UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

Form 10-K

 
(Mark One)
xANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the fiscal year ended December 31, 20172019
or
oTRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transaction period from            to            .
Commission file number: 000-28440
logoa19.jpg

 
Endologix, Inc.
(Exact name of registrant as specified in its charter)
 

 
Delaware 68-0328265
(State or other jurisdiction of
incorporation or organization)
 
(IRS Employer
Identification No.)
2 Musick, Irvine, California 92618
(Address of principal executive offices, including zip code)
Registrant’s telephone number, including area code: (949) 595-7200
 

 
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock, $0.001 par valueELGXThe NASDAQNasdaq Stock Market, LLC
Securities registered pursuant to Section 12(g) of the Act: None
  

 
Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act.    Yes  o No    x
Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act.    Yes  o    No  x
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes  x    No  o
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Website, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).    Yes  x    Noo
Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K (§229.405 of this chapter) is not contained herein, and will not be contained, to the best of registrant’s knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment to this Form 10-K.  o
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer”filer,” “smaller reporting company” and “smaller reporting“emerging growth company” in Rule 12b-2 of the Exchange Act. (Check one):
 
Large accelerated filer oAccelerated filer x
      
Non-accelerated filer 
o  (Do not check if a smaller reporting company)
Smaller reporting company x
Emerging growth companyo
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. o
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act).    Yes  o    No  x
As of June 30, 2017,28, 2019, the aggregate market value of the voting stock held by non-affiliates of the Registrant was $405,453,548$125,633,534 (based upon the $4.86$7.24 closing price for shares of the Registrant’s Common Stock as reported by the NASDAQNasdaq Global Select Market on June 30, 2017,28, 2019, the last trading date of the Registrant’s most recently completed second fiscal quarter).
On March 12, 2018,4, 2020, approximately 83,725,19719,092,266 shares of the Registrant’s Common Stock, $0.001 par value, were outstanding.
DOCUMENTS INCORPORATED BY REFERENCE
Portions ofIn accordance with Instruction G(3) to Form 10-K, certain information required by Part III (Items 10-14) of Form 10-K is incorporated by reference into this Annual Report on Form 10-K are incorporated by reference intoto the Registrant’s Proxy Statement for itsregistrant's definitive proxy statement on Schedule 14A relating to the registrant's 2020 Annual Meeting of Stockholders (the "Proxy Statement"), or an amendment to this Annual Report on Form 10-K, which shall, in either case, be filed not later than 120 days after the end of the fiscal year covered by this Annual Report on Form 10-K. Except for the portions of the Proxy Statement that may be specifically incorporated by reference in this Annual Report on Form 10-K, the Proxy Statement shall not be deemed to be held on June 14, 2018.filed as part hereof.

     





TABLE OF CONTENTS

ItemDescriptionPageDescriptionPage
PART IPART I PART I 
1.
1A.
1B.
2.
3.
4.
  
PART IIPART II PART II 
5.

6.
7.
7A.
8.
9.
9A.
9B.
  
PART IIIPART III PART III 
10.
11.
12.
13.
14.
  
PART IVPART IV PART IV 
15.
16.





Special Note Regarding Forward-Looking Statements
In addition to historical information, this Annual Report on Form 10-K contains “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, (the “Securities Act”), and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”).amended. These forward lookingforward-looking statements are intended to qualify for the safe harbor established by the Private Securities Litigation Reform Act of 1995. You can identify forward-looking statements by the use of forward-looking terminology such as “anticipates,” “believes,” “can,” “continue,” “could,” “estimates,” “expects,” “intends,” “may,” “plans,” “potential,” “predicts,” “projects,” “predicts,“should, “should” or “will” or the negative of these terms or other comparable terminology, or by discussions of strategies, opportunities, plans or intentions. Forward-looking statements also include the assumptions underlying or relating to such statements. In addition, any statements that refer to, among other things, projections of our future or assumed financial performance, results of operations, liquidity, business forecasts and plans, research and development plans, clinical studies, manufacturing plans, strategic plans and objectives, capital needs and financing plans, product launches, regulatory approvals, the impact of changes in the competitive environment and other trends in our businesses, the application of accounting guidance or other characterizations of future events or circumstances are forward-looking statements. We caution you that the foregoing list may not include all of the forward-looking statements made in this Annual Report on Form 10-K.
We have based these forward-looking statements largely on our current expectations based on information currently available to us and projections about future events and trends affecting the financial condition of our businesses. Although we do not make forward-looking statements unless we believe we have a reasonable basis for doing so, we cannot guarantee their accuracy. These forward-looking statements are subject to risks, uncertainties and other factors that could cause actual results and the timing of certain events to differ materially from future results expressed or implied by such forward-looking statements. The risks, uncertainties and other factors that could cause actual results and the timing of certain events to differ materially from future results expressed or implied by such forward-looking statements are set forth in the risk factors listed from time to time in our filings with the United States Securities and Exchange Commission (“SEC”) and those set forth in Item 1A, “Risk Factors.”
You are urged to carefully review and consider the various disclosures made by us, which attempt to advise you of the risks, uncertainties, and other factors that may affect our business, operating results and financial condition, for a discussion of other important factors that may cause our actual results to differ materially from those expressed or implied by our forward-looking statements. As a result of these factors, the forward-looking statements herein may not prove to be accurate. Furthermore, if our forward-looking statements prove to be inaccurate, the inaccuracy may be material. In light of the significant uncertainties in these forward-looking statements, you should not regard these statements as a representation or warranty by us or any other person that we will achieve our objectives and plans in any specified time frame, or at all.
Our forward-looking statements speak only as of the date each such statement is made. We expressly disclaim any intention or obligation to update or revise any financial projections or forward-looking statements after the date hereof to conform such statements to actual results or to changes in our opinions or expectations, except as required by applicable law or the rules and regulations of the Securities and Exchange CommissionSEC and the NASDAQNasdaq Global Select Market.
The industry and market data contained in this Annual Report on Form 10-K are based either on our management’s own estimates or on independent industry publications, reports by market research firms, or other published independent sources. Although we believe that these sources are reliable as of their respective dates, we have not independently verified the information and cannot guarantee its accuracy and completeness, as industry and market data are subject to change and cannot always be verified with complete certainty due to limits on the availability and reliability of raw data, the voluntary nature of the data gathering process, and other limitations and uncertainties inherent in any statistical survey of market shares. Accordingly, you should be aware that the industry and market data contained in this Annual Report on Form 10-K, and estimates and beliefs based on such data, may not be reliable.




PART I

Item 1.Business

Company Overview
We develop, manufacture, market and sell innovative medical devices for the treatment of aortic disorders. Our products are intended for the minimally invasive endovascular treatment of abdominal aortic aneurysms ("AAA"(“AAA”). Our AAA products are built on one of two platforms:
Traditional minimally-invasive endovascular aneurysm repair (“EVAR”); or
Endovascular aneurysm sealing (“EVAS”), our innovative solution for sealing the aneurysm sac while maintaining blood flow through two blood flow lumens.flow.
Our current EVAR products include the AFX® Endovascular AAA System (the “AFX System”), the VELA® Proximal Endograft (“VELA”), and the Ovation® Abdominal Stent Graft System (the “Ovation System”). Our current EVAS product is the Nellix® Endovascular Aneurysm Sealing System (the “Nellix EVAS System”). We sell our EVAR platforms (including extensions and accessories) to hospitalsproducts through a direct sales force in the United States Canada, New Zealand, South Korea and Europe,internationally through a combination of direct sales and a network of third party distributors and agents.
When used in this report, “we,” “our,” “us” or “Endologix” refer to Endologix, Inc. and our EVAS platform to hospitals in New Zealand and Europe. We sell our EVAR and EVAS platforms (including extensions and accessories) to third-party international distributors and agents in Asia, Europe, South America and in other parts ofconsolidated subsidiaries, unless otherwise expressly stated or the world. Such sales of our EVAR and EVAS platforms provide the sole source of our reported revenue.
context otherwise requires. Endologix®, AFX®, NellixDuraply®, VELA®, IntuiTrak®, OvationActiveSeal®, VELANellix®, Ovation®, Ovation Prime®, Duraply®, Ovation Alto®, and CustomSeal®, are registered trademarks of Endologix, Inc. and its subsidiaries. ActiveSeal™ and the respective product logos are trademarks of Endologix, Inc. andor its subsidiaries.
We have obtained CE Mark approval for the Nellix EVAS System in the European Union.Union (“EU”). The Nellix EVAS System is only approved as an investigational device in the United States. Ovation Alto® Abdominal Stent Graft System (the “Ovation Alto”), our next generation Ovation System device, is only approved as an investigational device and is not currently approved for commercial purposes in any market.
Our Mission
Our mission is to be the leading innovator of medical devices to treat aortic disorders. The key elements of our strategy to accomplish this mission are as follows:

Focus exclusively on the aorta for the commercialization of innovative products.products;
Design and manufacture EVAR and EVAS products that are easy to use and deliver excellent clinical outcomes.outcomes, backed by robust, high-quality clinical evidence;
Design EVAR and EVAS products to expandwhich generate compelling clinical evidence, supporting expansion into the treatment of complex AAA and thoracic anatomies.additional aortic indications;
Offer physicians and hospitals a broad range of products so they can provide the best deviceclinical options for each individual patient.patient; and
Provide exceptional clinical and technical support to physicians through an experienced and knowledgeable sales and clinical organization.
Market Overview and Opportunity
AAA Background
Atherosclerosis reduces the integrity and strength of blood vessel walls, causing the blood vessel to expand or balloon out, which is known as an “aneurysm”. Aneurysms are commonly diagnosed in the aorta, which is the body’s largest artery, extending from the chest to the abdomen. The abdominal aorta is the segment between the renal (kidney) arteriesdiaphragm and the area where the aorta divides into the two iliac arteries which travel down the legs. An abdominal aortic aneurysm (“AAA”) occursAAAs occur when a portion of the abdominal aorta bulges into an aneurysm because of a weakening of the vessel wall, which may result in life threateninglife-threatening internal bleeding upon rupture. AAA is more common in men than women.

Although AAA is one of the most serious cardiovascular diseases, many AAAs are never detected. Most AAA patients do not have symptoms at the time of their initial diagnosis. AAAs generally are discovered coincidentally through screening, during procedures to treat or diagnose unrelated medical conditions.conditions, or as an emergent rupture.



According to a paper titled Elective“Elective Versus Ruptured Abdominal Aortic Aneurysm Repair: A 1-Year Cost-Effectiveness Analysis, the overall patient mortality rate for ruptured AAA is approximately 80%, making it among the leading causes of


death in the United States. Once diagnosed patients with AAA require either non-invasive monitoring, or, dependingand dependent on the size and rate of growth of the AAA, patients with AAA require either non-invasive monitoring, endovascular repair consisting of EVAR or EVAS, or open surgical repair.
EVAR and EVAS Versus Open Surgical Repair
Our EVAR and EVAS products are used exclusively for minimally-invasive procedures, as opposed to open surgical repair of AAA. Open surgical repair is a highly invasive procedure requiringrequiring: (i) a large incision in the patient’s abdomen,abdomen; (ii) manipulation of the patient’s abdominal organs to gain access to the aneurysm,aneurysm; (iii) the cross clamping of the aorta to stop blood flow,flow; and (iv) implantation of a synthetic graft which is sutured to the aorta, connecting one end above the aneurysm toand the other end below the aneurysm.
Open surgical repair typically lasts for two2 to four4 hours, while the typical EVAR and EVAS procedure (endovascular repair) lasts for one1 to two2 hours. After receiving open surgical repair, a patient usually requires a few days in the hospital’s surgical intensive care unit, and the total hospital stay may be four4 to ten10 days. Post-procedure convalescence may take another four4 to six6 weeks due to the invasiveness of the operation. By comparison, patients are often discharged a day or two after their EVAR andor EVAS procedure, and once discharged, most patients return to normal activity within two2 weeks.
We estimate that approximately 75%76% of all treated AAAs in the United States arewere repaired through EVAR in 2019 and 25%24% through open surgical repair. Although EVAR and EVAS have many advantages over open surgical repair, many patients are not candidates for EVAR and EVAS due to the limitations of current EVAR devices to treatendovascular repair with available products when they have more complex AAA anatomies. We are developing new products to address these more challengingcomplex anatomies.
Market Size
We estimate the global endovascular aortic aneurysmAAA market potential to be $4.0was $3.5 billion annually.in 2019. Of this amount, we estimate the traditional aneurysm market potential, encompassing aneurysms with aortic neck length greater than or equal to 10mm, to be $1.6was approximately $2.2 billion. The majority of diagnosed aneurysms in this market can be treated with currently available EVAR products. We estimate that a $1.2an approximately $1.4 billion market opportunity exists for the treatment of challengingcomplex anatomies, defined as aneurysms with neck lengths less than 10mm. Currently, there are limited options withamong available EVAR products to treat these short or no neck aortic aneurysms. The thoracic aneurysm market includes aneurysms, dissections, and transections in the ascending aorta, the aortic arch, and the descending aorta. For many of these anatomies there are limited endovascular options due to anatomical and technological challenges. We believe the thoracic market potential is $1.2 billion. Below is a table summarizing the market potential and penetration by aneurysm type.
Market Description ($ in millions)PenetratedUnpenetratedTotal
Market Description (in millions)Penetrated Unpenetrated Total
Traditional$1,337
$306
$1,643
$1,652
 $503
 $2,155
Complex373
803
1,176
533
 857
 1,390
Thoracic589
606
1,195
Total$2,299
$1,715
$4,014
$2,185
 $1,360
 $3,545

We estimate that there arewere approximately 202,300250,000 AAA (EVAR and open surgical repair) procedures performed across the globe annually.in 2019.

In the United States alone, an estimated 1.2 million to 2.0 million people have an AAA and over 200,000 people are diagnosed with an AAA in the United States annually. Of those diagnosed with an AAA, approximately 60,00074,000 people underwent an AAA repair procedure in the United States in 2017,2019, of which approximately 46,00056,000 were addressed through EVAR.

According to United States Census Bureau estimates, the age 65 and over population in the United States presently numbersin 2019 was projected to be approximately 5154 million, or 16% of the total population, and is expected to grow by 3.4%3.3% annually to 5658 million by 2020. Accordingly, we2021. We believe that AAA treatments will naturally increase over time, given this demographic trend.

Since AAAs generally arise in people over the age of 65 and come with little warning, initiatives have been undertaken to increase screening. The most prominent of these initiatives is the Screening Abdominal Aortic Aneurysms Very Efficiently Act (“SAAAVE”), which was signed into law in the United States on February 8, 2006,2006. SAAAVE began providing coverage on January 1, 2007 and was updated effective January 1, 2014. SAAAVE provides for a one-time free AAA screening for men who have smoked at some time induring their life,lives and men or women who have a family history of the disease. In 2019, the U.S. Preventative Services Task Force (“USPSTF”) issued the following recommendations:

Men aged 65 to 75 years who have ever smoked. The USPSTF recommends one-time screening for AAA with ultrasonography in men aged 65 to 75 years who have ever smoked.



Men aged 65 to 75 years who have never smoked. The USPSTF recommends that clinicians selectively offer screening for AAA with ultrasonography in men ages 65 to 75 years who have never smoked rather than routinely screening all men in this group. Evidence indicates that the net benefit of screening all men in this group is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of evidence relevant to the patient’s medical history, family history, other risk factors, and personal values.

Women aged 65 to 75 years who have ever smoked. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for AAA with ultrasonography in women aged 65 to 75 years who have ever smoked or have a family history of AAA.
Women who have never smoked. The USPSTF recommends against routine screening for AAA with ultrasonography in women who have never smoked and have no family history of AAA.
Our Products
Our EVAR Platforms

Platform
AFX System and VELA:
The AFX System, which is comprised of AFX and AFX2 (discussed in further detail below), consists ofof: (i) a cobalt chromium alloy stent covered by expanded polytetrafluoroethylene (commonly referred to as ePTFE) graft materialmaterial; and (ii) accompanying delivery systems. Once fixed in its proper position withinon the abdominal aortic bifurcation, the AFX System provides a conduit for blood flow, thereby relieving pressure within the weakened or “aneurysmal” section of the vessel wall, which greatly reduces the potential for the AAA to rupture. In February 2014, we launched a new proximal extension in the United States, VELA, designed to be used in conjunction with our AFX bifurcated device. VELA features a circumferential graft line marker and controlled delivery system that enable predictable deployment and final positional adjustments. We began a commercial introduction of VELA in Europe in January 2015.

Anatomical Fixation. The AFX System is unique in that the main body of the device sits on the patient'spatient’s natural aortoiliac bifurcation.bifurcation (commonly referred to as “anatomical fixation”). This provides a solid foundation for the long-term stability of the device. Alternative EVAR devices rely on hooks, barbs and radial force to anchor within the aorta (commonly referred to as "proximal fixation"“proximal fixation”) near the renal arteries. The data from our clinical studies have demonstrated anatomical fixation can inhibit device migration within the aorta due to the inherent foundational support of the patient’s own anatomy.
Minimally Invasive Delivery System. The AFX System requires 17F introducer access on the ipsilateral side and 7F introducer access on the contralateral side. Comparative endovascular stent grafts for infrarenal repair require between 12F and 22F introducer access on the ipsilateral side and between 10F and 16F introducer access on the contralateral side.
Preserves Aortic Bifurcation. The AFX System allows for future endovascular procedures when access across the aortic bifurcation is required. Approximately 30% to 40% of AAA patients also have peripheral arterial disease (“PAD”). The AFX System is the only graft presently available that preserves the physician'sphysician’s ability to go back over the aortic bifurcation for future interventions. This is a meaningful feature of the AFX System, as many AAA patients today are living longer and returning to the hospital for PAD procedures.
Ovation System:
The Ovation System consists ofof: (i) a radiopaque nitinol suprarenal stent with integral anchors,anchors; (ii) a low-permeability polytetrafluoroethylene (“PTFE”), aortic body graft that contains a network of inflatable rings filled with a liquid polymer that solidifies during the deployment procedure,procedure; (iii) nitinol iliac limb stents encapsulated with PTFE,PTFE; and (iv) accompanying ultra-low profileultra-low-profile delivery systems, auto injector and fill polymer kit. The Ovation System creates a custom seal that conforms to anatomical irregularities and has a low profilelow-profile delivery system allowing for percutaneous access.

Patient Accessibility. Our FDAUnited States Food and Drug Administration (“FDA”) and CE Mark-approved Instructions for Use (“IFU”) allow for the on-label treatment of more patients who otherwise may undergo an off-label EVAR procedure, or be subject to open surgical repair or not receive treatment at all. Our differentiated platform expands the pool of patients eligible for EVAR by virtue of its low profile and flexible delivery system that addresses several key anatomical access challenges, while providing a novel sealing mechanism to address many of the difficulties of diseased patient anatomies.


Ability to Pass through Small Access Vessels. The Ovation System’s novel separation and optimization of fixation and seal minimize the overlap between metal and fabric within the catheter, allowing the device to be loaded in a delivery catheter that is smaller than those of conventional EVAR devices. At an outer diameter of 14F, or approximately 4.7mm, the Ovation System is the lowest overall profile FDA-approved stent graft.
Ability to Pass through Diseased and/or Tortuous Access Vessels. The Ovation System has the lowest profile FDA-approved delivery system. Its characteristics increase flexibility, designed to enable easier passage through access vessels.
The Ovation System Enables Minimally Invasive Techniques. The Ovation System’s low profile and proven safety record offer physicians the opportunity to provide percutaneous endovascular aneurysm repair access (“PEVAR”) with regional or local anesthesia to more patients. Studies have shown that the use of smaller profile delivery devices results in fewer access site complications.


Treatment of Complex Anatomy. The separation and optimization of the fixation and sealing mechanisms of the Ovation System enable the device to seal with a smaller aortic contact area than conventional EVAR devices.
Avoiding Aortic Neck Dilatation. The Ovation System’s polymer filledpolymer-filled sealing rings do not exert significant chronic, outward pressure at the`the neck of the aorta. In the Ovation Pivotal Trial, core lab results demonstrated stable neck diameter and durable seal with the Ovation System through five-year5-year follow-up.

Our EVAS Platform

Nellix EVAS System:
Our Nellix EVAS System is designed to seal the aneurysm and provide blood flow to the legs through two blood flow lumens. The Nellix EVAS System consists ofof: (i) bilateral covered stents with endobags,endobags; (ii) a biocompatible polymer injected into the endobags to seal the aneurysmaneurysm; and (iii) a delivery system and associated accessories. The Nellix EVAS System is intended to seal the entire aneurysm sac effectively excluding the aneurysm and reducing the likelihood of future aneurysm rupture.

Potentially Reduce Endoleaks Leading to Secondary Interventions.The Nellix EVAS System seals the entire aneurysm, potentially reducing the likelihood of many causes of secondary intervention in EVAR procedures.
Low Profile Introducer. The delivery catheter for the Nellix EVAS System has an outer diameter of 17F, which is beneficial for the delivery of the devices in tight access arteries, potentially reducing risk of vascular injuries to the patient.

Our EVAR and EVAS Extensions and Accessories
Aortic Extensions and Limb Extensions. We offer limb extensions for the Ovation System and proximal aortic extensions and limb extensions for the AFX System, which allow physicians to customize the implant to fit the patient'spatient’s anatomy. In February 2014, we launched a proximal extension in the United States, VELA, designed specifically for the treatment of proximal aortic neck anatomies with AFX.the AFX System. VELA features a circumferential graft line marker and controlled delivery system that enable predictable deployment and final positional adjustments. We commenced commercial sales of VELA in 2015.

Accessories. We offer various accessories to facilitate the delivery of our EVAR and EVAS products, including compatible guidewires, inflation devices and snares.
Our Product Evolution
We first commercialized the Powerlink System (the "Powerlink“Powerlink System for AAA"AAA”) in Europe in 1999 and in the United States in 2004. As our EVAR platform products evolved, we branded them under the names Powerlink System with Visiflex Delivery System, IntuiTrak®, and AFX. We added the Nellix EVAS System through our merger with Nellix, Inc. (“Nellix”) in December 2010. We added the Ovation System to our EVAR product portfolio through our merger with TriVascular Technologies, Inc. (“TriVascular”) in February 2016.
Powerlink System for AAA. The Powerlink System for AAA was our original EVAR product.
IntuiTrak. We received FDA approval for IntuiTrak in October 2008, CE Mark approval for IntuiTrak in March 2010, and Japanese Shonin approval from the Japanese Ministry of Health, Labor and Welfare (“MHLW”) for IntuiTrak in December 2012. IntuiTrak provided an updated delivery system that enhanced physician ease of use and for manufacturability.


AFX. In May 2011 and November 2011, we received FDA approval and CE Mark approval, respectively, for the AFX System, and we received Japanese Shonin approval for the AFX System in December 2015. We began a full commercial launch of the AFX System in the United States in August 2011 and in numerous international markets in 2012. In addition, we entered into a distribution arrangement with a Japanese distributor to introduce the AFX System in the Japanese market in the first quarter of 2016.
AFX2. In October 2015, we received FDA approval for our AFX2 Bifurcated Endograft System (“AFX2”).
Ovation TriVascular.Ovation. We received CE mark approval for the Ovation System in August 2010 and FDA approval for the Ovation System in October 2012. In February 2015, the FDA approved our next generation Ovation iX Iliac Stent Graft for the Ovation System, and in July 2015, the FDA approved the Ovation


iX Abdominal Stent Graft System. In September 2015, the first patients were treated with the Ovation iX Abdominal Stent Graft System in Europe, and in October 2015, we initiated the launch of our Ovation iX Iliac Stent Graft System in the United States.
Nellix EVAS System. In February 2013, we received CE Mark approval of the Nellix EVAS System, and we commenced a limited market introduction of the Nellix EVAS System in Europe. In December 2013, we received IDEInvestigational Device Exemption (“IDE”) approval in the United States to begin a clinical trial of the Nellix EVAS System which commenced in January 2014. Enrollment in the IDE study was completed in November 2014. In the fourth quarter of 2014, we obtained IDE continued access approval for additional patients. In April 2016, we announced achievementreceipt of CE Mark approval of the next-generation Nellix EVAS System. InSystem, and in September 2017, we further announced CE Mark approval for the Nellix EVAS System with the refined IFU. In May 2017, we announced that we would conduct a confirmatory IDE study in the United States, called the EVAS2 IDE Multicenter Safety and Effectiveness Confirmatory Study (“EVAS2”), to further evaluate the next-generation Nellix EVAS System, and in October 2017, we received IDE approval in the United States to begin the EVAS2 confirmatory clinical study to evaluate the next-generationcommence EVAS2. In early January 2019, we announced that our Nellix EVAS System would for the foreseeable future only be used under clinical protocol with pre-screened patients in procedures that adhere to the current indications for use. In mid-January 2019, we announced that the CE Mark for the Nellix EVAS System had been suspended by our notified body (an organization designated by the EU to regularly assess the conformity of certain products under applicable legislation before being placed on the market, a “Notified Body”). In June 2019, we announced that the CE Mark for the Nellix EVAS System had been reinstated by GMED, the EU Notified Body for the Nellix EVAS System. The reinstatement followed an assessment of clinical evidence.
ChEVAS. ChEVASChimney EndoVascular Aneurysm Sealing (“ChEVAS”) is a procedure where the Nellix EVAS System could potentially be used together with aortic branch stent grafts to treat patients with complex aortic anatomies.AAAs. Physicians initiated a clinical trial called ASCEND (AneurysmAneurysm Study for Complex AAA: Evaluation of Nellix Durability)Durability (“ASCEND”) to evaluate the clinical performance of ChEVAS. We are pursuing CE mark and FDAIn August 2019, we announced the IDE approval for this indication.the Nellix ChEVAS Protocol. This study will recruit 120 patients from up to 50 centers, both in the U.S. and internationally. We expect enrollment to begin in 2020.

Product Developments and Clinical Trials
Overview
We incurred expenses of $34.0 million in 2017, $48.6 million in 2016, and $41.8 million in 2015, on research and development activities and clinical studies. Our focus is to continually develop innovative and cost-effective medical devices for the treatment of aortic disorders. We believe that our ability to develop new technologies is a key to our future growth and success. Historically, we have focused on developing our EVAR and EVAS products to treat infrarenal AAA, including initial development of products to treat complex AAA anatomies. However, we expect to devote more resources in the future to developing, enhancing and obtaining expanded indications for our current EVAR and EVAS products and to develop new product indications to treat more complex anatomies.
Nellix EVAS System
Using the technology we acquired in the Nellix acquisition, we developed the Nellix EVAS System, a next-generation device, to treat infrarenal AAA. We have the following trials in process to build independent and collective clinical and economic evidence of clinical safety and effectiveness:


Nellix EVAS System

EVAS FORWARD IDE IDE.- We conducted this pivotal clinical trial to evaluate the safety and effectiveness of the Nellix EVAS System. This study is a prospective single arm registry which enrolled 179 patients at 29 centers in the United States and Europe. In November 2014, we completed enrollment in the study, and we submitted the one year results to the FDA in March 2016. In May 2016, we announced the results of the one yearone-year clinical data from the EVAS FORWARD IDE study that demonstrate that the Nellix EVAS System met the study primary endpoints for major adverse events at 30 days (safety) and treatment success at one year (effectiveness). Two-year imaging revealed a signal of migration, leading to a field safety notification issued in October 2016 and a dedicated root cause analysis, resulting in refinements to the IFU. Following the implementation of the refined IFU, the Nellix EVAS system is applicable to treat an estimated 40% of AAA patients with a traditional aneurysm.
Subsequently, the two-year results from the trial were announced.published in the Journal of Vascular Surgery in March 2018. This data was previously announced in June 2017 at the Society of Vascular Surgery Vascular Annual Meeting (“VAM”). Key highlights from the Nellix USUnited States IDE trial two-year clinical data are included below:
Freedom from all endoleaks (94%(95.1%), rupture (97%(99.4%), and all-cause mortality (97%(93.8%), and cardiovascular mortality (99%), among all patients.
Highest freedom of type II endoleaks, of 97%96.6%, ever reported at two years, among all patients.
When applying the refined IFUs for Nellix, patients at the two-year follow-up demonstrated 96%95.9% freedom from Type IA endoleak, migration >10mm, and sac growth.
EVAS2 IDEIDE. - In May 2017, we announced the decision to seek United StatesFDA approval of the Nellix EVAS System by conducting a confirmatory clinical study with the updatedrefined IFU and our next generation Nellix device design, the Gen2 device design.“Nellix 3.5 EVAS System.” The Gen2 deviceNellix 3.5 EVAS System incorporates design improvements to enhance ease of use and offers physicians more sizes to treat more patients with AAA. In October 2017, we announced our receipt of IDE approval from the FDA to commence a confirmatory clinical study to evaluate the safety and effectiveness of the Gen2 Nellix 3.5 EVAS System for the


endovascular treatment of infrarenal AAA. The EVAS2 IDE Multicenter Safety and Effectiveness Confirmatory Study (“EVAS2”) will prospectively evaluate the refined IFU and the Nellix Gen23.5 EVAS System. The study is approved to enroll up to 90105 primary patients, with one-year follow-up data required for the pre-market approval (“PMA”) application. We commenced EVAS2 patient enrollment in March 2018 and currently estimate a decision on our PMA application by the end ofexpect to complete enrollment in early 2020.
EVAS FORWARD Global Registry Registry.- This studyregistry is designed to provide real world clinical results to demonstrate the effectiveness and applicability of the Nellix EVAS System. The first phase of the registry included 300 patients enrolled in up to 30 international centers. The first patient in the registry was treated in October 2013. In2013, and in September 2014, we announced completion of patient enrollment in the EVAS FORWARD Global Registry. In November 2016, we announced positive two-year results on 300 patients from the EVAS FORWARD Global Registry at the annual VEITH meeting.Annual Symposium on Vascular and Endovascular Issues (the “VEITH Symposium”). The following outcomes were presented at the annual VEITH meeting:Symposium:
37% of the patients had complex anatomies;
98%98.1% freedom from any persistent endoleaks at latest follow-up;
No secondary interventions for Type II endoleaks;
97%97.4% freedom from aneurysm-related mortality; and
99%98.5% freedom from cardiovascular mortality.

In 2017, we commenced the EVAS FORWARD Global Registry 2, commenced a post marketpost-market evaluation of the Nellix Gen23.5 EVAS System, our second generation device design.

System.
ASCEND RegistryRegistry. - In April 2016, we announced the first data presentation with one-year outcomes from the ASCEND Registry, (Aneurysm Study for Complex AAA: Evaluation of Nellix Durability), a physician-initiated registry of the Nellix EVAS System used with aortic branch stent grafts for the treatment of patients with complex AAAs. The results of the study were formally published in the peer-reviewed Journal of Endovascular Therapy in December 2017.

Refined IFU -

In September 2017, we announced CE Mark approval for the Nellix EVAS System with the refined IFU. The Nellix EVAS System is being studied in the U.S.United States under an IDE. Following a thorough review of supporting clinical data, the Company'sour Notified Body, in the European Union, together with an independent clinical reviewer, has determined that the Nellix EVAS System, with the refined IFU, meetsmet the applicable safety and clinical performance requirements. As
In April 2018, we announced the results of a resultstudy, which was presented by Marc Schermerhorn, M.D., Chief of these evaluations,Vascular Surgery at Beth Israel Deaconess Medical Center, at the Notified BodyLate-Breaking Aortic Trials Session during the Charing Cross 40th International Symposium. The results of the study were also formally published in the Annals of Vascular Surgery in October 2019. This retrospective, propensity-weighted study compared long-term survival for the NellixEVAS System with traditional EVAR. The study reported significantly higher three-year survival for EVAS patients as compared to EVAR patients. Those patients with larger aneurysms (greater than 5.5 cm in diameter) treated with EVAS had half the mortality at three years as compared to those treated with traditional EVAR systems. The retrospective study included 333 EVAS patients from the original Nellix United States IDE Trial and 15,431 patients from the Society for Vascular Surgery Vascular Quality Initiative, all of whom were treated between 2014 and 2016. The patients were propensity weighted for AAA size, patient demographics, and cardiovascular risk factors. The primary outcome was overall survival, with a secondary analysis of overall survival stratified by aneurysm size.
In January 2019, we announced that in order to ensure optimal outcomes for patients, the Nellix EVAS System will, for the foreseeable future, only be available for use at approved centers outside of the United States in a clinical investigation setting with pre-screened patients that adhere to the current anatomical indications for use. All cases will be pre-screened by a physician panel to ensure adherence to protocol and use in accordance with current product indications. Compassionate use requests will be reviewed in accordance with the process established by us and associated national competent authorities. The existing inventory has granted abeen voluntarily recalled.
In January 2019, we announced that the CE Mark for the Nellix EVAS System had been suspended by our Notified Body following a voluntary recall and field safety notification issued by us on January 4, 2019. Suspension of the CE Mark means that we may not affix the CE Mark and sell the Nellix EVAS System in the EU during the term of the suspension.
In June 2019, we announced that the CE Mark for the Nellix EVAS System had been reinstated by GMED, the EU Notified Body for the Nellix EVAS System. The reinstatement followed an assessment of clinical evidence.
In August 2019, we announced that we have received IDE approval from the FDA to commence a new pivotal study to evaluate the safety and effectiveness of the ChEVAS for the endovascular treatment of complex AAA. The ChEVAS system is an endovascular AAA therapy designed to combine the Nellix 3.5 endograft with parallel visceral stents to enable treatment of patients with juxta-renal, para-renal, and suprarenal AAA. The application of EVAS for patients with complex aneurysms is expected to offer innovative new technology to a group of patients that are underserved by the refined IFU.current standard of care.
AFX System

In September 2014, we announced a new clinical study called LEOPARD (LookingLooking at EVAR Outcomes by Primary Analysis of Randomized Data)Data (“LEOPARD”). This study was designed to compare outcomes of the AFX System versus other commercially available EVAR devices. We designed the LEOPARDLEOPARD study to randomize and enroll at least 400 patients at up to 600 patients at 60 leading80 centers throughout the United States and commenced enrollment in the first quarter of 2015. The centers were a mix of our current and new customers, with each investigator selecting one competitive device to randomize against AFX.the AFX System. The LEOPARD study is being led by an independent steering committee of leading physicians who are involved with the study and responsible for presenting the results over the five-year5-year follow-up period.

Subsequently, positive interimPositive results from LEOPARD were announced.presented at the VEITH Symposium in November 2019. Based uponon those who completed follow up, the patients that have completed their one-year follow-up, freedom from Aneurysm Related Complications with AFX/AFX2 is 84.7%, compared(“ARC”) shows that overall the AFX system has a comparable performance to 82.0% with other devices. These preliminary results demonstrate similarAnalysis of individual clinical outcomes between the endografts under investigation. AFX/AFX2, however,suggests that different EVAR approaches may have advantages in different patient populations. The AFX System remains the only device that preserves the patient'spatient’s aortic bifurcation. Based upon the anticipated number of additional patients required to prove superiority, we stopped further randomization in the LEOPARD study and plan to continue to follow enrolled patients for the planned five years.

In December 2015, we announced that the AFX Endovascular AAA System for the treatment of AAA received Shonin approval from the Japanese Ministry of Health, Labor and Welfare (“MHLW”).

MHLW.
In February 2016, we announced the completion of the first United States commercial implant of AFX2, which reduces procedure steps for the delivery and deployment of the bifurcated endograft. AFX2 also facilitates PEVAR by providing the lowest profile contralateral access through a 7F introducer. These improvements bring together our ActiveSeal™ActiveSeal® technology, DuraPly® PTFE graft material and VELA, Proximal Endograft, into an integrated new EVAR system.



In December 2016, we received notice from our Notified Body in the European Union that the CE Mark for AFX and AFX2 would be suspended due to reports of Type III endoleaks with AFX with Strata graft material (“AFX Strata”), a prior generation of the AFX device. We had, forFor our current generation of AFX products, we had implemented device and graft material improvements and updated IFUs resulting in a substantial reduction in reported Type III endoleaks. We provided documentation of the foregoing reduction in Type III endoleaks to our Notified Body. In January 2017, we received notice from our Notified Body that the CE Mark for AFX and AFX2 had been re-instated,reinstated, effective immediately.

Additionally, in December 2016, we placed a temporary hold on shipments of AFX and AFX2 to complete an investigation of quality concerns with some sizes of these devices. Subsequently, we removed the temporary hold and resumed shipments of all sizes of AFX and the smaller diameter sizes of AFX2 and initiated a voluntary recall of (1)of: (i) the small remaining quantity of original AFX with Strata graft material,Strata; and (2)(ii) the larger diameter sizes of AFX2. In January 2017, we removed the temporary hold and resumed shipments of the remaining larger diameter sizes of AFX2.

In July 2018, we sent a voluntary safety notice (“Safety Notice”) to healthcare professional (“HCP”) users of the AFX System to provide updated information on comparative AFX Type III endoleak rates, patient-tailored surveillance recommendations, and recommendations for intervening through an AFX device or re-intervening on an AFX device. No product was removed from the field as part of that safety update action.
In October 2018, the FDA classified the July 2018 Safety Notice as a Class I recall. The FDA defines a Class I recall as including a firm’s correction of a marketed product in circumstances where there is a reasonable probability that use of or exposure to the device would cause serious adverse health consequences or death. 
The clinical conditions resulting in this Class I recall classification (Type III endoleaks) are principally related to AFX with Strata material. The AFX with Strata material was replaced by AFX incorporating the DuraPly material in both AFX and AFX2 devices. Strata was last manufactured in 2014, last sold in 2016, and removed from global inventories in the first half of 2017. There is no AFX with Strata product remaining in any commercial market.
No product return is required under this recall, and no further action by HCPs is required in addition to the Safety Notice. The guidance provided in the July 2018 Safety Notice remains current.
On October 8, 2019, our AFX2 product received a 3-year shelf-life approval from the FDA. On October 28, 2019, the FDA issued a safety update pertaining to our AFX system, in which the FDA referenced data from an integrated healthcare system (Rothenberg et. al.), published in a conference abstract and presented at American College of Surgeons Clinical Congress 2019 on October 28, 2019. The FDA interpreted such data as suggesting that there “may be a higher than expected risk of Type III endoleaks occurring with the use of AFX with Duraply and AFX2 endovascular grafts.” Both we and the FDA noted meaningful limitations in the referenced data, including with respect to our currently commercially available AFX2 system. We are assessing the referenced data and comparing them to our own multiple data sets, including data from the LEOPARD trial (the only randomized controlled trial of EVAR providing the highest level evidence on AFX Duraply and AFX2 systems), real-world data from a vascular registry, our benchmarked complaint data, and meta-analyses of current literature. The FDA safety update does not constitute a recall or correction to the AFX System, including the AFX2 system.
Ovation System

In May 2011, we initiated a three-year3-year European Post MarketPost-Market Registry to enroll 500 patients across 30 European centers. Enrollment ended in December 2013. In January 2017, we announced positive three-year3-year results from the Ovation EU Post MarketPost-Market Registry. The data werewas presented at the 2017 LINCLeipzig Interventional Course (“LINC”) meeting and showed that the Ovation platformSystem has the broadest range of patient applicability on IFU of all commercially available infrarenal endovascular AAA devices. The resulting outcomes included:

99% freedom from aneurysm-related mortality;
99% freedom from migration, rupture, and conversion;
97% freedom from Type I/III endoleak; and
Excellent freedom from secondary intervention for occlusion (97%), Type I endoleak (97%) and Type II endoleak 95%(95%).



In October 2014, we initiated the LIFE Study to illustrate the potential advantages of a fast track“Fast-Track” protocol including PEVAR, no general anesthesia, no time in ICU and a one nightone-night stay in the hospital with the Ovation System. In May 2016, we announced the completion of enrollment of 250 patients at 34 sites participating in the LIFE Study. In September 2016, we announcedFebruary 2018, the results of the one-month clinical data from the LIFE Study thatwere published in the Journal of Endovascular Therapy. These results demonstrate that the Ovation System met the study primary endpoint for major adverse events at 30 days. The following are highlights of the presentation,publication, with outcomes covering one-month follow-up:
Low major adverse event rate of 0.4%;
No ruptures, conversion, or secondary interventions;
99% and 100% freedom from type I and typeNo Type III endoleaks respectively;and low Type I endoleaks (0.4%);
Fast-Track completed in 216 patients (87%) patients,, with positive results compared to non-Fast-Track patients;
Procedure time of 84 minutes vs. 110 minutes;
General anesthesia use 0% vs.versus 18%;
ICU stay 0% vs.versus 32%; and
Mean hospital stay 1.2 vs.days versus 1.9 days.

In August 2015, we enrolled the first subject in the LUCY Study, a multi-center post-market registry designed to explore the clinical benefits associated with EVAR using the Ovation Abdominal Stent Graft PlatformSystem in female patients with AAA, as compared to males. It isThis was the first prospective study evaluating EVAR in females, a population that has historically been underrepresented in EVAR clinical trials. We announced completion of enrollment of 225 patients in the LUCY study Study in February 2017. The 30-day LUCY data showed that, in women, the ultra-low profile (14F) Ovation System device resulted in:

At least 28% greater EVAR eligibility for women with AAA;
1.3% major adverse events, the lowest rate reported for EVAR, compared to other contemporary, prospective, post-market registries;events;
No deaths;
No proximal endoleaks;
No limb occlusion;
Low readmission rate of 3.9%; and

100% procedural success.

100% procedural successIn June 2018 at the VAM, the 1-year results of the LUCY Study were announced in the late-breaking clinical trial session. Despite having more complex anatomies at the time of the index procedure women continue to demonstrate similar outcomes to men through one year. The 1-year outcomes of freedom from conversion, rupture, AAA-related mortality and device-related reintervention were similar between the two arms.

In February 2015, the FDA approved the next generation Ovation iX Iliac Stent Graft for the Ovation System, and in July 2015, the FDA approved the Ovation iX Abdominal Stent Graft System. In September 2015, the first patients were treated with the Ovation iX Abdominal Stent Graft System in Europe, and in August 2015, we initiated the launch of the Ovation iX System in the United States.
In November 2016, we announced at the VEITH Symposium that the five-year5-year results from the Ovation Global Pivotal Trial were positive and showed the following outcomes:

Broad patient applicability, with 40% of the patients treated outside the labeled indications of other EVAR devices;
Stable aortic neck diameters with an average expansion of 0.1%,0.1mm, compared to 25%5.3mm as reported with other EVAR devices;
97%96.6% freedom from secondary interventions related to typeType I endoleak; and
No migration or conversions.



In August 2016, we announced that the first two patients werehad been treated with the Ovation Alto,® Abdominal Stent Graft System, which is the newest device in the Ovation System platform of abdominal stent graft systems. Ovation Alto is an investigational device, currently not approved in any market. It expands EVAR to include the treatment of patients with complex AAAs, specifically patients with very short or otherwise complex aortic neck anatomy. This is achieved by the conformable O-rings with CustomSeal® polymer that have been repositioned near the top of the endograft, providing seal just below the renal arteries. In November 2016, we received IDE approval from the FDA to conduct a clinical study with the Ovation Alto® Abdominal Stent Graft System in the United States.

In March 2017, we announced the enrollment of the first patients in the Expanding Patient Applicability with Polymer Sealing Ovation Alto Stent Graft (“ELEVATE”) IDE clinical study, our pivotal clinical trial to evaluate the safety and effectiveness of Ovation Alto for the repair of infrarenal AAAs. The ELEVATE IDE clinical trial is approved to enroll 75 patients at up to 16 centers in the United States.

The Company plans to file regulatory submissions In February 2018, we announced the final patient enrollment in the third quarterELEVATE IDE clinical study.
In September 2019 and December 2019, the Effectiveness of 2018 and estimates potential approvalCustom Seal with Ovation: Review of Evidence (“ENCORE”) reports regarding the study of polymer endovascular aneurysm repair (“Polymer EVAR”) using Ovation System were published in the Journal of Vascular Surgery. ENCORE is a pooled retrospective analysis of the Alto device5 prospective clinical trials and registries and encompasses 1,296 patients, nearly 160 centers and over 200 investigators in both the U.S.United States, Europe and European markets in 2019.Latin America. The studies within ENCORE had predefined follow-up periods ranging from 1 month to up to 5 years, and across the studies the median follow up was greater than 2 years. At 5 years, the ENCORE analysis included the following results for the Ovation System based on the available data:

99% freedom from AAA-related mortality;
PEVAR99% freedom from conversion;
Vascular access99% freedom from rupture;
96% freedom from reintervention for EVAR previously required femoral artery exposure (commonly referred to as surgical cut-down) of one or both femoral arteries, allowing for safe introduction of the EVAR product. ComplicationsType Ia endoleak; and
92% freedom from femoral artery exposure during EVAR procedures is an inherent risk of current surgical practice. PEVAR procedures do not require an open surgical cut-down of either femoral artery, as access to the femoral artery is achieved via a needle-puncture through the skin and closure with use of a suture-mediated device. Advantages to the patient and to the health care system of an entirely percutaneous procedure include reduced surgical procedure times, less post-operative pain, and fewer access-related wound complications. 
In April 2013, we announced FDA approval of the PEVAR indication for use with our AFX and IntuiTrak products. Trial results show the safety and effectiveness of our device and PEVAR procedure facilitated with a suture-mediated closure device, and showed reduced surgical procedure time compared to surgical EVAR. Other trends favoring PEVAR include less medication prescribed for post-operative groin pain, reduced blood loss, and less hospitalization time. To date, no other company has conducted a randomized prospective FDA trial to specifically obtain approval for a PEVAR indication.

all device-related reintervention.
Manufacturing and Supply
Most of our commercial products are manufactured, assembled, and packaged at our 129,000 square foot leased facilities in Irvine, California and our 110,000 square foot leased facilities in Santa Rosa, California.

We rely on third parties for the supply of certain components used in our EVAR and EVAS products, such as the wire used to form our cobalt chromium alloy stent, PTFE, and the raw material used in the manufacturing of polymer. While we obtain many of these components from single sourcesingle-source suppliers, we believe there are alternative vendorssuppliers for the supply of the vast majority of our required components. Many of our third party manufacturers go through a formal qualification and approval process, including periodic renewal to ensure fitness for use and compliance with applicable FDA requirements and International Organization for Standardization (“ISO”) 13485 requirements, and/or other required quality standards. Additionally, we actively manage supply risk with our key suppliers through a combination of negotiating favorable terms of supply agreements, maintaining strategic inventory levels, and maintaining frequent communications with our suppliers.



Marketing and Sales
We market and sell our EVARplatform of products through a direct sales force and network of agents in the United States Canada, New Zealand, South Korea, and fourteen European6 other countries. In 20select countries in Europe, Asia Pacific, Latin America and other European countries, Japan, 12 Latin American countries,targeted international geographies, we market and seven other Asian countries we sell our EVAR products through independent distributors. In 2017, we marketeda network of third party distributors and agents. For the year ended December 31, 2019, there was one customer that represented 10% or more of our EVAR products in 56 countries outside the United States. consolidated revenue and consolidated accounts receivable.
United States. We market and sell our EVAR products in the United States through a direct sales force. The primary customer and decision-maker for our EVAR products is the vascular surgeon, and to a lesser extent, the cardiovascular surgeon, interventional radiologist and the interventional cardiologist. Through our direct sales force, we provide clinical support and service to many of the approximately 1,600 hospitals and approximately 4,000 physicians in the United States that perform EVAR. Approximately 68%66% of our revenues forrevenue in the year ended December 31, 2017 were2019 was generated from sales of our EVAR products in the United States.
International. We market and sell our products outside of the United States through a direct sales force and through a network of third party distributors and agents. Approximately 32%34% of our revenues forrevenue in the year ended December 31, 2017 were2019 was generated from sales of our EVAR and EVAS products outside of the United States.


Seasonality. Our global revenue does not reflect a significant degree of seasonality.  However, for our implant-based revenue, the number of medical procedures incorporating our products is generally lower during summer months.  We believe that this trend may be due to the summer holiday season in Europe and the United States.
See Note 7 of the Notes to theour Consolidated Financial Statements included in Item 8 of this Annual Report on Form 10-K for a tabular summary of our revenue by geographic region fordisaggregation in the fiscal years 2017, 2016ended December 31, 2019, 2018 and 2015.

2017.
Competition
The medical device industry is highly competitive. Any product we develop that achieves regulatory clearance or approval will have to compete for market acceptance and market share. We believe that the primary competitive factors in the AAA device market segment are:

clinical effectiveness;
product safety, reliability and durability;
ease of use;
sales force experience and relationships; and
price.
We experience significant competition and we expect that the intensity of competition will increase over time. For example, our major competitors, Medtronic, Inc., W.L. Gore Inc., and Cook Medical Products, Inc., have each obtained full regulatory approval for their EVAR products in the United States and/or other international markets. In addition to these major competitors, we also have smaller competitors, and emerging competitors with active EVAR system development programs.
Our major competitors have substantially greater capital resources than we do and also have greater resources in the areas of research and development, regulatory affairs, manufacturing, marketing and sales. In addition, these competitors have multiple product offerings, which some physicians and hospitals may find more convenient when developing business relationships. We also compete with other medical device companies for clinical trial sites and for the hiring of qualified personnel, including sales representatives and clinical specialists.

Patents and Proprietary Information
We believe that protection of our intellectual property and proprietary information is key to protecting our technology. We continue to build a portfolio of apparatus and method patents covering various aspects of our current and future technology. In the area of aorta treatment systems, our rights include 3743 United States patents, 916 pending United States patent applications 32and 42 issued foreign patents and 9 pending foreign patent applications. Our current AFX-related aorta treatment related patents have expiration dates from 2018 to 2038.patents. As a result of our acquisition of Nellix, we added additional patents to our portfolio which have evolved to currently include 2225 issued United States patents, 26 pending United States patent applications, and 1418 issued foreign patents, with expiration dates from 2018 to 2038.patents. As a result of our merger with TriVascular, we added patents to our portfolio which have evolved to currently including 46include 53 issued United States patents, 20 pending United States patent applications, and 87104 issued foreign patents. The expiration date of the patents with expiration datesin our combined portfolio ranges from 20182020 to 2037. We intend to continue to file patent applications to strengthen our intellectual property position as we continue to develop our technology, while simultaneously avoiding paying unnecessary fees to maintain patents and applications when we believe it is not in our best interest.


Our policy is to protect our proprietary position by, among other methods, filing United States and foreign patent applications to protect technology, inventions and improvements that are important to the development of our business. We also own trademarks to protect our brand. In addition to patents and trademarks, we rely on trade secrets and proprietary know-how protection as well.protection.
We seek protection of these trade secrets and proprietary know-how, in part, through confidentiality and proprietary information agreements. We make diligent efforts to require our employees, directors, consultants and advisors to execute confidentiality agreements at the beginning of their employment, consulting or other contractual relationships with us. These agreements provide that all confidential information developed or made known to the individual or entity during the course of the relationship is to be kept confidential and not be disclosed to third parties, except in specific circumstances. In the case of employees and certain other parties, the agreements also provide that all inventions conceived by the individual will be our exclusive property.

Third-Party
Third Party Reimbursement

In the United States, hospitals are the primary purchasers of our EVAR and EVAS products. Hospitals, in turn, bill various third-partythird party payors, such as Medicare, Medicaid and private health insurance plans, for the total healthcare services required to treat the patient’spatients’ AAA. Government agencies, private insurers and other payors determine whether to provide coverage for a particular procedure and to reimburse hospitals for medical treatment. While hospitals are often reimbursed at a fixed rate based on the diagnosis-related group (“DRG”) established by the United States Centers for Medicare and Medicaid Service (“CMS”), other insurers may negotiate differing approaches with hospitals. The fixed rate of reimbursement is based on the procedure performed and is unrelated to the specific medical devices used in that procedure.

Reimbursement of procedures utilizing our EVAR and EVAS products is currently are covered.available. Some payors may deny reimbursement if they determine that the device used in a treatment was unnecessary, not cost-effective or used for a non-approved indication.
Beginning on October 1, 2015, CMS started requiring those who make claims for reimbursement to use ICD-10 codes to designate diagnosis and treatment of Medicare beneficiaries. The following are the ICD-10-PCS codes associated with the endovascular treatment of abdominal aneurysms utilizing our devices indicated for that treatment.
ICD-10 PCSICD-10-PCSDescription
Abdominal Aorta
04V03DZRestriction of Abdominal Aorta, with Intraluminal Device, Percutaneous Approach
04V04DZRestriction of Abdominal Aorta, with Intraluminal Device, Percutaneous Endoscopic Approach
04V03DJRestriction of Abdominal Aorta, with Intraluminal Device, Temporary, Percutaneous Approach
04V04DJRestriction of Abdominal Aorta, with Intraluminal Device, Temporary, Percutaneous Endoscopic Approach
04U03JZSupplement of Abdominal Aorta with Synthetic Substitute, Percutaneous Approach
04U04JZSupplement of Abdominal Aorta with Synthetic Substitute, Percutaneous Endoscopic Approach
CMS reimburses these hospital inpatient procedures utilizing the following MS-DRGs. National average reimbursement values for 2019 are shown.
Aortic and Heart Assist Procedures Except Pulsation Balloon with MCC$37,59840,929
Aortic and Heart Assist Procedures Except Pulsation Balloon without MCC$24,01725,343
Outside of the United States, market acceptance of medical devices, including EVAR and EVAS systems, depends partly upon the availability of reimbursement within the prevailing healthcare payment system. Reimbursement levels vary significantly by country, and by region within some countries. Reimbursement is obtained from a variety of sources, including government sponsored healthcare and private health insurance plans.
Presently, the European Union (“EU”)EU is updating regulations for the sale and reimbursement of medical devices in EU countries. The current directives on active implantable medical devices (90/385/EEC) and on medical devices (93/42/EEC) will


be replaced by a regulation on medical devices. The legislation will harmonize such regulations throughout all EU countries. It is expected that the new regulations will require: (i) stricter guidelines for clinical evidence supporting device efficacy,efficacy; (ii) more powers for regulatory assessment bodies,bodies; (iii) stronger supervision of manufacturers, importers and distributors,distributors; and (iv) an extended database for medical devices and better traceability throughout the supply chain. The European Commission proposals have been discussed in the European Parliament and in the European Council, and a final text was agreed upon on June 15, 2016. Work is currently ongoing to translate the final texts in all the EU official languages and to correct technical inconsistencies. Final formal adoption was expected both on the Council and the Parliament sides during the first semester 2017. Regulation would then gradually come into effect by 2020.



Government Regulation - Medical Devices

Our medical devices are subject to regulation by various government agencies, including the FDA and similar agencies within governments outside of the United States. Each of these agencies requires us to comply with laws and regulations governing the development, qualification, manufacturing, labeling, marketing and distribution of our medical devices.
United States
In the United States, medical devices are regulated by the FDA under the Federal Food, Drug and Cosmetic Act. The FDA classifies medical devices into one of three classes based upon controls the FDA considers necessary to reasonably ensure their safety and effectiveness. Class I devices are subject to general controls such as labeling, adherence to good manufacturing practices and maintenance of product complaint records, but are usually exempt from premarketpre-market notification requirements. Class II devices are subject to the same general controls and are also are subject to special controls such as performance standards, FDA guidelines, and may also require clinical testing prior to approval. Class III devices are subject to the highest level of controls because they are life-sustaining or life-supporting devices. Class III devices require rigorous clinical testing prior to their approval and generally require a PMA or PMA supplement approval prior to marketing for sale.
Authorization to commercially distribute a medical device in the United States is generally received in one of two ways. The first, known as premarketpre-market notification (i.e., the 510(k) process), requires us to submit data to the United States FDA to demonstrate that our medical device is substantially equivalent to another medical device that is legally marketed in the United StatesStates. The United States FDA must issue a finding of substantial equivalence before we can commercially distribute our medical device. Devices that receive a finding of substantial equivalence are referred to as 510(k)-cleared devices. Modifications to medical devices cleared under the 510(k) process can be made under the 510(k) process or without the 510(k) process if the changes do not significantly affect safety or effectiveness.
The second process, known as premarketpre-market approval (i.e., the PMA process), requires us to collect and submit nonclinical and human clinical data on the medical device for its intended use to demonstrate that it is safe and effective. Human clinical data must be collected in compliance with FDA IDE regulations. The IDE application must be supported by data, typically including the results of animal and engineering testing of the device. If the IDE application is approved by the FDA, human clinical studies may begin at a specific number of investigational sites with a maximum number of patients. The clinical studies must be conducted under the review of an independent institutional review board to ensure the protection of the patients’ rights. In the PMA process, the FDA will approve the medical device and thereby authorize its commercial distribution in the United States if it determines that the probable benefits outweigh the risks for the intended patient population, and, therefore, makes a determination of reasonable assurances of safety and effectiveness. The PMA process takes longer and is more expensive than the 510(k) process. Our Powerlink, IntuiTrak AFX, AFX2 and Ovation EVAR Systems were approved through this PMA process. The Nellix EVAS System is currently engaged in the PMA process and we anticipate will be made commercially available in the United States following PMA approval. In addition, the Ovation Alto Stent Graft System is also currently engaged in the PMA process and we anticipate commercial availability in the United States following its PMA supplement approval.
We are required to register as a medical device manufacturer with the FDA. Additionally, the California Department of Health Services (“CDHS”) requires us to register as a medical device manufacturer. Because of this, the FDA and the CDHS routinely inspect us for compliance with Quality System“Quality System” regulations. These regulations require that we manufacture our products and maintain related documentation in a prescribed manner with respect to manufacturing, testing and control activities. We have undergone and expect to continue to undergo regular Quality System inspections in connection with the manufacture of our products at our facility.facilities. Further, the FDA requires us to comply with various regulations regarding labeling. The Medical Device Reporting (“MDR”) laws and regulations require us to provide information to the FDA on deaths or serious injuries alleged to have been associated with the use of our devices, as well as product malfunctions that likely would cause or contribute to death or serious injury if the malfunction were to recur. Although physicians are permitted to use their medical judgment to apply medical devices to indications other than those cleared or approved by the FDA, we are prohibited from promoting products for such “off-label” uses and can only market our products for the 510(k)-cleared or PMA-approved indications for use.


International
Internationally, our medical devices are subject to regulatory requirements in the countries in which they are sold. The requirements and regulatory approval processes vary from country to country. The regulatory requirements of select countries are set forth below.


