Table of ContentsContents


UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
xQUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
FOR THE QUARTERLY PERIOD ENDED JUNESEPTEMBER 30, 2018
OR
oTRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
FOR THE TRANSITION PERIOD FROM TO .
Commission File Number 0-18592
 
mmsi-20180930_g1.jpg
MERIT MEDICAL SYSTEMS, INC.
(Exact name of registrant as specified in its charter)
Utah87-0447695
(State or other jurisdiction of incorporation or organization)(IRS Employer Identification No.)
1600 West Merit Parkway, South Jordan, Utah 84095
(Address of principal executive offices, including zip code) 
Registrant’s telephone number, including area code: (801) 253-1600
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 web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files). Yes x  No o
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company” and "emerging growth company" in Rule 12b-2 of the Exchange Act.
Large Accelerated Filer x
Accelerated Filer o
Non-AcceleratedNon-Accelerated Filero(Do not check if a smaller reporting company)

Smaller Reporting Company o
Emerging Growth Company o
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 Exchange Act).  Yes o  No x
Indicate the number of shares outstanding of each of the Registrant’s classes of common stock, as of the latest practicable date.
Common Stock54,735,48654,833,602 
Title or class
Number of Shares
Outstanding at August 6,November 5, 2018






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Table of Contents
PART I - FINANCIAL INFORMATION

ITEM 1. FINANCIAL STATEMENTS

MERIT MEDICAL SYSTEMS, INC. AND SUBSIDIARIES 
CONSOLIDATED BALANCE SHEETS 
AS OF SEPTEMBER 30, 2018 AND DECEMBER 31, 2017 
(In thousands) 
September 30, December 31,
2018 2017 
(unaudited)
ASSETS 
CURRENT ASSETS: 
Cash and cash equivalents$51,955 $32,336 
Trade receivables — net of allowance for uncollectible accounts — 2018 — $2,011 and 2017 — $1,769 129,282 105,536 
Other receivables8,903 9,429 
Inventories181,439 155,288 
Prepaid expenses and other assets11,720 9,096 
Prepaid income taxes3,307 3,225 
Income tax refund receivables1,043 1,211 
Total current assets387,649 316,121 
PROPERTY AND EQUIPMENT: 
Land and land improvements26,926 19,877 
Buildings150,880 147,356 
Manufacturing equipment211,215 197,651 
Furniture and fixtures53,869 49,528 
Leasehold improvements33,365 31,161 
Construction-in-progress48,166 32,896 
Total property and equipment524,421 478,469 
Less accumulated depreciation(204,496)(185,649)
Property and equipment — net319,925 292,820 
OTHER ASSETS: 
Intangible assets:
Developed technology — net of accumulated amortization — 2018 — $93,680 and 2017 — $72,420 224,540 167,771 
Other — net of accumulated amortization — 2018 — $46,088 and 2017 — $38,127 64,565 59,553 
Goodwill249,023 238,147 
Deferred income tax assets2,254 2,359 
Other assets61,927 35,040 
Total other assets602,309 502,870 
TOTAL $1,309,883 $1,111,811 
See condensed notes to consolidated financial statements. (continued) 
3

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MERIT MEDICAL SYSTEMS, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
JUNE 30, 2018 AND DECEMBER 31, 2017
(In thousands)

 June 30, December 31,
 2018 2017
ASSETS(unaudited)  
    
CURRENT ASSETS:   
Cash and cash equivalents$43,512
 $32,336
Trade receivables — net of allowance for uncollectible accounts — 2018 — $1,921 and 2017 — $1,769131,943
 105,536
Other receivables8,490
 9,429
Inventories169,254
 155,288
Prepaid expenses and other assets12,142
 9,096
Prepaid income taxes3,292
 3,225
Income tax refund receivables2,331
 1,211
    
Total current assets370,964
 316,121
    
PROPERTY AND EQUIPMENT:   
Land and land improvements26,940
 19,877
Buildings150,726
 147,356
Manufacturing equipment205,911
 197,651
Furniture and fixtures52,649
 49,528
Leasehold improvements33,029
 31,161
Construction-in-progress40,454
 32,896
    
Total property and equipment509,709
 478,469
    
Less accumulated depreciation(197,941) (185,649)
    
Property and equipment — net311,768
 292,820
    
OTHER ASSETS:   
Intangible assets:   
Developed technology — net of accumulated amortization — 2018 — $86,023 and 2017 — $72,420232,880
 167,771
Other — net of accumulated amortization — 2018 — $43,246 and 2017 — $38,12766,188
 59,553
Goodwill248,998
 238,147
Deferred income tax assets2,318
 2,359
Other assets58,075
 35,040
    
Total other assets608,459
 502,870
    
TOTAL$1,291,191
 $1,111,811
    
See condensed notes to consolidated financial statements.  (continued)
MERIT MEDICAL SYSTEMS, INC. AND SUBSIDIARIES 
CONSOLIDATED BALANCE SHEETS 
AS OF SEPTEMBER 30, 2018 AND DECEMBER 31, 2017 
(In thousands) 
September 30, December 31,
2018 2017 
(unaudited)
LIABILITIES AND STOCKHOLDERS’ EQUITY 
CURRENT LIABILITIES: 
Trade payables$50,697 $34,931 
Accrued expenses65,530 58,932 
Current portion of long-term debt22,000 19,459 
Income taxes payable1,598 2,298 
Total current liabilities139,825 115,620 
LONG-TERM DEBT 186,867 259,013 
DEFERRED INCOME TAX LIABILITIES 23,102 23,289 
LONG-TERM INCOME TAXES PAYABLE 4,846 4,846 
LIABILITIES RELATED TO UNRECOGNIZED TAX BENEFITS 2,746 2,746 
DEFERRED COMPENSATION PAYABLE 12,176 11,181 
DEFERRED CREDITS 2,296 2,403 
OTHER LONG-TERM OBLIGATIONS 14,814 16,379 
Total liabilities386,672 435,477 
COMMITMENTS AND CONTINGENCIES (Notes 5, 10, 11, and 14) 
STOCKHOLDERS’ EQUITY: 
Preferred stock — 5,000 shares authorized as of September 30, 2018 and December 31, 2017; no shares issued — — 
Common stock, no par value; shares authorized — 2018 and 2017 - 100,000; issued and outstanding as of September 30, 2018 - 54,802 and December 31, 2017 - 50,248 568,051 353,392 
Retained earnings354,236 321,408 
Accumulated other comprehensive income924 1,534 
Total stockholders’ equity923,211 676,334 
TOTAL $1,309,883 $1,111,811 
See condensed notes to consolidated financial statements. (concluded) 



4

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MERIT MEDICAL SYSTEMS, INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS
JUNE 30, 2018 AND DECEMBER 31, 2017
(In thousands)

 June 30, December 31,
 2018 2017
LIABILITIES AND STOCKHOLDERS’ EQUITY(unaudited)  
    
CURRENT LIABILITIES:   
Trade payables$50,823
 $34,931
Accrued expenses65,838
 58,932
Current portion of long-term debt21,985
 19,459
Income taxes payable948
 2,298
    
Total current liabilities139,594
 115,620
    
LONG-TERM DEBT391,582
 259,013
    
DEFERRED INCOME TAX LIABILITIES23,148
 23,289
    
LONG-TERM INCOME TAXES PAYABLE4,846
 4,846
    
LIABILITIES RELATED TO UNRECOGNIZED TAX BENEFITS2,746
 2,746
    
DEFERRED COMPENSATION PAYABLE11,620
 11,181
    
DEFERRED CREDITS2,332
 2,403
    
OTHER LONG-TERM OBLIGATIONS16,069
 16,379
    
Total liabilities591,937
 435,477
    
COMMITMENTS AND CONTINGENCIES (Notes 5, 10, 11, and 14)

 

    
STOCKHOLDERS’ EQUITY:   
Preferred stock — 5,000 shares authorized as of June 30, 2018 and December 31, 2017; no shares issued
 
Common stock, no par value; shares authorized — 2018 and 2017 - 100,000; issued and outstanding as of June 30, 2018 - 50,635 and December 31, 2017 - 50,248359,570
 353,392
Retained earnings337,618
 321,408
Accumulated other comprehensive income2,066
 1,534
    
Total stockholders’ equity699,254
 676,334
    
TOTAL$1,291,191
 $1,111,811
    
See condensed notes to consolidated financial statements.  (concluded)
MERIT MEDICAL SYSTEMS, INC. AND SUBSIDIARIES 
CONSOLIDATED STATEMENTS OF INCOME 
FOR THE THREE AND NINE MONTHS ENDED SEPTEMBER 30, 2018 AND 2017 
(In thousands, except per share amounts - unaudited) 
Three Months Ended September 30, Nine Months Ended September 30, 
2018 2017 2018 2017 
NET SALES $221,659 $179,337 $649,504 $536,955 
COST OF SALES 119,620 98,823 359,400 296,358 
GROSS PROFIT 102,039 80,514 290,104 240,597 
OPERATING EXPENSES: 
Selling, general and administrative66,382 54,716 200,389 169,896 
Research and development14,525 12,838 44,163 38,676 
Intangible asset impairment charge 657 — 657 — 
Contingent consideration expense (benefit)(661)20 (442)39 
Acquired in-process research and development75 12,061 382 12,136 
Total operating expenses80,978 79,635 245,149 220,747 
INCOME FROM OPERATIONS 21,061 879 44,955 19,850 
OTHER INCOME (EXPENSE): 
Interest income359 94 847 266 
Interest expense(2,329)(1,590)(8,064)(5,935)
Gain on bargain purchase— (778)— 10,796 
Other income (expense) - net294 (810)(429)(376)
Other income (expense) — net(1,676)(3,084)(7,646)4,751 
INCOME (LOSS) BEFORE INCOME TAXES 19,385 (2,205)37,309 24,601 
INCOME TAX EXPENSE 2,766 1,364 4,481 3,884 
NET INCOME (LOSS) $16,619 $(3,569)$32,828 $20,717 
EARNINGS PER COMMON SHARE: 
Basic$0.31 $(0.07)$0.64 $0.43 
Diluted$0.30 $(0.07)$0.62 $0.42 
AVERAGE COMMON SHARES: 
Basic53,431 50,150 51,434 48,332 
Diluted55,103 51,599 53,096 49,555 
See condensed notes to consolidated financial statements. 



