Document:

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                                                                   Exhibit 10.19

                                                                    Confidential

                                (HEARTWARE LOGO)

                        CLINICAL INVESTIGATION AGREEMENT

     THIS CLINICAL INVESTIGATION AGREEMENT (this "Agreement") made and effective
as of this 17th day of February, 2006 (the "Effective Date"), is by and between
Heartware, Inc., a Delaware corporation having its principal offices at 3351
Executive Way, Miramar, FL 33023-3935, U.S.A. ("Sponsor"); and Royal Perth
Hospital ("Hospital") having its address at Wellington Street Perth, GPO Box
X2213, Western Australia, 6847; and Gerry A. O'Driscoll, having his address at
(address) ("Investigator").

     WHEREAS, Sponsor desires Hospital and Investigator to conduct, and Hospital
and Investigator desire to conduct for Sponsor, a Clinical Study of Sponsor's
implantable left ventricular assist System "LVAD" (the "Device"), according to
the protocol number HW002 (the "Protocol"), which is attached hereto as Exhibit
A (which, upon the reasonable request of any party hereto, may be amended from
time to time as set forth in section 10.5 of this Agreement);

     WHEREAS, the Clinical Study detailed in the protocol is of mutual interest
and benefit to Sponsor, Hospital and Investigator.

     NOW, THEREFORE, in consideration of the mutual promises and covenants
contained herein, and for other good and valuable consideration, the receipt and
sufficiency of which are hereby acknowledged, the parties hereto mutually
covenant and agree as follows:

1.   SCOPE OF WORK; TERM

1.1  Clinical Study

     Hospital and Investigator agree to use their best efforts and professional
expertise to perform the Clinical Study according to the Protocol as set forth
in Exhibit A. Hospital agrees to provide such qualified personnel, equipment,
materials (except materials to be provided by Sponsor as hereinafter set forth)
and facilities as are necessary to perform the Clinical Study. Hospital and
Investigator agree to comply with all applicable laws and regulations relating
to the use of such equipment, materials and facilities and to the employment of
such personnel.

1.2  Investigator.

     The Investigator, on behalf of the Hospital, shall undertake primary
responsibility for performing the Clinical Study in accordance with the Protocol
and the terms of this Agreement. Without limiting the generality of the
foregoing, the work to be performed hereunder shall be

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performed by the Hospital solely by or under the direct supervision of the
Investigator. In the event that Investigator is unable to continue with the
Clinical Study, Hospital shall promptly notify Sponsor in writing and propose a
substitute. Sponsor shall have the right to approve any such substitute, and may
terminate this Agreement upon ten (10) days prior written notice to Hospital if
the proposed substitute is not acceptable to Sponsor in its sole discretion.
Upon any such termination, Hospital shall be reimbursed for its costs incurred
through such termination date.

1.3  Co-Investigators.

     Upon the prior written consent of Sponsor, which shall not be unreasonably
withheld, Principal Investigator may appoint one or more collaborating
physicians, each of whom shall have special expertise in the field of clinical
research relating to the Study ("Co-Investigator"), to participate in this
Clinical Study. Such Co-Investigators shall work under the direct supervision of
the Investigator and shall otherwise agree to be bound by the same terms that
bind the Investigator hereunder. Prior to commencing participation in the
Clinical Study, each Co-Investigator shall execute the attached Co-Investigator
Acceptance Form attached hereto as Exhibit B and deliver the same to Sponsor,
together with a copy of such Co-Investigator's current curriculum vitae and a
signed Financial Disclosure Form attached hereto as Exhibit C.

     Hospital and/or the Investigator will take all necessary countermeasures to
ensure that any Co-Investigator complies with the obligations undertaken by
Hospital and/or the Investigator under this Agreement and shall be responsible
for any and all performance of Co-Investigator.

1.4  Ethics Committee.

     Hospital and/or Investigator shall submit an Ethics Committee Application
and the Protocol for approval to Hospital Ethics Committee. The Ethics
Committee's unconditional approval of the Protocol and patient consent form is a
prerequisite of participation under and compensation by this Agreement.

1.5  Protocol.

     Investigator and Hospital hereby confirm that they have each reviewed the
Protocol and have had the opportunity to ask questions and discuss any concerns
related thereto. Investigator and Hospital agree to conduct the Clinical Study
in accordance with this Agreement, the Protocol, EN540, ISO14155, ICH GCP, any
conditions of approval imposed by the Ethic Committee, and all applicable
European Community laws and regulations.

1.6  Compliance With Laws.

     In performing the Clinical Study, Hospital and the Investigator agree to
fully comply with all applicable federal, state and local laws and regulations,
including, without limitation relevant provisions of the European Community, and
with all terms and conditions of the Protocol. Sponsor shall be responsible for
notifying competent authorities of the nature of the Clinical Study and
obtaining any required approvals. Hospital and the Investigator shall provide
such assistance in obtaining such approvals as Sponsor may reasonably require.

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1.7  Supply of Device and Equipment.

     Sponsor shall be responsible for providing the Hospital a sufficient number
of Devices to conduct the Clinical Study. Sponsor and Hospital shall work
together prior to the commencement of the Clinical Study to estimate the number
of Devices required to carry out the Clinical Study. Investigator and Hospital
further agree that:

     (a)  Principal Investigator and Institution shall: (a) not distribute or
          sell the Devices to any other person or entity, (b) use the Devices
          only on Study Patients under the Principal Investigator's supervision;
          and (c) use reasonable care in storing the Devices in a secure
          location.

     (b)  If there is any adverse reaction to a Device or if the Device fails to
          perform its intended function during the Clinical Study, Investigator
          shall notify Sponsor immediately and return the affected Device to
          Sponsor for analysis. Unless otherwise directed by Sponsor, Hospital
          and Investigator shall return all unused and explanted Devices and
          related system components to Sponsor if the Clinical Study is
          terminated, suspended, discontinued or completed.

     (c)  The Device and any other materials provided hereunder are for
          investigational use only and provided only for carrying out activities
          within the scope of this Agreement. Sponsor can not, and does not,
          guarantee or warranty, either explicitly or implicitly, the fitness of
          the Device for the purposes, the objectives and the activities to be
          carried out within the scope of this Agreement or any infringement
          regarding the Device or any other equipment supplied by Sponsor under,
          or being part, of this Agreement or the Clinical Study.. Furthermore
          Sponsor does not guarantee or warrant, either explicitly or
          implicitly, the safety or efficacy of the Device or any other
          equipment supplied by Sponsor under, or being part of, this Agreement
          or the Clinical Study.

1.8  Term.

     This Agreement becomes effective on the Effective Date and shall continue
in effect for three (3) years unless extended or terminated earlier by mutual
agreement of the parties. Notwithstanding the foregoing, the provisions of
Section 3.3 and Articles 4 through 8 shall survive any expiration or termination
of this Agreement.

1.9  Early Termination.

     Sponsor may terminate this Agreement at any time by giving thirty (30) days
written notice of termination to Hospital. Sponsor reserves the right to
immediately terminate this Agreement and to exclude Hospital and Investigator
from further participation in the Clinical Study, if within three (3) months
after the Study Initiation Visit no patients are participating in the Clinical
Study. In the event of termination, Sponsor shall reimburse Hospital for all
contractual commitments and financial obligations reasonably incurred by
Hospital in the good faith performance of this Agreement prior to notice of such
termination, to the extent such financial obligations or contractual commitments
cannot be canceled by Hospital. Notwithstanding the foregoing, Sponsor and
Hospital agree that any termination requested hereunder shall not commence until
such date as patients in the Clinical Study can be transitioned out of the
Clinical

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Study without adverse medical effect to such patients. If the Clinical Study any
reason, Hospital and Investigator agree to conduct any follow-up required by the
Protocol or instituted by any regulatory authority as a condition of the
Clinical Study vice approval.

