Document:

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                             ASCENT PEDIATRICS, INC.
                        2000 CALIFORNIA STOCK OPTION PLAN
                  Amended and Restated as of February 14, 2001
                           to include Section 11 hereof

1.     Purpose
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     The  purpose  of  this  California Stock Option Plan (the "Plan") of Ascent
Pediatrics,  Inc.,  a  Delaware  corporation  (the "Company"), is to advance the
interests  of  the  Company's stockholders by enhancing the Company's ability to
attract,  retain  and  motivate  persons  who  make  (or  are  expected to make)
important  contributions  to  the  Company by providing such persons with equity
ownership  opportunities  and  performance-based  incentives  and thereby better
aligning the interests of such persons with those of the Company's stockholders.
Except  where  the  context otherwise requires, the term "Company" shall include
any  of  the  Company's  present  or future parent or subsidiary corporations as
defined  in  Sections  424(e)  or  (f)  of the Internal Revenue Code of 1986, as
amended,  and  any regulations promulgated thereunder (the "Code") and any other
business  venture  (including,  without  limitation,  joint  venture  or limited
liability  company)  in  which  the  Company  has  a  significant  interest,  as
determined  by  the  Board  of  Directors  of  the  Company  (the  "Board").
2.     Eligibility
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     All  of  the  Company's  employees,  officers,  directors,  consultants and
advisors  (and  any  individuals  who have accepted an offer for employment) are
eligible  to  be  granted options, restricted stock awards, or other stock-based
awards  (each,  an  "Award")  under  the  Plan,  provided  that such persons are
residents  of  the State of California on the date of grant of such Award.  Each
person  who  has  been  granted  an  Award  under  the  Plan  shall  be deemed a
"Participant".
3.     Administration  and  Delegation
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(a)     Administration  by Board of Directors.  The Plan will be administered by
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the  Board.  The  Board shall have authority to grant Awards and to adopt, amend
and  repeal  such administrative rules, guidelines and practices relating to the
Plan  as  it shall deem advisable.  The Board may correct any defect, supply any
omission  or  reconcile any inconsistency in the Plan or any Award in the manner
and  to  the extent it shall deem expedient to carry the Plan into effect and it
shall  be  the  sole  and  final judge of such expediency.  All decisions by the
Board  shall  be  made  in  the  Board's  sole discretion and shall be final and
binding  on  all  persons  having or claiming any interest in the Plan or in any
Award.  No  director or person acting pursuant to the authority delegated by the
Board  shall  be liable for any action or determination relating to or under the
Plan  made  in  good  faith.
(b)     Delegation to Executive Officers.  To the extent permitted by applicable
        --------------------------------
law, the Board may delegate to one or more executive officers of the Company the
power  to make Awards and exercise such other powers under the Plan as the Board
may  determine,  provided  that the Board shall fix the maximum number of shares
subject to Awards and the maximum number of shares for any one Participant to be
made  by  such  executive  officers.
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(c)     Appointment  of  Committees.  To the extent permitted by applicable law,
        ---------------------------
the  Board  may  delegate any or all of its powers under the Plan to one or more
committees or subcommittees of the Board (a "Committee").  All references in the
Plan  to  the  "Board"  shall  mean the Board or a Committee of the Board to the
extent  that  the Board's powers or authority under the Plan have been delegated
to  such  Committee.
4.     Stock  Available  for  Awards.
       -----------------------------
(a)     Number  of Shares.  Subject to adjustment under Section 8, Awards may be
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made  under  the Plan for up to 200,000 depositary shares ("Depositary Shares"),
each  Depositary  Share  representing  one share of common stock of the Company,
$.00004  par  value per share (the "Common Stock"), subject to a call option and
represented  by  a  depositary  receipt.  If any Award expires or is terminated,
surrendered  or  canceled without having been fully exercised or is forfeited in
whole  or  in part (including as the result of Depositary Shares subject to such
Award  being  repurchased by the Company at the original issuance price pursuant
to a contractual repurchase right) or results in any Depositary Shares not being
     issued,  the  unused Depositary Shares covered by such Award shall again be
available  for the grant of Awards under the Plan.  Shares issued under the Plan
may  consist  in  whole or in part of authorized but unissued shares or treasury
shares.  At no time while there is any Option (as defined below) outstanding and
held  by a Participant who was a resident of the State of California on the date
of  grant  of  such Option, shall the total number of Depositary Shares issuable
upon exercise of all outstanding options and the total number of shares provided
for  under  any stock bonus or similar plan of the Company exceed the applicable
percentage  as  calculated  in  accordance with the conditions and exclusions of
Section 260.140.45 of the California Code of Regulations, based on the shares of
the  Company  which  are  outstanding  at  the  time  the  calculation  is made.
(b)     Per-Participant  Limit.  Subject  to  adjustment  under  Section  8, the
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maximum  number  of  Depositary  Shares  with  respect  to which an Award may be
granted  to  any  Participant  under the Plan shall be 50,000 per calendar year.
The  per-Participant limit described in this Section 4(c) shall be construed and
applied  consistently  with  Section  162(m)  of  the  Code.
5.     Stock  Options
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(a)     General.  The  Board  may  grant  options  to purchase Depositary Shares
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(each,  an "Option") and determine the number of Depositary Shares to be covered
by  each  Option,  the  exercise  price  of  each  Option and the conditions and
limitations  applicable  to  the  exercise  of each Option, including conditions
relating  to  applicable  federal  or  state  securities  laws,  as it considers
necessary  or  advisable.  All  Options  under  this Plan shall be "Nonstatutory
Stock  Options"  and are not intended to comply with the requirements of Section
422  of  the  Code.
(b)     Exercise  Price.  The  Board  shall  establish the exercise price at the
        ---------------
time  each  Option is granted and specify it in the applicable option agreement.
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(c)     Duration of Options.  Each Option shall be exercisable at such times and
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subject  to such terms and conditions as the Board may specify in the applicable
