UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
FORM
10-K
☒
ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For
the fiscal year ended December 31 , 2021
OR
☐
TRANSITION REPORT UNDER SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For
the transition period from _____________ to ___________________
Commission
file number: 001-38325
enVVeno
Medical Corporation
(Exact
name of registrant as specified in its charter)
Delaware
33-0936180
(State
or other jurisdiction
of incorporation or organization)
(I.R.S.
Employer
Identification No.)
70
Doppler
Irvine ,
California 92618
(Address
of principal executive offices)
(949)
261-2900
(Registrant’s
telephone number, including area code)
Securities
registered pursuant to Section 12(b) of the Act:
Title
of Each Class:
Trading
Symbol(s):
Name
of Each Exchange on Which Registered:
Common
Stock, $0.00001 par value
NVNO
The
NASDAQ Stock Market LLC
Warrant
to Purchase Common Stock
NVNOW
The
NASDAQ Stock Market LLC
Securities
registered pursuant to Section 12(g) of the Act:
None
Indicate
by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☐ No ☒
Indicate
by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes ☐ No ☒
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 every 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
filer
☐
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(a) 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 ☒
The
aggregate market value of the voting and non-voting common stock held by non-affiliates of the registrant as of June 30, 2021 (the last
business date of the registrant’s most recently completed second fiscal quarter), based on the last sale price of the registrant’s
common stock on such date was $ 58.5 million.
As
of March 24, 2022, there were 9,469,850
shares of common stock outstanding.
ENVVENO
MEDICAL CORPORATION
TABLE
OF CONTENTS
PART I
ITEM 1. Business
2
ITEM 1A. Risk Factors
8
ITEM 1B. Unresolved Staff Comments
29
ITEM 2. Properties
29
ITEM 3. Legal Proceedings
29
ITEM 4. Mine and Safety Disclosures
29
PART II
ITEM 5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer of Equity Securities
30
ITEM 6. Selected Financial Data
30
ITEM 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations
31
ITEM 7A. Quantitative and Qualitative Disclosures and Market Risk
33
ITEM 8. Financial Statements and Supplementary Data
33
ITEM 9. Changes In and Disagreements with Accountants on Accounting and Financial Disclosures
34
ITEM 9A. Controls and Procedures
34
ITEM 9B. Other Information
34
ITEM 9C. Disclosure Regarding Foreign Jurisdictions That Prevent Inspections
34
PART III
ITEM 10. Directors, Executive Officers and Corporate Governance
35
ITEM 11. Executive Compensation
42
ITEM 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
53
ITEM 13. Certain Relationships and Related Transactions, and Director Independence
54
ITEM 14. Principal Accounting Fees and Services
55
PART IV
ITEM 15. Exhibits and Financial Statements Schedules
55
ITEM 16. Form 10-K Summary
57
Signatures
58
Financial Statements and Supplementary Data
F-1
PART
I
CAUTIONARY
NOTE ON FORWARD-LOOKING STATEMENTS
This
Annual Report on Form 10-K contains, or may contain, certain “forward-looking statements” within the meaning of the Private
Securities Litigation Reform Act of 1995. Such forward-looking statements involve significant risks and uncertainties. Such statements
may include, without limitation, statements with respect to the Company’s plans, objectives, projections, expectations and intentions
and other statements identified by words such as “may,” “will,” “could,” “would,” “should,”
“believes,” “expects,” “anticipates,” “estimates,” “intends,” “plans,”
“potential” or similar expressions. These statements are based upon the current beliefs and expectations of the Company’s
management and do not constitute guarantees of future performance. Actual results could differ materially from those contained in the
forward-looking statements and are subject to significant risks and uncertainties, including those discussed under “Risk Factors,”
as well as those discussed elsewhere in this Form 10-K. Actual results (including, without limitation, the actual timing for and results
of the clinical trials described herein, and FDA review of the Company’s products in development) may differ significantly from
those set forth in the forward-looking statements. These forward-looking statements involve risks and uncertainties that are subject
to change based on various factors (many of which are beyond the Company’s control).
You
are further cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this Form 10-K
or, in the case of documents referred to or incorporated by reference, the date of those documents.
All
subsequent written or oral forward-looking statements attributable to us or any person acting on our behalf are expressly qualified in
their entirety by the cautionary statements contained or referred to in this section. We do not undertake any obligation to release publicly
any revisions to these forward-looking statements to reflect events or circumstances after the date of this Form 10-K or to reflect the
occurrence of unanticipated events, except as may be required under applicable U.S. securities law. If we do update one or more forward-looking
statements, no inference should be drawn that we will make additional updates with respect to those or other forward-looking statements.
Unless
the context requires otherwise, references in this Annual Report on Form 10-K to “we,” “us,” “our,”
“our company,” “NVNO”, or similar terminology refer to enVVeno Medical Corporation.
We
use our registered trademarks and trade names, such as VenoValve® ™ in this Annual Report on Form 10-K. Solely for convenience,
trademarks and trade names referred to in this prospectus appear without the ® and ™ symbols, but those references are not
intended to indicate that we will not assert, to the fullest extent under applicable law, our rights, or that the applicable owner will
not assert its rights, to these trademarks and trade names. We do not intend our use or display of other companies’ trade names
or trademarks to imply a relationship with, or endorsement or sponsorship of us by, any other companies.
1
ITEM
1.
Business
Overview
enVVeno
Medical Corporation is a med-tech company focused on improving the standard of care in the treatment of venous disease. We are developing
tissue-based solutions that are designed to be life sustaining or life enhancing for patients with Chronic Venous Insufficiency (CVI).
CVI occurs when valves inside of the veins of the leg fail, resulting in insufficient blood being returned to the heart. We aim to
develop products to address large unmet medical needs by either offering treatments where none currently exist or by substantially
increasing the current standards of care. Our lead product is a porcine based device to be surgically implanted in the deep venous system
of the leg and is called the VenoValve®. The VenoValve is currently being evaluated in the SAVVE U.S. pivotal trial for the
purpose of obtaining approval to market and sell the device from the U.S. Food and Drug Administration (“FDA”). Our team
of officers and directors has been affiliated with numerous medical devices that have received FDA approval or CE marking and that have
been commercially successful. We develop and manufacture our products in a 14,507 sq. ft. leased manufacturing facility in Irvine, California,
which has been ISO 13485-2016 certified for the design, development and manufacturing of tissue based implantable medical devices.
On
September 21, 2021, we announced that we were changing our name from Hancock Jaffe Laboratories, Inc. to enVVeno Medical Corporation
and that our development strategy is to focus on the treatment of deep venous CVI. In addition to the VenoValve, we announced
that we have a second product in the early stages of development called enVVe. In connection with this change in strategy, we indicated
that we are not pursuing further development of the CoreoGraft, which is now outside of our primary focus area.
VenoValve
The
VenoValve is a porcine based valve developed at enVVeno Medical to be implanted in the deep venous system of the leg to treat severe
CVI. By reducing reflux, and lowering pressure (venous hypertension) within the deep venous system of the leg, the VenoValve has the
potential to reduce or eliminate the symptoms of severe deep venous CVI, including the potential to heal recurring venous leg ulcers.
The current version of the VenoValve is designed to be implanted into the femoral vein of the patient in an open surgical procedure via
a 5-to-6-inch incision in the upper thigh.
There
are presently no FDA approved medical devices to address valvular incompetence in the deep venous system, or effective treatments for
deep venous CVI. Current treatment options include compression garments, or constant leg elevation, and would care for venous ulcers.
These treatments are generally ineffective, as they attempt to alleviate the symptoms of CVI without addressing the underlying causes
of the disease. In addition, we believe compliance with compression garments and leg elevation is extremely low, especially among the
elderly. The premise behind the VenoValve is that by reducing the underlying causes of CVI, reflux and venous hypertension, the debilitating
symptoms of CVI will decrease, resulting in improvement in the quality of the lives of CVI sufferers.
We
estimate that there are approximately 2.4 million people in the U.S. that suffer from deep venous CVI due to valvular incompetence.
2
Background
Chronic
venous disease (“CVD”) is the world’s most prevalent chronic disease. CVD is generally classified using a standardized
system known as CEAP (clinical, etiological, anatomical, and pathophysiological). The CEAP system consists of seven clinical classifications
(C0 to C6) with C5 to C6 being the most severe cases of CVD.
Chronic
Venous Insufficiency (“CVI”) is a subset of CVD and is generally used to describe patients with C4 to C6 CVD. CVI is a debilitating
condition that affects the venous system of the leg causing pain, swelling, edema, skin changes, and ulcerations. The human leg contains
three vein systems: the deep vein system, the superficial vein system, and the perforator vein system which connects the deep system
to the superficial system. The deep venous system is located below the muscle and facia in the center portion of the leg and is responsible
for approximately 90% of the blood flow. In order for blood to return to the heart from the foot, ankle, and lower leg, the calf muscle
serves as a pump and pushes the blood up the veins of the leg against gravity and through a series of one-way valves. Each valve is supposed
to open as blood passes through, and then close as blood progresses up the veins of the leg to the next valve. CVI occurs when the one-way
valves in the veins of the leg fail and become incompetent. When the valves fail, gravity causes the blood to flow backwards and in the
wrong direction (reflux). As blood pools in the lower leg, pressure inside the veins increases (venous hypertension). Reflux, and the
resulting venous hypertension, causes the leg to swell, resulting in debilitating pain, and in the most severe cases, venous ulcers.
The VenoValve is being developed to treat CVI in the deep venous system with a focus on severe patients with C4b, C5 and C6 CVI.
We
estimate that approximately 2.4 million people in the U.S. have C5 to C6 CVI due to reflux in the deep venous system, including patients
that develop venous leg ulcers (C6 patients). Over one million new severe cases of CVI occur each year in the U.S., mostly from patients
who have experienced a deep vein thrombosis or blood clot. The average patient seeking treatment of a venous ulcer spends as much
as $30,000 a year on wound care, and the total direct medical costs from venous ulcer sufferers in the U.S. has been estimated to exceed
$38 billion a year. Aside from the direct medical costs, severe CVI sufferers experience a significantly reduced quality of life. Daily
activities such as preparing meals, housework, and personal hygiene (washing and bathing) become difficult due to reduced mobility. For
many severe CVI sufferers, intense pain, which frequently occurs at night, prevents patients from getting adequate sleep. Severe CVI
sufferers are known to miss approximately 40% more work days than the average worker. A high percentage of venous ulcer patients also
experience severe itching, leg swelling, and an odorous discharge. Wound dressing changes, which occur several times a week, can be extremely
painful. Venous ulcers from deep venous CVI are very difficult to heal, and a significant percentage of venous ulcers remain unhealed
for more than a year. Even if healed, recurrence rates for venous ulcers are known to be high (20% to 40%) within the first year and
as high as 60% after five years.
3
VenoValve
Clinical Status
After
consultation with the FDA, and as a precursor to the U.S. pivotal trial, we conducted a small first-in-human study for the VenoValve
in Colombia which included eleven (11) patients. In addition to providing safety and efficacy data, the purpose of the first-in-human
study was to provide proof of concept, and to provide valuable feedback to make any necessary product modifications or adjustments to
our surgical implantation procedure for the VenoValve prior to conducting the U.S. pivotal trial. Endpoints for the VenoValve first-in-human
study included safety (device related adverse events), reflux, measured by doppler, a VCSS score used by the clinician to measure disease
severity and progress, a VAS score used by the patient to measure pain, and a quality of life measurement.
Final
results from the one (1) year first-in-human study were presented at the Charing Cross International Symposium in April of 2021. Among
the eleven (11) patients in the study, reflux improved an average of 54%, Venous Clinical Severity Scores (“VCSSs”) improved
an average of 56%, and visual analog scale (VAS) scores, which are used by patients to measure pain, improved an average of 76%, all
at one (1) year when compared to pre-surgery levels. VCSS scores are commonly used by clinicians in practice and in clinical trials to
objectively assess outcomes in the treatment of venous disease, and include ten characteristics including pain, inflammation, skin changes
such as pigmentation and induration, the number of active ulcers, and ulcer duration. The improvement in VCSS scores is significant and
indicates the VenoValve patients who had severe CVI pre-surgery, had mild CVI or the complete absence of disease at one-year post surgery.
There
were no device related safety incidences during the one (1) year first-in-human study. Non-device related safety incidences were minor
and included one (1) fluid pocket (which was aspirated), intolerance from Coumadin anticoagulation therapy, three (3) minor wound infections
(treated with antibiotics), and one occlusion due to patient non-compliance with anti-coagulation therapy.
In
preparation for the VenoValve U.S. pivotal trial, on March 5, 2021, we submitted an IDE application with the FDA.
An
investigational device exemption or IDE from the FDA is required before a medical device company can proceed with a pivotal trial for
a class III medical device. On April 1, 2021, we received notification from the FDA that our IDE application was approved. We have named
the U.S. pivotal trial for the VenoValve the SAVVE (Surgical Anti-reflux Veno Valve Endoprosthesis) study. It is a prospective,
non-blinded, single arm, multi-center study of seventy-five (75) CVI patients to be enrolled at up to 20 U.S. sites.
No product
modifications for the VenoValve were necessary following the first-in-human study and the SAVVE trial is evaluating the same device that
was used in the first-in-human study. Endpoints for the SAVVE trial mirror those endpoints used for the first-in-human study.
The primary safety endpoint for the pivotal trial is a material adverse safety event (mortality, deep wound infection, major bleeding,
ipsilateral deep vein thrombosis, pulmonary embolism) in no more than twenty six percent (26%) of the patients at one (1) month
post implantation, and the primary effectiveness endpoint for the pivotal trial is improvement in reflux of at least thirty percent (30%),
measured at six (6) months post VenoValve implantation. In the first-in-human study there were no reported material adverse safety events
at one (1) month post implantation, and reflux improved an average of fifty six percent (56%) at six (6) months post implantation. VCSS
scoring to measure disease manifestations, VAS scores to measure pain, and quality of life measurements will also be monitored in the
study.
4
On
August 3, 2020, we announced that the FDA granted Breakthrough Device Designation status to the VenoValve. The FDA’s Breakthrough
Devices Program was established to enable priority review for devices that provide more effective treatment or diagnosis of life threatening
or irreversibly debilitating diseases or conditions. The goal of the FDA’s Breakthrough Devices Program is to provide patients
and health care providers with timely access to medical devices by speeding up their development, assessment, and review, while preserving
the FDA’s mission to protect and promote public health.
At
the end of the VenoValve first-in-human study, eight (8) study participants agreed to additional monitoring. In August of 2021, longer
term follow-up data was presented at the Society of Vascular Surgery Conference in San Diego, for the cohort of eight (8) patients. That
data indicated no recurrences of the severe CVI that was present pre-VenoValve, including no ulcer recurrences for those patients whose
venous ulcers had healed following VenoValve surgery. There were no reported safety issues from the end of one (1) year first-in-human
study to the end of the two (2) year reporting period. In addition, the patients continued to improve, reporting 63%, 60%, and 93%, average
improvements in reflux, VCSS, and VAS scores, respectively, at an average of two (2) years post VenoValve surgery compared to pre-VenoValve
levels.
In
October of 2021, we announced that the first patient in the SAVVE pivotal trial underwent successful VenoValve implantation surgery
and had been discharged from the hospital. The surgery was performed by Dr. Adriana Laser, associate professor of surgery at Albany
Medical College and a vascular surgeon with Albany Med Vascular Surgery. As of December 31, 2021, ten (10) of our clinical trial
sites were activated and eligible to enroll patients in the SAVVE pivotal trial. As of March 24, 2022 we have sixteen (16)
clinical trial sites that are active to enroll patients in the SAVVE trial and expect to have nineteen (19) active sites by March
31, 2022. Also, as of March 24, 2022, we have completed nine (9) successful surgeries in the SAVVE pivotal trial for the VenoValve.
We expect to have our tenth surgery completed by March 31, 2022.
The
resurgence of COVID and the Omicron variant had both direct and indirect consequences on our clinical trial. Several of our clinical
sites put elective surgeries on hold and prohibited potential study subjects from coming to the hospital for screening. Further, as reported
in the media, COVID resurgences put an enormous strain on all hospital resources including clinical staffs. In addition to caring for
the influx of COVID patients, hospitals become short staffed due to their own employees’ COVID sicknesses, resulting in clinical
staff being reassigned to cover the shortfall. The lack of available clinical personnel both slows enrollment and impacts the speed at
which we can activate clinical sites.
Finally,
COVID impacts our patient population. Patients with COVID or who have had COVID within ninety (90) days of their screening, are excluded
from our study until after the ninety (90) day period has passed. In addition, concerns about getting COVID impact the patients’
willingness to undergo an elective surgical procedure with a one-night hospital stay. As hospital clinical operations return to more
normal levels, our goal is to fully enroll the SAVVE pivotal trial by the end of 2022 or the beginning of 2023. We
continue to monitor the ongoing overall impact of COVID on the SAVVE clinical trial and will issue updates when appropriate.
In
February of 2021, we raised $41.4 million of capital in a public offering of our common stock. In September of 2021, we raised
$20 million dollars of capital in a registered direct offering priced at the market under Nasdaq rules and purchased by a fund
managed by Perceptive Advisors, a leading life sciences investment firm. We finished 2021 with approximately $55 million of cash.
At our existing cash burn rate of approximately $4 million per quarter, we should have sufficient cash to fund operations through the
end of 2024 and into 2025. With primary endpoints following full enrollment in the SAVVE pivotal trial of thirty (30) days for safety,
and six (6) months for effectiveness, we expect to have primary endpoint data well in advance of the need to raise additional capital.
5
Government
Regulation
Our
product candidates and our operations are subject to extensive regulation by the FDA, and other federal and state authorities in the
United States, as well as comparable authorities in foreign jurisdictions. Our product candidates are subject to regulation as medical
devices in the United States under the Federal Food, Drug, and Cosmetic Act (“FDCA”), as implemented and enforced by the
FDA. The FDA regulates the development, design, non-clinical and clinical research, manufacturing, safety, efficacy, labeling, packaging,
storage, installation, distribution, servicing, recordkeeping, premarket clearance or approval, adverse event reporting, advertising,
promotion, marketing, and import and export of medical devices to ensure that medical devices distributed domestically are safe and effective
for their intended uses and otherwise meet the requirements of the FDCA.
PMA
Approval Pathway
Class
III devices such as the VenoValve generally require pre-market approval (PMA) before they can be marketed in the U.S. The PMA review
and approval process is more demanding than the 510(k) premarket notification process. In a PMA, the manufacturer must demonstrate that
the device is safe and effective, and the PMA must be supported by extensive data, including data from preclinical studies and human
clinical trials. The PMA also must contain a full description of the device and its components, a full description of the methods, facilities
and controls used for manufacturing, and proposed labeling. Following receipt of a PMA, the FDA determines whether the application is
sufficiently complete to permit a substantive review. If FDA accepts the application for review, it has 180 days under the FDCA to complete
its review of a PMA, although in practice, the FDA’s review often takes significantly longer, and can take several years. An advisory
panel of experts from outside the FDA may be convened to review and evaluate the application and provide recommendations to the FDA as
to the approvability of the device. The FDA may or may not accept the panel’s recommendation. In addition, the FDA generally will
conduct a pre-approval inspection of the applicant or its third-party manufacturers’ manufacturing facility or facilities to ensure
compliance with the QSR. The FDA will approve the new device for commercial distribution if it determines that the data and information
in the PMA constitute valid scientific evidence and that there is reasonable assurance that the device is safe and effective for its
intended use(s).
The
FDA may approve a PMA with post-approval conditions intended to ensure the safety and effectiveness of the device, including, among other
things, restrictions on labeling, promotion, sale and distribution, and collection of long-term follow-up data from patients in the clinical
study that supported PMA approval, or requirements to conduct additional clinical studies post-approval. The FDA may condition PMA approval
on some form of post-market surveillance when deemed necessary to protect the public health or to provide additional safety and efficacy
data for the device in a larger population or for a longer period of use. In such cases, the manufacturer might be required to follow
certain patient groups for a number of years and to make periodic reports to the FDA on the clinical status of those patients. Failure
to comply with the conditions of approval can result in material adverse enforcement action, including withdrawal of the approval. Certain
changes to an approved device, such as changes in manufacturing facilities, methods or quality control procedures, or changes in the
design performance specifications, which affect the safety or effectiveness of the device, require submission of a PMA supplement. PMA
supplements often require submission of the same type of information as a PMA, except that the supplement is limited to information needed
to support any changes from the device covered by the original PMA and may not require as extensive clinical data or the convening of
an advisory panel. Certain other changes to an approved device require the submission of a new PMA, such as when the design change causes
a different intended use, mode of operation and technical basis of operation, or when the design change is so significant that a new
generation of the device will be developed, and the data that were submitted with the original PMA are not applicable for the change
in demonstrating a reasonable assurance of safety and effectiveness. The VenoValve will require the approval of a PMA.
Clinical
Trials in Support of PMA
Clinical
trials are almost always required to support a PMA submission. All clinical investigations of devices to determine safety and effectiveness
must be conducted in accordance with the FDA’s investigational device exemption (IDE) regulations, which govern investigational
device labeling, prohibit promotion of the investigational device and specify an array of recordkeeping, reporting and monitoring responsibilities
of study sponsors and study investigators. If the device presents a “significant risk,” to human health, as defined by the
FDA, the FDA requires the device sponsor to submit an IDE application to the FDA, which must become effective prior to commencing human
clinical trials. A significant risk device is one that presents a potential for serious risk to the health, safety or welfare of a patient
and either is implanted, used in supporting or sustaining human life, substantially important in diagnosing, curing, mitigating or treating
disease or otherwise preventing impairment of human health, or otherwise presents a potential for serious risk to a subject. The
VenoValve required IDE applications prior to human testing in the United States, and we believe any future products such as
the enVVE will also require IDE applications before human testing in the United States.
An
IDE application must be supported by appropriate data, such as animal and laboratory test results, showing that it is safe to test the
device in humans and that the testing protocol is scientifically sound. The IDE will automatically become effective 30 days after receipt
by the FDA unless the FDA notifies the company that the investigation may not begin. If the FDA determines that there are deficiencies
or other concerns with an IDE for which it requires modification, the FDA may permit a clinical trial to proceed under a conditional
approval.
In
addition to IDE approval, a human, the study must be approved by, and conducted under the oversight of, an Institutional Review Board,
or IRB, for each clinical site. The IRB is responsible for the initial and continuing review of the study, and may pose additional requirements
for the conduct of the study. If an IDE application is approved by the FDA and one or more IRBs, human clinical trials may begin at a
specific number of investigational sites with a specific number of patients, as approved by the FDA. Acceptance of an IDE application
for review does not guarantee that the FDA will allow the IDE to become effective and, if it does become effective, the FDA may or may
not determine that the data derived from the trials support the safety and effectiveness of the device or warrant the continuation of
clinical trials. An IDE supplement must be submitted to, and approved by, the FDA before a sponsor or investigator may make a
change to the investigational plan that may affect its scientific soundness, study plan or the rights, safety or welfare of human subjects.
During a study, the sponsor is required to comply with the applicable FDA requirements, including, for example, trial monitoring, selecting
clinical investigators and providing them with the investigational plan, ensuring IRB review, adverse event reporting, record keeping
and prohibitions on the promotion of investigational devices or on making safety or effectiveness claims for them. The clinical investigators
in the clinical study are also subject to FDA’s regulations and must obtain patient informed consent, rigorously follow the investigational
plan and study protocol, control the disposition of the investigational device and comply with all reporting and recordkeeping requirements.
Additionally, after a trial begins, we, the FDA or the IRB could suspend or terminate a clinical trial at any time for various reasons,
including a belief that the risks to study subjects outweigh the anticipated benefits.
6
Post-market
Regulation
After
a device is cleared or approved for marketing, numerous and pervasive regulatory requirements continue to apply. These include: establishing
registration and device listing with the FDA; QSR requirements, which require manufacturers, including third-party manufacturers, to
follow stringent design, testing, control, documentation and other quality assurance procedures during all aspects of the design and
manufacturing process; labeling regulations and FDA prohibitions against the promotion of investigational products, or “off-label”
uses of cleared or approved products; requirements related to promotional activities; clearance or approval of product modifications
that could significantly affect safety or effectiveness or that would constitute a major change in intended use of one of our cleared
devices; medical device reporting regulations, which require that a manufacturer report to the FDA if a device it markets may have caused
or contributed to a death or serious injury, or has malfunctioned and the device or a similar device that it markets would be likely
to cause or contribute to a death or serious injury, if the malfunction were to recur; correction, removal and recall reporting regulations,
which require that manufacturers report to the FDA field corrections and product recalls or removals if undertaken to reduce a risk to
health posed by the device or to remedy a violation of the FDCA; and post-market surveillance activities and regulations.
Regulation
Outside of the U.S.
Each
country or territory outside of the U.S. has its own rules and regulations with respect to the manufacture, marketing and sale of medical
devices. For example, in December of 2018, we received regulatory approval from Instituto Nacional de Vigilancia de Medicamentos y Alimentos,
the Colombian equivalent of the U.S. Food and Drug Administration, for our first-in-human study for the VenoValve in Colombia.
At this time, other than the first-in-human trial in Colombia, we have not determined which countries outside of the U.S., if any, we
will seek approval for our product candidates.
Our
Competitive Strengths
We
believe we will offer the venous disease treatment market a compelling value proposition with the launch of our product candidates,
if approved, for the following reasons:
●
We
have extensive experience of proprietary processing and manufacturing methodology specifically applicable to the design, processing,
manufacturing and sterilization of our biologic tissue devices.
●
We
operate a 14,507 square foot manufacturing facility in Irvine, California. Our facility is designed expressly for the manufacture
of Class III tissue based implantable medical devices and is equipped for research and development, prototype fabrication, current
good manufacturing practices, or cGMP, and manufacturing and shipping for Class III medical devices, including biologic cardiovascular
devices.
●
We
have attracted senior executives who are experienced in research and development and who have worked on numerous medical devices
that have received FDA approval or CE marking. We also have the advantage of an experienced board of directors and scientific advisory
board who will provide guidance as we move towards market launch.
Intellectual
Property
We
possess an extensive proprietary processing and manufacturing methodology specifically applicable to the design, processing, manufacturing
and sterilization of biologic devices. This includes FDA compliant quality control and assurance programs, proprietary tissue processing
technologies demonstrated to eliminate recipient immune responses, trusted relationship with abattoir suppliers, and a combination of
tissue preservation and gamma irradiation that enhances device functions and guarantees sterility. We have filed several patent applications
for the VenoValve with the U.S. Patent and Trademark Office (USPTO) and throughout the world. In February of 2021, we
received a notice for allowance from the USPTO for an application focusing on novel aspects of the VenoValve Frame.
Employees
As
of March 24, 2022, we had 24 full-time employees. None of our employees are represented by a collective bargaining agreement,
and we have never experienced any work stoppage. We believe we have good relations with our employees.
Corporate
Information
We
were incorporated in Delaware on December 22, 1999. Our principal executive offices are located at 70 Doppler, Irvine, California, 92618,
and our telephone number is (949) 261-2900. Our corporate website address is www.envveno.com. The information contained on or accessible
through our website is not a part of this prospectus, and the inclusion of our website address in this prospectus is an inactive textual
reference only.
7
ITEM
1A.
Risk
Factors
Investing
in our securities involves a high degree of risk. You should carefully consider the risks and uncertainties described below, together
with all of the other information contained in this Annual Report, before deciding to invest in our securities. If any of the following
risks materialize, our business, financial condition, results of operation and prospects will likely be materially and adversely affected.
In that event, the market price of our common stock could decline, and you could lose all or part of your investment.
Summary
The
risk factors described below are a summary of the principal risk factors associated with an investment in us. These are not the only
risks we face. You should carefully consider these risk factors and the other reports and documents filed by us with the SEC.
●
We
have incurred significant losses since our inception, expect to incur significant losses in the future and may never achieve or sustain
profitability;
●
We
currently depend entirely on the successful and timely regulatory approval and commercialization of our current lead product candidate,
and any future product candidates, which may not receive regulatory approval or, if our current lead or any future product candidate
does receive regulatory approval, we may not be able to successfully commercialize them;
●
The
success of our current or future products, if approved, will be determined based on whether surgeons and patients in our target
markets accept them;
●
Failure
to scale up the manufacturing process of our current or future product candidates in a timely manner, or at all;
●
Our
ability to retain and recruit key personnel, including the development of a sales and marketing infrastructure;
●
Reliance
on third party suppliers for certain components of our product candidates;
●
If
we successfully develop product candidates, our ability to commercialize and distribute our product candidates in the United States
and internationally, depends on our ability to demonstrate the efficacy and financial viability of our products to doctors,
hospitals, insurance companies, and other stakeholders;
●
Changes
in external competitive market factors;
●
Uncertainties
in generating sustained revenue or achieving profitability;
●
Unanticipated
working capital or other cash requirements;
●
Changes
in FDA regulations, including testing procedures, for medical devices and related promotional and marketing activities;
●
Our
estimates of our expenses, ongoing losses, future revenue, capital requirements and our needs for, or ability to obtain, additional
financing;
●
Our
ability to obtain and maintain intellectual property protection for our product candidates;
●
Product
liability lawsuits against us could cause us to incur substantial liabilities, limit sales of our existing product candidates and
limit commercialization of any products that we may develop;
●
Our
ability to maintain the listing of our securities on the Nasdaq Capital Market; and
●
Changes
in our business strategy or an inability to execute our strategy due to unanticipated changes in the medical device industry or
the impact of COVID-19 on our clinical trials.
Risks
Related to Our Business and Strategy
We
have incurred significant losses since our inception, expect to incur significant losses in the future and may never achieve or sustain
profitability.
