UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
DC 20549
FORM
10-Q
(Mark
One)
☒
QUARTERLY
REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For
the quarterly period ended March 31, 2022
OR
☐
TRANSITION
REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For
the transition period from _____ to _____
Commission
File Number: 001-40901
LUCID
DIAGNOSTICS INC.
(Exact
Name of Registrant as Specified in Its Charter)
Delaware
82-5488042
(State
or Other Jurisdiction of
(IRS
Employer
Incorporation
or Organization)
Identification
No.)
One
Grand Central Place
60
E. 42nd Street
Suite
4600
New
York , NY 10165
10165
(Address
of Principal Executive Offices
(Zip
Code)
(212)
949-4319
(Registrant’s
Telephone Number, Including Area Code)
Securities
registered under Section 12(b) of the Exchange Act:
Title
of each Class
Trading
Symbol(s)
Name
of each Exchange on which Registered
Common
Stock, $0.001 par value per share
LUCD
The
NASDAQ Stock Market LLC
Securities
registered under Section 12(g) of the Exchange Act: None
Indicate
by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange
Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2)
has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐
Indicate
by check mark whether the registrant has submitted electronically Interactive Data File required to be submitted pursuant to Rule 405
of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was
required to submit such files). Yes ☒ No ☐
Indicate
by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting
company, or an emerging growth company. See the definitions of “large accelerated filer”, “accelerated filer”, “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large
Accelerated filer
☐
Accelerated
filed
☐
Non-accelerated
filer
☒
Smaller
reporting company
☒
Emerging
growth company
☒
If
an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying
with any new or revised financial accounting standards provided pursuant to section 13(c) of the Exchange Act ☐
Indicate
by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness
of its internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C.7262(b)) by the registered
public accounting firm that prepared or issued its audit report. ☐
Indicate
by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No ☒
As
of May 12, 2022 there were 38,138,036 shares of the registrant’s Common Stock, par value $0.001 per share, issued
(with such number of shares inclusive of shares of common stock underlying unvested restricted stock awards granted under the Lucid Diagnostics
Inc. 2018 Long-Term Incentive Equity Plan as of such date).
TABLE
OF CONTENTS
Page
Part I - Financial Information
Item
1.
Financial Statements
Condensed Consolidated Balance Sheets (unaudited) as of March 31, 2022 and December 31, 2021
1
Condensed Consolidated Statements of Operations (unaudited) for the three months ended March 31, 2022 and 2021
2
Condensed Consolidated Statements of Changes in Stockholders’ Equity (Deficit) (unaudited) for the three months ended March 31, 2022 and 2021
3
Condensed Consolidated Statements of Cash Flows (unaudited) for the three months ended March 31, 2022 and 2021
4
Notes to Unaudited Condensed Consolidated Financial Statements
5
Item
2.
Management’s Discussion and Analysis of Financial Condition and Results of Operations
21
Item
4.
Controls and Procedures
32
Part II - Other Information
Item
1.
Legal Proceedings
33
Item
5.
Other Information
33
Item
6.
Exhibits
33
Signature
34
Exhibit Index
35
i
Part
I. Financial Information
Item
1. Financial Statements
LUCID
DIAGNOSTICS INC.
and
SUBSIDIARY
(a
majority-owned subsidiary of PAVmed Inc.)
CONDENSED
CONSOLIDATED BALANCE SHEETS
(in
thousands except number of shares and per share data - unaudited)
March 31, 2022
December 31, 2021
Assets:
Current assets:
Cash
$ 47,919
$ 53,656
Accounts receivable
89
200
Prepaid expenses, deposits, and other current assets
4,324
3,447
Total current assets
52,332
57,303
Fixed assets, net
1,095
971
Operating lease right-of-use assets
2,224
—
Intangible assets, net
5,714
—
Other assets
695
725
Total assets
$ 62,060
$ 58,999
Liabilities, Preferred Stock and Stockholders’ Equity
Current liabilities:
Accounts payable
$ 4,462
$ 1,490
Accrued expenses and other current liabilities
2,226
1,113
Operating lease liabilities, current portion
769
—
Contingent purchase consideration payable
4,887
—
Due To: PAVmed Inc. - MSA Fee and operating expenses
1,770
1,657
Total current liabilities
14,114
4,260
Long-term liabilities
Operating lease liabilities, less current portion
1,455
—
Total long-term liabilities
1,455
—
Total liabilities
15,569
4,260
Commitments and contingencies
Stockholders’ Equity:
Preferred stock, $ 0.001 par value, 20,000,000 shares authorized; no shares issued and outstanding as of March 31, 2022 and December 31, 2021
—
—
Common stock, $ 0.001 par value, 100,000,000 shares authorized; 35,171,796 and 34,917,907 shares issued and outstanding as of March 31, 2022 and December 31, 2021, respectively
35
35
Additional paid-in capital
100,630
96,608
Accumulated deficit
( 54,174 )
( 41,904 )
Total Stockholders’ Equity
46,491
54,739
Total Liabilities and Stockholders’ Equity
$ 62,060
$ 58,999
See
accompanying notes to the unaudited condensed consolidated financial statements.
1
LUCID
DIAGNOSTICS INC.
and
SUBSIDIARY
(a
majority-owned subsidiary of PAVmed Inc.)
CONDENSED
CONSOLIDATED STATEMENTS OF OPERATIONS
(in
thousands except number of shares and per share data - unaudited)
2022
2021
Three Months Ended March 31,
2022
2021
Revenue
$ 189
$ —
Cost of revenue
369
—
Gross profit (loss)
( 180 )
—
Operating expenses:
Sales and marketing
3,318
689
General and administrative
5,718
1,212
Research and development
2,881
1,752
Total operating expenses
11,917
3,653
Loss from operations
( 12,097 )
( 3,653 )
Other income (expense):
Change in fair value - contingent consideration payable
( 173 )
—
Other income (expense), net
( 173 )
—
Loss before provision for income tax
( 12,270 )
( 3,653 )
Provision for income taxes
—
—
Net loss
$ ( 12,270 )
$ ( 3,653 )
Net loss per share - basic and diluted
$ ( 0.35
)
$ ( 0.26 )
Weighted average common shares outstanding, basic and diluted
35,123,039
14,114,437
See
accompanying notes to the unaudited condensed consolidated financial statements.
2
LUCID
DIAGNOSTICS INC.
and
SUBSIDIARY
(a
majority-owned subsidiary of PAVmed Inc.)
CONDENSED
CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS’ EQUITY (DEFICIT)
for
the THREE MONTHS ENDED March 31, 2022 and 2021
(in
thousands except number of shares and per share data - unaudited)
Shares
Amount
Capital
Deficit
Total
Common Stock
Additional Paid-In
Accumulated
Shares
Amount
Capital
Deficit
Total
Balance as of December 31, 2021
34,917,907
$ 35
$ 96,608
$ ( 41,904 )
$ 54,739
Exercise - stock options - Lucid Diagnostics Inc. 2018 Equity Plan
253,889
—
187
—
187
Stock-based compensation - Lucid Diagnostics Inc. 2018 Equity Plan
—
—
3,537
—
3,537
Stock-based compensation - PAVmed Inc. 2014 Equity Plan
—
—
298
—
298
Net Loss
—
—
—
( 12,270 )
( 12,270 )
Balance as of March 31, 2022
35,171,796
$ 35
$ 100,630
$ ( 54,174 )
$ 46,491
Shares
Amount
Capital
Deficit
Total
Common Stock
Additional Paid-In
Accumulated
Shares
Amount
Capital
Deficit
Total
Balance as of December 31, 2020
14,114,707
$ 10
$ 298
$ ( 13,826 )
$ ( 13,518 )
Stock-based compensation - Lucid Diagnostics Inc. 2018 Equity Plan
—
—
802
—
802
Stock-based compensation - PAVmed Inc. 2014 Equity Plan
—
—
3
—
3
Net loss
—
—
—
( 3,653 )
( 3,653 )
Balance as of March 31, 2021
14,114,707
$ 10
$ 1,103
$ ( 17,479 )
$ ( 16,366 )
See
accompanying notes to the unaudited condensed consolidated financial statements.
3
LUCID
DIAGNOSTICS INC.
and
SUBSIDIARY
(a
majority-owned subsidiary of PAVmed Inc.)
CONDENSED
CONSOLIDATED STATEMENTS OF CASH FLOWS
(in
thousands except number of shares and per share data - unaudited)
2022
2021
Three Months Ended March 31,
2022
2021
Cash flows from operating activities
Net loss
$ ( 12,270 )
$ ( 3,653 )
Adjustments to reconcile net loss to net cash used in operating activities
Depreciation expense
24
3
Stock-based compensation - Lucid Diagnostics Inc. 2018 Equity Plan
3,537
802
Stock-based compensation - PAVmed Inc. 2014 Equity Plan
298
3
Fair value adjustment to contingent consideration payable
173
—
Changes in operating assets and liabilities:
Accounts receivable
111
—
Prepaid expenses and other current assets
168
104
Accounts payable
1,958
( 1,269 )
Accrued expenses and other current liabilities
112
( 108 )
Due To: PAVmed Inc. - operating expenses paid on-behalf-of Lucid Diagnostics Inc.
( 510 )
33
Due To: PAVmed Inc. - Management Services Agreement Fee
—
770
Due To: PAVmed Inc. - Employee Related Costs
623
—
Net cash flows used in operating activities
( 5,776 )
( 3,315 )
Cash flows from investing activities
Purchase of equipment
( 148 )
( 9 )
Net cash flows used in investing activities
( 148 )
( 9 )
Cash flows from financing activities
Proceeds – exercise of stock options
187
—
Proceeds – Due To: PAVmed Inc. - working capital cash advances
—
3,300
Net cash flows provided by financing activities
187
3,300
Net increase (decrease) in cash
( 5,737 )
( 24 )
Cash, beginning of period
53,656
111
Cash, end of period
$ 47,919
$ 87
See
accompanying notes to the unaudited condensed consolidated financial statements.
4
LUCID
DIAGNOSTICS INC.
and
SUBSIDIARY
(a
majority-owned subsidiary of PAVmed Inc.)
NOTES
TO UNAUDITED CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(amounts
in these accompanying notes are presented in thousands, except number of shares and per-share amounts.)
