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Exhibit 4.2    
    

 
 

COMMON STOCK PURCHASE WARRANT    
    

To
Purchase 136,364 Shares of Common Stock of 

 
  Aksys, Ltd    
    

UNDER NASD RULE 2710(c)(7)(A)(i) AND SUBJECT TO LIMITED EXCEPTIONS, THIS WARRANT AND THE UNDERLYING SHARES OF COMMON STOCK MAY NOT BE SOLD, TRANSFERRED, ASSIGNED,
PLEDGED OR HYPOTHECATED PRIOR TO JULY 1, 2004.

        THIS
COMMON STOCK PURCHASE WARRANT CERTIFIES that, for value received, Roth Capital Partners, LLC (the "Holder"), is entitled, upon the
terms and subject to the limitations on exercise and the conditions hereinafter set forth, at any time on or after June 30, 2003 (the "Initial Exercise
Date") and on or prior to the close of business on June 29, 2008 (the "Termination Date") but not thereafter, to
subscribe for and purchase from Aksys, Ltd, a corporation incorporated in the State of Delaware (the "Company"), up to 136,364 shares (the
"Warrant Shares") of Common Stock, par value $0.01 per share, of the Company (the "Common Stock"). The
purchase price of one share of Common Stock (the "Exercise Price") under this Warrant shall be $15.00,
subject to adjustment hereunder. 

        1.    Title to Warrant.    Prior to the Termination Date and subject to the transfer restrictions imposed by NASD
Rule 2710(c)(7)(A)(i) as set forth in the legend hereto, this Warrant and all rights hereunder are transferable, in whole or in part, at the office or agency of the Company by the Holder
in person or by duly authorized attorney, upon surrender of this Warrant together with the Assignment Form annexed hereto properly endorsed. 

        2.    Authorization of Shares.    The Company covenants that all Warrant Shares which may be issued upon the exercise
of the purchase rights represented by this Warrant will, upon exercise of the purchase rights represented by this Warrant, be duly authorized, validly issued, fully paid and nonassessable and free
from all taxes, liens and charges in respect of the issue thereof (other than taxes in respect of any transfer occurring contemporaneously with such issue). 

        3.    Exercise of Warrant.    

        (a)   Except
as provided in Section 4 herein, exercise of the purchase rights represented by this Warrant may be made at any time or times on or after the Initial
Exercise Date and on or before the Termination Date by the surrender of this Warrant and the Notice of Exercise Form annexed hereto duly executed, at the office of the Company (or such other office or
agency of the Company as it may designate by notice in writing to the registered Holder at the address of such Holder appearing on the books of the Company) and upon payment of the Exercise Price of
the shares thereby purchased by wire transfer or cashier's check drawn on a United States bank or by means of a "cashless exercise" pursuant to Section 3(c), the Holder shall be entitled to
receive a certificate for the number of Warrant Shares so purchased. Warrant Shares purchased hereunder shall be delivered to the Holder within three (3) business days after the date on which
this Warrant shall have been exercised as aforesaid. This Warrant has been registered on the Company's Registration Statement, Form S-3, File No. 333-100557 (the
"Registration Statement") and accordingly, if this Warrant is exercised at a time when the Registration Statement (or any registration statement
registering the sale of the Warrant Shares to the Holder upon exercise of this Warrant) is then effective and available for use or if this Warrant is exercised by means of a "cashless exercise"
pursuant to Section 3(c) (such condition each a "Condition"), the Company shall deliver the Warrant Shares to the Buyer, if eligible, via the
Depository Trust Company's ("DTC") Deposit Withdrawal Agent Commission ("DWAC") system via the DTC
instructions 

