This is my today´s mail to Paul Cataford. It may give some ideas for others to contact Titan:

Dear Mr. Cataford,

My family has invested into Titan medical since 2015. For the time being we own 400 Thousand shares.

With reference to your Investor presentation dated January 4th 2022, I kindly ask you to answer the following questions. Far too often long term investors like us experienced informations which shortly after turned out to be not correct or even false. If you and Titan´s management team are interested to win back investors trust I strongly recommend to give transparency high priority.

1. What exactly means "Complete development of the Enos system"? Repeatedly Titan has deceived investors by saying development is complete. I can not see why we should buy now in such an objective without knowing exactly what needs further development.

2. What exactly has been developed by: "Completed Under Medtronic
Collaboration and was achieved by milestone 4"? It can not be that one of the most important achievements and thus material information is still blinded to the owners of the company.

3. Which patents exactly have been licensed to Medtronic? Without such knowledge it simply is not possible for us imvestors being the owners of Titan, to calculate a realistic value potential of the IP portfolio.

4. What reasons make you believe That "Targeting a 15-month time-line to human clinical trials" is realistic and can be achieved?

5. Why is Titan still heading for an FDA approval first, whereas many companioes, e. g. MDT, give first priority to CE Mark approval?

Dear Mr. Cataford, I could easily add several additional questions. I strongly believe if Titans communication will not dramatically improve, Titan will fail to gain investor´s support.

Sincerely

Best regards to all Longs
Facetrain

A lot of confusion has been distibuted on ihub and twitter concerning the future prospects of Titan. Apparently from sources either lacking understanding how medical devices are developed or motivated by other reasons.
Despite Mr. Cataford stated, that the Board considered the Exchange of the CEO since a couple of months, the immediate booting out of Mr. Mac Nally smells and there may be more fire behind the smoke than reecently published.
A CEO manyfold during the year talking "everything is fine and the project has never been in better shape" and all of the sudden proclaims 2 1/2 years delay clearly has either violated his duty of supervision or simply lied. However the same duty applies to the board of directors. I assume I am not the only one who feels that fraud may be an issue here. Anyway MC Nally is out and things may improve inside Titan.

So whaT?

1. Delay: I did never understand why Titan aimed for an FDA approval first. Like many medtec companies Medtronic went the CE Route for Hugo first. Despite the entry barriers for a CE mark have strongly increased by the new MDR regulation it is still by far shorter than an FDA de novo pathway. If it is true what Titan has published concerning technology progress 1 year until CE mark seems feasable from my perspective. My own company is currently in this MDR transition process. One hurdle for Titan may be the current shortage of electronic components; bur that will be solved in 2022..

2. Partners.It is a matter of self understanding that Titan has no chance to do it alone. And it is obvious that the whole surgical worls is changing towards RAS. There will be multiple companies knocking at Titans doors once they are free to negotiate. I did not understand why Titan did not intensify the fruitfull co-operation with the IHU in Strasbourg. Karl Storz is one of the IHU founders; may be due to Secrecy resrictions by MDT?

I strongly hope that Titan will be more transparent in the near future. For the time being the lack of transparency is detrimental and noxious for any investor.

Best Regards to all Longs
Facetrain

I completely share your view, BelizeMe.
Management has crossed a red line concerning share holders´protection and my impression is it is done on full purpose.
Whatever Mr Mc Nally stands for I dont know but surely not for my interests. To care for the development of the robot is a matter of self understanding in a tech company but not enough for a CEO.
Next AGM I will vote him out. Money talks.
Thanks
Facetrain

Quick and Dirty impression of these raising "surprises":

# Estimated BO 4 Billion : 100 Mil. shares prior surprises = 40$/share
# Current depot 150.000 shares X 40 $ = 6 Million
# Estimnated BO 4 Billion : 130 Mil shares post surprises = 31$/share
# Exit 150.000 X 31$ = 4,6 Million = 22,5% less

Dilution more than 15% usually requires Share holders approval. Does anyone know whether limits exist and/or how this is actually regulated with titan?
Thanks
Facetrain

Another key question is whether MDT will by TMDI or will be satisfied with a license agreement. Some years ago MDT seemed to be more reluctant; e.g. in 2013 took a license for the German Air and Space MIRO robot which was developed to operate on an pulsating heart. Hugo seems to have incorporated some of Miro´s kinematics but nothing else.

