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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549


FORM 10-Q

(Mark One)

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

For the quarterly period ended April 3, 2004

     
¨
  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: 0-24663


     
ASPECT MEDICAL SYSTEMS, INC.
(Exact Name of Registrant as Specified in Its Charter)
 
     
Delaware   04-2985553
(State or Other Jurisdiction of
Incorporation or Organization)
  (I.R.S. Employer Identification No.)
 
     
141 Needham Street, Newton, Massachusetts   02464-1505
(Address of Principal Executive Offices)   (Zip Code)
 
     
(617) 559-7000
Registrant’s Telephone Number, Including Area Code


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   ý      NO   ¨

Indicate by check mark whether the registrant is an accelerated filer (as defined in Rule 12b-2 of the Exchange Act).

YES   ý      NO   ¨

The Registrant had 19,715,738 shares of Common Stock, $0.01 par value per share, outstanding as of May 3, 2004.

 


ASPECT MEDICAL SYSTEMS, INC.

TABLE OF CONTENTS

             
        Page
  FINANCIAL INFORMATION     1  
 
           
  Financial Statements (Unaudited)     1  
 
           
  Consolidated Balance Sheets as of April 3, 2004 and December 31, 2003     1  
 
           
  Consolidated Statements of Operations for the Three Months Ended April 3, 2004 and March 29, 2003     2  
 
           
  Consolidated Statements of Cash Flows for the Three Months Ended April 3, 2004 and March 29, 2003     3  
 
           
  Notes to Consolidated Financial Statements     4  
 
           
  Management’s Discussion and Analysis of Financial Condition and Results of Operations     13  
 
           
  Qualitative and Quantitative Disclosures About Market Risk     30  
 
  Controls and Procedures     31  
 
  OTHER INFORMATION     32  
 
  Legal Proceedings     32  
 
  Changes in Securities and Use of Proceeds     32  
 
  Defaults Upon Senior Securities     32  
 
  Submission of Matters to a Vote of Security Holders     32  
 
  Other Information     32  
 
  Exhibits and Reports on Form 8-K     32  
 
        33  
 EX-10.1 DEVELOPMENT PURCHASE AND LICENSE AGREEMENT
 EX-10.2 ADDENDUM 2
 EX-31.1 CERTIFICATION OF CEO
 EX-31.2 CERTIFICATION OF CFO
 EX-32.1 CERTIFICATION OF CEO PURSUANT TO SEC 906
 EX-32.2 CERTIFICATION OF CFO PURSUANT TO SEC 906

 


Table of Contents

PART I — FINANCIAL INFORMATION

Item 1. Financial Statements.

ASPECT MEDICAL SYSTEMS, INC.

CONSOLIDATED BALANCE SHEETS

                 
    April 3,   December 31,
    2004
  2003
    (Unaudited)        
ASSETS
               
Current assets:
               
Cash and cash equivalents
  $ 12,313,943     $ 12,343,808  
Restricted cash
    5,100,000       5,100,000  
Short-term investments
    9,202,311       13,718,727  
Accounts receivable, net of allowances of $55,000 at April 3, 2004 and $150,000 at December 31, 2003
    5,334,200       5,772,982  
Current portion of investment in sales-type leases
    1,776,988       1,797,044  
Inventory, net
    1,668,126       1,514,682  
Other current assets
    1,670,698       1,146,675  
 
   
 
     
 
 
Total current assets
    37,066,266       41,393,918  
Property and equipment, net
    2,751,500       2,996,272  
Long-term investments
    2,722,540        
Long-term investment in sales-type leases
    2,503,185       2,613,074  
Long-term portion of notes receivable from related parties
    516,833       736,833  
 
   
 
     
 
 
Total assets
  $ 45,560,324     $ 47,740,097    
 
   
 
     
 
 
LIABILITIES AND STOCKHOLDERS’ EQUITY
               
Current liabilities:
               
Current portion of long-term debt
  $ 598,627     $ 678,554  
Accounts payable
    1,044,474       1,189,198  
Accrued liabilities
    5,816,636       7,871,139  
Deferred revenue
    977,853       975,180  
 
   
 
     
 
 
Total current liabilities
    8,437,590       10,714,071  
Long-term portion of deferred revenue
    5,328,167       5,533,375  
Long-term debt
    395,041       525,018  
Commitments and contingencies
               
Stockholders’ equity:
               
Preferred Stock, $.01 par value; 5,000,000 shares authorized, no shares issued or outstanding
           
Common Stock, $.01 par value; 60,000,000 shares authorized, 19,678,252 and 19,502,079 shares issued and outstanding at April 3, 2004 and December 31, 2003, respectively
    196,783       195,021  
Additional paid-in capital
    132,357,565       131,131,044  
Notes receivable from employees and directors
    (78,335 )     (78,335 )
Accumulated other comprehensive loss
    (4,217 )     (3,731 )
Accumulated deficit
    (101,072,270 )     (100,276,366 )
 
   
 
     
 
 
Total stockholders’ equity
    31,399,526       30,967,633  
 
   
 
     
 
 
Total liabilities and stockholders’ equity
  $ 45,560,324     $ 47,740,097  
 
   
 
     
 
 

The accompanying notes are an integral part of these consolidated financial statements.

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ASPECT MEDICAL SYSTEMS, INC.

CONSOLIDATED STATEMENTS OF OPERATIONS

                 
    Three Months Ended
    April 3,   March 29,
    2004
  2003
    (Unaudited)   (Unaudited)
 
Revenue
  $ 12,797,277     $ 10,127,290  
Costs of revenue
    2,865,534       2,549,460  
 
   
 
     
 
 
Gross profit margin
    9,931,743       7,577,830  
 
Operating expenses:
               
Research and development
    1,945,401       1,880,956  
Sales and marketing
    6,565,297       6,316,618  
General and administrative
    2,396,819       2,098,788  
 
   
 
     
 
 
Total operating expenses
    10,907,517       10,296,362  
 
   
 
     
 
 
Loss from operations
    (975,774 )     (2,718,532 )
Interest income
    209,248       249,986  
Interest expense
    (29,378 )     (55,130 )
 
   
 
     
 
 
Net loss
  $ (795,904 )   $ (2,523,676 )
 
   
 
     
 
 
Net loss per share:
               
Basic and diluted
  $ (0.04 )   $ (0.13 )
Weighted average shares used in computing net loss per share:
               
Basic and diluted
    19,595,874       19,380,916  

The accompanying notes are an integral part of these consolidated financial statements.

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ASPECT MEDICAL SYSTEMS, INC.

CONSOLIDATED STATEMENTS OF CASH FLOWS

                 
    Three Months Ended
    April 3,   March 29,
    2004
  2003
    (Unaudited)   (Unaudited)
 
Cash flows from operating activities:
               
Net loss
  $ (795,904 )   $ (2,523,676 )
Adjustments to reconcile net loss to net cash used for operating activities –
               
Depreciation and amortization
    404,426       578,345  
Provision for doubtful accounts
    (50,000 )     (50,000 )
Compensation expense related to stock options
    33,755       13,537  
Changes in assets and liabilities –
               
Decrease (increase) in accounts receivable
    488,782       (690,084 )
(Increase) decrease in inventory
    (153,444 )     650,014  
Increase in other assets
    (537,045 )     (346,722 )
Decrease in investment in sales-type leases
    129,945       89,012  
(Decrease) increase in accounts payable
    (144,724 )     43,474  
Decrease in accrued liabilities
    (2,054,503 )     (1,327,924 )
Decrease in deferred revenue
    (202,535 )     (274,296 )
 
   
 
     
 
 
Net cash used for operating activities
    (2,881,247 )     (3,838,320 )
 
   
 
     
 
 
Cash flows from investing activities:
               
Payments on loans to related parties
    233,022       74,461  
Acquisition of property and equipment
    (159,654 )     (75,586 )
Purchases of marketable securities
    (4,041,610 )     (900,000 )
Proceeds from sales and maturities of marketable securities
    5,835,000       5,101,820  
 
   
 
     
 
 
Net cash provided by investing activities
    1,866,758       4,200,695  
 
   
 
     
 
 
Cash flows from financing activities:
               
Proceeds from sale of investment in sales-type leases
          141,221  
Principal payments on debt related to investment in sales-type leases
    (209,904 )     (252,084 )
Proceeds from payments on notes receivable from employees and directors
          84,545  
Proceeds from issuance of common stock
    1,194,528       24,500  
 
   
 
     
 
 
Net cash provided by (used for) financing activities
    984,624       (1,818 )
 
   
 
     
 
 
Net (decrease) increase in cash and cash equivalents
    (29,865 )     360,557  
Cash and cash equivalents, beginning of period
    12,343,808       11,542,833  
 
   
 
     
 
 
Cash and cash equivalents, end of period
  $ 12,313,943     $ 11,903,390  
 
   
 
     
 
 
Supplemental disclosure of cash flow information:
               
Interest paid
  $ 28,834     $ 55,130  

The accompanying notes are an integral part of these consolidated financial statements.

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ASPECT MEDICAL SYSTEMS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)

(1) Basis of Presentation

     The accompanying unaudited consolidated financial statements of Aspect Medical Systems, Inc. (the “Company”) have been prepared in accordance with accounting principles generally accepted in the United States for interim financial information and with the instructions to Form 10-Q and Regulation S-X. Accordingly, they do not include all of the information and footnotes required by accounting principles generally accepted in the United States for complete financial statements. In the opinion of management, all normal, recurring adjustments considered necessary for a fair presentation have been included. The consolidated financial statements and notes included herein should be read in conjunction with the audited consolidated financial statements for the year ended December 31, 2003 included in the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission (the “SEC”). Interim results of operations are not necessarily indicative of the results to be expected for the full year or any other interim period.

(2) Summary of Significant Accounting Policies

     A summary of the significant accounting policies used by the Company in the preparation of its financial statements follows:

Principles of Consolidation

     The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries. All material intercompany accounts and transactions have been eliminated.

Foreign Currency

     The functional currency of the Company’s international subsidiaries is the U.S. dollar. Foreign currency transaction gains and losses are recorded in the consolidated statements of operations and have not been material.

Cash, Cash Equivalents and Marketable Securities

     The Company invests its excess cash in money market accounts, certificates of deposit, high-grade commercial paper, high grade corporate bonds and debt obligations of various government agencies. The Company considers all highly liquid debt instruments purchased with an original maturity of three months or less to be cash equivalents. Investments which have contractual maturities of more than twelve months are included in long-term investments in the accompanying consolidated balance sheets.

     The Company accounts for its investments in marketable securities in accordance with Statement of Financial Accounting Standards (“SFAS”) No. 115, Accounting for Certain Investments in Debt and Equity Securities. In accordance with SFAS No. 115, the Company has classified all of its investments in marketable securities as available-for-sale at April 3, 2004 and December 31, 2003. The marketable securities are reported at fair value, with any unrealized gains and losses excluded from earnings and reported as a separate component of stockholders’ equity as other comprehensive income (loss).

Revenue Recognition

     The Company sells its BIS monitors primarily through a combination of a direct sales force and through distributors. The Company sells its BIS Module Kits to original equipment manufacturers who in turn sell them to the end-user. BIS Sensors are sold through a combination of a direct sales force, distributors and original equipment manufacturers. Direct product sales are structured as sales, sales-type lease arrangements or sales under the Company’s Equipment Placement (“EP”) program. Sales, sales-type lease agreements and sales under the EP program are subject to the Company’s standard terms and conditions of sale and do not include any customer acceptance criteria, installation or other post shipment obligations (other than warranty) or any rights of return. The Company’s BIS monitor is a standard product and does not require installation as it can be operated with the instructions included in the operator’s manual.

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ASPECT MEDICAL SYSTEMS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)

     The Company recognizes revenue from product sales when earned as required by generally accepted accounting principles and in accordance with Staff Accounting Bulletin (“SAB”) No. 104, Revenue Recognition and EITF 00-21, Revenue Arrangements with Multiple Deliverables. Revenue is recognized when persuasive evidence of an arrangement exists, product delivery has occurred or services have been rendered, the price is fixed or determinable and collectibility is reasonably assured. For product sales, revenue is not recognized until title and risk of loss have transferred to the customer.