5

MERIT MEDICAL SYSTEMS, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF INCOME
FOR THE THREE AND SIX MONTHS ENDED JUNE 30, 2018 AND 2017
(In thousands, except per share amounts - unaudited)

 Three Months Ended June 30, Six Months Ended June 30,
 2018 2017 2018 2017
NET SALES$224,810
 $186,549
 $427,844
 $357,618
        
COST OF SALES124,801
 102,408
 239,779
 197,535
        
GROSS PROFIT100,009
 84,141
 188,065
 160,083
        
OPERATING EXPENSES:       
Selling, general and administrative69,095
 57,409
 134,007
 115,180
Research and development15,316
 13,313
 29,638
 25,838
Contingent consideration expense (benefit)178
 (18) 219
 19
Acquired in-process research and development306
 75
 306
 75
        
Total operating expenses84,895
 70,779
 164,170
 141,112
        
INCOME FROM OPERATIONS15,114
 13,362
 23,895
 18,971
        
OTHER INCOME (EXPENSE):       
Interest income342
 89
 487
 172
Interest expense(3,338) (1,639) (5,736) (4,345)
Gain on bargain purchase
 (669) 
 11,574
Other income (expense) - net(553) 170
 (721) 434
        
Other income (expense) — net(3,549) (2,049) (5,970)
7,835
        
INCOME BEFORE INCOME TAXES11,565
 11,313
 17,925
 26,806
        
INCOME TAX EXPENSE624
 1,830
 1,715
 2,520
        
NET INCOME$10,941
 $9,483
 $16,210
 $24,286
        
EARNINGS PER COMMON SHARE:       
Basic$0.22
 $0.19
 $0.32
 $0.51
        
Diluted$0.21
 $0.19
 $0.31
 $0.50
        
AVERAGE COMMON SHARES:       
Basic50,473
 49,957
 50,376
 47,406
        
Diluted52,154
 51,188
 52,033
 48,516
        
See condensed notes to consolidated financial statements.      
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MERIT MEDICAL SYSTEMS, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME
FOR THE THREE AND SIXNINE MONTHS ENDED JUNESEPTEMBER 30, 2018 AND 2017
(In thousands - unaudited)

Three Months Ended September 30, Nine Months Ended September 30, 
2018201720182017
Net income $16,619 $(3,569)$32,828 $20,717 
Other comprehensive income (loss): 
Cash flow hedges667 (144)3,541 166 
Less income tax benefit (expense)(172)56 (910)(64)
Foreign currency translation adjustment(1,637)721 (3,241)2,925 
Less income tax (expense)— — — (252)
Total other comprehensive income (loss) (1,142)633 (610)2,775 
Total comprehensive income (loss) $15,477 $(2,936)$32,218 $23,492 
See condensed notes to consolidated financial statements. 



6

 Three Months Ended June 30, Six Months Ended June 30,
 2018 2017 2018 2017
Net income$10,941
 $9,483
 $16,210
 $24,286
Other comprehensive income (loss):      
Cash flow hedges881
 (527) 2,873
 310
Less income tax benefit (expense)(226) 205
 (738) (121)
Foreign currency translation adjustment(4,195) 1,425
 (1,603) 2,205
Less income tax expense
 
 
 (252)
Total other comprehensive income (loss)(3,540) 1,103
 532
 2,142
Total comprehensive income$7,401
 $10,586
 $16,742
 $26,428
        
See condensed notes to consolidated financial statements.      



MERIT MEDICAL SYSTEMS, INC. AND SUBSIDIARIES 
CONSOLIDATED STATEMENTS OF CASH FLOWS 
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2018 AND 2017 
(In thousands - unaudited) 
Nine Months Ended September 30, 
2018 2017 
CASH FLOWS FROM OPERATING ACTIVITIES: 
Net income$32,828 $20,717 
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization50,436 39,388 
Gain on bargain purchase— (10,796)
Loss on sales and/or abandonment of property and equipment425 219 
Write-off of patents and intangible assets744 86 
Acquired in-process research and development382 12,136 
Amortization of deferred credits(106)(111)
Amortization of long-term debt issuance costs603 514 
Deferred income taxes— (290)
Stock-based compensation expense4,494 2,883 
Changes in operating assets and liabilities, net of effects from acquisitions:
Trade receivables(25,482)(10,963)
Other receivables255 (449)
Inventories(19,375)(9,922)
Prepaid expenses and other current assets(2,719)(1,587)
Prepaid income taxes(120)(231)
Income tax refund receivables134 280 
Other assets(1,370)(2,992)
Trade payables15,936 (876)
Accrued expenses7,707 4,470 
Income taxes payable(1,528)(764)
Deferred compensation payable994 1,107 
Other long-term obligations(1,381)574 
Total adjustments30,029 22,676 
Net cash provided by operating activities62,857 43,393 
CASH FLOWS FROM INVESTING ACTIVITIES: 
Capital expenditures for:
Property and equipment(47,024)(29,522)
Intangible assets(2,234)(1,927)
Proceeds from the sale of property and equipment
Issuance of note receivable(10,750)— 
Cash paid in acquisitions, net of cash acquired(122,770)(103,500)
Net cash used in investing activities(182,771)(134,940)
See condensed notes to consolidated financial statements. (continued) 
7

MERIT MEDICAL SYSTEMS, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
FOR THE SIX MONTHS ENDED JUNE 30, 2018 AND 2017
(In thousands - unaudited)
 Six Months Ended June 30,
 2018 2017
CASH FLOWS FROM OPERATING ACTIVITIES:   
Net income$16,210
 $24,286
    
Adjustments to reconcile net income to net cash provided by operating activities:   
Depreciation and amortization32,779
 25,709
Gain on bargain purchase
 (11,574)
Loss on sales and/or abandonment of property and equipment371
 234
Write-off of patents and intangible assets86
 19
Acquired in-process research and development306
 75
Amortization of deferred credits(71) (76)
Amortization of long-term debt issuance costs402
 343
Deferred income taxes
 (295)
Stock-based compensation expense2,821
 1,691
Changes in operating assets and liabilities, net of effects from acquisitions:   
Trade receivables(27,947) (13,248)
Other receivables966
 (114)
Inventories(7,189) (2,160)
Prepaid expenses and other current assets(3,105) (1,230)
Prepaid income taxes(100) (92)
Income tax refund receivables(1,146) 294
Other assets(751) (1,500)
Trade payables15,767
 3,664
Accrued expenses7,467
 7,421
Income taxes payable(2,076) (301)
Deferred compensation payable438
 513
Other long-term obligations(179) 907
    
Total adjustments18,839
 10,280
    
Net cash provided by operating activities35,049
 34,566
    
CASH FLOWS FROM INVESTING ACTIVITIES:   
Capital expenditures for:   
Property and equipment(31,559) (17,782)
Intangible assets(1,755) (1,082)
Proceeds from the sale of property and equipment4
 3
Issuance of note receivable(10,500) 
Cash paid in acquisitions, net of cash acquired(118,654) (54,809)
    
Net cash used in investing activities(162,464) (73,670)
    
See condensed notes to consolidated financial statements.  (continued)
MERIT MEDICAL SYSTEMS, INC. AND SUBSIDIARIES 
CONSOLIDATED STATEMENTS OF CASH FLOWS 
FOR THE NINE MONTHS ENDED SEPTEMBER 30, 2018 AND 2017 
(In thousands - unaudited) 
Nine Months Ended September 30, 
20182017
CASH FLOWS FROM FINANCING ACTIVITIES: 
Proceeds from issuance of common stock$213,276 $143,069 
Offering costs(366)(816)
Proceeds from issuance of long-term debt380,825 151,462 
Payments on long-term debt(450,575)(197,962)
Contingent payments related to acquisitions(184)(45)
Payment of taxes related to an exchange of common stock(2,616)— 
Net cash provided by financing activities140,360 95,708 
EFFECT OF EXCHANGE RATES ON CASH (827)30 
NET INCREASE IN CASH AND CASH EQUIVALENTS 19,619 4,191 
CASH AND CASH EQUIVALENTS: 
Beginning of period32,336 19,171 
End of period$51,955 $23,362 
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION 
Cash paid during the period for: 
Interest (net of capitalized interest of $468 and $371, respectively) $8,018 $5,953 
Income taxes$6,069 $4,029 
SUPPLEMENTAL DISCLOSURES OF NON-CASH INVESTING AND FINANCING ACTIVITIES 
Property and equipment purchases in accounts payable $3,058 $1,394 
Acquisition purchases in accrued expenses and other long-term obligations $— $12,000 
Merit common stock surrendered (43 and 0 shares, respectively) in exchange for exercise of stock options $2,262 $— 
See condensed notes to consolidated financial statements. (concluded) 


