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Precipio

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FY2019 Annual Report · Precipio
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UNITED STATES  
SECURITIES AND EXCHANGE COMMISSION  
WASHINGTON, D.C. 20549  

FORM 10-K  

(Mark One)  

☒ 

☐ 

ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE 
ACT OF 1934 
For the fiscal year ended December 31, 2019 

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES 
EXCHANGE ACT OF 1934 
For the transition period from               to               

Commission File Number: 001-36439 

OR 

PRECIPIO, INC.  

(Exact name of registrant as specified in its charter)  

Delaware 
(State or other jurisdiction of incorporation or organization) 

91-1789357 
(I.R.S. Employer Identification No.) 

4 Science Park, New Haven, CT 
(Address of principal executive offices) 

06511 
(Zip Code) 

(203) 787-7888  
(Registrant’s telephone number, including area code)  

Securities registered pursuant to Section 12(b) of 
the Act: 

Title of each class 
Common Stock, $0.01 par value per share 

Ticker  symbol(s)     Name of each exchange on  which registered 

PRPO 

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      X  

Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Exchange Act.  

Yes                 No      X  

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      X         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      X           No  

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, 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 
Non-accelerated filer 
Emerging growth company 

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Accelerated filer 
Smaller reporting company 

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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   ☐    No   ☒  

The aggregate market value of the voting and non-voting common equity held by non-affiliates of the registrant based on the last reported 
closing price per share of  Common Stock as reported on the Nasdaq Capital  Market on the last business day of the registrant’s most recently 
completed second quarter was approximately $19.8 million.  

As of March 25, 2020, the number of shares of common stock outstanding was 8,870,129.  

DOCUMENTS INCORPORATED BY REFERENCE  

The Registrant’s definitive Proxy Statement for the Annual Meeting of Stockholders (the “2020 Proxy Statement”) is incorporated by 

reference in Part III of this Form 10-K to the extent stated herein. The 2020 Proxy Statement, or an amendment to this Form 10-K, will be filed 
with the SEC within 120 days after December 31, 2019. Except with respect to information specifically incorporated by reference in this Form 
10-K, the Proxy Statement is not deemed to be filed as a part hereof.  

Table of Contents  

PRECIPIO, INC.  
Annual Report on Form 10-K  
For the Year Ended December 31, 2019  

INDEX  

PART I.  

Item 1.   Business 
Item 1A.  Risk Factors 
Item 1B.  Unresolved Staff Comments 

Item 2.  Properties  
Item 3.  Legal Proceedings  
Item 4.  Mine Safety Disclosures 

PART II.  

Item 5.  Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of 

Equity Securities  

Item 6.   Selected Consolidated Financial Data 
Item 7.  Management’s Discussion and Analysis of Financial Condition and Results of Operations  

Item 7A.   Quantitative and Qualitative Disclosures About Market Price  

Item 8.   Financial Statements and Supplementary Data 

Report of Independent Registered Public Accounting Firm  
Consolidated Balance Sheets as of December 31, 2019 and 2018 
Consolidated Statements of Operations for the Years Ended December 31, 2019 and 2018 
Consolidated Statements of Stockholders’ Equity for the Years Ended December 31, 2019 and 
2018 
Consolidated Statements of Cash Flows for the Years Ended December 31, 2019 and 2018 
Notes to the Consolidated Financial Statements for the Years Ended December 31, 2019 and 
2018 

Item 9.   Changes in and Disagreements with Accountants on Accounting and Financial Disclosures  

Item 9A.  Controls and Procedures 
Item 9B.   Other Information  

PART III.     

Item 10.   Directors, Executive Officers and Corporate Governance    
Item 11.  Executive Compensation 
Item 12.  Security Ownership of Certain Beneficial Owners and Management and Related Stockholder 

Matters 

Item 13.  Certain Relationships and Related Transactions, and Director Independence  

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Item 14.  Principal Accounting Fees and Services 

PART IV.     

Item 15.  Exhibits, Financial Statement Schedules 
Item 16.  Form 10-K Summary  

Signatures    

Table of Contents  

1  

PART I.  

92  
93  
93  
97  

97  

FORWARD-LOOKING STATEMENTS  

This Annual Report on Form 10-K (this “Annual Report”), including  the sections entitled “Risk Factors” 
“Management’s  Discussion  &  Analysis  of  Financial  Condition  and  Results  of  Operations”  and  “Our  Business” 
contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, 
which statements involve substantial risks and uncertainties. These statements are based on management’s current 
views, assumptions or beliefs of future events and financial performance and are subject to uncertainty and changes 
in circumstances. Readers of this report should understand that these statements are not guarantees of performance or 
results. Many factors could affect our actual financial results and cause them to vary materially from the expectations 
contained in the forward-looking statements. These factors include, among other things: our expected revenue, income 
(loss),  receivables,  operating  expenses,  supplier  pricing,  availability  and  prices  of  raw  materials,  insurance 
reimbursements, product pricing, foreign currency exchange rates, sources of funding operations and acquisitions, our 
ability to raise funds, sufficiency of available liquidity, future interest costs, future economic circumstances, business 
strategy, industry conditions and key trends, our ability to execute our operating plans, the success of our cost savings 
initiatives, competitive environment and related market conditions, expected financial and other benefits from our 
organizational  restructuring  activities,  actions  of  governments  and  regulatory  factors  affecting  our  business, 
projections of future earnings, revenues, synergies, accretion or other financial items, any statements of the plans, 
strategies and objectives of management for future operations, retaining key employees and other risks as described 
in our reports filed with the Securities and Exchange Commission (the “SEC”). In some cases these statements are 
identifiable through the use of words such as “anticipate,” “believe,” “estimate,” “expect,” “intend,” “plan,” “project,” 
“target,” “can,” “could,” “may,” “should,” “will,” “would” or the negative of such terms and other similar expressions.  

You are cautioned not to place undue reliance on these forward-looking statements. The forward-looking 
statements we make are not guarantees of future performance and are subject to various assumptions, risks and other 
factors that could cause actual results to differ materially from those suggested by these forward-looking statements. 
Actual  results  may  differ  materially  from  those  suggested  by  these  forward-looking  statements  for  a  number  of 
reasons, including those described in Item 1A, “Risk Factors,” and other factors identified by cautionary language 
used elsewhere in this Annual Report.  

We expressly disclaim any obligation to update or revise any forward-looking statements, whether as a result 

of new information, future events or otherwise, except as required by law.  

The following discussion should be read together with our financial statements and related notes contained 
in this Annual Report. Results for the year ended December 31, 2019 are not necessarily indicative of results that may 
be attained in the future.  

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Item 1. Our Business  

Business Description  

Precipio, Inc., and its subsidiary, (collectively, “we”, “us”, “our”, the “Company” or “Precipio”) is a cancer 
diagnostics company providing diagnostic products and services to the oncology market. We have built and continue 
to develop a platform designed to eradicate the problem of misdiagnosis by harnessing the intellect, expertise and 
technologies developed within academic institutions, and delivering quality diagnostic information to physicians and 
their patients worldwide. We operate a cancer diagnostic laboratory located in New Haven, Connecticut and have 
partnered with various academic institutions to capture the expertise, experience and technologies developed within 
academia  to  provide  a  better  standard  of  cancer  diagnostics  and  aim  to  solve  the  growing  problem  of  cancer 
misdiagnosis.  We  also  operate  a  research  and  development  facility  in  Omaha,  Nebraska  which  focuses 
on development  of  various  technologies,  among  them  IV-Cell,  HemeScreen  and  ICE-COLD-PCR,  or  ICP,  the 
patented technology, described further below, which we exclusively licensed from Dana-Farber Cancer Institute, Inc., 
or Dana-Farber, at Harvard University. The research and development center focuses on the development of these 
technologies, which we believe will enable us to commercialize these and other technologies developed with our 
current and future academic partners. The facility in Omaha was also recently certified as a CLIA and CAP facility, 
and  we  have  begun  conducting  several  molecular  tests  internally  that  we  had  previously  outsourced  to  other 
laboratories.  Our  platform  also  connects  patients,  physicians  and  diagnostic  experts  residing  within  academic 
institutions.  

Industry  

We  believe  that  there  is  currently  a  significant  problem  with  unaddressed  rates  of  misdiagnosis  across 
numerous disease states (particularly in blood-related cancers) due to an inefficient and commoditized industry. We 
believe that the diagnostic industry focuses primarily on competitive pricing and test turnaround times, at the expense 
of quality and accuracy. Increasingly complex disease states are met with eroding specialization rather than increased 
expertise. According to a study conducted by the National Coalition of Health, this results in an industry with cancer 
misdiagnosis rates up to 28%, which is failing to meet the needs of physicians, patients and the healthcare system as 
a whole. New technologies offer improved accuracy; however, many are either inaccessible or are not economically 
practical for clinical use. Despite much publicity of the industry transitioning from fee-per-service to value-based 
payments,  this  transition  has  not  yet  occurred  in  diagnostics. When  a  patient  is  misdiagnosed,  physicians  end  up 
administering incorrect treatments, often creating adverse effects rather than improving outcomes. We believe that 
Insurance Providers, Medicare and Medicaid waste valuable dollars on the application of incorrect treatments and can 
incur substantial downstream costs. Most importantly however, patients pay the ultimate price of misdiagnosis with 
increased morbidity and mortality. According to a report by Pinnacle Health, the estimated cost of misdiagnosis within 
the healthcare system is $750 billion annually. We are of the view that the academic path of specialization produces 
the critical expertise necessary to correctly diagnose disease and that academic institutions have an unlocked potential 
to  address  this  problem.  Our  solution  is  to  create  an  exclusive  platform  that  harnesses  academic  expertise  and 
proprietary technologies to deliver the highest standard of diagnostic accuracy and patient care. Physicians, hospitals, 
payers and, most importantly, patients all benefit from more accurate diagnostics.  

Market  

As  a  services  and  technology  commercialization  company,  we  currently  participate  in  two  components 
within the U.S. domestic oncology diagnostics market. The first is the anatomic pathology services market, which is 
estimated to reach a $26.1 billion annual market by 2024 with a compound annual growth rate of 6.16%. The second 
component is the reagents market.  

Table of Contents  

Our Solution  

3  

Our Platform  

Our platform is designed to provide physicians and their patients access to necessary academic expertise and 
technology in order to better provide diagnoses. To our knowledge, we are the only company focused on addressing 
the issue of diagnostic accuracy with an innovative, robust and scalable business model by:  

·  
·  

·  

·  

 Providing physicians and their patients access to world-class academic experts and technologies; 
 Leveraging the largest network of academic experts by adding numerous leading academic institutions 
to our platform; 
 Allowing payers to benefit from quality-based outcomes to their patients and increase the likelihood of 
cost savings; and 
Enabling  cross-collaboration  between  physicians  and  academic  institutions  to  advance  research  and 
discovery. 

Our agreements with various academic institutions are part of a unique platform that, to our  knowledge, is 
not offered by other commercial laboratories. Our customers are oncologists who biopsy their patients in order to 
confirm or rule out the presence of cancer. After our customers send the samples to us, we conduct all the technical 
tests at our New Haven facility.  We then transmit the test results to the pathologists within our academic network 
who have access to our laboratory information system from their respective offices, enabling them to review and 
render their diagnostic interpretation of the test results for reporting. In partnership with an academic institution, we 
have developed a proprietary algorithm that is applied to each sample submitted to us for testing, resulting in our 
ability to render a more precise and accurate diagnosis. The final results are prepared by academic pathologists and 
integrated into the final report by us, and are then delivered electronically through our portal to the referring clinician. 
The  patient’s  insurance  is  billed  for  the  services;  we are  paid  for  the  technical  work  done  at  our  laboratory;  and 
academic institutions either bill the patient insurance or are paid by us for their diagnostic interpretation.  

Our Technology  

1.  

 IV-Cell 

We have developed IV-Cell, a proprietary culture media that addresses the problem of selective culturing – 
by creating a universal media that enables simultaneous culturing of all 4 hematopoietic cell lineages. This ensures 
that no cell lineage is missed in the diagnostic process, and the technician is able to select any of the 4 lineages during 
the culturing process.  

The diagnostic process of hematopoietic diseases involves chromosomal analysis by conducting cell-culture 
based tests by a cytogenetics laboratory to imitate in-vivo conditions. The four groups of cell lineages cultured are:  

·  
·  
·  
·  

 Myeloid cells – indicating myeloid neoplasms (MDS, AML, CML); 
 B-cells – indicating B-cell neoplasms (B-cell lymphoma, mantle cell lymphoma); 
 T-cells – indicating T-cell neoplasms (T-cell lymphoma); and 
 Plasma cells – indicating plasma cell neoplasms (multiple myeloma) 

The cytogeneticist must decide up front which cell lineage to select to be cultured. In most cases, due to 
specimen limitation, low cellularity, or cell viability, the cytogeneticist can select only one of the above cell lines to 
culture. Often, the initial clinical suspicion is not in line with the final diagnosis determined by the pathologist based 
on the rest of the work up. Our internal data has shown that this occurs in approximately 50% of bone marrow biopsies. 
If the wrong cell lineage is selected, the diagnosis may be compromised (or return a false negative diagnosis) because 
the lab will be culturing and investigating the wrong cells.  

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IV-Cell was validated in our laboratory in parallel with existing commercially available reagents and has 
successfully demonstrated superior results. Subsequently, IV-Cell has been used at our laboratory for the past 2 years 
on >1,000 clinical specimens, producing superior diagnostic results. IV-Cell also produces chromosomes with an 
average band resolution of 500, approximately 25% higher than achieved with standard culture media.  

We intend to commercialize this technology by providing major laboratories with access to the media. This 
can be achieved via a direct supply contract, whereby we will contract with a manufacturer (under license) to produce 
the media, and supply it to laboratories.  

2.  

  HemeScreen 

Each year, an estimated 140,000 patients are diagnosed with diseases in the MPN or MDS blood cancer 
categories. The National Comprehensive Cancer Network (the “NCCN”) guidelines require that these patients be 
tested for genetic mutations in four key genes:  

·  
·  
·  
·  

 JAK2 (V617F); 
 JAK2 (exon 12); 
 CALR; and 
 MPL 

Precipio has developed and patented a proprietary screening panel for all 4 genes in one rapid scanning panel, 
HemeScreen. The test screens for the presence of these mutations in a very economic manner. Due to the improved 
economics, laboratories can reduce the batch requirements for the test while still enjoying a positive economic model 
and reducing the turnaround time for results, providing improved clinical service to physicians.  

The clinical significance of these mutations is substantial to patient treatment. A positive result in either of 
the JAK2 mutations indicates the patient may be eligible for a targeted therapy. A positive result in the CALR or MPL 
gene indicates a good prognosis, meaning the disease is less aggressive, and the physician may therefore choose to 
treat the patient in a less aggressive manner. The results of these genetic tests are critical to determining a treatment 
plan, and therefore the importance, and the speed of which the results are delivered, may significantly impact patient 
care.  

At the current reimbursement levels (approximately $600 for full panel at Medicare rates) and given the costs 
to run the tests, laboratories running the test in house must either batch samples to gain efficiency, or send the test out 
to  another  reference  laboratory.  Most  hospital  laboratories  don’t  have  the  volume  and  patient  frequency  to 
economically  justify  running  the  test,  and  therefore  they  send  the  test  out.  This  has  created  an  industry  average 
turnaround time for results of between 2-4 weeks (depending on the lab providing the test).  

Precipio offers two HemeScreen commercial options:  

1.   Reference the send-out to Precipio. We offer an average of a 2-day turnaround time for the test, markedly 

better than the industry average of approximately 2 weeks.  

2.   Precipio to provide the reagents on an RUO (Research Use Only) basis, and a laboratory can set up the 

test In-house test as an LDT (Laboratory Developed Test).  

At  an  average  reimbursement  rate  of  approximately  $600  per  test,  the  US  Market  Revenue  Potential  is 

approximately $84 million per year, in addition to international demand.  

3.  

 ICE-COLD-PCR 

ICP technology was developed at Harvard and is licensed exclusively to us by Dana-Farber. ICP is a unique, 
proprietary, patented specimen enrichment technology that  increases the sensitivity of molecular based tests from 
approximately 90-95% to 99.99%. Traditional molecular testing is done on tumor biopsies. These tests are typically 
conducted at disease onset, when the patient undergoes a biopsy. In the typical course of treatment, a patient is rarely 
re- 

   
   
 
   
   
 
 
 
 
   
   
   
     
   
   
   
   
 
   
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5  

biopsied, and therefore, genetic information is based solely on the initial biopsy. Tumors are known to shed cells into 
the patient’s bloodstream where they circulate alongside normal cells; however, existing testing methodologies are 
not sufficiently sensitive to differentiate between tumor and normal cells. The increased sensitivity provided by ICP 
allows for testing of genetic mutations that occur within tumors to be conducted on peripheral blood samples, termed 
liquid biopsies. This technical capability enables physicians to test for genetic mutations through a simple blood test 
rather than an invasive biopsy extracted from the actual tumor. The results of such tests can be used for diagnosis, 
prognosis  and  therapeutic  decisions. The  technology  is  encapsulated  within  a  chemical  (reagent)  used  during  the 
specimen preparation process, which enriches (amplifies) the tumor DNA detected within the blood sample while 
suppressing the normal DNA. In addition to offering this technology as a clinical service, we are developing panels 
that will be sold as reagent kits to other laboratories to enable this testing in their facilities, thereby improving their 
test  sensitivity  and  more  accurate  diagnoses  via  liquid  biopsies.  The  business  model  of  selling  reagents  to  other 
laboratories expands the reach and impact of our technology while eliminating the reimbursement risks from running 
the tests in-house.  

Gene sequencing is performed on tissue biopsies taken surgically from the tumor site in order to identify 
potential therapies that will be more effective in treating the patient. There are several limitations to this process. 
First, surgical procedures have several limitations, including:  

·  
·  

·  

·  

 Cost: surgical procedures are usually performed in a costly hospital environment; 
 Surgical access: various tumor sites are not always accessible (e.g. brain tumors), in which cases 
no biopsy is available for diagnosis; 
 Risk: patient health may not permit undergoing an invasive surgery; therefore, a biopsy cannot be 
obtained at all; and 
 Time: the process of scheduling and coordinating a surgical procedure often takes time, delaying 
the start of patient treatment. 

Second, there are several tumor-related limitations that provide a challenge to obtaining such genetic 

information from a tumor:  

·  

·  

Tumors are heterogeneous by nature: a tissue sample from one area of the tumor may not properly 
represent the tumor’s entire genetic composition; thus, the diagnostic results from a tumor may be 
incomplete and non-representative. 
Metastases: in order to accurately test a patient with metastatic disease, ideally an individual 
biopsy sample should be taken from each site (if those sites are even known). These biopsies are 
very difficult to obtain; therefore, physicians often rely on biopsies taken only from the primary 
tumor site. 

We  license  the  ICP  technology  from  Dana-Farber  through  a  license  agreement  referred  to  herein  as  the 
License Agreement. The License Agreement grants us an exclusive license to the ICP technology, subject to a non-
exclusive  license  granted  to  the  U.S.  government,  in  the  areas  of  mutation  detection  using  Sanger  (di-deoxy) 
sequencing and mitochondrial DNA analysis for all research, diagnostic, prognostic and therapeutic uses in humans, 
animals, viruses, bacteria, fungi, plants or fossilized material. The License Agreement also grants us a non-exclusive 
license in the areas of mutation detection using DHPLC, surveyor-endonuclease-based mutation detection and next 
generation sequencing techniques. We paid Dana-Farber an initial license fee and are required to make milestone 
payments with respect to the first five licensed products or services we develop using the licensed technology, as well 
as royalties ranging from high single to low double digits on net sales of licensed products and services for sales made 
by us and sales made to any distributors. The License Agreement remains in effect until we cease to sell licensed 
products or services under said agreement. Dana-Farber has the right to immediately terminate the License Agreement 
if (i) we cease to carry on our business with respect to licensed products and services, (ii) we fail to make any payments 
under the License Agreement (subject to a cure period), (iii) we fail to comply with due diligence obligations under 
the License Agreement (subject to a cure period), (iv) we default in our obligations to procure and maintain insurance 

   
   
 
 
 
 
   
   
 
 
 
 
   
as required by the License Agreement, (v) any of our officers is convicted of a felony relating to the manufacture, use, 
sale or importation of licensed products under the License Agreement, (vi) we materially breach any provision of the 
License Agreement (subject to a cure period), or (vii) we or Dana-Farber become insolvent. We may terminate the 
License Agreement for convenience upon 180 days’ prior written notice.   

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Our Products & Services  

Our initial product offering consists of clinical diagnostic services harnessing the expertise of pathologists 
from  premier  academic  institutions  and  the  commercialization  and  application  of  our  various  technologies.  Our 
clinical diagnostic services focus on the diagnosis of different hematopoietic or blood-related cancers and the delivery 
of an accurate diagnosis to oncologists, with demonstrated superior results through the harnessing of subspecialized 
academic pathologists. We intend to enter into additional partnerships with premiere academic institutions during 
2020  that  will  further  broaden  and  strengthen  our  academic  expert  network.  Our  cutting-edge  liquid  biopsy 
technology,  ICP,  enables  detection  of  abnormalities  in  blood  samples  down  to  as  low  as  .01%.  Our  proprietary 
cytogenetics media IV-Cell enables laboratories to arrive at more accurate results while reducing inventory and other 
operating costs. Our proprietary HemeScreen panel enables hospitals and laboratories to run an important genetic 
mutation test at a lower cost, resulting in faster results delivered to physicians and their patients. Our customers are 
oncologists,  hospitals,  reference  laboratories,  and  pharma  and  biotech  companies.  These  technologies  enable  our 
customers to achieve more accurate results for their patients, with improved economics as well as clinical outcomes.  

We built and obtained CLIA and CAP certifications to operate our New Haven laboratory. The laboratory is 
approximately 3,000 square feet and has several sub-departments such as flow cytometry, immuno-histochemistry, 
cytogenetics, and molecular testing. The laboratory is currently operated by fourteen lab technicians/technologists and 
is supervised by a laboratory manager, technical director and a medical director. Our laboratory is inspected every 
two  years  by  a  Connecticut  state-appointed  inspector and/or  CAP.  Furthermore,  the  laboratory  supervisors  and 
medical director must conduct a self-inspection every two years (rotating with the state inspection) and must submit 
those results to the state department of health.  

Our Strategy      

Our  objective  is  to  eradicate  the  problem  of  misdiagnosis  by  harnessing  the  intellect,  expertise  and 
technology developed within academic institutions and to deliver quality diagnostic information to physicians and 
their patients worldwide. To achieve this objective, our strategy is to focus our efforts on the following areas:  

·  

·  

Clinical pathology services – we intend to continue building our platform by increasing the number of 
academic experts available on our platform and partnering with other academic institutions, allowing us 
to expand our portfolio of services to cover additional types of cancer. 

ICE-COLD  PCR –  we  believe  we  can  commercialize  and  develop  new  applications  for  our  ICP 
technology, including: 

oDeveloping specific application panels for patient monitoring for treatment resistance and disease 

recurrence;  

oBuilding focused diagnostic and screening panels for initial disease identification;  
oLeveraging  our  platform  customers  to  generate  demand  for  repeat,  localized,  in-house  liquid 

biopsy testing; and  

oApplying ICP technology to other markets, such as pre-natal and companion diagnostics.  

   
   
   
 
 
   
 
 
·  

New  product  pipeline  through  outsourced  research  and  development –  we  plan  on  utilizing  our 
partnerships with academic institutions to gain access to newly-developed technologies. We also believe 
there is an opportunity to partner with biotechnology companies to introduce their products into the U.S. 
market  through  our  platform. In  the  new  line  products  the  Company  has  developed  its  patented 
HemeScreen proprietary assay which substantially reduces the costs for running the assay, creating two 
key benefits as well as the IV-Cell. 

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7  

·  

Academic partnerships – we intend to leverage the intellectual expertise and technologies developed 
within academic institutions. We believe we have validated this model through previous partnerships 
and are currently in the process of adding new academic partners. 

Competition  

Our principal competition in clinical pathology services comes largely from  two groups. The first group 
consists of companies that specialize in oncology and offer directly competing services to our diagnostic services. 
These companies  provide a high level of service focused on  oncology and offer  their services to oncologists and 
pathology  departments  within  hospitals.  Competitors  in  this  group  include  Neogenomics  (Genoptix),  GenPath 
Diagnostics and Inform Diagnostics. The second group consists of large commercial companies that offer a wide 
variety of laboratory tests ranging from simple chemistry tests to complex genetic testing. Competitors in this group 
include LabCorp and Quest Diagnostics. We believe that companies in this industry primarily compete on price and 
rapid delivery of results. We have chosen to focus on the increased quality and accuracy of the results we provide. 
Within the liquid biopsy market, our competitors include Foundation Medicine, Guardant Health and Trovagene, Inc.  

Competitive Advantage  

We  capitalize  on  the  intellectual  expertise  and  technologies  developed  by  experts  within  academic 
institutions. While several industry papers report a case misdiagnosis rate as high as 28%, we believe that leveraging 
academic expertise can significantly reduce this rate. In an initial data set of over 100 clinical cases received and 
processed by us and with a diagnosis rendered by academic pathologists, we believe less than 1% have resulted in 
misdiagnosis. The diagnostic report provided by us was then requested by a patient or the patient’s physician for a 
second opinion to be conducted by another laboratory. In these instances, less than 1% were in disagreement with our 
report’s original diagnosis. Though less than 5% of all cancer patients are treated in academic centers that benefit 
from this specialized expertise, the majority of patients are diagnosed by commercial reference laboratories. These 
commercial laboratories and diagnostic companies have broad access to and serve over 95% of all cancer patients; 
however, their lack of specialized expertise results in significantly higher misdiagnosis rates. Academic institutions 
also invest heavily in the development of new technologies, most of which is used internally and does not benefit 
outside or commercial lab patients. Our platform provides all patients with access to these innovative technologies 
developed by us and in collaboration with other academic institutions we engage with.  

Government Regulation  

The healthcare industry is subject to extensive regulation by a number of governmental entities at the federal, 
state and local level. Laws and regulations in the healthcare industry are extremely complex and, in many instances, 
the industry does not have the benefit of significant regulatory or judicial interpretation. Our business is impacted not 
only by those laws and regulations that are directly applicable to us but also by certain laws and regulations that are 
applicable to our payors, vendors and referral sources. While our management believes we are in compliance with all 
of the existing laws and regulations applicable to us, such laws and regulations are subject to rapid change and often 
are uncertain in their application and enforcement. Further, to the extent we engage in new business initiatives, we 
must continue to evaluate whether new laws and regulations are applicable to us. There can be no assurance that we 

 
 
   
 
 
will not be subject to scrutiny or challenge under one or more of these laws or that any enforcement actions would 
not  be  successful.  Any  such challenge,  whether  or  not  successful,  could  have  a  material  adverse  effect  upon  our 
business and consolidated financial statements.  

Our current active laboratory certifications can be found on http://www.precipiodx.com/accreditations.html. 
The laboratory operations are governed by Standard Operating Procedure manuals, or SOPs, which detail each aspect 
of the laboratory environment including the work  flow, quality control, maintenance, and safety. These SOPs are 
reviewed and approved annually and signed off by the laboratory manager and medical director.  

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8  

Among the various federal and state laws and regulations that may govern or impact our current and planned 

operations are the following:  

Reimbursement  

As  blood-related  cancers  are  more  likely  to  be  developed  later  in  life,  the  largest  insurance  provider  is 
Medicare, which constitutes approximately 50% of our patients’ cases. Non-Medicare patients are typically insured 
by private insurance companies who provide patient coverage and pay for patients’ health-related costs. These private 
insurance companies will often adjust their rates according to the insurance rates annually published by the Center for 
Medicare and Medicaid Services, or CMS. We, and other providers, typically bill according to the codes relevant to 
the tests we conduct.  

Medicare and Medicaid Reimbursement  

Many of the services that we provide are reimbursed by Medicare and state Medicaid programs and are 

therefore subject to extensive government regulation.  

Medicare is a federally funded program that provides health insurance coverage for qualified persons age 65 
or older, some disabled persons, and persons with end-stage renal disease and persons with Lou Gehrig’s disease. 
Medicaid programs are jointly funded by the  federal and state governments and are administered by states under 
approved plans.  

Medicaid provides medical benefits to eligible people with limited income and resources and people with 
disabilities, among others. Although the federal government establishes general guidelines for the Medicaid program, 
each  state  sets  its  own  guidelines  regarding  eligibility  and  covered  services.  Some  individuals,  known  as  “dual 
eligibles”, may be eligible for benefits under both Medicare and a state Medicaid program. Reimbursement under the 
Medicare and Medicaid programs is contingent on the satisfaction of numerous rules and regulations, including those 
requiring certification and/or licensure. Congress often enacts legislation that affects the reimbursement rates under 
government healthcare programs.  

Approximately 45% of  our  revenue  for  the year  ended  December 31,  2019 was  derived  directly  from 
Medicare,  Medicaid  or  other  government-sponsored  healthcare  programs.  Also,  we  indirectly  provide  services  to 
beneficiaries  of Medicare, Medicaid  and  other  government-sponsored  healthcare  programs  through  managed  care 
entities. Should there be material changes to federal or state reimbursement methodologies, regulations or policies, 
our  direct  reimbursements  from  government-sponsored  healthcare  programs,  as  well  as  service  fees  that  relate 
indirectly to such reimbursements, could be adversely affected.  

Healthcare Reform  

   
   
   
   
   
   
In  recent  years,  federal  and  state  governments  have  considered  and  enacted  policy  changes  designed  to 
reform the healthcare industry. The most prominent of these healthcare reform efforts, the Affordable Care Act, has 
resulted in sweeping changes to the U.S. system for the delivery and financing of health care. As currently structured, 
the Affordable Care Act increases the number of persons covered under government programs and private insurance; 
furnishes  economic  incentives  for  measurable  improvements  in  health  care  quality  outcomes;  promotes  a  more 
integrated health care delivery system and the creation of new health care delivery.  

Research and Development Expenses  

For the years ended December 31, 2019 and 2018, we recorded $1.2 million and $1.1 million, respectively, 
of research and development expenses. More information regarding our research and development activities can be 
found  in  the  section  entitled  “Management’s  Discussion  and  Analysis  of  Financial  Condition  and  Results  of 
Operations” under Item 7 of this Annual Report.  

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Employees  

9  

As of March 15, 2020,  Precipio employed fifty  (50)  employees on a full-time basis and one (1) employee 
on  a  part-time  basis.  Of  the  total,  twelve  (12) were  in  Finance,  General  and  Administration,  fifteen  (15)  were  in 
laboratory operations, twelve  (12) were in Sales and Marketing, five  (5) were in Customer Service and Support and 
seven (7) were in Research & Development.  

Executive Officers of the Registrant  

Our executive officers, their ages as of March 27, 2020 and their respective positions are as follows:  

Ilan Danieli, Chief Executive Officer, age 48  

Mr. Danieli was the founder of Precipio Diagnostics LLC and was the Chief Executive Officer of Precipio 
Diagnostics LLC since 2011. Mr. Danieli assumed the role of Chief Executive Officer of Precipio, Inc. at the time of 
the Merger (as defined below). With over 20 years managing small and medium-size companies, some of his previous 
experiences include COO of Osiris, a publicly-traded company based in New York City with operations in the US, 
Canada, Europe and Asia; VP of Operations for Laurus Capital Management, a multi-billion dollar hedge fund; and 
in various other entrepreneurial ventures. Ilan holds an MBA from the Darden School at the University of Virginia, 
and a BA in Economics from Bar-Ilan University in Israel.  

Carl R. Iberger, Chief Financial Officer, age 67   

Mr.  Iberger  was  named  Chief  Financial  Officer  in  October  2016.  For  the  years  1990  through  2015,  Mr. 
Iberger held the positions of Chief Financial Officer and Executive Vice President at Dianon Systems, DigiTrace Care 
Services and SleepMed, Inc. Mr. Iberger has significant diagnostic healthcare experience in mergers and acquisitions, 
private equity transactions, public offerings and executive management in high growth environments. Mr. Iberger 
holds a Masters Degree in Finance from Hofstra University and a Bachelor of Science Degree in Accounting from the 
University of Connecticut.  

Compliance with Environmental Laws  

We believe we are in compliance with current environmental protection requirements that apply to us or our 

business. Costs attributable to environmental compliance are not currently material.  

Intellectual Property  

   
   
   
   
   
   
   
We license the ICP technology from Dana-Farber through the License Agreement. The License Agreement 
grants us an exclusive license to the ICP technology, subject to a non-exclusive license granted to the U.S. government, 
in  the  areas  of  mutation  detection  using  Sanger  (di-deoxy)  sequencing  and  mitochondrial  DNA  analysis  for  all 
research, diagnostic, prognostic and therapeutic uses in humans, animals, viruses, bacteria, fungi, plants or fossilized 
material. The Company has filed provisional patents for its proprietary HemeScreen and IV-Cell technologies.  

Corporate History   

Precipio,  Inc.  was  incorporated  in  Delaware  on  March 6,  1997. Our  principal  office  is  located  at  4 

Science Park, New Haven, Connecticut 06511.  

Our  internet  address  is  www.precipiodx.com.  Information  found  on  our  website  is  not  incorporated  by 
reference  into  this  report.  We  make  available  free  of  charge  through  our  website  our  Securities  and  Exchange 
Commission, or SEC, filings furnished pursuant to Section 13(a) or 15(d) of the Exchange Act as soon as reasonably 
practicable after we electronically file such material with, or furnish it to, the SEC.  

Item 1A. Risk Factors  

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10  

The  following  risks  and  uncertainties,  together  with  all  other  information  in  this  Annual  Report  on 
Form 10-K, including our consolidated financial statements and related notes, should be considered carefully. Any of 
the risk factors we describe below could adversely affect our business, financial condition or results of operations, 
and could cause the market price of our common stock to fluctuate or decline.  

Risks Related to Our Business and Strategy  

There is substantial doubt about our ability to continue as a going concern.  

Our  independent  registered  public  accounting  firm  has  issued  an  opinion  on  our  consolidated  financial 
statements included in this Annual Report on Form 10-K that states that the consolidated financial statements were 
prepared assuming we will continue as a going concern. Our consolidated financial statements have been prepared 
using accounting principles generally accepted in the United States of America applicable for a going concern, which 
assume that we will realize our assets and discharge our liabilities in the ordinary course of business. We have incurred 
substantial operating losses and have used cash in our operating activities for the past few years. For the year ended 
December 31, 2019, we had a net loss of $13.2 million, negative working capital of $2.5 million and net cash used in 
operating  activities  of  $9.1  million.  We  are  not  current  in  making  payments  to  all  lenders  and  vendors.  Our 
consolidated  financial  statements  do  not  include  any  adjustments  to  the  amounts  and  classification  of  assets  and 
liabilities that may be necessary should we be unable to continue as a going concern. We also cannot be certain that 
additional financing, if needed, will be available on acceptable terms, or at all, and our failure to raise capital when 
needed could limit our ability to continue our operations. There remains substantial doubt about the Company’s ability 
to continue as a going concern for the next twelve months from the date the consolidated financial statements were 
issued.  

To date, we have experienced negative cash flow from development of our diagnostic technology, as well as 
from  the  costs  associated  with  establishing  a  laboratory  and  building  a  sales  force  to  market  our  products  and 
services. We expect to incur substantial net losses for the foreseeable future to further develop and commercialize our 
diagnostic technology. We also expect that our selling, general and administrative expenses will continue to increase 
due to the additional costs associated with market development activities and expanding our staff to sell and support 
our products. Our ability to achieve or, if achieved, sustain profitability is based on numerous factors, many of which 

   
   
are beyond our control, including the market acceptance of our products, competitive product development and our 
market penetration and margins. We may never be able to generate sufficient revenue to achieve or, if achieved, 
sustain profitability.  

Because of the numerous risks and uncertainties associated with further development and commercialization 
of our diagnostic technology and any future tests, we are unable to predict the extent of any future losses or when we 
will become profitable, if ever. We may never become profitable and you may never receive a return on an investment 
in  our  securities. An  investor  in  our  securities  must  carefully  consider  the  substantial  challenges,  risks  and 
uncertainties inherent in the development and commercialization of tests in the medical diagnostic industry. We may 
never successfully commercialize our diagnostic technology or any future tests, and our business may fail.  

We will require significant additional financing to sustain our operations and without it we will not be able to 
continue operations.   

At December 31, 2019, we had a working capital deficit of $2.5 million. We had an operating cash flow 
deficit  of  $9.1  million  for  the  year  ended  December  31,  2019  and  a  net  loss  of  $13.2  million  for  the  year  ended 
December 31, 2019. We do not currently have sufficient financial resources to fund our operations or those of our 
subsidiary. Therefore, we need additional funds to continue these operations.  

To facilitate ongoing operations and product development, on September 7, 2018, the Company entered into 
a purchase agreement with Lincoln Park (the “LP Purchase Agreement” or “Equity Line”), pursuant to which Lincoln 
Park has agreed to purchase up to an aggregate of $10,000,000 of common stock of the Company (subject to certain 
limitations) from time to time over the term of the LP Purchase Agreement.  

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11  

On  December  20,  2018  the  Company  obtained  shareholder  approval  of  the  $10,000,000  Lincoln  Park 
Purchase Agreement. Per the terms of the LP Purchase Agreement, we may direct Lincoln Park to purchase up to 
$10,000,000 worth of shares of our common stock under our agreement over a 24-month period generally in amounts 
up to 30,000 shares of our common stock, which may be  increased to up to 36,666 shares of our common stock 
depending on the market price of our common stock at the time of sale and subject to a maximum commitment by 
Lincoln Park of $1,000,000 per regular purchase, on any business day on which the closing price of our common 
stock  is  not  less  than  the  Floor  Price,  defined  as  the  lower  of (i)  $1.50  per  share  (subject  to  adjustment  for  any 
reorganization,  recapitalization,  non-cash  dividend,  stock  split,  reverse  stock  split  or  other  similar  transaction  as 
provided in the LP Purchase Agreement) and (ii) $0.10 per share.    

The extent we rely on Lincoln Park as a source of funding will depend on a number of factors including, the 
prevailing market price of our common stock and the extent to which we are able to secure working capital from other 
sources. If obtaining sufficient funding from Lincoln Park were to prove unavailable or prohibitively dilutive, we will 
need to secure another source of funding in order to satisfy our working capital needs. Even if we sell all $10,000,000 
under the Purchase Agreement to Lincoln Park, we may still need additional capital to fully implement our business, 
operating and development plans. Should the financing we require to sustain our working capital needs be unavailable 
or prohibitively expensive when we require it, the consequences could be a material adverse effect on our business, 
operating results, financial condition and prospects. As of the date the consolidated financial statements were issued, 
we have already received an aggregate of  $9.3 million, including approximately $1.4 million from the sale of 328,590 
shares of common stock to Lincoln Park during 2018, $6.6 million from the sale of 2,778,077 shares of common stock 
to Lincoln Park during 2019, and $1.3 million from the sale of 900,012 shares of common stock to Lincoln Park from 
January 1, 2020 through the date the consolidated financial statements were issued.  

   
   
   
   
We will need to raise substantial additional capital to commercialize our diagnostic technology, and our failure to 
obtain funding when needed may force us to delay, reduce or eliminate our product development programs or 
collaboration efforts or force us to restrict or cease operations.  

As of December 31, 2019, we had cash of $0.8 million and our working capital was approximately negative 
$2.5 million. Due to our recurring losses from operations and the expectation that we will continue to incur losses in 
the future, we will be required to raise additional capital to complete the development and commercialization of our 
current  product  candidates  and  to  pay  off  our  obligations. To  date,  to  fund  our  operations  and  develop  and 
commercialize our products, we have relied primarily on equity and debt financings. When we seek additional capital, 
we may seek to sell additional equity and/or debt securities or to obtain a credit facility, which we may not be able to 
do on favorable terms, or at all. Our ability  to obtain additional financing will be subject to a number of factors, 
including market conditions, our operating performance and investor sentiment. If we are unable to raise additional 
capital  when  required  or  on  acceptable  terms,  we  may  have  to  significantly  delay,  scale  back  or  discontinue  the 
development and/or commercialization of one or more of our product candidates, restrict or cease our operations or 
obtain funds by entering into agreements on unattractive terms.  

