−Removed: (“Encision”, “we”, “us”, “our” or the “Company"), a medical device company
−Removed: based in Boulder, Colorado, has developed and markets innovative technology that provides unprecedented outcomes and patient safety in
−Removed: minimally-invasive surgery.
−Removed: We believe that our patented Active Electrode Monitoring (AEM®) Surgical Instruments are changing the
−Removed: marketplace for electrosurgical devices and laparoscopic instruments by providing a solution to a well-documented hazard unique to laparoscopic
−Removed: address market opportunities created by the increase in minimally-invasive surgery (“MIS”) and surgeons’ use of electrosurgery
−Removed: devices in these procedures.
−Removed: The product opportunity exists in that monopolar electrosurgery instruments used in laparoscopic procedures
−Removed: provide excellent clinical results but are also susceptible to causing inadvertent collateral tissue damage outside the surgeon’s
−Removed: field of view.
−Removed: The risk of unintended electrosurgical burn injury to the patient in laparoscopic surgery has been well documented.
−Removed: risk poses a threat to patient safety, including the risk of death, and creates liability exposure for surgeons and hospitals, and increased
−Removed: and preventable readmissions.
−Removed: Our technology helps to reduce hospital risk and liability.
−Removed: patented AEM technology provides surgeons with the desired tissue effects of cutting and coagulating tissue in laparoscopic procedures,
−Removed: while preventing stray electrosurgical energy that can cause complications and even death.
−Removed: AEM Surgical Instruments are equivalent to
−Removed: conventional instruments in size, shape, ergonomics and functionality, but they incorporate a proprietary shield and electrically connect
−Removed: to an Active Electrode Monitor to dynamically and continuously monitor the flow of electrosurgical current, thereby preventing patient
−Removed: injury from stray monopolar energy.
−Removed: With our “shielded and monitored” instruments, surgeons are able to perform electrosurgical
−Removed: procedures more safely, effectively and economically than is possible using conventional instruments.
−Removed: technology has been recommended and endorsed by sources from many groups involved in MIS.
−Removed: Surgeons, nurses, biomedical engineers, the
−Removed: medicolegal community, malpractice insurance carriers and electrosurgical device manufacturers advocate the use of AEM technology.
−Removed: May 2020, the Food and Drug Administration issued a Safety Communication that stated that, "In addition to serving as an ignition
−Removed: source, monopolar energy use can directly result in unintended patient burns from capacitive coupling and intra-operative insulation
−Removed: Patented Technology
−Removed: have developed and launched patented AEM Surgical Instruments and Monitors that enhance patient safety and patient outcomes in laparoscopic
−Removed: surgical procedures.
−Removed: We have been issued 16 unexpired patents relating to AEM technology from the United States Patent and Trademark
−Removed: Office, each encompassing multiple claims, and which have between one and seventeen years remaining.
−Removed: We also have patents relating to
−Removed: AEM technology issued in Europe, Japan, Canada and Australia.
−Removed: Solves a Well Documented Risk in Minimally Invasive Surgery
−Removed: offers significant benefits for patients by reducing trauma, hospital stays, recovery times and medical costs.
−Removed: However, these benefits
−Removed: have not been achieved without the emergence of new risks.
−Removed: The risk of unintended tissue damage from stray electrosurgical energy has
−Removed: been well documented.
−Removed: Such injuries can be especially troubling given that often these injuries are out of the field of view, can go
−Removed: unrecognized at the time of surgery, and can lead to a cascade of adverse events, including death.
−Removed: Our patented AEM technology eliminates
−Removed: the risk of stray electrosurgical burns in MIS while providing surgeons with the tissue effects they desire.
−Removed: Line has been Developed and Launched
−Removed: AEM Surgical Instruments and Monitors have been engineered to provide a seamless transition for surgeons switching from conventional
+Added: Encision Inc.
+Added: (“Encision”, “we”,
+Added: “us”, “our” or the “Company"), a medical device company based in Boulder, Colorado, has developed and
+Added: markets innovative technology that provides unprecedented outcomes and patient safety in minimally invasive surgery.
+Added: We believe that our
+Added: patented Active Electrode Monitoring (AEM®) Surgical Instruments are changing the marketplace for electrosurgical devices and laparoscopic
+Added: instruments by providing a solution to a well-documented hazard unique to laparoscopic surgery.
+Added: We address market opportunities created by the
+Added: increase in minimally invasive surgery (“MIS”) and surgeons’ use of electrosurgery devices in these procedures.
+Added: product opportunity exists in that monopolar electrosurgery instruments used in laparoscopic procedures provide excellent clinical results
+Added: but are also susceptible to causing inadvertent collateral tissue damage outside the surgeon’s field of view.
+Added: The risk of unintended
+Added: electrosurgical burn injury to the patient in laparoscopic surgery has been well documented.
+Added: This risk threatens patient safety, including
+Added: the risk of death, and creates liability exposure for surgeons and hospitals, and increases preventable readmissions.
+Added: Our technology helps
+Added: to reduce hospital risk and liability.
+Added: Our patented AEM technology provides surgeons
+Added: with the desired tissue effects of cutting and coagulating tissue in laparoscopic procedures, while preventing stray electrosurgical energy
+Added: that can cause complications and even death.
+Added: AEM Surgical Instruments are equivalent to conventional instruments in size, shape, ergonomics,
+Added: and functionality, but they incorporate a proprietary shield and electrically connect to an Active Electrode Monitor to dynamically and
+Added: continuously monitor the flow of electrosurgical current, thereby preventing patient injury from stray monopolar energy.
+Added: With our “shielded
+Added: and monitored” instruments, surgeons are able to perform electrosurgical procedures more safely, effectively, and economically than
+Added: is possible using conventional instruments.
+Added: AEM technology has been recommended and endorsed
+Added: by sources from many groups involved in MIS.
+Added: Surgeons, nurses, biomedical engineers, the medicolegal community, malpractice insurance
+Added: carriers, and electrosurgical device manufacturers advocate the use of AEM technology.
+Added: In May 2020, the Food and Drug Administration issued
+Added: a Safety Communication that stated, "In addition to serving as an ignition source, monopolar energy use can directly result in unintended
+Added: patient burns from capacitive coupling and intra-operative insulation failure.”
+Added: Proprietary, Patented Technology
+Added: We have developed and launched patented AEM Surgical
+Added: Instruments and Monitors that enhance patient safety and patient outcomes in laparoscopic surgical procedures.
+Added: We have been issued 21
+Added: unexpired patents relating to AEM technology from the United States Patent and Trademark Office, each encompassing multiple claims, and
+Added: which have between one and twenty years remaining.
+Added: We also have patents on AEM technology in Europe, Japan, Canada, and Australia.
+Added: Technology Solves a Well-Documented Risk
+Added: in Minimally Invasive Surgery
+Added: MIS significantly benefits patients by reducing
+Added: trauma, hospital stays, recovery times, and medical costs.
+Added: However, these benefits would not have been achieved without the emergence
+Added: of new risks.
+Added: The risk of unintended tissue damage from stray electrosurgical energy has been well documented.
+Added: Such injuries can be especially
+Added: troubling given that often these injuries are out of the field of view, can go unrecognized at the time of surgery, and can lead to a
+Added: cascade of adverse events, including death.
+Added: Our patented AEM technology eliminates the risk of stray electrosurgical burns in MIS while
+Added: providing surgeons with the desired tissue effects.
+Added: Product Line has been Developed and Launched.
+Added: Our AEM Surgical Instruments and Monitors have
+Added: been engineered to provide a seamless transition for surgeons switching from conventional laparoscopic instruments.
+Added: AEM technology has
+Added: been integrated into instruments that have the same look, feel, and functionality as conventional instruments that surgeons have been
+Added: using for years.
+Added: The AEM product line encompasses a full range of instrument sizes, types, and styles favored by surgeons.
+Added: quality-centric, we added a new level of customer-centricity with increased marketing focus on our reposable AEM EndoShield® 2 Burn
+Added: Protection System (“EndoShield 2”).
+Added: The EndoShield 2 can be used for a number of surgical procedures without reprocessing,
+Added: can easily be used in any OR room with all prevalent electrosurgical generators, and eliminates a significant barrier to adoption.
+Added: hospitals can make a complete and smooth conversion to our product line, thereby advancing patient safety in MIS.
+Added: Emerging as a Standard of Care
+Added: We believe that AEM technology is following a
+Added: similar path as previous technological developments in surgery.
+Added: Throughout the history of electrosurgery, companies that have developed
+Added: significant technological breakthroughs in patient safety have seen their technologies become widely used.
+Added: As with “Isolated”
+Added: electrosurgical generators in the 1970s and with “REM” technology in the 1980s, AEM technology is receiving the broad endorsements
+Added: that drove these previous new technologies to becoming a standard of care.
+Added: We believe that it is possible to follow a course similar to
+Added: that of pulse oximetry in becoming a standard of care.
+Added: Our proprietary AEM technology enhances patient safety in MIS, especially in light
+Added: of laparoscopic instruments being in closer proximity with single-port and reduced-port approaches.
+Added: As a result, knowledgeable clinicians
+Added: are now advocating AEM technology’s use.
+Added: Developing a Distribution Network is Advancing
+Added: Utilization of AEM Technology
+Added: Our AEM technology, in the hands of a sales network
+Added: with broad access to the surgery marketplace, will help to increase utilization and market share.
+Added: Historically, our sales and marketing
+Added: efforts have been hindered by our small size and limited distribution channels.
