<PAGE>
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13D
Under the Securities Exchange Act of 1934
(Amendment No. __)*
ICU Medical, Inc.
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(Name of Issuer)
Common Stock
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(Title of Class of Securities)
44930 G 10 7
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(CUSIP Number)
Stephen E. Newton, Esq., 601 S. Figueroa St., 40th Floor, Los Angeles, CA 90017
(213) 689-0200
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(Name, Address and Telephone Number of Person Authorized to Receive Notices and
Communications)
February 24, 1999
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(Date of Event which Requires Filing of this Statement)
If the filing person has previously filed a statement on Schedule 13G to report
the acquisition which is the subject of this Schedule 13D, and is filing this
schedule because of (S)(S) 240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the
following box [_].
Note: Schedules filed in paper format shall include a signed original and five
copies of the schedule, including all exhibits. See (S) 240.13d-7(b) for other
parties to whom copies are to be sent.
(Continued on following pages) (Page 1 of 8 Pages)
_________________________
*The remainder of this cover page shall be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities, and
for any subsequent amendment containing information which would alter
disclosures provided in a prior cover page.
The information required on the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the
Notes).
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SCHEDULE 13D
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CUSIP NO. 44930 G 10 7 PAGE 2 OF 8 PAGES
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NAME OF REPORTING PERSON
S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (entities only)
George A. Lopez, M.D. Second Family Limited Partnership (the
"Partnership")
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
2 (a) [_]
(b) [_]
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SEC USE ONLY
3
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SOURCE OF FUNDS*
4
N/A
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CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT
TO ITEMS 2(d) or 2(e) [_]
5
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CITIZENSHIP OR PLACE OF ORGANIZATION
6
The Partnership is a Nevada limited partnership.
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SOLE VOTING POWER
7
NUMBER OF 791,742
SHARES -----------------------------------------------------------
SHARED VOTING POWER
BENEFICIALLY 8
0
OWNED BY
-----------------------------------------------------------
EACH SOLE DISPOSITIVE POWER
9
REPORTING 791,742
PERSON -----------------------------------------------------------
SHARED DISPOSITIVE POWER
WITH 10
0
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
11
0
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES*
12
[_]
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
13
9.2%
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TYPE OF REPORTING PERSON*
14
PN
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*SEE INSTRUCTIONS BEFORE FILLING OUT!
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SCHEDULE 13D
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CUSIP NO. 44930 G 10 7 PAGE 3 OF 8 PAGES
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NAME OF REPORTING PERSON
1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (entities only)
George A. Lopez, M.D.
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
2 (a) [_]
(b) [_]
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SEC USE ONLY
3
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SOURCE OF FUNDS*
4
N/A
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CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT
5 TO ITEMS 2(d) or 2(e) [_]
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CITIZENSHIP OR PLACE OF ORGANIZATION
6
United States of America.
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SOLE VOTING POWER
7
NUMBER OF 0
SHARES -----------------------------------------------------------
SHARED VOTING POWER
BENEFICIALLY 8
791,742
OWNED BY
-----------------------------------------------------------
EACH SOLE DISPOSITIVE POWER
9
REPORTING 0
PERSON -----------------------------------------------------------
SHARED DISPOSITIVE POWER
WITH 10
791,742
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
11
1,882,397
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES*
12
[_]
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
13
20.0%
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TYPE OF REPORTING PERSON*
14
IN
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*SEE INSTRUCTIONS BEFORE FILLING OUT!
<PAGE>
SCHEDULE 13D
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CUSIP No. 44930 G 10 7 PAGE 4 OF 8 PAGES
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NAME OF REPORTING PERSON
1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (entities only)
Diana K. Lopez, M.D.
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CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
2 (a) [_]
(b) [_]
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SEC USE ONLY
3
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SOURCE OF FUNDS*
4
N/A
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CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT
TO ITEMS 2(d) or 2(e) [_]
5
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CITIZENSHIP OR PLACE OF ORGANIZATION
6
United States of America.
