SEC Form 4 · accession 0001073397-15-000032

ICU MEDICAL INC/DE · ICUI

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

George A Lopez

Director · 10% Owner

Period of report

Dec 7, 2015

Accepted (ET)

Dec 7, 2015 · 7:07 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0000883984

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock	Dec 7, 2015	X	8,800	$32.07	A	409,516	D
Common Stock^F2	Dec 7, 2015	S	5,091	$112.332	D	404,425	D
Common Stock^F3	Dec 7, 2015	S	1,909	$113.3873	D	402,516	D
Common Stock^F4	Dec 7, 2015	S	1,473	$114.222	D	401,043	D
Common Stock^F5	Dec 7, 2015	S	327	$115.241	D	400,716	D
Common Stock	holding	—	—		—	986,843	I	by Partnership

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Non-Qualified Stock Option (right to buy)	$32.07	Dec 7, 2015	X	8,800	D	Feb 4, 2014	Feb 4, 2019	Common Stock	8,800	36,200	D

Explanation of responses

F1The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 Plan adopted by the reporting person on June 11, 2015.
F2The price recorded in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $111.98 to $112.97, 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.
F3The price recorded in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $112.98 to $113.79, 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.
F4The price recorded in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $113.98 to $114.96, 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.
F5The price recorded in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $115.00 to $115.34, 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.