     The Company follows SFAS No. 13, Accounting For Leases, for its sales-type lease agreements. Under the Company’s sales-type leases, customers purchase BIS Sensors and the BIS monitor for the purchase price of the BIS Sensors plus an additional charge per BIS Sensor to pay for the purchase price of the BIS monitor and related financing costs over the term of the agreement. In accordance with SFAS No. 13, the minimum lease payment, consisting of the additional charge per BIS Sensor, less the unearned interest income, which is computed at the interest rate implicit in the lease, is recorded as the net investment in sales-type leases. The Company recognizes equipment revenue under sales-type lease agreements either at shipment or delivery in accordance with the agreed upon contract terms with interest income recognized over the life of the sales-type lease. The cost of the BIS monitor acquired by the customer is recorded as costs of revenue in the same period.

     In addition, the Company reviews and assesses the net realizability of its investment in sales-type leases at each reporting period. This review includes determining, on a customer specific basis, if a customer is significantly underperforming relative to the customer’s cumulative level of committed BIS Sensor purchases as required by the sales-type lease agreement. If a customer is underperforming, the Company records an allowance for lease payments as a charge to revenue to reflect the lower estimate of the net realizable investment in sales-type lease balance.

     As of April 3, 2004, the Company does not consider any sales-type lease agreement, against which an allowance for lease payments has been established, an impaired asset.

     Under the Company’s EP program, the customer is granted the right to use the BIS monitors for a mutually agreed upon period of time. During this period, the customer purchases BIS Sensors at a price that includes a premium above the list price of the BIS Sensors to cover the rental of the equipment, but without any minimum purchase commitments. At the end of the agreed upon period, the customer has the option of purchasing the BIS monitors, continuing to use them under the EP program or returning them to the Company. Under the EP program, no equipment revenue is recognized as the equipment remains the Company’s property and title does not pass to the customer, and the criteria for sales-type leases under SFAS No. 13 are not met. The BIS monitors under the EP program are depreciated over two years, and the depreciation is charged to costs of revenue. BIS Sensor revenue is recognized either at shipment or delivery of the BIS Sensors in accordance with the agreed upon contract terms.

     The Company’s obligations under warranty are limited to repair or replacement of any product that the Company reasonably determines to be covered by the warranty. The Company records an estimate for its total warranty obligation in accordance with SFAS No. 5, Accounting for Contingencies.

     In connection with the Stock Purchase Agreement and OEM Product Development Agreement with Boston Scientific Corporation (“BSC”) discussed in Note 9, the Company recorded approximately $6,300,000 of deferred revenue. The deferred revenue is being recognized ratably over the term of the OEM product development and distribution agreement with BSC, which represents the Company’s best estimate of its period of significant continuing obligation to provide BSC exclusive distribution rights to newly developed technology. The term of the OEM product development and distribution agreement continues until such time that BSC is no longer distributing the Company’s products, but in no event will extend beyond December 31, 2012.

Research and Development Costs

     The Company charges research and development costs to operations as incurred. Research and development costs include costs associated with new product development, product improvements and extensions, clinical studies and project consulting expenses.

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ASPECT MEDICAL SYSTEMS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)

Accounts Receivable

     Estimates are used in determining the Company’s allowance for doubtful accounts based on the Company’s historical collections experience, historical write-offs of its receivables, current trends, credit policy and a percentage of the Company’s accounts receivable by aging category. The Company also reviews the credit quality of its customer base as well as changes in the Company’s credit policies. The Company continually monitors collections and payments from its customers.

Inventory

     The Company values inventory at the lower of cost or estimated market, and determines cost on a first-in, first-out basis. The Company regularly reviews inventory quantities on hand and records a provision for excess or obsolete inventory primarily based on production history and on its estimated forecast of product demand. The medical industry in which the Company markets its products is characterized by rapid product development and technological advances that could result in obsolescence of inventory. Additionally, the Company’s estimates of future product demand may prove to be inaccurate, in which case it would need to change its estimate of the provision required for excess and obsolete inventory. If revisions are deemed necessary, the Company would recognize the adjustments in the form of a charge to its costs of revenue at the time of the determination.

Warranty

     Equipment that the Company sells is generally covered by a warranty period of one year. The Company accrues a warranty reserve for estimated costs to provide warranty services. The Company’s estimate of costs to service its warranty obligations is based on historical experience and an expectation of future conditions. Warranty expense for the three months ended April 3, 2004, and accrued warranty cost, included in accrued liabilities in the consolidated balance sheet at April 3, 2004, was as follows:

         
Balance as of December 31, 2003
  $ 147,313  
Warranty expense
    25,117  
Deductions and other
    (20,813 )
 
   
 
 
Balance as of April 3, 2004
  $ 151,617  
 
   
 
 

Guarantees

     The Company guarantees operating lease obligations of its subsidiaries for the lease of automobiles. The maximum potential future payment under these financial guarantees was approximately $172,000 at April 3, 2004.

Shipping and Handling Costs

     Shipping and handling costs are included in costs of revenue.

Advertising Costs

     Advertising costs are expensed as incurred. These costs are included in sales and marketing expense in the consolidated statements of operations.

Property and Equipment

     Property and equipment is recorded at cost and depreciated using the straight-line method over the estimated useful lives of the related equipment. Equipment held under capital leases is stated at the lower of the fair market value of the equipment or the present value of the minimum lease payments at the inception of the lease and is amortized on a straight-line basis over the shorter of the lives of the related assets or the term of the leases. Repair and maintenance expenditures are charged to expense as incurred. The Company does not develop software for internal use and the costs of software acquired for internal use are accounted for in accordance with the American Institute of Certified Public Accountant’s (“AICPA”) Statement of Position (“SOP”) 98-1, Accounting for the Costs of Computer Software Developed or Obtained for Internal Use.

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ASPECT MEDICAL SYSTEMS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)

Income Taxes

     The Company accounts for income taxes in accordance with SFAS No. 109, Accounting for Income Taxes. Under this method, deferred tax assets and liabilities are recognized for the expected future tax consequences, utilizing currently enacted tax rates, of temporary differences between the carrying amounts and the tax basis of assets and liabilities. Deferred tax assets are recognized, net of any valuation allowance, for the estimated future tax effects of deductible temporary differences and tax operating loss and credit carryforwards.

Concentration of Credit Risk

     Financial instruments that potentially expose the Company to concentrations of credit risk primarily consist of cash, cash equivalents, accounts receivable, investment in sales-type lease receivables and investments in marketable securities. To minimize the financial statement risk with respect to accounts receivable and investment in sales-type lease receivables, the Company maintains reserves for potential credit losses and such losses, in the aggregate, have not exceeded management’s expectations. The Company maintains cash, cash equivalents and investments in marketable securities with various financial institutions. The Company performs periodic evaluations of the relative credit quality of investments and Company policy is designed to limit exposure to any one institution or type of investment. The primary objective of the Company’s investment strategy is the safety of the principal invested. The Company does not maintain foreign exchange contracts or other off-balance sheet financial investments.

Single or Limited Source Suppliers

     The Company currently obtains certain key components of its products from single or limited sources. The Company purchases components pursuant to purchase orders rather than long-term supply agreements and generally does not maintain large volumes of inventory. The Company has experienced shortages and delays in obtaining certain components of its products in the past. There can be no assurance that the Company will not experience similar shortages and delays in the future. The disruption or termination of the supply of components or a significant increase in the costs of these components from these sources could have a material adverse effect on the Company’s business, financial position and results of operations.

Net Loss Per Share

     In accordance with SFAS No. 128, Earnings Per Share, basic and diluted net loss per share amounts for the three months ended April 3, 2004 and March 29, 2003, were computed by dividing the net loss available to common stockholders by the weighted average number of common shares outstanding during those periods.

     All shares of restricted common stock that are subject to repurchase and common stock issuable pursuant to the exercise of stock options and warrants have been excluded from the calculation of diluted net loss per share since the inclusion of such amounts would be antidilutive.

Comprehensive Income (Loss)

     Comprehensive income (loss) is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. Other than the Company’s net loss, the only other element of comprehensive income (loss) impacting the Company is the unrealized gains (losses) on its marketable securities for all periods presented.

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ASPECT MEDICAL SYSTEMS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)

Stock-Based Compensation

     SFAS No. 123, Accounting for Stock-Based Compensation, requires the measurement of the fair value of stock options or warrants to be included in the statement of income or disclosed in the notes to financial statements. The Company accounts for stock-based compensation for employees using the intrinsic value method under APB Opinion No. 25 and has adopted the fair value disclosure-only alternative under SFAS No. 148, Accounting for Stock-Based Compensation – Transition and Disclosure. The Company has computed the weighted-average fair value of options granted in the three months ended April 3, 2004 and March 29, 2003 using the Black-Scholes option-pricing model pursuant to SFAS No. 123. The following table shows the weighted average assumptions used in the applicable periods and the weighted average fair market value of the options granted in each period.

                 
    Three Months Ended
    April 3,   March 29,
    2004
  2003
    (Unaudited)   (Unaudited)
 
Risk free interest rate
    3.15 %     3.00 %
Expected dividend yield
           
Expected life of options
  5 years   5 years
Expected volatility
    56 %     57 %
Weighted average fair market value of options granted
  $ 9.07     $ 2.21  

     If the Company had recognized compensation cost for these awards consistent with SFAS No. 123, the Company’s net loss and pro forma net loss per common share would have been increased to the following pro forma amounts:

                 
    Three Months Ended
    April 3,   March 29,
    2004
  2003
    (Unaudited)   (Unaudited)
 
Net loss:
               
Net loss as reported
  $ (795,904 )   $ (2,523,676 )
Add: Stock-based employee compensation expense included in reported net loss
           
Deduct: Stock-based employee compensation expense determined under fair value based method for all awards
    (1,874,313 )     (1,826,580 )
 
   
 
     
 
 
Pro forma net loss
  $ (2,670,217 )   $ (4,350,256 )
 
   
 
     
 
 
Net loss per share:
               
Basic and diluted net loss per common share:
               
As reported
  $ (0.04 )   $ (0.13 )
Pro forma
  $ (0.14 )   $ (0.22 )

     The Black-Scholes option-pricing model was developed for use in estimating the fair value of traded options, which have no vesting restrictions and are fully transferable. In addition, option-pricing models require the input of highly subjective assumptions, including expected stock price volatility. Because the Company’s employee stock options have characteristics significantly different from those of traded options, and because changes in the subjective input assumptions can materially affect the fair value estimate, in management’s opinion, the existing models do not necessarily provide a reliable single measure of the fair value of its employee stock options. Also, because options vest over several years and the Company expects to grant options in future years, the above pro forma results of applying the provisions of SFAS No. 123 are not necessarily representative of the pro forma results in future years.

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ASPECT MEDICAL SYSTEMS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)

Use of Estimates

     The preparation of financial statements in conformity with accounting principles generally accepted in the United States requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.

Fair Value of Financial Instruments

     The estimated fair market values of the Company’s financial instruments, which include cash equivalents, investments in marketable securities, accounts receivable, investment in sales-type leases, accounts payable and long-term debt, approximate their carrying values.

(3) Comprehensive Income (Loss)

     The Company’s total comprehensive loss is as follows:

                 
    Three Months Ended
    April 3,   March 29,
    2004
  2003
    (Unaudited)   (Unaudited)
 
Net loss
  $ (795,904 )   $ (2,523,676 )
Other comprehensive income (loss):
               
Unrealized (loss) gain on marketable securities
    (486 )     10,660  
 
   
 
     
 
 
Comprehensive loss
  $ (796,390 )   $ (2,513,016 )
 
   
 
     
 
 

(4) Investment in Sales-Type Leases

     The components of the Company’s net investment in sales-type leases are as follows:

                 
    April 3,   December 31,
    2004
  2003
    (Unaudited)        
 
Total minimum lease payments receivable
  $ 6,261,953     $ 6,492,607  
Less:
               
Unearned interest income
    929,095       984,751  
Allowance for lease payments
    1,052,685       1,097,738  
 
   
 
     
 
 
Net investment in sales-type leases
    4,280,173       4,410,118  
Less — current portion
    1,776,988       1,797,044  
 
   
 
     
 
 
 
  $ 2,503,185     $ 2,613,074  
 
   
 
     
 
 

(5) Inventory

     Inventory consists of the following:

                 
    April 3,   December 31,
    2004
  2003
   
    (Unaudited)        
 
Raw materials
  $ 629,780     $ 739,331  
Work-in-progress
    72,473       61,763  
Finished goods
    965,873       713,588  
 
   
 
     
 
 
 
  $ 1,668,126     $ 1,514,682  
 
   
 
     
 
 

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ASPECT MEDICAL SYSTEMS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)

(6) Segment Information and Enterprise Reporting

     The Company operates in one reportable segment as it markets and sells one family of anesthesia monitoring systems. The Company does not disaggregate financial information by product or geographically, other than export sales by region and sales by product, for management purposes. Substantially all of the Company’s assets are located within the United States. All of the Company’s products are manufactured in the United States.

