MEDICAL DEVICE OUTSOURCING - INDUSTRY EYES RECOVERY AS ELECTIVE PROCEDURES RESUME - Capstone Partners
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MEDICAL DEVICE OUTSOURCING
INDUSTRY EYES RECOVERY AS
ELECTIVE PROCEDURES RESUME
September 2020
3
Medical Device Outsourcing
Industry Eyes Recovery as Elective Procedures Resume
TABLE OF CONTENTS INDUSTRY OUTLOOK
Industry Outlook While COVID-19 has severely ha mpered sales for medical device original
equipment ma nufacturers (OEMs), the resumption of elective surgeries has
M&A Overview begun to restore demand for devices and instruments. U.S. procedure volume
Private Equity Activity stood at 30% of pre-COVID levels at the start of Q2 but has grown to recover
COVID-19 Impacts near the rate seen at the beginning of the year, according to Intuitive Surgical
(Nasdaq:ISRG).1 As hospitals face a substantial backlog of elective surgeries that
Notable Transactions have been delayed, OEMs are likely to be tapped for new device orders, which
M&A Trends bodes well for full service and sophisticated co ntract manufacturing
Select Transactions organizations (CMOs).
Public Company Data COVID-19 has emphasized the need for scalable manufacturing operations
Report Contributors among OEMs, especially those undertaking production related to diagnostic
Firm Track Record systems and test kits. Full service CMOs continue to garner increased OEM
engagement, especially as supply chain issues remain a top priority.
Outsourced ma nufacturers tha t provide sophisticated development and
engineering expertise, robust quality a nd data support, and precision
production capabilities are attractive partners and acquisition targets. In
addition, current good manufacturing practices (cGMP), FDA registration, and
ISO 13485 and 9001 certifica tions remain requirements as regulatory hurdles
remain high in the Medical Device industry. Surgical robotics continue to serve
as the next wave of innovatio n in the Medical Device industr y and an avenue for
outsourced providers to offer value-added services. The complexity of surgical
platforms requires stringent quality control and is pushing the boundaries on
what is possible in terms of geometric dimensio ning and tolerancing. Altho ugh
Intuitive Surgical maintains a dominant position with its da Vinci surgical
CONTACTS platform, top medical device OEMs are increasingly entering the space.
Notably, Smith & Nephew (LSE:SN.) launched its next-generatio n robotics
Eric Williams platform, Cori, in July.2
Managing Director
215-854-4065 M&A Activity: Medical Device Outsourcing
ewilliams@capstoneheadwaters.com
100
# of Transactions
74
Mark Surowiak 80 59 57
Director 60 48 46
37
215-854-4063 40 19
msurowiak@capstoneheadwaters.com 20
0
2015 2016 2017 2018 2019 YTD 2019 YTD 2020
Year-to-date ended July 14
Source: Capital IQ, PitchBook, FactSet, and Capstone Research
www.capstoneheadwaters.com September 2020
3
Medical Device Outsourcing | September 2020
INDUSTRY OUTLOOK (CONTINUED)
Widespread postponements and cancellatio ns of elective Canceled Surgical Procedures
surgical procedures induced by COVID-19 ha ve caused
substantial challenges for hospitals and medical device
Normal Estimated Cancelation
manufacturers. An estimated 28 million surgical Volume Cancelations Rate
procedures were canceled or postponed during the height
of COVID-19 disrup tion, with the highest cancela tion rates Cancer Surgery
found in benign g ynecology, head and neck, and Colorectal 1,353,952.0 486,563.0 36%
orthopedic procedures, according to COVIDSurg Gynecology 834,839.0 328,505.0 39%
Collaborative.3 Notably, leading surgical robotics provider
Head and neck 959,190.0 373,603.0 39%
Intuitive Surgical experienced a 22% decrease in revenue
year-over-year (YOY) in conjunctio n with a 19% decline in Plastics 505,294.0 178,362.0 35%
procedure volume, according to its Q2 2020 earnings call.4 Benign Surgery
