Titan Medical Inc
TSX:TMD
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Titan Medical Inc
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Good evening, ladies and gentlemen, and welcome to Titan Medical's First Quarter 2021 Earnings Conference Call. [Operator Instructions] As a reminder, today's conference is being recorded. [Operator Instructions]I will now turn the conference over to Kristen Galfetti, Titan Medical's Vice President of Investor Relations and Corporate Communications. Please proceed.
Thank you, operator. Good evening, everyone, and thank you for joining us for Titan Medical's First Quarter 2021 Earnings Conference Call. During our call, we will review Titan's first quarter 2021 financial results and key business highlights, which were summarized in our earnings press release issued earlier today. A copy of the release can be found in the Investor Relations section of our website at www.titanmedicalinc.com.As a reminder, certain statements made during this conference call constitute forward-looking statements that reflect management's current expectations of the company's future growth, results of operations, performance and business prospects and opportunities. Wherever possible, words such as may, would, could, will, anticipate, believe, plan, expect, intend, estimate, potential for, as planned and similar expressions have been used to identify these forward-looking statements.These statements, including statements with respect to projected development plans, milestones, time lines, budgets, development status, anticipated regulatory pathways, anticipated license payments, the maintaining of worldwide rights to commercialize the technologies and intellectual property license to Medtronic, the goals that the e-mail system is being designed to address, the features that the e-mail system is designed to include, the medical outcomes that we expect the e-mail system will improve, the advantages that we expect users of the e-mail system will receive, the anticipated market demand for the e-mail system and the belief that the market is underpenetrated and plans to participate in certain investor conferences reflect management's current beliefs with respect to future events and are based on information currently available to management.Forward-looking statements involve significant risks, uncertainties and assumptions. Many factors could cause the company's actual results, performance or achievements to be materially different from any future results, performance or achievements that may be expressed or implied by such forward-looking statements, including, without limitation, those listed in the Risk Factors section of the company's Annual Information Form and Form 40-F for the fiscal year ended December 31, 2020, which may be viewed at www.sedar.com and at www.sec.gov.Should one or more of these risks or uncertainties materialize or should assumptions underlying the forward-looking statements prove incorrect, actual results, performance or achievements may vary materially from those expressed or implied by the forward-looking statements made during this conference call. These factors should be considered carefully and prospective investors should not place undue reliance on the forward-looking statements. Although the forward-looking statements made during this call are based upon what management currently believes to be reasonable assumptions, the company cannot assure current or prospective investors that actual results, performance or achievements will be consistent with these forward-looking statements.With that, I will turn the call over to David McNally, President and Chief Executive Officer of Titan Medical. David?
Thank you, Kristen. Good evening, and welcome to Titan Medical's First Quarter 2021 Earnings Call. I want to thank our shareholders for their support and confidence in our ability to successfully develop the Enos robotics single access surgical system. We are excited to share today's updates with shareholders who have been following the Titan story and with investors new to Titan Medical. Joining me on the call today will be Perry Genova, Senior Vice President, Research and Development and President of Titan Medical U.S.A.; and Monique Delorme, Titan Medical's Chief Financial Officer.2020 resulted in an incredible year of accomplishments that position Titan nicely going into 2021. During the first quarter of 2021 and in recent weeks that followed, the company secured more than $44.5 million from equity financings, separated the role of Chairman from President and CEO, expanded the Board of Directors, grew the senior leadership team, increased investor activities and communications and launched Titan Living Labs. Most importantly, we continued to accomplish our milestones and move closer to bringing the Enos surgical system to patients.We were opportunistic with market activities and, as noted, close 2 equity financings totaling $34.5 million and received an additional $10 million from the exercise of warrants held by investors from previous offerings. As a result of those efforts, we believe we are in a strong financial position to execute our strategy.The Board of Directors believe that sound principles of corporate governance are critical to our success as a company and to earning the trust and confidence of each of our stakeholders. In keeping with corporate governance best practices, we have separated the role of Chairman of the Board from President and CEO. And today, we announced that Paul Cataford has been appointed Titan's Chairman of the Board.Paul joined Titan's Board last fall as our Lead Independent Director. And during his tenure on the Board, he has demonstrated his strong leadership skills and corporate governance experience. He is the CEO and Co-Founder of Zephyr Sleep