SPECIAL NOTE
REGARDING FORWARD-LOOKING STATEMENTS
This Annual Report
on Form 10-KSB includes forward-looking statements within the
meaning of Section 27A of the United States Securities Act of 1933, as
amended (the Securities Act) and Section 21E of the United States
Securities Exchange Act of 1934, as amended (the Exchange Act). The
forward-looking statements include statements regarding our expectations with
respect to future development plans for our next generation product candidates,
particularly the Levacor TM Rotary VAD, the timing and scope of
pre-clinical testing and clinical trials, our ability to secure additional
funding or the ability to form strategic partnerships, our cost reduction
efforts and their impact on our ability to maintain operations, as well as
other statements that can be identified by the use of forward-looking language,
such as believe, feel, expect, may, will, should, seek, plan, anticipate,
or intend or the negative of those terms, or by discussions of strategy or
intentions. These forward-looking statements involve known and unknown risks,
uncertainties and other factors that may cause our actual results and
performance to be materially different from any future results and performance
expressed or implied by these forward-looking statements. Important factors
that could cause our actual results to differ materially from those expressed
or implied by such forward-looking statements include:
· our
need for additional significant financings in the future;
· costs
and delays associated with clinical trials for our products and next-generation
product candidates, such as Levacor Rotary VAD and Novacor II;
· decisions,
and the timing of decisions, made by health regulatory agencies regarding
approval of our products;
· continued
shift in market demand away from first generation VAD products, resulting in
further reduced sales of our Novacor Ò LVAS (Left
Ventricular Assist System) product;
· continued
slower Destination Therapy adoption rate for VADs;
· limitations
on third-party reimbursements;
· our
ability to obtain and enforce in a timely manner patent and other intellectual
property protection for our technology and products;
· our
ability to avoid, either by product design, licensing arrangement or otherwise,
infringement of third parties intellectual property;
· our
ability to enter into corporate alliances or other strategic relationships
relating to the development and commercialization of our technology and
products;
· loss
of commercial market share to competitors due to our financial condition; and
· other
factors we discuss under the heading RISK FACTORS.
We undertake no obligation
to update publicly or revise any forward-looking statements, whether as a
result of new information, future events or otherwise, except as may be
required under applicable securities laws.
CORPORATE STRUCTURE
Name, Address and
Incorporation
WorldHeart was incorporated by articles of
incorporation under the laws of the Province of Ontario on April 1, 1996. On
December 14, 2005, WorldHeart filed articles of continuance and continued
under the laws of Canada. Our head office is located at 7799 Pardee Lane,
Oakland, California, USA, 94621 and our head office telephone number is 510-563-5000.
We have an office at Cereslaan 34, 5384 VT, Heesch, Netherlands and a research
facility at 4750 Wiley Post Way, Suite 120, Salt Lake City, Utah, USA,
84116. Our registered office is located at 40 Elgin Street, Suite 1400,
Ottawa, Ontario, Canada, K1P 5K6 and our telephone number is (613) 238-2000.
Our articles of
incorporation were amended on June 22, 2000, to create a first series of
1,374,750 preferred shares designated as Cumulative Redeemable Convertible
Preferred Shares, Series A (the Series A Shares), in connection with
the acquisition by WorldHeart of the Novacor division of Edwards Lifesciences
LLC (Edwards). On November 26, 2003, our articles were amended to amend
the rights and privileges of the Series A Shares in connection with the
conversion by Edwards Lifesciences (U.S.) Inc. of its Series A Shares as
part of our financing transaction completed in September 2003. Our
articles were amended again on December 1, 2003, to effect a one common
share for seven common shares share consolidation. WorldHeart filed articles of
continuance on December 14, 2005, associated with the reincorporation
under the laws of Canada from the Province of Ontario. In conjunction with the
continuance, a new by-law was adopted by our directors.
Intercorporate
Relationships
World Heart Inc. is our wholly-owned subsidiary,
incorporated under the laws of the State of Delaware on May 22, 2000. World
Heart Inc. acquired the assets and liabilities of the Novacor division of
Edwards in June 2000, and is responsible for the manufacturing and primary
sales, marketing and support of the Novacor left ventricular assist system
(Novacor LVAS or Novacor) as well as next-generation product development.
World Heart B.V. is our wholly-owned subsidiary,
incorporated under the laws of the Netherlands on March 5, 2004, through
which we carry on sales, sales support and distribution in Europe.
2007262 Ontario Inc.
(2007262), was an associated research and development company of WorldHeart,
incorporated under the laws of the Province of Ontario on November 29,
2001, to carry out specified research and development for us. WorldHeart and
New Generation Biotech (Equity) Fund Inc. (NewGen), an Ontario labour-sponsored
venture capital corporation, each held 100 common shares of 2007262. On January 1,
2006, WorldHeart purchased the 100 common shares of NewGen and became the sole
shareholder of 2007262. 2007262 was dissolved by articles of dissolution on March 5,
2007.
BUSINESS OF
WORLDHEART
The Company
WorldHearts business is focused on the development
and sale of ventricular assist devices (VADs), particularly our Levacor TM Rotary VAD (Levacor VAD or Levacor). VADs are
mechanical assist devices that supplement the circulatory function of the heart
by re-routing blood flow through a mechanical pump allowing for the restoration
of normal blood circulation. WorldHeart believes both pulsatile and rotary
pumps are required to treat the full spectrum of the clinical needs of end and
late-stage heart failure patients and that pulsatile devices are best suited for
end-stage patients with poor ventricular contractility, who require full
support or functional replacement. Alternatively, rotary devices may best meet
the clinical needs of late-stage patients, with some contractility, who require
only partial support or an assist.
VADs are used for treatment of patients with severe
heart failure including primarily patients whose hearts are irreversibly
damaged and cannot be treated effectively by medical or surgical means other
than transplant. Bridge-to-Transplant therapy involves implanting a VAD in a
transplant-eligible patient to maintain or improve the patients health until a
donor heart becomes available. Destination Therapy is the implanting of a VAD
to provide long-term support for a patient not currently eligible for a natural
heart transplant. Bridge-to-Recovery involves use of VADs to restore a patients
cardiac function helping them recover use of their natural heart allowing
removal of the VAD.
We are focused on the development of the Levacor
Rotary VAD, the next-generation rotary device which we acquired as part of our
acquisition of the assets of MedQuest Products, Inc. (MedQuest) in July 2005.
