0001193125-16-465313.txt : 20160216 0001193125-16-465313.hdr.sgml : 20160215 20160216161911 ACCESSION NUMBER: 0001193125-16-465313 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20160216 DATE AS OF CHANGE: 20160216 GROUP MEMBERS: COVIDIEN GROUP S.A.R.L. SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ENTELLUS MEDICAL INC CENTRAL INDEX KEY: 0001374128 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 204627978 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-88622 FILM NUMBER: 161428599 BUSINESS ADDRESS: STREET 1: 3600 HOLLY LANE NORTH STREET 2: SUITE 40 CITY: PLYMOUTH STATE: MN ZIP: 55447 BUSINESS PHONE: 763-463-1595 MAIL ADDRESS: STREET 1: 3600 HOLLY LANE NORTH STREET 2: SUITE 40 CITY: PLYMOUTH STATE: MN ZIP: 55447 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: Medtronic plc CENTRAL INDEX KEY: 0001613103 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 000000000 FISCAL YEAR END: 0424 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 20 ON HATCH, LOWER HATCH STREET CITY: DUBLIN STATE: L2 ZIP: 2 BUSINESS PHONE: 01135314381700 MAIL ADDRESS: STREET 1: 20 ON HATCH, LOWER HATCH STREET CITY: DUBLIN STATE: L2 ZIP: 2 FORMER COMPANY: FORMER CONFORMED NAME: Medtronic Ltd DATE OF NAME CHANGE: 20150112 FORMER COMPANY: FORMER CONFORMED NAME: Medtronic Holdings Ltd DATE OF NAME CHANGE: 20140711 FORMER COMPANY: FORMER CONFORMED NAME: Kalani I Ltd DATE OF NAME CHANGE: 20140709 SC 13G 1 d143208dsc13g.htm SC 13G SC 13G

 

 

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

 

 

SCHEDULE 13G

(Rule 13d-102)

Information to be included in Statements Filed Pursuant to § 240.13d-1(b), (c) and (d) and Amendments Thereto Filed Pursuant to § 240.13d-2

Under the Securities Exchange Act of 1934

(Amendment No.     )*

 

 

Entellus Medical, Inc.

(Name of Issuer)

Common Stock, par value $0.001 per share

(Title of Class of Securities)

29363K 105

(CUSIP Number)

December 31, 2015

(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 on 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


SCHEDULE 13G

 

CUSIP No. 29363K 105   Page 2 of 7 Pages

 

  (1)   

Names of reporting persons

 

Medtronic plc

  (2)  

Check the appropriate box if a member of a group (see instructions)*

(a)  ¨        (b)  ¨

 

  (3)  

SEC use only

 

  (4)  

Citizenship or place of organization

 

    Ireland

Number of

shares

beneficially

owned by

each

reporting

person

with

   (5)    

Sole voting power

 

    956,926

   (6)   

Shared voting power

 

    0

   (7)   

Sole dispositive power

 

    956,926

   (8)   

Shared dispositive power

 

    0

  (9)  

Aggregate amount beneficially owned by each reporting person

 

    956,926

(10)  

Check if the aggregate amount in Row (9) excludes certain shares (see instructions)    ¨

 

(11)  

Percent of class represented by amount in Row (9)

 

    5.1% (1)

(12)  

Type of reporting person (see instructions)

 

    OO

 

(1) The percentage is based upon 18,788,325 shares of common stock outstanding as reported on the Issuer’s Quarterly Report on Form 10-Q for the quarter ended September 30, 2015, as filed with the Securities and Exchange Commission on November 6, 2015.

 

Page 2 of 7


SCHEDULE 13G

 

CUSIP No. 29363K 105   Page 3 of 7 Pages

 

  (1)   

Names of reporting persons

 

Covidien Group S.a.r.l.

