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Nuwellis, Inc. — Regulatory Filings 2017
Apr 6, 2017
35477_rf_2017-04-06_bd26034f-5be7-4149-a46c-9ee3a3db26f9.zip
Regulatory Filings
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Registration No. 333-216841
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
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Amendment No. 3 to
FORM S-1 REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933
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SUNSHINE HEART, INC. (Exact name of registrant as specified in its charter)
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Delaware (State of Incorporation) 3845 (Primary Standard Industrial Classification Code Number) 68-0533453 (I.R.S. Employer Identification Number)
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12988 Valley View Road Eden Prairie, Minnesota 55344 (952) 345-4200 (Address, Including Zip Code, and Telephone Number, Including Area Code, of Registrant's Principal Executive Offices)
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John Erb Chief Executive Officer Sunshine Heart, Inc. 12988 Valley View Road Eden Prairie, Minnesota 55344 (952) 345-4200 (Name, Address, Including Zip Code, and Telephone Number, Including Area Code, of Agent for Service)
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| Copies to: | |
|---|---|
| Phillip D. Torrence, Esq. Meredith Ervine, Esq. Honigman Miller Schwartz and Cohn LLP 350 East Michigan Avenue, Suite 300 Kalamazoo, MI 49007 Tel: (269) 337-7700 Fax: (269) 337-7703 | Joseph A. Smith Michael F. Nertney Ellenoff Grossman & Schole LLP 1345 Avenue of the Americas New York, NY 10105-0302 Tel: (212) 370-1300 Fax: (212) 401-4741 |
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Approximate date of commencement of proposed sale to the public: From time to time after this Registration Statement becomes effective.
If any securities being registered on this Form are to be offered on a delayed or continuous basis pursuant to Rule 415 under the Securities Act of 1933, check the following box: ý
If this Form is filed to register additional securities for an offering pursuant to Rule 462(b) under the Securities Act, check the following box and list the Securities Act registration statement number of the earlier effective registration statement for the same offering. o
If this Form is a post-effective amendment filed pursuant to Rule 462(c) under the Securities Act, check the following box and list the Securities Act registration statement number of the earlier effective registration statement for the same offering. o
If this Form is a post-effective amendment filed pursuant to Rule 462(d) under the Securities Act, check the following box and list the Securities Act registration statement number of the earlier effective registration statement for the same offering. o
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a small reporting company. See definitions of "large accelerated filer," "accelerated filer," and "smaller reporting company" in Rule 12b-2 of the Exchange Act. (Check one):
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Large accelerated filer o Accelerated filer o Non-accelerated filer o (Do not check if a smaller reporting company) Smaller reporting company ý
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The registrant hereby amends this registration statement on such date or dates as may be necessary to delay its effective date until the registrant shall file a further amendment which specifically states that this registration statement shall thereafter become effective in accordance with Section 8(a) of the Securities Act of 1933 or until the registration statement shall become effective on such date as the Securities and Exchange Commission, acting pursuant to said Section 8(a), may determine.
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EXPLANATORY NOTE: We are filing this Amendment No. 3 (this "Amendment") to our Registration Statement on Form S-1, which was originally filed with the Securities and Exchange Commission on March 20, 2017 and has been previously amended by Amendment Nos. 1 and 2 thereto (as so amended, the "Registration Statement"), solely to include an updated Exhibit 5.1. No other information in the Registration Statement, including the prospectus that forms a part thereof, is being modified. Accordingly, this Amendment consists only of the facing page, this explanatory note, Part II of the Registration Statement, the signature page to the Registration Statement, the Exhibit Index, and Exhibit 5.1 filed herewith. The prospectus that forms a part of the Registration Statement is unchanged and has therefore been omitted from this filing.
PART II
INFORMATION NOT REQUIRED IN PROSPECTUS
Item 13. Other Expenses of Issuance and Distribution.
The following table sets forth the estimated costs and expenses to be incurred in connection with the issuance and distribution of the securities registered under this Registration Statement. All amounts are estimates except the Securities and Exchange Commission registration fee.
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| Amount to be Paid | |
|---|---|
| SEC registration fee | $ 1,910 |
| FINRA filing fee | $ 3,000 |
| Legal fees and expenses | $ 100,000 |
| Printing expenses | $ 15,000 |
| Accountant's fees and expenses | $ 50,000 |
| Transfer agent and registrar fees | $ 5,000 |
| Miscellaneous expenses | $ 10,090 |
| Total | $ 185,000 |
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Item 14. Indemnification of Directors and Officers.
Our certificate of incorporation and bylaws provide that each person who was or is made a party or is threatened to be made a party to or is otherwise involved (including, without limitation, as a witness) in any action, suit or proceeding, whether civil, criminal, administrative or investigative, by reason of the fact that he or she is or was a director or an officer of Sunshine Heart, Inc. or is or was serving at our request as a director, officer, or trustee of another corporation, or of a partnership, joint venture, trust or other enterprise, including service with respect to an employee benefit plan, whether the basis of such proceeding is alleged action in an official capacity as a director, officer or trustee or in any other capacity while serving as a director, officer or trustee, shall be indemnified and held harmless by us to the fullest extent authorized by the Delaware General Corporation Law, as amended (the "DGCL"), against all expense, liability and loss (including attorneys' fees, judgments, fines, ERISA excise taxes or penalties and amounts paid in settlement) reasonably incurred or suffered by such.
