Persistent Negative Operating Cash FlowChronic negative operating cash flow signals the business consumes cash to operate and cannot self-fund growth or working capital. Over months this forces reliance on external financing, increases dilution or debt risk, and constrains investment into sales, regulatory clearance, or product improvements.
Fragile Balance Sheet With High LeverageDebt around twice reported equity limits financial flexibility and raises refinancing and covenant risk. For a small, loss-making medtech, elevated leverage reduces runway, increases interest burden, and makes the company vulnerable to revenue shortfalls or adverse financing market conditions.
Steep Revenue Decline And Widening LossesSharp revenue contraction while losses widen undermines unit economics and scalability of the CARA platform. Declining scale increases per-unit costs, weakens negotiating leverage with customers, and lengthens the path to breakeven absent material new contracts or cost restructuring.