Colorectal 1,201,825.0 976,992.0 81%
However, despite severe revenue losses and production
Gynecology 2,665,361.0 2,175,774.0 82%
constraints faced by medical device manufacturers, as
states have resumed elective procedures demand has Head and neck 4,845,604.0 3,950,551.0 82%
picked up, creating an improving pipeline of activity for Orthopedics 7,677,515.0 6,295,041.0 82%
outsourced providers. In addition, the forecasted backlog Plastics 933,822.0 764,033.0 82%
of 1.2 million orthopedic procedures supports industry Urology 3,051,523.0 2,492,604.0 82%
optimism for a potential recovery in late 2020. Top public
Obstetrics 1,735,483 441,611 25%
OEMs have begun to see a resurgence in demand
evidenced by Abbot’s (NYSE:ABT) procedure volumes Source: COVIDSurg Collaborative
rebounding to approximately 90% of pre-COVID levels in
the U.S. at the end of June, according to its earnings call.5
Stryker (NYSE:SYK), a leading medical equip ment and
device manufacturer, is forecasted to experience a 6%
decline in 2020 EBITDA, while projecting a strong rebound
“ OEMs are leveraging the expertise of contract
resources to manage the development and
launch of ent ire programs. This allev iates the
in 2021 with a 10.9% increase, according to an analysis resource load on the OEM and often improves
from Morningstar.6 launch cycle efficiency.
”
-Jim Medsker, President of Keystone Solutions Group
in a press release7
M&A OVERVIEW
Merger and acquisition (M&A) activity in the Medical Device Outsourcing (MDO) industry has stalled through the first half of
2020, with 19 transactions announced or completed in the year-to-date (YTD) compared to 46 deals in YTD 2019. However,
activity has begun to recover in recent months as strategics reengage to bolster capabilities and diversify offerings while
private equity (PE) firms ha ve targeted specialized outsourced providers through add-on acq uisitio ns. As COVID-19 levied
global supply chain disruptio n across the Healthcare indus try, it has presented an opportunity for domestic CMOs to capture
increased workloads from OEMs. As device validations, audits, and regulatory adherence remain stringent, CMOs with robust
processes and ability to shorten development cycles are poised to attract M&A interest.
Despite slowing consolidation activity in the Medical Device Outsourcing sector YOY, subsegments such as plastics
manufacturing for device applications has experienced sustained buyer interest through the pandemic. Notably, seven out
of 19 acquisitions in the YTD involved target companies that possessed a specialization or manufacturing capability in plastic
tubing, co mponents, molding, or cleaning solutions. Two of these acquisitio ns are highlighted o n page four (Inverness
Graham acquires Catheter & Medical Desig n; Molded Devices acquires MEDEFAB). In addition, private equity (PE) firms have
remained active acquirers in the MDO sector YTD (see next page).
3
Medical Device Outsourcing | September 2020
PRIVATE EQUITY ACTIVITY
PE firms have remained active buyers in the MDO industry, 2020 Buyer Breakdown
accounting for nearly 53% (10 deals) of transactions in YTD
2020. PE buyers have historically displayed strong appetite
for the sector, comprising 42% of transactions from 2017 to
2019. As PE add-on activity continues to make up a 10.5%
substantial portion of buyout transactions across all STRATEGIC 26.3%
industries, amounting to 71.4% in Q2 according to Public
PitchBook,8 this trend has permeated into high-growth and Private
resilient sectors such as the MDO industry. In May 2020, FINANCIAL
PNC Mezzanine Capital-backed Molded Devices acquired 36.9%
Direct
MEDEFAB (see next page), marking its fifth add-on Add-on
acquisition. In addition, Gener8, a portfolio company of 26.3%
Sverica Capital Management, acquired Symbient Product
Development in late February for an undisclosed sum.