We
have historically incurred substantial net losses, including net losses of $16.5 million and $9.1 million for the years ended December
31, 2021 and 2020, respectively. As a result of our historical losses, we had an accumulated deficit of $81.9 million as of December
31, 2021. Our losses have resulted primarily from costs related to general and administrative expenses relating to our operations, as
well as our research programs and the development of our product candidates. Currently, we are not generating revenue from operations,
and we expect to incur losses for the foreseeable future as we seek to obtain regulatory approval for our lead product candidate. Additionally,
we expect that our general and administrative expenses will increase due to the additional operational costs associated with our SAVVE
study as well as the projected expansion of our operations. We do not expect to generate significant revenue until any of our product
candidates are licensed or sold, if ever. We may never generate significant revenue or become profitable. Even if we do achieve profitability,
we may be unable to sustain or increase profitability on a quarterly or annual basis. Our failure to achieve and subsequently sustain
profitability could harm our business, financial condition, results of operations and cash flows.
We
currently depend entirely on the successful and timely regulatory approval and commercialization of our current lead product candidate,
and any future product candidates, which may not receive regulatory approval or, if any of our product candidates do receive regulatory
approval, we may not be able to successfully commercialize them.
We
currently have one product candidate, the VenoValve, and our business presently depends entirely on our success with this product candidate.
In order for our current lead and any future product candidates to succeed they need to be approved by regulatory authorities,
which may never happen. Our product candidates are based on technologies that have not been used previously in the manner we propose.
Market acceptance of our product candidates will largely depend on our ability to demonstrate their relative safety, efficacy, cost-effectiveness
and ease of use. We may not be able to successfully develop and commercialize our product candidates. If we fail to do so, we will not
be able to generate substantial revenues, if any.
We
are subject to rigorous and extensive regulation by the FDA in the United States and by comparable agencies in other jurisdictions, including
the European Medicines Agency, or EMA, in the European Union, or EU. Our lead product candidate is currently in development and we have
not received FDA approval for our product candidate. Our product candidates may not be marketed in the United States until they have
been approved by the FDA and may not be marketed in other jurisdictions until they have received approval from the appropriate foreign
regulatory agencies. Each product candidate requires significant research, development, preclinical testing and extensive clinical investigation
before submission of any regulatory application for marketing approval.
8
Obtaining
regulatory approval requires substantial time, effort and financial resources, and we may not be able to obtain approval of any of our
product candidates on a timely basis, or at all. The number, size, design and focus of preclinical and clinical trials that will be required
for approval by the FDA, the EMA or any other foreign regulatory agency varies depending on the device, the disease or condition that
the product candidates are designed to address and the regulations applicable to particular products. Preclinical and clinical data
can be interpreted in different ways, which could delay, limit or preclude regulatory approval. The FDA, the EMA and other foreign regulatory
agencies can delay, limit or deny approval of a product for many reasons, including, but not limited to:
●
a
product candidate may not be shown to be safe or effective;
●
the
clinical and other benefits of a product candidate may not outweigh its safety risks;
●
we
may not be able to enroll enough patients to complete our product studies;
●
clinical
trial results may be negative or inconclusive, or adverse medical events may occur during a clinical trial;
●
trial
patients may expire from reasons unrelated to our product, impairing our trials;
●
the
results of clinical trials may not meet the level of statistical significance required by regulatory agencies for approval;
●
regulatory
agencies may interpret data from pre-clinical and clinical trials in different ways than we do;
●
regulatory
agencies may not approve the manufacturing process or determine that the manufacturing is not in accordance with current good manufacturing
practices, or cGMPs;
●
a
product candidate may fail to comply with regulatory requirements; and/or
●
regulatory
agencies might change their approval policies or adopt new regulations.
If
our product candidates are not approved at all or quickly enough to provide net revenues to defray our operating expenses, our business,
financial condition, operating results and prospects could be harmed.
If
we are unable to successfully raise additional capital, our future clinical trials and product development could be limited and our long-term
viability may be threatened.
We
have experienced negative operating cash flows since our inception and have funded our operations primarily from proceeds received from
sales of our capital stock, the issuance of the convertible and non-convertible notes, and the sale of our products to larger medical
device companies. We will need to seek additional funds in the future through equity or debt financings, or strategic alliances with
third parties, either alone or in combination with equity financings, to complete our product development initiatives. These financings
could result in substantial dilution to the holders of our common stock, or require contractual or other restrictions on our operations
or on alternatives that may be available to us. If we raise additional funds by issuing debt securities, these debt securities could
impose significant restrictions on our operations. Any such required financing may not be available in amounts or on terms acceptable
to us, and the failure to procure such required financing could have a material and adverse effect on our business, financial condition
and results of operations, or threaten our ability to continue as a going concern.
Our
present and future capital requirements will be significant and will depend on many factors, including:
●
the
progress and results of our development efforts for our product candidates;
●
the
costs, timing and outcome of regulatory review of our product candidates;
●
the
costs and timing of preparing, filing and prosecuting patent applications, maintaining and enforcing our intellectual property rights
and defending any intellectual property-related claims;
●
the
effect of competing technological and market developments;
●
market
acceptance of our product candidates;
●
the
rate of progress in establishing coverage and reimbursement arrangements with domestic and international commercial third-party payors
and government payors;
●
the
ability to achieve revenue growth and improve gross margins;
●
the
extent to which we acquire or in-license other products and technologies; and
●
legal,
accounting, insurance and other professional and business-related costs.
We
may not be able to acquire additional funds on acceptable terms, or at all. If we are unable to raise adequate funds, we may have to
liquidate some or all of our assets or delay, reduce the scope of or eliminate some or all of our development programs.
If
we do not have, or are not able to obtain, sufficient funds, we may be required to delay development or commercialization of our product
candidates. We also may have to reduce the resources devoted to our product candidates or cease operations. Any of these factors could
harm our operating results.
9
The
COVID-19 pandemic has significantly negatively impacted our business.
The COVID-19 pandemic has
disrupted the global economy and has negatively impacted large populations including people and businesses that may be directly or
indirectly involved with the operation of our Company, the manufacturing, development, and testing of our product candidate, and the
clinical trials for our product candidate. The full scope and economic impact of COVID-19 is still unknown. There are many risks
from COVID-19 that could generally and negatively impact economies and healthcare providers in the countries where we do business,
the medical device industry as a whole, and development stage, pre-revenue companies such as NVNO. To-date, the primary impacts of
COVID-19 to our operations were stay-at-home work requirements, travel restrictions limiting our ability to initiate and continue
animal studies and patient trials, suspensions of elective surgeries at trial sites limiting our ability to enroll patients in
SAVVE, and disruptions to scheduled meetings with regulatory agencies such as the FDA. Notwithstanding these impacts, we were able
to use remote work tools, communications solutions, and other methods to continue our trials and regulatory submissions. The
resurgence of COVID and the Omicron variant caused several of our activated clinical sites to put elective surgeries on hold and
prohibit potential study subjects from coming to the hospital for screening. Labor shortages due to Omicron have also negatively
impacted hospital staffing in all departments, including clinical research. In addition to caring for the influx of COVID patients,
hospitals become short staffed due to their own employees’ COVID sicknesses, resulting in clinical staff being reassigned to
cover the shortfall. The lack of available clinical personnel both slows enrollment and impacts the speed at which we can activate
clinical sites. COVID also impacts our patient population. Patients with COVID or who have had COVID within ninety (90) days of
their screening, are excluded from our study until after the ninety (90) day period has passed. In addition, concerns about getting
COVID impact the patients’ willingness to undergo an elective surgical procedure with a one-night hospital stay. As a result,
the COVID resurgence has slowed patient enrollment for the SAVVE clinical trial and has resulted in delays in new clinical sites
being activated for enrollment. We are increasing the number of SAVVE sites and ensuring they are geographically dispersed to attempt
to mitigate the impact of reductions in elective surgery schedules. At this time, we have identified the following COVID-19
related risks that we believe have a greater likelihood of negatively impacting our Company, including, but not limited
to:
●
Federal,
State and local shelter-in-place directives which limit our employees from accessing our facility to manufacture, develop and test
our product candidates;
●
Federal,
State and local shelter-in-place directives which limit our ability to enroll sites or patients in our SAVVE trial;
●
Travel
restrictions and quarantine requirements which prevent us from initiating and continuing animal studies and patient trials both inside
and outside of the United States;
●
The
burden on hospitals and medical personnel resulting in the cancellation of non-essential medical procedures such as surgical procedures
needed to implant our product candidates for pre-clinical and clinical trials;
●
Delays
in the procurement of certain supplies and equipment that are needed to develop and test our product candidates;
●
Travel
restrictions which prevent patients from participating and continuing the participation in clinical trials.
We
may never be able to generate sufficient revenue from the commercialization of our product candidates to achieve and maintain profitability.
Our ability to operate profitably
in the future will depend upon, among other items, our ability to (i) fully develop product candidates, (ii) scale up our business and
operational structure, (iii) obtain regulatory approval of product candidates from the FDA, (iv) market and sell product candidates,
(v) successfully gain market acceptance of our product candidates, and (vi) obtain sufficient and on-time supply of components from our
third-party suppliers. If our product candidates are never successfully commercialized, we may never receive a return on our investments
in product development, regulatory compliance, manufacturing, and quality assurance, which may cause us to fail to generate revenue
and gain economies of scale from such investments.
10
We
only utilize a few suppliers for porcine tissue for our product candidate and the loss of a supplier could have an adverse impact on
our business.
We
rely on one domestic third-party vendor to supply porcine tissue for our product candidate. Our ability to supply our current
and future product candidates commercially, if approved, depends, in part, on our ability to obtain this porcine
tissue in accordance with our specifications and with regulatory requirements and in sufficient quantities to meet demand. Our ability
to obtain porcine tissue may be affected by matters outside our control, including that this supplier may cancel our arrangements
on short notice or have disruptions to their operations.
If
we are required to establish additional or replacement suppliers for the porcine tissue, it may not be accomplished quickly and our operations
could be disrupted. Even if we are able to find replacement suppliers, the replacement suppliers may need to be qualified and may require
additional regulatory authority approval, which could result in further delay. In the event of a supply disruption, our product inventories
may be insufficient to supply our customers and the development of any future product candidates would be delayed, limited or prevented,
which could have an adverse impact on our business.
We
depend upon third-party suppliers for certain components of our product candidate, making us vulnerable to supply problems and price
fluctuations, which could harm our business.
We
rely on a number of third-party suppliers to provide certain components of our product candidate. We do not have long-term supply agreements
with most of our suppliers, and, in many cases, we purchase goods on a purchase order basis. Our suppliers may encounter problems for
a variety of reasons, including unanticipated demand from larger customers, failure to follow specific protocols and procedures, failure
to comply with applicable regulations, equipment malfunction, quality or yield problems and environmental factors, any of which could
delay or impede their ability to meet our demand. Our reliance on these third-party suppliers also subjects us to other risks that could
harm our business, including:
●
interruption
of supply resulting from modifications to, or discontinuation of, a supplier’s operations;
●
delays
in product shipments resulting from defects, reliability issues or changes in components from suppliers;
●
price
fluctuations due to a lack of long-term supply arrangements for key components with our suppliers;
●
errors
in manufacturing components, which could negatively impact the effectiveness or safety of our product candidates or cause delays
in shipment of our product candidates;
●
discontinued
production of components, which could significantly delay our production and sales and impair operating margins;
●
inability
to obtain adequate supplies in a timely manner or on commercially reasonable terms;
●
difficulty
locating and qualifying alternative suppliers, especially with respect to our sole-source supplies;
●
delays
in production and sales caused by switching components, which may require product redesign and/or new regulatory submissions;
●
delays
due to evaluation and testing of devices from alternative suppliers and corresponding regulatory qualifications;
●
non-timely
delivery of components due to our suppliers supplying products for a range of customers;
●
the
failure of our suppliers to comply with strictly enforced regulatory requirements, which could result in disruption of supply or
increased expenses; and
●
inability
of suppliers to fulfill orders and meet requirements due to financial hardships.
In
addition, there are a limited number of suppliers and third-party manufacturers that operate under the FDA’s Quality System Regulation,
or QSR, requirements, maintain certifications from the International Organization for Standardization that are recognized as harmonized
standards in the European Economic Area, or EEA, and that have the necessary expertise and capacity to supply components for our product
candidates. As a result, it may be difficult for us to locate manufacturers for our anticipated future needs, and our anticipated growth
may strain the ability of our current suppliers to deliver products, materials and components to us. If we are unable to arrange for
third-party manufacturing of components for our product candidates, or to do so on commercially reasonable terms, we may not be able
to complete development of, market and sell our current or new product candidates. Further, any supply interruption from our suppliers
or failure to obtain additional suppliers for any of the components used in our product candidates would limit our ability to manufacture
our product candidates. Failure to meet these commitments could result in legal action by our customers, loss of customers or harm to
our ability to attract new customers, any of which could have a material and adverse effect on our business, financial condition, results
of operations and growth.
11
If we successfully develop
product candidates, we will have to demonstrate the efficacy and financial viability of our products to doctors, hospitals,
insurance companies, and other stakeholders.
There
are multiple stakeholders that determine the success of a medical device, including doctors, hospitals, medical insurance companies,
and others. Educating these stakeholders on the benefits of product candidates will require a significant commitment by a marketing
team and sales organization. Surgeons and hospitals may be slow to change their practices because of familiarity with existing devices
and/or treatments, perceived risks arising from the use of new devices, lack of experience using new devices, lack of clinical data supporting
the benefits of such devices or the cost of new devices. There may never be widespread adoption of our product candidates by surgeons
and hospitals. In addition, medical insurance companies would need to understand the costs and benefits of our product candidates compared
to the existing standards of care, if they are to provide reimbursement for the cost of our product candidates and the procedures to
implant our product candidates. We may have difficulty and may never achieve the market acceptance that we need from doctors, hospitals,
medical insurance companies and others that are necessary for a successful product.
We may be
unable to convince hospital facilities to approve the use of our product candidates.
In the United States, in
order for surgeons to use our product candidates, the hospital facilities where these surgeons treat patients will typically require
that the product candidates receive approval from the facility’s VAC. VACs typically review the comparative effectiveness and
cost of medical devices used in the facility. The makeup and evaluation processes for VACs vary considerably, and it can be a
lengthy, costly and time-consuming effort to obtain approval by the relevant VAC. For example, even if we have an agreement
with a hospital system for the purchase of a product, in most cases, they must obtain VAC approval by each hospital
within the system to sell at that particular hospital. Additionally, hospitals typically require separate VAC approval for each
specialty in which a product is used, which may result in multiple VAC approval processes within the same hospital even if
such product has already been approved for use by a different specialty group. VAC approval is often needed for each different
product to be used by the surgeons in that specialty. In addition, hospital facilities and group purchasing organizations, or GPOs,
which manage purchasing for multiple facilities, may also require us to enter into a purchasing agreement and satisfy
numerous elements of their administrative procurement process, which can also be a lengthy, costly and time-consuming effort. If we
do not receive access to hospital facilities in a timely manner, or at all, via these VAC and purchasing contract processes, or
otherwise, or if we are unable to secure contracts on commercially reasonable terms in a timely manner, or at all, our
costs may increase, our sales may decrease and our operating results may be harmed.
Our
long-term growth depends on our ability to develop and commercialize additional product candidates.
The
medical device industry is highly competitive and subject to rapid change and technological advancements. Therefore, it is important
to our business that we continue to enhance our product candidate offerings and introduce new product candidates. Developing new product
candidates is expensive and time-consuming. Even if we are successful in developing additional product candidates, the success of any
new product candidates or enhancements to existing product candidates will depend on several factors, including our ability to:
●
properly
identify and anticipate surgeon and patient needs;
●
develop
and introduce new product candidates or enhancements in a timely manner;
●
develop
an effective and dedicated sales and marketing team;
●
avoid
infringing upon the intellectual property rights of others;
●
demonstrate,
if required, the safety and efficacy of new product candidates with data from preclinical studies and clinical trials;
●
obtain
the necessary regulatory clearances or approvals for new product candidates or enhancements;
●
be
fully FDA-compliant with marketing of new product candidates or modified product candidates;
●
provide
adequate training to potential users of our product candidates; and
●
receive
adequate coverage and reimbursement for procedures performed with our product candidates.
12
If
we are unsuccessful in developing and commercializing additional devices in other areas, our ability to realize our revenue may
be impaired.
New
technologies, techniques or products could emerge that might offer better combinations of price and performance than the products and
services that we plan to offer. Existing markets for surgical devices are characterized by rapid technological change and innovation.
It is critical to our success that we anticipate changes in technology and customer requirements and physician, hospital and healthcare
provider practices. It is also important that we successfully introduce new, enhanced and competitive product candidates to meet our
prospective customers’ needs on a timely and cost-effective basis. At the same time, however, we must carefully manage our introduction
of new product candidates. If potential customers believe that such product candidates will offer enhanced features or be sold for a
more attractive price, they may delay purchases until such product candidates are available. We may also continue to offer older obsolete
products as we transition to new product candidates, and we may not have sufficient experience managing transitions. If we do not successfully
innovate and introduce new technology into our anticipated product lines or successfully manage the transitions of our technology to
new product offerings, our revenue, results of operations and business could be adversely impacted.
Our
competitors may be able to respond more quickly and effectively than we can to new or changing opportunities, technologies, industry
standards, distribution reach or customer requirements. We anticipate that we will face strong competition in the future as current or
future competitors develop new or improved product candidates and as new companies enter the market with novel technologies.
If
we are unable to produce an adequate supply of our product candidates for use in our current and planned clinical trials or for commercialization
because of our limited manufacturing resources or our facility is damaged or becomes inoperable, our regulatory, development and commercialization
efforts may be delayed.
Our
manufacturing resources for our product candidates are limited. We currently manufacture our product candidates for our research and
development and clinical trial purposes at our manufacturing facility in Irvine, California. If our existing manufacturing facility
experiences a disruption, we would have no other means of manufacturing our product candidates until we are able to restore the manufacturing
capability at our current facility or develop alternative manufacturing facilities. Additionally, any damage to or destruction of our
facilities or our equipment, prolonged power outage or contamination at our facilities would significantly impair our ability to produce
our product candidates and prepare our product candidates for clinical trials.
Additionally,
in order to produce our product candidates in the quantities that will be required for commercialization, we will have to increase or
“scale up” our production process over the current level of production. We may encounter difficulties in scaling up our production,
including issues involving yields, controlling and anticipating costs, quality control and assurance, supply and shortages of qualified
personnel. If our scaled-up production process is not efficient or results in a product that does not meet quality or other standards,
we may be unable to meet market demand and our revenues, business and financial prospects would be adversely affected. Further, third
parties with whom we may develop relationships may not have the ability to produce the quantities of the materials we may require for
clinical trials or commercial sales or may be unable to do so at prices that allow us to price our products competitively.
Our
facility and equipment would be costly to replace and could require substantial lead time to repair or replace. The facility may be harmed
or rendered inoperable by natural or man-made disasters, including earthquakes, flooding, fire, vandalism and power outages, which may
render it difficult to operate our business for some period of time. While we have taken precautions to safeguard our facilities, any
inability to operate our business during such periods could lead to the loss of customers or harm to our reputation. We also possess
insurance for damage to our property and the disruption of our business, but this insurance may not be sufficient to cover all of our
potential losses and this insurance may not continue to be available to us on acceptable terms, or at all.
13
We currently have no
sales and marketing infrastructure and we may not be able to build a sales and marketing infrastructure sufficient for us to commercialize our current product candidate or future product candidates, if approved, and may be unable to do
so or may never generate sufficient revenue to achieve or sustain profitability.
In order to commercialize products
that are approved by regulatory agencies, we will have to increase our expenditures to undertake development or commercialization
activities. If we are unable to successfully execute commercialization activities, we may have to curtail the development of our product
candidates, reduce or delay development programs, delay potential commercialization of our product candidates or reduce the scope of
any sales or marketing activities.
If
it becomes necessary for us to establish a sales and marketing infrastructure, we may not be able to do so or we may not realize a positive
return on this investment. We would have to compete with established and well-funded medical device companies to recruit, hire, train
and retain sales and marketing personnel. Once hired, the training process is lengthy because it requires significant education of new
sales representatives to achieve the level of clinical competency with our products expected by specialists. Upon completion of the training,
we expect our sales representatives would typically require lead time in the field to grow their network of accounts and achieve the
productivity levels we expect them to reach in any individual territory. If we are unable to attract, motivate, develop and retain a
sufficient number of qualified sales personnel, or if our sales representatives do not achieve the productivity levels in the time period
we expect them to, our revenue will not grow at the rate we expect and our business, results of operations and financial condition will
suffer. Also, to the extent we hire sales personnel from our competitors, we may be required to wait until applicable non-competition
provisions have expired before deploying such personnel in restricted territories or incur costs to relocate personnel outside of such
territories. Any of these risks may adversely affect our ability to increase sales of our product candidates. If we are unable to expand
our sales and marketing capabilities, we may not be able to effectively commercialize our product candidates, which would adversely affect
our business, results of operations and financial condition.
Product
liability lawsuits against us could cause us to incur substantial liabilities, limit sales of our existing product candidates and limit
commercialization of any products that we may develop.
Our
business exposes us to the risk of product liability claims that are inherent in the manufacturing, distribution, and sale of medical
devices. This risk exists even if a device is cleared or approved for commercial sale by the FDA and manufactured in facilities licensed
and regulated by the FDA or an applicable foreign regulatory authority. Manufacturing and marketing of our commercial devices and clinical
testing of our product candidates, may expose us to product liability and other tort claims. Furthermore, surgeons may misuse our product
candidates or use improper techniques if they are not adequately trained, potentially leading to injury and an increased risk of product
liability. If our product candidates are misused or used with improper technique, we may become subject to costly litigation by our customers
or their patients. Regardless of the merit or eventual outcome, product liability claims may result in:
●
significant
litigation costs;
●
decreased
demand for our product candidates and any product candidates that we may develop;
●
damage
to our reputation;
●
withdrawal
of clinical trial participants;
●
substantial
monetary awards to trial participants, patients or other claimants;
●
loss
of revenue; and
●
the
inability to commercialize any product candidates that we may develop.
Although
we maintain liability insurance, the coverage limits of our insurance policies may not be adequate, and one or more successful claims
brought against us may have a material adverse effect on our business and results of operations. If we are unable to obtain insurance
in the future at an acceptable cost or on acceptable terms with adequate coverage, we will be exposed to significant liabilities.
14
The
loss of our executive officers or our inability to attract and retain qualified personnel may adversely affect our business, financial
conditions and results of operations.
Our
business and operations depend to a significant degree on the skills, efforts and continued services of our executive officers who have
critical industry experience and relationships. Although we have entered into employment agreements with our executive officers, they
may terminate their employment with us at any time. Accordingly, these executive officers may not remain associated with us. The efforts
of these persons will be critical to us as we continue to develop our product candidates and business. We do not carry key person life
insurance on any of our management, which would leave our company uncompensated for the loss of any of our executive officers.
Further,
competition for highly-skilled and qualified personnel is intense. As such, our future viability and ability to achieve sales and profit
will also depend on our ability to attract, train, retain and motivate highly qualified personnel in the diverse areas required for continuing
our operations. If we were to lose the services one or more of our current executive officers or if we are unable to attract, hire and
retain qualified personnel, we may experience difficulties in competing effectively, developing and commercializing our products and
implementing our business strategies, which could have a material adverse effect on our business, operations and financial condition.
Our
ability to use our net operating loss carry-forwards and certain other tax attributes may be limited.
As
of December 31, 2021 and 2020, we had available federal net operating loss carryforwards, or NOLs, of approximately $45.7 million and
$35.0 million. Pre-2018 federal NOLs carryovers of $12.0 million may be carried forward for twenty years and begin to expire in 2029.
Under the Tax Act, post-2017 federal NOLs can be carried forward indefinitely and the annual limit of deduction equals 80% of taxable
income. However, to the extent the Company utilizes its NOL carryforwards in the future, the tax years in which the attribute was generated
may still be adjusted upon examination by the Internal Revenue Service or state tax authorities of the future period tax return in which
the attribute is used. As of December 31, 2021, and 2020, the Company had net operating loss carryforwards for state income tax purposes
of approximately $45.7 million and $35.0 million, respectively, which can be carried forward for twenty years and begin to expire in
2028.
As
of December 31, 2021, we also had federal research and development tax credit carryforwards of approximately $0.2 million which begin
to expire in 2027. In general, under Sections 382 and 383 of the Internal Revenue Code of 1986, as amended, or the Code, a corporation
that undergoes an “ownership change” (generally defined as a cumulative change in equity ownership by “5% shareholders”
that exceeds 50 percentage points over a rolling three-year period) may be subject to limitations on its ability to utilize its NOLs
and certain credit carryforwards to offset future taxable income and taxes. We have analyzed the tax impacts of ownership changes that
occurred in 2018 and in 2021. While those ownership changes have resulted in limits to the amount of NOLs that may be used in a given
year, these are all post 2017 NOLs and are carried forward indefinitely. Future changes in our stock ownership, as well as other changes
that may be outside of our control, could result in additional ownership changes. Our NOLs and credit carryforwards may also be limited
under similar provisions of state law. We have recorded a full valuation allowance related to our NOLs and other deferred tax assets
due to the uncertainty of the ultimate realization of the future tax benefits of such assets.
15
Risks
Related to Regulatory Approval and Other Governmental Regulations
Our
business and product candidates are subject to extensive governmental regulation and oversight, and our failure to comply with applicable
regulatory requirements could harm our business.
Our
product candidates and operations are subject to extensive regulation in the United States by the FDA and by regulatory agencies in other
countries where we anticipate conducting business activities. The FDA regulates the development, testing, manufacturing, labeling, storage,
record-keeping, promotion, marketing, sales, distribution and post-market support and reporting of medical devices in the United States.
The regulations to which we are subject are complex and may become more stringent over time. Regulatory changes could result in restrictions
on our ability to carry on or expand our operations, higher than anticipated costs or lower than anticipated sales.
In
order to conduct a clinical investigation involving human subjects for the purpose of demonstrating the safety and effectiveness of a
medical device, a company must, among other things, apply for and obtain Institutional Review Board, or IRB, approval of the proposed
investigation. In addition, if the clinical study involves a “significant risk” (as defined by the FDA) to human health,
the sponsor of the investigation must also submit and obtain FDA approval of an IDE application. Our product candidates are considered
significant risk devices requiring IDE approval prior to investigational use. We may not be able to obtain FDA and/or IRB approval to
undertake clinical trials in the United States for any new devices we intend to market in the United States in the future. If we obtain
such approvals, we may not be able to conduct studies which comply with the IDE and other regulations governing clinical investigations
or the data from any such trials may not support clearance or approval of the investigational device. Failure to obtain such approvals
or to comply with such regulations could have a material adverse effect on our business, financial condition and results of operations.
It is uncertain whether clinical trials will meet desired endpoints, produce meaningful or useful data and be free of unexpected adverse
effects, or that the FDA will accept the validity of foreign clinical study data, and such uncertainty could preclude or delay market
clearance or authorizations resulting in significant financial costs and reduced revenue.
Our
product candidates may be subject to extensive governmental regulation in foreign jurisdictions, such as the EEA, and our failure
to comply with applicable requirements could cause our business, results of operations and financial condition to suffer.
In
the EEA, our product candidates will need to comply with the Essential Requirements set forth in Medical Device Regulation. Compliance
with these requirements is a prerequisite to be able to affix a CE mark to a product, without which a product cannot be marketed or sold
in the EEA. To demonstrate compliance with the Essential Requirements and obtain the right to affix the CE mark to our product candidates,
we must undergo a conformity assessment procedure, which varies according to the type of medical device and its classification. The conformity
assessment procedure requires the involvement of a Notified Body, which is an organization designated by a competent authority of an
EEA country to conduct conformity assessments. The Notified Body would audit and examine the Technical File and the quality system for
the manufacture, design and final inspection of our products. The Notified Body issues a CE Certificate of Conformity following successful
completion of a conformity assessment procedure and quality management system audit conducted in relation to the medical device and its
manufacturer and their conformity with the Essential Requirements. This Certificate entitles the manufacturer to affix the CE mark to
its medical products after having prepared and signed a related EC Declaration of Conformity.
As
a general rule, demonstration of conformity of medical products and their manufacturers with the Essential Requirements must be based,
among other things, on the evaluation of clinical data supporting the safety and performance of the products during normal conditions
of use. Specifically, a manufacturer must demonstrate that the device achieves its intended performance during normal conditions of use
and that the known and foreseeable risks, and any adverse events, are minimized and acceptable when weighed against the benefits of its
intended performance, and that any claims made about the performance and safety of the device (e.g., product labeling and instructions
for use) are supported by suitable evidence. This assessment must be based on clinical data, which can be obtained from (1) clinical
studies conducted on the devices being assessed, (2) scientific literature from similar devices whose equivalence with the assessed device
can be demonstrated or (3) both clinical studies and scientific literature. However, the pre-approval and post-market clinical requirements
are much more rigorous. The conduct of clinical studies in the EEA is governed by detailed regulatory obligations. These may include
the requirement of prior authorization by the competent authorities of the country in which the study takes place and the requirement
to obtain a positive opinion from a competent Ethics Committee. This process can be expensive and time-consuming.
16
The
FDA regulatory approval, clearance and license process is complex, time-consuming and unpredictable.
In
the United States, our product candidates are expected to be regulated as medical devices. Before our medical device product candidates
may be marketed in the United States, we must submit, and the FDA must approve a PMA application. For the PMA approval process, the FDA
must determine that a proposed device is safe and effective for its intended use based, in part, on extensive data, including, but not
limited to, technical, pre-clinical, clinical trial, manufacturing and labeling data. In addition, modifications to products that are
approved through a PMA application generally require FDA approval. The time required to obtain approval, clearance or license by the
FDA to market a new therapy is unpredictable but typically takes many years and depends upon many factors, including the substantial
discretion of the FDA.
