0000883984-12-000003.txt : 20120127 0000883984-12-000003.hdr.sgml : 20120127 20120127185426 ACCESSION NUMBER: 0000883984-12-000003 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120127 FILED AS OF DATE: 20120127 DATE AS OF CHANGE: 20120127 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SHERMAN RICHARD MD CENTRAL INDEX KEY: 0001073391 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34634 FILM NUMBER: 12553138 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 X0304 4 2012-01-27 0 0000883984 ICU MEDICAL INC/DE ICUI 0001073391 SHERMAN RICHARD MD 951 CALLE AMANECER SAN CLEMENTE CA 92673 1 0 0 0 Common Stock 2012-01-27 2012-01-27 4 X 0 1875.0 28.8133 A 69676.0 D Common Stock 2012-01-27 2012-01-27 4 S 0 1875.0 46.0 D 67801.0 D Non-Qualified Stock Option (right to buy) 28.8133 2012-01-27 2012-01-27 4 X 0 1875.0 D 2002-05-02 2012-11-02 Common Stock 1875.0 0.0 D The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 Plan adopted by the reporting person on April 28, 2011. Transaction is the exercise of a derivative security; see Column 2. By: Lynn DeMartini For: Richard H. Sherman, M.D. 2012-01-27