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provided
to the Company in the Notice of Exercise. If either Condition is met at the time of exercise, the Warrant Shares shall be, when issued, unlegended and free of any resale restrictions. If no
Conditions are met at the time of such exercise, the certificates representing the Warrant Shares shall be issued in paper form and contain a standard Securities Act legend restricting resale without
registration or an exemption. This Warrant shall be deemed to have been exercised and such certificate or certificates shall be deemed to have been issued, and the Holder or any other person so
designated to be named therein shall be deemed to have become a holder of record of such shares for all purposes, as of the date the Warrant has been exercised by payment to the Company of the
Exercise Price and all taxes required to be paid by the Holder, if any, pursuant to Section 5 prior to the issuance of such shares, have been paid. If the Company fails to deliver to the Holder
a certificate or certificates representing the Warrant Shares pursuant to this Section 3(a) by the close of business on the third (3rd) business day after the date of exercise,
then the Holder will have the right to rescind such exercise. In addition to any other rights available to the Holder, if the Company fails to deliver to the Holder a certificate or certificates
representing the Warrant Shares pursuant to an exercise by the close of business on the third (3rd) business day after the date of exercise, and if after such third (3rd)
business day the Holder is required by its broker to purchase (in an open market transaction or otherwise) shares of Common Stock to deliver in satisfaction of a sale by the Holder of the Warrant
Shares which the Holder anticipated receiving upon such exercise (a "Buy-In"), then the Company shall (1) pay in cash to the Holder
the amount by which (x) the Holder's total purchase price (including brokerage commissions, if any) for the shares of Common Stock so purchased exceeds (y) the amount obtained by
multiplying (A) the number of Warrant Shares that the Company was required to deliver to the Holder in connection with the exercise at issue times (B) the price at which the sell order
giving rise to such purchase obligation was executed, and (2) at the option of the Holder, either reinstate the portion of the Warrant and equivalent number of Warrant Shares for which such
exercise was not honored or deliver to the Holder the number of shares of Common Stock that would have been issued had the Company timely complied with its exercise and delivery obligations hereunder.
For example, if the Holder purchases Common Stock having a total purchase price of $11,000 to cover a Buy-In with respect to an attempted exercise of shares of Common Stock with an
aggregate sale price giving rise to such purchase obligation of $10,000, under clause (1) of the immediately preceding sentence the Company shall be required to pay the Holder $1,000. The
Holder shall provide the Company written notice indicating the amounts payable to the Holder in respect of
the Buy-In, together with applicable confirmations and other evidence reasonably requested by the Company. Nothing herein shall limit a Holder's right to pursue any other remedies
available to it hereunder, at law or in equity including, without limitation, a decree of specific performance and/or injunctive relief with respect to the Company's failure to timely deliver
certificates representing shares of Common Stock upon exercise of the Warrant as required pursuant to the terms hereof. 

        (b)   If
this Warrant shall have been exercised in part, the Company shall, at the time of delivery of the certificate or certificates representing Warrant Shares, deliver to
Holder a new Warrant evidencing the rights of Holder to purchase the unpurchased Warrant Shares called for by this Warrant, which new Warrant shall in all other respects be identical with this
Warrant. 

        (c)   If,
but only if, at any time after the Initial Exercise Date the Registration Statement (or a registration statement registering the sale of the Warrant Shares to the
Holder upon exercise of this Warrant) is not then effective or unavailable for use as reasonably determined by the Company such that the Company is unable to otherwise issue the Warrant Shares
unlegended and free of any resale restrictions at such time, this Warrant may also be exercised at such time by 

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means
of a "cashless exercise" in which the Holder shall be entitled to receive a certificate for the number of Warrant Shares equal to the quotient obtained by dividing [(A-B)
(X)] by (A), where: 

	

(A) =	

the VWAP on the Trading Day preceding the date of such election;
	

(B) =	

the Exercise Price of the Warrant, as adjusted; and
	

(X) =	

the number of Warrant Shares issuable upon exercise of the Warrants in accordance with the terms of this Warrant.

"VWAP" means, for any date, the price determined by the first of the following clauses that applies: (a) the daily volume weighted average price
of the Common Stock for such date (or the nearest preceding date) on the primary market or exchange on which the Common Stock is then listed or quoted as reported by Bloomberg Financial L.P. (based on
a Trading Day from 9:30 a.m. Eastern Time
to 4:02 p.m. Eastern Time); (b) if the Common Stock is not then listed or quoted on a market or exchange and if prices for the Common Stock are then quoted on the OTC Bulletin Board, the
volume weighted average price of the Common Stock for such date (or the nearest preceding date) on the OTC Bulletin Board; (c) if the Common Stock is not then listed or quoted on the OTC
Bulletin Board and if prices for the Common Stock are then reported in the "Pink Sheets" published by the National Quotation Bureau Incorporated (or a similar organization or agency succeeding to its
functions of reporting prices), the average of the most recent bid and ask price per share of the Common Stock so reported; or (d) in all other cases, the fair market value of a share of Common
Stock as determined by a nationally recognized-independent appraiser selected in good faith by Holder. 