Our
product candidates could fail to receive regulatory approval, clearance or license for many reasons, including the following:
●
the
FDA may disagree with the design or implementation of our clinical trials or study endpoints;
●
we
may be unable to demonstrate to the satisfaction of the FDA that our product candidates are safe and effective for their proposed
indications or that our product candidates provide significant clinical benefits;
●
the
results of our clinical trials may not meet the level of statistical significance required by the FDA for approval, clearance or
license or may not support approval of a label that could command a price sufficient for us to be profitable;
●
the
FDA may disagree with our interpretation of data from preclinical studies or clinical trials;
●
the
opportunity for bias in the clinical trials as a result of the open-label design may not be adequately handled and may cause our
trial to fail;
●
our
product candidates may be subject to an FDA advisory committee review, which may be requested at the sole discretion of the FDA,
and which may result in unexpected delays or hurdles to approval;
●
the
FDA may determine that the manufacturing processes at our facilities or facilities of third-party manufacturers with which we contract
for clinical and commercial supplies are inadequate;
●
the
FDA may determine we cannot continue our clinical trials due to adverse patient reactions including patient deaths for reasons unrelated
to our products; and
●
the
approval, clearance or license policies or regulations of the FDA may significantly change in a manner rendering our clinical data
insufficient for approval.
Even
if we were to obtain approval, clearance or license, the FDA may grant approval, clearance or license contingent on the performance of
costly post-marketing clinical trials or may approve our product candidates with a label that does not include the labeling claims necessary
or desirable for successful commercialization of our product candidates. Any of the above could materially harm our product candidates’
commercial prospects.
17
Even
if our product candidates are approved by regulatory authorities, if we fail to comply with ongoing regulatory requirements, or if we
experience unanticipated problems with our product candidates, our product candidates could be subject to restrictions or withdrawal
from the market.
The
manufacturing processes, post-approval clinical data and promotional activities of any product candidate for which we obtain marketing approval will be subject to continual review and periodic inspections by the FDA and other regulatory bodies. Even if
regulatory approval of our product candidates is granted in the United States, the approval may be subject to limitations on the indicated
uses for which the product candidates may be marketed or contain requirements for costly post-marketing testing and surveillance to monitor
the safety or effectiveness of the product. Later discovery of previously unknown and unanticipated problems with our product candidates,
including but not limited to unanticipated severity or frequency of adverse events, delays or problems with the manufacturer or manufacturing
processes, or failure to comply with regulatory requirements, may result in restrictions on such product candidates or manufacturing
processes, withdrawal of the product candidates from the market, voluntary or mandatory recall, fines, suspension of regulatory approvals,
product seizures, injunctions or the imposition of civil or criminal penalties.
We
are required to report certain malfunctions, deaths and serious injuries associated with our products once approved by regulatory
bodies, which can result in voluntary corrective actions or agency enforcement actions.
All
manufacturers marketing medical devices in the EEA are legally bound to report incidents involving devices they produce or sell to the
regulatory agency, or competent authority, in whose jurisdiction the incident occurred. Under the EU Medical Devices Directive (Directive
93/42/EEC), an incident is defined as any malfunction or deterioration in the characteristics and/or performance of a device, as well
as any inadequacy in the labeling or the instructions for use which, directly or indirectly, might lead to or might have led to the death
of a patient, or user or of other persons or to a serious deterioration in their state of health. In addition, under the EU MDR, the
manufacturers are obligated to publish Periodic Safety Update Report (annually for high risk devices) which will be uploaded to EUDAMED
and require conformity assessment by Notified Bodies.
Malfunction
or misuse of our product candidates could result in future voluntary corrective actions, such as recalls, including corrections (e.g.,
customer notifications), or agency action, such as inspection or enforcement actions. If malfunctions or misuse do occur, we may be unable
to correct the malfunctions adequately or prevent further malfunctions or misuse, in which case we may need to cease manufacture and
distribution of the affected products, initiate voluntary recalls, and redesign the products or the instructions for use for those products.
Regulatory authorities may also take actions against us, such as ordering recalls, imposing fines, or seizing the affected products.
Any corrective action, whether voluntary or involuntary, will require the dedication of our time and capital, may distract management
from operating our business, and may harm our business, results of operations and financial condition.
Legislative
or regulatory reforms in the United States or the EU may make it more difficult and costly for us to obtain regulatory clearances or
approvals for product candidates or to manufacture, market or distribute product candidates after clearance or approval is obtained.
From
time to time, legislation is drafted and introduced in the U.S. Congress that could significantly change the statutory provisions governing
the regulation of medical devices or the reimbursement thereof. In addition, the FDA regulations and guidance are often revised or reinterpreted
by the FDA in ways that may significantly affect our business and our product candidates. For example, as part of the Food and Drug Administration
Safety and Innovation Act, or FDASIA, Congress reauthorized the Medical Device User Fee Amendments with various FDA performance goal
commitments and enacted several “Medical Device Regulatory Improvements” and miscellaneous reforms, which are further intended
to clarify and improve medical device regulation both pre- and post-clearance or approval. Any new statutes, regulations or revisions
or reinterpretations of existing regulations may impose additional costs or lengthen review times of any future products or make it more
difficult to manufacture, market or distribute our product candidates or future products. We cannot determine what effect changes in
regulations, statutes, legal interpretation or policies, when and if promulgated, enacted or adopted may have on our business in the
future. Such changes could, among other things, require:
●
additional
testing prior to obtaining clearance or approval;
●
changes
to manufacturing methods;
●
recall,
replacement or discontinuance of our systems or future products; or
●
additional
record keeping.
18
Any
of these changes could require substantial time and cost and could harm our business and our financial results.
The
highly publicized PIP scandal (use of non-medical grade silicone in breast implants) in 2010 led to publishing the first version of EU
Medical Device Regulation (MDR) by European Commission in 2012. After 347 amendments by European Parliament in 2014, followed by various
versions, the final version of the new EU Medical Device Regulation (MDR 2017/745) was published on May 5, 2017. The official entry to
force of the MDR started on May 26, 2017 with the transition period of 3 years. The date of application of all existing and new medical
devices under MDR is May 26, 2020; however, Notified Bodies are currently not accepting any new CE Mark applications under MDD
(Medical Device Directives). All existing MDD CE certificates become void on May 26, 2024. EU requires that all existing and new medical
device undergo assessment under MDR as if they are new product application.
The
changes from EU Medical Device Directives (MDD) to Medical Device Regulation (MDR) are significant, with stricter clinical requirements
and post-market surveillance, shift from pre-approval to Life-cycle approach, centralized EUDAMED database for public transparency (e.g.
Periodic Safety Update Reports) and device registration, more device specific requirements (e.g. Common Specifications), legal liability
for defective devices, etc. The QMS audit under MDR will be much more rigorous, including audits and assessment of suppliers and device
testing. In addition, EU MDR introduces new stakeholders participating during the application review process, which will result in a
longer and more burdensome assessment of our new products. The new stakeholders will include Medical Device Coordination Group (MDCG)
established by Member States and Expert Panels appointed by European Union.
Further,
under the FDA’s Medical Device Reporting or MDR regulations, we are required to report to the FDA any incident in which our product
candidates may have caused or contributed to a death or serious injury or in which our product malfunctioned and, if the malfunction
were to recur, would likely cause or contribute to death or serious injury. Any adverse event involving our products could result in
future voluntary corrective actions, such as product actions or customer notifications, or regulatory authority actions, such as inspection,
mandatory recall or other enforcement action. Repeated product malfunctions may result in a voluntary or involuntary product recall,
which could divert managerial and financial resources, impair our ability to manufacture our product candidates in a cost-effective and
timely manner and have an adverse effect on our reputation, financial condition and operating results.
Moreover,
depending on the corrective action we take to redress a product’s deficiencies or defects, the FDA may require, or we may decide,
that we will need to obtain new approvals or clearances for the device before we may market or distribute the corrected device. Seeking
such approvals or clearances may delay our ability to replace the recalled devices in a timely manner. Moreover, if we do not adequately
address problems associated with our product candidates, we may face additional regulatory enforcement action, including FDA warning
letters, product seizure, injunctions, administrative penalties, withdrawals or clearances or approvals or civil or criminal fines. We
may also be required to bear other costs or take other actions that may have a negative impact on our sales as well as face significant
adverse publicity or regulatory consequences, which could harm our business, including our ability to market our product candidates in
the future.
19
We
are subject to federal, state and foreign healthcare laws and regulations, and a finding of failure to comply with such laws and regulations
could have a material and adverse effect on our business.
Our
operations are, and will continue to be, directly and indirectly affected by various federal, state or foreign healthcare laws, including,
but not limited to, those described below. These laws include:
●
the
federal Anti-Kickback Statute, which prohibits, among other things, persons from knowingly and willfully soliciting, receiving, offering
or paying remuneration, directly or indirectly, in exchange for or to induce either the referral of an individual for, or the purchase,
order or recommendation of, any good or service for which payment may be made under federal healthcare programs, such as the Medicare
and Medicaid programs. A person or entity does not need to have actual knowledge of the federal Anti-Kickback Statute or specific
intent to violate it to have committed a violation. In addition, the government may assert that a claim including items or services
resulting from a violation of the federal Anti-Kickback Statute constitutes a false or fraudulent claim for purposes of the False
Claims Act. Violations of the federal Anti-kickback Statute may result in substantial civil or criminal penalties, including criminal
fines of up to $25,000, imprisonment of up to five years, civil penalties under the Civil Monetary Penalties Law of up to $50,000
for each violation, plus three times the remuneration involved, civil penalties under the federal False Claims Act of up to $11,000
for each claim submitted, plus three times the amounts paid for such claims and exclusion from participation in the Medicare and
Medicaid programs;
●
the
federal False Claims Act, which prohibits, among other things, individuals or entities from knowingly presenting, or causing to be
presented, claims for payment from Medicare, Medicaid or other federal third-party payors that are false or fraudulent. Suits filed
under the False Claims Act, known as “qui tam” actions, can be brought by any individual on behalf of the government
and such individuals, commonly known as “whistleblowers,” may share in any amounts paid by the entity to the government
in fines or settlement. When an entity is determined to have violated the False Claims Act, the government may impose penalties of
not less than $5,500 and not more than $11,000, plus three times the amount of the damages that the government sustains due to the
submission of a false claim and exclude the entity from participation in Medicare, Medicaid and other federal healthcare programs;
●
the
federal Civil Monetary Penalties Law, which prohibits, among other things, offering or transferring remuneration to a federal healthcare
beneficiary that a person knows or should know is likely to influence the beneficiary’s decision to order or receive items
or services reimbursable by the government from a particular provider or supplier;
●
HIPAA,
as amended by the HITECH Act, and their respective implementing regulations, which governs the conduct of certain electronic healthcare
transactions and protects the security and privacy of protected health information. Failure to comply with the HIPAA privacy and
security standards can result in civil monetary penalties up to $50,000 per violation, not to exceed $1.5 million per calendar year
for non-compliance of an identical provision, and, in certain circumstances, criminal penalties with fines up to $250,000 per violation
and/or imprisonment. State attorneys general can bring a civil action to enjoin a HIPAA violation or to obtain statutory damages
up to $25,000 per violation on behalf of residents of his or her state. HIPAA also imposes criminal penalties for fraud against any
healthcare benefit program and for obtaining money or property from a healthcare benefit program through false pretenses and provides
for broad prosecutorial subpoena authority and authorizes certain property forfeiture upon conviction of a federal healthcare offense.
Significantly, the HIPAA provisions apply not only to federal programs, but also to private health benefit programs. HIPAA also broadened
the authority of the U.S. Office of Inspector General of the U.S. Department of Health and Human Services to exclude participants
from federal healthcare programs;
●
the
federal physician sunshine requirements under the Patient Protection and Affordable Care Act, or PPACA, which requires certain manufacturers
of drugs, devices, biologics and medical supplies to report annually to the U.S. Department of Health and Human Services information
related to payments and other transfers of value to physicians, which is defined broadly to include other healthcare providers and
teaching hospitals and ownership and investment interests held by physicians and their immediate family members. Manufacturers are
required to submit reports to CMS by the 90 th day of each calendar year. Failure to submit the required information may
result in civil monetary penalties up to an aggregate of $150,000 per year (and up to an aggregate of $1 million per year for “knowing
failures”) for all payments, transfers of value or ownership or investment interests not reported in an annual submission,
and may result in liability under other federal laws or regulations; and
●
analogous
state and foreign law equivalents of each of the above federal laws, such as anti-kickback and false claims laws which may apply
to items or services reimbursed by any third- party payor, including commercial insurers; state laws that require device companies
to comply with the industry’s voluntary compliance guidelines and the applicable compliance guidance promulgated by the federal
government or otherwise restrict payments that may be made to healthcare providers and other potential referral sources; state laws
that require device manufacturers to report information related to payments and other transfers of value to physicians and other
healthcare providers or marketing expenditures; and state laws governing the privacy and security of health information in certain
circumstances, many of which differ from each other in significant ways and may not have the same effect, thus complicating compliance
efforts. Any failure by us to ensure that our employees and agents comply with applicable state and foreign laws and regulations
could result in substantial penalties or restrictions on our ability to conduct business in those jurisdictions, and our results
of operations and financial condition could be materially and adversely affected.
20
The
risk of our being found in violation of these laws is increased by the fact that many of them have not been fully interpreted by the
regulatory authorities or the courts, and their provisions are open to a variety of interpretations. Because of the breadth of these
laws and the narrowness of the statutory exceptions and safe harbors available under such laws, it is possible that some of our business
activities, including our relationships with surgeons and other healthcare providers, some of whom recommend, purchase and/or prescribe
our product candidates, and our distributors, could be subject to challenge under one or more of such laws.
If
our operations are found to be in violation of any of the laws described above or any other governmental regulations that apply to us
now or in the future, we may be subject to penalties, including civil and criminal penalties, damages, fines, disgorgement, exclusion
from governmental health care programs and the curtailment or restructuring of our operations, any of which could adversely affect our
ability to operate our business and our financial results. Any action against us for violation of these laws, even if we successfully
defend against it, could cause us to incur significant legal expenses and divert our management’s attention from the operation
of our business.
Regulatory
healthcare reform measures and other legislative changes may have a material and adverse effect on business, results of operations and
financial condition.
FDA
regulations and guidance are often revised or reinterpreted by FDA and such actions may significantly affect our business and our product
candidates. Any new regulations or revisions or reinterpretations of existing regulations may impose additional costs or lengthen review
times for our product candidates. Delays in receipt of, or failure to receive, regulatory approvals for our product candidates would
have a material and adverse effect on our business, results of operations and financial condition.
In
March 2010, the PPACA was signed into law, which includes a deductible 2.3% excise tax on any entity that manufactures or imports medical
devices offered for sale in the United States, with limited exceptions, that began on January 1, 2013. Although a two year moratorium
was placed on the medical device excise tax in 2016 and extended through December 31, 2019, it was permanently repealed on December 20,
2019. Other elements of the PPACA, including comparative effectiveness research, an independent payment advisory board and payment system
reforms, including shared savings pilots and other provisions, may significantly affect the payment for, and the availability of, healthcare
services and result in fundamental changes to federal healthcare reimbursement programs, any of which may materially affect numerous
aspects of our business, results of operations and financial condition.
In
addition, other legislative changes have been proposed and adopted in the United States since the PPACA was enacted. On August 2, 2011,
the Budget Control Act of 2011 created measures for spending reductions by Congress. A Joint Select Committee on Deficit Reduction, tasked
with recommending a targeted deficit reduction of at least $1.2 trillion for the years 2013 through 2021, was unable to reach required
goals, thereby triggering the legislation’s automatic reduction to several government programs. This includes aggregate reductions
of Medicare payments to providers up to 2% per fiscal year, which went into effect on April 1, 2013, and will remain in effect through
2024 unless additional Congressional action is taken. On January 2, 2013, the American Taxpayer Relief Act of 2012, or the ATRA, was
signed into law which further reduced Medicare payments to certain providers, including hospitals.
We
expect that additional state and federal healthcare reform measures will be adopted in the future, any of which could limit the amounts
that federal and state governments will pay for healthcare products and services, which could result in reduced demand for our product
candidates, if approved, and services or additional pricing pressures.
21
Our
relationships with physician consultants, owners and investors could be subject to additional scrutiny from regulatory enforcement authorities
and could subject us to possible administrative, civil or criminal sanctions.
Federal
and state laws and regulations impose restrictions on our relationships with physicians who are consultants, owners and investors. We
may enter into consulting agreements, license agreements and other agreements with physicians in which we provide cash as compensation.
We have or may have other written and oral arrangements with physicians, including for research and development grants and for other
purposes as well.
We
could be adversely affected if regulatory agencies were to interpret our financial relationships with these physicians, who may be in
a position to influence the ordering of and use of our product candidates for which governmental reimbursement may be available, as being
in violation of applicable laws. If our relationships with physicians are found to be in violation of the laws and regulations that apply
to us, we may be required to restructure the arrangements and could be subject to administrative, civil and criminal penalties, including
exclusion from participation in government healthcare programs, imprisonment, and the curtailment or restructuring of our operations,
any of which could negatively impact our ability to operate our business and our results of operations.
Our
company and many of our collaborators and potential collaborators are required to comply with the Federal Health Insurance Portability
and Accountability Act of 1996, the Health Information Technology for Economic and Clinical Health Act and implementing regulation affecting
the transmission, security and privacy of health information, and failure to comply could result in significant penalties.
Numerous
federal and state laws and regulations, including the Health Insurance Portability and Accountability Act of 1996, or HIPAA, and the
Health Information Technology for Economic and Clinical Health Act, or the HITECH Act, govern the collection, dissemination, security,
use and confidentiality of health information that identifies specific patients. HIPAA and the HITECH Act require our surgeon and hospital
customers and potential customers to comply with certain standards for the use and disclosure of health information within their companies
and with third parties. The Privacy Standards and Security Standards under HIPAA establish a set of standards for the protection of individually
identifiable health information by health plans, health care clearinghouses and certain health care providers, referred to as Covered
Entities, and the business associates with whom Covered Entities enter into service relationships pursuant to which individually identifiable
health information may be exchanged. Notably, whereas HIPAA previously directly regulated only these Covered Entities, the HITECH Act
makes certain of HIPAA’s privacy and security standards also directly applicable to Covered Entities’ business associates.
As a result, both Covered Entities and business associates are now subject to significant civil and criminal penalties for failure to
comply with Privacy Standards and Security Standards.
HIPAA
requires Covered Entities (like many of our customers and potential customers) and business associates to develop and maintain policies
and procedures with respect to protected health information that is used or disclosed, including the adoption of administrative, physical
and technical safeguards to protect such information. The HITECH Act expands the notification requirement for breaches of patient-identifiable
health information, restricts certain disclosures and sales of patient-identifiable health information and provides for civil monetary
penalties for HIPAA violations. The HITECH Act also increased the civil and criminal penalties that may be imposed against Covered Entities
and business associates and gave state attorneys general new authority to file civil actions for damages or injunctions in federal courts
to enforce the federal HIPAA laws and seek attorney fees and costs associated with pursuing federal civil actions. Additionally, certain
states have adopted comparable privacy and security laws and regulations, some of which may be more stringent than HIPAA.
Any
new legislation or regulation in the area of privacy and security of personal information, including personal health information, could
also adversely affect our business operations. If we do not comply with existing or new applicable federal or state laws and regulations
related to patient health information, we could be subject to criminal or civil sanctions and any resulting liability could adversely
affect our financial condition.
In
addition, countries around the world have passed or are considering legislation that would impose data breach notification requirements
and/or require that companies adopt specific data security requirements. If we experience a data breach that triggers one or more of
these laws, we may be subject to breach notification obligations, civil liability and litigation, all of which could also generate negative
publicity and have a negative impact on our business.
22
We
are currently, and in the future may be, subject to various governmental regulations related to the manufacturing of product candidates,
and we may incur significant expenses to comply with, experience delays in our product commercialization as a result of, and be subject
to material sanctions if we or our contract manufacturers violate these regulations.
Our
manufacturing processes and facility are required to comply with the FDA’s QSR, which covers the procedures and documentation of
the design, testing, production, control, quality assurance, labeling, packaging, sterilization, storage, and shipping of product
candidates. Although we believe we are compliant with the QSRs, the FDA enforces the QSR through periodic announced or unannounced inspections
of manufacturing facilities. We have been, and anticipate in the future being, subject to such inspections, as well as to inspections
by other federal and state regulatory agencies. We are required to register our manufacturing facility with the FDA and list all devices
that are manufactured. We also operate an International Organization for Standards, or ISO, 13485 certified facility and annual audits
are required to maintain that certification. The suppliers of our components are also required to comply with the QSR and are subject
to inspections. We have limited ability to ensure that any such third-party manufacturers will take the necessary steps to comply with
applicable regulations, which could cause delays in the delivery of our products. Failure to comply with applicable FDA requirements,
or later discovery of previously unknown problems with our products or manufacturing processes, including our failure or the failure
of one of our third-party manufacturers to take satisfactory corrective action in response to an adverse QSR inspection, can result in,
among other things:
●
administrative
or judicially imposed sanctions;
●
injunctions
or the imposition of civil penalties;
●
recall
or seizure of our product candidates;
●
total
or partial suspension of production or distribution;
●
the
FDA’s refusal to grant future clearance or pre-market approval for our product candidates;
●
withdrawal
or suspension of marketing clearances or approvals;
●
clinical
holds;
●
warning
letters;
●
refusal
to permit the import or export of our product candidates; and
●
criminal
prosecution of us or our employees.
Any
of these actions, in combination or alone, could prevent us from marketing, distributing, or selling our products and would likely harm
our business. In addition, a product defect or regulatory violation could lead to a government-mandated or voluntary recall by us. Regulatory
agencies in other countries have similar authority to recall devices because of material deficiencies or defects in design or manufacture
that could endanger health. Any recall would divert management attention and financial resources, could expose us to product liability
or other claims, including contractual claims from parties to whom we sold products and harm our reputation with customers. A recall
involving any of our product candidates would be particularly harmful to our business and financial results and, even if we remedied
a particular problem, would have a lasting negative effect on our reputation and demand for our products.
23
Risks
Related to Our Intellectual Property
If
we are unable to adequately protect our proprietary technology or maintain issued patents that are sufficient to protect our product
candidates, others could compete against us more directly, which could harm our business, financial condition and results of operations.
Our
success may depend in part on our success in obtaining and maintaining issued patents and other intellectual property rights in the United
States and elsewhere and protecting our proprietary technologies. If we do not adequately protect our intellectual property and proprietary
technologies, competitors may be able to use our technologies and erode or negate any competitive advantage we may have, which could
harm our business and ability to achieve profitability.
We
have filed patent applications for our VenoValve product and Implantable Vein Frame Two product with the U.S. Patent and Trademark Office
but there are no assurances that patents will be issued.
Our
patents may not have, or our pending patent applications that mature into issued patents may not include, claims with a scope sufficient
to protect our products, any additional features we develop for our current products or any new products. Other parties may have developed
technologies that may be related or competitive to our products, may have filed or may file patent applications and may have received
or may receive patents that overlap or conflict with our patent applications, either by claiming the same methods or devices or by claiming
subject matter that could dominate our patent position. The patent positions of medical device companies, including our patent position,
may involve complex legal and factual questions, and, therefore, the scope, validity and enforceability of any patent claims that we
may obtain cannot be predicted with certainty. Patents, if issued, may be challenged, deemed unenforceable, invalidated or circumvented.
Proceedings challenging our patents could result in either loss of the patent or denial of the patent application or loss or reduction
in the scope of one or more of the claims of the patent or patent application. In addition, such proceedings may be costly. Thus, any
patents that we may own may not provide any protection against competitors. Furthermore, an adverse decision in an interference proceeding
can result in a third party receiving the patent right sought by us, which in turn could affect our ability to commercialize our implant
systems.
Furthermore,
though an issued patent is presumed valid and enforceable, its issuance is not conclusive as to its validity or its enforceability and
it may not provide us with adequate proprietary protection or competitive advantages against competitors with similar products. Competitors
may also be able to design around our patents. Other parties may develop and obtain patent protection for more effective technologies,
designs or methods. We may not be able to prevent the unauthorized disclosure or use of our technical knowledge or trade secrets by consultants,
suppliers, vendors, former employees and current employees. The laws of some foreign countries do not protect our proprietary rights
to the same extent as the laws of the United States, and we may encounter significant problems in protecting our proprietary rights in
these countries. If any of these developments were to occur, they each could have a negative impact on our business and competitive position.
Our
ability to enforce our patent rights depends on our ability to detect infringement. It may be difficult to detect infringers who do not
advertise the components that are used in their products. Moreover, it may be difficult or impossible to obtain evidence of infringement
in a competitor’s or potential competitor’s product. We may not prevail in any lawsuits that we initiate and the damages
or other remedies awarded if we were to prevail may not be commercially meaningful.
In
addition, proceedings to enforce or defend our patents could put our patents at risk of being invalidated, held unenforceable or interpreted
narrowly. Such proceedings could also provoke third parties to assert claims against us, including that some or all of the claims in
one or more of our patents are invalid or otherwise unenforceable. If any of our patents covering our products are invalidated or found
unenforceable, our financial position and results of operations could be negatively impacted. In addition, if a court found that valid,
enforceable patents held by third parties covered one or more of our products, our financial position and results of operations could
be harmed.
We
rely upon unpatented trade secrets, unpatented know-how and continuing technological innovation to develop and maintain our competitive
position, which we will seek to protect, in part, by entering into confidentiality agreements with our employees and our collaborators
and consultants. We also have agreements with our employees and selected consultants that obligate them to assign their inventions to
us and have non-compete agreements with some, but not all, of our consultants. It is possible that technology relevant to our business
will be independently developed by a person that is not a party to such an agreement. Furthermore, if the employees and consultants who
are parties to these agreements breach or violate the terms of these agreements, we may not have adequate remedies for any such breach
or violation, and we could lose our trade secrets through such breaches or violations. Further, our trade secrets could otherwise become
known or be independently discovered by our competitors.
24
Obtaining
and maintaining our patent protection depends on compliance with various procedures, document submission requirements, fee payments and
other requirements imposed by governmental patent agencies, and our patent protection could be reduced or eliminated for non-compliance
with these requirements.
The
U.S. Patent and Trademark Office, or USPTO, and various foreign governmental patent agencies require compliance with a number of procedural,
documentary, fee payments such as maintenance and annuity fee payments and other provisions during the patent procurement process as
well as over the life span of an issued patent. There are situations in which noncompliance can result in abandonment or lapse of a patent
or patent application, resulting in partial or complete loss of patent rights in the relevant jurisdiction. In such an event, competitors
might be able to enter the market earlier than would otherwise have been the case.
We
may incur substantial costs as a result of litigation or other proceedings relating to patent and other intellectual property rights
and we may be unable to protect our rights to, or use, our technology.
Our
success will depend in part on our ability to operate without infringing the intellectual property and proprietary rights of third parties.
Our business, product candidates and methods could infringe the patents or other intellectual property rights of third parties.
The
medical device industry is characterized by frequent and extensive litigation regarding patents and other intellectual property rights.
Many medical device companies with substantially greater resources than us have employed intellectual property litigation as a way to
gain a competitive advantage. We may become involved in litigation, interference proceedings, oppositions, reexamination, protest or
other potentially adverse intellectual property proceedings as a result of alleged infringement by us of the rights of others or as a
result of priority of invention disputes with third parties, either in the United States or internationally. We may also become a party
to patent infringement claims and litigation or interference proceedings declared by the USPTO to determine the priority of inventions.
Third parties may also challenge the validity of any of our issued patents and we may initiate proceedings to enforce our patent rights
and prevent others from infringing on our intellectual property rights. Any claims relating to the infringement of third-party proprietary
rights or proprietary determinations, even if not meritorious, could result in costly litigation, lengthy governmental proceedings, diversion
of our management’s attention and resources, or entrance into royalty or license agreements that are not advantageous to us. In
any of these circumstances, we may need to spend significant amounts of money, time and effort defending our position. Some of our competitors
may be able to sustain the costs of complex patent litigation more effectively than we can because they have substantially greater resources.
In addition, any uncertainties resulting from the initiation and continuation of any litigation could have a material adverse effect
on our ability to raise the funds necessary to continue our operations.
Even
if we are successful in these proceedings, we may incur substantial costs and divert management time and attention in pursuing these
proceedings, which could have a material and adverse effect on us. If we are unable to avoid infringing the intellectual property rights
of others, we may be required to seek a license, defend an infringement action or challenge the validity of intellectual property in
court or redesign our product candidates.
25
Risks
Related to Ownership of Our Securities
The
trading price of our securities is likely to be volatile and could be subject to wide fluctuations in response to a variety of factors.
The
trading price of our securities is likely to be volatile and could be subject to wide fluctuations in response to a variety of factors,
which include:
●
whether
we achieve our anticipated corporate objectives;
●
actual
or anticipated fluctuations in our financial condition and operating results;
●
changes
in financial or operational estimates or projections;
●
the
development status of our product candidates and when our product candidates receive regulatory approval if at all;
●
our
execution of our sales and marketing, manufacturing and other aspects of our business plan;
●
performance
of third parties on whom we rely to manufacture our product candidate components and product candidates, including their ability
to comply with regulatory requirements;
●
the
results of our preclinical studies and clinical trials;
●
results
of operations that vary from those of our competitors and the expectations of securities analysts and investors;
●
our
announcement of significant contracts, acquisitions or capital commitments;
●
announcements
by our competitors of competing products or other initiatives;
●
announcements
by third parties of significant claims or proceedings against us;
●
regulatory
and reimbursement developments in the United States and internationally;
●
future
sales of our common stock;
●
product
liability claims;
●
healthcare
reform measures in the United States;
●
additions
or departures of key personnel; and
●
general
economic or political conditions in the United States or elsewhere.
