-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, Ci86JVvwS8SDXKpMJNKUGKbuzaajxXbx6U8qL6eQ/z3v+IuW30gVrI0GKrxYcSaZ wF2CoQ6h4b82HpTzles1rA== 0001010521-98-000162.txt : 19980212 0001010521-98-000162.hdr.sgml : 19980212 ACCESSION NUMBER: 0001010521-98-000162 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19980211 SROS: NASD GROUP MEMBERS: HANCOCK JOHN MUTUAL LIFE INSURANCE CO / MA GROUP MEMBERS: HANCOCK VENTURE PARTNERS GROUP MEMBERS: JOHN HANCOCK MUTUAL LIFE INSURANCE COMPANY GROUP MEMBERS: JOHN HANCOCK SUBSIDIARIES INC. SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: GENERAL SURGICAL INNOVATIONS INC CENTRAL INDEX KEY: 0000890763 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 973170244 STATE OF INCORPORATION: CA FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: SEC FILE NUMBER: 005-48225 FILM NUMBER: 98530741 BUSINESS ADDRESS: STREET 1: 10460 BUBB RD CITY: CUPERTINO STATE: CA ZIP: 95014 BUSINESS PHONE: 4158129740 MAIL ADDRESS: STREET 1: 3172A PORTER DRIVE CITY: PALO ALTO STATE: CA ZIP: 94304 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: HANCOCK JOHN MUTUAL LIFE INSURANCE CO / MA CENTRAL INDEX KEY: 0000917406 STANDARD INDUSTRIAL CLASSIFICATION: UNKNOWN SIC - 0000 [0000] IRS NUMBER: 041414660 STATE OF INCORPORATION: MA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: CORPORATE LAW DIVISION T-55 STREET 2: P O BOX 111 CITY: BOSTON STATE: MA ZIP: 02117 BUSINESS PHONE: 6175726000 MAIL ADDRESS: STREET 1: CORPORATE LAW DIVISION T-55 STREET 2: P O BOX 111 CITY: BOSTON STATE: MA ZIP: 02117 SC 13G/A 1 GENERAL SURGICAL INNOVATIONS, INC. ------------------------------ OMB APPROVAL OMB Number 3235-0145 Expires: December 31, 1997 Estimated average burden hours per response . . . 14.90 ------------------------------ UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. 1)* General Surgical Innovations, Inc. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock - -------------------------------------------------------------------------------- (Title of Class of Securities) 371013103 - -------------------------------------------------------------------------------- (CUSIP Number) Check here if a fee is being paid with this statement: (A fee is not required only if the filing person: (1) has a previous statement on file reporting beneficial ownership of more than five percent of the class of securities described in Item 1; and (2) has filed no amendment subsequent thereto reporting beneficial ownership of five percent or less of such class.) (See Rule 13d-7). *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 8 PAGES
- --------------------------------------- -------------------------------------- CUSIP No. 371013103 13G Page 2 of 8 Pages - --------------------------------------- -------------------------------------- - --------- --------------------------------------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON John Hancock Mutual Life Insurance Company I.R.S. No. 04-1414660 - --------- --------------------------------------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_| (b) |_| N/A - --------- --------------------------------------------------------------------------------------------------------------- 3 SEC USE ONLY - --------- --------------------------------------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Commonwealth of Massachusetts - --------- --------------------------------------------------------------------------------------------------------------- -------- ------------------------------------------------------------------------------------------ 5 SOLE VOTING POWER Number of Shares -0- -------- ------------------------------------------------------------------------------------------ Beneficially 6 SHARED VOTING POWER Owned by Each -0- -------- ------------------------------------------------------------------------------------------ Reporting 7 SOLE DISPOSITIVE POWER Person With -0- -------- ------------------------------------------------------------------------------------------ 8 SHARED DISPOSITIVE POWER -0- -------- ------------------------------------------------------------------------------------------ - --------- --------------------------------------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON None, except through its indirect, wholly-owned subsidiary, Hancock Venture Partners, Inc. - --------- --------------------------------------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* N/A - --------- --------------------------------------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 See line 9, above. - --------- --------------------------------------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IC, IA, HC - --------- --------------------------------------------------------------------------------------------------------------- *SEE INSTRUCTIONS BEFORE FILLING OUT! PAGE 2 OF 8 PAGES - --------------------------------------- -------------------------------------- CUSIP No. 371013103 