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Titan Medical Inc. AGM 2015 Presentation
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1
Titan Medical Inc.
Annual General Meeting
TSX: TMD | OTCQX: TITXF
June 9, 2015
2
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 dated April 4, 2014 and other
information contained in the Companys 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
3
2014 Ranking
The 2015 OTCQX Best 50 is a ranking of top performing companies on the
OTCQX Best Marketplace in 2014 based on one-year share price performance
and average daily dollar volume growth.
Source: http://www.otcmarkets.com/content/doc/2015-OTCQX-Best-50.pdf
4
March 31, 2015
Share Price (TMD)
$1.43
Cash, cash equivalents and
short-term investments
$27.4 million
Shares outstanding 102.6 million (105.2 million FD*)
Market value 146.7 million ($150.5 million FD*)
Management ownership (March 31, 2015)
6.21%
*Fully diluted includes, under the Treasury Stock method, an additional 2,224,604 options with a weighted-average exercise price of CDN $1.14. In addition, 3,665,900 warrants (@CDN $1.85 expiring December 10, 2015), 5,121,500 warrants (@CDN $2.00 expiring June 21, 2016), 3,484,500 warrants (@CDN $1.75 expiring December 22, 2016), 390,729 warrants (@CDN $1.77 expiring March 14, 2017), 5,300,705 warrants (@CDN $1.25 expiring March 13, 2018), 8,317,856 warrants (@CDN $2.00 expiring February 19, 2017), and an additional 12,346,914 warrants (@CDN $2.75 expiring April 23, 2017).
Financial Snapshot
TMD (TSX), TITXF (OTCQX)
(in US Dollars except warrants and options exercisable in Canadian dollars)
March 31, 2014
Share Price (TMD)
$1.97
Cash, cash equivalents and short-term investments
$15.6 million
Shares outstanding 84.5 million (91.1 million FD*)
Market value 166.5 million ($179.4 million FD*)
Management ownership
(March 31, 2014) 7.39%
5
Stock performance
$0.00
$50.00
$100.00
$150.00
$200.00
$250.00
$300.00
$350.00
$400.00
2009 2010 2011 2012 2013 2014
Titan Medical Inc. - Common Share Price Performance
Titan Medical Inc.
S&P/TSX Composite Index
As at December 31
31-Dec-09 31-Dec-10 31-Dec-11 31-Dec-12 31-Dec-13 31-Dec-14
Titan Medical Inc. 100.00 355.00 337.50 300.00 237.50 350.00
S&P/TSX Composite Index 100.00 114.45 101.78 105.85 115.97 124.57
The following table shows the value of CDN$100 invested in Common Shares on December 31, 2009 compared to CDN$100 invested in
the S&P/TSX Composite Index*:
*All amounts in Canadian $.
6
Based on current customer challenges:
Problems in delivery of high-quality outcomes
Issues that de-motivate staff
Workflow inefficiencies which increase costs, and
Anything that would diminish patient outcomes
Value-Based Account Management
A NEW GAME IN TOWN
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Capital equipment downtime/utilization
Surgical scheduling and procedural planning
Opportunities for surgical indications of general abdominal, gynecologic and urologic procedures
Staff morale
Increased patient wait time
Patient satisfaction scores
Staff retention and optimization
Workflow
Capacity
Revenues
Current Challenges
Clinical Financial Operational
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Builds trust in the customer relationship
Evolves the sales team from the feature-function product approach to value-based Account Management at its best
Fosters problem solving and trust with customers
Guides customers to find Clinical, Financial and Operational Mission-aligned solutions, and
Finally Assists the customer to monetize and thereby designate the value of the robotic solution
Value-Based Account Management Deliverables
9
1. GPOs
2. IDNs
3. Acute care hospitals
4. Health systems
5. Academic medical centers
6. Ambulatory care centers
7. DOD/VA Hospitals
8. Professional Healthcare Organizations
9. Large healthcare insurers
10. CMS (Center of Medicare Services)
11. American Hospital Association
12. Surgeons in North America, Europe and ROW
Voice of Customer/Industry Sources
10
The playing field
Capital Expense is $2 to $2.5 million
Service Fees are $170K to 10% of unit purchase price
Hospital spend is $1000 to $4000 more per robotic case than laparoscopic or open procedures
The game
Growth from 1000 procedures in 2000 to 570,000 in 2014
Growth potential is 4 million procedures
Estimated 3266 daVinci systems being used worldwide 2014
2223 systems in United States
1043 systems in ROW, including 21 systems in Canada
Total revenue in 2014 was $2.1 Billion
70% in United States ($1.47 Billion)
Sport Scouting Report
Sources: Intuitive Surgical Inc. Annual Report; General Surgery News Doing the Math: Can the Robot Be Cost Effective for General Surgery?
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1. A balance of expertise and skills
2. Ability to build value
a. Scientific discovery
b. Solid planning
3. Capacity to Strategically Work with the right partners
4. Ability to adapt with the changing environment
5. A solid track record
A great technology needs the right team and the right management
Titan Management Team Assessment
12
Titan Medical Inc.