2.   PAYMENT

     Sponsor shall compensate Hospital for the cost of completing CRF (Case
Report Form) for the Clinical Study according to the amount detailed in Exhibit
D.

3.   REPORTS; ACCESS

3.1  Documentation Provided by Hospital

Hospital shall submit the following documents to Sponsor prior to commencing the
Clinical Study:

     (a)  Documentation of Hospital's Ethics Committee's approval of the
          Protocol and patient consent form;

     (b)  Investigator's current curriculum vita and the curriculum vitae of any
          other Co-Investigators participating in the Clinical Study;

     (c)  A copy of the Protocol signed by Investigator and signed copy of the
          financial disclosure forms by the Investigator and Co-Investigators;

     (d)  Signed copies of Co-Investigators' acceptance forms; and

     (e)  A signed copy of this Clinical Study Agreement.

3.2  Records and Reports.

     (a)  Hospital and the Investigator shall prepare and submit to Sponsor case
          report forms ("CRF") for each patient, as detailed in the Protocol,
          and complete and maintain all other patient pre-operative and
          post-operative records, lab test records, follow-up reports and other
          records as required by the Protocol or by Hospital's standard patient
          documentation practices, Hospital's Ethics Committee, the European
          Community and any other applicable law, rule, regulation or practice.

     (b)  The CRF must permit the verification of the accuracy of the
          information furnished by the Investigator to the Sponsor. The
          Investigator and/or Hospital shall furnish to any authorized Sponsor
          employee or agent the records of any participating patient and the CRF
          so that such authorized Sponsor employee or agent may be able to
          verify the adequacy of the data reported.

     (c)  Hospital and/or Investigator shall periodically during the Clinical
          Study retrieve and submit Engineering Data recorded in the Device to
          Sponsor or provide reasonable assistance to Sponsor to allow Sponsor
          to retrieve such data.

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     (d)  Patient CRFs and all other records and reports required to be kept
          pursuant to this Agreement or Protocol or are otherwise related to the
          Clinical Study that have not yet been delivered to Sponsor shall be
          available for inspection or copying at reasonable times upon the
          request of any authorized Sponsor employee or agent or the authorized
          regulatory body, including the United States Food and Drug
          Administration ("FDA") or its European equivalent agency.

     (e)  All records and reports required by this Agreement or prepared in
          connection therewith shall be maintained by Hospital and the
          Investigator in a secure file for a period of ten (10) years after the
          latter of (i) the termination of this Agreement, (ii) the completion
          of the Clinical Study, (iii) the date that such materials are no
          longer required for purposes of supporting a pre-market approval (PMA)
          application or a notice of completion of a product development
          protocol or CE marking, or (iv) such longer period as Sponsor may
          reasonably request in order to comply with FDA or European equivalent
          regulations.

3.3  Access to Personnel.

     Hospital agrees to allow Sponsor reasonable access to Investigator,
Co-Investigators and Hospital staff working in the Clinical Study for the
purpose of progress reviews, internal reporting and other matters related to the
Clinical Study, including, without limitation, meetings with authorized
regulatory body representatives.

4.   SPONSOR PROPERTY

     All equipment, materials and documents provided to Hospital or Principal
Investigator by Sponsor, or prepared in connection with this Agreement,
including without limitation, all samples, case report forms, records, reports,
communications or analyses produced in connection with this Agreement ("Sponsor
Materials") are, and shall remain the exclusive property of the Sponsor.
Hospital and Principal Investigator shall keep all Sponsor Materials in its
custody and control during the term of this Agreement. All Sponsor Materials
shall be returned to the Sponsor or designee upon termination of this Agreement
or upon Sponsor's request, except that Institution may retain one copy of all
case report forms solely for archival purposes. Patient medical charts
maintained by Institution shall not be considered Sponsor Materials.

5.   INTELLECTUAL PROPERTY

5.1  Ownership and Assignment of Intellectual Property.

     All rights to and ownership of any intellectual property conceived or
developed during the course of or in connection with the Clinical Study relating
in any whatsoever to the Device ("Intellectual Property") shall vest exclusively
in Sponsor. Hospital shall promptly assign, and shall cause its personnel who
participate in the Clinical Studyto promptly assign to Sponsor and treat as
Sponsor's all Intellectual Property. Any other intellectual property conceived
and developed during the course of, or in connection with, the Clinical Studynot
related to the Device and (i) developed solely by Hospital shall belong
exclusively to Institution, (ii) developed solely by Sponsor shall belong
exclusively to Sponsor, and (iii) jointly developed by Hospital and Sponsor
shall belong jointly to Hospital and Sponsor. Notwithstanding any ownership or
partial ownership by Hospital of any Intellectual Property related to the
Clinical Studynvestigator agree

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that any such Intellectual Property shall be used exclusively for research,
patient care and teaching purposes as determined by its academic mission, and
not for any commercial purposes.

5.2  Disclosure of Intellectual Property.

     Hospital shall promptly disclose to Sponsor in writing any and all
Intellectual Property conceived or developed during the course of, or in
connection with, the Clinical Study, whether or not relating to the Device.

5.3  Licensing Intellectual Property.

     To the extent that Hospital owns the rights of sole or joint inventorship
with respect to such Intellectual Property, Sponsor is hereby granted, without
option fee, a first right to negotiate an exclusive worldwide, royalty bearing
license to Hospital's rights to any Intellectual Property which option shall
extend for ninety (90) days after Sponsor's receipt of an Intellectual Property
disclosure from Hospital. Upon Sponsor's exercise of its first right to
negotiate, the parties shall promptly negotiate a license agreement in good
faith, in accordance with the parties normal licensing practices and policies,
taking into consideration the relative contribution of the parties and the
commercial value of such Intellectual Property. If the parties fail to enter
into a license agreement as provided herein, Hospital shall have the right to
negotiate and grant a license to a third party, provided that such license is
not more favorable to the third party licensee than the terms offered to Sponsor
and provided further that no such license shall be granted to a competitor of
Sponsor.

5.4  Patents: Mutual Cooperation.

     Hospital will promptly notify Sponsor and will assist Sponsor, upon
Sponsor's request, in gaining patent protection for any patentable Intellectual
Property, or patentable licensed Hospital intellectual property, and Sponsor
will reimburse Hospital for all reasonable and documented out of pocket expenses
of Hospital incurred thereby. Any patent application, continuation in-part,
divisional, etc., will be filed, paid for and prosecuted by Sponsor for
Intellectual Property.

5.5  Principal Investigator.

     Hospital shall ensure that the Principal Investigator (a) has signed and
delivered to Sponsor, prior to such participation, an Investigator Agreement,
(b) is bound by and has agreed to comply with the terms of this Agreement, and
(c) does not enter into agreements with third parties which would prevent him
from participating in the Clinical Study.

5.6  No Grant of Right In Intellectual Property.

     Nothing in this Agreement shall be interpreted as giving Hospital any
rights in or to any intellectual property rights now or hereafter owned by
Sponsor. Nothing in this Agreement should be interpreted as giving Sponsor any
rights in or to any intellectual property rights now hereafter owned by Hospital
or Principal Investigator, except as expressly provided for herein.

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5.7  Ownership of Copyrights.

     Title to any copyrightable material reporting the Results, first produced
or composed by Principal Investigator shall remain with the Principal
Investigator; provided that Sponsor shall be granted an irrevocable,
royalty-free nonexclusive right to reproduce, translate and use such copyrighted
material (a) for Sponsor's own internal purposes prior to publication and (b)
after its publication for any purpose subject to Section 7 below.