We have incurred losses since our inception and expect to incur losses for the foreseeable future. We cannot be 
certain that we will achieve or sustain profitability.  

We have incurred losses since our inception and expect to incur losses in the future. As of December 31, 
2019, we had a net loss of $13.2 million, negative working capital of $2.5 million and net cash used in operating 
activities  of  $9.1  million.  For  the  year  ended  December  31,  2019,  we  have  experienced  negative  cash  flow  from 
development of our diagnostic technology, as well as from the costs associated with establishing a laboratory and 
building a sales force to market our products and services. We expect to incur substantial net losses for the foreseeable 
future to further develop and commercialize our diagnostic technology. We also expect that our selling, general and 
administrative expenses will continue to increase due to the additional costs associated with market development 
activities and expanding our staff to sell and support our products. Our ability to achieve or, if achieved, sustain 
profitability is based on numerous factors, many of which are beyond our control, including the market acceptance of 
our products, competitive product development and our market penetration and margins. We may never be able to 
generate sufficient revenue to achieve or, if achieved, sustain profitability.  

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12  

Because of the numerous risks and uncertainties associated with further development and commercialization 
of our diagnostic technology and any future tests, we are unable to predict the extent of any future losses or when we 
will become profitable, if ever. We may never become profitable and you may never receive a return on an investment 
in  our  securities.  An  investor  in  our  securities  must  carefully  consider  the  substantial  challenges,  risks  and 
uncertainties inherent in the development and commercialization of tests in the medical diagnostic industry. We may 
never successfully commercialize our diagnostic technology or any future tests, and our business may fail.  

We are subject to concentrations of revenue risk and concentrations of credit risk in accounts receivable.  

We have had several customers who have individually represented 10% or more of our total revenue, or 

whose accounts receivable balances individually represented 10% or more of our total accounts receivable.  

For the year ended December 31, 2019, two customers represented approximately 30% of our total revenue 

and for the year ended December 31, 2018 one customer accounted for 33% of our total revenue.  We expect to 
maintain the relationship with these customers, however, the loss of, or significant decrease in demand from, any of 
our top customers could have a material adverse effect on our business, results of operations and financial condition.  

   
   
   
   
   
At December 31, 2019, two customers accounted for approximately 29% of our total accounts receivable 
and at December 31, 2018 one customer accounted for 23%  of our  total accounts receivable.   The business risks 
associated with this concentration, including increased credit risks for these and other customers and the possibility 
of related bad debt write-offs, could negatively affect our margins and profits. Additionally, the loss of any of our top 
customers, whether through competition or consolidation, or a disruption in sales to such a customer, could result in 
a decrease of the Company’s future sales, earnings and cash flows.  Generally, we do not require collateral or other 
securities  to  support  our  accounts  receivable and  while  we are  directly  affected  by  the  financial  condition  of  our 
customers, management does not believe significant credit risks exist at December 31, 2019.  

We have been, and may continue to be, subject to costly litigation.  

We have been, and may continue to be, subject to legal proceedings. Due to the nature of our business and 
our lack of sufficient capital resources to pay  our obligations on a timely basis, we may be subject to a variety of 
regulatory investigations, claims, lawsuits and other proceedings in the ordinary course of our business. The results 
of these legal proceedings cannot be predicted with certainty due to the uncertainty inherent in litigation, including 
the effects of discovery of new evidence or advancement of new legal theories, the difficulty of predicting decisions 
of judges and juries and the possibility that decisions may be reversed on appeal. Such litigation has been, and in the 
future, could be, costly, time-consuming and distracting to management, result in a diversion of resources and could 
materially adversely affect our business, financial condition and operating results.  

In  addition,  we  may  settle  some  litigation  through  the  issuance  of  equity  securities  which  may  result  in 

significant dilution to our stockholders.  

The commercial success of our product candidates will depend upon the degree of market acceptance of these 
products  among  physicians,  patients,  health  care  payers  and  the  medical  community  and  on  our  ability  to 
successfully market our product candidates.  

Our products may never gain significant acceptance in the marketplace and, therefore, may never generate 
substantial revenue or profits for us. Our ability to achieve commercial market acceptance for our existing and future 
products will depend on several factors, including:  

·  

·  

 our ability to convince the medical community of the clinical utility of our products and their potential 
advantages over existing diagnostics technology; 
 the willingness of physicians and patients to utilize our products; and 

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13  

·  

the agreement by commercial third-party payers and government payers to reimburse our products, the 
scope and amount of which will affect patients’ willingness or ability to pay for our products and will 
likely heavily influence physicians’ decisions to recommend our products. 

In addition, physicians may rely on guidelines issued by industry groups, such as the NCCN, medical 

societies, such as the College of American Pathologists, or CAP, or other key oncology-related organizations before 
utilizing any diagnostic test. Although we have a study underway to demonstrate the clinical utility of our existing 
products, none of our products are, and may never be, listed in any such guidelines.  

We believe that publications of scientific and medical results in peer-reviewed journals and presentations at 
leading  conferences  are critical  to  the  broad  adoption  of  our  products.  Publication  in  leading  medical  journals  is 
subject to a peer-review process, and peer reviewers may not consider the results of studies involving our products 
sufficiently novel or worthy of publication. The failure to be listed in physician guidelines or to be published in peer-
reviewed journals could limit the adoption of our products. Failure to achieve widespread market acceptance of our 
products would materially harm our business, financial condition, and results of operations.  

   
 
 
 
 
   
If we cannot compete successfully with our competitors, including new entrants in the market, we may be unable 
to increase or sustain our revenue or achieve and sustain profitability.  

The  medical  diagnostic  industry  is  intensely  competitive  and  characterized  by  rapid  technological 
progress. We face significant competition from competitors ranging in size from diversified global companies with 
significant research and development resources to small, specialized firms whose narrower product lines may allow 
them  to  be  more  effective  in  deploying  related  PCR  technology  in  the  genetic  diagnostic  industry.  Our  closest 
competitors  fall  largely  into  two  groups,  consisting  of  companies  that  specialize  in  oncology  and  offer  directly 
competing services to our diagnostic services, offering their services to oncologists and pathology departments within 
hospitals, as well as large commercial companies that offer a wide variety of laboratory tests that range from simple 
chemistry tests to complex genetic testing. The technologies associated with the molecular diagnostics industry are 
evolving rapidly and there is intense competition within such industry. Certain molecular diagnostics companies have 
established technologies that may be competitive to our product candidates and any future tests that we develop. Some 
of these tests may use different approaches or means to obtain diagnostic results, which could be more effective or 
less expensive than our tests for similar indications. Moreover, these and other future competitors have or may have 
considerably greater resources than we do in terms of technology, sales, marketing, commercialization and capital 
resources. These competitors may have substantial advantages over us in terms of research and development expertise, 
experience  in  clinical  studies,  experience  in  regulatory  issues,  brand  name  exposure  and  expertise  in  sales  and 
marketing as well as in operating central laboratory services. Many of these organizations have financial, marketing 
and human resources greater than ours; therefore, there can be no assurance that we can successfully compete with 
present or potential competitors or that such competition will not have a materially adverse effect on our business, 
financial position or results of operations.  

We are currently engaged in a study, which commenced in July 2017, to demonstrate the impact of academic 
pathology expertise on diagnostic accuracy. There is no assurance that this study, or other studies or trials we may 
conduct, will demonstrate favorable results. If the results of this study, or other studies or trials we may conduct, 
demonstrate unfavorable or inconclusive results, customers may choose our competitors’ products over our products 
and our commercial opportunities may be reduced or eliminated.  

We  believe  that  many  of  our  competitors  spend significantly  more  on  research  and  development-related 
activities than we do. Our competitors may discover new diagnostic tools or develop existing technologies to compete 
with  our  diagnostic  technology. Our  commercial  opportunities  will  be  reduced  or  eliminated  if  these  competing 
products are more effective, are more convenient or are less expensive than our product candidates.  

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14  

We may not be able to develop new products or enhance the capabilities of our systems to keep pace with rapidly 
changing technology and customer requirements, which could have a material adverse effect on our business and 
operating results.  

Our success depends on our ability to develop new products and applications for our diagnostic technology 
in  existing  and  new  markets,  while  improving  the  performance  and  cost-effectiveness  of  our  systems.  New 
technologies, techniques or products could emerge that might offer better combinations of price and performance than 
our current or future products and systems. Existing or future markets for our products, as well as potential markets 
for our diagnostic product candidates, are characterized by rapid technological change and innovation. It is critical to 
our success that we anticipate changes in technology and customer requirements and successfully introduce new, 
enhanced and competitive technologies to meet our customers’ and  prospective customers’ needs on a timely and 
cost-effective  basis.  At  the  same  time,  however,  we  must  carefully  manage  the  introduction  of  new  products.  If 
customers believe that such products will offer enhanced features or be sold for a more attractive price, they may 
delay purchases until such products are available. We may also have excess or obsolete inventory of older products 
as we transition to new products and our experience in managing product transitions is very limited. If we do not 

   
   
successfully innovate and introduce new technology into our product lines or effectively manage the transitions to 
new product offerings, our revenues and results of operations will be adversely impacted.  

Competitors  may  respond  more  quickly  and  effectively  than  we  do  to  new  or  changing  opportunities, 
technologies, standards or customer requirements. We anticipate that we will face increased competition in the future 
as existing companies and competitors develop new or improved products and as new companies enter the market 
with new technologies.  

We currently depend on the services of pathologists at a single academic partner and the loss of the services of 
these pathologists would adversely impact our ability to develop, commercialize and deliver our products.  

We currently depend on the services of pathologists at a single academic partner to review and render their 
diagnostic interpretation of our test results and to prepare the final diagnostic results that we integrate into our final 
report for our customers. Although we are in the process of adding new academic partners, it would be difficult to 
replace the services provided by the pathologists at our current partner if their services became unavailable to us for 
any  reason  prior  to  adding  other  academic  partners.  If  this  academic  partner  does  not  successfully  carry  out  its 
contractual duties or obligations and meet expected deadlines; if this partner needs to be replaced, or if the quality or 
accuracy of the services provided by the pathologists at this partner were compromised for any reason, we would 
likely not be able to provide our services in a manner expected by our customers, and our financial results and the 
commercial prospects for our products could be harmed. The loss of the services of these pathologists would severely 
harm  our  ability  to  develop,  commercialize  and  deliver  our  products,  and  our  business,  financial  condition  and 
operating results would be materially adversely affected.  

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15  

We face risks related to health pandemics and other widespread outbreaks of contagious disease, including the 
novel coronavirus, COVID-19, which could significantly disrupt our operations and impact our financial results.  

Our business could be disrupted and materially adversely affected by the recent outbreak of COVID-19. In 
December  2019, an  outbreak  of  respiratory  illness  caused  by a  strain  of  novel  coronavirus, COVID-19,  began  in 
China. As of March 2020, that outbreak has led to numerous confirmed cases worldwide, including in the United 
States. The outbreak and government measures taken in response have also had a significant impact, both direct and 
indirect,  on  businesses  and  commerce.  Global  health  concerns,  such  as  coronavirus,  could  also  result  in  social, 
economic, and labor instability in the countries in which we or the third parties with whom we engage operate. The 
future progression of the outbreak and its effects on our business and operations are uncertain. We cannot presently 
predict the scope and severity of any potential business shutdowns or disruptions.  There can be no assurance that we 
will be able to avoid any impact from the spread of COVID-19 or its consequences, including downturns in global 
economies and financial markets that could affect our future operating results.  

We may experience temporary disruptions and delays in processing biological samples at our facilities.  

We may experience delays in processing biological samples caused by software and other errors. Any delay 

in processing samples could have an adverse effect on our business, financial condition and results of operations.  

We depend upon a limited number of key personnel, and if we are not able to retain them or recruit additional 
qualified personnel, the commercialization of our product candidates and any future tests that we develop could 
be delayed or negatively impacted.  

Our  success  is  largely  dependent  upon  the  continued  contributions  of  our  officers  and  employees. Our 
success  also  depends  in  part  on  our  ability  to  attract  and  retain  highly  qualified  scientific,  commercial  and 
administrative personnel. In order to pursue our test development and commercialization strategies, we will need to 
attract  and  hire  additional  personnel  with  specialized  experience  in  a  number  of  disciplines,  including  assay 

   
   
development, laboratory and clinical operations, sales and marketing, billing and  reimbursement. There is intense 
competition for personnel in the fields in which we operate. If we are unable to attract new employees and retain 
existing employees, the development and commercialization of our product candidates and any future tests could be 
delayed or negatively impacted. If any of them becomes unable or unwilling to continue in their respective positions, 
and we are unable to find suitable replacements, our business and financial results could be materially negatively 
affected.  

We will need to increase the size of our organization, and we may experience difficulties in managing growth.  

We are a small company with 50 full-time employees as of  March 15, 2020. Future growth will impose 
significant added responsibilities on members of management, including the need to identify, attract, retain, motivate 
and integrate highly skilled personnel. We may increase the number of employees in the future depending on the 
progress  of  our  development  of  diagnostic  technology. Our  future  financial  performance  and  our  ability  to 
commercialize our product candidates and to compete effectively will depend, in part, on our ability to manage any 
future growth effectively. To that end, we must be able to:  

·  
·  
·  

 integrate additional management, administrative, manufacturing and regulatory personnel; 
 maintain sufficient administrative, accounting and management information systems and controls; and 
 hire and train additional qualified personnel. 

We may not be able to accomplish these tasks, and our failure to accomplish any of them could harm our 

financial results.  

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16  

We currently have limited experience in marketing products. If we are unable to  establish marketing and sales 
capabilities and retain the proper talent to execute on our sales and marketing strategy, we may not be able to 
generate product revenue.  

We have developed limited experience in marketing our products and services. We intend  to continue to 
develop  our  in-house  marketing  organization  and  sales  force,  which  will  require  significant  capital  expenditures, 
management resources and time. We will have to compete with other diagnostic companies to recruit, hire, train and 
retain marketing and sales personnel.  

If we are unable to further grow our internal sales, marketing and distribution capabilities, we may pursue 
collaborative arrangements regarding the sales and marketing of our product candidates or future products, however, 
we may not be able to establish or maintain such collaborative arrangements, or if we are able to do so, they may not 
have effective sales forces. Any revenue we receive will depend upon the efforts of such third parties, which may not 
be successful. We may  have little or no control over the marketing and sales efforts of such third parties and our 
revenue from product sales may be lower than if we had commercialized our product candidates ourselves. We also 
face  competition  in  our  search  for  third  parties  to  assist  us  with  the  sales  and  marketing  efforts  of  our  product 
candidates.  

Cybersecurity risks could compromise our information and expose us to liability, which may harm our ability to 
operate effectively and may cause our business and reputation to suffer.  

Cybersecurity  refers  to  the  combination  of  technologies,  processes  and  procedures established  to  protect 
information technology systems and data from unauthorized access, attack, or damage. We rely on our information 
systems to provide security for processing, transmission and storage of confidential information about our patients, 
customers and personnel, such as names, addresses and other individually identifiable information protected by the 
Health Insurance Portability and Accountability Act, (“HIPAA”), other privacy laws. Cyber-attacks are increasingly 
more common, including in the health care industry. The regulatory environment surrounding information security 

 
 
 
   
and privacy is increasingly demanding, with the frequent imposition of new and changing requirements. Compliance 
with changes in privacy and information security laws and with rapidly evolving industry standards may result in our 
incurring  significant  expense  due  to  increased  investment  in  technology  and  the  development  of  new  operational 
processes.  

We have not experienced any known attacks on our information technology systems that compromised any 
confidential information. We maintain our information technology systems with safeguard protection against cyber-
attacks including passive intrusion protection, firewalls and virus detection software. However, these safeguards do 
not ensure that a significant cyber-attack could not occur. Although we have taken steps to protect the security of our 
information systems and the data maintained in those systems, it is possible that our safety and security measures will 
not  prevent  the  systems’  improper  functioning  or  damage  or  the  improper  access  or  disclosure  of  personally 
identifiable information such as in the event of cyber-attacks.  

Security  breaches,  including  physical  or  electronic  break-ins,  computer  viruses,  attacks  by  hackers  and 
similar  breaches  can  create  system  disruptions  or  shutdowns  or  the  unauthorized  disclosure  of  confidential 
information.  If  personal  information  or  protected  health  information  is  improperly  accessed,  tampered  with  or 
disclosed as a result of a security breach, we may incur significant costs to notify and mitigate potential harm to the 
affected  individuals,  and  we  may  be  subject  to sanctions  and  civil  or  criminal  penalties  if  we are  found  to  be  in 
violation of the privacy or security rules under HIPAA or other similar federal or state laws protecting confidential 
personal information. In addition, a security breach of our information systems could damage our reputation, subject 
us to liability claims or regulatory penalties for compromised personal information and could have a material adverse 
effect on our business, financial condition and results of operations.  

Our ability to use net operating loss carryforwards to offset future taxable income for U.S. federal tax purposes is 
subject to limitation and risk that could further limit our ability to utilize our net operating losses.  

Under U.S. federal income tax law, a corporation’s ability to utilize its net operating losses, or NOLs, to 
offset  future  taxable  income  may  be  significantly  limited  if  it  experiences  an  “ownership  change”  as  defined  in 
Section 382 of  

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the Internal Revenue Code, as amended. In general, an ownership change will occur if there is a cumulative change 
in a corporation’s ownership by “5-percent shareholders” that exceeds 50 percentage points over a rolling three-year 
period. A corporation that experiences an ownership change will generally be subject to an annual limitation on the 
use of its pre-ownership change NOLs equal to the value of the corporation immediately before the ownership change, 
multiplied by the long-term tax-exempt rate (subject to certain adjustments). The annual limitation for a taxable year 
generally is increased by the amount of any “recognized built-in gains” for such year and the amount of any unused 
annual limitation in a prior year. On December 22, 2017, a law commonly known as the Tax Cuts and Jobs Act, or 
the TCJ Act, was enacted in the United States. Certain provisions of the TCJ Act impact the ability to utilize NOLs 
generated in 2018 and forward; any limitation to our annual use of NOLs could require us to pay a greater amount of 
U.S. federal (and in some cases, state) income taxes, which could reduce our after-tax income from operations for 
future  taxable years  and  adversely  impact  our  financial  condition. Beginning  in  2018,  under  the  Act,  federal  loss 
carryforwards have an unlimited carryforward period, however such losses can only offset 80% of taxable income in 
any one year.  

Reimbursement and Regulatory Risks Relating to Our Business  

Governmental payers and health care plans have taken steps to control costs.  

Medicare,  Medicaid  and  private  insurers  have  increased  their  efforts  to  control  the  costs  of  health  care 
services, including clinical testing services. They may reduce fee schedules or limit/exclude coverage for certain types 

   
   
   
of  tests  that  we  perform.  Medicaid  reimbursement  varies  by  state  and  is  subject  to  administrative  and  billing 
requirements and budget pressures. We expect efforts to reduce reimbursements, impose more stringent cost controls 
and reduce utilization of testing services will continue. These efforts, including changes in laws or regulations, may 
have a material adverse impact on our business.  

Changes in payer mix could have a material adverse impact on our net sales and profitability.  

Testing  services  are  billed  to  physicians,  patients,  government  payers  such  as  Medicare,  and  insurance 
companies. Tests may be billed to different payers depending on a particular patient’s medical insurance coverage. 
Government payers have increased their efforts to control the cost, utilization and delivery of health care services as 
well as reimbursement for laboratory testing services. Further reductions of reimbursement for Medicare and Medicaid 
services or changes in policy regarding coverage of tests or other requirements for payment, such as prior authorization 
or  a  physician  or  qualified  practitioner’s  signature  on  test  requisitions,  may  be  implemented  from  time  to  time. 
Reimbursement  for  the  laboratory  services  component  of  our  business  is  also  subject  to  statutory  and  regulatory 
reduction. Reductions in the reimbursement rates and changes in payment policies of other third party payers may 
occur as well. Such changes in the past have resulted in reduced payments as well as added costs and have decreased 
test  utilization  for  the  clinical  laboratory  industry  by  adding  more  complex  new  regulatory  and  administrative 
requirements. As a result, increases in the percentage of services billed to government payers could have an adverse 
impact on our net sales.  

Our laboratories require ongoing CLIA certification.  

The Clinical Laboratory Improvement Amendments of 1988, or CLIA, extended federal oversight to virtually 
all  clinical  laboratories  by  requiring  that  they  be  certified  by  the  federal  government  or  by  a  federally-approved 
accreditation  agency. The  CLIA  requires  that  all  clinical  laboratories  meet  quality  assurance,  quality  control  and 
personnel standards. Laboratories must also undergo proficiency testing and are subject to inspections.  

The sanctions for failure to comply with the CLIA requirements include suspension, revocation or limitation 
of  a  laboratory’s  CLIA  certificate,  which  is  necessary  to  conduct  business,  cancellation  or  suspension  of  the 
laboratory’s approval to receive Medicare and/or Medicaid reimbursement, as well as significant fines and/or criminal 
penalties. The loss or suspension of a CLIA certification, imposition of a fine or other penalties, or future changes in 
the CLIA law or regulations (or interpretation of the law or regulations) could have a material adverse effect on us.  

We believe that we are in compliance with all applicable laboratory requirements, but no assurances can be 

given that our laboratories will pass all future certification inspections.  

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18  

Failure to comply with HIPAA could be costly.  

HIPAA and associated regulations protect the privacy and security of certain patient health information and 
establish standards for electronic health care transactions in the United States. These  privacy regulations establish 
federal standards regarding the uses and disclosures of protected health information. Our laboratories are subject to 
HIPAA and its associated regulations. If we fail to comply with these laws and regulations we could suffer civil and 
criminal penalties, fines, exclusion from participation in governmental health care programs and the loss of various 
licenses, certificates and authorizations necessary to operate our patient testing business. We could also incur liabilities 
from third party claims.  

Our failure to comply with any applicable government laws and regulations or otherwise respond to claims relating 
to improper handling, storage or disposal of hazardous chemicals that we use may adversely affect our results of 
operations.  

   
   
Our research and development and commercial activities involve the controlled use of hazardous materials 
and chemicals. We are subject to federal, state, local and international laws and regulations governing the use, storage, 
handling  and  disposal  of  hazardous  materials  and  waste  products.  If  we  fail  to  comply  with  applicable  laws  or 
regulations, we could be required to pay penalties or be held liable for any damages that result and this liability could 
exceed our financial resources. We cannot be certain that accidental contamination or injury will not occur. Any such 
accident could damage our research and manufacturing facilities and operations, resulting in delays and increased 
costs.  

We may become subject to the Anti-Kickback Statute, Stark Law, False Claims Act, Civil Monetary Penalties Law 
and may be subject to analogous provisions of applicable state laws and could face substantial penalties if we fail 
to comply with such laws.  

There are several federal laws addressing fraud and abuse that apply to businesses that receive reimbursement 
from a federal health care program. There are also a number of similar state laws covering fraud and abuse with 
respect to, for example, private payers, self-pay and insurance. Currently, we receive a substantial percentage of our 
revenue from private payers and from Medicare. Accordingly, our business is subject to federal fraud and abuse laws, 
such as the Anti-Kickback Statute, the Stark Law, the False Claims Act, the Civil Monetary Penalties Law and other 
similar laws. Moreover, we are already subject to similar state laws. We believe we have operated, and intend to 
continue to operate, our business in compliance with these laws. However, these laws are subject to modification and 
changes in interpretation, and are enforced by authorities vested with broad discretion. Federal and state enforcement 
entities  have  significantly  increased  their  scrutiny  of  healthcare  companies  and  providers  which  has  led  to 
investigations, prosecutions, convictions and large settlements. We continually monitor developments in this area. If 
these  laws  are  interpreted  in  a  manner  contrary  to  our  interpretation  or  are  reinterpreted  or  amended,  or  if  new 
legislation is enacted with respect to healthcare fraud and abuse, illegal remuneration, or similar issues, we may be 
required to restructure our affected operations to maintain compliance with applicable law. There can be no assurances 
that any such restructuring will be possible or, if possible, would not have a material adverse effect on our results of 
operations, financial position, or cash flows.  

Anti-Kickback Statute  

A federal law commonly referred to as the “Anti-Kickback Statute” prohibits the knowing and willful offer, 
payment, solicitation or receipt of remuneration, directly or indirectly, in return for the referral of patients or arranging 
for the referral of patients, or in return for the recommendation, arrangement, purchase, lease or order of items or 
services that are covered, in whole or in part, by a federal healthcare program such as Medicare or Medicaid. The term 
“remuneration” has been broadly interpreted to include anything of value such as gifts, discounts, rebates, waiver of 
payments or providing anything at less than its fair market value. The Patient Protection and Affordable Care Act, as 
amended by the Health Care and Education Reconciliation Act, or the PPACA, amended the intent requirement of the 
Anti-Kickback Statute such that a person or entity can be found guilty of violating the statute without actual knowledge 
of  the  statute  or specific  intent  to  violate  the  statute.  Further,  the  PPACA  now  provides  that  claims  submitted  in 
violation of the Anti-Kickback Statute constitute false or fraudulent claims for purposes of the federal False Claims 
Act, or FCA, including the failure to timely return an overpayment. Many states have adopted similar prohibitions 
against kickbacks  

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19  

and other practices that are intended to influence the purchase, lease or ordering of healthcare items and services 
reimbursed by a governmental health program or state Medicaid program. Some of these state prohibitions apply to 
remuneration for referrals of healthcare items or services reimbursed by any third-party payor, including commercial 
payors and self-pay patients.  

Stark Law  

   
   
   
   
Section 1877 of the Social Security Act, or the Stark Law, prohibits a physician from referring a patient to 
an entity for certain “designated health services” reimbursable by Medicare if the physician (or close family members) 
has a financial relationship with that entity, including an ownership or investment interest, a loan or debt relationship 
or a compensation relationship, unless an exception to the Stark Law is fully satisfied. The designated health services 
covered by the law include, among others, laboratory and imaging services. Some states have self-referral laws similar 
to the Stark Law for Medicaid claims and commercial claims.  

Violation  of  the  Stark  Law  may  result  in  prohibition  of  payment  for  services  rendered,  a  refund  of  any 
Medicare payments for services that resulted from an unlawful referral, $15,000 civil monetary penalties for specified 
infractions, criminal penalties, and potential exclusion from participation in government healthcare programs, and 
potential false claims liability. The repayment provisions in the Stark Law are not dependent on the parties having an 
improper intent; rather, the Stark Law is a strict liability statute and any violation is subject to repayment of all amounts 
arising  out  of  tainted  referrals.  If  physician  self-referral  laws  are  interpreted  differently  or  if  other  legislative 
restrictions are issued, we could incur significant sanctions and loss of revenues, or we could have to change our 
arrangements and operations in a way that could have a material adverse effect on our business, prospects, damage to 
our reputation, results of operations and financial condition.  

False Claims Act  

The FCA prohibits providers from, among other things, (1) knowingly presenting or causing to be presented, 
claims for payments from the Medicare, Medicaid or other federal healthcare programs that are false or fraudulent; 
(2) knowingly making, using or causing to be made or used, a false record or statement to get a false or fraudulent 
claim paid or approved by the federal government; or (3) knowingly making, using or causing to be made or used, a 
false record or statement to avoid, decrease or conceal an obligation to pay money to the federal government. The 
“qui tam” or “whistleblower” provisions of the FCA allow private individuals to bring actions under the FCA on 
behalf of the government. These private parties are entitled to share in any amounts recovered by the government, 
and,  as  a  result,  the  number  of  “whistleblower”  lawsuits  that  have  been  filed  against  providers  has  increased 
significantly in recent years. Defendants found to be liable under the FCA may be required to pay three times the 
actual  damages  sustained  by  the  government,  plus  civil  penalties  ranging  between  $5,500  and  $11,000  for  each 
separate false claim.  

There are many potential bases for liability under the FCA. The government has used the FCA to prosecute 
Medicare and other government healthcare program fraud such as coding errors, billing for services not provided, and 
providing care that is not medically necessary or that is substandard in quality. The PPACA also provides that claims 
submitted in connection with patient referrals that result from violations of the Anti-Kickback Statute constitute false 
claims for the purpose of the FCA, and some courts have held that a violation of the Stark law can result in FCA 
liability, as well. In addition, a number of states have adopted their own false claims and whistleblower provisions 
whereby a private party may file a civil lawsuit in state court. We are required to provide information to our employees 
and certain contractors about state and federal false claims laws and whistleblower provisions and protections.  

Civil Monetary Penalties Law  

The Civil Monetary Penalties Law prohibits, among other things, the offering or giving of remuneration to a 
Medicare  or  Medicaid  beneficiary  that  the  person  or  entity  knows  or  should  know  is  likely  to  influence  the 
beneficiary’s  selection  of  a  particular  provider  or  supplier  of items  or  services  reimbursable  by  a  federal  or state 
healthcare  program.  This  broad  provision  applies  to  many  kinds  of  inducements  or  benefits  provided  to  patients, 
including complimentary items, services or transportation that are of more than a nominal value. This law could affect 
how we have to structure our operations and activities.  

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20  

Intellectual Property Risks Related to Our Business  

   
   
   
   
   
   
We cannot be certain that measures taken to protect our intellectual property will be effective.  

We rely upon trade secrets, copyright and trademark laws, non-disclosure agreements and other contractual 
confidentiality  provisions  to  protect  our  confidential  and  proprietary  information  that  we  are  not  seeking  patent 
protection for various reasons. Such measures, however, may not provide adequate protection for our trade secrets or 
other proprietary information. If such measures do not protect our rights, third parties could use our technology and 
our ability to compete in the market would be reduced.  

We depend on certain technologies that are licensed to us. We do not control these technologies and any loss of 
our rights to them could prevent us from selling some of our products.  

We have entered into license agreements with third parties for certain licensed technologies that are, or may 
become, relevant to the products we market, or plan to market, including our license agreement with  Dana-Farber 
pursuant  to  which  we  license  our  ICP  technology.  In  addition,  we  may  in  the  future  elect  to  license  third  party 
intellectual property to further our business objectives and/or as needed for freedom to operate for our products. We 
do not and will not own the patents, patent applications or other intellectual property rights that are the subject of 
these licenses. Our rights to use these technologies and employ the inventions claimed in the licensed patents, patent 
applications and other intellectual property rights are or will be subject to the continuation of and compliance with the 
terms of those licenses.  

We might not be able to obtain licenses to technology or other intellectual property rights that we require. 
Even if such licenses are obtainable, they may not be available at a reasonable cost or multiple licenses may be needed 
for the same product (e.g., stacked royalties). We could therefore incur substantial costs related to royalty payments 
for licenses obtained from third parties, which could negatively affect our gross margins. Further, we could encounter 
delays in product introductions, or interruptions in product sales, as we develop alternative methods or products.  

In some cases, we do not or may not control the prosecution, maintenance, or filing of the patents or patent 
applications to which we hold licenses, or the enforcement of these patents against third parties. As a result, we cannot 
be certain that drafting or prosecution of the licensed patents and patent applications  by the licensors have been or 
will be conducted in compliance with applicable laws and regulations or will result in valid and enforceable patents 
and other intellectual property rights.   

Third parties may assert ownership or commercial rights to inventions we develop.  

Third parties may in the future make claims challenging the inventorship or ownership of our intellectual 
property. For example, third parties that have been introduced to or have benefited from our inventions may attempt 
to replicate or reverse engineer our products and circumvent ownership of our inventions. In addition, we may face 
claims that our agreements with employees, contractors, or consultants obligating them to assign intellectual property 
to us are ineffective, or in conflict with prior or competing contractual obligations of assignment, which could result 
in ownership disputes regarding intellectual property we have developed or will develop and interfere with our ability 
to capture the commercial value of such inventions. Litigation may be necessary to resolve an ownership dispute, and 
if we are not successful, we may be precluded from using certain intellectual property, or may lose our exclusive 
rights in that intellectual property. Either outcome could have an adverse impact on our business.  

Third parties may assert that our employees or consultants have wrongfully used or disclosed confidential 
information or misappropriated trade secrets.  

Although we try to ensure that our employees and consultants do not  use the proprietary information or 
know-how  of  others  in  their  work  for  us,  we  may  be subject  to  claims  that  we  or  our  employees,  consultants  or 
independent contractors have inadvertently or otherwise used or disclosed intellectual property, including trade secrets 
or other proprietary information, of a former employer or other third parties. Litigation may be necessary to defend 
against these claims. If we fail in defending any such claims, in addition to paying monetary damages, we may lose 
valuable  

21  

   
   
   
   
   
   
   
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intellectual property rights or personnel. Even if we are successful in defending against such claims, litigation could 
result in substantial costs and be a distraction to management and other employees.  

The testing, manufacturing and marketing of medical diagnostic devices entails an inherent risk of product 
liability and personal injury claims.  

To date, we have experienced no product liability or personal injury claims, but any such claims arising in 
the future could have a material adverse effect on our business, financial condition and results of operations. Potential 
product liability or personal injury claims may exceed the amount of our insurance coverage or may be excluded from 
coverage under the terms of our policy or limited by other claims under our umbrella insurance policy. Additionally, 
our existing insurance may not be renewed by us at a cost and level of coverage comparable to that presently in effect, 
if at all. In the event that we are held liable for a claim against which we are not insured or for damages exceeding the 
limits of our insurance coverage, such claim could have a material adverse effect on our cash flow and thus potentially 
a materially adverse effect on our business, financial condition and results of operations.  

All of our diagnostic technology development and our clinical services are performed at two laboratories, and in 
the event either or both of these facilities were to be affected by a termination of the lease or a man-made or 
natural disaster, our operations could be severely impaired.  

We are performing all of our diagnostic services in our CLIA laboratory located in New Haven, Connecticut 
and our research and development operations are based in our facility in Omaha, Nebraska. Despite precautions taken 
by us, any future natural or man-made disaster at these laboratories, such as a fire, earthquake or terrorist activity, 
could cause substantial delays in our operations, damage or destroy our equipment and testing samples or cause us to 
incur additional expenses.  

In addition, we are leasing the facilities where our laboratories operate. We are currently in compliance with 
all and any lease obligations, but should the leases terminate for any reason, or if at any time either of the laboratories 
is moved due to conditions outside our control, it could cause substantial delay in our diagnostics operations, damage 
or destroy our equipment and biological samples or cause us to incur additional expenses. In the event of an extended 
shutdown of either laboratory, we may be unable to perform our services in a timely manner or at all and therefore 
would be unable to operate in a commercially competitive manner. This could harm our operating results and financial 
condition.  

Further, if we have to use a substitute  laboratory while our facilities were shut down, we could only use 
another facility with established state licensure and accreditation under CLIA. We may not be able to find another 
CLIA-certified facility and comply with applicable procedures, or find any such laboratory that would be willing to 
perform the tests for us on commercially reasonable terms. Additionally, any new laboratory opened by us would be 
subject to certification under CLIA and licensure by various states, which would take a significant  amount of time 
and result in delays in our ability to continue our operations.  

An impairment in the carrying value of our intangible assets could negatively affect our results of operations.  

A significant portion of our assets are intangible assets which are reviewed at least annually for impairment. 
If we do not realize our business plan, our intangible assets may become impaired resulting in an impairment loss in 
our results of operations.  

Risks Related to Our Common Stock  

The price of our common stock may fluctuate significantly, which could negatively affect us and holders of our 
common stock.  

   
   
   
   
   
   
   
   
There has been, and continues to be, a limited public market for our common stock, and an active trading 
market for our common stock has not and may never develop or, if developed, be sustained. The trading price of our  

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common stock may be highly volatile and could be subject to wide fluctuations in response to various factors, some 
of which are beyond our control. These factors include:  

These factors include:  

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·  

·  

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·  

 actual or anticipated fluctuations in  our financial condition and operating results: 
 actual or anticipated changes in our growth rate relative to our competitors; 
 competition from existing products or new products that may emerge; 
 announcements by us, our academic institution partners, or our competitors of significant acquisitions, 
strategic partnerships, joint ventures, collaborations, or capital commitments; 
failure to meet or exceed financial estimates and projections of the investment community or that we 
provide to the public and the revision of any financial estimates and projections that we provide to the 
public; 
 issuance of new or updated research or reports by securities analysts; 
 fluctuations in the valuation of companies perceived by investors to be comparable to us; 
 share price and volume fluctuations attributable to inconsistent trading volume levels of our shares; 
 additions, transitions or departures of key management or scientific personnel; 
 disputes or other developments related to proprietary rights, including patents, litigation matters, and our 
ability to obtain patent protection for our technologies; 
 changes to reimbursement levels by commercial third-party payors and government payors, including 
Medicare, and any announcements relating to reimbursement levels; 
 Government  shut-down  or  partial  shut-downs  impacting  the  financial  markets,  the  United  States 
Securities and Exchange Commission and other related agencies; 
 announcement or expectation of additional debt or equity financing efforts; 
 sales of our common stock by us, our insiders, or our other stockholders; and 
 general economic and market conditions 

These and other market and industry factors may cause the market price and demand for our common stock 
to fluctuate substantially, regardless of our actual operating performance, which may limit or prevent investors from 
readily selling their shares of our common stock and may otherwise negatively affect the liquidity of our common 
stock. In addition, the stock market in general has experienced price and volume fluctuations that have often been 
unrelated or disproportionate to the operating performance of these companies. In the past, when the market price of 
a stock has been volatile, holders of that stock have instituted securities class action litigation against the company 
that issued the stock. If any of our stockholders brought a lawsuit against us, we could incur substantial costs defending 
the lawsuit. Such a lawsuit could also divert the time and attention of our management.  

The price of our stock may be vulnerable to manipulation.  

We believe our common stock has been the subject of significant short selling by certain market participants. 
Short  sales  are  transactions  in  which  a  market  participant  sells  a  security  that  it  does  not  own.  To  complete  the 
transaction, the market participant must borrow the security to make delivery to the buyer. The market participant is 
then obligated to replace the security borrowed by purchasing the security at the market price at the time of required 
replacement. If the price at the time of replacement is lower than the price at which the security was originally sold 
by the market participant, then the market participant will realize a gain on the transaction. Thus, it is in the market 
participant’s interest for the market price of the underlying security to decline as much as possible during the period 
prior to the time of replacement.  

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
Because our unrestricted public float has been small relative to other issuers, previous short selling efforts 
have impacted, and may in the future continue to impact, the value of our stock in an extreme and volatile manner to 
our detriment and the detriment of our shareholders. Efforts by certain market participants to manipulate the price of 
our common stock for their personal financial gain may cause our stockholders to lose a portion of their investment, 
may  make  it  more  difficult  for  us  to  raise  equity  capital  when  needed  without  significantly  diluting  existing 
stockholders, and may reduce demand from new investors to purchase shares of our stock.  

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If we cannot continue to satisfy NASDAQ listing maintenance requirements and other rules, our securities may be 
delisted, which could negatively impact the price of our securities.   

Although our common stock is listed on the NASDAQ Capital Market, we may be unable to continue to 
satisfy the listing maintenance requirements and rules. If we are unable to satisfy The NASDAQ Stock Market, or 
NASDAQ, criteria for maintaining our listing, our securities could be subject to delisting.  

On March 26, 2019, we were notified by the Listing Qualifications Staff of The NASDAQ Stock Market 
LLC that we did not meet the minimum closing bid price requirement of $1 for continued listing, as set forth in Nasdaq 
Listing Rule 5550(a)(2) (the “Bid Price Requirement”).  On April 25, 2019 we filed a Certificate of Amendment with 
the Secretary of State of Delaware, pursuant to which we effected a 1-for-15 reverse stock split (the “Reverse Stock 
Split”)  of  our  issued  and  outstanding  common  stock.  The  Reverse  Stock  Split  became  effective  as  of  5:00  p.m. 
(Eastern Time) on April 26, 2019, and our common stock began trading on a split-adjusted basis on the Nasdaq Capital 
Market at the market open on April 29, 2019.  On May 15, 2019, we received notification from NASDAQ that the 
Company’s stock price was in compliance with the Bid Price Requirement, and that the matter is now closed.  

If NASDAQ delists our securities, we could face significant consequences, including:  

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 a limited availability for market quotations for our securities; 
 reduced liquidity with respect to our securities; 
 a determination that our common stock is a “penny stock,” which will require brokers trading in our 
common stock to adhere to more stringent rules and possibly result in reduced trading; 
 activity in the secondary trading market for our common stock; 
 limited amount of news and analyst coverage; and 
 a decreased ability to issue additional securities or obtain additional financing in the future. 

