As filed with the Securities and Exchange Commission on
February 13, 2007
Registration
No.
333-
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington D.C. 20549
Form
S-1
REGISTRATION STATEMENT
UNDER
THE SECURITIES ACT OF 1933
BIOHEART, INC.
(Exact name of Registrant as specified in its Charter)
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Florida
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8731
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65-0945967
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(State or other jurisdiction of
incorporation or organization)
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(Primary Standard Industrial
Classification Code Number)
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(I.R.S. Employer
Identification Number)
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13794 NW 4th Street, Suite 212
Sunrise, Florida 33325
(954) 835-1500
(Address, including zip code, and telephone number,
including area code, of registrants principal executive
offices)
Howard J. Leonhardt
Chief Executive Officer
Bioheart, Inc.
13794 NW 4th Street, Suite 212
Sunrise, Florida 33325
(954) 835-1500
(Name, address, including zip code, and telephone number,
including area code, of Agent for Service)
Copies to:
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David E. Wells, Esq.
Hunton & Williams LLP
1111 Brickell Avenue, Suite 2500
Miami, Florida 33131
(305) 810-2500
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James A. Lebovitz, Esq.
Dechert LLP
2929 Arch Street
Philadelphia, Pennsylvania 19104
(215) 994-4000
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Approximate Date of Commencement of Proposed Sale to the
Public:
As soon as practicable after the effective date of
this Registration Statement.
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.
o
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.
o
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.
o
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.
o
CALCULATION OF REGISTRATION FEE
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Proposed Maximum
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Title of Each Class of
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Aggregate
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Amount of
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Securities to be Registered
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Offering Price(1)
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Registration Fee
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Common stock, par value $0.001 per share
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$35,000,000
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$3,745
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(1)
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Estimated solely for the purpose of calculating the registration
fee in accordance with Rule 457(o) under the Securities Act.
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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 Securities
and Exchange Commission, acting pursuant to said
Section 8(a), may determine.
The information
in this preliminary prospectus is not complete and may be
changed. These securities may not be sold until the registration
statement filed with the Securities and Exchange Commission is
effective. This preliminary prospectus is not an offer to sell
nor does it seek an offer to buy these securities in any
jurisdiction where the offer or sale is not
permitted.
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Prospectus
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Subject to Completion, dated February 13, 2007
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Shares
Common Stock
,
2007
This is our initial public offering of shares of our common
stock.
We are
offering shares
of common stock to be sold in this offering.
Prior to this offering, there has been no public market for the
shares of common stock. We currently expect that the initial
public offering price per share will be between
$ and
$ .
We plan to apply to list our common stock on the NASDAQ Global
Market under the symbol BHRT.
Neither the Securities and Exchange Commission nor any other
regulatory body has approved or disapproved of these securities
or passed upon the accuracy or adequacy of this prospectus. Any
representation to the contrary is a criminal offense.
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Per Share
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Total
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Initial public offering price
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$
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$
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Underwriting discount
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$
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$
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Proceeds, before expenses, to Bioheart, Inc.
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$
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$
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To the extent that the underwriters sell more
than shares
of common stock, the underwriters have the option to purchase up
to an
additional shares
of common stock from Bioheart, Inc. at the initial public
offering price less the underwriting discount.
The underwriters expect to deliver the common shares against
payment in New York, New York
on ,
2007.
Investing in our common stock involves risks. See Risk
Factors beginning on page 7.
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BMO Capital Markets
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Janney Montgomery Scott LLC
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Sole Book-Running Manager
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Co-Lead Manager
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Merriman Curhan Ford & Co.
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TABLE OF CONTENTS
Through and
including ,
2007 (the 25th day after the date of this prospectus), all
dealers effecting transactions in these securities, whether or
not participating in this offering, may be required to deliver a
prospectus. This is in addition to a dealers obligation to
deliver a prospectus when acting as an underwriter and with
respect to an unsold allotment or subscription.
You should rely only on the information contained in this
prospectus. We have not authorized anyone to provide you with
information different from that contained in this prospectus. We
are offering to sell, and seeking offers to buy, shares of our
common stock only in jurisdictions where offers and sales are
permitted. The information contained in this prospectus is
accurate only as of the date of this prospectus, regardless of
the time of delivery of this prospectus or of any sale of our
common stock. In this prospectus, unless otherwise stated or the
context otherwise requires, references to Bioheart,
we, us, our company, and
similar references refer to the consolidated operations of
Bioheart, Inc. and its subsidiaries.
For investors outside of the United States: Neither we nor
any of the underwriters have done anything that would permit
this offering or possession or distribution of this prospectus
in any jurisdiction where action for that purpose is required,
other than in the United States. Persons outside the United
States who come into possession of this prospectus must inform
themselves about, and observe any restrictions relating to, the
offering of the shares of common stock and the distribution of
this prospectus outside of the United States.
PROSPECTUS SUMMARY
This summary highlights selected information described more
fully elsewhere in this prospectus. This summary may not contain
all the information that is important to you. Before investing
in our common stock, you should read the entire prospectus,
including Risk Factors, Special
Note Regarding Forward-Looking Statements and our
consolidated financial statements and related notes. The
consolidated financial statements and related notes included in
this prospectus have been prepared in accordance with accounting
principles generally accepted in the United States. Unless
otherwise stated, all figures assume no exercise of the
underwriters option to purchase additional common
shares.
Our Business
We are a biotechnology company focused on the discovery,
development and commercialization of therapies using cells
derived from a patients body, and related devices, for the
treatment of heart damage. Our lead product candidate is
MyoCell, an innovative clinical therapy designed to populate
regions of scar tissue within a patients heart with living
muscle tissue for the purpose of improving cardiac function. The
core technology used in MyoCell has been the subject of human
clinical trials involving 90 enrollees and 62 treated patients
to date, conducted over the last seven years, and animal studies
conducted over the last 18 years. Our most recent clinical
trials of MyoCell include the SEISMIC Trial, a fully enrolled
46 patient Phase II clinical trial in various
countries in Europe and the MYOHEART Trial, a completed
20 patient Phase I dose escalation trial in the United
States. Interim results of the SEISMIC Trial were recently
announced and we have submitted to the U.S. Food and Drug
Administration, or the FDA, the protocol for a 450 patient,
multicenter Phase II trial of MyoCell in the United States,
or the MYOHEART II Trial. We have designed the
MYOHEART II Trial so that upon approval of the protocol, if
any, we anticipate asking the FDA to consider it a pivotal
trial. The SEISMIC Trial and the MYOHEART II Trial have
been designed to test the safety and efficacy of MyoCell in
treating severe non-acute damage to the heart in patients in
Class II or Class III heart failure according to the
New York Heart Association, or NYHA, heart failure
classification system.
MyoCell
We believe that MyoCell has the potential to become a leading
non-acute treatment for severe damage to the heart due to its
perceived ability to satisfy, at least in part, what we believe
to be a presently unmet demand for more effective and/or more
affordable non-acute therapies for heart damage. MyoCell is a
non-acute clinical therapy intended to improve cardiac function
and designed to be utilized months or even years after a patient
has suffered severe heart damage due to a heart attack or other
cause. MyoCell uses myoblasts, cells that are precursors to
muscle cells, from the patients own body. When injected
into scar tissue within the heart wall, myoblasts have shown to
be capable of engrafting in the surrounding tissue and
differentiating into mature skeletal muscle cells and/or cells
which exhibit properties of both skeletal and cardiac muscle
cells. As part of the MyoCell therapy, myoblasts are removed
from a patients thigh muscle, isolated, grown through our
proprietary cell culturing process, and injected directly in the
scar tissue of a patients heart. We anticipate that an
interventional cardiologist will perform the minimally invasive
cell injection process with MyoCath, our proprietary catheter,
or a similarly designed endoventricular catheter. By using
myoblasts obtained from a patients own body, we believe
MyoCell is able to avoid certain challenges currently faced by
other types of cell-based clinical therapies including tissue
rejection and instances of the cells differentiating into cells
other than muscle. Although a number of therapies have proven to
improve the cardiac function of a damaged heart, no currently
available treatment has demonstrated an ability to generate new
muscle tissue within the scarred regions of a heart.
Interim data from the MYOHEART Trial and the SEISMIC Trial were
presented by the lead investigator of each trial in January 2007
at the Third Annual International Conference on Cell Therapy for
Cardiovascular Diseases. The purpose of each trial is to assess
the safety and efficacy of MyoCell delivered via MyoCath. The
lead investigator for the MYOHEART Trial presented one-month
safety data for all 20 of the treated patients, and three and
six-month interim data for 16 of the 20 treated patients.
Although not statistically significant due, in part, to the
small number of patients treated, the lead investigator
indicated that
1
the safety of MyoCell is strongly suggested and the preliminary
efficacy data demonstrated a trend towards an improvement in
scores for six-minute walk distance, or Six-Minute Walk
Distance, and quality of life, or Quality of Life. The lead
investigator for the SEISMIC Trial presented data for 16 treated
patients and nine control group patients for which at least
one-month
follow-up
data was available. He reported on three efficacy endpoints:
Six-Minute Walk Distance scores, NYHA Class and left ventricular
ejection fraction, or LVEF. The SEISMIC Trials lead
investigator noted that the preliminary efficacy trends appear
encouraging and that the interim analysis suggests that the most
frequent adverse event, irregular heartbeats, appears to be
manageable with close observation and prophylactic use of
implantable cardioverter defibrillators, or ICDs, and
anti-arrhythmic drug therapy.
If the final six-month SEISMIC Trial data is generally
consistent with the interim data, we intend to seek approval in
the fourth quarter of 2007 from various European regulatory
bodies to market MyoCell to treat the subclass of patients who
would meet the eligibility criteria for participation in the
SEISMIC Trial and who have an expected annual mortality rate of
20% (i.e., generally the sickest 30% of NYHA Class III
heart failure patients), or the Class III Subgroup.
Assuming FDA approval of the protocol for the MYOHEART II
Trial, we intend to seek to enroll and treat all of the clinical
patients in the trial by the end of the second quarter of 2008.
If we meet that enrollment timeline, we would expect final trial
results in the first quarter of 2009. If the final safety and
efficacy results provide what we believe is significant proof
that MyoCell is safe and effective, we anticipate submitting
such data to the FDA to obtain regulatory approval of MyoCell.
In addition to studies we have sponsored, we understand that
myoblast-based clinical therapies have been the subject of at
least eleven clinical trials involving more than 325 enrollees,
including at least 200 treated patients. Although we believe
many of the trials are different from the trials sponsored by us
in a number of important respects, it is our view that the
trials have advanced the cell therapy industrys
understanding of the potential opportunities and limitations of
myoblast-based therapies.
We believe the market for treating patients in NYHA
Class II or NYHA Class III heart failure is
significant. According to the American Heart Association Heart
Disease Statistics 2007 Update, in the United States
alone there are approximately 5.2 million patients with
heart failure. We believe that approximately 60% of these
patients are in either NYHA Class II or NYHA Class III
heart failure.
Our Business Strategy
Our principal objective is to become a leading company that
discovers, develops and commercializes novel, autologous
(patient-derived) cell-based therapies and related devices, for
the treatment of heart damage. To achieve this objective, we
plan to pursue the following key strategies:
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seek to successfully commercialize our lead product candidate,
MyoCell;
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develop our sales and marketing capabilities in advance of
regulatory approval, if any;
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continue to refine our MyoCell cell culturing processes to
further reduce our costs and processing times;
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expand and enhance our intellectual property rights; and
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license, acquire and/or develop complementary products and
technologies.
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Pipeline
In addition to MyoCell, we are seeking to develop various other
cell-based therapies and related devices for the treatment of
heart damage. We have also acquired the rights to use certain
devices for the treatment of heart damage. The development of
the product candidates described below is not dependent on our
commercial development of MyoCell.
2
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MyoCath
(Phase II clinical
trials)
Disposable endoventricular catheter used
for the delivery of biologic solutions to the myocardium.
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TGI 100 Wound Dressing Kit
(510(k) application
submitted to FDA, European CE Mark expected to be sought in the
first half of 2007)
Convenience kit used to
prepare a cellulose coated wound dressing from patient-derived
fat cells to be prepared and applied at the
point-of
-care. We have
the right to use the technology incorporated in this device for
the treatment of acute myocardial infarction, or MI, commonly
known as a heart attack, and heart failure.
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TGI 1200 Adipose Tissue Processing System
(510(k) and CE Mark certification expected to be
sought in the first half of 2007)
Fully
automated device for the rapid processing of patient derived fat
tissue. We have the right to use for the treatment of acute MI
and heart failure.
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Bioheart Acute Cell Therapy
(expect to commence
animal studies in the first quarter of 2007)
Patient derived cell therapy for the treatment of acute MI using
cells processed by the TGI 100 or TGI 1200.
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MyoCell II with SDF-1
(preparing IND
application)
Non-acute, autologous, cell therapy
treatment for heart damage; myoblasts are modified to express
SDF-1 protein in an effort to stimulate angiogenesis and/or
recruitment of stem cells.
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MyoCath II
(anticipate commencing animal
studies by the second quarter of 2007)
Second
generation disposable endoventricular catheter modified to
provide multidirectional cell injection and used for the
delivery of biologic solutions to the myocardium.
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BioPace
(preclinical)
Non-acute
treatment of abnormal heart rhythm due to electrical
disturbances in the upper chambers of the heart.
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Risk Factors
We face numerous risks that could materially affect our
business, results of operations or financial condition. For
further discussion of these risks see Risk Factors.
Our Corporate Information
We were incorporated in the state of Florida in August 1999. Our
principal executive offices are located at 13794 NW
4th Street, Suite 212, Sunrise, Florida 33325 and our
telephone number is (954) 835-1500. Information about our
company is available on our corporate web site at
www.bioheartinc.com.
Information contained on our web
site does not constitute part of, and is not incorporated by
reference in, this prospectus.
MyoCell
®
,
MyoCath
®
,
MyoCell II with
SDF-1
tm
,
MyoCath II
tm
and
BioPace
tm
are trademarks of Bioheart, Inc. TGI
100
tm
and TGI
1200
tm
are trademarks of Tissue Genesis, Inc. This prospectus also
includes trademarks, trade names and service marks of other
companies. Use or display by us of other parties
trademarks, trade names or service marks is not intended to and
does not imply a relationship with, or endorsement or
sponsorship of us by, these other parties.
This prospectus contains market data and industry forecasts that
were obtained from industry publications, third-party market
research and publicly available information. These publications
generally state that the information contained therein has been
obtained from sources believed to be reliable, but the accuracy
and completeness of such information is not guaranteed. While we
believe the information from these publications is reliable, we
have not independently verified, and make no representation as
to the accuracy of, such information.
3
THE OFFERING
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Issuer
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Bioheart, Inc.
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Common stock offered by us
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shares
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Common stock to be outstanding after this offering
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shares
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Offering price
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$
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Over-allotment option
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shares
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Use of proceeds
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We estimate that the net proceeds from this offering will be
approximately
$ million,
or approximately
$ million
if the underwriters exercise their over- allotment option in
full, assuming an initial public offering price of
$ per
share, which is the midpoint of the price range listed on the
cover page of this prospectus, after deducting estimated
underwriting discounts and commissions and offering expenses
payable by us. We expect to use the net proceeds from this
offering:
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to fund the MYOHEART II and SEISMIC Trials;
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for projected payments pursuant to our license
agreements and to further develop and protect our intellectual
property portfolio;
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to fund the further development and clinical testing
of our pipeline product candidates; and
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for other general corporate purposes.
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See Use of Proceeds.
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Dividend policy
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We have not declared or paid any cash dividends on our capital
stock and do not anticipate paying any cash dividends in the
foreseeable future. See Dividend Policy and
Description of Capital Stock.
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Proposed NASDAQ Global Market symbol
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BHRT
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Risk factors
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You should carefully read and consider the information set forth
under Risk Factors and all other information set
forth in this prospectus before investing in our common stock.
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Except as otherwise noted, the number of shares of our common
stock to be outstanding after this offering
excludes shares
reserved for future issuance under our Officers and Employees
Stock Option Plan and our Directors and Consultants Stock Option
Plan.
Unless otherwise indicated, all information contained in this
prospectus assumes:
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that the underwriters do not exercise their option to purchase
up
to additional
shares of our common stock to cover over-allotments, if any;
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the amendment and restatement of our Articles of Incorporation,
which will become effective at the closing of this
offering; and
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that none of the estimated offering expenses payable by us at
the closing of this offering have been paid.
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4
SUMMARY CONSOLIDATED FINANCIAL DATA
The following summary consolidated financial data should be read
in conjunction with Managements Discussion and
Analysis of Financial Condition and Results of Operations
and our financial statements and related notes that are included
elsewhere in this prospectus. We derived the summary
consolidated statement of operations data for the years ended
December 31, 2003, 2004 and 2005 from our audited financial
statements and notes thereto that are included elsewhere in this
prospectus. We derived the summary consolidated statement of
operations data for the years ended December 31, 2001 and
2002 from our audited financial statements that do not appear in
this prospectus. We derived the consolidated statement of
operations data for the nine months ended September 30,
2005 and 2006 and the consolidated balance sheet data as of
September 30, 2006 from our unaudited financial statements
that are included elsewhere in this prospectus. The unaudited
interim financial statements have been prepared on the same
basis as our audited annual financial statements and, in our
opinion, reflect all adjustments, which include only normal
recurring adjustments, necessary to present fairly the results
of operations for the periods ended September 30, 2005 and
2006 and our financial condition as of September 30, 2006.
The historical results are not necessarily indicative of the
results to be expected for any future periods and the results
for the nine months ended September 30, 2006 should not be
considered indicative of results expected for the full fiscal
year.
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Nine Months Ended
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Year Ended December 31,
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September 30,
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2001
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2002
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2003
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2004
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2005
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2005
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2006
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(Unaudited)
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(In thousands, except per share data)
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Statement of Operations Data:
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Revenues
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$
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25
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$
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2
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$
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46
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$
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86
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$
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135
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$
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127
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$
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106
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Cost of sales
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30
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46
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87
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75
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63
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Gross profit
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25
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2
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16
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40
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48
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52
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43
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Expenses:
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Research and development
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6,597
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7,361
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3,502
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3,787
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4,534
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3,142
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5,339
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Marketing, general and administrative
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1,714
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1,946
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2,523
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1,731
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2,831
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2,111
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5,680
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Depreciation and amortization
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31
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34
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46
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33
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46
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Total expenses
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8,311
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9,307
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6,056
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5,552
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7,411
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|
5,286
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|
11,065
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Loss from operations
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(8,286
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)
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(9,305
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)
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(6,040
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)
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(5,512
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)
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(7,363
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)
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(5,234
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)
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|
|
(11,022
|
)
|
|
Total interest income (expense), net
|
|
|
113
|
|
|
|
47
|
|
|
|
2
|
|
|
|
(7
|
)
|
|
|
36
|
|
|
|
9
|
|
|
|
78
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net loss before income taxes
|
|
|
(8,173
|
)
|
|
|
(9,258
|
)
|
|
|
(6,038
|
)
|
|
|
(5,519
|
)
|
|
|
(7,327
|
)
|
|
|
(5,225
|
)
|
|
|
(10,944
|
)
|
Income taxes
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net loss
|
|
$
|
(8,173
|
)
|
|
$
|
(9,258
|
)
|
|
$
|
(6,038
|
)
|
|
$
|
(5,519
|
)
|
|
$
|
(7,327
|
)
|
|
$
|
(5,225
|
)
|
|
$
|
(10,944
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Basic and diluted net loss per share
|
|
$
|
(0.94
|
)
|
|
$
|
(0.95
|
)
|
|
$
|
(0.46
|
)
|
|
$
|
(0.37
|
)
|
|
$
|
(0.42
|
)
|
|
$
|
(0.31
|
)
|
|
$
|
(0.57
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted average shares outstanding basic and diluted
|
|
|
8,707
|
|
|
|
9,724
|
|
|
|
12,985
|
|
|
|
14,875
|
|
|
|
17,244
|
|
|
|
16,681
|
|
|
|
19,057
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
5
The following table presents a summary of our consolidated
balance sheet as of September 30, 2006:
|
|
|
|
|
on an actual basis;
|
|
|
|
on a pro forma basis to give effect to our issuance of
766,216 shares of our common stock between October 1,
2006 and January 31, 2007 for aggregate net proceeds of
approximately $3.6 million in a private placement to
accredited investors; and
|
|
|
|
on a pro forma as adjusted basis to give effect to the sale by
us of shares of our common stock at an assumed initial public
offering price of
$ per
share, the mid-point of the range set forth on the cover page of
this prospectus, and the receipt of net proceeds of this
offering, after deducting underwriting discounts and commissions
and estimated offering expenses payable by us. Each $1.00
increase (decrease) in the assumed initial public offering price
of
$ per
share would increase (decrease) each of cash and cash
equivalents, working capital, total assets and total
shareholders equity by approximately
$ million,
assuming that the number of shares offered by us, as set forth
on the cover page of this prospectus, remains the same, and
after deducting estimated underwriting discounts and commissions
and estimated offering expenses payable by us.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
As of September 30, 2006
|
|
|
|
|
|
|
|
|
|
Pro forma
|
|
|
|
Actual
|
|
|
Pro forma
|
|
|
as adjusted
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Unaudited)
|
|
|
|
|
|
|
|
(In thousands)
|
|
|
|
Consolidated Balance Sheet Data:
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash and cash equivalents
|
|
$
|
5,183
|
|
|
$
|
8,813
|
|
|
$
|
|
|
Working capital
|
|
|
2,769
|
|
|
|
6,399
|
|
|
|
|
|
Total assets
|
|
|
6,227
|
|
|
|
9,857
|
|
|
|
|
|
Long-term debt, less current portion
|
|
|
|
|
|
|
|
|
|
|
|
|
Deficit accumulated during the development stage
|
|
|
(62,276
|
)
|
|
|
(62,276
|
)
|
|
|
|
|
Total shareholders equity
|
|
|
3,416
|
|
|
|
7,046
|
|
|
|
|
|
6
RISK FACTORS
Investing in our common stock involves a high degree of risk.
You should carefully consider the risks and uncertainties
described below together with all of the other information
included in this prospectus, including the financial statements
and related notes appearing at the end of this prospectus before
deciding to invest in our common stock. If any of the following
risks actually occur they would harm our business, prospects,
financial condition and results of operations, possibly
materially. In this event, the market price of our common stock
could decline and you could lose part or all of your investment.
Please read Special Note Regarding Forward-Looking
Statements.
Risks Related to Our Financial Position and Potential Need
for Additional Financing
We are a development stage life sciences company with a
limited operating history and a history of net losses and
negative cash flows from operations. We may never be profitable,
and if we incur operating losses and generate negative cash
flows from operations for longer than expected, we may be unable
to continue operations.
We are a development stage life sciences company and have a
limited operating history, limited capital, limited sources of
revenue and have incurred losses since inception. Our operations
to date have been limited to organizing our company, developing
and engaging in clinical trials of our lead product candidate,
MyoCell, and our MyoCath product candidate, expanding our
pipeline of complementary product candidates through internal
development and third party licenses, expanding and
strengthening our intellectual property position through
internal programs and third party licenses and recruiting
management, research and clinical personnel. Consequently, you
may have difficulty in predicting our future success or
viability due to our lack of operating history. As of
September 30, 2006, we have accumulated a deficit during
our development stage of approximately $62.3 million. Our
lead product candidate has not generated any material revenues
and is not expected to generate any material revenues until late
2008 or early 2009. We have generated substantial net losses and
negative cash flows from operations since inception and
anticipate incurring significant and increasing net losses and
negative cash flows from operations for the foreseeable future
as we:
|
|
|
|
|
continue the SEISMIC Trial and commence the MYOHEART II
Trial;
|
|
|
|
continue research and development and undertake new clinical
trials with respect to our pipeline product candidates;
|
|
|
|
apply for regulatory approvals;
|
|
|
|
make capital expenditures to increase our research and
development and cell culturing capabilities;
|
|
|
|
add operational, financial and management information systems
and personnel and develop and protect our intellectual property;
|
|
|
|
make payments pursuant to license agreements upon achievement of
certain milestones; and
|
|
|
|
establish sales and marketing capabilities to commercialize
products for which we obtain regulatory approval, if any.
|
Our limited experience in conducting and managing preclinical
development activities, clinical trials and the application
process necessary to obtain regulatory approvals might prevent
us from successfully designing or implementing a preclinical
study or clinical trial. If we do not succeed in conducting and
managing our preclinical development activities or clinical
trials, or in obtaining regulatory approvals, we might not be
able to commercialize our product candidates, or might be
significantly delayed in doing so, which will materially harm
our business.
None of the products that we are currently developing has been
approved by the FDA or any similar regulatory authority in any
foreign country. Our ability to generate revenues from any of
our product candidates will depend on a number of factors,
including our ability to successfully complete clinical trials,
obtain necessary regulatory approvals and implement our
commercialization strategy. In addition, even if we are
successful in obtaining necessary regulatory approvals and
bringing one or more product candidates to
7
market, we will be subject to the risk that the marketplace will
not accept those products. We may, and anticipate that we will
need to, transition from a company with a research and
development focus to a company capable of supporting commercial
activities and we may not succeed in such a transition.
Because of the numerous risks and uncertainties associated with
our product development and commercialization efforts, we are
unable to predict the extent of our future losses or when or if
we will become profitable. Our failure to successfully
commercialize our product candidates or to become and remain
profitable could depress the market price of our common stock
and impair our ability to raise capital, expand our business,
diversify our product offerings and continue our operations.
Management believes that, in connection with the audit of
our financial statements for the year ended December 31,
2006, we may receive a report from our independent registered
public accounting firm expressing substantial doubt about our
ability to continue as a going concern.
Management believes that, in connection with the audit of our
financial statements for the year ended December 31, 2006,
we may receive a report from our independent registered public
accounting firm that describes the existence of conditions that
raise substantial doubt about our ability to continue as a going
concern. Our consolidated financial statements as of
December 31, 2006 are being prepared under the assumption
that we will continue as a going concern. If we are not able to
continue as a going concern, it is likely that holders of our
common stock will lose all of their investment.
We may need substantial additional funding and may be
unable to raise capital when needed, which would force us to
delay or curtail the development or commercialization of our
product candidates. An inability to obtain additional financing
could adversely affect our business, financial condition,
results of operations, and could even prevent us from continuing
our business at all.
Even if we secure approximately
$ million
of proceeds in connection with this offering, our demand for
capital may be significantly higher than anticipated. We may
require substantial future capital in order to continue the
research and development, preclinical and clinical programs, and
regulatory activities necessary to obtain regulatory approval of
our product candidates. In addition, subject to obtaining
regulatory approval for any of our product candidates, we expect
to incur significant commercialization expenses for product
sales and marketing, manufacturing the product and/or securing
commercial quantities of product from manufacturers and product
distribution.
The extent of our need for additional capital will depend on
numerous factors, including, but not limited to:
|
|
|
|
|
the scope, rate of scientific progress, results and cost of our
clinical trials and other research and development activities;
|
|
|
|
the costs and timing of seeking FDA and other regulatory
approvals;
|
|
|
|
our ability to obtain sufficient third-party insurance coverage
or reimbursement for our product candidates;
|
|
|
|
the effectiveness of commercialization activities (including the
volume and profitability of any sales achieved);
|
|
|
|
our ability to establish additional strategic, collaborative and
licensing relationships with third parties with respect to the
sales, marketing and distribution of our products, research and
development and other matters and the economic and other terms
and timing of any such relationships;
|
|
|
|
the ongoing availability of funds from foreign governments to
build new manufacturing facilities;
|
|
|
|
the costs involved in any potential litigation that may occur;
|
8
|
|
|
|
|
decisions by us to pursue the development of new product
candidates or technologies or to make acquisitions or
investments; and
|
|
|
|
the effect of competing products, technologies and market
developments.
|
We have no commitments or arrangements from third parties for
any additional financing to fund the research and development
and commercialization of any of our product candidates. We may
need to seek substantial additional financing through public
and/or private financing, which may include equity and/or debt
financings, and through other arrangements, including
collaborative arrangements. However, financing may not be
available when we need it, or may not be available on acceptable
terms. Debt financing, if available, may involve restrictive
covenants that limit our operating and financial flexibility and
prohibit us from making distributions to shareholders. If we
raise additional funds by issuing equity, equity-related or
convertible securities, the economic, voting and other rights of
our existing shareholders, including investors who purchase
shares in this offering, may be diluted, and those securities
may have rights superior to those of our common stock. If we
obtain additional capital through collaborative arrangements, we
may be required to relinquish greater rights to our technologies
or product candidates than we might otherwise have or become
subject to restrictive covenants that may affect our business.
If we are unable to raise additional funds when we need them, we
may be required to delay, scale back or eliminate expenditures
for our development programs, curtail efforts to commercialize
our product candidates or reduce the scale of our operations,
any of which could have a material adverse effect on our
operating results and business. Any inability to obtain
additional financing could adversely affect our business,
financial condition, results of operations, and could even
prevent us from continuing our business at all.
Risks Related to Product Development
We depend heavily on the success of our lead product
candidate, MyoCell. All of our product candidates are in an
early stage of development and we may never succeed in
developing and/or commercializing them. If we are unable to
commercialize MyoCell, or experience significant delays in doing
so, our business may fail.
We have invested a significant portion of our efforts and
financial resources in our lead product candidate, MyoCell, and
depend heavily on its success. MyoCell is currently being tested
in clinical trials. Even if MyoCell progresses through clinical
trials as we anticipate, we do not expect any of our product
candidates to be commercially available until, at the soonest,
the second half of 2007. We need to devote significant
additional research and development, financial resources and
personnel to develop commercially viable products, obtain
regulatory approvals and establish a sales and marketing
infrastructure.
We are likely to encounter hurdles and unexpected issues as we
proceed in the development of MyoCell and our other product
candidates. There are many reasons that we may not succeed in
our efforts to develop our product candidates, including the
possibility that:
|
|
|
|
|
our product candidates will be deemed ineffective, unsafe or
will not receive regulatory approvals;
|
|
|
|
our product candidates will be too expensive to manufacture or
market or will not achieve broad market acceptance;
|
|
|
|
others will hold proprietary rights that will prevent us from
marketing our product candidates; or
|
|
|
|
our competitors will market products that are perceived as
equivalent or superior.
|
Our approach of using cell-based therapy for the treatment
of heart damage is risky and unproven and no products using this
approach have received regulatory approval in the United States
or Europe.
No company has yet been successful in its efforts to obtain
regulatory approval in the United States or Europe of a
cell-based therapy product for the treatment of heart damage.
Cell-based therapy products, in general, may be susceptible to
various risks, including undesirable and unintended side
effects, unintended immune system responses, inadequate
therapeutic efficacy or other characteristics that may prevent
or limit their approval by regulators or commercial use. Many
companies in the industry have suffered significant setbacks in
advanced clinical trials, despite promising results in earlier
trials. One of our competitors exploring
9
the use of skeletal myoblasts has announced its intent to cease
to enroll new patients in its European Phase II clinical
trial based on the determination of its monitoring committee
that there was a low likelihood that the trial would result in
the hypothesized improvement in heart function. Although our
clinical research to date suggests that MyoCell may improve the
contractile function of the heart, we have not yet been able to
demonstrate a mechanism of action and additional research is
needed to precisely identify such mechanism.
If our clinical trials are unsuccessful or significantly
delayed, or if we do not complete our clinical trials, we will
not be able to commercialize our product candidates.
Our lead product candidate, MyoCell, is still in clinical
testing, has not yet received approval from the FDA or any
similar foreign regulatory authority for any indication and may
never be commercialized in the United States or other countries.
We cannot market any product candidate until regulatory agencies
grant approval or licensure. In order to obtain regulatory
approval for the sale of any product candidate, we must, among
other requirements, provide the FDA and similar foreign
regulatory authorities with preclinical and clinical data that
demonstrate to the satisfaction of regulatory authorities that
our product candidates are safe and effective for each
indication under the applicable standards relating to such
product candidate. The preclinical studies and clinical trials
of any product candidates must comply with the regulations of
the FDA and other governmental authorities in the United States
and similar agencies in other countries.
Even if we achieve positive interim results in clinical trials,
these results do not necessarily predict final results, and
positive results in early trials may not be indicative of
success in later trials. For example, MyoCell has been studied
in a limited number of patients to date. Even though our early
data has been promising, we have not yet completed any
large-scale pivotal trials to establish the safety and efficacy
of MyoCell. A number of participants in our clinical trials have
experienced serious adverse events adjudicated or determined by
trial investigators to be potentially attributable to MyoCell.
See Risk Factors Our product candidates may
never be commercialized due to unacceptable side effects and
increased mortality that may be associated with such product
candidates. There is a risk that safety concerns relating
to our product candidates or cell-based therapies in general
will result in the suspension or termination of our clinical
trials.
We may experience numerous unforeseen events during, or as a
result of, the clinical trial process that could delay or
prevent commercialization of our product candidates, including
the following:
|
|
|
|
|
the FDA or similar foreign regulatory authorities may find that
our product candidates are not sufficiently safe or effective or
may find our cell culturing processes or facilities
unsatisfactory;
|
|
|
|
officials at the FDA or similar foreign regulatory authorities
may interpret data from preclinical studies and clinical trials
differently than we do;
|
|
|
|
our clinical trials may produce negative or inconclusive results
or may not meet the level of statistical significance required
by the FDA or other regulatory authorities, and we may decide,
or regulators may require us, to conduct additional preclinical
studies and/or clinical trials or to abandon one or more of our
development programs;
|
|
|
|
the FDA or similar foreign regulatory authorities may change
their approval policies or adopt new regulations;
|
|
|
|
there may be delays or failure in obtaining approval of our
clinical trial protocols from the FDA or other regulatory
authorities or obtaining institutional review board approvals or
government approvals to conduct clinical trials at prospective
sites;
|
|
|
|
we, or regulators, may suspend or terminate our clinical trials
because the participating patients are being exposed to
unacceptable health risks or undesirable side effects;
|
|
|
|
we may experience difficulties in managing multiple clinical
sites;
|
10
|
|
|
|
|
enrollment in our clinical trials for our product candidates may
occur more slowly than we anticipate, or we may experience high
drop-out rates of subjects in our clinical trials, resulting in
significant delays;
|
|
|
|
we may be unable to manufacture or obtain from third party
manufacturers sufficient quantities of our product candidates
for use in clinical trials; and
|
|
|
|
our product candidates may be deemed unsafe or ineffective, or
may be perceived as being unsafe or ineffective, by healthcare
providers for a particular indication.
|
In the SEISMIC Trial, we have experienced delays attributable to
slower than anticipated enrollment of patients. We may continue
to experience difficulties in enrolling patients in our clinical
trials, which could increase the costs or affect the timing or
outcome of these trials and could prevent us from completing
these trials.
Failures or perceived failures in our clinical trials would
delay and may prevent our product development and regulatory
approval process, make it difficult for us to establish
collaborations, negatively affect our reputation and competitive
position and otherwise have a material adverse effect on our
business.
Our product candidates may never be commercialized due to
unacceptable side effects and increased mortality that may be
associated with such product candidates.
Possible side effects of our product candidates may be serious
and life-threatening. A number of participants in our clinical
trials of MyoCell have experienced serious adverse events
potentially attributable to MyoCell, including six patient
deaths and 14 patients experiencing irregular heartbeats. A
serious adverse event is generally an event that results in
significant medical consequences, such as hospitalization,
disability or death, and must be reported to the FDA. The
occurrence of any unacceptable serious adverse events during or
after preclinical and clinical testing of our product candidates
could temporarily delay or negate the possibility of regulatory
approval of our product candidates and adversely affect our
business. Both our trials and independent trials have reported
the occurrence of irregular heartbeats in treated patients, a
significant risk to patient safety. We and our competitors have
also, at times, suspended trials studying the effects of
myoblasts, at least temporarily, to assess the risk of irregular
heartbeats and it has been reported that one of our competitors
studying the effect of myoblast implantation prematurely
discontinued a study because of the high incidence of irregular
heartbeats. While we believe irregular heartbeats may be
manageable with the use of certain prophylactic measures
including an ICD and anti-arrhythmic drug therapy, these risk
management techniques may not prove to sufficiently reduce the
risk of unacceptable side effects. Although our early results
suggest that patients treated with MyoCell do not face
materially different health risks than heart failure patients
with similar levels of damage to the heart who have not been
treated with MyoCell, we are still in the process of seeking to
demonstrate that our product candidates do not pose unacceptable
health risks. We have not yet treated a sufficient number of
patients to allow us to make a determination that serious
unintended consequences will not occur.
We depend on third parties to assist us in the conduct of
our preclinical studies and clinical trials, and any failure of
those parties to fulfill their obligations could result in costs
and delays and prevent us from obtaining regulatory approval or
successfully commercializing our product candidates on a timely
basis, if at all.
We engage consultants and contract research organizations to
help design, and to assist us in conducting, our preclinical
studies and clinical trials and to collect and analyze data from
those studies and trials. The consultants and contract research
organizations we engage interact with clinical investigators to
enroll patients in our clinical trials. As a result, we depend
on these consultants and contract research organizations to
perform the studies and trials in accordance with the
investigational plan and protocol for each product candidate and
in compliance with regulations and standards, commonly referred
to as good clinical practice, for conducting,
recording and reporting results of clinical trials to assure
that the data and results are credible and accurate and the
trial participants are adequately protected, as required by the
FDA and foreign regulatory agencies. We may face delays in our
regulatory approval process if these parties do not perform
their obligations in a timely or competent fashion or if we are
forced to change service providers. The risk of
11
delays is heightened for our clinical trials conducted outside
of the United States, where it may be more difficult for us to
ensure that studies are conducted in compliance with foreign
regulatory requirements. Any third parties 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 these third parties do not successfully
carry out their duties or meet expected deadlines, or if the
quality, completeness or accuracy of the data they obtain is
compromised due to their failure to adhere to our clinical trial
protocols or for other reasons, our clinical trials may be
extended, delayed or terminated or may otherwise prove to be
unsuccessful. If there are delays or failures in clinical trials
or regulatory approvals as a result of the failure to perform by
third parties, our development costs will increase, and we may
not be able to obtain regulatory approval for our product
candidates. In addition, we may not be able to establish or
maintain relationships with these third parties on favorable
terms, if at all. If we need to enter into replacement
arrangements because a third party is not performing in
accordance with our expectations, we may not be able to do so
without undue delays or considerable expenditures or at all.
Risks Related to Government Regulation and Regulatory
Approvals
Our cell-based product candidates are based on novel
technologies and the FDA and regulatory agencies in other
countries have limited experience reviewing product candidates
using these technologies.
We are subject to the risks of failure inherent in the
development of product candidates based on new technologies. The
novel nature of our product candidates creates significant
challenges in regards to product development and optimization,
government regulation, third party reimbursement and market
acceptance. For example, the FDA and regulatory agencies in
other countries have relatively limited experience with
therapies based upon cellular medicine generally and, as a
result, the pathway to regulatory approval for our cell-based
product candidates may be more complex and lengthy. As a result,
the development and commercialization pathway for our cell-based
therapies may be subject to increased uncertainty, as compared
to the pathway for new conventional drugs.
We must comply with extensive government regulations in
order to obtain and maintain marketing approval for our products
in the United States and abroad. If we do not obtain regulatory
approval for our product candidates, we may be forced to cease
our operations.
Our product candidates are subject to extensive regulation in
the United States and in every other country where they will be
tested or used. These regulations are wide-ranging and govern,
among other things:
|
|
|
|
|
product design, development, manufacture and testing;
|
|
|
|
product safety and efficacy;
|
|
|
|
product labeling;
|
|
|
|
product storage and shipping;
|
|
|
|
record keeping;
|
|
|
|
pre-market clearance or approval;
|
|
|
|
advertising and promotion; and
|
|
|
|
product sales and distribution.
|
We cannot market our product candidates until we receive
regulatory approval. The process of obtaining regulatory
approval is lengthy, expensive and uncertain. Any difficulties
that we encounter in obtaining regulatory approval may have a
substantial adverse impact on our business and cause our stock
price to decline significantly.
In the United States, the FDA imposes substantial requirements
on the introduction of biological products and many medical
devices through lengthy and detailed laboratory and clinical
testing procedures, sampling activities and other costly and
time-consuming procedures. Satisfaction of these requirements
12
typically takes several years and the time required to do so may
vary substantially based upon the type and complexity of the
biological product or medical device.
In addition, product candidates that we believe should be
classified as medical devices for purposes of the FDA regulatory
pathway may be determined by the FDA to be biologic products
subject to the satisfaction of significantly more stringent
requirements for FDA approval. A 510(k) pre-market notification,
used for certain device candidates, for the TGI 100 product
candidate was filed by Tissue Genesis, Inc., or Tissue Genesis,
with the FDA in September 2006. We intend to use the same
regulatory pathway for the TGI 1200, an automated version of the
cell isolation component of the TGI 100. The FDAs 510(k)
clearance pathway usually takes from four to twelve months, but
it can last longer. The FDA has requested that Tissue Genesis
file a Request for Designation with the FDA Office of
Combination of Products requesting a determination of whether
the TGI 100 is properly classified as a medical device or a
biologic or drug. The FDA granted Tissue Genesis an extension
until April 2007 to file this Request for Designation. If the
FDA determines that the TGI 100 is a biologic or drug rather
than a medical device, we will not be able to sell the TGI 100
or TGI 1200 until we or Tissue Genesis conduct additional
preclinical studies and clinical trials and obtain FDA approval,
which could take years to obtain and which could have a material
adverse effect on our business.
The requirements governing the conduct of clinical trials and
cell culturing and marketing of our product candidates outside
the United States vary widely from country to country. Foreign
approvals may take longer to obtain than FDA approvals and can
require, among other things, additional testing and different
clinical trial designs. Foreign regulatory approval processes
generally include all of the risks associated with the FDA
approval processes. Some foreign regulatory agencies also must
approve prices of the products. Regulatory approval in one
country does not ensure regulatory approval in another, but a
failure or delay in obtaining regulatory approval in one country
may negatively impact the regulatory process in others. We may
not be able to file for regulatory approvals and may not receive
necessary approvals to market our product candidates in any
foreign country. If we fail to comply with these regulatory
requirements or fail to obtain and maintain required approvals
in any foreign country, we will not be able to sell our product
candidates in that country and our ability to generate revenue
will be adversely affected.
We cannot assure you that we will obtain FDA or foreign
regulatory approval to market any of our product candidates for
any indication in a timely manner or at all. If we fail to
obtain regulatory approval of any of our product candidates for
at least one indication, we will not be permitted to market our
product candidates and may be forced to cease our operations.
Even if some of our product candidates receive regulatory
approval, these approvals may be subject to conditions, and we
and our third party manufacturers will in any event be subject
to significant ongoing regulatory obligations and
oversight.
Even if any of our product candidates receives regulatory
approval, the manufacturing, marketing and sale of our product
candidates will be subject to stringent and ongoing government
regulation. Conditions of approval, such as limiting the
category of patients who can use the product, may significantly
impact our ability to commercialize the product and may make it
difficult or impossible for us to market a product profitably.
Changes we may desire to make to an approved product, such as
cell culturing changes or revised labeling, may require further
regulatory review and approval, which could prevent us from
updating or otherwise changing an approved product. If our
product candidates are approved by the FDA or other regulatory
authorities for the treatment of any indications, regulatory
labeling may specify that our product candidates be used in
conjunction with other therapies. For instance, we currently
anticipate that prior implantation of an ICD and treatment with
optimal drug therapy will be required at least initially as a
condition to treatment with MyoCell.
Once obtained, regulatory approvals may be withdrawn for a
number of reasons, including the later discovery of previously
unknown problems with the product. Regulatory approval may also
require costly post-marketing
follow-up
studies, and
failure of our product candidates to demonstrate sufficient
efficacy and safety in these studies may result in either
withdrawal of marketing approval or severe limitations on
permitted product usage. In addition, numerous additional
regulatory requirements relating to, among other processes,
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the labeling, packaging, adverse event reporting, storage,
advertising, promotion and record-keeping will also apply.
Furthermore, regulatory agencies subject a marketed product, its
manufacturer and the manufacturers facilities to continual
review and periodic inspections. Compliance with these
regulatory requirements are time consuming and require the
expenditure of substantial resources.
If any of our product candidates is approved, we will be
required to report certain adverse events involving our products
to the FDA, to provide updated safety and efficacy information
and to comply with requirements concerning the advertisement and
promotional labeling of our products. As a result, even if we
obtain necessary regulatory approvals to market our product
candidates for any indication, any adverse results,
circumstances or events that are subsequently discovered, could
require that we cease marketing the product for that indication
or expend money, time and effort to ensure full compliance,
which could have a material adverse effect on our business.
In response to recent events regarding questions about the
safety of certain approved prescription products, including the
lack of adequate warnings, the FDA and the U.S. Congress
are currently considering new regulatory and legislative
approaches to advertising, monitoring and assessing the safety
of marketed drugs, including legislation authorizing the FDA to
mandate labeling changes for approved products, particularly
those related to safety. It is possible that congressional and
FDA initiatives pertaining to ensuring the safety of marketed
biologics and similar initiatives in other countries, or other
developments pertaining to the pharmaceutical industry, could
require us to expend additional resources to comply with such
initiatives and could adversely affect our operations.