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SOLE VOTING POWER
7
NUMBER OF 262,006
SHARES -----------------------------------------------------------
SHARED VOTING POWER
BENEFICIALLY 8
791,742
OWNED BY
-----------------------------------------------------------
EACH SOLE DISPOSITIVE POWER
9
REPORTING 262,006
PERSON -----------------------------------------------------------
SHARED DISPOSITIVE POWER
WITH 10
791,742
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AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
11
1,053,748
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CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES*
12
[_]
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PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
13
11.2%
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TYPE OF REPORTING PERSON*
14
IN
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*SEE INSTRUCTIONS BEFORE FILLING OUT!
<PAGE>
Item 1. Security and Issuer:
(a) Title of Class of Equity Securities:
Common Stock, $0.10 par value (the "Common Stock")
(b) Name of Issuer:
ICU Medical, Inc.
(c) Address of Issuer's Principal Executive Office:
951 Calle Amanecer
San Clemente, California 92673
Item 2. Identity and Background:
The Reporting Persons are filing this statement on Schedule 13D in
connection with the acquisition of 791,742 shares (the "Shares") of the
Common Stock of the Issuer, as described in Item 4.
(a) The Reporting Persons are:
George A. Lopez, M.D. Second Family Limited Partnership (the
"Partnership");
George A. Lopez, M.D.; and
Diana K. Lopez, M.D.
George A. Lopez and Diana K. Lopez are the general partners (the
"General Partners") of the Partnership. They own, in the
aggregate, a one percent general partnership interest in the
Partnership and share power to vote and power to dispose of the
Shares and may, therefore, be deemed to have beneficial ownership
of the Shares. Except to the extent of their undivided one percent
general partnership interest in the assets of the Partnership, the
General Partners disclaim beneficial ownership of the Shares.
(b) The business address of the Partnership and of the General
Partners is:
951 Calle Amanecer
San Clemente, California 92673951
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(c) The principal business of the Partnership is investments, the
principal occupation of George A. Lopez is Chairman of the Board,
President and Chief Executive Officer of the issuer and the the
principal occupation of Diana K. Lopez is physician.
(d) None of the persons listed in Item 2(a) has been convicted in any
criminal proceeding (excluding traffic violations or similar
misdemeanors) during the last five years.
(e) None of the persons listed in Item 2(a) was a party to any civil
proceeding of a judicial or administrative body of competent
jurisdiction during the last five years as a result of which he,
she or it has been subject to a judgment, decree or final order
enjoining future violations of, or prohibiting or mandating
activities subject to, federal or state securities laws or finding
any violation with respect to such laws.
(f) The Partnership is organized under the laws of the state of
Nevada. The General Partners are citizens of the United States of
America.
Item 3. Source and Amount of Funds or Other Consideration:
Reference is made to Item 4 for a description of the transaction in
which the Partnership acquired the Shares. The consideration for the
Shares transferred to the Partnership was a 99% limited partnership
interest in the Partnership.
Item 4. Purpose of Transaction:
On February 24, 1999, Jesus Mejia, Trustee of the Christopher George
Lopez Children's Trust and the Nicholas George Lopez Children's Trust
(together, the "Trusts") transferred the 791,742 Shares owned by the
Trusts to the Partnership in exchange for a 99% limited partnership
interest in the Partnership. The General Partners of the Family
Partnership are the parents of the beneficiaries of the Trusts. The
General Partners together own a one-percent interest in the Family
Partnership. George A. Lopez is the founder, Chairman of the Board,
President and Chief Executive Officer of the Issuer. The purpose of the
transaction is to relieve the Trustee of the responsibility of making
voting and disposition decisions with respect to a block of stock of
sufficient size to affect the policies and direction of the Issuer and
vest such responsibility in the parents of the beneficiaries of the
Trusts.
Item 5. Interest in Securities of the Issuer:
(a) The Partnership is the direct beneficial owner of 791,742 shares
of Common Stock of the Issuer, constituting 9.2% of the issued and
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outstanding Common Stock as of March 2, 1999 (the "Outstanding
Shares").
