SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
BERTHE ASTRID MARIE

(Last) (First) (Middle)
3905 ANNAPOLIS LANE N.

(Street)
PLYMOUTH MN 55447

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
ATS MEDICAL INC [ ATSI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
VP-Reg Affairs/Qual Assurance
3. Date of Earliest Transaction (Month/Day/Year)
08/12/2010
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 08/12/2010 D 111,397.337 D (1) 0 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Restricted Stock Units (2) 08/12/2010 D 4,000(3) 10/02/2007(4) 10/02/2011(5) Common Stock 4,000 $4 0 D
Restricted Stock Units (2) 08/12/2010 D 4,000(3) 02/13/2008(4) 02/13/2012(5) Common Stock 4,000 $4 0 D
Restricted Stock Units (2) 08/12/2010 D 3,882(3) 03/15/2008(4) 03/15/2012(5) Common Stock 3,882 $4 0 D
Restricted Stock Units (2) 08/12/2010 D 20,000(3) 08/01/2008(4) 08/01/2012(5) Common Stock 20,000 $4 0 D
Restricted Stock Units (2) 08/12/2010 D 52,577(3) 03/15/2009(4) 03/15/2013(5) Common Stock 52,577 $4 0 D
Restricted Stock Units (2) 08/12/2010 D 52,852(3) 03/15/2010(4) 03/15/2014(5) Common Stock 52,852 $4 0 D
Restricted Stock Units (2) 08/12/2010 D 53,410(3) 03/01/2011(6) 03/01/2015(5) Common Stock 53,410 $4 0 D
Restricted Stock Units (2) 08/12/2010 D 30,000 03/01/2011(6) 03/01/2015 Common Stock 30,000 $4 0 D
Explanation of Responses:
1. In connection with the merger of a subsidiary of Medtronic, Inc. into Issuer on August 12, 2010 (the "Merger") pursuant to an agreement and plan of merger dated April 28, 2010, all shares of Issuer common stock were converted into the right to receive $4 per share in cash.
2. 1 unit for 1 share of Common Stock
3. This restricted stock unit, the vesting of which was accelerated in connection with the Merger, was cancelled in the merger in exchange for the right to receive a cash payment equal to the product of (i) the total number of shares of stock represented by the restricted stock unit, multiplied by (ii) $4 per share, less applicable withholding taxes.
4. Vests in 20% annual cumulative installments beginning the date shown.
5. Represents last vesting date.
6. Vests in 20% annual cumulative installments starting on the date shown.
Remarks:
/s/ Deborah K. Chapman, Attorney in Fact for Astrid Berthe 08/12/2010
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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 Number.