0000883984-13-000021.txt : 20130416 0000883984-13-000021.hdr.sgml : 20130416 20130416142956 ACCESSION NUMBER: 0000883984-13-000021 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130412 FILED AS OF DATE: 20130416 DATE AS OF CHANGE: 20130416 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BROWN JACK CENTRAL INDEX KEY: 0001073393 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34634 FILM NUMBER: 13763562 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 X0306 4 2013-04-12 0 0000883984 ICU MEDICAL INC/DE ICUI 0001073393 BROWN JACK 951 CALLE AMANECER SAN CLEMENTE CA 92673 1 0 0 0 Common Stock 2013-04-12 4 M 0 15000.0 39.25 A 28125 D Common Stock 2013-04-12 4 F 0 9797.0 60.09 D 18328 D Non-Qualified Stock Option (right to buy) 39.25 2013-04-12 4 M 0 15000.0 D 2002-11-16 2013-05-16 Common Stock 15000 0 D Transaction is the exercise of a derivative security; see Column 2. By: Lynn DeMartini For: Jack W. Brown 2013-04-16