In the EU, one regulatory approval process exists. We must comply with the requirements of the Medical Devices Directive (“MDD”), and appropriately affix the CE Mark on our products to attest to such compliance. To obtain a CE Mark, our products must meet minimum standards of safety, performance and quality (i.e., “Essential(“Essential Requirements”), and then comply with defined conformity assessment routes. A notified body,Notified Body, selected by us, assesses our Quality Management System (“QMS”) and our product conformity to the Essential Requirements and the requirements of the MDD. The notified bodyNotified Body must perform regular inspections to verify compliance. The EU government ministries of health ("(“Competent Authorities"Authorities”) oversee human clinical studies and post-market surveillance of approved products, referred to as Vigilance Reporting. We are required to report device failures and serious adverse events potentially related to product use to responsible Competent Authorities. We also must comply with additional requirements of individual countries in which our products are marketed. Our Powerlink, AFX, and Ovation EVAR SystemsSystem and Nellix EVAS System were approved through the CE marking process.process, though the CE Mark for the Nellix EVAS System has been suspended by our Notified Body. In addition, the new Medical Device Regulation which was finalized in 2017 (“MDR 2017”) will become effective in May 2020 in the EU. MDR 2017 will change several aspects of the existing regulatory framework, such as clinical data requirements, and introduce new ones, such as Unique Device Identification. We, and the Notified Bodies who will oversee compliance with MDR 2017, face uncertainties as MDR 2017 is rolled out and enforced, which, in addition to the increased costs of compliance, creates risks in several areas including the CE marking process and data transparency.
To be sold in Japan, most medical devices must undergo thorough safety examinations and demonstrate medical efficacy before they are granted approval, or “Shoninknown as “Shonin.. In Japan, the MHLW, with administration by the Pharmaceutical and Medical Devices Agency, regulates medical devices under the Pharmaceuticals and Medical Device Law (“PMD”). Our quality management systemQMS and product conformity to the PMD are overseen by MHLW and the Pharmaceutical and Medical Devices Agency. Our Powerlink System, AFX System, and AFXOvation System were approved through the ShoninShonin process. The Ovation System and the Nellix EVAS System requirerequires future approval through the foregoing process in order to be commercially available in Japan.
To be sold in China, all medical devices are required to have licenses from the China Food and Drug Administration (“CFDA”) (formerly State Food & Drug Administration or SFDA). Quality system, premarketpre-market testing and clinical investigation are required for Class II and III devices. CFDA released a new regulation on Innovative Medical Device Registration Applications in March 2014, which Endologixwe may utilize to register its productour products in China.China in the future. Class II and III submissions will have a full application review conducted; this will include a technical and administrative review. Novel and high-risk products may also be subject to an Expert Panel Meeting (which may result in an additionaladd 4 to 6 months to the review process), and the CFDA may conduct an onsiteon-site QMS audit of manufacturing facilities. The AFX System and the Ovation System, as well as the Nellix EVAS System, require future approval through the foregoing process in order to be commercially available in China.
We are also subject to other local, state, federal and international regulations relating to a variety of areas including laboratory practices, manufacturing practices, medical device export, quality system practices, as well as health carehealthcare reimbursement and delivery of products and services.
United States and Foreign Government Regulations -Regulation — Healthcare Fraud and Abuse and Privacy Laws

Healthcare Fraud and Abuse
We are subject to various United States and foreign governmental laws and regulations relating to the manufacturing, labeling, marketing and selling of our products, non-compliance with which could adversely affect our business, financial condition and results of operations. We have implemented and maintain a comprehensive compliance program that includes ongoing risk assessment, development of relevant policies, monitoring and training of our employees to ensure compliance with United States and foreign laws and regulations.
Various United States federal and state laws and regulations pertaining to health carehealthcare fraud and abuse govern how we can and cannot do business in the United States and globally, including the federal False Claims Act, which prohibits the submission of false or otherwise improper claims for payment to a federally-funded health carehealthcare program, the federal Anti-Kickback Statute, which prohibits offers to pay or receive remuneration of any kind for the purpose of inducing or rewarding referrals of items or services reimbursable by a Federal health carefederal healthcare program, and similar state false claims and anti-kickback laws and regulations that apply to state funded health carehealthcare programs. Violations of these laws and regulations are punishable by criminal and/or civil sanctions, including, in some instances, fines, imprisonment and, within the United States, exclusion from participation in federal and/or state health carehealthcare programs, including Medicare and Medicaid. The interpretation and enforcement of these laws and regulations are uncertain and subject to rapid change.


We conduct a significant amount of sales activity outside of the United States. We intend to continue to pursue growth opportunities internationally, including in emerging markets. Our international operations are, and will continue to be, subject to a complex set of laws and regulations, including:


Foreign medical reimbursement policies and programs;
Complex data privacy requirements and laws;
Ever-changing and contradictory country-specific guidelines, transparency requirements and laws;
The Foreign Corrupt Practices Act, a United States law, which prosecutes United States companies whowhich engage in bribery when doing business with physicians, distributors, agents, and other third parties outside of the United StatesStates. Many physicians outside of the United States are considered government officials, and United States companies, together with individuals who engaged in the bribery, face civil and criminal sanctions both in the United States and any country where bribery of a government official violates the law of that country;
Foreign anti-corruption laws, such as the UK Bribery Act; and
Trade protection measures, including import or export restrictions or sanctions, that may restrict us from doing business in and/or shipping products to certain parts of the world.

The foregoing are subject to change and evolving interpretations and any violation thereof could subject us to financial or other penalties.
USUnited States and Foreign Privacy Laws
We are subject to various United States federal and state privacy and security laws and regulations that protect the security and privacy of individually identifiable health information. For example, on January 1, 2020, the California Consumer Privacy Act (the “CCPA”), a bill intended to enhance privacy rights and consumer protection for residents of California, became effective. We are mindful that our systems require significant resources and oversight to protect employee, patient, physician and customer information. If we fail to maintain or protect our information systems and data integrity effectively, we could lose existing customers, have difficulty preventing, detecting, and controlling fraud, have disputes with customers, physicians, and other health carehealthcare professionals, have regulatory sanctions or other penalties imposed on us, have increases in operating expenses, incur expenses or lose revenuesrevenue as a result of a data privacy breach, or suffer other adverse consequences.
We are also impacted by the privacy and security requirements of countries outside of the United StatesStates. Privacy standards in Europe and Asia have become stricter. Enforcement actions and financial penalties related to privacy in the EU are growing, and foreign governmental authorities have passed new laws and restrictions relating to privacy requirements and standards. The management of cross bordercross-border transfers of information among and outside of EU member countries is becoming more complex, which may affect our consulting arrangements with physicians or our clinical research activities, as well as product offerings that involve transmission or use of clinical data.
The EU published the EU General Data Protection Regulation (“GDPR”(the “GDPR”) in April 2016.2016, which became effective in all EU member countries as of May 2018. This major piece of legislation represents the most significant change in EU data protection law since 1995. It will apply in all EU Member States as of May 2018. The GDPR mandates a baseline set of data privacy standards that will continue to have a significant impact on us as we are involved in the processing of personal data outside the EU. It will increaseThe GDPR also increases the penalties for noncompliance, with fines of up to €20 million or 4% of annual worldwide revenue.
Any significant breakdown, intrusion, interruption, corruption, or destruction of our systems or information could have a material adverse effect on our business, results of operations and financial condition. Thus, we will continue our efforts to comply with all applicable privacy and security laws and regulations. To the best of our knowledge at this time, we do not expect that the ongoing cost and impact of assuring compliance with applicable privacy and security laws and regulations will have a material impact on our business, results of operations or financial condition.
Product Liability
The manufacture and marketing of medical devices carries the significant risk of financial exposure to product liability claims. Our products are used in situations in which there is a high risk of serious injury or death. Such risks will exist even with respect to those products that have received, or in the future may receive, regulatory approval for commercial sale. We are currently covered under a product liability insurance policy with coverage limits of $20 million per occurrence and $20 million per year in the aggregate, subject to a customary deductible of $150,000.


Employees
As of December 31, 2017,2019, we had 675488 employees (as compared to 782528 employees as of December 31, 2016)2018), including 218174 in manufacturing, 4529 in research and development, 4139 in clinical and regulatory and clinical affairs, 7558 in quality, 191129 in sales and marketing, and 10559 in administration. We believe that the success of our business will depend on our ability to attract and retain


qualified personnel. Our employees are not subject to a collective bargaining agreement, and we believe that we have good relations with our employees.
General Information
We were incorporated in California in March 1992 under the name Cardiovascular Dynamics, Inc. and reincorporated in Delaware in June 1993. In January 1999, Cardiovascular Dynamics, Inc. (by then a publicly-traded company) merged with privately-held Radiance Medical Systems, Inc., and we changed our name to Radiance Medical Systems, Inc. In May 2002, we merged with then privately-held Endologix, Inc., and we changed our name to Endologix, Inc.
Our principal executive office is located at 2 Musick, Irvine, California and our telephone number is (949) 595-7200. Our website is located at www.endologix.com. The information on, or that can be accessed through, our website is not incorporated by reference into this Annual Report on Form 10-K and should not be considered to be a part hereof.
We make our annual reports on Form 10-K, quarterly reports on Form 10-Q, current reports on Form 8-K and related amendments to these reports, as applicable, available on our website, at www.endologix.com, free of charge as soon as practicable after filing or furnishing such reports with the United States SEC.

All such reports are also available free of charge via EDGAR through the SEC website at www.sec.gov. In addition, the public may read and copy materials filed by us with the SEC at the SEC’s public reference room located at 100 F Street, NE, Washington, D.C., 20549. Information regarding operation of the SEC’s public reference room can be obtained by calling the SEC at 1-800-SEC-0330.

Item 1A.Risk Factors

Before deciding to invest in our company, or to maintain or increase your investment, you should carefully consider the risks described below, in addition to the other information contained in this Annual Report on Form 10-K and other reports we have filed with the SEC. The risks and uncertainties described below are not the only ones we face. Additional risks and uncertainties not presently known to us, or that we currently deem immaterial, may also affect our business operations. If any of these risks are realized, our business, financial condition, or results of operations could be seriously harmed and, in that event, the market price for our common stock could decline and you may lose all or part of your investment.
These risk factors should be considered in connection with evaluating the forward-looking statements contained in this Annual Report on Form 10-K. These factors could cause actual results and conditions to differ materially from those projected in our forward-looking statements.
Risks Related to Our Business
All of our revenue is generated from a limited number of products, and any decline in the sales of these products, including as a result of negative perceptions regarding our financial stability, or any material departure in expected revenues from our products as against forecasts, will negatively impact our business.
We have focused heavily on the development and commercialization of a limited number of products for the treatment of AAA. If we are unable to continue to achieve and maintain market acceptance of these products and do not achieve sustained positive cash flow from operations, we will be constrained in our ability to fund development and commercialization of improvements and other product lines. In addition, if we are unable to market our products as a result of a manufacturing or quality problem or failure to maintain regulatory approvals, we would lose our only source of revenue and our business would be negatively affected. For example, in collaboration with certain EU regulatory authorities and GMED, the EU Notified Body for our Nellix EVAS System, we decided in early 2019 that, until determined otherwise, the Nellix EVAS System will only be available in the EU at approved centers in a clinical investigation setting with all cases pre-screened by a physician panel to ensure adherence to protocol and use in accordance with current product indications.


We may not succeed in commercializing our products for several reasons, including:
physicians and hospitals may continue relying on (or revert back to) open surgical repair, or use the other approved EVAR devices available for patients;
our direct sales force may not be large enough, or effective enough in its efforts, to train and educate physicians and hospitals about the benefits of our products so as to drive adoption and continued use of our products;
coverage and reimbursement for our products may not be sufficient for customers to choose our devices when in need of an EVAR device;
challenges in the manufacturing, validation and testing of our products may require us to take actions that delay or otherwise hinder new product introductions or that impact currently available products;
new technologies, or improved products by competitors, may limit or reduce adoption and use of our products;
clinical results associated with our products may not be deemed sufficient by us or applicable regulatory authorities to support the approval or commercial use of such products, or may not be sufficiently robust to drive widespread adoption or use;
adverse regulatory or other governmental statements, findings or reports regarding our products, specifically, our EVAR or EVAS technology and products may adversely affect the regulatory status and market for our products generally; and
negative publicity about, or actual or perceived problems with our products or with EVAR or EVAS devices and technologies generally, could discourage physician and hospital adoption or use of our products.
If we are unable to educate physicians and hospitals about the advantages of our products, do not achieve significantly greater market acceptance of our products, do not obtain or maintain required regulatory approvals for our products, are subjected to adverse regulatory actions, do not regain momentum in our sales activities, or fail to significantly grow our market share, we will not be able to grow our revenue and our business and financial condition will be adversely affected.
Furthermore, sales of our products may be adversely impacted by negative perceptions regarding our financial stability relative to that of our competitors and our ability to sustain our business operations on a long-term basis. While we recently consummated an equity financing and restructuring of our unsecured convertible indebtedness and secured term loan indebtedness in April 2019, which improved our balance sheet and near-term liquidity, negative perceptions of our stability may continue to affect our business. In addition, we will need to raise substantial additional capital in the future. If we are unable to access substantial additional capital or restructure our indebtedness in the future as needed and in a timely manner and upon terms reasonably favorable to us, negative perceptions as to our financial stability and prospects may become more pronounced. Further, our technical, human and other resources and capabilities, as well as our revenues and market share, are considerably smaller than those of our principal competitors. Negative perceptions of our overall financial stability, and resources and market share limitations, may cause our customers, suppliers and strategic partners, as well as independent distributors and third party payors, to question our ability to continue to sell our products, provide customer service, support our commercial organization and fulfill our strategic objectives. These concerns may arise from a number of factors, including our recent and projected financial results, our recent and projected cash positions, recent changes in and volatility of our stock price, perceptions about the dilutive impact of our financing and restructuring transactions, our current level of indebtedness and debt service costs, the competitive environment in our industry, and uncertainties regarding the regulatory environment for our products. Any such concerns, whether actual or perceived, could cause customers to delay the purchase of our products or purchase our competitors’ products.
If we fail to develop and retain our direct sales force, our business could suffer.
We have a direct sales force in the United States and in certain European countries. As we seek to increase our commercialization efforts with respect to existing products, and expand our commercialization efforts for new products, we will need to retain and develop our direct sales personnel to build upon their experience with our products and their relationships with customers. There is significant competition for sales personnel with experience in medical device sales, and the departure of high-performing sales personnel, or of leadership personnel within our sales organization, can lead to a significant loss of revenue, which could cause us to achieve revenue below our projections. If we are unable to attract, motivate and develop qualified sales personnel and thereby maintain and expand our commercial organization, we may not be able to maintain or increase our revenue in line with our forecasts or those of market participants. Further, we have experienced attrition within our sales organization in recent years, including with respect to key leadership positions, and if we are unable to retain and motivate the high-performing members of our sales force, we may suffer a loss of revenues that may not be recoverable in the near-term or at all.  Also, if our sales personnel are not sufficiently trained or qualified to successfully market and sell our products, our sales results and financial condition will be adversely affected.



We are in a highly competitive market segment, which is subject to rapid technological change. If our competitors are better able to develop and market products that are safer, more effective, less costly, easier to use, or otherwise more attractive than anythe products that we may develop, our business will be adversely impacted.
Our industry is highly competitive and subject to rapid technological change. Our success depends, in part, upon our ability to maintain a competitive position in the development of technologies and products for use in the treatment of AAA and other aortic disorders.AAA. We face competition from both established and development stage companies. Many of the companies developing or marketing competing products enjoy several advantages toover us, including:
greater financial and human resources for product development, sales and marketing and patent litigation;
greater name recognition;
long established relationships with physicians, customers, and third-partythird party payors;


additional lines of products, and the ability to offer rebates or bundle products to offer greater discounts or incentives;
more established sales and marketing programs, and distribution networks;
greater experience in conducting research and development, manufacturing, clinical trials, preparing regulatory submissions, and obtaining regulatory clearance or approval for products and marketing approved products; and
greater buying power and influence with suppliers.

Our competitors may develop and patent processes or products earlier than us, obtain regulatory clearance or approvals for competing products more rapidly than us, and develop more effective or less expensive products or technologies that render our technology or products obsolete or less competitive. We also face fierce competition in recruiting and retaining qualified scientific, sales, and management personnel, establishing clinical trial sites and patient enrollment in clinical trials, as well as in acquiring technologies and technology licenses complementary to our products or advantageous to our business. If our competitors are more successful than us in these matters, our business may be harmed.
If third-partythird party payors do not provide reimbursement for the use of our products, our revenuesrevenue may be negatively impacted.
Our success in marketing our products depends in large part on whether domestic and international government health administrative authorities, private health insurers and other organizations will reimburse customers for the cost of our products. Reimbursement systems in international markets vary significantly by country and by region within some countries, and reimbursement approvals must be obtained on a country-by-country basis. Further, many international markets have government managedgovernment-managed healthcare systems that control reimbursement for new devices and procedures. In most markets, there are private insurance systems as well as government-managed systems. In the United States, the healthcare industry is increasingly focused on cost containment as government and private health insurers seek to control healthcare costs by imposing lower payment rates and negotiating reduced contract rates with third-party payors. If sufficient reimbursement is not available for our current or future products, in either the United States or internationally, the demand for our products may be adversely affected or we may decide to cease commercial activities in any such region.
We are currently engaging in certain operational restructuring efforts which we may never realize the expected benefitsbe unsuccessful in executing and, even if successful, may lead to undesirable outcomes.
We are currently restructuring certain aspects of our business combination transactions.
In additionand operations to developing new productsreprioritize our sales and growingmarketing efforts, rationalize our international presence and related expenses, streamline our workforce and take other measures to increase efficiencies, facilitate access to capital to fund operations as needed, decrease our cash consumption and decrease our cost to serve, while refocusing our business internally, we have sought to grow through combinations with complementary businesses. Examples includeon strong execution of our recently completed merger with TriVascular in 2016core strategies. These restructuring plans reflect assumptions and analyses based on our merger with Nellix in 2010. Such business combination transactions involve risks, including the riskexperience and perception of historical trends, current conditions and expected future developments, as well as other factors that we may fail to realize some or all ofconsider appropriate under the anticipated benefits of the transaction. For example, the success ofcircumstances. Whether our recent business combination transactions largelyrestructuring efforts will prove successful depends on our ability to realize anticipated growth opportunities for existing products and potential new products. Our ability to realize these benefits, and the timing of this realization, depend upon a number of factors, including, but not limited to: (i) our ability to access the capital markets, when needed, on terms acceptable to us or at all, and future events, many of which we cannot control. These factorsto maintain adequate liquidity to satisfy our debt covenants and events include, without limitation, with respect to the acquiredallow us to execute our business plans, (ii) our ability to service or refinance our existing indebtedness and pay off such indebtedness as it comes due, (iii) our ability to maintain suppliers’, hospitals’, medical facilities’ and practitioners’ confidence in our products, (iv) our ability to obtain regulatory approvals for our new products and technologies,product iterations and to maintain our material product approvals, (v) our ability to efficiently reduce our operational expenditures, while retaining key employees and programs, and (vi) the resultsoverall success of clinical trials,our business. In addition, as long as these cost restructuring efforts continue, and for a substantial time afterwards, our employees may face considerable distraction and uncertainty and we may experience increased levels of employee attrition. The implementation of these restructuring efforts has occupied a substantial portion of the receipttime and attention of applicable regulatory approvals, obtainingour management and maintaining intellectual property rights and further developing an effective sales and marketing organization in global markets. Although we carefully planmay continue to impact our business, combination transactions, we may be unable to realize the expected benefits of such transactions.including revenue.


Our success depends on the growth in the number of AAA patients treated with endovascular devices.devices and the general support for EVAR and EVAS technologies in the medical community.
We estimate that over 200,000 people a year are diagnosed with AAA in the United States, and that in 2019 approximately 60,00074,000 people undergounderwent aneurysm repair, either via EVAR or open surgical repair, annually.repair. Our growth will depend upon an increasing percentage of patients with AAA being diagnosed, and an increasing percentage of those diagnosed receiving EVAR, as opposed to anundergoing open surgical procedure.repair. Initiatives to increase screening for AAA include SAAAVE, which was signed into law on February 8, 2006 in the United States. SAAAVE provides for one-time AAA screeningscreenings for men who have smoked at some time in their life,lives, and men or women who have a family history of the disease. Screening isBeginning January 1, 2007, screening has also been provided as part of the “Welcome to Medicare” physical and such coverage began on January 1, 2007.physical. Such general screening programs may never gain wide acceptance. The failure to diagnose more patients with AAA could negatively impact our revenue growth.
Furthermore, certain recent industry guidance in the EU has questioned the safety and effectiveness of EVAR and EVAS. In May 2018, the United Kingdom’s National Institute for Health and Care Excellence (“NICE”) issued draft guidance on AAA diagnosis and management that, among other things, states that patients should not be offered EVAR if open surgical repair is suitable. In November 2018, the European Society for Vascular Surgery (the “ESVS”) presented its updated guidelines on the treatment of AAA which included a strong negative recommendation regarding the use of EVAS in clinical practice outside of studies approved by research ethics committees and only with informed consent from the patients, until adequately evaluated. These recommendations and guidelines, and other recommendations and guidelines that may be released from time to time, may adversely affect the growth in the number of AAA patients that are treated with endovascular devices, and adversely affect the commercial availability and customer adoption of our EVAS products, which in turn could have a material adverse effect on our financial condition.
Our success depends on convincing physicians to use, and continue to use, our products in more endovascular AAA procedures and to assist us in development of new products.
If we are unable to continue convincingto educate physicians on the use of our products to drive use of our products and to use our products in more endovascular AAA procedures, our business could be negatively impacted. Additionally, ifFurther, we fail to maintain our working relationships with health care professionals, many of our products may not be developed and marketed in line with the needs and expectations of the professionals who use and support our products, which could cause a decline in our financial performance. The research, development, marketing, and sales of many of our new and improved products is dependent upon our maintaining working relationships with health care professionals. We rely on these professionals to provide us with considerable knowledge and experience regarding the research, development, marketing and sale of our


products. Physicians assist us as researchers, marketing and product consultants, inventors, and public speakers. If we are unable to maintain our strong relationships with thesethe professionals who use and support our products and continue to receive their advice and input, the development and marketingmany of our products could suffer,may not be developed and marketed in line with the needs and expectations of such professionals, which could have a material adverse effect on our consolidated earnings, financial condition, and/or cash flows.

Manufacturing and qualityIf we or our third party suppliers fail to comply with extensive FDA regulations relating to the manufacturing of our products or any component part, or otherwise encounter manufacturing problems, with our productsthis could harm our reputation, we may be subject to fines, injunctions and erodepenalties, and our competitive advantage, sales,ability to commercially distribute and market share.sell our products may be harmed.
The manufactureOur manufacturing facilities and the manufacturing facilities of manyany of our products isthird party component manufacturers, critical suppliers or third party sterilization facilities are required to comply with strict quality controls and highly complex and subject to strictrigorous quality requirements, including the FDA’s Quality System Regulation (“QSR”) which sets forth minimum standards for the procedures, execution and documentation of the design, testing, production, control, quality assurance, labeling, packaging, sterilization, storage and shipping of the products we sell. Medical device quality controls due in part to rigorous regulatory requirements. In addition, quality isare extremely important due to the serious and costly consequences of a product failure. Problems can arise during the process of manufacturing processour products and product components for a number of reasons, including equipment malfunction, failure to maintain or follow necessary protocols and procedures, raw material problems or human error.


The FDA and other regulatory authorities, and their respective representatives, may evaluate our compliance with the QSR and similar quality regulations in other jurisdictions outside of the United States, in a variety of ways, including through periodic announced or unannounced inspections, which could disrupt our operations and interrupt our manufacturing. If, in conducting an inspection of our manufacturing facilities or the manufacturing facilities of any of our third party component manufacturers, critical suppliers or third party sterilization facilities, investigators observe conditions or practices that are believed to violate the QSR or other applicable regulations, these problems ariseinvestigators may recommend, and the applicable regulatory authorities may take, administrative or if we otherwise failenforcement actions, including a corporate warning letter, consent decree, product seizure, injunction and/or civil or criminal prosecution, which could result in total or partial suspension of a facility’s production and/or distribution activities, product recalls, fines, civil penalties, suspension or termination of regulatory authorities’ review of product applications, heightened product liability exposure, and adverse publicity. Thus, an adverse inspection could force a shutdown of our manufacturing operations or a recall of our products. Adverse inspections could also delay or lead to meet our internal quality standards or thoserevocation of the FDA or other applicable regulatory bodies,approval of our products and could have an adverse effect on our production, sales and profitability.
We and any of our third party suppliers may also encounter other problems during manufacturing including failure to maintain or follow specific protocols and procedures, equipment malfunction, component or raw materials shortages and environmental factors, any of which include detailed record-keeping requirements,could delay or impede our reputationability to meet demand. The manufacture of our products also subjects us to risks that could be damaged, we could become subject to a safety alert or a recall, we could incur product liability and other costs, product approvals could be delayed, suspended or revoked andharm our business, including problems relating to the sterilization of our products, errors in manufacturing processes and defects in components that could otherwise be adversely affected.

negatively affect the efficacy or safety of our products or cause delays in shipment of our products. Any interruption or delay in the manufacture of the product or any of its components could impair our ability to meet the demand of our customers and cause them to cancel orders or switch to competitive products and could, therefore, have a material adverse effect on our business, financial condition and results of operations.
Our international operations involve operating risks, which could adversely impact our net sales, results of operations and financial condition.
Sales of our products outside of the United States represented approximately 32%34% of our revenue in 2017. As of December 31, 2017,2019. In select countries in Europe, Asia Pacific, Latin America and other targeted international geographies, we soldmarket and sell our products through 41a network of third party distributors located in the following countries outside of the United States: Argentina, Brazil, Chile, Columbia, Czech Republic, Israel, Japan, Mexico, Canada, Austria, Latvia, Romania, Poland, Sweden, Switzerland, Portugal, Spain, Slovakia, Italy, Hungary, Greece, Thailand, Singapore, Hong Kong, Russia, Cyprus, Ecuador, Australia, Turkey and South Korea. The sales territories authorized within these various distribution agreements cover a total of 54 countries.agents. The sale and shipment of our products across international borders, as well as the purchase of components and products from international sources, subjectssubject us to extensive United States and foreign governmental trade, import and export, and custom regulations and laws.
Pursuant to the SEC rules regarding disclosure of the use of certain minerals in our products, known as "conflict“conflict minerals,” which are mined from the Democratic Republic of the Congo and adjoining countries, we are now required to disclose the procedures we employ to determine the sourcing of such minerals, and metals produced from those minerals. The implementation ofOur adherence to these rules could adversely affect the sourcing, supply and pricing of materials used in our products.products, which could increase our expenses. In addition, there may be material costs associated with complying with the disclosure requirements, such as costs related to determining the source of certain minerals used in our products, as well as costs associated with possible changes to products, processes, or sources of supply as a consequence of such verification activities. Although we intend to disclose that we utilized certain of the four conflict minerals in our products in our conflict minerals report for the 20172019 calendar year, we have been unable in all instances to determine that our sources of these minerals have been certified as “conflict free.” We may continue to face difficulties in gathering this information in the future.



Compliance with these regulations is costly and exposes us to penalties for non-compliance. Other laws and regulations that can significantly impact us include various anti-bribery laws, including the United States Foreign Corrupt Practices Act, UK Bribery Act 2010, import/export regulations and requirements such as those imposed by the U.S. Department of Treasury’s Office of Foreign Assets Control and U.S. Department of Commerce’s Bureau of Industry and Security, and anti-boycott laws and similar laws in foreign jurisdictions. Any failure to comply with applicable legal and regulatory obligations could impact us in a variety of ways that include, but are not limited to, significant criminal, civil and administrative penalties, including imprisonment of individuals, fines and penalties, denial of export privileges, seizure of shipments, restrictions on certain business activities, and exclusion or debarment from government contracting. Also, the failure to comply with applicable legal and regulatory obligations could result in the disruption of our shipping and sales activities.activities, including as the result of the loss of one or more of our product registrations in these foreign jurisdictions. We may determine not to renew one or more of our product registrations in foreign jurisdictions at this time given the meaningful costs of renewing such registrations, including opportunity costs of allocating necessary resources to these renewals, when measured against the potential market opportunities. We and our distributors are required to expend considerable resources to comply with the laws of foreign jurisdictions in which our products are sold. These legal, regulatory and other requirements, individually and in the aggregate, may impact our decisions regarding where to obtain or maintain our product registrations, and the determination not to obtain or maintain a product registration in a certain country or territory may have a negative impact on our relationship with our distributors.
Substantially allA significant portion of our sales outside of the United States are denominated in local currencies and not in United States dollars. Measured in local currency, a substantial portion of our international sales was generated in Europe (and primarily denominated in the Euro) and in Japan. The United States dollar value of our international sales varies with currency exchange rate fluctuations. Decreases in the value of the United States dollar relative to the Euro or the British Pound Sterling, as well as other currencies, have the effect of increasing our reported revenuesrevenue even when the volume of international sales has remained constant. Increases in the value of the United States dollar relative to the Euro or the British Pound Sterling, as well as other currencies, have the opposite effect and, if significant, could have a material adverse effect on our reported revenuesrevenue and results of operations.
Public health threats such as COVID-19 could have a material adverse effect on our operations, the operations of our business partners, and the global economy as a whole.

Public health threats and other highly communicable diseases, outbreaks of which have already occurred in various parts of the world, could adversely impact our operations, as well as the operations of our customers, suppliers, distributors and other business partners.  For example, the outbreak in December 2019 of a novel coronavirus (COVID-19) has resulted in decreased economic activity in China, as well as a number of other countries, and the scope of the outbreak and its impacts is continuing to expand.  We anticipate that our business activities will be adversely affected by the COVID-19 outbreak, but it is not currently possible to understand the full extent of the direct and indirect impacts on our business, the business of our partners, or the global economy as a whole. 

The COVID-19 outbreak, or other similar outbreaks or epidemics, may have an adverse effect on the overall productivity of our workforce, and we may be required to take extraordinary measures to ensure the safety of our employees and those of our business partners. These measures could require that our employees refrain from traveling to their normal workplace for extended periods of time, which in turn could result in a decrease in our commercial activities, or result in higher costs or other inefficiencies.  In addition, our employees may be required to take time off for extended periods of time due to illness or as a result of government-imposed changes to daily routines, including school closures.  These impacts could result in delays in or the suspension of our manufacturing operations, research and product development activities, regulatory work streams, clinical development programs and other important commercial functions.  In particular, if we were required to suspend our manufacturing operations, we may encounter severe product shortages, which would adversely affect our results of operations and harm our reputation.  We are also dependent upon our suppliers for many of our product components, and the countries inoutbreak could have a material adverse impact on the operations of one or more of our suppliers, which could prevent them from timely delivering products to us.  Further, our business would be harmed if our customers seek to limit or prevent access by our sales and clinical support teams (or the sales and clinical support teams of our distribution partners) to their operating rooms, or to their facilities generally, which we sellhave already experienced in certain locations.  Finally, the outbreak has resulted in restrictions on domestic and international travel, which could have a negative impact on our products are, to some degree, subject to political, economiccustomer engagement efforts, including through the cancellation or social instability. postponement of Company-sponsored educational events, as well as third-party conferences, trade shows and similar events.  

We expect any further spread of the COVID-19 outbreak, or even the threat or perception that this could occur, could have a material adverse effect on our business, operations and financial results.



Our international operations expose us and our distributors to risks inherent in operating in foreign jurisdictions. These
The risks include:associated with international operations include the following:
major public health issues such as the outbreak of a pandemic or epidemic (such as Sudden Acute Respiratory Syndrome, Avian Influenza, H7N9 virus, the Ebola virus, or COVID-19), which could cause disruptions to our commercial operations or supply chain, or the commercial operations and supply chain of our customers, manufacturers, partners and other third-party collaborators;
difficulties in enforcing or defending intellectual property rights;
pricing pressure that wethat may experience internationally;


require us to curtail or terminate operations in certain jurisdictions;
a shortage of high-quality sales people and distributors;
changes in third-partythird party reimbursement policies that may require some of the patients who receive our products to directly absorb medical costs or that may necessitate the reduction of the selling prices of our products;
rulings, findings, reports, recommendations or guidance from governmental or industry entities that are adverse to our products or to EVAR/EVAS products and technologies generally;
the imposition of additional United States and foreign governmental controls or regulations;
political, economic and social instability;
disruptions caused by regional natural disasters, such as hurricanes, landslides, floods, earthquakes or other similar events,
changes in duties and tariffs, license obligations and other non-tariff barriers to trade;
the imposition of restrictions on the activities of foreign agents, representatives and distributors;travel within or across certain jurisdictions;
scrutiny of foreign tax authorities which could result in significant fines, penalties and additional taxes being imposed on us;
laws and business practices favoring local companies;
longer payment cycles;
difficulties in maintaining consistency with our internal guidelines;
difficulties in enforcing agreements and collecting receivables throughin certain foreign legal systems;jurisdictions;
the imposition of costly and lengthy new export licensing requirements;requirements or other trade restrictions; and
the imposition of United States or international sanctions against a country, company, person or entity with whom we do business that would restrict or prohibit continued business with the sanctioned country, company, person or entity; and
the imposition of new trade restrictions.entity.

If we experience any of these risks, it could have a material adverse impact on our financial condition and results of operations.

We depend on our officers and other skilled personnel to operate our business effectively. If we are not able to retain our current employees or recruit additional qualified personnel, our business will suffer and our future revenue and profitability will be impaired.
We are highly dependent on the skills and experience of our executive officers and key employees. In most cases, our officers and key employees may terminate their employment and work elsewhere without notice and without cause or good reason. Due to the specialized knowledge of each of our officers with respect to our products and operations, and the limited pool of people with relevant experience in the medical device field, the loss of service of one or more of these individuals could significantly affect our ability to operate and manage our business. The announcement of the loss of one or more of our key personnel could negatively affect our stock price. In particular, we believe that the skills and experience of Mr. Onopchenko, our Chief Executive Officer, are important to our success. The loss of Mr. Onopchenko’s services could significantly affect our ability to operate and manage our business and could negatively affect our stock price.
Under Mr. Onopchenko’s leadership, we streamlined and restructured certain of our operations and implemented certain management changes. These plans resulted in significant changes in the composition of the senior management team. The loss of these members of senior management, and any future attrition resulting from or arising during planned restructuring efforts (whether such attrition is expected or unexpected), could significantly impact our ability to operate and manage our business and could negatively impact our financial results. We anticipate that we may further augment our leadership team as we deem necessary or advisable. There is no assurance that our executive team will be successful in implementing our restructuring efforts and executing our long-term strategies, or will remain with us over the longer-term.



We also depend on our scientific and technical personnel for successful product development and innovation, which are critical to the success of our business. In addition, to succeed in the implementation of our business strategy, our management team must rapidly execute our sales in international countries may be harmedstrategy, obtain anticipated FDA clearances and approvals, achieve market acceptance of our resultsproducts and further develop products, while addressing our strategic objectives through the implementation and enhancement of operations would suffer.
If we fail to developeffective planning, manufacturing and retain our direct sales force, our business could suffer.operating processes.
We have experienced a directsignificant level of employee attrition in recent years, including within our sales force in the United Statesorganization.  In addition, we compete for personnel against companies with more expansive product offerings and in certain European countries. We also utilize a network of third-party distributors forgreater technical and financial resources. Successfully managing our business will require us to attract and retain talented and experienced management, sales outside of the United States. As we launch new products and increase our marketing efforts with respect to existing products,technical personnel, but there is no guaranty that we will needbe able to hire or retain and develop our direct sales personnel to build upon their experience, tenure with our products, and their relationships with customers. There is significant competition for sales personnel experienced in relevant medical device sales. such personnel.

If we are unable to provide meaningful equity incentives to our key employees, it could adversely affect our ability to retain these key employees, which in turn could affect our ability to implement our business strategies.
We are highly dependent upon the members of our management team, as well as high-performing sales representatives and other key employees. Many of these individuals have been employed by us for many years, have played integral roles in the growth of our business, and will continue to provide value to us. In our industry, it is common to attract motivate, develop, and retain qualified sales personnelexecutive talent and thereby growother employees with compensation packages that include a significant equity component. At this time, the vast majority of our sales force,outstanding equity awards, which are generally issued in the form of stock options, are significantly out-of-the-money, are unlikely to be exercised in the future absent material increases in our stock price, and as a result, provide little value to employees holding such awards. Further, for certain reasons, including the material decrease in the trading price of our common stock over the past couple of years, we have experienced significant shortages in the total number of shares of our common stock available for issuance under our Amended and Restated 2015 Stock Incentive Plan, as amended (the “2015 Plan”). We have been required to ask our stockholders to approve significant increases in the number of shares reserved for issuance under the 2015 Plan, but we do not believe that these increases will be sufficient to address the Company’s future equity compensation objectives. If our stockholders do not approve any future proposal by us to increase the share reserve under the 2015 Plan (or any successor or similar plan) as we deem necessary, we may be materially limited in our ability to offer equity incentives to our existing employees, which could meaningfully affect our ability to retain our key employees and to execute on our business strategies. Even if we do issue significant additional equity incentives, whether or not these incentives are subject to certain conditions precedent including the availability of sufficient shares for issuance under our 2015 Plan (or any successor or similar plan), there can be no assurance that we will be able to maintain or increaseattract and retain key executive talent. A loss of any of our revenues.key personnel may have a material adverse effect on our ability to execute our business strategy.
Our third-party
The actions and omissions of our third party distributors may not effectively distribute our products.subject us to revenue, compliance and other risk.
We depend in part on medical device distributors and strategic relationships for the marketing and sellingsale of our products outside of the United States and outside of certain countries in Europe. We depend on these distributors’ efforts to market our products effectively and in accordance with all applicable laws, rules and regulations, yet we are unable to control their efforts completely. For instance, if our distributors fail to provide us or applicable governmental authorities with timely quality, regulatory or other required notifications, including with respect to adverse events or other matters potentially affecting patient safety, then we could incur risk, including the risk of non-compliance with applicable FDA regulations or the regulations of the foreign jurisdiction(s) in which the distributors sell our products, and our business could suffer. In addition, we are unable to ensure that our distributors comply with all applicable laws regarding the sale of our products.products, including marketing and promotion of our products in accordance with applicable laws and regulations. If our distributors fail to effectively market and sell our products, andor to do so in full compliance with applicable laws, our operating results and business may suffer.
If clinical trials of our current or future products do not produce the results necessary to support regulatory clearance or approval in the United States or elsewhere, we will be unable to commercialize these products.
We are currently conducting clinical trials. We will likely need to conduct additional clinical trials in the future to support new product approvals, for the approval for new indications for the use of our products, or to support the use of existing products. Clinical testing is expensive, and typically takes many years, and carries uncertain outcomes. The initiation and completion of any of these studies may be prevented, delayed, or halted for numerous reasons, including, but not limited to, the following:
the FDA, institutional review boards or other regulatory authorities do not approve a clinical study protocol, force us to modify a previously approvedpreviously-approved protocol, or place a clinical study on hold;
patients do not enroll in, ordo not enroll at the expected rate we expect, or do not complete a clinical study;
patients or investigators do not comply with study protocols;
patients do not return for post-treatment follow-up at the expected rate;rate we expect;


patients experience serious or unexpected adverse side effects for a variety of reasons that may or may not be related to our products, such as the advanced stage of co-morbidities that may exist at the time of treatment, causing a clinical study to be put on hold or terminated.terminated;
sites participating in an ongoing clinical study may withdraw, requiring us to engage new sites;


difficulties or delays associated with establishing additional clinical sites;
third-partythird party clinical investigators decline to participate in our clinical studies, do not perform the clinical studies on the anticipated schedule, or take actions that are inconsistent with the investigator agreement, clinical study protocol, good clinical practices, and other FDA and Institutional Review Board requirements;
Failurefailure to complete data collection analysis in a timely or accurate manner;
regulatory inspections of our clinical studies require us to undertake corrective action or suspend or terminate our clinical studies;
changes in federal, state, or foreign governmental statutes, regulations or policies;
interim results are inconclusive or unfavorable as to immediate, andnear and/or long-term safety or efficacy;efficacy of our products;
the study design is inadequate to demonstrate safety and efficacy;efficacy of our products; or
the results of the study do not meet the study endpoints.

Clinical failure can occur at any stage of the testing. Our clinical trials may produce negative or inconclusive results, and we may decide, or regulators may require us, to conduct additional clinical and/or non-clinical testing in addition to those we have planned. For example, in 2017, the FDA required us to initiate a confirmatory trial, called EVAS2, of our Nellix EVAS System because it deemed the results of our EVAS1 trial insufficient to support regulatory clearance. Our failure to adequately demonstrate the efficacy and safety of any of our devices would prevent receipt of regulatory clearance or approval and, ultimately, the commercialization of that device or indication for use.
We relydepend on a significant number of third party suppliers, including single vendors tosourced suppliers that supply severalnumerous components for our product lines, and any disruption in the supply of such materials could impair our ability to manufacture our products or meet customer demand for our products in a timely and cost effective manner.
We currently rely, and expect to continue to rely, on third party suppliers to supply components of our current products and our potential future products. Our reliance on these third party suppliers, many of which are single source suppliers, exposes our operations to disruptions in supply, including disruptions caused by:
failure of our suppliers to comply with regulatory requirements;or quality requirements, or to comply with our specifications;
failure of our suppliers to timely notify us of changes to the components they supply;
contractual or other disputes with any such supplier, including with respect to compliance with product supply and/or payment terms;
change of ownership of a supplier through acquisition or sale of a business
any strike or work stoppage;
disruptions in shipping;
manufacturing limitations or other restrictions on availability or use of raw materials or components necessary for the development, testing, manufacture or sale of our products;
a natural disaster or extraordinary event caused by fire, flood, earthquakes, environmental accidents or earthquakes;health epidemics; or
a supply shortage experienced by a single source supplier.

For our business strategy to be successful, our suppliers must be able to provide us with components in sufficient quantities, in compliance with regulatory requirements and quality control standards, in accordance with agreed-upon specifications, at acceptable costs and on a timely basis.
AlthoughWe do not have long-term supply agreements with many of our suppliers and, in many cases, we take reasonable efforts to mitigate risk,make our purchases on a significant extending interruption from key suppliers could impactpurchase order basis. As a result, our ability to purchase adequate quantities of our components or products may be limited. Additionally, our suppliers may encounter problems that limit their abilities to manufacture components or products for us, including financial difficulties, change in ownership or damage to their manufacturing equipment or facilities. If we fail to obtain sufficient quantities of high quality components to meet demand on a timely basis, we could lose customer orders, our reputation may be harmed and adversely affectour business could suffer. Furthermore, negative perceptions among our suppliers regarding our overall financial stability, and our ability to sustain our business operations on a long-term basis, may cause one or more of our


suppliers to limit, suspend or terminate their relationships with us, or to claim that our financial condition causes them to demand different payment or supply terms. To the extent that we seek financial concessions from our suppliers, including with respect to payment or supply terms, these suppliers may decline to grant such concessions and may further respond by limiting or terminating their sales of product components to us.
Dependence on a significant number of sole suppliers exposes us to risks, including limited control over pricing, availability, quality and delivery schedules. Moreover, in some cases, we do not have long-standing relationships with our suppliers and the limited size of our order quantities for certain components may not be sufficient to convince suppliers to continue to make components available to us unless there is demand for such components from their other customers. As a result, there is a risk that certain components could be discontinued and no longer available to us. We have in the past been, and we may in the future be, required to make significant “last time” purchases of component inventory that is being discontinued by the manufacturer to ensure supply continuity. If any one or more of our suppliers cease to provide us with sufficient quantities of components in a timely manner or on terms acceptable to us, we would have to seek alternative sources of supply. Because of factors such as the proprietary nature of our products, our quality control standards and applicable regulatory requirements, we cannot quickly engage additional or replacement suppliers for some of our critical components. Failure of any of our suppliers to deliver products at the level our business requires would limit our ability to meet, or possibly prevent us from meeting, our sales commitments, which could harm our reputation and have a material adverse effect on our business, financial condition, and results of operations.
We may also have difficulty obtaining similar components from other suppliers that are acceptable to meet our own quality requirements, the FDA or other regulatory agencies, and the failure of our suppliers to comply with regulatory requirements could expose us to regulatory action including warning letters, product recalls, termination of distribution, product seizures or civil penalties. Such a failure by our suppliers could also require us to cease using the components, seek alternative components or technologies, and modify our products to incorporate alternative components or technologies, which could necessitate additional regulatory approvals. Any disruption of this nature, or any increased expenses associated with any such disruption, could negatively impact our ability to manufacture our products on a timely basis, in sufficient quantities, or at all, which could harm our commercialization efforts and have a material adverse impact on our operating results.
If we are unable to protect our intellectual property, our business may be negatively affected.
Our success depends significantly on our ability to protect our intellectual property and proprietary technologies. Our policy is to obtain and protect our intellectual property rights. We rely on patent protection, as well as a combination of copyright, trade secret and trademark laws, and nondisclosure, confidentiality and other contractual restrictions, to protect our proprietary technology. However, these legal means afford only limited protection and may not adequately protect our rights or permit us to gain or keep any competitive advantage. Our pending United States and foreign patent applications may not issue as patents or may not issue in a form that will be advantageous to us. Any patents we have obtained, or will obtain, may be challenged by re-examination, inter partes review, opposition or other administrative proceeding, or in litigation. Such challenges could result in a determination that the patent is invalid. In addition, competitors may be able to design alternative methods or devices that avoid infringement of our patents. To the extent our intellectual property protection offersis inadequate, protection, or is found to be invalid, we are exposed to a greater risk of direct competition. If our intellectual property does not provide adequate protection against our competitors’ products, our competitive position could be adversely affected, as could our business. Both the patent application process and the process of managing patent disputes can be time consuming and expensive. Furthermore, the laws of some foreign countries may not protect our intellectual property rights to the same extent as do the laws of the United States.States, if at all. In addition, changes in United States patent laws could prevent or limit us from filing patent applications or patent claims to protect our products and/or technologies or limit the exclusivity periods that are available to patent holders.
We also own trade secrets and confidential information that we try to protect by entering into confidentiality agreements and intellectual property assignment agreements with our employees, consultants and other parties. However, such agreements may not be honored or, if breached, we may not have sufficient remedies to protect our confidential information. Further, our competitors may independently learn our trade secrets or develop similar or superior technologies. To the extent that our employees, consultants or others apply technological information to our projects that they develop independently or others


develop, disputes may arise regarding the ownership of proprietary rights to such information, and such disputes may not be resolved in our favor. If we are unable to protect our intellectual property adequately, our business and commercial prospects will likely suffer.


The medical device industry is subject to extensive patent litigation, and if our products or processes infringe upon the intellectual property of third parties, or if we are involved in a claim that our products or processes infringe upon the intellectual property of third parties, the sale of our products may be challenged and we may have to defend costly and time-consuming legal proceedings.
Like other medical device companies, we receive notices of alleged patent infringement claims.from third parties in the ordinary course of our business. We are required to assess each of these claims and then determine appropriate disposition of each claim, which can take significant time, effort and financial resources. We are currently in the process of addressing a small number of these types of matters.
We may need to engage in expensive and prolonged litigation to assert or defend any of our intellectual property rights or to determine the scope and validity of rights claimed by other parties. With no certainty as to the outcome, litigation could be too expensive for us to pursue. Our failure to pursue or prevail in such litigation or our failure to pursue litigation could result in the loss of our rights, thatwhich could substantially hurt our business. In addition, the laws of some foreign countries do not protect
If we elect to settle an infringement claim, any such settlement could be on unfavorable financial or other terms that could affect our revenue, gross margins and other financial results.
Our failure to assert our intellectual property rights, to the same extent as the laws of the United States, if at all.
Our failure to obtain rights to intellectual property of third parties, or the potential for intellectual property litigation, could force us to do one or more of the following:
stop selling, making, or using products that use the disputed intellectual property;
obtain a license from the intellectual property owner to continue selling, making, licensing, or using products, which license may not be available on reasonable terms, or at all;
redesign our products, processes or services; or
subject us to significant liabilities to third parties.

If any of the foregoing occurs, we may be unable to manufacture and sell our products and may suffer severe financial harm. Whether or not an intellectual property claim is valid, the cost of responding to it, in terms of legal fees and expenses and the diversion of management resources, could harm our business.
We may face product liability claims that could result in costly litigation and significant liabilities.
The manufacture, marketing and sale of our commercial products, and the clinical testing of our products under development, may expose us to significant risk of product liability claims. In the past,Historically, we have had a small number of product liability claims relating to our products, none of which either individually, or in the aggregate, have resulted in a material negative impact on our business. InAs the future,result of recent field Safety Notices and related regulatory communications involving our AFX and Ovation systems, as well as commercial withdrawal of our Nellix EVAS System and related regulatory communications, we may be subject tosee an increase in product liability activity. For instance, we have experienced a recent increase in lawsuits regarding the Company’s legacy AFX with Strata product. These and any additional product liability claims some of which may have, individually or in the aggregate, a negative impact on our business.business if they are not resolved on terms favorable to the Company. Such claims could divert our management from pursuing our business strategy and may be costly to defend. Regardless of the merit or eventual outcome, product liability claims may result in:

decreased demand for our products;
injury to our reputation;
injury to our relationships with our customers;
significant litigation and other costs;
substantial monetary awards to or costly settlements with patients;
product recalls;
loss of revenue; and
the inability to commercialize new products.

products or maintain existing product approvals.
Although we have, and intend to maintain, product liability insurance, the coverage limits of our insurance policies may not be adequate to protect us from any liabilities that we may incur, and one or more claims brought against us for uninsured liabilities or in excess of our insurance coverage may have a material adverse effect on our business and results of operations. In addition, we may not be able to maintain insurance coverage at a reasonable cost or in sufficient amounts or scope to protect us against losses. Any claims against us, regardless of their merit, could severely harm our reputation and financial condition,


strain our management and other resources and adversely affect or eliminate the prospects for commercialization or sales of a product which is the subject of any such claim. Further, if one or more product liability lawsuits regarding our products survive our efforts to dismiss such lawsuits on federal pre-emption grounds (that is, that state tort claims are pre-empted by federal law regarding the PMA process), then we could face increased risk and expenses from existing lawsuits and from other potential lawsuits that may then be filed. In addition, a recall of our products, whether or not as a result of a product liability claim, could result in decreased demand for our products, injury to our reputation, significant litigation and other costs, substantial monetary awards to or costly settlements with patients, loss of revenue and our inability to commercialize new products or product candidates.






We are currently are involved in litigation, and may face future claims, that could adversely affect our business and
financial condition, divert management’s attention from our business, and subject us to significant liabilities.

On January 3, 2017 a stockholderand January 9, 2017, two stockholders purporting to represent a class of persons who purchased our securities between August 2, 2016 and November 16, 2016, filed a lawsuitlawsuits against us and certain of our officers in the United States District Court for the Central District of California.California (the “District Court”). The lawsuit allegeslawsuits allege that we made materially false and misleading statements and failed to disclose material adverse facts about our business, operational and financial performance, in violation of federal securities laws, relating to FDA PMA for our Nellix EVAS System. On January 11,May 26, 2017, a second stockholderthe plaintiffs filed a similar lawsuit against usan amended complaint extending the class period to include persons who purchased our securities between May 5, 2016 and May 18, 2017 and adding certain of our officers infactual assertions and allegations regarding the United States District Court for the Central District of California.Nellix EVAS System. The plaintiffs sought unspecified monetary damages on behalf of the alleged class, interest, and attorney’s fees and costs of litigation. The first lawsuit, Nguyen v. Endologix, Inc. et al., Case No. 2:17-cv-0017 AB (PLAx) (C.D. Cal.) (“Nguyen”), was consolidated with the second lawsuit, Ahmed v. Endologix, Inc. et al, Case No. 8:17-cv-00061 AB (PLAx) (C.D. Cal.), and lead Nguyen plaintiff filed a consolidated First Amended Complaint. On December 5, 2017, the District Court granted Endologix’sour motion to dismiss lead plaintiff’s First Amended Complaint, with leave to amend. On January 9, 2018, lead plaintiff filed a Second Amended Complaint.Complaint, and on March 12, 2018, we filed our Motion to Dismiss this Second Amended Complaint with prejudice. On September 6, 2018, the District Court dismissed the Second Amended Complaint with prejudice. On October 5, 2018, lead plaintiff filed a notice of appeal, and on March 15, 2019, lead plaintiff filed its opening brief with the appellate court. In April 2019, we filed our response brief to plaintiff’s appeal. We anticipate that the Appellate Court’s hearing on this matter will occur in the first quarter of 2020.

Four shareholdersAs of June 11, 2017, four stockholders have filed derivative lawsuits seeking unspecified monetary damages on behalf of Endologix, the nominal plaintiff, based on allegations substantially similar to those alleged by lead plaintiff in Nguyen. Those actions consist of: Sindlinger v. McDermott et al., Case No. BC662280 (Los Angeles Superior Court); Abraham v. McDermott et al., Case No. 30-2018-00968971-CU-BT-CSC (Orange County Superior Court); and Green v. McDermott et al., Case No. 8:17-cv-01155-AB (PLAx), which has been consolidated with Cocco v. McDermott et al., Case No. 8:17-cv-01183-AB (PLAx) (C.D. Cal.).

Although we believe that these lawsuits are without merit and intend to defend ourselves vigorously, we are not able to predict the ultimate outcome of these lawsuits. It is possible that they could cause us to incur substantial costs and that they could be resolved adversely to us, result in substantial damages, result in or be connected to additional claims, and divert management’s attention and resources, any of which could harm our business. While we maintain director and officer liability insurance, the amount of insurance coverage may not be sufficient to cover these claims and other claims to which we may become subject, and the continued availability of this insurance cannot be assured. Protracted litigation, including any adverse outcomes, may have an adverse impact on our business, results of operations or financial condition and could subject us to adverse publicity and require us to incur significant legal fees.

In July 2017, we learned that the SEC issued a Formal Order of Investigation to investigate, among other things, events surrounding the Nellix EVAS System and the prospect of its FDA pre-market approval. We are fully cooperating with the investigation but cannot predict its outcome or the timing of the investigation’s conclusions.

Our ability to maintain our competitive position depends on our ability to attract and retain highly qualified personnel.
Our future success depends, in part, upon our ability to retain and motivate key managerial, technical, and sales personnel, as well as our ability to continue to attract and retain additional highly qualified personnel. We compete for such personnel with other companies. We may be unsuccessful in retaining our current personnel or in hiring or retaining qualified personnel in the future. Key personnel may depart for various reasons, including as a result of difficulties with change or a desire not to remain with our company. Any unanticipated loss or interruption of services of our management team and our key personnel could significantly reduce our ability to meet our strategic objectives because it may not be possible for us to find appropriate replacement personnel should the need arise. Loss of key personnel or the inability to hire or retain qualified personnel in the future could have a material adverse effect on our ability to operate successfully.    
If our facilities or systems are damaged or destroyed, we may experience delays that could negatively impact our revenuesrevenue or have other adverse effects.
Our facilities and systems may be affected by natural or man-made disasters. We currently conduct our manufacturing, development and management activities in Santa Rosa, California and Irvine, California, near known earthquake fault zones and seasonal wildfire activity. Our finished goods inventory is split between our Santa Rosa and Irvine locations, and our distribution centerscenter in Memphis, TennesseeTilburg, the Netherlands, and Tilburg, The Netherlands.other forward stocking locations. We have taken precautions to safeguard our facilities and systems, including insurance, health and safety protocols, and off-site storage of computer data. However, our facilities and systems may be vulnerable to earthquakes, fire, storm, power loss, telecommunications failures, physical and software break-ins, software viruses and similar events which could cause substantial delays in our operations, damage or destroy our equipment or inventory, and cause us to incur additional expenses. In addition, the insurance coverage we maintain may not be adequate to cover our losses in any particular case and may not continue to be available to useus on acceptable terms, or at all.


FailureAny failure to protectmaintain the security of our information technology infrastructure against cyber-based attacks, network security breaches, service interruptions,systems, or data corruptionthe loss, theft, misuse, or unauthorized disclosure of confidential or sensitive information, could significantly disruptinterrupt our operationsbusiness processes or systems, damage our relationships with customers, suppliers or employees, and expose us to litigation or regulatory proceedings, any of which could materially adversely affect our business, and operating results.financial condition or results of operations.
We rely on information technology and telephone networks and systems including the Internet, to store, process and transmit a significant amount of confidential or sensitive electronic information, including the personal information of our employees and other individuals, information relating to our customers and suppliers, and information regarding our products and product development efforts, as well as our proprietary business, financial, operational and strategic data.   We also rely on our information technology and global communication systems to manage orand support a variety of critical business processes and activities, including manufacturing, supply chain, distribution, sales, billing and customer service, procurementservice.

The protection of our confidential or sensitive information, as well as information relating to our employees and supply chain, manufacturing,other individuals, customers and distribution.suppliers, is vitally important to us as the loss, theft, misuse or unauthorized disclosure of such information could lead to significant reputational or competitive harm, cause our suppliers to reconsider their relationships with us, result in litigation, expose us to regulatory proceedings, and subject us to significant liabilities, fines and penalties.  For example, we could be subject to regulatory or other actions pursuant to domestic and international privacy laws, including newer regulations such as the CCPA, which took effect on January 1, 2020, Action on the Protection of Personal Information in Japan and the GDPR in the EU. As a result, we believe our future success and growth depends, in part, on the ability of our business processes and systems to prevent the theft, loss or misuse of this confidential or sensitive information, and to respond quickly and effectively if security incidents do occur.

