0001193125-17-042954.txt : 20170214 0001193125-17-042954.hdr.sgml : 20170214 20170214143004 ACCESSION NUMBER: 0001193125-17-042954 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 2 FILED AS OF DATE: 20170214 DATE AS OF CHANGE: 20170214 GROUP MEMBERS: ARNOLD L. ORONSKY GROUP MEMBERS: GILBERT H. KLIMAN GROUP MEMBERS: INTERWEST MANAGEMENT PARTNERS X, LLC GROUP MEMBERS: KEVAL DESAI GROUP MEMBERS: KHALED A. NASR GROUP MEMBERS: PHILIP T. GIANOS GROUP MEMBERS: W. STEPHEN HOLMES III SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: OBALON THERAPEUTICS INC CENTRAL INDEX KEY: 0001427570 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-89741 FILM NUMBER: 17607140 BUSINESS ADDRESS: STREET 1: 5421 AVENIDA ENCINAS STREET 2: SUITE F CITY: San Diego STATE: CA ZIP: 92008 BUSINESS PHONE: 858-480-2400 MAIL ADDRESS: STREET 1: 5421 AVENIDA ENCINAS STREET 2: SUITE F CITY: San Diego STATE: CA ZIP: 92008 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: INTERWEST PARTNERS X LP CENTRAL INDEX KEY: 0001443898 IRS NUMBER: 263131621 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: C/O INTERWEST PARTNERS STREET 2: 2710 SAND HILL ROAD, SUITE 200 CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-854-8585 MAIL ADDRESS: STREET 1: C/O INTERWEST PARTNERS STREET 2: 2710 SAND HILL ROAD, SUITE 200 CITY: MENLO PARK STATE: CA ZIP: 94025 SC 13G 1 d347396dsc13g.htm SC 13G SC 13G
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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

 

 

SCHEDULE 13G

Under the Securities Exchange Act of 1934

(AMENDMENT NO            )*

 

 

Obalon Therapeutics, Inc.

(Name of Issuer)

Common Stock

(Title of Class of Securities)

67424L100

(CUSIP Number)

December 31, 2016

(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)

☒ 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).

Page 1 of 14 Pages

 

 

 


Cusip No. 67424L100    13G    Page 2 of 14 Pages

 

  1   

NAME OF REPORTING PERSONS

I.R.S. IDENTIFICATION NO(S). OF ABOVE PERSON(S) (ENTITIES ONLY)

 

InterWest Partners X, LP

  2  

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP

(a)  ☐        (b)  ☐

 

  3  

SEC USE ONLY

 

  4  

CITIZENSHIP OR PLACE OF ORGANIZATION

 

California

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

REPORTING

PERSON

WITH

     

SOLE VOTING POWER

 

2,453,338

   6   

SHARED VOTING POWER

 

0

   7   

SOLE DISPOSITIVE POWER

 

2,453,338

   8   

SHARED DISPOSITIVE POWER

 

0

  9  

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

2,453,338

10  

CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES :

 

11  

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

14.6%

12  

TYPE OF REPORTING PERSON

 

PN

 

 

Page 2 of 14 Pages


Cusip No. 67424L100    13G    Page 3 of 14 Pages

 

  1   

NAME OF REPORTING PERSONS

I.R.S. IDENTIFICATION NO(S). OF ABOVE PERSON(S) (ENTITIES ONLY)

 

InterWest Management Partners X, LLC (the General Partner of InterWest Partners X, LP)

  2  

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP

(a)  ☐        (b)  ☐

 

  3  

SEC USE ONLY

 

  4  

CITIZENSHIP OR PLACE OF ORGANIZATION

 

California

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

REPORTING

PERSON

WITH

     

SOLE VOTING POWER

 

2,453,338

   6   

SHARED VOTING POWER

 

0

   7   

SOLE DISPOSITIVE POWER

 

2,453,338

   8   

SHARED DISPOSITIVE POWER

 

0

  9  

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

2,453,338

10  

CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES :

 

11  

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

14.6%

12  

TYPE OF REPORTING PERSON

 

OO

 

 

Page 3 of 14 Pages


Cusip No. 67424L100    13G    Page 4 of 14 Pages

 

  1   

NAME OF REPORTING PERSONS

I.R.S. IDENTIFICATION NO(S). OF ABOVE PERSON(S) (ENTITIES ONLY)

 

Keval Desai (a Venture Member of InterWest Management Partners X, LLC)

  2  

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP

(a)  ☐        (b)  ☐

 

  3  

SEC USE ONLY

 

  4  

CITIZENSHIP OR PLACE OF ORGANIZATION

 

