Now I’d like to turn the call over to Mike Celebrezze. Mike?
Thank you, Jody. Good morning, everyone, and thank you for joining us. I’d like to welcome Bharat Kakar to this quarter’s call. In a few minutes he will be providing an overview of our marketing activities.
We’re encouraged by the positive results from our actions to improve our business in the current economic environment while building a platform for future success and profitability. As previously discussed we are focused on three business priorities namely cash conservations, patient acquisition and retentions and organizational effectiveness, and our actions under these priorities are tied to performance measures.
Our procedure volume and operating results continue to be adversely affected by the general economic slowdown and the associated decline in consumer confidence levels and high-end discretionary expenditures for many consumers. Despite these difficulties as a direct result of previously instituted cash conservation measures, we are reporting a positive operating cash flow for the quarter. The cash flow statement shows a $6.3 million negative change in cash but this includes our transfer of more than $8 million from cash to investment accounts. So our total cash and investment balance actually increased by $1.7 million during the quarter.
We ended the quarter with more than $56 million of cash and investments. We also reduced our adjusted operating loss by $4.7 million from the 2009 first quarter despite performing 32% fewer procedures. Later in the call Dave will discuss improvements in key operational metrics that we attribute to patient acquisitions and organizational effectiveness measures.
We recently received some good news. The class-action lawsuit filed against the company in 2007 has been dismissed. You may recall that in March 2009 the US district court for the Southern District of Ohio in a summary judgment dismissed all claims in the suit with prejudice. The lead plaintiff in this action (inaudible) subsequently filed a motion with the court for reconsideration. The court denied this motion last November and the plaintiff filed an appeal the following month with the U.S. Court of Appeals for the sixth circuit. This appeal was voluntarily dismissed in January 2010.