As with many businesses, we are subject to numerous data privacy and security risks, which may prevent us from maintaining the privacy of confidential or sensitive information, result in the interruption of our business processes and activities, and require us to expend significant resources attempting to protect such information and respond to incidents, any of which could materially adversely affect our business, financial condition or results of operations. As has been well documented in the media, the frequency of cyber-attacks, data incidents, computer viruses and similar incidents has increased in recent years, while the complexity and sophistication of these types of attacks and incidents have also increased. We use enterprisehave experienced and are continually at risk of being subject to these types of incidents.
Although we take the security of our information technology systems seriously, there can be no assurance that the security measures we implement will effectively prevent unauthorized persons from obtaining unauthorized access to record, process,our systems and summarize financialinformation.  Despite the implementation of reasonable security measures by us and our third party providers, our systems, sites, and information and results of operations for internal reporting purposes andmay be susceptible to comply with regulatory financial reporting, legal, and tax requirements. Ourcyber-attacks, data incidents, computer viruses or similar incidents. Therefore, despite our significant efforts, we may be unable to anticipate these incidents or implement adequate preventive measures in response. In addition, our information technology systems some of which are managed by third-parties, may be susceptiblesubject to damage, disruptions or shutdowns due to computer viruses, attacks by computer hackers,power outages, failures during the process of upgrading or replacing software, databases or components thereof, power outages, hardware failures, telecommunication failures, user errors or catastrophic events. events, any of which could have a material adverse impact on our business, financial condition or results of operations.

While we maintain insurance coverage that may, subject to policy terms and conditions, cover certain aspects of the losses associated with cyber-attacks, data incidents, computer viruses and similar incidents, such insurance coverage may be insufficient to cover all losses and would not remedy any damage to our reputation.  In addition, we may face difficulties in recovering any losses from our insurance provider, and any losses we recover may be lower than we expect.

We are not aware of any breachesmay never realize the expected benefits of our information technology infrastructure. Despite the precautionary measuresbusiness combination transactions.
In addition to developing new products and growing our business internally, we have takensought to prevent breakdownsgrow through combinations with complementary businesses. Examples include our merger with TriVascular in 2016 and our information technologymerger with Nellix in 2010. Such business combination transactions involve risks, including the risk that we may fail to realize some or all of the anticipated benefits of the transaction. For example, the success of our business combination transactions largely depends on our ability to achieve anticipated regulatory approvals and telephone systems, ifgrowth opportunities for existing products and potential new products. Our ability to realize these benefits, and the timing of this realization, depend upon a number of factors and future events, many of which we cannot control. With respect to the acquired products and technologies, these factors and events include, without limitation, the results of clinical trials, the receipt and maintenance of applicable regulatory approvals, obtaining and maintaining intellectual property rights and further developing an effective sales and marketing organization in global markets. Although we carefully plan our systems suffer severe damage, disruption or shutdown andbusiness combination transactions, we aremay be unable to effectively resolverealize the issues in a timely manner, our business and operating results may suffer.expected benefits of such transactions.


We are subject to credit risk from our accounts receivable related to our product sales, which include sales within European countries that are currently experiencing economic turmoil.
The majority of our accounts receivable arise from product sales in the United States. However, we also have significant receivable balances from customers within the European Union,EU, Japan, Brazil and Argentina.Singapore. Our accounts receivable in the United States are primarily due from public and private hospitals. Our accounts receivable outside of the United States are primarily due from public and private hospitals and to a lesser extent independent distributors. Our historical write-offs of accounts receivable have not been significant.
We monitor the financial performance and credit worthiness of our customers so that we can properly assess and respond to changes in their credit profile. Our independent distributors and sub-dealers operate in certain countries such as Greece and Italy, where economic conditions continue to present challenges to their businesses and, thus, could place in risk the amounts duethat they owe to us from them.at risk. These distributors are owed amounts from public hospitals that are funded by their governments. Adverse financial conditions in these countries may continue, thus negatively affecting the length of time that it will take us to collect associated accounts receivable or impact the likelihood of ultimate collection.
Consolidation in the health carehealthcare industry could have an adverse effect on our revenuesrevenue and results of operations.
The health carehealthcare industry has been consolidating, and organizations such as GPOs,group purchasing organizations, independent delivery networks, and large single accounts continue to consolidate purchasing decisions for many of our health carehealthcare provider customers. As a result, transactions with customers are larger, more complex, and tend to involve more long-term contracts. The purchasing power of these larger customers has increased, and may continue to increase, causing downward pressure on product pricing. If we are not one of the providers selected by one of these organizations, we may be precluded from making sales to its members or participants. Even if we are one of the selected providers, we may be at a disadvantage relative to other selected providers that are able to offer volume discounts based on purchases of a broader range of medical equipment and supplies. Further, we may be required to commit to pricing that has a material adverse effect on our revenuesrevenue and profit margins, business, financial condition and results of operations. We expect that market demand, governmental regulation, third-partythird party reimbursement policies and societal pressures will continue to change the worldwide health carehealthcare industry, resulting in further business consolidations and alliances, which may exert further downward pressure on the prices of our products and could adversely impact our business, financial condition and results of operations.
If any future acquisitions or business development efforts are unsuccessful, our business may be harmed.
As part of our business strategy to be an innovative leader in the treatment of aortic disorders, we may need to acquire other companies, technologies, and product lines in the future. Acquisitions involve numerous risks, including the following:
the possibility that we will pay more than the value we derive from the acquisition, which could result in future non-cash impairment charges;
difficulties in integration of the operations, technologies, and products of the acquired companies, which may require significant attention of our management that otherwise would be available for the ongoing development of our business;
the assumption of certain known and unknown liabilities of the acquired companies; and
difficulties in retaining key relationships with employees, customers, partners, and suppliers of the acquired company.



In addition, we may invest in new technologies that may not succeed in the marketplace. If they are not successful, we may be unable to recover our initial investment, which could include the cost of acquiring the license, funding development efforts, acquiring products, or purchasing inventory. Any of these would negatively impact our future growth and cash reserves.
Risks Related to Our Financial Condition
We have a history of operating losses and may be required to obtain additional funds to pursue our business strategy.
We have a history of operating losses and maywill need to seek additional capital in the future. We believe that our existing liquidity will be sufficient to meet our anticipated cash needs for at least the next 12 to 24 months. However,In the future we maywill need to obtain additional financing to pursue our business strategy, to discharge existing indebtedness as it comes due, to respond to new competitive pressures or to act on opportunities to acquire or invest in complementary businesses, products or technologies. Our cash requirements in the future may be significantly different from our current estimates and depend on many factors, including:
the results of our commercialization efforts for our existing and future products;
the revenuesrevenue generated by sales of our existing and future products;
the need for additional capital to fund existing and future development programs;
the need to adapt to changing technologies and technical requirements, and the costs related thereto;
the costs involved in obtaining and enforcing patents and other intellectual property;
the costs of defending or responding to any litigation or investigations initiated by third parties, regardingincluding intellectual property;property and securities litigation;
the establishment of high volumehigh-volume manufacturing and increased sales and marketing capabilities; and
whether we are successful if we enter into collaborative relationships with other parties.    
In addition, we are required to make periodic interest payments to the holders of our senior convertible notes and our senior secured lender under our term loan, and to make periodic amortization payments of principalprincipal. Further, under our term loan, we are required to pay certain termination and related fees upon conversion or maturity.termination of such loan. We may also be required to purchase our senior convertible notes from the holders thereof upon the occurrence of a fundamental change involving our company.company, or to refinance our senior convertible notes prior to their maturity dates. To finance the foregoing, we may seek funds through borrowings or through additional rounds of financing, including private or public equity or debt offerings and collaborative arrangements with corporate partners. We may be unable to raise funds on favorable terms, or at all.


The sale of additional equity or convertible debt securities, or the conversion of a portion of our outstanding indebtedness into common stock as provided in our agreements with our convertible note holders and with our senior secured lenders, could result in additional dilution to our stockholders. If we borrow additional funds or issue debt securities, these securities could have rights superior to holders of our common stock and could contain covenants that will restrict our operations. We might have to obtain funds through arrangements with collaborative partners or others that may require us to relinquish rights to our technologies, product candidates, or products that we otherwise would not relinquish. If we do not obtain additional resources, our ability to capitalize on business opportunities will be limited, and the growth of our business will be harmed.

Changes in the credit environment and covenant restrictions under our financing arrangements may adversely affect our business and financial condition.
Future volatility in the global financial markets could increase borrowing costs or affect our ability to access the capital markets. Future worsening economic conditions may also adversely affect the business of our customers, including their ability to pay for our products. This could result in a decrease in the demand for our products, longer sales cycles, slower adoption of new technologies, and increased price competition.
Further, our ability to enter into or maintain existing financing arrangements on acceptable terms, including our amended and restated facility agreement and credit agreement (“Amended Credit Agreement”), each dated August 9, 2018, with affiliates of Deerfield Management Company, L.P. (collectively, “Deerfield”), (each as amended to date, collectively the “Deerfield Agreements”), in respect of our $160.5 million term loan facility and $50.0 million revolving loan facility, respectively, could be adversely affected if there is a material decline in the demand for our products or the prices that we can command for our products, our customers become insolvent or decide to reduce or discontinue their purchase of our products, we encounter significant regulatory, quality, manufacturing or compliance issues, or there is any other material adverse event whichoccurs that impacts our business.
The Deerfield Agreements contain a number of restrictive and negative covenants, including, but not limited to, the incurrence additional indebtedness, maintenance of our listing on Nasdaq, compliance with certain financial covenants, and numerous others. Any deterioration in our revenue, key financial ratios, or non-compliance with certain financial, reporting, regulatory, operational or other covenants or terms in existing or future loan or credit agreements, including the Deerfield Agreements, may result in an event of default under such agreements, which also could also adversely affect our business and financial condition.
We have limited resourcesThe occurrence of an event of default under our Deerfield Agreements could result in an increase to investthe applicable interest rate, an acceleration of all obligations, an inability to access the revolving loan facility under the Amended Credit Agreement, a requirement to repay all obligations in researchfull and development anda right by Deerfield to grow our business and may needexercise all remedies available to raise additional funds in the future for these activities.
We believe that our growth will depend, in significant part, on our ability to develop new technologies for the treatment of AAA and other aortic disorders, and technology complementary to our current products. Our existing resources may not allow


us to conduct all of the research and development activities that we believe would be beneficial for our future growth. As a result, we may need to seek funds in the future to finance these activities.them. If we are unable to raise funds on favorable terms, or at all,pay those amounts, Deerfield could proceed against the collateral granted to it pursuant to the Deerfield Agreements and we may not be ablein turn lose access to increaseany sources of borrowing availability we may have. Any declaration of an event of default by Deerfield could also trigger an event of default under our researchoutstanding convertible senior notes requiring the repayment of principal and development activities and the growth of our business may be negatively impacted.
The accounting method for convertible debt securities that may be settled in cash, such as our senior convertible notes, is the subject of recent changes that could have a material effect on our reported financial results.
In May 2008, the Financial Accounting Standards Board ("FASB"), issued FASB Staff Position No. APB 14-1, Accounting for Convertible Debt Instruments That May Be Settled in Cash Upon Conversion (Including Partial Cash Settlement), which has subsequently been codified as Accounting Standards Codification 470-20, Debt with Conversion and Other Options, which we refer to as ASC 470-20. Under ASC 470-20, an entity must separately account for the liability and equity components of the convertible debt instruments (such as our senior convertible notes) that may be settled entirely or partially in cash upon conversion in a manner that reflects the issuer’s economic interest cost. The effect of ASC 470-20 on the accounting for our senior convertible notes is that the equity component is required to be included in the additional paid-in capital section of stockholders’ equity on our consolidated balance sheets and the value of the equity component would be treated as original issue discount for purposes of accounting for the debt component ofoutstanding under such notes. As a result, we will be required to record a greater amount of non-cash interest expense in current periods presented as a result of the accretion of the discounted carrying value of our senior convertible notes to their face amount over the term of such notes. We will report lower net income in our financial results because ASC 470-20 will require interest to include both the current period’s accretion of the debt discount and the instrument’s coupon interest, which could adversely affect our reported or future financial results and the market price of our common stock.
In addition, under certain circumstances, convertible debt instruments (such as the notes) that may be settled entirely or partly in cash are currently accounted for utilizing the treasury stock method, the effect of which is that the shares issuable upon conversion of the notes are not included in the calculation of diluted earnings per share except to the extent that the conversion value of the notes exceeds their principal amount. Under the treasury stock method, for diluted earnings per share purposes, the transaction is accounted for asFurther, if the number of shares of common stock that would be necessary to settle such excess, if we elected to settle such excess in shares, are issued. We cannot be sure that the accounting standards in the future will continue to permit the use of the treasury stock method. If we are unable to userepay our indebtedness and Deerfield institutes foreclosure proceedings against our assets, we could be forced into bankruptcy or liquidation and equity holders may lose the treasury stock methodentire value of their investment. In any such bankruptcy or liquidation scenario, the value that we receive for our assets could be significantly lower than the values reflected in accounting for the shares issuable upon conversion of the notes, then our diluted earnings per share would be adversely affected.financial statements.
Servicing our debt requires a significant amount of cash, and we may not have sufficient cash flow from our business to pay our debt.
Our ability to make scheduled payments of the principal of, to pay interest on, to pay any cash due upon conversionamortization of or to refinance our indebtedness, including the senior convertible notes, depends on our future performance, which is subject to economic, financial, competitive and other factors beyond our control. Our business may not continue to generate cash flow from operations in the future sufficient to service our debt and make necessary capital expenditures. If we are unable to generate such cash flow, we may be required to adopt one or more alternatives, such as selling assets, restructuring debt or obtaining additional equity capital on terms that may be onerous or highly dilutive. Our ability to refinance our indebtedness will depend on the capital markets and our financial condition at such time.
In April 2019, we consummated a restructuring of our indebtedness. Pursuant to an exchange agreement with two existing investors, we exchanged (the “2019 Exchange”) approximately $73.4 million of the $84.5 million principal amount of our outstanding 3.25% Convertible Senior Notes due 2020 (the “3.25% Notes”) for $25.0 million of principal amount of new 5.00% Mandatory Convertible Senior Notes due 2024 (the “5.00% Mandatory Notes”) and approximately $42.0 million of principal amount of the 5.00% Voluntary Convertible Senior Notes due 2024 (the “5.00% Voluntary Notes”, and together with the 5.00% Mandatory Notes, the “5.00% Notes”). The 5.00% Notes are convertible into common stock of the Company, on either a mandatory or voluntary basis, subject to satisfaction of certain conditions precedent (including satisfaction of certain stock price thresholds and compliance with aggregate ownership limitations). Simultaneously with the consummation of the Exchange, the Deerfield Agreements were amended to provide for, among other things, (i) the reduction of our global excess liquidity covenant from $22.5 million to $17.5 million and the reduction of the minimum net revenue financial covenants; and


(ii) reduction of our first term loan repayment amount to Deerfield, due April 2021, from $40 million to $20 million (and accompanying $10 million increase in each of our respective term loan repayments to Deerfield due in April 2022 and April 2023). The Company does not anticipate that the large majority of the mandatory and voluntary conversions of the 5.00% Notes into shares of our common stock will occur; thus, we may be required to pay these debt obligations in cash as they become due, unless we can refinance or exchange such notes on terms acceptable to the holders thereof.
In February 2020, pursuant to an exchange agreement with three existing investors, we exchanged (the “2020 Exchange”) approximately $11.0 million of the remaining $11.1 million principal amount of our 3.25% Notes plus accrued and unpaid interest for $11.1 million of principal amount of new 5.00% Voluntary Convertible Senior Notes due 2024 (the “2020 Exchange Notes”). The 2020 Exchange Notes are convertible into common stock of the Company, on a voluntary basis, subject to satisfaction of certain conditions precedent (including satisfaction of certain stock price thresholds and compliance with aggregate ownership limitations).
Further, approximately $0.2 million of the 3.25% Convertible Senior Notes remain outstanding after the 2019 Exchange and 2020 Exchange and will be subject to repayment upon maturity in November 2020 unless earlier exchanged or refinanced. We may not be ablehave sufficient cash to engage in any of these activities or engage in these activities on desirable terms,satisfy our repayment obligations as they become due, which could result in a default on our debt obligations.
Concurrently with the 2020 Exchange, we further amended the Deerfield Agreements in order to, among other things, extend the first amortization payment date from April 2021 to July 2021 and to establish a series of milestone events, the achievement of which would require Deerfield to convert up to approximately $70.7 million into shares of our Series DF-1 Preferred Stock, subject to satisfaction of certain other conditions precedent (including satisfaction of certain stock price thresholds). In total, more than $100 million of the aggregate $160.5 million outstanding principal amount (in addition to the preexisting right of Deerfield to obtain up to 1.43 million shares of common stock upon the conversion of a portion of the outstanding indebtedness under the term loan) is potentially convertible into shares of our common stock or Series DF-1 Preferred Stock. In addition, in the event we achieve net sales of our Alto product of at least $1.0 million by June 30, 2020 and provided that we report net revenue of at least $142.5 million for the year ended December 31, 2020 and complies with the global excess liquidity requirement, the maturity date shall be extended from April 2, 2023 to December 22, 2023 and the second amortization date shall be extended from April 2, 2022 to April 2, 2023. Further, the amendment provides that the interest payment date due April 1, 2020 will be payable in paid-in-kind interest by increasing the principal amount of the loans by an amount equal to the interest that has accrued.
We have limited resources to invest in research and development and to grow our business and may need to raise additional funds in the future for these activities.
We believe that our growth will depend, in significant part, on our ability to develop new technologies for the treatment of AAA and technology complementary to our current products. Our existing resources may not allow us to conduct all of the research and development activities that we believe would be beneficial for our future growth. As a result, we may need to seek funds in the future to finance these activities. If we are unable to raise funds on favorable terms, or at all, we may not be able to increase our research and development activities and the growth of our business may be negatively impacted.
The expense and potential unavailability of insurance coverage for our company may have an adverse effect on our financial position and results of operations.
While we currently have insurance for our business, property, directors and officers, and product liability, such insurance coverage is increasingly costly and the scope of coverage is narrower, and we may be required to assume more risk in the future. If we are subject to claims or suffer a loss or damage in excess of our insurance coverage, we will be required to cover the amounts outside of or in excess of our insurance limits. If we are subject to claims or suffer a loss or damage that is outside of our insurance coverage, we may incur significant costs associated with loss or damage that could have an adverse effect on our financial position and results of operations. Furthermore, any claims made on our insurance policies may impact our ability to obtain or maintain insurance coverage at reasonable costs or at all. We do not have the financial resources to self-insure, and it is unlikely that we will have these financial resources in the foreseeable future. Our product liability insurance covers our products and business operations, but we may need to increase and expand this coverage commensurate with our expanding business.


Risks Related to Regulation of Our Industry
Healthcare policy changes, including recent federal legislation to reform the United States healthcare system, may have a material adverse effect on us.
In response to perceived increases in health carehealthcare costs in recent years, there have been and continue to be proposals by the federal government, state governments, regulators and third-partythird party payors to control these costs and, more generally, to reform the United States healthcare system. Certain of these proposals could limit the prices we are able to charge for our products or the amounts of reimbursement available for our products and could limit the acceptance and availability of our products. Moreover, as discussed below, recent federal legislation would impose significant new taxes on medical device makers such as us. The adoption of some or all of these proposals, including the recent federal legislation, could have a material adverse effect on our financial position and results of operations.
On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Affordability Reconciliation Act (the “PPACA”). The total cost imposed on the medical device industry by the PPACA may be up to approximately $20 billion over ten years. The PPACA includes, among other things, a deductible 2.3% excise tax on any entity that manufactures or imports medical devices offered for sale in the United States, with limited exceptions, effective January 1, 2013. This excise tax will result in a significant increase in the tax burden on our industry, and if any efforts we undertake to offset the excise tax are unsuccessful, the increased tax burden could have an adverse effect on our results of operations and cash flows. Other elementsElements of the PPACA includinginclude comparative effectiveness research, an independent payment advisory board, payment system reforms including shared savings pilots and other provisions, which may significantly affect the payment for, and the availability of, healthcare services and result in fundamental changes to federal healthcare reimbursement programs, any of which may materially affect numerous aspects of our business.
On December 18, 2015, President Obama signed the Consolidated Appropriations Act of 2016, which imposed a two-year moratorium on the 2.3% excise tax beginning on January 1, 2016 and ending on December 31, 2017. On January 22, 2018, the continuing resolution extended this moratorium for an additional two years, through the 2019 calendar year. The continuing resolution provides that this additional delay applies to sales made after December 31, 2017. Therefore, as a result of both moratoriums, the medical devices tax will not apply to any sales made between January 1, 2016 and December 31, 2019. Upon the end of this period we believe the PPACA could continue to have an adverse effect on our results of operations and cash flows.
Our future success depends on our ability to develop, receive regulatory clearance or approval for, and introduce new products or product enhancements that will be accepted by the market in a timely manner.
It is important to our business that we continue to build a more completeextensive product offering for treatment of AAA and other aortic disorders. As such, ourAAA. Our success will depend in part on our ability to develop and introduce new products. However, we may not be able to successfully develop and obtain regulatory clearance or approval for product enhancements, or new products, or these products may not be accepted by physicians or the payors who financially support many of the procedures performed with our products. Recent industry guidance from NICE and the ESVS raises concerns regarding the regulatory and commercial prospects for EVAR and EVAS products in Europe. In the United States, the FDA’s requirement that we complete the EVAS2 confirmatory trial has delayed the commercial introduction of the Nellix EVAS System in the United States. Further, recent public communications from FDA regarding our AFX endografts have suggested that there may be higher than expected risk of Type III endoleaks occurring with our AFX with Duraply and AFX2 endografts. Any public FDA communications and any similar communications from other relevant regulatory authorities that call into question the safety and efficacy profiles of our products could materially and adversely affect our business. In the future we may face additional, similar regulatory constraints.
TheIn addition to conforming with an evolving regulatory landscape, the success of any new product offering or enhancement to an existing product will depend on several factors, including our ability to:
properly identify and anticipate physiciansphysicians’ and patientpatients’ needs;
develop and introduce new products or product enhancements in a timely manner;
avoid infringing upon the intellectual property rights of third parties;
demonstrate, if required, the safety and efficacy of new products with data from preclinicalpre-clinical studies and clinical trials;
obtain the necessary regulatory clearances or approvals for new products or product enhancements;
be fully FDA-compliant with marketing of new devices or modified products;
provide adequate training to potential users of our products;
receive adequate coverage and reimbursement for procedures performed with our products; and
develop an effective and FDA-compliant,regulatory-compliant, dedicated marketing and distribution network.

If we do not develop new products or product enhancements in time to meet market demand or if there is insufficient demand for these products or enhancements, our results of operations will suffer.


Our business is subject to extensive governmental regulation that could makemakes it more expensive and time consuming for us to introduce new or improved products.
Our products must comply with complex regulatory requirements imposed by the FDA and corresponding state agencies in the United States and similar agencies in foreign jurisdictions. These requirements involve lengthy and detailed laboratory and clinical testing procedures, sampling activities, an extensive agency review process,processes, and other costly and time-consuming procedures. It often takes severala number of years to satisfy these requirements, depending on the complexity and novelty of the product. We also are subject to numerous additional licensing and regulatory requirements relating to safe working conditions,


manufacturing practices, environmental protection, fire hazard control, and disposal of hazardous or potentially hazardous substances. Some of the most important requirements we face include:
FDA Regulations (Title 21 CFR);
European UnionEU CE markMark requirements, including the new Medical Device Regulations and MEDDEV 2.7.1 Rev.4, which implement stricter requirements for clinical data to support new product approvals;
Other international regulatory approval requirements;
Medical Device Single Audit Program (“MDSAP”);
Medical Device Quality Management SystemQMS Requirements (21 CFR 820, ISO 13485:2003, EN ISO 13485:2012, ISO 13485:2016, and other similar international regulations);
Occupational Safety and Health Administration requirements; and
California Department of Health ServicesCDHS requirements.

Government regulation may impede our ability to conduct continuing clinical trials and to manufacture our existing and future products. Government regulation also could delay our marketing of new products for a considerable period of time and impose costly procedures on our activities. The FDA and other regulatory agencies may not approve any of our future products on a timely basis, if at all. Any delay in obtaining, or failure to obtain, such approvals could negatively impact our marketing of any proposed products and reduce our product revenues.revenue.
Our products remain subject to strict regulatory controls on manufacturing, marketing and use. We may be forcedhave in the past been required to modify or recall our productproducts after release, either voluntarily or in response to regulatory action or unanticipated difficulties encountered in general use.use, and we may be required to do so again the future. Any such action could have a material effect on the reputation of our products and on our business and financial position.
Further, regulations may change, and any additional regulation could limit, delay or restrict our ability to use any ofmarket our technologies,products, which could harm our business. We could also be subject to new international, federal, state or local regulations that could affect our research and development programs and harm our business in unforeseen ways. For example, in the EU, the new MDR was finalized in 2017 and will become effective in May 2020. MDR 2017 will change several aspects of the existing regulatory framework, such as clinical data requirements, and introduce new ones, such as Unique Device Identification. We, and the notified bodies who will oversee compliance with MDR 2017, face uncertainties as MDR 2017 is rolled out and enforced, which, in addition to the increased costs of compliance, creates risks in several areas including the CE marking process and data transparency. If this happens,and as regulations are changed or new regulations are added, we may have to incur significant costs to comply with such laws and regulations, which will harm our results of operations.
The potential off-label promotion and subsequent off-label use of our products may harm our imagereputation in the marketplace and result in government investigations and/or penalties.
The products we currently market have been cleared or approved by the FDA and international regulatory authorities for specific indications for use, including in specific AAA anatomies. Physicians have the discretion, however, to use our products outside of those cleared/approved indications for use, a practice known as “off-label” use. Off-label use of our and our competitors’ products by physicians is common in the AAA field. We receive substantial revenue from the sale of our products for use by physicians in cases outside of the cleared/approved indications for use. Though physicians in most countries, including the United States, have the discretion to engage in off-label use of our products, ifFDA laws and regulations prohibit us from promoting our products for an unapproved use.


Our internal policies and procedures are designed to achieve compliance with these and other applicable requirements, but FDA or other regulatory authorities could determine that our sales, marketing and educational activities, when evaluated in connection with the use of our products in off-label procedures, have constituted or may constitute the unlawful promotion of our products for unapproved use. We specifically have a compliance mechanism in place to investigate and address instances of noncompliance with company policies and procedures, with confirmed violations resulting in disciplinary action up to and including termination. If we are deemed by the FDA or other regulatory bodies to have engaged in the promotion of our products for any such off-label use, we could be subject to prohibitions on the sale or marketing of our products in the United States or other jurisdictions, face significant fines and penalties, and be required to enter into onerous corporate integrity agreements, consent decrees or similar court or agency-imposed agreements. The imposition of any such fines, penalties or sanctions could affect our reputation and position within the industry and could materially and adversely affect our business, financial condition and results of operations and prospects, which in turn could cause our stock price to decline.operations. Additionally, the use of our products for indications other than those cleared/approved by the FDA or international regulatory authorities may result in suboptimal outcomes that could harm our reputation in the marketplace among physicians and patients. patients and lead to product liability claims.
Physicians may misuse our products or use improper techniques if they are not adequately trained, potentially leading to injury and an increased risk of product liability and similar claims. If our products are misused or used with improper technique, we may become subject to costly litigation by our customers or their patients. Product liability claims could divert management’s attention from our core business, be expensive to defend, and result in sizable damage awards against us that may not be covered by insurance.



Our products may in the future be subject from time to time to product recalls or voluntary market withdrawals that could harm our reputation, business and financial results.results.
The FDA and similar foreign governmental authorities have the authority to require the recall of commercialized products in the event of material deficiencies or defects in design or manufacture that could affect patient safety. In the case of the FDA, the authority to require a recall must be based on an FDA finding that there is a reasonable probability that the device would cause serious adverse health consequences or death. Manufacturers may, under their own initiative, recall a product if any material deficiency in a device is found or suspected. A government-mandated recall or voluntary recall by us or one of our distributors could occur as a result of component failures, manufacturing errors, design or labeling defects or other issues. Recalls,We have engaged in product recalls from time to time, including a voluntary Class II recall of our AFX products with Strata graft material and certain larger sizes of our AFX2 product in late 2016 and early 2017, which recall (i) resulted in expenditure of resources and diversion of management time and attention and (ii) was negatively received in the marketplace. In addition, in October 2018, FDA classified a July 2018 Safety Notice that we issued to users of the AFX Endovascular AAA System as a Class I recall. We may elect to engage, or be required by FDA to engage, in additional recalls or other corrective or safety actions in the future. Any future recalls, which include corrections as well as removals, of any of our products would divert managerial and financial resources and could have an adverse effect on our financial condition, harm our reputation with customers, and reduce our ability to achieve expected revenues.revenue.
We are required to comply with medical device reporting (“MDR”)MDR requirements and must report certain malfunctions, deaths, and serious injuries associated with our products to regulatory agencies, which can result in voluntary corrective actions or agency enforcement actions.
Under the FDA MDR regulations, medical device manufacturers are required to submit information to the FDA when they receive a report or become aware that a device has or may have caused or contributed to a death or serious injury or has or may have a malfunction that would likely cause or contribute to death or serious injury if the malfunction were to recur. All manufacturers placing medical devices on the market in the European Economic Area are legally bound to report any serious or potentially serious incidents involving devices they produce or sell to the regulatory agency or (“Competent Authority,Authority”), in whose jurisdiction the incident occurred. Material noncompliance with these reporting requirements may subject us to adverse regulatory action, including but not limited to receipt of a Warning Letter from FDA and enforcement action by the relevant Competent Authority.
Malfunction of our products could result in future voluntary corrective actions, such asincluding recalls, including corrections, or customer notifications, or agency action, such as inspection or enforcement actions. If malfunctions do occur, we may be unable to correct the malfunctions adequately or prevent further malfunctions, in which case we may need to cease manufacture and distribution of the affected products, initiate voluntary recalls, and redesign the products. Regulatory authorities may also take actions against us, such as ordering recalls, imposing fines, or seizing the affected products. Any corrective action, whether voluntary or involuntary, will require the dedication of our time and capital, distract management from operating our business, and may harm our reputation and financial results.


We may beare subject to federal, state and foreign healthcare fraud and abuse, transparency and other laws and regulations governing financial dealings with customers, physicians and payors, and a finding of failure to comply with such laws and regulations could have a material adverse effect on our business.
Our operations may be directly or indirectly affected by various broad federal, state or foreign healthcare fraud and abuse laws. In particular, theThe federal Anti-Kickback Statute prohibits any person from knowingly and willfully offering, paying, soliciting or receiving remuneration, directly or indirectly, in return for or to induce the referring, ordering, leasing, purchasing or arranging for or recommending the ordering, purchasing or leasing of an item or service, for which payment may be made under federal healthcare programs, such as the Medicare and Medicaid programs. We are also subject to the federal HIPAA statute,Health Insurance Portability and Accountability Act (“HIPAA”), which created federal criminal laws that prohibit executing a scheme to defraud any health carehealthcare benefit program or making false statements relating to health carehealthcare matters, and federal “sunshine” laws that require transparency regarding financial arrangements with health carehealthcare providers, such as the reporting and disclosure requirements imposed by PPACA on drug manufacturers regarding any “transfer of value” made or distributed to prescribers and other health carehealthcare providers.
In addition, the federal False Claims Act prohibits persons from knowingly filing, or causing to be filed, a false claim to, or the knowing use of false statements to obtain payment from the federal government. Suits filed under the False Claims Act, known as “qui tam” actions, can be brought by any individual on behalf of the government and such individuals, commonly known as “whistleblowers,” may share in any amounts paid by the entity to the government in fines or settlement. When an entity is determined to have violated the False Claims Act, it may be required to pay up to three times the actual damages sustained by the government, plus civil penalties for each separate false claim. Various states have also enacted laws modeled after the federal False Claims Act.
Many states have also adopted laws similar to each of the above federal laws, such as anti-kickback and false claims laws, which may apply to items or services reimbursed by any third-partythird party payor, including commercial insurers as well as laws that restrict our marketing activities with physicians, and require us to report consulting and other payments to physicians. Some states mandate implementation of commercial compliance programs to ensure compliance with these laws. We also are subject to foreign fraud and abuse laws, which vary by country. For instance, in the European Union,EU, legislation on inducements offered to physicians and other healthcare workers or hospitals differ from country to country. Breach of the laws relating to such inducements may expose us to the imposition of criminal sanctions.


The risk of our being found in violation of these laws is increased by the fact that many of them have not been fully interpreted by the regulatory authorities or the courts, and their provisions are open to a variety of interpretations. Moreover, recent health carehealthcare reform legislation has strengthened these laws. Further, we expect there will continue tomay be additional federal and state laws and/or regulations, proposed and implemented, that could impact our operations and business. The extent to which future legislation or regulations, if any, relating to health carehealthcare fraud abuse laws and/or enforcement, may be enacted or what effect such legislation or regulation would have on our business remains uncertain. If our operations are found to be in violation of any of the laws described above or any other governmental regulations that apply to us now or in the future, we may be subject to penalties, including civil and criminal penalties, damages, fines, exclusion from governmental health carehealthcare programs, and the curtailment or restructuring of our operations, any of which could adversely affect our ability to operate our business and our financial results.


We may be subject to health information privacy and security laws and regulations that protect personal health information and other types of personal information, and a finding of failure to comply with such laws and regulations could have a material adverse effect on our business.business
The HIPAA statute, and its implementing regulations, safeguard the privacy and security of individually-identifiable health information. Certain of our operations may be subject to these requirements. Penalties for noncompliance with these rules include both criminal and civil penalties. In addition, the Health Information Technology for Economic and Clinical Health Act (“HITECH Act”) expanded federal health information privacy and security protections. Among other things, HITECH makes certain of HIPAA’s privacy and security standards directly applicable to “business associates”-independentassociates,” such as independent contractors or agents of covered entities that receive or obtain protected health information in connection with providing a service on behalf of a covered entity. HITECH also set forth new notification requirements for health data security breaches, increased the civil and criminal penalties that may be imposed against covered entities, business associates and possibly other persons, and gave state attorneys general new authority to enforce HIPAA and seek attorney’s fees and costs associated with pursuing federal civil actions. In addition, many states have adopted data privacy and protection legislation offering similar or expanded protections to consumers and imposing security, reporting and notification requirements which are in some instances more stringent than those imposed by HIPAA or HITECH. In California, the CCPA, which took effect on January 1, 2020, imposes new requirements regarding the collection, use and sharing of the personal information of California residents and therefore may place similar ongoing compliance obligations on us. The CCPA permits California’s Attorney General to file a civil enforcement action and seek monetary penalties for violations of the CCPA. It also grants to California residents the right to sue for breaches of certain types of personal information, and courts may award statutory damages up to $750 per consumer per incident, or actual damages, whichever is greater. California’s Attorney General has proposed draft regulations for implementing the CCPA but regulations have not yet been adopted. The CCPA and its implementing regulations may change periodically, which could have an effect on our business operations if compliance becomes substantially costlier than under current requirements.
The global legislative and regulatory landscape for privacy and data protection continues to evolve, and implementation standards and enforcement practices are likely to remain uncertain for the foreseeable future. This evolution may create uncertainty in our business, result in liability or impose additional costs on us. The cost of compliance with these laws, regulations and standards is high and is likely to increase in the future. For example, the EU has adopted the GDPR, which introduces strict requirements for processing personal data. The GDPR has imposed additional compliance obligations on us, including by mandating additional documentation requirements and granting certain rights to individuals to control how we collect, use, disclose, retain and leverage information about them. The processing of sensitive personal data, such as physical health condition, may impose heightened compliance burdens under the GDPR and is a topic of active interest among foreign regulators. In addition, the GDPR provides for breach reporting requirements, more robust regulatory enforcement and fines of up to €20 million or up to 4% of the annual global revenue. While companies are afforded some flexibility in determining how to comply with the GDPR’s various requirements, it has and will continue to require significant effort and expense to ensure continuing compliance with the GDPR. Moreover, the requirements under the GDPR may change periodically or may be modified by EU national law and could have an effect on our business operations if compliance becomes substantially costlier than under current requirements.
Risks Related to Our Common Stock
We willhave certain contractual obligations pursuant to which we may be obligated to issue a significant number of additional shares of our common stock, which would result in a substantial amount of dilution to our existing stockholders.
Pursuant to the former stockholdersdebt restructuring transactions we consummated in April 2019 and February 2020:
Up to the entire $25 million of Nellix5.00% Mandatory Notes and $42.02 million of 5.00% Voluntary Notes are potentially convertible into our common stock upon satisfaction of certain conditions, including commencement of the applicable conversion period, achievement of minimum stock price thresholds, and compliance with ownership “blockers” (which are maximum ownership amounts that certain investors can hold at any one time expressed as a percentage of the Company’s total outstanding shares of common stock).

Up to the entire $11.1 million 2020 Exchange Notes are potentially convertible into our common stock upon satisfaction of certain conditions, including commencement of the applicable conversion period, achievement of minimum stock price thresholds, and compliance with ownership “blockers” (which are maximum ownership amounts that certain investors can hold at any one time expressed as a percentage of the Company’s total outstanding shares of common stock).


Approximately $100.7 million of the $160.0 million of indebtedness to Deerfield under the Deerfield Agreements are potentially convertible into shares of the Company’s common stock or Series DF-1 Preferred Stock (which is convertible into shares of common stock at any time, subject to ownership blockers), either at Deerfield’s election, or on a mandatory basis (subject to satisfaction of certain conditions precedent and compliance with ownership blockers).

As the “mandatory” and “voluntary” conversion events referenced above are subject to a number of conditions precedent, the actual dilution that could occur as a result of the remainder of these conversion features, though potentially material, is not susceptible of determination at this time.
In addition, under the terms of our satisfactionDeerfield Agreements, we have issued warrants to Deerfield to purchase up to an aggregate total of 1,522,002 shares of our common stock. In addition, Deerfield has the right to convert a certain milestone set forth inportion of the indebtedness outstanding under the Deerfield Agreements into a maximum of approximately 1.43 million shares of our common stock.
In addition, under the terms of our merger agreement with Nellix, and the other parties thereto, resulting in stock ownership dilution.
Under the terms of the merger agreement with Nellix and the other parties thereto, we agreed to issue additional shares of our common stock to the former stockholders of Nellix as contingent consideration upon our satisfaction of one or both of twocertain milestones related to the Nellix EVAS System, and described in the merger agreement, or upon a change of control of our company priorcompany. In the event the remaining regulatory-based milestone is achieved, we may be obligated to our completion of one or both milestones. On June 17, 2014, we issued anissue up to approximately 330,000 additional 2.7 million shares of our common stock to the former stockholdersstock.
These potential issuances of Nellix upon achievement of a revenue-based milestone. One additional regulatory related milestone remains, and the maximum aggregate number of shares of our common stock remaining issuable to the former Nellix stockholders upon our achievement of such regulatory milestone, or upon a change of control of our company prior to our achievement of such milestone, assuming the average per share closing price of our common stock (as determined under the terms of the Nellix merger agreement) at such time is 2.9 million shares.
Issuing additional shares of our common stock toor securities convertible into or exercisable for our common stock, would result in the former stockholders in satisfactionimmediate dilution of contingent consideration dilutes the ownership interests of holders of our common stock on the dates of such issuances. If we are unable
The price of our common stock has declined significantly and may continue to realizefluctuate in future periods.
The trading price of our common stock has declined significantly in the strategic, operationalpast 24 months. We believe our stock price has been, and financial benefitswill continue to be, subject to wide fluctuations in response to a variety of factors, including the following:
actual or anticipated from our acquisition of Nellix, our stockholders may experience dilution of their ownership interestsfluctuations in our financial and operating results from period to period;
our actual or perceived need for additional capital to fund our operations and future debt repayment obligations, and perceptions about the potential dilutive impact of common stock issued pursuant to conversion of portions of our senior convertible notes and Deerfield term loan, and future financing or restructuring transactions;
regulatory approval of our products or the products of our competitors, the loss of regulatory approvals or clearances, or the failure to obtain regulatory approvals or clearances in a timely manner or at all;
perceptions regarding the intentions of Deerfield with respect to the exercise of its warrants;
perceptions regarding our ability to comply with our financial covenants under the Deerfield Agreements;
perceptions about our financial stability generally, and relative to our competitors, including our ability to sustain our business operations, execute on our strategic plans and achieve profitability;
market acceptance of our products;
introduction of proposed products, technologies or treatment techniques by us or our competitors;
announcements of significant contracts, acquisitions or divestitures by us or our competitors;
product recalls involving our products or the products of our competitors;
perceptions regarding the effectiveness of our product quality systems;
speculative trading practices of market participants;
issuance of securities analysts’ reports or recommendations;
the failure of our operating results to meet expectations of securities analysts and investors, or to be consistent with our financial guidance;
threatened or actual litigation, government investigations or enforcement actions;
changes in healthcare laws or policies in the United States or other countries in which we conduct business; and
general political or economic conditions and other factors unrelated to our operating performance.
These and other factors might cause the market price of our common stock to fluctuate substantially and to decline even further. Fluctuations in our stock price may negatively affect the liquidity of our common stock, which could further adversely impact our stock price. If the recent negative volatility of our market capitalization is sustained, we may perform impairment


tests more frequently and it is possible that our goodwill could become impaired, which could result in a material charge and adversely affect our results of operations.
In recent years, the stock market has experienced significant price and volume fluctuations. This volatility has had a significant impact on the market price of securities issued by many companies across many industries. These changes may occur without regard to the financial condition or operating performance of the affected companies. Accordingly, the price of our common stock could fluctuate based upon factors that have little or nothing to do with our company, uponand these fluctuations could materially reduce the market price of our common stock.
Trading in our stock over the past 24 months has been limited, which may increase the volatility of the trading price of our stock.
The average daily trading volume in our common stock for the twenty four months ended December 31, 2019 was approximately 148,000 shares. If limited trading in our stock continues, it may be difficult for investors to sell their shares in the public market at any such future issuances ofgiven time at prevailing prices. Moreover, the market price for shares of our common stock without receiving any commensurate benefit.may be more volatile because of the relatively low volume of trading in our common stock. When trading volume is low, significant price movement can be caused by the trading of a relatively small number of shares. Volatility in our common stock may result in further downward pressure on the market price of our common stock. If the recent negative volatility of our market capitalization is sustained, we may perform impairment tests more frequently and it is possible that our goodwill could become impaired, which could result in a material charge and adversely affect our results of operations.
Our operating results may varyfluctuate significantly from quarter to quarter.
There has been and may continue to be meaningful variability in our operating results from quarter which may negatively impactto quarter, as well as within each quarter, especially around the time of anticipated new product launches or regulatory approvals by us or our stock price incompetitors. Our operating results, and the future.variability of these operating results, will be affected by numerous factors, including:
Our quarterly revenuesour ability to increase sales from our current products, and results of operations may fluctuate due to among others, the following reasons:
physician acceptance ofcommercialize and sell our future products;
the conduct and results of clinical trials;
the timing and expense of obtaining future regulatory approvals;
fluctuations in our expenses associated with expanding our operations;
the introduction of newproposed products, technologies or treatment techniques by us or our competitors;
the timingnumber and mix of product launch may lead to excess or obsolete inventory;
supplier, manufacturing or quality problems with our devices;


litigation expenses;
the timing of stocking orders from our distributors;products sold in each quarter;
changes in our pricing policies or in the pricing policies of our competitors or suppliers; and
changes in third-partythird party payors’ reimbursement policies.policies;

our ability to maintain and motivate our sales force;
our ability to manufacture products that meet quality and regulatory requirements;
results of clinical research and trials on our existing and future products;
the timing and expense associated with obtaining and maintaining regulatory approval of our products;
product recalls involving our products or the products of our competitors;
the timing of revenue and expense recognition associated with our product sales pursuant to applicable accounting standards.
Because of these and possibly other factors, it is likelypossible that in some future periodperiods our operating results will not meet investor expectations or those of publicsecurities analysts.

In addition, our operating expenses may exceed our projections for various reasons, including unanticipated litigation or regulatory expenses or other costs imposed as a result of third-party actions or omissions. Any such expenses in excess of forecast may exacerbate the quarterly fluctuations in our operating results. If our quarterly or annual operating results fall below the expectation of securities analysts or other market analysts.participants, or below the results expressed or implied by our financial guidance, the price of our common stock could decline substantially. Further, any quarterly or annual fluctuations in our operating results may, in turn, cause the price of our common stock to fluctuate substantially, and these price fluctuations could result in further pressure on our stock price. We believe quarterly comparisons of our financial results are not necessarily meaningful and should not be relied upon as an indication of our future performance.

Any unanticipated change in revenuesrevenue or other operating results is likely to cause our stock price to fluctuate since such changes reflect new information available to investors and analysts. New information may cause investors and analysts to revalue our business, which could cause a decline in the trading price of our stock.
The price of

We may not achieve the projections set forth in our stock may fluctuate unpredictably in responsefinancial guidance, or certain other anticipated goals and objectives that we announce publicly from time to factors unrelated totime, which could have a material adverse effect on our operating performance.
The stock market periodically experiences significant pricebusiness and volume fluctuations that are unrelated to the operating performance of particular companies. These broad market fluctuations may cause the market price of our common stock to drop. In particular, the market price of securities of medical device companies, like ours, has been very unpredictable and may vary in response to:
announcements by us or our competitors concerning technological innovations;
introductions of new products;
FDA and foreign regulatory actions;
developments or disputes relating to patents or proprietary rights;
maintain the effectiveness of our Quality System;
failure of our results of operations to meet the expectations of stock market analysts and investors;
changes in stock market analyst recommendations regarding our common stock;
the conversion of some or all of our senior convertible notes and any sales in the public market of shares of our common stock issued upon conversion of such notes;
changes in healthcare policy in the United States or other countries; and
general stock market and economic conditions and other factors unrelated to our operating performance.

These factors may materially and adversely affect the market price of our common stock.
We may not achieve our financial guidance or projected goals and objectives in the time periods that we anticipate or announce publicly, which could have an adverse effect on our business and could cause the market price of our ordinary shares to decline.

We typically provide financial guidance that is based on management’s then current expectations, which is subject to the risks and typically does not contain any significant margin of error or cushion for any specific uncertainties or for the uncertainties inherent in all financial forecasting. The failure to achieve our financial guidance, or the projections of securities analysts and investorsor other market participants, could have ana material adverse effect on our business,results of operations, and disappoint analysts and investors, andwhich could cause the market price of our common stock to drop. We also setdecline.
In addition, we regularly make public announcements relating to our expected achievement of certain goals and objectives for, and make public statements regarding, the timing of certain accomplishments and milestones regarding our business, or operating results, such as the timing of financial objectives,commercialization of new products, clinical trials, and regulatory actions.approvals. The actual timing of these events can vary dramaticallysignificantly due to a number of factors, including the risk factorsvarious risks and uncertainties described in this report.Annual Report. As a result, we may be unable to achieve our projected goals and objectives in the time periods that we anticipate or announce publicly.at all. The failure to achieve such projected goals and objectives in the time periods that we anticipate or announce publicly could have ana material adverse effect on our business, disappoint investorsfinancial condition and analysts,results of operations.
Anti-takeover provisions in our organizational documents and Delaware law may discourage or prevent a change of control, even if an acquisition would be beneficial to our stockholders, which could reduce our stock price and prevent our stockholders from replacing or removing our current management.
Our amended and restated certificate of incorporation and bylaws contain provisions that could delay or prevent a change of control of our company or changes in our board of directors that our stockholders might consider favorable. Some of these provisions:
authorize the issuance of preferred stock with powers, preferences and rights that may be senior to our common stock, which can be created and issued by the board of directors without prior stockholder approval;
provide for the adoption of a staggered board of directors whereby the board is divided into three classes each of which has a different three-year term;
provide that the number of directors shall be fixed by the board of directors;
prohibit our stockholders from filling board vacancies;
prohibit stockholders from calling special stockholder meetings; and
require advance written notice of stockholder proposals and director nominations.
We are subject to the provisions of Section 203 of the Delaware General Corporation Law, which may prohibit certain business combinations with stockholders owning 15% or more of our outstanding voting stock. These and other provisions in our amended and restated certificate of incorporation, bylaws and Delaware law could make it more difficult for stockholders or potential acquirers to obtain control of our board of directors or initiate actions that are opposed by our then-current board of directors, including a merger, tender offer or proxy contest involving our company. Any delay or prevention of a change of control transaction or changes in our board of directors could cause the market price of our common stock to decline.

Trading in our stock over the last twelve months has been limited, so investors may not be ableOur board of directors is authorized to sell as much stock as they wish at prevailing prices.
The average daily trading volume in our common stock for the twelve months ended December 31, 2017 was approximately 1,142,122 shares. If limited trading in our stock continues, it may be difficult for investors to sell their shares in the public market at any given time at prevailing prices. Moreover, the market price forissue and designate shares of our commonpreferred stock may be made more volatile becausein additional series without stockholder approval.
Our amended and restated certificate of incorporation authorizes our board of directors, without the relatively low volumeapproval of trading in our common stock. When trading volume is low,


significant price movement can be caused by the trading of a relatively small number of shares. Volatility in our common stock could cause stockholders, to incur substantial losses.
Some provisionsissue shares of our charter documentspreferred stock, subject to limitations prescribed by applicable law, rules and Delaware law may make takeover attempts difficult, which could depressregulations and the price of our stock and inhibit one’s ability to receive a premium price for their shares.
Provisionsprovisions of our amended and restated certificate of incorporation, could make it more difficult for a third party to acquire control of our business, even if such change in control would be beneficial to our stockholders. Our amended and restated certificate of incorporation allows our board of directors to issue up to five millionas shares of preferred stock in series, and to establish from time to time the number of shares to be included in each such series, and to fix the designation, powers, preferences and rights of the shares of each such series and the qualifications, limitations or restrictions thereof. The powers, preferences and rights of these additional series of preferred stock may be senior to or on parity with our common stock, and the issuance of such shares without stockholder approval. Anyin the future may reduce the value of our common stock.
We may be at increased risk of securities class action litigation.
In the past, securities class action litigation has been instituted against companies following periods of volatility in the overall market and in the price of a company’s securities. We believe this risk may be particularly relevant to us as we have experienced a significant stock price decline in the past 24 months and may experience significant stock price volatility in the future. If we face such issuancelitigation, it could make it more difficult forresult in substantial costs and a third party to acquirediversion of management’s attention and resources, which could harm our business, financial condition and results of operations.


If we fail to maintain an effective system of internal control over financial reporting, we may adversely affectnot be able to accurately report our financial results or prevent fraud, which could cause investors to lose confidence in our reported financial information and have a negative impact on the rightstrading price of our stockholders.common stock.
Effective internal control over financial reporting is necessary for us to provide reliable financial reports and, together with adequate disclosure controls and procedures, is designed to prevent fraud. Any failure to implement required new or improved controls, or difficulties encountered in their implementation, could cause us to fail to meet our reporting obligations. In addition, any testing by us conducted in connection with Section 404(a) of the Sarbanes-Oxley Act, or the testing by our boardindependent registered public accounting firm conducted in connection with Section 404(b) of directors is divided into three classesthe Sarbanes-Oxley Act, may reveal deficiencies in our internal controls over financial reporting that are deemed to be material weaknesses or that may require prospective or retroactive changes to our financial statements or identify other areas for staggered termsfurther attention or improvement. Undetected material weaknesses in our internal controls could lead to financial statement restatements and require us to incur the expense of three years. We are also subject to anti-takeover provisions under Delaware law, each ofremediation. In addition, deficiencies in our internal controls could result in enforcement actions by the SEC or other regulatory bodies, which could delaycause us to incur defense costs and pay penalties or preventother costs. Furthermore, deficiencies in our internal controls may cause investors to lose confidence in our reported financial information, which could have a change of control. Together these provisions may delay, deter or prevent a change in control of us, adversely affectingnegative effect on the markettrading price of our common stock.
We do not anticipate declaring anyintend to pay cash dividends on our common stock.dividends.
We have never declared or paid cash dividends on our common stock and do not planintend to pay any cash dividends infor the nearforeseeable future. Our current policy is to retain all funds and any earnings for use in the operation and expansion of our business. Our revolving credit facility and term loan contain restrictions prohibiting us from paying any cash dividends without the lender’s prior approval. If weAccordingly, investors may have to sell some or all of their shares of our common stock in order to generate cash flow from their investment.
United States federal income tax reform could adversely affect us and our stockholders.
On December 22, 2017, President Trump signed into law the Tax Cuts and Jobs Act (the “TCJA”), which significantly reforms the Internal Revenue Code of 1986, as amended. The TCJA, among other things, includes changes to United States federal tax rates, imposes significant additional limitations on the deductibility of interest, allows for the expensing of capital expenditures, and puts into effect the migration from a “worldwide” system of taxation to a territorial system. We do not pay dividends,expect tax reform to have a returnmaterial impact on one’s investmentour projection of minimal cash taxes. Our net deferred tax assets and liabilities were revalued at the newly-enacted U.S. corporate rate, and the impact was recognized in our tax expense, offset by a full valuation allowance, in the year of enactment. We continue to examine the impact that this tax reform legislation may only occur ifhave on our business. The impact of this tax reform on holders of our common stock is uncertain and could be adverse.
If securities or industry analysts do not publish research, or publish inaccurate or unfavorable research, about our business, our stock price rises aboveand trading volume could decline.
The trading market for our common stock depends, in part, on the research and reports that securities or industry analysts publish about us or our business. If one or more of the analysts who cover us downgrade our stock or publish inaccurate or unfavorable research about our business, our stock price it was purchased.would likely decline. In addition, if our operating results fail to meet the forecasts of analysts or other market participants, our stock price would likely decline. In addition, if one or more analysts cease coverage of our company or fail to publish reports on us regularly, demand for our common stock could decrease, which might cause our stock price and trading volume to decline. We believe we are currently at greater risk that analysts may cease coverage of our company due to the recent decline in our stock price and market capitalization.



Item 1B.Unresolved Staff Comments

None.

Item 2.Properties
On June 12, 2013, we entered into a lease agreement for two adjacent office, research and development, and manufacturing facilities in Irvine, California. The premises consist of approximately 129,000 combined square feet. The lease has a 15-year term beginning January 1, 2014 and provides for onean optional 5 year5-year extension. The initial base rent under the lease is $1.9 million per year, payable in monthly installments, and escalates by 3% per year for years 2015 through 2019, and 4% per year for years 2020 and beyond. We received a rent abatement for the first nine9 months of the lease. Refer to Note 8 of the Notes to the Consolidated Financial Statements for further discussion of properties.

OurIn 2019, we moved our European administrative office facility in the Netherlands from Rosmalen The Netherlands is anto 's-Hertogenbosch. This administrative office facility consists of approximately 2,9004,000 square feet under an operating lease scheduled to expire in December 2020.November 2024.
In conjunctionconnection with theour merger with TriVascular, merger, we assumed the lease for TriVascular'sTriVascular’s facility in Santa Rosa, California. We use the Santa Rosa facility for manufacturing, research &and development, and administrative purposes, and the facility consists of 110,000 square feet under an operating lease scheduled to expire in February 2023, which may be renewed for an additional five5 years.

We believe that all of our facilities and equipment are in good condition, suitable and adequate for their purposes, and are maintained on a consistent basis for sound operations.


Item 3.     Legal Proceedings
Item 3.Legal Proceedings

Refer to Note 8 of the Notes to theour Consolidated Financial Statements included in Item 8 of this Annual Report on Form 10-K for a discussion of legal proceedings.

Item 4.         Mine Safety Disclosures
Item 4Mine Safety Disclosures

Not applicable.



PART II

Item 5.Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity
Securities

Market Information
Our common stock trades on the NASDAQNasdaq Global Select Market under the symbol “ELGX.” The following table sets forth the high and low intraday prices for our common stock as reported on the NASDAQ Global Select Market for the periods indicated.

High
Low
Year Ended December 31, 2016


First Quarter$10.04

$6.51
Second Quarter13.60

8.13
Third Quarter14.50

11.33
Fourth Quarter13.25

4.78
Year Ended December 31, 2017


First Quarter$7.44

$5.45
Second Quarter7.66

4.21
Third Quarter5.37

4.08
Fourth Quarter6.50

4.50

Holders
On March 12, 2018, the closing price of our common stock on the NASDAQ Global Select Market was $4.49 per share, and4, 2020, there were 25484 holders of record of our common stock.

Unregistered Sales of Equity Securities
The following chart compares the yearly percentage change in the cumulative total stockholder return on our common stock for the period from December 31, 2011 through December 31, 2017, with the cumulative total return on the NASDAQ Composite Index and the NASDAQ Medical Equipment Index for the same period. The comparison assumes $100 was invested on December 31, 2012 in our common stock at the then closing priceNone.
Repurchases of $7.15 per share.Equity Securities
Comparison of 5 Year Cumulative Total Return*
Among Endologix, Inc., the NASDAQ Composite Index, and the NASDAQ Medical Equipment Index
*$100 invested on December 31, 2011 in stock or index, including reinvestment of dividends. Fiscal year ending December 31.None.



