-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, TPr1/7U7WeXtE9+Xr64TKx+5Co/6hgiq0jJFmf9gD467myXT5qZep1AYEOFbJhw1 RwWe8Iihf2sh+PxcKQlnnA== 0000883984-04-000041.txt : 20040609 0000883984-04-000041.hdr.sgml : 20040609 20040609142231 ACCESSION NUMBER: 0000883984-04-000041 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040607 FILED AS OF DATE: 20040609 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ICU MEDICAL INC/DE CENTRAL INDEX KEY: 0000883984 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 330022692 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92769 BUSINESS PHONE: 9493662183 MAIL ADDRESS: STREET 1: 951 CALLE AMANELER CITY: SANCLEMENTE STATE: CA ZIP: 92769 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LOPEZ GEORGE A CENTRAL INDEX KEY: 0001073397 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-19974 FILM NUMBER: 04855638 BUSINESS ADDRESS: STREET 1: C/O ICU MEDICAL INC STREET 2: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 BUSINESS PHONE: 9493662183 MAIL ADDRESS: STREET 1: C/O ICU MEDICAL STREET 2: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 4 1 edgardoc.xml PRIMARY DOCUMENT X0202 4 2004-06-07 0 0000883984 ICU MEDICAL INC/DE ICUI 0001073397 LOPEZ GEORGE A C/O ICU MEDICAL 951 CALLE AMANECER SAN CLEMENTE CA 92673 1 1 0 1 Chairman Chairman Common Stock 2004-06-07 2004-06-07 4 X 0 3500 5.5417 A 17522 D Common Stock 2004-06-07 2004-06-07 4 S 0 3500 35.06 D 14022 D Common Stock 2004-06-07 2004-06-07 4 X 0 2000 5.5417 A 16022 D Common Stock 2004-06-07 2004-06-07 4 S 0 2000 35.01 D 14022 D Common Stock 2004-06-07 2004-06-07 4 X 0 6500 5.5417 A 20522 D Common Stock 2004-06-07 2004-06-07 4 S 0 6500 35 D 14022 D Common Stock 2004-06-07 2004-06-07 4 X 0 1500 5.5417 A 15522 D Common Stock 2004-06-07 2004-06-07 4 S 0 1500 35.02 D 14022 D Common Stock 1186843 I by Partnership Common Stock 23223 I by Trust Non-Qualified Stock Option (right to buy) 5.5417 2004-06-07 2004-06-07 4 X 0 3500 35.06 D 1999-01-30 2008-01-31 Common Stock 3500 296500 D Non-Qualified Stock Option (right to buy) 5.5417 2004-06-07 2004-06-07 4 X 0 2000 35.01 D 1999-01-30 2008-01-31 Common Stock 2000 294500 D Non-Qualified Stock Option (right to buy) 5.5417 2004-06-07 2004-06-07 4 X 0 6500 35 D 1999-01-30 2008-01-31 Common Stock 6500 288000 D Non-Qualified Stock Option (right to buy) 5.5417 2004-06-07 2004-06-07 4 X 0 1500 35.02 D 1999-01-30 2008-01-31 Common Stock 1500 286500 D Excludes 22,959 shares held by Diana K. Lopez, M.D. Dr. Loez disclaimis any beneficial interest in the shares held by his wife. Common Stock owned by Lopez Family Trust. Drs. Lopez are trustees and beneficiaries of the Family Trust. Except to the extent of their peciuniary interests as beneficiaries of the Family Trust, Drs. Lopez disclaim any beneficial ownership of the shares owned by the Family Trust. By: Lylnn DeMartini For: George A. Lopez, M.D. 2004-06-09 -----END PRIVACY-ENHANCED MESSAGE-----