0001209191-23-003028.txt : 20230111 0001209191-23-003028.hdr.sgml : 20230111 20230111171747 ACCESSION NUMBER: 0001209191-23-003028 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230109 FILED AS OF DATE: 20230111 DATE AS OF CHANGE: 20230111 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Caruso James Joseph CENTRAL INDEX KEY: 0001397215 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38677 FILM NUMBER: 23524238 MAIL ADDRESS: STREET 1: 28 FIRST AVE CITY: SEASIDE PARK STATE: NJ ZIP: 08752 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: 5857 OWENS DRIVE, SUITE 300 CITY: CARLSBAD STATE: CA ZIP: 92009 BUSINESS PHONE: (760) 804-1648 MAIL ADDRESS: STREET 1: 5857 OWENS DRIVE, SUITE 300 CITY: CARLSBAD STATE: CA ZIP: 92009 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2023-01-09 0 0001716621 Ra Medical Systems, Inc. RMED 0001397215 Caruso James Joseph C/O RA MEDICAL SYSTEMS, INC. 5857 OWENS DRIVE, SUITE 300 CARLSBAD CA 92009 1 0 0 0 Series X Convertible Preferred Stock 2023-01-09 4 A 0 9.711 A Common Stock 9711 9.711 D 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/ Will McGuire, as Attorney-in-Fact 2023-01-11