13G Page 3 of 8 Pages - --------------------------------------- -------------------------------------- - --------- --------------------------------------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON John Hancock Subsidiaries, Inc. I.R.S. No. 04-2687223 - --------- --------------------------------------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_| (b) |_| N/A - --------- --------------------------------------------------------------------------------------------------------------- 3 SEC USE ONLY - --------- --------------------------------------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Delaware - --------- --------------------------------------------------------------------------------------------------------------- -------- ------------------------------------------------------------------------------------------ 5 SOLE VOTING POWER Number of Shares -0- -------- ------------------------------------------------------------------------------------------ Beneficially 6 SHARED VOTING POWER Owned by Each -0- -------- ------------------------------------------------------------------------------------------ Reporting 7 SOLE DISPOSITIVE POWER Person With -0- -------- ------------------------------------------------------------------------------------------ 8 SHARED DISPOSITIVE POWER -0- -------- ------------------------------------------------------------------------------------------ - --------- --------------------------------------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 799,640 through its direct, wholly-owned subsidiary, Hancock Venture Partners, Inc. - --------- --------------------------------------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* N/A - --------- --------------------------------------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 6.0 % - --------- --------------------------------------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* HC - --------- --------------------------------------------------------------------------------------------------------------- *SEE INSTRUCTIONS BEFORE FILLING OUT! PAGE 3 OF 8 PAGES - --------------------------------------- -------------------------------------- CUSIP No. 371013103 13G Page 4 of 8 Pages - --------------------------------------- -------------------------------------- - --------- --------------------------------------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Hancock Venture Partners, Inc. I.R.S. No. 04-2765223 - --------- --------------------------------------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) |_| (b) |_| N/A - --------- --------------------------------------------------------------------------------------------------------------- 3 SEC USE ONLY - --------- --------------------------------------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION Delaware - --------- --------------------------------------------------------------------------------------------------------------- -------- ------------------------------------------------------------------------------------------ 5 SOLE VOTING POWER Number of Shares 799,640 -------- ------------------------------------------------------------------------------------------ Beneficially 6 SHARED VOTING POWER Owned by Each -0- -------- ------------------------------------------------------------------------------------------ Reporting 7 SOLE DISPOSITIVE POWER Person With 799,640 -------- ------------------------------------------------------------------------------------------ 8 SHARED DISPOSITIVE POWER -0- -------- ------------------------------------------------------------------------------------------ - --------- --------------------------------------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 799,640 - --------- --------------------------------------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* N/A - --------- --------------------------------------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 6.0 % - --------- --------------------------------------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IA - --------- --------------------------------------------------------------------------------------------------------------- *SEE INSTRUCTIONS BEFORE FILLING OUT! PAGE 4 OF 8 PAGES