5.8  Use of Results.

     Without limiting any of the foregoing, Sponsor shall own and have the sole
right to use the Sponsor Property delivered by Hospital and Investigator under
the terms of this Agreement in any manner deemed appropriate to Sponsor's
business interests. Anything herein to the contrary notwithstanding, Hospital
and Investigator may with Sponsor's prior written consent use the results of the
Clinical Study exclusively for research, patient care and teaching purposes,
which consent will not be unreasonably withheld.

6.   CONFIDENTIAL INFORMATION

6.1  Confidential Information.

     As used herein, "Confidential Information" shall mean (a) the terms and
existence of this Agreement, (b) all information disclosed either directly or
indirectly, and whether disclosed verbally, in writing or by tangible products
or samples, by Sponsor to Hospital, Investigator or Co-Investigator and (c) any
and all information developed in the course of the Clinical Study, including,
without limitation, information relating to the Device, Clinical Study, Sponsor
Property, Intellectual Property and Inventions, Case Reports or Clinical Study
Results, Clinical Study participants and all other information regarding
Sponsor's (or its affiliated entities') past, present or future research
technology, designs, products, know-how, ideas, concepts, protocols, prototypes,
business plans, processes, drawings, specifications, compositions of matter,
product applications, methods, operations, trade secrets and any knowledge or
information developed by Hospital or Investigator, either alone or with others,
as a result of their work in connection with this Agreement.

     Each of Hospital and Investigator hereby agrees not to disclose, either
directly or indirectly, the Confidential Information to any third party or use
such Confidential Information for any purpose other than the performance of the
Clinical Study or as may be required by law or regulation.

For purposes of this Agreement, for foregoing obligation of confidentiality
shall not apply to:

(a)  information that was known to the recipient from a source(s) other than
     Sponsor or its agents prior to its disclosure hereunder, and this is
     demonstrably documented in written records of recipient;

(b)  information that can be shown to have been public knowledge prior to or
     after its disclosure, other than through acts or omissions attributable to
     the recipient;

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(c)  information was disclosed to the recipient by a third party who did not
     derive such information from the originator or otherwise in violation of
     law or an obligation not to disclose such information;

(d)  information can be shown to have been independently developed by the
     recipient without access to such information; or

(e)  the disclosure of Confidential Information required by law.

7.   PUBLICATIONS

7.1  Sponsor Review

     Subject to Section 7.3 hereof, Hospital and Principal Investigator reserve
the right to publish Results. Before publishing, however, Hospital and Principal
Investigator shall submit copies of any proposed publication or presentation to
Sponsor for review at least 60 days in advance of submission for publication or
presentation to a publisher or other third party. Sponsor shall review the data
provided in the proposed publication against the Study database for consistency.
Sponsor shall also review the proposed publication and reserves the right to
delete any Confidential Information from the proposed publication or
presentation. In addition, Sponsor may extend such review period for up to
another 60 days to allow for filing of patent applications or take other steps
to protect the Sponsor's intellectual property interests, or to otherwise avoid
a breach of law, or to remove from the proposed publication or presentation any
language that is incorrect or otherwise detrimental to Sponsor's intellectual
property interests or that discloses any Confidential Information.

     Sponsor, and any participating center designated by Sponsor, shall be
entitled to use any clinical data that Hospital or the Principal Investigator
has acquired from the Study and has submitted for publication.

7.2  Acknowledgement of Sponsor: Use of Reprints

     Hospital and Principal Investigator shall properly acknowledge Sponsor in
all publications or presentations resulting from the performance of the Study.
Sponsor shall be permitted to use reprints of any publications resulting from
the Study for its own purposes in a manner that is consistent with industry
practice.

7.3  Use of Names

     Except as required by law, no party may use the name of any other party in
any advertising or other form of publicity without the written permission of the
party whose name is to be used (such permission not to be unreasonably
withheld).

8.   INDEMNITIES AND INSURANCE

8.1  By Sponsor.

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     Sponsor shall indemnify, defend and hold harmless Hospital and Hospital's
officers, directors, trustees, employees, Investigator and any Co-Investigators
(the "Hospital Indemnities") from and against any and all liabilities, damages,
losses, claims or expenses (including reasonable attorneys' fees) incurred by or
imposed upon the Hospital Indemnities, or any one of them, that result from any
allegation that the Device was defective or the negligence of Sponsor in
connection with the Clinical Study, except to the extent such liability, damage,
loss, claim or expense is attributable to (a) prior treatment giving rise to the
condition for which the Device is used, (b) the negligence, reckless or willful
misconduct of one or more of the Hospital Indemnities, (c) any failure of one or
more of the Hospital Indemnities to adhere strictly to the terms of the Protocol
or to follow good clinical practices or (d) a breach of any applicable local
law, rule, regulation or practice by one or more of the Hospital Indemnities.

8.2  By Hospital.

     Hospital shall indemnify, defend and hold harmless Sponsor and Sponsor's
officers, directors, shareholders, employees and affiliates (the "Sponsor
Indemnities") from and against any and all liabilities, damages, losses, claims
or expenses (including reasonable attorneys' fees) incurred by or imposed upon
the Sponsor Indemnities, or any one of them, in connection with the Clinical
Study, to the extent such liability, damage, loss, claim or expense is
attributable to (a) prior treatment giving rise to the condition for which the
Device is used, (b) the negligence, reckless or willful misconduct of one or
more of the Hospital Indemnities, (c) any failure of one or more of the Hospital
Indemnities to adhere strictly to terms of the Protocol or to follow good
clinical practices, or (d) a breach of any applicable federal, state or local
law, rule, regulation or practice by one or more of the Hospital Indemnities.

8.3  Conditions of Indemnity.

     Sponsor's and Hospital's obligations pursuant to this Article 8 are
conditioned upon: (a) the indemnified party providing written notice to the
indemnifying party of any claim for indemnification hereunder within ten (10)
days after such party has knowledge of such a claim, except that the
indemnifying party shall not be relieved of its duty to defend unless the
indemnifying party can prove that it was materially prejudiced by any delay in
notification; (b) the indemnified party permitting the indemnifying party to
assume full responsibility for the investigation of, preparation for, and
defense of, any claim for which indemnification is being sought, (c) the
indemnified party assisting the indemnifying party, at the indemnifying party's
reasonable expense, in the investigation of, preparation for, and defense of,
any such claim, and (d) the indemnified party not compromising or settling any
such claim without the indemnifying party's prior written consent. Sponsor's
agreement in Section 8.1 to indemnify and hold the Hospital Indemnities harmless
is further conditioned on Hospital and Investigator obtaining (i) Ethics
Committee approval of the Clinical Study, including without limitation, the
Protocol and (ii) informed consent from each of the patients participating in
the Clinical Study.

8.4  Insurance.

     Sponsor, Investigator and Hospital shall each carry insurance from an
insurance carrier reasonably acceptable to the others in amounts and under
coverages in accordance with country laws. Each party shall provide to the other
party evidence of such coverages upon request.

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9.   COVENANTS AND WARRANTIES

9.1 Investigator represents and warrants that be has full right and authority to
enter into this Agreement under applicable law, and the internal rules of any
institution where work pursuant to this Agreement is performed, and
Investigator's employer, where appropriate. Investigator shall secure any
necessary notifications or approvals, administrative or governmental for the
work to be performed hereunder.

9.2 Investigator represents and warrants that all amounts received under this
Agreement are only for legitimate expenses, reimbursement of such expenses, or
compensation for the performance of the activities described in this Agreement,
and that receipt of such amounts is in all respects in full accordance with all
applicable laws, rules, regulations, policies and practices.

