our net operating loss
carryforwards accumulated to date to reduce future taxable income
and tax liabilities. Additionally, because United States tax laws
limit the time during which net operating loss carryforwards may be
applied against future taxable income and tax liabilities, we may
not be able to take advantage of our net operating loss
carryforwards for federal income tax purposes.
Net Loss
Net
loss for the year ended December 31, 2017 was $5,537,936, or
($0.04) per basic and diluted share, compared to a net loss of
$6,439,040, or ($0.06) per basic and diluted share, for the same
period in 2016, a decrease in the net loss of $901,104, or 14%. The
decrease in the net loss was primarily a result of decreased loss
on warrant valuation that is partially offset by increase in
operating expenses.
We anticipate
that our operating losses will continue over the next few years as
we prepare for the commercialization of the dermaPACE System for
the treatment of diabetic foot ulcers in the United States but if
we are able to successfully commercialize, market and distribute
the dermaPACE System, then we hope to partially or completely
offset these losses within the next few years.
Liquidity and Capital Resources
We
expect to devote substantial resources for the commercialization of
the dermaPACE System and will continue to research and develop the
non-medical uses of the PACE technology, both of which will require
additional capital resources. We incurred a net loss of $5,537,936
and $6,439,040 for the years ended December 31, 2017 and 2016,
respectively. These operating losses create uncertainty about our
ability to continue as a going concern.
At
December 31, 2017, the Company’s distributor in South Korea
accounted for 69% of the total outstanding accounts receivable. Due
to the political climate and uncertainty in South Korea, this
distributor has been unable to pay the Company in a timely manner.
The Company has accounted for 38% of the total outstanding accounts
receivable balance as a bad debt reserve as of December 31, 2017.
The Company continues to work with the South Korean distributor on
a payment plan to get their account current by April 30,
2018.
The continuation of our business is dependent upon
raising additional capital during or before the second quarter of
2018 to fund operations. Management expects the cash used in
operations for the Company will be approximately $225,000 to
$300,000 per month for the first quarter of 2018 and $275,000 to
$350,000 per month for the second quarter of 2018 as
resources are devoted to the expansion of our international
business, preparations for commercialization of the dermaPACE
product including hiring of new employees and continued research
and development of non-medical uses of our technology. Management’s plans are to obtain additional
capital in 2018 through investments by strategic partners for
market opportunities, which may include strategic partnerships or
licensing arrangements, or raise capital through the conversion of
outstanding warrants, issuance of common or preferred stock,
securities convertible into common stock, or secured or unsecured
debt. These possibilities, to the extent available, may be on terms
that result in significant dilution to our existing
shareholders. Although no assurances can be given,
management believes that potential additional issuances of equity
or other potential financing transactions as discussed above should
provide the necessary funding for us. If these efforts are unsuccessful, we may be
forced to seek relief through a filing under the U.S. Bankruptcy
Code. Our consolidated financial statements do not include any
adjustments relating to the recoverability of assets and
classification of assets and liabilities that might be necessary
should we be unable to continue as a going
concern.
On
December 29, 2017, the Company entered into a line of credit
agreement with A. Michael Stolarski, a
member of the Company’s board of directors and an existing
shareholder of the Company. The agreement established a line
of credit in the amount of $370,000 with an annualized interest
rate of 6%. The line of credit may be called for payment upon
demand. On January 26, 2018, the Company entered into a Master
Equipment Lease with NFS Leasing Inc. to provide financing for
equipment purchases to enable the Company to begin placing the
dermaPACE System in the marketplace. This agreement provides for a
lease line of up to $1,000,000 with a lease term of 36 months, and
grants NFS a security interest in the Company’s accounts
receivable, personal property and money and deposit accounts of the
Company.
We may
also attempt to raise additional capital if there are favorable
market conditions or other strategic considerations even if we have
sufficient funds for planned operations. To the extent that we
raise additional funds by issuance of equity securities, our
shareholders will experience dilution and we may be required to use
some or all of the net proceeds to repay our indebtedness, and debt
financings, if available, may involve restrictive covenants or may
otherwise constrain our financial flexibility. To the extent that
we raise additional funds through collaborative arrangements, it
may be necessary to relinquish some rights to our intellectual
property or grant licenses on terms that are not favorable to us.
In addition, payments made by potential collaborators or licensors
generally will depend upon our achievement of negotiated
development and regulatory milestones. Failure to achieve these
milestones would harm our future capital position.
For the
years ended December 31, 2017 and 2016, net cash used by operating
activities was $1,528,971 and $3,199,453, respectively, primarily
consisting of compensation costs, research and development
activities and general corporate operations. The decrease in the
use of cash for operating activities for the year ended December
31, 2017, as compared to the same period for 2016, of $1,670,482,
or 52%, was primarily due to the increase in accounts receivable of
$250,678 and in accounts payable and accrued expenses of
$1,082,071. Net cash used by investing activities in 2017 was $0 as
compared to net cash provided by investing activities in 2016 of
$8,770 from the purchase of property and equipment. Net cash
provided by financing activities for the year ended December 31,
2017 was $2,117,298, which primarily consisted of the net proceeds
from convertible promissory notes of $1,384,232, proceeds from
related party line of credit of $370,000, proceeds from advances
from related parties of $310,000 and proceeds from warrant
exercises of $93,066. Net cash provided by financing activities for
the year ended December 31, 2016 was $3,207,771, which primarily
consisted of the net proceeds from 2016 Public Offering of
$1,596,855, 2016 Private Placement of $1,528,200, and proceeds from
warrant exercises of $67,466. Cash and cash equivalents increased
by $596,613 for the year ended December 31, 2017 and cash and cash
equivalents decreased by $19,359 for the year ended December 31,
2016.
Contractual Obligations
Our
major outstanding contractual obligations relate to our operating
lease for our facility, purchase and supplier obligations for
product component materials and equipment, and our notes
payable.
In
August 2016, we entered into a lease agreement for the
operations, production and research and development office for
7,500 square feet of space. Under the terms of the lease, we pay
monthly rent of $10,844, as adjusted on an annual basis for
additional proportionate operating and insurance costs associated
with the building over the base amount. The term of the lease is 65
months.
We have
developed a network of suppliers, manufacturers, and contract
service providers to provide sufficient quantities of product
component materials for our products through the development,
clinical testing and commercialization phases. We have a
manufacturing supply agreement with Swisstronics Contract
Manufacturing AG in Switzerland, a division of Cicor Technologies
Ltd., covering the generator box component of our
devices.
In
August 2005, as part of the purchase of the orthopedic division
assets of HealthTronics, Inc., we issued two notes to
HealthTronics, Inc. for $2,000,000 each. The notes bear interest at
6% annually. Quarterly interest through June 30, 2010 was accrued
and added to the principal balance. Interest is paid quarterly in
arrears beginning September 30, 2010. All remaining unpaid accrued
interest and principal was due August 1, 2015. Accrued interest on
the notes which matured in August 2015 totaled $1,372,743 at
December 31, 2017 and 2016.
On June
15, 2015, we entered into an amendment (the “Note
Amendment”) with HealthTronics, Inc. to amend certain
provisions of the notes payable, related parties. The Note Amendment provides for the extension of
the due date to January 31, 2017. In connection with the
Note Amendment, we entered into a security agreement with
HealthTronics, Inc. to provide a first security interest in the
assets of the Company. The notes payable,
related parties will bear interest at 8% per annum effective August
1, 2015 and during any period when an Event of Default occurs, the
applicable interest rate shall increase by 2% per annum. Events of
Default under the notes payable, related parties have occurred and
are continuing on account of the failure of SANUWAVE, Inc., a
wholly owned subsidiary of the Company and the borrower under the
notes payable, related parties, to make the required payments of
interest which were due on December 31, 2016, March 31, 2017, June
30, 2017, September 30, 2017, and December 31, 2017 (collectively,
the “Defaults”). As a result of the Defaults, the notes
payable, related parties have been accruing interest at the rate of
10% per annum since January 2, 2017 and continue to accrue interest
at such rate. The Company will be required to make mandatory
prepayments of principal on the notes payable, related parties
equal to 20% of the proceeds received by the Company through the
issuance or sale of any equity securities in cash or through the
licensing of the Company’s patents or other intellectual
property rights.
In
addition, in connection with the Note Amendment, we issued to
HealthTronics, Inc. on June 15, 2015, an aggregate total of
3,310,000 warrants (the “Class K Warrants”) to purchase
shares of the Company’s common stock, $0.001 par value (the
“Common Stock”), at an exercise price of $0.55 per
share, subject to certain anti-dilution protection. Each Class K
Warrant represents the right to purchase one share of Common Stock.
The warrants vested upon issuance and expire after ten
years.
On June
28, 2016, the Company and HealthTronics, Inc. entered into a second
amendment (the “Second Amendment”) to amend certain
provisions of the notes payable, related parties. The Second
Amendment provides for the extension of the due date to January 31,
2018.
In
addition, the Company, in connection with the Second Amendment,
issued to HealthTronics, Inc. on June 28, 2016, an additional
1,890,000 Class K Warrants to purchase shares of the
Company’s Common Stock at an exercise price of $0.08 per
share, subject to certain anti-dilution protection. The exercise
price of the 3,310,000 Class K Warrants issued on June 15, 2015 was
decreased to $0.08 per share.
On
August 3, 2017, the Company and HealthTronics, Inc. entered into a
third amendment (the “Third Amendment”) to amend
certain provisions of the notes payable, related parties. The Third
Amendment provides for the extension of the due date to December
31, 2018, revision of the mandatory prepayment provisions and the
future issuance of additional warrants to HealthTronics upon
certain conditions.
In
addition, the Company, in connection with the Third Amendment,
issued to HealthTronics, Inc. on August 3, 2017, an additional
2,000,000 Class K Warrants to purchase shares of the
Company’s Common Stock at an exercise price of $0.11 per
share, subject to certain anti-dilution protection. Each Class K
Warrant represents the right to purchase one share of Common Stock.
The warrants vested upon issuance and expire after ten
years.
Recently Issued Accounting Standards
New
accounting pronouncements are issued by the Financial Standards
Board (“FASB”) or other standards setting bodies that
the Company adopts according to the various timetables the FASB
specifies. The Company does not expect the adoption of recently
issued accounting pronouncements to have a significant impact on
the Company’s results of operations, financial position or
cash flow.
In May
2014, the FASB issued Accounting Standards Update No. 2014-09,
Revenue from Contracts with
Customers (ASU 2014-09), which supersedes nearly all
existing revenue recognition guidance under U.S. GAAP. The core
principle of ASU 2014-09 is to recognize revenues when promised
goods or services are transferred to customers in an amount that
reflects the consideration to which an entity expects to be
entitled for those goods or services. ASU 2014-09 defines a five
step process to achieve this core principle and, in doing so, more
judgment and estimates may be required within the revenue
recognition process than are required under existing U.S. GAAP. The
standard is effective for annual periods beginning after December
15, 2017, and interim periods therein, using either of the
following transition methods: (i) a full retrospective method,
which requires the standard to be applied to each prior period
presented, or (ii) a modified retrospective method, which requires
the cumulative effect of adoption to be recognized as an adjustment
to the opening retained earnings in the period of adoption. In July
2015, the FASB confirmed a one-year delay in the effective date of
ASU 2014-09, making the effective date for the Company the first
quarter of fiscal 2018 instead of the current effective date, which
was the first quarter of fiscal 2017. This one year deferral was
issued by the FASB in ASU 2015-14, Revenue from Contracts with Customers (Topic
606). The Company can elect to adopt the provisions of ASU
2014-09 for annual periods beginning after December 31, 2017,
including interim periods within that reporting period. The FASB
also agreed to allow entities to choose to adopt the standard as of
the original effective date. The Company will adopt the standard
effective January 1, 2018 and currently anticipates using the
modified retrospective approach with a cumulative effect adjustment
to opening retained earnings. The evaluation of our contracts is
substantially complete and, based upon the results of our
evaluation, we do not expect the application of the new standard to
these contracts to have a material impact to our consolidated
statements of comprehensive loss, balance sheets, or cash flows
either at initial implementation or on an ongoing basis. We will be
finalizing our assessment in advance of the filing of our first
quarter 2018 Form 10-Q. The disclosures related to revenue
recognition will be significantly expanded under the standard,
specifically around the quantitative and qualitative information
about performance obligations and disaggregation of revenue. The
expanded disclosure requirements will be included in our first
quarter 2018 Form 10-Q.
In
February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842), which requires
lessees to recognize most leases on the balance sheet. The
provisions of this guidance are effective for the annual periods
beginning after December 15, 2018, and interim periods within those
years, with early adoption permitted. Management is evaluating the
requirements of this guidance and has not yet determined the impact
of the adoption on the Company’s financial position or
results of operations.
In
August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows: Classification of
Certain Cash Receipts and Cash Payments (Topic 230). This
ASU will make eight targeted changes to how cash receipts and cash
payments are presented and classified in the statement of cash
flows. The ASU will be effective for fiscal years beginning after
December 15, 2017. This standard will require adoption on a
retrospective basis unless it is impracticable to apply, in which
case it would be required to apply the amendments prospectively as
of the earliest date practicable. The new standard will be adopted
during the first quarter of 2018 using a retrospective transition
method. The adoption of this guidance will not have significant
impact on our financial statements.
In July
2017, the FASB issued ASU No. 2017-11, Earnings Per Share (Topic 260); Distinguishing
Liabilities from Equity (Topic 480): Derivatives and Hedging (Topic
815): (Part I) Accounting for Certain Financial Instruments with
Down Round Features, (Part II) Replacement of the Indefinite
Deferral for Mandatorily Redeemable Financial Instruments of
Certain Nonpublic Entities and Certain Mandatorily Redeemable
Noncontrolling Interests with a Scope Exception. Part I of
this ASU addresses the complexity and reporting burden associated
with the accounting for freestanding and embedded instruments with
down round features as liabilities subject to fair value
measurement. Part II of this ASU addresses the difficulty of
navigating Topic 480. Part I of this ASU will be effective for
fiscal years beginning after December 15, 2018. Early adoption is
permitted for an entity in an interim or annual period. Management
is evaluating the requirements of this guidance and has not yet
determined the impact of the pending adoption on the
Company’s financial position or results of
operations.
In February 2018, the FASB issued ASU
2018-02, Reclassification of Certain
Tax Effects from Accumulated Other Comprehensive
Income. This ASU requires
reclassification from accumulated other comprehensive income to
retained earnings for stranded tax effects resulting from the Tax
Cuts and Jobs Act. The amount of the reclassification is the
difference between the historical 35% corporate income tax rate and
the newly enacted 21% corporate income tax rate. Because the
amendments only relate to the reclassification of the income tax
effects of the Tax Cuts and Jobs Act, the underlying guidance that
requires that the effect of a change in tax laws of rates be
included in income from continuing operations is not affected. This
ASU is effective for fiscal years beginning after December 15,
2018. Early adoption is permitted. We have elected early adoption of this ASU. The
impact of the newly enacted 21% corporate income tax rate of the
Tax Cuts and Jobs Act was a $11.1 million adjustment to the gross
deferred tax assets which was offset by the same adjustment to the
valuation allowance at December 31, 2017.
Off-Balance Sheet Arrangements
Since
inception, we have not engaged in any off-balance sheet activities,
including the use of structured finance, special purpose entities
or variable interest entities.
Effects of Inflation
Because
our assets are, to an extent, liquid in nature, they are not
significantly affected by inflation. However, the rate of inflation
affects such expenses as employee compensation, office space
leasing costs and research and development charges, which may not
be readily recoverable during the period of time that we are
bringing the product candidates to market. To the extent inflation
results in rising interest rates and has other adverse effects on
the market, it may adversely affect our consolidated financial
condition and results of operations.
BUSINESS
Overview
We are
a shock wave technology company using a patented system of
noninvasive, high-energy, acoustic shock waves for regenerative
medicine and other applications. Our initial focus is regenerative
medicine – utilizing noninvasive, acoustic shock waves to
produce a biological response resulting in the body healing itself
through the repair and regeneration of tissue, musculoskeletal, and
vascular structures. Our lead regenerative product in the United
States is the dermaPACE® device, used
for treating diabetic foot ulcers, which was subject to two
double-blinded, randomized Phase III clinical studies. On December
28, 2017, the U.S. Food and Drug Administration (the
“FDA”) notified the Company to permit the marketing of
the dermaPACE System for the treatment of diabetic foot ulcers in
the United States.
Our
portfolio of healthcare products and product candidates activate
biologic signaling and angiogenic responses, including new
vascularization and microcirculatory improvement, helping to
restore the body’s normal healing processes and regeneration.
We intend to apply our Pulsed Acoustic Cellular Expression
(PACE®) technology in
wound healing, orthopedic, plastic/cosmetic and cardiac conditions.
In 2018, we have started marketing our dermaPACE System for sale in
the United States and will continue to generate revenue from sales
of the European Conformity Marking (CE Mark) devices and
accessories in Europe, Canada, Asia and Asia/Pacific.Our lead
product candidate for the global wound care market, dermaPACE, has
received FDA approval for commercial use to treat diabetic foot
ulcers in the United States and the CE Mark allowing for commercial
use on acute and chronic defects of the skin and subcutaneous soft
tissue. We believe we
have demonstrated that our patented technology is safe and
effective in stimulating healing in chronic conditions of the foot
and the elbow through our United States FDA Class III PMA approved
OssaTron® device, and in
the stimulation of bone and chronic tendonitis regeneration in the
musculoskeletal environment through the utilization of our
OssaTron, Evotron®, and
orthoPACE® devices in
Europe and Asia.
We are
focused on developing our Pulsed Acoustic Cellular Expression
(PACE) technology to activate healing in:
●
wound conditions,
including diabetic foot ulcers, venous and arterial ulcers,
pressure sores, burns and other skin eruption
conditions;
●
orthopedic
applications, such as eliminating chronic pain in joints from
trauma, arthritis or tendons/ligaments inflammation, speeding the
healing of fractures (including nonunion or delayed-union
conditions), improving bone density in osteoporosis, fusing bones
in the extremities and spine, and other potential sports injury
applications;
●
plastic/cosmetic
applications such as cellulite smoothing, graft and transplant
acceptance, skin tightening, scarring and other potential aesthetic
uses; and
●
cardiac
applications for removing plaque due to atherosclerosis improving
heart muscle performance.
In
addition to healthcare uses, our high-energy, acoustic pressure
shock waves, due to their powerful pressure gradients and localized
cavitational effects, may have applications in secondary and
tertiary oil exploitation, for cleaning industrial waters, for
sterilizing food liquids and finally for maintenance of industrial
installations by disrupting biofilms formation. Our business
approach will be through licensing and/or partnership
opportunities.
We were
formed as a Nevada corporation in 2004.
Pulsed Acoustic Cellular Expression (PACE) Technology for
Regenerative Medicine
Our
PACE product candidates, including our lead product candidate,
dermaPACE, deliver high-energy acoustic pressure waves in the
shockwave spectrum to produce compressive and tensile stresses on
cells and tissue structures. These mechanical stresses at the
cellular level have been shown in pre-clinical work to promote
angiogenic and positive inflammatory responses, and quickly
initiate the healing cascade. This has been shown in pre-clinical
work to result in microcirculatory improvement, including increased
perfusion and blood vessel widening (arteriogenesis), the
production of angiogenic growth factors, enhanced new blood vessel
formation (angiogenesis) and the subsequent regeneration of tissue
such as skin, musculoskeletal and vascular structures. PACE
procedures trigger the initiation of an accelerated inflammatory
response that speeds wounds into proliferation phases of healing
and subsequently returns a chronic condition to an acute condition
to help reinitiate the body’s own healing response. We
believe that our PACE technology is well suited for various
applications due to its activation of a broad spectrum of cellular
events critical for the initiation and progression of
healing.
High-energy,
acoustic pressure shock waves are the primary component of our
previously developed product, OssaTron, which was approved by the
FDA and marketed in the United States for use in chronic plantar
fasciitis of the foot in 2000 and for elbow tendonitis in 2003.
Previously, acoustic pressure shock waves have been used safely at
much higher energy and pulse levels in the lithotripsy procedure
(breaking up kidney stones) by urologists for over 25 years and has
reached the care status of “golden standard” for the
treatment of kidney stones.
We
research, design, manufacture, market and service our products
worldwide and believe we have already demonstrated that our
technology is safe and effective in stimulating healing in chronic
conditions of the foot and the elbow through our United States FDA
Class III PMA approved OssaTron device, and in the stimulation of
bone and chronic tendonitis regeneration in the musculoskeletal
environment through the utilization of our orthoPACE, Evotron and
OssaTron devices in Europe and Asia.
We
believe our experience from our preclinical research and the
clinical use of our predecessor legacy devices in Europe and Asia,
as well as our OssaTron device in the United States, demonstrates
the safety, clinical utility and efficacy of these products. In
addition, we have preclinical programs focused on the development
and better understanding of treatments specific to our target
applications.
Currently, there
are limited biological or mechanical therapies available to
activate the healing and regeneration of tissue, bone and vascular
structures. As baby boomers age, the incidence of their targeted
diseases and musculoskeletal injuries and ailments will be far more
prevalent. We believe that our pre-clinical and clinical studies
suggest that our PACE technology will be effective in targeted
applications. If successful, we anticipate that future clinical
studies should lead to regulatory approval of our regenerative
product candidates in the United States, Europe and Asia. If
approved by the appropriate regulatory authorities, we believe that
our product candidates will offer new, effective and noninvasive
treatment options in wound healing, orthopedic injuries,
plastic/cosmetic uses and cardiac procedures, improving the quality
of life for millions of patients suffering from injuries or
deterioration of tissue, bones and vascular
structures.
dermaPACE – Our Lead Product Candidate
The FDA
granted approval of our Investigational Device Exemption (IDE) to
conduct two double-blinded, randomized clinical trials utilizing
our lead device product for the global wound care market, the
dermaPACE device, in the treatment of diabetic foot
ulcers.
The
dermaPACE system was evaluated using two studies under IDE G070103.
The studies were designed as prospective, randomized, double-blind,
parallel-group, sham-controlled, multi-center 24-week studies at 39
centers. A total of 336 subjects were enrolled and treated with
either dermaPACE plus conventional therapy or conventional therapy
(a.k.a. standard of care) alone. Conventional therapy included, but
was not limited to, debridement, saline-moistened gauze, and
pressure reducing footwear. The objective of the studies was to
compare the safety and efficacy of the dermaPACE device to
sham-control application. The prospectively defined primary
efficacy endpoint for the dermaPACE studies was the incidence of
complete wound closure at 12 weeks post-initial application of the
dermaPACE system (active or sham). Complete wound closure was
defined as skin re-epithelialization without drainage or dressing
requirements, confirmed over two consecutive visits within
12-weeks. If the wound was considered closed for the first time at
the 12 week visit, then the next visit was used to confirm closure.
Investigators continued to follow subjects and evaluate wound
closure through 24 weeks.
The dermaPACE device completed its initial Phase
III, IDE clinical trial in the United States for the treatment of
diabetic foot ulcers in 2011 and a PMA application was filed with
the FDA in July 2011. The patient enrollment for the second,
supplemental clinical trial began in June 2013. We completed
enrollment for the 130 patients in this second trial in November
2014 and suspended further enrollment at that time.
The
only significant difference between the two studies was the number
of applications of the dermaPACE device. Study one (DERM01; n=206)
prescribed four (4) device applications/treatments over a two-week
period, whereas, study two (DERM02; n=130) prescribed up to eight
(8) device applications (4 within the first two weeks of
randomization, and 1 treatment every two weeks thereafter up to a
total of 8 treatments over a 10-week period). If the wound was
determined closed by the PI during the treatment regimen, any
further planned applications were not performed.
Between
the two studies there were over 336 patients evaluated, with 172
patients treated with dermaPACE and 164 control group subjects with
use of a non-functional device (sham). Both treatment groups
received wound care consistent with the standard of care in
addition to device application. Study subjects were enrolled using
pre-determined inclusion/exclusion criteria in order to obtain a
homogenous study population with chronic diabetes and a diabetic
foot ulcer that has persisted a minimum of 30 days and its area is
between 1cm2 and 16cm2, inclusive. Subjects
were enrolled at Visit 1 and followed for a run-in period of two
weeks. At two weeks (Visit 2 – Day 0), the first treatment
was applied (either dermaPACE or Sham Control application).
Applications with either dermaPACE or Sham Control were then made
at Day 3 (Visit 3), Day 6 (Visit 4), and Day 9 (Visit 5) with the
potential for 4 additional treatments in Study 2. Subject progress
including wound size was then observed on a bi-weekly basis for up
to 24 weeks at a total of 12 visits (Weeks 2-24; Visits
6-17).
A total
of 336 patients were enrolled in the dermaPACE studies at 37 sites.
The patients in the studies were followed for a total of 24 weeks.
The studies’ primary endpoint, wound closure, was defined as
“successful” if the skin was 100% re-epithelialized at
12 weeks without drainage or dressing requirements confirmed at two
consecutive study visits.
A
summary of the key study findings were as follows:
●
Patients treated
with dermaPACE showed a strong positive trend in the primary
endpoint of 100% wound closure. Treatment with dermaPACE increased
the proportion of diabetic foot ulcers that closed within 12 weeks,
although the rate of complete wound closure between dermaPACE and
sham-control at 12 weeks in the intention-to-treat (ITT) population
was not statistically significant at the 95% confidence level used
throughout the study (p=0.320). There were 39 out of 172 (22.67%)
dermaPACE subjects who achieved complete wound closure at 12 weeks
compared with 30 out of 164 (18.29%) sham-control
subjects.
●
In addition to the
originally proposed 12-week efficacy analysis, and in conjunction
with the FDA agreement to analyze the efficacy analysis carried
over the full 24 weeks of the study, we conducted a series of
secondary analyses of the primary endpoint of complete wound
closure at 12 weeks and at each subsequent study visit out to 24
weeks. The primary efficacy endpoint of complete wound closure
reached statistical significance at 20 weeks in the ITT population
with 61 (35.47%) dermaPACE subjects achieving complete wound
closure compared with 40 (24.39%) of sham-control subjects
(p=0.027). At the 24 week endpoint, the rate of wound closure in
the dermaPACE® cohort was 37.8% compared to 26.2% for the
control group, resulting in a p-value of 0.023.
●
Within 6 weeks
following the initial dermaPACE treatment, and consistently
throughout the 24-week period, dermaPACE significantly reduced the
size of the target ulcer compared with subjects randomized to
receive sham-control (p<0.05).
●
The proportion of
patients with wound closure indicate a statistically significant
difference between the dermaPACE and the control group in the
proportion of subjects with the target-ulcer not closed over the
course of the study (p-value=0.0346). Approximately 25% of
dermaPACE® subjects reached wound closure per the study
definition by day 84 (week 12). The same percentage in the control
group (25%) did not reach wound closure until day 112 (week 16).
These data indicate that in addition to the proportion of subjects
reaching wound closure being higher in the dermaPACE® group,
subjects are also reaching wound closure at a faster rate when
dermaPACE is applied.
●
dermaPACE
demonstrated superior results in the prevention of wound expansion
(≥ 10% increase in wound size), when compared to the control,
over the course of the study at 12 weeks (18.0% versus 31.1%;
p=0.005, respectively).
●
At 12 and 24 weeks,
the dermaPACE group had a higher percentage of subjects with a 50%
wound reduction compared to the control (p=0.0554 and p=0.0899,
respectively). Both time points demonstrate a trend towards
statistical significance.
●
The mean wound
reduction for dermaPACE subjects at 24 weeks was 2.10cm2 compared
to 0.83cm2 in the control group. There was a statistically
significant difference between the wound area reductions of the two
cohorts from the 6 week follow-up visit through the end of the
study.
●
Of the subjects who
achieved complete wound closure at 12 weeks, the recurrence rate at
24 weeks was only 7.7% in the dermaPACE group compared with 11.6%
in the sham-control group.
●
Importantly, there
were no meaningful statistical differences in the adverse event
rates between the dermaPACE treated patients and the sham-control
group. There were no issues regarding the tolerability of the
treatment which suggests that a second course of treatment, if
needed, is a clinically viable option.
We
retained Musculoskeletal Clinical Regulatory Advisers, LLC (MCRA)
in January 2015 to lead the Company’s interactions and
correspondence with the FDA for the dermaPACE, which have already
commenced. MCRA has successfully worked with the FDA on numerous
Premarket Approvals (PMAs) for various musculoskeletal, restorative
and general surgical devices since 2006.
Working
with MCRA, we submitted to FDA a de novo petition on July 23, 2016. Due
to the strong safety profile of our device and the efficacy of the
data showing statistical significance for wound closure for
dermaPACE subjects at 20 weeks, we believe that the dermaPACE
device should be considered for classification into Class II as
there is no legally marketed predicate device and there is not an
existing Class III classification regulation or one or more
approved PMAs (which would have required a reclassification under
Section 513(e) or (f)(3) of the FD&C Act). On December 28,
2017, the FDA determined that the criteria at section 513(a)(1)(A)
of (B) of the FD&C Act were met and granted the de novo clearance classifying dermaPACE
as Class II and available to be marketed immediately.
Finally, our
dermaPACE device has received the European CE Mark approval to
treat acute and chronic defects of the skin and subcutaneous soft
tissue, such as in the treatment of pressure ulcers, diabetic foot
ulcers, burns, and traumatic and surgical wounds. The dermaPACE is
also licensed for sale in Canada, Australia, New Zealand and South
Korea.
We are
actively marketing the dermaPACE to the European Community, Canada
and Asia/Pacific, utilizing distributors in select
countries.
Growth Opportunity in Wound Care Treatment
We are focused on the development of products that
treat unmet medical needs in large market opportunities. Our FDA
approval in the United States for our lead product candidate,
dermaPACE, is the first step in providing an option to a currently
unmet need in the treatment of diabetic foot ulcers.
Diabetes is common, disabling and deadly. In the United States,
diabetes has reached epidemic proportions. Based on our
research, foot ulcerations are one of the leading causes of
hospitalization in diabetic patients and lead to billions of
dollars in health care expenditures annually. According to a 2015 report by the Centers for
Disease Control and Prevention, approximately 30.3 million people
(diagnosed and undiagnosed), roughly 9.4% of the United States
population, have diabetes and 1.5
million new cases of diabetes were diagnosed in people aged 18
years or older in 2015. According to the same study,
approximately 25% of diabetics will develop a diabetic foot
ulceration (“DFU”) during their lifetime. Foot ulcers are a significant
complication of diabetes mellitus and often precede lower-extremity
amputation. The most frequent underlying etiologies are neuropathy,
trauma, deformity, high plantar pressures, and peripheral arterial
disease. Over 50% of DFUs will become infected, resulting in
high rates of hospitalization, increased morbidity and potential
lower extremity amputation. Diabetic foot infections
(“DFI”) are one of the most common diabetes related
cause of hospitalization in the United States, accounting for 20%
of all hospital admissions. Readmission rates for DFI patients are
approximately 40% and nearly one in six patients die within 1 year
of their infection. In a large prospective study of patients with
DFU, the presence of infection increased the risk of a minor
amputation by 50% compared to ulcer patients without infection.
DFUs account for more than half of the non-traumatic
lower-extremity amputations in the world. The Advanced Medical
Technology Association (“AdvaMed”) estimates that
chronic leg wounds (ulcers) account for the loss of many workdays
per year, at a cost of approximately $20.8 billion in lost
productivity. Advanced, cost-effective treatment modalities for
diabetes and its comorbidities, including diabetic foot ulcers, are
in great need globally, yet in short supply. According to the
International Diabetes Federation, 1 in 11 adults has diabetes
(approximately 425 million people) and 12% of global health
expenditure is spent on diabetes (approximately $727
billion).
A
majority of challenging wounds are non-healing chronic wounds and
in addition, chronic diabetic foot ulcers and pressure ulcers are
often slow-to-heal wounds, which often fail to heal for many
months, and sometimes, for several years. These wounds often
involve physiologic, complex and multiple complications such as
reduced blood supply, compromised lymphatic systems or immune
deficiencies that interfere with the body’s normal wound
healing processes. These wounds often develop due to a
patient’s impaired vascular and tissue repair capabilities.
Wounds that are difficult to treat do not always respond to
traditional therapies, which include hydrocolloids, hydrogels and
alginates, among other treatments. We believe that physicians and
hospitals need a therapy that addresses the special needs of these
chronic wounds with high levels of both clinical and cost
effectiveness.
We
believe we are developing a safe and advanced technology in the
wound healing and tissue regeneration market with PACE. dermaPACE
is noninvasive and does not require anesthesia, making it a
cost-effective, time-efficient and painless approach to wound care.
Physicians and nurses look for therapies that can accelerate the
healing process and overcome the obstacles of patients’
compromised conditions, and prefer therapies that are easy to
administer. In addition, since many of these patients are not
confined to bed, healthcare providers want therapies that are
minimally disruptive to the patient’s or the
caregiver’s daily routines. dermaPACE’s noninvasive
treatments are designed to elicit the body’s own healing
response and, followed by simple standard of care dressing changes,
are designed to allow for limited disruption to the patients’
normal lives and have no effect on mobility while their wounds
heal.
Developing Product Opportunities - Orthopedic
We
launched the orthoPACE device in Europe, which is intended for use
in orthopedic, trauma and sports medicine indications, following CE
Marking approval in 2010. The device features four types of
applicators including a unique applicator that is less painful for
some indications and may reduce or completely eliminate anesthesia
for some patients. In the orthopedic setting, the orthoPACE is
being used to treat tendinopathies and acute and nonunion
fractures, including the soft tissue surrounding the fracture to
accelerate healing and prevent secondary complications and their
associated treatment costs. In 2013, we obtained approval from
South Korea’s Ministry of Food and Drug Safety to market
orthoPACE in that country.