In addition, we would no longer be subject to NASDAQ rules, including rules requiring us to have a certain 

number of independent directors and to meet other corporate governance standards.  

Increased  costs  associated  with  corporate  governance  compliance  may  significantly  impact  our  results  of 
operations.  

As a public company, we incur significant legal, accounting, and other expenses due to our compliance with 
regulations and disclosure obligations applicable to us, including compliance with the Sarbanes-Oxley Act of 2002, 
or the Sarbanes-Oxley Act, as well as rules implemented by the SEC, and NASDAQ. The SEC and other regulators 
have continued to adopt new rules and regulations and make additional changes to existing regulations that require 
our compliance. In July 2010, the Dodd-Frank Wall Street Reform and Consumer Protection Act, or the Dodd-Frank 
Act, was enacted. There are significant corporate governance and executive compensation related provisions in the 
Dodd-Frank Act that have required  the SEC to adopt additional rules and regulations in these areas. Stockholder 
activism,  the  current  political  environment,  and  the  current  high  level  of  government  intervention  and  regulatory 
reform may lead to substantial new regulations and disclosure obligations, which may lead to additional compliance 
costs  and  impact,  in  ways  we  cannot  currently  anticipate,  the  manner  in  which  we  operate  our  business.  Our 
management and other personnel devote a substantial amount of time to these compliance programs and monitoring 

   
   
 
 
 
 
 
 
of public company reporting obligations, and as a result of the new corporate governance and executive compensation 
related rules, regulations, and guidelines prompted by the Dodd-Frank Act, and further regulations and disclosure 
obligations  expected  in  the  future,  we  will  likely  need  to  devote  additional  time  and  costs  to  comply  with  such 
compliance  programs and  rules.  These  rules  and  regulations will  cause  us  to  incur  significant  legal  and  financial 
compliance costs and will make some activities more time-consuming and costly.  

The Sarbanes-Oxley Act requires that we maintain effective disclosure controls and procedures and internal 
control over financial reporting. We are continuing to develop and refine our disclosure controls and other procedures 
that are designed to ensure that information required to be disclosed by us in the reports that we file with the SEC is 
recorded, processed, summarized, and reported within the time periods specified in SEC rules and forms, and that 
information required to be disclosed in reports under the Exchange Act is accumulated and communicated to our 
principal executive and financial officers. Our current controls and any new controls that we develop may become  

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24  

inadequate, and weaknesses in our  internal control over financial reporting may be discovered in the  future. Any 
failure to develop or maintain effective controls could adversely affect the results of periodic management evaluations 
and annual independent registered public accounting firm attestation reports regarding the effectiveness of our internal 
control over financial reporting, which we may be required to include in our periodic reports that we file with the SEC 
under  Section 404  of  the  Sarbanes-Oxley  Act,  and  could  harm  our  operating  results,  cause  us  to  fail  to  meet  our 
reporting  obligations,  or  result  in  a  restatement  of  our  prior  period  financial  statements.  If  we  are  not  able  to 
demonstrate compliance with the Sarbanes-Oxley Act, that our internal control over financial reporting is perceived 
as inadequate, or that we are unable to produce timely or accurate financial statements, investors may lose confidence 
in our operating results, and the price of our common stock could decline.  

We are required to comply with certain of the SEC rules that implement Section 404 of the Sarbanes-Oxley 
Act, which requires management to certify financial and other information in our quarterly and annual reports and 
provide  an  annual  management  report  on  the  effectiveness  of  our  internal  control  over  financial  reporting.  This 
assessment needs to include the disclosure of any material weaknesses in our internal control over financial reporting 
identified by our management or our independent registered public accounting firm. During the evaluation and testing 
process, if we identify one or more material weaknesses in our internal control over financial reporting or if we are 
unable to complete our evaluation, testing, and any required remediation in a timely fashion, we will be unable to 
assert that our internal control over financial reporting is effective.  

These developments could make it more difficult for us to retain qualified members of our Board of Directors, 
or  qualified  executive  officers.  We  are  presently  evaluating  and  monitoring  regulatory  developments  and  cannot 
estimate the timing or magnitude of additional costs we may incur as a result. To the extent these costs are significant, 
our general and administrative expenses are likely to increase.  

We have not paid dividends on our common stock in the past and do not expect to pay dividends on our common 
stock for the foreseeable future. Any return on investment may be limited to the value of our common stock.  

No  cash  dividends  have  been  paid  on  our  common  stock.   We  expect  that  any  income  received  from 
operations  will  be  devoted  to  our  future  operations and  growth.   We  do  not  expect  to  pay  cash  dividends  on  our 
common stock in the near future.  Payment of dividends would depend upon our profitability at the time, cash available 
for those dividends, and other factors as our board of directors may consider relevant.  If we do not pay dividends, 
our common stock may be less valuable because a return on an investor’s investment will only occur if our stock price 
appreciates.  Investors in our common stock should not rely on an investment in our company if they require dividend 
income.  

If securities or industry analysts do not publish research or reports about our business, or if they change their 
recommendations regarding our stock adversely, our stock price and trading volume could decline.  

   
   
   
The  trading  market  for  our  common  stock  relies  in  part  on  the  research  and  reports  that  equity  research 
analysts publish about us and our business. We do not control these analysts. The price of our common stock could 
decline  if  one  or  more  equity  research  analysts  downgrade  our  common  stock  or  if  they  issue  other  unfavorable 
commentary or cease publishing reports about us or our business.  

The sale or issuance of our common stock to Lincoln Park may cause significant dilution and the sale of the 
shares of common stock acquired by Lincoln Park, or the perception that such sales may occur, could cause the 
price of our common stock to fall.   

On September 7, 2018, we entered into the LP Purchase Agreement pursuant to which Lincoln Park has 
agreed to purchase up to an aggregate of $10,000,000 of our common stock (subject to certain limitations) from time 
to time over the term of the LP Purchase Agreement.  

On  December  20,  2018  we  obtained  shareholder  approval  of  the  $10,000,000  Lincoln  Park  Purchase 
Agreement. Per the terms of the LP Purchase Agreement, we may direct Lincoln Park to purchase up to $10,000,000 
worth of shares of our common stock under our agreement over a 24-month period  

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25  

The extent we rely on Lincoln Park as a source of funding will depend on a number of factors including, the 
prevailing market price of our common stock and the extent to which we are able to secure working capital from other 
sources.  The  purchase  price  for  the  shares  that  we  may  sell  to  Lincoln  Park  under  the  Purchase  Agreement  will 
fluctuate based on the price of our common stock. Depending on market liquidity at the time, sales of such shares may 
cause the trading price of our common stock to fall. We generally have the right to control the timing and amount of 
any future sales of our shares to Lincoln Park. Additional sales of our common stock, if any, to Lincoln Park will 
depend upon market conditions and other factors to be determined by us. We may ultimately decide to sell to Lincoln 
Park all, some or none of the additional shares of our common stock that may be available for us to sell pursuant to 
the Purchase Agreement. If and when we do sell shares to Lincoln Park, after Lincoln Park has acquired the shares, 
Lincoln Park may resell all, some or none of those shares at any time or from time to time in its discretion. Therefore, 
sales to Lincoln Park by us could result in substantial dilution to the interests of other holders of our common stock. 
Additionally, the sale of a substantial number of shares of our common stock to Lincoln Park, or the anticipation of 
such sales, could make it more difficult for us to sell equity or equity-related securities in the future at a time and at a 
price that we might otherwise wish to effect sales.  

As of the date the consolidated financial statements were issued, we have already received an aggregate 
of $9.3 million, including approximately $1.4 million from the sale of 328,590 shares of common stock to Lincoln 
Park during 2018, $6.6 million from the sale of 2,778,077 shares of common stock to Lincoln Park during 2019, and 
$1.3 million from the sale of 900,012 shares of common stock to Lincoln Park from January 1, 2020 through the date 
the consolidated financial statements were issued.  

The issuance of our common stock to creditors or litigants may cause significant dilution to our stockholders and 
cause the price of our common stock to fall  

We may seek to settle outstanding obligations to vendors, debtholders or litigants in any litigation through 
the issuance of our common stock or other security to such persons. Such issuances may cause significant dilution to 
our stockholders and cause the price of our common stock to fall.  

Item 1B. Unresolved Staff Comments  

None.  

   
   
   
   
   
   
Item 2. Properties  

We  currently  lease  approximately  7,630  square  feet  of  laboratory  and  office  space  in  New  Haven, 
Connecticut, which we occupy under a lease expiring in December 2021 with annual rental payments of $0.2 million. 
We also lease approximately 5,300 square feet of laboratory space in Omaha, Nebraska, which we occupy under a 
lease expiring in May 2022 with annual rental payments of less than $0.1 million. We believe that these facilities are 
adequate to meet our current and planned needs.  We believe that if additional space is needed in the future, we could 
find alternate space at competitive market rates as needed.  

Item 3. Legal Proceedings      

The healthcare industry is subject to numerous laws and regulations of federal, state and local governments. 
These  laws  and  regulations  include,  but  are  not  limited  to,  matters  such  as  licensure,  accreditation,  government 
healthcare program participation requirement, reimbursement for patient services and Medicare and Medicaid fraud 
and  abuse.  Government  activity  has  increased  with  respect  to  investigations  and  allegations  concerning  possible 
violations of fraud and abuse statutes and regulations by healthcare providers.  

Violations of these laws and regulations could result in expulsion from government healthcare programs 
together with the imposition of significant fines and penalties, as well as significant repayments for patient services 
previously billed. Management believes that the Company is in compliance with fraud and abuse regulations, as well 
as  other  applicable  government  laws  and  regulations.  While  no  material  regulatory  inquiries  have  been  made, 
compliance  

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26  

with such laws and regulations can be subject to future government review and interpretation, as well as regulatory 
actions unknown or unasserted at this time.  

The  outcome  of  legal  proceedings  and  claims  brought  against  us  are  subject  to  significant  uncertainty. 
Therefore, although management considers the likelihood of such an outcome to be remote, if one or more of these 
legal  matters  were  resolved  against  us  in  the  same  reporting  period  for  amounts  in  excess  of  management’s 
expectations, our financial statements for such reporting period could be materially adversely affected. In general, the 
resolution of a legal matter could prevent us from offering our services or products to others, could be material to our 
financial condition or cash flows, or both, or could otherwise adversely affect our operating results.  

The Company is delinquent on the payment of outstanding accounts payable for certain vendors and suppliers 

who have taken or have threatened to take legal action to collect such outstanding amounts.  

On February 21, 2017, XIFIN, Inc. (“XIFIN”) filed a lawsuit against us in the District Court for the Southern 
District of California alleging breach of written contract and seeking recovery of approximately $0.27 million owed 
by us to XIFIN for damages arising from a breach of our obligations pursuant to a Systems Services Agreement 
between us and XIFIN, dated as of February 22, 2013, as amended and restated on September 1, 2014. A liability of 
$0.1 million was reflected in accounts payable within the accompanying consolidated balance sheet at December 31, 
2018. On April 19, 2019, the Company executed a settlement agreement with XIFIN pursuant to which the Company 
paid  to  XIFIN  an  agreed  amount  of  $40,000  as  settlement  in  consideration  for  total  release  from  all  outstanding 
amounts due and payable by the Company to XIFIN. The settlement amount was paid in full by the Company on 
April 19, 2019.  

CPA Global provides us with certain patent management services. On February 6, 2017, CPA Global claimed 
that we owe approximately $0.2 million for certain patent maintenance services rendered. CPA Global has not filed 
claims against us in connection with this allegation.   A liability of less than $0.1 million has been recorded and is 
reflected in accounts payable within the accompanying consolidated balance sheet at December 31, 2019 and 2018.  

On February 17, 2017, Jesse Campbell (“Campbell”) filed a lawsuit individually and on behalf of others 
similarly situated against us in the District Court for the District of Nebraska alleging we had a materially incomplete 
and misleading proxy relating to a potential merger and that the merger agreement’s deal protection provisions deter 
superior offers. As a result, Campbell alleges that we have violated Sections 14(a) and 20(a) of the Exchange Act and 
Rule 14a-9 promulgated thereafter. The Company filed a motion to dismiss all claims, which motion was fully briefed 
on November 27, 2017. The Court granted the Company’s motion in full on May 3, 2018 and dismissed the lawsuit. 
The Eighth Circuit reversed the decision of the District Court and remanded the case back to the District Court. The 
parties filed a notice with the Court on May 22, 2019, announcing that they had reached a settlement in principle.  On 
June  21,  2019,  the  parties  filed  a stipulation  of  settlement,  in  which  defendants  are  released  from  all  claims  and 
expressly deny that that they have committed any act or omission giving rise to any liability.  The stipulation includes 
a settlement payment of $1.95 million, which will be primarily funded by our insurance.  On July 10, 2019, the Court 
entered an order preliminarily approving the settlement.  The settlement remains subject to final approval by the Court. 
The Company’s insurance policy includes a deductible of approximately $0.8 million and the Company has previously 
paid  approximately  $0.5  million  in  legal  fees  in  connection  with  the  litigation  which  have  been  applied  to  the 
deductible leaving approximately $0.3 million to be paid by the Company and approximately $1.7 million to be paid 
by the insurance company. During the third quarter of 2019, both the Company and the insurance company paid their 
respective amounts to an escrow account where the funds will be held until they are approved for distribution at a 
fairness hearing of the Court which took place on November 4, 2019. As of the date of this Annual Report on Form 
10-K, the Company is waiting for the Court to render its judgement which is still outstanding.  

On March 21, 2018, Bio-Rad Laboratories filed a lawsuit against us in the Superior Court Judicial Branch of 
the State of Connecticut for Summary Judgment in Lieu of Complaint requiring us to pay cash owed to Bio-Rad in 
the amount of $39,000 that was recorded in accounts payable within the accompanying consolidated balance sheet at 
December 31, 2018.  The obligation was paid in full during the second quarter 2019, resulting in no remaining amount 
due to Bio-Rad.  

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Item 4. Mine Safety Disclosures  

Not Applicable.  

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27  

28  

PART II  

Item 5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity 
Securities  

Market Information. Since June 30, 2017, the trading date following the consummation of the Merger, our 

common stock has traded on the NASDAQ Capital Market under the symbol “PRPO.”  

The following table sets forth the high and low closing prices for our common stock during each of the 

quarters of 2019 and 2018 as reported on the market exchange noted above.  

Quarter Ended March 31, 2020 
First Quarter (through March 25, 2020) 

      High 

      Low 

   $  2.29    $  0.68 

  
  
  
  
  
  
  
  
  
  
     
  
   
Year Ended December 31, 2019 
First Quarter 
Second Quarter 
Third Quarter 
Fourth Quarter 
Year Ended December 31, 2018 
First Quarter 
Second Quarter 
Third Quarter 
Fourth Quarter 

   $  3.90    $  1.83 
   $  9.15    $  1.89 
   $  4.08    $  2.18 
   $  2.60    $  1.81 

   $  19.50    $  7.15 
   $  8.19    $  5.43 
   $  7.58    $  4.92 
   $  6.03    $  2.25 

Performance Graph.   We are a smaller reporting company, as defined by Rule 12b-2 of the Exchange Act, 

and are not required to provide the information required under this item.  

Holders.    At  March  25,  2020,  there  were  8,870,129  shares  of  our  common  stock  outstanding  and 

approximately 57 holders of record.  

Dividends. No cash dividends have been paid on our common stock. We expect that any income received 
from operations will be devoted to our future operations and growth. We do not expect to pay cash dividends on our 
common stock in the near future. Payment of dividends would depend upon our profitability at the time, cash available 
for those dividends, and other factors as our board of directors may consider relevant. If we do not pay dividends, our 
common stock may be less valuable because a return on an investor’s investment will only occur if our stock price 
appreciates. Investors in our common stock should not rely on an investment in our company if they require dividend 
income.  

Issuer Purchases of Equity Securities.  We made no purchases of our common stock during the year ended 

December 31, 2019. Therefore, tabular disclosure is not presented.  

Recent Sales of Unregistered Securities.  Not applicable.  

Item 6. Selected Financial Data  

We are a smaller reporting company, as defined by Rule 12b-2 of the Securities Exchange Act of 1934, as 

amended, and are not required to provide the information required under this item.  

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29  

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations  

Forward-Looking Information  

This Annual Report on Form 10-K, including this Management’s Discussion and Analysis, contains forward-
looking  statements. These statements  are  based  on  management’s  current  views,  assumptions  or  beliefs  of  future 
events and financial performance and are subject to uncertainty and changes in circumstances. Readers of this report 
should understand that these statements are not guarantees of performance or results.  Many factors could affect our 
actual financial results and cause them to vary materially from the expectations contained in the forward-looking 
statements. These factors include, among other things: our expected revenue, income (loss), receivables, operating 
expenses,  supplier  pricing,  availability  and  prices  of  raw  materials,  insurance  reimbursements,  product  pricing, 
sources of funding operations and acquisitions, our ability to raise funds, sufficiency of available liquidity, future 
interest  costs,  future  economic  circumstances,  business  strategy,  industry  conditions,  our  ability  to  execute  our 
operating plans, the success of our cost savings initiatives, competitive environment and related market conditions, 
expected  financial  and  other  benefits  from  our  organizational  restructuring  activities, actions  of  governments and 

  
  
     
  
   
  
  
     
  
   
   
   
regulatory factors affecting our business, retaining key employees and other risks as described in our reports filed 
with the Securities and Exchange Commission. In some cases these statements  are identifiable through the use of 
words  such  as  “anticipate,”  “believe,”  “estimate,”  “expect,”  “intend,”  “plan,”  “project,”  “target,”  “can,”  “could,” 
“may,” “should,” “will,” “would” or the negative versions of these terms and other similar expressions.  

You are cautioned not to place undue reliance on these forward-looking statements. The forward-looking 
statements we make are not guarantees of future performance and are subject to various assumptions, risks and other 
factors that could cause actual results to differ materially from those suggested by these forward-looking statements. 
Actual  results  may  differ  materially  from  those  suggested  by  the  forward-looking  statements  that  we  make  for  a 
number of reasons, including those described in Part I, Item 1A, “Risk Factors,” of this Annual Report on Form 10-K.  

We expressly disclaim any obligation to update or revise any forward-looking statements, whether as a result 

of new information, future events or otherwise, except as required by law.  

Overview  

We are a cancer diagnostics company providing diagnostic products and services to the oncology market. 
We have built and continue to develop a platform designed to eradicate the problem of misdiagnosis by harnessing 
the  intellect,  expertise  and  technologies  developed  within  academic  institutions, and  delivering  quality  diagnostic 
information to physicians and their patients worldwide. We operate a cancer diagnostic laboratory located in New 
Haven, Connecticut and have partnered with various academic institutions to capture the expertise, experience and 
technologies  developed  within  academia  to  provide  a  better  standard  of  cancer  diagnostics  and  aim  to  solve  the 
growing problem of cancer misdiagnosis. We also operate a research and development facility in Omaha, Nebraska 
which focuses on development of various technologies, among them IV-Cell, HemeScreen and ICE-COLD-PCR, or 
ICP,  the  patented  technology  described  further  below,  which  we  exclusively  licensed  from  Dana-Farber  Cancer 
Institute,  Inc.,  or  Dana-Farber,  at  Harvard  University.  The  research  and  development  center  focuses  on  the 
development of these technologies, which we believe will enable us to commercialize these and other technologies 
developed with our current and future academic partners. The facility in Omaha was also recently certified as a CLIA 
and CAP facility, and we have begun bringing in house several molecular tests that the Company had previously 
referenced out to other laboratories. Our platform also connects patients, physicians and diagnostic experts residing 
within academic institutions.  

The following discussion should be read together with our financial statements and related notes contained 
in this Annual Report.  Results for the year ended December 31, 2019 are not necessarily indicative of results that 
may be attained in the future.  

Recent Developments  

On  March  16,  2020,  the  Company  announced  that  it  had  completed  a  non-cash  transaction  with  Poplar 
Healthcare to establish a strategic partnership that includes the acquisition of the customer base OncoMetrix, Poplar’s  

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30  

hematopathology  division.  Precipio  will  assume  responsibility  for  OncoMetrix’s  customer  base  and  associated 
revenues which should provide a substantial improvement to the Company’s laboratory economies of scale. As part 
of  the  transaction,  three  sales  representatives  of  OncoMetrix  have  transitioned  to  Precipio.  The  transition  of  the 
customer base involved no exchange of cash or equity with Poplar Healthcare.    

Going Concern  

The consolidated financial statements have been prepared using accounting principles generally accepted in 
the United States of America (“GAAP”) applicable for a going concern, which assume that the Company will realize 

   
its  assets  and  discharge  its  liabilities  in  the  ordinary  course  of  business.  The  Company  has  incurred  substantial 
operating losses and has used cash in its operating activities for the past several years. As of December 31, 2019, the 
Company had a net loss of $13.2 million, negative working capital of $2.5 million and net cash used in operating 
activities of $9.1 million. The Company’s ability to continue as a going concern over the next twelve months from 
the date the consolidated financial statements were issued is dependent upon a combination of achieving its business 
plan, including generating additional revenue, and raising additional financing to meet its debt obligations and paying 
liabilities arising from normal business operations when they come due.  

To meet its current and future obligations the Company has entered into a purchase agreement with Lincoln 
Park (the “LP Purchase Agreement” or “Equity Line”), pursuant to which Lincoln Park has agreed to purchase from 
the Company up to an aggregate of $10.0 million of common stock of the Company (subject to certain limitations) 
from time to time over the term of the LP Purchase Agreement. The extent we rely on Lincoln Park as a source of 
funding will depend on a number of factors including, the prevailing market price of our common stock and the extent 
to which we are able to secure working capital from other sources. As of the date the consolidated financial statements 
were issued, we have already received approximately $9.3 million in aggregate, including approximately $1.4 million 
from the sale of 328,590 shares of common stock to Lincoln Park during 2018, $6.6 million from the sale of 2,778,077 
shares of common stock to Lincoln Park during 2019 and $1.3 million from the sale of 900,012 shares of common 
stock to Lincoln Park from January 1, 2020 through the date the consolidated financial statements were issued, leaving 
the company an additional $0.7 million to draw upon.  

Notwithstanding the aforementioned circumstances, there remains substantial doubt about the Company’s 
ability to continue as a going concern for the next twelve months from the date the consolidated financial statements 
were  issued.  There  can  be  no  assurance  that  the  Company  will  be  able  to  successfully  achieve  its  initiatives 
summarized  above  in  order  to  continue  as  a  going  concern.  The  accompanying  financial  statements  have  been 
prepared assuming the Company will continue as a going concern and do not include any adjustments that might result 
should the Company be unable to continue as a going concern as a result of the outcome of this uncertainty.  

Results of Operations for the Years Ended December 31, 2019 and 2018  

Net Sales. Net sales were as follows:  

Dollars in Thousands 

Service revenue, net, less allowance for doubtful accounts 
Clinical research grants 
Other 
Net Sales 

Year Ended  
December 31,  

2019 

2018 

   $  3,083    $  2,751    $ 
100      
13      
   $  3,127    $  2,864    $ 

 —      
44      

Change 

      % 

$ 
332   
(100)   
31   
263   

12 % 
(100) % 
238 % 
 9 % 

Net sales for the year ended December 31, 2019 were $3.1 million, an increase of $0.3  million, or 9%, as 
compared to the same period in 2018.  During the year ended December 31, 2019, patient diagnostic service revenue 
had an increase of $0.9 million as compared to the same period in 2018 due to an increase in cases processed. We 
billed 1,672 cases during the year ended December 31, 2019 as compared to 1,345 cases during the same period in 
2018, or a 24% increase in cases. The increase in volume is the result of increased sales personnel.  This increase was 
offset by a  

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31  

decrease of $0.5 million in contract diagnostic service revenue and a decrease of $0.1 million in clinical research 
grants and other revenue for the year ended December 31, 2019 as compared to 2018.  

   
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
     
     
     
  
     
     
   
Cost of Sales. Cost of sales includes material and supply costs for the patient tests performed and other direct 
costs (primarily personnel costs and rent) associated with the operations of our laboratory and the costs of projects 
related to clinical research grants (personnel costs and operating supplies). Cost of sales increased by $0.3 million for 
the year ended December 31, 2019 as compared to the same period in 2018.   The increase included an increase in 
patient diagnostic costs offset by a decrease in contract diagnostic and clinical grant costs which are in line with the 
changes in related revenues discussed above.  

Gross Profit. Gross profit and gross margins were as follows:  

Gross Profit 

Dollars in Thousands 

Year Ended  
December 31,  

Margin % 

2019 

2018 

      2019 

2018 

   $ 

219    $ 

225   

 7 %   

 8 % 

Gross margin was 7% of total net sales, for the year ended December 31, 2019, compared to 8% of total net 
sales  for  the  same  period  in  2018  and the  gross  profit  was  approximately  $0.2  million  during  the year  ended 
December 31, 2019 and 2018, respectively.  

Operating Expenses. Operating expenses primarily consist of personnel costs, professional fees, travel costs, 
facility costs and depreciation and amortization, including any goodwill or intangible asset impairment.  Our operating 
expenses decreased by $2.9 million to $11.2 million for the year ended December 31, 2019 as compared to $14.1 
million for the year ended December 31, 2018. This decrease is the result of a decrease in goodwill and intangible 
asset impairment of $3.1 million, a decrease in legal and  other professional fees of $1.0 million and a decrease in 
amortization of acquired intangibles of $0.1 million. The decreases were partially offset by a $0.7 million increase  in 
sales and marketing costs, which is primarily increased personnel costs related to our increase in patient diagnostic 
service revenues, an increase of $0.2 million in stock compensation costs and an increase of $0.2 million in other 
general and administrative costs.  

 Other Income (Expense). Other expense, net was $2.3 million and $2.1 million for the year ended December 
31, 2019 and 2018, respectively, and included interest expense of $0.5 million and $0.3 million, respectively, income 
from  warrant  revaluations  of  $0.4  million  and  $1.9  million,  respectively, derivative  revaluations  expense  of  $0.4 
million and income of $0.3 million, respectively, a loss on modification of warrants $1.1 million and zero, respectively 
and a loss on litigation of $0.3 million and zero respectively. Additionally, the Company had a loss on issuance of 
convertible notes of $1.9 million and $1.3 million, respectively, gains on settlements of liabilities of $1.4 million and 
$0.3  million,  respectively,  and  a  loss  on  extinguishment  of  debt  of  less  than  $0.1  million  and  a  gain 
from extinguishment of debt of $0.4 million, respectively.  

During  the  year  ended  December  31  2018,  other  expense  also  included a  loss  on  extinguishment  of 

convertible notes of $2.9 million and a loss on settlement of equity instruments of $0.4 million.  

Liquidity and Capital Resources  

The consolidated financial statements have been prepared using accounting principles generally accepted in 
the United States of America (“GAAP”) applicable for a going concern, which assume that we will realize our assets 
and discharge our liabilities in the ordinary course of business. We have incurred substantial operating losses and have 
used cash in our operating activities for the past several years. For the year ended December 31, 2019, we had a net 
loss  of  $13.2  million  and  negative working  capital  of  $2.5  million.  Our  ability  to  continue  as  a  going  concern  is 
dependent upon a combination of achieving our business plan, including generating additional revenue, and raising 
additional financing to meet our debt obligations and paying liabilities arising from normal business operations when 
they come due.  

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32  

  
  
  
  
  
  
  
  
  
  
  
  
  
     
  
  
  
  
  
  
  
  
  
  
  
     
     
     
  
   
Our working capital positions at December 31, 2019 and 2018 were as follows:  

Dollars in Thousands 

Current assets (including cash of $848 and $381 respectively) 
Current liabilities 
Working capital 

     December 31, 2019      December 31, 2018       Change 
1,793    $ 
85 
   $ 
13,765      (9,431) 
(11,972)    $  9,516 

1,878    $ 
4,334      
(2,456)    $ 

   $ 

During  the  year  ended  December  31,  2019  we received  gross  proceeds  of  $6.6  million  from sale  of 
2,778,077 shares of our common stock, $1.6 million from the exercise of 310,200 warrants and $2.1 million from the 
issuance of convertible notes. We also converted $7.6 million of convertible notes, including interest, into 2,511,173 
shares of our common stock.  

Notwithstanding  the  aforementioned  circumstances,  there  remains  substantial  doubt  about  our  ability  to 
continue as a going concern for the next twelve months from the date the consolidated financial statements were 
issued.  There can be no assurance that we will be able to successfully achieve our initiatives summarized above in 
order to continue as a going concern. The accompanying financial statements have been prepared assuming we will 
continue as a going concern and do not include any adjustments that might result should we be unable to continue as 
a going concern as a result of the outcome of this uncertainty.  

Analysis of Cash Flows - Years Ended December 31, 2019 and 2018  

Net Change in Cash. Cash increased by $0.5 million during the year ended December 31, 2019, compared 

to a decrease of less than $0.1 million during the year ended December 31, 2018.  

Cash Flows Used in Operating Activities. The cash flows used in operating activities of $9.1 million during 
the year ended December 31, 2019 included a net loss of $13.2 million, an increase in accounts receivable of $0.8 
million, a decrease in accounts payable of $1.9 million and a decrease in operating lease liabilities of $0.2 million. 
These were partially offset by a decrease in other assets of $0.4 million and non-cash adjustments of $6.6 million. The 
non-cash adjustments to net loss include, among other things, depreciation and amortization, changes in provision for 
losses on doubtful accounts, warrant and derivative revaluations, stock based compensation, gains on settlements of 
liabilities, impairment of intangible assets and losses on the issuance of convertible notes.   The cash flows used in 
operating activities in the year ended December 31, 2018 included  net loss of $15.7 million, an increase in accounts 
receivable  of  $0.5  million  and  an  increase  in  inventories  of  less  than  $0.1  million.  These  were  partially  offset  a 
decrease in other assets of $0.1 million, an increase in accounts payable, accrued expenses and other liabilities of $0.6 
million and by non-cash adjustments of $8.8  million. The non-cash adjustments to net loss include, among other 
things, depreciation and amortization, impairment of goodwill, changes in provision for losses on doubtful accounts, 
warrant and derivative revaluations, stock based compensation, and gains or losses on settlements of liabilities or debt 
and extinguishments of debt and convertible notes.  

Cash Flows Used In Investing Activities. Cash flows used in investing activities were $0.1 million for the 

year ended December 31, 2019 and 2018, respectively, resulting from purchases of property and equipment.  

Cash  Flows  Provided  by  Financing  Activities.  Cash  flows  provided  by  financing  activities  totaled  $9.7 
million for the year ended December 31, 2019,  which included proceeds of $6.6 million from the issuance of common 
stock,  $1.6  million  from  the  exercise  of  warrants  and $2.1  million  from  the  issuance  of  convertible  notes.  These 
proceeds were partially offset by payments on our long-term debt and convertible notes of $0.5 million and payments 
for our finance lease obligations and deferred financing costs of approximately $0.1 million. Cash flows provided by 
financing  activities  totaled  $6.8  million  for  the year  ended  December 31,  2018,  which  included  proceeds  of  $2.0 
million from the issuance of common stock, $0.3 million from the issuance of long-term debt, $3.8 million from the 
issuance of convertible notes and $1.3 million from the exercise of warrants. These proceeds were partially offset by 
payments on our long-term debt of $0.4 million and payments for our capital lease obligations and deferred financing 
costs of $0.2 million.  

  
  
  
  
  
  
  
  
  
  
  
  
  
     
   
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33  

Off-Balance Sheet Arrangements  

At each of December 31, 2019 and December 31, 2018, we did not have any off-balance sheet arrangements 
that have or are reasonably likely to have a current or future effect on our financial condition, changes in financial 
condition, revenues or expenses, results of operations, liquidity, capital expenditures or capital resources.  

Contractual Obligations and Commitments  

At December 31, 2019, our contractual obligations and other commitments were as follows:  

Payments Due By Period 

(in thousands) 
Long term debt and convertible notes(1) 
Finance lease obligations(2) 
Operating lease obligations(2) 
Purchase obligations(3) 

More 
than 5 
Years 

Less 
Than 1 
Year 

1-3 

3-5 
Years 

Years       

   Total 
70    $  105 
70    $ 
   $ 2,676    $ 2,431    $ 
13 
55      
      200      
70      
62      
 — 
      583       242       289      
52      
     1,229       341       470       368      
50 
   $ 4,688    $ 3,076    $  899    $  545    $  168 

 (1)    See Note 5 - "Long-Term Debt" and Note  6 – “Convertible Notes” to our accompanying consolidated financial 

statements included with this Annual Report on Form 10-K. 

 (2)    See Note 8 -  "Leases" to our accompanying consolidated financial statements included with this Annual Report 
 (3)    These amounts represent purchase commitments, including all open purchase orders. 

on Form 10-K. 

Critical Accounting Policies and Estimates  

The following discussion and analysis of financial condition and results of operations are based upon the 
Company’s consolidated financial statements, which have been prepared in conformity with accounting principles 
generally accepted in the United States of America. The Company’s significant accounting policies are more fully 
described in Note 2 of the notes to Consolidated Financial Statements included with this Annual Report on Form 10-
K. Certain accounting estimates are particularly important to the understanding of the Company’s financial position 
and results of operations and require the application of significant judgment by the Company’s management and can 
be materially affected by changes from period to period in economic factors or conditions that are outside the control 
of management. The Company’s management uses its judgment to determine the appropriate assumptions to be used 
in the determination of certain estimates. Those estimates are based on historical operations, future business plans and 
projected  financial  results,  the  terms  of  existing  contracts,  the  observance  of  trends  in  the  industry,  information 
provided by customers and information available from other outside sources, as appropriate. The following discusses 
the Company’s critical accounting policies and estimates:  

Revenue Recognition  

The  Company  derives  its  revenues  from  diagnostic  testing  -  histology,  flow  cytometry,  cytology  and 
molecular testing; clinical research from bio-pharma customers, state and federal grant programs; and from biomarker 
testing from bio-pharma customers.  

Service  revenues  are  comprised  of  patient  diagnostic  services  for  cancer  as  well  as  contract  diagnostic 
services for pharmacogenomics trials.    Service revenue is recognized upon completion of the testing process and 
when  the  diagnostic  result  is  delivered  to  the  ordering  physician  and/or  customer.   Net  patient  service  revenue  is 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
     
     
     
     
  
 
   
reported at the estimated net realizable amounts from patients, third-party payers and others for services rendered, 
including retroactive adjustment under reimbursement agreements with third-party payers. Revenue under third-party 
payer agreements is  

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34  

subject to audit and retroactive adjustment. Provisions for third-party payer settlements are provided in the period in 
which the related services are rendered and adjusted in the future periods, as final settlements are determined.  

Revenue  from  clinical  research  grant  is  recognized  over  time  as  the  service  is  being  performed using  a 
proportional performance method. The Company uses an "efforts based" method of assessing performance. If the 
arrangement requires the performance of a specified number of similar acts (i.e. test), then revenue is recognized in 
equal amounts as each act is completed.  

Other revenues are comprised of the Company’s ICP technology kits sales to bio-pharma customers and 

contracted project based technology evaluations.  

For the year ended December 31, 2019, service revenue represented 99% of our consolidated revenues and 
other revenues represented 1%.    There was no revenue attributable to clinical grants during 2019. For the year ended 
December  31,  2018,   service  revenue  represented  96%  of  our  consolidated  revenues,  the  revenue  attributable  to 
clinical grants represented 3%  and other revenues represented 1%.  

Allowance for Contractual Discounts  

We are reimbursed by payers for services we provide. Payments for services covered by payers average less 
than billed charges. We monitor revenue and receivables from payers and record an estimated contractual allowance 
for certain revenue and receivable balances as of the revenue recognition date to properly account for anticipated 
differences  between  amounts  estimated  in  our  billing  system  and  amounts  ultimately  reimbursed  by  payers. 
Accordingly,  the  total  revenue  and  receivables  reported  in  our  financial  statements  are  recorded  at  the  amounts 
expected to be received from these payers. For service revenue, the contractual allowance is estimated based on several 
criteria, including unbilled claims, historical trends based on actual claims paid, current contract and reimbursement 
terms and changes in customer base and payer/product mix. The billing functions for the remaining portion of our 
revenue are contracted and fixed fees for specific services and are recorded without an allowance for contractual 
discounts.  

Allowance for Doubtful Accounts  

The allowance for doubtful accounts is based on estimates of losses related to receivable balances. The risk 
of collection varies based upon the service, the payer (commercial health insurance and government) and the patient’s 
ability to pay the amounts not reimbursed by the payer. We estimate the allowance for doubtful accounts based upon 
several factors including the age of the outstanding receivables, the historical experience of collections, adjusting for 
current  economic  conditions  and,  in  some  cases,  evaluating  specific  customer  accounts  for  the  ability  to  pay. 
Collection  agencies  are  employed  and  legal  action  is  taken  when  we  determine  that  taking  collection  actions  is 
reasonable relative to the probability of receiving payment on amounts owed. Management judgment is used to assess 
the  collectability  of  accounts  and  the  ability  of  our  customers  to  pay.  Judgment  is  also  used  to  assess  trends  in 
collections and the effects of systems and business process changes on our expected collection rates. We review the 
estimation process quarterly and make changes to the estimates as necessary. When it is determined that a customer 
account is uncollectible, that balance is written off against the existing allowance.  

Accounts Receivable  

Accounts Receivable results from diagnostic services provided to self-pay and insured patients, project based 
testing services and clinical research.  The services provided by the Company are generally due within 30 days from 
the  invoice  date.   Accounts  receivable  are  reduced  by  an  allowance  for  doubtful  accounts.  In  evaluating  the 
collectability of accounts receivable, the Company analyzes and identifies trends for each of its sources of revenue to 
estimate the appropriate allowance for doubtful accounts. For receivables associated with self-pay patients, including 
patients with insurance and a deductible and copayment, the Company records an allowance for doubtful accounts in 
the period of services on the basis of past experience of patients unable or unwilling to pay for service fee for which 
they  are  financially  responsible.  For  receivables  associated  with  services  provided  to  patients  with  third-party 
coverage, the Company analyzes contractually due amounts and provides an allowance, if necessary. The difference 
between  the  standard  rates  and  the  amounts  actually  collected  after  all  reasonable  collection  efforts  have  been 
exhausted is charged  

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35  

against  the  allowance  for  doubtful  accounts.   Service  revenues  account  for  all  reported  accounts  receivable  as  of 
December 31, 2019 and 2018.  

Stock-Based Compensation  

Stock-based compensation cost is measured at the grant date, based on the estimated fair value of the award, 
and is recognized as expense over the grantee’s requisite vesting period on a straight-line basis. For the purpose of 
valuing stock options granted to our employees, directors and officers, we use the Black-Scholes option pricing model. 
We granted options to purchase an aggregate of 292,604 and 224,365 shares of common stock during the years ended 
December 31, 2019 and 2018, respectively. To determine the risk-free interest rate, we utilized the U.S. Treasury 
yield curve in effect at the time of the grant with a term consistent with the expected term of our awards. The expected 
term of the options granted is in accordance with Staff Accounting Bulletins 107 and 110, and is based on the average 
between vesting terms and contractual terms. The expected dividend yield reflects our current and expected future 
policy for dividends on our common stock. The expected stock price volatility for our stock options was calculated 
by examining the trading history for our common stock. We will continue to analyze the expected stock price volatility 
and expected term assumptions and will adjust our Black-Scholes option pricing assumptions as appropriate  

Impairment of Long-Lived Assets and Goodwill  

We assess the recoverability of our long-lived assets, which include property and equipment and definite-
lived  intangible  assets,  whenever  significant  events  or  changes  in  circumstances  indicate  impairment  may  have 
occurred. If indicators of impairment exist, projected future undiscounted cash flows associated with the asset are 
compared to our carrying amount to determine whether the asset’s value is recoverable. Any resulting impairment is 
recorded as a reduction in the carrying value of the related asset in excess of fair value and a charge to operating 
results. We did not recognize any impairment charges related to definite-lived intangible assets for the years ending 
December 31, 2019 and 2018. During the year ended December 31, 2019, we recorded impairment of $1.6 million 
related to in-process research and development which had been accounted for as an indefinite-lived intangible asset.  