  (2)  

Check the appropriate box if a member of a group (see instructions)*

(a)  ¨        (b)  ¨

 

  (3)  

SEC use only

 

  (4)  

Citizenship or place of organization

 

    Luxembourg

Number of

shares

beneficially

owned by

each

reporting

person

with

   (5)    

Sole voting power

 

    956,926 (1)

   (6)   

Shared voting power

 

    0

   (7)   

Sole dispositive power

 

    956,926 (1)

   (8)   

Shared dispositive power

 

    0

  (9)  

Aggregate amount beneficially owned by each reporting person

 

    956,926 (1)

(10)  

Check if the aggregate amount in Row (9) excludes certain shares (see instructions)    ¨

 

(11)  

Percent of class represented by amount in Row (9)

 

    5.1% (2)

(12)  

Type of reporting person (see instructions)

 

    OO

 

(1) The percentage is based upon 18,788,325 shares of common stock outstanding as reported on the Issuer’s Quarterly Report on Form 10-Q for the quarter ended September 30, 2015, as filed with the Securities and Exchange Commission on November 6, 2015.

 

Page 3 of 7


Item 1(a) Name of Issuer:

Entellus Medical, Inc.

 

Item 1(b) Address of Issuer’s Principal Executive Offices:

3600 Holly Lane North, Suite 40

Plymouth, Minnesota 55447

 

Item 2(a) Name of Persons Filing:

Medtronic plc

Covidien Group S.a.r.l.

 

Item 2(b) Address of Principal Business Office or, if None, Residence:

Medtronic plc: 20 Lower Hatch Street, Dublin 2, Ireland

Covidien Group S.a.r.l.: 3b, Bd. Prince Henri, 4th Floor L-1724 Luxembourg

 

Item 2(c) Citizenship:

Medtronic plc: Ireland

Covidien Group S.a.r.l.: Luxembourg

 

Item 2(d) Title of Class of Securities:

Common Stock.

 

Item 2(e) CUSIP Number:

29363K 105

 

Item 3 If this statement is filed pursuant to §§ 240.13d-1(b), or 240.13d-2(b) or (c), check whether the person filing is a:

 

(a)    ¨    Broker or dealer registered under Section 15 of the Act.
(b)    ¨    Bank as defined in Section 3(a)(6) of the Act.
(c)    ¨    Insurance company as defined in Section 3(a)(19) of the Act.
(d)    ¨    Investment company registered under Section 8 of the Investment Company Act of 1940.
(e)    ¨    An investment adviser in accordance with § 240.13d-1(b)(1)(ii)(E).
(f)    ¨    An employee benefit plan or endowment fund in accordance with § 240.13d-1(b)(1)(ii)(F).
(g)    ¨    A parent holding company or control person in accordance with § 240.13d-1(b)(1)(ii)(G).
(h)    ¨    A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act.

 

Page 4 of 7


(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)    ¨    A non-U.S. institution in accordance with § 240.13d-1(b)(1)(ii)(J);
(k)    ¨    Group, in accordance with § 240.13d-1(b)(1)(ii)(K).

If filing as a non-U.S. institution in accordance with § 240.13d-1(b)(1)(ii)(J), please specify the type of institution:

 

Item 4 Ownership

See Cover Pages, Items 5 through 11.

 

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    ¨.

 

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 or Control Person:

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 Certifications:

Not applicable.

 

Exhibits Joint Filing Agreement, dated February 16, 2016, between Medtronic plc and Covidien Group, S.a.r.l.

 

Page 5 of 7


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.

 

Dated: February 16, 2016   Medtronic plc
 

/s/ Gary Ellis

  Name:   Gary Ellis
  Title:   Executive Vice President and Chief Financial Officer
Dated: February 16, 2016   Covidien Group S.a.r.l.
 

/s/ Michelangelo Stefani

  Name:   Michelangelo Stefani
  Title:   General Manager

 

Page 6 of 7


Joint Filing Agreement

The undersigned hereby agree to file a joint Schedule 13G and any future amendments thereto filed hereafter with respect to the interests of the undersigned in GI Dynamics, Inc. The Schedule 13G to which this Exhibit is attached has been filed on behalf of each of the undersigned and any future amendments thereto filed hereafter shall be filed on behalf of each of the undersigned.

 

Dated: February 16, 2016   Medtronic plc
 

/s/ Gary Ellis

  Name:   Gary Ellis
  Title:   Executive Vice President and Chief Financial Officer
Dated: February 16, 2016   Covidien Group S.a.r.l.
 

/s/ Michelangelo Stefani

  Name:   Michelangelo Stefani
  Title:   General Manager

 

Page 7 of 7