UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
Form
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
For the quarterly period ended
OR
TRANSITION REPORT PURSUANT TO SECTION 13 or 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
For the transition period from to
Commission file number:
(Exact name of registrant as specified in its charter)
(State or other jurisdiction | (IRS Employer |
(Address of principal executive offices, including zip code)
(Registrant’s telephone number, including area code)
Securities registered pursuant to Section 12(b) of the Act:
Title of Each Class |
| Trading Symbol | Name of Each Exchange on which Registered |
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The |
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.
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).
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 | ☐ |
☒ | 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 is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes
As of August 15, 2022,
INDEX
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Condensed Consolidated Balance Sheets as of June 30, 2022 and December 31, 2021 | 3 | |
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Management’s Discussion and Analysis of Financial Condition and Results of Operations | 24 | |
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36 |
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PART I – FINANCIAL INFORMATION
ITEM 1. CONDENSED CONSOLIDATED FINANCIAL STATEMENTS (Unaudited)
RESHAPE LIFESCIENCES INC.
Condensed Consolidated Balance Sheets
(unaudited)
(dollars in thousands, except per share amounts)
June 30, | December 31, | |||||
| 2022 |
| 2021 | |||
ASSETS | ||||||
Current assets: | ||||||
Cash and cash equivalents | $ | |
| $ | | |
Restricted cash | | | ||||
Accounts and other receivables (net of allowance for doubtful accounts of $ |
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Inventory |
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Prepaid expenses and other current assets |
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Total current assets |
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Property and equipment, net |
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Operating lease right-of-use assets | | | ||||
Other intangible assets, net | | | ||||
Other assets |
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Total assets | $ | |
| $ | | |
LIABILITIES AND STOCKHOLDERS’ EQUITY | ||||||
Current liabilities: | ||||||
Accounts payable | $ | |
| $ | | |
Accrued and other liabilities |
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Warranty liability, current | | | ||||
Operating lease liabilities, current | | | ||||
Total current liabilities |
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Operating lease liabilities, noncurrent | — | — | ||||
Warranty liability, noncurrent | | | ||||
Deferred income taxes, net | | | ||||
Total liabilities | |
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Commitments and contingencies (Note 13) | ||||||
Stockholders’ equity: | ||||||
Preferred stock, | ||||||
Series C convertible preferred stock, $ | ||||||
Common stock, $ |
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Additional paid-in capital |
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Accumulated deficit |
| ( |
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| ( | |
Accumulated other comprehensive loss | ( | ( | ||||
Total stockholders’ equity |
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Total liabilities and stockholders’ equity | $ | |
| $ | |
See accompanying notes to Condensed Consolidated Financial Statements.
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RESHAPE LIFESCIENCES INC.
Condensed Consolidated Statements of Operations
(unaudited)
(dollars in thousands, except per share amounts)
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||
2022 | 2021 |
| 2022 | 2021 | ||||||||
Revenue | $ | | $ | | $ | | $ | | ||||
Cost of revenue | |
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Gross profit | |
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Operating expenses: | ||||||||||||
Sales and marketing | |
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General and administrative | | | | | ||||||||
Research and development | |
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Loss on disposal of assets, net | | — | | — | ||||||||
Total operating expenses | |
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Operating loss | ( |
| ( |
| ( |
| ( | |||||
Other expense (income), net: | ||||||||||||
Interest (income) expense, net | ( | | ( | | ||||||||
Loss on extinguishment of debt, net | — | | — | | ||||||||
Loss (Gain) on foreign currency exchange, net | | ( | | ( | ||||||||
Other | | — | ( | — | ||||||||
Loss before income tax provision | ( | ( | ( | ( | ||||||||
Income tax (benefit) expense | | | ( | | ||||||||
Net loss | $ | ( | $ | ( | $ | ( | $ | ( | ||||
Net loss per share - basic and diluted: | ||||||||||||
Net loss per share - basic and diluted (as revised for the three and six months ended June 30, 2021, see Note 1) | ( | ( | ( | ( | ||||||||
Shares used to compute basic and diluted net loss per share (as revised for the three and six months ended June 30, 2021, see Note 1) | |
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See accompanying notes to Condensed Consolidated Financial Statements.