Section 145 of the DGCL permits a corporation to indemnify any director or officer of the corporation against expenses (including attorney's fees), judgments, fines and amounts paid in settlement actually and reasonably incurred in connection with any action, suit or proceeding brought by reason of the fact that such person is or was a director or officer of the corporation, if such person acted in good faith and in a manner that he or she reasonably believed to be in, or not opposed to, the best interests of the corporation, and, with respect to any criminal action or proceeding, if he or she had no reason to believe his or her conduct was unlawful. In a derivative action, (i.e., one brought by or on behalf of the corporation), indemnification may be provided only for expenses actually and reasonably incurred by any director or officer in connection with the defense or settlement of such an action or suit if such person acted in good faith and in a manner that he or she reasonably believed to be in, or not opposed to, the best interests of the corporation, except that no indemnification shall be provided if such person shall have been adjudged to be liable to the corporation, unless and only to the
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extent that the court in which the action or suit was brought shall determine that the defendant is fairly and reasonably entitled to indemnity for such expenses despite such adjudication of liability.
Pursuant to Section 102(b)(7) of the DGCL, our certificate of incorporation eliminates the liability of a director to us or our stockholders for monetary damages for such a breach of fiduciary duty as a director, except for liabilities arising:
We carry insurance policies insuring our directors and officers against certain liabilities that they may incur in their capacities as directors and officers.
The Company has entered into indemnification agreements with each of its directors and executive officers. Pursuant to the indemnification agreements, the Company agrees to hold harmless and indemnify its directors and executive officers to the fullest extent authorized or permitted by the provisions of the Company's certificate of incorporation and bylaws and the DGCL, including for any amounts that such director or officer becomes obligated to pay because of any claim to which such director or officer is made or threatened to be made a party, witness or participant, by reason of such director's or officer's service as a director, officer, employee or other agent of the Company.
There are certain exceptions from the Company's obligation to indemnify its directors and executive officers pursuant to the indemnification agreements, including for "short-swing" profit claims under Section 16(b) of the Exchange Act, losses that result from conduct that is established by a final judgment as knowingly fraudulent or deliberately dishonest or that constituted willful misconduct, or that constituted a breach of the duty of loyalty to the Company or resulted in any improper personal profit or advantage, where payment is actually made to a director or officer under an insurance policy, indemnity clause, bylaw or agreement, except in respect of any excess beyond payment under such insurance, clause, bylaw or agreement, for indemnification which is not lawful, or in connection with any proceeding initiated by such director or officer, or any proceeding against the Company or its directors, officers, employees or other agents, unless (i) such indemnification is expressly required to be made by law, (ii) the proceeding was authorized by the board of directors of the Company, (iii) such indemnification is provided by the Company, in its sole discretion, pursuant to the powers vested in the Company under the DGCL, or (iv) the proceeding is initiated to enforce a claim for indemnification pursuant to the indemnification agreement.
All agreements and obligations of the Company contained in the indemnification agreements shall continue during the period when the director or officer who is a party to an indemnification agreement is a director, officer, employee or other agent of the Company (or is or is serving at the request of the Company as a director, officer, employee or other agent of another corporation, partnership, joint venture, trust, employee benefit plan or other enterprise) and shall continue thereafter so long as such director or officer shall be subject to any possible claim or threatened, pending or completed action, suit or proceeding, whether civil, criminal, arbitrational, administrative or investigative. In addition, the indemnification agreements provide for partial indemnification and advance of expenses.
Insofar as indemnification for liabilities arising under the Securities Act of 1933 may be permitted to our directors, officers or controlling persons pursuant to the foregoing provisions, or otherwise, we have been advised that in the opinion of the Securities and Exchange Commission this indemnification is against public policy as expressed in the Securities Act, and is, therefore, unenforceable.
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Item 15. Recent Sales of Unregistered Securities.
The following sets forth information regarding all unregistered securities sold by the registrant in the three years preceding the date of this registration statement. This information has been retroactively adjusted to reflect the reverse stock split for all periods presented.
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ZEQ.=4,SEQ=5,EFW="2231719",CP="SUNSHINE HEART, INC.",DN="1",CHK=173017,FOLIO='blank',FILE='DISK121:[17ZAY1.17ZAY78901]JA78901A.;19',USER='JKEENE',CD=';6-APR-2017;09:34'
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Item 16. Exhibits and Financial Statement Schedules.
The following exhibits are included as part of this Form S-1.