     Revenue by geographic destination and as a percentage of total revenue is as follows:

                 
    Three Months Ended
    April 3,   March 29,
    2004
  2003
    (Unaudited)   (Unaudited)
Geographic Area by Destination
               
Domestic
  $ 10,379,658     $ 7,940,334  
International
    2,417,619       2,186,956  
 
   
 
     
 
 
 
  $ 12,797,277     $ 10,127,290  
 
   
 
     
 
 
                 
    Three Months Ended
    April 3,   March 29,
    2004
  2003
    (Unaudited)   (Unaudited)
 
Geographic Area by Destination
               
Domestic
    81 %     78 %
International
    19       22  
 
   
 
     
 
 
 
    100 %     100 %
 
   
 
     
 
 

     The Company did not have sales in any individual country, other than the United States, that accounted for more than 10% of the Company’s total revenue for the three months ended April 3, 2004 and March 29, 2003.

(7) Related Party Transactions

     Through April 30, 2002, the Company loaned, on a full recourse basis, an aggregate of $1,441,000, to certain officers, employees and a consultant of the Company. In May 2002, the Company loaned, on a full recourse basis, $50,000 to another officer of the Company, which together with accrued interest, was paid in full in March 2003, after that officer left the employ of the Company. All loans are evidenced by promissory notes bearing interest with rates ranging from 5.00% to 8.00% per annum. The loans are payable over periods ranging from one to five years and in each case are secured by assets of the borrower, including shares of the Company’s common stock owned by the borrower. The long-term portion of the loans is included in long-term notes receivable from related parties, and the short-term portion of approximately $31,000 and $44,000 at April 3, 2004 and December 31, 2003, respectively, is included in other current assets in the accompanying consolidated balance sheets. The aggregate outstanding balance on these loans at April 3, 2004 and December 31, 2003 was approximately $548,000 and $781,000, respectively.

     In January 2002, the Company entered into a consulting agreement with one of its directors to provide consulting, advisory and neuroscience business planning services to the Company. Effective April 11, 2003, this director resigned from the Company’s Board of Directors. Through April 11, 2003, the Company had paid approximately $9,000 to this director under his consulting agreement. From April 11, 2003 through April 3, 2004, the Company paid approximately $12,000 to this individual under this consulting agreement.

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ASPECT MEDICAL SYSTEMS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)

(8) Loan Agreements

     In May 2001, the Company entered into an agreement with a commercial bank for a revolving line of credit. The Company is entitled to borrow up to $5,000,000 under the revolving line of credit, which expires in May 2004 and, subject to annual review by the commercial bank, may be extended at the discretion of the commercial bank. Interest on any borrowings under the revolving line of credit is, at the election of the Company, either the prime rate or at LIBOR plus 2.25%. Up to $1,500,000 of the $5,000,000 revolving line of credit is available for standby letters of credit. At April 3, 2004, the Company had outstanding standby letters of credit with the commercial bank totaling $165,137. The Company is currently in the process of renewing the revolving line of credit with the commercial bank.

     The revolving line of credit agreement contains restrictive covenants that require the Company to maintain liquidity and net worth ratios and is secured by certain investments of the Company, which are shown as restricted cash in the accompanying consolidated balance sheets, in an amount equal to 102% of the $5,000,000 commitment, or $5,100,000. At April 3, 2004, there was no outstanding balance under the revolving line of credit, and the Company was in compliance with all covenants contained in the revolving line of credit agreement. At April 3, 2004, the interest rate on the revolving line of credit was 4.00%.

     In August 2002, the Company entered into an agreement for a $5,000,000 revolving line of credit with BSC in connection with a strategic alliance (see Note 9).

(9) Strategic Alliance with Boston Scientific Corporation

     On August 7, 2002, the Company formed a strategic alliance with BSC. In connection with this strategic alliance, the Company sold 1,428,572 shares of the Company’s common stock at a purchase price per share of $7.00 to BSC pursuant to a stock purchase agreement. Gross cash proceeds from this sale of common stock were $10,000,004. In addition, the Company granted BSC an option under an OEM product development and distribution agreement to distribute newly developed technology for monitoring patients under sedation in a range of less-invasive medical specialties. The Company allocated the fair market value between the common stock and the option to be the exclusive distributor. The excess of $4.41 per share paid by BSC over the closing price of the Company’s common stock, or approximately $6,300,000 in total, was attributed to the value of the rights provided to BSC under the OEM Product Development Agreement.

     Approximately $5,378,000 of the aggregate purchase price is recorded as deferred revenue in the accompanying consolidated balance sheet at April 3, 2004, which represents the unamortized portion of the purchase price in excess of the closing price of the Company’s common stock on August 7, 2002. The deferred revenue is being recognized ratably over the term of the OEM agreement, which represents the Company’s best estimate of its period of significant continuing obligation to provide BSC exclusive distribution rights to newly developed technology. The term of the agreement continues until such time that BSC is no longer distributing the Company’s products, but in no event will extend beyond December 31, 2012. Approximately $154,000 was recognized as revenue for the three months ended April 3, 2004 and March 29, 2003, respectively.

     As part of the strategic alliance with BSC, the Company also entered into an agreement pursuant to which BSC has agreed to provide the Company a $5,000,000 revolving line of credit, which expires in August 2007 and may be extended at the discretion of BSC. Interest on any borrowings under this revolving line of credit is at a rate equal to the LIBOR rate at which BSC, under its own revolving credit facility, is entitled to borrow funds, plus any additional amounts payable thereon by BSC under such revolving credit facility, plus eighty basis points. The Company’s revolving line of credit with BSC is secured by the Company’s inventory and certain of the Company’s accounts receivable and contains certain restrictive covenants covering the collateral. At April 3, 2004, there was no outstanding balance under this revolving line of credit, and the Company was in compliance with all covenants contained in the revolving line of credit agreement.

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ASPECT MEDICAL SYSTEMS, INC.

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)

     (10)  Subsequent Event

     On April 7, 2004, the Company entered into an agreement with BSC to issue and sell 500,000 shares of the Company’s common stock to BSC pursuant to a stock purchase agreement. Under the terms of the agreement, the purchase price per share will be equal to the average of the last reported sales price of the Company’s common stock on the Nasdaq National Market over the 30 trading days ending on the third trading day prior to the date of the closing of the transaction. In the event that the issuance and sale of these shares takes place as contemplated by the stock purchase agreement, the Company will grant BSC the right to require the Company to register these shares for resale under the Securities Act of 1933. The Company anticipates that the closing of this transaction will be at the end of May 2004, subject to a number of closing conditions, including the approval of the stock purchase agreement by the Company’s stockholders at the Company’s Annual Meeting of Stockholders on May 25, 2004 and the expiration or other termination of all applicable waiting periods under United States federal anti-trust laws.

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Item 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS.

     This Quarterly Report on Form 10-Q contains, in addition to historical information, forward-looking statements within the meaning of Section 21E of the Securities Exchange Act of 1934. These forward-looking statements involve risks and uncertainties and are not guarantees of future performance. Words such as “expect,” “anticipate,” “intend,” “plan,” “believe,” “seek,” “estimate” and variations of these words and similar expressions are intended to identify forward-looking statements. Our actual results could differ significantly from the results discussed in these forward-looking statements. In addition, subsequent events and developments may cause our expectations to change. While we may elect to update these forward-looking statements we specifically disclaim any obligation to do so, even if our expectations change. See the important factors in the cautionary statements below under the heading “Factors Affecting Future Operating Results” that we believe could cause our actual results to differ materially from the forward-looking statements we make.

Overview

     We develop, manufacture and market an anesthesia monitoring system that we call the BIS® system. The BIS system is based on our patented core technology, the Bispectral Index, which we refer to as the BIS index. The BIS system provides information that allows clinicians to better assess and manage a patient’s level of consciousness in the operating room and intensive care settings and administer the precise amount of anesthesia needed by each patient. Our proprietary BIS system includes our BIS monitor, or our BIS Module Kit, which allows original equipment manufacturers to incorporate the BIS index into their monitoring products, and our single-use disposable BIS Sensors. We collectively refer to our group of disposable sensors as BIS Sensors.

     Our latest generation monitor, the A-2000® BIS Monitor, was cleared for marketing by the United States Food and Drug Administration, or the FDA, in February 1998. Our latest version of the BIS system, the BIS XP system, was cleared for marketing by the FDA in June 2001. In addition to our A-2000 BIS Monitor, we offer original equipment manufacturers our BIS Module Kit for integration into equipment sold by the original equipment manufacturers. In February 2004, our BISx system was cleared for marketing by the FDA. The BISx system is our latest BIS monitoring system for integration into the equipment sold by the original equipment manufacturers. The BISx system provides the BIS XP functionality in a single device the size of a hockey puck, simplifying the incorporation of BIS XP into third-party patient monitoring systems.

     We derive our revenue primarily from sales of BIS monitors, BIS Module Kits and related accessories, which we collectively refer to as Equipment, and sales of BIS Sensors. For management purposes, we segregate our revenue by export sales by region and sales by products as shown in the following table:

                 
    Three Months Ended
    April 3, March 29,
    2004
  2003
   
    (in thousands)
 
Domestic revenue
  $ 10,380     $ 7,940  
Percent of total revenue
    81%       78%  
 
               
International revenue
  $ 2,417     $ 2,187  
Percent of total revenue
    19%       22%  
 
               
BIS Sensor revenue
  $ 9,207     $ 6,785  
Percent of total revenue
    72%       67%  
 
               
Equipment revenue
  $ 3,590     $ 3,342  
Percent of total revenue
    28%       33%  

     At April 3, 2004, we had cash, cash equivalents, restricted cash and investments of approximately $29.3 million and working capital of approximately $28.6 million.

     We follow a system of fiscal quarters as opposed to calendar quarters. Under this system, the first three quarters of each fiscal year end on the Saturday closest to the end of the calendar quarter and the last quarter of the fiscal year always ends on December 31.

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     We believe our ability to grow our revenue is directly related to our ability to sell our Equipment to healthcare organizations and influence our customers after they purchase our Equipment to continue to purchase and use our BIS Sensors. We believe the increase in our installed base of Equipment resulting from the sale of BIS monitors and the sale of original equipment manufacturers’ equipment incorporating our BIS Module Kit have been the primary reasons for the growth in revenue from the sale of BIS Sensors. In order to successfully grow our business, we need to continue to focus on both selling our Equipment and improving our per monitor and per module sensor utilization rate. To achieve this growth, we continue to implement new sales and marketing programs. We expect that as we grow our business, revenue from the sale of BIS Sensors should contribute an increasing percentage of total revenue. Additionally, we believe that over time, revenue from the sale of BIS Module Kits will increase as a percentage of total Equipment revenue as healthcare organizations purchase our technology as part of an integrated solution offered by our original equipment manufacturers. In the first quarter of 2004, approximately 49% of our growth in our installed base was attributable to placements by our original equipment manufacturers.

     We believe that maintaining our gross profit margin and controlling the growth of our operating expenses are important factors in achieving profitability. To maintain our gross profit margin we believe we must continue to focus on maintaining our average unit prices for both BIS monitors and BIS Sensors, increasing revenue from the sale of BIS Sensors as a percentage of total revenue, as BIS Sensors have a higher gross profit margin than Equipment, and continuing to reduce the costs of manufacturing our products.

     The transition from BIS monitor placements to BIS module placements has adversely impacted our gross profit margin on Equipment as BIS Module Kits have a lower gross margin than the BIS monitors. However, we believe that this transition should, over time, improve our total gross profit margin as we expect BIS module placements to be a contributing factor to increasing revenue from the sale of our BIS Sensors.