It uses a magnetically-levitated rotor resulting in no moving parts subject to
wear, which is expected to provide multi-year support. The Levacor VAD is in
the clinical development stage with initial human feasibility clinical trials
successfully completed in Europe during 2006. Two hospitals in Canada, Toronto
General Hospital and the University of Ottawa Heart Institute, are currently
approved to implant the Levacor Rotray VAD as a bridge to cardiac transplant
under Health Canadas Therapeutic Product Directorate Special Access Program. WorldHeart
intends to begin feasibility clinical trials in the United States in the fourth
quarter of 2007.
The Novacor LVAS (Novacor), WorldHearts first
generation pulsatile VAD, is commercially available as a Bridge-to-Transplant
in Europe, Japan, the United States and Canada. In Europe, it is also available
as an alternative to transplantation and as a Bridge-to-Recovery to support
patients who may be able to recover the use of their natural heart. WorldHeart is currently supporting medical centers and
patients utilizing Novacor, but not actively marketing the product.
WorldHearts next-generation pulsatile VAD, the
Novacor II, is currently in pre-clinical development. The Novacor II
is being designed as a smaller implantable heart assist device to provide
long-term pulsatile blood flow to patients suffering from heart failure. The first
animal implants of the Novacor II were completed in 2005 and 2006. We
intend to progress the development of the Novacor II after completion of the
Levacor VAD design, contingent on our ability to fund this program.
The pediatric VAD (PVAD)
is a small, magnetically levitated, axial rotary VAD currently under
pre-clinical development. Based on WorldHearts proprietary technology, it is
intended for use in newborns and infants. The PVAD is being developed by a
consortium, including WorldHeart and the University of Pittsburgh, with funding
provided by the National Institutes of Health.
Three-Year History
and Development of WorldHeart
Effective January 1, 2004, we assumed full sales
and support responsibility for the Novacor LVAS worldwide with the exception of
Japan. Edwards was previously our exclusive distributor for the Novacor LVAS in
all countries other than the United States. We continue to distribute the
Novacor LVAS through Edwards in Japan and through other distributors in
selected markets.
On March 18, 2004, our common shares, which had
been delisted from the Nasdaq Global Market (Nasdaq) on October 15, 2002,
were re-listed on Nasdaq under the symbol WHRT.
On April 22, 2004, with the announcement of our
first quarter results, we commenced reporting our results in United States
dollars.
On July 12, 2004, we announced that our first
quarter results would be restated, and on August 12, 2004, we released our
restated quarterly results. Restated revenues for the first quarter decreased
by $1.3 million to $2.2 million, as a result of a decrease in kit
shipments recognized as revenue by 25 kits to a total of 26 kits, which also
increased the net loss for the period.
In July 2004, we announced certain management
changes including the appointment of Jal S. Jassawalla as President
and Chief Executive Officer replacing Roderick M. Bryden who resigned from
those positions and from the board of directors of WorldHeart.
In August 2004, we commenced consolidation of our
operations from Ottawa, Canada to Oakland, California. The consolidation was
substantially completed by June 30, 2005.
On September 16, 2004, we completed the sale of
$13,318,750 of convertible debentures and warrants. The debentures were
convertible, at the option of the holder, into common shares at a conversion
rate of $1.25 per common share until September 15, 2009. The purchasers of
the convertible debentures were also issued a total of 10,655,000 warrants
to purchase common shares at an exercise price of $1.55 per common share
exercisable until September 15, 2009.
On January 31, 2005, we entered into an asset
purchase agreement with MedQuest, as amended by amendment no. 1 dated March 22,
2005, under which we agreed to purchase all of the assets of MedQuest for a
total purchase price of approximately $16.0 million plus the assumption of
certain liabilities of approximately $3.5 million, subject to certain
conditions, including shareholder approval (the MedQuest Acquisition). In
addition, we entered into a purchase agreement with Maverick Venture Management,
LLC (Maverick) to complete a private placement of 8.9 million common shares of
WorldHeart at $1.35 per common share for an aggregate purchase price of
$12 million. The closing of the private placement was contingent on the closing
of the MedQuest Acquisition and other conditions.
On March 22, 2005, WorldHeart announced that it
had ceased to be a foreign private issuer as defined under the Exchange Act
as a result of the consolidation and relocation of its headquarter operations
to Oakland, California.
On July 18, 2005, WorldHeart held its annual and
special meeting of shareholders and received approval from its shareholders for
the MedQuest Acquisition, the issuance of common shares of WorldHeart to
Maverick in the private placement, and a reduction of the exercise price from
$1.55 to $1.00 of certain warrants of WorldHeart in connection with the
conversion of all of the convertible debentures and exercise of all of the
warrants issued in September 2004. Matters related to the WorldHeart
employee stock option plan were also approved, as well as the continuance of
WorldHeart under the Canada Business Corporations Act.
On July 29, 2005, WorldHeart successfully
completed the MedQuest Acquisition, raised approximately $22.7 million in gross
financing proceeds from the private placement with Maverick and the exercise of
all the outstanding warrants, and converted all of its convertible debentures.
At the closing of the transactions, Maverick and the shareholders of MedQuest
held approximately 33% of the common shares of WorldHeart. Maverick was given
the right to nominate up to two designees to WorldHearts Board of Directors so
long as it holds or controls at least 25% of our issued and outstanding common
shares. Upon completion of the acquisition, WorldHeart retained most of
MedQuests employees at its facility in Salt Lake City, Utah, which continues
to serve as the primary development site for our Levacor Rotary VAD product.
On December 15, 2005, we reincorporated in Canada
from the Province of Ontario. In conjunction with our reincorporation in
Canada, Jal S. Jassawalla, President and Chief Executive Officer, was appointed
to the Board of Directors.
On December 21, 2005, the Board of Directors of
WorldHeart approved the accelerated vesting of all outstanding stock options
held by current employees or consultants, except for the options held by the
non-employee members of the Board of Directors.
On March 8, 2006, WorldHeart announced a
successful first in human implant of its next-generation Levacor VAD. The
procedure, performed at St. Lukes Hospital in Thessaloniki, Greece, was the
beginning of the Levacor
VAD feasibility trial. On May 10, 2006, a second successful Levacor
implant was completed at St. Lukes Hospital. Both patients were successfully
weaned from the device and discharged from the hospital in 2006.
On November 13, 2006, we entered into a purchase
agreement with certain new and current investors for a private placement
financing consisting of two tranches. The first tranche of the financing related
to the sale of 11.0 million common shares at $0.25 per share for a total of
$2.75 million in gross proceeds to WorldHeart was closed on November 16,
2006. The second closing for $11.31 million in gross proceeds to WorldHeart, or
45.2 million common shares, took place on December 21, 2006, following
shareholder approval received at our annual and special meeting held on December 20,
2006. Gross proceeds from both tranches of the financing totaled approximately
$14.1 million at a price of $0.25 per common share. In addition, we incurred
placement agent fees equal to 6% of the gross proceeds payable in common shares
totaling approximately 3.4 million common shares. Under the terms of the
transaction, we registered for resale all of the common shares issued in both
tranches of the financing.
