Document:

Amended and Restated Voting Agreement

 Exhibit 4.1 
 APPLIED MEDICAL CORPORATION 
 AMENDED AND RESTATED VOTING AGREEMENT

 This Amended and Restated Voting Agreement (as amended, this “Agreement”) is made as of June 25,
2012, by and among Applied Medical Corporation, a Delaware corporation (the “Company”), Said Hilal, Nabil Hilal and Ted Stanley, in their capacities as members of the voting committee described herein (the
“Committee”) and as direct or indirect stockholders of the Company, and the holders of shares of capital stock of the Company and/or stock options therefor listed in the schedule attached hereto (collectively, the
“Participants”). 
 RECITALS 
 WHEREAS, the parties believe that maintaining the Company’s independence (whether as a private or public company) is critical to allowing the Company to continue to advance its core values
and business philosophies and to achieve its long-term strategic objectives; 
 WHEREAS, in furtherance of the foregoing
objectives and the parties’ desire to explore opportunities to accommodate the liquidity requirements of certain other stockholders of the Company, the Participants, the Committee and the Company entered into a Voting Agreement, dated as of
February 24, 2011 (the “Original Voting Agreement”); and 
 WHEREAS, Participants holding more than 66.7%
of the aggregate voting power represented by Subject Securities covered by the Voting Agreement as of the date of this Amended and Restated Voting Agreement, for the purpose of maintaining and protecting the Participants’ efforts to foster the
Company’s core values and business philosophies and its long-term business objectives, desire to amend and restate the Original Voting Agreement as set forth below. 
 AGREEMENT 
 Now, therefore, in consideration of the mutual promises and
covenants hereinafter set forth, the parties hereto agree to amend and restate the Voting Agreement as follows: 
 1.
Definitions. 
 1.1 Certain Definitions. For the purposes of this Agreement: 

“Class A Common Stock” means the Class A Common Stock, par value $0.001 per share, of the Company. 

“Class B Common Stock” means the Class B Common Stock, par value $0.001 per share, of the Company. 

 “Common Stock” means common equity securities of the Company ranking junior
to any series of Preferred Stock with respect to redemption, dividends or liquidation rights, including but not limited to the Class A Common Stock and the Class B Common Stock. 

“Consenting Participants” means Participants who have agreed in writing to this Amended and Restated Voting Agreement or
otherwise agreed in writing to the provisions of Section 5.3 below. 
 “Exchange Act” means the Securities
Exchange Act of 1934, as amended. 
 “Family Member” means, with respect to any natural person who is a
Participant, the spouse, parents, grandparents, and lineal descendants, siblings and lineal descendants of siblings of such Participant. 
 “Initial Public Offering” means an initial public offering of any shares of Common Stock of the Company pursuant to a registration statement under the Securities Act. 

“Majority of Subject Securities” means more than fifty percent (50%) of the aggregate number of outstanding shares
of Subject Securities held by the relevant Participants, including shares of Preferred Stock of the Company on an as-converted to Class B Common Stock basis. 
 “Permitted Entity” shall mean with respect to a Participant (i) a Permitted Trust (as defined below) solely for the benefit of such Participant, one or more Family Members of such
Participant and/or any other Permitted Entity of such Participant, or (ii) any general partnership, limited partnership, limited liability company, corporation or other entity exclusively owned by one or more Participants, Family Members of
Participants and/or any other Permitted Entities of Participants. 
 “Permitted Transaction” means a Transfer
of Subject Securities (i) by reason of a sale of such Subject Securities in an Initial Public Offering, (ii) by a Participant to one or more Permitted Transferees, (iii) by a Permitted Entity of a Participant to such Participant or
one or more Permitted Transferees, and (iv) a pledge of Subject Securities by a Participant (or a Permitted Entity of such Participant) in favor of the Company to secure a monetary obligation of the Participant to the Company. 

“Permitted Transferee” means (i) the Company, (ii) any Participant, (iii) the Family Members of an
individual Participant, (iv) a Permitted Entity of a Participant, (v) with respect to a Participant which is a Permitted Entity, to one or more individual person(s) who own equity interests in such entity or for whose benefit such entity
was established, and (vi) the heirs, executors, administrators and beneficiaries of a Participant upon the death of an individual Participant; provided, that in the case of clauses (iii), (iv), (v) and (vi), such transferee shall
execute a counterpart signature page to this Agreement in accordance with Section 7.2 thereby agreeing to hold any Subject Securities subject to the terms of this Agreement. 

“Permitted Trust” shall mean a bona fide trust where each trustee is a Participant, a Family Member of such Participant,
or a professional in the business of providing trustee services, including private professional fiduciaries, trust companies and bank trust departments. 

  
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 “Sale Transaction” means any transaction, or series of related
transactions, that could reasonably be expected to result in (i) the acquisition or purchase by a person other than a Participant of all or substantially all of the assets or businesses of the Company, (ii) any merger, reorganization,
consolidation, business combination, recapitalization, joint venture, share exchange or similar transaction, in each case pursuant to which any person other than a Participant would acquire, directly or indirectly, 50% or more of any class of equity
securities of the Company, (iii) the liquidation or dissolution of the Company, or (iv) any combination of the foregoing. 
 “Securities Act” means the Securities Act of 1933, as amended. 

“Subject Securities” means (i) all equity securities of the Company (including all options, warrants and other
rights to acquire any equity securities of the Company) owned by the Participant as of the date they execute a counterpart signature page to this Agreement and (ii) all additional equity securities of the Company (including all options,
warrants and other rights to acquire any equity securities of the Company) with respect to which the Participant acquires direct or indirect ownership or the right to vote or direct the voting of any equity securities after such date (including any
Common Stock into which any equity securities of the Company are convertible). 
 “Transfer” means a sale,
transfer, tender, assignment, encumbrance, gift, pledge, hedge, swap or other disposition, directly or indirectly, of any Subject Securities or any right or interest therein. 
 “Voting Securities” means all Subject Securities that are entitled to vote on any matter presented to the vote or consent of holders of any class of the Company’s equity securities.

 2. Irrevocable Proxy; the Voting Committee. 
 2.1 Irrevocable Proxy. Each Participant hereby appoints and constitutes the Committee, and each of the members thereof, as such Participant’s sole and exclusive attorneys and proxies with full
power of substitution and resubstitution, to the full extent of such Participant’s rights, with respect to all Voting Securities owned by such Participant, which proxy (the “Proxy”) shall be irrevocable until this Agreement
terminates pursuant to its terms, to vote and otherwise act (by written consent or otherwise) with respect to all Voting Securities held by such Participant in the manner directed by the Committee on all matters presented to a vote or consent of the
stockholders of the Company, including with respect to all Sale Transactions, the election and removal of members of the Company’s board of directors and any amendments to the Company’s Certificate of Incorporation or Bylaws. Each
Participant agrees that the Proxy is coupled with an interest. In consideration for the grant of the Proxy, concurrently with the execution and delivery of the Original Voting Agreement, the Committee paid $1.00 to each other Participant, and by its
execution of this Agreement, each of the other Participants acknowledges its receipt of such amount. Each Participant hereby agrees that it will not grant any other proxy with respect to, or grant any other person authority to vote, its shares of
capital stock of the Company. Each Participant further agrees and acknowledges that the Company shall set aside any vote cast by any Participant or any member of the Committee that violates this Section 2.1 and will replace such
Participant’s vote with a vote of the majority of the members of the Committee cast in accordance with the authority granted by the Proxy. 

  
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 2.2 Exceptions. The irrevocable proxy provided to the Committee by Section 2.1
will not apply, and each Participant will retain sole discretion to vote its Voting Securities, with respect to all matters presented to a vote or consent of the Participants of the Company related to any Sale Transaction in which any member of the
Committee is a direct or indirect member of the acquiring group (as defined under Section 13(d) of the Exchange Act) (unless such membership in the acquiring group is solely because the acquiring group includes the Company or any of its
subsidiaries). 
 2.3 No Revocation. The voting agreements contained herein are coupled with an interest and may not be
revoked during the term of this Agreement. 
 2.4 Committee. Approval of the Committee of any matter to be determined by
the Committee pursuant to this Agreement shall require the affirmative vote of at least a majority of the members of the Committee (or the unanimous consent of the members of the Committee if there are fewer than three Committee members at the time
of any Committee decision). In the event of the death, disability or incapacity of a member of the Committee, the remaining member(s) of the Committee shall nominate a replacement Committee member, which proposed Committee member shall become a
Committee member upon written approval of Participants holding a Majority of Subject Securities. 
 3. Representations of the
Participants. Each Participant hereby represents and warrants as follows: 
 3.1 Authorization. The Participant has
the unrestricted right, requisite power and authority to enter into this Agreement and grant the Proxy (as defined below), to consummate the transactions contemplated hereby, and to otherwise carry out such Participant’s obligations hereunder.
The execution and delivery of this Agreement by the Participant and the consummation of the transactions contemplated hereby have been duly authorized by all necessary action on the part of the Participant and no further consent or action is
required, except any applicable Consent of Spouse (as defined below). This Agreement has been duly executed by the Participant and, when delivered in accordance with the terms hereof, will constitute the valid and binding obligation of such
Participant enforceable against the Participant in accordance with its terms. 
 3.2 No Conflicts or Consents.

 (a) The execution, delivery and performance of this Agreement by the Participant do not and will not (i) conflict with,
or constitute a default (or an event that with notice or lapse of time or both would become a default) under, or give to others any rights of termination, amendment, acceleration or cancellation (with or without notice, lapse of time or both) of, or
result (with or without notice or lapse of time) in the creation of any encumbrance or restriction on any of the Subject Securities pursuant to any contract to which the Participant is a party or by which any property or asset of the Participant is
bound or affected, or (ii) result in a violation of any law, in each case that would adversely affect the Participant’s ability to perform any of its obligations hereunder. 

  
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 (b) The execution, delivery and performance of this Agreement by the Participant do not and
will not require any consent or approval of any other person, except any applicable Consent of Spouse. 
 3.3 Title to
Securities. As of the date of this Agreement, the Participant owns (free and clear of any encumbrances, except such as may exist (i) under applicable securities laws or (ii) pursuant to any pledge agreement securing a
Participant’s obligations under a promissory note made by the Participant in favor of the Company) the number and type of securities of the Company set forth in such Participant’s counterpart signature page to this Agreement, none of which
are subject to any proxy, voting trust or other agreement, arrangement or restriction (whether written or oral) with respect to the voting thereof, except as expressly contemplated or permitted by this Agreement or the Original Voting Agreement.