     For those healthcare organizations desiring to purchase our BIS monitors, we offer two options. Our customers have the option either to purchase BIS monitors outright or to acquire BIS monitors pursuant to a sales-type lease agreement whereby the customer contractually commits to purchase a minimum number of BIS Sensors per BIS monitor per year. Under our sales-type leases, customers purchase BIS Sensors and the BIS monitor for the purchase price of the BIS Sensors plus an additional charge per BIS Sensor to pay for the purchase price of the BIS monitor and related financing costs over the term of the agreement. We also grant these customers an option to purchase the BIS monitors at the end of the term of the agreement, which is typically three to five years. We recognize equipment revenue under sales-type lease agreements either at shipment or delivery in accordance with the agreed upon contract terms with interest income recognized over the life of the sales-type lease. The cost of the BIS monitor acquired by the customer is recorded as costs of revenue in the same period. Sales-type leases accounted for approximately 3% and 2% of total revenue in the three months ended April 3, 2004 and March 29, 2003, respectively.

     Under certain limited circumstances, we also offer customers the opportunity to use the BIS monitors under our Equipment Placement program, which we refer to as the EP program. Under the EP program, the customer is granted the right to use the BIS monitors for a mutually agreed upon period of time. During this period, the customer purchases BIS Sensors at a price that includes a premium above the list price of the BIS Sensors to cover the rental of the equipment, but without any minimum purchase commitments. At the end of the agreed upon period, the customer has the option of purchasing the BIS monitors, continuing to use them under the EP program or returning them to us. Beginning in 2002, we substantially reduced our focus and reliance on the EP program. Sensor revenue related to the EP program was approximately $346,000 and $334,000 at April 3, 2004 and March 29, 2003, respectively.

     We have subsidiaries in The Netherlands and the United Kingdom to facilitate the sale of our products into the international market. We are continuing to develop our international sales and distribution program through a combination of distributors and marketing partners, including companies with which we have entered into original equipment manufacturer relationships.

     In January 1998, we entered into a distribution agreement with Nihon Kohden Corporation to distribute BIS monitors in Japan. In March 2000, Nihon Kohden received approval from the Japanese Ministry of Health, Labor and Welfare for marketing in Japan our A-1050 EEG Monitor with BIS and in May 2001, received approval for marketing in Japan our A-2000 BIS Monitor. Nihon Kohden has requested but has not yet received approval to market the BIS XP system in Japan. In January 2002, the Japanese Ministry of Health, Labor and Welfare granted reimbursement approval for use of our BIS monitors. With this approval, healthcare providers in Japan are eligible to receive partial reimbursement of 1,000 Yen each time BIS monitoring is used. In July 2002, the Japanese Ministry of Health, Labor and Welfare approved our BIS module for marketing in Japan. Sales to Nihon Kohden represented approximately 12% and 15%, respectively, of international revenue for the three months ended April 3, 2004 and March 29, 2003, respectively.

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     Various factors may adversely affect our quarterly operating results through the second fiscal quarter of 2004 and the year ending December 31, 2004. These factors include a potentially adverse effect on Equipment revenue and gross profit margin on Equipment as we continue to shift the focus of our placements from BIS monitors to BIS modules. In addition, in Japan, Nihon Kohden is awaiting approval of the BIS XP system, and we believe customers may continue to delay purchases of our products or may choose not to purchase our products pending this approval. Finally, on November 1, 2003, our international master distribution agreement with Datex-Ohmeda expired. We are currently replacing this agreement with country-specific distribution agreements with Datex-Ohmeda sales subsidiaries and other distributors in various countries. A delay in signing these country-specific distribution agreements may adversely affect Equipment revenue in the international market. To date, we have entered into several new country-specific distribution agreements, and we continue to negotiate others.

Critical Accounting Policies

     Management’s discussion and analysis of the financial condition and results of operations is based upon the consolidated financial statements which have been prepared in accordance with accounting principles generally accepted in the United States. Note 2 of the Notes to Consolidated Financial Statements included elsewhere in this Quarterly Report on Form 10-Q includes a summary of our significant accounting policies and methods used in the preparation of our financial statements. In preparing these financial statements, we have made estimates and judgments in determining certain amounts included in the financial statements. The application of these accounting policies involves the exercise of judgment and use of assumptions as to future uncertainties and, as a result, actual results could differ from these estimates. We do not believe there is a significant likelihood that materially different amounts would be reported under different conditions or using different assumptions. We believe that our critical accounting policies are as follows:

   Revenue Recognition

     We sell our BIS monitors primarily through a combination of a direct sales force and through distributors. Our BIS Module Kits are sold to original equipment manufacturers who in turn sell them to the end-user. BIS Sensors are sold through a combination of a direct sales force, distributors and original equipment manufacturers. Direct product sales are structured as sales, sales-type lease arrangements or sales under our EP program. We recognize revenue from product sales when earned as required by generally accepted accounting principles and in accordance with Staff Accounting Bulletin, or SAB, No. 104, Revenue Recognition and EITF 00-21, Revenue Arrangements with Multiple Deliverables. Revenue is recognized when persuasive evidence of an arrangement exists, product delivery has occurred or services have been rendered, the price is fixed or determinable and collectibility is reasonably assured. For product sales, revenue is not recognized until title and risk of loss have transferred to the customer.

     We also recognize revenue from prepaid license and royalty fees. This revenue is deferred until product shipment or delivery in accordance with the terms of the agreement and license and royalty fees are earned in accordance with the terms of the respective agreements. In August 2002, we recorded approximately $6,300,000 of deferred revenue related to an OEM product development and distribution agreement with Boston Scientific Corporation. The deferred revenue is being recognized ratably over the term of the OEM product development and distribution agreement, which represents our best estimate of our period of significant continuing obligation to provide Boston Scientific Corporation exclusive distribution rights to newly developed technology. If our estimate of the period of significant continuing obligation is revised, this may have an impact on our revenue recognition of the deferred revenue related to the Boston Scientific Corporation agreement.

     We follow Statement of Financial Accounting Standards, or SFAS, No. 13, Accounting For Leases, for our sales-type lease agreements. Under our sales-type leases, customers purchase BIS Sensors and the BIS monitor for the purchase price of the BIS Sensors plus an additional charge per BIS Sensor to pay for the purchase price of the BIS monitor and related financing costs over the term of the agreement. The minimum lease payment, consisting of the additional charge per BIS Sensor, less the unearned interest income, which is computed at the interest rate implicit in the lease, is recorded as the net investment in sales-type leases. We recognize Equipment revenue under sales-type lease agreements either at shipment or delivery in accordance with the agreed upon contract terms with interest income recognized over the life of the sales-type lease. The cost of the BIS monitor acquired by the customer is recorded as costs of revenue in the same period. We review and assess the net realizability of our investment in sales-type leases at each reporting period. This review includes determining, on a customer specific basis, if a customer is significantly underperforming relative to the customer’s cumulative level of committed BIS Sensor purchases as required by the sales-type lease agreement. If a customer is underperforming, we record an allowance for lease payments as a charge to revenue to reflect the lower estimate of the net realizable investment in sales-type lease balance.

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     We recognize revenue either at shipment or delivery in accordance with the agreed upon contract terms with distributors and original equipment manufacturers in accordance with SAB No. 104. Sales to distributors and original equipment manufacturers include a clause in the contracts that indicates that customer acceptance is limited to confirmation that our products function in accordance with our applicable product specifications in effect at the time of delivery. Formal acceptance by the distributor or original equipment manufacturer is not necessary to recognize revenue provided that we objectively demonstrate that the criteria specified in the acceptance provisions are satisfied. Each product is tested prior to shipment to ensure that it meets the applicable product specifications in effect at the time of delivery. Additionally, we have historically had a minimal number of defective products shipped to distributors and original equipment manufacturers and any defective products are subject to repair or replacement under warranty as distributors and original equipment manufacturers do not have a right of return.

   Accounts Receivable

     We determine our allowance for doubtful accounts by using estimates based on our historical collections experience, current trends, historical write-offs of our receivables, credit policy and a percentage of our accounts receivable by aging category. We also review the credit quality of our customer base as well as changes in our credit policies. We continuously monitor collections and payments from our customers. While credit losses have historically been within our expectations and the provisions established, our credit loss rates in the future may not be consistent with our historical experience. To the extent we experience a deterioration in our historical collections experience or increased credit losses, bad debt expense would likely increase in future periods.

   Inventories

     We value inventory at the lower of cost or estimated market, and determine cost on a first-in, first-out basis. We regularly review inventory quantities on hand and record a provision for excess or obsolete inventory primarily based on production history and on our estimated forecast of product demand. The medical industry in which we market our products is characterized by rapid product development and technological advances that could result in obsolescence of inventory. Additionally, our estimates of future product demand may prove to be inaccurate, in which case we would need to change our estimate of the provision required for excess or obsolete inventory. If revisions are deemed necessary, we would recognize the adjustments in the form of a charge to costs of revenue at the time of the determination. Therefore, although we continually update our forecasts of future product demand, any significant unanticipated declines in demand or technological developments, such as the introduction of new products by our competitors, could have a significant negative impact on the value of our inventory, results of operations and cash flows in future periods.

   Warranty

     Equipment that we sell generally is covered by a warranty period of one year. We accrue a warranty reserve for estimated costs to provide warranty services. Our estimate of costs to service our warranty obligations is based on our historical experience and expectation of future conditions. While our warranty costs have historically been within our expectations and the provisions established, to the extent we experience increased warranty claim activity or increased costs associated with servicing those claims, our warranty expenses will increase, and we would experience decreased gross profit margin and cash flow.

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Results of Operations

     The following tables present, for the three-month periods ended April 3, 2004 and March 29, 2003, information expressed as a percentage of revenue and a summary of our total revenue. This information has been derived from our consolidated statements of operations included elsewhere in this Quarterly Report on Form 10-Q. You should not draw any conclusions about our future results from the results of operations for any period.

                 
    Three Months Ended
    April 3,   March 29,
    2004
  2003
 
Revenue
    100 %     100 %
Costs of revenue
    22       25  
 
   
 
     
 
 
Gross profit margin
    78       75  
Operating expenses:
               
Research and development
    15       19  
Sales and marketing
    51       62  
General and administrative
    19       21  
 
   
 
     
 
 
Total operating expenses
    85       102  
Loss from operations
    (7 )     (27 )
Interest income, net
    1       2  
 
   
 
     
 
 
Net loss
    (6 )%     (25 )%
 
   
 
     
 
 

Three Months Ended April 3, 2004 Compared to Three Months Ended March 29, 2003

                         
    Three Months Ended
   
                    Percentage
    April 3,   March 29,   Increase
    2004
  2003
  (Decrease)
    (in thousands, except unit amounts)        
Revenue — Worldwide
                       
BIS Sensor
  $ 9,207     $ 6,785       36 %
BIS monitor
    2,193       1,588       38 %
BIS Module Kit
    542       935       (42 )%
Other equipment and accessories
    855       819       4 %
 
   
 
     
 
         
Total Equipment
    3,590       3,342       7 %
 
   
 
     
 
         
Total revenue
  $ 12,797     $ 10,127       26 %
 
   
 
     
 
         
Unit Analysis — Worldwide
                       
BIS Sensors
    651,000       503,000       29 %
BIS monitors
    416       371       12 %
Original equipment manufacturer BIS modules
    377       552       (32 )%
Installed base
    20,613       17,110       20 %

     Revenue. The 36% increase in revenue from the sale of BIS Sensors in the three months ended April 3, 2004 compared with the three months ended March 29, 2003 was primarily attributable to an increase of approximately 29% in the number of BIS Sensors sold as a result of growth in the installed base of BIS monitors and BIS modules. The increase in the number of BIS Sensors sold was complemented by an increase in the average selling price of BIS Sensors of approximately 5%. Our installed base of BIS monitors and BIS modules increased approximately 20% to 20,613 units at April 3, 2004 from 17,110 units at March 29, 2003.

