-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, Rd76w/H2XY+5V+qj0X3pMZPB7n+8I+uCJ0NWTYBQsZwRTAyMaXwajmE19NLMVfdJ foncgPHF7BtzXxcgDhfBLQ== 0000912057-01-005087.txt : 20010214 0000912057-01-005087.hdr.sgml : 20010214 ACCESSION NUMBER: 0000912057-01-005087 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20010213 GROUP MEMBERS: LAUFFER GRANTOR RETAINED ANNUITY TRUST GROUP MEMBERS: LAUFFER RANDALL B SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: EPIX MEDICAL INC CENTRAL INDEX KEY: 0001027702 STANDARD INDUSTRIAL CLASSIFICATION: IN VITRO & IN VIVO DIAGNOSTIC SUBSTANCES [2835] IRS NUMBER: 043030815 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: SEC FILE NUMBER: 005-52847 FILM NUMBER: 1538129 BUSINESS ADDRESS: STREET 1: 71 ROGERS ST CITY: CAMBRIDGE STATE: MA ZIP: 02142-1118 BUSINESS PHONE: 6172506000 MAIL ADDRESS: STREET 1: 71 ROGERS ST CITY: CAMBRIDGE STATE: MA ZIP: 02142-1118 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: LAUFFER RANDALL B CENTRAL INDEX KEY: 0001054594 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: EPIX MEDICAL INC STREET 2: 71 ROGERS STREET CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 6174991400 SC 13G/A 1 a2038299zsc13ga.txt SCHEDULE 13G/A UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 SCHEDULE 13G UNDER THE SECURITIES EXCHANGE ACT OF 1934 (AMENDMENT NO. 3) ------- EPIX MEDICAL, INC. -------------------------------------------------------------- (Name of Issuer) COMMON STOCK, $.01 PAR VALUE -------------------------------------------------------------- (Title of Class of Securities) 26881Q10 -------------------------------------------------------------- (CUSIP Number) DECEMBER 31, 2000 -------------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [ ] Rule 13d-1(b) [ ] Rule 13d-1(c) [x] Rule 13d-1(d) *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). ======================= CUSIP NO. 26881Q10 13G ======================= - ------------------------------------------------------------------------------- 1 NAME(S) OF REPORTING PERSON(S) S.S. OR I.R.S. IDENTIFICATION NO(S). OF ABOVE PERSON(S) LAUFFER GRANTOR RETAINED ANNUITY TRUST - ------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) / / NOT APPLICABLE (b) / / - ------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION MASSACHUSETTS - ------------------------------------------------------------------------------- 5 SOLE VOTING POWER NUMBER OF SHARES -0- ------------------------------ BENEFICIALLY 6 SHARED VOTING POWER OWNED BY -0- ------------------------------ EACH 7 SOLE DISPOSITIVE POWER REPORTING -0- ------------------------------ PERSON 8 SHARED DISPOSITIVE POWER WITH -0- - ------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON -0- - ------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES Not applicable - ------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 0.0% - ------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* OO - ------------------------------------------------------------------------------- ======================= CUSIP NO. 26881Q10 13G ======================= - ------------------------------------------------------------------------------- 1 NAME(S) OF REPORTING PERSON(S) S.S. OR I.R.S. IDENTIFICATION NO(S). OF ABOVE PERSON(S) Randall B. Lauffer - ------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) / / Not Applicable (b) / / - ------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION United States - ------------------------------------------------------------------------------- 5 SOLE VOTING POWER NUMBER OF SHARES 591,822 --------------------------------- BENEFICIALLY 6 SHARED VOTING POWER OWNED BY -0- --------------------------------- EACH 7 SOLE DISPOSITIVE POWER REPORTING 591,822 --------------------------------- PERSON 8 SHARED DISPOSITIVE POWER WITH -0- - ------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 591,822 - ------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES NOT APPLICABLE. - ------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 4.5% - ------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - ------------------------------------------------------------------------------- Item 1(a) Name of Issuer -------------- EPIX MEDICAL, INC. Item 1(b) Address of Issuer's Principal Executive Offices ----------------------------------------------- 71 ROGERS STREET CAMBRIDGE, MA 02142