Dividend Policy
We have never paid any dividends. We currently intend to retain all earnings, if any, for use in the expansion of our business and therefore do not anticipate paying any dividends in the foreseeable future. Additionally, the terms of our credit facility with Deerfield prohibit us from paying cash dividends without their consent.
Item 6.Selected Financial Data
The following selected consolidated financial data hashave been derived from our audited Consolidated Financial Statements. The audited Consolidated Financial Statements for the fiscal years ended December 31, 2017, 2016,2019, 2018 and 20152017 are included elsewhere in this Annual Report on Form 10-K. The information set forth below should be read in conjunction with “Management’s Discussion and Analysis of Financial Condition and Results of Operations” contained in Item 7 of this Annual Report on Form 10-K and the Consolidated Financial Statements and the relatedaccompanying notes theretoincluded in Item 8. of this Annual Report on Form 10-K.
 Year Ended December 31,
 2017
2016
2015
2014
2013
 (In thousands, except per share data)

Consolidated Statement of Operations Data:








Revenue$181,157

$192,925

$153,612

$147,588

$132,257
Cost of goods sold
59,828

69,133

51,821

41,801

32,750
Gross profit121,329

123,792

101,791

105,787

99,507
Operating expenses:









Research and development21,019

32,337

26,421

21,616

16,199
Clinical and regulatory affairs12,952

16,215

15,418

13,243

8,679
Marketing and sales92,400

107,759

78,213

73,411

63,588
General and administrative35,301

41,044

29,581

26,663

21,409
Restructuring cost1,477

11,093






Contract termination and business acquisition expenses


5,768

5,071




       Settlement costs


4,650






Total operating expenses
163,149

218,866

154,704

134,933

109,875
Loss from operations(41,820)
(95,074)
(52,913)
(29,146)
(10,368)
Total other income (expense)
(25,039)
(59,105)
(6,848)
(3,334)
(5,710)
Net loss before income tax benefit (expense)(66,859)
(154,179)
(59,761)
(32,480)
(16,078)
Income tax benefit (expense)459

(498)
9,337

62

10
Net loss$(66,400)
$(154,677)
$(50,424)
$(32,418)
$(16,068)
Basic and diluted net loss per share


$(0.80)
$(1.91)
$(0.75)
$(0.50)
$(0.26)
Shares used in computing basic and diluted loss per share
83,325

80,976

67,671

65,225

62,607
  
 December 31,
 2017
2016
2015
2014
2013
Consolidated Balance Sheet Data:(In thousands)
Cash and cash equivalents and marketable securities$57,991

$47,108

$177,321

$86,669

$126,465
Accounts receivable, net$32,294

$34,430

$28,531

$26,113

$24,972
Total assets$365,047

$359,684

$331,050

$248,209

$256,197
Debt$208,253
 $177,178

$167,748

$70,407

$67,101
Total liabilities$289,985

$246,891

$227,743

$124,059

$151,556
Accumulated deficit$520,001

$453,601

$298,924

$248,500

$216,082
Total stockholders’ equity$75,062

$112,793

$103,307

$124,150

$104,641
 Year Ended December 31,
(In thousands, except per share data)2019 2018 2017 2016 2015
Consolidated Statements of Operations Data:
 
 
 
 
Revenue$143,370
 $156,473
 $181,157
 $192,925
 $153,612
Loss from operations(42,549) (68,192) (41,820) (95,074) (52,913)
Net loss$(64,757) $(79,714) $(66,400) $(154,677) $(50,424)
Basic and diluted net loss per share$(3.84) $(9.07) $(7.97) $(19.10) $(7.45)
Shares used in computing basic and diluted loss per share16,850
 8,790
 8,333
 8,098
 6,767
  
 December 31,
(In thousands)2019 2018 2017 2016 2015
Consolidated Balance Sheet Data:         
Total assets307,164
 293,070
 365,047
 359,684
 331,050
Debt172,060
 198,078
 208,253
 177,178
 167,748
Total liabilities243,308
 253,424
 289,985
 246,891
 227,743
Total stockholders’ equity63,856
 39,646
 75,062
 112,793
 103,307



Item 7.Management’s Discussion and Analysis of Financial Condition and Results of Operations

The following discussion and analysis should be read in conjunction with “Selected Financial Data” and our audited Consolidated Financial Statements and the relatedaccompanying notes thereto included in this Annual Report on Form 10-K. This discussion contains forward-looking statements that involve risks and uncertainties. Our actual results could differ materially from those anticipated in the forward-looking statements as a result of various factors including the risks we discuss in Item 1A of Part I, “Risk Factors”Factors,” and elsewhere in this Annual Report on Form 10-K.

Overview
Our Business
Our corporate headquarters are located in Irvine, California and manufacturing facilities are located in Irvine, California and Santa Rosa, California. We develop, manufacture, market and sell innovative medical devices for the treatment of aortic disorders. Our principal products are intended for the minimally-invasive endovascular treatment of abdominal aortic aneurysms (“AAA”).AAA. Our AAA products are built on one of two platforms: (1)(i) traditional minimally-invasive endovascular repair (“EVAR”), and (2) endovascular sealing (“EVAS”),EVAR; or (ii) EVAS, our innovateinnovative solution for sealing the aneurysm sac while maintaining blood flow through two blood flow lumens.flow.
We sell our products through (i) our direct sales force in the United States and Europeaninternationally through a combination of direct sales forces and (ii) third-party internationala network of third party distributors and agents in Europe and in other parts of the world.

agents.
For an overview of our business, products, product development initiatives and clinical trials, please see Item 1, “Business.”
Recent Developments
IDE Approval and Shelf-Life Extension
In August 2019, we announced that we have received IDE approval from the FDA to commence a new pivotal study to evaluate the safety and effectiveness of ChEVAS for the endovascular treatment of complex AAA. The ChEVAS system is an endovascular AAA therapy designed to combine the Nellix 3.5 endograft with parallel visceral stents to enable treatment of patients with juxta-renal, para-renal, and suprarenal AAA. The application of EVAS for patients with complex aneurysms is expected to offer innovative new technology to a group of patients that are underserved by the current standard of care.
In October 2019, our AFX2 product received a 3-year shelf-life approval from the FDA.
Equity Financing and Debt Restructuring
On March 31, 2019, the Company entered into (i) a Purchase Agreement with select institutional investors and certain other parties, (ii) an Exchange Agreement, providing for the exchange by certain holders of the Company’s existing notes for new notes, (iii) a Second Amendment to Amended and Restated Facility Agreement and First Amendment to Amended and Restated Guaranty and Security Agreement with Deerfield Private Design Fund IV, L.P. and certain of its related funds and affiliates, (iv) a Second Amendment to Credit Agreement and First Amendment to Guaranty and Security Agreement with Deerfield ELGX Revolver, LLC and certain of its affiliates. As previously disclosed, the effectiveness of the Deerfield Agreements were conditioned on the closing of the transaction contemplated by the Purchase Agreement and the Exchange Agreement.
On April 3, 2019, the Company closed the transactions contemplated by each of the Purchase Agreement and the Exchange Agreement and the terms of the Deerfield Agreements became effective. The Company received gross proceeds of approximately $52.2 million pursuant to the Purchase Agreement and exchanged an aggregate principal amount of approximately $73.4 million of principal amount of old notes plus accrued but unpaid interest for an aggregate of $67.0 million of principal of new notes pursuant to the Exchange Agreement. The Company has issued the warrants and first out waterfall notes contemplated by the Deerfield Agreements. See Note 6 and Note 13 to our Consolidated Financial Statements included in Item 8 of this Annual Report on Form 10-K for additional details.
On February 24, 2020, the Company entered into a February 2020 Exchange Agreement and Fourth Amendment to Amended and Restated Facility Agreement and Amendment to First Out Waterfall Notes (the “Fourth Facility Amendment”). The Fourth Facility Amendment provides for, among other things, the conversion of certain portions of the outstanding convertible debt upon the achievement of certain milestones. In addition, 8.333% (or approximately $10.7 million as of February 24, 2020) of the First Out Waterfall Loans currently due on April 2, 2021 (the “First Amortization Payment”) will be extended to July 1, 2021. Further, the Fourth Facility Amendment provides that the interest payment date due April 1, 2020 will


be payable in paid-in-kind interest by increasing the principal amount of the loans by an amount equal to the interest that has accrued. See Note 14 to our Consolidated Financial Statements included in Item 8 of this Annual Report on Form 10-K for further details.
On February 24, 2020, the Company and three investors holding approximately $11.0 million of the principal amount of the Company’s 3.25% Senior Notes due 2020 (the “Holders”) entered into an Exchange Agreement (the “2020 Exchange Agreement”) providing for the exchange of the Holders’ existing notes (the “Existing Notes”) for new 5.00% Voluntary Convertible Senior Notes due 2024 (the “2020 5.00% Voluntary Notes”). Pursuant to the 2020 Exchange Agreement, on February 24, 2020, the exchanging Holders are exchanging all outstanding principal plus accrued and unpaid interest under the Existing Notes into the same amount of principal of 2020 5.00% Voluntary Notes pursuant to the 2020 Exchange Agreement. The 2020 5.00% Voluntary Notes are being issued in a transaction exempt from the registration requirements of the Securities Act of 1933, as amended (the “Securities Act”) by virtue of Section 4(a)(2) of the Securities Act and Rule 506 thereunder. See Note 14 to our Consolidated Financial Statements included in Item 8 of this Annual Report on Form 10-K for further details.

On February 24, 2020, the Company entered into a Fourth Amendment to Credit Agreement (the “Credit Amendment”) with Deerfield Revolver and certain funds managed by Deerfield Management Company, L.P., dated as of August 9, 2018. The Credit Amendment includes conforming revisions to reflect the changes in the Fourth Facility Amendment. In addition, the Credit Amendment provides that if the Company satisfies the Maturity Extension Conditions, the credit agreement maturity date will extend to the earlier of (i) December 22, 2023 or (ii) the date the loans pursuant to the Facility Agreement have been repaid in full.

International Expansion
In August 2019, we announced an agreement naming Boston Scientific Corporation (NYSE: BSX) the exclusive distributor of Endologix Products in China. We are continuing to assess discrete international expansion opportunities that are consistent with our business strategy, including entry into certain markets through established distributor partners.

Characteristics of Our Revenue and Expenses
Revenue
Revenue is derived from sales of our EVAR and EVAS products (including extensions and accessories) to hospitals upon completion of each AAA repair procedure, or from sales to distributors upon title transfer (which is typically at shipment), provided our other revenue recognition criteria have been met.
Cost of Goods Sold
Cost of goods sold includesprimarily consists of compensation (including stock-based compensation) and benefits offor production personnel and production support personnel. Cost of goods sold also includes depreciation expense for production equipment, amortization of developed technology, production materials and supplies expense, allocated facilities-related expenses,costs, and certain direct costs such as shipping.
Research and Development
Research and development expenses primarily consist of compensation (including stock-based compensation) and benefits for research and development personnel, materials and supplies, research and development consultants, outsourced and licensed research and development costs, and allocated facilities-related costs. Our research and development activities primarily relate to the development and testing of new devices and methods to treat aortic disorders.
Clinical and Regulatory
Clinical and regulatory expenses primarily consist of compensation (including stock-based compensation) and benefits for clinical and regulatory personnel, regulatory and clinical payments related to studies, regulatory costs related to registration and approval activities, and allocated facilities-related costs. Our clinical and regulatory activities primarily relate to obtaining regulatory approval for the commercialization of our devices.
Marketing and Sales
Marketing and sales expenses primarily consist of compensation (including stock-based compensation) and benefits for our sales force, clinical specialist,specialists, internal sales support functions and marketing personnel. ItMarketing and sales expenses also includesinclude costs attributable to marketing our products to our customers and prospective customers.


General and Administrative
General and administrative expenses primarily includeconsist of compensation (including stock-based compensation) and benefits for personnel that support our general operations such as information technology, executive management, financial accounting


and human resources. General and administrative expenses also include bad debt expense, patent and legal fees, financial audit fees, insurance, recruiting fees, other professional services, the federal Medical Device Excise Tax,medical device excise tax and allocated facilities-related expenses.costs.
Critical Accounting Policies and Estimates
The preparation of financial statements in conformity with United States generally accepted accounting principles in the United States (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets, liabilities, and the disclosure of contingent assets and liabilities as of the date of the financial statements and the reported amounts of revenue and expenses during the periods presented. While management believes these estimates are reasonable and consistent, they are, by their very nature, estimates of amounts that will depend on future events. Accordingly, actual results could differ from these estimates. Our Audit Committeeaudit committee of the Boardour board of Directorsdirectors periodically reviews our significant accounting policies. Our critical accounting policies arise in conjunction with the following:
Revenue recognition and accounts receivable;
Inventory - lower of cost or market;— lower-of-cost-or-market;
Business combinations;Debt and derivative liabilities;
Impairment of Goodwill, andindefinite-lived intangible assets, - impairment analysis;and long-lived assets;
Stock-based compensation;
Contingent consideration for business acquisition; and
Litigation accruals.
Revenue Recognition and Accounts Receivable
We measure revenue based on consideration specified in contracts with customers: hospitals and distributors. We exclude any amounts related to taxes assessed by governmental authorities from this revenue measurement and reduce revenue by any sales incentives offered by us to our customers. We recognize revenue when we satisfy a performance obligation by transferring control of products to customers.
Specifically, we recognize revenue when all of the following criteria are met:
We have appropriate evidence of a binding arrangementA contract has been identified with ourthe customer;
The salesperformance obligations have been identified;
The transaction price for our product (including extensions and accessories) is established with our customer;
Our product has been used bydetermined and allocated to the hospitalrespective performance obligations; and
The performance obligations have been satisfied.
Respective performance obligations are satisfied at a point in an AAA repair procedure, or our distributor
has assumed title with no right of return, as applicable; and
Collection from our customer is reasonably assured at the time of sale.

Forfor sales made to a direct customer (i.e., hospitals),both hospitals and distributors. Payment terms with customers range from 30 to 180 days which reflects days from the date we satisfy the performance obligations.
For implant-based sales, we recognize revenue upon completion of anwhen the AAA repairproducts are utilized in a procedure when our product isor implanted in a patient. For shipment-based sales, to distributors, we recognize revenue when control over a product has transferred to the customer, which is typically at the time of title transfer, which is typically at shipment. We do not offer anyshipment, without a right of returnreturn.
We provide certain sales incentives to customers for meeting certain purchase thresholds and, accordingly, the transaction price is reduced by our customers, other than honoring our standard warranty.

best estimate of this variable consideration. We estimate this variable consideration through the most-likely amount method.
We maintain allowances for doubtful accounts for estimated losses resulting from the inability of our customers to pay amounts due. These estimates are based on our review of the aging of customer balances, correspondence with the customer, and the customer’s payment history.


Inventory - Lower of Cost or Market— Lower-of-cost-or-market
We adjustvalue our inventory at the lower of the actual cost to purchase or manufacture the inventory or net realizable value for estimated amountssuch inventory. Cost is determined using the first-in, first-out method. We regularly review inventory quantities in process and on hand and, when appropriate, record a provision for obsolete and excess inventory. The provision is based on actual loss experience and a forecast of obsolete or unmarketable items. Such assumptions involve projectionsproduct demand compared to its remaining shelf life.
Debt and Derivative Liabilities
We account for the refinance of future customer demand,our debt in accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) 470-50, Debt Modifications and Extinguishment. We account for refinancing of debt as driven by economican extinguishment if terms of the new debt and market conditions,original debt are substantially different (i.e. the present value of the cash flows under the terms of the new debt is at least 10% different from the present value of the remaining cash flows under the terms of the original debt). The original debt is derecognized and the product’s shelf life.new debt is recorded at fair value, with the difference recorded as extinguishment gain or loss line item of the Consolidated Statements of Operations and Comprehensive Loss. If actual demand,the terms of the new debt and original debt are not substantially different, the debt refinancing is accounted for as debt modification where no gain or economic or market conditions are less favorable than those projected by us, additional inventory write-downs may be required.loss is recognized.
Business CombinationsWe incurred debt issuance costs in connection with the issuance and refinance of our convertible notes and term loan facility which we have presented as a direct deduction against the carrying amount of the debt and were amortized to interest expense using the effective interest method.
The applicationOur debt includes conversion features that meets the definition of acquisition accounting to a business acquisition requires that we identifyembedded derivative under ASC 815. Consequently, the individual assets acquiredembedded derivatives were bifurcated and liabilities assumed and estimateaccounted for separately at fair value. Changes in the fair value of each. Thethe derivative liabilities are determined at each period end and are recorded in the change in fair value of assets acquired andderivative liabilities assumed in a business acquisition are recognized at the acquisition date, with the purchase price exceeding the fair values being recognized as goodwill. Determining fair value of identifiable assets, particularly intangibles, liabilities acquired and contingent obligations assumed requires management to make estimates. In certain circumstances, the allocationsline item of the purchase price are based upon preliminary estimatesConsolidated Statements of Operations and assumptionsComprehensive Loss and subject to revision when we receive final information, including appraisals and other analysis. Accordingly, the measurement period for such purchase price allocations will end when the information, or the facts and circumstances, becomes available, but will not exceed twelve months. We will recognize measurement-period adjustments during the period of resolution, including the effect on earnings of any amounts that would have been recorded in previous periods if the accounting had been completed at the acquisition date.


Goodwill and intangible assets often represent a significant portionnon-current liabilities line items of the assets acquired in a business combination. We recognize the fair valueConsolidated Balance Sheets.
Impairment of an acquired intangible apart from goodwill whenever the intangible arises from contractual or other legal rights, or when it can be separated or divided from the acquired entity and sold, transferred, licensed, rented or exchanged, either individually or in combination with a related contract, asset or liability. Intangible assets consist primarily of technology, customer relationships, and trade name and trademarks acquired in business combinations and in-process research and development (“IPR&D”). We generally assess the estimated fair values of acquired intangibles using a combination of valuation techniques. To estimate fair value, we are required to make certain estimates and assumptions, including future economic and market conditions, revenue growth, market share, operating costs and margins, and risk-adjusted discount rates. Our estimates require significant judgment and are based on historical data, various internal estimates, and external sources. Our assessment of IPR&D also includes consideration of the risk that the projects may not achieve technological feasibility.

Goodwill, andIndefinite-Lived Intangible Assets - Impairment Analysisand Long-Lived Assets
Goodwill and other intangible assets with indefinite lives are not subject to amortization but are tested for impairment annually or whenever events or changes in business circumstances suggest the potential of an impairment. The evaluation of indefinite-lived intangible assets for impairment allows for a qualitative assessment to be performed. In performing our qualitative assessment, we consider relevant events and conditions including, but not limited to: macroeconomic trends, industry and market conditions, overall financial performance, cost factors, company-specific events, legal and regulatory factors and market capitalization.
We completed our annual test for impairment of goodwill and indefinite-lived intangible assets as of June 30, 2019, under the quantitative assessment, with no resulting impairment, as our market capitalization was in substantial excess of the value of our total stockholders’s equity (we have one reporting unit for purposes of our goodwill impairment test).
In the fourth quarter of the year ended December 31, 2019, we determined that there was a sufficient indicator to trigger an additional interim goodwill impairment test due to a significant decrease in our market capitalization during the fourth quarter of 2019. Our interim goodwill impairment test was prepared as of December 31, 2019 using a quantitative assessment to determine if the fair value of our single reporting unit was less than its carrying value as of the test date. Based on the results of the quantitative interim goodwill impairment test, the fair value of our single reporting unit substantially exceeded its carrying value and therefore, no impairment charge was recognized as of December 31, 2019.
In performing the quantitative goodwill assessment, we estimate the reporting unit's fair value based on its enterprise value plus an assumed control premium as evidence of fair value. The estimates used to determine the fair value of the reporting unit may change based on results of operations, macroeconomic conditions, stock price fluctuations or other factors. Changes in these estimates could materially affect our estimate of the fair value of the reporting unit and our resulting conclusion as to any goodwill impairment for the reporting unit.
If the recent negative volatility of our market capitalization is sustained, we may perform impairment tests more frequently in the future and it is possible that our goodwill could become impaired, which could result in a material charge and adversely affect our results of operations.
Long-lived assets, including finite-lived intangible assets, are tested for impairment whenever events or changes in circumstances indicate that the asset might be impaired.

We evaluate the possible impairment of definite-lived intangible assets if/when events or changes in circumstances occur that indicate that the carrying value of assetsthe long-lived intangible asset or asset group may not be recoverable. Thethe first step in the impairment reviews require significant estimates abouttesting involves a comparison of the sum of the undiscounted future cash flows of the asset or asset group to its carrying amount. If the sum of the undiscounted future cash flows exceeds the carrying amount, then no


impairment exists. If the carrying amount exceeds the sum of the undiscounted future cash flows, then a second step is performed to determine the amount of impairment, if any, to be recognized. An impairment loss is recognized to the extent that the carrying amount of the asset or asset group exceeds its fair value. The fair value including estimatesof the asset or asset group is based on estimated discounted future cash flows of the asset or asset group using a discount rate commensurate with the related risk. The estimate of future cash flows selectionrequires management to make assumptions and to apply judgment, including forecasting future sales and expenses and estimating useful lives of appropriate discount rates,the assets. These estimates can be affected by a number of factors, including, among others, future results, demand and estimateseconomic conditions, many of long-term growth rates. If actual results, orwhich can be difficult to predict.
For reasons similar to those described above related to goodwill, during the forecasts and estimates used in futurefourth quarter of 2019, we performed the first step of the impairment analysis are lower thanover our asset groups as of December 31, 2019. The results of the original estimates used to assessfirst step of the recoverabilityimpairment analysis indicated that the sums of these assets, we could incurthe undiscounted future cash flows of our asset groups exceeded their carrying amounts. Accordingly, no impairment charges.charge was recognized as of December 31, 2019.
Stock-BasedStock-based Compensation
We recognizevalue stock-based compensation expense for employees based onawards, including stock options, restricted stock awards (“RSAs”) and restricted stock units (“RSUs”), as of the date of grant. The fair value of stock options is estimated at the date of grant. For awards granted to consultants,grant using the award is marked-to-market each reporting period, with a corresponding adjustment to stock-based compensation expense.Black-Scholes option-pricing model. The fair value of equity awards that are expected to vest is amortized on a straight-line basis over (i) the requisite service period or (ii) the period from grant date to the expected date of the completion of the performance condition for vesting of the award. Stock-based compensation expense recognized is net of an estimated forfeiture rate, which is updated as appropriate.
We use the Black-Scholes option pricing model to value stock option grants. The Black-Scholes option pricing model requires the input of subjective assumptions, including the expected volatility of our common stock, expected risk-free interest rate,RSAs and the option’s expected life. The fair value of our restricted stockRSUs is based on the closing market price of our common stock on the dategrant date.
We recognize stock-based compensation expense (net of grant. A portionestimated forfeitures) using the straight-line method over the requisite or implicit service period, as applicable. Forfeitures of restricted stockemployee awards are estimated at the time of grant, and the forfeiture assumption is periodically adjusted for actual employee vesting is dependent on us achieving certain regulatory and financial milestones. behavior.
We use judgmentthe Black-Scholes option-pricing model, in estimatingcombination with the likelihooddiscounted employee price, in determining the value of expense related to our Amended and timing of achieving these milestones. Each period, we will reassess the likelihood and estimate the timing of reaching these milestones, and will adjust the expense accordingly.

Restated 2006 Employee Stock Purchase Plan, as amended (the “ESPP”) to be recognized during each offering period.
Contingent Consideration for Business Acquisition
We determinedetermined the fair value of contingently issuable common stock related toon the date of the Nellix acquisition using a probability-based income approach andwith an appropriate discount rate.rate (determined using both Level 1 and Level 3 inputs (see Note 2 to our Consolidated Financial Statements for additional details)). Changes in the fair value of the contingently issuable common stock are determined at each period end and are recorded in the other income (expense) section, net line item of the Consolidated Statements of Operations and Comprehensive Loss and the current and non-current liabilities sectionline items of the Consolidated Balance Sheets. The fair value of the contingent consideration liability could be impacted by changes such as: (i) fluctuations in the price of our common stock or (ii) the timing of achieving the underlining milestones.milestones
Litigation Accruals
From time to time we are involved in various claims and legal proceedings of a nature considered normal and incidental to our business. These matters may include product liability, intellectual property, employment and other general claims. We accrue for contingent liabilities when it is probable that a liability has been incurred and the amount can be reasonably estimated. The accruals are adjusted periodically as assessments change or as additional information becomes available.

Recent Accounting Pronouncements Issued But Not Adopted as of December 31, 2019
In February 2016,August 2018, the FASB issued Accounting Standards Update (“ASU”) No. 2018-13, “Fair Value Measurement (Topic 820): Disclosure Framework — Changes to the Disclosure Requirements for Fair Value Measurement,” which amends fair value disclosure requirements. ASU No. 2016-02, which amends the FASB Accounting Standards Codification and creates Topic 842, “Leases.” The new topic supersedes Topic 840, “Leases,” and increases transparency and comparability among organizations by recognizing lease assets and lease liabilities2018-13 removes disclosure requirements on the balance sheettransfers between Level 1 and requires disclosuresLevel 2 of key information about leasing arrangements. The guidance is effectivethe fair value hierarchy, the policy for reporting periods beginning after December 15, 2018.


ASU 2016-02 mandates a modified retrospective transition method. We are currently assessingtiming of transfers between levels, and the impact this guidance will have on our consolidated financial statements.

In August 2016, the FASB issuedvaluation processes for Level 3 fair value measurements. ASU No. 2016-15, Statement of Cash Flows – Classification of Certain Cash Receipts2018-13 clarifies the measurement uncertainty disclosure and Cash Payments. ASU 2016-15 provides guidance on the presentationadds disclosure requirements for Level 3 unrealized gains and classification of specific cash flow itemslosses and significant unobservable inputs used to improve consistency within the statement of cash flows. This guidance is effective for fiscal years, and interim periods within those fiscal years beginning after December 15, 2017, with early adoption permitted. We are evaluating the effect that ASU 2016-15 will have on our consolidated financial statements and related disclosures.

In October 2016, the FASB issued ASU No. 2016-16, “Intra-Entity Transfers of Assets Other Than Inventory,” which requires an entity to immediately recognize the tax consequences of intercompany transfer other than inventory.develop Level 3 fair value measurements. The guidance is effective for fiscal years beginning after December 15, 2017, including interim periods within those fiscal years.2019. Entities are permitted to early-adopt any removed or modified disclosures upon issuance and delay adoption of the additional disclosures until the effective date. We early-adopted ASU No. 2018-13 in the year ended December 31, 2018 as it pertains to removed and modified disclosures, which did not result in any change to our consolidated financial statements. We are currently assessing the impact this guidancethat adoption of the additional disclosures will have on our consolidated financial statements.

In November 2016,December 2019, the FASB issued ASU 2016-18, “Restricted Cash,”2019-12, “Simplifying the Accounting for Income Taxes” which enhances and simplifies various aspects of the income tax accounting guidance, including requirements such as tax basis step-up in goodwill obtained in a transaction that is intended to reduce the diversitynot a business combination, ownership changes in investments, and interim-period accounting


for enacted changes in tax law. The standard will be effective for us in the classification and presentationfirst quarter of changes in restricted cash in the statement of cash flows, by requiring entities to combine the changes in cash and cash equivalents and restricted cash in one line. As a result, entities will no longer present transfers between cash and cash equivalents and restricted cash in the statement of cash flows. In addition, if more than one line item is recorded on the balance sheet for cash and cash equivalents and restricted cash, a reconciliation between the statement of cash flows and balance sheet is required. This ASU is effective for annual and interim reporting periods beginning after December 15, 2017, andour fiscal year 2022, although early adoption wasis permitted. The retrospective transition method, requiring adjustment to all comparative periods presented, is required. We are assessingdo not expect that the impactadoption of this guidanceASU will have a significant impact on itsour consolidated financial statements.

In January 2017,Other recent accounting pronouncements issued by the FASB issued ASU No. 2017-04, “Intangibles—Goodwill(including its Emerging Issues Task Force), the American Institute of Certified Public Accountants and Other (Topic 350): Simplifying the Test for Goodwill Impairment”. This accounting standards update changes the procedural steps in applying the goodwill impairment test. A goodwill impairment will now be the amount by whichSEC are not expected to have a reporting unit's carrying value exceeds its fair value, not to exceed the carrying amount of goodwill. The guidance is effective prospectively for annual and interim periods beginning after December 15, 2019, with early adoption permitted. We are currently assessing the impact this guidance will havematerial effect on our consolidated financial statements.

In May 2017, the FASB issued ASU No. 2017-09, “Compensation - Stock Compensation: Scope of Modification Accounting,” which clarifies and aims to reduce the cost and complexity when applying the stock compensation modification accounting guidance. The amendments in this update provide guidance about which changes to the terms or conditions of a share-based payment award require an entity to apply modification accounting. ASU 2017-09 will be effective for public companies for fiscal years beginning after December 15, 2017, including interim periods. Early adoption is permitted. We are currently assessing the impact this guidance will have on our consolidated financial statements.



Results of Operations
Operations Overview - 20172019, 20162018, and 20152017
The following table presents our results of continuing operations and the related percentage of the period’s revenue (in thousands)thousands, except percentages):

Year Ended December 31,Year Ended December 31,

2017
2016
20152019 2018 2017
Revenue$181,157

100.0%
$192,925

100.0%
$153,612

100.0%$143,370
 100.0 % $156,473
 100.0 % $181,157
 100.0 %
Cost of goods sold59,828

33.0%
69,133

35.8%
51,821

33.7%52,284
 36.5 % 64,550
 41.3 % 59,828
 33.0 %
Gross profit121,329

67.0%
123,792

64.2%
101,791

66.3%91,086
 63.5 % 91,923
 58.7 % 121,329
 67.0 %
Operating expenses:










    
   
  
Research and development21,019

11.6%
32,337

16.8%
26,421

17.2%18,104
 12.6 % 20,793
 13.3 % 21,019
 11.6 %
Clinical and regulatory affairs12,952

7.1%
16,215

8.4%
15,418

10.0%14,036
 9.8 % 13,851
 8.9 % 12,952
 7.1 %
Marketing and sales92,400

51.0%
107,759

55.9%
78,213

50.9%64,673
 45.1 % 76,855
 49.1 % 92,400
 51.0 %
General and administrative35,301

19.5%
41,044

21.3%
29,581

19.3%35,984
 25.1 % 43,477
 27.8 % 35,301
 19.5 %
Restructuring costs
1,477

0.8%
11,093

5.7%


—%838
 0.6 % 3,270
 2.1 % 1,477
 0.8 %
Settlement costs


—%
4,650

2.4%


—%
Contract termination and business acquisition expenses

—%
5,768

3.0%
5,071

3.3%
Contract termination, product withdrawal and business acquisition expenses
  % 1,869
 1.2 % 
  %
Total operating expenses163,149

90.1%
218,866

113.4%
154,704

100.7%133,635
 93.2 % 160,115
 102.3 % 163,149
 90.1 %
Loss from operations(41,820)
(23.1)%
(95,074)
(49.3)%
(52,913)
(34.4)%(42,549) (29.7)% (68,192) (43.6)% (41,820) (23.1)%
Total other income (expense)(25,039)
(13.8)%
(59,105)
(30.6)%
(6,848)
(4.5)%
Net loss before income tax benefit(66,859)
(36.9)%
(154,179)
(79.9)%
(59,761)
(38.9)%
Income tax benefit (expense)459

0.3%
(498)
(0.3)%
9,337

6.1%
Total other expense, net(26,933) (18.8)% (11,238) (7.2)% (25,039) (13.8)%
Net loss before income taxes(69,482) (48.5)% (79,430) (50.8)% (66,859) (36.9)%
Income tax (expense) benefit4,725
 3.3 % (284) (0.2)% 459
 0.3 %
Net loss$(66,400)
(36.7)%
$(154,677)
(80.2)%
$(50,424)
(32.8)%$(64,757) (45.2)% $(79,714) (50.9)% $(66,400) (36.7)%
Year Ended December 31, 20172019 versus December 31, 20162018
Revenue

Year Ended December 31, 
 

2017 2016 Variance Percent Change

(in thousands) 
 
Revenue$181,157
 $192,925
 $(11,768) (6.1)%

 Year Ended December 31,    
(in thousands, except percentages)2019 2018 Variance Percent Change
Revenue$143,370
 $156,473
 $(13,103) (8.4)%
USUnited States Sales. Net sales in the United States totaled $123.2 million for the year ended December 31, 2017, a 9% decrease from $136.1$95.3 million in the year ended December 31, 2016. This2019, a 12.6% decrease wasfrom $109.1 million in the year ended December 31, 2018, due to lower sales volume driven by AFX product due to slower than expected customer recapture and sales force attrition partially offset by strong sales growth for the Ovation System.restructuring of the U.S. Sales team.

International Sales. Net sales of products in our international regions totaled $57.9 million for the year ended December 31, 2017, a 2% increase from $56.8$48.1 million in the year ended December 31, 2016. Both AFX and Ovation product lines posted strong growth which was offset by2019,decline1.4% increase from $47.4 million in Nellixnet sales reflecting the refined IFU. Ourof products in our international sales forregions in the year ended December 31, 2017 included a favorable currency impact2018. The increase was due to higher sales volume driven by the timing of approximately $0.4 million when comparedorders to distributors partially offset by the net sales forrestructuring of the year ended December 31, 2016, which had a 0.8% favorable impact on growth rate representing constant currency increase of 1.2%.European Sales team.




Cost of Goods Sold, Gross Profit and Gross Margin Percentage

 Year Ended December 31, 
 
 Year Ended December 31,    

 2017 2016 Variance Percent Change

 (in thousands) 
 
(in thousands, except percentages) 2019 2018 Variance Percent Change
Cost of goods sold $59,828
 $69,133
 $(9,305) (13.5)% $52,284
 $64,550
 $(12,266) (19.0)%
Gross profit 121,329
 123,792
 (2,463) (2.0)% 91,086
 91,923
 (837) (0.9)%
Gross margin percentage (gross profit as a percent of revenue) 67.0% 64.2% 2.8% 
 63.5% 58.7% 4.8% 
Gross margin percentage in the year ended December 31, 2019 increased to 63.5% from 58.7% in the year ended December 31, 2018. The increase in gross profit margin was attributable to lower inventory reserves, partially offset by an unfavorable geographic mix in the year ended December 31, 2019 compared to prior year period. In addition, gross profit in the year ended December 31, 2018 was negatively impacted by $8.7 million of inventory reserves related to our recall of our Nellix EVAS System (see further details included in Note 8 to our Consolidated Financial Statements included in Item 8 of this Annual Report on Form 10-K).
Operating Expenses
  Year Ended December 31,    
(in thousands, except percentages) 2019 2018 Variance Percent Change
Research and development $18,104
 $20,793
 $(2,689) (12.9)%
Clinical and regulatory affairs 14,036
 13,851
 185
 1.3 %
Marketing and sales 64,673
 76,855
 (12,182) (15.9)%
General and administrative 35,984
 43,477
 (7,493) (17.2)%
Restructuring costs 838
 3,270
 (2,432) (74.4)%
Contract termination, product withdrawal and business acquisition expenses 
 1,869
 (1,869) (100.0)%
Research and development. The $2.7 million decrease in research and development expenses for the year ended December 31, 2017 increased to 67.0% from 64.2% for the year ended December 31, 2016. The year ended December 31, 2016 included an $8.2 million impact of purchase price accounting for inventory acquired in the TriVascular merger. Excluding this impact, cost of goods sold decreased by $1.1 million in the year ended December 31, 2017 versus 2016. This decrease is driven by lower revenue.

Operating Expenses

 Year Ended December 31, 
 

 2017 2016 Variance Percent Change

 (in thousands) 
 
Research and development $21,019
 $32,337
 $(11,318) (35.0)%
Clinical and regulatory affairs 12,952
 16,215
 (3,263) (20.1)%
Marketing and sales 92,400
 107,759
 (15,359) (14.3)%
General and administrative 35,301
 41,044
 (5,743) (14.0)%
Restructuring costs
 1,477

11,093

(9,616)
(86.7)%
Settlement costs 

4,650

(4,650)
(100.0)%
Contract termination and business acquisition expenses 
 5,768

(5,768) (100.0)%
Research and development. The $11.3 million decrease in research and development expenses2019, as compared to the prior year period, was attributable to lower headcount driven by the restructuring of our operations and to the timing of project spending and synergies related to the TriVascular merger.spending.
Clinical and regulatory affairs. The $3.3$0.2 million decreaseincrease in clinical and regulatory affairs expenses, as compared to the prior year period, was dueattributable to synergies related to the TriVascular merger.costs associated with our investment in clinical evidence.
Marketing and sales. The $15.4$12.2 million decrease in marketing and sales expenses, as compared to the prior year period, was dueattributable to synergies related tolower headcount driven by the TriVascular merger.restructuring of our operations in both the U.S. and Europe.
General and administrative. The $5.7$7.5 million decrease in general and administrative expenses for the year ended December 31, 2019, as compared to the prior year period was primarily attributable to a decrease in headcountlower litigation expenses and costs related to synergiesthe transition of our Chief Executive Officer that occurred in 2018.
Restructuring costs. In 2019, we incurred $0.8 million in restructuring costs as a result of the TriVascular merger. The targeted reductions were initiatedCompany continue to provideimprove efficiencies and realignre-align resources as well as to allow for continued investment in strategic areas and drive growth.
Restructuring costs. Contract termination, product withdrawal and business acquisition expenses.The $9.6 In 2018, the Company incurred $1.9 million decrease in restructuring costs forproduct withdrawal expenses as a result of our voluntary recall of our Nellix EVAS System. No contract termination, product withdrawal and business acquisition expenses were incurred in 2019.



Other Expense, Net
  Year Ended December 31,    
(in thousands, except percentages) 2019 2018 Variance Percent Change
Other expense, net $(26,933) $(11,238) $(15,695) >100%
Other expense, net in the year ended December 31, 2017 was driven2019 consisted primarily of interest expense of $35.0 million and loss on debt extinguishment of $11.8 million, partially offset by fiscal year 2016 costs associated with TriVascular executive changeincome from changes in control agreements,the fair values of derivative liabilities of $17.7 million and severance and retention bonuses resulting from the TriVascular merger.

Other income (expense), net


Year Ended December 31,





2017
2016
Variance
Percent Change


(in thousands)



Other income (expense), net
$(25,039)
$(59,105)
$34,066

(57.6)%
Nellix contingent consideration of $1.7 million. Other expense, fornet in the year ended December 31, 2017 consists2018 consisted mainly of interest expense of $22.1$27.7 million and loss on debt extinguishment of $6.5$2.3 million, favorable changepartially offset by income from changes in the fair valuevalues of derivative liabilities of $12.1 million and Nellix contingent consideration related to the Nellix acquisition of $2.9 million, and foreign currency gain of $0.7$7.1 million. Other expenses for the year ended December 31, 2016 included interest expense of $15.8 million, the change in fair value of derivative of $43.8 million, $2.1 million currency remeasurement loss and a non-cash benefit of $2.5 million related to the fair value of the Nellix contingent consideration.

Income Tax Expense (Benefit)

Provision for Income Taxes


Year Ended December 31,





2017
2016
Variance
Percent Change


(in thousands)



Income tax benefit (expense)
$459

$(498)
$957

>100%
  Year Ended December 31,    
(in thousands, except percentages) 2019 2018 Variance Percent Change
Income tax expense (benefit) $4,725
 $(284) $5,009
 >100%
Our income tax benefit was $0.5$4.7 million and our effective tax rate was (0.7)(6.8)forin the twelve monthsyear ended December 31, 20172019, due to our tax positions in various jurisdictions and the impact of the Tax Reform Act.intraperiod allocation exception. In 2019 we recognized $5.0 million income tax benefit as a result of our exchange of the 3.25% convertible notes for new 5.00% convertible notes in April 2019. The transaction resulted in an increase to the temporary difference between the carrying amount and the tax basis of the convertible notes. The increase in the taxable temporary difference resulted in the recognition of a $5 million deferred tax liability (net of debt converted to equity), which was recorded as an offset to additional paid-in-capital. Our income tax expense was $0.5$0.3 million and our effective tax rate was (0.3)% for0.4% in the twelve monthsyear ended December 31, 20162018 due to our tax positions in various jurisdictions. DuringIn the twelve monthsyears ended December 31, 20172019 and 2016,2018, we had operating legal entities operating in the United States, Canada, Italy, New Zealand, Singapore, Poland, Singapore,Germany, Switzerland, South Korea and the Netherlands, (includingas well as registered sales branches of the Company’s Dutch entity in certain countries in Europe).Europe.

Year Ended December 31, 20162018 versus December 31, 20152017
Revenue


Year Ended December 31,





2016
2015
Variance
Percent Change


(in thousands)



Revenue
$192,925

$153,612

$39,313

25.6%

US Sales. Net sales totaled $136.1 millionFor a comparison of our results of operations for the years ended December 31, 2018 and 2017, see “Part II, Item 7. Management’s Discussion and Analysis of Financial Conditions and Results of Operations” of our Annual Report on Form 10-K for the fiscal year ended December 31, 2016, a 27% increase from 107.2 million in the year ended December 31, 2015. This increase was driven by sales contributed from products acquired as part of the TriVascular merger offset by the impact of the AFX and AFX2 products hold in the quarter ended December 31, 2016.

International Sales. Net sales of products in our international regions totaled $56.8 million for the year ended December 31, 2016, a 22% increase from $46.4 million in the year ended December 31, 2015, primarily due to sales contributed from products acquired as part of the TriVascular merger. Our international sales for the year ended December 31, 2016 included the impact from the temporary AFX CE Mark suspension along2018, filed with the AFX and AFX2 products hold in the quarter ended December 31, 2016.SEC on April 1, 2019.

Net sales contributed from products acquired as part of the TriVascular merger totaled $40.0 million for the year ended December 31, 2016.

Cost of Goods Sold, Gross Profit, and Gross Margin Percentage


Year Ended December 31,





2016
2015
Variance
Percent Change


(in thousands)



Cost of goods sold
$69,133

$51,821

$17,312

33.4%
Gross profit
123,792

101,791

22,001

21.6%
Gross margin percentage (gross profit as a percent of revenue)
64.2%
66.3%
(2.1)%

Gross margin for the year ended December 31, 2016 decreased to 64.2% from 66.3% for the year ended December 31, 2015. The increase in cost of goods sold is largely due to the impact of purchase price accounting for inventory and intangible assets acquired in the TriVascular merger, as well as due to the increase in sales.



Operating Expenses


Year Ended December 31,





2016
2015
Variance
Percent Change


(in thousands)



Research and development
$32,337

$26,421

$5,916

22.4%
Clinical and regulatory affairs
16,215

15,418

797

5.2%
Marketing and sales
107,759

78,213

29,546

37.8%
General and administrative
41,044

29,581

11,463

38.8%
Restructuring costs
1,477
11,093


 11,093

100.0%
Settlement costs

4,650



4,650

100.0%
Contract termination and business acquisition expenses

5,768

5,071

697

13.7%
Research and development. The $5.9 million increase in research and development expenses was attributable to increased product development investments related to Ovation.
Clinical and regulatory affairs. The $0.8 million increase in clinical and regulatory affairs expenses is due to increased regulatory fees and costs to support ongoing clinical activities, such as LUCY, EVAS FORWARD IDE and LEOPARD.
Marketing and sales. The $29.5 million increase in marketing and sales expenses for the year ended December 31, 2016, as compared to the prior year period, was driven by the integration of the TriVascular sales and marketing organization.
General and administrative. The $11.5 million increase in general and administrative expenses is primarily attributable to an increase in headcount related to the TriVascular merger, higher professional fees and stock-based compensation.
Restructuring costs. The $11.1 million increase in restructuring costs for the year ended December 31, 2016 is comprised of costs associated with TriVascular executive change in control agreements, severance and retention bonuses as a result of the TriVascular merger.
Settlement costs. The $4.7 million in settlement costs for the year ended December 31, 2016 is a result of the LifePort settlement.
Contract termination and business acquisition expenses. The $0.7 million increase in contract termination and business acquisition expenses for the year ended December 31, 2016, was primarily related to termination of some of our international distributors as well as transaction related expenses associated with the TriVascular merger.

Other income (expense), net


Year Ended December 31,





2016
2015
Variance
Percent Change


(in thousands)



Other income (expense), net
$(59,105)
$(6,848)
(52,257)
>100%
Other expense for the year ended December 31, 2016 consists mainly of interest expense of $15.8 million, the change in fair value of derivative of $43.8 million, $2.1 million currency re-measurement loss and a non-cash benefit of $2.5 million related to the fair value of the Nellix contingent consideration. Other expense for the year ended December 31, 2015 includes interest expense associated with our convertible notes of $7.5 million, a non-cash expense of $0.1 million related to the fair value of the Nellix contingent consideration offset by $0.5 million currency re-measurement gain of certain assets and liabilities that were not transacted in the functional currency of the corresponding operating entity and $0.2 million of interest income.
Provision for Income Taxes


Year Ended December 31,





2016
2015
Variance
Percent Change


(in thousands)



Income tax benefit (expense)
$(498)
$9,337

$(9,835)
>100%
Our income tax expense was $0.5 million and our effective tax rate was (0.3)% for the twelve months ended December 31, 2016 due to our tax positions in various jurisdictions. Our income tax benefit of $9.3 million for the twelve


months ended December 31, 2015 was due to our recognition of a deferred tax liability of $9.6 million as a result of the temporary difference between the carrying value and the tax basis of the 3.25% Senior Notes. This liability which was recorded as an adjustment to the additional paid-in capital resulted in a reduction of our valuation allowance which was recorded as a benefit to income tax expense in 2015. During the twelve months ended December 31, 2016 and 2015, we had operating legal entities in the United States, Canada, Italy, New Zealand, Poland and the Netherlands (including registered sales branches in certain countries in Europe).
Liquidity and Capital Resources
The chart providedtable below summarizes selected liquidity data and metrics as of December 31, 2017, 2016,2019, 2018 and 2015:2017:

December 31, 2017
December 31, 2016
December 31, 2015

(in thousands, except financial metrics data)
Cash and cash equivalents$57,991

$26,120

$124,553
Marketable securities$

$20,988

$52,768
Accounts receivable, net$32,294

$34,430

$28,531
Total current assets$143,134

$129,845

$236,412
Total current liabilities$60,630

$44,902

$50,855
Working capital surplus (a)$82,504

$84,943

$185,557
Current ratio (b)2.4

2.9

4.6
Days sales outstanding (“DSO”) (c)68

67

67
Inventory turnover (d)1.4

2.0

1.8
 December 31,
(dollars in thousands)2019 2018 2017
Cash and cash equivalents$41,560
 $23,531
 $57,991
Accounts receivable, net$22,392
 $20,651
 $32,294
Total current assets$93,703
 $78,931
 $143,134
Total current liabilities$55,793
 $38,927
 $60,630
Working capital surplus$37,910
 $40,004
 $82,504
Current ratio1.7
 2.0
 2.4
Days sales outstanding58
 55
 68
Inventory turnover1.8
 1.7
 1.4
(a) total current assets minus total current liabilities as of the corresponding balance sheet date.
(b) total current assets divided by total current liabilities as of the corresponding balance sheet date.
(c) net accounts receivable at period end dividedby revenue for the fourth quarter multiplied by 92 days.
(d) cost of goods sold divided by the average inventory balance for the corresponding period.

Year Ended December 31, 20172019 versus December 31, 2016

2018
Operating Activities
Cash used in operating activities in the years ended December 31, 2019 and 2018 was $38.5$29.6 million forand $38.6 million, respectively. Cash used in operating activities in the year ended December 31, 2017, as compared to cash2019 consisted of a net loss of $64.8 million, non-cash expenses of $27.8 million and changes in operating assets and liabilities of $7.3 million. Cash used in operating activities of $74.8 million in the prior year period. For the twelve months ended December 31, 2017, the decrease in cash usage was primarily due to (i) the decreased2018 consisted of a net loss of $66.4$79.7 million, (ii) noncash stock-based compensationnon-cash expenses of $11.6$18.2 million (iii) non-cash accretion of interest on convertible note of $10.2 million, (iv) depreciation and amortization of $9.1 million, (v) a decreasechanges in accounts receivableoperating assets and other receivables of $4.8 million, (vi) an increase in accrued expenses and other current liabilities of $4.4 million, (vii) an increase in accrued expenses and other current liabilities of $4.4 million and (viii) non-cash loss on debt extinguishment of $4.0 million. These decreases in cash usage were partially offset by a decrease in accrued payroll of $5.2 million, an increase in inventory expenditures of $3.0 million, a decrease in accounts payable of $1.8 million, and a decrease in prepaid expenses and other current assets of $1.0$22.9 million.
DuringIn the twelve monthsyears ended December 31, 20172019 and 2016,2018, our cash collections from customers totaled $186.8$142.3 million and $193.9$168.9 million, respectively, representing 103%99% and 101%108%, respectively, of reported revenue for the same periods.

Investing Activities
Cash provided by investing activities for the twelve months ended December 31, 2017 was $19.8 million, as compared to the cash used in investing activities of $28.5 million in the prior period. For the twelve months ended December 31, 2017, cash provided by investing activities consisted of $21.0 million from the proceeds from maturities of marketable securities, offset by $1.2 million used for machinery and equipment purchases. Cash used in investing activities forin the twelve monthsyears ended December 31, 20162019 and 2018 was $28.5$0.5 million and $0.6 million, respectively. Cash used in investing activities in the years ended December 31, 2019 and 2018 primarily consisted of $60.6 million used for the acquisitionpurchases of TriVascular, $21.0 million used to purchase marketable securitiesproperty and $2.8 million used for machinery and equipment purchases. This is offset by proceeds from the maturities of marketable securities of $55.9 million. 




equipment.
Financing Activities
Cash provided by financing activities was $49.7 million forin the twelve monthsyears ended December 31, 2017, as compared to cash provided by financing activities of $5.32019 and 2018 was $48.1 million in the prior year period. For the twelve months ended December 31, 2017, cash provided by financing activities consisted of $120.0and $3.7 million, from the proceeds from issuance of debt, $3.1 million from the exercise of stock options and proceeds from sales of common stock under our employee stock purchase plan; offset by $66.6 million used to repay debt and $6.8 million used to pay deferred financing costs.respectively. Cash provided by financing activities for the twelve months ended December 31, 2016 consisted of proceeds of $6.3 million from the exercise of stock options and proceeds from sales of common stock under our employee stock purchase plan; offset by deferred financing costs of $0.9 million, and $0.1 million used to pay minimum tax withholdings on behalf of employees for restricted stock units vested during the period.

Year Ended December 31, 2016 versus December 31, 2015

Operating Activities
Cash used in operating activities was $74.8 million for the year ended December 31, 2016, as compared to cash used in operating activities of $31.1 million in the prior year period. The increase in cash usage was2019 primarily due to (i) the increased net loss of $154.7 million, (ii) an increase in accounts receivable and other receivables of $2.9 million and (iii) a decrease in accounts payable of $5.2 million. These increases in cash usage were partially offset by non-cash stock-based compensation of $12.3 million, depreciation and amortization of $9.1 million, an increase in accrued payroll of $7.1 million, a decrease in inventory expenditures of $3.5 million, an increase in accrued expenses and other current liabilities of $2.9 million, non-cash accretion of interest on convertible note of $9.5 million, and change in fair value of derivative non-cash of $43.8 million.
During the twelve months ended December 31, 2016 and 2015, our cash collections from customers totaled $193.9 million and $152.7 million, respectively, representing 101% and 99% of reported revenue for the same periods.

Investing Activities
Cash used in investing activities for the twelve months ended December 31, 2016 was $28.5 million, as compared the cash provided by inventing activities of $2.9 million in the prior period. For the twelve months ended December 31, 2016, cash used in investing activities consisted of $60.6 million used for the acquisition of TriVascular, $21.0 million used to purchase marketable securities and $2.8 million used for machinery and equipment purchases. This is offset by proceeds from the maturities of marketable securities of $55.9 million. Cash provided by investing activities for the twelve months ended December 31, 2015 was $2.9 million and consisted of proceeds from maturityour common stock offering and prepaid warrants, net of marketable securitiesexpenses paid of $89.7 million. This is offset by (i) purchases of marketable securities of $82.6$52.0 million, and (ii) machinery and equipment purchases for $4.2 million.

Financing Activities
Cash provided by financing activities was $5.3$0.3 million for the twelve months ended December 31, 2016, as compared to cash provided by financing activities of $126.7 million in the prior year period. For the twelve months ended December 31, 2016, cash provided by financing activities consisted of $6.3 millionproceeds from the exercise of stock options and proceeds from sales of common stock under our employee stock purchase plan, partially offset by $0.9$4.0 million cash used to payin deferred financing costs and $0.1$0.2 million cash used to pay minimum tax withholdingswithholding on behalf of employees for restricted stock units that vested during the period.  Cash provided by financing activities for twelve monthsin the year ended December 31, 20152018 primarily consisted of (i) proceeds of $5.8$20.0 million from our common stock offering, $1.8 million from the sale of at-the-market shares and $2.2 million of proceeds from exercise of stock options and proceeds from salessale of common stock under our employee stock purchase plan; and (ii) net proceeds from issuance of convertible debt of $121.4 million,plan, partially offset by $0.5a $18.3 million used to pay minimum tax withholdingsrepayment of debt and $1.3 million cash paid for debt extinguishment. 
For comparison of our cash flow activities for the years ended December 31, 2018 versus December 31, 2017, see “Part II, item 7. Management’s Discussion and Analysis of Financial Conditions and Results of Operations” of our Annual Report on behalf of employeesForm 10-K for restricted stock units vested during the period.year ended December 31, 2018, filed with the SEC on April 1, 2019.

Credit Arrangements
See Note 6 of the Notes to theour Consolidated Financial Statements.Statements included in Item 8 of this Annual Report on Form 10-K for information on our credit arrangements. As of December 31, 2017, the Company was not2019, we were in compliance with the required minimum net revenue thresholdfinancial covenants set forth in the Credit Agreement. On January 5, 2018, the Company delivered a notice of termination to Deerfield for the Deerfield Revolver under the Credit and Security Agreement (the “Credit Agreement”), dated as of April 3, 2017. The termination of the Deerfield Revolver was effective on January 12, 2018 (the “Termination Date”) and required the Company to pay $1.3 million in termination fees.





our credit agreements.
Future Capital Requirements
We believe that the future growth of our business will depend upon our ability to successfully develop new technologies for the treatment of aortic disorders and successfully bring these technologies to market. We expect to incur significant expenditures in completing product development and clinical trials for our products. In addition, as a result of the completion of the merger with TriVascular, our future capital requirements are expected to increase.
The timing and amount of our future capital requirements will depend on many factors, including:
the need for working capital to support our sales growth;
the need for additional capital to fund future development programs;
the need for additional capital to fund our sales force expansion;
the need for additional capital to fund strategic acquisitions;
our requirements for additional facility space or manufacturing capacity;
our requirements for additional information technology infrastructure and systems; and
adverse outcomes from potential litigation and the cost to defend such litigation.
 
We believe that our world-wideworldwide cash resources are adequate to operate our business. We presently have several operating subsidiaries outside of the United StatesStates. As of December 31, 2017,2019, these subsidiaries holdheld an aggregate $7.3$5.2 million in foreign bank accounts to fund their local operations. These balances related to undistributed earnings, are deemed by management to be permanently reinvested in the corresponding countrycountries in which our subsidiary operates.subsidiaries operate. Management has no present or


planned intention to repatriate foreign earnings into the United States However,States; however, in the event that we require additional funds in the United States and may have to repatriate any foreign earnings to meet those needs, we would then need to accrue, and ultimately pay, incremental income tax expenses on such “deemed dividend,dividends,” unless we then have sufficient net operating losses to offset this potential tax liability.
If we require additional financing in the future, it may not be available on commercially reasonable terms, or at all. Even if we are able to obtain financing, it may cause substantial dilution (in the case of an equity financing), or may contain burdensome restrictions on the operation of our business (in the case of debt financing). If we are not able to obtain required financing, we may need to curtail our operations and/or our planned product development.
Contractual Obligations
Contractual obligation payments by year with initial terms in excess of one1 year were as follows as of December 31, 2017 (in thousands):2019:
Payments due by period   Payments due by period
Contractual ObligationsTotal201820192020202120222023 and thereafter
(in thousands)Total 2020 2021 2022 2023 2024 Thereafter
Long-term debt obligations$263,278$18,278$—$125,000$40,000$281,834
 $11,245 $22,399 $82,857 $103,314 $62,019 $
Interest on debt obligations50,24212,83212,42112,4556,9624,1751,39740,432
 12,260
 11,726
 9,441
 5,429
 1,576
 
Operating lease obligations36,2653,4503,5673,7353,6923,80018,02130,031
 3,831
 3,943
 3,994
 3,016
 2,909
 12,338
Purchase commitments1,676
 838
 838
 
 
 
 
Total$349,785$34,560$15,988$141,190$50,654$47,975$59,418$353,973
 $28,174
 $38,906
 $96,292
 $111,759
 $66,504
 $12,338
Refer toLong-term debt obligations include interest payable in kind on our term loan facility, a $11.1 million exit fee under our credit facility agreement with affiliates of Deerfield. Interest on debt obligations includes interest on the 5% convertible notes, which shall be paid, at the Company's option, either in cash or, if certain terms are met in accordance with the 5% convertible notes indentures, shares of common stock or paid in kind. See Note 6 of the Notes to the Consolidated Financial Statements for a discussion of long-term debt obligations and Note 88(a) of the Notes to the Consolidated Financial Statements for a discussion of operating lease obligations.

Off-Balance Sheet Arrangements
WeOther than the operating leases described above, we do not have noany off-balance sheet arrangements (except for operating leases) that provide financing, liquidity, market or credit risk support, or involve derivatives. In addition, we have no arrangements that may expose us to liability that are not expressly reflected in the accompanying Consolidated Financial Statements.
Asas of December 31, 2017, we did not have any relationships with unconsolidated entities or financial partnerships, often referred to as “structured finance” or “special purpose entities,” established for the purpose of facilitating off-balance sheet arrangements or other contractually narrow or limited purposes. As such, we are not subject to any material financing, liquidity, market or credit risk that could arise if we had engaged in such relationships.2019.



Item 7A.Quantitative and Qualitative Disclosures About Market Risk
Item 7A.Quantitative and Qualitative Disclosures About Market Risk
We do not believe that we currently have material exposure to interest rate or foreign currency transaction risks.
Interest Rate Risk and Market Risk.rate risk. We do not use derivative financial instruments in our investment portfolio. We are averse to principal loss and try to ensure the safety and preservation of our invested funds by limiting default risk, market risk, and reinvestment risk. We attempt to mitigate default risk by investing in only high credit quality securities and by positioning our portfolio to appropriately respond to a significant reduction in the credit rating of any investment issuer or guarantor.
We were exposed to market risk for changes in interest rates on the MidCap Credit Facility. All outstanding amounts under the MidCap Credit Facility bore interest at a variable rate equalapplicable to LIBOR, plus 4.10%. On April 3, 2017, we replaced the MidCap Credit Facilityour credit facility with a new revolving line of credit with Deerfield ELGX Revolver, LLC (“Deerfield Revolver”), pursuant to which the Company may borrow up to the lesser of $50 million or its applicable borrowing base from time to time prior to March 31, 2020 (the “Revolver”) and paid $2.5 million in termination fees to MidCap. AllDeerfield. Any outstanding principal under the Revolver borecredit facility will accrue interest at a rate equal to 3-month LIBORthe London Interbank Offered Rate (LIBOR) (with a 1% floor) plus 4.60%. On January 5, 2018, the Company delivered5.50%, payable in cash. The interest rate will accrue on a noticeminimum amount of termination to Deerfield, for the Deerfield Revolver under the Credit and Security Agreement (the “Credit Agreement”), dated as$9.75 million, whether or not such amount is drawn. As of April 3, 2017. The termination of the Credit Agreement was effective on January 12, 2018 (the “Termination Date”) following payment by the Company of approximately $1.3 million in termination fees and related fees and expenses. The Company decided to terminate the Credit Agreement after it determined that it had failed to satisfy the required minimum net revenue threshold set forth in the Credit Agreement for the twelve months ended December 31, 2017. There are2019, we had no borrowings currentlyamounts outstanding under the Credit Agreement.our credit facility.