8

MERIT MEDICAL SYSTEMS, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS
FOR THE SIX MONTHS ENDED JUNE 30, 2018 AND 2017
(In thousands - unaudited)
 Six Months Ended June 30,
 2018 2017
CASH FLOWS FROM FINANCING ACTIVITIES:   
Proceeds from issuance of common stock$3,251
 $140,989
Offering costs
 (815)
Proceeds from issuance of long-term debt320,827
 96,859
Payments on long-term debt(185,827) (179,359)
Contingent payments related to acquisitions(130) (30)
    
Net cash provided by financing activities138,121
 57,644
    
EFFECT OF EXCHANGE RATES ON CASH470
 (36)
    
NET INCREASE IN CASH AND CASH EQUIVALENTS11,176
 18,504
    
CASH AND CASH EQUIVALENTS:   
Beginning of period32,336
 19,171
    
End of period$43,512
 $37,675
    
SUPPLEMENTAL DISCLOSURES OF CASH FLOW INFORMATION   
Cash paid during the period for:   
Interest (net of capitalized interest of $314 and $240, respectively)$5,714
 $4,386
    
Income taxes$5,141
 $2,678
    
SUPPLEMENTAL DISCLOSURES OF NON-CASH INVESTING AND FINANCING ACTIVITIES   
Property and equipment purchases in accounts payable$3,943
 $1,560
    
Acquisition purchases in accrued expenses and other long-term obligations$
 $6,000
    
Merit common stock surrendered (32 and 0 shares, respectively) in exchange for exercise of stock options$1,684
 $
    
See condensed notes to consolidated financial statements.  (concluded)
Table of Contents


MERIT MEDICAL SYSTEMS, INC. AND SUBSIDIARIES
CONDENSED NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
(Unaudited)
 
1. Basis of Presentation. The interim consolidated financial statements of Merit Medical Systems, Inc. ("Merit," "we" or "us") for the three and six-monthnine-month periods ended JuneSeptember 30, 2018 and 2017 are not audited. Our consolidated financial statements are prepared in accordance with the requirements for unaudited interim periods and, consequently, do not include all disclosures required to be made in conformity with accounting principles generally accepted in the United States of America. In the opinion of our management, the accompanying consolidated financial statements contain all adjustments, consisting of normal recurring accruals, necessary for a fair presentation of our financial position as of JuneSeptember 30, 2018 and December 31, 2017, and our results of operations and cash flows for the three and six-monthnine-month periods ended JuneSeptember 30, 2018 and 2017. The results of operations for the three and six-monthnine-month periods ended JuneSeptember 30, 2018 and 2017 are not necessarily indicative of the results for a full-year period. These interim consolidated financial statements should be read in conjunction with the financial statements included in our Annual Report on Form 10-K (the "2017 Form 10-K") for the year ended December 31, 2017, which was filed with the Securities and Exchange Commission (the "SEC") on March 1, 2018.




2. Inventories. Inventories at JuneSeptember 30, 2018 and December 31, 2017, consisted of the following (in thousands):

June 30, December 31,September 30, December 31, 
2018 20172018 2017 
Finished goods$101,092
 $86,555
Finished goods $103,258 $86,555 
Work-in-process20,962
 12,799
Work-in-process 20,546 12,799 
Raw materials47,200
 55,934
Raw materials 57,635 55,934 
   
Total Inventories$169,254
 $155,288
Total Inventories $181,439 $155,288 
 


3. Stock-Based Compensation ExpenseThe stock-basedStock-based compensation expense before income tax expense for the three and sixnine months ended JuneSeptember 30, 2018 and 2017, consisted of the following (in thousands):


Three Months Ended September 30, Nine Months Ended September 30, 
2018 2017 2018 2017 
Cost of sales $241 $189 $657 $453 
Research and development 141 110 412 262 
Selling, general and administrative 1,291 893 3,425 2,168 
Stock-based compensation expense before taxes $1,673 $1,192 $4,494 $2,883 
 Three Months Ended June 30, Six Months Ended June 30,
 2018 2017 2018 2017
Cost of sales$232
 $168
 $416
 $264
Research and development147
 100
 271
 152
Selling, general and administrative1,186
 846
 2,134
 1,275
Stock-based compensation expense before taxes$1,565
 $1,114
 $2,821
 $1,691


We recognize stock-based compensation expense (net of a forfeiture rate) for those awards which are expected to vest on a straight-line basis over the requisite service period. We estimate the forfeiture rate based on our historical experience and expectations about future forfeitures. As of JuneSeptember 30, 2018, the total remaining unrecognized compensation cost related to non-vested stock options, net of expected forfeitures, was approximately $22.4$20.7 million and is expected to be recognized over a weighted average period of 3.463.25 years.


During the three and six-month periodsthree-month period ended JuneSeptember 30, 2018, we did not grant any new stock-based awards. During the nine-month period ended September 30, 2018, we granted stock-based awards representing 200,000 and 692,002 shares of our common stock, respectively.stock. During the three and six-monthnine-month periods ended JuneSeptember 30, 2017, we granted stock-based awards representing 20,000 and approximately 1.281.3 million shares of our common stock.stock, respectively. We use the Black-Scholes methodology to value the stock-based compensation expense for options. In applying the Black-Scholes methodology to the option grants, the fair value of our stock-based awards granted was estimated using the following assumptions for the periods indicated below:



9

Six Months Ended June 30,Nine Months Ended September 30, 
2018 201720182017
Risk-free interest rate2.63% - 2.77% 1.77% - 1.79%Risk-free interest rate 2.63% - 2.77%1.77% - 1.83%
Expected option life5.0 years 5.0 yearsExpected option life 5.0 years5.0 years
Expected dividend yield Expected dividend yield — — 
Expected price volatility34.06% - 34.32% 33.81% - 34.03%Expected price volatility 34.06% - 34.32% 33.81% - 34.07% 


The average risk-free interest rate is determined using the U.S. Treasury rate in effect as of the date of grant, based on the expected term of the stock options. We determine the expected term of the stock options using the historical exercise behavior of employees. The expected price volatility was determined using a weighted average of daily historical volatility of our stock price over the corresponding expected option life and implied volatility based on recent trends of the daily historical volatility. For options with a vesting period, compensation expense is recognized on a straight-line basis over the service period, which corresponds to the vesting period. 




4. Earnings Per Common Share (EPS). The computation of weighted average shares outstanding and the basic and diluted earnings per common share for the following periods consisted of the following (in thousands, except per share amounts):


Three Months Nine Months 
Net
Income
Shares 
Per Share
Amount
Net
Income
Shares 
Per Share
Amount
Period ended September 30, 2018: 
Basic EPS$16,619 53,431 $0.31 $32,828 51,434 $0.64 
Effect of dilutive stock options and warrants1,672 1,662 
Diluted EPS $16,619 55,103 $0.30 $32,828 53,096 $0.62 
Stock options excluded from the calculation of common stock equivalents as the impact was anti-dilutive 667 462 
Period ended September 30, 2017: 
Basic EPS$(3,569)50,150 $(0.07)$20,717 48,332 $0.43 
Effect of dilutive stock options and warrants1,449 1,223 
Diluted EPS $(3,569)51,599 $(0.07)$20,717 49,555 $0.42 
Stock options excluded from the calculation of common stock equivalents as the impact was anti-dilutive 200 434 


 Three Months Six Months
 
Net
Income
 Shares 
Per Share
Amount
 
Net
Income
 Shares 
Per Share
Amount
Period ended June 30, 2018: 
  
  
      
Basic EPS$10,941
 50,473
 $0.22
 $16,210
 50,376
 $0.32
Effect of dilutive stock options and warrants 
 1,681
  
   1,657
  
            
Diluted EPS$10,941
 52,154
 $0.21
 $16,210
 52,033
 $0.31
            
Stock options excluded from the calculation of common stock equivalents as the impact was anti-dilutive  535
     359
  
            
Period ended June 30, 2017: 
  
  
      
Basic EPS$9,483
 49,957
 $0.19
 $24,286
 47,406
 $0.51
Effect of dilutive stock options and warrants 
 1,231
  
   1,110
  
            
Diluted EPS$9,483
 51,188
 $0.19
 $24,286
 48,516
 $0.50
            
Stock options excluded from the calculation of common stock equivalents as the impact was anti-dilutive  1,007
     552
  


5. Acquisitions. During July 2018, we purchased 1,786,000 preferred limited liability company units of Cagent Vascular, LLC, a medical device company ("Cagent"), for approximately $2.2 million. Our investment has been accounted for as an equity investment reflected within other assets in the accompanying consolidated balance sheets because we are not able to exercise significant influence over the operations of Cagent. Our total investment in Cagent represents an ownership of approximately 19.5% of the outstanding limited liability company units.

On May 23, 2018, we entered into an asset purchase agreement with DirectACCESS Medical, LLC (“DirectACCESS”) to acquire its assets, including, certain product distribution agreements for the FirstChoice™ Ultra High Pressure PTA Balloon Catheter. We accounted for this acquisition as a business combination. The purchase price for the assets was approximately $7.3 million. The sales and results of operations related to the acquisition have been included in our cardiovascular segment since the acquisition date and were not material. Acquisition-related costs associated with the DirectACCESS acquisition, which were included in selling, general and administrative expenses in our consolidated statements of income, were not material. The purchase price was preliminarily allocated aas follows (in thousands):


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 Net Assets Acquired 
 Inventories$971
 Intangibles 
 Developed technology4,840
 Customer list120
 Trademarks400
 Goodwill938
   
 Total net assets acquired$7,269
Inventories$971 
Intangibles
Developed technology4,840 
Customer list120 
Trademarks400 
Goodwill938 
Total assets acquired $7,269 


We are amortizing the developed technology intangible asset over ten years, the related trademarks over ten years and the customer list on an accelerated basis over five years. The total weighted-average amortization period for these acquired intangible assets is approximately 9.9 years.