Item 2(a) Item 2(b) Item 2(c) Address of Principal -------------------- Name of Person Filing Principal Business Office Citizenship --------------------- ------------------------- ----------- RANDALL B. LAUFFER EPIX MEDICAL, INC. UNITED STATES 71 ROGERS STREET CAMBRIDGE, MA 02142 LAUFFER GRANTOR RETAINED EPIX MEDICAL, INC. UNITED STATES ANNUITY TRUST C/O RANDALL B. LAUFFER, TRUSTEE 71 ROGERS STREET CAMBRIDGE, MA 02142
Item 2(d) Title of Class of Securities ---------------------------- COMMON STOCK, $.01 PAR VALUE PER SHARE Item 2(e) CUSIP Number ------------ 26881Q10 Item 3. If this statement is filed pursuant to Rules 13d-1(b) or -------------------------------------------------------- 13d-2(b) or (c), check whether the person filing is a ----------------------------------------------------- (a) [ ] Broker or dealer registered under Section 15 of the Exchange Act. (b) [ ] Bank as defined in section 3(a)(6) of the Exchange Act. (c) [ ] Insurance company as defined in Section 3(a)(19) of the Exchange Act. (d) [ ] Investment company registered under Section 8 of the Investment Company Act. (e) [ ] An investment Adviser in accordance with Rule 13d-1(b)(1)(ii)(E). (f) [ ] An employee benefit plan or endowment fund in accordance with Rule 13d-1(b)(1)(ii)(F). (g) [ ] A parent holding company or control person in accordance with Rule 13d-1(b)(1)(ii)(G). (h) [ ] A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act. (i) [ ] A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act. (j) [ ] Group, in accordance with Rule 13d-1(b)(1)(ii)(J) If this statement is filed pursuant to Rule 13d-1(c), check this box.[ ] NOT APPLICABLE. Item 4. Ownership --------- Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1. (a) Amount Beneficially Owned: RANDALL B. LAUFFER 591,822 LAUFFER GRANTOR RETAINED ANNUITY TRUST 0 (b) Percent of Class: RANDALL B. LAUFFER 4.5% LAUFFER GRANTOR RETAINED ANNUITY TRUST 0.0% (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote: RANDALL B. LAUFFER 591,822 LAUFFER GRANTOR RETAINED ANNUITY TRUST 0 (ii) shared power to vote or to direct the vote: RANDALL B. LAUFFER 0 LAUFFER GRANTOR RETAINED ANNUITY TRUST 0 (iii) sole power to dispose or to direct the disposition of: RANDALL B. LAUFFER 591,822 LAUFFER GRANTOR RETAINED ANNUITY TRUST 0 (iv) shared power to dispose or to direct the disposition of: RANDALL B. LAUFFER 0 LAUFFER GRANTOR RETAINED ANNUITY TRUST 0 Item 5. Ownership of Five Percent or Less of a Class -------------------------------------------- If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following. [ X ] Item 6. Ownership of More than Five Percent on Behalf of Another Person --------------------------------------------------------------- NOT APPLICABLE. Item 7. Identification and Classification of the Subsidiary Which --------------------------------------------------------- Acquired the Security Being Reported on By the Parent Holding ------------------------------------------------------------- Company ------- NOT APPLICABLE. Item 8. Identification and Classification of Members of the Group --------------------------------------------------------- NOT APPLICABLE. Item 9. Notice of Dissolution of Group ------------------------------ NOT APPLICABLE. Item 10. Certification ------------- NOT APPLICABLE. SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. February 6, 2001 --------------------------------- (Date) /s/ Randall B. Lauffer --------------------------------- (Signature) Randall B. Lauffer --------------------------------- Chief Scientific Officer Exhibit 1 --------- Joint Filing Agreement of Randall B. Lauffer and Lauffer Grantor Retained Annuity Trust The undersigned hereby agree that the Schedule 13G with respect to the securities of EPIX Medical, Inc. dated as of even date herewith is filed on behalf of each of us pursuant to and in accordance with provisions of Rule 13(d)-1(k) under the Securities Exchange Act of 1934, as amended. Dated: February 6, 2001 /s/ Randall B. Lauffer --------------------------------- Randall B. Lauffer LAUFFER GRANTOR RETAINED ANNUITY TRUST /s/ Randall B. Lauffer ---------------------------------- Name: Randall B. Lauffer Its: Trustee -----END PRIVACY-ENHANCED MESSAGE-----