EXHIBIT INDEX
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| Exhibit Number | Exhibit Description | Incorporated By Reference — Form | File Number | Date of First Filing | Exhibit Number |
|---|---|---|---|---|---|
| 1.1 | Form of Underwriting Agreement. | S-1 | 333-216841 | April 4, 2017 | 1.1 |
| 2.1 | Asset Purchase Agreement between Sunshine Heart, Inc. and Gambro UF Solutions, Inc. dated August 5, 2016. | 8-K | 001-35312 | August 8, 2016 | 2.1 |
| 3.1 | Fourth Amended and Restated Certificate of Incorporation | 10 | 001-35312 | February 1, 2012 | 3.1 |
| 3.2 | Certificate of Amendment to the Fourth Amended and Restated Certificate of Incorporation | 8-K | 001-35312 | January 13, 2017 | 3.1 |
| 3.3 | Amended and Restated Bylaws | 10 | 001-35312 | September 30, 2011 | 3.2 |
| 3.4 | Form of Certificate of Designation of Series A Junior Participating Preferred Stock | 8-K | 001-35312 | June 14,2013 | 3.1 |
| 3.5 | Certificate of Designation of Preferences, Rights and Limitations of Series B Convertible Preferred Stock. | 8-K | 001-35312 | July 25, 2016 | 3.1 |
| 3.6 | Certificate of Designation of Preferences, Rights and Limitations of Series B-1 Convertible Preferred Stock. | 8-K | 001-35312 | November 3, 2016 | 3.1 |
| 3.7 | Certificate of Designation of Preferences, Rights and Limitations of Series C Convertible Preferred Stock. | 8-K | 001-35312 | November 3, 2016 | 3.2 |
| 3.8 | Certificate of Designation of Preferences, Rights and Limitations of Series D Convertible Preferred Stock. | 8-K | 001-35312 | November 3, 2016 | 3.3 |
| 3.9 | Form of Certificate of Designation of Preferences, Rights and Limitations of Series E Convertible Preferred Stock. | S-1 | 333-216841 | April 4, 2017 | 3.9 |
| 4.1 | Warrant to Purchase Stock, dated February 18, 2015, issued to Silicon Valley Bank | 8-K | 001-35312 | February 19, 2015 | 4.1 |
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| Exhibit Number | Exhibit Description | Incorporated By Reference — Form | File Number | Date of First Filing | Exhibit Number | Filed Herewith |
|---|---|---|---|---|---|---|
| 4.2 | Warrant to Purchase Stock, dated February 18, 2015, issued to Life Science Loans, LLC | 8-K | 001-35312 | February 19, 2015 | 4.2 | |
| 4.3 | Form of common stock Purchase Warrant issued pursuant to the Securities Purchase Agreement, dated July 20, 2016, among the Company and the purchasers signatory thereto. | 8-K | 001-35312 | July 22, 2016 | 4.3 | |
| 4.4 | Form of common stock Purchase Warrant issued to Northland Securities, Inc. | 8-K | 001-35312 | July 22, 2016 | 4.3 | |
| 4.5 | Registration Rights Agreement between Sunshine Heart, Inc. and Gambro UF Solutions, Inc. dated August 5, 2016 | 8-K | 001-35312 | August 8, 2016 | 4.1 | |
| 4.6 | Form of common stock Purchase Warrant issued pursuant to the Securities Purchase Agreement, dated October 30, 2016, among the Company and the purchasers signatory thereto. | 8-K | 001-35312 | October 31, 2016 | 4.1 | |
| 4.7 | Form of Common Stock Purchase Warrant issued pursuant to the Letter Agreement between the Company and the purchasers signatory thereto, dated February 15, 2017. | 8-K | 001-35312 | February 16, 2017 | 4.1 | |
| 4.8 | Form of Warrant to purchase shares of common stock. | S-1 | 333-216841 | April 4, 2017 | 4.8 | |
| 5.1 | Opinion of Honigman Miller Schwartz and Cohn LLP. | X | ||||
| 10.1 | Securities Purchase Agreement, dated July 20, 2016 among the Company and the purchasers signatory thereto. | 8-K | 001-35312 | July 22, 2016 | 10.1 | |
| 10.2 | Patent License Agreement between Sunshine Heart, Inc. and Gambro UF Solutions, Inc. dated August 5, 2016. | 8-K | 001-35312 | August 8, 2016 | 10.1 | |
| 10.3 | Loan and Security Agreement between Sunshine Heart, Inc. and Silicon Valley Bank dated August 5, 2016. | 8-K | 001-35312 | August 8, 2016 | 10.2 |
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| Exhibit Number | Exhibit Description | Incorporated By Reference — Form | File Number | Date of First Filing | Exhibit Number |
|---|---|---|---|---|---|
| 10.4 | Amended and Restated 2002 Stock Plan | 10 | 001-35312 | December 16, 2011 | 10.2 |
| 10.5 | Form of Notice of Stock Option Grant and Option Agreement for Amended and Restated 2002 Stock Plan | 10 | 001-35312 | September 30, 2011 | 10.3 |
| 10.6 | Second Amended and Restated 2011 Equity Incentive Plan, as amended | 14A | 001-35312 | July 27, 2012 | App. A |
| 10.7 | Form of Stock Option Grant Notice and Option Agreement for 2011 Equity Incentive Plan | 10 | 001-35312 | September 30, 2011 | 10.5 |
| 10.8 | Form of Stock Option Grant Notice and Option Agreement (Senior Management) for 2011 Equity Incentive Plan | 10 | 001-35312 | September 30, 2011 | 10.6 |
| 10.9 | Form of Stock Option Grant Notice and Option Agreement (Director) for 2011 Equity Incentive Plan | 8-K | 001-35312 | September 18, 2012 | 10.1 |
