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

ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the fiscal year ended December 31, 2016

2022

Or

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

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 001-14053


Milestone Scientific Inc.

(Exact name of registrant as specified in its charter)


Delaware

13-3545623

State or other jurisdiction of Incorporation or organization

(I.R.S. Employer Identification No.)

 

220 South Orange425 Eagle Rock Avenue, Livingston,Roseland, NJ 0703907068

(Address of principal executive offices)

Registrant’ss telephone number, including area code: 973-535-2717

Securities registered pursuant to Section12(b) of the Act:

 

Title of each class

Symbol

Name of each exchange on which registered

Common Stock, par value $.001 per share

MLSS

NYSE MKTAmerican

 

Securities registered pursuant to section 12(g) of the Act:                    NONENONE.


Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.    ☐ Yes    ☑ No

Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act.    ☐ Yes    ☑ No

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    ☐ No

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate website, if any, every Interactive Data File required to be submitted and posted 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 and post such files).    ☐ Yes   ☑ Yes    ☐  No

Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K (§ 229.405 of this chapter) is not contained herein and will not be contained, to the best of registrant’s knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment of this Form 10-K.    ☑

Indicate by check mark whether the registrant is a large, accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company, or an emerging growth company. See the definitions of “large, accelerated filer,” “accelerated filer”filer,” “smaller reporting company” and “smaller reporting“emerging growth company” in Rule 12b-2 of the Exchange Act.

Large, accelerated filer

Accelerated filer

    

Non-accelerated filer

  (Do not check if a smaller reporting company)

Smaller reporting company

Emerging Growth Company

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.    ☐

If securities are registered pursuant to Section 12(b) of the Act, indicate by check mark whether the financial statements of the registrant included in the filing reflect the correction of an error to previously issued financial statements.   ☐

Indicate by check mark whether any of those error corrections are restatements that required a recovery analysis of incentive-based compensation received by any of the registrant’s executive officers during the relevant recovery period pursuant to §240.10D-1(b).   ☐

Indicate by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness of its internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued its audit report. ☐.

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act).    Yes ☐   No ☑

 

As of June 30, 2016,2022, the last business day of the registrant'sregistrants most recently completed second fiscal quarter, the aggregate market value of the common stock held by non- affiliates of the issuer was $42,784,395.$43,102,239 This amount is based on the closing price of $2.80$0.92 per share of the registrant's common stock as of such date, as reported on the NYSE MKT.

American. As of March 31, 201730, 2023, the registrant has a total of 30,679,35369,998,525 shares of Common Stock, $0.001Stock, par value $0.001 per share outstanding.

 

DOCUMENTS INCORPORATED BY REFERENCE

None


 

 

MILESTONE SCIENTIFIC INC.

Form 10-K Annual Report

TABLE OF CONTENTS

 

PART I

  

Item 1.

Description of Business

4

Item 1A.

Risk Factors

1511

Item 1B.

Unresolved Staff Comments

21

Item 2.

Description of Property

2122

Item 3.

Legal Proceedings

2122

Item 4.

Mine Safety Disclosure

2122

PART II

  

Item 5.

Market for Common Equity, Related Stockholder Matters and Small Business Issuer Purchases of Equity Securities

2223

Item 6.

Selected Financial Data

2223

Item 7.

Management's Discussion and Analysis or Plan of Operations

2324

Item 7A.

Quantitative and Qualitative Disclosure about Market Risk

30

29

Item 8.

Financial Statements

30

29

Item 9.

Changes in and Disagreements with Accountants on Accounting and Financial Disclosure

3029

Item 9A.

Controls and Procedures

30

Item 9B.

Other Information

3130

Item 9C.

Disclosure regarding Foreign Jurisdiction that Prevent inspections

30

PART III

  

Item 10.

Directors, Executive Officers, Promoters and Control Persons and Corporate Governance; Compliance with Section 16 (a) of the Exchange Act

32

31

Item 11.

Executive Compensation

35

31

Item 12.

Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters

38

31

Item 13.

Certain Relationships and Related Transactions, and Director Independence

40

31

Item 14.

Principal Accounting Fees and Services

40

31

PART IV

  

Item 15.

Exhibits and Financial Statement Schedules

4132

SIGNATURES

4334

EXHIBITS

 

 


FORWARD-LOOKING STATEMENTS

 

Certain statements made in this Annual Report on Form 10-K are “forward-looking statements”forward-looking statements (within the meaning of the Private Securities Litigation Reform Act of 1995) regarding the plans and objectives of management for future operations. Such statements involve known and unknown risks, uncertainties and other factors that may cause actual results, performance, or achievements of Milestone Scientific Inc. (“(Milestone Scientific”Scientific) to be materially different from any future results, performance, or achievements expressed or implied by such forward-looking statements. The forward-looking statements included herein are based on current expectations that involve numerous risks and uncertainties. Milestone Scientific’ss plans and objectives are based, in part, on assumptions involving the continued expansion of its business. Assumptions relating to the foregoing involve judgments with respect to, among other things, future economic, competitive and market conditions and future business decisions, all of which are difficult or impossible to predict accurately and many of which are beyond the control of Milestone Scientific. Although Milestone Scientific believes that its assumptions underlying the forward-looking statements are reasonable, any of the assumptions could prove inaccurate. In light ofConsidering the significant uncertainties inherent in the forward-looking statements included herein, particularly in view of Milestone Scientific’sour history of operating losses that are expected to continue, requiring additional funding which we may be unable to raise capital when needed (which may force us to delay, curtail or eliminate commercialization efforts of our CompuFlo Epidural Computer Controlled Anesthesia System), the early stage operations of and relatively lack of acceptance of our medical products, relying exclusively on two third parties to manufacture our products, changes to our distribution arrangements exposes us to risks of interruption of marketing efforts and building new marketing channels, changes in our informal manufacturing arrangements made by the manufacturer of our products and disruptions at the manufacturing facility of our manufacturers, including shortages of or delays in obtaining chips and other components, exposes us to risks that may harm our business, raising additional funds by issuing securities or through licensing or lending arrangements may cause dilution to our existing stockholders, restrict our operations or require us to relinquish proprietary rights, if physicians do not accept nor use our CompuFlo Epidural Computer Controlled Anesthesia System, our ability to generate revenue from sales will be materially impaired, exposure to the risks inherent in international sales and operations, including China, and developments by competitors may render our products or technologies obsolete or non-competitive, the inclusion of such information should not be regarded as a representation by Milestone Scientific or any other person that the objectives and plans of Milestone Scientific will be achieved. Milestone Scientific undertakes no obligation to revise or update publicly any forward-looking statements for any reason.

Milestone Scientific is the owner of the following registered U.S. trademarks: CompuDent®; CompuMed®; CompuFlo®; DPS Dynamic Pressure Sensing Technology®; Milestone Scientific ®; the Milestone logo ®; SafetyWand®; STA Single Tooth Anesthesia System®; and The Wand ®.

 


PART

PART I

Item 1. Description of Business

 

All references in this report to Milestone“Milestone Scientific,” “us,” “our,” “we,” the “Company” or “Milestone” refer to Milestone Scientific Inc., and its consolidated subsidiaries, Wand Dental, Milestone Advanced Cosmetic andInc., Milestone Medical, Inc. (all described below) and affiliate, Milestone Education (described below), unless the context otherwise indicates. Milestone Scientific is the owner of the following registered U.S. trademarks: CCompuDent®ompuDent®; CompuMed®CompuMed®; CompuFlo®CompuFlo®; DPS Dynamic Pressure Sensing Technology®technology®; Milestone Scientific ®; ®;CathCheck®; the Milestone logo ®; SafetyWand®®; SafetyWand®; STA Single Tooth Anesthesia System®System®; and The Wand ®.®.

Item1. Business

Overview

 

Milestone Scientific was incorporated in the State of Delaware in August 1989. Milestone Scientific has developed a proprietary, revolutionary, computer-controlled anesthetic delivery instrument, throughdevice, our DPS Dynamic Pressure Sensing Technology® System, to meet the useneeds of various subcutaneous drug delivery injections and fluid aspiration – enabling healthcare practitioners to achieve multiple unique benefits that cannot currently be accomplished with the 160-year-old manual syringe. The device, using The Wand®, a single use disposable handpiece. The instrumenthandpiece, is marketed in dentistry under the trademark CompuDent®CompuDent®, and STA Single Tooth Anesthesia System®System® and in medicine under the trademark CompuMed®. CompuDent® is suitable for all dental procedures that require local anesthetic. CompuMed® is suitable for many medical procedures regularly performed in Plastic Surgery, Hair Restoration Surgery, Podiatry, Colorectal Surgery, Dermatology, Orthopedics and a number of other disciplines. The dental instrumentsdevices are sold in the United States, Canada and in over 47 countries abroad. To date there have been no medical instruments sold38 other countries. Milestone Scientific also has 510(k) marketing clearance from the U.S. Food and Drug Administration (FDA) on the CompuFlo® Epidural Computer Controlled Anesthesia System in the United States and limited amounts sold internationally, althoughlumbar spine region. In addition, certain medical instrumentsdevices have obtained CE mark approval and now can be marketed and sold in most European countries.   Milestone Scientific's products are manufactured by a third-party contract manufacturer.

 

In May 2014, Milestone Scientific completed a private placement (the “May 2014 Financing”), which raised aggregate gross proceeds $10 million, from the sale of $3 million of our common stock, $.001 par value per share (“common stock”) (two million shares at $1.50 per share) and $7 million of our Series A Convertible Preferred Stock (“preferred stock”) (7,000 shares at $1,000 per share), convertible into common stock at $2.37 per share (as adjusted to date) on May 14, 2019, or $1.50 per share if certain conditions are not met; both subject to anti-dilution adjustment.

In July 2014, Milestone Scientific acquired all of the outstanding shares of an inactive Florida corporation and changed its name to Wand Dental, Inc. ("Wand Dental"). In September 2014, that corporation was merged into a Delaware corporation, retaining the same name and capitalization. On July 1, 2014, Wand Dental was capitalized with cash and the contribution by Milestone Scientific of its dental business and related dental assets including the exclusive license of Milestone Scientific's patents, trademarks, and technology for use in the dental marketplace.

On June 1, 2015, our common stock was listed on the NYSE MKT LLC (“NYSE MKT”) under the ticker symbol “MLSS”.

In June 2016, we raised an additional $2.0 million of gross proceeds in a private placement of one million shares of common stock, at a price of $2.00 per share, to the same investors that participated in the May 2014 financing.

In the second quarter of 2016, Milestone Scientific initiated a share exchange program pursuant to which we exchanged one share of common stock for every two outstanding shares of Milestone Medical (described below) common stock, a previously consolidated variable interest entity. As a result of the exchange program, at December 31, 2016, Milestone Scientific owned approximately 91% of Milestone Medical.


In July 2016, Milestone Scientific raised gross proceeds of $250,000 in a registered direct offering of 104,200 shares of common stock at $2.40 per share. The transaction was covered by the prospectus supplement, filed with the United States Securities and Exchange Commission ("SEC") on July 22, 2016, to our shelf registration statement on Form S-3 (SEC File No.: 333-209466).

In July 2016, Milestone Scientific filed for 510(k) marketing clearance with the United States Food and Drug Administration ("FDA") Milestone Medical's epidural anesthetic injections instrument. This clearance is necessary to begin commercialization of these medical instruments in the United States.

In December 2016, we received notification from the FDA that based upon the 510(k) application submitted for the Company's Compu-Flo Intra Articular Computer Controlled Injection System, out did not adequately document that the device met the equivalency standard required for 510(k) clearance. Following consultation with the FDA Office of Device Evaluation, we intend to provide additional data, which could include a new Human Factor Validation study (HFV Study) in support of a new 510(k) application for the device. An HFV Study demonstrates the ease of use of a product. The cost to generate this incremental data is estimated to be approximately $100,000.

In December 2016, we completed an underwritten public offering of 2,000,000 shares of common stock and warrants to purchase up to 1,592,775 shares of common stock, including 92,775 additional warrants pursuant to a partial exercise of the over-allotment option granted to the underwriters. The public offering price for each share and related warrant was $1.50. The warrants have a three-year term and an exercise price of $2.55 per share. In January 2017, the underwriter exercised a portion of its over-allotment option to purchase an additional 123,700 shares of common stock at the public offering price of $1.499 per share. The gross proceeds from this offering, including proceeds from partial exercises of the over-allotment option, were approximately $3,200,000, before deducting underwriting discounts and commissions and other offering expenses. This offering was covered by the prospectus supplement, filed with the SEC on December 16, 2016, to our shelf registration statement on Form S-3 (SEC File No.: 333-209466).

          As of December 31, 2016, Milestone Scientific's financial statements are consolidated to include the accounts of its wholly-owned and majority-owned subsidiaries including, Wand Dental, Milestone Advanced Cosmetic Systems, Inc., ("Milestone Advance Cosmetic"), and Milestone Medical Inc. ("Milestone Medical"). Milestone Education LLC ("Milestone Education") is a variable interest entity of which Milestone Scientific is the primary beneficiarya biomedical technology research and is consolidated into Milestone Scientific's financial statements as of January 1, 2016.     

BUSINESS

Background

development company that patents, designs, develops and commercializes innovative diagnostic and therapeutic injection technologies and devices for medical, and dental Since itsour inception, Milestone Scientific haswe have engaged in pioneering proprietary, innovative, computer-controlled injection technologies, and solutions for the medical and dental markets. Milestone Scientific hasWe believe our technologies are proven and well established. Our common stock was initially listed on the NYSE American on June 1, 2015 and trades under the symbol “MLSS”. The Company is focused on building its resourcesintellectual; property portfolio across numerous indications.

The recent receipt of chronology-Specific CPT Code for the Company's technology by the American Medical Association marks an important milestone, that could increase the potential number of anesthesia pain management clinics adopting the CompuFlo instrument. A CPT code expands the potential for reimbursement of epidural procedures in pain management utilizing the CompuFlo Epidural System., which should help accelerate the commercial roll-out of CompuFlo in the U.S.

DPS Dynamic Pressure Sensing Technology; Our Proprietary Core Technology Platform

Given our experience and established brand awareness within the dental industry beginning with our first commercial product, the first computer-controlled local anesthesia delivery (C-CLAD) system marketed as the Wand® and re-branded as the CompuDent® System, now the market leader in dental injection technology, we elected to focus our product development efforts on redefiningimproving the worldwide standard of care for injection techniques bypatient experience and making the experiencedevice more comfortableversatile and precise for the patient and by reducing the anxiety and stress of administering injections for the healthcare provider.practitioner.

 

Milestone Scientific and its technology are widely recognized by key opinion leaders, industry experts and medical and dental practitioners as the noted leader in the emerging, high growth, computer-controlled injection industry; and remains intent on expanding the use and application of its proprietary, patented technologies to achieve greater operational efficiencies, enhanced patient safety and therapeutic adherence, and improved quality of care within a broad range of medical disciplines.

In 1997, Milestone Scientific first introduced The Wand® (CompuDent® instrument) and the disposable Wand® handpiece. CompuDent® provides painless injections for all routine dental treatments, including implants, root canals, crowns, fillings and cleanings. Milestone Scientific's Computer-Controlled Local Anesthetic Delivery (C-CLAD) instrument handpiece does not look or feel like a syringe.


Milestone Scientific expanded its product offerings with the introduction of its CompuMed® advanced injection instrument, designed for use in a wide range of applications within the medical industry, including cosmetic surgery, hair restoration surgery, podiatry, colorectal surgery, nasal and sinus surgery, dermatology and orthopedics, among others.

In 2007, Milestone Scientific received FDA 510(k) clearance for the marketing and sale of its STA Single Tooth Anesthesia System® instruments (dental instrument). Milestone Scientific introduced the instrument to the market in February 2007 and this instrument is currently being marketed throughout the world.

Central to Milestone Scientific’sOur next significant intellectual property platform and current productadvancement was a improvement over our CompuDent® System – the development strategy is its patented CompuFlo® technology for the precise delivery of medicaments. The CompuFlo® pressure/forceour proprietary CompuFlo® Computer-Controlled Local AnestheticDrug Delivery (C-CLAD) technology isSystem with DPS Dynamic Pressure Sensing Technology, an advanced patented and FDA-approved medical technology for the painless and accurate delivery of drugs, anesthetics, and other medicaments into all tissue types, as well as for the aspiration of bodily fluids or previously injected substances. Its regulation and control of the flow rate continues to provide the CompuDent®painless delivery benefits, of painless injections, while its DPS Dynamic Pressure Sensing Technology®innovative dynamic pressure sensing capability provides visual and audible in-tissue pressure feedback, identifying tissue types to the healthcare provider. This pressure feedback extends the benefit of painlessness from anesthetics with known viscosities to a wide range of liquid drugs and other medicaments with varying viscosities and flow rates. The Such pressure feedback, part of our DPS Dynamic Pressure Sensing Technology,® also allows the healthcare provider to know when certain types of tissues have been penetrated and permits the healthcare provider to inject medicaments precisely at the desired location. Thus, real-time continuous pressure feedback can prevent the suffusion ofinjection to tissue outside the intended target area, a vitallyan important characteristic in the injection of chemotherapeutics and other toxic substances.

The CompuFlo® technology consists of two critical elements. One element isIn addition to the ability to determine exit pressure In Situin-situ (in the injection site tissue) at the tip of the needle. This minimizesneedle, minimizing tissue damage (and eliminateseliminating the pain of the injection) because the flow rate and pressure of the injection are controlled. The other critical element of the technology is an integrated injection database of algorithms that have been definedprecisely controlled, CompuFlo® computer-controlled Drug Delivery Systems features a proprietary algorithm, which allow for the measurement of the exit pressure. This database ofThese algorithms containscontain the critical components of specific drugs, parameters of needles, tubing and syringes and all other pertinent components for the safe and efficacious delivery of medications for all procedures.CompuFlo®technology also enables devices to provide a digital record of the time and volume of anesthetic or medicament injected.

 

The CompuFlo® technologyEach Wand/STA System also consists ofincludes a disposable injection handpiece that providesis extremely comfortable, light, and easy to use, providing for precise tactile control during the injection, an electromechanicalelectro-mechanical (computer-controlled) fluid delivery instrument and the ability to record data from the injection event. The pencil grip used with the handpieces provides the practitioner with enhanced tactile sense and accurate control and allows bi-directional rotation, eliminating needle deflection, resulting in a greater accuracy and success. The handpiece is vibration-free because it does not have a motor or electrical component in it and, since the handpiece does not look like a typical syringe, we believe it also reduces patient anxiety and offers the possibility of curing dental phobia of which an estimated 40 million Americans suffer.


As confirmed by numerous noted medical and dental experts within academia and the clinical practice arenas, CompuFlo®CompuFlo Systems using DPS hasDynamic Pressure Sensing technology have the potential to greatly increase the safety and efficacy of many drug delivery procedures that currently rely upon the over 150-year-old160-year-old hypodermic syringe technology and the tactile senses and delivery expertise of the administrator.

 

On September 14, 2004, Milestone Scientific was issued United States Patent No. 6,786,885 for theDevices using CompuFlo®DPS technology, entitled “Pressure/Force Computer Controlled Drug Delivery Instrument with Exit Pressure.” Proprietary software, working with an innovative technology, allows the instrument to continuously monitor and control the exit pressure of fluid and/or medication during an injection. This same technology also enables doctors to accurately identify different tissue types based on exit pressure during an injection. The technology has numerous applications in both medicine and dentistry, including epidural and intra-articular injections.

In December 2004, the United States Patent Office issued a “Notice of Allowance” for patent protection on two additional critical elements of the CompuFlo® automated drug delivery technology: “Drug Delivery Instrument with Profiles” and “Pressure/Force Computer Controlled Drug Delivery with Automated Charging”.

In December 2005, Milestone Scientific submitted a pre-market notification to the FDA on its CompuFlo® technology, which was subsequently cleared by the FDA in July of 2006. This initial submission was critical for Milestone Scientific’s continuing efforts to develop and commercialize this important technology. Milestone Scientific has identified a number of potential applications for CompuFlo®, including single-tooth dental injections, self-administered drug delivery, osteoarthritis joint pain management and epidurals.

Given Milestone Scientific’s experience and established brand awareness within the dental industry, it elected to focus its initial product development efforts on the integration of CompuFlo® into its legacy computer-controlled dental injection instrument. As a result, Milestone Scientific developed the industry’s first solution for painlessly administering a single-tooth injectionDynamic Pressure Sensing Technology such as the only injection necessary for achieving anesthesia, foregoing the need to administer a traditional nerve branch block. This instrument, which also utilizes a disposable handpiece, was trademarked the “STA Single Tooth Anesthesia System ®”.


After receiving FDA 510(k) approval for the marketing and sale of the STA Instrument, Milestone Scientific introduced the instrument to market in February 2007 at the Chicago Dental Society’s 143rd Midwinter Meeting. The patented STA Instrument incorporates the "pressure feedback" elements of Milestone Scientific's patented CompuFlo® technology, thereby allowing dentists to administer injections accurately and painlessly into the periodontal ligament space, effectively anesthetizing a single tooth. This injection is of significant value in that it allows the dentist to profoundly anesthetize the tooth within one or two minutes, versus up to 15-18 minutes for a block injection to take effect. Utilizing the STA Instrument single tooth injection, the patient will suffer neither pain nor collateral anesthesia in the cheek, lips or tongue at any time. The STA Instrument is capable of performing all of the injections that can be done with a conventional dental syringe, including the palatal-anterior superior alveolar, anterior middle superior alveolar and inferior alveolar nerve block. The STA Instrument achieves these injections predictably and reliably.

Initial market response to the STA Instrument following its commercial debut in February 2007 proved to be less than robust. Moreover, at that time, Milestone Scientific had granted exclusive United States and Canadian distribution and marketing rights for the STA Instrument to Henry Schein, Inc. (“Henry Schein”), the largest distributor of healthcare products and services to office-based practitioners in the combined North American and European markets. Following several months of lackluster sales and after making critical senior management changes, Milestone Scientific initiated an in-depth market study to reassess its positioning and marketing strategies for the STA Instrument. The insight gained from this study led management to redefine and implement a new messaging platform, created to emphasize key benefits that Milestone Scientific discovered are of most value to dental professionals. This new product messaging was launched in January 2008 and has remained in constant review.

In the spring of 2009, Milestone Scientific signed a distribution and marketing agreement with China National Medicines Corporation, dba Sinopharm, which is China's largest domestic manufacturer, distributor and marketer of pharmaceuticals and importer of medical devices and China's largest domestic distributor of dental anesthetic carpules to the Chinese dental industry. The distribution and marketing agreement with China National Medicines was terminated in September 2014. Proximate to that time, we entered into a new distribution and marketing agreement with Milestone China Ltd. ("Milestone China") to be our distributor for the STA Instruments and handpieces in China. Milestone Scientific owns forty (40%) percent of Milestone China.

In early October 2012, the State Food and Drug Administration (“CFDA”) of the People’s Republic of China approved our STA Single Tooth Anesthesia System® Instrument. However, the CFDA’s approval of the Wand® handpieces was received in May 2014 and the distribution of these handpieces in China began in the fourth quarter of 2014.

According to a 2011 report published by the U.S. Department of Commerce, titled “China’s Emerging Markets: Opportunities in the Dental and Dental Lab Industry,” China’s dental market lags behind other healthcare services and has largely been neglected in the past. In fact, a CS Market Research report indicates that 50% of adults and 70% of children out of China’s estimated 1.3 billion plus population have tooth decay problems and over 90% have periodontal disease. (See Shuyu Sun & Seth Pierrepont. The Dental Equipment Market Over in China, CS Market Research (Sept. 20, 2005) and Opportunities Abound for Dental Care in China, CHINA BRIEFING (February 27, 2015)). However, with increasing affluence of the Chinese population, as well as increasing attention towards personal care, demand for dental services has been growing. Market research firm Freedonia agrees, noting that demand for dental products in China is expected to climb due primarily to escalating personal income levels and government programs promoting awareness of the benefits of good oral care.

Shortly before the end of the second quarter of 2009, Milestone Scientific elected to refine its international marketing strategy to gain greater access to and penetration of the international dental markets. The revised sales strategy provides for increasing hands-on oversight and support of its existing international distribution network, while also attracting new distributors throughout Europe, Asia and South America.


In November 2012, Milestone Scientific signed an exclusive distributor and marketing agreement with a well-known US domestic manufacturer and distributor, for the sale and distribution of the STA instrument and handpieces in the United States and Canada. The marketing initiative included participation in US and Canadian dental shows, as well as pediatric dental shows; an active advertising initiative targeting major dental publications; and direct mailing campaigns to over 150,000 dentists across the United States and Canada. The exclusive distributor and marketing agreement was converted to a non-exclusive agreement on December 31, 2016.

In January of 2015, Milestone Scientific added a President, a full-time CEO for Wand Dental, a Senior Business Brand Manager, and a Senior Manager of Project Management. This increase in staffing was to support the growth of our initiative in our CompuFlo® software for anticipated new medical and dental instruments.

In September 2016, Milestone Scientific added a senior Vice President of Marketing and Sales to focus on the medical sector of our business.

Beginning January 1, 2016, Milestone Scientific entered into a non-exclusive distribution agreement with Henry Schein. In June 2016, that agreement was replaced by a new agreement with Henry Schein providing for an exclusive distribution arrangement for our dental products in the United States and Canada. We believe that this exclusive arrangements will be more effective than previous arrangements relying on Wand Dental's appearances at dental shows and catalog sales.

CompuFlo® Advanced Injection Technology – Core Technology

Our next significant intellectual property was the development of our proprietary patented CompuFlo® technology for the precise delivery of anesthetics and other medicaments into various tissues and bodily cavities. The CompuFlo® technology has been FDA approved and allows the practitioner to precisely regulate and control the flow rate of the injectable material while receiving visual and audible in-tissue pressure feedback, allowing the practitioner to determine the tissue into which the injectable material is being delivered. The CompuFlo® technology encompasses the painless delivery benefits of the CompuDent® while allowing the practitioner to know which tissues have been penetrated and to inject medicaments precisely into the desired location. With CompuFlo®, the injection of chemotherapeutics and other toxic substances outside the targeted area can be avoided. The instruments developed using the CompuFlo® also provide a digital record of the time and amount of anesthetic or medicament injected.  

Our first system utilizing the CompuFlo® technology was our STA instrument and related handpiece for the dental market. The STA instrument and handpiece continue to provide all of the benefits of the CompuDent® system while better facilitating single tooth anesthesia (now generally performed with a high pressure spring loaded gun-like instrument) by allowing the practitioner to monitor and precisely control pressure, rate and volume. Instruments using the CompuFlo® technology System can be used to inject a wide variety of liquid medicaments as well as anesthetics. We believe our CompuFlo® System avoids the negative side effects from the use of traditional hypodermic drug delivery injection instruments,devices, which are well documented in dental and medical literature and include risk of death, transient or permanent paralysis, pain, tissue damage and post-operative complications. Pain and tissue damage often result from uncontrolled flow rates and pressure created during the administration of drug solutions into human tissue. While several technologies have been capable of controllingcan control the flow rate, we believe our patented DPS Dynamic Pressure Sensing technology and CompuFlo Systems provide the ability tocontrol of pressure during the injection as well accurately and precisely control pressure has been unobtainable untildelivery the development of drug.

CompuFlo®. Epidural Computer Controlled Anesthesia System

 

The next systems utilizing CompuFlo Epidural Computer Controlled Anesthesia System (or the CompuFlo Epidural System) is one such platform extension of our ®DPS technology we developed were instruments for administering epidural injections and intra-articular related disposable and an instrument for administering hyaluronic acid Dynamic Pressure Sensing Technology platform, providing anesthesiologists and other medicaments into both major and minor jointshealthcare providers the ability, for the alleviation offirst time, to quantitatively determine and document the pressure at the needle tip in real-time for proper needle placement in epidural procedures used for labor/delivery and back pain associated with arthritismanagement. Our proprietary DPS Dynamic Pressure Sensing Technology allows the CompuFlo Epidural System to provide objective visual and other deleterious joint conditions.audible in-tissue pressure feedback that allows anesthesiologists to identify and confirm placement in the epidural space.

 

Our epidural injection instrument using CompuFlo® pressure sensing technologyEpidural System provides an objective tool that we believe consistently and accurately identifies the epidural space by detecting the difference in pressure between the ligamentum flavum and the extraligamentaryintrafilamentary tissue. In studies, utilizing the CompuFloEpidural System® technologywith DPS Dynamic Pressure Sensing Technology has been shown to be effective in correctly identifying the epidural space has been correctly identified 100% of the time.space. Knowing the precise location of a needle tip during an epidural injection procedure provides a measure of safety not presently available to doctors using conventional syringes, insyringes. In the absence of fluoroscopy, who identifyidentifying the epidural space by relying on the subjective perception of loss of resistance to saline.


Precisely controlling in-tissue pressure increases patient safety by reducingsaline requires a very long education period and learning curve and could result in morbidity and lack of efficacy. During back pain management epidural procedures, where fluoroscopy is commonly used, the risk of tissue damage and post-treatment pain related to excessive pressure that may occur during certain injections. Identification ofCompuFlo Epidural System allows the tissue, in which the needle tip is imbedded, is believed to be highly important in epidural injections, intra-articular injections and numerous organ, subcutaneous and intramuscular injections.

We believe that our intra-articular injection instrument will be particularly efficacious for arthritis patients who are obliged to endure multiple painful injections annually for a lifetime. Often these injections are not efficacious because the doctor using a syringe failsclinician to locate the intra-articularepidural space, or does not injectwithout using fluoroscopy, thereby protecting the appropriate volume of hyaluronic acid or other medicament into that space. The CompuFlo® technology has been successful in administering hyaluronic acidpatient and other medicaments into the intra-articular space in both smallclinician from unnecessary exposure to radiation along with significantly reducing capital and large joints using its computer-controlled pressure sensing capabilities in an independent animal study.operating costs.

 

BothWand/STA Dental Product

Since its market introduction in early 2007, the Wand STA System and prior C-CLAD devices have been used to deliver over 80 million safe, effective, and comfortable injections. The instrument has also been favorably evaluated in numerous peer-reviewed, published clinical studies and associated articles. Moreover, there appears to be a growing consensus among users that the STA Instrument is proving to be a valuable and beneficial instrument that is positively impacting the practice of dentistry worldwide.

Medical Market Product

During 2016, Milestone Scientific filed for 510(k) marketing clearance with the U.S. Food and Drug Administration (FDA) for both intra-articular and epidural and intra-articular instruments have obtained CE mark approval and may now be marketed and sold in most European countries and many other countries accepting CEinjections with the CompuFlo Epidural System.  In June 2017, the FDA approved instruments. In the United States, we have completed required testingCompuFlo Epidural System for the epidural instrument for birthing and pain management and have submitted the favorable results of these tests to the FDA. We expect to receive FDA approval of our epidural instrument by the end of the second quarter 2017 and of our intra-articular instrument some time later in 2017; however we are unable to provide any assurances when approval will be received, if ever. Upon FDA approval, we intend to establish an international marketing network of independent distributors for the devices, although a limited number of European and near-east distributors have already been appointed.injections.

 

In December 2016, we received notification fromaddition, the FDA that based upon the 510(k) application submittedrecent receipt of chronology-Specific CPT Code for the Company's Compu-Flo Intra Articular Computer Controlled Injectiontechnology by American Medical Association marks an important milestone, that could increase the potential number of anesthesia pain management clinics adopting the CompuFlo instrument. A CPT code expands the potential for reimbursement of epidural procedures in pain management utilizing the CompuFlo Epidural System., thereby helping accelerate the commercial roll-out of CompuFlo in the U.S. 

Cosmetic Botulinum Product

Milestone Advanced Cosmetic Systems, Inc. (“Advanced Cosmetic Systems”), was originally owned 50% by us and 50% by Milestone China Company Limited (“Milestone China”), a company organized under the laws of Hong Kong and initially owned 40% by Milestone Scientific. Milestone China contributed $900,000 of cash to the joint venture, and we have provided a royalty-free license to utilize our technology to the joint venture to develop a botulinum toxin injection device.

In November 2017, we announced plans for the commercial launch of our proprietary cosmetic injection device using our DPS Dynamic Pressure Sensing technology platform and our CompuFlo Cosmetic System wefor delivery of botulinum toxin. Our proprietary cosmetic injection device features improved needle placement with a comfortable stylus grip, precise dosing, the same technology platform that has made dental and epidural injections painless, and a new, intuitive touch-screen interface. Although the Company received positive outcomes of multi-state human factor studies with targeted customers, the Company did not adequately document thathave the device met the equivalency standard required for 510(k) clearance. Following consultationnecessary capital to move forward with the FDA Officecommercial launch of Device Evaluation, we intend to provide additional data, which could include a new Human Factor Validation study (HFV Study)our cosmetic device and apply for marketing clearance in support of a new 510(k) application for the device. An HFV Study demonstrates the ease of use of a product. The cost to generate this incremental data is estimated to be approximately $100,000.Europe (CE clearance), and United States (FDA clearance). 

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OtherPossible Products

 

At earlier stages of development are potential products,The Company is reviewing using our CompuFlo’s ®DPS technologyDynamic Pressure Sensing Technology for less painful injections into the eye and for the subcutaneous injection of fillersuse in rhinoplasty, colorectal surgery, podiatry, and other substances in the dermatology market.disciplines. In the self-injectable market, there are a number ofmany injectable drugs routinely self-administered in a home or office setting using spring loaded automatic injection devices by people who suffer from long termlong-term chronic conditions such as Multiple Sclerosis, Rheumatoid Arthritis,multiple sclerosis, rheumatoid arthritis, and other diseases of the auto immune system. We believe the CompuFlo’s ®DPS technology,Dynamic Pressure Sensing Technology, using pressure sensing capabilities, can serve as a less painless subcutaneous injection method for these self-administered drugs. A significant reduction in pain during delivery should have a positive impact on compliance, which is a major consideration when physicians are treating patients. In addition, the abilityHowever, there can be no assurance that we will be able to record the injectionsuccessfully develop any such products, or that if developed, that we will allow for significantly enhanced monitoring of the patient.

Instruments Platform-Medical and Dental

Milestone Scientific has developed and broughtbe able to obtain FDA approval to market any such products, or even if we do obtain such FDA approval, that any such products will generate any revenue for us or be a highly differentiated portfolio of industry innovations. Milestone Scientific’s proprietary solutions have succeeded in elevating the innovation in the professional dental arena. The product portfolio includes:commercial success.

 

Ukraine

Sanctions imposed by the United States and other western democracies, because of the Ukrainian-Russian conflict, and any expansion thereof, is likely to have unpredictable and wide-ranging effects on the domestic and global economy and financial markets, which could have an adverse effect on our business and results of operations. As direct impact from the conflict, we have experienced a decrease in international sales to Ukraine and halted all sales to Russia. We will continue to monitor the situation carefully and, if necessary, take action to protect our business, operations, and financial condition. 

COVID-19 Pandemic

The COVID-19 pandemic materially adversely affected the Company’s financial results and business operations during 2021. During the year 2022, the demand increased, and recovery of the dental business was seen, however, it is unclear what the effect other possible variants might have on the business during 2023. Therefore, such increased demand may or may not continue and/or demand may or may not increase from historical levels depending on the duration and severity of the COVID-19 pandemic, the transmissibility and severity of variants, the effectiveness of the on-going vaccination process, the length of time it takes for normal economic and operating conditions to resume, additional governmental actions that may be taken and/or extensions of time for restrictions that have been imposed to date, and numerous other uncertainties. Such events may result in business and manufacturing disruption, inventory shortages, delivery delays, and reduced sales and operations, any of which could materially affect our business, financial condition, and results of operations.

However, there can be no assurance that we will be able to successfully develop any such products, or that if developed, that we will be able to obtain FDA approval to market any such products, or even if we do obtain such FDA approval, that any such products will generate any revenue for us or be a commercial success.

The Company’s employees have been and are being affected by the COVID-19 pandemic. The health of the Company’s workforce is of primary concern and the Company may need to enact further precautionary measures to help minimize the risk of our employees being exposed to the coronavirus. Further, our management team is focused on mitigating the adverse effects of the COVID-19 pandemic. If these conditions worsen, the Company’s ability to manage its business may be impaired, and operational risks, cybersecurity risks and other risks facing the Company prior to the pandemic may be elevated. The COVID-19 pandemic is affecting the Company’s customers, suppliers, vendors, and other business partners, but the Company is not able to  predict the ultimate consequences that will result therefrom.

We are experiencing supply delays and shortages due to the disruptions the ongoing COVID-19 pandemic is having on the global supply chain, especially with respect to goods from China. The ongoing COVID-19 pandemic has resulted in significant disruption to the operations of certain suppliers in China and the related transportation of their goods to the United States that are parts of our global supply chain. We have been able to make alternative delivery arrangements for limited quantities of goods, at increased cost. While we have not yet experienced material shortages in supply because of these disruptions and our alternative delivery arrangements, if they were to be prolonged or expanded in scope, there could be resulting supply shortages which could impact our ability to have manufactured and delivered our products to the United States and, ultimately to our customers. Accordingly, such supply shortages and delivery limitations could have a material adverse effect on our business, financial condition, results of operations, and cash flows.  All of these factors may have far reaching impacts on the Company’s business, operations, and financial results and conditions, directly and indirectly, including without limitation impacts on the health of the Company’s management.

Patents and Intellectual Property

Milestone Scientific and its subsidiaries currently hold approxi mately 216 U.S. and foreign patents, and many patent applications. The Company’s patents and patent applications relate to drug delivery methodologies, drug flow rate measurement, pressure/force computer-controlled drug delivery with exit pressure, dynamic pressure sensing, automated rate control, automated charging, drug profiles, audible and visual pressure/force feedback, tissue identification, drug delivery injection unit, drug drive unit for anesthetic, handpiece, and injection device. Milestone Scientific and its subsidiaries also currently hold approximately 36 registered U.S. and foreign trademarks, including CompuDent® , CompuFlo® , DPS Dynamic Pressure Sensing technology® , Safety Wand® , STA Single Tooth Anesthesia System® System®, and Instrument

The STA Single Tooth Anesthesia WandSystem® Instrument (or STA Instrument) is a patented, computer-controlled local anesthesia delivery instrument that incorporates the “pressure feedback” elements of Milestone Scientific’s patented CompuFlo® technology, thereby allowing dentists to administer injections accurately into the periodontal ligament space, effectively anesthetizing a single tooth. While the periodontal ligament injection has been available for some time, there has been no effective technology that allows dentists to easily perform the procedure painlessly, safely and predictably until now. With this STA Instrument dentists can easily and predictably anesthetize a single tooth root in one minute as the primary and sole injection, as compared to a general blocking injection with a waiting time of up to 18 minutes (or longer if the blocking injection needs to be re-administered) before proceeding to perform a procedure on the targeted tooth. An instrument which allows dentists to effectively anesthetize a single tooth will greatly enhance the productivity of dental practices and, when combined with the painless injection capabilities already present in the CompuDent® instrument, such an instrument should provide a compelling value in the marketplace. The STA Instrument will generate recurring revenues from per-patient disposable handpieces.

®

 


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Since its market introduction in the spring of 2007, the STA Instrument has received favorable reviews and awards from the dental industry. In July 2007, noted industry publication Dentistry Today featured the STA Instrument as one of the “Top 100 Products in 2007,” helping to promote much broader recognition of the instrument and validating STA’s value proposition for dentists and patients, alike. In early 2008, Medical Device & Diagnostic Industry magazine distinguished the STA Instrument as a 2008 Medical Design Excellence Award winner in the “Dental Instruments, Equipment and Supplies” product category. Of the 33 products to receive this coveted award, the STA was one of only two winning products that serve dental practitioners. In December 2008, Milestone Scientific continued to win broad acclaim for the STA Instrument by winning a “Townie Choice Award”. The “Townie Choice” awards were originally started by Dr. Howard Darran and Farran Media, publisher of Dentaltown Magazine, to assist dentists in making product purchasing decisions, and are considered the “people’s choice” of the products and services available to the dental industry today. That same month, the STA Instrument was also named as a Dental Products Report “Top 100 2008 Product of Distinction.” Additionally, the STA Instrument was named one of Dentistry Today’s “Top 100 Products” for the third consecutive year in 2010.

CompuDent®

CompuDent® is Milestone Scientific’s proprietary, patented Computer-Controlled Local Anesthetic Delivery (C-CLAD) instrument and predecessor of the STA Instrument. CompuDent® delivers anesthesia at a precise and consistent rate below a patient’s pain threshold. Over the years, CompuDent® has been widely heralded as a revolutionary instrument, considered one of the major advances in dentistry in the 20th Century. The instrument has been favorably evaluated in more than 50 peer reviewed or independent clinical research reports. CompuDent®, including its ergonomically designed single-use handpieces (The Wand®), provides numerous, well documented benefits:

CompuDent® minimizes the pain associated with palatal, mandibular block and all other injections, resulting in a more comfortable injection experience for the patient;

the pencil grip used with The Wand® handpieces allows unprecedented tactile sense and accurate control;

new injections made possible with the CompuDent® technology eliminate collateral numbness of the tongue, lips and facial muscles;

bi-directional rotation of The Wand® handpieces eliminates needle deflection resulting in greater success and more rapid onset of anesthesia in mandibular block injections;

the use of a single patient use, disposable handpieces minimizes the risk of cross contamination; and

The ergonomic design of The Wand® handpieces makes an injection easier and less stressful to administer, lowering the risk of carpal tunnel syndrome.