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RESHAPE LIFESCIENCES INC.
Condensed Consolidated Statements of Comprehensive Loss
(unaudited)
(dollars in thousands)
Three Months Ended June 30, | Six Months Ended June 30, | |||||||||||
2022 |
| 2021 |
| 2022 | 2021 | |||||||
Net loss | $ | ( | $ | ( | $ | ( | $ | ( | ||||
Foreign currency translation adjustments | ( | ( | | | ||||||||
Other comprehensive (loss) income, net of tax | ( | ( | | | ||||||||
Comprehensive loss | $ | ( | $ | ( | $ | ( | $ | ( |
See accompanying notes to Condensed Consolidated Financial Statements.
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RESHAPE LIFESCIENCES INC.
Condensed Consolidated Statements of Stockholders’ Equity
(unaudited)
(dollars in thousands)
Three Months Ended June 30, 2022 | ||||||||||||||||||||||
Series C Convertible | Additional | Accumulated Other | Total | |||||||||||||||||||
Preferred Stock | Common Stock | Paid-in | Accumulated | Comprehensive | Stockholders’ | |||||||||||||||||
| Shares |
| Amount |
| Shares |
| Amount |
| Capital |
| Deficit |
| Loss |
| Equity | |||||||
Balance March 31, 2022 | | $ | — | | $ | | $ | | $ | ( | $ | ( | $ | | ||||||||
Net loss | — | — | — | — | — | ( | — | ( | ||||||||||||||
Other comprehensive loss, net of tax | — | — | — | — | — | — | ( | ( | ||||||||||||||
Stock compensation | — | — | — | — | | — | — | | ||||||||||||||
Issuance of stock from RSUs | — | — | | — | — | — | — | — | ||||||||||||||
Exercise of warrants | — | — | | | | — | — | | ||||||||||||||
Balance June 30, 2022 | | $ | — | | $ | | $ | | $ | ( | $ | ( | $ | |
Six Months Ended June 30, 2022 | ||||||||||||||||||||||
Series C Convertible | Additional | Accumulated Other | Total | |||||||||||||||||||
Preferred Stock | Common Stock | Paid-in | Accumulated | Comprehensive | Stockholders’ | |||||||||||||||||
| Shares |
| Amount |
| Shares |
| Amount |
| Capital |
| Deficit |
| Loss |
| Equity | |||||||
Balance December 31, 2021 | | $ | — | | $ | | $ | | $ | ( | $ | ( | $ | | ||||||||
Net loss | — | — | — | — | — | ( | — | ( | ||||||||||||||
Other comprehensive income, net of tax | — | — | — | — | — | — | | | ||||||||||||||
Stock compensation | — | — | — | — | | — | — | | ||||||||||||||
Issuance of stock from RSUs | — | — | | | ( | — | — | — | ||||||||||||||
Exercise of warrants | — | — | | | | — | — | | ||||||||||||||
Balance June 30, 2022 | | $ | — | | $ | | $ | | $ | ( | $ | ( | $ | |
See accompanying Notes to Condensed Consolidated Financial Statements.
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RESHAPE LIFESCIENCES INC.
