-----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, RIvrRUkTrq9FXah2vmGQzWSp4b/i1nMkLPVboxZAL/M6/Aj5xDu1hGIuxaoIkBzQ lpkasKwmX9kNaCQy5jh3yg== 0000883984-05-000034.txt : 20050420 0000883984-05-000034.hdr.sgml : 20050420 20050420113702 ACCESSION NUMBER: 0000883984-05-000034 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050419 FILED AS OF DATE: 20050420 DATE AS OF CHANGE: 20050420 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: 05761036 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 2005-04-19 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 2005-04-19 4 S 0 300 37.45 D 14622 D Common Stock 2005-04-19 4 S 0 600 37.46 D 14022 D Common Stock 1186843 I by Partnership Common Stock 23223 I by Trust Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 47944 D 1999-01-30 2007-06-26 Common Stock 47944 202056 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 9656 D 1999-01-30 2007-06-26 Common Stock 9656 192400 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 1800 D 1999-01-30 2007-06-26 Common Stock 1800 190600 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 1419 D 1999-01-30 2007-06-26 Common Stock 1419 189181 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 1500 D 1999-01-30 2007-06-26 Common Stock 1500 187681 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 800 D 1999-01-30 2007-06-26 Common Stock 800 186881 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 781 D 1999-01-30 2007-06-26 Common Stock 781 186100 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 800 D 1999-01-30 2007-06-26 Common Stock 800 185300 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 1100 D 1999-01-30 2007-06-26 Common Stock 1100 184200 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 500 D 1999-01-30 2007-06-26 Common Stock 500 183700 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 200 D 1999-01-30 2007-06-26 Common Stock 200 183500 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 500 D 1999-01-30 2007-06-26 Common Stock 500 183000 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 600 D 1999-01-30 2007-06-26 Common Stock 600 182400 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 600 D 1999-01-30 2007-06-26 Common Stock 600 181800 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 100 D 1999-01-30 2007-06-26 Common Stock 100 181700 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 700 D 1999-01-30 2007-06-26 Common Stock 700 181000 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 500 D 1999-01-30 2007-06-26 Common Stock 500 180500 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 400 D 1999-01-30 2007-06-26 Common Stock 400 180100 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 700 D 1999-01-30 2007-06-26 Common Stock 700 179400 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 600 D 1999-01-30 2007-06-26 Common Stock 600 178800 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 100 37.32 D 1999-01-30 2007-06-26 Common Stock 100 178700 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 100 D 1999-01-30 2007-06-26 Common Stock 100 178600 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 100 D 1999-01-30 2007-06-26 Common Stock 100 178500 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 400 D 1999-01-30 2007-06-26 Common Stock 400 178100 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 200 D 1999-01-30 2007-06-26 Common Stock 200 177900 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 1000 D 1999-01-30 2007-06-26 Common Stock 1000 176900 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 300 D 1999-01-30 2007-06-26 Common Stock 300 176600 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 300 D 1999-01-30 2007-06-26 Common Stock 300 176300 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 400 D 1999-01-30 2007-06-26 Common Stock 400 175900 D Non-Qualified Stock Option (right to buy) 10.25 2005-04-19 4 X 0 300 D 1999-01-30 2007-06-26 Common Stock 300 175600 D Excludes 22,959 shares held by Diana K. Lopez, M.D. Dr. Lopez disclaims 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. Transaction is the exercise of a derivative security; see Column 2. By: Lynn DeMartini For: George A. Lopez, M.D 2005-04-19 -----END PRIVACY-ENHANCED MESSAGE-----