+Added: While these limitations continue, we improved our sales
+Added: network, which provided new hospital accounts with AEM technology in our fiscal year ended March 31, 2025.
+Added: Our supplier agreements with
+Added: Group Purchasing Organizations (“GPOs”) and other key hospital systems are beginning to expose more hospitals to the benefits
+Added: of our AEM technology.
+Added: During the year ended March 31, 2020, our proprietary patient safety technology was recognized by the U.S.
+Added: of Veterans Affairs, and provides us with the opportunity to market our instruments and monitors in VA medical centers.
+Added: The VA is the
+Added: largest medical system in the U.S., providing services to more than nine million veterans across more than 1,200 facilities.
+Added: the year ended March 31, 2020, we were awarded a prestigious Vizient Innovative Technology Contract for monopolar surgical instruments
+Added: and monitors.
+Added: Vizient represents a diverse membership base that includes academic medical centers, pediatric facilities, community hospitals,
+Added: integrated health delivery networks, and non-acute health care providers.
+Added: We believe that our patented AEM technology provides
+Added: us with marketing leverage toward gaining an increased share, both in terms of penetrations, as well as increasing our impact per procedure
+Added: with AEM instrumentation.
+Added: In the 1990s, surgeons began widespread use of
+Added: minimally invasive surgical techniques.
+Added: The benefits of MIS are substantial and include reduced trauma for the patient, reduced hospital
+Added: stay, shorter recovery time and lower medical costs.
+Added: With improvements in the surgical laparoscopic camera and in the variety of available
+Added: instruments, laparoscopic surgery became popular among general surgeons, gynecologic surgeons and other specialties.
+Added: Laparoscopy now accounts
+Added: for a large percentage of all surgical procedures performed in the United States.
+Added: Approximately 75% of surgeons employ monopolar electrosurgery
+Added: for laparoscopy according to Interactive Surveys.
+Added: There are over 4.4 million laparoscopic procedures performed annually in the United
+Added: States, and this number is increasing annually.
+Added: except as otherwise stated, market estimates in this section are as reported by
+Added: Patient Safety & Quality Healthcare).
+Added: A component of the endoscopic surgery products
+Added: market includes laparoscopic hand instruments, including scissors, graspers, dissectors, forceps, suction/irrigation devices, clip appliers
+Added: and other surgical instruments of various designs, which provide a variety of tissue effects.
+Added: Among the laparoscopic hand instruments,
+Added: approximately $500 million in sales annually are derived from instruments designed for "monopolar" electrosurgical utility.
+Added: This market for laparoscopic monopolar electrosurgical instruments is the market we are targeting with our innovative AEM Surgical Instruments.
+Added: Our proprietary AEM product line supplants the conventional “non-shielded, non-monitored” electrosurgical instruments commonly
+Added: used in laparoscopic surgery.
+Added: When a hospital decides to use our AEM technology,
+Added: we make recurring sales to such hospitals for replacement instruments.
+Added: Sales from reusable and disposable AEM products in hospitals represented
+Added: over 90% of our sales in the fiscal year ended March 31, 2025, and we expect this sales stream to grow as new hospitals increasingly adopt
+Added: AEM technology and existing hospitals increase usage of AEM instrumentation.
+Added: We also expect to increase the value per procedure delivered
+Added: to our customers and, therefore, expect the dollars per procedure to increase.
+Added: AEM Instruments are competitively priced compared to conventional
laparoscopic instruments.
−Removed: AEM technology has been integrated into instruments that have the same look, feel and functionality as conventional
−Removed: instruments that surgeons have been using for years.
−Removed: The AEM product line encompasses a full range of instrument sizes, types and styles
−Removed: favored by surgeons.
−Removed: While always quality-centric, we added a new level of customer-centricity with increased marketing focus on our
−Removed: reposable AEM EndoShield® 2 Burn Protection System (“EndoShield 2”).
−Removed: The EndoShield 2 can be used for a number of surgical
−Removed: procedures without reprocessing, can easily be used in any OR room with all prevalent electrosurgical generators, and eliminates a significant
−Removed: barrier to adoption.
−Removed: Thus, hospitals can make a complete and smooth conversion to our product line, thereby advancing patient safety
−Removed: as a Standard of Care
−Removed: believe that AEM technology is following a similar path as previous technological developments in surgery.
−Removed: Throughout the history of
−Removed: electrosurgery, companies that have developed significant technological breakthroughs in patient safety have seen their technologies
−Removed: become widely used.
−Removed: As with “Isolated” electrosurgical generators in the 1970s and with “REM” technology in the
−Removed: 1980s, AEM technology is receiving the broad endorsements that drove these previous new technologies to becoming a standard of care.
−Removed: We believe that it is possible to follow a course similar to that of pulse oximetry in becoming a standard of care.
−Removed: Our proprietary AEM
−Removed: technology enhances patient safety in MIS, especially in light of laparoscopic instruments being in closer proximity with single-port
−Removed: and reduced-port approaches.
−Removed: As a result, knowledgeable clinicians are now advocating AEM technology’s use.
−Removed: Distribution Network is Advancing Utilization of AEM Technology
−Removed: AEM technology, in the hands of a sales network with broad access to the surgery marketplace, will help to increase utilization and market
−Removed: Historically, our sales and marketing efforts have been hindered by our small size and limited distribution channels.
−Removed: limitations continue, we improved our sales network which provided new hospital accounts with AEM technology in our fiscal year ended
−Removed: March 31, 2024.
−Removed: Our supplier agreements with Group Purchasing Organizations (“GPOs”) and other key hospitals systems are
−Removed: beginning to expose more hospitals to the benefits of our AEM technology.
−Removed: During the year ended March 31, 2020, our proprietary patient
−Removed: safety technology was recognized by the U.S.
−Removed: Department of Veterans Affairs and provides us with the opportunity to market our instruments
−Removed: and monitors into VA Medical Centers.
−Removed: The VA is the largest medical system in the U.S.
−Removed: providing service to more than nine million veterans
−Removed: across more than 1,200 facilities.
−Removed: Also, during the year ended March 31, 2020, we were awarded a prestigious Vizient Innovative Technology
−Removed: Contract for monopolar surgical instruments and monitors.
−Removed: Vizient represents a diverse membership base that includes academic medical
−Removed: centers, pediatric facilities, community hospitals, integrated health delivery networks and non-acute health care providers and represents
−Removed: approximately $100 billion in annual medical devices and supplies purchasing volume.
−Removed: believe that our patented AEM technology provides us with marketing leverage toward gaining an increased share, both in terms of penetrations,
−Removed: as well as increasing our impact per procedure with AEM instrumentation.
−Removed: the 1990s, surgeons began widespread use of minimally invasive surgical techniques.
−Removed: The benefits of MIS are substantial and include reduced
−Removed: trauma for the patient, reduced hospital stay, shorter recovery time and lower medical costs.
−Removed: With improvements in the surgical laparoscopic
−Removed: camera and in the variety of available instruments, laparoscopic surgery became popular among general surgeons, gynecologic surgeons
−Removed: and other specialties.
−Removed: Laparoscopy now accounts for a large percentage of all surgical procedures performed in the United States.
−Removed: Approximately
−Removed: 75% of surgeons employ monopolar electrosurgery for laparoscopy according to INTERactive SURVeys.
−Removed: There are over 4.4 million laparoscopic
−Removed: procedures performed annually in the United States, and this number is increasing annually.
−Removed: except as otherwise stated, market
−Removed: estimates in this section are as reported by Patient Safety & Quality Healthcare).
−Removed: component of the endoscopic surgery products market includes laparoscopic hand instruments, including scissors, graspers, dissectors,
−Removed: forceps, suction/irrigation devices, clip appliers and other surgical instruments of various designs, which provide a variety of tissue
−Removed: Among the laparoscopic hand instruments, approximately $500 million in sales annually are derived from instruments designed
−Removed: for "monopolar" electrosurgical utility.
−Removed: This market for laparoscopic monopolar electrosurgical instruments is the market we
−Removed: are targeting with our innovative AEM Surgical Instruments.
−Removed: Our proprietary AEM product line supplants the conventional “non-shielded,
−Removed: non-monitored” electrosurgical instruments commonly used in laparoscopic surgery.
−Removed: a hospital decides to use our AEM technology, we make recurring sales to such hospital for replacement instruments.
−Removed: Sales from reusable
−Removed: and disposable AEM products in hospitals represented over 90% of our sales in the fiscal year ended March 31, 2024, and we expect this
−Removed: sales stream to grow as new hospitals increasingly adopt AEM technology and existing hospitals increase usage of AEM instrumentation.
−Removed: We also expect to increase the value per procedure delivered to our customers and, therefore, expect the dollars per procedure to increase.
−Removed: AEM Instruments are competitively priced compared to conventional laparoscopic instruments.
−Removed: aim to further develop the market by continuing to educate healthcare professionals about the benefits of AEM technology to advance patient
−Removed: We are developing new devices that integrate AEM technology, which we believe will have high surgeon appeal.
−Removed: We are also working
−Removed: to improve the reach of our sales network to key decision makers who purchase or recommend the purchase of laparoscopic instruments and
−Removed: electrosurgical devices.
−Removed: We are also pursuing relationships with selected GPOs, hospital systems and integrated delivery networks to
−Removed: assist in promoting the benefits of AEM technology.
−Removed: We are seeking increasing international opportunities for AEM technology sales.
−Removed: estimate sales outside the U.S.
−Removed: to be at least as large as that of the U.S.
−Removed: We are growing our presence in Australia and New
−Removed: Zealand and are seeking a new presence in the Middle East and Europe.
