David Lawrence Blue - 01 Aug 2025 Form 4 Insider Report for SHOULDER INNOVATIONS, INC. (SI)

Reporting relationship: Officer Title: Chief Customer Experience Officer
Issuer ticker: SI
Reported as of: 01 Aug 2025
Net transaction value: $0
SEC form: 4
Accepted by SEC: 05 Aug 2025, 16:05:14 UTC
Prior SEC filing: 30 Jul 2025
Next SEC filing: 15 Sep 2025
Source filing: View source filing
Reporting owner signature: Jeffrey Points, as Attorney-in-Fact

Key filing fact

David Lawrence Blue filed Form 4 for SHOULDER INNOVATIONS, INC. (SI) on 05 Aug 2025.

Key facts

This page summarizes David Lawrence Blue's Form 4 filing for SHOULDER INNOVATIONS, INC. (SI).
6 reported transactions and 5 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: $0.

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 0002071751 Primary reporting owner

Blue David Lawrence

Relationship: Officer Title: Chief Customer Experience Officer
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: +43,937
Change %
Price
Shares after: 43,937
Date: 01 Aug 2025
Ownership: Direct
Footnotes: F1

Reported derivative securities

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

SI transaction Derivative

Series Seed Convertible Preferred Stock

Conversion of derivative security

Transaction value
Shares: -100,000
Change %: -100%
Price
Shares after: 0
Date: 01 Aug 2025
Ownership: By David Lawrence Blue Living Trust
Underlying class: Common Stock
Underlying amount: 5,241
Exercise price
Footnotes: F1

SI transaction Derivative

Series A Convertible Preferred Stock

Conversion of derivative security

Transaction value
Shares: -346,333
Change %: -100%
Price
Shares after: 0
Date: 01 Aug 2025
Ownership: By David Lawrence Blue Living Trust
Underlying class: Common Stock
Underlying amount: 18,151
Exercise price
Footnotes: F1

SI transaction Derivative

Series B Convertible Preferred Stock

Conversion of derivative security

Transaction value
Shares: -308,916
Change %: -100%
Price
Shares after: 0
Date: 01 Aug 2025
Ownership: By David Lawrence Blue Living Trust
Underlying class: Common Stock
Underlying amount: 16,190
Exercise price
Footnotes: F1

SI transaction Derivative

Series C Convertible Preferred Stock

Conversion of derivative security

Transaction value
Shares: -46,512
Change %: -100%
Price
Shares after: 0
Date: 01 Aug 2025
Ownership: By David Lawrence Blue Living Trust
Underlying class: Common Stock
Underlying amount: 2,437
Exercise price
Footnotes: F1

SI transaction Derivative

Series E Convertible Preferred Stock

Conversion of derivative security

Transaction value
Shares: -36,614
Change %: -100%
Price
Shares after: 0
Date: 01 Aug 2025
Ownership: By David Lawrence Blue Living Trust
Underlying class: Common Stock
Underlying amount: 1,918
Exercise price
Footnotes: F1

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

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 1 footnote

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.

SEC remarks

Officer Title: Chief Customer Experience Officer

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