Goodwill is not amortized, but is assessed for impairment on an annual basis or more frequently if impairment 
indicators exist. We have the option to perform a qualitative assessment of goodwill to determine whether it is more 
likely than not that the fair value of its reporting unit is less than its carrying amount, including goodwill and other 
intangible assets. If we were to conclude that this is the case, then we must perform a goodwill impairment test by 
comparing the fair value of the reporting unit to its carrying value. An impairment charge is recorded to the extent the 
reporting unit’s carrying value exceeds its fair value, with the impairment loss recognized not to exceed the total 
amount of goodwill allocated to that reporting unit. For the year ended December 31, 2018, goodwill impairment 
charges were $4.7 million, resulting in no goodwill outstanding at December 31, 2019 and 2018.  

Recently Adopted Accounting Pronouncements  

In  February 2016,  the  FASB  issued  ASU  No. 2016-02, Leases-Topic  842.  The  new standard  amends  the 
recognition of lease assets and lease liabilities by lessees for those leases currently classified as operating leases and 
amends  disclosure  requirements  associated  with  leasing  arrangements.  The  new  standard  was  adopted,  effective 
January 1, 2019, using a modified retrospective transition, and thus did not adjust comparative periods. The new 
standard provides a number of optional practical expedients in transition.  The Company has elected the “package of 
practical  expedients”,  which  permits  it  not  to  reassess  under  the  new  standard  its  prior  conclusions  about  lease 
identification, lease classification and initial direct costs.  The Company did not elect the use-of-hindsight practical 
expedient. As a result of the adoption of Topic 842 the Company recognized approximately $0.7 million of lease 
liabilities  and  corresponding  right-of-use  (“ROU”)  assets  in  its  consolidated  balance  sheet  on  the  date  of  initial 
application. See Note 8 – Leases for additional information, included with this Annual Report on Form 10-K.  

In June 2018, the FASB issued ASU 2018-07 “Compensation—Stock Compensation (Topic 718)”, which 
expands the scope of Topic 718 to include share based payment transactions for acquiring goods and services from 
non-employees. The Company adopted this guidance on January 1, 2019. The adoption of  this guidance was not 
material to our consolidated financial statements.  

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36  

Recently Accounting Pronouncements Not Yet Adopted  

In June 2016, the FASB issued ASU 2016-13 “Measurement of Credit Losses on Financial Instruments”, 
which  replaces  current  methods  for  evaluating  impairment  of  financial  instruments  not  measured  at  fair  value, 
including trade accounts receivable and certain debt securities, with a current expected credit loss model. This ASU 
is effective for the Company for reporting periods beginning after December 15, 2022. We are currently assessing the 
potential impact that the adoption of this ASU will have on our consolidated financial statements  

In August 2018, the FASB issued ASU 2018-15 “Intangibles—Goodwill and Other—Internal Use Software 
(Subtopic  350-40)”,  which  aligns  the  requirements  for  capitalizing  implementation  costs  incurred  in  a  cloud 
computing hosting arrangement that is a service contract with the requirements for capitalizing implementation costs 
incurred  to  develop  or  obtain  internal  use  software.  This  ASU  is  effective  for  reporting  periods  beginning  after 
December 15, 2019. We are currently assessing the potential impact that the adoption of this ASU will have on our 
consolidated financial statements.  

In August 2018, the FASB issued ASU 2018-13 “Fair Value Measurement (Topic 820)”, which modifies 
certain disclosure requirements in Topic 820, such as the removal of the need to disclose the amount of and reason 
for transfers between Level 1 and Level 2 of the fair value hierarchy, and several changes related to Level 3 fair value 
measurements. This ASU is effective for reporting periods beginning after December 15, 2019. We are currently 
assessing the potential impact that the adoption of this ASU will have on our consolidated financial statements.  

In December 2019, the FASB issued ASU 2019-12 “Income Taxes (Topic 740): Simplifying the Accounting 
for Income Taxes”, which is intended to improve consistent application and simplify the accounting for income taxes. 
This  ASU  removes  certain  exceptions  to  the  general  principles  in  Topic  740  and  clarifies  and  amends  existing 
guidance. This standard is effective for annual reporting periods beginning after December 15, 2020, including interim 
reporting periods within those annual reporting periods, with early adoption  permitted. The Company is currently 
evaluating the impact of adoption of this ASU and does not expect the adoption of this new standard to have a material 
impact on its consolidated financial statements.  

Impact of Inflation  

We do not believe that price inflation or deflation had a material adverse effect on our financial condition or 

results of operations during the periods presented.  

Item 7A. Quantitative and Qualitative Disclosure about Market Risk  

We are a smaller reporting company, as defined by Rule 12b-2 of the Securities Exchange Act of 1934, as 

amended, and are not required to provide the information required under this item.  

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37  

Item 8. Financial Statements and Supplementary Data  

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM  

To the Stockholders and Board of Directors of  
Precipio, Inc.  

Opinion on the Financial Statements  

We have audited the accompanying consolidated balance sheets of Precipio, Inc. (the “Company”) as of December 31, 
2019 and 2018, the related consolidated statements of operations, stockholders’ equity and cash flows for each of the two years in 
the period ended December 31, 2019, and the related notes (collectively referred to as the “consolidated financial statements”). In 
our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company as 
of December 31, 2019 and 2018, and the results of its operations and its cash flows for each of the two years in the period ended 
December 31, 2019, in conformity with accounting principles generally accepted in the United States of America.  

Explanatory Paragraph – Going Concern  

The accompanying consolidated financial statements have been prepared assuming that the Company will continue as a 
going  concern.  As  more  fully  described  in  Note 1,  the  Company  has  a  significant  working  capital  deficiency,  has  incurred 
significant  losses  and  needs  to  raise  additional  funds  to  meet  its  obligations  and  sustain  its  operations.  These  conditions  raise 
substantial doubt about the Company’s ability to continue as a going concern. Management’s plans in regard to these matters are 
also described in Note 1. The consolidated financial statements do not include any adjustments that might result from the outcome 
of this uncertainty.  

Adoption of New Accounting Standards  

As discussed in Note 2 to the consolidated financial statements, the Company has changed its method of accounting for 
leases in 2019 due to the adoption of ASU No. 2016-12, Leases (Topic 842), as amended, effective January 1, 2019, using the 
modified retrospective approach.  

Basis for Opinion  

These consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to 
express  an  opinion  on  the  Company’s  consolidated  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  

We have served as the Company’s auditor since 2016.  

38  

PRECIPIO, INC. AND SUBSIDIARY  
CONSOLIDATED BALANCE SHEETS  
December 31, 2019 and 2018  
(Dollars in thousands, except share data)  

Hartford, CT  

March 27, 2020  

Table of Contents  

ASSETS 
CURRENT ASSETS: 

Cash 
Accounts receivable, net 
Inventories 
Other current assets 
Total current assets 

PROPERTY AND EQUIPMENT, NET 

OTHER ASSETS: 

Operating lease right-of-use assets 
Intangibles, net 
Other assets 

Total assets 

LIABILITIES AND STOCKHOLDERS’ EQUITY 
CURRENT LIABILITIES: 

Current maturities of long-term debt, less debt issuance costs 
Current maturities of convertible notes, less debt discounts and debt issuance costs 
Current maturities of finance lease liabilities 
Current maturities of operating lease liabilities 
Accounts payable 
Accrued expenses 
Deferred revenue 
Other current liabilities 
Total current liabilities 
LONG TERM LIABILITIES: 

Long-term debt, less current maturities and debt issuance costs 
Finance lease liabilities, less current maturities 
Operating lease liabilities, less current maturities 
Common stock warrant liabilities 
Derivative liabilities 
Deferred tax liability 
Other long-term liabilities 

Total liabilities 

COMMITMENTS AND CONTINGENCIES (Note 9) 
STOCKHOLDERS’ EQUITY: 

$ 

  $ 

$ 

2019 

2018 

  $ 

  $ 

  $ 

848 
574 
184 
272 
1,878 

431 

519 
16,658 
25 
19,511 

321 
142 
52 
209 
1,936 
1,639 
35 
 — 
4,334 

198 
119 
317 
1,338 
 — 
 — 
 — 
6,306 

381 
690 
197 
525 
1,793 

496 

 — 
19,291 
25 
21,605 

263 
4,377 
57 
 — 
5,169 
1,940 
49 
1,910 
13,765 

253 
155 
 — 
1,132 
62 
70 
45 
15,482 

  
  
  
  
  
  
  
  
     
     
  
    
       
  
    
       
  
  
  
    
  
  
    
  
  
    
    
    
  
  
  
       
  
  
  
    
  
  
  
       
  
  
  
       
  
  
  
    
  
  
    
  
  
    
  
  
       
  
  
  
       
  
  
  
  
    
  
  
    
  
  
    
  
  
    
  
  
    
  
  
    
  
  
    
    
    
  
  
       
  
  
  
    
  
  
    
  
  
    
  
  
    
  
  
    
  
  
    
  
  
    
    
    
    
       
  
  
  
       
  
Preferred stock - $0.01 par value, 15,000,000 shares authorized at December 31, 2019 
and December 31, 2018, 47 shares issued and outstanding at December 31, 2019 and 
December 31, 2018, liquidation preference of $42 at December 31, 2019 
Common stock, $0.01 par value, 150,000,000 shares authorized at December 31, 2019 
and December 31, 2018, 7,898,117 and 2,298,738 shares issued and outstanding at 
December 31, 2019 and December 31, 2018, respectively 
Additional paid-in capital  
Accumulated deficit 

Total stockholders’ equity 
Total liabilities and stockholders’ equity 

 — 

 — 

79 
74,065 
(60,939)      
13,205 
19,511 

  $ 

23 
53,796 
(47,696) 
6,123 
21,605 

$ 

See notes to consolidated financial statements.  

Table of Contents  

39  

PRECIPIO, INC. AND SUBSIDIARY  
CONSOLIDATED STATEMENTS OF OPERATIONS  
For the Years Ended December 31, 2019 and 2018  
(Dollars in thousands, except per share data)  

SALES: 

Service revenue, net 
Clinical research grants 
Other 
Revenue, net of contractual allowances and adjustments 
less allowance for doubtful accounts 
Net sales 

COST OF SALES: 
Service revenue 
Clinical research grants 
Total cost of sales 
Gross profit 

OPERATING EXPENSES: 

Operating expenses 
Impairment of intangible assets and goodwill 

TOTAL OPERATING EXPENSES 
OPERATING LOSS 
OTHER INCOME (EXPENSE): 

Interest expense, net 
Warrant revaluation 
Loss on modification of warrants 
Derivative revaluation 
Gain on settlement of liability, net 
(Loss) gain on extinguishment of debt 
Loss on extinguishment of convertible notes 
Loss on litigation 
Loss on issuance of convertible notes 
Loss on settlement of equity instruments 
Total other expenses 

LOSS BEFORE INCOME TAXES 
INCOME TAX BENEFIT 
NET LOSS 

  $ 

2019 

2018 

4,051    $ 
 —      
44      
4,095      
(968)      
3,127      

2,908      
 —      
2,908      
219      

3,335 
100 
13 
3,448 
(584) 
2,864 

2,549 
90 
2,639 
225 

9,623      
1,590      
11,213      
(10,994)      

9,452 
4,685 
14,137 
(13,912) 

(473)      
416      
(1,128)      
(415)      
1,437      
(20)      
 —      
(266)      
(1,870)      
 —      
(2,319)      
(13,313)      
70      
(13,243)      

(269) 
1,918 
 — 
267 
263 
376 
(2,903) 
 — 
(1,328) 
(385) 
(2,061) 
(15,973) 
279 
(15,694) 

  
  
    
  
  
    
  
  
    
  
  
    
    
  
   
  
  
  
  
  
  
  
  
  
  
     
  
  
  
     
    
        
   
    
    
    
    
    
    
        
   
    
    
    
    
    
        
   
    
    
    
    
    
        
   
    
    
    
    
    
    
    
    
    
    
    
    
    
    
  
      
       
Deemed dividends related to beneficial conversion feature of preferred stock and fair value of 
consideration issued to induce conversion of preferred stock 
TOTAL DIVIDENDS 
NET LOSS AVAILABLE TO COMMON STOCKHOLDERS 

BASIC AND DILUTED LOSS PER COMMON SHARE  
BASIC AND DILUTED WEIGHTED-AVERAGE SHARES OF COMMON STOCK 
OUTSTANDING  

 —      
 —      
(13,243)    $ 

(4,222) 
(4,222) 
(19,916) 

(2.33)    $ 

(13.82) 

  $ 

  $ 

    5,695,159      1,441,113 

See notes to consolidated financial statements.  

Table of Contents  

40  

PRECIPIO, INC. AND SUBSIDIARY  
CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY  
For the Years Ended December 31, 2019 and 2018  
(Dollars in thousands)  

Preferred Stock 

Common Stock 

   Additional      

   Outstanding    Par       Outstanding       Par     Paid-in     Accumulated      
      Shares 

     Value       Capital        Deficit 

     Value       Shares 

      Total 

Balance, January 1, 2018 

Net loss 
Conversion of preferred stock into common 
stock 
Conversion of convertible notes into common 
stock 
Issuance of common stock in connection with 
purchase agreements 
Issuance of common stock in exchange for 
cancelation of other current liabilities 
Issuance of common stock upon exercise of 
warrants 
Issuance of common stock for consulting 
services 
Warrant modification recorded as debt 
discount in conjunction with convertible note 
issuance 
Beneficial conversion feature on issuance of 
convertible notes 
Write-off beneficial conversion feature in 
conjunction with convertible note 
extinguishment 
Write-off debt discounts (net of debt 
premiums) in conjunction with convertible 
note conversions 
Write-off debt derivative liability in 
conjunction with convertible note conversions   
Liability recorded related to equity purchase 
agreement repricing 
Non-cash stock-based compensation 

Balance, December 31, 2018 

Net loss 
Conversion of convertible notes into common 
stock 

4,935    $  —   
 —        —   

679,774    $   7     $  44,560     $ 
 —       

 —        —       

(31,542)    $ 13,025 
(15,694)      (15,694) 

(4,888)        —   

431,022      

 4       

(4)      

 —      

 — 

 —        —   

384,896      

 4        2,352       

 —       2,356 

 —        —   

428,050      

 5        2,003       

 —       2,008 

 —        —   

120,983      

 1        1,896       

 —       1,897 

 —        —   

252,486      

 2        1,269       

 —       1,271 

 —        —   

1,527        —       

39       

 —      

39 

 —        —   

 —        —       

11       

 —      

11 

 —        —   

 —        —        2,118       

 —       2,118 

 —        —   

 —        —        (1,029)      

 —       (1,029) 

 —        —   

 —        —       

(210)      

 —      

(210) 

 —        —   

 —        —       

301       

 —      

301 

 —        —   
 —        —   
47    $  —    2,298,738 
 —        —   

 —        —       
 —        —       

 —       
490       
  $  23     $  53,796     $ 
 —       

 —        —       

(460)      
 —      

(460) 
490 
(47,696)    $  6,123 
(13,243)      (13,243) 

 —        —    2,511,173       25        7,528       

 —       7,553 

    
    
  
      
       
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
     
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
Issuance of common stock in connection with 
purchase agreements 
Proceeds upon issuance of common stock 
from exercise of warrants 
Write-off warrant liability in conjunction with 
warrant exercises 
Beneficial conversion feature on issuance of 
convertible notes 
Write-off debt discounts (net of debt 
premiums) in conjunction with convertible 
note conversions 
Write-off debt derivative liability in 
conjunction with convertible note conversions   
Non-cash stock-based compensation 
Payment of fractional common shares in 
conjunction with reverse stock split 

Balance, December 31, 2019 

 —        —    2,778,077       28        6,600       

 —       6,628 

 —        —   

310,200      

 3        1,572       

 —       1,575 

 —        —   

 —        —        2,364       

 —       2,364 

 —        —   

 —        —        1,792       

 —       1,792 

 —        —   

 —        —       

(731)      

 —      

(731) 

 —        —   
 —        —   

 —        —       
 —        —       

477       
668       

 —      
 —      

477 
668 

 —        —   
47    $  —    7,898,117 

(71)        —       

(1)      
  $  79     $  74,065     $ 

 —      

(1) 
(60,939)    $ 13,205 

See notes to consolidated financial statements.  

Table of Contents  

41  

PRECIPIO, INC. AND SUBSIDIARY  
CONSOLIDATED STATEMENTS OF CASH FLOWS  
For the Years Ended December 31, 2019 and 2018  
(Dollars in thousands)  

CASH FLOWS FROM OPERATING ACTIVITIES: 

Net loss 

2019 

2018 

   $ 

(13,243)    $ 

(15,694) 

Adjustments to reconcile net loss to net cash flows used in operating activities: 

Depreciation and amortization 
Amortization of operating lease right-of-use asset 
Amortization of finance lease right-of-use asset 
Amortization (accretion) of deferred financing costs, debt discounts and debt premiums   
Loss (gain) on extinguishment of debt 
Gain on settlement of liability, net 
Loss on settlement of equity instrument 
Loss on litigation 
Loss on issuance of convertible notes 
Loss on extinguishment of convertible notes 
Stock-based compensation 
Impairment of intangible assets and goodwill 
Provision for losses on doubtful accounts 
Warrant revaluation 
Loss on modification of warrants 
Derivative revaluation  

Changes in operating assets and liabilities: 

Accounts receivable 
Inventories 
Other assets 
Accounts payable 
Operating lease liabilities 
Accrued expenses and other liabilities 
Net cash used in operating activities 

1,118   
231   
63   
111   
20   
(1,437)   
 —   
266   
1,870   
 —   
668   
1,590   
966   
(416)   
1,128   
415   

(850)   
13   
427   
(1,884)   
(223)   
26   
(9,141)   

1,265 
 — 
 — 
(21) 
(376) 
(263) 
385 
 — 
1,328 
2,903 
529 
4,685 
581 
(1,918) 
 — 
(267) 

(541) 
(36) 
127 
309 
 — 
250 
(6,754) 

  
  
  
  
  
  
  
  
   
  
  
  
  
  
  
  
  
     
     
  
     
  
     
  
  
     
  
     
  
  
     
  
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
     
  
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
CASH FLOWS FROM INVESTING ACTIVITIES: 

Purchase of property and equipment 

Net cash used in investing activities 

CASH FLOWS FROM FINANCING ACTIVITIES: 
Principal payments on finance lease obligations 
Payment of deferred financing costs 
Payment of fractional common shares in conjunction with reverse stock split  
Issuance of common stock, net of issuance costs 
Proceeds from exercise of warrants 
Proceeds from long-term debt 
Proceeds from convertible notes 
Principal payments on convertible notes 
Principal payments on long-term debt 

Net cash flows provided by financing activities 

NET CHANGE IN CASH 
CASH AT BEGINNING OF PERIOD 
CASH AT END OF PERIOD 

(55)   
(55)   

(46)   
(120)   
(1)   
6,628   
1,575   
 —   
2,150   
(50)   
(473)   
9,663   
467   
381   
848    $ 

(97) 
(97) 

(58) 
(138) 
 — 
2,008 
1,271 
300 
3,850 
 — 
(422) 
6,811 
(40) 
421 
381 

   $ 

See notes to consolidated financial statements.  

Table of Contents  

42  

PRECIPIO, INC. AND SUBSIDIARY  
CONSOLIDATED STATEMENTS OF CASH FLOWS - continued  
For the Years Ended December 31, 2019 and 2018  

(Dollars in thousands)  

SUPPLEMENTAL CASH FLOW INFORMATION 

Cash paid during the period for interest 

SUPPLEMENTAL DISCLOSURE OF CONSULTING SERVICES OR ANY OTHER 
NON-CASH COMMON STOCK RELATED ACTIVITY 
Purchases of equipment financed through accounts payable 
Equipment financed through finance lease obligations 
Deferred debt issuance cost financed through accounts payable 
Discount of 9% on issuance of convertible bridge notes 
Other current liabilities canceled in exchange for common shares 
Conversion of convertible debt plus interest into common stock 
Beneficial conversion feature on issuance of convertible notes 
Initial valuation of derivative liability recorded in conjunction with issuance of convertible 
notes 
Initial valuation of warrant liability recorded in conjunction with issuance of convertible 
notes 
Long-term debt exchanged for convertible notes 
Liabilities exchanged for convertible notes 
Prepaid insurance financed with loan 
Accounts payable converted to long-term debt 
Liability recorded related to equity purchase agreement repricing 
Warrant liability canceled due to settlement of equity instruments 
Issuance of common stock for consulting services 
Modification of warrant in conjunction with convertible note issuance 
Proceed from issuance of convertible note recorded through other current assets 

2019 

2018 

   $ 

36    $ 

42 

 1   
23   
 —   
188   
 —   
7,553   
1,792   

 —   

1,858   
 —   
2,150   
434   
 —   
 —   
 —   
 —   
 —   
 —   

38 
106 
57 
405 
1,897 
2,356 
2,118 

610 

2,665 
3,191 
 — 
375 
74 
460 
456 
39 
11 
250 

  
  
     
  
   
  
  
  
  
  
  
  
  
     
  
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
   
   
   
   
   
  
  
  
  
  
  
  
  
  
     
  
  
    
  
  
  
  
     
  
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
Write-off of beneficial conversion feature in conjunction with convertible note 
extinguishment 
Right-of-use assets obtained in exchange for lease obligations 
Amounts included in measurement of lease liabilities 
Write-off warrant liability in conjunction with warrant exercises 
Write-off of debt discounts (net of debt premiums) in conjunction with convertible note 
conversions 
Write-off of derivative liability in conjunction with convertible note conversions 

 —   
750   
273   
2,364   

731   
477   

1,029 
 — 
 — 
 — 

210 
310 

See notes to consolidated financial statements.  

Table of Contents  

43  

PRECIPIO, INC. AND SUBSIDIARY  
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS  
For the Years Ended December 31, 2019 and 2018  

1. BUSINESS DESCRIPTION  

Business Description.  

Precipio, Inc., and its subsidiary, (collectively, “we”, “us”, “our”, the “Company” or “Precipio”) is a cancer 
diagnostics company providing diagnostic products and services to the oncology market. We have built and continue 
to develop a platform designed to eradicate the problem of misdiagnosis by harnessing the intellect, expertise and 
technologies developed within academic institutions, and delivering quality diagnostic information to physicians and 
their patients worldwide. We operate a cancer diagnostic laboratory located in New Haven, Connecticut and have 
partnered with various academic institutions to capture the expertise, experience and technologies developed within 
academia  to  provide  a  better  standard  of  cancer  diagnostics  and  aim  to  solve  the  growing  problem  of  cancer 
misdiagnosis.  We  also  operate  a  research  and  development  facility  in  Omaha,  Nebraska  which  focuses  on 
development of various technologies, among them IV-Cell, HemeScreen and ICE-COLD-PCR, or ICP, the patented 
technology described further below, which we exclusively licensed from Dana-Farber Cancer Institute, Inc., or Dana-
Farber, at Harvard University. The research and development center focuses on the development of these technologies, 
which we believe will enable us to commercialize these and other technologies developed with our current and future 
academic partners. The facility in Omaha was also recently certified as a CLIA and CAP facility, and we have begun 
bringing in house several molecular tests that the Company had previously referenced out to other laboratories. Our 
platform also connects patients, physicians and diagnostic experts residing within academic institutions.  

Going Concern.  

The consolidated financial statements have been prepared using accounting principles generally accepted in 
the United States of America (“GAAP”) applicable for a going concern, which assume that the Company will realize 
its  assets  and  discharge  its  liabilities  in  the  ordinary  course  of  business.  The  Company  has  incurred  substantial 
operating losses and has used cash in its operating activities for the past several years. As of December 31, 2019, the 
Company had a net loss of $13.2 million, negative working capital of $2.5 million and net cash used  in operating 
activities of $9.1 million. The Company’s ability to continue as a going concern, for the next twelve months from the 
date the consolidated financial statements were issued, is dependent upon a combination of achieving its business 
plan, including generating additional revenue, and raising additional financing to meet its debt obligations and paying 
liabilities arising from normal business operations when they come due.  

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
   
   
   
   
   
To meet its current and future obligations the Company has entered into a purchase agreement with Lincoln 
Park (the “LP Purchase Agreement” or “Equity Line”), pursuant to which Lincoln Park has agreed to purchase from 
the Company up to an aggregate of $10.0 million of common stock of the Company (subject to certain limitations) 
from time to time over the term of the LP Purchase Agreement. The extent we rely on Lincoln Park as a source of 
funding will depend on a number of factors including, the prevailing market price of our common stock and the extent 
to  which  we  are  able  to  secure  working  capital  from  other  sources.  As  of  the  date  of  the  consolidated  financial 
statements were issued, we have already received approximately $9.3 million in aggregate, including approximately 
$1.4 million from the sale of 328,590 shares of common stock to Lincoln Park during 2018, $6.6 million from the 
sale of 2,778,077 shares of common stock to Lincoln Park during 2019 and $1.3 million from the sale of 900,012 
shares of common stock to Lincoln Park from January 1, 2020 through the date the consolidated financial statements 
were issued, leaving the company an additional $0.7 million to draw upon.  

Notwithstanding the aforementioned circumstances, there remains substantial doubt about the Company’s 
ability to continue as a going concern for the next twelve months from the date the consolidated financial statements 
were  issued.  There  can  be  no  assurance  that  the  Company  will  be  able  to  successfully  achieve  its  initiatives 
summarized  above  in  order  to  continue  as  a  going  concern.  The  accompanying  financial  statements  have  been 
prepared assuming the Company will continue as a going concern and do not include any adjustments that might result 
should the Company be unable to continue as a going concern as a result of the outcome of this uncertainty.  

Table of Contents  

44  

2. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES  

Principles of Consolidation.  

The  consolidated  financial  statements  include  the  accounts  of  Precipio, Inc.  and  our  wholly  owned 

subsidiaries. All inter-company balances and transactions have been eliminated in consolidation.  

Use of Estimates.  

The preparation of the consolidated financial statements in conformity with GAAP requires management to 
make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent 
assets and liabilities at the date of the financial statements and the reported amounts of net sales and expenses during 
the  reporting  period.  The  most  significant  estimates  and  assumptions  with  regard  to  these  consolidated  financial 
statements relate to the allowance for doubtful accounts, assumptions used within the fair value of debt and equity 
transactions, contractual allowances and related impairments. These assumptions require considerable judgment  by 
management. Actual results could differ from the estimates and assumptions used in preparing these consolidated 
financial statements.  

Risks and Uncertainties.  

Certain risks and uncertainties are inherent in our day-to-day operations and in the process of preparing our 
financial  statements.  The  more  significant  of  those  risks  are  presented  below  and  throughout  the  notes  to  the 
consolidated financial statements.  

The  Company  operates  in  the  healthcare  industry  which  is  subject  to  numerous  laws  and  regulations  of 
federal, state and local governments. These laws and regulations include, but are not necessarily limited to, matters 
such as licensure, accreditation, government healthcare program participation requirements, reimbursement for patient 
services,  and  Medicare  and  Medicaid  fraud  and  abuse.  Government  activity  has  increased  with  respect  to 
investigations and allegations concerning possible violations of fraud and abuse statutes and regulations by healthcare 
providers. Violations of these laws and regulations could result in expulsion from government healthcare programs 

   
together with the imposition of significant fines and penalties, as well as significant repayments for patient services 
previously billed. Management believes that the Company is in compliance with fraud and abuse regulations, as well 
as  other  applicable  government  laws  and  regulations.  While  no  material  regulatory  inquiries  have  been  made, 
compliance with such laws and regulations can be subject to future government review and interpretation as well as 
regulatory actions unknown or unasserted at this time.  

Fair Value.  

Unless otherwise specified, book value approximates fair value. The common stock warrant liabilities and 

derivative liabilities are recorded at fair value. See Note 12 - Fair Value for additional information.  

Other Current Assets.  

Other current assets of $0.3 million as of December 31, 2019 include prepaid insurance of $0.2 million and 
prepaid assets and other receivables of $0.1 million. Other current assets of $0.5 million as of December 31, 2018 
include prepaid assets of less than $0.1 million, prepaid insurance of $0.2 million and other receivables of $0.3 million.  

Concentrations of Risk.  

From time to time, we may maintain a cash position with financial institutions in amounts that exceed Federal 
Deposit Insurance Corporation insured limits of up to $250,000 per depositor per financial institution. We have not 
experienced any losses on such accounts as of December 31, 2019.  

Table of Contents  

45  

Service  companies  in  the  health  care  industry  typically  grant  credit  without  collateral  to  patients.  The 
majority of these patients are insured under third-party insurance agreements. The services provided by the Company 
are routinely billed utilizing the Current Procedural Terminology (CPT) code set designed to communicate uniform 
information about medical services and procedures among physicians, coders, patients, accreditation organizations, 
and payers for administrative, financial, and analytical purposes. CPT codes are currently identified by the Centers 
for  Medicare  and  Medicaid  Services  and  third-party  payers. The Company  utilizes  CPT  codes  for  Pathology and 
Laboratory Services contained within codes 80000-89398.  

Inventories.  

Inventories consist of laboratory supplies and are valued at cost (determined on an average cost basis, which 
approximates the first-in, first-out method) or net realizable value, whichever is lower. We evaluate inventory for 
items that are slow moving or obsolete and record an appropriate reserve for obsolescence if needed. We determined 
that no allowance for slow moving or obsolete inventory was necessary at December 31, 2019 and 2018.  

Property and Equipment, net.  

Property and equipment are carried at cost, net of accumulated depreciation and amortization. Expenditures 
for maintenance and repairs are expensed as incurred. Depreciation and amortization are computed by the straight-
line method over the estimated useful lives of the related assets as follows:  

Furniture and fixtures 

Laboratory equipment 
Computer equipment and software 

     5 to 7 years 
3 to 

10 years 
   3 to 7 years 

  
  
  
  
  
   
For assets sold or otherwise disposed of, the cost and related accumulated depreciation and amortization are 
removed from the accounts, and any related gain or loss is reflected in operations for the period. Expenditures for 
major betterments that extend the useful lives of property and equipment are capitalized.  

Goodwill and Intangible Assets.  

Goodwill  

Goodwill represents the excess of the purchase price over the fair value of identifiable net assets of a business 
acquired and is tested for impairment annually, as of October 1st, or when impairment triggering events may occur 
during a quarterly reporting period. Throughout the year ended December 31, 2018, at certain quarterly reporting 
periods, the Company experienced a decline in its share price and a significant reduction in its market capitalization, 
indicating that it was more likely than not that the fair value of the Company was less than its carry value. Through 
valuation analysis of the fair value of the Company using the market capitalization, the discounted cash flow model 
and market analysis, the Company concluded that its carrying value exceeded its fair value and goodwill impairment 
in the amount of $4.7 million was recorded for the year ended December 31, 2018. As of December 31, 2018, goodwill 
was fully written off and no balance remained.  

Intangibles  

We review our amortizable long-lived assets for impairment annually or whenever events indicate that the 
carrying amount of the asset (group) may not be recoverable. An impairment loss may be needed if the sum of the 
future undiscounted cash flows is less than the carrying amount of the asset (group). The amount of the loss would be 
determined  by  comparing  the  fair  value  of  the  asset  to  the  carrying  amount  of  the  asset  (group).  There  were  no 
impairment charges on our amortizable long-lived assets during the years ended December 31, 2019 and 2018.  

In-process  research  and  development  (“IPR&D”)  represents  the  fair  value  assigned  to  research  and 
development assets that were not fully developed when acquired. Until the IPR&D projects are completed, the assets 
are  accounted  for  as  indefinite-lived  intangible  assets  and  subject  to  impairment  testing.  The  IPR&D  principally 
related to  

Table of Contents  

46  

research  projects  that  were  not  related  to  IV-Cell,  HemeScreen  or  ICP. During  2019,  the  Company  made  a 
determination to suspend further research and analysis of these projects, and, as a result, it was more likely than not 
that  the  IPR&D  was  fully  impaired,  resulting  in  an  impairment  charge  of  $1.6  million  in  2019.  There  was  no 
impairment of IPR&D during the year ended December 31, 2018.  

Debt Issuance Costs, Debt Discounts and Debt Premiums.  

Debt issuance costs, debt discounts and debt premiums are being amortized or accreted over the lives of the 
related financings on a basis that approximates the effective interest method. Costs and discounts are presented as a 
reduction  of  the  related  debt  and  premiums  are  presented  as an  increase  to  the  related  debt  in  the  accompanying 
balance sheets. The amortization amount recorded was expense, net of income, of $0.1 million in 2019 and income, 
net of expense, of less than $0.1 million in 2018. Debt discounts and debt premiums are amortized or accreted to 
interest expense and interest income on the consolidated statement of operations, respectively. See Note 5  – Long 
Term Debt and Note 6 – Convertible Notes for further discussion.  

Stock-Based Compensation.  

All stock-based awards to date have exercise prices equal to the market price of our common stock on the 
date of grant and have ten-year contractual terms. Stock-based compensation cost is based on the fair value of the 

portion of stock-based awards that is ultimately expected to vest. The Company utilizes the Black-Scholes option 
pricing model for determining the estimated fair value for stock-based awards. Unvested awards as of December 31, 
2019 had vesting periods of up to four years from the date of grant. At December 31, 2019, 53,334 unvested awards 
outstanding  are  subject  to  performance  vesting  conditions  and  no  awards  are  subject  to  market-based  vesting 
conditions. No awards outstanding at December 31, 2018 were subject to performance or market-based vesting.  

Net Sales Recognition.  

Revenue recognition occurs when a customer obtains control of the promised goods and service. Revenue 
assigned to the goods and services reflects the consideration which the Company expects to receive in exchange for 
those goods and services.   

The Company derives its revenues from diagnostic testing - histology, flow cytometry, cytology and molecular 
testing; clinical research from bio-pharma customers, state and federal grant programs; and from biomarker testing 
from bio-pharma customers. All sources of revenue are recorded net of accruals for estimated chargebacks, rebates, 
cash  discounts,  other  allowances,  and  returns.  Due  to  differences  in  the  substance  of  these  revenue  types,  the 
transactions require, and the Company utilizes, different revenue recognition policies for each. See more detailed 
information on revenue in Note 14 – Sales Service Revenue, Net And Accounts Receivable.  

The  Company  recognizes  revenue  utilizing  the  five-step  framework  of  ASC  606.  Control  of  the  laboratory 
testing  services  is  transferred  to  the  customer  at  a  point  in  time.  As  such,  the  Company  recognizes  revenue  for 
diagnostic testing at a point in time based on the delivery method (web-portal access or fax) for a patient’s laboratory 
report. Diagnostic testing service revenue is reported at the estimated net realizable amounts from patients, third-party 
payers and others for services rendered, including retroactive adjustment under reimbursement agreements with third-
party payers. Provisions for third-party payer settlements are provided in the period in which the related services are 
rendered and adjusted in the future periods, as final settlements are determined. For clinical research and biomarker 
services, the Company utilizes an “effort based” method of assessing performance and measures progress towards 
satisfaction  of  the  performance  obligation  based  upon  the  delivery  of  results  per  the  contract.  When  we  receive 
payment in advance, we initially defer the revenue and recognize it when we deliver the service.  

Deferred net sales included in the balance sheet as deferred revenue was approximately $0.1 million as of 

December 31, 2019 and 2018.  

Taxes  collected  from  customers  and  remitted  to  government  agencies  for  specific  net  sales  producing 

transactions are recorded net with no effect on the income statement.  

Table of Contents  

Accounts Receivable  

47  

Accounts Receivable result from diagnostic services provided to self-pay and insured patients, project based 
testing services and clinical research. The payment for services provided by the Company are generally due within 
30 days from the invoice date. Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating 
the collectability of accounts receivable, the Company analyzes and identifies trends for each of its sources of revenue 
to  estimate  the  appropriate  allowance  for  doubtful  accounts.  For  receivables  associated  with  self-pay  patients, 
including patients with insurance and a deductible and copayment, the Company records an allowance for doubtful 
accounts in the period of services on the basis of past experience of patients unable or unwilling to pay for service fee 
for which they are financially responsible. For receivables associated with services provided to patients with third-
party  coverage,  the  Company  analyzes  contractually  due  amounts  and  provides  an  allowance,  if  necessary.  The 
difference between the standard rates and the amounts actually collected after all reasonable collection efforts have 
been exhausted is charged against the allowance for doubtful accounts.  

   
   
   
Presentation of Insurance Claims and Related Insurance Recoveries.  

The Company  accounts  for  its  insurance claims  and  related  insurance  recoveries at  their  gross  values  as 
standards  for  health  care entities  do  not  allow  the  Company  to  net  insurance  recoveries  against  the  related  claim 
liabilities. There were no insurance claims or insurance recoveries recorded during the years ended December 31, 
2019 and 2018.  

Advertising Costs.  

Advertising  costs  are  expensed  as  incurred  and  are  included  in  operating  expenses  on  the  consolidated 
statement of operations.  Advertising costs charged to operations  totaled less than $0.1 million in 2019 and 2018, 
respectively.  

Research and Development Costs.  

All costs associated with internal research and development are expensed as incurred. These costs include 
salaries and employee related expenses, operating supplies and facility-related expenses. Research and development 
costs charged to operations totaled $1.2 million and $1.1 million for the years ended December 31, 2019 and 2018, 
respectively.  

Income Taxes.  

Deferred tax assets and liabilities are determined based on the differences between the financial reporting 
and tax basis of assets and liabilities at each balance sheet date using tax rates expected to be in effect in the year the 
differences are expected to reverse. The effect on the deferred tax assets and liabilities of a change in tax rates is 
recognized in the period when the change in tax rates is enacted.  

A valuation allowance is established when it is determined that it is more likely than not that some portion 
or all of the deferred tax assets will not be realized. A full valuation allowance has been applied against the Company’s 
net deferred tax assets as of December 31, 2019 and 2018, due to projected losses and because it is not more likely 
than not that the Company will realize future benefits associated with these deferred tax assets.  

Management’s conclusions regarding uncertain tax positions may be subject to review and adjustment at a 
later date based upon ongoing analysis of, or changes in tax laws, regulations and interpretations thereof as well as 
other factors. The Company’s policy is to record interest and penalties directly related to income taxes as income tax 
expense in the accompanying consolidated statements of operations, of which there was none for the years ended 
December 31, 2019 and 2018.  

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Common Stock Warrants.  

48  

The  Company  classifies  the  issuance  of  common  stock  warrants  as  equity  any  contracts  that  (i) require 
physical settlement or net-stock settlement or (ii) gives the Company a choice of net-cash settlement or settlement in 
its  own  stocks  (physical  settlement  or  net-stock  settlement).  The  Company  classifies  as  assets  or  liabilities  any 
contracts that (i) require net-cash settlement (including a requirement to net-cash settle the contract if an event occurs 
and if that event is outside of the Company’s control), or (ii) gives the counterparty a choice of net-cash settlement or 
settlement in stock (physical settlement or net-stock settlement).  

Certain of our issued and outstanding warrants to purchase common stock do not qualify to be treated as 
equity and accordingly, are recorded as a liability (“Common Stock Warrant Liability”). We are required to present 

   
these instruments at fair value at each reporting date and any changes in fair values are recorded as an adjustment to 
earnings.  

Beneficial Conversion Features.  

The intrinsic value of a beneficial conversion feature (“BCF”) inherent to a convertible note payable, which 
is not bifurcated and accounted for separately from the convertible note payable and may not be settled in cash upon 
conversion, is treated as a discount to the convertible note payable. This discount is amortized over the period from 
the date of issuance to the first conversion date using the effective interest method. If the note payable is retired prior 
to the end of its contractual term, the unamortized discount is expensed in the period of retirement to interest expense. 
In general, the BCF is measured by comparing the effective conversion price, after considering the relative fair value 
of detachable instruments included in the financing transaction, if any, to the fair value of the common shares at the 
commitment date to be received upon conversion.  

Deemed dividends are also recorded for the intrinsic value of conversion options embedded in preferred 
shares based upon the differences between the fair value of the underlying common stock at the commitment date of 
the transaction and the effective conversion price embedded in the preferred shares. When the preferred shares are 
non-redeemable the BCF is fully amortized into additional paid-in capital and preferred discount. If the preferred 
shares are redeemable, the discount is amortized from the commitment date to the first conversion date.  