Technologies, a medical device company specializing in the treatment and diagnoses of sleep-disordered breathing. Paul brings significant technology transfer and early-stage company experience to Titan Medical's Board and has served as an independent corporate director on a number of public Boards of Directors at companies listed on the TSX, TSX-V and NASDAQ, including Sierra Wireless, Trakopolis IoT Corporation, SemiBioSys Genetics and AGJunction. We are proud to have him in place as our new Chairman of the Board.We are also delighted to announce today that Heather Knight has been appointed as an additional independent director to the Board. Heather is a dynamic sales and marketing executive and brings to us nearly 25 years of proven health care commercial experience. Heather currently serves as General Manager of U.S. hospital products at Baxter Healthcare where she is responsible for U.S. commercialization, including sales, national accounts, marketing, commercial operations and business integration. She previously served as Global President of Sofradim, France and Vice President and General Manager for Surgical Innovations, MITG at Medtronic where she led all portfolio, strategy and growth initiatives for the global business, including commercialization in all regions across the globe.Heather is the executive sponsor for the Baxter Black Alliance, employee business resource group and previously served as Co-Chair of the Medtronic Women's Network Executive Committee. She is the 2021 Healthcare Business Women's Association luminary and the Founding Member of Chief, Chicago. Heather serves on the Board of Directors of Technovation and Linkage Women in Leadership.We are equally excited to announce that Cathy Steiner has been nominated to join the Board upon shareholder approval at our annual meeting. Cathy brings over 20 years of investment banking and financial and capital markets experience in dealings with public and private health care companies. She is currently Principal of Origin Merchant Partners, an independent investment bank specializing in mergers and acquisitions and corporate finance where she leads the health care practice.Previously, Cathy held the role of Chief Financial Officer for technology companies through capital raising and M&A transactions being responsible for financial accounting oversight and risk management. For over a decade prior to that, she was Managing Director for Nucleus GC, a boutique health care advisory firm working with clients on financing and strategic transactions as well as product development, commercialization, positioning and launch. For nearly 10 years prior to that, Cathy led Healthcare Investment Banking for CIBC World Markets and Yorkton Securities. Cathy is currently a Director at Cipher Pharmaceuticals, a TSX-listed company, and serves as a member of the Audit Committee.We are delighted to have these 2 talented professionals join our Board and look forward to utilizing their expertise and insight to support Titan's success.Stephen Randall, who retired in September 2020 after previously serving as Titan's CFO until September 2020, has remained on the Board during the transition period during which we have augmented the independence of the Board. We are grateful for Stephen's distinguished service during his more than 10 years as CFO and 4 years as a director. Please visit our website for additional governance details, policy, member bios and committee composition.We recently announced the expansion of the senior leadership team, appointing Kristen Galfetti as Vice President, Investor Relations and Corporate Communications; and Chien Huang as Vice President, Finance. Each has over 20 years experience in their respective fields and will contribute to Titan's continued growth and success.Kristen is responsible for executing our Investor Relations strategy and serves as the primary contact for our investors and media interest. Chien is applying his expertise to develop and implement financial systems that will support Titan's growth. We are very pleased that they have joined the leadership team, and they are already contributing to our progress in meaningful ways.We also continue to augment our R&D team in Chapel Hill, North Carolina, adding experienced engineers, technical experts and support staff where the team now totals over 30 employees. Perry will provide more details on the exciting work the R&D team is doing in Chapel Hill.Overall, Titan remains focused on achieving milestones, both in regard to those established for our Enos system development and those under the Medtronic development program. The upcoming Medtronic milestone anticipated for completion this month includes an associated license payment to Titan of $10 million.Titan and Medtronic currently operate under a development and license agreement that leverages Titan's technology and provides Medtronic access to a portion of our intellectual property portfolio in exchange for milestone payments. Importantly, Titan maintains perpetual royalty-free worldwide rights to commercialize the licensed technologies for use with the Enos system. And furthermore, we have our own patent portfolio that continues to grow as we continue to innovate in robotic surgery with over 160 global patents and applications pending.The landscape for single access robotic surgery is rapidly evolving. We believe that there is high demand in the market for a versatile single access robotic platform. While improved patient outcomes are paramount, hospitals and surgeons are looking for greater cost effectiveness and efficiency and improved functionality. We remain committed to enhancing robotic-assisted surgery using innovative technology through a single access point with the goals of improved patient outcomes, lower operating room costs and