9.3 Hospital and the Investigator warrant that they (a) have not been found by
officials from the authorized regulatory bodies to have violated any statutes,
rules, or regulations concerning the conduct of clinical investigations and (b)
have not been terminated from any investigation or research project for reasons
other than completion of the research project.

9.4 Hospital and Investigator warrant that they have the unrestricted right to
disclose any information submitted to Sponsor, free of all claims of third
parties, and that such disclosures do not breach or conflict with any
confidentiality provisions of any agreement to which either is a party.

9.5 Hospital and Investigator further warrant that the services covered by this
Agreement are not in violation of any other agreement with other parties or of
any restrictions of any kind to which either is bound. 9.6 Hospital and
Investigator represent and warrant that all of Hospital employees, agents and
associates whose services may be used to fulfill their respective obligations
under this Agreement are or will be appropriately informed of the terms of this
Agreement and are under legal obligation to either Hospital or Investigator, by
contract or otherwise, sufficient to enable them to fully comply with all
provisions of this Agreement.

10.  MISCELLANEOUS

10.1 Notices.

     All notices or other communication which are required or permitted
hereunder shall be in writing and sufficient if delivered personally, sent by
prepaid nationally recognized overnight courier, sent by mail or sent by
facsimile transmission (with confirmation of receipt), addressed as follows:

          If to Institution: ________________________________________

                             ________________________________________

                             ________________________________________

                             Attention: _____________________________

                             Facsimile: _____________________________

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          If to Principal
          Investigator:      Cardiac Transplant Unit, Level 4, 'A' Block
                             Royal Perth Hospital
                             Wellington St. Perth WA 6000, Australia
                             Attention: Gerry O'Driscoll
                             Facsimile: (08) 92241464

          If to Sponsor:     Heartware, Inc.
                             3351 Executive Way
                             Miramar, FL 33023-3935
                             USA
                             Attention: Jane E. Reedy
                             Facsimile: 01-925-426-0761

     Any such communication shall be deemed to have been given when delivered if
personally delivered, on the business day after sent if sent by nationally
recognized overnight courier, on the fifth business day following the date of
mailing if sent by prepaid first class certified mail, return receipt requested,
and on the date transmitted if sent by facsimile.

10.2 Assignment.

     This Agreement shall not be assignable by any party without the prior
written consent of the other parties, provided that Sponsor may, without such
consent, assign this Agreement and its rights and obligations hereunder in
connection with the transfer or sale of all or substantially all of its
business, or in the event of its merger or consolidation or change in control or
similar transaction.

10.3 Governing Law.

     This Agreement shall be governed by the laws of the State of Florida,
United States of America, without regard to the doctrines of conflicts of law or
choice of law.

10.4 Force Majeure.

     No party hereto shall be liable to another for its failure to perform any
of the obligations imposed by this Agreement, provided such failure shall be
occasioned by fire, flood, explosion, earthquake, discontinuity in the supply of
power, governmental interference, civil commotion, riot, war, strikes, labor
disturbance, or any cause beyond the reasonable control of the non-performing
party, provided that if such failure lasts for more than 30 days, either party
may terminate this Agreement.

10.5 Entire Agreement.

     Unless otherwise specified, this Agreement embodies the entire
understanding among Hospital, Investigator and Sponsor for this project, and any
prior or contemporaneous agreements between the parties relating to the subject
matter hereof, either oral or written, are hereby superseded. No amendments or
changes to this Agreement, including without limitation,

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changes to Exhibit A, shall be effective unless made in writing and signed by
authorized representatives of the parties.

10.6 Headings.

     The headings in this Agreement are intended solely for convenience or
reference and shall be given no effect in the construction or interpretation of
this Agreement.

10.7 Counterparts.

     This Agreement may be executed and delivered in one or more counterparts,
each of which when executed and delivered shall be deemed to be an original but
all of which when taken together shall constitute one and the same Agreement.

10.8 Validity of the Agreement.

     Should any article of this Agreement be declared void, this will not imply
or constitute the avoidance of the entire agreement. The other articles will
then be interpreted in such a way, to comply with the meaning and intention of
the article which has been declared void.

IN WITNESS WHEREOF, Sponsor, Hospital and Investigator have caused this
Agreement to be executed as of the date first set forth above by their
respective officers thereunto duly authorized.

Heartware, Inc.

By: /s/ Jane E. Reedy                   3/30/06
    ---------------------------------
Name: Jane E. Reedy
Title: Vice President of Clinical and
       Marketing

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Hospital:

By: /s/ Robyn Lawrence
    ---------------------------------
Name: Robyn Lawrence
Title: A/Dir Med Services

Investigator

By: /s/ G. O'Driscoll
    ---------------------------------
Name: G. O'Driscoll
Title: Medical Head Cardiac T Unit

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                               EXHIBIT A PROTOCOL

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EXHIBIT B

                         CO-INVESTIGATOR ACCEPTANCE FORM

Sponsor, Institution, and Principal Investigator have entered into a Clinical
Study Agreement dated February 1, 2006 ("Agreement"). Each of the undersigned
collaborating physicians ("Co-Investigators"), acting as either the Research
Institution's employee or agent, will be primarily responsible, together with
Principal Investigator, for performing the obligations of Principal Investigator
in the Agreement. The undersigned Co-Investigators each hereby expressly: (a)
acknowledge that they have received copies of the Agreement and the Protocol;
(b) acknowledge that they have read and understand the Agreement, the Study and
the Protocol, and have had the opportunity to ask questions and discuss any
concerns related thereto; (c) make the representations and warranties and agree
to keep and perform each and every obligation of Principal Investigator under
the Agreement (other that those relating to Principal Investigator's obligations
to supervise the Clinical Study and use of the Devices in connection with the
Clinical Study, which obligations shall he performed solely by Principal
Investigator); and (d) agree that their participation in the Clinical Study will
at all times be under the supervision of the Principal Investigator.

1. /S/ Kaitlyn Lam
   ----------------------------------
   Co-Investigator Signature
   Print Name: Kaitlyn Lam
   Date: 28/2/06

2. /S/ Matthew Best
   ----------------------------------
   Co-Investigator Signature
   Print Name: Matthew Best
   Date: 2-3-6

3. /S/
   ----------------------------------
   Co-Investigator Signature
   Print Name:
               ----------------------
   Date: 2/3/06

4.
   ----------------------------------
   Co-Investigator Signature
   Print Name:
               ----------------------
   Date:
         ----------------------------

                                  Page 15 of 16

<PAGE>

EXHIBIT D

                                  STUDY BUDGET

Sponsor will reimburse Institution for the time associated for a research nurse
and/or other personnel to manage patient adherence to follow-up requirements of
the protocol and the time to prepare case report forms. The Sponsor hereby
agrees to pay Institution 6600 Australian Dollars (AUS) for each study subject
upon completion of all required case report forms.

Printed name of Participating Center    Royal Perth Hospital

Name to be Printed on Reimbursement     Heart Failure Trials Fund/
Check                                   Cardiac Transplant Research

                                        Account. No: 107047

Address to Which Checks Should be       Cardiac Transplant Unit, Level 4, 'A'
Mailed                                  Block
(Include Department and/or Mail Stop)
                                        Royal Perth Hospital

City/State/Zip                          Wellington St.
                                        Perth WA 6000,
                                        Australia<PAGE>
                                                                   Exhibit 10.20

                        CLINICAL INVESTIGATION AGREEMENT

                  THIS AGREEMENT DATED 23RD DAY OF OCTOBER 2006

                                   IS BETWEEN

                     ROYAL BROMPTON & HAREFIELD NHS TRUST OF
                                 SYDNEY STREET,
                                LONDON SW3 6NP UK
                       (HEREINAFTER KNOWN AS THE "TRUST")

                                       AND

                                 HEARTWARE, INC.
                               3351 EXECUTIVE WAY
                          MIRAMAR, FL 33023-3935 U.S.A.
                      (HEREINAFTER KNOWN AS THE "SPONSOR")

                                       NOW

It is hereby agreed that the Trust undertakes to participate in a Sponsored
Clinical Investigation of a medical device entitled

"Evaluation of the HeartWare LVAD System for the Treatment of Advanced Hean
Failure"

The purpose of this Agreement is to set out the terms and conditions under which
the Trust is prepared to participate in the Clinical Investigation.