     The increase in revenue from the sale of Equipment in the three months ended April 3, 2004 compared with the three months ended March 29, 2003 was primarily driven by a 38% increase in BIS monitor revenue. The increase in BIS monitor revenue was the result of two factors. First, there was an increase of approximately 12% in unit volume, as we shipped 416 BIS monitors in the first quarter of 2004 compared with 371 BIS monitors in the first quarter of 2003. Second, the increase in the number of BIS monitors shipped was accompanied by an increase in the monitor average unit price of approximately 23% in the first quarter of 2004 compared with the first quarter of 2003. The increase in BIS monitor revenue was offset by a decrease in BIS Module Kit revenue of approximately 42%. This decrease was a result of a decrease in the number of BIS Module Kits shipped to our original equipment manufacturers, from 552 BIS Module Kits in the first quarter of 2003 to 377 BIS Module Kits in the first quarter of 2004. The decrease in the number of BIS Module Kits shipped was related to unusually high levels of shipments to Japan and South America in the first quarter of 2003.

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     Our gross profit margin was approximately 78% of revenue in the first quarter of 2004 compared with a gross profit margin of approximately 75% of revenue in the first quarter of 2003. The increase in the gross profit margin in the first quarter of 2004 was the result of two factors. First, we experienced increased sales of our BIS Sensors as a percentage of total revenue in the first quarter of 2004, and BIS Sensors have a higher gross profit margin than Equipment. BIS Sensors accounted for approximately 72% of our total revenue in the first quarter of 2004 compared with approximately 67% of revenue in the first quarter of 2003. The increased unit volume of BIS Sensors, combined with an increase in the BIS Sensor average unit selling price contributed to the increase in our gross profit margin in the first quarter of 2004. Second, we had an increase of approximately 23% in the average unit price of BIS monitors in the first quarter of 2004 compared with the first quarter of 2003.

Expense Overview

                         
    Three Months Ended
   
                    Percentage
    April 3,   March 29,   Increase
    2004
  2003
  (Decrease)
    (in thousands)        
Expenses
                       
Research and development
  $ 1,945     $ 1,881       3 %
Sales and marketing
  $ 6,565     $ 6,317       4 %
General and administrative
  $ 2,397     $ 2,099       14 %

     Research and Development. The slight increase in research and development expenses in the three months ended April 3, 2004 compared with the three months ended March 29, 2003 was primarily attributable to an increase in payroll related expenses of approximately $103,000, offset by a decrease in consulting expenses of approximately $35,000. We expect research and development expenses to increase slightly in the second quarter of 2004 compared with the first quarter of 2004 as we continue to invest in clinical studies and expand applications for our technology, including our initiatives into neuroscience.

     Sales and Marketing. The increase in sales and marketing expenses in the three months ended April 3, 2004 compared with the three months ended March 29, 2003 was attributable to an increase in operating expenses associated with our international subsidiaries of approximately $454,000. The $454,000 increase in our international operating expenses was the result of an increase of approximately $219,000 in payroll related expenses and an increase of approximately $88,000 in travel and entertainment expenses. The increase in international operating expenses was also the result of unfavorable exchange rate fluctuations between the U.S. dollar and the local currencies of our subsidiaries. The increase in international operating expenses was offset by a decrease of approximately $145,000 in commissions expense. We expect sales and marketing expenses to decrease in the second quarter of 2004 compared with the first quarter of 2004 as a result of cost reductions in various programs and control over discretionary spending.

     General and Administrative. The increase in general and administrative expenses in the three months ended April 3, 2004 compared with the three months ended March 29, 2003 was primarily attributable to increases in payroll related expenses of approximately $100,000 and approximately $194,000 in professional and consulting services. We expect general and administrative expenses to increase slightly in the second quarter of 2004 compared with the first quarter of 2004 as we anticipate increases in expenses for professional services and consultants, primarily related to services in connection with our assessment of internal controls as required by Section 404 of the Sarbanes-Oxley Act of 2002.

     Interest Income. Interest income decreased to approximately $209,000 in the three months ended April 3, 2004 from approximately $250,000 in the three months ended March 29, 2003, a decrease of approximately 16%. The decrease in interest income was primarily attributable to lower cash and investments balances resulting from continued operating losses and other uses of cash, and lower interest rates on our investments as a result of general interest rate declines. We expect interest income to decrease in the second quarter of 2004 as compared with the first quarter of 2004 as a result of continuing low interest rates and a lower cash and investment balance.

     Interest expense. Interest expense decreased to approximately $29,000 in the three months ended April 3, 2004 from approximately $55,000 in the three months ended March 29, 2003, a decrease of approximately 47%. The decrease in interest expense in the three months ended April 3, 2004 was a result of lower average outstanding debt obligations. We expect interest expense to decrease slightly in the second quarter of 2004 as compared with the first quarter of 2004 as a result of lower average outstanding debt obligations.

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     Net Loss. As a result of the factors discussed above, for the three months ended April 3, 2004, we had a net loss of approximately $796,000 as compared with a net loss of approximately $2.5 million for the three months ended March 29, 2003.

Liquidity and Capital Resources

     Our liquidity requirements have historically consisted of research and development expenses, sales and marketing expenses, capital expenditures, working capital and general corporate expenses. From our inception through January 2000, we financed our operations primarily from the sale of convertible preferred stock. Through April 3, 2004, we raised approximately $77.6 million from private equity financings and received approximately $3.4 million in equipment financing and approximately $5.1 million of financing related to our investment in sales-type leases. We also received approximately $2.8 million of financing under a term loan in December 1999. The outstanding principal on the equipment and term loans was paid in May 2001. In February 2000, we closed our initial public offering of an aggregate of 4,025,000 shares of common stock and received net proceeds of approximately $54.6 million.

     In May 2001, we entered into an agreement with Fleet National Bank, or Fleet, for a $5.0 million revolving line of credit, which expires in May 2004. The revolving line of credit with Fleet contains restrictive covenants that require us to maintain liquidity and net worth ratios and is secured by certain of our investments, which are shown as restricted cash on our consolidated balance sheet. We are required to maintain restricted cash and securities with a net equity value equal to 102% of the $5.0 million commitment. Interest on any borrowings under the revolving line of credit with Fleet is, at our election, either the prime rate or at LIBOR plus 2.25%. At April 3, 2004, the interest rate on the line of credit with Fleet was 4.00%. Up to $1.5 million of the $5.0 million revolving line of credit is available for standby letters of credit. There was no outstanding balance under this line of credit at April 3, 2004. At April 3, 2004, we had standby letters of credit outstanding with Fleet in the amount of $165,137. We are currently in the process of renewing the revolving line of credit with Fleet.

     In August 2002, we entered into a strategic alliance with Boston Scientific Corporation whereby we sold 1,428,572 shares of our common stock at a purchase price per share of $7.00 to Boston Scientific Corporation. Gross cash proceeds from this sale of common stock were $10,000,004. Note 9 of our Notes to Consolidated Financial Statements included elsewhere in this Quarterly Report on Form 10-Q includes additional information relating to the strategic alliance with Boston Scientific Corporation.

     In connection with our strategic alliance with Boston Scientific Corporation, we also entered into an agreement with Boston Scientific Corporation for a revolving line of credit under which we are entitled to borrow up to $5.0 million. The revolving line of credit expires in August 2007 and may be extended at the discretion of Boston Scientific Corporation. Interest on any borrowings under this revolving line of credit is at a rate equal to the LIBOR rate at which Boston Scientific Corporation, under its own revolving credit facility, is entitled to borrow funds, plus any additional amounts payable thereon by Boston Scientific Corporation under such revolving credit facility, plus eighty basis points. Our revolving line of credit with Boston Scientific Corporation is secured by our inventory and certain of our accounts receivable and contains certain restrictive covenants covering the collateral. At April 3, 2004, there was no outstanding balance under this revolving line of credit.

     On April 7, 2004, in order to raise cash for working capital and other general corporate purposes, we entered into a stock purchase agreement with Boston Scientific Corporation pursuant to which we have agreed to issue and sell to Boston Scientific Corporation an aggregate of 500,000 shares of our common stock at a purchase price per share equal to the average of the last reported sales price of our common stock on the Nasdaq National Market over the 30 trading days ending on the third trading day prior to the date of the closing of the transaction. We anticipate that this transaction will close at the end of May 2004. The transaction is subject to a number of closing conditions, including the approval of the stock purchase agreement by our stockholders at our Annual Meeting of Stockholders on May 25, 2004 and the expiration or other termination of all applicable waiting periods under United States federal anti-trust laws.

     We expect to meet our short-term liquidity needs through the use of cash and short-term investments on hand at April 3, 2004. We believe that the financial resources available to us, including our current working capital and available revolving lines of credit will be sufficient to finance our planned operations and capital expenditures through at least the end of 2005. However, our future liquidity and capital requirements will depend upon numerous factors, including the resources required to further develop our marketing and sales organization domestically and internationally, to finance our research and development programs, to implement new marketing programs, to finance our sales-type lease program and to meet market demand for our products.

     Working capital at April 3, 2004 was approximately $28.6 million compared to approximately $30.7 million at December 31, 2003. The decrease in working capital from December 31, 2003 to April 3, 2004 was primarily attributable to our net loss of approximately $796,000 and the purchase of long-term investments.

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     Cash Used for Operations. We used approximately $2.9 million of cash for operations in the three months ended April 3, 2004 as compared with approximately $3.8 million in the three months ended March 29, 2003. Cash used for operations in the three months ended April 3, 2004 was primarily driven by operating losses, a decrease in accrued liabilities of approximately $2.1 million and an increase in other assets of approximately $537,000. These were offset by a decrease in accounts receivable of approximately $489,000. The decrease in accrued liabilities of $2.1 million was primarily driven by a decrease in accrued bonus of approximately $1.5 million and a decrease in accrued commission of approximately $413,000.

     Cash from Investing Activities. We received approximately $1.9 million of cash from investing activities in the three months ended April 3, 2004 as compared with approximately $4.2 million in the three months ended March 29, 2003. The cash received from investing activities in the three months ended April 3, 2004 was primarily the result of the sales and maturities of our investments in marketable securities. We received approximately $1.8 million, net, of proceeds from sales and maturities of marketable securities and invested approximately $160,000 primarily related to expenditures for the purchase of computer hardware and third-party software. In the three months ended March 29, 2003, we received approximately $4.2 million, net, of proceeds from sales and maturities of marketable securities and invested approximately $76,000 primarily for the purchase of computer hardware and third-party software and machinery and equipment.

     Cash from Financing Activities. We received approximately $985,000 of cash from financing activities in the three months ended April 3, 2004 primarily as a result of proceeds from the issuance of our common stock upon the exercise of stock options granted under our stock option plans of approximately $1.2 million, offset by payments of principal on debt related to our investment in sales-type leases of approximately $210,000. In the three months ended March 29, 2003, we used approximately $2,000 of cash for financing activities primarily as a result of payments of principal on debt related to our investment in sales-type leases of approximately $252,000 offset by proceeds from the sales of our investment in sales-type leases of approximately $141,000 and proceeds from payments on notes receivable from employees and directors of approximately $85,000.

     We guarantee certain operating lease obligations of our subsidiaries of approximately $172,000 for the lease of automobiles.

     In July 1999, we entered into an agreement under which we can sell a portion of our existing and future investment in sales-type leases to Americorp Financial, Inc. Through April 3, 2004, we sold approximately $5.1 million of our investment in sales-type leases. In accordance with SFAS No. 140, Accounting for Transfers and Servicing of Financial Assets and Extinguishments of Liabilities — A replacement of FASB Statement No. 125, the proceeds from these sales are classified as debt. Payments on the outstanding principal under this debt match the timing of the payments due on the underlying investment in sales-type leases. At April 3, 2004, approximately $994,000 is recorded as debt on our consolidated balance sheet.

     We had capital expenditures of approximately $160,000 for the quarter ended April 3, 2004, which related primarily to the purchase of computer hardware and third-party software. At April 3, 2004, we had entered into an agreement to purchase a piece of manufacturing equipment for use in the production of our BIS Sensors. We anticipate that the level of capital expenditures in the second quarter of 2004 will increase from the level of capital expenditures during the first quarter of 2004 mostly as a result of the expected purchase of this manufacturing equipment.