greater patient throughput. As a reminder, Titan's innovative technology is being designed to be both effective and easy to use to allow medical professionals to perform their best to improve patient outcomes.Our multi-articulating instruments are designed to allow a remarkable range of motion in a confined space and deliver the necessary strength for common surgical tasks. Our Enos surgical system is being designed with an ergonomic focus and to provide for a surgical experience that indicates the real-life movements that surgeons regularly execute during minimally invasive surgery. We continue to work closely with key opinion-leading surgeons as we value their feedback and interest in seeing the Enos system come to market. Additionally, we believe that the market we aim to serve is underpenetrated, thus presenting an exciting opportunity for our system to make a difference in patients' lives.Titan's Enos system is being developed as a single access surgical system aiming to become the new standard of care for single access robotic surgery. The Enos system is being designed to include the advantages of dual 3D and 2D high-definition vision systems for improved visualization. multi-articulating instruments for increased dexterity and an ergonomic surgeon workstation for surgeon comfort.The Enos system's initial clinical focus will include benign gynecologic surgery for the U.S. market. We believe that the associated patient population is particularly motivated to embrace a surgical solution that has the potential to reduce trauma, pace in healing and reduce scarring. Additionally, based on our preclinical success, we anticipate that the versatility of the Enos system will eventually be found attractive for broad use in multiple subspecialties. We continue to hone our relationships with leading surgeons that have provided us with excellent feedback and insights regarding opportunities for us to satisfy unmet needs across numerous procedures.As we shared previously, communications with the U.S. FDA indicates that the regulatory pathway for our Enos single access surgical system is expected via the de novo process reserved for novel medical devices. We plan to finalize product development of the Enos surgical system this year. And upon approval of our application for an investigational device exemption, or IDE, we anticipate commencing IDE clinical studies in 2022.Upon completing the studies, we expect to file for marketing authorization with the FDA in the first half of 2023 with possible product launch in the second half of 2023 upon successful receipt of authorization from the FDA. We look forward to future correspondents and conversations with the FDA and communicating our progress on getting the Enos system cleared for marketing and into the hands of surgeons.Our relationship with Medtronic resulted in $20 million in license payments received in 2020, and we believe that we are well positioned to meet the remaining 2 milestones in 2021, earning up to an additional $21 million in license payments. This month, we expect to complete the first of the 2 remaining milestones in the development program with Medtronic, which would result in an associated license payment of $10 million. Following received this payment, the final phase of development is anticipated to be completed later this year providing an additional license payment of approximately $11 million. Monique will be providing you more detail with her update on our quarter end finances as of March 31, 2021.During the first quarter, increased investor relations activities and improved stakeholder communications included. One, new analyst coverage. Suraj Kalia of Oppenheimer & Co. initiated coverage on Titan on April 7, 2021, with a buy rating. David Martin of Bloom Burton & Co. initiated coverage on April 19, 2021, with a buy rating as well. We appreciate the work these professionals invested in researching and reporting on prospects for our business.Two, as I mentioned earlier, we hired Kristen Galfetti as Vice President of Investor Relations and Corporate Communications with over 20 years experience to serve as your point of contact and to build corporate communications with other audiences on behalf of Titan.Three, the Board of Directors established a shareholder engagement policy that recognizes and encourages regular and constructive communication between shareholders and the company. A copy of this policy is available on our website.Four, we have updated the Investors section on our corporate website with enhanced navigation to facilitate access to information and improve communication with investors.Five, last Thursday, we launched a second edition of Titan Living Labs on our website. That provides the opportunity for viewers to engage in our journey through product development. This second video builds upon the first released earlier this year and illustrates the enhanced kinematic engine, improved independence of dexterous multi-articulating instruments and displays the 2 independent LED light sources, 1 within our custom steerable 3D high-definition camera and another in the insertion tube with integrated 2D high-definition camera. The video features our dedicated team and the detailed development work that is required as we work towards finalizing product development of our Enos system.And lastly, we invite you to visit our website to view the newest vignette and navigate the updated Investors section.I will now turn the call over to Dr. Perry Genova, Senior Vice President of R&D for Titan Medical Inc. and President of Titan Medical U.S.A. Inc. who will provide an update on activities in Chapel Hill, details on development activities relating to the Enos surgical system and advancements pursuant to the ongoing development and license agreement with Medtronic.