−Removed: As decisions are made at a system level, our intent is to highlight
−Removed: the clinical, economic and safety benefits of using AEM technology.
−Removed: Electrosurgical Burn Injury to the Patient
−Removed: Electrosurgical
−Removed: technology is a valuable and prevalent resource for surgeons.
−Removed: Since its introduction in the 1930s, electrosurgical technology has continually
−Removed: evolved and is estimated to be used in over 75% of all surgeries.
−Removed: primary form of electrosurgery, monopolar electrosurgery, is a standard tool for general surgeons throughout the world.
−Removed: electrosurgery, the surgeon uses an instrument (typically scissors, grasper/dissectors, spatula blades or suction-irrigation electrodes)
−Removed: to deliver electrical current to patient tissue.
−Removed: This “active electrode” provides the surgeon with the ability to cut, coagulate
−Removed: or ablate tissue as needed during the surgery.
−Removed: With the advent of MIS procedures, surgeons have continued using monopolar electrosurgery
−Removed: as a primary tool for hemostatic incision, coagulation of bleeding tissues, excision and ablation.
−Removed: Unfortunately, conventional laparoscopic
−Removed: electrosurgical instruments from competing manufacturers are susceptible to emitting stray electrical currents during the procedure.
−Removed: This risk is exacerbated by the fact that laparoscopic camera systems limit the surgical field of view.
−Removed: Ninety percent of the instrument
−Removed: may be outside the surgeon's field of view at any given time during the surgery.
−Removed: dangers of stray energy are twofold.
−Removed: Not only is there the danger created by the burn injury itself, but there is the compounding danger
−Removed: that the burn will go unnoticed during the surgery and be allowed to manifest post-operatively as fecal peritonitis or other potentially
−Removed: deadly and devastating outcomes.
−Removed: In many cases, the surgeon cannot detect stray electrosurgical burns at the time of the procedure because
−Removed: it is out of their field of visualization.
−Removed: The resulting complication usually presents itself days later in the form of a severe infection
−Removed: or sepsis, which often results in a hospital readmission and a difficult course of remedial surgeries and prolonged hospital recovery
−Removed: for the patient.
−Removed: This situation has even resulted in fatalities.
−Removed: electrosurgical burn injury can result from two causes – instrument insulation failure and capacitive coupling.
−Removed: Instrument insulation
−Removed: failure can be a common occurrence with laparoscopic instruments.
−Removed: Conventional active electrodes for laparoscopic surgery are designed
−Removed: with the same basic construction – a single conductive element and an outer insulation coating.
−Removed: This insulation can fail during
−Removed: the course of normal use during surgery.
−Removed: One university study found insulation defects in new disposable instruments before they were
−Removed: used or after limited surgical use.
−Removed: It is also possible for instrument insulation to become flawed during the handling, cleaning and
−Removed: sterilization process.
−Removed: This common insulation failure can allow electrical currents to "spark" from the instrument to unintended
−Removed: and unseen tissue with potentially serious consequences for the patient, such as bowel perforations.
−Removed: Four different studies indicate
−Removed: that the insulation failure rate in reusable instruments can be as high as one in five.
−Removed: Capacitive coupling is another way stray electrosurgical
−Removed: energy can cause unintended burns during laparoscopy.
−Removed: Capacitive coupling is an electrical phenomenon that occurs when current is induced
−Removed: from the instrument to nearby tissue or another instrument despite intact insulation.
−Removed: This potential for capacitive coupling is present
−Removed: in all laparoscopic surgeries that utilize monopolar electrosurgery devices and are likely to occur outside the surgeon’s field
−Removed: Conventional,
−Removed: “non-shielded, non-monitored” laparoscopic instruments are susceptible to causing unintended, unseen burn injuries to the
−Removed: patient in MIS.
−Removed: Instrument insulation failure and capacitive coupling are the primary causes of stray electrosurgical burns in laparoscopy
−Removed: and are the two events over which the surgical team has traditionally had no control.
−Removed: Although alternative forms to monopolar electrosurgery
−Removed: energy exist, these alternative energies tend to be less effective, take longer to achieve the desired surgical effect and are costlier.
−Removed: AEM Surgical Instruments
−Removed: technology eliminates the risk of stray electrical energy caused by instrument insulation failure and capacitive coupling, and thus prevents
−Removed: unintended burn injuries to patients.
−Removed: Surgical Instruments are an innovative solution to stray electrosurgical burns in laparoscopic surgery and are designed with the same
−Removed: look, feel and functionality as conventional instruments.
−Removed: They direct electrosurgical energy where the surgeon desires, while continuously
−Removed: monitoring the current flow to prevent stray electrosurgical energy from instrument insulation failure or capacitive coupling.
−Removed: conventional instruments are simply a conductive element with a layer of insulation coating, AEM Surgical Instruments have a patented,
−Removed: multi-layered design with a built-in “shield,” a concept much like the third-wire ground in standard electrical cords.
−Removed: shield in these instruments is electrically connected and referenced back to an AEM Monitor at the electrosurgical generator.
−Removed: event of a harmful level of stray electrical energy, the monitor shuts down the power at the source, assuring patient safety.
−Removed: If instrument
−Removed: insulation failure should occur, the AEM system, while continually monitoring the instrument, immediately interrupts monopolar output
−Removed: from the electrosurgical generator and alerts the surgical staff.
−Removed: The AEM system protects against capacitive coupling by providing a
−Removed: neutral return path for “capacitive” electrical energy.
−Removed: Capacitive energy is continually drained away from the instrument
−Removed: and away from the patient through the protective shield built into all AEM instruments and the connected AEM Monitor.
−Removed: AEM system consists of shielded 5mm AEM Instruments and an AEM monitor.
−Removed: The AEM Instruments are designed to function identically to the
−Removed: conventional 5mm instruments that surgeons are familiar with, but with the added benefit of enhanced patient safety.
−Removed: Our entire line
−Removed: of laparoscopic instruments has the integrated AEM design and includes the full range of instruments that are common in laparoscopic
−Removed: surgery today.
−Removed: The AEM monitor is compatible with most electrosurgical generators, and can also be adapted for use in robotic systems.
−Removed: AEM Surgical Instruments provide enhanced patient safety, require no change in surgeon technique and are cost competitive.
−Removed: Thus, conversion
−Removed: to AEM Surgical Instruments is easy and economical.
−Removed: were organized as a Colorado corporation in 1991 and spent several years developing the AEM monitoring system and protective sheaths
−Removed: to adapt to conventional electrosurgical instruments.
−Removed: During this period, we conducted product trials and applied for patents with the
−Removed: United States Patent and Trademark Office and with International patent
−Removed: Our patents relate to the basic shielding and monitoring technologies that we incorporate
−Removed: into our AEM products.
−Removed: As of March 31, 2024, we have 16 unexpired United States patents relating to specific implementations of shielding
−Removed: and monitoring in instruments and continue to add patents as we further develop our proprietary technology and its applications.
−Removed: we evolved, it was clear to us that our “active electrode monitoring” technology needed to be integrated into the standard
−Removed: laparoscopic instrument design.
−Removed: As the development program proceeded, it also became apparent that the merging of electrical and mechanical
−Removed: engineering skills in the instrument development process for our patented, integrated electrosurgical instruments was a complex and difficult
−Removed: As a result, instruments with integrated AEM technology were not completed for several years.
−Removed: Prior to offering a full range of
−Removed: laparoscopic electrosurgical instrumentation, it was difficult for hospitals to commit to the AEM solution, as we did not have adequate
−Removed: comparable surgical instrument options to match surgeon demand.
−Removed: the broad array of AEM instruments now available, the surgeon has a wide choice of instrument options and does not have to change surgical
+Added: We aim to further develop the market by continuing
+Added: to educate healthcare professionals about the benefits of AEM technology to advance patient safety.
+Added: We are developing new devices that
+Added: integrate AEM technology, which we believe will have high surgeon appeal.
+Added: We are also working to improve the reach of our sales network
+Added: to key decision makers who purchase or recommend the purchase of laparoscopic instruments and electrosurgical devices.
+Added: We are also pursuing
+Added: relationships with selected GPOs, hospital systems, and integrated delivery networks to assist in promoting the benefits of AEM technology.
+Added: We are seeking to increase international opportunities for AEM technology sales.
+Added: We estimate sales outside the U.S.
+Added: to be at least as
+Added: large as those of the U.S.
+Added: We are growing our presence in Australia and New Zealand and are seeking a new presence in the Middle
+Added: East and Europe.
+Added: As decisions are made at a system level, we intend to highlight the clinical, economic, and safety benefits of AEM technology.
+Added: The Technology
+Added: Stray Electrosurgical Burn Injury to the
+Added: Electrosurgical technology is a valuable and
+Added: prevalent resource for surgeons.
+Added: Since its introduction in the 1930s, electrosurgical technology has continually evolved and is estimated
+Added: to be used in over 75% of all surgeries.
+Added: The primary form of electrosurgery, monopolar
+Added: electrosurgery, is a standard tool for general surgeons throughout the world.
+Added: In monopolar electrosurgery, the surgeon uses an instrument
+Added: (typically scissors, grasper/dissectors, spatula blades or suction-irrigation electrodes) to deliver electrical current to patient tissue.
+Added: This “active electrode” provides the surgeon with the ability to cut, coagulate or ablate tissue as needed during the surgery.
+Added: With the advent of MIS procedures, surgeons have continued using monopolar electrosurgery as a primary tool for hemostatic incision, coagulation
+Added: of bleeding tissues, excision and ablation.