Note
1 — Summary Description of the Company
The
accompanying unaudited condensed consolidated financial statements are those of Lucid Diagnostics Inc. (“Lucid Diagnostics”
or “the Company”), which was incorporated in the State of Delaware on May 8, 2018. Lucid Diagnostics Inc. is a majority-owned
subsidiary of PAVmed Inc., as discussed below.
The
Company operates in one segment as a commercial-stage medical diagnostics technology company focused on the millions of patients with
gastroesophageal reflux disease - “GERD” - which is also known as chronic heartburn, acid reflux or simply reflux, who are
at risk for developing esophageal precancer and cancer, specifically highly lethal esophageal adenocarcinoma (EAC).
Lucid
Diagnostics Inc. entered into a patent license agreement with Case Western Reserve University (“CWRU”), captioned the Amended
and Restated License Agreement, dated August 23, 2021 (“Amended CWRU License Agreement”). The Amended CWRU License Agreement
is a successor to and replaced in its entirety the previous CWRU License Agreement, dated May 12, 2018. The Amended CWRU License Agreement
terminates upon the expiration of certain related patents, or on May 12, 2038 in countries where no such patents exist, or upon expiration
of any exclusive marketing rights granted by the FDA or other U.S. government agency, whichever comes later.
The
Amended CWRU License Agreement (as did the predecessor CWRU License Agreement) provides for the exclusive worldwide license of the intellectual
property rights for the proprietary technologies of two distinct technology components - the “EsoCheck Cell Collection Device”
referred to as “EsoCheck®”; and a panel of proprietary methylated DNA biomarkers, a laboratory developed test (“LDT”),
referred to as “EsoGuard®”; and together are collectively referred to as the “EsoGuard Technology”. See Note
3, Patent License Agreement – Case Western Reserve University, for a discussion of the Amended CWRU License Agreement.
Since
its inception, the Company has advanced the proprietary technologies underlying EsoGuard and EsoCheck from the academic research laboratory
to commercial diagnostics tests and devices with scalable manufacturing capacity. The Company is presently focused on expanding commercialization
across multiple sales channels, including: the communication and education of medical practitioners and clinicians of the EsoGuard LDT;
and establishing “Lucid Diagnostics Test Centers” for the collection of cell samples using EsoCheck Up and until February
25, 2022, delivery of the collected cell samples were sent to ResearchDX Inc. (“RDx”), a CLIA certified commercial
laboratory service provider, for the performance of the EsoGuard LDT. See LucidDx Labs, Inc. and Asset Purchase Agreement-February
2022 below. Additionally, the Company is conducting two concurrent clinical trials, including each of: the “EsoGuard screening
study” (“ESOGUARD-BE-1”); and the “EsoGuard case control study” (“ESOGUARD-BE-2”), to support
a United States Food and Drug Administration (“FDA”) pre-market approval (“PMA”) of the use of EsoGuard and EsoCheck
as an in-vitro diagnostic medical device (“IVD”). Further, the Company is developing expanded clinical evidence to support
recommendation of our products in professional society guidelines.
5
Note 1 — Summary Description of the Company - continued
Since
its inception and through the date of the Company’s IPO on October 14, 2021, the operations of Lucid Diagnostics Inc. have been
funded by PAVmed Inc. providing working capital cash advances and the payment by PAVmed Inc. of certain operating expenses on-behalf-of
Lucid Diagnostics Inc. Additionally, the daily operations of Lucid Diagnostics Inc. continue to be managed by personnel employed by PAVmed
Inc., for which Lucid Diagnostics Inc. incurs expense according to the provisions of a Management Services Agreement between Lucid Diagnostics
Inc. and PAVmed Inc. See Note 5, Related Party Transactions , for information with respect to the Management Services Agreement;
and Note 6, Due To PAVmed Inc. , for further information with respect to amounts owed to PAVmed Inc. by Lucid Diagnostics Inc.
The
Company is subject to all of the risks and uncertainties typically faced by medical device and diagnostic and medical device companies
that devote substantially all of their efforts to the commercialization of their initial product and services and ongoing research and
development activities and conducting clinical trials. The Company expects to continue to experience recurring losses from operations
and will continue to fund its operations with debt and equity financing transactions. Notwithstanding, however, with the cash on-hand
as of the date hereof and other debt and equity committed sources of capital with Lucid and its parent company, PAVmed, the Company expects
to be able to fund its future operations for one year from the date of the issue of the Company’s unaudited condensed consolidated
financial statements, as included herein in this Quarterly Report on Form 10-Q for the period ended March 31, 2022.
Lucid
Diagnostics Inc. Initial Public Offering - October 14, 2021
On
October 14, 2021, Lucid Diagnostics Inc. completed an initial public offering (“IPO”) of its common stock under an effective
registration statement on Form S-1 (SEC File No. 333-259721), wherein a total of 5.0 million IPO shares of common stock were issued,
with such total IPO shares inclusive of 571,428 IPO shares issued to PAVmed Inc., at an IPO price of $ 14.00 per share, resulting gross
proceeds of $ 70.0 million, before underwriting fees of $ 4.9 million, and approximately $ 0.7 million of offering costs incurred by the
Company.
LucidDx Labs Inc.
In
December 2021, Lucid Diagnostics, Inc. formed a new wholly owned subsidiary, LucidDx Labs Inc., principally to construct and operate
a Company-owned Commercial Lab Improvements Act (“CLIA”) certified, College of American Pathologists (“CAP”)
accredited commercial clinical laboratory.
On February 25, 2022, LucidDx
Labs, Inc., entered into an asset purchase agreement (“APA”) with ResearchDx, Inc. (“RDx”), an unrelated third-party
- “RDx APA”. Under the RDx APA, LucidDx Labs Inc. acquired certain assets from RDx to be combined with LucidDx Labs Inc.
purchased and leased property and equipment to establish a Company-owned CLIA certified, CAP accredited commercial clinical laboratory
capable of performing the EsoGuard® Esophageal DNA assay, inclusive of DNA extraction, next generation sequencing (“NGS”)
and specimen storage. See Note 7, Acquisitions - Asset Purchase Agreement - Research Dx Inc. , for a further discussion of the
RDx APA.
6
Note
2 — Summary of Significant Accounting Policies and Recent Accounting Standards Updates
Significant
Accounting Policies
The
Company’s significant accounting policies are as disclosed in the Company’s annual report on Form 10-K for the year ended
December 31, 2021 as filed with the SEC on April 6, 2022, except as otherwise noted herein below.
Basis
of Presentation
The
accompanying unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally
accepted in the United States of America (“U.S. GAAP”), and applicable rules and regulations of the United States Securities
and Exchange Commission (“SEC”), and include the accounts of the Company and its wholly-owned subsidiary, LucidDx Labs Inc.
All intercompany transactions and balances have been eliminated in consolidation. Lucid Diagnostics Inc. (“the Company”)
is a majority-owned consolidated subsidiary of PAVmed Inc., which has a majority equity ownership interest and has financial control
of Lucid Diagnostics Inc. The Company manages its operations as a single operating segment for the purposes of assessing performance
and making operating decisions.
All
amounts in the accompanying consolidated financial statements and these notes thereto are presented in thousands of dollars, if not otherwise
noted as being presented in millions of dollars, except for shares and per share amounts.
Use
of Estimates
In
preparing the unaudited condensed consolidated financial statements in conformity with U.S. GAAP, management is required to make estimates
and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent losses, as of the date of
the consolidated financial statements, as well as the reported amounts of revenue and expenses during the reporting period. Significant
estimates in these consolidated financial statements include those related to the estimated fair value of stock-based equity awards and
contingent consideration. Other significant estimates include the provision or benefit for income taxes and the corresponding
valuation allowance on deferred tax assets. Additionally, management’s assessment of the Company’s ability to continue as
a going concern involves the estimation of the amount and timing of future cash inflows and outflows. On an ongoing basis, the Company
evaluates its estimates and assumptions. The Company bases its estimates on historical experience and on various other assumptions believed
to be reasonable. Due to inherent uncertainty involved in making estimates, actual results reported in future periods may be affected
by changes in these estimates.
Contingent
Consideration
Contingent
Consideration relates to the potential payment for an acquisition that is contingent upon the achievement of the acquired business meeting
certain milestones. The Company records contingent consideration at fair value at the date of acquisition based on the consideration
expected to be transferred. For potential payments related to milestone achievements, the Company estimated the
fair value based on the probability of achievement of such milestones. The assumptions utilized in the calculation of the acquisition
date fair value include probability of success and the discount rates. Contingent consideration involves certain assumptions requiring
significant judgment and actual results may differ from assumed and estimated amounts. Contingent consideration is remeasured each reporting
period, and subsequent changes in fair value, including accretion for the passage of time, are recognized within other income (expense),
net in the Company’s unaudited condensed consolidated statements of operations.
7
Note
2 — Summary of Significant Accounting Policies and Recent Accounting Standards Updates - continued
Recent
Accounting Standards Updates Adopted
Effective
December 31, 2021, the Company adopted FASB ASC Topic 842, Leases, (“ASC 842”). ASC 842 established a right-of-use (“ROU”)
model requiring a lessee to recognize a ROU asset and a lease liability for all leases with terms greater-than 12 months. Leases are
classified as either finance or operating, with classification affecting the pattern of expense recognition in the income statement.
The Company’s adoption of ASC 842 did not have an effect on the Company’s consolidated financial statements. See Note 9,
Leases.
Note
3 — Patent License Agreement - Case Western Reserve University
The Company has a patent license
agreement with CWRU which provides for each of patent fees reimbursement payments, milestone payments and royalty payments - each as
discussed below. For further details of this agreement, see Note 3 of the Company’s Consolidated Financial Statements in the Company’s
Form 10-K for the year ended December 31, 2021.
Lucid
Diagnostics Inc. is responsible for reimbursement of certain CWRU billed patent fees. See Note 5, Related Party Transactions ,
for patent fee reimbursement payments paid to CWRU in the periods ended March 31, 2022 and 2021.
The
CWRU License Agreement contained milestones for
which a $ 75
research and development expense was recognized
and paid with respect to the achievement of the regulatory milestone related to FDA clearance of EsoCheck. The CWRU License Agreement
was amended effective February 12, 2021 such that a regulatory milestone related to FDA PMA submission of a licensed product
(“PMA Milestone”) is included in the Amended CWRU License Agreement, and is the sole remaining unachieved milestone, for
which a $ 200 milestone
payment would be payable to CWRU upon its achievement.