In addition, the FDA and similar foreign governmental
authorities have the authority to require the recall of
commercialized products in the event of any failure to comply
with applicable laws and regulations or defects in design or
manufacture. In the event any of our product candidates receives
approval and is commercialized, a government-mandated or
voluntary product recall by us could occur as a result of
component failures, device malfunctions, or other negative
events such as serious injuries or deaths, or quality-related
issues such as cell culturing errors or design or labeling
defects. Recalls of any of our potential products could divert
managerial and financial resources, harm our reputation and
adversely affect our financial condition, results of operations
and stock price.
Any failure by us, or by any third parties that may manufacture
or market our products, to comply with the law, including
statutes and regulations administered by the FDA or other
U.S. or foreign regulatory authorities, could result in,
among other things, warning letters, fines and other civil
penalties, suspension of regulatory approvals and the resulting
requirement that we suspend sales of our products, refusal to
approve pending applications or supplements to approved
applications, export or import restrictions, interruption of
production, operating restrictions, closure of the facilities
used by us or third parties to manufacture our product
candidates, injunctions or criminal prosecution. Any of the
foregoing actions could have a material adverse effect on our
business.
We must comply with federal, state and foreign laws,
regulations and other rules relating to the healthcare business,
and, if we do not fully comply with such laws, regulations and
other rules, we could face substantial penalties.
We are, or will be directly or indirectly through our customers,
subject to extensive regulation by the federal government, the
states and foreign countries in which we may conduct our
business. The laws that directly or indirectly affect our
ability to operate our business include the following:
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the federal Medicare and Medicaid Anti-Kickback law, which
prohibits persons from knowingly and willfully soliciting,
offering, receiving or providing remuneration, directly or
indirectly, in cash or in kind, to induce either the referral of
an individual or furnishing or arranging for a good or service,
for which payment may be made under federal healthcare programs
such as Medicare and Medicaid;
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other Medicare laws, regulations, rules, manual provisions and
policies that prescribe the requirements for coverage and
payment for services performed by our customers, including the
amount of such payment;
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the Federal False Claims Act, which imposes civil and criminal
liability on individuals and entities who submit, or cause to be
submitted, false or fraudulent claims for payment to the
government;
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the Federal False Statements Act, which prohibits knowingly and
willfully falsifying, concealing or covering up a material fact
or making any materially false statement in connection with
delivery of or payment for healthcare benefits, items or
services; and
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state and foreign law equivalents of the foregoing.
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If our operations are found to be in violation of any of the
laws, regulations, rules or policies described above or any
other law or governmental regulation to which we or our
customers are or will be subject, or if the interpretation of
the foregoing changes, we may be subject to civil and criminal
penalties, damages, fines, exclusion from the Medicare and
Medicaid programs and the curtailment or restructuring of our
operations. Similarly, if our customers are found non-compliant
with applicable laws, they may be subject to sanctions, which
could also have a negative impact on us. Any penalties, damages,
fines, curtailment or restructuring of our operations would
adversely affect our ability to operate our business and our
financial results. The risk of our being found in violation of
these laws is increased by the fact that many of them have not
been fully interpreted by the regulatory authorities or the
courts, and their provisions are open to a variety of
interpretations, and additional legal or regulatory change. Any
action against us for violation of these laws, even if we
successfully defend against it, could cause us to incur
significant legal expenses, divert our managements
attention from the operation of our business and damage our
reputation.
Our business involves the use of hazardous materials that
could expose us to environmental and other liability.
Our facility in Sunrise, Florida is subject to various local,
state and federal laws and regulations relating to the use and
disposal of hazardous or potentially hazardous substances,
including chemicals and micro-organisms used in connection with
our research and development activities. In the United States,
these laws include the Occupational Safety and Health Act, the
Toxic Test Substances Control Act and the Resource Conservation
and Recovery Act. Although we believe that our safety procedures
for handling and disposing of these materials comply with the
standards prescribed by these regulations, we cannot assure you
that accidental contamination or injury to employees and third
parties from these materials will not occur. We do not have
insurance to cover claims arising from our use and disposal of
these hazardous substances other than limited
clean-up
expense
coverage for environmental contamination due to an otherwise
insured peril, such as fire.
Risks Related to Commercialization of our Product
Candidates
The biopharmaceutical and medical communities have
relatively little experience with therapies based on cellular
medicine and, accordingly, if our product candidates do not
become widely accepted by physicians, patients, third party
payors and those healthcare communities, we may be unable to
generate significant revenue, if any.
We are developing cell-based therapy product candidates for the
treatment of heart damage that represent novel and unproven
treatments and, if approved, will compete with a number of more
conventional products and therapies manufactured and marketed by
others, including major pharmaceutical companies. We cannot
predict or guarantee that physicians, patients, healthcare
insurers, third party payors or health maintenance
organizations, or the healthcare community in general, will
accept or utilize any of our product candidates. We anticipate
that, if approved, we will market MyoCell primarily to
interventional cardiologists, who are generally not the primary
care physicians for patients we intend to be eligible for
treatment with MyoCell. Accordingly, our commercial success may
be dependent on third party physicians referring their patients
to interventional cardiologists for MyoCell treatment.
If we are successful in obtaining regulatory approvals for any
of our product candidates, the degree of market acceptance of
those products will depend on many factors, including:
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our ability to provide acceptable evidence and the perception of
patients and the healthcare community, including third party
payors, of the positive characteristics of our product candidates
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relative to existing treatment methods, including their safety,
efficacy, cost effectiveness and/or other potential advantages;
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the incidence and severity of any adverse side effects of our
product candidates;
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the availability of alternative treatments;
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the labeling requirements imposed by the FDA and foreign
regulatory agencies, including the scope of approved indications
and any safety warnings;
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our ability to obtain sufficient third party insurance coverage
or reimbursement for our products candidates;
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the inclusion of our products on insurance company coverage
policies;
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the willingness and ability of patients and the healthcare
community to adopt new technologies;
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the procedure time associated with the use of our product
candidates;
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our ability to manufacture or obtain from third party
manufacturers sufficient quantities of our product candidates
with acceptable quality and at an acceptable cost to meet
demand; and
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marketing and distribution support for our products.
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Failure to achieve market acceptance would limit our ability to
generate revenue and would have a material adverse effect on our
business. In addition, if any of our product candidates achieve
market acceptance, we may not be able to maintain that market
acceptance over time if competing products or technologies are
introduced that are received more favorably or are more
cost-effective.
There is substantial uncertainty as to the coverage that
may be available and the reimbursement rates that may be
established for our product candidates. Any failure to obtain
third party coverage or an adequate level of reimbursement for
our product candidates will likely have a material adverse
effect on our business.
If we successfully develop, and obtain necessary regulatory
approvals for, our product candidates we intend to sell them
initially in Europe and the United States. We have not yet
submitted any of our product candidates to the Center for
Medicare and Medicaid Services, or CMS, or any private or
governmental third party payor in the United States to determine
whether or not our product candidates will be covered under
private or public health insurance plans or, if they are
covered, what coverage or reimbursement rates may be available.
Although we believe hospitals may be entitled to some procedure
reimbursement for MyoCell, we cannot assure you that such
reimbursement will be adequate or available at all.
In Europe, the pricing of prescription pharmaceutical products
and services and the level of government reimbursement generally
are subject to governmental control. Reimbursement and
healthcare payment systems in European markets vary
significantly by country, and may include both
government-sponsored healthcare and private insurance. In these
countries, pricing negotiations with governmental authorities
can take six to twelve months or longer after the receipt of
marketing approval for a product. To obtain reimbursement or
pricing approval in some countries, we may be required to
conduct one or more clinical trials that compares the cost
effectiveness of our product candidates to other available
therapies. Conducting one or more clinical trials for this
purpose would be expensive and result in delays in
commercialization of our product candidates. We may not obtain
coverage or reimbursement or pricing approvals from countries in
Europe in a timely manner, or at all. Any failure to receive
coverage or reimbursement or pricing approvals from one or more
European countries could effectively prevent us from selling our
product candidates in those countries, which could materially
adversely affect our business.
In the United States, our revenues will depend upon the coverage
and reimbursement rates and policies established for our product
candidates by third party payors, including governmental
authorities, managed-care providers, public health insurers,
private health insurers and other organizations. These third
party payors are increasingly attempting to contain healthcare
costs by limiting both coverage and the level of reimbursement
for new healthcare products approved for marketing by the FDA or
regulatory agencies in other
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countries. As a result, significant uncertainty exists as to
whether newly approved medical products will be eligible for
coverage by third party payors or, if eligible for coverage,
what the reimbursement rates will be for those products.
Furthermore, cell-based therapies like MyoCell may be more
expensive than pharmaceuticals, due to, among other things, the
higher cost and complexity associated with the research,
development and production of these therapies. This, in turn,
may make it more difficult for us to obtain adequate
reimbursement from third party payors, particularly if we cannot
demonstrate a favorable cost-benefit relationship. Third party
payors may also deny coverage or offer inadequate levels of
reimbursement for our potential products if they determine that
the product has not received appropriate clearances from the FDA
or other government regulators or is experimental, unnecessary
or inappropriate. Accordingly, we cannot assure you that
adequate third party coverage or reimbursement will be available
for any of our product candidates to allow us to successfully
commercialize these product candidates.
Coverage and reimbursement rates for our product candidates may
be subject to increased restrictions both in the United States
and in other countries in the future. Coverage policies and
reimbursement rates are subject to change and we cannot
guarantee that current coverage policies and reimbursement rates
will be applicable to our product candidates in the future.
U.S. federal, state and foreign agencies and legislatures
from time to time may seek to impose restrictions on coverage,
pricing, and reimbursement level of drugs, devices and
healthcare services in order to contain healthcare costs.
We have only limited experience culturing our cell-based
product candidates, and we may not be able to culture our
product candidates in quantities sufficient for clinical studies
or for commercial sale. We also face certain risks in connection
with our use of third party manufacturers and cell culturing
service providers.
We may encounter difficulties in the production of our
cell-based product candidates, including MyoCell, due to our
limited experience internally culturing our product candidates.
We have a cell culturing facility in Sunrise, Florida, which we
believe has the capacity to meet substantially all of our
projected demand for MyoCell in the United States for the
balance of 2007. We began culturing cells at this facility for
preclinical uses in the third quarter of 2006. Prior to such
date, we outsourced our various cell culturing needs. We
anticipate that we will begin culturing cells at this facility
for clinical uses upon commencement of the MYOHEART II
Trial. We have no experience in culturing our product candidates
for the number of patients that will be required for later stage
clinical studies or commercialization and may be unable to
culture sufficient quantities of our product candidates for our
clinical trials or our commercial needs on a timely and
cost-effective basis. Difficulties arising from our limited cell
culturing experience could reduce sales of our products,
increase our costs or cause production delays, any of which
could adversely affect our results of operations.
We anticipate that we will continue to use third party cell
culturing service providers, including Pharmacell and Cambrex
Bioscience, to supply a portion of our cell-based product
candidates, including MyoCell, for clinical trials and
commercial sales outside of the United States. We may not be
able to, and in our Phase I/ II clinical trial experienced
delays because we were not at times able to, obtain sufficient
quantities of MyoCell from third party cell culturing service
providers. In addition, our third party cell culturing providers
may be unable to culture commercial quantities of our product
candidates on a timely and cost-effective basis. The term of our
supply agreement with Pharmacell expires six months following
the end of completion of the SEISMIC and MYOHEART II Trials
unless terminated earlier. We cannot be certain that we will be
able to maintain our relationships with our third party cell
culturing service providers, including Pharmacell, or establish
relationships with other cell culturing service providers on
commercially acceptable terms.
We currently use and expect to continue to use third party
manufacturers to supply our device product candidates, including
MyoCath. Our contract with our only MyoCath manufacturer is
scheduled to terminate in September 2007. We anticipate either
renegotiating our contract with this manufacturer or negotiating
a new agreement with another manufacturer. The transition to a
replacement contract manufacturer has additional risks,
including those risks associated with the development by the
replacement contract manufacturer of sufficient levels of
expertise in the manufacturing process. If we are unable to
renegotiate this agreement or enter into a replacement agreement
with another contract manufacturer on reasonable terms and
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in a timely manner, or if any replacement contract manufacturer
is unable to develop sufficient manufacturing expertise in a
timely manner, we could experience shortages of clinical trial
materials, which could adversely affect our business.
Our cell culturing facility and those of our contract
manufacturers and other cell culturing service providers will be
subject to ongoing, periodic inspection by the FDA to confirm
that the facilities comply with the FDAs current Good
Manufacturing Practices, or cGMP, if the facility manufactures
biologics, and quality system regulations if the facility
manufactures devices. Foreign regulatory agencies, for example,
the International Standards Organization and the European
authorities related to obtaining a CE mark on a
device in Europe, may also impose similar requirements on us and
conduct similar inspections of the facilities that manufacture
our product candidates. Failure to follow and document adherence
to such cGMP regulations or other regulatory requirements by us
or our contract manufacturers or third party cell culturing
service providers may lead to significant delays in the
availability of our product candidates for commercial use or
clinical study, may result in the delay or termination of a
clinical trial, or may delay or prevent filing of applications
for or our receipt of regulatory approval of our product
candidates. If we or such third parties fail to comply with
applicable regulations, the FDA or other regulatory authorities
could impose sanctions on us, including fines, injunctions,
civil penalties, denial of marketing approval of our product
candidates, delays, suspension or withdrawal of approvals,
license revocation, seizures or recalls of our product
candidates, operating restrictions and criminal prosecutions.
Any of these events could adversely affect our financial
condition, profitability and ability to develop and
commercialize products on a timely and competitive basis.
If we are unable to establish sales and marketing
capabilities or enter into agreements with third parties to
market and sell our product candidates, we may be unable to
generate product revenues.
We do not have a sales and marketing force and related
infrastructure and have limited experience in the sales,
marketing and distribution of our product candidates. To achieve
commercial success for any approved product, we must either
develop a sales and marketing force or outsource these functions
to third parties. Currently, we intend to internally develop a
direct sales and marketing force in both Europe and the United
States as we approach commercial approval of our product
candidates. The development of our own sales and marketing force
will result in us incurring significant costs before the time
that we may generate revenues. We may not be able to attract,
hire, train and retain qualified sales and marketing personnel
to build a significant or effective marketing and sales force
for sales of our product candidates.
Product liability and other claims against us may reduce
demand for our products or result in substantial damages. We
anticipate that we will need to obtain and maintain additional
or increased insurance coverage, and we may not be able to
obtain or maintain such coverage on commercially reasonable
terms, if at all.
A product liability claim, a clinical trial liability claim or
other claim with respect to uninsured liabilities or for amounts
in excess of insured liabilities could have a material adverse
effect on our business. Our business exposes us to potential
liability risks that may arise from the clinical testing of our
product candidates in human clinical trials and the manufacture
and sale of any approved products. Any clinical trial liability
or product liability claim or series of claims or class actions
brought against us, with or without merit, could result in:
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liabilities that substantially exceed our existing clinical
trial liability insurance, or any clinical trial liability or
product liability insurance that we may obtain in the future,
which we would then be required to pay from other sources, if
available;
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an increase in the premiums we pay for our clinical trial
liability insurance and any clinical trial liability or product
liability insurance we may obtain in the future or the inability
to renew or obtain clinical trial liability or product liability
insurance coverage in the future on acceptable terms, or at all;
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withdrawal of clinical trial volunteers or patients;
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damage to our reputation and the reputation of our products,
including loss of market share;
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regulatory investigations that could require costly recalls or
product modifications;
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litigation costs; and
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diversion of managements attention from managing our
business.
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Although we have clinical trial liability insurance, our current
clinical trial liability insurance is subject to deductibles and
coverage limitations. This insurance currently covers claims of
up to $5 million each and up to $5 million in the
aggregate each year. Our current clinical trial liability
insurance may not continue to be available to us on acceptable
terms, if at all, and, if available, the coverage may not be
adequate to protect us against future clinical trial liability
claims. We are currently seeking to increase our clinical trial
liability insurance coverage.
We do not currently have product liability insurance because
none of our product candidates has yet been approved for
commercialization. While we plan to seek product liability
insurance coverage if any of our product candidates are sold
commercially, we cannot assure you that we will be able to
obtain product liability insurance on commercially acceptable
terms, if at all, or that we will be able to maintain such
insurance at a reasonable cost or in sufficient amounts to
protect against potential losses.
Claims may be made by consumers, healthcare providers, third
party strategic collaborators or others selling our products if
one of our products or product candidates causes, or appears to
have caused, an injury. We may be subject to claims against us
even if an alleged injury is due to the actions of others. For
example, we rely on the expertise of physicians, nurses and
other associated medical personnel to perform the medical
procedures and processes related to our product candidates. If
these medical personnel are not properly trained or are
negligent in using our product candidates, the therapeutic
effect of our product candidates may be diminished or the
patient may suffer injury, which may subject us to liability. In
addition, an injury resulting from the activities of our
suppliers may serve as a basis for a claim against us.
We do not intend to promote, or to in any way support or
encourage the promotion of, our product candidates for off-label
or otherwise unapproved uses. However, if our product candidates
are approved by the FDA or similar foreign regulatory
authorities, we cannot prevent a physician from using them for
any off-label applications. If injury to a patient results from
such an inappropriate use, we may become involved in a product
liability suit, which will likely be expensive to defend.
These liabilities could prevent or interfere with our clinical
efforts, product development efforts and any subsequent product
commercialization efforts, all of which could have a material
adverse effect on our business.
Our success will depend in part on establishing and
maintaining effective strategic partnerships, collaborations and
licensing agreements.
Our strategy for the development, testing, culturing and
commercialization of our product candidates relies on
establishing and maintaining numerous collaborations with
various corporate partners, consultants, scientists,
researchers, licensors, licensees and others, including the
collaborations described in this prospectus. While we are
continually in discussions with a number of companies,
universities, research institutions, consultants, scientists,
researchers, licensors, licensees and others to establish
additional relationships and collaborations, which are typically
complex and time consuming to negotiate, document and implement,
we may not reach definitive agreements with any of them. Even if
we enter into these arrangements, we may not be able to maintain
these relationships or establish new ones in the future on
acceptable terms.
Furthermore, any collaboration that we enter into may not be
successful. The success of our collaboration arrangements, if
any, will depend heavily on the efforts and activities of our
collaborators. Possible future collaborations have risks,
including the following:
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our collaboration agreements are likely to be for fixed terms
and subject to termination by our collaborators in the event of
a material breach or lack of scientific progress by us;
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our collaborators are likely to have the first right to maintain
or defend our intellectual property rights and, although we
would likely seek to secure the right to assume the maintenance
and defense of our
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intellectual property rights if our collaborators do not, our
ability to do so may be compromised by our collaborators
acts or omissions;
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our collaborators may utilize our intellectual property rights
in such a way as to invite litigation that could jeopardize or
invalidate our intellectual property rights or expose us to
potential liability;
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our collaborators may underfund or not commit sufficient
resources to the testing, marketing, distribution or development
of our product candidates; and
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our collaborators may develop alternative products either on
their own or in collaboration with others, or encounter
conflicts of interest or changes in business strategy or other
business issues, which could adversely affect their willingness
or ability to fulfill their obligations to us.
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These arrangements also may require us to grant certain rights
to third parties, including exclusive marketing rights to one or
more products, or may have other terms that are burdensome to
us, and may involve the issuance of our securities. If any of
our partners terminates its relationship with us or fails to
perform its obligations in a timely manner, the development or
commercialization of our technology and product candidates may
be substantially delayed. Further, disputes may arise with our
collaborators 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.
Risks Related to Our Intellectual Property
We have licensed and therefore do not own any of the
intellectual property that is critical to our business. Any
events or circumstances that result in the termination or
limitation of our rights under any of the agreements between us
and the licensors of our intellectual property could have a
material adverse effect on our business.
All of the intellectual property that is critical to our
business has been licensed to us by various third parties. The
operative terms of some of our material license agreements are
vague or subject to interpretations which may increase the risks
of dispute with our licensors.
Under certain of our patent license agreements, we are subject
to development, payment, commercialization and other obligations
and, if we fail to comply with any of these requirements or
otherwise breach those agreements, our licensors may have the
right to terminate the license in whole or in part, terminate
the exclusive nature of the license to the extent such license
is exclusive or otherwise limit our rights thereunder, which
could have a material adverse effect on our business. For
instance, we are obligated to pay aggregate fees of
$8 million to Cell Transplants International, LLC, or Cell
Transplants International, upon commencement of a U.S. Phase II
human clinical trial of MyoCell and upon FDA approval of
patented technology for heart muscle regeneration. We are also
obligated to make certain payments to the Cleveland Clinic in
the aggregate amount of $2.25 million upon our achievement
of certain development and commercialization objectives in
connection with the development of MyoCell.
Under our material license agreements, including, but not
limited to, our license agreement for the primary patent for
MyoCell, our licensors generally have the right to control the
filing, prosecution, maintenance and defense of all licensed
patents and patent applications and, if a third party infringes
on any of those licensed patents, to control any legal or other
proceedings instituted against that third party for
infringement. As a result, our licensors may take actions or
make decisions relating to these matters with which we do not
agree or which could have a material adverse effect on our
business. Likewise, our licensors may in the future grant
licenses outside the field of heart damage treatment to third
parties to use the patents and other intellectual property to
which we have rights under our exclusive or conditionally
exclusive license agreements. Should our licensors elect not to
pursue the filing, prosecution or maintenance of a licensed
patent application or patent or institute legal or other
proceedings against a third party for infringements of those
patents, then we may be required to undertake these proceedings
alone or jointly with others, who may have interests that are
different from ours. Under certain of our license agreements, we
have no right to undertake these proceedings even if our
licensors refuse to do so. As a result, we may have no control
or only limited control over the prosecution, maintenance,
defense and enforcement of patent applications and patents that
are critical to our business. In that regard, certain of our
license agreements require that we contribute to the
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costs of filing, prosecuting, maintaining, defending and
enforcing the licensed patent applications, patents and other
intellectual property, whether or not we agree with those
actions. Further, such actions typically require the expenditure
of considerable time and money.
Any termination or limitation of, or loss of exclusivity under,
our exclusive or conditionally exclusive license agreements
would have a material adverse effect on us and could delay or
completely terminate our product development efforts.
We do not have patent protection for MyoCell outside of
the United States and we may not be able to effectively enforce
our intellectual property rights in certain countries, which
could have a material adverse effect on our business.
We are seeking or intend to seek regulatory approval to market
our product candidates in a number of foreign countries,
including various countries in Europe. MyoCell, however, is not
protected by patents outside of the United States, which means
that competitors will be free to sell products that incorporate
the same technologies that are used in MyoCell in those
countries, including in European countries, which we believe may
be one of the largest potential markets for these product
candidates. In addition, the laws and practices in some of those
countries, or others in which we may seek to market our other
product candidates in the future, may not protect intellectual
property rights to the same extent as in the United States. We
or our licensors may not be able to effectively obtain, maintain
or enforce rights with respect to the intellectual property
relating to our product candidates in those countries. Our lack
of patent protection in one or more countries, or the inability
to obtain, maintain or enforce intellectual property rights in
one or more countries, could adversely affect our ability to
commercialize our products in those countries and otherwise have
a material adverse effect on our business.
Our success depends on the protection of our intellectual
property rights, particularly the patents that have been
licensed to us, and our failure to secure and maintain these
rights would materially harm our business.
Our commercial success depends to a significant degree on our
ability to:
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obtain and/or maintain protection for our product candidates
under the patent laws of the United States and other countries;
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defend and enforce our patents once obtained;
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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;
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maintain trade secrets and other intellectual property rights
relating to our product candidates; and
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operate without infringing upon the patents and proprietary
rights of third parties.
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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
have been licensed or sublicensed to us, and the patent
applications that we own or that have been licensed to us,
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 U.S. Patent and 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.
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In particular, we cannot assure you that:
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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;
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others will not independently develop similar or alternative
technologies or duplicate any of our technologies;
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any of our patent applications will result in issued patents;
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the patents and the 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;
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the patents and the patent applications that have been licensed
to us are valid and enforceable;
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we will develop additional proprietary technologies that are
patentable;
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we will be successful in enforcing the patents that we own or
that have been licensed to us and any patents that may be issued
or licensed to us in the future against third parties; or
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the patents of third parties will not have an adverse effect on
our ability to do business.
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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, which may instigate expensive and time
consuming litigation which 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.
The patent we believe is the primary basis for the
protection of MyoCell is scheduled to expire in the United
States in July 2009 and if we are unable to secure a patent term
extension, we will have to seek to protect MyoCell through a
combination of patents on other aspects of our technology and
trade secrets, which may not prove to be effective.
We anticipate that we will seek to collaborate with the owners
of the patent, Dr. Peter Law and Cell Transplants
International, to extend the term of this patent and, provided
that MyoCell is approved by the FDA prior to the patent
expiration date and certain other material conditions are
satisfied, we believe that this patent will be eligible for a
five-year extension of its term until July 2014. It is possible
that the FDA will not complete review of and grant approval for
MyoCell before this patent expires. In such event, a regular
patent term extension will not be available, but Dr. Law
and Cell Transplants International could request a one-year
interim extension of the patent term during the period beginning
six months before and ending fifteen days before the patent
expiration. The request for interim extension must satisfy a
number of material conditions including those conditions
necessary to receive a regular patent term extension. Under
certain circumstances the patent owner can request up to four
additional one-year interim extensions. However, we cannot
assure you that Dr. Law and Cell Transplants International
will seek to obtain, or will be successful in obtaining, any
regular or interim patent term extension.
Once this patent expires, competitors will not be prevented from
developing or marketing their own similar or identical
compositions for the treatment of muscle degeneration, assuming
they receive the requisite regulatory approval.
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We have limited recourse available in the event that
patents necessary for the use by our customers of the TGI 100 or
TGI 1200 product candidates, certain disposable products used in
conjunction with these product candidates or processes or cells
derived from these product candidates directly or indirectly
infringe any patent rights of a third party.
Our customers use of the TGI 100 product candidate, the
TGI 1200 product candidate, certain disposable products used in
conjunction with these product candidates and processes or cells
derived from these product candidates may be determined to
directly or indirectly infringe on patent rights held by third
parties, including Thomas Jefferson University, or Third Party
Patent Rights.
The recourse available to us in the event that these patents are
determined to directly or indirectly infringe any of the Third
Party Patent Rights is limited by the terms of our exclusive
license and distribution agreement with Tissue Genesis. Pursuant
to this agreement, Tissue Genesis has agreed that we and our
customers will not be liable for damages for directly or
indirectly infringing any Third Party Patent Rights for the
treatment of acute heart attacks. Tissue Genesis has, subject to
certain conditions, also agreed to indemnify and hold harmless
us and our customers from all claims that the products infringe
any patents, copyrights or trade secret rights of a third party.
However, if our use of the products is enjoined or if Tissue
Genesis wishes to minimize its liability, Tissue Genesis may, at
its option and expense, either:
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substitute a substantially equivalent non-infringing product for
the infringing product;
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modify the infringing product so that it no longer infringes but
remains functionally equivalent; or
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obtain for us the right to continue using such item.
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If none of the foregoing is feasible, Tissue Genesis is required
to accept a return of the infringing product and refund to us
the amount paid for such product. Any termination of our right
to use, lease or sell the TGI 100 product candidate, the TGI
1200, certain disposable products used in conjunction with these
product candidates and/or the processes or cells derived from
these product candidates or any inability by Tissue Genesis to
refund to us the amounts we paid for such products could have a
material adverse effect on us.
Patent applications owned by 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 U.S. Patent and Trademark
Office and foreign patent offices 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 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 or any
of our licensors was or will be the first creator of inventions
covered by our (or their) patents or applications or the first
to file such patent applications. As a result, our issued
patents and 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 U.S. Patent
and Trademark Office to determine priority of discovery or
invention. Interference proceedings, if resolved adversely to us
or our licensors, 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 have been
or may be owned by or licensed to us or that we or our licensors
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
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the future, leading to uncertainty over the scope of the patents
owned by or licensed to us or that may in the future be owned by
us or 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.
Challenges raised in patent infringement litigation brought by
or against us may result in determinations that patents that
have been issued 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 have been licensed to us
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 may not provide us with any competitive
advantage or provide meaningful protection against
competitors.
We own, hold licenses or hold sublicenses to an intellectual
property portfolio consisting of approximately 19 patents and 19
patent applications in the United States, and approximately
twelve patents and 51 patent applications in foreign countries,
for use in the field of heart muscle regeneration. However, the
discoveries or technologies covered by these patents 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. With the exception of the
technology related to MyoCell, 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 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. We believe we will need to, among other
things, license additional intellectual property to
commercialize a number of our product candidates, including
MyoCell II with SDF-1, in the form we believe may prove to be
the most safe and/or effective.
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. For example, we believe that a number of our
competitors have proposed catheter designs that are apparently
intended to avoid infringing upon our catheter related
technology.
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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 and, under our
license agreements, we may not have the right to initiate
proceedings to obtain patents in those countries. 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.
Litigation or other proceedings relating to patent and
other intellectual property rights could result in substantial
costs and liabilities and prevent us from commercializing our
product candidates.
Our commercial success depends significantly on our ability to
operate in a way that does not infringe or violate the
intellectual property rights of third parties in the United
States and in foreign countries. We are not currently a party to
any litigation or other adverse proceeding with regard to our
patents or intellectual property rights. However, 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. Further, we, or our
licensors, may need to participate in interference, opposition,
protest, reexamination or other potentially adverse proceedings
in the U.S. Patent and Trademark Office or in similar agencies
of foreign governments with regards to our patents and
intellectual property rights. In addition, we or our licensors
may need to initiate suits to protect our intellectual property
rights.
Certain of our competitors in the field have acquired patents
which might be used to attempt to prevent commercialization of
MyoCell. We are aware of at least three such patent families. We
believe the patents in these three families are narrow, and that
we do not infringe any valid claims of these patents in our
current practice. The U.S. Patent and Trademark Office has
commenced a re-examination relating to one of these patent
families. There is no assurance that we will receive a favorable
ruling in this proceeding. In the event that the proceeding
fails to result in limitation of the claims of the subject
patent, such outcome may have a material adverse effect on our
business, financial condition and results of operation.
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 partys patented intellectual property, those rights
may be non-exclusive 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 studies or submitting technical, cell
culturing, 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.
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Additionally, any involvement of us in litigation in which we 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.
If we are not able to protect and control unpatented trade
secrets, know-how and other technological innovation, we may
suffer competitive harm.
In addition to patented intellectual property, we also rely on
unpatented technology, trade secrets, confidential information
and proprietary know-how to protect our technology and maintain
our competitive position, especially when we do not believe that
patent protection is appropriate or can be obtained. Trade
secrets are difficult to protect. In order to protect
proprietary technology and processes, we rely in part on
confidentiality and intellectual property assignment agreements
with our employees, consultants and others. These agreements
generally provide that the individual must keep confidential and
not disclose to other parties any confidential information
developed or learned by the individual during the course of the
individuals relationship with us except in limited
circumstances. These agreements generally also provide that we
shall own all inventions conceived by the individual in the
course of rendering services to us. These agreements may not
effectively prevent disclosure of confidential information or
result in the effective assignment to us of intellectual
property, and may not provide an adequate remedy in the event of
unauthorized disclosure of confidential information or other
breaches of the agreements. In addition, others may
independently discover trade secrets and proprietary information
that have been licensed to us or that we own, and in such case
we could not assert any trade secret rights against such party.
Enforcing a claim that a party illegally obtained and is using
trade secrets that have been licensed to us or that we own is
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 licensors, 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.
Other Risks Related to Our Business
Our operations are consolidated primarily in one facility.
A disaster at this facility is possible and could result in a
prolonged interruption of our business.
All of our administrative operations and substantially all of
our U.S. cell culturing operations are located at our facilities
in Sunrise, Florida. Our business is and will continue to be
influenced by local economic, financial and other conditions
affecting the South Florida area. This may include prolonged or
severe inclement weather in the South Florida area or a
catastrophic event such as a hurricane or tornado, all of which
are common events in Florida.
We depend on attracting and retaining key management and
scientific personnel and the loss of these personnel could
impair the development of our products candidates.
Our success depends on our continued ability to attract, retain
and motivate highly qualified management, clinical and
scientific personnel and on our ability to develop and maintain
important relationships with academic institutions, clinicians
and scientists. We are seeking to hire a new Chief Executive
Officer and anticipate that once a new Chief Executive Officer
is located Mr. Howard J. Leonhardt, our current Chairman
and Chief Executive Officer, will continue with us as our
Executive Chairman and Chief Technology Officer. We are highly
dependent upon our senior scientific staff. The loss of services
of one or more members of our senior scientific staff could
significantly delay or prevent the successful completion of our
clinical trials or commercialization of our product candidates.
The employment of each of our employees with us is at
will, and each employee can terminate his or her
employment with us at any time. We do not have a succession plan
in place for any of our officers and key employees. Although we
are seeking to secure key person
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insurance on Mr. Leonhardt, we do not carry insurance on
any of our other key employees and, accordingly, their death or
disability may have a material adverse effect on our business.
The competition for qualified personnel in the life sciences
field is intense. We will need to hire additional personnel,
including regulatory and sales personnel, as we continue to
expand our development activities. We may not be able to attract
and retain quality personnel on acceptable terms given our
geographic location and the competition for such personnel among
life sciences, biotechnology, pharmaceutical and other
companies. If we are unable to attract new employees and retain
existing employees, we may be unable to continue our development
and commercialization activities and our business may be harmed.
If we acquire other businesses and technologies our
performance may suffer.
If we are presented with opportunities, we may seek to acquire
additional businesses and/or technologies. The acquisition of
businesses and technologies may require significant expenditures
and management resources that could otherwise be available for
development of other aspects of our business. Future
acquisitions may require the issuance of additional shares of
stock or other securities which would further dilute your
investment or the incurrence of additional debt and liabilities
which could create additional expenses, any of which may
negatively impact our financial results and result in
restrictions on our business that may harm our future outlook
and cause our stock price to decline.
We may not be able to effectively manage our future
growth.
If we are able to commercialize one or more of our product
candidates, we may not be able to manage future growth following
such commercialization because:
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we may be unable to effectively manage our personnel and
financial operations;
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we may be unable to hire or retain key management and staff; and
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commercial success may stimulate competitive challenges that we
may be unable to meet, resulting in declining market share and
sales of our products.
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Any inability to manage our growth effectively could adversely
affect our business.
Expansion into international markets is important to our
long-term success, and our inexperience in operations outside
the United States increases the risk that our international
operations may not be successful.
We believe that our future growth depends on obtaining
regulatory approvals to sell our product candidates in foreign
countries and our ability to sell our product candidates in
those countries. We have only limited experience with operations
outside the United States. Our goal of selling our products into
international markets will require management attention and
resources and is subject to inherent risks, which may adversely
affect us, including:
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unusual or burdensome foreign laws or regulations and unexpected
changes in regulatory requirements, including potential
restrictions on the transfer of funds;
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no or less effective protection of our intellectual property;
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foreign currency risks;
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political instability, including adverse changes in trade
policies between countries in which we may maintain operations;
and
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longer accounts receivable payment cycles and difficulties in
collecting payments.
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These factors and other factors could adversely affect our
ability to execute our international marketing strategy or
otherwise have a material adverse effect on our business.
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Because we have operated as a private company, we have no
experience complying with public company obligations. Compliance
with these requirements will increase our costs and require
additional management resources, and we may still fail to
comply.
We will incur significant additional legal, accounting,
insurance and other expenses as a result of being a public
company that we have not incurred as a private company. For
example, laws and regulations affecting public companies,
including the provisions of the Sarbanes-Oxley Act of 2002, or
the Sarbanes-Oxley Act, and rules related to corporate
governance and other matters subsequently adopted by the
Securities and Exchange Commission, or the SEC, and the NASDAQ
Global Market will result in substantially increased costs to
us, including legal and accounting costs, and may divert our
managements attention from other matters that are
important to our business. These rules and any related
regulations that may be proposed in the future will likely make
it more difficult or more costly for us to obtain certain types
of insurance, including directors and officers
liability insurance, and we may be forced to accept reduced
policy limits and coverage or incur substantially higher costs
to obtain the same or similar coverage. The impact of these
laws, rules and regulations could also make it more difficult
for us to attract and retain qualified persons to serve on our
board of directors, our board committees or as executive
officers. We cannot predict or estimate the amount of the
additional costs we may incur, but we expect our operating
results will be adversely affected by the costs of operating as
a public company.
Our internal control over financial reporting may be
insufficient to detect in a timely manner misstatements that
could occur in our financial statements in amounts that may be
material.
In connection with the audit of our financial statements for the
year ended December 31, 2005, we identified a significant
deficiency in our internal control over financial reporting
which constituted a material weakness. A material weakness is a
significant deficiency, or combination of significant
deficiencies, that results in more than a remote likelihood that
a material misstatement of the annual or interim financial
statements will not be prevented or detected. The significant
deficiency related to our year-end closing methodologies and was
based on the number and size of year-end adjustments we
recorded. While we have taken steps to attempt to remedy this
material weakness and the significant deficiency through our
addition of a chief financial officer and corporate controller,
we may still experience material weaknesses and significant
deficiencies, which, if not remediated, may render us unable to
prevent or detect in a timely manner material misstatements that
could occur in our monthly or interim financial statements.
Failure to achieve and maintain effective internal control
over financial reporting in accordance with Section 404 of
the Sarbanes-Oxley Act could have a material adverse effect on
our business.
As a public company, within the next 24 months, we will be
required to document and test our internal financial control
procedures in order to satisfy the requirements of
Section 404 of the Sarbanes-Oxley Act, which will require
annual management assessments of the effectiveness of our
internal control over financial reporting and a report by our
independent auditors that both addresses managements
assessments and provides for the independent auditors
assessment of the effectiveness of our internal control over
financial reporting. During the course of our testing, we may
identify deficiencies which we may not be able to remediate in
time to meet our deadline for compliance with Section 404,
and we may also identify inaccuracies or deficiencies in our
financial reporting that could require revisions to or
restatement of prior period results. Testing and maintaining
internal control over financial reporting also will involve
significant costs and can divert our managements attention
from other matters that are important to our business. We may
not be able to conclude on an ongoing basis that our internal
control over financial reporting is effective in accordance with
Section 404, and our independent registered public
accounting firm may not be able or willing to issue a favorable
assessment of our conclusions. Failure to achieve and maintain
an effective internal control environment could harm our
operating results and could cause us to fail to meet our
reporting obligations and could require that we restate our
financial statements for prior periods, any of which could cause
investors to lose confidence in our reported financial
information and cause a decline, which could be material, in the
trading price of our common stock.
28
We face intense competition in the biotechnology and
healthcare industries.
We face, and will continue to face, intense competition from
pharmaceutical, biopharmaceutical, medical device and
biotechnology companies developing heart failure treatments both
in the United States and abroad, as well as numerous academic
and research institutions, governmental agencies and private
organizations engaged in drug discovery activities or funding
both in the United States and abroad. We also face competition
from entities and healthcare providers using more traditional
methods, such as surgery and pharmaceutical regimens, to treat
heart failure. We believe there are a substantial number of
heart failure products under development by numerous
pharmaceutical, biopharmaceutical, medical device and
biotechnology companies, and it is likely that other competitors
will emerge. We are also aware of several competitors developing
cell-based therapies for the treatment of heart damage,
including MG Biotherapeutics, LLC (a joint venture between
Genzyme Corporation and Medtronic, Inc.), Mytogen, Inc., Baxter
International, Inc., Osiris Therapeutics, Inc., Viacell, Inc.,
Cytori Therapeutics, Inc. and potentially others. We also
recognize that there may be competitors and competing
technologies, therapies and/or products that we are not aware of.
These third parties also compete with us in recruiting and
retaining qualified personnel, establishing clinical trial sites
and registering patients for clinical trials, as well as
acquiring or licensing intellectual property and technology.
Many competitors have more experience than we do in research and
development, marketing, cell culturing, manufacturing,
preclinical testing, conducting clinical trials, obtaining FDA
and foreign regulatory approvals and marketing approved
products. The competitors, some of which have their own sales
and marketing organizations, have greater financial and
technical resources than we do and may be better equipped than
we are to sell competing products, obtain patents that block or
otherwise inhibit our ability to further develop and
commercialize our product candidates, obtain approvals from the
FDA or other regulatory agencies for products more rapidly than
we do, or develop treatments or cures that are safer or more
effective than those we propose to develop. In addition,
academic institutions, governmental agencies, and other public
and private organizations conducting research in the field of
heart damage may seek patent protection with respect to
potentially competitive products or technologies and may
establish exclusive collaborative or licensing relationships
with our competitors.
MyoCell is a non-acute clinical therapy designed to be utilized
at least a few months after a patient has suffered heart damage.
Our competitors may discover technologies and techniques for the
acute treatment of heart failure, which, if successful in
treating heart failure shortly after its occurrence, may reduce
the market size for non-acute treatments, including MyoCell.
Our industry is subject to rapid technological
change.
Our industry is subject to rapid technological change and our
cellular-based therapies involve new and rapidly developing
technology. Our competitors may discover technologies and
techniques, or enter into partnerships with collaborators in
order to develop, competing products that are more effective or
less costly than the products we develop. We expect this
technology to undergo significant change in the future. If there
is rapid technological development, our current and future
product candidates or methods may become obsolete or
noncompetitive before or after we commercialize them.
Risks Related to This Offering
There is no prior public market for our stock. Our stock
price may be volatile and you may be unable to sell your shares
at or above the offering price.
There previously has been no public market for our common stock.
The initial public offering price for our shares was determined
by negotiations between us and representatives of the
underwriters and does not purport to be indicative of prices
that will prevail in the trading market. The market price of our
common stock could be subject to wide fluctuations in response
to many risk factors described in this section and other
matters, including:
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publications of clinical trial results by clinical investigators
or others about our products and competitors products
and/or our industry;
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29
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changes by securities analysts in financial estimates of our
operating results and the operating results of our competitors;
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publications of research reports by securities analysts about
us, our competitors or our industry;
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fluctuations in the valuation of companies perceived by
investors to be comparable to us;
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actual or anticipated fluctuations in our quarterly or annual
operating results;
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retention and departures of key personnel;
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our failure or the failure of our competitors to meet
analysts projections or guidance that we or our
competitors may give to the market;
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strategic decisions by us or our competitors, such as
acquisitions, divestitures, spin-offs, joint ventures, strategic
investments or changes in business strategy;
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the passage of legislation or other regulatory developments
affecting us or our industry;
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speculation in the press or investment community; and
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natural disasters, terrorist acts, acts of war or periods of
widespread civil unrest.
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Furthermore, the stock markets have experienced extreme price
and volume fluctuations that have affected and continue to
affect the market prices of equity securities of many companies,
especially life sciences and pharmaceutical companies. These
fluctuations often have been unrelated or disproportionate to
the operating performance of those companies. These broad market
and industry fluctuations, as well as general economic,
political and market conditions, may negatively affect the
market price of our common stock. As a result, the market price
of our common stock is likely to be similarly volatile and
investors in our common stock may experience a decrease, which
could be substantial, in the value of their stock. In the past,
many companies that have experienced volatility in the market
price of their stock have been subject to securities class
action litigation. We may be the target of this type of
litigation in the future. Securities litigation against us could
result in substantial costs and divert our managements
attention from other business concerns, which could have a
material adverse effect on our business.
Our existing shareholders, including Mr. Leonhardt,
have significant control of our management and affairs, which
they could exercise against your best interests.
Immediately following the completion of this offering, based on
shares outstanding as
of ,
2007, our executive officers and directors and persons and
entities that were our shareholders prior to this offering will
beneficially own an aggregate of
approximately %
of our outstanding common stock, or
approximately %
of our outstanding common stock if the underwriters
over-allotment option is exercised in full. In particular, Mr.
Leonhardt will own
approximately %
of our outstanding common stock immediately following this
offering, or
approximately %
of our outstanding common stock if the underwriters
over-allotment option is exercised in full, in each case based
on shares outstanding as
of ,
2007. As a result, Mr. Leonhardt currently has, and will
continue to have, a significant influence over the outcome of
all corporate actions requiring shareholder approval.
Consequently, this concentration of ownership may have the
effect of delaying or preventing a change of control, including
a merger, consolidation or other business combination involving
us, or discouraging a potential acquirer from making a tender
offer or otherwise attempting to obtain control, even if such a
change of control would benefit our other shareholders. The
interests of these shareholders may not coincide with our
interests or the interests of other shareholders.
An active trading market for our common stock may not
develop.
This is our initial public offering of common stock, and prior
to this offering there has been no public market for our common
stock. The initial public offering price for our common stock
will be determined through negotiations with the representatives
of the underwriters. Although we have applied to have our common
stock approved for quotation on the NASDAQ Global Market, an
active trading market for our common stock may never develop or
be sustained following this offering. If an active market for
our common
30
stock does not develop, it may be difficult for you to sell
shares you purchase in this offering without depressing the
market price for our common stock.
If you purchase shares of common stock sold in this
offering, you will experience immediate and substantial
dilution. You may also experience dilution in the future.
The initial public offering price per share is substantially
higher than the net tangible book value per share immediately
after the offering. As a result, you will pay a price per share
that substantially exceeds the book value of our assets after
subtracting our liabilities. Assuming an offering price of
$ ,
the midpoint of the range set forth on the cover of this
prospectus, you will incur immediate and substantial dilution of
$ in
the net tangible book value per share of the common stock from
the price you paid. We also have outstanding stock options to
purchase shares
of our common stock at a weighted average exercise price
of per
share as
of ,
2007. To the extent that options with an exercise price less
than the initial public offering price are exercised, there will
be further dilution.
