1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security |
5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Series A Convertible Preferred Stock
|
Â
(2)
|
Â
(2)
|
Common Stock
|
12,558,567
(3)
|
$
0.65
(4)
|
I
|
See footnote
(1)
|
Common Stock Warrant (right to buy)
|
09/29/2016 |
09/29/2021 |
Common Stock
|
12,307,692
(5)
|
$
0.7
(4)
|
I
|
See footnote
(1)
|
Common Stock Warrant (right to buy)
|
08/07/2013 |
11/11/2018 |
Common Stock
|
1,041,357
|
$
3.361
|
I
|
See footnote
(1)
|
* |
If the form is filed by more than one reporting person, see Instruction 5(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) |
Held by funds of which DAFNA Capital Management, LLC, a Delaware limited liability company, is the investment manager and general partner. Dr. Fischel is the Chief Executive Officer, of DAFNA Capital Management, LLC. |
(2) |
The Series A convertible preferred stock is convertible at the election of the holder at any time and has no expiration date. |
(3) |
The number of shares is based on the initial conversion price of $.65. The conversion price is subject to adjustment. For purposes of determining the number of shares of common stock upon conversion, the value of the convertible preferred stock will be increased by the amount of dividends at a rate of 6% per annum, which will be cumulative and accrue daily from the date of issuance on the $1,000 stated value. The conversion of the Series A convertible preferred stock, and exercising of the warrants are restricted to the extent that, upon such conversion or exercise, the number of shares of common stock then beneficially owned by the holder of such securities and its affiliates would exceed 4.99% of the total number of shares of common stock then outstanding. |
(4) |
Initial conversion/exercise price. The conversion/exercise price is subject to adjustment. |
(5) |
The number of shares is based on the initial exercise price of $.70. The exercise price is subject to adjustment. The conversion of the Series A convertible preferred stock, and exercising of the warrants are restricted to the extent that, upon such conversion or exercise, the number of shares of common stock then beneficially owned by the holder of such securities and its affiliates would exceed 4.99% of the total number of shares of common stock then outstanding. |