0001654954-23-003617.txt : 20230327
0001654954-23-003617.hdr.sgml : 20230327
20230327172202
ACCESSION NUMBER: 0001654954-23-003617
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230109
FILED AS OF DATE: 20230327
DATE AS OF CHANGE: 20230327
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Meline Susanne
CENTRAL INDEX KEY: 0001731684
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38677
FILM NUMBER: 23765479
MAIL ADDRESS:
STREET 1: P.O. BOX 515381
STREET 2: #86506
CITY: LOS ANGELES
STATE: CA
ZIP: 90051
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Ra Medical Systems, Inc.
CENTRAL INDEX KEY: 0001716621
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 383661826
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1670 HIGHWAY 160 WEST
STREET 2: SUITE 205
CITY: FORT MILL
STATE: SC
ZIP: 29708
BUSINESS PHONE: 973-691-2000
MAIL ADDRESS:
STREET 1: 1670 HIGHWAY 160 WEST
STREET 2: SUITE 205
CITY: FORT MILL
STATE: SC
ZIP: 29708
4
1
section16.xml
PRIMARY DOCUMENT
X0407
4
2023-01-09
0001716621
Ra Medical Systems, Inc.
RMED
0001731684
Meline Susanne
C/O RA MEDICAL SYSTEMS, INC.
1670 HIGHWAY 160 WEST, SUITE 205
FORT MILL
SC
29708
true
false
false
false
Common Stock
2023-03-23
4
C
false
2575
0
A
2575
I
By Spouse
Common Stock
36
D
Common Stock
800
I
See footnote
Series X Convertible Preferred Stock
0
2023-01-09
4
A
false
14.0560
0
A
Common Stock
14056
14.056
I
By Spouse
Series X Convertible Preferred Stock
0
2023-03-23
4
C
false
2.575
0
D
Common Stock
11481
11.481
I
By Spouse
This the transaction was the result of the automatic conversion of shares of Series X Preferred upon receipt of stockholder approval.
Securities are owned by Catalysis Partners ("CP"). The reporting person has an investment interest in CP through her IRA and, together with an immediate family member, owns a controlling interest in Francis Capital Management, LLC, which also has an investment interest in CP and serves as both its Managing Member and Investment Manager. The reporting person disclaims beneficial interest of these securities except to the extent of her pecuniary interest therein.
Following stockholder approval of the conversion of Series X Convertible Preferred Stock into shares of Common Stock, each share of Series X Convertible Preferred Stock automatically converts into 1,000 shares of Common Stock, subject to certain limitations.
On January 9, 2023, the Issuer, completed its acquisition of Catheter Precision, Inc., a privately-held Delaware corporation ("Catheter"), pursuant to an Amended and Restated Agreement and Plan of Merger (the "Merger"). In connection with the Merger, each share of Catheter common stock previously outstanding held by the reporting person now represents a number of shares of Series X Convertible Preferred Stock equal to approximately 0.6697, divided by one thousand (1,000).
Series X Convertible Preferred Stock has no expiration date.
/s/ Susanne Meline
2023-03-27