On November 14, 2006, we announced a significant
restructuring and realignment of our business operations to better focus on the
development of our next generation Levacor VAD. The restructuring program
reduced manufacturing, selling and administrative costs, primarily associated
with the Novacor LVAS product. The program included a reduction in workforce of
41 persons, primarily at our Oakland, California, and Heesch, Netherlands
locations. The costs attributable to the restructuring recorded during the year
ended December 31, 2006 were $0.6 million consisting of severance costs
and a fixed assets write down. In addition, WorldHeart wrote off $4.6 million
($3.5 million and $1.1 million in the third and fourth quarters of 2006,
respectively) of raw material, in-process and finished goods inventory
associated with the Novacor LVAS product, which management has determined will
not be utilized in future periods.
On December 14, 2006,
we announced that, consistent with the restructuring program and after
discussions with the FDA, we were discontinuing enrollment in our Novacor LVAS
RELIANT Trial. WorldHeart had commenced the RELIANT Trial in 2004 to seek
approval for Novacor for use in Destination Therapy. At this time, we also
announced that two clinical teams from prestigeous medical centers in Canada
completed the technical and clinical training for use of our Levacor Rotary VAD
in Canada.
Our Products
Our current
business is based on several generations of implantable VADs. The current
generation, commercially available product is our Novacor LVAS. Our
development-stage VADs include the Levacor VAD and Novacor II product
candidates. In addition, WorldHeart is developing the PVAD and a Minimally
Invasive VAD (MIVAD) based on PVAD technology. Specifically:
· the
Novacor LVAS is currently commercially available as a Bridge-to-Transplant in
the United States, Canada, Europe and Japan. In Europe, it is also commercially
available for Destination Therapy and as a Bridge-to-Recovery.
· the
Levacor Rotary VAD is a small, fourth-generation, magnetically levitated,
centrifugal, rotary VAD. Two human feasibility clinical trials were
successfully completed in Europe in 2006.
· the
Novacor II is a small, bearingless, next-generation, pulsatile VAD
currently in pre-clinical development. Successful animal experiments were
conducted in July 2005 and August 2006.
· the
PVAD is a small, magnetically levitated, axial rotary VAD currently under
development by a consortium, including WorldHeart, intended for use in infants.
Development is funded by the National Institutes of Health, under a contract
awarded to the University of Pittsburgh.
· WorldHearts Minimally
Invasive VAD design is based on the technology incorporated in the PVAD device
using vascular connections to allow placement through minimally invasive
techniques. It is intended to provide partial circulatory support in patients
at an earlier stage of heart failure than currently used VADs.
The Novacor LVAS
The Novacor LVAS is our commercially available,
implantable, pulsatile VAD, which has been in clinical use for more than 20
years and has been implanted in more than 1,700 patients worldwide. The product
is an electromagnetically-driven pump, about the size of a human heart, that
provides circulatory support for patients with life-threatening heart failure
by taking over part or all of the workload of the left ventricle of the heart. The
Novacor LVAS is self-regulating, responding instantaneously to the recipients
changing heartbeat and circulatory demands.
Novacor sales during 2006 did not meet our growth
targets and, in November 2006, we announced that we would reduce our
commercial efforts on the Novacor to focus our resources on the development of
our Levacor Rotary VAD. WorldHeart will continue to make the Novacor LVAS
available to medical centers and will continue to support current patients on
the device.
WorldHeart commenced an
equivalency clinical trial in the second quarter of 2004 in the United States,
called the RELIANT Trial to seek approval for the Novacor LVAS for use in
Destination Therapy. In conjunction with the above restructuring and our focus
on next-generation technology, we announced in December 2006 that we were
discontinuing the RELIANT Trial.
Next-Generation VAD
Platform
Levacor Rotary VAD
Through the acquisition of MedQuest in July of
2005, we obtained the Levacor Rotary VAD, a fourth-generation, rotary blood
pump intended for a range of circulatory support indications. Unlike the
initial generation of rotary pumps with blood-lubricated bearings, the Levacor
VAD is a compact, bearingless, magnetically-levitated, centrifugal pump with an
impeller that is completely magnetically levitated. Full magnetic levitation
eliminates wear mechanisms within the pump and provides for greater clearances
for more optimized blood flow around the impeller, while eliminating dependence
on the patients blood for suspension. The products levitation technology
employs a unique combination of passive and single-axis active control, resulting
in a system of optimal simplicity.
Having successfully
completed initial human feasibility clinical trials in Europe in 2006, we
expect to conduct additional feasibility use in Canada in the first half of
2007. We intend to start a U.S. feasibility trial late in 2007 and a CE mark
trial in Europe in the first half of 2008, subject to successful initial trial
results and the availability of funding. If clinical testing is successfully
completed and regulatory approvals are obtained, we plan to pursue commercial
approvals in Europe and the United States.
Novacor II VAD
Our next-generation
pulsatile VAD, Novacor II, has been under development as an implantable,
pulsatile VAD designed for a range of circulatory support indications. Novacor II
is expected to be approximately half the size of the Novacor LVAS, with no
mechanical bearings. For the fully implantable configuration, its dual chamber
design eliminates the need for volume compensation and the need for external
venting, and incorporates remote power and monitoring (i.e. across-the-skin
power and data transfer) and an implanted controller/battery. These features
are expected to provide recipients with an enhanced quality of life by allowing
freedom of movement and minimal limitations to their regular activities. It is
magnetically-driven, allowing for simple operation with no wearing elements or
precision
components.
In conjunction with the restructuring, we suspended development of the Novacor
II. Subsequent to the development of the Levacor VAD, we expect to resume the
development and clinical evaluation of the Novacor II, dependent, in part, on
our ability to fund this program.
Research and
Development Expenditures
WorldHearts research and
development expenditures were $9,002,373, $7,388,385 and $5,838,754 in 2006,
2005, and 2004, respectively. Research and development spending for the Levacor
VAD is expected to increase in 2007.
Third-party
Reimbursement for VADs
The United States currently provides for public
reimbursement of VADs used as a Bridge-to-Transplant. In addition, the majority
of private insurance carriers in the United States provide reimbursement for
VAD use. In October 2003, a National Coverage Decision by the Centers for
Medicare & Medicaid Services (CMS) in the United States extended
reimbursement to VADs approved by the U.S. Food and Drug Administration (FDA)
for Destination Therapy. In October 2004, CMS implemented a previously
announced increase in reimbursements for centers implanting VADs resulting in
average domestic reimbursement rates of $130,000 to $140,000. In October 2005,
CMS updated Healthcare Common Procedural Coding System (HCPCS) codes to include
coverage of VADs.
