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Condensed Consolidated Statements of Cash Flows - USD ($)
9 Months Ended
Sep. 30, 2021
Sep. 30, 2020
Operating activities    
Net loss $ (11,953,881) $ (16,580,237)
Adjustments to reconcile net loss to net cash used in operating activities:    
Depreciation and amortization 568,380 1,039,989
Accretion of discount on NuvoGen obligation (9,206) (9,771)
Provision for excess inventory 60,143 5,649
Amortization of QNAH Convertible Note issuance costs   6,505
Amortization of MidCap Credit Facility discount and issuance costs   101,482
Amortization of SVB Term Loan discount and issuance costs 351,068 121,168
Stock-based compensation expense 1,000,368 1,163,742
Employee stock purchase plan expense 41,950 15,972
Non-cash operating lease expense 359,014 465,504
Accrued interest on available-for-sale securities investments (18,394) (101,996)
Stock compensation expense in connection with LP Purchase Agreement   205,538
Gain on forgiveness of PPP Loan (1,735,792)  
Loss on extinguishment of Midcap Credit Facility and QNAH Convertible Note   522,394
Loss on abandonment and disposal of assets, net 178,925 77,498
Changes in operating assets and liabilities:    
Accounts receivable (597,489) 1,793,975
Inventory (892,655) (255,718)
Prepaid expenses and other (300,469) 457,504
Deferred offering costs   140,320
Accounts payable (50,230) (778,706)
Accrued liabilities 205,015 (474,521)
Contract liabilities 53,062 (74,700)
Operating lease liabilities (378,355) (583,828)
Net cash used in operating activities (13,118,546) (12,742,237)
Investing activities    
Purchase of property and equipment (590,736) (418,712)
Maturities of available-for-sale securities 9,000,000 25,450,000
Purchase of available-for-sale securities (17,871,203) (11,565,882)
Net cash (used in) provided by investing activities (9,461,939) 13,465,406
Financing activities    
Proceeds from issuance of SVB Term Loan   10,000,000
Payment of SVB Term Loan issuance costs   (115,193)
Proceeds from ATM Offering, net of commissions of $0.3 million 10,665,819 6,387,982
Proceeds from LP Purchase Agreement 599,979  
Proceeds from PPP Loan   1,717,000
Proceeds from Series A convertible preferred stock in private placement   562,955
Payments on NuvoGen obligation (379,431) (539,323)
Proceeds from exercise of pre-funded warrants   31,768
Proceeds from shares purchased under stock purchase plans 53,437 25,133
Payments on financing leases (18,040) (32,553)
Proceeds from exercise of stock options 326  
Taxes paid for net share settlement of restricted stock awards (2,571) (12,824)
Payments on 2021 and 2020 Insurance Notes (494,352) (324,301)
Net cash provided by financing activities 10,425,167 7,262,021
Effect of exchange rates on cash (12,848) 9,283
Increase (decrease) in cash, cash equivalents and restricted cash (12,168,166) 7,994,473
Cash, cash equivalents and restricted cash at beginning of period 22,397,812 10,889,995
Cash, cash equivalents and restricted cash at end of period 10,229,646 18,884,468
Supplemental disclosure of noncash investing and financing activities    
Issuance of Series A convertible preferred stock in exchange for outstanding common stock   2,424,900
Issuance of common stock upon conversion of Series A convertible preferred stock   1,622,500
Issuance of common stock from cashless exercise of pre-funded warrants 145  
Operating lease right-of-use assets obtained in exchange for operating lease liabilities 1,302,457 21,078
Carrying value of demonstration units transferred from property and equipment to inventory 16,128 18,817
2021 and 2020 Insurance Notes issued for insurance premiums 746,360 735,195
Gain on forgiveness of PPP Loan 1,735,792  
Supplemental cash flow information    
Cash paid for interest 450,344 719,676
Cash paid for taxes $ 12,665 9,961
QNAH Convertible Note    
Financing activities    
Payments for extinguishment of debt   (3,000,000)
MidCap Credit Facility    
Financing activities    
Payments for extinguishment of debt   $ (7,438,623)