Under certain of our patent license agreements, including our
license agreements with Cell Transplants International and the
Cleveland Clinic, we are required to make certain large
milestone payments upon our achievement of certain development
and commercialization objectives. We may be required to or, to
the extent we do not have the cash resources necessary to
satisfy our obligations may seek to, issue shares or other
securities in satisfaction of our financial obligations under
these license agreements. To the extent we issue shares at a
price per share less than the initial public offering price per
share, you will incur dilution in the net tangible book value
per share.
Following this offering, a substantial number of our
shares of common stock will become available for sale in the
public market, which may cause the market price of our stock to
decline.
Sales of our common stock in the public market following this
offering, or the perception that those sales may occur, could
cause the market price of our common stock to decline.
Immediately upon completion of this offering, we will
have outstanding
shares of common stock based on shares outstanding as
of ,
2007. In general, the shares sold in this offering will be
freely tradable without restriction, assuming they are not held
by our affiliates. The
remaining shares
of common stock outstanding after this offering will be
available for sale in the public markets, pursuant to
Rule 144 or Rule 701 under the Securities Act of 1933,
or the Securities Act, 180 days (subject to extension for
up to an additional 34 days under limited circumstances as
described under Underwriting) after the completion
of this offering following the expiration of lock-up agreements
entered into by our directors and officers and holders of more
than 1% of our common stock for the benefit of the underwriters.
In addition, we intend to file one or more registration
statements to register shares of common stock subject to
outstanding stock options and common stock reserved for issuance
under our Officers and Employees Stock Option Plan and Directors
and Consultants Stock Option Plan. We expect these additional
registration statements to become effective immediately upon
filing.
Furthermore, immediately after completion of this offering, the
holders
of shares
of our outstanding common stock will also have the right to
require that we register those shares under the Securities Act
on several occasions and will also have the right to include
those shares in any registration statement we file with the SEC,
subject to exceptions, which would enable those shares to be
sold in the public markets, subject to the restrictions under
lock-up agreements referred to above.
Any or all shares subject to the lock-up agreements may be
released, without notice to the public, for sale in the public
markets prior to expiration of the lock-up period at the
discretion of BMO Capital Markets Corp.
Our management has broad discretion in the use of the net
proceeds from this offering and may not use them
effectively.
As of the date of this prospectus, we cannot specify with
certainty the amount of net proceeds from this offering that we
will spend on particular uses. Although our management currently
intends to use the net
31
proceeds in the manner described in Use of Proceeds,
it will have broad discretion in the application of the net
proceeds. The failure by our management to apply these funds
effectively could adversely affect our ability to continue to
maintain and expand our business.
Anti-takeover provisions of Florida law, our articles of
incorporation and our bylaws may prevent or delay an acquisition
of us that shareholders may consider favorable or attempts to
replace or remove our management that could be beneficial to our
shareholders.
Our articles of incorporation and bylaws contain provisions,
such as the right of our directors to issue preferred stock from
time to time with voting, economic and other rights superior to
those of our common stock without the consent of our
shareholders, all of which could make it more difficult for a
third party to acquire us without the consent of our board of
directors. In addition, our bylaws impose restrictions on the
persons who may call special shareholder meetings. Furthermore,
the Florida Business Corporation Act contains an
affiliated transaction provision that prohibits a
publicly-held Florida corporation from engaging in a broad range
of business combinations or other extraordinary corporate
transactions with an interested shareholder unless,
among others, (i) the transaction is approved by a majority
of disinterested directors before the person becomes an
interested shareholder; (ii) the interested shareholder has
owned at least 80% of the corporations outstanding voting
shares for at least five years; or (iii) the transaction is
approved by the holders of two-thirds of the corporations
voting shares other than those owned by the interested
shareholder. An interested shareholder is defined as a person
who together with affiliates and associates beneficially owns
more than 10% of the corporations outstanding voting
shares. The Florida Business Corporation Act also prohibits the
voting of shares in a publicly-held Florida corporation that are
acquired in a control share acquisition unless the
holders of a majority of the corporations voting shares
(exclusive of shares held by officers of the corporation, inside
directors or the acquiring party) approve the granting of voting
rights as to the shares acquired in the control share
acquisition or unless the acquisition is approved by the
corporations Board of Directors. These provisions may have
the effect of delaying or preventing a change of control of our
company even if this change of control would benefit our
shareholders.
We do not intend to pay cash dividends on our common stock
in the foreseeable future.
Our policy is to retain earnings to provide funds for the
operation and expansion of our business and, accordingly, we
have never declared or paid any cash dividends on our common
stock or other securities and do not currently anticipate paying
any cash dividends in the foreseeable future. Consequently,
shareholders will need to sell shares of our common stock to
realize a return on their investments, if any. The declaration
and payment of dividends by us are subject to the discretion of
our Board of Directors and the restrictions specified in our
articles of incorporation and by applicable law. Any future
determination to pay cash dividends will depend on our results
of operations, financial condition, capital requirements,
contractual restrictions and other factors deemed relevant by
our Board of Directors.
32
SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS
This prospectus may contain forward-looking statements that are
based on our managements beliefs and assumptions and on
information currently available to our management. Any such
forward-looking statements would be contained principally in
Prospectus Summary, Risk Factors,
Managements Discussion and Analysis of Financial
Condition and Results of Operations and
Business. Forward-looking statements include
information concerning our possible or assumed future results of
operations, business strategies, financing plans, competitive
position, industry environment, potential growth opportunities
and the effects of regulation. Forward-looking statements
include all statements that are not historical facts and can be
identified by terms such as anticipates,
believes, could, estimates,
expects, hopes, intends,
may, plans, potential,
predicts, projects, should,
will, would or similar expressions.
The forward-looking statements in this prospectus include, among
other things, statements about:
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the initiation and completion of clinical trials;
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the announcement of data concerning the results of clinical
trials for MyoCell;
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our estimates regarding future revenues and timing thereof,
expenses, capital requirements and needs for additional
financing;
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our ongoing and planned discovery programs, preclinical studies
and additional clinical trials;
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the timing of and our ability to obtain and maintain regulatory
approvals for our product candidates;
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the rate and degree of market acceptance and clinical utility of
our products;
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our ability to quickly and efficiently identify and develop
product candidates;
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our commercialization, marketing and manufacturing capabilities
and strategy; and
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our intellectual property position.
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Forward-looking statements involve known and unknown risks,
uncertainties and other factors which may cause our actual
results, performance or achievements to be materially different
from any future results, performance or achievements expressed
or implied by the forward-looking statements. We discuss many of
these risks in greater detail in Risk Factors. Given
these uncertainties, you should not place undue reliance on
these forward-looking statements. Also, forward-looking
statements represent our managements beliefs and
assumptions only as of the date of this prospectus. You should
read this prospectus and the documents that we reference in this
prospectus and have filed as exhibits to the registration
statement, of which the prospectus is a part, completely and
with the understanding that our actual future results may be
materially different from what we expect.
Except as required by law, we assume no obligation to update
these forward-looking statements publicly, or to update the
reasons actual results could differ materially from those
anticipated in these forward-looking statements, even if new
information becomes available in the future. The forward-looking
statements contained in this prospectus are not eligible for the
safe harbor protection provided by the Private Securities
Litigation Reform Act of 1995 and Section 27A of the
Securities Act of 1933, as amended.
33
USE OF PROCEEDS
Based upon an assumed initial public offering price of
$ per
share (the mid-point of the range set forth on the cover page of
this prospectus), we estimate that our net proceeds from the
sale
of shares
of our common stock in this offering, after deducting
underwriting discounts and commissions and estimated offering
costs of approximately
$ million
payable by us, will be approximately
$ million
(or $ million if the underwriters exercise their
over-allotment option in full). A $1.00 increase
(decrease) in the assumed initial public offering price of
$ per
share would increase (decrease) the net proceeds to us from
this offering by
$ million,
assuming the number of shares offered by us, as set forth on the
cover page of this prospectus, remains the same and after
deducting the estimated underwriting discounts and commissions
and estimated expenses payable by us.
We intend to use the net proceeds of this offering to fund the
growth of our business, including:
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approximately
$ million for the
MYOHEART II and SEISMIC Trials;
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approximately
$ million for
projected payments pursuant to our license agreements and to
further develop and protect our intellectual property portfolio;
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approximately
$ million for the
further development and clinical testing of our pipeline product
candidates; and
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approximately
$ million for
general corporate purposes, including working capital needs,
development of a sales and marketing force, and potential
acquisitions of technologies or businesses or the establishment
of partnerships and collaborations complementary to our business.
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The amounts and timing of our actual expenditures may vary
significantly from our expectations depending upon numerous
factors, including our results of operation, financial condition
and capital requirements. Accordingly, we will retain the
discretion to allocate the net proceeds of this offering among
the identified uses described above, and we reserve the right to
change the allocation of the net proceeds among the uses
described above.
Pending their use, we intend to invest the net proceeds in
short-term, interest-bearing, investment-grade securities.
DIVIDEND POLICY
Our policy is to retain earnings to provide funds for the
operation and expansion of our business and, accordingly, we
have never declared or paid any cash dividends on our common
stock or other securities and do not currently anticipate paying
any cash dividends in the foreseeable future. Consequently,
shareholders will most likely need to sell shares of our common
stock to realize a return on their investments, if any. The
declaration and payment of dividends by us are subject to the
discretion of our Board of Directors and the restrictions
specified in our articles of incorporation and by applicable
law. Any future determination to pay cash dividends will depend
on our results of operations, financial condition, capital
requirements, contractual restrictions and other factors deemed
relevant by our Board of Directors.
34
CAPITALIZATION
The following table presents our cash and cash equivalents and
our capitalization as of September 30, 2006:
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on an actual basis;
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on a pro forma basis to give effect to our issuance of 766,216
shares of our common stock between October 1, 2006 and
January 31, 2007 for aggregate net proceeds of
approximately $3.6 million in a private placement to
accredited investors; and
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on a pro forma as adjusted basis to give effect to the sale by
us of shares of our common stock at an assumed initial public
offering price of
$ per
share, the mid-point of the range set forth on the cover page of
this prospectus, and the receipt of net proceeds of this
offering, after deducting underwriting discounts and commissions
and estimated offering expenses payable by us. Each $1.00
increase (decrease) in the assumed initial public offering
price of
$ per
share would increase (decrease) each of cash and cash
equivalents, working capital, total assets and total
shareholders equity by approximately
$ million,
assuming that the number of shares offered by us, as set forth
on the cover page of this prospectus, remains the same, and
after deducting estimated underwriting discounts and commissions
and estimated offering expenses payable by us.
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The pro forma information below is illustrative only and our
capitalization table following the completion of this offering
will be adjusted based on the actual initial public offering
price and other terms of this offering determined at pricing.
You should read this table together with the sections of this
prospectus entitled Managements Discussion and
Analysis of Financial Condition and Results of Operations
and our financial statements and the related notes included
elsewhere in this prospectus.
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As of September 30, 2006
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(Unaudited)
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Pro Forma
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Actual
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Pro Forma
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as Adjusted
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Cash and cash equivalents
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$
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5,183,441
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$
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8,812,583
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$
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Shareholders equity:
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Preferred stock: 5,000,000 shares authorized, none issued and
outstanding actual, pro forma and pro forma as adjusted
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$
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$
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$
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Common stock: 40,000,000 shares authorized, actual and pro
forma; 100,000,000 shares authorized, pro forma as adjusted;
20,098,537 shares issued and outstanding, actual; 20,864,753
shares issued and outstanding, pro forma;
and shares
issued and outstanding, pro forma as adjusted
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20,099
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20,865
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Additional paid-in capital
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65,671,979
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69,300,355
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Deficit accumulated during the development stage
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(62,275,676
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)
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(62,275,676
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)
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Total shareholders equity
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3,416,402
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7,045,544
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Total capitalization
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$
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3,416,402
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$
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7,045,544
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$
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The table above excludes as of September 30, 2006:
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an aggregate of 3,107,275 shares of common stock issuable upon
exercise of outstanding options under our stock option plans,
with a weighted average exercise price of $3.01 per share;
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an aggregate of 1,892,725 additional shares of common stock
reserved for future awards under our stock option plans; and
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an aggregate of 357,632 shares of common stock issuable upon the
exercise of outstanding warrants with a weighted average
exercise price of $3.68 per share.
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From October 1, 2006 through December 31, 2006, we
granted options to purchase an aggregate of 39,852 shares of our
common stock under our stock option plans with an exercise price
of $4.75 per share and warrants to purchase an aggregate of
2,500,000 shares of our common stock with an exercise price of
$4.75 per share. From January 1, 2007 through
January 31, 2007, we granted options to purchase an
aggregate of 56,000 shares of our common stock under our stock
option plans with an exercise price of $5.23 per share.
DILUTION
If you invest in our common stock, your interest will be diluted
to the extent of the difference between the initial public
offering price per share of our common stock in this offering
and the pro forma net tangible book value per share of our
common stock after completion of this offering.
Our net tangible book value as of September 30, 2006 was
approximately $3.4 million, or approximately $0.17 per
share of our common stock. Net tangible book value per share is
determined at any date by subtracting our total liabilities from
our total tangible assets (total assets less intangible assets)
and dividing the difference by the number of our shares of
common stock deemed to be outstanding at that date. Dilution in
net tangible book value per share represents the difference
between the amount per share paid by purchasers of shares of
common stock in this offering and the net tangible book value
per share of common stock immediately after completion of this
offering. Our pro forma net tangible book value as of
September 30, 2006 was approximately $7.0 million or
$0.34 per share. Pro forma net tangible book value per share
gives effect to our issuance of 766,216 shares of our common
stock between October 1, 2006 and January 31, 2007 for
aggregate net proceeds of approximately $3.6 million in a
private placement to accredited investors.
After giving effect to the sale
of shares
offered by us in this offering at an assumed initial public
offering price of
$ per
share, the midpoint of the range set forth on the cover page of
this prospectus, and after deducting estimated underwriting
discounts and commissions and our estimated offering expenses,
our pro forma as adjusted net tangible book value as of
September 30, 2006 would have been approximately
$ million,
or approximately
$ per
share of common stock. This represents an immediate increase in
pro forma as adjusted net tangible book value of
$ per
share to existing shareholders and an immediate dilution in pro
forma as adjusted net tangible book value of
$ per
share to new investors. The following table illustrates this per
share dilution:
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Assumed initial public offering price per share
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$
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Net tangible book value per share as of September 30, 2006
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$
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0.17
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Pro forma increase in net tangible book value per share
attributable to issuance of common stock between October 1,
2006 and January 31, 2007
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$
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0.17
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Pro forma net tangible book value per share as of
September 30, 2006
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$
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0.34
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Pro forma increase in net tangible book value per share
attributable to this offering
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$
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Pro forma as adjusted net tangible book value per share after
this offering
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$
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Dilution per share to new investors
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$
|
|
|
The following table summarizes as of September 30, 2006 the
number of shares of our common stock purchased from us, the
total consideration paid to us, and the average price per share
paid to us by our existing shareholders and to be paid by new
investors purchasing shares of our common stock in this offering
based on
36
an assumed public offering price of
$ per share,
before deducting the estimated underwriting discounts and
commissions and estimated offering expenses payable by us:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Shares Purchased
|
|
|
Total Consideration
|
|
|
Average
|
|
|
|
|
|
|
|
|
|
Price per
|
|
|
|
Number
|
|
|
Percentage
|
|
|
Amount
|
|
|
Percentage
|
|
|
Share
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Existing shareholders
|
|
|
20,098,537
|
|
|
|
|
|
|
$
|
51,122,401
|
|
|
|
|
|
|
$
|
2.54
|
|
New investors
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
The number of shares of common stock outstanding in the table
above is based on the number of shares outstanding as of
September 30, 2006 and excludes:
|
|
|
|
|
an aggregate of 3,107,275 shares of common stock issuable upon
exercise of outstanding options under our stock option plans,
with a weighted average exercise price of $3.01 per share;
|
|
|
|
an aggregate of 1,892,725 additional shares of common stock
reserved for future awards under our stock option plans; and
|
|
|
|
an aggregate of 357,632 shares of common stock issuable upon the
exercise of outstanding warrants with a weighted average
exercise price of $3.68 per share.
|
From October 1, 2006 through December 31, 2006, we
granted options to purchase an aggregate of 39,852 shares of our
common stock under our stock option plans with an exercise price
of $4.75 per share and warrants to purchase an aggregate of
2,500,000 shares of our common stock with an exercise price of
$4.75 per share. From January 1, 2007 through
January 31, 2007, we granted options to purchase an
aggregate of 56,000 shares of our common stock under our stock
option plans with an exercise price of $5.23 per share.
Because the exercise price of the outstanding options and
warrants is below the anticipated offering price, investors
purchasing common stock in this offering will suffer additional
dilution when and if these options or warrants are exercised.
See Management Our stock option plans
for further information regarding our equity incentive plans.
A $1.00 increase (decrease) in the assumed initial public
offering price of
$ per
share would increase (decrease) our pro forma as adjusted net
tangible book value by
$ million
and the pro forma as adjusted net tangible book value per share
after completion of this offering by
$ per
share, assuming the number of shares offered by us, as set forth
on the cover page of this prospectus, remains the same, and
after deducting the estimated underwriting discounts and
commissions and estimated offering expenses payable by us.
If the underwriters exercise their over-allotment option in
full, the net tangible book value per share after completion of
this offering would be
$ per
share, the increase in net tangible book value per share to
existing shareholders would be
$ per
share and the dilution in net tangible book value to new
investors would be
$ per
share.
37
SELECTED CONSOLIDATED FINANCIAL DATA
The following table presents selected consolidated historical
financial data. We derived the selected consolidated statement
of operations data for the years ended December 31, 2003,
2004 and 2005 and consolidated balance sheet data as of
December 31, 2004 and 2005 from our audited financial
statements and notes thereto that are included elsewhere in this
prospectus. We derived the selected consolidated statement of
operations data for the years ended December 31, 2001 and
2002 and the consolidated balance sheet data as of
December 31, 2001, 2002 and 2003 from our audited financial
statements that do not appear in this prospectus. We derived the
consolidated statement of operations data for the nine months
ended September 30, 2005 and 2006 and the consolidated
balance sheet data as of September 30, 2006 from our
unaudited financial statements that are included elsewhere in
this prospectus. The unaudited interim financial statements have
been prepared on the same basis as our audited annual financial
statements and, in our opinion, reflect all adjustments, which
include only normal recurring adjustments, necessary to present
fairly the results of operations for the periods ended
September 30, 2005 and 2006 and our financial condition as
of September 30, 2006. The historical results are not
necessarily indicative of the results to be expected for any
future periods and the results for the nine months ended
September 30, 2006 should not be considered indicative of
results expected for the full fiscal year.
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Nine Months Ended
|
|
|
|
Year Ended December 31,
|
|
|
September 30,
|
|
|
|
|
|
|
|
|
|
|
2001
|
|
|
2002
|
|
|
2003
|
|
|
2004
|
|
|
2005
|
|
|
2005
|
|
|
2006
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Unaudited)
|
|
|
|
(In thousands, except per share data)
|
|
Statement of Operations Data:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Revenues
|
|
$
|
25
|
|
|
$
|
2
|
|
|
$
|
46
|
|
|
$
|
86
|
|
|
$
|
135
|
|
|
$
|
127
|
|
|
$
|
106
|
|
Cost of sales
|
|
|
|
|
|
|
|
|
|
|
30
|
|
|
|
46
|
|
|
|
87
|
|
|
|
75
|
|
|
|
63
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Gross profit
|
|
|
25
|
|
|
|
2
|
|
|
|
16
|
|
|
|
40
|
|
|
|
48
|
|
|
|
52
|
|
|
|
43
|
|
Expenses:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Research and development
|
|
|
6,597
|
|
|
|
7,361
|
|
|
|
3,502
|
|
|
|
3,787
|
|
|
|
4,534
|
|
|
|
3,142
|
|
|
|
5,339
|
|
Marketing, general and administrative
|
|
|
1,714
|
|
|
|
1,946
|
|
|
|
2,523
|
|
|
|
1,731
|
|
|
|
2,831
|
|
|
|
2,111
|
|
|
|
5,680
|
|
Depreciation and amortization
|
|
|
|
|
|
|
|
|
|
|
31
|
|
|
|
34
|
|
|
|
46
|
|
|
|
33
|
|
|
|
46
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Total expenses
|
|
|
8,311
|
|
|
|
9,307
|
|
|
|
6,056
|
|
|
|
5,552
|
|
|
|
7,411
|
|
|
|
5,286
|
|
|
|
11,065
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Loss from operations
|
|
|
(8,286
|
)
|
|
|
(9,305
|
)
|
|
|
(6,040
|
)
|
|
|
(5,512
|
)
|
|
|
(7,363
|
)
|
|
|
(5,234
|
)
|
|
|
(11,022
|
)
|
Total interest income (expense), net
|
|
|
113
|
|
|
|
47
|
|
|
|
2
|
|
|
|
(7
|
)
|
|
|
36
|
|
|
|
9
|
|
|
|
78
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net loss before income taxes
|
|
|
(8,173
|
)
|
|
|
(9,258
|
)
|
|
|
(6,038
|
)
|
|
|
(5,519
|
)
|
|
|
(7,327
|
)
|
|
|
(5,225
|
)
|
|
|
(10,944
|
)
|
Income taxes
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Net loss
|
|
$
|
(8,173
|
)
|
|
$
|
(9,258
|
)
|
|
$
|
(6,038
|
)
|
|
$
|
(5,519
|
)
|
|
$
|
(7,327
|
)
|
|
$
|
(5,225
|
)
|
|
$
|
(10,944
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Basic and diluted net loss per share
|
|
$
|
(0.94
|
)
|
|
$
|
(0.95
|
)
|
|
$
|
(0.46
|
)
|
|
$
|
(0.37
|
)
|
|
$
|
(0.42
|
)
|
|
$
|
(0.31
|
)
|
|
$
|
(0.57
|
)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted average shares outstanding basic and diluted
|
|
|
8,707
|
|
|
|
9,724
|
|
|
|
12,985
|
|
|
|
14,875
|
|
|
|
17,244
|
|
|
|
16,681
|
|
|
|
19,057
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
As of December 31,
|
|
|
As of
|
|
|
|
|
|
|
September 30,
|
|
|
|
2001
|
|
|
2002
|
|
|
2003
|
|
|
2004
|
|
|
2005
|
|
|
2006
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Unaudited)
|
|
Balance Sheet Data:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Cash and cash equivalents
|
|
$
|
2,980
|
|
|
$
|
2,231
|
|
|
$
|
635
|
|
|
$
|
182
|
|
|
$
|
5,158
|
|
|
$
|
5,183
|
|
Working capital (deficit)
|
|
|
2,010
|
|
|
|
554
|
|
|
|
(784
|
)
|
|
|
(2,000
|
)
|
|
|
4,210
|
|
|
|
2,769
|
|
Total assets
|
|
|
3,251
|
|
|
|
2,540
|
|
|
|
921
|
|
|
|
729
|
|
|
|
5,869
|
|
|
|
6,227
|
|
Long-term debt, less current portion
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Deficit accumulated during the development stage
|
|
|
(23,191
|
)
|
|
|
(32,449
|
)
|
|
|
(37,877
|
)
|
|
|
(44,005
|
)
|
|
|
(51,332
|
)
|
|
|
(62,276
|
)
|
Total shareholders equity (deficit)
|
|
$
|
2,129
|
|
|
$
|
788
|
|
|
$
|
(554
|
)
|
|
$
|
(1,857
|
)
|
|
$
|
4,586
|
|
|
$
|
3,416
|
|
38
MANAGEMENTS DISCUSSION AND ANALYSIS OF
FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The following discussion and analysis by our management of
our financial condition and results of operations should be read
in conjunction with our consolidated financial statements and
the accompanying notes included elsewhere in this prospectus.
This discussion and other parts of this prospectus contain
forward-looking statements that involve risks and uncertainties,
such as statements of our plans, objectives, expectations and
intentions. Our actual results could differ materially from
those discussed in the forward-looking statements. Factors that
could cause or contribute to such differences include, but are
not limited to, those discussed in Risk Factors.
Moreover, past financial and operating performances are not
necessarily reliable indicators of future performance and you
are cautioned in using our historical results to anticipate
future results or to predict future trends.
Overview
We are a biotechnology company focused on the discovery,
development and commercialization of therapies using cells
derived from a patients body, and related devices, for the
treatment of heart damage. Our lead product candidate is
MyoCell, an innovative clinical therapy designed to populate
regions of scar tissue within a patients heart with living
muscle tissue for the purpose of improving cardiac function.
Since our inception in August 1999, our principal activities
have included:
|
|
|
|
|
developing and engaging in clinical trials of our lead product
candidate, MyoCell, and our MyoCath product candidate;
|
|
|
|
expanding our pipeline of complementary product candidates
through internal development and third party licenses;
|
|
|
|
expanding and strengthening our intellectual property position
through internal programs and third party licenses; and
|
|
|
|
recruiting management, research and clinical personnel.
|
Our principal objective is to become a leading company that
discovers, develops and commercializes novel, autologous
(patient derived) cell-based therapies and related devices, for
the treatment of heart damage. To achieve this objective, we
plan to pursue the following key strategies:
|
|
|
|
|
obtain initial regulatory approval of MyoCell by targeting
patients with severe heart damage;
|
|
|
|
obtain regulatory approval of MyoCell to treat patients with
less severe heart damage;
|
|
|
|
continue to develop our pipeline of cell-based therapies and
related devices for the acute and non-acute treatment of heart
damage;
|
|
|
|
develop our sales and marketing capabilities in advance of
regulatory approval, if any;
|
|
|
|
continue to refine our MyoCell cell culturing processes to
further reduce our costs processing times;
|
|
|
|
expand and enhance our intellectual property rights; and
|
|
|
|
license, acquire and/or develop complementary products and
technologies.
|
In January 2007, we enrolled the final patient in the SEISMIC
Trial. We anticipate that we will complete the MyoCell
implantation procedure on the final patient by the end of the
first quarter 2007.
If the final six-month SEISMIC Trial data is generally
consistent with the interim data, we intend to seek approval in
the fourth quarter of 2007 from various European regulatory
bodies to market MyoCell to treat the subclass of patients who
would meet the eligibility criteria for participation in the
SEISMIC Trial and who have an expected annual mortality rate of
20% (i.e., generally the sickest 30% of NYHA Class III
heart failure patients), or the Class III Subgroup.
39
In November 2006, we submitted our amended Investigational New
Drug application, or IND application, setting forth the proposed
protocol for the MYOHEART II Trial to the FDA. This study is
planned to include 450 patients, including 150 controls, at up
to 60 sites in the United States and five sites in Europe.
We are a development stage company and our lead product
candidate has not generated any material revenues and is not
expected to until late 2008 or early 2009. We have generated
substantial net losses and negative cash flow from operations
since inception and anticipate incurring significant and
increasing net losses and negative cash flows from operations
for the foreseeable future as we continue clinical trials,
undertake new clinical trials, apply for regulatory approvals,
make capital expenditures, add information systems and
personnel, make payments pursuant to our license agreements upon
our achievement of certain milestones, continue development of
additional product candidates using our technology, establish
sales and marketing capabilities and incur the additional cost
of operating as a public company. In particular, we expect that
our research and development and general and administrative
expenses will increase substantially from prior periods.
As of September 30, 2006, our deficit accumulated during
our development stage was approximately $62.3 million. From
inception in August 1999 through January 31, 2007, we have
financed our operations through private placements of our common
stock in which we have raised an aggregate of $52.5 million.
We conduct operations in one business segment. We may organize
our business into more discrete business units when and if we
generate significant revenue from the sale of our product
candidates. Substantially all of our revenue since inception has
been generated in the United States, and the majority of our
long-lived assets are located in the United States.
Financial Operations Overview
We have not generated any material revenues from our lead
product candidate. The revenues we have recognized to date are
related to (i) sales of MyoCath to Advanced Cardiovascular
Systems, Inc., or ACS, originally a subsidiary of Guidant
Corporation and now d/b/a Abbott Vascular, a division of Abbott
Laboratories, in connection with the testing of MyoCell,
(ii) fees associated with our assignment to ACS of our
rights relating to the primary patent covering MyoCath, or the
Primary MyoCath Patent, and (iii) revenues generated from a
paid registry trial in Mexico.
In June 2003, we entered into agreements with ACS pursuant to
which we assigned to ACS our rights relating to the Primary
MyoCath Patent, committed to deliver 160 units of MyoCath and
sold other related intellectual property for aggregate
consideration of $900,000. We initially recorded payments
received by us pursuant to these agreements as deferred revenue.
We are recognizing the $900,000 as revenue on a pro rata basis
as the catheters are delivered.
We do not anticipate that our revenues will materially increase
unless and until our lead product candidate, MyoCell, receives
regulatory approval. Our revenue may vary substantially from
quarter to quarter and from year to year. We believe that
period-to-period comparisons of our results of operations are
not meaningful and should not be relied upon as indicative of
our future performance.
Cost of sales consists primarily of the costs associated with
the production of MyoCath and the costs associated with the
culturing of cells for paid registry trials.
Our research and development expenses consist of costs incurred
in identifying, developing and testing our product candidates.
These expenses consist primarily of costs related to our
clinical trials, the acquisition
40
of intellectual property licenses and preclinical studies. We
expense research and development costs as incurred.
Clinical trial expenses include costs related to the culture and
preparation of cells in connection with our clinical trials,
costs of contract research, costs of clinical trial facilities,
costs of delivery systems, salaries and related expenses for
clinical personnel and insurance costs. Preclinical study
expenses include costs of contract research, salaries and
related expenses for personnel, costs of development biopsies,
costs of delivery systems and costs of lab supplies.
We are focused on the development of a number of autologous
cell-based therapies, and related devices, for the treatment of
heart damage. Accordingly, many of our costs are not
attributable to a specifically identified product candidate. We
use our employee and infrastructure resources across several
projects, and we do not account for internal research and
development costs on a product candidate by product candidate
basis. From inception through September 30, 2006, we
incurred aggregate research and development costs of
approximately $44 million related to our product candidates.
Clinical trials and preclinical studies are time-consuming and
expensive. Our expenditures on current and future preclinical
and clinical development programs are subject to many
uncertainties. We generally test our products in several
preclinical studies and then conduct clinical trials for those
product candidates that we determine to be the most promising.
As we obtain results from clinical trials, we may elect to
discontinue or delay trials for some product candidates in order
to focus our resources on more promising product candidates.
Completion of clinical trials may take several years or more,
but the length of time generally varies substantially according
to the type, size of trial and intended use of the product
candidate.
Due to the risks inherent in the clinical trial process,
development completion dates and costs vary significantly for
each product candidate, are difficult to estimate and are likely
to change as clinical trials progress. We currently estimate
that, in addition to the costs we have incurred through
September 30, 2006, it will cost us approximately
$1.1 million to complete the SEISMIC Trial and
approximately $16.2 million to complete the MYOHEART II
Trial.
The cost of clinical trials may vary significantly over the life
of a project as a result of a variety of factors, including the
number of patients who participate in the clinical trials, the
number of sites included in the clinical trials, the length of
time required to enroll trial participants, the efficacy and
safety profile of our product candidates and the costs and
timing of and our ability to secure regulatory approvals.
|
|
|
Marketing, General and Administrative
|
Our marketing, general and administrative expenses primarily
consist of the costs associated with our general management and
clinical marketing and trade programs, including, but not
limited to, salaries and related expenses for executive,
administrative and marketing personnel, rent, insurance, legal
and accounting fees, consulting fees, travel and entertainment
expenses, conference costs and other clinical marketing and
trade program expenses.
Stock-based compensation reflects our recognition as an expense
of the value of stock options issued to our employees and
non-employees over the vesting period of the options. The fair
value of the common stock underlying options granted during 2005
and the first three quarters of 2006 was estimated by our Board
of Directors, with input from our management and an independent
valuation firm. Based on these factors, we granted stock options
in 2005 and during the first two quarters of 2006 at an exercise
price of $3.50 per share. In the third quarter of 2006, we
granted stock options at exercise prices of $3.50 and $4.75 per
share
During 2005 and the nine months ended September 30, 2006,
we recognized stock-based compensation expense of
$2.0 million and $4.3 million, respectively. A
substantial portion of the expense recognized in the nine months
ended September 30, 2006 relates to our issuance of common
stock, stock options and stock warrants to an employee as part
of a settlement in August 2006. Further stock-based compensation
of $256,264 is expected to be recognized in the fourth quarter
of 2006. We intend to grant stock options and
41
other stock-based compensation in the future and we may
therefore recognize additional stock-based compensation in
connection with these future grants. See Managements
Discussion and Analysis of Financial Condition and Results of
Operations Liquidity and Capital Resources.
Critical Accounting Policies
This 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
accounting principles generally accepted in the United States.
The preparation of these financial statements requires us to
make estimates and judgments that affect the reported amounts of
assets, liabilities, revenues and expenses. We base our
estimates on historical experience and on various other
assumptions that we believe to be reasonable under the
circumstances, the results of which form the basis for making
judgments about the carrying values of assets and liabilities
that are not readily apparent from other sources. Actual results
may differ from these estimates under different assumptions or
conditions. While our critical accounting policies are described
in Note 1 to our financial statements appearing elsewhere
in this prospectus, we believe the following policies are
important to understanding and evaluating our reported financial
results:
Prior to January 1, 2006, we accounted for stock-based
compensation arrangements with employees under the intrinsic
value method specified in Accounting Principles Board Opinion
No. 25, or APB No. 25. Statement of Financial
Accounting Standards, or SFAS, No. 123,
Accounting for
Stock-Based Compensation,
as amended by
SFAS No. 148,
Accounting for Stock-Based
Compensation Transition and Disclosure,
established the use of the fair value based method of accounting
for stock-based compensation arrangements, under which
compensation cost is determined using the fair value of
stock-based compensation determined as of the grant date, and is
recognized over the periods in which the related services are
rendered. SFAS No. 123 permitted companies to elect to
continue using the intrinsic value accounting method specified
in APB No. 25 to account for stock-based compensation
related to option grants and stock awards to employees. In 2005,
we elected to retain the intrinsic value based method for such
grants and awards and disclosed the pro forma effect of using
the fair value based method to account for our stock-based
compensation in Note 1 to our financial statements. Option
grants to non-employees are valued using the fair value based
method prescribed by SFAS No. 123 and expensed over
the period services are provided.
In December 2004, the Financial Accounting Standards Board, or
FASB, issued SFAS No. 123 (revised 2004)
Share-Based Payment, or SFAS No. 123R.
SFAS No. 123R eliminates, among other items, the use
of the intrinsic value method of accounting and requires
companies to recognize the cost of employee services received in
exchange for awards of equity instruments, based on the grant
date fair value of those awards, in the financial statements.
SFAS No. 123R became effective for us as of
January 1, 2006, resulting in an increase in our
stock-based compensation expense. We expense amounts related to
employee stock options granted after January 1, 2006
utilizing the Black-Scholes option pricing model to measure the
fair value of stock options. We amortize the estimated fair
value of employee stock option grants over the vesting period.
Additionally, we are required to apply the provisions of
SFAS No. 123R on a modified prospective basis to
awards granted before January 1, 2006. Stock-based
compensation expense for 2006 and future periods will include
the unamortized portion of employee stock options granted prior
to January 1, 2006. Our future equity-based compensation
expense will also depend on the number of stock options granted
and the estimated value of the underlying common stock at the
date of grant.
Since inception, we have not generated any material revenues
from our lead product candidate. In accordance with Staff
Accounting Bulletin No. 101,
Revenue Recognition in
Financial Statements,
as amended by SEC Staff Accounting
Bulletin No. 104,
Revenue Recognition,
our
revenue policy is to recognize revenues from product sales and
service transactions generally when persuasive evidence of an
arrangement exists, the price is fixed or determined, collection
is reasonably assured and delivery of product or service has
occurred.
42
We initially recorded payments received by us pursuant to our
agreements with ACS as deferred revenue. Revenues are recognized
on a pro rata basis as the catheters are delivered pursuant to
those agreements.
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Research and Development Activities
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Research and development expenditures, including payments to
collaborative research partners, are charged to expense as
incurred. We expense amounts paid to obtain patents or acquire
licenses as the ultimate recoverability of the amounts paid is
uncertain.
Results of Operations
We are a development stage company and our lead product
candidate has not generated any material revenues and is not
expected to until late 2008 or early 2009. We have generated
substantial net losses and negative cash flow from operations
since inception and anticipate incurring significant and
increasing net losses and negative cash flows from operations
for the foreseeable future as we continue clinical trials,
undertake new clinical trials, apply for regulatory approvals,
make capital expenditures, add information systems and
personnel, make payments pursuant to our license agreements upon
our achievement of certain milestones, continue development of
additional product candidates using our technology, establish
sales and marketing capabilities and incur the additional cost
of operating as a public company. In particular, we expect that
our research and development and marketing, general and
administrative expenses will increase substantially from prior
periods.
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Comparison of Nine Months Ended September 30, 2006
and September 30, 2005
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Total revenues were $106,000 in the nine-month period ended
September 30, 2006, a decrease of $21,000 from total
revenues of $127,000 in the nine-month period ended
September 30, 2005. Revenues decreased due to fewer
catheters being delivered during the nine-month period ended
September 30, 2006. In the nine-month period ended
September 30, 2005, we generated $90,000 of revenue from
sales of MyoCath to ACS.
Cost of sales was $63,000 in the nine month period ended
September 30, 2006 as compared to $75,000 in the nine month
period ended September 30, 2005. The decrease in cost of
sales was primarily attributable to our decreased sales of
MyoCath in the first nine months of 2006.
Research and development expenses were $5.4 million in the
nine month period ended September 30, 2006, an increase of
$2.3 million, or 74.2%, from research and development
expenses of $3.1 million in the nine-month period ended
September 30, 2005. Our increase in research and
development expenses in the first nine months of 2006 was
primarily attributable to $1.5 million of expenses
recognized in connection with the licensing agreement with
Cleveland Clinic (discussed below), stock-based compensation
costs of $238,000 and increased clinical costs of $288,000.
Approximately $1.9 million of the expenses incurred in the
first nine months of 2006 were related to the MYOHEART and
SEISMIC Trials, including approximately $720,500 of fees paid to
our clinical trial investigators, approximately $479,000 of
costs related to cell culturing and approximately $340,000 of
clinical site expenses.
On February 1, 2006, we entered into a patent licensing
agreement with the Cleveland Clinic pursuant to which we
acquired worldwide exclusive licenses to five pending U.S.
patent applications related to our MyoCell II with SDF-1 product
candidate. Pursuant to this agreement, we paid Cleveland Clinic
an upfront license fee of $250,000 and additional license fees
of $312,000 and $938,000 on September 28, 2006 and
October 2, 2006, respectively.
43
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Marketing, General and Administrative
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Marketing, general and administrative expenses were
$5.7 million in the nine-month period ended
September 30, 2006, an increase of $3.6 million, or
171.4%, from marketing, general and administrative expenses of
$2.1 million in the nine month period ended
September 30, 2005. The increase in marketing, general and
administrative expenses during the first nine months of 2006 was
primarily attributable to the stock-based compensation costs
related to the issuance of common stock, stock options and stock
warrants to a related party pursuant to a settlement.
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Total Net Interest Income
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Total net interest income consists of interest expense, offset
by earnings on our cash and cash equivalents. Total net interest
income was $78,000 in the nine months ended September 30,
2006 compared to total net interest income of $9,000 in the nine
months ended September 30, 2005. The increase in total net
interest income was primarily attributable to higher cash
balances resulting from sales of our common stock received in
the third quarter of 2006.
In the nine month period ended September 30, 2006, we
incurred a loss from operations of $11.0 million, which was
approximately $5.8 million greater than the loss from
operations incurred in the nine month period ended
September 30, 2005.
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Comparison of Years Ended December 31, 2005 and
December 31, 2004
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Total revenues were $135,000 in 2005, an increase of $49,000
from total revenues of $86,000 in 2004. The increase in revenues
is primarily attributable to sales of MyoCath to ACS in 2005.
Cost of sales was $87,000 in 2005, an increase of $41,000 from
cost of sales of $46,000 in 2004. The increase in cost of sales
is primarily attributable to increased sales of MyoCath to ACS
in 2005.
Research and development expenses were $4.5 million in
2005, an increase of $700,000, or 18.4%, from research and
development expenses of $3.8 million in 2004, primarily
attributable to an increase in the number of patients
participating in our clinical trials in 2005. Approximately
$2.5 million of the expenses incurred in 2005 were related
to the MYOHEART and SEISMIC Trials, including costs related to
cell culturing, cell shipping, investigator fees, and clinical
site expenses. Approximately $1.2 million of the expenses
incurred in 2005 were related to our preclinical studies.
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Marketing, General and Administrative
|
Marketing, general and administrative expenses were
$2.8 million in 2005, an increase of $1.1 million, or
64.7%, from marketing, general and administrative expenses of
$1.7 million in 2004. The increase in marketing, general
and administrative expenses was primarily due to stock-based
compensation expense of $1.2 million in 2005 compared to
$149,000 in 2004.
44
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Total Net Interest Income
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Total net interest income was $37,000 in 2005 compared to total
net interest expense of $7,000 in 2004.
In the year ended December 31, 2005, we incurred a loss
from operations of $7.3 million, which is approximately
$1.8 million greater than the loss from operations incurred
in the year ended December 31, 2004.
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Comparison of Years Ended December 31, 2004 and
December 31, 2003
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Total revenues were $86,000 in 2004, an increase of $40,000 from
total revenues of $46,000 in 2003. The increase in revenues is
primarily attributable to an increase in sales of MyoCath to ACS
and revenues generated from the sale of certain intellectual
property rights.
Cost of sales was $46,000 in 2004, an increase of $16,000 from
cost of sales of $30,000 in 2003. The increase in cost of sales
is primarily attributable to increased sales of MyoCath to ACS
in 2004.
Research and development expenses were $3.8 million in
2004, an increase of $300,000, or 8.6%, from research and
development expenses of $3.5 million in 2003, primarily
attributable to costs related to sponsored research.
Approximately $2.2 million of the expenses incurred in 2004
were related to the MYOHEART Trial and our Phase I/ II clinical
trial of MyoCell and MyoCath in various countries in Europe,
including costs related to cell culturing, cell shipping,
investigator fees, and clinical site expenses. Approximately
$1.0 million of the expenses incurred in 2004 were related
to our preclinical studies.
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Marketing, General and Administrative
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Marketing, general and administrative expenses were
$1.7 million in 2004, a decrease of $800,000, or 32.0%,
from marketing, general and administrative expenses of
$2.5 million in 2003. The reduction in marketing, general
and administrative expenses was primarily due to reductions in
costs stemming from our closure of office locations outside of
South Florida as well as reductions in travel costs,
professional fees and salary expenses.
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Total Net Interest Income
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Total net interest expense was $7,000 in 2004 compared to total
net interest income of $2,000 in 2003.
In the year ended December 31, 2004, we incurred a loss
from operations of $5.5 million, which is approximately
$500,000 less than the loss from operations incurred in the year
ended December 31, 2003.
Liquidity and Capital Resources
Net cash used in operating activities was $5.2 million in
the nine months ended September 30, 2006 as compared to
$4.4 million of cash used in the nine months ended
September 30, 2005, primarily due to net losses of
$10.9 million in the nine months ended September 30,
2006 and $5.2 million in the nine months ended
September 30, 2005.
45
Our uses of cash in the nine months ended September 30,
2006 were partly offset by the following sources of cash:
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$1.3 million of accounts payable increases; and
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$4.3 million of stock-based compensation.
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Net cash used in investing activities was $155,000 in the nine
months ended September 30, 2006 as compared to $289,000 in
the nine months ended September 30, 2005. All of the cash
utilized in investing activities for the nine months ended
September 30, 2006 and 2005 related to our acquisition of
property and equipment.
Net cash provided by financing activities was $5.4 million
during the nine months ended September 30, 2006, all of
which was generated from our issuance of common stock. Net cash
provided by financing activities was $10.1 million in the
first nine months of 2005, which was generated from our issuance
of common stock.
During the nine-month period ended September 30, 2006, we
agreed to pay $153,000 in cash and issued equity instruments
with a fair value of $3.4 million in connection with a
settlement with one of our officers. We also issued warrants
with a fair value of $97,000 during this same period in exchange
for licenses of intellectual property.
For the years ended December 31, 2005, 2004 and 2003, net
cash used in operating activities was $5.8 million,
$5.0 million, and $4.9 million, respectively,
primarily attributable to net losses of $7.3 million in
2005, $5.5 million in 2004 and $6.0 million in 2003.
In 2005, our other primary uses of cash in operating activities
were:
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$399,000 of accounts payable reductions; and
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$120,000 of deferred revenue reductions.
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Our uses of cash in 2005 were partly offset by the following
sources of cash:
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$2.0 million of stock-based compensation; and
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$182,000 of inventory reductions.
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For the years ended December 31, 2005, 2004 and 2003, net
cash used in investing activities was approximately $326,000,
$59,000, and $32,000, respectively. All of our investing
activities from January 1, 2003 through December 31,
2005 related to our acquisition of property and equipment.
For the years ended December 31, 2005, 2004 and 2003, net
cash provided by financing activities was $11.1 million,
$4.6 million, and $3.4 million, respectively.