On May 18, 2018, we paid $750,000 for a distribution agreement with QXMédical, LLC ("QXMédical") for the Q50® PLUS Stent Graft Balloon Catheter. We accounted for this acquisition as an asset purchase. We are amortizing the distribution agreement as an intangible asset over a period of ten years.

On April 6, 2018, we entered into long-term agreements with NinePoint Medical, Inc. (“NinePoint”), pursuant to which, we (a) became the exclusive worldwide distributor for the NvisionVLE® Imaging System with Real-time Targeting™ using Optical Coherence Tomography (OCT) and (b) acquired an option to purchase up to 100% of the outstanding equity in NinePoint throughout a three-month period commencing 18 months subsequent to the agreement date, both in exchange for total consideration of $10.0 million. We accounted for this transaction as an asset purchase. The results of operations related to the distribution agreement have been included in our endoscopy operating segment since the acquisition date. During the period from April 6, 2018 to Junethree and nine months ended September 30, 2018, our net sales of NinePoint products were approximately $1.1 million.$1.4 million and $2.5 million, respectively. We believe the NinePoint products will enhance the product offerings of our Endotekendoscopy operating segment and will be another step in our strategy to add therapy and disease-state products to our portfolio. The NinePoint products have 510(k) clearance in the United States, and NinePoint is preparing a CE mark application. We plan to launch the NinePoint products globally on a measured basis.


In addition, on April 6, 2018, we made a loan to NinePoint for $10.5 million with a maturity date of April 6, 2023, at which time the loan, together with accrued interest thereon, will be due and payable. The loan bears interest at aan annual rate of 9% and is collateralized by NinePoint's rights, interest and title to the NvisionVLE® Imaging System and anysubstantially all other product owned or licensed byassets of NinePoint. This loan has been recorded as a note receivable within other long-term assets in our consolidated balance sheets.


On February 14, 2018, we acquired certain divested assets from Becton, Dickinson and Company ("BD"), for an aggregate purchase price of $100.3 million. The assets acquired include the soft tissue core needle biopsy products sold under the tradenames of Achieve® Programmable Automatic Biopsy System, Temno® Biopsy System, Tru-Cut® Biopsy Needles as well as Aspira® Pleural Effusion Drainage Kits, and the Aspira® Peritoneal Drainage System. We accounted for this acquisition as a business combination.


During the three and six-monthnine-month periods ended JuneSeptember 30, 2018, our net sales of BD products were approximately $12.2$11.8 million and $18.5$30.3 million, respectively. It is not practical to separately report earnings related to the products acquired from BD, as we cannot split out sales costs related solely to the products we acquired from BD, principally because our sales representatives sell multiple products (including the products we acquired from BD) in our cardiovascular business segment. Acquisition-related costs associated with the BD acquisition, which are included in selling, general and administrative expenses in the accompanying consolidated statements of income, were approximately $41,000 and $1.8 million for the three and six-month periodsnine-month period ended JuneSeptember 30, 2018. The following table summarizes the preliminary purchase price allocated to the assets acquired from BD (in thousands):

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  Preliminary Allocation 
Adjustments (1)
 Revised Allocation
 Inventories$6,039
 $(235) $5,804
 Property and equipment581
 167
 748
 Intangibles     
 Developed technology79,900
 (5,900) 74,000
 Customer list3,500
 700
 4,200
 Trademarks4,700
 200
 4,900
 Goodwill5,387
 5,226
 10,613
       
 Total net assets acquired$100,107
 $158
 $100,265
       
(1)Under U.S. GAAP, measurement period adjustments are recognized on a prospective basis in the period of change, instead of restating prior periods. There was no impact to reported earnings in connection with these measurement period adjustments for the periods presented. Amounts represent adjustments to the preliminary purchase price allocation first presented in our Quarterly Report on Form 10-Q for the quarter ended March 31, 2018 resulting from a final working capital adjustment and our ongoing activities with respect to finalizing asset valuations for this acquisition.
Inventories$5,804 
Property and equipment748 
Intangibles
Developed technology74,000 
Customer list4,200 
Trademarks4,900 
Goodwill10,613 
Total assets acquired $100,265 


We are amortizing the developed technology intangible assets over eight years, the related trademarks over nine years, and the customer lists on an accelerated basis over seven years. The total weighted-average amortization period for these acquired intangible assets is approximately eight years.


On October 2, 2017, we acquired a custom procedure pack business located in Melbourne, Australia from ITL Healthcare Pty Ltd. ("ITL"), for an aggregate purchase price of $11.3 million. We accounted for this acquisition as a business combination. The following table summarizes the aggregate purchase price allocated to the assets acquired from ITL (in thousands):
Assets Acquired 
Trade receivables$1,287 
Other receivables56 
Inventories1,808 
Prepaid expenses and other assets65 
Property and equipment1,053 
Intangibles
Customer lists5,940 
Goodwill3,945 
Total assets acquired 14,154 
Liabilities Assumed 
Trade payables(216)
Accrued expenses(747)
Deferred income tax liabilities(1,901)
Total liabilities assumed (2,864)
Total net assets acquired $11,290 
Assets Acquired 
Trade receivables$1,287
Other receivables56
Inventories1,808
Prepaid expenses and other assets65
Property and equipment1,053
Intangibles 
Customer lists5,940
Goodwill3,945
Total assets acquired14,154
  
Liabilities Assumed 
Trade payables(216)
Accrued expenses(747)
Deferred tax liabilities(1,901)
Total liabilities assumed(2,864)
  
Total net assets acquired$11,290


We are amortizing the customer list on an accelerated basis over seven years. Acquisition-related costs associated with the ITL acquisition, which were included in selling, general and administrative expenses in the consolidated statements of income in the 2017 Form 10-K, were not material. The results of operations related to this acquisition have been included in our cardiovascular operating segment since the acquisition date. During the three and sixnine months ended JuneSeptember 30, 2018, our net sales of ITL products were approximately $2.0$1.9 million and $4.2$6.1 million, respectively. It is not practical to separately report the earnings related to the ITL acquisition, as we cannot split out sales costs related solely to the products we acquired from ITL, principally because our sales representatives sell multiple products (including the products we acquired from ITL) in our cardiovascular business segment.


On August 4, 2017, we acquired from Laurane Medical S.A.S. ("Laurane") and its shareholders inventories and the intellectual property rights associated with certain manual bone biopsy devices, manual bone marrow needles and muscle biopsy kits for an aggregate purchase price of $16.5 million. We also recorded a contingent consideration liability of $5.5 million related to royalties potentially payable to Laurane's shareholders pursuant to the terms of an intellectual property purchase agreement.

We accounted for this acquisition as a business combination. The following table summarizes the aggregate purchase price (including contingent royalty payment liabilities) allocated to the assets acquired from Laurane (in thousands):
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 Net Assets Acquired 
 Inventories$594
 Intangibles 
 Developed technology14,920
 Customer list120
 Goodwill6,366
   
 Total net assets acquired$22,000
Inventories$594 
Intangibles
Developed technology14,920 
Customer list 120 
Goodwill 6,366 
Total assets acquired $22,000 


We are amortizing the developed technology intangible asset over 12 years and the customer list on an accelerated basis over one year. The total weighted-average amortization period for these acquired intangible assets is 11.9 years. The sales and results of operations related to the acquisition have been included in our cardiovascular segment since the acquisition date and were not material. Acquisition-related costs associated with the Laurane acquisition, which were included in selling, general and administrative expenses in the consolidated statements of income of our 2017 Form 10-K, were not material.


On July 3, 2017, we acquired from Osseon LLC (“Osseon”) substantially all the assets related to Osseon’s vertebral augmentation products. We accounted for this acquisition as a business combination. The purchase price for the assets was approximately $6.8 million. Acquisition-related costs associated with the Osseon acquisition, which were included in selling, general and administrative expenses in the consolidated statements of income of our 2017 Form 10-K, were not material. The results of operations related to this acquisition have been included in our cardiovascular segment since the acquisition date. During the three and sixnine months ended JuneSeptember 30, 2018, our net sales of Osseon products were approximately $588,000$478,000 and $1.1$1.6 million, respectively. It is not practical to separately report the earnings related to the Osseon acquisition, as we cannot split out sales costs related solely to the products we acquired from Osseon, principally because our sales representatives sell multiple products (including the products we acquired from Osseon) in our cardiovascular business segment. The following table summarizes the purchase price allocated to the net assets acquired (in thousands):
Inventories $979 
Property and equipment 58 
Intangibles 
Developed technology 5,400 
Customer list 200 
Goodwill 203 
Total assets acquired $6,840 
 Net Assets Acquired 
 Inventories$979
 Property and equipment58
 Intangibles 
 Developed technology5,400
 Customer list200
 Goodwill203
   
 Total net assets acquired$6,840


We are amortizing the developed technology intangible asset over nine years and customer lists on an accelerated basis over eight years. The total weighted-average amortization period for these acquired intangible assets is approximately 9.0 years.


