-----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, Oas4h0/RQ1pnHovipfJfxqHy7iR8IjKexuZ3cCz+KTXKPDlYjF9t0A1beoEnFta1 35InkDf7B1hF+/dQsLBG8A== 0001029869-98-000136.txt : 19980211 0001029869-98-000136.hdr.sgml : 19980211 ACCESSION NUMBER: 0001029869-98-000136 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19980210 SROS: NASD GROUP MEMBERS: LAUFFER RANDALL B GROUP MEMBERS: RANDALL B. LAUFFER 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 SEC ACT: SEC FILE NUMBER: 005-52847 FILM NUMBER: 98529629 BUSINESS ADDRESS: STREET 1: 71 ROGERS ST CITY: CAMBRIDGE STATE: MA ZIP: 02142-1118 BUSINESS PHONE: 6174991406 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 BUSINESS ADDRESS: STREET 1: EPIX MEDICAL INC STREET 2: 71 ROGERS STREET CITY: CAMBRIDGE STATE: MA ZIP: 02142 BUSINESS PHONE: 6174991400 SC 13G 1 SCHEDULE 13G UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No.____)* EPIX Medical, Inc. ------------------ (Name of Issuer) Common Stock, $.01 par value ------------------------------ (Title of Class of Securities) 26881Q10 -------------- (CUSIP Number) *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). Page 1 of 7 pages - ------------------------- --------------------------- |CUSIP NO. 237920-10-3 | 13G | Page 2 of 7 Pages | | ----------- | | --- --- | - ------------------------- --------------------------- |--------|---------------------------------------------------------------------| | 1 | NAME OF REPORTING PERSON | | | S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON | | | Lauffer Grantor Retained Annuity Trust | | | 04-6829383 | |--------|---------------------------------------------------------------------| | 2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] | | | (b) [ ] | | | Not Applicable | |--------|---------------------------------------------------------------------| | 3 | SEC USE ONLY | | | | |--------|---------------------------------------------------------------------| | 4 | CITIZENSHIP OR PLACE OF ORGANIZATION | | | | | | Massachusetts | |--------|-----------------|--------|------------------------------------------| | | 5 | SOLE VOTING POWER | | | | 0 | | NUMBER OF |--------|------------------------------------------| | SHARES | 6 | SHARED VOTING POWER | | BENEFICIALLY | | 811,237 | | OWNED BY |--------|------------------------------------------| | EACH | 7 | SOLE DISPOSITIVE POWER | | REPORTING | | 0 | | PERSON |--------|------------------------------------------| | WITH | 8 | SHARED DISPOSITIVE POWER | | | | 811,237 | |--------|---------------------------------------------------------------------| | 9 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON | | | | | | 811,237 | |--------|---------------------------------------------------------------------| | 10 | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN | | | SHARES* [ ] | | | | |--------|---------------------------------------------------------------------| | 11 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) | | | 7.23% | |--------|---------------------------------------------------------------------| | 12 | TYPE OF REPORTING PERSON* | | | 00 | - -------------------------------------------------------------------------------- *SEE INSTRUCTIONS BEFORE FILLING OUT! Page 2 of 7 pages - ------------------------- --------------------------- |CUSIP NO. 237920-10-3 | 13G | Page 3 of 7 Pages | | ----------- | | --- --- | - ------------------------- --------------------------- |--------|---------------------------------------------------------------------| | 1 | NAME OF REPORTING PERSON | | | S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON | | | Randall B. Lauffer | | | ###-##-#### | |--------|---------------------------------------------------------------------| | 2 | CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [ ] | | | (b) [ ] | | | Not Applicable | |--------|---------------------------------------------------------------------| | 3 | SEC USE ONLY | | | | |--------|---------------------------------------------------------------------| | 4 | CITIZENSHIP OR PLACE OF ORGANIZATION | | | | | | United States | |--------|-----------------|--------|------------------------------------------| | | 5 | SOLE VOTING POWER | | | | 267,761 | | NUMBER OF |--------|------------------------------------------| | SHARES | 6 | SHARED VOTING POWER | | BENEFICIALLY | | 873,903 | | OWNED BY |--------|------------------------------------------| | EACH | 7 | SOLE DISPOSITIVE POWER | | REPORTING | | 267,761 | | PERSON |--------|------------------------------------------| | WITH | 8 | SHARED DISPOSITIVE POWER | | | | 873,903 | |--------|---------------------------------------------------------------------| | 9 | AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON | | | | | | 1,141,664 | |--------|---------------------------------------------------------------------| | 10 | CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN | | | SHARES* [ ] | | | | |--------|---------------------------------------------------------------------| | 11 | PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) | | | 10.18% | |--------|---------------------------------------------------------------------| | 12 | TYPE OF REPORTING PERSON* | | | IN | - -------------------------------------------------------------------------------- *SEE INSTRUCTIONS BEFORE FILLING OUT! Page 3 of 7 pages Item 1 (a) Name of Issuer. EPIX Medical, Inc. Item 1 (b) Address of Issuer's Principal Executive Office. 71 Rogers Street Cambridge, Massachusetts 02142
Item 2 (a) Name of Person Filing Item 2 (b) Address of Principal Business Item 2 (c) Citizenship Office Randall B. Lauffer EPIX Medical, Inc. United States 71 Rogers Street Cambridge, Massachusetts 02142 Lauffer Grantor Retained Annuity EPIX Medical, Inc. Massachusetts Trust c/o Randall B. Lauffer, Trustee 71 Rogers Street Cambridge, Massachusetts 02142
Item 2 (d) Title of Class of Securities. Common Stock, $.01 par value per share Item 2 (e) CUSIP Number. 26881Q10 Item 3 Type of Reporting Person. Not applicable; this statement is filed pursuant to Rule 13d-1(c). Item 4 Ownership. Item 4 (a) Amount Beneficially Owned as of December 31, 1997. Randall B. Lauffer 1,141,664(1) Lauffer Grantor Retained Annuity Trust 811,237 Item 4 (b) Percentage of Class. Randall B. Lauffer 10.18% Lauffer Grantor Retained Annuity Trust 7.23% - ----------------------- (1) Includes 46,666 shares held of record by Mr. Lauffer's wife. Also includes 16,000 shares held of record by The Lauffer Irrevocable Trust dated September 22, 1995 and 811,237 shares held of record by the Lauffer Grantor Retained Annuity Trust. The filing of this statement shall not be construed as an admission that Mr. Lauffer is the beneficial owner of any of the shares held of record by his wife or The Lauffer Irrevocable Trust dated September 22, 1995. Page 4 of 7 pages Item 4 (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote: Randall B. Lauffer 267,761 Lauffer Grantor Retained Annuity Trust 0 (ii) shared power to vote or to direct the vote: Randall B. Lauffer 873,903 Lauffer Grantor Retained Annuity Trust 811,237 (iii) sole power to dispose or to direct the disposition of: Randall B. Lauffer 267,761 Lauffer Grantor Retained Annuity Trust 0 (iv) shared power to dispose or to direct the disposition of: Randall B. Lauffer 873,903 Lauffer Grantor Retained Annuity Trust 811,237 The Lauffer Grantor Retained Annuity Trust expressly disclaims beneficial ownership of any shares of EPIX Medical, Inc., except any shares held directly of record. Item 5 Ownership of Five Percent or Less of a Class. Not applicable. 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; this statement is filed pursuant to Rule 13d-1(c). Attached as Exhibit 1 hereto is a Joint Filing Agreement executed by each of the filing persons pursuant to Rule 13d-1(f). Page 5 of 7 pages SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, each of the undersigned certifies that the information set forth in this statement is true, complete and correct. Dated: February 1, 1998 /s/ Randall B. Lauffer --------------------------------- Randall B. Lauffer LAUFFER GRANTOR RETAINED ANNUITY TRUST /s/ Randall B. Lauffer --------------------------------- Name: Randall B. Lauffer Its: Trustee Page 6 of 7 pages 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 13d-1(f) under the Securities Exchange Act of 1934, as amended. Dated: February 1, 1998 /s/ Randall B. Lauffer --------------------------------- Randall B. Lauffer LAUFFER GRANTOR RETAINED ANNUITY TRUST /s/ Randall B. Lauffer --------------------------------- Name: Randall B. Lauffer Its: Trustee Page 7 of 7 pages -----END PRIVACY-ENHANCED MESSAGE-----