     We have summarized below our contractual cash obligations as of April 3, 2004:

                                         
    Payments Due By Period
            Less Than   One to Three   Three to Five   After Five
    Total
  One Year
  Years
  Years
  Years
Contractual Obligations
                                       
Operating leases
  $ 3,357,102     $ 1,256,535     $ 1,953,058     $ 147,509     $      —  
Debt related to the sale of investment in sales type leases
    993,668       598,627       394,573       468        
 
   
 
     
 
     
 
     
 
     
 
 
Total contractual cash obligations
  $ 4,350,770     $ 1,855,162     $ 2,347,631     $ 147,977     $  
 
   
 
     
 
     
 
     
 
     
 
 

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Off-Balance Sheet Arrangements

     We do not have any off-balance sheet arrangements or relationships with unconsolidated entities or financial partnerships, such as entities often referred to as structured finance or special purpose entities, which are typically established for the purpose of facilitating off-balance sheet arrangements or other contractually narrow or limited purposes.

Income Taxes

     We have net operating loss and research and development tax credit carryforwards for federal income tax purposes that began expiring in the year 2002 and will continue to expire through the year 2023 if not utilized.

     The net operating loss and research and development tax credit carryforwards are subject to review by the Internal Revenue Service. Ownership changes, as defined under Sections 382 and 383 in the Internal Revenue Code, may limit the amount of these tax attributes that can be utilized annually to offset future taxable income or tax liabilities. The amount of the annual limitation is determined based on our value immediately prior to the ownership change. Subsequent ownership changes may further affect the limitation in future years.

Effects of Inflation

     We believe that inflation and changing prices over the past year have not had a significant impact on our revenue or on our results of operations.

FACTORS AFFECTING FUTURE OPERATING RESULTS

     This Quarterly Report on Form 10-Q includes forward-looking statements, including information relating to our ability to achieve profitability, information with respect to market acceptance of our BIS system, continued growth in sales of our BIS monitors, BIS Module Kits and BIS Sensors, our dependence on the BIS system, our ability to remain competitive and achieve future growth, information with respect to other plans and strategies for our business and factors that may influence our revenue for the fiscal quarter ending July 3, 2004 and for the year ending December 31, 2004. The following important factors represent current challenges to us that create risk and uncertainty. Failure to adequately overcome any of the following challenges could have a material adverse effect on our results of operations, business or financial condition.

We will not be profitable if hospitals and anesthesia providers do not buy and use our BIS system in sufficient quantities.

     Our customers may determine that the cost of the BIS system exceeds cost savings in drugs, personnel and post-anesthesia care recovery resulting from use of the BIS system. In addition, hospitals and anesthesia providers may not accept the BIS system as an accurate means of assessing a patient’s level of consciousness during surgery or in the intensive care unit. If extensive or frequent malfunctions occur, healthcare providers may also conclude that the BIS system is unreliable. If hospitals and anesthesia providers do not accept the BIS system as cost-effective, accurate and reliable, they will not buy and use the BIS system in sufficient quantities to enable us to be profitable.

     The success of our business also depends in a large part on continued use of the BIS system by our customers and, accordingly, sales by us of BIS Sensors. We expect that over time sales of BIS Sensors will increase as a percentage of our revenue as compared to sales of Equipment as we build our installed base of monitors and modules. If use of our BIS system, and accordingly, sales of our BIS Sensors, do not increase, it could adversely affect our revenue.

We depend on our BIS system for substantially all of our revenue, and if the BIS system does not gain widespread market acceptance, then our revenue will not grow.

     We began selling our current BIS system in early 1998 and introduced the latest version, the BIS XP system, at the end of the third fiscal quarter of 2001. In 2002, we introduced commercially the BIS Extend Sensor for patients who are monitored over an extended period of time, such as in intensive care unit settings. To date, we have not achieved widespread market acceptance of the BIS system for use in the operating room or in the intensive care unit from healthcare providers or the professional organizations that influence market behavior. Because we depend on our BIS system for substantially all of our revenue and we have no other significant products, if we fail to achieve widespread market acceptance for the BIS system, we will not be able to sustain or grow our product revenue.

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Various market factors may adversely affect our quarterly operating results through the second fiscal quarter of 2004 and for the year ending December 31, 2004.

     Various factors may adversely affect our quarterly operating results through the second fiscal quarter of 2004 and the year ending December 31, 2004. First, we continue to shift the focus of our placements from BIS monitors to BIS modules which may lead to a reduction in Equipment revenue and gross margin on Equipment. Second, in Japan, Nihon Kohden is awaiting approval of the BIS XP system from the Japanese Ministry of Health, Labor and Welfare which may cause delays in purchasing decisions by customers in Japan, or these potential customers may choose not to purchase our products. Third, on November 1, 2003, our international master distribution agreement with Datex-Ohmeda expired. We are currently replacing this agreement with country-specific distribution agreements with Datex-Ohmeda sales subsidiaries and other distributors in various countries. A delay in signing these country-specific distribution agreements may adversely affect Equipment revenue in the international market. The continuation of difficult worldwide economic conditions, reductions in hospital purchasing programs and the cost of transitioning our installed base to the BIS XP system may also adversely impact our revenue and operating results through the second fiscal quarter of 2004 and for the year ending December 31, 2004.

Fluctuations in our quarterly operating results could cause our stock price to decrease.

     Our operating results have fluctuated significantly from quarter to quarter in the past and are likely to vary in the future. These fluctuations are due to several factors relating to the sale of our products, including:

  the timing and volume of customer orders for our BIS system,
 
  implementation of, and our subsequent reduction on the focus of, our EP program,
 
  use of and demand for our BIS Sensors,
 
  transition of sales focus from BIS monitors to BIS Module Kits,
 
  customer cancellations,
 
  introduction of competitive products,
 
  regulatory approvals,
 
  changes in management,
 
  turnover in our direct sales force,
 
  effectiveness of new marketing and sales programs,
 
  reductions in orders by our distributors and original equipment manufacturers, and
 
  the timing and amount of our expenses.

     Because of these fluctuations, it is likely that in some future quarter or quarters our operating results could again fall below the expectations of securities analysts or investors. If our quarterly operating results are below expectations in the future, the market price of our common stock would also likely decrease. In addition, because we do not have a significant backlog of customer orders for our BIS system, revenue in any quarter depends on orders received in that quarter. Our quarterly results may also be adversely affected because some customers may have inadequate financial resources to purchase our products or may fail to pay for our products after receiving them. In particular, hospitals are increasingly experiencing financial constraints, consolidations and reorganizations as a result of cost containment measures and declining third-party reimbursement for services, which may result in decreased product orders or an increase in bad debts in any quarter.

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If the estimates we make, and the assumptions on which we rely in preparing our financial statements prove inaccurate, our actual results may vary from those reflected in our projections and accruals.

     Our financial statements have been prepared in accordance with accounting principles generally accepted in the United States. The preparation of these financial statements requires us to make estimates and judgments that affect the reported amounts of our assets, liabilities, revenues and expenses, the amounts of charges accrued by us and related disclosure of contingent assets and liabilities. We base our estimates on historical experience and on various other assumptions that we believe to be reasonable under the circumstances. There can be no assurance, however, that our estimates, or the assumptions underlying them, will be correct.

If approval of our BIS XP system is not obtained in Japan, our revenue and operating results could be adversely affected.

     In Japan, Nihon Kohden is awaiting approval of the BIS XP system from the Japanese Ministry of Health, Labor and Welfare. Until approval is obtained, customers in Japan may delay their purchasing decisions with respect to our products or may decide not to purchase our products at all. As a result, if approval for this product is not obtained in Japan in the near future, or at all, it could limit the growth of our international revenue.

We may need additional financing for our future capital needs and may not be able to raise additional funds on terms acceptable to us, or at all.

     We believe that the financial resources available to us, including our current working capital and available revolving lines of credit, will be sufficient to finance our planned operations and capital expenditures through at least the end of 2005. If we are unable to increase our revenue and achieve positive cash flow, we will need to raise additional funds. We may also need additional financing if:

  we need additional cash to fund research and development costs of products currently under development,
 
  we decide to expand faster than currently planned,
 
  we develop new or enhanced services or products ahead of schedule,
 
  we decide to undertake new sales and/or marketing initiatives,
 
  we are required to defend or enforce our intellectual property rights,
 
  sales of our products do not meet our expectations in the United States or internationally,
 
  we need to respond to competitive pressures, or
 
  we decide to acquire complementary products, businesses or technologies.

     We can provide no assurance that we will be able to raise additional funds on terms acceptable to us, if at all. If future financing is not available or is not available on acceptable terms, we may not be able to fund our future needs which would significantly limit our ability to implement our business plan. In addition, we may have to issue securities that may have rights, preferences and privileges senior to our common stock.

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Cases of awareness with recall during monitoring with the BIS system could limit market acceptance of BIS systems and could expose us to product liability claims.

     Clinicians have reported to us cases of possible awareness with recall during surgical procedures monitored with the BIS system. In most of the cases that were reported to us, when BIS index values were recorded at the time of awareness, high BIS index values were noted, indicating that the BIS index correctly identified the increased risk of awareness with recall in these patients. However, in a small number of these reported cases, awareness with recall may not have been detected by monitoring with the BIS system. We have not systematically solicited reports of awareness with recall. It is possible that additional cases of awareness with recall during surgical procedures monitored with the BIS system have not been reported to us. Anesthesia providers and hospitals may elect not to purchase and use BIS systems if there is adverse publicity resulting from the report of cases of awareness with recall that were not detected during procedures monitored with the BIS system. If anesthesia providers and hospitals do not purchase and use the BIS system, then we may not sustain or grow our product revenue. Although clinical studies have demonstrated that patient monitoring with the BIS system may reduce the incidence of awareness with recall we may be subject to product liability claims for cases of awareness with recall during surgical procedures monitored with the BIS system. These claims could require us to spend significant time and money in litigation or to pay significant damages.

     Data that was collected in our three multi-center, multinational studies to assess the incidence of awareness with recall and the impact of BIS monitoring were reported during 2003. Results from these studies demonstrated that awareness with recall occurs in approximately 1 to 2 cases per 1,000 patients during general anesthesia. Use of BIS monitoring to help guide anesthetic administration may be associated with the reduction of the incidence of awareness with recall in adults using general anesthesia and sedation. If the patient safety benefits of BIS monitoring are not persuasive enough to lead to wider adoption of our BIS technology, our business could be adversely affected.

We may not be able to compete with new products or alternative techniques developed by others, which could impair our ability to remain competitive and achieve future growth.

     The medical industry in which we market our products is characterized by rapid product development and technological advances. Our competitors have introduced commercially three anesthesia monitoring products approved by the United States Food and Drug Administration, or FDA. If we do not compete effectively with these monitoring products, our revenue will be adversely affected. Our current or planned products are at risk of obsolescence from:

  other new monitoring products, based on new or improved technologies,
 
  new products or technologies used on patients or in the operating room during surgery in lieu of monitoring devices,
 
  electrical or mechanical interference from new or existing products or technologies,
 
  alternative techniques for evaluating the effects of anesthesia,
 
  significant changes in the methods of delivering anesthesia, and
 
  the development of new anesthetic agents.

     We may not be able to improve our products or develop new products or technologies quickly enough to maintain a competitive position in our markets and continue to grow our business.

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If we do not successfully develop and introduce enhanced or new products we could lose revenue opportunities and customers.

     As the market for our BIS system matures, we need to develop and introduce new products for anesthesia monitoring or other applications. In 2002, we introduced commercially the BIS Extend Sensor for patients who are typically monitored for an extended period of time, such as in intensive care unit settings. We do not know whether the use of the BIS system in the intensive care unit will achieve market acceptance. In addition, we have begun to research the use of BIS monitoring to diagnose and track neurological diseases, and face at least the following two related risks:

  we may not successfully adapt the BIS system to function properly for procedural sedation, when used with anesthetics we have not tested or with patient populations we have not studied, such as infants, and
 
  our technology is complex, and we may not be able to develop it further for applications outside anesthesia monitoring, such as the diagnosis and tracking of neurological diseases.

     If we do not successfully adapt the BIS system for new products and applications both within and outside the field of anesthesia monitoring, or if such products and applications are developed but not successfully commercialized, then we could lose revenue opportunities and customers.

If we do not develop and implement a successful sales and marketing strategy, we will not expand our business.