We
believe there are significant opportunities in the worldwide
orthopedic market, driven by aging baby boomers and their desire
for active lifestyles well into retirement and the growth in the
incidence of osteoporosis, osteoarthritis, obesity, diabetes and
other diseases that cause injury to orthopedic tissues and/or
impair the ability of the body to heal injuries.
We have
experience in the sports medicine field (which generally refers to
the non-surgical and surgical management of cartilage, ligament and
tendon injuries) through our legacy devices, OssaTron and Evotron.
Common examples of these injuries include extremity joint pain,
torn rotator cuffs (shoulder), tennis elbow, Achilles’ tendon
tears and torn meniscus cartilage in the knee. Injuries to these
structures are very difficult to treat because the body has a
limited natural ability to regenerate these tissues. Cartilage,
ligament and tendons seldom return to a pre-injury state of
function. Due to a lack of therapies that can activate
healing and regenerate these tissues, many of these injuries will
result in a degree of permanent impairment and chronic pain. Prior
investigations and pre-clinical work indicate that PACE can
activate various cell types and may be an important adjunct to the
management of sports medicine injuries.
Trauma
injuries are acute and result from any physical damage to the body
caused by violence or accident or fracture. Surgical treatment of
traumatic fractures often involves fixation with metallic plates,
screws and rods (internal fixation) and include off-loading to
prevent motion, permitting the body to initiate a healing response.
In the United States, six million traumatic fractures are treated
each year, and over one million internal fixation procedures are
performed annually. The prevalence of non-union among these
fractures is between 2.5% and 10.0% depending on the fracture type
and risk factors such as diabetes and smoking history or other
systemic diseases. At the time of surgery, adjunctive agents (such
as autograft, cadaver bone and synthetic filling materials) are
often implanted along with internal fixation to fill bony gaps or
facilitate the healing process to avoid delayed union or non-union
(incomplete fracture healing) results. Both pre-clinical and
clinical investigations have shown positive results, suggesting our
technology could potentially be developed as an adjunct to these
surgeries or primary treatment protocol for delayed or non-union
events.
Non-Medical Uses For Our Shockwave Technology
We
believe there are significant license/partnership opportunities for
our shockwave technology in non-medical uses, including in the
energy, water, food and industrial markets.
Due to
their powerful pressure gradients and localized cavitational
effects, we believe that high-energy, acoustic pressure shock waves
can be used to clean, in an energy efficient manner, contaminated
fluids from impurities, bacteria, viruses and other harmful
micro-organisms, which provides opportunities for our technology in
cleaning industrial and domestic/municipal waters. Based on the
same principles of action of the acoustic pressure shock waves
against bacteria, viruses and harmful micro-organisms, we believe
our technology can be applied for cleaning or sterilization of
various foods such as milk, natural juices and meats.
In the
energy sector, we believe that the acoustic pressure shock waves
can be used to improve oil recovery (IOR), as a supplement to or in
conjunction with existing fracking technology, which utilizes high
pressurized water/gases to crack the rocks that trapped oil in the
underground reservoir. Through the use of our high-energy, acoustic
pressure shock waves the efficiency can be improved and in the same
time the environmental impact of the fracking process can be
reduced. Furthermore, we believe our technology can be used for
enhanced oil recovery (EOR) based on the changes in oil flow
characteristics resulting from acoustic pressure shock wave
stimulation, as a tertiary method of oil recovery from older oil
fields.
Additionally, we
demonstrated through two studies performed at Montana State
University that high-energy, acoustic pressure shock waves are
disrupting biofilms and thus can be used for surface cleaning or to
unclog pipes in the energy industry (shore or off-shore
installations), food industry and water management industry, which
will reduce or eliminate down times with significant financial
benefits for maintenance of existing infrastructure.
Market Trends
We are
focused on the development of regenerative medicine products that
have the potential to address substantial unmet clinical needs
across broad market indications. We believe there are limited
therapeutic treatments currently available that directly and
reproducibly activate healing processes in the areas in which we
are focusing, particularly for wound care and repair of certain
types of musculoskeletal conditions.
According to
AdvaMed and Centers for Medicare & Medicaid Services data and
our internal projections, the United States advanced wound healing
market for the dermaPACE is estimated at $20 billion, which
includes diabetic foot ulcers, pressure sores, burns and traumatic
wounds, and chronic mixed leg ulcers. We also believe there are
significant opportunities in the worldwide orthopedic and spine
markets, driven by aging baby boomers and their desire for active
lifestyles well into retirement and the growth in the incidence of
osteoporosis, osteoarthritis, obesity, diabetes and other diseases
that cause injury to orthopedic tissues and/or impair the ability
of the body to heal injuries.
With
the success of negative pressure wound therapy devices in the wound
care market over the last decade and the recognition of the global
epidemic associated with certain types of wounds, as well as
deteriorating musculoskeletal conditions attributed to various
disease states such as obesity, diabetes and ischemia due to
vascular and heart disease, as well as sports injuries, we believe
that Medicare and private insurers have become aware of the costs
and expenditures associated with the adjunctive therapies being
utilized for wound healing and orthopedic conditions with limited
efficacies in full skin closure, or bone and tissue regeneration.
We believe the wound healing and orthopedic markets are undergoing
a transition, and market participants are interested in biological
response activating devices that are applied noninvasively and seek
to activate the body’s own capabilities for regeneration of
tissue at injury sites in a cost-effective manner.
Strategy
Our
primary objective is to be a leader in the development and
commercialization of our acoustic pressure shock wave technology
for regenerative medicine and other applications. Our initial focus
is regenerative medicine – utilizing noninvasive
(extracorporeal), acoustic pressure shock waves to produce a
biological response resulting in the body healing itself through
the repair and regeneration of skin, musculoskeletal tissue and
vascular structures. Our lead regenerative product in the United
States is the dermaPACE device for treating diabetic foot ulcers,
which was subject to two double-blinded, randomized Phase III
clinical studies and cleared by the FDA on December 28, 2017. Our
portfolio of healthcare products and product candidates activate
biologic signaling and angiogenic responses, including new
vascularization and microcirculatory improvement, helping to
restore the body’s normal healing processes and regeneration.
We intend to apply our Pulsed Acoustic Cellular Expression (PACE)
technology in wound healing, orthopedic, plastic/cosmetic and
cardiovascular conditions.
Our
immediate goal for our regenerative medicine technology involves
leveraging the knowledge we gained from our existing human heel and
elbow indications to enter the advanced wound care market with
innovative treatments.
The key
elements of our strategy include the following:
●
Commercialize and support the domestic distribution of our
dermaPACE device to treat diabetic foot ulcers.
We initially focused on obtaining FDA approval in
the United States for our lead product candidate, dermaPACE, for
the treatment of diabetic foot ulcers, which we believe represents
a large, unmet need. On December 28, 2017, the FDA notified
the Company to permit the marketing of the dermaPACE System for the
treatment of diabetic foot ulcers in the United States.
We plan to begin the commercialization
of dermaPACE in the United States in 2018 through strategic
partnerships or commercialize the product ourselves. For
example, in February 2018, we entered into an agreement with
Premier Shockwave Wound Care, Inc. (“PSWC”) and Premier
Shockwave, Inc. (“PS”) for the purchase by PSWC and PS
of dermaPACE Systems and related equipment sold by us, including a
minimum purchase of 100 units over 3 years, and granting PSWC and
PS limited but exclusive distribution rights to provide dermaPACE
Systems to certain governmental healthcare facilities in exchange
for the payment of certain royalties to us.
●
Develop and commercialize our noninvasive biological response
activating devices in the regenerative medicine area for the
treatment of skin, musculoskeletal tissue and vascular
structures.
We
intend to use our proprietary technologies and know-how in the use
of high-energy, acoustic pressure shock waves to address unmet
medical needs in wound care, orthopedic, plastic/cosmetic and
cardiac indications, possibly through potential license and/or
partnership arrangements.
●
License and seek partnership opportunities for our non-medical
acoustic pressure shock wave technology platform, know-how and
extensive patent portfolio.
We
intend to use our acoustic pressure shock wave technology and
know-how for non-medical uses, including energy, food, water
cleaning and other industrial markets, through license/partnership
opportunities.
●
Support the global distribution of our products.
Our
portfolio of products, the dermaPACE and orthoPACE, are CE Marked
and sold through select distributors in certain countries in
Europe, Canada, Asia and Asia/Pacific. Our revenues will continue
from sales of the devices and related applicators in these markets.
We intend to continue to add additional distribution partners in
the Americas, Middle East, Africa, Europe and
Asia/Pacific.
Scientific Advisors
We have
established a network of advisors that brings expertise in wound
healing, orthopedics, cosmetics, clinical and scientific research,
and FDA experience. We consult our scientific advisors on an
as-needed basis on clinical and pre-clinical study design, product
development, and clinical indications.
We pay
consulting fees to certain members of our scientific advisory board
for the services they provide to us, in addition to reimbursing
them for incurred expenses. The amounts vary depending on the
nature of the services. We paid our advisors aggregate consulting
fees through the issuance of stock options in 2017 and 2016 and
recorded stock-based compensation expense of $39,127 and $30,421
for the years ended December 31, 2017 and 2016,
respectively.
Sales, Marketing and Distribution
Following FDA
approval in December 2017, we intend to seek a development and/or
commercialization partnership, or to commercialize a product
ourselves. Outside the United States, we retain distributors to
represent our products in selective international markets. These
distributors have been selected based on their existing business
relationships and the ability of their sales force and distribution
capabilities to effectively penetrate the market with our PACE
product line. We rely on these distributors to manage physical
distribution, customer service and billing services for our
international customers. Three distributors accounted for 8%, 38% and 24%
of revenues for the year ended December 31, 2017, and 69%, 17% and
0% of accounts receivable at December 31, 2017.
Manufacturing
We have
developed a network of suppliers, manufacturers and contract
service providers to provide sufficient quantities of our
products.
We are
party to a manufacturing supply agreement with Swisstronics
Contract Manufacturing AG in Switzerland, a division of Cicor
Technologies Ltd., covering the generator box component of our
products. Our generator boxes are manufactured in accordance with
applicable quality standards (EN ISO 13485) and applicable industry
and regulatory standards. We produce the applicators and applicator
kits for our products. In addition, we program and load software
and perform the final product testing and certifications internally
for all of our devices.
Our
facility in Suwanee, Georgia consists of 7,500 square feet and
provides office, research and development, quality control,
production and warehouse space. It is a FDA registered facility and
is ISO 13485 certified (for meeting the requirements for a
comprehensive management system for the design and manufacture of
medical devices).
Intellectual Property
Our
success depends in part on our ability to obtain and maintain
proprietary protection for our products, product candidates,
technology, and know-how, to operate without infringing on the
proprietary rights of others and to prevent others from infringing
upon our proprietary rights. We seek to protect our proprietary
position by, among other methods, filing United States and selected
foreign patent applications and United States and selected foreign
trademark applications related to our proprietary technology,
inventions, products, and improvements that are important to the
development of our business. Effective trademark, service mark,
copyright, patent, and trade secret protection may not be available
in every country in which our products are made available. The
protection of our intellectual property may require the expenditure
of significant financial and managerial resources.
Patents
We
consider the protection afforded by patents important to our
business. We intend to seek and maintain patent protection in the
United States and select foreign countries where deemed appropriate
for products that we develop. There are no assurances that any
patents will result from our patent applications, or that any
patents that may be issued will protect our intellectual property,
or that any issued patents or pending applications will not be
successfully challenged, including as to ownership and/or validity,
by third parties. In addition, if we do not avoid infringement of
the intellectual property rights of others, we may have to seek a
license to sell our products, defend an infringement action or
challenge the validity of intellectual property in court. Any
current or future challenges to our patent rights, or challenges by
us to the patent rights of others, could be expensive and time
consuming.
We
derive our patent rights, including as to both issued patents and
“patent pending” applications, from three sources: (1)
assignee of patent rights in technology we developed; (2) assignee
of patent rights purchased from HealthTronics, Inc.
(“HealthTronics”); and (3) as licensee of certain
patent rights assigned to HealthTronics. In August 2005, we
purchased a significant portion of our current patents and patent
applications from HealthTronics, to whom we granted back perpetual
and royalty-free field-of-use license rights in the purchased
patent portfolio primarily for urological uses. We believe that our
owned and licensed patent rights provide a competitive advantage
with respect to others that might seek to utilize certain of our
apparatuses and methods incorporating extracorporeal acoustic
pressure shock wave technologies that we have patented; however, we
do not hold patent rights that cover all of our products, product
components, or methods that utilize our products. We also have not
conducted a competitive analysis or valuation with respect to our
issued and pending patent portfolio in relation to our current
products and/or competitor products.
We
are the assignee of twenty-eight issued United States patents and
eighteen issued foreign patents, which on average have remaining
useful lives of ten years with the longest useful life extending to
2036. Our current issued United States and foreign patents include
patent claims directed to particular electrode configurations,
piezoelectric fiber shock wave devices, chemical components for
shock wave generation, reflector geometries, medical systems
general construction, and detachable therapy heads with data
storage devices. Our United States patents also include patent
claims directed to methods of using acoustic pressure shock waves,
including devices such as our products, to treat ischemic
conditions, spinal cord scar tissue and spinal injuries, bone
fractures and osteoporosis, blood sterilization, stem cell
stimulation, tissue cleaning, and, within particular treatment
parameters, diabetic foot ulcers and pressure sores. While such
patented method claims may provide patent protection against
certain indirect infringing promotion and sales activities of
competing manufacturers and distributors, certain medical methods
performed by medical practitioners or related health care entities
may be subject to exemption from potential infringement claims
under 35 U.S.C. § 287(c) and, therefore, may limit enforcement
of claims of our method patents as compared to device and
non-medical method patents.
We
also currently maintain eleven United States non-provisional patent
applications and seven foreign patent applications. Our
patent-pending rights include inventions directed to certain shock
wave devices and systems, ancillary products, and components for
acoustic pressure shock wave treatment devices, and various methods
of using acoustic pressure shock waves. Such patent-pending methods
include, for example, using acoustic pressure shock waves to treat
soft tissue disorders, bones, joints, wounds, skin, blood vessels
and circulatory disorders, lymphatic disorders, cardiac tissue, fat
and cellulite, cancer, blood and fluids sterilization, to destroy
pathogens, to process fluids, meat and dairy products, to destroy
blood vessels occlusions and plaques, and to perform personalized
medical treatments. All of our United States and foreign pending
applications either have yet to be examined or require response to
an examiner’s office action rejections and, therefore, remain
subject to further prosecution, the possibility of further
rejections and appeals, and/or the possibility we may elect to
abandon prosecution, without assurance that a patent may issue from
any pending application.
Under
our license to HealthTronics, we reserve exclusive rights in our
purchased portfolio as to orthopedic, tendonopathy, skin wounds,
cardiac, dental, neural medical conditions and to all conditions in
animals (Ortho Field). HealthTronics receives field-exclusive and
sublicensable rights under the purchased portfolio as to (1)
certain HealthTronics lithotripsy devices in all fields other than
the Ortho Field, and (2) all products in the treatment of renal,
ureteral, gall stones and other urological conditions (Litho
Field). HealthTronics also receives non-exclusive and
non-sublicensable rights in the purchased portfolio as to any
products in all fields other than the Ortho Field and Litho
Field.
Pursuant
to mutual amendment and other assignment-back rights under the
patent license agreement with HealthTronics, we are also a licensee
of certain patents and patent applications that have been assigned
to HealthTronics. We received a perpetual, non-exclusive and
royalty-free license to nine issued foreign patents. Our
non-exclusive license is subject to HealthTronics’ sole
discretion to further maintain any of the patents and pending
applications assigned back to HealthTronics.
As
part of the sale of the veterinary business in June 2009, we have
also granted certain exclusive and non-exclusive patent license
rights to Pulse Veterinary Technologies, LLC for most of our patent
portfolio issued before 2009 to utilize acoustic pressure shock
wave technologies in the field of non-human mammals.
Given
our international patent portfolio, there are growing risks of
challenges to our existing and future patent rights. Such
challenges may result in invalidation or modification of some or
all of our patent rights in a particular patent territory and
reduce our competitive advantage with respect to third party
products and services. Such challenges may also require the
expenditure of significant financial and managerial
resources.
If
we become involved in future litigation or any other adverse
intellectual property proceeding, for example, as a result of an
alleged infringement, or a third party alleging an earlier date of
invention, we may have to spend significant amounts of money and
time and, in the event of an adverse ruling, we could be subject to
liability for damages, including treble damages, invalidation of
our intellectual property and injunctive relief that could prevent
us from using technologies or developing products, any of which
could have a significant adverse effect on our business, financial
condition and results of operation. In addition, any claims
relating to the infringement of third party proprietary rights, or
earlier date of invention, even if not meritorious, could result in
costly litigation or lengthy governmental proceedings and could
divert management’s attention and resources and require us to
enter into royalty or license agreements which are not
advantageous, if available at all.
Trademarks
Since
other products on the market compete with our products, we believe
that our product brand names are an important factor in
establishing and maintaining brand recognition.
We have the following trademark
registrations: SANUWAVE®
(United States, European Community,
Canada, Japan, Switzerland, Taiwan and under the Madrid Protocol),
dermaPACE®
(United States, European Community,
Japan, South Korea, Switzerland, Taiwan, Canada and under the
Madrid Protocol), angioPACE®
(Australia, European Community and
Switzerland), PACE®
(Pulsed Acoustic Cellular Expression)
(United States, European Community, China, Hong Kong, Singapore,
Switzerland, Taiwan, and Canada), orthoPACE®
(United States and European
Community), DAP®
(Diffused Acoustic Pressure) (United
States and European Community) and Profile™
(United States, European Community and
Switzerland).
We also maintain trademark registrations for:
OssaTron®
(United States and Germany),
evoPACE®
(Australia, European Community and
Switzerland), Evotron®
(Germany and Switzerland),
Evotrode®
(Germany and Switzerland),
Orthotripsy®
(United States). We are phasing out
the Reflectron®
(Germany and Switzerland) and
Reflectrode®
(Germany and Switzerland) trademarks
due to the fact that these two products are no longer available for
sale in any market.
Potential Intellectual Property Issues
Although
we believe that the patents and patent applications, including
those that we license, provide a competitive advantage, the patent
positions of biotechnology and medical device companies are highly
complex and uncertain. The medical device industry is characterized
by the existence of a large number of patents and frequent
litigation based on allegations of patent infringement. Our success
will depend in part on us not infringing on patents issued to
others, including our competitors and potential competitors, as
well as our ability to enforce our patent rights. We also rely on
trade secrets, know-how, continuing technological innovation and
in-licensing opportunities to develop and maintain our proprietary
position.
Despite
any measures taken to protect our intellectual property,
unauthorized parties may attempt to copy aspects of our products
and product candidates, or to obtain and use information that we
regard as proprietary. In enforcement proceedings in Switzerland,
we assisted HealthTronics as an informer of misappropriation by a
Swiss company called SwiTech and related third parties of
intellectual property rights in legacy proprietary software and
devices relating to assets we purchased from HealthTronics in
August 2005. As a result of this action, SwiTech was forced into
bankruptcy. We also pursued the alleged misappropriation by another
Swiss company called SwiTalis and related third parties of
intellectual property rights in legacy proprietary software and
devices relating to assets we purchased from HealthTronics in
August 2005. In 2016, SwiTalis claimed copyright rights on the High
Voltage Modules that were used in our devices and the old line of
Pulse Vet devices during the manufacturing process at Swisstronics
in Switzerland. At this time, however, no such court action against
Swisstronics is pending in Switzerland and we believe that it is
unlikely that SwiTalis will pursue their earlier allegations
against Swisstronics and, indirectly, us. In 2017, we abandoned our
action against SwiTalis. There can be no assurance, however, that
future claims or lawsuits against us may not be brought, and such
present or future actions against violations of our intellectual
property rights may result in us incurring material expense and
divert the attention of management.
Third
parties that license our proprietary rights, such as trademarks,
patented technology or copyrighted material, may also take actions
that diminish the value of our proprietary rights or reputation. In
addition, the steps we take to protect our proprietary rights may
not be adequate and third parties may infringe or misappropriate
our copyrights, trademarks, trade dress, patents, and similar
proprietary rights.
We
collaborate with other persons and entities on research,
development, and commercialization activities and expect to do so
in the future. Disputes may arise about inventorship and
corresponding rights in know-how and inventions resulting from the
joint creation or use of intellectual property by us and our
collaborators, researchers, licensors, licensees and consultants.
In addition, other parties may circumvent any proprietary
protection that we do have. As a result, we may not be able to
maintain our proprietary position.
Competition
We
believe the advanced wound care market can benefit from our
technology which up-regulates the biological factors that promote
wound healing. Current medical technologies developed by Acelity
(formerly Kinetic Concepts, Inc.), Organogenesis, Inc., Smith &
Nephew plc, Derma Sciences, Inc., MiMedx Group, Inc., Osiris
Therapeutics, Inc., Molnlycke Health Care, and Systagenix Wound
Management (US), Inc. (now owned by Acelity) manage wounds, but, in
our opinion, do not provide the value proposition to the patients
and care givers like our PACE technology has the potential to do.
The leading medical device serving this market is the Vacuum
Assisted Closure (“V.A.C.”) System marketed by KCI. The
V.A.C. is a negative pressure wound therapy device that applies
suction to debride and manage wounds.
There
are also several companies that market extracorporeal shock wave
device products targeting lithotripsy and orthopedic markets,
including Dornier MedTech, Storz Medical AG, Electro Medical
Systems (EMS) S.A., CellSonic Medical and Tissue Regeneration
Technologies, LLC, and could ultimately pursue the wound care
market. Nevertheless, we believe that dermaPACE has a competitive
advantage over all of these existing technologies by achieving
wound closure by means of a minimally invasive process through
innate biological response to PACE.
Developing
and commercializing new products is highly competitive. The market
is characterized by extensive research and clinical efforts and
rapid technological change. We face intense competition worldwide
from medical device, biomedical technology and medical products and
combination products companies, including major pharmaceutical
companies. We may be unable to respond to technological advances
through the development and introduction of new products. Most of
our existing and potential competitors have substantially greater
financial, marketing, sales, distribution, manufacturing and
technological resources. These competitors may also be in the
process of seeking FDA or other regulatory approvals, or patent
protection, for new products. Our competitors may commercialize new
products in advance of our products. Our products also face
competition from numerous existing products and procedures, which
currently are considered part of the standard of care. In order to
compete effectively, our products will have to achieve widespread
market acceptance.
Regulatory Matters
FDA Regulation
Each
of our products must be approved or cleared by the FDA before it is
marketed in the United States. Before and after approval or
clearance in the United States, our product candidates are subject
to extensive regulation by the FDA under the Federal Food, Drug,
and Cosmetic Act and/or the Public Health Service Act, as well as
by other regulatory bodies. FDA regulations govern, among other
things, the development, testing, manufacturing, labeling, safety,
storage, record-keeping, market clearance or approval, advertising
and promotion, import and export, marketing and sales, and
distribution of medical devices and pharmaceutical
products.
In
the United States, the FDA subjects medical products to rigorous
review. If we do not comply with applicable requirements, we may be
fined, the government may refuse to approve our marketing
applications or to allow us to manufacture or market our products,
and we may be criminally prosecuted. Failure to comply with the law
could result in, among other things, warning letters, civil
penalties, delays in approving or refusal to approve a product
candidate, product recall, product seizure, interruption of
production, operating restrictions, suspension or withdrawal of
product approval, injunctions, or criminal
prosecution.
The
FDA has determined that our technology and product candidates
constitute “medical devices.” The FDA determines what
center or centers within the FDA will review the product and its
indication for use, and also determines under what legal authority
the product will be reviewed. For the current indications, our
products are being reviewed by the Center for Devices and
Radiological Health. However, we cannot be sure that the FDA will
not select a different center and/or legal authority for one or
more of our other product candidates, in which case the
governmental review requirements could vary in some
respects.
FDA Approval or Clearance of Medical Devices
In
the United States, medical devices are subject to varying degrees
of regulatory control and are classified in one of three classes
depending on the extent of controls the FDA determines are
necessary to reasonably ensure their safety and
efficacy:
●
Class I:
general controls, such as labeling and adherence to quality system
regulations;
●
Class II:
special controls, pre-market notification (510(k)), specific
controls such as performance standards, patient registries, and
post market surveillance, and additional controls such as labeling
and adherence to quality system regulations; and
●
Class III:
special controls and approval of a pre-market approval (PMA)
application.
Each
of our product candidates require FDA authorization prior to
marketing, by means of either a 510(k) clearance or a PMA
approval.
To
request marketing authorization by means of a 510(k) clearance, we
must submit a pre-market notification demonstrating that the
proposed device is substantially equivalent to another legally
marketed medical device, has the same intended use, and is as safe
and effective as a legally marketed device and does not raise
different questions of safety and effectiveness than does a legally
marketed device. 510(k) submissions generally include, among other
things, a description of the device and its manufacturing, device
labeling, medical devices to which the device is substantially
equivalent, safety and biocompatibility information, and the
results of performance testing. In some cases, a 510(k) submission
must include data from human clinical studies. Marketing may
commence only when the FDA issues a clearance letter finding
substantial equivalence. After a device receives 510(k) clearance,
any product modification that could significantly affect the safety
or effectiveness of the product, or that would constitute a
significant change in intended use, requires a new 510(k) clearance
or, if the device would no longer be substantially equivalent,
would require a PMA. If the FDA determines that the product does
not qualify for 510(k) clearance, then a company must submit and
the FDA must approve a PMA before marketing can begin.
In
the past, the 510(k) pathway for product marketing required only
the proof of significant equivalence in technology for a given
indication with a previously cleared device. Currently, there
has been a trend of the FDA requiring additional clinical work to
prove efficacy in addition to technological equivalence.
Thus, no matter which regulatory pathway we may take in the future
towards marketing products in the United States, we will be
required to provide clinical proof of device
effectiveness.
Within
the past few years, the FDA has released guidelines for the
FDA’s reviewers to use during a product’s submission
review process. This guidance provides the FDA reviewers with
a uniform method of evaluating the benefits verses the risks of a
device when used for a proposed specific indication. Such a
benefit/risk evaluation is very useful when applied to a novel
device or to a novel indication and provides the FDA with a
consistent tool to document their decision process. While
intended as a guide for internal FDA use, the public availability
of this guidance allows medical device manufacturers to use the
review matrix to develop sound scientific and clinical backup to
support proposed clinical claims and to help guide the FDA, through
the decision process, to look at the relevant data. We intend
to use this benefit/risk tool in our FDA submissions.
A
PMA application must provide a demonstration of safety and
effectiveness, which generally requires extensive pre-clinical and
clinical trial data. Information about the device and its
components, device design, manufacturing and labeling, among other
information, must also be included in the PMA. As part of the PMA
review, the FDA will inspect the manufacturer’s facilities
for compliance with Quality System Regulation requirements, which
govern testing, control, documentation and other aspects of quality
assurance with respect to manufacturing. If the FDA determines the
application or manufacturing facilities are not acceptable, the FDA
may outline the deficiencies in the submission and often will
request additional testing or information. Notwithstanding the
submission of any requested additional information, the FDA
ultimately may decide that the application does not satisfy the
regulatory criteria for approval. During the review period, an FDA
advisory committee, typically a panel of clinicians and
statisticians, is likely to be convened to review the application
and recommend to the FDA whether, or upon what conditions, the
device should be approved. The FDA is not bound by the advisory
panel decision. While the FDA often follows the panel’s
recommendation, there have been instances where the FDA has not. If
the FDA finds the information satisfactory, it will approve the
PMA. The PMA approval can include post-approval conditions,
including, among other things, restrictions on labeling, promotion,
sale and distribution, or requirements to do additional clinical
studies post-approval. Even after approval of a PMA, a new PMA or
PMA supplement is required to authorize certain modifications to
the device, its labeling or its manufacturing process. Supplements
to a PMA often require the submission of the same type of
information required for an original PMA, except that the
supplement is generally limited to that information needed to
support the proposed change from the product covered by the
original PMA.
During
the review of either a PMA application or 510(k) submission, the
FDA may request more information or additional studies and may
decide that the indications for which we seek approval or clearance
should be limited. We cannot be sure that our product candidates
will be approved or cleared in a timely fashion or at all. In
addition, laws and regulations and the interpretation of those laws
and regulations by the FDA may change in the future. We cannot
foresee what effect, if any, such changes may have on
us.
Obtaining
medical device clearance, approval, or licensing in the United
States or abroad can be an expensive process. The fees for
submitting an original PMA to the FDA for consideration of device
approval are substantial. Fees for supplement PMA’s are less
costly but still can be substantial. International fee structures
vary from minimal to substantial, depending on the country. In
addition, we are subject to annual establishment registration fees
in the United States and abroad. Device licenses require periodic
renewal with associated fees as well. In the United States, there
is an annual requirement for submitting device reports for Class
III/PMA devices, along with an associated fee. Currently, we are
registered as a Small Business Manufacturer with the FDA and as
such are subject to reduced fees. If, in the future, our revenues
exceed a certain annual threshold limit, we may not qualify for the
Small Business Manufacturer reduced fee amounts and will be
required to pay full fee amounts.
Clinical Trials of Medical Devices
One
or more clinical trials are almost always required to support a PMA
application and more recently are becoming necessary to support a
510(k) submission. Clinical studies of unapproved or un-cleared
medical devices or devices being studied for uses for which they
are not approved or cleared (investigational devices) must be
conducted in compliance with FDA requirements. If an
investigational device could pose a significant risk to patients,
the sponsor company must submit an IDE application to the FDA prior
to initiation of the clinical study. An IDE application must be
supported by appropriate data, such as animal and laboratory test
results, showing that it is safe to test the device on humans and
that the testing protocol is scientifically sound. The IDE will
automatically become effective 30 days after receipt by the
FDA unless the FDA notifies the company that the investigation may
not begin. Clinical studies of investigational devices may not
begin until an institutional review board (IRB) has approved the
study.
During
the study, the sponsor must comply with the FDA’s IDE
requirements. These requirements include investigator selection,
trial monitoring, adverse event reporting, and record keeping. The
investigators must obtain patient informed consent, rigorously
follow the investigational plan and study protocol, control the
disposition of investigational devices, and comply with reporting
and record keeping requirements. We, the FDA, or the IRB at each
institution at which a clinical trial is being conducted, may
suspend a clinical trial at any time for various reasons, including
a belief that the subjects are being exposed to an unacceptable
risk. During the approval or clearance process, the FDA typically
inspects the records relating to the conduct of one or more
investigational sites participating in the study supporting the
application.
Post-Approval Regulation of Medical Devices
After
a device is cleared or approved for marketing, numerous and
pervasive regulatory requirements continue to apply. These
include:
●
the
FDA Quality Systems Regulation (QSR), which governs, among other
things, how manufacturers design, test, manufacture, exercise
quality control over, and document manufacturing of their
products;
●
labeling
and claims regulations, which prohibit the promotion of products
for unapproved or “off-label” uses and impose other
restrictions on labeling;
●
the
Medical Device Reporting regulation, which requires reporting to
the FDA of certain adverse experiences associated with use of the
product; and
●
post
market surveillance, including documentation of clinical experience
and also follow-on, confirmatory studies.
We
continue to be subject to inspection by the FDA to determine our
compliance with regulatory requirements, as are our suppliers,
contract manufacturers, and contract testing
laboratories.
International
sales of medical devices manufactured in the United States that are
not approved or cleared by the FDA are subject to FDA export
requirements. Exported devices are subject to the regulatory
requirements of each country to which the device is exported.
Exported devices may also fall under the jurisdiction of the United
States Department of Commerce/Bureau of Industry and Security and
compliance with export regulations may be required for certain
countries.
Manufacturing cGMP Requirements
Manufacturers
of medical devices are required to comply with FDA manufacturing
requirements contained in the FDA’s current Good
Manufacturing Practices (cGMP) set forth in the quality system
regulations promulgated under section 520 of the Food, Drug and
Cosmetic Act. cGMP regulations require, among other things, quality
control and quality assurance as well as the corresponding
maintenance of records and documentation. The manufacturing
facility for our products must meet cGMP requirements to the
satisfaction of the FDA pursuant to a pre-PMA approval inspection
before we can use it. We and some of our third party service
providers are also subject to periodic inspections of facilities by
the FDA and other authorities, including procedures and operations
used in the testing and manufacture of our products to assess our
compliance with applicable regulations. Failure to comply with
statutory and regulatory requirements subjects a manufacturer to
possible legal or regulatory action, including the seizure or
recall of products, injunctions, consent decrees placing
significant restrictions on or suspending manufacturing operations,
and civil and criminal penalties. Adverse experiences with the
product must be reported to the FDA and could result in the
imposition of marketing restrictions through labeling changes or in
product withdrawal. Product approvals may be withdrawn if
compliance with regulatory requirements is not maintained or if
problems concerning safety or efficacy of the product occur
following the approval.
International Regulation
We
are subject to regulations and product registration requirements in
many foreign countries in which we may sell our products, including
in the areas of product standards, packaging requirements, labeling
requirements, import and export restrictions and tariff
regulations, duties and tax requirements. The time required to
obtain clearance required by foreign countries may be longer or
shorter than that required for FDA clearance, and requirements for
licensing a product in a foreign country may differ significantly
from FDA requirements.
The
primary regulatory environment in Europe is the European Union,
which consists of 28 member states encompassing most of the major
countries in Europe. In the European Union, the European Medicines
Agency (EMA) and the European Union Commission have determined that
dermaPACE, orthoPACE, OssaTron and Evotron will be regulated as
medical device products. These devices have been determined to be
Class IIb devices. These devices are CE Marked and as such can be
marketed and distributed within the European Economic
Area.
The
primary regulatory body in Canada is Health Canada. In addition to
needing appropriate data to obtain market licensing in Canada, we
must have an ISO 13485 certification, as well as meet additional
requirements of Canadian laws. We currently maintain this
certification. We maintain a device license for dermaPACE with
Health Canada for the indication of “devices for application
of shock waves (pulsed acoustic waves) on acute and chronic defects
of the skin and subcutaneous soft tissue”.