 4. Additional Covenants and Representations. 
 4.1 Legends. 
 (a) Prior to the consummation of an Initial Public Offering,
each certificate representing shares of the Company’s capital stock held by the Participants, or any assignee of the Participants, shall bear the following legend: 
 “THE SHARES EVIDENCED HEREBY ARE SUBJECT TO AN AMENDED AND RESTATED VOTING AGREEMENT BY AND AMONG THE COMPANY AND CERTAIN STOCKHOLDERS OF THE COMPANY (A COPY OF WHICH MAY BE OBTAINED FROM THE
COMPANY) CONTAINING PROVISIONS RESTRICTING THE TRANSFER OF SUCH SHARES, AND SUCH SHARES MAY NOT BE TRANSFERRED OTHER THAN IN ACCORDANCE WITH SUCH PROVISIONS. BY ACCEPTING ANY INTEREST IN SUCH SHARES, THE PERSON ACCEPTING SUCH INTEREST SHALL BE
DEEMED TO AGREE TO AND SHALL BECOME BOUND BY ALL THE PROVISIONS OF SUCH VOTING AGREEMENT.” 
 (b) Following the
consummation of an Initial Public Offering, each certificate representing shares of the Company’s capital stock held by the Participants, or any assignee of the Participants, shall bear the following legend: 

“THE SHARES EVIDENCED HEREBY ARE SUBJECT TO AN AMENDED AND RESTATED VOTING AGREEMENT BY AND AMONG THE COMPANY AND CERTAIN
STOCKHOLDERS OF THE COMPANY (A COPY OF WHICH MAY BE OBTAINED FROM THE COMPANY) CONTAINING PROVISIONS RESTRICTING THE TRANSFER OF SUCH SHARES, AND SUCH SHARES MAY NOT BE TRANSFERRED OTHER THAN IN ACCORDANCE WITH SUCH PROVISIONS.” 

  
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 4.2 Stockholder Capacity. Notwithstanding any provision of this Agreement to the
contrary, no Participant or member of the Committee or any person who owns, directly or indirectly, any capital stock or membership interest in any Participant or any director, officer, trustee, partner, manager or managing member of any
Participant, in each case, who is or becomes during the term of this Agreement a director or officer of the Company will be deemed to make any agreement or understanding in this Agreement in that person’s capacity as a director or officer of
the Company. This Agreement is being entered into by each Participant and each member of the Committee solely in its capacity as the record holder and beneficial owner of such Participant’s Subject Securities, and nothing in this Agreement will
limit or affect any actions taken by any Participant, any person who owns, directly or indirectly, any capital stock or membership interest in any Participant or any director, officer, manager or managing member of any Participant in his or her
capacity as a director or officer of the Company. 
 4.3 No Other Duties. Each Participant expressly agrees and
acknowledges that: (i) this Agreement does not give rise to any duties or obligations not expressly set forth in this Agreement, including without limitation, any implied obligations or duties whether by the covenant of good faith and fair
dealing or otherwise; and (ii) the duties created by this Agreement are strictly contractual in nature and do not create any non-contractual duties or obligations, whether of a fiduciary nature or otherwise. Moreover, each Participant expressly
acknowledges that by executing this Agreement such Participant is granting the Committee sole subjective discretion to vote such Participant’s Voting Securities as set forth in this Agreement. Each Participant agrees and acknowledges that in
exercising the voting rights granted pursuant to this Agreement, each of the members of the Committee shall be entitled to consider only such interests and factors, including their own, as they desire or deem appropriate, and he shall have no duty
or obligation to consider any other interests or factors whatsoever. To the fullest extent permitted by the law, each Participant hereby waives any claim for any breach of fiduciary or any other duty that such Participant may have now or in the
future against any or all of the members of the Committee in connection with their exercise of the authority granted pursuant to this Agreement and disclaims the benefit of any covenant of good faith or fair dealing as well as any other legal or
equitable doctrine that might otherwise permit the Participant to challenge the Committee’s ability or right to vote all Voting Securities in accordance with the terms of this Agreement as it deems appropriate in the sole subjective discretion
of the members of the Committee. 
 4.4 Waiver. Each Participant expressly acknowledges that it has had, or has had and
waived, the opportunity to be advised by independent legal counsel and hereby waives and relinquishes all rights and benefits afforded by, and does so understanding and acknowledging the significance and consequence of such specific waiver of, any
applicable statute or common law similar in nature Section 1542 of the California Civil Code, which provides: 
 A GENERAL
RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE CREDITOR DOES NOT KNOW OR SUSPECT TO EXIST IN HIS FAVOR AT THE TIME OF EXECUTING THE RELEASE, WHICH IF KNOWN BY HIM MUST HAVE MATERIALLY AFFECTED THE SETTLEMENT WITH THE DEBTOR. 

  
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 5. Certain Restrictions. 

5.1 Pre-Initial Public Offering. Prior to the consummation of an Initial Public Offering, each Participant agrees that it will not
Transfer any Subject Securities other than Transfers in connection with a Permitted Transaction. A transferee (other than the Company or a Participant already bound hereby) of Subject Securities received in a Transfer that is a Permitted Transaction
prior to the consummation of an Initial Public Offering shall become a Stockholder subject to this Agreement. 
 5.2 Lock-up
Agreement. Each Participant hereby further agrees not to Transfer any Subject Securities (other than those included in the registration statement filed in connection with an Initial Public Offering or otherwise in a Permitted Transaction) until
the expiration of the 180-day period following the effective date of the registration statement for the Initial Public Offering. Each Participant further agrees to execute and deliver such other agreements as may reasonably be requested by the
Company and the underwriter(s) which are consistent with the foregoing or which are necessary to give effect thereto (a “Lockup Agreement”). The foregoing provisions of this Section 5.2 do not apply to Consenting Participants.

 5.3 Post-Initial Public Offering. From and after the consummation of an Initial Public Offering, each Participant may
Transfer any Subject Securities without restriction under this Agreement and in accordance with applicable securities laws except (i) in violation of a Lockup Agreement, (ii) if a Consenting Participant Transfers any shares of Class B
Common Stock to a transferee other than a Permitted Transferee, such Consenting Participant hereby irrevocably elects that such shares of Class B Common Stock be converted into shares of Class A Common Stock prior to the Transfer thereof, in
accordance with the terms of the Class B Common Stock set forth in the Company’s certificate of incorporation, as amended or restated as of the date of Transfer, and (iii) each Participant agrees not to Transfer any Subject Securities in
connection with any tender offer that could reasonably be expected to result in any person other than a Participant acquiring, directly or indirectly, 50% or more of any class of equity securities of the Company (a “Tender Offer”)
unless the Committee approves the tender of Subject Securities in connection with such Tender Offer; provided, in the case of clause (iii), that no member of the Committee is a direct or indirect member of the acquiring group (as defined
under Section 13(d) of the Exchange Act) (unless such membership in the acquiring group is solely because the acquiring group includes the Company or any of its subsidiaries) in such Tender Offer. The Committee will notify each Participant of
its decision whether or not to permit the tender of such Participant’s shares in connection with any Tender Offer in writing no later than five (5) business days prior to the deadline for tendering shares in such Tender Offer. 

6. Termination of Agreement. This Agreement shall terminate on June 30, 2017. 

  
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 7. Miscellaneous. 

7.1 Assignment; Binding Effect. The terms and conditions of this Agreement shall inure to the benefit of, and be binding upon, the
respective successors and assigns of the parties hereto. Nothing in this Agreement, express or implied, is intended to confer upon any party other than the parties hereto or their respective successors and assigns, any rights, remedies, obligations,
or liabilities under or by reason of this Agreement, except as expressly provided in this Agreement. 
 7.2 Additional
Participants. Any holder of equity securities of the Company, whether such holder owns such securities as of the date hereof or acquires such securities from the Company after the date hereof (each, an “Additional Participant”)
may become a party to this Agreement after the date hereof without the consent of any of the other parties hereto by executing a counterpart signature page to this Agreement. As a condition to becoming a party to this Agreement, each Additional
Participant agrees (i) that it shall be deemed to be a “Participant” for all purposes under this Agreement, subject to and bound by all of the terms and conditions applicable to a “Participant” under this Agreement, and
(ii) to irrevocably terminate and waive all voting or similar rights applicable to any Subject Securities held by such Additional Participant pursuant to any agreement or understanding of any kind other than those contained in this Agreement,
such termination and waiver to be effective immediately upon such Additional Participant’s execution of this Agreement. The Company shall update the list of Participants from time to time to reflect the addition of any Additional Participants
pursuant to this Section 7.2. Any update to such list of Participants or the joining of any Additional Participant as a party to this Agreement pursuant to this Section 7.2 shall not require the consent of, or notice to, any of the parties
to this Agreement. Any transfer or assignment of any Subject Securities in violation of this Section 7.2 shall be void and be of no force or effect. 
 7.3 Amendment and Waiver. Any provision set forth in Section 5 may be waived at any time in writing by approval of the Committee in its sole discretion. Any term hereof may be amended only
with the written consent of (a) the Company and (b) Participants holding Sixty Six and 7/10 percent (66.7%) of the aggregate voting power represented by the Subject Securities covered by this Agreement at the time of the
relevant amendment (excluding, for the avoidance of doubt, options and warrants to acquire equity securities of the Company that do not possess voting rights prior to exercise); provided, however, that the consent of the Company under this
Section 7.3 shall not be required for any amendments to Section 2 or Sections 5.1 or 5.3. Any amendment or waiver effected in accordance with this Section 7.3 shall be binding upon the Participants, the Company and each of their
respective successors and assigns. 
 7.4 Notices. All notices and other communications required or permitted hereunder
shall be in writing and shall be deemed effectively given (i) upon actual delivery to the party to be notified, (ii) one business day after sending by email if such email was transmitted on a business day, (iii) 24 hours after
confirmed facsimile transmission, (iv) one business day after deposit with a recognized overnight courier, or (v) three business days after deposit with the U.S. Postal Service by first class certified or registered mail, return receipt
requested, postage prepaid, addressed (a) if to a Participant, at such address as set forth on the signature page of such Participant hereto, or (b) if to the Company, at 22872 Avenida Empresa, Rancho Santa Margarita, CA 92688, Attention:
General Counsel, or at such other address as the Company shall have furnished to the Participants in writing upon 10 days’ notice. 

  
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 7.5 Severability. If one or more provisions of this Agreement are held to be
unenforceable under applicable law, the parties agree to renegotiate such provision in good faith. In the event that the parties cannot reach a mutually agreeable and enforceable replacement for such provision, then (i) such provision shall be
excluded from this Agreement, (ii) the balance of the Agreement shall be interpreted as if such provision were so excluded and (iii) the balance of the Agreement shall be enforceable in accordance with its terms. 

7.6 Construction. The headings herein are for convenience of reference only, do not constitute a part of this Agreement and shall
not be deemed to limit or affect any of the provisions hereof. Whenever the words “include,” “includes” or “including” are used in this Agreement, they shall be deemed to be followed by the words “without
limitation.” The words “hereof,” “herein” and “hereunder” and words of similar import when used in this Agreement shall refer to this Agreement as a whole and not to any particular provision of this Agreement. The
definitions contained in this Agreement are applicable to the singular as well as the plural forms of such terms and to the masculine as well as to the feminine and neuter genders of such term. All parties hereto have participated in the drafting of
this Agreement, the language used in this Agreement will be deemed to be the language chosen by the parties to express their mutual intent, and no rules of strict construction will be applied against any party. 