+Added: Unfortunately, conventional laparoscopic electrosurgical instruments from competing manufacturers
+Added: are susceptible to emitting stray electrical currents during the procedure.
+Added: This risk is exacerbated by the fact that laparoscopic camera
+Added: systems limit the surgical field of view.
+Added: Ninety percent of the instrument may be outside the surgeon's field of view at any given time
+Added: during the surgery.
+Added: The dangers of stray energy are twofold.
+Added: only is there the danger created by the burn injury itself, but there is the compounding danger that the burn will go unnoticed during
+Added: the surgery and be allowed to manifest post-operatively as fecal peritonitis or other potentially deadly and devastating outcomes.
+Added: many cases, the surgeon cannot detect stray electrosurgical burns at the time of the procedure because it is out of their field of visualization.
+Added: The resulting complication usually presents itself days later in the form of a severe infection or sepsis, which often results in a hospital
+Added: readmission and a difficult course of remedial surgeries and prolonged hospital recovery for the patient.
+Added: This situation has even resulted
+Added: in fatalities.
+Added: Stray electrosurgical burn injury can result
+Added: from two causes – instrument insulation failure and capacitive coupling.
+Added: Instrument insulation failure can be a common occurrence
+Added: with laparoscopic instruments.
+Added: Conventional active electrodes for laparoscopic surgery are designed with the same basic construction –
+Added: a single conductive element and an outer insulation coating.
+Added: This insulation can fail during the course of normal use during surgery.
+Added: One university study found insulation defects in new disposable instruments before they were used or after limited surgical use.
+Added: also possible for instrument insulation to become flawed during the handling, cleaning and sterilization process.
+Added: This common insulation
+Added: failure can allow electrical currents to "spark" from the instrument to unintended and unseen tissue with potentially serious
+Added: consequences for the patient, such as bowel perforations.
+Added: Four different studies indicate that the insulation failure rate in reusable
+Added: instruments can be as high as one in five.
+Added: Capacitive coupling is another way stray electrosurgical energy can cause unintended burns
+Added: during laparoscopy.
+Added: Capacitive coupling is an electrical phenomenon that occurs when current is induced from the instrument to nearby
+Added: tissue or another instrument despite intact insulation.
+Added: This potential for capacitive coupling is present in all laparoscopic surgeries
+Added: that utilize monopolar electrosurgery devices and are likely to occur outside the surgeon’s field of view.
+Added: Conventional, “non-shielded, non-monitored”
+Added: laparoscopic instruments are susceptible to causing unintended, unseen burn injuries to the patient in MIS.
+Added: Instrument insulation failure
+Added: and capacitive coupling are the primary causes of stray electrosurgical burns in laparoscopy and are the two events over which the surgical
+Added: team has traditionally had no control.
+Added: Although alternative forms to monopolar electrosurgery energy exist, these alternative energies
+Added: tend to be less effective, take longer to achieve the desired surgical effect and are costlier.
+Added: Encision’s AEM Surgical Instruments
+Added: AEM technology eliminates the risk of stray electrical
+Added: energy caused by instrument insulation failure and capacitive coupling, and thus prevents unintended burn injuries to patients.
+Added: AEM Surgical Instruments are an innovative solution
+Added: to stray electrosurgical burns in laparoscopic surgery and are designed with the same look, feel and functionality as conventional instruments.
+Added: They direct electrosurgical energy where the surgeon desires, while continuously monitoring the current flow to prevent stray electrosurgical
+Added: energy from instrument insulation failure or capacitive coupling.
+Added: Whereas conventional instruments are simply a
+Added: conductive element with a layer of insulation coating, AEM Surgical Instruments have a patented, multi-layered design with a built-in
+Added: “shield,” a concept much like the third-wire ground in standard electrical cords.
+Added: The shield in these instruments is electrically
+Added: connected and referenced back to an AEM Monitor at the electrosurgical generator.
+Added: In the event of a harmful level of stray electrical
+Added: energy, the monitor shuts down the power at the source, assuring patient safety.
+Added: If instrument insulation failure should occur, the AEM
+Added: system, while continually monitoring the instrument, immediately interrupts monopolar output from the electrosurgical generator and alerts
+Added: the surgical staff.
+Added: The AEM system protects against capacitive coupling by providing a neutral return path for “capacitive”
+Added: electrical energy.
+Added: Capacitive energy is continually drained away from the instrument and away from the patient through the protective
+Added: shield built into all AEM instruments and the connected AEM Monitor.
+Added: The AEM system comprises shielded 5mm AEM Instruments
+Added: and an AEM monitor.
+Added: The AEM Instruments are designed to function identically to the conventional 5mm instruments that surgeons are familiar
+Added: with, but with the added benefit of enhanced patient safety.
+Added: Our entire line of laparoscopic instruments has the integrated AEM design
+Added: and includes the full range of instruments common in laparoscopic surgery today.
+Added: The AEM monitor is compatible with most electrosurgical
+Added: generators and can be adapted for robotic systems.
+Added: AEM Surgical Instruments provide enhanced patient safety, require no change in surgeon
+Added: techniques, and are cost-competitive.
+Added: Thus, conversion to AEM Surgical Instruments is easy and economical.
+Added: organized as a Colorado corporation in 1991 and spent several years developing the AEM monitoring system and protective sheaths to adapt
+Added: to conventional electrosurgical instruments.
+Added: During this period, we conducted product trials and applied for patents with the United States
+Added: Patent and Trademark Office and International patent agencies.
+Added: Our patents relate to
+Added: the basic shielding and monitoring technologies we incorporate into our AEM products.
+Added: As of March 31, 2025, we have 21 unexpired United
+Added: States patents relating to specific implementations of shielding and monitoring in instruments, and we continue to add patents as we further
+Added: develop our proprietary technology and its applications.
+Added: As we evolved, it was clear to us that our “active
+Added: electrode monitoring” technology needed to be integrated into the standard laparoscopic instrument design.
+Added: As the development program
+Added: proceeded, it also became apparent that the merging of electrical and mechanical engineering skills in the instrument development process
+Added: for our patented, integrated electrosurgical instruments was a complex and difficult task.
+Added: As a result, instruments with integrated AEM
+Added: technology were not completed for several years.
+Added: Prior to offering a full range of laparoscopic electrosurgical instrumentation, it was
+Added: difficult for hospitals to commit to the AEM solution, as we did not have adequate comparable surgical instrument options to match surgeon
+Added: broad array of AEM instruments now available, the surgeon has a wide choice of instrument options and does not have to change surgical
technique to use our AEM products.
−Removed: Since c onversion
−Removed: to AEM technology is transparent to the surgeon, hospitals can now universally convert to AEM technology,
−Removed: thus providing all of their laparoscopic surgery patients a higher level of safety.
−Removed: This development coincides with the continued
−Removed: expansion of independent endorsements for AEM technology.
−Removed: Recommendations from the malpractice insurance and medicolegal communities
−Removed: complement the broad clinical endorsements that AEM technology has garnered over the past few years, leading to better awareness for
−Removed: the benefits of the technology.
−Removed: produce and market a full line of AEM Instruments, which are “shielded and monitored” to prevent stray electrosurgical burns
−Removed: from insulation failure and capacitive coupling.
−Removed: Our product line includes a broad range of endo-mechanical instruments (scissors, graspers
−Removed: and dissectors), fixed-tip electrodes and suction-irrigation electrodes.
−Removed: These AEM Instruments are available in a wide array of reusable
−Removed: and disposable options.
−Removed: Also, we have a line of handles that are used for advanced laparoscopic procedures that incorporate stiffer shafts
−Removed: and ergonomic features.
−Removed: In addition, we market an AEM monitor product line that is used in conjunction with AEM Instruments.
−Removed: EndoShield® 2 Burn Protection System can be used for a number of surgical procedures without reprocessing, reduces the customer’s
−Removed: cost per use significantly, and eliminates a significant barrier to adoption.
−Removed: Thus, hospitals can make a complete and smooth conversion
−Removed: to our product line, thereby advancing patient safety in MIS.
−Removed: The EndoShield 2 integrates our patented AEM technology into a disposable
−Removed: smart cord and eliminates the need for a separate AEM monitor.
−Removed: It is changing the marketplace for electrosurgical devices and laparoscopic
−Removed: instruments by providing a solution to a well-documented hazard unique to laparoscopic surgery.
−Removed: introduction of our AEM 2X enTouch® Scissors (“2X Scissors”) brought new levels of performance and economy
−Removed: to the surgical scissor market by combining the best-in-class performance of our enTouch Disposable Scissors with the value and economy
−Removed: of a multi-use device.
−Removed: We believe that our 2X Scissors will have a significant impact on the disposable laparoscopic scissor market.
−Removed: Our enTouch Disposable Scissors have long been the surgeon preferred product because of their sharpness and micro-serrations.
−Removed: Our 2X Scissors
−Removed: provide all those benefits at half the cost per use and reduce hospital waste and the impact on the environment as well.
−Removed: The thermochromic
−Removed: technology integrated into 2X Scissors lets the hospital know when to replace the scissors with new ones and makes tracking
−Removed: their use simple and easy.
−Removed: 2X Scissors work with hot AEM dissection and have a price point that makes them suitable for cold dissection
−Removed: 2X Scissors should open new use segments for us and create an opportunity for customers to standardize on our entire portfolio
−Removed: of Active Electrode Monitoring (AEM®) products.
−Removed: February 2023, we signed a Proof-of-Concept Services Agreement with Vicarious Surgical Inc.