On May 1, 2017, we entered into an agreement and plan of merger with Vascular Access Technologies, Inc. ("VAT"), pursuant to which we acquired the SAFECVAD™ device. We accounted for this acquisition as a business combination. The purchase price for the acquisition was $5.0 million. We also recorded $4.9 million of contingent consideration related to royalties potentially payable to VAT pursuant to the merger agreement. The following table summarizes the purchase price allocated to the net assets acquired and liabilities assumed (in thousands):

Intangibles 
Developed technology $7,800 
In-process technology 920 
Goodwill 4,281 
Deferred tax liabilities (3,101)
Total net assets acquired $9,900 
 Net Assets Acquired 
 Intangibles 
 Developed technology$7,800
 In-process technology920
 Goodwill4,281
 Deferred tax liabilities(3,101)
   
 Total net assets acquired$9,900


We are amortizing the developed technology intangible asset over 15 years. The sales and results of operations related to the acquisition have been included in our cardiovascular segment since the acquisition date and were not material. Acquisition-related costs associated with the VAT acquisition, which were included in selling, general and administrative expenses in the consolidated statements of income of our 2017 Form 10-K, were not material.


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On January 31, 2017, we acquired the critical care division of Argon Medical Devices, Inc. ("Argon"), including a manufacturing facility in Singapore, the related commercial operations in Europe and Japan, and certain inventories and intellectual property rights within the United States. We made an initial payment of approximately $10.9 million and received a subsequent reduction to the purchase price of approximately $797,000 related to a working capital adjustment according to the terms of the purchase agreement. We accounted for the acquisition as a business combination.


Acquisition-related costs associated with the acquisition of the Argon critical care division during the year ended December 31, 2017, which were included in selling, general and administrative expenses in the consolidated statements of income of our 2017 Form 10-K, were approximately $2.6 million. The results of operations related to this acquisition have been included in our cardiovascular segment since the acquisition date. During the three and sixnine months ended JuneSeptember 30, 2018, our net sales of the Argon critical care products were approximately $11.2$11.0 million and $23.7$34.2 million, respectively. It is not practical to separately report the earnings related to the Argon critical care acquisition, as we cannot split out sales costs related solely to the products we acquired from Argon, principally because our sales representatives sell multiple products (including the products we acquired from Argon) in our cardiovascular business segment.


The assets and liabilities in the purchase price allocation for the Argon critical care acquisition are stated at fair value based on estimates of fair value using available information and making assumptions our management believes are reasonable. The following table summarizes the purchase price allocated to the net tangible and intangible assets acquired and liabilities assumed (in thousands):

Assets Acquired
Cash and cash equivalents $1,436 
Trade receivables 8,351 
Inventories 11,222 
Prepaid expenses and other assets 1,275 
Income tax refund receivables 165 
Property and equipment 2,319 
Deferred income tax assets 202 
Intangibles 
Developed technology 2,200 
Customer lists 1,500 
Trademarks 900 
Total assets acquired 29,570 
Liabilities Assumed 
Trade payables (2,414)
Accrued expenses (5,083)
Deferred income tax liabilities (934)
Total liabilities assumed (8,431)
Total net assets acquired 21,139 
Gain on bargain purchase (1)
(11,039)
Total purchase price $10,100 
(1)
The total fair value of the net assets acquired from Argon exceeded the purchase price, resulting in a gain on bargain purchase which was recorded within other income (expense) in our consolidated statements of income. We believe the reason for the gain on bargain purchase was a result of the divestiture of a non-strategic, slow-growth critical care business for Argon. It is our understanding that the divestiture allows Argon to focus on its higher growth interventional portfolio. A reduction of $1.2 million was recorded since the bargain purchase gain was first presented in our Quarterly Report on Form 10-Q for the quarter ended March 31, 2017, resulting from our ongoing activities, including reassessment of the assets acquired and liabilities assumed. The purchase price allocation for this acquisition is now final.
 Assets Acquired 
 Cash and cash equivalents$1,436
 Trade receivables8,351
 Inventories11,222
 Prepaid expenses and other assets1,275
 Income tax refund receivables165
 Property and equipment2,319
 Deferred income tax assets202
 Intangibles 
 Developed technology2,200
 Customer lists1,500
 Trademarks900
 Total assets acquired29,570
   
 Liabilities Assumed 
 Trade payables(2,414)
 Accrued expenses(5,083)
 Deferred income tax liabilities(934)
 Total liabilities assumed(8,431)
   
 Total net assets acquired21,139
 
Gain on bargain purchase (1)
(11,039)
 Total purchase price$10,100
   
(1) 
The total fair value of the net assets acquired from Argon exceeded the purchase price, resulting in a gain on bargain purchase which was recorded within other income (expense) in our consolidated statements of income. We believe the reason for the gain on bargain purchase was a result of the divestiture of a non-strategic, slow-growth critical care business for Argon. It is our understanding that the divestiture allows Argon to focus on its higher growth interventional portfolio. A reduction of $1.2 million was recorded since the bargain purchase gain was first presented in our Quarterly Report on Form 10-Q for the quarter ended March 31, 2017, resulting from our ongoing activities, including reassessment of the assets acquired and liabilities assumed. The purchase price allocation for this acquisition is now final.


With respect to the Argon critical care assets, we are amortizing developed technology over seven years and customer lists on an accelerated basis over five years. While U.S. trademarks can be renewed indefinitely, we estimate that we will generate cash flow from the acquired trademarks for a period of five years from the acquisition date. The total weighted-average amortization period for these acquired intangible assets is approximately 6.0 years.


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On January 31, 2017, we acquired substantially all the assets, including intellectual property covered by approximately 40 patents and pending applications, and assumed certain liabilities, of Catheter Connections, Inc. (“Catheter Connections”), in exchange for payment of $38.0 million. Catheter Connections, based in Salt Lake City, Utah, developed and marketed the DualCap® System, an innovative family of disinfecting products designed to protect patients from intravenous infections resulting from infusion therapy. We accounted for this acquisition as a business combination.


Acquisition-related costs associated with the Catheter Connections acquisition during the year ended December 31, 2017, which were included in selling, general and administrative expenses were approximately $482,000. The results of operations related to this acquisition have been included in our cardiovascular operating segment since the acquisition date. During the three and sixnine months ended JuneSeptember 30, 2018, our net sales of the products acquired from Catheter Connections were approximately $3.1$3.7 million and $6.3$10.1 million, respectively. It is not practical to separately report the earnings related to the products acquired from Catheter Connections, as we cannot split out sales costs related solely to those products, principally because our sales representatives sell multiple products (including the DualCap System) in the cardiovascular business segment. The purchase price was allocated as follows (in thousands):

Assets Acquired 
Trade receivables $958 
Inventories 2,157 
Prepaid expenses and other assets 85 
Property and equipment 1,472 
Intangibles 
Developed technology 21,100 
Customer lists 700 
Trademarks 2,900 
Goodwill 8,989 
Total assets acquired 38,361 
Liabilities Assumed 
Trade payables (338)
Accrued expenses (23)
Total liabilities assumed (361)
Total net assets acquired $38,000 
Assets Acquired 
Trade receivables$958
Inventories2,157
Prepaid expenses and other assets85
Property and equipment1,472
Intangibles 
Developed technology21,100
Customer lists700
Trademarks2,900
Goodwill8,989
Total assets acquired38,361
  
Liabilities Assumed 
Trade payables(338)
Accrued expenses(23)
Total liabilities assumed(361)
  
Net assets acquired$38,000


We are amortizing the Catheter Connections developed technology asset over 12 years, the related trademarks over 10ten years, and the associated customer list on an accelerated basis over eight years. We have estimated the weighted average life of the intangible Catheter Connections assets acquired to be approximately 11.7 years.

On July 6, 2016, we acquired all of the issued and outstanding shares of DFINE Inc. ("DFINE"). The DFINE acquisition added a line of vertebral augmentation products for the treatment of vertebral compression fractures, as well as medical devices used to treat metastatic spine tumors. We made an initial payment of $97.5 million to certain DFINE stockholders on July 6, 2016 and paid approximately $578,000 related to a net working capital adjustment subject to review by Merit and the preferred stockholders of DFINE. We accounted for the acquisition as a business combination. Acquisition-related costs during the year ended December 31, 2016, which are included in selling, general, and administrative expenses were approximately $1.6 million. The results of operations related to this acquisition have been included in our cardiovascular segment since the acquisition date. During the three and six months ended June 30, 2018, our net sales of DFINE products were approximately $7.2 million and $14.5 million, respectively. It is not practical to separately report the earnings related to the DFINE acquisition, as we cannot split out sales costs related to DFINE products, principally because our sales representatives are selling multiple products (including DFINE products) in the cardiovascular business segment. The purchase price was allocated to the net tangible and intangible assets acquired and liabilities assumed, based on estimated fair values, as follows (in thousands):

Assets Acquired 
Trade receivables$4,054
Other receivables6
Inventories8,585
Prepaid expenses and other assets630
Property and equipment1,630
Other long-term assets145
Intangibles 
Developed technology67,600
Customer lists2,400
Trademarks4,400
Goodwill24,818
Total assets acquired114,268
  
Liabilities Assumed 
Trade payables(1,790)
Accrued expenses(5,298)
Deferred income tax liabilities - current(701)
Deferred income tax liabilities - noncurrent(10,844)
Total liabilities assumed(18,633)
  
