The Securities and Exchange Commission has not necessarily reviewed the information in this filing and has not determined if it is accurate and complete.
The reader should not assume that the information is accurate and complete.

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 13F

FORM 13F INFORMATION TABLE
OMB APPROVAL
OMB Number: 3235-0006
Estimated average burden
hours per response: 23.8
COLUMN 1 COLUMN 2 COLUMN 3 COLUMN 4 COLUMN 5 COLUMN 6 COLUMN 7 COLUMN 8
VALUE SHRS OR SH/ PUT/ INVESTMENT OTHER VOTING AUTHORITY
NAME OF ISSUER TITLE OF CLASS CUSIP (x$1000) PRN AMT PRN CALL DISCRETION MANAGER SOLE SHARED NONE
AMERISOURCEBERGEN CORP COM 03073E105 9,965 133,934 SH   DFND   0 133,934 0
ABBOTT LABORATORIES COM 002824100 3,525 48,737 SH   DFND   0 48,737 0
ACHIEVE LIFE SCIENCES INC COM NEW 004468203 723 597,373 SH   DFND   0 597,373 0
AFFIMED NV COM N01045108 503 161,635 SH   DFND   0 161,635 0
ALIGN TECHNOLOGY INC COM 016255101 3,738 17,847 SH   DFND   0 17,847 0
ALNYLAM PHARMACEUTICALS INC COM 02043Q107 11,275 154,637 SH   DFND   0 154,637 0
ALEXION PHARMACEUTICALS INC COM 015351109 1,655 17,000 SH   DFND   0 17,000 0
AMGEN INC COM 031162100 3,309 17,000 SH   DFND   0 17,000 0
AMGEN INC PUT 031162100 9,734 50,000 SH Put DFND   0 50,000 0
ACTINIUM PHARMACEUTICALS INC COM 00507W107 132 339,796 SH   DFND   0 339,796 0
AXSOME THERAPEUTICS INC COM 05464T104 1,074 380,812 SH   DFND   0 380,812 0
BECTON DICKINSON AND CO COM 075887109 3,605 16,000 SH   DFND   0 16,000 0
BRISTOL-MYERS SQUIBB CO COM 110122108 2,599 50,000 SH   DFND   0 50,000 0
BIONANO GENOMICS INC COM 09075F107 3,746 714,842 SH   DFND   0 714,842 0
BIONANO GENOMICS INC *W EXP 08/21/2023 09075F107 1,108 721,619 SH   DFND   0 721,619 0
CARDINAL HEALTH INC COM 14149Y108 9,322 209,009 SH   DFND   0 209,009 0
CYMABAY THERAPEUTICS INC COM 23257D103 1,474 187,327 SH   DFND   0 187,327 0
CATALYST BIOSCIENCES INC COM NEW 14888D208 2,301 291,625 SH   DFND   0 291,625 0
CHEMOCENTRYX INC COM 16383L106 1,847 169,257 SH   DFND   0 169,257 0
CELGENE CORP COM 151020104 6,562 102,390 SH   DFND   0 102,390 0
CONFORMIS INC COM 20717E101 402 1,121,894 SH   DFND   0 1,121,894 0
CIGNA CORP COM 125523100 9,917 52,216 SH   DFND   0 52,216 0
CVS HEALTH CORP COM 126650100 9,486 144,777 SH   DFND   0 144,777 0
DICERNA PHARMACEUTICALS INC COM 253031108 4,740 443,409 SH   DFND   0 443,409 0
EMERGENT BIOSOLUTIONS INC COM 29089Q105 4,374 73,793 SH   DFND   0 73,793 0
ESTABLISHMENT LABS HOLDINGS INC COM G31249108 1,445 52,701 SH   DFND   0 52,701 0
FOAMIX PHARMACEUTICALS LTD SHS M46135105 4,134 1,151,510 SH   DFND   0 1,151,510 0
GILEAD SCIENCES INC COM 375558103 6,035 96,480 SH   DFND   0 96,480 0
GW PHARMACEUTICALS PLC ADS 36197T103 8,199 84,186 SH   DFND   0 84,186 0
HCA HEALTHCARE INC COM 40412C101 8,467 68,039 SH   DFND   0 68,039 0