+Added: Since c onversion to AEM technology is transparent to the surgeon, hospitals
+Added: can now universally convert to AEM technology, thus providing all of their laparoscopic surgery patients a higher level of safety.
+Added: development coincides with the continued expansion of independent endorsements for AEM technology.
+Added: Recommendations from the malpractice
+Added: insurance and medicolegal communities complement the broad clinical endorsements that AEM technology has garnered over the past few years,
+Added: leading to better awareness for the benefits of the technology.
+Added: We produce and market a full line of AEM Instruments,
+Added: which are “shielded and monitored” to prevent stray electrosurgical burns from insulation failure and capacitive coupling.
+Added: Our product line includes a broad range of endo-mechanical instruments (scissors, graspers and dissectors), fixed-tip electrodes and suction-irrigation
+Added: These AEM Instruments are available in a wide array of reusable and disposable options.
+Added: Also, we have a line of handles that
+Added: are used for advanced laparoscopic procedures that incorporate stiffer shafts and ergonomic features.
+Added: In addition, we market an AEM monitor
+Added: product line that is used in conjunction with AEM Instruments.
+Added: Our AEM EndoShield® 2 Burn Protection System can be used for a number
+Added: of surgical procedures without reprocessing, reduces the customer’s cost per use significantly, and eliminates a significant barrier
+Added: Thus, hospitals can make a complete and smooth conversion to our product line, thereby advancing patient safety in MIS.
+Added: EndoShield 2 integrates our patented AEM technology into a disposable smart cord and eliminates the need for a separate AEM monitor.
+Added: is changing the marketplace for electrosurgical devices and laparoscopic instruments by providing a solution to a well-documented hazard
+Added: unique to laparoscopic surgery.
+Added: The introduction of our AEM 2X enTouch®
+Added: Scissors (“2X Scissors”) brought new levels of performance and economy to the surgical scissor market by combining the
+Added: best-in-class performance of our enTouch Disposable Scissors with the value and economy of a multi-use device.
+Added: We believe that our 2X Scissors
+Added: will have a significant impact on the disposable laparoscopic scissor market.
+Added: Our enTouch Disposable Scissors have long been the surgeon
+Added: preferred product because of their sharpness and micro-serrations.
+Added: Our 2X Scissors provide all those benefits at half the cost per
+Added: use and reduce hospital waste and the impact on the environment as well.
+Added: The thermochromic technology integrated into 2X Scissors
+Added: lets the hospital know when to replace the scissors with new ones and makes tracking their use simple and easy.
+Added: 2X Scissors work
+Added: with hot AEM dissection and have a price point that makes them suitable for cold dissection as well.
+Added: 2X Scissors should open new
+Added: use segments for us and create an opportunity for customers to standardize on our entire portfolio of Active Electrode Monitoring (AEM®)
+Added: In February 2023, we signed a Proof-of-Concept Services
+Added: Agreement with Vicarious Surgical Inc.
(“Vicarious”).
−Removed: The Vicarious
−Removed: robot design intends to maximize visualization, precision, and control of instruments in robotic-assisted minimally invasive surgery.
+Added: The Vicarious robot design intends to maximize visualization, precision,
+Added: and control of instruments in robotic-assisted minimally invasive surgery.
and Marketing Overview
−Removed: believe that AEM technology can become the standard of care in laparoscopic surgery worldwide.
−Removed: Our marketing efforts are focused on building
−Removed: awareness by providing technical education for Health Care Providers on the dangers of stray electrosurgical energy and in providing
−Removed: clinical and economic evidence to substantiate the value of AEM technology to hospitals, their staff, and their patients.
−Removed: We also leverage
−Removed: relationships with prominent hospitals and surgeons where AEM Technology has increased their level of patient care and improved their
−Removed: overall surgical outcomes.
−Removed: addition, there is increasing public interest in the reduction of medical errors and the advancement of patient safety.
−Removed: the National Quality Forum and CMS (Centers for Medicare and Medicaid Services) recognize “patient death or serious disability
−Removed: associated with a burn incurred from any source while being cared for in a healthcare facility” as a “never-event”.
−Removed: We believe that the credibility and importance of our technology is complemented by this expanding public interest in advancing patient
−Removed: safety in new CMS Hospital Quality Metrics.
−Removed: cost effectively expand market coverage, we focus on optimizing our distribution network comprised of direct and independent sales representatives
−Removed: who are managed and directed by our regional sales managers throughout the United States.
−Removed: In some instances, customers have recognized
−Removed: the patient safety risks inherent in monopolar electrosurgery and have accepted AEM technology as the way to eliminate those risks.
−Removed: other instances, we have found selling the concept behind AEM technology more difficult.
−Removed: This difficulty is due to several factors, including
−Removed: the necessity to make surgeons, nurses and hospital risk managers aware of the potential for unintended electrosurgical burns (which
−Removed: exists when conventional instruments are used during laparoscopic monopolar electrosurgery) and the resulting increased patient injury
−Removed: and medicolegal liability exposure.
−Removed: Additionally, we must contend with the overall lack of single purchasing points in the industry (surgeons,
−Removed: hospital personnel, and value analysis committees have to be in substantial agreement as to the benefits of new technology), and the
−Removed: resulting need to make multiple sales calls on personnel with the authority to commit to hospital expenditures.
−Removed: Other challenges include
−Removed: the fact that many hospitals have exclusive contractual agreements with manufacturers of competing surgical instruments.
−Removed: goal is to optimize a network that has experience selling into the hospital operating room environment.
−Removed: We believe that improvement in
−Removed: this network offers us the best opportunity to cost effectively broaden acceptance of our product line and generate increased and recurring
−Removed: Additionally, we are pursuing supplier agreements with the major selected GPOs, hospital systems and integrated delivery networks.
−Removed: addition to the efforts to broaden market acceptance in the United States, we have contracted with independent distributors in Australia
−Removed: and New Zealand to market our products internationally.
−Removed: We have achieved Conformité Européene (“CE”) marking
−Removed: for our products so that we may sell into the European marketplace.
−Removed: The CE marking indicates that a manufacturer has conformed to all
−Removed: of the obligations imposed by European health, safety and environmental legislation.
−Removed: While CE certification opens up incremental markets
−Removed: in Europe, our distribution options in the European marketplace are developing, and sales in international markets are small.
−Removed: believe that the expanding awareness for AEM technology through education and the improved sales network of independent representatives
−Removed: will provide the basis for increased sales and continuing profitable operations.
−Removed: However, these measures, or any others that we may adopt,
−Removed: may not result in increased sales or profitable operations.
+Added: We believe that AEM technology can become the
+Added: standard of care in laparoscopic surgery worldwide.
+Added: Our marketing efforts are focused on building awareness by providing technical education
+Added: for healthcare providers on the dangers of stray electrosurgical energy and clinical and economic evidence to substantiate the value of
+Added: AEM technology to hospitals, their staff, and their patients.
+Added: We also leverage relationships with prominent hospitals and surgeons where
+Added: AEM Technology has increased their level of patient care and improved their overall surgical outcomes.
+Added: In addition, there is increasing public interest
+Added: in the reduction of medical errors and the advancement of patient safety.
+Added: For example, the National Quality Forum and CMS (Centers for
+Added: Medicare and Medicaid Services) recognize “patient death or serious disability associated with a burn incurred from any source while
+Added: being cared for in a healthcare facility” as a “never-event”.
+Added: We believe that the credibility and importance of our
+Added: technology is complemented by this expanding public interest in advancing patient safety in new CMS Hospital Quality Metrics.
+Added: To cost-effectively expand market coverage, we
+Added: focus on optimizing our distribution network, comprised of direct and independent sales representatives who are managed and directed by
+Added: our regional sales managers throughout the United States.
+Added: In some instances, customers have recognized the patient safety risks inherent
+Added: in monopolar electrosurgery and have accepted AEM technology as the way to eliminate those risks.
+Added: In other instances, we have found selling
+Added: the concept behind AEM technology more difficult.
+Added: This difficulty is due to several factors, including the necessity to make surgeons,
+Added: nurses, and hospital risk managers aware of the potential for unintended electrosurgical burns (which exists when conventional instruments
+Added: are used during laparoscopic monopolar electrosurgery) and the resulting increased patient injury and medicolegal liability exposure.
+Added: Additionally, we must contend with the overall lack of single purchasing points in the industry (surgeons, hospital personnel, and value
+Added: analysis committees have to be in substantial agreement as to the benefits of new technology), and the resulting need to make multiple
+Added: sales calls on personnel with the authority to commit to hospital expenditures.
+Added: Other challenges include the fact that many hospitals
+Added: have exclusive contractual agreements with manufacturers of competing surgical instruments.
+Added: Our goal is to optimize a network that has experience
+Added: selling into the hospital operating room environment.
+Added: We believe that improvement in this network offers us the best opportunity to cost-effectively
+Added: broaden acceptance of our product line and generate increased and recurring sales.
+Added: Additionally, we are pursuing supplier agreements with
+Added: the major selected GPOs, hospital systems, and integrated delivery networks.
+Added: In addition to the efforts to broaden market
+Added: acceptance in the United States, we have contracted with independent distributors in Australia and New Zealand to market our products
+Added: internationally.
+Added: We have achieved Conformité Européene (“CE”) marking for our products so that we may sell into
+Added: the European marketplace.
+Added: The CE marking indicates that a manufacturer has conformed to all of the obligations imposed by European health,
+Added: safety and environmental legislation.
+Added: While CE certification opens up incremental markets in Europe, our distribution options in the European
+Added: marketplace are developing, and sales in international markets are small.