Japan and several
countries in Europe provide reimbursement for VADs. Reimbursements, however,
vary between countries and governmental budget constraints can limit certain
reimbursements.
Application of
Ventricular Assist Devices (VADs) in Patient Care
Current Treatment
Methods for End-Stage Heart Failure
Research is ongoing
for an effective treatment for advanced heart failure. While providing some
benefit, therapies such as medication and transplantation have significant
limitations, and alternative emerging technologies are being investigated. The
following are treatment methods currently being employed for advanced heart
failure:
· Medication . Pharmaceutical drugs are the first line of
defense against heart failure; however, in spite of many advances, drug
therapies continue to be able to provide only limited benefit particularly in
advanced heart failure patients. Drug therapies usually do not treat the
underlying disorder and, thus, can only slow progression of the disease. Moreover,
a significant number of heart failure patients may be resistant to treatment
with drug therapies, and often such therapies have adverse side effects.
· Heart Transplantation . Heart
transplantation is currently the intervention of choice for some patients with
end-stage heart failure. However, the availability of donor organs, as well as
other major limitations, has limited the number of transplants worldwide to
about 4,000 per year and about 2,000 in the United States according to the
American Heart Association. Limited availability of and waiting times for
suitable donor hearts, as well as high costs, have impacted adversly the
utility of heart transplantation.
· Artificial Heart Technology . Both VADs and total
artificial hearts (each a form of mechanical circulatory support) have been
shown to be viable treatments for end-stage heart failure. These devices have
saved thousands of lives during temporary use as a Bridge-to-Transplant and
have selectively been used for Bridge-to-Recovery or as an alternative to
transplantation. Adoption rates for long-term use are continuing to increase,
although at a slower rate than anticipated.
Advantages of VADs
VADs that are either externally placed or implanted
have been demonstrated as being effective in supporting blood circulation in
patients with a failing heart. To date, more than 10,000 patients have been
supported by VADs.
The following
advantages over other treatments generally apply to VADs that are currently
approved and in use, including the Novacor LVAS. Although certain advantages
may not apply in every situation or for all patients, we expect that these
potential advantages will also apply to our Levacor Rotary VAD and the
Novacor II:
· Supply . As a manufactured device,
VADs are generally available as and when needed, including on an emergency
basis, to treat advanced heart failure patients.
· Reduced Hospitalization . Unlike
transplant patients, VAD patients go to surgery without a protracted wait for a
donor organ, and in the case of implantable VADs, patients are generally able
to leave the hospital after a relatively short recovery period, thus
potentially reducing health care costs.
· Improved Patient Health . After VAD
implantation, blood circulation is improved throughout the body and most
patients experience improved levels of health as shown in a number of clinical
studies, including those for the Novacor LVAS.
· Reduction in Medication Use . Unlike
transplants, VADs typically do not cause rejection responses and, as a result,
VAD patients typically do not need the administration of immuno-suppressive
medication. Accordingly, patients are not subject to the risks and costs
associated with long-term administration of these medications.
· Natural Heart Recovery . Unlike total artificial heart
systems, VADs leave the natural heart intact and assist it when it is unable to
provide sufficient cardiac function to maintain blood circulation. Several
patients have been weaned from the Novacor LVAS and the first two Levacor VAD
patients were successfully weaned from the device.
Marketing,
Manufacturing and Distribution Strategy
Since the acquisition of the Novacor division of
Edwards in 2000, WorldHeart has had access to several key medical centers
involved in cardiac transplantation in North America, Europe and Japan. Until November 2006,
we sold directly within the United States through a dedicated sales force. Before
2004, the Novacor LVAS was distributed by Edwards outside the United States. In
January 2004, we assumed full sales and support responsibility for the
Novacor LVAS primarily in Europe but excluding Japan. WorldHeart continues to
distribute its products through Edwards in Japan and through other distributors
in selected markets. Our United States operations have experienced clinical and
technical personnel who support key medical centers, as well as their leading
clinicians and medical staff. Approximately 64% of WorldHearts 2006 revenue
came from sales of the Novacor LVAS in the United States.
WorldHeart manufactures,
distributes and services its commercial product at its Oakland, California
facility. Manufacturing is highly specialized, requiring qualified personnel
and a facility that is compliant with the provisions of the United States
Quality System Regulations and ISO Standards that pertain to the manufacture,
inspection, and distribution of medical devices.
Intellectual
Property
We have been granted six active United States patents
for the Novacor LVAS and its associated subsystems. A subset of these patents
has also been filed and granted in the major European countries, in Canada and
in Japan.
To date, we have been granted two United States
patents and two patent applications are pending for the Novacor II, and
corresponding applications are also pending in Europe, Japan and Canada. The
Transcutaneous Energy Transfer technology licensed to WorldHeart from the
Ottawa Heart Institute, has been patented in the United States, Canada and the
United Kingdom.
WorldHeart holds various patents and licenses to
patents related to the Levacor Rotary VAD and other potential future products.
These licenses are through university research foundations and other
organizations. WorldHeart has ownership and/or exclusive licenses to 11 patents
related to the Levacor implantable blood pump technology. In addition, two
patents related to control of rotary blood pumps are non-exclusively licensed.
Additional patents are pending.
We have a number of trademarks, and we have federally
registered several, including the WORLDHEART logo mark and the NOVACOR mark,
the MEDQUEST mark and the AUTOME mark. Pending applications for registration of
other marks include the HEARTQUEST mark, MAGLEV mark and the LEVACOR mark.
We generally enter into
confidentiality and invention agreements with our employees and consultants,
and control access to and distribution of information related to our technology
and products, documentation and other proprietary information.
License Agreements
Licenses related to the
Levacor Rotary VAD include an exclusive license with the University of Utah on
four issued patents and on which WorldHeart has no future obligations, an
exclusive royalty-based license on four patents with the University of Virginia
and an exclusive royalty-based license with Magnetic Moments, Inc. (d.b.a.
LaunchPoint Technologies) on four issued and pending patents. In addition to
the Levacor VAD product, we hold an exclusive fully paid and royalty-based
license from the University of Pittsburgh on patents related to a right
ventricular assist device (RVAD), and the PVAD. There is also a royalty-based
agreement with The Heart Lung Institute, LLC, which funded early research of
the Levacor VAD.