The
primary regulatory bodies and paths in Asia and Australia are
determined by the requisite country authority. In most cases,
establishment registration and device licensing are applied for at
the applicable Ministry of Health through a local intermediary. The
requirements placed on the manufacturer are typically the same as
those contained in ISO 9001 or ISO 13485.
European Good Manufacturing Practices
In
the European Union, the manufacture of medical devices is subject
to current good manufacturing practice (cGMP), as set forth in the
relevant laws and guidelines of the European Union and its member
states. Compliance with cGMP is generally assessed by the competent
regulatory authorities. Typically, quality system evaluation is
performed by a Notified Body, which also recommends to the relevant
competent authority for the European Community CE Marking of a
device. The Competent Authority may conduct inspections of relevant
facilities, and review manufacturing procedures, operating systems
and personnel qualifications. In addition to obtaining approval for
each product, in many cases each device manufacturing facility must
be audited on a periodic basis by the Notified Body. Further
inspections may occur over the life of the product.
United States Anti-Kickback and False Claims Laws
In
the United States, there are Federal and state anti-kickback laws
that prohibit the payment or receipt of kickbacks, bribes or other
remuneration intended to induce the purchase or recommendation of
healthcare products and services. Violations of these laws can lead
to civil and criminal penalties, including exclusion from
participation in Federal healthcare programs. These laws are
potentially applicable to manufacturers of products regulated by
the FDA as medical devices, such as us, and hospitals, physicians
and other potential purchasers of such products. Other provisions
of Federal and state laws provide civil and criminal penalties for
presenting, or causing to be presented, to third-party payers for
reimbursement, claims that are false or fraudulent, or which are
for items or services that were not provided as claimed. In
addition, certain states have implemented regulations requiring
medical device and pharmaceutical companies to report all gifts and
payments over $50 to medical practitioners. This does not apply to
instances involving clinical trials. Although we intend to
structure our future business relationships with clinical
investigators and purchasers of our products to comply with these
and other applicable laws, it is possible that some of our business
practices in the future could be subject to scrutiny and challenge
by Federal or state enforcement officials under these
laws.
Third Party Reimbursement
We
anticipate that sales volumes and prices of the products we
commercialize will depend in large part on the availability of
coverage and reimbursement from third party payers. Third party
payers include governmental programs such as Medicare and Medicaid,
private insurance plans, and workers’ compensation plans.
These third party payers may deny coverage and reimbursement for a
product or therapy, in whole or in part, if they determine that the
product or therapy was not medically appropriate or necessary. The
third party payers also may place limitations on the types of
physicians or clinicians that can perform specific types of
procedures. In addition, third party payers are increasingly
challenging the prices charged for medical products and services.
Some third party payers must also pre-approve coverage for new or
innovative devices or therapies before they will reimburse
healthcare providers who use the products or therapies. Even though
a new product may have been approved or cleared by the FDA for
commercial distribution, we may find limited demand for the device
until adequate reimbursement has been obtained from governmental
and private third party payers.
In
international markets, reimbursement and healthcare payment systems
vary significantly by country, and many countries have instituted
price ceilings on specific product lines and procedures. There can
be no assurance that procedures using our products will be
considered medically reasonable and necessary for a specific
indication, that our products will be considered cost-effective by
third party payers, that an adequate level of reimbursement will be
available or that the third party payers’ reimbursement
policies will not adversely affect our ability to sell our products
profitably.
In
the United States, some insured individuals are receiving their
medical care through managed care programs, which monitor and often
require pre-approval of the services that a member will receive.
Some managed care programs are paying their providers on a per
capita basis, which puts the providers at financial risk for the
services provided to their patients by paying these providers a
predetermined payment per member per month, and consequently, may
limit the willingness of these providers to use products, including
ours.
One
of the components in the reimbursement decision by most private
insurers and governmental payers, including the Centers for
Medicare & Medicaid Services, which administers Medicare, is
the assignment of a billing code. Billing codes are used to
identify the procedures performed when providers submit claims to
third party payers for reimbursement for medical services. They
also generally form the basis for payment amounts. We will seek new
billing codes for the wound care indications of our products as
part of our efforts to commercialize such products.
The
initial phase of establishing a professional billing code for a
medical service typically includes applying for a CPT Category III
code for both hospital and in-office procedures. This is a tracking
code without relative value assigned that allows third party payers
to identify and monitor the service as well as establish value if
deemed medically necessary. The process includes CPT application
submission, clinical discussion with Medical Professional Society
CPT advisors as well as American Medical Association (AMA) CPT
Editorial Panel review. A new CPT Category III code will be
assigned if the AMA CPT Editorial Panel committee deems it meets
the applicable criteria and is appropriate. In 2018, we applied for
two, new CPT Category III codes for extracorporeal shock wave
therapy (ESWT) in wound healing. It is anticipated these codes will
be published by AMA/CPT for use beginning in 2020.
The
secondary phase in the CPT billing code process includes the
establishment of a permanent CPT Category I code in which relative
value is analyzed and established by the AMA. The approval of this
code, is based on, among other criteria, widespread usage and
established clinical efficacy of the medical service.
There
are also billing codes that facilities, rather than health care
professionals, utilize for the reimbursement of operating costs for
a particular medical service. For the hospital outpatient setting,
the Centers for Medicare & Medicaid Services automatically
classified the new ESWT wound healing CPT Category III codes into
interim APC groups. The APC groups are services grouped together
based on clinical characteristics and similar costs. An APC
classification does not guarantee payment.
We
believe that the overall escalating costs of medical products and
services has led to, and will continue to lead to, increased
pressures on the healthcare industry to reduce the costs of
products and services. In addition, recent healthcare reform
measures, as well as legislative and regulatory initiatives at the
Federal and state levels, create significant additional
uncertainties. There can be no assurance that third party coverage
and reimbursement will be available or adequate, or that future
legislation, regulation, or reimbursement policies of third party
payers will not adversely affect the demand for our products or our
ability to sell these products on a profitable basis. The
unavailability or inadequacy of third party payer coverage or
reimbursement would have a material adverse effect on our business,
operating results and financial condition.
Confidentiality and Security of Personal Health
Information
The
Health Insurance Portability and Accountability Act of 1996, as
amended (“HIPAA”), contains provisions that protect
individually identifiable health information from unauthorized use
or disclosure by covered entities and their business associates.
The Office for Civil Rights of HHS, the agency responsible for
enforcing HIPAA, has published regulations to address the privacy
(the “Privacy Rule”) and security (the “Security
Rule”) of protected health information (“PHI”).
HIPAA also requires that all providers who transmit claims for
health care goods or services electronically utilize standard
transaction and data sets and to standardize national provider
identification codes. In addition, the American Recovery and
Reinvestment Act (“ARRA”) enacted the HITECH Act, which
extends the scope of HIPAA to permit enforcement against business
associates for a violation, establishes new requirements to notify
the Office for Civil Rights of HHS of a breach of HIPAA, and allows
the Attorneys General of the states to bring actions to enforce
violations of HIPAA. Rules implementing various aspects of HIPAA
are continuing to be promulgated.
We
anticipate that, as we expand our dermaPACE business, we will in
the future be a covered entity under HIPAA. We intend to adopt
policies and procedures to comply with the Privacy Rule, the
Security Rule and the HIPAA statute as such regulations become
applicable to our business and as such regulations are in effect at
such time.
In
addition to the HIPAA Privacy Rule and Security Rule described
above, we may become subject to state laws regarding the handling
and disclosure of patient records and patient health information.
These laws vary widely. Penalties for violation include sanctions
against a laboratory’s licensure as well as civil or criminal
penalties. Additionally, private individuals may have a right of
action against us for a violation of a state’s privacy laws.
We intend to adopt policies and procedures to ensure material
compliance with state laws regarding the confidentiality of health
information as such laws become applicable to us and to monitor and
comply with new or changing state laws on an ongoing
basis.
Environmental and Occupational Safety and Health
Regulations
Our
operations are subject to extensive Federal, state, provincial and
municipal environmental statutes, regulations and policies,
including those promulgated by the Occupational Safety and Health
Administration, the United States Environmental Protection Agency,
Environment Canada, Alberta Environment, the Department of Health
Services, and the Air Quality Management District, that govern
activities and operations that may have adverse environmental
effects such as discharges into air and water, as well as handling
and disposal practices for solid and hazardous wastes. Some of
these statutes and regulations impose strict liability for the
costs of cleaning up, and for damages resulting from, sites of
spills, disposals, or other releases of contaminants, hazardous
substances and other materials and for the investigation and
remediation of environmental contamination at properties leased or
operated by us and at off-site locations where we have arranged for
the disposal of hazardous substances. In addition, we may be
subject to claims and lawsuits brought by private parties seeking
damages and other remedies with respect to similar matters. We have
not to date needed to make material expenditures to comply with
current environmental statutes, regulations and policies. However,
we cannot predict the impact and costs those possible future
statutes, regulations and policies will have on our
business.
Research and Development
For the
years ended December 31, 2017 and 2016, we spent $1,292,531 and
$1,128,640, respectively, on research and development activities
which consists of fixes to the dermaPACE device software per FDA
request, responses to FDA questions and research costs by
partnering universities for non-medical uses of the PACE
technology.
Employees
As of
April 18, 2018, we had a total of eight full time employees in the
United States. Of these, five were engaged in research and
development which includes clinical, regulatory and quality. None
of our employees are represented by a labor union or covered by a
collective bargaining agreement. We believe our relationship with
our employees is good.
Properties
Our
operations, production and research and development office is in a
leased facility in Suwanee, Georgia, consisting of 7,500 square
feet of space. Under the terms of the lease, we pay monthly rent of
$10,844, as adjusted on an annual basis for additional
proportionate operating and insurance costs associated with the
building over the base amount. The term of the lease is 65
months.
Legal Proceedings
We
are engaged in various legal actions, claims and proceedings
arising in the ordinary course of business, including claims
related to breach of contracts and intellectual property matters
resulting from our business activities. As with most actions such
as these, an estimation of any possible and/or ultimate liability
cannot always be determined.
There
are no material proceedings known to us to be contemplated by any
governmental authority.
There
are no material proceedings known to us, pending or contemplated,
in which any of our directors, officers or affiliates or any of our
principal security holders, or any associate of any of the
foregoing, is a party or has an interest adverse to
us.
MANAGEMENT, EXECUTIVE COMPENSATION AND CORPORATE
GOVERNANCE
Below
are the names and certain information regarding the Company’s
executive officers and directors.
Name
|
|
Age
|
|
Position
Held
|
Kevin
A. Richardson, II
|
|
49
|
|
Director,
Chairman and Acting Chief Executive Officer
|
Lisa E.
Sundstrom
|
|
48
|
|
Chief
Financial Officer
|
Peter
Stegagno
|
|
58
|
|
Vice
President, Operations
|
Iulian
Cioanta, PhD
|
|
55
|
|
Vice
President, Research and Development
|
John F.
Nemelka
|
|
52
|
|
Director
|
Alan L.
Rubino
|
|
63
|
|
Director
|
A.
Michael Stolarski
|
|
47
|
|
Director
|
Maj-Britt
Kaltoft
|
|
54
|
|
Director
|
Kevin A. Richardson,
II joined the Company as chairman of the board of directors
in October of 2009 and joined SANUWAVE, Inc. as chairman of the
board of directors in August of 2005. In November 2012, upon the
resignation of the Company’s former President and Chief
Executive Officer, Christopher M. Cashman, Mr. Richardson assumed
the role of Active Chief Executive Officer, in addition to
remaining Chairman of the Board, through the hiring of Mr.
Chiarelli in February 2013. In April 2014, Mr. Richardson assumed
the role of Co-Chief Executive Officer. When Mr. Chiarelli departed
the Company in 2014, Mr. Richardson again assumed the role as
Acting Chief Executive Officer. Mr. Richardson brings to our board
of directors a broad array of financial knowledge for healthcare
and other industries. Since 2004, Mr. Richardson served as managing
partner of Prides Capital LLC, an investment management firm, until
its liquidation in September 2015.
Lisa E. Sundstrom
joined the Company as Controller in October of 2006, and in August
of 2015, assumed the responsibilities of Interim Chief Financial
Officer. In December 2015, Ms. Sundstrom was promoted to Chief
Financial Officer. Ms. Sundstrom has extensive financial accounting
experience with Automatic Data Processing (ADP) and Mitsubishi
Consumer Electronics. She began her career with a small public
accounting firm, Carnevale & Co., P.C., was Senior Accountant
at Mitsubishi Consumer Electronics responsible for the close
process and was Accounting Manager for the Benefit Services
division of ADP and assisted in the documentation of internal
controls for Sarbanes-Oxley compliance. Ms. Sundstrom holds a
Bachelor of Science in Accounting from the State University of New
York at Geneseo.
Peter Stegagno
joined the Company as Vice President, Operations in March 2006. Mr.
Stegagno brings to the Company sixteen years experience in the
medical device market encompassing manufacturing, design and
development, quality assurance and international and domestic
regulatory affairs. He most recently served as Vice President of
Quality and Regulatory Affairs for Elekta, and other medical device
companies including Genzyme Biosurgery. Before focusing on the
medical field, Mr. Stegagno enjoyed a successful career
encompassing production roles in the space industry, including
avionics guidance systems for military applications and control
computers for the space shuttle. Mr. Stegagno graduated from Tufts
University with a Bachelor of Science degree in Chemical
Engineering.
Iulian Cioanta, PhD
joined the Company in June 2007 as Vice President of Research and
Development. Dr. Cioanta most recently served as Business Unit
Manager with Cordis Endovascular, a Johnson & Johnson company.
Prior to that, Dr. Cioanta worked as Director of Development
Engineering with Kensey Nash Corporation, Research Manager at
AgroMed Inc. and Project Manager and Scientist with the Institute
for the Design of Research Apparatus. Dr. Cioanta also worked in
academia at Polytechnic University of Bucharest in Romania,
Leicester University in the United Kingdom and Duke University in
the United States. Dr. Cioanta received a Master of Science degree
in Mechanical Engineering and Technology form the Polytechnic
University of Bucharest and he earned his PhD degree in Biomedical
Engineering from Duke University in the field of extracorporeal
shock wave lithotripsy.
John F. Nemelka
joined the Company as a member of the board of directors in October
of 2009 and joined SANUWAVE, Inc. as a member of the board of
directors in August of 2005. Mr. Nemelka founded NightWatch
Capital Group, LLC, an investment management business, and served
as its Managing Principal since its incorporation in July 2001
until its liquidation in December 2015. From 1997 to 2000, he was a
Principal at Graham Partners, a private investment firm and
affiliate of the privately-held Graham Group. From 2000 to 2001,
Mr. Nemelka was a Consultant to the Graham Group. Mr. Nemelka
brings to our board of directors a diverse background with both
financial and operations experience. He holds a B.S. degree in
Business Administration from Brigham Young University and an M.B.A.
degree from the Wharton School at the University of
Pennsylvania.
Alan L. Rubino
joined the Company as a member of the board of directors in
September of 2013. Mr. Rubino has served as President and Chief
Executive Officer of Emisphere Technologies, Inc. since September,
2012. Previously, Mr. Rubino served as the CEO and President of New
American Therapeutics, Inc., CEO and President of Akrimax
Pharmaceuticals, LLC., and President and COO of Pharmos
Corporation. Mr. Rubino has continued to expand upon a highly
successful and distinguished career that included Hoffmann-La Roche
Inc. where he was a member of the U.S. Executive and Operating
Committees and a Securities and Exchange Commission (SEC) corporate
officer. During his Roche tenure, he held key executive positions
in marketing, sales, business operations, supply chain and human
resource management, and was assigned executive committee roles in
marketing, project management, and globalization. Mr. Rubino also
held senior executive positions at PDI, Inc. and Cardinal Health.
He holds a BA in economics from Rutgers University with a minor in
biology/chemistry and completed post-graduate educational programs
at the University of Lausanne and Harvard Business School. Mr.
Rubino serves on the boards of Aastrom Biosciences, Inc. and
Genisphere, LLC and is also on the Rutgers University Business
School Board of Advisors.
A. Michael Stolarski
joined the Company as a member of the board of directors in April
2016. Mr. Stolarski founded Premier Shockwave, Inc. in October 2008
and has since served as its President & CEO. From 2005 to 2008,
Mr. Stolarski was the Vice President of Business Development and,
previously, Acting CFO of SANUWAVE, Inc. From 2001 to 2005, he was
the President – Orthopaedic Division and Vice President of
Finance for HealthTronics Surgical Services, Inc. From 1994 to
2001, he was the CFO and Controller of the Lithotripsy Division,
Internal Auditor, and Paralegal of Integrated Health Services, Inc.
Mr. Stolarski brings to our board an in-depth understanding of the
orthopaedic and podiatric shockwave market. In addition to being a
Certified Public Accountant in the state of Maryland (inactive), he
holds a M.S. in Finance from Loyola College, Baltimore a B.S. in
Accounting and a B.S. in Finance from the University of Maryland,
College Park.
Dr. Maj-Britt
Kaltoft joined the Company as a member of the board of
directors in June 2017. Since January 2017, Dr. Kaltoft heads the
business development and patent functions at the Danish State Serum
Institute, an institution under the Danish Ministry of Health. From
2011 to 2016, she was the Vice President – Corporate Alliance
Management, Licensing Director and Business Development with Novo
Nordisk headquartered in Bagsvaerd, Denmark. She has obtained
outstanding results in the areas of business development, licensing
and alliance management in the pharmaceutical and biotech industry
at Lundbeck, Nycomed, and EffRx. Dr. Kaltoft brings 20 years of
international specialization in development and successful
execution of business development strategies, contractual
structures and alliance management within all sectors of the life
science industry.
Summary Compensation Table for Fiscal Years 2017 and
2016
The
following table provides certain information concerning
compensation earned for services rendered in all capacities by our
named executive officers during the fiscal years ended
December 31, 2017 and 2016.
Name and
Principal Position
|
|
|
|
|
|
Non Equity
Incentive Plan Compensation ($)
|
Nonqualified
Deferred Compensation Earnings ($)
|
All Other
Compensation ($)(3)
|
|
(a)
|
(b)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Kevin A.
Richardson, II
|
2017
|
$120,000(1)
|
-
|
$130,882(2)
|
-
|
-
|
-
|
-
|
$250,882
|
Chairman of the
Board and Acting Chief Executive Officer (principal executive
officer)
|
2016
|
$120,000(1)
|
-
|
$114,021(2)
|
-
|
-
|
-
|
-
|
$234,021
|
|
|
|
|
|
|
|
|
|
Lisa E.
Sundstrom
|
2017
|
$115,000
|
-
|
$88,352(2)
|
-
|
-
|
-
|
$12,652
|
$216,004
|
Chief Financial
Officer (principal financial officer)
|
2016
|
$115,000
|
-
|
$81,444(2)
|
-
|
-
|
-
|
$13,284
|
$209,728
|
|
|
|
|
|
|
|
|
|
Peter
Stegano
|
2017
|
$200,000
|
-
|
$88,352(2)
|
-
|
-
|
-
|
$13,498
|
$301,850
|
Vice President,
Operations
|
2016
|
$200,000
|
-
|
$81,444(2)
|
-
|
-
|
-
|
$13,339
|
$294,783
|
|
|
|
|
|
|
|
|
|
Iulian
Cioanta
|
2017
|
$200,000
|
-
|
$88,352(2)
|
-
|
-
|
-
|
$19,583
|
$307,935
|
Vice President,
Research and Development
|
2016
|
$200,000
|
-
|
$81,444(2)
|
-
|
-
|
-
|
$19,892
|
$301,336
|
(1)
Mr. Richardson
has been the Company's Chairman of the Board since the Company's
inception. Since 2014, Mr. Richardson has also been our Acting
Chief Executive Officer. We continue to compensate Mr. Richardson
as a director as described in "Discussion of Director Compensation"
below, however we pay him an additional $10,000 per month in
recognition of his additional role as Acting Chief Executive
Officer.
(2)
This dollar
amount reflects the full fair value of the grant at the date of
issuance and is recognized for financial statement reporting
purposes with respect to each fiscal year over the vesting terms in
accordance with ASC 718-10.
(3)
Includes health,
dental, life and disability insurance premiums and 401(k) matching
contributions.
Stock Incentive Plan
On
October 24, 2006, SANUWAVE, Inc.’s board of directors adopted
the 2006 Stock Incentive Plan of SANUWAVE, Inc. (the “2006
Plan”). On November 1, 2010, the Company approved the Amended
and Restated 2006 Stock Incentive Plan of SANUWAVE Health, Inc.
effective as of January 1, 2010 (previously defined as the
“Stock Incentive Plan”). The Stock Incentive Plan
permits grants of awards to selected employees, directors and
advisors of the Company in the form of restricted stock or options
to purchase shares of common stock. Options granted may include
nonstatutory options as well as qualified incentive stock options.
The Stock Incentive Plan is currently administered by the board of
directors of the Company. The Stock Incentive Plan gives broad
powers to the board of directors of the Company to administer and
interpret the particular form and conditions of each option. The
stock options granted under the Stock Incentive Plan are
nonstatutory options which vest over a period of up to three years,
and have a maximum ten year term. The options are granted at an
exercise price equal to the fair market value of the common stock
on the date of the grant which is approved by the board of
directors of the Company. The Stock Incentive Plan had 22,500,000
shares of common stock reserved for grant at December 31,2017 and
2016.
The
terms of the options granted under the Stock Incentive Plan expire
as determined by individual option agreements (or on the tenth
anniversary of the grant date), unless terminated earlier on the
first to occur of the following: (1) the date on which the
participant’s service with the Company is terminated by the
Company for cause; (2) 60 days after the participant’s death;
or (3) 60 days after the termination of the participant’s
service with the Company for any reason other than cause or the
participant’s death; provided that, if during any part of
such 60 day period the option is not exercisable solely because of
specified securities law restrictions, the option will not expire
until the earlier of the expiration date or until it has been
exercisable for an aggregate period of 60 days after the
termination of the participant’s service with the Company.
The options vest as provided for in each individual’s option
agreement and the exercise prices for the options are determined by
the board of directors at the time the option is granted; provided
that the exercise price shall in no event be less than the fair
market value per share of the Company’s Common Stock on the
grant date. In the event of any change in the Common Stock
underlying the options, by reason of any merger or exchange of
shares of common stock, the board of directors shall make such
substitution or adjustment as it deems to be equitable to (1) the
class and number of shares underlying such option, (2) the exercise
price applicable to such option, or (3) any other affected terms of
such option.
In the
event of a change of control, unless specifically modified by an
individual option agreement: (1) all options outstanding as of the
date of such change of control will become fully vested; and (2)
notwithstanding (1) above, in the event of a merger or share
exchange, the board of directors may, in its sole discretion,
determine that any or all options granted pursuant to the Stock
Incentive Plan will not vest on an accelerated basis if the board
of directors, the surviving corporation or the acquiring
corporation, as the case may be, has taken such action as in the
opinion of the board of directors is equitable or appropriate to
protect the rights and interests of the participants under the
Stock Incentive Plan.
On
December 31, 2017, there were 2,238,281 shares of common stock
available for grant under the Stock Incentive Plan. For the years
ended December 31, 2017 and 2016, there were 2,700,000 and
4,067,800 options, respectively, granted to the Company’s
executive officers under the Stock Incentive Plan.
Outstanding Equity Awards at 2017 Fiscal Year End
The
following table provides certain information concerning the
outstanding equity awards for each named executive officer as of
December 31, 2017.
|
|
|
Name
|
Number of
Securities Underlying Unexercised Options/ Warrants (#)
Exercisable
|
Number of
Securities Underlying Unexercised Options/ Warrants (#)
Unexercisable
|
Equity
Incentive Plan Awards: Number of Securities Underlying Unexercised
Unearned Options (#)
|
Option/
Warrant Exercise Price ($)
|
Option/
Warrant Expiration Date
|
Number of
Shares or Units of Stock That Have Not Vested (#)
|
Market Value
of Shares or Units of Stock That Have Not Vested ($)
|
Equity
Incentive Plan Awards: Number of Unearned Shares, Units or Other
Rights That Have Not Vested (#)
|
Equity
Incentive Plan Awards: Market or Payout Value of Unearned Shares,
Units or Other Rights That Have Not Vested ($)
|
(a)
|
|
|
|
|
(f)
|
|
|
|
|
Kevin A.
Richardson, II
|
115,000(1)
|
-
|
-
|
$0.35
|
02/21/2023
|
-
|
-
|
-
|
-
|
Chairman of the
Board and Co-Chief Executive Officer (principal executive
officer)
|
452,381(3)
|
-
|
-
|
$0.11
|
10/1/2025
|
-
|
-
|
-
|
-
|
|
297,619(3)
|
-
|
-
|
$0.06
|
10/1/2025
|
-
|
-
|
-
|
-
|
|
700,000(4)
|
-
|
-
|
$0.04
|
6/16/2026
|
-
|
-
|
-
|
-
|
|
594,300(5)
|
-
|
-
|
$0.18
|
11/9/2026
|
-
|
-
|
-
|
-
|
|
900,000(6)
|
-
|
-
|
$0.11
|
6/14/2027
|
-
|
-
|
-
|
-
|
|
640,000(7)
|
-
|
-
|
$0.11
|
3/17/2019
|
-
|
-
|
-
|
-
|
Lisa
Sundstrom
|
65,000(1)
|
-
|
-
|
$0.35
|
02/21/2023
|
-
|
-
|
-
|
-
|
Chief Finanical
Officer (principal financial officer)
|
25,000(2)
|
-
|
-
|
$0.55
|
5/7/2024
|
-
|
-
|
-
|
-
|
|
301,587(3)
|
-
|
-
|
$0.11
|
10/1/2025
|
-
|
-
|
-
|
-
|
|
198,413(3)
|
-
|
-
|
$0.06
|
10/1/2025
|
-
|
-
|
-
|
-
|
|
500,000(4)
|
-
|
-
|
$0.04
|
6/16/2026
|
-
|
-
|
-
|
-
|
|
424,500(5)
|
-
|
-
|
$0.18
|
11/9/2026
|
-
|
-
|
-
|
-
|
|
600,000(6)
|
-
|
-
|
$0.11
|
6/14/2027
|
-
|
-
|
-
|
-
|
|
440,000(7)
|
-
|
-
|
$0.11
|
3/17/2019
|
-
|
-
|
-
|
-
|
Peter
Stegano
|
333,644(1)
|
-
|
-
|
$0.35
|
02/21/2023
|
-
|
-
|
-
|
-
|
Vice President,
Operations
|
50,000(2)
|
-
|
-
|
$0.55
|
5/7/2024
|
-
|
-
|
-
|
-
|
|
301,587(3)
|
-
|
-
|
$0.11
|
10/1/2025
|
-
|
-
|
-
|
-
|
|
198,413(3)
|
-
|
-
|
$0.06
|
10/1/2025
|
-
|
-
|
-
|
-
|
|
500,000(4)
|
-
|
-
|
$0.04
|
6/16/2026
|
-
|
-
|
-
|
-
|
|
424,500(5)
|
-
|
-
|
$0.18
|
11/9/2026
|
-
|
-
|
-
|
-
|
|
600,000(6)
|
-
|
-
|
$0.11
|
6/14/2027
|
-
|
-
|
-
|
-
|
|
440,000(7)
|
-
|
-
|
$0.11
|
3/17/2019
|
-
|
-
|
-
|
-
|
Iulian
Cioanta
|
296,241(1)
|
-
|
-
|
$0.35
|
02/21/2023
|
-
|
-
|
-
|
-
|
Vice President,
Research and Development
|
50,000(2)
|
-
|
-
|
$0.55
|
5/7/2024
|
-
|
-
|
-
|
-
|
|
301,587(3)
|
-
|
-
|
$0.11
|
10/1/2025
|
-
|
-
|
-
|
-
|
|
198,413(3)
|
-
|
-
|
$0.06
|
10/1/2025
|
-
|
-
|
-
|
-
|
|
500,000(4)
|
-
|
-
|
$0.04
|
6/16/2026
|
-
|
-
|
-
|
-
|
|
424,500(5)
|
-
|
-
|
$0.18
|
11/9/2026
|
-
|
-
|
-
|
-
|
|
600,000(6)
|
-
|
-
|
$0.11
|
6/14/2027
|
-
|
-
|
-
|
-
|
|
440,000(7)
|
-
|
-
|
$0.11
|
3/17/2019
|
-
|
-
|
-
|
-
|
(1)
On February 21,
2013, the Company, by mutual agreement with all active employees
and directors of the Company, cancelled options granted to the
active employees and directors in the year ended December 31, 2011
and prior. In exchange for these options, the
active employees and directors received new options to purchase
shares of common stock at an exercise price of $0.35 per share. The
Company cancelled all options which were previously granted to Mr.
Richardson, Ms. Sundstrom, Mr. Stegagno and Mr. Cioanta. The
Company granted Mr. Richardson 115,000 options, Ms. Sundstrom
65,000 options, Mr. Stegagno 333,644 options and Mr. Cioanta
296,241 options on February 21, 2013 which vests one-third at grant
date, one-third on February 21, 2014 and one-third on February 21,
2015.
(2)
The Company
granted Ms. Sundstrom 25,000 options, Mr. Stegagno 50,000 options
and Mr. Cioanta 50,000 options on May 7, 2014 which vests one-third
at grant date, one-third on May 7, 2015 and one-third on May 7,
2016.
(3)
The Company
granted Mr. Richardson 750,000 options, Ms. Sundstrom 500,000
options, Mr. Stegagno 500,000 options and Mr. Cioanta 500,000
options on October 1, 2015 which vests at grant date.
(4)
The Company
granted Mr. Richardson 700,000 options, Ms. Sundstrom 500,000
options, Mr. Stegagno 500,000 options and Mr. Cioanta 500,000
options on June 16, 2016 which vests at grant date.
(5)
The Company
granted Mr. Richardson 594,300 options, Ms. Sundstrom 424,500
options, Mr. Stegagno 424,500 options and Mr. Cioanta 424,500
options on November 9, 2016 which vests at grant date.
(6)
The Company
granted Mr. Richardson 900,000 options, Ms. Sundstrom 600,000
options, Mr. Stegagno 600,000 options and Mr. Cioanta 600,000
options on June 15, 2017 which vests at grant date.
(7)
The Company
granted Mr. Richardson 640,000 warrants, Ms. Sundstrom 440,000
warrants, Mr. Stegagno 440,000 warrants and Mr. Cioanta 440,000
warrants on Deccember 11, 2017 which vests at grant
date.
`
Director Compensation Table for Fiscal 2017
The
following table provides certain information concerning
compensation for each director during the fiscal year ended
December 31, 2017.
Name
|
Fees Earned or
Paid in Cash ($)
|
|
|
Non Equity
Incentive Plan Compensation ($)
|
Nonqualified
Deferred Compensation Earnings ($)
|
All Other
Compensation ($)
|
|
(a)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Kevin A.
Richardson, II (1)
|
$24,000
|
-
|
$130,882
|
-
|
-
|
-
|
$154,882
|
|
|
|
|
|
|
|
|
John F.
Nemelka
|
$24,000
|
-
|
$42,530
|
-
|
-
|
-
|
$66,530
|
|
|
|
|
|
|
|
|
Alan L.
Rubino
|
$24,000
|
-
|
$42,530
|
-
|
-
|
-
|
$66,530
|
|
|
|
|
|
|
|
|
A. Michael
Stolarski
|
$24,000
|
-
|
$42,530
|
-
|
-
|
-
|
$66,530
|
|
|
|
|
|
|
|
|
Maj-Britt
Kaltoft
|
$13,000
|
-
|
$42,530
|
-
|
-
|
-
|
$55,530
|
|
|
|
|
|
|
|
|
(1)
Mr. Richardson
has been the Company's Chairman of the Board since the Company's
inception. Since 2014, Mr. Richardson has also been our Acting
Chief Executive Officer. We continue to compensate Mr. Richardson
as a director as described in "Discussion of Director Compensation"
below, however we pay him an additional $10,000 per month in
recognition of his additional role as Acting Chief Executive
Officer.
The
following are the aggregate number of option awards outstanding
that have been granted to each of our non-employee directors as of
December 31, 2017: Kevin A. Richardson, II – 3,059,300;
John F. Nemelka – 1,034,800;Alan L. Rubino – 1,019,800;
A. Michael Stolarski – 669,800 and Maj-Britt Kaltoft –
300,000.
Discussion of Director Compensation
Effective January
1, 2017, the Company began to compensate its three outside
directors at an annual rate of $24,000 each. On June 15, 2017, the
Company issued 900,000 options to purchase the Company’s
common stock at $0.11 per share to non-employee director Kevin A.
Richardson II and the Company issued 300,000 to purchase the
Company’s common stock at $0.11 per share to non-employee
directors John F. Nemelka, Alan L. Rubino, A. Michael Stolarski and
Maj-Britt Kaltoft. On November 9, 2016, the Company issued 594,300
options to purchase the Company’s common stock at $0.18 per
share to non-employee director Kevin A. Richardson II and the
Company issued 169,800 to purchase the Company’s common stock
at $0.18 per share to non-employee directors John F. Nemelka, Alan
L. Rubino and A. Michael Stolarski. On June 16, 2016, the Company
issued 700,000 options to purchase the Company’s common stock
at $0.04 per share to non-employee director Kevin A. Richardson II
and the Company issued 200,000 to purchase the Company’s
common stock at $0.04 per share to non-employee directors John F.
Nemelka, Alan L. Rubino and A. Michael Stolarski. On October 1,
2015, the Company issued 452,381 options to purchase the
Company’s common stock at $0.11 per share and 297,619 options
to purchase the Company’s common stock at $0.50 per share to
non-employee director Kevin A. Richardson II and the Company issued
150,795 options to purchase the Company’s common stock at
$0.11 per share and 99,205 options to purchase the Company’s
common stock at $0.50 per share to non-employee directors John F.