AGM Technology, Training, Regulatory Update
13
The SPORT Surgical System
14
THE SPORT SURGICAL SYSTEM
Technology Development Strategy
15
Focused on meeting the Customers Needs
Capital cost too expensive
Cost per case too high
Lack of mobility reduces operational efficiency
Return on investment not realized in many programs
Efficiency color coding instruments, etc.
Training programs need improvement
Customer support and service
Data collection and analytics
Titan Medical Inc. Strategy
16
The SPORT Surgical System delivers
Next Generation Surgical Robotic Technology
Innovative Robotic Platform to Enable Computer-assisted surgery
Automation and Navigation
Automate tasks and subtasks
The SPORT Surgical System is NOT
Just a teleoperation device
Just a single port device
THE SPORT Surgical System
17
THE SPORT SURGICAL SYSTEM
Technology Update
18
THE SPORT Surgical System
Traditional Surgical Robotic Features
Teleoperation
3-Dimensional (Stereoscopic) Imaging
Restores intuitive control
Enhanced or New Functionality
Enhanced Ergonomics
19
State of the Art 3D High Definition 32 display
Improved Dexterity
Outstanding Controllability
Information Delivery 2nd Display
Automated functionality
Data collection and analytics
For surgeon
For OR Team
Enhanced Functionality/Features
20
More comfortable working position
More comfortable, adjustable
seat Elbow Support not Forearm
Support
Familiar Flat Panel Immersive Interface
Touch Panel GUI
Familiar
Improved Ergonomics
The machine adapts to the surgeon instead of the surgeon adapting to the machine.
21
Two Major Components
CAD Renderings of SPORT Surgical System
The SPORT Surgical System
Patient Cart Surgeon Workstation
22
The surgeon interface at which the surgeon sits
3D High Definition Display
2nd Display Information Delivery
2 master controllers
Foot pedals
Surgeon Workstation
CAD Rendering of SPORT Surgical System
23
Looks-Like Workstation
24
Looks-Like Workstation
25
Looks-Like Workstation
26
Looks-Like Workstation
27
Rolling Cart at Bedside
Mast and Boom
Central Unit
Insertion Tube
Camera Module
Insertable Robotic Arms
Tools
Patient Cart
28
Patient Cart
29
Central Unit
Motors Connections for
Insertion Tube Instruments
30
Camera Module and Robotic Arms
19 mm Diameter Insertion Tube
Stereoscopic Camera Module
Pan and Tilt
Digital Zoom
Two Snake-Like Robotic Arms
Tools
31
Single-Patient Use Tool Tips
Sterile
No Reprocessing Required
First Use Quality Every Case
Reposable Robotic Arms
More Cases for Each Arm
Reduces per Case Cost
Tools
32
THE SPORT SURGICAL SYSTEM
Training Update
33
We believe that adults learn best from experience
But you cant just throw a simulator at them
Pyramid of Learning Experiences
Teach others
Discussion group
Demonstration
Audiovisual
Reading
Practice by doing
5%
10%
20%
30%
50%
75%
80%
Average
Retention Rate
National Training Laboratories, Bethel, Maine, USA
Lecture
34
Training Curriculum
Cognitive pre-training Knowledge Acquisition
Psychomotor skills training Technical Skills Acquisition
Team training Choreography & Communication
Troubleshooting Crisis Mitigation
Overview of safety Optimal Skills and Teamwork
The SPORT Surgical System
35
Training Curriculum
Cognitive pre-training
Knowledge Acquisition
Psychomotor skills training
Technical Skills Acquisition
Team training Choreography & Communication
Troubleshooting Crisis Mitigation
Overview of safety Optimal Skills and Teamwork
SAIL Center James and Sylvia Earl Simulation to Advance Innovation and Learning Center
Post-Training Assessment
Design assessment tools
Define: skills, setting, scoring method, scenarios, & train raters
Validate assessment tools
Construct Validity, Predictive Validity
Learning Experiences
Assessment Tools
36
THE SPORT SURGICAL SYSTEM
Regulatory Update
37
Regulatory Update
All Regulatory Processes are based on the Development Timeline
FDA
CE Mark
Notified Body
QMS
38
Key Milestones
1Q 2015
4Q 2015
3Q 2016
Mid-2017 4Q 2016
U.S. Commercial
Launch (Pending 510(k)
Market Clearance)
Pivotal Trial Completed, 510(k) Submitted to FDA
O.U.S. Commercial
Launch (Pending CE Mark Approval)
Design and
Test of Feasibility Prototype Completed 2Q 2016
Pivotal Human
Clinical Trial Commenced
Early Human Feasibility Report
Completed
Audit for CE Mark Commenced
Units Built and
Ready for Engineering Verification
39
Pre-submission meetings Next 9 months
Animal Study
Software Validation
Pivotal Clinical Trial
Symposium July 2015
Titan Participating
Early Feasibility Human Trial
Contract Research Organization
Regulatory Update FDA
40
CE Mark
Notified Body Summer 2015
Quality Management System
Processes Implemented
Standard Operating Protocols
Technical Files
Electronic Documentation and Infrastructure (August 2015)