0001410442-21-000010.txt : 20211230 0001410442-21-000010.hdr.sgml : 20211230 20211230165906 ACCESSION NUMBER: 0001410442-21-000010 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211228 FILED AS OF DATE: 20211230 DATE AS OF CHANGE: 20211230 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jain Vivek CENTRAL INDEX KEY: 0001410442 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34634 FILM NUMBER: 211533475 MAIL ADDRESS: STREET 1: ICU MEDICAL, INC. STREET 2: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 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 4 1 edgardoc.xml PRIMARY DOCUMENT X0306 4 2021-12-28 0 0000883984 ICU MEDICAL INC/DE ICUI 0001410442 Jain Vivek 951 CALLE AMANECER SAN CLEMENTE CA 92673 1 1 0 0 Chairman and CEO Common Stock 2021-12-28 4 M 0 164 58.79 A 12943 D Common Stock 2021-12-28 4 S 0 164 240.0 D 12779 D Common Stock 2021-12-29 4 M 0 10677 58.79 A 23456 D Common Stock 2021-12-29 4 S 0 10677 240.0012 D 12779 D Common Stock 2021-12-30 4 M 0 1159 58.79 A 13938 D Common Stock 2021-12-30 4 S 0 1159 240.0 D 12779 D Common Stock 60000 I by Trust Non-Qualified Stock Option (right to buy) 58.79 2021-12-28 4 M 0 164 0.0 D 2018-02-13 2024-02-24 Common Stock 164 254202 D Non-Qualified Stock Option (right to buy) 58.79 2021-12-29 4 M 0 10677 0.0 D 2018-02-13 2024-02-24 Common Stock 10677 243525 D Non-Qualified Stock Option (right to buy) 58.79 2021-12-30 4 M 0 1159 0.0 D 2018-02-13 2024-02-24 Common Stock 1159 242366 D The option exercises and sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on September 15, 2021. All shares sold were sold at the exact price disclosed. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $240.00 to $240.07, 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 separate price within the range set forth in this Form 4. This transaction represented a gift of securities from the reporting person to two trusts for the benefit of family members, who share the same household. The reporting person disclaims beneficial ownership of the shares held by the trusts, and this report shall not be deemed as an admission that the reporting person is the beneficial owner of the trust's shares for purposes of Section 16 or for any other purpose. By: Paula Darbyshire, Attorney-in-fact For: Vivek Jain 2021-12-30