Nemelka and Alan L. Rubino. On September 3, 2013, the Company
issued 100,000 options to purchase the Company’s common stock
at $0.65 per share to non-employee director Alan L. Rubino. On
February 21, 2013, the Company, by mutual agreement with all the
active employees and directors of the Company, cancelled options
granted to the active employees and directors in the year ended
December 31, 2011 and prior. In exchange for these options, the
active employees and directors received new options to purchase
shares of common stock at an exercise price of $0.35 per share.
Kevin A. Richardson, II, and John F. Nemelka, each cancelled 15,000
options and were each issued 115,000 options at an exercise price
of $0.35 per share.
Committee Interlocks and Insider Participation
The
Compensation Committee is comprised of Alan L. Rubino, Kevin A.
Richardson, II, A. Michael Stolarski and Maj-Britt Kaltoft. Mr.
Richardson and Mr. Stolarski have had certain relationships and
related party transactions described further in the section
entitled “Certain Relationships and Related
Transactions—Related Party Transactions.” During 2017,
none of our executive officers served as a director or member of a
compensation committee (or other committee serving an equivalent
function) of any other entity whose executive officers served as a
director or member of the Compensation Committee.
CORPORATE GOVERNANCE AND BOARD MATTERS
The
Company adopted a formal Corporate Governance policy in January
2012 which included establishing formal board committees and a code
of conduct for the board of directors and the Company.
The Board of Directors
Recent Developments
The
Company’s current board of directors consists of five
members, two of whom have been determined by the board to be
“independent” as defined under the rules of the NASDAQ
stock market. The Company expects to add additional independent
directors in 2018.
Board’s Leadership Structure
The
Company’s board of directors elects the Company’s chief
executive officer and its chairman, and each of these positions may
be held by the same person or may be held by two persons. The
chairman’s primary responsibilities are to manage the board
and serve as the primary liaison between the board of directors and
the chief executive officer, while the primary responsibility of
the chief executive officer is to manage the day-to-day affairs of
the Company, taking into account the policies and directions of the
board of directors. Such an arrangement promotes more open and
robust communication among the board, and provides an efficient
decision making process with proper independent oversight. The
Company’s board of directors has determined that it is
currently in the best interest of the Company and its shareholders
to combine the roles of chairman of the board and chief executive
officer.
The
Company believes, however, that there is no single leadership
structure that is the best and most effective in all circumstances
and at all times. Accordingly, the board of directors retains the
authority to later combine these roles if doing so would be in the
best interests of the Company and its shareholders.
The
Company’s board of directors is authorized to have an audit
committee, a compensation committee and a nominating and corporate
governance committee, to assist the Company’s board of
directors in discharging its responsibilities. The Company’s
current board of directors consists of five members, two of whom
has been determined by the board to be “independent” as
defined under the rules of the NASDAQ stock market. The board of
directors has determined that Mr. Richardson, Mr. Nemelka and Mr.
Stolarski are not independent under the applicable marketplace
rules of the NASDAQ stock market and Rule 10A-3 under the Exchange
Act. The Company expects to add additional independent directors in
2018
Board’s Role in Risk Oversight
While
the Company’s management is responsible for the day-to-day
management of risk to the Company, the board of directors has broad
oversight responsibility for the Company’s risk management
programs. The various committees of the board of directors assist
the board of directors in fulfilling its oversight responsibilities
in certain areas of risk. In particular, the audit committee
focuses on financial and enterprise risk exposures, including
internal controls, and discusses with management and the
Company’s independent registered public accountants the
Company’s policies with respect to risk assessment and risk
management. The compensation committee is responsible for
considering those risks that may be implicated by the
Company’s compensation programs and reviews those risks with
the Company’s board of directors and chief executive
officer.
Audit Committee
The
current members of the Company’s audit committee are John F.
Nemelka (Chairperson), Kevin A. Richardson, II, and A. Michael
Stolarski. Mr. Nemelka, who chairs the committee, has been
determined by the board of directors to be an audit committee
financial expert as defined pursuant to the rules of the SEC.
Pursuant to the Company’s Audit Committee Charter, the audit
committee is required to consist of at least two independent
directors. The Company expects to add additional independent
directors to the board of directors in 2018.
The
audit committee operates under a written charter adopted by the
board of directors which is available on the Company’s
website at www.sanuwave.com.
The primary responsibility of the audit committee is to oversee the
Company’s financial reporting process on behalf of the board
of directors. Among other things, the audit committee is
responsible for overseeing the Company’s accounting and
financial reporting processes and audits of the Company’s
financial statements, reviewing and discussing with the independent
auditors the critical accounting policies and practices for the
Company, engaging in discussions with management and the
independent auditors to assess risk for the Company and management
thereof, and reviewing with management the effectiveness of the
Company’s internal controls and disclosure controls and
procedures. The audit committee is directly responsible for the
appointment, compensation, retention and oversight of the work of
the Company’s independent auditors, currently Cherry Bekaert,
LLP, including the resolution of disagreements, if any, between
management and the auditors regarding financial reporting. In
addition, the audit committee is responsible for reviewing and
approving any related party transaction that is required to be
disclosed pursuant to Item 404 of Regulation S-K promulgated under
the Exchange Act.
Compensation Committee
The
current members of the Company’s compensation committee are
Alan L. Rubino (Chairperson), Kevin A. Richardson II, A. Michael
Stolarski and Maj-Britt Kaltoft. The primary purpose of the
compensation committee is to discharge the responsibilities of the
board of directors relating to compensation of the Company’s
executive officers. Pursuant to the Company’s Compensation
Committee Charter, the compensation committee is required to
consist of at least two independent directors. The Company expects
to add additional independent directors to the board of directors
in 2018.
The
compensation committee operates under a written charter adopted by
the board of directors which is available on the Company’s
website at www.sanuwave.com.
Specific responsibilities of the compensation committee include
reviewing and recommending approval of compensation of the
Company’s named executive officers, administering the
Company’s stock incentive plan, and reviewing and making
recommendations to the Company’s board of directors with
respect to incentive compensation and equity plans.
Nominating and Corporate Governance Committee
The
current members of the Company’s nominating and corporate
governance committee are Maj-Britt Kaltoft (Chairperson), Kevin A.
Richardson, II, John F. Nemelka, and Alan L. Rubino. Pursuant to
the Company’s Nominating and Corporate Governance Committee
Charter, the nominating and corporate governance committee is
required to consist of at least two independent directors. The
Company expects to add additional independent directors to the
board of directors in 2018.
The
nominating and corporate governance committee operates under a
written charter adopted by the board of directors which is
available on the Company’s website at www.sanuwave.com.
Specific responsibilities of the nominating and corporate
governance committee include: identifying and recommending nominees
for election to the Company’s board of directors; developing
and recommending to the board of directors the Company’s
corporate governance principles; overseeing the evaluation of the
board of directors; and reviewing and approving compensation for
non-employee members of the board of directors.
The
nominating and corporate governance committee’s charter
outlines how the nominating and corporate governance committee
fulfills its responsibilities for assessing the qualifications and
effectiveness of the current board members, assessing the needs for
future board members, identifying individuals qualified to become
members of the board and its committees, and recommending
candidates for the board of director’s selection as director
nominees for election at the next annual or other properly convened
meeting of shareholders.
The
nominating and corporate governance committee considers director
candidates recommended by shareholders for nomination for election
to the board of directors. The committee applies the same standards
in considering director candidates recommended by the shareholders
as it applies to other candidates. Any shareholder entitled to vote
for the election of directors may recommend a person or persons for
consideration by the committee for nomination for election to the
board of directors. The Company must receive written notice of such
shareholder’s recommended nominees(s) no later than January
31st of
the year in which the shareholder wishes such recommendation to be
considered by the committee in connection with the next meeting of
shareholders at which the election of directors will be held. To
submit a recommendation, a shareholder must give timely notice
thereof in writing to the Secretary of the Company. A
shareholder’s notice to the Secretary shall set forth: (i)
the name and record address of the shareholder making such
recommendation and any other shareholders known by such shareholder
to be supporting such recommendation; (ii) the class and number of
shares of the Company which are beneficially owned by the
shareholder and by any other shareholders known by such shareholder
to be supporting such recommendation; (iii) the name, age and five
year employment history of such recommended nominee; (iv) the
reasons why the shareholder believes the recommended nominee meets
the qualifications to serve as a director of the Company; and (v)
any material or financial interest of the shareholder and, if
known, the recommended nominee in the Company.
Shareholder Communications with the Board of Directors
The
board of directors has implemented a process for shareholders to
send communications to the board of directors. Shareholders who
wish to communicate directly with the board of directors or any
particular director should deliver any such communications in
writing to the Secretary of the Company. The Secretary will
compile any communications they receive from shareholders and
deliver them periodically to the board of directors or the specific
directors requested. The Secretary of the Company will not screen
or edit such communications, but will deliver them in the form
received from the shareholder.
Code of Conduct and Ethics
It
is the Company’s policy to conduct its affairs in accordance
with all applicable laws, rules and regulations of the
jurisdictions in which it does business. The Company has adopted a
code of business conduct and ethics with policies and procedures
that apply to all associates (all employees are encompassed by this
term, including associates who are officers) and directors,
including the chief executive officer, chief financial officer,
controller, and persons performing similar functions.
The Company has made the code of business conduct
and ethics available on its website at www.sanuwave.com.
If any substantive amendments to the
code of business conduct and ethics are made or any waivers are
granted, including any implicit waiver, the Company will disclose
the nature of such amendment or waiver on its website or in a
report on Form 8-K.
No Family Relationships Among Directors and Officers
There
are no family relationships between any director or executive
officer of the Company and any other director or executive officer
of the Company.
Director Independence
Our
board of directors has determined that Alan L. Rubino and Dr.
Maj-Britt Kaltoft qualify as independent directors based on the
NASDAQ Stock Market definition of “independent
director.”
Limitation of Directors Liability and Indemnification
The
Nevada Revised Statutes authorize corporations to limit or
eliminate, subject to certain conditions, the personal liability of
directors to corporations and their stockholders for monetary
damages for breach of their fiduciary duties. Our certificate of
incorporation limits the liability of our directors to the fullest
extent permitted by Nevada law.
We have
director and officer liability insurance to cover liabilities our
directors and officers may incur in connection with their services
to us, including matters arising under the Securities Act of 1933,
as amended. Our certificate of incorporation and bylaws also
provide that we will indemnify our directors and officers who, by
reason of the fact that he or she is one of our officers or
directors, is involved in a legal proceeding of any
nature.
There
is no pending litigation or proceeding involving any of our
directors, officers, employees or agents in which indemnification
will be required or permitted. We are not aware of any threatened
litigation or proceeding that may result in a claim for such
indemnification.
Section 16(a) Beneficial Ownership Reporting
Compliance
Section
16(a) of the Exchange Act requires our directors and executive
officers, and persons who own more than 10% of our equity
securities which are registered pursuant to Section 12 of the
Exchange Act, to file with the SEC initial reports of ownership and
reports of changes in ownership of our equity securities. Officers,
directors and greater than 10% shareholders are required by SEC
regulations to furnish us with copies of all Section 16(a)
reports they file.
Based
solely upon a review of the Forms 3, 4 and 5 (and amendments
thereto) furnished to us for our fiscal year ended December 31,
2017, we have determined that our directors, officers and greater
than 10% beneficial owners complied with all applicable Section 16
filing requirements.
Disclosure of Commission Position on Indemnification of Securities
Act Liabilities
Insofar
as indemnification for liabilities arising under the Securities Act
may be permitted to directors, officers and controlling persons of
the registrant pursuant to the foregoing provisions, or otherwise,
the registrant has been advised that in the opinion of the
Securities and Exchange Commission such indemnification is against
public policy as expressed in the Act and is, therefore,
unenforceable. In the event that a claim for indemnification
against such liabilities (other than the payment by the registrant
of expenses incurred or paid by a director, officer or controlling
person of the registrant in the successful defense of any action,
suit or proceeding) is asserted by such director, officer or
controlling person in connection with the securities being
registered, the registrant will, unless in the opinion of its
counsel the matter has been settled by controlling precedent,
submit to a court of appropriate jurisdiction the question whether
such indemnification by it is against public policy as expressed in
the Act and will be governed by the final adjudication of such
issue.
SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND
MANAGEMENT
The
following table sets forth certain information, as of April 12,
2018, with respect to the beneficial ownership of the
Company’s outstanding Common Stock by (i) any holder of more
than five percent (5.0%), (ii) each of the Company’s
executive officers and directors, and (iii) the Company’s
directors and executive officers as a group.
|
|
|
|
|
|
Name of
Beneficial Owner (1)
|
|
|
A. Michael
Stolarski (3)
|
16,439,333
|
10.6%
|
Kevin A.
Richardson, II (4)
|
12,549,870
|
8.3%
|
Peter Stegagno
(5)
|
3,511,780
|
2.4%
|
Iulian Cioanta
(6)
|
2,826,146
|
2.0%
|
Lisa E. Sundstrom
(7)
|
2,554,500
|
1.8%
|
John F. Nemelka
(8)
|
1,246,055
|
0.9%
|
Alan Rubino
(9)
|
1,219,800
|
0.9%
|
Maj-Britt Kaltoft
(10)
|
500,000
|
0.4%
|
All directors and
executive officers as a group (8 persons)
|
40,847,484
|
27.2%
|
5%
Beneficial Owner:
|
|
|
Jerome Gildner
(11)
|
13,333,334
|
9.0%
|
John McDermott
(11)
|
12,575,756
|
8.5%
|
James McGraw
(11)
|
11,610,694
|
7.8%
|
(1)
Unless otherwise
noted, each beneficial owner has the same address as
us.
(2)
Applicable
percentage ownership is based on 142,012,979 shares of common stock
outstanding as of April 12, 2018, “Beneficial
ownership” includes shares for which an individual, directly
or indirectly, has or shares voting or investment power, or both,
and also includes options, warrants and common shares available
upon the conversion of convertible promissory notes that are
exercisable within 60 days of April 12, 2018. Unless otherwise
indicated, all of the listed persons have sole voting and
investment power over the shares listed opposite their names.
Beneficial ownership as reported in the above table has been
determined in accordance with Rule 13d-3 of the Exchange
Act.
(3)
Includes
options to purchase up to 669,800 shares of common stock, warrants
to purchase up to 7,499,452 shares of common stock and 4,545,455
common shares available upon conversion of convertible promissory
note.
(4)
Includes
options to purchase up to 3,059,300 shares of common stock,
warrants to purchase up to 3,222,583 shares of common stock and
2,363,636 common shares available upon conversion of convertible
promissory note. In addition, this amount includes 138,782 shares
of common stock owned directly by Prides Capital Fund I, L.P.
Prides Capital Partners LLC is the general partner of Prides
Capital Fund I, L.P. and Mr. Richardson is the controlling
shareholder of Prides Capital Partners LLC; therefore, under
certain provisions of the Exchange Act, he may be deemed to be the
beneficial owner of such securities. Mr. Richardson has also been
deputized by Prides Capital Partners LLC to serve on the board of
directors of the Company. Mr. Richardson disclaims beneficial
ownership of all such securities except to the extent of any
indirect pecuniary interest (within the meaning of Rule 16a-1 of
the Exchange Act) therein.
(5)
Consists
of options to purchase up to 2,408,144 shares of common stock,
warrants to purchase up to 771,818 shares of common stock and
331,818 common shares available upon conversion of convertible
promissory note.
(6)
Consists
of options to purchase up to 2,370,741 shares of common stock and
warrants to purchase up to 440,000 shares of common
stock.
(7)
Consists
of options to purchase up to 2,114,500 shares of common stock and
warrants to purchase up to 440,000 shares of common
stock.
(8)
Includes
options to purchase up to 1,034,800 shares of common stock and
warrants to purchase up to 200,000 shares of common
stock.
(9)
Includes
options to purchase up to 1,019,800 shares of common stock and
warrants to purchase up to 200,000 shares of common
stock.
(10)
Includes
options to purchase up to 300,000 shares of common stock and
warrants to purchase up to 200,000 shares of common
stock.
(11)
Based
on records of the Company.
CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS
Related Party Transactions
Other
than as described below, since January 1, 2017, there have been no
transactions with related persons required to be disclosed in this
report.
On
February 13, 2018, the Company entered into an Agreement for
Purchase and Sale, Limited Exclusive Distribution and Royalties,
and Servicing and Repairs with Premier Shockwave Wound Care, Inc.,
a Georgia Corporation (“PSWC”), and Premier Shockwave,
Inc., a Georgia Corporation (“PS”). Each of PS and PSWC
is owned by A. Michael Stolarski, a member of the Company’s
board of directors and an existing shareholder of the Company. The
agreement provides for the purchase by PSWC and PS of dermaPACE
System and related equipment sold by the Company and includes a
minimum purchase of 100 units over 3 years. The agreement grants
PSWC and PS limited but exclusive distribution rights to provide
dermaPACE Systems to certain governmental healthcare facilities in
exchange for the payment of certain royalties to the Company. Under
the agreement, the Company is responsible for the servicing and
repairs of such dermaPACE Systems and equipment. The agreement also
contains provisions whereby in the event of a change of control of
the Company (as defined in the agreement), the stockholders of PSWC
have the right and option to cause the Company to purchase all of
the stock of PSWC, and whereby the Company has the right and option
to purchase all issued and outstanding shares of PSWC, in each case
based upon certain defined purchase price provisions and other
terms. The agreement also contains certain transfer restrictions on
the stock of PSWC.
On
December 29, 2017, the Company entered into a line of credit
agreement with A. Michael Stolarski, a
member of the Company’s board of directors and an existing
shareholder of the Company. The agreement established a line
of credit in the amount of $370,000 with an annualized interest
rate of 6%. The line of credit may be called for payment upon
demand. The outstanding balance as of December 31, 2017 with
accrued interest was $370,179 and $0 interest was paid for the
period ending December 31, 2017.
On
December 11, 2017, the Company issued Class O Warrant Agreements to
active employees, independent contractors, members of the board of
directors and members of the medical advisory boards to purchase
3,940,000 shares of common stock at an exercise price of $0.11 per
share. Kevin A. Richardson II and A.
Michael Stolarski, both members of the Company’s board of
directors and existing shareholders of the Company, were
issued 640,000 and 200,000 warrants, respectively. John Nemelka,
Alan Rubino and Maj-Britt Kaltoft, members of the Company’s
board of directors, were each issued 200,000 warrants. Lisa E.
Sundstrom, an officer of the Company was issued 440,000
warrants.
On
March 27, 2017, the Company began
offering subscriptions for 10% convertible promissory notes (the
“10% Convertible Promissory Notes”) to selected
accredited investors. The Company intends to use the
proceeds from the 10% Convertible Promissory Notes for working
capital and general corporate purposes. The initial offering closed
on August 15, 2017, at which time $55,000 aggregate principal
amount of 10% Convertible Promissory Notes were issued and the
funds paid to the Company. Subsequent offerings were closed on
November 3, 2017, November 30, 2017, and December 21, 2017, at
which times $1,069,440, $259,310 and $150,000, respectively,
aggregate principal amounts of 10% Convertible Promissory Notes
were issued and the funds paid to the Company. The 10% Convertible Promissory Notes include a
warrant agreement (the “Class N Warrant Agreement”) to
purchase Common Stock equal to the amount obtained by dividing the
(i) sum of the principal amount, by (ii) $0.11. The Class N Warrant
Agreement expires March 17, 2019. On November 3, 2017, the
Company issued 10,222,180 Class N Warrants in connection with the
initial and second closings of 10% Convertible Promissory Notes. On
November 30, 2017, and December 21, 2017, the Company issued
2,357,364 and 1,363,636, respectively, Class N Warrants in
connection with the closings of 10% Convertible Promissory Notes.
A. Michael Stolarski, a member of the
Company’s board of directors and an existing shareholder of
the Company, was a purchaser in the 10% Convertible
Promissory Notes in the amount of
$330,000. A. Michael Stolarski and Kevin A. Richardson II, both
members of the Company’s board of directors and existing
shareholders of the Company, had subscribed $130,000 and $140,000,
respectively, to the Company as advances from related parties to be
used to purchase 10% Convertible Promissory Notes. The 10%
Convertible Promissory Notes associated with these subscriptions
were issued in January 2018.
DESCRIPTION OF SECURITIES TO BE REGISTERED
Our
authorized capital stock consists of 355,000,000 shares, of which
350,000,000 shares are designated as Common Stock and 5,000,000
shares are designated as preferred stock. As of April 12,
2018, there were issued and outstanding:
●
142,012,979 shares
of Common Stock,
●
warrants to
purchase 110,657,062 shares of Common Stock at a weighted average
exercise price of $0.12 per share, and
●
stock options to
purchase 21,593,385 shares of Common Stock at a weighted average
exercise price of $0.31 per share.
The
following summary of the material provisions of our Common Stock,
preferred stock and warrants is qualified by reference to the
provisions of our articles of incorporation and bylaws and the
forms of warrant included or incorporated by reference as exhibits
to the registration statement of which this prospectus is a
part.
Common Stock
All
shares of our Common Stock have equal voting rights and, when
validly issued and outstanding, have one vote per share in all
matters to be voted upon by the stockholders. Cumulative
voting in the election of directors is not allowed, which means
that the holders of more than 50% of the outstanding shares can
elect all the directors if they choose to do so and, in such event,
the holders of the remaining shares will not be able to elect any
directors. The affirmative vote of a plurality of the shares
of Common Stock voted at a stockholders meeting where a quorum is
present is required to elect directors and to take other corporate
actions. Holders of our Common Stock are entitled to receive
ratably such dividends, if any, as may be declared by our board of
directors out of legally available funds. However, the current
policy of our board of directors is to retain earnings, if any, for
the operation and expansion of the Company. Upon liquidation,
dissolution or winding-up, the holders of our Common Stock are
entitled to share ratably in all of our assets which are legally
available for distribution, after payment of or provision for all
liabilities and the liquidation preference of any outstanding
preferred stock. The holders of our Common Stock have no
preemptive, subscription, redemption or conversion rights. All
issued and outstanding shares of Common Stock are, and the Common
Stock reserved for issuance upon exercise of our stock options and
warrants will be, when issued, fully-paid and
non-assessable.
Preferred Stock
Our
articles of incorporation authorize the issuance of up to 5,000,000
shares of “blank check” preferred stock with
designations, rights and preferences as may be determined from time
to time by our board of directors.
Warrants
The
following is a brief summary of material provisions of
the warrants offered in this offering.
Exercise Price and
Terms. Each warrant entitles the holder thereof to
purchase at any time until March 17, 2019, at a price of $0.08 per
share, subject to certain adjustments referred to below, shares
of our Common Stock. The holder of any warrant may
exercise such warrant by surrendering the warrant to us,
with the notice of exercise properly completed and executed,
together with payment of the exercise price. The warrants may be
exercised at any time in whole or in part at the applicable
exercise price until expiration of the warrants. No
fractional shares will be issued upon the exercise of the
warrants.
Adjustments. The
exercise price and the number of shares of Common Stock
purchasable upon the exercise of the warrants are subject to
adjustment upon the occurrence of certain events, including stock
dividends, stock splits, combinations or reclassifications of the
Common Stock. Additionally, an adjustment would be made in the
case of a reclassification or exchange of Common Stock,
consolidation or merger of our Company with or into
another corporation (other than a consolidation or merger in
which we are the surviving corporation) or sale of all or
substantially all of our assets in order to enable holders of
the warrants to acquire the kind and number of shares of stock
or other securities or property receivable in such event by a
holder of the number of shares of Common Stock that might
otherwise have been purchased upon the exercise of
the warrant. No adjustment to the number of shares and
exercise price of the shares subject to the warrants will be
made for dividends (other than stock dividends), if any, paid
on our Common Stock.
Transfer, Exchange and
Exercise. The warrants may be presented to us for
exchange or exercise at any time on or prior to March 17, 2019, at
which time the warrants become wholly void and of no
value. Prior to any transfer of the warrants the holder
must notify us of the same and, if subsequently requested, provide
a legal opinion regarding the transfer to us.
Warrantholder Not a
Stockholder. The warrants do not confer upon
holders any voting, dividend or other rights as a shareholder
of our Company.
Trading Information
Our
shares of Common Stock are currently quoted in the over-the-counter
market on the OTCQB under the symbol
“SNWV”.
Transfer Agent
The
transfer agent and registrar for our Common Stock and preferred
stock is Action Stock Transfer Corp., 7069 S. Highland Drive, Suite
300, Salt Lake City, Utah 84121
SHARES AVAILABLE FOR FUTURE SALE
As of
April 12, 2018, we had 142,012,979 shares of Common Stock
outstanding, not including shares issuable upon the exercise of
outstanding warrants, stock options and other convertible
securities. All shares sold in this offering will be freely
tradable without restriction or further registration under the
Securities Act, unless they are purchased by our
“affiliates,” as that term is defined in Rule 144
promulgated under the Securities Act.
The
outstanding shares of our Common Stock not included in this
prospectus will be available for sale in the public market as
follows:
Public Float
Of our
outstanding shares, 40,847,484 shares are beneficially owned by
executive officers, directors and affiliates of the
Company. The remaining 101,165,495 shares constitute our
public float which, based on the last sale price of our Common
Stock reported on the OTC Bulletin Board on April 12, 2018, equaled
approximately $54,882,281.
Rule 144
In
general, under Rule 144, as currently in effect, a person who has
beneficially owned shares of our Common Stock for at least six (6)
months, including the holding period of prior owners other than
affiliates, is entitled to sell his or her shares without any
volume limitations; an affiliate, however, can sell such number of
shares within any three-month period as does not exceed the greater
of:
●
1% of the number of
shares of our Common Stock then outstanding, which equaled
1,420,130 shares as of April 12, 2018, or
●
the average weekly
trading volume of our Common Stock, assuming our shares are then
traded on a national securities exchange, during the four calendar
weeks preceding the filing of a notice on Form 144 with respect to
that sale.
Sales
under Rule 144 are also subject to manner-of-sale provisions,
notice requirements and the availability of current public
information about us.
LEGAL MATTERS
Certain
legal matters will be passed upon for us by Smith, Gambrell &
Russell, LLP, Atlanta, Georgia.
EXPERTS
The
consolidated financial statements as of December 31, 2017 and 2016
and for the years then ended included in this prospectus and in the
registration statement have been so included in reliance on the
report of Cherry Bekaert LLP, an independent registered public
accounting firm, (the report on the financial statements contains
an explanatory paragraph regarding the Company’s ability to
continue as a going concern) appearing elsewhere herein and in the
registration statement, given on the authority of said firm as
experts in auditing and accounting.
INTEREST OF NAMED EXPERTS AND COUNSEL
No
expert or counsel named in this prospectus as having prepared or
certified any part of this prospectus or having given an opinion
upon the validity of the securities being registered or upon other
legal matters in connection with the registration or offering of
the Common Stock was employed on a contingency basis, or had, or is
to receive, in connection with the offering, a substantial
interest, direct or indirect, in the registrant or any of its
parents or subsidiaries. Nor was any such person connected
with the registrant or any of its parents or subsidiaries as a
promoter, managing or principal underwriter, voting trustee,
director, officer, or employee.
WHERE YOU CAN FIND MORE INFORMATION; INCORPORATION OF CERTAIN
INFORMATION BY REFERENCE
We have
filed a registration statement on Form S-1 with the SEC to register
the shares of our Common Stock being offered by this
prospectus. In addition, we file annual, quarterly and current
reports, proxy statements and other information with the
SEC. You may read and copy any reports, statements or other
information that we file at the SEC’s public reference
facilities at 100 F Street, N.E., Washington, D.C.
20549. Please call the SEC at 1-800-SEC-0330 for further
information regarding the public reference facilities. The SEC
maintains a website, http://www.sec.gov that contains
reports, proxy statements and information statements and other
information regarding registrants that file electronically with the
SEC, including us. Our SEC filings are also available to the
public from commercial document retrieval
services. Information contained on our website should not be
considered part of this prospectus.
The SEC
allows the “incorporation by reference” of information
into this prospectus, which means that information may be disclosed
to you by referring you to other documents filed or which will be
filed with the SEC. The following documents filed or to be filed by
the Company with the SEC pursuant to Section 13(a), 13(c), 14 or
15(d) of the Exchange Act, other than information in these
documents that is not deemed to be filed with the SEC are so
incorporated by reference:
●
Annual Report of
the Company on Form 10-K for the fiscal year ended December 31,
2017;
●
Quarterly Reports
of the Company on Form 10-Q for the quarters ended March 31, June
30 and September 30, 2017;
●
Current Reports of
the Company on Form 8-K filed with the SEC on January 24, April 6,
May 18, June 16, July 27, August 4, August 17, September 29,
November 9, November 22 and December 29, 2017, January 11, February
14, February 16 and April 2, 2018; and
●
All documents
subsequently filed by the Company pursuant to Sections 13(a),
13(c), 14 or 15(d) of the Exchange Act prior to the termination of
the offering (including filings made after the date of the
post-effective amendment to the registration statement of which
this prospectus is a part and prior to the effectiveness of such
post-effective amendment).
All
documents filed by the Company with the SEC pursuant to Sections
13(a), 13(c), 14 or 15(d) of the Exchange Act subsequent to the
date of this prospectus will be deemed to be incorporated by
reference into this prospectus, other than information in the
documents that is not deemed to be filed with the SEC.* The Company
will file an updated prospectus annually pursuant to the Securities
Act. A statement contained in this prospectus or any prospectus
supplement, or in a document incorporated or deemed to be
incorporated by reference into this prospectus or any prospectus
supplement, will be deemed to be modified or superseded to the
extent that a statement contained in any subsequently filed
document that is incorporated by reference into this prospectus or
any prospectus supplement, modifies or supersedes that statement.
Any statements so modified or superseded will not be deemed, except
as so modified or superseded, to constitute a part of this
prospectus or the applicable prospectus supplement. The public may
read and copy any materials the Company files with the SEC at the
SEC’s Public Reference Room located at 100 F Street, N.E.,
Washington, DC 20549 SEC and online at www.sec.gov. More
information concerning the operation of the Public Reference Room
of the SEC may obtained by calling the SEC at 1-800-SEC-0330 or
visiting online at www.sec.gov.
The
Company, will provide to each person, including any beneficial
owner, to whom a prospectus is delivered, a copy of any or all of
the reports or documents that have been incorporated by reference
in the prospectus contained in the registration statement but not
delivered with the prospectus at no cost upon written or oral
request. Such requests may be directed to the attention of SANUWAVE
Health, Inc., 3360 Martin Farm Road, Suite 100, Suwanee, Georgia
30024 Attn: Lisa Sundstrom, Chief Financial Officer, Telephone:
(770) 419-7525 or by email to lisa.sundstrom@sanuwave.com. The
reports and other documents incorporated by reference may also be
accessed is http://www.sanuwave.com.
*We are
not incorporating and will not incorporate by reference into this
prospectus past or future information on reports furnished or that
will be furnished under Items 2.02 and/or 7.01 of, or otherwise
with, Form 8-K.
You may
also request a copy of our filings at no cost by writing or
telephoning us at:
SANUWAVE
Health, Inc.
3360
Martin Farm Road, Suite 100
Suwanee,
Georgia 30024
Attn:
Lisa Sundstrom, Chief Financial Officer
Telephone:
(770) 419-7525
PART I — FINANCIAL INFORMATION
INDEX TO FINANCIAL STATEMENTS
Audited Consolidated Financial Statements for the Years Ended
December 31, 2017 and 2016
Report of Independent Registered Public Accounting
Firm
|
F-1
|
|
|
Consolidated Balance Sheets as of December 31, 2017 and
2016
|
F-2
|
|
|
Consolidated Statements of Comprehensive Loss for the Years Ended
December 31, 2017 and 2016
|
F-3
|
|
|
Consolidated Statements of Stockholder’s Deficit for the
Years Ended December 31, 2017 and 2016
|
F-4
|
|
|
Consolidated Statements of Cash Flows for the Years Ended December
31, 2017 and 2016
|
F-5
|
|
|
Notes to Consolidated Financial Statements
|
F-6
|
PART II
INFORMATION
NOT REQUIRED IN PROSPECTUS
The
following table lists the costs and expenses payable by the
registrant in connection with the sale of the common stock covered
by this prospectus. All amounts shown are estimates except for the
SEC registration fee.
SEC registration
fee
|
$3,770
|
Legal fees and
expenses
|
20,000
|
Accounting fees and
expenses
|
20,000
|
Miscellaneous fees
and expenses
|
0
|
Total
|
$43,770
|
ITEM 14. Indemnification of Directors and Officers
The
Nevada General Corporation Law (“NGCL”) provides that a director
or officer is not individually liable to the corporation or its
stockholders or creditors for any damages as a result of any act or
failure to act in his capacity as a director or officer unless (i)
such act or omission constituted a breach of his/her fiduciary
duties as a director or officer, and (ii) his/her breach of those
duties involved intentional misconduct, fraud or a knowing
violation of law. Under the NGCL, a corporation may indemnify
directors and officers, as well as other employees and individuals,
against any threatened, pending or completed action, suit or
proceeding, except an action by or in the right of the corporation,
by reason of the fact that he/she is or was a director, officer,
employee or agent of the corporation so long as such person acted
in good faith and in a manner which he/she reasonably believed to
be in or not opposed to the best interests of the corporation, and,
with respect to any criminal action or proceeding, had no
reasonable cause to believe his/her conduct was unlawful. The
termination of any action, suit or proceeding by judgment, order,
settlement, conviction or upon a plea of nolo contendere or its
equivalent, does not, of itself, create a presumption that the
person did not act in good faith and in a manner which he/she
reasonably believed to be in or not opposed to the best interests
of the corporation, or that, with respect to any criminal action or
proceeding, he/she had reasonable cause to believe that his/her
conduct was unlawful.