1    DEFINITIONS:

     The following words and phrases have the following meanings:

     "Clinical Investigation" means the investigation to be conducted by the
     Principal Investigator at the Investigation Site in accordance with the
     Protocol.

     "Device" means HeartWare left ventricular assist device (LVAD) System.

     "Sponsor" means the Company that is the sponsor of the study, as specified
     in the preamble hereto.

     "Monitor" means the person appointed by the Sponsor to monitor and report
     on the Clinical Investigation.

<PAGE>

     "Principal Investigator" means the person appointed by the Trust to lead
     and co-ordinate the work in a multi-centre investigation or that of several
     investigators at one Investigation Site to carry out the work of the
     Clinical Investigation. The Principal Investigator at the date of this
     Agreement is the person named in Clause 2.1.

     "Investigation Site" means premises occupied by the Trust and located at
     Hill End Road, Harefield Middlesex.

     "The Protocol" means the plan of investigation (Clinical Investigation
     Plan) for the Clinical Investigation titled "Evaluation of the HeartWare
     LVAD System for the Treatment of Advanced Heart Failure" reference Version
     2, dated February 10, 2006, a copy of which comprises Appendix 1 to this
     Agreement, or such amended Protocol as which upon the reasonable request of
     Sponsor, may be amended from time to time. Such amendments will be signed
     and attached to this Agreement.

     "MHRA" means Medicines and Healthcare Products Regulatory Agency, which is
     the UK Competent Authority that administers Medical Device Regulations
     within the UK.

     "Intellectual Property Rights" means patents, trademarks, copyrights,
     rights to extract information from a database, design rights and all rights
     or forms of protection of a similar nature or having equivalent or the
     similar effect to any of them which may subsist anywhere in the world,
     whether or not any of them are registrable or registered, and including
     applications for registration of any of them.

     "Know How" means all technical and other information which is not in the
     public domain, including but not limited to information comprising or
     relating to concepts, discoveries, data, designs, formulae, ideas,
     inventions, methods, models, procedures, designs for experiments and tests
     and results of experimentation and testing, processes, specifications and
     techniques, laboratory records, clinical data, manufacturing data and
     information contained in submissions to regulatory authorities.

     "Confidential Information" means:

     (a) all information disclosed either directly or indirectly, and whether
     disclosed verbally, in writing or by tangible products or samples, by
     Sponsor to the Trust, the Principal Investigator or Co-Investigator or any
     other person at the Investigation Site involved in the Clinical
     Investigation; and

     (c) any and all information developed in the course of the Clinical
     Investigation, including, without limitation, information relating to the
     Device, Clinical Investigation, Sponsor Materials, Intellectual Property
     Rights, Know How, CRFs or Clinical Investigation results, Clinical
     Investigation patients; and all other information regarding Sponsor's (or
     its affiliated entities') past, present or future research technology,
     designs, products, ideas, concepts, protocols, prototypes, business plans,
     processes, drawings, specifications, compositions of matter, product
     applications, methods, operations, trade secrets and any knowledge or
     information developed by the Trust or Principal Investigator or any other
     persons at the Investigation Site involved in the Clinical Investigation,
     either alone or with others, as a result of their work in connection with
     this Agreement.

                                       2

<PAGE>

     "Party" means the Sponsor, or the Trust and "Parties" shall mean both of
     them.

2    PRINCIPAL INVESTIGATOR

     2.1  The Principal Investigator for the Clinical Investigation will be
          Asghar Khaghani, (Tel number (0) 1895-828779). The Trust represents
          that it is entitled to procure and will procure the services of the
          named person to act as Principal Investigator and shall ensure the
          performance of the obligations of the Principal Investigator set out
          in this Agreement.

     2.2  The Trust represents that the Principal Investigator has the necessary
          expertise to lead and perform the Clinical Investigation.

     2.3  The Trust shall notify the Sponsor if the person named in Clause 2.1
          ceases to be employed by or associated with the Trust, and shall use
          its best endeavours to find a replacement acceptable to both the
          Sponsor and the Trust. If no mutually acceptable replacement can be
          found the Sponsor may terminate this Agreement pursuant to Clause 17.1
          below.

     2.4  Upon the prior written consent of the Sponsor, which shall not be
          unreasonably withheld, the Trust may appoint one or more collaborating
          physicians, each of whom shall have special expertise in the field of
          clinical research relating to the Clinical Investigation (each, a
          "Co-Investigator"), to participate in the Clinical Investigation. The
          Trust shall ensure that the Co-Investigators shall work under the
          direct supervision of the Principal Investigator, complies with the
          obligations undertaken by the Trust under this Agreement and shall be
          responsible for any and all performance of any such Co-Investigators.

3    CLINICAL INVESTIGATION

     The Medical Contact for the Clinical Investigation will be Jane E. Reedy
     (Tel number 925-417-2000) and the Sponsor shall arrange for the named
     individual to be reasonably available as a point of contact.

                                       3

<PAGE>

4    The Parties will comply, and the Trust will procure that performance of the
     Clinical Investigation at the Investigation Site complies with relevant
     European Directive(s) and UK Statutory Instruments (Medical Device
     Regulations) concerning Medical Devices and any other law, rule, regulation
     or practice applicable to the conduct of the Clinical Investigation at the
     investigation Site.

5    The Parties will at all times operate in accordance with European Standard
     EN540, IS014155:2003, as applicable; and with all National Health Service
     and Trust policies and codes of practice, ethical and anti-corruption
     guidelines requisite for the performance of this Agreement.

6    The Sponsor, the Principal Investigator and the Trust will carry out this
     Clinical Investigation in accordance with and in the spirit of the Helsinki
     Declaration adopted by the 18th World Medical Assembly in Helsinki,
     Finland, in 1964 and as last amended.

7    SUPPORT DOCUMENTATION

     7.1  The Parties will at all times comply with the Protocol.

     7.2  60 day notification of this Clinical Investigation has been made to
          the MHRA and no letter of objection has been received (Appendix 2),

     7.3  The proposal for the Clinical Investigation has obtained the approval
          of a properly constituted and competent Ethics Committee (Appendix 3).

     7.4  Informed written consent, as approved by the Ethics Committee, has
          been or shall be obtained by the Principal Investigator from all
          patients recruited onto this Clinical Investigation, and originals of
          such consent shall be retained by the Trust for a period of 15 years
          from the date of termination of the Clinical Investigation unless a
          longer retention period is required by law.

8    SUPPLY OF DEVICE AND EQUIPMENT

     The Sponsor shall be responsible for providing to the Trust a sufficient
     number of Devices to conduct the Clinical Investigation. The Sponsor and
     the Trust shall work together prior to the commencement of the Clinical
     Investigation to estimate the number of Devices required to carry out the
     Clinical Investigation. The Principal Investigator and the Trust further
     agree that:

     8.1  The Principal Investigator and the Trust shall: (a) not distribute or
          sell the Devices to any other person or entity, (b) use the Devices
          only on Clinical Investigation patients under the Principal
          Investigator's supervision: and (c) use reasonable care in storing the
          Devices in a secure location.