Loss Per Share.  

Basic loss per share is calculated based on the weighted-average number of common shares outstanding 
during  each  period.  Diluted  loss  per  share  includes  shares  issuable  upon  exercise  of  outstanding  stock  options, 
warrants or conversion rights that have exercise or conversion prices below the market value of our common stock. 
Options, warrants and conversion rights pertaining to 2,281,701 and 2,517,675 shares of our common stock have been 
excluded from the computation of diluted loss per share at December 31, 2019 and 2018, respectively, because the 
effect is anti-dilutive due to the net loss.  

The following table summarizes the outstanding securities not included in the computation of diluted net loss 

per share:  

Stock options 
Warrants 
Preferred stock 
Convertible notes 
Total 

December 31,  

2018 
2019 
224,895 
490,330   
917,573 
909,189   
20,888   
20,888 
861,294    1,354,319 
2,281,701    2,517,675 

Recently Adopted Accounting Pronouncements.  

In  February 2016,  the  FASB  issued  ASU  No. 2016-02, Leases-Topic  842.  The  new standard  amends  the 
recognition of lease assets and lease liabilities by lessees for those leases currently classified as operating leases and  

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49  

amends  disclosure  requirements  associated  with  leasing  arrangements.  The  new  standard  was  adopted  effective 
January 1, 2019, using a modified retrospective transition, and thus did not adjust  comparative periods. The new 
standard provides a number of optional practical expedients in transition.  The Company has elected the “package of 
practical  expedients”,  which  permits  it  not  to  reassess  under  the  new  standard  its  prior  conclusions  about  lease 
identification, lease classification and initial direct costs.  The Company did not elect the use-of-hindsight practical 

  
  
  
  
  
  
  
  
     
     
  
  
  
  
  
   
expedient. As a result of the adoption of Topic 842 the Company recognized approximately $0.7 million of lease 
liabilities  and  corresponding  right-of-use  (“ROU”)  assets  in  its  consolidated  balance  sheet  on  the  date  of  initial 
application. See Note 8 – Leases for additional information.  

In June 2018, the FASB issued ASU 2018-07 “Compensation—Stock Compensation (Topic 718)”, which 
expands the scope of Topic 718 to include share based payment transactions for acquiring goods and services from 
non-employees. The Company adopted this guidance on January 1, 2019. The adoption of  this guidance was not 
material to our consolidated financial statements.  

Recent Accounting Pronouncements Not Yet Adopted.  

In December 2019, the FASB issued ASU 2019-12 “Income Taxes (Topic 740): Simplifying the Accounting 
for Income Taxes”, which is intended to improve consistent application and simplify the accounting for income taxes. 
This  ASU  removes  certain  exceptions  to  the  general  principles  in  Topic  740  and  clarifies  and  amends  existing 
guidance. This standard is effective for annual reporting periods beginning after December 15, 2020, including interim 
reporting periods within those annual reporting periods, with early adoption permitted. The Company is currently 
evaluating the impact of adoption of this ASU and does not expect the adoption of this new standard to have a material 
impact on its consolidated financial statements.  

In August 2018, the FASB issued ASU 2018-13 “Fair Value Measurement (Topic 820)”, which modifies 
certain disclosure requirements in Topic 820, such as the removal of the need to disclose the amount of and reason 
for transfers between Level 1 and Level 2 of the fair value hierarchy, and several changes related to Level 3 fair value 
measurements. This ASU is effective for reporting periods beginning after December 15, 2019. We are currently 
assessing the potential impact that the adoption of this ASU will have on our consolidated financial statements.  

In August 2018, the FASB issued ASU 2018-15 “Intangibles—Goodwill and Other—Internal Use Software 
(Subtopic  350-40)”,  which  aligns  the  requirements  for  capitalizing  implementation  costs  incurred  in  a  cloud 
computing hosting arrangement that is a service contract with the requirements for capitalizing implementation costs 
incurred  to  develop  or  obtain  internal  use  software.  This  ASU  is  effective  for  reporting  periods  beginning  after 
December 15, 2019. We are currently assessing the potential impact that the adoption of this ASU will have on our 
consolidated financial statements.  

In June 2016, the FASB issued ASU 2016-13 “Measurement of Credit Losses on Financial Instruments”, 
which  replaces  current  methods  for  evaluating  impairment  of  financial  instruments  not  measured  at  fair  value, 
including trade accounts receivable and certain debt securities, with a current expected credit loss model. This ASU 
is effective for the Company for reporting periods beginning after December 15, 2022. We are currently assessing 
the potential impact that the adoption of this ASU will have on our consolidated financial statements.  

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50  

3. PROPERTY AND EQUIPMENT, NET  

A summary of property and equipment at December 31, 2019 and 2018 is as follows:  

Furniture and fixtures 
Laboratory equipment 
Computer equipment and software 
Equipment under finance leases 
Construction in process 

   $ 

2019 

2018 

12    $ 
299      
463      
425      
23      
1,222      

12 
299 
369 
402 
67 
1,149 

   
   
   
   
   
  
  
  
  
  
  
  
  
     
     
     
     
     
     
  
     
Less—accumulated depreciation and amortization 

Total 

   $ 

(791)      
431    $ 

(653) 
496 

Depreciation expense was approximately $0.1 million for both the years ended December 31, 2019 and 2018. 

Depreciation expense during each year includes depreciation related to equipment acquired under finance leases.  

4. INTANGIBLES  

Intangible assets consist of the following:  

Dollars in Thousands 
December 31, 2019 

Technology 
Customer relationships 
Backlog 
Covenants not to compete 
Trademark 
IPR&D 

Technology 
Customer relationships 
Backlog 
Covenants not to compete 
Trademark 
IPR&D 

Technology 
Customer relationships 
Backlog 
Covenants not to compete 
Trademark 

Cost 
   $ 18,990    $ 
250      
200      
30      
40      
      1,590      
   $ 21,100    $ 

     Accumulated      Impairment      Net Book 
   Amortization   

Charge 

Value 

2,374    $ 
208      
200      
30      
40      
 —      

 —    $ 16,616 
42 
 —      
 — 
 —      
 — 
 —      
 — 
 —      
 — 
1,590      
2,852    $  1,590    $ 16,658 

Dollars in Thousands 
December 31, 2018 

     Accumulated      Impairment      Net Book 
   Amortization   

Charge 

Value 

Cost 
   $ 18,990    $ 
250      
200      
30      
40      
      1,590      
   $ 21,100    $ 

1,424    $ 
125      
200      
30      
30      
 —      
1,809    $ 

 —    $ 17,566 
125 
 —      
 — 
 —      
 — 
 —      
 —      
10 
 —       1,590 
 —    $ 19,291 

     Estimated Useful Life 

20 years 
 3 years 
 1 year 
 1 year 
 2 years 

Our  IPR&D  projects  were  accounted  for  as  indefinite-lived  intangible  assets  and  subject  to  impairment 
testing. During 2019, the Company reviewed its IPR&D for impairment and determined that it was more likely than 
not that the  

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51  

IPR&D  was  fully  impaired,  resulting  in  an  impairment  charge  of  $1.6  million  in  2019.  For  the year  ended 
December 31, 2018, there was no impairment of IPR&D.  

Amortization expense for intangible assets was $1.0 million during the year ended December 31, 2019 and 
$1.2 million during the year ended December 31, 2018. Amortization expense for intangible assets is expected to be 

     
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
       
  
  
  
  
     
     
     
     
  
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
       
  
  
  
  
     
     
     
     
  
   
  
  
  
  
  
  
  
  
  
  
  
   
$1.0 million, $0.9 million, $0.9 million, $0.9 million and $0.9 million for each of the years ending December 31, 
2020, 2021, 2022, 2023 and 2024, respectively.  

5. LONG-TERM DEBT  

Long-term debt consists of the following:  

Department of Economic and Community Development (DECD) 
DECD debt issuance costs 
Financed insurance loan 
September 2018 Settlement 
Total long-term debt 
Current portion of long-term debt 
Long-term debt, net of current maturities 

Department of Economic and Community Development  

Dollars in Thousands 
     December 31, 2019      December 31, 2018 
274 
249    $ 
   $ 
(28) 
(24)      
204 
260      
66 
34      
516 
519      
(263) 
(321)      
253 
198    $ 

   $ 

On January 8, 2018, the Company received gross proceeds of $400,000 when it entered into an agreement 
with DECD by which the Company received a grant of $100,000 and a loan of $300,000 secured by substantially all 
of  the  Company’s  assets  (the  “DECD  2018  Loan”.)  For  the  year  ended  December  31,  2018,  $100,000  has  been 
recorded as clinical research grant revenue in the consolidated statements of operations. The DECD 2018 Loan is a 
ten-year loan due on December 31, 2027 and includes interest paid monthly at 3.25%.  

Debt issuance costs associated with the DECD 2018 Loan were approximately $31,000. Amortization of the 
debt issuance cost was approximately $3,000 for the years ended December 31, 2019 and 2018, respectively. Net debt 
issuance  costs  were  approximately  $24,000  and  $28,000  at  December  31,  2019  and  2018,  respectively,  and  are 
presented as a reduction of the related debt in the accompanying consolidated balance sheets. Amortization for each 
of the next five years is expected to be approximately $3,000.  

Financed Insurance Loan.  

The Company finances certain of its insurance premiums (the “Financed Insurance Loans”).  In July 2018, 
the Company financed $0.4 million with a 4.89% interest rate and fully paid off such loan as of July 2019.   In July 
2019, the Company financed $0.4 million with a 5.0% interest rate and will make monthly payments through May of 
2020. As of December 31, 2019 and 2018, the Financed Insurance Loan outstanding balance of $0.3 million and $0.2 
million, respectively, was included in current maturities of long-term debt in the Company’s consolidated balance 
sheets. A corresponding prepaid asset was included in other current assets.  

Settlement Agreement.  

On September 21, 2018, the Company entered into a settlement and forbearance agreement with a creditor 
(the “September 2018 Settlement”) pursuant to which, the Company agreed to make monthly principal and interest 
payments to the creditor over a two year period,  from November 1, 2018 to November 1, 2020, in full and final 
settlement of $0.1 million of indebtedness that was owed to the creditor on the date of the September 2018 Settlement. 
The  settlement  amount  will  accrue  interest at  the  rate  of  10%  per  annum  until  paid  in  full.  The  September  2018 
Settlement outstanding balance of approximately $0.1 million was included in current maturities of long-term debt in 
the Company’s  

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consolidated balance sheet as of December 31, 2019 and in long-term debt and accounts payable in the Company’s 
consolidated balance sheet as of December 31, 2018.  

The aggregate future maturities required on gross long-term debt at December 31, 2019 are as follows:  

DECD loan 
Financed Insurance Loan 
September 2018 Settlement 

      2021        2022        2023        2024 

2025 and 
      2020 
thereafter       Total 
   $  30    $  28    $  30    $  30    $  31    $  100    $  249 
 —       260 
      260      
34 
 —      
34      
   $  324    $  28    $  30    $  30    $  31    $  100    $  543 

 —        —        —      
 —        —        —      

 —      
 —      

6. CONVERTIBLE NOTES.  

Convertible notes consists of the following:  

Convertible bridge notes 
Convertible bridge notes discount and debt issuance costs 
Convertible bridge notes premiums 
Convertible promissory notes - Exchange Notes 
Convertible promissory notes - Exchange notes debt issuance costs 
Total convertible notes 
Current portion of convertible notes 
Convertible notes, net of current maturities 

Convertible Bridge Notes.  

Dollars in Thousands 

     December 31, 2019      December 31, 2018 
4,294 
1,938    $ 
   $ 
(1,111) 
(1,796)      
647 
 —      
630 
 —      
(83) 
 —      
4,377 
142      
(4,377) 
(142)      
 — 
 —    $ 

   $ 

On April 20, 2018, the Company entered into a securities purchase agreement (the “2018 Note Agreement”) 
with certain investors (the “April 2018 Investors”), pursuant to which the Company would issue up to approximately 
$3,296,703 in Senior Secured Convertible Promissory Notes along with warrants (the “Transaction”). The number of 
warrants  is  equal  to  the  number  of  shares  of  common  stock  issuable  upon  conversion  of  the  notes  based  on  the 
conversion price at the time of issuance. Some of the warrants were issued with a one-year term and some with a five-
year term. The 2018 Note Agreement includes customary representations, warranties and covenants by the Company 
and customary closing conditions.  

The Transaction consisted of a series unregistered Senior Secured Convertible Notes (the “Bridge Notes”), 
bearing interest at a rate of 8% annually and an original issue discount of 9%. The Bridge Notes are convertible at a 
price of $7.50 per share, provided that if the notes are not repaid within 180 days of the note’s issuance date, the 
conversion price shall be adjusted to 80% of the lowest volume weighted average price during the prior 10 days, 
subject to a minimum conversion price of $4.50 per share.  

The Transaction consisted of a number of drawdowns. The initial closing on April 20, 2018 provided the 
Company with proceeds of $1,660,000, net of an original issue discount of 9% and before debt issuance costs, for the 
issuance of notes with an aggregate principal of $1,824,176 (the “April 2018 Bridge Notes”). The Company completed 
three additional drawdowns for aggregate proceeds of $1.3 million, net of an original issue discount of 9% and before 
debt  issuance cost,  for  the  issuance  of  notes  with  an aggregate  principal  of  $1.5  million,  during  the  third  quarter 
2018.  Drawdowns included the following funding from the April 2018 Investors (i) $348,104 in July 2018 for Bridge 
Notes with an aggregate principal of $382,526, (ii) $495,955 in August 2018 for Bridge Notes with an aggregate 
principal of $545,005 and (iii) $495,941 in September 2018 for Bridge Notes with an aggregate principal of $544,990 
(collectively, the “Q3 2018 Bridge Notes”).  

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
     
     
  
   
   
  
  
  
  
  
  
  
  
  
  
     
     
     
     
     
     
   
   
   
   
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53  

The Bridge Notes are payable by the Company on the earlier of (i) the one year anniversary after each closing 
date or (ii) upon the closing of a qualified offering, namely the Company raising gross proceeds of at least $7,000,000 
(the “Maturity Date”). At any time, provided that the Company gives 5 business days written notice, the Company 
has the right to redeem the outstanding principal amount of the Bridge Notes, including accrued but unpaid interest, 
all liquidated damages and all other amounts due under the Bridge Notes, for cash as follows: (i) an amount which is 
equal to the sum of 105% if the Company exercises its right to redeem the Bridge Notes within 90 days of the initial 
closing, (ii) 110% if the Company exercises its right to redeem the Bridge Notes within 180 days of the initial closing, 
or (iii) 115% if the Company exercises its right to redeem 180 days from the initial closing.  

The terms of the 2018 Note Agreement also stipulate that upon written  demand by one of the April 2018 
Investors, for any of their draws throughout the year associated with the 2018 Note Agreement after a period of time 
as defined within the 2018 Note Agreement, the Company shall file a registration statement within thirty (30) days 
after written demand covering the resale of all or such portion of the conversion shares for an offering to be made on 
a continuous basis pursuant to Rule 415. The registration statement filed shall be on Form S-3 or Form S-1, at the 
option of the Company. If the Company does not file a registration statement in accordance with the terms of the 2018 
Note Agreement, then on the business day following the applicable filing date and on each monthly anniversary of 
the business day following the applicable filing date (if no registration statement shall have been filed by the Company 
in accordance herewith by such date), the Company shall pay to the April 2018 Investors an amount in cash, as partial 
liquidated damages, equal to 1% per month (pro-rata for partial months) based upon the gross purchase price of the 
Bridge  Notes  (calculated  on  a  daily  basis)  under  the  2018  Note  Agreement.  As  requested  by  certain  April  2018 
Investors, conversion shares related to the April 2018 Note Agreement were included in a registration statement on 
Form S-3 that the Company filed with the SEC on February 6, 2019 and which became effective with the SEC on 
February 13, 2019.  

The  obligations  under  the  Bridge  Notes  are  secured,  subject  to  certain  exceptions  and  other  permitted 

payments by a perfected security interest on the assets of the Company.  

The 9% discount associated with the April 2018 Bridge Notes was approximately $164,000 and was recorded 
as a debt discount. The Company also incurred legal and advisory fees associated with the April 2018 Bridge Notes 
of approximately $164,000 and these were recorded as debt issuance costs. The 9% discount associated with the Q3 
2018 Bridge Notes was approximately $133,000 and was recorded as a debt discount.  

As  part  of  the  initial  closing,  the  April  2018  Investors  received  243,224  warrants  to  purchase  shares  of 
common stock of the Company (the “April 2018 Warrants”) that are exercisable at a 150% premium to the April 2018 
Bridge Notes conversion price or $11.25. Half of such April 2018 Warrants had a five-year term and half had a one-
year  term.  The  Company  reviewed  the  provisions  of  the  April  2018  Warrants  to  determine  the  balance  sheet 
classification of the April 2018 Warrants. The Company concluded that there is an obligation to repurchase the April 
2018  Warrants  by  transferring  assets  and  accordingly  the  warrants  were  classified  as  a  liability.  The  April  2018 
Warrants were valued using a Black-Scholes option pricing model with an initial value of approximately $1.1 million 
at the date of issuance and were recorded as a liability with an offset to debt discount. The April 2018 Investors 
received 196,340 warrants to purchase shares of common stock of the Company in connection with the Q3 Bridge 
Note issuances (the “Q3 2018 Warrants”) with an initial exercise price of $11.25.  Half of such Q3 2018 Warrants 
had a five-year term and half had a one-year term. The terms of the Q3 2018 Warrants are the same as the April 2018 
Warrants and, as such, were classified as liabilities. The Q3 2018 Warrants were valued using a Black-Scholes option 
pricing  model  with  an  initial  value  of  approximately  $0.7  million  at  the  date  of  issuance and  were  recorded as a 
liability with an offset to debt discount. See Note 12 – Fair Value for further discussion.  

On September 20, 2018, immediately after the final drawdown of the Bridge Notes, the Company entered 
into an agreement with the April 2018 Investors whereby the exercise price of all warrants issued to the April 2018 
Investors in connection with both the 2018 Note Agreement and the Q3 Bridge Notes were amended from $11.25 to 
$7.50. The Company reviewed this repricing to determine the appropriate accounting treatment and concluded that 

   
   
   
   
   
the repricing would be treated as a modification of the warrant agreements. As the warrants related to the Bridge 
Notes  are  classified  as  liabilities,  the  change  in  fair  value  attributable  to  the  repricing  would  be  reflected  in  the 
subsequent measurement on  

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54  

the warrants. Management calculated the change in fair value due to repricing to be an expense of approximately $0.1 
million which is included in warrant revaluation in the consolidated statements of operations.  

Pursuant to a letter agreement, dated as of April 20, 2018 (the “Letter Agreement”), the Company engaged 
a registered broker dealer as a  financial advisor (the “Financial Advisor”). Pursuant to the Letter Agreement, the 
Company paid the Financial Advisor a fee of $116,000, approximately 7% of the proceeds from the sale of the April 
2018  Bridge  Notes.  This  is  included  in  the  debt  issuance  costs  discussed  above.  Per  the  Letter  Agreement,  the 
Company also issued to the Financial Advisor 15,466 warrants to purchase shares of common stock of the Company 
with an exercise price of $11.25 (the “Advisor Warrants”). The Advisor Warrants are exercisable at any time and 
from time to time, in whole or in part, during the four-year period commencing six months from the date of the Letter 
Agreement. Like the April 2018 Warrants and like the Q3 2018 Warrants, the Advisor Warrants met the criteria to be 
classified as a liability. The Advisor Warrants were valued using a Black-Scholes option pricing model with an initial 
value of approximately $0.1 million at the date of issuance and were recorded as a liability with an offset to debt 
discount. See Note 12 – Fair Value for further discussion.  

The Company reviewed the conversion option of the April 2018 Bridge Notes and determined that there was 
a beneficial conversion feature in connection with the issuance of the April 2018 Bridge Notes since the calculated 
effective conversion price was at a discount to the fair market value of the Company's common stock at issuance date. 
For purposes of calculating the beneficial conversion feature, the proceeds of $1.7 million from the April 2018 Bridge 
Notes were allocated to the notes and warrants based on their relative fair values at the date of issuance. The portion 
allocated to the April 2018 Bridge Notes was $0.6 million with the remaining $1.1 million allocated to the April 2018 
Warrants. As a result of the allocation of the proceeds, the Company calculated a beneficial conversion feature of 
approximately $1.1 million which was recorded as a debt discount with an offset to additional paid in capital. The Q3 
2018  Bridge  Notes  also  contained  beneficial  conversion  features.  For  purposes  of  calculating  the  beneficial 
conversion features, the net proceeds of $1.3 million from the Q3 2018 Bridge Notes were allocated to the notes and 
warrants based on their relative fair values at the date of issuance. The portion allocated to the Q3 2018 Bridge Notes 
was $0.6 million with the remaining $0.7 million allocated to the Q3 2018 Warrants. As a result of the allocation of 
the  proceeds,  the  Company  calculated  a  beneficial  conversion  feature  of  approximately  $0.5  million  which  was 
recorded as a debt discount with an offset to additional paid in capital.  

The  Company  reviewed  the  redemption  features  of  the  Bridge  Notes  and  determined  that  there  is  a 
redemption feature (the “Bridge Notes Redemption Feature”) that qualifies as an embedded derivative instrument 
which is required to be separated from the debt host contract and accounted for separately as a derivative. For the 
April 2018 Bridge Notes, the Company determined the initial fair value of the derivative at the time of issuance to be 
approximately $0.1 million which was recorded as a debt discount with an offset to derivative liability. For the Q3 
2018 Bridge Notes, the Company determined the initial fair value of the derivatives at the time of issuance to be 
approximately $0.1 million which was recorded as a debt discount with an offset to derivative liability. The valuations 
were  performed  using  the  “with  and  without”  approach,  whereby  the  Bridge  Notes  were  valued  both  with  the 
embedded derivative and without, and the difference in values was recorded as the derivative liability. See Note 12 – 
Fair Value for further discussion.  

As detailed above, debt discounts and debt issuance costs related to the April 2018 Bridge Notes totaled $2.7 
million. Since the costs exceeded the $1.8 million face amount of the debt, the Company recorded $1.8 million of 
debt discount and debt issuance costs as a reduction of the related debt with the excess $0.9 million expensed as a loss 
on  issuance  of  convertible  notes  in  the  consolidated  statements  of  operations.  The  total  debt  discounts  and  debt 
issuance costs related to the Q3 2018 Bridge Notes totaled $1.4 million, of which the Company recorded $1.3 million 

   
   
   
   
of debt discount and debt issuance costs as a reduction of the related debt with $0.1 million expensed as a loss on 
issuance of convertible notes in the consolidated statements of operations. The $0.1 million recorded as a loss on 
issuance of convertible notes was due to the fact that one of the drawdowns during the third quarter of 2018 had debt 
discount and debt issuance costs in excess of the face amount of the related debt. The debt discount and debt issuance 
costs will be amortized to interest expense over the life of the respective April 2018 Bridge Notes and Q3 2018 Bridge 
Notes on a basis that approximates the effective interest method.  

On  November  29,  2018,  the  Company  entered  into  an  amendment  and  restatement  agreement  (the 
“Amendment  Agreement”)  amending  and  restating  the  terms  of  the  2018  Note  Agreement.  The  Amendment 
Agreement provided for  

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55  

the issuance of up to $1,318,681 of additional Bridge Notes together with applicable warrants, in one or more tranches, 
with substantially the same terms and conditions as the previously issued Bridge Notes and related warrants. The 
conversion price of the notes was amended so that it shall be equal to the greater of $3.75 or $0.75 above the closing 
bid price of our common stock on the date prior to the original issue date. In the event the notes are not paid in full 
prior to 180 days after the original issue date, the conversion price shall be equal to 80% of the lowest volume weighted 
average price (“VWAP”) in the 10 trading days prior to the date of the notice of conversion, but in no event below 
the floor price of $2.25.  

In connection with the Amendment Agreement, during the fourth quarter of 2018, the Company completed 
two additional drawdowns for aggregate proceeds of $1.1 million, net of an original issue discount of 9% and before 
debt issuance costs, for the issuance of notes with an aggregate principal of $1.2 million (collectively, the “Q4 2018 
Bridge Notes”). Approximately $0.3 million of the $1.1 million of proceeds was received after December 31, 2018 
and is included in other current assets on our consolidated balance sheet at December 31, 2018. The 9% discount 
associated  with  the Q4  2018  Bridge Notes  was approximately  $108,000  and  was  recorded as a  debt  discount.  In 
connection  with  the  Q4  2018  Bridge  Note  issuances,  the  Company  issued  to  the  investors  300,115  warrants  to 
purchase shares of common stock of the Company (the “Q4 2018 Warrants”) with an initial exercise price of $5.40 
and a five-year term. The terms of the Q4 2018 Warrants are the same as the April 2018 Warrants and, as such, were 
classified as liabilities. The Q4 2018 Warrants were valued using a Black-Scholes option pricing model with an initial 
value of approximately $0.7 million at the date of issuance and were recorded as a liability with an offset to debt 
discount. See Note 12 – Fair Value for further discussion.  

The Company reviewed the conversion option of the Q4 2018 Bridge Notes and determined that there was a 
beneficial conversion feature in connection with the issuance of the Q4 2018 Bridge Notes, as there was with the 
previously issued Bridge Notes. For purposes of calculating the beneficial conversion features, the net proceeds of 
$1.1 million from the Q4 2018 Bridge Notes were allocated to the notes and warrants based on their relative fair 
values at the date of issuance. The portion allocated to the Q4 2018 Bridge Notes was $0.4 million with the remaining 
$0.7 million allocated to the Q4 2018 Warrants. As a result of the allocation of the proceeds, the Company calculated 
a beneficial conversion feature of approximately $0.5 million which was recorded as a debt discount with an offset to 
additional paid in capital. The Q4 2018 Bridge Notes contain the Bridge Notes Redemption Feature that qualifies as 
an embedded derivative instrument which is required to be separated from the debt host contract and accounted for 
separately  as  a  derivative.  For  the  Q4  2018  Bridge  Notes,  the  Company  determined  the  initial  fair  value  of  the 
derivatives at the time of issuance to be approximately $15,000 which was recorded as a debt discount with an offset 
to derivative liability. See Note 12 – Fair Value for further discussion.  

The total debt discounts and debt issuance costs related to the Q4 2018 Bridge Notes totaled $1.4 million, of 
which the Company recorded $1.1 million of debt discount and debt issuance costs as a reduction of the related debt 
in the accompanying consolidated balance sheet with $0.3 million expensed as a loss on issuance of convertible notes 
in the consolidated statements of operations. The $0.3 million recorded as a loss on issuance of convertible notes was 

   
   
   
   
due to the fact that one of the drawdowns during the fourth quarter of 2018 had debt discount and debt issuance costs 
in excess of the face amount of the related debt.  

At the time of the Amendment Agreement, the conversion price related to $3.3 million of previously issued 
Bridge Notes, the April 2018 Bridge Notes and Q3 2018 Bridge Notes, was amended. The Company reviewed the 
modification to the conversion price and concluded that the amendment will be treated as an extinguishment of the 
related Bridge Notes. The difference between the carrying value of the notes just prior to modification (the “Old 
Debt”) and the fair value of the notes just after modification (the “New Debt”) would be recorded as a gain or loss on 
extinguishment in the consolidated statements of operations. The Company removed the carrying value of the Old 
Debt which included $3.1 million of unamortized debt discounts, beneficial conversion features of $1.0 million and 
less than $0.1 million in derivative liabilities. The Company calculated the fair value of the New Debt to be $4.2 
million.  The  Company  reviewed  whether  or  not  a  beneficial conversion  feature existed  on  the  New Debt  but  the 
calculation resulted in zero intrinsic value to the conversion options so no new beneficial conversion feature was 
recorded. Management also reviewed the Bridge Notes Redemption Feature of the New Notes but their fair value was 
zero so no derivative liability was recorded at the time of modification, however this will be reassessed at the end of 
each reporting period. As a result,  

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56  

the Company recorded a debt premium on the New Debt of $0.9 million and a loss on extinguishment of convertible 
notes of $2.9 million in the consolidated statements of operations during the year ended December 31, 2018.  

in  November  2018 

On April 16, 2019, the Company entered into an amendment and restatement agreement (“Amendment No.2 
Agreement”)  amending  and  restating  the  terms  of  the  2018  Note  Agreement  (as  first  amended  pursuant  to  the 
amendment  agreement 
(the  Amendment  Agreement”)).  The  Amendment  No. 2 
Agreement provided the Company with approximately $0.9 million of gross proceeds for the issuance of notes with 
an  aggregate  principal  of  $1.0  million  (the  “April  2019  Bridge  Notes”)  together  with  applicable  warrants,  with 
substantially  the same  terms  and  conditions  as  the  previously  issued Bridge  Notes  and  related  warrants. The  9% 
discount associated with the April 2019 Bridge Notes was approximately $0.1 million and was recorded as a debt 
discount. In connection with the April 2019 Bridge Note issuances, the Company issued to the investors 147,472 
warrants to purchase shares of common stock of the Company with a five year term and exercise price of $5.40 (the 
“April 2019 Warrants”). The April 2019 Warrants had an initial value of approximately $1.0 million at the date of 
issuance  and  were  recorded  as  a  liability  with  an  offset  to  debt  discount.  See  Note  12  –  Fair  Value  for  further 
discussion.  The  April  2019  Bridge  Notes  were  issued  to  investors that  previously  participated  in  the  2018  Note 
Agreement.   

The conversion price of the April 2019 Bridge Notes shall be equal to the greater of $3.75 or $0.75 above 
the closing bid price of our common stock on the date prior to the original issue date. In the event the notes are not 
paid in full prior to 180 days after the original issue date, the conversion price shall be equal to 80% of the lowest 
volume weighted average price (“VWAP”) in the 10 trading days prior to the date of the notice of conversion, but in 
no event below the floor price of $2.25.  

The Company reviewed the conversion option of the April 2019 Bridge Notes and determined that there was 
a beneficial conversion feature with a value of approximately $0.9 million which was recorded as a debt discount with 
an offset to additional paid in capital. The April 2019 Bridge Notes also contain the Bridge Notes Redemption Feature 
and the Company performed a valuation at the time of issuance which resulted in zero value, at that time, due to the 
high value of the conversion feature and a limited upside from the redemption premium.  

Debt discounts and debt issuance costs related to the April 2019 Bridge Notes totaled $2.0 million. Since the 
costs exceeded the $1.0 million face amount of the debt at issuance, the Company recorded $1.0 million of debt 
discount and debt issuance costs as a reduction of the related debt in the accompanying consolidated balance sheet 

   
   
   
   
   
with the excess $1.0 million expensed as a loss on issuance of convertible notes in the consolidated statements of 
operations during the year ended December 31, 2019.  

Pursuant  to  the  Amendment  No.2  Agreement,  previously  issued  warrants  were  amended  such  that  the 
exercise price of such warrants was amended from $7.50 to $5.40 and any warrant that had a one-year term was 
amended to have a five-year term. The Company reviewed the amendments to the warrants and determined that they 
will be treated as a modification of an outstanding equity instrument at the time of the Amendment No.2 Agreement. 
Management calculated the change in fair value due to  the modifications to be an expense of approximately $1.1 
million which is included in loss on modification of warrants in the consolidated statements of operations.  

On  May  14,  2019,  the  Company  entered  into  a  securities  purchase  agreement  pursuant  to  which,  the 
Company was provided with $1.0 million of gross proceeds for the issuance of notes with an aggregate principal of 
$1.1 million (the “May 2019 Bridge Notes”) together with applicable warrants, with substantially the same terms and 
conditions as the previously issued Bridge Notes and related warrants. The 9% discount associated with the May 2019 
Bridge Notes was approximately $0.1 million and was recorded as a debt discount. In connection with the May 2019 
Bridge Note issuances, the Company issued to the investors 154,343 warrants to purchase shares of common stock of 
the Company with a five year term and exercise price of $9.56 (the “May 2019 Warrants”). The May 2019 Warrants 
had an initial value of approximately $0.9 million at the date of issuance and were recorded as a liability with an offset 
to  debt  discount.  See  Note  12  –  Fair  Value  for  further  discussion.  The  May  2019  Bridge  Notes  were  issued  to 
investors that previously participated in the 2018 Note Agreement.   

The conversion price of the May 2019 Bridge Notes is $7.12, provided that a) in the event the notes are not 
paid in full prior to 180 days after the original issue date or b) upon a registration statement (as defined in the purchase  

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57  

agreement) being declared effective, whichever occurs earlier, the conversion price shall be equal to 80% of the lowest 
VWAP in the 10 trading days prior to the date of the notice of conversion, but in no event below the floor price of 
$2.25.  

The Company reviewed the conversion option of the May 2019 Bridge Notes and determined that there was 
a beneficial conversion feature with a value of approximately $0.9 million which was recorded as a debt discount with 
an offset to additional paid in capital. The May 2019 Bridge Notes also contain the Bridge Notes Redemption Feature 
and the Company performed a valuation at the time of issuance which resulted in zero value, at that time, due to the 
high value of the conversion feature and a limited upside from the redemption premium.  

Debt discounts and debt issuance costs related to the May 2019 Bridge Notes totaled $2.0 million. Since the 
costs exceeded the $1.1 million face amount of the debt, the Company recorded $1.1 million of debt discount and debt 
issuance costs as a reduction of the related debt in the accompanying consolidated balance sheet with the excess $0.9 
million expensed as a loss on issuance of convertible notes in the consolidated statements of operations during the 
year ended December 31, 2019.  

During the years ended December 31, 2019 and 2018, $4.4 million and $0.2 million, respectively, of Bridge 
Notes, plus interest, were converted into 1,900,766 and 93,334 shares of common stock of the Company, respectively. 
As a result of the conversions, the Company wrote-off approximately $0.5 million of derivative liability, with an 
offset to additional paid-in capital, during the year ended December 31, 2019 and approximately $0.1 million of debt 
premium with an offset to additional paid in capital during the year ended December 31, 2018.  

During the years ended December 31, 2019 and 2018, the change in Bridge Note debt discounts and debt 

premiums was as follows:  

For the Year Ended December 31, 

   
   
   
   
   
   
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
Beginning balance at January 1 

Additions: 
Deductions: 

2019 

Debt 
Discounts   

   $ 

(1,111)    $ 
(2,088)      

2018 

Debt 
Premiums   
647   
 —   

Debt 
Discounts   

$ 

 —    $ 

(4,275)   

Debt 
Premiums 
 — 
879 

Amortization (accretion)  (1) 
Write-off related to note conversions  (2) 
Write-off related to note extinguishment  (3) 

(170) 
(62) 
 — 
647 
(1)    Amortization/accretion  is  recognized  as  interest  expense/income  within  the  consolidated  statements  of 

118   
 —   
3,046   
(1,111)    $ 

273      
1,130      
 —      
(1,796)    $ 

(167)   
(480)   
 —   
 —   

   $ 

Balance at December 31 

$ 

operations based on the effective interest method. 

(2)    Write-offs associated with note conversions are recognized as an offset to additional paid-in capital at the time 

of the conversion. 

(3)    Write-offs associated with note extinguishment are recognized as a loss and included in loss on extinguishment 

of convertible notes in the consolidated statements of operations. 

The remaining debt discounts of $1.8 million, as of December 31, 2019, are expected to be fully amortized 

by the end of the second quarter of 2020.  

Convertible Promissory Notes – Exchange Notes.  

In 2017, the Company entered into Debt Settlement Agreements (the “Settlement Agreements”) with certain 
of its accounts payable and accrued liability vendors (the  “Creditors”) pursuant to which the Creditors, who were 
owed $6.3 million (the “Debt Obligations”) by the Company, agreed to reduce and exchange the Debt Obligations for 
a  secured  obligation  in  the  amount  of  $3.2  million,  $1.9  million  in  shares  of  the  Company’s  common  stock  and 
warrants, with a fair value of approximately $0.2 million, to purchase shares of the Company’s common stock.  

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58  

The Debt Obligations were restructured as follows:  

·  

·  

·  

The  Company  entered  into  a  scheduled  long-term  debt  repayment  agreement  of  approximately  $3.2 
million, which includes interest of approximately $0.6 million, to be paid in forty-eight equal monthly 
installments beginning in July 2018 (the “Secured Debt Obligations”). 
Debt  Obligations  of  $1.9  million  were  canceled  in  exchange  for  120,983  shares  of  the  Company’s 
common stock with a weighted average price per share of $15.60 (the “Settlement Common Shares”). 
The stock was issued in February 2018. 
Warrants to purchase 7,207 shares of the Company’s common stock at an exercise price of $112.50 per 
share (the “Creditor Warrants”) were issued to certain Creditors. The Creditor Warrants were issued in 
February 2018. 

During 2018, the Company entered into an Exchange Agreement (the “Exchange Agreements”) with three 
institutional  investors  (the  “Holders”)  pursuant  to  which  the  Company  issued  convertible  promissory  notes,  due 
January 1, 2021 (the “Exchange Notes”) in exchange (the “Exchange”) for amounts owed to the Holders pursuant to 
certain debt settlement agreements, dated October 31, 2017. For the year ended December 31, 2018, $3.2 million of 
Secured  Debt  Obligations  were  exchanged  for  $2.8  million  of  Exchange  Notes.  The  Company  considered  the 
appropriate  accounting  treatment  of  the  Exchange  and  determined  that  the  Exchange  will  be  treated  as  a  debt 
extinguishment and the difference between the carrying amount of the Secured Debt Obligations and the face value 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
       
    
  
    
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
 
   
   
   
 
 
 
 
 
 
of the Exchange Notes will be treated as a gain on extinguishment. The Company recorded a $0.4 million gain on 
extinguishment of debt in the consolidated statements of operations for the year ending December 31, 2018.  

Pursuant to the terms of the Exchange Notes, the Company shall pay to the Holders the aggregate principal 
amount of the Exchange Notes in eighteen equal installments beginning on August 1, 2019 and ending on January 1, 
2021. In accordance with the terms of the Exchange Notes, the Holder shall have the right, to convert at the then 
applicable conversion price any amount of the Exchange Notes up to $300,000 on any given Trading Day, with a 
maximum conversion amount up to $500,000 during a period of five Trading Days (the “Conversion Option”). The 
conversion price shall be the lesser of (i) the average volume weighted average price for the five trading days prior to 
the date of conversion multiplied by 1.65 and (ii) $15.00 (the “Conversion Price”).  At any time at which there is no 
Equity Conditions Failure, as defined in the terms of the Exchange Note, and only once every ten trading days, the 
Company shall have the right, but not the obligation, to direct the Holders to convert up to 20% of the then outstanding 
principal amount of the Exchange Notes under specified conditions (the “Company Put Option”). The Company will 
be subject to certain restrictive covenants pursuant to the Notes, including limitations on (i) amending its certificate 
of  incorporation  and  bylaws  (ii)  indebtedness,  (iii) asset  sales  or  leases,  (iv) restricted  payments and  investments, 
(v) redemptions or repurchases of capital stock and (vi) transactions with affiliates, and the conversion price of the 
Exchange  Notes  shall  be  subject  to  certain  customary  adjustments  in  the  event  of  stock  splits,  dividends,  rights 
offerings or other pro rata distributions to holders of the Company’s common stock.  

The  Company  reviewed  the  Conversion  Option  and  concluded  that  it  meets  the  criteria  for  derivative 
accounting and requires bifurcation and separate accounting as a derivative. The Company determined the initial fair 
value of the derivative at the time of issuance to be approximately $0.4 million which was recorded as a debt discount 
with an offset to derivative liability. The valuation was performed using a Monte Carlo Simulation. See Note 12  – 
Fair Value for further discussion.  

The  Company  reviewed  the  Company  Put  Option  and concluded  that  it  meets  the  criteria  for  derivative 
accounting and requires bifurcation and separate accounting as a derivative. The Company determined the initial fair 
value of the derivative at the time of issuance to be immaterial. The valuation was performed using a Monte Carlo 
Simulation.  

The Company also reviewed certain redemption provisions and call options that exist in the terms of the 

Exchange Notes and determined that neither require bifurcation or separate accounting.  

During the year ended December 31, 2019 and 2018, Exchange Notes of approximately  $0.6 million and 
$2.2  million,  respectively,  were  converted  into  155,351  and  291,562  shares  of  common  stock  of  the  Company, 
respectively.  