| 10.10 | Form of Stock Grant Notice and Award Agreement for 2011 Equity Incentive Plan | 8-K | 001-35312 | September 10, 2013 | 10.1 |
| 10.11 | Form of Restricted Stock Unit Grant Notice and Agreement for 2011 Equity Incentive Plan | 8-K | 001-35312 | September 10, 2013 | 10.2 |
| 10.12 | 2013 Non-Employee Directors' Equity Incentive Plan | 14A | 001-35312 | April 5, 2013 | App. A |
| 10.13 | Form of Stock Option Grant Notice and Option Agreement for 2013 Non-Employee Directors' Equity Incentive Plan | 10-K | 001-35312 | March 20, 2014 | 10.10 |
| 10.14 | Form of Restricted Stock Unit Award Grant Notice and Agreement for 2013 Non-Employee Directors' Equity Incentive Plan | 10-K | 001-35312 | March 20, 2014 | 10.11 |
| 10.15 | New-Hire Equity Incentive Plan | 10-Q | 001-35312 | August 8, 2013 | 10.1 |
| 10.16 | First Amendment to New-Hire Equity Incentive Plan | 10-Q | 001-35312 | November 12, 2013 | 10.1 |
| 10.17 | Second Amendment to New-Hire Equity Incentive Plan | 10-Q | 333-202904 | March 20, 2015 | 10.1 |
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| Exhibit Number | Exhibit Description | Incorporated By Reference — Form | File Number | Date of First Filing | Exhibit Number |
|---|---|---|---|---|---|
| 10.18 | Form of Stock Option Grant Notice and Option Agreement for New-Hire Equity Incentive Plan | 10-K | 001-35312 | March 20, 2014 | 10.14 |
| 10.19 | Form of Indemnity Agreement for the Company's executive officers and directors | 10 | 001-35312 | September 30, 2011 | 10.1 |
| 10.20 | Form of Change in Control Agreement for the Company's executive officers | 10-K | 001-35312 | March 20, 2015 | 10.16 |
| 10.21 | Non-Employee Director Compensation Policy | 10-Q | 001-35312 | August 8, 2013 | 10.2 |
| 10.22 | Executive Employment Agreement dated February 6, 2013 by and between the Company and David A. Rosa | 8-K | 001-35312 | February 6, 2013 | 10.1 |
| 10.23 | Lease Agreement dated October 21, 2011 by and between the Company and Silver Prairie Crossroads, LLC | 10 | 001-35312 | December 16, 2011 | 10.18 |
| 10.24 | Sales Agreement dated March 21, 2014 by and between the Company and Cowen and Company, LLC | S-3 | 333-194731 | March 21, 2014 | 1.2 |
| 10.25 | Loan and Security Agreement between the Company and Silicon Valley Bank dated February 18, 2015 | 8-K | 001-35312 | February 19, 2015 | 10.1 |
| 10.26 | First Amendment to Loan and Security Agreement between the Company and Silicon Valley Bank dated December 8, 2015 | 8-K | 001-35312 | December 9, 2015 | 99.1 |
| 10.27 | Second Amendment to Lease, dated as of April 20, 2015, by and between the Company and Capital Partners Industrial Fund I, LLLP dba Prairie Crossroads Business Center | 8-K | 001-35312 | April 23, 2015 | 10.1 |
| 10.28 | Termination and Release Agreement dated January 1, 2015 by and between the Company and William S. Peters | 10-Q | 001-35312 | May 7, 2015 | 10.2 |
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| Exhibit Number | Exhibit Description | Incorporated By Reference — Form | File Number | Date of First Filing | Exhibit Number | Filed Herewith |
|---|---|---|---|---|---|---|
| 10.29 | Separation and Release Agreement dated June 19, 2015 by and between the Company and Kimberly A. Oleson | 10-Q | 001-35312 | August 5, 2015 | 10.2 | |
| 10.30 | Separation and Release Agreement between the Company and David A. Rosa, dated November 30, 2015 | 8-K | 001-35312 | November 30, 2015 | 99.1 | |
| 10.31 | Executive Employment Agreement between Sunshine Heart, Inc. and John L. Erb, dated March 1, 2016 | 8-K | 001-35312 | March 2, 2016 | 10.1 | |
| 10.32 | Separation and Release Agreement by and between Sunshine Heart, Inc. and Brian J. Brown, dated February 3, 2016 | 10-Q | 001-35312 | May 5, 2015 | 10.2 | |
| 10.33 | Separation and Release Agreement by and between Sunshine Heart, Inc. and Debra Kridner, dated January 24, 2016 | 10-Q | 001-35312 | May 5, 2016 | 10.3 | |
| 10.34 | Third Amendment to the Sunshine Heart, Inc. New-Hire Equity Incentive Plan | S-8 | 333-210215 | March 15, 2016 | 99.1 | |
| 10.35 | Claudia Drayton Retention Bonus Letter, dated as of December 12, 2016 | 8-K | 001-35312 | December 16, 2016 | 10.1 | |
| 10.36 | Molly Wade Retention Bonus Letter, dated as of December 12, 2016 | 10-K | 001-35312 | March 8, 2017 | 10.33 | |
| 10.37 | Letter Agreement dated February 15, 2017 among the Company, Sabby Volatility Warrant Master Fund, Ltd. and Sabby Healthcare Master Fund, Ltd. | 8-K | 003-35312 | February 16, 2017 | 10.1 | |
| 21 | List of Subsidiaries | 10-K | 001-35312 | March 8, 2017 | 21 | |
| 23.1 | Consent of Independent Registered Public Accounting Firm | S-1 | 333-216841 | April 4, 2017 | 23.1 | |
| 23.2 | Consent of Honigman Miller Schwartz & Cohn LLP | Included in Exhibit 5.1 | ||||
| 24.1 | Power of Attorney | S-1 | 333-216841 | March 20, 2017 | 24.1 |
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Indicates management compensatory plan, contract or arrangement.