The
NGCL further provides that indemnification may not be made for any
claim as to which such a person has been adjudged by a court of
competent jurisdiction, after exhaustion of all appeals therefrom,
to be liable to the corporation or for amounts paid in settlement
to the corporation, unless and only to the extent that the court in
which the action or suit was brought or other court of competent
jurisdiction determines upon application that, in view of all the
circumstances of the case, the person is fairly and reasonably
entitled to indemnity for such expenses as the court deems proper.
To the extent that a director, officer, employee or agent of a
corporation has been successful on the merits or otherwise in
defense of any action, suit or proceeding or in defense of any
claim, issue or matter therein, the corporation must indemnify
him/her against expenses, including attorneys’ fees, actually
and reasonably incurred in connection with the defense. The NGCL
provides that this is not exclusive of other rights to which those
seeking indemnification may be entitled under any bylaw, agreement,
vote of stockholders, or disinterested directors or
otherwise.
The
registrant’s articles of incorporation provide that the
directors and officers will not be personally liable to the
registrant or its stockholders for monetary damages for breach of
their fiduciary duty as a director or officer, except for liability
of a director or officer for acts or omissions involving
intentional misconduct, fraud or a knowing violation of law, or the
payment of dividends in violation of the NGCL. The registrant's
bylaws and contractual arrangements with certain of its directors
and officers provide that the registrant is required to indemnify
its directors and officers to the fullest extent permitted by law.
The registrant's bylaws and these contractual arrangements also
require the registrant to advance expenses incurred by a director
or officer in connection with the defense of any proceeding upon
receipt of an undertaking by or on behalf of the director or
officer to repay the amount if it is ultimately determined by a
court of competent jurisdiction that he/she is not entitled to be
indemnified by the registrant. The registrant's bylaws also permit
the registrant to purchase and maintain errors and omissions
insurance on behalf of any director or officer for any liability
arising out of his/her actions in a representative capacity. The
registrant does not presently maintain any such errors and
omissions insurance for the benefit of its directors and
officers.
Insofar
as indemnification for liabilities arising under the Securities Act
may be permitted to directors, officers or persons controlling us
pursuant to the foregoing provisions, we have been informed that,
in the opinion of the Securities and Exchange Commission, such
indemnification is against public policy as expressed in the
Securities Act and is therefore unenforceable. In the event that a
claim for indemnification against such liabilities (other than the
payment by the registrant of expenses incurred or paid by a
director, officer or controlling person of the registrant in the
successful defense of any action, suit or proceeding) is asserted
by such director, officer or controlling person in connection with
the securities being registered, we will, unless in the opinion of
our counsel the matter has been settled by controlling precedent,
submit to a court of appropriate jurisdiction the question whether
such indemnification by us is against public policy as expressed
hereby in the Securities Act and we will be governed by the final
adjudication of such issue.
ITEM 15. Recent Sales of Unregistered Securities
In
connection with each of the following unregistered sales and
issuances of securities, except as otherwise provided below, the
Company relied upon the exemption from registration provided by
Section 4(a)(2) of the Securities Act of 1933, as amended, for
transactions not involving a public offering.
Restricted Stock Issued Upon Warrant Exercises
On
February 23, 2018, the Company issued 100,000 shares of common
stock upon the exercise of 100,000 Class O Warrants to purchase
shares of stock for $0.11 per share under the terms of the Class O
Warrant agreement.
On
March 28, 2018, the Company issued 75,666 shares of restricted
common stock upon the exercise of 75,666 Series A Warrants to
purchase shares of stock for $0.0334 per share under the terms
of the Series A Warrant agreement.
On
April 25, 2017, the Company issued 100,000 shares of restricted
common stock upon the exercise of 100,000 Class L Warrants to
purchase shares of stock for $0.08 per share under the terms of the
Class L Warrant Agreement.
On
April 3, 2017, the Company issued 100,000 shares of restricted
common stock upuon the exercise of 100,000 Class L Warrants to
purchase shares of stock for $0.08 per share under the terms of the
Class L Warrant Agreement.
On March 10, 2017, the Company issued 363,333 shares of restricted
common stock upon the exercise of 363,333 Class L Warrants to
purchase sharees of stock for $0.08 per share under the terms of
the Class L Warrant Agreement.
On January 24, 2017, the Company issued 600,000 shares of
restricted common stock upon the exercise of 600,000 Class L
Warrants to purchase shares of stock for $0.08 per share under the
terms of the Class L Warrant Agreement.
Convertible Promissory Note
On January
29, 2018, the Company entered into a convertible promissory
note (the “Convertible Promissory Note”) with an
accredited investor in the amount of $71,500. The Company
intends to use the proceeds from the Convertible Promissory Notes
for payment of services to an investor relations company and the
account of the attorney updating the Registration Statement on Form
S-1 of the Company filed under the Securities Act of 1933, as
amended, on January 3, 2017 (File No. 333-213774), which
registration statement shall also register the shares issuable upon
conversion of the Convertible Promissory Note and issuable upon the
exercise of a Class N common stock purchase warrant issued
concurrently with the issuance of this Convertible Promissory
Note.
The
Convertible Promissory Note has a six month term from the
subscription date and the note holders can convert the Convertible
Promissory Note at any time during the term to the number of
shares of Company common stock, equal to the amount
obtained by dividing (i) the amount of the unpaid principal and
interest on the note by (ii) $0.11.
The
Convertible Promissory Note includes a warrant agreement (the
“Class N Common Stock Purchase Warrant”) to purchase
Common Stock equal to the amount obtained by dividing the (i) sum
of the principal amount, by (ii) $0.11. The Class N Common Stock
Purchase Warrant expires on March 17, 2019. On January 29,
2018, the Company issued 650,000 Class N Common Stock Purchase
Warrants in connection with this Convertible Promissory
Note.
Class O Warrants
On
December 11, 2017, in consideration for services rendered, the
Company issued Class O Warrant Agreements to active employees,
independent contractors, members of the board of directors and
members of the medical advisory boards to purchase 3,940,000 shares
of common stock at an exercise price of $0.11 per share.
Kevin A. Richardson II and A. Michael
Stolarski, both members of the Company’s board of directors
and existing shareholders of the Company, were issued
640,000 and 200,000 warrants, respectively. John Nemelka, Alan
Rubino and Maj-Britt Kaltoft, members of the Company’s board
of directors, were each issued 200,000 warrants. Lisa E. Sundstrom,
an officer of the Company was issued 440,000 warrants.
On
December 6, 2017, the Company issued Class O Warrant Agreements to
a vendor to purchase 100,000 shares of common stock at an exercise
price of $0.11 per share. Each Class O Warrant represents the
right to purchase one share of Common Stock. The estimated fair
value of the Class O Warrants at the grant date was $8,125 and was
recorded as general and administrative expense and an increase to
additional paid-in capital. The warrants vested upon issuance and
expire on March 17, 2019.
On
November 30, 2017, the Company issued Class O Warrant Agreements to
a vendor to purchase 2,500,000 shares of common stock at an
exercise price of $0.11 per share. Each Class O Warrant
represents the right to purchase one share of Common Stock. The
estimated fair value of the Class O Warrants at the grant date was
$174,731 and was recorded as general and administrative expense and
an increase to additional paid-in capital. The warrants vested upon
issuance and expire on March 17, 2019.
Consulting Agreement
In
November 2017, the Company entered into a three month consulting
agreement for which a portion of the fee for the services was to be
paid with Company common stock. The number of shares to be paid
with Company common stock was calculated by dividing the amount of
the fee to be paid with Company common stock of $4,000 by the
Company stock price at the close of business on the eighth business
day of each month. The Company issued 26,667 and 23,529 shares,
respectively in each of the first two months of the
agreement. The Company issued 18,182 shares on January 9,
2018, for the third month of the agreement.
10% Convertible Promissory Notes
On
March 27, 2017, the Company began
offering subscriptions for 10% convertible promissory notes (the
“10% Convertible Promissory Notes”) to selected
accredited investors. The Company intends to use the
proceeds from the 10% Convertible Promissory Notes for working
capital and general corporate purposes. The initial offering closed
on August 15, 2017, at which time $55,000 aggregate principal
amount of 10% Convertible Promissory Notes were issued and the
funds paid to the Company. Subsequent offerings were closed on
November 3, 2017, November 30, 2017, and December 21, 2017, at
which times $1,069,440, $259,310 and $150,000, respectively,
aggregate principal amounts of 10% Convertible Promissory Notes
were issued and the funds paid to the Company. The 10% Convertible Promissory Notes include a
warrant agreement (the “Class N Warrant Agreement”) to
purchase Common Stock equal to the amount obtained by dividing the
(i) sum of the principal amount, by (ii) $0.11. The Class N Warrant
Agreement expires March 17, 2019. On November 3, 2017, the
Company issued 10,222,180 Class N Warrants in connection with the
initial and second closings of 10% Convertible Promissory Notes. On
November 30, 2017, and December 21, 2017, the Company issued
2,357,364 and 1,363,636, respectively, Class N Warrants in
connection with the closings of 10% Convertible Promissory Notes.
A. Michael Stolarski, a member of the
Company’s board of directors and an existing shareholder of
the Company, was a purchaser in the 10% Convertible
Promissory Notes in the amount of
$330,000. A. Michael Stolarski and Kevin A. Richardson II, both
members of the Company’s board of directors and existing
shareholders of the Company, had subscribed $130,000 and $140,000,
respectively, to the Company as advances from related parties to be
used to purchase 10% Convertible Promissory Notes. The 10%
Convertible Promissory Notes associated with these subscriptions
were issued in January 2018. Sales commissions of $72,625 were paid
to WestPark Capital, Inc. in connection with these
offerings.
A
subsequent offering of the 10% Convertible Promissory Notes was
closed on January 10, 2018, at which time $1,496,000 aggregate
principal amount of 10% Convertible Promissory Notes were issued
with $1,066,000 of funds paid to the Company. The remaining
$430,000 of principal came from advances from related and unrelated
parties balance at December 31, 2017 of $310,000 (see Note 7) and
conversion of $120,000 of unpaid executive compensation by related
party, Kevin A. Richardson II. On January 10, 2018, the
Company issued 13,599,999 Class N Warrants in connection with such
subsequent closing. Sales commission of $64,100 was paid to
WestPark Capital, Inc. in connection with this
offering.
The
final offering of the 10% Convertible Promissory Notes was closed
on February 2, 2018, at which time $100,000 aggregate principal
amount of 10% Convertible Promissory Notes were issued and the
funds paid to the Company. On February 2, 2018, the Company
issued 909,091 Class N Warrants in connection with such final
closing.
Cashless Warrant Exercise, exempt from registration pursuant to
Section 3(a)(9)
On
March 9, 2018, the Company issued 251,408 shares of common stock
upon the cashless exercise of 271,000 Series A Warrants to purchase
shares of stock for $0.0334 per share based on a current market
value of $0.462 per share as determined under the terms of the
Series A Warrant agreement.
On
March 2, 2018, the Company issued 407,461 shares of common stock
upon the cashless exercise of 600,000 Class L Warrants to purchase
shares of stock for $0.08 per share based on a current market value
of $0.2493 per share as determined under the terms of the Class L
Warrant Private Offering agreement.
On
February 14, 2018, the Company issued 229,515 shares of common
stock upon the cashless exercise of 400,000 Class L Warrants to
purchase shares of stock for $0.08 per share based on a current
market value of $0.1877 per share as determined under the terms of
the Class L Warrant Private Offering agreement.
On
January 11, 2018, the Company issued 50,432 shares of common stock
upon the cashless exercise of 59,000 Series A Warrants to purchase
shares of stock for $0.0334 per share based on a current market
value of $0.23 per share as determined under the terms of the
Series A Warrant agreement.
On
October 24, 2017, the Company issued 150,083 shares of common stock
to DeMint Law, PLLC upon the cashless exercise of 300,166 Class L
Warrants to purchase shares of stock for $0.08 per share based on a
current market value of $0.16 per share as determined under the
terms of the Class L Warrant Private Offering
agreement.
On June
22, 2017, the Company issued 84,514 shares of common stock to
Arthur Motch III upon the cashless exercise of 125,246 Series A
Warrants to purchase shares of stock for $0.0334 per share based on
a current market value of $0.1027 per share as determined under the
terms of the Series A Warrant agreement.
On
March 13, 2017, the Company issued 297,035 shares of common stock
to Lucas Hoppel upon the cashless exercise of 583,333 Class L
Warrants to purchase shares of stock for $0.08 per share based on a
current market value of $0.163 per share as determined under the
terms of the Class L Warrant Private Offering
agreement.
On
February 6, 2017, the Company issued 80,804 shares of common stock
to Intracoastal Capital, LLC upon the cashless exercise of 100,000
Series A Warrants to purchase shares of stock for $0.0334 per share
based on a current market value of $0.174 per share as determined
under the terms of the Series A Warrant agreement.
On
February 2, 2017, the Company issued 158,240 shares of common stock
to Intracoastal Capital, LLC upon the cashless exercise of 200,000
Series A Warrants to purchase shares of stock for $0.0334 per share
based on a current market value of $0.17 per share as determined
under the terms of the Series A Warrant agreement.
On
January 26, 2017, the Company issued 79,998 shares of common stock
to Intracoastal Capital, LLC upon the cashless exercise of 100,000
Series A Warrants to purchase shares of stock for $0.0334 per share
based on a current market value of $0.1669 per share as determined
under the terms of the Series A Warrant agreement.
On
January 20, 2017, the Company issued 15,951 shares of common stock
to Intracoastal Capital, LLC upon the cashless exercise of 20,000
Series A Warrants to purchase shares of stock for $0.0334 per share
based on a current market value of $0.165 per share as determined
under the terms of the Series A Warrant agreement.
On
November 18, 2016, the Company issued 117,510 shares of common
stock to DeMint Law, PLLC upon the cashless exercise of 143,400
Series A Warrants to purchase shares of stock for $0.0334 per share
based on a current market value of $0.185 per share as determined
under the terms of the Series A Warrant agreement.
On
September 8, 2016, the Company issued 526,288 shares of common
stock to Vigere Capital LP upon the cashless exercise of 971,667
Class M Warrants to purchase shares of stock for $0.06 per share
based on a current market value of $0.11 per share as determined
under the terms of the Class M Warrant agreement.
On
August 23, 2016, the Company issued 343,434 shares of common stock
to JDF Capital, Inc. upon the cashless exercise of 971,667 Class M
Warrants to purchase shares of stock for $0.06 per share based on a
current market value of $0.17 per share as determined under the
terms of the Class M Warrant agreement.
On
August 23, 2016, the Company issued 1,640,589 shares of common
stock to JDF Capital, Inc. upon the cashless exercise of 4,641,667
Class J Warrants to purchase shares of stock for $0.06 per share
based on a current market value of $0.17 per share as determined
under the terms of the Class J Warrant agreement.
August 2016 Private Placement
On
August 24, 2016, the Company entered into a Securities Purchase
Agreement with certain “accredited investors” (as that
term is defined in the Commission’s Regulation D) (the
“Purchasers”) for the issuance of an aggregate
total 28,300,001 shares of the Company’s common stock,
par value $0.001 per share (the “Common Stock”) for an
aggregate total purchase price of $1,698,000. The Company intends
to use the proceeds from the private placement for working capital
and general corporate purposes.
In
addition, the Company, in connection with the private placement,
issued to the Purchasers an aggregate total of 28,300,001
warrants (the “Class L Warrants”) to purchase shares of
Common Stock at an exercise price of $0.08 per warrant. Each Class
L Warrant represents the right to purchase one share of Common
Stock. The warrants vested upon issuance and expire on March 17,
2019.
Pursuant to the
terms of a Registration Rights Agreement that the Company entered
with the Purchasers in connection with the private placement, the
Company is required to file a registration statement or
registration statements with the Commission that cover the resale
by the Purchasers in the private placement of the shares of Common
Stock and the shares of Common Stock issuable upon exercise of the
Class L Warrants. The failure on the part of the Company to satisfy
certain deadlines described in the Registration Rights Agreement
may subject the Company to payment of certain monetary
penalties.
Anthony
M. Stolarski, a member of our board of directors and an existing
shareholder of the Company and Michael Nemelka, the brother of a
member of our board of directors and an existing shareholder of the
Company, were purchasers in this private placement.
At the
closing of the private placement, we paid WestPark Capital, Inc.,
the placement agent for the private placement, a fee of (i) ten
percent (10%) of the aggregate purchase price of the securities
sold in the private placement and (ii) warrants to purchase ten
percent (10%) of the number of shares sold in the private
placement. Accordingly, the Placement Agent was issued warrants to
purchase 2,830,000 shares of Common Stock at an exercise price
of $0.08 per share.
Private Placement Convertible Debenture Investment
On July
29, 2016, the Company entered into a financing transaction for the
sale of a Convertible Debenture (the “Debenture”) in
the principal amount of $200,000, with gross proceeds of $175,000
to the Company after payment of a 10% original issue discount. The
offering was conducted pursuant to the exemption from registration
provided by Section 4(a)(2) of the Act and Rule 506 of Regulation D
thereunder. The Company did not utilize any form of general
solicitation or general advertising in connection with the
offering. The Debenture was offered and sold to one accredited
investor.
The
Debenture was issued pursuant to the terms of a purchase agreement
among the Company and the Investor. The Debenture is secured by the
accounts receivable of the Company and, unless earlier redeemed,
matures on the third anniversary date of issuance. The Company paid
to Investor a non-accountable fee (the “Commitment
Fee”) of (i) Two Thousand Five Hundred and 00/100 Dollars
($2,500.00) and (ii) Eight Hundred Thirty-Five Thousand (835,000)
shares of Restricted Stock for Investor’s expenses and
analysis performed in connection with the analysis of the Company
and the propriety of the Investor’s making the contemplated
investment. The Commitment Fee was paid on the signing closing date
immediately upon receipt of the signing purchase
price.
In
September 2016, the Company repaid the Debenture in full which
totaled $210,000 with a Redemption Price of 105% of the sum of the
Principal Amount per the agreement.
Consulting Agreement
In
August 2016, the Company entered into a consulting agreement for
which the fee for the services performed was paid with Company
common stock. The Company issued 435,392 shares of common stock to
Vigere Capital LP under this agreement. The fair value of the
common stock issued to the consultant, based upon the closing
market price of the Company’s common stock at the date the
common stock was issued, was recorded as a non-cash general and
administrative expense for the year ended December 31,
2016.
August 2016 Warrants issued for consulting services
In
August 2016, the Company issued 2,140,000 warrants to purchase
shares of Common Stock at an exercise price of $0.08 per warrant to
Millennium Park Capital LLC. Each Class L Warrant represents the
right to purchase one share of Common Stock. The warrants vested
upon issuance and expire on March 17, 2019. This issuance was made
pursuant to the exemption from registration provided by Section
4(a)(2) of the Act and Rule 506 of Regulation D thereunder. The
Company did not utilize any form of general solicitation or general
advertising in connection with the issuance.
June 2016 Warrants issued for consulting services
In June
2016, the Company issued 500,000 warrants to purchase shares of
Common Stock at an exercise price of $0.08 per warrant to
Millennium Park Capital LLC. Each Class L Warrant represents the
right to purchase one share of Common Stock. The warrants vested
upon issuance and expire on March 17, 2019. This issuance was made
pursuant to the exemption from registration provided by Section
4(a)(2) of the Act and Rule 506 of Regulation D thereunder. The
Company did not utilize any form of general solicitation or general
advertising in connection with the issuance.
Employee Stock Option Grant
On
June 15, 2017, the Company granted to the active employees, members
of the board of directors and three members of the Company's
Medical Advisory Board option to purchase an aggregate total of
5,550,000 shares of the Company's common stock at an exercise price
of $0.11 per share and vested upon issuance. Using the
Black-Scholes option pricing model, management has determined that
the options had a fair value per share of $0.0869 per option
resulting in compensation expense of $482,295. Compensation
cost was recognized upon grant.
On
November 9, 2016, the Company granted to the active employees,
members of the board of directors and two members of the
Company’s Medical Advisory Board options to purchase
2,830,000 shares each of the Company’s common stock at an
exercise price of $0.18 per share and vested upon issuance.
Management will utilize the Black-Scholes option pricing model to
determine the fair value of the options per shares and record the
appropriate compensation cost as of grant.
On June
16, 2016, the Company granted to the active employees, members of
the board of directors and two members of the Company’s
Medical Advisory Board options to purchase 3,300,000 shares each of
the Company’s common stock at an exercise price of $0.04 per
share and vested upon issuance. Using the Black-Scholes option
pricing model, management has determined that the options had a
fair value per share of $0.0335 resulting in compensation expense
of $110,550. Compensation cost was recognized upon
grant.
On
October 1, 2015, the Company granted to the active employees,
members of the board of directors and members of the medical
advisory board options to purchase 1,900,000 shares of common stock
at an exercise price of $0.11 per share and 1,450,000 shares of
common stock at an exercise price of $0.50 per share. Using the
Black-Scholes option pricing model, management has determined that
the options had a fair value per share of $0.10567 resulting in
compensation expense of $354,000. Compensation cost was recognized
at grant date.
HealthTronics Note
On
August 3, 2017, the Company and HealthTronics, Inc. entered into a
third amendment (the “Third Amendment”) to amend
certain provisions of the notes payable, related parties. The Third
Amendment provides for the extension of the due date to December
31, 2018, revision of the mandatory prepayment provisions and the
future issuance of additional warrants to HealthTronics upon
certain conditions. In addition, the Company, in connection with
the Third Amendment, issued to HealthTronics, Inc. on August 3,
2017, an additional 2,000,000 Class K Warrants to purchase shares
of the Company’s Common Stock at an exercise price of $0.11
per share, subject to certain anti-dilution protection. Each Class
K Warrant represents the right to purchase one share of Common
Stock. The warrants vested upon issuance and expire after ten
years.
On June
28, 2016, the Company and HealthTronics, Inc. entered into a second
amendment (the “Second Amendment”) to amend certain
provisions of the notes payable, related parties. The Second
Amendment provides for the extension of the due date to January 31,
2018. In addition, the Company, in connection with the Second
Amendment, issued to HealthTronics, Inc. on June 28, 2016, an
additional 1,890,000 Class K Warrants to purchase shares of the
Company’s Common Stock at an exercise price of $0.08 per
share, subject to certain anti-dilution protection. The exercise
price of the 3,310,000 Class K Warrants issued on June 15, 2015 was
decreased to $0.08 per share.
On June
15, 2015, the Company, and its wholly owned subsidiary SANUWAVE,
Inc., a Delaware corporation (the “Borrower”) entered into an
amendment (the “Amendment”) to amend certain
provisions of two promissory notes (the “Promissory Notes”) dated August
1, 2005 between the Borrower and HealthTronics, Inc., with an
aggregate outstanding principal balance of $5,372,742. In
connection with the Amendment, the Company issued to HealthTronics,
on June 15, 2015, an aggregate total of 3,310,000 warrants (the
“Class K
Warrants”) to purchase shares of the Company’s
Common Stock, at an exercise price of $0.55 per share, subject to
certain anti-dilution protection. Each Class K Warrant represents
the right to purchase one share of Common Stock. The warrants
vested upon issuance and expire after ten (10) years.
ITEM 16. Exhibits and Financial Statement Schedules
Exhibit No.
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Description
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Agreement and Plan of Merger, dated as of September 25, 2009, by
and between Rub Music Enterprises, Inc., RME Delaware Merger Sub,
Inc. and SANUWAVE, Inc. (Incorporated by reference to Form 8-K
filed with the SEC on September 30, 2009).
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Articles of Incorporation (Incorporated by reference to the Form
10-SB filed with the SEC on December 18, 2007).
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Certificate of Amendment to the Articles of Incorporation
(Incorporated by reference to Appendix A to the Definitive Schedule
14C filed with the SEC on October 16, 2009).
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Certificate of Amendment to the Articles of Incorporation
(Incorporated by reference to Appendix A to the Definitive Schedule
14C filed with the SEC on April 16, 2012).
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Bylaws (Incorporated by reference to the Form 10-SB filed with the
SEC on December 18, 2007).
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Certificate of Designation of Preferences, Rights and Limitations
of Series A Convertible Preferred Stock of the Company dated March
14, 2014 (Incorporated by reference to the Form 8-K filed with the
SEC on March 18, 2014).
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Certificate of Amendment to the Articles of Incorporation, dated
September 8, 2015 (Incorporated by reference to the Form 10-K filed
with the SEC on March 30, 2016).
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Certificate of Designation of
Preferences, Rights and Limitations of Series B
Convertible Preferred Stock of the Company
dated January 12, 2016 (Incorporated by reference to the Form 8-K
filed with the SEC on January 19, 2016).
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Form of Class A Warrant Agreement (Incorporated by reference to
Form 8-K filed with the SEC on September 30, 2009).
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Form of Class B Warrant Agreement (Incorporated by reference to
Form 8-K filed with the SEC on September 30, 2009).
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Form of Class D Warrant Agreement (Incorporated by reference to
Form 8-K filed with the SEC on October 14, 2010).
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Form of Class E Warrant Agreement (Incorporated by reference to
Form 8-K filed with the SEC on April 7, 2011).
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Form of Series A Warrant (Incorporated by reference to the Form 8-K
filed with the SEC on March 18, 2014).
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Form of Series B Warrant (Incorporated by reference to the Form 8-K
filed with the SEC on March 18, 2014).
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Form of 18% Senior Secured Convertible Promissory Note issued by
the Company to select accredited investors (Incorporated by
reference to Form 8-K filed with the SEC on February 27,
2013).
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Form of Convertible Promissory Note between the Company and
accredited investors party thereto (Incorporated by reference to
the Form 8-K filed with the SEC on March 18, 2014).
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Amendment No. 1 to the Convertible Note Agreement between the
Company and accredited investors party thereto (Incorporated by
reference to the Form 8-K filed with the SEC on March 18,
2014).
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Class K Warrant Agreement by and between the Company and
HealthTronics, Inc., dated June 15, 2015 (Incorporated by reference
to the Form 8-K filed with the SEC on June 18, 2015).
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Amendment No. 1 to Class K Warrant Agreement by and between the
Company and HealthTronics, Inc., dated June 28, 2016 (Incorporated
by reference to the Form 10-Q filed with the SEC on August 15,
2016).
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Form of Class L Warrant Common Stock Purchase Warrant (Incorporated
by reference to the Form 8-K filed with the SEC on March 17,
2016).
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Second Form of Class L Warrant Common Stock Purchase Warrant
(Incorporated by reference to the Form 8-K filed with the SEC on
August 24, 2016).
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Registration Rights Agreement dated January 13, 2016 among the
Company and the investors listed therein (Incorporated by reference
to the Form 8-K filed with the SEC on January 19,
2016).
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Class K Warrant Agreement dated as of August 3, 2017, between the
Company and HealthTronics, Inc. (Incorporated by reference to Form
8-K filed with the SEC on August 4, 2017).
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Form of Class N Warrant. (Incorporated by reference to Form 8-K
filed with the SEC on November 9, 2017).
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Opinion of Smith, Gambrell & Russell, LLP.
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Amended and Restated 2006 Stock Option Incentive Plan of SANUWAVE
Health, Inc. (Incorporated by reference to Form 8-K filed with the
SEC on November 3, 2010).
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Form of Securities Purchase Agreement, by and among the Company and
the accredited investors party thereto, dated March 17, 2014
(Incorporated by reference to the Form 8-K filed with the SEC on
March 18, 2014).
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Form of Registration Rights Agreement, by and among the Company and
the holders party thereto, dated March 17, 2014 (Incorporated by
reference to the Form 8-K filed with the SEC on March 18,
2014).
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Form of Subscription Agreement for the 18% Convertible Promissory
Notes between the
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Amendment to certain Promissory Notes that were dated August 1,
2005, by and among the Company, SANUWAVE, Inc. and HealthTronics,
Inc., dated June 15, 2015 (Incorporated by reference to the Form
8-K filed with the SEC on June 18, 2015.)
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Security Agreement, by and between the Company and HealthTronics,
Inc., dated June 15, 2015 (Incorporated by reference to the Form
8-K filed with the SEC on June 18, 2015).
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Exchange Agreement dated January 13, 2016 among the Company and the
investors listed therein (Incorporated by reference to the Form 8-K
filed with the SEC on January 19, 2016).
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Escrow Deposit Agreement dated January 25, 2016 among the Company,
Newport Coast Securities, Inc. and Signature Bank (Incorporated by
reference to the Form S-1/A filed with the SEC on February 3,
2016).
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Second Amendment to Certain Promissory Notes entered into as of
June 28, 2016 by and among the Company, SANUWAVE, Inc. and
HealthTronics, Inc. (Incorporated by reference to the Form 10-Q
filed with the SEC on August 15, 2016).
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Form of Securities Purchase Agreement, by and among the Company and
the accredited investors a party thereto, dated March 11, 2016
(Incorporated by reference to the Form 8-K filed with the SEC on
March 17, 2016).
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Form of Securities Purchase Agreement, by and between the Company
and the accredited investors a party thereto, dated August 24, 2016
(Incorporated by reference to the Form 8-K filed with the SEC on J
August 25, 2016).
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Form of Registration Rights Agreement, by and between the Company
and the holders a party thereto, dated August 24, 2016
(Incorporated by reference to the Form 8-K filed with the SEC on
August 25, 2016).
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Third Amendment to promissory notes entered into as of August 3,
2017 by and among the Company, SANUWAVE, Inc. and HealthTronics,
Inc. (Incorporated by reference to Form 8-K filed with the SEC on
August 4, 2017).
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Binding Term Sheet for Joint Venture Agreement between the Company
and MundiMed Distribuidora Hospitalar LTDA effective as of
September 25, 2017 (Incorporated by reference to Form 10-Q filed
with the SEC on November 15, 2017).
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Agreement for Purchase and Sale, Limited Exclusive Distribution and
Royalties, and Servicing and Repairs of dermaPACE Systems and
Equipment among the Company, and Premier Shockwave Wound Care, Inc.
and Premier Shockwave, Inc. dated as of February 13, 2018
(Incorporated by reference to Form 10-K filed with the SEC on March
29, 2018).
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List of subsidiaries (incorporated by reference to the
Company’s Annual Report on Form 10-K for the fiscal year
ended December 31, 2017)
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Consent of Cherry Bekaert LLP, independent registered public
accountants.
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Consent of Smith, Gambrell & Russell, LLP (included in its
opinion filed as Exhibit 5.1).
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24.1*
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Power of Attorney (set forth on the signature page of this
registration statement).
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______________________________________________________________
∞
Indicates
management contract or compensatory plan or
arrangement.
#
Confidential
treatment has been requested as to certain portions of this
exhibit, which portions have been omitted and submitted
separately to the Securities and Exchange Commission.
ITEM 17. Undertakings
(a) The
undersigned Registrant hereby undertakes:
(1) To file,
during any period in which offers or sales are being made, a
post-effective amendment to this registration
statement:
(i) To include
any prospectus required by Section 10(a)(3) of the Securities Act
of 1933;
(ii) To
reflect in the prospectus any facts or events arising after the
effective date of the registration statement (or the most recent
post-effective amendment thereof) which, individually or in the
aggregate, represent a fundamental change in the information set
forth in the registration statement. Notwithstanding the foregoing,
any increase or decrease in volume of securities offered (if the
total dollar value of securities offered would not exceed that
which was registered) and any deviation from the low or high end of
the estimated maximum offering range may be reflected in the form
of prospectus filed with the Commission pursuant to Rule 424(b) if,
in the aggregate, the changes in volume and price represent no more
than 20 percent change in the maximum aggregate offering price set
forth in the “Calculation of Registration Fee” table in
the effective registration statement;
(iii) To
include any material information with respect to the plan of
distribution not previously disclosed in the registration statement
or any material change to such information in the Registration
Statement;
(2) That, for
the purpose of determining any liability under the Securities Act
of 1933, each such post-effective amendment shall be deemed to be a
new registration statement relating to the securities offered
therein, and the offering of such securities at that time shall be
deemed to be the initial bona fide offering thereof.
(3) To remove
from registration by means of a post-effective amendment any of the
securities being registered which remain unsold at the termination
of the offering.
(4) That, for
the purpose of determining liability under the Securities Act of
1933 to any purchaser:
(i) Each
prospectus filed by the registrant pursuant to Rule 424(b)(3) shall
be deemed to be part of the registration statement as of the date
the filed prospectus was deemed part of and included in the
registration statement; and
(ii)
Each prospectus required to be filed pursuant to Rule 424(b)(2),
(b)(5), or (b)(7) as part of a registration statement in reliance
on Rule 430B relating to an offering made pursuant to Rule
415(a)(1)(i), (vii), or (x) for the purpose of providing the
information required by section 10(a) of the Securities Act of 1933
shall be deemed to be part of and included in the registration
statement as of the earlier of the date such form of prospectus is
first used after effectiveness or the date of the first contract of
sale of securities in the offering described in the prospectus. As
provided in Rule 430B, for liability purposes of the issuer and any
person that is at that date an underwriter, such date shall be
deemed to be a new effective date of the registration statement
relating to the securities in the registration statement to which
that prospectus relates, and the offering of such securities at
that time shall be deemed to be the initial bona fide offering
thereof. Provided, however, that no statement made in a
registration statement or prospectus that is part of the
registration statement or made in a document incorporated or deemed
incorporated by reference into the registration statement or
prospectus that is part of the registration statement will, as to a
purchaser with a time of contract of sale prior to such effective
date, supersede or modify any statement that was made in the
registration statement or prospectus that was part of the
registration statement or made in any such document immediately
prior to such effective date.
