0001235802-17-000173.txt : 20171221 0001235802-17-000173.hdr.sgml : 20171221 20171221160859 ACCESSION NUMBER: 0001235802-17-000173 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171219 FILED AS OF DATE: 20171221 DATE AS OF CHANGE: 20171221 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Mashaal Michael Y CENTRAL INDEX KEY: 0001642607 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33818 FILM NUMBER: 171269559 MAIL ADDRESS: STREET 1: 309 WAVERLEY OAKS RD., SUITE 105 CITY: WALTHAM STATE: MA ZIP: 02452 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ReShape Lifesciences Inc. CENTRAL INDEX KEY: 0001371217 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 481293684 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2800 Patton Rd CITY: St Paul STATE: MN ZIP: 55113 BUSINESS PHONE: 651-634-3003 MAIL ADDRESS: STREET 1: 2800 Patton Rd CITY: St Paul STATE: MN ZIP: 55113 FORMER COMPANY: FORMER CONFORMED NAME: EnteroMedics Inc DATE OF NAME CHANGE: 20060802 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2017-12-19 0 0001371217 ReShape Lifesciences Inc. RSLS 0001642607 Mashaal Michael Y 2800 PATTON ROAD ST. PAUL MN 55113 1 0 0 0 Common Stock, $0.01 par value per share 2017-12-19 4 C 0 2048700 A 2617077 I See footnote Series C Convertible Preferred Stock, $0.01 par value 2017-12-19 4 S 0 20487 D 26200 I See footnote Each share of Series C Convertible Preferred Stock converted into 100 shares of common stock. Consists of shares held directly by HealthCor Partners Fund II, L.P. ("HCPII"). The shares held by HCPII may be deemed to be beneficially owned by HealthCor Partners II, L.P. ("HCP2LP"), its general partner, and by HealthCor Partners GP, LLC ("HCPGP"), the general partner of HCP2LP. Dr. Mashaal is a managing director of HealthCor Partners Management, L.P. ("HCP Management"), which is the investment manager to HCPII, and may be deemed to have shared voting and investment power over such shares. Each of HCPLP, HCP2LP, HCPGP, HCP Management and Dr. Mashaal hereby disclaims any beneficial ownership of shares held by HCPII except to the extent of any pecuniary interest therein. /s/ Scott P. Youngstrom, attorney-in-fact 2017-12-21