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Item 17. Undertakings.
The undersigned registrant hereby undertakes that, for the purpose of determining any liability under the Securities Act of 1933, as amended, each such post-effective amendment shall be deemed to be a new registration statement relating to the securities offered therein, and the offering of such securities at that time shall be deemed to be the initial bona fide offering thereof.
The undersigned registrant hereby undertakes to remove from registration by means of a post-effective amendment any of the securities being registered that remain unsold at the termination of the offering.
The undersigned registrant hereby undertakes that, for the purposes of determining liability to any purchaser, if the registrant is subject to Rule 430C, each prospectus filed pursuant to Rule 424(b) as part of a registration statement relating to an offering, other than registration statements relying on Rule 430B or other than prospectuses filed in reliance on Rule 430A, shall be deemed to be part of and included in the registration statement as of the date it is first used after effectiveness. Provided, however, that no statement made in a registration statement or prospectus that is part of the registration statement or made in a document incorporated or deemed incorporated by reference into the registration statement or prospectus that is part of the registration statement will, as to a purchaser with a time of contract of sale prior to such first use, supersede or modify any statement that was made in the registration statement or prospectus that was part of the registration statement or made in any such document immediately prior to such date of first use.
The undersigned registrant hereby undertakes that, for the purpose of determining liability of the registrant under the Securities Act of 1933 to any purchaser in the initial distribution of the securities:
The undersigned registrant undertakes that in a primary offering of securities of the undersigned registrant pursuant to this registration statement, regardless of the underwriting method used to sell the securities to the purchaser, if the securities are offered or sold to such purchaser by means of any of the following communications, the undersigned registrant will be a seller to the purchaser and will be considered to offer or sell such securities to such purchaser:
Insofar as indemnification for liabilities arising under the Securities Act of 1933, as amended, may be permitted to directors, officers and controlling persons of the undersigned registrant according the foregoing provisions, or otherwise, the undersigned registrant has been advised that in the opinion of the Securities and Exchange Commission such indemnification is against public policy as expressed in the Act and is, therefore, unenforceable. In the event that a claim for indemnification against such liabilities (other than the payment by the Registrant of expenses incurred or paid by a director, officer or controlling person of the registrant in the successful defense of any action, suit or proceeding) is asserted by such director, officer or controlling person in connection with the securities being registered, the registrant will, unless in the opinion of its counsel the matter has been settled by controlling precedent, submit to a court of appropriate jurisdiction the question whether such indemnification by it is against public policy as expressed in the Securities Act of 1933, as amended, and will be governed by the final adjudication of such issue.
ZEQ.=1,SEQ=11,EFW="2231719",CP="SUNSHINE HEART, INC.",DN="1",CHK=414865,FOLIO='blank',FILE='DISK121:[17ZAY1.17ZAY78901]JE78901A.;5',USER='CHE108077',CD=';6-APR-2017;02:11'
The undersigned registrant hereby undertakes that, for purposes of determining any liability under the Securities Act of 1933, each filing of the registrant's annual report pursuant to section 13(a) or section 15(d) of the Securities Exchange Act of 1934 (and, where applicable, each filing of an employee benefit plan's annual report pursuant to section 15(d) of the Securities Exchange Act of 1934) that is incorporated by reference in the registration statement shall be deemed to be a new registration statement relating to the securities offered therein, and the offering of such securities at that time shall be deemed to be the initial bona fide offering thereof.
ZEQ.=2,SEQ=12,EFW="2231719",CP="SUNSHINE HEART, INC.",DN="1",CHK=723846,FOLIO='blank',FILE='DISK121:[17ZAY1.17ZAY78901]JE78901A.;5',USER='CHE108077',CD=';6-APR-2017;02:11' THIS IS THE END OF A COMPOSITION COMPONENT
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SIGNATURES
Pursuant to the requirements of the Securities Act of 1933, the registrant has duly caused this registration statement to be signed on its behalf by the undersigned, thereunto duly authorized in the City of Eden Prairie, State of Minnesota, on this 6th day of April, 2017.
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| SUNSHINE HEART, INC. | |
|---|---|
| By: | /s/ JOHN L. ERB John L. Erb Chief Executive Officer and Chairman of the Board |
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Pursuant to the requirements of the Securities Act of 1933, this registration statement has been signed by the following persons in the capacities and on the dates indicated.