        Notwithstanding
the foregoing right of "cashless exercise" by the Holder, the Company shall use commercially reasonable efforts to keep the Registration Statement (or any registration
statement registering the sale of the Warrant Shares to the Holder upon exercise of this Warrant) continuously effective under the Securities Act until the Termination Date. 

        4.    No Fractional Shares or Scrip.    No fractional shares or scrip representing fractional shares shall be issued
upon the exercise of this Warrant. As to any fraction of a share which Holder would otherwise be entitled to purchase upon such exercise, the Company shall pay a cash adjustment in respect of such
final fraction in an amount equal to such fraction multiplied by the Exercise Price. 

        5.    Charges, Taxes and Expenses.    Issuance of certificates for Warrant Shares shall be made without charge to the
Holder for any issue or transfer tax or other incidental expense in respect of the issuance of such certificate, all of which taxes and expenses shall be paid by the Company, and such certificates
shall be issued in the name of the Holder or in such name or names as may be directed by the Holder; provided,  however, that in the event certificates for
Warrant Shares are to be issued in a name other than the name of the Holder, this Warrant when surrendered
for exercise shall be accompanied by the Assignment Form attached hereto duly executed by the Holder; and the Company may require, as a condition thereto, the payment of a sum sufficient to reimburse
it for any transfer tax incidental thereto. 

        6.    Closing of Books.    The Company will not close its stockholder books or records in any manner which prevents
the timely exercise of this Warrant, pursuant to the terms hereof. 

        7.    Transfer, Division and Combination.    

        (a)   Subject
to the transfer restrictions imposed by NASD Rule 2710(c)(7)(A)(i) as set forth in the legend hereto, this Warrant and all rights hereunder are
transferable, in whole or in part, upon surrender of this Warrant at the principal office of the Company, together with a written assignment of this Warrant substantially in the form attached hereto
duly executed by the Holder or its agent or attorney and funds sufficient to pay any transfer taxes payable upon the making of such transfer. Upon such surrender and, if required, such payment, the
Company shall execute and 

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deliver
a new Warrant or Warrants in the name of the assignee or assignees and in the denomination or denominations specified in such instrument of assignment, and shall issue to the assignor a new
Warrant evidencing the portion of this Warrant not so assigned, and this Warrant shall promptly be cancelled. A Warrant, if properly assigned, may be exercised by a new holder for the purchase of
Warrant Shares without having a new Warrant issued. 

        (b)   Subject
to the transfer restrictions imposed by NASD Rule 2710(c)(7)(A)(i) as set forth in the legend hereto, this Warrant may be divided or combined with
other Warrants upon presentation hereof at the aforesaid office of the Company, together with a written notice specifying the names and denominations in which new Warrants are to be issued, signed by
the Holder or its agent or attorney. Subject to compliance with Section 7(a), as to any transfer which may be involved in such division or combination, the Company shall execute and deliver a
new Warrant or Warrants in exchange for the Warrant or Warrants to be divided or combined in accordance with such notice. 

        (c)   The
Company shall prepare, issue and deliver at its own expense (other than transfer taxes) the new Warrant or Warrants under this Section 7. 

        (d)   The
Company agrees to maintain, at its aforesaid office, books for the registration and the registration of transfer of the Warrants. 

        8.    No Rights as Shareholder until Exercise.    This Warrant does not entitle the Holder to any voting rights or
other rights as a shareholder of the Company prior to the exercise hereof. Upon the surrender of this Warrant and the payment of the aggregate Exercise Price (or by means of a cashless exercise), the
Warrant Shares so purchased shall be and be deemed to be issued to such Holder as the record owner of such shares as of the close of business on the later of the date of such surrender or payment. 

        9.    Loss, Theft, Destruction or Mutilation of Warrant.    The Company covenants that upon receipt by the Company of
evidence reasonably satisfactory to it of the loss, theft, destruction or mutilation of this Warrant or any stock certificate relating to the Warrant Shares, and in case of loss, theft or destruction,
of indemnity or security reasonably satisfactory to it (which, in the case of the Warrant, shall not include the posting of any bond), and upon surrender and cancellation of such Warrant or stock
certificate, if mutilated, the Company will make and deliver a new Warrant or stock certificate of like tenor and dated as of such cancellation, in lieu of such Warrant or stock certificate. 

        10.    Saturdays, Sundays, Holidays, etc.    If the last or appointed day for the taking of any action or the
expiration of any right required or granted herein shall be a Saturday, Sunday or a legal holiday, then such action may be taken or such right may be exercised on the next succeeding day not a
Saturday, Sunday or legal holiday. 