Condensed Consolidated Statements of Stockholders’ Equity (Continued)
(unaudited)
(dollars in thousands)
Three Months Ended June 30, 2021 | |||||||||||||||||||||||||||
Series B Convertible | Series C Convertible | Additional | Accumulated | Total | |||||||||||||||||||||||
Preferred Stock | Preferred Stock | Common Stock | Paid-in | Accumulated | Comprehensive | Stockholders’ | |||||||||||||||||||||
Shares |
| Amount |
| Shares |
| Amount |
| Shares |
| Amount |
| Capital |
| Deficit | Income (Loss) |
| Equity | ||||||||||
Balance March 31, 2021 | | $ | — | | $ | | | $ | | $ | | $ | ( | $ | ( | $ | | ||||||||||
Net loss | — | — | — | — | — | — | — | ( | — | ( | |||||||||||||||||
Other comprehensive income (loss), net of tax | — | — | — | — | — | — | — | — | ( | ( | |||||||||||||||||
Issuance of common stock pursuant to reverse acquisition | ( | — | — | ( | | | | — | — | | |||||||||||||||||
Reversal of stock compensation | — | — | — | — | — | — | ( | — | — | ( | |||||||||||||||||
Deferred issuance cost of shares held in abeyance | — | — | — | — | — | — | | — | — | | |||||||||||||||||
Exercise of warrants | — | — | — | — | | | | — | — | | |||||||||||||||||
Stock options exercised | — | — | — | — | | — | | — | — | | |||||||||||||||||
Balance June 30, 2021 | — | $ | — | | $ | — | | $ | | $ | | $ | ( | $ | ( | $ | |
Six Months Ended June 30, 2021 | |||||||||||||||||||||||||||
Series B Convertible | Series C Convertible | Additional | Accumulated Other | Total | |||||||||||||||||||||||
Preferred Stock | Preferred Stock | Common Stock | Paid-in | Accumulated | Comprehensive | Stockholders’ | |||||||||||||||||||||
Shares |
| Amount |
| Shares |
| Amount |
| Shares |
| Amount |
| Capital |
| Deficit | Loss |
| Equity | ||||||||||
Balance December 31, 2020 | | $ | — | | $ | | | $ | | $ | | $ | ( | $ | ( | $ | | ||||||||||
Net loss | — | — | — | — | — | — | — | ( | — | ( | |||||||||||||||||
Other comprehensive income, net of tax | — | — | — | — | — | — | — | — | | | |||||||||||||||||
Issuance of common stock pursuant to reverse acquisition | ( | — | — | ( | | | | — | — | | |||||||||||||||||
Reversal of stock compensation | — | — | — | — | — | — | ( | — | — | ( | |||||||||||||||||
Issuance of warrants | — | — | — | — | — | — | | — | — | | |||||||||||||||||
Deferred issuance cost for shares held in abeyance | — | — | — | — | — | — | | — | — | | |||||||||||||||||
Institutional exercise of warrants | — | — | — | — | | | | — | — | | |||||||||||||||||
Stock options exercised | — | — | — | — | | — | | — | — | | |||||||||||||||||
Balance June 30, 2021 | — | $ | — | | $ | — | | $ | | $ | | $ | ( | $ | ( | $ | |
See accompanying Notes to Condensed Consolidated Financial Statements.
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RESHAPE LIFESCIENCES INC.
Condensed Consolidated Statements of Cash Flows
(unaudited)
(dollars in thousands)
Six Months Ended June 30, | ||||||
2022 | 2021 | |||||
Cash flows from operating activities: |
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Net loss | $ | ( | $ | ( | ||
Adjustments to reconcile net loss to net cash used in operating activities: | ||||||
Depreciation expense |
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Amortization of intangible assets | | | ||||
Noncash interest expense | — | | ||||
Loss on extinguishment of debt, net | — | | ||||
Loss on disposal of assets, net | | — | ||||
Stock-based compensation | | ( | ||||
Bad debt expense | ( | | ||||
Provision for inventory excess and obsolescence | | | ||||
Deferred income tax | ( | — | ||||
Amortization of debt discount and deferred debt issuance costs | — | | ||||
Other noncash items | ( | | ||||
Change in operating assets and liabilities, net of business combination: |
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Accounts and other receivables |
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| ( | ||
Inventory |
| ( |
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Prepaid expenses and other current assets |
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| ( | ||
Accounts payable and accrued liabilities | | | ||||
Warranty liability |
| ( |
| ( | ||
Other |
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Net cash used in operating activities | ( | ( | ||||
Cash flows from investing activities: | ||||||
Capital expenditures | ( | ( | ||||
Proceeds from acquisition | — | | ||||
Proceeds from sale of capital assets | | — | ||||
Cash provided by investing activities: | | | ||||
Cash flows from financing activities: | ||||||
Proceeds from warrants exercised | | | ||||
Proceeds from stock options exercised | — | | ||||
Proceeds from credit agreement | — | | ||||
Payment of credit agreement | — | ( | ||||
Net cash provided by financing activities | | | ||||
Effect of currency exchange rate changes on cash and cash equivalents |
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Net (decrease) increase in cash, cash equivalents and restricted cash |
| ( |
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Cash, cash equivalents and restricted cash at beginning of period | | | ||||
Cash, cash equivalents and restricted cash at end of period | $ | | $ | | ||
Supplemental disclosure: | ||||||
Cash paid for income taxes | $ | — | $ | | ||
Cash paid for interest | | |||||
Noncash investing and financing activities: | ||||||
Capital expenditures accruals | $ | | $ | | ||
Purchase price, net of cash received | — | | ||||
Deferred issuance cost related to abeyance of shares | — | | ||||
Fair value of warrants included as a component of loss on extinguishment of debt | — | |
See accompanying notes to Condensed Consolidated Financial Statements.
