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Investor Presentation TSX: TMD / OTCQX: TITXF May 2016

Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

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Page 1: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

Investor PresentationTSX: TMD / OTCQX: TITXF

May 2016

Page 2: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

This presentation contains "forward-looking statements" which reflect the current expectations of management of the Company's future growth, results of operations,

technological development and implementation, performance and business prospects, opportunities, and illustrations and prototypes of the SPORT™ Surgical Systems.

Wherever possible, words such as "may", "would", "could", "will", "anticipate", "believe", "plan", "expect", "intend", "estimate" and similar expressions have been used to

identify these forward-looking statements. These statements reflect management's current beliefs with respect to future events and are based on information currently

available to management. Forward-looking statements involve significant risks, uncertainties and assumptions. Many factors could cause the Company's actual results,

performance, achievements or technological development and implementation to be materially different from any future results, performance, achievements or

technological development and implementation that may be expressed or implied by such forward-looking statements, including, without limitation, those listed in the

"Risk Factors" section of the Company's Annual Information Form in respect of the fiscal year ended December 31, 2015 and other information contained in the

Company’s public filings (which may be viewed at www.sedar.com). Information contained in this presentation is qualified in its entirety by such public filings. Should

one or more of these risks or uncertainties materialize, or should assumptions underlying the forward looking statements prove incorrect, actual results, performance or

achievements may vary materially from those expressed or implied by the forward-looking statements contained in this presentation. These factors should be considered

carefully and prospective investors should not place undue reliance on the forward-looking statements. Although the forward-looking statements contained in the

presentation are based upon what management currently believes to be reasonable assumptions, the Company cannot assure prospective investors that actual results,

performance or achievements will be consistent with these forward-looking statements. This presentation does not constitute an offer to sell any class of securities of the

Company in any jurisdiction.

Forward Looking Statements

/ PG 2

Page 3: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

Titan Medical is…the designer and developer of SPORT™, a highly versatile single incision advanced

surgical system that significantly expands the addressable market for single and multi-

quadrant abdominal surgeries performed on a robotic platform. The System is designed to

provide superior clinical capabilities and unparalleled OR efficiency at operating costs similar

to traditional laparoscopic surgery.

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Page 4: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

Investment Considerations• Addressing market opportunity for robotic surgery valued at $20 billion* by 2021

• Highly versatile single incision advanced surgical technology including 13 patents and 30 patent

applications pending

• Substantial benefits to patient, surgeon and hospital versus competitive offerings

• More features, more OR flexibility, lower cost, improved economics versus da Vinci®

• Highly experienced management team with significant track record of success

• Attractive business model; expect 510(k) submission in the second half of 2017**

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* Source: WinterGreen Research Report 2014** Last reported in Titan MD&A filed May 16, 2016

Page 5: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

Robotic Surgery Market Opportunity

Total market opportunity for

robotic surgery valued at

$20 billion

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Page 6: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

10000 0

10003500

6000

PRIMARY A ND S ECONDA RY TERT IA RY AMBULA TOR Y S URGERY CENTERS

USHOSPITALS FORROBOTIC SYSTEMS

daVinciPenetration AvailableMarket

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$10B Capital Revenue Opportunity

/ PG 6

~ 10,500 Placement Opportunitieswith $10B Capital Revenue Potential (1)

(1) $950K per system and on average, 1 system per hospital

Page 7: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

$1,050,000,000

$2,700,000,000

$0

$500,000,000

$1,000,000,000

$1,500,000,000

$2,000,000,000

$2,500,000,000

$3,000,000,000

ServiceRevneue ProcedureRevenue

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$3.75B in Annual Recurring Revenue

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~ 2.5M Available Procedures

with $2.7B Procedure Revenue Potential (2)

~ 10,500 Placement Opportunities

with $1.05B Service Revenue Potential (1)