        11.    Adjustments of Exercise Price and Number of Warrant Shares; Stock Splits, etc.    The number and kind of
securities purchasable upon the exercise of this Warrant and the Exercise Price shall be subject to adjustment from time to time upon the happening of any of the following. In case the Company shall
(i) pay a dividend in shares of Common Stock or make a distribution in shares of Common Stock to holders of its outstanding Common Stock, (ii) subdivide its outstanding shares of Common
Stock into a greater number of shares, (iii) combine its outstanding shares of Common Stock into a smaller number of shares of Common Stock, or (iv) issue any shares of its capital stock
in a reclassification of the Common Stock, then the number of Warrant Shares purchasable upon exercise of this Warrant immediately prior thereto shall be adjusted so that the Holder shall be entitled
to receive the kind and number of Warrant Shares or other securities of the Company which it would have owned or have been entitled to receive had such Warrant been exercised in advance thereof. Upon
each such adjustment of the kind and number of Warrant Shares or other securities of the Company which are purchasable hereunder, the Holder shall thereafter be entitled to purchase the number of
Warrant 

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Shares
or other securities resulting from such adjustment at an Exercise Price per Warrant Share or other security obtained by multiplying the Exercise Price in effect immediately prior to such
adjustment by the number of Warrant Shares purchasable pursuant hereto immediately prior to such adjustment and dividing by the number of Warrant Shares or other securities of the Company resulting
from such adjustment. An adjustment made pursuant to this paragraph shall become effective immediately after the effective date of such event retroactive to the record date, if any, for such event. 

        12.    Reorganization, Reclassification, Merger, Consolidation or Disposition of Assets.    In case the Company shall
reorganize its capital, reclassify its capital stock, consolidate or merge with or into another corporation (where the Company is not the surviving corporation or where there is a change in or
distribution with respect to the Common Stock of the Company), or sell, transfer or otherwise dispose of all or substantially all its property, assets or business to another corporation and, pursuant
to the terms of such reorganization, reclassification, merger, consolidation or disposition of assets, shares of common stock of the successor or acquiring corporation, or any cash, shares of stock or
other securities or property of any nature whatsoever (including warrants or other subscription or purchase rights) in addition to or in lieu of common stock of the successor or acquiring corporation
("Other Property"), are to be received by or distributed to the holders of Common Stock of the Company, then the Holder shall have the right thereafter
to receive, upon exercise of this Warrant, instead of the shares of Common Stock, the number of shares of common stock and/or Other Property receivable upon or as a result of such reorganization,
reclassification, merger, consolidation or disposition of assets by a Holder of the number of shares of Common Stock for which this Warrant is exercisable immediately prior to such event. In case of
any such reorganization, reclassification, merger, consolidation or disposition of assets, the successor or acquiring corporation (if other than the Company) shall expressly assume the due and
punctual observance and performance of each and every covenant and condition of this Warrant to be performed and observed by the Company and all the obligations and liabilities
hereunder, subject to such modifications as may be deemed appropriate (as determined in good faith by resolution of the Board of Directors of the Company) in order to provide for adjustments of
Warrant Shares for which this Warrant is exercisable which shall be as nearly equivalent as practicable to the adjustments provided for in this Section 12. For purposes of this
Section 12, "common stock" shall include stock of such corporation of any class which is not preferred as to dividends or assets over any other class of stock of such corporation and which is
not subject to redemption and shall also include any evidences of indebtedness, shares of stock or other securities which are convertible into or exchangeable for any such stock, either immediately or
upon the arrival of a specified date or the happening of a specified event and any warrants or other rights to subscribe for or purchase any such stock. The foregoing provisions of this
Section 12 shall similarly apply to successive reorganizations, reclassifications, mergers, consolidations or disposition of assets. 

        13.    Voluntary Adjustment by the Company.    The Company may at any time during the term of this Warrant reduce the
then current Exercise Price to any amount and for any period of time deemed appropriate by the Board of Directors of the Company. 

        14.    Notice of Adjustment.    Whenever the number of Warrant Shares or number or kind of securities or other
property purchasable upon the exercise of this Warrant or the Exercise Price is adjusted, as herein provided, the Company shall give notice thereof to the Holder, which notice shall state the number
of Warrant Shares (and other securities or property) purchasable upon the exercise of this Warrant and the Exercise Price of such Warrant Shares (and other securities or property) after such
adjustment, setting forth a brief statement of the facts requiring such adjustment and setting forth the computation by which such adjustment was made. 