Despite CompuDent® many benefits, including the administration of less painful and more comfortable injections, dentists in the United States have been slow to give up the use of traditional syringes. Dentists have all been trained to use syringes in dental school and often have become accustomed to and are comfortable with their use during many years of clinical practice, in spite of the obvious reluctance and/or fear of the patient in relation to injections administered by hypodermic syringe. There are approximately 40 million dental phobics, those people afraid to visit a dentist, in the United States. Therefore, Milestone Scientific believes there is a disconnect in the way dentists perceive their patients’ attitudes toward injection by hypodermic syringe. The CompuDent® is used today by thousands of dentists around the world, many of whom have long since abandoned the over 150-year old syringe.



CompuMed®

CompuMed® is a patented computer-controlled injection instrument geared to the needs of the medical market and providing benefits similar to CompuDent®. CompuMed® allows many medical procedures, now requiring intravenous sedation, to be performed with only local anesthesia due to dramatic pain reduction. Also, dosages of local anesthetic can often be significantly reduced, thus reducing side effects, accelerating recovery times, lowering costs and eliminating potential complications. CompuMed® has accumulated clinical evidence demonstrating benefits from use in colorectal surgery; podiatry; dermatology, including surgery for the removal of basal cell carcinomas and other oncological dermatologic procedures; nasal and sinus surgery, including rhinoplasty; hair transplantation and cosmetic surgery, among others. The CompuMed® is being replaced by instruments that include CompuFlo® technology geared to specific medical disciplines.

The Wand® 

Our first commercial product, the CompuDent®, and its associated disposable The Wand® handpiece for the dental market is intended to allow the dentist to provide painless injections for virtually all dental procedures, including routine cleanings and fillings, as well as more sophisticated implants, root canals and crowns. New injections made possible by the CompuDent®eliminate collateral numbness of the tongue, lips and facial muscles and often hasten the onset of anesthesia by eliminating the need for mandibular blocks. The pencil grip used with The Wand® handpieces provides the practitioner with unprecedented tactile sense and accurate control and allows bi-directional rotation eliminating needle deflection, resulting in a greater success rate. Since the Wand® handpiece does not look like a typical syringe it also reduces patient anxiety and offers the possibility of curing dental phobia of which 40 million Americans suffer (see the Colgate Oral Care website). The CompuDent®instrument is considered one of the major advances in dentistry in the 20th Century and has been favorably evaluated in more than 50 peer reviewed or independent clinical research reports, which we have reviewed.

Competition

Milestone Scientific’s proprietary, patented Computer-Controlled Local Anesthesia Delivery (C-CLAD) instruments compete with disposable and reusable syringes that generally sell at lower prices and that use established and well-understood methodologies in both the dental and medical marketplaces. Upon commercial introduction and sale, Milestone Medical’s epidural injection instrument will also compete with APAD, a computer controlled injection instrument which claims to be able to reliably identify the epidural space.

Milestone Scientific’s instruments compete on the basis of their performance characteristics and the benefits provided to the practitioner, patient and the dental business operations. Clinical studies have shown that the instruments reduce fear, pain and anxiety for many patients, and Milestone Scientific believes that they can reduce practitioner stress levels, as well. Milestone Scientific’s newest product introduction, the STA Instrument, can be used for all dental injections that can be performed with a traditional dental syringe. Moreover, the STA Instrument can also be used for new and modified dental injection techniques that cannot be performed with traditional syringes. These new techniques allow for faster procedures shortening chair-time, minimizing the numbing of the lips and facial muscles, enhancing practice productivity, reducing stress and virtually eliminating pain and anxiety for both the patient and the dentist.

Milestone Scientific faces intense competition from many companies in the medical and dental device industry, possessing substantially greater financial, marketing, personnel, and other resources. Most competitors have established reputations, stemming from their success in the development, sale, and service of competing dental products. Further, rapid technological change and research may affect the products. Current or new competitors could, at any time, introduce new or enhanced products with features that render the products less marketable or even obsolete. Therefore, Milestone Scientific must devote substantial efforts and financial resources to improve existing products, bring products to market quickly, and develop new products for related markets. In addition, the ability to compete successfully requires that Milestone Scientific establish an effective distribution network with a strong marketing plan. Historically, Milestone Scientific has been unsuccessful in executing the marketing plans for its products, primarily due to resource constraints. New products must be approved by regulatory authorities before they may be marketed. Milestone Scientific cannot assure that it can compete successfully, that competitors will not develop technologies or products that render the products less marketable or obsolete, or, that Milestone Scientific will succeed in improving the existing products, effectively develop new products, or obtain required regulatory approval for those products.


Patents and Intellectual Property

Milestone Scientific holds the following U.S. utility and design patents:  

Computer Controlled Drug Delivery Systems

U.S. Patent

Number

Date of Issue

Dental Anesthetic and Delivery Injection Unit

6,022,337

2/8/2000

Cartridge Holder for Injection Device

6,132,414

10/17/2000

Dental Anesthetic Delivery Injection Unit

6,152,734

11/28/2000

Pressure/Force Computer Controlled Drug Delivery System

6,200,289

3/13/2001

Dental Anesthetic and Delivery Injection Unit with Automated Rate Control

6,652,482

11/25/2003

Pressure/Force Computer Controlled Drug Delivery System with Exit Pressure

6,786,885

9/14/2004

Pressure/Force Computer Controlled Drug Delivery System with Automated Charging

6,887,216

5/3/2005

Drug Delivery System with Profiles

6,945,954

9/20/2005

Cartridge Holder for Anesthetic and Delivery Injection Device

D558,340

12/25/2007

Design for Drive Unit for Anesthetic

D566,265

4/8/2008

Design for Drive Unit for Anesthetic

D579,540

10/28/2008

Drug Infusion Device with Tissue Identification Using Pressure Sensing

7,449,008

11/11/2008

Computer Controlled Drug Delivery Systems with Pressure Sensing

7,618,409

11/17/2009

Hand Piece for Fluid Administration

7,625,354

12/1/2009

Self-Administration Injection System

7,740,612

6/22/2010

Computer controlled drug delivery system with dynamic pressure sensing

7,896,833

3/1/2011

Injection Device Adapter

D741,811

10/27/2015

Epidural Injection Device

D765,832

9/6/2016

Device and Method for Identification of a Target Region

9,504,790

11/29/2016

Engineered Sharps Injury Protection Devices

Handpiece for Injection Device with a Retractable and Rotating Needle

6,428,517

8/6/2002

Safety IV Catheter Device

6,726,658

4/27/2004

Safety IV Catheter Infusion Device

6,905,482

6/14/2005

Handpiece for Injection Device with a Retractable and Rotating Needle

6,966,899

11/22/2005

During the 2016 and 2015 fiscal years, Milestone Scientific expended on a consolidated basis $1,270,471 and $100,856, respectively, on research and development activities.

Milestone Scientific relies on a combination of patent, copyright, trade secret and trademark laws and employee and third partythird-party non-disclosure agreements to protect its intellectualintellectual property rights. Despite the precautions taken by Milestone Scientific to protect products,its IP rights, unauthorized parties may attempt to reverse engineer, copy, or obtain and use products and information that Milestone Scientific regards as proprietary, or may design products serving similar purposes that do not infringe on Milestone Scientific’s patents. Milestone Scientific’s failure to protect its proprietary information and the expenses of doing so could have a material adverse effect on our business, financial condition, and results of operations.

 

In the event thatIf Milestone Scientific’sScientific’s products infringe upon patent or proprietary rights of others, we may be required to modify processes or to obtain licenses. There can be no assurance that Milestone Scientific would be able to do so in a timely manner, upon acceptable terms and conditions, or at all. The failure to do so could have a material adverse effect on our business, financial condition, and results of operations.

 


Government RegulationManufacturing

Milestone Scientific has informal arrangements with an U.S. manufacturer of the Wand/STA System, and epidural devices. Pursuant to these informal arrangements, our third-party manufacturer manufactures the Wand/STA System under specific purchase orders without minimum purchase commitments, and at prices to be agreed upon in each such purchase order.

Our agreement with the principal manufacturer of dental handpieces includes pricing terms. Milestone Scientific has been supplied by the manufacturer of the Wand/STA System and its predecessor, the CompuDent System, since the commencement of production in 1998, and by the manufacturer of its dental handpieces since 2003. The manufacturer of our dental handpieces is in the People’s Republic of China and the manufacturer of the Wand/STA System is in the United States. Refer to Item 1A. Risk Factors.

Changes to pricing of the Wand/STA System instruments by the manufacturer could have a material adverse effect on our financial condition, business, and results of operations. Termination of the manufacturing relationship with any of these third-party manufacturers could significantly and adversely affect our ability to produce and sell the products.

Though other alternate sources of supply for dental handpieces exist, Milestone Scientific would need to establish relationships with new suppliers, and with respect to the Wand/STA System recover its existing tools or have new tools produced and “burn in” and other manufacturing and quality control software re-produced. Establishing new manufacturing relationships could involve significant expense and delay. Any curtailment or interruptions of supply, whether as a result of the inability of a supplier to meet our product delivery needs or termination of the relationship, would have a material adverse effect on our financial condition, business, and results of operations.

Distribution and Marketing

Dental Products

 

The FDA clearedCompany has used a combination of exclusive and non-exclusive distributors to sell its dental products.  In the United States and Canada the Company’s largest distributor was Henry Schein, Inc. (“Henry Schein”).  In December 2021, Henry Schein’s exclusive distribution arrangement with respect to the Wand STA System became a non-exclusive distribution arrangement for the United States and Canada, and on December 31, 2022 such non-exclusive distribution arrangement terminated.

In anticipation of such termination, in January 2021, the Company began a process of signing non-exclusive dental distribution arrangements with dental distributors in specific geographical locations in the United States and Canada. As of December 31, 2022, there are twelve new non-exclusive dental distributors engaged in the United States and Canada. In addition, the Company developed its own United States direct distribution channel which was launched in January of 2023.

On the global front, we have granted exclusive marketing and distribution rights for the Wand STA System to select dental suppliers in various international regions in Asia, Africa, South America, and Europe. Additionally, the Company is in the process of evaluating current international distributors and adding new distributors globally as required based on the economics of the region.

CompuDent®Medical Product

The company, markets and sell it’s medical products in the international markets such as Italy, Switzerland, Greece, Canada and the Middle East through exclusive distributors. In the United States the Medical products are sold by a direct sales team of 3 full time employees and CTI a medical distributor covering 22 states.

Competition

As of this filing, there is no subcutaneous drug delivery platform or device on the market regulating the flow rate and pressure of an injection capable of delivering a painless injection at the desired location like Milestone Scientific’s proprietary, patented devices having our DPS Dynamic Pressure Sensing technology.

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Milestone Scientific’s devices compete based on their performance characteristics and the benefits provided to the patient, practitioner, and their business operations. Clinical studies have shown that our devices reduce fear, pain and anxiety for many patients, and Milestone Scientific believes that they can reduce practitioner stress levels, as well. Other computer-controlled local anesthesia delivery (C-CLAD) options are the Quicksleeper and SleeperOne, from Dental Hi Tec, Dentapen from Septodant, the Calajet from Aseptico, and the Comfort Control Syringe by Dentsply. In the medical segment, for needle verification and placement the EpiFaith Syringe made its market entry in 2023.

The Quicksleeper was invented in France by Dr. Alain Villette in 1991. It is marketed as the only local anesthetic delivery device in France that allows the ability to perform all intraoral local anesthetic injection techniques, including osteocentral anesthesia, quickly and without failure. The extra feature that gives the Quicksleeper this ability is a built-in motor in the syringe/handpiece that renders the syringe both an injector and a perforator of bone. That is, the handpiece of the Quicksleeper can perform an intraosseous injection via a motor driven perforation of the cortical plate of bone. A standard dental needle that attaches to the syringe spins as the motor rotates the handpiece thus acting as a perforator. However, the handpiece is relatively heavy, weighing 240 g. as compared to a standard syringe that weighs 80 g. Injection speed increases during the injection, but the operator cannot control when the injection speed increases.

The Calajet instrument, and its disposable handpieces formanufactured in Europe, has been very slow to grow market acceptance. It recently began marketing in the United States for dental applicationswith similar slow acceptance. The instrument is a higher price than the Wand STA and does not provide dynamic pressure sensing technology. Although a competitor, we believe that without a substantial distribution network this instrument will have a difficult time to be successful in July 1996; the CompuMed® instrument forUnited States.

The Dentapen from Septodent is the newest competitor in the market. This device is manufactured in Europe and began marketing in the United States for medical applications in May 2001; and Safety Wand® for marketing2018. This device is priced similar to the Wand/STA device, but at this time, to our knowledge, it has been slow to attract viable distribution in the United StatesStates.

The EpiFaith Syringe claims to assist the physicians in entering the epidural space. The instrument is introduced at a lower price. Although a potential competitor, we believe that our technology is well documented and is the only pressure sensor guidance system for epidural analgesia assisting the physician over the entire trajectory of epidural needle placement and catheter verification.

Milestone Scientific’s proprietary, patented devices with its DPS Dynamic Pressure Sensing Technology platform also compete with disposable and reusable syringes that generally sell at lower prices and that use established and well-understood methodologies in both the dental applications in September 2003. For us to commercialize otherand medical marketplaces.

Rapid technological change and research may affect our products. Current or new competitors could, at any time, introduce new or enhanced products in United States,with features that render our products less marketable or even obsolete. Therefore, Milestone Scientific would havemust devote substantial efforts and financial resources to submit additional 510(k) applicationsimprove existing products, bring products to market quickly, and develop new products for related markets. In addition, the FDA.ability to compete successfully requires that Milestone Scientific received FDA 510(k)maintain an effective distribution network with a strong marketing plan. Any new products must comply with applicable regulatory authorities before they may be marketed. Milestone Scientific cannot assure that it can compete successfully, that competitors will not develop technologies or products that render our products less marketable or obsolete, or, that Milestone Scientific will succeed in improving its existing products, effectively develop new products, or obtain required regulatory approval for the STA Instrument in August 2006.those products.

Government Regulation

 

The manufacture and sale of medical devices and other medical products are subject to extensive regulation by the FDAFood and Drug Administration  ("FDA") pursuant to the FDCU.S. Food, Drug and Cosmetic Act (“FD&C Act”), and by other federal, state, and foreign authorities. UnderUnder the FDCFD&C Act, medical devices must receive FDA clearance before they can be marketed commercially in the United StatesStates. Some medical products must undergo rigorous pre-clinical and clinical testing and an extensive FDA approval process before they can be marketed. 

These processes can take a number ofmany years and require the expenditure of substantial resources. The time required for completing such testing and obtaining such approvals is uncertain, and FDA clearance may never be obtained. Delays or rejections may be encountered based upon changes in FDA policy during the period of product development and FDA regulatory review of each product submitted. Similar delays also may be encountered in other countries. Following the enactment of the Medical Device Amendments to the FDCU.S. Food, Drug and Cosmetic Act in May 1976, the FDA classified medical devices in commercial distribution into one of three classes. This classification is based on the controls necessary to reasonably ensure the safety and effectiveness of the medical devices. Class I devices are those devices whose safety and effectiveness can reasonably be ensured through general controls, such as adequate labeling, pre-market notification, and adherence to the FDA’s Quality InstrumentSystem Regulation (“QSR”), also referred to as “Good Manufacturing Practices” (“GMP”) regulations. Some Class I devices are further exempted from some of the general controls. Class II devices are those devices whose safety and effectiveness reasonably can be ensured through the use ofusing special controls, such as performance standards, post-market surveillance, patient registries, and FDA guidelines. Class III devices are those which must receive pre-market approval by the FDA to ensure their safety and effectiveness. Generally, Class III devices are limited to life-sustaining, life-supporting or implantable devices.

 

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If a manufacturer or distributor can establish that a proposed device is “substantially equivalent”Prior to a legally marketed Class I or Class II medical device or to a Class III medical device for which the FDA has not required pre-market approval, the manufacturer or distributor may seek FDA marketing clearance for the device by filing a 510(k) Pre-market Notification. The 510(k) Pre-market Notification and the claim of substantial equivalence may have to be supported by various types of data and materials, including test results indicating that the device is as safe and effective for its intended use as a legally marketed predicate device. Following submission of the 510(k) Pre-market Notification,clearance, the manufacturer or distributor may not place the device into commercial distribution until an order is issued by the FDA. By regulation, the FDA has no specific time limit by which it must respond to a 510(k) Pre-market Notification. At this time,Currently, the FDA typically responds to the submission of a 510(k) Pre-market Notification within 180 days. The FDA response may declare that the device is substantially equivalent to another legally marketed device and allow the proposed device to be marketed in the United StatesStates. However, the FDA may determine that the proposed device is not substantially equivalent or may require further information, such as additional test data, before the FDA is able to make a determinationdecide regarding substantial equivalence. Such determination or request for additional information could delay market introduction of products and could have a material adverse effect on our business, financial condition and results of operations.products. If a device that has obtained 510(k) Pre-market Notification clearance is changed or modified in design, components, method of manufacture, or intended use, such that the safety or effectiveness of the device could be significantly affected, separate 510(k) Pre-market Notificationnotification clearance must be obtained before the modified device can be marketed in the United States. If a manufacturer or distributor cannot establish that a proposed device is substantially equivalent to a legally marketed device, the manufacturer or distributor will have to seek pre-market approval of the proposed device, a more difficult procedure requiring extensive data, including pre-clinical and human clinical trial data, as well as extensive literature to prove the safety and efficacy of the device.

The FDA cleared the Wand, our CompuDent System, and its disposable handpieces, for marketing in the United States for dental applications in July 1996; the CompuMed® System for marketing in the United States for medical applications in May 2001; the Safety Wand® for marketing in the United States for dental applications in September 2003; the Wand/STA System for dental applications in August 2006; and our CompuFlo Epidural System in June 2017.

For us to commercialize other products in the United States, Milestone Scientific would have to submit and have cleared additional 510(k) applications to the FDA. In 2017, the FDA reduced the barrier to marketing clearance for certain dental devices. As a result, other manufacturers of injection devices could more easily enter the dental market. However, we believe that any new device will be very limited in sales volume without a significant distributor in the dental market.

 

Though the STA Instrument, CompuDent®, Safety Wand®certain dental and CompuMed®medical devices have received FDA marketing clearance, there can be no assurance that any of the other productsmedical devices under development will obtain the required regulatory clearance in a timely manner, or at all. If regulatory clearance of a product is granted, such clearance may entail limitations on the indicated uses for which the product may be marketed. In addition, modifications may be made to the products to incorporate and enhance their functionality and performance based upon new data and design review. There can be no assurance that the FDA will not request additional information relating to product improvements; that any such improvements would not require further regulatory review, thereby delaying the testing, approval, and commercialization of product improvements; or that ultimately any such improvements will receive FDA clearance.

 


Compliance with applicable regulatory requirements is subject to continual review and will beis monitored through periodic inspections by the FDA. Later discovery of previously unknown problems with a product, manufacturer or facility may result in restrictions on such product or manufacturer, including fines, delays or suspensions of regulatory clearances, seizures or recalls of products, operating restrictions, and criminal prosecution and could have a material adverse effect on our business, financial condition and results of operations.prosecution.

 

Milestone Scientific is subject to pervasive and continuing regulation by the FDA, whose regulations require manufacturers of medicalmedical devices to adhere to certain QSR requirements as defined by the FDCFD&C Act. QSR compliance requires testing, quality control and documentation procedures. Failure to comply with QSR requirements can result in the suspension or termination of production, product recall or fines and penalties. Products also must be manufactured in registered establishments. In addition, labeling and promotional activities are subject to scrutiny by the FDA and, in certain circumstances, by the Federal Trade Commission. The export of devices is also subject to regulation in certain instances.

 

The Medical Device Reporting (“MDR”) regulation obligates us to provide information to the FDA on product malfunctions or injuries alleged to have been associated with the use of the product or in connection with certain product failures that could cause serious injury. If, as a resultbecause of FDA inspections, MDR reports or other information, the FDA believes that Milestone Scientific is not in compliance with the law, the FDA can institute proceedings to detain or seize products, enjoin future violations, or assess civil and/or criminal penalties against us, theour officers, or employees. Any action by the FDA could result in disruption of operations for an undetermined amount of time.

 

In March 2012,May 2022, the Company initiated a Corrective Action Preventative Action (CAPA) investigation of the Epidural Disposable Kit, Part # 6100-01, lot HC 51, the scope of the voluntary market withdrawal needed to be expanded to include Part # 6100-03, lot HC 50. A new non-conformance was initiated, and Lot HC 50 was added to the scope of the CAPA initiated above. The investigation via the CAPA identified that there is an issue with the id adaptors used in both lot’s HC 51 and HC 50. However, the Health Hazard Evaluation shows that there is no risk to the patient or the user, thus management has determined there are no potential impacts to patients or users. Lot’s HC 51 and HC 50 are worth approximately $22,000 and $10,000 respectively. Management has determined that no other lots were affected.

In May 2022, the Company was notified that Wand STA handpieces, reference # STA—5050-2725, lot B210113 were packaged incorrectly. The Company initiated a Corrective Action Preventative Action (CAPA) investigation to determine the root cause and implement corrective actions. The Health Hazard Evaluation was completed and showed that there is no risk to the patient or the user due to this discrepancy, thus management has determined there are no potential impacts to patients or users. However, to provide the highest quality products to the market, Milestone Scientific received approval for The Wand® and the STA Single Tooth Anesthesia System ®Instrument from ANVISA in Brazil. In June 2007, Milestone Scientific receiveddecided to initiate a CE mark for the marketing of the STA Instrument in Europe. In June 2003 Milestone Scientific received a CE mark for the marketing of the Safety Wand® and The Wand® handpieces with needle in Europe. In July 2003, Milestone Scientific obtained regulatory approval to sell CompuDent® and its handpieces in Australia and New Zealand.voluntary market withdrawal on May 13, 2022. Lot B210113 is worth approximately $25,000. 

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Human Capital

 

As of May 2014, China National Medicines received the appropriate registration approval from the regulatory body in China, therefore, shipment of STA handpieces began in China. In the fourth quarter of 2014, the distribution agreement with China National Medicines was terminated and Milestone China Ltd. (owned 40% by Milestone Scientific) became the authorized distributor of the STA instruments and handpieces in China.

Product Liability

Failure to use any of the products in accordance with recommended operating procedures could potentially result in health hazards or injury. Failures of the products to function properly could subject Milestone Scientific to claims of liability. Milestone Scientific maintains liability insurance in an amount that Milestone Scientific believes is adequate. However, there can be no assurance that the insurance coverage will be sufficient to pay product liability claims brought against Milestone Scientific. A partially or completely uninsured claim, if successful and of significant magnitude, could have a material adverse effect on our business, financial condition and results of operations.

Employees

As of December 31, 2016, Milestone hadThe Company has a total 1720 full-time employees, consisting ofincluding two executive officers of Milestone Scientific,  a director of clinical affairs, a director of engineering, a senior vice president of marketing, a senior project manager, three customer service representatives, two accountants, four clinical hygienist, a quality engineer, and an administrative manager.officers. Milestone Scientific also has a consultant who serves as a Director of Clinical AffairsAffairs. None of our employees are subject to a collective bargaining agreement and a business development consultant.we believe our employee relations are

good. 

Corporate Information

We were organized in August 1989 under the laws of the State of Delaware. Our principal executive office is located at 425 Eagle Rock Avenue, Roseland, New Jersey 07068. Our telephone number is (973) 535-2717. 

 


Global Advisory Board

We have a Global Advisory Board (GAB), which is staffed by highly qualified consultants with the background and expertise we need to carry out our long-term business objectives. Our GAB members work with our management team in the planning, development and execution of business strategies to commercialize our epidural and other medical instruments on a worldwide basis. It reviews, and advises management on our progress in research and clinical development as well as new scientific perspectives. The GAB is composed of well-respected, experienced leaders with diverse expertise and knowledge in a variety of areas, including developing partnerships with medical and healthcare organizations in the United States and around the world, public health, clinical research and trial management, US healthcare policy, and business development.

Item 1A. Risk Factors

 

You should consider carefully the risks and uncertainties described below, together with all of the other information in this Annual Report on Form 10-K. If any of the following risks are realized, our business, financial condition, results of operations and prospects could be materially and adversely affected. The following factorsrisks described below are not the only risks facing us. Risks and uncertainties not currently known to us or that we currently deem to be immaterial also may materially adversely affect the growthour business, financial condition, results of operations and/or prospects.

Risks Related to Our Financial Position and profitability of Milestone Scientific and should be considered by any prospective purchaser or current holder of our securities:Need for Additional Capital

 

Milestone Scientific does notWe have incurred significant losses since our inception.These operating losses are expected to continue, and we are unable to predict the extent of future losses, whether we will generate significant revenues or whether we will achieve or sustain profitability.

We are a consistentsmall, non-diversified medical device company with a history of profitablelimited revenue and significant operating losses and our prospects must be evaluated considering the uncertainties, risks, expenses, and difficulties frequently encountered by similarly situated companies. The Company has generated net losses in all periods since the commencement of our operations. ContinuingThe operating losses could exhaustcapital resourceswere $8.8 million and force Milestone Scientific to discontinue operations.

For$7.4 million, for the years ended December 31, 20162022, and 2015,2021, respectively.

We expect to make substantial expenditures and incur increasing operating costs in the future and our accumulated deficit will increase significantly as we undertake to commercialize our CompuFlo Epidural System. Our losses have had, and are expected to continue to have, an adverse impact on our working capital, total assets, and stockholders' equity.  Because of the risks and uncertainties associated with product acceptance, we are unable to predict the extent of any future losses, whether we will ever generate significant revenues were approximately $10.5 millionor if we will ever achieve or sustain profitability.  Even if we do generate profits from operations, we may not be able to sustain or increase profitability on a quarterly or annual basis. Our failure to generate profits from operations, and $9.4 million, respectively. Milestone Scientific has a net lossto become and remain profitable, could impair our ability to raise capital, expand our business, and maintain our commercial efforts or continue our operations. A decline in the value of approximately $5.9 million for year our company could also cause our shareholders to lose all or part of their investment

We may require additional funding and may be unable to raise capital when needed, which may force us to delay, curtail or eliminate commercialization efforts of our CompuFlo Epidural Computer Controlled Anesthesia System.

Our operations have consumed substantial amounts of cash since inception.  During the years ended December 31, 20162022 and 2021, net cash flow used in operations was approximately $6.0 million and approximately $4.0 million, respectively.  We expect to continue to spend substantial amounts on commercialization and marketing activities, including the continued commercialization and marketing of our FDA-approved CompuFlo Epidural Computer Controlled Anesthesia System.  Until such time, if ever, as we can generate a netsufficient amount of product revenue and achieve positive cash flow, we expect to seek to finance future cash needs through equity financings or corporate collaboration and licensing arrangements and may seek the sale of non-medical assets.  

Sales of a substantial number of shares of our common stock, or the perception that such sales may occur, may adversely impact the price of our common stock.

Almost all our 69,306,497 outstanding shares of common stock on December 31, 2022, as well as a substantial number of shares of our common stock underlying outstanding warrants, are available for sale in the public market, either freely or pursuant to Rule 144 under the Securities Act of 1933, as amended. Sales of a substantial number of shares of our common stock, or the perception that such sales may occur, may adversely impact the price of our common stock. 

In February 2019, we issued 6,282,400 shares and 1,570,600 warrants to purchase common shares under our S-3 registration statement. During 2019 the Company issued 639,375 shares associated the warrants issued in February 2019. Since the year ended December 31, 2019, the Company issued 675,000 shares of common stock for warrants exercised at  $0.50  for proceeds of $337,500.

In February 2019, in a private placement we issued 714,286 restricted common shares and 178,571 warrants to purchase common stock.  

In April 2020, we completed a Common Stock offering generating gross proceeds of approximately $5.1 million (5,420,000 common shares and 2,710,000 warrants). The combined price of the shares and warrants was $0.95 per share. The warrants are exercisable at a price of $1.20 per share and have an expiration of three (3) years from the issue date.

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In June 2020, we completed a second Common Stock offering generating gross proceeds of approximately $14.6 million (6,770,000 common shares and 3,749,000 warrants). The combined price of the shares and warrants was $2.15 per share. The warrants are exercisable at $2.60 and expire three (3) years from the issue date.

Raising additional capital by issuing securities or through licensing or lending arrangements may cause dilution to our existing stockholders, restrict our operations, or require us to relinquish proprietary rights.

To the extent that we raise additional capital by issuing equity securities, the share ownership of existing stockholders will be diluted.  Any future debt financing may involve covenants that restrict our operations, including limitations on our ability to incur liens or additional debt, pay dividends, redeem our stock, make certain investments, and engage in certain merger, consolidation, or asset sale transactions, among other restrictions.  In addition, if we raise additional funds through licensing arrangements or the disposition of any of our assets, it may be necessary to relinquish potentially valuable rights to our product candidates or grant licenses on terms that are not favorable to us. 

Recent developments in financial institutions could adversely affect our current and projected business operations, financial condition and results of operations.

Recent events involving limited liquidity, defaults, non-performance and other adverse developments that affect financial institutions have led to market-wide liquidity concerns. For example, on March 10, 2023, Silicon Valley Bank was closed by the California Department of Financial Protection and Innovation, which appointed the Federal Deposit Insurance Corporation, or FDIC, as receiver. On March 12, 2023, Signature Bank and Silvergate Capital Corp. were also placed into receivership. Future increases of the borrowing rate by the Federal Reserve Board, to slow inflation or for other reasons, may expose other financial institutions to greater interest rate risk and exacerbate liquidity and other adverse developments affecting such institutions. 

The Company currently keeps more than $250,000, the maximum amount insured by the Federal Deposit Insurance Corporation (“FDIC”), in its current bank depositary.  The Company may experience delayed access or a loss of approximately $5.4 million for year endedits uninsured deposits or other financial assets should its existing financial institution experience financial distress.  While the U.S. Department of Treasury, FDIC and Federal Reserve Board have provided access to uninsured funds in connection with the Silicon Valley Bank crisis, there is no guarantee that these institutions will provide access to uninsured funds in the future in the event of the closure of other banks or financial institutions, or that they would do so in a timely fashion.  The Company is currently evaluating its banking relationships with the intent of increasing the amount of deposits that are fully insured or invested in risk free instruments.

The results of events or concerns that involve non-performance by financial institutions could include a variety of material and adverse impacts on our current and projected business operations and our financial condition and results of operations.  In addition, any further deterioration in the macroeconomic economy or financial services industry, or delayed access or loss of uninsured deposits or loss of the ability to draw on existing credit facilities involving a troubled or failed financial institution by our customers or vendors, could lead to losses or defaults by companies with whom we do business, which in turn could have a material adverse effect on our current and/or projected business operations, results of operations and financial condition. In addition, other companies could be adversely affected by any of the liquidity or other risks that are described above as factors that could result in material adverse impacts on us, including but not limited to delayed access or loss of uninsured deposits or loss of the ability to draw on existing credit facilities involving a troubled or failed financial institution.

Risks Related to Sales and Distribution of Milestone Scientific Products

Changes in our distribution arrangements exposes us to risks of interruption of marketing efforts and building new marketing channels.

Effective December 31, 2015. In addition, Milestone Scientific has had losses for each year since2022, the commencementCompany's  termination of operationsits U.S. distribution agreement with the exceptionHenry Schein became effective. The goal of 2013. Milestone Scientific had an accumulated deficit of approximately $73 million at December 31, 2016. At December 31, 2016, Milestone Scientific had cash and cash equivalents approximately $3.6 million, and working capital of approximately $7.7 million. Dental revenues are projected to improvechanging our marketing plan from a sole exclusive distributor in the upcoming 12 months due to the new exclusive distribution arrangement for its dental products for the United States and Canada, with Henry Scheinto a large number of non-exclusive distributors and increase dental revenues from out China business sector. To further reduce our expenditures, Milestone Medical expenses related to FDA clearance for the epidural and intra-articular instruments canan e-commerce platform, may not be controlled as required to meet our budget. By limiting the FDA related expenses and increasing the dental instrument and handpieces revenue through the new distribution agreement, management believes that Milestone Scientific will have sufficient cash to meet all of its anticipated obligations over the next twelve months from the filing date of this Form 10-K.

Milestone Scientific management continues to examine all areas of the business to manage our cash flow. Milestone Scientific is actively pursuing the generation of positive cash flows from operating activities through an increase in revenue based upon management’s assessment of present contracts and reductions in operating expenses.seamless or uninterrupted .

 

We cannot become successful unless we gain greater market acceptance for our products and technology.

As with any new technology, there is substantial risk that the marketplace will not accept the potential benefits of this technology or be unwilling to pay for any cost differential with the existing technologies. Market acceptance of CompuDent®, STA Instrument, The Safety Wand®, CompuMed® and CompuFlo® depends, in large part, upon the ability to educate potential customers of the product’s distinctive characteristics and benefits and will require substantial marketing efforts and expense. More than 47,000 of the STA Instrument and its predecessors have been sold worldwide since 1998. Since being introduced to market in February 2007, more than 20,000 of the STA Instrument have been sold. Milestone Scientific cannot assure that its current or proposed products will obtain enough of a broad based acceptance practitioners or that any of the current or proposed products will be able to compete effectively against current and alternative products.


Our limited distribution channels must be expanded in order to become successful.

Future revenues depend on Milestone Scientific's ability to market and distribute its computer-controlled injection products successfully. Beginning January 1, 2016, Milestone Scientific entered into a non-exclusive distribution agreement with Henry Schein. In June 2016, we established new exclusive distribution arrangements for our dental products for the United States and Canada with Henry Schein. Under these arrangements we will, for the first time, have a semi-dedicated independent sales force visiting dentists. We believe that these arrangements will be more effective than previous arrangements which primarily relied on appearances at dental shows and catalog sales. To be successful, Milestone Scientific will need to engage additional distributors, on a worldwide bases provide for their proper training and ensure adequate customer support. Milestone Scientific cannot assure that it will be able to hire and retain an adequate sales force and modify management or engage suitable distributors, or that the sales efforts or distributors will be able to successfully market and sell the products.

Excessive returnsReturns under the June 2016 Exclusiveour Distribution and Supply Agreement with Henry Schein, Inc. could have amaterial adverse effect on our business, financial condition, and results of operationsoperations. .

 

In June 2016, we entered into a new exclusive distributionUnder our Distribution and supply agreementSupply Agreement with Henry Schein, pursuant to which they were appointed as the exclusive distributor for our dental products in the United States and Canada.  Under that agreement, Henry Schein has a right to return our products for full credit against the purchase price paid by them under limited circumstances in accordance with such agreement, including but not limited to, returns due to shipment error by us or factory defect. Excessive returnsOn December 31, 2022, such non-exclusive distribution arrangement terminated, subject to certain post-termination rights and obligations of the parties, all in accordance with such agreement.

Milestone Scientifics International Operations Subject it to Certain Business Risks.

A substantial amount of Milestone Scientific’s sales come from its operations outside the United States and we intend to continue to pursue growth opportunities outside of the United States. Milestone Scientific’s international operations subject it to certain risks relating to, among other things, fluctuations in foreign currency exchange, local economic and political conditions, competition from local companies, increases in trade protectionism, United States relations with the governments of the foreign countries in which Milestone Scientific operates, foreign regulatory requirements or changes in such requirements, changes in local healthcare payment systems and healthcare delivery systems, local product preferences and requirements, longer payment terms for account receivables than we experience in the United States, difficulty in establishing and managing foreign operations, weakening or loss of the protection of intellectual property rights in some countries and import or export licensing requirements.

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We are exposed to the risks inherent in international sales.

In 2022, export sales outside of the United States made up approximately 63% of our total sales, and we sell our products to customers in approximately 30 countries and U.S. territories.  We have exposure to risks of operating in many foreign countries, including:

fluctuations in foreign currency exchange rates, could increase the end user cost for instruments;

restrictions on, or difficulties and costs associated with, the currency exchange from foreign countries to obtain U.S. dollars;

difficulties and costs associated with complying with a wide variety of complex laws, treaties, and regulations;

unexpected changes in political or regulatory environments;

political and economic instability;

import and export restrictions and other trade barriers; and

difficulties in obtaining approval for significant transactions.

If physicians do not accept nor use our CompuFlo Epidural System, our ability to generate revenue from sales will be materially impaired.

Although the FDA has cleared our application to begin marketing the CompuFlo Epidural System, this is no assurance that physicians, hospitals, clinics, and other health care providers will accept and use it.  Acceptance and use of the CompuFlo Epidural System will depend on many factors including:

perceptions by members of the health care community, including physicians, about the safety and effectiveness of our product;

cost-effectiveness of our product relative to competing products and systems;

convenience, ease of use and reliability of our product relative to competing products and systems;                       

patient satisfaction;

product availability as well as, manufacturer warranty, maintenance, and customer and technical support;

availability of reimbursement for our product from government or other healthcare payers; and

effectiveness of marketing and distribution efforts by us and our licensees and distributors.

Because we expect sales of the CompuFlo Epidural Computer Controlled Anesthesia System to generate substantially all our medical product revenues in the near-term, the failure of this product to find market acceptance would harm our business and could require us to seek additional financing or make such financing difficult to obtain on favorable terms, if at all.

Milestone Scientifics sales and marketing efforts rely upon independent distributors that are free to market products that compete with Milestone Scientifics products, and if Milestone Scientific is unable to maintain or expand its network of independent distributors, its business could be materially adversely affected.

Milestone Scientific believes that a significant portion of its sales will continue to be to independent distributors for the foreseeable future, and it is possible that the percentage of its sales to independent distributors could increase. None of Milestone Scientific’s independent distributors in the United States have been required to sell Milestone Scientific products exclusively, and each of them may freely sell the products of Milestone Scientific’s competitors. If Milestone Scientific is unable to maintain or expand its network of independent distributors, its sales may be negatively affected.  If any of its key independent distributors were to cease to distribute Milestone Scientific’s products or reduce their promotion of such products as compared to the products of Milestone Scientific’s competitors, Milestone Scientific may need to seek alternative independent distributors or increase its reliance on other independent distributors which alternative arrangements may not be sufficient to prevent a material reduction in sales of its products.

Developments by competitors may render our products or technologies obsolete or non-competitive.

The medical device industry is intensely competitive and subject to rapid and significant technological change.  We expect that other companies (or individuals), whether located in the United States or abroad, will pursue the development of alternative injection-based or imaging-based systems that will compete with our products.  Many of these potential competitors have substantially greater capital resources, larger research and development staffs and facilities, longer product development history in obtaining regulatory approvals and greater manufacturing and marketing capabilities than we do.  These companies also compete with us to attract qualified personnel and parties for acquisitions, joint ventures, or other collaborations.  As a result, we may not be able to compete effectively against these companies or their products.

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Our ability to commercialize our products will depend in part on the extent to which reimbursement will be available from governmental agencies, health administration authorities, private health maintenance organizations and health insurers and other healthcare payers.

Our ability to generate revenues from our products will be diminished if the products sell for inadequate prices or hospitals or physicians are unable to obtain adequate levels of reimbursement for the cost they incur in connection with the use of the product.  Significant uncertainty exists as to the reimbursement status of newly approved healthcare products.  Healthcare payers, including Medicare, are challenging the prices charged for medical products and services.  Government and other healthcare payers increasingly attempt to contain healthcare costs by limiting both coverage and the level of reimbursement for products.  Insurance coverage may not be available, or reimbursement levels may be inadequate, to cover the charges for the use of such product.  If government and other healthcare payers do not provide adequate coverage and reimbursement for any of our products, market acceptance of such product could be reduced. 

Prices in many countries, including many in Europe, are subject to local regulation and price controls.  In the United States, where pricing levels for medical products, procedures and services are substantially established by third-party payors, including Medicare, if payors reduce the amount of reimbursement for a product, it may cause groups or individuals dispensing the product to discontinue use of the product, to substitute lower cost products even if the alternatives are less effective or to seek additional price-related concessions.  These actions could have a negative effect on our financial results.  The existence of direct and indirect price controls and pressures on our products could materially adversely affect our financial prospects and performance.

We could lose our market advantage earlier than expected.

We believe that our products represent a significant improvement over any existing drug delivery injection system in use today.  However, this competitive advantage can evaporate quickly if we are not able to commercialize our products quickly.  In the medical device industry, the majority of an innovative product’s commercial value is realized during the early stages of commercialization, before competing products are developed.  Our market advantage is based, in part, on patent rights and the need for new competing products and systems to obtain regulatory approval before they can be commercialized.  The scope of our patent rights may be limited and may also depend on the availability of meaningful legal remedies. 

Our failure to adequately protect our intellectual property rights, through patents or otherwise, or limitations on the use or loss of such rights, could have a material adverse effect on our ability to prevent the commercialization of competing anesthetic delivery systems.  In some countries, basic patent protections for our products may not exist because certain countries did not historically offer the right to obtain specific types of patents and/or we (or our licensors) did not file in those markets.  In addition, the patent environment can be unpredictable, and the validity and enforceability of patents cannot be predicted with certainty.

Risks Related to the Covid-19 Pandemic

The COVID-19 pandemic has and may continue to adversely affect the Companys business. Additional factors could exacerbate such negative consequences and/or cause other materially adverse effects.

