Specialized Disclosure Report (sd)
May 31 2016 - 4:13PM
Edgar (US Regulatory)
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM SD
Specialized Disclosure Report
HEARTWARE
INTERNATIONAL, INC.
(Exact name of registrant as specified in its charter)
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Delaware
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001-34256
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26-3636023
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(State of Incorporation)
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(Commission File Number)
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(I.R.S. Employer
Identification No.)
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500 Old Connecticut Path
Framingham, Massachusetts 01701
+1 508 739 0950
(Address
of principal executive offices)
(Registrants telephone number, including area code)
Larry Knopf
Senior Vice
President, General Counsel and Secretary
+1 508 739 0950
(Name and telephone number, including area code,
of the person to contact in connection with this report.)
Check the appropriate box to indicate the rule pursuant to which this form is being filed, and provide the period to which the information in this form
applies:
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Rule 13p-1 under the Securities Exchange Act (17 CFR 240.13p-1) for the reporting period from January 1 to December 31, 2015.
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Section 1 - Conflict Minerals Disclosure
Item 1.01 Conflict Minerals Disclosure and Report
Unless the context requires otherwise, references in this Special Disclosure Report on Form SD to HeartWare, the
Company, we, us and our refer to HeartWare International, Inc. and its consolidated direct and indirect subsidiaries.
This Specialized Disclosure Form (herein Form SD) of HeartWare is filed pursuant to Rule 13p-1 (herein, the Rule)
promulgated under the Securities Exchange Act of 1934, as amended, for the reporting period from January 1, 2015 to December 31, 2015.
The Rule requires disclosure of certain information when a company manufactures or contracts to manufacture products for which the minerals
specified in the Rule are necessary to the functionality or production of those products. The specified minerals are gold, columbite-tantalite (coltan), cassiterite and wolframite, including their derivatives, which are limited to tantalum, tin and
tungsten (collectively, 3TG) that originated in the Democratic Republic of the Congo (DRC) and certain adjoining countries (collectively, the Covered Countries).
HeartWare is a medical device company that develops and manufactures miniaturized implantable heart pumps, or ventricular assist devices, to
treat patients suffering from advanced heart failure. We have one operating segment, which designs, manufactures and markets our medical devices. We are headquartered in Framingham, Massachusetts, and have primary facilities in Miami
Lakes, Florida and Hannover, Germany. The Company procures components from third-party suppliers and incorporates those components into the manufacturing process of our products.
We evaluated each component of the HVAD System and other devices in development. Our initial goal was to determine whether certain
HeartWare product components contained tin, tungsten, tantalum or gold during calendar year 2015. After having completed our components review, we determined that during calendar year 2015 certain HeartWare product components contained 3TG.
HeartWare then completed a good faith reasonable country-of-origin inquiry (RCOI) regarding 3TG. The goals of the RCOI were
to determine whether any 3TG present in HeartWare product components: (i) originated in a Covered Country; or (ii) originated from recycled or scrap sources. By doing so, we complied with the requirements of the Rule.
In certain circumstances, HeartWare was unable to determine whether some of the 3TG used in HeartWare product components manufactured in 2015
originated in the Covered Countries. HeartWare was also unable to determine whether some of the 3TG used in HeartWare product components manufactured in 2015 definitively originated from recycled or scrap sources. The Company then made
additional efforts to determine the source and chain of custody of the 3TG used to manufacture HeartWare product components.
Conflict Minerals
Disclosure
A copy of HeartWares Conflict Minerals Report is filed as Exhibit 1.02 herewith and is publicly available at the
Investor Relations portion of the HeartWare website (
http://www.heartware.com./
).
Item 1.02 Exhibit
As specified in Section 2, Item 2.01 of this Form SD, HeartWare is hereby filing its Conflict Minerals Report as Exhibit 1.01 to this Form SD.
Section 2 - Exhibits
Item 2.01 Exhibits
List below the following exhibit filed as part of this report.
Exhibit 1.01: HeartWare Conflict Minerals Report For the Year Ended December 31, 2015.
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SIGNATURES
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.
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HeartWare International, Inc.
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(Registrant)
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/s/ Lawrence J. Knopf
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May 31, 2016
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By:
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Lawrence J. Knopf
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Date
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Title:
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Senior Vice President, General Counsel and Secretary
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