     8.2  If there is any adverse reaction or suspected adverse reaction to a
          Device or if a Device fails to perform its intended function during
          the Clinical Investigation, the Principal Investigator shall notify
          the Sponsor immediately and return the affected Device to the Sponsor
          for analysis. Unless otherwise directed by the Sponsor, the

                                       4

<PAGE>

          Trust and the Principal Investigator shall return all unused and
          explanted Devices and related system components to the Sponsor if the
          Clinical Investigation is terminated, suspended, discontinued or
          completed.

     8.3  The Device and any other materials provided hereunder are for
          investigational use only and provided only for carrying out activities
          within the scope of this Agreement.

9    REPORTS AND ACCESS

     9.1  The Trust and the Principal Investigator shall prepare and submit to
          the Sponsor case report forms (each, a "CRF") for each patient, as
          detailed in the Protocol and in Clause 9.2, and complete and maintain
          all other patient pre-operative and post-operative records, lab test
          records, follow-up reports and other records as required by the
          Protocol or by the Trust's standard patient documentation practices,
          the Trust's Ethics Committee, MHRA rules and regulations, and any
          other applicable law, rule, regulation or practice.

     9.2  The Principal Investigator and/or the Trust shall furnish to the
          Monitor the records of any participating patient and the CRF so that
          such Monitor is able to verify the adequacy of the data reported.

     9.3  During the Clinical Investigation, the Trust and/or Principal
          Investigator shall periodically retrieve and submit engineering data
          recorded in the Device to the Sponsor or provide reasonable assistance
          to the Sponsor to allow the Sponsor to retrieve such data.

     9.4  Subject to the Data Protection Act 1998, the principles set out in the
          Report of the Caldicott Committee on the review of patient
          identifiable information dated December 1997 and the principles of
          medical confidentiality, patient CRFs and all other records and
          reports required to be kept pursuant to this Agreement or the Protocol
          or otherwise related to the Clinical Investigation that have not yet
          been delivered to the Sponsor shall be available for inspection and
          copying at reasonable times upon the request of any authorized Sponsor
          employee or agent or, upon reasonable prior notice to the Sponsor (who
          shall have a right to attend such inspection), by the authorized
          regulatory body, including the United States Food and Drug
          Administration ("FDA") or the MHRA.

     9.5  At the expense of the Sponsor, the Trust shall maintain all records
          and reports required by this Agreement or the Protocol or prepared in
          connection with either or both of them in a secure file for a period
          of 5 years after the later of (i) the termination of this Agreement,
          (ii) the completion of the Clinical Investigation, (iii) the date that
          such materials are no longer required for purposes of supporting a
          pre-market approval (PMA) application or a notice of completion of a
          product development protocol or CE marking, or (iv) the expiry of such
          longer period as the Sponsor may reasonably request in order to comply
          with FDA, MHRA or other regulations.

                                       5

<PAGE>

     9.6  The Trust agrees to allow the Sponsor reasonable access to the
          Principal Investigator, Co-Investigators and the Trust staff working
          in the Clinical Investigation for the purpose of progress reviews,
          internal reporting and other matters related to the Clinical
          Investigation, including, without limitation, meetings with authorized
          regulatory body representatives.

10   SPONSOR MATERIALS

          All equipment, materials and documents provided to the Trust or
          Principal Investigator by or on behalf of the Sponsor, or prepared in
          connection with this Agreement, including without limitation, all
          samples, CRFs, records, reports, communications or analyses produced
          in connection with this Agreement ("Sponsor Materials") are, and shall
          remain, or, as the case may be, shall become, the exclusive property
          of the Sponsor. The Trust and Principal Investigator shall keep all
          Sponsor Materials in the Trust's custody and control during the term
          of this Agreement. All Sponsor Materials shall be returned to the
          Sponsor or its designee upon termination of this Agreement or at any
          time upon the Sponsor's request, except that the Trust may retain in
          strict confidence one copy of all CRFs solely for archival purposes.
          Patient medical charts maintained by the Trust shall not be considered
          Sponsor Materials.

11   COVENANTS AND WARRANTIES

     11.1 The Trust and the Principal Investigator each represent and warrant
          that (a) it or he has not been found by officials from the authorized
          regulatory bodies to have violated any statutes, rules, or regulations
          concerning the conduct of clinical investigations, and (b) has not
          been involved in any investigation or research project that has been
          terminated as a result of the improper actions or inactions of either
          of them.

     11.2 The Trust and the Principal Investigator each represent and warrant
          that it or he has the unrestricted right to disclose any information
          submitted to the Sponsor. free of all claims of third parties, and
          that such disclosures do not breach or conflict with any
          confidentiality provisions of any agreement to which either is a
          party.

     11.3 The Trust and the Principal Investigator each further represent and
          warrant that the services covered by this Agreement are not in
          violation of any other agreement with other parties or of any
          restrictions of any kind to which it or he is bound.

12   INDEMNITY AND INSURANCE

     12.1 The Sponsor and the Trust shall not take any responsibility for the
          acts or omissions of the other Party's servants, agents or employees.

     12.2 The Sponsor shall indemnify, defend and hold harmless the Trust and
          its officers, directors, trustees, employees, the Principal
          Investigator and any Co-Investigators

                                       6

<PAGE>

          (the "Trust Indemnitees") from and against any and all liabilities,
          damages, losses, claims or expenses (including reasonable attorneys'
          fees) incurred by or imposed upon the Trust Indemnitees, or any one of
          them, to the extent that they result from a defective Device or the
          negligence of Sponsor in connection with the Clinical Investigation,
          except to the extent such liability, damage, loss, claim or expense is
          attributable to (a) prior treatment giving rise to the condition for
          which the Device is used, (b) the negligence of one or more of the
          Trust Indemnitees, (c) any failure of one or more of the Trust
          Indemnitees to adhere strictly to the terms of this Agreement or the
          Protocol or to follow good clinical practices or (d) a breach of any
          applicable local law, rule, regulation or practice by one or more of
          the Trust Indemnitees.

     12.3 The Sponsor's obligations pursuant to this Clause 12 are conditional
          upon: (a) the Trust providing written notice to the Sponsor of any
          claim for indemnification hereunder within ten (10) days after it has
          knowledge of such a claim, except that the Sponsor shall not be
          relieved of its duty to defend unless the Sponsor can prove that it
          was materially prejudiced by any delay in notification; (b) the Trust
          permitting the Sponsor to assume full responsibility for the
          investigation of, preparation for, and defense of, any claim for which
          indemnification is being sought, (c) the Trust assisting the Sponsor,
          at the Sponsor's reasonable expense, in the investigation of,
          preparation for, and defense of, any such claim, and (d) the Trust not
          compromising or settling any such claim without the Sponsor's prior
          written consent. The Sponsor's agreement in Clause 12.2 to indemnify
          and hold the Trust Indemnitees harmless is further conditional on the
          Trust and Principal investigator obtaining appropriate informed
          consent from each of the patients participating in the Clinical
          Investigation.

     12.4 Without prejudice to Clause 12.2 the Sponsor will take out appropriate
          insurance cover in respect of its potential liability hereunder and
          such cover shall be for a minimum of $4,000,000 in respect of any one
          incident. The Sponsor shall produce to the Trust on request
          documentary evidence that such insurance covers in force (Appendix
          4a). The Sponsor's authorised representative will sign the Form of
          Indemnity annexed hereto (Appendix 4b).

     12.5 The Sponsor shall keep the Trust fully informed of developments and,
          subject always to the terms of its insurance policy, will not unduly
          prejudice the Trust's position in so conducting the claim.

13   CONFIDENTIALITY

     13.1 The Parties shall treat, and shall cause its respective employees,
          servants and agents to treat as strictly confidential and not to
          divulge to any third party the terms of this Agreement without prior
          written consent of the other Party.