Certain COVID-19 pandemic-related impacts were experienced by our businesses during 2022 and may continue for an indeterminable period. These included supply chain delays for some of our products which are manufactured in China and supply shortages in key components in our dental products. Future resurgences in COVID-19 infections or other new viral outbreaks may affect the prioritization of non-acute versus acute healthcare utilization, which may temporarily weaken future demand for certain of our products and increase the demand for other of our products. Also, adverse macroeconomic conditions may worsen if governments impose future restrictions, such as lockdowns or quarantine requirements, in order to control infection rates associated with COVID-19 or other viruses.

Additionally, the pandemic escalated challenges that existed for global healthcare systems prior to the pandemic, including budget constraints and staffing shortages, particularly shortages of nursing staff. Changes in the ways healthcare services are delivered, including the transition of more care from acute to non-acute settings and increased focus on chronic disease management, may place additional financial pressure on hospitals and the broader healthcare system. Healthcare institutions may take actions to mitigate any calendar yearpersistent pressures on their budgets and such actions could impact the future demand for our products.

We are experiencing supply delays and shortages due to the disruptions the ongoing COVID-19 pandemic is having on the global supply chain, especially with respect to goods from China.

We are experiencing supply delays and shortages due to the disruptions the ongoing COVID-19 pandemic is having on the global supply chain, especially with respect to goods from China. The ongoing COVID-19 pandemic has resulted in significant disruption to the operations of certain suppliers in China and the related transportation of their goods to the United States that are parts of our global supply chain. We have been able to make alternative delivery arrangements for limited quantities of goods, at an increased cost. While we have not yet experienced material shortages in supply as a result of these disruptions and our alternative delivery arrangements, if they were to be prolonged or expanded in scope, there could be resulting supply shortages which could impact our ability to have manufactured and delivered our products to the United States and, ultimately to our customers. Accordingly, such supply shortages and delivery limitations could have a material adverse effect on our business, financial condition, and results of operations.operations, and cash flows.

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Risks Related to Employee Matters 

 

Our near-term prospects are dependent on the marketing success of our epidural anesthetic injections and intra-articular injection instruments in the EU community. If we fail to successfully commercialize these instrumentsin the EU, our business and prospects would be harmed significantly.

Our near-term prospects are dependent upon our success in marketing our epidural anesthetic injections and intra-articular injection instruments in the EU community where we have previously received CE approval.  There can be no assurance that we willWe may not be able to successfully commercialize these productsattract and retain qualified employees.

Our future success depends upon the continued service of our executive officer and other key management and technical personnel, and on our ability to continue to identify, attract, retain, and motivate them. Implementing our business strategy requires specialized territory managers and other talent, as our revenues are highly dependent on technological and product innovations. The market for employees in the EU.our industry is extremely competitive, a number of such competitors are significantly larger than us and are able to offer compensation in excess of what we are able to offer. If we failare unable to successfully commercialize these products in the EU,attract and retain qualified employees, our business and prospects wouldmay be harmed significantly.harmed. 

Risk Related to Our Dependence on Third Parties

 

Our prospects are dependentRelying exclusively on FDA approvalthird parties to manufacture our products, changes in our informal manufacturing arrangements made by the manufacturer of our epidural anesthetic injections instrumentproducts and disruptions at the manufacturing facility of our manufacturers and failure to permit marketingmaintain existing supply relationships exposes us to risks that may harm our business.

We have limited internal experience in manufacturing operations and have not historically established our own manufacturing facilities. We currently lack the internal resources to manufacture any of our products, including our CompuFlo® Epidural Computer Controlled Anesthesia System. 

Milestone Scientific has been supplied by the manufacturer of the Wand/STA System and its predecessor, the CompuDent System, since the commencement of production in 1998, and by the manufacturer of its handpieces since 2003. The manufacturer of our handpieces is in the United States If we fail to obtainPeople’s Republic of China and the regulatory approvals necessary to sell this instrument in the United States, or upon approval,fail to successfully commercialize this instrumentin the United States, our business and prospects would be harmed significantly.

Our prospects are dependent upon our receipt of FDA approval of our epidural anesthetic injections instrument.  We have filed a 510(k) application with respect to this instrument with the FDA and approval, which will permit us to commence marketingmanufacturer of the instruments in the United States,Wand/STA System is pending.  There can be no assurance that we will obtain the FDA approvals necessary to sell our epidural anesthetic injections instrument in the United States. In addition, even ifAt present, we obtain such regulatory approvals, there can be no assurance thathave an informal arrangement with the manufacturers of our products. Our current arrangement with our manufacturers is on a purchase order-by-purchase order basis. As a result, we will be abledo not have price protection or a supply commitment for our devices or handpieces. If either manufacturer insists on a material change in terms or determines to successfully commercialize this productdiscontinue manufacture of our products, it could have an adverse effect on our financial condition and results of operation.

An operational disruption in the United States. If we failfacility of the manufacturer of, or their ability to obtain the regulatory approvals necessary to sell this instrumentship, our handpieces or fail to successfully commercialize this productdevices could negatively impact our financial results. The occurrence of a natural disaster, such as a hurricane, tropical storm, earthquake, tornado, severe weather, flood, fire, or epidemic, pandemic, or other health emergency, or other unanticipated problems such as labor difficulties, equipment failure or unscheduled maintenance, in the United States, our business and prospects would be harmed significantly.each case could cause operational disruptions of varied duration.   

 

ChangesThese types of disruptions could materially adversely affect our financial condition and results of operations to varying degrees dependent upon the facility, the duration of the disruption, our ability to shift business to another facility or find alternative sources of supply.  Any losses due to these events may not be covered by our existing insurance policies or may be subject to certain deductibles.  Given our current manufacturing relationships, it is possible that our manufacturing requirements may exceed the available supply allotments under our existing agreements. Our anticipated future reliance on third-party manufacturers exposes us to the following additional risks:

We may be unable to identify manufacturers on acceptable terms or at all because the number of potential manufacturers is limited, and the FDA must approve any replacement contractor.  This approval would require new testing and compliance inspections. In addition, a new manufacturer would have to develop substantially equivalent processes for production of our products.

Contract manufacturers may not perform as agreed or may not remain in the contract manufacturing business for the time required to successfully produce, store, and distribute our products.

Contract manufacturers are subject to ongoing periodic unannounced inspections by the FDA and corresponding state agencies to ensure strict compliance with current good manufacturing practice and other government regulations and corresponding foreign standards. We do not have control over third-party manufacturers' compliance with these regulations and standards and our manufacturers may be found to be in noncompliance with certain regulations, which may impact their ability to manufacture our products.

If any third-party manufacturer makes improvements in the manufacturing process for our products, we may not own, or may have to share, the intellectual property rights to the innovation.  We may be required to pay fees or other costs for access to such improvements.

Though other alternate sources of supply for dental handpieces exist, Milestone Scientific would need to establish relationships with new suppliers, and with respect to the Wand/STA System recover its existing tools or have new tools produced and “burned in” and other manufacturing and quality control software re-produced. Establishing new manufacturing relationships could involve significant expense and delay.

Each of these risks could delay the commercialization of our CompuFlo Epidural Computer Controlled Anesthesia System, limit our available supply of The Wand/ STA for dental applications, cause damage to our reputation, result in laws and regulations over which wehigher costs and/or deprive us of potential product revenues.  Any curtailment or interruptions of the supply, whether as a result of termination of the relationship or otherwise, would have no control can significantly affecta material adverse effect on our financial condition, business, and results of operations.

 

AnyOur business is exposed to risks associated with the economic, environmental, and political conditions in China because the sole manufacturer of our handpieces is located in China.

Because the sole manufacturer of our dental handpieces is located in China, our business is disproportionately exposed to the economic, environmental, and political conditions of the region. China’s political and economic systems are very different from most developed countries in many respects, including, the amount of government involvement, the level of development, the control of foreign exchange and the allocation of resources. Uncertainties may arise with changing governmental entitypolicies and measures. China also faces many social, economic, and political challenges that regulatesmay produce instabilities in both its domestic arena and in its relationship with other countries.

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These instabilities may significantly and adversely affect our operationssupply of dental handpieces which would in turn adversely affect our financial performance. In addition, as the countryChinese legal system develops, there can be no assurance that changes in which they are located may enact new legislation or adopt new laws and regulations and their interpretation or policies at any time, and new judicial decisions may change the interpretation of existing legislation or regulations at any time in any of the countries in which our operations or projects are located. We have no control over any such changes. Any new laws or regulations governing our operations could have an adverse impact on our business, results of operations and prospects.


Our planned operations in the developing world could cause us to incur additional costs and risks associated with doing business in developing markets.

We are seeking to operate in the developing world (e.g., China), which would make us vulnerable to political, economic and social instability in such areas. Many areas of the developing world have experienced political, economic and social uncertainty in recent years, including an economic crisis characterized in some cases by increased inflation, high domestic interest rates, negative economic growth, reduced consumer purchasing power and high unemployment. Political, economic and social instability in these countries may have an adverse effect on our business, financial condition and results of operations.

We participate in a highly competitive environment.

The medical device industry is characterized by rapid technological change, changing customer needs and frequent new product introductions. Our products may be rendered obsolete as a result of future innovations. We face intense competition from other manufacturers. Some of our competitors may be larger than we are and may have greater financial, technical, research, marketing, sales, distribution and other resources than we do. We believe that price competitiontheir enforcement will continue among products developed in our markets. Our competitors may develop or market technologies and products that are more effective or commercially attractive than any we are developing or marketing. Our competitors may succeed in obtaining regulatory approval and introducing or commercializing products before we do. Such developments could have a significant negative effect on our business, financial condition and results of operations. Even if we are able to compete successfully, we may not be able to do so in a profitable manner.

Our success depends upon the development of new products and product enhancements, which entails considerable time and expense.

We place a high priority on the development of new products to add to our product portfolio, as well as on the development of enhancements to our existing products. Product development involves substantial expense and we cannot be certain that a completed product will generate sufficient revenue for our business to justify the resources that we devote to research and development related to such product. The time and expense required to develop new products and product enhancements is difficult to predict and we cannot guarantee that we will succeed in developing, introducing and marketing new products and product enhancements. Our inability to successfully develop and introduce new or enhanced products on a timely basis or at all, or to achieve market acceptance of such products, could materially impair our business.

We are dependent on adequate protection of our patent and proprietary rights.

We rely on patents, trade secrets, trademarks, copyrights, know-how, license agreements and contractual provisions to establish and protect our intellectual property rights. However, these legal means afford us only limited protection and may not adequately protect our rights or remedies to gain or keep any advantages we may have over our competitors. We cannot guarantee that others may not independently develop the same or similar technologies or otherwise obtain access to our technology and trade secrets. Our competitors, many of which have substantial resources and may make substantial investments in competing technologies, may apply for and obtain patents that will prevent, limit, or interfere with our ability to manufacture or market our products. Further, while we do not believe that any of our products or processes interfere with the rights of others, third parties may nonetheless assert patent infringement claims against us in the future.

Costly litigation may be necessary to enforce patents issued to us, to protect trade secrets or know-how we own, to defend us against claimed infringement of the rights of others or to determine the ownership, scope, or validity of our proprietary rights and the rights of others. Any claims of infringement against us may involve significant liabilities to third parties, could require us to seek licenses from third parties and could prevent or delay us from manufacturing, selling or using our products. The occurrence of such litigation or the effect of an adverse determination in any of this type of litigation could have a material adverse effect on our business financial conditionrelationship with the sole manufacturer of our dental handpieces. Any adverse change in the economic, environmental, and resultspolitical conditions in China could have a material adverse effect on economic growth and the level of investments and availability of capital in China, which in turn could lead to a reduction in the supply of our dental handpieces and consequently have a material adverse effect on our businesses.

Issues with product quality could have a material adverse effect upon our business, subject us to regulatory actions and cause a loss of customer confidence in us or our products.

In general, our success depends upon the quality of our products.  Quality management plays an essential role in meeting customer requirements, preventing defects, improving our products and services, and assuring the safety and efficacy of our products.  Our future success depends on our ability to maintain and continuously improve our quality management program.  A quality or safety issue may result in adverse inspection reports, warning letters, product recalls or seizures, monetary sanctions, injunctions to halt manufacture and distribution of products, civil or criminal sanctions, costly litigation, refusal of a government to grant approvals and licenses, restrictions on operations or withdrawal of existing approvals and licenses.  An inability to address a quality or safety issue in an effective and timely manner may also cause negative publicity, a loss of customer confidence in us or our current or future products, which may result in the loss of sales and difficulty in successfully launching new products. See Item 1; “Government Regulation.”

Use of third parties to manufacture our products may increase the risk that we will not have sufficient quantities of our products or such quantities at acceptable levels of cost and quality, which could impair our commercialization efforts.

Milestone Scientific relies on a number of third parties to supply and manufacture the components and raw materials for its products and its does not have long-term supply agreements with suppliers of these component parts and raw materials, and its arrangements with these suppliers are on a purchase-order basis. These products we obtain from suppliers are subject to fluctuations in price and availability attributable to a number of factors, including general economic conditions, commodity price fluctuations, the demand by other companies for the same raw materials and the availability of complementary and substitute materials.

While Milestone Scientific works with suppliers to ensure continuity of supply, no assurance can be given that these efforts will be successful. In the event that any of its existing supply arrangements are terminated or there is a reduction or interruption of supply under these existing arrangements, Milestone Scientific expects that it will be able to enter into new arrangements with alternative suppliers, but these new arrangements may be on terms that are less favorable, including with respect to price and volume, and it may be costly or cause delays in our manufacturing process to transition to a new supplier, particularly in cases in which we must comply with regulatory requirements relating to qualification of new suppliers. The termination, reduction or interruption in supply of these raw materials and components could adversely impact Milestone Scientific Scientific’s ability to manufacture and sell certain of its products.

Third-party suppliers may encounter problems during manufacturing for a variety of reasons, including failure to follow specific protocols and procedures, failure to comply with applicable regulations, equipment malfunction, component part supply constraints, and environmental factors, any of which could delay or impede their ability to supply the components and raw materials for Milestone Scientific’s products. Any such failure to perform or a reduction or interruption in supply could have a material adverse effect on Milestone Scientific’s business and operations.

 


Risks Related to Regulatory Compliance and Other Legal Matters

We are subject to substantial domestic and international government regulation, including regulatory quality standards applicable to our manufacturing and quality processes. Failure by us to comply with these standards could have an adverse effect on our business, financial condition, or results of operations.

 

The FDA regulates the approval, manufacturing and sales and marketing of many of our products in the United States. Significant government regulation also exists in other countries in which we conduct business. As a device manufacturer, we are required to register with the FDA and are subject to periodic inspection by the FDA for compliance with the FDA’sFDA’s Quality System Regulation requirements, which require manufacturers of medical devices to adhere to certain regulations, including testing, quality control and documentation procedures. In addition, the federal Medical Device Reporting regulations require us to provide information to the FDA whenever there is evidence that reasonably suggests that a device may have caused or contributed to a death or serious injury or, if a malfunction were to occur, could cause or contribute to a death or serious injury. Compliance with applicable regulatory requirements is subject to continual review and is rigorously monitored through periodic inspections by the FDA.

In the European community, we are required to maintain certain ISO certifications to sell our products and must undergo periodic inspections by notified bodies to obtain and maintain these certifications. Failure to comply with current governmental regulations and quality assurance guidelines could lead to temporary manufacturing shutdowns, product recalls or related field actions, product shortages or delays in product manufacturing. Efficacy or safety concerns, an increase in trends of adverse events in the marketplace, and/or manufacturing quality issues with respect to our products could lead to product recalls or related field actions, withdrawals, and/or declining sales.

 

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We may be subject, directly, or indirectly, to U.S. federal and state health care fraud and abuse and false claims laws and regulations. Prosecutions under such laws have increased in recent years and we may become subject to such litigation. If we are unable to comply or have not fully complied with such laws, we could face substantial penalties.

Our operations are and will continue to be directly, or indirectly through our distributors, customers, and health care professionals, subject to various U.S. federal and state fraud and abuse laws, including, without limitation, the federal Anti-Kickback Statute, federal False Claims Act, and the Foreign Corrupt Practice Act of 1977 (“FCPA”). These laws may impact, among other things, our proposed sales, and marketing and education programs. The federal Anti-Kickback Statute prohibits persons from knowingly and willfully soliciting, offering, receiving, or providing remuneration, directly or indirectly, in exchange for or to induce either the referral of an individual, or the furnishing or arranging for a good or service, for which payment may be made under a federal health care program such as Medicare or Medicaid. Several courts have interpreted the statute’sstatute’s intent requirement to mean that if any one purpose of an arrangement involving remuneration is to induce referrals of federal health care covered business, the statute has been violated. The Anti-Kickback Statute is broad and, despite a series of narrow safe harbors, prohibits many arrangements and practices that are lawful in businesses outside of the health care industry. Penalties for violations of the federal Anti-Kickback Statute include criminal penalties and civil and administrative sanctions such as fines, imprisonment, and possible exclusion from Medicare, Medicaid, and other federal health care programs. An alleged violation of the Anti-Kickback Statute may be used as a predicate offense to establish liability pursuant to other federal laws and regulations such as the federal False Claims Act. Many states have also adopted laws similar tolike the federal Anti-Kickback Statute, some of which apply to the referral of patients for health care items or services reimbursed by any source, not only the Medicare and Medicaid programs.

 

The federal False Claims Act prohibits persons from knowingly filing, or causing to be filed, a false claim to, or the knowing use of false statements to obtain payment from, the federal government. Suits filed under the False Claims Act, known as “qui tam” actions, can be brought by any individual on behalf of the government and such individuals, commonly known as “relators” or “whistleblowers,” may share in any amounts paid by the entity to the government in fines or settlement. The frequency of filing qui tam actions has increased significantly in recent years, causing greater numbers of medical device, pharmaceutical and health care companies to have to defend False Claim Act actions. The Affordable Care Act includes provisions expanding the ability of certain relators to bring actions that would have been previously dismissed under prior law. When an entity is determined to have violated the federal False Claims Act, it may be required to pay up to three times the actual damages sustained by the government, plus civil penalties for each separate false claim. The Deficit Reduction Act of 2005 encouraged states to enact or modify their state false claims act to be at least as effective as the federal False Claims Act by granting states a portion of any federal Medicaid funds recovered through Medicaid-related actions. Most states have enacted state false claims laws, and many of those states included laws with qui tam provisions. States had until March 31, 2013 to enact or amend their false claims laws modeled after the federal False Claims Act for review and approval to receive a greater portion of any recovery.

 


The Affordable Care Act includes provisions known as the Physician Payments Sunshine Act (section 6002), which require manufacturers of drugs, biologics, devices, and medical supplies covered under Medicare and Medicaid starting in 2012 to recorddisclose to the Centers for Medicare and Medicaid Services any transfers of value to physicians and teaching hospitals beginning in August 2013 and to report to the Centers for Medicare and Medicaid Services starting in 2014 for subsequent public disclosure. hospitals.

Manufacturers must also disclose investment interests held by physicians and their family members. Failure to submit the required information may result in civil monetary penalties of up to $1 million per year for knowing violations and may result in liability under other federal laws or regulations. Similar reporting requirements have also been enacted on the state level in the United States, and an increasing number of countries worldwide either have adopted or are considering similar laws requiring transparency of interactions with health care professionals. In addition, some states, such as Massachusetts and Vermont, impose an outright ban on certain gifts to physicians. If we receive FDA clearance to market our epidural anesthetic injections and/or our intra-articular injection instruments in the United States, theseThese laws could affect our promotional activities by limiting the kinds of interactions we could have with hospitals, physicians or other potential purchasers or users of our system.products. Both the disclosure laws and gift bans will impose administrative, cost and compliance burdens on us.

We are unable to predict whether we could be subject to actions under any of these laws, or the impact of such actions. If we are found to be in violation of any of the laws described above and other applicable state and federal fraud and abuse laws, we may be subject to penalties, including civil and criminal penalties, damages, fines, or an administrative action of suspension or exclusion from government health care reimbursement programs and the curtailment or restructuring of our operations.operations

 

In addition, we are subject to the FCPAForeign Corrupt Practices Act (“FCPA”) and other countriescountries’ anti-corruption/anti-bribery regimes, such as the U.K. Bribery Act. The FCPA prohibits improper payments or offers of payments to foreign governments and their officials for the purpose of obtaining or retaining business.

Safeguards we implement to discourage improper payments or offers of payments by our employees, consultants, sales agents, or distributors may be ineffective, and violations of the FCPA and similar laws may result in severe criminal or civil sanctions, or other liabilities or proceedings against us, any of which would likely harm our reputation, business, results of operations and financial condition.

Safeguards we implement to discourage improper payments or offers of payments by our employees, consultants, sales agents, or distributors may be ineffective, and violations of the FCPA and similar laws may result in severe criminal or civil sanctions, or other liabilities or proceedings against us, any of which would likely harm our reputation, business, results of operations and financial condition.

 

We dependChanges in United States policy regarding international trade, including import and export regulation and international trade agreements, could also negatively impact Milestone Scientific’s business. The United States has imposed tariffs and export controls on two principal manufacturers. Ifcertain goods and products imported from China and certain other countries, which has resulted in retaliatory tariffs by China and other countries. Additional tariffs imposed by the United States on a broader range of imports, or further retaliatory trade measures taken by China or other countries in response, could result in an increase in supply chain costs that Milestone Scientific cannot maintainmay not be able to offset or that otherwise adversely impact its existingrelationships or develop new ones, it mayresults of operations. In addition, political tensions between the United States and China have to cease operations.

Milestone Scientificescalated in recent years. Rising political tensions could reduce trade, investment and its subsidiary has informal arrangements withother economic activities between the manufacturer of the STA Instrument, CompuDent® and CompuMed® and with one of the principal manufacturers of the handpieces, for those items, respectively. Pursuant to the informal arrangements, they manufacture these instruments and handpieces under specific purchase orders without minimum purchase commitment. Milestone Scientific has a manufacturing agreement with one of the principal manufacturers, which is a related party, of its handpieces pursuant to which they manufacture products under specific purchase orders but without minimum purchase commitments. Milestone Scientific has been supplied by the manufacturer of the STA Instrument, CompuDent® and CompuMed® epidural and intra-articular instruments since the commencement of production in 1998, the manufacturer of its handpieces since 2003. However, termination of the manufacturing relationship with anytwo major economies. Any of these manufacturers could significantly and adversely affect the ability to produce and sell the products. Though other alternate sources of supply for handpieces exist, Milestone Scientific would need to recover its existing tools or have new tools produced to establish relationships with new suppliers. Establishing new manufacturing relationships could involve significant expense and delay. Any curtailment or interruptions of the supply, whether or not as a result or termination of the relationship, would have a material adverse effect on our financial condition, business and results of operations.

We may be subject to product liability claims that are not fully covered by insurance and that could put Milestone Scientific under financial strain.

Milestone Scientific could be subject to claims for personal injury from the alleged malfunction or misuse of the dental and medical products. While Milestone Scientific carries liability insurance that is believed to be adequate, Milestone Scientific cannot assure that the insurance coverage will be sufficient to pay such claims should they be successful. A partially or completely uninsured claim, if successful and of significant magnitude,factors could have a material adverse effect on ourMilestone Scientific’s business, prospects, financial condition and results of operations.

 


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Certain modifications to Milestone Scientifics products may require new 510(k) clearances or other marketing authorizations and may require Milestone Scientific reliesto recall or cease marketing its products.

Once a medical device is permitted to be legally marketed in the United States pursuant to a 510(k) clearance, a manufacturer may be required to notify the FDA of certain modifications to the device.

Manufacturers determine in the first instance whether a change to a product requires a new 510(k) clearance or premarket submission, but the FDA may review any manufacturer’s decision. The FDA may not agree with Milestone Scientific’s decisions regarding whether new clearances are necessary. Milestone Scientific has made modifications to its products in the past and has determined based on its review of the continuing servicesapplicable FDA regulations and guidance that in certain instances new 510(k) clearances or other premarket submissions were not required. Milestone Scientific may make similar modifications or add additional features in the future that it believes does not require a new 510(k) clearance. If the FDA disagrees with Milestone  Scientific’s determinations and requires it to submit new 510(k) notifications, Milestone Scientific may be required to cease marketing or to recall the modified product until it obtains clearance, and it may be subject to significant regulatory fines or penalties.

Milestone Scientific may be subject to enforcement actions if it engages in improper marketing or promotion of its Chief Executive Officer and Director of Clinical Affairs.products.

 

Milestone Scientific depends onScientific’s promotional materials and training methods must comply with applicable laws, regulations and regulatory authority’s rules and guidelines, including the personal effortsFDA and abilitiesthe Federal Trade Commission (the “FTC”). If the FDA, the FTC or another regulatory agency determines that Milestone Scientific’s promotional or training material constitutes off-label, false or misleading, unfair or deceptive promotion of its Chief Executive Officer and Director of Clinical Affairs.products, it could request that Milestone Scientific maintainsmodify its training or promotional materials or subject Milestone Scientific to regulatory or enforcement actions, including the issuance of an untitled letter, a key man life insurance policy in the amount of $1,000,000 on the lifewarning letter, injunction, seizure, civil fine or criminal penalties. It is also possible that other federal, state or foreign enforcement authorities might take action if they consider Milestone Scientific’s promotional or training materials to constitute off-label, false or misleading, unfair or deceptive promotion of its Chief Executive Officer. However, the loss of his servicesproducts, which could result in significant fines or the services of its Director of Clinical Affairs, on whom Milestone Scientific maintains no insurance, could have a materially adverse effect on the business.penalties under other statutory authorities, such as laws prohibiting false claims for reimbursement, and reputational harm.

 

The market priceChanges in laws and regulations over which we have no control can significantly affect our business and results of Milestone Scientific’s common stock has been volatile and may continue tooperations.fluctuate significantly because of various factors, some of which are beyondMilestone Scientific’s control.

 

Milestone Scientific’s stock price has been extremely volatile, fluctuating duringAny governmental entity that regulates our operations in the last two years between $4.00country in which they are located may enact new legislation or adopt new laws and $1.27. The market priceregulations or policies at any time, and new judicial decisions may change the interpretation of common stockexisting legislation or regulations at any time in any of the countries in which our operations or projects are located. We have no control over any such changes. Any new laws or regulations governing our operations could continue to fluctuate significantly in response to a varietyhave an adverse impact on our business, results of factors, some of which may be beyond Milestone Scientific’s control.operations and prospects.

 

Risks Related to Milestone Scientific Common Stock

Milestone Scientific is effectively controlled by a limited number of stockholders.

 

Milestone Scientific’s Scientific’s principal stockholders, Leonard Osser and Gian Domenico Trombetta K. Tucker Andersen, and Robert Gintel beneficially owncontrol approximately 50%25% of the issued and outstanding shares of common stock. As a result, they have the ability tocan exercise substantial control over Milestone Scientific’sour affairs and corporate actions requiring stockholder approval, including electing directors, selling all or substantially all of theour assets, merging with another entity, or amending itsour certificate of incorporation. This de facto control could delay, deter, or prevent a change in control and could adversely affect the price that investors might be willing to pay in the future for Milestone Scientific’s securities.  In addition, because of the concentration of ownership of our shares of common stock, our stockholders may from time to time, observe instances where there may be less liquidity in the public markets for our securities.

 

Future sales orFailure to implement effective internal controls required by the potential for saleSarbanes-Oxley Act of 2002 could result in material misstatements in our financial statements, cause investors to lose confidence in the Companys reported financial information and have a substantial number of shares of common stock could causenegative effect on the trading price of our common stock tostock.decline and could impair Milestone Scientific’s ability to raise capital through subsequent equityofferings.

 

Sales of a substantial number of shares of common stock in the public markets, or the perception that these sales may occur, could cause the market priceSection 404 of the stock to decline and could materially impair its ability to raise capital through the sale of additional equity securities. At December 31, 2016, Milestone Scientific had outstanding options to purchase 1,736,994 shares of common stock at prices ranging from $0.75 to $3.89 per share with a weighted average exercise price of $1.85. Holders of these options are given the opportunity to profit from a rise in the market price of the common stock and are likely to exercise their securities at a time when Milestone Scientific would be able to obtain additional equity capital on more favorable terms. Thus, the terms upon which Milestone Scientific will be able to obtain additional equity capital may be adversely affected, since the holders of outstanding options and warrants can be expected to exercise them at a time when Milestone Scientific would, in all likelihood, be able to obtain any needed capital on terms more favorable than the exercise terms provided by such outstanding securities. The market price of the common stock has been volatile and may continue to fluctuate significantly because of various factors, many of which are beyond Milestone Scientific’s control.

Adherence to Sarbanes-Oxley Act of 2002 requires management of public companies to develop and SECrules concerningimplement internal controls may be so costly that compliance could havean adverse effect on Milestone Scientific.

The management of Milestone Scientific has assessedover financial reporting and evaluate the effectiveness thereof. A material weakness is a deficiency, or a combination of deficiencies, in internal control over financial reporting as of December 31, 2016. In making this assessment, management used the criteria established in Internal Control-Integrated Framework issued by the Committee of Sponsoring Organizationssuch that there is a reasonable possibility that a material misstatement of the Treadway Commission (COSO). Milestone Scientific complied with Sarbanes-Oxley requirements to include in theCompany’s annual report a management report on the effectiveness of the internal control overand interim financial reporting. In 2005, Milestone Scientific hired an outside consultant to assist with the development and implementation of the necessary internal controls and reporting procedures. In 2016 and 2015, Milestone Scientific utilized the outside consultantstatements will not be prevented or detected on a quarterly basistimely basis. Any failure to review compliance withcomplete the Company’s assessment of its internal controls over financial reporting. This expense amountedreporting or to approximately $20,000remediate any material weaknesses that management may identify could harm the Company’s operating results, cause the Company to fail to meet its reporting obligations or result in material misstatements in the Company’s financial statements. Inadequate disclosure controls and $14,000procedures and internal controls over financial reporting could also cause investors to lose confidence in 2016the Company’s public disclosures and 2015, respectively andreported financial information, which could have a negative effect on the cost is expected to continue in 2017.trading price of our common stock.

 


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Item The market price of our common stock may be volatile and may fluctuate significantly, and stockholders could lose all or part of their investment in Milestone Scientific

Our stock price may experience substantial volatility because of many factors, including:

our failure to meet analysts’ expectations;

sales or potential sales of substantial amounts of our common stock;

delay or failure in initiating our strategy to commercialize our CompuFlo Epidural System;

the success of our strategy to commercialize our CompuFlo Epidural System;

announcements about us or about our competitors, including clinical trial results, regulatory approvals or new product introductions that could adversely impact the market acceptance or competitive advantages of our CompuFlo Epidural System;

developments concerning our licensors or product manufacturers;

litigation and other developments relating to our patents or other proprietary rights or those of our competitors;

our ability to successfully develop and commercialize products and services for the healthcare industry;

conditions in the medical device industry;

governmental regulation and legislation;

variations in our anticipated or actual operating results; and

change in securities analysts’ estimates of our performance, or our failure to meet analysts’ expectations.

Many of these factors are beyond our control. The stock markets in general, and the market for small, medical device companies, in particular, have historically experienced extreme price and volume fluctuations. These fluctuations often have been unrelated or disproportionate to the operating performance of these companies. These broad market and industry factors could reduce the market price of our common stock, regardless of our actual operating performance.

We have never paid and do not intend to pay cash dividends in the foreseeable future.As a result, capital appreciation, if any, will be your sole source of gain.

We have never paid cash dividends on any of our capital stock, and we currently intend to retain future earnings, if any, to fund the development and growth of our business. In addition, the terms of existing and future debt agreements may preclude us from paying dividends. As a result, capital appreciation, if any, of our common stock will be your sole source of gain for the foreseeable future.

Provisions in our certificate of incorporation, our by-laws and Delaware law might discourage, delay, or prevent a change in control of our company or changes in our management and, therefore, depress the trading price of our common stock.

Provisions of our certificate of incorporation, our by-laws and Delaware law may have the effect of deterring unsolicited takeovers or delaying or preventing a change in control of our company or changes in our management, including transactions in which our stockholders might otherwise receive a premium for their shares over then current market prices. In addition, these provisions may limit the ability of stockholders to approve transactions that they may deem to be in their best interests.  These provisions include:

the inability of stockholders to call special meetings;

the ability of our Board of Directors to designate the terms of and issue new series of preferred stock without stockholder approval, which could include the right to approve an acquisition or other change in our control or could be used to institute a rights plan, also known as a poison pill, that would work to dilute the stock ownership of a potential hostile acquirer, likely preventing acquisitions that have not been approved by our Board of Directors; and

limitations on filling of vacancies.  

All of which could make it more difficult for a third party to acquire, or discourage a third party from seeking to acquire, control of our company.

In addition, Section 203 of the Delaware General Corporation Law prohibits a publicly held Delaware corporation from engaging in a business combination with an interested stockholder, generally a person which together with its affiliates owns, or within the last three years, has owned 15% of our voting stock, for a period of three years after the date of the transaction in which the person became an interested stockholder, unless the business combination is approved in a prescribed manner.  The existence of the forgoing provisions and anti-takeover measures could limit the price that investors might be willing to pay in the future for shares of our common stock.  They could also deter potential acquirers of our Company, thereby reducing the likelihood that you could receive a premium for your common stock in an acquisition. 

If we fail to adhere to the strict listing requirements of NYSE American, we may be subject to delisting.As a result, our stock price may decline, and our common stock may be de-listed.If our stock were no longer listed on NYSE American, the liquidity of our securities likely would be impaired.

Our common stock currently trades on the NYSE American under the symbol “MLSS”. If we fail to adhere to NYSE American's strict listing criteria, including with respect to stock price, our market capitalization and stockholders’ equity, our stock may be de-listed. This could potentially impair the liquidity of our securities not only in the number of shares that could be bought and sold at a given price, which may be depressed by the relative illiquidity, but also through delays in the timing of transactions and the potential reduction in media coverage.  As a result, an investor might find it more difficult to dispose of our common stock.  Any failure at any time to meet the continuing NYSE American listing requirements could have an adverse impact on the value of and trading activity in our common stock.

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Your percentage of ownership in Milestone Scientificmay be diluted in the future

In the future, your percentage ownership in Milestone Scientific may be diluted because of equity issuances for acquisitions, capital market transactions or otherwise, including any equity awards that Milestone Scientific will grant to its directors, officers, employees and consultants. Such awards will have a dilutive effect on outstanding share count which could adversely affect the market price of Milestone Scientific’s common stock.

Risks Related to Our Intellectual Property

If we are unable to adequately protect our patents, trade secrets and other proprietary rights, if our patents are challenged or if our provisional patent applications do not get approved, our competitiveness and business prospects may be materially damaged.

Intellectual property rights, including patents, trade secrets, confidential information, trademarks, trade names and trade address, are important to our business. We will endeavor to protect our intellectual property rights in key jurisdictions in which our products are produced or used and in jurisdictions into which our products are imported. Our success will depend to a significant degree upon our ability to protect and preserve our intellectual property rights. However, we may be unable to obtain or maintain protection for our intellectual property in key jurisdictions.  

Although we own and have applied for patents and trademarks throughout the world, we may have to rely on judicial enforcement of our patents and other proprietary rights. Our patents and other intellectual property rights may be challenged, invalidated, circumvented, and rendered unenforceable or otherwise compromised. A failure to protect, defend or enforce our intellectual property could have an adverse effect on our financial condition and results of operations. Similarly, third parties may assert claims against us and our customers and distributors alleging our products infringe upon third party intellectual property rights.

We believe that the intellectual property underlying our products is a competitive advantage. We rely on a combination of patent rights, trade secrets and nondisclosure and non-competition agreements to protect our proprietary intellectual property, and we will continue to do so. There can be no assurance that our patents, trade secret policies and practices or other agreements will adequately protect our intellectual property.  Our issued patents may be challenged, found to be over-broad or otherwise invalidated in subsequent proceedings before courts or the U.S. Patent and Trademark Office. Even if enforceable, we cannot provide any assurances that they will provide significant protection from competition. The processes, systems, and/or security measures we use to preserve the integrity and confidentiality of our data and trade secrets may be breached, and we may not have adequate remedies resulting from such breaches.  In addition, our trade secrets may otherwise become known or be independently discovered by competitors. There can be no assurance that the confidentiality, nondisclosure and non-competition agreements with employees, consultants and other parties with access to our proprietary information to protect our trade secrets, proprietary technology, processes and other proprietary rights, or any other security measures relating to such trade secrets, proprietary technology, processes and proprietary rights, will be adequate, will not be breached, that we will have adequate remedies for any breach, that others will not independently develop substantially equivalent proprietary information or that third parties will not otherwise gain access to our trade secrets or proprietary knowledge.  To the extent that our consultants, contractors, or collaborators use intellectual property owned by others in their work for us, disputes may arise as to the rights in related or resulting know-how and inventions.

If we must take legal action to protect, defend or enforce our intellectual property rights, any suits or proceedings could result in significant costs and diversion of our resources and our management’s attention, and we may not prevail in any such suits or proceedings.  A failure to protect, defend or enforce our intellectual property rights could have an adverse effect on our results of operations.

Third parties could obtain patents that may require us to negotiate licenses to commercialize our technologies, and we cannot assure you that the required licenses would be available on reasonable terms or at all.

Third parties may claim that one or more aspects of our technologies or products may infringe on their intellectual property rights. 

Our computer-controlled anesthesia systems are complex systems and numerous U.S. and foreign patents and pending patent applications owned by third parties exist in fields that relate to the development and commercialization of drug delivery systems.  In addition, many companies have employed intellectual property litigation as a strategy to gain a competitive advantage.  It is possible that infringement claims may occur as the number of products and competitors in our market increases.  In addition, to the extent that we gain greater visibility and market exposure as a public company, we face a greater risk of being the subject of intellectual property infringement claims.  We cannot be certain that the conduct of our business does not and will not infringe intellectual property or other proprietary rights of others in the U.S. and in foreign jurisdictions.  If any of our computer-controlled anesthesia systems are found to infringe third party patent rights, we could be prohibited from manufacturing and commercializing the infringing technology unless we obtain a license under the applicable third-party patent and pay royalties or are able to design around such patent.  

We may be unable to obtain a license on terms acceptable to us, or at all, and we may not be able to redesign the system to avoid infringement.  Even if we can redesign our products or processes to avoid an infringement claim, our efforts to design around the patent could require significant time, effort and expense and ultimately may lead to an inferior or costlier product.  Any claim of infringement by a third party, even those without merit, could cause us to incur substantial costs defending against the claim and could distract our management from our business. 

Furthermore, if any such claim is successful, a court could order us to pay substantial damages, including compensatory damages for any infringement, plus prejudgment interest and could, in certain circumstances, treble the compensatory damages and award attorney fees.  These damages could be substantial and could harm our reputation, business, financial condition, and operating results.  A court also could enter orders that temporarily, preliminary, or permanently prohibit us, our licensees, if any, and our customers from making, using, selling, offering to sell, or importing one or more of our products or using our proprietary technologies or processes, or could enter an order mandating that we undertake certain remedial activities. 

20

Any of these events could seriously harm our business, operating results, and financial condition.

General Business Risks

Continued instability in the credit and financial markets may negatively impact our ability to commercialize our products.

Financial markets in the United States, Canada, Europe, and Asia continue to experience disruption, including, among other things, significant volatility in security prices, declining valuations of certain investments, as well as severely diminished liquidity and credit availability.  Business activity across a wide range of industries and regions continues to be reduced.  As a small medical device company, we rely on third parties for several important aspects of our business, including contract manufacturing of products, distribution of our products and sales and marketing.  These third parties may be unable to satisfy their commitments to us due to tightening of global credit from time to time, which would adversely affect our business.  The continued volatility in the credit and financial market conditions may also negatively impact our ability to access capital and credit markets and our ability to manage our cash balance.  While we are unable to predict the continued duration and severity of any adverse conditions in the United States and other countries, any of the circumstances mentioned above could adversely affect our business, financial condition, operating results and cash flow or cash position.

Our business and operations would suffer in the event of cybersecurity or other system failures.

Despite the implementation of security measures, our internal computer systems, and those of any third parties with which we partner are vulnerable to damage from computer viruses, unauthorized access, natural disasters, terrorism, war and telecommunication and electrical failures. While we have not experienced any cybersecurity or system failure, accident or breach to date, if an event were to occur, it could result in a material disruption of our operations, substantial costs to rectify or correct the failure, if possible, and potentially violation of HIPAA and other privacy laws applicable to our operations. If any disruption or security breach resulted in a loss of or damage to our data or applications or inappropriate disclosure of confidential or protected information, we could incur liability, further development of our products could be delayed, and our operations could be disrupted, any of which could severely harm our business and financial condition. Issues with product quality could have a material adverse effect upon our business, subject us to regulatory actions and cause a loss of customer confidence in us or our products.

In general, our success depends upon the quality of our products.  Quality management plays an essential role in meeting customer requirements, preventing defects, improving our products and services, and assuring the safety and efficacy of our products.  Our future success depends on our ability to maintain and continuously improve our quality management program.  A quality or safety issue may result in adverse inspection reports, warning letters, product recalls or seizures, monetary sanctions, injunctions to halt manufacture and distribution of products, civil or criminal sanctions, costly litigation, refusal of a government to grant approvals and licenses, restrictions on operations or withdrawal of existing approvals and licenses.  An inability to address a quality or safety issue in an effective and timely manner may also cause negative publicity, a loss of customer confidence in us or our current or future products, which may result in the loss of sales and difficulty in successfully launching new products.

Insurance coverage may be inadequate or unavailable to cover any product liability losses we incur.

