<SEC-DOCUMENT>0001654954-23-008946.txt : 20230707
<SEC-HEADER>0001654954-23-008946.hdr.sgml : 20230707
<ACCEPTANCE-DATETIME>20230707162449
ACCESSION NUMBER:		0001654954-23-008946
CONFORMED SUBMISSION TYPE:	SD
PUBLIC DOCUMENT COUNT:		1
<RULE>
<RULE-NAME>13p-1
<ITEM>
<ITEM-NUMBER>1.01
<ITEM-PERIOD>20221231
</ITEM>
</RULE>
FILED AS OF DATE:		20230707
DATE AS OF CHANGE:		20230707

FILER:

	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

	FILING VALUES:
		FORM TYPE:		SD
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-38677
		FILM NUMBER:		231077047

	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
</SEC-HEADER>
<DOCUMENT>
<TYPE>SD
<SEQUENCE>1
<FILENAME>rmed_sd.htm
<DESCRIPTION>FORM SD
<TEXT>
<html><head><title>rmed_sd.htm</title><!--Document created using EDGARMaster--></head><body style="TEXT-ALIGN: justify; FONT: 10pt times new roman"><table style="font-size:1px;width:100%"> <tr > <td style="BORDER-BOTTOM: 5px solid;"></td></tr> <tr > <td style="BORDER-BOTTOM: 2px solid;"></td></tr></table> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong><font style="font-size:12pt">UNITED STATES </font></strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong><font style="font-size:12pt">SECURITIES AND EXCHANGE COMMISSION </font></strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong><font style="font-size:12pt">WASHINGTON, D.C. 20549</font></strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">&nbsp; </p> <table style="border-spacing:0;font-size:10pt;text-align:justify;margin-left:auto;margin-right:auto;width:60%" cellpadding="0"> <tr style="height:15px"> <td style="width:34%;vertical-align:top;"> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong><font style="font-size:18pt">FORM SD</font></strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong>Specialized Disclosure Report</strong></p></td></tr></table> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp; </p> <table style="border-spacing:0;font-size:10pt;text-align:left;margin-left:auto;margin-right:auto;width:60%" cellpadding="0"> <tr style="height:15px"> <td style="BORDER-BOTTOM: #000000 1px solid;"> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong><font style="font-size:18pt">RA MEDICAL SYSTEMS, INC.</font></strong></p></td></tr> <tr style="height:15px"> <td> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">(Exact name of registrant as specified in its charter) </p></td></tr></table><strong></strong> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">&nbsp;</p> <table style="border-spacing:0;font-size:10pt;text-align:justify;margin-left:auto;margin-right:auto;width:85%" cellpadding="0"> <tr style="height:15px"> <td style="BORDER-BOTTOM: #000000 1px solid;width:30%;vertical-align:top;"> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong>Delaware</strong><strong></strong></p></td> <td style="width:5%;"> <p style="font-size:10pt;font-family:times new roman;margin:0px">&nbsp;</p></td> <td style="BORDER-BOTTOM: #000000 1px solid;width:30%;vertical-align:top;"> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong>001-38677</strong><strong></strong></p></td> <td style="width:5%;"> <p style="font-size:10pt;font-family:times new roman;margin:0px">&nbsp;</p></td> <td style="BORDER-BOTTOM: #000000 1px solid;width:30%;vertical-align:top;"> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong>38-3661826</strong><strong></strong></p></td></tr> <tr style="height:15px"> <td style="vertical-align:top;"> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">(State or Other Jurisdiction </p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">of Incorporation)</p></td> <td> <p style="font-size:10pt;font-family:times new roman;margin:0px">&nbsp;</p></td> <td style="vertical-align:top;"> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">(Commission </p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">File Number)</p></td> <td> <p style="font-size:10pt;font-family:times new roman;margin:0px">&nbsp;</p></td> <td style="vertical-align:top;"> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">(IRS Employer </p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">Identification No.)&nbsp;</p></td></tr></table> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong>1670 Highway 160 West </strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong>Suite 205</strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong><u>Fort Mill, SC 29708</u></strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">(Full mailing address of principal executive offices)</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">&nbsp; &nbsp;</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong>Steve Passey </strong><strong>(973) 691-2000</strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">(Name and telephone number, including area code, of the person in connection with this report.)</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">Check the appropriate box to indicate the rule pursuant to which the form is being filed, and provide the period to which this form is being filed:</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&#9746;&nbsp;&nbsp;&nbsp;&nbsp; Rule 13p-1 under the Securities Exchange Act (17CFR 240.13p-1) for the reporting period from January 1 to December 31, 2022</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&#9744;&nbsp;&nbsp;&nbsp; &nbsp;Rule 13q-1 under the Securities Exchange Act (17 CFR 240.13q-1) for the fiscal year ended __________.