     13.2 The Parties shall treat, and shall cause their respective employees,
          servants and agents to treat as strictly confidential and not to
          divulge to any third party the Confidential Information and not to
          make use of any such Confidential

                                       7

<PAGE>

          Information without prior written consent of the other Party save
          where disclosure is required for: (i) the due performance of the
          Clinical Investigation; or (ii) the publication of the data or results
          of the Clinical Investigation by the Trust or its employees in
          accordance with Clause 13; or (iii) disclosure to a regulatory
          authority or as required by law,

     13.3 Save for all patient medical records, the Confidential Information is,
          and shall remain, or, as the case may be, shall become, the exclusive
          property of the Sponsor. The Trust and Principal Investigator shall
          keep all Confidential Information in the Trust's custody and control
          during the term of this Agreement. All Confidential information shall
          be returned to the Sponsor or its designee upon termination of this
          Agreement or at any time upon the Sponsor's request, except that the
          Trust may retain in strict confidence one copy of all CRFs and
          original informed written consent pursuant to clause 7.4 above solely
          for archival purposes.

     13.4 In the event of any party visiting the establishment of any other, the
          visiting party undertakes to the disclosing party that any further
          confidential information not included within the definition of
          Confidential Information which may come to the visiting party's
          knowledge as a result of any such visit, shall be kept strictly
          confidential and that any such confidential information will not be
          divulged to any third party or made use of in any way by the visiting
          party without prior written permission of the disclosing party.

     13.5 Confidentiality will not apply to:

          13.5.1 information that was known to the recipient from a source(s)
               other than the Sponsor or its employees, servants or agents prior
               to its disclosure hereunder, and this is demonstrably documented
               in written records of the recipient; or

          13.5.2 information that can be shown to have been public knowledge
               prior to or after its disclosure, other than through acts or
               omissions attributable to the recipient; or

          13.5.3 information that was or is disclosed to the recipient by a
               third party who did not derive such information from the
               originator or otherwise in violation of law or an obligation not
               to disclose such information; or

          13.5.4 information that can be shown to have been independently
               developed by the recipient without access to such Confidential
               Information; or

          13.5.5 the disclosure of Confidential Information required by law,
               provided that if a receiving Party becomes legally compelled to
               disclose any Confidential Information, such receiving Party shall
               provide the disclosing Party with prompt notice so that the
               disclosing Party may seek a protective order or other appropriate
               remedy and/or waive compliance with the provisions of this
               Section 13, and provided further that in the event that

                                       8

<PAGE>

               such protective order or other remedy is not obtained, or the
               disclosing Party waives compliance with the provisions of this
               Agreement, the receiving Party will furnish only that portion of
               the Confidential Information that it is advised by counsel is
               legally required and will exercise its best efforts to obtain
               reliable assurance that confidential treatment will be accorded
               the Confidential Information

     13.6 The Sponsor agrees to adhere to the principles of medical
          confidentiality in relation to patients involved in the Clinical
          Investigation under the terms of this Agreement, and Appendices and
          Schedules relating thereto

     13.7 Except as required by law or regulations, the Sponsor will not use the
          name of the Trust, nor of any member of the Trust staff, in any
          publicity, advertising or news release without the prior written
          approval of an authorised representative of the Trust, such approval
          not to be unreasonably withheld. The Trust will not use the name of
          the Sponsor nor of any of its employees, in any publicity without the
          prior written approval of the Sponsor, such approval not to be
          unreasonably withheld. The names of the parties to this Agreement may
          be used if they are part of the publication of the data or results of
          the Clinical Investigation.

14   PUBLICATION

     14.1 The Trust and the Principal Investigator acknowledge and agree that
          the Sponsor has the unrestricted and exclusive right to use the
          results of the Clinical Investigation in whatever manner it desires,
          both during and following termination of this Agreement.

     14.2 The Sponsor recognises that: (i) the Trust may wish to publish the
          results of the Clinical Investigation; and (ii) the Trust employees
          engaged in the Clinical Investigation may wish to present at symposia,
          national or regional professional meetings, and to publish in
          journals, theses or dissertation, or otherwise of their own choosing,
          methods and results of the Clinical Investigation. The Sponsor agrees
          to such publications by the Trust or Trust employees, provided that
          they comply with the terms of this Clause 14.

     14.3 The Sponsor shall receive copies of any proposed publication or
          presentation at least 60 days in advance of the submission of such
          proposed publication or presentation to a journal, editor or other
          third party.

     14.4 The Sponsor shall have 30 days, after receipt of said copies, to
          object to such proposed presentation or proposed publication on the
          grounds that its publication may prejudice the obtaining of a patent
          or the obtaining or maintenance of any other Intellectual Property
          Rights or that it contains commercially sensitive subject matter or
          Confidential Information which needs protection. The Sponsor reserves
          the right to delete any Confidential Information from the proposed
          publication or presentation

                                       9

<PAGE>

          In the event that the Sponsor makes such objection, the Trust shall
          and shall procure that the said Trust employees shall refrain from
          making such publication or presentation for a maximum of six months
          from the date of receipt of such objection in order for the Sponsor to
          file UK and/or other patent application(s) or obtain or maintain other
          available Intellectual Property Rights protection directed to the
          patentable or commercially sensitive subject matter contained in the
          proposed publication or presentation.

     14.5 Sponsor, and any participating centre designated by Sponsor, shall be
          entitled to use any clinical data that Trust or the Principal
          Investigator has acquired from the Study and has submitted for
          publication.

     14.6 Trust and Principal Investigator shall properly acknowledge Sponsor in
          all publications or presentations resulting from the performance of
          the Study. Sponsor shall be permitted to use reprints of any
          publications resulting from the Study for its own purposes in a manner
          that is consistent with industry practice.

                                       10

<PAGE>

                                   APPENDIX 1

                             PROTOCOL AND AMENDMENTS

<PAGE>

15   INTELLECTUAL PROPERTY

     15.1 All Intellectual Property Rights and Know How owned by or licensed to
          the Trust prior to and after the date of this Agreement other than
          those in the Results (as defined below) are and shall remain the
          property of the Trust.

     15.2 All Intellectual Property Rights and Know How owned by or licensed to
          the Sponsor prior to and after the date of this Agreement are and
          shall remain the property of the Sponsor.

     15.3 All Intellectual Property Rights and Know How subsisting in or arising
          from the Clinical Investigation results of the Clinical Investigation
          (the "Results") shall vest in or be exclusively licensed to the
          Sponsor in accordance with Clauses 15.4 and 15.5 below.

     15.4 The Trust and the Principal investigator hereby assign, to the extent
          legally possible (and where a future assignment is not possible but an
          agreement to assign once rights come into existence is possible,
          hereby agree to assign with effect from that time) their respective
          rights, in the Results to the Sponsor, throughout the world, for the
          full term of such rights (including all extensions and renewals) and
          free of all liens and encumbrances. At the request and expense of the
          Sponsor, the Trust and the Principal Investigator shall execute all
          such documents and do all such other acts and things as the Sponsor
          may reasonably require in order to vest fully and effectively all such
          rights in the Sponsor or its nominee.

     15.5 The Trust and the Principal Investigator shall promptly disclose to
          the Sponsor any and all Results and undertake not to use the Results
          other than: (i) for the purposes of this Agreement; or (ii) subject to
          the prior written consent of the Sponsor, such consent not to be
          unreasonably withheld, for the purpose of treatment of patients at any
          premises occupied by the Trust. To the extent the Results cannot be
          fully assigned (now or in the future) to the Sponsor, the Trust and
          the Principal Investigator hereby grant to the Sponsor an exclusive,
          worldwide, irrevocable, perpetual, fully paid up, royalty free and
          assignable licence, with the right to sub-license, to exploit the
          Results for any purpose whatsoever.