Substantially all of the cash provided by financing activities
from January 1, 2003 to December 31, 2006 has been
generated from our issuance of common stock in various private
placements. Since our inception in August 1999 through
September 30, 2006, we have received aggregate net proceeds
of $48.9 million from these private placements.
Existing Capital Resources and Future Capital Requirements
At September 30, 2006 and January 31, 2007, we had
cash and cash equivalents totaling $5.2 million and
$4.8 million, respectively. Assuming that we secure
$ million
of net proceeds in connection with this offering, we believe
that the net proceeds together with our existing cash and cash
equivalents will be sufficient to fund our currently budgeted
cash needs for at least the next 24 months.
Our lead product candidate has not generated any material
revenues. We do not expect to generate any material revenues or
cash from sales of our lead product candidate until late 2008 or
early 2009. We have generated substantial net losses and
negative cash flow from operations since inception and
anticipate incurring significant and increasing net losses and
negative cash flows from operations for the foreseeable future.
These matters raise substantial doubt about our ability to
continue as a going concern. To date, we have relied on proceeds
from the private placement of our common stock to provide the
funds necessary to conduct our research and development
activities and to meet our other cash needs.
46
We expect that our expenses and capital expenditures will
increase significantly during 2007 and beyond as a result of a
number of factors, including:
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costs related to our continuation of clinical trials with
respect to MyoCell;
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costs related to our continued research and development and new
clinical trials with respect to our pipeline product candidates;
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costs of applying for regulatory approvals;
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capital expenditures to increase our research and development
and cell culturing capabilities;
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costs associated with our addition of operational, financial and
management information systems and personnel and development and
protection of our intellectual property;
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our obligations to make payments pursuant to license agreements
upon achievement of certain milestones; and
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costs associated with our establishment of sales and marketing
capabilities to commercialize products for which we obtain
regulatory approval, if any.
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The magnitude of our future expenditures and cash requirements
will depend on numerous factors, including, but not limited to:
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the scope, rate of scientific progress, results and cost of our
clinical trials and other research and development activities;
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the costs and timing of seeking FDA and other regulatory
approvals;
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our ability to obtain sufficient third-party insurance coverage
or reimbursement for our product candidates;
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the effectiveness of commercialization activities (including the
volume and profitability of any sales achieved);
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our ability to establish additional strategic, collaborative and
licensing relationships with third parties with respect to the
sales, marketing and distribution of our products, research and
development and other matters and the economic and other terms
and timing of any such relationships;
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the ongoing availability of funds from foreign governments to
build new manufacturing facilities;
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the costs involved in any potential litigation that may occur;
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decisions by us to pursue the development of new product
candidates or technologies or to make acquisitions or
investments; and
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the effect of competing products, technologies and market
developments.
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See Risk Factors We may need substantial
additional funding and may be unable to raise capital when
needed, which would force us to delay or curtail the development
or commercialization of our product candidates. An inability to
obtain additional financing could adversely affect our business,
financial condition, results of operations, and could even
prevent us from continuing our business at all.
Effects of Being a Public Company
After completion of this offering, we will become subject to the
periodic reporting requirements of the Exchange Act and the
other rules and regulations of the SEC. We will also be subject
to various other regulatory requirements, including the
Sarbanes-Oxley Act of 2002. In addition, upon completion of this
offering, we will become subject to the rules of the NASDAQ
Global Market.
We are working with our legal and accounting advisors to
identify those areas in which changes should be made to our
financial and management control systems to manage our growth
and our obligations as a public company. These areas include
corporate governance, corporate control, internal audit,
disclosure controls and
47
procedures and financial reporting and accounting systems. We
have made, and will continue to make, changes in these and other
areas, including our internal control over financial reporting.
In addition, compliance with reporting and other requirements
applicable to public companies will create additional costs for
us and will require the time and attention of management. We
currently expect to incur an estimated $2.0 million of
incremental operating expenses in our first year of being a
public company and an estimated $1.9 million per year
thereafter. The incremental costs are estimates and actual
incremental expenses could be materially different from these
estimates. We cannot estimate with reasonable certainty the
amount of the additional costs we may incur, the timing of such
costs or the degree of impact that our managements
attention to these matters will have on our business.
Commitments and Contingencies
The table below summarizes our commitments and contingencies at
September 30, 2006. The information in the table reflects
future unconditional payments and is based on the terms of the
relevant agreements and appropriate classification of items
under generally accepted accounting principles currently in
effect.
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Payments Due by Period
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Less than
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12
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13-36
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37+
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Total
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Months
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Months
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Months
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Operating lease obligations
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$390,000
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$
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106,000
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$242,000
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$42,000
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We have entered into several operating lease agreements for
facilities and equipment, primarily for our office building and
cell culturing facility in Sunrise, Florida. Terms of certain
lease arrangements include renewal options, payment of executory
costs such as real estate taxes, insurance, common area
maintenance and escalation clauses.
Under our licensing agreement and related agreements with
Dr. Law and his affiliate, Cell Transplants International,
we are required to pay to Cell Transplants International a
$3 million payment upon commencement of a bona fide
U.S. Phase II human clinical trial that utilizes
technology claimed under the patent for heart muscle
regeneration licensed to us by Dr. Law and a
$5 million payment upon FDA approval of patented technology
for heart muscle regeneration. In addition, we are required to
pay royalties to Cell Transplants International equal to 5% of
gross sales in the territories where the licensed patents are
issued of products and services that read directly on the claims
of the licensed patents.
Our licensing agreement with the Cleveland Clinic requires us to
make certain milestone payments to the Cleveland Clinic upon
expected milestones including: (a) $200,000 upon FDA or
foreign equivalent approval of an IND application covering
product candidates derived from the licensed patents,
(b) $300,000 upon full enrollment of an FDA approved
Phase I clinical trial, (c) $750,000 upon full
enrollment of the last clinical trial needed prior to a Biologic
License Application submission to the FDA or foreign equivalent
and (d) $1.0 million upon the first commercial sale of
an FDA approved product derived from the licensed patent. At the
option of the Cleveland Clinic, we may be required to pay
one-half of any milestone payment in shares of our common stock.
The number of shares payable will be based upon the market value
of our common stock on the date of the milestone payment. To the
extent we do not complete a milestone activity by the target
completion date, we will be required to pay $100,000, or the
Extension Fee, to extend the target completion date for an
additional one year period, or the Extension Period. If such
milestone activity is achieved during the first six months of
the Extension Period, the Extension Fee will be credited against
the applicable milestone payment. We will also be required to
pay Cleveland Clinic royalty fees equal to 5% of net sales of
any products derived from the licensed patents.
Off-Balance Sheet Arrangements
We do not have any off-balance sheet arrangements that have or
are reasonably likely to have a current or future effect on our
financial condition, changes in financial condition, revenues or
expenses, results of operations, liquidity, capital expenditures
or capital resources that are material to investors.
48
Quantitative and Qualitative Disclosure About Market Risks
Our exposure to market risk is limited to interest income
sensitivity, which is affected by changes in the general level
of U.S. interest rates, particularly because the majority
of our investments are expected to be in short-term debt
securities. The primary objective of our investment activities
is to preserve principal while at the same time maximizing the
income we receive without significantly increasing risk. To
reduce risk, we maintain our portfolio of cash, cash equivalents
and short-term and long-term investments in a variety of
interest-bearing instruments, including U.S. government and
agency securities, high-grade U.S. corporate bonds,
asset-backed securities, commercial paper and money market
funds. We do not have any derivative financial investments in
our investment portfolio. Due to the nature of our investments
and expected investments, we believe that we are not subject to
any material market risk exposure.
Recent Accounting Pronouncements
In December 2004, the FASB issued Statement 123(R),
Share-Based Payment,
which addresses the accounting for
share-based payment transactions (for example, stock options and
awards of restricted stock) in which an employer receives
employee services in exchange for equity securities of the
company or liabilities that are based on a fair value of the
companys equity securities. This statement eliminates use
of APB No. 25, and requires such transactions to be
accounted for using a fair value-based method and recording
compensation expense rather than optional pro forma disclosure.
The new standard substantially amends SFAS No. 123.
The statement is effective on January 1, 2006 and will
require the Company to recognize an expense for the fair value
of its unvested outstanding stock options in future financial
statements. The adoption of this standard will result in the
Company recording additional compensation expense of $197,972 in
2006, for options granted as of December 31, 2005.
In May 2005, the FASB issued SFAS No. 154,
Accounting Changes and Error Corrections
(SFAS No. 154), which changes the
requirements for the accounting and reporting of a change in
accounting principle. SFAS No. 154 applies to all
voluntary changes in accounting principle as well as to changes
required by an accounting pronouncement that does not include
specific transition provisions. SFAS No. 154 requires
that changes in accounting principle be retrospectively applied.
SFAS No. 154 is effective for accounting changes and
corrections of errors made in fiscal years beginning after
December 15, 2005. The Company does not expect the adoption
of SFAS No. 154 to have a material effect on the
Companys financial statements.
In June 2006, the FASB issued FASB Interpretation Number 48, or
FIN 48,
Accounting for Uncertainty in Income
Taxes an interpretation of FASB Statement
No. 109.
FIN 48 contains a two step approach to
recognizing and measuring uncertain tax positions accounted for
in accordance with SFAS No. 109. The first step is to
evaluate the tax position for recognition by determining if the
weight of available evidence indicates it is more likely than
not that the position will be sustained on audit, including
resolution of related appeals or litigation processes, if any.
The second step is to measure the tax benefit as the largest
amount, which is more than 50% likely of being realized upon
ultimate settlement. FIN 48 is effective for fiscal years
beginning after December 15, 2006. The Company has not yet
analyzed the impact that FIN 48 will have on the financial
condition, results of operations, cash flows or disclosures.
In September 2006, the FASB issued SFAS No. 157,
Fair Value Measurements.
SFAS No. 157 defines
fair value, establishes a framework for measuring fair value,
and expands disclosures about fair value measurements.
SFAS No. 157 does not require any new fair value
measurements, but provides guidance on how to measure fair value
by providing a fair value hierarchy used to classify the source
of the information. SFAS No. 157 is effective for
fiscal years beginning after December 15, 2006. The Company
does not expect the adoption of SFAS No. 157 to have a
material effect on the Companys financial statements.
In September 2006, the SEC issued Staff Accounting Bulletin, or
SAB, No. 108,
Considering the Effects of Prior Year
Misstatements when Quantifying Misstatements in Current Year
Financial Statements,
which provides interpretive guidance
on the consideration of the effects of prior year misstatements
in quantifying current year misstatements for the purpose of a
materiality assessment. SAB No. 108 requires
registrants to quantify misstatements using both the balance
sheet and income statement approaches and to evaluate
49
whether either approach results in quantifying an error that is
material based on relevant quantitative and qualitative factors.
The guidance is effective for the first fiscal period ending
after November 15, 2006. The Company is currently
evaluating the impact of the adoption of SAB No. 108
on the Companys financial statements.
A variety of proposed or otherwise potential accounting
standards are currently under study by standard-setting
organizations and various regulatory agencies. Because of the
tentative and preliminary nature of these proposed standards,
management has not determined whether implementation of such
proposed standards would be material to the Companys
consolidated financial statements.
50
BUSINESS
Overview
We are a biotechnology company focused on the discovery,
development and commercialization of therapies using cells
derived from a patients body, and related devices, for the
treatment of heart damage. Our lead product candidate is
MyoCell, an innovative clinical therapy designed to populate
regions of scar tissue within a patients heart with living
muscle tissue for the purpose of improving cardiac function. The
core technology used in MyoCell has been the subject of human
clinical trials involving 90 enrollees and 62 related patients
to date, conducted over the last seven years, and animal studies
conducted over the last 18 years. Our most recent clinical
trials of MyoCell include the SEISMIC Trial, a fully enrolled
46 patient Phase II clinical trial in various
countries in Europe and the MYOHEART Trial a completed
20 patient Phase I dose escalation trial in the United
States. Interim results of the SEISMIC Trial were recently
announced and we have submitted to the FDA the protocol for a
450 patient, multicenter Phase II trial of MyoCell in
the United States, or the MYOHEART II Trial. We have
designed the MYOHEART II Trial so that upon approval of the
protocol, if any, we anticipate asking the FDA to consider it a
pivotal trial. The SEISMIC Trial and the MYOHEART II Trial
have been designed to test the safety and efficacy of MyoCell in
treating severe non-acute damage to the heart in patients in
Class II or Class III heart failure according to the
New York Heart Association, or NYHA, heart failure
classification system.
MyoCell is a non-acute clinical therapy intended to improve
cardiac function and designed to be utilized months or even
years after a patient has suffered severe heart damage due to a
heart attack or other cause. MyoCell uses myoblasts, cells that
are precursors to muscle cells, from the patients own
body. When injected into scar tissue within the heart wall,
myoblasts have shown to be capable of engrafting in the
surrounding tissue and differentiating into mature skeletal
muscle cells and/or cells which exhibit properties of both
skeletal and cardiac muscle cells. As part of the MyoCell
therapy, myoblasts are removed from a patients thigh
muscle, isolated, grown through our proprietary cell culturing
process, and injected directly in the scar tissue of a
patients heart. We anticipate that an interventional
cardiologist will perform the minimally invasive cell injection
process with MyoCath, our proprietary catheter, or a similarly
designed endoventricular catheter. By using myoblasts obtained
from a patients own body, we believe MyoCell is able to
avoid certain challenges currently faced by other cell-based
clinical therapies including tissue rejection and instances of
the cells differentiating into cells other than muscle. Although
a number of therapies have proven to improve the cardiac
function of a damaged heart, no currently available treatment
has demonstrated an ability to generate new muscle tissue within
the scarred regions of a heart.
Interim data from the MYOHEART Trial and the SEISMIC Trial were
presented by the lead investigator of each trial in January 2007
at the Third Annual International Conference on Cell Therapy for
Cardiovascular Diseases and are described in greater detail
below. The purpose of each trial is to assess the safety and
efficacy of MyoCell delivered via MyoCath. The lead investigator
for the MYOHEART Trial presented one-month safety data for all
20 of the treated patients, and three and six-month interim data
for 16 of the 20 treated patients. Although not statistically
significant due, in part, to the limited number of patients
treated, the lead investigator indicated that the safety of
MyoCell is strongly suggested and the preliminary efficacy data
demonstrated a trend towards an improvement in scores for
six-minute walk distance, or Six-Minute Walk Distance, and an
improvement in quality of life, or Quality of Life. The lead
investigator for the SEISMIC Trial presented data for 16 treated
patients and nine control group patients for which at least
one-month
follow-up
data was available. He reported on three efficacy endpoints:
Six-Minute Walk Distance scores, NYHA Class and left ventricular
ejection fraction, or LVEF. The SEISMIC Trials lead
investigator noted that the preliminary efficacy trends appear
encouraging and that the interim analysis suggests that the most
frequent adverse event, irregular heartbeats, appears to be
manageable with close observation and prophylactic use of
implantable cardioverter defibrillators, or ICDs, and
anti-arrhythmic drug therapy.
If the final six-month SEISMIC Trial data is generally
consistent with the interim data, we intend to seek approval in
the fourth quarter of 2007 from various European regulatory
bodies to market MyoCell to treat the subclass of patients who
would meet the eligibility criteria for participation in the
SEISMIC Trial and who have an expected annual mortality rate of
20% (i.e., generally the sickest 30% of NYHA Class III
51
heart failure patients), or the Class III Subgroup.
Assuming FDA approval of the protocol for the MYOHEART II
Trial, we intend to seek to enroll and treat all of the clinical
patients in the trial by the end of the second quarter of 2008.
If we meet that enrollment timeline, we would expect final trial
results in the first quarter of 2009. If the final safety and
efficacy results provide what we believe is significant proof
that MyoCell is safe and effective, we anticipate submitting
such data to the FDA to obtain regulatory approval of MyoCell.
In addition to studies we have sponsored, we understand that
myoblast-based clinical therapies have been the subject of at
least eleven clinical trials involving more than 325 enrollees,
including at least 200 treated patients. Although we believe
many of the trials are different from the trials sponsored by us
in a number of important respects, it is our view that the
trials have advanced the cell therapy industrys
understanding of the potential opportunities and limitations of
myoblast-based therapies.
We believe the market for treating patients in NYHA
Class II or NYHA Class III heart failure is
significant. According to the American Heart Association Heart
Disease Statistics 2007 Update, in the United States
there are approximately 5.2 million patients with heart
failure. We believe that approximately 60% of these patients are
in either NYHA Class II or NYHA Class III heart
failure.
Business Strategy
Our principal objective is to become a leading company that
discovers, develops and commercializes novel, autologous
(patient derived) cell-based therapies, and related devices, for
the treatment of heart damage. To achieve this objective, we
plan to pursue the following key strategies:
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Obtain initial regulatory approval of MyoCell by targeting
patients with severe heart damage.
In January 2007, we
completed the enrollment of patients in the 46 patient
SEISMIC Trial. If the final six-month SEISMIC Trial data is
generally consistent with the interim data, we intend to seek
approval in the fourth quarter of 2007 from various European
regulatory bodies to market MyoCell to treat the Class III
Subgroup. By targeting a class of patients for whom existing
therapies are very expensive, unavailable or not sufficiently
effective, we hope to expedite regulatory approval of MyoCell.
Assuming our U.S. clinical trial experience is comparable
to our experience to date in European trials, we anticipate
utilizing a similar strategy in our efforts to secure
U.S. regulatory approval of our lead product candidate.
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Obtain regulatory approval of MyoCell to treat patients with
less severe heart damage.
If we obtain initial regulatory
approval of MyoCell for the Class III Subgroup, we intend
to continue to sponsor clinical trials in an effort to
demonstrate that MyoCell should receive regulatory approval to
treat all patients in NYHA Class II or NYHA Class III
heart failure and, provided we believe we have a reasonable
basis to support such an indication, we intend to seek
regulatory approval for these patients.
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Continue to develop our pipeline of cell-based therapies and
related devices for the acute and non-acute treatment of heart
damage.
In parallel with our efforts to secure regulatory
approval of MyoCell, we intend to continue to develop and test
other product candidates for the acute and non-acute treatment
of heart damage. These efforts are expected to initially focus
on our MyoCath, MyoCell II with
SDF-1,
MyoCath II,
TGI 100 and TGI 1200 product candidates. We anticipate that,
concurrent with our efforts to seek regulatory approval of
MyoCell in certain European countries in the fourth quarter of
2007, we will also seek certification to apply the CE
Mark to MyoCath for its commercial sale and distribution
within the European Union.
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Develop our sales and marketing capabilities.
In advance
of any regulatory approval of our lead product candidate, we
intend to internally build a sales force which we anticipate
will market MyoCell primarily to interventional cardiologists.
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Continue to refine our MyoCell cell culturing processes.
We intend to seek to automate a significant portion of our cell
culturing processes in an effort to further reduce our culturing
costs and processing times. In addition, we intend to seek to
further optimize our processing times by building our
facilities, or contracting with a small number of cell culturing
facilities, in strategic regional locations.
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52
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Expand and enhance our intellectual property rights.
We
intend to continue to seek to expand and enhance our
intellectual property rights.
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License, acquire and/or develop complementary products and
technologies.
We intend to strengthen and expand our product
development efforts through the license, acquisition and/or
development of products and technologies that support our
business strategy.
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Industry Background
Myocardial Infarction (Heart Attack)
Myocardial infarction, or MI, commonly known as a heart attack,
occurs when a blockage in a coronary artery severely restricts
or completely stops blood flow to a portion of the heart. When
blood supply is greatly reduced or blocked for more than a short
period of time, heart muscle cells die. If the healthy heart
muscle cells do not replace the dead cells within approximately
two months, the injured area of the heart becomes unable to
function properly. In the healing phase after a heart attack,
white blood cells migrate into the affected area and remove the
dead heart muscle cells. Then, fibroblasts, the connective
tissue cells of the human body, proliferate and form a collagen
scar in the affected region of the heart. Following a heart
attack, the hearts ability to maintain normal function
will depend on the location and amount of damaged tissue. The
remaining initially undamaged heart muscle tissue must perform
more work to adequately maintain cardiac output. Because the
uninjured region is then compelled to work harder than normal,
the heart can progressively deteriorate until it is unable to
pump adequate blood to oxygenate the body properly leading to
heart failure and ultimately death.
Congestive Heart Failure (CHF)
Congestive heart failure, or CHF, is a debilitating condition
that occurs as the heart becomes progressively less able to pump
an adequate supply of blood throughout the body resulting in
fluid accumulation in the lungs, kidneys and other body tissues.
Persons suffering from NYHA Class II or worse heart failure
experience high rates of mortality, frequent hospitalization and
poor quality of life. CHF has many causes, generally beginning
in patients with a life-long history of high blood pressure or
after a patient has suffered a major heart attack or some other
heart-damaging event. CHF itself may lead to other complicating
factors such as pulmonary hypertension, edema, pulmonary edema,
liver dysfunction and kidney failure. Although medical therapy
for CHF is improving, it remains a major debilitating condition.
According to the American Heart Association Heart Disease
Statistics 2007 Update, the estimated, total direct
and indirect costs of heart failure in the United States in 2006
were approximately $33.2 billion.
Classifying Heart Failure
The NYHA heart failure classification system provides a simple
and widely recognized way of classifying the extent of heart
failure. It places patients in one of four categories based on
how limited they are during physical activity. NYHA Class I
heart failure patients have no limitation of activities and
suffer no symptoms from ordinary activities. NYHA Class II
heart failure patients have a mild limitation of activity and
are generally comfortable at rest or with mild exertion. NYHA
Class III heart failure patients suffer from a marked
limitation of activity and are generally comfortable only at
rest. NYHA Class IV heart failure patients generally suffer
discomfort and symptoms at rest and should remain confined to a
bed or chair.
53
The following chart illustrates the various stages of heart
failure, their NYHA classifications and the associated current
standard of treatment.
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NYHA
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Class
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NYHA Functional Classification
(1)
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Specific Activity Scale
(2)(3)
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Current Standard of Treatment
(4)
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I
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Symptoms only with above normal physical activity
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Can perform more than 7 metabolic equivalents
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ACE Inhibitor, Beta-Blocker
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II
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Symptoms with normal physical activity
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Can perform more than 5 metabolic equivalents
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ACE Inhibitor, Beta-Blocker, Diuretics
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III
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Symptoms with minimal physical activity
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Can perform more than 2 metabolic equivalents
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ACE Inhibitor, Beta-Blocker, Diuretics, Digoxin, Bi-ventricular
pacers
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IV
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Symptoms at rest
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Cannot perform more than 2 metabolic equivalents
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ACE Inhibitor, Beta-Blocker, Diuretics, Digoxin, Hemodynamic
Support, Mechanical Assist Devices, Bi-ventricular pacers,
Transplant
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(1)
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Symptoms include fatigue, palpitations, dyspnea and angina pain;
normal activity is equivalent to walking one flight of stairs or
several blocks.
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(2)
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Based upon the Goldman Activity Classification of Heart Failure,
which classifies severity of heart failure based on estimated
metabolic cost of various activities; the four classes of the
Goldman Activity Classification system correlate to the NYHA
Classes.
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(3)
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7 metabolic equivalents = shovel snow, carry 24 lbs. up 8
stairs, recreational sports; 5 metabolic equivalents = garden,
rake, dance, walk 4 mph on level ground, have intercourse; 2
metabolic equivalents = shower without stopping, strip and make
bed, dress without stopping.
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(4)
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Source: American College of Cardiology/ American Heart
Association 2005 Guideline Update for the Diagnosis and
Management of Chronic Heart Failure in the Adult.
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Diagnosis and Management of Heart Failure
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Heart disease has been the leading cause of death from 1950
through 2003 within the United States according to the
U.S. Department of Health and Human Services. The American
College of Cardiology/ American Heart Association 2005 Guideline
Update for the Diagnosis and Management of Chronic Heart Failure
in the Adult, or the ACC/ AHA Guidelines, provides
recommendations for the treatment of non-acute heart failure in
adults with normal or low LVEF. The treatment escalates and
becomes more invasive as the heart failure worsens. Current
non-acute treatment options for severe heart damage include, but
are not limited to, heart transplantation and other surgical
procedures, bi-ventricular pacers, drug therapies, ICDs, and
ventricular assist devices. Therapies utilizing drugs, ICDs and
bi-ventricular pacers are currently by far the most commonly
prescribed treatments for patients suffering from NYHA
Class II or NYHA Class III heart failure. Since the
therapies generally each address a particular feature of heart
disease or a specific subgroup of heart failure patients, the
therapies are often complementary and used in combination.
Drug Therapies.
The ACC/ AHA Guidelines recommend that
most patients with heart failure should be routinely managed
with a combination of ACE inhibitors, beta-blockers and
diuretics. The value of these drugs has been established by the
results of numerous large-scale clinical trials and the evidence
supporting a central role for their use is, according to the
ACC/ AHA Guidelines, compelling and persuasive. ACE inhibitors
and beta blockers have been shown to improve a patients
clinical status and overall sense of well being and reduce the
risk of death and hospitalization. Side effects of ACE
inhibitors include hypotension, worsening kidney function,
potassium retention, cough and angioedema. Side effects of
beta-blockers include fluid retention, fatigue, bradycardia and
heart block and hypotension.
Bi-ventricular Pacers.
The ACC/ AHA Guidelines recommend
bi-ventricular pacers for persons who, in addition to suffering
from heart failure, have left and right ventricles that do not
contract in sync, known as ventricular dyssynchrony and who have
a LVEF less than or equal to 35%, sinus rhythm and NYHA
Class III or NYHA Class IV symptoms despite
recommended optimal medical therapy. Bi-ventricular pacers are
54
surgically implanted electrical generators that function
primarily by stimulating the un-damaged portion of the heart to
beat more strongly using controlled bursts of electrical
currents in synchrony. Compared with optimal medical therapy
alone, bi-ventricular pacers have been shown in a number of
clinical trials to significantly decrease the risk of all-cause
hospitalization and all-cause mortality as well as to improve
LVEF, NYHA Class and Quality of Life. According to the ACC/ AHA
Guidelines, there are certain risks associated with the
bi-ventricular pacer including risks associated with
implantation and device-related problems.
Implantable Cardioverter Defibrillators.
ACC/ AHA
Guidelines recommend ICDs primarily for patients who have
experienced a life-threatening clinical event associated with a
sustained irregular heartbeat and in patients who have had a
prior heart attack and a reduced LVEF. ICDs are surgically
implanted devices that continually monitor patients at high risk
of sudden heart attack. When an irregular rhythm is detected,
the device sends an electric shock to the heart to restore
normal rhythm. In 2001, ICDs were implanted in approximately
62,000 and 18,000 patients in the United States and Europe,
respectively. Although ICDs have not demonstrated an ability to
improve cardiac function, according to the ACC/ AHA Guidelines,
ICDs are highly effective in preventing sudden death due to
irregular heartbeats. However, according to the ACC/ AHA
Guidelines, frequent shocks from an ICD can lead to a reduced
quality of life, whether triggered appropriately or
inappropriately. In addition, according to the ACC/ AHA
Guidelines, ICDs have the potential to aggravate heart failure
and have been associated with an increase in heart failure
hospitalizations.
Heart Transplantation and Other Surgical Procedures.
According to the ACC/ AHA Guidelines, heart transplantation is
currently the only established surgical approach for the
treatment of severe heart failure that is not responsive to
other therapies. Heart transplantation is a major surgical
procedure in which the diseased heart is removed from a patient
and replaced with a healthy donor heart. Heart transplantation
has proven to dramatically improve cardiac function in a
majority of the patients treated and most heart transplant
recipients return to work, travel and normal activities within
three to six months after the surgery. In addition, the risk of
hospitalization and mortality for transplant recipients is
dramatically lower than the risk faced by patients in NYHA
Class III or NYHA Class IV heart failure. Heart
transplants are not, for a variety of reasons, readily available
to all patients with severe heart damage. The availability of
heart transplants is limited by, among other things, cost and
donor availability. In addition to the significant cost involved
and the chronic shortage of donor hearts, one of the serious
challenges in heart transplantation is potential rejection of
the donor heart. For many heart transplant recipients, chronic
rejection significantly shortens the length of time the donated
heart can function effectively and such recipients are generally
administered costly anti-rejection drug regimens which can have
adverse and potentially severe side effects.
There are a number of alternate surgical approaches for the
treatment of severe heart failure under development, including
cardiomyoplasty, a surgical procedure where the patients
own body muscle is wrapped around the heart to provide support
for the failing heart, the Batista procedure, a surgical
procedure that reduces the size of an enlarged heart muscle so
that the heart can pump more efficiently and vigorously, and the
Dor procedure. According to the ACC/ AHA Guidelines, both
cardiomyoplasty and the Batista procedure have failed to result
in clinical improvement and are associated with a high risk of
death. The Dor procedure involves surgically removing scarred,
dead tissue from the heart following a heart attack and
returning the left ventricle to a more normal shape. While the
early published single-center experience with the Dor procedure
demonstrated early and late improvement in NYHA Class and LVEF,
according to the ACC/ AHA Guidelines, this procedures role
in the management of heart failure remains to be defined.
Ventricular Assist Devices.
Ventricular assist devices
are mechanical heart pumps that replace or assist the pumping
role of the left ventricle of a damaged heart too weak to pump
blood through the body. Ventricular assist devices are primarily
used as a bridge for patients on the waiting list for a heart
transplant and have been shown in published studies to be
effective at halting further deterioration of the patients
condition and decreasing the likelihood of death before
transplantation. In addition, ventricular assist devices are a
destination therapy for patients who are in NYHA Class IV
heart failure despite optimal medical therapy and who are not
eligible for heart transplant. According to the ACC/ AHA
Guidelines, device related adverse events are reported to be
numerous and include bleeding, infection, blood clots and device
failure. In addition, ventricular assist devices are very
expensive, with the average first-year cost estimated at
$222,460.
55
We believe the heart failure treatment industry generally has a
history of adopting therapies that have proven to be safe and
effective complements to existing therapies and using them in
combination with existing therapies. It is our understanding
that there is no one or two measurement criteria, either
quantitative or qualitative, that define when a therapy for
treating heart failure will be deemed safe and effective by the
FDA. We believe that the safety and efficacy of certain existing
FDA approved therapies for heart damage were demonstrated based
upon a variety of endpoints, including certain endpoints (such
as LVEF) that individually did not demonstrate large numerical
differences between the treated patients and untreated patients.
For instance, the use of bi-ventricular pacers with optimal drug
therapy has proven to significantly decrease the risk of
all-cause hospitalization and all-cause-mortality as well as to
improve LVEF, NYHA Class and quality of life as compared to the
use of optimal drug therapy alone. In the Multicenter InSync
Randomized Clinical Evaluation (MIRACLE) trial, one of the
first large studies to measure the therapeutic benefits of
bi-ventricular pacing, 69% of the patients in the treatment
group experienced an improvement in NYHA Class by one or more
classes at six-month
follow-up
versus a 34%
improvement in the control group. However, patients in the
treatment group experienced on average only a 2.1% improvement
in LVEF as compared with a 1.7% improvement for patients in the
control group. Although a number of the therapies described
above have proven to improve the cardiac function of a damaged
heart, no currently available heart failure treatment has
demonstrated an ability to generate new muscle tissue within the
scarred regions of a heart.
Our Proposed Solution
Our lead product candidate is MyoCell. We believe MyoCell has
the potential to become a leading non-acute treatment for severe
damage to the heart due to its perceived ability to satisfy, at
least in part, what we believe to be a presently unmet demand
for more effective and/or more affordable non-acute therapies
for heart damage.
MyoCell
The human heart does not have cells that naturally repair or
replace damaged heart muscle. Accordingly, the human body
cannot, without medical assistance, repopulate regions of scar
tissue within the heart with functioning muscle. MyoCell is a
non-acute clinical therapy designed to improve cardiac function
by populating regions of scar tissue within a patients
heart with myoblasts derived from a biopsy of a patients
thigh muscle. Myoblasts are precursors to muscle cells that have
the capacity to fuse with other myoblasts or with damaged muscle
fibers to regenerate skeletal muscle. When injected into scar
tissue within the heart wall, myoblasts have been shown to be
capable of engrafting in the surrounding tissue and
differentiating into mature skeletal muscle cells and/or cells
which exhibit properties of both skeletal and cardiac muscle
cells. By using myoblasts obtained from a patients own
body, we believe MyoCell is able to avoid certain challenges
currently faced by other cell-based clinical therapies intended
to be used for the non-acute treatment of heart damage including
tissue rejection and instances of the cells differentiating into
cells other than muscle.
Our clinical research to date suggests that MyoCell may improve
the contractile function of the heart. However, we have not yet
been able to demonstrate a mechanism of action. The engrafted
skeletal muscle tissues are not believed to be coupled with the
surrounding heart muscle by the same chemicals that allow heart
muscle cells to contract simultaneously. The theories regarding
why contractile function may improve include:
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the engrafted muscle tissue can contract in unison with the
other muscles in the heart by stretching or by the channeling of
electric currents;
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the myoblasts acquire certain characteristics of heart muscle or
fuse with them; and/or
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the injected myoblasts release various proteins that indirectly
result in a limit on further scar tissue formation.
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As part of the MyoCell therapy, a general surgeon removes
approximately five to ten grams of thigh muscle tissue from the
patient utilizing local anesthesia, typically on an outpatient
basis. The muscle tissue is then express-shipped to a cell
culturing site. At the cell culturing site, our proprietary
techniques are used to
56
isolate and remove myoblasts from the muscle tissue. We
typically produce enough cells to treat a patient within
approximately 21 days of his or her biopsy. Such production
time is expected to continue to decrease as we continue to
refine our cell culturing processes. After the cells are
subjected to a variety of tests, the cultured cells are packaged
in injectate media and express shipped to the interventional
cardiologist. Within four days of packaging, the cultured
myoblasts are injected via catheter directly into the scar
tissue of the patients heart. The injection process takes
on average about one hour and can be performed with or without
general anesthesia. Following treatment, patients generally
remain in the hospital for approximately 48-72 hours for
monitoring.
The MyoCell injection process is a minimally invasive procedure
which presents less risk and considerably less trauma to a
patient than conventional (open) heart surgery. Patients
are able to walk immediately following the injection process and
require significantly less time in the hospital compared with
surgically treated patients. In the 62 patients who have
received MyoCell delivered via percutaneous catheter, only two
procedure-related events (3.2%) have been reported. In both
cases, however, no complications resulted from the event, with
the patients in each case remaining asymptomatic at all times
during and after the procedure.
We use a number of proprietary processes to create therapeutic
quantities of myoblasts from a patients thigh muscle
biopsy. We have developed and/or licensed what we believe are
proprietary or patented techniques to:
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transport muscle tissue and cultured cells;
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disassociate muscle tissue with manual and chemical processes;
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separate myoblasts from other muscle cells;
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culture and grow myoblasts;
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identify a cell population with the propensity to engraft,
proliferate and adapt to the cardiac environment, including
areas of scar tissue; and
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maintain and test the cell quality and purity.
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We have also developed and/or licensed a number of proprietary
and/or patented processes related to the injection of myoblasts
into damaged heart muscle, including the following:
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package the cultured cells in a manner that facilitates shipping
and use by the physician administering MyoCell;
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methods of using MyoCath;
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the use of an injectate media that assists in the engraftment of
myoblasts;
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cell injection techniques utilizing contrast medias to assist in
the cell injection process; and
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cell injection protocols related to the number and location of
injections.
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Assuming we secure regulatory approval of MyoCell for the
treatment of all NYHA Class II and NYHA Class III
patients, we believe MyoCell will provide a treatment
alternative for the millions of NYHA Class II and NYHA
Class III patients in the United States and Europe who
either do not qualify for or have access to heart transplant
therapy. Furthermore, we anticipate that the time incurred and
cost of identifying patients qualified to receive MyoCell as
well as the cost of MyoCell, including any ICD, drug and
bi-ventricular pacer therapies that are simultaneously
prescribed, if any, will be less expensive than the current cost
of heart transplant therapy. Moreover, MyoCell is less invasive
than a heart transplant and is not subject to the tissue
rejection and immune system suppression issues associated with
heart transplants.
We believe there is still a large population of patients
exhibiting symptoms consistent with NYHA Class II and NYHA
Class III heart failure that is seeking an effective or
more effective non-acute therapy for heart damage than ICDs,
bi-ventricular
pacers
and drug therapies. We hope to demonstrate that MyoCell is
complementary to various therapies using ICDs,
bi-ventricular
pacers
and drugs. In the MYOHEART and SEISMIC Trials, enrolled patients
are required to have an ICD and to be on optimal drug therapy to
be
57
included in the study. While we do not require patients to have
previously received a
bi-ventricular
pacer to
participate in our clinical trials, we plan to accept patients
in our MYOHEART II Trial who have had prior placement of a
bi-ventricular
pacer.
We are hopeful that the results of our future clinical trials
will demonstrate that MyoCell is complementary to existing
therapies for treating heart damage.
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Clinical Trials and Planned Clinical Trials
Several clinical trials have been conducted for the purpose of
demonstrating the safety and efficacy of MyoCell and MyoCath. We
have sponsored five clinical trials and one registry study of
MyoCell involving 90 enrollees, including 62 treated
patients to date. In addition to studies we have sponsored, we
believe myoblast-based clinical therapies have been the subject
of at least eleven clinical trials involving more than
325 enrollees, including at least 200 treated patients.
The following table summarizes our planned, ongoing and
completed clinical trials of MyoCell. In addition to delivery
via MyoCath, MyoCell has been tested in certain trials using
Johnson & Johnsons
Myostar
tm
catheter, or the Myostar catheter, and Medtronics
TransAccess
tm
catheter, or the TransAccess catheter.
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Number of
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Clinical Trial
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Clinical Trial
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Patients
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Sites
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Objective
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Status
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MYOHEART II (Phase II Clinical Trial)
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450 anticipated, including 150 controls
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Up to 60 sites in the United States and five sites in Europe
anticipated
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|
Designed to be a double-blind, randomized, placebo-controlled,
multicenter trial to evaluate MyoCell and MyoCath for safety and
efficacy
|
|
Assuming approval of submitted amended IND, six-month interim
data anticipated in the fourth quarter 2008
|
SEISMIC (Phase II Clinical Trial)
|
|
46, including 16 controls
|
|
12 sites in the Netherlands, Germany, Belgium, Spain, Poland and
the United Kingdom
|
|
Phase II European study to assess the safety and efficacy
of MyoCell delivered via MyoCath
|
|
Trial commenced in 2005; enrollment completed for
46 patients; treatment completed for 18 of the 30
non-control group patients; treatment for the remaining patients
anticipated to be completed by the end of the first quarter
2007; final results anticipated in the fourth quarter 2007
|
MYOHEART (Phase I Clinical Trial)
|
|
20
|
|
5 sites in the United States
|
|
Phase I dose escalation study to assess safety, feasibility
and efficacy of MyoCell delivered via MyoCath
|
|
Trial commenced in 2003; treatment of all 20 patients
completed in October 2006; monitoring patients through twelve
month follow-up; interim three-month data received in
January 2007 and final twelve-month data anticipated in
November 2007
|
Phase I/II Clinical Trial
|
|
15
|
|
3 sites in the Netherlands, Germany and Italy
|
|
Phase I/II European study to assess the safety and efficacy
of MyoCell
|
|
Trial commenced in 2002; twelve-month follow-up completed in
June 2004
|
Netherlands Pilot Trial
|
|
5
|
|
1 site in the Netherlands
|
|
Pilot study to assess safety and feasibility of MyoCell
|
|
Trial commenced in 2001; six-month follow-up completed in
October 2003
|
2002 Trial
|
|
3
|
|
1 site in the Netherlands
|
|
Designed to evaluate the safety and efficacy of MyoCell
delivered via the TransAccess catheter
|
|
Trial commenced in 2002; discontinued upon Transvasculars
acquisition by Medtronic
|
Partial Reimbursement Registry Studies
|
|
Up to 140 anticipated in the next two years
|
|
6 sites in Korea, Mexico, Switzerland, The Bahamas, Singapore
and South Africa anticipated
|
|
Designed to generate additional safety and efficacy data and
revenues
|
|
Requisite regulatory approval to conduct trials received at all
sites; contracts in place with an institution in each of Mexico,
the Bahamas, Switzerland and Korea; implantation of one patient
in Mexico complete
|
59
|
|
|
Metrics Used to Evaluate Safety and Efficacy of Heart
Failure Treatments
|
The performance of therapies used to treat damage to the heart
is assessed using a number of metrics, which compare data
collected at the time of initial treatment to data collected
when a patient is re-assessed at follow-up. The time periods for
follow-up
are usually
three, six and twelve months. Statistical data is often
accompanied by a p-value, which is the mathematical probability
that the data are the result of random chance. A result is
considered statistically significant if the p-value is less than
or equal to 5%. The common metrics used to evaluate the efficacy
of these therapies include:
|
|
|
Metric
|
|
Description
|
|
|
|
LVEF
|
|
LVEF is a measure of the hearts efficiency and can be used
to estimate the function of the left ventricle, which pumps
blood to the rest of the body. The LVEF is the amount of blood
pumped divided by the amount of blood the ventricle contains. A
normal LVEF is more than 55% of the blood volume. Damage to the
heart impairs the hearts ability to efficiently pump and
therefore reduces LVEF.
|
NYHA Class
|
|
The NYHA heart failure classification system is a functional and
therapeutic classification system based on how much cardiac
patients are limited during physical activity.
|
Six-Minute Walk Distance
|
|
Six-Minute Walk Distance is an objective evaluation of
functional exercise capacity which measures the distance a
patient can walk in six minutes. The distance walked during this
test has been shown to correlate with the severity of heart
failure.
|
Quality of Life
|
|
Quality of Life is evaluated by patient questionnaire, which
measures subjective aspects of health status in heart failure
patients.
|
Number of Hospital Admissions and Mean Length of Stay
|
|
The Number of Hospital Admissions and Mean Length of Stay
measure the aggregate number of times that a patient is admitted
to the hospital during a defined period and the number of days a
patient remains in the hospital during each such admission.
|
Total Days Hospitalized
|
|
The Total Days Hospitalized measures the aggregate number of
days a patient is admitted to the hospital during a defined
period.
|
End-Systolic Volume
|
|
End-Systolic Volume is a measurement of the adequacy of cardiac
emptying, related to the function of the heart during
contraction.
|
End-Diastolic Volume
|
|
End-Diastolic Volume is the amount of blood in the ventricle
immediately before a cardiac contraction begins and is used as a
measurement of the function of the heart at rest.
|
LV Volume
|
|
Left Ventricular Volume, or LV Volume, is measured in terms
of left ventricular End-Diastolic Volume and left ventricular
End-Systolic Volume. Both measure the reduction in volume of
blood in the left ventricle of the heart following expansion and
contraction, respectively. Reduction in volume generally is
reflective of positive ventricular remodeling and improvement in
the hearts ability to circulate oxygenated blood through
the arteries.
|
Wall Motion
|
|
Wall Motion is a test designed to show whether the heart is
receiving adequate quantities of oxygen-rich blood. Wall motion
is generally measured by a stress echocardiography test.
|
Cardiac Output
|
|
Cardiac Output is a measure of the amount of blood that is
pumped by the heart per unit time, measured in liters per minute.
|
BNP Level
|
|
B-Type Natriuretic Peptide, or BNP, is a substance secreted from
the ventricles or lower chambers of the heart in response to
changes in pressure that occur when heart failure develops and
worsens. The level of BNP in the blood increases when heart
failure symptoms worsen and decreases when the heart failure
condition is stable.
|
60
|
|
|
MYOHEART II, proposed Phase II Clinical Trial in
the United States and certain countries in Europe
|
The MYOHEART II Trial is designed to be a double-blind,
randomized, placebo-controlled multicenter trial to evaluate
MyoCell and MyoCath for safety and efficacy. We submitted our
amended IND application setting forth the proposed protocol for
this clinical trial to the FDA in November 2006. We have
designed the MYOHEART II Trial so that upon approval of the
protocol, if any, we anticipate asking the FDA to consider it a
pivotal trial. This study is planned to include
450 patients, including 150 controls, at up to 60 sites in
the United States and five sites in Europe. We currently
anticipate that we will collect data at three months and six
months following treatment.
We anticipate that all of the patients selected for enrollment
in the MYOHEART II Trial will have (i) symptoms
associated with NYHA Class II or NYHA Class III heart
failure, (ii) suffered a previous heart attack at least
90 days prior to the date of treatment, (iii) a LVEF
of greater than or equal to 10% and less than or equal to 35%,
(iv) been on optimal drug therapy for at least two months
prior to enrollment and (v) had prior placement of an ICD
at least one month prior to enrollment. We anticipate that
patients will be required to use Amiodarone, an anti-arrhythmic
drug therapy, at least 24 hours prior to MyoCell
implantation.
We anticipate that the patients will be divided into three
equally sized groups. Patients in the first group will receive
16 injections during one visit of a dosage of approximately
800 million myoblast cells and placebo injections at a
second visit. Patients in the second group will receive
injections during two visits of dosages of approximately
400 million myoblast cells per visit with approximately
eight injections per visit. Patients in the third group will
receive placebo injections during two visits.