option  agreement;  provided, however, that no Option will be granted for a term
in  excess  of 10 years and that no Option granted hereunder may be exercised on
the  Option  Closing  Date  (as  defined  in  Section  8(d)  below).
(d)     Exercise of Option.  Options may be exercised by delivery to the Company
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of a written notice of exercise signed by the proper person or by any other form
of  notice  (including  electronic  notice)  approved by the Board together with
payment  in full as specified in Section 5(e) for the number of shares for which
the  Option  is  exercised.
(e)     Payment Upon Exercise.  Depositary Shares purchased upon the exercise of
        ----------------------
an  Option  granted  under  the  Plan  shall  be  paid  for  as  follows:
(1)     in  cash  or  by  check,  payable  to  the  order  of  the  Company;
(2)     except as the Board may, in its sole discretion, otherwise provide in an
option  agreement,  by  (i)  delivery  of  an  irrevocable  and  unconditional
undertaking  by  a  creditworthy  broker  to  deliver  promptly  to  the Company
sufficient  funds  to pay the exercise price and any required tax withholding or
(ii)  delivery  by  the  Participant to the Company of a copy of irrevocable and
unconditional  instructions  to a creditworthy broker to deliver promptly to the
Company  cash  or  a check sufficient to pay the exercise price and any required
tax  withholding;
(3)     by  delivery  of  Depositary  Shares  owned by the Participant valued at
their  fair market value as determined by (or in a manner approved by) the Board
in good faith ("Fair Market Value"), provided (i) such method of payment is then
permitted  under  applicable  law  and  (ii) such Depositary Shares, if acquired
directly  from  the  Company,  was  owned by the Participant at least six months
prior  to  such  delivery;
(4)     to  the  extent  permitted  by  the Board, in its sole discretion by (i)
delivery  of  a  promissory  note  of  the  Participant  to the Company on terms
determined  by  the Board, or (ii) payment of such other lawful consideration as
the  Board  may  determine;  or
(5)     by  any  combination  of  the  above  permitted  forms  of  payment.
(f)     Substitute  Options.  In connection with a merger or consolidation of an
        -------------------
entity  with  the Company or the acquisition by the Company of property or stock
of  an  entity,  the  Board may grant Options in substitution for any options or
other  stock  or  stock-based  awards  granted  by  such  entity or an affiliate
thereof.  Substitute  Options  may  be  granted on such terms as the Board deems
appropriate  in  the  circumstances,  notwithstanding any limitations on Options
contained  in  the  other  sections  of  this  Section  5  or  in  Section  2.
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6.     Restricted  Stock
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(a)     Grants.  The  Board  may  grant  Awards  entitling recipients to acquire
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Depositary Shares, subject to the right of the Company to repurchase all or part
     of such shares at their issue price or other stated or formula price (or to
require  forfeiture  of  such shares if issued at no cost) from the recipient in
the event that conditions specified by the Board in the applicable Award are not
satisfied  prior  to  the  end  of  the applicable restriction period or periods
established  by  the  Board  for  such Award (each, a "Restricted Stock Award").
(b)     Terms  and  Conditions.  The  Board  shall  determine  the  terms  and
        ----------------------
conditions  of  any  such  Restricted  Stock Award, including the conditions for
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repurchase  (or  forfeiture)  and  the  issue  price,  if  any.
(c)     Depositary  Receipts.  Any  depositary  receipts  issued in respect of a
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Restricted  Stock  Award shall be registered in the name of the Participant and,
unless otherwise determined by the Board, deposited by the Participant, together
with a stock power endorsed in blank, with the Company (or its designee). At the
expiration of the applicable restriction periods, the Company (or such designee)
shall  deliver the depositary receipts no longer subject to such restrictions to
the  Participant  or if the Participant has died, to the beneficiary designated,
in  a manner determined by the Board, by a Participant to receive amounts due or
exercise  rights of the Participant in the event of the Participant's death (the
"Designated  Beneficiary").  In  the  absence  of  an effective designation by a
Participant,  Designated  Beneficiary  shall  mean  the  Participant's  estate.
7.     Other  Stock-Based  Awards
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     The  Board  shall  have  the  right  to  grant  other Awards based upon the
Depositary  Shares  having such terms and conditions as the Board may determine,
including  the  grant  of  shares  based  upon  certain conditions, the grant of
securities  convertible  into  Depositary  Shares  and  the  grant  of  stock
appreciation  rights.
8.     Adjustments  for  Changes  in  Depositary Shares and Certain Other Events
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(a)     Changes  in  Capitalization.  In  the  event of any stock split, reverse
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stock  split,  stock  dividend,  recapitalization,  combination  of  shares,
reclassification  of  shares, spin-off or other similar change in capitalization
or  event,  or  any  distribution  to  holders of Depositary Shares other than a
normal  cash  dividend,  (i)  the number and class of securities available under
this  Plan, (ii) the number and class of securities and exercise price per share
subject to each outstanding Option, (iii) the repurchase price per share subject
     to  each  outstanding  Restricted  Stock  Award, and (iv) the terms of each
other  outstanding  Award  shall  be  appropriately  adjusted by the Company (or
substituted  Awards  may  be  made, if applicable) to the extent the Board shall
determine, in good faith, that such an adjustment (or substitution) is necessary
and  appropriate.  If this Section 8(a) applies and Section 8(c) also applies to
any event, Section 8(c) shall be applicable to such event, and this Section 8(a)
shall  not  be  applicable.
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(b)     Liquidation  or  Dissolution.  In the event of a proposed liquidation or
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dissolution  of  the  Company,  the  Board  shall  upon  written  notice  to the
Participants  provide  that  all  then  unexercised  Options  will  (i)  become
exercisable  in  full  as of a specified time at least 10 business days prior to
the  effective  date  of  such  liquidation  or  dissolution  and (ii) terminate
effective  upon  such liquidation or dissolution, except to the extent exercised
before  such  effective date.  The Board may specify the effect of a liquidation
or  dissolution  on  any Restricted Stock Award or other Award granted under the
Plan  at  the  time  of  the  grant  of  such  Award.
(c)     Acquisition  Events
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(1)     Definition.  An  "Acquisition  Event"  shall  mean:  (a)  any  merger or
