SEC Form 4 · accession 0001375852-16-000008

ICU MEDICAL INC/DE · ICUI

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

Reporting owner

Scott E Lamb

Officer — Chief Financial Officer,

Period of report

Sep 12, 2016

Accepted (ET)

Sep 13, 2016 · 3:29 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	Sep 12, 2016	X	14,676	$43.62	A	19,057	D
Common Stock^F2	Sep 12, 2016	S	12,490	$121.748	D	6,567	D
Common Stock^F3	Sep 12, 2016	S	2,186	$122.0838	D	4,381	D
Common Stock	Sep 12, 2016	X	13,850	$43.12	A	18,231	D
Common Stock^F4	Sep 12, 2016	S	11,150	$121.6916	D	7,081	D
Common Stock^F5	Sep 12, 2016	S	2,700	$122.075	D	4,381	D

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)^F7,F6	$43.12	Sep 12, 2016	X	13,850	D	—	Feb 2, 2021	Common Stock	13,850	1,150	D
Non-Qualified Stock Option (right to buy)^F7,F6	$43.62	Sep 12, 2016	X	14,676	D	—	Jul 20, 2021	Common Stock	14,676	324	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 August 11, 2016.
F2The price reported in Column 4 is an average weighted price. These shares were sold in multiple transactions at prices ranging from $121.04 to $122.02, 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 reported in Column 4 is an average weighted price. These shares were sold in multiple transactions at prices ranging from $122.04 to $122.24, 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 reported in Column 4 is an average weighted price. These shares were sold in multiple transactions at prices ranging from $121.00 to $121.99, 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 reported in Column 4 is an average weighted price. These shares were sold in multiple transactions at prices ranging from $122.01 to $122.18, 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.
F6Options vest and are exercisable as to 25% of the underlying grant one year after the date of grant and in equal monthly installments thereafter for three additional years.
F7Transaction is the exercise of a derivative security; see Column 2.