In
addition, the stock market in general, and the stock of medical device companies like ours in particular, have experienced extreme price
and volume fluctuations that have often been unrelated or disproportionate to the operating performance of the issuer. These market and
industry factors may negatively affect the market price of our common stock, regardless of our actual operating performance.
We
have issued a significant number of options and warrants and may continue to do so in the future. The vesting and, if applicable, exercise
of these securities and the sale of the shares of common stock issuable thereunder may dilute your percentage ownership interest and
may also result in downward pressure on the price of our common stock.
As
of the date of this Annual Report, we have issued and outstanding options to purchase 3,463,107 shares of our common stock with
a weighted average exercise price of $9.14, 402,082 restricted stock units subject to vesting, and warrants to purchase 6,311,705
shares of our common stock with a weighted average exercise price of $8.81. Further, we have 619,087 shares available for issuance
under our Amended and Restated 2016 Omnibus Incentive Plan. The number of shares subject to the Plan may be adjusted from time to time
such that shares authorized under the plan shall at all times be equal to at least 20% of the issued and
outstanding shares of the Company on a fully diluted basis. Because the market for our common stock is thinly traded, the sales and/or
the perception that those sales may occur, could adversely affect the market price of our common stock. Furthermore, the mere existence
of a significant number of shares of common stock issuable upon vesting and, if applicable, exercise of these securities may be perceived
by the market as having a potential dilutive effect, which could lead to a decrease in the price of our common stock.
We
will need to raise additional capital to meet our business requirements in the future, and such capital raising may be costly or difficult
to obtain and can be expected to dilute current stockholders’ ownership interests .
We
will need to raise additional capital in the future.
Such additional capital may not be available on reasonable terms or at all. Any future issuance of our equity or equity-backed securities
may dilute then-current stockholders’ ownership percentages. If we are unable to obtain required additional capital, we may have
to curtail our growth plans or cut back on existing business.
We
may incur substantial costs in pursuing future capital financing, including investment banking fees, legal fees, accounting fees, securities
law compliance fees, printing and distribution expenses and other costs. We may also be required to recognize non-cash expenses in connection
with certain securities we may issue, such as convertible notes, restricted stock, stock options and warrants, which may adversely impact
our financial condition.
26
Future
sales or issuances of substantial amounts of our common stock could result in significant dilution.
Any
future issuance of our equity or equity-backed securities, including, potentially, the issuance of securities in connection with a merger
transaction, may dilute then-current stockholders’ ownership percentages and could also result in a decrease in the fair market
value of our equity securities, because our assets would be owned by a larger pool of outstanding equity. As stated above, we intend
to conduct additional rounds of financing in the future and we may need to raise additional capital through public or private offerings
of our common stock or other securities that are convertible into or exercisable for our common stock. We may also issue securities in
connection with hiring or retaining employees and consultants (including stock options issued under an equity incentive plan), as payment
to providers of goods and services, in connection with future acquisitions or for other business purposes. Our Board of Directors may
at any time authorize the issuance of additional common stock without stockholder approval, subject only to the total number of authorized
shares of common stock set forth in our articles of incorporation. The terms of equity securities issued by us in future transactions
may be more favorable to new investors, and may include dividend and/or liquidation preferences, superior voting rights and the issuance
of warrants or other derivative securities, which may have a further dilutive effect. Also, the future issuance of any such additional
shares of common stock or other securities may create downward pressure on the trading price of the common stock. There can be no assurance
that any such future issuances will not be at a price (or exercise prices) below the price at which shares of the common stock are then
traded on Nasdaq or other then-applicable over-the-counter quotation system or exchange.
Our
failure to meet the continued listing requirements of Nasdaq could result in a de-listing of our Common Stock.
While
we are currently in compliance with Nasdaq’s continued listing requirements, we have received deficiency notices in the past and
there is no guarantee that we will be able to continue to meet the continued listing requirements of Nasdaq. In the event we are unable
to do so, our securities may be delisted from The Nasdaq Stock Market. Such a delisting would likely have a negative effect on the price
of our Common Stock and would impair your ability to sell or purchase our Common Stock when you wish to do so. In the event of a delisting,
we would expect to take actions to restore our compliance with Nasdaq Marketplace Rules, but our common stock may not be listed again,
stabilize the market price or improve the liquidity of our common stock, prevent our common stock from dropping below the Nasdaq minimum
bid price requirement or prevent future non-compliance with the Nasdaq Marketplace Rules.
We
are an “emerging growth company” and the reduced disclosure requirements applicable to emerging growth companies could make
our common stock less attractive to investors.
We
are an “emerging growth company,” as defined in the JOBS Act. We may remain an emerging growth company until as late as December
2023 (the fiscal year-end following the fifth anniversary of the completion of our initial public offering), though we may cease to be
an emerging growth company earlier under certain circumstances, including (1) if the market value of our common stock that is held by
non-affiliates exceeds $700 million as of any June 30, in which case we would cease to be an emerging growth company as of the following
December 31, or (2) if our gross revenue exceeds $1.07 billion in any fiscal year. Emerging growth companies may take advantage of certain
exemptions from various reporting requirements that are applicable to other public companies, including not being required to comply
with the auditor attestation requirements of Section 404 of the Sarbanes-Oxley Act, reduced disclosure obligations regarding executive
compensation in our periodic reports and proxy statements and exemptions from the requirements of holding a nonbinding advisory vote
on executive compensation and stockholder approval of any golden parachute payments not previously approved. Investors could find our
common stock less attractive because we may rely on these exemptions. If some investors find our common stock less attractive as a result,
there may be a less active trading market for our common stock and our stock price may be more volatile.
In
addition, Section 102 of the JOBS Act also provides that an emerging growth company can take advantage of the extended transition period
provided in Section 7(a)(2)(B) of the Securities Act of 1933, as amended, or the Securities Act, for complying with new or revised accounting
standards. An emerging growth company can therefore delay the adoption of certain accounting standards until those standards would otherwise
apply to private companies. We have irrevocably elected not to avail ourselves of this exemption from new or revised accounting standards
and, therefore, we will be subject to the same new or revised accounting standards as other public companies that are not emerging growth
companies.
27
Provisions
of our charter documents or Delaware law could delay or prevent an acquisition of us, even if the acquisition would be beneficial to
our stockholders, which could make it more difficult for you to change management.
Provisions
in our amended and restated certificate of incorporation and our amended and restated bylaws may discourage, delay or prevent a merger,
acquisition or other change in control that stockholders may consider favorable, including transactions in which stockholders might otherwise
receive a premium for their shares. In addition, these provisions may frustrate or prevent any attempt by our stockholders to replace
or remove our current management by making it more difficult to replace or remove our board of directors. These provisions include, but
are not limited to:
●
a
classified board of directors so that not all directors are elected at one time;
●
a
prohibition on stockholder action through written consent;
●
no
cumulative voting in the election of directors;
●
the
exclusive right of our board of directors to elect a director to fill a vacancy created by the expansion of the board of directors
or the resignation, death or removal of a director;
●
a
requirement that special meetings of the stockholders may be called only by our chairman of the board, chief executive officer or
president, or by a resolution adopted by a majority of our board of directors;
●
an
advance notice requirement for stockholder proposals and nominations;
●
the
authority of our board of directors to issue preferred stock with such terms as our board of directors may determine; and
●
a
requirement of approval of not less than 50% of all outstanding shares of our capital stock entitled to vote to amend any bylaws
by stockholder action, or to amend specific provisions of our amended and restated certificate of incorporation.
In
addition, the Delaware General Corporate Law, or DGCL, prohibits a publicly held Delaware corporation from engaging in a business combination
with an interested stockholder, generally a person who, together with its affiliates, owns, or within the last three years has owned,
15% or more of our voting stock, for a period of three years after the date of the transaction in which the person became an interested
stockholder, unless the business combination is approved in a prescribed manner. Accordingly, the DGCL may discourage, delay,
or prevent a change in control of our company.
Furthermore,
our amended and restated certificate of incorporation specifies that the Court of Chancery of the State of Delaware will be the sole
and exclusive forum for most legal actions involving actions brought against us by stockholders. We believe this provision benefits us
by providing increased consistency in the application of the DGCL by chancellors particularly experienced in resolving corporate disputes,
efficient administration of cases on a more expedited schedule relative to other forums and protection against the burdens of multi-forum
litigation. However, the provision may have the effect of discouraging lawsuits against our directors and officers.
We
do not anticipate paying any cash dividends on our common stock in the foreseeable future and, as such, capital appreciation, if any,
of our common stock will be your sole source of gain for the foreseeable future.
We
have never declared or paid cash dividends on our common stock. We do not anticipate paying any cash dividends on our common stock in
the foreseeable future. We currently intend to retain all available funds and any future earnings to fund the development and growth
of our business. In addition, and any future loan arrangements we enter into may contain, terms prohibiting or limiting the amount of
dividends that may be declared or paid on our common stock. As a result, capital appreciation, if any, of our common stock will be your
sole source of gain for the foreseeable future.
28
ITEM
1B.
Unresolved
Staff Comments
None
ITEM
2.
Properties
and Facilities
We
lease a 14,507 square foot manufacturing facility in Irvine, California. We amended our lease on November 17, 2021 to extend the term
an additional 60 months from its September 30, 2022 expiration date to a new expiration date of September 30, 2027. Our facility is designed
expressly for the manufacture of biologic vascular grafts and is equipped for research and development, prototype fabrication, cGMP manufacturing
and shipping for Class III medical devices, including biologic cardiovascular devices. We believe that our facilities are sufficient
for the near future as there is present capacity to manufacture up to approximately 24,000 venous valves per year to meet potential market
demands.
ITEM
3.
Legal
Proceedings
From
time to time, we may be subject to litigation and arbitration claims incidental to its business. Such claims may not be covered by our
insurance coverage, and even if they are, if claims against us are successful, they may exceed the limits of applicable insurance coverage.
On July 9, 2020, the Company
was served with a civil complaint filed in the Superior Court for the State of California, County of Orange by a former employee, Robert
Rankin, who resigned his employment on or about March 30, 2020. The case is entitled Rankin v. Hancock Jaffe Laboratories, Inc.
et al., Case No. 30-2020-01146555-CU-WR-CJC and was filed on May 27, 2020. The complaint asserts several causes of action, including
a cause of action for failure to timely pay Mr. Rankin’s accrued and unused vacation and three months’ severance under his
July 16, 2018 employment agreement with the Company. Mr. Rankin alleges that he was forced to resign, however, we believe that he did
not give the Company notice or an opportunity to cure the allegations. The complaint seeks, inter alia, back pay, unpaid wages, compensatory
damages, punitive damages, attorneys’ fees, and costs. On September 3, 2020 the Company and its Chief Executive Officer were served
with a second complaint filed in the Superior Court for the State of California, County of Orange by Mr. Rankin. The case is entitled
Rankin v. Hancock Jaffe Laboratories, Inc. et al., Case No. 30-2020-01157857 and was filed on August 31, 2020. The complaint asserts
several causes of action, including defamation, unlawful labor code violations, sex-based discrimination, unfair competition, and seeks
damages for lost wages, emotional and mental distress, consequential damages, punitive damages and attorney’s fees and costs. Mr.
Rankin resigned as the Company’s Chief Financial Officer, Secretary and Treasurer on March 30, 2020. The Company has denied
all claims in both matters (which have now been consolidated) and has filed a counterclaim asserting that Rankin has breached his employment
agreement with the Company to the Company’s damage. The Company continues to believe it has meritorious defenses to both matters,
which are set for trial June 27, 2022.
ITEM
4.
Mine
and Safety Disclosure
Not
applicable.
29
PART
II
ITEM
5.
Market
for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities
Market
Information
Our
common stock trades on Nasdaq under the symbol “NVNO.” Our listed warrants trade on Nasdaq under the symbol “NVNOW.”
Holders
of Record
On
March 24, 2022, the closing price per share of our common stock and listed warrants were $5.00 and $0.19, respectively
as reported on The Nasdaq Capital Market. We had approximately 76 stockholders of record and 1 listed warrant holder of record
as of March 24, 2022. On March 24, 2022 there were 9,469,850 shares of our common stock issued and outstanding
and 69,000 shares of common stock issuable upon exercise of listed warrants issued and outstanding. In addition, we believe that a significant
number of beneficial owners of our common stock and listed warrants hold their shares in street name.
Securities
Authorized for Issuance under Equity Compensation Plan
The
following information is as of December 31, 2021.
Plan Category
Number of
securities to
be issued upon
exercise of
outstanding
options
Weighted-average
exercise price of
outstanding
options
Number of
granted restricted
stock unit awards
outstanding
Number of
securities
remaining
available for
future
issuance
under equity
compensation
plans
Equity compensation plans approved by security holders
3,441,907
$ 9.16
402,082
640,287
Equity compensation plans not approved by security holders
-
-
-
3,441,907
$ 9.16
402,082
640,287
Dividend
Policy
We
have never declared or paid any cash dividends on our capital stock. We do not anticipate paying cash dividends on our common stock in
the foreseeable future. We currently intend to retain all available funds and any future earnings to support our operations and finance
the growth and development of our business. Any future determination related to our dividend policy will be made at the discretion of
our board of directors and will depend upon, among other factors, our results of operations, financial condition, capital requirements,
contractual restrictions, business prospects, the requirements of current or then-existing debt instruments and other factors our board
of directors may deem relevant.
Recent
Sales of Unregistered Securities
None
Repurchases
of Equity Securities by Our Company
None.
ITEM
6.
Selected
Financial Data
As
a “smaller reporting company” as defined by Item 10 of Regulation S-K, the Company is not required to provide this information.
30
ITEM
7.
Management’s
Discussion and Analysis of Financial Condition and Results of Operations
The
following discussion should be read in conjunction with our consolidated financial statements and the related notes contained elsewhere
in this Annual Report on Form 10-K and in our other Securities and Exchange Commission filings. The following discussion may contain
predictions, estimates, and other forward-looking statements that involve a number of risks and uncertainties, including those discussed
under “Risk Factors” and elsewhere in this Annual Report on Form 10-K. These risks could cause our actual results to differ
materially from any future performance suggested below.
Overview
enVVeno
Medical Corporation is a med-tech company focused on improving the standard of care in the treatment of venous disease. We are developing
tissue-based solutions that are designed to be life sustaining or life enhancing for patients with deep venous Chronic Venous Insufficiency
(CVI). CVI occurs when valves inside of the veins of the leg fail, resulting in insufficient blood being returned to the heart. Our products
are being developed to address large unmet medical needs by either offering treatments where none currently exist or by substantially
increasing the current standards of care. Our lead product is a porcine based device to be surgically implanted in the deep venous system
of the leg, and is called the VenoValve®. The VenoValve is currently being evaluated in our SAVVE U.S. pivotal trial for the
purpose of obtaining approval to market and sell the device from the U.S. Food and Drug Administration (“FDA”). Our team
of officers and directors has been affiliated with numerous medical devices that have received FDA approval or CE marking and have been
commercially successful. We currently lease a 14,507 sq. ft. manufacturing facility in Irvine, California, where we manufacture medical
devices for our clinical trials, and which has capacity for commercial manufacturing.
On
September 21, 2021, we announced that we were changing our name from Hancock Jaffe to enVVeno Medical Corporation and that our development
strategy is to focus on the treatment of venous disease. In addition to the VenoValve, we announced that we have begun development of
a second device for the treatment of venous disease which we are calling enVVe. In connection with this change in strategy, we indicated
that we are not pursuing further development of the CoreoGraft, which is now outside of our primary focus area.
Results
of Operations
Comparison
of the year ended December 31, 2021 to the year ended December 31, 2020
Net
Loss
We
reported net losses of $16.5 million and $9.1 million for the years ended December 31, 2021 and 2020, respectively, representing an increase
in net loss of $7.4 million or 81%, resulting from, as described in further detail below, an increase in operating expenses of $7.8 million,
and an decrease in other expense (income) of $0.4 million.
Revenues
As
a developmental stage company, our revenue, if any, is expected to be diminutive and dependent on our ability to commercialize our product
candidates which is not expected in the near future.
Selling,
General and Administrative Expenses
For
the year ended December 31, 2021, selling, general and administrative expenses increased by $6.3 million or 129%, to $11.2 million
from $4.9 million for the year ended December 31, 2020. Of this increase, $5.3 million was due to share based compensation from
grants made during 2021, which increased share-based compensation cost to $6.0 million in 2021 from $0.7 million in 2020. The
remaining $1.0 million increase reflects $0.3 million in higher compensation due to the elevation of our chief financial
officer from interim, with the related costs included in consulting expenses, to full-time, with the related costs
included in compensation, and directors’ cash compensation in 2021, an increase in insurance expense of $0.2 million
primarily from the Company’s D&O insurance, $0.2 million from higher Delaware franchise taxes in 2021, $0.2 million from
consulting for reimbursement codes for the Company’s product once commercially approved, $0.4 million from higher information
technology and other office expense to support increases in staff, partially offset by a $0.3 million decrease in legal expenses
which decreased because of the resolution of several matters in 2020.
31
Research
and Development Expenses
For
the year ended December 31, 2021, research and development expenses increased by $1.4 million or 35%, to $5.7 million from $4.3 million
for the year ended December 31, 2020. The increase is primarily due to an increase of $1.1 million in compensation from the increases
in staffing to support the SAVVE trial and continued product development, $0.5 million in higher lab costs and supplies, also
to support the SAVVE trial and product development, an increase of $0.4 million for lab quality testing to prepare for regulatory audits
and the SAVVE trial, partially offset by a $0.6 million decrease in trial related consulting as the Columbian first in human trial wrapped
up in 2020 and the SAVVE trial was not launched until late in 2021. We expect our research and development costs will continue at
these levels with more moderate increases as we move through the SAVVE trial.
Gain
on Extinguishment of Note Payable
For
the year ended December 31, 2021 the Company recorded a one-time $0.3 million gain on extinguishment of note payable due to the forgiveness
of the loan it had obtained under the PPP program authorized by the CARES act.
Change
in Fair Value of Derivative Liability
For
the year ended December 21, 2020, we recorded a loss on the change in fair value of derivative liabilities of $0.1 million. Our derivative
liabilities were related to warrants issued in connection with our Bridge Offering in February 2020. There were no similar instruments
outstanding during the year ended December 31, 2021.
Other
Expenses
Other
expenses in 2020 primarily consisted of and $0.1 million in charges for warrants to purchase 6,400 shares of common stock issued to a
consultant and for repricing of warrants issued to the placement agent in the Company’s February 2020 private placement, and a
$0.1 million expense for warrants issued to certain participants in the exchange of preferred stock for common stock.
Liquidity
and Capital Resources
For
the twelve-months ended December 31, 2021, the Company incurred losses from operations of $16.9 million and used $11.8 million cash in
operating activities. The net cash used in operating activities during 2021 increased by $4.1
from $7.7 million for the year ended December 31, 2020.
The losses and the uses
of cash are primarily due to the Company’s administrative and product research and development activities. Administrative
functions relate to costs to support the Company’s public reporting and investor relations activities as well as internal
administrative functions. Research and development activities are for continued product development and clinical trials for the
VenoValve. The Company will continue to incur these costs to complete its clinical trials, enhance products, develop new products, and
operate as a public company. Although we have discretion in how we use the Company’s cash resources, we expect to continue
these activities for the foreseeable future as we seek to obtain regulatory approval for our lead product candidate. We are not
currently generating revenue.
Our cash flows from investing activity have historically consisted of purchases
of property and equipment for our lab and offices. In the year ended December 31, 2021 we purchased $0.4 million of property and equipment
consisting of $0.2 million for lab and test equipment, and $0.2 million for other computer equipment and software. In the year ended December
31, 2020 we purchased $0.2 million of property and equipment consisting of $0.1 million for lab and test equipment and $0.1 million for
other computer equipment and software. We do not currently have material commitments for capital expenditures or other expenditures with
the exception of our facility lease commitment of $0.4 million per year. However, we expect a modest increase in cash used in investment
activities as we continue SAVVE and plan for commercialization of the VenoValve.
The
Company has historically funded its operations through financing activities such as the capital raises completed in 2020 and 2021. During
2021, the Company raised an aggregate of $57.4 million in net proceeds in private and public placements of its securities. During 2020,
the Company raised an aggregate of $14.7 million in net proceeds in private and public placements of its common stock and of its preferred
stock. Our cash balance as of December 31, 2021, is $54.7 million.
Our future capital requirements
will remain dependent upon a variety of factors, especially including the success of our clinical trials and related product development
costs and our ability to successfully bring products to market. At our existing cash burn rate of approximately $4 million per quarter, we should have sufficient cash to fund operations through the
end of 2024 and into 2025. With primary endpoints following full enrollment in the SAVVE pivotal trial of thirty (30) days for safety,
and six (6) months for effectiveness, we expect to have primary endpoint data well in advance of the need to raise additional capital. Any inability to raise additional financing would have a material adverse effect on us.
Based
upon our cash and working capital as of December 31, 2021, we have sufficient capital resources to meet our obligations as they become
due within one year after the date of this Annual Report and sustain operations.
32
Off-Balance
Sheet Arrangements
None.
Contractual
Obligations
As
a “smaller reporting company” as defined by Item 10 of Regulation S-K, we are not required to provide the information requested
by paragraph (a)(5) of this Item.
Critical
Accounting Policies and Estimates
Basis
of Presentation
The
accompanying audited financial statements have been prepared in accordance with accounting principles generally accepted in the United
States of America (“GAAP”).
Use
of Estimates
The
preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires
management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosures of contingent
liabilities at the dates of the financial statements and the reported amounts of revenues and expenses during the reporting periods.
Actual results could differ from these estimates. Significant estimates and assumptions include the valuation allowance related to the
Company’s deferred tax assets, and the valuation of warrants and derivative liabilities.
Stock-Based
Compensation
The
Company measures the cost of services received in exchange for an award of equity instruments based on the fair value of the award. The
fair value of the award is measured on the grant date and recognized over the period services are required to be provided in exchange
for the award, usually the vesting period. Forfeitures of unvested stock options are recorded when they occur.
Concentrations
The
Company maintains cash with major financial institutions. Cash held in United States bank institutions is currently insured by the Federal
Deposit Insurance Corporation (“FDIC”) up to $250,000 at each institution. There were aggregate uninsured cash balances of
$54.5 million and $9.1 million as of December 31, 2021 and 2020, respectively.
ITEM
7A.
Quantitative
and Qualitative Disclosure About Market Risk
As
a “smaller reporting company” as defined by Item 10 of Regulation S-K, we are not required to provide information required
by this Item.
ITEM
8.
Financial
Statements and Supplementary Data
Please
see the financial statements beginning on page F-1 following the signature pages in this Annual Report on Form 10-K and incorporated
herein by reference.
33
ITEM
9.
Changes
in and Disagreements with Accountants on Accounting and Financial Disclosure
Not
Applicable.
ITEM
9A.
Controls
and Procedures
Evaluation
of Controls and Procedures
Our
management carried out an evaluation, under the supervision and with the participation of our Chief Executive Officer (who is our Principal
Executive Officer) and our Chief Financial Officer (who is our Principal Financial Officer and Principal Accounting Officer), of the
effectiveness of the design of our disclosure controls and procedures (as defined by Exchange Act Rules 13a-15(e) or 15d-15(e)) as of
December 31, 2021, pursuant to Exchange Act Rule 13a-15(b). Based upon that evaluation, our Principal Executive Officer and
Principal Financial Officer concluded that our disclosure controls and procedures were effective as of December 31, 2021 to provide reasonable
assurance that information required to be disclosed by us in the reports that we file or submit under the Exchange Act is accumulated
and communicated to management, including our Chief Executive Officer and our Chief Financial Officer, as appropriate, to allow timely
decisions regarding required disclosure and are effective to provide reasonable assurance that such information is recorded, processed,
summarized and reported within the time periods specified by the Securities and Exchange Commission’s rules and forms.
Inherent
Limitations on Effectiveness of Controls
It
should be noted that any system of controls, however well designed and operated, can provide only reasonable, and not absolute, assurance
that the objectives of the system will be met. In addition, the design of any control system is based in part upon certain assumptions
about the likelihood of future events. Because of these and other inherent limitations of control systems, there is only reasonable assurance
that our controls will succeed in achieving their goals under all potential future conditions.
Management’s
Report on Internal Control Over Financial Reporting
There
were changes in our internal control over financial reporting identified in connection with the evaluation required by Exchange Act Rule
13a-15(d) during the quarter ended December 31, 2021 that have materially affected, or are reasonably likely to materially affect, our
internal control over financial reporting. The change was to remediate and eliminate our previously disclosed material weakness over
reporting of complex financial transactions. Management, including the principal executive officer and principal financial officer, does
not expect that our disclosure controls and procedures or our internal control over financial reporting will prevent or detect all error
and all fraud. Controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving
their objectives and management necessarily applies its judgment in evaluating the cost-benefit relationship of possible controls and
procedures. Because of the inherent limitations in all control systems, no evaluation of controls can provide absolute assurance that
all control issues and instances of fraud, if any, within the Company have been detected. These inherent limitations include the realities
that judgments in decision-making can be faulty, and that breakdowns can occur because of a simple error or mistake. Additionally, controls
can be circumvented by the individual acts of some persons, by collusion of two or more people, or by management override of the controls.
The design of any system of controls also is based in part upon certain assumptions about the likelihood of future events, and there
can be no assurance that any design will succeed in achieving its stated goals under all potential future conditions. Over time, controls
may become inadequate because of changes in conditions, or deterioration in the degree of compliance with the policies or procedures.
Because of the inherent limitations in a cost-effective control system, misstatements due to error or fraud may occur and not be detected.
Our internal control over financial reporting is designed to provide reasonable assurance regarding the reliability of financial reporting
and the preparation of consolidated financial statements for external purposes in accordance with generally accepted accounting principles.
Under the supervision and
with the participation of our management, including the principal executive officer and principal financial officer, we conducted an
evaluation as to the effectiveness of our internal control over financial reporting as of December 31, 2021. In making this assessment,
our management used the criteria for effective internal control set forth by the Committee of Sponsoring Organizations of the Treadway
Commission in the 2013 Internal Control – Integrated Framework. Based on this assessment, our management concluded that our internal
control over financial reporting was effective as of December 31, 2021.
This
Annual Report on Form 10-K does not include an attestation report of our independent registered public accounting firm regarding internal
control over financial reporting. Management’s report was not subject to attestation by the Company’s independent registered
public accounting firm pursuant to a permanent exemption of the Commission that permits the Company to provide only management’s
report in this Annual Report on Form 10-K. Accordingly, our management’s assessment of the effectiveness of our internal control
over financial reporting as of December 31, 2021 has not been audited by our auditors, Marcum LLP.
Item
9B.
Other
Information
Not
Applicable.
Item 9C.
Disclosure Regarding Foreign Jurisdictions
That Prevent Inspections
Not Applicable.
34
PART
III
ITEM
10.
Directors,
Executive Officers and Corporate Governance
Listed
below are the names of the directors and executive officers of the Company, their ages as of the date of this Annual Report, their positions
held and the year they commenced service with the Company.
Name
Age
Position(s)
Held
Year
of Service Commencement
Robert
A. Berman
59
Director,
Chief Executive Officer
2018
Craig
Glynn
60
Chief
Financial Officer and Treasurer
2020
Dr.
Francis Duhay
61
Director
2018
Dr.
Sanjay Shrivastava
54
Director
2018
Matthew
M. Jenusaitis
60
Director
2019
Robert
C. Gray
75
Director
2019
Marc
H. Glickman, M.D.
73
Senior
Vice President and Chief Medical Officer
2016
Robert
A. Berman Robert Berman has served as our Chief Executive Officer and a member of our Board of Directors since April of 2018.
Mr. Berman has over 25 years of experience in a broad variety of areas including healthcare, finance, acquisitions, marketing, compliance,
turnarounds, and the development and licensing of emerging technologies. From September 2012 until July 2017, he served as the President,
Chief Executive Officer, and a member of the Board of Directors of ITUS Corporation (now called Anixa Biosciences), which at the time
he joined the company was a developer of flat panel display technologies, and under his leadership became a Nasdaq listed cancer therapeutics
company. From 2000 to March 2007, Mr. Berman was the Chief Operating Officer and General Counsel of Acacia Research Corporation, where
he successfully transitioned the company from being an incubator of internet startups into a preeminent, publicly traded company for
licensing and enforcing patented technologies with a market cap exceeding $2 billion. Mr. Berman started his career at the law firm of
Blank Rome. Mr. Berman has a B.S. in Entrepreneurial Management from the Wharton School of the University of Pennsylvania and holds a
J.D. from the Northwestern University School of Law, where he is an adjunct faculty member. We believe that Mr. Berman is qualified to
serve as a member of our board of directors because of his experience in a broad variety of areas including healthcare, finance, acquisitions,
marketing, compliance, turnarounds, and the development and licensing of emerging technologies.
Dr.
Francis Duhay has served as member of our board of directors since October 2018. A trained cardiac and thoracic surgeon, Dr.
Duhay has served the President and Chief Operating officer of Aegis Surgical Inc. and Atrius Inc., makers of cardiac accessory devices,
since 2016, and as a Partner in K5_Ventures, an early stage venture fund since 2017. Dr. Duhay is the former Chief Medical Officer at
Edwards Life Sciences, a world leader in heart valve products, where he led medical and clinical affairs for transcatheter and surgical
heart valves. During his tenure at Edwards Life Sciences, from 2008 to 2016, Dr. Duhay led the preparation and submission, and ultimate
regulatory approval, of two FDA Premarket Approval (PMA) applications for transcatheter and surgical heart valve therapies and was responsible
for the design and execution of the applicable clinical trials. From April 2008 to October 2011, Dr. Duhay was also the Vice President
and General Manager of the Ascendra™ transcatheter heart valve business unit at Edwards, where he grew the unit from sixteen to
eighty employees and contributed to annual growth in sales from $3 million to $250 million. From 1998 to 2003, Dr. Duhay served as the
Chief of the Department of Cardiothoracic Surgery and Cardiology at Kaiser Permanente. Dr. Duhay has also served as an industry representative
and clinical expert, and a member of the working group for ISO 5840, the international quality standard for the design, development,
and testing of heart valves. Dr. Duhay received his MBA from the University of Hawaii - Shidler College of Business and received his
board certification for Cardiothoracic Surgery and General Surgery from the Duke University School of Medicine and from the University
of California, San Francisco, respectively. We believe that Dr. Duhay is qualified to serve as a member of our board of directors because
he is a trained cardiac and thoracic surgeon and former Chief Medical Officer at Edwards Life Sciences.