HILL-ROM HOLDINGS INC COM 431475102 2,186 24,682 SH   DFND   0 24,682 0
IMPRIMIS PHARMACEUTICALS, INC. COM NEW 415858109 1,908 335,364 SH   DFND   0 335,364 0
HUMANA INC COM 444859102 4,674 16,317 SH   DFND   0 16,317 0
ICON PLC SHS G4705A100 2,787 21,566 SH   DFND   0 21,566 0
IMMUNOMEDICS INC COM 452907108 370 25,900 SH   DFND   0 25,900 0
INOGEN INC COM 45780L104 1,592 12,824 SH   DFND   0 12,824 0
INVACARE CORP COM 461203101 1,063 247,196 SH   DFND   0 247,196 0
KURA ONCOLOGY INC COM 50127T109 2,028 144,411 SH   DFND   0 144,411 0
LOGICBIO THERAPEUTICS INC COM 54142F102 1,653 158,958 SH   DFND   0 158,958 0
LEXICON PHARMACEUTICALS INC PUT 528872302 143 21,600 SH Put DFND   0 21,600 0
MCKESSON CORP COM 58155Q103 5,140 46,530 SH   DFND   0 46,530 0
MEDTRONIC PLC SHS G5960L103 11,926 131,115 SH   DFND   0 131,115 0
MEDPACE HOLDINGS INC COM 58506Q109 3,344 63,180 SH   DFND   0 63,180 0
MEI PHARMA INC COM NEW 55279B202 6,267 2,373,841 SH   DFND   0 2,373,841 0
MOLINA HEALTHCARE INC COM 60855R100 4,982 42,869 SH   DFND   0 42,869 0
MYLAN NV SHS EURO N59465109 5,129 187,175 SH   DFND   0 187,175 0
NEUROCRINE BIOSCIENCES INC COM 64125C109 4,927 69,000 SH   DFND   0 69,000 0
NOVO NORDISK A/S ADR 670100205 6,790 147,378 SH   DFND   0 147,378 0
OSMOTICA PHARMACEUTICALS PLC SHS G6S41R101 2,685 346,410 SH   DFND   0 346,410 0
PENUMBRA INC PUT 70975L107 4,155 34,000 SH Put DFND   0 34,000 0
PFENEX INC COM 717071104 681 213,608 SH   DFND   0 213,608 0
KONINKLIJKE PHILIPS NV NY REG SH NEW 500472303 1,756 50,000 SH   DFND   0 50,000 0
PREMIER INC CL A 74051N102 5,020 134,412 SH   DFND   0 134,412 0
RIGEL PHARMACEUTICALS INC COM NEW 766559603 5,015 2,180,546 SH   DFND   0 2,180,546 0
RA MEDICAL SYSTEMS INC COM 74933X104 3,865 486,107 SH   DFND   0 486,107 0
REVANCE THERAPEUTICS INC COM 761330109 3,376 167,724 SH   DFND   0 167,724 0
SENSEONICS HOLDINGS INC COM 81727U105 1,243 479,858 SH   DFND   0 479,858 0
SMITH & NEPHEW PLC SPDN ADR NEW 83175M205 3,819 102,163 SH   DFND   0 102,163 0
SANOFI SA SPONSORED ADR 80105N105 11,651 268,388 SH   DFND   0 268,388 0
SUTRO BIOPHARMA INC COM 869367102 2,543 281,914 SH   DFND   0 281,914 0
TITAN MEDICAL INC COM NEW 88830X819 544 445,680 SH   DFND   0 445,680 0
UNITEDHEALTH GROUP INC COM 91324P102 3,539 14,207 SH   DFND   0 14,207 0
UROVANT SCIENCES LTD SHS G9381B108 5,324 807,860 SH   DFND   0 807,860 0
UNITED THERAPEUTICS CORP COM 91307C102 3,267 30,000 SH   DFND   0 30,000 0
VERACYTE INC COM 92337F107 883 70,199 SH   DFND   0 70,199 0
VICAL INC COM NEW 925602203 1,907 1,615,887 SH   DFND   0 1,615,887 0
VIKING THERAPEUTICS INC COM 92686J106 4,873 637,046 SH   DFND   0 637,046 0
DENTSPLY SIRONA INC COM 24906P109 2,443 65,666 SH   DFND   0 65,666 0
ZIMMER BIOMET HOLDINGS INC COM 98956P102 3,645 35,144 SH   DFND   0 35,144 0