8
Note
3 — Patent License Agreement - Case Western Reserve University - continued
Under
the Amended CWRU License Agreement, the Company is required to pay a royalty fee to CWRU with respect to the “Licensed Products”
(as defined in the CWRU License Agreement) of a percentage of “Net Sales”, as defined in the Amended CWRU License Agreement,
as follows: 5.0% of Net Sales up to $100.0 million per year; and 8.0% of Net Sales of $100.0 million or greater per year, with such amounts
subject-to a minimum annual royalty fee. The Company recorded a royalty expense of $ 10 for the three months ended March 31, 2022
Note
4 — Revenue from Contracts with Customers
Revenue
is recognized when the satisfaction of the performance obligation occurs, which is when the delivery of product and /or the provision
of service is rendered, and is measured as the amount of estimated consideration expected to be realized. In the period ended March 31,
2022, the Company recognized revenue under the EsoGuard Commercialization Agreement, dated August 1, 2021, as discussed below.
EsoGuard
Commercialization Agreement
The
Company entered into the EsoGuard Commercialization Agreement, dated August 1, 2021, with its CLIA certified commercial laboratory
service provider, ResearchDX Inc. (“RDx”), an unrelated third-party. The EsoGuard Commercialization Agreement initial term
was on a month-to-month basis and was terminated on February 25, 2022 upon the execution of the RDx APA. See Note 7, Acquisitions
- Asset Purchase Agreement - Research Dx Inc. , for a further discussion of the RDx APA.
Revenue
Recognized
In
the three months ended March 31, 2022, the Company recognized total revenue of $ 189
under the EsoGuard Commercialization Agreement ,
which represents the minimum fixed monthly fee of
$ 100
for the period January 1, 2022 to the February
25, 2022 termination date as discussed above. The monthly fee was deemed to be collectible for such period as RDx has timely
paid the applicable respective monthly fee.
Cost
of Revenue
The
cost of revenue recognized with respect to the revenue recognized under the EsoGuard Commercialization Agreement for the period January
1, 2022 to February 25, 2022 totaled $ 369 ,
inclusive of employee related costs of employees engaged in the delivery of the administration to patients of the EsoCheck cell sample
collection procedure, EsoCheck devices and EsoGuard mailers (cell sample shipping costs) distributed to medical practitioners’
locations and the Lucid Test Centers; Lucid Test Centers operating expenses, including rent expense and supplies; and royalty fees incurred
under the Amended CWRU License Agreement.
9
Note
5 — Related Party Transactions
Case
Western Reserve University and Physician Inventors - CWRU License Agreement
Case
Western Reserve University (“CWRU”) and each of the three physician inventors of the intellectual property licensed under
the CWRU License Agreement (“Physician Inventors”) each hold equity ownership minority interests in Lucid Diagnostics Inc.
The expenses incurred with respect to the CWRU License Agreement and the three Physician Inventors, as classified in the accompanying
consolidated statement of operations for the periods indicated are summarized as follows:
Schedule of Incurred Expenses of Minority Shareholders
2022
2021
Three Months Ended March 31,
2022
2021
Cost of Revenue
CWRU – Royalty Fee
$ 9
$ —
Cost of Revenue
369
-
General and Administrative Expense
Stock-based compensation expense – Physician Inventors’ restricted stock awards
272
91
General and Administrative Expense
5,718
1,212
Research and Development Expense
CWRU License Agreement - reimbursement of patent legal fees
—
—
Fees - Physician Inventors’ consulting agreements
8
13
Sponsored research agreement
3
—
Stock-based compensation expense – Physician Inventors’ stock options
46
6
Research and Development Expense
2,881
1,752
Total Related Party Expenses
$ 338
$ 110
Lucid
Diagnostics Inc. entered into consulting agreements with each of the three Physician Inventors, with each such consulting agreement providing
for compensation on a contractual rate per hour for consulting services provided, and an expiration date of May 12, 2024, upon the agreements’
renewal effective May 12, 2021. Additionally, as discussed below, each of the Physician Inventors have been granted stock options under
the PAVmed Inc. 2014 Long-Term Incentive Equity Plan, and stock options and restricted stock awards under the Lucid Diagnostics Inc.
2018 Long-Term Incentive Equity Plan.
Under
each of their respective (initial) consulting agreements with Lucid Diagnostics Inc., the three Physician Inventors were each granted
25,000 stock options under the PAVmed Inc. 2014 Equity Plan, with a grant date of May 12, 2018, an exercise price of $ 1.59 per share
of common stock of PAVmed Inc., vesting ratably on a quarterly basis commencing June 30, 2018 and ending March 31, 2021, and a contractual
period of ten years from the date of grant. As of March 31, 2021, such stock options were fully vested and exercisable. Subsequent to
March 31, 2021, each of the Physician Inventors were granted 50,000 stock options under the PAVmed Inc. 2014 Equity Plan, with a grant
date of June 21, 2021, an exercise price of $ 6.41 per share of common stock of PAVmed Inc., vesting ratably on a quarterly basis commencing
June 30, 2021 and ending March 31, 2024, and a contractual period of ten years from the date of grant.
On
March 1, 2021, restricted stock awards were granted under the Lucid Diagnostics Inc. 2018 Equity Plan to each of the three Physician
Inventors, with such restricted stock awards having a single vesting date of March 1, 2023, with the fair value of such restricted stock
awards recognized as stock-based compensation expense ratably on a straight-line basis over the vesting period, which is commensurate
with the service period. The restricted stock awards are subject to forfeiture if the requisite service period is not completed.
10
Note
5 — Related Party Transactions - continued
PAVmed
Inc. - Management Services Agreement
The
daily operations of Lucid Diagnostics Inc. are managed by personnel employed by PAVmed Inc., for which Lucid Diagnostics Inc. incurs
a service fee, referred to as the “MSA Fee”, according to the provisions of a Management Services Agreement (“MSA”)
with PAVmed Inc. The MSA does not have a termination date, but may be terminated by the Lucid Diagnostics Inc. board of directors. The
MSA Fee is charged on a quarterly basis and is subject-to periodic adjustment corresponding with changes in the number of PAVmed Inc.
employees providing services to Lucid Diagnostics Inc., with the change in the MSA Fee approved by each of the Lucid Diagnostics Inc.
and PAVmed Inc. board of directors.
Lucid
Diagnostics Inc. recognized MSA Fee expense of $ 1,170 and $ 770
in the periods ended March 31, 2022 and 2021,
respectively. The MSA Fee expense classification in the unaudited condensed consolidated statement of operations for the periods noted
is as follows:
Schedule of MSA Fee Expense Classification in Unaudited Condensed Statement of Operations
2022
2021
Three Months Ended March 31,
2022
2021
Cost of Revenues
$ —
$ —
Sales & Marketing
183
323
General & Administrative
640
270
Research & Development
347
177
Total MSA Fee
$ 1,170
$ 770
The
classification of the MSA Fee as presented above is based on the PAVmed Inc. classification of employee salary expense. In this regard,
PAVmed Inc. classifies employee salary expense as cost-of-revenue for employees engaged in service delivery under the EsoGuard Commercialization
Agreement, and sales and marketing expenses for employees performing sales, marketing, and reimbursement activities and functions, general
and administrative, and research and development except for those employees who are engaged in product and services engineering development
and design and /or clinical trials activities, for which such employee salary is classified as research and development expense.
Other
Related Party Transactions
Lucid
Diagnostics Inc. previously entered into a consulting agreement with Stanley N. Lapidus, effective June 2020 with such consulting agreement
providing for compensation on a contractual rate per hour for consulting services provided. In July 2021, Mr. Lapidus was appointed as
Vice Chairman of the Board of Directors of Lucid Diagnostics Inc. Lucid Diagnostics Inc. recognized general and administrative expense
of $ 6 in
the period ended March 31, 2021 in connection with the consulting agreement.
11
Note
6 — Due To PAVmed Inc.
The
aggregate Due To: PAVmed Inc., inclusive of the Senior Unsecured Promissory Note, for the periods indicated is summarized as follows:
Schedule of Senior Unsecured Promissory Note
Working Capital Cash Advances
PAVmed Inc. OBO Payments
Employee-Related
Costs
MSA Fees
Total
Balance - December 31, 2021
$ —
$ 620
$ 1,037
$ —
$ 1,657
MSA fees
—
—
—
1,170
1,170
On Behalf Of (OBO) activities
—
153
—
—
153
ERC - Payroll & Benefits
—
—
2,122
—
2,122
Cash payments to PAVmed Inc.
—
( 662 )
( 1,500 )
( 1,170 )
( 3,332 )
Balance - March 31, 2022
$ —
$ 111
$ 1,659
$ —
$ 1,770
Prior
to the Company’s initial public offering (IPO), it
principally financed its operations through working capital cash advances from PAVmed Inc. and the periodic payment of certain operating
expenses by PAVmed Inc. on-behalf-of Lucid Diagnostics Inc. (the “PAVmed Inc. OBO Payments”). Additionally, the daily operations
of Lucid Diagnostics Inc. are managed by personnel employed by PAVmed Inc., for which the Company incurs expense according to the provisions
of a Management Services Agreement (the “MSA”) between the Company and PAVmed Inc (the “MSA Fee”). See
Note 5 , Related Party Transactions , for further information regarding the MSA.
12
Note
7 — Acquisitions
Asset
Purchase Agreement - ResearchDx Inc.
On
February 25, 2022, LucidDx Labs, Inc., entered into an asset purchase agreement (“APA”) with ResearchDx, Inc. (“RDx”),
an unrelated third-party - “RDx APA”. Under the RDx APA, LucidDx Labs Inc. acquired certain assets from RDx to be combined
with LucidDx Labs Inc. purchased and leased property and equipment to establish a Company-owned CLIA certified, CAP accredited commercial
clinical laboratory capable of performing the EsoGuard® Esophageal DNA assay, inclusive of DNA extraction, next generation sequencing
(“NGS”) and specimen storage. Prior to consummation of
the RDx APA, RDx provided such laboratory services at its owned CLIA-certified, CAP-accredited laboratory.
As of March 31, 2022, the
Company’s preliminary analysis is the RDx APA transaction is a business combination, resulting in the recognition
and measurement of a preliminary purchase consideration in accordance with the valuation methodology described in Note
2, Summary of Significant Accounting Policies and Recent Accounting Standards Updates .