35
Dr.
Sanjay Shrivastava has served as a member of our board of directors since October 2018. He has been involved in developing, commercializing,
evaluating, and acquiring medical devices for more than 21 years, including serving in leadership positions in research and development,
business development, and marketing at J&J, BTG, plc, Medtronic, Abbott Vascular, and Edwards Life Sciences. He is presently serving
as the chief executive officer at Innova Vascular, Inc., a medical device company funded largely via an investment from a publicly traded
medical device company. Prior to this, he co-founded BlackSwan Vascular, Inc., which is a clinical stage medical device company and where
he serves on the board of directors. He led the strategic alliance for BlackSwan with Sirtex Medical, which was announced in 2020. Dr.
Shrivastava worked on several acquisition and investment deals during his roles as a senior director, business development at J&J
and a vice president, upstream marketing and strategy at BTG, a medical device and specialty pharmaceutical company with annual revenue
of about $800 million. At Medtronic, Dr. Shrivastava was the Director of Global Marketing for the Cardiac and Vascular Group where he
helped build the embolization business, from its initiation to a substantial revenue with a very high CAGR over a period of six years.
Dr. Shrivastava was a Manager of Research and Development for the peripheral vascular business at Abbott Vascular and a Principal Research
and Development Engineer for Trans-Catheter heart valves at Edwards Life Sciences. Dr. Shrivastava received his Bachelor of Science in
engineering at the Indian Institute of Technology and a doctorate degree in materials science and engineering from the University of
Florida. We believe that Dr. Shrivastava is qualified to serve as a member of our board of directors because of having served in Chief
Executive Officer and board of director positions at several medical device start-ups, and leadership positions in research and development,
business development, and marketing at Innova Vascular, Inc., BTG, Medtronic, Abbott Vascular, and Edwards Life Sciences.
Matthew
M. Jenusaitis has served as a member of our board of directors since September 2019. He has over 30 years of health care experience
with an emphasis on building and selling companies that develop medical devices to treat vascular diseases. Since March 2015, Mr. Jenusaitis
has been a senior administrative executive at the UC San Diego Health System. He currently serves as the Chief Administrative Officer
for UCSD’s Moore’s Cancer Center and UCSD Oncology. From June 2009 to March 2015, Mr. Jenusaitis was President and CEO of
OCTANe Foundation for Innovation, a non-profit focused on the development of innovation in Orange County, CA. Over the course of his
career, Mr. Jenusaitis has been on the board of directors of Pulsar Vascular (2008-2017), which was sold to Johnson and Johnson, Creagh
Medical (2008-2015), which was sold to SurModics, and Precision Wire Components (2009-2014), which was sold to Creganna Medical. Mr.
Jenusaitis was also a Senior Vice President at ev3 (April 2006 to July 2008), which was sold to Covidian and later purchased by Medtronics.
In addition, Mr. Jenusaitis was the President of the Peripheral Division at Boston Scientific (July 2003 to August 2005) and was an Executive
in Residence at Warburg Pincus (September 2005 to March 2006). Mr. Jenusaitis has an MBA from the University of California, Irvine, a
Masters Degree in Biomedical Engineering from Arizona State University, and a Bachelors Degree in Chemical Engineering from Cornell University.
We believe that Mr. Jenusaitis is qualified to serve as a member of our board of directors because of over 30 years of health care experience
with an emphasis on building and selling companies that develop medical devices to treat vascular diseases and his prior board experiences.
Robert
C. Gray has served as a member of our board of directors since September 2019. He had a 20-year career at Highmark, Inc., one
of America’s largest health insurance organizations, which serves over 20 million subscribers, and includes Highmark Blue Cross
Blue Shield Pennsylvania, Highmark Blue Cross Blue Shield Delaware, and Highmark Blue Cross Blue Shield West Virginia, which he retired
from in 2008. While at Highmark, Mr. Gray helped increase revenues to $12.3 billion from $6.9 billion, and helped generate an operating
gain of $375 million from an operating loss of $91 million. In addition to being the board chairman, Chief Executive Officer, and President
of several of Highmark’s subsidiaries and affiliated companies, Mr. Gray was the Chief Financial Officer of Highmark’s parent
company and was the primary contact to Highmark’s board of directors for Highmark’s audit, investment and compensation (incentive
plans) committees. His many responsibilities at Highmark included rate setting and reimbursement negotiations. Following Highmark, Mr.
Gray co-founded U.S. Holdings LLC (U.S. Implants LLC.), a national distributor of orthopedic implants, and has served as Vice President
since 2009. Since 2011, Mr. Gray has also been self-employed as a strategy and financial consultant. Mr. Gray engaged in Postgraduate
Studies at the University of North Carolina–Chapel Hill and has an undergraduate degree from Bucknell University. We believe that
Mr. Gray is qualified to serve as a member of our board of directors because of his financial and medical reimbursement expertise having
served as the Chief Financial Officer at Highmark, Inc., one of America’s largest health insurance organization.
Marc
H. Glickman, M.D. has served as our Senior Vice President and Chief Medical Officer since May 2016 and served as member of our
board of directors from July 2016 to August 2017. In 1981, Dr. Glickman started a vascular practice in Norfolk, Virginia. He established
the first Vein Center in Virginia and also created a dialysis access center. He was employed by Sentara Health Care as director of Vascular
Services until he retired in 2014. Dr. Glickman is a board certified vascular surgeon. Dr. Glickman received his Doctor of Medicine from
Case Western Reserve, in Cleveland, Ohio and completed his residency at the University of Washington, Seattle. He is board certified
in Vascular Surgery and was the past president of the Vascular Society of the Americas. He has served on the advisory boards of Possis
Medical, Cohesion Technologies, Thoratec, GraftCath, Inc., TVA medical, Austin, Texas.
Craig
Glynn was hired as our interim Chief Financial Officer in April 2020 and has subsequently been elevated to our fulltime Chief
Financial Officer effective January 2021. Mr. Glynn has more than thirty-five years of experience providing financial services to a variety
of public and private companies, including in the role as Chief Financial Officer. In 2012, Mr. Glynn founded Edward Thomas Associates,
a firm that provides public and private companies with accounting and finance services, including chief financial officer services. Mr.
Glynn has been a Managing Director of Edward Thomas Associates since 2012. Mr. Glynn has a proven record of success managing the financial
aspects of dynamic organizations either as a member of the management team or in a consulting capacity. He started his career as an auditor
with Deloitte and went on to be the CFO and Controller of several technology, manufacturing, and distribution companies. Mr. Glynn earned
his BS and MS degrees in Accounting from California State University Northridge. He is a member of the American Institute of CPAs.
36
Family
Relationships
There
are no arrangements between our directors and any other person pursuant to which our directors were nominated or elected for their positions.
There are no family relationships between any of our directors or executive officers.
Section
16(a) Beneficial Ownership Reporting Compliance
Section
16(a) of the Exchange Act requires our directors, executive officers and ten percent stockholders to file initial reports of ownership
and reports of changes in ownership of our common stock with the Commission. Directors, executive officers and ten percent stockholders
are also required to furnish us with copies of all Section 16(a) forms that they file. Based upon a review of these filings, we believe
that all required Section 16(a) reports were made on a timely basis during fiscal year 2021.
Board
Composition
Our
business and affairs are organized under the direction of our board of directors, which currently consists of five members. Our directors
hold office until the earlier of their death, incapacity, removal or resignation, or until their successors have been elected and qualified.
Our board of directors does not have a formal policy on whether the roles of a Chief Executive Officer and Chairman of our board of directors
should be separate. The primary responsibilities of our board of directors are to provide oversight, strategic guidance, counseling and
direction to our management. Our board of directors meets on a regular basis. Our bylaws provide that the authorized number of directors
may be changed only by resolution of the board of directors.
We
have no formal policy regarding board diversity. Our priority in selection of board members is identification of members who will further
the interests of our stockholders through his or her established record of professional accomplishment, the ability to contribute positively
to the collaborative culture among board members, knowledge of our business and understanding of the competitive landscape.
Our
amended and restated certificate of incorporation divides our board of directors into three classes, with staggered three-year terms,
as follows:
Class
I Directors (serving until the 2024 Annual Meeting of Stockholders, or until their earlier death, disability, resignation or removal):
Dr.
Francis Duhay* and Dr. Sanjay Shrivastava*
Class
II Directors (serving until the 2022 Annual Meeting of Stockholders, or until their earlier death, disability, resignation or removal) :
Matthew
M. Jenusaitis*, Robert A. Berman
Class
III Director (serving until the 2023 Annual Meeting of Stockholders, or until his earlier death, disability, resignation or removal) :
Robert
C. Gray*
(*)
Independent Director.
At
each annual meeting of stockholders to be held after the initial classification, the successors to directors whose terms then expire
will serve until the third annual meeting following their election and until their successors are duly elected and qualified. The authorized
size of our board of directors is currently five members. The authorized number of directors may be changed only by resolution of the
board of directors. Any additional directorships resulting from an increase in the number of directors will be distributed between the
three classes so that, as nearly as possible, each class will consist of one-third of the directors. This classification of the board
of directors may have the effect of delaying or preventing changes in our control or management. Our directors may be removed for cause
by the affirmative vote of the holders of at least 66 2/3% of our voting stock.
37
Director
Independence
The
Nasdaq Marketplace Rules require a majority of a listed company’s board of directors to be comprised of independent directors within
one year of listing. In addition, the Nasdaq Marketplace Rules require that, subject to specified exceptions, each member of a listed
company’s audit, compensation and nominating and corporate governance committees be independent and that audit committee members
also satisfy independence criteria set forth in Rule 10A-3 under the Exchange Act.
Under
Rule 5605(a)(2) of the Nasdaq Marketplace Rules, a director will only qualify as an “independent director” if, in the opinion
of our board of directors, that person does not have a relationship that would interfere with the exercise of independent judgment in
carrying out the responsibilities of a director. In order to be considered independent for purposes of Rule 10A-3 of the Exchange Act,
a member of an audit committee of a listed company may not, other than in his or her capacity as a member of the audit committee, the
board of directors, or any other board committee, accept, directly or indirectly, any consulting, advisory, or other compensatory fee
from the listed company or any of its subsidiaries or otherwise be an affiliated person of the listed company or any of its subsidiaries.
Our
board of directors has reviewed the composition of our board of directors and its committees and the independence of each director. Based
upon information requested from and provided by each director concerning his background, employment and affiliations, including family
relationships, our board of directors has determined that each of Dr. Duhay, Mr. Gray, Mr. Jenusaitis and Dr. Shrivastava is an “independent
director” as defined under Rule 5605(a)(2) of the Nasdaq Marketplace Rules. Our board of directors also determined that Mr. Gray,
Mr. Jenusaitis and Dr. Shrivastava will serve on our audit committee, Mr. Gray and Mr. Jenusaitis and Dr. Shrivastava will serve on our
compensation committee, and Dr. Duhay, Mr. Jenusaitis and Dr. Shrivastava will serve on our nominating and corporate governance committee,
and that each of the committees satisfy the independence standards for such committees established by the SEC and the Nasdaq Marketplace
Rules, as applicable. In making such determinations, our board of directors considered the relationships that each such non-employee
director has with our company and all other facts and circumstances our board of directors deemed relevant in determining independence,
including the beneficial ownership of our capital stock by each non-employee director.
Meetings
of the Board and Stockholders
Our
board of directors met in person and telephonically seven times during 2021 and also acted by unanimous written consent. There were four
Audit Committee meetings, two Compensation meetings and one Nominating and Corporate Governance meeting held in 2021. Our board of directors
had 100% attendance for the Annual Meeting that was held on November 30, 2021. It is our policy that all directors must attend all stockholder
meetings, barring extenuating circumstances.
38
Board
Committees
Our
board of directors has established three standing committees—audit, compensation, and nominating and corporate governance—each
of which operates under a charter that has been approved by our board of directors. Copies of each committee’s charter are posted
on the Investors section of our website, which is located at www.envvenojaffe.com. Each committee has the composition and responsibilities
described below. Our board of directors may from time to time establish other committees.
Audit
Committee
Our
audit committee consists of Mr. Gray, who is the chair of the audit committee, Mr. Jenusaitis and Dr. Shrivastava. Our board of directors
has determined that each of the members of our audit committee satisfies the Nasdaq Marketplace Rules and SEC independence requirements.
The functions of this committee include, among other things:
●
evaluating
the performance, independence and qualifications of our independent auditors and determining whether to retain our existing independent
auditors or engage new independent auditors;
●
reviewing
and approving the engagement of our independent auditors to perform audit services and any permissible non-audit services;
●
reviewing
our annual and quarterly financial statements and reports, including the disclosures contained under the caption “Management’s
Discussion and Analysis of Financial Condition and Results of Operations,” and discussing the statements and reports with our
independent auditors and management;
●
reviewing
with our independent auditors and management significant issues that arise regarding accounting principles and financial statement
presentation and matters concerning the scope, adequacy and effectiveness of our financial controls;
●
reviewing
our major financial risk exposures, including the guidelines and policies to govern the process by which risk assessment and risk
management is implemented; and
●
reviewing
and evaluating on an annual basis the performance of the audit committee, including compliance of the audit committee with its charter.
Our
board of directors has determined that Mr. Gray qualifies as an “audit committee financial expert” within the meaning of
applicable SEC regulations and meets the financial sophistication requirements of the Nasdaq Marketplace Rules. Both our independent
registered public accounting firm and management periodically meet privately with our audit committee.
39
Compensation
Committee
Our
compensation committee consists of Dr. Shrivastava, who is the chair of the committee, Mr. Gray and Mr. Jenusaitis. Our board of directors
has determined that each of the members of our compensation committee is an outside director, as defined pursuant to Section 162(m) of
the Internal Revenue Code of 1986, as amended, or the Code, and satisfies the Nasdaq Marketplace Rules independence requirements. The
functions of this committee include, among other things:
●
reviewing,
modifying and approving (or if it deems appropriate, making recommendations to the full board of directors regarding) our overall
compensation strategy and policies;
●
reviewing
and approving the compensation, the performance goals and objectives relevant to the compensation, and other terms of employment
of our Chief Executive Officers and our other executive officers;
●
reviewing
and approving (or if it deems appropriate, making recommendations to the full board of directors regarding) the equity incentive
plans, compensation plans and similar programs advisable for us, as well as modifying, amending or terminating existing plans and
programs;
●
reviewing
and approving the terms of any employment agreements, severance arrangements, change in control protections and any other compensatory
arrangements for our executive officers;
●
reviewing
with management and approving our disclosures under the caption “Compensation Discussion and Analysis” in our periodic
reports or proxy statements to be filed with the SEC; and
●
preparing
the report that the SEC requires in our annual proxy statement.
Nominating
and Corporate Governance Committee
Our
nominating and corporate governance committee consists of Dr. Duhay, who is the chair of the committee, Mr. Jenusaitis and Dr. Shrivastava.
Our board of directors has determined that each of the members of this committee satisfies the Nasdaq Marketplace Rules independence
requirements. The functions of this committee include, among other things:
●
identifying,
reviewing and evaluating candidates to serve on our board of directors consistent with criteria approved by our board of directors;
●
evaluating
director performance on our board of directors and applicable committees of our board of directors and determining whether continued
service on our board of directors is appropriate;
●
evaluating,
nominating and recommending individuals for membership on our board of directors; and
●
evaluating
nominations by stockholders of candidates for election to our board of directors.
40
Code
of Conduct
Our
board of directors has adopted a written code of conduct that applies to our directors, officers and employees, including our principal
executive officer, principal financial officer, principal accounting officer or controller, or persons performing similar functions.
We have posted on our website a current copy of the code and all disclosures that are required by law or Nasdaq Marketplace Rules concerning
any amendments to, or waivers from, any provision of the code.
Board
Leadership Structure
Our board of directors is free
to select the Chairman of the board of directors and a Chief Executive Officer in a manner that it considers to be in the best interests
of our company at the time of selection. Currently, Robert A. Berman serves as our Chief Executive Officer. The office of the Chairman
of the board of directors has been vacant since May 2019. We currently believe that this leadership structure is in our best interests
and strikes an appropriate balance between our Chief Executive Officer’s responsibility for the day-to-day management of our company
and the Chairman of the board of directors’ responsibility to provide oversight, including setting the board of directors’
meeting agendas and presiding at executive sessions of the independent directors. Additionally, four of our five members of our board
of directors have been deemed to be “independent” by the board of directors, which we believe provides sufficient independent
oversight of our management. Our board of directors has not designated a lead independent director.
Our
board of directors, as a whole and also at the committee level, plays an active role overseeing the overall management of our risks.
Our Audit Committee reviews risks related to financial and operational items with our management and our independent registered public
accounting firm. Our board of directors is in regular contact with our Chief Executive Officer, who reports directly to our board of
directors and who supervises day-to-day risk management.
Role
of Board in Risk Oversight Process
Our
board of directors believes that risk management is an important part of establishing, updating and executing on our business strategy.
Our board of directors has oversight responsibility relating to risks that could affect the corporate strategy, business objectives,
compliance, operations, and the financial condition and performance of our company. Our board of directors focuses its oversight on the
most significant risks facing us and on our processes to identify, prioritize, assess, manage and mitigate those risks. Our board of
directors receives regular reports from members of our senior management on areas of material risk to us, including strategic, operational,
financial, legal and regulatory risks. While our board of directors has an oversight role, management is principally tasked with direct
responsibility for management and assessment of risks and the implementation of processes and controls to mitigate their effects on us.
Certain
Legal Proceedings
None
of the Company’s directors or executive officers have been involved, in the past ten years and in a manner material to an evaluation
of such director’s or officer’s ability or integrity to serve as a director or executive officer, in any of those “Certain
Legal Proceedings” more fully detailed in Item 401(f) of Regulation S-K, which include but are not limited to, bankruptcies, criminal
convictions and an adjudication finding that an individual violated federal or state securities laws.
41
ITEM
11.
Executive
Compensation
The
following table sets forth total compensation paid to our named executive officers for the years ended December 31, 2021 and 2020. Individuals
we refer to as our “named executive officers” include our current Chief Executive Officer, our current and previous Chief
Financial Officer and our other most highly compensated executive officer whose salary and bonus for services rendered in all capacities
exceeded $100,000 during the fiscal year ended December 31, 2021.
Name and
Principal
Position
Year
Salary
($)
Bonus
($)
Option
Awards ($)
Other
Equity Incentive Plan Compensation ($)
Nonqualified
Deferred Compensation Earnings ($)
All
Other Compensation ($)
Total
($)
Robert A. Berman
2021
400,000
250,000
7,674,046 (3)
1,340,000 (9)
15,655 (12)
9,679,701
Chief Executive Officer
2020
400,000
200,000
478,171 (4)
15,808 (13)
1,093,979
Craig Glynn
2021
225,000
25,000
2,960,418 (5)
335,000 (10)
651 (14)
3,546,069
Chief Financial Officer
2020
143,000 (1)
32,020 (6)
-
175,020
Marc H. Glickman, M.D.
2021
350,000
50,000
4,247,442 (7)
670,000
(11)
56,948 (15)
5,374,390
Chief Medical Officer and Senior Vice President
2020
350,000 (2)
50,000
321,928 (8)
-
-
53,976 (16)
775,904
(1)
Mr.
Glynn served as our Chief Financial Officer on an interim basis during 2020. Amounts in this column for Mr. Glynn include the amounts
paid to him in that capacity during 2020. In January 2021, the board of directors elevated Mr. Glynn to permanent Chief Financial
Officer. The company entered into an employment agreement with Mr. Glynn in February 2021.
(2)
Beginning
July 26, 2019, Dr. Glickman’s annual base salary rate under his employment agreement dated July 26, 2019, which superseded
his prior employment agreement, was $350,000. Amounts in this column for Dr. Glickman reflect his base salary earned for 2019.
(3)
Represents
the grant date fair value of 838,000 stock options granted on February 18, 2021, and 349,781 stock options granted on November 30,
2021, computed in accordance with FASB ASC Topic 718. The February options vest quarterly over a two-year period and the November
options vest quarterly over a three-year period.
(4)
Represents
the grant date fair value of 40,000 stock options granted on July 18, 2020, computed in accordance with FASB ASC Topic 718. The options
vest monthly over a three-year period. Also included is the fair value of his existing 43,209 options that were repriced from $124.75
per share to $10.00 per share.
(5)
Represents
the grant date fair value of 324,000 stock options granted on February 18, 2021 and 125,925 stock options granted on November 30,
2021, computed in accordance with FASB ASC Topic 718. The options vest quarterly over a three-year period.
(6)
Represents
the grant date fair value of 4,000 stock options granted on July 18, 2020, computed in accordance with FASB ASC Topic 718. The options
vest quarterly over a three-year period.
(7)
Represents
the grant date fair value of 406,000 stock options granted on February 18, 2021 and 265,700 stock options granted on November 30,
2021, computed in accordance with FASB ASC Topic 718. The February options vest quarterly over a two-year period and the November
options vest quarterly over a three-year period.
42
(8)
Represents
the grant date fair value of 40,000 stock options granted on July 18, 2020, computed in accordance with FASB ASC Topic 718. The options
vest monthly over a three-year period.
(9)
Represents
the grant date fair value of 200,000 shares of restricted stock units granted on November 30, 2021, computed based on the
closing price of the Company’s stock on the grant date.
(10)
Represents
the grant date fair value of 50,000 shares of restricted stock units granted on November 30, 2021, computed based on the closing
price of the Company’s stock on the grant date.
(11)
Represents
the grant date fair value of 100,000 shares of restricted stock units granted on November 30, 2021, computed based on the
closing price of the Company’s stock on the grant date.
(12)
Includes
company paid healthcare of $1,155 and 401(k) match of $14,500.
(13)
Includes
company paid healthcare of $1,404 and 401(k) match of $14,404.
(14)
Includes
company paid healthcare of $651.
(15)
Includes
company paid healthcare of $42,447 and 401(k) match of $14,500.
(16)
Includes
company paid healthcare of $39,691 and 401(k) match of $14,285.
43
Employment
Agreements
We
have entered into various employment agreements with certain of our executive officers. Set forth below is a summary of many of the material
provisions of such agreements, which summaries do not purport to contain all of the material terms and conditions of each such agreement.
For purposes of the following employment agreements:
●
“Cause”
generally means the executive’s (i) willful misconduct or gross negligence in the performance of his or her duties to us; (ii)
willful failure to perform his or her duties to us or to follow the lawful directives of the Chief Executive Officer (other than
as a result of death or disability); (iii) indictment for, conviction of or pleading of guilty or nolo contendere to, a felony or
any crime involving moral turpitude: (iv) repeated failure to cooperate in any audit or investigation of our business or financial
practices; (v) performance of any material act of theft, embezzlement, fraud, malfeasance, dishonesty or misappropriation of our
property; or (vi) material breach of his or her employment agreement or any other material agreement with us or a material violation
of our code of conduct or other written policy.
●
“Good
reason” generally means, subject to certain notice requirements and cure rights, without the executive’s consent, (i)
material diminution in his or her base salary or annual bonus opportunity; (ii) material diminution in his or her authority or duties
(although a change in title will not constitute “good reason”), other than temporarily while physically or mentally incapacitated,
as required by applicable law; (iii) relocation of his or her primary work location by more than 25 miles from its then current location;
or (iv) a material breach by us of a material term of the employment agreement.
●
“Change
of control” generally means (i) the acquisition, other than from us, by any individual, entity or group (within the meaning
of Section 13(d)(3) or Section 14(d)(2) of the Exchange Act), other than us or any subsidiary, affiliate (within the meaning of Rule
144 promulgated under the Securities Act) or employee benefit plan of ours, of beneficial ownership (within the meaning of Rule 13d-3
promulgated under the Exchange Act) of more than 50% of the combined voting power of our then outstanding voting securities entitled
to vote generally in the election of directors; (ii) a reorganization, merger, consolidation or recapitalization of us, other than
a transaction in which more than 50% of the combined voting power of the outstanding voting securities of the surviving or resulting
entity immediately following such transaction is held by the persons who, immediately prior to the transaction, were the holders
of our voting securities; or (iii) a complete liquidation or dissolution of us, or a sale of all or substantially all of our assets.
Robert
A. Berman
On
March 30, 2018, we entered into an employment agreement with Robert A. Berman, our current Chief Executive Officer and director. Pursuant
to the terms of his employment agreement, Mr. Berman’s base salary is $400,000, subject to annual review and adjustment at the
discretion of our compensation committee, and he will be eligible for an annual year-end discretionary bonus of up to 50% of his base
salary, subject to the achievement of key performance indicators, as determined by our compensation committee. The initial term of Mr.
Berman’s employment agreement may be terminated at anytime with or without cause and with or without notice or for good reason
thereunder. In connection with his employment, Mr. Berman received an initial equity grant of an option to purchase 43,209 options with
8,642 vesting on the date of his Employment Agreement, March 30, 2018, and the remaining 80% vesting ratably on a monthly basis over
the following 24 months. In February 2021, the board of directors approved an option grant to Mr. Berman to purchase 838,000 shares of
common stock at an exercise price of $8.20 per shares (the closing price of the Company’s common stock on February 18, 2021). The
stock option vests in equal quarterly installments over a two year period. Additionally, the board of directors paid Mr. Berman a cash
bonus of $250,000 for 2021 and $200,000 for 2020.
Mr.
Berman is entitled to participate in our employee benefit, pension and/or profit sharing plans, and we will pay certain health and dental
premiums on his behalf. Mr. Berman’s employment agreement prohibits him from inducing, soliciting or entertaining any of our employees
to leave our employ during the term of the agreement and for 12 months thereafter.
Pursuant
to the terms of his employment agreement, Mr. Berman is entitled to severance in the event of certain terminations of employment. In
the event Mr. Berman’s employment is terminated by us without cause and other than by reason of disability or he resigns for good
reason, subject to his timely executing a release of claims in our favor and in addition to certain other accrued benefits, he is entitled
to receive 6 month of base salary if termination occurred prior to the second anniversary of his employment or 12 months of continued
base salary on and after the second anniversary of his employment (or 24 months if such termination occurs within 24 months following
a change of control).
44
Craig
Glynn
On
February 19, 2021, the Company entered into an employment agreement with Mr. Glynn, in connection with Mr. Glynn’s elevation to
full time Chief Financial Officer in addition to treasurer and secretary of the Company. Pursuant to the employment agreement, Mr. Glynn
will earn $225,000 per year. In addition, Mr. Glynn will receive stock options to purchase 324,000 shares of common stock of the Company
at an exercise price of $8.20 per shares (the closing price of the Company’s common stock on February 18, 2021). The stock options
vest in equal quarterly installments over a three year period with a six month cliff. The employment agreement further provides that
Mr. Glynn is entitled to participate in any employee benefit plans that the Company has adopted or may adopt.
Pursuant
to the terms of the employment agreement, Mr. Glynn’s employment agreement is terminable due to Mr. Glynn’s disability or
death, for “Cause” (as defined in the employment agreement) or without “Cause” by the Company, and for “Good
Reason” (as defined in the employment agreement) or voluntarily by Mr. Glynn. In the event of Mr. Glynn’s death or disability,
or termination for “Cause” by the Company or without “Good Reason” by Mr. Glynn, Mr. Glynn (or his estate) is
entitled to receive any unpaid base salary through the termination date, reimbursement for unreimbursed business expenses, accrued but
unused vacation time in accordance with the Company’s policy and any other payments or benefits that Mr. Glynn as entitled to in
accordance with any Company benefit plans (collectively, the “Accrued Benefits”). Upon termination without “Cause”
(other than by reason of death or disability) or resignation for “Good Reason,” Mr. Glynn will be entitled to three months
of severance for each year Mr. Glynn is employed up to one year of severance, in addition to all Accrued Benefits. Any outstanding unvested
securities owned by Mr. Glynn on the termination date will vest (or terminate) in accordance with the terms of such grant.
Prior
to his full time role as Chief Financial Officer, on April 6, 2020 he was appointed as Interim Chief Financial Officer and Interim Treasurer.
For his services as Interim Chief Financial Officer and Interim Treasurer, Mr. Glynn was paid $10,000 per month of employment.
45
Marc
H. Glickman, M.D.
On
July 22, 2016, we entered into an employment agreement with Marc H. Glickman, M.D., our Senior Vice President and Chief Medical Officer
(the “Pre-existing Employment Agreement”). Pursuant to the terms of his Pre-existing Employment Agreement, Dr. Glickman’s
base salary is $300,000, subject to annual review and adjustment at the discretion of our board of directors, and he will be eligible
for an annual year-end discretionary bonus of up to 50% of his base salary, subject to the achievement of key performance indicators,
as determined by our board of directors. In connection with his Pre-existing Employment Agreement, Dr. Glickman received an initial equity
grant of an option to purchase up to 7,380 shares of our common stock with 20% of the shares vesting immediately and 80% vesting on a
monthly basis over 24 months thereafter. The initial term of Dr. Glickman’s Pre-existing Employment Agreement ended on December
31, 2018 and was automatically extended for additional three-year terms.