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ReShape Lifesciences Inc.
Notes to Condensed Consolidated Financial Statements
(dollars in thousands, except per share amounts; unaudited)
(1) Basis of Presentation
The accompanying interim condensed consolidated financial statements and related disclosures of Reshape Lifesciences Inc. (the “Company” or “ReShape”) have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission ("SEC") and should be read in conjunction with the consolidated financial statements and notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2021, filed on April 8, 2022. Certain information and footnote disclosures normally included in financial statements prepared in accordance with generally accepted accounting principles in the United States of America ("GAAP") have been condensed or omitted.
In the opinion of management, the interim consolidated condensed financial statements reflect all adjustments considered necessary for a fair statement of the interim periods. All such adjustments are of a normal, recurring nature. The results of operations for the interim periods are not necessarily indicative of the results of operations to be expected for the full year.
Revision of Previously Issued Financial Statement for Correction of Immaterial Errors
The Company revised the statement of operations for the periods ended December 31, 2020, March 31, 2021, June 30, 2021, September 30, 2021, December 31, 2021, and March 31, 2022, to reflect the correction of an immaterial error in the computation of the weighted average shares used to compute basic and diluted net loss per share. This revision has no impact on the Company’s net loss or accumulated deficit.
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The following table summarizes the effect of the revision on each financial statement line item for the periods ended as indicated:
Condensed Consolidated Statement of Operations | |||||||||
As Previously | |||||||||
Reported | Adjustment | As Revised | |||||||
For the year ended December 31, 2020 | |||||||||
Net loss per share - basic and diluted: | |||||||||
Net loss per share - basic and diluted | ( | ( | ( | ||||||
Shares used to compute basic and diluted net loss per share | | ( | | ||||||
Three months ended March 31, 2021 | |||||||||
Net loss per share - basic and diluted: | |||||||||
Net loss per share - basic and diluted | ( | $ | — | ( | |||||
Shares used to compute basic and diluted net loss per share | | | | ||||||
Three months ended June 30, 2021 | |||||||||
Net loss per share - basic and diluted: | |||||||||
Net loss per share - basic and diluted | ( | ( | ( | ||||||
Shares used to compute basic and diluted net loss per share | | ( | | ||||||
Six months ended June 30, 2021 | |||||||||
Net loss per share - basic and diluted: | |||||||||
Net loss per share - basic and diluted | ( | ( | ( | ||||||
Shares used to compute basic and diluted net loss per share | | ( | | ||||||
Three months ended September 30, 2021 | |||||||||
Net loss per share - basic and diluted: | |||||||||
Net loss per share - basic and diluted | ( | | ( | ||||||
Shares used to compute basic and diluted net loss per share | | | | ||||||
Nine months ended September 30, 2021 | |||||||||
Net loss per share - basic and diluted: | |||||||||
Net loss per share - basic and diluted | ( | ( | ( | ||||||
Shares used to compute basic and diluted net loss per share | | ( | | ||||||
For the year ended December 31, 2021 | |||||||||
Net loss per share - basic and diluted: | |||||||||
Net loss per share - basic and diluted | ( | ( | ( | ||||||
Shares used to compute basic and diluted net loss per share | | ( | | ||||||
Three months ended March 31, 2022 | |||||||||
Net loss per share - basic and diluted: | |||||||||
Net loss per share - basic and diluted | ( | | ( | ||||||
Shares used to compute basic and diluted net loss per share | | | |
Reverse Stock Split and Merger Exchange Ratio
On June 15, 2021, and immediately prior to the closing of the merger of Obalon Therapeutics, Inc. and ReShape Lifesciences Inc., the Company effected a
Summary of Significant Accounting Policies
The Company’s significant accounting policies are described in Note 2 to its audited consolidated financial statements for the year ended December 31, 2021, which are included in the Company’s Annual Report on Form 10-K which was filed with the SEC on April 8, 2022.
