0000883984-12-000083.txt : 20120806 0000883984-12-000083.hdr.sgml : 20120806 20120806171326 ACCESSION NUMBER: 0000883984-12-000083 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120806 FILED AS OF DATE: 20120806 DATE AS OF CHANGE: 20120806 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CONNORS JOHN J CENTRAL INDEX KEY: 0001073396 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34634 FILM NUMBER: 121010564 MAIL ADDRESS: STREET 1: C/O ICU MEDICAL STREET 2: 951 CALLE AMANECER CITY: SAN CLEMENTE STATE: CA ZIP: 92673 4 1 edgardoc.xml PRIMARY DOCUMENT X0306 4 2012-08-06 0 0000883984 ICU MEDICAL INC/DE ICUI 0001073396 CONNORS JOHN J 951 CALLE AMANECER SAN CLEMENTE CA 92673 1 0 0 0 Common Stock 2012-08-06 4 X 0 4662.0 39.25 A 4662.0 I by Trust Common Stock 2012-08-06 4 S 0 4662.0 54.0 D 0.0 I by Trust Common Stock 300.0 D Incentive Stock Option (right to buy) 39.25 2012-08-06 4 X 0 4662.0 D 2002-11-16 2013-05-16 Common Stock 4662.0 10338.0 I by Trust Option to purchase shares of ICU Medical, Inc. Common Stock assigned to the trustees of The John J. Connors Family Irrevocable Trust. Mr. Connors retains no pecuniary or other beneficial interest in the shares assigned to the Family Trust. Transaction is the exercise of a derivative security; see Column 2. By: Lynn DeMartini For: John J. Connors 2012-08-06