        15.    Notice of Corporate Action.    If at any time: 

        (a)   the
Company shall take a record of the holders of its Common Stock for the purpose of entitling them to receive an extraordinary dividend or other distribution, or any
right to subscribe 

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for
or purchase any evidences of its indebtedness, any shares of stock of any class or any other securities or property, or to receive any other right, or 

        (b)   there
shall be any capital reorganization of the Common Stock, any reclassification or recapitalization of the capital stock of the Company or any consolidation or
merger of the Company with, or any sale, transfer or other disposition of all or substantially all the property, assets or business of the Company to, another corporation, or 

        (c)   there
shall be a voluntary or involuntary dissolution, liquidation or winding up of the Company, or 

        (d)   no
registration statement registering the sale of the Warrant Shares to the Holder upon exercise of this Warrant is then effective or such registration statement is not
then available for use, as reasonably determined by the Company; 

then,
in any one or more of such cases, the Company shall give to Holder (i) at least 10 days' prior written notice of the date on which a record date shall be selected for such
dividend, distribution or right or for determining rights to vote in respect of any such reorganization, reclassification, merger, consolidation, sale, transfer, disposition, liquidation or winding
up, and (ii) in the case of any such reorganization, reclassification, merger, consolidation, sale, transfer, disposition, dissolution, liquidation or winding up, at least 10 days' prior
written notice of the date when the same shall take place, and (iii) in the case of the absence of any effective registration statement registering the sale of the Warrant Shares to the Holder
upon exercise of this Warrant or unavailability thereof, promptly upon knowledge by the Company of such occurrence. Such notice in accordance with the foregoing clauses (a)-(c) also shall specify
(i) the date on which any such record is to be taken for the purpose of such dividend, distribution or right, the date on which the holders of Common Stock shall be entitled to any such
dividend, distribution or right, and the amount and character thereof, and (ii) the date on which any such reorganization, reclassification, merger, consolidation, sale, transfer, disposition,
dissolution, liquidation or winding up is to take place and the time, if any such time is to be fixed, as of which the holders of Common Stock shall be entitled to exchange their Warrant Shares for
securities or other property deliverable upon such disposition, dissolution, liquidation or winding up. Such notice in accordance with clause (d) shall also specify the Company's good faith
believe as to when a registration statement registering such sale shall be filed or amended or available for use again. Each such written notice shall be sufficiently given if addressed to Holder at
the last address of Holder appearing on the books of the Company and delivered in accordance with Section 17(e). 

        16.    Authorized Shares.    The Company covenants that during the period the Warrant is outstanding, it will reserve
from its authorized and unissued Common Stock a sufficient number of shares to provide for the issuance of the Warrant Shares upon the exercise of any purchase rights under this Warrant. The Company
further covenants that its issuance of this Warrant shall constitute full authority to its officers who are charged with the duty of executing stock certificates to execute and issue the necessary
certificates for the Warrant Shares upon the exercise of the purchase rights under this Warrant. The Company will take all such reasonable action as may be necessary to assure that such Warrant Shares
may be issued as provided herein without violation of any applicable law or regulation, or of any requirements of the principal market or exchange upon which the Common Stock may be listed. 

        Except
and to the extent as waived or consented to by the Holder, the Company shall not by any action, including, without limitation, amending its certificate of incorporation or through
any reorganization, transfer of assets, consolidation, merger, dissolution, issue or sale of securities or any other voluntary action, avoid or seek to avoid the observance or performance of any of
the terms of this Warrant, but will at all times in good faith assist in the carrying out of all such terms and in the taking of all such actions as may be necessary or appropriate to protect the
rights of Holder as set forth in this Warrant against impairment. Without limiting the generality of the foregoing, the Company 

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will
(a) not increase the par value of any Warrant Shares above the amount payable therefor upon such exercise immediately prior to such increase in par value, (b) take all such action
as may be necessary or appropriate in order that the Company may validly and legally issue fully paid and nonassessable Warrant Shares upon the exercise of this Warrant, and (c) use
commercially reasonable efforts to obtain all such authorizations, exemptions or consents from any public regulatory body having jurisdiction thereof as may be necessary to enable the Company to
perform its obligations under this Warrant. 

        Before
taking any action which would result in an adjustment in the number of Warrant Shares for which this Warrant is exercisable or in the Exercise Price, the Company shall obtain all
such authorizations or exemptions thereof, or consents thereto, as may be necessary from any public regulatory body or bodies having jurisdiction thereof. 