The "New MDT" speaks a completely different language. All press releases, speeches and whatever I have read since Martha took over says "Absolut worldwide leadership in Medical devices is the name of the game".

In case of a substantial semiexclusive license agreement a quick and dirty calculation could be 3% of MDT´s turnover.
2 Billion turnover = 60 million anual license income X 20 = 1,2 Billion market value TMDI. So for the time being nothing to worry.

Thanks Facetrain

Some posters question whether the FDA approval commands the timeline for a TMDI BO. There are indicators that CE Mark may have an earlier impact on what and when MDT might do in robotics.

In the conference on Januray 11th, Martha in his speech about RAS clearly stated that RAS in combination with AI has absolute priority.

CREATING & DISRUPTING BIG MARKETS HUGO™ SOFT-TISSUE ROBOTIC-ASSISTED SURGERY PLATFORM (https://investorrelations.medtronic.com/static-files/3c0a77bd-7651-41db-892a-7461733a0ee1)

Concerning the timeline his chart says:
"Embarking on global launch sequence; expect to file for CE Mark and U.S. IDE approval Q1 calendar year 2021"

66 Mustang (Post #122426) asked me whether I see a CE pathway that is substantially easier/quicker for the European market compared to the FDA. A simplified answer is: the FDA is a governmental institution whereas the CE mark regulation is based upon so called "Notified bodys". Notified bodys are privately owned companies; profit oriented and there are more than 50 of them competing in Europe. Your budget has an influence which speed and competence they may offer in a regulatory process. However most of them have absolut tight lips since secrecy violations can be very expensive.

My personal guess is 2nd Qu. 2021 things will culminate. There are rumors that Storz and Zeiss both early this year will come out with new robotics and the market is heating. Martha is not known for strolling.

Thanks Facetrain

Medtronic last week started to advertise several expert and middle management positions to build up the robotic assisted surgery allover Europe. E.g. marketing managers in Germany and other countries reporting to a senior in Norway. Financial expert/s helping to finance hospitals a.s.o.
I see an increasing probability that MDT indeed is preparing a broader market entry this year; may be in 2nd quarter as indicated by Martha.
Thanks + Good Luck to all Longs
Facetrain

Mc would not have lied if MDT would go CE mark first and TMDI FDA thereafter. MDT frequently went CE first.
What if both sides concluded that TMDI is heading the technical development and MDT the clinical affairs side. MDT has 1000s of experienced people in approval processes, whereas TMDI never did this before. In this case Mc would not have lied if MDT would pursue human trials earlier than 12 months.
P.S. My prior comment related to the S-part of the arms.
Thanks
Facetrain

It is not a rotation of the tips. The loopings affected a redirection of the arms.

I wonder how scarce posts on this board adress technical features of Titans robot and how this will impact potential success. Patents are nice to have, but you ned to have patents on features which really matter: A difference to be a difference has to make a difference.

At the end of a day advantageous USPs will decide, whether a surgeon desires the device. Transenterix shows what happens if USPs are missing: no chance to capture substantial market share; no BO interest.

One major risk in visceral surgery are adhäsions due to mechanical trauma from the instruments. A friend of mine, visceral surgeon by himself, nearly died this year due to a mechanical ileus, following deep anterior colonic resection five years ago. Many years ago I had a project in cooperation with a maior university, trying to prevent bowel adhäsions with Hyaluronic films and liquids. We were not successful; the problem still remains up to now and even gets worse the more mechanic is brought into the body during surgery.

I got attention of the SPORT snake arms 4 years ago, and immediately thought this could be a solution for the risks caused by trauma from rigid instruments. In my mental cinema I saw the snake arms elegantly gliding over the bowels and reaching out to every abdominal quadrant with only one incision. So I decided to invest. Consequently I was not surprised when Titan anounced that they planned to start with endometriosis where you have to look into even the most hidden corners of the abdomen.

Last year a contact to the IHU in Strasbourg destroyed my mental cinema, due to unpublished experience with the first generation of Sport. The snake arms in total rotated when the head changed direction and this required very much getting used to maneuvers. One can imagine this effect as half of a stable ring is tilt from one side to the other, a kind of "looping" which make movements in narrow cavities difficult. Snakes can turn off this looping due to nervous contral of each body segment. Frankly speaking the contact told me as long as this would not be solved he would not buy.

