<PAGE>
<TABLE>
<CAPTION>
- -------- U.S. SECURITIES AND EXCHANGE COMMISSION --------------------------------
FORM 4 Washington, D.C. 20549 OMB APPROVAL
- -------- --------------------------------
[ ] Check this box if no STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB Number: 3235-0287
longer subject to Expires: September 30, 1998
Section 16. Form 4 Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Estimated average burden
or Form 5 obligations Section 17(a) of the Public Utility Holding Company Act of 1935 hours per response.......... 0.5
may continue. See or Section 30(f) of the Investment Company Act of 1940 --------------------------------
Instruction 1(b).
(Print or Type Responses)
- -----------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C>
1. Name and Address of 2. Issuer Name and Ticker or 6. Relationship of Reporting Person to Issuer
Reporting Person* Trading Symbol (Check all applicable)
Michael Kovalchik, MD ICU Medical, Inc. (ICUI) X Director 10% Owner
- ---------------------------------------------------------------------------------- ---- ----
(Last) (First) (Middle) 3. IRS or Social 4. Statement for ____ Officer (give ____ Other (specify
Security Number of Month/Year title below below)
Reporting Person February 1999
951 Calle Amanecer (Voluntary) ---------------------- -------------------------------------------
- -------------------------------- 5. If Amendment, 7. Individual or Joint/Group Filing (Check
(Street) Date of Original Applicable Line)
(Month/Year) X Form filed by One Reporting Person
San Clemente, CA 92673 -----
_____ Form filed by More than One Reporting
Person
- -----------------------------------------------------------------------------------------------------------------------------------
(City) (State) (Zip) Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
- -----------------------------------------------------------------------------------------------------------------------------------
1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature of
(Instr. 3) action action or Disposed of (D) Securities ship Indirect
Date Code (Instr. 3, 4 and 5) Beneficially Form: Beneficial
(Instr. 8) Owned at Direct Ownership
(Month/ End of Month (D) or In-
Day/ direct (I)
Year) (Instr. 3 (Instr.4) (Instr. 4)
and 4)
------------------------------------------------
Common Stock Code V Amount (A) or Price
(D)
- ------------------------------------------------------------------------------------------------------------------------------------
Self, Self and Spouse Jointly 2/3/99 S 1,200 D 18.75
- ------------------------------------------------------------------------------------------------------------------------------------
Self, Self and Spouse Jointly 2/10/99 S 1,000 D 20.06 6,175 D
- ------------------------------------------------------------------------------------------------------------------------------------
By Self as Trustee for Children 2/19/99 S 800 D 20.00
- ------------------------------------------------------------------------------------------------------------------------------------
By Self as Trustee for Children 2/22/99 S 600 D 19.94 1,700 I(b) (a)
- ------------------------------------------------------------------------------------------------------------------------------------
By Spouse in IRA 1,650 D(b)
- ------------------------------------------------------------------------------------------------------------------------------------
By Nephrology Associates Pension Plan 3,250 I (a)
- ------------------------------------------------------------------------------------------------------------------------------------
(**) As of 4/24/98 pursuant to Directors' Stock Award Plan
- ------------------------------------------------------------------------------------------------------------------------------------
(a) See first column
(b) Dr. Kovalchik disclaims beneficial ownership of all shares held as custodian and all shares held by his spouse.
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
* If the form is filed by more than one reporting person, see Instruction 4(b)(v). SEC 1474 (7-96)
</TABLE>
<PAGE>
FORM 4 (Continued) Table II - Derivative Securities Acquired, Disposed of,
or Beneficially owned
(e.g., puts, calls, warrants, options, convertible
securities)
<TABLE>
<CAPTION>
- -----------------------------------------------------------------------------------------------------------------------------------
1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount of
Security (Instr. 3) sion or action action Derivative cisable and Underlying Securities
Exercise Date Code Securities Expiration (Instr. 3 and 4)
Price of (Month/ (Instr. 8) Acquired (A) Date (Month/
Deriv- Day/ or Disposed Day/Year)
ative Year) of (D) (Instr. ----------------------------------------
Security 3, 4 and 5) Date Expira- Amount or
-------------------------------- Exer- tion Title Number of
Code V (A) (D) cisable Date Shares
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C>
Option to Buy Common Stock 16.125 5/12/97 4/22/01 Common 3,750
- ------------------------------------------------------------------------------------------------------------------------------------
16.125 4/23/98 4/22/01 Common 3,750
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- -----------------------------------------------------------------------------------------------------------------------------------
<CAPTION>
1. Title of Derivative 8. Price 9. Number 10. Ownership 11. Nature of
Security (Instr. 3) of of Form of Indirect
Deriv- Deriv- Derivative Beneficial
ative ative Security: Ownership
Security Securities Direct (D) (Instr. 4)
(Instr. 5) Beneficially or Indirect
Owned at (I)
End of Month (Instr. 4)
(Instr. 4)
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C>
Option to buy common stock N/A 3,750 D
- ------------------------------------------------------------------------------------------------------------------------------------
N/A 3,750 D
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
</TABLE>
Explanation of Responses:
** Intentional misstatements or /s/ Michael Kovalchik 3/9/1999
omissions of facts constitute ---------------------- --------------
Federal Criminal Violations. **Signature of Date
See 18 U.S.C. 1001 and Reporting Person
15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If
space is insufficient, see Instruction 6 for procedure.
Potential persons who are to respond to the collection of information contained
in this form are not required to respond unless the form displays a currently
valid OMB Number.
Page 2
SEC 1474 (7-96)