On
July 26, 2019, we entered into an employment agreement with Dr. Glickman (the “New Employment Agreement”) that supersedes
the terms of the Pre-existing Employment Agreement. Pursuant to the terms of the New Employment Agreement, Dr. Glickman’s base
salary is $350,000 per year, subject to annual review and adjustment at the discretion of the Board. In connection with entering into
the New Employment Agreement, Dr. Glickman’s existing seven thousand three hundred and eighty (7,380) options (“Existing
Options”) to purchase Company common stock at two hundred and fifty dollars ($250.00) per share until October 1, 2026, were repriced
to fifty dollars ($50.00) per share. Additionally, Dr. Glickman, in connection to the New Employment Agreement, was granted stock options
for the right to purchase seven thousand two hundred (7,200) common stock at a price equal to two dollars ($50.00) per share exercisable
until July 26, 2029, which shall vest quarterly over a three (3) year period. In February 2021, the board of directors approved an option
grant to Dr. Glickman to purchase 406,000 shares of common stock at an exercise price of $8.20 per shares (the closing price of the Company’s
common stock on February 18, 2021). The stock option vests in equal quarterly installments over a two year period. Additionally, the
board of directors paid Mr. Berman a cash bonus of $50,000.
Pursuant
to the terms of the New Employment Agreement, Dr. Glickman is an at-will employee and is entitled to severance in the event of certain
terminations of his employment. In the event that Dr. Glickman’s employment is terminated by the Company without Cause (as defined
in the New Employment Agreement), other than by reason of Disability (as defined in the New Employment Agreement), or he resigns for
Good Reason (as defined in the New Employment Agreement), subject to his timely executing a release of claims in favor of the Company
and in addition to certain other accrued benefits, Dr. Glickman is entitled to receive three months of his base salary for each year
that he has been employed by the Company at the time of termination, up to a total of one year of his base salary.
Potential
Payments Upon Termination or Change-in-Control
Pursuant
to the terms of the employment agreements discussed above, we will pay severance in the event of certain terminations of employment.
In the event employment is terminated by us without cause and other than by reason of disability or if the executive resigns for good
reason, subject to his or her timely executing a release of claims in our favor and in addition to certain other accrued benefits, he
or she is entitled to receive severance pursuant to the terms of his or her employment agreements discussed above.
46
Outstanding
Equity Awards at Fiscal Year-End
The
following table sets forth information regarding equity awards held by our named executive officers as of December 31, 2021.
Name
Number of securities underlying unexercised options (#) exercisable
Number of securities underlying unexercised options (#) unexercisable
Equity incentive plan awards: Number of securities underlying unexercised unearned options (#)
Option exercise price ($)
Option
expiration date
Robert A. Berman ,
43,209 (1)
- (1)
N/A
$ 10.00
September 23, 2028
Chief Executive Officer
19,333 (2)
20,667 (2)
$ 10.00
July 18, 2030
364,297 (3)
473,703 (3)
$ 8.20
February 18, 2031
349,781
(4)
349,781
(4)
$
6.70
November 30, 2031
Marc H. Glickman, M.D.
3,000 (5)
4,200 (5)
N/A
$ 50.00
July 25, 2029
Chief Medical Officer and Senior Vice President
7,380 (5)
-
N/A
$ 50.00
October 1, 2026
19,333 (2)
20,667 (2)
-
$ 10.00
July 18, 2030
176,497 (3)
229,503 (3)
$ 8.20
February 18, 2031
265,700
(4)
265,700
(4)
$
6.70
November 30, 2031
Craig Glynn, Chief Financial Officer (6)
1,933 (7)
2,067 (7)
N/A
$ 10.00
July 18, 2030
93,900 (8)
230,100 (8)
$ 8.20
February 18, 2031
125,925
(4)
125,925
(4)
$
6.70
November 30, 2031
(1)
Options
were granted on September 24, 2018, and vested 20% on the date of his Employment Agreement, March 30, 2018, and the remaining 80%
vests ratably on a monthly basis over the 24 months following the date of his Employment Agreement.
(2)
Options
were granted on July 18, 2020 and vest ratably on a monthly basis over 36 months.
(3)
Options
were granted on February 18, 2021 and vest ratably on a quarterly basis over two years.
(4)
Options
were granted on November 30, 2021 and vest ratably on a quarterly basis over three years.
(5)
On
July 26, 2019, the Company entered a new employment agreement with Dr. Glickman that superseded the terms of his existing employment
agreement. In connection with entering into the new employment agreement, Dr. Glickman’s existing 7,380 options that were granted
on October 1, 2016 were repriced from $250.00 to $50.00 per share. Additionally, on July 26, 2019, Dr. Glickman was granted 7,200
options at $50.00 per share vesting quarterly over a three-year period.
(6)
Mr.
Glynn was elevated to permanent Chief Financial Officer in January 2021.
(7)
Options
were granted on July 18, 2020 and vest ratably on a quarterly basis over three years.
(8)
Options
were granted on February 18, 2021 and vest ratably on a quarterly basis over three years.
Name
Grant Date
Number of unearned restricted stock units that
have not vested
Market
value of unearned restricted stock units that have not vested (a)
Robert A. Berman, Chief Executive Officer
11/30/2021
200,000 (1)
$ 1,318,000
Marc H. Glickman, M.D., Chief Medical Officer and Senior Vice President
11/30/2021
100,000 (1)
$ 659,000
Craig Glynn, Chief Financial Officer
11/30/2021
50,000 (1)
$ 329,500
(a)
Determined
by multiplying the number of restricted stock units that have not vested by $6.59, the closing price of NVNO’s common stock on December 31,
2021.
(1)
On
November 30, 2021, Mr. Berman was granted 200,000 restricted stock units, Dr. Glickman was granted 100,000 restricted stock units,
and Mr. Glynn was granted 50,000 restricted stock units. The restricted stock units are subject to milestone-based vesting as follows:
(i) 50% upon SAVVE (Surgical Anti-reflux Venous Valve Endoprosthesis) endpoints being achieved, and (ii) 50% upon the Pre-Market
Approval of the VenoValve.
47
Employee
Benefit Plans
Amended
and Restated 2016 Omnibus Incentive Plan
On
October 1, 2016, our board of directors and our stockholders adopted and approved the enVVeno Medical Corporation 2016 Omnibus
Incentive Plan, and, subsequently, on April 26, 2018, our board of directors and our stockholders adopted and approved the Amended and
Restated 2016 Omnibus Incentive Plan which was subsequently amended by Amendment No. 1 to the Amended and Restated 2016 Omnibus Incentive
Plan following receipt of stockholder approval on December 17, 2020 and by Amendment No. 2 to the Amended and Restated 2016 Omnibus Incentive
Plan following receipt of stockholder approval on November 30, 2021 (as amended, the “2016 Plan”). The principal features
of the 2016 Plan are summarized below. This summary is qualified in its entirety by reference to the text of the 2016 Plan, which is
filed as an exhibit to the registration statement of which this prospectus is a part.
Share
Reserve
We currently have reserved 4,500,000
shares of our common stock for issuance under the 2016 Plan, provided, however, if at any time the Company issues additional shares
of Common Stock or securities that are convertible or exercisable into shares of Common Stock (other than pursuant to the Plan) then
the number of shares authorized to be awarded under the Plan shall increase to an amount equal to no less than 20% of the issued and
outstanding shares of common stock of the Company on a fully diluted basis. Such increase, if any, shall occur automatically upon each
applicable issuance of securities by the Company. All shares available for issuance under the Plan may be granted as incentive
stock options under Code Section 422. The shares of common stock issuable under the 2016 Plan will consist of authorized and unissued
shares, treasury shares or shares purchased on the open market or otherwise, all as determined by our company from time to time.
If
any award is canceled, terminates, expires or lapses for any reason prior to the issuance of shares or if shares are issued under the
2016 Plan and thereafter are forfeited to us, the shares subject to such awards and the forfeited shares will not count against the aggregate
number of shares of common stock available for grant under the 2016 Plan. In addition, the following items will not count against the
aggregate number of shares of common stock available for grant under the 2016 Plan: (1) shares issued under the 2016 Plan repurchased
or surrendered at no more than cost or pursuant to an option exchange program, (2) any award that is settled in cash rather than by issuance
of shares of common stock, (3) shares surrendered or tendered in payment of the option price or purchase price of an award or any taxes
required to be withheld in respect of an award or (4) awards granted in assumption of or in substitution for awards previously granted
by an acquired company.
Administration
The
2016 Plan may be administered by our board of directors or our compensation committee. Our compensation committee, in its discretion,
selects the individuals to whom awards may be granted, the time or times at which such awards are granted and the terms and conditions
of such awards. Our board of directors also has the authority, subject to the terms of the 2016 Plan, to amend existing options (including
to reduce the option’s exercise price), to institute an exchange program by which outstanding options may be surrendered in exchange
for options that may have different exercise prices and terms, restricted stock, and/or cash or other property.
Eligibility
Awards
may be granted under the 2016 Plan to officers, employees, directors, consultants and advisors of us and our affiliates. Incentive stock
options may be granted only to employees of us or our subsidiaries.
48
Awards
The
2016 Plan permits the granting of any or all of the following types of awards:
●
Stock
Options . Stock options entitle the holder to purchase a specified number of shares of common stock at a specified price (the
exercise price), subject to the terms and conditions of the stock option grant. Our compensation committee may grant either incentive
stock options, which must comply with Code Section 422, or nonqualified stock options. Our compensation committee sets exercise prices
and terms and conditions, except that stock options must be granted with an exercise price not less than 100% of the fair market
value of our common stock on the date of grant (excluding stock options granted in connection with assuming or substituting stock
options in acquisition transactions). Unless our compensation committee determines otherwise, fair market value means, as of a given
date, the closing price of our common stock. At the time of grant, our compensation committee determines the terms and conditions
of stock options, including the quantity, exercise price, vesting periods, term (which cannot exceed 10 years) and other conditions
on exercise.
●
Stock
Appreciation Rights . Our compensation committee may grant SARs, as a right in tandem with the number of shares underlying stock
options granted under the 2016 Plan or as a freestanding award. Upon exercise, SARs entitle the holder to receive payment per share
in stock or cash, or in a combination of stock and cash, equal to the excess of the share’s fair market value on the date of
exercise over the grant price of the SAR. The grant price of a tandem SAR is equal to the exercise price of the related stock option
and the grant price for a freestanding SAR is determined by our compensation committee in accordance with the procedures described
above for stock options. Exercise of a SAR issued in tandem with a stock option will reduce the number of shares underlying the related
stock option to the extent of the SAR exercised. The term of a freestanding SAR cannot exceed 10 years, and the term of a tandem
SAR cannot exceed the term of the related stock option.
●
Restricted
Stock, Restricted Stock Units and Other Stock-Based Awards . Our compensation committee may grant awards of restricted stock,
which are shares of common stock subject to specified restrictions, and restricted stock units, or RSUs, which represent the right
to receive shares of our common stock in the future. These awards may be made subject to repurchase, forfeiture or vesting restrictions
at our compensation committee’s discretion. The restrictions may be based on continuous service with us or the attainment of
specified performance goals, as determined by our compensation committee. Stock units may be paid in stock or cash or a combination
of stock and cash, as determined by our compensation committee. Our compensation committee may also grant other types of equity or
equity-based awards subject to the terms and conditions of the 2016 Plan and any other terms and conditions determined by our compensation
committee.
●
Performance
Awards . Our compensation committee may grant performance awards, which entitle participants to receive a payment from us, the
amount of which is based on the attainment of performance goals established by our compensation committee over a specified award
period. Performance awards may be denominated in shares of common stock or in cash, and may be paid in stock or cash or a combination
of stock and cash, as determined by our compensation committee. Cash-based performance awards include annual incentive awards.
49
Clawback
All
cash and equity awards granted under the 2016 plan will be subject to all applicable laws regarding the recovery of erroneously awarded
compensation, any implementing rules and regulations under such laws, any policies we adopted to implement such requirements and any
other compensation recovery policies as we may adopt from time to time.
Change
in Control
Under
the 2016 Plan, in the event of a change in control (as defined in the 2016 Plan), outstanding awards will be treated in accordance with
the applicable transaction agreement. If no treatment is provided for in the transaction agreement, each award holder will be entitled
to receive the same consideration that stockholders receive in the change in control for each share of stock subject to the award holder’s
awards, upon the exercise, payment or transfer of the awards, but the awards will remain subject to the same terms, conditions and performance
criteria applicable to the awards before the change in control, unless otherwise determined by our compensation committee. In connection
with a change in control, outstanding stock options and SARs can be cancelled in exchange for the excess of the per share consideration
paid to stockholders in the transaction, minus the option or SARs exercise price.
Subject
to the terms and conditions of the applicable award agreements, awards granted to non-employee directors will fully vest on an accelerated
basis, and any performance goals will be deemed to be satisfied at target. For awards granted to all other service providers, vesting
of awards will depend on whether the awards are assumed, converted or replaced by the resulting entity.
●
For
awards that are not assumed, converted or replaced, the awards will vest upon the change in control. For performance awards, the
amount vesting will be based on the greater of (1) achievement of all performance goals at the “target” level or (2)
the actual level of achievement of performance goals as of our fiscal quarter end preceding the change in control, and will be prorated
based on the portion of the performance period that had been completed through the date of the change in control.
●
For
awards that are assumed, converted or replaced by the resulting entity, no automatic vesting will occur upon the change in control.
Instead, the awards, as adjusted in connection with the transaction, will continue to vest in accordance with their terms and conditions.
In addition, the awards will vest if the award recipient has a separation from service within two years after a change in control
by us other than for “cause” or by the award recipient for “good reason” (each as defined in the applicable
award agreement). For performance awards, the amount vesting will be based on the greater of (1) achievement of all performance goals
at the “target” level or (2) the actual level of achievement of performance goals as of our fiscal quarter end preceding
the change in control, and will be prorated based on the portion of the performance period that had been completed through the date
of the separation from service.
Amendment
and Termination of the 2016 Plan
Unless
earlier terminated by our board of directors, the 2016 Plan will terminate, and no further awards may be granted, 10 years after October
1, 2016, the date on which it was approved by our stockholders. Our board of directors may amend, suspend or terminate the 2016 Plan
at any time, except that, if required by applicable law, regulation or stock exchange rule, stockholder approval will be required for
any amendment. The amendment, suspension or termination of the 2016 Plan or the amendment of an outstanding award generally may not,
without a participant’s consent, materially impair the participant’s rights under an outstanding award.
50
Limitation
of Liability and Indemnification Matters
Our
amended and restated certificate of incorporation limits the liability of our directors for monetary damages for breach of their fiduciary
duties, except for liability that cannot be eliminated under the DGCL. Consequently, our directors will not be personally liable for
monetary damages for breach of their fiduciary duties as directors, except liability for any of the following:
●
any
breach of their duty of loyalty to us or our stockholders;
●
acts
or omissions not in good faith or that involve intentional misconduct or a knowing violation of law;
●
unlawful
payments of dividends or unlawful stock repurchases or redemptions as provided in Section 174 of the DGCL; or
●
any
transaction from which the director derived an improper personal benefit.
Our
amended and restated bylaws also provide that we will indemnify our directors and executive officers and may indemnify our other officers
and employees and other agents to the fullest extent permitted by law. Our amended and restated bylaws also permit us to secure insurance
on behalf of any officer, director, employee or other agent for any liability arising out of his or her actions in this capacity, regardless
of whether our amended and restated bylaws would permit indemnification. We have obtained directors’ and officers’ liability
insurance.
We
have entered into separate indemnification agreements with our directors and executive officers, in addition to indemnification provided
for in our amended and restated bylaws. These agreements, among other things, provide for indemnification of our directors and executive
officers for expenses, judgments, fines and settlement amounts incurred by this person in any action or proceeding arising out of this
person’s services as a director or executive officer or at our request. We believe that these provisions and agreements are necessary
to attract and retain qualified persons as directors and executive officers.
The
above description of the indemnification provisions of our amended and restated bylaws and our indemnification agreements is not complete
and is qualified in its entirety by reference to these documents, each of which is incorporated by reference as an exhibit to the registration
statement to which this prospectus forms a part.
The
limitation of liability and indemnification provisions in our amended and restated certificate of incorporation and amended and restated
bylaws may discourage stockholders from bringing a lawsuit against directors for breach of their fiduciary duties. They may also reduce
the likelihood of derivative litigation against directors and officers, even though an action, if successful, might benefit us and our
stockholders. A stockholder’s investment may be harmed to the extent we pay the costs of settlement and damage awards against directors
and officers pursuant to these indemnification provisions. Insofar as indemnification for liabilities under the Securities Act may be
permitted to directors, officers or persons controlling us pursuant to the foregoing provisions, we have been informed that in the opinion
of the SEC such indemnification is against public policy as expressed in the Securities Act and may be unenforceable. There is no pending
litigation or proceeding naming any of our directors or officers as to which indemnification is being sought, nor are we aware of any
pending or threatened litigation that may result in claims for indemnification by any director or officer.
Director
Compensation
The Board determines
the form and amount of director compensation after its review of recommendations made by the Compensation Committee. A substantial portion
of each director’s annual retainer is in the form of equity. Under the Company’s nonemployee director compensation program
members of the Board who are not also Company employees (“Non-Employee Directors”) are granted options worth up to thirty-seven
thousand five hundred dollars ($37,500) per annum (the “Annual Award”). Prior to February 18, 2021, the equity
portion of director compensation included eight hundred options and restricted stock units (“RSU’s” worth up to twenty-five
thousand dollars ($25,000) per annum. A Non-Employee Director who is newly appointed to the Board other than in connection with an
annual meeting of stockholders will generally receive a grant of two thousand four hundred (2,400) options and RSUs worth up to seventy-five
thousand dollars ($75,000) upon appointment (an “Initial Award”), which covers their compensation for their first three years
of service. The Initial Award and Annual Award to Non-Employee Directors will vest as long as they remain directors in equal annual portions
over three years following the date in which the award is granted.
51
The
table below shows the compensation paid to our non-employee directors during 2021 and 2020.
Name
Fees earned or paid in cash
Stock awards ($)
Option awards
($)(4)
Non-equity incentive plan compensation ($)
Nonqualified deferred compensation earnings
($)
All other compensation($)
Total ($)
Francis Duhay,
2021
$ 32,500
-
$ 37,500 (2)
-
-
-
$ 70,000
M.D.
2020
$ 20,000
$ 25,000 (1)
$ 31,180 (3)
-
-
-
$ 76,180
Dr. Sanjay
2021
$ 37,500
-
$ 37,500 (2)
-
-
-
$ 75,000
Shrivastava
2020
$ 25,000
25,000 (1)
31,180 (3)
-
-
-
$ 81,180
Robert Gray
2021
$ 40,000
-
$ 37,500 (2)
$ 77,500
2020
$ 27,500
$ 25,000 (1)
$ 31,180 (3)
$ 83,680
Matthew
2021
$ 37,500
-
$ 37,500 (2)
$ 75,000
Jenusaitis
2020
$ 25,000
$ 25,000 (1)
$ 31,180 (3)
$ 81,180
(1)
Under the Company’s nonemployee director compensation program, Dr. Duhay, Dr. Shrivastava, Mr. Gray and Mr. Jenusaitis were each
granted 2,500 Restricted Stock Grants on July 17, 2020, which based on the Company’s closing stock price on the grant date were
valued at $10.00 per share. These Restricted Stock Grants fully vested on December 31, 2020.
(2)
Under the Company’s nonemployee director compensation program, Dr. Duhay, Dr. Shrivastava, Mr. Gray and Mr. Jenusaitis were each
granted 5,673 options to purchase shares of our common stock on February 18, 2021 at an exercise price of $8.20 per share. The options
were valued at $6.61 per share as of the date of the grant. All of these options vest in equal quarterly portions from the grant date
through December 31, 2021, such that they are fully vested at December 31, 2021, and valued in accordance with FASB ASC Topic 718.
(3)
Under the Company’s nonemployee director compensation program, Dr. Duhay, Dr. Shrivastava, Mr. Gray and Mr. Jenusaitis were each
granted 4,000 options to purchase shares of our common stock on July 17, 2020 at an exercise price of $10.00 per share. The options were
valued at $7.80 per share as of the date of the grant. All of these options vest in equal quarterly portions from the grant date through
December 31, 2020, such that they are fully vested at December 31, 2020, and valued in accordance with FASB ASC Topic 718.
(4) Under the Company’s nonemployee
director compensation program, Dr. Duhay, Dr. Shrivastava, Mr. Gray and Mr. Jenusaitis were each granted 7,211 options to purchase shares
of our common stock on November 30, 2021, as part of their compensation for the year ending December 31, 2022, at an exercise price of
$6.70 per share. The options were valued at $5.20 per share as of the date of the grant and will vest in equal quarterly portions starting
on March 31, 2022 and through December 31, 2022, such that they are fully vested at December 31, 2022. The grant date value of each grant
determined in accordance with FASB ASC Topic 718 was $37,500.
52
ITEM
12.
Security
Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
The
following table lists, as of March 24, 2022, the number of shares of common stock of our Company that are beneficially owned
by (i) each person or entity known to our Company to be the beneficial owner of more than 5% of the outstanding common stock; (ii) each
officer and director of our Company; and (iii) all officers and directors as a group.
Applicable
percentage ownership is based on 9,469,850 shares of common stock outstanding as the date of this Form 10-K. We have determined beneficial
ownership in accordance with the rules of the SEC. These rules generally attribute beneficial ownership of securities to persons who
possess sole or shared voting or dispositive power with respect to such securities. In addition, pursuant to such rules, we deemed outstanding
shares of common stock subject to options or warrants held by that person that are currently exercisable or exercisable within 60 days
of March 24, 2022. We did not deem such shares outstanding, however, for the purpose of computing the percentage ownership
of any other person. Except as indicated by the footnotes below, we believe, based on the information furnished to us, that the beneficial
owners named in the table below have sole voting and dispositive power with respect to all shares of our common stock that they beneficially
own, subject to applicable community property laws.
Beneficial Ownership
Name and Address of Beneficial Owner (1)
Number of
Shares
Percentage
5% Stockholders
Perceptive Life Sciences Master Fund Ltd. (2)
937,515
9.9
%
Named Executive Officers and Directors
Robert A. Berman (3)
627,177
6.2
%
Marc Glickman, M.D. (4)
302,577
3.1
%
Craig Glynn (5)
143,554
1.5
%
Francis Duhay, M.D. (6)
27,036
*
Dr. Sanjay Shrivastava (7)
16,764
*
Robert Gray (8)
19,689
*
Matthew Jenusaitis (9)
18,959
*
All directors and executive officers as a group (7 persons)
1,155,757
10.9
%
*
Represents beneficial ownership of less than 1%.
(1)
Except
as otherwise noted below, the address for each person or entity listed in the table is c/o enVVeno Medical Corporation, 70
Doppler, Irvine, California 92618.
(2)
Based
on a Schedule 13G filed by the Perceptive Live Sciences Master Fund Ltd. (the “Master Fund”). The Master Fund directly
holds 781,615 shares of common stock and 1,759,035 pre-funded warrants. The pre-funded warrants may not be exercised if the Master
Fund would beneficially own more than 9.9% of the Company’s outstanding shares of common stock after giving effect to such
exercise. Perceptive Advisors serves as the investment manager to the Master Fund and may be deemed to beneficially own such shares.
Mr. Edelman is the managing member of Perceptive Advisors and may be deemed to beneficially own such shares.
(3)
Includes
588,071 shares of common stock issuable upon exercise of options that are currently exercisable or exercisable within 60 days of
March 24, 2022.
(4)
Includes
278,836 shares of common stock that are issuable upon exercise of options that are currently exercisable or exercisable within 60
days of March 24, 2022.
(5)
Includes
133,060 shares of common stock that are issuable upon exercise of options that are currently exercisable or exercisable within 60
days of March 24, 2022.
(6)
Includes
13,476 shares of common stock that are issuable upon exercise of options that are currently exercisable or exercisable within 60
days of March 24, 2022.
(7)
Includes
13,476 shares of common stock that are issuable upon exercise of options that are currently exercisable or exercisable within 60
days of March 24, 2022.
(8)
Includes
13,076 shares of common stock that are issuable upon exercise of options that are currently exercisable or exercisable within 60
days of March 24, 2022.
(9)
Includes
13,076 shares of common stock that are issuable upon exercise of options that are currently exercisable or exercisable within 60
days of March 24, 2022.
53
ITEM
13.
Certain
Relationships and Related Transactions, and Director Independence
The
following is a description of transactions since January 1, 2021 to which we were a party in which (i) the amount involved exceeded or
will exceed the lesser of (A) $120,000 or (B) one percent of our average total assets at year end for the last two completed fiscal years
and (ii) any of our directors, executive officers or holders of more than 5% of our capital stock, or any member of the immediate family
of, or person sharing the household with, any of the foregoing persons, who had or will have a direct or indirect material interest,
other than equity and other compensation, termination, change in control and other similar arrangements, which are described under “Executive
Compensation.”
None
Indemnification
of Officers and Directors
Our
amended and restated certificate of incorporation and amended and restated bylaws provide that we will indemnify each of our directors
and officers to the fullest extent permitted by the DGCL. Further, we intend to enter into indemnification agreements with each of our
directors and officers, and we intend to purchase a policy of directors’ and officers’ liability insurance that insures our
directors and officers against the cost of defense, settlement or payment of a judgment under certain circumstances. For further information,
see “Executive Compensation—Limitations of Liability and Indemnification Matters.”
To
the best of our knowledge, during the past two fiscal years, other than as set forth above, there were no material transactions, or series
of similar transactions, or any currently proposed transactions, or series of similar transactions, to which we were or are to be a party,
in which the amount involved exceeds the lesser of (A) $120,000 or (B) one percent of our average total assets at year end for the last
two completed fiscal years, and in which any director or executive officer, or any security holder who is known by us to own of record
or beneficially more than 5% of any class of our common stock, or any member of the immediate family of any of the foregoing persons,
has an interest (other than compensation to our officers and directors in the ordinary course of business).
Policies
and Procedures for Related Party Transactions
All
future transactions between us and our officers, directors or five percent stockholders, and respective affiliates will be on terms no
less favorable than could be obtained from unaffiliated third parties and will be approved by a majority of our independent directors
who do not have an interest in the transactions and who had access, at our expense, to our legal counsel or independent legal counsel.
Director
Independence
The
information provided in Item 10, under the subheading “Director Independence” is incorporated herein.
54
ITEM
14.
Principal
Accounting Fees and Services
Audit
Fees. The aggregate fees billed by Marcum LLP (“ Marcum ”) for professional services rendered for the audit of our
annual financial statements, review of the financial information included in our Forms 10-Q for the respective periods and other required
filings with the SEC for the years ended December 31, 2021 and 2020 totaled $126,000 and $244,000, respectively. The above
amounts include interim procedures, audit fees, fees related to registration statements filed during those years, and attendance at audit
committee meetings.
All
Other Fees. None.
Procedures
For Board of Directors Pre-Approval of Audit and Permissible Non-Audit Services of Independent Auditor
Our
audit committee is ultimately responsible for reviewing and approving, in advance, any audit and any permissible non-audit engagement
or relationship between us and our independent registered public accounting firm. Our engagement of Marcum to conduct all audit and permissible
non-audit related activities incurred during fiscal years 2021 and 2020 were approved by our audit committee in accordance with these
procedures.
PART
IV
ITEM
15.
Exhibits
and Financial Statements Schedules
1.
Consolidated
Financial Statements
Our
financial statements and the notes thereto, together with the report of our independent registered public accounting firm on those financial
statements, are hereby filed as part of this report beginning on page F-1.
2.
Financial
Statement Schedules
All
financial statement schedules have been omitted since the required information is not applicable or is not present in amounts sufficient
to require submission of the schedule, or because the information required is included in the consolidated financial statements and notes
thereto.
55
3.
Exhibits
The
following is a complete list of exhibits filed as part of this Form 10-K. Exhibit numbers correspond to the numbers in the Exhibit Table
of Item 601 of Regulation S-K.
Exhibit
Number
Description
3.1
Fifth Amended and Restated Certificate of Incorporation (incorporated by reference to Exhibit 3.1 of the Registrant’s Current Report on Form 8-K filed on September 16, 2020).
3.2
Amended and Restated Bylaws (incorporated by reference to Exhibit 3.2 to the Registrant’s Current Report on Form 8-K filed on June 6, 2018).
3.3
Certificate of Amendment to the Fifth Amended and Restated Certificate of Incorporation (incorporated by reference to Exhibit 3.1to the Registrant’s Current Report on Form 8-K filed on December 2, 2020).
3.4
Certificate of Amendment to the Fifth Amended and Restated Certificate of Incorporation (incorporated by reference to Exhibit 3.1 to the Registrant’s Current Report on Form 8-K filed on October 1, 2021).
4.1
Specimen common stock certificate (incorporated by reference to Exhibit 4.1 to the Registrant’s Registration Statement on Form S-1 (No. 333-220372) filed on September 7, 2017).
4.2
Form of Series A Preferred Stock Placement Agents’ Warrant (incorporated by reference to Exhibit 4.4 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on December 14, 2017).
4.3
Form of Series B Preferred Stock Placement Agents’ Warrant (incorporated by reference to Exhibit 4.5 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on December 14, 2017).
4.4
Form of Common Stock Purchase Warrant (issued in connection with the 2017 Notes) (incorporated by reference to Exhibit 4.6 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on December 14, 2017).
4.5
Form of Underwriters’ Warrant (incorporated by reference to Exhibit 4.7 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on January 26, 2018).
4.6
Form of Warrant to Purchase Shares of Common Stock (issued to Mr. Cantor) (incorporated by reference to Exhibit 4.8 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on December 14, 2017).
4.7
Form of Amended and Restated Common Stock Purchase Warrant (issued in connection with the 2017 Notes) (incorporated by reference to Exhibit 4.9 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on January 26, 2018).