(1) $100K of Annual Service Revenue(2) $1075 per procedure revenue

Page 8: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

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Evolution of Surgical Care

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Open Surgery

- Broad application

- Requires significant

hospital stay and

recovery time

- Significant risk of

adverse events

MIS

- Minimally Invasive Surgery

(“MIS”) has been a growing trend

over the past 25 years

- Reduced hospitalization time

- Reduced risk of adverse events

- Requires highly skilled surgeons

Robotic Surgery

- Further expands upon the benefits

of MIS

- Robotic procedures have grown

from 1,000 procedures in 2000 to

650,000* in 2015

- However, most robots are

expensive and have procedural

and operational limitations

SPORT

- A premier solution

that will transform

the challenges facing

robotics today

- Will be significantly

more affordable, agile

and versatile as

compared to existing

robotic solutions

* Source: Intuitive Surgical Earnings Call Transcript for Q4 2015

Page 9: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

/ PG 9

Today’s Robotic Surgery Environment

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To mitigate the downside of MIS and improve surgical care of patient outcomes, robotic technology

was introduced to the operating room:

Benefits- Better Dexterity

- Improved 3D Visualization

- Improved Ergonomics

Challenges- High Cost of Entry

- Huge Footprint

- High Level of Training

- Increased Cost For Each Case

- Reduced Operational Efficiency-

Long Setup Time

- Low ROI for Hospitals

- Limited Procedural Capability

“Proven technology is easily replaced by same or better if it provides a greater ROI--clinically, financially and operationally”- Rand A. Ballard, Chief Commercial Officer, Vizient Inc. (New VHA, MedAssets, Novation and UHS Combined Entity)

Last year only 650,000 surgeries out of a possible 4,000,000 were done using a robot…

Page 10: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

Benefits to Patient

- Less Pain

- Quicker Recovery

- Fewer and Smaller Scars

- Shorter Hospital Stay

- Reduced Blood Loss

- Reduced Risk of Infection

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SPORT: Benefits

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Benefits to Surgeon

- Improved Visualization with 3D Vision

- Improved Dexterity With Multi-

Articulating Instruments

- Easier and Shorter Learning Curve

- Improved Precision

- Improved Ergonomics

- Automation of Tasks and Subtasks

Benefits to Hospital

- Decreased Length of Hospital Stay

- Increased Patient Satisfaction

- Potentially Longer Operating Careers of

Surgeons

- Increased Surgical Case Volume

- Employee Participation and Retention

- Improved ROI- Clinically, Financially, and

Operationally

“A surgeon could use SPORT for every abdominal operation!”- David Larson, Chief of Colorectal Surgery, Mayo Clinic, Rochester, MN

Page 11: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

Ergonomic Mobile Workstation

Open 3D High Definition Visualization

Single-Arm Mobile Patient Cart

Camera Insertion Tube with Self-Cleaning Lens

Natural Multi-articulated Handle Control Interface

SPORT: Robotic Surgery Optimized

/ PG 11

Multi-articulated Instruments with Replaceable Tips

Page 12: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

SPORT Workstation- Highly Ergonomic Design

- Natural Multi-articulated Handle Interface with

Proximity Finger Sensors

- Open Un-obtrusive 3D High Definition

Platform with 32-inch Flat-screen Monitor

- Multi-configurable Elbow Resting and Pedal

Positioning Feature

- Adjunct Touchscreen LCD monitor that can

interface to hospital information systems,

including PACS for images

- Swiveling Easy Gliding Coasters

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Page 13: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

SPORT Patient Cart

- Single-arm configuration

- Mobile, compact, transportation capability

- Easy to maneuver and position Central Unit

- Easy to load and unload Camera Insertion Tube

(CIT) and Instrument Interface

- Single cable for easy cable management

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Page 14: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

SPORT CIT and Instruments

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- Camera Insertion Tube (CIT) accommodates 2

multi-articulated instruments with self-cleaning

dual channel camera

- 10 Multi-Articulated Multi-Use instruments with

Single-Use Replaceable Tips

- Monopolar, Bipolar, Vessel Sealing and Clip

Applier capabilities

- Multi-quadrant access

Page 15: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

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SPORT in Action

/ PG 15

Page 16: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

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Intellectual Property

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The Company anticipates expanding its patent portfolio by filing patent applications as it

progresses in the development of robotic surgical technologies and by licensing suitable

technologies

Patents & Patent Applications

- 11 U.S. Patents

- 27 Patent Applications

(PCT, US, EP, CA, CN, JP, IN)