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| Signature | Date | |
|---|---|---|
| /s/ JOHN L. ERB John L. Erb | Chief Executive Officer and Chairman of the Board | April 6, 2017 |
| /s/ CLAUDIA DRAYTON Claudia Drayton | Chief Financial Officer | April 6, 2017 |
| * Steve Brandt | Director | April 6, 2017 |
| * Matthew Likens | Director | April 6, 2017 |
| * Jon W. Salveson | Director | April 6, 2017 |
| * Gregory Waller | Director | April 6, 2017 |
| * Warren Watson | Director | April 6, 2017 |
| *By: | /s/ JOHN L. ERB John L. Erb Attorney-in-fact |
end of user-specified TAGGED TABLE
ZEQ.=1,SEQ=13,EFW="2231719",CP="SUNSHINE HEART, INC.",DN="1",CHK=355903,FOLIO='blank',FILE='DISK121:[17ZAY1.17ZAY78901]JG78901A.;19',USER='CHE108077',CD=';6-APR-2017;02:11' THIS IS THE END OF A COMPOSITION COMPONENT
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EXHIBIT INDEX
COMMAND=ADD_TABLEWIDTH,"140%" User-specified TAGGED TABLE
| Exhibit Number | Exhibit Description | Incorporated By Reference — Form | File Number | Date of First Filing | Exhibit Number |
|---|---|---|---|---|---|
| 1.1 | Form of Underwriting Agreement. | S-1 | 333-216841 | April 4, 2017 | 1.1 |
| 2.1 | Asset Purchase Agreement between Sunshine Heart, Inc. and Gambro UF Solutions, Inc. dated August 5, 2016. | 8-K | 001-35312 | August 8, 2016 | 2.1 |
| 3.1 | Fourth Amended and Restated Certificate of Incorporation | 10 | 001-35312 | February 1, 2012 | 3.1 |
| 3.2 | Certificate of Amendment to the Fourth Amended and Restated Certificate of Incorporation | 8-K | 001-35312 | January 13, 2017 | 3.1 |
| 3.3 | Amended and Restated Bylaws | 10 | 001-35312 | September 30, 2011 | 3.2 |
| 3.4 | Form of Certificate of Designation of Series A Junior Participating Preferred Stock | 8-K | 001-35312 | June 14,2013 | 3.1 |
| 3.5 | Certificate of Designation of Preferences, Rights and Limitations of Series B Convertible Preferred Stock. | 8-K | 001-35312 | July 25, 2016 | 3.1 |
| 3.6 | Certificate of Designation of Preferences, Rights and Limitations of Series B-1 Convertible Preferred Stock. | 8-K | 001-35312 | November 3, 2016 | 3.1 |
| 3.7 | Certificate of Designation of Preferences, Rights and Limitations of Series C Convertible Preferred Stock. | 8-K | 001-35312 | November 3, 2016 | 3.2 |
| 3.8 | Certificate of Designation of Preferences, Rights and Limitations of Series D Convertible Preferred Stock. | 8-K | 001-35312 | November 3, 2016 | 3.3 |
| 3.9 | Form of Certificate of Designation of Preferences, Rights and Limitations of Series E Convertible Preferred Stock. | S-1 | 333-216841 | April 4, 2017 | 3.9 |
| 4.1 | Warrant to Purchase Stock, dated February 18, 2015, issued to Silicon Valley Bank | 8-K | 001-35312 | February 19, 2015 | 4.1 |
| 4.2 | Warrant to Purchase Stock, dated February 18, 2015, issued to Life Science Loans, LLC | 8-K | 001-35312 | February 19, 2015 | 4.2 |
end of user-specified TAGGED TABLE
ZEQ.=1,SEQ=14,EFW="2231719",CP="SUNSHINE HEART, INC.",DN="1",CHK=944778,FOLIO='blank',FILE='DISK121:[17ZAY1.17ZAY78901]JI78901A.;21',USER='JKEENE',CD=';6-APR-2017;09:36'
COMMAND=ADD_TABLEWIDTH,"140%" User-specified TAGGED TABLE
| Exhibit Number | Exhibit Description | Incorporated By Reference — Form | File Number | Date of First Filing | Exhibit Number | Filed Herewith |
|---|---|---|---|---|---|---|
| 4.3 | Form of common stock Purchase Warrant issued pursuant to the Securities Purchase Agreement, dated July 20, 2016, among the Company and the purchasers signatory thereto. | 8-K | 001-35312 | July 22, 2016 | 4.3 | |
| 4.4 | Form of common stock Purchase Warrant issued to Northland Securities, Inc. | 8-K | 001-35312 | July 22, 2016 | 4.3 | |
| 4.5 | Registration Rights Agreement between Sunshine Heart, Inc. and Gambro UF Solutions, Inc. dated August 5, 2016 | 8-K | 001-35312 | August 8, 2016 | 4.1 | |
| 4.6 | Form of common stock Purchase Warrant issued pursuant to the Securities Purchase Agreement, dated October 30, 2016, among the Company and the purchasers signatory thereto. | 8-K | 001-35312 | October 31, 2016 | 4.1 | |