7.7 Governing Law. This Agreement and all acts and transactions pursuant hereto and the rights and obligations of the parties
hereto shall be governed, construed and interpreted in accordance with the laws of the State of Delaware, without giving effect to principles of conflicts of law. 
 7.8 Stock Splits, Stock Dividends, etc. In the event of any issuance of shares of the Company’s capital stock hereinafter to any of the parties hereto (including, without limitation, in
connection with any stock split, stock dividend, recapitalization, reorganization or the like), such shares shall become subject to this Agreement and shall be endorsed with the legend set forth in Section 4.1 hereof. 

7.9 Entire Agreement; No Inconsistent Agreements. This Agreement, together with all exhibits and schedules hereto, is intended to
be the sole agreement and understanding of the parties as it relates to this subject matter and does hereby supersede any and all prior negotiations, correspondence, agreements, understandings, duties or obligations between the parties relating to
the subject matter hereof. Each Participant hereby covenants and agrees to not enter into any agreement or understanding with any party the effect of which would be inconsistent with or would violate any provision of this Agreement. 

7.10 Counterparts. This Agreement may be executed in one or more counterparts, each of which shall be deemed an original and all
of which together shall constitute one instrument. 
 7.11 Specific Performance and Equitable Remedies. The parties
hereto agree that irreparable harm would occur in the event that any of the provisions of this Agreement were 

  
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not performed fully by the parties hereto in accordance with their specific terms or conditions or were otherwise breached and that money damages are an inadequate remedy for breach of this
Agreement because of the difficulty of ascertaining and quantifying the amount of damages that will be suffered by the parties hereto in the event that this Agreement is not performed in accordance with its terms or conditions or is otherwise
breached. It is accordingly hereby agreed that the parties hereto shall be entitled to an injunction or injunctions and any other equitable relief necessary to restrain, enjoin and prevent breaches of this Agreement by the other parties and to
enforce specifically such terms and provisions of this Agreement exclusively in the Chancery Court of the State of Delaware, such remedy being in addition to and not in lieu of, any other rights and remedies to which the other parties are entitled
to at law or in equity. Each party on their behalf as well as on behalf of any successors or assigns hereby consents to the exclusive jurisdiction of the Delaware Court of Chancery over themselves and this Agreement for the purpose of enforcing this
Agreement under this Section 7.11. 
 7.12 Expenses. If any action at law or in equity is necessary to enforce or
interpret the terms of this Agreement, the prevailing party shall be entitled to reasonable attorney’s fees, costs and necessary disbursements in addition to any other relief to which such party may be entitled. 

7.13 Arbitration. Subject to Section 7.11 above, any dispute, claim or controversy arising out of or relating to this
Agreement or the breach, termination, enforcement, interpretation or validity thereof, including the determination of the scope or applicability of this agreement to arbitrate, shall be determined by arbitration in Orange County, California, before
three arbitrators. The arbitration shall be administered by JAMS pursuant to its Comprehensive Arbitration Rules and Procedures. Judgment on the arbitration award may be entered in any court having jurisdiction. This clause shall not preclude
parties from seeking provisional remedies in aid of arbitration from the Delaware Court of Chancery pursuant to Section 7.11 above. The arbitrators may, in the arbitration award, allocate all or part of the costs of the arbitration, including
the fees of the arbitrators and the reasonable attorneys’ fees of the prevailing party. The parties to any arbitration shall be entitled to appeal the arbitration award to a three-member appeal panel in accordance with the JAMS Optional
Arbitration Appeal Procedure. 
 7.14 Spousal Consent. If any individual Participant is married on the date of this
Agreement, such Participant’s spouse shall execute and deliver to the Committee a consent of spouse in the form attached hereto (the “Consent of Spouse”), effective on the date hereof. Notwithstanding the execution and delivery
thereof, such consent shall not be deemed to confer or convey to the spouse any rights in such Participant’s Subject Securities that do not otherwise exist by operation of law or the agreement of the parties. If any individual Participant
should marry or remarry subsequent to the date of this Agreement, such Participant shall within fifteen days thereafter obtain his or her new spouse’s acknowledgement of and consent to the existence and binding effect of all restrictions
contained in this Agreement by causing such spouse to execute and deliver a Consent of Spouse acknowledging the restrictions and obligations contained in this Agreement and agreeing and consenting to the same. 

  
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 7.15 Company Approval. The Company hereby consents to the amendments to
Section 1, Section 5.2 and Section 6 of the Original Voting Agreement made by this Amended and Restated Voting Agreement. 
 [Remainder of page intentionally left blank] 

  
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 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as
of the date first written above. 
  

			
	COMPANY (with respect to amendments to Sections 1, 5.2 and 6 of the Original Voting Agreement only):
	
	APPLIED MEDICAL CORPORATION
		
	By:	 	 /s/ Said S. Hilal

	Name:	 	Said S. Hilal
	Title:	 	Chief Executive Officer
	
	VOTING COMMITTEE:
	
	 /s/ Said S. Hilal

	Said S. Hilal, Member of Voting Committee
	
	 /s/ Nabil Hilal

	Nabil Hilal, Member of Voting Committee
	
	 /s/ Ted Stanley

	Ted Stanley, Member of Voting Committee

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Susan Ahlberg

		
	Print Name(s):	 	 Susan Ahlberg

	
	 /s/ Russ Ahlberg

		
	Print Name(s):	 	 Russ Ahlberg

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Jeremy Albrecht

		
	Print Name(s):	 	 Jeremy Albrecht

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Wassim Aliahmad

		
	Print Name(s):	 	 Wassim Aliahmad

	
	 /s/ Samara Aliahmad

		
	Print Name(s):	 	 Samara Aliahmad

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Entities) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	 AMC FAMILY HOLDINGS A, LLC,
 a Delaware limited liability company

	
	 By: AMC Family Management A, Inc.,
 a Delaware corporation

			
		 	By:	 	 /s/ Said S. Hilal

		 	Name:	 	Said S. Hilal
		 	Title:	 	President

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Entities) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	 AMC FAMILY HOLDINGS B, LLC,
 a Delaware limited liability company

	
	 By: AMC Family Management B, Inc.,
 a Delaware corporation

			
		 	By:	 	 /s/ Nabil Hilal

		 	Name:	 	Nabil Hilal
		 	Title:	 	President

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Entities) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	 AMC FAMILY HOLDINGS C, LLC,
 a Delaware limited liability company

	
	 By: AMC Family Management C, Inc.,
 a Delaware corporation

			
		 	By:	 	 /s/ Samir Tall Hilal

		 	Name:	 	Samir Tall
		 	Title:	 	President

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Entities) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	 AMC FAMILY HOLDINGS D, LLC,
 a Delaware limited liability company

	
	 By: AMC Family Management D, Inc.,
 a Delaware corporation

			
		 	By:	 	 /s/ Dima Hilal

		 	Name:	 	Dima Hilal
		 	Title:	 	President

  
 [Signature
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 COUNTERPART SIGNATURE PAGE 

(Securities held by Entities) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	 AMC FAMILY HOLDINGS E, LLC,
 a Delaware limited liability company

	
	 By: AMC Family Management E, Inc.,
 a Delaware corporation

			
		 	By:	 	 /s/ Serene Wachli

		 	Name:	 	Serene Wachli
		 	Title:	 	President

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Entities) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	 PARTICIPANT:

 

	AMC FAMILY HOLDINGS F, LLC,
	 a Delaware limited liability company

 

	By: AMC Family Management F, Inc.,
	 a Delaware corporation

 

		 	By:	 	 /s/ Gary Johnson

		 	Name:	 	Gary Johnson
		 	Title:	 	President

  
 [Signature
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 COUNTERPART SIGNATURE PAGE 

(Securities held by Entities) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	 PARTICIPANT:

 

	AMC FAMILY HOLDINGS G, LLC,
	 a Delaware limited liability company

 

	By: AMC Family Management G, Inc.,
	 a Delaware corporation

 

		 	By:	 	 /s/ Stephen E. Stanley

		 	Name:	 	Stephen E. Stanley
		 	Title:	 	President

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Entities) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	AMC FAMILY HOLDINGS H, LLC,
	a Delaware limited liability company
	
	By: AMC Family Management H, Inc.,
	a Delaware corporation
			
		 	By:	 	 /s/ Mary Jo Stegwell

		 	Name:	 	Mary Jo Stegwell
		 	Title:	 	President

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Entities) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	AMC FAMILY HOLDINGS I, LLC,
	a Delaware limited liability company
	
	By: AMC Family Management I, Inc.,
	a Delaware corporation
			
		 	By:	 	 /s/ Samir Tall

		 	Name:	 	Samir Tall
		 	Title:	 	Authorized Officer

  
 [Signature
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 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Laurina Bai

		
	Print Name(s):	 	 Laurina Bai

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
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 COUNTERPART SIGNATURE PAGE 

(Securities held by Trusts) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	Insert full name of Trust:
	
	Peter E. Bolta 1999 Revocable Living Trust
			
	By:	 	 /s/ Peter E. Bolta
	 	, Trustee
	Name:	 	Peter E. Bolta	 	
			
	By:	 	  
	 	, Trustee
	Name:	 		 	
	
	(Please arrange for signatures of all Trustees of the Trust)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Sherry Castillo

		
	Print Name(s):	 	 Sherry Castillo

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Heather C. Chase

		
	Print Name(s):	 	 Heather C. Chase

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
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 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Cathy L. Conklin

		
	Print Name(s):	 	 Cathy L. Conklin

	
	 /s/ Richard W. Conklin

		
	Print Name(s):	 	 Richard W. Conklin

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Sheri A. Dando

		
	Print Name(s):	 	 Sheri A. Dando

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Trusts) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	Insert full name of Trust:
	
	DeMarchi Living Trust dated February 4, 1998
			
	By:	 	 /s/ Thomas DeMarchi
	 	, Trustee
	Name:	 	Thomas DeMarchi	 	
			
	By:	 	 /s/ Joanne DeMarchi
	 	, Trustee
	Name:	 	Joanne DeMarchi	 	
	
	(Please arrange for signatures of all Trustees of the Trust)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ John Donohue

		
	Print Name(s):	 	 John Donohue

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Trusts) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	Insert full name of Trust:
	
	The Robert and Nancy Jane Felsenfeld Trust, as Restated November 16, 2006
			
	By:	 	 /s/ Nancy Felsenfeld
	 	, Trustee
	Name:	 	Nancy Felsenfeld	 	
			
	By:	 	 /s/ Robert Felsenfeld
	 	, Trustee
	Name:	 	Robert Felsenfeld	 	
	
	(Please arrange for signatures of all Trustees of the Trust)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Dennis Fowler

		
	Print Name(s):	 	 Dennis Fowler

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Raymond A. Frame

		
	Print Name(s):	 	 Raymond A. Frame

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Raymond C. Frame

		
	Print Name(s):	 	 Raymond C. Frame

	
	 /s/ Arlene A. Frame

		
	Print Name(s):	 	 Arlene A. Frame

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Trusts) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	Insert full name of Trust:
	