Net assets acquired, net of cash received of $1,327$95,635

The gross amount of trade receivables we acquired in the acquisition was approximately $4.3 million, of which approximately $224,000 was expected to be uncollectible or returned. With respect to the DFINE assets, we are amortizing developed technology over 15 years and customer lists on an accelerated basis over nine years. While U.S. trademarks can be renewed indefinitely, we currently estimate that we will generate cash flow from the acquired trademarks for a period of 15 years from the acquisition date. The total weighted-average amortization period for these acquired intangible assets is 14.8 years.
On February 4, 2016, we purchased the HeRO® Graft device and other related assets from CryoLife, Inc., a developer of medical devices based in Kennesaw, Georgia ("CryoLife"). The HeRO Graft is a fully subcutaneous vascular access system intended for use in maintaining long-term vascular access for chronic hemodialysis patients who have failing fistulas, grafts or are catheter dependent due to a central venous blockage. The purchase price was $18.5 million, which was paid in full during 2016. We accounted for this acquisition as a business combination. The purchase price was allocated as follows (in thousands):
Assets Acquired 
Inventories$2,455
Property and equipment290
Intangibles 
Developed technology12,100
Trademarks700
Customers Lists400
Goodwill2,555
  
Total assets acquired$18,500

We are amortizing the developed HeRO Graft technology asset over 10 years, the related trademarks over 5.5 years, and the associated customer lists over 12 years. We have estimated the weighted average life of the intangible HeRO Graft assets acquired to be approximately 9.8 years. Acquisition-related costs related to the HeRO Graft device and other related assets during the year ended December 31, 2016, which are included in selling, general and administrative expenses, were not material. The results of operations related to this acquisition have been included in our cardiovascular segment since the acquisition date. During the three and six months ended June 30, 2018, our net sales of the products acquired from CryoLife were approximately $2.2 million and $4.2 million, respectively. It is not practical to separately report the earnings related to the products acquired from CryoLife, as

we cannot split out sales costs related to those products, principally because our sales representatives are selling multiple products (including the HeRO Graft device) in the cardiovascular business segment.


The following table summarizes our consolidated results of operations for the six-monthnine-month period ended JuneSeptember 30, 2017, as well as unaudited pro forma consolidated results of operations as though the acquisition of the Argon critical care division had occurred on January 1, 2016 (in thousands, except per common share amounts):


Six Months EndedNine Months Ended 
June 30, 2017September 30, 2017
As Reported Pro FormaAs Reported Pro Forma 
Net sales$357,618
 $360,378
Net sales $536,955 $539,715 
Net income24,286
 12,444
Net income 20,717 10,039 
Earnings per common share:   Earnings per common share:
Basic$0.51
 $0.26
Basic $0.43 $0.21 
Diluted$0.50
 $0.26
Diluted $0.42 $0.20 
* The pro forma results for the three-month periods ended JuneSeptember 30, 2018 and 2017 and the six-monthnine-month period ended JuneSeptember 30, 2018 are not included in the table above because the operating results for the Argon critical care division acquisition were included in our consolidated statements of income for these periods.


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The unaudited pro forma information set forth above is for informational purposes only and includes adjustments related to the step-up of acquired inventories, amortization expense of acquired intangible assets, interest expense on long-term debt and changes in the timing of the recognition of the gain on bargain purchase. The pro forma information should not be considered indicative of actual results that would have been achieved if the acquisition of the Argon critical care division had occurred on January 1, 2016, or results that may be obtained in any future period. The pro forma consolidated results of operations do not include the acquisition of assets from BD because it was deemed impracticable to obtain information to determine net income associated with the acquired product lines which represent a small product line of a large, consolidated company without standalone financial information. The pro forma consolidated results of operations do not include the DirectACCESS, ITL, Laurane, Osseon, VAT or Catheter Connections acquisitions as we do not deem the pro forma effect of these transactions to be material.

The goodwill arising from the acquisitions discussed above consists largely of the synergies and economies of scale we hope to achieve from combining the acquired assets and operations with our historical operations. The goodwill recognized from certain acquisitions is expected to be deductible for income tax purposes.




6. Revenue from Contracts with Customers.


In accordance with Accounting Standards Update ("ASU") 2014-09, We sell our medical products through a direct sales force in the U.S. and through OEM relationships, custom procedure tray manufacturers and a combination of direct sales force and independent distributors in international markets. Revenue from Contracts with Customers (Topic 606) ("ASC 606"), we recognize revenueis recognized when a customer obtains control of promised goods. The amount of revenue recognized reflectsgoods based on the consideration we expect to receive in exchange for these goods. To achieve thisThis core principle we applyis achieved through the following five steps:


1.
Identify the contract with the customer. A contract with a customer exists when (i) we enter into an enforceable contract with a customer that defines each party’s rights regarding the goods to be transferred and identifies the payment terms related to these goods, (ii) the contract has commercial substance and, (iii) we determine that collection of substantially all consideration for services that are transferred is probable based on the customer’s intent and ability to pay the promised consideration. We do not have significant costs to obtain contracts with customers. For commissions on product sales, we have elected the practical expedient to expense the costs as incurred if the amortization period would have been one year or less.

2.
Identify the performance obligations in the contract. Generally, our contracts with customers do not include multiple performance obligations to be completed over a period of time. Our performance obligations relate to delivering single-use medical products to a customer, subject to the shipping terms of the contract. Limited warranties are provided, under which we typically accept returns and provide either replacement parts or refunds. We do not have significant returns. We do not typically offer extended warranty or service plans.

3.
Determine the transaction price. Payment by the customer is due under customary fixed payment terms, and we evaluate if collectability is reasonably assured. None of our contracts as of June 30, 2018 contained a significant financing

component. Further, our methodology to estimate and recognize variable consideration is consistent with the requirementscustomer. A contract with a customer exists when (i) we enter into an enforceable contract with a customer that defines each party’s rights regarding the goods to be transferred and identifies the payment terms related to these goods, (ii) the contract has commercial substance and, (iii) we determine that collection of ASC 606.substantially all consideration for services that are transferred is probable based on the customer’s intent and ability to pay the promised consideration. We do not have significant costs to obtain contracts with customers. For commissions on product sales, we have elected the practical expedient to expense the costs as incurred if the amortization period would have been one year or less.

Identify the performance obligations in the contract. Generally, our contracts with customers do not include multiple performance obligations to be completed over a period of time. Our performance obligations generally relate to delivering single-use medical products to a customer, subject to the shipping terms of the contract. Limited warranties are provided, under which we typically accept returns and provide either replacement parts or refunds. We do not have significant returns. We do not typically offer extended warranty or service plans.

Determine the transaction price. Payment by the customer is due under customary fixed payment terms, and we evaluate if collectability is reasonably assured. None of our contracts as of September 30, 2018 contained a significant financing component. Revenue is recorded at the net sales price, which includes estimates of variable consideration such as product returns, rebates, discounts, and other adjustments. The estimates of variable consideration are based on historical payment experience, historical and projected sales data, and current contract terms. Variable consideration is included in revenue only to the extent that it is probable that a significant reversal of the revenue recognized will not occur when the uncertainty associated with the variable consideration is subsequently resolved. Taxes collected from customers relating to product sales and remitted to governmental authorities are excluded from revenues.


4.
Allocate the transaction price to performance obligations in the contract. We typically do not have multiple performance obligations in our contracts with customers. As such, we recognize revenue upon delivery of the product to the customer's control at contractually stated pricing.

Allocate the transaction price to performance obligations in the contract. We typically do not have multiple performance obligations in our contracts with customers. As such, we recognize revenue upon transfer of the product to the customer's control at contractually stated pricing.
5.
Recognize revenue when or as we satisfy a performance obligation. We satisfy performance obligations at a point in time upon either shipment or delivery of goods, in accordance with the terms of each contract with the customer. We do not have significant service revenue.


Recognize revenue when or as we satisfy a performance obligation. We satisfy performance obligations at a point in time upon either shipment or delivery of goods, in accordance with the terms of each contract with the customer. We do not have significant service revenue. 

Disaggregation of Revenue


The disaggregation of revenue is based on type of product and geographical region. For descriptions of our product offerings and segments, see Note 12 in our 2017 Form 10-K.


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The following tables present revenue from contracts with customers for the three and six-monthnine-month periods ended JuneSeptember 30, 2018 and 2017 (in thousands):

Three Months Ended September 30, 2018 Three Months Ended September 30, 2017 
United States International Total United States International Total 
Cardiovascular 
Stand-alone devices$52,173 $38,802 $90,975 $36,383 $32,366 $68,749 
Custom kits and procedure trays23,199 9,896 33,095 23,085 7,326 30,411 
Inflation devices7,819 15,074 22,893 8,241 11,792 20,033 
Catheters18,081 22,510 40,591 15,377 16,374 31,751 
Embolization devices5,145 7,250 12,395 5,414 6,838 12,252 
CRM/EP10,462 1,739 12,201 8,202 1,325 9,527 
Total 116,879 95,271 212,150 96,702 76,021 172,723 
Endoscopy 
Endoscopy devices9,229 280 9,509 6,389 225 6,614 
Total $126,108 $95,551 $221,659 $103,091 $76,246 $179,337 

Nine Months Ended September 30, 2018 Nine Months Ended September 30, 2017 
United States International Total United States International Total 
Cardiovascular 
Stand-alone devices$147,125 $119,592 $266,717 $109,750 $93,709 $203,459 
Custom kits and procedure trays69,184 31,175 100,359 68,823 22,259 91,082 
Inflation devices23,647 45,970 69,617 24,257 35,072 59,329 
Catheters50,055 63,775 113,830 46,529 47,828 94,357 
Embolization devices15,272 22,434 37,706 16,548 20,388 36,936 
CRM/EP31,058 5,105 36,163 28,212 3,765 31,977 
Total 336,341 288,051 624,392 294,119 223,021 517,140 
Endoscopy 
Endoscopy devices24,269 843 25,112 19,195 620 19,815 
Total $360,610 $288,894 $649,504 $313,314 $223,641 $536,955 