In the video on the Titan homepage shown during the AGM there are some short moments showing the arms at the trial board in rotating maneuvers. One may get the impression that the looping is over or at least less pronounced; but the film is immediately cut every time this could be verified. If Titan has solved this problem it would be a very important step forward. If not it would be an explanation for no new timeline up to now.

Concerning the MDT event today I do not expect comments supporting the pps of TMDI. It would be contrary to MDTs interest to buy in as cheap as possible.


Thanks Facetrain

As Martha stated yesterday. Go big or go home!
At the end of the day it will be a strategic decision and a strategic prize they are willing to pay.

However do not believe that until that day the MDT financial guys forget their duties: Buy cheap is the name of the game!

Titan is a very very special case: Our current prize mirrors the ugly past, secrecy plays and very tricky short activities. That can change from one second to the other. I totally agree with Roll: a spring situation.

Thanks Facetrain

Good afternoon Honeycomb777,
Answer the Question "Cui bono"
and you will find the answer why we sit at 0,75 $.
The secrecy part of the contract (s) between MDT and TMDI has one simple reason: allow the Buyer time as long as possible to scoop cheapies. Until Mazor was taken over MDT already had assembled 1/4 of the shares. I wonder how many they will have once the TMDI deal is anounced.
What really made me furious is the Raising strategy by Titan in the past. Small small; like a cook book how to sink a share prize. Christmas Time for shorts. Cui Bono?
Thanks
Facetrain

Hi 66Mustang!
I am from Germany. I am in the medical device industrie since 35 years, 15 thereof in international concerns, 20 in my own medical company, which is certified by ISO 13485:2016. I did 4 BO during my concern time; not billions only millions but the scheme is the same.

I have some experience how to value patents, did 18 by myself. One took immedistely 40% marketshare from 3M, a group of 4 others 30% from Ethicon.

One tiny little patent by Coloplast about round corners (!) of hydrogel dressings locked my divison out for nearly 8 years from a fast growing market.

Translated into Titan`s value: It doesn`t really matter what date Sport is launched. The patent basket is worth minimum 1,5 -2,0 Billion $ by its own. A ready to market Sport product ? May be additional 3 to 4 billion ?

Matter of self understanding; my personel opinion.
Thanks
Facetrain

Do we have tools to stop the shorts?
The question was raised sometime ago whether we are capabel to fight the shorts back. If it is correct, that around 400 share holders actively watch this board, and the average share hold would be 10.000, we would control 4 Million shares, which may be 5% of the total.
However, since many here owe more shares, I myself more than 100.000, we may control 10%, 15% or even more. This could be a maiority of the freefloat.
If everybody of us stops selling any share and prohibits his broker from lending our shares to shorts, the source for shorts could dry out rather soon. Anyway my impression is that since a couple of days the shorts are trading from left to right pocket.
Any comments and opinions are wellcome.
Thanks
Facetrain

For those who are not familiar with BO calculations here schematicaly summarized.
1. Prospects of a Premarket Company are estimated regarding potential market share gain
2. Profitability is calculated on earnings before tax and depreciation
3. BO prize is calculated based on 1 + 2 and discounted (X%) and potentially leveraged due to strategic reasons.

Due to figures presented at the SRS by Goldman Sachs Global Investment research the Us Medical Robotics Market has been In 2019 and will grow to in 2025/2030 in Billion §:
# Soft Tissue Robotic Revenue 3,5/8,1/12,2
# Hard Tissue Robotic Revenue 0,3/ 1,1/1,7
# Flexibel Endoluminal Robotic Revenue 0,0/0,9/2,8

If Martha aims for minimum 25% marketshare cumulative revenue soft tissue for the years 2022 to 2028 would be about 15 Billion.
One can estimate that the rest of the world may contribute half the amount in total so we talk about 22 to 25 Billion for soft Tissue.
Lets assume profitability is minimum 30 % we came up with earnings 6 to 7 Billions. In this case I would guess strategic reasons equalize discounting. MDT payed 1,5 Billion for a 0,3 billion market. J&J payed 3,6 Billion for a non existing market.
I wonder what MDT will pay for the biggest market.
Thanks
Facetrain

For those who are not familiar with the CE Route.
Titan in 2019 has implemented a Quality system according to ISO 13485.
28 Countries i.e. EU, Canada, Japan und Australia have recognized ISO 13485 however the USA still requests the FDA Quality System Regulation (QSR). ISO 13485 and (QSR) differ in many important aspects.