Symbient provides design engineering and design-for-
manufacturing of medical devices that use plastics. Source: Capital IQ, PitchBook, FactSet, and Capstone Research
COVID-19 IMPACT ON PUBLIC COMPANIES
Public companies in the Medical Device industry have combated severe headwinds throughout the pandemic with EBITDA
multiples in Capstone’s Medical Device Index falling to 12.3x on March 23. However, valuations have rebounded substantially
since its trough as multiples have appreciated nearly 88% to 23.1x, outperforming S&P 500 multiples of 16.0x. Notably, leading
medical device outsourced manufacturer Integer Holdings (NYSE:ITGR) has experienced a 50% increase in EV/EBITDA since
declining to 9.4x on March 23. Despite the disruption of COVID-19, Integer has continued to invest in expansion and innovation
initiatives, evidenced by the opening of The Galway Research and Development Innovation Centre in Ireland in late June.9 The
broader Medical Devices OEM and Biotechnology market has also displayed a strong recovery in recent months. The iShares U.S.
Medical Devices ETF, which includes 59 domestic companies that manufacture and distribute medical devices, has outperformed
the S&P 500 YTD. As of August 31, EBITDA multiples in the ETF stood at 27.6x while the fund has registered a total return of
21.8% YTD.
Capstone Medical Device Index vs. S&P 500 iShares Medical Devices ETF vs. S&P 500
S&P 500 Capstone Medical Device Index S&P 500 iShares U.S. Medical Devices ETF
25x 30x
25x
20x
20x
EV/EBITDA
15x
EV/EBITDA
15x
10x
10x
5x
5x
0x 0x
Aug-18 Dec-18 Apr-19 Aug-19 Dec-19 Apr-20 Aug-20 Aug-18 Dec-18 Apr-19 Aug-19 Dec-19 Apr-20 Aug-20
Index includes: BSX, CNMD, ITGR, IART, MDT, NUVA, SYK, TFX, ZBH Source: Capital IQ, FactSet as of August 31, 2020
4
Medical Device Outsourcing | September 2020
NOTABLE TRANSACTIONS
Several notable transactions have been announced or completed in the industry in 2020. Select transactions are outlined belo w,
followed by a more comprehensive list.
Inverness Graham Investments, Inc. acquires Catheter & Medical Design, Inc.
(June 2020, Undisclosed)
Inverness Graham has acquired leading contract manufacturer of complex catheters and catheter
components, Catheter & Medical Design (CMD) for an undisclosed sum. CMD is an OEM ISO 9001 and
ISO 13485 certified provider of custom medical catheters, braided and coiled tubing, and plastic
extrusion products to the Medical Device industry. It operates through four phases of services: design,
prototype, process validation, and production. The acquisition marks Inverness Graham’s third
investment in the Medical Device Outsourcing sector. Notably, Inverness acquired AdvancedCath
Acquires
Technologies (October 2013, undisclosed) through its subsidiary TechDevice Corporation, which was
later sold to TE Connectivity (NYSE:TEL) for an enterprise value of $190 million.
“As medical device companies continue to outsource their complex design and manufacturing needs,
we expect CMD to become an increasingly important strategic partner. We look forward to leveraging
our industry expertise and robust network to build upon CMD’s impressive performance and will look
to drive growth both organically and through strategic acquisitions, while also looking to enhance their
in-house capabilities and expand geographic reach,” commented Aliya Khaydarova, Managing Principal
of Inverness Graham, in a press release.10
Nordson Corporation acquires Fluortek, Inc.
(June 2020, $0.12 Million)
Nordson (Nasdaq:NDSN) has acquired Fluortek, a precision plastic extrusion manufacturer. Founded in
1980, Fluortek provides the Medical Device Industry with custom dimensioned tubing, offering
capabilities in conceptual design, through product engineering. It holds ISO 13485 registration,
ensuring its products and processes align with the stringent requirements of the Medical Device sector.
Acquires Fluortek will be integrated into Nordson’s MEDICAL product line within its Advanced Technology
Solutions segment. The acquisition bolsters Nordson’s product offerings, improving its capabilities in
producing critical components to complex medical device assemblies. The addition of Fluortek
enhances Nordson’s position as leading full-service solutions provider of component and device
manufacturing for OEM’s operating in the Interventional, Minimally Invasive, and Surgical Medical
Device industries.