(5) That, for
the purpose of determining liability of the registrant under the
Securities Act of 1933 to any purchaser in the initial distribution
of the securities:
The
undersigned registrant undertakes that in a primary offering of
securities of the undersigned registrant pursuant to this
registration statement, regardless of the underwriting method used
to sell the securities to the purchaser, if the securities are
offered or sold to such purchaser by means of any of the following
communications, the undersigned registrant will be a seller to the
purchaser and will be considered to offer or sell such securities
to such purchaser:
(i) Any
preliminary prospectus or prospectus of the undersigned registrant
relating to the offering required to be filed pursuant to Rule
424;
(ii) Any free
writing prospectus relating to the offering prepared by or on
behalf of the undersigned registrant or used or referred to by the
undersigned registrant;
(iii) The
portion of any other free writing prospectus relating to the
offering containing material information about the undersigned
registrant or its securities provided by or on behalf of the
undersigned registrant; and
(iv) Any other
communication that is an offer in the offering made by the
undersigned registrant to the purchaser.
(b)
The undersigned registrant hereby undertakes that, for
purposes of determining any liability under the Securities Act of
1933, each filing of the registrant’s annual report pursuant
to section 13(a) or section 15(d) of the Securities Exchange Act of
1934 that is incorporated by reference in the registration
statement shall be deemed to be a new registration statement
relating to the securities offered therein, and the offering of
such securities at that time shall be deemed to be the initial bona
fide offering thereof.
(c) Insofar as
indemnification for liabilities arising under the Securities Act of
1933 may be permitted to directors, officers and controlling
persons of the registrant pursuant to the foregoing provisions, or
otherwise, the registrant has been advised that in the opinion of
the Securities and Exchange Commission such indemnification is
against public policy as expressed in the Act and is, therefore,
unenforceable. In the event that a claim for indemnification
against such liabilities (other than the payment by the registrant
of expenses incurred or paid by a director, officer or controlling
person of the registrant in the successful defense of any action,
suit or proceeding) is asserted by such director, officer or
controlling person in connection with the securities being
registered, the registrant will, unless in the opinion of its
counsel the matter has been settled by controlling precedent,
submit to a court of appropriate jurisdiction the question whether
such indemnification by it is against public policy as expressed in
the Act and will be governed by the final adjudication of such
issue.
(d) The
undersigned registrant hereby undertakes that:
(1) For
purposes of determining any liability under the Securities Act of
1933, the information omitted from the form of prospectus filed as
part of this registration statement in reliance upon Rule 430A and
contained in a form of prospectus filed by the registrant pursuant
to Rule 424(b)(1) or (4) or 497(h) under the Securities Act shall
be deemed to be part of this registration statement as of the time
it was declared effective.
(2) For the
purposes of determining liability under the Securities Act of 1933,
each post-effective amendment that contains a form of prospectus
shall be deemed to be a new registration statement relating to the
securities offered therein, and the offering of such securities at
that time shall be deemed to be the initial bona fide offering
thereof.
SIGNATURES
Pursuant to the
requirements of the Securities Act of 1933, the registrant has duly
caused this registration statement to be signed on its behalf by
the undersigned, thereunto duly authorized in the City of Suwanee,
State of Georgia, on April 19, 2018.
|
SANUWAVE Health, Inc.
|
|
|
|
|
|
|
|
|
|
|
By:
|
/s/ Kevin
A. Richardson, II
|
|
|
Name:
|
Kevin
A. Richardson, II
|
|
|
Title:
|
Acting
Chief Executive Officer
|
|
POWER OF ATTORNEY
KNOW
ALL MEN BY THESE PRESENTS, that each person whose signature appears
below constitutes and appoints Kevin A. Richardson, II, as his or
her true and lawful attorney-in-fact, with full power of
substitution and resubstitution, for him or her and in his or her
name, place and stead, in any and all capacities to sign any and
all amendments (including post-effective amendments) to this
registration statement and to sign a registration statement
pursuant to Section 462(b) of the Securities Act of 1933, and to
file the same with all exhibits thereto, and other documents in
connection therewith, with the Securities and Exchange Commission,
granting unto said attorney-in-fact, full power and authority to do
and perform each and every act and thing requisite and necessary to
be done in and about the premises, as fully to all intents and
purposes as he might or could do in person, hereby ratifying and
confirming all that said attorney-in-fact or his substitute or
substitutes, may lawfully do or cause to be done by virtue
hereof.
Pursuant to the
requirements of the Securities Act of 1933, as amended, this
registration statement has been signed by the following persons in
the capacities and on the dates indicated:
Signatures
|
|
Capacity
|
|
Date
|
|
|
|
|
|
By: /s/
Kevin A. Richardson, II
|
|
Director
and Acting Chief Executive Officer
|
|
April
19, 2018
|
Name: Kevin A.
Richardson, II
|
|
(principal
executive officer)
|
|
|
|
|
|
|
|
By: /s/
Lisa Sundstrom
|
|
Chief
Financial Officer
|
|
April
19, 2018
|
Name: Lisa
Sundstrom
|
|
(principal
financial and accounting officer)
|
|
|
|
|
|
|
|
By: /s/
John F. Nemelka
|
|
Director
|
|
April
19, 2018
|
Name: John F.
Nemelka
|
|
|
|
|
|
|
|
|
|
By:
/s/ Alan L.
Rubino
|
|
Director
|
|
April
19, 2018
|
Name: Alan L.
Rubino
|
|
|
|
|
|
|
|
|
|
By:
/s/ A. Michael
Stolarski
|
|
Director
|
|
April
19, 2018
|
Name:
A. Michael Stolarski
|
|
|
|
|
By:
/s/ Maj-Britt
Kaltoft
|
|
Director
|
|
April
19, 2018
|
Name:
Maj-Britt Kaltoft
|
|
|
|
|
REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING
FIRM
To
the Board of Directors and
Stockholders of
SANUWAVE Health, Inc. and Subsidiaries
Opinion
on the Financial Statements
We have audited the
accompanying consolidated balance sheets of SANUWAVE Health, Inc.
and Subsidiaries (the “Company”) as of December 31,
2017 and 2016 and the related consolidated statements of
comprehensive loss, stockholders’ deficit, and cash flows for
the years then ended, and the related notes (collectively referred
to as the financial statements). In our opinion, the consolidated
financial statements present fairly, in all material respects, the
financial position of the Company as of December 31, 2017 and 2016,
and the results of its operations and its cash flows for each of
the years then ended, in conformity with accounting principles
generally accepted in the United States of America.
Substantial Doubt about the Company's Ability
to Continue as a Going Concern
The accompanying
consolidated financial statements have been prepared assuming that
the Company will continue as a going concern. As discussed in
Note (1) to the consolidated finacial statements, the Company has
suffered recurring losses from operations and is dependent upon
future issuances of equity or other financing to fund ongoing
operations, both of which raise substantial doubt about its ability
to continue as a going concern. Management's plans in regard
to these matters are described in Note (1). The conolidated
financial statements do not include any adjustments that might
result for the outcome of this uncertainty.
Basis
for Opinion
These consolidated
financial statements are the responsibility of the Company’s
management. Our responsibility is to express an opinion on these
consolidated financial statements based on our audits. We are a
public accounting firm registered with the Public Company
Accounting Oversight Board (United States) (PCAOB) and are required
to be independent with respect to the Company in accordance with
the U.S. federal securities laws and the applicable rules and
regulations of the Securities and Exchange Commission and the
PCAOB.
We conducted our
audits in accordance with the standards of the PCAOB. Those
standards require that we plan and perform the audit to obtain
reasonable assurance about whether the consolidated financial
statements are free of material misstatement, whether due to error
or fraud. The Company is not required to have, nor were we engaged
to perform, an audit of its internal control over financial
reporting. As part of our audits, we are required to obtain an
understanding of internal control over financial reporting, but not
for the purpose of expressing an opinion on the effectiveness of
the Company’s internal control over financial reporting.
Accordingly, we express no such opinion.
Our audits included
performing procedures to assess the risks of material misstatement
of the consolidated financial statements, whether due to error or
fraud, and performing procedures that respond to those risks. Such
procedures include examining, on a test basis, evidence regarding
the amounts and disclosures in the consolidated financial
statements. Our audits also included evaluating the accounting
principles used and significant estimates made by management, as
well as evaluating the overall presentation of the consolidated
financial statements. We believe that our audits provide a
reasonable basis for our opinion.
CHERRY
BEKAERT LLP
We
have served as the Company’s auditor since 2016.
Atlanta,
Georgia
March
29, 2018
SANUWAVE HEALTH, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
December 31, 2017 and 2016
|
|
|
ASSETS
|
|
|
CURRENT
ASSETS
|
|
|
Cash
and cash equivalents
|
$730,184
|
$133,571
|
Accounts
receivable, net of allowance for doubtful accounts
|
|
|
of
$92,797 in 2017 and $35,196 in 2016
|
152,520
|
460,799
|
Inventory,
net (Note 3)
|
231,532
|
231,953
|
Prepaid
expenses
|
90,288
|
87,823
|
TOTAL
CURRENT ASSETS
|
1,204,524
|
914,146
|
|
|
|
PROPERTY
AND EQUIPMENT, net (Note 4)
|
60,369
|
76,938
|
|
|
|
OTHER
ASSETS
|
13,917
|
13,786
|
TOTAL
ASSETS
|
$1,278,810
|
$1,004,870
|
|
|
|
LIABILITIES
|
|
|
CURRENT
LIABILITIES
|
|
|
Accounts
payable
|
$1,496,523
|
$712,964
|
Accrued
expenses (Note 6)
|
673,600
|
375,088
|
Accrued
employee compensation
|
1,680
|
64,860
|
Advances
from related and unrelated parties (Note 7)
|
310,000
|
-
|
Line
of credit, related parties (Note 8)
|
370,179
|
-
|
Convertible
promissory notes, net (Note 9)
|
455,606
|
-
|
Interest
payable, related parties (Note 10)
|
685,907
|
109,426
|
Short
term loan, net (Note 11)
|
-
|
47,440
|
Warrant
liability (Note 15)
|
1,943,883
|
1,242,120
|
Notes
payable, related parties, net (Note 10)
|
5,222,259
|
5,364,572
|
TOTAL
CURRENT LIABILITIES
|
11,159,637
|
7,916,470
|
|
|
|
TOTAL
LIABILITIES
|
11,159,637
|
7,916,470
|
|
|
|
COMMITMENTS
AND CONTINGENCIES (Note 16)
|
|
|
|
|
|
STOCKHOLDERS'
DEFICIT
|
|
|
PREFERRED
STOCK, SERIES A CONVERTIBLE, par value $0.001,
|
|
|
6,175
authorized; 6,175 shares issued and 0 shares
outstanding
|
|
|
in
2017 and 2016 (Note 14)
|
-
|
-
|
|
|
|
PREFERRED
STOCK, SERIES B CONVERTIBLE, par value $0.001,
|
|
|
293
authorized; 293 shares issued and 0 shares
outstanding
|
|
|
in
2017 and 2016, respectively (Note 14)
|
-
|
-
|
|
|
|
PREFERRED
STOCK - UNDESIGNATED, par value $0.001, 4,993,532
|
|
|
shares
authorized; no shares issued and outstanding (Note 14)
|
-
|
-
|
|
|
|
COMMON
STOCK, par value $0.001, 350,000,000 shares
authorized;
|
|
|
139,300,122
and 137,219,968 issued and outstanding in 2017 and
|
|
|
2016,
respectively (Note 13)
|
139,300
|
137,220
|
|
|
|
ADDITIONAL
PAID-IN CAPITAL
|
94,995,040
|
92,436,697
|
|
|
|
ACCUMULATED
DEFICIT
|
(104,971,384)
|
(99,433,448)
|
|
|
|
ACCUMULATED
OTHER COMPREHENSIVE LOSS
|
(43,783)
|
(52,069)
|
TOTAL
STOCKHOLDERS' DEFICIT
|
(9,880,827)
|
(6,911,600)
|
TOTAL
LIABILITIES AND STOCKHOLDERS' DEFICIT
|
$1,278,810
|
$1,004,870
|
The
accompanying notes to consolidated financial
|
statements
are an integral part of these statements.
|
SANUWAVE HEALTH, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS
Years Ended December 31, 2017 and 2016
|
|
|
|
|
|
REVENUES
|
$738,527
|
$1,376,063
|
|
|
|
COST OF
REVENUES (exclusive of depreciation and amortization shown
below)
|
241,970
|
565,129
|
|
|
|
OPERATING
EXPENSES
|
|
|
Research and
development
|
1,292,531
|
1,128,640
|
General and
administrative
|
3,004,403
|
2,673,773
|
Depreciation
|
24,069
|
19,858
|
Amortization
|
-
|
306,756
|
Gain of sale of
assets, property and equipment
|
-
|
(1,594)
|
TOTAL OPERATING
EXPENSES
|
4,321,003
|
4,127,433
|
|
|
|
OPERATING
LOSS
|
(3,824,446)
|
(3,316,499)
|
|
|
|
OTHER INCOME
(EXPENSE)
|
|
|
Loss on warrant
valuation adjustment and conversion
|
(568,729)
|
(2,223,718)
|
Interest expense,
net
|
(1,139,711)
|
(854,980)
|
Loss on foreign
currency exchange
|
(5,050)
|
(12,329)
|
TOTAL OTHER INCOME
(EXPENSE), NET
|
(1,713,490)
|
(3,122,541)
|
|
|
|
NET
LOSS
|
(5,537,936)
|
(6,439,040)
|
|
|
|
OTHER COMPREHENSIVE
INCOME (LOSS)
|
|
|
Foreign currency
translation adjustments
|
8,286
|
(18,907)
|
TOTAL COMPREHENSIVE
LOSS
|
$(5,529,650)
|
$(6,457,947)
|
|
|
|
LOSS PER
SHARE:
|
|
|
Net loss - basic and
diluted
|
$(0.04)
|
$(0.06)
|
|
|
|
Weighted average
shares outstanding - basic and diluted
|
138,838,602
|
107,619,869
|
The
accompanying notes to consolidated financial
|
statements
are an integral part of these statements.
|
SANUWAVE HEALTH, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF STOCKHOLDERS' DEFICIT
Years Ended December 31, 2017 and 2016
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Balances as of
December 31, 2015
|
-
|
$-
|
63,056,519
|
$63,057
|
$87,086,677
|
$(92,994,408)
|
$(33,162)
|
$(5,877,836)
|
Net
loss
|
-
|
-
|
-
|
-
|
-
|
(6,439,040)
|
-
|
(6,439,040)
|
Series A Warrant
conversion to stock
|
293
|
-
|
7,447,954
|
7,447
|
880,971
|
-
|
-
|
888,418
|
Equity
Offering
|
-
|
-
|
30,016,670
|
30,017
|
1,566,838
|
-
|
-
|
1,596,855
|
Preferred stock
conversion
|
(293)
|
-
|
3,657,278
|
3,657
|
(3,657)
|
-
|
-
|
-
|
Peak One -
Convertible Debenture
|
-
|
-
|
835,000
|
835
|
49,265
|
-
|
-
|
50,100
|
PIPE
Offering
|
-
|
-
|
28,300,001
|
28,300
|
1,499,900
|
-
|
-
|
1,528,200
|
Warrant
exercise
|
-
|
-
|
843,333
|
843
|
66,623
|
-
|
-
|
67,466
|
Cashless warrant
conversion
|
-
|
-
|
2,627,821
|
2,628
|
263,093
|
-
|
-
|
265,721
|
Shares issued for
services
|
-
|
-
|
435,392
|
436
|
43,104
|
-
|
-
|
43,540
|
Stock-based
compensation - options
|
-
|
-
|
-
|
-
|
547,842
|
-
|
-
|
547,842
|
Beneficial
conversion feature on debt
|
-
|
-
|
-
|
-
|
191,231
|
-
|
-
|
191,231
|
Warrants issued
for services
|
-
|
-
|
-
|
-
|
186,410
|
-
|
-
|
186,410
|
Warrants issued
with short term loan
|
-
|
-
|
-
|
-
|
58,400
|
-
|
-
|
58,400
|
Foreign currency
translation adjustment
|
-
|
-
|
-
|
-
|
-
|
-
|
(18,907)
|
(18,907)
|
|
|
|
|
|
|
|
|
|
Balances as of
December 31, 2016
|
-
|
-
|
137,219,968
|
137,220
|
92,436,697
|
(99,433,448)
|
(52,069)
|
(6,911,600)
|
Net
loss
|
-
|
-
|
-
|
-
|
-
|
(5,537,936)
|
-
|
(5,537,936)
|
Warrant
exercise
|
-
|
-
|
1,163,333
|
1,163
|
91,903
|
-
|
-
|
93,066
|
Cashless warrant
exercise
|
-
|
-
|
866,625
|
867
|
66,100
|
-
|
-
|
66,967
|
Shares issued for
services
|
-
|
-
|
50,196
|
50
|
7,950
|
-
|
-
|
8,000
|
Warrants issued
for services
|
-
|
-
|
-
|
-
|
182,856
|
-
|
-
|
182,856
|
Stock-based
compensation - options and warrants
|
-
|
-
|
-
|
-
|
768,105
|
-
|
-
|
768,105
|
Warrants issued
with convertible promissory note
|
-
|
-
|
-
|
-
|
620,748
|
-
|
-
|
620,748
|
Beneficial
conversion feature on debt
|
-
|
-
|
-
|
-
|
820,681
|
-
|
-
|
820,681
|
Foreign currency
translation adjustment
|
-
|
-
|
-
|
-
|
-
|
-
|
8,286
|
8,286
|
|
|
|
|
|
|
|
|
|
Balances as of
December 31, 2017
|
-
|
$-
|
139,300,122
|
$139,300
|
$94,995,040
|
$(104,971,384)
|
$(43,783)
|
$(9,880,827)
|
The
accompanying notes to consolidated
financialstatements
are an integral part of these statements.
SANUWAVE HEALTH, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
Years Ended December 31, 2017 and 2016
|
|
|
|
|
|
CASH
FLOWS FROM OPERATING ACTIVITIES
|
|
|
Net
loss
|
$(5,537,936)
|
$(6,439,040)
|
Adjustments to reconcile loss from continuing
operations
|
|
|
to net cash used by operating activities
|
|
|
Amortization
|
-
|
306,756
|
Depreciation
|
24,069
|
19,858
|
Change
in allowance for doubtful accounts
|
57,601
|
26,233
|
Stock-based
compensation - employees, directors and advisors
|
768,105
|
547,842
|
Loss
on warrant valuation adjustment
|
568,729
|
2,223,718
|
Amortization
of debt issuance costs
|
431,087
|
225,786
|
Warrants
issued for services
|
182,856
|
186,410
|
Amortization
of debt discount
|
110,247
|
31,514
|
Stock
issued for consulting services
|
8,000
|
43,540
|
Loss
on conversion option of promissory notes payable
|
-
|
75,422
|
Stock
issued with convertible debenture
|
-
|
50,100
|
Gain
on sale of asset, property and equipment
|
-
|
(1,594)
|
Changes
in assets - (increase)/decrease
|
|
|
Accounts receivable - trade
|
250,678
|
(412,578)
|
Inventory
|
(7,079)
|
(29,249)
|
Prepaid expenses
|
(2,465)
|
36,165
|
Other
|
(131)
|
(2,689)
|
Changes
in liabilities - increase/(decrease)
|
|
|
Accounts payable
|
783,559
|
203,698
|
Accrued expenses
|
298,512
|
15,714
|
Accrued employee compensation
|
(63,180)
|
(176,682)
|
Accrued interest
|
21,896
|
-
|
Interest payable, related parties
|
576,481
|
(130,377)
|
NET
CASH USED BY OPERATING ACTIVITIES
|
(1,528,971)
|
(3,199,453)
|
|
|
|
CASH
FLOWS FROM INVESTING ACTIVITIES
|
|
|
Proceeds
from sale of property and equipment
|
-
|
1,594
|
Purchases
of property and equipment
|
-
|
(10,364)
|
NET
CASH USED BY INVESTING ACTIVITIES
|
-
|
(8,770)
|
|
|
|
CASH
FLOWS FROM FINANCING ACTIVITIES
|
|
|
Proceeds
from convertible promissory notes, net
|
1,384,232
|
106,000
|
Proceeds
from line of credit, related party
|
370,000
|
-
|
Advances
from related parties
|
310,000
|
-
|
Proceeds
from warrant exercise
|
93,066
|
67,466
|
Proceeds
from 2016 Public Offering, net
|
-
|
1,596,855
|
Proceeds
from 2016 Private Offering, net
|
-
|
1,528,200
|
Proceeds
from convertible debenture, net
|
-
|
175,000
|
Proceeds
from short term loan
|
-
|
100,000
|
Payment
of short term loan
|
(40,000)
|
-
|
Payment
of convertible promissory notes
|
-
|
(155,750)
|
Payment
of convertible debenture
|
-
|
(210,000)
|
NET
CASH PROVIDED BY FINANCING ACTIVITIES
|
2,117,298
|
3,207,771
|
|
|
|
EFFECT
OF EXCHANGE RATES ON CASH
|
8,286
|
(18,907)
|
|
|
|
NET
INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS
|
596,613
|
(19,359)
|
|
|
|
CASH
AND CASH EQUIVALENTS, BEGINNING OF PERIOD
|
133,571
|
152,930
|
CASH
AND CASH EQUIVALENTS, END OF PERIOD
|
$730,184
|
$133,571
|
|
|
|
SUPPLEMENTAL
INFORMATION
|
|
|
Cash
paid for interest, related parties
|
$-
|
$630,549
|
|
|
|
NONCASH
INVESTING AND FINANCING ACTIVITIES
|
|
|
Stock
issued with convertible debenture
|
$-
|
$50,100
|
|
|
|
Stock
issued for services
|
$8,000
|
$43,540
|
|
|
|
Loss
on warrant conversion to stock
|
$-
|
$888,418
|
|
|
|
Beneficial
conversion feature on convertible promissory notes
|
820,681
|
66,331
|
Beneficial
conversion feature on convertible debenture
|
-
|
124,900
|
Beneficial
conversion feature on convertible debt
|
$820,681
|
$191,231
|
|
|
|
Warrants
issued for services
|
$182,856
|
$186,410
|
|
|
|
Warrants
issued with convertible promissory note
|
$620,748
|
$-
|
Warrants
issued for short tem loan
|
-
|
58,400
|
Warrants
issued for debt
|
$620,748
|
$58,400
|
The
accompanying notes to consolidated financial
|
statements
are an integral part of these statements.
|
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
As shown in the
accompanying consolidated financial statements, SANUWAVE Health,
Inc. and Subsidiaries (the “Company”) incurred a net
loss of $5,537,936 and $6,439,040 during the years ended December
31, 2017 and 2016, respectively, and the net cash used by operating activities was
$1,528,971 and $3,199,453, respectively. As of December 31,
2017, the Company had a net working capital deficit of $9,955,113,
total stockholders’ deficit of $9,880,827 and cash and cash equivalents of $730,184.
These factors create an uncertainty about the Company’s
ability to continue as a going concern.
The Company does
not currently generate significant recurring revenue and will
require additional capital during the second quarter of 2018.
Although no assurances can be given, management of the Company
believes that existing capital resources should enable the Company
to fund operations into the second quarter of 2018.
The continuation of the Company’s business
is dependent upon raising additional capital during the second
quarter of 2018 and potentially into 2019 to fund operations.
Management’s plans are to obtain additional capital in 2018
through investments by strategic partners for market opportunities,
which may include strategic partnerships or licensing arrangements,
or raise capital through the conversion of outstanding warrants,
the issuance of common or preferred stock, securities convertible
into common stock, or secured or unsecured debt. These
possibilities, to the extent available, may be on terms that result
in significant dilution to the Company’s existing
shareholders. Although no assurances can be given,
management of the Company believes that potential additional
issuances of equity or other potential financing transactions as
discussed above should provide the necessary funding for the
Company to continue as a going concern. If these efforts are unsuccessful, the Company may
be forced to seek relief through a filing under the U.S. Bankruptcy
Code. The consolidated financial statements do not include
any adjustments that might be necessary if the Company is unable to
continue as a going concern.
2.
Summary
of significant accounting policies
Description of the
business – The Company is a shock wave technology company using a patented
system of noninvasive, high-energy, acoustic shock waves for
regenerative medicine and other applications. The Company’s
initial focus is regenerative medicine – utilizing
noninvasive, acoustic shock waves to produce a biological response
resulting in the body healing itself through the repair and
regeneration of tissue, musculoskeletal and vascular structures.
The Company’s lead regenerative product in the United States
is the dermaPACE®
device, used for treating diabetic
foot ulcers, which was subject to two double-blinded, randomized
Phase III clinical studies. On December 28, 2018, the U.S. Food and
Drug Administration (the "FDA") notified the Companyto permit the
marketing of the dermaPACE System for the treatment of diabetic
foot ulcers in the United States. In 2018, the Company plans
to begin marketing its dermaPACE System for sale in the United
States and will continue to generate revenue from sales of
the European Conformity Marking (CE Mark) devices and accessories
in Europe, Canada, Asia, and Asia/Pacific.
The significant
accounting policies followed by the Company are summarized
below:
Foreign currency
translation - The functional currencies of the
Company’s foreign operations are the local currencies. The
financial statements of the Company’s foreign subsidiary have
been translated into United States dollars in accordance with ASC
830, Foreign Currency
Matters, Foreign Currency Translation. All balance sheet
accounts have been translated using the exchange rates in effect at
the balance sheet date. Income statement amounts have been
translated using the average exchange rate for the year.
Translation adjustments are reported in other comprehensive loss in
the consolidated statements of comprehensive loss and as cumulative
translation adjustments in accumulated other comprehensive income
(loss) in the consolidated statements of stockholders’
deficit.
Principles of
consolidation - The consolidated financial statements
include the accounts of the Company and its wholly-owned
subsidiaries. All significant intercompany accounts and
transactions have been eliminated.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
2.
Summary
of significant accounting policies (continued)
Estimates –
These consolidated financial statements have been prepared in
accordance with generally accepted accounting principles in the
United States of America. Because a precise determination of assets
and liabilities, and correspondingly revenues and expenses, depend
on future events, the preparation of consolidated financial
statements for any period necessarily involves the use of estimates
and assumptions. Actual amounts may differ from these estimates.
These consolidated financial statements have, in management’s
opinion, been properly prepared within reasonable limits of
materiality and within the framework of the accounting policies
summarized herein. Significant estimates include the recording of
allowances for doubtful accounts, estimated reserves for inventory,
valuation of derivatives, accrued expenses, the determination of
the valuation allowances for deferred taxes, estimated fair value
of stock-based compensation, and estimated fair value of warrants
and warrant liabilities.
Cash and cash
equivalents - For purposes of the consolidated financial
statements, liquid instruments with an original maturity of 90 days
or less when purchased are considered cash and cash equivalents.
The Company maintains its cash in bank accounts which may exceed
federally insured limits.
Concentration of credit
risk and limited suppliers - Management routinely assesses
the financial strength of its customers and, as a consequence,
believes accounts receivable are stated at the net realizable value
and credit risk exposure is limited. Three distributors accounted
for 8%, 38% and 24% of revenues for the year ended December 31,
2017, and 69%, 17% and 0% of accounts receivable at December 31,
2017. Two distributors accounted for 50% and 32% of revenues for
the year ended December 31, 2016, and 87% and 10% of accounts
receivable at December 31, 2016.
We
depend on suppliers for product component materials and other
components that are subject to stringent regulatory requirements.
We currently purchase most of our product component materials from
single suppliers and the loss of any of these suppliers could
result in a disruption in our production. If this were to occur, it
may be difficult to arrange a replacement supplier because certain
of these materials may only be available from one or a limited
number of sources. In addition, establishing additional or
replacement suppliers for these materials may take a substantial
period of time, as certain of these suppliers must be approved by
regulatory authorities.
Accounts receivable
- Accounts receivable are stated at the amount management expects
to collect from outstanding balances. Management provides for
probable uncollectible amounts through a charge to earnings based
on its assessment of the current status of individual accounts.
Receivables are generally considered past due if greater than 60
days old. Balances that are still outstanding after management has
used reasonable collection efforts are written off through a charge
to the allowance for doubtful accounts.
Inventory -
Inventory consists of finished medical equipment and parts and is
stated at the lower of cost or market, which is valued using the
first in, first out (“FIFO”) method. Market is based
upon realizable value less allowance for selling and distribution
expenses. The Company analyzes its inventory levels and writes
down inventory that has, or is expected to, become
obsolete.
Depreciation of property
and equipment - The straight-line method of depreciation is
used for computing depreciation on property and equipment.
Depreciation is based on estimated useful lives as follows:
machines and equipment, 3 years; old or used devices, 5 years; new
devices, 15 years; office and computer equipment, 3 years;
furniture and fixtures, 3 years; and software, 2
years.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
2.
Summary
of significant accounting policies (continued)
Intangible assets -
Intangible assets subject to amortization consist of patents which
are recorded at cost. Patents are amortized on a straight-line
basis over 11.4 years. The Company regularly reviews intangible
assets to determine if facts and circumstances indicate that the
useful life is shorter than the Company originally estimated or
that the carrying amount of the assets may not be recoverable.
Factors the Company considers important and could trigger an
impairment review include the following:
●
Significant changes
in the manner in which the Company uses its assets or significant
changes in the Company’s overall business strategy;
and
●
Significant
underperformance of the Company’s assets relative to future
operating results.
If such facts and
circumstances exist, the Company assesses the recoverability of the
intangible assets by comparing the projected undiscounted net cash
flows associated with the related asset or group of assets over
their remaining lives against their respective carrying amounts. If
recognition of an impairment charge is necessary, it is measured as
the amount by which the carrying amount of the intangible asset
exceeds its fair value.
Fair value of financial
instruments - The book values of accounts receivable,
accounts payable, and other financial instruments approximate their
fair values, principally because of the short-term maturities of
these instruments.
The Company has
adopted ASC 820-10, Fair Value
Measurements, which defines fair value, establishes a
framework for measuring fair value and requires disclosures about
fair value measurements. The framework that is set forth in this
standard is applicable to the fair value measurements where it is
permitted or required under other accounting
pronouncements.
The ASC 820-10
hierarchy ranks the quality and reliability of inputs, or
assumptions, used in the determination of fair value and requires
financial assets and liabilities carried at fair value to be
classified and disclosed in one of the following three
categories:
Level 1 -
Observable inputs that reflect quoted prices (unadjusted) in active
markets for identical assets and liabilities;
Level 2 - Inputs
other than quoted prices included within Level 1 that are
observable for the asset or liability, either directly or
indirectly; and
Level 3 -
Unobservable inputs that are not corroborated by market data,
therefore requiring the Company to develop its own
assumptions.
The Company
accounts for derivative instruments under ASC 815, Accounting for Derivative Instruments and
Hedging Activities, as amended and interpreted. ASC 815
requires that the Company recognize all derivatives on the balance
sheet at fair value. The fair value of the warrant liability is
determined based on a lattice solution, binomial approach pricing
model, and includes the use of unobservable inputs such as the
expected term, anticipated volatility and risk-free interest rate,
and therefore is classified within level 3 of the fair value
hierarchy.
The following table
sets forth a summary of changes in the fair value of the derivative
liability for the year ended December 31, 2017:
|
|
|
|
Balance
at December 31, 2016
|
$1,242,120
|
New
issuances
|
200,000
|
Redemptions
|
(66,966)
|
Change
in fair value
|
568,729
|
Balance
at December 31, 2017
|
$1,943,883
|
The Company’s
notes payable, related parties had an aggregate outstanding
principal balance of $5,222,259, net of $150,484 debt discount at
December 31, 2017 and $5,364,572, net of $8,171 debt discount at
December 31, 2016, respectively. Interest accrues on the notes at a
rate of ten percent per annum, effective January 2, 2017 due
to interest payments being in default. The fair value was
determined using estimated future cash flows discounted at current
rates, which is a Level 3 measurement. The estimated fair value of
the Company’s notes payable, related parties was $5,488,720
and $4,923,723 at December 31, 2017 and 2016,
respectively.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
2.
Summary
of significant accounting policies (continued)
Impairment of long-lived
assets – The Company reviews long-lived assets for
impairment whenever facts and circumstances indicate that the
carrying amounts of the assets may not be recoverable. An
impairment loss is recognized only if the carrying amount of the
asset is not recoverable and exceeds its fair value. Recoverability
of assets to be held and used is measured by comparing the carrying
amount of an asset to the estimated undiscounted future cash flows
expected to be generated by the asset. If the asset’s
carrying value is not recoverable, an impairment charge is
recognized for the amount by which the carrying amount of the asset
exceeds its fair value. The Company determines fair value by using
a combination of comparable market values and discounted cash
flows, as appropriate.
Revenue recognition
- Sales of medical devices, including related applicators, are
recognized when shipped to the customer. Shipments under agreements
with distributors are invoiced at a fixed price, are not subject to
return, and payment for these shipments is not contingent on sales
by the distributor. The Company recognizes revenues on shipments to
distributors in the same manner as with other customers. Fees from
services performed are recognized when the service is performed.
Fees for upfront distribution license agreements will be recognized
as identified performance obligations are satisfied.
Shipping and handling
costs - Shipping charges billed to customers are included in
revenues. Shipping and handling costs incurred have been recorded
in cost of revenues.
Income taxes -
Income taxes are accounted for utilizing the asset and liability
method prescribed by the provisions of ASC 740, Income
Taxes, Accounting for Income
Taxes. Deferred tax assets and liabilities are determined
based on differences between the financial reporting and tax basis
of assets and liabilities and are measured using the enacted tax
rates and laws that will be in effect when the differences are
expected to reverse. A valuation allowance is provided for the
deferred tax assets, including loss carryforwards, when it is more
likely than not that some portion or all of a deferred tax asset
will not be realized.