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Use of Estimates
The preparation of financial statements in conformity with GAAP requires management to make estimates and judgments that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. The Company bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances. Actual results may materially differ from these estimates. The Company reviews its estimates on an ongoing basis or as new information becomes available to ensure that these estimates appropriately reflect changes in its business.
Acquisition
The Company accounts for business combinations in accordance with Accounting Standards Codification (“ASC”) 805, Business Combinations. The results of businesses acquired in a business combination are included in the Company’s consolidated financial statements from the date of the acquisition. Purchase accounting results in assets and liabilities of an acquired business generally being recorded at their estimated fair values on the acquisition date. Any excess consideration over the fair value of assets acquired and liabilities assumed is recognized as goodwill. Transaction costs associated with business combinations are expensed as incurred and are included in general and administrative related costs in the consolidated statements of operations. The Company performs valuations of assets acquired and liabilities assumed and allocates the purchase price to its respective assets and liabilities. Determining the fair value of assets acquired and liabilities assumed requires management to use significant judgment and estimates.
Upon completion of the business combination with Obalon on June 15, 2021, the transaction was treated as a “reverse acquisition” for financial accounting purposes. As a result of the controlling interest of the former shareholders of ReShape, for financial statement reporting and accounting purposes, ReShape was considered the acquirer under the acquisition method of accounting in accordance with the Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) 805-10-55. The reverse acquisition is deemed a capital transaction in substance whereas the historical assets and liabilities of Obalon before the business combination were replaced with the historical financial statements of ReShape in all future filings with the SEC.
Goodwill and Long-Lived Assets
Goodwill represents the excess of the cost of an acquired business over the fair value of the identifiable tangible and intangible assets acquired and liabilities assumed in a business combination.
Indefinite-lived intangible assets relate to in-process research and development ("IPR&D") acquired in business combinations. The estimated fair values of IPR&D projects acquired in a business combination which have not reached technological feasibility are capitalized and accounted for as indefinite-lived intangible assets until completion or abandonment of the projects. In accordance with guidance within FASB ASC 350 “Intangibles - Goodwill and Other,” goodwill and identifiable intangible assets with indefinite lives are not subject to amortization but must be evaluated for impairment.
We evaluate long-lived assets, including finite-lived intangible assets, for impairment by comparison of the carrying amounts to future net undiscounted cash flows expected to be generated by such assets when events or changes in circumstances indicate the carrying amount of an asset may not be recoverable. Should an impairment exist, the impairment loss would be measured based on the excess carrying value of the asset over the asset’s fair value or estimates of future discounted cash flows.
For goodwill and indefinite-lived intangible assets, in-process research and development, we review for impairment annually and upon the occurrence of certain events as required by ASC Topic 350, “Intangibles — Goodwill and Other.” Goodwill and indefinite-lived intangible assets are tested at least annually for impairment and more frequently if events or changes in circumstances indicate that the asset might be impaired. We review goodwill for impairment by first assessing qualitative factors to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount as a basis for determining whether it is necessary to perform the two-step goodwill impairment test. If we are able to determine that it is not more likely than not that the fair value of a reporting unit is less than its carrying amount, we would conclude that goodwill is not impaired. If the carrying amount of a reporting unit is zero or negative, the second step of the impairment test is performed to measure the amount of
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impairment loss, if any, when it is more likely than not that a goodwill impairment exists. The Company did
Fair Value of Financial Instruments
The carrying amounts of cash equivalents, accounts receivable, accounts payable and certain accrued and other liabilities approximate fair value due to their short-term maturities. Refer to Note 5 regarding the fair value of debt instruments and Note 9 regarding fair value measurements and inputs of warrants.