</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <table style="font-size:1px;width:100%"> <tr > <td style="BORDER-BOTTOM: 2px solid;"></td></tr> <tr > <td style="BORDER-BOTTOM: 5px solid;"></td></tr></table> <table style="border-spacing:0;font:10pt times new roman;width:100%" cellpadding="0"> <tr style="height:15px"> <td class="hpbhr">&nbsp;</td></tr> <tr style="height:15px"> <td style="TEXT-INDENT: 0px;"></td></tr> <tr style="height:15px"> <td><p style='page-break-after: always'></p></td></tr> <tr style="height:15px"> <td>&nbsp;</td></tr></table> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp; </p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;"><strong>Section 1 &#8211; Conflict Minerals Disclosure</strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;"><strong>Item 1.01 Conflict Minerals Disclosure and Report</strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;"><strong>Conflict Minerals Disclosure</strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">This Specialized Disclosure Form (Form SD) of Ra Medical Systems, Inc. (the &#8220;Company&#8221;) is filed pursuant to Rule 13p-1 of the Securities Exchange Act of 1934, as amended, as modified by relevant SEC guidance (together, the &#8220;Rule&#8221;). The Rule requires a public company to annually file a Form SD with respect to a calendar year if it manufactured or contracted to manufacture products (the &#8220;Products&#8221;) during that year that contained Conflict Minerals (defined below) necessary to the functionality or production of those products, and disclose whether those Conflict Minerals originated in a Covered Country (defined below) or came from recycled or scrap sources. &#8220;Conflict Minerals&#8221; include gold, columbite-tantalite (coltan), cassiterite, and wolframite, including their derivatives, which are limited to tantalum, tin and tungsten. Covered Countries include the Democratic Republic of the Congo (&#8220;DRC&#8221;) plus those countries that share an internationally recognized border with the DRC.</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">The Company has determined that during calendar year 2022 it may have manufactured or contracted to manufacture products containing Conflict Minerals. Following its January 2023 merger with Catheter Precision, Inc., the Company no longer manufactures or sells any of these products. Nevertheless, the Company has undertaken to conduct a good faith reasonable country of origin inquiry regarding the Conflict Minerals that may have been included in the Products to determine whether any of the Conflict Minerals originated in a Covered Country or were from recycled or scrap sources, by engaging with third party suppliers of parts that contained or may have contained Conflict Minerals and making inquiry to such suppliers regarding the source of those Conflict Minerals. Based on responses received to date, the Company cannot conclude that any Conflict Minerals necessary to products that it manufactured or contracted to be manufactured by others during 2022 did not originate in any of the Covered Countries or that all such Conflict Minerals originated from recycled or scrap sources. However, as noted above, the Company no longer manufactures or sells any of such products.</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;"><strong>Website Disclosure</strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;"><strong>&nbsp;</strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">This Form SD is publicly available at www.ramed.com in the &#8220;Governance&#8212;Governance Documents&#8221; section under &#8220;Investor Relations,&#8221; at https://ir.ramed.com/governance-docs, as well as the SEC&#8217;s EDGAR database at www.sec.gov. The content of any website referred to in this Form SD is included for general information only and is not incorporated by reference in this Form SD.</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <table style="border-spacing:0;font:10pt times new roman;width:100%" cellpadding="0"> <tr style="height:15px"> <td class="hpbhr">&nbsp;</td></tr> <tr style="height:15px"> <td style="BORDER-BOTTOM: black 1px solid; TEXT-INDENT: 0px;"> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">2</p></td></tr> <tr style="height:15px"> <td><p style='page-break-after: always'></p></td></tr> <tr style="height:15px"> <td>&nbsp;</td></tr></table> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong>SIGNATURES</strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;"><strong>&nbsp; </strong></p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the duly authorized undersigned.</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <table style="border-spacing:0;font-size:10pt;width:100%" cellpadding="0"> <tr style="height:15px"> <td style="BORDER-BOTTOM: 1px solid;width:35%;vertical-align:top;"> <p style="font-size:10pt;font-family:times new roman;margin:0px"><strong>Ra Medical Systems, Inc.</strong></p></td> <td> <p style="font-size:10pt;font-family:times new roman;margin:0px">&nbsp;</p></td> <td style="width:15%;"> <p style="font-size:10pt;font-family:times new roman;margin:0px">&nbsp;</p></td></tr> <tr style="height:15px"> <td style="vertical-align:top;"> <p style="font-size:10pt;font-family:times new roman;margin:0px">(Registrant)</p></td> <td> <p style="font-size:10pt;font-family:times new roman;margin:0px">&nbsp;</p></td> <td> <p style="font-size:10pt;font-family:times new roman;margin:0px">&nbsp;</p></td></tr> <tr style="height:15px"> <td> <p style="font-size:10pt;font-family:times new roman;margin:0px">&nbsp;</p></td> <td> <p style="font-size:10pt;font-family:times new roman;margin:0px">&nbsp;</p></td> <td> <p style="font-size:10pt;font-family:times new roman;margin:0px">&nbsp;</p></td></tr> <tr style="height:15px"> <td style="BORDER-BOTTOM: 1px solid;vertical-align:top;"> <p style="font-size:10pt;font-family:times new roman;margin:0px">/s/ Steven Passey</p></td> <td> <p style="font-size:10pt;font-family:times new roman;margin:0px">&nbsp;</p></td> <td style="BORDER-BOTTOM: 1px solid;vertical-align:top;"> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">July 7, 2023</p></td></tr> <tr style="height:15px"> <td style="vertical-align:top;"> <p style="font-size:10pt;font-family:times new roman;margin:0px">Steven Passey</p> <p style="font-size:10pt;font-family:times new roman;margin:0px">Chief Financial Officer and Corporate Secretary </p></td> <td> <p style="font-size:10pt;font-family:times new roman;margin:0px">&nbsp;</p></td> <td style="vertical-align:top;"> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">(Date)</p></td></tr></table> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p> <table style="border-spacing:0;font:10pt times new roman;width:100%" cellpadding="0"> <tr style="height:15px"> <td class="hpbhr">&nbsp;</td></tr> <tr style="height:15px"> <td style="BORDER-BOTTOM: black 1px solid; TEXT-INDENT: 0px;"> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:center;">3</p></td></tr></table> <p style="FONT-SIZE: 10pt; FONT-FAMILY: times new roman; MARGIN: 0px; text-align:justify;">&nbsp;</p><body>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