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59  

As of December 31, 2019 and 2018, the outstanding balance of the Exchange Notes, net of discounts, was zero and 
$0.6 million, respectively, and was presented within convertible notes in the Company’s consolidated balance sheet.  

During the year ended December 31, 2019 and 2018, the change in Exchange Note debt discounts was as 

follows:  

(Dollars in thousands) 

Beginning balance at January 1 

   $ 

Additions: 
Deductions: 

Amortization  (1) 

For the Year Ended December 31, 

2019 

2018 

(83)    $ 
 —   

 2   

 — 
(383) 

28 

   
   
   
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
    
  
  
  
  
  
Balance at December 31 

Write-off related to note conversions  (2) 

272 
(83) 
(1)    Amortization  is  recognized  as  interest  expense  within  the  condensed  consolidated  statements  of 

81   
 —    $ 

   $ 

operations based on the effective interest method. 

(2)    Write-offs associated with note conversions are recognized as an offset to additional paid-in capital at the 

time of the conversion. 

As a result of the Exchange Note conversions, during the years ended December 31, 2019 and 2018, the 
Company wrote-off approximately $0.1 million and $0.3 million, respectively, of derivative liability with an offset to 
additional paid-in capital.  

Convertible Promissory Notes – Crede Note.  

On January 15, 2019, the Company and Crede Capital Group LLC (“Crede”) entered into an amendment and 
restatement agreement (the “Crede Amendment Agreement”) in order to enable the Company to provide Crede with 
an alternative means of payment of a previous settlement amount, See Note 7 – Accrued Expenses and Other Current 
Liabilities, by issuing to Crede a convertible note in the amount of $1.45 million (the “Crede Note”). The conversion 
price of the Crede Note shall equal 90% of the closing bid price of the Company’s common stock on the date prior to 
each conversion date. The Crede Note is payable by the Company on the earlier of (i) January 15, 2021 or (ii) upon 
the closing of a qualified offering in which the Company receives gross proceeds of at least $4.0 million. The Crede 
Note may not be converted if, after giving effect to the conversion, Crede together with its affiliates would beneficially 
own in excess of 4.99% of the outstanding shares of the Company’s common stock. The Company, at its option, may 
redeem some or all of the then outstanding principal amount of the Crede Note for cash.  

In accordance with the terms of the Crede Amendment Agreement, during the period commencing on the 
date of issuance of the Crede Note and ending on the date Crede no longer beneficially owns any portion of the Crede 
Note, Crede shall not sell, on any given trading day, more than the greater of (i) $10,000 of common stock (subject to 
adjustment  for  any  stock  splits  or  combinations,  stock  dividends,  recapitalizations  or  similar  event  after  the  date 
hereof) and (ii) 10% of the daily average composite trading volume of the Company’s common stock as reported by 
Bloomberg,  LP  (subject  to  adjustment  for  any  stock  splits  or  combinations,  stock  dividends,  recapitalizations  or 
similar event after the date hereof) for such trading day.  

On April 16, 2019, the entire outstanding amount of $1.45 million was converted into 270,699 shares of 
common stock of the Company and as of December 31, 2019 the remaining amount due on the Crede Note was zero.  

Convertible Promissory Notes – Leviston Note  

On  February 8,  2018,  the  Company  entered  into  an  equity  purchase  agreement  (the  “2018  Purchase 
Agreement”) with Leviston Resources LLC (“Leviston”), see Note 11 – Stockholders Equity for details of the 2018 
Purchase Agreement. On January 29, 2019, the Company entered into a settlement agreement (the “Leviston  

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60  

Settlement”) with Leviston pursuant to which the Company issued to Leviston a convertible note in the amount of 
$0.7 million (the “Leviston Note”) in full satisfaction of certain obligations to Leviston. The Leviston Note is payable 
by the Company (i) in fourteen equal monthly installments commencing on the earlier to occur of (x) the last day of 
the month upon which a registration statement to be filed by the Company covering the resale of the shares of common 
stock underlying the Leviston Note is declared effective by the Securities and Exchange Commission and (y) the six 
month anniversary of the date of issuance, (ii) upon the closing of a qualified offering, namely the Company raising 
gross proceeds of at least $4.0 million or (iii) such earlier date as the Leviston Note is required or  permitted to be 

  
  
  
 
 
   
   
   
   
   
repaid pursuant to its terms. The Company, at its option, may redeem some or the entire then outstanding principal 
amount of the Leviston Note for cash.  

The conversion price in effect on any conversion date shall equal the VWAP of the common stock on such 
Conversion Date. The Leviston Note may not be converted if, after giving effect to the conversion, Leviston together 
with its affiliates, would beneficially own in excess of 4.99% of the outstanding shares of the Company’s common 
stock.  

In accordance with the terms of the Leviston Settlement, during the period commencing on the issuance date 
of the Leviston Note and ending on the date Leviston no longer beneficially owns any shares of common stock issuable 
upon conversion of the Leviston Note, Leviston shall not sell, on any given trading day, more than the greater of (i) 
$10,000  of  common  stock  (subject  to  adjustment  for  any  stock  splits  or  combinations,  stock  dividends, 
recapitalizations or similar event after the date hereof) and (ii) 10% of the daily average composite trading volume of 
the  Company’s  common  stock  as  reported  by  Bloomberg,  LP  (subject  to  adjustment  for  any  stock  splits  or 
combinations, stock dividends, recapitalizations or similar event after the date hereof) for such trading day.  

In addition to the Leviston Settlement and the Leviston Note, the Company and Leviston have each executed 
a release pursuant to which each of the Company and Leviston agreed to release the other party from their respective 
obligations arising from or concerning the Obligations.  

During the year ended December 31, 2019, the Company made cash payments of less than $0.1 million on 
the Leviston Note and $0.7 million of the Leviston note was converted into 184,357 shares of common stock of the 
Company. As of December 31, 2019, the remaining amount due on the Leviston Note was zero. As of December 31, 
2018, the Company had recorded liabilities related to Leviston of $0.5 million and $0.2 million which were included 
in other current liabilities and accrued expenses, respectively, in the consolidated balance sheet.  

7. ACCRUED EXPENSES AND OTHER CURRENT LIABILITIES.  

Accrued expenses at December 31, 2019 and 2018 are as follows:  

(dollars in thousands) 
Accrued expenses 
Accrued compensation 
Accrued interest 

     December 31, 2019      December 31, 2018 
1,583 
   $ 
118 
239 
1,940 

1,268    $ 
247      
124      
1,639    $ 

   $ 

The  Company  was  able  to  reduce  certain  accrued  expense  and  accounts  payable  amounts  through 
negotiations with certain vendors to settle outstanding liabilities and the Company recorded these amounts as gains 
which are included in gain on settlement of liability, net in the consolidated statements of operations. During the years 
ended December 31, 2019 and 2018, approximately $1.4 million and $0.3 million, respectively, was recorded as a 
gain.  

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61  

Other current liabilities at December 31, 2019 and 2018 are as follows:  

(dollars in thousands) 
Liability related to equity purchase agreement 
Liability for settlement of equity instrument 

     December 31, 2019      December 31, 2018 
460 
 —      
1,450 
 —      
1,910 
 —    $ 

   $ 

   
   
   
   
  
  
  
  
  
  
  
     
     
  
   
  
  
  
  
  
  
  
     
     
  
   
On  February 20,  2018,  Crede  Capital  Group  LLC  (“Crede”)  filed  a  lawsuit  against  the  Company  in  the 
Supreme Court of the State of New York for Summary Judgment in Lieu of Complaint requiring the Company to pay 
cash owed to Crede. Crede claimed that Precipio had breached a Securities Purchase Agreement and Warrant that 
Crede entered into in connection with an investment in Transgenomic and that pursuant to those agreements, Precipio 
owed Crede approximately $2.2 million. On March 12, 2018, Precipio entered into a settlement agreement (the “Crede 
Agreement”) with Crede pursuant to which Precipio agreed to pay Crede a total sum of $1.925 million over a period 
of 16 months payable in cash, or at the Company’s discretion, in stock, in accordance with terms contained in the 
Crede Agreement. In accordance with the terms of the agreement and in addition to the agreement to pay, we also 
executed and delivered to Crede an affidavit of confession of judgment.   

As of the date of the Crede Agreement, the fair value of the common stock warrant liability related to Crede 
was revalued to approximately $0.4 million, resulting in a gain of $0.2 million included in warrant revaluation in the 
consolidated statement of operations during the year ended December 31, 2018. See Note 12 – Fair Value for further 
discussion. At the time of the Crede Agreement, the Company recorded an additional loss of $0.4 million, which  is 
included in loss on settlement of equity instruments in the consolidated statement of operations during the year ended 
December 31, 2018. During 2018, the Company paid approximately $0.5 million to Crede, with a remaining balance 
of $1.45 million as of December 31, 2018. On January 15, 2019, the $1.45 million liability was replaced with the 
Crede Note.  

As of December 31, 2018, the Company had recorded a liability of approximately $0.5 million related to an 
equity purchase agreement with Leviston, which is included in other current liabilities on our consolidated balance 
sheet. On January 29, 2019, the Company entered into the Leviston Settlement pursuant to which the Company issued 
the Leviston Note in full satisfaction of the $0.5 million discussed above along with approximately $0.2 million of 
other  obligations  owed  to  Leviston  which  are  included  in  accrued  expenses  in  our  consolidated  balance  sheet  at 
December 31, 2018. See Note 6 – Convertible Notes.  

8. LEASES  

On January 1, 2019, the Company recorded initial ROU assets and corresponding operating lease liabilities 
of approximately $750,000 and a reversal of deferred rent and prepaid expenses of approximately $6,000 resulting in 
no  cumulative  effect  adjustment  upon  adoption  of  Topic  842.  The  Company  leases  administrative  facilities  and 
laboratory  equipment  through  operating  lease  agreements.  In  addition  we  rent  various  equipment  used  in  our 
diagnostic lab and in our administrative offices through finance lease arrangements.  Our operating leases include 
both lease (e.g., fixed payments including rent) and non-lease components (e.g., common area or other maintenance 
costs). The facility leases include one or more options to renew, from 1 to 5 years or more. The exercise of lease 
renewal options is typically at our sole discretion, therefore, the renewals to extend the lease terms are not included 
in  our  ROU  assets  and  lease  liabilities  as  they  are  not  reasonably  certain  of  exercise.  We  regularly  evaluate  the 
renewal options and, when they are reasonably certain of exercise, we include the renewal period in our lease term.  As 
our  leases  do  not  provide  an  implicit  rate,  we  use  our  collateralized  incremental  borrowing  rate  based  on  the 
information available at the lease commencement date in determining the present value of the lease payments.  

Operating leases result in the recognition of ROU assets and lease liabilities on the balance sheet. ROU assets 
represent our right to use the leased asset for the lease term and lease liabilities represent our obligation to make lease 
payments. Operating lease ROU assets and liabilities are recognized at commencement date based on the present 
value of lease payments over the lease term. Lease expense is recognized on a straight-line basis over the lease term. 
Leases with an initial term of 12 months or less are not recorded on the balance sheet. The primary leases we enter 
into with initial terms of 12 months or less are for equipment.  

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62  

Upon the adoption of Topic 842, our accounting for finance leases, previously referred to as capital leases, 

remains substantially unchanged from prior guidance.  

   
The balance sheet presentation of our operating and finance leases is as follows:  

(dollars in thousands) 

Classification on the Condensed Consolidated Balance Sheet 

   December 31, 2019 

Assets: 

Operating lease assets 
Finance lease assets 
Total lease assets 

Liabilities: 
Current: 

Operating lease right-of-use assets, net 
Property and equipment, net 

Operating lease obligations 
Finance lease obligations 

Current maturities of operating lease liabilities 
Current maturities of finance lease liabilities 

Noncurrent: 

Operating lease obligations 
Finance lease obligations 
Total lease liabilities 

Operating lease liabilities, less current maturities 
Finance lease liabilities, less current maturities 

   $ 

   $ 

   $ 

   $ 

519 
184 
703 

209 
52 

317 
119 
697 

As of December 31, 2019, the estimated future minimum lease payments, excluding non-lease components, 

are as follows:  

(dollars in thousands) 
2020 
2021 
2022 
2023 
2024 
Thereafter 
Total lease obligations 
Less: Amount representing interest 
Present value of net minimum lease obligations 
Less, current portion 
Long term portion 

Other information as of December 31, 2019:  

Weighted-average remaining lease term (years): 

Operating leases 
Finance leases 

Weighted-average discount rate: 

Operating leases 
Finance leases 

   $ 

      Operating Leases    
   $ 

242    $ 
241   
48   
35   
17   
 —   
583   
(57)   
526   
(209)   
317    $ 

Finance Leases 

Total 

62    $ 
38   
32   
28   
27   
13   
200   
(29)   
171   
(52)   
119    $ 

304 
279 
80 
63 
44 
13 
783 
(86) 
697 
(261) 
436 

2.8 
4.3 

8.00%  
7.25%  

During the year ended December 31, 2019, operating cash flows from operating leases was $144,000 and 

ROU assets obtained in exchange for operating lease liabilities was $750,000.  

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Operating Lease Costs  

63  

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
   
  
  
  
  
   
Operating lease costs were $0.3 million during the year ended December 31, 2019 and 2018, respectively. 
These costs are primarily related to long-term operating leases for the Company’s facilities and laboratory equipment. 
Short-term and variable lease costs were less than $0.1 million for the years ended December 31, 2019 and 2018, 
respectively.  

Finance Lease Costs  

Finance leases are included in property and equipment, net and finance lease liabilities, less current maturities 
on the consolidated balance sheets. The associated amortization expense and interest included in the consolidated 
statements of operations for the year ended December 31, 2019 and 2018 is less than $0.1 million, respectively.  

9. COMMITMENTS AND CONTINGENCIES  

PURCHASE COMMITMENTS  

The Company has entered into purchase commitments for reagents from suppliers. These agreements started 
in 2011 and run through 2025. The Company and the suppliers will true up the amounts on an annual basis. The future 
minimum purchase commitments under these and other purchase agreements are as follows:  

Years ending December 31,  
2020 
2021 
2022 
2023 
2024 
Thereafter 

LITIGATIONS  

(dollars in 
thousands) 

341 
242 
228 
219 
149 
50 
1,229 

   $ 

   $ 

The Company is delinquent on the payment of outstanding accounts payable for certain vendors and suppliers 

who have taken or have threatened to take legal action to collect such outstanding amounts.  

On February 21, 2017, XIFIN, Inc. (“XIFIN”) filed a lawsuit against us in the District Court for the Southern 
District of California alleging breach of written contract and seeking recovery of approximately $0.27 million owed 
by us to XIFIN for damages arising from a breach of our obligations pursuant to a Systems Services Agreement 
between us and XIFIN, dated as of February 22, 2013, as amended and restated on September 1, 2014. A liability of 
$0.1 million was reflected in accounts payable within the accompanying consolidated balance sheet at December 31, 
2018. On April 19, 2019, the Company executed a settlement agreement with XIFIN pursuant to which the Company 
paid  to  XIFIN  an  agreed  amount  of  $40,000  as  settlement  in  consideration  for  total  release  from  all  outstanding 
amounts due and payable by the Company to XIFIN. The settlement amount was paid in full by the Company on 
April 19, 2019.  

CPA Global provides us with certain patent management services. On February 6, 2017, CPA Global claimed 
that we owe approximately $0.2 million for certain patent maintenance services rendered. CPA Global has not filed 
claims against us in connection with this allegation. A liability of less than $0.1 million has been recorded and is 
reflected in accounts payable within the accompanying consolidated balance sheet at December 31, 2019 and 2018.  

On February 17, 2017, Jesse Campbell (“Campbell”) filed a lawsuit individually and on behalf of others 
similarly situated against us in the District Court for the District of Nebraska alleging we had a materially incomplete 
and misleading proxy relating to a potential merger and that the merger agreement’s deal protection provisions deter 
superior offers. As a result, Campbell alleges that we have violated Sections 14(a) and 20(a) of the Exchange Act and 
Rule 14a-9 promulgated thereafter. The Company filed a motion to dismiss all claims, which motion was fully briefed  

   
  
  
  
  
       
     
     
     
     
     
  
   
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64  

on November 27, 2017. The Court granted the Company’s motion in full on May 3, 2018 and dismissed the lawsuit. 
The Eighth Circuit reversed the decision of the District Court and remanded the case back to the District Court. The 
parties filed a notice with the Court on May 22, 2019, announcing that they had reached a settlement in principle.  On 
June  21,  2019,  the  parties  filed  a stipulation  of  settlement,  in  which  defendants  are  released  from  all  claims  and 
expressly deny that that they have committed any act or omission giving rise to any liability.  The stipulation includes 
a settlement payment of $1.95 million, which will be primarily funded by our insurance.  On July 10, 2019, the Court 
entered an order preliminarily approving the settlement.  The settlement remains subject to final approval by the Court. 
The Company’s insurance policy includes a deductible of approximately $0.8 million and the Company has previously 
paid  approximately  $0.5  million  in  legal  fees  in  connection  with  the  litigation  which  have  been  applied  to  the 
deductible leaving approximately $0.3 million to be paid by the Company and approximately $1.7 million to be paid 
by the insurance company. During the third quarter of 2019, both the Company and the insurance company paid their 
respective amounts to an escrow account where the funds will be held until they are approved for distribution at a 
fairness  hearing  of  the  Court  which  took  place  on  November  4,  2019.  As  of  the  date  the  consolidated  financial 
statements were issued, the Company is waiting for the Court to render its judgement which is still outstanding.  

On March 21, 2018, Bio-Rad Laboratories filed a lawsuit against us in the Superior Court Judicial Branch of 
the State of Connecticut for Summary Judgment in Lieu of Complaint requiring us to pay cash owed to Bio-Rad in 
the amount of $39,000 that was recorded in accounts payable within the accompanying consolidated balance sheet at 
December 31, 2018.  The obligation was paid in full during the second quarter 2019, resulting in no remaining amount 
due to Bio-Rad.  

LEGAL AND REGULATORY ENVIRONMENT  

The healthcare industry is subject to numerous laws and regulations of federal, state and local governments. 
These  laws  and  regulations  include,  but  are  not  limited  to,  matters  such  as  licensure,  accreditation,  government 
healthcare program participation requirement, reimbursement for patient services and Medicare and Medicaid fraud 
and  abuse.  Government  activity  has  increased  with  respect  to  investigations  and  allegations  concerning  possible 
violations of fraud and abuse statutes and regulations by healthcare providers.  

Violations of these laws and regulations could result in expulsion from government healthcare programs 
together with the imposition of significant fines and penalties, as well as significant repayments for patient services 
previously billed. Management believes that the Company is in compliance with fraud and abuse regulations, as well 
as  other  applicable  government  laws  and  regulations.  While  no  material  regulatory  inquiries  have  been  made, 
compliance with such laws and regulations can be subject to future government review and interpretation, as well as 
regulatory actions unknown or unasserted at this time.  

10. INCOME TAXES  

The  Company  recorded  a  deferred  tax  liability  of  $0.1  million  as  of  December 31,  2018,  related  to  the 
acquisition of IPR&D through the Merger. This deferred tax liability was recorded to account for the book versus tax 
basis difference related to the IPR&D intangible asset. This deferred tax liability was excluded from sources of future 
taxable income, as the timing of its reversal cannot be predicted due to the indefinite life of this IPR&D. As such, this 
deferred tax liability cannot be used to offset the valuation allowance. As a result of the write-off of the IPR&D in 
2019, the related deferred tax liability of $0.1 million was eliminated and is included in income  tax benefit in the 
consolidated statements of operations for the year ended December 31, 2019.  

Deferred income taxes reflect the net effects of temporary differences between the carrying amounts of assets 
and liabilities for financial reporting purposes and the amounts used for income tax purposes. The Company’s net 
deferred tax assets relate primarily to its net operating loss carryforwards and stock based compensation, offset by 
property and equipment and intangible assets. With the exception of the IPR&D, the Company has recorded a full 

valuation allowance to offset the net deferred tax assets, because it is not more likely than not that the Company will 
realize future benefits associated with these net deferred tax assets at December 31, 2019 and 2018.  

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65  

At December 31, 2019 and 2018, the Company had net deferred tax assets of $10.7 million and $8.7 million, 
respectively, against which a valuation allowance of $10.7 million and $8.8 million, respectively, had been recorded. 
The valuation allowance excluded the deferred tax liability for IPR&D assigned as an indefinite life intangible asset 
for book purposes, also known as a “naked credit” in the amount of $0.1 million at December 31, 2018. The increase 
in  the  valuation  allowance  for  the year  ended  December 31,  2019 is  $1.9  million,  resulting  from  additional  net 
operating losses generated in the year.  The deferred tax liabilities associated with the book versus tax basis difference 
of intangible assets are the result of an asset step-up pursuant to the Merger. Significant components of the Company’s 
deferred tax assets at December 31, 2019 and 2018 are as follows:  

Deferred tax assets: 

Net operating loss and credit carryforwards 
Stock-based compensation 
Other 

Gross deferred tax assets 
Deferred tax liabilities: 

Property and equipment 
Intangible assets  
IPR&D intangible assets 
Gross deferred tax liabilities  
Net deferred tax assets 
Less valuation allowance  
Net deferred liability 

Dollars in Thousands 
2018 
2019 

   $  13,989    $  10,202 
192 
426 
10,820 

292   
666   
14,947   

(95)   
(4,148)   
 —   
(4,243)   
10,704   
(10,704)   

   $ 

 —    $ 

42 
(2,084) 
(70) 
(2,112) 
8,708 
(8,778) 
(70) 

The Company’s provision for income taxes for the year ended December 31, 2019 and December 31, 2018 
relates to income taxes in states and other jurisdictions and differs from the amounts determined by applying the 
statutory federal income tax rate to the loss before income taxes for the following reasons:  

Benefit at federal rate 
Increase (decrease) resulting from: 
State income taxes—net of federal benefit 
Miscellaneous permanent differences 
Warrant liability revaluation 
Impairment of goodwill 
Impairment of in-process research and development 
Other 
Change in valuation allowance 
Total income tax benefit 

   Dollars in Thousands 

2019 

2018 

   $ (2,796)    $ (3,354) 

(517)      
78      
(104)      

(633) 
 — 
(479) 
 —       1,170 
 — 
(70)      
 —      
14 
      3,339       3,003 
(279) 
(70)    $ 
   $ 

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66  

  
  
  
  
  
  
  
  
  
  
     
     
  
  
     
  
   
  
  
  
  
  
  
  
  
  
  
  
     
  
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
   
  
  
  
  
  
  
  
  
  
  
  
     
        
   
     
     
     
     
     
     
   
The income tax expense consists of the following at December 31, 2019 and 2018.  

Federal: 
Current 
Deferred 

Total Federal 

State: 

Current 
Deferred 

Total State 

Foreign: 
Current 
Deferred 

Total Foreign 
Total Tax Provision 

   Dollars in Thousands 

2019 

2018 

   $ 

   $ 

   $ 

   $ 

   $ 

   $ 
   $ 

 —    $ 
(70)      
(70)    $ 

 — 
(279) 
(279) 

 —    $ 
 —      
 —    $ 

 — 
 — 
 — 

 —    $ 
 —      
 —    $ 
(70)    $ 

 — 
 — 
 — 
(279) 

The  Company  had  approximately  $61  million  and  $39  million  of  available  gross  federal  and  state  net 
operating loss (“NOL”) carryforwards as of December 31, 2019 and 2018, respectively. Beginning in 2018, under the 
Act, federal loss carryforwards have an unlimited carryforward period, however such losses can only offset 80% of 
taxable income in any one year. Included in the total NOLs for 2019 are $31 million of federal losses that fall under 
these new rules. Section 382 of the Internal Revenue Code, and similar state regulations, contain provisions that may 
limit the NOL carryforwards available to be used to offset income in any given year upon the occurrence of certain 
events, including changes in the ownership interests of significant stockholders. In the event of a cumulative change 
in ownership in excess of 50% over a three-year period, the amount of the NOL carryforwards that the Company may 
utilize in any one year may be limited. The Company reduced its tax attributes (NOLs and tax credits) and generated 
a limitation on utilization of such attributes resulting from the Merger.  

At December 31, 2019 and 2018, and as a result of the limitations under Section 382 of the Internal Revenue 
Code, the Company had a total of unused federal tax net operating loss carryforwards with expiration dates as follows:  

2036 
2037 
Unlimited life 
Total Federal 

   Dollars in Thousands 

2019 

2018 

   $ 13,470    $ 13,470 
      3,441       3,441 
     42,100      21,138 
   $ 59,011    $ 38,049 

The  Company  has  adopted  guidance  on  accounting  for  uncertainty  in  income  taxes  which  clarified  the 
accounting for income taxes by prescribing the minimum threshold a tax  position is required to meet before being 
recognized  in  the  financial  statements  as  well  as  guidance  on  de-recognition,  measurement,  classification  and 
disclosure of tax positions. There are no material uncertain tax positions that would require recognition in the financial 
statements. The Company is obligated to file income tax returns in the U.S. federal jurisdiction and various U.S. states. 
Since  the  Company  had  losses  in  the  past,  all  prior years  that  generated  NOLs  are  open  and  subject  to  audit 
examination  in  relation  to  the  NOL  generated  from  those years.  Our  evaluation  of  uncertain  tax  positions  was 
performed for the tax years ended December 31, 2014 and forward.  

11. STOCKHOLDERS’ EQUITY  

Common Stock  

Pursuant to our Third Amended and Restated Certificate of Incorporation, as amended, we currently have 
150,000,000 shares of common stock authorized for issuance. On December 20, 2018, the Company’s shareholders  

  
  
  
  
  
  
  
  
  
     
     
     
        
   
     
     
        
   
     
     
        
   
     
   
  
  
  
  
  
  
  
  
  
     
     
   
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67  

approved the proposal to authorize the Company’s Board of Directors to, in its discretion, to amend the Company’s 
Third Amended and Restated Certificate of Incorporation to increase the total number of authorized shares of common 
stock from 150,000,000 shares to 250,000,000 shares. The Company has not yet affected this increase.  

On  February 12,  2018,  the  Company  issued  120,983  shares  of  its  common  stock  in  exchange  for 

approximately $1.9 million of debt obligations.  See Note 6 – Convertible Notes.  

During  the year  ended  December 31,  2018,  the  Company  issued  208,000  shares  of  its  common  stock  in 
connection with conversions of its Series B Preferred Stock and 223,022 shares of its common stock in connection 
with conversions of its Series C Preferred Stock. Aside from 4,000 shares of common stock issued in connection with 
conversions of its Series C Preferred Stock, all of the shares of common stock issued for the year ended December 
31, 2018 in connection with conversions of its Series B Preferred Stock and Series C Preferred Stock (together the 
“Preferred Stock”) were issued after the Company induced the holders of its Preferred Stock to convert their shares 
of Preferred Stock to shares of the company’s common stock (see below - Preferred Stock induced conversions).  

During the years ended December 31, 2019 and 2018, the Company issued 310,200 and 252,486 shares of 
its common stock, respectively, in connection with the exercise of 310,200 and 252,486 warrants, respectively. The 
warrant exercises resulted in net cash proceeds to the Company of approximately $1.6 million and $1.3 million during 
the years ended December 31, 2019 and 2018, respectively.  

Also  during  the  years  ended  December  31,  2019  and  2018,  the  Company  issued  2,511,173  and  384,896 
shares of its common stock, respectively, in connection with the conversion of convertible notes, plus interest, totaling 
$7.6 million and $2.4 million, respectively. See Note 6 – Convertible Notes.  

2018 Purchase Agreement  

On  February  8,  2018  the  Company  entered  into  an  equity  purchase  agreement  (the  “2018  Purchase 
Agreement”) with Leviston for the purchase of up to $8,000,000 (the “Aggregate Amount”) of shares (the “Shares”) 
of  the  Company’s  common  stock  from  time  to  time,  at  the  Company’s  option.  Shares  offered  and  sold  prior  to 
February 13, 2018 were issued pursuant to the Company’s shelf registration statement on Form S-3 (and the related 
prospectus)  that  the  Company  filed  with  the  Securities  and  Exchange  Commission  (the  “SEC”)  and  which  was 
declared effective by the SEC on February 13, 2015 (the “Shelf Registration Statement”).  

Leviston purchased 48,076 shares (the “Investor Shares”) of the Company’s common stock following the 
close of business on February 9, 2018, subject to customary closing conditions, at a price per share of $15.60 for 
approximately $750,000. The shares were sold pursuant to the Shelf Registration Statement. The Company incurred 
approximately $132,000 in costs which have been treated as issuance costs within additional paid-in capital in the 
accompanying consolidated balance sheet.  

As required by the terms of the 2018 Purchase Agreement, the Company timely filed an S-1 on April 16, 
2018.  The S-1 Registration Statement was not declared effective by the SEC and on August 10, 2018 the Company 
filed a withdrawal request with the SEC. No securities had been issued or sold under this Registration Statement. The 
Company determined not to proceed with the offering as the Company sought to re-negotiate the terms of the equity 
purchase agreement in order to comply with the requirements of the SEC pursuant to a letter from the SEC dated 
August 7, 2018.  

In consideration of Leviston’s agreement to enter into the 2018 Purchase Agreement, the Company agreed 
to pay to Leviston a commitment fee in shares of the Company’s common stock equal in value to 5.25% of the total 
Aggregate  Amount  (the  “Leviston  Commitment  Shares”),  payable  in  three  installments  upon  achieving  certain 
milestones. The first installment of 1.75% was due on or before February 12, 2018 and this amount, of $140,000, was 
paid to Leviston through the issuance of 11,381 shares of the Company’s common stock on February 12, 2018.  

   
   
   
   
   
In accordance with the terms of the 2018 Purchase Agreement, the Company provided Leviston with a price 
protection  provision,  if  the  Company  issues any  warrants  in connection  with  issuances, sales  or  an  agreement  in 
writing to issue common stock or common stock equivalents of the Company, Leviston will have the right to receive 
a  

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68  

proportionate amount of such warrants, cash or shares, at Leviston’s sole election, valued using the Black Scholes 
formula. As a result of 2018 Note Agreement and the April 2018 Warrants issued, the Company was required to 
provide Leviston with a proportionate and equivalent coverage in the form of warrants, stock or cash in the amount 
of approximately $460,000. As Leviston has the ability to elect the form of compensation, the Company has recorded 
the $460,000 as a liability as of December 31, 2018, within the other current liabilities line of the accompanying 
consolidated balance sheet.  

As  of  December  31,  2018,  the  Company  had  a  total  of  $0.7  million  in  accruals  (see  Note  7  –  Accrued 
Expenses and Other Current Liabilities) for potential obligations to Leviston, but had not issued any additional shares 
or made any payments to Leviston. On January 29, 2019, the Company entered into the Leviston Settlement pursuant 
to which the Company issued to Leviston the Note in full satisfaction of all obligations owed to Leviston. See Note 6 
– Convertible Notes for further details of the Leviston Note.  

LP Purchase Agreement  

On September 7, 2018, the Company entered the LP Purchase Agreement, pursuant to which Lincoln Park 

has agreed to purchase from the Company up to an aggregate of $10,000,000 of common stock of the Company 
(subject to certain limitations) from time to time over the term of the LP Purchase Agreement. Pursuant to the terms 
of the LP Purchase Agreement, on the agreement date, the Company issued 40,000 shares of its common stock to 
Lincoln Park as consideration for its commitment to purchase shares of common stock of the Company under the 
LP Purchase Agreement (the “LP Commitment Shares”). Also on September 7, 2018, the Company entered into a 
registration rights agreement with Lincoln Park (the “LP Registration Rights Agreement”), pursuant to which on 
September 14, 2018, the Company filed with the SEC a registration statement on Form S-1 to register for resale 
under the Securities Act of 1933, as amended, or the Securities Act, 466,667 shares of common stock, which 
includes the LP Commitment Shares, that have been or may be issued to Lincoln Park under the LP Purchase 
Agreement. The Form S-1 was declared effective by the SEC on September 28, 2018.  As of January 16, 2019, all 
shares registered under this S-1 had been sold and/or issued to Lincoln Park. On February 1, 2019, the Company 
filed with the SEC a registration statement on Form S-1 to register for resale under the Securities Act of 1933, as 
amended, or the Securities Act, an additional 1,000,000 shares of common stock that have been or may be issued to 
Lincoln Park under the LP Purchase Agreement. The Form S-1 was declared effective by the SEC on February 12, 
2019. As of August 5, 2019, all shares registered under this S-1 had been sold and/or issued to Lincoln Park. On 
August 9, 2019, the Company filed with the SEC a registration statement on Form S-1 to register for resale under 
the Securities Act of 1933, as amended, or the Securities Act, an additional 1,800,000 shares of common stock that 
have been or may be issued to Lincoln Park under the LP Purchase Agreement. As of December 31, 2019, 
1,680,000 shares registered under this S-1 had been sold and/or issued to Lincoln Park and 120,000 were sold and/or 
issued to Lincoln Park in January 2020. On January 14, 2020, the Company filed with the SEC a registration 
statement on Form S-1 to register for resale under the Securities Act of 1933, as amended, or the Securities Act, an 
additional 920,654 shares of common stock that have been or may be issued to Lincoln Park under the LP Purchase 
Agreement. From January 1, 2020 through the date the consolidated financial statements were issued,  780,012 
shares registered under this S-1 had been sold and/or issued to Lincoln Park.  

Under the LP Purchase Agreement, the Company may, from time to time and at its sole discretion, on any 

single business day on which the closing price of its common stock is not less than the Floor Price, defined as the 
lower of (i) $1.50 per share (subject to adjustment for any reorganization, recapitalization, non-cash dividend, stock 

   
   
   
   
   
split, reverse stock split or other similar transaction as provided in the LP Purchase Agreement) and (ii) $0.10 per 
share, direct Lincoln Park to purchase shares of its common stock in amounts up to 30,000 shares, which amounts 
may be increased to up to 36,666 shares depending on the market price of its common stock at the time of sale and 
subject to a maximum commitment by Lincoln Park of $1,000,000 per single purchase, which the Company refers 
to as “regular purchases”, plus other “accelerated amounts” and/or “additional accelerated amounts” under certain 
circumstances. The Company will control the timing and amount of any sales of its common stock to Lincoln Park. 
The purchase price of the shares that may be sold to Lincoln Park in regular purchases under the LP Purchase 
Agreement will be based on the market price of the common stock of the Company preceding the time of sale as 
computed under the LP Purchase Agreement. The purchase price per share will be equitably adjusted for any 
reorganization, recapitalization, non-cash dividend, stock split, or other similar transaction occurring during the 
business days used to compute such price. The Company may at any time in its sole discretion terminate the LP 
Purchase Agreement without fee, penalty or cost upon one business day  

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69  

notice.  There are no restrictions on future financings, rights of first refusal, participation rights, penalties or 
liquidated damages in the LP Purchase Agreement or LP Registration Rights Agreement, other than a prohibition on 
the Company entering into certain types of transactions that are defined in the LP Purchase Agreement as “Variable 
Rate Transactions”. Lincoln Park may not assign or transfer its rights and obligations under the Purchase 
Agreement.  

Under applicable rules of The Nasdaq Capital Market, in no event may the Company issue or sell to 

Lincoln Park under the LP Purchase Agreement more than 19.99% of the shares of its common stock outstanding 
immediately prior to the execution of the LP Purchase Agreement (which is 308,590 shares based on 1,543,724 
shares outstanding immediately prior to the execution of the LP Purchase Agreement), which limitation the 
Company refers to as the Exchange Cap, unless (i) the Company obtains stockholder approval to issue shares of 
common stock in excess of the Exchange Cap or (ii) the average price of all applicable sales of the Company’s 
common stock to Lincoln Park under the LP Purchase Agreement equals or exceeds $7.05 (which represents the 
closing consolidated bid price of the Company’s common stock on September 7, 2018, plus an incremental amount 
to account for the issuance of the LP Commitment Shares to Lincoln Park), such that issuances and sales of the 
Company’s common stock to Lincoln Park under the LP Purchase Agreement would be exempt from the Exchange 
Cap limitation under applicable NASDAQ rules. In any event, the LP Purchase Agreement specifically provides that 
the Company may not issue or sell any shares of its common stock under the LP Purchase Agreement if such 
issuance or sale would breach any applicable NASDAQ rules. The Company received shareholder approval on 
December 20, 2018.  

The LP Purchase Agreement also prohibits the Company from directing Lincoln Park to purchase any 
shares of common stock if those shares, when aggregated with all other shares of the Company’s common stock 
then beneficially owned by Lincoln Park and its affiliates, would result in Lincoln Park and its affiliates having 
beneficial ownership, at any single point in time, of more than 4.99% of the then total outstanding shares of the 
Company’s common stock, as calculated pursuant to Section 13(d) of the Securities Exchange Act of 1934, as 
amended, or the Exchange Act, and Rule 13d-3 thereunder, which limitation the Company refers to as the Beneficial 
Ownership Cap as defined in the LP Agreement.  

As of the date the consolidated financial statements were issued, we have already received $9.3 million in 
aggregate,  including  approximately  $1.4  million  from  the  sale  of  328,590  shares  of  common  stock  to  Lincoln 
Park during 2018, $6.6 million from the sale of 2,778,077 shares of common stock to Lincoln Park during 2019, and 
$1.3 million from the sale of 900,012 shares of common stock to Lincoln Park from January 1, 2020 through the date 
the consolidated financial statements were issued.  

Preferred Stock  

    
   
   
The Company’s Board of Directors is authorized to issue up to 15,000,000 shares of preferred stock in one 
or more series, from time to time, with such designations, powers, preferences and rights and such qualifications, 
limitations and restrictions as may be provided in a resolution or resolutions adopted by the Board of Directors. The 
authority of the Board of Directors includes, but is not limited to, the determination or fixing of the following with 
respect to shares of such class or any series thereof: (i) the number of shares; (ii) the dividend rate, whether dividends 
shall be cumulative and, if so, from which date; (iii) whether shares are to be redeemable and, if so, the terms and 
amount of any sinking fund providing for the purchase or redemption of such shares; (iv) whether shares shall be 
convertible and, if so, the terms and provisions thereof; (v) what restrictions are to apply, if any, on the issue or reissue 
of any additional preferred stock; and (vi) whether shares have voting rights. The preferred stock may be issued with 
a preference over the common stock as to the payment of dividends. We have no current plans to issue any additional 
preferred stock. Classes of stock such as the preferred stock may be used, in certain circumstances, to create voting 
impediments on extraordinary corporate transactions or to frustrate persons seeking to effect a merger or otherwise to 
gain control of the Company. For the foregoing reasons, any additional preferred stock issued by the Company could 
have an adverse effect on the rights of the holders of the common stock.  

Series B Preferred Stock  

The  Company  filed  a  Certificate  of  Designation  of  Preferences,  Rights  and  Limitations  of  Series B 
Convertible Preferred Stock (“Series B Preferred Stock”) with the State of Delaware which designates 6,900 shares 
of our preferred  

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70  

stock as Series B Preferred Stock. The Series B Preferred Stock has a stated value of $1,000 per share and a par value 
of $0.01 per share. The Series B Preferred Stock includes a beneficial ownership blocker but has no dividend rights 
(except to the extent dividends are also paid on the common stock). On August 28, 2017, the Company completed an 
underwritten public offering (the “August 2017 Offering”) consisting of the Company’s Series B Preferred Stock and 
warrants.  

The conversion price of the Series B Preferred Stock contains a down round  feature. The Company will 
recognize the effect of the down round feature when it is triggered. At that time, the effect would be treated as a 
deemed dividend and as a reduction of income available to common shareholders in our basic earnings per share 
calculation.  

The 2018 Purchase Agreement triggered the down round feature of the Series B Preferred Stock and, as a 
result, the conversion price of the Company’s Series B Convertible Preferred Stock was automatically adjusted to 
$15.60 per share. In connection with the down round adjustment, the Company calculated an incremental beneficial 
conversion feature of approximately $1.4 million which was recognized as a deemed dividend  at time of the down 
round adjustment (“Deemed Dividend A”).  