 Three Months Ended June 30, 2018 Three Months Ended June 30, 2017
 United States International Total United States International Total
Cardiovascular           
Stand-alone devices$50,941
 $41,555
 $92,496
 $37,202
 $33,854
 $71,056
Custom kits and procedure trays23,667
 10,325
 33,992
 24,271
 7,526
 31,797
Inflation devices8,160
 16,145
 24,305
 8,042
 12,747
 20,789
Catheters16,704
 22,670
 39,374
 16,022
 16,407
 32,429
Embolization devices5,094
 7,630
 12,724
 5,593
 6,565
 12,158
CRM/EP11,758
 1,738
 13,496
 10,264
 1,170
 11,434
Total116,324
 100,063
 216,387
 101,394
 78,269
 179,663
            
Endoscopy           
Endoscopy devices8,121
 302
 8,423
 6,712
 174
 6,886
            
Total$124,445
 $100,365
 $224,810
 $108,106
 $78,443
 $186,549


 Six Months Ended June 30, 2018 Six Months Ended June 30, 2017
 United States International Total United States International Total
Cardiovascular           
Stand-alone devices$94,953
 $80,789
 $175,742
 $73,366
 $61,343
 $134,709
Custom kits and procedure trays45,984
 21,280
 67,264
 45,737
 14,935
 60,672
Inflation devices15,828
 30,896
 46,724
 16,017
 23,279
 39,296
Catheters31,974
 41,265
 73,239
 31,151
 31,454
 62,605
Embolization devices10,126
 15,184
 25,310
 11,134
 13,551
 24,685
CRM/EP20,596
 3,366
 23,962
 20,011
 2,440
 22,451
Total219,461
 192,780
 412,241
 197,416
 147,002
 344,418
            
Endoscopy           
Endoscopy devices15,040
 563
 15,603
 12,806
 394
 13,200
            
Total$234,501
 $193,343
 $427,844
 $210,222
 $147,396
 $357,618


7. Segment Reporting. We report our operations in two operating segments: cardiovascular and endoscopy. Our cardiovascular segment consists of cardiology and radiology medical device products which assist in diagnosing and treating coronary artery disease, peripheral vascular disease and other non-vascular diseases and includes embolotherapeutic, cardiac rhythm management ("CRM"), electrophysiology ("EP"), critical care, and interventional oncology and spine devices. Our endoscopy segment focuses on the gastroenterology, pulmonary and thoracic surgery specialties, with a portfolio consisting primarily of stents, dilation balloons, certain inflation devices, guidewires, and other disposable products. We evaluate the performance of our operating segments based on operating income. 


Financial information relating to our reportable operating segments and reconciliations to the consolidated totals for the three and six-monthnine-month periods ended JuneSeptember 30, 2018 and 2017, are as follows (in thousands):

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Three Months Ended September 30, Nine Months Ended September 30, 
Three Months Ended June 30, Six Months Ended June 30,2018 2017 2018 2017 
2018 2017 2018 2017
Net Sales (1)
 
  
  
  
Net SalesNet Sales
Cardiovascular$216,387
 $179,663
 $412,241
 $344,418
Cardiovascular$212,150 $172,723 $624,392 $517,140 
Endoscopy8,423
 6,886
 15,603
 13,200
Endoscopy9,509 6,614 25,112 19,815 
Total net sales$224,810
 $186,549
 $427,844
 $357,618
Total net sales$221,659 $179,337 $649,504 $536,955 
       
Operating Income (1)
       
Operating Income (Loss)Operating Income (Loss)
Cardiovascular$12,663
 $11,493
 $19,060
 $15,475
Cardiovascular$18,199 $(1,207)$37,263 $14,239 
Endoscopy2,451
 1,869
 4,835
 3,496
Endoscopy2,862 2,086 7,692 5,611 
Total operating income$15,114
 $13,362
 $23,895
 $18,971
Total operating income$21,061 $879 $44,955 $19,850 
(1) Sales and operating income have been adjusted from prior disclosure to reflect changes in product classifications between our operating segments, which were made to be consistent with updates in the management of our product portfolios in 2018.



8. Recently Issued Financial Accounting Standards


Recently Adopted


In October 2016, the Financial Accounting Standards Board (the "FASB") issued ASUAccounting Standards Update ("ASU") No. 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other than Inventory, which requires the recognition of the income tax consequences of an intra-entity transfer of an asset, other than inventory, when the transfer occurs. ASU 2016-16 became effective for us as of January 1, 2018. The adoption of ASU 2016-16 did not have a material impact on our consolidated financial statements.



In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments, which addresses eight specific cash flow issues with the objective of reducing the existing diversity in practice in how certain cash receipts and cash payments are presented and classified in the statement of cash flows. We adopted ASU 2016-15 on January 1, 2018. The adoption of ASU 2016-15 did not have a material impact on our consolidated financial statements.


In January 2016, the FASB issued ASU No. 2016-01, Financial Instruments - Overall: Recognition and Measurement of Financial Assets and Financial Liabilities, which amends the guidance regarding the classification and measurement of financial instruments. Changes to the current guidance primarily affect the accounting for equity investments, financial liabilities under the fair value option, and the presentation and disclosure requirements for financial instruments. In addition, ASU 2016-01 clarifies guidance related to the valuation allowance assessment when recognizing deferred tax assets resulting from unrealized losses on available-for-sale debt securities. We adopted ASU 2016-01 on January 1, 2018. The adoption of ASU 2016-01 did not have a material impact on our consolidated financial statements.


TheIn May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), which provides a single comprehensive model for entities to use in accounting for revenue arising from contracts with customers. We adopted this ASU (and all subsequent ASUs that modified Topic 606) effective January 1, 2018 on a modified retrospective basis. Adoption of this standard did not result in significant changes to our accounting policies, business processes, systems or controls, or have a material impact on our financial position, results of operations or cash flows. As such, prior period amounts are not adjusted and continue to be reported under accounting standards then in effect, and we did not record a cumulative adjustment to the opening equity balance of retained earnings as of January 1, 2018. However, additional disclosures have been added in accordance with the requirements of Topic 606 and are reflected in Note 6.


Not Yet Adopted


In August 2018, the FASB issued ASU 2018-15, Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350-40). The new guidance reduces complexity for the accounting for costs of implementing a cloud computing service arrangement and aligns the requirements for capitalizing implementation costs incurred in a hosting arrangement that is a service contract with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software (and hosting arrangements that include an internal use software license). ASU 2018-15 is effective for fiscal years beginning after December 15, 2019, and interim periods within those fiscal years, with early adoption permitted. Implementation may be applied either retrospectively or prospectively to all implementation costs incurred after the date of adoption. We are currently evaluating the anticipated impact of adopting ASU 2018-15 on our consolidated financial statements.

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In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820)—Disclosure Framework—Changes to the Disclosure Requirements for Fair Value Measurement, which modifies disclosure requirements related to fair value measurements. The amendments in this ASU are effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019. Implementation on a prospective or retrospective basis varies by specific disclosure requirement. The standard allows for early adoption of any removed or modified disclosures upon issuance of this ASU while delaying adoption of the additional disclosures until their effective date. We are currently evaluating the anticipated impact of adopting ASU 2018-13 on our consolidated financial statements.

In June 2018, the FASB issued ASU 2018-07, Compensation-Stock Compensation (Topic 718): Improvements to Nonemployee Share-Based Payment Accounting, which simplifies the accounting for nonemployee share-based payment transactions by expanding the scope of ASC Topic 718, Compensation - Stock Compensation, to include share-based payment transactions for acquiring goods and services from nonemployees. Under the new standard, most of the guidance on stock compensation payments to nonemployees would be aligned with the requirements for share-based payments granted to employees. This standard is effective for annual reporting periods beginning after December 15, 2018, and interim periods within those fiscal years, with early adoption permitted. While we continue to assess the potential impact of this standard, we do not expect the adoption of this standard to have a material impact on our consolidated financial statements.


In February 2018, the FASB issued ASU 2018-02, Income Statement-Reporting Comprehensive Income (Topic 220): Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income, which allows a reclassification from accumulated other comprehensive income to retained earnings for stranded tax effects resulting from U.S. federal tax legislation commonly referred to as the Tax Cuts and Jobs Act, which was enacted in December 2017 (the "2017 Tax Act"). ASU 2018-02 is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. Early adoption is permitted. We are currently evaluating the anticipatedWhile we continue to assess our adoption policy for this standard, we do not expect adoption to have a material impact of adopting ASU 2018-02 on our consolidated financial statements.


In August 2017, the FASB issued ASU 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities, which expands and refines hedge accounting for both financial and non-financial risk components, aligns the recognition and presentation of the effects of hedging instruments and hedge items in the financial statements, and includes certain targeted improvements to ease the application of current guidance related to the assessment of hedge effectiveness. ASU 2017-12 is effective for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. Early adoption is permitted. We are currently evaluating the anticipated impact of adopting ASU 2017-12 on our consolidated financial statements.