United States

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

REPORTING

PERSON

WITH

     

SOLE VOTING POWER

 

0

   6   

SHARED VOTING POWER

 

2,453,338

   7   

SOLE DISPOSITIVE POWER

 

0

   8   

SHARED DISPOSITIVE POWER

 

2,453,338

  9  

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

2,453,338

10  

CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES :

 

11  

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

14.6%

12  

TYPE OF REPORTING PERSON

 

IN

Neither the filing of this statement on Schedule 13G nor any of its contents shall be deemed to constitute an admission by Keval Desai that he is the beneficial owner of any of the Common Stock referred to herein for purposes of Section 13(d) of the Securities Exchange Act of 1934, as amended, or for any other purpose, and such beneficial ownership is expressly disclaimed, except to the extent of his pecuniary interest.

 

Page 4 of 14 Pages


Cusip No. 67424L100    13G    Page 5 of 14 Pages

 

  1   

NAME OF REPORTING PERSONS

I.R.S. IDENTIFICATION NO(S). OF ABOVE PERSON(S) (ENTITIES ONLY)

 

Philip T. Gianos (a Managing Director of InterWest Management Partners X, LLC)

  2  

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP

(a)  ☐        (b)  ☐

 

  3  

SEC USE ONLY

 

  4  

CITIZENSHIP OR PLACE OF ORGANIZATION

 

United States

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

REPORTING

PERSON

WITH

     

SOLE VOTING POWER

 

0

   6   

SHARED VOTING POWER

 

2,453,338

   7   

SOLE DISPOSITIVE POWER

 

0

   8   

SHARED DISPOSITIVE POWER

 

2,453,338

  9  

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

2,453,338

10  

CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES :

 

11  

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

14.6%

12  

TYPE OF REPORTING PERSON

 

IN

Neither the filing of this statement on Schedule 13G nor any of its contents shall be deemed to constitute an admission by Philip T. Gianos that he is the beneficial owner of any of the Common Stock referred to herein for purposes of Section 13(d) of the Securities Exchange Act of 1934, as amended, or for any other purpose, and such beneficial ownership is expressly disclaimed, except to the extent of his pecuniary interest.

 

Page 5 of 14 Pages


Cusip No. 67424L100    13G    Page 6 of 14 Pages

 

  1   

NAME OF REPORTING PERSONS

I.R.S. IDENTIFICATION NO(S). OF ABOVE PERSON(S) (ENTITIES ONLY)

 

W. Stephen Holmes III (a Managing Director of InterWest Management Partners X, LLC)

  2  

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP

(a)  ☐        (b)  ☐

 

  3  

SEC USE ONLY

 

  4  

CITIZENSHIP OR PLACE OF ORGANIZATION

 

United States

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

REPORTING

PERSON

WITH

     

SOLE VOTING POWER

 

0

   6   

SHARED VOTING POWER

 

2,453,338

   7   

SOLE DISPOSITIVE POWER

 

0

   8   

SHARED DISPOSITIVE POWER

 

2,453,338

  9  

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

2,453,338

10  

CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES :

 

11  

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

14.6%

12  

TYPE OF REPORTING PERSON

 

IN

Neither the filing of this statement on Schedule 13G nor any of its contents shall be deemed to constitute an admission by W. Stephen Holmes III that he is the beneficial owner of any of the Common Stock referred to herein for purposes of Section 13(d) of the Securities Exchange Act of 1934, as amended, or for any other purpose, and such beneficial ownership is expressly disclaimed, except to the extent of his pecuniary interest.

 

Page 6 of 14 Pages


Cusip No. 67424L100    13G    Page 7 of 14 Pages

 

  1   

NAME OF REPORTING PERSONS

I.R.S. IDENTIFICATION NO(S). OF ABOVE PERSON(S) (ENTITIES ONLY)

 

Gilbert H. Kliman (a Managing Director of InterWest Management Partners X, LLC)

  2  

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP

(a)  ☐        (b)  ☐

 

  3  

SEC USE ONLY

 

  4  

CITIZENSHIP OR PLACE OF ORGANIZATION

 

United States

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

REPORTING

PERSON

WITH

     

SOLE VOTING POWER

 

0

   6   

SHARED VOTING POWER

 

2,453,338

   7   

SOLE DISPOSITIVE POWER

 

0

   8   

SHARED DISPOSITIVE POWER

 

2,453,338

  9  

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

2,453,338

10  

CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES :

 

11  

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

14.6%

12  

TYPE OF REPORTING PERSON

 

IN

Neither the filing of this statement on Schedule 13G nor any of its contents shall be deemed to constitute an admission by Gilbert H. Kliman that he is the beneficial owner of any of the Common Stock referred to herein for purposes of Section 13(d) of the Securities Exchange Act of 1934, as amended, or for any other purpose, and such beneficial ownership is expressly disclaimed, except to the extent of his pecuniary interest.