Under
the terms of the RDx APA, LucidDx Labs Inc. will pay RDx an aggregate purchase price of up to $ 6.2
million for the acquired assets. The total
of $ 6.2
million is comprised of non-contingent purchase
consideration of $ 1.0
million (included in “Accrued expenses
and other liabilities” in the accompanying unaudited condensed consolidated balance sheets, as of March 31, 2022), and contingent
purchase consideration of a total of $ 5.2
million face value, with such contingent purchase
consideration having a preliminary $ 4,714
initial estimated fair value
as of the transaction date. The preliminary $ 5,714
purchase consideration (inclusive of both
the non-contingent and contingent purchase consideration discussed above) is unallocated as of March 31, 2022, and as such is included
in intangible assets in the accompanying unaudited consolidated balance sheet. The preliminary estimated fair value of the contingent
purchase price consideration and the identification and estimated fair value of acquired assets are subject-to further revision.
Concurrent with the RDx
APA, LucidDx Labs Inc. and RDx also entered into a management services agreement (“RDx MSA”), with a term of three
years , and a total of approximately $ 1.8
million payable in equal quarterly payments.
Pro Forma Information.
The
RDx APA transaction impact for purposes of pro forma financial statement disclosures would have primarily impacted the Company’s
EsoGuard Commercialization Agreement with RDx, summarized as follows:
Schedule
of Business Acquisition Pro Forma Information
Three Months Ended March 31,
2022
2021
Revenue
As reported
$ 189
$ —
Pro forma
$ —
$ —
Net Loss
As reported
$ ( 12,270 )
$ ( 3,653 )
Pro forma
$ ( 12,459 )
$ ( 3,653 )
Basic and diluted net loss per share
As reported
$ ( 0.35 )
$ ( 0.26 )
Pro forma
$ ( 0.35 )
$ ( 0.26 )
13
Note
8 — Prepaid Expenses, Deposits, and Other Current Assets
Prepaid
expenses and other current assets consisted of the following as of:
Schedule of Prepaid Expenses and Other Current Assets
March 31, 2022
December 31, 2021
Advanced payments to service providers and suppliers
$ 259
$ 260
Prepaid insurance
1,052
1,578
Deposits
1,668
1,116
Deferred financing charges
1,014
—
EsoCheck cell collection supplies
266
434
EsoGuard mailer supplies
65
59
Total prepaid expenses, deposits and other current assets
$ 4,324
$ 3,447
Note
9 — Leases
Supplemental
disclosure of cash flow information related to the Company’s cash and non-cash activities with its leases are as follows:
Schedule
of Cash Flow Supplemental Information
2022
2021
Three Months Ended March 31,
2022
2021
Cash paid for amounts included in the measurement of lease liabilities
Operating cash flows from operating leases
$ 224
$ —
Non-cash investing and financing activities
Right-of-use assets obtained in exchange for new operating lease liabilities
$ 2,404
$ —
Weighted-average remaining lease term - operating leases (in years)
2.72
—
Weighted-average discount rate - operating leases
7.875 %
— %
As
of March 31, 2022, the Company’s right-of-use assets from operating leases are $ 2,224 ,
which are reporting in right-of-use assets - operating leases in the unaudited condensed consolidated balance sheets. As of March 31,
2022, the Company has outstanding operating lease obligations of $ 2,224 ,
of which $ 769 is
reported in operating lease liabilities, current portion and $ 1,455
is reporting in operating lease liabilities less
current portion in the Company’s unaudited condensed consolidated balance sheets. The Company did not have operating leases as
of December 31, 2021. The Company calculates its incremental borrowing rates for specific lease terms, used to discount future lease
payments, as a function of the financing terms the Company would likely receive on the open market.
14
Note
10 — Financial
Instruments Fair Value Measurements
Recurring
Fair Value Measurements
The
fair value hierarchy table for the reporting dates noted is as follows:
Schedule
of Fair value Measurement on Recurring Basis
Level-1 Inputs
Level-2 Inputs
Level-3 Inputs
Total
Fair Value Measurement on a Recurring Basis at Reporting
Date Using (1)
Level-1 Inputs
Level-2 Inputs
Level-3 Inputs
Total
March 31, 2022
Contingent consideration payable (1)
$ —
$ —
$ 4,887
$ 4,887
Totals (1)
$ —
$ —
$ 4,887
$ 4,887
(1) As noted above,
as presented in the fair value hierarchy table, Level-1 represents quoted prices in active markets for identical items, Level-2 represents
significant other observable inputs, and Level-3 represents significant unobservable inputs. There were no transfers between the respective
Levels during the period ended March 31, 2022.
Fair
value measurements of contingent consideration
The
Company recorded $ 4.9
million, which is the fair value, of contingent
consideration related to the RDx acquisition. The Company is required to make contingent consideration payments of up to $ 5.2
million related to the RDx APA agreement. The
contingent agreement is based on achieving milestones to obtain certain certifications and licensing rights. The Company estimated
the fair value on a probability based model that assessed achievement of such milestones. The model used present
value factors, that applied probability ranges of 94 - 99 % , a discount rate of 7.875 % and achievement times ranging from one
month to six months to achieve the respective milestones.
The
final settlement of contingent consideration liabilities for the acquisition could vary from current estimates based on
the actual results of the financial measures described above. This liability is considered to be a Level 3 financial liability that is
re-measured each reporting period. The change in fair value of contingent consideration for these acquisitions is included in other income
(expense), net.
The
following table presents a reconciliation of the liability measured at fair value on a recurring basis using significant unobservable
inputs (Level 3):
Schedule
of Reconciliation of Liability Measured at Fair Value Recurring Basis Using Unobservable Inputs
March 31, 2022
Fair value of contingent consideration at the date of acquisition
$ 4,714
Payments
—
Change in fair value of contingent consideration
173
Contingent consideration payable
$ 4,887
As
of December 31, 2021 there were no fair value measurements.
15
Note
11 — Stock-Based Compensation
Lucid
Diagnostics Inc. 2018 Long-Term Incentive Equity Plan
The
Lucid Diagnostics Inc. 2018 Long-Term Incentive Equity Plan (“Lucid Diagnostics Inc. 2018 Equity Plan”) is separate and apart
from the PAVmed Inc. 2014 Equity Plan discussed below. The Lucid Diagnostics Inc. 2018 Equity Plan is designed to enable Lucid Diagnostics
Inc. to offer employees, officers, directors, and consultants, as defined, an opportunity to acquire shares of common stock of Lucid
Diagnostics Inc. The types of awards that may be granted under the Lucid Diagnostics Inc. 2018 Equity Plan include stock options, stock
appreciation rights, restricted stock, and other stock-based awards subject to limitations under applicable law. All awards are subject
to approval by the Lucid Diagnostics Inc. board of directors.
A
total of 5,644,000 shares of common stock of Lucid Diagnostics Inc. are reserved for issuance under the Lucid Diagnostics Inc. 2018 Equity
Plan, with 733,541 shares available for grant as of March 31, 2022. The share reservation is not diminished by a total of 473,300 Lucid
Diagnostics Inc. stock options and restricted stock awards granted outside the Lucid Diagnostics Inc. 2018 Equity Plan, as of March 31,
2022.
Lucid
Diagnostics Inc. 2018 Equity Plan - Stock Options
Stock
options issued and outstanding under the Lucid Diagnostics Inc. 2018 Equity Plan and including Lucid Diagnostics stock options granted
outside the plan is as follows:
Schedule of Stock Options Issued and Outstanding Activities
Number of Stock Options
Weighted Average Exercise Price
Remaining Contractual Term (Years)
Outstanding stock options at December 31, 2021
1,419,242
$ 0.73
7.0
Granted (1)
1,760,000
$ 4.16
Exercised
( 253,889 )
$ 0.74
Forfeited
( 60,926 )
$ 4.61
Outstanding stock options at March 31, 2022
2,864,427
$ 2.75
6.9
Vested and exercisable stock options at March 31, 2022
1,277,026
$ 0.99
3.3
(1) Stock
options granted under the Lucid Diagnostics Inc. 2018 Equity Plan generally vest ratably
over twelve quarters, with the vesting commencing with the grant date quarter, and have a
ten-year contractual term from date-of-grant.
See
Note 5, Related Party Transactions , for a summary of the stock-based compensation expense recognized with respect to the stock
options granted under the Lucid Diagnostics Inc. 2018 Equity Plan to the Physician Inventors.
16
Note
11 — Stock-Based Compensation - continued
Lucid
Diagnostics Inc. 2018 Equity Plan – Restricted Stock Awards
A
summary of restricted stock award activity is as follows:
Schedule
of Restricted Stock Award Activity
Number of Restricted Stock Awards
Weighted Average Grant Date Fair Value
Unvested restricted stock awards as of December 31, 2021
1,890,740
$ 12.94
Granted
320,000
4.53
Vested
—
—
Forfeited
—
—
Unvested restricted stock awards as of March 31, 2022
2,210,740
$ 11.07
On
January 7, 2022, 320,000
restricted stock awards were granted under
the Lucid Diagnostics Inc 2018 Equity Plan, with such restricted stock awards having a single vesting date on January 7, 2025, and an
aggregate grant date fair value of approximately $ 1.4
million, measured as the grant date closing
price of Lucid Diagnostics Inc. common stock, with such aggregate estimated fair value recognized as stock-based compensation expense
ratably on a straight-line basis over the vesting period, which is commensurate with the service period. The restricted stock awards
are subject to forfeiture if the requisite service period is not completed.
PAVmed
Inc. 2014 Equity Plan
The
PAVmed Inc. 2014 Long-Term Incentive Equity Plan (the “PAVmed Inc. 2014 Equity Plan”), is separate and apart from the Lucid
Diagnostics Inc. 2018 Equity Plan (as such equity plan is discussed above).
The
three Physician Inventors were each granted 25,000 stock options under the PAVmed Inc. 2014 Equity Plan, with a grant date of May 12,
2018, an exercise price of $ 1.59 per share of common stock of PAVmed Inc., vesting ratably on a quarterly basis commencing June 30, 2018
and ending March 31, 2021, and a contractual period of ten years from the date of grant. Additionally, the three Physician Inventors
were each granted 50,000 stock options under the PAVmed Inc. 2014 Equity Plan, with a grant date of June 21, 2021, an exercise price
of $ 6.41 per share of common stock of PAVmed Inc., vesting ratably on a quarterly basis commencing June 30, 2021 and ending March 31,
2024, and a contractual period of ten years from the date of grant. See Note 5, Related Party Transactions , for a summary of the
stock-based compensation expense recognized with respect to the stock options granted under the PAVmed Inc. 2014 Equity Plan to the Physician
Inventors.
