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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series A-1 Preferred Stock | (1) | 11/18/2011 | P | 19,651 | (2) | (1) | Common Stock | 196,510 | $ 81.42 | 39,302 | D (3) | ||||
Series A-1 Preferred Stock | (1) | 12/14/2011 | P | 19,651 | (2) | (1) | Common Stock | 196,510 | $ 81.42 | 58,953 | D (3) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
HEALTHCARE VENTURES VII LP 55 CAMBRIDGE PARKWAY SUITE 301 CAMBRIDGE, MA 02142 |
X | |||
HealthCare Partners VII, L.P. 55 CAMBRIDGE PARKWAY SUITE 301 CAMBRIDGE, MA 02142 |
X | |||
CAVANAUGH JAMES H C/O HEALTHCARE VENTURES LLC 55 CAMBRIDGE PARKWAY, SUITE 301 CAMBRIDGE, MA 02142 |
X | |||
LAWLOR AUGUSTINE 55 CAMBRIDGE PARKWAY SUITE 301 CAMBRIDGE, MA 02142 |
X | |||
LITTLECHILD JOHN W 55 CAMBRIDGE PARKWAY SUITE 301 CAMBRIDGE, MA 02142 |
X | |||
Mirabelli Christopher 55 CAMBRIDGE PARKWAY SUITE 301 CAMBRIDGE, MA 02142 |
X | |||
WERNER HAROLD R C/O HEALTHCARE VENTURES LLC 55 CAMBRIDGE PARKWAY, SUITE 301 CAMBRIDGE, MA 02142 |
X |
/s/Jeffrey Steinberg, Administrative Partner for HealthCare Ventures VII, L.P. | 12/23/2011 | |
**Signature of Reporting Person | Date | |
Jeffrey Steinberg, Administrative Partner | 12/23/2011 | |
**Signature of Reporting Person | Date | |
Jeffrey Steinberg, Attorney-in-Fact | 12/23/2011 | |
**Signature of Reporting Person | Date | |
Jeffrey Steinberg, Attorney-in-Fact | 12/23/2011 | |
**Signature of Reporting Person | Date | |
Jeffrey Steinberg, Attorney-in-Fact | 12/23/2011 | |
**Signature of Reporting Person | Date | |
Jeffrey Steinberg, Attorney-in-Fact | 12/23/2011 | |
**Signature of Reporting Person | Date | |
Jeffrey Steinberg, Attorney-in-Fact | 12/23/2011 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Not Applicable |
(2) | These shares are convertible at any time, in whole or in part at the election of the holder, into 196,510 shares of Common Stock of the Issuer. |
(3) | These securities are owned directly by HealthCare Ventures VII, L.P. ("HCVVII"). These securities are owned indirectly by HealthCare Partners VII, L.P. ("HCPVII"), the General Partner of HCVVII, and each of James Cavanaugh, Harold Werner, John Littlechild, Christopher Mirabelli and Augustine Lawlor, the general partners of HCPVII. Drs. Cavanaugh and Mirabelli and Messrs. Werner, Littlechild and Lawlor disclaim beneficial ownership of those securities in which they do not have a pecuniary interest and this report shall not be deemed an admission that they are the beneficial owners of these securities for purposes of Section 16. |