0000883984-12-000062.txt : 20120424 0000883984-12-000062.hdr.sgml : 20120424 20120424175446 ACCESSION NUMBER: 0000883984-12-000062 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120424 FILED AS OF DATE: 20120424 DATE AS OF CHANGE: 20120424 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: COSTELLO RICHARD A CENTRAL INDEX KEY: 0001073401 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34634 FILM NUMBER: 12777047 MAIL ADDRESS: STREET 1: C/O 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 X0305 4 2012-04-24 0 0000883984 ICU MEDICAL INC/DE ICUI 0001073401 COSTELLO RICHARD A 951 CALLE AMANECER SAN CLEMENTE CA 92673 0 1 0 0 Vice President Sales Common Stock 2012-04-24 4 X 0 5000.0 32.61 A 5000.0 D Common Stock 2012-04-24 4 S 0 5000.0 49.0 D 0.0 D Non-Qualified Stock Option (right to buy) 32.61 2012-04-24 4 X 0 5000.0 D 2007-01-01 2015-04-08 Common Stock 5000.0 0.0 D Transaction is the exercise of a derivative security; see Column 2. By: Lynn DeMartini For: Richard A. Costello 2012-04-24