CUSIP No. 0003611281 Page 1 of 6 Pages
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
----------------------
SCHEDULE 13G
(Rule 13d-102)
INFORMATION TO BE INCLUDED IN STATEMENTS FILES PURSUANT
TO RULES 13d-1(b)(c), AND (d) AND AMENDMENTS THERETO FILED
PURSUANT TO RULE 13d-2(b)
(Amendment No. 1)1
Fusion Medical Technologies, Inc.
- --------------------------------------------------------------------------------
(Name of Issuer)
Common Stock
- --------------------------------------------------------------------------------
(Title of Class of Securities)
0003611281
- --------------------------------------------------------------------------------
(CUSIP Number)
December 31, 1998
- --------------------------------------------------------------------------------
Date of Event Which Requires Filing of this Statement
Check the appropriate box to designate the rule pursuant to which this Schedule
is Filed:
[ ] Rule 13d-1(b)
[ ] Rule 13d-1(c)
[X] Rule 13d-1(d)
- --------
1The remainder of this cover page shall be filled out for a reporting
person's initial filing on this form with respect to the subject class of
securities, and for any subsequent amendment containing information which would
alter disclosures provided in a prior cover page. The information required on
the remainder of this cover page shall not be deemed to be "filed" for the
purpose of Section 18 of the Securities Exchange Act of 1934 or otherwise
subject to the liabilities of that section of the Act but shall be subject to
all other provisions of the Act.
<PAGE>
CUSIP No. 0003611281 Page 2 of 6 Pages
- --------------------------------------------------------------------------------
1) Name of Reporting Person Domain Partners
I.R.S. Identification III, L.P.
No. of Above Person
(Entities Only)
- --------------------------------------------------------------------------------
2) Check the Appropriate Box (a) [ X ]
if a Member of a Group (b) [ ]
- --------------------------------------------------------------------------------
3) SEC Use Only
- --------------------------------------------------------------------------------
4) Citizenship or Place Delaware
of Organization
- --------------------------------------------------------------------------------
Number of 5) Sole Voting 588,088 shares
Shares Beneficially Power of Common Stock
Owned by Each
Reporting Person
With
---------------------------------------------------
6) Shared Voting
Power -0-
---------------------------------------------------
7) Sole Disposi- 588,088 shares
tive Power of Common Stock
---------------------------------------------------
8) Shared Dis-
positive Power -0-
---------------------------------------------------
9) Aggregate Amount Beneficially 588,088 shares
Owned by Each Reporting person of Common Stock
- --------------------------------------------------------------------------------
10) Check if the Aggregate
Amount in Row (9)
Excludes Certain Shares
- --------------------------------------------------------------------------------
11) Percent of Class
Represented by 8.2%
Amount in Row (9)
- --------------------------------------------------------------------------------
12) Type of Reporting
Person PN
<PAGE>
CUSIP No. 0003611281 Page 3 of 6 Pages
- --------------------------------------------------------------------------------
1) Name of Reporting Person DP III Associates,
I.R.S. Identification L.P.
No. of Above Person
(Entities Only)
- --------------------------------------------------------------------------------
2) Check the Appropriate Box (a) [ X ]
if a Member of a Group (b) [ ]
- --------------------------------------------------------------------------------
3) SEC Use Only
- --------------------------------------------------------------------------------
4) Citizenship or Place Delaware
of Organization
- --------------------------------------------------------------------------------
Number of 5) Sole Voting 20,655 shares
Shares Beneficially Power of Common Stock
Owned by Each
Reporting Person
With
---------------------------------------------------
6) Shared Voting
Power -0-
---------------------------------------------------
7) Sole Disposi- 20,655 shares
tive Power of Common Stock
---------------------------------------------------
8) Shared Dis-
positive Power -0-
---------------------------------------------------
9) Aggregate Amount Beneficially 20,655 shares
Owned by Each Reporting person of Common Stock
- --------------------------------------------------------------------------------
10) Check if the Aggregate
Amount in Row (9)
Excludes Certain Shares
- --------------------------------------------------------------------------------
11) Percent of Class
Represented by 0.3%
Amount in Row (9)
- --------------------------------------------------------------------------------
12) Type of Reporting
Person PN
<PAGE>
CUSIP No. 0003611281 Page 4 of 6 Pages
- --------------------------------------------------------------------------------
1) Name of Reporting Person Domain Associates,
I.R.S. Identification L.L.C.