The  2018  Inducement  Agreement,  discussed  below,  triggered  the  down  round  feature  of  the  Series  B 
Preferred Stock and, as a result, the conversion price of the Company’s Series B Convertible Preferred Stock was 
automatically adjusted from $15.60 per share to $11.25 per share. In connection with the down round adjustment, the 
Company calculated an incremental beneficial conversion feature of approximately $40,000 which was recognized as 
a deemed dividend at time of the down round adjustment (“Deemed Dividend B”).  

The 2018 Note Agreement, see Note 6 – Convertible Notes, triggered the down round feature of the Series 
B Preferred Stock and, as a result, the conversion price of the Company’s Series B Convertible Preferred Stock was 
automatically adjusted from $11.25 per share to $4.50 per share. In connection with the down round adjustment, the 
Company  calculated  an  incremental  beneficial  conversion  feature  of  approximately  $0.2  million  which  was 
recognized as a deemed dividend at time of the down round adjustment (“Deemed Dividend C”).  

   
   
On  November  29,  2018,  the  Amendment  Agreement  triggered  the  down  round  feature  of  the  Series  B 
Preferred Stock and, as a result, the conversion price of the Company’s Series B Convertible Preferred Stock was 
automatically adjusted from $4.50 per share to $2.25 per share. In connection with the down round adjustment, the 
Company  calculated  an  incremental  beneficial  conversion  feature  of  approximately  $0.3  million  which  was 
recognized as a deemed dividend at time of the down round adjustment (“Deemed Dividend D”).  

During the year ended December 31, 2018, 2,340 shares of Series B Preferred Stock, that were outstanding, 

were converted into 208,000 shares of our common stock.  

At December 31, 2019 and 2018, the Company had 6,900 shares of Series B designated and issued and 47 

shares of Series B outstanding.  

Series C Preferred Stock  

The  Company  filed  a  Certificate  of  Designation  of  Preferences,  Rights  and  Limitations  of  Series C 
Convertible Preferred Stock (“Series C Preferred Stock”) with the State of Delaware which designates 2,748 shares 
of our preferred stock as Series C Preferred Stock. The Series C Preferred Stock has a stated value of $1,000 per share 
and  a  par  value  of $0.01  per  share.  On  November 2,  2017,  the  Company  completed  a  registered  direct  offering 
consisting  of  the  Company’s  Series C  Preferred  Stock  and  warrants  (the  “Series C  Preferred  Offering”).  The 
conversion price of the Series C Preferred Stock contains a down round feature.  

The 2018 Purchase Agreement triggered the down round feature of the Series C Preferred Stock and, as a 
result, the conversion price of the Company’s Series C Convertible Preferred Stock was automatically adjusted from 
$21.00 per share to $15.60 per share. In connection with the down round adjustment, the Company calculated an 
incremental beneficial conversion feature of approximately $0.8 million which was recognized as a deemed dividend 
at time of the  

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71  

down round adjustment (“Deemed Dividend E”). There were no further adjustments to the  conversion price of the 
Series C Preferred stock because all of the Series C Preferred Stock was converted in 2018.  

During the year ended December 31, 2018, 2,548 shares of Series C Preferred Stock were converted into 

223,022 shares of our common stock.  

At December 31, 2019 and 2018, the Company had 2,748 shares of Series C designated and issued and zero 

shares of Series C outstanding.  

Liquidation Preferences  

The following is the liquidation preferences for the Company’s preferred stock;  

The  Series B  Preferred  Stock  and  Series C  Preferred  Stock  have  identical  terms  regarding  liquidation 
preferences. Upon any liquidation, dissolution or winding-up of the Corporation, whether voluntary or involuntary, 
the holders shall be entitled to receive out of the assets of the Corporation an amount equal to the par value, plus any 
accrued and unpaid dividends thereon, for each share of Preferred Stock before any distribution or payment shall be 
made to the holders of the Common Stock, and if the assets of the Corporation shall be insufficient to pay in full such 
amounts,  then  the  entire  assets  to  be  distributed  to  the  holders  shall  be  ratably  distributed  among  the  holders  in 
accordance with the respective amounts that would be payable on such shares. If all amounts were paid in full; and 
thereafter, the holders shall be entitled to receive out of the assets, whether capital or surplus, of the Corporation the 
same amount that a holder of Common Stock would receive if the Preferred Stock were fully converted to Common 
Stock which amount shall be paid pari passu with all holders of Common Stock.  

Preferred Stock induced conversions  

On March 21, 2018, the Company entered into a letter agreement (the “2018 Inducement Agreement”) with 
certain  holders  of  shares  of  the  Company’s  Series  B  Preferred  Stock  and  Series  C  Preferred  Stock  (together  the 
“Preferred Stock”), and warrants (the “Warrants”) to purchase shares of the Company’s common stock, issued in the 
Company’s public offering in August 2017 and registered direct offering in November 2017. Pursuant to the 2018 
Inducement Agreement, the Company and the Investors agreed that, as a result of the issuance of shares of common 
stock pursuant to that Purchase Agreement, dated February 8, 2018, by and between the Company and the investor 
named therein, and effective as of the time of execution of the 2018 Inducement Agreement, the exercise price of the 
Warrants was reduced to $11.25 per share (the “Exercise Price Reduction”) and the conversion price of the Preferred 
Stock was reduced to $11.25 (the “Conversion Price Reduction”). As consideration for the Company’s agreement to 
the Exercise Price Reduction and the Conversion Price Reduction, (i) each investor agreed to convert the shares of 
Preferred Stock held by such investor into shares of Common Stock in increments of up to 4.99% of the shares of 
common stock outstanding as of the date of the 2018 Inducement Agreement and (ii) one investor agreed to exercise 
44,444 Warrants and another investor agreed to exercise 33,333 Warrants in increments of up to 4.99% of the shares 
of common stock outstanding as of the date of the 2018 Inducement Agreement, in each case in accordance with the 
beneficial ownership limitations set forth in the Company’s Certificate of Designation of Preferences, Rights and 
Limitations of Series B Convertible Preferred Stock, the Company’s Certificate of Designation of Preferences, Rights 
and Limitations of Series C Convertible Preferred Stock and the Warrants. As discussed above, as of December 31, 
2019, all shares of Preferred Stock, except 47 shares of Series B Preferred Stock, were converted to shares of our 
common stock pursuant to the terms of the 2018 Inducement Agreement and 20,000 Warrants were exercised at the 
$11.25 exercise price.  

The 2018 Inducement Agreement represented an inducement by the Company to convert shares of the Preferred 
Stock. The conversion price of the Preferred Stock and the exercise price of the Warrants were reduced from $15.60 
per share to $11.25 per share, respectively. The Company calculated the fair value of the additional securities and 
consideration to be approximately $1.2 million (“Deemed Dividend F”). During the year ended December 31, 2018, 
this amount was recorded as a charge to additional paid-in-capital and as a deemed dividend resulting in a reduction 
of income available to common shareholders in our basic earnings per share calculation. The $1.2 million is comprised 
of two components: 1) $1.1 million related to the fair value of the additional common shares issued upon conversion 
of the  

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72  

Preferred Stock due to the reduced conversion price and 2) $0.1 million in incremental fair value of the Warrants 
resulting from the reduction of the exercise price.  

Common Stock Warrants.    

The following represents a summary of the warrants outstanding as of December 31, 2019:  

Warrants 
(1) 
(2) 

(3) 
(4) 
(5) 
(5) 
(6) 

   Issue Year    

Expiration 

Shares  

Price 

     Underlying       Exercise 

   2014 
   2015 

   2015 
   2016 
   2017 
   2017 
   2017 

April 2020 
   February 2020   
December 
2020 
January 2021    
June 2022 
June 2022 
June 2022 

832    $ 1,800.00 
1,588    $ 1,008.00 

272    $  747.00 
596    $  544.50 
41.25 
7.50 
6,095    $  105.00 

2,540    $ 
500    $ 

   
   
   
  
  
  
  
  
  
  
  
  
  
  
     
  
     
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
(7) 
(8) 
(9) 
(9) 
(10) 
(10) 
(11) 
(12) 
(13) 
(14) 
(14) 
(15) 
(16) 
(16) 
(16) 
(16) 

(16) 

(16) 

(17) 

(17) 
(18) 
(19) 

   2017 
   2017 
   2017 
   2017 
   2017 
   2017 
   2017 
   2017 
   2018 
   2018 
   2018 
   2018 
   2018 
   2018 
   2018 
   2018 

   2018 

   2018 

   2018 

   2018 
   2019 
   2019 

   August 2022    
   August 2022    
   August 2022    
   August 2022    
   August 2022    
   August 2022    
   October 2022    
   May 2023 
   October 2022    
April 2023 
April 2023 
   October 2022    
July 2023 
July 2023 
   August 2023    
   August 2023    
September 
2023 
September 
2023 
November 
2023 
December 
2023 
April 2024 
   May 2024 

2.25 
25,201    $ 
4,000    $ 
46.88 
47,995    $  150.00 
7.50 
9,101    $ 
2.25 
16,664    $ 
2.25 
7,335    $ 
2.25 
666    $ 
2.25 
 —    $ 
7,207    $  112.50 
5.40 
69,964    $ 
5.40 
   121,552    $ 
11.25 
15,466    $ 
5.40 
14,671    $ 
5.40 
14,672    $ 
5.40 
36,334    $ 
5.40 
36,334    $ 

19,816    $ 

5.40 

20,903    $ 

5.40 

75,788    $ 

5.40 

51,282    $ 
   147,472    $ 
   154,343    $ 

5.40 
5.40 
9.56 

      909,189   

 (1)    These warrants were issued in connection with a private placement which was completed in October 2014. 
 (2)    These warrants were issued in connection with an offering which was completed in February 2015. 
 (3)    These warrants were issued in connection with an offering which was completed in July 2015. 
(4)  

These  warrants  were  issued  in  connection  with  an  offering  which  was  completed  in  January 2016.  Of  the 
remaining outstanding warrants as of December 31, 2019, 357 warrants are recorded as liability, See Note 12 – 
Fair Value for further discussion, and 239 warrants are treated as equity. 

New Bridge Warrants. 

 (5)    These warrants were issued in connection with a June 2017 merger transaction (the “Merger”) and are the 2017 
 (6)    These warrants were issued in connection with the Merger and are considered the Side Warrants. 
(7)  

These  warrants  were  issued  in  connection  with  an  underwritten  public  offering  consisting  of  the  Company’s 
Series B Preferred Stock and warrants (the “August 2017 Offering”) and are the August 2017 Offering Warrants 
discussed below. 

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73  

discussed below. 

 (8)    These warrants were issued in connection with the August 2017 Offering and are the Representative Warrants 
 (9)    These warrants were issued 2017 and are the Series A Conversion Warrants discussed below. 
 (10)   These warrants were issued in connection with the  conversion of convertible bridge notes, at the time of the 

closing of the August 2017 Offering, and are the Note Conversion Warrants discussed below. 
These warrants were issued in connection with a waiver of default the Company received in the fourth quarter of 
2017 in connection with certain convertible promissory notes and are the Convertible Promissory Note Warrants 
discussed below. 

(11)  

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
     
      
 
 
 
 
 
 
 
 (12)   These warrants (the “Series C Warrants’) were issued in connection with the Series C Preferred Offering and are 

discussed below. 

 (13)   These  warrants  were  issued  in  connection  with  the  Settlement  Agreements  and  are  the  Creditor  Warrants 

discussed below. 

 (14)   These  warrants  were  issued  in  connection  with  the  2018  Note  Agreement  and  are  the  April  2018  Warrants 

discussed below. 

 (15)   These warrants were issued in connection with the 2018 Note Agreement and are the Advisor Warrants discussed 

below. 

 (16)   These warrants were issued in connection with the 2018 Note Agreement and are the Q3 2018 Warrants discussed 

below. 

 (17)   These  warrants  were  issued  in  connection  with  the  2018  Note  Agreement,  and  subsequent  Amendment 

Agreement, and are the Q4 2018 Warrants discussed below. 

 (18)   These warrants were issued in connection with  the 2018 Note Agreement and subsequent Amendment No. 2 

Agreement and are the April 2019 Warrants discussed below. 

 (19)   These  warrants were  issued  in  connection  with  the May  2019  Bridge  Notes  and are  the May  2019  Warrants 

discussed below. 

2017 New Bridge Warrants  

The initial exercise price of the 2017 New Bridge Warrants was $112.50 (subject to adjustments). These 
warrants had a one-time down round provision. As a result of the August 2017 Offering, the exercise price of the 2017 
New Bridge Warrants was adjusted to $41.25 per share, and the down round provision for these warrants no longer 
exists after this adjustment.  

At  the  time  of  the  Amendment  Agreement  in  2018,  the  exercise  price  of  500  of  the  2017  New  Bridge 
Warrants was modified so that the exercise price became $7.50 per share. The fair value of this warrant modification 
was calculated to be less than $1,000 which was recorded as a debt discount in conjunction with the issuance of the 
Q4 2018 Bridge Notes with an offset to additional paid-in-capital.  

Side Warrants  

The Company issued warrants to purchase an aggregate of 6,095 shares of the Company’s common stock at 
an exercise price of $105.00 per share (subject to adjustment). The warrants (“Side Warrants”) have a term of 5 years.  

August 2017 Offering Warrants  

In connection with the August 2017 Offering, the Company issued 178,667 warrants at an exercise price of 
$45.00, which contain a down round provision. The August 2017 Offering Warrants were exercisable immediately 
and expire 5 years from date of issuance.  

In February 2018, as a result of 2018 Purchase Agreement, the exercise price of the August 2017 Offering 
Warrants was adjusted to $15.60. At the time the exercise price was adjusted, the Company calculated the fair value 
of the down round provision on the warrants to be approximately $62,000 and recorded this as a deemed dividend 
(“Deemed Dividend G”) during 2018. In addition, as a result of the 2018 Inducement Agreement, the exercise price 
of the August 2017 Offering Warrants was further adjusted to $11.25 as a result of the Exercise Price Reduction 
discussed above.  

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74  

In  April  2018,  as  a  result  of  the  2018  Note  Agreement,  the  exercise  price  of  the  August  2017  Offering 
Warrants was adjusted to $4.50. At the time the exercise price was adjusted, the Company calculated the fair value of 

   
   
the  down  round  provision  on  the  warrants  to  be  approximately  $63,000  and  recorded  this  as  a  deemed  dividend 
(“Deemed Dividend H”).  

In November 2018, as a result of the Amendment Agreement, the exercise price of the August 2017 Offering 
Warrants was adjusted to $2.25. At the time the exercise price was adjusted, the Company calculated the fair value of 
the  down  round  provision  on  the  warrants  to  be  approximately  $5,000  and  recorded  this  as  a  deemed  dividend 
(“Deemed Dividend I”).  

There were 6,800 and 146,666 August 2017 Offering Warrants exercised during the year ended December 
31, 2019 and 2018, respectively, for proceeds to the Company of approximately $15,000 and $795,000, respectively. 
During  the  year  ended  December  31,  2019  and  2018,  the  intrinsic  value  of  the  August  2017  Offering  Warrants 
exercised was approximately $36,000 and $420,000.  

Representative Warrants  

The  Representative  Warrants  are  exercisable  beginning  one year  after  the  date  of  the  prospectus  for  the 
August 2017 Offering and expiring on a date which is no more than five years from the date of the prospectus for the 
August 2017 Offering.  

Series A Conversion Warrants  

These warrants were issued in connection with the conversion of our Series A Senior stock, at the time of 

the closing of the August 2017 Offering, and have a term of 5 years.  

At the time of the Amendment Agreement in 2018, the exercise price of 9,101 of the Series A Conversion 
Warrants was modified so that the exercise price became $7.50 per share. The fair value of this warrant modification 
was calculated to be approximately $10,000 which was recorded as a debt discount in conjunction with the issuance 
of the Q4 2018 Bridge Notes with an offset to additional paid-in-capital.  

Note Conversion Warrants  

Upon  the  closing  of  the  August 2017  Offering, the  Company  issued  23,999 warrants  to  purchase  the 
Company's common stock (the “Note Conversion Warrants”). The Note Conversion Warrants have an exercise price 
of $45.00 per share, a five year term and contain a down round provision. As a result of the Series C Preferred Offering 
in 2017, the exercise price of the Note Conversion Warrants was adjusted to $21.00 per share.  

In  February  2018,  as  a  result  of  2018  Purchase  Agreement,  the  exercise  price  of  the  Note  Conversion 
Warrants was adjusted to $15.60 per share. At the time the exercise price was adjusted, the Company calculated the 
fair value of the down round provision on the warrants to be approximately $8,000 and recorded this as a deemed 
dividend (“Deemed Dividend J”). In addition, as a result of the 2018 Inducement Agreement, the exercise price of the 
Note Conversion Warrants was further adjusted to $11.25. At the time the exercise price was adjusted, the Company 
calculated the fair value of the down round provision on the warrants to be approximately $5,000 and recorded this 
as a deemed dividend (“Deemed Dividend K”).  

In April 2018, as a result of the 2018 Note Agreement, the exercise price of the Note Conversion Warrants 
was adjusted to $4.50. At the time the exercise price was adjusted, the Company calculated the fair value of the down 
round provision on the warrants to be approximately $10,000 and recorded this as a deemed dividend  (“Deemed 
Dividend L”).  

In November 2018, as a result of the Amendment Agreement, the exercise price of the Note Conversion 
Warrants was adjusted to $2.25. At the time the exercise price was adjusted, the Company calculated the fair value of 
the  down  round  provision  on  the  warrants  to  be  approximately  $4,000  and  recorded  this  as  a  deemed  dividend 
(“Deemed Dividend M”).  

75  

   
   
   
   
   
   
   
   
Table of Contents  

Convertible Promissory Note Warrants  

The Convertible Promissory Note Warrants had an original exercise price of $45.00 per share and contain a 
down round provision. As a result of the Series C Preferred Offering, the exercise price of the Convertible Promissory 
Note Warrants was adjusted to $21.00 per share.  

In February 2018, as a result of 2018 Purchase Agreement, the exercise price of the Convertible Promissory 
Note Warrants was adjusted to $15.60. At the time the exercise price was adjusted, the Company calculated the fair 
value of the down round provision on the warrants to be less than $1,000 and recorded this as a deemed dividend 
(“Deemed  Dividend  N”).  In  addition,  as  a  result  of  the  2018  Inducement  Agreement,  the  exercise  price  of  the 
Convertible Promissory Note Warrants was further adjusted to $11.25. At the time the exercise price was adjusted, 
the Company calculated the fair value of the down round provision on the warrants to be less than $1,000 and recorded 
this as a deemed dividend (“Deemed Dividend O”).  

In April 2018, as a result of the 2018 Note Agreement, the exercise price of the Convertible Promissory Note 
Warrants was adjusted to $4.50. At the time the exercise price was adjusted, the Company calculated the fair value of 
the down round provision on the warrants to be less than $1,000 and recorded this as a deemed dividend (“Deemed 
Dividend P”).  

In  November  2018,  as  a  result  of  the  Amendment  Agreement,  the  exercise  price  of  the  Convertible 
Promissory Note Warrants was adjusted to $2.25. At the time the exercise price was adjusted, the Company calculated 
the  fair value of the down round provision on the warrants to be less than $1,000 and recorded this as a deemed 
dividend (“Deemed Dividend Q”).  

Series C Warrants  

In connection with the Series C Preferred Offering, the Company issued 130,857 warrants at an exercise 
price  of  $24.45,  which  contain  a  down  round  provision.  Series C  Warrants  are  exercisable  on  the  six-month 
anniversary of the date of issuance and expire 5 years from date they are initially exercisable. The terms of the Series C 
Warrants prohibit a holder from exercising its Series C Warrants if doing so would result in such holder (together 
with its affiliates) beneficially owning more than 4.99% of the Company’s outstanding shares of common stock after 
giving effect to such exercise, provided that, at the election of a holder and notice to the Company, such beneficial 
ownership limitation may be increased to 9.99% of the Company’s outstanding shares of common stock after giving 
effect to such exercise.  

In February 2018, as a result of 2018 Purchase Agreement, the exercise price of the Series C Warrants was 
adjusted to $15.60. At the time the exercise price was adjusted, the Company calculated the fair value of the down 
round provision on the warrants to be approximately $58,000 and recorded this as  a deemed dividend  (“Deemed 
Dividend R”). In addition, as a result of the 2018 Inducement Agreement, the exercise price of the Series C Warrants 
was further adjusted to $11.25 as a result of the Exercise Price Reduction discussed above.  

In April 2018, as a result of the 2018 Note Agreement, the exercise price of the Series C Warrants was 
adjusted to $4.50. At the time the exercise price was adjusted, the Company calculated the fair value of the down 
round provision on the warrants to be approximately $45,000 and recorded this as a deemed dividend  (“Deemed 
Dividend S”).  

In November 2018, as a result of the Amendment Agreement, the exercise price of the Series C Warrants 
was adjusted to $2.25. At the time the exercise price was adjusted, the Company calculated the fair value of the down 
round  provision  on  the  warrants  to  be  approximately  $4,000  and  recorded  this  as  a  deemed  dividend  (“Deemed 
Dividend T”).  

There were 25,037 and 105,820 Series C Warrants exercised during the year ended December 31, 2019 and 
2018, respectively, for proceeds to the Company of approximately $56,000 and $476,000, respectively. During the 

year ended December 31, 2019 and 2018, the intrinsic value of the Series C Warrants exercised was approximately 
$443,000 and $294,000, respectively.  

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Creditor Warrants  

76  

In the fourth quarter of 2017, the Company entered into Settlement Agreements with the Creditors pursuant 
to which the Company agreed to issue, to certain of its Creditors, warrants to purchase 7,207 shares of the Company’s 
common stock at an exercise price of $112.50 per share. The warrants were issued in February 2018. See Note 5 – 
Long-Term Debt.  

April 2018 Warrants  

In connection with the issuance of the April 2018 Bridge Notes, the Company issued 243,224 warrants at an 
exercise price of $11.25 at time of issuance. At issuance, half of these April 2018 Warrants had a five-year term and 
half had a one-year term. In September 2018, the exercise price was amended to $7.50. At the time of issuance, as 
discussed in Note 7 - Convertible Notes, the April 2018 Warrants had a fair value of approximately $1.1 million and 
were recorded as a liability with an offset to debt discount.  

In April 2019, as a result of the Amendment No.2 Agreement, the exercise price of the April 2018 Warrants 
was  adjusted  to  $5.40  and  all  April  2018  Warrants  that  had  a  one-year  term  were  amended  to  have  a  five-year 
term. Due to these modifications, the change in fair value of the April 2018 Warrants was calculated to be an expense 
of approximately $0.7 million which is included in loss on modification of warrants in the consolidated statements of 
operations for the year ended December 31, 2019.  

During the year ended December 31, 2019, 51,708 April 2018 Warrants were exercised for proceeds to the 
Company of $279,000. During the year ended December 31, 2019, the intrinsic value of the April 2018 Warrants 
exercised was approximately $128,000.  

Advisor Warrants  

At the time of the 2018 Note Agreement, the Company issued 15,466 warrants with an exercise price of 
$11.25 to a financial advisor. At the time of issuance, as discussed in Note 7 - Convertible Notes, the Advisor Warrants 
had a fair value of approximately $0.1 million and were recorded as a liability with an offset to debt discount.  

Q3 2018 Warrants  

In connection with the issuance of the Q3 2018 Bridge Notes, the Company issued 196,340 warrants with an 
exercise price of $11.25 at time of issuance. Half of these Q3 2018 Warrants were issued with a five-year term and 
half with a one-year term. At the time of issuance, as discussed in Note 7 - Convertible Notes, the Q3 2018 Warrants 
had a  fair value of approximately $0.7 million and were recorded as a liability with an offset to debt discount. In 
September 2018, the exercise price was modified to $7.50. The Company calculated the change in fair value due to 
repricing to be an expense of approximately $0.1 million which is included in warrant revaluation in the consolidated 
statements of operations for the year ended December 31, 2018.  

In April 2019, as a result of the Amendment No.2 Agreement, the exercise price of the Q3 2018 Warrants 
was adjusted to $5.40 and all Q3 2018 Warrants that had a one-year term were amended to have a five-year term. Due 
to  these  modifications,  the  change  in  fair  value  of  the  Q3  2018  Warrants  was  calculated  to  be  an  expense  of 
approximately $0.4 million which is included in loss on modification of warrants in the consolidated statements of 
operations for the year ended December 31, 2019.  

   
There were 53,610 Q3 2018 Warrants exercised during the year ended December 31, 2019 for proceeds to 
the Company of $289,000. During the year ended December 31, 2019, the intrinsic value of the Q3 2018 Warrants 
exercised was approximately $133,382.  

Q4 2018 Warrants  

In connection with the issuance of the Q4 2018 Bridge Notes, the Company issued 300,115 warrants with an 

exercise price of $5.40 at time of issuance and a five-year term. At the time of issuance, as discussed in Note 7 -  

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77  

Convertible Notes, the Q4 2018 Warrants had a fair value of approximately $0.7 million and were recorded as a 
liability with an offset to debt discount.  

There were 173,045 Q4 2018 Warrants exercised during the year ended December 31, 2019 for proceeds to 
the Company of $934,000. During the year ended December 31, 2019, the intrinsic value of the Q4 2018 Warrants 
exercised was approximately $489,000.  

April 2019 Warrants  

In connection with the issuance of the April 2019 Bridge Notes, the Company issued 147,472 warrants with 
an exercise price of $5.40 and a five-year term. At the time of issuance, as discussed in Note 7 - Convertible Notes, 
the April 2019 Warrants had a fair value of approximately $1.0 million and were recorded as a liability with an offset 
to debt discount.  

May 2019 Warrants  

In connection with the issuance of the May 2019 Bridge Notes, the Company issued 154,343 warrants with 
an exercise price of $5.40 and a five-year term. At the time of issuance, as discussed in Note 7 - Convertible Notes, 
the May 2019 Warrants had a fair value of approximately $0.9 million and were recorded as a liability with an offset 
to debt discount.  

Deemed Dividends  

As discussed above, certain of our preferred stock and warrant issuances contain down round provisions 
which require us to recognize the effect of the down round feature when it is triggered. That effect is treated as a 
dividend and as a reduction of income available to common shareholders in basic EPS.  

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78  

There were no dividends recorded in 2019. The following represents a summary of the dividends recorded 

for the year ended December 31, 2018:  

Deemed Dividends 

Dividends resulting from the 2018 Purchase Agreement 
Deemed Dividend A 

Amount Recorded 
(in thousands) 

$ 

1,358 

   
   
   
  
  
  
  
  
  
     
  
  
  
  
  
  
  
  
Deemed Dividend E 
Deemed Dividend G 
Deemed Dividend J 
Deemed Dividend N 
Deemed Dividend R 

Dividends resulting from the 2018 Inducement Agreement 
Deemed Dividend B 
Deemed Dividend F 
Deemed Dividend K 
Deemed Dividend O 

Dividends resulting from the 2018 Note Agreement 
Deemed Dividend C 
Deemed Dividend H 
Deemed Dividend L 
Deemed Dividend P 
Deemed Dividend S 

Dividends resulting from the Amendment Agreement 
Deemed Dividend D 
Deemed Dividend I 
Deemed Dividend M 
Deemed Dividend Q 
Deemed Dividend T 

829 
62 
 8 
* 
58 

40 
1,154 
 5 
* 

216 
63 
10 
* 
45 

361 
 5 
 4 
* 
 4 

Total 2018 Deemed Dividends 

$ 

4,222 

* Represents less than one thousand dollars  

12. FAIR VALUE  

FASB guidance on fair value measurements, which defines fair value, establishes a framework for measuring 
fair value and expands disclosures about fair value measurements for our financial assets and liabilities, as well as for 
other assets and liabilities that are carried at fair value on a recurring basis in our consolidated financial statements.  

FASB guidance establishes a three-level fair value hierarchy based upon the assumptions (inputs) used to 

price assets or liabilities. The three levels of inputs used to measure fair value are as follows:  

Level 1—Unadjusted quoted prices in active markets for identical assets or liabilities;  

Level 2—Observable inputs other than those included in Level 1, such as quoted prices for similar assets and 

liabilities in active markets or quoted prices for identical assets or liabilities in inactive markets; and  

Level 3—Unobservable  inputs  reflecting  our  own  assumptions  and  best  estimate  of  what  inputs  market 

participants would use in pricing the asset or liability.  

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79  

Common Stock Warrant Liabilities.  

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
Certain of our  issued and outstanding warrants to purchase shares of common stock do not qualify to be 
treated as equity and, accordingly, are recorded as a liability. We are required to record these instruments at fair value 
at each reporting date and changes are recorded as a non-cash adjustment to earnings. The gains or losses included in 
earnings are reported in other income (expense) in our consolidated statement of operations.  

2016 Warrant Liability  

The  Company  has  a  warrant  liability  related  to  warrants  issued  in  January  2016  (the  “2016  Warrant 
Liability”)  and  it  represents  the  fair  value  of  such  warrants,  of  which,  357  warrants  remain  outstanding  as  of 
December 31, 2019.  

In March 2018, a portion of the 2016 Warrant Liability was part of a settlement agreement pursuant to a 
lawsuit that was filed against the Company by one of the warrant holders. As such, approximately $0.4 million of the 
warrant liability, representing 1,347 warrants, was canceled on the date of the settlement agreement and replaced by 
amounts that were recorded as other current liabilities. For further detail, see discussion of the Crede Agreement in 
Note 8 – Accrued Expenses and Other Current Liabilities.  

The 2016 Warrant Liability is considered a Level 3 financial instrument and was valued using the Monte 
Carlo methodology. As of December 31, 2019, assumptions and inputs used in the valuation of the common stock 
warrants include: remaining life to maturity of one year; annual volatility of 140%;   and a risk-free interest rate of 
1.59%.   As of December 31, 2018, assumptions and inputs used in the valuation of the 2016 Warrant Liability include: 
remaining life to maturity of two years; annual volatility of 176%; and a risk-free interest rate of 2.48%  

Bridge Note Warrant Liabilities  

During  2019  and  2018,  the  Company  issued  154,343  of  May  2019  Warrants, 147,472  of  April  2019 
Warrants, 243,224 of April 2018 Warrants, 15,466 of Advisor Warrants, 196,340 of Q3 2018 Warrants and 300,115 
of Q4 2018 Warrants. All of these warrants issuances were classified as warrant liabilities (the “Bridge Note Warrant 
Liabilities”).  See Note 6 - Convertible Notes for further discussion of each warrant.  

The Bridge Note Warrant Liabilities are considered Level 3 financial instruments and were valued using the 
Black  Scholes  model.  As  of  December  31,  2019,  assumptions  used  in  the  valuation  of  the  Bridge  Note  Warrant 
Liabilities include: remaining life to maturity of 2.3 to 4.4 years; annual volatility of 141% to 163%; and risk free rate 
of 1.58% to 1.65%. As of December 31, 2018, assumptions used in the valuation of the Bridge Note Warrant Liabilities 
include: remaining life to maturity of 0.3 to 5.0 years; annual volatility of 85% to 162%; and risk free rate of 2.45% 
to 2.63%.  

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80  

During the years ended December 31, 2019 and 2018, the change in the fair value of the warrant liabilities 

measured using significant unobservable inputs (Level 3) were comprised of the following:  

Dollars in Thousands 

Year Ended December 31, 2019 

Beginning balance at January 1 

Additions: 
Total (gains) losses: 

Revaluation recognized in earnings 
Modification recognized in earnings 
Deductions – warrant exercises 

2016 
Warrant 
      Liability 
   $ 

116 
 – 

Bridge Note 

Total 
Warrant 
     Warrant Liabilities       Liabilities 
1,132 
1,016 
1,858 
1,858 

  $ 

  $ 

(46)      
 – 
 – 

(370)      
1,128 
(2,364)      

(416)    
1,128 
(2,364)    

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
     
  
     
    
    
  
     
   
    
   
    
   
  
     
     
    
    
  
     
    
Balance at December 31 

   $ 

70 

  $ 

1,268 

  $ 

1,338 

Year Ended December 31, 2018 

Beginning balance at January 1 

Additions: 
Total (gains) losses: 

2016 
Warrant 
      Liability 
   $ 

841 
 – 

Bridge Note 

Total 
Warrant 
     Warrant Liabilities       Liabilities 
841 
2,665 

 – 
2,665 

  $ 

  $ 

Revaluation recognized in earnings 
Modification recognized in earnings 
Deductions – warrant liability settlement 

Balance at December 31 

   $ 

(269)      
 – 
(456)      
  $ 
116 

(1,792)      
143 
 – 
1,016 

  $ 

(2,061)    
143 
(456)    
1,132 

Derivative Liabilities.  

Certain  of  our  issued  and  outstanding  convertible  notes  contain  features  that  are  considered  derivative 
instruments and are required to bifurcated from the debt host and accounted for separately as derivative liabilities. 
The estimated fair value of the derivatives will be remeasured at each reporting date and any change in estimated fair 
value of the derivatives will be recorded as non-cash adjustments to earnings. The gains or losses included in earnings 
are reported in other income (expense) in our consolidated statement of operations.  

Bridge Notes Redemption Feature  

At the time of the Bridge Note issuances, the Company recorded derivative instruments as liabilities with an 
initial fair value of approximately $0.3 million. The valuations were performed using the “with and without” approach, 
whereby the Bridge Notes were valued both with the embedded derivative and without, and the difference in values 
was recorded as the derivative liability. In November 2018, the conversion price of the April 2018 Bridge Note and 
the Q3 2018 Bridge Note was amended. The amendment was treated as an extinguishment which resulted in less than 
$0.1 million of derivative liabilities being written off in November 2018. See Note 6 - Convertible Notes for further 
discussion.  

Conversion Option  

The Company recorded derivative liabilities related to the Conversion Option of the Exchange Notes issued 
during the year ended December 31, 2018 with an initial fair value of approximately $0.4 million. The valuations 
were performed using the Monte Carlo methodology. Approximately $0.1 million and $0.3 million of Conversion 
Option derivative liabilities were written off due to Exchange Note conversions during the years ended December 31, 
2019 and 2018, respectively. See Note 6 - Convertible Notes for further discussion.  

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81  

During the years ended December 31, 2019 and 2018, the change in the fair value of the derivative liabilities 

was comprised of the following:  

Beginning balance at January 1 

Deductions - write-off in conjunction with convertible note 
conversions 
Total loss: 

Year Ended December 31, 2019 

   Bridge Notes 
   Redemption 

   Conversion 

Feature 

Option 

   Total Derivative 
Liabilities 

   $ 

30    $ 

32    $ 

62 

(438)      

(39)      

(477) 

  
  
     
       
       
     
  
  
  
  
  
  
  
  
  
     
  
     
    
    
  
     
   
    
   
    
   
  
     
     
    
    
  
     
    
  
   
  
  
  
  
  
  
  
  
  
  
  
     
  
       
       
  
  
  
  
  
  
  
  
  
        
        
   
Revaluation recognized in earnings 

Balance at December 31 

   $ 

408      
 —    $ 

 7      
 —    $ 

415 
 — 

Beginning balance at January 1 

Additions: 
Deductions - write-off in conjunction with convertible note 
conversions 
Total gain: 

Extinguishment recognized in earnings 
Revaluation recognized in earnings 

Balance at December 31 

13. EQUITY INCENTIVE PLAN  

Year Ended December 31, 2018 

   Bridge Notes 
   Redemption 

   Conversion 

Feature 

Option 

   Total Derivative 
Liabilities 

   $ 

 —    $ 
269      

 —    $ 
383      

 — 
652 

 —      

(301)      

(301) 

(22)      
(217)      
30    $ 

 —      
(50)      
32    $ 

(22) 
(267) 
62 

   $ 

The Company’s 2006 Equity Incentive Plan (the "2006 Plan") was terminated as to future awards on July 12, 
2016.  The  Company’s  2017  Stock  Option  and  Incentive  Plan  (the  "2017  Plan")  was  adopted  by  the  Company’s 
stockholders on June 5, 2017 and there were 44,444 shares of common stock reserved for issuance under the 2017 
Plan. The 2017 Plan will expire on June 5, 2027.  

The Plan is administered by the Compensation Committee of the Board of Directors (the “Committee”), 
which has the authority to set the number, exercise price, term and vesting provisions of the awards granted under the 
Plan, subject to the terms thereof. Either incentive or non-qualified stock options may be granted to employees of the 
Company, but only non-qualified stock options may be granted to non-employee directors and advisors. However, in 
either case, the Plan requires that stock options must be granted at exercise prices not less than the fair market value 
of the common stock on the date of the grant. Options issued under the plan vest over periods as determined by the 
Committee and expire 10 years after the date the option was granted.  

The Company accounts for all stock-based compensation payments to employees and directors, including 
grants of employee stock options, at fair value and expenses the benefit in operating expense in the consolidated 
statements of operations over the service period of the awards. The fair value of each stock option granted is estimated 
on the date of grant using the Black-Scholes option pricing model, which requires various assumptions including 
estimating stock price volatility, expected life of the stock option, risk free interest rate and estimated forfeiture rate.  

Amendment of the 2017 Stock Option and Incentive Plan  

On January 31, 2018, at a special meeting of the stockholders of the Company, the stockholders approved an 

amendment and restatement of the Company’s 2017 Stock Option and Incentive Plan (the “2017 Plan”) to:  

·  

 increase the aggregate number of shares authorized for issuance under the 2017 Plan by 359,300 shares 
to 403,744 shares; 

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82  

·  

increase the maximum number of shares that may be granted in the  form of stock options or stock 
appreciation rights to any one individual in any one calendar year and the maximum number of shares 
underlying any award intended to qualify as performance-based compensation to any one individual in 
any performance cycle, in each case to 66,667 shares of common stock; and 

  
  
  
  
  
       
       
  
  
  
  
       
       
  
  
  
  
  
  
  
  
  
  
  
        
        
   
  
  
  
  
   
   
 
 
 
·  

add an “evergreen” provision, pursuant to which the aggregate number of shares authorized for issuance 
under the 2017 Plan will be automatically increased each year on January 1st, beginning on January 1, 
2019, by 5% of the number of shares of common stock issued and outstanding on the immediately 
preceding  December  31st,  or  such  lesser  number  of  shares  determined  by  the  Company’s  Board  of 
Directors or Compensation Committee. 

Stock Options.  

The Company accounts for all stock-based compensation payments to employees and  directors, including 
grants of employee stock options, at fair value at the date of grant and expenses the benefit in operating expense in 
the condensed consolidated statements of operations over the service period of the awards. The Company records the 
expense for stock-based compensation awards subject to performance-based milestone vesting over the remaining 
service period when management determines that achievement of the milestone is probable. Management evaluates 
when  the  achievement  of  a  performance-based  milestone  is  probable  based  on  the  expected  satisfaction  of  the 
performance conditions as of the reporting date. The fair value of each stock option granted is estimated on the date 
of grant using the Black-Scholes option pricing model, which requires various assumptions including estimating stock 
price volatility, expected life of the stock option, risk free interest rate and estimated forfeiture rate.  

During the year ended December 31, 2019, The Company granted stock options to employees and directors 
to purchase up to 292,604 shares of common stock at a weighted average exercise price of $2.36. These awards have 
vesting periods of up to four years and had a weighted average grant date fair value of $2.15. The fair value calculation 
of options granted during 2019 used the follow assumptions: risk free interest rates of 1.60% to 2.53%, based on the 
U.S. Treasury yield in effect at the time of grant; expected life of six years; and volatility of 133% to 139% based on 
historical volatility of the Company’s common stock over a time that is consistent with the expected life of the option.  

The following table summarizes stock option activity under our plans during the year ended December 31, 

2019:  

Outstanding at January 1, 2019 

Granted 
Forfeited 

Outstanding at December 31, 2019 
Exercisable at December 31, 2019 

      Number of 

Options 
224,895    $ 
292,604      
(27,169)      
490,330    $ 
181,705    $ 

Weighted-
Average 
Exercise Price 
15.90 
2.36 
6.03 
8.30 
13.48 

As of December 31, 2019, there were 413,174 options that were vested or expected to vest with an aggregate 

intrinsic value of zero and a remaining weighted average contractual life of 8.7 years.  

During the year ended December 31, 2018, there were 224,365 options granted with a weighted average 

exercise price of $10.50 and 15,236 options forfeited with a weighted average exercise price of $29.94.  