     In the past, we have experienced high turnover in our direct sales force. It is possible that high turnover may occur in the future. If new sales representatives do not acquire the technological skills to sell our products in a timely and successful manner or we experience high turnover in our direct sales force, we may not be able to sustain and grow our product revenue. On an ongoing basis, we develop and introduce new sales and marketing programs. If we do not implement these new sales and marketing programs in a timely and successful manner, we may not be able to achieve the level of market awareness and sales required to expand our business. We have only limited sales and marketing experience both in the United States and internationally and may not be successful in developing and implementing our strategy. We need to:

  provide or assure that distributors and original equipment manufacturers provide the technical and educational support customers need to use the BIS system successfully,
 
  promote frequent use of the BIS system so that sales of our disposable BIS Sensors increase,
 
  establish and implement successful marketing and sales programs that encourage our customers to purchase our products or the products that are made by original equipment manufacturers incorporating our technology,
 
  manage geographically dispersed operations, and
 
  modify our products and marketing and sales programs for foreign markets.

In order to reach the level of sales we need to achieve profitability, we need to further develop our direct and indirect sales channels.

     In order to increase our sales, we need to continue to strengthen our relationships with our international distributors and continue to add international distributors. We need to also continue to strengthen our relationships with our original equipment manufacturers and other sales channels and increase sales through these channels. On an ongoing basis we develop and implement new sales and marketing programs and clinical education programs to promote the use of the BIS system by our customers. If we do not further develop our direct and indirect sales channels and successfully implement the new sales and marketing programs and clinical education programs that encourage our customers to purchase and use our products, we will not reach the level of sales necessary to achieve profitability

Our third-party distribution and original equipment manufacturer relationships could negatively affect our profitability, cause sales of our products to decline and be difficult to terminate if we are dissatisfied.

     Sales through distributors could be less profitable than direct sales. Sales of our products through multiple channels could also confuse customers and cause the sale of our products to decline. We do not control our original equipment manufacturers and distribution partners. Our partners could sell competing products, may not incorporate our technology into their products in a timely manner and may devote insufficient sales efforts to our products. In addition, our partners are generally not required to purchase minimum quantities. As a result, even if we are dissatisfied with the performance of our partners, we may be unable to terminate our agreements with these partners or enter into alternative arrangements.

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We may not be able to generate enough additional revenue from our international expansion to offset the costs associated with establishing and maintaining foreign operations.

     A component of our growth strategy is to expand our presence in foreign markets. We conduct international business primarily in Europe and Japan and we are attempting to increase the number of countries in which we do business. It is costly to establish international facilities and operations and to promote the BIS system in international markets. We have encountered barriers to the sale of our BIS system outside the United States, including less acceptance by anesthesia providers for use of disposable products, such as BIS Sensors, delays in regulatory approvals outside of the United States, particularly in Japan, and difficulties selling through indirect sales channels. In addition, we have little experience in marketing and distributing products in these markets. Revenue from international activities may not offset the expense of establishing and maintaining these foreign operations.

We may not be able to meet the unique operational, legal and financial challenges that we will encounter in our international operations, which may limit the growth of our business.

     We are increasingly subject to a number of challenges which specifically relate to our international business activities. These challenges include:

  failure of local laws to provide the same degree of protection against infringement of our intellectual property,
 
  protectionist laws and business practices that favor local competitors, which could slow our growth in international markets,
 
  difficulties in terminating or modifying distributor arrangements because of restrictions in markets outside the United States,
 
  less acceptance by foreign anesthesia providers of the use of disposable products similar to the BIS Sensors,
 
  delays in regulatory approval of our products,
 
  currency conversion issues arising from sales denominated in currencies other than the United States dollar,
 
  foreign currency exchange rate fluctuations,
 
  longer sales cycles to sell products like the BIS system to hospitals and outpatient surgical centers, which could slow our revenue growth from international sales, and
 
  longer accounts receivable payment cycles and difficulties in collecting accounts receivable.

     If we are unable to meet and overcome these challenges, our international operations may not be successful which would limit the growth of our business.

We may experience customer dissatisfaction and our reputation could suffer if we fail to manufacture enough products to meet our customers’ demands.

     We rely on third-party manufacturers to assemble and manufacture the components of our BIS monitors, BIS Module Kits and a portion of our BIS Sensors. We manufacture substantially all BIS Sensors in our own manufacturing facility. We have only one manufacturing facility. If we fail to produce enough products at our own manufacturing facility or at a third-party manufacturing facility or experience a termination or modification of any manufacturing arrangement with a third party, we may be unable to deliver products to our customers on a timely basis. Our failure to deliver products on a timely basis could lead to customer dissatisfaction and damage our reputation.

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Our reliance on sole-source suppliers could adversely affect our ability to meet our customers’ demands for our products in a timely manner or within budget.

     Some of the components that are necessary for the assembly of our BIS system, including some of the components used in our BIS Sensors, are currently provided to us by sole-source suppliers or a limited group of suppliers. We purchase components through purchase orders rather than long-term supply agreements and generally do not maintain large volumes of inventory. We have experienced shortages and delays in obtaining some of the components of our BIS systems in the past, and we may experience similar shortages or delays in the future. The disruption or termination of the supply of components could cause a significant increase in the costs of these components, which could affect our profitability. A disruption or termination in the supply of components could also result in our inability to meet demand for our products, which could lead to customer dissatisfaction and damage our reputation. If a supplier is no longer willing or able to manufacture components that we purchase and integrate into the BIS system, we may attempt to design replacement components ourselves that would be compatible with our existing technology. In doing so, we would incur additional research and development expenses, and there can be no assurance that we would be successful in designing or manufacturing any replacement components. Furthermore, if we are required to change the manufacturer of a key component of the BIS system, we may be required to verify that the new manufacturer maintains facilities and procedures that comply with quality standards and with all applicable regulations and guidelines. The delays associated with the verification of a new manufacturer could delay our ability to manufacture BIS systems in a timely manner or within budget.

We may be required to bring litigation to enforce our intellectual property rights, which may result in substantial expense and may divert our attention from the implementation of our business strategy.

     We believe that the success of our business depends, in part, on obtaining patent protection for our products, defending our patents once obtained and preserving our trade secrets. We rely on a combination of contractual provisions, confidentiality procedures and patent, trademark and trade secret laws to protect the proprietary aspects of our technology. These legal measures afford only limited protection and competitors may gain access to our intellectual property and proprietary information. Litigation may be necessary to enforce our intellectual property rights, to protect our trade secrets and to determine the validity and scope of our proprietary rights. Any litigation could result in substantial expense and diversion of our attention from the growth of the business and may not be adequate to protect our intellectual property rights.

We may be sued by third parties which claim that our products infringe on their intellectual property rights, particularly because there is substantial uncertainty about the validity and breadth of medical device patents.

     We may be exposed to litigation by third parties based on claims that our products infringe the intellectual property rights of others. This risk is exacerbated by the fact that the validity and breadth of claims covered in medical technology patents involve complex legal and factual questions for which important legal principles are unresolved. Any litigation or claims against us, whether or not valid, could result in substantial costs, could place a significant strain on our financial resources and could harm our reputation. In addition, intellectual property litigation or claims could force us to do one or more of the following:

  cease selling, incorporating or using any of our products that incorporate the challenged intellectual property, which would adversely affect our revenue,
 
  obtain a license from the holder of the infringed intellectual property right, which license may not be available on reasonable terms, if at all, and
 
  redesign our products, which would be costly and time-consuming.

We could be exposed to significant product liability claims which could divert management attention and adversely affect our cash balances, our ability to obtain and maintain insurance coverage at satisfactory rates or in adequate amounts and our reputation.

     The manufacture and sale of our products expose us to product liability claims and product recalls, including those which may arise from misuse or malfunction of, or design flaws in, our products or use of our products with components or systems not manufactured or sold by us. Product liability claims or product recalls, regardless of their ultimate outcome, could require us to spend significant time and money in litigation or to pay significant damages. We currently maintain product liability insurance; however, it may not cover the costs of any product liability claims made against us. Furthermore, we may not be able to obtain insurance in the future at satisfactory rates or in adequate amounts. In addition, publicity pertaining to the misuse or malfunction of, or design flaws in, our products could impair our ability to successfully market and sell our products.

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Several class action lawsuits have been filed against the underwriters of our initial public offering which may result in negative publicity and potential litigation against us that would be costly to defend and the outcome of which is uncertain and may harm our business.

     The underwriters of our initial public offering are named as defendants in several class action complaints which have been filed allegedly on behalf of certain persons who purchased shares of our common stock between January 28, 2000 and December 6, 2000. These complaints allege violations of the Securities Act of 1933 and the Securities Exchange Act of 1934. Primarily they allege that there was undisclosed compensation received by our underwriters in connection with our initial public offering. While we and our officers and directors have not been named as defendants in these suits, based on comparable lawsuits filed against other companies, there can be no assurance that we and our officers and directors will not be named in similar complaints in the future. In addition, the underwriters may assert that we are liable for some or all of any liability that they are found to have to the plaintiffs, pursuant to the indemnification provisions of the underwriting agreement we entered into as part of the initial public offering, or otherwise.

     We can provide no assurance as to the outcome of these complaints or any potential suit against us or our officers and directors. Any conclusion of these matters in a manner adverse to us could have a material adverse affect on our financial position and results of operations. In addition, the costs to us of defending any litigation or other proceeding, even if resolved in our favor, could be substantial. Such litigation could also substantially divert the attention of our management and our resources in general. Even if we are not named as defendants in these lawsuits, we may also be required to incur significant costs and our management may be distracted by being required to provide information, documents or testimony in connection with the actions against our underwriters. Uncertainties resulting from the initiation and continuation of any litigation or other proceedings and the negative publicity associated with this litigation could harm our ability to compete in the marketplace.

Boston Scientific Corporation may be able to impact corporate actions requiring stockholder approval because it owns a significant amount of our common stock, and, if our strategic alliance with Boston Scientific Corporation is not successful, our operating results will be adversely affected.

     As of May 3, 2004, Boston Scientific Corporation owned approximately 19.6% of our outstanding common stock. On April 7, 2004, we entered into an agreement with Boston Scientific Corporation to issue and sell an additional 500,000 shares of our common stock to Boston Scientific Corporation (subject to a number of closing conditions). We also have an agreement with Boston Scientific Corporation, pursuant to which Boston Scientific Corporation has agreed not to acquire any shares of our common stock in excess of 25% of the outstanding shares of our common stock prior to December 31, 2004 without our prior approval. If Boston Scientific Corporation maintains or increases its ownership of our outstanding common stock, it may have the ability to impact corporate actions requiring stockholder approval. In addition, on August 7, 2002, we formed a strategic alliance with Boston Scientific Corporation. In connection with this strategic alliance, we entered into an agreement pursuant to which we granted Boston Scientific Corporation an option to distribute newly developed technology for monitoring patients under sedation in a range of less-invasive medical specialties. If such products are not successfully developed, marketed and sold under the agreement in a manner consistent with our expectations, the growth of our business and our operating results will be adversely affected. Even if we successfully develop new sedation management technology for less-invasive medical procedures, Aspect and Boston Scientific Corporation may not successfully market and sell this new technology.

We may not reserve amounts adequate to cover product obsolescence, claims and returns, which could result in unanticipated expenses and fluctuations in operating results.

     Depending on factors such as the timing of our introduction of new products which utilize our BIS technology, as well as warranty claims and product returns, we may need to reserve amounts in excess of those currently reserved for product obsolescence, excess inventory, warranty claims and product returns. These reserves may not be adequate to cover all costs associated with these items. If these reserves are inadequate, we would be required to incur unanticipated expenses which could result in unexpected fluctuations in quarterly operating results.

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We may not be able to compete effectively, which could result in price reductions and decreased demand for our products.