Molded Devices, Inc. acquires Medefab – HMD, Inc.
(March 2020, Undisclosed)
Molded Devices has acquired full-service manufacturer of plastic medical devices and components,
MEDEFAB. Terms of the transactions were not disclosed. Founded in 1990, MEDEFAB offers contract
manufacturing to leading medical device companies providing both simple extrusion solutions and
complex catheter or device assembly. It also provides packaging and sterilization services, pad printing
services, insert molding, and over-molding. MEDEFAB maintains an ISO 13485 registration for its
Acquires quality management system.
Molded Devices is a leading contract manufacturer to the global OEM market, operating through 11
manufacturing facilities across the United States and Mexico. Its services include plastic dip molding,
dip coating, custom plastic injection molding, thin-wall blow molding, and extrusion. The acquisition
significantly bolsters its capabilities in extrusion, molding, and complex device assembly.
5
Medical Device Outsourcing | September 2020
MEDICAL DEVICE OUTSOURCING M&A TRENDS
HISTORIC M&A Transactions Total Disclosed Value (mm)
ACTIVITY
100 $14,000
Number of Transactions
74 $12,000
80
Transaction volume $10,000
59 57
spiked in 2019 at 74 60 48 $8,000
46
deals, however
37 $6,000
activity has slowed 40
through YTD 2020 $4,000
19
20
$2,000
0 $0
2015 2016 2017 2018 2019 YTD 2019 YTD 2020
Source: Capital IQ, Factset, Pitchbook, and Capstone Research
HISTORIC BUYER Private Public PE Platform PE Add-on
BREAKDOWN
100%
Percentage of Transactions
25% 26% 25% 27% 26% 26%
80%
PE has accounted for a 15%
17% 18% 14% 20%
majority of transaction 60% 26%
activity YTD, with 16% 25%
22% 16%
platform and add-ons 40% 35% 11%
comprising an equal share
20% 36% 40% 35% 38% 37%
24%
0%
2015 2016 2017 2018 2019 YTD 2020
Source: Capital IQ, Factset, Pitchbook, and Capstone Research
VC AND PE GROWTH Total Capital Raised Fund Count
FUNDING
$100 200
$80
150
Number of funds
$ in Billions
After reaching nearly
$84B in 2018, VC $60
funding and PE 100
growth investments $40
declined slightly in 50
2019 at $76B $20
$0 0
2015 2016 2017 2018 2019 2020
Source: Pitchbook and Capstone Research
6Medical Device Outsourcing | September 2020
SELECT TRANSACTIONS
Enterprise EV / LTM
Date Target Acquirer Target Business Description Value (mm) Revenue EBITDA
Catheter & Medical Inverness Graham Designs, develops, and manufactures medical catheter
06/18/20 - - -
Design Investments tubing products.
Provides precision plastic tubing and contract
06/01/20 Fluortek Nordson - -
manufacturing for the Medical Device industry.
Designs, manufactures, and distributes cleaners,
05/28/20 MicroCare Capital Partners - - -
lubricants, and wipes for medical device applications.
Offers medical device testing for ophthalmic indications
05/22/20 Ophthy-DS Experimentica - - -
and drug discovery services.
Cline Tool and Provides contract manufacturing for Medical,
05/11/20 Davis Tool - - -
Service Consumer, and Aerospace industries.
Applied Technical Creation Offers electronics manufacturing to industries
05/05/20 - - -
Services Technologies including Medical, Military, and Energy.
Precinmac Precision Pine Island, Bain Manufactures precision machined components
04/01/20 - - -
Machining Capital Credit to industries including Medical and Aerospace.
Medefab- Manufactures medical devices and plastic medical
03/16/20 Molded Devices - - -
HMD disposables.
Symbient Product Offers design engineering for medical devices
02/26/20 Gener8 - - -
Development specializing in plastics.
ARCH Global Manufactures high-precision components and
02/24/20 MMi Sonora CF CF CF
Precision assemblies for robotic-assisted surgical systems.