Stock-Based
Compensation Expense
The
stock-based compensation expense recognized by the Company for both the Lucid Diagnostics Inc. 2018 Equity Plan and the PAVmed Inc. 2014
Equity Plan, for the periods indicated, was as follows:
Schedule of Stock-Based Compensation Expense
2022
2021
Three Months Ended March 31,
2022
2021
Lucid Diagnostics Inc 2018 Equity Plan – sales and marketing expenses
$ 265
$ —
Lucid Diagnostics Inc 2018 Equity Plan - general and administrative expense
3,201
789
Lucid Diagnostics Inc 2018 Equity Plan - research and development expenses
71
13
PAVmed Inc 2014 Equity Plan - sales and marketing expenses
175
—
PAVmed Inc 2014 Equity Plan - general and administrative expenses
68
—
PAVmed Inc 2014 Equity Plan - research and development expenses
55
3
Total stock-based compensation expense
$ 3,835
$ 805
The
stock-based compensation expense, as presented above, is inclusive of: stock options and restricted stock awards granted under the Lucid
Diagnostics Inc. 2018 Equity Plan to employees of PAVmed Inc., the Physician Inventors (as discussed above), and members of the board
of directors of Lucid Diagnostics Inc., as well as the stock options granted under the PAVmed Inc. 2014 Equity Plan to the Physician
Inventors (as discussed above).
17
Note
11 — Stock-Based Compensation - continued
As
of March 31, 2022, unrecognized stock-based compensation expense and weighted average remaining requisite service period with respect
to stock options and restricted stock awards issued under each of the Lucid Diagnostics Inc. 2018 Equity Plan and the PAVmed Inc. 2014
Equity Plan, as discussed above, is as follows:
Schedule of Unrecognized Compensation Expense and Weighted Average Remaining Service Period
Unrecognized
Expense
Weighted Average Remaining Service Period (Years)
Lucid Diagnostics Inc. 2018 Equity Plan
Stock Options
$ 4,660
2.7
Restricted Stock Awards
$ 14,080
1.3
PAVmed Inc. 2014 Equity Plan
Stock Options
$ 2,317
2.1
Restricted Stock Awards
$ 264
1.7
Stock-based
compensation expense recognized with respect to stock options granted under the Lucid Diagnostics Inc. 2018 Equity Plan was based on
a weighted average estimated fair value of such stock options of $ 2.95 per share during the year ended March 31, 2022. There were no
stock-based awards granted under the Lucid Diagnostics Inc. 2018 Equity Plan during the period ended March 31, 2021. The stock-based
compensation was calculated using the following weighted average Black-Scholes valuation model assumptions:
Schedule of Stock-based Compensation Valuation Assumptions
2022
Three Months Ended March 31,
2022
Expected term of stock options (in years)
5.6
Expected stock price volatility
86 %
Risk free interest rate
1.7 %
Expected dividend yield
— %
Lucid
Diagnostics, Inc Employee Stock Purchase Plan (“ESPP”)
The
Lucid Diagnostics Inc Employee Stock Purchase Plan (“Lucid Diagnostics Inc ESPP”), initial six-month stock purchase
period is April 1, 2022 to September 30, 2022. The Lucid Diagnostics Inc. ESPP has a total reservation of 500,000
shares of common stock for which all shares are
available-for-issue as of March 31, 2022.
18
Note
12 — Stockholders’ Equity
Lucid
Diagnostics Inc. Common Stock
There
were 35,171,796 and 34,917,907 shares of common stock issued and outstanding as of March 31, 2022 and December 31, 2021, respectively.
As of March 31, 2022, PAVmed Inc. holds 27,927,190 shares, representing a majority-interest equity ownership and has a controlling financial
interest in Lucid Diagnostics Inc.
Committed
Equity Facility - March 28, 2022
On March 28, 2022,
Lucid Diagnostics, Inc. entered into a committed equity facility with an affiliate of Cantor Fitzgerald (“Cantor”). Under
the terms of the committed equity facility, Cantor has committed to purchase up to $ 50
million of Lucid Diagnostics Inc. common stock from time to time at the request of the Company. While there are distinct differences,
the facility is structured similarly to a traditional at-the-market equity facility, insofar as it allows the Company to raise primary
equity capital on a periodic basis at prices based on the existing market price.
In
connection with the execution of the agreement for the committed equity facility, the Company agreed to pay Cantor $ 1.0 million as consideration
for its irrevocable commitment to purchase the shares upon the terms and subject to the satisfaction of the conditions set forth in such
agreement. In addition, pursuant to the agreement, we agreed to reimburse Cantor for certain of its expenses. the Company also entered
into a registration rights agreement with Cantor. the Company has the right to terminate the agreement at any time after initial satisfaction
of the conditions to Cantor’s obligation to purchase shares under the facility, at no cost or penalty, upon three trading days’
prior written notice.
19
Note
13 — Net Loss Per Share
The
“Net loss per share basic and diluted” for the respective periods indicated - is as follows:
Schedule of Basic and Fully Diluted Net Loss Per Share
2022
2021
Three Months Ended March 31,
2022
2021
Numerator
Net loss
$ ( 12,270 )
$ ( 3,653 )
Denominator
Weighted average common shares outstanding, basic and diluted
35,123,039
14,114,437
Loss per share
Net loss per share - basic and diluted
$ ( 0.35
)
$ ( 0.26 )
Basic
weighted-average number of shares of common stock outstanding for the periods ended March 31, 2022 and 2021 include the shares of the
Company issued and outstanding during such periods, each on a weighted average basis. The basic weighted average number of shares common
stock outstanding excludes common stock equivalent incremental shares, while diluted weighted average number of shares outstanding includes
such incremental shares. However, as the Company was in a loss position for all periods presented, basic and diluted weighted average
shares outstanding are the same, as the inclusion of the incremental shares would be anti-dilutive. The common stock equivalents excluded
from the computation of diluted weighted average shares outstanding are as follows:
Schedule of Anti-dilutive Securities Excluded from Computation of Diluted Earnings Per Share
Three Months Ended March 31,
2022
2021
Lucid Diagnostics Inc. 2018 Equity Plan:
Stock options
3,287,727
1,145,353
Unvested restricted stock awards
2,260,740
1,467,440
Total
5,548,467
2,612,793
The total of stock options and unvested restricted stock awards presented in the table above, are inclusive of 423,300 stock options as
of March 31, 2022 and 2021, and 50,000 restricted stock awards as of March 31, 2022, granted outside the Lucid Diagnostics Inc. 2018 Equity
Plan.
Note
14 — Subsequent Events
CapNostics,
LLC
On
October 5, 2021, PAVmed Subsidiary Corporation, a wholly-owned subsidiary of PAVmed Inc., acquired all of the outstanding common stock
of CapNostics, LLC (“CapNostics”) for total (gross) purchase consideration of approximately $ 2.1
million of cash, paid at the closing of the transaction.
In April 2022, following the approval from both the PAVmed and Lucid board of directors, the respective companies entered
into an agreement to transfer the CapNostics, LLC assets from PAVmed to Lucid as well as transferring the consulting agreement
with the previous principal owner of CapNostics, LLC. The transfer price is $ 2.1
million for the assets.
EsoCure
EsoCure
has been in development as an Esophageal Ablation Device by PAVmed, with the intent to allow a clinician to treat dysplastic BE before
it can progress to EAC, a highly lethal esophageal cancer, and to do so without the need for complex and expensive capital equipment.
In April 2022, following the approval from both the PAVmed and Lucid board of directors have the Companies entered
into an intercompany license between PAVmed and Lucid such that Lucid will be granted the rights to commercialize EsoCure for the treating
dysplastic Barrett’s Esophagus, including a royalty arrangement whereby Lucid will pay PAVmed a 5 %
royalty on all EsoCure sales up to $ 100
million per calendar year, and 8% above that
threshold. Lucid will obligated to fund ongoing development costs and cumulative patent expenses. EsoCure will become part of an integrated
suite of Lucid products addressing BE-EAC.
20
Item
2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
The
following discussion and analysis of our unaudited condensed consolidated financial condition and results of operations should be read
together with our Annual Report on Form 10-K for the year ended December 31, 2021 (the “Form 10-K”), as filed with the Securities
and Exchange Commission (the “SEC”). We are a majority-owned consolidated subsidiary of PAVmed Inc.
Unless
the context otherwise requires, references herein to “we”, “us”, and “our”, and to the “Company”
or “Lucid Diagnostics” are to Lucid Diagnostics Inc and its subsidiary LucidDx Labs Inc. (“LucidDx Labs”).
FORWARD-LOOKING
STATEMENTS
This
Quarterly Report on Form 10-Q (this “Form 10-Q”), including the following discussion and analysis of our (unaudited)
condensed consolidated financial condition and results of operations, contains forward-looking statements that involve substantial risks
and uncertainties. All statements, other than statements of historical facts, contained in this Form 10-Q, including statements regarding
our future results of operations and financial position, business strategy and plans and objectives of management for future operations,
are forward-looking statements. The words “may,” “will,” “should,” “expects,” “plans,”
“anticipates,” “could,” “intends,” “target,” “projects,” “contemplates,”
“believes,” “estimates,” “predicts,” “potential” or “continue” or the negative
of these terms or other similar expressions are intended to identify forward-looking statements, although not all forward-looking statements
contain these identifying words. Forward-looking statements are not guarantees of future performance and the Company’s actual results
may differ significantly from the results discussed in the forward-looking statements. Factors that might cause such differences include,
but are not limited to, those discussed in Item 1A of Part I of the Form 10-K under the heading “Risk Factors.”
Important
factors that may affect our actual results include:
● our
limited operating history;
● our
financial performance, including our ability to generate revenue;
● our
ability to obtain regulatory approval for the commercialization of our products;
● our
ability of our products to achieve market acceptance;
● our
success in retaining or recruiting, or changes required in, our officers, key employees or
directors;
● our
potential ability to obtain additional financing when and if needed;
● our
ability to protect our intellectual property;
● our
ability to complete strategic acquisitions;
● our
ability to manage growth and integrate acquired operations;
● the
potential liquidity and trading of our securities;
● regulatory
and operational risks;
● cybersecurity
risks;
● risks
related to SARS-CoV-2 /COVID-19 pandemic;
● the
impact of the material weakness identified by our management; and
● our
estimates regarding expenses, future revenue, capital requirements and needs for additional
financing.