	The Gadberry Family Trust
			
	By:	 	 /s/ Donald Lee Gadberry
	 	, Trustee
	Name:	 	Donald Lee Gadberry	 	
			
	By:	 	 /s/ Arlene Rae Gadberry
	 	, Trustee
	Name:	 	Arleen Rae Gadberry	 	
	
	(Please arrange for signatures of all Trustees of the Trust)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Amy Garces

		
	Print Name(s):	 	 Amy Garces

	
	 /s/ Maxwell Garces

		
	Print Name(s):	 	 Maxwell Garces

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Karen A. Gibbs

		
	Print Name(s):	 	 Karen A. Gibbs

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Dennis Grosshans

		
	Print Name(s):	 	 Dennis Grosshans

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Carl Hadley

		
	Print Name(s):	 	 Carl Hadley

	
	 /s/ Gabrielle Hadley

		
	Print Name(s):	 	 Gabrielle Hadley

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Charles Hart

		
	Print Name(s):	 	 Charles Hart

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ David Heaton II

		
	Print Name(s):	 	 David Heaton II

	
	 /s/ Melissa K. Heaton

		
	Print Name(s):	 	 Melissa K. Heaton

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Thomas C. Hoster

		
	Print Name(s):	 	 Thomas C. Hoster

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Ahmad Husami

		
	Print Name(s):	 	 Ahmad Husami

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Patrick Ikehara

		
	Print Name(s):	 	 Patrick Ikehara

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Bassam Istanbouli

		
	Print Name(s):	 	 Bassam Istanbouli

	
	 /s/ Sahar Istanbouli

		
	Print Name(s):	 	 Sahar Istanbouli

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Houssam Istanbouli

		
	Print Name(s):	 	 Houssam Istanbouli

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Tala Istanbouli

		
	Print Name(s):	 	 Tala Istanbouli

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ James R. Johnson

		
	Print Name(s):	 	 James R. Johnson

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Trusts) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	Insert full name of Trust:
	
	The Kahle Family Trust dated May 1, 2007
			
	By:	 	 /s/ Henry Kahle
	 	, Trustee
	Name:	 	Henry Kahle	 	
			
	By:	 	 /s/ Julia L. Kahle
	 	, Trustee
	Name:	 	Julia L. Kahle	 	
	
	(Please arrange for signatures of all Trustees of the Trust)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Trusts) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	Insert full name of Trust:
	
	The Kasten Family Trust Agreement
			
	By:	 	 /s/ Thomas M. Kasten
	 	, Trustee
	Name:	 	Thomas M. Kasten	 	
			
	By:	 	 /s/ Kendra Kasten
	 	, Trustee
	Name:	 	Kendra Kasten	 	
	
	(Please arrange for signatures of all Trustees of the Trust)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Ken Lacoste

		
	Print Name(s):	 	 Ken Lacoste

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Entities) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	PENSION PLAN OF ROBERT A. LAUDERDALE M.D.
		
	By:	 	 /s/ Robert A. Lauderdale

	Name:	 	Robert A. Lauderdale

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Entities) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	ROBERT A. LAUDERDALE FAMILY LIMITED PARTNERSHIP
		
	By:	 	 /s/ Robert A. Lauderdale

	Name:	 	Robert A. Lauderdale
	Title:	 	General Partner
		
	By:	 	 /s/ Joanne W. Lauderdale

	Name:	 	Joanne W. Lauderdale
	Title:	 	General Partner
	
	(Please arrange for signatures of all General Partners)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Kimberlee Ann Lauletta

		
	Print Name(s):	 	 Kimberlee Ann Lauletta

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Grant Lenning

		
	Print Name(s):	 	 Grant Lenning

	
	 /s/ Natali Lenning

		
	Print Name(s):	 	 Natali Lenning

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Mitra Lutchmansingh

		
	Print Name(s):	 	 Mitra Lutchmansingh

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Greg Mahoney

		
	Print Name(s):	 	 Greg Mahoney

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Wael Muakkassa

		
	Print Name(s):	 	 Wael Muakkassa

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ David Nader

		
	Print Name(s):	 	 David Nader

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ George Y. Nader

		
	Print Name(s):	 	 George Y. Nader

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Samir N. Nader

		
	Print Name(s):	 	 Samir N. Nader

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Eric Nguyen

		
	Print Name(s):	 	 Eric Nguyen

	
	 /s/ Hannah Nguyen

		
	Print Name(s):	 	 Hannah Nguyen

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Trusts) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	Insert full name of Trust:
	
	Manaktala-Petrime Family Trust
			
	By:	 	 /s/ Matt Petrime
	 	, Trustee
	Name:	 	Matt Petrime	 	
			
	By:	 	 /s/ Shalini Manaktala
	 	, Trustee
	Name:	 	Shalini Manaktala	 	
	
	(Please arrange for signatures of all Trustees of the Trust)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Edward D. Pingleton

		
	Print Name(s):	 	 Edward D. Pingleton

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Boun Pravong

		
	Print Name(s):	 	 Boun Pravong

	
	 /s/ Natalie Pravong

		
	Print Name(s):	 	 Natalie Pravong

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Trusts) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

					
	PARTICIPANT:
	
	Insert full name of Trust:
	
	Stephen G. Roth and Michelle E. Roth Revocable Living Trust
			
	By:	 	 /s/ Stephen G. Roth
	 	, Trustee
	Name:	 	Stephen G. Roth	 	
			
	By:	 	 /s/ Michelle E. Roth
	 	, Trustee
	Name:	 	Michelle E. Roth	 	
	
	(Please arrange for signatures of all Trustees of the Trust)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Ghassan Sakakine

		
	Print Name(s):	 	 Ghassan Sakakine

	
	 /s/ Rindala Tannir

		
	Print Name(s):	 	 Rindala Tannir

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Darren Sax

		
	Print Name(s):	 	 Darren Sax

	
	 /s/ Kimberly Sax

		
	Print Name(s):	 	 Kimberly Sax

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Fazlia Seraj

		
	Print Name(s):	 	 Fazlia Seraj

	
	 /s/ M. Ali Seraj

		
	Print Name(s):	 	 M. Ali Seraj

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Garth O. Smithers

		
	Print Name(s):	 	 Garth O. Smithers

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Karen J. Stegwell

		
	Print Name(s):	 	 Karen J. Stegwell

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Arpad Szabo

		
	Print Name(s):	 	 Arpad Szabo

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Samer Tall

		
	Print Name(s):	 	 Samer Tall

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Jenny Tang

		
	Print Name(s):	 	 Jenny Tang

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Scott Taylor

		
	Print Name(s):	 	 Scott Taylor

	
	 /s/ Steffay Taylor

		
	Print Name(s):	 	 Steffay Taylor

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Canh Tran

		
	Print Name(s):	 	 Canh Tran

	
	 /s/ Vicki Pham

		
	Print Name(s):	 	 Vicki Pham

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Bao-Liang Tsai

		
	Print Name(s):	 	 Bao-Liang Tsai

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Frans VandenBroek

		
	Print Name(s):	 	 Frans VandenBroek

	
	 /s/ Karen L. VandenBroek

		
	Print Name(s):	 	 Karen L. VandenBroek

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Michael Vaughn

		
	Print Name(s):	 	 Michael Vaughn

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Matthew Wixey

		
	Print Name(s):	 	 Matthew Wixey

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Gail P. Wooldridge

		
	Print Name(s):	 	 Gail P. Wooldridge

	
	 /s/ Craig Wooldridge

		
	Print Name(s):	 	 Craig Wooldridge

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 COUNTERPART SIGNATURE PAGE 

(Securities held by Individuals) 
 IN WITNESS WHEREOF, the parties have executed this Amended and Restated Voting Agreement as of the date first written above. 

 

			
	PARTICIPANT:
	
	 /s/ Haruyasu Yawata

		
	Print Name(s):	 	 Haruyasu Yawata

	
	  

		
	Print Name(s):	 	  

	
	(If securities are held jointly by two persons, such as husband and wife, please have both persons sign)

  
 [Signature
Page to Voting Agreement] 

 List of Participants 
 Samir Abboud* 
 Russ Ahlberg and Susan Ahlberg 

Jeremy Albrecht 
 Wassim Aliahmad and Samara
Aliahmad 
 AMC Family Holdings A, LLC 

AMC Family Holdings B, LLC 
 AMC Family
Holdings C, LLC 
 AMC Family Holdings D, LLC 
 AMC Family Holdings E, LLC 
 AMC Family Holdings F, LLC 

AMC Family Holdings G, LLC 
 AMC Family
Holdings H, LLC 
 AMC Family Holdings I, LLC 
 Laurina Bai 
 Peter E. Bolta 1999 Revocable Living Trust 

Sherry Dianne Castillo 
 Heather Chase

 Cathy Conklin 
 Richard Conklin

 Sheri Dando 
 Thomas Anthony
Demarchi and Joanne Demarchi, Trustees of The Demarchi Living Trust Dated February 4, 1998 
 John Donohue 

Robert Felsenfeld and Nancy Jane Felsenfeld, as Trustees of The Robert and Nancy Jane Felsenfeld Trust as Restated November 16, 2006 

Dennis Fowler, M.D. 
 Raymond A. Frame

 Raymond C. Frame 
 Donald Lee
Gadberry and Arleen Rae Gadberry, Co-Trustees, or their Successors in Trust, under The Gadberry Family Trust Dated July 11, 2005 
 Amy
Garces 
 Karen Gibbs 

 Dennis Grosshans 
 Carl Hadley and Gabrielle Hadley 
 Charles Hart 

David Heaton 
 Thomas Hoster 

Ahmad Husami 
 Patrick Ikehara 

Bassam Istanbouli 
 Dana B. Qahoush*

 Houssam Istanbouli 
 Tala
Istanbouli 
 James R. Johnson 
 Henry
Kahle and Julia Lee Kahle, Co-Trustees, or their Successors in Trust, under the Kahle Family Trust Dated May 1, 2007 
 Thomas M. Kasten
and Kendra Kasten, as Trustees of The Kasten Family Trust Agreement Dated November 5, 2001 
 Kenneth Lacoste 

Pension Plan of Robert A. Lauderdale M.D. 