Licensed Technology

- 2 U.S. Patent

- 3 Patent Applications (US, EP)

The SPORT system is a single incision robotic surgical system that has been

developed from the ground up with a unique technical footprint

Page 17: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

PG 17

Critical Features for Robotic Surgery SPORT™ daVinci® SurgiBOT™ Alf-X™

Multi-Articulated Instruments

3D High Definition Visualization

Natural Handle Control (left is left, right is right, up is up and down is down)

Ergonomic Surgeon Workstation or Console

Needle Driver/ Graspers/ Monopolar / Bipolar / Advanced Instruments

Dual Channel Endoscope for High-caliber 3-D

Mobile, Low Profile Footprint with Minimal Cables (Ease of Transportation)

Ease of Setup (single arm is easy, having multiple arms is complex)

Quick and Easy Intraoperative Multi Quadrant Access

New Tips for each procedure (No compromise on instrument performance)

Open, Non-isolated Display (Surgeon always has direct view of OR table)

Scope Lens-washing Capability (Minimal scope cleaning adds to efficiency)

Tool or Eye tracking Camera Movement (Least disruptive to procedural flow)

Competition

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Source: Product Information from Intuitive Surgical and TransEnterix websites

Page 18: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

/ PG 18

SPORT™ daVinci®

System Cost ~$950,000 ~$1,800,000 (1)

No. of Cases Amortized Over (7 years at 150 per year) 1,050 1,050

Amortized Robot Cost Per Case $905 $1,714

Instrument and Accessory Cost Per Case $1,075 $1,835

Annual Service Agreement (10% of System Cost) $95,000 $180,000

Amortization Period (150 cases) 150 150

Cost of Service Agreement Per Case $634 $1,200

Estimated Cost Per Procedure $2,614 $4,749

SPORT vs da Vinci® - Hospital Savings Per Procedure

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(1 ) Initial cost of daVinci will vary based on features purchased

Page 19: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

Example - Med Assets – New Technology Meeting

- One of the largest GPOs – 4,500 acute care members

- 200+ applicants – Only 88 selected

- 420 committee members (representing 200 healthcare systems)

reviewed new technologies and rated them on a scale of 1-5 in 5

key areas:

- Innovative technology

- Improves quality of care at my facility

- Improves efficiencies at my facility

- Meets a need in healthcare

- Ready to purchase

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Rated Top 5 at GPO Technology Expo!

/ PG 19

Page 20: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

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Voice of Customer – SAGES and AORN

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“I see this as a potential in most of my bariatric patients….”

“Out of all the robotic platforms I’ve seen, this is the best design and has the most potential….”

“You have to create a sense of organization around robotic surgery to understand that the robotic system is a total program, not a piece of technology.”

“Proven technology is easily replaced by same or better if it provides a greater ROI--clinically, financially and operationally”

Page 21: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

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Remaining Development Milestones• Initiate usability study – 1H 2016

• Complete usability study – 2H 2016

• Optimization trials – 1H 2017

• System design freeze – 1H 2017

• Build design verification units / Initial audit for CE mark – 2H 2017

• Complete design verification and validation – 2H 2017

• Final CE mark audit – 2H 2017

• Submit 510 (k) application to FDA – 2H 2017

Page 22: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

- Develop clinical support – Regional Centers of

Excellence by Specialty

- Develop executive support – Executive Champions

Network for Execution Guidance

- Deliver “ROI” to support the program investment

for Healthcare Institutions

- Train, support and service our customers

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Titan Medical: Clinical Adoption Strategy

/ PG 22

Page 23: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

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Financial Snapshot

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*Fully diluted includes, under the Treasury Stock method, an additional 3,453,055 options with a weighted-average exercise price of CDN $1.32, as well as common shares issued as result of the public offering, November 16, 2015 and the private placement of November 23, 2015.