| 4.7 | Form of Common Stock Purchase Warrant issued pursuant to the Letter Agreement between the Company and the purchasers signatory thereto, dated February 15, 2017. | 8-K | 001-35312 | February 16, 2017 | 4.1 | |
| 4.8 | Form of Warrant to purchase shares of common stock. | S-1 | 333-216841 | April 4, 2017 | 4.8 | |
| 5.1 | Opinion of Honigman Miller Schwartz and Cohn LLP. | X | ||||
| 10.1 | Securities Purchase Agreement, dated July 20, 2016 among the Company and the purchasers signatory thereto. | 8-K | 001-35312 | July 22, 2016 | 10.1 | |
| 10.2 | Patent License Agreement between Sunshine Heart, Inc. and Gambro UF Solutions, Inc. dated August 5, 2016. | 8-K | 001-35312 | August 8, 2016 | 10.1 | |
| 10.3 | Loan and Security Agreement between Sunshine Heart, Inc. and Silicon Valley Bank dated August 5, 2016. | 8-K | 001-35312 | August 8, 2016 | 10.2 | |
| 10.4 | Amended and Restated 2002 Stock Plan | 10 | 001-35312 | December 16, 2011 | 10.2 | |
| 10.5 | Form of Notice of Stock Option Grant and Option Agreement for Amended and Restated 2002 Stock Plan | 10 | 001-35312 | September 30, 2011 | 10.3 |
end of user-specified TAGGED TABLE
ZEQ.=2,SEQ=15,EFW="2231719",CP="SUNSHINE HEART, INC.",DN="1",CHK=131020,FOLIO='blank',FILE='DISK121:[17ZAY1.17ZAY78901]JI78901A.;21',USER='JKEENE',CD=';6-APR-2017;09:36'
COMMAND=ADD_TABLEWIDTH,"140%" User-specified TAGGED TABLE
| Exhibit Number | Exhibit Description | Incorporated By Reference — Form | File Number | Date of First Filing | Exhibit Number |
|---|---|---|---|---|---|
| 10.6 | Second Amended and Restated 2011 Equity Incentive Plan, as amended | 14A | 001-35312 | July 27, 2012 | App. A |
| 10.7 | Form of Stock Option Grant Notice and Option Agreement for 2011 Equity Incentive Plan | 10 | 001-35312 | September 30, 2011 | 10.5 |
| 10.8 | Form of Stock Option Grant Notice and Option Agreement (Senior Management) for 2011 Equity Incentive Plan | 10 | 001-35312 | September 30, 2011 | 10.6 |
| 10.9 | Form of Stock Option Grant Notice and Option Agreement (Director) for 2011 Equity Incentive Plan | 8-K | 001-35312 | September 18, 2012 | 10.1 |
| 10.10 | Form of Stock Grant Notice and Award Agreement for 2011 Equity Incentive Plan | 8-K | 001-35312 | September 10, 2013 | 10.1 |
| 10.11 | Form of Restricted Stock Unit Grant Notice and Agreement for 2011 Equity Incentive Plan | 8-K | 001-35312 | September 10, 2013 | 10.2 |
| 10.12 | 2013 Non-Employee Directors' Equity Incentive Plan | 14A | 001-35312 | April 5, 2013 | App. A |
| 10.13 | Form of Stock Option Grant Notice and Option Agreement for 2013 Non-Employee Directors' Equity Incentive Plan | 10-K | 001-35312 | March 20, 2014 | 10.10 |
| 10.14 | Form of Restricted Stock Unit Award Grant Notice and Agreement for 2013 Non-Employee Directors' Equity Incentive Plan | 10-K | 001-35312 | March 20, 2014 | 10.11 |
| 10.15 | New-Hire Equity Incentive Plan | 10-Q | 001-35312 | August 8, 2013 | 10.1 |
| 10.16 | First Amendment to New-Hire Equity Incentive Plan | 10-Q | 001-35312 | November 12, 2013 | 10.1 |
| 10.17 | Second Amendment to New-Hire Equity Incentive Plan | 10-Q | 333-202904 | March 20, 2015 | 10.1 |
| 10.18 | Form of Stock Option Grant Notice and Option Agreement for New-Hire Equity Incentive Plan | 10-K | 001-35312 | March 20, 2014 | 10.14 |
| 10.19 | Form of Indemnity Agreement for the Company's executive officers and directors | 10 | 001-35312 | September 30, 2011 | 10.1 |
end of user-specified TAGGED TABLE
ZEQ.=3,SEQ=16,EFW="2231719",CP="SUNSHINE HEART, INC.",DN="1",CHK=620145,FOLIO='blank',FILE='DISK121:[17ZAY1.17ZAY78901]JI78901A.;21',USER='JKEENE',CD=';6-APR-2017;09:36'
COMMAND=ADD_TABLEWIDTH,"140%" User-specified TAGGED TABLE
| Exhibit Number | Exhibit Description | Incorporated By Reference — Form | File Number | Date of First Filing | Exhibit Number |
|---|---|---|---|---|---|
| 10.20 | Form of Change in Control Agreement for the Company's executive officers | 10-K | 001-35312 | March 20, 2015 | 10.16 |