Robert A. Lauderdale Family Limited Partnership 

Kimberlee Ann Lauletta 
 Natali and Grant
Lenning 
 Mitra Lutchmansingh 
 Greg
Mahoney 
 Wael Muakkassa 
 Richard L.
Myers, as Trustee for Richard L. Myers Living Trust Dated Aug 25, 1999* 
 David Nader 
 George Nader 
 Samir Nader 
 Eric Nguyen and Hannah Nguyen 
 Petrime-Manaktala Family Trust 

Linda Phinouwong and Manop Phinouwong* 
 Edward
D. Pingleton 
 Boun Pravong and Natalie Pravong 

 Stephen G. Roth and Michelle E. Roth, Trustees of The Stephen G. and Michelle E. Roth Revocable Living Trust
under Agreement Dated July 14, 2010 
 Carlos A. Saez* 
 Ghassan Sakakine and Rindala Tannir 
 Darren Sax 

Lincoln Schlotterback* 
 Rebecca Lynnette
Selby* 
 Fazlia Seraj and Mohammed Ali Seraj 
 Garth Smithers 
 Jeffrey Brian Stegwell* 
 Karen Jean Stegwell 
 Arpad Szabo 
 Samer Tall 
 Jenny Tang 
 Scott Taylor 
 T. Peter Thomas and Jacqueline Sue Stewart, Trustees of The Thomas-Stewart Family
Trust U/D/T Dated 10/16/1996* 
 Art Thomas* 
 Canh Tran 
 Bao-Liang Tsai 
 Frans Vandenbroek and Karen Vandenbroek 
 Michael Vaughn 

Stavros Vizirgianakis* 
 Matthew Wixey

 Gail P. Wooldridge and Craig A. Wooldridge 
 Haruyasu Yawata 
  

	*	Participant did not consent to the Voting Agreement Amendment dated 6/25/12Amended and Restated Master Rights Agreement

 Exhibit 4.2 
 AMENDED AND RESTATED MASTER RIGHTS AGREEMENT 
 This Agreement is entered into on November 8, 1991
among Applied Medical Resources Corporation, a California corporation (the “Company”) and the individuals and entities listed on Attachment A (“Investors”). 

Certain of the Investors possess rights of first offer, registration rights and certain financial information rights as set forth in the
Company’s Amended Master Rights Agreement dated as of July 1, 1991. The Company and such Investors now desire to amend and restate said rights of first offer, registration rights and information rights in this Agreement. 

NOW THEREFORE, the parties hereby agree as follows: 
 1. Right of First Offer. 
 (a) Major Investor. Each Investor who holds at least 300,000 shares
of either Series A, Series B, Series C, Series D, Series E or Series F Preferred Stock of the Company (together referred to as “Preferred Stock”) (or Common Stock of the Company issued or issuable upon conversion thereof or some
combination thereof) is hereby defined as a Major Investor. For purposes of this Agreement, a Major Investor includes any general partners and affiliates of such Major Investor, and for purposes of identifying a Major Investor, the shares held by
Berkeley Medical Investments Limited, Berkeley/NED Development Capital Limited, KB Berkeley Japan Development Capital Limited and Dunedin Berkeley Development Capital Limited (the “Berkeley Investors”) shall be aggregated. Each Major
Investor shall be entitled to apportion the right of first offer hereby granted it among itself and its partners and affiliates in such proportions as it deems appropriate. 
 (b) Procedure. The Company hereby grants to each Major Investor a right of first offer with respect to future sales by the Company of its New Securities (as hereinafter defined). Each time the Company
proposes to offer any shares of, or securities convertible into or exercisable for any shares of, any class of its capital stock (“New Securities”), the Company shall first make an offering of such New Securities to the Major Investors in
accordance with the following provisions. 
 (i) The company shall deliver a notice by certified mail (“Notice”) to each of the
Major Investors stating (A) its bona fide intention to offer New Securities, (B) the number of such New Securities to be offered, and (C) the price, if any, for which it proposes to offer such New Securities. 

(ii) Within 20 calendar days after receipt of the Notice, each Major Investor may elect to purchase or obtain, at the price and on the terms
specified in the Notice, up to that portion of such New Securities which equals the proportion that the number of shares of Common Stock issued and held, or issuable upon conversion of the Preferred Stock then held, by such Major Investor bears to
the total number of shares of Common Stock issued and held, or issuable upon conversion of the Preferred Stock then held, by all shareholders. The Company shall promptly, in writing, inform each Major Investor which purchases all the New Securities
available to it (“Fully-Exercising Investor”) of any other Major Investor’s failure to do likewise. 

  
 1 

 
During the ten-day period commencing after receipt of such information, each Fully-Exercising Investor shall be entitled to obtain that portion of the New Securities offered to the Major
Investors which was not subscribed for, which is equal to the proportion that the number of shares of Common Stock issued and held, or issuable upon conversion of Preferred Stock then held, by such Fully-Exercising Investor bears to the total number
of shares of Common Stock issued and held, or issuable upon conversion of the Preferred Stock then held, by all Fully-Exercising Investors who wish to purchase some of the unsubscribed shares. 

(iii) If all such New Securities referred to in the Notice are not elected to be obtained as provided in Section 1(b) hereof, the Company
may, during the 90-day period following the expiration of the period provided in Section 1(b) hereof, offer the remaining unsubscribed New Securities to any person or persons at a price not less than, and upon terms no more favorable to the
offeree than those specified in the Notice. If the Company does not enter into an agreement for the sale of the New Securities within such period, or if such agreement is not consummated within 90 days of the execution thereof, the Major Investors
right of first offer with respect to such New Securities provided hereunder shall be deemed to be revived and such New Securities shall not be offered unless first reoffered to each Major Investor in accordance herewith. 

(c) Exclusions. The right of first offer in this Section 1 shall not be applicable (A) to the issuance or sale of Common Stock
(or options therefor) to employees and consultants of the Company for the primary purpose of soliciting or retaining their employment or as part of an incentive program, and any other shares issued with the unanimous approval of the board of
directors, (B) on or after consummation of a bona fide, firmly underwritten public offering of shares of Common Stock, registered under the Act pursuant to a registration statement on Form S-1, at a price per share of at least $9.00 (adjusted
for any recapitalization, stock splits or dividends) and for an aggregate consideration in excess of $10,000,000, (C) to securities issuable upon exercise or conversion of outstanding securities, or (D) to securities issued in connection
with any stock split, stock dividend or recapitalization of the Company. 
 (d) Amendment. With the written consent of a majority
of the then outstanding shares of Preferred Stock (or Common Stock issued or issuable upon conversion thereof) held by the Major Investors, the obligations of the Company and the rights of the Major Investors under this Section 1 may be waived
(either generally or in a particular instance, either retroactively or prospectively and either for a specified period of time or indefinitely), and with the same consent the Company, when authorized by resolution of its board of directors, may
enter into a supplementary agreement for the purpose of adding any provisions to or changing in any manner or eliminating any of the provisions of this Section 1. 
 2. Registration Rights. 
 (a) Definitions. For purposes of this Section 2:

 (i) The term “register”, “registered”, and “registration” refer to a registration effected by preparing
and filing a registration statement or similar document in compliance with the Act, and the declaration or ordering of effectiveness of such registration statement or document; 

  
 2 

 (ii) The term “Registrable Securities” means (1) the Common Stock issuable or issued
upon conversion of the Series A Preferred Stock, Series B Preferred Stock, Series C Preferred Stock, Series D Preferred Stock, Series E Preferred Stock and Series F Preferred Stock, (2) the Common Stock issuable upon conversion of Series C
Preferred Stock issued or issuable upon exercise of a Warrant issued under the Securities Purchase Agreement dated August 3, 1990, (3) the number of shares of Common Stock issued to and held by the Founders (as hereinafter defined), and
(4) any Common Stock of the Company issued as (or issuable upon the conversion or exercise of any warrant, right or other security which is issued as) a dividend or other distribution with respect to, or in exchange for or in replacement of,
such Series A Preferred Stock, Series B Preferred Stock, Series C Preferred Stock, Series D Preferred Stock, Series E Preferred Stock, or Series F Preferred Stock or Common Stock, excluding in all cases, however, (i) any Registrable Securities
sold by a person in a transaction in which his rights under this Section 2 are not assigned, or (ii) any Registrable Securities sold to or through a broker or dealer or underwriter in a public distribution or a public securities
transaction; 
 (iii) The number of shares of “Registrable Securities then outstanding” shall be determined by the number of
shares of Common Stock outstanding which are, and the number of shares of Common Stock issuable pursuant to then exercisable or convertible securities which are, Registrable Securities; 

(iv) The term “Holder” means any Investor owning or having the right to acquire Registrable Securities or any assignee thereof in
accordance with Section 2(m) hereof; 
 (v) The term “Form S-3” means such form under the Act as in effect on the date
hereof or any registration form under the Act subsequently adopted by the Securities and Exchange Commission (“SEC”) which permits inclusion or incorporation of substantial information by reference to other documents filed by the Company
with the SEC; 
 (vi) The term “Founder” shall mean each of Said S. Hilal, Robert P. Cooper, Thomas J. Fogarty, Ralph V.
Clayman, George Wallace and Nabil Hilal, but only so long as such individual remains an employee of or consultant to the Company (or in the case of Thomas J. Fogarty, a licensor of the Company); and 

(vii) The term “Act” shall mean the Securities Act of 1933, as amended. 

(b) Request for Registration. 
 (i) If the Company shall receive at any time after the earlier of (1) December 31, 1994, or (2) six (6) months after the effective date of the first registration statement for a public offering
of securities of the Company (other than a registration statement relating either to the sale of securities to employees of the Company pursuant to a stock option, stock purchase or similar plan or a SEC Rule 145 transaction), a written request from
the Holders of at least fifty percent (50%) of the Registrable Securities (including securities convertible into Registrable Securities, but not including Registrable Securities defined under Section 2(a)(ii)(3) above) then outstanding
that the Company file a registration statement under the Act covering the registration of Registrable Securities, with an anticipated aggregate offering price, net of underwriting discounts and commissions, which would exceed $5,000,000, then the
Company 

  
 3 

 
shall, within ten (10) days of the receipt thereof, give written notice of such request to all Holders and shall, subject to the limitations of subsection 2(b)(ii), effect as soon as
practicable, and in any event within 90 days of the receipt of such request, the registration under the Act of all Registrable Securities which the Holders request to be registered within twenty (20) days of the mailing of such written notice
by the Company; provided, however, that the Company shall not be obligated to take any action to effect any such registration, qualification or compliance pursuant to this subsection 2(b)(1); 

(A) During the period starting with the date sixty (60) days prior to the Company’s estimated date of filing of, and ending on the date
120 days immediately following the effective date of, any registration statement pertaining to securities of the company (other than a registration of securities in a Rule 145 transaction or with respect to an employee benefit plan), provided that
the Company is actively employing in good faith all reasonable efforts to cause such registration statement to become effective; 
 (B)
After the Company has effected two such registrations pursuant to this subsection 2(b)(i), and such registrations have been declared or ordered effective; 
 (C) If the Company shall furnish to such Holders a certificate signed by the President of the Company stating that in the good faith judgment of the Board of Directors it would be seriously detrimental to the
Company or its share holders for a registration statement to be filed at such time, then the Company’s obligation to use its best efforts to register, qualify or comply under this subsection 2(b)(i) shall be deferred for a period not to exceed
90 days from the date of receipt of written request from the Holders; provided, however, that the Company may not utilize this right more than once in any twelve month period. 