The original statement shall be signed by each person on whose behalf the statement is filed or his authorized representative. If the statement is signed on behalf of a person by his authorized representative other than an executive officer or general partner of the filing person, evidence of the representative's authority to sign on behalf of such person shall be filed with the statement, provided, however, that a power of attorney for this purpose which is already on file with the Commission may be incorporated by reference. The name and any title of each person who signs the statement shall be typed or printed beneath his signature. Note: Six copies of this statement, including all exhibits, should be filed with the Commission. Attention: Intentional misstatements or omissions of fact constitute Federal criminal violations (See 18 U.S.C. 1001) Item 1(a) Name of Issuer: General Surgical Innovations, Inc. Item 1(b) Address of Issuer's Principal Executive Offices: 10460 Bubb Road Cupertino, CA 94304 Item 2(a) Name of Person Filing: This filing is made on behalf of John Hancock Mutual Life Insurance Company ("JHMLICO"), JHMLICO's direct, wholly-owned subsidiary, John Hancock Subsidiaries, Inc. ("JHSI"), and JHSI's wholly-owned subsidiary, Hancock Venture Partners, Inc. ("Venture"). Item 2(b) Address of the Principal Offices: The principal business offices of JHMLICO and JHSI are located at John Hancock Place, P.O. Box 111, Boston, MA 02117. The principal business office of Venture is One Financial Center, Boston, Massachusetts 02111. Item 2(c) Citizenship: JHMLICO was organized and exists under the laws of the Commonwealth of Massachusetts. JHSI and Venture were organized and exist under the laws of the State of Delaware. Item 2(d) Title of Class of Securities: Common Stock Item 2(e) CUSIP Number: 371013103 Item 3 If the Statement is being filed pursuant to Rule 13d-1(b), or 13d-2(b), check whether the person filing is a: JHMLICO:(c) (X) Insurance Company as defined in ss.3(a) (19) of the Act. (e) (X) Investment Adviser registered under ss.203 of the Investment Advisers Act of 1940. JHSI: (g) (X) Parent Holding Company, in accordance with ss.240.13d-1(b)(ii)(G). Venture:(e) (X) Investment Adviser registered under ss.203 of the Investment Advisers Act of 1940. PAGE 5 OF 8 PAGES Item 4 Ownership: (a) Amount Beneficially Owned: Venture has beneficial ownership of 799,640 shares of Common Stock. Venture is a managing general partner of the general partner of HarbourVest Partners IV-Direct Fund L.P. ("Fund IV") which holds shares of the Issuer. Venture has sole beneficial ownership of the shares held in this partnership. Through their parent-subsidiary relationship to Venture, JHMLICO and JHSI have indirect beneficial ownership of the Venture shares. (b) Percent of Class: 6.0% (c) (i) sole power to vote or to direct the vote: Venture has sole power to vote or to direct the vote of 799,640 shares of Common Stock. (ii) shared power to vote or to direct the vote: -0- (iii) sole power to dispose or to direct the disposition of: Venture has sole power to dispose or to direct the disposition of 799,640 shares of Common Stock. (iv) shared power to dispose or to direct the disposition of: -0- 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: See Item 4 above. Item 7 Identification and Classification of the Subsidiary which Acquired the Security Being Reported on by the Parent Holding Company: See Items 3 and 4 above. Item 8 Identification and Classification of Members of the Group: Not applicable. Item 9 Notice of Dissolution of a Group: Not applicable. Item 10 Certification: By signing below the undersigned certifies that, to the best of its knowledge and belief, the securities referred to above were acquired in the ordinary course of business and were not acquired for the purpose of and do not have the effect of changing or influencing the control of the issuer of such securities and were not acquired in connection with or as a participant in any transaction having such purpose or effect. PAGE 6 OF 8 PAGES SIGNATURE After reasonable inquiry and to the best of its knowledge and belief, each of the undersigned certifies that the information set forth in this statement is true, complete and correct. John Hancock Mutual Life Insurance Company By: /s/John T. Farady ----------------------------------- Name: John T. Farady Dated: January 24, 1998 Title: Senior Vice President & Treasurer John Hancock Subsidiaries, Inc. By: /s/John T. Farady ----------------------------------- Name: John T. Farady Dated: January 24, 1998 Title: Treasurer Hancock Venture Partners, Inc. By: /s/Martha D. Vorlicek ----------------------------------- Name: Martha D. Vorlicek Dated: January 24, 1998 Title: Managing Director PAGE 7 OF 8 PAGES EXHIBIT A JOINT FILING AGREEMENT John Hancock Mutual Life Insurance Company, John Hancock Subsidiaries, Inc., and Hancock Venture Partners, Inc. agree that the Schedule 13G, (Amendment No. 1), to which this Agreement is attached, relating to the Common Stock of General Surgical Innovations, Inc. is filed on behalf of each of them. John Hancock Mutual Life Insurance Company By: /s/John T. Farady ----------------------------------- Name: John T. Farady Dated: January 24, 1998 Title: Senior Vice President & Treasurer John Hancock Subsidiaries, Inc. By: /s/John T. Farady ----------------------------------- Name: John T. Farady Dated: January 24, 1998 Title: Treasurer Hancock Venture Partners, Inc. By: /s/Martha D. Vorlicek ----------------------------------- Name: Martha D. Vorlicek Dated: January 24, 1998 Title: Managing Director PAGE 8 OF 8 PAGES -----END PRIVACY-ENHANCED MESSAGE-----