Competition
Overview
In addition to competing with other less-invasive
therapies for heart failure, our VADs compete with commercially approved VADs
and VADs under development sold by a number of companies. Competition from
medical device companies is intense and may increase. Many of our competitors
have substantially greater financial, technical, manufacturing, distribution
and marketing resources than WorldHeart.
At present, only two companies in North America have
developed implantable, electric VADs approved for commercial sale in the United
States: WorldHeart and Thoratec
Corporation (Thoratec). Thoratec has two pulsatile left ventricular assist
device models of its HeartMate that have been approved in the United States for
commercial sale. One is pneumatically driven (Heartmate IP LVAS), and the other
is electrically driven (HeartMate XVE). The HeartMate XVE has maintained a
dominant market share in the United States.
Thoratec, and other companies such as Abiomed, Inc.
(Abiomed), have VADs that are designed for temporary use but are not typically
implanted in the body. Their pumps are external and are attached to the natural
heart via connecting tubes running through the recipients skin and tissue. Abiomeds
VAD is approved by the FDA for in-hospital use only.
In Europe and certain
other countries outside North America, several companies including Berlin
Heart, Medos Medizentechnik AG, Ventracor Limited, Micromed Inc., Heartware
Limited and Jarvik Heart, Inc. provide VADs.
Future Product
Competition
Pulsatile versus
Rotary Flow (Non-Pulsatile) VADs
We believe that effective
treatment of advanced heart failure will require both pulsatile and rotary
pumps to treat the full spectrum of clinical needs of end- and late-stage heart
failure patients. Further, we believe that pulsatile devices are best suited
for end-stage patients with poor ventricular contractility, who require
functional replacement; while rotary devices are better suited for late-stage
patients, with some left ventricular contractility, who require only partial
support or, assist.
Rotary Flow VADs
There are a number of non-pulsatile, or rotary flow,
VADs in varying stages of development. Thoratec is developing the Heartmate II,
a second generation axial rotary pump which is in advanced clinical development
in the United States. Thoratec recently discontinued development on a
centrifugal pump, called the HeartMate III. Ventracor Limited, an Australian
company, is developing the VentrAssist, a third generation rotary VAD, which is
in clinical development in Australia and the United States. Another Australian
company, HeartWare Limited is in clinical development with a third generation
rotary device, called the HeartWare HVAD. Another rotary device, which had been
undergoing United States clinical trials and is approved for use in Europe, is
the MicroMed DeBakey® VAD being developed by MicroMed Technology, Inc. The
Jarvik 2000 Flowmaker®, developed by Jarvik Heart, is a device at a comparable
state of development similar to the MicroMed VAD. The Incor rotary pump from
Berlin Heart is also approved for use in Europe.
We believe that the
Levacor Rotary VAD is the most technologically advanced, fourth generation,
rotary pump under development. This bearingless, centrifugal,
magnetically-levitated rotor results in a pump with no moving parts subject to
wear, in a small device design to provide patients with multi-year support. We
believe, WorldHeart is currently the only company that has technologies capable
of developing next-generation rotary and pulsatile VAD systems.
Government
Regulations
Overview
Most countries, including
the United States, Canada and countries that comprise the European Community
(EC), require regulatory approval prior to the commercial distribution of
medical devices. In particular, active implantable medical devices generally
are subject to rigorous clinical testing as a condition of approval by the FDA
and by similar authorities in Canada, in the EC and in other countries. The
approval process for our Levacor Rotary VAD and the Novacor II will be expensive and time consuming.
United States
Regulation
In the United States, the FDA regulates the
manufacture, distribution, labeling and promotion of medical devices pursuant
to the United States Federal Food, Drug and Cosmetic Act (FDC Act) and
regulations under the FDC Act. The Novacor LVAS, Levacor Rotary VAD and Novacor
II devices are regulated as Class III medical devices. Human clinical
trials are conducted pursuant to an Investigational Design Exemption (IDE) in
the United States, the results of which must demonstrate, to the satisfaction
of the FDA, the safety and efficacy of the medical device.
Before commercial distribution of our devices is
permitted in the United States, an application for Premarket Approval must be
approved by the FDA.
In addition, any medical
device distributed in the United States is subject to continuing regulation by
the FDA. Products must be manufactured in registered establishments and must be
manufactured in accordance with the Quality System Regulation. Labeling and
promotional activities are subject to scrutiny by the FDA and, in certain
instances, by the Federal Trade Commission. Failure to comply with these
requirements could result in enforcement action, including seizure, injunction,
prosecution, civil penalties, recall and suspension of FDA approval.
Canadian Regulation
The sale and advertising of medical devices in Canada
are governed by the Food and Drugs Act (Canada) through the Medical Devices
Regulations, administered by the Medical Devices Bureau of Health Canada (MDB).
The current Medical Devices Regulations are undergoing revisions that may align
the Canadian regulatory process with those of Canadas international trading
partners. We believe that international harmonization of the regulatory process
will be more likely to accelerate, rather than slow, the approval process as it
relates to WorldHearts next-generation VAD, Levacor Rotary VAD and the Novacor
II.
Our Levacor Rotary VAD and
the Novacor II are expected to be classified as Class IV medical devices
under the Medical Devices Regulations, requiring WorldHeart to apply for
authorization from the MDB to conduct investigational testing on human subjects
in Canada. At the conclusion of the human clinical trials, we plan to apply for
a medical device license that will allow for general marketing of the device.
Regulatory
Requirements in Other Countries
It is also our intention to market the Levacor Rotary
VAD and the Novacor II in the EC and other countries. We will be required to
meet the applicable medical devices standards in each such country or region. Although
harmonization has been under negotiation for some time among various countries,
the approval process varies from country to country and approval in one country
does not necessarily result in approval in another.
We intend to apply for CE
marking, an international symbol of quality and compliance, for the Levacor
Rotary VAD and the Novacor II. The International Standards Organization (ISO)
is a worldwide federation of national bodies, founded in Geneva, Switzerland in
1946. ISO standards are integrated requirements which, when implemented, form
the foundation and framework for an effective quality management system. These standards
were developed and published by the ISO. ISO certification is widely regarded
as essential to enter Western European markets. All companies are required to
obtain ISO certification and the CE mark, in order to market medical devices
in Europe. ISO 13485:2003 certification is the most current and most stringent
standard in the ISO series and covers design, production, installation and
servicing of products. WorldHeart received ISO 13485:2003 certification in September 2005.
WorldHeart received the CE mark for the Novacor LVAS in 1993.
