Natus Medical Incorporated is a leading provider of healthcare products used for the screening, detection, treatment, monitoring and tracking of common medical ailments such as hearing impairment, neurological dysfunction, epilepsy, sleep disorders, and newborn care. Product offerings include computerized neurodiagnostic systems for audiology, neurology, polysomnography, and neonatology, as well as newborn care products such as hearing screening systems, phototherapy devices for the treatment of newborn jaundice, head-cooling products for the treatment of brain injury in newborns, and software systems for managing and tracking disorders and diseases for public health laboratories. Natus Medical Inc. has a market cap of $416.49 million; its shares were traded at around $14.69 with a P/E ratio of 31.26 and P/S ratio of 2.57. Highlight of Business Operations: General and administrative expenses increased $775,000, or 15.8%, to $5.7 million in the three months ended September 30, 2009 compared to $4.9 million in the same period in 2008. During the third quarter 2009 Neurocom and Alpine Biomed contributed to $627,000 of general and administrative expenses for which we had no such costs in the 2009 period. We also recorded $460,000 of direct acquisition costs associated with the acquisitions of Hawaii Medical and Alpine Biomed in the third quarter 2009. Other general and administrative expense exclusive of those associated with Neurocom and Alpine, and the referenced acquisition costs, were $312,000 less in the 2009 third quarter compared to the same period in 2008, which resulted primarily from a reduction in outside consulting expenses.
Device and systems revenue decreased $8.0 million, or 10.9%, to $63.6 million in the nine months ended September 30, 2009 compared to $71.6 million in the same period in 2008. Neurocom and Alpine Biomed contributed to $7.8 million of revenue from devices and systems offset by a $10.8 million decrease in revenue from other neurology and sleep diagnostics products, a $3.7 million decrease in revenue from hearing products, and a $1.2 million decrease in revenue from newborn care and other products. Revenue from devices and systems was 55.4% of consolidated revenue in the nine months ended September 30, 2009 compared to 60.4% of consolidated revenue for the same period in 2008.
As of September 30, 2009, we had cash and cash equivalents of $28.7 million, short-term investments of $944,000, stockholders equity of $238.3 million, and working capital of $73.7 million, compared with cash and cash equivalents of $56.9 million, stockholders equity of $226.5 million, and working capital of $102.3 million as of December 31, 2008.
Cash provided by operations increased by $16.7 million for the nine months ended September 30, 2009 to $20.9 million, compared to $4.2 million for the same period in 2008. The sum of our net income and non-cash expense items, such as reserves, depreciation and amortization, and stock based compensation, was approximately $17.9 million in the 2009 period, compared to $16.7 million in 2008. The overall impact of changes in certain operating assets and liabilities on total operating cash flows resulted in a cash inflow of $3.0 million in 2009 compared with a cash outflow of $12.5 million in 2008.
Cash used in investing activities was $50.6 million for the nine months ended September 30, 2009 compared to $18.1 million for the same period in 2008. During the nine months ended September 30, 2009 we paid $47.1 million for acquired businesses and earnout obligations, net of cash acquired, and $944,000 for investment in marketable securities, compared to $13.8 million paid for net business acquisitions and $12.1 million for marketable securities in 2008. We paid $1.9 million for purchases of property and equipment for the nine months ended September 30, 2009 compared to $2.2 million in the same period of 2008, and capitalized $637,000 of internal use software development costs in 2009 compared to $1.2 million in 2008.
Cash provided by financing activities was $188,000 during the nine months ended September 30, 2009, compared to $68.8 million in the same period in 2008. We raised cash through sales of our stock pursuant to our stock awards plans and our employee stock purchase plan in the amount of $542,000 and $2.6 million in the nine months ended September 30, 2009 and 2008, respectively. We raised an aggregate of $99.3 million through underwritten public offerings of our common stock in April and May 2008 with no similar transactions in 2009. We also realized an excess tax benefit of $31,000 on the exercise of employee stock options for the nine months ended September 30, 2009 that was recorded as an increase to stockholders equity, as compared with a tax benefit of $2.1 million in the first nine months of 2008. During the nine months ended September 30, 2008, we increased our borrowings under our credit facility by $6.0 million and we repaid $25.2 million on our term loan and $16.0 million on our revolving credit facility resulting in a net cash outflow of $41.2 million for the nine months ended September 30, 2008, compared with payments of $385,000 for the nine months ended September 30, 2009.
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