0000883984-12-000028.txt : 20120313 0000883984-12-000028.hdr.sgml : 20120313 20120313185434 ACCESSION NUMBER: 0000883984-12-000028 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120313 FILED AS OF DATE: 20120313 DATE AS OF CHANGE: 20120313 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: 92763-6212 BUSINESS PHONE: 949-366-2183 MAIL ADDRESS: STREET 1: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92763-6212 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: 001-34634 FILM NUMBER: 12688404 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 X0304 4 2012-03-13 0 0000883984 ICU MEDICAL INC/DE ICUI 0001073397 LOPEZ GEORGE A 951 CALLE AMANECER SAN CLEMENTE CA 92673 1 1 1 0 Chairman Common Stock 2012-03-13 4 X 0 15294.0 25.6233 A 349213.0 D Common Stock 2012-03-13 4 S 0 15294.0 45.8666 D 333919.0 D Common Stock 1186843.0 I by Partnership Non-Qualified Stock Option (right to buy) 25.6233 2012-03-13 4 X 0 15294.0 D 2004-06-08 2012-06-08 Common Stock 15294.0 50000.0 D The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 Plan adopted by the reporting person on February 2, 2012. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $45.42 to $46.41, inclusive. The reporting person undertakes to provide ICU Medical, Inc., any security holder of ICU Medical, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each price within the range set forth in this Form 4. Common Stock owned by George A. Lopez M.D. Second Family Limited Partnership. Dr. Lopez holds a one-percent general partnership interest in the Partnership. As general partner, he has the power to vote and power to dispose of the 1,186,843 shares owned by the Partnership and may be deemed to be beneficial owner of such shares. The Partnership acquired the shares on 2/24/99 from Trusts for the benefit of the Lopez children, the Christopher George Lopez Children's Trust and the Nicholas George Lopez Children's Trust, which own a 99% limited partnership in the Partnership. Dr. Lopez is not trustee of and has no interest in the children's Trusts. Except to the extent of his undivided one percent general partnership interest in the assets of the Partnership, Dr. Lopez disclaims any beneficial ownership of the shares owned by the Partnership. Transaction is the exercise of a derivative security; see Column 2. By: Lynn DeMartini For: George A. Lopez, M.D. 2012-03-13