Titan MedicalTitan Medical (TSX:TMD;OTC:TITFX) shares took a hit today on fourth-quarter losses that topped -$20 million.

The Toronto-based company posted losses of -$20.6 million, for the three months ended Dec. 31, 2020, for a bottom-line slide into the red after posting profits of $2.4 million in the fourth quarter of 2019.

Titan Medical attributed the results to an increase in non-cash loss on the fair value of warrants, totaling $29.8 million, plus an increase of $3.4 million in R&D expenses after securing additional financing. However, some of that was offset by the $10 million collected in revenue from a development and license agreement with Medtronic.

For the full year, Titan Medical’s losses totaled -$24.2 million, or -36¢ per share, compared to losses of -$41.9 million (-$1.37 per share) in 2019.

“The progress made in the second half of 2020 resulted in an incredible year of accomplishments to position Titan for success. Recently announced financing arrangements and warrant exercises add to that progress, further strengthening our cash position to support the development of the Enos robotic single access surgical system, as we prepare to commence human clinical studies,” Titan president & CEO David McNally said in a news release. “During 2020, we also executed a license agreement and a separate development and license agreement with Medtronic, resulting in the Company’s first revenue of $20.0 million, by way of license payments.

“We believe Titan is in an excellent position to validate our vision of providing an innovative single access robotic surgical system. We are proud of our progress and recognize that our success is a direct result of the commitment and hard work of our entire team.”

Titan Medical did not offer financial guidance for the first quarter of 2021 or for the full year.

TMD shares were down -6.2% at $2.42 per share in mid-afternoon trading today. MassDevice’s MedTech 100 Index — which includes stocks of the world’s largest medical device companies — was down -0.9%.