        17.    Miscellaneous.    

        (a)    Jurisdiction.    This Warrant shall constitute a contract under the laws of New York, without regard to its
conflict of law, principles or rules. 

        (b)    Restrictions.    The Holder acknowledges that the Warrant Shares acquired upon the exercise of this Warrant, if
not registered, will have restrictions upon resale imposed by state and federal securities laws. 

        (c)    Nonwaiver and Expenses.    No course of dealing or any delay or failure to exercise any right hereunder on the
part of Holder shall operate as a waiver of such right or otherwise prejudice Holder's rights, powers or remedies, notwithstanding all rights hereunder terminate on the Termination Date. If the
Company willfully and knowingly fails to comply with any provision of this Warrant, which results in any material damages to the Holder, the Company shall pay to Holder such amounts as shall be
sufficient to cover any costs and expenses including, but not limited to, reasonable attorneys' fees, including those of appellate proceedings, incurred by Holder in collecting any amounts due
pursuant hereto or in otherwise enforcing any of its rights, powers or remedies hereunder. 

        (d)    NASD Rules.    Notwithstanding anything contained in this Warrant, the terms of this Warrant are intended to
comply with the rules and regulations of the National Association of Securities Dealers, Inc. relating to the compensation of underwriters and placement agents, and any provision of this
Warrant that is determined to be inconsistent with such rules shall be deemed to be modified to the extent necessary to comply with such rules. 

        (e)    Notices.    Any notice, request or other document required or permitted to be given or delivered to the Holder
by the Company shall be delivered in accordance with the notice provisions of the Purchase Agreement; provided upon any permitted assignment of this Warrant, the assignee shall promptly provide the
Company with its contact information. 

        (f)    Limitation of Liability.    No provision hereof, in the absence of any affirmative action by Holder to exercise
this Warrant or purchase Warrant Shares, and no enumeration herein of the rights or privileges of Holder, shall give rise to any liability of Holder for the purchase price of any Common Stock or as a
stockholder of the Company, whether such liability is asserted by the Company or by creditors of the Company. 

        (g)    Remedies.    Holder, in addition to being entitled to exercise all rights granted by law, including recovery of
damages, will be entitled to specific performance of its rights under this Warrant. The Company agrees that monetary damages would not be adequate compensation for any loss incurred by reason of a
breach by it of the provisions of this Warrant and hereby agrees to waive the defense in any action for specific performance that a remedy at law would be adequate. 

7

 

        (h)    Successors and Assigns.    Subject to applicable securities laws, this Warrant and the rights and obligations
evidenced hereby shall inure to the benefit of and be binding upon the successors of the Company and the successors and permitted assigns of Holder. The provisions of this Warrant are intended to be
for the benefit of all Holders from time to time of this Warrant and shall be enforceable by any such Holder or holder of Warrant Shares. 

        (i)    Amendment.    This Warrant may be modified or amended or the provisions hereof waived with the written consent
of the Company and the Holder; provided, however, if this Warrant is subsequently transferred to other
Persons, this Warrant may be modified or amended or the provisions hereof waived with the written consent of such transferees (and the original Holder if such Holder holds any part of the Warrant at
such time) holding Warrant(s) exercisable into a majority of the Warrant Shares then issuable under the Warrants derived from the initial Warrant. 

        (j)    Severability.    Wherever possible, each provision of this Warrant shall be interpreted in such manner as to be
effective and valid under applicable law, but if any provision of this Warrant shall be prohibited by or invalid under applicable law, such provision shall be ineffective to the extent of such
prohibition or invalidity, without invalidating the remainder of such provisions or the remaining provisions of this Warrant. 

        (k)    Headings.    The headings used in this Warrant are for the convenience of reference only and shall not, for any
purpose, be deemed a part of this Warrant. 

******************** 

8

 

        IN
WITNESS WHEREOF, the Company has caused this Warrant to be executed by its officer thereunto duly authorized. 

Dated:
June 30, 2003 

	 	 	AKSYS, LTD
	

 	
 	

By:	

/s/  LAWRENCE D. DAMRON      
 Name: Lawrence D. Damron

Title: Senior Vice President and CFO

9

 
 

NOTICE OF EXERCISE    
    

	To:
	Aksys, Ltd

        (1)   The
undersigned hereby elects to purchase            Warrant Shares of Aksys, Ltd pursuant to the terms of the attached Warrant (only if exercised in full),
and tenders herewith payment of the exercise price in full, together with all applicable transfer taxes, if any. 

