# EDGAR Filing Document

**Accession Number:** 0001837493
**File Stem:** 0001185185-26-000978
**Filing Date:** 2026-3
**Character Count:** 4787
**Document Hash:** 7c0fbe9745e3b8245952ca529136836e
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001185185-26-000978.hdr.sgml**: 20260415

**ACCESSION NUMBER**: 0001185185-26-000978

**CONFORMED SUBMISSION TYPE**: 3

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20260318

**FILED AS OF DATE**: 20260319

**DATE AS OF CHANGE**: 20260319

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** Ben-Noon Dagi Shahar
- **CENTRAL INDEX KEY:** 0001911928

**ORGANIZATION NAME:**

**FILING VALUES:**
- **FORM TYPE:** 3
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 001-40303
- **FILM NUMBER:** 26774235

**MAIL ADDRESS:**
- **STREET 1:** 696 HAHADAS
- **CITY:** BURGATA
- **STATE:** L3
- **ZIP:** 4286000
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** Inspira Technologies OXY B.H.N. Ltd
- **CENTRAL INDEX KEY:** 0001837493
- **STANDARD INDUSTRIAL CLASSIFICATION:** SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
- **ORGANIZATION NAME:** 08 Industrial Applications and Services
- **EIN:** 000000000
- **STATE OF INCORPORATION:** L3
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** HATIDHAR 2
- **STREET 2:** 11TH FLOOR
- **CITY:** RA'ANANA
- **STATE:** L3
- **ZIP:** 4366504
- **BUSINESS PHONE:** 972-9-9664488

**MAIL ADDRESS:**
- **STREET 1:** HATIDHAR 2
- **STREET 2:** 11TH FLOOR
- **CITY:** RA'ANANA
- **STATE:** L3
- **ZIP:** 4366504

### UNITED STATES SECURITIES AND EXCHANGE COMMISSION
**Washington, D.C. 20549**

## FORM 3

### INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>Ben-Noon Dagi Shahar<br><sub>(Last) (First) (Middle)</sub><br>2 HA-TIDHAR ST.<br><sub>(Street)</sub><br>RA'ANANA,  4366504<br><sub>(City) (State) (Zip)</sub> | **3. Issuer Name and Ticker or Trading Symbol**<br>Inspira Technologies OXY B.H.N. Ltd [ IINN ] | **5. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  |
| **2. Date of Event Requiring Statement (Month/Day/Year)**<br>2026-03-18 | **4. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[X] Director   [ ] 10% Owner<br>[X] Officer (give title below)   [ ] Other (specify below)<br>_Chief Executive Officer_ | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities Beneficially Owned

---

|  |  |  |  |
| --- | --- | --- | --- |
| 1. Title of Security | 2. Amount of Securities Beneficially Owned | 3. Ownership Form | 4. Nature of Indirect Beneficial Ownership |
| Ordinary shares | 2927239<sup>(1)</sup> | D |  |

---

## Table II - Derivative Securities Beneficially Owned

---

|  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Underlying Securities | 3. Title and Amount of Underlying Securities | 4. Conversion or Exercise Price | 5. Ownership Form | 6. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 4. Conversion or Exercise Price | 5. Ownership Form | 6. Nature of Indirect Beneficial Ownership |
| Employee share options (right to buy) | 2021-01-01 | 2030-04-20 | Ordinary shares | 57159<sup>(2)</sup> | 0.12<sup>(3)</sup> | D |  |

---

### Footnotes:

(1) Includes: (i) 293,334 restricted stock units ("RSUs") which vest on a quarterly basis until February 1, 2027; and (ii) 533,334 RSUs which vest on a quarterly basis until February 1, 2028.

(2) The options were granted on November 1, 2020 and became fully vested as of January 1, 2021.

(3) The options were granted with an exercise price of NIS 0.3675 and have been converted based on a ratio of NIS 3.096 to USD $1.00 as of March 18, 2026.

**Signature:** /s/ Dagi Ben-Noon Shahar  
**Date:** 2026-03-19

### Remarks:

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).

** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.

**Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.**