(ii) If the Holders initiating the registration request hereunder (“Initiating Holders”) intend to distribute the Registrable Securities
covered by their request by means of an underwriting, they shall so advise the Company as a part of their request made pursuant to this Section 2(b)(ii) and the Company shall include such information in the written notice referred to in
subsection 2(b)(i). In such event, the right of any Holder to include his Registrable Securities in such registration shall be conditioned upon such Holder’s participation in such underwriting and the inclusion of such Holder’s Registrable
Securities in the underwriting (unless otherwise mutually agreed by a majority in interest of the Initiating Holders and such Holder) to the extent provided herein. All Holders proposing to distribute their securities through such underwriting shall
(together with the Company as provided in subsection 2(d)(v)) enter into an underwriting agreement in customary form with the underwriter or underwriters selected for such underwriting by a majority in interest of the Initiating Holders.
Notwithstanding any other provision of this Section 2(b), if the underwriter advises the Initiating Holders in writing that marketing factors require a limitation of the number of shares to be underwritten, then all shares other than
Registrable Securities shall first be excluded, and the Initiating Holders shall so advise all Holders of Registrable Securities which would otherwise be underwritten pursuant hereto, and the number of shares of Registrable Securities that may be
included in the underwriting shall be allocated among all Holders thereof, including the Initiating Holders, in proportion (as nearly as practicable) to the amount of Registrable Securities of the Company owned by each Holder. 

  
 4 

 (c) Company Registration. If (but without any obligation to do so) the Company proposes to
register (including for this purpose a registration effected by the Company for shareholders other than the Holders) any of its stock or other securities under the Act in connection with the public offering of such securities (other than a
registration relating solely to the sale of securities to participants in a Company stock plan, or a registration on any form which does not include substantially the same information as would be required to be included in a registration statement
covering the sale of the Registrable Securities), the Company shall, at such time, promptly give each Holder written notice of such registration. Upon the written request of each Holder given within twenty (20) days after mailing of written
notice by the Company, the Company shall, subject to the provisions of Section 2(h), cause to be registered under the Act all of the Registrable Securities that each such Holder has requested to be registered. 

(d) Obligations of the Company. Whenever required under this Section 2 to effect the registration of any Registrable Securities, the
Company shall, as expeditiously as reasonably possible: 
 (i) Prepare and file with the SEC a registration statement with respect to
such Registrable Securities and use its best efforts to cause such registration statement to become effective, and, upon the request of the Holders of a majority of the Registrable Securities registered thereunder, keep such registration statement
effective for up to ninety (90) days. 
 (ii) Prepare and file with the SEC such amendments and supplements to such registration
statement and the prospectus used in connection with such registration statement as may be necessary to comply with the provisions of the Act with respect to the disposition of all securities covered by such registration statement. 

(iii) Furnish to the Holders such numbers of copies of a prospectus, including a preliminary prospectus, in conformity with the requirements of
the Act, and such other documents as they may reasonably request in order to facilitate the disposition of Registrable Securities owned by them. 
 (iv) Use its best efforts to register and qualify the securities covered by such registration statement under such other securities or Blue Sky laws of such jurisdictions as shall be reasonably requested by the
Holders, provided that the Company shall not be required in connection therewith or as a condition thereto to qualify to do business or to file a general consent to service of process in any such states or jurisdictions. 

(v) In the event of any underwritten public offering, enter into and perform its obligations under an underwriting agreement, in usual and
customary form, with the managing under writer of such offering. Each Holder participating in such under writing shall also enter into and perform its obligations under such an agreement provided that such underwriting agreement shall not provide
for indemnification or contribution obligations on the part of the holders greater than the obligations set forth in Section 2(j)(ii). 
 (vi) Notify each Holder of Registrable Securities covered by such registration statement at any time when a prospectus relating thereto is required to be delivered under the Act of the happening of any event as a
result of which the prospectus included in such 

  
 5 

 
registration statement, as then in effect, includes an untrue statement of a material fact or omits to state a material fact required to be stated therein or necessary to make the statements
therein not misleading in the light of the circumstances then existing. 
 (vii) Furnish, at the request of any Holder requesting
registration of Registrable Securities pursuant to this Section 2, on the date that such Registrable Securities are delivered to the underwriters for sale in connection with a registration pursuant to this Section 2, if such securities are
being sold through underwriters, or, if such securities are not being sold through underwriters, on the date that the registration statement with respect to such securities becomes effective, (1) an opinion, dated such date, of the counsel
representing the Company for the purposes of such registration, in form and substance as is customarily given to underwriters in an underwritten public offering, addressed to the underwriters, if any, and to the Holders requesting registration of
Registrable Securities and (2) a letter dated such date, from the independent certified public accountants of the Company, in form and substance as is customarily given by independent certified public accountants to underwriters in an
underwritten public offering, addressed to the underwriters, if any, and to the Holders requesting registration of Registrable Securities. 
 (e) Furnish Information. It shall be a condition precedent to the obligations of the Company to take any action pursuant to this Section 2 with respect to the Registrable Securities of any selling
Holder that such holder shall furnish to the Company such information regarding itself, the Registrable Securities held by it, and the intended method of disposition of such securities as shall be required to effect the registration of such
Holder’s Registrable Securities. 
 (f) Expenses of Demand Registration. All expenses other than underwriting discounts and
commissions incurred in connection with registrations, filings or qualifications pursuant to Section 2(b), including (without limitation) all registration, filing and qualification fees, printers’ and accounting fees, fees and
disbursements of counsel for the Company, and the reasonable fees and disbursements (not to exceed $25,000 provided counsel for the company shall be responsible for and shall prepare all material documentation related to said Demand Registration) of
one counsel for the selling Holders shall be borne by the Company; provided, however, that the Company shall not be required to pay for any expenses of any registration proceeding begun pursuant to Section 2(b) if the registration request is
subsequently withdrawn at the request of the Holders of a majority of the Registrable Securities to be registered (in which case all Participating Holders shall bear such expenses), unless the Holders of a majority of the Registrable Securities
agree to forfeit their right to one demand registration pursuant to Section 2(b); provided further, however, that if at the time of such withdrawal, the Holders have learned of a material adverse change in the condition, business, or prospects
of the Company from that known to the Holders at the time of their request, then the Holders shall not be required to pay any of such expenses and shall retain their rights pursuant to Section 2(b). 

(g) Expenses of Company Registration. The Company shall bear and pay all expenses incurred in connection with any registration, filing or
qualification of Registrable Securities with respect to the registrations pursuant to Section 2(c) for each Holder (which right may be assigned as provided in Section 2(m), including (without limitation) all registration, filing, and
qualification fees, printers and accounting fees relating or apportionable thereto and 

  
 6 

 
the fees and disbursements (not to exceed $25,000 provided counsel for the Company shall be responsible for and shall prepare all documentation related to said Company registration) of one
counsel for the selling Holders selected by them, but excluding underwriting discounts and commissions relating to Registrable Securities. 
 (h) Underwriting Requirements. In connection with any offering involving an underwriting of shares being issued by the Company, the Company shall not be required under Section 2(c) to include any of the
Holders’ securities in such underwriting unless they accept the terms of the underwriting as agreed upon between the Company and the underwriters selected by it, and then only in such quantity as will not, in the opinion of the underwriters,
jeopardize the success of the offering by the Company; provided that such underwriting agreement shall not provide for indemnification or contribution obligations on the part of the Holders greater than the obligations set forth in
Section 2(j)(ii). If the total amount of securities, including Registrable Securities, requested by shareholders to be included in such offering exceeds the amount of securities sold other than by the Company that the underwriters reasonably
believe compatible with the success of the offering, then the Company shall be required to include in the offering only that number of such securities, including Registrable Securities, which the underwriters believe will not jeopardize the success
of the offering (the securities so included to be apportioned pro rata among the selling shareholders according to the total amount of securities entitled to be included therein owned by each selling shareholder or in such other proportions as shall
mutually be agreed to by such selling shareholders) but in no event shall (1) any securities of Founders or other selling shareholders be included in the offering to the exclusion of Registrable Securities held by Holders other than Founders or
other selling shareholders, (2) the amount of securities of the selling Holders (other than Founders or other selling shareholders) included in the offering be reduced below thirty percent (30%) of the total amount of securities included
in such offering, unless such offering is the initial public offering of the Company’s securities in which case all selling shareholders may be excluded if the underwriters make the determination described above and no Founders or other share
holder’s securities are included or (3) notwithstanding (2) above, any shares being sold by a shareholder exercising a demand registration right similar to that granted in Section 2(b) be excluded from an offering pursuant to
such demand registration. For purposes of the preceding parenthetical concerning apportionment, for any selling shareholder which is a Holder of Registrable Securities and which is a partnership or corporation, the partners, retired partners and
shareholders of such Holder, or the estates and family members of any such partners and retired partners and any trusts for the benefit of any of the foregoing persons shall be deemed to be a single “selling shareholder”, and any pro rata
reduction with respect to such “selling shareholder” shall be based upon the aggregate amount of shares carrying registration rights owned by all entities and individuals included in such “selling shareholder,” as defined in this
sentence. 
 (i) Delay of Registration. No Holder shall have any right to obtain or seek an injunction restraining or otherwise
delaying any such registration as the result of any controversy that might arise with respect to the interpretation or implementation of this Section 2. 
 (j) Indemnification. In the event any Registrable Securities are included in a registration statement under this Section 2: 

  
 7 

 (i) To the extent permitted by law, the Company will indemnify and hold harmless each Holder, any
underwriter (as defined in the Act) for such Holder and each person, if any, who controls such Holder or underwriter within the meaning of the Act or the Securities Exchange Act of 1934, amended (the “1934 Act”), against any losses,
claims, damages, or liabilities (joint or several) to which they may become subject under the Act, the 1934 Act or other federal or state law, insofar as such losses, claims, damages, or liabilities (or actions in respect thereof) arise out of or
are based upon any of the following statements, omissions or violations (collectively a “Violation”): (i) any untrue statement or alleged untrue statement of a material fact contained in such registration statement, including any
preliminary prospectus or final prospectus contained therein or any amendments or supplements thereto, (ii) the omission or alleged omission to state therein a material fact required to be stated therein, or necessary to make the statements
therein not misleading, or (iii) any violation or alleged violation by the Company of the Act, the 1934 Act, any state securities law or any rule or regulation promulgated under the Act, the 1934 Act or any state securities law; and the Company
will pay to each such Holder, underwriter or controlling person, as incurred, any legal or other expenses reasonably incurred by them in connection with investigating or defending any such loss, claim, damage, liability, or action; provided,
however, that the indemnity agreement contained in this subsection 2(j)(i) shall not apply to amounts paid in settlement of any such loss, claim, damage, liability, or action if such settlement is effected without the consent of the Company (which
consent shall not be unreasonably withheld), nor shall the Company be liable in any such case for any such loss, claim, damage, liability, or action to the extent that it arises out of or is based upon a Violation which occurs in reliance upon and
in conformity with written information furnished expressly for use in connection with such registration by any such Holder, underwriter or controlling person. 
 (ii) To the extent permitted by law, each selling Holder will indemnify and hold harmless the Company, each of its directors, each of its officers who has signed the registration statement, each person, if any, who
controls the Company within the meaning of the Act, any underwriter, any other Holder selling securities in such registration statement and any controlling person of any such underwriter or other Holder, against any losses, claims, damages, or
liabilities (joint or several) to which any of the foregoing persons may become subject, under the Act, the 1934 Act or other federal or state law, insofar as such losses, claims, damages, or liabilities (or actions in respect thereto) arise out of
or are based upon any Violation, in each case to the extent (and only to the extent) that such Violation occurs in reliance upon and in conformity with written information furnished by such Holder expressly for use in connection with such
registration; and each such Holder will pay any legal or other expenses reasonably incurred by any person intended to be indemnified pursuant to this subsection 2(j)(ii), in connection with investigating or defending any such loss, claim, damage,
liability, or action; provided, however, that the indemnity agreement contained in this subsection 2(j)(ii) shall not apply to amounts paid in settlement of any such loss, claim, damage, liability or action if such settlement is effected without the
consent of the Holder, which consent shall not be unreasonably withheld; and provided, further that, in no event shall any indemnity obligation of any Holder under this subsection 2(j)(ii) exceed the proceeds from the offering received by such
Holder. 
 (iii) Promptly after receipt by an indemnified party under this Section 2(j) of notice of the commencement of any action
(including any governmental action), such indemnified party will, if a claim in respect thereof is to be made against any indemnifying party 