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consolidation  of  the  Company with or into another entity as a result of which
the  Depositary  Shares are converted into or exchanged for the right to receive
cash,  securities or other property or (b) any exchange of shares of the Company
for cash, securities or other property pursuant to a share exchange transaction.
(2)     Consequences  of an Acquisition Event on Options. Upon the occurrence of
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an  Acquisition  Event,  or  the  execution by the Company of any agreement with
respect  to  an  Acquisition Event, the Board shall provide that all outstanding
Options  shall  be  assumed,  or equivalent options shall be substituted, by the
acquiring  or  succeeding  corporation  (or an affiliate thereof).  For purposes
hereof,  an  Option shall be considered to be assumed if, following consummation
of  the  Acquisition  Event,  the Option confers the right to purchase, for each
Depositary  Share subject to the Option immediately prior to the consummation of
the  Acquisition  Event,  the  consideration  (whether cash, securities or other
property) received as a result of the Acquisition Event by holders of Depositary
Shares  for  each Depositary Share held immediately prior to the consummation of
the  Acquisition  Event  (and if holders were offered a choice of consideration,
the type of consideration chosen by the holders of a majority of the outstanding
Depositary  Shares);  provided, however, that if the consideration received as a
result  of  the Acquisition Event is not solely common stock of the acquiring or
succeeding  corporation  (or  an  affiliate  thereof), the Company may, with the
consent  of  the  acquiring  or  succeeding  corporation,  provide  for  the
consideration  to  be received upon the exercise of Options to consist solely of
common  stock  of  the  acquiring  or  succeeding  corporation  (or an affiliate
thereof) equivalent in fair market value to the per share consideration received
by  holders  of  outstanding  Depositary  Shares  as a result of the Acquisition
Event.
     Notwithstanding  the  foregoing, if the acquiring or succeeding corporation
(or  an  affiliate  thereof)  does  not agree to assume, or substitute for, such
Options,  then the Board shall, upon written notice to the Participants, provide
that  all  then  unexercised  Options  will  become  exercisable in full as of a
specified  time  prior  to  the Acquisition Event and will terminate immediately
prior  to  the  consummation  of  such  Acquisition  Event, except to the extent
exercised by the Participants before the consummation of such Acquisition Event;
provided,  however, that in the event of an Acquisition Event under the terms of
which holders of Depositary Shares will receive upon consummation thereof a cash
payment for each Depositary Share surrendered pursuant to such Acquisition Event
(the  "Acquisition  Price"),  then  the  Board  may  instead  provide  that  all
outstanding  Options shall terminate upon consummation of such Acquisition Event
and  that  each  Participant shall receive, in exchange therefor, a cash payment
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equal  to  the  amount (if any) by which (A) the Acquisition Price multiplied by
the  number of Depositary Shares subject to such outstanding Options (whether or
not then exercisable), exceeds (B) the aggregate exercise price of such Options.
To  the  extent  all or any portion of an Option becomes exercisable solely as a
result of the first sentence of this paragraph, upon exercise of such Option the
Participant shall receive shares subject to a right of repurchase by the Company
or  its successor at the Option exercise price.  Such repurchase right (1) shall
lapse  at  the  same  rate as the Option would have become exercisable under its
terms  and  (2)  shall  not  apply to any shares subject to the Option that were
exercisable  under  its  terms  without  regard  to  the  first sentence of this
paragraph.
If  any  Option  provides  that  it may be exercised for Depositary Shares which
remain  subject  to  a  repurchase  right  in  favor  of  the  Company, upon the
occurrence of an Acquisition Event, any shares of restricted stock received upon
exercise  of  such Option shall be treated in accordance with Section 8(c)(3) as
if  they  were  a  Restricted  Stock  Award.
(3)     Consequences  of  an Acquisition Event on Restricted Stock Awards.  Upon
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the  occurrence  of an Acquisition Event, the repurchase and other rights of the
Company under each outstanding Restricted Stock Award shall inure to the benefit
     of the Company's successor and shall apply to the cash, securities or other
property  which  the  Depositary  Shares  were  converted  into or exchanged for
pursuant  to such Acquisition Event in the same manner and to the same extent as
they  applied  to  the Depositary Shares subject to such Restricted Stock Award.
(4)     Consequences  of  an Acquisition Event on Other Awards.  The Board shall
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specify  the effect of an Acquisition Event on any other Award granted under the
Plan  at  the  time  of  the  grant  of  such  Award.
(d)     Alpharma  Call  Option.
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(1)     From  and  after  the  date  of  adoption  of  this Plan by the Board of
Directors  of the Company until the Option Determination Date (as defined in the
Depositary  Agreement  dated  as  of February 16, 1999 by and among the Company,
Alpharma  USPD, Inc. and State Street Bank and Trust Company (the "Depositary"),
as  amended  (the  "Depositary  Agreement")),  the class of securities available
under  this  Plan  shall  mean  the  Depositary  Shares, and a Participant shall
receive from the Depositary, upon the exercise of an Option a depositary receipt
     representing the number of Depositary Shares issuable upon exercise of such
Option.
(2)     From  and  after  the  Option Closing Date (as defined in the Depositary
Agreement),  a  Participant  shall receive from the Company, upon exercise of an
Option,  cash in an amount equal to the Option Exercise Price (as defined in the
Depositary  Agreement)  for  each  Depositary  Share issuable upon conversion or
exercise  of  such Option.  Upon the occurrence of an Option Closing (as defined
in  the Depositary Agreement), except to the extent specifically provided to the
contrary  in the instrument evidencing any Option, Restricted Stock Award, other
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Award  or  any  other  agreement  between a Participant and the Company: (i) all
Options  then-outstanding  shall automatically become immediately exercisable in
full,  (ii)  all Restricted Stock Awards then-outstanding shall automatically be
deemed  free of all conditions or restrictions, and (iii) all other Awards shall
become  exercisable,  realizable  or  vested  in  full,  or shall be free of all
conditions  or  restrictions,  as  applicable  to  each  such  Award.
(3)     From  and after the Option Expiration Date (as defined in the Depositary
Agreement),  the  class  of  securities available under this Plan shall mean the
Common Stock, and a Participant shall receive from the Company, upon exercise of
an  Option,  the  number  of shares of Common Stock of the Company issuable upon
conversion  or  exercise  of  such  Option.