In
addition, our forward-looking statements do not reflect the potential impact of any future financings, acquisitions, mergers, dispositions,
joint ventures or investments we may make.
We
may not actually achieve the plans, intentions, and /or expectations disclosed in our forward-looking statements, and you should not
place undue reliance on our forward-looking statements. You should read this Form 10-Q and the Form 10-K, and the documents we have filed
as exhibits to this Form 10-Q and the Form 10-K, completely and with the understanding our actual future results may be materially different
from what we expect. We do not assume any obligation to update any forward-looking statements, whether as a result of new information,
future events or otherwise, except as required by applicable law.
21
Overview
We
are a commercial-stage, cancer prevention, medical diagnostics technology company focused on the millions of patients with long-standing
gastroesophageal reflux disease (“GERD”) who are at risk of developing esophageal precancer and cancer, specifically
highly lethal esophageal adenocarcinoma (“EAC”), which is expected to lead to approximately 16,000 U.S. deaths in
2021.
We
believe that our lead products, the EsoGuard Esophageal DNA Test performed on samples collected with the EsoCheck Esophageal Cell Collection
Device, constitute the first and only commercially available diagnostic test capable of serving as a widespread screening tool to prevent
EAC deaths, through early detection of esophageal precancer in at-risk GERD patients.
● EsoGuard
is a DNA test performed on surface esophageal cells collected with EsoCheck in a brief noninvasive
office procedure which has been shown to be over 90% sensitive and specific at detecting
Barrett’s Esophagus (“BE”), a precancerous condition of the esophagus and
all conditions along the BE-EAC spectrum, including on samples collected with EsoCheck (Moinova,
et al. Sci Transl Med. 2018 Jan 17;10(424): eaao5848).
● EsoCheck
is an FDA 510(k) and CE Mark cleared noninvasive swallowable balloon capsule catheter capable
of sampling surface esophageal cells in a less than five-minute office procedure. We believe
its proprietary Collect+Protect™ technology makes it the only noninvasive esophageal
cell collection device capable of anatomically targeted and protected sampling to prevent
dilution and contamination during device withdrawal.
EsoGuard
is commercialized in the U.S. as a laboratory developed test (“LDT”). It was previously performed by our unrelated
third-party commercial clinical laboratory service partner ResearchDx Inc. (with a d/b/a “Pacific Dx”) (“RDx”),
at their Clinical Laboratory Improvement Amendments (“CLIA”) certified commercial clinical laboratory, located in Irvine,
CA. Beginning in March 2022, the EsoGuard LDT has been performed at our own CLIA-certified commercial clinical laboratory,
located in Lake Forest, CA. Additionally, RDx also manufactures our EsoGuard Specimen Kits. EsoCheck is commercialized in the U.S. as
a 510(k) cleared esophageal cell collection device currently manufactured for us by our contract manufacturing partner, Sage Product
Development Inc., located in Foxborough, MA. We are in the process of transferring EsoCheck manufacturing to Coastline International
Inc., a high-volume manufacturer headquartered in San Diego, CA with plants in Mexico. Both EsoGuard and EsoCheck have completed
the CE Mark certification process. While EsoGuard and EsoCheck may be marketed separately, they are not presently approved for marketing
together as an in vitro diagnostic device (“IVD”). EsoGuard, used with EsoCheck as an IVD, was granted FDA Breakthrough
Device designation and is the subject of two large, actively enrolling, international multicenter PMA clinical trials.
The
EsoGuard PLA code 0114U secured final Medicare payment determination of $1,938.01, effective January 1, 2021. The CLIA certified laboratory
where the EsoGuard assay is performed has begun to submit claims and receive out-of-network private insurance payments. We are awaiting
Medicare local coverage determination. We are also aggressively pursuing EsoGuard U.S. private payor payment and coverage as well as
payment in Europe.
We
are working to expand EsoGuard commercialization across multiple channels by building a direct sales and marketing team targeting
primary care physicians, specialists, institutions and consumers. To assure sufficient testing capacity and geographic coverage,
as part of this expansion, we are building our own network of Lucid Test Centers, staffed by Lucid-employed clinical personnel, where
patients can undergo the EsoCheck procedure and have the sample sent for EsoGuard testing, starting with three test centers launched
in the Phoenix metropolitan area and have recently expanded our test centers into Utah, Nevada, Colorado, Washington, Oregon and Idaho.
We’ve also established an EsoGuard Telemedicine Program, in partnership with UpScript, LLC, an independent third-party
telemedicine provider, that can accommodate EsoGuard self-referrals from direct-to-consumer marketing.
We
are a majority owned subsidiary of PAVmed. We are party to an amended and restated patent license agreement with CWRU, dated August 23,
2021 (“Amended CWRU License Agreement”), which provides for the exclusive worldwide license of the intellectual property
rights for the proprietary technologies underlying EsoCheck and EsoGuard.
22
Recent Developments
Business
Clinical
Guideline Update - ACG
In
April 2022, the American College of Gastroenterology
(“ACG”) updated its clinical guideline to support esophageal precancer (“Barrett’s Esophagus”, “BE”)
screening to prevent highly lethal esophageal cancer (“EAC”) utilizing our EsoGuard® DNA Test on samples collected
with our EsoCheck® Cell Collection Device. The clinical guideline reiterates the ACG’s long-standing recommendation
for esophageal precancer screening in at-risk patients with gastroesophageal reflux disease (“GERD”), commonly known as chronic
heartburn, acid reflux or simply reflux. In its Recommendation 5, the ACG suggests a single screening endoscopy in patients with chronic
GERD symptoms and 3 or more additional risk factors for BE, including male sex, age >50 yr, White race, tobacco smoking, obesity,
and family history of BE or EAC in a first-degree relative. Furthermore, and importantly for the first time, the clinical guideline also
endorses nonendoscopic biomarker screening as an acceptable alternative to costly and invasive endoscopy by stating in its Recommendation
6 that the ACG suggests that a swallowable, nonendoscopic capsule device combined with a biomarker is an acceptable alternative to endoscopy
for screening for BE. The clinical guideline specifically mentions EsoCheck, along with Lucid’s EsophaCap® device, as such
swallowable, nonendoscopic esophageal cell collection devices, as well as methylated DNA biomarkers such as EsoGuard. The summary of
evidence for this recommendation cites the seminal NIH-funded multicenter, case-control study published in 2018 in Science Translational
Medicine, which demonstrated that EsoGuard is highly accurate at detecting esophageal precancer and cancer, including on samples collected
with EsoCheck.
Local
Coverage Determination Update - CMS
In April 2022, a proposed
Local Coverage Determination (“LCD”) DL39256, entitled “Molecular Testing for Detection of Upper Gastrointestinal Metaplasia,
Dysplasia, and Neoplasia” was published on the Center for Medicare and Medicaid Services (“CMS”) website by MAC Palmetto
GBA. The proposed LCD is a further step in Lucid’s efforts to secure Medicare coverage and payment for EsoGuard.
The
proposed LCD, which the CMS website explicitly characterizes as a “work in progress” for “public review,” outlines
criteria that MolDX expects upper gastrointestinal precancer and cancer molecular diagnostic tests to meet. These criteria include active
GERD with at least two risk factors, as well as evidence of analytic validity, clinical validity, and clinical utility. Although it found
that no currently existing test has fulfilled all these criteria, it indicated that it will “monitor the evidence and will provide
coverage based on the pertinent literature and society recommendations.” Notably, the proposed LCD pre-dated, and therefore does
not include consideration of, the most recent ACG clinical guideline update endorsing swallowable, nonendoscopic capsule devices combined
with a biomarker, such as EsoCheck and EsoGuard. The publication of the proposed LCD included a written comment period that extended
through May 14, 2022. MolDX held an open meeting on May 10, 2022, during which stakeholders and other interested parties had the opportunity
to address the proposed LCD.
We
have used the written comment process and the open meeting to bring to MolDX essential information that was not incorporated into the
proposed LCD. These include: the updated ACG clinical guideline; the fact that EsoGuard’s published performance is at or above
accepted performance criteria for detection of lower gastrointestinal cancers in approved and currently effective Medicare coverage determinations;
and data from ongoing clinical utility studies Lucid and clinical investigators are performing. A final LCD will not be issued until
the MAC has had the opportunity to assess and consider the comments and input from the written comment period and the open meeting.
MediNcrease
Health Plans
In
May 2022 LucidDx Labs, Inc. entered into a participating provider agreement with MediNcrease Health Plans, LLC (“MediNcrease”).
A national directly-contracted, multi-specialty PPO provider network with over 8 million lives covered through its clients and payers,
which include regional and national health plans, insurance companies, third party administrators, self-insured employer groups, municipalities,
unions and other entities involved in the management of medical claims. Pursuant to the agreement, persons covered by MediNcrease clients
and payers will have in-network access to Lucid’s EsoGuard® DNA test, the first and only commercially available test capable
of serving as a widespread tool to prevent esophageal cancer deaths through the early detection of esophageal precancer in at-risk chronic
heartburn patients. The agreement provides rates of reimbursement as a percent of charges for services rendered to such covered persons
by LucidDx Labs, including the performance of the EsoGuard test.
23
Recent Developments - continued
Business - continued
CLIA
Lab Acquisition
In
February 2022, Lucid Diagnostics, Inc. through its wholly owned subsidiary LucidDx Labs, Inc. entered into an asset purchase agreement
(“APA”) with ResearchDx, Inc. (“RDx”) Under the APA, LucidDx Labs acquired certain licenses and other related
assets necessary to operate a CLIA-certified, CAP-accredited clinical laboratory. The acquired assets, together with certain additional
assets necessary to commence laboratory operations that were separately purchased by LucidDx Labs, will be used by Lucid to perform the
EsoGuard® Esophageal DNA assay.
EsoCure
Intercompany License
In
April 2022, we entered into an intercompany license between PAVmed and Lucid such that Lucid has been granted the rights to commercialize
EsoCure for treating dysplastic Barrett’s Esophagus, including a royalty arrangement whereby Lucid will pay PAVmed will be obligated
to fund ongoing development costs and cumulative patent expenses. EsoCure will become part of an integrated suite of Lucid products addressing
BE-EAC. EsoCure is in development as an “Esophageal Ablation Device” with the intent to allow a clinician to treat dysplastic
BE before it can progress to EAC, a highly lethal esophageal cancer, and to do so without the need for complex and expensive capital
equipment. We have successfully completed a pre-clinical feasibility animal study of EsoCure demonstrating excellent, controlled circumferential
ablation of the esophageal mucosal lining. We plan to conduct additional development work and animal testing of EsoCure to support a
planned FDA 510(k) submission in the second half of 2022.