4.8
Form of Common Stock Purchase Warrant (issued in connection with the 2018 Notes) (incorporated by reference to Exhibit 4.10 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on January 26, 2018).
4.9
Form of Second Amended and Restated Common Stock Purchase Warrant (issued in connection with the 2017 Notes) (incorporated by reference to Exhibit 4.11 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on April 16, 2018).
4.10
Form of Amended and Restated Common Stock Purchase Warrant (issued in connection with the 2018 Notes) (incorporated by reference to Exhibit 4.12 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on April 16, 2018).
4.11
Form of Warrant Agreement (incorporated by reference to Exhibit 4.13 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on May 14, 2018).
4.12
Amendment to Warrant to Purchase Shares (incorporated by reference to Exhibit 4.14 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on April 16, 2018).
4.13
Form of Warrant Certificate (incorporated by reference to Exhibit 4.15 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on May 14, 2018).
4.14
Form of Warrant (incorporated by reference to Exhibit 4.1 to the Registrant’s Current Report on Form 8-K filed on March 2, 2020).
4.15
Form of Warrant (incorporated by reference to Exhibit 4.1 to the Registrant’s Current Report on Form 8-K filed on April 28, 2020).
4.16
Form of Warrant (incorporated by reference to Exhibit 4.1 to the Registrant’s Current Report on Form 8-K filed on June 3, 2020).
4.17
Form of Warrant Agent Agreement, inclusive of Form of Warrant (incorporated by reference to Exhibit 4.1 to the Registrant’s Current Report on Form 8-K filed on July 21, 2020).
4.18
Form of Private Placement Warrant (incorporated by reference to Exhibit 4.18 to the Registrant’s Registration Statement on Form S-1/A (No. 333-239658) filed on July 16, 2020).
4.19
Form of Warrant (incorporated by reference to Exhibit 4.1 to the Registrant’s Current Report on Form 8-K filed on October 8, 2020).
4.20
Form of Warrant Agent Agreement (including Form of Warrant Certificate) (incorporated by reference to Exhibit 4.20 to the Registrant’s Registration Statement on Form S-1/A (No. 333 -251528) filed on February 5, 2021).
4.21
Form of Pre-Funded Warrant (Form of Placement Agency Agreement, dated September 3, 2021 (incorporated by reference to Exhibit 4.1 to the Registrant’s Current Report on Form 8-K filed on September 8, 2021).
4.22
Form of Warrant (Form of Placement Agency Agreement, dated September 3, 2021 (incorporated by reference to Exhibit 4.2 to the Registrant’s Current Report on Form 8-K filed on September 8, 2021).
4.23
Description of the Company’s Securities Registered under Section 12 of the Exchange Act (incorporated by reference to Exhibit 4.21 to the Registrant’s Annual Report on Form 10-K for the year ended December 31, 2020)
10.1
Form of Indemnification Agreement (incorporated by reference to Exhibit 10.30 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on December 14, 2017).
56
10.2
Employment Agreement, dated as of March 30, 2018, by and between the Registrant and Robert A. Berman. (incorporated by reference to Exhibit 10.47 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on April 16, 2018).
10.3
Amended and Restated 2016 Omnibus Incentive Plan (incorporated by reference to Exhibit 10.50 to the Registrant’s Registration Statement on Form S-1/A (No. 333-220372) filed on May 14, 2018).
10.4
Amendment No. 1 to Amended and Restated 2016 Omnibus Incentive Plan. (incorporated by reference to Exhibit 10.4 to the Registrant’s Annual Report on Form 10-K for the year ended December 31, 2020).
10.5
Amendment No. 2 to Amended and
Restated 2016 Omnibus Incentive Plan.*
10.6
Form of Stock Option Grant under Amended and Restated 2016 Omnibus Incentive Plan (incorporated by reference to Exhibit 10.44 to the Registrant’s Annual Report on Form 10-K for the year ended December 31, 2018).
10.7
Form of Restricted Stock Unit under Amended and Restated 2016 Omnibus Incentive Plan (incorporated by reference to Exhibit 10.45 to the Registrant’s Annual Report on Form 10-K for the year ended December 31, 2018).
10.8
Employment
Agreement, dated as of July 26, 2019, by and between enVVeno Medical Corporation and Marc Glickman, M.D. (incorporated by
reference to Exhibit 10.1 to the Registrant’s Current Report on Form 8-K filed on August 1, 2019).
10.9
Form of Securities Purchase Agreement dated as of February 25, 2020 (incorporated by reference to Exhibit 10.1 to the Registrant’s Current Report on Form 8-K filed on March 2, 2020).
10.10
Form of Securities Purchase Agreement, dated as of April 24, 2020 (incorporated by reference to Exhibit 10.1 to the Registrant’s Current Report on Form 8-K filed on April 28, 2020).
10.11
Form
of Placement Agency Agreement, dated as of April 24, 2020, by and between enVVeno Medical Corporation and Spartan Capital
Securities, LLC (incorporated by reference to Exhibit 10.2 to the Registrant’s Current Report on Form 8-K filed on April 28,
2020).
10.12
Form of Securities Purchase Agreement dated as of June 1, 2020 (incorporated by reference to Exhibit 10.1 to the Registrant’s Current Report on Form 8-K filed on June 3, 2020).
10.13
Form of Securities Purchase Agreement (incorporated by reference to Exhibit 10.53 to the Registrant’s Registration Statement on Form S-1/A (No. 333-239658) filed on July 16, 2020).
10.14
Form of Registration Rights Agreement (incorporated by reference to Exhibit 10.54 to the Registrant’s Registration Statement on Form S-1/A (No. 333-239658) filed on July 16, 2020).
10.15
Form of Securities Purchase Agreement, dated as of October 7, 2020 (incorporated by reference to Exhibit 10.1 to the Registrant’s Current Report on Form 8-K filed on October 8, 2020).
10.16
Form of Placement Agency Agreement, dated as of October 7, 2020 (incorporated by reference to Exhibit 10.2 to the Registrant’s Current Report on Form 8-K filed on October 8, 2020).
10.17
Employment Agreement, dated as of February 19, 2021, by and between enVVeno Medical Corporation and Craig Glynn (incorporated by reference to Exhibit 10.18 to the Registrant’s Annual Report on Form 10-K for the year ended December 31, 2020).
10.18
At-the-Market Offering Agreement, dated August 12, 2021, by and between enVVeno Medical Corporation and Ladenburg Thalmann & Co. Inc. (incorporated by reference to Exhibit 10.1 to the Registrant’s Current Report on Form 8-K filed on August 12, 2021).
10.19
Form of Securities Purchase Agreement, dated September 3, 2021 (incorporated by reference to Exhibit 10.1 to the Registrant’s Current Report on Form 8-K filed on September 8, 2021).
10.20
Form of Placement Agency Agreement, dated September 3, 2021 (incorporated by reference to Exhibit 10.2 to the Registrant’s Current Report on Form 8-K filed on September 8, 2021).
14.1
Code of Conduct (incorporated by reference to Exhibit 14.1 to the Registrant’s Annual Report on Form 10-K for the year ended December 31, 2020).
21.1
Subsidiaries of the registrant incorporated by reference to Exhibit 21.1 to the Registrant’s Annual Report on Form 10-K for the year ended December 31, 2020).
23.1
Consent of Marcum LLP, independent registered public accounting firm*
31.1
Certification of Chief Executive Officer pursuant to Rule 13a-14(a) or Rule 15d-14(a) of the Exchange Act. *
31.2
Certification of Chief Financial Officer pursuant to Rule 13a-14(a) or Rule 15d-14(a) of the Sarbanes-Oxley Act. *
32
Certification of Chief Executive Officer and Chief Financial Officer pursuant to Rule 13a-14(a) or Rule 15d-14(a) of the Exchange Act**
101.INS
Inline
XBRL Instance Document*
101.SCH
Inline
XBRL Taxonomy Extension Schema Document*
101.CAL
Inline XBRL
Taxonomy Extension Calculation Linkbase Document*
101.DEF
Inline XBRL
Taxonomy Extension Definition Linkbase Document*
101.LAB
Inline XBRL
Taxonomy Extension Label Linkbase Document*
101.PRE
Inline XBRL
Taxonomy Extension Presentation Linkbase Document*
*
Filed
herewith.
**
Furnished
and not filed herewith.
ITEM
16. Form 10-K Summary
Not
applicable
57
SIGNATURES
Pursuant
to the requirements of Section 12 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.
Date:
March 28, 2022
ENVVENO
MEDICAL CORPORATION
By:
/s/
Robert Berman
Robert
Berman
Chief
Executive Officer
(Principal
Executive Officer)
By:
/s/
Craig Glynn
Craig
Glynn
Chief
Financial Officer
(Principal
Financial and Accounting Officer)
58
ENVVENO
MEDICAL CORPORATION
ANNUAL
REPORT ON FORM 10-K
INDEX
TO AUDITED FINANCIAL STATEMENTS
Report of Independent Registered Public Accounting Firm (PCAOB: 688 )
F-2
Balance Sheets as of December 31, 2021 and 2020
F-3
Statements of Operations for the Years Ended December 31, 2021 and 2020
F-4
Statements of Stockholders’ Equity for the Years Ended December 31, 2021 and 2020
F-5
Statements of Cash Flows for the Years Ended December 31, 2021 and 2020
F-6
Notes
to Financial Statements
F-8
F- 1
REPORT
OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
To
the Shareholders and Board of Directors of
enVVeno
Medical Corporation
Opinion
on the Financial Statements
We
have audited the accompanying balance sheets of enVVeno Medical Corporation (the “Company”) as of December 31, 2021
and 2020, the related statements of operations, changes in stockholders’ equity and cash flows for each of the two years in the
period ended December 31, 2021, and the related notes (collectively referred to as the “financial statements”). In our opinion,
the financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 2021 and
2020, and the results of its operations and its cash flows for each of the two years in the period ended December 31, 2021, in conformity
with accounting principles generally accepted in the United States of America .
Basis
for Opinion
These
financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s
financial statements based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board
(United States) (“PCAOB”) and are required to be independent with respect to the Company in accordance with the U.S. federal
securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.
We
conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audits to obtain
reasonable assurance about whether the financial statements are free of material misstatement, whether due to error or fraud. The Company
is not required to have, nor were we engaged to perform, an audit of its internal control over financial reporting. As part of our audits
we are required to obtain an understanding of internal control over financial reporting but not for the purpose of expressing an opinion
on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion.
Our
audits included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error
or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding
the amounts and disclosures in the financial statements. Our audits also included evaluating the accounting principles used and significant
estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that our audits
provide a reasonable basis for our opinion.
/s/
Marcum llp
Marcum
llp
We
have served as the Company’s auditor since 2015.
New
York, NY
March 28,
2022
F- 2
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
BALANCE
SHEETS
2021
2020
December 31,
2021
2020
Assets
Current Assets:
Cash and cash equivalents
$ 54,727,740
$ 9,334,584
Prepaid expenses and other current assets
312,350
234,467
Total Current Assets
55,040,090
9,569,051
Property and equipment, net
617,855
398,967
Operating lease right-of-use assets, net
1,986,704
539,974
Security deposits and other assets
54,493
29,843
Total Assets
$ 57,699,142
$ 10,537,835
Liabilities and Stockholders’ Equity
Current Liabilities:
Accounts payable
$ 560,083
$ 1,390,362
Accrued expenses and other current liabilities
728,876
1,168,969
Note Payable
-
312,700
Current portion of operating lease liabilities
291,104
314,202
Total Current Liabilities
1,580,063
3,186,233
Long-term operating lease liabilities
1,714,871
253,746
Total Liabilities
3,294,934
3,439,979
Commitments and Contingencies (Note 9)
-
Stockholders’ Equity:
Preferred stock, par value $ 0.00001 , 10,000,000 shares authorized: no shares issued or outstanding
-
-
Common stock, par value $ 0.00001 , 250,000,000 shares authorized, 9,469,850 and 2,541,529 shares issued and outstanding as of December 31, 2021 and December 31, 2020, respectively
95
25
Additional paid-in capital
136,255,346
72,421,242
Accumulated deficit
( 81,851,233 )
( 65,323,411 )
Total Stockholders’ Equity
54,404,208
7,097,856
Total Liabilities and Stockholders’ Equity
$ 57,699,142
$ 10,537,835
The
accompanying notes are an integral part of these financial statements.
F- 3
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
STATEMENTS
OF OPERATIONS
2021
2020
For the Years Ended
December 31,
2021
2020
Operating Expenses:
Selling, general and administrative expenses
$ 11,164,858
$ 4,882,877
Research and development expenses
5,727,645
4,252,249
Loss from Operations
( 16,892,503 )
( 9,135,126 )
Other (Income) Expense:
Gain on extinguishment of note payable
( 312,700 )
-
Interest (income) expense, net
( 18,709 )
( 3,739 )
Change in fair value of derivative liabilities
-
( 211,807 )
Other (income) expense
( 33,272 )
215,906
Total Other (Income) Expense
( 364,681 )
360
Net Loss
( 16,527,822 )
( 9,135,486 )
Deemed dividend to Series C Preferred Stockholders
-
( 607,220 )
Net Loss Attributable to Common Stockholders
$ ( 16,527,822 )
$ ( 9,742,706 )
Net Loss Per Basic and Diluted Common Share:
$ ( 1.90 )
$ ( 7.54 )
Weighted Average Number of Common Shares Outstanding:
Basic and Diluted
8,679,824
1,291,469
The
accompanying notes are an integral part of these financial statements.
F- 4
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
STATEMENTS
OF CHANGES IN STOCKHOLDERS’ EQUITY
Shares
Amount
Shares
Amount
Capital
Deficit
Equity
Series C
Convertible
Preferred Stock
Common Stock
Additional Paid-in
Accumulated
Total Stockholders’
Shares
Amount
Shares
Amount
Capital
Deficit
Equity
Balance at January 1, 2020
-
$ -
717,274
$ 7
$ 57,177,858
$ ( 56,187,925 )
$ 989,940
Common stock issued in private placement offering [1]
52,000
1
24,304
-
24,305
Common stock issued in public offerings [2]
1,148,996
11
9,847,890
-
9,847,901
Preferred stock issued in private placement [3]
4,205,406
42
-
-
1,358,060
-
1,358,102
Preferred stock exchange to common stock
( 4,205,406 )
( 42 )
243,125
2
40
-
-
Common stock issued for exercise of warrants
367,660
4
2,985,751
-
2,985,755
Fair Value of Warrants Issued
Shares issued in satisfaction of trade payable
Shares issued in satisfaction of trade payable, shares
Common stock issued in At the Market Transactions (ATM)
Common stock issued in At the Market Transactions (ATM), shares
Common stock issued in registered direct offering
Common stock issued in registered direct offering, shares
Reclassification of Warrant Derivatives to Equity
-
-
334,230
-
334,230
Share-Based Compensation
12,474
-
693,109
-
693,109
Net loss
-
-
-
( 9,135,486 )
( 9,135,486 )
Balance at December 31, 2020
-
$ -
2,541,529
$ 25
$ 72,421,242
$ ( 65,323,411 )
$ 7,097,856
[1]
net of offering
costs of $ 0.1 million.
[2]
net of offering costs of $ 2.2 million.
[3]
net of offering costs of $ 0.2 million.
Shares
Amount
Capital
Deficit
Equity
Common Stock
Additional
Paid-in
Accumulated
Total
Stockholders’
Shares
Amount
Capital
Deficit
Equity
Balance at January 1, 2021
2,541,529
$ 25
$ 72,421,242
$ ( 65,323,411 )
$ 7,097,856
Common stock issued in public offering
5,914,284
59
38,127,717
-
38,127,776
Common stock issued for exercise of warrants
52,827
1
245,249
-
245,250
Fair Value of Warrants Issued
-
-
211,976
-
211,976
Shares issued in satisfaction of trade payable
5,772
-
37,576
-
37,576
Common stock issued in At The Market Transactions (ATM)
170,963
2
960,273
-
960,275
Common stock issued in registered direct offering
781,615
8
18,273,583
-
18,273,591
Shared-Based Compensation
2,860
-
5,977,730
-
5,977,730
Net loss
-
-
-
( 16,527,822 )
( 16,527,822 )
Balance at December 31, 2021
9,469,850
95
136,255,346
( 81,851,233 )
54,404,208
The
accompanying notes are an integral part of these financial statements.
F- 5
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
STATEMENTS
OF CASH FLOWS
2021
2020
For the Years Ended
December 31,
2021
2020
Cash Flows from Operating Activities
Net loss
$ ( 16,527,822 )
$ ( 9,135,486 )
Adjustments to reconcile net loss to net cash used in operating
activities:
Share-based compensation
5,999,178
881,213
Depreciation and amortization
149,002
97,549
Amortization of right-of-use assets
303,907
286,423
Change in fair value of derivatives
-
( 211,807 )
Gain on extinguishment of note payable
( 312,700 )
-
Loss on disposition of fixed assets
-
27,802
Changes in operating assets and liabilities:
Prepaid expenses and other current assets
( 37,883 )
( 117,820 )
Security deposit and other assets
( 24,650 )
-
Accounts payable
( 832,703 )
169,173
Accrued expenses
( 249,565 )
614,428
Payments on lease liabilities
( 312,610 )
( 288,685 )
Total adjustments
4,681,976
1,458,276
Net Cash Used in Operating Activities
( 11,845,846 )
( 7,677,210 )
Cash Flows from Investing Activities
Purchase of property and equipment
( 367,890 )
( 180,291 )
Net Cash Used in Investing Activities
( 367,890 )
( 180,291 )
Cash Flows from Financing Activities
Proceeds from private placement, net
-
570,341
Proceeds from shares issued under ATM
960,275
-
Proceeds from registered direct offering
18,273,591
-
Proceeds from public offerings, net
38,127,776
9,847,901
Proceeds from preferred stock issued in private placement, net
-
1,358,102
Proceeds from issuance of note payable
-
312,700
Proceeds from warrant exercises
245,250
2,985,755
Net Cash Provided by Financing Activities
57,606,892
15,074,799
Net Increase (Decrease) in Cash, Cash Equivalent, and Restricted Cash
45,393,156
7,217,298
Cash, cash equivalents and restricted cash - Beginning of year
9,334,584
2,117,286
Cash, cash equivalents and restricted cash - End of year
$ 54,727,740
$ 9,334,584
The
accompanying notes are an integral part of these financial statements.
F- 6
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
STATEMENTS
OF CASH FLOWS - continued
Year Ended
December 31,
2021
2020
Supplemental Disclosures of Cash Flow Information:
Cash Paid During the Period For:
Interest paid
$ -
$ -
Income taxes paid
$ -
$ -
Non-Cash Investing and Financing Activities
Gain on extinguishment of note payable
$ ( 312,700 )
$ -
Fair value of common stock issued in satisfaction of trade payable
35,576
-
Fair value of warrants issued to Preferred Exchange Participants, SABR and re-priced placement agent warrant
( 211,976 )
-
Derivative liabilities reclassified to equity
$ -
$ 334,229
The
accompanying notes are an integral part of these financial statements.
F- 7
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES
TO FINANCIAL STATEMENTS
Note
1 – Business Organization and Nature of Operations
enVVeno
Medical Corporation is a med-tech company focused on improving the standard of care in the treatment of venous disease. We are developing
tissue-based solutions that are designed to be life sustaining or life enhancing for patients with deep venous Chronic Venous Insufficiency
(CVI). CVI occurs when valves inside of the veins of the leg fail, resulting in insufficient blood being returned to the heart. Our products
are being developed to address large unmet medical needs by either offering treatments where none currently exist or by substantially
increasing the current standards of care. Our lead product is a porcine based device to be surgically implanted in our deep venous
system of the leg, and is called the VenoValve®. The VenoValve is currently being evaluated in the SAVVE U.S. pivotal trial for the
purpose of obtaining approval to market and sell the device from the U.S. Food and Drug Administration (“FDA”). Our team
of officers and directors has been affiliated with numerous medical devices that have received FDA approval or CE marking and have been
commercially successful. We currently lease a 14,507 sq. ft. manufacturing facility in Irvine, California, where we manufacture medical
devices for our clinical trials, and which has capacity for commercial manufacturing.
On
September 21, 2021, we announced that we were changing our name from Hancock Jaffe to enVVeno Medical Corporation and that our development
strategy is to focus on the treatment of venous disease. In addition to the VenoValve, we announced that we have begun development of
a second device for the treatment of venous disease which we are calling enVVe. In connection with this change in strategy, we indicated
that we are not pursuing further development of the CoreoGraft, which is now outside of our primary focus area.
Note
2 – Management’s Liquidity Plan
As
of December 31, 2021, the Company had a cash balance of $ 54.7
million and working capital of $ 53.5
million. Although the Company expects to continue
incurring losses for the foreseeable future and may need to raise additional capital to sustain its operations, pursue its product development
initiatives and penetrate markets for the sale of its products, Management believes that our capital resources at December 31, 2021,
are sufficient to meet our obligations as they become due within one year after the date of this Annual Report, and sustain operations.
Note
3 – Significant Accounting Policies
Use
of Estimates
The
preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires
management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosures of contingent
liabilities at the dates of the financial statements and the reported amounts of revenues and expenses during the reporting periods.
Actual results could differ from these estimates. Significant estimates and assumptions include the valuation allowance related to the
Company’s deferred tax assets, and the valuation of warrants and derivative liabilities.
Property
and Equipment, Net
Property
and equipment are stated at cost, net of accumulated depreciation using the straight-line method over their estimated useful lives, which
range from 5 to 7 years. Leasehold improvements are amortized over the lesser of (a) the useful life of the asset; or (b) the remaining
lease term. Expenditures for maintenance and repairs, which do not extend the economic useful life of the related assets, are charged
to operations as incurred, and expenditures, which extend the economic life are capitalized. When assets are retired, or otherwise disposed
of, the costs and related accumulated depreciation or amortization are removed from the accounts and any gain or loss on disposal is
recognized.
Impairment
of Long-lived Assets
The
Company reviews for the impairment of long-lived assets whenever events or changes in circumstances indicate that the carrying amount
of an asset may not be recoverable. An impairment loss would be recognized when estimated future cash flows expected to result from the
use of the asset and its eventual disposition are less than its carrying amount.
F- 8
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES
TO FINANCIAL STATEMENTS
Income
Taxes
The
Company follows the asset and liability method of accounting for income taxes under ASC 740, “Income Taxes.” Deferred tax
assets and liabilities are recognized for the estimated future tax consequences attributable to differences between the financial statement
carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured
using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered
or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that included
the enactment date. Valuation allowances are established, when necessary, to reduce deferred tax assets to the amount expected to be
realized.
ASC
740 prescribes a recognition threshold and a measurement attribute for the financial statement recognition and measurement of tax positions
taken or expected to be taken in a tax return. For those benefits to be recognized, a tax position must be more likely than not to be
sustained upon examination by taxing authorities. The Company recognizes accrued interest and penalties related to unrecognized tax benefits
as income tax expense. There were no unrecognized tax benefits and no amounts accrued for interest and penalties as of December 31, 2021
and December 31, 2020. The Company is currently not aware of any issues under review that could result in significant payments, accruals
or material deviation from its position.
Fair
Value of Financial Instruments
The
Company measures the fair value of financial assets and liabilities based on the guidance of Financial Accounting Standards Board (“FASB”)
Accounting Standards Codification (“ASC”) ASC 820 “Fair Value Measurements and Disclosures” (“ASC 820”)
which defines fair value, establishes a framework for measuring fair value, and expands disclosures about fair value measurements.
FASB
ASC 820 defines fair value as the exchange price that would be received for an asset or paid to transfer a liability (an exit price)
in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the
measurement date. ASC 820 also establishes a fair value hierarchy, which requires an entity to maximize the use of observable inputs
and minimize the use of unobservable inputs when measuring fair value. ASC 820 describes three levels of inputs that may be used to measure
fair value:
Level 1
Quoted prices available
in active markets for identical assets or liabilities trading in active markets.
Level 2
Observable inputs other
than quoted prices included in Level 1, such as quotable prices for similar assets and liabilities in active markets; quoted prices
for identical or similar assets and liabilities in markets that are not active; or other inputs that are observable or can be corroborated
by observable market data.
Level 3
Unobservable inputs that
are supported by little or no market activity and that are significant to the fair value of the assets or liabilities. This includes
certain pricing models, discounted cash flow methodologies and similar valuation techniques that use significant unobservable inputs.
Financial instruments, including accounts payable
are carried at cost, which management believes approximates fair value due to the short-term nature of these instruments. Derivative liabilities
are accounted for at fair value on a recurring basis.
F- 9
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES
TO FINANCIAL STATEMENTS
Derivative
Liabilities
Derivative
financial instruments are recorded as a liability at fair value and are marked-to-market as of each balance sheet date. The change in
fair value at each balance sheet date is recorded as a change in the fair value of derivative liabilities on the statement of operations
for each reporting period. The fair value of the derivative liabilities was determined using a Monte Carlo simulation, incorporating
observable market data and requiring judgment and estimates. The Company reassesses the classification of the financial instruments at
each balance sheet date. If the classification changes as a result of events during the period, the financial instrument is marked to
market and reclassified as of the date of the event that caused the reclassification.
Net
Loss per Share
The
Company computes basic and diluted loss per share by dividing net loss attributable to common stockholders by the weighted average number
of common shares outstanding during the period including warrants exercisable for little or no cash consideration. Net loss attributable
to common stockholders in 2020 consists of net loss adjusted for the convertible preferred stock deemed dividend resulting from the 8%
cumulative dividend on the Preferred Stock (see Note 10 - Stockholders Equity Series C Convertible Preferred Stock ). Basic and
diluted net loss per common share are the same since the inclusion of common stock issuable pursuant to the exercise of warrants and
options, would have been anti-dilutive.
F- 10
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES
TO FINANCIAL STATEMENTS
Stock-Based
Compensation
The
Company has an Equity Incentive Plan under which the Board of Directors may grant restricted stock or stock options to employees and
nonemployees. The accounting treatment for share-based payments to employees and non-employees is substantially equivalent.
Share-based
compensation cost is recorded for all option grants and awards of non-vested stock based on the grant date fair value of the award, and
is recognized over the service period required for the award.
The
fair value of the Company’s stock options is estimated at the date of grant using the Black-Scholes based option valuation model.
For the expected term, the Company uses SEC Staff Accounting Bulletin No. 107 simplified method for “plain vanilla” options
with following characteristics: (i) the share options are granted at the market price on the grant date; (ii) exercisability is conditional
on performing service through the vesting date on most options; (iii) if an employee terminates service prior to vesting, the employee
would forfeit the share options; (iv) if an employee terminates service after vesting, the employee would have 30 to 90 days to exercise
the share options; and (v) the share options are nontransferable and nonhedgeable.
The
volatility assumption is based on the historical volatility of the Company’s common stock with an equivalent remaining expected
term. The dividend yield assumption is based on the Company’s history and expectation of future dividend payouts on the common
stock. The risk-free interest rate is based on the implied yield available on U.S. treasury zero-coupon issues with an equivalent remaining
expected term.
For
option grants without performance conditions, the Company recognizes compensation expense over the requisite service period ratably,
recognizing expense for each tranche of each grant starting on the grant date. For grants that have both service and performance conditions,
the Company recognizes compensation expense using the graded attribution method. Compensation expense for grants with performance conditions
is recognized only for those awards expected to vest.
Forfeitures of unvested stock options are recorded
when they occur.
Concentrations
The
Company maintains cash with major financial institutions. Cash held in United States bank institutions is currently insured by the Federal
Deposit Insurance Corporation (“FDIC”) up to $ 250,000 at each institution. There were aggregate uninsured cash balances of
$ 54.5 million and $ 9.1 million as of December 31, 2021 and 2020, respectively.
Recently
Adopted Accounting Standards
In
December 2019, the FASB issued ASU No. 2019-12, Simplifying the Accounting for Income Taxes, which is intended to simplify various
aspects of the income tax accounting guidance, including requirements such as tax basis step-up in goodwill obtained in a transaction
that is not a business combination, ownership changes in investments, and interim-period accounting for enacted changes in tax law. ASU
2019-12 is effective for public business entities for fiscal years beginning after December 15, 2020, including interim periods within
those fiscal years, and early adoption is permitted. The
adoption of this standard did not have a material impact on our financial statements.
Recent
Accounting Standards
In
January 2020, the FASB issued Accounting Standards Update 2020-01 (“ASU 2020-01”) Investments-Equity Securities (Topic 321),
Investments-Equity Method and Joint Ventures (Topic 323), and Derivatives and Hedging (Topic 815). The amendments in ASU 2020-01 clarify
certain interactions between the guidance to account for certain equity securities under Topic 321, the guidance to account for investments
under the equity method of accounting in Topic 323, and the guidance in Topic 815, which could change how an entity accounts for an equity
security under the measurement alternative or a forward contract or purchased option to purchase securities that, upon settlement of
the forward contract or exercise of the purchased option, would be accounted for under the equity method of accounting or the fair value
option in accordance with Topic 825, Financial Instruments. These amendments improve current GAAP by reducing diversity in practice and
increasing comparability of the accounting for these interactions. The amendments in this update are effective for fiscal years beginning
after December 15, 2020, and interim periods within those fiscal years. The adoption of this standard will not have a material impact
on our financial statements and related disclosures.
In
August 2020, the FASB issued Accounting Standards Update 2020-06 (“ASU 2020-06”), Accounting for Convertible Instruments
and Contracts in an Entity’s Own Equity. The amendments in ASU 2020-06 include guidance on convertible instruments and the derivative
scope exception for contracts in an entity’s own equity and simplifies the accounting for convertible instruments which include
beneficial conversion features or cash conversion features by removing certain separation models in Subtopic 470-20. Additionally, ASU
2020-06 will require entities to use the “if-converted” method when calculating diluted earnings per share for convertible
instruments. The amendments in this update are effective for fiscal years beginning after December 15, 2021, including interim periods
within those fiscal years. We do not expect the adoption of this standard to have a material impact on our financial statements and related
disclosures.