Thank you, David, and it's a pleasure to be speaking to all of you this evening. As David mentioned, we continued to advance our development work during the first quarter. Our growing U.S. subsidiary based in Chapel Hill, North Carolina, has deepened our technical expertise in the areas of software, electrical and mechanical engineering, quality assurance and program management as the advancement of the Enos surgical system continues.During the first quarter of 2021, the team leveraged its deep knowledge of physics and kinematics to improve the natural motion, surgeon feel and strength of Titan's unique instruments. With the diligent efforts of our technical team, the Enos system's instruments are designed to precisely mirror a surgeon's discrete hand motions. Surgeons appreciate the natural movement designed into the Enos system that translates physical inputs into dextrous arm movements.Additionally, we have created capability for surgeons to work very close to the surgical incision or entry point to the body, resulting in greater work area within the patient. Simultaneously, the in-house team further advanced the Enos steerable camera system, providing outstanding maneuverability and visualization for the surgeon. Titan's independent 2D and 3D high-definition systems illuminate, visualize and move better and are closer to commercialization than ever before.Our software development team has worked tirelessly and continues to do so to improve robot kinematics, decrease electromechanical system response times and increase system reliability, all while adding those features necessary for successful commercialization. We also continue our deep commitment to implementing display overlays for augmented informatics to improve the surgical experience for surgeons while making improvements to our integrated simulation training suite. The proximity of Titan's Chapel Hill facility to independent evaluation laboratories and some of the top U.S. thought-leading hospitals has proven to be an excellent asset that we have leveraged in support of Titan's robotics technology development and ongoing innovation.Managing product development in-house has provided us with tight control of our design and shortened modification timing turnaround as we make iterative updates to the Enos system. This has improved our ability to take substantially greater control over our technology development and expeditiously execute on our milestones, manage spending and continue to innovate and expand our intellectual property portfolio.Our development program under the Medtronic development and license agreement continues to proceed according to plan. The joint steering committee comprised of the equivalent number of members from each company who regularly coordinates activities and maintains development schedules. We are presently on track to achieve the next planned milestone for the program by the end of this month.I am very pleased with and proud of our accomplishments over the past year and look forward to sharing additional updates with you going forward through press releases and additional vignettes on Titan Living Labs. As David mentioned, Titan Living Labs on our website provides the opportunity to join our team of motivated and very talented engineers on our journey of innovation and to witness the growth of our expertise and advancement of the Enos surgical system.I will now turn the call to Monique Delorme, our CFO, to review our financial results. Monique?
Thank you, Perry. It's my pleasure to be addressing all of you on this call this evening. As of March 31, 2021, we had cash and cash equivalents on hand of approximately $53.4 million compared to $25.5 million at December 31, 2020. The increase was due to the receipt of $10 million from the exercise of warrants by investors from a previous financing, and aggregate gross proceeds of $34.5 million from 2 equity financings that closed in the first quarter of 2021. The company continues to carry a loan from an affiliate of Medtronic in the amount of $2 million, including accrued interest, evidenced by an 8% senior secured promissory note on our books.Net and comprehensive loss for the 3 months ended March 31, 2021, was $14.8 million compared with a net and comprehensive loss of $800,000 for the 3 months ended March 31, 2020. The increased loss is primarily due to increased R&D expenses of $7.6 million in the first quarter of 2021 as we progressed on the development of our Enos system and the activities under the development and license agreement with Medtronic.In the first quarter of 2020, R&D expenses were $50,000, reflecting our temporary suspension of our R&D activities at that time. As we increased staffing through the quarter and invested in strategic business development and corporate governance, general and administrative expenses increased to $4.1 million in the first quarter of 2021 compared to $1.7 million in the first quarter of 2020. During the first quarter of 2021, the company also recognized a noncash loss on fair value of warrant derivative liabilities of $3.1 million compared to a noncash gain of $1.1 million recorded in the first quarter of 2020.As of March 31, 2021, current liabilities, excluding warrant derivative liability, were $5.2 million compared with $6.6 million at December 31, 2020. As of March 31, 2021, the company had working capital of $50.6 million compared to a working capital of $20.4 million at December 31, 2020.The growth our company has experienced over the past year has been incredible, augmenting the management team, establishing our U.S. subsidiary, tripling our workforce and achieving milestones internally for our Enos system and delivering those in our development and license agreement with Medtronic have been great accomplishments for Titan.Meanwhile, we continue to hone our financial reporting process and increase the efficiency with which we deliver our finance solutions. Working together with members of the senior management and Audit Committee of our Board of Directors, we continue to evolve our accounting systems and judiciously apply resources to address the rapidly changing needs of both our Canadian and U.S. operations.As we noted during our year-end earnings call, we had identified material weaknesses in our internal controls of the financial reporting as we completed the preparation of our annual financial filings, resulting in noncash adjustments to our statements. All corrections were made prior to the approval of the financial statements by our Board and prior to the release of year-end financial statements.Since that time, we've taken several remedial actions, including engaging additional human resources to assist with the preparation of financial reports, engaging the services of third-party financial experts to assist in the preparation and review of more complex financial transactions and leveraging systems and technologies to reduce the risk of errors. Based on our assessment, we have concluded that the 2021 first quarter financial statements are fairly presented in accordance with IFRS.In summary, our balance sheet remains strong and is expected to support the completion of the Medtronic development program and continue progress on the Enos surgical system through 2022 as we prepare for regulatory filings and surgeons perform human clinical studies upon receipt of anticipated IDE approval from the FDA.With that, I'll turn the call back over to David.