Our 3.25% Senior Notes, 2.25% Senior NotesThe remainder of our debt, which is comprised of a term loan facility, convertible senior notes and Term Loan bearother note payable, bears fixed interest rates, and, therefore, would not be subject to interest rate risk. The capped call transactions are derivative instruments that qualify for classification within stockholders’ equity because they meet an exemption from mark-to-market derivative accounting. The settlement amounts for the capped call transactions are each determined based upon the difference betweenFor a strike price and a traded pricecomplete summary of our common stock.debt, see Note 6 to our Consolidated Financial Statements included in Item 8 of this Annual Report on Form 10-K.

Foreign Currency Transaction Risk.currency transaction risk. While a majority of our business is denominated in the United States dollar, a portion of our revenuesrevenue and expenses are denominated in foreign currencies. Fluctuations in the rate of exchange between the United States dollar and the Euro or the British Pound Sterling may affect our results of operations and the period-to-period comparisons of our operating results. Foreign currency transaction gains and losses are caused by transactions denominated in a currency other than theour or our respective subsidiaries’ functional currency and must be remeasured at each balance sheet date or upon settlement. ForeignRealized and unrealized foreign currency transaction realized and unrealizedexchange gains and losses resulted in approximately $0.7$0.3 million of gaingains in 2017,the year ended December 31, 2019, primarily related to intercompany payables and receivables associated with our European operations. We expect to continue to limit our exposure through future settlements.


Item 8.         Financial Statements and Selected Supplementary Data
Item 8.Financial Statements and Selected Supplementary Data

ENDOLOGIX, INC.
FORM 10-K ANNUAL REPORT
For the Fiscal Year Ended December 31, 20172019

INDEX TO CONSOLIDATED FINANCIAL STATEMENTS

Item Page
 
 
 
 
 
 
 
 

All other schedules are omitted because the required information is not applicable or the information is presented in the Consolidated Financial Statements or the related notes thereto.


Report of Independent Registered Public Accounting Firm
To the Stockholders and Board of Directors
Endologix, Inc.:
Opinion on the Consolidated Financial Statements
We have audited the accompanying consolidated balance sheets of Endologix, Inc. and subsidiaries (the “Company”) as of December 31, 20172019 and 2016,2018, the related consolidated statements of operations and comprehensive loss, stockholders’ equity, and cash flows for each of the years in the three‑year period ended December 31, 2017,2019, and the related notes and financial statement schedule of valuation and qualifying accounts (collectively, the “consolidated financial statements”). In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 20172019 and 2016,2018, and the results of its operations and its cash flows for each of the years in the three‑year period ended December 31, 2017,2019, in conformity with U.S. generally accepted accounting principles.
We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (“PCAOB”), the Company’s internal control over financial reporting as of December 31, 2017,2019, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission, and our report dated March 13, 201811, 2020 expressed an unqualified opinion on the effectiveness of the Company’s internal control over financial reporting.
Change in Accounting Principle
As discussed in Note 2 to the consolidated financial statements, the Company has changed its method of accounting for leases due to the adoption of Accounting Standards Codification (ASC) Topic 842, Leases in the first quarter of 2019.
Basis for Opinion
These consolidated financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on these consolidated financial statements based on our audits. We are a public accounting firm registered with the PCAOB and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.
We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud. Our audits included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. We believe that our audits provide a reasonable basis for our opinion.

/s/ KPMG LLP
We have served as the Company’s auditor since 2012.
Irvine, California
March 13, 201811, 2020




Report of Independent Registered Public Accounting Firm
To the Stockholders and Board of Directors
Endologix, Inc.:
Opinion on Internal Control Over Financial Reporting
We have audited Endologix, Inc. and subsidiaries’ (the “Company”) internal control over financial reporting as of December 31, 2017,2019, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission. In our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2017,2019, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission.
We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (“PCAOB”), the consolidated balance sheets of the Company as of December 31, 20172019 and 2016,2018, the related consolidated statements of operations and comprehensive loss, stockholders’ equity, and cash flows for each of the years in the three-year period ended December 31, 2017,2019, and the related notes and financial statement schedule of valuation and qualifying accounts (collectively, the “consolidated financial statements”), and our report dated March 13, 201811, 2020 expressed an unqualified opinion on those consolidated financial statements.
Basis for Opinion
The Company’s management is responsible for maintaining effective internal control over financial reporting and for its assessment of the effectiveness of internal control over financial reporting, included in the accompanying Management’s Report on Internal Control over Financial Reporting appearing under Item 9A. Our responsibility is to express an opinion on the Company’s internal control over financial reporting based on our audit. We are a public accounting firm registered with the PCAOB and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.
We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether effective internal control over financial reporting was maintained in all material respects. Our audit of internal control over financial reporting included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audit also included performing such other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion.
Definition and Limitations of Internal Control Over Financial Reporting
A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal control over financial reporting includes those policies and procedures that (1) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and (3) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements.
Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.

/s/ KPMG LLP

March 13, 201811, 2020
Irvine, California


ENDOLOGIX, INC.
CONSOLIDATED BALANCE SHEETS
(In thousands, except share and par value amounts)


December 31, December 31,


2017
2016 2019 2018
ASSETS



    
Current assets:



    
Cash and cash equivalents
$57,991

$26,120
 $41,560
 $23,531
Restricted cash
2,608

2,001
 1,200
 1,200
Marketable securities


20,988
Accounts receivable, net of allowance for doubtful accounts of $470 and $1,037, respectively
32,294

34,430
Accounts receivable, net of allowance for doubtful accounts of $1,317 and $802, respectively 22,392
 20,651
Other receivables
418

1,787
 282
 329
Inventories
45,153

41,160
 26,405
 30,399
Prepaid expenses and other current assets
4,670

3,359
 1,864
 2,821
Total current assets
$143,134

$129,845
 93,703
 78,931
Property and equipment, net
19,212

23,265
 13,152
 16,033
Goodwill
120,927

120,711
 120,814
 120,848
Intangibles, net
80,403

84,511
Other intangible assets, net 72,603
 76,163
Deposits and other assets
1,371

1,352
 1,124
 1,095
Operating lease right-of-use assets 5,768
 
Total assets
$365,047

$359,684
 $307,164
 $293,070





LIABILITIES AND STOCKHOLDERS’ EQUITY



    
Current liabilities:





    
Accounts payable
$12,351

$13,237
 $14,024
 $10,986
Accrued payroll
15,054

19,997
 18,232
 14,627
Accrued expenses and other current liabilities
16,002

11,668
 12,931
 13,314
Current portion of debt
17,202


 10,606
 
Revolving line of credit
21


Total current liabilities
$60,630

$44,902
 55,793
 38,927
Deferred income taxes
201

879
 150
 150
Deferred rent
7,724

7,949
 
 8,065
Operating lease liabilities 11,621
 
Derivative liabilities 940
 4,012
Other liabilities
3,877

3,783
 2,244
 1,992
Contingently issuable common stock
9,300

12,200
 500
 2,200
Debt
208,253

177,178
 172,060
 198,078
Total liabilities
$289,985

$246,891
 243,308
 253,424
Commitments and contingencies





 

 

Stockholders’ equity:





    
Convertible preferred stock, $0.001 par value; 5,000,000 shares authorized. No shares issued and outstanding.



Common stock, $0.001 par value; 135,000,000 shares authorized. 83,855,824 and 82,986,244 shares issued, respectively. 83,643,585 and 82,774,005 shares outstanding, respectively.
84

83
Convertible preferred stock, $0.001 par value, 5,000,000 shares authorized, no shares issued and outstanding 
 
Common stock, $0.001 par value, 170,000,000 shares authorized, 18,190,054 and 10,387,926 shares issued, respectively, 18,098,464 and 10,345,367 shares outstanding, respectively 18
 10
Treasury stock, at cost, 91,590 and 42,559 shares, respectively (4,235) (4,026)
Additional paid-in capital
594,586

567,765
 730,729
 640,789
Accumulated deficit
(520,001)
(453,601) (664,472) (599,715)
Treasury stock, at cost, 212,239 and 212,239 shares, respectively.
(2,942)
(2,942)
Accumulated other comprehensive income
3,335

1,488
 1,816
 2,588
Total stockholders’ equity
$75,062

$112,793
 63,856
 39,646
Total liabilities and stockholders’ equity
$365,047

$359,684
 $307,164
 $293,070
See accompanying notes to these consolidated financial statements.


ENDOLOGIX, INC.
Consolidated Statements of Operations and Comprehensive LossCONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS
(In thousands, except per share amounts)


Year Ended December 31,Year Ended December 31,
2017
2016
20152019
2018
2017
Revenue$181,157

$192,925

$153,612
$143,370
 $156,473
 $181,157
Cost of goods sold
59,828

69,133

51,821
52,284
 64,550
 59,828
Gross profit121,329

123,792

101,791
91,086
 91,923
 121,329
Operating expenses:






 
 
Research and development21,019

32,337

26,421
18,104
 20,793
 21,019
Clinical and regulatory affairs12,952

16,215

15,418
14,036
 13,851
 12,952
Marketing and sales92,400

107,759

78,213
64,673
 76,855
 92,400
General and administrative35,301

41,044

29,581
35,984
 43,477
 35,301
Restructuring costs
1,477

11,093


838
 3,270
 1,477
Settlement costs


4,650


Contract termination and business acquisition expenses


5,768

5,071
Contract termination, product withdrawal and business acquisition expenses
 1,869
 
Total operating expenses
163,149

218,866

154,704
133,635
 160,115
 163,149
Loss from operations(41,820)
(95,074)
(52,913)(42,549) (68,192) (41,820)
Other income (expense):






 
 
Interest income83

228

175
6
 10
 83
Interest expense(22,064)
(15,841)
(7,476)(34,973) (27,658) (22,064)
Other income (expense), net554

(2,161)
553
Change in fair value of contingent consideration related to acquisition
2,900

2,500

(100)1,700
 7,100
 2,900
Loss on extinguishment of debt(6,512)




Loss on debt extinguishment(11,756) (2,270) (6,512)
Change in fair value of derivative liabilities


(43,831)

17,713
 12,097
 
Total other income (expense)
(25,039)
(59,105)
(6,848)
Net loss before income tax benefit
(66,859)
(154,179)
(59,761)
Income tax benefit (expense)459

(498)
9,337
Other (expense) income, net377
 (517) 554
Total other expense, net(26,933) (11,238) (25,039)
Net loss before income taxes(69,482) (79,430) (66,859)
Income tax (expense) benefit4,725
 (284) 459
Net loss$(66,400)
$(154,677)
$(50,424)$(64,757) $(79,714) $(66,400)
Other comprehensive income (loss) foreign currency translation1,847

978

(1,762)
     
Comprehensive loss, net of taxes:     
Net loss$(64,757) $(79,714) $(66,400)
Other comprehensive (loss) income on foreign currency translation(772) (747) 1,847
Comprehensive loss$(64,553)
$(153,699)
$(52,186)$(65,529) $(80,461) $(64,553)











 

 

Basic and diluted net loss per share$(0.80)
$(1.91)
$(0.75)$(3.84) $(9.07) $(7.97)
Shares used in computing basic and diluted loss per share83,325

80,976

67,671
16,850
 8,790
 8,333
See accompanying notes to these consolidated financial statements.


ENDOLOGIX, INC.
CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY
(In thousands)
 Common Stock
Additional
Paid-In
Capital

Accumulated
Deficit

Treasury
Stock

Accumulated Other Comprehensive Income (Loss)
Total Stockholders’
Equity
 Common Stock Additional
Paid-In
Capital
 Accumulated
Deficit
 Treasury
Stock
 Accumulated Other Comprehensive Income (Loss) Total Stockholders’
Equity
Issued Shares
$0.001 Par Value
Issued Shares Par Value 
Balance at December 31, 201467,322

$67

$372,639

$(248,500)
$(2,328)
$2,272

$124,150
Exercise of common stock options397

1

2,870







2,871
Employee stock purchase plan355



2,962







2,962
Treasury stock purchased







(481)


(481)
Stock compensation expense



6,266







6,266
Issuance of restricted stock161












Restricted stock expense



2,843







2,843
Non-employee restricted stock expense



146







146
Equity conversion option



17,547







17,547
Debt issuance costs allocated to equity



(811)






(811)
Net loss





(50,424)




(50,424)
Other comprehensive loss









(1,762)
(1,762)
Balance at December 31, 201568,235

68

404,462

(298,924)
(2,809)
510

103,307
Exercise of common stock options524

2

3,127







3,129
Employee stock purchase plan394



3,216







3,216
Issuance of common stock13,587

13

100,799







100,812
Treasury stock purchased11







(133)


(133)
Stock compensation expense



8,541







8,541
Issuance of restricted stock235












Restricted stock expense



3,715







3,715
Non-employee restricted stock expense



30







30
Equity conversion option



43,875







43,875
Net loss





(154,677)




(154,677)
Other comprehensive income









978

978
Balance at December 31, 201682,986

83

567,765

(453,601)
(2,942)
1,488

112,793
8,299
 $8
 $567,840
 $(453,601) $(2,942) $1,488
 $112,793
Exercise of common stock options129



546







546
13
 
 546
 
 
 
 546
Employee stock purchase plan446

1

2,518







2,519
45
 
 2,519
 
 
 
 2,519
Stock compensation expense



8,538







8,538
Stock-based compensation expense
 
 8,538
 
 
 
 8,538
Issuance of restricted stock294












29
 
 
 
 
 
 
Restricted stock expense



3,027







3,027

 
 3,106
 
 
 
 3,106
Non-employee restricted stock expense



79







79
Equity conversion option



(2,235)






(2,235)
 
 (2,235) 
 
 
 (2,235)
Deerfield warrants



14,704







14,704

 
 14,704
 
 
 
 14,704
Debt issuance costs allocated to equity



(356)






(356)
 
 (356) 
 
 
 (356)
Net loss





(66,400)




(66,400)
 
 
 (66,400) 
 
 (66,400)
Other comprehensive income
 
 
 
 
 1,847
 1,847
Balance at December 31, 20178,386
 8
 594,662
 (520,001) (2,942) 3,335
 75,062
Exercise of common stock options, net of shares withheld to cover exercise price44
 
 1,586
 
 
 
 1,586
Employee stock purchase plan61
 
 1,346
 
 
 
 1,346
Issuance of common stock1,841
 2
 21,827
 
 
 
 21,829
Treasury stock purchased21
 
 
 
 (1,084) 
 (1,084)
Stock-based compensation expense
 
 8,404
 
 
 
 8,404
Issuance of restricted stock35
 
 
 
 
 
 
Restricted stock expense
 
 2,626
 
 
 
 2,626
Deerfield warrants
 
 10,396
 
 
 
 10,396
Debt issuance costs allocated to equity
 
 (58) 
 
 
 (58)
Net loss
 
 
 (79,714) 
 
 (79,714)
Other comprehensive income
 
 
 
 
 (747) (747)
Balance at December 31, 201810,388
 $10
 $640,789
 $(599,715) $(4,026) $2,588
 $39,646
Employee stock purchase plan107
 
 344
 
 
 
 344
Issuance of common stock6,422
 6
 42,279
 
 
 
 42,285
Treasury stock purchased49
 
 
 
 (209) 
 (209)
Stock-based compensation expense
 
 5,986
 
 
 
 5,986
Issuance of restricted stock206
 1
 
 
 
 
 1
Restricted stock expense
 
 4,862
 
 
 
 4,862
Equity conversion option
 
 19,321
 
 
 
 19,321
Deerfield warrants
 
 4,854
 
 
 
 4,854
Prepaid warrants
 
 9,700
 
 
 
 9,700
Debt issuance costs allocated to equity
 
 (762) 
 
 
 (762)
Shares issued upon conversion of debt1,018
 1
 3,356
 
 
 
 3,357
Net loss
 
 
 (64,757) 
 
 (64,757)
Other comprehensive loss









1,847

1,847

 
 
 
 
 (772) (772)
Balance at December 31, 201783,855

$84

$594,586

$(520,001)
$(2,942)
$3,335

$75,062
Balance at December 31, 201918,190
 $18
 $730,729
 $(664,472) $(4,235) $1,816
 $63,856
See accompanying notes to these consolidated financial statements.


ENDOLOGIX, INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS
(In thousands)
Year Ended December 31,Year Ended December 31,
2017 2016 20152019 2018 2017
Cash flows from operating activities:




     
Net loss$(66,400)
$(154,677)
$(50,424)$(64,757) $(79,714) $(66,400)
Adjustments to reconcile net loss to net cash used in operating activities:




     
Deferred income taxes(696)


(9,635)(4,950) (57) (696)
Bad debt expense(235)
916

107
534
 552
 (235)
Depreciation and amortization9,111

9,149

5,886
6,890
 7,982
 9,111
Stock-based compensation11,644

12,286

9,255
10,849
 11,030
 11,644
Change in fair value of derivative liabilities


43,831


(17,713) (12,097) 
Change in fair value of contingent consideration related to acquisition(2,900)
(2,500)
100
(1,700) (7,100) (2,900)
Accretion of interest & amortization of deferred financing costs on convertible notes10,165

9,539

4,842
Accretion on marketable securities
 (87) 59
Non-cash loss on debt extinguishment3,997




Accretion of interest and amortization of deferred financing costs14,264
 11,801
 10,165
Payable in kind interest expense on term loan facility7,978
 3,084
 
Loss on debt extinguishment11,756
 2,270
 6,512
Loss on disposal of assets

123

58

 64
 
Non-cash foreign exchange (gain) loss(678)
2,112

(504)
Non-cash foreign exchange loss (gain)(330) 711
 (678)
Non-cash lease expense260
 
 
Changes in operating assets and liabilities:




     
Restricted cash(607)
(2,001)

Accounts receivable and other receivables4,771

(2,911)
(3,193)(2,180) 10,913
 4,771
Inventories(3,035)
3,540

3,528
3,623
 13,805
 (3,035)
Prepaid expenses and other current assets(1,034)
1,070

167
1,121
 1,693
 (1,034)
Accounts payable(1,826)
(5,152)
8,342
3,107
 (1,350) (1,826)
Accrued payroll(5,176)
7,079

(75)3,624
 (350) (5,176)
Accrued expenses and other current liabilities4,374

2,875

395
Accrued expenses and other liabilities(1,946) (1,850) 4,374
Net cash used in operating activities$(38,525)
$(74,808)
$(31,092)(29,570) (38,613) (35,403)
Cash flows from investing activities:




     
Purchases of marketable securities

(20,976)
(82,646)
Maturity on marketable securities21,000

55,850

89,690
Maturities of marketable securities
 
 21,000
Purchases of property and equipment(1,170)
(2,796)
(4,191)(455) (602) (1,170)
Acquisition of business, net of cash acquired of $24,012

(60,622)

Net cash provided by (used in) investing activities$19,830

$(28,544)
$2,853
Net cash (used in) provided by investing activities(455) (602) 19,830
Cash flows from financing activities:





 
 
Net proceeds from revolving line of credit21




Cash paid for debt extinguishment
 (1,310) (2,515)
Net (payments) proceeds from revolving line of credit
 (21) 21
Deferred financing costs(6,755)
(918)
(3,617)(3,977) (391) (6,755)
Proceeds from sale of common stock under employee stock purchase plan2,519

3,216

2,962
346
 1,346
 2,519
Proceeds from common stock offering and pre-paid warrants, net of expenses paid51,985
 20,000
 
Proceeds from the sale of at-the-market shares
 1,829
 
Proceeds from exercise of stock options546

3,129

2,871

 892
 546
Proceeds from issuance of debt120,000



125,000

 
 120,000
Repayment of debt(66,613)




 (18,278) (66,613)
Minimum tax withholding paid on behalf of employees for restricted stock units

(133)
(481)
Minimum tax withholding paid on behalf of employees for stock-based compensation(209) (390) 
Net cash provided by financing activities$49,718

$5,294

$126,735
48,145
 3,677
 47,203
Effect of exchange rate changes on cash and cash equivalents848

(375)
(741)
Net increase (decrease) in cash and cash equivalents31,871

(98,433)
97,755
Cash and cash equivalents, beginning of year26,120

124,553

26,798
Cash and cash equivalents, end of year$57,991

$26,120

$124,553
Supplemental disclosure of cash flow information:




Cash paid for interest$9,836

$6,262

$1,957
Cash paid for income taxes681

208

124
Non-cash investing and financing activities:




Landlord funded leasehold improvements$

$

$46
Fair value of warrants issued for business acquisition

44


Fair value of common stock issued for business acquisition

100,812


Acquisition of property and equipment included in accounts payable



155
Fair value of warrants issued in connection with the Facility Agreement14,704




Effect of exchange rate changes on cash, cash equivalents and restricted cash(91) (330) 848
Net (decrease) increase in cash, cash equivalents and restricted cash18,029
 (35,868) 32,478
Cash, cash equivalents and restricted cash, beginning of year24,731
 60,599
 28,121
Cash, cash equivalents and restricted cash, end of year$42,760
 $24,731
 $60,599
Reconciliation of cash, cash equivalents and restricted cash to the Consolidated Balance Sheets:     
Cash and cash equivalents$41,560
 $23,531
 $57,991
Restricted cash1,200
 1,200
 2,608
Total cash, cash equivalents and restricted cash$42,760
 $24,731
 $60,599
See accompanying notes to these consolidated financial statements.


ENDOLOGIX, INC.
CONSOLIDATED STATEMENTS OF CASH FLOWS (CONTINUED)
(In thousands)
 Year Ended December 31,
 2019 2018 2017
Supplemental disclosure of cash flow information:     
       Cash paid for interest$10,321
 $12,499
 $9,836
       Cash paid for income taxes156
 272
 681
       Cash paid for amounts included in the measurement of operating lease liabilities3,402
 
 
Non-cash investing and financing activities:     
       Acquisition of property and equipment included in accounts payable102
 53
 
Fair value of embedded derivative issued in connection with loan agreements (Note 6)20,447
 15,655
 
Conversion of debt to equity3,289
 
 
       Fair value of warrants issued in connection with loan agreements (Note 6)
 10,396
 14,704
Conversion of refund to note payable (Note 6)
 4,281
 
See accompanying notes to these consolidated financial statements.




ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

1. Description of Business, Basis of Presentation, and Operating Segment
(a)Description of Business
Endologix®, Inc. (the “Company”) is a Delaware corporation with corporate headquarters located in Irvine, California and production facilities located in Irvine, California and Santa Rosa, California. The Company develops, manufactures, markets and sells innovative medical devices for the treatment of aortic disorders. The Company’s products are intended for the minimally-invasive endovascular treatment of abdominal aortic aneurysms (“AAA”). The Company’s AAA products are built on one of two platforms: (1)(i) traditional minimally-invasive endovascular aneurysm repair (“EVAR”) and (2); or (ii) endovascular aneurysm sealing (“EVAS”), the Company’s innovative solution for sealing the aneurysm sac while maintaining blood flow through two blood flow lumens.flow. The Company’s current EVAR products include the Ovation®AFX® Endovascular AAA System, the VELA® Proximal Endograft and the Ovation® Abdominal Stent Graft System (“Ovation”), Endologix AFX Endovascular AAA System (“AFX”), the VELA™ Proximal Endograft System (“VELA”) and the Endologix IntuiTrak Endovascular AAA System (“IntuiTrak”).System. The Company’s current EVAS product is the Nellix® Endovascular Aneurysm Sealing System (“Nellix(the “Nellix EVAS System”). SalesThe Company derives all of the Company’sits reported revenue from sales of its EVAR and EVAS platformsproducts (including extensions and accessories) to hospitals in the United States and Europe, and to third-party international distributors, provide the sole source of the Company’s reported revenue.

third party distributors.
(b) Basis of Presentation
The accompanying Consolidated Financial Statementsconsolidated financial statements in this Annual Report on Form 10-K have been prepared in accordance with generally accepted accounting principles in the United States of America (“GAAP”) and with the rules and regulations of the United States Securities and Exchange Commission (“SEC”). These financial statements include the financial position, results of operations and cash flows of the Company, including its subsidiaries, all of which are wholly-owned. All inter-company accounts and transactions have been eliminated in consolidation. For the years ended December 31, 2017, 2016,2019, 2018 and 20152017, there were no related party transactions.

In August 2014, the Financial Accounting Standards Board (“FASB”) issued ASU 2014-15, “Disclosure of Uncertainties About an Entity's Ability to Continue as a Going Concern.” ASU 2014-15 explicitly requires management to assess an entity's ability to continue as a going concern, and to provide related footnote disclosure in certain circumstances. ASU 2014-15 is intended to define management’s responsibility to evaluate whether there is substantial doubt about an entity’s ability to continue as a going concern and to provide related footnote disclosures. The new standard is effective for all entities in the first annual period ending after December 15, 2016 and for annual periods and interim periods thereafter. We have adopted the guidance for the year ended December 31, 2016. The adoption of ASU 2014-15 did not impact our disclosures.

In April 2015, the FASB issued ASU No. 2015-03, "Simplifying the Presentation of Debt Issuance Costs", which requires debt issuance costs related to a recognized debt liability to be presented on the balance sheet as a direct deduction from the debt liability, similar to the presentation of debt discounts. The ASU was effective for the Company on January 1, 2016. The Company adopted ASU 2015-03, "Simplifying the Presentation of Debt Issuance Costs" during the first quarter of 2016, utilizing retrospective application as permitted. As a result, the Company reclassified debt issuance costs from other assets to reduce the convertible notes as of December 31, 2015 and 2016. In conjunction with the Company’s adoption of ASU 2015-03, the Company also adopted an update thereof or ASU 2015-15 “Presentation and Subsequent Measurement of Debt Issuance Costs Associated with Line-of Credit Arrangements.” As a result, the Company classified debt issuance costs related to a line-of-credit arrangement as other assets.

In September 2015, the FASB issued ASU No. 2015-16, “Business Combinations (Topic 805): Simplifying the Accounting for Measurement-Period Adjustments,” which requires that an acquirer recognize adjustments to provisional amounts that are identified during the measurement period in the reporting period in which the adjustment amounts are determined. The new guidance also requires that the acquirer record, in the same period's financial statements, the effect on earnings of changes in depreciation, amortization, or other income effects, if any, as a result of the change to the provisional amounts, calculated as if the accounting had been completed at the acquisition date. The guidance is effective for fiscal years beginning after December 15, 2015, including interim periods within those fiscal years. The Company adopted this standard and has applied it to amounts related to the TriVascular acquisition.    

In July 2015, the FASB issued ASU No. 2015-11, “Simplifying the Measurement of Inventory,” which requires an entity to measure inventory within the scope of the amendment at the lower of cost and net realizable value. Net realizable value is the estimated selling price in the ordinary course of business, less reasonably predictable costs of completion, disposal, and

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except per share, per unit, and number of years)

transportation. We adopted this new accounting standard prospectively in the first quarter of 2017. This new accounting standard did not have a significant impact on our consolidated financial statements.

In March 2016, the FASB issued ASU No. 2016-09, “Compensation - Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting,” which modifies certain aspects of the accounting for share-based payment transactions, including income taxes, classification of awards, and classification in the statement of cash flows. We adopted this standard effective January 1, 2017. As a result, excess tax benefits are no longer recorded in additional paid-in capital and instead are applied against taxes payable or recognized in the consolidated statements of operations. In addition, our income tax expense and associated effective tax rate will be impacted by fluctuations in stock price between the grant dates and vesting dates of equity awards. We also determined that there were no significant changes to disclosure or financial statement presentation and changes in accounting for excess tax benefits and deficiencies were not material as a result of adoption.    

In May 2014, the FASB issued Accounting Standards Update (“ASU”) No. 2014-09, “Revenue from Contracts with Customers”, which requires an entity to recognize the amount of revenue to which it expects to be entitled for the transfer of promised goods or services to customers. ASU No. 2014-09 will replace most existing revenue recognition guidance in U.S. GAAP when it becomes effective. The FASB agreed to a one-year deferral of the revenue recognition standard's effective date for all entities. The new revenue standard is effective for us on January 1, 2018. Early application is permitted, but not before the original effective date, which would have been January 1, 2017 for us. The new revenue standard permits the use of either the full retrospective or modified retrospective transition method; these methods may be applied retrospectively to each prior period presented or retrospectively with the cumulative effect recognized as of the date of initial application.
Accordingly, in 2016, we established a cross-functional implementation team to analyze the impact of the new revenue standard. This preliminary analysis included the review of an initial sample of contracts, as well as reviewing current accounting policies and customary business practices to identify potential differences that would result from applying the requirements of the new standard to our revenue contracts. We currently expect revenue related to the completion of an EVAR or EVAS procedure in hospitals and shipments to distributors of our products, to remain substantially unchanged. As part of our review, we separated revenue streams into portfolios of contracts with similar characteristics and selected samples thereof, as we do not expect the financial statement effects to differ materially when applying this approach to individual contracts. In addition, we are in the process of implementing appropriate changes to our business processes, systems and controls to support recognition and disclosure under the new revenue standard. We currently expect to adopt the new revenue standard in our first quarter of 2018 utilizing the modified retrospective adoption method. We continue to expect that the new revenue standard will not have a material impact on the amount and timing of revenue recognized in our consolidated financial statements; we also currently do not expect to have an adjustment to the opening balance of retained earnings under the modified retrospective adoption method in our first quarter of 2018 financial statements. We are also in the process of reviewing the expansion of our disclosures relating to the nature, amount, timing, and uncertainty of revenue and cash flows arising from contracts with our customers, as required by the new revenue standard. We are continuing to evaluate our impact and will continue to monitor any modifications or interpretations communicated by the FASB that may impact any of our final assessments.
(c) Operating Segment
The Company has one operating and reporting segment that is focused exclusively on the development, manufacture, marketing and sale of EVAR and EVAS products for the treatment of aortic disorders. For the year ended December 31, 2017,2019, all of the Company'sCompany’s revenue and related expenses were solely attributable to these activities. Substantially all of the Company'sCompany’s long-lived assets are located in the United States.

(d) Reverse Stock Split

At a special meeting of stockholders held on February 22, 2019, the Company’s stockholders approved a proposal to amend the Amended and Restated Certificate of Incorporation, as amended, to effect a reverse stock split of the Company’s issued and outstanding common stock at a ratio not less than 1-for-5 and not greater than 1-for-10 (inclusive), with the exact ratio to be set as a whole number within that range at the discretion of the board of directors (the “Board”) before February 22, 2020 without further approval or authorization of our stockholders. On February 26, 2019, the Board approved the reverse stock split at a ratio of 1-for-10. On March 5, 2019, the Company filed a Certificate of Amendment of Amended and Restated Certificate of Incorporation, as Amended, with the Secretary of State of the State of Delaware to effect the reverse stock split. Unless stated otherwise, all share and per share amounts in this Annual Report on Form 10-K have been retroactively adjusted to reflect the reverse stock split.

2. Use of Estimates and Summary of Significant Accounting Policies
(i) Use of Estimates
The preparation of financial statements in conformity with GAAP requires the Company'sCompany’s management to make estimates and assumptions that affect the reported amounts of assets and liabilities, revenuesrevenue and expenses, and the related disclosure of contingent liabilities. On an on-going basis,assets and liabilities as of the Company's managementdate of the financial statements and the reported amounts of revenue and expenses during the periods presented. Management evaluates its estimates on an ongoing basis, including those related toto: (i) collectibility of customer accounts; (ii) whether the cost of inventories can be recovered; (iii) the value of goodwill and intangible assets; (iv) realization of tax assets and estimates of tax liabilities; (v) likelihood of payment and the value of contingent liabilities; and (vi) the potential outcome of litigation. Such estimates are based on management'smanagement’s judgment which takes into account historical experience and various assumptions. Nonetheless, actual results may differ from management'smanagement’s estimates.
The following critical accounting policies and estimates were used in the preparation of the accompanying Consolidated Financial Statements:

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

(i)(ii) Cash and Cash Equivalents
We considerThe Company considers all highly liquid investments that are readily convertible into cash and have a maturity of three3 months or less at the time of purchase to be cash equivalents. The cost of these investments approximates their fair value.
(ii) Marketable securities(iii) Restricted Cash
At December 31, 2016,The Company entered into a corporate credit card agreement whereby the Company was required to maintain a $1.2 million deposit in favor of the credit card issuer. The deposit account related to these credit cards was presented as restricted cash on the Company’s investments included short-term marketable securities, which were classified as held-to-maturity investments as the Company had the positive intent and ability to hold the investments to maturity. These investments were therefore recorded on an amortized cost basis. Discounts or premiums were amortized to interest income using the interest method. Marketable securities are investments with original maturities of greater than 90 days. Management reviewed the Company’s investments as of December 31, 2016, and concluded that there were no securities with other than temporary impairments in the investment portfolio. The Company’s investments were matured during the year ended December 31, 2017 and at December 31, 2017, the Company had no marketable securities.Consolidated Balance Sheets.
(ii)(iv) Accounts Receivable
Trade accounts receivable are recorded at the invoiced amount, inclusive of applicable value-added tax ("VAT"(“VAT”), and do not bear interest. Revenue is recorded net of VAT. The allowance for doubtful accounts is management'smanagement’s best estimate of the amount of probable credit losses in existing accounts receivable. These estimates are based on our review of the aging of customer balances, correspondence with the customer, and the customer’s payment history. Account balances are charged off against the allowance after appropriate collection efforts are exhausted.
(iii)(v) Inventories
The Company values its inventory at the lower of the actual cost to purchase or manufacture the inventory or net realizable value for such inventory. Cost is determined onusing the first-in, first-out method. The Company regularly reviews inventory quantities in process and on hand,on-hand and, when appropriate, records a provision for obsolete and excess inventory. The provision is based on actual loss experience and a forecast of product demand compared to its remaining shelf life.
(iv)(vi) Property and Equipment
Property and equipment are stated at cost and depreciated on a straight-line basis over the following estimated useful lives:
Property Class Useful Life
Office furniture Seven7 years
Computer hardware Three3 years
Computer software Three to eight3-8 years
Production equipment and molds Three to seven3-7 years
Leasehold improvements Shorter of expected useful life or remaining term of lease
Upon the sale or disposition of property and equipment, any gain or loss is included in the accompanying Consolidated Statements of Operations and Comprehensive Loss. Property and equipment are tested for impairment only when impairment indicators are present.
(v)(vii) Goodwill and Intangible Assets
Goodwill and intangible assets often represent a significant portion of the assets acquired in a business combination. The Company recognize the fair value of an acquired intangible asset apart from goodwill whenever the intangible asset arises from contractual or other legal rights, or when it can be separated or divided from the acquired entity and sold, transferred, licensed, rented or exchanged, either individually or in combination with a related contract, asset or liability. Intangible assets consist primarily of technology, customer relationships, trade name and trademarks acquired in business combinations, and in-process research and development (“IPR&D”). The Company generally assess the estimated fair values of acquired intangible assets using a combination of valuation techniques. To estimate fair value, the Company is required to make certain estimates and assumptions, including future economic and market conditions, revenue growth, market share, operating costs and margins, and risk-adjusted discount rates. The Company’s estimates require significant judgment and are based on historical data, various internal estimates and external sources. The Company’s assessment of IPR&D also includes consideration of the risk that the projects may not achieve technological feasibility.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

Intangible assets with definite lives are amortized over their estimated useful lives using a method that reflects the pattern over which the economic benefit is expected to be realized, and is as follows:
Intangible Asset ClassUseful Life
GoodwillIndefinite lived
Trademarks and tradenamesIndefinite lived
Developed technologyEleven to thirteen years
Customer relationshipsTen years
realized.
In-process research and development will beis amortized over its useful life upon commencement of commercial sales and it is expected to be amortized over its useful life.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except per share, per unit, and number of years)

sales.
Goodwill and other intangible assets with indefinite lives are not subject to amortization but are tested for impairment annually or whenever events or changes in business circumstances suggest the potential of an impairment. Under the FASB guidance, theThe evaluation of indefinite-lived intangible assets for impairment allows for a qualitative assessment to be performed, which is similar to the FASB guidance for evaluating goodwill for impairment.performed. In performing theseits qualitative assessments,assessment, the Company consideredconsiders relevant events and conditions including, but not limited to: macroeconomic trends, industry and market conditions, overall financial performance, cost factors, company-specific events, legal and regulatory factors and the Company's market capitalization. The Company completed its annual indefinite lived intangible asset impairment test as of June 30, 2017, with no resulting impairment.
The Company most recently completed its annual test for impairment of goodwill as of June 30, 2017,2019, under the quantitative assessment, with no resulting impairment, as itsthe Company’s market capitalization was in substantial excess of the value of its total stockholders'stockholders’s equity (the(The Company hashave one "reporting unit"reporting unit for purposes of theits goodwill impairment test).
IntangibleIn the fourth quarter of the year ended December 31, 2019, the Company determined that there was a sufficient indicator to trigger an additional interim goodwill impairment test due to a significant decrease in the the Company’s market capitalization during the fourth quarter of 2019. The interim goodwill impairment test was prepared as of December 31, 2019 using a quantitative assessment to determine if the fair value of the Company’s single reporting unit was less than its carrying value as of the test date. Based on the results of the quantitative interim goodwill impairment test, the fair value of the Company’s single reporting unit substantially exceeded its carrying value and therefore, no impairment charge was recognized as of December 31, 2019.
In performing quantitative goodwill assessment the Company estimated the reporting unit's fair value based on its enterprise value plus an assumed control premium as evidence of fair value. The estimates used to determine the fair value of the reporting unit may change based on results of operations, macroeconomic conditions stock price fluctuations or other factors. Changes in these estimates could materially affect the estimate of the fair value of the reporting unit and the resulting conclusion as to any goodwill impairment for the reporting unit.
If the recent negative volatility of the Company’s market capitalization is sustained, the Company may perform impairment tests more frequently and it is possible that the Company’s goodwill could become impaired, which could result in a material charge and adversely affect the Company’s results of operations.
Long-lived assets, with finite livesincluding finite-lived intangible assets, are tested for impairment only whenwhenever events or changes in circumstances indicate that the carrying value of finite-lived intangible asset or asset group may not be recoverable. The first step in the impairment indicators are present.testing involves a comparison of the sum of the undiscounted future cash flows of the asset or asset group to its carrying amount. If the sum of the undiscounted future cash flows exceeds the carrying amount, then no impairment exists. If the carrying amount exceeds the sum of the undiscounted future cash flows, then a second step is performed to determine the amount of impairment, if any, to be recognized. An impairment loss is recognized to the extent that the carrying amount of the asset or asset group exceeds its fair value. The fair value of the asset or asset group is based on estimated discounted future cash flows of the asset or asset group using a discount rate commensurate with the related risk. The estimate of future cash flows requires management to make assumptions and to apply judgment, including forecasting future sales and expenses and estimating useful lives of the assets. These estimates can be affected by a number of factors, including, among others, future results, demand and economic conditions, many of which can be difficult to predict.
(vi)For reasons similar to those described above related to goodwill, during the fourth quarter of 2019, the Company performed the first step of the impairment analysis over the Company’s asset groups as of December 31, 2019. The results of the first step of the impairment analysis test indicated that the sums of the undiscounted future cash flows of the asset groups exceeded their carrying amounts. Accordingly, no impairment charge was recognized as of December 31, 2019.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

(viii) Fair Value Measurements
InWhen determining the fair value measurements for assets and liabilities required or permitted to be recorded at fair value, the Company considers the principal or most advantageous market in which it would transact and considers assumptions that market participants would use when pricing the asset or liability, such as inherent risk, transfer restrictions and risk of nonperformance. The Company uses the following three levels of inputs in determining the fair value of itsthe Company’s assets and liabilities, the Company uses various valuation approaches. Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. The fair value hierarchy distinguishes between (i) market participant assumptions developed based on market data obtained from independent sources (observable inputs) and (ii) an entity's own assumptions about market participant assumptions developed basedfocusing on the best information available in the circumstances (unobservable inputs). The fair value hierarchy consists of three broad levels, which gives the highest priority to unadjusted quotedmost observable inputs when available:
Level 1 — Quoted prices in active markets for identical assets or liabilities (Level 1) and the lowest priority to unobservable inputs (Level 3). The three levels of the fair value hierarchy are described below:
Level 1 - Unadjusted quoted prices in active markets that are accessible at the measurement date for identical, unrestricted assets or liabilities.
Level 2 - Inputs— Observable inputs other than quoted prices included within Level 1 that are observable for the asset or liability, either directly or indirectly, includingprices such as: quoted prices for similar assets or liabilities in active markets andliabilities; quoted prices for identical or similar assets or liabilities in markets that are not active;with insufficient volume or infrequent transactions (less active markets); or model-derived valuations in which all significant inputs other than quoted prices that are observable for the asset or liability (e.g., interest rates); and inputs that arecan be derived principally from or corroborated by observable market data by correlationfor substantially the full term of the assets or other means.liabilities.
Level 3 - Inputs— Unobservable inputs to the valuation methodology that are both significant to the measurement of fair value measurement and unobservable.of assets or liabilities.
The availability of observable inputs can vary among the various types of financial assets and liabilities. To the extent that the valuation is based on models or inputs that are less observable or unobservable in the market, the determination of fair value requires more judgment. In certain cases, the inputs used to measure fair value may fall into different levels of the fair value hierarchy. In such cases, for financial statement disclosure purposes, the level in the fair value hierarchy within which the fair value measurement is categorized is based on the lowest level input that is significant to the overall fair value measurement.
The Company’s held-to-maturity securities, which are fixed income investments, are comprised of obligations of United States government agencies, corporate debt securities and other interest bearing securities. These held-to-maturity securities are recorded at amortized cost and are therefore not included in the Company’s market value measurement disclosure. Money market funds, which are cash and cash equivalents, are valued using quoted market prices with no valuation adjustments applied. Accordingly, these securities are categorized in Level 1. The recorded values of all our other financial instruments approximate their current fair values because of their nature and respective relatively short maturity dates or durations.
The recorded values of all our accounts receivable and accounts payable approximate their current fair values because of their nature and respective relatively short maturity dates or durations.
(vii)(ix) Contingent Consideration for Business Acquisition
The Company's managementCompany determined the fair value of contingently issuable common stock on the date of the Nellix, Inc. (“Nellix”) acquisition date (see Note 9) using a probability-based income approach with an appropriate discount rate (determined using both Level 1 and Level 3 inputs). Changes in the fair value of thisthe contingently issuable common stock are determined at each period end and are recorded in the other income (expense) section, net line item of the accompanying Consolidated Statements of Operations and Comprehensive Loss, and the current and non-current liabilities sectionline items of the accompanying Consolidated Balance Sheets.
(viii) Revenue Recognition(x) Litigation Accruals
From time to time the Company is involved in various claims and legal proceedings of a nature considered normal and incidental to its business. These matters may include product liability, intellectual property, employment and other general claims. The Company accrues for contingent liabilities when it is probable that a liability has been incurred and the amount can be reasonably estimated. The accruals are adjusted periodically as assessments change or as additional information becomes available.
(xi) Debt and Derivative Liabilities
The Company accounted for the refinance of its debt in accordance with Financial Accounting Standards Board (“FASB”) Accounting Standards Codification (“ASC”) 470-50, Debt Modifications and Extinguishment. The Company accounted for refinancing of debt as an extinguishment if terms of the new debt and original debt are substantially different (i.e. the present value of the cash flows under the terms of the new debt is at least 10% different from the present value of the remaining cash flows under the terms of the original debt). The original debt is derecognized and the new debt is recorded at fair value, with the difference recorded as extinguishment gain or loss line item of the Consolidated Statements of Operations and Comprehensive Loss. If the terms of the new debt and original debt are not substantially different, the debt refinancing is accounted for as debt modification where no gain or loss is recognized.
The Company incurred debt issuance costs in connection with the issuance and refinance of its convertible notes and term loan facility, which are presented as a direct deduction against the carrying amount of the debt and is amortized to interest expense using the effective interest method.
The Company’s debt includes conversion feature that meets the definition of embedded derivative under ASC 815. Consequently, the embedded derivative was bifurcated and accounted for separately at fair value. Changes in the fair value of the derivative liabilities are determined at each period end and are recorded in the change in fair value of derivative liabilities line item of the Consolidated Statements of Operations and Comprehensive Loss and the non-current liabilities line items of the Consolidated Balance Sheets.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

(xii) Revenue Recognition
The Company measures revenue based on consideration specified in contracts with customers: hospitals and distributors. The Company excludes any amounts related to taxes assessed by governmental authorities from this revenue measurement and reduces revenue by any sales incentives offered by the Company to its customers. The Company recognizes revenue when it satisfies a performance obligation by transferring control of products to customers.
Specifically, the Company recognizes revenue when all of the following criteria are met:

Appropriate evidence of a binding arrangement existsA contract has been identified with the customer;
The sales price for the EVAR or EVAS product (including device extensions and accessories) is established with the customer;performance obligations have been identified;
The EVAR or EVAS producttransaction price has been used bydetermined and allocated to the hospitalrespective performance obligations; and
The performance obligations have been satisfied.
Respective performance obligations are satisfied at a point in an EVAR procedure, or the distributor has assumed title with no right of return; and
Collection of the corresponding receivable from the customer is reasonably assured at the time of sale.
Forfor sales made to both hospitals and distributors. Payment terms with customers range from 30 to 180 days which reflects days from the date the Company satisfies the performance obligations.
For implant-based sales, the Company recognizes revenue upon completion of an EVAR or EVAS procedure, when the EVAR or EVASAAA products are utilized in a procedure or implanted in a patient. For shipment-based sales, made to distributors, the Company recognizes revenue when title passes,control over a product has transferred to the customer, which is typically at the time of shipment, as this represents the period that the customer has assumed custody of the EVAR or EVAS product, without a right of return, and assumed risk of loss.return.
The Company does not offer rightsprovides certain sales incentives to customers for meeting certain purchase thresholds and, accordingly, the transaction price is reduced by the Company’s best estimate of return, other than honoring a standard warranty.this variable consideration. The Company estimates this variable consideration through the most-likely amount method.
(ix)(xiii) Stock-based Compensation
The Company values stock-based awards, including stock options, restricted stock awards (“RSAs”) and restricted stock units (“RSUs”), as of the date of grant. The fair value of stock options is estimated at the date of grant using the Black-Scholes option-pricing model. The fair value of RSAs and RSUs is based on the closing market price of the Company’s common stock on the grant date.
The Company recognizes stock-based compensation expense (net of estimated forfeitures) using the straight-line method over the requisite or implicit service period, as applicable. Forfeitures of employee awards are estimated at the time of grant, and the forfeiture assumption is periodically adjusted for actual employee vesting behavior.
The Company uses the Black-Scholes option-pricing model, in combination with the discounted employee price, in determining the value of expense related to its Amended and Restated 2006 Employee Stock Purchase Plan, as amended (the “ESPP”) to be recognized during each offering period.
(xiv) Shipping Costs
Shipping and handling costs billed to customers are reported within revenue, with the corresponding costs reported within cost of goods sold. In addition, any shipping and handling costs related to outbound freight after control over a product has transferred to a customer are accounted for as fulfillment costs and are included in cost of goods sold.
(x)(xv) Foreign Currency Transactions
The assets and liabilities of the Company'sCompany’s foreign subsidiaries are translated atusing the exchange rates of exchange at the balance sheet date. The income and expense items of these subsidiaries are translated atusing average monthly rates of exchange.exchange rates. Gains and losses resulting from foreign currency transactions, which are denominated in a currency other than the respective entity’s functional currency are included in other income (expense), net, within the accompanying Consolidated Statements of Operations and Comprehensive Loss.net. Foreign currency translation adjustments between the respective entity'sentity’s functional currency and the United States dollar are recorded toincluded in accumulated other comprehensive loss within the stockholders' equity section of the accompanying Consolidated Balance Sheets.income (loss). There were no items reclassified out of accumulated other comprehensive loss and into net loss duringincome (loss) in the years ended December 31, 2017, 2016,2019, 2018 and 2015. The only activity2017.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in the accumulated other comprehensive loss was related to foreign currency translation.thousands, except share, per share and per unit data, and number of years)
(xi)
(xvi) Income Taxes
The Company records the estimated future tax effects of temporary differences between the tax basisbases of assets and
liabilities and amounts reported in the financial statements, as well as operating losses and tax credit carry forwards. The Company has recorded a valuation allowance to substantially reduce its net deferred tax assets, because the Company believes that, based upon a number of factors, it is more likely than notmore-likely-than-not that substantially all of the deferred tax assets will not be realized. If the Company werewas to determine that it would be able to realize additional deferred tax assets in the future, an adjustment to the valuation allowance on its deferred tax assets would increase net income in the period such determination was made. In the event that the Company werewas assessed interest and/or penalties from taxing authorities, such amounts would be included in "incomeincome tax expense" within the Consolidated Statements of Operations and Comprehensive Lossbenefit (expense) in the period the notice of such interest and/or penalties was received.
(xii)(xvii) Net Loss Per Share
Net loss per common share is computed using the weighted average number of common shares outstanding
during the periods presented. Because of the net losses during the years ended December 31, 2017, 2016, and 2015, options to purchase the common stock, restricted stock awards, and restricted stock units of the Company were excluded from the computation of net loss per share for these periods because the effect would have been antidilutive.
(xiii)(xviii) Research and Development Costs
Research and development costs are expensed as incurred.
(xiv)(xix) Product Warranty
Within six6 months of shipment, certain customers may request replacement of products they receive that do not meet product specifications; nospecifications. No other warranties are offered. The Company contractually disclaims responsibility for any damages associated with physician'sa physician’s use of its EVAR or EVAS product.products. Historically, the Company has not experienced a significant amount of costs associated with its warranty policy.
(xx) Reclassifications
Certain amounts in prior periods have been reclassified to conform to current period presentation. See the “Recent Accounting Pronouncements” section below for details.
(xxi)Recently Adopted Accounting Pronouncements
In February 2016, the Financial Accounting Standards Board (the “FASB”) issued Accounting Standards Update (“ASU”) No. 2016-02, which amends the FASB Accounting Standards Codification and creates Topic 842, “Leases.” The new topic supersedes Topic 840, “Leases,” and increases transparency and comparability among organizations by recognizing lease assets and lease liabilities on the balance sheet and requires disclosures of key information about leasing arrangements. In July 2018, the FASB made targeted improvements to ASU No. 2016-02, including providing an additional and optional modified retrospective transition method. Under this method, an entity initially applies the standard at the adoption date, including the election of certain transition reliefs and recognizes a cumulative effect adjustment to the opening balance of retained earnings in the period of adoption. Effective January 1, 2019, the Company adopted this new accounting standard using the modified retrospective approach with no restatement of prior periods or cumulative adjustment to retained earnings. The Company elected certain practical expedients permitted under the transition guidance, including the election to carry forward historical lease classification. The Company also elected the short-term lease practical expedient, which allowed it to not recognize leases with a term of less than twelve months on our consolidated balance sheets. Upon adoption of the new lease accounting standard the Company recognized an operating lease right-of-use asset of $5.8 million and a corresponding operating lease liability of $13.7 million, respectively as of January 1, 2019. The operating lease liability was determined based on the present value of the remaining minimum rental payments and the operating lease asset was determined based on the value of the lease liability, adjusted for the deferred rent balances of $7.9 million. The adoption of the new lease accounting standard did not have an impact on our consolidated statements of operations and comprehensive loss and consolidated statements of cash flows. See Note 8(a) of the Notes to the Consolidated Financial Statements for further discussion.
Other recent accounting pronouncements issued by the FASB (including its Emerging Issues Task Force), the American Institute of Certified Public Accountants and the SEC did not have a material effect on our consolidated financial statements.


ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)


3. Balance Sheet Account Detail
(a) Property and Equipment
Property and equipment consisted of the following:
December 31,December 31,
2017 20162019 2018
Production equipment, molds, and office furniture$12,118

$11,714
Production equipment, molds and office furniture$10,844
 $11,854
Computer hardware and software8,115

8,162
7,897
 8,235
Leasehold improvements15,499

15,495
15,594
 15,535
Construction in progress (software and related implementation, production equipment, and leasehold improvements)743

839
Construction in progress (software and related implementation, production equipment and leasehold improvements)795
 993
Property and equipment, at cost36,475

36,210
35,130
 36,617
Accumulated depreciation(17,263)
(12,945)(21,978) (20,584)
Property and equipment, net$19,212

$23,265
$13,152
 $16,033
Depreciation expense for property and equipment for the years ended December 31, 2019, 2018 and 2017 2016, and 2015 was $5.0$3.3 million, $5.3$3.7 million, and $4.6$5.0 million, respectively.

(b) Inventories
Inventories consisted of the following:

December 31,December 31,

2017
20162019
2018
Raw materials$12,226

$13,133
$5,362
 $4,636
Work-in-process7,736

10,139
4,132
 6,401
Finished goods25,191

17,888
16,911
 19,362
Inventories$45,153

$41,160
Total Inventories$26,405
 $30,399
(c) Goodwill and Other Intangible Assets
The change in the carrying amount of goodwill for the year ended December 31, 2019 was as follows:
Balance at December 31, 2018$120,848
Foreign currency translation adjustment(34)
Balance at December 31, 2019120,814

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

(c) Goodwill and Intangible Assets
The following table presents goodwill, indefinite livedOther intangible assets finite lived intangible assets, and related accumulated amortization:consisted of the following:
 December 31,
 2017
2016
Goodwill$120,927

$120,711




Intangible assets:




Indefinite lived intangibles


Trademarks and trade names$2,708

$2,708
In-process research and development11,200

11,200




Finite lived intangibles


Developed technology$67,600

$67,600
Accumulated amortization(7,167)
(3,810)
 Developed technology, net$60,433

$63,790




Customer relationship$7,500

$7,500
Accumulated amortization(1,438)
(687)
 Customer relationship, net$6,062

$6,813




 Intangible assets (excluding goodwill), net$80,403

$84,511
The change in the carrying amount of goodwill for the year ended December 31, 2017 is as follows (in thousands):
Balance at January 1, 2017

120,711
Foreign currency translation adjustment

216
Balance at December 31, 2017

$120,927
   December 31, 2019 December 31, 2018
 
Estimated Useful Life
(in years)
 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount
Indefinite-lived intangible assets:             
Trademarks and trade namesN/A $2,708
 N/A $2,708
 $2,708
 N/A $2,708
In-process research and developmentN/A 11,200
 N/A 11,200
 11,200
 N/A 11,200
Total indefinite-lived intangible assets  13,908
 
 13,908
 13,908
   13,908
Finite-lived intangible assets:             
Developed technology11-24 67,600
 $(13,467) 54,133
 67,600
 $(10,657) 56,943
Customer relationships10 7,500
 (2,938) 4,562
 7,500
 (2,188) 5,312
Total finite-lived intangible assets  75,100
 (16,405) 58,695
 75,100
 (12,845) 62,255
Other intangible assets, net  $89,008
 $(16,405) $72,603
 $89,008
 $(12,845) $76,163
Amortization expense for intangible assets for the years ended December 31, 20172019, 20162018, and 20152017 was $4.1$3.6 million, $3.8$4.2 million and $1.34.1 million, respectively.
Estimated amortization expense for the five5 succeeding years and thereafter is as follows:

Amortization Expense
2018$4,095
20194,300
20204,944
20217,020
20228,734
2023 and thereafter37,402
Total$66,495











ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except per share, per unit, and number of years)
2020$3,185
20213,276
20223,319
20233,378
20243,497
Thereafter42,040
Total$58,695

(d) Marketable securities

Investments in held-to-maturity marketable securities consist of the following at December 31, 2016:


December 31, 2016


Amortized
Cost

Gross
Unrealized
Gain
 Gross
Unrealized
Loss
 Fair Value
Agency bonds
$6,488

$2
 $

$6,490
Corporate bonds
10,513



(21)
$10,492
Commercial paper
3,987





3,987
Total
$20,988

$2

$(21)
$20,969

At December 31, 2017, the Company had no marketable securities. There were no realized gains or losses on the investments for the year ended December 31, 2017.

(e) Fair Value Measurements
The following fair value hierarchy table presents information about each major category of the Company’s assets and liabilities measured at fair value on a recurring basis as of December 31, 20172019 and 2016:2018:


 Fair value measurement at reporting date using:
 
Quoted prices in
active markets for
identical assets
(Level 1)

Significant other
observable
inputs
(Level 2)

Significant
unobservable
inputs
(Level 3)

Total
At December 31, 2017







Cash and cash equivalents
$57,991

$

$

$57,991
Restricted cash
$2,608

$

$

$2,608
Contingently issuable common stock
$

$

$9,300

$9,300
At December 31, 2016











Cash and cash equivalents
$26,120

$

$

$26,120
Restricted cash
$2,001

$

$

$2,001
Contingently issuable common stock
$

$

$12,200

$12,200
  December 31, 2019 December 31, 2018
  Level 1 Level 2 Level 3 Total Level 1 Level 2 Level 3 Total
Financial liabilities:                
Contingently issuable common stock(a)$
 $
 $500
 $500
 $
 $
 $2,200
 $2,200
Derivative liabilities(b)
 
 940
 940
 
 
 4,012
 4,012
Total financial liabilities $
 $
 $1,440
 $1,440
 $
 $
 $6,212
 $6,212

There were no remeasurements to fair value during the years ended December 31, 2017 and 2016 of financial assets and liabilities that are not measured at fair value on a recurring basis. There were no transfers between Level 1, Level 2, or Level 3 securities during the years ended December 31, 2017 and 2016.
(f) Instruments Not Recorded at Fair Value on a Recurring Basis
The Company measures the fair value of their Senior Notes carried at amortized cost quarterly for disclosure purposes. The estimated fair value of the Senior Notes is determined by Level 2 inputs and is based primarily on quoted market prices for the same or similar issues. Based on the market prices, the fair value of our Senior Notes was $131.2 million as of December 31, 2017 and $187.6 million as of December 31, 2016.

