Casey M. Tansey - 01 Aug 2025 Form 4 Insider Report for SHOULDER INNOVATIONS, INC. (SI)

Reporting relationship: Director, 10%+ Owner
Issuer ticker: SI
Reported as of: 01 Aug 2025
Net transaction value: +$600,000
SEC form: 4
Accepted by SEC: 05 Aug 2025, 16:05:09 UTC
Prior SEC filing: 30 Jul 2025
Next SEC filing: 07 Aug 2025
Source filing: View source filing
Reporting owner signature: Jeffrey Points, as Attorney-in-Fact

Key filing fact

Casey M. Tansey filed Form 4 for SHOULDER INNOVATIONS, INC. (SI) on 05 Aug 2025.

Key facts

This page summarizes Casey M. Tansey's Form 4 filing for SHOULDER INNOVATIONS, INC. (SI).
8 reported transactions and 3 derivative rows are listed below.
Accepted by SEC: 05 Aug 2025, 16:05.

Change

Previous filing in this sequence was filed on 30 Jul 2025.
Current net transaction value: +$600,000.

Research use

This tells you what this filing adds before you inspect full transaction and derivative tables.
You can trace every row back to the original SEC filing document.

Evidence

Filed on Form 4

Ownership activity is grounded in SEC Form 4 disclosures.

View source filing

Reporting Owners (1)

CIK 0001474322 Primary reporting owner

Tansey Casey M

Relationship: Director, 10%+ Owner
Address: C/O SHOULDER INNOVATIONS, INC., 1535 STEELE AVENUE SW, SUITE B, GRAND RAPIDS
Signature: Jeffrey Points, as Attorney-in-Fact
Signature date: 05 Aug 2025

Reported non-derivative transactions

Shares, units, or other non-derivative securities reported in this filing.

SI transaction

Common Stock

Conversion of derivative security

Transaction value
Shares: +1,686,403
Change %
Price
Shares after: 1,686,403
Date: 01 Aug 2025
Ownership: By U.S. Venture Partners XII, L.P.
Footnotes: F1, F2, F3

SI transaction

Common Stock

Conversion of derivative security

Transaction value
Shares: +85,587
Change %
Price
Shares after: 85,587
Date: 01 Aug 2025
Ownership: By U.S. Venture Partners XII-A, L.P.
Footnotes: F1, F2, F3

SI transaction

Common Stock

Conversion of derivative security

Transaction value
Shares: +921,131
Change %
Price
Shares after: 921,131
Date: 01 Aug 2025
Ownership: By U.S. Venture Partners Select Fund I-A, L.P.
Footnotes: F1, F2, F3

SI transaction

Common Stock

Award

Transaction value: $0
Shares: +7,666
Change %
Price: $0.000000
Shares after: 7,666
Date: 01 Aug 2025
Ownership: Direct
Footnotes: F4

SI transaction

Common Stock

Purchase

Transaction value: $600,000
Shares: +40,000
Change %: +522%
Price: $15.00
Shares after: 47,666
Date: 01 Aug 2025
Ownership: Direct

Reported derivative securities

Options, warrants, convertible securities, or similar derivative positions disclosed in the filing.

SI transaction Derivative

Series C Convertible Preferred Stock

Conversion of derivative security

Transaction value
Shares: -20,930,233
Change %: -100%
Price
Shares after: 0
Date: 01 Aug 2025
Ownership: See Footnotes
Underlying class: Common Stock
Underlying amount: 1,096,971
Exercise price
Footnotes: F1, F2, F3, F5

SI transaction Derivative

Series D Convertible Preferred Stock

Conversion of derivative security

Transaction value
Shares: -9,950,208
Change %: -100%
Price
Shares after: 0
Date: 01 Aug 2025
Ownership: See Footnotes
Underlying class: Common Stock
Underlying amount: 521,498
Exercise price
Footnotes: F1, F2, F3, F5

SI transaction Derivative

Series E Convertible Preferred Stock

Conversion of derivative security

Transaction value
Shares: -20,504,376
Change %: -100%
Price
Shares after: 0
Date: 01 Aug 2025
Ownership: See Footnotes
Underlying class: Common Stock
Underlying amount: 1,074,652
Exercise price
Footnotes: F1, F2, F3, F5

^* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 5 footnotes

Footnote F1

Immediately prior to the closing of the Issuer's initial public offering, the shares of preferred stock of the Issuer automatically converted into shares of Common Stock on a one-for-0.052410901 basis.

Footnote F2

Presidio Management Group XII, L.L.C. ("PMG XII") is the general partner of U.S. Venture Partners XII, L.P. ("USVP XII") and U.S. Venture Partners XII-A, L.P ("USVP XII-A") and has sole voting and dispositive power with respect to the shares held by USVP XII and USVP XII-A. The Reporting Person, Steven M. Krausz, Richard W. Lewis, Jonathan D. Root and Dafina Toncheva are the managing members of PMG XII, and share voting and dispositive power with respect to the shares held by USVP XII and USVP XII-A. Presidio Management Group Select Fund I, L.L.C. ("PMG Select") is the general partner of U.S. Venture Partners Select Fund I-A, L.P. ("USVP Select") and has sole voting and dispositive power with respect to the shares held by USVP Select.

Footnote F3

The Reporting Person, Richard W. Lewis, Jonathan D. Root and Dafina Toncheva are the managing members of PMG Select and share voting and dispositive power with respect to the shares held by USVP Select. Each of the managing members of PMG XII and PMG Select disclaims beneficial ownership of such holdings, except to the extent of their pecuniary interest in the shares.

Footnote F4

Represents an award of restricted stock units ("RSUs"). The RSUs will vest on the earlier of the date of the annual meeting of stockholders to be held in 2026 or August 1, 2026. Each RSU represents a contingent right to receive one share of the Issuer's Common Stock and has no expiration date.

Footnote F5

Consists of (i) 1,043,988 shares of Common Stock underlying Series C Preferred Stock, 496,309 shares of Common Stock underlying Series D Preferred Stock and 146,106 shares of Common Stock underlying Series E Preferred Stock held by USVP XII; (ii) 52,983 shares of Common Stock underlying Series C Preferred Stock, 25,189 shares of Common Stock underlying Series D Preferred Stock, and 7,415 shares of Common Stock underlying Series E Preferred Stock held by USVP XII-A; and (iii) 921,131 shares of Common Stock underlying Series E Preferred Stock held by U.S. Venture Partners Select Fund I, L.P. on its own behalf and as a nominee for USVP Select.