9.     General  Provisions  Applicable  to  Awards
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(a)     Transferability  of Awards.  Except as the Board may otherwise determine
        --------------------------
or provide in an Award, Awards shall not be sold, assigned, transferred, pledged
     or  otherwise  encumbered  by  the  person to whom they are granted, either
voluntarily  or  by  operation of law, except by will or the laws of descent and
distribution, and, during the life of the Participant, shall be exercisable only
by  the Participant.  References to a Participant, to the extent relevant in the
context,  shall  include  references  to  authorized  transferees.
(b)     Documentation.  Each  Award  shall  be  evidenced in such form (written,
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electronic  or  otherwise)  as the Board shall determine. Each Award may contain
terms  and  conditions  in  addition  to  those  set  forth  in  the  Plan.
(c)     Board  Discretion.  Except as otherwise provided by the Plan, each Award
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may  be  made alone or in addition or in relation to any other Award.  The terms
of  each  Award need not be identical, and the Board need not treat Participants
uniformly.
(d)     Termination of Status.  The Board shall determine the effect on an Award
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of  the  disability,  death,  retirement,  authorized  leave of absence or other
change  in  the  employment  or  other status of a Participant and the extent to
which,  and  the  period  during which, the Participant, the Participant's legal
representative,  conservator,  guardian  or  Designated Beneficiary may exercise
rights  under  the  Award.
(e)     Withholding.  Each  Participant  shall  pay  to  the  Company,  or  make
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provision satisfactory to the Board for payment of, any taxes required by law to
be withheld in connection with Awards to such Participant no later than the date
of  the  event  creating  the  tax liability.  Except as the Board may otherwise
provide  in  an  Award,  Participants  may,  to  the extent then permitted under
applicable  law, satisfy such tax obligations in whole or in part by delivery of
Depositary  Shares,  including  shares  retained from the Award creating the tax
obligation, valued at their Fair Market Value; provided, however, that the total
tax withholding where stock is being used to satisfy such tax obligations cannot
exceed the Company's minimum statutory withholding obligations (based on minimum
statutory  withholding  rates  for  federal  and  state  tax purposes, including
payroll  taxes,  that  are  applicable to such supplemental taxable income). The
Company  may,  to  the  extent permitted by law, deduct any such tax obligations
from  any  payment  of  any  kind  otherwise  due  to  a  Participant.
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(f)     Amendment  of  Award.  The  Board  may  amend,  modify  or terminate any
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outstanding  Award,  including but not limited to, substituting therefor another
Award  of  the  same  or  a  different type and changing the date of exercise or
realization,  provided  that  the  Participant's consent to such action shall be
required  unless  the  Board determines that the action, taking into account any
related  action,  would  not  materially  and  adversely affect the Participant.
(g)     Conditions  on Delivery of Shares.  The Company will not be obligated to
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deliver  any  Depositary  Shares  pursuant to the Plan or to remove restrictions
from  shares previously delivered under the Plan until (i) all conditions of the
Award  have  been met or removed to the satisfaction of the Company, (ii) in the
opinion of the Company's counsel, all other legal matters in connection with the
issuance  and  delivery  of  such  shares  have  been  satisfied,  including any
applicable  securities  laws  and  any applicable stock exchange or stock market
rules  and  regulations, and (iii) the Participant has executed and delivered to
the  Company  such  representations  or  agreements  as the Company may consider
appropriate  to  satisfy  the  requirements  of  any  applicable  laws, rules or
regulations.
(h)     Acceleration.  The  Board  may  at any time provide that any Award shall
        ------------
become  immediately  exercisable  in  full  or  in  part,  free  of  some or all
restrictions  or  conditions, or otherwise realizable in full or in part, as the
case  may  be.
10.     Miscellaneous
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(a)     No  Right To Employment or Other Status.  No person shall have any claim
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or  right  to  be  granted  an  Award,  and  the  grant of an Award shall not be
construed as giving a Participant the right to continued employment or any other
     relationship with the Company.  The Company expressly reserves the right at
any  time  to dismiss or otherwise terminate its relationship with a Participant
free from any liability or claim under the Plan, except as expressly provided in
the  applicable  Award.
(b)     No  Rights  As Stockholder.  Subject to the provisions of the applicable
        --------------------------
Award,  no  Participant  or  Designated  Beneficiary  shall have any rights as a
stockholder with respect to any Depositary Shares to be distributed with respect
to  an  Award  until becoming the record holder of such shares.  Notwithstanding
the foregoing, in the event the Company effects a split of the Depositary Shares
by  means of a stock dividend and the exercise price of and the number of shares
subject  to  such  Option are adjusted as of the date of the distribution of the
dividend (rather than as of the record date for such dividend), then an optionee
who  exercises  an  Option between the record date and the distribution date for
such  stock dividend shall be entitled to receive, on the distribution date, the
stock  dividend  with respect to the Depositary Shares acquired upon such Option
exercise,  notwithstanding  the fact that such shares were not outstanding as of
the  close  of  business  on  the  record  date  for  such  stock  dividend.
(c)     Effective Date and Term of Plan.  The Plan shall become effective on the
        -------------------------------
date  on  which it is adopted by the Board. No Awards shall be granted under the
Plan  after  the  completion  of  ten  years from the date on which the Plan was
adopted by the Board, but Awards previously granted may extend beyond that date.
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(d)     Amendment  of  Plan.  The Board may amend, suspend or terminate the Plan
        -------------------
or  any  portion  thereof  at  any  time.