Thank you, Monique. We believe that the Enos surgical system will address an underpenetrated but high-demand segment of the robotic-assisted surgical device market, promising less patient trauma and faster recovery times and savings on capital equipment, service and procedure costs for hospitals. We look forward to keeping you apprised on Titan's progress towards the exciting milestones ahead, including advancing our Enos robotic single access surgical system toward commencing human clinical studies and meeting additional milestones under the Medtronic development program.We remain committed to corporate governance and shareholder engagement and look forward to communicating with you through news releases, our newly enhanced website, social media, and remaining engaged with the investor community through our participation in virtual investor conferences, investor roadshows, meetings with institutional investors and discussions with our covering analysts.Planned participation in upcoming virtual investor conferences include the Oppenheimer & Co. MedTech Summit on May 26 and Cantor Global Healthcare Conference at the end of September. Importantly, we will be holding our Annual and Special Meeting of Shareholders virtually on June 9. Details of the meeting, including instructions on how to connect to the online platform, can be found on our website in the Investors section under News & Events. We encourage all of our shareholders to cast their votes and attend virtually for additional updates. Thank you for your support. We will now open the line for questions. Operator?
[Operator Instructions] And our first question is from Suraj Kalia with Oppenheimer.
David, can you hear me all right?
Yes, Suraj. Thank you.
Perfect. So David, what all remains to be done to freeze product design and move into IDE trials?
Thank you for asking the question, Suraj. And as you've seen on Titan Living Labs, we've been able to demonstrate the functionality of the improvements to the camera systems and the instruments. Now comes the part that's not as obvious to the outside world, which is moving through the processes of biocompatibility of materials, perfecting the manufacturing processes and verification and validation. And those steps are necessary before we can say the design is truly frozen and ready for production.I can say, however, that the design is firm and that we have been able to test the instruments, the interfaces and the improvements to the system in the laboratory environment. And we feel comfortable with the architecture of the system, but it's the details that take us from an exciting system that operates in a preclinical environment to one that is ready for clinical use. And of course, these activities must be completed before we file for our investigational device exemption planned for early next year.
So David, IDE next year, can you just back up when must the design be completely frozen? I presume you're already in discussions about an IDE design in benign hysterectomy. So just kind of what should we expect over the next 3 quarters in terms of milestones as we prepare for the IDE?
So in terms of the milestones, we're performing, as we've noted in our MD&A, the biocompatibility testing. Of course, that's on for the current quarter that's Q2. We're also marching forward toward verification and validation, completing software development this current quarter as well. And continuing to communicate with the FDA regarding the clinical study, that is, the design of the clinical study in benign hysterectomy so that when we go to file for our IDE in the first quarter of next year that we've already worked out with FDA, the details of the number of patients, the number of sites and the endpoints associated with that study.The cadence of over these next several quarters of this year include not only those activities related to our Enos robotic single access surgical system, but also in parallel execution to the Medtronic milestones, of which there are 2 remaining. One, as we confirm today that we expect to achieve this very month of May. And the fourth milestone to be achieved later this year, earning license payments of approximately $10 million and $11 million, respectively, related to those milestones.
Got it. David, one final question, I'll let others jump in. So David, as you all think about the IDE early next year, obviously, you'll have to be targeting your low-hanging fruit. Is the thought process to go into larger university centers or to tackle more community centers? And also, if you could touch upon the training and credentialing groundwork you all would be laying in anticipation of an eventual commercial launch.