61
We anticipate the MYOHEART II Trial will measure the
following safety and efficacy endpoints of the MyoCell treatment
at three and six months following MyoCell implantation:
|
|
|
|
|
|
|
Primary Safety
|
|
Primary Efficacy
|
|
Secondary Efficacy
|
|
Tertiary Efficacy
|
Endpoints
|
|
Endpoints
|
|
Endpoints
|
|
Endpoints
|
|
|
|
|
|
|
|
Number of serious adverse events in treatment group as compared
to the control group
|
|
Change in Six-Minute Walk Distance from baseline to six months
as compared to control group, or
Quality of Life scores assessed using Minnesota Living with
Heart Failure questionnaire from baseline to six months as
compared to control group, or
Proportion of patients with an improved NYHA Class from baseline
to six months as compared to control group
|
|
Total Days Hospitalized in treatment group as compared to
control group
Cause-specific hospitalizations in treatment group as compared
to control group
Total days alive out of hospital over the six- month study
period
Change in LVEF from baseline to six months as compared to
control group
Change in LV Volume and wall motion from baseline to six months
as compared to control group
Change in BNP Level from baseline to six months as compared to
control group
|
|
Total cost and healthcare utilization within six months
Time to death or CHF hospitalization
Change in degree of mitral regurgitation from baseline to six
months
Change in Six-Minute Walk Distance from baseline to three months
as compared to control group
Quality of Life scores assessed using Minnesota Living with
Heart Failure questionnaire from baseline to three months as
compared to control group
Proportion of patients with improved NYHA Class from baseline to
three months as compared to control group
|
We anticipate that the clinical trial will also measure as a
primary safety endpoint the number of serious adverse events
specifically related to MyoCath.
Assuming FDA approval of the protocol for the MYOHEART II
Trial, we intend to seek to enroll and treat all of the clinical
patients in the trial by the end of the second quarter of 2008.
If we meet that enrollment timeline, we would expect final trial
results in the first quarter of 2009. If the final safety and
efficacy results provide what we believe is significant proof
that MyoCell is safe and effective, we anticipate submitting
such data to the FDA to obtain regulatory approval of MyoCell.
|
|
|
SEISMIC Trial, Phase II clinical trial in
Europe
|
The purpose of the SEISMIC Trial is to assess the safety and
efficacy of MyoCell delivered via MyoCath. Of the
46 patients, 30 patients, or the Treatment Group
Patients, will receive a dosage of between 150 million and
800 million myoblast cells and 16 patients will
comprise the control group, or the Control Group Patients. The
primary efficacy endpoint is the change in LVEF at three-month
and six-month
follow-up
as compared to baseline LVEF and secondary efficacy endpoints
include change in NYHA Class, change in Six-Minute Walk
Distance, the effect of MyoCell treatment on hospitalizations or
the need for medical treatment outside of hospitalizations and
improvements in global contractility, wall thickness,
62
coronary perfusion and change in scar size. The primary safety
endpoint is the relative incidence of serious adverse events at
three-month and six-month
follow-up
experienced
by the Treatment Group Patients as compared to the Control Group
Patients. Serious adverse events are defined to include any
adverse events that are fatal, life-threatening, result in
permanent impairment or surgery to preclude permanent impairment
of a body function, or require in-patient hospitalization that
is not specifically required by the clinical trial protocol or
is elective. Secondary safety endpoints include the Number of
Hospital Admissions and Mean Length of Stay in the six-month
period following MyoCell treatment in the Treatment Group
Patients as compared to the Control Group Patients.
In January 2007, we enrolled the final patient in the SEISMIC
Trial. We anticipate that we will complete the MyoCell
implantation procedure on the final patient by the end of the
first quarter of 2007. All of the patients selected for
enrollment in the SEISMIC Trial have (i) symptoms
associated with NYHA Class II or NYHA Class III heart
failure, (ii) suffered a previous heart attack at least
90 days prior to the date of treatment, (iii) a LVEF
of between 20% to 45%, (iv) been on optimal drug therapy
for at least two months prior to enrollment and (v) had
prior placement of an ICD at least six months prior to
enrollment. All of the patients in the SEISMIC Trial were
prescribed Amiodarone to reduce the potential incidence of
irregular heartbeats. In Europe, twelve cardiology centers in
six countries, including the Netherlands, Germany, Belgium,
Spain, Poland and the United Kingdom are conducting the SEISMIC
Trial. One of the SEISMIC Trial investigators, Pr. Nicholas
Peters, MD, PhD, is a member of our Scientific Advisory Board.
Interim data from the SEISMIC Trial was presented by Professor
Patrick Serruys, MD, PhD, the lead investigator, at the Third
Annual International Conference on Cell Therapy for
Cardiovascular Diseases in January 2007 with respect to the 16
Treatment Group Patients and nine Control Group Patients, for
which at least one month
follow-up
data was
available. The 16 Treatment Group Patients received an average a
dosage of 598
±
110 million myoblast cells.
Pr. Serruys indicated in his presentation that the limited
amount of
follow-up
at
this time prevents meaningful insight to efficacy analysis,
however, the preliminary efficacy trends appear encouraging.
Pr. Serruys presented the interim results of three efficacy
endpoints: Six-Minute Walk Distance, NYHA Class and LVEF. The
following information was derived from Pr. Serruys
presentation or interim data provided to us by Pr. Serruys:
|
|
|
|
|
Six-Minute Walk Distance.
We currently have six-month
follow-up
Six-Minute
Walk Distance data available for three Treatment Group Patients
and four Control Group Patients. The Treatment Group
Patients Six-Minute Walk Distance scores improved, on
average, 97
±
51.4
meters as compared to an average decline of 20
±
147.1 meters
experienced by the Control Group Patients.
|
|
|
|
NYHA Class.
We currently have three-month
follow-up
NYHA Class
data available for eight Treatment Group Patients and six
Control Group Patients. The Treatment Group Patients NYHA
Class decreased, on average, from 2.5 at baseline to 2.125 at
three months following treatment, with 37.5% of the Treatment
Group Patients improving by at least one NYHA Class. This
compares to an average increase in the Control Group
Patients NYHA Class from 2.25 at baseline to 2.7 at three
months following treatment, with none of the Control Group
Patients improving at least one NYHA Class. We currently have
six-month
follow-up
NYHA Class data available for two Treatment Group Patients and
four Control Group Patients. The Treatment Group Patients
NYHA Class decreased, on average, from 2.5 at baseline to 2.0 at
six months following treatment, with 50% of the Treatment Group
Patients improving by at least one NYHA Class. This compares to
an average increase in the Control Group Patients NYHA
Class from 2.25 at baseline to 2.5 at six months following
treatment, with 25% percent of the Control Group Patients
improving at least one NYHA Class. None of our Treatment Group
Patients experienced a worsening in NYHA Class at either three
or six months following treatment.
|
|
|
|
LVEF.
We currently have three-month
follow-up
LVEF data
available for eight Treatment Group Patients and five Control
Group Patients. The Treatment Group Patients LVEF
increased, on average, from 30.0
±
10.4 at baseline to
30.2
±
8.9 at three
months following treatment. This compares to an average decrease
in the Control Group Patients LVEF from 32.8
±
11.1 at baseline to
32.4
±
8.9 at
|
63
|
|
|
|
|
three months following treatment. We currently have six-month
follow-up
LVEF data
available for three Treatment Group Patients and three Control
Group Patients. The Treatment Group Patients LVEF
increased, on average, from 30.0
±
10.4 at baseline to
31.7
±
21.8 at six
months following treatment. This compares to an average decrease
in the Control Group Patients LVEF from 32.8
±
11.1 at baseline to
31.7
±
8.3 at six
months following treatment.
|
Six of the 16 Treatment Group Patients (37.5%) experienced
twelve serious adverse events, including one patient death from
multiple organ failure 30 days following MyoCell treatment
determined by the investigator as possibly attributable to
MyoCell. However, for the Treatment Group Patients who were
compliant with the SEISMIC Trial protocol, including the
prescribed Amiodarone drug therapy, only three of such 13
Treatment Group Patients (23.1%) versus two of the nine Control
Group Patients (22.2%) experienced serious adverse events.
Seven of the twelve total serious adverse events involved
irregular heartbeats, five of which have been investigator
determined to be possibly attributable to MyoCell. However, 75%
of the patients experiencing irregular heartbeats following
MyoCell treatment did not comply with the trials protocol
for Amiodarone use and all of these patients have previously
experienced irregular heartbeats prior to MyoCell implantation.
Pr. Serruys indicated in his January presentation that the
interim analysis suggests that irregular heartbeats appear to be
manageable with close observation and prophylactic use of ICDs
and Amiodarone. Pr. Serruys did not present secondary
safety endpoint data. The Independent Data Safety and Monitoring
Board for the SEISMIC Trial reviewed the serious adverse events
experienced by the Treatment Group Patients and has not asked us
to alter or terminate the trial and is expected to continue to
monitor the occurrence of any serious adverse events.
We expect final six-month data for the balance of the SEISMIC
Trial patients to be available during the fourth quarter of 2007.
If the final six-month SEISMIC Trial data is generally
consistent with the interim data, we intend to seek approval in
the fourth quarter of 2007 from various European regulatory
bodies to market MyoCell and MyoCath to treat the Class III
Subgroup.
|
|
|
MYOHEART Phase I Dose Escalation Clinical Trial in
the United States
|
In October 2006, we completed the MyoCell implantation procedure
on the final patient in our 20 patient Phase I dose
escalation MYOHEART Trial in the United States. The purpose of
the MYOHEART Trial was to assess the safety, feasibility and
efficacy of MyoCell delivered via MyoCath. We divided the
patients into four cohorts of five and each group has received a
progressively increasing dose of myogenic cells, ranging from
25 million (first cohort) to 675 million (fourth
cohort). Safety endpoints were the evaluation of the nature and
frequency of serious adverse events during the twelve month
period following MyoCell treatment. The MYOHEART Trial was
conducted at five clinical sites. Dr. Warren Sherman, the
lead investigator, as well as two of the other MYOHEART Trial
investigators, Dr. Nicolas Chronos and Dr. Stephen
Ellis, are members of our Scientific Advisory Board.
All of the patients selected for enrollment in the MYOHEART
Trial had (i) symptoms associated with NYHA Class II
or NYHA Class III heart failure, (ii) suffered a
previous heart attack at least twelve weeks prior to the date of
treatment, (iii) a LVEF of between 20% to 40%,
(iv) been on optimal drug therapy and (v) prior
placement of an ICD at least one month prior to enrollment. The
patients in the MYOHEART Trial did not take Amiodarone to reduce
the potential incidence of irregular heartbeats.
At the January 2007 Third Annual International Conference on
Cell Therapy for Cardiovascular Diseases, Dr. Sherman
presented one month safety data for all 20 of the patients
treated in the MYOHEART Trial. He also presented three and
six-month interim efficacy data for 16 of the patients treated,
including all of the patients treated in the first three patient
cohorts and one patient treated in the fourth cohort, and twelve
month data for 10 of the patients treated.
64
With regards to efficacy, the interim data from the MYOHEART
Trial demonstrates a preliminary trend towards an improvement in
Six-Minute Walk Distance and an improvement of Quality of Life.
Although not statistically significant due, in part, to the
limited number of patients treated in the MYOHEART Trial:
|
|
|
|
|
patients treated in the first, second, third and fourth cohort
demonstrated a 6%, 10%, 22% and 20% respective improvement in
their mean Six-Minute Walk Distance at three months as depicted
in the charts below:
|
|
|
|
|
|
relative to a baseline Quality of Life score, patients reported
an improvement in their mean Quality of Life score at three
months, six months and twelve months; and
|
|
|
|
relative to a baseline LVEF, patients treated in the first and
third cohort experienced a mean increase in LVEF at three
months, six months and twelve months and patients treated in the
second cohort experienced a mean increase in LVEF at six months
and twelve months.
|
In line with our expectations for the study, as of January 2007,
16 serious adverse events were reported in eight patients
during follow-up. Two of the 20 patients died, adjudicated
as possibly related to MyoCell. Six patients experienced
irregular heartbeats, four of which have been adjudicated as
possibly related to MyoCell. Of these six patients experiencing
irregular heartbeats, three patients had previously suffered
from this condition prior to MyoCell implantation. Although not
statistically significant due, in part, to the limited number of
patients treated, Dr. Sherman indicated in his January
presentation that the safety of MyoCell is strongly suggested by
the MYOHEART results to date.
We expect to present additional interim data from the MYOHEART
Trial in March 2007 and to receive and present final twelve
month data from this trial in November 2007.
Phase I/II Clinical Trials in Europe
We were one of the financial sponsors of a five patient pilot
clinical trial of MyoCell in 2002. The primary endpoint of the
study was to assess the safety and feasibility of MyoCell,
measured by occurrence of serious adverse events at six months
following treatment. The secondary endpoint was to assess
improvement of LVEF at one, three and six months following
treatment. The trial was performed in the Netherlands by
physicians at the Thorax Center of the Erasmus Medical Center.
Each patient enrolled in this clinical trial had
(i) symptoms associated with NYHA Class II, NYHA
Class III or NYHA Class IV heart failure,
(ii) suffered a previous heart attack at least four weeks
prior to the date of treatment and (iii) a LVEF between 20%
to 45%. Patients received injections of between 25 million
and 293 million myoblast cells.
65
For the five patients who participated in the trial, it was
reported that, on average, the patients LVEF increased
from 36
±
11% at the
baseline to 41
±
9% at
three months (p = .009) and 45
±
8% at six months
(p = .23).
Although not statistically significant due, in part, to the
limited number of patients treated, of these patients, we noted
that:
|
|
|
|
|
100% and 60% of the patients improved one NYHA Class at three
months and six months following therapy, respectively;
|
|
|
|
40% of the patients improved two NYHA Classes at both three
months and six months following therapy;
|
|
|
|
100% of the patients LVEF improved by at least 4% at three
months following therapy; and
|
|
|
|
60% of the patients LVEF improved by at least 20% at six
months following therapy.
|
All of the MyoCell injection procedures in the pilot clinical
trial were without complication and no serious adverse events
occurred during the
follow-up
period. One
patient who experienced irregular heart contractions received an
ICD within six months of the injection procedure.
The results of this pilot clinical trial were published by the
physicians conducting the trial in the Journal of the American
College of Cardiology in December 2003. In the published
article, the physicians concluded that the pilot study was the
first to demonstrate the potential and feasibility of
percutaneous skeletal myoblast delivery as a stand-alone
procedure for myocardial repair in patients with post-heart
attack heart failure. The physicians further concluded that more
data was needed to confirm safety.
|
|
|
Phase I/ II Clinical Trial
|
We conducted a non-randomized, multicenter 15 patient
Phase I/II clinical trial of MyoCell at institutions
located in the Netherlands, Germany and Italy in 2003 to assess
the safety of MyoCell and its effect on global ventricular
function. As part of this clinical trial, we also assessed the
safety and feasibility of MyoCell delivery via MyoCath. Each
patient enrolled in the Phase I/II clinical trial had
(i) symptoms associated with NYHA Class II or NYHA
Class III heart failure, (ii) suffered a previous
heart attack at least four weeks prior to the date of treatment,
(iii) a LVEF of between 20% to 40% and (iv) been using
beta-blocker therapy unless these drugs were not tolerated or
clearly contraindicated. Following treatment of the first six
patients participating in this clinical trial, we amended the
trial protocol to require that patients have placement of an ICD
at least one month prior to enrollment and use of Amiodarone to
reduce the potential incidence of irregular heartbeats at least
two months prior to and for at least two months following the
MyoCell implantation. Patients received injections of between
40 million and 448 million myoblast cells, with an
average dosage of 214
±
117 million myoblast cells.
The primary efficacy endpoint of the Phase I/II clinical
trial was the effect of MyoCell on global ventricular function
at three, six and twelve months following implantation as
determined by, among other things, NYHA Class, LVEF,
End-Diastolic Volume, End-Systolic Volume, Cardiac Output and
Wall Motion as measured by stress echocardiography at rest and
at low dose. The primary safety endpoint was the clinical status
of the patient as measured by, among other things, a comparison
of serious adverse events occurring before and following MyoCell
implantation.
66
The clinical trial investigators observed a tendency towards
statistically significant improvement in systolic function at
six and twelve-month follow-up. Efficacy data from this trial is
summarized in more detail in the following table:
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Endpoints
|
|
Baseline
|
|
|
3-month
|
|
|
p-value
|
|
|
6-month
|
|
|
p-value
|
|
|
12-month
|
|
|
p-value
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
NYHA
Class
(1)
|
|
|
2.8
|
|
|
|
2.1
|
|
|
|
|
|
|
|
1.6
|
|
|
|
|
|
|
|
1.9
|
|
|
|
|
|
LVEF
(2)
|
|
36.3
±
8
|
|
.0 34.3
±
|
|
|
9.1 0.3
|
|
|
34
±
7.8
|
|
|
0.3
|
|
|
38.7
±
9
|
|
|
.4 0.4
|
|
End-Diastolic
Volume
(2)
|
|
225
±
83
|
|
186
±
5
|
|
|
9 0.03
|
|
|
214
±
37
|
|
|
0.7
|
|
|
197
±
30
|
|
|
0.4
|
|
End-Systolic
Volume
(2)
|
|
145
±
64
|
|
124
±
4
|
|
|
9 0.05
|
|
|
143
±
37
|
|
|
0.9
|
|
|
122
±
29
|
|
|
0.2
|
|
Cardiac
output
(3)
|
|
4.6
±
0.
|
|
|
91 N/A
|
|
|
|
N/A
|
|
|
5.6
±
1.6
|
|
|
0.06
|
|
|
5.4
±
1.
|
|
|
5 0.05
|
|
Wall motion as measured by stress echocardiography at
rest
(1)
|
|
3.0
±
0.
|
|
5 2.9
±
|
|
|
0.6 0.65
|
|
|
2.8
±
0.6
|
|
|
0.95
|
|
|
2.8
±
0.
|
|
|
7 0.70
|
|
Wall motion as measured by stress echocardiography at low
dose
(3)
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2.8
±
0.
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4 2.6
±
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0.5 0.65
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|
2.5
±
0.5
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|
0.95
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2.5
±
0.
|
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|
6 0.70
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|
(1)
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Matched data provided for 13 of the 15 patients.
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(2)
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Matched data provided for eight of the 15 patients.
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(3)
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Matched data provided for five of the 15 patients.
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Although the data showed a decrease in End-Diastolic Volume,
trends towards a reduction in End-Systolic Volume and an
increase in LVEF, the data cannot be considered statistically
significant. The clinical trial investigators were, however,
able to conclude from this data that global left ventricular
function remained stable and that no further deterioration of
the left ventricles occurred during the twelve months following
treatment, which, given the clinical status of the patient
group, was determined by the researchers to be a significant
observation.
Although not statistically significant due, in part, to the
limited number of patients treated, we noted that:
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85% and 62% of the 13 surviving patients improved one NYHA Class
at six months and twelve months following therapy, respectively;
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31% and 23% of the 13 surviving patients improved two NYHA
Classes at six months and twelve months following therapy,
respectively;
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of the eleven patients for which we have six-month data
regarding LVEF, 36% of such patients LVEF improved by at
least 4% and 9% of such patients LVEF improved by at least
20% at six months following therapy; and
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of the twelve patients for which we have twelve-month data
regarding LVEF, 50% of such patients LVEF improved by at
least 4% and 17% of such patients LVEF improved by at
least 20% at twelve months following therapy.
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Eleven serious adverse events were reported in nine of the
15 patients during follow-up, seven of which were
investigator determined to be possibly attributable to MyoCell.
Two of the seven serious adverse events potentially attributable
to MyoCell were death, which occurred relatively shortly after
receiving the MyoCell therapy. In the course of describing the
cause of death, electrophysiologists who reviewed and analyzed
the data indicated that one of the deaths was most likely
attributable to irregular heart contractions brought on by the
MyoCell injection procedure. The cause of death for the other
patient is unknown as permission for histology and autopsy
analysis were denied by the patients family. Following
these patient deaths, we requested an assessment by an
independent European Data Safety Monitoring Board who, following
their investigation and our incorporation of their
recommendations to, among other things, require prior placement
of an ICD and require holter and ICD readings every week for the
first month following the MyoCell injection procedure, supported
the continuation of the trial. The other five serious adverse
events possibly attributable to MyoCell also involved irregular
heart contractions. These patients recovered and no other
adverse events were reported for such patients.
67
The results of this trial were presented at the 2005 Annual
Meeting of the American College of Cardiology.
2002 Trial
In May 2002, we initiated a clinical trial of MyoCell in the
Netherlands in collaboration with Transvascular, Inc., or the
2002 Trial, to evaluate the safety and efficacy of MyoCell using
the investigational TransAccess catheter. Three patients were
treated in this clinical trial, which was discontinued for
reasons unrelated to the trial following the acquisition of
Transvascular by Medtronic in August 2003. All of the patients
selected for enrollment in the 2002 Trial had (i) symptoms
associated with NYHA Class II, NYHA Class III or NYHA
Class IV heart failure, (ii) suffered a previous heart
attack at least four weeks prior to the date of treatment,
(iii) a LVEF of between 20% to 40%, (iv) been on
optimal drug therapy and (v) prior placement of an ICD at
least one month prior to enrollment. The primary safety endpoint
of the study was the clinical status of the patient as measured
by, among other things, a comparison of serious adverse events
occurring before and following MyoCell implantation. The primary
efficacy endpoints were the same endpoints used in the
Phase I/ II trial we conducted in Europe. Twelve month
follow-up
on these
three patients showed one death adjudicated by the physicians
conducting the trial as unrelated to MyoCell, with the other two
patients event-free.
Paid Registry Studies
We have taken steps to initiate paid registry studies of MyoCell
and MyoCath in six centers and countries, including Korea,
Mexico, Switzerland, The Bahamas, Singapore and South Africa and
finalized contracts with an institution in each of Korea,
Mexico, Switzerland and The Bahamas. A paid registry study is a
research study conducted at a private hospital or research
institution in accordance with a specific protocol approved by
the appropriate regulators in the country and agreed to by
contract between us and the institution conducting the study.
The institution conducting the registry study and/or the
patients enrolled in the trial reimburse us for some or all of
the costs of cell culturing, biopsy processing and MyoCath.
These registry studies are primarily designed to generate
revenues and to gather additional clinical research data
regarding the safety and efficacy of MyoCell and MyoCath.
As of January 2007, one patient has undergone the MyoCell
implantation procedure at the Mexico center. We anticipate that,
starting in the first quarter of 2007, MyoCell implantation
procedures will begin to be performed at the other centers.
Other Trials of Myoblast Implantation in the Heart
In addition to studies we have sponsored, we believe
myoblast-based clinical therapies have been the subject of at
least eleven clinical trials involving more than 325 enrollees,
including at least 200 treated patients.
MG Therapeutics Myoblast Autologous Grafting in Ischemic
Cardiomyopathy (MAGIC) Trial
The following summary of the results of the Myoblast Autologous
Graft in Ischemic Cardiomyopathy (MAGIC) clinical trial
sponsored by MG Biotherapeutics, LLC is based upon a
presentation given by Philippe
Menasché, M.D., Ph.D. at the American Heart
Associations Scientific Sessions 2006 and news reports of
the presentation.
Dr. Menasché reported that the MAGIC trial was a
Phase II, randomized, double blind, placebo-controlled
multicenter clinical trial in various countries in Europe to
assess the safety and efficacy of skeletal myoblast implantation
injected during coronary artery bypass graft (CABG) surgery into
the scarred region of the heart. 97 patients were enrolled
in the MAGIC trial before it was discontinued after an analysis
by an independent data-monitoring board indicated the trial was
unlikely to show that the treatment was superior to placebo on
the primary endpoints.
68
Dr. Menasché reported that the primary safety
endpoints of the study were the nature and frequency of serious
adverse events and ventricular arrhythmias during the six months
following myoblast implantation and the primary efficacy
endpoints of the study were functional improvements in Wall
Motion or LVEF, as measured by echocardiography six months
following myoblast transplantation. Dr. Menasché
reported that the secondary efficacy endpoints included
End-Systolic Volume and End-Diastolic Volume at six months.
Dr. Menasché reported that the 97 patients were
randomized into three groups. The high-dose group
(30 patients) received direct injections of myoblasts in
and around the scarred area totaling about 800 million
myoblasts via 30 injections, the low-dose group
(33 patients) received direct injections of about
400 million myoblasts and the third group, the placebo
group (34 patients), received injections of the suspension
medium without active cells. Dr. Menasché reported
that all of the patients selected for enrollment in the MAGIC
trial had (i) suffered a heart attack at least four weeks
prior to myoblast implantation, (ii) a LVEF between 15% and
35% and (iii) a planned CABG. All patients in the MAGIC
trial received ICDs before hospital discharge.
The data presented at the American Heart Associations
Scientific Sessions 2006 indicated that there were no signals of
safety concerns in either the high-dose or low-dose groups over
six months. Serious adverse event rates and ventricular
arrhythmias were no different between the groups and none of the
deaths in the myoblast groups were attributable to the procedure
or to arrhythmias.
The data presented further indicated that the MAGIC trial failed
to find any significant differences in either Wall Motion or
LVEF as measured by echocardiography. However, measurements of
End-Diastolic Volume and End-Systolic Volume showed that,
although patients hearts that were significantly dilated
at baseline showed no change in the placebo or low-dose groups,
at six months, dilation appeared to decrease in the high-dose
group.
In addition, in a subset of patients in each group, LVEF was
also measured using radionuclide angiography. In these patients,
Dr. Menasché reported that the absolute change in LVEF
in the high-dose group was 3%, significantly greater than in the
placebo group, where LVEF was unchanged from baseline at six
months.
69
Pipeline
In addition to MyoCell, we are seeking to develop various other
cell-based therapies and related devices for the treatment of
heart damage. We have also acquired the rights to use certain
devices for the treatment of heart damage. The development of
the product candidates described below is not dependent on our
commercial development of MyoCell.
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Candidate
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Proposed Use or Indication
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Status/Phase
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Comments
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MyoCath
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Disposable endoventricular catheter used for the delivery of
biologic solutions to the myocardium
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Phase II clinical trials
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Assuming the facility manufacturing MyoCath satisfies the
requirements of the International Standards Organization,
anticipate seeking certification to apply the CE Mark for
commercial sale and distribution within the European Union in
the fourth quarter of 2007
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TGI 100 Wound Dressing Kit
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Convenience kit used to prepare a cellulose coated wound
dressing from patient-derived fat cells to be prepared and
applied at the point-of-care
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510(k) pre-market notification filed by Tissue Genesis with the
FDA in September 2006; FDA granted an extension until April 2007
to submit additional information requested; European CE Mark
certification expected to be sought in the first half of 2007
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Regulatory approval is being sought based on animal studies
previously completed by Tissue Genesis; we have the right to use
for the treatment of acute MI and heart failure
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TGI 1200 Adipose Tissue Processing System
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Fully automated device for the rapid processing of patient
derived fat tissue
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Performing initial validation studies
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510(k) and CE Mark certification as a laboratory tissue
processing device expected to be sought based on results of
laboratory and animal studies to be conducted by Tissue Genesis
and Bioheart commencing in the first half of 2007
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Bioheart Acute Cell Therapy
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Acute, autologous, cell therapy treatment for acute MI
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Developmental
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Cells processed using the TGI 100 or TGI 1200; anticipate
commencing animal studies in the first quarter of 2007 at
Indiana University
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MyoCell II with SDF-1
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Non-acute, autologous, cell therapy treatment for severe damage
to the heart; modified to express angiogenic factors
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Preparing IND application
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Preparing IND application based on preclinical studies completed
by the Cleveland Clinic and the University of Florida and
conducted by MPI Research; anticipate filing IND application in
the second quarter of 2007
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MyoCath II
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Second generation disposable endoventricular catheter modified
to provide multidirectional cell injection and used for the
delivery of biologic solutions to the myocardium
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Developmental
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Laboratory studies currently being conducted; anticipate
commencing animal studies by the second quarter of 2007
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70
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Candidate
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Proposed Use or Indication
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Status/Phase
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Comments
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BioPace
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Non-acute treatment of abnormal heart rhythm due to electrical
disturbances in the upper chambers of the heart
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Preclinical
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Preclinical development by Bioheart
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We believe MyoCath has the potential to be approved for
commercial use with MyoCell and warrants testing for other
commercial applications as well. MyoCath is a disposable
endoventricular catheter used for the delivery of biologic
solutions to a targeted treatment site within the myocardium,
the inner wall of the heart. MyoCath provides for multiple
injections to a pre-determined needle insertion depth with a
single core needle of 25 gauge diameter that can be advanced and
retracted from the tip of the catheter. MyoCath is intended for
use with commercially available Becton-Dickinson 1
milliliter and 3 milliliter syringes.
Although we hope to prove that MyoCell can be administered with
a variety of different catheters, MyoCath has been specifically
designed to be used for delivery of MyoCell. It is our hope that
MyoCath will prove to be more cost effective than, and as safe
and effective as, other catheters at delivering MyoCell. We are
still in the process of determining what catheter features are
most important to the doctors performing implantation procedures
and remain hopeful that MyoCath has already incorporated such
features in its design. In our clinical experience to date, our
procedure time using MyoCath in connection with MyoCell is
approximately one hour. In addition to MyoCath, physicians in
our clinical trials of MyoCell have used the Myostar catheter
and the TransAccess catheter.
Although MyoCath has been designed for use with MyoCell, we
believe that there are a number of other clinical therapies to
treat heart disease currently in development by other companies
that could be delivered via MyoCath including gene, protein,
cytokine and growth factor therapies. Three clinical trials have
been initiated by biopharmaceutical companies and other
institutions utilizing MyoCath to deliver growth factors in an
effort to increase blood supply to a damaged heart.
TGI 100 Wound Dressing Kit, TGI 1200
Adipose-Tissue Processing System and Bioheart Acute Cell
Therapy
We have acquired from Tissue Genesis the right to use and sell
the TGI 100 Wound Dressing Kit and the TGI 1200
Adipose-Tissue Processing System product candidates. Tissue
Genesis has filed for regulatory approval of the TGI 100
and is in the process of finalizing the design of the
TGI 1200, which is intended to be a fully automated version
of the cell isolation component of the TGI 100. We intend
to use the TGI 100 and the TGI 1200 in our efforts to
develop the Bioheart Acute Cell Therapy, an acute,
autologous cell therapy treatment for acute MI.
The TGI 100 product candidate is a convenience kit used to
prepare a cellulose coated wound dressing from patient-derived
fat cells to be prepared and applied at the
point-of
-care. As part
of the TGI 100 wound dressing process, fat tissue is
removed from the patient and manually processed to separate and
isolate endothelial progenitor and stem cells into a pulpy
composition. The pulpy composition is then applied to a
collagen-based wound dressing and the wound dressing is applied
to the cover the wound. Tissue Genesis filed a 510(k) pre-market
notification for the TGI 100 with the FDA in September
2006. To obtain 510(k) clearance, a manufacturer must submit a
pre-market notification demonstrating that the proposed device
is substantially equivalent in intended use and in safety and
efficacy to a previously 510(k) cleared device, a device that
has received pre-market approval or a device that was in
commercial distribution before May 28, 1976. We believe the
TGI 100 is substantially equivalent in intended use and in
safety and efficacy to the 510(k)-cleared Johnson &
Johnson Medical, Ltd.s Promogran Matrix Wound Dressing.
The FDA has requested that Tissue Genesis file a Request for
Designation with the FDA Office of Combination of Products
requesting a determination of whether the TGI 100 is
properly classified as a medical device or a biologic or drug.
The FDA granted Tissue Genesis an extension until April 2007 to
file this Request for Designation.
71
The TGI 1200 system is a compact, fully automated cell
isolation device for the rapid processing of patient-derived fat
tissue to separate, isolate and produce large yields of stem and
regenerative cells. We anticipate that the TGI 1200 system
will process cells within a one-hour time period. Tissue Genesis
has indicated that once the design of the TGI 1200 system
is finalized, which they expect to occur in the first half of
2007, they intend to commence laboratory and animal studies of
the TGI 1200. Assuming Tissue Genesis is able to
demonstrate that the TGI 1200 produces a pulpy composition
comparable to the TGI 100, Tissue Genesis has indicated
their intent to file a 510(k) pre-market notification with the
FDA and for CE Mark certification in Europe.
We have secured the exclusive, worldwide right to sell or lease
to medical practitioners and related healthcare entities the
following items for the treatment of acute MI:
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the TGI 100;
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the TGI 1200 and certain disposable products used in
conjunction with the TGI 1200, or collectively with the
TGI 100, the TGI Licensed Products;
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processes that use the TGI Licensed Products, or the
TGI Licensed Processes; and
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the cells derived using the TGI Licensed Products and/or
TGI Licensed Process.
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We are in the process of designing preclinical studies to test
the Bioheart Acute Cell Therapy. Unlike MyoCell which is
designed to be utilized to treat severe heart damage months or
even years after a heart attack, the Bioheart Acute Cell
Therapy is being designed to be used for the treatment of heart
muscle damage immediately following a heart attack. We hope to
demonstrate that the injection of endothelial progenitor and
stem cells derived from fat tissue by the TGI 100 and/or
TGI 1200 is a safe and effective means of limiting or
reversing some of the effects of acute MI and preventing or
slowing a patients progression from MI to CHF. We
anticipate that our preclinical studies testing the safety and
efficacy of this therapy will commence in the first quarter of
2007 at Indiana University. Until the design of the
TGI 1200 is finalized, to commence our preclinical studies
we intend to manually separate and isolate the cells from fat
tissue using the cell isolation techniques used as part of the
TGI 100. Once the TGI 1200 is available to us and
provided that testing demonstrates that the TGI 1200
produces a pulpy composition comparable to the TGI 100, we
anticipate that we will use the TGI 1200, rather than the
TGI 100, for our preclinical and clinical studies. If
approved, we intend to market the Bioheart Acute Cell
Therapy primarily to interventional cardiologists.
MyoCell II with
SDF-1
Our MyoCell II with
SDF-1
product
candidate, which has recently completed preclinical testing, is
intended to be an improvement to MyoCell. In February 2006, we
signed a patent licensing agreement with the Cleveland Clinic of
Cleveland, Ohio which gave us exclusive license rights to
pending patent applications in connection with MyoCell II
with
SDF-1.
We expect
this collaboration to give us access to the extensive underlying
animal studies supporting the patent applications. In addition,
in connection with our establishment of this relationship with
the Cleveland Clinic, Dr. Marc Penn, the Medical Director
of the Cardiac Intensive Care Unit at the Cleveland Clinic and a
staff cardiologist in the Departments of Cardiovascular Medicine
and Cell Biology, joined our Scientific Advisory Board.
We anticipate that MyoCell II with
SDF-1
will be similar
to MyoCell, except that the myoblast cells to be injected will
be modified prior to injection by an adenovirus vector so that
they will release extra quantities of the
SDF-1
protein, which
expresses angiogenic factors. Following injury which results in
inadequate blood flow to the heart, such as a heart attack, the
human body naturally increases the level of
SDF-1
protein in the
heart. By modifying the myoblasts to express
SDF-1
prior to
injection, we are seeking to increase the
SDF-1
protein levels
present in the heart. We are seeking to demonstrate that the
presence of additional quantities of
SDF-1
protein released
by the myoblasts will stimulate the recruitment of the
patients existing stem cells to the cell transplanted area
and, thereafter, the recruited stem cells will assist in the
tissue repair and blood vessel formation process. Preclinical
animal studies showed a definite improvement of cardiac function
when
72
the myoblasts were modified to express
SDF-1
protein prior to
injection as compared to when the myoblasts were injected
without modification.
We anticipate that we will file an IND application in the second
quarter of 2007 for Phase I clinical trials of MyoCell with
SDF-1.
MyoCath II
We are testing MyoCath II, a second generation catheter in
laboratory studies. It provides a modified injection needle
which has a closed tip and side holes that result in
multidirectional cell injection rather than injection solely
from the tip of the needle. We are seeking to determine whether
MyoCath II will increase the bioretention of the cells
injected in the heart and disperse the cells more efficiently
throughout the scar tissue. We anticipate commencing animal
studies of MyoCath II by the second quarter of 2007.
BioPace
Our BioPace product candidate is in preclinical studies. It is
an autologous cell-based therapy intended to be used as a
biological pacemaker for the treatment of sino-atrial nodal
dysfunction disease, a disease in which the natural pacemaker
cells of the heart do not properly function due to electrical
disturbances in the upper chambers of the heart and which
results in an abnormal heart rhythm. The sino-atrial node is the
impulse generating tissue located in the right atrium of the
heart. As part of the BioPace therapy, cells from the
sino-atrial node are removed from the right atrium of a
patients heart and cultured in our temperature controlled
cell culturing facility. These cells are cultured in vitro
in a solution containing oxygen and nutrients. While the cells
are being cultured, we anticipate the patient will receive an
external pacemaker to pace the remaining portions of the
patients sino-atrial node. The cultured cells are then
implanted into the myocardial tissue of the right ventricle to
provide biological pacing for the heart.
Research
We supervise and perform experimental work in the areas of
improving cell culturing, cell engraftment, and other advanced
research projects related to our product candidates from our
Sunrise cell culturing facility. The primary focus of a
substantial majority of our employees is advancing our clinical
trials, preclinical studies, research and product development.
In addition, we work with a number of third parties within and
outside the United States on various research and product
development projects, including:
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preclinical small and large animal testing for lead product
candidate enhancements and pipeline product candidate
development; and
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contract research for clinical and preclinical testing of our
pipeline product candidates.
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Cell Culturing
We have an approximately 2,000 square foot cell culturing
facility at our headquarters in Sunrise, Florida. We began
culturing cells at this facility for preclinical uses in the
third quarter of 2006. We anticipate that we will begin
culturing cells at this facility for clinical uses upon
commencement of the MYOHEART II Trial. We believe our cell
culturing facility and processes comply with cGMP. We anticipate
that this facility will manufacture approximately 90% of the
capacity needed in the United States through 2007 for the
MYOHEART II Trial.
Over the last two years, we have significantly improved our
ability to:
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culture in excess of 800 million myoblast cells per
biopsy; and
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produce cell cultures with a high percentage of viable myoblast
cells.
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Accordingly, we have been able to increase the maximum dosage of
myoblast cells injected as part of the MyoCell therapy to
approximately 800 million myoblast cells, which we believe
will be the most effective
73
therapeutic dose. We expect that we will seek to further refine
our MyoCell cell culturing processes. We intend to seek to
automate a significant portion of our cell culturing processes
in an effort to reduce our culturing costs and processing times.
We have licensed patents from Dr. Law relating to this
automation process.
We have historically met and, with respect to the cell culturing
of our product candidates in Europe, expect to meet, our cell
culturing needs by contracting with third party manufacturers.
In December 2006, we entered into a non-exclusive supply
agreement with Pharmacell BV, or Pharmacell. We anticipate that
approximately 90% of MyoCell inventory to be cultured or
purchased in Europe between the date of this prospectus and the
end of 2007 will be cultured by Pharmacell at their facility in
Massetricht, Netherlands, which opened in June 2006. Pursuant to
the supply agreement, Pharmacell has agreed to provide us with
MyoCell cell culturing at its cost plus a certain percentage per
culture. We have no minimum purchase obligation under the supply
agreement. The supply agreement expires six months following the
completion of the SEISMIC and MYOHEART II Trials unless
terminated earlier. Either party may terminate the supply
agreement upon the other partys insolvency or the other
partys material default or breach of any provision of the
supply agreement.
We also have cell culturing contracts with Cambrex Bioscience
for the culturing of cells at their facilities in Maryland,
United States and Verviers, Belgium. Pursuant to our agreements
with Cambrex Bioscience, we do not have any minimum purchase
commitment and, while Cambrex has agreed to use reasonable
efforts to meet our manufacturing needs, they have not
guaranteed that they will be able to do so. We compensate
Cambrex for its cell culturing services on a per patient basis
at a fixed cost per culture and at hourly rates for services
they provide to us not directly related to the scheduling and
processing of a biopsy.
For the balance of 2007, we expect that we will meet our cell
culturing needs in Europe pursuant to our agreement with
Pharmacell as well as from our Florida facility and pursuant to
our agreement with Cambrex Bioscience.
We have entered into a contract with Bolton Medical for the
manufacture of MyoCath. Pursuant to our contract with Bolton
Medical, Bolton Medical has the right to manufacture not less
than 200 catheters per year at a fixed per-unit cost provided
that the per-unit cost charged by Bolton Medical is not greater
than the per-unit cost charged by Guidant Corporation or its
affiliates. We have further agreed that we will not use any
third-party manufacturer for MyoCath other than Bolton Medical
or Guidant Corporation or its affiliates. Either party may
terminate the agreement upon the other partys uncured
material breach of the agreement and in the event of bankruptcy.
Unless terminated earlier, this agreement will terminate in
September 2007.
We intend to seek to further optimize our processing times by
building our facilities or contracting with a small number of
cell culturing facilities in strategic regional locations. We
have established and/or are currently evaluating establishing
joint venture manufacturing relationships in Korea, China and
Australia. We anticipate that a portion of the funds necessary
to construct new manufacturing facilities may be made available
to us by the governments of the countries where we seek to build
such facilities.
Third Party Reimbursement
Government and private insurance programs, such as Medicare,
Medicaid, health maintenance organizations and private insurers,
fund the cost of a significant portion of medical care in the
United States. As a result, government imposed limits on
reimbursement of hospitals and other healthcare providers have
significantly impacted their spending budgets and buying
decisions. Under certain government insurance programs, a
healthcare provider is reimbursed a fixed sum for services
rendered in treating a patient, regardless of the actual cost of
such treatment incurred by the healthcare provider. Private
third party reimbursement plans are also developing increasingly
sophisticated methods of controlling healthcare costs through
redesign of benefits and exploration of more cost-effective
methods of delivering healthcare. In general, we believe that
these government and private measures have caused healthcare
providers to be more selective in the purchase of medical
products.
74
As of the date of this prospectus, CMS has agreed to reimburse
certain of the centers that are participating in the MYOHEART
Trial for costs deemed routine in nature for
patients suffering from heart failure. Examples of these
reimbursable costs include, but are not limited to, costs
associated with physical examination of the patients, x-rays,
holter monitoring, MUGA scan and echocardiography. However, at
present, CMS reimbursement does not cover the cost of MyoCell
implantation.
Reimbursement for healthcare costs outside the United States
varies from country to country. In European countries, the
pricing of prescription pharmaceutical products and services and
the level of government reimbursement are subject to
governmental control. In these countries, pricing negotiations
with governmental authorities can take six to twelve months or
longer after the receipt of marketing approval for a product. To
obtain reimbursement or pricing approval in some countries, we
may be required to conduct one or more clinical trials that
compares the cost effectiveness of our product candidates to
other available therapies. Conducting one or more clinical
trials would be expensive and result in delays in
commercialization of our product candidates.
Research Grants
Historically, part of our research and development efforts have
been indirectly funded by research grants to various centers
and/or physicians that have participated in our MyoCell and
MyoCath clinical trials. As part of our development strategy, we
intend to continue to seek to develop research partnerships with
centers and/or physicians.
Patents and Proprietary Rights
We own or hold licenses or hold sublicenses to an intellectual
property portfolio consisting of approximately 19 patents and 19
patent applications in the United States, and approximately
twelve patents and 57 patent applications in foreign countries,
for use in the field of heart muscle regeneration. We have
described our most material license and sublicense agreements
below in the section entitled Business
Technology In-Licenses and Other Agreements. References in
this prospectus to our patents and patent
applications and other similar references include the patents
and patent applications that are owned by, or licensed or
sublicensed to us, and references to patents and patent
applications that are licensed to us and other
similar references refer to patents, patent applications and
other intellectual property that are licensed or sublicensed to
us.
Our intellectual property strategy emphasizes method, product
and device patents. We rely primarily on one U.S. patent
for MyoCell, or the Primary MyoCell Patent, one U.S. patent
for MyoCath, or the Primary MyoCath Patent and a number of
patents for MyoCath II. We rely on four pending
U.S. patent applications and corresponding foreign patent
applications for MyoCell II with SDF-1 and three
U.S. patents for BioPace. For most of our other product
candidates, we rely on one primary patent, multiple patents in
combination and/or proprietary processes.
The following provides a description of our key patents and
pending applications and is not intended to represent an
assessment of claims, limitations or scope.
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Expiration Date Assuming
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Patent
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Subject Matter
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Related Product(s)
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No Patent Extension
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US5,130,141
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Compositions for and methods of treating muscle degeneration and
weakness
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MyoCell; MyoCell II with SDF-1
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July 14, 2009
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US5,972,013
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Direct Pericardial Access Device with Deflecting Mechanism and
Method
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MyoCath; MyoCath II
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Sep. 19, 2017
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US6,241,710
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Hypodermic Needle with Weeping Tip and Method of Use
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MyoCath II
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Dec. 20, 2019
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75
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Expiration Date Assuming
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Patent
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Subject Matter
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Related Product(s)
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No Patent Extension
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US6,547,769
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Catheter Apparatus with Weeping Tip and Method of Use
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MyoCath II
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Dec. 20, 2019
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US6,855,132
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Apparatus with Weeping Tip and Method of Use
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MyoCath II
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Dec. 20, 2019 (with 101 day adjustment: Mar. 30,
2020)
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US6,949,087
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Apparatus with Weeping Tip and Method of Use
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MyoCath II
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Dec. 20, 2019
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Patent Application
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Subject Matter
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Related Product(s)
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US2004/0161412
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Cell-Based VEGF Delivery
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MyoCell II with SDF-1
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WO 04/056186
(US03/34411)
(PCT)
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Cell-Based VEGF Delivery
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MyoCell II with SDF-1
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US2004/0037811
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Stromal Cell-Derived Factor-1 Mediates Stem Cell Homing and
Tissue Regeneration in Ischemic Cardiomyopathy
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MyoCell II with SDF-1
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WO 04/017978
(US03/26013)
(PCT)
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Stromal Cell-Derived Factor-1 Mediates Stem Cell Homing and
Tissue Regeneration in Ischemic Cardiomyopathy
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MyoCell II with SDF-1
|
Patent life determination depends on the date of filing of the
application or the date of patent issuance and other factors as
promulgated under the patent laws. Under the U.S. Drug
Price Competition and Patent Term Restoration Act of 1984, as
amended, a patent which claims a product, use or method of
manufacture covering drugs and certain other products, including
biologic products, may be extended for up to five years to
compensate the patent holder for a portion of the time required
for research and FDA review of the product. Only one patent
applicable to an approved drug or biologic product is eligible
for a patent term extension. This law also establishes a period
of time following approval of a drug or biologic product during
which the FDA may not accept or approve applications for certain
similar or identical drugs or biologic products from other
sponsors unless those sponsors provide their own safety and
efficacy data.