(e)     Authorization  of  Sub-Plans.  The Board may from time to time establish
        ----------------------------
one  or more sub-plans under the Plan for purposes of satisfying applicable blue
sky, securities or tax laws of various jurisdictions.  The Board shall establish
such  sub-plans  by  adopting  supplements  to  this  Plan  containing  (i) such
limitations  on  the  Board's  discretion  under  the  Plan  as  the Board deems
necessary  or  desirable  or  (ii)  such  additional  terms  and  conditions not
otherwise  inconsistent  with  the  Plan  as  the  Board shall deem necessary or
desirable.  All  supplements  adopted by the Board shall be deemed to be part of
the  Plan,  but  each  supplement  shall  apply  only to Participants within the
affected jurisdiction and the Company shall not be required to provide copies of
any  supplement  to Participants in any jurisdiction which is not the subject of
such  supplement.
(f)     Governing Law.  The provisions of the Plan and all Awards made hereunder
        -------------
shall be governed by and interpreted in accordance with the laws of the State of
Delaware,  without  regard  to  any  applicable  conflicts  of  law.
11.     Change  in  Control  of  Company.
        --------------------------------
     (a)     Notwithstanding  anything  in  the  Plan to the contrary, effective
upon  the consummation of a Change in Control of the Company, the exercisability
of  all  options then outstanding under the Plan shall be accelerated in full so
that  such  options  shall become immediately exercisable to purchase all of the
Depositary Shares covered by such options and all restrictions and conditions on
awards  outstanding  under  the Plan shall automatically be deemed terminated or
satisfied.
(b)     For  purposes  of  the  Plan,  a  "Change  in  Control"  shall  mean:
     (1)     the  acquisition  by  an  individual,  entity  or group (within the
meaning  of  Section  13(d)(3)  or 14(d)(2) of the Exchange Act) (a "Person") of
beneficial  ownership  of  any  capital  stock  of  the  Company  if, after such
acquisition,  such  Person  beneficially  owns (within the meaning of Rule 13d-3
promulgated  under  the  Exchange  Act)  50%  or  more  of  either  (x)  the
then-outstanding  Depositary  Shares of the Company (the "Outstanding Depositary
Shares")  or (y) the combined voting power of the then-outstanding securities of
the  Company  entitled  to  vote  generally  in  the  election of directors (the
"Outstanding  Company Voting Securities"); provided, however, that the following
                                           --------  -------
acquisitions  shall  not  constitute  a  Change  in Control: (A) any acquisition
directly  from  the  Company (excluding an acquisition pursuant to the exercise,
conversion  or  exchange  of  any  security exercisable for, convertible into or
exchangeable  for  Depositary Shares or voting securities of the Company, unless
the  Person  exercising,  converting  or  exchanging such security acquired such
security  directly  from the Company or an underwriter or agent of the Company),
(B) any acquisition by any employee benefit plan (or related trust) sponsored or
maintained  by  the Company or any corporation controlled by the Company, or (C)
any  acquisition  by  any  corporation  pursuant  to  a Business Combination (as
defined below) which complies with clauses (x) and (y) of subsection (3) of this
definition;  or
10
<PAGE>
(2)     such  time  as  the  Continuing  Directors  (as  defined  below)  do not
constitute a majority of the Board (or, if applicable, the Board of Directors of
a  successor  corporation  to the Company), where the term "Continuing Director"
means  at  any  date  a member of the Board (x) who was a member of the Board on
December  13,  2000, or (y) who was nominated or elected subsequent to such date
by  at  least  a  majority of the directors who were Continuing Directors at the
time  of  such  nomination  or  election  or  whose  election  to  the Board was
recommended  or  endorsed  by  at  least  a  majority  of the directors who were
Continuing  Directors  at  the  time  of  such nomination or election; provided,
                                                                       --------
however,  that there shall be excluded from this clause (y) any individual whose
     --
initial  assumption  of  office  occurred as a result of an actual or threatened
election  contest  with respect to the election or removal of directors (as such
terms  are  used in Rule 14a-11 of Regulation 14A promulgated under the Exchange
Act) or other actual or threatened solicitation of proxies or consents, by or on
behalf  of  a  person  other  than  the  Board;  or
(3)     the  consummation  of  a  merger,  consolidation,  reorganization,
recapitalization  or statutory share exchange involving the Company or a sale or
other  disposition  of  all or substantially all of the assets of the Company (a
"Business  Combination"),  unless,  immediately  following  such  Business
Combination,  each  of  the  following  two  conditions is satisfied: (x) all or
substantially all of the individuals and entities who were the beneficial owners
of  the  Outstanding Depositary Shares and Outstanding Company Voting Securities
immediately  prior  to  such  Business Combination beneficially own, directly or
indirectly,  more than 50% of the then-outstanding common stock and the combined
voting  power  of  the then-outstanding securities entitled to vote generally in
the  election  of directors (or other persons having the general power to direct
the  affairs  of  such  entity),  respectively,  of  the  resulting or acquiring
corporation  in  such  Business  Combination  (which  shall  include,  without
limitation, a corporation which as a result of such transaction owns the Company
or  substantially  all of the Company's assets either directly or through one or
more  subsidiaries)  (such  resulting  or  acquiring  corporation is referred to
herein  as the "Acquiring Corporation") in substantially the same proportions as
their  ownership  of  the  Outstanding Depositary Shares and Outstanding Company
Voting  Securities, respectively, immediately prior to such Business Combination
and  (y)  no Person (excluding the Acquiring Corporation or any employee benefit
plan  (or  related  trust)  maintained  or  sponsored  by  the Company or by the
Acquiring Corporation) beneficially owns, directly or indirectly, 50% or more of
the  then-outstanding  Depositary Shares of the Acquiring Corporation, or of the
combined  voting  power  of  the then-outstanding securities of such corporation
entitled  to  vote  generally in the election of directors (except to the extent
that  such  ownership  existed  prior  to  the  Business  Combination);  or
(4)     the  approval  by  the stockholders of the Company of a complete plan of
liquidation.VISION TWENTY-ONE, INC