Suraj, as always, great questions in your research. So we're targeting a mix of facilities for our IDE studies that range from large teaching hospitals to smaller community hospitals. And we do see that this also would demonstrate to the FDA that facilities of a broad range are potential candidates to safely use our technology. So it's strategic in the design of those.Key to this as well is that we're working with surgeons that we believe can really further single access surgery with their hands on the Enos system. So very much focused on the right surgeons who we've handpicked and by mutual agreement, sharing the inspiration of where we can take single access surgery are also interested in teaching other surgeons. So we view our initial sites for the IDE study as evolving into teaching sites where we can train other early adopter surgeons and ramp our commercial launch once we have cleared the FDA.And then with respect to credentialing, we expect that the training modules that we have been developing and implementing on the workstation will be invaluable not only to the surgeons and their performance in the operating room, but to the hospitals for accreditation. So we're investing heavily in integrated training software on our platform. We're also working with our key opinion-leading surgeons who will lead the IDE studies that may also proctor in terms of cases with early commercial adopters outside of the surgeons perform in the IDE study. So we're very keen on optimizing the outcomes associated not only with the IDE studies, but focused on excellent patient outcomes as we roll into commercialization after clearance.
And there are no more questions over the phone lines. I'll hand it back to David.
Actually, we do have some questions from the webcast, which I'd like to share. First up, with the increased funding that the company has successfully completed, is it possible to speed up the FDA submission?
Kristen, I'll be happy to take that. This is David. Unfortunately, the more money does not make a difference in terms of, one, completing the product and, more importantly, getting the -- navigating the regulatory pathway. There are certain response times associated with interaction with the FDA.I can say that to date, the FDA has been very responsive and supportive of our drive to move forward with advanced technology. But there are certain processes that cannot be circumvented even by capital or more personnel. So what we've put forth in our milestone plan are what we believe to be realistic projections based on the known regulatory pathway ahead.
Great. Another question. Is the increased loss due to R&D expected? And when do you think you will need to raise additional funds?
Monique, would you like to take that one?
Yes, David, thank you. I'd love to. And thank you for the question from our webcast readers or listeners. So as we mentioned earlier on the call, we expect our current cash to last through the end of 2022. Our reserves, we're in great shape. Our reserves will allow us to finalize the product development of the Enos system that David was just speaking about. And upon FDA approval of our application for the IDE, we anticipate that we will be able to commence and complete our IDE human clinical studies in 2022 as well.Meanwhile, we have anticipated license payments from Medtronic that will add to our funding. And pursuant to our development and license agreement, as David mentioned, we expect to earn $10 million in the coming weeks as well as an additional $11 million later this year.Also, as recent warrant exercises have continued to strengthen our balance sheet, there also remains additional warrants outstanding that could be exercised at values of around $2 and $3, which will also increase our runway. So although we acknowledge that additional financing will eventually be required to carry us through commercialization, we're in good shape today, and there is no urgency for us to go back to market.
Great. Next question. Is there a plan to increase insider ownership?
I'll be happy to take that, Kristen. This is David again. And with respect to share ownership, our new independent Board believes that equity ownership is important for directors, management and, frankly, for all employees. Since meeting for the first time in October of last year, the Board has begun developing and implementing policies and mechanisms to increase insider ownership. And it's something that the Board and management remain committed to.
Excellent. Another question. If Medtronic does not wish to pursue a long-term partnership with Titan Medical once the Medtronic milestones are completed, would Titan Medical be able to license the IP that Medtronic used in the Medtronic milestones to other companies who may be interested in that IP?
Again, this is David. Great, great question. And it's important, too, for me to make the point that Titan Medical's future we see to be based on our Enos system. We retain a nonexclusive perpetual royalty worldwide license to all intellectual property developed under the Medtronic development and license agreement. But it's important to know also that -- and remember that we retain all rights to the greater portion of our IP portfolio that we continue to develop independently.We're free to develop strategic relationships globally, including M&A without intervention from Medtronic. I say that with all due respect to Medtronic, who we value as a development and strategic partner. We hold them in very high regard. But at the same time, when it comes to Titan Medical, our future is open to many possibilities.
Next question. Even with all the progress that is being made, the share price continues to slide downward. Is there anything the company can do to raise it?