A provision of ASC
740, Income Taxes,
Accounting for Uncertainty in Income Taxes (FIN 48) specifies the
way public companies are to account for uncertainties in income tax
reporting, and prescribes a methodology for recognizing, reversing,
and measuring the tax benefits of a tax position taken, or expected
to be taken, in a tax return. ASC 740 requires the evaluation of
tax positions taken or expected to be taken in the course of
preparing the Company’s tax returns to determine whether the
tax positions would “more-likely-than-not” be sustained
if challenged by the applicable tax authority. Tax positions not
deemed to meet the more-likely-than-not threshold would be recorded
as a tax benefit or expense in the current year.
The Company will
recognize in income tax expense interest and penalties related to
income tax matters. For the years ended December 31, 2017 and 2016,
the Company did not have any amounts recorded for interest and
penalties.
Loss per share -
The Company calculates net income
(loss) per share in accordance with ASC 260, Earnings Per
Share. Under the
provisions of ASC 260, basic net income (loss) per share is
computed by dividing the net income (loss) attributable to common
stockholders for the period by the weighted average number of
shares of common stock outstanding for the
period. Diluted net income (loss) per share is computed
by dividing the net income (loss) attributable to common
stockholders by the weighted average number of shares of common
stock and dilutive common stock equivalents then
outstanding. To the extent that securities are
“anti-dilutive,” they are excluded from the calculation
of diluted net income (loss) per share. As a result of the net loss
for the years ended December 31, 2017 and 2016, respectively, all
potentially dilutive shares were anti-dilutive and therefore
excluded from the computation of diluted net loss per share.
Anti-dilutive equity securities consists of the following at
December 31, 2017 and 2016, respectively:
|
|
|
Stock
Options
|
21,593,385
|
16,203,385
|
Warrants
|
97,977,851
|
78,086,749
|
Warrants
|
14,641,190
|
-
|
Anti-dilutive
equity securities
|
134,212,426
|
94,290,134
|
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
2.
Summary
of significant accounting policies (continued)
Comprehensive income
– ASC 220, Comprehensive
Income, Reporting Comprehensive Income establishes standards
for reporting comprehensive income (loss) and its components in a
financial statement. Comprehensive income (loss) as defined
includes all changes in equity (net assets) during a period from
non-owner sources. The only source of other comprehensive income
(loss) for the Company, which is excluded from net income (loss),
is foreign currency translation adjustments.
Stock-based
compensation - The Company uses the fair value method of
accounting prescribed by ASC 718, Compensation – Stock
Compensation, Accounting for Stock-Based Compensation for
its employee stock option program. Under ASC 718, stock-based
compensation cost is measured at the grant date based on the fair
value of the award and is recognized as expense over the applicable
vesting period of the stock award.
Research and
development - Research and development costs are expensed as
incurred. Research and development costs include payments to third
parties that specifically relate to the Company’s products in
clinical development, such as payments to contract research
organizations, consulting fees for FDA submissions, universities
performing non-medical related research and insurance premiums for
clinical studies and non-medical research. In addition, employee
costs (salaries, payroll taxes, benefits and travel) for employees
of the regulatory affairs, clinical affairs, quality assurance, and
research and development departments are classified as research and
development costs.
Liabilites
related to warrants issued - The Company records
certain common stock warrants issued at fair value and recognizes
the change in the fair value of such warrants as a gain or loss,
which is reported in the Other Income (Expense) section of the
Consolidated Statements of Comprehensive Loss. The Company
reports these warrants at fair value and classified as liabilities
because they contain certain down-round provisions allowing for
reduction of their exercise price. The fair value of these
warrants is estimated using a binomial options pricing
model.
Warrants
related to debt issued - The Company records a
warrant discount related to warrants issued with debt at fair value
and recognizes the cost using the straight-line method over the
term of the related debt as interest expense, which is reported in
the Other Income (Expense) section of our Consolidated Statements
of Comprehensive Loss. This warrant discount is reported as a
reduction of the related debt liability.
Beneficial
conversion feature on convertible debt - The Company
records a beneficial conversion feature related to convertible debt
at fair value and recognizes the cost using the straight-line
method over the term of the related debt as interest expense, which
is reported in the Other Income (Expense) section of our
Consolidated Statements of Comprehensive Loss. The beneficial
conversion feature is reported as a reduction of the related debt
liability.
Recent
pronouncements – New accounting pronouncements are
issued by the Financial Standards Board (“FASB”) or
other standards setting bodies that the Company adopts according to
the various timetables the FASB specifies.
In May 2014, the
FASB issued Accounting Standards Update No. 2014-09, Revenue from Contracts with Customers
(ASU 2014-09), which supersedes nearly all existing revenue
recognition guidance under U.S. GAAP. The core principle of ASU
2014-09 is to recognize revenues when promised goods or services
are transferred to customers in an amount that reflects the
consideration to which an entity expects to be entitled for those
goods or services. ASU 2014-09 defines a five step process to
achieve this core principle and, in doing so, more judgment and
estimates may be required within the revenue recognition process
than are required under existing U.S. GAAP. The standard is
effective for annual periods beginning after December 15, 2017, and
interim periods therein, using either of the following transition
methods: (i) a full retrospective method, which requires the
standard to be applied to each prior period presented, or (ii) a
modified retrospective method, which requires the cumulative effect
of adoption to be recognized as an adjustment to the opening
retained earnings in the period of adoption. In July 2015, the FASB
confirmed a one-year delay in the effective date of ASU 2014-09,
making the effective date for the Company the first quarter of
fiscal 2018 instead of the previous effective date, which was the
first quarter of fiscal 2017. This one year deferral was issued by
the FASB in ASU 2015-14, Revenue
from Contracts with Customers (Topic 606). The Company can
elect to adopt the provisions of ASU 2014-09 for annual periods
beginning after December 31, 2017, including interim periods within
that reporting period. The FASB also agreed to allow entities to
choose to adopt the standard as of the original effective date. The
Company will adopt the standard effective January 1, 2018 and
currently anticipates using the modified retrospective approach
with a cumulative effect adjustment to opening retained earnings.
The evaluation of our contracts is substantially complete and,
based upon the results of our evaluation, we do not expect the
application of the new standard to these contracts to have a
material impact to our consolidated statements of comprehensive
loss, balance sheets, or cash flows either at initial
implementation or on an ongoing basis. We will be finalizing our
assessment in advance of the filing of our first quarter 2018 Form
10-Q. The disclosures related to revenue recognition will be
significantly expanded under the standard, specifically around the
quantitative and qualitative information about performance
obligations and disaggregation of revenue. The expanded disclosure
requirements will be included in our first quarter 2018 Form
10-Q.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
2.
Summary
of significant accounting policies (continued)
In February 2016,
the FASB issued ASU No. 2016-02, Leases (Topic 842), which requires
lessees to recognize most leases on the balance sheet. The
provisions of this guidance are effective for the annual periods
beginning after December 15, 2018, and interim periods within those
years, with early adoption permitted. Management is evaluating the
requirements of this guidance and has not yet determined the impact
of the adoption on the Company’s financial position or
results of operations.
In August 2016, the
FASB issued ASU No. 2016-15, Statement of Cash Flows: Classification of
Certain Cash Receipts and Cash Payments (Topic 230). This
ASU will make eight targeted changes to how cash receipts and cash
payments are presented and classified in the statement of cash
flows. The ASU will be effective for fiscal years beginning after
December 15, 2017. This standard will require adoption on a
retrospective basis unless it is impracticable to apply, in which
case it would be required to apply the amendments prospectively as
of the earliest date practicable. The new standard will be adopted
during the first quarter of 2018 using a retrospective transition
method. The adoption of this guidance will not have significant
impact on our financial statements.
In July 2017, the
FASB issued ASU No. 2017-11, Earnings Per Share (Topic 260); Distinguishing
Liabilities from Equity (Topic 480): Derivatives and Hedging (Topic
815): (Part I) Accounting for Certain Financial Instruments with
Down Round Features, (Part II) Replacement of the Indefinite
Deferral for Mandatorily Redeemable Financial Instruments of
Certain Nonpublic Entities and Certain Mandatorily Redeemable
Noncontrolling Interests with a Scope Exception. Part I of
this ASU addresses the complexity and reporting burden associated
with the accounting for freestanding and embedded instruments with
down round features as liabilities subject to fair value
measurement. Part II of this ASU addresses the difficulty of
navigating Topic 480. Part I of this ASU will be effective for
fiscal years beginning after December 15, 2018. Early adoption is
permitted for an entity in an interim or annual period. Management
is evaluating the requirements of this guidance and has not yet
determined the impact of the pending adoption on the
Company’s financial position or results of
operations.
In February 2018, the FASB issued ASU
2018-02, Reclassification of Certain
Tax Effects from Accumulated Other Comprehensive
Income. This ASU requires
reclassification from accumulated other comprehensive income to
retained earnings for stranded tax effects resulting from the Tax
Cuts and Jobs Act. The amount of the reclassification is the
difference between the historical 35% corporate income tax rate and the newly enacted
21% corporate income tax rate. Because the amendments
only relate to the reclassification of the income tax effects of
the Tax Cuts and Jobs Act, the underlying guidance that requires
that the effect of a change in tax laws of rates be included in
income from continuing operations is not affected. This ASU is effective for fiscal years
beginning after December 15, 2018. Early adoption is permitted. We
have elected early adoption of this ASU. The impact of the
newly enacted 21% corporate income tax rate of the Tax Cuts and
Jobs Act was a
$11.1 million adjustment to the gross deferred tax assets which was
offset by the same adjustment to the valuation allowance
at December 31,
2017.
Inventory consists
of the following at December 31, 2017 and 2016:
|
|
|
|
|
|
Inventory
- finished goods
|
$136,534
|
$218,592
|
Inventory
- parts
|
167,613
|
89,621
|
Gross
inventory
|
304,147
|
308,213
|
Provision
for losses and obsolescence
|
(72,615)
|
(76,260)
|
Net
inventory
|
$231,532
|
$231,953
|
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
4.
Property
and equipment
Property and
equipment consists of the following at December 31, 2017 and
2016:
|
|
|
|
|
|
Machines
and equipment
|
$240,295
|
$240,295
|
Office
and computer equipment
|
156,860
|
156,860
|
Devices
|
89,704
|
82,204
|
Software
|
34,528
|
34,528
|
Furniture
and fixtures
|
16,019
|
16,019
|
Other
assets
|
2,259
|
2,259
|
Total
|
539,665
|
532,165
|
Accumulated
depreciation
|
(479,296)
|
(455,227)
|
Net property and equipment
|
$60,369
|
$76,938
|
Depreciation
expense was $24,069 and $19,858 for the years ended December 31,
2017 and 2016, respectively. The depreciation policies followed by
the Company are described in Note 2.
Intangible assets
consist of the following at December 31, 2017 and
2016:
|
|
|
|
|
|
Patents,
at cost
|
$3,502,135
|
$3,502,135
|
Less
accumulated amortization
|
(3,502,135)
|
(3,502,135)
|
Net intangible assets
|
$-
|
$-
|
Amortization
expense was $0 and $306,756 for the years ended December 31, 2017
and 2016, respectively. The amortization policies followed by the
Company are described in Note 2.
Accrued expenses
consist of the following at December 31, 2017 and
2016:
|
|
|
|
|
|
Accrued
outside services
|
$165,427
|
$31,533
|
Accrued
board of director's fees
|
125,000
|
16,000
|
Accrued
executive severance
|
118,000
|
100,000
|
Accrued
audit and tax preparation
|
73,800
|
100,000
|
Accrued
legal professional fees
|
61,890
|
45,000
|
Deferred
rent
|
51,191
|
41,341
|
Accrued
travel
|
39,926
|
-
|
Accrued
clinical study expenses
|
13,650
|
13,650
|
Deferred
revenue
|
13,317
|
18,810
|
Accrued
other
|
11,399
|
8,754
|
|
$673,600
|
$375,088
|
On November 6,
2012, the Company entered into a Severance and Advisory Agreement
(the “Severance Agreement”) with Christopher M. Cashman
in connection with his resignation as President and Chief Executive
Officer, and a director of the Company. Pursuant to the Severance
Agreement, Mr. Cashman will receive, as severance along with other
non-cash items, six months of his base salary payable over the
following six month period and bonus payments of $100,000 upon each
of four bonus payment events tied to the Company’s clinical
trial plan for the dermaPACE device, or December 31, 2016,
whichever occurs first. The Company achieved three of the four
bonus payment events in 2014 and paid $300,000 in accrued executive
severance during the year ended December 31, 2014. The accrued
executive severance at December 31, 2017 represents the unpaid
portion of the bonus payments plus accrued interest due to late
payment and the accrued executive severance at December 31, 2016
represents the unpaid portion of the bonus payments.
On May 1, 2017, the
Company entered into an agreement with an investment company to
provide business advisory and consulting services. The
compensation for those services was to be paid in a combination of
cash and Company common stock. At December 31, 2017, the
Company accrued $120,000 of expense for the services
provided. The common stock was issued in March 2018 in the
amount of 467,423 shares.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
7.
Advances
from related and unrelated parties
The Company has
received cash advances from related parties and accredited
investors to help fund the Company’s operations. These
advances are a part of an agreement that the Company is offering to
issue convertible promissory notes. As of December 31, 2017, the
Company had received $310,000 from related parties and accredited
investors. A. Michael Stolarski and
Kevin A. Richardson II, both members of the Company’s board
of directors and existing shareholders of the Company, had
subscribed $130,000 and $140,000, respectively, to the Company as
advances from related parties to be used to purchase 10%
Convertible Promissory Notes. The convertible promissory
notes for this balance were issued on January 10, 2018 (see Note
20).
8.
Line
of credit, related parties
The Company entered
into a line of credit agreement with a related party at December
29, 2017. The agreement established a line of credit in the amount
of $370,000 with an annualized interest rate of 6%. The line of
credit may be called for payment upon demand.
Interest expense on
line of credit, related parties totaled $179 and $0 for the years
ended December 31, 2017 and 2016, respectively.
9.
Convertible
promissory notes
On March 27, 2017,
the Company began offering
subscriptions for 10% convertible promissory notes (the “10%
Convertible Promissory Notes”) to selected accredited
investors. The Company intends to use the proceeds from the
10% Convertible Promissory Notes for working capital and general
corporate purposes. The initial offering closed on August 15, 2017,
at which time $55,000 aggregate principal amount of 10% Convertible
Promissory Notes were issued and the funds paid to the Company.
Subsequent offerings were closed on November 3, 2017, November 30,
2017, and December 21, 2017, at which times $1,069,440, $199,310
and $150,000, respectively, aggregate principal amounts of 10%
Convertible Promissory Notes were issued and the funds paid to the
Company. On November 30, 2017, the outstanding balance of $60,000
of a short term loan with Millennium Park Capital LLC was converted
into a 10% Convertible Promissory Notes agreement (see Note
10).
The 10% Convertible Promissory Notes have a six
month term from the subscription date and the note holders can
convert the 10% Convertible Promissory Notes at any time during the
term to the number of shares of Company common stock, $0.001 par value (the
“Common Stock”), equal to the amount obtained by
dividing (i) the amount of the unpaid principal and interest on the
note by (ii) $0.11.
The 10% Convertible Promissory Notes include a
warrant agreement (the “Class N Warrant Agreement”) to
purchase Common Stock equal to the amount obtained by dividing the
(i) sum of the principal amount, by (ii) $0.11. The Class N Warrant
Agreement expires March 17, 2019. On November 3, 2017, the
Company issued 10,222,180 Class N Warrants in connection with the
initial and second closings of 10% Convertible Promissory Notes. On
November 30, 2017, and December 21, 2017, the Company issued
2,357,364 and 1,363,636, respectively, Class N Warrants in
connection with the closings of 10% Convertible Promissory
Notes.
Pursuant to the
terms of a Registration Rights Agreement (the “Registration
Rights Agreement”) that the Company entered with the
accredited investors in connection with the 10% Convertible
Promissory Notes, the Company is required to file a registration
statement that covers the shares of Common Stock issuable upon
conversion of the 10% Convertible Promissory Notes or upon exercise
of the Class N Warrants. The failure on the part of the Company to
satisfy certain deadlines described in the Registration Rights
Agreement may subject the Company to payment of certain monetary
penalties.
The Company
recorded $820,681 debt discount for the beneficial conversion
feature of the promissory notes, $620,748 in debt discount for the
discount on the Class N Warrant agreement and $89,518 in debt
issuance costs to be amortized over the lives of the 10%
Convertible Promissory Notes. Additional debt issuance costs will
be incurred and amortized over the remaining lives of the 10%
Convertible Promissory Notes when Class N Warrants are issued per
the engagement letter with West Park Capital.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
9.
Convertible
promissory notes (continued)
The 10% Convertible
Promissory Notes had an aggregate outstanding principal balance of
$455,606, net of $1,099,861 beneficial conversion feature, warrant
discount and debt issuance costs at December 31, 2017.
Interest expense on
the 10% Convertible Promissory Notes totaled $452,804 for the year
ended December 31, 2017.
A. Michael Stolarski, a member of the
Company’s board of directors and an existing shareholder of
the Company, was a purchaser in the 10% Convertible
Promissory Notes in the amount of
$330,000 and was issued 3,000,000 Class N
Warrants.
10.
Notes
payable, related parties
The notes payable,
related parties were issued in conjunction with the Company’s
purchase of the orthopedic division of HealthTronics, Inc. on
August 1, 2005. The notes payable, related parties bear interest at
6% per annum. Quarterly interest through June 30, 2010, was accrued
and added to the principal balance. Interest was paid quarterly in
arrears beginning September 30, 2010. All remaining unpaid accrued
interest and principal was due August 1, 2015.
On June 15, 2015,
the Company and HealthTronics, Inc. entered into an amendment (the
“Note Amendment”) to amend certain provisions of the
notes payable, related parties. The
Note Amendment provides for the extension of the due date to
January 31, 2017. In connection with the Note Amendment, the
Company entered into a security agreement with HealthTronics, Inc.
to provide a first security interest in the assets of the
Company. The notes payable, related parties bear interest at
8% per annum effective August 1, 2015 and during any period when an
Event of Default occurs, the applicable interest rate shall
increase by 2% per annum. Events of Default under the notes
payable, related parties have occurred and are continuing on
account of the failure of SANUWAVE, Inc., a Delaware corporation, a
wholly owned subsidiary of the Company and the borrower under the
notes payable, related parties, to make the required payments of
interest which were due on December 31, 2016, March 31, 2017, June
30, 2017, September 30, 2017, and December 31, 2017 (collectively,
the “Defaults”). As a result of the Defaults, the notes
payable, related parties have been accruing interest at the rate of
10% per annum since January 2, 2017 and continue to accrue interest
at such rate. The Company will be required to make mandatory
prepayments of principal on the notes payable, related parties
equal to 20% of the proceeds received by the Company through the
issuance or sale of any equity securities in cash or through the
licensing of the Company’s patents or other intellectual
property rights.
On June 28, 2016,
the Company and HealthTronics, Inc. entered into a second amendment
(the "Second Amendment") to amend certain provisions of the notes
payable, related parties. The Second Amendment provides for
the extension of the due date to January 31, 2018.
On August 3, 2017,
the Company and HealthTronics, Inc. entered into a third amendment
(the "Third Amendment") to amend certain provisions of the notes
payable, related parties. The Third Amendment provides for
the extension of the due date to December 31, 2018, revision of the
mandatory prepayment provisions and the future issuance of
additional warrants to HealthTronics upon certain
conditions.
The notes payable,
related parties had an aggregate outstanding principal balance of
$5,222,259, net of $150,484 debt discount at December 31, 2017 and
$5,364,572, net of $8,171 debt discount at December 31, 2016,
respectively.
In addition, the
Company, in connection with the Note Amendment, issued to
HealthTronics, Inc. on June 15, 2015, a total of 3,310,000 warrants
(the “Class K Warrants”) to purchase shares of Common
Stock, at an exercise price of $0.55 per share, subject to certain
anti-dilution protection. Each Class K Warrant represents the right
to purchase one share of Common Stock. The warrants vested upon
issuance and expire after ten years. The fair value of these warrants on the date of
issuance was $0.0112 and $36,989 was recorded as a debt discount to
be amortized over the life of the amendment.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
10.
Notes
payable, related parties (continued)
In addition, the
Company, in connection with the Second Amendment, issued to
HealthTronics, Inc. on June 28, 2016, an additional 1,890,000 Class
K Warrants to purchase shares of the Company’s Common Stock
at an exercise price of $0.08 per share, subject to certain
anti-dilution protection. The exercise price of the 3,310,000 Class
K Warrants issued on June 15, 2015 was decreased to $0.08 per
share. The fair value of these
warrants on the date of issuance was $0.005 and $9,214 was recorded
as a debt discount to be amortized over the life of the
amendment.
In addition, the
Company, in connection with the Third Amendment, issued to
HealthTronics, Inc. on August 3, 2017, an additional 2,000,000
Class K Warrants to purchase shares of the Company’s Common
Stock at an exercise price of $0.11 per share, subject to certain
anti-dilution protection. The fair
value of these warrants on the date of issuance was $0.10 per
warrant and $200,000 was recorded as a debt discount to be
amortized over the life of the amendment.
Accrued interest
currently payable totaled $685,907 and $109,426 at December 31,
2017 and 2016, respectively.
As of January 1,
2017, we are in default with our interest payment and the note is
callable by HealthTronics, Inc. The notes payable, related parties
are shown as a current liability.
Maturities on notes
payable, related parties are as follows:
Years ending December 31,
|
|
|
|
2018
|
$5,372,743
|
Total
|
$5,372,743
|
Interest expense on
notes payable, related parties totaled $634,169 and $541,982 for
the years ended December 31, 2017 and 2016,
respectively.
On December 21,
2016, the Company entered into a short term loan with Millennium
Park Capital LLC (the “Holder”) in the principal amount
of $100,000. The principal amount shall be due and payable on March
31, 2017, the date that money is obtained from the Company’s
Korean distributor, or the date that money is obtained from a new
distributor.
In addition, the
Company will issue to the Holder 500,000 warrants to purchase
shares of Common Stock, at an exercise price of $0.17. Each warrant
will represent the right to purchase one share of Common Stock. The
warrants will vest upon issuance and have an expiration date of
March 17, 2019. The fair value of
these warrants on the date of issuance $0.1168, using the
Black-Scholes option pricing model, and $58,400 was recorded as a debt discount to be
amortized over the life of the short term loan. The Company issued
the Holder 500,000 warrants to purchase shares of the
Company’s common stock at an exercise price of $0.11 on
November 30, 2017. The warrants will vest upon issuance and
have an expiration date of March 17, 2019. The estimated fair value of these warrants on the
date of issuance at the new exercise price was $10,662 and was
recorded as an increase to additional paid-in
capital.
On November 30,
2017, the outstanding balance of $60,000 was converted into the
10% Convertible Promissory Notes (see
Note 9).
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
The Company files
income tax returns in the United States federal jurisdiction and
various state and foreign jurisdictions. The Company is no longer
subject to United States federal and state and non-United States
income tax examinations by tax authorities for years before
2014.
Deferred income
taxes are provided for temporary differences between the carrying
amounts and tax basis of assets and liabilities. Deferred taxes are
classified as current or noncurrent based on the financial
statement classification of the related asset or liability giving
rise to the temporary difference. For those deferred tax assets or
liabilities (such as the tax effect of the net operating loss
carryforwards) which do not relate to a financial statement asset
or liability, the classification is based on the expected reversal
date of the temporary difference.
The income tax
provision (benefit) from continuing operations consists of the
following at December 31, 2017 and 2016:
|
|
|
Current:
|
|
|
Federal
|
$-
|
$-
|
State
|
-
|
-
|
Foreign
|
-
|
-
|
|
-
|
-
|
Deferred:
|
|
|
Federal
|
8,371,516
|
(1,367,488)
|
State
|
1,489,172
|
(150,246)
|
Foreign
|
(19,224)
|
7,128
|
Change
in valuation allowance
|
(9,841,464)
|
1,510,606
|
|
$-
|
$-
|
On December 22,
2017, H.R. 1, commonly known as the Tax Cuts and Jobs Act (the
“Act”) was signed into law. The Act reduced the
Company’s corporate federal tax rate from 35% to 21%
effective January 1, 2018 and changed certain other provisions.
As a result, the Company is required
to re-measure the deferred tax assets and liabilities using the
enacted rate at which they expect them to be recovered or settled.
The effect of this re-measurement is recorded to income tax expense
in the year the tax law is enacted. For 2017, the re-measurement of
our net deferred tax asset resulted in a $11.1 million adjustment
to the income tax provision (benefit) at December 31,
2017.
The income tax
provision (benefit) amounts differ from the amounts computed by
applying the United States federal statutory income tax rate of 35%
for the years ended December 31, 2017 and 2016 to pretax income
(loss) from continuing operations as a result of the following for
the years ended December 31, 2017 and 2016:
|
|
|
|
|
|
Tax
benefit at statutory rate
|
$(1,938,278)
|
$(2,253,664)
|
Increase
(reduction) in income taxes resulting from:
|
|
|
State
income benefit, net of federal benefit
|
(136,538)
|
(160,335)
|
Non-deductible
loss on warrant valuation adjustment
|
199,055
|
665,719
|
Income
(loss) from foreign subsidiaries
|
(34,552)
|
17,077
|
Change
in valuation allowance - United States
|
(9,841,464)
|
1,510,606
|
Tax
reform rate adjustment
|
11,827,143
|
-
|
Other
|
(75,366)
|
220,597
|
Income tax expense (benefit)
|
$-
|
$-
|
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
12.
Income
taxes (continued)
The tax effects of
temporary differences that give rise to the deferred tax assets at
December 31, 2017 and 2016 are as follows:
|
|
|
Deferred
tax assets:
|
|
|
Net
operating loss carryforwards
|
$19,406,373
|
$27,839,703
|
Net
operating loss carryforwards - foreign
|
139,675
|
120,451
|
Excess
of tax basis over book value of
|
|
|
property and equipment
|
6,978
|
13,933
|
Excess
of tax basis over book value
|
|
|
of intangible assets
|
220,180
|
447,626
|
Stock-based
compensation
|
906,526
|
2,038,638
|
Accrued
employee compensation
|
-
|
24,030
|
Captialized
equity costs
|
49,471
|
75,471
|
Inventory
reserve
|
17,962
|
28,777
|
|
20,747,165
|
30,588,629
|
Valuation
allowance
|
(20,747,165)
|
(30,588,629)
|
Net deferred tax assets
|
$-
|
$-
|
The Company’s
ability to use its net operating loss carryforwards could be
limited and subject to annual limitations. In connection with
future offerings, the Company may realize a “more than 50%
change in ownership” which could further limit its ability to
use its net operating loss carryforwards accumulated to date to
reduce future taxable income and tax liabilities. Additionally,
because United States tax laws limit the time during which net
operating loss carryforwards may be applied against future taxable
income and tax liabilities, the Company may not be able to take
advantage of all or portions of its net operating loss
carryforwards for federal income tax purposes.
The federal net
operating loss carryforwards at December 31, 2017 will begin to
expire in 2025.
Warrant Exercise
For
the year ended December 31, 2017, the Company issued 1,163,333
shares of common stock upon the exercise of 1,163,333 Class L
Warrants to purchase shares of stock for $0.08 per share under the
terms of the Class L Warrant agreement.
For
the year ended December 31, 2016, the Company issued 843,333 shares
of common stock upon the exercise of 843,333 Class L Warrants to
purchase shares of stock for $0.08 per share under the terms of the
Class L Warrant agreement.
Cashless Warrant Exercise
For the year ended
December 31, 2017, the Company issued 447,118 shares of common
stock upon the cashless exercise of 883,499 Class L Warrants to
purchase shares of stock for $0.08 per share based on the current
market value per share as of the date of conversion as determined
under the terms of the Class L Warrant agreement.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
13.
Equity
Transactions (continued)
For the year ended
December 31, 2017, the Company issued 419,507 shares of common
stock upon the cashless exercise of 545,246 Series A Warrants to
purchase shares of stock for $0.0334 per share based on the current
market value per share as of the date of conversion as determined
under the terms of the Series A Warrant agreement.
For the year ended
December 31, 2016, the Company issued 117,510 shares of common
stock upon the cashless exercise of 143,400 Series A Warrants to
purchase shares of stock for $0.0334 per share based on the current
market value per share as of the date of conversion as determined
under the terms of the Series A Warrant agreement.
For the year ended
December 31, 2016, the Company issued 869,722 shares of common
stock upon the cashless exercise of 1,943,334 Class M Warrants to
purchase shares of stock for $0.06 per share based on the current
market value per share as of the date of conversion as determined
under the terms of the Class M Warrant agreement.
For the year ended
December 31, 2016, the Company issued 1,640,589 shares of common
stock upon the cashless exercise of 4,641,667 Class J Warrants to
purchase shares of stock for $0.06 per share based on a current
market value per share as of the date of conversion as determined
under the terms of the Class J Warrant agreement.
2016 Private Placement
On August 11, 2016,
the Company began a private placement of securities (the
“2016 Private Placement”) with select accredited
investors in reliance upon the exemption from securities
registration afforded by Section 4(a)(2) of the Securities Act of
1933, as amended (the “Securities Act”), an Rule 506 of
Regulation D (“Regulation D”) as promulgated by the
United States Securities and Exchange Commission (the
“Commission”) under the Securities Act. The 2016
Private Placement offered Units (the “Units”) at a
purchase price of $0.06 per Unit, with each Unit consisting of (i)
one (1) share of our Common Stock and, (ii) one (1) detachable
warrant (the “Warrants”) to purchase one (1) share of
our Common Stock at an exercise price of $0.08 per
share.
On August 25, 2016
and September 27, 2016 in conjunction with the 2016 Private
Placement, the Company issued an aggregate of 22,766,667 and
5,533,334, respectively, shares of common stock for an aggregate
purchase price of $1,366,000 and $332,000,
respectively.
The Company, in
connection with the 2016 Private Placement, issued to the investors
an aggregate of 28,300,001 warrants (the “Class L
Warrants”) to purchase shares of common stock at an exercise
price of $0.08 per share. Each Class L Warrant represents the right
to purchase one share of Common Stock. The warrants vested upon
issuance and expire on March 17, 2019.
Pursuant to the
terms of a Registration Rights Agreement that the Company entered
with the accredited investors in connection with the 2016 Private
Placement, the Company is required to file a registration statement
that covers the shares of Common Stock and the shares of common
stock issuable upon exercise of the Warrants. The failure on the
part of the Company to satisfy certain deadlines described in the
Registration Rights Agreement may subject the Company to payment of
certain monetary penalties.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
13.
Equity
Transactions (continued)
Michael N. Nemelka, the brother of a member of the
Company’s board of directors and an existing shareholder of
the Company, was a purchaser in the 2016 Private Placement
of $75,000. A. Michael Stolarski, a
member of the Company’s board of directors and an existing
shareholder of the Company, was a purchaser in the 2016
Private Placement of
$60,000.
At the closing of
the 2016 Private Placement, the Company paid West Park Capital,
Inc., the placement agent for the equity offering, cash
compensation of $169,800 based on the gross proceeds of the private
placement and 2,830,000 Class L Warrants.
Consulting Agreement
In November 2017,
the Company entered into a three month consulting agreement for
which a portion of the fee for the services was to be paid with
Common Stock. The number of shares to be paid with Common Stock was
calculated by dividing the amount of the fee to be paid with Common
Stock of $4,000 by the Company stock price at the close of business
on the eighth business day of each month. The Company issued 26,667
and 23,529 shares, respectively in each of the first two months of
the agreement. The $4,000 was recorded as a non-cash general and
administrative expense for each of the first two months of the
agreement.
In August 2016, the
Company entered into a consulting agreement for which the fee for
the services performed was paid with Common Stock. The Company
issued 435,392 shares of Common Stock to Vigere Capital LP under
this agreement. The fair value of the Common Stock issued to the
consultant, based upon the closing market price of the Common Stock
at the date the Common Stock was issued, was recorded as a non-cash
general and administrative expense for the year ended December 31,
2016.
Convertible Debenture and Restricted Stock
On July 29, 2016,
the Company entered into a financing transaction for the sale of a
Convertible Debenture (the “Debenture”) in the
principal amount of $200,000, with proceeds of $175,000 to the
Company after payment of a 10% original issue discount. The
offering was conducted pursuant to the exemption from registration
provided by Section 4(a)(2) of the Act and Rule 506 of Regulation D
thereunder. The Company did not utilize any form of general
solicitation or general advertising in connection with the
offering. The Debenture was offered and sold to one accredited
investor (the “Investor”).
The Investor is
entitled to, at any time or from time to time, commencing on the
date that is one hundred fifty one (151) days from the issuance
date set forth above convert the conversion amount into conversion
shares, at a conversion price for each share of common stock
equal to either (i) if the Company is
Deposit/Withdrawal at Custodian (“DWAC”) operational at
the time of conversion, seventy percent (70%) of the lowest closing
bid price (as reported by Bloomberg LP) of common stock for the
twenty (20) trading days immediately preceding the date of the date
of conversion of the Debentures, or (ii) if either the Company is
not DWAC operational or the common stock is traded on the bottom
tier over-the-counter Pink (or, “pink sheets”) at the
time of conversion, sixty five percent (65%) of the lowest closing
bid price (as reported by Bloomberg LP) of the common stock for the
twenty (20) trading days immediately preceding the date of
conversion of the Debentures, subject in each case to equitable
adjustments resulting from any stock splits, stock dividends,
recapitalizations or similar events.
The Company
recorded $124,900 in interest expense for the beneficial conversion
feature of the debenture in December 2016.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
13.
Equity
Transactions (continued)
The Debenture is
secured by the accounts receivable of the Company and, unless
earlier redeemed, matures on the third anniversary date of
issuance. The Company paid a commitment fee of of $2,500 and issued
835,000 shares of restricted stock. The fair value of the restricted stock on the date
of issuance was $0.06 per share and $50,100 was recorded as
interest expense in July 2016.