EXHIBITS 4.48 and 10.117

Vision Twenty-One, Inc.

Third Amendment to Convertible Note Agreement, Warrant Agreement, 

and warrants

This Third Amendment to Convertible Note Agreement, Warrant Agreement, and Warrants (herein, the "Amendment") is entered into as of July 12, 2001, among Vision Twenty-One, Inc., a Florida corporation (the "Borrower"), the Lenders party hereto, and Bank of Montreal as Agent for the Lenders.

Preliminary Statements

A.The Borrower, the Lenders, and the Agent are parties to a Convertible Note Agreement, dated as of November 10, 2000, as amended (herein, the "Convertible Note Agreement"), and a Warrant Agreement dated as of November 10, 2000, as amended (herein, the "Warrant Agreement").  All capitalized terms used herein without definition shall have the same meanings herein as such terms have in the Convertible Note Agreement.

B.The Borrower and the Lenders have agreed to amend the Convertible Note Agreement, the Warrant Agreement, and the Warrants issued under the Warrant Agreement on the terms and conditions as provided for in this Amendment.

Now, Therefore, for good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties hereto agree as follows:  

Section 1.Amendments to the Convertible Note Agreement. 

Subject to the satisfaction of the conditions precedent set forth in Section 3 below, the Convertible Note Agreement shall be and hereby is amended as follows:
1.1.Section 4.1(i) of the Convertible Note Agreement shall be amended and restated in its entirety to read as follows:
(i)the Borrower and its shareholders fail to approve and authorize the increase in the authorized shares of the Borrower's capital stock pursuant to the Plan of Restructuring by September 30, 2001, or the Borrower fails to reserve sufficient shares of authorized capital stock of the Borrower to satisfy the requirements of the Notes and this Agreement by such date.

1.2.The definition of "Additional Shares of Common Stock" appearing in Section 6.1 of the Convertible Note Agreement shall be amended by amending and restating clause (v) thereof to read as follows:
(v)up to 11,194,000 shares of Common Stock (as such number shall be appropriately adjusted by the board of directors of the Company for stock splits, dividends, combinations and other similar events) to be issued on or before September 30, 2001, or to be issued upon exercise of options granted before September 30, 2001, in connection with, and as an express part of, the consummation of the Plan of Restructuring.

1.3.Section 7.8 of the Convertible Note Agreement shall be amended and restated in its entirety to read as follows:
Section 7.8.Reservation of Common Stock. The Borrower represents and warrants that on the Closing Date it has reserved and set aside solely for the purpose of issuance upon the conversion of the Notes 32,405,937 authorized shares of its Common Stock and agrees that it will, on or before September 30, 2001, cause the requisite number of shareholders required to approve and ratify under applicable state law an increase in the number of authorized shares of capital stock of the Company so that from and after the date such approval is obtained (and in all events, from and after September 30, 2001) it will at all times reserve and keep available such number of authorized shares of its Common Stock, solely for the purpose of issue upon the conversion of Notes as herein provided for, as shall then be issuable upon the conversion of all outstanding Notes.