Other Regulatory
Requirements
We are also subject to
various Canadian and United States federal, provincial, state and local laws
and regulations relating to such matters as safe working conditions, laboratory
and manufacturing practices, and the use, handling and disposal of hazardous or
potentially hazardous substances used in connection with WorldHearts research,
development and production work. The manufacture of biomaterials is also
subject to compliance with various federal environmental regulations and those
of various provincial, state and local agencies. Although we believe that we
are in compliance with these laws and regulations in all
material
respects, there can be no assurance that we will not be required to incur
significant cost to comply with environmental and health and safety regulations
in the future.
Our Employees
At March 15, 2007, we had 63 full time employees
located primarily in Oakland, California and in Salt Lake City, Utah. Approximately
78% of our employees are involved with research, development, manufacturing,
quality, clinical affairs and regulatory, and 22% are in finance and
administration.
We currently maintain
compensation, benefits, equity participation and work environment policies
intended to assist in attracting and retaining qualified personnel. We believe
that the success of our business will depend, to a significant extent, on our
ability to attract and retain such personnel. We have access to skilled labor
resources in Oakland and Salt Lake City where there are well-developed
technology industries. None of our employees are subject to a collective
bargaining agreement nor have we experienced any work stoppages.
RISK FACTORS
You should carefully
consider the following risk factors in evaluating WorldHeart. Additional risks
and uncertainties not presently known to us or that we currently consider not
material may also impair our business, financial condition and results of
operations. If any of the events described below actually occurs, our business,
financial condition and results of operations could be materially adversely
affected.
Risk Factors
Relating to Our Business
We will require
significant capital investment to continue our product development programs and
to bring future products and product enhancements to market, and if adequate
funding is not available, our financial condition will be adversely affected
and we may have to further curtail or eliminate our development programs and
significantly reduce our expenses.
Our investment of capital has been and will continue
to be significant. Developing our technology, future products and continued
product enhancements, including those of the Levacor Rotary VAD and Novacor II
technologies, require a commitment of substantial funds to conduct the costly
and time-consuming research and clinical trials necessary for such development
and regulatory approval. We have had difficulties raising the necessary
capital, and while we recently completed a private placement financing raising
gross proceeds of about $14.1 million, we will require additional financings in
the future. If adequate funds are not available when needed, we may be required
to delay, reduce the scope of, or eliminate one or more of our research or
development programs or obtain funds through arrangements with collaborative
partners or others that may require us to relinquish rights to certain of our
technologies, potential products or products that we would otherwise seek to
develop or commercialize ourselves. In addition, while in November 2006 we
announced a significant restructuring and cost reductions initiatives, we may
be required to further reduce our operating expenses, including but not limited
to, reductions in salaries and/or elimination of employees and consultants. The
inability to obtain additional financing or enter into strategic relationships
when needed will have a material adverse effect on our business, financial
condition and results of operations. In addition, our November 2006
restructuring may not result in the cost reductions that we anticipate and our
ability to curtail expenses in the future may be limited.
We have had
substantial losses since incorporation and expect to continue to operate at a
loss while our products are under development, and we may never become
profitable.
Since our inception in 1996, we incurred cumulative
losses of approximately $272 million, a significant portion of which relates to
the costs of internally developed and acquired technologies. Our research and
development expenses have increased significantly over the past year, primarily
due to our investment in
the development programs
for our next generation products, Levacor Rotary VAD and Novacor II. Our
research and development activities will likely result in additional
significant losses in future periods. These expenditures include costs
associated with performing pre-clinical testing and clinical trials for our
next generation products, continuing research and development, seeking
regulatory approvals and, if we receive these approvals, commencing commercial
manufacturing, sales and marketing of our products.
We may be unable to
obtain regulatory approvals, which will prevent us from selling our products
and generating revenue.
Most countries, including the United States, Canada
and countries in Europe, require regulatory approval prior to the commercial
distribution of medical devices. In particular, implanted medical devices
generally are subject to rigorous clinical testing as a condition of approval
by the FDA and by similar authorities in Canada (e.g., Health Canada), and in
European and other countries. The approval process is expensive and time
consuming. Non-compliance with applicable regulatory requirements can result
in, among other things, fines, injunctions, civil penalties, recall or seizure
of products, total or partial suspension of production, government refusal to
grant marketing approval for devices, withdrawal of marketing approvals and
criminal prosecution. The inability to obtain the appropriate regulatory
approvals for our products in the United States, Canada and the rest of the
world will prevent us from selling our products, which would have a material
adverse effect on our business, financial condition and results
of operations.
In the United States, we commenced our RELIANT Trial
in the second quarter of 2004 to support submission of a PMA Supplement to the
FDA for the use of the Novacor LVAS for Destination Therapy. Although in April 2006
we received conditional approval from the FDA to change the trial inclusion
criteria and to reduce the number of patients required for approvability,
enrolment in the RELIANT Trial continued to be slower than anticipated,
primarily due to what we believe to be a shift in market demand away from first
generation VADs, including our Novacor LVAS, and the loss of commercial market share to our competitors
due to our financial condition. As a result, in December 2006 we
discontinued enrollment in the RELIANT Trial to focus our resources on the
next generation products, in particular our Levacor Rotary VAD, which began an
initial human feasibility clinical trial in March 2006 in Europe.
There can be no assurance that the FDA, Health Canada
or any other regulatory authority will act favorably or quickly in its review of
our applications, if and when made, and we may face significant difficulties
and costs obtaining such approvals that could delay or preclude us from selling
our next-generation products in the United States, Europe, Canada and elsewhere.
Failure to receive, or delays in receiving, such approvals, including the need
for extended clinical trials or additional data as a prerequisite to approval,
limitations on the intended use of our next-generation products, the
restriction, suspension or revocation of any approvals obtained or any failure
to comply with approvals obtained could have a material adverse effect on our
business, financial condition and results of operations.
We are dependent on
a limited number of products.
To date, all of our revenues have resulted from sales
of the Novacor LVAS and related technologies. With our restructuring announced
in November 2006, we expect those revenues to continue to decline. Our
future financial performance depends primarily on our ability to realign our
resources to focus on the development, regulatory approval, introduction,
customer acceptance and sales and marketing of the Levacor Rotary VAD. Prior to
any commercial use, our products currently under development will require
significant additional capital for research and development efforts, extensive
pre-clinical and clinical testing and regulatory approval.
New product development is highly uncertain and
unanticipated developments, clinical and regulatory delays, adverse or
unexpected side effects or inadequate therapeutic efficacy could delay or
prevent the commercialization of the Levacor Rotary VAD and Novacor II. Any
significant delays in, or premature
termination of, clinical
trials of our products under development would have a material adverse effect
on our business, financial condition and results of operations.