In September 2016,
the Company repaid the Debenture in full which totaled $210,000
with a Redemption Price of 105% of the sum of the Principal Amount
per the agreement. The premium of $10,000 paid upon redemption was
recorded as interest expense in September 2016.
2016 Equity Offering
On March 11, 2016,
April 6, 2016, and April 15, 2016 in conjunction with an equity
offering of securities (the “2016 Equity Offering”)
with select accredited investors, the Company issued an aggregate
of 25,495,835, 3,083,334 and 1,437,501, respectively, shares of
common stock for an aggregate purchase price of $1,529,750,
$185,000, and $86,200, respectively. The mandatory prepayment of
principal on the Notes payable, related parties equal to 20% of the
proceeds received by the Company required by the Note Amendment on
June 15, 2015 was waived by HealthTronics, Inc. for this 2016
Equity Offering.
The Company, in
connection with the 2016 Equity Offering, issued to the investors
an aggregate of 30,016,670 warrants (the “Class L
Warrants”) to purchase shares of common stock at an exercise
price of $0.08 per share. Each Class L Warrant represents the right
to purchase one share of Common Stock. The warrants vested upon
issuance and expire on March 17, 2019.
Pursuant to the
terms of a Registration Rights Agreement that the Company entered
into with the investors in connection with the 2016 Equity
Offering, the Company is required to file a registration statement
that covers the shares of common stock and the shares of common
stock issuable upon exercise of the Class L Warrants. The
registration statement was declared effective by the SEC on
February 16, 2016.
Michael
N. Nemelka, the brother of a member of the Company’s board of
directors and an existing shareholder of the Company, was a
purchaser in the 2016 Equity Offering of $100,000. A. Michael
Stolarski, a member of the Company’s board of directors and
an existing shareholder of the Company, was a purchaser in the 2016
Equity Offering of $75,000.
At the closing of
the 2016 Equity Offering, the
Company paid Newport Coast Securities, Inc., the placement agent
for the equity offering, cash compensation of $180,095 based on the
gross proceeds of the private placement and 3,001,667 Class L
Warrants. In addition, the Company paid an escrow fee of
$4,000 and an attorney fee of $20,000 from the gross
proceeds.
Series A Warrant Conversion
On January 13,
2016, the Company entered into an Exchange Agreement (the
“Exchange Agreement”) with certain beneficial owners
(the “Investors”) of Series A warrants (the
“Warrants”) to purchase shares of Common Stock,
pursuant to which the Investors exchanged (the
“Exchange”) all of their respective Warrants for either
(i) shares of Common Stock or (ii) shares of Common Stock and
shares of the Company’s Series B Convertible Preferred Stock,
$0.001 par value (the “Preferred Stock”).
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
13.
Equity
Transactions (continued)
The Exchange was
based on the following exchange ratio (the “Exchange
Ratio”): 1 Series A Warrant = 0.4685 shares of capital stock.
Investors who, as a result of the Exchange, owned in excess of
9.99% (the “Ownership Threshold”) of the outstanding
Common Stock, received a mixture of Common Stock and shares of
Preferred Stock. They received Common Stock up to the Ownership
Threshold, and received shares of Preferred Stock beyond the
Ownership Threshold (but the total shares of Common Stock and
Preferred Stock issued to such holders was still based on the same
Exchange Ratio). The relative rights, preferences, privileges and
limitations of the Preferred Stock are as set forth in the
Company’s Certificate of Designation of Series B Convertible
Preferred Stock, which was filed with the Secretary of State of the
State of Nevada on January 12, 2016 (the “Series B
Certificate of Designation”).
In the Exchange an
aggregate number of 23,701,428 Warrants were exchanged for
7,447,954 shares of Common Stock and 293 shares of Preferred Stock.
Pursuant to the Series B Certificate of Designation, each of the
Preferred Stock shares is convertible into shares of Common Stock
at an initial rate of 1 Preferred Stock share for 12,500 Common
Stock shares, which conversion rate is subject to further
adjustment as set forth in the Series B Certificate of Designation.
Pursuant to the terms of the Series B Certificate of Designation,
the holders of the Preferred Stock shares will generally be
entitled to that number of votes as is equal to the number of
shares of Common Stock into which the Preferred Stock may be
converted as of the record date of such vote or consent, subject to
the Beneficial Ownership Limitation.
In connection with
entering into the Exchange Agreement, the Company also entered into
a Registration Rights Agreement, dated January 13, 2016, with the
Investors. The Registration Rights Agreement requires that the
Company file with the SEC a registration statement to register for
resale the shares of the Common Stock issued in connection with the
Exchange and the Common Stock issuable upon conversion of the
Preferred Stock shares (the “Preferred Stock Conversion
Shares”). The registration statement was declared effective
by the SEC on February 16, 2016.
The Company’s
Articles of Incorporation authorize the issuance of up to 5,000,000
shares of “blank check” preferred stock with
designations, rights and preferences as may be determined from time
to time by the board of directors. On January 12, 2016,
the Company filed a Certificate of Designation of Preferences,
Rights and Limitations for Series B Convertible Preferred Stock of
the Company (the “Certificate of Designation”) with the
Nevada Secretary of State. The Certificate of Designation amends
the Company’s Articles of Incorporation to designate 293
shares of preferred stock, par value $0.001 per share, as Series B
Convertible Preferred Stock. The Series B Convertible Preferred
Stock has a stated value of $1,000 per share. On January 13, 2016,
in connection with the Series A Warrant Conversion, the Company
issued 293 shares of Series B Convertible Preferred Stock (for a
more detailed discussion regarding the Series A Warrant Conversion,
see Note 13).
Under the
Certificate of Designation, holders of Series B Convertible
Preferred Stock are entitled to receive dividends equal (on an
as-if-converted-to-common-stock basis) to and in the same form as
dividends (other than dividends in the form of common stock)
actually paid on shares of the common stock when, as and if such
dividends are paid. Such holders will participate on an equal basis
per-share with holders of common stock in any distribution upon
winding up, dissolution, or liquidation of the Company. Holders of
Series B Convertible Preferred Stock are entitled to convert each
share of Series A Convertible Preferred Stock into 2,000 shares of
common stock, provided that after giving effect to such conversion,
such holder, together with its affiliates, shall not beneficially
own in excess of 9.99% of the number of shares of common stock
outstanding (the “Beneficial Ownership Limitation”).
Holders of the Series B Convertible Preferred Stock are entitled to
vote on all matters affecting the holders of the common stock on an
“as converted” basis, provided that such holder shall
only vote such shares of Series B Convertible Preferred Stock
eligible for conversion without exceeding the Beneficial Ownership
Limitation.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
14.
Preferred
Stock (continued)
On April 29, 2016,
the holders of Series B Convertible Preferred Stock converted the
outstanding 293 shares of Series B Convertible Preferred Stock into
3,657,278 shares of common stock. As of April 29, 2016, there were
no outstanding shares of Series B Convertible Preferred
Stock.
On March 14, 2014,
the Company filed a Certificate of Designation of Preferences,
Rights and Limitations for Series A Convertible Preferred Stock of
the Company (the “Certificate of Designation”) with the
Nevada Secretary of State. The Certificate of Designation amends
the Company’s Articles of Incorporation to designate 6,175
shares of preferred stock, par value $0.001 per share, as Series A
Convertible Preferred Stock. The Series A Convertible Preferred
Stock has a stated value of $1,000 per share. On March 17, 2014, in
connection with a Private Placement, the Company issued 6,175
shares of Series A Convertible Preferred Stock. As of January 6,
2015 there were no outstanding shares of Series A Convertible
Preferred Stock.
A
summary of warrants as of December 31, 2017 and 2016, and the
changes during the years ended December 31, 2017 and 2016, is
presented as follows:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Warrant
class
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Class E
Warrants
|
3,576,737
|
-
|
-
|
-
|
(3,576,737)
|
-
|
-
|
-
|
-
|
Class F
Warrants
|
300,000
|
-
|
-
|
-
|
-
|
300,000
|
-
|
-
|
300,000
|
Class G
Warrants
|
1,503,409
|
-
|
-
|
-
|
-
|
1,503,409
|
-
|
-
|
1,503,409
|
Class H
Warrants
|
1,988,095
|
-
|
-
|
-
|
-
|
1,988,095
|
-
|
-
|
1,988,095
|
Class I
Warrants
|
1,043,646
|
-
|
-
|
-
|
-
|
1,043,646
|
-
|
-
|
1,043,646
|
Class J
Warrants
|
629,378
|
4,012,289
|
(4,641,667)
|
-
|
-
|
-
|
-
|
-
|
-
|
Class K
Warrants
|
3,310,000
|
1,890,000
|
-
|
-
|
-
|
5,200,000
|
2,000,000
|
-
|
7,200,000
|
Class L
Warrants
|
-
|
66,788,338
|
(843,333)
|
-
|
-
|
65,945,005
|
-
|
(2,046,832)
|
63,898,173
|
Class M
Warrants
|
-
|
1,943,333
|
(1,943,333)
|
-
|
-
|
-
|
-
|
-
|
-
|
Class N
Warrants
|
-
|
-
|
-
|
-
|
-
|
-
|
13,943,180
|
-
|
13,943,180
|
Class O
Warrants
|
-
|
-
|
-
|
-
|
-
|
-
|
6,540,000
|
-
|
6,540,000
|
Series A
Warrants
|
25,951,421
|
-
|
(143,400)
|
(23,701,427)
|
-
|
2,106,594
|
-
|
(545,246)
|
1,561,348
|
|
38,302,686
|
74,633,960
|
(7,571,733)
|
(23,701,427)
|
(3,576,737)
|
78,086,749
|
22,483,180
|
(2,592,078)
|
97,977,851
|
A
summary of the warrant exercise price per share and expiration date
is presented as follows:
|
|
Expiration
|
|
|
date
|
|
|
|
Class
F Warrants
|
$0.35
|
February
2018
|
Class
G Warrants
|
$0.80
|
July
2018
|
Class
H Warrants
|
$0.80
|
July
2018
|
Class
I Warrants
|
$0.85
|
September
2018
|
Class
K Warrants
|
$0.08
|
June
2025
|
Class
K Warrants
|
$0.11
|
August
2027
|
Class
L Warrants
|
$0.08
|
March
2019
|
Class
N Warrants
|
$0.11
|
March
2019
|
Class
O Warrants
|
$0.11
|
March
2019
|
Series
A Warrants
|
$0.03
|
March
2019
|
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
The
exercise price and the number of shares covered by the warrants
will be adjusted if the Company has a stock split, if there is a
recapitalization of the Company’s common stock, or if the
Company consolidates with or merges into another
company.
The exercise price
of the Class K Warrants and the Series A Warrants are subject to a
“down-round” anti-dilution adjustment if the Company
issues or is deemed to have issued securities at a price lower than
the then applicable exercise price of the warrants. The Class
K Warrants may be exercised on a physical settlement or on a
cashless basis. The Series A Warrants may be exercised on a
physical settlement basis if a registration statement underlying
the warrants if effective. If a registration statement is not
effective (or the prospectus contained therein is not available for
use) for the resale by the holder of the Series A Warrants, then
the holder may exercise the warrants on a cashless
basis.
In June 2015, the
Company, in connection with the Note Amendment (Note 10), issued to
HealthTronics, Inc. an aggregate total of 3,310,000 Class K
Warrants to purchase shares of the Company’s common stock,
$0.001 par value, at an exercise price of $0.55 per share, subject
to certain anti-dilution protection. Each Class K Warrant
represents the right to purchase one share of Common Stock. The
warrants vested upon issuance and expire after ten
years.
In June 2016, the
Company, in connection with the Second Amendment (Note 10), issued
to HealthTronics, Inc., an additional 1,890,000 Class K Warrants to
purchase shares of the Company’s Common Stock at an exercise
price of $0.08 per share, subject to certain anti-dilution
protection. The exercise price of the 3,310,000 Class K Warrants
issued on June 15, 2015 was decreased to $0.08 per share. The
warrants vested upon issuance and expire after ten
years.
In August 2017, the
Company, in connection with the Third Amendment (Note 10), issued
to HealthTronics, Inc., an additional 2,000,000 Class K Warrants to
purchase shares of the Company’s Common Stock at an exercise
price of $0.11 per share, subject to certain anti-dilution
protection. The warrants vested upon issuance and expire after ten
years.
On November 30,
2017, the Company issued Class O Warrant Agreements to a vendor to
purchase 2,500,000 shares of common stock at an exercise price of
$0.11 per share. Each Class O Warrant
represents the right to purchase one share of Common Stock. The
estimated fair value of the Class O Warrants at the grant date was
$174,731 and was recorded as general and administrative expense and
an increase to additional paid-in capital. The warrants vested upon
issuance and expire on March 17, 2019.
On December 6,
2017, the Company issued Class O Warrant Agreements to a vendor to
purchase 100,000 shares of common stock at an exercise price of
$0.11 per share. Each Class O Warrant
represents the right to purchase one share of Common Stock. The
estimated fair value of the Class O Warrants at the grant date was
$8,125 and was recorded as general and administrative expense and
an increase to additional paid-in capital. The warrants vested upon
issuance and expire on March 17, 2019.
On December 11,
2017, the Company issued Class O Warrant Agreements to active
employees, independent contractors, members of the board of
directors and members of the medical advisory boards to purchase
3,940,000 shares of common stock at an exercise price of $0.11 per
share. Each Class O Warrant represents
the right to purchase one share of Common Stock. The estimated fair
value of the Class O Warrants at the grant date was $285,810 and
was recorded as research and development expense in the amount of
$98,655 and general and administrative expense in the amout of
$187,155 and an increase to additional paid-in capital for the full
amount of $285,810. The warrants vested upon issuance and expire on
March 17, 2019. Kevin A. Richardson II and A. Michael Stolarski,
both members of the Company’s board of directors and existing
shareholders of the Company, were issued 640,000 and 200,000
warrants, respectively. John Nemelka, Alan Rubino and Maj-Britt
Kaltoft, members of the Company’s board of directors, were
each issued 200,000 warrants. Lisa E. Sundstrom, an officer of the
Company was issued 440,000 warrants.
The fair value of
each Class O Warrant Agreement grant is estimated on the date of
grant using the BlackScholes option pricing model using the
following assumptions for the year ended December 31,
2017:
|
|
Expected
life in years
|
1.26
- 1.29
|
Risk
free interest rate
|
1.70%
- 1.76%
|
Volatility
|
88.06%
- 90.00%
|
Forfeiture
rate
|
0.0%
|
Expected
dividend yield
|
0.0%
|
The Class K
Warrants, the Series A Warrants and the Series B Warrants are
classified as derivative financial instruments. The estimated fair
values of the Class K Warrants at the dates of grant were $36,989
on June 15, 2015, $9,214 on June 28, 2016, and $200,000 on August
3, 2017. These amounts were recorded as debt discount, which is
accreted to interest expense through the amended maturity dates of
the related notes payable, related parties. The estimated fair
values of the Series A Warrants and the Series B Warrants at the
date of grant were $557,733 for the warrants issued in conjunction
with the 2014 Private Placement and $47,974 for the warrants issued
in conjunction with the 18% Convertible Promissory Notes. The fair
value of the Series A Warrants and Series B Warrants were recorded
as equity issuance costs in 2014, a reduction of additional paid-in
capital. The Series B Warrants expired unexercised in March
2015.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
The estimated fair
values of the derivative classified warrants were determined using
a binomial option pricing model based on various assumptions.
The Company’s derivative liabilities are adjusted to reflect
estimated fair value at each period end, with any decrease or
increase in the estimated fair value being recorded in other income
or expense accordingly, as adjustments to the fair value of
derivative liabilities. Various factors are considered in the
pricing models the Company uses to value the warrants, including
the Company’s current common stock price, the remaining life
of the warrants, the volatility of the Company’s common stock
price, and the risk-free interest rate. In addition, as of
the valuation dates, management assessed the probabilities of
future financing and other re-pricing events in the binominal
valuation models.
The
fair value of the derivative classified warrants is estimated using
the binomial option pricing model using the following assumptions
for the year endeds December 31, 2017 and 2016:
|
|
|
Expected
life in years
|
1.21
- 9.60
|
2.20
- 8.50
|
Risk
free interest rate
|
1.79%
- 2.39%
|
1.25%
- 2.35%
|
Volatility
|
109.00%
- 133.00%
|
150.00%
|
Forfeiture
rate
|
0.0%
|
0.0%
|
Expected
dividend yield
|
0.0%
|
0.0%
|
A
summary of the changes in the warrant liability as of December 31,
2017 and December 31, 2016, and the changes during the years ended
December 31, 2017 and 2016, is presented as follows:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Warrant
liability as of December 31, 2015
|
$2,900
|
$22,700
|
$-
|
$112,500
|
$138,100
|
Issued
|
-
|
25,350
|
9,091
|
-
|
34,441
|
Redeemed
|
(153,175)
|
-
|
(114,492
|
(886,472)
|
(1,154,139)
|
Change
in fair value
|
150,275
|
835,950
|
105,401
|
1,132,092
|
2,223,718
|
Warrant
liability as of December 31, 2016
|
$-
|
$884,000
|
$-
|
$358,120
|
$1,242,120
|
Issued
|
-
|
200,000
|
-
|
-
|
200,000
|
Redeemed
|
-
|
-
|
-
|
(66,966)
|
(66,966)
|
Change
in fair value
|
-
|
532,000
|
-
|
36,729
|
568,729
|
Warrant
liability as of December 31, 2017
|
$-
|
$1,616,000
|
$-
|
$327,883
|
$1,943,883
|
16.
Commitments
and contingencies
Operating Leases
The Company leases
office and storage space. Rent expense for the years ended December
31, 2017 and 2016, was $159,583 and $178,073, respectively. Minimum
future lease payments under the operating lease consist of the
following:
Year ending December 31,
|
|
|
|
2018
|
$138,861
|
2019
|
143,318
|
2020
|
147,617
|
2021
|
152,046
|
Total
|
$581,842
|
Litigation
The Company is
involved in various legal matters that have arisen in the ordinary
course of business. While the ultimate outcome of these matters is
not presently determinable, it is the opinion of management that
the resolution will not have a material adverse effect on the
financial position or results of operations of the
Company.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
17.
Stock-based
compensation
On November 1,
2010, the Company approved the Amended and Restated 2006 Stock
Incentive Plan of SANUWAVE Health, Inc. effective as of January 1,
2010 (the “Stock Incentive Plan”). The Stock Incentive
Plan permits grants of awards to selected employees, directors and
advisors of the Company in the form of restricted stock or options
to purchase shares of common stock. Options granted may include
non-statutory options as well as qualified incentive stock options.
The Stock Incentive Plan is currently administered by the board of
directors of the Company. The Stock Incentive Plan gives broad
powers to the board of directors of the Company to administer and
interpret the particular form and conditions of each option. The
stock options granted under the Stock Incentive Plan are
non-statutory options which generally vest over a period of up to
three years and have a ten year term. The options are granted at an
exercise price determined by the board of directors of the Company
to be the fair market value of the common stock on the date of the
grant. At December 31, 2017 and 2016, the Stock Incentive Plan
reserved a total of 22,500,000 shares of common stock for
grant.
On June 15, 2017,
the Company granted to the active employees, members of the board
of directors and three members of the Company’s Medical
Advisory Board options to purchase an aggregate total of 5,550,000
shares of the Company’s common stock at an exercise price of
$0.11 per share and vested upon issuance. Using the Black-Scholes
option pricing model, management has determined that the options
had a fair value per share of $0.0869 per option resulting in
compensation expense of $482,295. Compensation cost was recognized
upon grant.
On November 9,
2016, the Company granted to the active employees, members of the
board of directors and two members of the Company’s Medical
Advisory Board options to purchase 2,830,000 shares each of the
Company’s common stock at an exercise price of $0.18 per
share and vested upon issuance. Using the Black-Scholes option
pricing model, management has determined that the options had a
fair value per share of $0.1524 per option resulting in
compensation expense of $431,292. Compensation cost was recognized
upon grant.
On June 16, 2016,
the Company granted to the active employees, members of the board
of directors and two members of the Company’s Medical
Advisory Board options to purchase 3,300,000 shares each of the
Company’s common stock at an exercise price of $0.04 per
share and vested upon issuance. Using the Black-Scholes option
pricing model, management has determined that the options had a
fair value per share of $0.0335 per option resulting in
compensation expense of $110,550. Compensation cost was recognized
upon grant.
On October 1, 2015,
the Company granted to the active employees and members of the
board of directors options to purchase 1,900,000 shares of common
stock at an exercise price of $0.11 per share and vested upon
issuance. Using the Black-Scholes option pricing model, management
has determined that the options had a fair value per share of $0.11
resulting in compensation expense of $209,000. Compensation cost
was recognized upon grant.
On October 1, 2015,
the Company granted to the active employees, members of the board
of directors and members of the Medical Advisory Board options to
purchase 1,450,000 shares of common stock an exercise price of
$0.50 per share and vested upon issuance. Using the Black-Scholes
option pricing model, management has determined that the options
had a fair value per share of $0.10 resulting in compensation
expense of $145,000. Compensation cost was recognized upon
grant.
On August 13, 2015, Mr. Chiarelli and the Company
entered into a confidential settlement agreement in response to an
action filed against the Company by Mr. Chiarelli. The settlement
agreement contains the entire understanding and complete agreement
of the parties involved with respect to the circumstances, matters,
events and transactions that were a subject of the action. A part
of the settlement was the issuance of stock options. Using
the Black-Scholes option pricing model, management has determined
that the options had a fair value resulting in compensation expense
of $98,100. Compensation cost was recognized upon
grant.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
17.
Stock-based
compensation (continued)
On April 28, 2015,
the Company granted two members of the Company’s Medical
Advisory Board each options to purchase 50,000 shares of the
Company’s common stock at an exercise price of $0.55 per
share in place of an annual cash consulting fee for calendar year
2015. Using the Black-Scholes option pricing model, management has
determined that the options had a fair value per share of $0.11
resulting in compensation expense of $11,107. Compensation cost was
recognized over the requisite service period in calendar year
2015.
On May 7, 2014, the
Company granted to the active employees options to purchase 900,000
shares of common stock at an exercise price of $0.55 per share.
Using the Black-Scholes option pricing model, management has
determined that the options had a fair value per share of $0.48
resulting in total compensation expense of $429,001 that was
recognized over the three year vesting period of the options.
Compensation expense related to this grant was $6,000 and $30,000
for the years ended December 31, 2016 and 2015,
respectively.
On February 21,
2013, the Company, granted the active employees and directors
options to purchase 2,243,644 shares of common stock at an exercise
price of $0.35 per share. Using the Black-Scholes option pricing
model, management has determined that the options had an average
fair value per share of $0.223 resulting in total compensation of
$499,621. Compensation cost is being recognized over the requisite
service period. Compensation expense related to this grant was $0
and $11,327 for the years ended December 31, 2016 and 2015,
respectively.
The
fair value of each option award is estimated on the date of grant
using the Black-Scholes option pricing model using the following
weighted average assumptions for the years ended December 31, 2017
and 2016:
|
|
|
Weighted
average expected life in years
|
5.0
|
5.0
|
Weighted
average risk free interest rate
|
1.76%
|
1.28%
|
Weighted
average volatility
|
120.00%
|
133.54%
|
Forfeiture
rate
|
0.0%
|
0.0%
|
Expected
dividend yield
|
0.0%
|
0.0%
|
The
expected life of options granted represent the period of time that
options granted are expected to be outstanding and are derived from
the contractual terms of the options granted. The risk-free rate
for periods within the contractual life of the option is based on
the United States Treasury yield curve in effect at the time of the
grant. The expected volatility is based on the average
volatility of the Company and that of peer group companies similar
in size and value to us. We estimate pre-vesting forfeitures
at the time of grant and revise those estimates in subsequent
periods if actual forfeitures differ from those estimates. The
expected dividend yield is based on our historical dividend
experience, however, since our inception, we have not declared
dividends. The amount of stock-based compensation expense
recognized during a period is based on the portion of the awards
that are ultimately expected to vest. Ultimately, the total expense
recognized over the vesting period will equal the fair value of the
awards that actually vest.
For the years ended
December 31, 2017 and 2016, the Company recognized $482,295 and
$547,842, respectively, as compensation cost related to options
granted. As of December 31, 2017, there are no unamortized
compensation costs related to options granted.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
17.
Stock-based
compensation (continued)
A summary of option
activity as of December 31, 2017 and 2016, and the changes during
the years ended December 31, 2017 and 2016, is presented as
follows:
|
|
|
|
|
|
|
|
|
|
|
|
Outstanding
at December 31, 2015
|
10,073,385
|
$0.62
|
Granted
|
6,130,000
|
$0.10
|
Exercised
|
-
|
$-
|
Forfeited
or expired
|
-
|
$-
|
Outstanding
at December 31, 2016
|
16,203,385
|
$0.38
|
Granted
|
5,550,000
|
$0.11
|
Exercised
|
-
|
$-
|
Forfeited
or expired
|
(160,000)
|
$0.22
|
Outstanding
at December 31, 2017
|
21,593,385
|
$0.31
|
|
|
|
Vested
and exercisable at December 31, 2017
|
21,593,382
|
$0.31
|
The range of
exercise prices for options was $0.04 to $2.00 for options
outstanding at December 31, 2017 and 2016, respectively. The
aggregate intrinsic value for outstanding options was $2,073,641
and $702,500 at December 31, 2017 and 2016, respectively. The
aggregate intrinsic value for all vested and exercisable options
was $2,073,641 and $702,500 at December 31, 2017 and 2016,
respectively.
The weighted
average remaining contractual term for outstanding exercisable
stock options is 7.37 years and 5.88 years as of December 31, 2017
and 2016, respectively.
A summary of the
Company’s nonvested options as of December 31, 2017 and 2016,
and changes during the years ended December 31, 2017 and 2016, is
presented as follows:
|
|
|
|
|
|
|
|
|
|
|
|
Outstanding
at December 31, 2015
|
175,002
|
$0.36
|
Granted
|
6,130,000
|
$0.10
|
Vested
|
(6,305,002)
|
$0.11
|
Forfeited
or expired
|
-
|
$-
|
Outstanding
at December 31, 2016
|
-
|
$-
|
Granted
|
5,550,000
|
$0.11
|
Vested
|
(5,550,000)
|
$0.11
|
Forfeited
or expired
|
-
|
$-
|
Outstanding
at December 31, 2017
|
-
|
$-
|
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
On September 27,
2017, the Company entered into a binding term sheet with MundiMed
Distribuidora Hospitalar LTDA (“MundiMed”), effective
as of September 25, 2017, pursuant to which the Company and
MundiMed will enter into a joint venture for the manufacture, sale
and distribution of the Company’s dermaPACE device. The
binding term sheet provides that the parties will work together to
enter into a definitive agreement reflecting the binding term sheet
terms, but that to the extent a definitive agreement has not been
executed by the parties by September 30, 2017, the terms set forth
in the binding term sheet shall be binding.
Under the binding
term sheet, MundiMed will pay the Company an upfront distibution
fee on September 30, 2017, which fee was received on October 6,
2017, with monthly upfront distibution fees payable thereafter over
the following eighteen months. MundiMed bears the cost of any and
all fees and expenses incurred in connection with the formation,
organization and start-up of the joint venture, which fees and
expenses are expected not to exceed $200,000. Profits from the
joint venture are distributed as follows: 45% to the Company, 45%
to MundiMed and 5% each to LHS Latina Health Solutions Gestão
Empresarial Ltda. and Universus Global Advisors LLC, who acted as
advisors in the transaction.
The binding term
sheet terminates upon the earlier of (1) the date a definitive
agreement evidencing the terms of the binding term sheet is
executed by the parties and (2) May 30, 2019.
19.
Segment
and geographic information
The Company has one
line of business with revenues being generated from sales in
Europe, Canada, Asia and Asia/Pacific. All significant expenses are
generated in the United States. All significant assets are located
in the United States.
10% Convertible Promissory Notes
A subsequent
offering of the 10% Convertible Promissory Notes was closed on
January 10, 2018, at which time $1,496,000 aggregate principal
amount of 10% Convertible Promissory Notes were issued with
$1,066,000 of funds paid to the Company. The remaining $430,000 of
principal came from advances from related and unrelated parties
balance at December 31, 2017 of $310,000 (see Note 7) and
conversion of $120,000 of unpaid executive compensation by related
party, Kevin A. Richardson II. On January 10, 2018, the
Company issued 13,599,999 Class N Warrants in connection with such
subsequent closing.
The final offering
of the 10% Convertible Promissory Notes was closed on February 2,
2018, at which time $100,000 aggregate principal amount of 10%
Convertible Promissory Notes were issued and the funds paid to the
Company. On February 2, 2018, the Company issued 909,091
Class N Warrants in connection with such final
closing.
Convertible Promissory Note
On January 29,
2018, the Company entered into a
convertible promissory note (the “Convertible Promissory
Note”) with an accredited investor in the amount of
$71,500. The Company intends to use the proceeds from the
Convertible Promissory Notes for payment of services to an investor
relations company and the account of the attorney updating the
Registration Statement on Form S-1 of the Company filed under the
Securities Act of 1933, as amended, on January 3, 2017 (File No.
333-213774), which registration statement shall also register the
shares issuable upon conversion of the Convertible Promissory Note
and issuable upon the exercise of a Class N common stock purchase
warrant issued concurrently with the issuance of this Convertible
Promissory Note.
The Convertible Promissory Note has a six month
term from the subscription date and the note holders can convert
the Convertible Promissory Note at any time during the term
to the number of shares of Company common stock, equal to the amount
obtained by dividing (i) the amount of the unpaid principal and
interest on the note by (ii) $0.11.
SANUWAVE
HEALTH, INC. AND SUBSIDIARIES
NOTES
TO CONSOLIDATED FINANCIAL STATEMENTS
Years
Ended December 31, 2017 and 2016
20.
Subsequent
events (continued)
The Convertible Promissory Note includes a warrant
agreement (the “Class N Common Stock Purchase Warrant”)
to purchase Common Stock equal to the amount obtained by dividing
the (i) sum of the principal amount, by (ii) $0.11. The Class N
Common Stock Purchase Warrant expires on March 17, 2019. On
January 29, 2018, the Company issued 650,000 Class N Common Stock
Purchase Warrants in connection with this Convertible Promissory
Note.
Warrant Exercise
On
February 23, 2018, the Company issued 100,000 shares of common
stock upon the exercise of 100,000 Class O Warrants to purchase
shares of stock for $0.11 per share under the terms of the Class O
Warrant agreement.
On March 28, 2018,
the Company issued 75,666 shares of restricted common stock upon
the exercise of 75,666 Series A Warrants to purchase shares of
stock for $0.0334 per share under the terms of teh Series A
Warrant agreement.
Cashless Warrant Exercise
On January 11,
2018, the Company issued 50,432 shares of common stock upon the
cashless exercise of 59,000 Series A Warrants to purchase shares of
stock for $0.0334 per share based on a current market value of
$0.23 per share as determined under the terms of the Series A
Warrant agreement.
On February 14,
2018, the Company issued 229,515 shares of common stock upon the
cashless exercise of 400,000 Class L Warrants to purchase shares of
stock for $0.08 per share based on a current market value of
$0.1877 per share as determined under the terms of the Class L
Warrant Private Offering agreement.
On March 2, 2018,
the Company issued 407,461 shares of common stock upon the cashless
exercise of 600,000 Class L Warrants to purchase shares of stock
for $0.08 per share based on a current market value of $0.2493 per
share as determined under the terms of the Class L Warrant Private
Offering agreement.
On March 9, 2018,
the Company issued 251,408 shares of common stock upon the cashless
exercise of 271,000 Series A Warrants to purchase shares of stock
for $0.0334 per share based on a current market value of $0.462 per
share as determined under the terms of the Series A Warrant
agreement.
Consulting Agreement
In November 2017,
the Company entered into a three month consulting agreement for
which a portion of the fee for the services was to be paid with
Company common stock. The number of shares to be paid with Company
common stock was calculated by dividing the amount of the fee to be
paid with Company common stock of $4,000 by the Company stock price
at the close of business on the eighth business day of each month.
The Company issued 18,182 shares on January 9, 2018, for the third
month of the agreement. The $4,000 was recorded as a non-cash
general and administrative expense for each of the first two months
of the agreement.
New Agreements
On January 26,
2018, the Company, entered into a Master Equipment Lease with NFS
Leasing Inc. to provide financing for equipment purchases to enable
the Company to begin placing the dermaPACE System in the
marketplace. This agreement provides for a lease line of up to
$1,000,000 with a lease term of 36 months, and grants NFS a
security interest in the Company’s accounts receivable,
personal property and money and deposit accounts of the
Company.
On February 13,
2018, the Company, entered into an Agreement for Purchase and Sale,
Limited Exclusive Distribution and Royalties, and Servicing and
Repairs with Premier Shockwave Wound Care, Inc., a Georgia
Corporation (“PSWC”), and Premier Shockwave, Inc., a
Georgia Corporation (“PS”). The agreement provides for
the purchase by PSWC and PS of dermaPACE System and related
equipment sold by the Company and includes a minimum purchase of
100 units over 3 years. The agreement grants PSWC and PS limited
but exclusive distribution rights to provide dermaPACE Systems to
certain governmental healthcare facilities in exchange for the
payment of certain royalties to the Company. Under the agreement,
the Company is responsible for the servicing and repairs of such
dermaPACE Systems and equipment. The agreement also contains
provisions whereby in the event of a change of control of the
Company (as defined in the agreement), the stockholders of PSWC
have the right and option to cause the Company to purchase all of
the stock of PSWC, and whereby the Company has the right and option
to purchase all issued and outstanding shares of PSWC, in each case
based upon certain defined purchase price provisions and other
terms. The agreement also contains certain transfer restrictions on
the stock of PSWC. Each of PS and PSWC is owned by Anthony Michael
Stolarski, a member of the Company’s board of directors and
an existing shareholder of the Company.