In
May 2021, the FASB issued Accounting Standards Update 2021-04 (“ASU No. 2021-04”), Issuer’s Accounting for Certain
Modifications or Exchanges of Freestanding Equity-Classified Written Call Options. The guidance in ASU 2021-04 requires the issuer to
treat a modification of an equity-classified written call option (the “option”) that does not cause the option to become
liability-classified as an exchange of the original option for a new option. This guidance applies whether the modification is structured
as an amendment to the terms and conditions of the option or as termination of the original option and issuance of a new option. The
amendments in this update are effective for fiscal years beginning after December 15, 2021, including interim periods within those fiscal
years. We do not expect the adoption of this standard to have a material impact on our financial statements and related disclosures.
In
October 2021, the FASB issued Accounting Standards Update 2021-08 (“ASU No. 2021-08”), Business Combinations (Topic 805):
Accounting for Contract Assets and Contract Liabilities from Contracts with Customers, to require that an acquirer recognize and measure
contract assets and contract liabilities acquired in a business combination in accordance with Topic 606, Revenue from Contracts with
Customers. At the acquisition date, an acquirer should account for the related revenue contracts in accordance with Topic 606 as if it
had originated the contracts. The amendments in this update should be applied prospectively and are effective for fiscal years beginning
after December 15, 2022, including interim periods within those fiscal years. We do not expect the adoption of this standard to have
a material impact on our financial statements and related disclosures.
F- 11
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES
TO FINANCIAL STATEMENTS
Note
4 – Property and Equipment
As
of December 31, 2021, and 2020, property and equipment consist of the following:
Schedule
of Property and Equipment
2021
2020
December 31,
2021
2020
Laboratory equipment
$ 522,539
$ 320,830
Furniture and fixtures
124,093
98,392
Computer equipment
164,298
65,078
Leasehold improvements
192,668
158,092
Software
251,163
244,479
Total property and equipment
1,254,761
886,871
Less: accumulated depreciation
( 636,906 )
( 487,904 )
Property and equipment, net
$ 617,855
$ 398,967
Depreciation
expense was $ 0.1 million for the years ended December 31, 2021 and 2020. Depreciation expense is reflected in general and administrative
expenses in the accompanying statements of operations.
Note
5 – Right-of-Use Assets and Lease Liabilities
On
November 17, 2021, the Company amended its operating lease for its manufacturing facility in Irvine, California, to extend the term an
additional 60 months from its September 30, 2022 expiration date to a new expiration date of September 30, 2027. The initial lease rate
at the date of the amendment was $ 30,206 per month with escalating payments. In connection with the lease, the Company is obligated to
pay $ 7,254 monthly for operating expenses for building repairs and maintenance. The Company has no other operating or financing leases
with terms greater than 12 months .
The
Company determined the lease liabilities using the Company’s estimated incremental borrowing rate of 3.95 % to estimate the present
value of the remaining monthly lease payments.
Our
operating lease cost is as follows:
Schedule
of Operating Lease Cost
For the Year Ended
December 31, 2021
Operating lease cost
$ 345,857
Supplemental
cash flow information related to our operating lease is as follows:
Schedule
of Supplemental Cash Flow Information Related to Operating Lease
For the Year Ended
December 31, 2021
Operating cash flow information:
Cash paid for amounts included in the measurement of lease
liabilities
$ 354,561
Remaining
lease term and discount rate for our operating lease is as follows:
Schedule
of Operating Remaining Lease Term and Discount Rate
December 31, 2021
Remaining lease term
5.7 years
Discount rate
3.95 %
Maturity
of our lease liabilities by fiscal year for our operating lease is as follows:
Schedule
of Maturity of Lease Liabilities
Year ended December 31, 2022
$ 365,190
Year ended December 31, 2023
376,146
Year ended December 31, 2024
387,435
Year ended December 31, 2025
399,054
Year ended December 31, 2026
411,024
Year ended December 31, 2027
315,153
Total
$ 2,254,002
Less: Imputed interest
( 248,027 )
Present value of our lease liability
$ 2,005,975
F- 12
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES
TO FINANCIAL STATEMENTS
Note
6 – Accrued Expenses
As
of December 31, 2021 and 2020, accrued expenses consist of the following:
Schedule
of Accrued Expenses
2021
2020
December 31,
2021
2020
Accrued compensation costs
$ 524,529
$ 473,799
Accrued professional fees
84,375
79,650
Accrued research and development
59,922
368,809
Accrued warrants
-
188,104
Other
60,050
58,607
Accrued expenses
$ 728,876
$ 1,168,969
Note
7 – Note Payable
On
April 12, 2020, the Company obtained a loan (the “Loan”) in the amount of $ 312,700 , pursuant to the Paycheck Protection Program
(the “PPP”) under Division A, Title I of the CARES Act, which was enacted March 27, 2020.
The
Loan, which was in the form of a Note dated April 12, 2020, was to mature on April 12, 2022 , and bore interest at a rate of 1 % per annum,
payable monthly commencing on November 12, 2020. On September 8, 2021, the Company was notified the Loan and any accrued interest had
been forgiven. In connection with this, the Company recorded a gain on extinguishment of debt of $ 312,700 .
Note
8 – Income Taxes
The
following summarizes the Company’s income tax provision (benefit):
Schedule
of Income Tax Provision (Benefit)
For the Years Ended December 31,
2021
2020
Federal:
Current
$ -
$ -
Deferred
( 2,700,372 )
( 1,828,584 )
State and local:
Current
-
-
Deferred
( 900,124 )
( 609,528 )
Current and Deferred Federal, State and Local, Tax Expense
(Benefit)
( 3,600,496 )
( 2,438,112 )
Change in valuation allowance
3,600,496
2,438,112
Income tax provision (benefit)
$ -
$ -
The
reconciliation between the U.S. statutory federal income tax rate and the Company’s effective tax rate for the year’s ended
December 31, 2021 and 2020 is as follows:
Schedule
of Effective Income Tax Rate Reconciliation
For
the Years Ended December 31,
2021
2020
Tax benefit at federal statutory rate
( 21.0 ) %
( 21.0 ) %
State taxes, net of federal benefit
( 7.0 ) %
( 7.0 ) %
Nondeductible compensation
6.2 %
-
Permanent differences
( 0.5 )%
2.0 %
True up adjustments
0.5 %
( 0.7 ) %
Change in valuation allowance
21.8 %
26.7 %
Effective income tax rate
0.0 %
0.0 %
F- 13
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES
TO FINANCIAL STATEMENTS
Significant
components of the Company’s deferred tax assets at December 31, 2021 and 2020 are as follows:
Schedule
of Deferred Tax Assets and Liabilities
2021
2020
December 31,
2021
2020
Deferred tax assets:
Net operating loss carryforwards
$ 12,881,729
$ 9,811,086
Research and development credit carryforwards
185,680
185,680
Intangible assets
276,184
305,027
Operating lease liability
78,194
159,025
Stock-based compensation
923,540
311,304
Impairment loss
136,612
136,612
Total gross deferred tax assets
14,481,939
10,908,734
Deferred tax liabilities
Operating lease asset
( 70,994 )
( 151,193 )
Property and equipment
( 102,107 )
( 49,199 )
Total net deferred tax assets
14,308,838
10,708,342
Less: valuation allowance
( 14,308,838 )
( 10,708,342 )
Total
$ -
$ -
ASC
740 requires that the tax benefit of net operating losses, temporary differences and credit carryforwards be recorded as an asset to
the extent that management assesses that realization is “more likely than not.” Realization of the future tax benefits is
dependent on the Company’s ability to generate sufficient taxable income within the carryforward period. Because of the Company’s
history of operating losses, management believes that recognition of the deferred tax assets arising from the above listed future tax
benefits is currently not more likely than not to be realized and, accordingly, has provided a full valuation allowance. The valuation
allowance increased by $ 3.6
million and $ 2.4
million during the years ended December 31, 2021
and 2020, respectively.
Under
Section 382 of the Internal Revenue Code of 1986, as amended, if a corporation undergoes an “ownership change” (generally
defined as a greater than 50% change (by value) in its equity ownership over a three-year period), the corporation’s ability to
use its pre-change net operating loss, or NOL, carryforwards and other pre-change tax attributes to offset its post-change income taxes
may be limited. In accordance with Section 382 of the Internal Revenue Code, the usage of the Company’s NOL carry forwards are
subject to annual limitations due to a greater than 50 % ownership change in 2021.
At
December 31, 2021 and 2020, the Company had post-ownership change net operating loss carryforwards for federal income tax purposes
of approximately $ 45.7
million and $ 35.0
million, respectively. Pre-2018 federal NOLs
of approximately $ 12.0 million
may be carried forward for twenty years and begin to expire in 2029. Based on the 2021 ownership change, the Company expects $ 7.6
million of its pre-2018 federal NOLs to expire unused. Under the Tax Act, post-2017 federal NOLs in the aggregate amount of $ 33.0
million can be carried forward indefinitely and
the annual limit of deduction equals 80 %
of taxable income. However, to the extent the Company utilizes its NOL carryforwards in the future, the tax years in which the attribute
was generated may still be adjusted upon examination by the Internal Revenue Service or state tax authorities of the future period tax
return in which the attribute is utilized. The Company also has federal research and development tax credit carryforwards of approximately
$ 0.2
million which begin to expire in 2027.
As
of December 31, 2021 and 2020, the Company had net operating loss carryforwards for state income tax purposes of approximately
$ 45.7
million and $ 35.0
million, respectively, which can be carried forward for twenty years and begin to expire in 2028.
The
Company files income tax returns in the U.S. federal jurisdiction as well as California and local jurisdictions and is subject to examination
by those taxing authorities. The Company’s federal income taxes for the years beginning in 2018 remain subject to examination.
The Company’s state and local income tax returns for the years beginning in 2017 remain subject to examination. No tax audits were
initiated during 2021 or 2020.
Management
has evaluated and concluded that there were no material uncertain tax positions requiring recognition in the Company’s financial
statements as of December 31, 2021 and 2020. The Company does not expect any significant changes in its unrecognized tax benefits within
twelve months of the reporting date. The Company’s policy is to classify assessments, if any, for tax related interest as interest
expense and penalties as general and administrative expenses in the statements of operations.
On
March 27, 2020, the CARES Act was enacted in response to COVID-19 pandemic. Under ASC 740, the effects of changes in tax rates and laws
are recognized in the period which the new legislation is enacted. The CARES Act made various tax law changes including among other things
(i) increasing the limitation under Section 163(j) of the Internal Revenue Code of 1986, as amended (the “IRC”) for 2019
and 2020 to permit additional expensing of interest (ii) enacting a technical correction so that qualified improvement property can be
immediately expensed under IRC Section 168(k), (iii) making modifications to the federal net operating loss rules including permitting
federal net operating losses incurred in 2018, 2019, and 2020 to be carried back to the five preceding taxable years in order to generate
a refund of previously paid income taxes and (iv) enhancing the recoverability of alternative minimum tax credits. The Company has evaluated
the impact CARES Act on its provision for income taxes and determined there is not a significant impact to income taxes because of the
CARES Act.
On June 29, 2020, California’s Governor Newsom
signed AB85 suspending California net operating loss (“NOL”) utilization and imposing a cap on the amount of business incentives
tax credits (R&D credit) for tax years 2020-2022. Given the tax loss in 2020 and an expected tax loss for 2021, the
suspension will not have an impact on the Company’s NOL in California. On February 9, 2022, Mr. Newsom signed SB113 which removes
the restrictions in AB85 effective for the 2022 tax year.
F- 14
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES
TO FINANCIAL STATEMENTS
Note
9 – Commitments and Contingencies
Litigation
Claims and Assessments
In
the normal course of business, the Company may be involved in legal proceedings, claims and assessments arising in the ordinary course
of business. The Company records legal costs associated with loss contingencies as incurred and accrues for all probable and estimable
settlements.
Robert
Rankin Complaints
On
July 9, 2020, the Company was served with a civil complaint filed in the Superior Court for the State of California, County of Orange
by a former employee, Robert Rankin, who resigned his employment on or about March 30, 2020. The case is entitled Rankin v. Hancock
Jaffe Laboratories, Inc. et al., Case No. 30-2020-01146555-CU-WR-CJC and was filed on May 27, 2020. On September 3, 2020 the Company
and its Chief Executive Officer were served with a second complaint filed in the Superior Court for the State of California, County of
Orange by Mr. Rankin. The case is entitled Rankin v. Hancock Jaffe Laboratories, Inc. et al., Case No. 30-2020-01157857 and was
filed on August 31, 2020. The complaints assert several causes of action including a cause of action for failure to timely pay Mr. Rankin’s
accrued and unused vacation and three months’ severance under his July 16, 2018 employment agreement, defamation, unlawful labor
code violations, sex-based discrimination, and unfair competition, and seeks damages for lost wages, emotional and mental distress, consequential
damages, punitive damages and attorney’s fees and costs. The Company has denied all claims in both matters (which have now been
consolidated) and has filed a counterclaim asserting that Rankin has breached his employment agreement with the Company to the Company’s
damage. The Company continues to believe it has meritorious defenses to both matters. As of the date of these financial statements,
the amount of loss associated with these complaints, if any, cannot be reasonably estimated. Accordingly, no amounts related to these
complaints are accrued as of December 31, 2021.
Note
10 – Stockholders’ Equity
On
November 30, 2020, the Company”) effected a one-for-twenty-five (1:25) reverse stock split (the “Reverse Stock Split”)
of the shares of the Company’s common stock, par value $ 0.00001 per share (the “Common Stock”). As a result of the
Reverse Stock Split, every twenty-five shares of issued and outstanding Common Stock was automatically combined into one issued and outstanding
share of Common Stock, without any change in the par value per share. No fractional shares were issued as a result of the Reverse Stock
Split and any fractional shares resulting from the Reverse Stock Split were rounded up to the nearest whole share.
Equity
Issuances
During
2021 and 2020 the Company has completed various equity transactions to raise capital through the placement of its common and preferred
stock. The following table provides an overview of these transactions.
Schedule
of Equity Transactions to Raise Capital Through the Placement
Date
Description
Type
Number of shares
Net Proceeds
2020
February 25, 2020
Private placement
Common Stock
52,000
$ 570,341
April 28, 2020
Registered Direct Offering
Common Stock
75,472
$ 811,641
June 3, 2020
Registered Direct Offering
Common Stock
117,216
$ 1,161,334
July 17, 2020
Public Offering
Common Stock
575,000
$ 3,881,907
July 17, 2020
Private Placement
Preferred Stock
4,205,406
$ 1,358,099
October 9, 2020
Registered Direct Offering
Common Stock
381,308
$ 4,450,500
Total
$ 12,233,822
2021
February 11, 2021
Public Offering
Common Stock
5,914,284
$ 38,127,776
August 2021
At-the-Market Equity Program
Common Stock
170,963
$ 970,575
September 9, 2021
Registered Direct Offering
Common Stock
781,615
$ 18,273,591
Total
$ 57,371,942
F- 15
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES
TO CONDENSED FINANCIAL STATEMENTS
Series
C Convertible Preferred Stock
On
July 17, 2020, the Company issued 4,205,406 shares of Preferred Stock in a private placement. On November 17, 2020, the holders of the
Preferred Stock purchased in the July 17, 2020 private placement entered exchange agreements with the Company whereby the holders agreed
to exchange all of their 4,205,406 shares of Preferred Stock for 243,125 shares of common stock. This was the original conversion rate
of the Preferred Stock after giving effect to the 25:1 reverse split of the Company’s common stock.
While
the Preferred Stock was outstanding, the holders of the Company’s Preferred Stock could vote with holders of the Common Stock,
and with any other shares of preferred stock that vote with the Common Stock, with each holder of Preferred Stock being entitled to one
vote per share of Preferred Stock, and were entitled to receive 8 % non-compounding cumulative dividends, payable when, as and if declared
by the Board of Directors. The Series C Preferred Stock ranked senior to the common stock as to dividends and the distribution of assets
in the event of any liquidation, dissolution, or winding up of the Company, either voluntary or involuntary, or any sale of the Company.
In
the event of any liquidation, dissolution, or winding up of the Company, either voluntary or involuntary, or any sale of the Company,
the holders of Preferred Stock were entitled to receive, before and in preference to any distribution of any of the assets to the holders
of the common stock, or any other series of the Company’s preferred stock that would then be junior to the Preferred Stock, an
amount per share equal to $0.37 for each outstanding share of Preferred Stock (the “Original Series C Issue Price”), plus
all accrued but unpaid dividends thereon through the date of such event.
In
certain circumstances, the holders of Preferred Stock were entitled to receive a liquidation preference payment of $ 0.37 per share of
Preferred Stock, plus accrued and unpaid dividends. Those accrued and unpaid dividends were $ 23,859 in the aggregate as of September
30, 2020 and were reflected as a deemed dividend in determining net loss available to common stockholders during that period. As a result
of the exchange of the Preferred Stock for common stock, it is no longer outstanding (see below).
The
liquidation preference of the Preferred Stock was subordinate and ranks junior to all indebtedness of the Company.
The
Company had the ability to elect to convert the Preferred Stock to common stock in the event the Company either (i) consummated a merger,
or (ii) raised an aggregate of at least $8,000,000 in gross proceeds in a transaction or series of transactions within any twelve (12)
month period. In the event the Company elected to affect such a conversion, each share of Series C Preferred Stock would have been convertible
into 0.05781 shares of common stock.
F- 16
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES TO CONDENSED FINANCIAL STATEMENTS
The
Company determined that the Preferred Stock represented permanent equity due to the absence of a redemption feature and that the embedded
conversion option was clearly and closely related to the equity host and did not require bifurcation. The $ 2,431,250 fair value of the
warrants was calculated using the Black-Scholes option pricing model, using the $ 11.00 stock price, an expected term of 7.0 years, volatility
of 118.7 %, a risk-free rate of 0.47 % and expected dividends of 0.00 %. The $ 1,556,000 of gross proceeds were allocated on a relative fair
value basis of $ 607,220 to the Preferred Stock and $ 948,781 to the warrants. The Preferred Stock includes a contingent beneficial conversion
feature (“BCF”) which was valued at its $ 2,067,155 intrinsic value using the commitment date stock price of $ 11.00 per share
and the effective conversion price of $2.50 per share, but was limited to the $607,220 of proceeds that were allocated to the Preferred
Stock .
The
November 17, 2020 exchange agreements resolved the contingency related to the BCF and, accordingly, the contingent BCF was recognized
as a deemed dividend for the purposes of determining the net loss attributable to common stockholders for calculating net loss per share.
In addition, since the Company does not have retained earnings, the dividend has been recorded against additional paid-in capital.
F- 17
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES
TO FINANCIAL STATEMENTS
Warrants
A
summary of warrant activity during the years ended December 31, 2021 and 2020 is presented below:
Schedule of Stock Warrant Activity
Common Stock
Number of
Warrants
Weighted
Average
Exercise
Price
Weighted
Average
Remaining
Life in
Years
Intrinsic
Value
Outstanding, January 1, 2020
174,681
$ 127.50
Issued
1,702,810
9.26
Exercised
( 367,660 )
8.13
Cancelled
( 2,029 )
107.50
Outstanding, January 1, 2021
1,507,802
$ 20.10
5.3
$ 448,140
Issued
4,895,016
4.59
Exercised
( 52,827 )
5.03
Cancelled
( 38,286 )
16.10
Outstanding and exercisable, December 31, 2021
6,311,705
$ 8.80
4.2
$ 474,464
In
November 2020 as part of resolving a dispute,
the Company agreed to issue warrants to purchase 17,618
shares of common stock at a purchase price of
$ 8.00
per share, and warrants to purchase 18,056
shares of common stock at a purchase price of
$ 10.25
per share. These amounts were in dispute and
were paid pursuant to an investment banking agreement dated February 12, 2020 in connection with financings which occurred in July and
October 2020. The fair value of these warrants on the settlement date was $ 0.1
million and $ 0.1
million , respectively. The
total amount of the payment to settle the dispute was $ 0.5
million, including the value of the warrants. and
was included in the cost of the July and October financings. The fair value of the warrants was determined using the Black-Scholes method
with the following assumptions: stock price of $ 8.00
and $ 10.35 ,
risk-free interest rate of 0.46 %,
volatility of 112.7 %,
annual rate of quarterly dividends of 0 %,
and an expected term of 2.5
years. The investment banking agreement has now been terminated with no further obligations.
In
November 2020 the Company’s Board of Directors approved the issuance of warrants to purchase 6,400
shares of common stock to an advisor and warrants
to purchase 20,000
shares of common stock to certain participants
in the preferred share exchange (see Note 10, Stockholders Equity – Series C Convertible Preferred Stock ). Separately
the Company agreed to re-price warrants issued to the placement agent for the Company’s February 25, 2020 private placement. These
warrants and the re-priced warrant were issued in February 2021. The value of these warrants at December 31, 2020 was $ 188,804
and is included in accrued expenses. The Company
determined their value using the Black-Scholes method with the following assumptions: stock price of $ 8.65 ,
risk-free interest rate of 0.36 %,
volatility of 114.3 %,
annual rate of quarterly dividends of 0 %,
and an expected term of 2.5
to 3.5
years.
F- 18
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES
TO FINANCIAL STATEMENTS
Warrants
– Derivative Liabilities
The
warrants issued in connection with our February 25, 2020 Bridge Offering were determined to be derivative financial instruments when
issued because the Company did not have control of the obligation to obtain shareholder approval by May 25, 2020 to increase the number
of authorized shares or to approve a reverse stock split. The accounting treatment of derivative financial instruments required that
the Company record the warrants as a liability at fair value and marked-to-market the instruments at fair values as of each subsequent
balance sheet date. Any change in fair value is recorded as a change in the fair value of derivative liabilities for each reporting period
at each balance sheet date.
The
warrant derivatives were valued as of the February 25, 2020 issuance date, as of the quarter ended March 31, 2020, as of June 30, 2020,
and as of September 15, 2020 when the Company’s stockholders approved an increase in authorized shares in an amount sufficient
to allow full exercise of these warrants. The value at issuance was $ 546,036 and was recorded as a derivative liability. The value of
the derivative liability was $ 199,907 at March 31, 2020, $ 281,183 at June 30, 2020, and $ 334,229 at September 15, 2020.
The
derivative liability increased $ 53,046 and decreased $ 211,807 during the three and nine months ended September 30, 2020, respectively.
The changes in derivative liability is reflected in Other Income on the accompanying Statement of Operations.
The
Company reassessed the classification at each balance sheet date to determine if it should be changed as a result of events during the
period. On September 15, 2020, the fair value of derivative liabilities was reclassified to equity when the Company’s stockholders
approved items comprising a Capital Event. Accordingly, there is no fair value of derivative liabilities as of December 31, 2020.
The
fair value of the warrants was determined using a Monte Carlo simulation, incorporating observable market data and requiring judgment
and estimates. The following inputs and assumptions were used for the valuation of the derivative liability:
Schedule of Assumption Used for Valuation of Derivative Liability
February 25,
2020
March 31,
2020
June 30,
2020
September 15,
2020
Projected Volatility
97.1 %
102.7 %
102.7 %
110.7 %
Risk-Free Rate
1.36 %
0.38 %
0.29 %
0.31 %
Contractual Term (Years)
5
5
4.75
4.5
●
It was assumed the stock
price would fluctuate with the Company’s projected volatility.
●
The projected volatility
was based on the historical volatility of the Company.
●
If the Company was required
to pay the fair value of the warrant in cash as of May 25, 2020, the obligation was discounted at the Company’s estimated cost
of debt based on short-term C-CCC bond ratings of 19.5% and 28.5% .
●
The likelihood of the Company
calling a shareholder meeting and achieving shareholder approval was 90% as of February 25, 2020 .
●
As June 30, 2020, the Company
projected shareholder approval would not be obtained until approximately 8/31/20. No mandatory exercise was allowed prior to that
date.
●
Until the Company obtained
shareholder approval to increase the authorized shares on September 15, 2020, we assumed the warrant holders have an option to require
the Company to pay the fair value of the warrants. The derivative value at that date was $ 334,229 .
F- 19
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES
TO FINANCIAL STATEMENTS
The
following table sets forth a summary of the changes in the fair value of Level 3 derivative liabilities that are measured at fair value
on a recurring basis:
Schedule of Fair Value of Level 3 Derivative Liabilities on Fair Value of Recurring Basis
Derivative
Liabilities
Balance – January 1, 2020
$ -
Derivative liabilities associated with the issuance of common stock warrants
513,534
Derivative liabilities associated with the issuance of placement agent warrants
32,502
Change in fair value of derivative liabilities
( 211,807 )
Reclassification of warrant derivatives to equity
( 334,229 )
Balance – December 31, 2020
$ -
Note
11 – Share Based Compensation
Omnibus
Incentive Plan
The
Company issues share-based awards under its Company’s 2016 Omnibus Incentive Plan, which enables the Company to grant stock options,
stock appreciation rights, restricted stock, restricted stock units, unrestricted stock, other share based awards and cash awards to
associates, directors, consultants, and advisors of the Company and its affiliates, and to improve the ability of the Company to attract,
retain, and motivate individuals upon whom the Company’s sustained growth and financial success depend, by providing such persons
with an opportunity to acquire or increase their proprietary interest in the Company. Stock options granted under the 2016 Plan may be
non-qualified stock options or incentive stock options, within the meaning of Section 422(b) of the Internal Revenue Code of 1986, except
that stock options granted to outside directors and any consultants or advisers providing services to the Company or an affiliate shall
in all cases be non-qualified stock options. The option price must be at least 100% of the fair market value on the date of grant and
if issued to a 10% or greater shareholder must be 110% of the fair market value on the date of the grant .
The
2016 Plan is to be administered by the Board, which has discretion over the awards and grants thereunder. No awards may be issued
after November 21, 2026.
The
Plan was adopted in 2016 and amended in 2018, 2020 and 2021 to increase the number of shares authorized to be awarded under
the Plan. As of December 31, 2021 there are 4,500,000 shares
authorized under the Plan as a result of the increase authorized by our shareholders in 2021. The number of shares subject to
the Plan is automatically adjusted from time to time such that shares authorized under the plan shall at all times be equal
to at least 20 %
of the issued and outstanding shares of the Company on a fully diluted basis. The current number of shares authorized is greater
than the 20 % minimum.
Stock
Options
The
fair value of each option grant is estimated at the grant date using the Black Scholes method. The following assumptions were used in
estimating fair value:
Schedule of Stock Options Assumptions in Estimated Fair Value
2021
2020
Expected term
5.44 – 6.5 years
5.16 – 5.76 years
Volatility
112.94 – 103.6 %
107.5 %
Risk free interest rate
0.08 – 1.20 %
0..30 – 0.36 %
Dividend yield
0.00 %
0.00 %
The
Company estimated the expected term of the options using the simplified method. The Company uses its stock’s historical market
information to calculate volatility used in estimating fair value of options granted.
F- 20
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES
TO FINANCIAL STATEMENTS
A
summary of the option activity during the years ended December 31, 2021 and 2020 is presented below:
Schedule of Stock Option Activity
Weighted
Weighted
Average
Average
Remaining
Aggregate
Number of
Exercise
Life
Intrinsic
Options
Price
In Years
Value
Outstanding, January 1, 2020
99,689
$ 111.00
Granted
122,000
10.00
Forfeited
( 11,000 )
63.88
Outstanding, December 31, 2020
210,689
$ 31.48
8.7
$ -
Granted
3,246,551
$ 7.70
Forfeited
( 15,333 )
8.36
Outstanding, December 31, 2021
3,441,907
$ 9.16
9.3
$ -
Exercisable, December 31, 2021
982,921
$ 12.94
8.9
$ -
The
Company includes share-based compensation expense in selling, general and administrative expenses, and recognized $ 6.0 million and $ 0.7
million during the years ended December 31, 2021 and 2020, respectively.
As
of December 31, 2021, there was $ 15.2 million of unrecognized share-based compensation expense related to outstanding stock options and
restricted stock units that will be recognized over the weighted average remaining vesting period of 2 years.
F- 21
ENVVENO
MEDICAL CORPORATION
f/k/a
HANCOCK JAFFE LABORATORIES, INC.
NOTES
TO FINANCIAL STATEMENTS
Restricted
Stock Units
The
Company also issues restricted shares and restricted stock units under the 2016 Plan. A summary of the restricted share and restricted
stock units activity during the years ended December 31, 2021 and 2020 is presented below:
Schedule
of Stock Option Activity Restricted Shares
Number of
Restricted Shares
Outstanding, January 1, 2020
7,806
Granted
10,000
Shares vested
( 12,864 )
Outstanding, December 31, 2020
4,942
Granted
400,000
Shares Vested
( 2,860 )
Outstanding, December 31, 2021
402,082
A
summary of outstanding restricted stock units as of December 31, 2021 is presented below:
Schedule of Outstanding and Exercisable Restricted Stock Units
Restricted Stock Units
Grant Date
Restricted Stock Unit for
Outstanding
Number of
Units
Weighted
Average
Remaining
Life In
Years
9/13/2019
Common Stock
2,082
0.9
11/30/2021
Common Stock
400,000
-
Total
402,082
Note 12 – Net Loss Per Share
The
following table summarizes the number of potentially dilutive common stock equivalents excluded from the calculation of diluted net loss
per common share as of December 31, 2021 and 2020:
Schedule
of Dilutive Net Loss Per Common Share
2021
2020
December 31,
2021
2020
Shares of common stock issuable upon exercise of warrants
4,552,670
1,507,802
Shares of common stock issuable upon exercise of options and restricted stock
units
3,843,989
215,631
Potentially dilutive common stock equivalents excluded from diluted net loss
per share
8,396,659
1,723,433
F- 22
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.