Market acceptance
of our technologies and products is uncertain and our selling and distribution
capability is limited and has been further reduced by our recent cost reduction
initiatives.
The Novacor LVAS and our next-generation Levacor
Rotary VAD and Novacor II represent ventricular assist technologies that
must compete with other products as well as with other therapies for heart
failure, such as medication, transplants, cardiomyoplasty and total artificial
heart devices. In addition, although we believe that the Destination Therapy
market opportunity for VADs is significant, adoption rates have continued to be
much slower than anticipated.
We have a limited number of sales and technical
support personnel compared with other medical device companies in our industry
segment, and our financial condition recently required us to make significant
personnel reductions in those areas, which may put us at a further competitive
disadvantage in the marketplace. Failure of our products to achieve significant
market acceptance due to competitive therapies and our very limited selling and
distribution could have a material adverse effect on our business, financial
condition and results of operations.
We face significant
competition and technological obsolescence of our products.
In addition to competing with other less-invasive
therapies for heart failure, including medications and pacing technology, our
products, if regulatory approvals are obtained, will compete with ventricular
assist technology being developed and sold by a number of other companies. Competition
from medical device companies and medical device subsidiaries of healthcare and
pharmaceutical companies is intense and expected to increase.
Most of our competitors have financial, technical,
manufacturing, distribution and marketing resources substantially greater than
ours. Third parties may succeed in developing or marketing technologies and
products which are more effective and more timely than those developed or
marketed by us which could render our technology and products non-competitive
or obsolete, or we may not be able to keep pace with technological developments
or our competitors time frames, all of which could have a material adverse
effect on our business, financial condition and results of operations.
In addition, companies in similar businesses are
entering into business combinations with one another, which may create more
powerful or aggressive competitors. We may not be able to compete successfully
as future markets evolve, and we may have to pursue additional acquisitions or
other business combinations or strategic alliances. Increased competitive
pressure could lead to lower sales and prices of our products, and this could
harm our business, results of operations and financial condition.
There are
limitations on third-party reimbursement for the cost of implanting our
devices.
Individual patients will seldom be able to pay
directly for the costs of implanting our devices. Successful commercialization
of our products will depend in large part upon the availability of adequate
reimbursement for the treatment and medical costs from third-party payers,
including governmental and private health insurers and managed care
organizations. Consequently, we expect that our products will typically be
purchased by healthcare providers, clinics, hospitals and other users who will
bill various third-party payers, such as government programs and private
insurance plans, for the healthcare services provided to their patients.
The coverage and the level of payment provided by
third-party payers in the United States and other countries vary according to a
number of factors, including the medical procedure, third-party payer, location
and cost. In the United States, many private payers follow the recommendations
of the Centers of Medicare and Medicaid Services, which establish guidelines
for the governmental coverage of procedures, services and medical equipment.
There can be no assurance with respect to any markets
in which we seek to distribute our products that third-party coverage and
reimbursement will be adequate, that current levels of reimbursement will not
be decreased in the future or that future legislation, regulation or
reimbursement policies of third-party payers will not otherwise adversely
affect the demand for our products or our ability to sell our products on a
profitable basis, particularly if the installed cost of our systems and devices
should be more expensive than competing products or procedures. The
unavailability of third-party payer coverage or the inadequacy of reimbursement
would have a material adverse effect on our business, financial condition and
results of operations.
If we cannot
protect our intellectual property, our business could be adversely affected.
Our intellectual property rights, including those
relating to our Levacor Rotary VAD, are and will continue to be, a critical
component of our success. The loss of critical licenses, patents or trade
secret protection for technologies or know-how relating to our current product
and our products in development could adversely affect our business prospects. Our
business will also depend in part on our ability to defend our existing and
future intellectual property rights and conduct our business activities free of
infringement claims by third parties. We intend to seek additional patents, but
our pending and future patent applications may not be approved, may not give us
a competitive advantage and could be challenged by others. Patent proceedings
in the United States and in other countries may be expensive and time consuming.
In addition, patents issued by foreign countries may afford less protection
than is available under United States intellectual property law, and may not
adequately protect our proprietary information.
Our competitors may independently develop proprietary
non-infringing technologies and processes that are substantially similar to
ours, or design around our patents. In addition, others could develop
technologies or obtain patents, which would render our patents and patent
rights obsolete. Claims by competitors and other third parties that our
products allegedly infringe the patent rights of others could have a material
adverse effect on our business. We could encounter legal and financial
difficulties in enforcing our licenses and patent rights against alleged
infringers. The medical device industry and cardiovascular device market, in
particular, is characterized by frequent and substantial intellectual property
litigation. Intellectual property litigation is complex and expensive and the
outcome of this litigation is difficult to predict. Any future litigation,
regardless of outcome, could result in substantial expense and significant
diversion for our technical and management personnel. An adverse determination
in any such proceeding could subject us to significant liabilities or require
us to seek additional licenses from third parties, pay damages and/or royalties
that may be substantial or force us to redesign the related product. These
alternatives may be uneconomical or impossible. Furthermore, we cannot assure
you that if additional licenses are necessary that they would be available on
satisfactory terms or at all. Accordingly, an adverse determination in a judicial
or administrative proceeding or failure to obtain necessary licenses could
prevent us from manufacturing or selling certain of our products, any of which
could have a material adverse effect on our business, financial condition and
results of operations.
We are exposed to
product liability claims.
Our business exposes us to an inherent risk of
potential product liability claims related to the manufacturing, marketing and
sale of the Novacor LVAS, and if and when regulatory approvals are received, the
Levacor Rotary VAD and the Novacor II, by device recipients in whom the
devices are implanted or by their families. Claims of this nature, if
successful, could result in substantial damage awards to the claimants, which
may exceed the limits of any applicable insurance coverage held by us. A
successful claim brought against us in excess of, or outside of, our insurance
coverage would have a material adverse effect on our financial condition. Claims
against us, regardless of their merit or potential outcome, could also have a
material adverse effect on our ability to obtain physician endorsement of our
products, to expand our business or obtain insurance in the future, which could
have a material adverse effect on our business and results of operations.
We face risks
associated with our manufacturing operations, risks resulting from dependence
on third-party manufacturers, and risks related to dependence on sole
suppliers.
The manufacture of our products is a complex operation
involving a number of separate processes and components. Material costs are
high and certain of the manufacturing processes involved are labor-intensive. The
conduct of manufacturing operations is subject to numerous risks, including
reliance on third-party manufacturers, unanticipated technological problems and
delays. We, or any entity manufacturing products or components on our behalf,
may not be able to comply with applicable governmental regulations or satisfy
regulatory inspections in connection with the manufacture of our products,
which would have a material adverse effect on our business, financial condition
and results of operations.