George A. Lopez may be deemed to be the beneficial owner of
1,882,397 shares of Common Stock of the Issuer, constituting 20.0%
of the Outstanding Shares. The 1,882,397 shares includes: (i) by
virtue of the relationships described in Item 2, the Shares owned
directly by the Partnership, as to which he disclaims any
beneficial ownership, except to the extent of his undivided one-
half percent general partnership interest in the assets of the
Partnership; and (ii) currently exercisable options to purchase
1,090,655 shares. The percentage of shares as to which he
may be deemed to be the beneficial owner is based on the number of
Outstanding Shares plus the number of shares subject to his
currently exercisable options.
Diana K. Lopez may be deemed to be the beneficial owner of
1,053,748 shares of Common Stock of the Issuer, constituting 11.2%
of the Outstanding Shares. The 1,053,748 shares includes: (i)
12,006 shares directly owned by her; (ii) 250,000 shares held by
her as Trustee of the Lopez CRT #1 for the benefit of Diana K.
Lopez and George A. Lopez; and (iii) by virtue of the
relationships described in Item 2, the Shares owned directly by
the Partnership, as to which she disclaims any beneficial
ownership, except to the extent of her undivided one-half percent
general partnership interest in the assets of the Partnership.
(b) The number of shares of Common Stock as to which each of the
persons named in paragraph (a) has sole or shared power to vote or
direct the vote or sole or shared power to dispose or direct the
disposition is as follows:
<TABLE>
<CAPTION>
Power to Vote or Power to Dispose or
Direct the Vote Direct the Disposition
----------------------------------------------------
Sole Shared Sole Shared
----------------------------------------------------
<S> <C> <C> <C> <C>
The Partnership 791,742 0 791,742 0
George A. Lopez 0 791,742 0 791,742
Diana K. Lopez 262,006 791,742 262,006 791,742
</TABLE>
(c) As described in Item 4, the Partnership acquired the Shares from
the Trustee on February 24, 1999 in exchange for a 99% limited
partnership interest in the Partnership issued by the Partnership
to the Trusts. None of the persons named in paragraph (a) has
engaged in any other transactions in the Common Sock during the
past 60 days.
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(d) N/A.
(e) N/A.
Item 6. Contracts, Arrangements, Understandings or Relationships with Respect
to Securities of the Issuer:
None.
Item 7. Material to be Filed as Exhibits:
Exhibit (a) Joint Filing Agreement
Signature
After reasonable inquiry as to the best of my knowledge and belief, I certify
that the information set forth in this statement is true, complete and correct.
Date: March 4, 1999 George A. Lopez, M.D. Second
Family Limited Partnership
By /s/ George A. Lopez, M.D.
--------------------------
George A. Lopez, M.D.
General Partner
/s/ George A. Lopez, M.D.
--------------------------
George A. Lopez, M.D.
/s/ Diana K. Lopez, M.D.
--------------------------
Diana K. Lopez, M.D.
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EXHIBIT 99 (a)
JOINT FILING AGREEMENT
----------------------
In accordance with Rule 13d-1(f) under the Securities Exchange Act of 1934, as
amended, the undersigned hereby agree to the joint filing with all other
Reporting Persons identified in item 2(a) of the Schedule 13D referred to below
on behalf of each of them of a statement on Schedule 13D (including amendments
thereto) with respect to the Common Stock, $0.10 par value, of ICU Medical, Inc.
and that this Agreement be included as an Exhibit to such joint filing. This
Agreement may be executed in any number of counterparts all of which taken
together shall constitute one and the same instrument.
IN WITNESS WHEREOF, the undersigned hereby execute this Agreement this 4th day
of March, 1999.
The George A. Lopez, M.D. Second Family
Limited Partnership
By: /s/ George A. Lopez, M.D.
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George A. Lopez, M.D.
/s/ George A. Lopez, M.D.
------------------------------------
George A. Lopez, M.D.
/s/ Diana K. Lopez, M.D.
------------------------------------
Diana K. Lopez, M.D.