Our business exposes us to potential product liability claims that are inherent in the design, manufacture, testing, inspection, and sale of dental and medical devices. We are subject to product liability lawsuits alleging that component failures, manufacturing flaws, manufacturing defects, negligence in manufacturing, design defects, negligence in design, or inadequate disclosure of product-related risks, warnings, or product-related information resulted in an unsafe condition, injury, or death to customers. The risk of one or more product liability claims or lawsuits may be even greater after we launch new products with new features or enter new markets where we have no prior experience selling our products and rely on newly-hired staff or new independent distributors or contractors to provide new customer training and customer support. In addition, the misuse of our products or the failure of customers to adhere to operating guidelines could cause significant harm to customers, including death, which could result in product liability claims. Product liability lawsuits and claims, safety alerts or product recalls, with or without merit, regardless of any available insurance coverage, could cause us to incur substantial costs, and could place a significant strain on our financial resources, divert the attention of management from our core business, harm our reputation and adversely affect our ability to attract and retain customers, any of which could have a material adverse effect on our business, financial condition and operating results.

Item1B. Unresolved Staff Comments

 

None.

 

21

Item 2. DescriptionDescription of Property

 

The headquarters for Milestone Scientific is located at 220 South Orange Ave, Livingston,425 Eagle Rock Avenue, Roseland, New Jersey. Milestone Scientific leases approximately 7,625Jersey 07068, and our telephone number is (973) 535-2717. In August 2019, the Company signed a seven year lease for a facility in Roseland, New Jersey (the “Roseland Facility”). The Roseland Facility carries monthly lease payments of $9,275, commencing April 1, 2021. The Company is also responsible for electric charges equal to $2.00 per square feetfoot, which is equal to $11,130 annually, payable in equal monthly installments of office space.$928. The lease term expires January 31, 2020 at a monthly costCompany will also be required to pay its proportionate share of $12,522. Additionally, Milestone Scientific has other smaller insignificant leases ending through 2017.certain operating costs and property taxes applicable to the leased premises in excess of new base year amounts. A third partythird-party distribution and logistics center in Pennsylvania handles shipping and order fulfillment on a month-to-month basis.

 

Milestone Scientific does not own or intend to invest in any real property. Milestone Scientific currently has no policy with respect to investments oror interests in real estate, real estate mortgages or securities of, or interests in, persons primarily engaged in real estate activities.

 

Item Item3. Legal Proceedings

 

At the present time, Milestone Scientific is not involved in any material litigation.

 

Item Item4. Mine Safety Disclosure

Not applicable.

 


PART

PART II

 

Item Item5. Market for Common Equity, and Related Stockholder Matters and Small Business Issuer Purchases of Equity Securities

 

Market Information

 

On June 1, 2015, our common stock was listed on the NYSE MKTAmerican under the symbol “MLSS”. Prior to its listing on the NYSE MKT, Milestone’s common stock traded on the OTC Market on the OTCQB market tier under the same symbol. The following table sets forth the high and low sales prices of Milestone’s common stock for the periods presented.

 

2016

 

HIGH

  

LOW

 

2015

 

HIGH

  

LOW

 

2022

 

High

 

Low

 

2021

 

High

 

Low

 

First Quarter

 $2.54  $1.27 

First Quarter

 $3.00  $2.35  $2.20  $1.13 

First Quarter

 $4.85  $2.11 

Second Quarter

 $3.10  $1.70 

Second Quarter

 $4.00  $2.42  $1.60  $0.75 

Second Quarter

 $3.83  $1.88 

Third Quarter

 $2.96  $1.94 

Third Quarter

 $3.52  $2.55  $1.27  $0.71 

Third Quarter

 $2.51  $1.47 

Fourth Quarter

 $2.19  $1.29 

Fourth Quarter

 $3.20  $2.16  $0.87  $0.45 

Fourth Quarter

 $3.00  $1.79 

 

Holders

 

As of March 29, 2017,31, 2023, we had approximately 130approximately 99 stockholders of record of our common stock. We believe that we have approximately 1,737 beneficialapproximately 3,911 beneficial owners of our common stock.

 

Dividends

 

The holders of common stock are entitled to receive such dividends as may be declared by Milestone Scientific’s Board of Directors. Milestone Scientific has not paid and does not expect to declare or pay any dividends in the foreseeable future.

For information regarding securities authorized under the equity compensation plan, see Item 12.

 

Sales of Unregistered Securities

 

See NOTE J – STOCKHOLDERS’ EQUITY, to the audited financial statements that accompany this Report for information regarding the issuance of unregistered securities. These issuances were exempt from registration pursuant to Section 4(a)(2) of the Securities Act of 1933, as amended (the "Act") and a legend restricting the sale, transfer, or other disposition of these shares other than in compliance with the Act was imprinted on stock certificates evidencing the shares.Not applicable.

 

ITEM 6. Selected Financial Data

 

MilestoneMilestone Scientific is a “smaller reporting company” as defined by Regulations S-K and as such, is not required to provide the information contained in this item pursuant to Regulation S-K.

 


ITEM 7. Management’ss Discussion and Analysis of Financial conditionCondition and Results of Operations

 

The following discussions of the financial condition and results of operations should be read in conjunction with the financial statements and the notes to those statements included elsewhere in this annual report. Certain statements in this discussion and elsewhere in this report constitute forward-looking statements, within the meaning of section 21E of the Exchange Act, that involve risks and uncertainties. The actual results may differ materially from those anticipated in these forward-looking statements. See "Risk Factors" elsewhere in this Form 10-K.

 

OVERVIEW

 

Milestone Scientific is a biomedical technology research and development company that patents, designs, develops and commercializes innovative diagnostic and therapeutic injection technologies and devices for medical, dental and cosmetic use. Since our inception, we have engaged in pioneering proprietary, innovative, computer-controlled injection technologies, and solutions for the medical and dental markets. We believe our technologies are proven and well established. Our common stock was initially listed on the NYSE MKTAmerican on June 1, 2015, and trades under the symbol “MLSS”.

We have focused our resources on redefining the worldwide standard of care for injection techniques by making the experience more comfortable for the patient by reducing the anxiety and stress of receiving injections from the healthcare provider. Our computer-controlled injection devices make injections precise, efficient, and virtually painless.

Milestone Scientific has developed a proprietary, computer-controlled anesthetic delivery instrument, through the use of device, using The Wand®, a single use disposable handpiece. The instrumentdevice is marketed in dentistry under the trademark CompuDent®CompuDent®, and STA Single Tooth Anesthesia System®System® and in medicine under the trademark CompuMed®. CompuDent® is suitable for all dental procedures that require local anesthetic. Our proprietary CompuMed®DPS Dynamic Pressure Sensing technology® is suitable for many medical procedures regularly performed in plastic surgery, hair restoration surgery, podiatry, colorectal surgery, dermatology, orthopedicsour technology platform that advances the development of next-generation devices. It regulates flow rate and a number of other disciplines. The dental instruments are sold inmonitoring pressure from the United States and in over 47 countries abroad. There have been no medical instruments sold in the United States and limited amounts sold internationally astip of the reporting date, although certainneedle, through platform extensions for local anesthesia for subcutaneous drug delivery, used in various dental and medical instruments have obtained CE mark approvalinjections. It has specific medical applications for epidural space identification in regional anesthesia procedures and now can be marketed and sold in most European countries. Milestone Scientific’s products are manufactured by a third-party contract manufacturer.intra-articular joint injections.

 

In 2016, Milestone Scientific remainedremains focused on advancing efforts to achieve ourthe following three primary objectives; those being:objectives:

Establishing Milestone’s DPS Dynamic Pressure Sensing technology platform as the standard-of-care in painless and precise drug delivery, providing for the first time, objective visual and audible in-tissue pressure feedback, and continuing to expand platform applications;

Following obtaining successful FDA clearance of our first medical device, Milestone Scientific is transitioning from a research and development organization to a commercially focused medical device company; and

Expanding our global footprint of our CompuFlo Epidural and CathCheck System by utilizing a targeted field sales force and partnering with distribution companies worldwide.

Because of combining the ability to regulate the flow rate and monitor pressure at the tip of the needle, Milestone Scientific developed the industry’s first solution for painlessly administering an intra-ligamentary injection, i.e., “single-tooth anesthesia” which could be used as the only injection necessary for achieving dental anesthesia, foregoing the need to administer traditional injections such as a nerve branch block. In addition to single-tooth anesthesia,the STA System can effectively perform all the traditional injections that dentists routinely give but can provide them virtually pain free and with numerous clinical advantages. This device, which also utilizes a disposable handpiece, is currently marketed by Milestone Scientific as the WandSTA® System. 

 

        ObtainingOur dental devices have been used to administer tens of millions of injections worldwide. Each of our devices has a related single use disposable handpiece, leading to a continuing revenue stream following sale of the 510(k) marketingdevice. At present, we sell disposable handpieces unique to our legacy product (the Wand and CompuDent) to users who have not upgraded to our current dental product, the WandSTA System. 

Building on the success of our proprietary, core technology platform for dental injections, and desiring to pursue other growth opportunities, we have recently begun to expand the uses and applications of our proprietary, patented technologies to achieve greater operational efficiencies, enhanced patient safety and therapeutic adherence, patient satisfaction, and improved quality of care across a broad range of medical specialties. In June 2017, we received FDA regulatory clearance withto sell the CompuFlo Epidural Computer Controlled Anesthesia System in the United States Foodfor certain medical applications. We intend to continue to expand the uses and Drug Administration ("FDA") forapplications of our DPS Dynamic Pressure Sensing technology. We believe that we and our technology solutions are widely recognized by key opinion leaders (i.e., academics, anesthesiologists and practicing dentists whose opinions are widely respected), industry experts and medical and dental practitioners as a leader in the epidural and intra articular instruments.emerging, computer-controlled injection industry.

 

        Enhancing our global reach by partnering with distribution companies in the medical sector; and

24

 

        Optimizing our tactical approach to product sales and marketing in order to materially increase penetration of the global dental and medical markets with our proprietary, patented Computer-Controlled Local Anesthesia Delivery (C-CLAD) solution, the Wand/STA Single Tooth Anesthesia System® Instrument (STA Instrument). 

STA Instrument GrowthDental Product

 

Since its market introduction in early 2007, the Wand STA InstrumentSystem and prior C-CLAD productsdevices have been used to deliver over 6680 million safe, effective, and comfortable injections. The instrument has also been favorably evaluated in numerous peer-reviewed, published clinical studies and associated articles. Moreover, there appears to be a growing consensus among users that the STA Instrument is proving to be a valuable and beneficial instrument that is positively impacting the practice of dentistry worldwide.

 

Global Distribution NetworkMedical Market Product

 

United States and Canadian Market

Beginning January 1,During 2016, Milestone Scientific entered into a non-exclusive distribution agreementfiled for 510(k) marketing clearance with Henry Schein, Inc. (“Henry Schein”). In June 2016, that agreement was replaced with an exclusive distribution arrangement for our dental products for the United States and Canada with Henry Schein. Under this arrangement we, for the first time, have a semi-dedicated independent sales force visiting dentists. We believe that this arrangement will be more effective than previous arrangements relying on appearances at dental shows and catalog sales.


To date, Henry Schein has endeavored to accomplish the goals set forth in the exclusive distribution agreement forThe Wand® STA instrument and handpieces, including training of its exclusive products sales specialists. Specifically, 25 exclusive product sales specialists have now been fully trained as experts in the features, advantages and benefits of The Wand® STA instrument and handpieces and all 25 are currently in the field selling the instrument. Henry Schein also plans to train an additional two to three dedicated customer service representatives to support dentists across North America through its exclusive product sales customer call center.  

Henry Schein’s exclusive products sales specialist team, which is comprised of 25 products sales specialists and supported by over 1,000 field service representatives, will exclusively market and distribute The Wand® STA instrument and handpieces, together with a select group of other devices in the United States and Canada. Our agreement with Henry Schein has minimum purchase order requirements to maintain exclusivity in the third through tenth year of the term of the agreement. 

International Market

On the global front, we also have granted exclusive marketing and distribution rights for the STA Instrument to select dental suppliers in various international regions in Asia, Africa, South America and Europe. They include Istrodent in South Africa and Unident in the Scandinavian countries of Denmark, Sweden, Norway and Iceland.

In October 2012, the StateU.S. Food and Drug Administration (CFDA) of(FDA) for both intra-articular and epidural injections with the People’s Republic of China approved our STA Single Tooth Anesthesia System® (STA System).CompuFlo Epidural System.  In May 2014,June 2017, the CFDA alsoFDA approved the STA handpiecesCompuFlo Epidural System for sale in China.

In September 2014, Milestone Medical received CE clearance to distribute their epidural and intra-articular instruments in European Community (EU). Milestone Medical is actively pursuing distributors for the instrument in the EU community. Milestone Medical signed a distribution agreement in March 2015 with a medical distributor in Poland for the distribution of the epidural instrument. This distribution agreement was terminated in late 2016 due to the distributor’s inadequate performance under the distribution agreement.injections.

In June 2014, Milestone Scientific invested $1 million in Milestone China Ltd. (“Milestone China”) by contributing 772 STA Instruments to Milestone China for a 40% ownership interest. Milestone Scientific recorded this investment under the equity method of accounting. Since September 2014, we have an established exclusive distribution arrangement with Milestone China for the distribution of the STA Instrument in China, which has led to the placement of our dental instruments in clinics serving major cities in China. Milestone China purchases STA Instruments from us for cash as required. We believe that Milestone China will make a positive impact on the dental and future medical business opportunities in China and other parts of Asia.

In China, where the dental market lags behind other health care services and has largely been neglected in the past, a CS Market Research report indicates that 50% of adults and 70% of children out of China’s estimated 1.3 billion plus population have tooth decay problems and over 90% have periodontal disease. (See Shuyu Sun & Seth Pierrepont. The Dental Equipment Market Over in China, CS Market Research(Sept. 20, 2005) andOpportunities Abound for Dental Care in China,CHINA BRIEFING (February 27, 2015)). With increasing affluence and increasing attention towards personal care, the provision of dental services has been growing rapidly. We expect this will lead to both increased sales of dental instruments and our single-use handpieces.


 

The following table shows a breakdown of Milestone Scientific’sScientific’s product sales (net), domestically and internationally, by product category, and the percentage of product sales (net) by eachbusiness segment product category:

 

  

Years Ended December 31,

 
  

2016

  

2015

 

DOMESTIC

                

Instruments

 $852,148   27.5% $623,195   17.8%

Handpieces

  2,102,394   67.9%  2,799,785   79.8%

Other

  143,762   4.6%  83,362   2.4%

Total Domestic

 $3,098,304   100.0% $3,506,342   100.0%

INTERNATIONAL

                

Instruments

 $3,264,633   44.2% $2,062,556   34.5%

Handpieces

  4,063,811   55.1%  3,836,002   64.1%

Other

  55,257   0.7%  86,669   1.4%

Total International

 $7,383,701   100.0% $5,985,227   100.0%

DOMESTIC/INTERNATIONAL ANALYSIS

                

Domestic

 $3,098,304   29.6% $3,506,342   36.9%

International

 $7,383,701   70.4% $5,985,227   63.1%

Total Product Sales

 $10,482,005   100.0% $9,491,569   100.0%
  

For the Year Ended December 31, 2022

 

Domestic: US

 

Dental

  

Medical

  

Grand Total

 

Instruments

 $524,715  $7,500  $532,215 

Handpieces

  2,653,914   25,250   2,679,164 

Accessories

  78,493   -   78,493 

Grand Total

 $3,257,122  $32,750  $3,289,872 
             

International: Rest of World

 

Dental

  

Medical

  

Grand Total

 

Instruments

 $1,413,525  $-  $1,413,525 

Handpieces

  3,391,748   20,000   3,411,748 

Accessories

  60,797   -   60,797 

Grand Total

 $4,866,070  $20,000  $4,886,070 
             

International: China

 

Dental

  

Medical

  

Grand Total

 

Instruments

 $270,000  $-  $270,000 

Handpieces

  359,964   -   359,964 

Accessories

  -   -   - 

Grand Total

 $629,964  $-  $629,964 
             

Total Product Sales

 $

8,753,156

  $52,750  $8,805,906 

  

For the Year  Ended December 31, 2021

 

Domestic: US

 

Dental

  

Medical

  

Grand Total

 

Instruments

 $560,424  $-  $560,424 

Handpieces

  2,905,354   35,200   2,940,554 

Accessories

  69,271   1,300   70,571 

Grand Total

 $3,535,049  $36,500  $3,571,549 
             

International: Rest of World

 

Dental

  

Medical

  

Grand Total

 

Instruments

 $1,226,486  $70,000  $1,296,486 

Handpieces

  3,246,302   44,900   3,291,202 

Accessories

  46,546   800   47,346 

Grand Total

 $4,519,334  $115,700  $4,635,034 
             

International: China

 

Dental

  

Medical

  

Grand Total

 

Instruments

 $303,000  $-  $303,000 

Handpieces

  1,795,128   -   1,795,128 

Accessories

  -   -   - 

Grand Total

 $2,098,128  $-  $2,098,128 
             

Total Product Sales

 $10,152,511  $152,200  $10,304,711 

25

 

Milestone Scientific earned gross profit of 60% and 68% in the years ended December 31, 2016 and 2015, respectively. However, the revenues and related gross profits have not been sufficient to support overhead, new product introduction and research and development expenses. Although Milestone Scientific anticipates expending funds for research and development in 2017, these amounts will vary based on the operating results for each quarter.

In 2017, Milestone Scientific plans to support increased sales and marketing activity through our current distributors and through newly appointed distributors of the STA instruments and handpieces in the international market. In the United States and Canada, Milestone Scientific will continue the utilization of independent hygienists for training individual practitioners and group practices domestically, refined and directed advertising to dental professionals, continue to develop Key Opinion Leaders (KOL) and support and broaden our global distribution network.

Current Product Platform

 

See Item 1. Description of Business.

 


Summary of Critical Accounting Policies and Significant Judgments and Estimates

Milestone Scientific's discussion and analysis of the financial condition and results of operations is based upon its consolidated financial statements that have been prepared in accordance with accounting principles generally accepted in the United States ("GAAP") and include the accounts of its wholly-owned and majority-owned subsidiaries including, Wand Dental, Milestone Advanced Cosmetic and Milestone Medical. Milestone Education is a variable interest entity of which Milestone Scientific is the primary beneficiary and is consolidated into Milestone Scientific's financial statements. All significant, intra-entity transactions and balances have been eliminated in the consolidation.   

 

The preparation of these consolidated financial statements requires us to make estimates and judgments that affect the reported amounts of assets, liabilities, revenues and expenses, and related disclosure of contingent assets and liabilities.liabilities. On an on-going basis, Milestone Scientific evaluates its estimates, including those related to accounts receivable, inventories, stock-based compensation, and contingencies. Milestone Scientific bases its estimates on historical experience and on various other assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparentclear from other sources. Actual results may differ from those estimates under different assumptions or conditions.

 

While significant accounting policies are more fully described in Note BC to the consolidated financial statements included elsewhere in this report, Milestone Scientific believesbelieves that the following accounting policies and significant judgmentsjudgment and estimates are most critical in understanding and evaluating the reported financial results.

 

Principles of Consolidation

Milestone Scientific's discussion and analysis of the financial condition and results of operations is based upon its consolidated financial statements that have been prepared in accordance with accounting principles generally accepted in the United States ("GAAP") and include the accounts of Milestone Scientific and its wholly-owned and majority-owned subsidiaries including, Wand Dental, and Milestone Medical. All significant, intra-entity transactions and balances are eliminated in the consolidation. 

If Milestone Scientific determines that it has operating power and the obligation to absorb losses or receive benefits, Milestone Scientific consolidates the VIE as the primary beneficiary. Milestone Scientific’s involvement constitutes power that is most significant to the entity when it has unconstrained decision-making ability over key operational functions within the entity. Milestone Scientific has completed the VIE analysis relating to Milestone China and Anhui Maishida Medical Technology, Co. Ltd. (“Anhui”).

Milestone Scientific has determined that due to the loss of equity investment in Anhui, the company no longer has significant influence of Anhui and therefore Anhui is not a variable interest. Milestone Scientific has a variable interest in Milestone China, it considered the guidance in ASC 810, “Consolidation” as it relates to determining whether Milestone China is a VIE and, if so, identifying the primary beneficiary. Milestone Scientific would be considered the primary beneficiary of the VIE if it has both of the following characteristics:

Power Criterion: The power to direct the activities that most significantly impact the entity’s economic performance; and

Losses/Benefits Criterion: The obligation to absorb losses that could potentially be significant or the right to receive benefits that could potentially be significant to the VIE

Milestone Scientific does not have the ability to control the activities that most significantly impact Milestone China's economics and, therefore, the power criterion has not been met. Management placed the most weight on the relationship and significance of activities of Milestone China to the CEO of Milestone China who have the power to direct the activities that most significantly impact the economic performance of Milestone China. Management has concluded that Milestone Scientific is not the primary beneficiary under ASC 810. Accordingly, Milestone China has not been consolidated into the financial statements of Milestone Scientific and is accounted for under the equity method. See Note F.

Assessment of our Ability to Continue as a Going Concern

 

Our management has made various estimatesIn accordance with  (“ASC”) 205-40, “Presentation of Financial Statements – Going Concern”, the Company continually  evaluates whether there are conditions or events, considered in assessing ourthe aggregate, that raise substantial doubt about the Company's ability to continue as a going concern within one year after the date that the consolidated financial statements are issued. Milestone Scientific has incurred operating losses and negative cash flows from operating activities in virtually each year since its inception.

The Company has evaluated whether there are conditions or events, considered in the aggregate, that raise substantial doubt about the Company's ability to continue as a going concern within one year after the date that the consolidated financial statements are issued. Total operating losses since inception of $116.4 million.  The operating losses were $8.8 million and $7.4 million, for the reportyears ended December 31, 2022, and 2021, respectively. Management has prepared cashflow forecasts covering a period of 12 months from the date of our Friedman LLP's, our independent auditor's, report included in this Form 10-K.issuance of these financial statements. These estimatesforecasts include an increase inseveral revenue and operating expense assumptions which indicate that the revenues generated by Wand Dental as a result of the new distribution agreement with Henry Schein, an increase in the revenues generated by Milestone China, a reduction in our profit margins due to the nature of the distribution relationships with both Henry ScheinCompany’s current cash and Milestone China, and reduction our selling, general and administrative costs for one-time expenses incurred during 2016. Based on this assessment, management believes that our cash on hand, accounts receivable and the anticipated revenues from the dental business will beliquidity is sufficient to fund our business operationsfinance the operating requirements for at least the next 12 months. Management believes that the Company will have sufficient cash reserves to meet its anticipated obligations for at least the next twelve months from the filing date of this Form 10-K.report. Milestone Scientific is actively pursuing the generation of positive cash flows from operating activities through an increase in revenue from its dental business worldwide, the generation of revenue from its medical devices and disposables business in the United States and worldwide, and a reduction in operating expenses. However, the Company’s continued operations will depend on its ability to raise additional capital through various potential sources until it achieves profitability, if ever.

 

Accounts Receivable

26

 

Milestone Scientific sells a significant amount of its product on credit terms to its major distributors. Milestone Scientific estimates losses from the inability of its customers to make payments on amounts billed. A majority of credit sales are due within ninety days from invoicing. Milestone Scientific has not incurred any significant credit losses.

Inventories

 

Inventories principally consist of finished goods and component parts stated at the lower of cost (first-in, first-outfirst-out method) or market.net realizable value. Inventory quantities on hand are reviewed on a quarterly basis and a provision for excess and obsolete inventory is recorded if required based on past and expected future sales, potential technological obsolescence and product expiration requirement and regulations.


Impairment of Long-Lived Assets

 

Milestone Scientific reviews long-lived assets for impairment whenever events or circumstances (i.e. a triggering event) indicate that the carrying amounts may not be recoverable. The carrying value of the assets is evaluated in relation to the operating performance and future undiscounted cash flows of the underlying assets. Milestone Scientific adjusts the net book value of an underlying asset if its fair value is determined to be less than its net book value. There have been no impairment indicators or triggering events and therefore, no impairment reviews have been performed for the period ending December 31, 2016.Revenue Recognition

 

Revenue RecognitionThe Company recognizes revenue when its customer obtains control of promised goods or services, in an amount that reflects the consideration which the Company expects to receive in exchange for those goods or services. To perform revenue recognition  the Company performs the following five steps:

i.

identification of the promised goods or services in the contract;

ii.

determination of whether the promised goods or services are performance obligations including whether they are distinct in the context of the contract;

iii.

measurement of the transaction price, including the constraint on variable consideration;

iv.

allocation of the transaction price to the performance obligations based on estimated selling prices; and

v.

recognition of revenue when (or as) the Company satisfies each performance obligation. A performance obligation is a promise in a contract to transfer a distinct good or service to the customer and is the unit of account in ASC 606.

The Company derives its revenues from the sale of its products, primarily dental instruments, handpieces, and other related products. The Company sells its products through a global distribution network and that includes both exclusive and non-exclusive distribution agreements with related and third parties.

 

Revenue from product sales is recognized netupon transfer of discounts and allowancescontrol of a product to domestic distributors on thea customer, generally upon date of shipment for essentially all shipments, sinceshipment. For certain arrangements where the shipmentshipping terms are FOB warehouse. Milestone Scientific will recognize revenue on date of arrival of the goods at the customer's location, where shipments are FOB destination. Shipments to international distributors are FOB warehouse, thereforedestination, revenue is recognized upon the shipment of the goods. In all cases the price to the buyer is fixed and the collectability is reasonably assured. Further, Milestone Scientificdelivery. The Company has no obligation on theseproduct sales for any post installation, set-up, or maintenance, these being the responsibility of the buyer. Milestone Scientific's only obligation after sale is the normal commercial warranty against manufacturing defects if the alleged defective unit is returned within the warranty period. The instrument sales and hand piece sales are sold separately and not bundled and, as such, there are no multiple element assessments or determinations for revenue recognition.

 

Results of OperationsOperations.

 

The following table sets forth for the consolidated results of operations for the year ended December 31, 20162022 compared to 2015 as a percentage of revenues. In 2015, the consolidated statement of operations do not include in the revenue and expenses of Milestone Medical and Milestone Education both of which were previously equity investments until they were determined as of December 31, 2015 and January 1, 2016, respectively, to be variable interest entities for which Milestone Scientific is the primary beneficiary. The trends suggested by this table may not be indicative of future operating results:

  

Year Ended December 31,

 
  

2016

  

2015

 

Revenue

                

Product sales, net

 $10,482,005   100% $9,491,569   100%

Cost of products sold

  4,175,533   40%  3,048,260   32%

Gross profit

  6,306,472   60%  6,443,309   68%

Selling, general and administrative expenses

  11,549,961   110%  9,399,201   99%

Research and development expenses

  1,270,471   12%  100,856   1%

Total operating expenses

  12,820,432   122%  9,500,057   100%

Loss from operations

  (6,513,960)  (62)%  (3,056,748)  (32)%

Other (expenses)

  (5,088)  (0)%  (5,347)  (0)%

Interest expense

  1,285   0%  3,838   0%

Loss before provision for income tax and equity in net earnings of equity investments

  (6,517,763)  (62)%  (3,058,257)  (32)%

Provision for income tax

  19,101   0%  (36,157)  (0)%

Loss before equity in net earnings of equity investments

  (6,498,662)  (62)%  (3,094,414)  (33)%

Loss on earnings from Milestone Medical

  -   0%  (2,019,211)  (21)%

Income (Loss) on earnings from Education Joint Venture

  -   0%  (7,846)  (0)%

Loss on earnings from China Joint Venture

  (795,827)  (8)%  (418,432)  (4)%

Loss in equity investments

  (795,827)  (8)%  (2,445,489)  (26)%

Net Loss

  (7,294,489)  (70)%  (5,539,903)  (58)%

Net loss attributable to noncontrolling interests

  (1,347,982)  (13)%  (72,381)  (1)%

Net loss attributable to Milestone Scientific Inc.

 $(5,946,507)  (57)% $(5,467,522)  (58)%


Yearyear ended December 31, 20162021.

  

December 31, 2022

  

December 31, 2021

 

Operating results:

        

Product sales, net

 $8,805,906  $10,304,711 

Cost of products sold

  3,905,092   3,992,811 

Gross profit

  4,900,814   6,311,900 
         

Operating expenses:

        

Selling, general and administrative expenses

  12,514,323   12,738,362 

Research and development expenses

  1,150,209   878,210 

Depreciation and amortization expense

  63,755   73,836 

Total operating expenses

  13,728,287   13,690,408 

Loss from operations

  (8,827,473)   (7,378,508)

Other income, and interest expense net

  54,607   502,076 

Net loss

  (8,772,866)  (6,876,432)

Net loss attributable to noncontrolling interests

  66,735   58,115 

Net loss attributable to Milestone Scientific Inc.

  (8,706,131) $(6,818,317)

Cash flow:

 

December 31, 2022

  

December 31, 2021

 

Net cash used in operating activities

 (6,031,996)  (4,033,664) 

Net cash used in investing activities

 (8,527)  (15,189) 

Net cash (used in) provided by financing activities

 (8,544)  4,589,282 

27

Year endedDecember 31, 2022, compared to year ended December 31, 20152021.

 

Total revenuesNet sales for years ended December 31,2022, and 2021were as follows:

  

2022

  

2021

  

Change

 

Dental

 $8,753,156  $10,152,511  $(1,399,355)

Medical

  52,750   152,200  $(99,450)

Total sales, net

 $8,805,906  $10,304,711  $(1,498,805)

Consolidated revenue for the twelve monthsyears ended December 31, 20162022, and 2015, principally dental revenues, were2021 was approximately $10.5$8.8 million and $9.4$10.3 million, respectively. Dental revenue for the years ended December 31, 2022 and 2021 was approximately $8.8 million and $10.1 million, respectively.  The totaldecrease in Dental revenue increased by approximately $1 million or 10%, which was principally related to the increase in instrument and handpiece sales to China.

Domestic sales decreased by approximately $408,000 in 2016. In the fourth quarter of 2016, Henry Schein did not purchase instruments and handpieces as they continued to introduce our instrument to the market and sell down their existing inventory. International sales in 2016 increased by  approximately $1.4 million overfor the same periodyear ended December 31, 2022, as compared to 2021 was driven by lower revenue from China of approximately $1.5 million and a decrease in 2015 principallydomestic revenue of approximately $278,000 of which $179,000 related to an allowance for sales returns from Henry Schein due to a shipmentthe termination of STA Instruments and handpiecesthe distribution agreement. Dental international revenue increased approximately $347,000 compared to Milestone China. However, we believe that the June 2016 exclusive distribution agreement with Henry Schein will lead to increased domestic sales in 2017 as the product and sales force training has been substantially completed as of December 31, 2016.2021. Medical revenue decreased approximately $100,000 for the year ended December 31, 2022 , as compared to December 31, 2021, which was primarily the result of changes to the Company’s near term commercial strategy.

 

Gross Profit for years ended December 31,2022 and 2021 were as follows:

  

2022

  

2021

  

Change

 

Dental

 $5,446,175  $6,223,051  $(776,876)

Medical

  (545,361)  88,849  $(634,210)

Total gross profit

 $4,900,814  $6,311,900  $(1,411,086)

Consolidated gross profit for the years ended December 31, 2022 and 2021 decreased approximately $1.4 million or 22%. The decrease was driven by an allowance of approximately $550,000 on slow moving Medical finished goods.  

Selling, general and administrative expenses for twelve monthsyears ended December 31, 20162022 and2021 were as follows:

  

2022

  

2021

  

Change

 

Dental

 $3,225,032  $2,946,108  $278,924 

Medical

  4,183,983   4,106,689   77,294 

Corporate

  5,105,308   5,685,565   (580,257)

Total selling, general and administrative expenses

 $12,514,323  $12,738,362  $(224,039)

Consolidated selling, general and administrative expenses for the years ended December 31, 2022 and 2021 were approximately $11.5$12.5 million versus $9.4and $12.7 million, in 2015.respectively. The increasedecrease of approximately $2.1 million$224,000 is predominantlycategorized in several areas. Employee salaries, and benefits expenses decreased approximately $886,000 during the year ended December 31, 2022 compared to the same period in 2021. The Company reduced director fees, bonuses, employee recruiting fees, and medical insurance for year ended December 31, 2022. The Company reduced marketing expense for the year ended December 31, 2022 by approximately $86,000 due to decreased trade show participation and decrease royalties expenses by approximately $4,000. The Company increased employee travel and professional fees by approximately $322,000 for the years ended December 31, 2022 compared to December 31, 2021 due to international commercial efforts. During year ended December 31, 2022 warehousing, and quality control expenses associated with quality assurance in connection with ISO certification and digitizing parts of our quality control increased approximately $379,000, and other selling, general and administrative expenses increased approximately $51,000 due to the consolidation of Milestone Medical commencing on December 31, 2015 which had $ 2.5 million in SG&A expenses in 2016 versus $ 3.0 million in SG&A expenses in 2015 which was included within Loss on Earnings from Milestone Medicaladditional professional services quality control required in the consolidated statement of operations. In 2015, Milestone Medical was accounted for under the equity method, until December 2015 when it was determined that Milestone Medical did not have sufficient capital at risk to support its activities without financial support from Milestone Scientificcompliance and therefore consolidated (See Note E to the consolidated financial statements).regulations

 

Research and Developmentfor years ended December 31,2022 and 2021 were as follows:

  

2022

  

2021

  

Change

 

Dental

 $1,095,523  $797,509  $298,014 

Medical

  54,686   80,701   (26,015)

Corporate

  -   -   - 

Total research and development

 $1,150,209  $878,210  $271,999 

Consolidated research and development expenses for the twelve monthsyears ended December 31, 20162022, and 20152021, were approximately $1.3$1.2 million and $100,000,$878,000, respectively. In 2015, Milestone Medical incurred $792,000 The increase of research and development expenses that were included in a single line item on loss on earning for Milestone Medical for reporting purposes. Giving the effectapproximately $272,000 is related to the Milestone Medical research development expenses on a consolidated basis in 2015,Company developing the comparable amount of researchnext generation to the STA Single Tooth Anesthesia System product line.

28

Profit (Loss) from Operationsfor years ended December 31,2022 and development cost would be $892,000.2021 were as follows:

  

2022

  

2021

  

Change

 

Dental

 $1,121,815  $2,475,059  $(1,353,244)

Medical

  (4,788,105)  (4,105,854)  (682,251)

Corporate

  (5,161,183)  (5,747,713)  586,530 

Total loss from operations

 $(8,827,473) $(7,378,508) $(1,448,965)

 

The loss from operations was approximately $8.8 million and $7.4 million for the twelve monthsyears ended December 31, 20162022 and 2015 was approximately $6.5 million and $3.1 million, respectively, an increase of approximately $3.4 million.2021, respectively.  The increase in the loss from operations was primarily driven the decrease in 2016 is primarily the result of the consolidation of Milestone Medical in 2016. 

The loss on earnings from the China Joint Venture was approximately $796,000 and $418,000 for the twelve months ended December 31, 2016 and 2015, respectively, an increase of approximately $378,000. The increase in loss on earnings from the China Joint Venture is primarily due to the China Joint Venture being in its initial operating and expansion cycle in China.gross profit.

 

Liquidity and Capital Resources

At December 31, 2016, Milestone Scientific had cash and cash equivalents of approximately $3.6 million, total current assets of approximately $12.7 million and working capital of approximately $7.7 million.  We believe that our cash on hand, accounts receivable and the anticipated revenues from the dental business will be sufficient to fund our business operations for at least the next 12 months from the filing date of this Form 10-K.

Milestone Scientific continues to take positive steps to maintain adequate inventory levels and advances on contracts to maintain available inventory to meet our domestic and international sales requirements. For the twelve months ended December 31, 2016 and 2015, we had negative cash flows from operating activities of approximately $5.4 million and $2.9 million, respectively.

 

Milestone Scientific has incurred annual operating losses and negative cash flows from operating activities since its inception, except for the year ended December 31, 2013.inception. Milestone Scientific is actively pursuing the generation of positive cash flows from operating activities through increasesan increase in revenues based upon management's assessment of present contracts,revenue from its dental business and current negotiationsthe medical business worldwide, and reductionsa reduction in operating expenses. On December 31, 2022, Milestone Scientific believes that clearance to commercialize its epiduralhad cash and intra-articular instruments will improve ourcash equivalents of approximately $8.7 million and working capital raising opportunitiesof approximately $9.7 million. Forthe years ended December 31, 2022 and financial condition.  Although there can be no assurances on the timing2021, we had cash flows used in operating activities of approximately $6.0 million and ultimate outcome, management believes that FDA clearance for Milestone Medical's 510(k) epidural application may occur by the end of the second quarter of 2017.$4.0 million, respectively

 


Milestone ScientificManagement believes that the June 2016 exclusive distribution agreementCompany has sufficient cash, along with Henry Schein will improve its dental revenues in 2017. To further reduce Milestone Scientific's expenditures, Milestone Medical is carefully managing expenses related to obtaining FDA clearance for the epiduralcurrent cash flow and intra-articular instruments. By limiting the FDA related expenses and increasingsupport from the dental instrument revenue throughbusiness to  mitigate the new distribution agreement and performing a cash flow projectionexpected selling expenditures for commercialization of the consolidated companyEpidural medical device, as well as other operating expenditures and its subsidiaries, management believes that Milestone Scientific will have resources to fund its operationsplanned new product development programs, over the next 12twelve months from the filing date of this Form 10-K.report.

 

Our consolidated balance sheet included in this report reflects an increase of approximately $890,000 in current assets from 2015 to 2016. This increase in current assets was primarily due to increases in the amount due from related party, deferred cost, and inventories of an aggregate of approximately $2.6 million, offset by decreases in cash and cash equivalents, accounts receivable and advances on contracts of approximately $1.8 million.

Current liabilities increased by approximately $1.4 million from approximately $3.7 million to approximately $5.0 million. The increase is primarily due to an increase in accounts payable and deferred revenue from a related party, as result of consolidating Milestone Medical at December 31, 2016.

In June 2016, we raised an additional $2.0 million of gross proceeds in a private placement of one million shares of common stock, at a price of $2.00 per share, to the same investors that participated in the May 2014 Financing.

In July 2016, Milestone Scientific raised gross proceeds of $250,000 in a registered direct offering of 104,200 shares of common stock at $2.40 per share. The transaction was covered by the prospectus supplement, filed with the SEC on July 22, 2016, to our shelf registration statement on Form S-3 (SEC File No.: 333-209466).

In December 2016, we completed an underwritten public offering of 2,000,000 shares of common stock and warrants to purchase up to 1,592,775 shares of common stock, including 92,775 additional warrants pursuant to a partial exercise of the over-allotment option granted to the underwriters.  Each share of common stock was sold in combination with a warrant to purchase 0.75 shares of common stock. The public offering price for each share and related warrant was $1.50. The warrants have a three-year term and an exercise price of $2.55 per share. In January 2017, the underwriter exercised a portion of its over-allotment option to purchase an additional 123,700 shares of common stock at the public offering price of $1.499 per share. The gross proceeds from this offering, including proceeds from partial exercises of the over-allotment option, were approximately $3.2 million, before deducting underwriting discounts and commissions and other offering expenses. This offering was covered by a prospectus supplement, filed with the SEC on December 16, 2016, to our shelf registration statement on Form S-3 (SEC File No.: 333-209466).

Off-Balance Sheet Arrangements

Milestone Scientific does not have any off-balance sheet arrangements that are currently material or reasonably likely to be material to the financial position or results of operations.


Contractual Obligations

 

The impact of the consolidated contractual obligations at December 31, 2016,2022, expected on the liquidity and cash flows in future periods, is as follows:

Payments Due by Period

 
  

Total

  

Less than 1 Year

  

1-3 Years

  

3-5 Years

 

Operating lease obligations

 $597,196  $141,518  $420,201  $35,477 
                 

Purchase obligations (1)

 $2,233,838  $2,233,838  $-  $- 
                 

Total

 $2,831,034  $2,375,356  $420,201  $35,477 

 

Payments Due by Period

 
  

Total

  

Less than
1 Year

  

1-3 Years

  

3-5 Years

 

Operating lease obligations

 $658,730  $163,965  $339,198  $155,567 
                 

Purchase obligations (1)

 $1.577,042  $1,409,162  $167,880  $- 
                 

Total

 $2,235,772  $1,573,127  $507,078  $155,567 

(1)    Purchase obligations include agreements for the purchase of dental devices, including purchase obligations entered into post year end, which will require payment in during the year ended 2023.

(1)

Purchase obligations include agreements for the purchase of instruments and handpieces.

 

Recent Accounting Pronouncements

 

See Note B“Note C - Summary of Significant Accounting Policies” to the consolidated financial statements for explanation of recent accounting pronouncements impacting Milestone Scientific.

 

Item 7A. Quantitative and QualitativeQualitative Disclosures about Market Risk

 

Milestone Scientific is a smaller“smaller reporting company” as defined by Regulation S-K and, as such, is not required to provide the information required by this item.

 

Item 8. FinancialFinancial Statements

 

The financial statements of Milestone Scientific required by this Item are set forth beginning on page F-1.

 

Item 9. Change in and Disagreements with AccountantsAccountants on Accounting and Financial Disclosure

 

None.