Net Loss Per Share
The following table sets forth the potential shares of common stock that are not included in the calculation of diluted net loss per share because to do so would be anti-dilutive as of the end of each period presented:
June 30, | ||||
| 2022 |
| 2021 | |
Stock options |
| |
| |
Convertible preferred stock | | | ||
Warrants |
| |
| |
Recent Accounting Pronouncements
There were no new accounting standards adopted by the Company during the six months ended June 30, 2022.
New accounting standards not yet adopted are discussed below.
In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments – Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, which is intended to provide financial statement users with more useful information about expected credit losses on financial assets held by a reporting entity at each reporting date. In May 2019, the FASB issued ASU No. 2019-05, which amended the new standard by providing targeted transition relief. The new guidance replaces the existing incurred loss impairment methodology with a methodology that requires consideration of a broader range of reasonable and supportable forward-looking information to estimate all expected credit losses. In November 2019, the FASB issued ASU No. 2019-11, which amended the new standard by providing additional clarification. This guidance is effective for the fiscal years and interim periods within those years beginning after December 15, 2022. The Company is currently evaluating the impact the guidance will have on its consolidated financial statements.
(2) Liquidity and Management’s Plans
The Company currently does not generate revenue sufficient to offset operating costs and anticipates such shortfalls to continue primarily due to the unpredictability of new variants of COVID-19, which may result in a slow-down of elective surgeries and restrictions in some locations. As of June 30, 2022, the Company had net working capital of approximately $
Given the Company’s projected operating requirements and its existing cash and cash equivalents management’s plans include evaluating different strategies to obtain the required funding of future operations. Our anticipated operations include plans to (i) integrate the sales and operations of the Company with the Lap-Band product line in order to expand sales domestically and internationally (ii) improve operational efficiencies, resulting in a reduction of
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operational expenses, as well as a reduction to marketing and advertising costs, primarily due to focusing on digital media rather than television and print and (iii) to continue promoting reshapecare as an addition to bariatric surgery or as an alternative to individuals that do not meet the criteria and/or do not want to go through bariatric surgery. If sales do not improve, we will reduce our expenditures for marketing, clinical and product development activities to maintain operational activities until a period of time in which we could obtain additional debt or equity financing to support our operations. However, there can be no assurance that the Company will be able to secure such additional financing. Therefore, the plans cannot be deemed probable of being implemented. As a result, the Company’s plans do not alleviate substantial doubt about our ability to continue as a going concern.
The accompanying financial statements have been prepared on a going concern basis, which contemplates the realization of assets and satisfaction of liabilities in the ordinary course of business. The financial statements do not include any adjustments relating to the recoverability and classification of recorded asset amounts or the amounts and classification of liabilities that might result from the outcome of the uncertainties described above.
COVID-19 Risk and Uncertainties and CARES Act
Since the first quarter of 2020, the COVID-19 pandemic has led to unprecedented restrictions on, distributions in, and other related impacts on business and personal activities, including a shift in healthcare priorities, which resulted in a significant decline in medical procedures in 2020 in the United States and foreign countries. Concerns remain regarding the pace of economic recovery due to virus resurgence, including new variants, across the globe as well as vaccine distribution and hesitancy. The United States and other foreign governments may reimplement restrictions and other requirements in light of the continuing spread of the COVID-19 pandemic. Due to the uncertainty caused by the COVID-19 pandemic, the full extent to which the pandemic will directly or indirectly impact the Company’s business, results of operations and financial condition, including sales, expenses, manufacturing, clinical trials, research and development costs, reserves and allowances, will depend on future developments that are highly uncertain and difficult to predict. These developments include, but are not limited to, the duration and spread of the outbreak (including new and more contagious variants of COVID-19), its severity, the actions to contain the virus or address its impact, the public acceptance and efficacy of vaccines and other treatments, United States and foreign governments actions to respond to the reduction of global activity, and how quickly and to what extent normal economic and op