 

Page 7 of 14 Pages


Cusip No. 67424L100    13G    Page 8 of 14 Pages

 

  1   

NAME OF REPORTING PERSONS

I.R.S. IDENTIFICATION NO(S). OF ABOVE PERSON(S) (ENTITIES ONLY)

 

Khaled A. Nasr (a Venture Member of InterWest Management Partners X, LLC)

  2  

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP

(a)  ☐        (b)  ☐

 

  3  

SEC USE ONLY

 

  4  

CITIZENSHIP OR PLACE OF ORGANIZATION

 

United States

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

REPORTING

PERSON

WITH

     

SOLE VOTING POWER

 

0

   6   

SHARED VOTING POWER

 

2,453,338

   7   

SOLE DISPOSITIVE POWER

 

0

   8   

SHARED DISPOSITIVE POWER

 

2,453,338

  9  

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

2,453,338

10  

CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES :

 

11  

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

14.6%

12  

TYPE OF REPORTING PERSON

 

IN

Neither the filing of this statement on Schedule 13G nor any of its contents shall be deemed to constitute an admission by Khaled A. Nasr that he is the beneficial owner of any of the Common Stock referred to herein for purposes of Section 13(d) of the Securities Exchange Act of 1934, as amended, or for any other purpose, and such beneficial ownership is expressly disclaimed, except to the extent of his pecuniary interest.

 

Page 8 of 14 Pages


Cusip No. 67424L100    13G    Page 9 of 14 Pages

 

  1   

NAME OF REPORTING PERSONS

I.R.S. IDENTIFICATION NO(S). OF ABOVE PERSON(S) (ENTITIES ONLY)

 

Arnold L. Oronsky (a Managing Director of InterWest Management Partners X, LLC)

  2  

CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP

(a)  ☐        (b)  ☐

 

  3  

SEC USE ONLY

 

  4  

CITIZENSHIP OR PLACE OF ORGANIZATION

 

United States

NUMBER OF

SHARES

BENEFICIALLY

OWNED BY

REPORTING

PERSON

WITH

     

SOLE VOTING POWER

 

0

   6   

SHARED VOTING POWER

 

2,453,338

   7   

SOLE DISPOSITIVE POWER

 

0

   8   

SHARED DISPOSITIVE POWER

 

2,453,338

  9  

AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 

2,453,338

10  

CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES :

 

11  

PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 

14.6%

12  

TYPE OF REPORTING PERSON

 

IN

Neither the filing of this statement on Schedule 13G nor any of its contents shall be deemed to constitute an admission by Arnold L. Oronsky that he is the beneficial owner of any of the Common Stock referred to herein for purposes of Section 13(d) of the Securities Exchange Act of 1934, as amended, or for any other purpose, and such beneficial ownership is expressly disclaimed, except to the extent of his pecuniary interest.

 

Page 9 of 14 Pages


ITEM 1.

 

  (a) NAME OF ISSUER : Obalon Therapeutics, Inc.

 

  (b) ADDRESS OF ISSUER’S PRINCIPAL EXECUTIVE OFFICE:

5421 Avenida Encinas, Suite F, Carlsbad, CA 92008

 

ITEM 2.

 

  (a) NAME OF PERSON(S) FILING:

InterWest Partners X, LP (“IWP X”)

InterWest Management Partners X, LLC (“IMP X”)

Keval Desai (“Desai”)

Philip T. Gianos (“Gianos”)

W. Stephen Holmes III (“Holmes”)

Gilbert H. Kliman (“Kliman”)

Khaled A. Nasr (“Nasr”)

Arnold L. Oronsky (“Oronsky”)

 

  (b) ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE:

2710 Sand Hill Road, Suite 200, Menlo Park, CA 94025

 

  (c) CITIZENSHIP/PLACE OF ORGANIZATION:

 

IWP X:                

   California

IMP X:

   California

Desai:

   United States

Gianos:

   United States

Holmes:

   United States

Kliman:

   United States

Nasr:

   United States

Oronsky:

   United States

 

 

Page 10 of 14 Pages


  (d) TITLE OF CLASS OF SECURITIES: Common Stock

 

  (e) CUSIP NUMBER: 67424L100

 

ITEM 3. NOT APPLICABLE.

