Exhibit 10.1








 


FIFTH AMENDMENT TO THE AMENDED AND RESTATED LOAN AND SECURITY
AGREEMENT


 


THIS FIFTH AMENDMENT to the Amended
and Restated Loan and Security Agreement (this “Amendment”) is made effective as of December 28, 2022 (the “Fifth
Amendment Date”) and made by and among WESTERN ALLIANCE BANK, an Arizona corporation (“Bank”) and
CYTOSORBENTS CORPORATION, a Delaware corporation and CYTOSORBENTS MEDICAL, INC., a Delaware corporation (individually and
collectively, jointly and severally “Borrower”).


 


WHEREAS, Bank and Borrower have entered
into that certain Amended and Restated Loan and Security Agreement, dated as of March 29, 2018 (as amended, supplemented, restated or
otherwise modified from time to time, the “Loan Agreement”) pursuant to which Bank has provided to Borrower certain
loans in accordance with the terms and conditions thereof; and


 


WHEREAS, Bank and Borrower desire to
amend certain provisions of the Loan Agreement as provided herein and subject to the terms and conditions set forth herein.


 


NOW, THEREFORE, in consideration of
the promises, covenants and agreements contained herein, and other good and valuable consideration, the receipt and adequacy of which
are hereby acknowledged, Bank and Borrower hereby agree as follows:


 


		1.	Capitalized terms used herein but not otherwise defined shall have the respective
meanings given to them in the Loan Agreement.



 


		2.	Section 1.1 of the Loan Agreement is hereby amended by amending and restating the
following definitions therein as follows:



 


“Third Draw Period” means the period commencing
on the Fourth Amendment Date and ending on the earlier of (i) March 1, 2023 and (ii) the occurrence of an Event of Default; provided further
that no Term C Loan as would cause the aggregate principal amount of Term C Loans to exceed Five Million Dollars ($5,000,000.00) shall
be made during the Third Draw Period unless on the Funding Date of such Term C Loan, the Required Reserves Test is met and on or before
the Funding Date of such Term C Loan (but no earlier than ten (10) days prior to the Funding Date), the Seventy Five Percent Test is met.


 


		3.	Limitation of Amendment.



 


		a.	The amendments and the consents set forth above are effective for the purposes set forth herein and shall be limited precisely as
written and shall not be deemed to (a) be a consent to any amendment, waiver or modification of any other term or condition of any Loan
Document, or (b) otherwise prejudice any right, remedy or obligation which the Bank or Borrower may now have or may have in the future
under or in connection with any Loan Document, as amended hereby.



 


		b.	This Amendment shall be construed in connection with and as part of the Loan Documents and all terms, conditions,
representations, warranties, covenants and agreements set forth in the Loan Documents, except as herein amended, are hereby ratified and
confirmed and shall remain in full force and effect.



 


		4.	To induce the Bank to enter into this Amendment, Borrower hereby represents and warrants
to the Bank as follows:



 


		a.	Immediately after giving effect to this Amendment (a) the representations and warranties contained in the
Loan Documents are true, accurate and complete in all material respects as of the date hereof (except to the extent such representations
and warranties relate to an earlier date, in which case they are true and correct in all material respects
as of such date), and (b) no Event of Default has occurred and is continuing;



 






    	 	 	 



     


    




 


		b.	Borrower has the power and due authority to execute and deliver this Amendment and
to perform its obligations under the Loan Agreement, as amended by this Amendment;



 


		c.	The organizational documents of Borrower delivered to the Bank on the Effective Date, and updated pursuant
to subsequent deliveries by the Borrower to the Bank, if any, remain true, accurate and complete and have not been amended, supplemented
or restated and are and continue to be in full force and effect;



 


		d.	The execution and delivery by Borrower of this Amendment and the performance by Borrower
of its obligations under the Loan Agreement, as amended by this Amendment, will not constitute an event of default under any material
agreement with a Person binding on Borrower, or a breach of any provision contained in the Articles of Incorporation or Bylaws of Borrower;
and



 


		e.	This Amendment has been duly executed and delivered by Borrower and is the binding obligation of Borrower,
enforceable against Borrower in accordance with its terms, except as such enforceability may be limited by bankruptcy, insolvency, reorganization,
liquidation, moratorium or other similar laws of general application and by general equitable principles.



 


		5.	Except as expressly set forth herein, the Loan Agreement shall continue in full force and effect without
alteration or amendment. This Amendment and the Loan Documents represent the entire agreement about this subject matter and supersede
prior negotiations or agreements.



 


		6.	This Amendment shall be deemed effective as of the Amendment Date upon the due execution and delivery
to the Bank of this Amendment by each party hereto.



 


		7.	This Amendment may be executed in any number of counterparts, each of which shall
be deemed an original, and all of which, taken together, shall constitute one and the same instrument.



 


		8.	This Amendment and the rights and obligations of the parties hereto shall be governed
by and construed in accordance with the laws of the State of California.



 


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IN WITNESS WHEREOF, the parties
hereto have caused this Fifth Amendment to the Amend and Restated Loan and Security Agreement to be executed as of the date first set
forth above.


  


 


	 	CYTOSORBENTS CORPORATION, A
    DELAWARE CORPORATION
		 
	 	By:	/s/ Kathleen P. Bloch
	 	Name:	Kathleen P. Bloch
	 	Title:	Chief Financial Officer
	 	 
	 	 
	 	CYTOSORBENTS MEDICAL, INC., A
    DELAWARE CORPORATION
	 	 
		 
	 	By:	/s/ Kathleen P. Bloch
	 	Name:	Kathleen P. Bloch
	 	Title: 	Chief Financial Officer
		 
	 	 
	 	WESTERN ALLIANCE BANK, AN
    ARIZONA CORPORATION
	 	 
		 
	 	By:	/s/ Bill Wickline
	 	Name:	Bill Wickline
	 	Title:	Managing Director