The Company measures the fair value of its Term Loan carried at amortized cost quarterly for disclosure purposes. The estimated fair value of the Term Loan is determined by Level 3 inputs and is based primarily on unobservable inputs that are not corroborated by market data. The fair value of the Company's Term Loan was $101.9 million as of December 31, 2017.

Due to its short-term nature, the Company believes that the carrying value of its revolving line of credit approximated its fair value at December 31, 2017.
(a)Included in other liabilities in the Consolidated Balance Sheets. See Note 9 for additional details.
(b)See Note 6 for additional details.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)


The Company measuresChanges in the fair value of our held-to-maturity marketable securities carriedthe Company’s Level 3 liabilities were as follows:
 Contingently issuable common stock
(a)
 Derivative liabilities
(b)
Balance at December 31, 2018$2,200
 $4,012
Additions
 14,641
Fair value adjustment(1,700) (17,713)
Balance at December 31, 2019$500
 $940
(a)See Note 9 for additional details.
(b)See Note 6 for additional details.
There were no transfers of financial assets or liabilities into or out of Level 3 in the years ended December 31, 2018 and 2017.
Financial Instruments Not Recorded at amortized cost quarterly for disclosure purposes. Fair Value on a Recurring Basis
The table below summarizes the carrying and fair values of the Company’s long-term debt:
 December 31, 2019 December 31, 2018
 Carrying value Fair value Carrying value Fair value
Term loan facility$141,273
 $131,892
 $117,880
 $116,916
Convertible notes26,506
 24,548
 75,917
 50,489
Other debt4,281
 1,416
 4,281
 1,221
 $172,060
 $157,856
 $198,078
 $168,626
The fair values of the Company’s long-term debt are determined using Level 3 inputs, with the exception of the 3.25% Senior Notes, which are determined using Level 2 inputs. See Note 6 for further details. The carrying value of certain marketable securities is determined by Level 2 inputsthe Company’s Revolving loan facility approximates fair value.


ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and is based primarily on quoted market prices for the same or similar instruments. per unit data, and number of years)

4. Stock-Based Compensation
2015 Stock Incentive Plan
The Company has one active stockholder-approvedUnder the Company’s stock-based compensation plan thewhich is governed by its Amended and Restated 2015 Stock Incentive Plan, as amended (the "2015 Plan"“2015 Plan”), which replaced the Company's former stockholder-approved plans. IncentiveCompany may grant incentive stock options, non-qualified stock options, restricted stock awards, restricted stock units,RSAs, RSUs and stock appreciation rights may be granted under the 2015 Plan.
rights. The maximum number of shares of the Company'sCompany’s common stock available for issuance under the 2015 Plan is 9.8 million4,130,000 shares. As of December 31, 2017, 0.9 million2019, 1,100,992 shares were available for grant. It is the Company'sCompany’s policy that before stock is issued through the exercise of stock options, the Company must first receive all required cash payment for such shares. The stock issuable under the 2015 Plan shallmust be shares of authorized new unissued shares.
Stock-based awards are governed by agreements between the Company and the recipients. Incentive stock options and nonqualifiednon-qualified stock options may be granted under the 2015 Plan at an exercise price of not less than 100% of the closing fair market value of the Company'sCompany’s common stock on the respective date of grant. The grant date is generally the first day of employment for new hire grants and the date of approval for all others. Awards are approved by either a delegated member of the Company's Executive Management or by the Compensation Committeegrant. The Company’s standard stock-based awards vest as to 1/3 of the Board of Directors for awards that exceedshares underlying the Company's Executive Management's authority.
The Company's standard stock-based award vests 25% on the first1st anniversary of the date of grant, or for new hires, the first1st anniversary of their initial date of employment with the Company. Awards vest monthly thereafter on a straight-line basis over three2 years. StockAll stock options must be exercised, if at all, no later thanhave 10 years from the date of grant. Upon termination of employment with the Company, vested stock options may be exercised within -year terms.90 days from the last date of employment. In the event of an optionee's death, disability, or retirement, the exercise period is 365 days from the last date of employment.

2017 Inducement Stock Incentive Plan
On October 27, 2017, the Board of Directors (the “Board”) of the Company adopted the 2017 Inducement Stock Incentive Plan, as amended (the “2017 Inducement Plan”). The 2017 Inducement Plan provides for the grant of equity-based awards in the form of non-qualified stock options, restricted stock, restricted stock units,RSAs, RSUs, stock appreciation rights, performance shares and performance units. In accordance with Nasdaq Listing Rules, awards under the 2017 Inducement Plan may only be made to an employee who has not previously been an employee of the Company or a member of the Board, or an employee or member of the board of directorsBoard of any subsidiary of the Company, or following a bona fide period of non-employment with the Company or any subsidiary of the Company, if he or she is granted such award in connection with his or her commencement of employment with the Company or a subsidiary of the Company and such grant is an inducement material to his or her entering into employment with the Company or such subsidiary.
The Board has reserved 2,000,000maximum number of shares of the Company’s common stock available for issuance pursuant to awards granted under the 2017 Inducement Plan and the 2017 Inducement Plan will be administered by the Compensation Committee of the Board.is 900,000 shares. As of December 31, 2017, 1.7 million2019, 497,059 shares were available for grant.
Employee Stock Purchase Plan
Under the terms of the Company's Amended and Restated 2006 Employee Stock Purchase Plan, as amended (the "ESPP"),ESPP, eligible employees can purchase common stock, through payroll deductions. As of December 31, 2017, 1.0 million shares were available for grant. Thedeductions, at a purchase price is equal to the closing price of the Company'sCompany’s common stock on the first or last day of the offering period (whichever is less), minus a 15% discount. The Company uses the Black-Scholes option-pricing model, in combination with the discounted employee price, in determining the valueAs of ESPP expense to be recognized during each offering period.December 31, 2019, 434,542 shares were available for grant.
The table below summarizes the stock-based compensation recognized,expense, common stock shares purchased by Company employees and the average purchase price per share as part ofunder the ESPP program duringin the years ended December 31, 2017, 2016,2019, 2018 and 20152017.
 Year Ended December 31,
 2019 2018 2017
Stock-based compensation expense$131
 $1,033
 $850
Common stock purchased by Company employees103,981
 60,695
 44,649
Average purchase price per share$3.33
 $22.16
 $56.43
Stock-based Compensation Expense Summary
The table below summarizes the impact of recording stock-based compensation expense in the Consolidated Statements of Operations and Comprehensive Loss in the years ended December 31, 2019, 2018 and 2017:

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

 Year Ended December 31,
 2017 2016 2015
Stock-based compensation expense$850

$1,205

$921
Common stock shares purchased by Company employees446,490

394,120

355,557
Average purchase price per share$5.64

$8.17

$8.33
Stock Options and Restricted Stock
The Company values stock-based awards, including stock options and restricted stock, as of the date of grant (and is marked-to-market at each reporting period for unvested grants issued to non-employees).
The Company recognizes stock-based compensation expense (net of estimated forfeitures) using the straight-line method over the requisite or implicit service period, as applicable. Forfeitures of employee awards are estimated at the time of grant and the forfeiture assumption is periodically adjusted for actual employee vesting behavior. For purposes of this estimate, the Company has applied an estimated forfeiture rate of 11%, 11%, and 14% for the years ended December 31, 2017, 2016, and 2015, respectively.
Stock-Based Compensation Expense Summary
The Company classifies related compensation expense in the accompanying Consolidated Statements of Operations and Comprehensive Loss, based on the Company department to which the recipient belongs. Stock-based compensation expense included in cost of goods sold and operating expenses for years ended December 31, 2017, 2016, and 2015 was as follows:

Year Ended December 31,Year Ended December 31,

2017
2016
20152019
2018
2017
Cost of goods sold$828

$944

$1,000
$829
 $830
 $828
Operating expenses:







     
Research and development1,259

1,528

1,005
1,346
 1,132
 1,259
Clinical and regulatory affairs770

672

858
790
 483
 770
Marketing and sales3,796

4,335

3,237
3,100
 3,468
 3,796
General and administrative4,991

4,807

3,155
4,784
 5,117
 4,991
Total operating expenses$10,816

$11,342

$8,255
10,020
 10,200
 10,816









Total$11,644

$12,286

$9,255
Total stock-based compensation expense$10,849
 $11,030
 $11,644
In addition, the Company had $0.4 million, $0.5 million, $0.3 million and $0.6$0.4 million of stock-based compensation expense capitalized in inventory as of December 31, 2017, 2016,2019, 2018 and 2015,2017, respectively.

Valuation Assumptions
The grant-date fair value per share for restricted stock awards was based upon the closing market price of the Company’s common stock on the award grant-date.
The fair value of stock options granted was estimated at the date of grant using the Black-Scholes option-pricing model. The following assumptions were used to determine fair value for the stock awardsoptions granted in the applicable year:

Year Ended December 31,Year Ended December 31,

2017
2016
20152019
2018
2017
Average expected option life (in years) (a)5.6
5.5
5.5
Expected life (in years)5.7 5.6 5.6
Volatility (b)51.3%
44.2%
43.3%62.9% 56.5% 51.3%
Risk-free interest rate (c)1.9%
1.2%
1.6%2.3% 2.7% 1.9%
Dividend yield (d)

  
Weighted-average grant-date fair value per stock option$2.51
$3.45
$6.37
Weighted average grant date fair value per share$6.48 $10.66 $25.13
Stock Option Activity
Stock option activity in the year ended December 31, 2019 was as follows:
 Number of
Shares
 Weighted
Average
Exercise Price
 Weighted-
Average
Remaining
Contractual Life 
(in years)
 Aggregate Intrinsic Value (a)
Outstanding balance at December 31, 20181,315,360
 $54.20
    
Granted2,039,387
 6.48
    
Exercised
 
    
Forfeited(508,630) 38.86
    
Expired(504,591) 81.28
    
Outstanding balance at December 31, 20192,341,526
 $10.12
 8.6 $
Vested and expected to vest balance at December 31, 20192,081,243
 $10.53
 8.6 $
Exercisable balance at December 31, 2019482,446
 $21.65
 8.1 $
(a)The aggregate intrinsic value of stock options as of December 31, 2019 is calculated based on the difference between the Company’s closing stock price on the last trading day of the period reported and the stock option exercise price.
In the year ended December 31, 2019, no stock options were exercised. In the years ended December 31, 2018 and 2017, the aggregate intrinsic value of stock options exercised was $1.3 million and $0.2 million, respectively.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

(a) Determined by the historical stock option exercise behavior of the Company's employees (maximum term is 10 years).
(b) Measured using daily price observations for a period equal to the stock options' expected terms.
(c) Based upon the United States Treasury yields in effect (for a period equaling the stock options' expected terms).
(d) The Company has never paid cash dividends on its common stock and does not expect to declare any cash dividends.
Stock Option Activity
Stock option activity during the year ended December 31, 2017 is as follows:
 Number of
Stock Options

Weighted
Average
Exercise Price

Weighted-
Average
Remaining
Contractual
Life (Years)

Aggregate Intrinsic Value
Outstanding — January 1, 20178,673,215
9.22




Granted5,370,408
5.44




Exercised(129,478)
4.21

(a)$226
Forfeited(1,405,534)
8.20




Expired(684,279)
11.38




Outstanding — December 31, 201711,824,332
$7.56
7.1(b)$4,570
Vested and Expected to Vest — December 31, 201710,629,743
7.67
6.9(b)$4,173
Vested — December 31, 20175,041,775
8.48
4.9(b)$2,530
(a) Represents the total difference between the Company's stock price at the time of exercise and the stock option exercise price, multiplied by the number of options exercised.
(b) Represents the total difference between the Company's closing stock price on the last trading day of period reported on and the stock option exercise price, multiplied by the number of in-the-money options as of the period reported on. The amount of intrinsic value will change based on the fair market value of the Company's stock.

For years ended December 31, 2017, 2016 and 2015 the total intrinsic value of options exercised was $0.2 million, $2.7 million and $3.2 million respectively. The Company recognized stock option expense of $7.7 million, $7.4 million and $5.3 million for the years ended December 31, 2017, 2016, and 2015, respectively.
As of December 31, 2017, there was $14.5 million of total2019, the aggregate unrecognized compensation expense related to granted, but unvested stock options whichof $8.7 million is expected to be recognized over aan estimated weighted average period of 2.72.6 years.
The following table summarizes information regarding outstanding and exercisable stock options as of December 31, 2019:
  Outstanding Exercisable
Range of Exercise Prices Number of Shares Weighted
Average
Remaining
Contractual
Term (in years)
 Weighted
Average
Exercise
Price
 Number of Shares Weighted
Average
Remaining
Contractual
Term (in years)
 Weighted
Average
Exercise
Price
$2.30
$6.35
 317,162
 6.4 $5.12
 
 0.0 $
6.67
6.67
 1,450,075
 9.3 6.67
 146,982
 9.0 6.67
6.76
7.45
 290,484
 9.0 7.29
 214,631
 9.0 7.43
7.53
75.30
 265,773
 7.2 31.02
 103,021
 5.8 56.95
77.60
175.80
 18,032
 2.2 112.55
 17,812
 2.1 112.52
$2.30
$175.80
 2,341,526
 8.6 $10.12
 482,446
 8.1 $21.65
RSU Activity
The following table summarizes the activity for RSUs:
 Number of
Shares
 Weighted Average
Grant Date Fair
Value
Unvested as of December 31, 2018422,720
 $26.15
Granted (1)745,498
 6.51
Forfeited(41,363) 31.50
Vested(255,873) 16.69
Unvested as of December 31, 2019870,982
 $11.88
(1)Shares granted in 2019 include 470,886 performance stock units that require certain performance conditions to be achieved in order to vest.
In the years ended December 31, 2019, 2018 and 2017, the weighted average grant date fair value of RSUs granted was $6.51, $15.02 and $50.10, respectively.
In the years ended December 31, 2019, 2018 and 2017, the total fair value of RSUs vested was $0.9 million, $2.1 million and $1.8 million, respectively.
As of December 31, 2019, the aggregate unrecognized compensation expense related to RSUs of $4.3 million is expected to be recognized over an estimated weighted average period of 1.54 years.
Award Modifications
There were no award modifications in the year ended December 31, 2019. In the year ended December 31, 2018, there were award modifications affecting 2 individuals, a former executive and a former director of the Company, in connection with their departures. The employees were provided with accelerated vesting and extended exercisability for certain awards outstanding which included stock options, RSUs and performance stock units. The total incremental stock-based compensation expense recognized in the years ended 2019, 2018 and 2017 related to award modifications was $0 million, $1.8 million and $0.3 million, respectively.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

The following table summarizes information regarding outstanding stock option grants as5. Net Loss Per Share
Because of December 31, 2017:
  Outstanding
Exercisable
Range of Exercise Prices Granted
Stock Options
Outstanding

Weighted-
Average
Remaining
Contractual
Life (Years)

Weighted-
Average
Exercise
Price

Granted
Stock Options
Exercisable

Weighted-
Average
Exercise
Price
$1.64
$4.42
 2,390,446
5.6
$3.76

1,135,219
$3.27
4.49
6.62
 3,626,065
8.6
5.72

691,585
5.72
6.66
7.53
 2,865,141
7.6
7.39

1,298,962
7.40
7.57
15.51
 2,373,560
5.9
12.22

1,543,700
12.52
15.53
17.58
 569,120
6.3
16.58

372,309
16.53
$1.64
$17.58
 11,824,332
7.1
$7.56

5,041,775
$8.48

Non-Employee - Stock Options
As of December 31, 2017, 2016, and 2015, a total of 1,500, 11,500, and 31,500 non-employee stock options, respectively, were outstanding and fully vested.
Restricted Stock Award Activity
The following table summarizes activity and related information for the Company's restricted stock awards:

Number of
Restricted Stock Awards(2)

Weighted Average
Fair
Value per Share at Grant Date

Grant Date Fair Value
Vest Date Fair Value(1)
Unvested as of December 31, 20161,310,019

$10.19






Granted1,590,662

5.01

$7,969



Forfeited(470,626)
9.74






Vested(293,612)
11.39




$1,757
Unvested as of December 31, 20172,136,443

$6.27





(1) Represents the Company's stock price on the vesting date multiplied by the number of vested shares.
(2) Shares grantednet losses in 2017 include 513,011 performance stock units that have certain performance conditions required to be achieved to vest.

For years ended December 31, 2017, 2016 and 2015, the weighted average grant date fair value of shares granted was $5.01, $8.29, and $16.03, respectively.
For years ended December 31, 2017, 2016 and 2015, the total fair value of shares vested was $1.8 million, $2.6 million, and $2.2 million, respectively.
The Company recognized restricted stock expense of $3.0 million, $3.7 million, and $2.8 million for the years ended December 31, 2019, 2018 and 2017, 2016, and 2015, respectively. As of December 31, 2017, there was $5.2 million of unrecorded expense related to issued restricted stock that will be recognized over an estimated weighted average period of 1.9 years.
Non-Employee Restricted Stock
During the years ended December 31, 2017, 2016, and 2015, $79 thousand, $30 thousand, and $0.1 million, respectively, was recorded as compensation expense for the change in the fair value of unvested non-employee restricted stock. There were no restricted stock units granted to non-employees during the year ended December 31, 2016.
As of December 31, 2017, 2016, and 2015, a total of 41,000, 41,000, and 72,000 shares of unvested restricted stock, respectively, issued to non-employees were outstanding.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except per share, per unit, and number of years)

Award Modifications
During 2017, there was an award modification affecting one employee. The employee was provided with twelve months of accelerated vesting for all awards outstanding which included stock options, restricted stock units, and four performance stock units. The total incremental stock compensation expense recognized for the years ended 2017, 2016 and 2015 related to awards modifications was $286,000, $273,000 and $46,000, respectively.
5. Net Loss Per Share
Net loss per share was computed by dividing net loss by the weighted average number of common shares outstanding for the years ended December 31, 2017, 2016, and 2015:

Year Ended December 31,

2017
2016
2015
Net loss$(66,400)
$(154,677)
$(50,424)
Shares used in computing basic and diluted net loss per share83,325

80,976

67,671
Basic and diluted net loss per share$(0.80)
$(1.91)
$(0.75)

The following outstanding Company securities, using the treasury stock method, were excluded from the above calculations of net loss per share because their impactthe effect would have been anti-dilutive due to the net losses during the years ended December 31, 2017, 2016, and 2015:anti-dilutive:

 Year Ended December 31, Year Ended December 31,

2017
2016
20152019 2018 2017
Common stock options520
1,248
1,65162
 11,276
 52,029
Restricted stock awards119
129
1333,501
 11,616
 11,898
Restricted stock units250
370
23070,472
 21,974
 25,005
Warrants1,522,002
 
 
Total889
1,747
2,0141,596,037
 44,866
 88,932

Conversion of Senior Notes
As discussed in Note 6, in December 2013, the Company issued $86.3 million in aggregate principal amount of 2.25% Convertible Senior Notes due 2018 (the “2.25% Senior Notes”) in an underwritten public offering. In October 2015, the Company also issued $125.0 million in aggregate principal amount of 3.25% Convertible Senior Notes due 2020 (the “3.25% Senior Notes”) in an underwritten public offering. Upon any conversion, the 2.25% Senior Notes and/or 3.25% Senior Notes, (collectively the "Senior Notes") may be settled, at the Company’s election, in cash, shares of the Company’s common stock or a combination of cash and shares of the Company’s common stock. For purposes of calculating the maximum dilutive impact, it is presumed that the Senior Notesconvertible notes will be settled in common stock and all conversion features within the term loan facility will be exercised with the resulting potential common shares included in diluted earnings per share if the effect is more dilutive. The effect of the conversion of the Senior Notesconvertible senior notes and term loan facility is excluded from the calculation of diluted loss per share because the impact of these securities would be anti-dilutive.
The potential dilutive effect of these securities is shown in the table below:
 Year Ended December 31,
 2019 2018 2017
Convertible notes8,211,088
 755,695
 1,193,938
Conversion features under term loan facility10,486,604
 1,522,002
 647,001
The effect of the contingently issuable common stock (see Note 9) is excluded from the calculation of basic net loss per share until all necessary conditions for issuance have been satisfied.

6. Credit Facilities
Debt consisted of the following:
 December 31,
 2019 2018
Term loan facility$167,858
 $161,622
Convertible notes73,165
 84,500
Other debt4,281
 4,281
Debt discounts and deferred financing costs(62,638) (52,325)
Long-term debt, including current portion182,666
 198,078
Less current portion(10,606) 
Long-term debt$172,060
 $198,078
Deerfield Warrants

Facility Agreement, as Amended
On April 3, 2017 (the “Original Agreement Date”), the Company entered into a Facility Agreement (the “Facility Agreement”)facility agreement with affiliates of Deerfield Management Company, L.P. (collectively, “Deerfield”), pursuant to which Deerfield agreed to loan to the Company up to $120.0 million (the “Term Loan”), subject to the terms and conditions set forth in the facility agreement (the “Original Facility Agreement”). The Company drew the entire principal amount of the Term Loan on the Original Agreement Date.
On August 9, 2018 (the “Restated Agreement Date”), the Company entered into an amended and restated facility agreement (the “Restated Facility Agreement”) with Deerfield, pursuant to which Deerfield and the Company canceled and

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

extinguished the $40.5 million principal amount of 3.25% Convertible Senior Notes due 2020 (the “3.25% Senior Notes”) held by Deerfield in exchange for an additional $40.5 million of indebtedness under the Restated Facility Agreement (as a last-out waterfall tranche under the Restated Facility Agreement). The Company entered into the Restated Facility Agreement with Deerfield to, among other things, allow for the Company’s entry into the Restated Credit Agreement (as defined in the “Deerfield Revolver” section below) and the transactions contemplated therein. The Restated Facility Agreement amended and restated in its entirety the Company’s Original Facility Agreement with Deerfield.
On November 18, 2018, the Company and Deerfield amended the Restated Facility Agreement pursuant to that certain First Amendment to Amended and Restated Facility Agreement, dated November 20, 2018 (the “First Facility Amendment”), which amendment permitted the Company to incur debt pursuant to its subordinated promissory note (the “JLL Note”) with Japan Lifeline Co., Ltd. (“JLL”), subject to certain conditions.
On March 31, 2019, the Company and Deerfield entered into a Second Amendment to Amended and Restated Facility Agreement (the “Term Loan”“Second Facility Amendment” and collectively with the Restated Facility Agreement and First Facility Amendment, the “Deerfield Facility Agreements”). Pursuant toOn April 3, 2019, the terms of the Second Facility Amendment became effective.
The Second Facility Amendment provides for, among other things, the reduction in the Company’s global excess liquidity covenant from $22.5 million to $17.5 million and the reduction of the Company’s minimum net revenue financial covenants. In addition, the percentage of the $120.0 million of first out waterfall loans (the “First Out Waterfall Loans”) due on April 2, 2021 decreased from 33.33% to 16.67%  of the First Out Waterfall Loans outstanding on such date, while the percentage of the remainder of the First Out Waterfall Loans due on April 2, 2022 remained at 50% of the First Out Waterfall Loans outstanding on such date.
The Deerfield Facility Agreements provide for the exchange of the existing notes representing the First Out Waterfall Loans for amended notes (the “First Out Waterfall Notes”) that provide that in the event that, in any calendar month beginning April 1, 2019 and ending June 30, 2020 (the “Mandatory Conversion Period”), if (A)(i) the arithmetic mean of the volume weighted average prices of the Company’s common stock (the “VWAP”) on the five (5) consecutive trading days ending on the 15th calendar day (or, if not a trading day, the first trading day thereafter) (the “Mandatory Conversion Measurement Date”) and (ii) the closing price for the Company’s common stock on the Mandatory Conversion Measurement Date, both exceed $6.625 (as may be adjusted to reflect certain events) (the “Fixed Conversion Price”) and (B)(i) the VWAP on the five (5) consecutive trading days ending on (and including) the third (3rd) trading day immediately prior to the Mandatory Conversion Measurement Date (the “Initial Mandatory Conversion Measurement Date”) and (ii) the closing price for the Company’s common stock on the Initial Mandatory Conversion Measurement Date both exceed the Fixed Conversion Price, Deerfield shall be obligated to convert $1,666,666 of the principal amount of the loan into shares of common stock at the Fixed Conversion Price (each, a “Deerfield Mandatory Conversion”), up to a maximum aggregate amount of $25.0 million over the Mandatory Conversion Period.
Deerfield also has the option to convert up to an additional $50.0 million of the Company’s outstanding debt (the “Voluntary Conversion Amount”) at the greater of the Fixed Conversion Price and 85% of the arithmetic average of the VWAP of the Company’s common stock on each of the fifteen (15) consecutive trading days prior to the conversion date (the “15 Day VWAP”). The Company has the option to require conversion of the Voluntary Conversion Amount (less the amount of prior voluntary conversions) if the Company’s 15 Day VWAP is greater than 175% of the Fixed Conversion Price (each of the foregoing conversions, a “Deerfield Voluntary Conversion”). The First Out Waterfall Notes also provide that in no event may Deerfield convert any note amounts, whether voluntarily or mandatorily, into shares of common stock if such conversion would result in Deerfield beneficially owning more that 4.985% of the Company’s outstanding common stock. The First Out Waterfall Notes also revises Deerfield’s existing right to convert a portion of the outstanding principal amount of the First-Out Waterfall Loan into a maximum of 1,430,001 shares of the Company’s common stock from the current conversion price of 96% of the arithmetic average of the VWAP of the Company’s common stock on each of the three (3) consecutive trading days prior to the conversion date (the “96% VWAP Price”) to the greater of (i) $6.625 (subject to certain adjustments) or (ii) the 96% VWAP Price (a “Deerfield Elective Conversion”).
Further, the Second Facility Amendment also provided for an increase of $5.0 million, from $6.1 million to $11.1 million, in the amounts payable to Deerfield as a fee upon termination (or reduction, or required reduction of the outstanding amounts under the First Out Waterfall Notes to less than $10,000,000) of the Deerfield Facility Agreements and to reimburse Deerfield for all expenses incurred by Deerfield in connection with the negotiation and documentation of the Second Facility Amendment.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

The terms of the Second Facility Amendment became effective on April 3, 2019 upon satisfaction of certain conditions precedent, including consummation of the purchase and sale of an aggregate of 7,889,552 shares of the Company’s common stock (the “Equity Shares”) to select institutional investors and certain other parties (“Investors”) at a price per share of $6.61 (the “Equity Offering Price”), for an aggregate cash purchase price of approximately $52.15 million. The Company has issued the Deerfield Warrants and the First Out Waterfall Notes contemplated by the Second Facility Amendment.
The Company evaluated the accounting for Second Facility Amendment transaction and determined it represented an extinguishment of the previously issued First Out Waterfall Loans under the Restated Facility Agreement, primarily due to the addition and significance of the conversion features as described above. During the twelve months ended December 31, 2019, the Company recorded a loss on debt extinguishment of $29.3 million, which includes the change in fair value of the Deerfield Warrants of $4.8 million, offset by the removal of $5.9 million of derivative liabilities associated with the debt prior to the transaction.
Any outstanding principal under the Deerfield Facility Agreements will accrue interest at a rate equal to 5.00% payable in cash and 4.75% payable in kind. The Deerfield Facility Agreements contain the same operating covenants applicable to First Credit Amendment. The Company’s prior right to satisfy interest payments on the First Out Waterfall Loans with up to 250,000 shares of its common stock was eliminated in connection with entry into the Second Facility Amendment.
On February 24, 2020, the Company entered into a February 2020 Exchange Agreement and Fourth Amendment to Amended and Restated Facility Agreement and Amendment to First Out Waterfall Notes (the “Fourth Facility Amendment”). The Fourth Facility Amendment provides for, among other things, the conversion of certain portions of the outstanding convertible debt upon the achievement of certain milestones. In addition, 8.333% (or approximately $10.7 million as of February 24, 2020) of the First Out Waterfall Loans currently due on April 2, 2021 (the “First Amortization Payment”) will be extended to July 1, 2021. Further, the Fourth Facility Amendment provides that the interest payment date due April 1, 2020 will be payable in paid-in-kind interest by increasing the principal amount of the loans by an amount equal to the interest that has accrued. For more information regarding the Fourth Facility Amendment see Note 14 for further details.
The Company’s obligations under the Deerfield Facility Agreements are secured by a first priority security interest in substantially all of the Company’s assets including intellectual property, with the priority of such security interest being pari passu with the security interest granted to Deerfield pursuant to the Restated Credit Agreement.
During the twelve months ended December 31, 2019, the Company converted $1.7 million of principal, or $1.3 million carrying value, of the First Out Waterfall Notes into 251,571 shares of common stock pursuant to Deerfield Mandatory Conversions.
As of December 31, 2019, the Company had a carrying amount of $141.3 million, inclusive of deferred financing costs of $2.6 million, related to the Term Loan. As of December 31, 2019, annual interest expense on the Term Loan will range from $4.5 million to $29.6 million from the effectiveness of the second Facility Amendment date through maturity.
Upon a change of control of the Company, if the acquirer satisfies certain conditions set forth in the Deerfield Facility Agreements, such acquirer may assume the outstanding principal amount under the Deerfield Facility Agreements without penalty. If such acquirer does not satisfy the conditions set forth in the Deerfield Facility Agreements, Deerfield may, at its option, require the Company to repay the outstanding principal balance under the Facility Agreement plus, depending on the timing of the change of control transaction, the Company may be required to pay a make-whole premium and will be required to pay a change of control fee.
At any time on or after April 2, 2021 (the “First Amortization Date”), the Company has the right to prepay any amounts owed under the Deerfield Facility Agreements without premium or penalty, unless such prepayment occurs in connection with a change of control of the Company, in which case the Company must pay Deerfield a change of control fee unless such change of control occurs beyond a certain period after the maturity date. At any time prior to the First Amortization Date, any prepayment made by the Company will be subject to a make-whole premium and, if such prepayment occurs in connection with a change of control of the Company, a change of control fee.
Any amounts drawn under the Deerfield Facility Agreements may become immediately due and payable upon customary events of default, as defined in the Deerfield Facility Agreements, or the consummation of certain change of control transactions, as described above.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

Deerfield Warrants
In connection with the execution of the Original Facility Agreement and the Restated Facility Agreement, the Company issued warrants to Deerfield (the “Original 2017 Deerfield Warrants” and the “Original 2018 Deerfield Warrants,” respectively). In connection with entry into the Second Facility Amendment, the Company amended the Original 2017 Deerfield Warrants and the Original 2018 Deerfield Warrants in order to purchase an aggregate of 6,470,000 shares of common stockreduce the exercise price (as amended, the “2017 Deerfield Warrants” and the “2018 Deerfield Warrants”; collectively, the “Deerfield Warrants”) as summarized below:
 Number of shares of common stock Previous Exercise Price Amended Exercise price
2017 Deerfield Warrants647,001
 $92.30
 $6.61
2018 Deerfield Warrants875,001
 $47.10
 $6.61
All other material terms and conditions of the Company at an exercise price of $9.23 per share (the “Deerfield Warrants”). Deerfield Warrants remain the same.
The number of shares of common stock of the Company into which the Deerfield Warrants are exercisable and the exercise price of the Deerfield Warrants will be adjusted to reflect any stock splits, recapitalizations or similar adjustments in the number of outstanding shares of common stock of the Company. Refer to Note 6

The 2017 Deerfield Warrants expire on the 7th anniversary of the NotesAgreement Date. Subject to certain exceptions, the 2017 Deerfield Warrants contain limitations such that the Company may not issue shares of common stock of the Company to Deerfield upon the exercise of the 2017 Deerfield Warrants if such issuance would result in Deerfield beneficially owning in excess of 4.985% of the total number of shares of common stock of the Company then issued and outstanding.
The holders of the 2017 Deerfield Warrants may exercise the 2017 Deerfield Warrants for cash, on a cashless basis or through a reduction of an amount of principal outstanding under the Term Loan. In connection with certain major transactions, the holders may have the option to convert the 2017 Deerfield Warrants, in whole or in part, into the right to receive the transaction consideration payable upon consummation of such major transaction in respect of a number of shares of common stock of the Company equal to the CondensedBlack-Scholes value of the 2017 Deerfield Warrants, as defined therein, and in the case of other major transactions, the holders may have the right to exercise the 2017 Deerfield Warrants, in whole or in part, for a number of shares of common stock of the Company equal to the Black-Scholes value of the 2017 Deerfield Warrants.
The 2018 Deerfield Warrants expire on the 7th anniversary of the Restated Agreement Date. The holders of the 2018 Deerfield Warrants may exercise the 2018 Deerfield Warrants for cash, on a cashless basis, or by reduction of the principal owed to Deerfield pursuant to the Restated Facility Agreement.
As a result of the amendment to the Deerfield Warrants in connection with entry into the Second Facility Amendment, the change in fair value in the 2017 and 2018 Deerfield Warrants was $2.1 million and $2.7 million, respectively. The foregoing was charged to loss on debt extinguishment.

Derivative Liabilities
In accordance with Accounting Standards Codification (“ASC”) 815, “Derivatives and Hedging”, and ASC 470, “Debt”, the Company assessed whether any provisions within the Second Facility Amendment constitute embedded derivatives requiring bifurcation from the host instrument, and assessed the fair values of any such features. The Company determined that the Deerfield Voluntary Conversion, when converted at 85% of 15 Day VWAP, effectively provided the holders with an embedded put option derivative meeting the definition of an “embedded derivative” pursuant to ASC 815. Consequently, the embedded derivative was bifurcated and accounted for separately. The Second Facility Amendment retained a provision that, upon a change of control of the Company, Deerfield may declare the outstanding principal of the loans to be immediately due and payable in full, together with any accrued and unpaid interest, a “Change of Control” fee, and a specified make-whole amount (prior to prior to the First Amortization Date). This feature remained substantively the same as outlined under the previous Restated Facility Agreement. The Company concluded that this provision meets the definition of a derivative and requires bifurcation and separate accounting pursuant to ASC 815. As of April 3, 2019, the Company measured the fair value of the above embedded derivatives at $20.4 million and recorded the amount in derivative liabilities in the Consolidated Financial Statements for further discussion.

Balance Sheet.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

The potential dilutive effectFor the years ended December 31, 2019 and 2018, the Company recorded income of these securities is shown$17.7 million and $12.1 million, respectively, as a fair value adjustment of the derivative liabilities. Adjustments to the fair value of the derivative liabilities are recognized within other income (expense), net in the chart below:
Consolidated Statements of Operations and Comprehensive Loss.

Year Ended December 31,

2017
2016
2015
Conversion of the Senior Notes11,939
14,767
14,767
Deerfield Warrants6,470

Deerfield Revolver
On the Agreement Date, the Company entered into a Credit and Security Agreement (the “Credit Agreement”) with Deerfield ELGX Revolver, LLC (“Deerfield Revolver”) pursuant to which the Company could borrow up to the lesser of $50.0 million or its applicable borrowing base (the “Previous Revolver”). The Company recorded $1.2 million in deferred financing costs related to the Previous Revolver and presented these costs as a deferred asset and amortized as interest expense over the term of the Previous Revolver on the Company’s Consolidated Balance Sheets.

The effectEffective January 12, 2018, the Company terminated its Credit Agreement with Deerfield Revolver and paid $1.3 million in termination fees. Additionally, the Company wrote off $1.0 million in unamortized deferred financing costs as of the contingently issuable common stock is excludedtermination date. The total of $2.3 million was charged to loss on debt extinguishment on the Company’s Consolidated Statements of Operations and Comprehensive Loss.
On the Restated Agreement Date, the Company entered into a Credit Agreement (the “Restated Credit Agreement”) with Deerfield Revolver, pursuant to which the Company may borrow up to the lesser of $50.0 million or its applicable borrowing base from time to time prior to April 2, 2022 (the “ABL Facility”).
On March 31, 2019, the calculationCompany entered into a Second Amendment to Credit Agreement and First Amendment to Guaranty and Security Agreement (the “Second Credit Amendment” and collectively with the Restated Credit Agreement and First Credit Amendment, the “Deerfield Credit Agreements”). The Second Credit Amendment includes conforming revisions to reflect the changes in the Second Facility Amendment. In addition, the Second Credit Amendment extends the maturity date of basic loss per share until all necessary conditions for issuancethe Deerfield Credit Agreements to the earlier of (i) April 2, 2023 or (ii) the date the loans pursuant to the Deerfield Facility Agreements have been satisfied. Referrepaid in full.
The borrowing base consists of eligible accounts, eligible inventory and eligible equipment. On the Restated Agreement Date, availability under the ABL Facility was $24.0 million. Any outstanding principal under the ABL Facility will accrue interest at a rate equal to Note 9the London Interbank Offered Rate (LIBOR) (with a 1% floor) plus 5.50%, payable in cash. The interest rate will accrue on a minimum amount of $9.75 million, whether or not such amount is drawn (which amount in excess of the Notesrevolver usage accruing interest will not be subject to the Consolidated Financial Statements for further discussion.

6. Credit Facilities
2.25% Convertible Senior Notes
On December 10, 2013,unused line fee). The Company is subject to other fees in addition to interest on the Company issued $86.3 million in aggregateoutstanding principal amount under the ABL Facility, including a commitment fee of 2.25% Senior Notes. The 2.25% Senior Notes mature on December 15, 2018 unless earlier repurchased by the Company or converted. The Company received net proceeds from the sale of the 2.25% Senior Notes of approximately $82.6$0.5 million after deducting underwriting discounts and commissions and offering expenses($0.2 million payable by the Company. Interest isupon closing, $0.2 million payable on the 2.25% Senior Notes1st anniversary of the closing and $0.1 million payable on June 15the 2nd anniversary of the closing), a $1.0 million fee upon the expiration of the ABL Facility, and December 15an early commitment termination or reduction fee of each2.5% in the 1st year, beginning June 15, 2014.1.5% in the 2nd year, 0.5% in the 3rd year and 0% thereafter. The Company recorded $0.6 million in deferred financing costs, including the commitment fee, related to the ABL Facility and presented these costs as a deferred asset, to be subsequently amortized as interest expense over the term of the ABL Facility, on the Company’s Consolidated Balance Sheets. In conjunction with entering in the Second Credit Amendment, the Company recorded as additional $0.4 million in deferred financing costs.
The 2.25% Senior NotesDeerfield Credit Agreements have a $17.5 million minimum global liquidity requirement, net revenue tests, fixed charge coverage, capital expenditure limitations and operating expense tests. No event of default with respect the Company’s financial covenants had been declared as of December 31, 2019. The Deerfield Credit Agreements also contains various representations and warranties, events of default, and affirmative and negative covenants, customary for financings of this type, including reporting requirements, requirements that the Company maintain timely reporting with the SEC and restrictions on the ability of the Company and its subsidiaries to incur additional liens on their assets, incur additional indebtedness and acquire and dispose of assets outside the ordinary course of business.
The Company’s obligations under the Deerfield Credit Agreements are governedsecured by a first priority security interest in substantially all of the termsCompany’s assets including intellectual property, with the priority of a base indenture (the “Base Indenture”), as supplemented bysuch security interest being pari passu with the first supplemental indenturesecurity interest granted to Deerfield pursuant to the Company’s Deerfield Facility Agreements (as described above).
As of December 31, 2019, the Company had no outstanding borrowings and $0.8 million in deferred financing costs relating to the 2.25% Senior Notes (the “First Supplemental Indenture,” and together with the Base Indenture, the “2.25% Senior Notes Indenture”), between the Company and Wells Fargo Bank, National Association (the “Trustee”), each of which were entered into on December 10, 2013.
ABL Facility. The 2.25% Senior Notes are senior unsecured obligations and are: (a) senior in right of payment to the Company’s future indebtedness that is expressly subordinated in right of payment to the 2.25% Senior Notes; (b) equal in right of payment to the Company’s existing and future unsecured indebtedness that is not so subordinated; (c) effectively junior to any of the Company’s secured indebtedness to the extent of the value of the assets securing such indebtedness; and (d) structurally junior to all existing and future indebtedness (including trade payables) incurred by the Company’s subsidiaries.
On or after December 15, 2016, the Company may redeem for cash all or any portion of the 2.25% Senior Notes, at its option, but only if the closing sale price of the Company’s common stock for at least 20 trading days (whether or not consecutive) during any 30 consecutive trading day period ending on, and including, the second trading day immediately preceding the date on which the Company provides notice of redemption, exceeds 130% of the conversion price on each applicable trading day. The redemption price will equal 100% of the principal amount of the 2.25% Senior Notes to be redeemed, plus accrued and unpaid interest to, but excluding, the redemption date. No sinking fund is provided for the 2.25% Senior Notes.
Holders may convert their 2.25% Senior Notes at any time prior to the close of business on the business day immediately preceding September 15, 2018 only under the following circumstances: (1) during any calendar quarter commencing after the calendar quarter ending on March 31, 2014, if the closing sale price of the Company’s common stock, for at least 20 trading days (whether or not consecutive) in the period of 30 consecutive trading days ending on the last trading day of the calendar quarter immediately preceding the calendar quarter in which the conversion occurs, is more than 130% of the conversion price of the 2.25% Senior Notes in effect on each applicable trading day; (2) during the five consecutive business-day period following any five consecutive trading-day period in which the trading price for the 2.25% Senior Notes for each such trading dayremaining borrowings available was less than 98% of the closing sale price of the Company’s common stock on such date multiplied by the then-current conversion rate; (3) if the Company calls all or any portion of the 2.25% Senior Notes for redemption, at any time prior to the close of business on the second scheduled trading day prior to the redemption date; or (4) upon the occurrence of specified corporate events. On or after September 15, 2018 until the close of business on the second scheduled trading day immediately preceding the stated maturity date, holders may surrender their 2.25% Senior Notes for conversion at any time, regardless of the foregoing circumstances.
Upon conversion, the Company will at its election pay or deliver, as the case may be, cash, shares of the Company’s common stock or a combination of cash and shares of the Company’s common stock.$18.5 million.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

The initial conversion rate will be 41.6051 shares of the Company’s common stock for each $1,000 principal amount of 2.25% Senior Notes, which represents an initial conversion price of approximately $24.04 per share. Following certain corporate transactions that occur on or prior to the stated maturity date or the Company’s delivery of a notice of redemption, the Company will increase the conversion rate for a holder that elects to convert its 2.25% Senior Notes in connection with such a corporate transaction.
If a fundamental change (as defined in the 2.25% Senior Notes Indenture) occurs prior to the stated maturity date, holders may require the Company to purchase for cash all or any portion of their 2.25% Senior Notes at a fundamental change purchase price equal to 100% of the principal amount of the 2.25% Senior Notes to be purchased, plus accrued and unpaid interest to, but excluding, the fundamental change purchase date.
The 2.25% Senior Notes Indenture contains customary terms and covenants and events of default with respect to the 2.25% Senior Notes. If an event of default (as defined in the 2.25% Senior Notes Indenture) occurs and is continuing, either the Trustee or the holders of at least 25% in aggregate principal amount of the outstanding 2.25% Senior Notes may declare the principal amount of the 2.25% Senior Notes to be due and payable immediately by notice to the Company (with a copy to the Trustee). If an event of default arising out of certain events of bankruptcy, insolvency or reorganization involving the Company or a significant subsidiary (as set forth in the 2.25% Senior Notes Indenture) occurs with respect to us, the principal amount of the 2.25% Senior Notes and accrued and unpaid interest, if any, will automatically become immediately due and payable.
The Company was not required to separate the conversion option in the 2.25% Senior Notes under ASC 815, "Derivatives and Hedging", and has the ability to settle the 2.25% Senior Notes in cash, common stock or a combination of cash and common stock, at its option. In accordance with cash conversion guidance contained in ASC 470-20, "Debt with Conversion and Other Options", the Company accounted for the 2.25% Senior Notes by allocating the issuance proceeds between the liability and the equity component. The equity component is classified in stockholders’ equity and the resulting discount on the liability component is accreted such that interest expense equals the Company’s nonconvertible debt borrowing rate. The separation was performed by first determining the fair value of a similar debt that does not have an associated equity component. That amount was then deducted from the initial proceeds of the 2.25% Senior Notes as a whole to arrive at a residual amount, which was allocated to the conversion feature that is classified as equity. The initial fair value of the indebtedness was $66.9 million resulting in a $19.3 million allocation to the embedded conversion option. The embedded conversion option was recorded in stockholders’ equity and as debt discount, to be subsequently accreted to interest expense over the term of the 2.25% Senior Notes. Underwriting discounts and commissions and offering expenses totaled $3.7 million and were allocated between the liability and the equity component in proportion to the allocation of proceeds and accounted for as debt issuance costs and equity issuance costs, respectively. As a result, $2.9 million attributable to the indebtedness was recorded as deferred financing costs in other assets, to be subsequently amortized as interest expense over the term of the 2.25% Senior Notes, and $0.8 million attributable to the equity component was recorded as a reduction to additional paid-in-capital in stockholders’ equity. During the three months ended March 31, 2016, the Company adopted ASU 2015-03, "Simplifying the Presentation of Debt Issuance Costs" utilizing retrospective application as permitted. As a result, the Company reclassified $1.9 million of debt issuance costs from current and non-current other assets to reduce the 2.25% Senior Notes as of December 31, 2015.
On April 3, 2017, the Company entered into the Facility Agreement with Deerfield, pursuant to which Deerfield agreed to loan to the Company up to $120 million, subject to the terms and conditions set forth in the Facility Agreement. The Company used a portion of the proceeds from the Term Loan to repurchase $68 million aggregate principal amount of outstanding 2.25% Senior Notes, plus the accrued but unpaid interest thereon, from the holders thereof in privately negotiated transactions. Refer to the section entitled Deerfield Facility Agreement below for further discussion. The embedded conversion option of the 2.25% Senior Notes, which was originally recorded in additional paid-in capital, was reduced by $2.2 million. Additionally, $3.2 million related to the reduction of outstanding principal related to the 2.25% Senior Notes was charged to loss on debt extinguishment on the Company’s Consolidated Statements of Operations and Comprehensive Loss.
As of December 31, 2017, the Company had outstanding borrowings of $17.4 million, and deferred financing costs of $0.2 million, related to the 2.25% Senior Notes. There are no principal payments due during the term. Annual interest expense on these notes will range from $1.1 million to $1.5 million through maturity.
Capped Call Transactions
On December 10, 2013, in connection with the pricing of the 2.25% Senior Notes and the exercise in full of their overallotment option by the underwriters, the Company entered into privately-negotiated capped call transactions (the “Capped Call Transactions”) with Bank of America, N.A., an affiliate of Merrill Lynch, Pierce, Fenner & Smith Incorporated. The Capped Call Transactions initial conversion rate and number of options substantially corresponds to each $1,000 principal

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except per share, per unit, and number of years)

amount of 2.25% Senior Notes. The Company used approximately $7.4 million of the net proceeds from the 2.25% Senior Notes offering to pay for the cost of the Capped Call Transactions.
The Capped Call Transactions are separate transactions entered into by the Company with Bank of America, N.A., are not part of the terms of the 2.25% Senior Notes and will not change the holders’ rights under the 2.25% Senior Notes. The Capped Call Transactions have anti-dilution adjustments substantially similar to those applicable to the 2.25% Senior Notes. The Capped Call Transactions are derivative instruments that qualify for classification within stockholders’ equity because they meet an exemption from mark-to-market derivative accounting.
The Capped Call Transactions are expected generally to reduce the potential dilution and/or offset potential cash payments that the Company is required to make in excess of the principal amount upon conversion of the 2.25% Senior Notes in the event that the market price per share of the Company’s common stock, as measured under the terms of the Capped Call Transactions, is greater than the strike price of the Capped Call Transactions, which initially corresponds to the $24.04 conversion price of the 2.25% Senior Notes. If, however, the market price per share of the Company’s common stock, as measured under the terms of the Capped Call Transactions, exceeds the initial cap price of $29.02, there would nevertheless be dilution and/or there would not be an offset of such potential cash payments, in each case, to the extent that such market price exceeds the cap price of the Capped Call Transactions.
The Company will not be required to make any cash payments to Bank of America, N.A. or any of its affiliates upon the exercise of the options that are a part of the Capped Call Transactions, but will be entitled to receive from Bank of America, N.A. (or an affiliate thereof) a number of shares of the Company’s common stock and/or an amount of cash generally based on the amount by which the market price per share of the Company’s common stock, as measured under the terms of the Capped Call Transactions, is greater than the strike price of the Capped Call Transactions during the relevant valuation period under the Capped Call Transactions. However, if the market price of the Company’s common stock, as measured under the terms of the Capped Call Transactions, exceeds the cap price of the Capped Call Transactions during such valuation period under the Capped Call Transactions, the number of shares of common stock and/or the amount of cash the Company expects to receive upon exercise of the Capped Call Transactions will be capped based on the amount by which the cap price exceeds the strike price of the Capped Call Transactions.
For any conversions of 2.25% Senior Notes prior to the close of business on the 55th scheduled trading day immediately preceding the stated maturity date of the 2.25% Senior Notes, including without limitation upon an acquisition of the Company or similar business combination, a corresponding portion of the Capped Call Transactions will be terminated. Upon such termination, the portion of the Capped Call Transactions being terminated will be settled at fair value (subject to certain limitations), as determined by Bank of America, N.A., in its capacity as calculation agent under the Capped Call Transactions, which the Company expects to receive from Bank of America, N.A., and no payments will be due Bank of America, N.A. The capped call expires on December 13, 2018.
In connection with the Company’s repurchase of approximately $68 million aggregate principal amount of outstanding 2.25% Senior Notes in April 2017, the Company and Bank of America, N.A. unwound the portion of the Capped Call Transactions relating to the repurchased 2.25% Senior Notes. These Capped Call Transactions were originally classified in stockholders’ equity and continued to meet the criteria for classification thereof while outstanding, and therefore were not subsequently measured at fair value. The Company did not pay or receive any compensation related to the unwind of the Capped Call Transactions. Therefore, the Company accounted for the unwind of the Capped Call Transactions by removing these options at their carrying value in additional paid-in capital and recording an offsetting entry to additional paid-in capital. As a result, the Company did not recognize any gain or loss, and the unwind had no net impact on additional paid-in capital.
3.25% Convertible Senior Notes dueDue 2020
On November 2, 2015, the Company issued $125.0 million aggregate principal amount of 3.25% Senior Convertible Notes due 2020 (the “3.25% Senior Notes”).in an underwritten public offering. The 3.25% Senior Notes are governed by the a base indenture (“Base Indenture,Indenture”), as amended and supplemented by the second supplemental indenture relating to the 3.25% Senior Notes (the “Second Supplemental Indenture,” and together with the Base Indenture, the “3.25% Senior Notes Indenture”), dated as of November 2, 2015, by and between the Company and the Trustee.Trustee (as defined therein).
The 3.25% Senior Notes are senior unsecured obligations and are: senior in right of payment to the Company’s future indebtedness that is expressly subordinated in right of payment to the 3.25% Senior Notes; equal in right of payment to the Company’s existing and future unsecured indebtedness that is not so subordinated, including the 2.25% Senior Notes; effectively junior to any of the Company’s secured indebtedness to the extent of the value of the assets securing such

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except per share, per unit, and number of years)

indebtedness; and structurally junior to all existing and future indebtedness (including trade payables) incurred by the Company’s subsidiaries.
The 3.25% Senior Notes accrue interest at a rate of 3.25% per year, payable semi-annually in arrears on May 1 and November 1 of each year, commencing May 1, 2016.semi-annually. The 3.25% Senior Notes mature on November 1, 2020, unless earlier purchased, redeemed or converted into shares of common stock in accordance with the terms of the 3.25% Senior Notes Indenture.
The Company may not redeem the 3.25% Senior Notes prior to November 1, 2018. On or after November 1, 2018, the Company may redeem for cash all or any portion of the 3.25% Senior Notes, at its option, but only if the closing sale price of the Company’s common stock for at least 20 trading days (whether or not consecutive) during any 30 consecutive trading day period ending on, and including, the second trading day immediately preceding the date on which the Company provides notice of redemption, exceeds 130% of the conversion price on each applicable trading day. The redemption date can be no sooner than 30 trading days from the date on which notice of redemption is provided to the holders, during which time, up until two2 trading days prior to the redemption, the holders may elect to convert all or a portion of the 3.25% Senior Notes into shares of the Company’s common stock. The redemption price will equal 100% of the principal amount of the 3.25% Senior Notes to be redeemed, plus accrued and unpaid interest to,until, but excluding, the redemption date. No sinking fund is provided for the 3.25% Senior Notes.
The 3.25% Senior Notes are convertible at the option of the holders: (1)(i) in the calendar quarter following any quarter in which, for at least 20 out of the 30 consecutive trading days (whether or not consecutive) ending on the last day of the quarter, the closing price of the Company’s common stock is more than 130% of the then-current conversion price of the 3.25% Senior Notes; (2)(ii) in the five5 business days following any five day5-day period in which the trading price per $1,000 note was less than 98% of the product of the closing sale price of the Company’s common stock and the current conversion rate; (3)(iii) in the event that the Company has provided notice of redemption, but no later than two2 trading days prior to the Company’s proposed redemption date; or (4)(iv) upon the occurrence of specified corporate events. On or after August 1, 2020 until the close of business on the second scheduled trading day immediately preceding the stated maturity date, holders may surrender their 3.25% Senior Notes for conversion at any time, regardless of the foregoing circumstances.
The initial conversion rate of the 3.25% Senior Notes is 89.43148.9431 shares of the Company’s common stock per $1,000 principal amount of the 3.25% Senior Notes, which is equivalent to an initial conversion price of approximately $11.18$111.82 per share. The conversion rate is subject to adjustment upon the occurrence of certain specified events. Upon conversion, the Company, will at its election pay or deliver, as the case may be, cash, shares of the Company’s common stock or a combination of cash and shares of the Company’s common stock.
If a fundamental change (as defined in the 3.25% Senior Notes Indenture) occurs prior to the stated maturity date, holders may require the Company to purchase for cash all or any portion of their 3.25% Senior Notes at a fundamental change purchase price equal to 100% of the principal amount of the 3.25% Senior Notes to be purchased, plus accrued and unpaid interest.
The 3.25% Senior Notes Indenture contains customary terms and covenants and events of default with respect to the 3.25% Senior Notes. If an event of default (as defined in the 3.25% Senior Notes Indenture) occurs and is continuing, either the Trustee or the holders of at least 25% in aggregate principal amount of the outstanding 3.25% Senior Notes may declare the principal amount of the 3.25% Senior Notes to be due and payable immediately by notice to the Company (with a copy to the Trustee). If an event of default arising out of certain events of bankruptcy, insolvency or reorganization involving the Company or a significant subsidiary (as set forth in the 3.25% Senior Notes Indenture) occurs with respect to us,the Company, the principal amount of the 3.25% Senior Notes and accrued and unpaid interest, if any, will automatically become immediately due and payable.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

Upon issuance, and through December 31, 2015, the Company was not required to separate the conversion option from the 3.25% Senior Notes under ASC 815, "Derivatives“Derivatives and Hedging"Hedging”. However, because the Company has the ability to settle the 3.25% Senior Notes in cash, common stock or a combination of cash and common stock, the Company applied the cash conversion guidance contained in ASC 470-20, "Debt“Debt With Conversion and other Options"Options”, and accounted for the 3.25% Senior Notes by allocating the issuance proceeds between the liability-classified debt component and a separate equity component attributable to the conversion option. The equity component is classified in stockholders’ equity and the resulting discount on the liability component is accreted such that interest expense equals the Company’s borrowing rate for nonconvertible loan products of similar duration. The separation was performed by first determining the fair value of a similar debt that does not have an associated equity component. That amount was then deducted from the initial proceeds of the 3.25% Senior Notes as a whole to arrive at a residual amount, which was allocated to the conversion feature that is classified as equity. The initial fair value of the indebtedness was $97.8 million resulting in a $27.2 million allocation to the embedded conversion option. The embedded conversion option was recorded in stockholders’ equity and as a debt discount, to be subsequently accreted to interest

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except per share, per unit, and number of years)

expense over the term of the 3.25% Senior Notes. Underwriting discounts and commissions and offering expenses totaled $3.7 million and were allocated between the liability and the equity componentcomponents in proportion to the allocation of proceeds and accounted for as debt issuance costs and equity issuance costs, respectively. As a result, $2.9 million attributable to the indebtedness was recorded as deferred financing costs, in other assets, to be subsequently amortized as interest expense over the term of the 3.25% Senior Notes, and $0.8 million attributable to the equity component was recorded as a reduction to additional paid-in-capital in stockholders’ equity. During the three months ended March 31, 2016, the company adopted ASU 2015-03, "Simplifying the Presentation of Debt Issuance Costs", utilizing retrospective application as permitted. As a result,
On August 9, 2018, the Company reclassified $2.9entered into the Restated Facility Agreement with Deerfield, pursuant to which Deerfield and the Company canceled and extinguished the $40.5 million principal amount of debt issuance costs from current and non-current other assets to reduce the 3.25% Senior Notes held by Deerfield in exchange for an additional $40.5 million of indebtedness under the Restated Facility Agreement (as a last-out waterfall tranche under the Restated Facility Agreement).
On March 31, 2019, the Company and two investors holding $73.4 million of the principal amount of the 3.25% Senior Notes entered into an Exchange Agreement (the “2019 Exchange Agreement”) providing for the exchange of the holders’ 3.25% Senior Notes for new 5.00% Voluntary Convertible Senior Notes due 2024 (the “2019 5.00% Voluntary Notes”) and new 5.00% Mandatory Convertible Senior Notes due 2024 (the “5.00% Mandatory Notes”, and together with the 2019 5.00% Voluntary Notes, the “5.00% Notes”) which was completed on April 3, 2019.
The Company evaluated the accounting for the 2019 Exchange Agreement transaction and determined it represented an extinguishment of the previously issued 3.25% Senior Notes, primarily due to the addition and significance of the conversion features as ofdescribed above. During the twelve months ended December 31, 2015.2019, the Company recorded a gain on debt extinguishment of $17.5 million relating to the exchange of debt instruments. Additionally, the embedded conversion option of the 3.25% Senior Notes, which was originally recorded in additional paid-in capital, was reduced by $16.9 million.
As of December 31, 2017,2019, the Company had outstanding borrowings of $108.1$10.7 million and deferred financing costs of $1.8$0.1 million, related to the 3.25% Senior Notes. There arewere no principal payments due during the term. Annual interest expense on thesethe 3.25% Senior Notes will range from $9.1$0.7 million to $10.7$0.8 million through maturity.
In connection with its merger with TriVascular in February 2016,
5.00% Convertible Senior Notes due 2024
On April 3, 2019, the Company issued 13.6completed the transactions contemplated by the 2019 Exchange Agreement, issuing $25.0 million of principal amount of the 5.00% Mandatory Notes and $42.0 million of principal amount of the 2019 5.00% Voluntary Notes to the holders. The exchanging holders received $900 principal amount of 5.00% Notes for every $1,000 principal amount of 3.25% Senior Notes plus accrued interest.
The 2019 5.00% Voluntary Notes and 5.00% Mandatory Notes are governed by separate Indentures (respectively, the “2019 5.00% Voluntary Notes Indenture” and “5.00% Mandatory Notes Indenture”, and collectively, the “Indentures”), each dated April 3, 2019, by and between the Company and Wilmington Trust, National Association (“Wilmington”), as trustee. The 5.00% Notes will accrue interest at a rate of 5.00% per year, payable semi-annually in arrears on April 1 and October 1 of each year, commencing October 1, 2019. Such interest amount shall be paid, at the Company’s option, either in cash or, if certain terms are met in accordance with the Indentures, shares of common stock as consideration toor paid in kind. The 5.00% Notes mature on April 3, 2024, unless earlier purchased, redeemed or converted in accordance with the former stockholders. As a result of the Company's issuance of such shares in the merger, the quantity of authorized common shares available for future issuance was reduced to a level insufficient to honor all of the potential common shares underlying instruments then outstanding. Such instruments include the conversion options related to the 3.25% Senior Notes and 2.25% Senior Notes, employee stock options, restricted stock units, contingently issuable common stock relating to the prior Nellix acquisition, and stock warrants. The creation of this authorized share deficiency in February 2016 required the Company, during the first quarter of 2016, to separate as a stand-alone derivative the 3.25% Senior Notes conversion option and a portion of the 2.25% Senior Notes conversion option for which no authorized shares are available to effect share settlement in the event of a conversion. Accordingly, in February 2016 the Company re-classed $24.8 million of the conversion features originally recorded in stockholder’s equity of the Senior Notes to derivative liabilities which will be marked to market each period until the Company authorizes sufficient new common shares to alleviate the deficiency.