 

29

Item 9A. Controls and Procedures

 

Milestone Scientific’s Chief Executive OfficerEvaluation of Disclosure Controls and Chief Financial Officer have evaluated the effectiveness of the design and operation of Milestone Scientific’sProcedure

We maintain disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) as of the end of the period covered by this report. Based upon that evaluation, Milestone Scientific’s Chief Executive Officer and Chief Financial Officer have concluded that the disclosure controls and procedures as of December 31, 2016 are effectivedesigned to ensure that the information we are required to be discloseddisclose in the reports Milestone Scientific filesthat we file or submitssubmit under the Exchange Act is recorded, processed, summarized and reported within the time periods specified inunder the SEC’s rules and forms of the SEC. Disclosure controls and procedures include, without limitation, controls and procedures designed to ensure that such information is accumulated and communicated to Milestone Scientific'sour management, including theour Chief Executive Officer, and Chief Financial Officer as appropriate to allow timely decisions regarding required disclosure.disclosures. As required by paragraph (b) of Rules 13a-15 and 15d-15 under the Exchange Act, our Chief Executive Officer, and Chief Financial Officer carried out an evaluation of the effectiveness of the design and operation of our disclosure controls and procedures as of December 31, 2022. Based on this evaluation, our Chief Executive Officer, and Chief Financial Officer concluded that our disclosure controls and procedures (as defined in paragraph (e) of Rules 13a-15 and 15d-15 under the Exchange Act) were effective at December 31, 2022. 

 


Management’ss Annual Report on Internal Control over Financial Reporting

 

Milestone Scientific managementManagement is responsible for establishing and maintaining internal controls over financial reporting. The internal controls over financial reporting includes those policies and procedures that:

Pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets;

Provide reasonable assurance that transactions are recorded as necessary to permit preparation of the financial statements in accordance with generally accepted accounting principles in the United States, and that the receipts and expenditures are being made only in accordance with authorizations of the management and directors; and

Provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of the assets that could have a material effect on the financial statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate. All internal control instruments, no matter how well designed, have inherent limitations. Therefore, even those instruments determined to be effective can provide only reasonable assurance with respect to financial statement preparation and presentation. Because of the inherent limitations of internal control, there is a risk that material misstatements may not be prevented or detected on a timely basis by internal control over financial reporting. However, these inherent limitations are known features of the financial reporting process. Therefore, it is possible to design into the process safeguards to reduce, though not eliminate, this risk.

Milestone Scientific management assessed the effectiveness of itsadequate internal control over financial reporting, as such term is defined in Rule 13a-15(f) under the Exchange Act. Our management conducted an assessment of December 31, 2016. In making this assessment, management used the frameworkeffectiveness of our internal control over financial reporting based on the criteria set forth in Internal Control — Integrated“Internal Control-Integrated Framework (2013)” issued by the Committee of Sponsoring OrganizationsOrganization of the Treadway Commission (“COSO”) adopted in 2013.Commission. Based on thethis assessment, and the criteria set forth by COSO, management believesconcluded that, Milestone Scientific maintained effectiveas of December 31, 2022, our internal control over financial reporting as of December 31, 2016.was effective.

 

There have been no changesChanges in Milestone Scientific’s internal controlInternal Control over financial reporting identified in connection withFinancial Reporting

During the evaluation that occurred during Milestone Scientific’s last fiscal quarteryear ended December 31, 2016 that have materially affected, or that are reasonably likely to materially affect, Milestone Scientific’s internal controls over financial reporting.2022, the Company remediated the identified material weakness from December 31, 2021.

 

Item 9B. Other Information

None. 

Item 9C. Disclosure regarding Foreign Jurisdiction that Prevent inspections

 

None.

 


30

PARTPART III
 


The information required by Part III is omitted from this Annual Report because it will be included in our definitive proxy statement to be filed pursuant to Regulation 14A for our 2023 Annual Meeting of Stockholders, or the 2023 Proxy Statement, and such information is incorporated herein by reference.
 
Item 10.    Directors, Executive Officers, Promoters and Control Persons and CorporateGovernance; Compliance with Section 16 (a) of the Exchange Act.Act

Milestone Scientific’s directors are elected annually by the stockholders and serve for one-year terms until his/her successor is elected and qualified or until such director’s earlier death, resignation or removal.
 
The executive officers and key personnel are appointed by and serve at the pleasure of the Board of Directors.

The current executive officers and directors of Milestone Scientific and their respective ages as of March 31, 2017 are as follows: 

NAME

AGE

POSITION

DIRECTOR

SINCE

Leslie Bernhard (1) (2) (3)

72

Chairman of the Board and Director

2003

Leonard Osser

69

Chief Executive Officer and Director

1991

Joseph D'Agostino

65

Chief Financial Officer and Chief Operating Officer

 

Leonard Schiller (1) (2) (3)

76

Director

1997

Gian Domenico Trombetta

56

Director

2014

Edward J. Zelnick, M.D. (1) (3)

71

Director

2015

1.

Member of the Audit Committee

2.

Member of the Compensation Committee

3.

Member of the Nominating and Corporate Governance Committee

The following are the names of individuals who are not executive officers of Milestone Scientific but are deemed key personnel of Milestone Scientific, their respective ages and positions as of March 31, 2017:

NAME

AGE

POSITION

Eugene Casagrande, D.D.S.

73

Director of Professional Relations

Mark Hochman, D.D.S.

58

Director of Clinical Affairs

Leslie Bernhard, Chairman of the Board

Leslie Bernhard has been serving as Milestone Scientific’s non-executive Chairman of the Board since October 2009. In addition, Ms. Bernhard has also been serving as an Independent Director (as defined below) of Milestone Scientific since May 2003. Since 2007, Ms. Bernhard has also been serving as an independent director of Universal Power Group, Inc. (OTC Markets: UPGI), a global supplier of power solutions. In 1986 she co-founded AdStar, Inc., an electronic ad intake service to the newspaper industry, and served as its president, chief executive officer and executive director until 2012. Ms. Bernhard holds a BS Degree in Education from St. John’s University. Ms. Bernhard’s professional experience and background with AdStar and with us, as one of our directors since 2003, have given her the expertise needed to serve as Chairman of the Board.

Leonard Osser, Chief Executive Officer and Director

Leonard Osser has been Milestone Scientific’s Chief Executive Officer and a director since September 2009. Prior to that, he served as Milestone Scientific’s Chairman from 1991 until September of 2009, and during that time, from 1991 until 2007, was also Chief Executive Officer of Milestone Scientific. In September 2009, he resigned as Chairman of Milestone Scientific, but remained a director, and assumed the position of Chief Executive Officer. From 1980 until the consummation of Milestone Scientific’s public offering in November 1995, Mr. Osser was primarily engaged as the principal owner and Chief Executive Officer of U.S. Asian Consulting Group, Inc., a New Jersey-based provider of consulting services specializing in distressed or turnaround situations in both the public and private markets. Mr. Osser’s knowledge of our business and background with us since 1980 provides the Board with valuable leadership skills and insight into our business and accordingly, the expertise needed to serve as one of our directors.


Joseph D’Agostino, Chief Financial Officer and Chief Operating Officer

Joseph D'Agostino has been Milestone Scientific's Chief Financial Officer since October 2008 and Chief Operating Officer since September 2011. Mr. D'Agostino joined Milestone Scientific in January 2008 as Acting CFO and has over 25 years of finance and accounting experience serving both publicly and privately held companies. A results-oriented and decisive leader, he has specific proven expertise in treasury and cash management, strategic planning, information technology, internal controls, Sarbanes-Oxley compliance, operations and financial and tax accounting. Mr. D'Agostino served as Senior Vice President and Treasurer of Summit Global Logistics, a publicly traded, full service international freight forwarder and customs broker with operationsrequired under this item will be contained in the United States2023 Proxy Statement and China. Previous executive posts also includedis hereby incorporated by reference.
 
Item 11.    Executive Vice President and CFO of Haynes Security, Inc., a leading electronic and manned security solutions company serving government agencies and commercial enterprises; Executive Vice President of Finance and Administration for Casio, Inc., the U.S. subsidiary of Casio Computer Co., Ltd., a leading manufacturer of consumer electronics with subsidiaries throughout the world; and Manager of Accounting and Auditing for Main Hurdman's National Office in New York City (merged into KPMG). Mr. D'Agostino is a Certified Public Accountant and holds membershipsCompensation
 
The information required under this item will be contained
in the American Institute of CPA's, New Jersey Society of CPA's, Financial Executive Institute, He is a graduate of William Paterson University where he earned a Bachelor of Arts degree in Science.

Leonard M. Schiller, Director

Leonard Schiller has been a director of Milestone Scientific since April 1997. Mr. Schiller has been a partner in the Chicago law firm of Schiller Strauss & Lavin PC since 1977 and since 2002, its President. Mr. Schiller also serves as a director on the boards of Jerrick Media Holdings, Inc. (OTCQB: JMDA), a public media company, since February 2016 and Point Capital, Inc. (OTCQB: PTCI), a business development company, since July 2014. Mr. Schiller’s professional experience and background have given him the expertise needed to serve as one of our directors.

Gian Domenico Trombetta, Director

Gian Domenico Trombetta has been a director of Milestone Scientific in May 2014 and the President and Chief Executive Officer of Milestone Scientific’s Dental Division (Wand Dental Inc.) since October 2014. He founded Innovest S.p.A in 1993, a special situation firm acting in development and distressed capital investments. He has been its President and Chief Executive Officer since its inception. He served as the Chief Executive Officer or a board member of several private commercial companies in different industries including both industrial (e.g. IT, media, web, and fashion) and holding companies. Before founding Innovest, Mr. Trombetta was Project Manager for Booz Allen & Hamilton Inc., a management consulting firm from 1988 to 1992. Mr. Trombetta holds a degree in business administration from the Luiss University in Rome, Italy and a MBA degree from INSEAD-Fontainbleau-France. Mr. Trombetta’s business background and experience has given him the expertise needed to serve as one of our directors.

Edward J. Zelnick, M.D., Director

Edward J. Zelnick, M.D. has been a director of Milestone Scientific since February 2015. Dr. Zelnick has been a medical doctor for over 45 years and has a background in clinical research. Since June 2002 he has been the chief executive officer of Horizon Institute for Clinical Research, a company that recruits test subjects and clinicians for clinical research trials. Dr. Zelnick received a Bachelor of Science degree in chemistry from the University of Pittsburgh in 1966 and his M.D. degree from New York Medical College in 1970. Dr. Zelnick's professional experience and background as a medical doctor and in clinical research, have given him the expertise needed to serve as one of our directors.

Mark Hochman, D.D.S., Director of Clinical Affairs

Mark Hochman, D.D.S. has served as Milestone Scientific’s Director of Clinical Affairs and Director of Research and Development since 1999. He has a Doctorate of Dental Surgery with advanced training in the specialties of Periodontics and Orthodontics from New York University of Dentistry and has been practicing dentistry since 1984. He is a former clinical associate professor at NYU School of Dental Surgery. Recognized as a world authority on Advanced Drug Delivery Instruments, Dr. Hochman has published numerous articles in this area, and shares in the responsibility for inventing much of the technology currently available from Milestone Scientific.


Dr. Eugene Casagrande, Director of International & Professional Relations

Since 1998, Eugene Casagrande, D.D.S. has served as Director of International and Professional Relations, charged with pursuing a broad range of clinical and industry-related strategic business opportunities for Milestone Scientific. Dr. Eugene R. Casagrande has practiced Cosmetic and Restorative Dentistry for over 30 years in Los Angeles.  He is past president of the California State Board of Dentistry and the Los Angeles Dental Society2023 Proxy Statement and is a Fellow of the American and International Colleges of Dentists.  Dr. Casagrande was a member of the faculty of the University of Southern California, School of Dentistry.  He was also the Executive Director of the Los Angeles Oral Health Foundation and the Program Director of the Los Angeles Pediatric Oral Health Access Program.  As the Director of International & Professional Relations for Milestone Scientific for over 19 years, he has published multiple articles and has lectured both nationally and internationally at over 100 dental schools and in over 50 countries on Computer-Controlled Local Anesthesia. 

Director Independence and Committees of the Board

The Board has determined that Leonard M. Schiller, Leslie Bernhard and Edward J. Zelnick, M.D. (the “Independent Directors”) are independent as that term is defined in the listing standards of the NYSE MKT. As disclosed above, Leslie Bernhard, Edward J. Zelnick, M..D. and Leonard M. Schiller are members of the Audit Committee and Nominating Committee and are independent for such purposes. Leonard M. Schiller and Leslie Bernhard are members of the Compensation Committee and are independent for such purposes.

In determining director independence, the Board considered the stock awards to the Independent Directors for the year ended December 31, 2016, disclosed in “Item 11 – Executive Compensation – Director Compensation” above, and determined that such awards were compensation for services rendered to the Board and therefore did not impact their ability to continue to serve as Independent Directors.

Milestone Scientific’s Board of Directors has established a compensation, audit and nominating and corporate governance committees (respectively, “Compensation Committee,” “Audit Committee,” and “Nominating Committee”.) The Compensation Committee reviews and recommends to the Board of Directors the compensation and benefits of all the officers of Milestone Scientific, reviews general policy matters relating to compensation and benefits of employees of Milestone Scientific, and administers the issuance of stock options to Milestone Scientific’s officers, employees, directors and consultants. All compensation arrangements between Milestone Scientific and its directors, officers and affiliates are reviewedhereby incorporated by the Compensation Committee. The Audit Committee meets with management and Milestone Scientific’s independent auditors to determine the adequacy of internal controls and other financial reporting matters; all of the members are independent directors. The Board of Directors has determined that Leslie Bernhard qualifies as an Audit Committee Financial Expert pursuant to Item 407(d)(5) of Regulation S-K. Ms. Bernhard is independent, as that term is defined in the listing standards of the NYSE MKT.

The Nominating Committee has dual responsibilities. The Nominating Committee will assist the board by identify and recommending individuals qualified to become member of the board. Additionally, the committee will evaluate the size and composition of the board and its members, reviewing governance issues and making recommendations to the board regarding possible changes and reviewing and monitoring compliance with the code of ethics and insider trading policy.

Section 16(a) Beneficial Ownership Reporting Compliance

Section 16(a) of the Securities Exchange Act of 1934 requires our officers and directors, and persons who own more than ten percent of a registered class of our equity securities, to file reports of ownership and changes in ownership with the SEC. Officers, directors and greater than ten-percent stockholders are required by SEC regulation to furnish us with copies of all Section 16(a) forms they file. Based solely on review of the copies of such forms furnished to us, or written representations that no Forms 5 were required, we believe that all Section 16(a) filing requirements applicable to our officers and director were complied with during the fiscal year ended December 31, 2016.


Code of Ethics

Milestone Scientific has adopted a code of ethics that applies to its directors, principal executive officer, principal financial officer and other persons performing similar functions. This code of ethics is filed herewith as an exhibit to this annual report and is posted on Milestone Scientific’s web site at www.milestonescientific.com. Milestone Scientific will also provide a copy of the Code of Ethics to any person without charge, upon written request addressed to the Chief Financial Officer, Joseph D’Agostino at the principal executive office, located at 220 South Orange Avenue, Livingston, NJ 07039.

reference.
 
Item 11. Executive Compensation.

The following Summary Compensation Table sets forth all compensation earned, in all capacities, during the fiscal years ended December 31, 2016 and 2015 by Milestone Scientific’s (i) CEO and (ii) two most highly compensated executive officers other than the CEO who was serving as an executive officer at the end of the 2016 fiscal year and whose salary as determined by Regulation S-K, Item 402, exceeded $100,000 (the individuals falling within categories (i) and (ii) are collectively referred to as the “Named Executive Officers”).

SUMMARY COMPENSATION TABLE

Name and Principal Position

Year

 

Salary

  

Bonuses

   

Option Awards (2)

  

Other Compensation

   

Total

 

Leonard A. Osser

                       

Chief Executive Officer

2016

 $300,000  $400,000 (1) $442,019  $238,030 (1) $1,380,049 
 

2015

 $300,000  $400,000 (1) $101,245  $236,267 (1) $1,037,512 

Gian Domenico Trombetta

                       

Chief Executive Officer - Wand Dental Inc

2016

 $279,999  $160,000 (4) $221,743  $-   $661,742 
 

2015

 $340,000  $80,000 (4) $161,992  $-   $581,992 

Joseph D'Agostino

                    $- 

Chief Financial Officer

2016

 $171,600  $80,000 (4) $222,344  $35,144 (3) $509,088 
 

2015

 $171,600  $114,500 (4) $174,413  $44,996 (3) $505,509 

1.      Recognition of $400,000 of bonuses for the years ended December 31, 2016 and 2015, respectively, of which $150,000 in 2016 and $200,000 in 2015, were deferred and will be paid in common stock upon the termination of his employment with Milestone Scientific in accordance with the terms of his employment agreement. In accordance with Mr. Osser's employment agreement, one half of his annual bonus is paid in cash and one half in common stock. Other compensation represents payments made for health insurance coverage, pension plan, and car allowance.

2.      The amounts in this column reflect the fair value of the options on the date of grant. For details used in the assumption calculating the fair value of the option reward, see Note B to the Financial Statements for the year ended December 31, 2016 and 2015, which is located on pages F-9 through F-14 of this Report. Compensation cost is generally recognized over the vesting period of the award. See the table below entitled Outstanding Equity Awards at December 31, 2016.

3.      Other compensation represents payments made for health insurance coverage and car allowance.

4.      One half of the bonus for 2016 was deferred and will be paid in common stock upon the termination of their employment from Milestone Scientific. The 2015 bonuses were deferred in full and will be paid common stock upon the termination of their employment from Milestone Scientific.


Employment Contracts

As of September 1, 2009, Milestone Scientific entered into a five-year employment agreement with Leonard Osser as its chief executive officer (CEO). The term of the 2009 agreement is automatically extended for successive one-year periods unless prior to August 1 of any year, either party notifies the other that he or it chooses not to extend the term. Under the 2009 agreement, the CEO receives base compensation of $300,000 per year. In addition, the CEO, may earn annual bonuses up to an aggregate of $400,000, payable one half in cash and one half in common stock, contingent upon achieving targets set for each year by the Compensation. In addition, if in any year of the term of the agreement the CEO earns a bonus, he shall also be granted five-year stock options to purchase twice the number of bonus shares earned. Each such option is to be exercisable at a price per share equal to the fair market value of a share on the date of grant (110%) of the fair market value if the CEO is a 10% or greater stockholder on the date of grant). The options shall vest and become exercisable to the extent of one-third of the shares covered at the end of each of the first three years following the date of grant, but shall only be exercisable while the CEO is employed by Milestone Scientific or within 30 days after the termination of his employment.

In accordance with the employment contract, 855,810 shares of common stock are to be paid out at the end of the contract in settlement of $980,906 at December 31, 2016 and 776,862 shares of common stock are to be paid out at the end of the contract in settlement of $830,985 at December 31, 2015 of accrued deferred compensation and, accordingly, such shares have been classified in stockholders' equity with the common stock classified as to be issued.

The 2009 employment agreement suspended the previous 2008 employment with 40-months remaining in its term. In March 2014, the 2009 agreement was amended to extend its remaining term to 120-months.

On December 1, 2016, Wand Dental and Gian Domenico Trombetta entered into an Amended and Restated Employment Agreement, pursuant to which Mr. Trombetta receives base compensation of $280,000 per year and is eligible to receive annual bonuses in the sole discretion of the Compensation Committee. Pursuant to the agreement, Mr. Trombetta will continue to serve as the Chief Executive Officer of Wand Dental for a period of one-year beginning on September 1, 2016 through August 31, 2017; which term automatically renews for a one-year period, from September 1st through August 31st of each successive year, unless prior to June 1st of the then current term either party notifies the other that he or it chooses not to extend the term of employment in accordance with the terms of the agreement.

Objective of Executive Compensation Program

The primary objective of the executive compensation program is to attract and retain qualified, energetic managers who are enthusiastic about the mission and culture of Milestone Scientific. A further objective of the compensation program is to provide incentives and reward each manager for their contribution. In addition, Milestone Scientific strives to promote an ownership mentality among key leadership and the Board of Directors.

The Compensation Committee reviews and approves, or in some cases recommends for the approval of the full Board of Directors, the annual compensation procedures for the Named Executive Officers.

The compensation program is designed to reward teamwork, as well as each manager’s individual contribution. In measuring the Named Executive Officers’ contribution, the Compensation Committee considers numerous factors including the growth, strategic business relationships and financial performance. Regarding most compensation matters, including executive and director compensation, the management provides recommendations to the Compensation Committee; however, the Compensation Committee does not delegate any of its functions to others in setting compensation. Milestone Scientific does not currently engage any consultant to advice on executive and/or director compensation matters.

Stock price performance has not been a factor in determining annual compensation because the price of Milestone Scientific’s common stock is subject to a variety of factors outside of Milestone Scientific’s control. Milestone Scientific does not have an exact formula for allocating between cash and non-cash compensation.


Annual CEO compensation consists of a base salary component and periodic stock option grants. It is the Compensation Committee’s intention to set totals for the CEO for cash compensation sufficiently high enough to attract and retain a strong motivated leadership team, but not so high that it creates a negative perception with the other stakeholders. The CEO receives stock option grants under the stock option plan. The number of stock options granted to the executive officer is made on a discretionary rather than a formula basis by the Compensation Committee. The CEO’s current and prior compensation is considered in setting future compensation. In addition, Milestone Scientific reviews the compensation practices of 28 other companies. To some extent, the compensation plan is based on the market and the companies that compete for executive management. The elements of the plan (e.g., base salary, bonus and stock options) are similar to the elements used by many companies. The exact base pay, stock option grant, and bonus amounts are chosen in an attempt to balance the competing objectives of fairness to all stakeholders and attracting and retaining executive managers.

Outstanding Equity Awards at December 31, 2016

The following table includes certain information with respect to all unexercised stock options and unvested shares of common stock of Milestone Scientific outstanding owned by the Named Executive Officers at December 31, 2016.

  

Options Awards

 

Stock Awards

 

Name

 

Number of Securities Underlying Unexercised Options (#) Exercisable (1)

  

Number of Securities Underlying Unexercised Options (#) Unexercisable (1)

  

Option Exercise Price ($)

 

Option Expiration Date

 

Number of Shares or Units of Stock that have not vested (#) (2)

  

Market Value of Number of Shares or Units of Stock that have not vested ($) (3)

 

Leonard Osser

  73,333   -  $1.49 

11/20/2019

  855,809  $1,198,133 
   248,448   -  $1.65 

12/31/2018

        
   83,333      $0.75 

1/9/2017

        
   144,033   41,152  $2.38 

11/20/2019

        
   31,836   25,470  $3.49 

6/20/2020

        
   27,663   55,325  $1.89 

2/4/2021

        
   57,143   114,286  $1.93 

11/10/2021

        

Total

  665,789   236,233        855,809  $1,198,133 

Gian Domenico Trombetta

  44,260   88,520  $1.89 

2/4/2021

  66,390  $92,946 

Total

  44,260   88,520        66,390  $92,946 

Joseph D'Agostino

  116,520   33,334  $2.09 

11/11/2019

  166,201  $232,681 
   38,315   10,947  $2.03 

11/20/2019

        
   66,666   -  $1.50 

12/31/2018

        
   78,126   -  $1.28 

12/31/2017

        
   44,380   44,380  $1.72 

2/4/2021

        

Total

  344,154   88,661        166,201  $232,681 

1.

Represents stock option grants at fair market value on the date of grant.

2.

Issuance of the shares of common stock has been deferred until the termination of his employment with Milestone Scientific in accordance with the terms of his respective employment arrangement.

3.

Based on the closing price per share of $1.40 as reported on the NYSE MKT on December 31, 2016.


Director Compensation

NAME

 

Fees Earned or Paid in

Cash ($)

  

Total ($)

 

Leslie Bernhard

 $36,000  $36,000 

Leonard Schiller

 $36,000  $36,000 

Edward J. Zelnick, M.D.

 $33,000  $33,000 

Item 12.    Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Stockholders Matters

The following table, together with the accompanying footnotes, sets forth information, as of March 31, 2017, regarding stock ownership of all persons known by Milestone Scientific to own beneficially more than 5% of Milestone Scientific’s outstanding common stock, Named Executives, all directors, and all directors and officers of Milestone Scientific as a group:

Names of Beneficial Owner (1)

 

Shares of Common
Stock Beneficially
Owned (2)

   

Percentage of
Ownership

 

Executive Officers and Directors

         

Leonard Osser

  3,777,118 (3)  11.77%

Joseph D'Agostino

  1,625,465 (4)  5.21%

Leslie Bernhard

  -    0.00%

Leonard Schiller

  185,158 (5)  *%

Edward J. Zelnick, M.D.

  8,750 (6)  *%

Gian Domenico Trombetta

  6,176,558 (7)  18.29%

All directors & executive officers as group (6 persons)

  11,773,049 (8)  32.84%

K. Tucker Andersen

  3,241,050    10.59%

Tom Cheng

  1,562,599    5.11%

Debra Ginsberg

  1,605,000 (9)  5.25%

* Less than 1%

         

1.      The addresses of the persons named in this table are as follows: Leonard Osser, Joseph D'Agostino, Gian Domenico Trombetta, Leslie Bernhard and Edward Zelnick, M.D. are at 220 South Orange Avenue in, New Jersey 07039; Leonard M. Schiller, c/o Schiller, Klein & McElroy, P.C., 33 North Dearborn Street, Suite 1030, Chicago, Illinois 60602; K. Tucker Andersen, c/o Above All Advisors, 61 Above All Road, Warren, CT 06754, Tom Cheng, c/o United Systems 18725 E. Gale Ave Suite 221, City of Industry, CA 91748 and Debra Ginsberg, 5 Bay Ridge Road Key Largo FL 33037. 

2.      A person is deemed to be a beneficial owner of securities that can be acquired by such person within 60 days from March 31, 2017, as applicable, upon the exercise of options and warrants or conversion of convertible securities. Each beneficial owner's percentage ownership is determined by assuming that options, warrants and convertible securities that are held by such person (but not held by any other person) and that are exercisable or convertible within 60 days from March 31, 2017 have been exercised or converted. Except as otherwise indicated, and subject to applicable community property and similar laws, each of the persons named has sole voting and investment power with respect to the shares shown as beneficially owned. The percentages for each beneficial owner are determined based on dividing the number of shares of common stock beneficially owned by the sum of the outstanding shares of common stock on March 31, 2017 and the number of shares underlying options exercisable and convertible securities convertible within 60 days from March 31, 2017 held by the beneficial owner.

3.      Includes 2,293,706 shares held by Mr. Osser or his family, 886,865 shares to be issued at the termination of his employment agreement, and 596,547 shares subject to common stock options with the following per share exercise prices: 73,333 at $1.49, 230,044 at $1.65 and 130,315 at $2.38, 31,837 at $3.49, 51,533 at $1.89, 57,143 at $1.93 and 22,342 at $1.77. 


4.      Includes 1,044,117 shares held by Mr. D'Agostino, 191,046 shares to be issued at the termination of his employment, and 390,302 shares subject to common stock options with the following per share exercise prices: 78,126 shares at $1.28, 66,666 shares at $1.50; 116,666 shares at $2.09; 38,314 at $2.03, 73,967 at $1.72 and 16,563 shares at $1.61.

5.      Includes 179,533 shares held by Mr. Schiller and 5,625 shares subject to common stock warrants exercisable at $2.55 per share.

6.       Includes 5,000 shares held by Dr. Zelnick and 3,750 shares subject to common stock warrants exercisable at $2.55 per share.

7.      Includes 116,079 shares to be issued at the termination of his employment, 106,893 shares subject to common stock options with the following per share exercise prices: 73,767 at $ 1.89 and 33,126 at $1.61, and 5,953,586 shares held directly by BP4 S.r.l. ("BP4") of which 2,953,586 shares are issuable upon the conversion of $7 million of preferred stock at $2.37 per share, as adjusted to date. Innovest S.p.A. ("Innovest") is the controlling shareholder of BP4 and Mr. Trombetta is a controlling shareholder and director of Innovest, and, as such, is deemed to have voting and investment power over the securities held by BP4. Mr. Trombetta disclaims beneficial ownership of all securities held by BP4.

8.      Includes an aggregate of 1,103,117 shares of common stock underlying outstanding options, 1,193,990 shares of common stock issuable upon termination of employment and 2,953,586 shares of common stock issuable upon the conversion of $7 million of preferred stock at $2.37 per share.

9.
 
The information with respect to their 5% shareholder has been derived fromrequired under this item will be contained in the Schedule 13G files with the SEC on February 1, 2017, reporting beneficial ownership as of December 31, 2016.

Securities Authorized for Issuance under Equity Compensation Plans

Equity Compensation Plan Information

The following table summarizes, as of December 31, 2016, the (i) options granted under the Milestone Scientific 2004 Stock Option Plan (the “2004 Plan”)2023 Proxy Statement and (ii) options granted under the Milestone Scientific 2011 Equity Compensation Plan (f/k/a Milestone Scientific 2011 Stock Option Plan) (the “2011 Plan”). The shares coveredis hereby incorporated by outstanding options and warrants are subject to adjustment for changes in capitalization, stock splits, stock dividends and similar events. No other equity compensation has been issued.

Equity compensation plan approved by stockholders

 

Number of Securities to be issued upon exercise of outstanding options

  

Weighted-average exercise price of outstanding options

  

Number of securities remaining available for future issuance under equity compensation plan

 

Grants under our 2004 Stock Option Plan (1)

  73,333  $1.49   - 
             

Grants under our 2011 Stock Option Plan (2)

  1,663,661  $1.94   1,485,229 
             

Total

  1,736,994       1,485,229 

            (1)          The 2004 Plan, as amended, provided for awards of options up to a maximum 750,000 shares of Milestone Scientific's common stock and expired in July 2014. Options were granted to employees, officers, directors and consultants of Milestone Scientific for the purchase of common stock of Milestone Scientific at a price not less than the fair market value of the common stock on the date of the grant. In general, options awarded under the 2004 Plan became exercisable over a three-year period from the grant date and expire five years after the date of grant. No options were exercised in 2016.

            (2)          The 2011 Plan, as amended, provides for awards of restricted common stock and options to purchase up to a maximum 4,000,000 shares of common stock and expires in June 2021. Options may be granted to employees, directors and consultants of Milestone Scientific for the purchase of shares of common stock at a price not less than the fair market value of common stock on the date of grant. In general, options become exercisable over a three-year period from the grant date and expire five years after the date of grant. For the year ended December 31, 2016, 327,778 shares were exercised.


reference.
 
Item 13. Certain Relationships and Related Transactions, and DirectorIndependence.

In 2016, Milestone Scientific entered a three-year consulting agreement with K. Tucker Anderson to provide business Independence
 
The information required under this item will be contained in the 2023 Proxy Statement
and strategic services to Milestone Scientific. The fee for these services are $100,000 per year which is paid in shares of common stock on a quarterly basis, valued at the closing price per share of common stock on the last trading day of each quarter.

Tom Cheng, is a controlling shareholder of a major supplier of handpieces to Milestone Scientific. Milestone Scientific purchased $3,025,249 and $2,698,522 from this supplier for the years ended December 31, 2016 and 2015, respectively.

hereby incorporated by reference.
 
Item 14. Principal AccountingAccountant Fees and Services

Effective July 18, 2016, our Audit Committee engaged Friedman LLP (“Friedman”) to replace Baker Tilly Virchow Krause, LLP (“Baker Tilly”) as our new principal accounting firm.
 
The aggregate fees billed by our principal accounting firms for the years ended December 31, 2016 and 2015 are as follows:

 

 

2016

  

2015

 

Audit Fees and Audit Related fees

 $291,500 (1) $277,000 

Tax Fees

  30,000     

Total Fees

 $321,500  $277,000 

* Includes fees for professional services rendered for the audit of our annual financial statements and the review of financial statements included in our report on Form 10-Qs or services that are reasonably related to the performance of the audit or normally provided in connection with statutory and regulatory filings.

(1) The audit fees in 2016 includes $180,000 of fees incurred with Friedman and $93,500 of fees billed by Baker Tilly.

Audit Committee Pre-Approval Policies and Procedures

The Audit Committee charter provides that the Audit Committeeinformation required under this item will pre-approve audit services and non-audit services to be provided by the independent auditors before the accountant is engaged to render these services. The Audit Committee may consult with managementcontained in the decision-making process, but may not delegate this authority to management. The Audit Committee may delegate its authority to preapprove services to one or more committee members, provided that the designees present the pre-approvals to the full committee at the next committee meeting. All audit2023 Proxy Statement and non-audit services performedis hereby incorporated by the independent accountants have been pre-approved by the Audit Committee to assure that such services do not impair the auditors’ independence from us.reference.

 


31

PART

PART IV

 

Item 15. Exhibits and FinancialFinancial Statement Schedules

 

The following documents are filed as part of this Report:

 

1.1

Financial Statements. See Index to Financial Statements on page F-1.

2.2

Financial Statement Schedule

Schedules are omitted because the information required is not applicable or the required information is shown in the consolidated financial statements or notes thereto.

3.3

Exhibits

Certain of the following exhibits were filed as Exhibits to previous filings filed by Milestone Scientific under the Securities Act of 1933, as amended, or reports filed under the Securities and Exchange Act of 1934, as amended, and are hereby incorporated by reference.

 

Exhibit NO.

No

Description

3.1

Restated Certificate of Incorporation of Milestone filed on September 6, 2013 (11)

3.2

Form of Certificate of Designation filed on April 18, 2014 (12)

3.3

Certificate of Correction to the Certificate of Designation filed on May 12, 2014 (13)

3.4

Amended and Restated By-laws of Milestone  (1)filed April 1, 2019 (23)

 4.13.5

Certificate of Amendment to Restated Certificate of Incorporation (24)

4.1

Specimen stock certificate (2)

 4.24.3

Form of warrant agreement, including form of warrant (4)

4.3

Form of Common Stock Purchase Warrant issued in the 2016 Public Offering (16)

4.4

Form of Common Stock Purchase Warrant issued in the Feb. 2019 Public Offering (21)

4.5

Form of Common Stock Purchase Warrant issued in the Feb. 2019 Private Placement (22)

4.6

Description of Registrant’s Securities (30)

4.7

Form of Common Stock Purchase Warrant issued in the Apr. 2021  Public offering  (25)

4.8

Form of Common Stock Purchase Warrant issued in the Jun. 2021  Public Offering (26)

10.1

Lease dated November 25, 1996 between Livingston Corporate Park Associates, L.L.C. and Milestone (3)

10.2

Lease amendment dated April 28, 2004 between Livingston Corporate Park Associates, L.L.C. And Milestone (4)

10.3

2011 Equity Compensation Plan (7)

10.4

Employment Agreement with Leonard Osser, dated September 1, 2009** (6)

10.5

2011 Equity Compensation Plan (7)

10.6

Amendment to the Employment Agreement with Leonard Osser, dated March 6, 2013** (11)

10.7

Master Supply and Distribution Agreement, dated July 3, 2013, between Milestone Scientific Inc and Tri-anim Health Services, Inc (9)

 10.810.5

Amendment to the Employment Agreement with Leonard Osser, effective March 17, 2014** (10)

 10.9

Agreement with Mark Hochman, dated July 2015 (13)

10.110.6

Investment Agreement, dated April 15, 2014, between Milestone Scientific Inc. and BP4 S.p.A. (12)

10.1110.7

Exclusive Distribution and Supply Agreement, dated as of June 20, 2016, among Milestone Scientific Inc., Wand Dental, Inc. and Henry Schein, Inc. (14)

10.1210.8

Amended and Restated Employment Agreement, dated December 1, 2016, between Wand Dental Inc. and Gian Domenico Trombetta (15)

21.110.9

ListFinal Form of Subsidiaries (12)Asset Purchase Agreement, dated June 2, 2017, among APAD Octrooi B.V., APAD B.V., and Milestone Scientific Inc. (17)

23.110.10

Final form of the Memorandum of Agreement, dated June 6, 2017, between Solee Science & Technology U.S.A. Ltd. and Milestone Scientific Inc. (18)

10.11

Final form of the Promissory Note, dated June 6, 2017, in the principal amount of $1,275,000 made by Solee Science & Technology U.S.A. Ltd. to Milestone Scientific Ltd. (18)

10.12

Final form of the Stock Option Agreement, dated June 6, 2017, Solee Science & Technology U.S.A. Ltd. and Milestone Scientific Inc. (18)

10.13

New Employment Agreement between Milestone Scientific Inc. and Leonard Osser dated as of July 11, 2017. (19)

10.14

Employment Agreement between Milestone Scientific Inc. and Daniel Goldberger dated as of July 11, 2017. (19)

10.15

Covenant Agreement between Milestone Scientific Inc. and Daniel Goldberger dated and effective as of July 11, 2017. (19)

10.16

Consultant Agreement between Milestone Medical Inc. and U.S. Asian Consulting Group, LLC dated as of July 10, 2017. (20)

10.17

Underwriting Agreement, dated as of February 1, 2019 between Milestone Scientific Inc. and Maxim Group LLC, as underwriter (21)

10.18

Stock Purchase Agreement, dated as of February 8, 2019 between Milestone Scientific Inc. and BP4 S.p.A. (22)

10.19

Underwriting Agreement, dated as of April 9, 2021  between the Company and Maxim Group LLC (25)


10.20

Underwriting Agreement, dated as of June 25, 2021  between the Company and Maxim Group  LLC (26)

10.21

Buy Sell Agreement, dated as of November 22, 2021, by and between Wand Dental, Inc. and Michelle Zhang dba Solee Science & Technology USA (31)

10.22

Succession Agreement between Leonard Osser and Milestone Scientific Inc. (27)

10.23

Amended and Restated 2021  Equity Incentive Plan (28)

10.24Employment Agreement, dated and effective as of January 1, 2022, between Arjan Haverhals and Milestone Scientific Inc.** (29)
10.25Offer Letter, dated as of February 1, 2023, between Peter Milligan and Milestone Scientific Inc.* ** 
21.1List of Subsidiaries*
23.1Consent of Friedman,Marcum LLP*

23.2

Consent of Baker Tilly Virchow Krause,Friedman, LLP*

31.1

Rule 13a-14(a) Certification-Chief Executive Officer*

31.2

Rule 13a-14(a) Certification-Chief FinancialCertification-Financial Officer*

32.1

Section 1350 Certifications-Chief Executive Officer***

32.2

Section 1350 Certifications-Chief Financial Officer***

101.INS

Inline XBRL Instance Document*

101.SCH

Inline XBRL Taxonomy Extension Schema Document*

101.CAL

Inline XBRL Taxonomy Extension Calculation Linkbase Document*

101.LAB

Inline XBRL Taxonomy Extension Label Linkbase Document*

101.PRE101.PRE

Inline XBRL Taxonomy Extension Presentation Linkbase Document*

101.DEF

Inline XBRL Taxonomy Extension Definition Linkbase Document*

104

Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101)

*     Filed herewith.

**   Indicates management contract or compensatory plan or arrangement.

*** Furnished, not filed, in accordance with item 601(32) (ii) of Regulations-S-K.


*

Filed herewith.

**

Indicates management contract or compensatory plan or arrangement.

***

Furnished, not filed, in accordance with item 601(32) (ii) of Regulations-S-K.

 

1)

Incorporated by reference to Milestone Scientific’s Registration Statement on Form SB-2 No. 333-92324.

2)

Incorporated by reference to Amendment No. 1 to Milestone Scientific’sScientific’s Registration Statement on Form SB-2 No. 333-92324.10-KSB for the year ended May 15, 1995

3)

Incorporated by reference to MilestoneMilestone Scientific’s Form 10-KSB for the year ended December 31, 1996.

4)

Incorporated by reference to Milestone Scientific’sScientific’s Form 10-KSB for the year ended December 31, 2004.

5)

Incorporated by reference to Milestone Scientific’s Registration Statement on Form S-2 No. 333-110367, Amendment No. 5.

6)

Incorporated by reference to Milestone Scientific’s Form 10-K for the year ended December 31, 2009.

7)

Filed as Appendix A to Milestone Scientific’sScientific’s Proxy Statement filed with the SEC on May 2, 2011 and incorporated herein by reference.

8)

9)

Incorporated by reference to Milestone Scientific’s 10-K for the year ended December 31, 2014.

9)

Incorporated by reference to Milestone Scientific’sScientific’s Form 8-K filed with the SEC on July 9, 2014.2013.

10)

11)

Incorporated by reference to Milestone Scientific’s Form 10-Q filed with the SEC on May 13, 2014.

11)

Incorporated by reference to Milestone Scientific’s Form 10-K for the year ended December 31, 2013.

12)

Incorporated by reference to Milestone Scientific’s Form 8-K filed with the SEC on April 18, 2014.

13)

Incorporated by reference to Milestone Scientific’s Form 10-K for the year ended December 31, 2015.2013.

14)

12)

Incorporated by reference to Milestone Scientific’sScientific’s Form 8-K filed with the SEC on April 18, 2014.

13)

Incorporated by reference to Milestone Scientific’s Form 10-K for the year ended December 31, 2015.

14)

Incorporated by reference to Milestone Scientific’s Form 8-K filed with the SEC on June 30, 2016.

15)

Incorporated by reference to Milestone Scientific’sScientific’s Form 8-K filed with the SEC on December 2, 2016.

16)

Incorporated by reference to Milestone Scientific’sScientific’s Form 8-K filed with the SEC on December 16, 2016.

17)

Incorporated by reference to Milestone Scientific’s Form 8-K filed with the SEC on June 2, 2017.

18)

Incorporated by reference to Milestone Scientific’s Form 8-K filed with the SEC on June 7, 2017.