 

ITEM 4. OWNERSHIP.

 

     IWP X     IMP X (1)     Desai (2)  

Beneficial Ownership

     2,453,338        2,453,338        2,453,338   

Percentage of Class

     14.6     14.6     14.6

Sole Voting Power

     2,453,338        2,453,338        0   

Shared Voting Power

     0        0        2,453,338   

Sole Dispositive Power

     2,453,338        2,453,338        0   

Shared Dispositive Power

     0        0        2,453,338   

 

     Fisher (3)     Gianos (2)     Holmes (2)  

Beneficial Ownership

     3,875        2,453,338        2,453,338   

Percentage of Class

     0.02     14.6     14.6

Sole Voting Power

     3,875        0        0   

Shared Voting Power

     0        2,453,338        2,453,338   

Sole Dispositive Power

     3,875        0        0   

Shared Dispositive Power

     0        2,453,338        2,453,338   

 

     Kliman (2)     Nasr (2)     Oronsky (2)  

Beneficial Ownership

     2,453,338        2,453,338        2,453,338   

Percentage of Class

     14.6     14.6     14.6

Sole Voting Power

     0        0        0   

Shared Voting Power

     2,453,338        2,453,338        2,453,338   

Sole Dispositive Power

     0        0        0   

Shared Dispositive Power

     2,453,338        2,453,338        2,453,338   

 

(1) IMP X is the general partner of IWP X.
(2) Gianos, Holmes, Kliman, and Oronsky are Managing Directors of IMP X. Desai and Nasr are Venture Members of IMP X. The Managing Directors and Venture Members of IMP X share voting and investment control over shares held by IWP X. Beneficial ownership is expressly disclaimed, except to the extent of their pecuniary interest.
(3) Douglas Fisher, a former Venture Member of InterWest X, serves on the Issuer’s Board of Directors.

 

 

Page 11 of 14 Pages


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.

Under certain circumstances set forth in the limited liability company operating agreement of IMP X, the members of such limited liability company have the right to receive dividends from, or the proceeds from the sale of, the common stock of Issuer beneficially owned by such limited liability company.

 

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.

No reporting person is a member of a group as defined in section 240.13d-1(b)(1)(iii)(H) of the Act.

 

ITEM 9. NOTICE OF DISSOLUTION OF THE GROUP.

Not applicable.

 

ITEM 10. CERTIFICATION.

Not applicable.

EXHIBITS

Joint Filing Statement attached as Exhibit A.

 

 

Page 12 of 14 Pages


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.

Date: February 14, 2017

 

INTERWEST PARTNERS X, LP
By: InterWest Management Partners X, LLC, its General Partner
By:  

/s/ Gilbert H. Kliman

  Managing Director
INTERWEST MANAGEMENT PARTNERS X, LLC
By:  

/s/ Gilbert H. Kliman

  Managing Director
By:  

/s/ Keval Desai

Name:   Keval Desai
By:  

/s/ Philip T. Gianos

Name:   Philip T. Gianos
By:  

/s/ W. Stephen Holmes by Karen A. Wilson, Power of Attorney

Name:   W. Stephen Holmes
By:  

/s/ Gilbert H. Kliman

Name:   Gilbert H. Kliman
By:  

/s/ Khaled A. Nasr

Name:   Khaled A. Nasr
By:  

/s/ Arnold L. Oronsky

Name:   Arnold L. Oronsky

 

 

Page 13 of 14 Pages

EX-99.A 2 d347396dex99a.htm EX-99.A EX-99.A

EXHIBIT A

Joint Filing Statement

We, the undersigned, hereby express our agreement that the attached Schedule 13G is filed on behalf of each of us.

Date: February 14, 2017

 

INTERWEST PARTNERS X, LP
By: InterWest Management Partners X, LLC, its General Partner
By:  

/s/ Gilbert H. Kliman

  Managing Director
INTERWEST MANAGEMENT PARTNERS X, LLC
By:  

/s/ Gilbert H. Kliman

  Managing Director
By:  

/s/ Keval Desai

Name:   Keval Desai
By:  

/s/ Philip T. Gianos

Name:   Philip T. Gianos
By:  

/s/ W. Stephen Holmes by Karen A. Wilson, Power of Attorney

Name:   W. Stephen Holmes
By:  

/s/ Gilbert H. Kliman

Name:   Gilbert H. Kliman
By:  

/s/ Khaled A. Nasr

Name:   Khaled A. Nasr
By:  

/s/ Arnold L. Oronsky

Name:   Arnold L. Oronsky

 

 

Page 14 of 14 Pages