Well, this is a fundamental question. David again here, Kristen, and thanks to our audience here. With respect to valuation, we view execution to our milestones to be paramount, including those related to our Enos robotic single access surgical system as well as those related to the Medtronic development and license agreements. At the same time, we remain committed to investor outreach, having hired Kristen as our Vice President of Investor Relations and Corporate Communications.Evidence of our outreach also includes new analyst coverage by Suraj Kalia of Oppenheimer and David Martin of Bloom Burton. And the things that we're doing tactically in terms of ramping up our activity on the website with an enhanced Investor Relations page. And additional vignettes, as Perry referred to, on Titan Living Labs. All of this is part of a coordinated effort for us to continue to get the word out as we announce our milestones.
Another question. Having had an opportunity to peruse through the updated website, it seems the Enos system is in the completion stage. Is this the reason for the change of Board members, bringing in those with M&A and valuation experience?
The -- David, here again. There's an even bigger picture here when we look at our Board. So our new Board members complement our increasingly independent and diverse Board. When we look to the future, we, as a Board, have looked to the skill sets with which we'd like to augment our Board. So the investor inquiry is on to something here.When we think about Heather Knight, who brings us commercialization experience that is particularly relevant to our planned commercial launch following FDA clearance. Also, on the management information circular, we've nominated Cathy Steiner, who brings a depth of investment banking, M&A, capital markets and finance experience that will help us to navigate the opportunities that lie ahead as we execute on our strategy and also manage financially at the Board level. So we're very excited to bring both of them on to our Board. And I can say that they are strategic as we look ahead to the company's needs.
Great. What is the projected completion date? And when will Titan satisfy the outstanding $1.5 million from Medtronic since there are sufficient funds to pay off the debt now?
I'll turn that one over to Monique.
Yes. Thank you, Kristen. And dual part question. The first part of your question was? Kristen?
The projected completion date and when will Titan satisfy the outstanding loan?
So I'm going to assume that our listener was asking about the completion of the Medtronic milestones on the Medtronic project as they're referring to the loan that's associated with the Medtronic project.And our Medtronic project is ongoing through to the end of this year. It should complete before the end of the year. We have 2 milestones left as we mentioned, milestone 3, we expect to complete this month and report on. And the fourth milestone we expect to complete closer to the end of the year.And associated with the loan and when do we expect to pay it and why do we not pay it back now. It is a loan that our commitment to Medtronic was to repay this loan at the end and the completion of milestone 4 under our development and license agreement. And so we continue to hold the loan just until that time.
Great. Next question. Do you plan to manufacture and commercialize the e-mail systems yourself?
I'll be happy to take that, Kristen. This is David again. And indeed, we intend to go to market ourselves, managing outcomes with respect to our Enos single access system as being the top priority. That is ensuring that with early commercial uptake that we're seeing an increasing number of cases being performed at each of the early install sites with excellent patient outcomes. That's our priority.So our current plan is for us to launch in a very measured way and to control that with our own internal team and internal resources who have been with us on this journey, augmented by clinical expertise and, of course, at the appropriate time more sales resources.
Thank you. With the growth of the facilities in North Carolina, is it possible that you would consider closing the Toronto office?
We are committed to being a Canadian company. Our roots are Canadian. We have a very strong Canadian shareholder base. We have demonstrated earlier this year that there have been great benefits in terms of being able to raise capital on both sides of the border. So our plans are to remain a Canadian entity to enjoy the advantages and the pride that we have in that. And at the same time, to ramp up our commercial and, of course, development team here in Chapel Hill, where in spite of COVID-19, that team has grown and thrived and executed on the milestones.So we believe that we're living the best of both worlds, and we remain committed to move forward as a -- I'll look at it as a global company with headquarters in Toronto and our primary development facility here in the United States in Chapel Hill.
Okay. Thank you. I believe that's the last question. So I'll turn it back to David for closing.
Thank you, Kristen. So in closing, I'd like to thank all of our listeners again for joining us on the call this evening and for your support of Titan Medical.We continue to push forward and plan to bring our robotic single access surgical system to the market for the benefit of patients and surgeons. We're proud of our accomplishments to date and recognize that it is a direct result of the commitment and hard work of our employees, the leadership of our Board of Directors and the support of our shareholders.We're very excited about the future ahead and look forward to keeping you informed of our progress. Thank you again, and have a great evening.
And this concludes today's conference, and you may disconnect your lines at this time. Thank you for your participation.