On June 2, 2016, the Company amended their Amended and Restated Certificate of Incorporation to increase the number of authorized shares of common stock from 100,000,000 to 135,000,000, which is currently at a level sufficient to alleviate the share deficiency. Accordingly, on June 2, 2016, the Company re-classed $68.6 million of the conversion features of the Senior Notes from derivative liabilities to additional paid-in capital.

For the year ended December 31, 2016, the Company recorded $43.8 million as a fair value adjustment of derivative liabilities. The primary factor causing the change in the fair value of the derivative liability was during the period February 3, 2016 through June 2, 2016 when the Company's stock price increased. Adjustments to the fair value of the derivative liabilities are recognized within other income (expense) in the Consolidated Statements of Operations and Comprehensive Loss.

The value of the derivative liabilities were estimated using a “with” and “without” approach utilizing observable and unobservable inputs causing this to be a Level 3 measurement. In the “with” scenario, the value of the Senior Notes were estimated in a binomial lattice model that considers all terms of the SeniorIndentures. The Indentures governing the 5.00% Notes including the conversion features, with a rangecontain customary terms and covenants and events of probabilities and assumptions related to the timing and likelihood of the conversion features being exercised by either the Company or the holders of the Senior Notes. In the “without” scenario the value of the Senior Notes absent the conversion options were estimated. The difference between the values estimated in the “with” and “without” scenarios represents the value of the derivative liabilities. Changes in the value of the derivative liabilities were driven by changes in the Company’s stock price, expected volatility, credit spreads, and market yields.
Bank of America Line of Credit
On July 21, 2015, the Company entered into a revolving credit facility with Bank of America, N.A. (“BOA”), whereby the Company could borrow up to $20.0 million (the “BOA Credit Facility”). All amounts owing under the BOA Credit Facility would become due and payable upon its expiration on July 21, 2017. A sub-feature in the line of credit allowed for the issuance of up to $10.0 million in letters of credit. The BOA Credit Facility was collateralized by all of the Company's assets, except its intellectual property. The BOA Credit Facility could be terminated at any time during the two year term by the Company upon three business days’ notice. The BOA Credit Facility usage was priced at a spread over the one-, two-, three- and six-month LIBOR rates, and was subject to a covenant related to timely providing publicly reported information and a liquidity covenant tied to Unencumbered Liquid Assets ("ULA") of not less than $30.0 million. If not in default, the Company had the ability to reduce the ULA covenant requirement by reducing the BOA Credit Facility, with the ULA maintained at 1.5 times the BOA Credit Facility.default.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

The Company terminated5.00% Voluntary Notes are convertible at the BOA Credit Facilityoption of each holder into shares of common stock at any time on or after July 29, 2016 concurrent with its entry into a credit and security agreement with MidCap.
MidCap Credit Facility
On July 29, 2016,1, 2020, but prior to the close of business on the business day immediately preceding January 1, 2024, provided that, except if the Company entered intoundergoes a creditfundamental change (as defined in the 2019 5.00% Voluntary Notes Indenture) and security agreement with MidCap Financial Trust ("MidCap"for certain other customary circumstances of conversion, each holder may not convert more than 30% the initial aggregate principal amount of his or her outstanding 2019 5.00% Voluntary Notes per calendar quarter (a “2019 5.00% Voluntary Conversion”), as agent. Thereafter, until the close of business on the business day immediately preceding the maturity date, the 2019 5.00% Voluntary Notes will be convertible at the option of the holder at any time regardless of the conditions described in this paragraph. The initial conversion rate of the 2019 5.00% Voluntary Notes in a 2019 5.00% Voluntary Conversion is 0.12103 shares of the Company’s common stock per $1.00 principal amount of the 2019 5.00% Notes, which is equivalent to an initial conversion price per share equal to $8.2624 (the “2019 5.00% Voluntary Conversion Price”). The conversion rate is subject to adjustment upon the occurrence of certain specified events. Except if the Company undergoes a fundamental change (as defined in the 2019 5.00% Voluntary Notes Indenture) and for certain other customary circumstances of conversion, in no event prior to the close of business on the business day immediately preceding January 1, 2024 may the 2019 5.00% Voluntary Notes be converted in a calendar quarter unless the closing sale price of the Company’s common stock for at least twenty (20) trading days during the period of thirty (30) consecutive trading days ending on the last trading day of the immediately preceding calendar quarter is greater than or equal to 7.271 (subject to adjustment upon the occurrence of certain specified events) (the “2019 5.00% Voluntary Conversion Threshold”).
The 5.00% Mandatory Notes provide for the lenders party theretomandatory conversion (a “5.00% Mandatory Conversion”) of $1,666,666 of the aggregate principal amount each calendar month for fifteen (15) consecutive months beginning on the calendar month beginning with April 3, 2019, if and only if at the end of the prior calendar month the trailing average VWAP of the last five (5) trading days of the prior calendar month is greater than $6.61. In the event of a 5.00% Mandatory Conversion, $1,666,666 of the 5.00% Mandatory Notes would mandatorily convert at a conversion rate of 0.15129 shares of the Company’s common stock per $1.00 principal amount of the 5.00% Notes, which is equivalent to a price per share equal to $6.61. The 5.00% Mandatory Notes will be convertible at the option of each holder into shares of common stock at the 5.00% Voluntary Conversion Price at any time prior to the close of business on the business day immediately preceding January 1, 2024, provided that, except if the Company undergoes a fundamental change (as defined in the 5.00% Mandatory Notes Indenture) and for certain other customary circumstances of conversion, each holder may not convert more than 30% of the initial aggregate principal amount of his or her outstanding New Mandatory Note per calendar quarter, and provided further, that (i) voluntary conversions may be effected only if the 5.00% Voluntary Conversion Threshold has been achieved and (ii) a voluntary conversion may not take place in the same calendar quarter as a 5.00% Mandatory Conversion. Thereafter, until the close of business on the business day immediately preceding the maturity date, the 5.00% Mandatory Notes will be convertible at the option of the holder at any time regardless of the conditions described in this paragraph.
The Indentures provide that in no event may a holder convert, whether in a 2019 5.00% Voluntarily Conversion or a 5.00% Mandatory Conversion or otherwise, into shares of common stock if such conversion would result in the holder beneficially owning more that 9.5% of the Company’s outstanding common stock.
Upon issuance, the Company was not required to separate the conversion options from the 5.00% Notes under ASC 815, “Derivatives and Hedging”. However, because the Company has the ability to settle the 5.00% Notes in cash, common stock or a combination of cash and common stock, the Company applied the cash conversion guidance contained in ASC 470-20, “Debt With Conversion and other Options”, and accounted for the 5.00% Notes by allocating the issuance proceeds between the liability-classified debt component and a separate equity component attributable to the conversion options. The equity component is classified in stockholders’ equity and the resulting discount on the liability component is accreted such that interest expense equals the Company’s borrowing rate for nonconvertible loan products of similar duration. The separation was performed by first determining the fair value of a similar debt that does not have an associated equity component. That amount was then deducted from the initial proceeds of the 5.00% Notes as a whole to arrive at a residual amount, which was allocated to the conversion feature that is classified as equity. The initial fair value of the indebtedness was $67.2 million resulting in a $41.2 million allocation to the embedded conversion option. The embedded conversion option was recorded in stockholders’ equity and as a lender, wherebydebt discount, to be subsequently accreted to interest expense over the Company may borrow upterm of the 5.00% Notes. Debt issuance costs totaled $1.2 million and were allocated between the liability and the equity components in proportion to the lesserallocation of $50.0 million or its applicable borrowing base of asset-based revolving loans (the “MidCap Credit Facility”). All amounts owing under the MidCap Credit Facility shall accrue interest at a rate equal to the LIBOR Rate plus fourproceeds and one tenth percent (4.10%). For purposes of the MidCap Credit Facility, LIBOR Rate means a per annum rate of interest equal to the greater of (a) one half of one percent (0.50%)accounted for as debt issuance costs and (b) the rate determined by MidCap by dividing (i) the Base LIBOR Rate, meaning the base London interbank offer rate for the applicable interest period, by (ii) the sum of one minus the daily average during such interest period of the aggregate maximum reserve requirement then imposed under Regulation D of the Board of Governors of the Federal Reserve System for Eurocurrency Liabilities (as defined therein).

The MidCap Credit Facility was secured by substantially all of the Company's assets, excluding its intellectual property (“Collateral”), and placed customary limitations on indebtedness, liens, distributions, acquisitions, investments, and other activities of the Company in a manner designed to protect the Collateral.

Deferred financingequity issuance costs, directly related to the MidCap Credit Facility such as legal, origination, and professional services fees totaled $0.9 million. In conjunction with the Company’s adoption of ASU 2015-03 “Simplifying the Presentation of Debt Issuance Costs” during the first quarter of 2016, the Company also adopted an update thereof or ASU 2015-15 “Presentation and Subsequent Measurement of Debt Issuance Costs Associated with Line-of Credit Arrangements.”respectively. As a result, $0.9$0.5 million attributable to the MidCap Credit Facilityindebtedness was recorded as deferred financing costs, in other assets, to be subsequently amortized as interest expense over the term of the MidCap Credit Facility. The MidCap Credit Facility also contained a lockbox arrangement clause requiring the Company to maintain a lockbox bank account in favor of the MidCap Credit Facility; Company cash receipts remitted5.00% Notes, and $0.7 million attributable to the lockbox bank account were swept on a regular basis to reduce outstanding borrowings related to the MidCap Credit Facility.

In conjunction with the Company’s termination of the BOA Credit Facility and concurrent entry into a credit and security agreement with MidCap in July 2016, the Company entered into a corporate credit card agreement whereby the Company is required to maintain a $2.0 million deposit in favor of the credit card issuer. The deposit account related to these credit cards will be presented as restricted cash on the Company’s Consolidated Balance Sheets.

On April 3, 2017, the Company replaced the MidCap Credit Facility with a new revolving line of credit with Deerfield ELGX Revolver, LLC. As a result, the Company wrote off approximately $0.8 million in deferred financing costs and was required to pay a $2.5 million termination fee to Midcap; the foregoing were charged to loss on debt extinguishment on the Company’s Consolidated Statements of Operations and Comprehensive Loss.
Deerfield Facility Agreement
On April 3, 2017 (“the Agreement Date”), the Company entered into a Facility Agreement (the “Facility Agreement”) with affiliates of Deerfield Management Company, L.P. (collectively, “Deerfield”), pursuant to which Deerfield agreed to loan to the Company up to $120.0 million, subject to the terms and conditions set forth in the Facility Agreement (the “Term Loan”). The Company drew the entire principal amount of the Term Loan on the Agreement Date. The Company agreed to pay Deerfield a yield enhancement fee equal to 2.25% of the principal amount of the funds disbursed on the Agreement Date. The Company also agreed to reimburse Deerfield for all reasonable out-of-pocket expenses incurred by Deerfield in connection with the negotiation and documentation of the Facility Agreement up to a capped amount. Accordingly, deferred financing costs of $5.1 millionequity component was recorded on the Company’s Consolidated Balance Sheets as a direct reduction of the Term Loan, to be subsequently amortized as interest expense over the effective period of the Term Loan. Concurrently with entering into the Facility Agreement, the Company entered into a Guaranty and Security Agreement with Deerfield (the “Security Agreement”), pursuant to which, as security for the repayment of the Company’s obligations under the Facility Agreement, the Company granted to Deerfield a first priority security interestadditional paid-in-capital in substantially all of the Company’s assets including intellectual property, with the priority of such security interest being pari passu with the security interest granted pursuant to the Facility Agreement.

stockholders’ equity.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

Any amounts drawnDuring the twelve months ended December 31, 2019, the Company converted $5.0 million of principal, or carrying value of $2.0 million, of the 5.00% Mandatory Notes, together with $67 thousand of accrued and unpaid interest into 766,652 shares of common stock pursuant to 5.00% Mandatory Conversions.
As of December 31, 2019, the Company had a carrying amount of $26.5 million, inclusive of deferred financing costs of $0.4 million, related to the 5.00% Notes. Annual interest expense on these 5.0% Notes will range from $4.4 million to $14.7 million through maturity.
Japan Lifeline Co., Ltd. Subordinated Promissory Note
On November 20, 2018, the Company issued the JLL Note to JLL, the Company’s Japanese distributor, pursuant to which the Company converted a $4.3 million refund payable to a note payable. The amount owing under the Facility Agreement accrueJLL Note accrues interest at a rate of 6.87%2.5% per annum payable quarterly in arrears beginningand, subject to the terms of the subordination agreement among the Company, JLL and certain Deerfield entities entered into on July 1, 2017November 20, 2018, would become due and payable on the first business dayearlier of: (i) December 31, 2023; or (ii) the date the JLL Note is declared due and payable by JLL upon the occurrence of each calendar quarter thereafter and on the Maturity Date, unless repaid earlier. certain events of default.
Principal Maturities of Long-term Debt
The Company will be required to pay Deerfield on eachaggregate principal maturities of April 2, 2021, April 2, 2022 and April 2, 2023 (the “Maturity Date”), an amortization payment equal to $40 million (or, if on the Maturity Date, the remaining outstanding principal amountlong-term debt as of the Term Loan).December 31, 2019 are as follows:
 Term loan facility Convertible notes Other debt Total
Year ending December 31:      
2020$
 $11,145
 $
 $11,145
202120,846
 
 
 20,846
202273,506
 
 
 73,506
202373,506
 
 4,281
 77,787
2024
 62,019
 
 62,019
 $167,858
 $73,164
 $4,281
 $245,303

Upon a change
7. Revenue Disaggregation
The Company disaggregated revenue in accordance with the new revenue standard to depict how the nature, amount, timing, and uncertainty of revenue and cash flows are affected by economic factors. These economic factors are primarily attributable to different geographic regions and the timing of transfer of control of products to customers. Accordingly, sales in which control of the product has passed to the customer at the time of procedure or implant into a patient or at the time of shipment have been bifurcated as “Implant-based” and “Shipment-based” revenue, respectively. The table below includes a reconciliation of disaggregated revenue with the Company’s reportable segment:
 Year Ended December 31,
 2019 2018 2017
 Implant-based Shipment-based Total Implant-based Shipment-based Total Implant-based Shipment-based Total
United States$92,071
 $3,245
 $95,316
 $106,014
 $3,079
 $109,093
 $120,572
 $2,637
 $123,209
International13,745
 34,309
 48,054
 21,097
 26,283
 47,380
 23,246
 34,702
 57,948
Total Revenue$105,816
 $37,554
 $143,370
 $127,111
 $29,362
 $156,473
 $143,818
 $37,339
 $181,157

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

8. Commitments and Contingencies
(a) Leases
The Company ifdetermines whether an arrangement is a lease at inception. The Company leases facilities located in Irvine, California and Santa Rosa, California and an office located in 's-Hertogenbosch, the acquirer satisfies certain conditions set forth in the Facility Agreement, such acquirer may assume the outstanding principal amount under the Facility Agreement without penalty. If such acquirer does not satisfy the conditions set forth in the Facility Agreement, Deerfield may, at its option,Netherlands. These facility lease agreements require the Company to repay the outstanding principal balance under the Facility Agreement plus, dependingpay variable operating costs, including property taxes, insurance and maintenance based on the timing of the change of control transaction, the Company may be required to pay a make-whole premium and will be required to pay a change of control fee.

Atcosts incurred or actual usage. The Company’s facility leases do not contain any time on or after the fourth anniversary of the Agreement Date,residual value guarantees. In addition, the Company has certain equipment and automobiles under long-term agreements that were not material for the right to prepay any amounts owed undertwelve months ended December 31, 2019.
All facility leases are accounted for as operating leases. A right-of-use asset, representing the Facility Agreement without premium or penalty, unless such prepayment occurs in connection withunderlying asset during the lease term, and a change of controllease liability, representing the payment obligation arising from the lease, are recognized on the balance sheet at lease commencement based on the present value of the Company, in which casepayment obligation. For operating leases, expense is recognized on a straight-line basis over the Company must pay Deerfield a changelease term. Short-term leases with an initial term of control fee unless such change of control occurs beyond a certain period after12 months or less are not recorded on the Maturity Date. At any time prior to the fourth anniversary of the Agreement Date, any prepayment made by the Company will be subject to a make-whole premium and, if such prepayment occurs in connection with a change of control of the Company, a change of control fee.

Any amounts drawn under the Facility Agreement may become immediately due and payable upon customary events of default, as defined in the Facility Agreement, or the consummation of certain change of control transactions, as described above.

balance sheet.
The Facility Agreement contains various representationsCompany primarily uses its incremental borrowing rate in determining the present value of lease payments as the Company's facility leases generally do not provide an implicit rate.
The Company’s facility leases have remaining lease terms ranging from less than 3 years to 9 years, some of which include options to extend the lease term for up to five years.
For the year ended December 31, 2019, components of facility lease costs consist of $3.4 million in operating lease expense and warranties, events$0.9 million in variable lease costs.
Maturities of default, and affirmative and negative covenants, customaryfacility lease liabilities by fiscal year for financingsthe Company’s operating leases are as follows as of this type, including reporting requirements, requirements that the Company maintain timely reporting with the SEC and restrictions on the ability of the Company and its subsidiaries to incur additional liens on their assets, incur additional indebtedness and acquire and dispose of assets outside the ordinary course of business.December 31, 2019:

2020$3,584
20213,753
20223,861
20232,950
20242,849
2025 and thereafter12,338
Total lease payments$29,335
Less: Imputed Interest(15,877)
Present value of operating lease liabilities$13,458
As of December 31, 2017,2019, the Company had outstanding borrowingscurrent portion of $106.5the Company’s operating lease liabilities was $1.8 million and deferred financing costsis classified within accrued expenses and other current liabilities in the Company’s Consolidated Balance Sheets.
As of $4.5 million,December 31, 2019, the weighted-average remaining lease term was 7.8 years and weighted-average discount rate was 22.1%.
Disclosures related to periods prior to adopting the Term Loan. Annual interest expense on these notes will range from $1.5 million to $12.7 million through maturity.new lease guidance
Warrants
In connectionFuture minimum payments by year under non-cancelable leases with the execution of the Facility Agreement, the Company issued to Deerfield warrants to purchase an aggregate of 6,470,000 shares of common stock of the Company at an exercise price of $9.23 per share (the “Deerfield Warrants”). The number of shares of common stock of the Company into which the Warrants are exercisable and the exercise price of the Warrants will be adjusted to reflect any stock splits, recapitalizations or similar adjustments in the number of outstanding shares of common stock of the Company.

The Warrants expire on the seventh anniversary of the Agreement Date. Subject to certain exceptions, the Warrants contain limitations such that the Company may not issue shares of common stock of the Company to Deerfield upon the exercise of the Warrants if such issuance would result in Deerfield beneficially owninginitial terms in excess of 4.985%1 year were as follows as of the total number of shares of common stock of the Company then issued and outstanding.

The holders of the Warrants may exercise the Warrants for cash, on a cashless basis or through a reduction of an amount of principal outstanding under the Term Loan. In connection with certain major transactions, the holders may have the option to convert the Warrants, in whole or in part, into the right to receive the transaction consideration payable upon consummation of such major transaction in respect of a number of shares of common stock of the Company equal to the Black-Scholes value of the Warrants, as defined therein, and in the case of other major transactions, the holders may have the right to exercise the Warrants, in whole or in part, for a number of shares of common stock of the Company equal to the Black-Scholes value of the Warrants.

The Company measured the initial fair value of the 6,470,000 shares underlying the Deerfield Warrants at $14.3 million, net of issuance costs of $0.4 million, and recorded the amount in additional paid-in-capital and as a direct reduction of the Term Loan, to be subsequently amortized as interest expense over the effective period of the Term Loan.December 31, 2018:

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)


Registration Rights Agreement
In connection with the Term Loan and the issuance of the Warrants, the Company entered into a Registration Rights Agreement with Deerfield (the “Registration Rights Agreement”). Pursuant to the terms of the Registration Rights Agreement, the Company agreed to file a registration statement on Form S-3 with the SEC on or prior to the 30th day following the Agreement Date, to register for resale the shares of common stock of the Company issuable upon the exercise of the Warrants. The registration statement was filed on Form S-3 on May 2, 2017.
Credit and Security Agreement
On April 3, 2017, the Company entered into a Credit and Security Agreement (the “Credit Agreement”) with Deerfield ELGX Revolver, LLC (“Deerfield Revolver”), pursuant to which the Company could borrow up to the lesser of $50 million or its applicable borrowing base from time to time prior to March 31, 2020 (the “Revolver”). Any outstanding principal under the Revolver will accrue interest at a rate equal to 3-month LIBOR (with a 1% floor) plus 4.60%, payable monthly in arrears on the first business day of the immediately succeeding calendar month and on the maturity date. The Company is subject to other fees in addition to interest on the outstanding principal amount under the Revolver, including in connection with an early termination of the Revolver.

As described above, the Revolver replaces the Company’s $50.0 million asset-based revolving line of credit with MidCap Financial Trust. In conjunction with the Company’s adoption of ASU 2015-03 “Simplifying the Presentation of Debt Issuance Costs” during the first quarter of 2016, the Company also adopted an update thereof or ASU 2015-15 “Presentation and Subsequent Measurement of Debt Issuance Costs Associated with Line-of Credit Arrangements.” As a result, the Company recorded $1.2 million in deferred financing costs related to the Revolver and presents these costs as a deferred asset, to be subsequently amortized as interest expense over the term of the Revolver, on the Company’s Consolidated Balance Sheets. The Company’s obligations under the Credit Agreement are secured by a first priority security interest in substantially all of the Company’s assets including intellectual property, with the priority of such security interest being pari passu with the security interest granted pursuant to the Term Loan. As of December 31, 2017, the Company had outstanding borrowings of $21 thousand under, and deferred financing costs of $1.0 million related to, the Revolver.

In conjunction with the Company’s entry into the Credit Agreement, the Company entered into a corporate credit card agreement whereby the Company is required to maintain a $2.0 million deposit in favor of the credit card issuer. The deposit account related to these credit cards will be presented as restricted cash on the Company’s Consolidated Balance Sheets.

As of December 31, 2017, the Company was not in compliance with the required minimum net revenue threshold set forth in the Credit Agreement. On January 5, 2018, the Company delivered a notice of termination to Deerfield for the Deerfield Revolver under the Credit and Security Agreement (the “Credit Agreement”), dated as of April 3, 2017. The termination of the Deerfield Revolver was effective on January 12, 2018 (the “Termination Date”) and required the Company to pay $1.3 million in termination fees.

7. Revenue by Geographic Region
The Company's revenue by geographic region was as follows:
 Year Ended December 31,
 2017
2016
2015
United States$123,209
68.0%
$136,111
70.6%
$107,228
69.8%
Total International57,948
32.0%
56,814
29.4%
46,384
30.2%
Revenue$181,157
100%
$192,925
100%
$153,612
100%
8. Commitments and Contingencies
(a) Leases
The Company leases its administrative, research, and manufacturing facilities located in Irvine and Santa Rosa, California and an administrative office located in Rosmalen, The Netherlands. These facility lease agreements require the Company to pay

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except per share, per unit, and number of years)

operating costs, including property taxes, insurance, and maintenance. In addition, the Company has certain equipment and automobile under long-term agreements that are accounted for as operating leases.
Future minimum payments by year under non-cancelable leases with initial terms in excess of one year were as follows as of December 31, 2017:
2018$3,450
20193,567
20203,735
20213,692
20223,800
2023 and thereafter18,021
Total$36,265
20203,791
20213,819
20223,871
20232,889
20242,794
2025 and thereafter12,338
Total lease payments$29,502
Facilities rent expense in 2017, 2016the years ended December 31, 2019, 2018 and 20152017 was $3.4 million, $3.3$3.4 million and $2.3$3.4 million, respectively.
On June 12, 2013, the Company entered into a lease agreement for two adjacent office, research and development, and manufacturing facilities in Irvine, California. The premises consist of approximately 129,000 combined square feet. The lease has a 15-year term beginning January 1, 2014 and provides for one optional 5 year extension. The initial base rent under the lease is $1.9 million per year, payable in monthly installments, and escalates by 3% per year for years 2015 through 2019, and 4% per year for years 2020 and beyond. The Company received a rent abatement for the first nine months of the lease. These premises replaced the Company's previous Irvine facilities. The terms of this lease agreement provide for $6.8 million of landlord-funded improvements (and certain other allowances) to this facility, in order to best suit the Company's requirements.
The Company's Rosmalen facility is an administrative office of approximately 2,900 square feet and in August 2015, the Company extended the lease term for the Rosmalen facility until December 2020.
In conjunction with the TriVascular merger, the Company assumed the lease for TriVascular's facility in Santa Rosa, California. The facility is being used for manufacturing, research & development, and administrative purposes and consists of 110,000 square feet under an operating lease scheduled to expire in February 2023, which may be renewed for an additional five years.
(b) Employment Agreements and Retention Plan
On February 1, 2014, theThe Company entered into newhas employment agreements with certain of its executive officers under which payment and benefits would become payable in the event of termination by the Company for any reason other than cause, death or disability or termination by the employee for good reason (collectively, an “Involuntary Termination”) prior to, upon or following a change in control of the Company. The severance payment will generally be in a range of six6 to eighteen18 months of the employee’s then current salary for an Involuntary Termination prior to a change in control of the Company, and will generally be in a range of eighteen18 to twenty-four24 months of the employee’s then current salary for an Involuntary Termination upon or following a change in control of the Company.
(c) Legal Matters
We areThe Company is from time to time involved in various claims and legal proceedings of a nature we believeit believes is normal and incidental to a medical device business. These matters may include product liability, intellectual property, employment, and other general claims. Such cases and claims may raise complex factual and legal issues and are subject to many uncertainties, including, but not limited to, the facts and circumstances of each particular case or claim, the jurisdiction in which each suit is brought, and differences in applicable law. We accrueThe Company accrues for contingent liabilities when it is probable that a liability has been incurred and the amount can be reasonably estimated. The accruals are adjusted periodically as assessments change or as additional information becomes available.
LifePort Sciences LLC v. Endologix, Inc.
On December 28, 2012, LifePort Sciences, LLC (“LifePort”) filed a complaint against the Company in the United States District Court, District of Delaware, alleging that certain of the Company's products infringe United States Patent Nos. 5,489,295, 5,676,696, 5,993,481, 6,117,167, 6,302,906, and 8,192,482, which were alleged to be owned by LifePort. On March 17, 2016, the Company entered into a Settlement and Patent License Agreement with LifePort (the “Settlement Agreement”) whereby LifePort granted the Company license rights to patents in exchange for a settlement of $4.7 million. The Settlement

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except per share, per unit, and number of years)

Agreement resolves this litigation and fully and finally releases the Company and LifePort from any claims arising out of or in connection with the litigation or the subject patents. The Settlement Agreement also contained a covenant not to sue for other patents owned by LifePort. However, since the subject patents were all expired and the Company was not currently using and has no plans to use the other patents owned by LifePort in products that could reach technological feasibility during the covenant not to sue period, there is no alternative future use and the full amount was recorded as settlement costs in the accompanying Consolidated Statements of Operations and Comprehensive Loss.

Steven M. Ortiz v. Endologix, Inc.

On September 9, 2016, former employee Steven M. Ortiz filed a class action lawsuit against the Company in Orange County Superior Court, claiming the Company’s failure to pay all overtime wages owing; failure to provide meal periods and failure to pay meal period premiums; failure to pay all wages owed at time of termination seeking waiting time penalties under Labor Code section 203; failure to provide accurate wage statements; and violations of Business and Professions Code section 17200 and alleging claims for penalties under the Private Attorneys General Act of 2004.  While the Company contests the allegations asserted in the litigation, a mediation was held on February 24, 2017 at which time the parties agreed to settle the case for $750,000.  The court has given final approval to the settlement agreement and the settlement funds have been deposited with the class administrator.  It is anticipated that the court will enter final judgment in this case in March 2018, which will officially conclude this litigation.

Stockholder Securities Litigation

InOn January 3, 2017 and January 9, 2017, two stockholders purporting to represent a class of persons who purchased the Company’s securities between August 2, 2016 and November 16, 2016, filed lawsuits against the Company and certain of its officers in the United States District Court for the Central District of California.California (the “District Court”). The lawsuits allege that the Company made materially false and misleading statements and failed to disclose material adverse facts about its business, operational and financial performance, in violation of federal securities laws, relating to U.S.United States Food and Drug Administration Premarket Approval(the “FDA”) pre-market approval for the Company’s Nellix EVAS System. On May 26, 2017, the plaintiffs filed an amended complaint extending the class period to include persons who purchased the Company’s securities between May 5, 2016 and May 18, 2017 and adding certain factual assertions and allegations regarding the Nellix EVAS System. The plaintiffs sought unspecified monetary damages on behalf of the alleged class, interest, and attorney’s fees and costs of litigation. The first lawsuit, Nguyen v. Endologix, Inc. et al., Case No. 2:17-cv-0017 AB (PLAx) (C.D. Cal.) (“Nguyen”), was consolidated with the second lawsuit, Ahmed v. Endologix, Inc. et al, Case No. 8:17-cv-00061 AB (PLAx) (C.D. Cal.), and lead Nguyen plaintiff filed a consolidated First Amended Complaint. On December 5, 2017, the District Court granted Endologix’s motion to dismiss lead plaintiff’s First Amended Complaint, with leave to amend. On January 9, 2018, lead plaintiff filed a Second Amended Complaint.Complaint and on March 12, 2018, the Company filed its Motion to Dismiss lead plaintiff’s Second Amended Complaint with prejudice. On September 6, 2018, the District Court dismissed the Second Amended Complaint with prejudice and, on October 5, 2018, lead plaintiff filed a notice of appeal and on March 15, 2019, lead plaintiff filed its opening brief with the appellate court. In April 2019, the Company filed its response brief to plaintiff’s appeal. The Appellate Court’s hearing on the appeal occurred in February 2020, and the Company expects the Appellate Court’s decision to be rendered later in 2020. The Company believes these lawsuits are without merit and intendscontinues to defend itself vigorously.


ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

Stockholder Derivative Litigation

Four shareholdersAs of June 11, 2017, four stockholders have filed derivative lawsuits seeking unspecified monetary damages on behalf of Endologix, the nominal plaintiff, based on allegations substantially similar to those alleged by lead plaintiff in Nguyen. Those actions consist of: Sindlinger v. McDermott et al., Case No. BC662280 (Los Angeles Superior Court); Abraham v. McDermott et al., Case No. 30-2018-00968971-CU-BT-CSC (Orange County Superior Court); and Green v. McDermott et al., Case No. 8:17-cv-01155-AB (PLAx), which has been consolidated with Cocco v. McDermott et al., Case No. 8:17-cv-01183-AB (PLAx) (C.D. Cal.). The Company believes these lawsuits are without merit and intendscontinues to defend itself vigorously.

SEC Investigation

In July 2017, the Company learned that the SEC issued a Formal Order of Investigation to investigate, among other things, events surrounding the Nellix EVAS System and the prospect of its FDA pre-market approval. TheOn February 5, 2019, the Company is fully cooperatingreceived notification that the SEC staff had concluded its investigation and did not intend to recommend an enforcement action.
(d) Product Withdrawal
Voluntary Recall of the Nellix EVAS System
On January 4, 2019, the Company announced that in order to ensure optimal outcomes for patients, the Nellix EVAS System will, for the foreseeable future, only be available for use at approved centers in a clinical investigation setting with pre-screened patients that adhere to the current indications outside of the United States. All cases will be pre-screened by a physician panel and supported by the Company’s clinical specialists to ensure adherence to protocol and use in accordance with current product indications. Compassionate use requests will be reviewed in accordance with the investigation, but cannot predictprocess established by the Company and associated national competent authorities. The existing inventory has been voluntarily recalled.
In January 2019, the Company announced that the CE Mark for the Nellix EVAS System had been suspended by its outcome orNotified Body following a voluntary recall and field safety notification issued by the timingCompany on January 4, 2019. Suspension of the investigation’s conclusion.CE Mark means that the Company may not affix the CE Mark and sell the Nellix EVAS System in the European Union (“EU”) during the term of the suspension.
In June 2019, the Company announced that the CE Mark for the Nellix EVAS System had been been reinstated by its Notified Body, which reinstatement was accompanied by certain limitations on clinical use of Nellix. The reinstatement followed an assessment of clinical evidence.
(e) Concentrations of Risk and Major Customer
For the year ended and as of December 31, 2019, there was one customer that represented 10% or more of consolidated revenue and consolidated accounts receivable. For the year ended and as of December 31, 2018, there was no single customer that represented 10% or more of consolidated revenue and/or consolidated accounts receivable.





ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

(d) Contract Termination
In the year ended December 31, 2016, the Company sent notices of termination to certain of its distributors providing for the termination of the respective distribution agreements. In accordance with ASC No. 420 “Exit or Disposal Cost Obligations”, the Company expensed distributor termination costs in the period in which the written notification of termination occurred. As a result, the Company incurred termination costs of $2.5 million for the year ended December 31, 2016. Such termination costs were included in contract termination and business acquisition expenses for the year ended December 31, 2016.

9. Contingently Issuable Common Stock
On October 27, 2010, the Company, entered into an Agreement and Plan of Merger and Reorganization (the “Merger Agreement”) with Nepal Acquisition Corporation, a wholly-owned subsidiary of the Company, (“Merger Sub”), Nellix, Inc. (“Nellix”), certain of Nellix’s stockholders named therein and Essex Woodlands Health Ventures, Inc., as representative of the former Nellix stockholders. On December 10, 2010 (the “Nellix Closing Date”), the Company completed its acquisition of Nellix, Inc., a pre-revenue, AAA medical device company.Nellix. The purchase price consisted of 3.2 millionshares of the Company'sCompany’s common shares,stock issuable to the former Nellix stockholders as of the Nellix Closing Date, then representing a value of $19.4 million.Date. Additional payments, solely in the form of shares of the Company'sCompany’s common shares (the “Contingent Payment”),stock will be made upon the achievement of a revenue milestone and a regulatory approval milestone (collectively, the “Nellix Milestones”).
Under the Merger Agreement, the ultimate value of the Contingent Paymentcontingently issuable common stock would be determined on the date that each Nellix Milestone is achieved. The number of issuable shares would be established using an applicable per share price, which is subject to a ceiling and/or floor, resulting at the closing of the merger in a potential in a maximum of 10.2 millionapproximately 1,020,000 shares issuable upon the achievement of the Nellix Milestones. As of the Closing Date, the fair value of the Contingent Paymentcontingently issuable common stock was estimated to be $28.2 million.
The Merger Agreement provides that, in addition to the shares of common stock of the Company (the “Common Stock”) issued to the former Nellix stockholders at the closing of the Merger,Nellix Closing Date, if the Company receives approval from the FDA to sell the Nellix Productone of Nellix’s products in the United States (the “PMA Milestone”), the Company will issue additional shares of the Common Stockits common stock to the former stockholders of Nellix. The dollar value of the shares of the Common StockCompany’s common stock to be issued upon achievement of the PMA Milestone will be equal to $15.0 million (less the dollar value of certain cash payments and other deductions). The price per share of the shares of the Common StockCompany’s common stock to be issued upon achievement of the PMA Milestone is subject to a stock price floor of $4.50$45.00 per share but not subject to a stock price ceiling.

At December 31, 2017, the Company's stock price closed at $5.35 per share. Thus, had the PMA Milestone been achieved on December 31, 2017, the Contingent Payment would have comprised 2.9 million shares (based on the 30-day average closing stock price ending 5 days prior to the announcement, subjected to the stock price floor of $4.50), representing a value of $15.2 million.
The value of the Contingent Paymentcontingently issuable common stock is derived using a discounted income approach model, with a range of probabilities and assumptions related to the timing and likelihood of achievement of the PMA Milestone (which include Level 3 inputs - see Note 3(e) and the Company'sCompany’s stock price (Level 1 input) as of the balance sheet date). These varying probabilities and assumptions and changes in the Company'sCompany’s stock price have required fair value adjustments of the Contingent Paymentcontingently issuable common stock in periods subsequent to the Nellix Closing Date.

The Contingent Payment fair value of the contingently issuable common stock will continue to be evaluated on a quarterly basis until milestone achievement occurs or until the expiration of the "earn-out period,"“Earn-Out Period,” as defined within the Nellix purchase agreement.Merger Agreement. Adjustments to the fair value of the Contingent Paymentcontingently issuable common stock are recognized within other income (expense), net in the Consolidated Statements of Operations and Comprehensive Loss. See the “Fair Value Measurements” section of Note 3 for further details. As of December 31, 2019, the fair value of the contingently issuable common stock was presented in non-current liabilities.

At December 31, 2019, the Company’s stock price closed at $1.58 per share. Thus, had the PMA Milestone been achieved on December 31, 2019, the contingently issuable common stock would have comprised approximately 333,149 shares (based on the 30-day average closing stock price ending 5 days prior to the announcement, subjected to the stock price floor of $45.00 per share), representing a value of $0.5 million.

10. Income Taxes

Net loss before income taxes attributable to United States and international operations, consisted of the following:

Fair Value of Contingently Issuable Common Stock
December 31, 2016$12,200
Fair value adjustment of Contingent Payment for year ended December 31, 2017(2,900)
December 31, 2017$9,300
 Year Ended December 31,
 2019 2018 2017
United States$(64,076) $(70,176) $(56,178)
Foreign(5,406) (9,254) (10,681)
Net loss before income taxes$(69,482) $(79,430) $(66,859)

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

As of December 31, 2017, $9.3 million was presented in non-current liabilities due to the expected achievement of the PMA milestone in the fourth quarter of 2020.

10. Income Tax Expense

Net loss before income tax benefit attributable to United States and international operations, consistsexpense (benefit) consisted of the following:

Year Ended December 31,

2017
2016
2015
United States$(56,178)
$(135,925)
$(44,114)
Foreign(10,681)
(18,254)
(15,647)
Net loss before income tax$(66,859)
$(154,179)
$(59,761)

 Year Ended December 31,
 2019 2018 2017
Current:     
Federal$
 $
 $(102)
State53
 81
 102
Foreign172
��260
 237
Total current225
 341
 237
Deferred:     
Federal(4,133) (27) (699)
State(819) (19) 
Foreign2
 (11) 3
Total deferred(4,950) (57) (696)
Total:     
Federal(4,133) (27) (801)
State(766) 62
 102
Foreign174
 249
 240
Income tax expense (benefit)$(4,725) $284
 $(459)
Income tax expense (benefit) expense consists ofwas computed by applying the following:United States federal statutory rate to net loss before income taxes as follows:
 Year Ended December 31,
 2017 2016 2015
Current:     
Federal$(102) $(50) $50
State102
 90
 100
Foreign237
 458
 148
Total current$237
 $498
 $298
Deferred:     
Federal$(699) $
 $(8,621)
State
 
 (1,008)
Foreign3
 
 (6)
Total deferred$(696) $
 $(9,635)
Total:     
Federal$(801) $(50) $(8,571)
State102
 90
 (908)
Foreign240
 458
 142
Income tax expense (benefit)$(459) $498
 $(9,337)
 Year Ended December 31,
 2019 2018 2017
Income tax benefit at federal statutory rate$(14,591) $(16,680) $(22,732)
State income tax benefit, net of federal benefit(1,160) (1,756) (1,114)
Meals and entertainment178
 230
 454
Research and development credits(931) (1,211) (913)
Stock-based compensation1,825
 2,016
 3,203
163(l) limited interest expense4,391
 994
 
Contingent consideration(357) (1,491) (986)
Foreign tax rate differential(269) (405) 692
Net change in valuation allowance2,899
 16,360
 (24,976)
Return to provision2,387
 1,612
 5,719
Unrecognized tax benefits466
 605
 457
Federal tax rate change
 
 39,807
NOL expiration and other, net437
 10
 (70)
Income tax expense (benefit)$(4,725) $284
 $(459)

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

Income tax benefit was computed by applying the United States federal statutory rate of 34% to net loss before taxes as follows:

Year Ended December 31,

2017
2016
2015
Income tax benefit at federal statutory rate$(22,732)
$(52,418)
$(20,315)
State income tax benefit, net of federal benefit(1,114)
(2,323)
(937)
Meals and entertainment454

445

328
Research and development credits(913)
(2,041)
(1,756)
Stock-based compensation3,203

2,604

1,633
Derivative loss

14,903


Contingent consideration(986)
(850)
34
Foreign tax rate differential692

1,394

1,013
Net change in valuation allowance(24,976)
35,678

10,052
Return to provision true-up5,719

1,981

583
Unrecognized tax benefits457

971

928
Federal tax rate change39,807




Other, net(70)
154

(900)
Income tax benefit$(459)
$498

$(9,337)

Significant components of the Company’s deferred tax assets and (liabilities) arewere as follows:

Year Ended December 31,Year Ended December 31,

2017
20162019 2018
Deferred tax assets:






 

Net operating loss carryforwards$101,423

$124,881
$114,124
 $110,130
Accrued expenses5,617

6,582
3,647
 3,757
Tax credits11,826

11,314
13,054
 12,540
Bad debt78

91
240
 104
Inventory2,160

4,424
4,056
 4,821
Capitalized research and development16,079

21,374
20,161
 17,931
Deferred compensation2,535

3,596
Equity compensation2,965
 2,669
Operating lease liabilities3,239
 
Interest expense8,418
 3,718
Other1,099

964
873
 1,174
Deferred tax asset140,817

173,226
170,777
 156,844
Valuation allowance(118,551)
(133,784)(139,855) (135,216)
Total deferred tax assets22,266

39,442
30,922
 21,628
Deferred tax liabilities:




   
Developed technology and trademark(9,033)
(14,218)(8,842) (8,830)
Trademarks and tradenames(733)
(1,027)
Trademarks and trade names(826) (765)
Depreciation and amortization(8,961)
(15,316)(6,924) (8,034)
Convertible debt(3,740)
(9,760)(12,878) (4,149)
Operating lease right-of-use assets(1,372) 
Other


(230) 
Total deferred tax liabilities(22,467)
(40,321)(31,072) (21,778)
Net deferred tax liability$(201)
$(879)$(150) $(150)
The Company has evaluated the available evidence supporting the realization of its gross deferred tax assets, including the amount and timing of future taxable income, and has determined that it is more likely than not that the domestic and foreign

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except per share, per unit, and number of years)

deferred tax assets will not be realized. Due to such uncertainties surrounding the realization of the domestic and foreign deferred tax assets, the Company maintainsmaintained a valuation allowance of $118.6$139.9 million against a substantial portion of its deferred tax assets as of December 31, 2017.2019. For the year ended December 31, 2017,2019, the total change in valuation allowance was $(15.2)$4.6 million, of which $(25.0)$2.9 million was recorded as a tax benefitexpense through the income statement and $9.8$1.7 million was recordeddue to equity mainly in connection with the Company's adoption of ASU 2016-09.state net operating loss not taking federal benefit on deferred balances. Realization of the deferred tax assets will be primarily dependent upon the Company'sCompany’s ability to generate sufficient taxable income prior to the expiration of its net operating losses.
At December 31, 2017,2019, the Company had net operating loss carryforwards for federal and state income tax purposes of approximately $314.0$350.8 million and $173.0$217.1 million, respectively. As a result of the Tax Cuts and Jobs Act (“TCJA”), the federal net operating losses generated in 2018 and 2019 will be carried forward indefinitely and are limited to an 80% deduction of taxable income. The 80% limitation is not applicable to net operating losses generated before 2018.
Federal and state net operating loss carryforwards began expiring in 20172020 and will continue to expire through 2037.2038. The federal net operating loss carryforwards generated after December 31, 2017 do not expire but are limited to 80% taxable income in the year of utilization. The majority of the state net operating losses are attributable to California. In addition, the Company had research and development credits for federal and state income tax purposes of approximately $9.4$10.2 million and $14.3$15.9 million, respectively, which will begin to expire in 2020.2021. The California research and development credits do not expire.
Under Section 382 of the Internal Revenue Code of 1986, as amended (“IRC”), substantial changes in ourthe Company’s ownership may limit the amount of net operating loss and research and development income tax credit carryforwards that could be utilized annually in the future to offset taxable income. Specifically, this limitation may arise in the event of a cumulative

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

change in ownership of our companythe Company of more than 50% within a three-year3-year period. Any such annual limitation may significantly reduce the utilization of the net operating loss carryforwards before they expire.
Since the Company'sCompany’s formation, the Company has raised capital through the issuance of capital stock on several occasions which, combined with the purchasing stockholders'stockholders’ subsequent disposition of those shares, may have resulted in such an ownership change, or could result in an ownership change in the future upon subsequent disposition. The Company intends to complete a study in the future to assess whether an ownership change has occurred or whether there have been multiple ownership changes since the Company'sCompany’s formation.
The Company completed an analysis under IRC Sections 382 and 383 to determine if the acquired TriVascular Technologies, Inc.'sTriVascular’s net operating loss carryforwards and research and development credits are limited due to a change in ownership. The Company concluded that TriVascular Technologies, Inc. had an ownership change as of February 3, 2016. As a result of the ownership change, the Company reduced the acquired federal and state net operating loss carryforwards by $230.3 million and $209.4 million, respectively, and federal research and development credits by $3.1 million.

The following is a tabular reconciliation of the total amounts of unrecognized tax benefits (in thousands):
benefits:

Year Ended December 31, 2017Year Ended December 31, 2016Year Ended December 31,
Balance at January 1, 2017$11,754
$8,928
2019 2018
Balance at January 1$12,888
 $12,207
Additions for tax positions related to prior periods
1,654

 
Decreases related to prior year tax positions(160)(95)(26) (17)
Lapse of statute of limitations


 
Additions for tax positions related to current period613
1,267
538
 698
Balance at December 31, 2017$12,207
$11,754
Balance at December 31$13,400
 $12,888
OurThe Company’s gross unrecognized gross tax benefits presented above would not reduce ourits annual effective tax rate if they were to be recognized because we havethe Company has recorded a full valuation allowance on the deferred tax assets. We doThe Company does not foresee any material changes to our gross unrecognized tax benefitbenefits within the next twelve12 months. We recognizeThe Company recognizes interests and/or penalties related to income tax matters in income tax expense. WeThe Company did not recognize any accrued interest and penalties related to gross unrecognized tax benefits related to the year ended December 31, 2017.2019.
The undistributed earnings of the Company'sCompany’s foreign subsidiaries are considered to be indefinitely reinvested. Accordingly, no provisionprovisions for U.S.United States federal and state income taxes or foreign withholding taxes have been provided on such undistributed earnings. As of December 31, 2017,2019, the cumulative amount of earnings uponwith respect to which U.S.United States income taxes have not been provided is approximately $0.1 million. Determination of the potential amount of unrecognized deferred U.S.United States income tax liability and foreign withholding taxes is not practicable because of the complexities associated with its hypothetical calculation; however, net operating losses and unrecognized foreign tax credits would be available to reduce some portion of the U.S.United States liability.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except per share, per unit, and number of years)

In general, the Company is no longer subject to United States federal, state, local, or foreign examinations by taxing authorities for years before 2013,2015, however, net operating loss and other tax attribute carryforwards utilized in subsequent years continue to be subject to examination by the tax authorities until the year to which the net operating loss and/or other tax attributes are carried forward is no longer subject to examination.
For the twelve monthsyear ended December 31, 2017, our2019, the Company’s provision for income taxes was $0.5$4.7 million benefit and ourits effective tax rate was (0.69%)(6.8)%. The tax benefit recorded in continuing operations was due to the application of the exception to the tax intraperiod allocation rules. The exchange of 3.25% convertible notes for new 5.00% convertible notes in April 2019 resulted in an increase to the temporary difference between the carrying amount and tax basis of the convertible notes. The increase in the taxable temporary difference resulted in the recognition of a $5.0 million deferred tax liability (net of debt converted to equity), which was recorded as an offset to additional paid-in-capital. In accordance with ASC 740-20, Intraperiod Tax Allocation, the increase in the deferred tax liability provided an additional source of income to realize the benefit from the current year loss from continuing operations, which resulted in the recognition of a $5.0 million income tax benefit during the year ended December 31, 2017. During2019. This exception was eliminated in the twelve monthsrecently issued ASU 2019-12 Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes in 2019 which is required to be adopted by public business entities in 2021 and interim period within that year. Although early adoption is permitted, the Company did not early adopt during year ended 2019.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

In the year ended December 31, 2017, we2019, The Company had operating legal entities operating in the United States, Italy, New Zealand, Singapore, Poland, Germany, Switzerland, South Korea and the Netherlands, (plusas well as registered sales branches of ourthe Company’s Dutch entity in certain countries in Europe).Europe.
On December 22, 2017, the President of the United States signed into law the Tax Reform Act. The legislation significantly changes U.S. tax law by, among other things, lowering corporate income tax rates, implementing a territorial tax system and imposing a repatriation tax on deemed repatriated earnings of foreign subsidiaries. The Tax Reform Act permanently reduces the U.S. corporate income tax rate from a maximum of 35% to a flat 21% rate, effective January 1, 2018.
The Company uses the asset and liability method of accounting for income taxes. Under this method, deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax basis. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to reverse. As a result of the reduction in the U.S. corporate income tax rate from 35% to 21% under the Tax Reform Act,In addition, the Company revalued its ending net deferredhas federal alternative minimum tax liabilities at December 31, 2017 and recognized a $0.4credit carryforwards of $0.1 million tax benefitthat will be refundable in the Company’s consolidated statement of income for the year ended December 31, 2017.
The Tax Reform Act provided for a one-time deemed mandatory repatriation of post-1986 undistributed foreign subsidiary earnings and profits (“E&P”) through the year ended December 31, 2017. The Company does not have undistributed foreign E&P subjectfuture years due to the deemed mandatory repatriation and therefore has not recognized income tax expense in the Company’s consolidated statement of operations and comprehensive loss for the year ended December 31, 2017.TCJA.

While the Tax Reform ActTCJA provides for a territorial tax system, beginning in 2018, it includes two new U.S.United States tax base erosion provisions, the global intangible low-taxed income (“GILTI”) provisions and the base-erosion and anti-abuse tax (“BEAT”) provisions.
The GILTI provisions require the Company to include in its U.S.United States income tax return foreign subsidiary earnings in excess of an allowable return on the foreign subsidiary’s tangible assets beginning in 2018. The Company does not believe that it will be subject to excess tax at this time under this new provision. In the event the Company becomes subject to this provision, it will elect to either account for the additional tax in the period in which it is incurred or to account for it through deferred taxes. On December 22, 2017, the SEC staff issued Staff Accounting Bulletin No. 118 (“SAB 118”) to address the application of U.S. GAAP in situations when a registrant does not have the necessary information available, prepared, or analyzed (including computations) in reasonable detail to complete the accounting for certain income tax effects of the Tax Reform Act. The Company has recognized the provisional tax impacts related to deemed repatriated earnings and the revaluation of deferred tax assets and liabilities and included these amounts in its consolidated financial statements for the year ended December 31, 2017. The ultimate impact may differ from these provisional amounts, possibly materially, due to, among other things, additional analysis, changes in interpretations and assumptions the Company has made, additional regulatory guidance that may be issued, and actions the Company may take as a result of the Tax Reform Act. The accounting is expected to be complete when the 2017 U.S. corporate income tax return is filed in 2018.


ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except per share, per unit, and number of years)

11. Quarterly Results of Operations (Unaudited)
Three Months Ended:Revenue
Gross Profit
Operating expenses
Net loss
Basic and Diluted loss per share
December 31, 2017$44,003

$31,356

$40,261

$(14,521)
$(0.17)
September 30, 201745,986

29,107

38,454

(14,273)
(0.17)
June 30, 201748,556

32,224

40,130

(16,292)
(0.20)
March 31, 201742,612

28,642

44,304

(21,314)
(0.26)
Three Months Ended:








December 31, 2016$47,463

$29,461

$51,669

$(24,924)
$(0.30)
September 30, 201652,122

36,931

48,165

(15,245)
(0.18)
June 30, 201650,974

29,459

52,687

(66,837)
(0.81)
March 31, 201642,366

27,941

66,345

(47,671)
(0.62)
 Revenue Gross profit Operating expenses Net loss Basic and diluted loss per share
Three Months Ended:         
December 31, 2019$35,751
 $21,829
 $31,687
 $(7,830) $(0.40)
September 30, 201935,775
 23,074
 33,904
 (7,765) (0.40)
June 30, 201936,238
 22,984
 32,851
 (27,134) (1.50)
March 31, 201935,606
 23,199
 35,193
 (22,028) (2.12)
Three Months Ended:
 
 
 
 
December 31, 2018$34,693
 $11,366
 $35,062
 $(25,955) $(2.67)
September 30, 201834,756
 22,627
 38,546
 (10,116) (1.20)
June 30, 201844,740
 29,604
 45,110
 (23,876) (2.80)
March 31, 201842,284
 28,326
 41,397
 (19,767) (2.40)

12. Restructuring Charges

In the years ended December 31, 20172019, 2018 and 2016,2017, the Company recorded $1.5$0.8 million, $3.3 million and $11.1$1.5 million, respectively, in restructuring costs within operating expenses related to focused reductions of its workforce. The Company began substantially formulating plans around this workforce reduction during the first quarter of 2016 in conjunction with its merger of TriVascular.with TriVascular in 2016. The targeted reductions and other restructuring activities were initiated to provideimprove efficiencies and realignre-align resources as well as to allow for continued investment in strategic areas and to drive growth.

In August 2018, the Company continued its restructuring activities including: restructuring certain aspects of its business and operations to re-prioritize its sales and marketing efforts; rationalizing its international presence and related expenses; streamlining its workforce and taking other measures to increase efficiencies; decreasing its cash consumption and decreasing its cost to serve; and refocusing its business on strong execution of its core strategies. The Company expectsdetermined to streamline and restructure certain of its operations and implement certain management changes. These plans have resulted in significant changes in the composition of the senior management team.
As of December 31, 2019, the Company estimates that it will incur a total of $12.6$16.7 million in restructuring charges upon the completion of the plan, of which represents$16.7 million has already been incurred since the Company’s best estimate asfirst quarter of December 31, 2017.2016.

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

The recognition of restructuring charges requires that the Company make certain judgments and estimates regarding the nature, timing and amount of costs associated with the planned reductions of its workforce. At the end of each reporting period, the Company will evaluate the remaining accrued balance to ensure that no excess accruals are retained and the utilization of the provisions are for their intended purpose in accordance with developed plans. The following table reflects the movement of activity of the restructuring reserve for the year ended December 31, 2017:

2019:

One-time Termination BenefitsOne-time termination benefits
Accrual balance as of December 31, 2016$2,754
Accrual balance as of December 31, 2018$562
Restructuring charges1,477
838
Utilization(3,223)(1,310)
Accrual balance as of December 31, 2017$1,008
Accrual balance as of December 31, 2019$90
The accrual balance as of December 31, 20172019 is classified within accrued expenses and other current liabilities in the Company’s Consolidated Balance Sheets.

13. Equity Financing
On March 31, 2019, the Company entered into a Purchase Agreement (the “Purchase Agreement”) with Investors, whereby the Company agreed to issue and sell to the Investors, and the Investors agreed to purchase the Equity Shares at the Equity Offering Price for an aggregate cash purchase price of $52.2 million. For any Investor whose purchase of the Equity Shares resulted in such Investor beneficially owning in excess of 19.99% of the shares (the excess shares, the “Blocked Shares”) of common stock outstanding immediately after giving effect to the issuance, in lieu of issuing the Blocked Shares which such Investor would have received, the Company issued to such Investor pre-paid warrants to purchase 1,467,494 shares of common stock equal to the number of Blocked Shares that would have been received (the “Pre-Paid Warrants”) for the Equity Offering Price per share. Each Pre-Paid Warrant will be exercisable upon issuance, provided that such exercise does not result in the issuance of Blocked Shares, and will expire ten years from the date of issuance. The Pre-Paid Warrants were included in shares used to compute basic and diluted loss per shares during the twelve months ended December 31, 2019.