We anticipate that we will seek to collaborate with the owners
of the patent, Dr. Law and Cell Transplants International,
to extend the term of this patent and, provided that MyoCell is
approved by the FDA prior to the patent expiration date and
certain other material conditions are satisfied, we believe that
this patent will be eligible for a five-year extension of its
term until July 2014. It is possible that the FDA will not
complete review of and grant approval for MyoCell before this
patent expires. In such event, a regular patent term extension
will not be available, but Dr. Law and Cell Transplants
International could request a one-year interim extension of the
patent term during the period beginning six months before and
ending fifteen days before the patent expiration. The request
for interim extension must satisfy a number of material
conditions including those conditions necessary to receive a
regular patent term extension. Under certain circumstances the
patent owner can request up to four additional one-year interim
extensions. However, we cannot assure you that Dr. Law and
Cell Transplants International will seek to obtain, or will be
successful in obtaining, any regular or interim patent term
extension.
MyoCell is not protected by patents outside of the United
States, which means that competitors will be free to sell
products that incorporate the same or similar technologies that
are used in MyoCell without infringing our patent rights in
those countries, including in European countries, which we
believe may be one of the largest potential markets for MyoCell.
As a result, MyoCell, if approved for use in any of these
76
countries, may be vulnerable to competition. In addition, many
of the patent and patent applications that have been licensed to
us that pertain to our other product candidates do not cover
certain countries within Europe.
Our commercial success will depend to a significant degree on
our ability to:
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defend and enforce our patents and/or compel the owners of the
patents licensed to us to defend and enforce such patents;
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obtain additional patent and other proprietary protection for
MyoCell and our other product candidates;
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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;
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preserve trade secrets and other intellectual property rights
relating to our product candidates; and
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operate without infringing the patents and proprietary rights of
third parties.
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In addition to patented intellectual property, we also rely on
trade secrets and proprietary know-how to protect our technology
and maintain our competitive position, especially when we do not
believe that patent protection is appropriate or can be
obtained. Our policy is to require each of our employees,
consultants and advisors to execute a confidentiality and
inventions assignment agreement before beginning their
employment, consulting or advisory relationship with us. The
agreements generally provide that the individual must keep
confidential and not disclose to other parties any confidential
information developed or learned by the individual during the
course of the individuals relationship with us except in
limited circumstances. These agreements generally also provide
that we shall own all inventions conceived by the individual in
the course of rendering services to us. Moreover, some of our
academic institution licensors, collaborators and scientific
advisors have rights to publish data and information to which we
have rights, which may impair our ability to protect our
proprietary information or obtain patent protection in the
future.
We work with others in our research and development activities
and one of our strategies is to enter into collaborative
agreements with third parties to develop our proposed products.
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 licensors,
collaborators, consultants and others. In addition, other
parties may circumvent any proprietary protection we do have. As
a result, we may not be able to maintain our proprietary
position.
We are not currently a party to any litigation or other adverse
proceeding with regard to our patents or intellectual property
rights. However, if we become involved in 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, lengthy governmental proceedings, divert
managements attention and resources and require us to
enter royalty or license agreements which are not advantageous,
if available at all.
See Risk Factors Risks Related to Our
Intellectual Property for a discussion of additional risks
we face with respect to our intellectual property rights.
Technology In-Licenses and Other Agreements
The Primary MyoCell Patent includes claims we believe cover a
composition for the treatment of muscle degeneration, comprised
of cultured myogenic cells for use in their administration to
diseased muscle. The Primary MyoCell Patent expires in the
United States in July 2009. Provided that MyoCell is approved
prior to
77
the expiration date of the Primary MyoCell Patent and certain
other material conditions are satisfied, we believe the Primary
MyoCell Patent will be eligible for a five-year extension of its
term until July 2014. We anticipate that we will seek to
collaborate with the owners of the patent, Dr. Law and Cell
Transplants International, to extend the term of the Primary
MyoCell Patent.
In February 2000, we entered into a License Agreement, or the
Law License Agreement, with Dr. Law and Cell Transplants
International pursuant to which Dr. Law and Cell
Transplants International granted us a conditionally exclusive
license (i.e., a non-exclusive license with a right of
first refusal) to certain patent and patent applications,
including the Primary MyoCell Patent, or, collectively, the Law
Patents, for the life of such Law Patents as well as future
developments related to heart muscle regeneration and
angiogenesis for the purpose of developing a commercially viable
product within the field of heart muscle repair and
angiogenesis, or, collectively, the Law IP. We are not
permitted to sublicense our rights under the Law License
Agreement to third parties. If Dr. Law or Cell Transplants
International desires to license or otherwise convey any rights
in and to any of the Law Patents, including the Primary MyoCell
Patent, or any of their technology, inventions or other patent
rights in the field of heart muscle regeneration or angiogenesis
to a third party, we have a right of first refusal, exercisable
within thirty days, to obtain either an exclusive or
non-exclusive license for such rights. Dr. Law and Cell
Transplants International have agreed that they will not
consider any such third party offer if the aggregate
consideration offered is less than $14 million. Pursuant to
the Law License Agreement, the exercise price of our right of
first refusal will be equal to the lesser of the price offered
by the third party or $25 million.
Under the Law License Agreement, we are required to pay to Cell
Transplants International a $3 million payment upon
commencement of a bona fide U.S. Phase II human
clinical trial that utilizes technology claimed under the
Primary MyoCell Patent and a $5 million payment upon FDA
approval of patented technology for heart muscle regeneration.
In addition, we are required to pay royalties to Cell
Transplants International equal to 5% of gross sales in the
territories where the licensed patents are issued for products
and services that are covered by the Law IP.
Dr. Law and Cell Transplants International have agreed to
use reasonably diligent and prompt efforts to enforce the
patents licensed pursuant to the Law License Agreement by
instituting litigation against all third parties to whom
Dr. Law and/or Cell Transplants International have a
reasonable basis for claiming infringement. Dr. Law and
Cell Transplants International are entitled to any and all
damages recovered in connection with any such litigation. We do
not have the right to initiate or exercise any control over the
prosecution, maintenance, defense or enforcement of the Law IP.
See Risk Factors Risks Related to Our
Intellectual Property for a discussion of additional risks
we face with respect to our intellectual property rights.
Primary MyoCath Patent
The Primary MyoCath Patent includes device claims that we
believe covers, among other things, the structure of MyoCath.
The Primary MyoCath Patent expires in the United States in
September 2017. A patent application for the Primary MyoCath
Patent has been filed in Europe and is currently pending.
In January 2000, we entered into a license agreement with
Comedicus, Incorporated pursuant to which Comedicus granted us a
royalty-free, fully paid-up, non-exclusive and irrevocable
license to the Primary MyoCath Patent in exchange for a payment
of $50,000. This agreement was amended in August 2000 to provide
us an exclusive license to the Primary MyoCath Patent in
exchange for a payment of $100,000 and our loan of $250,000 to
Comedicus. Pursuant to this amendment we also received the
right, but not the obligation, with Comedicus consent,
which consent is not to been unreasonably withheld, to defend
the Primary MyoCath Patent against third party infringers.
In June 2003, we entered into agreements with ACS pursuant to
which we assigned our rights under the license agreement with
Comedicus, as amended, committed to deliver 160 units of
MyoCath and sold certain of our other catheter related
intellectual property, or, collectively, with the Primary
MyoCath Patent, the Catheter IP, for aggregate
consideration of $900,000. In connection with these agreement,
ACS granted to us
78
a co-exclusive, irrevocable, fully
paid-up
license to the
Catheter IP for the life of the patents related to the
Catheter IP.
ACS has the exclusive right, at its own expense, to file,
prosecute, issue, maintain, license, and defend the
Catheter IP, and the primary right to enforce the
Catheter IP against third party infringers. If ACS fails to
enforce the Catheter IP against a third party infringer
within a specified period of time, we have the right to do so at
our expense. The party enforcing the Catheter IP is
entitled to retain any recoveries resulting from such
enforcement. The asset purchase agreement only pertains to the
Catheter IP developed or acquired by us prior to
June 24th, 2003. Our subsequent catheter related
developments and/or acquisitions, such as MyoCath II, were
not sold or licensed to ACS.
MyoCell II with SDF-1 Patents
To develop our MyoCell II with
SDF-1
product
candidate, we intend to rely primarily on patents we have
licensed from the Cleveland Clinic in addition to the Primary
MyoCell Patent. These patents relate to methods of repairing
damaged heart tissue by transplanting myoblasts that express
SDF-1
and other
therapeutic proteins capable of recruiting other stem cells
within a patients own body to the cell transplant area. We
believe we will also need to, among other things, license some
additional intellectual property to commercialize
MyoCell II with
SDF-1
in the form we
believe may prove to be the most safe and/or effective.
In February 2006, we signed a patent licensing agreement with
the Cleveland Clinic which provides us with the worldwide,
exclusive rights to four pending U.S. patent applications
and certain corresponding foreign filings in the following
jurisdictions: Australia, Brazil, Canada, China, Europe and
Japan, or, collectively, the Cleveland Clinic IP, related
to methods of repairing damaged heart tissue by transplanting
myoblasts that express SDF-1 and other therapeutic proteins
capable of recruiting other stem cells within a patients
own body to the cell transplant area. The term of our agreement
with the Cleveland Clinic extends to the date on which the last
of the Cleveland Clinic IP expires, at which time our
license will become irrevocable, paid up and royalty-free.
We have paid the Cleveland Clinic aggregate fees of
$1.5 million and are required to pay an annual maintenance
fee of $150,000.
In addition, we are required to make payments upon our
achievement of certain milestone activities which we have agreed
to use commercially reasonable efforts to complete by target
dates agreed to by the parties. The table below sets forth the
milestone activity, required milestone payment and target
completion date.
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Milestone
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Target
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Milestone Activity
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Payment
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Completion Date
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FDA or foreign equivalent approval of an IND application
covering product candidates derived from the Cleveland
Clinic IP
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$
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200,000
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February 3, 2007
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Full enrollment of an FDA approved Phase I clinical trial
for the first product candidate derived from the Cleveland
Clinic IP
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$
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300,000
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February 3, 2008
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Full enrollment of the last clinical trial needed prior to a
Biologic License Application submission to the FDA or foreign
equivalent related to the first product candidate derived from
the Cleveland Clinic IP
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$
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750,000
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February 3, 2009
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First commercial sale of an FDA approved product derived from
the Cleveland Clinic IP
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$
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1,000,000
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February 3, 2011
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To the extent we do not complete a milestone activity by the
target completion date, we will be required to pay $100,000, or
the Extension Fee, to extend the target completion date for an
additional one year period, or the Extension Period. If such
milestone activity is achieved during the first six months of
the Extension Period, the Extension Fee will be credited against
the applicable milestone payment. We will also be required to
pay Cleveland Clinic royalty fees equal to 5% of net sales of
any product derived from the Cleveland Clinic IP until the
expiration of the patents. In addition, in the event we do not
complete a milestone activity
79
by the target completion date and fail to achieve such milestone
activity within 90 days of receiving written notice from
the Cleveland Clinic, our license to the Cleveland
Clinic IP will automatically convert into a non-exclusive
license. In the event such milestone activity remains
uncompleted one year following the target completion date and is
not completed within 90 days of receiving written notice
from the Cleveland Clinic, our license to the Cleveland
Clinic IP will automatically terminate. We did not receive
FDA or foreign equivalent approval of an IND application
covering product candidates derived from the Cleveland
Clinic IP by February 3, 2007, the target completion
date for such milestone activity. We are presently involved in
active discussions with the Cleveland Clinic to extend this
target completion date.
Pursuant to our license agreement with the Cleveland Clinic, we
are permitted to sublicense the Cleveland Clinic IP.
However, prior to enrollment of the first human in an FDA
approved clinical trial, we are required to pay Cleveland Clinic
20% of all revenue received from our granting of sublicenses to
the Cleveland Clinic IP. Following enrollment of the first
human in an FDA approved clinical trial, we will be required to
pay Cleveland Clinic 10% of all revenue received from our
granting of sublicenses to the Cleveland Clinic IP. These
sublicense fees do not include amounts paid by a sublicensee to
us relating to, among other things, net sales of products
derived from the Cleveland Clinic IP.
The Cleveland Clinic has agreed to diligently prosecute and
maintain the rights to the Cleveland Clinic IP and has the
right, but not the obligation, to prosecute and/or defend, at
its own expense, any infringement of, and/or challenge to, the
patent rights. To the extent the Cleveland Clinic determines not
to initiate suit against any infringer, we have the right, but
not the obligation, to commence litigation for such alleged
infringement. Any damages recovered will be treated as royalties
received by us from sublicensees and shared by us and the
Cleveland Clinic accordingly.
In addition to the Cleveland Clinics right to terminate
due to our failure to complete milestone activities as described
above, the Cleveland Clinic may terminate our agreement with the
Cleveland Clinic if we breach the agreement and fail to cure
such breach within a specified cure period. The agreement also
will terminate automatically in the event of our bankruptcy.
MyoCath II Patents
In April 2006, we entered into an agreement with Tricardia,
LLC pursuant to which Tricardia granted us a sublicenseable
license to certain patents and patent applications in the United
States, Australia, Canada, Europe and Japan covering the
modified injection needle we intend to use as part of
MyoCath II, or the MyoCath II Patents, in exchange for
a one time payment of $100,000. Our license covers and is
exclusive with respect to products developed under the
MyoCath II Patents for the delivery of therapeutic
compositions to the heart. Unless earlier terminated by mutual
consent of the parties, our agreement with Tricardia will
terminate upon the expiration date of the last MyoCath II
Patent.
Tricardia has the obligation to take all actions necessary to
file, prosecute and maintain the MyoCath II Patents. We are
required to reimburse Tricardia, on a pro-rata basis with other
licensees of Tricardia of the MyoCath II Patents, for all
reasonable
out-of
-pocket costs and
expenses incurred by Tricardia in prosecuting and maintaining
the MyoCath II Patents. To the extent we do not wish to
incur the cost of any undertaking or defense of any opposition,
interference or similar proceeding involving the MyoCath II
Patents with respect to any jurisdiction, the license granted to
us pursuant to agreement will be automatically amended to
exclude such jurisdiction.
Tricardia also has the first right, but not the obligation, to
take any actions necessary to prosecute or prevent any
infringement or threatened infringement of the MyoCath II
Patents. To the extent Tricardia determines not to initiate suit
against any infringer, we have the right, but not the
obligation, to commence litigation for such alleged
infringement. Our share of any recovery will equal 50% in the
event Tricardia commences litigation and 90% in the event we
commence litigation.
80
TGI 100 and TGI 1200 Patent
On December 12, 2006, or the Effective Date, we entered
into an agreement with Tissue Genesis, or the Tissue Genesis
Agreement, that provides us an exclusive, worldwide right to
individually use or to sell or lease to medical practitioners
and related healthcare entities the following items, for the
treatment of acute MI and heart failure, or the Field of Use:
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the TGI 100;
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the TGI 1200 and certain disposable products used in
conjunction with the devices, or, collectively, with the
TGI 100 and certain other products, the TGI Licensed
Product Candidates;
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processes that use the TGI Licensed Product Candidates, or the
TGI Licensed Processes; and
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the cells derived using the TGI Licensed Product Candidates
and/or the TGI Licensed Processes, or the TGI Licensed Cells.
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Under the Tissue Genesis Agreement, we are restricted from
transferring or sublicensing our rights to distribute and use,
respectively, the TGI Licensed Product Candidates and related
technology, or the TGI Product Candidate Technology.
Under the Tissue Genesis Agreement, we have agreed to diligently
pursue commercialization of the TGI Licensed Product Candidates
for the treatment of acute MI and heart failure. We have also
agreed to use commercially reasonable efforts to obtain FDA
approval for the TGI Licensed Product Candidates within five
years of the Effective Date and to make the first sale of a TGI
Licensed Product Candidate within seven years of the Effective
Date. Tissue Genesis has agreed to provide us with reasonable
assistance to obtain regulatory approvals.
Tissue Genesis has agreed to sell us equipment and disposables
on pricing terms as favorable as the terms offered to any other
direct customer. Tissue Genesis has agreed to provide us with
any reasonably available information and instructions related to
the operation and maintenance of any equipment we purchase.
We have granted Tissue Genesis an exclusive, worldwide license
to use, for purposes other than the treatment of acute MI and
heart failure, any improvements we make to the TGI Product
Candidate Technology. Tissue Genesis has granted us a right of
first refusal to acquire any improvements made or acquired by
Tissue Genesis to the TGI Licensed Product Candidates or TGI
Product Candidate Technology.
We may terminate the Tissue Genesis Agreement for any reason
upon 90 days written notice to Tissue Genesis. In the event
we terminate the Tissue Genesis Agreement, the warrant we
granted Tissue Genesis (described below) will immediately become
fully vested. In the event we fail to obtain FDA approval for a
TGI Licensed Product Candidate within seven years of the
Effective Date, our exclusive license and distribution right
will automatically become non-exclusive. In the event we fail to
obtain FDA approval for a TGI Licensed Product Candidate within
eight years of the Effective Date, our license and distribution
right will automatically terminate. In the event we pay Tissue
Genesis royalties of less than $1 million over any one year
royalty period at any time after two years following the receipt
of FDA approval for a TGI Licensed Product Candidate, our
exclusive license and distribution right will automatically
terminate 30 days after receipt of notice from Tissue
Genesis unless we demonstrate that we continue to pursue
commercialization and FDA approval of TGI Licensed Product
Candidates and have spent at least the following cumulative
amounts toward our commercialization and FDA approval efforts:
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$500,000 within two years of the Effective Date;
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$1,250,000 within three years of the Effective Date;
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$2,000,000 within four years of the Effective Date; and
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an additional $100,000 each year after four years of the
Effective Date.
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Tissue Genesis also has the right to terminate the agreement if
we are in material breach thereof and we do not cure the breach
within 30 days of receiving written notice of such breach.
We have the right, but not
81
the obligation, to request that Tissue Genesis commence
litigation against a third party infringer of the patents,
including certain patents licensed by Tissue Genesis from Thomas
Jefferson University, or the TJU Patents, necessary for our
customers use of the TGI Licensed Product Candidates, the
TGI Licensed Processes and the TGI Licensed Cells within the
Field of Use. In the event (i) Tissue Genesis fails to
bring suit within 120 days of receipt of our written
request, which request must be accompanied by an opinion of
counsel as to the alleged infringement and (ii) sales of
the infringing products reduce our net sales of the TGI Licensed
Product Candidates by at least $250,000 per year, we will
be relieved of our obligation to pay Tissue Genesis royalty fees
until Tissue Genesis initiates litigation against the third
party infringer or obtains discontinuance of the infringement.
If requested by Tissue Genesis, we may be required to pay for
one third of the expenses, including legal fees, of any such
litigation. To the extent we are required to contribute to the
costs of litigation, we will have the right to participate in
the prosecution of the alleged infringement and to receive one
third of any damages recovered by Tissue Genesis.
As consideration for the license, we have issued to Tissue
Genesis 21,052 shares of our common stock and granted
Tissue Genesis a warrant to purchase 2,500,000 shares
of our common stock at an exercise price of $4.75 per
share. The warrant is scheduled to vest and become exercisable
as follows:
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1,000,000 shares will vest upon our successful completion
of any internationally recognized Phase I clinical trial of
a TGI Licensed Product Candidate;
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750,000 shares will vest upon the earlier of our net sales
of $10 million of TGI Licensed Product Candidates or our
receipt of $2 million of net profits from the sale of TGI
Licensed Product Candidates; and
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750,000 shares will vest upon the earlier of our net sales
of $100 million of TGI Licensed Product Candidates or our
receipt of $20 million of net profits from the sale of TGI
Licensed Product Candidates.
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In the event we merge or are acquired, the warrant will
immediately become fully vested as to all 2,500,000 shares.
Any vested portion of the warrant will be exercisable at any
time and from time to time until December 31, 2026.
We have also agreed to pay Tissue Genesis royalty fees equal to
2% of net sales of any TGI Licensed Product Candidate, TGI
Licensed Processes and TGI Licensed Cells, up until such
time as the items are no longer qualified for legal protection
by a valid patent claim.
Tissue Genesis has agreed that we and our customers will not be
liable for damages for directly or indirectly infringing various
patents, including the TJU patents necessary for our
customers use of the TGI Licensed Product Candidates, the
TGI Licensed Processes and the TGI Licensed Cells for the
treatment of acute MI. Tissue Genesis has, subject to certain
conditions, also agreed to indemnify and hold harmless us and
our customers from all claims that the products infringe any
patents, copyrights or trade secret rights of a third party.
However, if our use of the products is enjoined or if Tissue
Genesis wishes to minimize its liability, Tissue Genesis may, at
its option and expense, either:
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substitute a substantially equivalent non-infringing product for
the infringing product;
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modify the infringing product so that it no longer infringes but
remains functionally equivalent; or
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obtains for us the right to continue using such item.
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If none of the foregoing is feasible, Tissue Genesis is required
to accept a return of the infringing product and refund to us
the amount paid for such product. Our agreement with Tissue
Genesis provides that Tissue Genesis entire liability and
obligation with respect to claims of infringement are limited to
the liabilities and obligations described above.
Other License Agreements
In June 2000, we entered into an agreement with William
Beaumont Hospital, or WBH, pursuant to which WBH granted to us a
worldwide, exclusive, non-sublicenseable license to two
U.S. method patents
82
covering the inducement of human adult myocardial cell
proliferation in vitro, or the WBH IP. We utilize the
methods under these patents in connection with our BioPace and
certain other product candidates in development. We do not have
rights to patents outside the United States relating to BioPace.
In addition to a payment of $55,000 we made to acquire the
license, we are required to pay WBH an annual license fee of
$10,000 and royalties ranging from 2% to 4% of net sales of
products that are covered by the WBH IP. In order to
maintain these exclusive license rights, our aggregate royalty
payments in any calendar year must exceed a minimum threshold as
established by the agreement. The minimum threshold was $30,000
and $50,000 for 2004 and 2005, respectively. This minimum
threshold increased to $100,000 in 2006 and will increase to
$200,000 for 2007 and thereafter. To the extent that our annual
net sales of products covered by the WBH IP do not exceed
the minimum threshold for such year, we have the option of
paying any shortfall in cash to WBH by the end of the applicable
year or having our license to the WBH IP become
non-exclusive. In addition to the patents licensed from WBH, we
purchased a U.S. patent and its corresponding Japanese
filing, which are directed to biological pacemakers, by
assignment from Angeion Corporation on September 1, 2000.
As of the date of this prospectus, we have not made any payments
to WBH other than the initial payment to acquire the license.
Accordingly, WBH may terminate the license to the WBH IP at
any time at their sole option. We are currently in negotiations
with WBH to amend the terms of the license agreement. Unless
earlier terminated by WBH or by either party upon the other
partys breach of the agreement, the agreement will
terminate upon the expiration date of the last patent covered by
the WBH Agreement.
Sales and Marketing
In advance of any expected commercial approval of our lead
product candidate, we intend to internally develop a direct
sales and marketing force in both Europe and the United States.
We anticipate the team will be comprised of salespeople,
clinical and reimbursement specialists and product marketing
managers.
We intend to market MyoCell to interventional cardiologists. In
the typical healthcare system the interventional cardiologist
functions as a gate keeper for determining the
course of appropriate medical care for our target patient
population.
We anticipate our marketing efforts will be focused on informing
interventional cardiologists of the availability of a our
treatment alternative through the following channels of
communication: (i) articles published in medical journals
by widely recognized interventional cardiologists, including
cardiologists that have participated in our clinical trials;
(ii) seminars and speeches featuring widely recognized
interventional cardiologists; and (iii) advertisements in
medical journals.
Collaborative Arrangements for Seeking Regulatory Approvals
and Distribution of Products Outside of the United States and
Europe
Japan
On November 19, 2001, we entered into an agreement with
Getz Brothers Co., Ltd. pursuant to which we appointed Getz
Brothers as the exclusive distributor of all of our products in
Japan. Pursuant to this agreement, during the three-year period
following the Reimbursement Date (as defined below), Getz
Brothers has agreed to purchase a minimum number of units of our
products per year at prices to be negotiated upon our receipt of
approval from the Japanese Ministry of Health, Labor and Welfare
to sell our products in Japan, or the Japan Regulatory Approval.
Under this distribution agreement, Getz Brothers has agreed to
use its best efforts to obtain government approval for, promote
and distribute our products in Japan using generally the same
channels and methods, exercising the same diligence and adhering
to the same standards which Getz Brothers employs for its own
products and other medical products it distributes. To assist
Getz Brothers in registering and marketing our products in
Japan, we have agreed to provide them with, among other things,
written materials necessary to obtain the Japan Regulatory
Approval, information on our marketing and promotional plans for
our products, certificates of analysis concerning any products
purchased by Getz Brothers, certificates of free sale, trademark
authorizations and any other documents they may reasonably
request.
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This agreement with Getz Brothers terminates five years
following the date that the necessary Japanese regulatory
authorities approve reimbursement for MyoCell, or the
Reimbursement Date. Getz Brothers may terminate the agreement
upon 30 days written notice. In the event that the
Reimbursement Date does not occur by November 19, 2009, we
may terminate the agreement upon 30 days written notice. If
our agreement with Getz Brothers is not terminated prior to the
end of the five year period following the Reimbursement Date,
the agreement will be automatically renewed for additional
one-year periods unless either party provides 180 days
advance written notice to the other party of its desire not to
renew the agreement.
We may also terminate this agreement at any time upon
180 days notice subject to our one-time payment of a
buy-out fee to Getz Brothers. If we exercise this buy-out option
prior to our receipt of the Japan Regulatory Approval, the
payment to Getz Brothers will be equal to the greater of
(i) $5 million and (ii) two times the sum of Getz
Brothers expenditures incurred in connection with seeking
regulatory approvals and conducting clinical trials for our
product candidates. If we exercise this buy-out option
subsequent to our receipt of the Japan Regulatory Approval, the
payment to Getz Brothers will be equal to the greater of
(ii) $10 million and (ii) the product of 24 and
the monthly average of Getz Brothers gross revenues
received from sales of our products during the six months
preceding our exercise of this buy-out option.
Other Countries in Asia and Australia/ Oceania
On November 19, 2001, we entered into an agreement with
Getz Brothers pursuant to which we appointed Getz Brothers as
the exclusive distributor of all of our products in the
countries of Australia, Bangladesh, Burma, Cambodia, China, Hong
Kong, Indonesia, Laos, Malaysia, New Zealand, Pakistan,
Philippines, Singapore, Sri Lanka, Taiwan, Thailand and Vietnam,
or, collectively, the Territory. Pursuant to this agreement,
during the three-year period following the date that the
necessary regulatory authorities approve reimbursement for our
MyoCell therapy within the Territory, Getz Brothers has agreed
to purchase a minimum number of units of our products per year
at prices to be negotiated upon our first receipt of approval
from the appropriate regulatory agencies to sell our products in
the Territory. Under this agreement, Getz Brothers has agreed to
use its best efforts to obtain government approval for, promote
and distribute our products in the Territory using generally the
same channels and methods, exercising the same diligence and
adhering to the same standards which Getz Brothers employs for
its own products and other medical products it distributes. To
assist Getz Brothers in registering and marketing our products
in the Territory, we have agreed to provide them with, among
other things, written materials necessary to obtain the
requisite regulatory approvals, information on our marketing and
promotional plans for our products, certificates of analysis
concerning any products purchased by Getz Brothers, certificates
of free sale, trademark authorizations and any other documents
they may reasonably request.
This agreement with Getz Brothers terminates on
November 19, 2007. The agreement will be automatically
renewed at the end of the initial term for additional one-year
periods unless either party provides 180 days advance
written notice to the other party of its desire not to renew the
agreement. We may also terminate the agreement at any time upon
180 days notice subject to our one-time payment of a
buy-out fee to Getz Brothers equal to the greater of
(i) $200,000, (ii) 1.5 times the sum of Getz
Brothers expenditures incurred in connection with seeking
regulatory approvals and conducting clinical trials for our
product candidates in the Territory and (iii) the product
of 28 and the monthly average of Getz Brothers gross
revenues received from sales of our products in the Territory
during the six months preceding our exercise of this buy-out
option.
Government Regulation
The research and development, preclinical studies and clinical
trials, and ultimately, the culturing, manufacturing, marketing
and labeling of our product candidates are subject to extensive
regulation by the FDA and other regulatory authorities in the
United States and other countries. We believe MyoCell and
MyoCath are subject to regulation in the United States and
Europe as a biological product and a medical device,
respectively.
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Biological products are subject to regulation under the Federal
Food, Drug, and Cosmetic Act, or the FD&C Act, the Public
Health Service Act, or the PHS Act and their respective
regulations as well as other federal, state, and local statutes
and regulations. Medical devices are subject to regulation under
the FD&C Act and the regulations promulgated thereunder
as well as other federal, state, and local statutes and
regulations. The FD&C Act and the PHS Act and the
regulations promulgated thereunder govern, among other things,
the testing, cell culturing, manufacturing, safety, efficacy,
labeling, storage, record keeping, approval, clearance,
advertising and promotion of our product candidates. Preclinical
studies, clinical trials and the regulatory approval process
typically take years and require the expenditure of substantial
resources. If regulatory approval or clearance of a product is
granted, the approval or clearance may include significant
limitations on the indicated uses for which the product may be
marketed.
FDA Regulation Approval of Biological
Products
The steps ordinarily required before a biological product may be
marketed in the United States include:
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completion of preclinical studies according to good laboratory
practice regulations;
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the submission of an IND application to the FDA, which must
become effective before human clinical trials may commence;
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performance of adequate and well-controlled human clinical
trials according to good clinical practices to establish the
safety and efficacy of the proposed biological product for its
intended use;
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satisfactory completion of an FDA pre-approval inspection of the
manufacturing facility or facilities at which the product is
manufactured, processes, packaged or held to assess compliance
cGMP; and
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the submission to, and review and approval by, the FDA of a
biologics license application, or BLA, that includes
satisfactory results of preclinical testing and clinical trials.
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Preclinical tests include laboratory evaluation of the product
candidate, its formulation and stability, as well as animal
studies to assess the potential safety and efficacy of the
product candidate. The FDA requires that preclinical tests be
conducted in compliance with good laboratory practice
regulations. The results of preclinical testing are submitted as
part of an IND application to the FDA together with
manufacturing information for the clinical supply, analytical
data, the protocol for the initial clinical trials and any
available clinical data or literature. A
30-day
waiting period
after the filing of each IND application is required by the FDA
prior to the commencement of clinical testing in humans. In
addition, the FDA may, at any time during this
30-day
waiting period
or any time thereafter, impose a clinical hold on proposed or
ongoing clinical trials. If the FDA imposes a clinical hold,
clinical trials cannot commence or recommence without FDA
authorization.
Clinical trials to support BLAs involve the administration of
the investigational product to human subjects under the
supervision of qualified investigators. Clinical trials are
conducted under protocols detailing, among other things, the
objectives of the study, the parameters to be used in monitoring
safety and the efficacy criteria to be evaluated.
Clinical trials are typically conducted in three sequential
phases, but the phases may overlap.
In Phase I clinical trials, the initial introduction of the
biological product candidate into human subjects or patients,
the product candidate is tested to assess safety, dosage
tolerance, absorption, metabolism, distribution and excretion,
including any side effects associated with increasing doses.
Phase II clinical trials usually involve studies in a
limited patient population to identify possible adverse effects
and safety risks, preliminarily assess the efficacy of the
product candidate in specific, targeted indications; and assess
dosage tolerance and optimal dosage.
If a product candidate is found to be potentially effective and
to have an acceptable safety profile in Phase II
evaluations, Phase III trials are undertaken within an
expanded patient population at multiple study sites to further
demonstrate clinical efficacy and safety, further evaluate
dosage and establish the risk-benefit ratio of the product and
an adequate basis for product labeling.
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Phase IV, or post-marketing, trials may be mandated by
regulatory authorities or may be conducted voluntarily.
Phase IV trials are typically initiated to monitor the
safety and efficacy of a biological product in its approved
population and indication but over a longer period of time, so
that rare or long-term adverse effects can be detected over a
much larger patient population and time than was possible during
prior clinical trials. Alternatively, Phase IV trials may
be used to test a new method of product administration, or to
investigate a products use in other indications. Adverse
effects detected by Phase IV trials may result in the
withdrawal or restriction of a drug.
If the required Phase I, II and III clinical testing is
completed successfully, the results of the required clinical
trials, the results of product development, preclinical studies
and clinical trials, descriptions of the manufacturing process
and other relevant information concerning the safety and
effectiveness of the biological product candidate are submitted
to the FDA in the form of a BLA. In most cases, the BLA must be
accompanied by a substantial user fee. The FDA may deny a BLA if
all applicable regulatory criteria are not satisfied or may
require additional data, including clinical, toxicology, safety
or manufacturing data. It can take several years for the FDA to
approve a BLA once it is submitted, and the actual time required
for any product candidate may vary substantially, depending upon
the nature, complexity and novelty of the product candidate.
Before approving an application, the FDA will inspect the
facility or facilities where the product is manufactured. The
FDA will not approve a BLA unless it determines that the
manufacturing processes and facilities are in compliance with
cGMP requirements.
If the FDA evaluations of the BLA and the manufacturing
facilities are favorable, the FDA may issue either an approval
letter or an approvable letter. The approvable letter usually
contains a number of conditions that must be met to secure final
FDA approval of the BLA. When, and if, those conditions have
been met to the FDAs satisfaction, the FDA will issue an
approval letter. If the FDAs evaluation of the BLA or
manufacturing facility is not favorable, the FDA may refuse to
approve the BLA or issue a non-approvable letter that often
requires additional testing or information.
FDA Regulation Approval of Medical
Devices
Medical devices are also subject to extensive regulation by the
FDA. To be commercially distributed in the United States,
medical devices must receive either 510(k) clearance or
pre-market approval, or PMA, from the FDA prior to marketing.
Devices deemed to pose relatively low risk are placed in either
Class I or II, which requires the manufacturer to
submit a pre-market notification requesting permission for
commercial distribution, or 510(k) clearance. Devices deemed by
the FDA to pose the greatest risk, such as life-sustaining,
life-supporting or implantable devices, devices deemed not
substantially equivalent to a previously 510(k) cleared device
and certain other devices are placed in Class III which
requires PMA. We anticipate that MyoCath will be classified as a
Class III device.
To obtain 510(k) clearance, a manufacturer must submit a
pre-market notification demonstrating that the proposed device
is substantially equivalent in intended use and in safety and
efficacy to a previously 510(k) cleared device, a device that
has received PMA or a device that was in commercial distribution
before May 28, 1976. The FDAs 510(k) clearance
pathway usually takes from four to twelve months, but it can
last longer.
After a device receives 510(k) clearance, any modification that
could significantly affect its safety or efficacy, or that would
constitute a major change in its intended use, requires a new
510(k) clearance or could require PMA. The FDA requires each
manufacturer to make this determination, but the FDA can review
any such decision. If the FDA disagrees with a
manufacturers decision not to seek a new 510(k) clearance,
the agency may retroactively require the manufacturer to seek
510(k) clearance or PMA. The FDA also can require the
manufacturer to cease marketing and/or recall the modified
device until 510(k) clearance or PMA is obtained.
A product not eligible for 510(k) clearance must follow the PMA
pathway, which requires proof of the safety and efficacy of the
device to the FDAs satisfaction. The PMA pathway is much
more costly, lengthy
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and uncertain than the 510(k) approval pathway. A PMA
application must provide extensive preclinical and clinical
trial data and also information about the device and its
components regarding, among other things, device design,
manufacturing and labeling. As part of the PMA review, the FDA
will typically inspect the manufacturers facilities for
compliance with quality system regulation requirements, which
impose elaborate testing, control, documentation and other
quality assurance procedures. Upon acceptance by the FDA of what
it considers a completed filing, the FDA commences an in-depth
review of the PMA application, which typically takes from one to
two years, but may last longer. The review time is often
significantly extended as a result of the FDA asking for more
information or clarification of information already provided.
If the FDAs evaluation of the PMA application is
favorable, and the applicant satisfies any specific conditions
(e.g., changes in labeling) and provides any specific
additional information (e.g., submission of final
labeling), the FDA will issue a PMA for the approved
indications, which can be more limited than those originally
sought by the manufacturer. The PMA can include post-approval
conditions that the FDA believes necessary to ensure the safety
and efficacy of the device including, among other things,
restrictions on labeling, promotion, sale and distribution.
Failure to comply with the conditions of approval can result in
an enforcement action, which could have material adverse
consequences, including the loss or withdrawal of the approval.
Even after approval of a pre-market application, a new PMA or
PMA supplement is required in the event of a modification to the
device, its labeling or its manufacturing process.
FDA Regulation Post-Approval
Requirements
Even if regulatory clearances or approvals for our product
candidates are obtained, our products and the facilities
manufacturing our products will be subject to continued review
and periodic inspections by the FDA. For example, as a condition
of approval of a new drug application, the FDA may require us to
engage in post-marketing testing and surveillance and to monitor
the safety and efficacy of our products. Holders of an approved
new BLA, PMA or 510(k) clearance product are subject to several
post-market requirements, including the reporting of certain
adverse events involving their products to the FDA, provision of
updated safety and efficacy information, and compliance with
requirements concerning the advertising and promotion of their
products.
In addition, manufacturing facilities are subject to periodic
inspections by the FDA to confirm the facilities comply with
cGMP requirements. In complying with cGMP, manufacturers must
expend money, time and effort in the area of production and
quality control to ensure full compliance. For example,
manufacturers of biologic products must establish validated
systems to ensure that products meet high standards of
sterility, safety, purity, potency and identity. Manufacturers
must report to the FDA any deviations from cGMP or any
unexpected or unforeseeable event that may affect the safety,
quality, or potency of a product. The regulations also require
investigation and correction of any deviations from cGMP and
impose documentation requirements.
In addition to regulations enforced by the FDA, we are also
subject to regulation under the Occupational Safety and Health
Act, the Environmental Protection Act, the Toxic Substances
Control Act, the Resource Conservation and Recovery Act and
other federal, state and local regulations. Our research and
development activities involve the controlled use of hazardous
materials, chemicals, biological materials and radioactive
compounds.
International Regulation
Our product candidates are subject to regulation in every
country where they will be tested or used. Whether or not we
obtain FDA approval for a product candidate, we must obtain the
necessary approvals from the comparable regulatory authorities
of foreign countries before we can commence testing or marketing
of a product candidate in those countries. The requirements
governing the conduct of clinical trials and the approval
processes vary from country to country and the time required may
be longer or shorter than that associated with FDA approval.
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In the European Economic Area, composed of the 25 European Union
Member States, plus Norway, Iceland and Lichtenstein, marketing
authorization applications for medicinal products may be
submitted under a centralized or national procedure. Detailed
preclinical and clinical data must accompany all marketing
authorization applications that are submitted in the European
Union. The centralized procedure provides for the grant of a
single marketing authorization, referred to as a community
authorization, that is valid for the entire European Economic
Area. Under the national or decentralized procedure, a medicinal
product may only be placed on the market when a marketing
authorization, referred to as a national authorization, has been
issued by the competent authority of a European Economic Area
country for its own territory. If marketing authorization is
granted, the holder of such authorization may submit further
applications to the competent authorities of the remaining
member states via either the decentralized or mutual recognition
procedure. The decentralized procedure enables applicants to
submit an identical application to the competent authorities of
all member states where approval is sought at the same time as
the first application. We believe that, by virtue of the nature
of MyoCell, we are eligible to seek commercial approval of
MyoCell under either the centralized or national procedure. We
anticipate that we will first seek to obtain commercial approval
of MyoCell in the Netherlands, Belgium and Germany pursuant to
the national procedure.
Under the mutual recognition procedure, products are authorized
initially in one member state, and other member states where
approval is sought are subsequently requested to recognize the
original authorization based upon an assessment report prepared
by the original authorizing competent authority. The other
member states then have 90 days to recognize the decision
of the original authorizing member state. If the member states
fail to reach an agreement because one of them believes that
there are grounds for supposing that the authorization of the
medicinal product may present a potential serious risk to public
health, the disagreement may be submitted to the Committee for
Medicinal Products for Human Use of the European Medicines
Agency for arbitration. The decision of this committee is
binding on all concerned member states and the marketing
authorization holder. Other member states not directly concerned
at the time of the decision are also bound as soon as they
receive a marketing application for the same product. The
arbitration procedure may take an additional year before a final
decision is reached and may require the delivery of additional
data.
The European Economic Area requires that manufacturers of
medical devices obtain the right to affix the CE Mark to
their products before selling them in member countries. The
CE Mark is an international symbol of adherence to quality
assurance standards and compliance with applicable European
medical device directives. In order to obtain the right to affix
the CE Mark to a medical device, the medical device in
question must meet the essential requirements defined under the
Medical Device Directive (93/42/EEC) relating to safety and
performance, and the manufacturer of the device must undergo
verification of regulatory compliance by a third party standards
certification provider, known as a notified body. We anticipate
that we will file an application to obtain the right to affix
the CE Mark to MyoCath in the fourth quarter of 2007.
In addition to regulatory clearance, the conduct of clinical
trials in the European Union is governed by the European
Clinical Trials Directive (2001/20/EC), which was implemented in
May 2004. This directive governs how regulatory bodies in
member states may control clinical trials. No clinical trial may
be started without authorization by the national competent
authority and favorable ethics approval.
Manufacturing facilities are subject to the requirements of the
International Standards Organization. In complying with these
requirements, manufacturers must expend money, time and effort
in the area of production and quality control to ensure full
compliance.
Despite efforts to harmonize the registration process in the
European Union, the different member states continue to have
different national healthcare policies and different pricing and
reimbursement systems. The diversity of these systems may
prevent a simultaneous pan-European launch, even if centralized
marketing authorization has been obtained.
In some cases, we plan to submit applications with different
endpoints or other elements outside the United States due to
differing practices and requirements in particular
jurisdictions. However, in cases where different endpoints will
be used outside the United States, we expect that such
submissions will be discussed with the FDA to ensure that the
FDA is comfortable with the nature of human trials being
conducted in any
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part of the world. As in the United States, post-approval
regulatory requirements, such as those regarding product
manufacture, marketing, or distribution, would apply to any
product that is approved in Europe.
Competition
Our industry is subject to rapid and intense technological
change. We face, and will continue to face, competition from
pharmaceutical, biopharmaceutical, medical device and
biotechnology companies developing heart failure treatments both
in the United States and abroad, as well as numerous academic
and research institutions, governmental agencies and private
organizations engaged in drug funding or discovery activities
both in the United States and abroad. We also face competition
from entities and healthcare providers using more traditional
methods, such as surgery and pharmaceutical regimens, to treat
heart failure. We believe there are a substantial number of
heart failure products under development by numerous
pharmaceutical, biopharmaceutical, medical device and
biotechnology companies, and it is likely that other competitors
will emerge.
Many of our existing and potential competitors have
substantially greater research and product development
capabilities and financial, scientific, marketing and human
resources than we do. As a result, these competitors may succeed
in developing competing therapies earlier than we do; obtain
patents that block or otherwise inhibit our ability to further
develop and commercialize our product candidates; obtain
approvals from the FDA or other regulatory agencies for products
more rapidly than we do; or develop treatments or cures that are
safer or more effective than those we propose to develop. These
competitors may also devote greater resources to marketing or
selling their products and may be better able to withstand price
competition. In addition, these competitors may introduce or
adapt more quickly to new technologies or scientific advances,
which could render our technologies obsolete, and may introduce
products that make the continued development of our product
candidates uneconomical. These competitors may also be more
successful in negotiating third party licensing or collaborative
arrangements and may be able to take advantage of acquisitions
or other strategic opportunities more readily than we can.
Our ability to compete successfully will depend on our continued
ability to attract and retain skilled and experienced
scientific, clinical development and executive personnel, to
identify and develop viable heart failure product candidates and
to exploit these products and compounds commercially before
others are able to develop competitive products.
We believe the principal competitive factors affecting our
markets include, but are not limited to:
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the safety and efficacy of our product candidates;
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the freedom to develop and commercialize cell-based therapies,
including appropriate patent and proprietary rights protection;
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the timing and scope of regulatory approvals;
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the cost and availability of our products;
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the availability and scope of third party reimbursement
programs; and
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the availability of alternative treatments.