1.4.Section 4(c) of the Representations and Warranties set forth in Exhibit B to the Convertible Note Agreement shall be amended and restated in its entirety to read as follows:
(c)have been duly authorized by proper corporate and shareholder action on the part of the Borrower, executed and delivered by the Borrower and the Agreement, the Notes or the Registration Rights Agreement constitute the legal, valid and binding obligations, contracts and agreements of the Borrower enforceable in accordance with their respective terms; provided, however, shareholder approval authorizing the increase in the authorized shares of the Borrower's capital stock required for the conversion of all Notes into Common Stock shall be obtained in connection with the Plan of Restructuring on or before September 30, 2001.

Section 2.Amendments to the Warrant Agreement and the Warrants.
2.1.Section 1.4 of the Warrant Agreement shall be amended and restated in its entirety to read as follows:
Section1.4.Covenant to Increase Authorized Shares. The Company agrees to use its best efforts to cause the requisite number of shareholders required to approve and ratify under applicable state law an increase in the number of authorized shares of capital stock of the Company by September 30, 2001, sufficient at all times to permit the Lenders to exercise the Warrants in accordance with their terms.

2.2.Section 2 of Exhibit A-1 to the Warrant Agreement and Section 2 of each Class A Warrant issued under the Warrant Agreement shall be amended and restated in its entirety to read as follows:
Section 2.Reservation of Common Stock.  The Company covenants and agrees that at all times from and after September 30, 2001, and on or prior to the Expiration Date it will have authorized, and in reserve solely for the purpose of delivery upon the exercise of the rights represented by this Warrant, a sufficient number of shares of its Common Stock to provide for the exercise of the rights represented by the unexercised portion of this Warrant and such shares issuable upon the exercise of this Warrant shall at no time have an aggregate par value which is in excess of the Aggregate Warrant Price.

2.3.Clause (v) of the definition of "Additional Shares of Common Stock" appearing in Section 12 of Exhibit A-1 to the Warrant Agreement and in Section 12 of each Class A Warrant issued under the Warrant Agreement shall be amended and restated in its entirety to read as follows:
(v) up to 11,194,000 shares of Common Stock (as such number shall be appropriately adjusted by the board of directors of the Company for stock splits, dividends, combinations and other similar events) to be issued on or before September 30, 2001, or to be issued upon exercise of options granted before September 30, 2001, in connection with, and as an express part of, the consummation of the Plan of Restructuring.

2.4.Section 2 of Exhibit A-2 to the Warrant Agreement and Section 2 of each Class B Warrant issued under the Warrant Agreement shall be amended and restated in its entirety to read as follows:
Section 2.Reservation of Common Stock.  The Company covenants and agrees that at all times from and after September 30, 2001, and on or prior to the Expiration Date it will have authorized, and in reserve solely for the purpose of delivery upon the exercise of the rights represented by this Warrant, a sufficient number of shares of its Common Stock to provide for the exercise of the rights represented by the unexercised portion of this Warrant and such shares issuable upon the exercise of this Warrant shall at no time have an aggregate par value which is in excess of the Aggregate Warrant Price.

2.5.Clause (v) of the definition of "Additional Shares of Common Stock" appearing in Section 12 of Exhibit A-2 to the Warrant Agreement and in Section 12 of each Class B Warrant issued under the Warrant Agreement shall be amended and restated in its entirety to read as follows:
(v) up to 11,194,000 shares of Common Stock (as such number shall be appropriately adjusted by the board of directors of the Company for stock splits, dividends, combinations and other similar events) to be issued on or before September 30, 2001 or to be issued upon exercise of options granted before September 30, 2001 in connection with, and as an express part of, the consummation of the Plan of Restructuring.

2.6.Section 4(c) of the Representations and Warranties set forth in Exhibit B to the Warrant Agreement shall be amended and restated in its entirety to read as follows:
(c)have been duly authorized by proper corporate and shareholder action on the part of the Company, executed and delivered by the Company, and the Agreement and the Warrants constitute the legal, valid and binding obligations, contracts and agreements of the Company enforceable in accordance with their respective terms; provided, however, shareholder approval authorizing the increase in the authorized shares of the Borrower's Capital Stock required for the exercise of all Warrants into common stock shall be obtained in connection with the Plan of Restructuring on or before September 30, 2001.

Section 3.Conditions Precedent.

The effectiveness of this Amendment is subject to the satisfaction of all of the following conditions precedent:
3.1.The Borrower, the Agent, and the Lenders shall have executed and delivered this Amendment.

3.2.Each Subsidiary (other than Dormant Subsidiaries) shall have executed its acknowledgement and consent to this Amendment in the space provided for that purpose below.

3.3.Legal matters incident to the execution and delivery of this Amendment shall be satisfactory to the Agent and its counsel.

Section 4.Release of Claims.

To induce the Lenders and the Agent to enter into this Amendment, the Borrower and, by signing the acknowledgement and consent referred to below, each of its Subsidiaries hereby release, acquit, and forever discharge the Lenders and the Agent and each of their Affiliates, and their officers, directors, agents, employees, successors, and assigns, from all liabilities, claims, demands, actions, and causes of action of any kind (if any there be), whether absolute or contingent, due or to become due, disputed or undisputed, at law or in equity, that they now have or ever had against the Lenders and the Agent and their Affiliates, or any one or more of them individually, under or in connection with the Convertible Note Agreement or any of the other Convertible Loan Documents or the Warrant Agreement or any of the warrants issued thereunder or any other credit, deposit or other financial accommodation made available to the Borrower or any one or more of its Subsidiaries.