EsophaCap
Intercompany Assignment
In
April 2022, following the approval from both the PAVmed and Lucid board of directors, the respective companies entered into an agreement
to transfer the CapNostics, LLC assets from PAVmed to Lucid as well as transferring the consulting agreement with the previous principal
owner of CapNostics, LLC. The transfer price is $2.1 million for the assets. On October 5, 2021, PAVmed Subsidiary Corporation, a wholly-owned
subsidiary of PAVmed Inc., acquired all of the outstanding common stock of CapNostics, LLC (“CapNostics”) for a total (gross)
purchase consideration of approximately $2.1 million of cash, paid at the closing of the transaction.
Financing
In
March 2022, Lucid Diagnostics, Inc. entered into a committed equity facility with an affiliate of Cantor Fitzgerald (“Cantor”).
Under the terms of the facility, Cantor has committed to purchase up to $50 million of Lucid Diagnostics Inc. common stock from time
to time at the request of Lucid Diagnostics Inc. While there are distinct differences, the facility is structured similarly to a traditional
at-the-market equity facility, insofar as it allows Lucid Diagnostics Inc. to raise primary capital on a periodic basis at prices based
on the existing market price.
24
Impact
of SARS-CoV-2 - COVID-19 Pandemic
Previously,
in December 2019, there was an outbreak of a novel strain of a coronavirus occurred, with such coronavirus designated by the United Nations
World Health Organization (“WHO”) as the “Severe Acute Respiratory Syndrome Coronavirus 2” - or “SARS-CoV-2”.
The SARS-CoV-2 spread on a global basis to other countries, including the United States. On March 11, 2020, the WHO declared a pandemic
resulting from SARS-CoV-2, with such pandemic commonly referred to by its resulting illness of coronavirus disease 2019, or “COVID-19”.
The COVID-19 pandemic is ongoing, and we continue to monitor the ongoing impact of the COVID-19 pandemic on the United States national
economy, the global economy, and our business.
The
COVID-19 pandemic may have an adverse impact on our operations, supply chains, and distribution systems and /or those of our contractors,
and increase our expenses, including as a result of impacts associated with preventive and precautionary measures being taken, restrictions
on travel, quarantine polices, and social distancing. Such adverse impact may include, for example, the inability of our employees and
/or those of our contractors to perform their work or curtail their services provided to us.
We
expect the significance of the COVID-19 pandemic, including the extent of its effect on our consolidated financial condition and consolidated
operational results and cash flows, to be dictated by the success of United States and global efforts to mitigate the spread of and /or
to contain the SARS-CoV-2 and the impact of such efforts.
In
addition, the spread of the SARS-CoV-2 has disrupted the United States’ healthcare and healthcare regulatory systems which could
divert healthcare resources away from, or materially delay United States Food and Drug Administration (“FDA”) approval with
respect to our products.
Furthermore,
our clinical trials have been and may be further affected by the COVID-19 pandemic, as site initiation and patient enrollment may be
delayed, for example, due to prioritization of hospital resources toward the virus and /or illness response, as well as travel restrictions
imposed by governments, and the inability to access clinical test sites for initiation and monitoring.
The
COVID-19 pandemic may have an adverse impact on the economies and financial markets of many countries, including the USA, resulting in
an economic downturn that could adversely affect demand for our products and services and /or our product candidates.
Although
we are continuing to monitor and assess the effects of the COVID-19 pandemic on our business, the ultimate impact of the COVID-19 pandemic
(or a similar health epidemic) is highly uncertain and subject to change, and therefore, its impact on our consolidated financial condition,
consolidated results of operations, and /or consolidated cash flows, the adverse impact could be material.
25
Results
of Operations
Overview
Revenue
Revenue
was recognized with respect to the EsoGuard Commercialization Agreement, dated August 1, 2021, between the Company’s majority-owned
subsidiary, Lucid Diagnostics Inc., and ResearchDX Inc. (“RDx”), a CLIA certified commercial laboratory service provider.
On February 25, 2022, the EsoGuard Commercialization Agreement was terminated upon the execution of an Asset Purchase
Agreement between LucidDx Labs Inc., a wholly-owned subsidiary of Lucid Diagnostics Inc. and RDx.
Cost
of revenue
The
cost of revenue recognized with respect to the revenue recognized under the EsoGuard Commercialization Agreement is inclusive of: a royalty
fee incurred under the Amended CWRU License Agreement; the MSA Fee (as defined and discussed herein below) allocated to cost of revenue,
which is principally employee related costs of PAVmed employees engaged in the administration to patients of the EsoCheck cell sample
collection procedure (principally at the LUCID Test Centers); the EsoCheck devices and EsoGuard mailers (cell sample shipping costs)
distributed to medical practitioners locations and the LUCID Test Centers; and LUCID Test Centers operating expenses, including rent
expense and supplies.
Sales
and marketing expenses
Sales
and marketing expenses consist primarily of the portion of the MSA Fee allocated to sales and marketing expenses, which are principally
employee related costs of PAVmed employees, as well as advertising and promotion expenses. We anticipate our sales and marketing expenses
will increase in the future, as we anticipate an increase in payroll and related expenses related to the roll-out of our commercial sales
and marketing operations as we execute on our business strategy.
General
and administrative expenses
General
and administrative expenses consist primarily of professional fees, accounting and legal services, consultants and expenses associated
with obtaining and maintaining patents within our intellectual property portfolio, along with the portion of the MSA Fee allocated to
general and administrative expenses.
We
anticipate our general and administrative expenses will increase in the future, as we anticipate an increase in the MSA Fee allocated
to general and administrative expense, related to continued expansion of our overall business operations. We also anticipate expenses
related to being a public company, including professional services fees for legal, accounting, tax, audit, employees involved in third-party
payor reimbursement contract negotiations and regulatory services associated with maintaining compliance as a public company, along with
insurance premiums, investor relations, and other corporate expenses.
26
Results of Operations - continued
Overview - continued
Research
and Development Expenses
Research
and development expenses are recognized in the period they are incurred and consist principally of internal and external expenses incurred
for the development of our technologies and conducting clinical trials, including:
● consulting
costs charged to us by various external contract research organizations we contract with
to conduct preclinical studies and engineering studies;
● costs
associated with regulatory filings;
● patent
license fees;
● cost
of laboratory supplies and acquiring, developing, and manufacturing preclinical prototypes;
● product
design engineering studies;
● fees
associated with conducting clinical trials for our EsoGuard diagnostic assay; and
● MSA
Fee allocated to research and development, as such MSA Fee are discussed below.
We
plan to incur research and development expenses for the foreseeable future as we continue the development of our existing products as
well as new innovations. Our research and development activities are focused principally on obtaining FDA approvals and developing product
improvements or extending the utility of the lead products in our pipeline, including EsoCheck and EsoGuard.
Presentation of Dollar Amounts
All dollar amounts in this Management’s
Discussion and Analysis of Financial Condition and Results of Operations are presented in thousands of dollars, if not otherwise indicated
as being presented as dollars in millions, except for the number of shares and per share amounts.
27
Three
Months ended March 31, 2022 as
compared to three months ended March 31, 2021
Revenue
In
the three months ended March 31, 2022, revenue was $0.2 million as compared to no revenue in the corresponding period in the prior
year. The $0.2 million increase principally relates to our EsoGuard Commercialization Agreement, dated August 1, 2021, which resulted
in revenue recognition of $0.1 million per month beginning August 2021 - through the February 25, 2022 termination date of such agreement.
Cost
of revenue
In
the three months ended March 31, 2022, cost of revenue was approximately $0.4 million, compared to no cost of revenue in the corresponding
period in the prior year. The $0.4 million increase principally relates to costs associated with the EsoGuard Commercialization Agreement
noted above.
Sales
and marketing expenses
In
the three months ended March 31, 2022, sales and marketing costs were approximately $3.3 million, compared to $0.7 million
for the corresponding period in the prior year. The net increase of $2.6 million was principally related to:
● approximately
$2.2 million increase in compensation related costs, including stock-based compensation
of approximately $0.4 million in stock based compensation with respect to restricted stock awards (“RSA”) grants under the Lucid Diagnostics Inc. 2018 Long-Term
Incentive Equity Plan (“Lucid Diagnostics Inc. 2018 Equity Plan”) to Lucid Diagnostics and PAVmed
employees and non-employees, and an increase in stock options granted corresponding with
the increase in the number of employees principally related to an increase in headcount;
● approximately
$0.5 million increase in outside professional services related to EsoCheck, EsoGuard
and consulting and professional services fees.
● approximately
$0.1 million decrease in the MSA fee allocation from PAVmed related to the
growth and expansion of Lucid’s business and the services incurred through PAVmed.
General
and administrative expenses
In
the three months ended March 31, 2022, general and administrative costs were approximately $5.7 million, compared to $1.2
million for the corresponding period in the prior year. The net increase of $4.5 million was principally related to:
● approximately
$1.6 million increase in compensation related costs, including stock-based compensation
of approximately $1.4 million in stock based compensation with respect to
RSA grants under the Lucid Diagnostics Inc. 2018 Long-Term Incentive Equity Plan (“Lucid
Diagnostics Inc. 2018 Equity Plan”) to Lucid Diagnostics and PAVmed employees
and non-employees, and an increase in stock options granted corresponding with the increase
in the number of employees principally related to an increase in headcount;
● approximately
$2.5 million in consulting services related to patents, regulatory compliance, legal
processes for contract review, transition of public relations and investor relations
firms, and public company expenses; and
● approximately
$0.4 million increase in the MSA fees, after allocation, from PAVmed related to the
growth and expansion of our business and the services incurred through PAVmed.
28
Three Months ended March 31, 2022 as compared to three months ended
March 31, 2021 - continued
Research
and development expenses
In
the three months ended March 31, 2022, research and development costs were approximately $2.9 million, compared to $1.8
million for the corresponding period in the prior year. The net increase of $1.1 million was principally related to:
● approximately
$0.8 million increase in development costs, particularly in clinical trial activities
and outside professional and consulting fees with respect to EsoCheck, EsoCure and EsoGuard;
● approximately
$0.1 million increase in compensation related costs and related to expanded clinical
and engineering staff; and
● approximately
$0.2 million increase in the MSA fee allocation from PAVmed related to the growth
and expansion of Lucid’s business and the services incurred through PAVmed.