Southeast Life Provides research services for Medical Device and
02/21/20 Southeast BIO - - -
Sciences Bio/Pharma industries.
Manufactures custom plastic products including
02/05/20 Teel Plastics MPE Partners - - -
catheter packaging and medical plastic tubing.
FingerPaint Provides compliance, consulting, and reimbursement
02/03/20 1798 Consultants - - -
Marketing services to industries including Medical Device.
Designs and Manufactures plastic injection molding
01/23/20 Imark Molding Comar - - -
products for the Surgical Medical Device industry.
Provides commercial materials testing and serves
01/15/20 NSL Analytical May River Capital - - -
industries including Medical Device and Aerospace.
Lightview Capital, Provides regulatory compliance and systems validation
01/09/20 Covex - - -
Clarke Solutions to medical device and biopharmaceutical clients.
Integrated Offers contract manufacturing and furnace brazing to
01/02/20 Altair Technologies - - -
Manufacturing Medical, Security, and Defense industries.
Provides precision welding, laser cutting, and
12/17/19 EB Industries MCM Capital CF CF CF
related services to med device and A&D.
AdvanSource’s TPU Mitsubishi Provides polymer materials manufacturing for
11/25/19 $8.9 2.5x 8.8x
Business Chemical design and development of medical devices.
East West Provides electronic contract manufacturing services for
11/18/19 Adcotron EMS - - -
Manufacturing the Medical Electronics industry.
Syntech Offers precision thermoplastic injection molds and
11/13/19 Accent Plastics - - -
Development molded components.
N. Harris Develops computer-aided design and computer-
11/06/19 BobCAD-CAM - - -
Computer aided manufacturing software.
Falcon Manufactures injection molded plastic parts
11/01/19 Poly-Cast - - -
Plastics for medical devices.
Note: CF = confidential, highlighted deals are Capstone Headwaters’ transactions
Source: Capital IQ, PitchBook, FactSet, and Capstone Research
7Medical Device Outsourcing | September 2020
PUBLIC COMPANY TRADING & OPERATING DATA
Price % 52 Wk Market Enterprise LTM EV / LTM
Company 07/23/20 High Cap Value Revenue EBITDA Margin Revenue EBITDA
Boston Scientific Corporation $38.39 82.3% $54,701.9 $64,935.9 $10,785.0 $2,673.0 24.8% NM 24.3x
CONMED Corporation $82.11 70.3% $2,343.1 $3,105.0 $950.7 $161.6 17.0% 3.3x 19.2x
Integer Holdings Corporation $71.60 71.6% $2,350.9 $3,204.1 $1,271.8 $248.6 19.5% 2.5x 12.9x
Integra LifeSciences Holdings $48.83 75.0% $4,142.9 $5,570.9 $1,512.2 $358.6 23.7% 3.7x 15.5x
Medtronic plc $97.49 79.8% $130,763.2 $145,689.2 $1,512.2 $358.6 23.7% 3.7x 15.5x
NuVasive, Inc. $57.94 70.7% $2,969.3 $3,574.0 $1,153.2 $250.0 21.7% 3.1x 14.3x
Stryker Corporation $194.87 86.1% $73,150.0 $80,004.0 $14,956.0 $4,159.0 27.8% NM 19.2x
Teleflex Incorporated $389.41 97.7% $18,078.5 $20,136.1 $2,612.4 $724.4 27.7% NM 27.8x
Zimmer Biomet Holdings, Inc. $133.09 82.6% $27,523.3 $34,752.8 $7,790.5 $2,311.1 29.7% 4.5x 15.0x
Mean 24.0% 3.5x 18.2x
EV = enterprise value; LTM = last twelve months Median 23.7% 3.5x 15.5x
$ in millions, except per share data
NM = Not Meaningful Harmonic Mean 23.3% 3.3x 17.5x
Last Twelve Month Margin Performance
Gross Margin % EBITDA Margin %
80% 70.6% 73.1% 71.9%
64.4% 68.0% 65.7%
55.6% 57.5%
60%
40% 28.5% 29.7%
24.8% 27.8% 27.7%
23.7% 23.7% 21.7%
17.0% 19.5%
20%
0%
Boston Scientific CONMED Integer Integra Medtronic NuVasive Styker Teleflex Zimmer Biomet
Last Twelve Month Revenue Growth
10.0% 8.5% 8.5% 7.8%
5.6%
5.0% 2.8% 2.5% 3.3%
0.0%
-1.3%
-5.0%
-5.4%
-10.0%
Boston CONMED Integer Integra Medtronic NuVasive Styker Teleflex Zimmer Biomet
Scientific
Source: Capital IQ as of July 23, 2020
8Medical Device Outsourcing | September 2020
MEDICAL DEVICE OUTSOURCING REPORT CONTRIBUTORS
Eric Williams
Managing Director
ewilliams@capstoneheadwaters.com | 215-854-4065
Eric serves as Managing Director and Head of the Atlantic Region for Capstone Head waters, based out