No. of Above Person
(Entities Only)
- --------------------------------------------------------------------------------
2) Check the Appropriate Box (a) [ X ]
if a Member of a Group (b) [ ]
- --------------------------------------------------------------------------------
3) SEC Use Only
- --------------------------------------------------------------------------------
4) Citizenship or Place Delaware
of Organization
- --------------------------------------------------------------------------------
Number of 5) Sole Voting 8,285 shares
Shares Beneficially Power of Common Stock
Owned by Each (including shares
Reporting Person restricted and
With subject to vesting)
---------------------------------------------------
6) Shared Voting
Power -0-
---------------------------------------------------
7) Sole Disposi- 8,285 shares
tive Power of Common Stock
(including shares
restricted and
subject to vesting)
---------------------------------------------------
8) Shared Dis-
positive Power -0-
---------------------------------------------------
9) Aggregate Amount Beneficially 8,285 shares
Owned by Each Reporting person of Common Stock
(including shares
restricted and
subject to vesting)
- --------------------------------------------------------------------------------
10) Check if the Aggregate
Amount in Row (9)
Excludes Certain Shares
- --------------------------------------------------------------------------------
11) Percent of Class
Represented by 0.1%
Amount in Row (9)
- --------------------------------------------------------------------------------
12) Type of Reporting
Person OO
<PAGE>
CUSIP No. 0003611281 Page 5 of 6 Pages
Amendment No. 1 to Schedule 13G
-------------------------------
Reference is hereby made to the statement on Schedule 13G originally
filed on February 13, 1997 (the "Schedule 13G"). Terms used in the Schedule 13G
are used herein as so defined.
The following Items of the Schedule 13G are hereby amended and
restated to read in their entirety as follows:
Item 4 - Ownership.
(a) Amount Beneficially Owned:
Domain III: 588,088 shares of Common Stock
DP III A: 20,655 shares of Common Stock
DA: 8,285 shares of Common Stock (including shares
restricted and subject to vesting)
(b) Percent of Class:
Domain III: 8.2%
DP III A: 0.3%
DA: 0.1%
(c) Number of shares as to which such person has:
(i) sole power to vote or to direct the vote:
Domain III: 588,088 shares of Common Stock
DP III A: 20,655 shares of Common Stock
DA: 8,285 shares of Common Stock (including shares
restricted and subject to vesting)
(ii) shared power to vote or to direct the vote: -0-
(iii) sole power to dispose or to direct the disposition of:
Domain III: 588,088 shares of Common Stock
DP III A: 20,655 shares of Common Stock
DA: 8,285 shares of Common Stock (including shares
restricted and subject to vesting)
(iv) shared power to dispose or to direct the
disposition of: -0-
<PAGE>
CUSIP No. 0003611281 Page 6 of 6 Pages
Signature:
After reasonable inquiry and to the best of my knowledge and belief, I
certify that the information set forth in this statement is true, complete and
correct.
DOMAIN PARTNERS III, L.P.
By: One Palmer Square Associates
III L.P., General Partner
By /s/ Kathleen K. Schoemaker
---------------------------------
General Partner
DP III ASSOCIATES, L.P.
By: One Palmer Square Associates
III L.P., General Partner
By /s/ Kathleen K. Schoemaker
---------------------------------
General Partner
DOMAIN ASSOCIATES, L.L.C.
By /s/ Kathleen K. Schoemaker
---------------------------------
Managing Member
Date: February 2, 1999