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We are still in the process of determining, among other things:
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if MyoCell is safe and effective;
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the timing and scope of regulatory approvals; and
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the availability and scope of third party reimbursement programs.
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Accordingly, we have a limited ability to predict how
competitive MyoCell will be relative to existing treatment
alternatives and/or treatment alternatives that are under
development. See Business Diagnosis and
Management of Heart Failure.
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If approved, MyoCell will compete with surgical, pharmaceutical
and mechanical based therapies. Surgical options include heart
transplantation and left ventricular reconstructive surgery.
Although not readily accessible, heart transplantation has
proven to be an effective treatment for patients with severe
damage to the heart who locate a donor match and are in
sufficiently good health to undergo major surgery. Mechanical
therapies such as biventricular pacing, ventricular restraint
devices and mitral valve therapies have been developed by
companies such as Medtronic, Inc., Acorn Cardiovascular, Inc.,
St. Jude Medical, Inc., World Heart Corporation, Guidant
Corporation, a part of Boston Scientific, and Edwards
Lifesciences Corp. Pharmaceutical therapies include
anti-thrombotics, calcium channel blockers such as Pfizers
Norvasc
®
and ACE inhibitors such as Sanofis
Delix
®
.
The field of regenerative medicine is rapidly progressing, as
many organizations are initiating or expanding their research
efforts in this area. We are also aware of several competitors
seeking to develop cell-based therapies for the treatment of
cardiovascular disease, including MG Biotherapeutics, LLC (a
joint venture between Genzyme Corporation and Medtronic, Inc),
Mytogen, Inc., Baxter International, Inc., Osiris Therapeutics,
Inc., Viacell, Inc., Cytori Therapeutics, Inc., and potentially
others.
It is our understanding that some of our large competitors have
devoted considerable resources to developing a myoblast-based
cell therapy for treating severe damage to the heart. For
instance, Mytogen and MG Biotherapeutics, like Bioheart,
have been seeking to develop cell-based therapies utilizing
skeletal myoblasts isolated from muscle, expanded in culture,
and injected into a patients heart to repair scar tissue.
In January 2006, Mytogen began recruiting patients for a
U.S. Phase I clinical trial of catheter injections of
myoblasts. Mytogen has announced that this Phase I clinical
trial concluded recruitment in September 2006 and that they
anticipate they will commence enrollment in a Phase II,
double blind, placebo-controlled clinical trial in early 2007.
MG Biotherapeutics announced in February 2006 that it had
ceased enrollment of new patients in its Phase II trial,
the MAGIC Trial, after its data monitoring committee concluded
there was a low likelihood that the trial would result in the
hypothesized improvements in heart function.
Some organizations are involved in research using alternative
cell sources, including bone marrow, embryonic and fetal tissue,
umbilical cord and peripheral blood, and adipose tissue. For
instance, Baxter Healthcare is currently conducting a
U.S. Phase II study using stem cells extracted from
peripheral blood as an investigational treatment for myocardial
ischemia. Osiris Therapeutics is conducting a Phase I study
using mesenchymal stem cells isolated from donor bone marrow,
expanded in culture to treat damage caused by acute MI. Cytori
Therapeutics is developing adipose-tissue derived stem cells
intended to be used in cardiac patients in an autologous manner
and is in preclinical investigations using large animal models.
ViaCell is currently in preclinical development using allogeneic
cells derived from umbilical cord blood for cardiac disease and
they are expected to enter clinical trials in 2007.
For further information regarding our competitive risks, see
Risk Factors We face intense competition in the
biotechnology and healthcare industries.
Legal Proceedings
From time to time, we may become involved in litigation relating
to claims arising from the ordinary course of our business. We
are not presently engaged in any material litigation and are
unaware of any threatened material litigation. However, the
biotechnology and medical device industries have been
characterized by extensive litigation regarding patents and
other intellectual property rights. See Risk Factors
for a discussion of various litigation related risks we face.
Facilities
Our headquarters are located in Sunrise, Florida and consist of
8,600 square feet of space, which we lease at a current
rent of approximately $116,000 per year. The lease expires
in January 2010. In addition to our corporate offices, at
this location, we maintain:
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our MyoCell cell culturing facility for supply within the United
States; and
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a fully equipped cell culturing laboratory where we perform
experimental work in the areas of improving cell culturing, cell
engraftment, and other advanced research projects related to our
core business.
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We believe the space available at our headquarters will be
sufficient to meet the needs of our operations for the
foreseeable future.
Employees
As of January 31, 2007, we had 22 employees, including five
executive officers. A substantial majority of our employees work
in our Sunrise, Florida headquarters. Each employee has signed a
confidentiality, inventions assignment and proprietary rights
agreement and a non-compete and non-solicitation agreement. None
of our employees is covered by a collective bargaining
agreement. We have never experienced employment-related work
stoppages and consider our employee relations to be good.
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MANAGEMENT
Executive Officers and Directors
Set forth below is information regarding our executive officers
and directors as of January 31, 2007.
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Name
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Age
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Position
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Howard J. Leonhardt
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45
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Chairman of the Board and Chief Executive Officer
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William H. Kline
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61
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Chief Financial Officer
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Richard T. Spencer IV
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34
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Vice President of Clinical Affairs and Physician Relations
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Scott Bromley
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45
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Vice President of Public Relations
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Catherine Sulawske-Guck
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37
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Vice President of Administration and Human Resources
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Samuel S. Ahn, M.D., MBA
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52
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Director
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Bruce Carson
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43
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Director
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Peggy A. Farley
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59
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Director
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David J. Gury
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68
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Director
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William P. Murphy, Jr., M.D.
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83
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Director
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Richard T. Spencer III
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70
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Director
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Mike Tomas
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41
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Director
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Linda Tufts
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53
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Director
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Executive Officers
Howard J. Leonhardt.
Mr. Leonhardt is the co-founder
of Bioheart and has served as our Chairman of the Board and
Chief Executive Officer since our incorporation in August 1999.
In 1986, Mr. Leonhardt founded World Medical Manufacturing
Corporation, or World Medical, and served as its Chief Executive
Officer from 1986 until December 1998 when World Medical was
acquired by Arterial Vascular Engineering, Inc., or AVE. AVE was
acquired by Medtronic, Inc. in January 1999. Mr. Leonhardt
was the co-inventor of World Medicals primary product, the
TALENT (Taheri-Leonhardt) stent graft system. From December 1998
until June 1999, Mr. Leonhardt served as President of World
Medical Manufacturing Corporation, a subsidiary of Medtronic.
Scientific articles written by Mr. Leonhardt have been
published in a number of publications including Techniques in
Vascular and Endovascular Surgery and the Journal of
Cardiovascular Surgery. Mr. Leonhardt received a diploma in
International Trade from the Anoka-Hennepin Technical College,
attended the University of Minnesota and Anoka-Ramsey Community
College and holds an honorary Doctorate Degree in Biomedical
Engineering from the University of Northern California.
William H. Kline.
Mr. Kline has served as our Chief
Financial Officer since August 2006. Previously, from October
1999 until August 2006, Mr. Kline served as Senior Vice
President for WildCard Systems, Inc., a debit card processing
company that provides technology for electronic stored-value
accounts and related Web-based software. At WildCard Systems,
Mr. Kline was responsible for, among other things, the
implementation of accounting, financial reporting and budget
systems. He also was involved in all capital transactions at
WildCard Systems, including the sale of the company to eFunds,
Inc. in July 2005. Prior to joining WildCard Systems,
Mr. Kline was the
Partner-in
-charge of
the financial services practice for KPMG LLP in South Florida.
Mr. Kline has over 30 years of diversified financial,
operational and managerial experience and was the managing
partner of KPMGs healthcare practice in Tulsa and Boston.
Mr. Kline received an M.B.A. in Finance and Accounting from
the Wharton School of the University of Pennsylvania in 1972, an
M.S. in Statistics from the University of Delaware in 1971, and
a B.A. in Mathematics from Harvard College in 1967.
92
Richard T. Spencer IV.
Mr. Spencer has served as our
Vice President of Clinical Affairs and Physician Relations since
September 2004. Mr. Spencer has eight years of experience
in the medical device industry, including two years, from 1997
until 1999, as Technical Support Manager of Marketing at
Medtronic Vascular, Inc., a company dedicated to the treatment
of vascular disease and more recently, from August 2000 until
September 2004, as Product Director of Global Drug Eluting Stent
Marketing for the Cordis Cardiology Division of
Johnson & Johnson, a cardiology concern dedicated to
the treatment of coronary artery disease. Mr. Spencer
received an M.B.A. from Columbia Business School in 2000, a J.D.
from the University of Florida in 1997, and a B.A. in Political
Science from Columbia University in 1994.
Scott Bromley.
Mr. Bromley joined Bioheart in
December 1999 and serves in a full-time capacity as our Vice
President of Public Relations. From 1986 until 1998,
Mr. Bromley was employed in the sales and marketing
department at World Medical. In May 1986, Mr. Bromley
co-founded Bromley Printing, Inc., a private printing and
communications firm.
Catherine Sulawske-Guck.
Since January 2007,
Ms. Sulawske-Guck has served as our Vice President of
Administration and Human Resources. Ms. Sulawske-Guck
joined Bioheart in the full-time capacity as Director of
Administration and Human Resources in January 2004 after having
served us in a consulting capacity since December 2001. Prior to
joining Bioheart, from May 1989 until November 2001,
Ms. Sulawske-Guck served as Director of Operations and
Customer Service for World Medical.
Board of Directors
Samuel S. Ahn, M.D., MBA.
Dr. Ahn has served as
a member of our Board of Directors since January 2001. Since
April 2006, Dr. Ahn has served as the President of
University Vascular Associates, a medical practice, and Vascular
Management Associates, a healthcare management business. From
July 1986 to April 2006, Dr. Ahn served as the Professor of
Surgery in the Division of Vascular Surgery at UCLA, where he
was also the Director of the Endovascular Surgery Program.
Dr. Ahn is a member of the board of directors of several
private companies. Dr. Ahn received an M.D. from
Southwestern Medical School in Dallas in 1978 and a B.A. in
biology from the University of Texas in 1974. He also received
an M.B.A. from the UCLA Anderson School of Management in August
2004. Dr. Ahn serves on five vascular journal editorial
boards, and has published over 125 peer-reviewed manuscripts, 50
book chapters, and five textbooks, including one of the first
textbooks on endovascular surgery. During the past
15 years, he has provided consulting services to over 40
biomedical companies, both new and established, and has authored
over 15 patents.
Bruce C. Carson.
Mr. Carson has served as a member
of our Board of Directors since January 2001. Since May 2001,
Mr. Carson has served as the Vice President of Sales of
FinishMaster, Inc., a privately held company specializing in the
distribution of paints and products to the automotive and
industrial refinishing industries. From 1987 until May 2001,
Mr. Carson was President of Badger Paint Plus, Inc., a
privately held distributor of paints and products, until Badger
Paint Plus merger with FinnishMaster, Inc. Mr. Carson
is co-owner of the Southern Minnesota Express Hockey Club, a
member of the North American Hockey League. Mr. Carson is
also the founder and President of the Athletic Performance
Academy in Eden Prairie, Minnesota, a privately held athletic
training facility that has specialized in sports specific
training for elite athletes since August 2004.
David J. Gury.
Mr. Gury has served as a member of
our Board of Directors since July 2005. Since June 2004,
Mr. Gury has served as the principal of Gury Consulting,
LLC in Boca Raton, Florida. In May 1984, Mr. Gury joined
Nabi Biopharmaceuticals, a publicly traded biopharmaceutical
company that primarily develops products for hepatitis and
transplant, gram-positive bacterial infections and nicotine
addiction, as President and Chief Operating Officer. He was
elected Chairman of the Board, Chief Executive Officer and
President in April 1992 and served in such positions until his
retirement in May 2004. Prior to joining Nabi
Biopharmaceuticals, Mr. Gury was employed in various
administrative and executive positions with Alpha Therapeutics
Corporation, a spin off of Abbott Laboratories. Since December
2003, Mr. Gury has been a member of the board of directors
of Oragenics, Inc., a publicly traded emerging biotechnology
company, and was elected as Chairman in December 2004. In April
2005, Mr. Gury was appointed by Floridas Governor Jeb
Bush to serve as a Director on the Scripps Florida Funding
Corporation Board. Mr. Gury received an
93
M.B.A. from the University of Chicago in 1962 specializing in
accounting and finance and an A.B. in economics from Kenyon
College, Gambier, Ohio, in 1960. Mr. Gury is Chairman of
the Florida Research Consortium and past Chairman and a member
of BioFlorida, Floridas independent statewide bioscience
organization.
Peggy A. Farley.
Ms. Farley has served as a member
of our Board of Directors since January 2007. Ms. Farley
was appointed to our Board as a representative of Ascent Medical
Technology Funds. Since January 1998, Ms. Farley has served
as a managing director of the general partner and co-founder of
the Ascent Medical Technology Funds. She is also the President
and Chief Executive Officer of Ascent Capital Management, Inc.
From 1984 until 1997, Ms. Farley was Chief Executive
Officer of a set of firms that she developed as the locus for
investment in the United States for non-US investors, engaging
in venture capital investments, identifying and conducting
acquisition transactions in the United States and South Asia as
well as directing the management of private and corporate
assets. From 1978 to 1984, she was with Morgan Stanley & Co.
Incorporated, in the International Group of the Corporate
Finance Division. Prior to joining Morgan Stanley,
Ms. Farley served as consultant to U.S. corporations,
including Avon, Ingersoll-Rand, Citibank, and Morgan Stanley.
Her career in business began in the mid-1970s in Citibanks
Athens-based Middle East and North Africa Regional Office. She
received an M.A. from Columbia University in 1972 and an A.B.
from Barnard College in 1970.
William P. Murphy, Jr., M.D.
Dr. Murphy
has served as a member of our Board of Directors since June
2003. Dr. Murphy founded Small Parts, Inc., a supplier of
high quality mechanical components for design engineers, and
served as its Chairman and Chief Executive Officer from August
1999 until his retirement in April 2005. Small Parts, Inc. was
acquired by Amazon.com, Inc. in March 2005. From October 1999
until October 2004, Dr. Murphy served as the Chairman and
Chief Executive Officer of Hyperion, Inc., a medical diagnosis
company which had an involuntary bankruptcy filed against it in
December 2003. Dr. Murphy is the founder of Cordis
Corporation (now Cordis Johnson & Johnson) which he led
as President, Chairman and Chief Executive Officer at various
times during his 28 years at Cordis until his retirement in
October 1985. Cordis Johnson & Johnson is a leading
firm in cardiovascular instrumentation. Dr. Murphy received
an M.D. in 1947 from the University of Illinois and a B.S in
pre-medicine from Harvard College in 1946. He also studied
physiologic instrumentation at Massachusetts Institute of
Technology, or MIT. After a two year rotating internship at St.
Francis Hospital in Honolulu, he become a Research Fellow in
Medicine at the Peter Bent Brigham Hospital in Boston where he
was the dialysis engineer on the first clinical dialysis team in
the United States. He continued as an Instructor in Medicine and
then a research Associate in Medicine at Harvard Medical School.
Dr. Murphy is the author of numerous papers and owns 17
patents. He is the recipient of a number of honors, including
the prestigious Lemelson-MIT Lifetime Achievement Award, the MIT
Corporate Leadership Award, the Distinguished Service Award from
North American Society of Pacing and Electrophysiology, and the
Jay Malina Award from the Beacon Council of Miami, Florida.
Richard T. Spencer, III.
Mr. Spencer has served
as a member of our Board of Directors since December 2001. From
April 1982 until July 1987, Mr. Spencer was President of
the Marketing Division of Cordis Corporation (now Cordis
Johnson & Johnson) and a member of its executive
committee and a Vice President of Cordis Dow Corporation, a
joint venture of the Dow Chemical Company and Cordis to
manufacture hollow fiber dialysers and machinery for dialysis.
Mr. Spencer was Chief Operating Officer and held other
executive positions with World Medical from 1993 to January
1999. Mr. Spencer received a B.A. in Economics in 1959 from
the University of Michigan. He has studied business theory, case
studies and financial management while attending executive
programs at the Stanford University School of Business, the
University of Pennsylvanias Wharton School of Business and
the Clemson University School of Business. Between his
University of Michigan studies and embarking on a career in
healthcare, Mr. Spencer served in Europe with the U.S. Army
Counter Intelligence Corps as a military intelligence analyst
with top secret security clearance. Mr. Spencer is also the
founder and a member of the board of directors of Viacor, Inc.,
a private company that is developing percutaneous repair of
heart mitral valves.
Mike Tomas.
Mr. Tomas has served as a member of our
Board of Directors since April 2003. Mr. Tomas was
appointed to our Board as a representative of The Astri Group.
Since January 2001, Mr. Tomas has served as President of
The Astri Group, an early-stage private equity investment company
94
providing capital, business development and strategic marketing
support to emerging private companies. Prior to this,
Mr. Tomas was President of Apex Capital from June 2000
until January 2001, when the private equity investment company
was acquired by The Astri Group. From 1984 until June 2000,
Mr. Tomas was Chief Marketing Officer at Avantel-MCI, MCI
Worldcoms joint venture with Grupo Financiero Banamex.
Mr. Tomas is also a member of the board of directors of
several private companies. Mr. Tomas received an M.B.A.
from the University of Miami in 2000 and a B.A. in Industrial
Organizational Psychology from Florida International University
in 1990.
Linda Tufts.
Ms. Tufts has served as a member of our
Board of Directors since October 2004. Ms. Tufts was
appointed to our Board as a representative of Tyco
International, or Tyco. Since 1989, Ms. Tufts has served as
a Vice President and Partner of Fletcher Spaght, Inc. and leads
its Healthcare/ Life Sciences Practice Group. Ms. Tufts is
also a General Partner of Fletcher Spaght Ventures, a venture
capital fund investing in emerging growth high technology and
healthcare companies. Fletcher Spaght has been engaged by Tyco
to manage certain of Tycos investments, including
Tycos investment in Bioheart. Prior to joining Fletcher
Spaght in 1989, Ms. Tufts was affiliated with the Sony
Corporation of America as an internal consultant. From 1982
until 1988, Ms. Tufts was a manager with Bain &
Company, a leading worldwide strategy consultancy. At Bain, she
managed assignments in healthcare and service industries and was
also a manager of Travenol Management Services, a Bain-Baxter
joint program which provided consulting services to hospitals
and other health providers. Before joining Bain in 1982,
Ms. Tufts was a Consultant with Strategic Planning
Associates, now Mercer Management Consulting. Ms. Tufts is
also a member of the board of directors for several private
companies. Ms Tufts received an S.M. in Management from the
Sloan School of MIT in 1978 as well as an S.B. in Electrical
Engineering and Computer Science and an S.B. in Humanities and
Science from MIT in 1975.
Information Regarding the Board of Directors and Corporate
Governance
Director Independence
Our Board of Directors has affirmatively determined that
Ms. Farley, Mr. Gury, Dr. Murphy, Mr. Tomas
and Ms. Tufts meet the definition of independent
director under Rule 4200(a)(15) of the National
Association of Securities Dealers listing standards.
Family Relationships
Mr. Spencer, III, a member of our Board of Directors,
is the father of Mr. Spencer, IV, our Vice President of
Clinical Affairs and Physician Relations.
Mr. Leonhardt, our Chairman and Chief Executive Officer, is
the cousin of Mr. Bromley, our Vice President of Public
Relations, and the
brother-in
-law of
Ms. Sulawske-Guck, our Vice President of Administration and
Human Resources.
Other than as set forth above, there are no family relationships
among our officers and directors.
Director Appointment Rights
Pursuant to a Stockholder Agreement, dated February 5,
2001, among us, Tyco Sigma Limited and Mr. Leonhardt,
Mr. Leonhardt agreed that, for as long as he owns at least
one-third of the outstanding shares of our common stock, there
would either be a director designated by Tyco on the Board of
Directors or that he would use commercially reasonable efforts
to nominate at least one director reasonably acceptable to Tyco.
Ms. Tufts is Tycos current designee to our Board of
Directors. Tycos director designation rights will
terminate upon the closing of this offering.
Pursuant to a Stockholder Agreement, dated March 31, 2003,
among us, The Astri Group, LLC and Mr. Leonhardt,
Mr. Leonhardt agreed that, for a period of three years from
the date of the agreement, he would vote all shares owned by him
and all other shares that he has the right to vote pursuant to
proxies executed in his favor to elect a director designated by
The Astri Group. Mr. Tomas was designated to our Board of
Directors pursuant to this agreement.
95
Pursuant to a Stockholder Agreement, dated August 31, 2006,
among us, Ascent Medical Technology Fund II and
Mr. Leonhardt, Mr. Leonhardt agreed that, for a period
of three years from the first annual meeting of shareholders
following the date Ascent acquires an aggregate of
631,579 shares of our common stock in accordance with the
terms of the Subscription Agreement between Ascent and us, he
would vote all shares owned by him and all other shares that he
has the right to vote pursuant to proxies executed in his favor
to elect a director designated by Ascent. In January 2007,
Ms. Farley was appointed to the Board of Directors as
Ascents designee. Ascents director designation
rights will terminate upon the closing of this offering.
The Board has three committees: the Audit Committee, the
Compensation Committee and the Governance & Nominating
Committee.
The Board of Directors has adopted a written charter for each of
the Audit Committee, the Compensation Committee and the
Governance & Nominating Committee. The full text of
these Committee charters are available on our website located at
www.bioheartinc.com
The following table describes the current members of each of the
Board Committees:
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|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Governance
|
|
|
|
|
|
|
and
|
|
|
Audit
|
|
Compensation
|
|
Nominating
|
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|
|
|
|
|
|
Howard J. Leonhardt
|
|
|
|
|
|
|
|
|
|
|
|
|
Samuel S. Ahn, M.D., MBA
|
|
|
|
|
|
|
|
|
|
|
X
|
|
Bruce Carson
|
|
|
|
|
|
|
X
|
|
|
|
|
|
David J. Gury*
|
|
|
X
|
(1)
|
|
|
|
|
|
|
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Peggy A. Farley*
|
|
|
|
|
|
|
X
|
|
|
|
X
|
(1)
|
William P. Murphy, Jr., M.D.*
|
|
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X
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Richard T. Spencer III
|
|
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X
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|
|
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Mike Tomas*
|
|
|
|
|
|
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X
|
(1)
|
|
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X
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Linda Tufts*
|
|
|
X
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|
(1)
|
Currently serves as Chairperson of the Committee.
|
The Audit Committees primary function is to assist the
Board in fulfilling its oversight responsibilities relating to
(i) the quality and integrity of our financial statements
and corporate accounting practices, (ii) our compliance
with legal and regulatory requirements, (iii) the
independent auditors qualifications and independence and
(iv) the performance of our internal audit function and
independent auditors. The specific responsibilities in carrying
out the Audit Committees oversight role are delineated in
the Audit Committee Charter.
The Board of Directors has determined that each member of the
Audit Committee, other than Mr. Spencer, III, is
independent pursuant to Rule 4200(a)(15) of the NASDAQ
Marketplace Rules. The SEC Rules and NASDAQ Marketplace Rules
require us to have one independent Audit Committee member upon
initial listing of our securities, a majority of independent
Audit Committee members within 90 days of the initial
listing of our securities and all independent Audit Committee
members within one year of the initial listing of our
securities. We intend to comply with these independence
requirements within the time periods specified.
96
The Compensation Committees primary objectives include
making recommendations to the Board of Directors regarding the
compensation of our directors, executive officers, non-officer
employees and consultants and administering our stock option
plans, including our Officers and Employees Stock Option Plan
and our Directors and Consultants Stock Option Plan.
The Board of Directors has determined that each member of the
Compensation Committee, other than Mr. Carson, is
independent pursuant to Rule 4200(a)(15) of the NASDAQ
Marketplace Rules. The NASDAQ Marketplace Rules require us to
have one independent Compensation Committee member upon initial
listing of our securities, a majority of independent Audit
Committee members within 90 days of the initial listing of
our securities and all independent Compensation Committee
members within one year of the initial listing of our
securities. We intend to comply with these independence
requirements within the time periods specified.
|
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|
Governance & Nominating Committee
|
The primary objectives of the Governance & Nominating
Committee include: (i) assisting the Board by identifying
individuals qualified to become Board members and recommending
to the Board the director nominees for the next Annual Meeting
of Shareholders; (ii) overseeing the governance of the
corporation including recommending Corporate Governance
Guidelines to the Board of Directors; (iii) leading the
Board in its annual review of the Boards performance; and
(iv) recommending to the Board director nominees for each
Board Committee.
The Board of Directors has determined that each member of the
Governance & Nominating Committee, other than
Dr. Ahn, is independent pursuant to Rule 4200(a)(15)
of the NASDAQ Marketplace Rules.
The Governance & Nominating Committee was established
in January 2007.
The Governance & Nominating Committees Charter
provides that shareholder nominees to the Board of Directors
will be evaluated using the same guidelines and procedures used
in evaluating nominees nominated by other persons. In evaluating
director nominees, the Governance & Nominating
Committee will consider the following factors:
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the appropriate size and the diversity of our Board;
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our needs with respect to the particular talents and experience
of our directors;
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the knowledge, skills and experience of nominees, including
experience in technology, business, finance, administration or
public service, in light of prevailing business conditions and
the knowledge, skills and experience already possessed by other
members of the Board;
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familiarity with national and international business matters;
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experience in political affairs;
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experience with accounting rules and practices;
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whether such person qualifies as an audit committee
financial expert pursuant to the SEC Rules;
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appreciation of the relationship of our business to the changing
needs of society; and
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the desire to balance the considerable benefit of continuity
with the periodic injection of the fresh perspective provided by
new members.
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In identifying director nominees, the Governance &
Nominating Committee will first evaluate the current members of
the Board of Directors willing to continue in service. Current
members of the Board with skills and experience that are
relevant to our business and who are willing to continue in
service shall be considered for re-nomination, balancing the
value of continuity of service by existing members of the Board
with that of obtaining a new perspective. Generally, the
Governance & Nominating Committee strives to assemble a
Board of Directors that brings to us a variety of perspectives
and skills derived from business and
97
professional experience. In doing so, the Governance &
Nominating Committee will also consider candidates with
appropriate non-business backgrounds. If any member of the Board
does not wish to continue in service or if the
Governance & Nominating Committee or the Board decides
not to re-nominate a member for re-election, the
Governance & Nominating Committee will identify the
desired skills and experience of a new nominee in light of the
criteria above. Other than the foregoing, there are no specific,
minimum qualifications that the Governance & Nominating
Committee believes that a Committee-recommended nominee to the
Board of Directors must possess, although the
Governance & Nominating Committee may also consider
such other factors as it may deem are in our and our
shareholders best interests.
In its deliberations, the Governance & Nominating
Committee is aware that our Board must, within one year of the
date of our initial listing on the NASDAQ Global Market, be
comprised of a majority of independent directors, as
such term is defined by the NASDAQ Marketplace Rules. The
Governance & Nominating Committee also believes it
appropriate for certain key members of our management to
participate as members of the Board.
The Governance & Nominating Committee and Board of
Directors are polled for suggestions as to individuals meeting
the criteria of the Governance & Nominating Committee.
Research may also be performed to identify qualified individuals.
Communications with the Board of Directors
In January 2007, the Board of Directors adopted a Shareholder
Communication Policy for shareholders wishing to communicate
with various Board committees and individual members of the
Board of Directors. Shareholders wishing to communicate with the
Board of Directors, the Governance & Nominating
Committee and specified individual members of the Board of
Directors can send communications to the Board of Directors and,
if applicable, to the Governance & Nominating Committee
or to specified individual directors in writing
c/o Catherine Sulawske-Guck, Bioheart, Inc., 13794 NW
4th Street, Suite 212, Sunrise, FL 33325. We do not
screen such mail and all such letters will be forwarded to the
intended recipient.
Legal Proceedings
There are no pending, material legal proceedings to which any
director, officer or affiliate of Bioheart, any owner of record
or beneficially of more than five percent of any class of voting
securities of Bioheart, or any associate of any such director,
officer, affiliate of Bioheart, or security holder is a party
adverse to Bioheart or any of its subsidiaries or has a material
interest adverse to Bioheart.
Code of Business Conduct and Ethics
We have adopted a Code of Ethics that applies to our principal
executive officer, principal financial officer, principal
accounting officer and persons performing similar functions. We
have also adopted a Code of Business Conduct and Ethics
applicable to all employees, officers, directors and consultants
of the Company. Copies of the Code of Ethics and the Code of
Business Conduct and Ethics are available on our website at
www.bioheartinc.com.
Whistleblower Policy
In January 2007, the Board of Directors adopted Procedures for
the Submission, Receipt and Handling of Concerns and Complaints
Regarding Internal Controls and Auditing Matters, or a
whistleblower policy. This policy outlines the process for the
submission, receipt, retention and treatment of concerns and
complaints received by us regarding our and our affiliates
respective accounting, auditing and internal controls practices
and procedures, including the process for the confidential,
anonymous submission by our directors, officers and employees of
concerns regarding questionable accounting or auditing matters.
98
Compensation Committee Interlocks and Insider
Participation
No member of the Compensation Committee has been an officer or
employee of ours at any time. Also, none of our executive
officers serves, nor served in 2006, on the Board of Directors
or compensation committee of a company with an executive officer
serving on our Board of Directors or Compensation Committee.
99
COMPENSATION DISCUSSION & ANALYSIS
The primary goals of our Compensation Committee with respect to
executive compensation are to attract and retain the most
talented and dedicated executives possible, to assure that our
executives are compensated effectively in a manner consistent
with our strategy and competitive practice and to align
executives incentives with shareholder value creation. To
achieve these goals, our Compensation Committee, with
managements input, recommends executive compensation
packages to our Board of Directors that are generally based on a
mix of salary, discretionary bonus and equity awards. Although
our Compensation Committee has not adopted any formal guidelines
for allocating total compensation between equity compensation
and cash compensation, we believe it is important for these
executives to have equity ownership in our company to provide
them with long-term incentives to build value for our
shareholders. Accordingly, we generally award our principal
executive officers, other than our Chairman and Chief Executive
Officer, initial option grants upon the commencement of their
employment with us and ongoing option grants as circumstances
warrant. Our Chairman and Chief Executive Officer owns a
significant percentage of our outstanding common stock and,
accordingly, we believe his interests are strongly aligned with
the interests of our shareholders. We intend to implement and
maintain compensation plans that tie a substantial portion of
our executives overall compensation to achievement of
corporate goals and value-creating milestones. We believe that
performance and equity-based compensation are important
components of the total executive compensation package for
maximizing shareholder value while, at the same time,
attracting, motivating and retaining high-quality executives.
We have not retained a compensation consultant to review our
policies and procedures with respect to executive compensation.
We conduct an annual review of the aggregate level of our
executive compensation, as well as the mix of elements used to
compensate our executive officers. The Compensation Committee
develops our compensation plans by utilizing publicly available
compensation data for national and regional companies in the
biopharmaceutical industry and/or the South Florida market. We
believe that the practices of this group of companies provide us
with appropriate compensation benchmarks, because these
companies have similar organizational structures and tend to
compete with us for executives and other employees. For
benchmarking executive compensation, we typically review the
compensation data we have collected from the complete group of
companies, as well as a subset of the data from those companies
that have a similar number of employees as our company.
Our Compensation Committee may retain the services of
third-party executive compensation specialists from time to
time, as it sees fit, in connection with the establishment of
cash and equity compensation and related policies.
Elements of Compensation
Our Compensation Committee evaluates individual executive
performance with a goal of setting compensation at levels the
Compensation Committee believes are comparable with executives
in other companies of similar size and stage of development
operating in the biopharmaceutical industry and/or the South
Florida market. The compensation received by our executive
officers consists of the following elements:
Base Salary.
Base salaries for our executives are
established based on the scope of their responsibilities and
individual experience, taking into account competitive market
compensation paid by other companies for similar positions
within our industry and geographic market. Base salaries are
reviewed at least annually, and adjusted from time to time to
realign salaries with market levels after taking into account
individual responsibilities, performance and experience.
Discretionary Annual Bonus.
In addition to base salaries,
our Compensation Committee has the authority to award
discretionary annual bonuses to our executive officers. In 2006,
the Compensation Committee awarded discretionary cash bonuses of
$1,000 to each of our executive officers. The annual incentive
bonuses are intended to compensate officers for achieving
corporate goals and for achieving what the Compensation
Committee believes to be value-creating milestones. Our annual
bonus is paid in cash in an amount reviewed and approved by our
Compensation Committee. Each executive officer is eligible for a
discretionary annual bonus up to an amount equal to 50% of such
executive officers salary.
100
The Compensation Committee expects to adopt a more formal
process for discretionary annual bonuses in 2007. The
Compensation Committee intends to utilize annual incentive
bonuses to compensate officers for achieving financial and
operational goals and for achieving individual annual
performance objectives. These objectives will vary depending on
the individual executive, but will relate generally to strategic
factors such as establishment and maintenance of key strategic
relationships, development of our product candidates,
identification and advancement of additional product candidates,
and to financial factors such as improving our results of
operations and increasing the price per share of our common
stock.
Long-Term Incentive Program.
At present, our long-term
compensation consists primarily of stock options. Our option
grants are designed to align managements performance
objectives with the interests of our shareholders. Our
Compensation Committee grants options to key executives in order
to enable them to participate in the long-term appreciation of
our shareholder value, while personally feeling the impact of
any business setbacks, whether Company-specific or industry
based. We have not adopted stock ownership guidelines, and,
other than for Mr. Leonhardt, our equity benefit plans have
provided the principal method for our executive officers to
acquire equity or equity-linked interests in our company.
Since inception, we have granted equity awards to our executive
officers through our Officers and Employees Stock Option Plan,
which was adopted by our Board of Directors and shareholders to
permit the grant of stock options to our officers and employees.
The initial option grant made to each executive upon joining us
is primarily based on competitive conditions applicable to the
executives specific position. In addition, the
Compensation Committee considers the number of options owned by
other executives in comparable positions within our company and
has established stock option targets for specified categories of
executives. We believe this strategy is consistent with the
approach of other development stage companies in our industry
and, in our Compensation Committees view, is appropriate
for aligning the interests of our executives with those of our
shareholders over the long term.
We do not have any program, plan or obligation that requires us
to grant equity compensation on specified dates and, because we
have not been a public company, we have not made equity grants
in connection with the release or withholding of material
non-public information. Authority to make equity grants to
executive officers rests with our Compensation Committee,
although our Compensation Committee does consider the
recommendations of our Chairman and Chief Executive Officer for
officers other than himself.
In 2006, certain named executive officers were awarded stock
options under our Officers and Employees Stock Option Plan in
the amounts indicated in the section below entitled Grants
of Plan Based Awards. These equity awards included the
grant of a stock option and warrant for an aggregate of
762,500 shares of common stock to Mr. Bromley, our
Vice President of Public Relations, pursuant to the terms of a
letter agreement we entered into with Mr. Bromley in August
2006, or the Bromley Letter Agreement. Mr. Bromley was also
issued 77,143 shares of our common stock pursuant to the
Bromley Letter Agreement. Prior to entering the Bromley Letter
Agreement, certain disputes had arisen between Mr. Bromley
and us as to the number of stock options he had been awarded
since he commenced his employment with us in December 1999. The
shares, options and warrants granted to Mr. Bromley
pursuant to the Bromley Letter Agreement were issued in
settlement of any unpaid salary or other compensation for
services provided to us by Mr. Bromley from December 1999
through August 2006 and in consideration for
Mr. Bromleys release of any claims he may have
against us related to or arising from his employment or any
compensation owed to him.
Other Compensation.
We maintain broad-based benefits that
are provided to full-time employees, including health insurance,
life and disability insurance, dental insurance and vision
insurance. In 2006, we agreed to reimburse Mr. Bromley for
federal and state income taxes he pays in connection with our
issuance to him of 77,143 shares of our common stock
pursuant to the terms of the Bromley Letter Agreement. The
perquisite was negotiated as part of our settlement with
Mr. Bromley and we do not anticipate providing similar
perquisites to him or any of our executive officers on a
going-forward basis.
101
Compensation Committee Report
The Compensation Committee has reviewed and discussed the
Compensation Discussion & Analysis set forth above with
management and, based upon such review and discussions, the
Compensation Committee has recommended to the Board of Directors
that the Compensation Discussion & Analysis be included
in this prospectus.
|
|
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THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS
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Mike Tomas
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Bruce Carson
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Peggy A. Farley
|
Summary Compensation Table
The following table sets forth, for the fiscal year ended
December 31, 2006, the aggregate compensation awarded to,
earned by or paid to our Chief Executive Officer, both persons
who served as our Chief Financial Officer during 2006, and our
two other most highly compensated executive officers who were
serving at December 31, 2006, or collectively, the Named
Executive Officers.
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Long-Term
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Compensation Awards
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Annual Compensation
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Stock
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Option
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All Other
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Name and Principal Position
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Year
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Salary
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Bonus
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Awards
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Awards(1)
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Compensation
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Total
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Howard J. Leonhardt
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2006
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$
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151,000
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$
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1,000
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$
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152,000
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Chief Executive Officer
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William H.
Kline
(2)
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2006
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$
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51,000
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$
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1,000
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$
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97,500
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(3)
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$
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149,500
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Chief Financial Officer
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Brian
Neill
(4)
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2006
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$
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45,000
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$
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45,000
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Former Chief Financial Officer
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Richard T. Spencer, IV
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2006
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$
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126,000
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$
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1,000
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$
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19,500
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(5)
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$
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146,500
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Vice President of Clinical Affairs and Physician Relations
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Scott Bromley
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2006
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$
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131,000
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$
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1,000
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$
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366,429
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(6)
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$
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2,928,000
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(7)
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$
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153,000
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(8)
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$
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3,579,429
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Vice President of Public Relations
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(1)
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Amount reflects the expensed fair value of stock options granted
in 2006, calculated in accordance with
SFAS No. 123(R). See Note 5 of the Notes to
Consolidated Financial Statements (unaudited) Stock
Options for the nine month period ending
September 30, 2006 for a discussion of assumptions made in
determining the grant date fair value and compensation expense
of our stock options.
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(2)
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Mr. Kline commenced his employment with us in August 2006.
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(3)
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Represents the expensed fair market value of options to
purchase 250,000 shares of our common stock granted
August 7, 2006, with an exercise price of $3.50 per
share. The options vest in four equal installments on each of
August 7, 2007, August 7, 2008, August 7, 2009
and August 7, 2010.
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(4)
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Mr. Neill resigned effective April 30, 2006.
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(5)
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Represents the expensed fair market value of options to
purchase 25,000 shares of our common stock granted
April 19, 2006, with an exercise price of $3.50 per
share. The options vest in four equal installments on each of
April 19, 2007, April 19, 2008, April 19, 2009
and April 19, 2010.
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(6)
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Relates to a grant of 77,143 shares to Mr. Bromley in
accordance with the terms of the Bromley Letter Agreement.
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(7)
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Represents the expensed fair market value of (i) options to
purchase 457,500 shares of our common stock granted
August 24, 2006, with an exercise price of $3.50 per
share and (ii) warrants to
purchase 305,000 shares of our common stock granted
August 24, 2006, with an exercise price of $3.50 per
share.
|
102
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(8)
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Relates to amounts to be paid to Mr. Bromley to reimburse
him for federal and state income taxes due in connection with
his receipt of 77,143 shares of our common stock in
accordance with the Bromley Letter Agreement.
|
Bromley Letter Agreement
On August 24, 2006, we entered into the Bromley Letter
Agreement with Mr. Bromley regarding his employment with
us. Pursuant to this agreement:
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we issued to Mr. Bromley 77,143 shares of our common
stock as a full and complete settlement for any unpaid salary or
other compensation owed to Mr. Bromley for services he
rendered to us prior to the date of the Bromley Letter Agreement
and agreed to reimburse Mr. Bromley for federal and state
income taxes he will be required to pay in connection with his
receipt of such shares.
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we agreed to pay Mr. Bromley an annual base salary of
$130,000 for his continued provision of services as our Vice
President of Public Relations.
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we granted to Mr. Bromley a fully-vested incentive stock
option to purchase 457,500 shares of our common stock
at an exercise price of $3.50 per share.
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we granted to Mr. Bromley a fully-vested warrant to
purchase 305,000 shares of our common stock at an
exercise price of $3.50 per share.
|
Mr. Bromleys employment with us may be terminated by
him or us at any time and for any reason. Other than this
agreement, we do not have any employment agreements with any of
our Named Executive Officers.
Grants of Plan Based Awards
In 2006, the Compensation Committee approved option awards under
our Officers and Employees Stock Option Plan to certain of our
Named Executive Officers and awarded stock and warrants to
Mr. Bromley. Our Compensation Committee has not established
guidelines for the grant of plan-based awards for 2007. Set
forth below is information regarding awards granted during 2006.
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All Other
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Option
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All Other
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Awards:
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Grant Date
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Stock Awards:
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Number of
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Exercise or Base
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Fair Value of
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Number of
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Securities
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Price of Option
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Stock and
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Shares of
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Underlying
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Awards
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Option
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Name
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Grant Date
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Stock (#)
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Options (#)
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($/share)
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Awards
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William H. Kline
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8/7/06
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250,000
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(1)
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$
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3.50
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$
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960,000
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Richard T. Spencer, IV
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4/19/06
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25,000
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(1)
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$
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3.50
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$
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96,000
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Scott Bromley
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8/24/06
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77,143
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$
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366,429
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8/24/06
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762,500
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(2)
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$
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3.50
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$
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2,928,000
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(1)
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The options vest in four equal installments on each of
August 7, 2007, August 7, 2008, August 7, 2009
and August 7, 2010.
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(2)
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Includes (i) options to purchase 457,500 shares
of our common stock granted August 24, 2006, with an
exercise price of $3.50 per share and (ii) warrants to
purchase 305,000 shares of our common stock granted
August 24, 2006, with an exercise price of $3.50 per
share.
|
Our Stock Option Plans
In December 1999, our Board of Directors and shareholders
adopted our Officers and Employees Stock Option Plan, or the
Employee Plan, and the Directors and Consultants Stock Option
Plan, or the Directors Plan. The Employees Plan and the
Directors Plan are collectively referred to herein as the Plans.
The Plans are administered by the Compensation Committee. The
objectives of the Plans include attracting and retaining key
personnel by encouraging stock ownership in the Company by such
persons.
103
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Options Available for Issuance
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There are an aggregate of 5,000,000 shares of common stock
authorized for options grants under the Employee Plan and
Director Plan. As of January 31, 2007, an aggregate of
1,796,873 shares of common stock were available for grant
under the Plans. The options to be delivered under the Plans
will be made available, at the discretion of the Compensation
Committee, from authorized but unissued shares or outstanding
options that expire or are cancelled. If shares covered by an
option cease to be issuable for any reason such number of shares
will no longer count against the shares authorized under the
Plans and may again be granted under the Plans.
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|
Material Terms of the Plans
|
The Employee Plan provides for the grant of options to employees
and officers, and the Director Plan provides for the grant of
options to directors, consultants and certain other
non-employees. Only the Employee Plan permits the granting of
incentive stock options within the meaning of
Section 422 of the Internal Revenue Code of 1986, as
amended from time to time, or the Code, and both Plans permit
grants of non-qualified options (options that are
not incentive stock options). As of the date of this prospectus,
all options granted to employees under the Plans are incentive
stock options and all options granted to persons other than
employees are non-qualified options.
The Compensation Committee determines those individuals who
shall receive options, the time period during which the options
may be partially or fully exercised, the number of shares that
may be purchased under each option and the option price, as well
as other terms in their discretion. However, in no event shall
an option be exercisable after the expiration of 10 years
from the date of the grant of the option. In addition, no person
is entitled to be granted options to purchase more than an
aggregate of 600,000 shares of our common stock pursuant to
the Plans. Unless otherwise provided in any option agreement,
each outstanding option shall become fully exercisable in the
event of a change in control (as such term is
defined in the Plans). In connection with a liquidation of the
company or any merger, reorganization or similar corporate
transaction in which we are not the surviving corporation and
the successor corporation does not assume our outstanding
options, the Compensation Committee or Board of Directors may
cancel any options that remain unexercised effective as of the
closing of such transaction.
Each option is evidenced by an option agreement. In granting
options, the Compensation Committee takes into consideration the
contribution the person has made to our success and such other
factors as the Compensation Committee shall determine. The Plans
provide for circumstances under which the options shall
terminate.
The option price per share of any option shall be any price
determined by the Compensation Committee but shall not be less
than the par value per share; provided, that in no event shall
the option price per share of any incentive stock option be less
than the Fair Market Value (as determined under the
Plans) of the shares underlying such option on the date the
option is granted.