Section 5.Miscellaneous.
5.1.The Borrower has heretofore executed and delivered to the Agent and the Lenders certain of the Collateral Documents.  The Borrower hereby acknowledges and agrees that, notwithstanding the execution and delivery of this Amendment, the Collateral Documents remain in full force and effect and the rights and remedies of the Agent and the Lenders thereunder, the obligations of the Borrower thereunder, and the liens and security interests created and provided for thereunder remain in full force and effect and shall not be affected, impaired, or discharged hereby.  Nothing herein contained shall in any manner affect or impair the priority of the liens and security interests created and provided for by the Collateral Documents as to the indebtedness which would be secured thereby prior to giving effect to this Amendment.

5.2.Except as specifically amended herein, the Convertible Note Agreement, the Warrant Agreement and the Warrants issued thereunder shall continue in full force and effect in accordance with their original terms.  Reference to this specific Amendment need not be made in the Convertible Note Agreement, the Notes, the Warrant Agreement, the Warrants, or any other instrument or document executed in connection therewith, or in any certificate, letter or communication issued or made pursuant to or with respect to the Convertible Note Agreement, the Warrant Agreement, or the Warrants any reference in any of such items to the Convertible Note Agreement, the Warrant Agreement, or the Warrants being sufficient to refer to the Convertible Note Agreement, the Warrant Agreement, and the Warrants as amended hereby.

5.3.The Borrower agrees to pay on demand all costs and expenses of or incurred by the Agent in connection with the negotiation, preparation, execution, and delivery of this Amendment and the other instruments and documents to be executed and delivered in connection herewith, including the fees and expenses of counsel for the Agent.

5.4.This Amendment may be executed in any number of counterparts, and by the different parties on different counterpart signature pages, all of which taken together shall constitute one and the same agreement.  Any of the parties hereto may execute this Amendment by signing any such counterpart and each of such counterparts shall for all purposes be deemed to be an original.  This Amendment shall be governed by the internal laws of the State of Illinois.

5.5.This Amendment together with the other Convertible Loan Documents, the Warrant Agreement and the Warrants issued thereunder represent the entire agreement of the Borrower, its Subsidiaries, the Lenders and the Agent with respect to the subject matter hereof and thereof, and there are no promises or undertakings by the Lenders or the Agent relative to the subject matter hereof or thereof not expressly set forth therein.  

[Signature Pages to Follow]

This Third Amendment to Convertible Note Agreement, Warrant Agreement, and Warrants is dated as of the date and year first above written.

	
	
VISION TWENTY-ONE, INC.

BY /S/ MARK GORDON

TITLE C.E.O

	     acknowledged and agreed to as of the date first above written.

	
Bank of Montreal, in its individual capacity as a Lender and as Agent

By /s/ Jack J. Kane 

Name  Jack J. Kane

Title   Director
	
Bank One Texas, N.A.

By   /s/Ronnie Kaplan

Name  Ronnie Kaplan

Title  First Vice President

	
Pacifica Partners I, L.P.

By:Imperial Credit Asset Management, as its Investment Manager

By  /s/Dean K. Kawai

Name Dean K. Kawai

Title Vice President 
	
Pilgrim Prime Rate Trust

By:ING Pilgrim Investments,  as its Investment Manager

By  Charles E. LeMieux,

Name Charles E. LeMieux, CFA

Title  Vice President

	
Pilgrim America High Income Investments Ltd.

By:ING Pilgrim Investments, as its Investment Manager

By  /s/ Charles E. LeMieux

Name Charles E. LeMieux, CFA

Title  VicePresident
	
Merrill Lynch Business Financial Services, Inc.

By  /s/Gary L. Stewart

Name  Gary L. Stewart

Title  Vice President

 

Acknowledgement and Consent

The undersigned Subsidiaries of Vision Twenty-One, Inc., have heretofore executed and delivered to the Agent and the Lenders one or more Guaranties and Collateral Documents.  Each of the undersigned hereby consents to the Third Amendment to Convertible Note Agreement, Warrant Agreement, and Warrants as set forth above and confirms that its Guaranty and Collateral Documents, and all of its obligations thereunder, remain in full force and effect.  Each of the undersigned further agrees that the consent of the undersigned to any further amendments to the Convertible Note Agreement, Warrant Agreement, and Warrants shall not be required as a result of this consent having been obtained.

	
"Guarantors"

	
Vision 21 Physician Practice Management Company

	
Vision 21 Managed Eye Care of Tampa Bay, Inc.

	
Vision Twenty-One Managed Eye Care IPA, Inc.

	
BBG-COA, Inc.

	
LSI Acquisition, Inc.

	
MEC Health Care, Inc.

	
Vision Twenty-One Eye Surgery Centers, Inc.

	
Eye Surgery Center Management, Inc.

	
Vision Twenty-One Refractive Center, Inc.

	
Vision Twenty-One of Wisconsin, Inc.

	
New Jersey Eye Laser Centers, Inc.

	
Vision Twenty-One Eye Laser Centers, Inc.

	
Block Vision, Inc.

	
UVC Independent Practice Association, Inc.

	
By  /s/ Mark Gordon

	
Mark B. Gordon, an authorized signatory for

	
each of the above-referenced entities

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