SEC Form 4 · accession 0001190251-17-000003

ICU MEDICAL INC/DE · ICUI

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

Reporting owner

Director

Period of report

May 16, 2017

Accepted (ET)

May 16, 2017 · 7:15 pm EDT

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
Common Stock^F1	May 16, 2017	M	743	$0.00	A	3,091	D
Common Stock	May 16, 2017	X	1,500	$34.48	A	4,591	D
Common Stock	May 16, 2017	X	1,500	$37.36	A	6,091	D
Common Stock	May 16, 2017	X	1,500	$38.85	A	7,591	D
Common Stock^F2	May 16, 2017	S	4,500	$162.505	D	3,091	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	D/I
Common Stock^F1,F3	—	May 16, 2017	M	743	D	May 16, 2017	May 16, 2017	Common Stock	743	D
Non-Qualified Stock Option (right to buy)^F5,F4	$34.48	May 16, 2017	X	1,500	D	—	Apr 20, 2019	Common Stock	1,500	D
Non-Qualified Stock Option (right to buy)^F5	$37.36	May 16, 2017	X	1,500	D	Oct 21, 2010	Oct 21, 2019	Common Stock	1,500	D
Non-Qualified Stock Option (right to buy)^F5	$38.85	May 16, 2017	X	1,500	D	Jul 22, 2010	Jul 22, 2019	Common Stock	1,500	D

F1These securities are Restricted Stock Units.
F2The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $162.405 to $162.60, 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.
F3There is neither a purchase price nor an exercise price for the Restricted Stock Units.
F4Options exercisable in four equal annual cumulative installments commencing one year after the grant date.
F5Transaction is the exercise of a derivative security; see Column 2.