  
 8 

 
under this Section 2(j), deliver to the indemnifying party a written notice of the commencement thereof and the indemnifying party shall have the right to participate in, and, to the extent
the indemnifying party so desires, jointly with any other indemnifying party similarly noticed, to assume the defense thereof with counsel mutually satisfactory to the parties; provided, however, that an indemnified party shall have the right to
retain its own counsel, with the fees and expenses to be paid by the indemnifying party, if representation of such indemnified party by the counsel retained by the indemnifying party would be inappropriate due to actual or potential differing
interests between such indemnified party and any other party represented by such counsel in such proceeding. The failure to deliver written notice to the indemnifying party within a reasonable time of the commencement of any such action, if
prejudicial to its ability to defend such action, shall relieve such indemnifying party of any liability to the indemnified party under this Section 2(j), but the omission so to deliver written notice to the indemnifying party will not relieve
it of any liability that it may have to any indemnified Party otherwise than under this Section 2(j). 
 (iv) The obligations of the
Company and Holders under this Section 2(j) shall survive the completion of any offering of Registrable Securities in a registration statement under this Section 2, and otherwise. 

(k) Reports Under Securities Exchange Act of 1934. With a view to making available to the Holders the benefits of Rule 144 promulgated
under the Act and any other rule or regulation of the SEC that may at any time permit a Holder to sell securities of the Company to the public without registration or pursuant to a registration on Form S-3, the Company agrees to: 

(i) make and keep public information available, as those terms are understood and defined in SEC Rule 144, at all times after ninety
(90) days after the effective date of the first registration statement filed by the Company for the offering of its securities to the general public; 
 (ii) take such action, including the voluntary registration of its Common Stock under Section 12 of the 1934 Act, as is necessary to enable the Holders to utilize Form S-3 for the sale of their Registrable
Securities, such action to be taken as soon as practicable after the end of the fiscal year in which the first registration statement filed by the Company for the offering of its securities to the general public is declared effective; 

(iii) file with the SEC in a timely manner all reports and other documents required of the Company under the Act and the 1934 Act; and 

(iv) furnish to any Holder, so long as the Holder owns any Registrable Securities, forthwith upon request (1) a written statement by the
Company that it has complied with the reporting requirements of SEC Rule 144 (at any time after ninety (90) days after the effective date of the first registration statement filed by the Company), the Act and the 1934 Act (at any time after it
has become subject to such reporting requirements), or that it qualifies as a registrant whose securities may be resold pursuant to Form S-3 (at any time after it so qualifies), (2) a copy of the most recent annual or quarterly report of the
Company and such other reports and documents so filed by the Company, and (3) such other information as may be reasonably 

  
 9 

 
requested in availing any Holder of any rule or regulation of the SEC which permits the selling of any such securities without registration or pursuant to such form. 

(l) Form S-3 Registration. In case the Company shall receive from any Holder or Holders (other than Founders) who hold in excess of two
percent (2%) of the Company’s Common Stock or securities convertible thereto, a written request or requests that the Company effect a registration on Form S-3 and any related qualification or compliance with respect to all or a part of the
Registrable Securities owned by such Holder or Holders, the Company will: 
 (i) promptly give written notice of the proposed
registration, and any related qualification or compliance, to all other Holders; and 
 (ii) as soon as practicable, effect such
registration and all such qualifications and compliances as may be so requested and as would permit or facilitate the sale and distribution of all or such portion of such Holder’s or Holders’ Registrable Securities as are specified in such
request, together with all or such portion of the Registrable Securities of any other Holder or Holders joining in such request as are specified in a written request given within 15 days after receipt of such written notice from the Company;
provided, however, that the Company shall not be obligated to effect any such registration, qualification or compliance, pursuant to this Section 2(1): (1) if Form S-3 is not available for such offering by the Holders; (2) if the
Holders, together with the holders of any other securities of the Company entitled to inclusion in such registration, propose to sell Registrable Securities and such other securities (if any) at an aggregate price to the public (net of any
underwriters’ discounts or commissions) of less than $500,000; (3) if the Company shall furnish to the Holders a certificate signed by the President of the Company stating that in the good faith judgment of the Board of Directors of the
Company, it would be seriously detrimental to the Company and its shareholders for such Form S-3 Registration to be effected at such time, in which event the Company shall have the right to defer the filing of the Form S-3 registration statement for
a period of not more than 90 days after receipt of the request of the Holder or Holders under this Section 2(1); provided, how ever, that the Company shall not utilize this right more than once In any twelve (12) month period; (4) if
the Company has already effected four registrations on Form S-3 for the Holders pursuant to this Section 2(1); or (5) in any particular jurisdiction in which the Company would be required to qualify to do business or to execute a general
consent to service of process in effecting such registration, qualification or compliance. 
 (iii) Subject to the foregoing, the Company
shall file a registration statement covering the Registrable Securities and other securities so requested to be registered as soon as practicable after receipt of the request or requests of the Holders. All expenses incurred in connection with a
registration requested pursuant to Section 2(1), including (without limitation) all registration, filing and qualification fees, printers’ and accounting fees, fees-and disbursements of counsel for the Company and the reasonable fees and
disbursements of one counsel for the selling Holder shall be borne by the Company; provided, however, that the Company shall not be required to pay for any expenses of any registration proceeding begun pursuant to Section 2(1) if the
registration request is subsequently withdrawn at the request of the Holders of a majority of the Registrable Securities to be registered (in which case all Participating Holders shall bear such expenses), unless the Holders of a majority of the

  
 10 

 
Registrable Securities agree to forfeit the right to a demand registration pursuant to Section 2(1); provided, further, however, that if at the time of such withdrawal, the Holders have
learned of a material adverse change in the condition, business or prospects of the company from that known to the Holders at the time of their request, then the Holders shall not be required to pay any of such expenses and shall retain their rights
pursuant to Section 2(1). Registrations effected pursuant to this Section 2(1) shall not be counted as demands for registration or registrations effected pursuant to Section 2(b) or 2(c), respectively. 

(m) Assignment of Registration Rights. The rights to cause the Company to register Registrable Securities pursuant to this Section 2
may be assigned by a Holder to a transferee or assignee of such securities who acquires at least 300,000 shares, provided the Company is, within a reasonable time after such transfer, furnished with written notice of the name and address of such
transferee or assignee and the securities with respect to which such registration rights are being assigned; and provided, further, that such assignment shall be effective only if immediately following such transfer the further disposition of such
securities by the transferee or assignee is restricted under the Act. Notwithstanding the above, such rights may be assigned by a Holder to a limited partner, general partner, parent or subsidiary corporation or other affiliate of an Investor (the
“Transferee”) regardless of the number of shares acquired by such Transferee. 
 (n) Limitations on Subsequent Registration
Rights. From and after the date of this Agreement, the Company shall not enter into any agreement with any holder or prospective holder of any securities of the Company which would allow such holder or prospective holder to include such
securities in any registration filed under the Securities Act of 1933 with the Securities and Exchange Commission (“Subsequent Registration Rights Agreement”) unless (i) the Company has previously registered shares or securities of
the Company with the Securities and Exchange Commission pursuant to the Securities Act of 1933 or has registered securities pursuant to the Securities Exchange Act of 1934 or (ii) the Company has first requested that the Holders amend this
Agreement to include any securities of the Company which are being acquired by such holder or prospective holder in the definition of Registrable Securities hereunder and to include such holder or prospective holder in the definition of Holder
hereunder for purposes of this Section 2 and the Holders of a majority of the outstanding Registrable Securities (including securities convertible into Registrable Securities, but not including Registrable Securities, defined under
Section 2(a)(ii)(3) above) have agreed to such inclusion. In case of (ii) above, if the Holders of a majority have not agreed within thirty (30) days after receipt of notice of such request, the company may enter into a Subsequent
Registration Rights Agreement provided that such agreement shall not allow the holder or prospective holder to make a demand registration which could result in such registration statement being declared effective prior to the earlier of either the
date set forth in subsection 2(b)(i) or within ninety (90) days of the effective date of any registration effected pursuant to Section 2(b). 
 (o) “Market Stand-Off” Agreement. Each holder of securities which are or at one time were Registrable Securities (or which are or were convertible into Registrable Securities) hereby agrees that,
during a period not to exceed 120 days, following the effective date of a registration statement of the Company filed under the Act, it shall not, to the extent requested by the Company and such underwriter, sell or otherwise transfer or dispose of
(other than to donee who agree to be similarly bound) any Common Stock of the Company held by it at 

  
 11 

 
any time during such period except Common Stock included in such registration; provided, however, that: 
 (i) such agreement shall be applicable only to the first such registration statement of the Company which covers Common Stock (or other securities) to be sold on its behalf to the public in an underwritten
offering; and 
 (ii) all officers and directors of the Company, and all other persons with registration rights (whether or not pursuant
to this Agreement) enter into similar agreements. 
 In order to enforce the foregoing covenant, the Company may impose stop-transfer
instructions with respect to the Registrable Securities of each Investor (and the shares or securities of every other person subject to the foregoing restriction) until the end of such period. 