        (2)   Please
issue a certificate or certificates representing said Warrant Shares in the name of the undersigned or in such other name as is specified below: 

The
Warrant Shares shall be delivered to the following DTC account: 

   

   

	 	 	ROTH CAPITAL PARTNERS, LLC
	

 	
 	

By:	

    
 Name:

Title:
	

Dated:	

    

 
 

ASSIGNMENT FORM    
    

(To
assign the foregoing warrant, execute

this form and supply required information.

Do not use this form to exercise the warrant.) 

        FOR
VALUE RECEIVED, the foregoing Warrant and all rights evidenced thereby are hereby assigned to 

___________________________________________
whose address is 

_________________________________________________________

_________________________________________________________

Dated:
_________, ____ 

Holder's
Signature:
________________________                                     
                     
 

Holder's
Address:
________________________                                     
                     

________________________                                    
                      

Signature
Guaranteed: ______________________________________ 

NOTE:
The signature to this Assignment Form must correspond with the name as it appears on the face of the Warrant, without alteration or enlargement or any change whatsoever, and must be guaranteed
by a bank or trust company. Officers of corporations and those acting in a fiduciary or other representative capacity should file proper evidence of authority to assign the foregoing Warrant. 

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Exhibit 4.2

COMMON STOCK PURCHASE WARRANT

Aksys, Ltd

NOTICE OF EXERCISE

ASSIGNMENT FORMQuickLinks
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Exhibit 10.1    
    

 
 

SUBSCRIPTON AGREEMENT    
    

        This subscription (this "Subscription") is dated June 30, 2003 between Aksys, Ltd.
("Buyer") and The Riverview Group, LLC ("Seller"), whereby the parties agree as follows: 

1.    Subscription.    

	a)
	On
the date hereof, the Buyer shall buy and the Seller agrees to sell and issue to the Buyer 1,363,637 shares of the Seller's common stock (the
"Shares") for a per share purchase price of $11.00 and a warrant (the "Warrant"), in the form of  Exhibit A attached hereto, to purchase up to 204,546 shares of the Seller's common stock, on the date hereof, for an aggregate purchase price of
$15,000,000 (the "Purchase Price").

	b)
	The
Shares and Warrant have been registered on a Form S-3, File No. 333-100557, which registration statement (the
"Registration Statement") has been declared effective by the Securities and Exchange Commission, has remained effective since such date and is effective
on the date hereof.

	c)
	On
the date hereof, the Seller shall deliver the Shares to the Buyer via the Depository Trust Company's ("DTC") Deposit Withdrawal Agent
Commission ("DWAC") system via the DTC instructions set forth on the signature page hereto. Upon receipt of the Shares into the Buyer's DTC account, the
Buyer shall have wire the Purchase Price, less $20,000 for Buyer's legal and administrative costs and expenses, to the Seller pursuant to the wire instructions set forth below. Within 3 business days
of the date hereof, the Seller shall deliver the Warrant to the Buyer. The Shares, Warrant and the shares of common stock issuable upon exercise of the Warrant shall be, when issued, unlegended and
free of any resale restrictions. Both parties hereby agree and acknowledge that delivery of the Shares via DTC's DWAC system is a material obligation of the Seller and furthermore, with respect to
each party's obligations hereunder, time is of the essence. 

2.    Seller Representations and Warranties.    The Seller represents and warrants that: (a) it has full right, power and
authority to enter into this Subscription and to perform all of its obligations hereunder; (b) this Subscription has been duly authorized and executed by and constitutes a valid and binding
agreement of the Seller enforceable in accordance with its terms; (c) the execution and delivery of this Subscription and the consummation of the transactions contemplated hereby do not
conflict with or result in a breach of (i) the Seller's certificate of incorporation or by-laws, or (ii) any agreement to which the Seller is a party or by which any of its
property or assets is bound; (d) the Shares and Warrant are duly and validly issued and outstanding fully paid and non-assessable, and, with respect to the Shares (and any shares
issued upon exercise of the Warrant), the Buyer is (or, in the case of shares issued upon exercise of the Warrant, will be) entitled to all rights accorded to a holder of the Seller's common stock;
and (e) the Registration Statement and the final prospectus included therein do not contain any untrue statement of a material fact or omit to state any material fact required to be stated
therein or necessary in order to make the statements therein not misleading in light of the circumstances under which they were made. 