+Added: We believe that the expanding awareness for AEM
+Added: technology through education and the improved sales network of independent representatives will provide the basis for increased sales
+Added: and continuing profitable operations.
+Added: However, these measures, or any others that we may adopt, may not result in increased sales or profitable
and Development
−Removed: aim to continually expand our AEM Instrument product line to satisfy the evolving needs of surgeons.
−Removed: For AEM technology to fully become
−Removed: a standard of care, we must satisfy surgeons’ preferred instrument shapes, sizes, styles and functionality with integrated AEM
−Removed: This commitment includes expanding the styles of electrosurgical instruments available for MIS applications so that the conversion
−Removed: to AEM technology is transparent to surgeons and does not require significant change in their current surgical techniques.
−Removed: full-time engineers and use independent contractors from time to time in our research and product development efforts.
−Removed: This group continuously
−Removed: explores ways to broaden and enhance the product line.
−Removed: Current research and development efforts are focused primarily on line-extension
−Removed: projects to further expand our AEM Instrument product offering to increase surgeons’ choices and options in laparoscopic surgery.
−Removed: Our research and development expenses were $621,894 in fiscal year 2024 and $816,119 in fiscal year 2023.
−Removed: We expense research and development
−Removed: costs for products and processes as incurred.
−Removed: Costs that are included in research and development expenses include direct salaries, contractor
−Removed: fees, materials, facility costs and administrative expenses that relate to research and development.
+Added: We aim to continually expand our AEM Instrument
+Added: product line to satisfy the evolving needs of surgeons.
+Added: For AEM technology to fully become a standard of care, we must satisfy surgeons’
+Added: preferred instrument shapes, sizes, styles, and functionality with integrated AEM technology.
+Added: This commitment includes expanding the styles
+Added: of electrosurgical instruments available for MIS applications so that the conversion to AEM technology is transparent to surgeons and
+Added: does not require a significant change in their current surgical techniques.
+Added: We employ full-time engineers and use independent contractors
+Added: from time to time in our research and product development efforts.
+Added: This group continuously explores ways to broaden and enhance the product
+Added: Current research and development efforts are focused primarily on line-extension projects to further expand our AEM Instrument product
+Added: offering to increase surgeons’ choices and options in laparoscopic surgery.
+Added: Our research and development expenses were $593,152
+Added: in fiscal year 2025 and $621,894 in fiscal year 2024.
+Added: We expense research and development costs for products and processes as incurred.
+Added: Costs that are included in research and development expenses include direct salaries, contractor fees, materials, facility costs and administrative
+Added: expenses that relate to research and development.
Manufacturing,
Regulatory Affairs and Quality Assurance
−Removed: engage in various manufacturing and assembly activities at our leased facility in Boulder, Colorado.
−Removed: These operations include disposable
−Removed: scissor inserts manufacturing and assembly of our AEM Instrument system as well as fabrication, assembly and test operations for instruments,
−Removed: monitors and accessories.
−Removed: We also have relationships with a number of outside suppliers.
−Removed: Three vendors accounted for approximately 47%
−Removed: of our inventory purchases.
−Removed: believe that the use of both internal and external manufacturing capabilities allows for increased flexibility in meeting our customer
−Removed: delivery requirements and significantly reduces the need for investment in specialized capital equipment.
−Removed: We have developed multiple
−Removed: sources of supply where possible.
−Removed: Our relationship with our suppliers is generally limited to individual purchase order agreements supplemented,
−Removed: as appropriate, by contractual relationships to help ensure the availability and low cost of certain products.
−Removed: All components, materials
−Removed: and sub-assemblies used in our products, whether produced in-house or obtained from others, are inspected to ensure compliance with our
−Removed: specifications.
−Removed: All finished products are subject to our quality assurance and performance testing procedures.
−Removed: discussed in the section on Government Regulation, we are subject to the rules and regulations of the United States Food and Drug Administration
−Removed: Our leased facility of 28,696 square feet contains approximately 15,100 square feet of manufacturing, regulatory
−Removed: affairs and quality assurance space.
−Removed: The facility is designed to comply with the Quality System Regulation (“QSR”), as specified
−Removed: in published FDA regulations.
−Removed: Our latest inspection by the FDA occurred in October 2015.
−Removed: achieved CE marking in August 2000, which required prior certification of our quality system and product documentation.
−Removed: Maintenance of
−Removed: the CE marking status requires periodic audits of the quality system and technical documentation by our European Notified Body, TUV Rheinland.
−Removed: The most recent audit was completed in February 2023.
+Added: We engage in various manufacturing and assembly
+Added: activities at our leased facility in Boulder, Colorado.
+Added: These operations include disposable scissor inserts manufacturing and assembly
+Added: of our AEM Instrument system as well as fabrication, assembly and test operations for instruments, monitors and accessories.
+Added: relationships with a number of outside suppliers.
+Added: Three vendors accounted for approximately 54% of our inventory purchases.
+Added: We believe that the use of both internal and
+Added: external manufacturing capabilities allows for increased flexibility in meeting our customer delivery requirements and significantly reduces
+Added: the need for investment in specialized capital equipment.
+Added: We have developed multiple sources of supply where possible.
+Added: Our relationship
+Added: with our suppliers is generally limited to individual purchase order agreements supplemented, as appropriate, by contractual relationships
+Added: to help ensure the availability and low cost of certain products.
+Added: All components, materials and sub-assemblies used in our products, whether
+Added: produced in-house or obtained from others, are inspected to ensure compliance with our specifications.
+Added: All finished products are subject
+Added: to our quality assurance and performance testing procedures.
+Added: As discussed in the section on Government Regulation,
+Added: we are subject to the rules and regulations of the United States Food and Drug Administration (“FDA”).
+Added: Our leased facility
+Added: of 28,696 square feet contains approximately 15,100 square feet of manufacturing, regulatory affairs and quality assurance space.
+Added: facility is designed to comply with the Quality System Regulation (“QSR”), as specified in published FDA regulations.
+Added: latest inspection by the FDA occurred in October 2015.
+Added: We achieved CE marking in August 2000, which
+Added: required prior certification of our quality system and product documentation.
+Added: Maintenance of the CE marking status requires periodic audits
+Added: of the quality system and technical documentation by our European Notified Body, TUV Rheinland.
+Added: The most recent audit was completed in
+Added: February 2023.
Patent Applications and Intellectual Proprietary Rights
−Removed: have invested heavily in an effort to protect our valuable technology, and, as a result of this effort, we have been issued 16 unexpired
−Removed: relevant patents that together form a significant intellectual property position.
−Removed: Our patents relate to the basic shielding and monitoring
−Removed: technologies that we incorporate into our AEM products.
−Removed: As of March 31, 2024, we have 16 unexpired United States patents relating to
−Removed: specific implementations of shielding and monitoring in instruments.
−Removed: As of March 31, 2024, there are between one and seventeen years
−Removed: remaining on our AEM patents.
−Removed: We have five patent applications in process, and we have four trademarks.
−Removed: technical progress depends to a significant degree on our ability to maintain patent protection for products and processes, to preserve
−Removed: our trade secrets and to operate without infringing the proprietary rights of third parties.
−Removed: Our policy is to attempt to protect our
−Removed: technology by, among other things, filing patent applications for technology that we consider important to the development of our business.
−Removed: The validity and breadth of claims covered in medical technology patents involve complex legal and factual questions and, therefore,
−Removed: may be highly uncertain.
−Removed: Even though we hold patented technology, others might copy our technology or otherwise incorporate our technology
−Removed: into their products.
−Removed: require our employees to execute non-disclosure agreements upon commencement of employment.
−Removed: These agreements generally provide that all
−Removed: confidential information developed or made known to the individual by us during the course of the individual's employment is our property
−Removed: and is to be kept confidential and not to be disclosed to third parties.
−Removed: electrosurgical device market is intensely competitive and tends to be dominated by a relatively small group of large and well-financed
−Removed: We compete directly for customers with those companies that currently make conventional electrosurgical instruments.
−Removed: competitors include Advanced Surgical Technologies Group (a division of Medtronic plc) and Ethicon Endo-Surgery (a division of Johnson
−Removed: While we know of no competitor (including those referenced above) that can provide a continuous solution to stray electrosurgical
−Removed: burns, the manufacturers of conventional (non-monitored, non-shielded) instruments will resist any loss of market share resulting from
−Removed: the presence of our products in the marketplace.
−Removed: What clearly differentiates us from the competition is that while competitive technologies
−Removed: may somewhat reduce the risk of stray energy burns, only AEM Technology completely eliminates it.
−Removed: also believe that manufacturers of products based on alternative technology to monopolar electrosurgery are our competitors.
−Removed: These alternative
−Removed: technologies include other “advanced energy” technologies such as bipolar electrosurgery, laser surgery and ultrasonic dissector
−Removed: Leading manufacturers in these areas include Advanced Surgical Technologies Group, Gyrus/ACMI (a division of Olympus Corporation
−Removed: and a leader in bi-polar electrosurgery), Lumenis (laser surgery) and Ethicon Endo-Surgery (a division of Johnson and Johnson, manufacturers
−Removed: of the harmonic scalpel).
−Removed: We believe that monopolar electrosurgery offers substantial competitive, functional and financial advantages
−Removed: over these alternative energy technologies and will remain the primary tool for the surgeon, as it has been for decades.