     We are facing increased competition in the domestic level of consciousness monitoring market as a result of three competitors’ monitoring systems which have been approved by the FDA. These products are marketed by well-established medical products companies with significant resources. We may not be able to compete effectively with these and other potential competitors. We may also face substantial competition from companies which may develop sensor products that compete with our proprietary BIS Sensors for use with our BIS monitors or with third-party monitoring systems or anesthesia delivery systems that incorporate the BIS index. We also expect to face competition from companies currently marketing conventional electroencephalogram, or EEG, monitors using standard and novel signal-processing techniques. Other companies may develop anesthesia-monitoring systems that perform better than the BIS system and/or sell for less. In addition, one or more of our competitors may develop products that are substantially equivalent to our FDA-approved products, in which case they may be able to use our products as predicate devices to more quickly obtain FDA approval of their competing products. Medical device companies developing these and other competitive products may have greater financial, technical, marketing and other resources than we do. Competition in the sale of anesthesia-monitoring systems could result in price reductions, fewer orders, reduced gross margins and loss of market share.

Our ability to market and sell our products and generate revenue depends upon receipt of domestic and foreign regulatory approval of our products and manufacturing operations.

     Before we can market new products in the United States, we must obtain clearance from the FDA. If the FDA concludes that any of our products do not meet the requirements to obtain clearance of a premarket notification under Section 510(k) of the Food, Drug and Cosmetic Act, then we would be required to file a premarket approval application. The approval process for a premarket approval application is lengthy, expensive and typically requires extensive preclinical and clinical trial data. We may not obtain clearance of a 510(k) notification or approval of a premarket approval application with respect to any of our products on a timely basis, if at all. If we fail to obtain timely clearance or approval for our products, we will not be able to market and sell our products, which will limit our ability to generate revenue. We may also be required to obtain clearance of a 510(k) notification from the FDA before we can market certain previously marketed products which we modify after they have been cleared. We have made certain enhancements to our currently marketed products which we have determined do not necessitate the filing of a new 510(k) notification. However, if the FDA does not agree with our determination, it will require us to file a new 510(k) notification for the modification and we may be prohibited from marketing the modified device until we obtain FDA clearance.

     The FDA also requires us to adhere to current Good Manufacturing Practices regulations, which include production design controls, testing, quality control, storage and documentation procedures. The FDA may at any time inspect our facilities to determine whether adequate compliance has been achieved. Compliance with current Good Manufacturing Practices regulations for medical devices is difficult and costly. In addition, we may not continue to be compliant as a result of future changes in, or interpretations of, regulations by the FDA or other regulatory agencies. If we do not achieve continued compliance, the FDA may withdraw marketing clearance or require product recall. When any change or modification is made to a device or its intended use, the manufacturer may be required to reassess compliance with current Good Manufacturing Practices regulations, which may cause interruptions or delays in the marketing and sale of our products.

     Sales of our products outside the United States are subject to foreign regulatory requirements that vary from country to country. The time required to obtain approvals from foreign countries may be longer than that required for FDA approval, and requirements for foreign licensing may differ from FDA requirements.

     The federal, state and foreign laws and regulations regarding the manufacture and sale of our products are subject to future changes, as are administrative interpretations of regulatory agencies. If we fail to comply with applicable federal, state or foreign laws or regulations, we could be subject to enforcement actions, including product seizures, recalls, withdrawal of clearances or approvals and civil and criminal penalties.

If we do not retain our senior management and other key employees, we may not be able to successfully implement our business strategy.

     Our president and chief executive officer, Nassib Chamoun, joined us at our inception in 1987. Our chairman, J. Breckenridge Eagle, began serving as a director in 1988. Many other members of our management and key employees have extensive experience with us and other companies in the medical device industry. Our success is substantially dependent on the ability, experience and performance of these members of our senior management and other key employees. Because of their ability and experience, if we lose one or more of the members of our senior management or other key employees, our ability to successfully implement our business strategy could be seriously harmed.

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If we do not attract and retain skilled personnel, we will not be able to expand our business.

     Our products are based on complex signal-processing technology. Accordingly, we require skilled personnel to develop, manufacture, sell and support our products. Our future success will depend largely on our ability to continue to hire, train, retain and motivate additional skilled personnel, particularly sales representatives who are responsible for customer education and training and post-installation customer support. Consequently, if we are not able to attract and retain skilled personnel, we will not be able to expand our business.

Failure of users of the BIS system to obtain adequate reimbursement from third-party payors could limit market acceptance of the BIS system, which could prevent us from achieving profitability.

     Anesthesia providers are generally not reimbursed separately for patient monitoring activities utilizing the BIS system. For hospitals and outpatient surgical centers, when reimbursement is based on charges or costs, patient monitoring with the BIS system may reduce reimbursements for surgical procedures, because charges or costs may decline as a result of monitoring with the BIS system. Failure by hospitals and other users of the BIS system to obtain adequate reimbursement from third-party payors, or any reduction in the reimbursement by third-party payors to hospitals and other users as a result of using the BIS system could limit market acceptance of the BIS system, which could prevent us from achieving profitability.

Item 3. Qualitative and Quantitative Disclosures About Market Risk.

   Interest Rate Exposure

     Our investment portfolio consists primarily of high-grade commercial paper, high grade corporate bonds and debt obligations of various governmental agencies. We manage our investment portfolio in accordance with our investment policy. The primary objectives of our investment policy are to preserve principal, maintain a high degree of liquidity to meet operating needs, and obtain competitive returns subject to prevailing market conditions. Investments are made with an average maturity of 12 months or less and a maximum maturity of 24 months. These investments are subject to risk of default, changes in credit rating and changes in market value. These investments are also subject to interest rate risk and will decrease in value if market interest rates increase. Due to the conservative nature of our investments and relatively short effective maturities of the debt instruments, we believe interest rate risk is mitigated. Our investment policy specifies the credit quality standards for our investments and limits the amount of exposure from any single issue, issuer or type of investment.

     Our investment in sales-type leases, line of credit agreements and sales-type lease debt agreements are also subject to market risk. The interest rates implicit in our sales-type leases and on our sales-type lease debt agreements are fixed and not subject to interest rate risk. The interest rates on our line of credit agreements are variable and subject to interest rate risk. The interest rate risk related to the lines of credit is mitigated primarily by the fact that the lines of credit, when drawn on, are generally outstanding for short periods of time in order to fund short-term cash requirements.

   Foreign Currency Exposure

     Most of our revenue, expenses and capital spending are transacted in U.S. dollars. The expenses and capital spending of our two international subsidiaries are transacted in the respective country’s local currency and subject to foreign currency exchange rate risk. Our foreign currency transactions are translated into U.S. dollars at prevailing rates. Gains or losses resulting from foreign currency transactions are included in current period income or loss as incurred. Currently, all material transactions are denominated in U.S. dollars, and we have not entered into any material transactions that are denominated in foreign currencies.

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Item 4. Controls and Procedures.

(a)   Evaluation of Disclosure Controls and Procedures.
     
    Our management, with the participation of our Chief Executive Officer, or CEO, and Chief Financial Officer, or CFO, evaluated the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act) as of April 3, 2004. In designing and evaluating our disclosure controls and procedures, our management recognized that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving their objectives, and our management necessarily applied its judgment in evaluating the cost-benefit relationship of possible controls and procedures. Based on this evaluation, our CEO and CFO concluded that, as of April 3, 2004, our disclosure controls and procedures were (1) designed to ensure that material information relating to us, including our consolidated subsidiaries, is made known to our CEO and CFO by others within those entities, particularly during the period in which this report was being prepared and (2) effective, in that they provide reasonable assurance that information required to be disclosed by us in the reports that we file or submit under the Securities Exchange Act is recorded, processed, summarized and reported within the time periods specified in the Securities and Exchange Commission’s rules and forms.
     
(b)   Changes in Internal Controls.  
 
    No change in our internal control over financial reporting (as defined in Rules 13a-15(f) and 15d-15(f) under the Securities Exchange Act) occurred during the fiscal quarter ended April 3, 2004 that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting.

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PART II — OTHER INFORMATION

     
Item 1. 
  Legal Proceedings.
 
       We are not a party to any material threatened or pending legal proceedings.
     
Item 2.
  Changes in Securities and Use of Proceeds.
 
   
       On February 2, 2000, we sold 3,500,000 shares of our common stock, at an initial public offering price of $15.00 per share, pursuant to a Registration Statement on Form S-1 (Registration No. 333-86295), which was declared effective by the Securities and Exchange Commission on January 27, 2000. On February 4, 2000, the underwriters exercised in full their over-allotment option to purchase an additional 525,000 shares of our common stock at $15.00 per share. The managing underwriters of our initial public offering were Morgan Stanley & Co. Incorporated, Deutsche Bank Securities Inc. and U.S. Bancorp Piper Jaffray Inc.
 
   
       The aggregate gross proceeds raised in the offering were approximately $60.4 million. Our total expenses in connection with the offering were approximately $5.7 million, of which $4.2 million was for underwriting discounts and commissions and, based on our reasonable estimate, approximately $1.5 million was for other expenses. Our net proceeds from the offering were approximately $54.6 million. From January 27, 2000 through April 3, 2004, we used approximately $9.7 million of the net proceeds for the acquisition of machinery and equipment, leasehold improvements, furniture and fixtures, demonstration and evaluation equipment and new information systems. In addition, from January 27, 2000 through April 3, 2004, we used approximately $42.2 million of the net proceeds for general corporate purposes, including the funding of operating losses, working capital, product development, increasing our sales and marketing capabilities and expanding our international operations. As of April 3, 2004, we had approximately $2.7 million of proceeds remaining from the offering, and pending use of the proceeds, we have invested these funds in both short-term and long-term, interest-bearing, investment-grade securities.
     
Item 3. 
  Defaults Upon Senior Securities.
 
  None.
     
Item 4. 
  Submission of Matters to a Vote of Security Holders.
 
  None.
     
Item 5. 
  Other Information.
 
  None.
     
Item 6.
  Exhibits and Reports on Form 8-K.
         
 
       
  (a)   Exhibits
 
       
      The exhibits listed in the Exhibit Index immediately preceding the exhibits are filed as part of this Quarterly Report on Form 10-Q.
 
       
 
  (b)   Reports on Form 8-K
 
 
      On February 4, 2004, we furnished a Current Report on Form 8-K to the Securities and Exchange Commission announcing our financial results for the fiscal quarter ended December 31, 2003. The date of this Current Report on Form 8-K is February 4, 2004.
 
      On April 8, 2004, we filed a Current Report on Form 8-K with the Securities and Exchange Commission reporting that we had entered into an agreement with Boston Scientific Corporation for the sale of 500,000 shares of our common stock to Boston Scientific Corporation subject to a number of closing conditions. The date of this Current Report on Form 8-K is April 7, 2004.
 
       
      On April 21, 2004, we furnished a Current Report on Form 8-K to the Securities and Exchange Commission announcing our financial results for the fiscal quarter ended April 3, 2004. The date of this Current Report on Form 8-K is April 21, 2004.

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SIGNATURE

     Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

         
    ASPECT MEDICAL SYSTEMS, INC.
         
Date: May 12, 2004   By:   /s/ J. Neal Armstrong

J. Neal Armstrong
Vice President and Chief Financial Officer
(Principal Financial and Accounting Officer)

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EXHIBIT INDEX

     
EXHIBIT    
NUMBER   EXHIBIT
 
10.1†
  BISx Development, Purchase and License Agreement dated January 28, 2004, by and between the Registrant and Draeger Medical Systems, Inc.
 
   
10.2†
  Addendum 2, effective January 1, 2004, to the OEM Development and Purchase Agreement, dated August 6, 1999, by and between the Registrant and Philips Medizinsysteme Boeblingen GmbH (formerly Agilent Technologies, Inc.).
 
   
10.3
  Stock Purchase Agreement, dated as of April 7, 2004, by and between the Registrant and Boston Scientific Corporation is incorporated herein by reference to Exhibit 10.1 to the Registrant’s Current Report on Form 8-K dated April 7, 2004 (File No. 0-24663).
 
   
31.1
  Certification by Chief Executive Officer Pursuant to Rule 13a-14(a) and 15d-14(a) of the Securities Exchange Act of 1934, as amended.
 
   
31.2
  Certification by Chief Financial Officer Pursuant to Rule 13a-14(a) and 15d-14(a) of the Securities Exchange Act of 1934, as amended.
 
   
32.1
  Certification by Chief Executive Officer Pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.
 
   
32.2
  Certification by Chief Financial Officer Pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.


  Confidential treatment has been requested as to certain portions of this Exhibit. Such portions have been omitted and filed separately with the Securities and Exchange Commission.