19)

Incorporated by reference to Milestone Scientific’s Form 8-K filed with the SEC on July 10, 2017.

20)

Incorporated by reference to Milestone Scientific’s Form 10-Q filed with the SEC on August 14, 2017.

21)

Incorporated by reference to Milestone Scientific’s Form 8-K filed with the SEC on February 1, 2019.

22)

Incorporated by reference to Milestone Scientific’s Form 8-K filed with the SEC on February 14, 2019.

23)

Incorporated by reference to Milestone Scientific’s Form 10-K filed with the SEC on April 1, 2019.

24)

Incorporated by reference to Milestone Scientific’s Form 10-K/A filed with the SEC on April 2, 2021 .

25)

Incorporated by reference to Milestone Scientific’s Form 8-K filed with the SEC on April 9, 2021 .

26)

Incorporated by reference to Milestone Scientific’s Form 8-K  filed with the SEC on June 25, 2021

27)

Incorporated by reference to Milestone Scientific’s Form 8-K  filed with the SEC on April 7, 2021

28)

Incorporated by reference to Milestone Scientific’s Proxy Statement on Schedule 14A filed with the SEC on April 30, 2021

29)Incorporated by reference to Milestone Scientific’s Form 10-Q filed with the SEC on August 15, 2022.
30)Incorporated by reference to Milestone Scientific’s Form 10-K filed with the SEC on March 31, 2022
31)Incorporated by reference to Milestone Scientific’s Form 10-K filed with the SEC on March 31, 2022

 


SIGNATURES

SIGNATURES

 

In accordance with Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.

 

Milestone Scientific Inc.

By:

/s/Arjan Haverhals

Chief Executive Officer

Milestone Scientific Inc.

 

By:

/s/ Leonard OsserPeter Milligan

 
 

Chief ExecutiveFinancial Officer

 

(Principal Executive Officer)

Date: March 31, 201730, 2023

 

In accordance withPursuant to the requirements 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

Date

Title

/s/ Neal Goldman

March 30, 2023

Chairman and Director

Neal Goldman

 

 

/s/ Leonard Osser

March 31, 201730, 2023

Chief Executive OfficerVice Chairman and Director

Leonard Osser

 

(Principal Executive Officer)

 

/s/ Joseph D'Agostino

March 31, 2017

Chief Financial Officer and Chief Operating Officer

Joseph D'Agostino

(Principal Financial Officer)

/s/ Leonard Schiller

March 31, 2017

Director

Leonard Schiller

/s/ Leslie Bernhard

March 31, 2017

Chairman and Director

Leslie Bernhard

 

/s/ Gian Domenico Trombetta

March 31, 201730, 2023

Director

Gian Domenico Trombetta

 

 

/s/ Edward J. Zelnick, M.D.Benedetta Casamento

March 31, 201730, 2023

Director

Edward J. Zelnick, M.D.Benedetta Casamento

 

/s/ Michael McGeehan

March 30, 2023

Director

Michael McGeehan

/s/ Arjan J. Haverhals

March 30, 2023

Director

Arjan J. Haverhals


REPORTINDEX TO CONSOLIDATED FINANCIAL STATEMENTS

For the Years Ended December 31, 2022and 2021

Reports of Independent Registered Public Accounting Firms (Marcum LLP PCAOB ID Number 688 and Friedman LLP PCAOB ID Number 711)

F-2

   
 


INDEX TO CONSOLIDATED

FINANCIAL STATEMENTS

For the Years ended December 31, 2016 and 2015

Reports of  Independent Registered Public Accounting Firms

F-2-3

Consolidated Financial Statements:

Consolidated Balance Sheets

F-4

Consolidated Statements of Operations

F-5

Consolidated Statements of Changes in StockholdersStockholders’ Equity

F-6

Consolidated Statements of Cash Flows

F-7

Notes to Consolidated Financial Statements

F-8-24F-8- F-24

F-1


REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

 

To the Shareholders Audit Committee and Board of Directors of

Milestone Scientific, Inc. and Subsidiaries

Opinion on the Consolidated Financial Statements

 

We have audited the accompanying consolidated balance sheet of Milestone Scientific, Inc. and subsidiaries (the “Company”) as of December 31, 2016,2022 and the related consolidated statement of operations, consolidated statementstockholders’ equity and cash flows for year ended December 31, 2022, and the related notes(collectively referred to as the “financial statements”). In our opinion, the financial statements present fairly, in all material respects, the financial position of changes in stockholders' equitythe Company as ofDecember 31, 2022, and the results of its operations and its cash flows for the year ended December 31, 2016. Milestone Scientific Inc.'s management is responsible2022, in conformity with accounting principles generally accepted in the United States of America.

Basis for these consolidatedOpinion

These financial statements.statements are the responsibility of the Company's management. Our responsibility is to express an opinion on these consolidatedthe Company's financial statements based on our audit. 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 audit in accordance with the standards of the Public Company Accounting Oversight Board (United States).PCAOB. Those standardsstandards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. The company is not requiredmisstatement, whether due to have, nor were we engaged to perform, an audit of its internal control over financial reporting. Our audit included consideration of internal control over financial reporting as a basis for designing audit procedures that are appropriate in the circumstances, 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. An audit also includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements, assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audit provides a reasonable basis for our opinion.

In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of Milestone Scientific Inc. as of December 31, 2016, and the results of its operations and its cash flow for the year ended December 31, 2016, in conformity with accounting principles generally accepted in the United States of America.

/s/ Friedman LLP

East Hanover, New Jersey

March 31, 2017


REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

To the Shareholders, Audit Committee and Board of Directors

Milestone Scientific Inc. Livingston, NJ

We have audited the accompanying consolidated balance sheet of Milestone Scientific Inc. as of December 31, 2015, and the related consolidated statements of operations stockholders' equity and cash flows for the year then ended. These consolidated financial statements are the responsibility of the Company's management. Our responsibility is to express an opinion on these consolidated financial statements based on our audit.

We conducted our audit in accordance with the standards of the Public Company Accounting Oversight Board (United States). Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement.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.

Our As part of our audit included considerationwe are required to obtain an understanding of its internal controlcontrol over financial reporting as a basis for designing audit procedures that are appropriate in the circumstances, 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. An

Our audit includesincluded 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 supportingregarding the amounts and disclosures in the consolidated financial statements. AnOur audit also includes assessingincluded evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall consolidatedpresentation of the financial statement presentation.statements. We believe that our audit provideprovides a reasonable basis for our opinion.

 

Critical Audit Matters

Critical audit matters are matters arising from the current period audit of the financial statements that were communicated or required to be communicated to the audit committee and that: (1) relate to accounts or disclosures that are material to the financial statements and (2) involved our especially challenging, subjective, or complex judgments. We determined that there are no critical audit matters.

/s/ Marcum LLP

We have served as the Company’s auditor since 2016 (such date takes into account the acquisition of certain assets of Friedman LLP by Marcum LLP effective September 1, 2022)

East Hanover, New Jersey

March 30, 2023


REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

To the Board of Directors and Stockholders of Milestone Scientific, Inc.

Opinion on the Consolidated Financial Statements

We have audited the accompanying consolidated balance sheet of Milestone Scientific, Inc. (the “Company”) as of December 31, 2021, the related consolidated statement of operations, stockholders’ equity and cash flows for the year ended December 31, 2021, and the related notes (collectively referred to as the “financial statements”). In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of Milestone Scientific Inc.the Company as of December 31, 20152021, and the results of its operations and its cash flows for the year then ended December 31, 2021, in conformity with U.S.accounting principles generally accepted accounting principles.in the United States of America.

 

Basis for Opinion

These financial statements are the responsibility of the Company's management. Our responsibility is to express an opinion on the Company's financial statements based on our audit. 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 audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the consolidated 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 audit 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 audit included performing procedures to assess the risks of material misstatement of the consolidated 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 audit 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 audit provides a reasonable basis for our opinion.

Critical Audit Matters

The critical audit matters communicated below are matters arising from the current period audit of the financial statements that were communicated or required to be communicated to the audit committee and that: (1) relate to accounts or disclosures that are material to the consolidated financial statements and (2) involved our especially challenging, subjective, or complex judgments. The communication of critical audit matters does not alter in any way our opinion on the financial statements, taken as a whole, and we are not, by communicating the critical audit matters below, providing separate opinions on the critical audit matters or on the accounts or disclosures to which they relate.

The valuation of inventories requires management to make significant assumptions and complex judgments about the future salability of the inventory and its net realizable value. These assumptions include the assessment of net realizable value by inventory category considering future usage and forecast product demand for the Company’s products. Changes in such assumptions could have a significant impact on the valuation of the Company’s inventories. Additionally, management makes qualitative judgments related to slow moving and obsolete inventories. This leads to a high degree of auditor judgment and an increased extent of effort is required when performing audit procedures to evaluate the methodology and reasonableness of the estimates and assumptions.

How We Addressed the Matter in Our Audit

The following are the most relevant procedures we performed to address this critical audit matter:

Testing of whether the data used to assess obsolescence associated with inventory on hand  was complete and  sufficiently precise.

Evaluating whether the expected customer demand used was reasonable, considering the Company’s current and past marketing efforts and their market studies in developing the estimate of future demand, the estimated useful life of the inventory, current economic and competitive conditions that could impact the forecasts, and the timing of the introduction and development of new or enhanced products.

Evaluating the reasonableness of management’s assumption related to the risk of technological or competitive obsolescence for products considering the technological or competitive obsolescence experiences during the product life cycle of existing products used in other business lines.

 

/s/ Baker Tilly Virchow Krause,Friedman LLP

 

New York, New York

April 6,We have served as the Company’s auditor from 2016 to 2022.

 

East Hanover, New Jersey
March 31, 2022

F-3

MILESTONE SCIENTIFIC AND SUBSIDIARIES

CONSOLIDATED BALANCE SHEETS

  

December 31, 2022

  

December 31, 2021

 

ASSETS

        

Current assets:

        

Cash and cash equivalents

 $8,715,279  $14,764,346 

Accounts receivable, net

  693,717   943,272 

Prepaid expenses and other current assets

  443,872   375,360 

Inventories

  1,792,335   1,541,513 

Advances on contracts

  1,325,301   1,309,260 

Total current assets

  12,970,504   18,933,751 

Furniture, fixtures and equipment, net

  18,146   23,713 

Intangibles, net

  227,956   277,619 

Right of use assets finance lease

  17,645   26,294 
Right of use assets operating lease  443,685   524,217 

Other assets

  24,150   24,150 

Total assets

 $13,702,086  $19,809,744 
         
         

LIABILITIES AND STOCKHOLDERS’ EQUITY

        

Current liabilities:

        

Accounts payable

 $1,102,729  $780,428 

Accounts payable, related party

  803,492   395,857 

Accrued expenses and other payables

  1,124,839   1,417,248 

Accrued expenses, related party

  167,549   414,241 

Current portion of finance lease liabilities

  9,365   8,545 

Current portion of operating lease liabilities

  91,701   81,001 

Total current liabilities

  3,299,675   3,097,320 

Non-current portion of finance lease liabilities

  10,698   20,062 

Non-current portion of operating lease liabilities

  385,279   476,980 

Total liabilities

 $3,695,652  $3,594,362 
         

Commitments

          
         

Stockholders’ equity

        

Common stock, par value $.001;authorized 100,000,000 shares; 69,306,497 shares issued and 69,273,164 shares outstanding as of December 31, 2022; 68,153,336 shares issued and 68,120,003 shares outstanding as of December 31, 2021

  69,306   68,153 

Additional paid in capital

  127,478,325   124,915,560 

Accumulated deficit

  (116,410,405)  (107,704,274)

Treasury stock, at cost, 33,333 shares

  (911,516)  (911,516)

Total Milestone Scientific, Inc. stockholders' equity

  10,225,710   16,367,923 

Noncontrolling interest

  (219,276)  (152,541)

Total stockholders’ equity

  10,006,434   16,215,382 
         

Total liabilities and stockholders’ equity

 $13,702,086  $19,809,744 

See notes to Consolidated Financial Statements

F-4

MILESTONE SCIENTIFIC AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF OPERATIONS

YEARS ENDED DECEMBER 31,

  

2022

  

2021

 
         

Product sales, net

 $8,805,906  $10,304,711 

Cost of products sold

  3,905,092   3,992,811 

Gross profit

  4,900,814   6,311,900 
         

Selling, general and administrative expenses

  12,514,323   12,738,362 

Research and development expenses

  1,150,209   878,210 

Depreciation and amortization expense

  63,755   73,836 

Total operating expenses

  13,728,287   13,690,408 
         

Loss from operations

  (8,827,473)  (7,378,508)

Interest income (expense)

  54,607   (16,360)

Gain on debt extinguishment-PPP

  -   276,180 

Loss before provision for income taxes and equity investments

  (8,772,866)  (7,118,688)

Provision for income taxes

  -   (333)

Loss before equity investment

  (8,772,866)  (7,119,021)

Deferred profit and divesture-equity investment (See Note F)

  -   242,589 

Net loss

  (8,772,866)  (6,876,432)

Net loss attributable to noncontrolling interests

  66,735   58,115 

Net loss attributable to Milestone Scientific Inc.

 $(8,706,131) $(6,818,317)
         

Net loss per share applicable to common stockholders—

        

Basic and Diluted

  (0.12)  (0.10)
         

Weighted average shares outstanding and to be issued—

        

Basic and Diluted

  70,607,338   68,829,860 

See notes to Consolidated Financial Statements

 


 

MILESTONE SCIENTIFIC INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS' EQUITY

YEARS ENDED DECEMBER 31 2022 AND  2021

CONSOLIDATED BALANCE SHEETS

 

  

December 31, 2016

  

December 31, 2015

 
ASSETS        

Current Assets:

        

Cash and cash equivalents

 $3,602,229  $4,194,384 

Accounts receivable, net of allowance for doubtful accounts of $10,000 as of December31, 2016 and $5,000 as of December 31, 2015

  802,384   1,437,401 

 Account receivable from related party

  2,083,610   356,400 

Other receivable

  10,000   58,140 

Inventories

  4,602,719   4,258,094 

Advances on contracts

  700,900   1,215,128 
Deferred cost  620,041   - 

Prepaid expenses and other current assets

  291,929   304,604 

Total current assets

  12,713,812   11,824,151 

Investment in Milestone Education LLC

  -   16,346 

Furniture, fixtures & equipment net of accumulated depreciation of $659,144 as of December 31, 2016 and $566,477 as of December 31, 2015

  159,026   235,935 

Patents, net of accumulated amortization of $717,086 as of December 31, 2016 and $646,388 as of December 31, 2015

  660,457   715,540 

Other assets

  17,355   17,355 

Total assets

 $13,550,650  $12,809,327 
LIABILITIES AND STOCKHOLDERS’ EQUITY        

Current Liabilities:

        

Accounts payable

 $2,576,259  $2,088,268 

Accrued expenses and other payables

  1,436,262   1,555,567 

Deferred revenue

  1,001,800   - 

Total current liabilities

  5,014,321   3,643,835 
         

Commitments and Contingencies

        

Stockholders’ Equity

        

Series A convertible preferred stock, par value $.001, authorized 5,000,000 shares, 33,333 shares held in the treasury, and 7,000 shares issued and outstanding as December 31, 2016 and December 31, 2015

  7   7 

Common stock, par value $.001; authorized 50,000,000 shares; 30,457,224 shares issued, 1,270,481 shares to be issued and 30,423,891 shares outstanding as of December 31, 2016; 21,720,497 shares issued, 963,451 shares to be issued and 21,687,164 shares outstanding as of December 31, 2015

  31,720   22,685 

Additional paid-in capital

  82,761,503   78,632,383 

Accumulated deficit

  (73,381,491)  (67,434,984)

Treasury stock, at cost, 33,333 shares

  (911,516)  (911,516)

Total Milestone Scientific Inc. stockholders' equity

  8,500,223   10,308,575 

Noncontrolling interest

  36,106   (1,143,083)

Total Equity

  8,536,329   9,165,492 

Total liabilities and stockholders’ equity

 $13,550,650  $12,809,327 
   Common Stock Shares   Common Stock Amount   Additional Paid in Capital   Accumulated Deficit   Noncontrolling Interest   Treasury Stock   Total 

Balance January 1, 2021

  64,171,435  $64,171  $117,934,696  $(100,885,957) $(94,426) $(911,516) $16,106,968 

Stock based compensation

  -   -   790,915   -   -   -   790,915 

Common stock issued to employee for compensation expensed in prior periods

  7,075   7   (7)  -   -   -   - 

Common stock to be issued for payment of consulting services expensed in prior periods

  40,010   40   (40)  -   -   -   - 

Common stock issued to board of directors for services expensed in prior periods

  18,879   19   (19)  -   -   -   - 

Common stock to be issued to employees for bonuses

  -   -   100,000   -   -   -   100,000 

Common stock issued to employee for stock options exercised

  826,499   826   1,381,060   -   -   -   1,381,886 

Common stock issued to employee for compensation

  18,345   18   107,482   -   -   -   107,500 

Common stock to be issued for payment of consulting services

  289,661   290   770,044   -   -   -   770,334 

Common stock issued to board of directors for services

  277,767   278   617,889   -   -   -   618,167 

Common stock issued to employee for bonus expensed in prior periods

  402,490   402   (402)  -   -   -   - 

Common stock issued for warrants exercised

  2,101,175   2,102   3,213,942   -   -   -   3,216,044 

Net loss

  -   -   -   (6,818,317)  (58,115)  -   (6,876,432)

Balance at December 31, 2021

  68,153,336  $68,153  $124,915,560  $(107,704,274) $(152,541) $(911,516) $16,215,382 

Stock based compensation

  -   -   1,499,302   -   -   -   1,499,302 

Common stock to be issued to employees for bonuses

  -   -   264,385   -   -   -   264,385 

Common stock issued to employee for compensation

  30,196   30   39,973   -   -   -   40,003 

Common stock issued for payment of consulting services

  577,074   577   746,774   -   -   -   747,351 

Common stock issued to employees for bonuses

  147,338   147   (147)           - 

Common stock issued to board of directors for services

  398,553   399   12,478   -   -   -   12,877 

Net loss

  -   -   -   (8,706,131)  (66,735)  -   (8,772,866)

Balance December 31, 2022

  69,306,497  $69,306  $127,478,325  $(116,410,405) $(219,276) $(911,516) $10,006,434 

See notes to Consolidated Financial Statements


 

See Notes

MILESTONE SCIENTIFIC AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

YEARS ENDED DECEMBER 31,

  

2022

  

2021

 

Cash flows from operating activities:

        

Net loss

 $(8,772,866) $(6,876,432)

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

        

Depreciation expense

  14,180   22,205 

Amortization of intangibles

  49,663   51,630 

Stock based compensation

  1,499,302   790,915 

Employees paid in stock

  317,265   793,110 

Expense paid in stock

  747,351   707,861 

Inventory Reserve

  582,299   - 

Amortization of right-of-use asset

  80,533   73,552 

Gain on debt extinguishment-PPP

  -   (276,180)

Deferred profit and divesture-equity investment (See Note F)

  -   (242,589)

Changes in operating assets and liabilities:

        

Decrease in accounts receivable

  249,555   137,384 

(Increase) decrease in inventories

  (833,121)  878,666 

(Increase) in advances on contracts

  (16,041)  (895,058)

(Increase) decrease in prepaid expenses and other current assets

  (68,512)  40,555 

Increase in accounts payable

  322,300   297,456 

Increase in accounts payable, related party

  407,636   10,719 

(Decrease) increase in accrued expenses

  (292,495)  562,824 

(Decrease) in accrued expenses, related party

  (246,692)  (47,493)

Decrease operating lease liability

  (72,353)  (62,789)

Net cash used in operating activities

 $(6,031,996) $(4,033,664)
         

Cash flows from investing activities:

        

Purchase of furniture, fixtures, and equipment

  (8,527)  (15,189)

Net cash used in investing activities

 $(8,527) $(15,189)
         

Cash flows from financing activities:

        

Payments finance lease obligations

  (8,544)  (8,648)

Proceeds from exercise of warrants

  -   3,216,044 

Common stock issued to employee for option exercised

  -   1,381,886 

Net cash used in (provided by) financing activities

 $(8,544) $4,589,282 
         

Net (decrease) increase in cash and cash equivalents

  (6,049,067)  540,429 

Cash and cash equivalents at beginning of period

  14,764,346   14,223,917 

Cash and cash equivalents at end of period

 $8,715,279  $14,764,346 

See notes to Consolidated Financial Statements


MILESTONE SCIENTIFIC INC.

CONSOLIDATED STATEMENTS OF OPERATIONS

YEARS ENDED DECEMBER 31, 2016 AND 2015

  

2016

  

2015

 

Revenue

        

Product sales, net

 $10,482,005  $9,491,569 

Cost of products sold

  4,175,533   3,048,260 

Gross profit

  6,306,472   6,443,309 

Selling, general and administrative expenses

  11,549,961   9,399,201 

Research and development expenses

  1,270,471   100,856 

Total operating expenses

  12,820,432   9,500,057 

Loss from operations

  (6,513,960)  (3,056,748)

Other (expenses)

  (5,088)  (5,347)

Interest income

  1,285   3,838 

Loss before provision for income tax and equity in net earnings of equity investments

  (6,517,763)  (3,058,257)

Provision for income tax

  19,101   (36,157)
Loss before equity in net earnings of equity investments  (6,498,662)  (3,094,414)

Loss on earnings from Milestone Medical

  -   (2,019,211)

Income (Loss) on earnings from Education Joint Venture

  -   (7,846)

Loss on earnings from China Joint Venture

  (795,827)  (418,432)

Loss in equity investments

  (795,827)  (2,445,489)

Net Loss

  (7,294,489)  (5,539,903)

Net loss attributable to noncontrolling interests

  (1,347,982)  (72,381)

Net loss attributable to Milestone Scientific Inc.

 $(5,946,507) $(5,467,522)
         

Net loss per share applicable to common stockholders

        

Basic

 $(0.22) $(0.26)

Diluted

 $(0.22) $(0.26)

Weighted average shares outstanding and to be issued

        

Basic

  26,966,988   21,429,993 

Diluted

  26,966,988   21,429,993 

See Notes to Consolidated Financial Statements

 


 

MILESTONE SCIENTIFIC INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS' EQUITY

YEARS ENDED DECEMBER 31, 2016 AND 2015

  

Preferred Stock

  

Common Stock

                     
  

Shares

  

Amount

  

Shares

  

Amount

  

Additional
Paid-in
Capital

  

Accumulated
Deficit

  

Noncontrolling
interest

  

Treasury
Stock

  

Total

 

Balance, December 31, 2014

  7,000  $7   22,379,447  $22,380  $77,504,415  $(61,967,462) $394,528  $(911,516) $15,042,352 
                                     

Consolidation of Milestone Medical

  -   -   -   -   -   -   (1,965,230)  -   (1,965,230)

Stock based compensation

  -   -   -   -   637,108   -   -   -   637,108 

Capital contribution from noncontrolling interest

  -   -   -   -       -   500,000   -   500,000 

Common stock issued for payment of consulting services

  -   -   41,365   41   119,959   -   -   -   120,000 

Common stock issued for payment of employee compensation

  -   -   17,817   18   49,982   -   -   -   50,000 

Common stock to be issued to employee for bonuses

  -   -   29,865   29   99,971   -   -   -   100,000 

Common stock issued to employee for exercise of stock options

  -   -   200,000   200   199,800   -   -   -   200,000 

Exercise of stock options for consultants

  -   -   16,666   17   21,148   -   -   -   21,165 

Net loss

  -   -   -   -       (5,467,522)  (72,381)  -   (5,539,903)

Balance, December 31, 2015

  7,000  $7   22,685,160   22,685   78,632,383   (67,434,984)  (1,143,083)  (911,516)  9,165,492 

Consolidation of Milestone Education

  -   -           -   -   16,346   -   16,346 

Stock based compensation

  -   -   -   -   580,347   -   -   -   580,347 

Common stock to be issued to employee for compensation

          14,181   14   29,986   -   -   -   30,000 

Common stock to be issued to employee for stock program

          31,053   31   58,969   -   -   -   59,000 

Common stock issued to employee for exercise of stock options

          327,778   328   137,172   -   -   -   137,500 

Common stock issued for payment of consulting services

          270,526   263   504,150   -   -   -   504,413 

Common stock to be issued to employee for bonuses

          259,765   260   539,240   -   -   -   539,500 

Sale of Common Stock - Private Placement

          1,104,200   1,104   2,223,896   -   -   -   2,225,000 

Sale of Common Stock - Public Offering

          2,000,000   2,000   2,571,220               2,573,220 

Common Stock exchanged for Milestone Medical Inc.

          5,035,042   5,035   (2,515,860)  -   2,510,825   -   - 

Net loss

  -   -               (5,946,507)  (1,347,982)  -   (7,294,489)

Balance, December 31, 2016

  7,000  $7   31,727,705  $31,720  $82,761,503  $(73,381,491) $36,106  $(911,516) $8,536,329 

See Notes to Consolidated Financial Statements


MILESTONE SCIENTIFIC INC. AND SUBSIDIARIES

CONSOLIDATED STATEMENTS OF CASH FLOWS

YEARS ENDED DECEMBER 31, 2016 AND 2015

  

2016

  

2015

 

Cash flows from operating activities:

        

Net loss

 $(7,294,489) $(5,539,903)
Adjustments to reconcile net loss to net cash (used in) by operating activities        

Depreciation expense

  92,667   27,947 

Amortization of patents

  70,699   69,428 

Common stock and options for compensation, consulting and vendor services

  1,850,760   1,128,274 

Equity loss on Milestone Medical Inc.

  -   2,019,211 

Equity loss on Education joint venture

  -   7,846 

Equity loss on China joint venture

  795,827   348,651 

Changes in operating assets and liabilities:

        

Increase (Decrease) in accounts receivable

  635,017   (207,248)
Increase in due from related party  (1,727,210)  - 

Decrease (Increase) in other receivable

  48,515   (58,140)

Increase in inventories

  (509,462)  (875,034)

Decrease (Increase) to advances on contracts

  514,228   (450,407)
Increase in deferred cost  (620,041)  - 

Decrease to prepaid expenses and other current assets

  12,675   192,601 

(Increase) in other assets

  -   (2,670)

Increase in accounts payable

  486,348   173,068 

Decrease in accrued expenses and other payables

  (755,915)  220,038 
Increase in deferred revenue  1,001,800   - 

Net cash (used in) operating activities

  (5,398,581)  (2,946,338)

Cash flows from investing activities:

        

Purchases of intangible assets

  (15,615)  (9,939)

Purchases of property and equipment

  (15,344)  (67,581)

Consolidation of variable interest entity

  39,165   (3,649,751)

Net cash provided by (used in) investing activities

  8,206   (3,727,271)

Cash flows from financing activities:

        

Net proceeds on private placement offering

  2,225,000   - 

Net proceeds on public offering

  2,573,220   - 

Capital contribution from noncontrolling interest

  -   500,000 

Net cash provided by investing activities

  4,798,220   500,000 

Net (decrease) in cash and cash equivalents

  (592,155)  (6,173,609)

Cash and cash equivalents at beginning of year

  4,194,384   10,367,993 

Cash and cash equivalents at end of year

 $3,602,229  $4,194,384 
         

Supplemental disclosure of cash flow information:

        

Net assets acquired from variable interest entity

 $16,346  $566,775 

See Notes to Consolidated Financial Statements


MILESTONE SCIENTIFIC INC.

NOTESNOTES TO CONSOLIDATED FINANCIAL STATEMENTS

 

NOTE A ORGANIZATION BUSINESS AND BASIS OF PRESENTATIONBUSINESS

 

All references in this report to Milestone“Milestone Scientific,” “us,” “our,” “we,” the “Company” or “Milestone” refer to Milestone Scientific Inc., and its consolidated subsidiaries, Wand Dental, Inc., Milestone Advanced CosmeticMedical, Inc. and Milestone MedicalEducation LLC (all described below) and affiliate, Milestone Education (described below), unless the context otherwise indicates. Milestone Scientific is the owner of the following registered U.S. trademarks: CCompuDent®ompuDent®; CompuMed®CompuMed®; CompuFlo®CompuFlo®; DPS Dynamic Pressure Sensing Technology®technology®; Milestone Scientific ®; ®;the Milestone logo ®; SafetyWand®®; SafetyWand®; STA Single Tooth Anesthesia System®System®; and The Wand ®.®.

 

Milestone Scientific was incorporated in the State of Delaware in August 1989. Milestone Scientific has developed a proprietary, computer-controlled anesthetic delivery instrument, through the use of device, using The Wand®Wand®, a single use disposable handpiece. The instrumentdevice is marketed in dentistry under the trademark CompuDent®CompuDent®, and STA Single Tooth Anesthesia System®System® and in medicine under the trademark CompuMed®CompuMed®. CompuDent®CompuDent® is suitable for all dental procedures that require local anesthetic. CompuMed®CompuMed® is suitable for many medical procedures regularly performed in Plastic Surgery, Hair Restoration Surgery, Podiatry, Colorectal Surgery, Dermatology, Orthopedicsplastic surgery, hair restoration surgery, podiatry, colorectal surgery, dermatology, orthopedics, and a number ofmany other disciplines. The dental instrumentsdevices are sold in the United States, Canada and in over 47 countries abroad. There have been no60 other countries. Certain medical instruments sold in the United States and limited amounts sold internationally as of the reporting date, although certain medical instrumentsdevices have obtained CE mark approval and now can be marketed and sold in most European countries. Milestone Scientific’s products are manufactured by a third-party contract manufacturer.

In May of 2014, June 2017, Milestone Scientific completed a private placement (the “May 2014 Financing”), which raised aggregate gross proceeds $10 million,received 510(k) marketing clearance from the sale of $3 million of our common stock, $.001 par value per share (“common stock”) (two million shares at $1.50 per share) and $7 million of our Series A Convertible Preferred Stock (7,000 shares at $1,000 per share), convertible into common stock at $2.37 per share (as adjusted to date) on May 14, 2019, or $1.50 per share if certain conditions are not met; both subject to an anti-dilution adjustment.

On June 1, 2015, we listed our common stock on the NYSE MKT LLC (“NYSE MKT”) under the ticker symbol “MLSS”.

In June 2016, Milestone Scientific raised an additional $2.0 million of gross proceeds in a private placement of one million shares of common stock, at a price of $2.00 per share, to the same investors that participated in the May 2014 Financing.

In the second quarter of 2016, Milestone Scientific initiated a share exchange program pursuant to which we exchanged one share of common stock for every two outstanding shares of Milestone Medical (described below) common stock, a previously consolidated variable interest entity. As a result of the exchange program, at December 31, 2016, Milestone Scientific owned approximately 91% of Milestone Medical.

In July 2016, Milestone Scientific filed for 510(k) marketing clearance with the United StatesU.S. Food and Drug Administration ("FDA"(FDA) on the CompuFlo® Epidural Computer Controlled Anesthesia System (“Epidural”) Milestone Medical's epidural anesthetic injections instrument. This clearance is necessary to begin commercialization.

We are in the process of thesemeeting with medical facilities and device distributors within the United States, Middle East and Europe.  Certain of our medical instruments have obtained European CE mark approval and can be marketed and sold in the United States.most European countries.

 

In December 2016, Milestone Scientific2020, the Company received notificationa Notice of Allowance from the FDAUnited States Patent and Trademark Office (USPTO) related to its new CompuPulse System, which combines the benefits of our CompuWave technology with a manual syringe. The new CompuPulse System allows one to identify a pulsatile pressure waveform in a variety of applications, thereby improving the reliability and safety of a drug delivery procedure. Importantly, not all procedures require the sophistication of our CompuFlo system, which precisely controls the administration and flow rate of medication as it is being administered. This new technology provides an efficient and low-cost alternative for procedures where a manual syringe may suffice, while still providing the ability to verify needle and subsequent catheter placement.

NOTE B-LIQUIDITYAND UNCERTAINTIES

The Company has evaluated whether there are conditions or events, considered in the aggregate, that based upon the 510(k) application submitted forraise substantial doubt about the Company's Compu-Flo Intra Articular Computer Controlled Injection System, it did not adequately documentability to continue as a going concern within one year after the date that the device met the equivalency standard required for 510(k) clearance. Following consultation with the FDA Office of Device Evaluation, we intend to provide additional data, which could include a new Human Factor Validation study (HFV Study) in support of a new 510(k) application for the device. An HFV Study demonstrates the ease of use of a product. The cost to generate this incremental data is estimated to be approximately $100,000.


In December 2016, Milestone Scientific completed an underwritten public offering of 2,000,000 shares of common stock and warrants to purchase up to 1,592,775 shares of common stock, including 92,775 additional warrants pursuant to a partial exercise of the over-allotment option granted to the underwriters. The public offering price for each share and related warrant was $1.50. The warrants have a three-year term and an exercise price of $2.55 per share. In January 2017, the underwriter exercised a portion of its over-allotment option to purchase an additional 123,700 shares of common stock at the public offering price of $1.499 per share. The gross proceeds from this offering, including proceeds from partial exercises of the over-allotment option, were approximately $3,200,000, before deducting underwriting discounts and commissions and other offering expenses. This offering was covered by the prospectus supplement, filed with the SEC on December 16, 2016, to our shelf registration statement on Form S-3 (SEC File No.: 333-209466).

As of December 31, 2016, Milestone Scientific'sconsolidated financial statements are consolidated to include the accounts of its wholly-owned,  majority-owned subsidiaries variable interest entity including, Wand Dental, Inc., a Delaware corporation ("Wand Dental"), Milestone Advanced Cosmetic Systems, Inc. ("Milestone Advanced Cosmetic"), Milestone Medical Inc. ("Milestone Medical") and Milestone Education LLC ("Milestone Education"). Milestone Education are variable interest entity for which Milestone Scientific is the primary beneficiary. All significant, intra-entity transactions and balances have been eliminated in the consolidation. (See Note E to the Consolidated Financial Statements).

Milestone Scientific has incurredissued. Total operating losses since inception of $116.4 million.  The operating losses were $8.8 million and negative$7.4 million, for the years ended December 31, 2022, and 2021, respectively. Management has prepared cashflow forecasts covering a period of 12 months from the date of issuance of these financial statements. These forecasts include several revenue and operating expense assumptions which indicate that the Company’s current cash flowsand liquidity is sufficient to finance the operating requirements for at least the next 12 months Management believes that the Company will have sufficient cash reserves to meet its anticipated obligations for at least the next twelve months from operating activities since its inception, except for 2013.the filing date of this report. Milestone Scientific is actively pursuing the generation of increasedpositive cash flows from operating activities through an increase in revenue positivefrom its dental business worldwide, the generation of revenue from its medical devices and disposables business in the United States and worldwide, and a reduction in operating income and cash flow from operations. The previous equity financings provided Milestone Scientific withexpenses. However, the opportunity to continue to develop medical instruments and aggressively marketCompany’s continued operations will depend on its already commercialized dental instruments throughout the world. Management believes its cash on hand and remaining net current assets are sufficient to meet its obligations over the next twelve months from the filing of this form 10K. Milestone Scientific may needability to raise additional capital prior to management's expected generation of sustainable positive cash flow from operating activities.   through various potential sources until it achieves profitability, if ever.

 

In addition to its employees, the Company relies on (i) distributors, agents, and third-party logistics providers in connection with product sales and distribution and (ii) raw material and component suppliers in the U.S., Europe, and China. If the Company, or any of these entities encounter any disruptions to its or their respective operations or facilities, or if the Company or any of these third-party partners were to shut down for any reason, including by fire, natural disaster, such as a hurricane, tornado or severe storm, power outage, systems failure, labor dispute, pandemic or other public health crises, or other unforeseen disruption, then the Company or they may be prevented or delayed from effectively operating its or their business, respectively.

The coronavirus (COVID-19) adversely impacted the Company's operations, our distributors and suppliers in recent years. Notwithstanding the reopening of dental offices, hospitals, and pain clinics throughout the country and the rest of the world, revenues for years ended December 31, 2022, and 2021 were adversely affected. Any business interruptions, resulting from COVID-19, or new variant, could significantly disrupt our operations further and could have a material adverse impact on our business in the future.

F- 8

Sanctions imposed by the United States and other western democracies, against Russia because of Ukraine conflict, and any expansion of the conflict, is likely to have unpredictable and wide-ranging effects on the domestic and global economy and financial markets, which could have an adverse effect on our business and results of operations. The conflict has caused market volatility, a sharp increase in certain commodity prices, and an increasing number and frequency of cybersecurity threats. As direct impact from the conflict, we have experienced a decrease in international sales to Ukraine and halted all sales to Russia. We will continue to monitor the situation carefully and, if necessary, take action to protect our business, operations, and financial condition.

NOTE B C SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

 

1.Principles of Consolidation

 

The accompanying consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States ("GAAP"), and the applicable rules and regulations of the Securities and Exchange Commission (SEC) include the accounts of Milestone Scientific and its wholly owned and majority owned subsidiaries, including, Wand Dental Milestone Advanced Cosmetic(wholly owned), and Milestone Medical. Milestone Education is a variable interest entity of which Milestone Scientific is the primary beneficiary and is consolidated into Milestone Scientific's financial statements. Prior to December 31, 2015, Milestone Medical was accounted for as an equity investment (See Note E)(majority owned).  All significant, intra-entity transactions and balances have been eliminated in the consolidation.

 

2.     Reclassifications Use of Estimates

 

Certain reclassifications have been madeThe preparation of consolidated financial statements in conformity with GAAP requires management to make estimates and assumptions in determining the reported amounts of assets and liabilities and disclosure of contingent liabilities at the date of the financial statements and reported amounts of revenues and expenses during the reporting period. The most significant estimates relate to the 2015 financial statementsallowance for doubtful accounts, inventory valuation, and cash flow assumptions regarding evaluations for impairment of long-lived assets and going concern considerations, stock compensation expense, and valuation allowances on deferred tax assets. Actual results could differ from those estimates.

3.Revenue Recognition

The Company recognizes revenue when its customer obtains control of promised goods or services, in an amount that reflects the consideration which the Company expects to conformreceive in exchange for those goods or services. To perform revenue recognition, the Company performs the following five steps:

i.

identification of the promised goods or services in the contract;

ii.

determination of whether the promised goods or services are performance obligations including whether they are distinct in the context of the contract;

iii.

measurement of the transaction price, including the constraint on variable consideration;

iv.

allocation of the transaction price to the performance obligations based on estimated selling prices; and

v.

recognition of revenue when (or as) the Company satisfies each performance obligation. A performance obligation is a promise in a contract to transfer a distinct good or service to the customer and is the unit of account in ASC 606.

The Company derives its revenues from the sale of its products, primarily dental instruments, handpieces, and other related products. The Company sells its products through a global distribution network and that includes both exclusive and non-exclusive distribution agreements with related and third parties.

Revenue from product sales is recognized upon transfer of control of a product to a customer, generally upon date of shipment. The Company has no obligation on product sales for any installation, set-up, or maintenance, these being the responsibility of the buyer. Milestone Scientific's only obligation after sale is the normal commercial warranty against manufacturing defects if the alleged defective unit is returned within the warranty period. 

Sales Returns

The Company records allowances for product returns as a reduction of revenue at the time product sales are recorded. Several factors are considered in determining whether an allowance for product returns is required, including the customers’ return rights and the Company’s historical experience with returns and the amount of product in the distribution channel not consumed by end users and subject to return. The Company relies on historical return rates to estimate returns. In the future, if any of these factors and/or the history of product returns change, adjustments to the consolidated 2016 financial statement presentation. These reclassifications had no effectallowance for product returns may be required. The Company recorded allowance of approximately $179,000 for sales returns from Henry Schein due to the termination of  the contract on net loss or cash flows as previously reported.December 31, 2022.

F- 9

Financing and Payment

 

3. The Company's payment terms differ by geography and customer, but payment is required within 90 days from the date of shipment or delivery.

Disaggregation of Revenue

The Company operates in two operating segments: dental and medical. Therefore, results of the Company operations are reported on a consolidated basis for purposes of segment reporting, consistent with internal management reporting. See Note M for revenues by geographical market, based on the customer’s location, and product category for the twelve months ended December 31, 2022, and 2021.

4.Variable Interest Entities

 

A variable interest entity (“VIE”("VIE") is an entity that either (i) has insufficient equity to permit the entity to finance its activities without additional subordinated financial support or (ii) has equity investors who lack the characteristics of a controlling financial interest. A VIE is consolidated by its primary beneficiary. The primary beneficiary has both the power to direct the activities that most significantly impact the entity's economic performance and the obligation to absorb losses or the right to receive benefits from the entity that could potentially be significant to the VIE.

 

If Milestone Scientific determines that it has operating power and the obligation to absorb losses or receive benefits, Milestone Scientific consolidates the VIE as the primary beneficiary. Milestone Scientific’sScientific’s involvement constitutes power that is most significant to the entity when it has unconstrained decision makingdecision-making ability over key operational functions within the entity. Milestone Scientific has completed the VIE analysis relating to Milestone China and Anhui Maishida Medical Technology, Co. Ltd. (“Anhui”).

 

Milestone Scientific has determined that due to the loss of equity investment in Anhui, the company no longer has significant influence of Anhui and therefore Anhui is the primary beneficiary of Milestone Medical as of December 31, 2015 (see Note E) and Milestone Education as of January 2016. Accordingly, the assets and liabilities of Milestone Medical and Milestone Education are included in the accompanying consolidated financial statements.


