0001274375-16-000001.txt : 20160815 0001274375-16-000001.hdr.sgml : 20160815 20160812201701 ACCESSION NUMBER: 0001274375-16-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160815 DATE AS OF CHANGE: 20160812 EFFECTIVENESS DATE: 20160815 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PATIENTSAFE SOLUTIONS, INC. CENTRAL INDEX KEY: 0001274375 IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-268897 FILM NUMBER: 161829661 BUSINESS ADDRESS: STREET 1: 5375 MIRA SORRENTO PLACE STREET 2: SUITE 500 CITY: SAN DIEGO STATE: CA ZIP: 92121 BUSINESS PHONE: (858) 746-3100 MAIL ADDRESS: STREET 1: 5375 MIRA SORRENTO PLACE STREET 2: SUITE 500 CITY: SAN DIEGO STATE: CA ZIP: 92121 FORMER COMPANY: FORMER CONFORMED NAME: INTELLIDOT CORP DATE OF NAME CHANGE: 20031224 D 1 primary_doc.xml X0707 D LIVE 0001274375 PATIENTSAFE SOLUTIONS, INC. 5375 MIRA SORRENTO PLACE SUITE 500 SAN DIEGO CA CALIFORNIA 92121 (858) 746-3100 DELAWARE INTELLIDOT CORP Corporation true Christopher Kersey c/o PatientSafe Solutions, Inc. 5375 Mira Sorrento Place, Suite 500 San Diego CA CALIFORNIA 92121 Director Richard Norling c/o PatientSafe Solutions, Inc. 5375 Mira Sorrento Place, Suite 500 San Diego CA CALIFORNIA 92121 Director Cayce Denton c/o PatientSafe Solutions, Inc. 5375 Mira Sorrento Place, Suite 500 San Diego CA CALIFORNIA 92121 Director Joel Krikston c/o PatientSafe Solutions, Inc. 5375 Mira Sorrento Place, Suite 500 San Diego CA CALIFORNIA 92121 Director Stephen Krupa c/o PatientSafe Solutions, Inc. 5375 Mira Sorrento Place, Suite 500 San Diego CA CALIFORNIA 92121 Director Lawrence Low c/o PatientSafe Solutions, Inc. 5375 Mira Sorrento Place, Suite 500 San Diego CA CALIFORNIA 92121 Director Siliang Luo c/o PatientSafe Solutions, Inc. 5375 Mira Sorrento Place, Suite 500 San Diego CA CALIFORNIA 92121 Executive Officer Director Other Health Care Decline to Disclose 06b false 2016-08-03 false true true true true Consists of Convertible Promissory Notes convertible into shares of Preferred Stock of the Issuer. false 0 10020001 4467237 5552764 Total Offering Amount includes amounts receivable by the Issuer upon exercise of warrants to purchase the issuer's Series D Preferred Stock (assuming no net exercise, where applicable). The warrants have not yet been exercised. false 7 0 0 0 false PATIENTSAFE SOLUTIONS, INC. /s/ Siliang Luo Siliang Luo President and CEO 2016-08-11