During  the years  ended  December 31,  2019  and  2018,  we  recorded  compensation  expense  for  all  stock 
awards of $0.7 million and $0.5 million, respectively, within operating expense in the accompanying statements of 
operations. As of December 31, 2019, the unrecognized compensation expense related to unvested stock awards was 
$1.7 million, which is expected to be recognized over a weighted-average period of 2.0 years.  

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83  

14. SALES SERVICE REVENUE, NET AND ACCOUNTS RECEIVABLE  

 
 
   
  
  
  
  
  
  
  
     
  
  
  
  
  
  
  
  
   
ASC Topic 606, “Revenue from contracts with customers”  

On January 1, 2018, the Company adopted ASC 606 that amends the guidance for the recognition of revenue 
from contracts with customers to transfer goods and services by using the modified-retrospective method applied to 
any contracts that were not completed as of January 1, 2018. The Company performed a comprehensive review of its 
existing revenue arrangements following the five-step model:  

Step 1: Identification of the contract with the customer.  Sub-steps include determining the customer in a 
contract; Initial contract identification and determine if multiple contracts should be combined and accounted for as a 
single transaction.   

Step 2: Identify the performance obligation in the contract.  Sub-steps include identifying the promised goods 

and services in the contract and identifying which performance obligations within the contract are distinct.  

Step 3: Determine the transaction price.  Sub-steps include variable consideration, constraining estimates of 
variable consideration, the existence of a significant financing component in the contract, noncash consideration and 
consideration payable to a customer.  

Step 4: Allocate transaction price.  Sub-steps include assessing the amount of consideration to which the 

Company expects to be entitled in exchange for transferring the promised goods or services to the customer.  

Step 5: Satisfaction of performance obligations.  Sub-steps include ascertaining the point in time when an 
asset  is  transferred  to  the  customer and  the  customer  obtains  control  of  the  asset  upon  which  time  the  Company 
recognizes revenue.   

Based on the Company's analysis, there were no changes identified that impacted the amount or timing of 
revenues recognized under the new guidance as compared to the previous guidance (ASC 605). Additionally, the 
Company's analysis indicated that there were no changes to how costs to obtain and fulfill our customer contracts 
would  be  recognized  under  the  new  guidance  as  compared  to  the  previous  guidance.  Accordingly,  the  initial 
application of the new revenue standard did not result in the recognition of a cumulative effect adjustment to the 
opening balance of accumulated deficit as of January 1, 2018.  

Nature of Contracts and Customers  

The Company’s contracts and related  performance obligations are similar for its customers and the sales 
process for all customers starts upon the receipt of requisition forms from the customers for patient diagnostic testing 
and the execution of contracts for biomarker testing and clinical research.  Payment terms for the services provided 
are 30 days, unless separately negotiated.  

Diagnostic testing  

Control of the laboratory testing services is transferred to the customer at a point in time. As such, the 

Company recognizes revenue for laboratory testing services at a point in time based on the delivery method (web-
portal access or fax) for the patient’s laboratory report, per the contract.  

Clinical research grants  

Control of the clinical research services are transferred to the customer over time.  The Company will 

recognize revenue utilizing the “effort based” method, measuring its progress toward complete satisfaction of the 
performance obligation.    

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84  

   
   
   
   
   
   
   
   
   
Biomarker testing and clinical project services  

Control of the biomarker testing and clinical project services are transferred to the customer over time.  The 
Company utilizes an “effort based” method of assessing performance and measures progress towards satisfaction of 
the performance obligation based upon the delivery of results.  

The Company generates revenue from the provision of diagnostic testing provided to patients, biomarker 
testing  provided  to  bio-pharma  customers  and clinical  research  grants  funded  by  both  bio-pharma  customers  and 
government health programs.   

Disaggregation of Revenues by Transaction Type  

We  operate  in  one  business  segment  and,  therefore,  the  results  of  our  operations  are  reported  on  a 
consolidated basis for purposes of segment reporting, consistent with internal management reporting. Service revenue, 
net for the years ended December 31, 2019 and 2018 was as follows (prior-period amounts are not adjusted under the 
modified-retrospective method of adoption):  

(dollars in thousands) 

Medicaid 
Medicare 
Self-pay 
Third party payers 
Contract diagnostics 
Service revenue, net 

Diagnostic Testing 
2018 
2019 

For the Year Ended December 31,  
Biomarker Testing 
2018 
2019 

Total 

2018 

2019 

50    $ 

28    $ 

   $ 
      1,669   
34   
      1,725   
 —   

50 
   1,000 
138 
960 
   1,187 
   $  3,456    $  2,148    $  595    $  1,187    $  4,051    $ 3,335 

 —    $ 
 —       1,669   
 —      
34   
 —       1,725   
595   

 —    $ 
 —   
 —   
 —   
595   

   1,000   
138   
960   
 —   

   1,187      

28    $ 

Revenue  from  the  Medicare  and  Medicaid  programs  account  for  a  portion  of  the  Company’s  patient 
diagnostic service revenue. Laws and regulations governing those programs are extremely complex and subject to 
interpretation. As a result, there is at least a reasonable possibility that recorded estimates will change by a material 
amount in the near term.  

Revenue Recognition  

Revenue is recognized when a customer obtains control of promised goods or services, in an amount that 
reflects the consideration which the entity expects to receive in exchange for those goods or services. To the extent 
the transaction price includes variable consideration, the Company estimates the amount of variable consideration that 
should  be  included  in  the  transaction  price  using  the expected  value  method  based  on  historical  experience.  The 
Company does not typically enter arrangements where multiple contracts can be combined as the terms regarding 
services are generally found within a single agreement/requisition form. The Company derives its revenues from three 
types of transactions: diagnostic testing (“Diagnostic”), and clinical research grants from state and federal research 
programs, and other revenues from the Company’s ICP technology and bio-pharma projects encompassing genetic 
diagnostics (collectively “Biomarker”).  

Deferred revenue  

Deferred revenue, or unearned revenue, refers to advance payments for products or services that are to be 
delivered in the future. The Company records such prepayment of unearned revenue as a liability, as revenue that has 
not yet been earned, but represents products or services that are owed to a customer.  As the product or service is 
delivered  over  time,  the  Company  recognizes  the  appropriate  amount  of  revenue  from  deferred  revenue.  As  of 
December 31, 2019 and 2018, the deferred revenue was $35,000 and $49,000, respectively.  

85  

   
   
   
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
     
     
     
     
     
     
  
  
     
  
  
  
  
  
  
  
  
     
  
  
   
   
   
   
   
   
Table of Contents  

Contractual Allowances and Adjustments  

We are reimbursed by payers for services we provide. Payments for services covered by payers average less 
than billed charges. We monitor revenue and receivables from payers and record an estimated contractual allowance 
for certain revenue and receivable balances as of the revenue recognition date to properly account for anticipated 
differences  between  amounts  estimated  in  our  billing  system  and  amounts  ultimately  reimbursed  by  payers. 
Accordingly, the total revenue and receivables reported in our consolidated financial statements are recorded at the 
amounts expected to be received from these payers. For service revenue, the contractual allowance is estimated based 
on  several  criteria,  including  unbilled  claims,  historical  trends  based  on  actual  claims  paid,  current  contract  and 
reimbursement terms and changes in customer base and payer/product mix. The billing functions for the remaining 
portion of our revenue are contracted and fixed fees for specific services and are recorded without an allowance for 
contractual discounts. The following table presents our revenues initially recognized for each associated payer class 
during the year ended December 31, 2019 and 2018.  

(dollars in thousands) 

For the Year Ended December 31,  

Medicaid 
Medicare 
Self-pay 
Third party payers 
Contract diagnostics 

Clinical research grants and other 

Allowance for Doubtful Accounts  

   Contractual Allowances and    Revenues, net of Contractual  
   Allowances and adjustments 

adjustments 

31    $ 

   Gross Revenues 
      2019 
      2018 
   $ 
86    $ 
     1,686      1,019      
34       138      
     5,785      2,358      
      595      1,187      
     8,131      4,788      
44       113      
   $ 8,175    $ 4,901    $ 

2019 

2018 

2019 

2018 

(3)    $ 

(17)   
 —   
(4,060)   
 —   
(4,080)   
 —   

(36)    $ 
(19)      
 —      
(1,398)      
 —      
(1,453)      
 —      
(4,080)    $  (1,453)    $ 

28    $ 

1,669   
34   
1,725   
595   
4,051   
44   
4,095    $ 

50 
1,000 
138 
960 
1,187 
3,335 
113 
3,448 

The Company provides for a general allowance for collectability of services when recording net sales.  The 
Company has adopted the policy of recognizing net sales to the extent it expects to collect that amount.  Reference 
FASB 954-605-45-5 and ASU 2011-07, Health Care Entities: Presentation and Disclosure of Patient Service Revenue, 
Provision for Bad Debt, and the Allowance for Doubtful Accounts.  The change in the allowance for doubtful accounts 
is directly related to the increase in patient service revenues.  The following table presents our reported revenues net 
of the collection allowance and adjustments for the year ended December 31, 2019 and 2018.  

(dollars in thousands) 

   Contractual Allowances 

   Allowances for doubtful 

Revenues, net of 

For the Year Ended December 31,  

and adjustments 

2019 

2018 

accounts 

Total 

2019 

2018 

2019 

2018 

Medicaid 
Medicare 
Self-pay 
Third party payers 
Contract diagnostics 

Clinical research grants and other 

   $ 

28    $ 
1,669      
34      
1,725      
595      
4,051      
44      

50    $ 
1,000      
138      
960      
1,187      
3,335      
113      
   $  4,095    $  3,448    $ 

(28)    $ 
(251)      
 —      
(689)      
 —      
(968)      
 —      
(968)    $ 

Costs to Obtain or Fulfill a Customer Contract  

(50)    $ 
(150)      
 —      
(384)      
 —      
(584)      
 —      

 — 
850 
138 
576 
1,187 
2,751 
113 
(584)    $  3,127    $  2,864 

 —    $ 
1,418      
34      
1,036      
595      
3,083      
44      

   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
     
     
     
     
  
  
     
  
  
  
  
  
  
  
  
  
     
  
  
  
   
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
     
     
     
     
     
     
     
     
     
     
  
     
     
  
   
   
Sales commissions are expensed when incurred because the amortization period would have been one year 

or less. These costs are recorded in operating expenses in the consolidated statements of operations.  

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86  

Shipping and handling costs are comprised of inbound and outbound freight and associated labor. The 
Company accounts for shipping and handling activities related to contracts with customers as fulfillment costs 
which are included in cost of sales in the consolidated statements of operations.  

Accounts Receivable  

The Company has provided an allowance for potential credit losses, which has been determined based on 
management’s industry experience. The Company grants credit without collateral to  its patients, most of who are 
insured under third party payer agreements.  

The following summarizes the mix of receivables for the years ended December 31, 2019 and 2018:  

(dollars in thousands) 
Medicaid 
Medicare 
Self-pay 
Third party payers 
Contract diagnostic services 

Less allowance for doubtful accounts 
Accounts receivable, net 

     December 31, 2019      December 31, 2018 
82 
107    $ 
   $ 
633 
814      
108 
88      
1,382 
2,203      
193 
36      
2,398 
3,248    $ 
(1,708) 
(2,674)      
690 
574    $ 

   $ 

   $ 

The  following  table  presents  the  roll-forward  of  the  allowance  for  doubtful  accounts  for  the  year  ended 

December 31, 2019:  

(dollars in thousands) 
Balance, January 1, 2019 
Collection Allowance: 
Medicaid 
Medicare 
Third party payers 

Bad debt expense 
Total charges 
Balance, December 31, 2019 

      Allowance for 

Doubtful 
Accounts 

      $ 

(1,708) 

   $ 

   $ 

(28)   
(251)   
(689)   
(968)   
 2   

      $ 

(966) 
(2,674) 

Customer Revenue and Accounts Receivable Concentration  

Customer  revenue  and  accounts  receivable  concentration  amounted  to  the  following  for  the  identified 

periods.  

Year Ended 
December 31, 

   
   
  
  
  
  
  
  
  
     
     
     
     
  
     
   
   
  
  
  
  
  
  
  
  
        
  
  
  
  
  
  
  
  
  
  
  
  
  
  
     
  
   
  
   
  
  
  
   
  
  
  
   
  
  
  
  
   
  
   
  
  
     
  
  
  
   
  
  
  
  
  
  
  
  
  
  
  
  
Percentage of net sales by customer: 

Customer A 
Customer B 
Customer C 

* represents less than 10% 

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87  

Percentage of total accounts receivable by customer: 

Customer A 
Customer B 
Customer C 

* represents less than 10% 

15. SUBSEQUENT EVENTS  

2019 

2018 

19  % 
11    
*   

33  % 
*   
*   

December 31, 
2019 

December 31, 
2018 

*   
17  % 
12  % 

23  % 
*   
*   

The Company has evaluated events and transactions subsequent to December 31, 2019 through the date the 

consolidated financial statements were issued.  

Strategic Partnership  

On  March  16,  2020,  the  Company  announced  that  it  had  completed  a  non-cash  transaction  with  Poplar 
Healthcare to establish a strategic partnership that includes the acquisition of the customer base OncoMetrix, Poplar’s 
hematopathology  division.  Precipio  will  assume  responsibility  for  OncoMetrix’s  customer  base  and  associated 
revenues which should provide a substantial improvement to the Company’s laboratory economies of scale. As part 
of  the  transaction,  three  sales  representatives  of  OncoMetrix  have  transitioned  to  Precipio.  The  transition  of  the 
customer based involved no exchange of cash or equity with Poplar Healthcare.  

Purchase Agreement  

On March 26, 2020, the Company entered into a purchase agreement (the “LP 2020 Purchase Agreement”) 
and a registration rights agreement (the “LP 2020 Registration Rights Agreement”) with Lincoln Park pursuant to 
which Lincoln Park has agreed to purchase from us, from time to time, up to $10,000,000 of our common stock, 
subject to certain limitations, during the 24 month term of the LP 2020 Purchase Agreement. Pursuant to the terms of 
the LP 2020 Registration Rights Agreement, we will file with the SEC the registration statement on form S-1 in order 
to register for resale under the Securities Act the shares that have been or may be issued to Lincoln Park under the LP 
2020 Purchase Agreement.  

As consideration for its commitment to purchase shares of our common stock under the LP 2020 Purchase 

Agreement, we agreed to issue 250,000 commitment shares to Lincoln Park as a commitment fee.  

We do not have the right to commence any sales to Lincoln Park under the LP 2020 Purchase Agreement 
until  certain  conditions set  forth  in  the  LP  2020  Purchase  Agreement,  all  of  which  are  outside  of  Lincoln  Park’s 
control, have been satisfied, including the registration statement on form S-1 being declared effective by the SEC. 
Thereafter, under the LP 2020 Purchase Agreement, on any business day selected by us, we may direct Lincoln Park 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
   
   
   
   
   
   
   
to purchase up to 50,000 shares of our common stock on any such business day, which we refer to as a Regular 
Purchase in the LP 2020 Purchase Agreement, provided, however, that (i) the Regular Purchase may be increased to 
up to 80,000 shares, provided that the closing sale price is not below $1.00 on the purchase date and (ii) the Regular 
Purchase may be increased to up to 100,000 shares, provided that the closing sale price is not below $1.50 on the 
purchase date.  In each case, the maximum amount of any single Regular Purchase may not exceed $1,000,000 per 
purchase.  Lincoln Park has no right to require the Company to sell any shares of common stock to Lincoln Park, but 
Lincoln Park is obligated to make purchases as we direct, subject to certain conditions. The purchase price for Regular 
Purchases shall be equal to the lesser of: (i) the lowest sale price of the common shares during the purchase date, or 
(ii) the average of the three (3) lowest closing sale prices of the common shares during the ten (10) business days prior 
to the purchase date.  

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88  

Convertible Note Amendment  

On March 26, 2020, the Company entered into an amendment agreement (the “March 2020 Amendment”) 
amending the terms of that certain Amendment No. 2 Agreement dated April 16, 2019 and the securities purchase 
agreement dated May 14, 2019.  As a result of the March 2020 amendment, (i) the maturity date of the April 2019 
Bridge Notes and the May 2019 Bridge Notes was extended three months from April 16, 2020 to July 16, 2020, (ii) 
the floor price at which conversions may occur under the April 2019 Bridge Notes and the May 2019 Bridge Notes 
was amended from $2.25 to $0.40, and (iii) guaranteed interest on the April 2019 Bridge Notes and the May 2019 
Bridge Notes was amended from twelve months to eighteen months.  

The  Company  is  currently  reviewing  the  appropriate  accounting  treatment  related  to  the  March  2020 

Amendment and will record the necessary accounting in the first quarter 2020.  

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89  

Item 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure  

None.  

Item 9A. Controls and Procedures  

(a)         Evaluation of Disclosure Controls and Procedures  

We maintain a system of disclosure controls and procedures that are  designed to ensure that information 
required to be disclosed by is in the reports we file or submit under the Act is recorded, processed, summarized, and 
reported within the time periods specified in the Commission’s rules and forms, and to ensure that such information 
is accumulated and communicated to our management, including our Chief Executive Officer and our Chief Financial 
Officer,  or  persons  performing  similar  functions,  as  appropriate,  to  allow  timely  decisions  regarding  required 
disclosure.  

Our management, including our Chief Executive Officer and Chief Financial Officer, does not expect that 
our  disclosure  controls  and  procedures  (as  defined  in  Rules  13a-15(e)  and  15d-15(e)  of  the  Exchange  Act) 

   
   
   
   
(“Disclosure Controls”) will prevent all errors and  all fraud. A control system, no matter how well conceived and 
operated,  can  provide  only  reasonable,  not  absolute,  assurance  that  the  objectives  of  the  control  system  are  met. 
Further, the design of a control system must reflect the fact that there are resource constraints, and the benefits of 
controls  must  be  considered  relative  to  their  costs.  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  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 control. 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. Because of the inherent limitations in a cost-effective control system, misstatements due 
to error or fraud may occur and not be detected. We monitor our Disclosure Controls and make modifications as 
necessary; our intent in this regard is that the Disclosure Controls will be modified as systems change and conditions 
warrant.  

An evaluation of the effectiveness of the design and operation of our Disclosure Controls was performed as 
of the end of the period covered by this Report. This evaluation was performed under the supervision and with the 
participation of our management, including our Chief Executive Officer and Chief Financial Officer. Based on this 
evaluation, we concluded that our disclosure controls and procedures were effective at a reasonable assurance level 
as of December 31, 2019.  

(b)         Management’s Report on Internal Control Over Financial Reporting  

Our management is responsible for establishing and maintaining adequate internal control over financial 
reporting (as defined in Rules 13a-15(f) and 15d-15(f) of the Exchange Act). In order to evaluate the effectiveness of 
internal  control  over  financial  reporting,  as  required  by  Section  404  of  the  Sarbanes-Oxley  Act  of  2002,  our 
management, with the participation of our principal executive officer and principal financial officer has conducted an 
assessment, including testing, using the criteria in Internal Control – Integrated Framework, issued by the Committee 
of Sponsoring Organizations of the Treadway Commission (“COSO”) (2013). Our system of internal control over 
financial reporting is designed to provide reasonable assurance regarding the reliability of financial reporting and the 
preparation of financial statements for external purposes in accordance with generally accepted accounting principles. 
Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. 
This assessment included review of the documentation of controls, evaluation of the design effectiveness of controls, 
testing of the operating effectiveness of controls and a conclusion on this evaluation.  

Based  on  this  evaluation,  management  concluded  that  our  internal  control  over  financial  reporting  was 

effective as of December 31, 2019.   

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90  

(c)         Changes in internal control over financial reporting  

There  were  no  changes  in  our  internal  control  over  financial  reporting  during  the  fiscal  quarter  ended 
December 31, 2019, that has materially affected, or is reasonably likely to materially affect, our internal control over 
financial reporting.  

As a smaller reporting company, the Company is not required to include in this Annual Report a report on 
the  effectiveness  of  internal  control  over  financial  reporting  by  the  Company’s  independent  registered  public 
accounting firm.  

Item 9B. Other Information  

   
   
   
None.      

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91  

Part III  

Item 10. Directors, Executive Officers and Corporate Governance  

We intend to file with the Securities and Exchange Commission a definitive Proxy Statement, which we refer 
to herein as the 2020 Proxy Statement, not later than 120 days after the close of the fiscal year ended December 31, 
2019. The information required by this item is incorporated herein by reference to the 2020 Proxy Statement. The 
information  required  by  this  item  related  to  the  executive  officers  can  be  found  in  the  section  captioned 
“Executive Officers of the Registrant” under Part I, “Item 1. Our Business” of this Annual Report on Form 10-K, 
and is also incorporated herein by reference.  

Item 11. Executive Compensation  

The information required by this item is incorporated herein by reference to the 2020 Proxy Statement to be 

filed with the SEC within 120 days after the year ended December 31, 2019.  

Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder 
Matters  

The information required by this item is incorporated herein by reference to the 2020 Proxy Statement to be 

filed with the SEC within 120 days after the year ended December 31, 2019.  

Item 13. Certain Relationships and Related Transactions, and Director Independence  

The information required by this item is incorporated herein by reference to the 2020 Proxy Statement to be 

filed with the SEC within 120 days after the year ended December 31, 2019.  

Item 14. Principal Accountant Fees and Services  

The information required by this item is incorporated herein by reference to the 2020 Proxy Statement to be 

filed with the SEC within 120 days after the year ended December 31, 2019.  

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92  

Part IV  

Item 15. Exhibits, Financial Statement Schedules  

 (a)    The following documents are filed as part of this report: 

1            Financial Statements. The following financial statements of the Registrant are included in response t

o Item 8 of this report:  

   
Report of Independent Registered Public Accounting Firm.  

Consolidated Balance Sheets of the Registrant and Subsidiary as of December 31, 2019 and 2018.  

Consolidated Statements of Operations of the Registrant and Subsidiary for the years ended December 31, 
2019 and 2018.  

Consolidated  Statements  of  Stockholders’  Equity  of  the  Registrant  and  Subsidiary  for  the years  ended 
December 31, 2019 and 2018.  

Consolidated Statements of Cash Flows of the Registrant and Subsidiary for the years ended December 31, 
2019 and 2018.  

Notes to Consolidated Financial Statements of the Registrant and Subsidiary.  

2            Financial Statement Schedules.  

All financial statement schedules are omitted because the information is inapplicable or presented in the 
notes to the financial statements.  

3            Exhibits. The following exhibits are filed as required by Item 15(a)(3) of this report. Exhibit numbers 

refer to the paragraph numbers under Item 601 of Regulation S-K:  

2.1   Agreement and Plan of Merger, dated October 12, 2016 by and among Transgenomic, Inc., New Haven 
Labs Inc.  and  Precipio  Diagnostics,  LLC  (incorporated  by  reference  to  Exhibit 2.1  of  the  Company’s 
Form 8-K filed on October 13, 2016).  

2.2   First  Amendment  to  Agreement  and  Plan  of  Merger,  dated  as  of  February 3,  2017  by  and  among 
Transgenomic, Inc., New Haven Labs Inc. and Precipio Diagnostics, LLC (incorporated by reference to 
Exhibit 2.1 of the Company’s Form 8-K filed on February 2, 2017). 

2.3   Second  Amendment  to  Agreement  and  Plan  of  Merger,  dated  as  of  June 27,  2017  by  and  among 
Transgenomic, Inc., New Haven Labs Inc. and Precipio Diagnostics, LLC (incorporated by reference to 
Exhibit 2.1 of the Company’s Form 8-K filed on June 30, 2017).  

3.1   Third  Amended  and  Restated  Certificate  of  Incorporation,  as  amended  (incorporated  by  reference  to 

Exhibit 3.1 of the Company’s 8-K filed on June 30, 2017).  

3.2   Amended and Restated Bylaws (incorporated by reference to Exhibit 3.2 of the Company’s Form 8-K filed 

on June 30, 2017).  

3.3   Certificate of Elimination (incorporated by reference to Exhibit 3.3 of the Company’s Form 8-K filed on 

June 30, 2017). 

3.4   Certificate of Designation for Series B Preferred Stock (incorporated by reference to Exhibit 3.1 of the 

Company’s Form 8-K filed on August 31, 2017).  

3.5   Certificate of Designation for Series C Preferred Stock (incorporated by reference to Exhibit 3.1 of the 

Company’s Form 8-K filed on November 6, 2017).  

3.6   Certificate of Amendment to the Third Amended and Restated Certificate of Incorporation, dated April 

25, 2019 (incorporated by reference to Exhibit 3.1 of the Company's Form 8-K filed on April 26, 2019).  

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93  

4.1   Form of  Certificate  of  the  Company’s  Common  Stock  (incorporated  by  reference  to  Exhibit 4  of  the 
Company’s Registration Statement on Form S-1 (Registration No. 333-32174) filed on March 10, 2000).  
4.2   Form of Offering Warrant (incorporated by reference to Exhibit 4.1 of the Company’s Form 8-K filed on 

August 23, 2017). 

   
  
  
4.3   Form of Underwriter Warrant (incorporated by reference to Exhibit 4.2 of the Company’s Form 8-K filed 

on August 23, 2017). 

4.4   Form of Conversion Warrant (incorporated by reference to Exhibit 4.3 of the Company’s Form 8-K filed 

on August 23, 2017). 

4.5   Form of  Warrant  (incorporated  by  reference  to  Exhibit 4.1  of  the  Company’s  Form 8-K  filed  on 

November 6, 2017). 

4.6   Form of  Warrant  (incorporated  by  reference  to  Exhibit 4.1  of  the  Company’s  Form 8-K  filed  on 

November 13, 2017).  

4.7   Description of Securities of the Registrant.  
10.1   License  Agreement  between  the  Company  and  Dana-Farber  Cancer  Institute  dated  October 8,  2009 

(incorporated by reference to Exhibit 10.1 of the Company’s Form 10-Q filed on November 5, 2009).  

10.2   Waiver Letter Agreement by and among the Company, Potomac Capital Partners, L.P., MAZ Partners, LP, 
David Wambeke and Craig-Hallum Capital Group, LLC dated as of January 10, 2017 (incorporated by 
reference to Exhibit 10.1 of the Company’s Form 8-K filed on January 17, 2017).  

10.3   First  Amendment  to  Unsecured  Convertible  Promissory  Note by  and  among  the  Company  and  MAZ 
Partners LP, dated as of January 17, 2017 (incorporated by reference to Exhibit 10.1 of the Company’s 
Form 8-K filed on January 20, 2017).  

10.4   Termination and Tenth Amendment to Loan and Security Agreement, dated as of February 3, 2017, by 
and among Third Security Senior Staff 2008 LLC, as administrative agent and a lender, the other lenders 
party thereto and the Company (incorporated by reference to Exhibit 10.1 of the Company’s Form 8-K 
filed on February 2, 2017).  

10.5   Promissory  Note,  dated  February 2,  2017  between  the  Company  and  Precipio  Diagnostics,  LLC 
(incorporated by reference to Exhibit 10.2 of the Company’s Form 8-K filed on February 3, 2017).  
10.6   Securities Purchase Agreement, dated as of April 13, 2017 by and between the Company and the investors 
set  forth  on  Schedule  A attached  thereto  (incorporated  by  reference  to  Exhibit 10.1  of  the  Company’s 
Form 8-K filed on April 17, 2017).  

10.7   Form of  Promissory  Note,  issued  by  the  Company  to  certain  investors,  dated  as  of  April 13,  2017 

(incorporated by reference to Exhibit 10.2 to the Company’s Form 8-K filed on April 17, 2017).  

10.8   Form of Warrant to Purchase Common Stock, issued by the Company to certain investors, dated as of 
April 13, 2017 (incorporated by reference to Exhibit 10.3 of the Company’s Form 8-K filed on April 17, 
2017).  

10.9   Precipio Diagnostics, LLC Subordinated Promissory Note, issued by Precipio to the Company, dated as of 
April 13, 2017 (incorporated by reference to Exhibit 10.4 of the Company’s Form 8-K filed on April 17, 
2017). 

10.10   Subordination Agreement, dated as of April 13, 2017, by and between the Company and Webster Bank, 
National  Association  (incorporated  by  reference  to  Exhibit 10.5  of  the  Company’s  Form 8-K  filed  on 
April 17, 2017).  

10.11   Side  Letter  to  extend  Maturity  Date  of  Unsecured  Convertible  Promissory  Note by  and  between  the 
Company and MAZ Partners LP, dated as of June 21, 2017 (incorporated by reference to Exhibit 10.1 of 
the Company’s Form 8-K filed on June 27, 2017). 

10.12†  Amended and Restated 2017 Stock Option and Incentive Plan (incorporated by reference to Annex D of 

the Company’s Definitive Proxy Statement on Schedule 14A filed on December 29, 2017).  

10.13†  Form of Non-Qualified Stock Option Agreement for Non-Employee Directors (incorporated by reference 

to Exhibit 10.2 of the Company’s Form 8-K filed on June 28, 2017).  

10.14†  Form of Non-Qualified Stock Option Agreement for Company Employees (incorporated by reference to 

Exhibit 10.3 of the Company’s Form 8-K filed on June 28, 2017).  

10.15†  Form of Incentive Stock Option Agreement (incorporated by reference to Exhibit 10.4 of the Company’s 

Form 8-K filed on June 28, 2017).  

10.16   Securities  Purchase  Agreement  with  the  Private  Placement  Purchasers  (incorporated  by  reference  to 

Exhibit 10.1 of the Company’s Form 8-K filed on June 30, 2017).  

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94  

10.17   Investors’ Rights Agreement (incorporated by reference to Exhibit 10.2 of the Company’s Form 8-K filed 

on June 30, 2017).  

10.18   Exchange  Agreement  (incorporated  by  reference  to  Exhibit 10.3  of  the  Company’s  Form 8-K  filed  on 

June 30, 2017).  

10.19   New Bridge Securities Purchase Agreement (incorporated by reference to Exhibit 10.4 of the Company’s 

Form 8-K filed on June 30, 2017).  

10.20   Form of  New  Bridge  Promissory  Note (incorporated  by  reference  to  Exhibit 10.5  of  the  Company’s 

Form 8-K filed on June 30, 2017).  

10.21   Form of New Bridge Warrant (incorporated by reference to Exhibit 10.6 of the Company’s Form 8-K filed 

on June 30, 2017).  

10.22   Form of Side Warrant (incorporated by reference to Exhibit 10.7 of the Company’s Form 8-K filed on 

June 30, 2017).  

10.23#  Amended  and  Restated  Pathology  Services  Agreement,  dated  March 21,  2017,  by  and  between  the 
Company and Yale University (incorporated by reference to Exhibit 10.1 of the Company’s Form 8-K/A 
filed on July 31, 2017). 

10.24   Lease, dated July 11, 2017, by and between the Company and Science Park Development Corporation 
(incorporated by reference to Exhibit 10.2 of the Company’s Form 8K/A filed on July 31, 2017).  
10.25   Underwriting Agreement, dated August 22, 2017, by and among the Company and the underwriters party 

thereto (incorporated by reference to Exhibit 1.1 of the Company’s Form 8-K filed on August 23, 2017).  

10.26   Placement Agency Agreement, dated as of November 2, 2017, by and between Precipio, Inc. and Aegis 
Capital Corp. (incorporated by reference to Exhibit 10.1 of the Company’s Form 8-K filed on November 3, 
2017). 

10.27   Debt  Settlement  Agreement,  dated  October 31,  2017,  by  and  among  Precipio, Inc.,  the  Creditors  and 
Collateral Services, LLC (incorporated by reference to Exhibit 10.1 of the Company’s Form 8-K filed on 
November 6, 2017). 

10.28   Security Agreement, dated October 31, 2017, by and between Precipio, Inc. and Collateral Services LLC, 
in  its  capacity  as  collateral  agent  for  the  Vendors  (as  defined  therein)  (incorporated  by  reference  to 
Exhibit 10.2 of the Company’s Form 8-K filed on November 6, 2017).  

10.29   Amendment, dated November 9, 2017, to Placement Agency Agreement, dated November 2, 2017, by and 
between  Precipio, Inc.  and  Aegis  Capital  Corp.  (incorporated  by  reference  to  Exhibit 10.1  of  the 
Company’s Form 8-K filed on November 13, 2017).  

10.30   Form of 8% Senior Secured Convertible Promissory Note (incorporated by reference to Exhibit 10.1 of 

the Company’s Form 8-K filed on April 23, 2018).  

10.31   Form of Warrant to Purchase Common Stock (incorporated by reference to Exhibit 10.2 of the Company’s 

Form 8-K filed on April 23, 2018).  

10.32   Form of Security Agreement by and among the Company and the investors named therein, dated April 20, 

2018 (incorporated by reference to Exhibit 10.3 of the Company’s Form 8-K filed on April 23, 2018).  

10.33   Securities Purchase Agreement by and among the Company and the Purchasers named therein, dated April 
20, 2018 (incorporated by reference to Exhibit 10.4 of the Company’s Form 8-K filed on April 23, 2018).  
10.34   Purchase Agreement by and among the Company and Lincoln Park Capital Fund LLC dated September 7, 
2018 (incorporated by reference to Exhibit 10.1 of the Company’s Form 8-K filed on September 13, 2018).  
10.35  Registration Rights Agreement, dated September 7, 2018, by and between Precipio, Inc. and Lincoln Park 
Capital  Fund,  LLC  (incorporated  by  reference  to  Exhibit  10.2  of  the  Company’s  Form  8-K  filed  on 
September 13, 2018). 

10.36  Exchange Agreement by and among the Company and the Purchasers named therein dated September 17, 
2018 (incorporated by reference to Exhibit 10.1 of the Company’s Form 8-K filed on September 20, 2018).  
10.37  Form of Promissory Note (incorporated by reference to Exhibit 10.2 of the Company’s Form 8-K filed on 

September 20, 2018). 

10.38  Form of Letter Agreement by and among the Company and the Investors named therein (incorporated by 

reference to Exhibit 10.1 of the Company’s form 8-K filed on September 25, 2018).  

10.39  Amendment Agreement by and among the Company and the Purchasers named therein, dated November 
29, 2018 (incorporated by  reference to Exhibit 10.1 of the Company’s Form 8-K  filed on December 3, 
2018). 

10.40  Form of 8% Senior Secured Convertible Promissory Note (incorporated by reference to Exhibit 10.3 of the 

Company’s Form 8-K filed on December 3, 2018).  

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95  

10.41  Form of Letter Agreement regarding repricing of warrants (incorporated by reference to Exhibit 10.3 of the 

Company’s Form 8-K filed on December 3, 2018).  

10.42  Form of Warrant to Purchase Common Stock (incorporated by reference to Exhibit 10.4 of the Company’s 

Form 8-K filed on December 3, 2018).  

10.43  Amendment No. 2 Agreement by and among the Company and the Purchasers named therein, dated April 
16, 2019 (incorporated by reference to Exhibit 10.43 of the Company’s Form 10-K filed on April 16, 2019).  
10.44  Form  of  8%  Senior  Secured  Convertible  Promissory  Note  relating  to  Amendment  No.  2  Agreement 
(incorporated by reference to Exhibit 10.44 of the Company’s Form 10-K filed on April 16, 2019).  
10.45  Form of Warrant to Purchase Common Stock relating to Amendment No. 2 Agreement (incorporated by 

reference to Exhibit 10.45 of the Company’s Form 10-K filed on April 16, 2019).  

10.46  Form of Settlement Agreement, dated January 2, 2019 (incorporated by reference to Exhibit 10.1 of the 

Company’s Form 8-K filed on January 7, 2019).  

10.47  Form of Amendment and Restatement Agreement, dated January 15, 2019 (incorporated by reference to 

Exhibit 10.1 of the Company's Form 8-K filed on January 22, 2019).  

10.48  Form  of  Convertible  Note,  dated  January  15,  2019  (incorporated  by  reference  to  Exhibit  10.2  of  the 

Company's Form 8-K filed on January 22, 2019).  

10.49  Form  of  Convertible  Note,  dated  January  29,  2019  (incorporated  by  reference  to  Exhibit  3.1  of  the 

Company's Form 8-K filed on January 30, 2019).  

10.50  Form of Settlement Agreement, dated January 29, 2019 (incorporated by reference to Exhibit 10.1 of the 

Company's Form 8-K filed on January 30, 2019).  

10.51  Form of Release, dated January 29, 2019 (incorporated by reference to Exhibit 10.2 of the Company's Form 

8-K filed on January 30, 2019).  

10.52  Form of Amendment Agreement No.1, dated March 26, 2020. 
10.53  Form of 8% Senior Secured Convertible Promissory Note, dated May 14, 2019 (incorporated by reference 

to Exhibit 10.1 of the Company’s Form 10-Q filed on May 16, 2019).  

10.54  Form of Warrant to Purchase Common Stock dated May 14, 2019 (incorporated by reference to Exhibit 

10.2 of the Company’s Form 10-Q filed on May 16, 2019).  

10.55  Form of Security Agreement by and among the Company and the investors named therein, dated May 14, 
2019 (incorporated by reference to Exhibit 10.3 of the Company’s Form 10-Q filed on May 16, 2019).  
10.56  Form of Securities Purchase Agreement by and among the Company and the Purchasers named therein, 
dated May 14, 2019 (incorporated by reference to Exhibit 10.4 of the Company’s Form 10-Q filed on May 
16, 2019). 

21.1   Subsidiaries of the Company. 
23.1   Consent of Marcum LLP. 
31.1   Certification of Principal Executive Officer, pursuant to Section 302 of the Sarbanes-Oxley Act of 2002, 

as amended. 

31.2   Certification of Principal Financial Officer, pursuant to Section 302 of the Sarbanes-Oxley Act of 2002, 

as amended. 

32.1*  Certification of Principal Executive Officer, pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, 

as amended. 

32.2*  Certification of Principal Financial Officer, pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, 

as amended. 

101.INS  XBRL Instance Document 
101.SCH  XBRL Taxonomy Extension Schema Document 
101.CAL  XBRL Taxonomy Extension Calculation Linkbase Document 
101.DEF  XBRL Taxonomy Extension Definition Linkbase Document 
101.LAB  XBRL Taxonomy Extension Label Linkbase Document 
101.PRE  XBRL Taxonomy Extension Presentation Linkbase Document 

*     This certification is not deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, 
or otherwise subject to the liability of that section. Such certification will not be deemed to be incorporated 

 
by reference into any filing under the Securities Act of 1933 or the Securities Exchange Act of 1934, except 
to the extent that the Registrant specifically incorporates it by reference.  

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96  

#     Confidential  treatment  has  been  requested  or  granted  for  certain  information  contained  in  this  exhibit.  Such 

information has been omitted and filed separately with the Securities and Exchange Commission.  

†     Indicates a management contract or any compensatory plan, contract or arrangement.  

Item 16. Form 10-K Summary  

None.  

SIGNATURES  

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant 
has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized on this 27th day of 
March 2020.  

Precipio, Inc. 

By: 

/s/ ILAN DANIELI 
Ilan Danieli, 
Chief Executive Officer (Principal Executive Officer) 

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, this report has 
been signed below by the following persons on behalf of the registrant and in the capacities and on the dates indicated.  

Signature 

Title 

Date 

/s/ Ilan Danieli 
Ilan Danieli 

Director and Chief Executive Officer  
(Principal Executive Officer) 

/s/ Carl Iberger 
Carl Iberger 

Chief Financial Officer  
(Principal Financial and Accounting Officer) 

March 27, 2020 

March 27, 2020 

/s/ Douglas Fisher, M.D. 
Douglas Fisher, M.D. 

Chairman of the Board of Directors 

March 27, 2020 

/s/ Kathleen LaPorte 
Kathleen LaPorte 

   Director 

/s/ Mark Rimer 
Mark Rimer 

/s/ Richard Sandberg 
Richard Sandberg 

Director 

Director 

/s/ Jeffrey Cossman, M.D. 

Director 

March 27, 2020 

March 27, 2020 

March 27, 2020 

March 27, 2020 

   
   
  
  
  
  
  
  
   
  
  
  
  
  
     
     
  
     
     
  
  
  
     
  
     
     
  
  
  
     
  
     
     
  
  
  
  
  
  
  
     
     
  
     
     
  
     
     
  
  
  
  
  
  
  
     
     
  
  
  
  
  
  
  
     
     
  
  
Jeffrey Cossman, M.D. 

/s/ David Cohen 
David Cohen 

Director 

March 27, 2020 

97