We often depend on single-source third-party
manufacturers for several of the components used in our products. We do not
have agreements with many of such single-source manufacturers and purchase
these components pursuant to purchase orders placed from time to time in the
ordinary course of business. We are substantially dependent on the ability of
these manufacturers to provide adequate inventories of these components on a
timely basis and on favorable terms. These manufacturers also produce
components for certain of our competitors, as well as other large customers,
and there can be no assurance that such manufacturers will have sufficient
production capacity to satisfy our inventory or scheduling requirements during
any period of sustained demand, or that we will not be subject to the risk of
price fluctuations and periodic delays. Although we believe that our
relationships with our manufacturers are satisfactory and that alternative
sources for the components we currently purchase from single-source suppliers
are currently available, the loss of the services of such manufacturers or
substantial price increases imposed by such manufacturers, in the absence of
readily available alternative sources of supply, would have a material adverse
effect on us. Failure or delay by such manufacturers in supplying components to
us on favorable terms could also adversely affect our operating margins and our
ability to develop and deliver our products on a timely and competitive basis,
which could have a material adverse effect on our business, financial condition
and results of operations.
We are dependent on
key personnel.
As a result of the
specialized scientific nature of our business, we are dependent on our ability
to attract and retain qualified scientific, technical and key management
personnel. We face intense competition for such persons and we may not be able
to attract or retain such individuals. Our recent restructuring and cost
reduction efforts may make it even more difficult for us to attract and retain
qualified personnel.
Risk Factors
Relating to Our Common Shares
The price of our
shares is highly volatile, and if we do not regain compliance with Nasdaq
minimum share price requirements, we may be delisted.
As a small capitalization medical device company, the
price of our common shares has been, and is likely to continue to be, highly
volatile. Future announcements concerning us or our competitors, quarterly
variations in operating results, introduction of new products, delays in the
introduction of new products or changes in product pricing policies by us or
our competitors, acquisition or loss of significant customers, partners,
distributors and suppliers, changes in earnings estimates or our ratings by
analysts, regulatory developments, or fluctuations in the economy or general
market conditions, among other factors, could cause the market price of our
common shares to fluctuate substantially. There can be no assurance that the
market price of our common shares will not decline below its current price or
that it will not experience significant fluctuations in the future, including
fluctuations that are unrelated to our performance.
Currently our common shares are quoted on the Nasdaq
Capital Market under the symbol WHRT and listed on the Toronto Stock Exchange
(TSX) under the symbol WHT. We must
satisfy certain minimum listing maintenance requirements to maintain the Nasdaq
quotation, including a series of financial tests relating to shareholders
equity or net income or market value, public float, number of market makers and
shareholders, market capitalization, and maintaining a minimum bid price of
$1.00 per share.
On June 20, 2006 we received a letter from Nasdaq
Global Market, where our shares were listed at the time, indicating that, for
30 consecutive business days, the bid price of our common shares had closed
below the minimum $1.00 per share requirement for continued listing on Nasdaq
and that, in accordance with Nasdaq rules, we had 180 calendar days (until December 18,
2006) to regain compliance. On November 20, 2006, we received a letter
from the Nasdaq Global Market indicating that our shareholders equity did not
comply with the minimum $10,000,000 requirement for continued listing on the
Nasdaq Global Market. On December 5, 2006, we announced that we applied
for transfer of the listing of our common shares to the Nasdaq Capital Market,
which transfer was effective on December 13, 2006.
As part of the transfer to the Nasdaq Capital Market,
we have been granted an additional 180-day period, or until June 15,
2007, to regain compliance with the minimum bid price rules. If we do not
regain compliance within the allotted compliance period, our common shares may
be delisted from Nasdaq. At that time, we would be entitled to appeal the staffs
determination to a Nasdaq Listing Qualifications Panel. If the common shares
were to be delisted, they would trade on the Over-the-Counter Bulletin Board or
in the pink sheets maintained by the National Quotation Bureau, Inc.,
which are viewed by most investors as less desirable and less liquid market
places. This could make trading more difficult for our investors, leading to
lower trading volumes and declines in share price, which would also make it
more difficult and expensive for us to raise additional capital.
Our Board of Directors believes that a reverse stock
split may be the most effective means of avoiding delisting of our common
shares from the Nasdaq Capital Market, and therefore has unanimously approved
an amendment to our articles that would permit the Board, in its sole
discretion, to effect a reverse stock split of our outstanding common shares in
an exchange ratio ranging from two-to-one to ten-to-one. The discretionary
authority to allow our Board of Directors to amend our articles was approved by
our shareholders at our Annual and Special Meeting of Shareholders held on December 20,
2006. The reverse stock split, if effected, may not result in our regaining
compliance with Nasdaq rules.
The sales of common
shares by our shareholders could depress the price of our common shares.
If our shareholders sell substantial amounts of our
common shares in the public market, the market price of our common shares could
fall. These sales might also make it more difficult for us to sell equity or
equity related securities at a time and price that we would deem appropriate. All
of the common shares we issued in the private placement during the fourth
quarter of 2006 have been registered pursuant to a resale registration
statement. We have also previously registered for resale shares issued in
connection with the MedQuest acquisition and a related private placement
completed in 2005. Sales by these shareholders could have an adverse impact on
the trading price of our common shares.
The concentration
of our capital stock ownership, following the completion of the recent private
placement, may limit your ability to influence corporate matters.
Our common shares are held by a relatively small
number of investors. After the completion of our $14.1 million private
placement financing in December 2006, our two largest shareholders
collectively beneficially own approximately 52% of our common shares. These
investors also have certain rights to designate members of our Board of
Directors and may exercise significant influence over all matters requiring
shareholder approval, including elections of directors and significant
corporate transactions, such as a merger or other sale of our Company or our
assets for the foreseeable future. This concentrated
control may limit your
ability to influence corporate matters, and, as a result, we may take actions
that our shareholders do not view as beneficial.
Because we do not
intend to pay, and have not paid, any cash dividends on our common shares, our
shareholders will not be able to receive a return on their common shares unless
the value of our common shares appreciates and they sell them.
We have never paid any
cash dividends on our common shares and intent to retain future earnings, if
any, to finance the development and expansion of our business. We do not
anticipate paying any cash dividends on our common shares in the foreseeable
future. As a result, our shareholders will not be able to receive a return on
their common shares unless the value of our common shares appreciates and they
sell them.
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Research Report
Description
Level 2 quotes
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Balance Sheet
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Insiders
SEC Filings
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Historical Prices
Recent Material Events
Key executives
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