| 10.21 | Non-Employee Director Compensation Policy | 10-Q | 001-35312 | August 8, 2013 | 10.2 |
| 10.22 | Executive Employment Agreement dated February 6, 2013 by and between the Company and David A. Rosa | 8-K | 001-35312 | February 6, 2013 | 10.1 |
| 10.23 | Lease Agreement dated October 21, 2011 by and between the Company and Silver Prairie Crossroads, LLC | 10 | 001-35312 | December 16, 2011 | 10.18 |
| 10.24 | Sales Agreement dated March 21, 2014 by and between the Company and Cowen and Company, LLC | S-3 | 333-194731 | March 21, 2014 | 1.2 |
| 10.25 | Loan and Security Agreement between the Company and Silicon Valley Bank dated February 18, 2015 | 8-K | 001-35312 | February 19, 2015 | 10.1 |
| 10.26 | First Amendment to Loan and Security Agreement between the Company and Silicon Valley Bank dated December 8, 2015 | 8-K | 001-35312 | December 9, 2015 | 99.1 |
| 10.27 | Second Amendment to Lease, dated as of April 20, 2015, by and between the Company and Capital Partners Industrial Fund I, LLLP dba Prairie Crossroads Business Center | 8-K | 001-35312 | April 23, 2015 | 10.1 |
| 10.28 | Termination and Release Agreement dated January 1, 2015 by and between the Company and William S. Peters | 10-Q | 001-35312 | May 7, 2015 | 10.2 |
| 10.29 | Separation and Release Agreement dated June 19, 2015 by and between the Company and Kimberly A. Oleson | 10-Q | 001-35312 | August 5, 2015 | 10.2 |
| 10.30 | Separation and Release Agreement between the Company and David A. Rosa, dated November 30, 2015 | 8-K | 001-35312 | November 30, 2015 | 99.1 |
end of user-specified TAGGED TABLE
ZEQ.=4,SEQ=17,EFW="2231719",CP="SUNSHINE HEART, INC.",DN="1",CHK=477169,FOLIO='blank',FILE='DISK121:[17ZAY1.17ZAY78901]JI78901A.;21',USER='JKEENE',CD=';6-APR-2017;09:36'
COMMAND=ADD_TABLEWIDTH,"140%" User-specified TAGGED TABLE
| Exhibit Number | Exhibit Description | Incorporated By Reference — Form | File Number | Date of First Filing | Exhibit Number | Filed Herewith |
|---|---|---|---|---|---|---|
| 10.31 | Executive Employment Agreement between Sunshine Heart, Inc. and John L. Erb, dated March 1, 2016 | 8-K | 001-35312 | March 2, 2016 | 10.1 | |
| 10.32 | Separation and Release Agreement by and between Sunshine Heart, Inc. and Brian J. Brown, dated February 3, 2016 | 10-Q | 001-35312 | May 5, 2015 | 10.2 | |
| 10.33 | Separation and Release Agreement by and between Sunshine Heart, Inc. and Debra Kridner, dated January 24, 2016 | 10-Q | 001-35312 | May 5, 2016 | 10.3 | |
| 10.34 | Third Amendment to the Sunshine Heart, Inc. New-Hire Equity Incentive Plan | S-8 | 333-210215 | March 15, 2016 | 99.1 | |
| 10.35 | Claudia Drayton Retention Bonus Letter, dated as of December 12, 2016 | 8-K | 001-35312 | December 16, 2016 | 10.1 | |
| 10.36 | Molly Wade Retention Bonus Letter, dated as of December 12, 2016 | 10-K | 001-35312 | March 8, 2017 | 10.33 | |
| 10.37 | Letter Agreement dated February 15, 2017 among the Company, Sabby Volatility Warrant Master Fund, Ltd. and Sabby Healthcare Master Fund, Ltd. | 8-K | 003-35312 | February 16, 2017 | 10.1 | |
| 21 | List of Subsidiaries | 10-K | 001-35312 | March 8, 2017 | 21 | |
| 23.1 | Consent of Independent Registered Public Accounting Firm | S-1 | 333-216841 | April 4, 2017 | 23.1 | |
| 23.2 | Consent of Honigman Miller Schwartz & Cohn LLP | Included in Exhibit 5.1 | ||||
| 24.1 | Power of Attorney | S-1 | 333-216841 | March 20, 2017 | 24.1 |
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Indicates management compensatory plan, contract or arrangement.
ZEQ.=5,SEQ=18,EFW="2231719",CP="SUNSHINE HEART, INC.",DN="1",CHK=471883,FOLIO='blank',FILE='DISK121:[17ZAY1.17ZAY78901]JI78901A.;21',USER='JKEENE',CD=';6-APR-2017;09:36' THIS IS THE END OF A COMPOSITION COMPONENT
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TOC_BEGIN PART II INFORMATION NOT REQUIRED IN PROSPECTUS
TOC_BEGIN
EXHIBIT INDEX TOC_BEGIN
TOC_BEGIN SIGNATURES TOC_BEGIN EXHIBIT INDEX SEQ=,FILE='QUICKLINK',USER=CMATTI,SEQ=,EFW="2231719",CP="SUNSHINE HEART, INC.",DN="1" TOCEXISTFLAG