TMD (TSX), TITXF (OTCQX)

Share price (TMD) $0.78

Shares outstanding 145.4 million FD*

Management ownership (3/31/16) 4.48%

Cash, cash equivalents (3/31/16) $12 million

(As of May 24, 2016)

Page 24: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

• Addressing market opportunity for robotic surgery valued at $20 billion by 2021

• Highly versatile single incision advanced surgical technology including 13 patents and 30 patent

applications pending

• Substantial benefits to patient, surgeon and hospital versus competitive offerings

• More features, more OR flexibility, lower cost, improved economics versus da Vinci®

• Highly experienced management team with significant track record of success

• Attractive business model; expect 510(k) submission in the second half of 2017

Su

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Summary

/ PG 24

Page 25: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

Thank You

TSX: TMD / OTCQX: TITXF

Page 26: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

Management TeamJohn Hargrove, Chairman & CEO

- 40 years of executive-level health care experience

- Vice President of Corporate Accounts, Johnson & Johnson; President, Corporate Account Management, Ohmeda Inc.

- B.A. from the University of Georgia

Dr. Reiza Rayman MD, PhD, President- Collaborated in the world’s first robotic beating heart cardiac bypass surgery in September 1999

- Entrenched researcher on all available robotic platforms, Active practitioner with over 400 robotic surgeries under belt

- M.D. from Univ of Toronto and Ph.D. in Telesurgery from Univ of Western Ontario; M.Sc. In Fluid Dynamics from Univ of Western Ontario,

Stephen Randall, CFO

- +19 years of Executive level experience

- Extensive experience in accounting, finance, capital markets, tax planning, compliance, IT management, mergers/acquisitions and operations

- CPA, CGA, B. Comm

Dr. Dennis Fowler MD, MPH, Executive Vice President, Clinical and Regulatory Affairs

- Co-inventor of the single-incision Insertable Robotic Effector Platform (IREP) technology licensed from Columbia University to Titan Medical

- Certified by the American Board of Surgery; Formerly the Gerald and Janet Carrus Professor of Surgical Science, Director of the Center for Innovation and

Outcomes Research in the Department of Surgery, Columbia University College of Physicians and Surgeons

- MD from University of Kansas School of Medicine, Master in Public Health from Columbia University

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Page 27: Titan Investor Presentation 5-24-16 (handouts) · PDF fileunderstand that the robotic system is a total program, ... 2015 and the private placement of November 23, 2015. TMD ... Titan

Commercial Leadership TeamSachin Sankholkar, Vice President, Marketing

- +15 Years of Robotic Device Development, Launch and Marketing Experience at Intuitive Surgical, +19 Years of Med Device Experience

- Exceptional Surgeon Network and KOL Development Expertise in GYN, Urology, General, Colorectal and Bariatric Surgery.

- M.B.A. in Marketing and General Management at USC Marshall School of Business, M.S. in Biomedical Engineering at Drexel University

Paige Hargrove, Vice President, WW Sales- +8 Years of Robotic Sales and Management Experience at Intuitive Surgical and Stereotaxis, +11 Years of Tenure at J&J

- Years of track record with team building, strategic planning, training, customer retention and business development

- BA, Bloomsburg University of Pennsylvania

Chris Seibert, Vice President, Corporate Accounts

- +10 Years of Robotic Sales and Management Experience at Intuitive Surgical and Stereotaxis, +12 Years of total Med Device Experience

- Entrenched IDN/GPO sales channel expertise and C-level access/network within top GPOs/IDNs

- MBA at University of South Alabama; MA at University of Oklahoma; BA at University of Alabama.

Frederic Nahon, Vice President, Sales EMEA and Asia

- + 12 Years of Capital/Clinical Sales Management Experience at Intuitive Surgical, Stereotaxis and Imacor

- Sergeant Major in the French Army;

- OR Chief, Hospital Jean Prince, Tahiti, French Polynesia.

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