See
our accompanying unaudited condensed consolidated financial statements for each of: Note 5 , Related Party Transactions,
for a discussion of the consulting fee expense and stock based compensation expense recognized with respect to the Physician
Inventors consulting agreements and stock options and restricted stock awards; and the MSA between Lucid Diagnostics and PAVmed;
and Note 11 , Stock-Based Compensation , for information regarding each of the Lucid Diagnostics 2018 Equity Plan
and the PAVmed Inc. 2014 Equity Plan.
29
Liquidity
and Capital Resources
We
have financed our operations principally through advances from PAVmed and through the issuance of common stock in our initial public
offering (“IPO”). We are subject to all of the risks and uncertainties typically faced by medical device and diagnostic companies
that devote substantially all of their efforts to the commercialization of their initial product and services and ongoing R&D activities
and clinical trials. We expect to continue to experience recurring losses from operations, and will continue to fund our operations with
debt and/or equity financing transactions. Notwithstanding, however, with the cash on-hand as of March 31, 2022, we expect to be able
to fund our future operations for one year from the date of the issue of our unaudited condensed consolidated financial statements, as
included herein in this Quarterly Report on Form 10-Q for the period ended March 31, 2022.
Due
To: PAVmed Inc.
Since
our inception in May 2018 through our IPO in October 2021, our operations were been funded by PAVmed providing
working capital cash advances and the payment by PAVmed of certain operating expenses on-our-behalf. Additionally, our daily operations
have been and continue to be principally managed by personnel employed by PAVmed, for which we incur a MSA Fee expense according
to the provisions of the MSA discussed above.
As
of March 31, 2022, we had a Due To: PAVmed Inc. payment obligation liability of an aggregate of approximately $1.8 million payable
to reimburse for employee related costs and certain operating expenses paid by PAVmed Inc. on our behalf. See our accompanying
unaudited condensed consolidated financial statements Note 6, Due To PAVmed Inc.
Lucid
Diagnostics Inc. Committed Equity Facility
In
March 2022, we entered into a committed equity facility with an affiliate of Cantor Fitzgerald (“Cantor”). Under the
terms of the facility, Cantor has committed to purchase up to $50 million in our shares of our common stock from time to time at our
request. While there are distinct differences, the facility is structured similarly to a traditional at-the-market equity facility, insofar
as it allows the Company to raise primary equity capital on a periodic basis at prices based on the existing market price.
Upon
the initial satisfaction of the conditions to Cantor’s obligation to purchase shares under the facility, including that a registration
statement registering the resale by Cantor of the Shares under the Securities Act is declared effective by the SEC and a final prospectus
relating thereto is filed with the SEC, we will have the right, but not the obligation, from time to time at our sole discretion until
the first day of the month next following the expiration of the 36-month period after the effective date of the registration statement,
to direct Cantor to purchase shares in accordance with the terms of the facility, by delivering written notice to Cantor prior to the
commencement of trading on any trading day, subject to certain maximum amounts. The purchase price of the shares will be 96% of the volume
weighted average price of the shares of common stock during the trading date on which we have timely delivered written notice to Cantor
directing it to purchase shares under the facility.
We
will not sell, and Cantor will not purchase, any shares pursuant to the facility, if the aggregate number of shares of common stock issued
pursuant to the facility would exceed 7,482,763 shares of common stock, unless we obtain approval of our stockholders for the sale of
shares in excess of such amount. In addition, we will not sell, and Cantor will not purchase, any shares pursuant to the facility, which,
when aggregated with all other shares of common stock then beneficially owned by Cantor and its affiliates, would result in the beneficial
ownership by Cantor and its affiliates of more than 4.99% of our outstanding voting power or shares of common stock.
In
connection with the execution of the agreement for the facility, we agreed to pay Cantor $1.0 million as consideration for its irrevocable
commitment to purchase the shares upon the terms and subject to the satisfaction of the conditions set forth in such agreement. In addition,
pursuant to the agreement, e agreed to reimburse Cantor for certain of its expenses. We also entered into a registration rights agreement
with Cantor. We have the right to terminate the agreement at any time after initial satisfaction of the conditions to Cantor’s
obligation to purchase shares under the facility, at no cost or penalty, upon three trading days’ prior written notice.
30
Critical
Accounting Policies and Significant Judgments and Estimates
The
discussion and analysis of our (unaudited) financial condition and consolidated results of operations is based on our unaudited condensed
consolidated financial statements, which have been prepared in accordance with generally accepted accounting principles in the United
States of America (“U.S. GAAP”). The preparation of these unaudited condensed consolidated financial statements requires
us to make estimates and assumptions affecting the reported amounts of assets, liabilities, and equity, along with the disclosure of
contingent assets and liabilities at the date of the unaudited condensed consolidated financial statements and the reported amounts of
expenses during the corresponding periods. In accordance with U.S. GAAP, we base our estimates on historical experience and on various
other assumptions we believe are reasonable under the circumstances. Actual results may differ from these estimates under different assumptions
or conditions. Please see Note 2, Summary of Significant Accounting Policies and Recent Accounting Standards Updates , of our unaudited
condensed consolidated financial statements included herein in this Form 10-Q, for a summary of significant accounting policies.
31
Item
4. Controls and Procedures
Evaluation
of Disclosure Controls and Procedures
Our
management, with the participation of our principal executive officer and our principal financial officer, evaluated the effectiveness
of our disclosure controls and procedures as of March 31, 2022. Based on such evaluation, our principal executive officer and principal
financial officer concluded our disclosure controls and procedures (as defined in Rules 13a-15(f) and 15d-15(f) under the Exchange Act)
were effective as of such date to provide reasonable assurance the information required to be disclosed by us in the reports we file
or submit under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC’s
rules and forms. Disclosure controls and procedures include, without limitation, controls and procedures designed to ensure information
required to be disclosed by us in the reports we file or submit under the Exchange Act is accumulated and communicated to our management,
including our principal executive officer and principal financial officer, as appropriate to allow timely decisions regarding required
disclosure.
Changes
to Internal Controls Over Financial Reporting
There
has been no change in our internal controls over financial reporting (as defined in Rules 13a-15(f) and 15d-15(f) under
the Exchange Act) that occurred during our fiscal quarter ended March 31, 2022 that has materially affected, or is reasonably likely
to materially affect, our internals control over financial reporting.
32
Part
II - Other Information
Item
1. Legal Proceedings
In
the ordinary course of our business, particularly as it begins commercialization of its products, the Company may be subject to certain
other legal actions and claims, including product liability, consumer, commercial, tax and governmental matters, which may arise from
time to time. Except as otherwise noted herein, the Company does not believe it is currently a party to any other pending legal proceedings.
Notwithstanding, legal proceedings are subject-to inherent uncertainties, and an unfavorable outcome could include monetary damages,
and excessive verdicts can result from litigation, and as such, could result in a material adverse impact on the Company’s business,
financial position, results of operations, and /or cash flows. Additionally, although the Company has specific insurance for certain
potential risks, the Company may in the future incur judgments or enter into settlements of claims which may have a material adverse
impact on the Company’s business, financial position, results of operations, and /or cash flows.
Item
5. Other Information
None.
Item
6. Exhibits
The
exhibits filed as part of this Quarterly Report on Form 10-Q are set forth in the “ Exhibit Index ” below.
33
SIGNATURES
Pursuant
to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed
on its behalf by the undersigned, thereunto duly authorized.
Lucid
Diagnostics Inc.
May
16, 2022
By:
/s/
Dennis M McGrath
Dennis
M McGrath
Chief Financial Officer
(Principal
Financial and Accounting Officer)
34
EXHIBIT INDEX
Incorporation
by Reference
Exhibit
No.
Description
Form
Exhibit
No.
Date
2.1‡
Asset
Purchase Agreement, dated as of February 25, 2022, by and among LucidDx Labs Inc., Lucid Diagnostics Inc. and ResearchDx, Inc.
‡
8-K
2.1
3/3/2022
10.1
Common Stock Purchase Agreement, dated as of March 28, 2022, by and between CF Principal Investments LLC and Lucid Diagnostics Inc.
8-K
10.1
4/1/2022
10.2
Registration Rights Agreement, dated as of March 28, 2022, by and between CF Principal Investments LLC and Lucid Diagnostics Inc.
8-K
10.2
4/1/2022
10.3
Management Services Agreement, dated as of February 25, 2022, by and among LucidDx Labs Inc. and ResearchDx, Inc.
8-K
10.1
3/3/2022
10.4
Employment Agreement, dated as of February 22, 2022, by and between Lishan Aklog, M.D. and Lucid Diagnostics Inc.
8-K
10.1
1/20/2022
10.5
Employment Agreement, dated as of February 22, 2022, by and between Dennis McGrath and Lucid Diagnostics Inc.
8-K
10.2
1/20/2022
10.6
Employment Agreement, dated as of February 22, 2022, by and between Shaun O’Neil and Lucid Diagnostics Inc. (incorporated by reference to Exhibit to the Current Report on Form filed by Lucid Diagnostics on).
8-K
10.1
3/23/2022
31.1
Certification of Principal Executive Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
*
31.2
Certification of Principal Financial and Accounting Officer pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.
*
32.1
Certification of Principal Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
*
32.2
Certification of Principal Financial and Accounting Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
*
101.INS
Inline
XBRL Instance Document
*
101.CAL
Inline
XBRL Taxonomy Extension Schema
*
101.DEF
Inline
XBRL Taxonomy Extension Calculation Linkbase
*
101.LAB
Inline
XBRL Taxonomy Extension Label Linkbase
*
101.PRE
Inline
XBRL Taxonomy Extension Presentation Linkbase
*
104
Cover
Page Interactive Data File (embedded within the Inline XBRL document)
*
Filed herewith.
‡
Certain exhibits and schedules have been omitted pursuant to Item 601(b)(10) of Regulation S-K. The registrant hereby undertakes to furnish
supplementally a copy of any omitted exhibit or schedule upon request by the Securities and Exchange Commission.
35
Text extracted from the filing as submitted to EDGAR. Formatting, tables and exhibits are simplified for reading; the original document is authoritative for anything you rely on.