On April 3, 2019, the Company closed the transactions contemplated by the Purchase Agreement. The Company recorded proceeds of $52.0 million, net of offering costs of $0.2 million as additional paid-in capital.

14. Subsequent Events

13. TriVascular MergerConvertible Note Exchange

On February 3, 2016,24, 2020, the Company completed its merger with TriVascular pursuant toand three investors holding approximately $11.0 million of the principal amount of the Company’s 3.25% Senior Notes due 2020 (the “Holders”) entered into an Exchange Agreement and Plan(the “2020 Exchange Agreement”) providing for the exchange of Mergerthe Holders’ existing notes (the “Merger Agreement”“Existing Notes”), dated October 26, 2015, by and among Endologix, TriVascular and Teton Merger Sub, Inc., a Delaware corporation and direct wholly-owned subsidiary of Endologix (“Merger Sub” for new 5.00% Voluntary Convertible Senior Notes due 2024 (the “2020 5.00% Voluntary Notes”). Pursuant to the terms2020 Exchange Agreement, on February 24, 2020, the exchanging Holders are exchanging all outstanding principal plus accrued and unpaid interest under the Existing Notes into the same amount of principal of 2020 5.00% Voluntary Notes pursuant to the 2020 Exchange Agreement. The 2020 5.00% Voluntary Notes are being issued in a transaction exempt from the registration requirements of the Merger Agreement, Endologix acquired allSecurities Act of TriVascular’s outstanding capital stock through the merger1933, as amended (the “Securities Act”) by virtue of Merger Sub with and into TriVascular (the “Merger”), with TriVascular surviving the Merger as a wholly-owned subsidiary of Endologix. The Company completed the merger in order to become the innovation leader with broad clinical indications for the treatment of AAA, leverage the combined company’s commercial capabilities, and provide an accelerated path to profitability. The total purchase

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except per share, per unit, and number of years)

consideration given related to the acquisition follows:
Cash consideration$84,634
Common stock consideration100,812
Fair value of assumed TriVascular stock warrants44
Total purchase consideration$185,490

Common stock consideration consisted of 13,586,503 shares of Endologix common stock, worth $100.8 million based on the market value of $7.42 per share asSection 4(a)(2) of the effective date of the Merger on February 3, 2016.

In connection with the Merger, the Company assumed stock warrants, originally issued by TriVascular,Securities Act and converted them to Endologix stock warrants. The fair value of the stock warrants represents a component of the total consideration for the Merger. Stock warrants assumed were valued using the Black-Scholes option pricing model as of the effective date of the Merger.
The acquisition was recorded by allocating the costs of the net assets acquired based on their estimated fair values at the acquisition date. The excess of the cost of the acquisition over the fair value of the net assets acquired is recorded as goodwill. The fair values were based on management’s analysis, including work performed by third-party valuation specialists. The following presents the allocation of the purchase consideration to the assets acquired and liabilities assumed on February 3, 2016 (in thousands):
  Cash and cash equivalents$24,012
  Short-term investments3,008
  Accounts receivable5,780
  Inventories17,765
  Prepaid expenses and other current assets1,895
  Property and equipment3,152
  Intangible assets46,200
  Other assets317
  Accounts payable(2,214)
  Accrued liabilities and other(6,450)
  Notes payable(61)
  Net assets acquired$93,404
Goodwill$92,086
Total purchase consideration$185,490
Rule 506 thereunder.

The goodwill is primarily attributable to strategic opportunities that arose from the acquisition of TriVascular, such as broadening the product portfolio for the treatment of AAA2020 5.00% Voluntary Notes will be governed by an Indenture (the “New Indenture”), by and leveraging the combined company’s technology and commercial capabilities. The goodwill is not expected to be deductible for tax purposes.
During the year ended December 31, 2016,between the Company revisedand Wilmington, as trustee. The 2020 5.00% Voluntary Notes will accrue interest at a rate of 5.00% per year, payable semi-annually in arrears on April 1 and October 1 of each year, commencing April 1, 2020. The 2020 5.00% Voluntary Notes will mature on April 2, 2024, unless earlier purchased, redeemed or converted in accordance with the opening net assets acquired and goodwill by $27.1 million, which was comprisedterms of the following: an increase in inventoriesNew Indenture. The New Indenture governing the 2020 5.00% Voluntary Notes will contain customary terms and covenants and events of $0.2 million; an increase in prepaid expenses and
other current assets of $0.1 million; an increase in accounts receivable of $0.2 million; and an increase in accrued liabilities
and other of $0.6 million as a result of gathering additional information during the measurement period. The Company also
revised the initial values of intangible assets by decreasing them $27.0 million as a result of switching from utilizing
publicly available benchmarking information to determine the fair value of the intangible assets to primarily utilizing an income
method based on forecasts of expected future cash flows. During the three months ended June 30, 2016, the Company recorded
an adjustment to the amortization of intangible assets of $0.3 million, comprising of a $0.2 million and $49 thousand decrease within cost of goods sold and marketing and sales expense, respectively, in the Consolidated Statement of Operations and Comprehensive Loss, that would have been recorded during the three months ended March 31, 2016, if the adjustment to the intangible assets had been recognized as of the date of the Merger.default.


ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

Trade payables, as well as other current and non-current assets and liabilities, were valuedThe 2020 5.00% Voluntary Notes will be convertible at the existing carrying values as they representedoption of each Holder into shares of common stock at any time prior to the fair valueclose of those itemsbusiness on the business day immediately preceding January 1, 2024; provided that, except if the Company undergoes a fundamental change (as defined in the New Indenture) and for certain other customary circumstances of conversion, each Holder may not convert more than 30% the initial aggregate principal amount of its outstanding 2020 5.00% Voluntary Notes per calendar quarter (a “Voluntary Conversion”). Beginning January 1, 2024, until the close of business on the business day immediately preceding the maturity date, the 2020 5.00% Voluntary Notes will be convertible at the acquisition date, based on management’s judgments and estimates. Trade receivables included gross contractual amountsoption of $5.8 million and the Company's best estimateholder at any time regardless of the conditions described in this paragraph. The initial conversion rate of the 2020 5.00% Voluntary Notes in a nominalVoluntary Conversion is 0.4445 shares of the Company’s common stock per $1.00 principal amount of contractual cash flows not expectedthe 2020 5.00% Voluntary Notes, which is equivalent to an initial conversion price per share equal to $2.25 (the “Conversion Price”). The conversion rate is subject to adjustment upon the occurrence of certain specified events. Except if the Company undergoes a fundamental change (as defined in the New Indenture) and for certain other customary circumstances of conversion, in no event prior to the close of business on the business day immediately preceding January 1, 2024 may the 2020 5.00% Voluntary Notes be collected atconverted in a calendar quarter unless the acquisition date.
The fair value of property, plant and equipment utilized a combinationclosing sale price of the cost and market approaches, dependingCompany’s common stock for at least twenty (20) trading days during the period of thirty (30) consecutive trading days ending on the characteristicslast trading day of the asset classification. Ofimmediately preceding calendar quarter is greater than or equal to 110% of the $46.2 millionConversion Price (subject to adjustment upon the occurrence of acquired intangible assets, $7.5 million was assigned to customer relationships (10 year life), $27.5 million was assigned to developed technology (11 year life), and $11.2 million was assigned to in-process research and development.
Pro Forma Combined Financial Information (Unaudited)certain specified events) (the “Voluntary Conversion Threshold”).

The following unaudited pro forma financial information summarizes2020 5.00% Voluntary Notes will be secured by the resultsCompany’s assets pursuant to a Junior Lien Security Agreement by and between the Company and Wilmington, as collateral agent (the “JLSA”). The JLSA grants a second lien on the Company’s assets that is second in priority to the security interests granted (i)_to Deerfield, as agent, pursuant to the Amended and Restated Guaranty and Security Agreement, dated August 9, 2018, by and among the Company, its subsidiaries and Deerfield, as agent, as amended to date and (ii) to Deerfield ELGX Revolver, LLC, as agent (“Deerfield ELGX”), pursuant to the Guaranty and Security Agreement, dated as of operationsAugust 9, 2018, by and among the Company, its subsidiaries and Deerfield ELGX, as agent. as amended to date. In connection with the issuance of the 2020 5.00% Voluntary Notes, the parties entered into Subordination and Intercreditor Agreement, dated as of February 24, 2020, by and among the Company, Deerfield, Deerfield ELGX and Wilmington, as collateral agent (the “Subordination Agreement”). The Subordination Agreement contains customary provisions associated with the subordination of the security interest of the 2020 5.00% Voluntary Notes.

The New Indenture will provide that in no event may a Holder convert into shares of common stock if such conversion would result in the Holder beneficially owning more that 9.5% of the Company’s outstanding common stock.

Exchange Agreement and Fourth Amendment to Facility Agreement

On February 24, 2020, the Company entered into a February 2020 Exchange Agreement and Fourth Amendment to Amended and Restated Facility Agreement and Amendment to First Out Waterfall Notes (the “Fourth Facility Amendment”) with Deerfield, dated August 9, 2018 (as amended to date, the “Fourth Facility Agreement”). The Facility Amendment provides for, among other things, the conversion of certain portions of the outstanding convertible debt upon the achievement of certain milestones. In addition, 8.333% (or approximately $10.7 million as of February 24, 2020) of the First Out Waterfall Notes currently due on the First Amortization Date (the “First Amortization Payment”) will be extended to July 1, 2021. In the event the Company satisfies the Initial Exchange Condition (as defined below) and provided that the Company reports net revenue of at least $142.5 million for the periods indicated asyear ended December 31, 2020 and complies with the global excess liquidity requirement (the “Maturity Extension Conditions”), the maturity date shall be extended from April 2, 2023 to December 22, 2023 and the second amortization date shall be extended from April 2, 2022 to April 2, 2023. Further, the Fourth Facility Agreement provides that the interest payment date due April 1, 2020 will be payable in paid-in-kind interest by increasing the principal amount of the loans by an amount equal to the interest that has accrued.

The Fourth Facility Amendment provides for the exchange of the existing notes representing the First Out Waterfall Notes for amended notes (the “Amended First Out Waterfall Notes”). The Amended First Out Waterfall Notes reduced the Fixed Conversion Price under the existing notes from $6.625 to $2.00 (the “New Fixed Conversion Price”); provided that if the TriVascular merger had been completed asInitial Exchange Condition (as defined below) is not met by June 30, 2020, then such price shall revert to $6.625. The Amended First Out Waterfall Notes provide that the Company may require Deerfield to convert up to $40.0 million of January 1, 2015. Pro forma information reflects adjustmentsprincipal amount (the “Forced Conversion Cap”) provided that are expected to havethe arithmetic average of the volume weighted average price of the Company’s common stock on each of the fifteen (15) consecutive trading days ending on the conversion date (the “Forced Conversion 15 Day VWAP”), and the closing price on the conversion date, is greater than 200% of the New Fixed Conversion Price into shares of the Company’s newly created Series DF-1 Preferred Stock, par value $0.001 per share (the “Preferred Stock”), at a continuing impact on our results of operations and are directly attributableprice per share equal to the merger. The unaudited pro forma results include adjustments to reflectproduct of (i) the amortizationPreferred Exchange Rate (as defined below) and (ii) and 85% of the inventory step-up, direct transaction costs relating to the acquisition, the incremental intangible asset amortization to be incurred based on the values of each identifiable intangible asset, and to eliminate interest expense related to legacy TriVascular's former loans, which was repaid upon completionlesser of the TriVascular merger. The pro forma amounts do not purport to be indicative of the results that would have actually been obtained if the merger had occurred as of January 1, 2015 or that may be obtained in the future, and do not reflect future synergies, integration costs, or other such costs or savings.closing

Twelve Months Ended

December 31,

2016
2015
Combined net sales$195,596

$195,605
Combined net loss from continuing operations(150,054)
(113,534)
Combined basic and diluted net loss per share$(1.82)
$(1.40)



ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

14. Subsequent Eventprice of the common stock on such conversion date (the “Closing Price”) and the Forced Conversion 15 Day VWAP, provided that such lesser price is greater than or equal to 170% of the New Fixed Conversion Price and other conditions are met (each such conversion, a “Forced Conversion”). A Forced Conversion may only occur once every 31 calendar days and any individual Forced Conversion may not exceed the lesser of (i) $3.5 million or (ii) the Forced Conversion Cap less any prior Forced Conversions or Discretionary Conversions (as defined below).

TransitionDeerfield also has the option to convert up to $60.0 million (less any amounts converted pursuant to Forced Conversions) of Chief Executive Officerthe Company’s outstanding debt (any such conversion, a “Discretionary Conversion”) into, at Deerfield’s option and subject to the Ownership Cap, shares of Common Stock at a rate equal to the greater of the New Fixed Conversion Price and 85% of the 15 Day VWAP, provided that such conversion price is not less than the Floor Price (the “Discretionary Common Conversion Rate”) or shares of Preferred Stock at a rate (the “Discretionary Preferred Conversion Rate”) equal to the product of (i) the Preferred Exchange Rate (as defined below) multiplied by (ii) the Discretionary Common Conversion Rate.

On February 21, 2018,The Preferred Stock is convertible into common stock at an initial rate of 100 shares of common stock for each share of Preferred Stock, as may be adjusted pursuant to the Company announcedCertificate of Designation of Preferences, Rights and Limitations of Series DF-1 Preferred Stock (the “Certificate of Designation”) (the “Preferred Exchange Rate”). Pursuant to the Certificate of Designation, 1,105,000 shares of Preferred Stock have been authorized for issuance. The Preferred Stock does not possess any voting rights. The Preferred Stock is subject to customary adjustments for stock events. The Preferred Stock provides that Mr. John McDermott,in no event may Deerfield convert the Preferred Stock into shares of common stock if such conversion would result in Deerfield beneficially owning more that 4.985% of the Company’s outstanding common stock (the “Ownership Cap”).
The Amended First Out Waterfall Notes also revises Deerfield’s existing right to convert a portion of the outstanding principal amount of the first-out waterfall loan into a maximum of 1,430,000 shares of the Company’s common stock at the current conversion price to Deerfield may, at its Chief Executive Officer, will step down effective asoption, convert into 1,430,000 shares of a datecommon stock at the Discretionary Common Conversion Rate, or the equivalent number of shares of Preferred Stock at the Discretionary Preferred Conversion Rate.

The Fourth Facility Amendment provides that, in the event that on or prior to the ninetieth (90th) day following the receipt of regulatory approval to sell the Company’s Ovation Alto Abdominal Stent Graft System (“Alto”) in the United States, but in any event no later than June 30, 2018.2020, net sales of Alto shall be in excess of $1.0 million (the “Initial Exchange Condition”), Deerfield will exchange 8.333% (or approximately $10.7 million as of February 24, 2020) of the principal amount of the First Out Waterfall Notes, including any such principal that has resulted from payment-in-kind (“PIK”) interest payments made on or prior to such date, plus any accrued PIK interest thereon through such exchange date into shares of Preferred Stock (the “Initial Exchange”) at a rate equal to the Preferred Exchange Rate multiplied by $0.8282 (the “Floor Price”). In addition, upon consummation of the Initial Note Exchange, payment of the remaining portion of the First Amortization Payment will be extended until the Second Amortization Date (as defined in the Facility Agreement) and maturity date in accordance with the Facility Agreement.

In addition, in the event that the Initial Exchange has occurred and the Company completes the first submission to the FDA of a full PMA application with respect to the Nellix EVAS System on or prior to September 30, 2021, Deerfield will exchange $2.5 million into shares of Preferred Stock (the “Nellix Submission Exchange”) at a rate (the “Conditional Exchange Rate”) equal to the product of the (i) Preferred Exchange Rate multiplied by (ii) the 85% of the lesser of (x) the Closing Price and (y) the 15 Day VWAP (the “Conditional Price”). In the event that the Initial Exchange and the Nellix Submission Exchange have occurred and the Company receives the PMA from the FDA with respect to the Nellix EVAS System as shall be necessary for the sale of the Nellix EVAS System in the United States on or prior to June 30, 2022 (the “Nellix Approval Exchange Condition”), Deerfield will exchange $7.5 million into shares of Preferred Stock (the “Nellix Approval Exchange”) at the Conditional Exchange Rate. In the event that the Initial Exchange, the Nellix Submission Exchange and the Nellix Approval Exchange have occurred and net sales of the Nellix EVAS System are in excess of $10.0 million within nine months of satisfaction of the Nellix Approval Exchange Condition, Deerfield will exchange $10.0 million into shares of Preferred Stock (the “Nellix Sales Exchange”) at the Conditional Exchange Rate. Notwithstanding the above, none of the foregoing exchanges shall take place if the Conditional Price at the time of such exchange is less than the Floor Price.

The Fourth Facility Amendment provides that if, during the period beginning on the first business day following satisfaction of the Initial Exchange Condition and ending on the date that is three months thereafter, the Company completes an equity financing resulting in net proceeds to the Company of at least $5.0 million and subject to certain other conditions set forth in the Fourth Facility Amendment, then Deerfield will exchange $0.50 of principal of First Out Waterfall Notes for each $1 of net proceeds up to an aggregate of $20 million in net proceeds into shares of Preferred Stock at a rate equal to the Preferred Exchange Rate multiplied by the lowest price per share of common stock purchased in such financing, provided that

ENDOLOGIX, INC.
NOTES TO CONSOLIDATED FINANCIAL STATEMENTS—(Continued)
(all tabular amounts presented in thousands, except share, per share and per unit data, and number of years)

such price per share is not less than the Floor Price. Deerfield would also receive the number of such other securities, if any, issued with each share of common stock sold in such financing for each as-converted share of Common Stock issued to Deerfield.

Further, the Fourth Facility Amendment also provides, upon signing, the Company shall pay a restructuring fee of $2.0 million in cash or a combination of shares of common stock at the Floor Price and shares of Preferred Stock at a rate equal to the product of the Floor Price multiplied by the Preferred Exchange Rate. The Company currently anticipateselected to satisfy the fee by issuing 950,000 shares of common stock and 14,648.75 shares of Preferred Stock at signing.

The Fourth Facility Amendment provides that, Mr. Dermottupon the satisfaction of the Initial Exchange Condition, the Company will continueamend the outstanding 2017 Deerfield Warrants and 2018 Deerfield Warrants to serve asreduce the Company’s Chief Executive Officer throughexercise price of the Warrants to $1.50. All other material terms and conditions of the 2017 Deerfield Warrants and 2018 Deerfield Warrants remain the same.

The Fourth Facility Amendment also provides that, upon completion of the recruitment and transition processInitial Note Exchange, the remaining interest payments on the First Out Waterfall Notes will be due monthly. For 18 months beginning with the first calendar month following completion of the Initial Note Exchange the Company will, subject to certain conditions precedent, make such interest payments in shares of Preferred Stock at a new Chief Executive Officer and will remain availablerate equal to the Companyproduct of (i) the Preferred Exchange Rate as necessary to facilitate a smooth leadership transition. The Board of Directors has commenced a search for a new Chief Executive Officer to replace Mr. Dermott.the interest payment date multiplied by (ii) ninety percent (90%) of the lesser of (a) the closing price on the date immediately preceding the interest payment date and (b) the 15 Day VWAP immediately preceding the interest payment date.

Fourth Amendment to Credit Agreement


On February 24, 2020, the Company entered into a Fourth Amendment to Credit Agreement (the “Credit Amendment”) with Deerfield Revolver and certain funds managed by Deerfield Management Company, L.P., dated as of August 9, 2018. The Credit Amendment includes conforming revisions to reflect the changes in the Fourth Facility Amendment. In addition, the Credit Amendment provides that if the Company satisfies the Maturity Extension Conditions, the credit agreement maturity date will extend to the earlier of (i) December 22, 2023 or (ii) the date the loans pursuant to the Facility Agreement have been repaid in full.


Item 9.Changes in and Disagreements with Accountants on Accounting and Financial Disclosure

None.

Item 9A        CONTROLS AND PROCEDURES.
Item 9AControls and Procedures

Management’s Annual Report on Internal Control over Financial Reporting
Our management, including our chief executive officer and chief financial officer, is responsible for establishing and maintaining adequate internal control over financial reporting as defined in Rules 13a-15(f) and 15d-15(f) under the Securities Exchange Act.Act of 1934, as amended (the “Exchange Act”). Our internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of the financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. This process includes those policies and procedures thatthat: (i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of our assets; (ii) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that our receipts and expenditures are being made only in accordance with authorizations of our management and directors; and (iii) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of our assets that could have a material effect on our financial statements.
Because of its inherent limitations, internal control over financial reporting may not prevent or detect all material misstatements. In addition, projections of any evaluation of the internal control over financial reporting to future periods are subject to risk that the internal control may become inadequate because of changes in conditions, or that the degree of compliance with policies or procedures may deteriorate.
Our management assessed the effectiveness of our internal control over financial reporting as of December 31, 20172019. In making this assessment, our management used the criteria set forth by the Committee of Sponsoring Organizations of the Treadway Commission in the report entitled Internal Control-Integrated Framework (2013). Based on its assessment, our management has concluded that, as of December 31, 2017,2019, our internal control over financial reporting was effective based on those criteria.
KPMG LLP, an independent registered public accounting firm, has auditedissued an attestation report on the effectiveness of our internal control over financial reporting as of December 31, 20172019 as stated in its report, which is included herein.

Disclosure Controls and Procedures

We maintain disclosure controls and procedures, as defined in Rule 13a-15(e) and 15d-15(e) under the Exchange Act. Our disclosure controls and procedures are designed to ensure that information required to be disclosed by us in the reports that we file or submit under the Exchange Act is recorded, processed, summarized and reported, within the time periods specified in the SEC’s rules and forms, and that such information is accumulated and communicated to our management, including our chief executive officer and chief financial officer, as appropriate, to allow timely decisions regarding required disclosure. In designing and evaluating the disclosure controls and procedures, management recognized that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving the desired control objectives, and management was required to apply its judgment in evaluating the cost-benefit relationship of possible controls and procedures.

We carried out an evaluation, under the supervision of and with the participation of our management, including our chief executive officer and chief financial officer, of the effectiveness of our disclosure controls and procedures as of December 31, 2017,2019, pursuant to Rule 13a-15(b) under the Exchange Act. Based on that evaluation, our chief executive officer and chief financial officer have concluded that our disclosure controls and procedures were effective as of December 31, 2017.2019.

Changes in Internal Control over Financial Reporting
There has been no change in our internal control over financial reporting (as defined in Rules 13a-15(f) and 15d-15(f) under the Exchange Act) during the fourth quarter of the fiscal year ended December 31, 20172019 that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting.


Item 9B.Other Information

Not applicable.



PART III

Item 10.Directors, Executive Officers and Corporate Governance
The information required hereunder is incorporated herein by reference to our definitive Proxy Statement on Schedule 14A related to our 2020 Annual Meeting of Stockholders, or to an amendment to this Annual Report on Form 10-K, to be filed within 120 days of December 31, 2017 and delivered to stockholders in connection with our Annual Meeting of Stockholders to be held on June 14, 2018.

2019.
Item 11.Executive Compensation
The information required hereunder is incorporated herein by reference to our definitive Proxy Statement on Schedule 14A related to our 2020 Annual Meeting of Stockholders, or to an amendment to this Annual Report on Form 10-K, to be filed within 120 days of December 31, 2017 and delivered to stockholders in connection with our Annual Meeting of Stockholders to be held on June 14, 2018.

2019.
Item 12.Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
The information required hereunder is incorporated herein by reference to our definitive Proxy Statement on Schedule 14A related to our 2020 Annual Meeting of Stockholders, or to an amendment to this Annual Report on Form 10-K, to be filed within 120 days of December 31, 2017 and delivered to stockholders in connection with our Annual Meeting of Stockholders to be held on June 14, 2018.2019.

Item 13.Certain Relationships and Related Transactions, and Director Independence
The information required hereunder is incorporated herein by reference to our definitive Proxy Statement on Schedule 14A related to our 2020 Annual Meeting of Stockholders, or to an amendment to this Annual Report on Form 10-K, to be filed within 120 days of December 31, 2017 and delivered to stockholders in connection with our Annual Meeting of Stockholders to be held on June 14, 2018.2019.

Item 14.Principal Accountant Fees and Services
The information required hereunder is incorporated herein by reference to our definitive Proxy Statement on Schedule 14A related to our 2020 Annual Meeting of Stockholders, or to an amendment to this Annual Report on Form 10-K, to be filed within 120 days of December 31, 2017 and delivered to stockholders in connection with our Annual Meeting of Stockholders to be held on June 14, 2018.


2019.

PART IV

Item 15.Exhibits, Financial Statement Schedules

(a)      Financial Statements and Schedules
(a)Financial Statements and Schedules
The following financial statements and schedules listed below are included in this Annual Report on Form 10-K:
Financial Statements
Reports of Independent Registered Public Accounting Firm
Consolidated Balance Sheets as of December 31, 20172019 and 20162018
Consolidated Statements of Operations and Comprehensive Loss for the years ended December 31, 2017, 2016,2019, 2018 and 20152017
Consolidated Statements of Stockholders’ Equity for the years ended December 31, 2017, 2016,2019, 2018 and 20152017
Consolidated Statements of Cash Flows for the years ended December 31, 2017, 2016,2019, 2018 and 20152017
Notes to the Consolidated Financial Statements
Financial Statement Schedule:
Schedule II - Valuation and Qualifying Accounts for the years ended December 31, 2017, 2016,2019, 2018 and 2015.2017. All other schedules are omitted, as required information is inapplicable or the information is presented in the consolidated financial statements.Consolidated Financial Statements.


SCHEDULE II — VALUATION AND QUALIFYING ACCOUNTS
Years Ended December 31, 20172019, 20162018, and 20152017  
Column AColumn B
Column C
Column D
Column E Column B Column C Column D Column E
 
Additions
(Reductions)

 
    Additions
(reductions)
    
DescriptionBalance at
Beginning of
Period

Charged to Bad Debt Expense
Charged
to Other
Accounts

Deductions (1)
Balance at
End of
Period
 Balance at
beginning of
period
 Charged to bad debt expense Charged
to other
accounts
 Deductions (1) Balance at
end of
period
(In thousands)     (In thousands)    
Year ended December 31, 2019          
Allowance for doubtful accounts $802
 $534
 $
 $(19) $1,317
Year ended December 31, 2018          
Allowance for doubtful accounts $470
 $552
 $
 $(220) $802
Year ended December 31, 2017








          
Allowance for doubtful accounts$1,037

$(235)
$

$(332)
$470
 $1,037
 $(235) $
 $(332) $470
Year ended December 31, 2016








Allowance for doubtful accounts$226

$916

$

$(105)
$1,037
Year ended December 31, 2015








Allowance for doubtful accounts$185

$107

$

$(66)
$226
 
(1)Deductions represent the actual write-off of accounts receivable balances.

(b)     Exhibits
The following is a list of exhibits required by Item 601 of Regulation S-K filed as part of this Annual Report on Form 10-K. For exhibits that we previously filed with the SEC, we incorporate those exhibits herein by reference. The exhibit table below includes the form type and filing date of the previous filing, the original exhibit number in the previous filing which is being incorporated by reference herein, and a hyperlink thereto.



Exhibit Number Exhibit Description
 Agreement and Plan of Merger and Reorganization, dated October 27, 2010, by and among Endologix, Inc., Nepal Acquisition Corporation, Nellix, Inc., certain of Nellix, Inc.’s stockholders listed therein and Essex Woodlands Health Ventures, Inc., as representative of Nellix, Inc.’s stockholders (Incorporated by reference to Exhibit 2.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on October 27, 2010).
 Agreement and Plan of Merger, dated October 26, 2015, by and among Endologix, Inc., Teton Merger Sub, Inc. and TriVascular Technologies, Inc. (Incorporated by reference to Exhibit 2.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on October 26, 2015).
 Amended and Restated Certificate of Incorporation, as amended (Incorporated by reference to Exhibit 3.1 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on August 5, 2016).
 Amended and Restated Bylaws, as amended (Incorporated by reference to Exhibit 3.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on December 14, 2010).
4.1 Specimen Certificate of Common Stock (Incorporated by reference to Exhibit 4.1 to Amendment No. 2 to Endologix, Inc. Registration Statement on Form S-1, No. 333-04560, filed on June 10, 1996).
 Updated Specimen Certificate of Common Stock effective as of May 22, 2014 (Incorporated by reference to Exhibit 4.1.1 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 2, 2015).
 Indenture, dated December 10, 2013, between Endologix, Inc. and Wells Fargo Bank, National Association, as trustee (Incorporated by reference to Exhibit 4.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on December 10, 2013).
 First Supplemental Indenture, dated December 10, 2013, between Endologix, Inc. and Wells Fargo Bank, National Association, as trustee (Incorporated by reference to Exhibit 4.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on December 10, 2013).
 Form of 2.25% Convertible Senior Notes due 2018 (Incorporated by reference to Exhibit A to Exhibit 4.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on December 10, 2013).
 Second Supplemental Indenture, dated November 2, 2015, between Endologix, Inc. and Wells Fargo Bank, National Association, as trustee (Incorporated by reference to Exhibit 4.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on November 2, 2015).
 Form of 3.25% Convertible Senior Notes due 2020 (Incorporated by reference to Exhibit A to Exhibit 4.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on November 2, 2015).
 
Form of Warrant to Purchase Common Stock of Endologix, Inc., issued to Deerfield Private Design Fund IV, L.P., Deerfield International Master Fund, L.P., Deerfield Partners, L.P., and Deerfield Private Design Fund III, L.P., together with a schedule of holders and amounts (issued April 3, 2017) (Incorporated by reference to Exhibit 4.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 5, 2017).

 
Registration Rights Agreement, dated April 3, 2017, by and among Endologix, Inc., Deerfield Private Design Fund IV, L.P., Deerfield International Master Fund, L.P., Deerfield Partners, L.P., and Deerfield Private Design Fund III, L.P. (Incorporated by reference to Exhibit 4.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 5, 2017).

10.1(1)1997 Supplemental Stock Option Plan (Incorporated by reference to Exhibit 99.1 to Endologix, Inc. Registration Statement on Form S-8, No. 333-42161, filed on December 12, 1997).
(1)1996 Stock Option/Stock Issuance Plan (Incorporated by reference to Exhibit 4.1 to Endologix, Inc. Registration Statement on Form S-8, No. 333-122491, filed on February 2, 2005).
(1)2006 Stock Incentive Plan, as amended (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on May 24, 2013).
(1)Form of Stock Option Agreement under 2006 Stock Incentive Plan (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on November 9, 2006).
(1)Form of Restricted Stock Award Agreement under 2006 Stock Incentive Plan (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on November 9, 2006).
(1)Form of Employee Restricted Stock Unit Award Agreement under 2006 Stock Incentive Plan (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on November 1, 2012).
(1)Form of Director Restricted Stock Unit Award Agreement under 2006 Stock Incentive Plan (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on November 1, 2012).
Exhibit Number Exhibit Description
 Agreement and Plan of Merger and Reorganization, dated October 27, 2010, by and among Endologix, Inc., Nepal Acquisition Corporation, Nellix, Inc., certain of Nellix, Inc.’s stockholders listed therein and Essex Woodlands Health Ventures, Inc., as representative of Nellix, Inc.’s stockholders (Incorporated by reference to Exhibit 2.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on October 27, 2010).
 Agreement and Plan of Merger, dated October 26, 2015, by and among Endologix, Inc., Teton Merger Sub, Inc. and TriVascular Technologies, Inc. (Incorporated by reference to Exhibit 2.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on October 26, 2015).
 Amended and Restated Certificate of Incorporation (as updated through March 5, 2019 and currently in effect) (Incorporated by reference to Exhibit 3.1 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on April 1, 2019).
 Certificate of Designation of Preferences, Rights and Limitations of Series DF-1 Preferred Stock (Incorporated by reference to Exhibit 3.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on February 24, 2020).
 Amended and Restated Bylaws (as updated through June 14, 2018 and currently in effect) (Incorporated by reference to Exhibit 3.2 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on April 1, 2019).
 Specimen Certificate of Common Stock (Incorporated by reference to Exhibit 4.1 to Amendment No. 2 to Endologix, Inc. Registration Statement on Form S-1, No. 333-04560, filed on June 10, 1996).
 Updated Specimen Certificate of Common Stock effective as of May 22, 2014 (Incorporated by reference to Exhibit 4.1.1 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 2, 2015).
(2)Description of Endologix, Inc. Capital Stock
 Indenture, dated December 10, 2013, between Endologix, Inc. and Wells Fargo Bank, National Association, as trustee (Incorporated by reference to Exhibit 4.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on December 10, 2013).
 First Supplemental Indenture, dated December 10, 2013, between Endologix, Inc. and Wells Fargo Bank, National Association, as trustee (Incorporated by reference to Exhibit 4.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on December 10, 2013).
 Form of 2.25% Convertible Senior Notes due 2018 (Incorporated by reference to Exhibit A to Exhibit 4.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on December 10, 2013).
 Second Supplemental Indenture, dated November 2, 2015, between Endologix, Inc. and Wells Fargo Bank, National Association, as trustee (Incorporated by reference to Exhibit 4.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on November 2, 2015).
 Form of 3.25% Convertible Senior Notes due 2020 (Incorporated by reference to Exhibit A to Exhibit 4.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on November 2, 2015).
 Form of Indenture in respect of 5.00% Mandatory Convertible Senior Notes due 2024 (Incorporated by reference to Exhibit 4.5 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 1, 2019).
 Form of 5.00% Mandatory Convertible Senior Note due 2024 (Incorporated by reference to Exhibit 4.6 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 1, 2019).
 Form of Indenture, dated April 3, 2019, in respect of 5.00% Voluntary Convertible Senior Notes due 2024 (Incorporated by reference to Exhibit 4.7 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 1, 2019).
 Form of Indenture, dated February 24, 2020, in respect of 5.00% Voluntary Convertible Senior Notes due 2024 (Incorporated by reference to Exhibit 4.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on February 24, 2020).
 Form of 5.00% Voluntary Convertible Senior Note due 2024, issued on April 3, 2019 (Incorporated by reference to Exhibit 4.8 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 1, 2019).
 Form of 5.00% Voluntary Convertible Senior Note due 2024, issued on February 24, 2020 (Incorporated by reference to Exhibit 4.3 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on February 24, 2020).
 Form of Pre-Paid Warrant to Purchase Common Stock (Incorporated by reference to Exhibit 4.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 1, 2019).


(1)Amended and Restated 2006 Employee Stock Purchase Plan, as amended (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on June 7, 2016).
(1)
2015 Stock Incentive Plan, as amended (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on June 2, 2017).

(1)Form of Stock Option Agreement under 2015 Stock Incentive Plan (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on June 1, 2015).
(1)
Form of Restricted Stock Unit Award Agreement under 2015 Stock Incentive Plan (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on June 1, 2015).

(1)2017 Inducement Stock Incentive Plan (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on October 30, 2017).
(1)Employment Agreement, dated February 1, 2014, by and between Endologix, Inc. and John McDermott (Incorporated by reference to Exhibit 10.18 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 3, 2014).
(1)Severance Agreement and General Release, dated February 21, 2018, by and between Endologix, Inc. and John McDermott (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on February 21, 2018).
(1)
Employment Agreement, dated February 25, 2016, by and between Endologix, Inc. and Vaseem Mahboob (Incorporated by reference to Exhibit 10.12 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on February 29, 2016).

(1)Employment Agreement, dated February 1, 2014, by and between Endologix, Inc. and Robert D. Mitchell (Incorporated by reference to Exhibit 10.20 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 3, 2014).
(1)(2)
Separation Agreement and General Release, dated December 15, 2017, by and between Endologix, Inc. and Robert D. Mitchell, including the Agreement for Independent Contractor Services attached as Exhibit A thereto.


(1)(2)
Second Amendment to Restricted Stock Award Agreement, dated December 15, 2017, by and between Endologix, Inc. and Robert D. Mitchell.

(1)
Employment Agreement, dated as of February 3, 2016, by and between Endologix, Inc. and Michael Chobotov, Ph.D. (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on May 5, 2017).

(1)
Employment Agreement, dated as of February 3, 2016, by and between Endologix, Inc. and Shari O’Quinn (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on May 5, 2017).

(1)Form of Indemnification Agreement entered into with Endologix, Inc. officers and directors (Incorporated by reference to Exhibit 10.23 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 3, 2014).
(1)
Employment Agreement, dated as of October 30, 2017, by and between Endologix, Inc. and John Onopchenko (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on November 7, 2017).

 Standard Industrial/Commercial Single-Tenant Lease - Net, dated November 2, 2004, by and between Endologix, Inc. and Del Monico Investments, Inc. (Incorporated by reference to Exhibit 10.46 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on November 24, 2004).
 Addendum No. 2 to Standard Industrial/Commercial Single-Tenant Lease - Net, by and between Endologix, Inc. and Del Monico Investments, Inc., dated June 9, 2009 (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on November 2, 2009).
 Addendum No. 3 to Standard Industrial/Commercial Single-Tenant Lease - Net, by and between Endologix, Inc. and Del Monico Investments, Inc., dated June 9, 2009 (Incorporated by reference to Exhibit 10.17.2 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 2, 2015).
 Addendum No. 4 to Standard Industrial/Commercial Single-Tenant Lease - Net, by and between Endologix, Inc. and Del Monico Investments, Inc., dated June 9, 2009 (Incorporated by reference to Exhibit 10.17.3 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 2, 2015).
 Standard Industrial/Commercial Multi -Tenant Lease - Net, by and between Endologix, Inc. and Four-In-One Associates, dated August 28, 2009 (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on November 2, 2009).
 Addendum No. 3 to Standard Industrial/Commercial Multi -Tenant Lease - Net, by and between Endologix, Inc. and Four-In-One Associates, dated August 28, 2009 (Incorporated by reference to Exhibit 10.18.1 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 2, 2015).
Exhibit Number Exhibit Description
 Form of Amended and Restated (2017) Warrant (Incorporated by reference to Exhibit 4.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 1, 2019).
 Registration Rights Agreement, dated April 3, 2017, by and among Endologix, Inc., Deerfield Private Design Fund IV, L.P., Deerfield International Master Fund, L.P., Deerfield Partners, L.P., and Deerfield Private Design Fund III, L.P. (Incorporated by reference to Exhibit 4.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 5, 2017).
 Form of Amended and Restated Additional (2018) Warrant (Incorporated by reference to Exhibit 4.3 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 1, 2019).
 Form of First Out Waterfall Note (Incorporated by reference to Exhibit 4.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on February 24, 2020).
 
Note, issued August 9, 2018, issued by Endologix, Inc. and certain of its subsidiaries to Deerfield Private
Design Fund III, L.P. (Incorporated by reference to Exhibit 4.8 to Endologix, Inc. Current Report on Form
8-K, File No. 000-28440, filed on August 10, 2018).
 
Note, issued August 9, 2018, issued by Endologix, Inc. and certain of its subsidiaries to Deerfield Private
Design Fund IV, L.P. (Incorporated by reference to Exhibit 4.9 to Endologix, Inc. Current Report on Form
8-K, File No. 000-28440, filed on August 10, 2018).
 
Note, issued August 9, 2018, issued by Endologix, Inc. and certain of its subsidiaries to Deerfield
Partners, L.P. (Incorporated by reference to Exhibit 4.10 to Endologix, Inc. Current Report on Form 8-K,
File No. 000-28440, filed on August 10, 2018).
 
Last Out Waterfall Note ($40,500,000), issued August 9, 2018, issued by Endologix, Inc. to Deerfield
Partners, L.P. (Incorporated by reference to Exhibit 4.11 to Endologix, Inc. Current Report on Form 8-K,
File No. 000-28440, filed on August 10, 2018).
(1)Amended and Restated 2006 Employee Stock Purchase Plan, as amended (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on November 7, 2019).
(1)Amended and Restated 2015 Stock Incentive Plan, as amended (Incorporated by reference to Appendix A to Endologix, Inc. Definitive Proxy Statement on Schedule 14A, File No. 000-28440, filed on July 8, 2019).
(1)Form of Stock Option Agreement under 2015 Stock Incentive Plan (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on June 1, 2015).
(1)Form of Restricted Stock Unit Award Agreement under 2015 Stock Incentive Plan (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on June 1, 2015).
(1)(2)2017 Inducement Stock Incentive Plan, as amended.
(1)Severance Agreement and General Release, dated February 21, 2018, by and between Endologix, Inc. and John McDermott (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on February 21, 2018).
(1)Amended and Restated Employment Agreement, dated as of December 4, 2018, by and between Endologix, Inc. and Vaseem Mahboob (Incorporated by reference to Exhibit 10.5 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on April 1, 2019).
(1)Separation Agreement and General Release, dated December 15, 2017, by and between Endologix, Inc. and Robert D. Mitchell, including the Agreement for Independent Contractor Services attached as Exhibit A thereto. (Incorporated by reference to Exhibit 10.9.1 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 13, 2018).
(1)Second Amendment to Restricted Stock Award Agreement, dated December 15, 2017, by and between Endologix, Inc. and Robert D. Mitchell. (Incorporated by reference to Exhibit 10.9.2 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 13, 2018).
(1)Employment Agreement, dated as of February 3, 2016, by and between Endologix, Inc. and Michael Chobotov, Ph.D. (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on May 5, 2017).
(1)Employment Agreement, dated as of February 3, 2016, by and between Endologix, Inc. and Shari O’Quinn (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on May 5, 2017).
(1)Form of Indemnification Agreement entered into with Endologix, Inc. officers and directors (Incorporated by reference to Exhibit 10.23 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 3, 2014).


 Standard Industrial/Commercial Multi-Tenant Lease - Net, for 2 Musick, Irvine, California and 35 Hammond, Irvine, dated June 12, 2013, by and between Endologix, Inc. and The Northwestern Mutual Life Insurance Company (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed with on August 5, 2013).
Cross License Agreement dated as of October 26, 2011, by and between Endologix, Inc. and Bard Peripheral Vascular, Inc. (Incorporated by reference to Exhibit 10.19 to Endologix Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 6, 2012).
Settlement Agreement, dated October 16, 2012 by and among Endologix, Inc., Cook Incorporated, Cook Group and Cook Medical, Inc. (Incorporated by reference to Exhibit 10.22 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed with on March 14, 2013).
 Base Capped Call Confirmation, dated December 4, 2013, between Endologix, Inc. and Bank of America, N.A. (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on December 6, 2013).
 Additional Capped Call Confirmation, dated December 5, 2013, between Endologix, Inc. and Bank of America, N.A. (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on December 6, 2013).
 
Facility Agreement, dated April 3, 2017, by and among Endologix, Inc., certain subsidiaries of Endologix, Inc., Deerfield Private Design Fund IV, L.P., Deerfield International Master Fund, L.P., Deerfield Partners, L.P., and Deerfield Private Design Fund III, L.P. (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 5, 2017).

 
Credit and Security Agreement, dated April 3, 2017, by and among Endologix, Inc., certain subsidiaries of Endologix, Inc. and Deerfield ELGX Revolver, LLC. (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 5, 2017).

(2)
Lease Agreement, dated June 16, 2005, by and among TriVascular, Inc., Carmel River, LLC, Carlsen Investments, LLC, and Rieger Investments, LLC.

(2)
Consent, Assignment, First Amendment to Lease and Non-Disturbance Agreement, dated March 28, 2008, by and among Boston Scientific Santa Rosa Corp., Carmel River, LLC, Carlsen Investments, LLC, Rieger Investments, LLC, and Boston Scientific Corporation.

(2)
Second Amendment to Lease, dated December 6, 2011, by and among TriVascular, Inc., Sonoma Airport Properties LLC and Boston Scientific Corporation.

 
Third Amendment to Lease, by and between TriVascular, Inc. and Sonoma Airport Properties LLC, dated July 3, 2017 (Incorporated by reference to Exhibit 10.4 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on August 4, 2017).

(2)Computation of Ratio of Earnings to Fixed Charges.
 Code of Ethics for Chief Executive Officer and Principal Financial Officers (Incorporated by reference to Exhibit 14 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 26, 2004).
(2)List of Subsidiaries.
(2)Consent of Independent Registered Public Accounting Firm (KPMG LLP).
(2)Power of Attorney (included on signature page hereto).
(2)Certification of Chief Executive Officer Pursuant to Rule 13a-14(a)/15d-14(a) under the Securities Exchange Act of 1934.
(2)Certification of Chief Financial Officer Pursuant to Rule 13a-14(a)/15d-14(a) under the Securities Exchange Act of 1934.
(2)(3)Certification of Chief Executive Officer Pursuant to Rule 13a-14(b)/15d-14(b) under the Securities Exchange Act of 1934 and 18 U.S.C. Section 1350.
(2)(3)Certification of Chief Financial Officer Pursuant to Rule 13a-14(b)/15d-14(b) under the Securities Exchange Act of 1934 and 18 U.S.C. Section 1350.
101.INS(2)XBRL Instance Document
101.SCH(2)XBRL Taxonomy Extension Schema Document
101.CAL(2)XBRL Taxonomy Extension Calculation Link Base Document
101.DEF(2)XBRL Taxonomy Extension Definition Link Base Document
101.LAB(2)XBRL Taxonomy Extension Label Link Base Document
101.PRE(2)XBRL Taxonomy Extension Presentation Link Base Document
Exhibit Number Exhibit Description
(1)Employment Agreement, dated as of May 2, 2018, by and between Endologix, Inc. and John Onopchenko (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on August 9, 2018).
(1)Employment Agreement, dated as of June 25, 2018, by and between Endologix, Inc. and Jeffrey Fecho (Incorporated by reference to Exhibit 10.3 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on August 9, 2019).
(1)Amended and Restated Employment Agreement, dated as of December 4, 2018, by and between Endologix, Inc. and Jeremy Hayden (Incorporated by reference to Exhibit 10.11 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on April 1, 2019).
(1)Amended and Restated Employment Agreement, dated as of December 4, 2018, by and between Endologix, Inc. and Matthew Thompson (Incorporated by reference to Exhibit 10.12 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on April 1, 2019).
(1)Employment Agreement, dated as of January 7, 2019, by and between Endologix, Inc. and John Zehren (Incorporated by reference to Exhibit 10.4 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on August 9, 2019).
 Standard Industrial/Commercial Multi-Tenant Lease - Net, for 2 Musick, Irvine, California and 35 Hammond, Irvine, dated June 12, 2013, by and between Endologix, Inc. and The Northwestern Mutual Life Insurance Company (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed with on August 5, 2013).
Cross License Agreement dated as of October 26, 2011, by and between Endologix, Inc. and Bard Peripheral Vascular, Inc. (Incorporated by reference to Exhibit 10.19 to Endologix Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 6, 2012).
 Credit Agreement, dated August 9, 2018, by and among Endologix, Inc. and Deerfield ELGX Revolver, LLC and certain of its affiliates (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on August 10, 2018).
 First Amendment to Credit Agreement, dated November 20, 2018, by and among Endologix, Inc. and ELGX Revolver, LLC and certain of its affiliates (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on November 26, 2018).
 Second Amendment to Credit Agreement and First Amendment to Guaranty and Security Agreement, dated March 31, 2019, by and among Endologix, Inc. and Deerfield ELGX Revolver, LLC and certain of its affiliates (Incorporated by reference to Exhibit 10.3 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 1, 2019).

Third Amendment to Credit Agreement, dated May 31, 2019, by and between Endologix, Inc. and Deerfield Partners, L.P. and certain of this affiliates (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on August 9, 2019).
 Fourth Amendment to Credit Agreement, dated February 24, 2020, by and among Endologix, Inc. and Deerfield ELGX Revolver, LLC and certain of its affiliates (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on February 24, 2020).
 Amended and Restated Facility Agreement, dated August 9, 2018, by and among Endologix, Inc. and Deerfield Private Design Fund IV, L.P. and certain of its affiliates (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on August 10, 2018).
 First Amendment to Amended and Restated Facility Agreement, dated November 20, 2018, by and among Endologix, Inc. and Deerfield Private Design Fund IV, L.P. and certain of its affiliates (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on November 26, 2018).
 Second Amendment to Amended and Restated Facility Agreement and First Amendment to Guaranty and Security Agreement, dated March 31, 2019, by and among Endologix, Inc. and Deerfield Private Design Fund IV, L.P. and certain of its affiliates (Incorporated by reference to Exhibit 10.4 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 1, 2019).

Third Amendment to Amended and Restated Facility Agreement, dated May 31, 2019, by and between Endologix, Inc. and Deerfield Private Design Fund IV, L.P. and certain of this affiliates (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on August 9, 2019).
 Amended and Restated Registration Rights Agreement, dated August 9, 2018, by and between Endologix, Inc. and Deerfield Private Design Fund IV, L.P. (Incorporated by reference to Exhibit 10.3 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on August 10, 2018).


Exhibit NumberExhibit Description
Amended and Restated Guaranty and Security Agreement, dated August 9, 2018, by and among Endologix, Inc., its subsidiaries and Deerfield Private Design Fund IV, L.P. (Incorporated by reference to Exhibit 10.4 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on August 10, 2018).
Guaranty and Security Agreement, dated August 9, 2018, by and among Endologix, Inc., its subsidiaries and Deerfield ELGX Revolver, LLC. (Incorporated by reference to Exhibit 10.5 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on August 10, 2018).
Intercompany Subordination Agreement, dated August 9, 2018, by and among Endologix, Inc., its subsidiaries and Deerfield Private Design Fund IV, L.P. (Incorporated by reference to Exhibit 10.6 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on August 10, 2018).
Intercompany Subordination Agreement, dated August 9, 2018, by and among Endologix, Inc., its subsidiaries and Deerfield ELGX Revolver, LLC. (Incorporated by reference to Exhibit 10.7 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on August 10, 2018).
Junior Lien Security Agreement, dated February 24, 2020, by and between Endologix, Inc. and Wilmington Trust, National Association (Incorporated by reference to Exhibit 10.5 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on February 24, 2020).
Intercreditor Agreement, dated August 9, 2018, by and among Endologix, Inc., its subsidiaries, Deerfield ELGX Revolver, LLC and Deerfield Private Design Fund IV, L.P. (Incorporated by reference to Exhibit 10.8 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on August 10, 2018).
Subordination and Intercreditor Agreement, dated February 24, 2020, by and among Endologix, Inc., Deerfield Private Design Fund IV, L.P., Deerfield ELGX Revolver, LLC and Wilmington Trust, National Association (Incorporated by reference to Exhibit 10.4 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on February 24, 2020).
Reaffirmation Agreement, dated August 9, 2018, by and among Endologix, Inc., its subsidiaries and Deerfield Private Design Fund IV, L.P. (Incorporated by reference to Exhibit 10.9 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on August 10, 2018).
Patent Security Agreement, dated August 9, 2018, by and among Endologix, Inc., certain of its subsidiaries and Deerfield ELGX Revolver, LLC. (Incorporated by reference to Exhibit 10.10 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on August 10, 2018).
Trademark Security Agreement, dated August 9, 2018, by and among Endologix, Inc., certain of its subsidiaries and Deerfield ELGX Revolver, LLC. (Incorporated by reference to Exhibit 10.11 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on August 10, 2018).
First Supplement to Patent Security Agreement, dated August 9, 2018, by and among Endologix, Inc., certain of its subsidiaries and Deerfield Private Design Fund IV, L.P. (Incorporated by reference to Exhibit 10.12 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on August 10, 2018).
First Supplement to Trademark Security Agreement, dated August 9, 2018, by and among Endologix, Inc., certain of its subsidiaries and Deerfield Private Design Fund IV, L.P. (Incorporated by reference to Exhibit 10.13 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on August 10, 2018).
Purchase Agreement, dated March 31, 2019, by and among Endologix, Inc. and the investors named on Schedule I thereto (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 1, 2019).
Exchange Agreement, dated March 31, 2019, by and among Endologix, Inc. and the noteholders named on Schedule A thereto (Incorporated by reference to Exhibit 10.2 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on April 1, 2019).
Exchange Agreement, dated February 24, 2020, by and among Endologix, Inc. and the noteholders named on Schedule A thereto (Incorporated by reference to Exhibit 10.1 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on February 24, 2020).
February 2020 Exchange Agreement and Fourth Amendment to Amended and Restated Facility Agreement and Amendment First Out Waterfall Notes, dated February 24, 2020, by and among Endologix, Inc. and Deerfield Private Design Fund IV, L.P. and certain of its affiliates (Incorporated by reference to Exhibit 10.3 to Endologix, Inc. Current Report on Form 8-K, File No. 000-28440, filed on February 24, 2020).
Lease Agreement, dated June 16, 2005, by and among TriVascular, Inc., Carmel River, LLC, Carlsen Investments, LLC, and Rieger Investments, LLC. (Incorporated by reference to Exhibit 10.23 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 13, 2018).


Exhibit Number Exhibit Description
 Consent, Assignment, First Amendment to Lease and Non-Disturbance Agreement, dated March 28, 2008, by and among Boston Scientific Santa Rosa Corp., Carmel River, LLC, Carlsen Investments, LLC, Rieger Investments, LLC, and Boston Scientific Corporation. (Incorporated by reference to Exhibit 10.23.1 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 13, 2018).
 Second Amendment to Lease, dated December 6, 2011, by and among TriVascular, Inc., Sonoma Airport Properties LLC and Boston Scientific Corporation. (Incorporated by reference to Exhibit 10.23.2 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 13, 2018).
 Third Amendment to Lease, by and between TriVascular, Inc. and Sonoma Airport Properties LLC, dated July 3, 2017 (Incorporated by reference to Exhibit 10.4 to Endologix, Inc. Quarterly Report on Form 10-Q, File No. 000-28440, filed on August 4, 2017).
 Code of Ethics for Chief Executive Officer and Principal Financial Officers (Incorporated by reference to Exhibit 14 to Endologix, Inc. Annual Report on Form 10-K, File No. 000-28440, filed on March 26, 2004).
(2)List of Subsidiaries.
(2)Consent of Independent Registered Public Accounting Firm (KPMG LLP).
(2)Power of Attorney (included on signature page hereto).
(2)Certification of Chief Executive Officer Pursuant to Rule 13a-14(a)/15d-14(a) under the Securities Exchange Act of 1934.
(2)Certification of Chief Financial Officer Pursuant to Rule 13a-14(a)/15d-14(a) under the Securities Exchange Act of 1934.
(2)(3)Certification of Chief Executive Officer Pursuant to Rule 13a-14(b)/15d-14(b) under the Securities Exchange Act of 1934 and 18 U.S.C. Section 1350.
(2)(3)Certification of Chief Financial Officer Pursuant to Rule 13a-14(b)/15d-14(b) under the Securities Exchange Act of 1934 and 18 U.S.C. Section 1350.
101.INS(2)XBRL Instance Document
101.SCH(2)XBRL Taxonomy Extension Schema Document
101.CAL(2)XBRL Taxonomy Extension Calculation Link Base Document
101.DEF(2)XBRL Taxonomy Extension Definition Link Base Document
101.LAB(2)XBRL Taxonomy Extension Label Link Base Document
101.PRE(2)XBRL Taxonomy Extension Presentation Link Base Document
________________________
Portions of this exhibit are omitted and were filed separately with the SEC pursuant to Endologix Inc.'s’s application requesting confidential treatment under Rule 24b-2 of the Securities Exchange Act of 1934, as amended.



(1)These exhibits are identified as management contracts or compensatory plans or arrangements of the registrant pursuant to Item 15(a)(3) of Form 10-K.
(2)Filed herewith.
(3)Furnished herewith and not “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended.



Item 16.Form 10-K Summary.Summary
None.

SIGNATURES
Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, as amended, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.
 
ENDOLOGIX, INC.
  
By: 
/S/    JOHN MOCDERMOTTNOPCHENKO        
  
John McDermottOnopchenko
Chief Executive Officer
(Principal Executive Officer)
Date: March 13, 201811, 2020

POWER OF ATTORNEY
We, the undersigned directors and officers of Endologix, Inc., do hereby constitute and appoint Vaseem Mahboob and Jeremy Hayden, and each of them, as our true and lawful attorneys-in-fact and agents with power of substitution, to do any and all acts and things in our name and on our behalf in our capacities as directors and officers and to execute any and all instruments for us and in our names in the capacities indicated below, which said attorney-in-fact and agent may deem necessary or advisable to enable said corporation to comply with the Securities Exchange Act of 1934, as amended, and any rules, regulations and requirements of the Securities and Exchange Commission, in connection with this Annual Report on Form 10-K, including specifically but without limitation, power and authority to sign for us or any of us in our names in the capacities indicated below, any and all amendments (including post-effective amendments) hereto; and we do hereby ratify and confirm all that said attorney-in-fact and agent shall do or cause to be done by virtue hereof.
Pursuant to the requirements of the Securities Exchange Act of 1934, as amended, this report has been signed below by the following persons on behalf of the registrant and in the capacities and on the dates indicated.
 


Signature  Title Date
   
/s/ JOHN McDERMOTTONOPCHENKO       Chief Executive Officer and Director March 13, 201811, 2020
(John McDermott)Onopchenko)  (Principal Executive Officer)  
   
/s/ VASEEM MAHBOOB  Chief Financial Officer March 13, 201811, 2020
(Vaseem Mahboob )Mahboob)  (Principal Financial and Accounting Officer)  
   
   
/s/ DAN LEMAITRE  Chairman of the Board March 13, 201811, 2020
(Dan Lemaitre)     
   
/s/ THOMAS F. ZENTY III  Director March 13, 201811, 2020
(Thomas F. Zenty III)     
   
/s/ THOMAS C. WILDER  Director March 13, 201811, 2020
(Thomas C. Wilder)
/s/ GUIDO J. NEELSDirectorMarch 13, 2018
(Guido J. Neels)
    
   
/s/ GREGORY D. WALLER  Director March 13, 201811, 2020
(Gregory D. Waller)     
   
/s/ LESLIE V. NORWALK  Director March 13, 201811, 2020
(Leslie V. Norwalk)     
/s/ CHRISTOPHER G. CHAVEZDirectorMarch 13, 2018
(Christopher G. Chavez)

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