Becausenot a variable interest. Milestone Scientific had an increasinghas a variable interest in Milestone China, it further considered the guidance in Accounting Standard Codification ("ASC") ASC 810, “Consolidation” as it relates to determining whether Milestone China is a VIE and, if so, identifying the primary beneficiary. As Milestone China’s equity at risk and voting rights were not proportional to their economic interest, Milestone China was determined to be a VIE. Milestone Scientific would be considered the primary beneficiary of the VIE if it has both of the following characteristics:

 

 

Power Criterion: The power to direct the activities that most significantly impact the entity’sentity’s economic performance; and

 

Losses/Benefits Criterion: The obligation to absorbabsorb losses that could potentially be significant or the right to receive benefits that could potentially be significant to the VIE.VIE

 

Milestone managementScientific does not have the ability to control the activities that most significantly impact Milestone China'sChina's economics and, therefore, the power criterion has not been met. Management placed the most weight on the relationship and significance of activities of Milestone China to the majority shareholder/CEO of Milestone China.  As majority shareholder, majority holder of voting rights, and the active CEO, the 53% investor hasChina who have the power to direct the activities that most significantly impact the economic performance of Milestone China. Management has concluded that Milestone Scientific is not the primary beneficiary under ASC 810. Accordingly, Milestone China has not been consolidated into the financial statements of Milestone Scientific and continues to beis accounted for under the equity method (seemethod. See Note F).F.

 

4.

5.Cash and Cash Equivalents

 

Milestone Scientific considers all highly liquid investments purchased with an original maturity of three months or less to be cash equivalents. As of December 31, 2022, and 2021 Milestone Scientific has approximately $8.7 million and $14.8 million, respectively, invested in cash. As of December 31, 2022, and 2021 Milestone Scientific had approximately $8.3 million and $13.9 million, respectively, invested in cash that exceeded the Federal Deposit Insurance Corporation insurance limit of $250,000.

 

5.

6.Accounts Receivable

 

Milestone Scientific sells a significant amount of its product on credit terms to its major distributors. Milestone Scientific estimates losses from the ability or inability of its customers to make payments on amounts billed. A majority ofMost credit sales are due within ninety90 days from invoicing. There have not been any significant credit losses incurred to date. As of December 31, 2022 and 2021, accounts receivable was recorded, net of allowance for doubtful accounts of $10,000.

 

6. Product Return and Warranty

Milestone Scientific generally does not accept non-defective returns from its customers. Product returns under warranty are accepted, evaluated and repaired or replaced in accordance with the Warranty Policy. Returns not within the Warranty Policy are evaluated and the customer is charged for the repair.

7.Inventories

 

Inventories principally consist of finished goods and component parts stated at the lower of cost (first-in, first-out method)(first-in, first-out method) or market.net realizable value. Inventory quantities on hand are reviewed on a quarterly basis and a provision for excess, slow moving, defective, and obsolete inventory is recorded if required based on past and expected future sales, potential technological obsolescence, and product expiration requirements.

F- 10

The valuation allowance creates a new cost basis for the inventory, and it is not subsequently marked up through a reduction in the valuation allowance based on any changes in the underlying facts and circumstances. When the valuation allowance is initially recorded, the increase to the allowance is recognized as an increase in cost of sales. The valuation allowance is only reduced if or when the underlying inventory is sold or destroyed, at which time cost of sales recognized would include the previous adjusted cost basis.

 

8.Equity Method Investments

 

Investments in which Milestone Scientific has the ability tocan exercise significant influence, but do not control, are accounted for under the equity method of accounting and are included in the long termlong-term assets on the Consolidated BalanceBalance Sheets. Under this method of accounting, Milestone Scientific's share of the net earnings or losses of the investee is presented below the provision for income tax line on the Consolidated Statements of  Operations. Milestone Scientific evaluates its equity method investments whenever events or changes in circumstance indicate that the carrying amounts of such investments may be impaired. If a decline in the value of an equity method investment is determined to be other than temporary, a loss is recorded in earnings in the current period.

 

9.Furniture, Fixture and Equipment

 

Equipment is recorded at cost, less accumulated depreciation. Depreciation expense is computed using the straight-line method over the estimated useful lives of the assets, which range from fivethree to seven years. The costs of maintenance and repairs are charged to operations as incurred.

 


10.Intangible Assets - Patents and Developed Technology

 

Patents are recorded at cost to prepare and file the applicable documents with the USUnited States Patent Office, or internationally with the applicable governmental office in the respective country. Although certain patents have not yet been approved, theThe costs related to these patents are being amortized using the straight-line method over the estimated useful life of the patent. IfPatents and other developed technology acquired from another business entity are recorded at acquisition cost and be amortized at the applicable patent application is ultimately rejected, the remaining unamortized balance will be expensed in the period in which Milestone Scientific receives notice of such rejection.estimated useful life.  Patent defense costs, to the extent applicable, are expensed as incurred.  Patent applications filed and patents obtained in foreign countries are subject to the laws and procedures that differ from those in the United States. Patent protection in foreign countries may be different from patent protection under United States laws and may not be favorable to Milestone Scientific. Milestone Scientific also attempts to protect the proprietary information through the use of confidentiality agreements and by limiting access to its facilities. There can be no assurance that the program of patents, confidentiality agreements and restricted access to the facilities will be sufficient to protect the proprietary technology.

                      

 

11.Impairment of Long-Lived Assets

 

Milestone Scientific reviews long-livedLong-lived assets with finite lives are tested for impairment whenever events or changes in circumstances (i.e. a triggering event) indicate that the carrying amounts amount of an asset may not be recoverable. The carrying valueCompany’s impairment review process is based upon an estimate of the assets is evaluated in relation to the operating performance and future undiscounted cash flowsflow. Factors the Company considers that could trigger an impairment review include the following:

significant under performance relative to expected historical or projected future operating results;

significant changes in the manner of our use of the acquired assets or the strategy for our overall business;

significant negative industry or economic trends; and

significant technological changes, which would render the technology obsolete.

Recoverability of the underlying assets. Milestone Scientific adjusts the net book value of an underlying asset if its fair value is determinedassets that will continue to be less than its net book value. There have been no impairment indicators or triggering events and therefore, no impairment reviews have been performedused in the period ending December 31, 2016.

12. Revenue Recognition

Revenue from product salesCompany's operations is recognized, net of discounts and allowances to domestic distributors, onmeasured by comparing the date of shipment for substantially all shipments, since the shipment terms are FOB warehouse. Milestone Scientific recognizes revenue on date of arrival of the goods at the customer's location, where shipments are FOB destination. Shipments to international distributors are FOB warehouse, therefore revenue is recognized on shipment of the goods. In all cases the pricecarrying value to the buyer is fixedfuture net undiscounted cash flows expected to be generated by the asset or asset group. Future undiscounted cash flows include estimates of future revenues, driven by market growth rates, and the collectability is reasonably assured. Further, Milestone Scientific has no obligation on these sales for any post installation, set-up or maintenance, these being the responsibility of the buyer. Milestone Scientific's only obligation after sale is the normal commercial warranty against manufacturing defects if the alleged defective unit is returned within the warranty period. Instrument and hand pieces are not bundled but rather sold separately and, as such, there are no multiple element determinations in connection with the revenue recognition.estimated future costs.

13. Shipping and Handling Costs

Milestone Scientific includes shipping and handling costs in cost of goods sold. These costs are billed to customers at the time of shipment for domestic shipments. International shipments are FOB warehouse, therefore no costs are incurred by Milestone Scientific.

 

14.

12. Note Payable

On April 27, 2020, the Company received a loan (the “Loan”) from Savoy Bank. in the aggregate amount of approximately $276,000, pursuant to the Paycheck Protection Program (the “PPP”) under Division A, Title I of the CARES Act, which was enacted March 27, 2020. The Company received forgiveness for the Loan during the year ended December 31, 2021 and recorded a gain on debt extinguishment of $276,180.

13.Research and Development

 

Research and development costs, which consist principally of new product development costs payable to third parties, are expensed as incurred. Advance payments for the research are amortized to expense either as services are performed or over the relevant service period using the straight line method.

 

15.

F- 11

14.Income Taxes

 

Milestone Scientific accounts for income taxes pursuant tounder the asset and liability method which requires deferred income tax assets and liabilities to be computed for temporary differences between the financial statement and tax basis of assets and liabilities that will result in taxable or deductible amounts in the future based on enacted tax laws and rates applicable to the periods in which the differences are expected to affect taxable income. Valuation allowances are established when necessary to reduce deferred tax assets to the amount expected to be realized.

 


16. At December 31, 2022 and 2021, we had no uncertain tax positions that required recognition in the consolidated financial statements. Milestone Scientific's policy is to recognize interest and penalties on unrecognized tax benefits in income tax expense in the Consolidated Statements of Operations. No interest and penalties are present for periods open. Tax returns for the 2019,2020, and 2021 years are subject to audit by federal and state jurisdictions.

15.Basic and diluted net loss per common shareDiluted Net Loss Per Common Share

 

Milestone Scientific presents basic”“basic” earnings (loss) per common share applicable to common stockholders and, if applicable, “diluted” earnings (loss) per common share applicable to common stockholders pursuant to the provisions of Statement of Financial Accounting Standards ASC Topic 260.260, “Earnings per Share”. Basic earnings (loss) per common share is calculated by dividing net income or loss applicable to common stockholders by the weighted average number of common shares outstanding and to be issued common shares of 70,607,338 and 68,829,860 during each period.the years ended December 31, 2022 and 2021, respectively. The calculation of diluted earnings per common share is similar tolike that of basic earnings per common share, except that the denominator is increased to include the number of additional common shares that would have been outstanding if all potentially dilutive common shares, such as those issuable upon the exercise of stock options warrants, and the conversion of debtwarrants were issued during the period.

 

Since Milestone Scientific had net losses for 2016 in the years ended December 31, 2022 and 2015,2021, the assumed effects of the exercise of potentially dilutive outstanding stock options, unissued restricted stock awards (“RSA”) and warrants, were not included in the calculation as their effect would have been anti-dilutive. Such outstanding options, RSA and warrants totaled 3,329,7697,855,160 and 1,427,769 at 7,291,800 on December 31, 20162022 and 2015,2021, respectively.

 

17. Use of Estimates

The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and assumptions in determining the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and reported amounts of revenues and expenses during the reporting period. The most significant estimates relate to the allowance for doubtful accounts, inventory valuation, and cash flow assumptions regarding evaluations for impairment of long-lived assets and going concern considerations, and valuation allowances on deferred tax assets. Actual results could differ from those estimates.16.

18. Fair Value of Financial Instruments

 

Fair Value Measurements:  We follow the provisions of ASC 820, Fair Value Measurements and Disclosures related to financial assets and liabilities that are being measured and reported on a fair value basis. Fair value is the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants in the principal market at the measurement date (exit price). We areThe Company required to classify fair value measurements in one of the following categories:categories

 

 

Level 1 inputs which are defined as quoted prices (unadjusted)(unadjusted) in active markets for identical assets or liabilities that the reporting entity has the ability toCompany can access at the measurement date.

 

Level 2 inputs which are defined as inputs other than quoted prices included within Level 1 that are observable forfor the assets or liabilities, either directly or indirectly.

 

Level 3 inputs are defined as unobservable inputs for the assets or liabilities.

 

Financial assets and liabilities are classified based on the lowest level of input that is significant to the fair value measurement. Our assessment of the significance of a particularan input to the fair value measurement requires judgment and may affect the valuation of the fair value of assets and liabilities and their placement within the fair value hierarchy levels. As of December 31, 2022 and 2021, the Company does not have any assets or liabilities that were measured at fair value on a recurring basis.

 

19.

17. Stock-Based Compensation

 
 

Milestone Scientific accounts for stock-based compensation under ASC Topic 718, Share-Based Payment. ASC Topic 718 requires all share-based payments to employees, non-employees, directors, and officers, including grants of employee stock options, to be recognized in the Statementsconsolidated statements of Operationsoperations over the service period, as an operating expense, based on the grant-date fair values.

F- 12

The weighted-average fair value of the options granted during 2016 and 2015 was estimated as $1.70 and $3.01, respectively, on the date of grant. The fair value for 2016 and 2015 was determined using the Black-Scholes option-pricing model with the following weighted average assumptions:18.Reclassifications

 


Certain reclassification has been made to the 2021 consolidated financial statements to conform to the 2022 consolidated financial statement presentation. These reclassifications had no effect on net loss or cash flows as previously reported.

  

2016

  

2015

 
         

Volatility

  181%  167%
         

Risk-free interest

  0.99%  1.73%
         

Expected Life (in years)

  5   5 
         

Dividend yield

  0%  0%
         

Forfeiture Rate

  6%  6%

 

20.

19. Recent Accounting Pronouncements

 

In May 2014, the FinancialAugust 2020, FASB issued ASU 2020-06, “Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting Standards Board (“FASB”) issuedfor Convertible Instruments and Contracts in an Entity’s Own Equity”, which, generally, provides guidance for revenue recognitionaccounting regarding derivatives relating to entities common stock and earnings per share. ASU 2020-06 is effective for contracts, supersedingall entities with fiscal years beginning after December 15, 2021, including interim periods therein. The adoption of this standard did not have an impact on the previous revenue recognition requirements, along with most existing industry-specific guidance. The guidance requires an entity to review contracts in five steps: 1) identify the contract, 2) identify performance obligations, 3) determine the transaction price, 4) allocate the transaction price, and 5) recognize revenue. The new standard will result in enhanced disclosures regarding the nature, amount, timing and uncertainty of revenue arising from contracts with customers. Company's consolidated financial statement.

In August 2015, June 2016, the FASB issued ASU 2016-13,Measurement of Credit Losses on Financial Instruments (“ASU 2016-13”), which amends the guidance approving a one-year deferral, makingon measuring credit losses for certain financial assets measured at amortized cost, including trade receivables. The FASB has subsequently issued several updates to the standard, providing additional guidance on certain topics covered by the standard. This update requires entities to recognize an allowance for credit losses using a forward-looking expected loss impairment model, taking into consideration historical experience, current conditions, and supportable forecasts that impact collectability.

In November 2019, the FASB issued ASU 2019-10,Financial Instruments - Credit Losses (Topic, 326), Derivatives and hedging (Topic 815), and Leases (Topic 842): Effectivedates, which deferred the effective date of ASU 2016-13 for the Company. As a result of ASU 2019-10, ASU 2016-13 is effective for reporting periodsall entities with fiscal years beginning after December 15, 2017, with early2022, including interim periods. The adoption permitted only for reporting periods beginning after December 15, 2016. The FASB continuesof this update is not expected to release guidance clarifying certain aspects of the revenue guidance. We do not believe that this new accounting pronouncement will have a material impact on ourthe Company's consolidated financial statements.statement.

In August 2014, the FASB issued a new standard Accounting Standards Update (“ASU”) No.2014-15, “Presentation of Financial Statements – Going Concern” (Subtopic 205-40).The new standard is intended to enhance the disclosure as it relates to management’s assessment of the abilities to continue as a going concern. The standard will be effective for the annual period ending after December 15, 2016. Milestone Scientific adopting this standard with its annual reporting as December 31, 2016.

In November 2015, the FASB issued guidance simplifying the balance sheet classification of deferred taxes. The new guidance requires that all deferred taxes be presented as noncurrent, rather than separated into current and noncurrent amounts. The guidance is effective for reporting periods beginning after December 15, 2016 and early adoption is permitted. In addition, the adoption of guidance can be applied either prospectively or retrospectively to all periods presented. We do not believe that this new accounting pronouncement will have a material impact on our financial statements.

In February 2016, the FASB issued a new standard ASU No.2016-02, “Leases“(Topic 842). The new standard is intended to increase transparency and comparability among organizations to recognize lease assets and liabilities on the balance sheet and disclose key information about leasing arrangements. It will be effective for fiscal years beginning after December 15, 2018 and for interim periods within fiscal years beginning after December 15, 2020. Milestone Scientific is in the process of determining what impact, if any, the adoption of this ASU will have on its financial position, results of operations and cash flows.

In March 2016, the FASB issued a new standard ASU No.2016-07, “Investments - Equity Method and Joint Ventures” (Topic 323): The new standard is intended to eliminate the requirement that when an investment qualifies for the use of the equity method as a result of an in increase in the level of ownership or degree of influence, results of operations and retained earnings retroactively on a step-by-step basis as if the equity method had been in effect all of the previous periods that the investment was held. It will be effective for all entities for fiscal years and interim periods, beginning after December 15, 2016. Milestone Scientific is in the process of determining what impact, if any, the adoption of this ASU will have on its financial position, results of operations and cash flows.

In March 2016, the FASB issued a new standard ASU No.2016-07, “Investments - Equity Method and Joint Ventures” (Topic 323): The new standard is intended to eliminate the requirement that when an investment qualifies for the use of the equity method as a result of an in increase in the level of ownership or degree of influence, results of operations and retained earnings retroactively on a step-by-step basis as if the equity method had been in effect all of the previous periods that the investment was held. It will be effective for all entities for fiscal years and interim periods, beginning after December 15, 2016. Milestone Scientific does not believe that this new accounting pronouncement will have a material impact on our financial statements.


In June 2016, the FASB issued a new standard ASU No.2016-13, “Financial Instruments – Credit Losses” (Topic 326).: The new standard is intended to replace the incurred loss impairment methodology in current GAAP with a methodology that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates. It will be effective for all entities for fiscal years and interim periods, beginning after December 15, 2018. Milestone Scientific is in the process of determining what impact, if any, the adoption of this ASU will have on its financial position, results of operations and cash flows.

In August 2016, the FASB issued a new standard ASU No.2016-15, “Statement of Cash Flows – Classification of Certain Cash Receipts and Cash Disbursements” (Topic 230). The new standard provides guidance as to the conformity of presentation of certain cash receipts and disbursements. It will be effective for all entities for fiscal years and interim periods, beginning after December 15, 2017. Milestone Scientific is in the process of determining what impact, if any, the adoption of this ASU will have on its presentation within the statement of cash flows.

NOTE C — INVENTORIES

  

December 31

 
  

2016

  

2015

 

Inventories consist of the following:

        

Finished goods

 $4,573,667  $4,252,612 

Component parts and other materials

  29,052   5,482 

Total

 $4,602,719  $4,258,094 

NOTE D INVENTORIES

  

December 31, 2022

  

December 31, 2021

 
         

Dental finished goods

 $1,315,263  $342,465 

Medical finished goods

  334,124   1,119,709 

Component parts and other materials

  142,948   79,339 

Total inventories

 $1,792,335  $1,541,513 

The Company recorded an allowance on slow moving Medical finished goods of approximately $582,000, and $450,000 as of December 31, 2022 and 2021, respectively due to the slow adoption of the epidural instruments and handpieces. The Company recorded an allowance on slow moving Dental finished goods of approximately $0 as of December 31, 2022 and 2021, respectively.

NOTE E — ADVANCES ON CONTRACTS

 

Milestone Scientific has entered into fixed arrangements with a contract manufacturer to manufacture STA Instruments and handpieces, CompuDent®. The contract manufacturer bills Milestone Scientific as the work progresses and it is Milestone Scientific’s policy to record these billings as advances on contracts. These advances are reclassified intocontracts represent funding of future dental STA "Single Tooth Anesthesia System" and epidural inventory when the contract manufacturer ships the productpurchases and title passes to Milestone Scientific.epidural replacements parts. The balance of the advances as of December 31, 2016 2022 and 2015 are $700,900 and $1,215,128, respectively. The advance is classified as current based on the estimated annual usage of the underlying inventory.2021 was approximately $1.3 million. 

NOTE E F– CONSOLIDATION OF VARIABLE INTEREST ENTITY

Milestone Medical

As of December 31, 2016, Milestone Medical is approximately 91% owned by Milestone Scientific. Milestone Medical was established to develop and commercialize intra-articular and epidural drug delivery instruments, utilizing an exclusive royalty-free license to Milestone Scientific's CompuFlo technology. The license was contributed by Milestone Scientific for its initial 50% ownership in Milestone Medical in September, 2011. 

Since its initial investment in Milestone Medical, Milestone Scientific had accounted for the investment in accordance with the equity method of accounting. However, during 2015, Milestone Scientific provided short term bridge financing to Milestone Medical in anticipation of the completion of a secondary stock offering in Poland. In December 2015, Milestone Medical suspended this capital raise efforts meriting re-consideration of the initial accounting for the investment as an equity method investment. In April 2016, Milestone Medical cancelled the uplisting of its shares to the Poland Warsaw Stock Exchange.  

As a result of the change in circumstances around the proposed offering in December 2015 by Milestone Medical, Milestone Scientific reevaluated its relationship with Milestone Medical and Milestone Medical's status as a VIE and determined that Milestone Medical did not have sufficient capital at risk to support its activities without additional financial support from Milestone Scientific.  Since the factors giving rise to concluding that Milestone Medical is a VIE happened proximate to the end of fiscal year 2015, the date for measuring the consolidation of Milestone Medical was deemed to be December 31, 2015.


In the second quarter of 2016, Milestone Scientific initiated a share exchange program pursuant to which it would exchange one share of common stock for every two outstanding shares of Milestone Medical common stock. As there was no change in control, the acquisition of the non-controlling interest is reflected as an equity transaction with the carrying value of the non-controlling interest adjusted to reflect Milestone Scientific's increased ownership interest in the subsidiary.  As a result of these exchanges, Milestone Scientific owns approximately 91% of Milestone Medical at December 31, 2016.

Milestone Education LLC

Milestone Education is a 50% owned subsidiary of Milestone Scientific which began operations in 2013 to provide training and education to dentists throughout the world. Milestone Scientific accounted for its investment in Milestone Education using the equity method of accounting through December 31, 2015. Approximately 81% of the revenue earned by Milestone Education is from services performed for Milestone Scientific as of December 31, 2016. As a result of this relationship, we determined that we have the power to direct the activities that most significantly impact Milestone Education's economic performance, and that it is a VIE and should be consolidated in the financials of Milestone Scientific effective January 2016.

The financial information in the table below summarizes the combined results of operations of Milestone Scientific and its subsidiaries, including Milestone Medical and Milestone Education, on a pro forma basis as though the companies had been combined as of the beginning of the earliest period presented. The pro forma financial information is presented for informational purposes only and is not indicative of the result of operations that would have been achieved if the consolidation had taken place at the beginning of the period presented.

 

December 31,

2015 Pro Forma

(unaudited)

 

Revenue

   

Sales

$9,624,375 

Cost of products sold

 3,061,299 

Gross Profit

 6,563,076 

Selling, general and administrative expenses

 12,781,813 

Research and development expenses

 892,255 

Operating expenses

 13,674,068 

Loss from operations

 (7,110,992)

Other expenses

 (6,845)

Interest  income

 3,846 

Loss before provision for income tax and equity in net earnings of equity investments

 (7,113,991)

Provision for Income Tax

 (36,157)

Loss before equity in net earnings of equity investments

 (7,150,148)

Loss on earnings from China Joint Venture

 (418,432)

Loss in equity investments

 (418,432)

Net loss

 (7,568,580)

Less: Net loss attributable to the noncontrolling interests

 (2,101,056)

Net loss attributable to Milestone Scientific Inc.

$(5,467,524)

NOTE F INVESTMENT IN AND TRANSACTIONS WITH EQUITY INVESTEESUNCONSOLIDATED SUBSIDIARIES

Advance Ocular Science SA

Advanced Ocular Sciences SA (“Advanced Ocular”) is an entity organized to develop an instrument that delivers injections into the eyes. Advanced Ocular is a shell company as of December 31, 2016. Milestone Scientific owns 25% of this entity. During 2015, Milestone Scientific advanced $78,798 for marketing and strategy planning to Advanced Ocular and they, or their organizers, are obligated to repay this advance once a public offering of Advanced Ocular equity is approved and funded in Poland during 2016. No public offering was completed in Poland as of December 31, 2016.


As such, Milestone Scientific has written-off the $78,798 advanced to Advanced Ocular as of December 31, 2016. Advance Ocular was not included in the consolidated financial statements at December 31, 2016 as no investment has been made by Milestone Scientific. The suspended losses approximated $19,700 at December 31, 2016. 

 

Milestone China Ltd.

 

Ownership

In June 2014, Milestone Scientific invested $1 million through the contribution of 772 STA instruments (at a distributor price of approximately $1,296 per instrument) for a forty percent (40%) ownership in Milestone China.  In 2014, the instruments were shipped and were recorded as an investment in Milestone China at the cost of the inventory contributed. In January 2016, Ltd. (“Milestone Scientific contributed 308 STAChina”) by contributing dental instruments with a retail value of approximately $400,000 ($1,296 per instrument) to Milestone China which increasedfor a 40% ownership interest. Milestone Scientific's investment byChina owns approximately $165,000 which represents75% of Milestone Beijing Medical Equipment Company, Ltd (“Milestone Beijing”). At the costtime, Milestone Beijing had primary responsibility for the sales, marketing, and distribution of the instruments. This did not increase Milestone Scientific's percentage of ownership since the contribution was proportionate to contributions from other shareholders.

Company’s dental products in China. Milestone Scientific recorded a loss on its investment in Milestone China under the equity method of $795,827 accounting. 

In first quarter of 2020, Milestone China and $418,432certain manufacturing/marketing affiliates entered into a reorganization agreement (the “Transaction”) pursuant to which Milestone China was to merge into an affiliated manufacturing company, Anhui Maishida Medical Technology, Co. Ltd. (“Anhui”), with Anhui as the surviving entity and to have complete responsibility for sales, marketing, and distribution for the twelve months ended Company’s dental products in China. After completion of the Transaction, Milestone Scientific was expected to have an approximate 28.4% direct ownership in Anhui. Due to the COVID-19 pandemic, the regulatory approval of the planned Transaction was delayed while applicable government offices were closed in China and Hong Kong. Until the completion of the transaction Milestone Scientific's 28.4% in Anhui was held by Milestone China.

F- 13

On November 23, 2021, management of Milestone Scientific became aware that on October 8, 2021, without approval from Milestone Scientific, (i) Milestone China entered into an Equity Transfer Agreement whereby Milestone China’s 28.4% equity stake in Anhui was transferred to Lidong Zhang, the CEO of Milestone China and Anhui, in exchange for RMB 2,840 million (approximately $440,351) of which no amounts have been or are expected to be received, see below, and (ii) Anhui held a shareholders’ meeting at which the Equity Transfer Agreement was approved by the shareholders of Anhui, eliminating Milestone China’s equity interest in Anhui and Milestone Scientific’s indirect equity interest in Anhui. Based on a review of the minutes of the Anhui shareholders’ meeting, Milestone China was not listed as a shareholder in such meeting due to the executed Equity Transfer Agreement between Lidong Zhang and Milestone China.

Though management believes that this conveyance by Milestone China to Lidong Zhang is outside of the laws of Hong Kong and/or China, as may be applicable, at this juncture Milestone Scientific has no ownership in Anhui and Milestone China has no assets or operations. After considering taking action to assert our rights in the matter, and based on the acknowledgement that such course of action is not without its procedural and substantive challenges in Hong Kong and/or China and, importantly, in view of Michelle Zhang dba Solee Science & Technology USA (“Solee”) (see below), a company located in New Jersey, then becoming the independent distributor for Milestone China and its subsidiaries, and due to the good working relationship then developing between Milestone Scientific and Solee and to the reduction of Milestone Scientific’s credit exposure to a Chinese entity, management is not pursuing any legal action at this time to recover our equity interest. The Company does not believe it is prudent at this time to continue to pursue its investigation of any options it may have regarding its Chinese distributor, and therefore, in order to preserve cash the Company is for the time being suspending its investigation. 

At this time, Milestone Scientific has not received any consideration, does not know if any of such consideration promised to Milestone China for its interest in Anhui has been paid and, if paid, whether it can recover its share of such consideration. Unless circumstances change, Milestone Scientific does not expect it will receive any of the consideration received by Milestone China for its assets without pursuing legal action. As a result, Milestone Scientific has not recorded a gain or receivable related to the transfer of Anhui. As of December 31, 2016, 2022 and 2015, respectively. Milestone Scientific'December 31, 2021, the investment in Milestone China was $0 as of December 31, 2016 and 2015. Milestone Scientific had suspended losses on its investment in Milestone China of $1,124,350, and $215,347 as of December 3, 2016 and 2015.zero.

Related Party Transactions

 

Milestone Scientific China Distribution Agreement

Milestone China had $3,425,000 of related party revenue for sales of instrumentsbeen Milestone Scientific’s exclusive distributor in China. During 2017 and handpiecesprior to the payment default during the twelve months ended December 31, 2016 to Milestone China.2018, Milestone Scientific recorded deferred revenues and cost associates with salesagreed to sell inventory to Milestone China and its agent. During 2018, Milestone Scientific entered into a payment arrangement with Milestone China to satisfy past due receivables from Milestone China and its agents which amounted to $2.8 million at the time of $1,001,800the payment arrangement. Milestone Scientific collected $950,000 under this arrangement, until Milestone China defaulted on the payment arrangements.

Beginning in mid- November 2021, Milestone Scientific entered into discussions with Michelle Zhang dba Solee Science & Technology USA (“Solee”), a company located in New Jersey, to become Milestone Scientific’s independent distributor for China, replacing its former distributor Milestone China and $620,041its subsidiaries. On November 22, 2021, Wand Dental, Inc., respectively asa United States subsidiary of Milestone Scientific, entered into a Buy and Sell Agreement with Solee, pursuant to which Milestone Scientific granted Solee the right to sell Milestone Scientific’s STA instruments, associated handpieces, and spare parts in China to Anhui.

For the twelve months ended December 31, 2016.  Milestone China owes $2,714,600 to Milestone Scientific for STA instruments and handpieces shipped in 2016, which is included in due from related party at December 31, 2016. During 2015, 2022, Milestone Scientific shipped $507,000instruments or handpieces to Solee for sale to Anhui and recognized revenue of approximately $630,000. For the twelve months ended December 31, 2021, Milestone Scientific shipped instruments or handpieces to Solee for sale to Anhui and recognized revenue of approximately $2.1 million. As of December 31,2022, the Company had no deposits from Solee for future shipment of goods included in handpieces and $938,304accrued expenses on the accompanying consolidated balance sheet.  As of December 31, 2021, the Company had approximately $89,000 of deposits from Solee for future shipment of goods included in instruments to Milestone China Ltd.accrued expenses on the accompanying consolidated balance sheet. 

 

Milestone Scientific recognizes the total revenue and costs of goods sold at the time the shipment of instruments and handpieces to Milestone China. However, dueGross Profit Deferral

Due to timing differences of when the inventory is sold to Milestone China, Anhui or their agent is recognized and when Milestone China and Anhui sells the acquired inventory to third parties, an elimination of the intra-entityrecorded profit is required as of the balance sheet date. In accordance with ASC 323Investment Equity Method and Joint Ventures, Milestone Scientific has deferred its ownership percentage of the gross profit associated with inventory shippedrecognized revenue from sales to Milestone China, Solee as an agent, and Anhui until that has not beenproduct is sold to third parties. The deferred profit of $630,990 and $ 69,781, as of December 31, 2016 and 2015, respectively is included in the loss from Milestone China within the Consolidated Statements of Operations and presented in due from related parties in the Consolidated Balance Sheets. Milestone Scientific received payment of $1.7 million of the amount outstanding at December 31, 2016 subsequent to year end.

The following table includes summarized financial information of Milestone China:

  

December 31, 2016

(unaudited)

  

December 31, 2015

(unaudited)

 
         

Assets:

        

    Current Assets

 $9,362,198  $772,999 

    Non -Current Assets

  2,467,547   903,766 

Total Assets:

  11,829,745   1,676,765 
         

Liabilities:

        

   Current Liabilities

  9,900,611   580,613 

Stockholders' equity

  1,929,134   1,096,152 

Total liabilities and stockholders’ equity

 $11,829,745  $1,676,765 

  

December 31, 2016

(unaudited)

  

December 31, 2015

(unaudited)

 

Net Sales

 $1,126,484  $2,303,660 

Cost of Goods Sold

  976,106   2,096,569 

Gross Profit

  150,378   207,091 

Other Expenses

  (2,834,980)  (1,342,357)

Net Losses

 $(2,684,602) $(1,135,266)

 


F- 14

As of December 31, 2022 and 2021, the Company had no deferred profit in the consolidated balance sheets. For the twelve months ended December 31, 2021 Milestone Scientific recorded loss on equity investment of approximately $242,000 in relation to gross profit previously deferred on product sold to Milestone China, Anhui, and Solee, recorded as deferred profit and divesture-equity investment on the accompanying consolidated statement of operations. 

NOTE G FURNITURE, FIXTURES AND EQUIPMENT

 

 

December 31

  

December 31, 2022

 

December 31, 2021

 
 

2016

  

2015

  

Furniture, Fixtures and Equipment consist of the following:

        

Leasehold improvements

 $24,734  $24,734  $24,734  $24,734 

Office furniture and equipment

  135,802   134,948  178,058  174,147 

Molds

  7,200   7,200  7,200  7,200 

Trade show displays

  143,357   136,029  151,462  151,462 

Computers and software

  224,840   217,265  280,066  275,364 

Tooling Safety Wand

  125,022   20,377  125,022  125,022 

Tooling equipment-STA & Wand

  11,100   115,745  11,100  11,100 

EPI and IA Instruments

  82,363   82,362  82,363  82,363 

STA Trials Instruments

  63,752   63,752   63,752   63,752 

Total

  818,170   802,412  923,757  915,144 

Less accumulated depreciation

  (659,144)  (566,477)  (905,611)  (891,431)

Total

 $159,026  $235,935  $18,146  $23,713 

Depreciation expense was $92,226$14,180 and $27,947$22,205 for the years ended December 31, 2016 2022, and 2015,2021, respectively.

NOTE H PATENTS

  

December 31, 2022

     
  

Cost

  

Accumulated Amortization

  

Net

 

Patents-foundation intellectual property

  $1,377,863   $(1,149,907)  $227,956 

Total

  $1,377,863   $(1,149,907)  $227,956 

  

December 31, 2021

     
  

Cost

  

Accumulated Amortization

  

Net

 

Patents-foundation intellectual property

  $1,377,863   $(1,100,244)  $277,619 

Total

  $1,377,863   $(1,100,244)  $277,619 

 

Patents are amortized utilizing the straight-line method over estimated useful lives ranging from 103 to 20 years, with a weighted average amortization period of 12 years. Amortization expense amountedwas $49,663 and $53,011 for the years ended December 31, 2022 and 2021 , respectively. The annual amortization expense expected to $70,699 in 2016be recorded for existing intangibles assets for the years 2023 through 2027 is approximately $52,000, $34,000, $28,000, $28,000 and $69,428 in 2015.$86,000, respectively.

NOTE I STOCKHOLDERS’ STOCKHOLDERS EQUITY

 

ISSUANCES COMMON STOCK

In June 2016, Milestone Scientific raised an additional $2.0 million of gross proceedsAt the annual shareholders meeting in a private placement of one million2021, the Company received approval to increase its authorized shares of common stock at a price of $2.00 per share,from 85,000,000 to the same investors that participated in the May 2014 Financing.

           In July 2016, Milestone Scientific raised gross proceeds of $250,000 in a registered direct offering of 104,200 shares of common stock at $2.40 per share. The transaction was covered by the prospectus supplement, filed with the United States Securities and Exchange Commission ("SEC) on July 22, 2016, to our shelf registration statement on Form S-3 (SEC File No.: 333-209466). 

In December 2016, Milestone Scientific completed an underwritten public offering of 2,000,000 shares of common stock and warrants to purchase up to 1,592,775 shares of common stock, including 92,775 additional warrants pursuant to a partial exercise of the over-allotment option granted to the underwriters. Each share of common stock was sold in combination with a warrant to purchase 0.75 shares of common stock. The public offering price for each share and related .75 share warrant was $1.50 for gross proceeds of $3,000,000. The warrants have a three-year term and an exercise price of $2.55 per share.  In January 2017, the underwriter exercised a portion of its over-allotment option to purchase an additional 123,700 shares of common stock at the public offering price of $1.499 per share for gross proceeds of approximately $186,000. The gross proceeds from this offering, including proceeds from partial exercises of the over-allotment option, were approximately $3,200,000, before deducting underwriting discounts and commissions and other offering expenses of $426,780.  100,000,000 shares.

 


F- 15

ISSUANCES OF PREFERRED STOCKWARRANTS

 

In May of 2014, Milestone completed a private placement, which raised gross proceeds in the total of $10 million, from the sale of $3 million of Milestone Scientific common stock (two millionThe following table summarizes information about shares issuable under warrants outstanding at $1.50 per share) and $7 million of our Series A Convertible Preferred Stock ("preferred stock") (7,000 shares at $1,000 per share), convertible into common stock at $2.37 per share (as adjusted to date) on May 14, 2019, or $1.50 per share unless certain conditions are not met both subject to anti-dilution adjustment.  Generally, each share of preferred stock entitles the holder to vote together with the holders of Milestone Scientific common stock, as a single class, on all matters submitted for the approval of the holders of Milestone Scientific common stock and has the number of votes equal to the number of shares of our common stock into which they are then convertible.  In addition, preferred stock is also entitled to share, pari passu, in any cash dividends declared on Milestone Scientific common stock on as converted basis.December 31, 2022:

  

Warrant shares outstanding

  

Weighted Average exercise price

  

Weighted Average remaining life

  

Intrinsic value

 
                 

Outstanding at January 1, 2022

  4,268,221   2.18   1.50   1,187,546 

Issued

  -   -   -   - 

Exercised

  -   -   -   - 

Outstanding and exercisable at December 31, 2022

  4,268,221   2.18   .50   - 

SHARES TO BE ISSUED

As of December 31, 2016 2022 and 2015,2021 , there were 1,270,4812,057,976 and 963,4511,891,979, respectively shares respectively,to be issued whose issuance has been deferred under the terms of an employment agreements with the former Interim Chief Executive Officer, former Chief Financial Officer, and other employees of Milestone Scientific. Such shares will be issued to each party upon termination of their employment. 

As of December 31, 2022 and 2021, there were 382,697 and 174,364, respectively shares to be issued to non-employees, that will be issued to non-employees for services rendered. The number of shares was fixed at the date of grant and were fully vested upon grant date.

 

SHARES RESERVED FOR FUTURE ISSUANCEThe following table summarizes information about shares to be issue at December 31, 2022 and 2021

 

At December 31, 2016 and 2015 there were 4,600,250 and 2,391,220 shares reserved for future issuance and 3,329,769 and 1,427,769 shares underlying other stock options and warrants outstanding, respectively. At December 31, 2016 and 2015 there were 1,270,481 shares and 963,451 shares, respectively, reserved for issuance in settlement of deferred compensation to officers of Milestone Scientific.

  

December 31, 2022

  

December 31, 2021

 
         

Shares-to-be-issued, outstanding

  2,066,343   2,428,329 

Granted in current period

  524,814   93,918 

Issued in current period

  (150,484)  (455,904)

Shares-to be issued outstanding

  2,440,673   2,066,343 

NOTE J STOCK OPTION PLANS

 

The 2004 Stock OptionMilestone Scientific Inc. 2020 Equity Compensation Plan, providedas amended and restated (the "2020 Plan"), provides for the grantawards of restricted common, stock restricted stock units, options to purchase and other awards, up to 750,000a maximum 4,000,000 shares of Milestone Scientific's common stock. stock and expires in June 2031. Options may be granted to employees, officers, directors, and consultants of Milestone Scientific for the purchase of shares of common stock at a price not less than the fair market value of common stock on the date of grant. Generally, options become exercisable over a three-year period from the grant date and expire five years after the date of grant. As of December 31, 2022 and 2021, the Company had 323,190 and 811,597, respectively, remaining options available for grants under the Plan.

On April 8, 2021, as part of its Succession Plan going into effect on April 23, 2021, the Company announced that Leonard Osser, the Interim Chief Executive Officer, would be accepting the role of Vice Chairman of the Board of Directors. As part of accepting this role, he would be granted options to purchase 2,000,000 shares of common stock, exercisable at the fair market value of the common stock on the date of grant, vesting over the grant. In general, options become exercisable over a three-yearfive-year period fromafter he steps down as Interim Chief Executive Officer of the grant date and expire fiveCompany or ten years afterfrom the date of grant. Theregrant, whichever shall end first. The options were no shares available for grant at December 31, 2016 under this plan.issued pursuant to the 2020 Plan.

 

 In June 2011, the stockholders of Milestone Scientific approved the 2011 Stock Option Plan (the "2011 Plan") which originally provided for stock options to our employees, directors and consultants and incentive and non-qualified stock options to purchase up to 2,000,000 shares of common stock. Such future share issuances are included in the above noted shares reserved for future issuances.  In general, options become exercisable over a three-year period from the grant date and expire five years after the date of grant. 

In May 2016, Milestone Scientific's stockholders approved the following amendments to the 2011 Plan:

                                    i.         Renaming of the 2011 plan to the “Milestone Scientific Inc., 2011 Equity Compensation Plan”

                                    ii.        Providing for awards of restricted common stock; and

                                   iii.        Increasing the maximum number of shares of common stock reserved for grants under the 2011 Plan from 2,000,000 to 4,000,000.

F- 16

Milestone Scientific recognizes compensation expense on a straight line basis over the requisite service period and in the case of performance basedperformance-based options over the period of the expected performance. For the twelve monthsyears ended December 31, 2016 2022 and 2015 respectively,2021, Milestone Scientific recognized $579,103approximately $961,000 and $637,108$763,000 of total employee compensation cost, respectively. respectively, recorded in general and administrative expenses on the statement of operations.