(p) Amendment of Registration Rights. Any provision of this Section 2 may be amended and the observance thereof may be waived (either
generally or in a particular instance and either retroactively or prospectively), only with the written consent of the Company and the holders of a majority of the Registrable Securities then outstanding (excluding for this Section 2(p) any
shares of Registrable Securities held by the Founders). Any amendment or waiver effected in accordance with this paragraph shall be binding upon each holder of any securities which are or at one time were Registrable Securities (or which are or were
convertible into Registrable Securities), each future holder of all such securities, and the Company. 
 (q) Termination of
Registration Rights. No shareholder shall be entitled to exercise any right provided for in this Section 2 after five (5) years following the consummation of the sale of securities pursuant to a registration statement filed by the
company under the Act in connection with the initial firm commitment underwritten offering of its securities to the general public. 
 3.
Delivery of Financial Statements. The Company shall deliver to each Investor which holds, together with its affiliates, an aggregate of 300,000 of Preferred Stock or Common Stock issued or issuable upon conversion of such Preferred Stock:

 (a) Annual Financials. As soon as practicable, but in any event within ninety (90) days after the end of each fiscal year
of the Company commencing with the fiscal year ending December 31, 1991, a balance sheet, and statements of operations and cash flow for such fiscal year. Such year-end financial reports to be in reasonable detail, prepared in accordance with
generally accepted accounting principles (“gaap”), and audited and certified by independent public accountants of nationally recognized standing selected by the Company; 

(b) Monthly Financials. Within thirty (30) days of the end of each month, and until a public offering of Common Stock of the Company,
an unaudited statement of operations and balance sheet for and as of the end of such month, in reasonable detail and prepared in accordance with gaap, subject to year end audit adjustments and the absence of footnotes; 

(c) Business Plan. Within forty-five (45) days prior to the end of each fiscal year, a budget and business plan for the next fiscal
year, prepared on a monthly basis, including a 

  
 12 

 
balance sheet and statement of operations for such months and, as soon as prepared, any other budgets or revised budgets prepared by the Company; 

(d) Certificate. With respect to the financial statements called for in subjection (b) of this Section 3, an instrument executed
by the Chief Financial Officer, President or Chairman of the Company and certifying that such financials were prepared in accordance with gaap consistently applied with prior practice for earlier periods and fairly present the financial condition of
the Company and its results of operation for the period specified, subject to year-end audit adjustments and the absence of footnotes; 

(e) Requested Information. Such other information relating to the financial condition, business, prospects or corporate affairs of the
Company as the Investor or any assignee of the Investor may from time to time request, provided, however, that the Company shall not be obligated to provide information which it deems in good faith to be proprietary. 

(f) Visitation. The Company shall permit each Investor which holds, together with is affiliates, an aggregate of 300,000 shares of
Preferred Stock or Common Stock issued to issuable upon conversion of such Preferred Stock, at such Investor’s expense to visit and inspect the Company’s properties, to examine its books of account and records and to discuss the
Company’s affairs, finances and accounts with its officers, all at such reasonable times as may be requested by the Investor; provided, however, that the Company shall not be obligated pursuant to this Section 3 to provide access to any
information which it reasonably considers to be a trade secret or similar confidential information unless such Investor agrees in writing to hold such information in confidence. 

(g) Market Stand-Off. So long as each Investor is, or may be, bound by the provisions of Section 2(o), the Company shall obtain from
each employee who is a purchaser of shares of the Company’s Common Stock, a market stand-off provision similar to or more restrictive than Section 2(o). 
 (h) Termination of Information and Inspection Covenants. The covenants set forth in Section 3 shall terminate as to the Investor and be of no further force or effect when the sale of securities pursuant
to a registration statement filed by the Company under the Act in connection with the firm commitment underwritten offering of its securities to the general public is consummated or when the Company first becomes subject to the periodic reporting
requirements of Sections 12(g) or 15(d) of the Securities Exchange Act of 1934, whichever event shall first occur. 
 (i) Board
Visitation Rights. For so long as a Berkeley Investor or any affiliated transferee of a Berkeley Investor which is subject to the provisions of ERISA is entitled to information under this Section 3, one representative of such Berkeley
Investors and any such affiliated transferee (the “Berkeley Representative”), shall have the right, at its expense, to attend all meetings of the Company’s Board of Directors. At such meetings, the Berkeley Representative shall have
the right to participate in discussions and advise the directors and any officers present at the meeting with respect to the Company’s business. The Company shall give the Berkeley Representative copies of all notices, minutes, consents and
other materials that it provides to its directors; provided, however, that the Berkeley Representative shall agree in 

  
 13 

 
writing to hold in confidence and trust all information so provided (but may disclose such information to their legal or financial advisers or to their affiliates who agree to be bound by the
confidentiality provisions hereof); and provided, further, that no Berkeley Representative or affiliate thereof shall, in the reasonable determination of the Board of Directors, be a competitor of the Company. The Company reserves the right to
withhold any information and to exclude the Berkeley Representative from any meeting or portion of a meeting if access to such information discussed at a meeting or attendance at such meeting could, in the opinion of counsel to the Company,
adversely affect the attorney-client privilege between the Company and its counsel. The Company shall notify the Berkeley Representative within 10 days of the taking of any written action by the Board of Directors of the Company in lieu of a meeting
thereof and provide a written description of such action. 
 (j) Quarterly Management Review Meetings. Within 30 days after the
end of each fiscal quarter, the Company shall at the request of a Berkeley Investor hold a meeting with the Berkeley Representative to review the results of the preceding fiscal quarter. The meeting may be held by means of telephonic conference
call. The Berkeley Representative shall have the opportunity to consult with, advise, ask questions of, and receive answers from officers of the Company regarding the operation of the business and the management of the Company. 

(k) FIRPTA Undertakings. The Company shall make, in a timely manner, all necessary filings and shall take all other actions as are
necessary to establish that the Company is not a United States real property holding corporation, as defined in Section 897 of the Internal Revenue Code and the rules and regulations thereunder. The Company shall indemnify, defend and hold each
of the Berkeley Investors harmless from and against any federal income tax liability incurred by such Berkeley Investor upon disposition of the shares of the Company by reason of the Company’s failure to establish that it is not a United States
real property holding corporation as defined in Section 897 of the Internal Revenue Code and the rules and regulations thereunder. 

4. Miscellaneous. 
 (a)
Waiver of Right of First Offer. The Investors, who are holders of at least 66-2/3% of the outstanding shares of Preferred Stock held by the Major Investors (as defined in the Amended Master Rights Agreement dated July 1, 1991), hereby
waive their right of first offer under Section 1 of the Amended Master Rights Agreement dated July 1, 1991 with regard to (i) the Series F Preferred Stock (and the Common Stock into which it is convertible) issued pursuant to the
Series F Preferred Stock Purchase Agreement dated on or about November 4, 1991 and (ii) the 7,500 shares of Common Stock issued to Aspen Venture Partners at $.30 per share. 

(b) Successors and Assigns. The terms and conditions of this Agreement shall inure to the benefit of and be binding upon the respective
successors and assigns of the parties. Nothing in this Agreement, express or implied, is intended to confer upon any party other than the parties hereto or their respective successors and assigns any rights, remedies, obligations, or liabilities
under or by reason of this Agreement, except as expressly provided in this Agreement. 

  
 14 

 (c) Governing Law. This Agreement shall be governed by and construed under the laws of the
State of California as applied to agreements among California residents entered into and to be performed entirely within California. 

(d) Counterparts. This Agreement may be executed in two or more counterparts, each of which shall be deemed an original, but all of which
together shall constitute one and the same instrument. 
 (e) Titles and Subtitles. The titles and subtitles used in this
Agreement are used for convenience only and are not to be considered in construing or interpreting this Agreement. 
 (f) Notices.
Unless otherwise provided, any notice required or permitted under this Agreement shall be given in writing and shall be deemed effectively given upon personal delivery to the party to be notified or three (3) days after deposit with the United
States Post Office, by registered or certified mail, postage prepaid and addressed to the party to be notified at the address indicated for such party on Attachment A, or at such other address as such party may designate by ten (10) days’
advance written notice to the other parties. A copy of all notices or other communications hereunder from the Company to any Berkeley Investor (as identified on Exhibit A) shall also be telecopied to the Berkeley Investor, and a copy shall be sent
to Berkeley International Capital Corporation, 600 Montgomery Street, San Francisco, California 94111, Attention: President. 
 (g)
Amendments and Waivers. Any provision of this Section 4 may be amended and the observance thereof may be waived (either generally or in a particular instance and either retroactively or prospectively), only with the written consent of
the company and a majority of the Investors. Any amendment or waiver effected in accordance with this paragraph shall be binding upon all present and future Investors. 
 (h) Severability. If one or more provisions of this Agreement are held to be unenforceable under applicable law, such provision shall be excluded from this Agreement and the balance of the Agreement shall be
interpreted as if such provision were so excluded and shall be enforceable in accordance with its terms. 

  
 15 

 This Agreement is effective as of the date first above written. 

 

			
	APPLIED MEDICAL RESOURCES CORPORATION
		
	By:	 	/s/ Said S. Hilal
	Title:	 	President

  

			
	INVESTORS:
	
	BERKELEY MEDICAL INVESTMENTS LIMITED
		
	By:	 	/s/ Clive Chaplin
	Name:	 	 Clive Chaplin 

  

			
	3i LP CORPORATION
		
	By:	 	/s/ Michael A. Henos
	Name:	 	Michael A. Henos

  

			
	 ADVANCED MARKETING DECISIONS,

PROFIT SHARING PLAN

		
	By:	 	/s/ L. James Strand
	Name:	 	L. James Strand

  

			
	INSTITUTIONAL VENTURE MANAGEMENT IV
		
	By:	 	/s/ T. Peter Thomas
	Name:	 	T. Peter Thomas

  

			
	INSTITUTIONAL VENTURE PARTNERS IV
		
	By:	 	/s/ T. Peter Thomas
	Name:	 	T. Peter Thomas

  

			
	FIRST SMALL BUSINESS INVESTMENT CO.
		
	By:	 	/s/ J.V. McGoodwin
	Name:	 	J.V. McGoodwin

  

			
	WS INVESTMENTS CO.
		
	By:	 	/s/ J. Casey McGlynn
	Name:	 	 J. Casey McGlynn 

  
 16 

			
		
	By:	 	/s/ J.A.C. Deuss
	Name:	 	J.A.C. Deuss

  

			
		
	By:	 	/s/ Ronald R. Giannotti
	Name:	 	Ronald R. Giannotti

  

			
		
	By:	 	/s/ Said S. Hilal
	Name:	 	Said S. Hilal

  

			
		
	By:	 	/s/ Nabil Hilal
	Name:	 	Nabil Hilal

  

			
		
	By:	 	/s/ George B. Wallace
	Name:	 	George B. Wallace

  

			
		
	By:	 	/s/ John T. Meitner
	Name:	 	John T. Meitner

  

			
		
	By:	 	/s/ Michael A. Henos
	Name:	 	Michael A. Henos

  
  

  
 17 

			
		
	By:	 	/s/ Byron Barnes
	Name:	 	Byron Barnes

  

			
		
	By:	 	/s/ Frederick Grafton
	Name:	 	Frederick Grafton

  

			
		
	By:	 	/s/ Aidan A. Raney, Jr.
	Name:	 	Aidan A. Raney, Jr.

  
 18

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