−Removed: risk exists that these alternative technologies may gain greater market share and that new competitive techniques may be developed and
−Removed: mentioned in the Sales and Marketing discussion, the competitive issues involved in selling our AEM product line do not primarily revolve
−Removed: around a comparison of cost or features, but rather involve generating an awareness of the inherent hazards of electrosurgery and the
−Removed: potential for injury to the patient.
−Removed: This involves conceptual selling, rather than just product selling, which results in a longer sales
−Removed: cycle and generally higher sales costs.
−Removed: Independent endorsements of AEM technology have greatly enhanced the credibility of AEM Instruments.
−Removed: However, our efforts to increase market awareness of this technology may not be successful, and our competitors may develop alternative
−Removed: strategies and/or products to counter our marketing efforts.
−Removed: of our competitors and potential competitors have widely-used products and significantly greater financial, technical, product development,
−Removed: marketing and other resources.
−Removed: In addition to our direct sales force, we utilize a network of independent distributor representatives
−Removed: in selected areas.
−Removed: In some cases, our options for independent distribution have conflicting and competing product interests which compromise
−Removed: our ability to make market advances in certain areas.
−Removed: We may not be able to compete successfully against current and future competitors,
−Removed: and competitive pressures faced by us may have a material adverse impact on our business, operating results and financial condition.
−Removed: regulation in the United States and other countries is a significant factor in the development and marketing of our products and in our
−Removed: ongoing manufacturing, research and development activities.
−Removed: The FDA regulates us and our products under a number of statutes, including
−Removed: the Federal Food, Drug and Cosmetics Act (the “FDC Act”).
−Removed: Under the FDC Act, medical devices are classified as Class I, II
−Removed: or III based on the controls deemed necessary to reasonably ensure their safety and effectiveness.
−Removed: Class I devices are subject to the
−Removed: least extensive controls, as their safety and effectiveness can be reasonably assured through general controls (e.g., labeling, pre-market
−Removed: notification and adherence to QSR).
−Removed: For Class II devices, safety and effectiveness can be assured using special controls (e.g., performance
−Removed: standards, post-market surveillance, patient registries and FDA guidelines).
−Removed: Class III devices (e.g., life-sustaining or life-supporting
−Removed: implantable devices or new devices which have been found not to be substantially equivalent to legally marketed devices) require the
−Removed: highest level of control, generally requiring pre-market approval by the FDA to ensure their safety and effectiveness.
−Removed: Our products are
−Removed: Class II devices.
−Removed: a manufacturer or distributor of medical devices can establish that a proposed device is "substantially equivalent" to a legally
−Removed: marketed Class I or Class II medical device or to a Class III medical device for which the FDA has not required a pre-market approval
−Removed: application, the manufacturer or distributor may seek FDA marketing clearance for the device by filing a 510(k) pre-market notification.
−Removed: Following submission of the 510(k) notification, the manufacturer or distributor may not place the device into commercial distribution
−Removed: in the United States until an order has been issued by the FDA.
−Removed: The FDA's target for issuing such orders is within 90 days of submission,
−Removed: but the process can take significantly longer.
−Removed: The order may declare the FDA's determination that the device is "substantially equivalent"
−Removed: to another legally marketed device and allow the proposed device to be marketed in the United States.
−Removed: The FDA may, however, determine
−Removed: that the proposed device is not substantially equivalent or may require further information, such as additional test data, before deciding
−Removed: regarding substantial equivalence.
−Removed: Any adverse determination or request for additional information could delay market introduction and
−Removed: have a material adverse effect on our continued operations.
−Removed: We have received a favorable 510(k) notification for our AEM monitors and
−Removed: AEM Instruments, all of which are designated as Class II medical devices.
−Removed: and promotional activities are subject to scrutiny by the FDA and, in certain instances, by the Federal Trade Commission.
−Removed: imposes post-marketing controls on us and our products, and registration, listing, medical device reporting, post-market surveillance,
−Removed: device tracking and other requirements on medical devices.
−Removed: Failure to meet these pervasive FDA requirements or adverse FDA determinations
−Removed: regarding our clinical and preclinical trials could subject us and/or our employees to injunction, prosecution, civil fines, seizure
−Removed: or recall of products, prohibition of sales or suspension or withdrawal of any previously granted approvals, which could lead to a material
−Removed: adverse impact on our financial position and results of operations.
−Removed: FDA regulates our quality control and manufacturing procedures by requiring us and our contract manufacturers to demonstrate compliance
−Removed: with the QSR as specified in published FDA regulations.
−Removed: The FDA requires manufacturers to register with the FDA, which subjects them
−Removed: to periodic FDA inspections of manufacturing facilities.
−Removed: If violations of applicable regulations are noted during FDA inspections of
−Removed: our manufacturing facilities or the facilities of our contract manufacturers, the continued marketing of our products may be adversely
−Removed: Such regulations are subject to change and depend heavily on administrative interpretations.
−Removed: In October 2015, the FDA conducted
−Removed: a QSR inspection of our facilities.
−Removed: We believe that we have the internal resources and processes in place to be reasonably assured that
−Removed: we are in compliance with all applicable United States regulations regarding the manufacture and sale of medical devices.
−Removed: we were found not to be in compliance with the QSR, in the future, such findings could result in a material adverse impact on our financial
−Removed: condition, results of operations and cash flows.
−Removed: of medical devices outside of the United States are subject to United States export requirements and foreign regulatory requirements.
−Removed: Legal restrictions on the sale of imported medical devices vary from country to country.
−Removed: The time required to obtain approval by a foreign
−Removed: country may be longer or shorter than that required for FDA approval and the requirements may differ.
−Removed: Our Certificate of Export from
−Removed: the United States Department of Health and Human Services has expired and we will seek to renew it.
−Removed: However, a specific foreign country
−Removed: in which we wish to sell our products may not accept or continue to accept the Certificate of Export.
−Removed: Entry into the European Economic
−Removed: Area market also requires prior certification of our quality system and product documentation.
−Removed: We achieved CE marking in August 2000,
−Removed: allowing a launch into the European marketplace.
−Removed: Maintenance of the CE marking status requires annual audits of the quality system and
−Removed: technical documentation by our European Notified Body, TUV Rheinland.
+Added: We have invested heavily in an effort to protect
+Added: our valuable technology, and, as a result of this effort, we have been issued 26 unexpired relevant patents that together form a significant
+Added: intellectual property position.
+Added: Our patents relate to the basic shielding and monitoring technologies that we incorporate into our AEM
+Added: As of March 31, 2025, we have 21 unexpired United States patents relating to specific implementations of shielding and monitoring
+Added: in instruments.
+Added: As of March 31, 2025, there are between one and twenty years remaining on our AEM patents.
+Added: We have four patent applications
+Added: in process, and we have four trademarks.
+Added: Our technical progress depends to a significant
+Added: degree on our ability to maintain patent protection for products and processes, to preserve our trade secrets, and to operate without
+Added: infringing the proprietary rights of third parties.
+Added: Our policy is to attempt to protect our technology by, among other things, filing
+Added: patent applications for technology that we consider important to the development of our business.
+Added: The validity and breadth of claims covered
+Added: in medical technology patents involve complex legal and factual questions and, therefore, may be highly uncertain.
+Added: Even though we hold
+Added: patented technology, others might copy our technology or otherwise incorporate our technology into their products.
+Added: We require our employees to execute non-disclosure
+Added: agreements upon commencement of employment.
+Added: These agreements generally provide that all confidential information developed or made known
+Added: to the individual by us during the course of the individual's employment is our property and is to be kept confidential and not to be
+Added: disclosed to third parties.
+Added: The electrosurgical device market is intensely
+Added: competitive and tends to be dominated by a relatively small group of large and well-financed companies.
+Added: We compete directly for customers
+Added: with those companies that currently make conventional electrosurgical instruments.
+Added: Larger competitors include Advanced Surgical Technologies
+Added: Group (a division of Medtronic plc) and Ethicon Endo-Surgery (a division of Johnson & Johnson).
+Added: While we know of no competitor (including
+Added: those referenced above) that can provide a continuous solution to stray electrosurgical burns, the manufacturers of conventional (non-monitored,
+Added: non-shielded) instruments will resist any loss of market share resulting from the presence of our products in the marketplace.
+Added: differentiates us from the competition is that while competitive technologies may somewhat reduce the risk of stray energy burns, only
+Added: AEM Technology completely eliminates it.
+Added: We also believe that manufacturers of products
+Added: based on alternative technology to monopolar electrosurgery are our competitors.
+Added: These alternative technologies include other “advanced
+Added: energy” technologies such as bipolar electrosurgery, laser surgery and ultrasonic dissector sealers.
+Added: Leading manufacturers in these
+Added: areas include Advanced Surgical Technologies Group, Gyrus/ACMI (a division of Olympus Corporation and a leader in bi-polar electrosurgery),
+Added: Lumenis (laser surgery) and Ethicon Endo-Surgery (a division of Johnson and Johnson, manufacturers of the harmonic scalpel).
+Added: that monopolar electrosurgery offers substantial competitive, functional and financial advantages over these alternative energy technologies
+Added: and will remain the primary tool for the surgeon, as it has been for decades.
+Added: However, the risk exists that these alternative technologies
+Added: may gain greater market share and that new competitive techniques may be developed and introduced.
+Added: As mentioned in the Sales and Marketing discussion,
+Added: the competitive issues involved in selling our AEM product line do not primarily revolve around a comparison of cost or features, but
+Added: rather involve generating an awareness of the inherent hazards of electrosurgery and the potential for injury to the patient.
+Added: This involves
+Added: conceptual selling, rather than just product selling, which results in a longer sales cycle and generally higher sales costs.