104
Outstanding Equity Awards at Fiscal Year End
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Number of Securities
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|
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Underlying Unexercised
|
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Options and Warrants
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Option
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Option
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Name
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Exercisable
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Unexercisable
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Exercise Price
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|
Expiration Date
|
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|
|
|
|
|
|
|
|
|
|
|
Howard J. Leonhardt
|
|
|
37,500
|
|
|
|
|
|
|
$
|
3.50
|
|
|
12/31/11
|
|
|
|
5,198
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|
|
|
|
|
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$
|
3.50
|
|
|
12/31/15
|
William H. Kline
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|
|
|
|
|
|
250,000
|
(1)
|
|
$
|
3.50
|
|
|
8/7/16
|
Brian Neill
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|
|
|
|
|
|
|
|
|
|
|
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Richard T. Spencer, IV
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50,000
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|
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|
50,000
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|
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$
|
3.50
|
|
|
10/1/14
|
|
|
|
500
|
|
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|
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(2)
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$
|
3.50
|
|
|
12/31/15
|
|
|
|
|
|
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25,000
|
(3)
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|
$
|
3.50
|
|
|
4/19/16
|
Scott Bromley
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|
100,000
|
|
|
|
|
|
|
$
|
0.79
|
|
|
12/25/09
|
|
|
|
42,000
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|
|
|
|
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|
$
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3.50
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|
|
12/18/10
|
|
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|
500
|
|
|
|
|
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|
$
|
3.50
|
|
|
12/31/15
|
|
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|
457,500
|
|
|
|
|
|
|
$
|
3.50
|
|
|
8/24/16
|
|
|
|
305,000
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|
|
|
|
|
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$
|
3.50
|
|
|
8/24/16
|
|
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(1)
|
The options vest in four equal installments on each of
August 7, 2007, August 7, 2008, August 7, 2009
and August 7, 2010.
|
|
(2)
|
The options vest in two equal installments on each of
October 1, 2007 and October 1, 2008.
|
|
(3)
|
The options vest in four equal installments on each of
April 19, 2007, April 19, 2008, April 19, 2009
and April 19, 2010.
|
Option Exercises
During the 2006 fiscal year, none of our Named Executive
Officers exercised any options to purchase shares of our common
stock.
Pension Benefits
We do not have any plan that provides for payments or other
benefits at, following, or in connection with the retirement of
any of our employees.
Nonqualified Defined Contribution and Other Nonqualified
Deferred Compensation Plans
We do not have any defined contribution or other plan that
provides for the deferral of compensation on a basis that is not
tax-qualified.
Potential Payments Upon Termination or Change-In
Control
We do not have any contract, agreement, plan or arrangement that
provides for any payment to any of our Named Executive Officers
at, following, or in connection with a termination of the
employment of such Named Executive Officer, a change in control
of the Company or a change in such Named Executive
Officers responsibilities.
105
Director Compensation
We currently have eight non-employee directors that qualify for
compensation. Our non-employee directors do not receive cash
compensation for their services as directors. However, in August
of each year, each non-employee director receives a grant of
options to purchase 10,000 shares of our common stock
provided that he or she has served as a member of our Board of
Directors for at least six months and one day of the twelve
month period immediately preceding the date of grant. In
addition, we reimburse non-employee directors for actual
out-of
-pocket expenses
incurred. The following table sets forth, for the fiscal year
ended December 31, 2006, the aggregate compensation awarded
to, earned by or paid to our non-employee directors.
Ms. Farley joined the Board of Directors in January 2007
and, accordingly, did not receive any compensation for serving
as a director in 2006.
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Option
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Name
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Awards
(1)(2)(3)
|
|
|
Total
|
|
|
|
|
|
|
|
|
Samuel S. Ahn, M.D., MBA
|
|
$
|
36,700
|
|
|
$
|
36,700
|
|
Bruce Carson
|
|
$
|
36,700
|
|
|
$
|
36,700
|
|
David J. Gury
|
|
$
|
36,700
|
|
|
$
|
36,700
|
|
William P. Murphy, Jr., M.D.
|
|
$
|
36,700
|
|
|
$
|
36,700
|
|
Richard T. Spencer III
|
|
$
|
36,700
|
|
|
$
|
36,700
|
|
Mike Tomas
|
|
$
|
36,700
|
(4)
|
|
$
|
36,700
|
|
Linda Tufts
|
|
$
|
36,700
|
(5)
|
|
$
|
36,700
|
|
|
|
(1)
|
Amount reflects the expensed fair value of stock options granted
in 2006, calculated in accordance with
SFAS No. 123(R). See Note 5 of the Notes to
Consolidated Financial Statements (unaudited) Stock
Options for the nine month period ending
September 30, 2006 for a discussion of assumptions made in
determining the grant date fair value and compensation expense
of our stock options.
|
|
(2)
|
Each person listed received options to
purchase 10,000 shares of our common stock granted
August 1, 2006, with an exercise price of $4.75 per
share. The options vested immediately upon grant.
|
|
(3)
|
The grant date fair value of the stock options issued to
directors in 2006 is equal to the expensed fair value of such
stock options.
|
|
(4)
|
Options were issued in the name of the Astri Group, LLC, over
which Mr. Tomas has shared voting and investment power.
|
|
(5)
|
Options were issued in the name of Tyco International. Ms. Tufts
does not have voting and investment power over these securities
and disclaims beneficial ownership thereof.
|
Limitations on Liability and Indemnification
Our articles of incorporation require us to indemnify and limit
the liability of directors to the fullest extent permitted by
the Florida Business Corporation Act, or the FBCA, as it
currently exists or as it may be amended in the future.
Pursuant to the FBCA, a Florida corporation may indemnify any
person who may be a party to any third party proceeding by
reason of the fact that such person is or was a director,
officer, employee or agent of the corporation, or is or was
serving at the request of the corporation as a director,
officer, employee, or agent of another entity, against liability
incurred in connection with such proceeding (including any
appeal thereof) if he or she acted in good faith and in a manner
he or 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 or her conduct was unlawful.
In addition, in accordance with the FBCA, a Florida corporation
is permitted to indemnify any person who may be a party to a
derivative action if such person acted in any of the capacities
set forth in the preceding paragraph, against expenses and
amounts paid in settlement not exceeding, in the judgment of the
board of directors, the estimated expenses of litigating the
proceeding to conclusion, actually and reasonably incurred in
connection with the defense or settlement of such proceeding
(including appeals), provided that the person acted under the
standards set forth in the preceding paragraph. However, no
indemnification shall be made for any claim, issue, or matter
for which such person is found to be liable unless, and only to
the extent that, the court determines that, despite the
adjudication of liability, but in view of all the circumstances
106
of the case, such person is fairly and reasonably entitled to
indemnification for such expenses which the court deems proper.
Any indemnification made under the above provisions, unless
pursuant to a courts determination, may be made only after
a determination that the person to be indemnified has met the
standard of conduct described above. This determination is to be
made by a majority vote of a quorum consisting of the
disinterested directors of the board of directors, by duly
selected independent legal counsel or by a majority vote of the
disinterested shareholders. The board of directors also may
designate a special committee of disinterested directors to make
this determination. Notwithstanding the foregoing, a Florida
corporation must indemnify any director, officer, employee or
agent of a corporation who has been successful in the defense of
any proceeding referred to above.
Generally, pursuant to the FBCA, a director of a Florida
corporation is not personally liable for monetary damages to our
company or any other person for any statement, vote, decision,
or failure to act, regarding corporate management or policy,
unless: (a) the director breached or failed to perform his
duties as a director; and (b) the directors breach
of, or failure to perform, those duties constitutes (i) a
violation of criminal law, unless the director had reasonable
cause to believe his conduct was lawful or had no reasonable
cause to believe his or her conduct was unlawful, (ii) a
transaction from which the director derived an improper personal
benefit, either directly or indirectly, (iii) an approval
of an unlawful distribution, (iv) with respect to a
proceeding by or in the right of the company to procure a
judgment in its favor or by or in the right of a shareholder,
conscious disregard for the best interest of the company, or
willful misconduct, or (v) with respect to a proceeding by
or in the right of someone other than the company or a
shareholder, recklessness or an act or omission which was
committed in bad faith or with malicious purpose or in a manner
exhibiting wanton and willful disregard of human rights, safety,
or property. The term recklessness, as used above,
means the action, or omission to act, in conscious disregard of
a risk: (a) known, or so obvious that it should have been
known, to the directors; and (b) known to the director, or
so obvious that it should have been known, to be so great as to
make it highly probable that harm would follow from such action
or omission.
Furthermore, under the FBCA, a Florida corporation is authorized
to make any other further indemnification or advancement of
expenses of any of its directors, officers, employees or agents
under any bylaw, agreement, vote of shareholders or
disinterested directors, or otherwise, both for actions taken in
an official capacity and for actions taken in other capacities
while holding such office. However, a corporation cannot
indemnify or advance expenses if a judgment or other final
adjudication establishes that the actions of the director,
officer, employee, or agent were material to the adjudicated
cause of action and the director, officer, employee, or agent
(a) violated criminal law, unless the director, officer,
employee, or agent had reasonable cause to believe his or her
conduct was unlawful, (b) derived an improper personal
benefit from a transaction, (c) was or is a director in a
circumstance where the liability for unlawful distributions
applies, or (d) engaged in willful misconduct or conscious
disregard for the best interests of the corporation in a
proceeding by or in right of the corporation to procure a
judgment in its favor.
We maintain a liability insurance policy, pursuant to which our
directors and officers may be insured against liability they
incur for serving in their capacities as directors and officers
of our company.
We believe that the limitation of liability provision in our
articles of incorporation and the liability insurance policy
that we maintain will facilitate our ability to continue to
attract and retain qualified individuals to serve as our
directors and officers.
These limitation of liability and indemnification provisions may
discourage a shareholder from bringing a lawsuit against
directors for breach of their fiduciary duties. The provisions
may also reduce the likelihood of derivative litigation against
directors and officers, even though an action, if successful,
might benefit us and our shareholders. A shareholders
investment may be adversely affected to the extent we pay the
costs of settlement and damage awards against directors and
officers pursuant to these limitation of liability and
indemnification provisions.
107
SCIENTIFIC ADVISORY BOARD
The members of our scientific advisory board, none of whom are
our officers or employees, assist us with various projects and
matters including, but not limited to, (i) product design
evaluation and development strategies, (ii) evaluation of
instructional and training materials for physicians,
(iii) clinical and consultation support to centers using
our products candidates and (iv) clinical trials and design
of clinical protocols. We consider our advisory board members to
be the opinion leaders in their respective fields.
As of January 31, 2007, our Scientific Advisory Board
consisted of the following members:
|
|
|
|
|
Name
|
|
Specialty
|
|
Position
|
|
|
|
|
|
Samuel S. Ahn, M.D., MBA
|
|
Endovascular specialist
|
|
President
University Vascular Associates
Vascular Management Associates
Los Angeles, California
|
Barry J. Byrne, M.D., Ph.D.
|
|
Preclinical research
|
|
Professor and Associate Chair of Pediatrics,
Molecular Genetics & Microbiology
University of Florida
Gainesville, Florida
|
Juan C. Chachques, M.D., Ph.D.
|
|
Preclinical research
|
|
Director of Surgical and Clinical Research
Broussais and Pompidou Hospitals
Paris, France
|
Ray Chiu, M.D., Ph.D.
|
|
Preclinical research
|
|
Professor of Surgery
McGill University
Quebec, Canada
|
Nicolas Chronos, M.D., MRCP, FACC, FESC, FAHA
|
|
Interventional cardiology
|
|
Chief Medical and Scientific Officer
American Cardiovascular Research Institute
Atlanta, Georgia
|
Eric Crumpler, Ph.D.
|
|
Preclinical research
|
|
Assistant Professor of Bioreactors, Bioengineering, and
Biomaterials
Florida International University
Miami, Florida
|
Edward Diethrich, M.D.
|
|
Cardiac surgery and endovascular specialist
|
|
Director
Arizona Heart Hospital
Phoenix, Arizona
|
Stephen G. Ellis, M.D.
|
|
Interventional cardiology
|
|
Director
Sones Cardiac Catheterization Laboratory
Cleveland Clinic Foundation
Cleveland, Ohio
|
Jorge Genovese, M.D.
|
|
Preclinical research
|
|
Research Professor
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania
|
Miranda Grounds, Ph.D.
|
|
Preclinical research
|
|
Professor, School of Anatomy
and Human Biology
The University of Western Australia
Crawley, Western Australia
|
Richard Ham, Ph.D.
|
|
Preclinical research and cell- culturing
|
|
Professor Emeritus of Molecular, Cellular
and Developmental Biology
University of Colorado
Boulder, Colorado
|
Richard Heuser, M.D.
|
|
Interventional cardiology
|
|
Director of Cardiology
Phoenix Heart Institute
Phoenix, Arizona
|
108
|
|
|
|
|
Name
|
|
Specialty
|
|
Position
|
|
|
|
|
|
Race L. Kao, Ph.D.
|
|
Preclinical research and cell- culturing
|
|
Professor and Carroll H. Long Chair of Excellence
for Surgical Research
James H. Ouillen College of Medicine,
East Tennessee State University
Johnson City, Tennessee
|
Barry T. Katzen, M.D.
|
|
Interventionist and endovascular specialist
|
|
Medical Director of the Miami Cardiac
and Vascular Institute
and Clinical Professor of Radiology University of Miami School
of Medicine
Miami, Florida
|
Wendell King
|
|
Preclinical research
|
|
Chairman
Gateway Alliance II (consulting firm)
St. Paul, Minnesota
Inventor of biological pacemaker
|
George J. Magovern, M.D.
|
|
Cardiac surgery
|
|
Retired Chairman,
Department of Cardiothoracic Surgery
Allegheny Hospital
Pittsburgh, Pennsylvania
|
Keith March, M.D., Ph.D.
|
|
Preclinical research
|
|
Director
Indiana University Center for Vascular Biology
Indianapolis, Indiana
|
James Margolis, M.D.
|
|
Interventional cardiology
|
|
Director of Cardiovascular Research and Education
Miami International Cardiology Consultants
Miami, Florida
|
Dr. P.A. Merrifield
|
|
Preclinical research
|
|
Associate Professor, Department of
Anatomy & Cell Biology
University of Western Ontario
Ontario, Canada
|
Dr. Christopher M. OConnor
|
|
Congestive heart failure and ischemic heart disease
|
|
Director, Duke Heart Failure Program
Associate Director, Duke Clinical Research Institute
Duke University
Durham, North Carolina
|
Harold Ott, M.D., Ph.D.
|
|
Preclinical research
|
|
Research Associate, Center for Cardiovascular Repair
University of Minnesota
Minneapolis, Minnesota
|
Marc Penn, M.D., Ph.D.
|
|
Preclinical Research
|
|
Medical Director, Coronary Intensive Care Unit
Director, Experimental Animal Laboratory
and Associated Director
The Cleveland Clinic Foundation
Cleveland, Ohio
|
Nicholas S. Peters, M.D., Ph.D.
|
|
Electrophysiology
|
|
Professor of Cardiology,
Head of Cardiac Electrophysiology
St. Marys Hospital and Imperial College
University of London, UK
Director of Electrophysiology Research
American Cardiovascular Research Institute
Atlanta, Georgia
|
Philip Poole-Wilson, M.D., Ph.D.
|
|
Heart failure specialist
|
|
Professor of Cardiology,
National Heart and Lung Institute
Faculty of Medicine,
Imperial College London,
Royal Brompton and Harefield Hospitals
London, England
|
Felipe Prósper, Ph.D.
|
|
Preclinical Research
|
|
Associate Professor of Medicine
Universidad de Navarra
Attending Physician, Hematology
and Cell Therapy Area
Navarra, Spain
|
109
|
|
|
|
|
Name
|
|
Specialty
|
|
Position
|
|
|
|
|
|
Dr. Sergio Pinski
|
|
Cardiology and electrophysiology
|
|
Head, Section of Cardiac Pacing
and Electrophysiology
Department of Cardiology
Cleveland Clinic Florida
Weston, Florida
|
Stephen Ramee, M.D.
|
|
Interventional Cardiology
|
|
Director,
Cardiac Catheterization Laboratory
Ochsner Clinic Foundation
New Orleans, Louisiana
|
Camillo Ricordi, M.D.
|
|
Preclinical research and cell- culturing
|
|
Stacy Joy Goodman Professor of
Surgery and Medicine
Chief of the Division of Cellular Transplantation
Scientific Director and Chief Academic Officer
of the Diabetes Research Institute
University of Miami
Miami, Florida
|
Robert S. Schwartz, M.D.
|
|
Preclinical research
|
|
Research Cardiologist
Minneapolis Heart Institute
Minneapolis, Minnesota
|
Warren Sherman, M.D., FACC
|
|
Interventional cardiology
|
|
Director of Medical Education and Associate
Director, Cardiac Catheterization Laboratories
The Zena and Michael A. Wiener
Cardiovascular Institute
Mount Sinai Hospital
New York, New York
|
Doris A. Taylor, Ph.D.
|
|
Preclinical research and cell- culturing
|
|
Medtronic Bakken Chair and
Director of the Center for Cardiovascular Repair
University of Minnesota
Minneapolis, Minnesota
|
Syde A. Taheri, M.D.
|
|
Preclinical Research
|
|
Cardiovascular and Thoracic Surgeon
Millard Fillmore Hospital
Buffalo, New York
|
Robert Van Tassel, M.D.
|
|
Interventional cardiology
|
|
Senior Consultant in Cardiology
Minneapolis Heart Institute
Minneapolis, Minnesota
|
Stuart Williams, Ph.D.
|
|
Preclinical Research
|
|
Professor of Biomedical Engineering, Surgery,
Physiology, and Material Science Engineering
University of Arizona Health Sciences Center
Tucson, Arizona
|
Zachariah P. Zachariah, M.D.
|
|
Interventional cardiology
|
|
Cardiologist
Holy Cross Hospital
Ft. Lauderdale, Florida
|
The Scientific Advisory Board meets in person at least once each
year and individual members of the Scientific Advisory Board
regularly consult with our management and the Board of Directors
upon request.
Members of the Scientific Advisory Board generally serve
three-year terms, subject to earlier termination for cause by
us. As compensation for his or her services as members of the
Scientific Advisory Board, each member receives a one-time grant
of between 1,500 to 64,000 options to purchase shares of our
common stock, which options vest in three equal annual
installments. However, Dr. Sherman, the lead investigator
in the MYOHEART Trial, elected not to receive any options or
other securities from us. We reimburse members of the Scientific
Advisory Board for reasonable expenses incurred in performing
services to the Company.
On September 18, 2002, we entered into a consulting
agreement with Wendell King, a member of the Scientific Advisory
Board, for a one-year term. In addition to the one-time grant of
options to purchase shares of our common stock, Mr. King
may receive $2,000 per month as compensation for his
consulting services and, if his consulting services exceed
16 hours in a given month, an additional $125 per hour.
110
Effective August 31, 2006, we entered into a consulting
agreement with March Consulting, LLC, pursuant to which Keith
March, M.D. serves as a member of the Scientific Advisory
Board for a one-year term. In addition to the one-time grant of
options to purchase shares of our common stock, Dr. March
may receive a maximum monthly compensation of $3,750 and a
maximum annual compensation of $40,000.
111
CERTAIN RELATIONSHIPS AND RELATED-PARTY TRANSACTIONS
Stock Sales
Since January 1, 2004, the following executive officers,
directors and holders of more than 5% of our common stock have
acquired shares of our common stock from us in the amounts, as
of the dates and for the consideration set forth below:
|
|
|
|
|
|
|
|
|
|
|
|
|
Aggregate
|
|
|
|
|
|
Consideration
|
|
Directors and Executive Officers
|
|
Shares
|
|
|
Paid(1)
|
|
|
|
|
|
|
|
|
Howard J. Leonhardt
|
|
|
179,605
|
(2)
|
|
$
|
628,617
|
(2)
|
Samuel S. Ahn, M.D., MBA
|
|
|
230,000
|
|
|
$
|
805,000
|
(3)
|
David J. Gury
|
|
|
15,000
|
|
|
$
|
52,500
|
(3)
|
William P. Murphy, Jr., M.D.
|
|
|
75,000
|
|
|
$
|
281,250
|
(3)
|
Richard T. Spencer, III
|
|
|
30,001
|
|
|
$
|
100,002
|
(3)
|
|
|
(1)
|
Per share purchase prices ranged from $3.50 per share to $4.75
per share.
|
|
(2)
|
Includes (i) 24,523 shares issued to
Mr. Leonhardt in satisfaction of accrued salary and
(ii) 155,082 shares issued to Mr. Leonhardt in
satisfaction of advances he made on our behalf. See
Conversion of Cash Advances and Accrued Salary into Common
Stock below for more information.
|
|
(3)
|
Aggregate consideration paid in cash.
|
Transactions with Management
The following is a description of transactions since
January 1, 2004 to which we were or are a party, in which
the amount involved exceeded or exceeds $120,000, and in which
any of our directors, executive officers or holders of more than
five percent of our capital stock had or will have a direct or
indirect material interest.
|
|
|
Conversion of Cash Advances and Accrued Salary into Common
Stock
|
On various occasions, Mr. Leonhardt has agreed to accept
shares of our common stock in satisfaction of accrued salary or
advances he has made on our behalf. More specifically:
|
|
|
|
|
in December 2004, we issued 24,523 shares of our common
stock to Mr. Leonhardt in satisfaction of $85,830 of
accrued salary earned by Mr. Leonhardt during the fiscal
year ended December 31, 2004.
|
|
|
|
in October 2005, we issued 155,082 shares of our common
stock to Mr. Leonhardt in satisfaction of $542,787 of
expense reimbursements owed to him for expenses he advanced
during the fiscal years ended December 31, 2001, 2002 and
2003.
|
|
|
|
Guarantees provided by Mr. Leonhardt
|
From time to time, Mr. Leonhardt has, without compensation,
personally guaranteed certain of our financial obligations. As
of the date of this prospectus, he is the guarantor of our
obligations under the lease for our facilities in Sunrise,
Florida. He is also the guarantor of our obligations under
corporate credit cards issued by Bank of America.
Mr. Leonhardt does not receive any compensation for
providing these guarantee services.
Mr. Leonhardt has guaranteed Dr. Murphy, a director,
the repayment of his initial $200,000 investment in the Company.
112
On August 24, 2006, we entered the Bromley Letter Agreement
with Mr. Bromley, Mr. Leonhardts cousin and Vice
President of Public Relations, regarding his employment with us.
Pursuant to this agreement:
|
|
|
|
|
we issued to Mr. Bromley 77,143 shares of our common
stock as a full and complete settlement and agreed to reimburse
Mr. Bromley for federal and state income taxes he will be
required to pay in connection with his receipt of such shares.
|
|
|
|
we agreed to pay Mr. Bromley an annual base salary of
$130,000 for his continued provision of services as our Vice
President of Public Relations.
|
|
|
|
we granted to Mr. Bromley a fully-vested incentive stock
option to purchase 457,500 shares of our common stock
at an exercise price of $3.50 per share.
|
|
|
|
we granted to Mr. Bromley a fully-vested warrant to
purchase 305,000 shares of our common stock at an
exercise price of $3.50 per share.
|
|
|
|
Consulting Agreements with Directors
|
We have, from time to time, entered into consulting agreements
and arrangements with certain members of our Board of Directors.
These agreements and arrangements are summarized in the table
set forth below:
|
|
|
|
|
|
|
|
|
|
|
Consideration Paid for
|
|
|
Director
|
|
Nature of Consulting Services
|
|
Consulting Services
|
|
Term of Arrangement
|
|
|
|
|
|
|
|
Bruce C. Carson
|
|
Consulting services included (i) assisting us to meet our
financial goals, (ii) providing leadership training to our
directors, officers, employees and consultants,
(iii) providing guidance regarding strategic partnerships
and (iv) appearing at selected events
|
|
Grant of option to purchase 100,000 shares of common
stock at an exercise price of $3.50(1)
|
|
February 2004 to December 2004
|
Bruce C. Carson
|
|
Consulting services included (i) assisting us to meet our
financial goals, (ii) providing leadership training to our
directors, officers, employees and consultants,
(iii) providing guidance regarding strategic partnerships
and (iv) appearing at selected events
|
|
Grant of option to purchase 100,000 shares of common
stock at an exercise price of $3.50(2)
|
|
January 2005 to October 2005
|
Richard T. Spencer, III
|
|
Consulting services include (i) assisting us to meet our
financial goals, (ii) providing leadership training to our
directors, officers, employees and consultants and
(iii) appearing at selected events
|
|
Grant of option to purchase 80,000 shares of common
stock at an exercise price of $3.50(3)
|
|
March 2004 to March 2007
|
113
|
|
|
|
|
|
|
|
|
|
|
Consideration Paid for
|
|
|
Director
|
|
Nature of Consulting Services
|
|
Consulting Services
|
|
Term of Arrangement
|
|
|
|
|
|
|
|
Samuel S. Ahn
|
|
Consulting services included (i) serving as our consultant for
cardiomyoplasty, (ii) providing advice to us with respect
to cardiomyoplasty and related technologies and matters, and
(iii) performing other services from time to time as we
request
|
|
Grant of options to purchase 57,000 shares of common
stock at an exercise price of $1.75 and 7,000 shares of
common stock at an exercise price of $3.50(4)
|
|
March 2000 to March 2003
|
Samuel S. Ahn
|
|
Consulting services included (i) assisting us to meet our
financial goals, (ii) providing leadership training to our
directors, officers, employees and consultants,
(iii) providing guidance regarding strategic partnerships
and (iv) appearing at selected events
|
|
Grant of option to purchase 100,000 shares of common
stock at an exercise price of $3.50(2)
|
|
February 2004 to October 2005
|
|
|
(1)
|
1
/
4
of the options vested on each December 31, 2005 and
December 31, 2006. The remaining
1
/
2
of the options are scheduled to vest equally on
December 31, 2007 and December 31, 2008.
|
|
(2)
|
The options vested on October 1, 2005 upon our attainment
of various financial goals.
|
|
(3)
|
1
/
3
of the options vested on each of March 18, 2005 and
March 18, 2006. The remaining
1
/
3
of the options are scheduled to vest on March 18, 2007.
|
|
(4)
|
57,000 options vested on February 14, 2003 and 7,000
options vested on July 14, 2003.
|
Dr. Samuel S. Ahn, a member of our Board of Directors, is
also a member of our Scientific Advisory Board and has entered
into our standard Scientific Advisory Board agreement. Pursuant
to his agreement, which expires in January 2007, we granted
Dr. Ahn a stock option to purchase 10,500 shares
of our common stock with an exercise price of $1.75 per
share as consideration for his service on our Scientific
Advisory Board.
114
PRINCIPAL SHAREHOLDERS
The following table sets forth certain information regarding
beneficial ownership of our common stock as of January 31,
2007, and as adjusted to reflect the sale of common stock in
this offering, by
|
|
|
|
|
each person or group known by us to own beneficially more than
5% of our common stock;
|
|
|
|
each of our directors;
|
|
|
|
each of our Named Executive Officers; and
|
|
|
|
all of our current directors and executive officers as a group.
|
As of January 31, 2007, we had 21,496,977 shares of
common stock outstanding. Immediately following the completion
of this offering, there will
be shares
of common stock outstanding assuming that the underwriters
over-allotment option is not exercised. Beneficial ownership is
determined in accordance with
Rule
13d-3
of the
Securities and Exchange Act of 1934. In computing the number of
shares beneficially owned by a person or a group and the
percentage ownership by that person or group, shares of our
common stock subject to options or warrants beneficially owned
by that person or group and currently exercisable or exercisable
within 60 days after January 31, 2007 are deemed
outstanding but are not deemed outstanding for the purposes of
computing the ownership of any other person. Except as otherwise
indicated in the footnotes to this table and subject to
applicable community property laws, each shareholder named in
the table is assumed to have sole voting and investment power
with respect to the number of shares listed opposite the
shareholders name. Unless otherwise indicated, the address
of each of the individuals and entities named below is:
c/o Bioheart, Inc., 13794 NW 4th Street,
Suite 212, Sunrise, Florida 33325.
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Percentage of Shares
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Beneficially Owned
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Number of Shares
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Before the
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After the
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Name of Beneficial Owner
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Beneficially Owned
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Offering (%)
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Offering (%)
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5% Shareholders:
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Howard J. Leonhardt
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7,462,124
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(1)
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34.7
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William H. Kline
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(2)
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*
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Scott Bromley
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982,143
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(3)
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4.6
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Richard T. Spencer, IV
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58,708
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(4)
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*
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Samuel S. Ahn, M.D.
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474,500
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(5)
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2.2
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Bruce Carson
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532,500
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(6)
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2.5
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David J. Gury
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35,000
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(7)
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*
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Peggy A. Farley
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800,299
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(8)
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3.7
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William P. Murphy, M.D.
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120,000
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(9)
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*
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Richard T. Spencer, III
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123,334
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(10)
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*
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Mike Tomas
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593,570
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(11)
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2.8
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Linda Tufts
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*
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All directors and executive officers as a group (13 persons)
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11,247,948
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52.0
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*
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Indicates less than one percent
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(1)
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Consists of (i) 7,419,426 shares directly owned by
Mr. Leonhardt and (ii) 42,698 shares issuable
upon the exercise of presently exercisable stock options at an
exercise price of $3.50 per share.
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(2)
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Does not include 250,000 shares issuable upon the exercise
of stock options at an exercise price of $3.50 per share
that are not subject to exercise within 60 days.
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(3)
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Consists of (i) 77,143 shares directly owned by
Mr. Bromley, (ii) 100,000 shares issuable upon
the exercise of presently exercisable stock options at an
exercise price of $0.79 per share,
(iii) 500,000 shares issuable upon the exercise of
presently exercisable stock options at an exercise price of
$3.50 per share and (iv) 305,000 shares issuable
upon the exercise of vested warrants at an exercise price of
$3.50 per share.
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115
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(4)
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Consists of (i) 8,208 shares directly owned by
Mr. Spencer, IV and (ii) 50,500 shares issuable
upon the exercise of presently exercisable stock options at an
exercise price of $3.50 per share. Does not include
125,000 shares issuable upon the exercise of stock options
at an exercise price of $3.50 per share that are not
subject to exercise within 60 days.
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(5)
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Consists of (i) 180,000 shares directly owned by
Dr. Ahn, (ii) 67,500 shares issuable upon the
exercise of presently exercisable stock options at an exercise
price of $1.75 per share, (iii) 117,000 shares
issuable upon the exercise of presently exercisable stock
options at an exercise price of $3.50 per share and
(iv) 10,000 shares issuable upon the exercise of
presently exercisable stock options at an exercise price of
$4.75 per share.
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(6)
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Consists of (i) 337,500 shares directly owned by
Mr. Carson, (ii) 210,000 shares issuable upon the
exercise of presently exercisable stock options or stock options
exercisable within 60 days of January 31, 2007 at an
exercise price of $3.50 per share and
(iii) 10,000 shares issuable upon the exercise of
presently exercisable stock options at an exercise price of
$4.75 per share.
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(7)
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Includes (i) 15,000 shares directly owned by
Mr. Gury, (ii) 10,000 shares issuable upon the
exercise of presently exercisable stock options at an exercise
price of $3.50 per share and (iii) 10,000 shares
issuable upon the exercise of presently exercisable stock
options at an exercise price of $4.75 per share.
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(8)
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Includes (i) 43,720 shares directly owned by
Ms. Farley and (ii) 125,000 shares owned by
Ascent Medical Technology Fund, LP, over which Ms. Farley
has shared voting and investment power and
(iii) 631,579 shares owned by Ascent Medical
Technology Fund II, LP, over which Ms. Farley has
shared voting and investment power.
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(9)
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Includes (i) 90,000 shares directly owned by trusts
controlled by Dr. Murphy and his spouse,
(ii) 20,000 shares issuable upon the exercise of
presently exercisable stock options at an exercise price of
$3.50 per share and (iii) 10,000 shares issuable
upon the exercise of presently exercisable stock options at an
exercise price of $4.75 per share.
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(10)
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Includes (i) 30,000 shares directly owned by
Mr. Spencer, III, (ii) 83,333 shares
issuable upon the exercise of presently exercisable stock
options at an exercise price of $3.50 per share and
(iii) 10,000 shares issuable upon the exercise of
presently exercisable stock options at an exercise price of
$4.75 per share. Does not include 26,667 shares
issuable upon the exercise of stock options at an exercise price
of $3.50 per share that are not subject to exercise within
60 days.
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(11)
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Includes (i) 573,570 shares held by the Astri Group,
LLC, over which Mr. Tomas has shared voting and investment
power, (ii) 10,000 shares issuable upon the exercise
of presently exercisable stock options issued in the name of the
Astri Group, LLC at an exercise price of $3.50 per share,
over which Mr. Tomas has shared voting and investment power
and (iii) 10,000 shares issuable upon the exercise of
presently exercisable stock options issued in the name of the
Astri Group, LLC at an exercise price of $4.75 per share,
over which Mr. Tomas has shared voting and investment power.
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DESCRIPTION OF CAPITAL STOCK
Our authorized capital stock of the Company consists of
40,000,000 shares of common stock, par value $.001 per
share, and 5,000,000 shares of preferred stock, par value
$.001 per share. As of January 31, 2007, there were
21,496,977 shares of common stock outstanding, held of
record by approximately 450 shareholders and zero shares of
preferred stock outstanding.
Upon the closing of this offering:
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Our Articles of Incorporation will be amended and restated to
provide for total authorized capital consisting of
100,000,000 shares of common stock and
5,000,000 shares of undesignated preferred stock;
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Based on the number of shares outstanding as of January 31,
2007, a total
of shares
of common stock will be outstanding after giving effect to the
sale of common stock we are offering hereunder, which does not
include any exercise of the underwriters over-allotment
option or of any options or warrants.
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Common Stock
The holders of common stock are entitled to one vote for each
share held of record on all matters submitted to a vote of the
shareholders. Subject to preferential rights with respect to any
outstanding Preferred Stock, holders of common stock are
entitled to receive ratably such dividends as may be declared by
the Board of Directors out of funds legally available therefor.
In the event of a liquidation, dissolution or winding up of the
Company, holders of common stock are entitled to share ratably
in all assets remaining after payment of liabilities and
satisfaction of preferential rights with respect to any
outstanding shares of Preferred Stock and have no rights to
convert their common stock into any other securities. The issued
and outstanding shares of
116
common stock are, and the common stock to be issued and
outstanding upon completion of this offering will be, fully paid
and non-assessable.
Preferred Stock
The Board of Directors is authorized to issue the preferred
stock in one or more classes or series and to fix the rights,
preferences, privileges and restrictions, including the dividend
rights, conversion rights, voting rights, redemption rights and
prices, liquidation preferences and the number of shares
constituting any such class or series of preferred stock
(including without limitation, rights and preferences of
preferred stock that are superior to rights of holders of the
common stock with respect to voting, dividend and liquidation or
other rights), without any further vote or action by the
shareholders. The issuance of preferred stock may adversely
affect the voting power and other rights of the holders of
common stock. We have no present plans to issue any shares of
preferred stock.
Anti-Takeover Effects of Certain Provisions of our Articles
of Incorporation, Bylaws and Florida Law
Issuance of preferred stock
As noted above, our Board of Directors, without shareholder
approval, has the authority under our articles of incorporation
to issue preferred stock with rights superior to the rights of
the holders of common stock. As a result, preferred stock could
be issued quickly and easily, could adversely affect the rights
of holders of common stock and could be issued with terms
calculated to delay or prevent a change of control or make
removal of management more difficult.
Requirements for advance notification of shareholder
nominations and proposals
Our bylaws contain advance notice procedures with respect to
shareholder proposals and the nomination of candidates for
election as directors, other than nominations made by or at the
direction of the Board of Directors or a committee thereof. Our
bylaws also specify certain requirements as to the form and
content of a shareholders notice. These provisions may
preclude our shareholders from bringing matters before our
annual meeting of shareholders or from making nominations for
directors at our annual meeting or a special meeting of
shareholders.
Shareholder meetings
Our articles of incorporation and bylaws provide that our
shareholders may call a special meeting only upon the request of
holders of at least a majority of the outstanding shares
entitled to vote at such meeting. Additionally, the Board of
Directors, the Chairman of the Board or the Chief Executive
Officer may call special meetings of shareholders.
Amendment of bylaws
Our bylaws provide that shareholders can amend the bylaws only
upon the affirmative vote of the holders of at least
75 percent of the outstanding shares of the capital stock
then entitled to vote, voting together as a single class.
Florida law
The FBCA prohibits the voting of shares in a publicly held
Florida corporation that are acquired in a control share
acquisition unless the holders of a majority of the
corporations voting shares (exclusive of shares held by
officers of the corporation, inside directors or the acquiring
party) approve the granting of voting rights as to the shares
acquired in the control share acquisition or unless the
acquisition is approved by the corporations Board of
Directors. A control share acquisition is defined as
an acquisition that immediately thereafter entitles the
acquiring party to vote in the election of directors within each
of the following ranges of voting power: (i) one-fifth or
more but less than one-third of all voting power;
(ii) one-third or more but less than a majority of all
voting power; and (iii) more than a majority of all voting
power.
117
The FBCA also contains an affiliated transaction
provision that prohibits a publicly held Florida corporation
from engaging in a broad range of business combinations or other
extraordinary corporate transactions with an interested
shareholder unless, among others, (i) the transaction
is approved by a majority of disinterested directors before the
person becomes an interested shareholder; (ii) the
interested shareholder has owned at least 80% of the
corporations outstanding voting shares for at least five
years; or (iii) the transaction is approved by the holders
of two-thirds of the corporations voting shares other than
those owned by the interested shareholder. An interested
shareholder is defined as a person who together with affiliates
and associates beneficially owns more than 10% of the
corporations outstanding voting shares.
We are subject to the Florida anti-takeover provisions under the
FBCA because we have not elected to opt out of those provisions
in our articles of incorporation or bylaws as permitted by the
Florida law.
Transfer Agent And Registrar
The transfer agent and registrar for our common stock is
Continental Stock Transfer & Trust Company.
NASDAQ Global Market Listing
We are applying for our common stock to be quoted on the NASDAQ
Global Market under the symbol BHRT.
SHARES ELIGIBLE FOR FUTURE SALE
Prior to this offering, there has been no market for our common
stock, and a liquid trading market for our common stock may not
develop or be sustained after this offering. Future sales of
substantial amounts of common stock, including shares issued
upon exercise of outstanding options and warrants, in the public
market after this offering or the anticipation of those sales
could adversely affect market prices prevailing from time to
time and could impair our ability to raise capital through sales
of our equity securities.
Sale of Restricted Shares and Lock-Up Agreements
After the closing of this offering, we will
have shares
of common stock outstanding, assuming no exercise of the
underwriters over-allotment option and no exercise of
outstanding options or warrants. Of these shares, the shares
sold in this offering will be freely tradable without
restriction under the Securities Act unless purchased by any of
our affiliates as that term is defined in
Rule 144 under the Securities Act. The remaining shares of
common stock outstanding held by existing shareholders are
restricted shares as that term is defined in
Rule 144
and of
these restricted shares are also subject to the
lock-up
agreements
described in Underwriting. Though these restricted
shares subject to
lock-up
agreements may
be eligible for earlier sale under the provisions of the
Securities Act, absent a waiver of the
lock-up
agreements with
BMO Capital Markets Corp., Janney Montgomery Scott LLC and
Merriman Curhan Ford & Co., none of these
locked-up
shares may be
sold until 181 days after the date of this prospectus. The
180-day
restricted
period will be automatically extended if: (1) during the
period that begins on the date that is 15 calendar days plus
three business days before the last day of the
180-day
restricted
period, we issue an earnings release or announce material news
or a material event; or (2) prior to the expiration of the
180-day
restricted
period, we announce that we will release earnings results during
the
16-day
period
following the last day of the
180-day
period, in
which case the restrictions described in the preceding paragraph
will continue to apply until the expiration of the date that is
15 calendar days plus three business days after the date on
which the earnings release is issued or the material news or
material event occurs.
Immediately after the date of the prospectus,
approximately restricted
shares will be eligible for resale. Beginning 91 days after
the date of this prospectus,
approximately additional
restricted shares will be eligible for resale. Beginning
181 days after the date of this prospectus, all of the
approximately million
restricted shares that are subject to the
lock-up
agreements will
be eligible for sale in the US public market, subject to the
limitations imposed by Rule 144. In addition, as of
January 31, 2007, there were outstanding options to
purchase shares
of common stock and warrants to
purchase shares
118
of common stock.
Approximately %
of the shares issued upon exercise of these options and warrants
will be subject to
lock-up
agreements.
Rule 144 and Rule 144(k)
In general, under Rule 144 as currently in effect, a
person, or persons whose shares are aggregated, who has
beneficially owned restricted shares for at least one year is
entitled to sell within any three-month period up to that number
of shares that does not exceed the greater of: (i) 1% of
the number of shares of common stock then outstanding, which
immediately following this offering is expected to equal
approximately shares,
or (ii) the average weekly trading volume of the common
stock during the four calendar weeks preceding the filing of a
Form 144 with respect to the sale. Sales under
Rule 144 are also subject to certain manner of
sale provisions and notice requirements and to the
requirement that current public information about the issuer be
available. Under Rule 144(k), a person who is not deemed to
have been an affiliate of the issuer at any time during the
three months preceding a sale, and who has beneficially owned
the shares proposed to be sold for at least two years, including
the holding period of any prior owner except an affiliate, is
entitled to sell those shares without complying with the manner
of sale, public information, volume limitation or notice
provisions of Rule 144.
Rule 701
Rule 701 under the Securities Act permits resales of
qualified shares held by some affiliates in reliance upon
Rule 144 but without compliance with some restrictions,
including the holding period requirement, of Rule 144.
Rule 701 further provides that non-affiliates may sell
shares in reliance on Rule 144 without having to comply
with the holding period, public information, volume limitation
or notice provisions of Rule 144. Any of our employees,
officers, directors or consultants who purchased his or her
shares pursuant to a written compensatory plan or contract may
be entitled to rely on the resale provisions of Rule 701.
All holders of shares of common stock to which Rule 701 is
applicable are required to wait until 90 days after the
date of this prospectus before selling shares. The holders of
approximately outstanding
shares of our common stock will be eligible to sell these shares
90 days after the date of this prospectus in reliance on
Rule 701.
Approximately shares
issued pursuant to Rule 701 are subject to the
lock-up
agreements
referred to above and absent a waiver of the
lock-up
agreements with
BMO Capital Markets Corp., Janney Montgomery Scott LLC and
Merriman Curhan Ford & Co., will only become eligible
for sale upon the expiration of the
180-day
lock-up.
We intend to file, shortly after the effectiveness of this
offering, a registration statement on
Form
S-8
under the
Securities Act covering all shares of common stock reserved for
issuance under our equity incentive plan. Shares of common stock
issued upon exercise of options under the
Form
S-8
will be
available for sale in the public market, subject to limitations
under Rule 144 applicable to our affiliates and subject to
the
lock-up
agreements
described above.
Registration Rights
Pursuant to various shareholders agreements among certain
purchasers of our common stock, Mr. Leonhardt and us, the
holders of an aggregate
of shares
of our common stock outstanding immediately after this offering
and the holder of a warrant to
purchase 2,500,000 shares or our common stock subject
to certain vesting conditions are entitled to include their
shares in any registration statement we file under the
Securities Act to register any of our securities, subject to
exceptions, and also to include those shares in any underwritten
offering contemplated by that registration statement.
These registration rights are subject to conditions and
limitations, including the right of the underwriters of an
offering to limit the number of shares included in the offering.
In addition, no shareholder will have any rights under the
agreement to include shares in a registration statement if all
shares held by such holder may be sold pursuant to Rule 144
under the Securities Act in any three month period.
119
UNDERWRITING
BMO Capital Markets Corp., Janney Montgomery Scott LLC and
Merriman Curhan Ford & Co. are acting as the
representatives of the underwriters. Subject to the terms and
conditions stated in the underwriting agreement dated the date
of this prospectus, each underwriter named below has agreed to
purchase from us, and we have agreed to sell to such
underwriter, the respective number of shares of common stock
shown opposite its name below.
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Underwriter
|
|
Number of Shares
|
|
|
|
|
|
BMO Capital Markets Corp.
|
|
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|
|
Janney Montgomery Scott LLC
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|
|
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Merriman Curhan Ford & Co.
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|
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Total
|
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|
|
The underwriting agreement provides that the obligations of the
underwriters to purchase the shares included in this offering
are subject to approval of legal matters by counsel and to other
conditions. The underwriters are obligated to purchase all of
the shares (other than those covered by the over-allotment
option described below) if they purchase any of the shares.
The representatives have advised us that the underwriters
propose to offer the shares directly to the public at the public
offering price presented on the cover page of this prospectus
and to selected dealers, who may include the underwriters, at
the public offering price less a selling concession not in
excess of
$ per
share. The underwriters may allow, and the selected dealers may
reallow, a concession not in excess of
$ per
share to brokers and dealers. If all of the ordinary shares are
not sold at the initial offering price, the underwriter may
change the public offering price and the other selling terms.
The representatives have advised us that the underwriters do not
intend to confirm sales to any accounts over which they exercise
discretionary authority.
We have granted to the underwriters an option to purchase up to
an aggregate
of shares
of common stock, exercisable solely to cover over-allotments, if
any, at the public offering price less the underwriting
discounts and commissions shown on the cover page of this
prospectus. The underwriters may exercise this option in whole
or in part at any time on or before the 30th day after the
date of the underwriting agreement. To the extent the
underwriters exercise this option, each underwriter will be
committed, so long as the conditions of the underwriting
agreement are satisfied, to purchase a number of additional
shares proportionate to that underwriters initial
commitment as indicated in the preceding table.
We, our directors and executive officers have agreed with the
underwriters, subject to certain exceptions, not to dispose of
or hedge any shares of common stock or securities convertible
into or exchangeable for shares of common stock, subject to
specified exceptions, during the period from the date of this
prospectus continuing through the date 180 days after the
date of this prospectus, except with the prior written consent
of BMO Capital Markets Corp. See Shares Eligible for
Future Sale for a discussion of certain transfer