As of December 31, 2016 2022 and 2015,2021, there was $678,842$2.5 million and $1,167,865$3.2 million of total unrecognized compensation cost related to nonvestednon-vested options, respectively. Which Milestone Scientific expects to recognize these costcosts over a weighted average period of 2.58 years3.09 and 2.783.49 years as of December 31, 2016 2022 and 2015,2021, respectively.

 


A summary of option activity for employees under the plans and changes during the year ended December 31, 2016, 2022 is presented below:

 

  

Number of Options

  

Weighted Averaged Exercise Price $

  

Weighted Average Remaining Contractual Life (Years)

  

Aggregate Intrinsic Options Value $

 
Outstanding January 1, 2015  1,472,130   0.79   2.88   1,430,231 

Exercisable, December 31, 2015

  1,036,185   1.10   2.75   1,244,074 

Granted

  157,306   3.01   4.18     

Exercised during 2015

  (200,000)  1.00   -   - 

Forfeited or expired

  (10,000)  1.00   -   - 
Outstanding December 31, 2015  1,419,436   1.56   2.79   1,220,338 

Exercisable, December 31, 2015

  1,041,680   1.29   2.41   1,135,819 

Granted

  520,337   1.79   4.38   - 

Exercised during 2016

  (327,778)  .75   -   - 

Forfeited or expired

  (100,000)  2.35   -   - 
Outstanding December 31,2016  1,511,995   1.74   2.97   102,605 

Exercisable, December 31, 2016

  1,054,202   1.65   2.51   102,605 
  

Number of Options

  

Weighted Averaged Exercise Price $

  

Weighted Average Remaining Contractual Life (Years)

  

Aggregate Intrinsic Options Value $

 

Options outstanding January 1, 2022

  2,843,693   2.39   7.69   49,246 

Granted during 2022

  216,296   1.52   2.23   - 

Exercised during 2022

  -   -   -   - 

Forfeited or expired during 2022

  -   -   -   - 

Options outstanding December 31, 2022

  3,059,989   2.36   6.38   - 

Exercisable, December 31, 2022

  1,026,987   2.18   4.93   - 

The weighted-average grant date fair value per share of options granted to employees during the years ended December 31, 2022 and 2021 was $0.82 and $1.56, respectively. The aggregate intrinsic value of options granted to employees exercised was $0 and $290,688 for the years ended December 31, 2022 and 2021, respectively.

The Company used the following assumptions to calculate the fair value of the stock option grants using the Black-Scholes option pricing model on the measurement date during the year ended December 31, 2022, risk free interest rate of 2.45%, Volatility of 89.60% (which is based on the Company’s historical volatility over the expected term), expected term of 3 years, 0% dividend rate and closing price of the stock of $1.52.   

 

A summary of option activity for non-employees under the plans as of December 31, 2016 and 2015, and changes during the year ended December 31, 2022 is presented below:

 

 

 

Number of Options

 

 

Weighted Averaged Exercise Price $

 

 

Weighted Average Remaining Contractual Life (Years)

 

 

Aggregate Intrinsic Options Value $

 

Outstanding, January 1, 2015

 

 

16,666

 

 

 

1.27

 

 

 

0.62

 

 

 

17,166

 

Exercisable, January 1, 2015

 

 

16,666

 

 

 

1.27

 

 

 

0.62

 

 

 

17,166

 

Granted

 

 

8333

 

 

 

2.70

 

 

 

4.83

 

 

 

22,499

 

Exercised

 

 

(16,666

)

 

 

1.27

 

 

 

-

 

 

 

-

 

Outstanding, December 31, 2015

 

 

8,333

 

 

 

2.70

 

 

 

4.83

 

 

 

-

 

Exercisable, December 31, 2015

 

 

2,777

 

 

 

2.70

 

 

 

4.83

 

 

 

-

 

Granted

 

 

216,666

 

 

 

2.53

 

 

 

-

 

 

 

-

 

Exercised

 

 

-

 

 

 

-

 

 

 

-

 

 

 

-

 

Outstanding, December 31, 2016

 

 

224,999

 

 

 

2.53

 

 

 

5.32

 

 

 

-

 

Exercisable, December 31, 2016

 

 

14,734

 

 

 

2.72

 

 

 

4.36

 

 

 

-

 

  

Number of Options

  

Weighted Averaged Exercise Price $

  

Weighted Average Remaining Contractual Life (Years)

  

Aggregate Intrinsic Options Value $

 

Options outstanding January 1, 2022

  83,330   1.85   3.33   49,748 

Granted during 2022

  8,333   0.73   4.80   - 

Exercised during 2022

  -   -   -   - 

Options outstanding December 31, 2022

  91,663   1.75   2.55   1,083 

Exercisable, December 31, 2022

  77,776   1.66   2.30   1,083 

 


The fair value of the non-employee options was estimated on the date of grant using the Black Scholes option-pricing model at the date of grant. In accordance with the provisions of FASB ASC 505, Milestone Scientific will re-measure the value of the grant at each presentation date unless there is a significant disincentive for non-performance or until performance has been. For the twelve months end years ended December 31, 2016,2022 and 2021, Milestone Scientific recognized $25,346approximately $22,900 and $27,600 expense related to non-employee options.options, respectively.

The Company used the following assumptions to calculate the fair value of the stock option grants using the Black-Scholes option pricing model on the measurement date during the year ended December 31, 2022, risk free interest rate of 4.12%, Volatility of 91.46% expected term of 5 years, 0% dividend rate and closing price of the stock of $0.73.  

F- 17

The information below summarizes the restricted stock award activity for year ended December 31, 2022:

  

Number of Shares

  

Weighted Average Grant-Date Fair Value per Award

 

Non-vested as January 1, 2022

  96,557   2.33 

Granted

  975,148   0.86 

Vested

  (449,695)  - 

Cancelled

  (186,717)  - 

Non-vested as December 31, 2022

  435,293   1.18 

As of December 31, 2022, there were 49,615 restricted shares granted and deferred under the terms of an employment agreements with the Territory Manager of Milestone Scientific. Such shares will be issued to each party upon completion of 2 years of employment. For the twelve months end years ended December 31, 2015, Milestone Scientific2022 and 2021, the Company recognized $7,050negative stock compensation expense and stock compensation expense of approximately ($20,000) and $70,000, respectively. As of December 31, 2022, the total unrecognized compensation expense was $37,500 related to non-employee options. As of December 31, 2016, there was a total of $678,842 of unrecognized compensation cost related to non-vested options,unvested restricted stock awards for Territory Managers, which Milestone Scientificthe Company expects to recognize over an estimated weighted-average period of 1.03 years.

As of December 31, 2022, the Company entered into restricted stock agreements with members of the Board of Directors of the Company. The Company granted 899,390 restricted stock awards with a fair market value of $0.82 per share. Such restricted stock vests as follows: 25% on the grant date in June 2022, and 25% quarterly, on the first day of the following months:  October 2022, January 2023, and April 2023. These awards vest immediately upon a change of control as defined in the agreements. For the year ended December 31, 2022, the Company recognized approximately $549,000 for restricted stock expenses recorded in general and administrative expenses on the statement of operation. As of December 31, 2022, the total unrecognized stock compensation expense was approximately $160,000 related to non-vested restricted stock awards with the members of the Board of Directors, which the Company expects to recognize over an estimated weighted average period of 2.490.25 years.

NOTE K– KEMPLOYMENT CONTRACT AND DEFERRED COMPENSATIONCONSULTING AGREEMENTS

 

Employment Contracts

 

 K. Tucker Andersen, a significant stockholder of Milestone Scientific, has an agreement with Milestone Scientific to provide financial and business strategic services. Expenses recognized on this agreement were $100,000 for years ended December 31,2022 and 2021, respectively. 

The Director of Clinical Affairs’ royalty fee was approximately $442,000 and $446,000 for the years ended December 31, 2022 and 2021, respectively. Additionally, Milestone Scientific expensed consulting fees to the Director of Clinical Affairs of  $154,000 and $158,000 for the year ended December 31, 2022 and 2021, respectively. As of September 1, 2009, December 31, 2022, and 2021, Milestone Scientific owed the Director Clinical Affairs for royalties of approximately $120,000 and $123,000, respectively, which is included in accounts payable, related party and accrued expense, related party, in the consolidated balance sheet.

On March 2, 2021, Milestone Scientific entered into a five-year employment agreementRoyalty Sharing Agreement with Leonard Osser, as itsthe Company’s then Interim Chief Executive Officer, (the "2009 Agreement"). The term of the 2009 Agreement is automatically extended for successive one-year periods unless prior to August 1 of any year, either party notifies the other that he or it chooses not to extend the term. Under the 2009 Agreement, the CEO receives base compensation of $300,000 per year. In addition, the CEO, may earn annual bonuses up to an aggregate of $400,000, payable one half in cash and one half in common stock, contingent upon achieving targets set for each year by the Compensation Committee. In addition, if in any year of the term of the agreement the CEO earns a bonus, he shall also be granted five-year stock options to purchase twice the number of bonus shares earned. Each such option is to be exercisable at a price per share equal to the fair market value of a share on the date of grant (110%) of the fair market value if the CEO is a 10% or greater stockholder on the date of grant). The options shall vest and become exercisable to the extent of one-third of the shares covered at the end of each of the first three years following the date of grant, but shall only be exercisable while the CEO is employed by Milestone Scientific or within 30 days after the termination of his employment. In 2012 the CEO waived the option component of his bonus for that year.

In accordance with the 2009 Agreement, 855,810 shares of common stock are to be paid out at the end of the term in settlement of $980,906 of deferred compensation accrued at December 31, 2016 and 735,369 shares of common stock are to be paid out at the end of the contract in settlement of $730,985 of deferred compensation accrued at December 31, 2015 and, accordingly, such shares have been classified in stockholders' equity with the common stock classified as to be issued.

On December 1, 2016, Wand Dental and Gian Domenico Trombetta (“Trombetta”) entered into an Amended and Restated Employment Agreement (the “Agreement”), pursuant to which Trombetta receives base compensationMr. Osser sold, transferred and assigned to the Company all of $280,000 per yearhis rights in and to a certain patent application as to which he is eligiblea co-inventor with Dr. Hochman, and the Company agreed to receive annual bonuses in the sole discretionpay to Mr. Osser, beginning May 9, 2027, half of the Compensation Committee. royalty (2.5%) on net sales that would otherwise be payable to Dr. Hochman and his wife under their Technology Sale Agreement with the Company, the Hochman's having agreed with the Company pursuant to an addendum to such Technology Sale Agreement dated February 25, 2021 to reduce from 5% to 2.5% the payments due to them on May 9, 2027 and thereafter, with respect to dental products.

F- 18

Pursuant to a Succession Agreement dated April 6, 2021 between Mr. Osser and the Company: (i) the Employment Agreement Trombetta will continuedated as of July 10, 2017 between Mr. Osser and the Company, pursuant to servewhich upon Mr. Osser stepping down as theInterim Chief Executive Officer of Wand Dental for a period of one-year beginning on September 1, 2016 through August 31, 2017 (the “Employment Term”). The Employment Term automatically renews for a one-year period, from September 1st through August 31st of each successive year (each a “Renewal Term”), unless priorthe Company, the Company agreed to June 1stemploy him as Managing Director, China Operations of the Employment Term or any Renewal Term,Company (the “China Operations Agreement”), and (ii) the Consulting Agreement dated as applicable, either party notifies of July 10, 2017 (the other that he or it chooses not“Consulting Agreement”) between the Company and U.S. Asian Consulting Group, LLC, a company of which Mr. Osser is a principal, the compensation under the China Operations Agreement was modified to extendreduce the termoverall compensation by $100,000 to $200,000, split equally between a cash amount and an amount in shares, and the compensation under the Consulting Agreement is increased by $100,000 to $200,000, equally split between a cash amount and an amount in shares, which shares were formerly payable under the China Operations Agreement.  Compensation under the China Operations Agreement and the Consulting Agreement are payable for 9.5 years from May 19, 2021. The Company recorded expense of employment in accordance with$200,000 and $125,000 related to the termsManaging Director, China Operations for the year ended December 31, 2022, and 2021, respectively. The Company recorded expense of $200,000 and $125,000 related to the Agreement.

US Asian Consulting Group, LLC for the year ended December 31, 2022, and 2021, respectively. 


NOTE L INCOME TAXES

 

Due to Milestone Scientific®€™sScientific's history of operating losses, a full valuation allowances hashave been provided for all of Milestone Scientific®€™sScientific's deferred tax assets at assets. At December 31, 2016 2022 and 2015,2021, no recognition was given to the utilization of the remaining net operating loss carryforwards.carry forwards in each of these periods.

 

Deferred tax attributes resulting from differences between financial accounting amounts and tax bases of assets and liabilities at December 31, 2016 2022 and 20152021 are as follows:     

  

2016

  

2015

 

Current assets

        

Allowance for doubtful accounts-short term

 $4,000  $2,000 

Warranty reserve

  36,000   43,000 

Deferred officers compensation

  395,000   643,000 

Subtotal

  435,000   688,000 

Valuation allowance

  (435,000)  (688,000)

Non-current assets

        

Depreciation and amortization

 $135,000  $149,000 

Net operating loss carryforward

  18,456,000   16,160,000 

Federal tax effect of state deferred tax assets

  -   (117,000)

Subtotal

  18,591,000   16,192,000 

Valuation allowance

  (18,591,000)  (16,192,000)

  

2022

  

2021

 

Allowance for Doubtful Accounts

  2,000  $2,000 

Warranty Reserve

  2,000   3,000 

Impaired Assets

  -   - 

Capitalized Sec. 174 R&D

  242,000   - 

Inventory Reserve

  242,000   108,000 

Deferred Officer's Compensation

  428,000   439,000 

Depreciation and Amortization

  (56,000)  (52,000)

Net Operating Loss Carryforwards

  19,315,000   18,895,000 

Tax Credits

  688,000   660,000 

Other

  155,000   45,000 

Subtotal

  21,018,000   20,100,000 

Valuation allowance

  (21,018,000)  (20,100,000)

Non-current deferred tax asset

  -   - 

 

As of December 31, 2016,2022 and 2021,  federal net operating loss carryforwardscarry-forwards are approximately $51,807,000.$71,700,000 and $68,300,000, respectively. As of December 31, 2015 and 2022, Milestone Scientific has federal net operating loss carryforwards oflosses generated before December 31, 2017 will be available to offset future income, if any, through December 2037. Net operating losses generated in 2018 or after can be carried forward indefinitely.

State net operating losses were approximately $46,875,000, which is comprised solely of losses attributable Milestone Scientific$60,500,000 and its subsidiaries.$63,400,000 for the periods ended December 31, 2022 and 2021, respectively. Net operating losses will be available to offset future taxable income, if any, through December 2036. As of December 31, 2016 state net operating losses were approximately $10,047,000. As of December 31, 2015 Milestone Scientific has state net operating loss carryforwards of approximately $3,771,000.  Net operating losses will be available to offset future taxable income, if any, through December 2036.2041.

 

The utilization of Milestone Scientific's net operating losses may be subject to a substantial limitation due to the "change of ownership provisions" under Section 382 of the Internal Revenue Code and similar state provisions. Such limitation may result in the expiration of the net operating loss carry forwards before their utilization. Milestone Scientific has established a 100% valuation allowance for all of its deferred tax assets due to uncertainty as to their future realization.

For the year ended December 31, 2016 and 2015, state tax liability was approximately $13,000 and $62,000. Such expense was recognized in the accompanying consolidated financial statements.

A reconciliation of the statutory tax rates for the years ended December 31, is as follows: 

 

 

2016

 

 

2015

 

 

 

 

 

 

 

 

 

 

Statutory rate

 

 

34

%

 

 

34

%

State income tax - all states

 

 

6

%

 

 

6

%

Non-deductible stock based compensation

 

 

3

%

 

 

-

 

   43%  40%

Current year valuation allowance

 

 

(43

%)

 

 

(40

%)

Benefit for income taxes

 

 

0

%

 

 

0

%


Accounting for Uncertain Tax Positions:

 

Accounting for uncertainties in income taxes prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return, and also provides guidance on derecognition, classification, interest and penalties, disclosure, and transition. At December 31, 2016, 2022 and 2015,2021, we had no uncertain tax positions that required recognition in the consolidated financial statements. Milestone Scientific's policy is to recognize interest and penalties on unrecognized tax benefits in income tax expense in the Statements of Operations. No interest and penalties are present for periods open. Tax returns for the 2013, 2014,2019,2020, and 20152021 years are subject to audit by federal and state jurisdictions.

 

F- 19

A reconciliation of the statutory tax rates for the years ended December 31, is as follows:   

  

2022

  

2021

 

Statutory Rate

  21.00%  21.00%

State income tax - all states

  -2.74%  7.44%

Stock compensation

  -2.57%  0.00%

NOL Expiration

  -4.69%  -9.13%

Other

  -0.56%  -7.79%

Subtotal

  10.44%  11.52%

Valuation Allowance

  -10.44%  -11.52%

Effective tax Rate

  -0.00%  0.00%

NOTE M PRODUCT SALES SEGMENT AND SIGNIFICANT CUSTOMERS AND VENDORSGEOGRAPHIC DATA

 

Milestone Scientific’s consolidated dentalThe Company conducts its business through two reportable segments: Dental and Medical. These segments offer different products and services to different customer base. The Company provides general corporate services to its segments; however, these services are not considered when making operating decisions and assessing segment performance. These services are reported under “Corporate Services” below and these include costs associated with executive management, investor relations, patents, trademarks, licensing agreements, new instruments developments, financing activities and public company compliance.

The following tables present information about our reportable and operating segments:

  

Year ended December 31,

 

Sales

        

Net Sales:

 

2022

  

2021

 

Dental

 $8,753,156  $10,152,511 

Medical

  52,750   152,200 

Total net sales

 $8,805,906  $10,304,711 
         

Operating Income (Loss):

 

2022

  

2021

 

Dental

 $1,121,815  $2,475,059 

Medical

  (4,788,105)  (4,105,854)

Corporate

  (5,161,183)  (5,747,713)

Total operating loss

 $(8,827,473) $(7,378,508)
         

Depreciation and Amortization:

 

2022

  

2021

 

Dental

 $3,805  $4,351 

Medical

  4,075   7,313 

Corporate

  55,875   62,172 

Total depreciation and amortization

 $63,755  $73,836 
         

Income (loss) before taxes and equity in earnings of affiliates:

 

2022

  

2021

 

Dental

 $1,116,598  $2,544,730 

Medical

  (4,794,089)  (4,111,159)

Corporate

  (5,095,375)  (5,552,259)

Total loss before taxes and equity in earnings of affiliate

 $(8,772,866) $(7,118,688)
         

Total Assets

 

December 31, 2022

  

December 31, 2021

 

Dental

 $3,875,978  $6,163,169 

Medical

  620,373   1,373,511 

Corporate

  9,205,735   12,273,064 

Total assets

 $13,702,086  $19,809,744 

F- 20

The following table presents information about our operations by geographic area as of December 31, 2022 and 2021. Net sales by product and by geographical regiongeographic area are as follows:based on the respective locations of our subsidiaries.

 

  

Years Ended December 31,

 
  

2016

  

2015

 

DOMESTIC

                

Instruments

 $852,148   27.5% $623,195   17.8%

Handpieces

  2,102,394   67.9%  2,799,785   79.8%

Other

  143,762   4.6%  83,362   2.4%

Total Domestic

 $3,098,304   100.0% $3,506,342   100.0%

INTERNATIONAL

                

Instruments

 $3,264,633   44.2% $2,062,556   34.5%

Handpieces

  4,063,811   55.1%  3,836,002   64.1%

Other

  55,257   0.7%  86,669   1.4%

Total International

 $7,383,701   100.0% $5,985,227   100.0%

DOMESTIC/INTERNATIONAL ANALYSIS

                

Domestic

 $3,098,304   29.6% $3,506,342   36.9%

International

 $7,383,701   70.4% $5,985,227   63.1%

Total Product Sales

 $10,482,005   100.0% $9,491,569   100.0%
  

2022

  

2021

 

Domestic: US

 

Dental

  

Medical

  

Grand Total

  

Dental

  

Medical

  

Grand Total

 

Instruments

 $524,715  $7,500  $532,215  $560,424  $-  $560,424 

Handpieces

  2,653,914   25,250   2,679,164   2,905,354   35,200   2,940,554 

Accessories

  78,493   -   78,493   69,271   1,300   70,571 

Grand Total

 $3,257,122  $32,750  $3,289,872  $3,535,049  $36,500  $3,571,549 
                         

International: Rest of World

  Dental   Medical   Grand Total  

Dental

  

Medical

   Grand Total 

Instruments

 $1,413,525  $-  $1,413,525  $1,226,486  $70,000  $1,296,486 

Handpieces

  3,391,748   20,000   3,411,748   3,246,302   44,900   3,291,202 

Accessories

  60,797   -   60,797   46,546   800   47,346 

Grand Total

 $4,866,070  $20,000  $4,886,070  $4,519,334  $115,700  $4,635,034 
                         

International: China

  Dental   Medical   Grand Total  

Dental

  

Medical

   Grand Total 

Instruments

 $270,000  $-  $270,000  $303,000  $-  $303,000 

Handpieces

  359,964   -   359,964   1,795,128   -   1,795,128 

Accessories

  -   -   -   -   -   - 

Grand Total

  629,964   -  $629,964  $2,098,128  $-  $2,098,128 
                         

Total Product Sales

 $8,753,156  $52,750  $8,805,906  $10,152,511  $152,200  $10,304,711 

NOTE N-- CONCENTRATIONS

 

Milestone Scientific has informal arrangements with the manufacturerthird-party U.S. manufacturers of the STA, CompuDent®CompuDent and CompuMed® instruments, one of the principal manufacturers for those instrumentsCompuMed devices, pursuant to which they manufacture these products under specific purchase orders but without any long-term contract or minimum purchase commitment. In March 2016, Milestone Scientific entered into a new purchase commitment for delivery of 3,000 instruments. An advance an aggregate of $656,752 was recorded at December 31, 2016. Consequently, advances on contracts have been classified as current at December 31, 2016 2022 and 2015.

For the year ended December 31, 2016, Milestone Scientific had two customers (distributors, one is a related party) that purchased approximately 58% (31% and 27%), of its net product sales. Accounts receivable for the two major customers amounted to approximately $2,994,686, or 85% of gross accounts receivable for the years ended December 31, 2016. For the year ended December 31, 2015, Milestone Scientific had two customers (distributors, one is a related party) that purchased approximately 33% (15% and 15%), of its net product sales. Accounts receivable for the three major customers amounted to approximately $1,100,000, or 69% of gross accounts receivable for the years ended December 31, 2015.


NOTE N -- RELATED PARTIES

Milestone Scientific has a manufacturing agreement with one of its principal manufacturers, which is a related party, of its handpieces pursuant to which they manufacture products under specific purchase orders, but without minimum purchase commitments. Purchases of handpieces from this vendor in China were $3,025,249 and $2,698,522 during the years ended December 31, 2016 and 2015 respectively. All other purchases from other suppliers were not significant for the period. Milestone Scientific Inc owed $1,235,052 and $716,519 to this supplier as of December 31, 2016 and 2015, respectively.

Milestone Scientific has $3,245,000 of related party revenue for sales of instruments and handpieces during the twelve months ended December 31, 2016 to Milestone China. Milestone Scientific recorded deferred revenues and cost associates with the sales to Milestone China $1,001,800 and $620,041 as of December 31, 2016.  Milestone China owes $2,714,600 to Milestone Scientific for STA instruments and handpieces shipped in 2016, which is included in due from related party at December 31, 2016.  During 2015, Milestone Scientific shipped $507,000 in handpieces and $938,304 in instruments to Milestone China Ltd.

Milestone Scientific recognizes the total revenue and costs of goods sold at the time the shipment of instruments and handpieces to Milestone China. However, due to timing differences of when the inventory is sold to Milestone China and when Milestone China sells the acquired inventory to third parties, elimination of the intra-entity profit is required as of the balance sheet date. In accordance with ASC 323 Equity Method and Joint Ventures, Milestone Scientific has deferred the gross profit associated with inventory shipped to Milestone China that has not been sold to third parties. The deferred profit of $630,990 and $ 69,781, as of December 31, 2016 and 2015, respectively is included in the loss from Milestone China within the Consolidated Statements of Operations and presented in due from related parties in the Consolidated Balance Sheets. Milestone Scientific received payment of $1.7 million of the amount outstanding at December 31, 2016 subsequent to year end.

       In June 2016, Milestone Scientific raised an additional $2.0 million of gross proceeds in a private placement of one million shares of common stock, at a price of $2.00 per share, to Innovest, a related party.

         In August 2013, a stockholder of Milestone Scientific entered a three-year agreement with Milestone Scientific to provide financial and business strategic services. The fee for these services are $100,000 annually.

NOTE O — COMMITMENTS AND OTHER

(1) Lease Commitments

The headquarters for Milestone Scientific is located at 220 South Orange Ave, Livingston, New Jersey. Milestone Scientific leases approximately 7,625 square feet of office space. The lease term expires January 31, 2020 at a monthly cost of $12,522. Additionally, Milestone Scientific has other smaller insignificant leases ending through 2017. A third party distribution and logistics center in Pennsylvania handles shipping and order fulfillment on a month-to-month basis.

Aggregate minimum rental commitments under noncancelable operating leases are as follows:

  

Year Ending December 31,

 

2017

  150,264 

2018

  150,264 

2019

  161,532 

2020

  152,142 
  $614,202 

For the years ended December 31, 2016 and 2015, respectively, rent expense amounted to $133,657and $121,866 respectively.


(2) Contract Manufacturing Arrangement

Milestone Scientific has informal arrangements for the manufacture of its product, The STA Single Tooth Anesthesia System® instrument is manufactured for Milestone Scientific by Tricor Systems, Inc. pursuant to specific purchase orders. The STA and the Wand® Handpiece with Needle is supplied to Milestone Scientific by a contractor in the United States, which arranges for its manufacture with two factories in China.

2021.The termination of the manufacturing relationship with any of the abovethese manufacturers could have a material adverse effect on Milestone Scientific’s ability to produce and sell its products. Although alternate sources of supply exist, and new manufacturing relationships could be established, Milestone Scientific would need to recover its existing tools or have new tools produced. Establishment of new manufacturing relationships could involve significant expense and delay. Any curtailment or interruption of the supply, whether or not as a resultbecause of termination of such a relationship, would have a material adverse effect on Milestone Scientific’s financial condition, business, and results of operations.

 

(3) Other CommitmentsWe had two customers that accounted for 32%, and 11% amount of revenue respectively for the year ended December 31, 2022. We had two customers that accounted for 35%, and 20% amount of revenue respectively for the year ended December 31, 2021.

We had two customers that accounted for 33%, and 20% amount of accounts receivable, respectively as of December 31, 2022. We had three customers that accounted for 29%, 28%, and 13% amount of accounts receivable, respectively as of December 31, 2021.

We had one vendor that accounted for 42%, of accounts payable and accounts payable related party, respectively as of December 31, 2022. We had two vendor that accounted for 14% and 34 %, of accounts payable and accounts payable related party, respectively as of December 31, 2021.

NOTE O-- RELATED PARTY TRANSACTIONS

United Systems

 

Milestone Scientific's employmentScientific has a supply agreement with United Systems (whose controlling shareholder, Tom Cheng, is a significant stockholder of Milestone Scientific), the principal supplier  of its Chief Executive Officer provides for payments of $203,111 per year for five yearshandpieces, pursuant to the executive, or as he directs such payments, to a third party to fund his acquisition of, or contribution to, an annuity, pension, or deferred distribution plan; or for an investmentwhich it procures manufactured products under specific purchase orders, but without minimum purchase commitments. Purchases from this supplier were approximately $3.4 million and $1.7 million for the benefittwelve months ended December 31, 2022, and 2021, respectively.  As December 31, 2022, and December 31, 2021, Milestone Scientific owed this supplier approximately $819,000 and $548,000, respectively, which is included in accounts payable and accrued expenses related party on the consolidated balance sheets. In June 2021, the Company signed a ten-year agreement with United Systems for supplier of the executive and his family. For the twelve months ended December 31, 2016 and 2015 approximately $203,111 and $236,963 was charged to expense, respectively to fund this obligation.  handpieces.

 

The technology underlying the SafetyWand® and CompuFlo®, and an improvement to the controls for CompuDent® were developed by the DirectorMilestone China

See Note F.

F- 21

Other

 K. Tucker Andersen, a significant stockholder of Clinical Affairs and assigned to Milestone Scientific. Milestone Scientific, purchased this technology pursuant tohas an agreement dated January 1, 2005. The Director of Clinical Affairs will receive additional payments of 2.5% of the total sales of products using certain of these technologies, and 5% of the total sales of products using certain other of the technologies. The Director of Clinical Affairs was granted, pursuant to the agreement, an option to purchase, at fair market value on the date of the grant 8,333 shares of common stock upon the issuance of each additional patent relating to these technologies. If products produced by third parties use any of these technologies (under license from us) then the Director of Clinical Affairs will receive the corresponding percentage of the consideration received bywith  Milestone Scientific to provide financial and business strategic services. Expenses recognized on this agreement were $100,000 for such sale or license.years ended December 31,2022 and 2021, respectively. 

 

The Director of Clinical Affairs’ royalty fee was $526,737approximately $442,000 and $442,763$446,000 for the twelve monthsyears ended December 31, 2016 2022 and 2015,2021, respectively. Additionally, Milestone Scientific expensed consulting fees to the Director of Clinical Affairs of  $275,000$154,000 and $185,751$158,000 for the twelve monthsyear ended December 31, 2016 2022 and 2015,2021, respectively. As of December 31, 2022, and 2021, Milestone Scientific owed the Director Clinical Affairs for royalties of approximately $120,000 and $123,000, respectively, which is included in accounts payable, related party and accrued expense, related party, in the consolidated balance sheet.

On March 2, 2021, Milestone Scientific entered into a Royalty Sharing Agreement with Leonard Osser, the Company’s then Interim Chief Executive Officer, pursuant to which Mr. Osser sold, transferred and assigned to the Company all of his rights in and to a certain patent application as to which he is a co-inventor with Dr. Hochman, and the Company agreed to pay to Mr. Osser, beginning May 9, 2027, half of the royalty (2.5%) on net sales that would otherwise be payable to Dr. Hochman and his wife under their Technology Sale Agreement with the Company, the Hochman's having agreed with the Company pursuant to an addendum to such Technology Sale Agreement dated February 25, 2021 to reduce from 5% to 2.5% the payments due to them on May 9, 2027 and thereafter, with respect to dental products.

Pursuant to a Succession Agreement dated April 6, 2021 between Mr. Osser and the Company: (i) the Employment Agreement dated as of July 10, 2017 between Mr. Osser and the Company, pursuant to which upon Mr. Osser stepping down as Interim Chief Executive Officer of the Company, the Company agreed to employ him as Managing Director, China Operations of the Company (the “China Operations Agreement”), and (ii) the Consulting Agreement dated as of July 10, 2017 (the “Consulting Agreement”) between the Company and U.S. Asian Consulting Group, LLC, a company of which Mr. Osser is a principal, the compensation under the China Operations Agreement was modified to reduce the overall compensation by $100,000 to $200,000, split equally between a cash amount and an amount in shares, and the compensation under the Consulting Agreement is increased by $100,000 to $200,000, equally split between a cash amount and an amount in shares, which shares were formerly payable under the China Operations Agreement.  Compensation under the China Operations Agreement and the Consulting Agreement are payable for 9.5 years from May 19, 2021.The Company recorded expense of $200,000 and $125,000 related to the Managing Director, China Operations for the year ended December 31, 2022, and 2021, respectively. The Company recorded expense of $200,000 and $125,000 related to the US Asian Consulting Group, LLC for the year ended December 31, 2022, and 2021, respectively. 

NOTE P — COMMITMENTS

 

(1) Contract Manufacturing Agreement

Milestone Scientific has informal arrangements with third-party manufacturers of the STA, CompuDent® and CompuMed® devices, pursuant to which they manufacture these products under specific purchase orders but without any long-term contract or minimum purchase commitment. The company entered a new purchase commitment for the delivery of 2,040 STA CompuDent® instruments. As of December 31, 2022, the purchase order commitment was approximately $1.7 million, and approximately $1.2 million was paid and reported in advances on contracts in the consolidated balance sheet. As of  December  31,2021, the purchase order commitment was approximately $2.6 million, approximately $1.3 million was paid and  reported in advances on contracts in the consolidated balance sheet. As of December 31, 2022 and 2021 the company also has advances on an open purchase order for long lead items for a future purchase order for the manufacturing of Epidural instrument of approximately $76,000 and $34,000, respectively.

F- 22

(2)Leases

Operating Leases

In August 2019, the Company made the decision to not renew its existing office lease for its corporate headquarters located in Livingston, New Jersey and instead signed a new seven year lease in a new facility located in Roseland, New Jersey (the “Roseland Facility”), which commenced of January 8, 2021 . Under the Roseland Facility lease, rent payments commence on April 1, 2021 , and the monthly lease payments escalate annually on January 1 of each year, and range from $9,275 to $10,898 per month over the lease term. The Company is also required to pay a fixed electric charge equal to $2.00 per square foot which is  paid in equal monthly installments over the lease term or $11,130 annually. These fixed monthly payments have been included in the measurement of the operating lease liability and related operating lease right-of-use asset as the Company has elected the practical expedient to not separate lease and non-lease components for all leases. The Company is also required to pay its proportionate share of certain operating costs and property taxes applicable to the leased premises more than new base year amounts, which are accounted for as variable lease expenses. 

As of December 31, 2022, total finance right-of-use assets were $17,645 and total finance liabilities were $20,063 of which $9,365 and $10,698 were classified as current and non-current, respectively. As of December 31, 2022, total operating right-of use assets were$443,685 and total operating lease liabilities were $476,980, of which $91,701 and $385,279 were classified as current and non-current, respectively.  As of December 31, 2021, total  finance right-of-use assets were $26,294 and total finance liabilities were $28,607 of which $8,545 and $20,062 were classified as current and non-current, respectively. As of December 31, 2021, total operating right-of use assets were $524,217 and total operating lease liabilities were $557,981, of which $81,001 and $476,980 were classified as current and non-current, respectively. 

The Company identified and assessed the following significant assumptions in recognizing its right-of-use assets and corresponding lease liabilities:

As the Company’s leases do not provide an implicit rate, the Company estimated the incremental borrowing rate in calculating the present value of the lease payments. The Company has utilized its incremental borrowing rate based on the long-term borrowing costs of comparable companies in the Medical Device industry.

Since the Company elected to account for each lease component and its associated non-lease components as a single combined lease component, all contract consideration was allocated to the combined lease component.

The expected lease terms include non-cancellable lease periods. Renewal option periods are not included in the determination of the lease terms as they were not reasonably certain to be exercised.

The components of lease expense were as follows:

  

December 31, 2022

  

December 31, 2021

 

Cash paid for operating lease liabilities

 $127,995  $127,526 

Cash paid for finance lease liabilities

  10,740   10,740 

Right-of-use assets obtained in exchange for new operating lease liabilities (1)

  -   663,009 

Property and equipment obtained in exchange for new finance lease liabilities

  -   43,242 

Weighted Average Remaining Lease Term

        

Finance leases (years)

 

2.04 years

  

3.04 years

 

Operating leases (years)

 

4.25 years

  

5.25 years

 

Weighted-average discount rate – operating leases

  9.20%  9.20%

Weighted-average discount rate – finance leases

  9.20%  9.20%

Maturity of lease liabilities as of December 31, 2022

 

Operating Leases

  

Finance Leases

 

2023

 $130,778  $10,740 

2024

  133,560   10,740 

2025

  136,343   433 

2026

  139,125   - 

2027

  35,477   - 

Total future minimum lease payments

  575,283   21,913 

Less: interest

  (98,303)  (1,850)

Present value of lease liabilities

 $476,980  $20,063 

F- 23

NOTE P Q PENSION BENEFIT PLAN

 

Milestone Scientific has a Defined Contribution Plan that allows eligible employees to contribute part of their salary through payroll deductions. Milestone Scientific does not contribute to this plan, but does pay the administrative costs of the plan, which were not significant.

 

NOTE Q R SUBSEQUENT EVENTS

On January 3, 2023 ,the Company launched an E-Commerce platform, selling and shipping STA Single Tooth Anesthesia System® (STA) and handpieces directly to dental office, and dental groups within the US.

On January 4, 2023, Leslie Bernhard tendered her resignation to Milestone Scientific Inc. (the "Company”) as a director, Chairman of the Audit Committee and Chairman of the Board of the Company. Ms. Bernhard’s resignation comes after nearly 20 years of service as a director of the Company. Ms. Bernhard indicated that her decision to resign was not the result of a disagreement with the Company. The Company thanks Ms. Bernhard for her long, dedicated service on the Board and wishes her well in her future pursuits.

 

In January 2017, in connection with Milestone Scientific public offeringMs. Bernhard’s resignation, on January 4, 2023, the Company’s Board of shares in December 2016, the underwriterDirectors (the "Board”) unanimously appointed Neal Goldman, who has been a member of the offering exercisedBoard since 2019, as Chairman of the Board. Mr. Goldman is the President and Founder of Goldman Capital Management, Inc., a portionfamily office since 2018, which was previously an investment advisory firm founded in 1985. Mr. Goldman was First Vice President of its over-allotment optionResearch at Shearson Lehman Hutton. He has also held senior positions as a money manager and purchased an additional 123,700 sharesresearch analyst with a variety of common stock atfirms including Neuberger Berman, Moseley Hallgarten Estabrook and Weeden, Bruns Nordeman, and Russ and Company. Mr. Goldman has served as Chairman of Charles & Colvard, Ltd. since 2016 and served on the public offering priceboard of $1.499 per share.directors of Imageware Systems, Inc. until November 2020. He also serves on the board of directors of Koil Energy Solutions Inc. Prior to their respective acquisitions, he served on the boards of Blyth Industries and IPASS Corporation. Mr. Goldman received his B.A. degree in Economics from The gross proceeds to Milestone Scientific from this exercise was approximately $186,000 before deducting underwriting discounts and commissions and other offering expenses.City University of New York (City College).

 

In January 2017, Milestone Scientific continued its Milestone Medical exchange program and exchanged 1,065,084 shares of Milestone Medical shares for 532,542 shares of Milestone Scientific common stock. Giving effect to Also on January 4, 2023, the exchange, Milestone Scientific now owns approximately 96%Board unanimously appointed Arjan Haverhals as a director of the shares in Milestone Medical.Company. Mr. Haverhals has been the Company’s Chief Executive Officer since May 2021 and President since September 2020. Mr. Haverhals has also been the President and Chief Executive Officer of the Company’s Dental Division (Wand Dental, Inc.) since June 2020.

 

In February 2017, On January 10, 2023, the Company issuedannounced it has entered into a purchase orderdistribution agreement granting TEKMIKA Health Technologies exclusive distribution rights to its supplier for 2,000market Milestone’s STA instrumentsSingle Tooth Anesthesia System® (STA) in the amountBrazil. TEKMIKA Health Technologies is a leading distributor in Brazil, focused on importing, promotion, marketing and distribution of $1.4 million which are expected to be delivered beginning in the third quarter of 2017.             high-tech medical equipment and device.

 

On January 12, 2023, the Company announced it has entered into a distribution agreement with Sweden & Martina, a leading European dental distributor and manufacturer. Under the agreement, Sweden & Martina has been awarded the exclusive rights to market Milestone’s STA Single Tooth Anesthesia System® (STA) in the new markets of Spain, Portugal and France. In addition, Sweden & Martina will replace the Company’s current distributor in Italy and become its exclusive STA distributor in this market.

On February 6, 2023, Milestone Scientific Inc. (the "Company”) announced the appointment of Peter Milligan as the Company’s Chief Financial Officer, on a part-time basis, effective February1,2023. In connection with serving as the Company’s Chief Financial Officer, Mr. Milligan will be entitled to receive an annual salary of $120,000 and be eligible to receive an annual incentive bonus with a target of 40% of his annual cash compensation, which shall be payable in shares of the Company’s common stock. Mr. Milligan will also be entitled to receive $100,000 in shares of the Company’s common stock on an annual basis, of which, $50,000 shall have a grant date of February 1 and $50,000 shall have a grant date as of August 1 of each year beginning in 2023, valued at the closing price of the Company’s common stock on the NYSE American on the grant date, and which shares are to be issued to Mr. Milligan following the expiration of sixty (60) days after the termination of his employment with the Company. Mr. Milligan holds an M.B.A. from New York University with a concentration in Finance and Economics and a B.B.A. in Accounting from Hofstra University. There are no family relationships between Mr. Milligan and any of the Company’s directors or executive officers, and there is no arrangement or understanding between Mr. Milligan or any other person and the Company or any of its subsidiaries pursuant to which he was appointed as an officer of the Company. There are no transactions between Mr. Milligan or any of his immediate family members and the Company or any of its subsidiaries that would be required to be reported under Item 404(a) of Regulation S-K.

On February  27,2023, the Company  announced that its CompuFlo® Epidural System has received 510(k) FDA clearance for use in the thoracic region of the spine, including the cervical thoracic junction. This approval expands upon the Company’s prior approval of CompuFlo for use within the lumbar region of the spine, where the focus has been on labor and delivery.

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