of Philadelphia. Prior to Capstone Head waters, Eric was responsible for managing the Eastern region
for Morgan Stanley Smith Barney’s Capital Strategies Group and its predecessor, Citi Capital Strategies.
Eric has more than 20 years of experience managing strategic sale assignments and leveraged
recapitalizations for owners of privately held compa nies. He is head of Capstone Headwaters’ Health
and Medical practice and has successfully completed over 100 transactions in a wide range of
industries including medical device, contract manufacturing, pharmaceutical outsourcing, health care
services and education a nd training. In 2016, he received the “USA Deal of the Year” at the M&A Atlas
Awards for his work on the acq uisitio n of Progressus Therapy, LLC and in 2014 was awarded both
“M&A North American Middle Market Deal of the Year” at the M&A Atlas Awards and “Cross Border
Deal of the Year” from the M&A Advisor for his work on the sale of T-DOC Company LLC. Eric has
executed co mplex cross-border transactions with foreign buyers based in London, Germa ny, Sweden
and Switzerland and has structured deals with leading private equity groups and strategic corporate
buyers. He graduated cum laude from the University of California and is a Series 7 and 63 Registered
Securities Representative as well as a Series 24 Registered Securities Principal.
Mark Surowiak
Director
msurowiak@capstoneheadwaters.com | 215-854-4063
Mark is a Director in the Philadelphia office, supporting the management of the Atlantic
Region. Previously, Mark served over 10 years as a senior investment banking professional in Morgan
Stanley Smith Barney’s Capital Strategies Group. Over his career, Mark has focused on developing
deep credentials and expertise in the sale and recapitalization of privately held businesses. Prior to
investment banking, Mark enjoyed a career in the social services field. Mark is a graduate of Illinois
State University with a BS in Business Administration. He is a Series 7 and 63 Registered Securities
Representative.
Connor McLeod
Research Associate
cmcleod@capstoneheadwaters.com | 617-619-3319
Connor is a Research Associate at Capstone Headwaters primarily specializing in Building Products &
Construction Services, Healthcare, Business Services, and Cybersecurity.
Prior to joining Capstone Headwaters, Connor was a specialist with the Investor Services team at
BlackRock where he worked with mutual funds, closed end funds, and excha nge traded funds and
communica ted fund performance, relevant market dyna mics, and facilitated trades for shareholders,
financial advisors, and institutional clients. Connor holds a BA in Economics from Bates College and is
a Series 7 Registered Securities Representative.
9Medical Device Outsourcing | September 2020
FIRM TRACK RECORD
Capstone Headwaters maintains an active Healthcare practice in the middle market, with Medical Device Outsourcing being
an important vertical within our focus. This market presence allows Capstone Headwaters to provide Medical Device
Outsourcing co mpanies with up-to-date market data a nd access to key decision ma kers among the ind ustry’s most active
acquirers and investors.
has been acquired by has been acquired by has been recapitalized by has been acquired by
a portfolio company of
has been acquired by has recapitalized with has been acquired by has been acquired by
has been acquired by has been acquired by has been acquired by has been acquired by
10Medical Device Outsourcing | September 2020
CITATIONS
1. Intuitive Surgical, “Q2 2020 Supplemental Information,” https://isrg.intuitive.com/investors, accessed July 22, 2020.
2. Mass Device, “Smith+Nephew launches next-gen surgical robotics system,”
https://www.massdevice.com/smithnep hew-launches-next-gen-surgical-robotics-system/, accessed July 23, 2020.