     15.6 The Trust and the Principal Investigator will promptly notify the
          Sponsor and will assist the Sponsor, upon the Sponsor's request, in
          gaining patent or other Intellectual Property Rights protection for
          any Results, and the Sponsor will reimburse the Trust and the
          Principal Investigator for all reasonable and documented out of pocket
          expenses of the Trust and the Principal Investigator incurred thereby.
          Any patent application, continuation in-part, divisional, will be
          filed, paid for and prosecuted by the Sponsor if it so chooses.

16   FINANCIAL AGREEMENT

     16.1 Arrangements relating to the financing of this Clinical Investigation
          by the Sponsor are set out in Appendix 5 hereto.

                                       11

<PAGE>

     16.2 All payments will be made according to the schedule contained in
          Appendix 5 against presentation of a valid invoice to the Sponsor by
          the Trust. The Principal Investigator enters into this Agreement in
          consideration of the obligations undertaken by the other parties.

     16.3 The Sponsor shall make payment within thirty (30) days of the date of
          receipt of the invoice mentioned in Clause 16.2 above.

     16.4 Any delay in the payment of the invoices by the Sponsor will incur an
          interest charge payable monthly on any amounts overdue at the rate of
          2 per cent per annum above the National Westminster Bank plc base rate
          prevailing on the date the payment is due.

     16.5 All payments should be made to The Royal Brompton & Harefield NHS
          Trust as per the invoice's payment instructions.

17   TERM

     The Clinical Investigation will have an anticipated duration of 24 months
     or if longer until completion of the data for the last follow up of any
     patient in the Clinical Investigation, unless terminated earlier pursuant
     to Clause 18 below. The duration of the Clinical Investigation may be
     modified by mutual written agreement of the parties hereto under acceptable
     terms.

18   TERMINATION

     18.1 The Trust or the Sponsor may (by notice in writing to the other)
          terminate this Agreement at any time on any of the following events
          occurring:

          18.1.1 Should the other party be declared insolvent or have an
               Administrator or Receiver appointed over all or any part of their
               assets;

          18.1.2 Should the other party be reasonably of the opinion that the
               Clinical Investigation should cease in the interests of the
               patients involved in the Clinical Investigation;

          18.1.3 Should patient recruitment, in the reasonable opinion of the
               Sponsor, be unsatisfactory;

          18.1.4 Should the Sponsor require termination due to significant
               protocol deviation or violation;

          18.1.5 Should the person from time to time appointed with the
               Sponsor's consent as Principal Investigator cease to be employed
               by the Trust or otherwise cease to be able to fulfil her/his
               duties and no mutually acceptable replacement can be found.

                                       12

<PAGE>

     18.2 After receipt of any and all documentation, data, and information
          regarding the Clinical Investigation, including but not limited to the
          Confidential Information, by the Sponsor from the Trust and the
          Principal Investigator, the Sponsor shall make payment for reasonable
          costs necessarily and irrevocably incurred and committed (as supported
          by written evidence) up to the date of receipt of the notice of
          termination by the Trust. Upon receipt of the notice of termination,
          the Trust shall use best efforts to mitigate costs related to the
          termination. The Sponsor shall not be liable for any costs if
          termination is caused by or is in any way related to the negligence,
          breach of contract or misconduct of the Trust or the Principal
          Investigator, or is a result of a force majeure event pursuant to
          Clause 21. Any funds not expended by the Trust for the Clinical
          Investigation prior to the effective termination date shall be
          credited or returned by the Trust to the Sponsor.

     18.3 Either Party may withdraw from this Clinical Investigation at any time
          if the other Party is in breach of any of its obligations hereunder
          and fails to remedy such breach, where it is capable of remedy, within
          30 days of a written notice from the non-breaching Party to the other,
          specifying the nature of the breach.

     18.4 Immediately upon receipt of a notice of termination, the Trust and the
          Principal investigator shall stop any further enrolling of patients
          into the Clinical Investigation.

     18.5 Termination of this Agreement will be without prejudice to the accrued
          rights and liabilities of the parties under this Agreement.

     18.6 Notwithstanding the foregoing, the Parties agree that any termination
          notified hereunder shall not commence until such date as patients in
          the Clinical Investigation can be transitioned out of the Clinical
          Investigation without adverse medical effect to such patients. If the
          Clinical Investigation is terminated for any reason, the Trust and
          Principal Investigator agree to conduct any follow-up required by the
          Protocol or instituted by any regulatory authority as a condition of
          the Clinical Investigation approval.

     18.7 If this Agreement is terminated before completion of the Clinical
          Investigation, the Trust and the Principal Investigator shall furnish
          the Sponsor with an acceptable investigator's report for the Clinical
          Investigation as soon as reasonably practicable.

18   RELATIONSHIP BETWEEN THE PARTIES

     18.1 In the performance of all services hereunder the Trust and the
          Principal Investigator shall each be deemed to be and shall be an
          independent contractor of the Sponsor.

     18.2 Neither Party is authorised to act as agent for the other for any
          purpose and shall not on behalf of the other enter into any contract,
          warranty or representation as to any matter. Neither shall be bound by
          the acts or conduct of the other.

                                       13

<PAGE>

     18.3 Neither Party may assign its rights under this Agreement or any part
          thereof and may not delegate the performance of its obligations under
          this Agreement without the prior written consent of the other, such
          consent shall not be unreasonably withheld.

     18.4 Any formal notices or communications between the Parties must be in
          writing and either delivered personally, via facsimile (with
          confirmation of receipt), by internationally recognized overnight
          courier service, or by recorded delivery post.

19   GOVERNING LAW

     This Agreement shall be interpreted and governed by English Law.

20   AGREEMENT AND MODIFICATION

     20.1 Any agreement to change the terms of this Agreement in any way shall
          be valid only if the change is made in writing and approved by mutual
          agreement of authorised representatives of the parties hereto.

     20.2 This Agreement including its Appendices and Schedules contains the
          entire understanding between the Parties and replaces all other
          Agreements of prior date between the Parties relating to the Clinical
          Investigation which is the subject of this Agreement. Accordingly, all
          other terms, conditions, representations, warranties and other
          statements which would otherwise be implied (by law or otherwise)
          shall not form part of this Agreement.

21   FORCE MAJEURE

     Neither the Sponsor nor the Trust shall be in default of its obligations
     hereunder if such default is the result of war, hostilities, revolution,
     civil commotion, strike, epidemic, accident, fire, wind, flood or because
     of any law, order, proclamation, regulation or ordinance, or any act of God
     or other cause beyond the reasonable control of the Party affected,
     provided that if the force majeure event continues for more than 90 days,
     the unaffected Party, without limiting the termination right provided for
     in Clause 17, may terminate this Agreement forthwith by notice to the
     other.

22   THIRD PARTIES

     Nothing in this Agreement is intended to confer on any person any right to
     enforce any term of this Agreement which that person would not have had but
     for the Contracts (Rights of Third Parties) Act 1999.

                                       14

<PAGE>

Signed on behalf of
HEARTWARE, INC.

/s/ Jane E. Reedy                       Date 09/11/06
-------------------------------------
Jane E. Reedy
Vice President - Clinical and
Marketing

Signed on behalf of
ROYAL BROMPTON & HAREFIELD NHS TRUST

/s/ Martin Cowie                        Date 10/25/2006
-------------------------------------
Professor Martin Cowie,
Director of Research and Development

Appendices

1    The Clinical Investigation Protocol and Schedules

2    MHRA Approval - Letter of Agreement

3    Ethics Committee Approval

4    (a) Insurance

     (b) Form of Indemnity

5    Investigator/Financial Agreement

                                       15

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