Due to the encouriging statements by Martha today it is very unlikely that MDT will not utilize the CE route first. If the validation of the Sport Hard- and Software is finalized in 2020, market entry in Europe is feasible in Europe second quarter 2021. However more likely in India since MDT currently is creating its second largest R+D Center worldwide in India.

This szenario is in particular more likely since the new Medical device regulation (MDR), coming up with by far tighter preconditions, was postponed until May 2021. For the time being every device maker is hurrying to match this timeline.
Thanks
Facetrain

Some posters ask for an FDA Timeline as if this would decide on live or die for Sport.
Sport first generation has been tested at the IHU in Strasbourg, the most important teaching hospital in Europe for robot assisted surgery. Tests have been published elsewere. I talked with one of the surgeons November last year waiting for a new generation of sport and testing slots already had been reserved at the IHU.
From my perspective it will be much easier to start with a CE application and aproval in Europe, which is accepted in India as well, than to come up with an FDA intermingle. This strategy was used lately by MDT for the new Interstim generation and other innovative devices.
Thanks
Facetrain

Its so easy and I wonder whether many people do not understand the reasons why Titans share prize is so low. 2000 Years ago the first question by romans in confusing situations was "Cui bono?" Who makes profit from a specfic situation?

1. I estimate that MDT already owns 1/3 of Titan directly or indirectly, scooped at unbelievably cheap prizes. From my perspective MDT already saved 0,5 Billion Buyout money minimum. Megane Rosenblatt stated last Friday at SRS that MDT and TMDI are in discussions since years. What means dicussions?
Covidien was taken over for 43 Billions 6 Years ago. Now they are in serious danger to loose their homemarket in traditional open and in minimal invasive surgery. The markets are rapidly transferring towards robots and it seems that they have nothing ready in the pipeline. The whole senior management would loose their jobs and heads if not getting prepared to buy into available technology.

2. TMDI Management as well absolutely could not have had real interest in higher share prizes. 9 Million options for 0.88 $ each vs. about 3.5 $ before is a difference of 24 Million less investment = more profit. Serious money for employees of a tiny little company.

I guess things have changed now that the dramatic problems of J&J and MDT have become so obvious. Here in Europe both companies Ethicon and Covidien are cutting down jobs since staplers are facing heavy competition by chinese clones. And both are loosing profit rapidly.
House is burning! Hurry up.

So; Cui bono?

Thanks
Facetrain

Some posts have reflected negatively and disappointed on the SRS presentations by MDT and TMDI. However they put attention to a Saturday session which had only limited importance and 9 minute quickies.
By far more important and informative has been the Friday session for investors. Gary Guthart, CEO Intuitive, had a 45 minutes slide presentation in which he explained in details, why he believes in the future role of single port: opening the market by expending the indications, being cheaper and lessfootprint.

Later on, in a separate 45 minute dicussion betweeh him and vipul patel, one of the leading roboter surgeons he disagreed with Vipul. Vipul showed a split film radical prostatectomy, left side multiport , right side single port and complained about single port being more complicated and takink more time. Gary clearly stated, multiport as being fifth generation and single port, being first generation, are in different technique adoption cycles but Single port will be essential for the future.

In another 45 minutes discussion Megane Rosenblatt was asked several times by the moderator abour the relationship between MDT and TMDI and once her tight lips slipped while answering that MDT and TMDT have been in dicussions since several years.

My conclusion from these 3 sessions is:
1. Those posters, saying single port is not necessary to compete are totaly wrong. Single port is abolutetly essential for the next phase of market development.
2. MDT has nothing promising in the pipeline but plans
3. MDT and J&J are in enourmos danger to loose their homemarkets in surgery
4. TMDI will be one of the most important buy out cabndidates isa fast changing market
THanks
Facetrain