3.    Buyer Representations and Warranties.    The Buyer represents and warrants that: (a) it has full right, power and
authority to enter into this Subscription and to perform all of its obligations hereunder; (b) this Subscription has been duly authorized and executed by and constitutes a valid and binding
agreement of the Buyer enforceable in accordance with its terms; (c) the execution and delivery of this Subscription and the consummation of the transactions contemplated hereby do not conflict
with or result in a breach of (i) the Buyer's certificate of incorporation or by-laws, or (ii) any agreement to which the Buyer is a party or by which any of its property or
assets is bound; and (d) on June 27, 2003, 

1

 

the
Buyer did not then hold a short position in the Seller's common stock by means of any "short sales", as that term is defined in applicable Securities and Exchange Commission and NASD rules. 

4.    Notice.    All communications hereunder, except as may be otherwise specifically provided herein, shall be in writing and
shall be mailed, hand delivered, sent by a recognized overnight courier service such as Federal Express, or sent via facsimile and confirmed by letter, to the party to whom it is addressed at the
following addresses or such other address as such party may advise the other in writing: 

        To
the Seller:        as set forth on the signature page hereto. 

        To
the Buyer:        as set forth on the signature page hereto. 

        All
notices hereunder shall be effective upon receipt by the party to which it is addressed. 

5.    Jurisdiction.    This Agreement shall be governed by and interpreted in accordance with the laws of the State of New York for
contracts to be wholly performed in such state and without giving effect to the principles thereof regarding the conflict of laws. Each of the parties consents to the exclusive jurisdiction of the
federal courts whose districts encompass any part of the City of New York or the state courts of the State of New York sitting in the City of New York in connection with any dispute arising under this
Agreement and hereby waives, to the maximum extent permitted by law, any objection based on forum non conveniens, to the bringing of any such proceeding in such jurisdiction. To the extent determined
by such court, the prevailing party shall reimburse the other party for any reasonable legal fees and disbursements incurred in enforcement of, or protection of any of its rights under this Agreement. 

6.    Miscellaneous.    

	a)
	This
Subscription constitutes the entire understanding and agreement between the parties with respect to its subject matter and there are no agreements or understandings with respect
to the subject matter hereof which are not contained in this Subscription. This Subscription may be modified only in writing signed by the party to be charged hereunder.

	b)
	This
Subscription may be executed in any number of counterparts, all of which taken together shall constitute one and the same instrument and shall become effective when counterparts
have been signed by each party and delivered to the other parties hereto, it being understood that all parties need not sign the same counterpart. Execution may be made by delivery by facsimile.

	c)
	The
provisions of this Subscription are severable and, in the event that any court or officials of any regulatory agency of competent jurisdiction shall determine that any one or more
of the provisions or part of the provisions contained in this Subscription shall, for any reason, be held to be invalid, illegal or unenforceable in any respect, such invalidity, illegality or
unenforceability shall not affect any other provision or part of a provision of this Subscription and this Subscription shall be reformed and construed as if such invalid or illegal or unenforceable
provision, or part of such provision, had never been contained herein, so that such provisions would be valid, legal and enforceable to the maximum extent possible, so long as such construction does
not materially adversely effect the economic rights of either party hereto. 

***********************

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        If
the foregoing correctly sets forth our agreement, please confirm this by signing and returning to us the duplicate copy of this letter. 

	 	 	AGREED AND ACCEPTED:
	
Address for Notice:

Two Marriot Drive

Lincolnshire, Illinois 60069

Fax: 1-847-229-2235

Attn: Lawrence D. Damron	
 	

SELLER:

  
 AKSYS, LTD.
	 	 	By:	/s/  LAWRENCE D. DAMRON      
 Name: Lawrence D. Damron

Title: SVP & CFO

Wire Instructions:  

	AGREED AND ACCEPTED:	 	 
	

BUYER:	
 	

 
	
THE RIVERVIEW GROUP, LLC	
 	
Address for Notice:

C/o Millennium Partners, L.P.

666 5th Avenue
	By:	/s/  TERRY FEENEY      
 Name: Terry Feeney

Title: Chief Operating Officer	 	8th Floor

New York, New York 10103

Fax: (212) 841-6302

Attn: Daniel Cardella

DTC Account Instructions:  

3

QuickLinks

Exhibit 10.1

SUBSCRIPTON AGREEMENT

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