+Added: endorsements of AEM technology have greatly enhanced the credibility of AEM Instruments.
+Added: However, our efforts to increase market awareness
+Added: of this technology may not be successful, and our competitors may develop alternative strategies and/or products to counter our marketing
+Added: Many of our competitors
+Added: and potential competitors have widely-used products and significantly greater financial, technical, product development, marketing and
+Added: other resources.
+Added: In addition to our direct sales force, we utilize a network of independent distributor representatives in selected areas.
+Added: In some cases, our options for independent distribution have conflicting and competing product interests which compromise our ability
+Added: to make market advances in certain areas.
+Added: We may not be able to compete successfully against current and future competitors, and competitive
+Added: pressures faced by us may have a material adverse impact on our business, operating results and financial condition.
+Added: Government regulation in the United States and
+Added: other countries is a significant factor in the development and marketing of our products and in our ongoing manufacturing, research, and
+Added: development activities.
+Added: The FDA regulates us and our products under a number of statutes, including the Federal Food, Drug, and Cosmetics
+Added: Act (the “FDC Act”).
+Added: Under the FDC Act, medical devices are classified as Class I, II, or III based on the controls deemed
+Added: necessary to reasonably ensure their safety and effectiveness.
+Added: Class I devices are subject to the least extensive controls, as their safety
+Added: and effectiveness can be reasonably assured through general controls (e.g., labeling, pre-market notification, and adherence to QSR).
+Added: For Class II devices, safety and effectiveness can be assured using special controls (e.g., performance standards, post-market surveillance,
+Added: patient registries, and FDA guidelines).
+Added: Class III devices (e.g., life-sustaining or life-supporting implantable devices or new devices
+Added: which have been found not to be substantially equivalent to legally marketed devices) require the highest level of control, generally
+Added: requiring pre-market approval by the FDA to ensure their safety and effectiveness.
+Added: Our products are Class II devices.
+Added: If a manufacturer or distributor of medical devices
+Added: can establish that a proposed device is "substantially equivalent" to a legally marketed Class I or Class II medical device
+Added: or to a Class III medical device for which the FDA has not required a pre-market approval application, the manufacturer or distributor
+Added: may seek FDA marketing clearance for the device by filing a 510(k) pre-market notification.
+Added: Following submission of the 510(k) notification,
+Added: the manufacturer or distributor may not place the device into commercial distribution in the United States until an order has been issued
+Added: The FDA's target for issuing such orders is within 90 days of submission, but the process can take significantly longer.
+Added: order may declare the FDA's determination that the device is "substantially equivalent" to another legally marketed device and
+Added: allow the proposed device to be marketed in the United States.
+Added: The FDA may, however, determine that the proposed device is not substantially
+Added: equivalent or may require further information, such as additional test data, before deciding regarding substantial equivalence.
+Added: determination or request for additional information could delay market introduction and have a material adverse effect on our continued
+Added: We have received a favorable 510(k) notification for our AEM monitors and AEM Instruments, all of which are designated as
+Added: Class II medical devices.
+Added: Labeling and promotional activities are subject
+Added: to scrutiny by the FDA and, in certain instances, by the Federal Trade Commission.
+Added: The FDA also imposes post-marketing controls on us
+Added: and our products, and registration, listing, medical device reporting, post-market surveillance, device tracking and other requirements
+Added: on medical devices.
+Added: Failure to meet these pervasive FDA requirements or adverse FDA determinations regarding our clinical and preclinical
+Added: trials could subject us and/or our employees to injunction, prosecution, civil fines, seizure or recall of products, prohibition of sales
+Added: or suspension or withdrawal of any previously granted approvals, which could lead to a material adverse impact on our financial position
+Added: and results of operations.
+Added: The FDA regulates our quality control and manufacturing
+Added: procedures by requiring us and our contract manufacturers to demonstrate compliance with the QSR as specified in published FDA regulations.
+Added: The FDA requires manufacturers to register with the FDA, which subjects them to periodic FDA inspections of manufacturing facilities.
+Added: If violations of applicable regulations are noted during FDA inspections of our manufacturing facilities or the facilities of our contract
+Added: manufacturers, the continued marketing of our products may be adversely affected.
+Added: Such regulations are subject to change and depend heavily
+Added: on administrative interpretations.
+Added: In October 2015, the FDA conducted a QSR inspection of our facilities.
+Added: We believe that we have the
+Added: internal resources and processes in place to be reasonably assured that we are in compliance with all applicable United States regulations
+Added: regarding the manufacture and sale of medical devices.
+Added: However, if we were found not to be in compliance with the QSR, in the future,
+Added: such findings could result in a material adverse impact on our financial condition, results of operations and cash flows.
+Added: Sales of medical devices outside of the United
+Added: States are subject to United States export requirements and foreign regulatory requirements.
+Added: Legal restrictions on the sale of imported
+Added: medical devices vary from country to country.
+Added: The time required to obtain approval by a foreign country may be longer or shorter than
+Added: that required for FDA approval and the requirements may differ.
+Added: Our Certificate of Export from the United States Department of Health
+Added: and Human Services has expired and we will seek to renew it.
+Added: However, a specific foreign country in which we wish to sell our products
+Added: may not accept or continue to accept the Certificate of Export.
+Added: Entry into the European Economic Area market also requires prior certification
+Added: of our quality system and product documentation.
+Added: We achieved CE marking in August 2000, allowing a launch into the European marketplace.
+Added: Maintenance of the CE marking status requires annual audits of the quality system and technical documentation by our European Notified
+Added: Body, TUV Rheinland.
The most recent audit was completed in February 2023.
−Removed: Safety Communication was released by the FDA on May 29, 2020.
+Added: A Safety Communication was released by the FDA
+Added: on May 29, 2020.
It is on the FDA's website at:
https://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm608637.htm.
−Removed: The Safety Communication states that, "In addition to serving as an ignition source, monopolar energy use can directly result in
−Removed: unintended patient burns from capacitive coupling and intra-operative insulation failure.
−Removed: If a monopolar electrosurgical units (ESU)
−Removed: Do not activate when near or in contact with other instruments.”
+Added: The Safety Communication states that, "In
+Added: addition to serving as an ignition source, monopolar energy use can directly result in unintended patient burns from capacitive coupling
+Added: and intra-operative insulation failure.
+Added: If a monopolar electrosurgical units (ESU) is used:
+Added: Do not activate when near or in contact with
+Added: other instruments.”
Environmental
Laws and Regulations
−Removed: time to time we receive materials returned from customers, sales representatives and other sources which are potentially biologically
−Removed: These materials are segregated, and disposed of in accordance with specific procedures that minimize potential exposure to
−Removed: The costs of compliance with these procedures are not significant.
−Removed: Our operations, in general, do not involve the use of environmentally
−Removed: sensitive materials.
−Removed: are covered under comprehensive general liability insurance policies, which have per occurrence and aggregate limits of $1 million and
−Removed: $2 million, respectively, and a $10 million umbrella policy.
−Removed: We maintain customary property and casualty, workers’ compensation,
−Removed: employer liability and other commercial insurance policies.
−Removed: of March 31, 2024, we employed 22 full-time and 2 part-time individuals, of which 2 full-time and 2 part-time are engaged directly in
−Removed: research, development, and regulatory activities, 8 full-time in manufacturing/operations, 7 full-time in marketing and sales, and 5
−Removed: full-time time in administrative positions.
−Removed: None of our employees are covered by a collective bargaining agreement, and we consider our
−Removed: relations with our employees to be good.
−Removed: internet address is www.encision.com.
−Removed: We are not including the information contained in our website as part of, or incorporating it by
−Removed: reference into, this document.
−Removed: We make available, free of charge, through our website our annual reports on Form 10-K, quarterly reports
−Removed: on Form 10-Q, current reports on Form 8-K and amendments to these reports filed or furnished pursuant to Section 13(a) or 15(d)
−Removed: of the Exchange Act, as soon as reasonably practicable after we electronically file such materials with, or furnish such materials to,
+Added: From time to time we receive materials returned
+Added: from customers, sales representatives and other sources which are potentially biologically hazardous.
+Added: These materials are segregated,
+Added: and disposed of in accordance with specific procedures that minimize potential exposure to employees.
+Added: The costs of compliance with these
+Added: procedures are not significant.
+Added: Our operations, in general, do not involve the use of environmentally sensitive materials.
+Added: We are covered under comprehensive general liability
+Added: insurance policies, which have per occurrence and aggregate limits of $1 million and $2 million, respectively, and a $10 million umbrella
+Added: We maintain customary property and casualty, workers’ compensation, employer liability and other commercial insurance policies.
+Added: As of March 31, 2025, we employed 22 full-time
+Added: and 2 part-time individuals, of which 3 full-time and 1 part-time are engaged directly in research, development, and regulatory activities,
+Added: 6 full-time and 1 part time in manufacturing/operations, 6 full-time in marketing and sales, and 7 full-time time in administrative positions.
+Added: None of our employees are covered by a collective bargaining agreement, and we consider our relations with our employees to be good.
+Added: Available information
+Added: Our internet address is www.encision.com.
+Added: are not including the information contained in our website as part of, or incorporating it by reference into, this document.
+Added: We make available,
+Added: free of charge, through our website our annual reports on Form 10-K, quarterly reports on Form 10-Q, current reports on Form 8-K and amendments
+Added: to these reports filed or furnished pursuant to Section 13(a) or 15(d) of the Exchange Act, as soon as reasonably practicable after
+Added: we electronically file such materials with, or furnish such materials to, the SEC.
Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.