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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13D
Under the Securities Exchange Act of 1934
(Amendment No. 1 )*
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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 5 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 5 PAGES
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NAME OF REPORTING PERSON
1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
Jesus Mejia, Trustee of the Christopher George Lopez Children's Trust and
the Nicholas George Lopez Children's Trust
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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
Jesus Mejia is a U.S. Citizen. The Trusts were founded under California
law.
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SOLE VOTING POWER
7
NUMBER OF
0
SHARES -----------------------------------------------------------
SHARED VOTING POWER
BENEFICIALLY 8
OWNED BY 0
-----------------------------------------------------------
EACH SOLE DISPOSITIVE POWER
9
REPORTING
0
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
0
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TYPE OF REPORTING PERSON*
14
IN
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*SEE INSTRUCTIONS BEFORE FILLING OUT!
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This Amendment No. 1 to a statement on Schedule 13D dated December 29,
1993 is filed by Jesus Mejia, Trustee of the Christopher George Lopez
Children's Trust and the Nicholas George Lopez Children's Trust, to
report the disposition of all of the Common Stock of the Issuer held by
the Reporting Person on February 24,1999. This Amendment No. 1 is the
initial electronic filing by the Reporting Person.
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:
Jesus Mejia, Trustee of the Christopher George Lopez Children's Trust
and the Nicholas George Lopez Children's Trust (together, the "Trusts")
is filing this Amendment No. 1 to a statement on Schedule 13D in
connection with the disposition of 791,742 shares (the "Shares") of the
Common Stock of the Issuer.
(a) The Reporting Person is Jesus Mejia, Trustee of the Trusts
(hereinafter, the "Trustee.")
(b) The business address of the Trustee and of the Trusts is:
Mejia Accountancy
2440 South Hacienda Boulevard, Suite 222
Hacienda Heights, California 91745
(c) The principal occupation of the Trustee is accountant, and the
principal business of the Trusts is investments.
(d) The person listed in Item 2(a) has not been convicted in any
criminal proceeding (excluding traffic violations or similar
misdemeanors) during the last five years.
Page 3 of 5
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(e) The person listed in Item 2(a) was not 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
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 Trustee is a citizen of the United States of America. The
Trusts were formed under the laws of the state of California.
Item 3. Source and Amount of Funds or Other Consideration:
Not applicable.
Item 4. Purpose of Transaction:
On February 24, 1999, the Trustee transferred the 791,742 Shares owned
by the Trusts to the George A. Lopez, M.D. Second Family Limited
Partnership (the "Partnership") in exchange for a 99% limited
partnership interest in the Partnership. The general partners (the
"General Partners") of the Partnership are George A. Lopez and Diana
Lopez, the parents of the beneficiaries of the Trusts. The General
Partners together own a one-percent interest in the 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:
As described in Item 4, the Trustee holds a 99% limited partnership
interest in the Partnership that owns the Shares. The Trustee's only
interest in the securities of the Issuer consists of an indirect,
undivided 99% interest in the assets of the Partnership. The Trustee
holds the 99% interest in the Partnership for the benefit of the
beneficiaries of the Trusts and disclaims beneficial ownership or other
direct or indirect interest in any of the assets of the Trusts.
(a) The number of shares of Common Stock owned by the Trustee is 0.
(b) The number of shares of Common Stock as to which the Trustee has
sole or shared power to vote or direct the vote or sole or shared
power to dispose or direct the disposition is 0.
Page 4 of 5
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(c) As described in Item 4, the Trustee transferred the Shares to the
Partnership on February 24, 1999 in excahnge for a 99% limited
partnership interest in the Partnership. The Trustee engaged in
no other transactions in the Common Sock during the past 60 days.
(d) N/A.
(e) The Trustee ceased to be the beneficial owner of the Shares on
February 24, 1999.
Item 6. Contracts, Arrangements, Understandings or Relationships with Respect
to Securities of the Issuer:
None.
Item 7. Material to be Filed as Exhibits:
None.
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 /s/ Jesus Mejia
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Jesus Mejia, Trustee of the Christopher
George Lopez Children's Trust and the
Nicholas George Lopez Children's Trust
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