3. COVIDSURGE Collaborative, “Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling
to inform surgical recovery plans,” https://globalsurg.org/covidsurg/, accessed July 22, 2020.
4. Intuitive Surgical, “Q2 2020 Intuitive Surgical Earnings Call,” https://isrg.intuitive.com/, accessed July 22, 2020.
5. Abbot Laboratories, “Q2 2020 Abbot Laboratories Earnings Call,” https://www.abbott.com/investors.html, accessed July
22, 2020.
6. Morningstar, “Backlog for Orthopedic Procedures Grows in the U.S., No Change to Our Fair Value Estimates,”
https://my.pitchbook.com, accessed July 21, 2020.
7. MPO, “Contract Partners: A Discussion of Full Services Outsourcing,” https://www.mpo-mag.com/issues/2020-05-
01/view_features/contract-partners-a-discussion-of-full-service-outsourcing/28724, accessed July 17, 2020.
8. PitchBook, “Q2 2020 US PE Breakdown,” https://my.pitchbook.com, accessed July 20, 2020.
9. Global Newswire, “Integer Opens New Innovative Ireland Research and Development Facility,”
https://www.globenewswire.com/news-release/2020/06/25/2053713/0/en/Integer-Opens-New-Inno vative -Ireland -
Research-and-Development-Facility.html, accessed July 21, 2020.
10. Inverness Graham Investments, “Inverness Graham Completes Acquisition of Catheter & Medical Design,”
http://www.invernessgraham.com/docs/Inver ness-Graham-PR-CM D_VFinal.pdf, accessed July 22, 2020.
Disclosure: This report is a periodic compilation of certain economic and corporate information, as well as completed and announced merger and acquisi-
tion activity. Information contained in this report should not be construed as a recommendation to sell or buy any security. Any reference to or omission of
any reference to any company in this report should not be construed as a recommendation to buy, sell or take any other action with respect to any security of
any such company. We are not soliciting any action with respect to any security or company based on this report. The report is published solely for the
general information of clients and friends of Capstone Headwaters. It does not take into account the particular investment objectives, financial situation or
needs of individual recipients. Certain transactions, including those involving early-stage companies, give rise to substantial risk and are not suitable for all
investors. This report is based upon information that we consider reliable, but we do not represent that it is accurate or complete, and it should not be relied
upon as such. Prediction of future events is inherently subject to both known and unknown risks and other factors that may cause actual results to vary
materially. We are under no obligation to update the information contained in this report. Opinions expressed are our present opinions only and are subject
to change without notice. Additional information is available upon request. The companies mentioned in this report may be clients of Capstone Headwaters.
The decisions to include any company in this report is unrelated in all respects to any service that Capstone Headwaters may provide to such company. This
report may not be copied or reproduced in any form, or redistributed without the prior written consent of Capstone Headwaters. The information contained
herein should not be construed as legal advice.
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Boston Boise Burlington Chicago
Dallas Denver Greenwich Houston 450+ professionals
Los Angeles New York Orange 60+ offices in 40 countries
County Philadelphia San Diego
San Francisco St Louis Tampa Asia: China India Japan
Washington DC Latin America: Argentina Brazil Chile Colombia Mexico Peru
Africa: Congo Egypt Ghana Ivory Coast Mauritius Morocco Senegal South Africa
Europe: Belgium Bosnia Croatia Czech Republic Finland France Germany Herzegovina
Hungary Ireland Italy London Netherlands Norway Poland Russia Serbia Slovenia
Spain Sweden Switzerland Turkey United Kingdom
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