In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842), which eliminates the current tests for lease classification under U.S. GAAP and requires lessees to recognize the right-of-use assets and related lease liabilities on the balance sheet for all leases greater than one year in duration. ASU 2016-02 is effective for fiscal years beginning after December 15, 2018, including interim periods within those fiscal years. Early adoption of ASU 2016-02 is permitted. In July 2018, the FASB issued ASU 2016-02 provides that lessees (for capital and operating leases) and lessors (for sales-type, direct financing, and operating leases) must2018-11 to provide a transition practical expedient by allowing entities to initially apply the new leases standard at the adoption date, recognize a modified retrospective transition approach for leases existing at, or entered into after,cumulative-effect adjustment to the beginningopening balance of the earliest comparative period presentedretained earnings in the financial statements. The modified retrospective approach wouldperiod of adoption, and not require any transition accounting for leases that expired beforerestate prior periods. We expect to adopt this as well as certain other practical expedients available to us under the earliest comparative period presented. Lesseesnew guidance. We have implemented processes and lessors may not apply a full retrospective transition approach.information technology tools to assist in our ongoing lease data collection and analysis. We are assessingcurrently finalizing our lease portfolio analysis to determine the impact that ASU 2016-02 is anticipated to have on our consolidated financial statements. Westatements, and currently expect that most of our operating lease commitments will be subject to the new standard and recognized as lease liabilities and right-of-use assets upon our adoption of ASU 2016-02. We are updating our accounting policies and internal controls that will be impacted by the new guidance to ensure readiness for adoption in the first quarter of 2019.



We do not believe any other issued and not yet effective accounting standards will be relevant to our consolidated financial statements.




9. Income Taxes. On December 22, 2017, the 2017 Tax Act was signed into law. At December 31, 2017, we recorded a provisional net tax benefit related to the remeasurement of deferred taxes and a one-time tax expense for the transition tax. In accordance with SEC Staff Accounting Bulletin 118, (“SAB 118”), income tax effects of the 2017 Tax Act may be refined upon obtaining, preparing, and/or analyzing additional information during the measurement period and such changes could be material. During the measurement period, provisional amounts may also be adjusted for the effects, if any, of interpretative guidance issued after December 31, 2017 by U.S. regulatory and standard-setting bodies. As of JuneSeptember 30, 2018, the amounts recorded for the 2017 Tax Act remain provisional and may be impacted by further analysis and subsequently issued guidance.


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For tax years beginning after December 31, 2017, the 2017 Tax Act introduces new provisions of U.S. taxation of certain Global Intangible Low-Taxed Income (“GILTI”). We have not yet determined our policy election with respect to whether to record deferred taxes for temporary basis differences expected to reverse as GILTI in future periods, or account for taxes on GILTI using the period cost method. We have, however, included an estimate of the current GILTI impact in our tax provision for the three and sixnine months ended JuneSeptember 30, 2018.


Our non-U.S. earnings are currently considered as indefinitely reinvested overseas. Previously, any repatriation by way of a dividend may have been subject to both U.S. federal and state income taxes, as adjusted for any non-U.S. tax credits. Under the 2017 Tax Act, such dividends should no longer be subject to U.S. federal tax. We are still analyzing how the 2017 Tax Act impacts our existing accounting position to indefinitely reinvest foreign earnings and have yet to determine whether we plan to change our position. We will record the tax effects of any change to our existing assertion in the period that we complete our analysis. If such earnings were to be distributed, any foreign withholding taxes could be material.


Our provision for income taxes for the three months ended JuneSeptember 30, 2018 and 2017 was a tax expense of approximately $624,000$2.8 million and $1.8$1.4 million, respectively, which resulted in an effective tax rate of 5.4%14.3% and 16.2%(61.9)%, respectively. The change in the effective tax rate for the third quarter of 2018 compared to the third quarter of 2017 is primarily due to the discrete tax impact of the in-process research and development charge attributable to the IntelliMedical acquisition completed in the third quarter of 2017, which is not deductible for tax purposes.

Our provision for income taxes for the sixnine months ended JuneSeptember 30, 2018 and 2017 was a tax expense of approximately $1.7$4.5 million and $2.5$3.9 million, respectively, which resulted in an effective tax rate of 9.6%12.0% and 9.4%15.8%, respectively. The decrease in the effective income tax rate for the second quarter ofnine months ended September 30, 2018 compared to the second quartercorresponding period of 2017 was primarily caused by a decrease in the federal statutory tax rate, as well asdue to a discrete tax benefit related to share-based payment awards. Despite the decrease resulting from these items, the effective tax rate for the six months ended June 30, 2018 is relatively unchanged when compared to the corresponding period in 2017 due primarily to the nontaxable gain on the bargain purchase recorded in connection with the 2017 acquisition of the Argon critical care division.




10. Revolving Credit Facility and Long-Term Debt. Principal balances outstanding under our long-term debt obligations as of JuneSeptember 30, 2018 and December 31, 2017, consisted of the following (in thousands):
September 30, 2018December 31, 2017
2016 Term loan $76,250 $85,000 
2016 Revolving credit loans 126,000 187,000 
Collateralized debt facility 7,000 6,959 
Less unamortized debt issuance costs (383)(487)
Total long-term debt 208,867 278,472 
Less current portion 22,000 19,459 
Long-term portion $186,867 $259,013 
 June 30, 2018 December 31, 2017
2016 Term loan$80,000
 $85,000
2016 Revolving credit loans327,000
 187,000
Collateralized debt facility6,985
 6,959
Less unamortized debt issuance costs(418) (487)
Total long-term debt413,567
 278,472
Less current portion21,985
 19,459
Long-term portion$391,582
 $259,013


2016 Term Loan and Revolving Credit Loans


On July 6, 2016, we entered into a Second Amended and Restated Credit Agreement (as amended to date, the “Second Amended Credit Agreement”), with Wells Fargo Bank, National Association, as administrative agent, swingline lender and a lender, and Wells Fargo Securities, LLC, as sole lead arranger and sole bookrunner. In addition to Wells Fargo Bank, National Association, Bank of America, N.A., U.S. Bank, National Association, and HSBC Bank USA, National Association, are parties to the Second Amended Credit Agreement as lenders. The Second Amended Credit Agreement amends and restates in its entirety our previously outstanding Amended and Restated Credit Agreement and all amendments thereto. The Second Amended Credit Agreement was amended on September 28, 2016 to allow for a new revolving credit loan to our wholly-owned subsidiary, on March 20, 2017 to allow flexibility in how we apply net proceeds received from equity issuances to prepay outstanding indebtedness, on December 13, 2017 to increase the revolving credit commitment by $100 million up to $375 million, and on March 28, 2018 to amend certain debt covenants.


The Second Amended Credit Agreement provides for a term loan of $150 million and a revolving credit commitment up to an aggregate amount of $375 million, which includes a reserve of $25 million to make swingline loans from time to time. The term loan is payable in quarterly installments in the amounts provided in the Second Amended Credit Agreement until the maturity date of July 6, 2021, at which time the term and revolving credit loans, together with accrued interest thereon, will be due and payable. At any time prior to the maturity date, we may repay any amounts owing under all revolving credit loans, term loans, and all swingline loans in whole or in part, subject to certain minimum thresholds, without premium or penalty, other than breakage costs.


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Revolving credit loans denominated in dollars and term loans made under the Second Amended Credit Agreement bear interest, at our election, at either a Base Rate or Eurocurrency Base Rate (as such terms are defined in the Second Amended Credit Agreement) plus the applicable margin, which increases as our Consolidated Total Leverage Ratio (as defined in the Second Amended Credit Agreement) increases. Revolving credit loans denominated in an Alternative Currency (as defined in the Second Amended Credit Agreement) bear interest at the Eurocurrency rate plus the applicable margin. Swingline loans bear interest at the Base Rate plus the applicable margin. Upon an event of default, the interest rate may be increased by 2.0%. The revolving credit commitment also carries a commitment fee of 0.15% to 0.40% per annum on the unused portion.


The Second Amended Credit Agreement is collateralized by substantially all our assets. The Second Amended Credit Agreement contains covenants, representations and warranties, and other terms customary for loans of this nature. The Second Amended Credit Agreement requires that we maintain certain financial covenants, as follows:
Covenant Requirement 
Consolidated Total Leverage Ratio (1)
January 1, 2018 and thereafter 3.5 to 1.0 
Consolidated EBITDA (2)
1.25 to 1.0 
Consolidated Net Income (3)
$0 
Facility Capital Expenditures (4)
$30 million 
Covenant Requirement
Consolidated Total Leverage Ratio (1)
January 1, 2018 and thereafter3.5 to 1.0
Consolidated EBITDA (2)
1.25 to 1.0
Consolidated Net Income (3)
$0
Facility Capital Expenditures (4)
$30 million
(1)
Maximum Consolidated Total Leverage Ratio (as defined in the Second Amended Credit Agreement) as of any fiscal quarter end.
(2)
Minimum ratio of Consolidated EBITDA (as defined in the Second Amended Credit Agreement and adjusted for certain expenditures) to Consolidated Fixed Charges (as defined in the Second Amended Credit Agreement) for any period of four consecutive fiscal quarters.
(3)
Minimum level of Consolidated Net Income (as defined in the Second Amended Credit Agreement) for certain periods, and subject to certain adjustments.
(4)
Maximum level of the aggregate amount of all Facility Capital Expenditures (as defined in the Second Amended Credit Agreement) in any fiscal year.


Additionally, the Second Amended Credit Agreement contains customary events of default and affirmative and negative covenants for transactions of this type. As of JuneSeptember 30, 2018, we believe we were in compliance with all covenants set forth in the Second Amended Credit Agreement.


As of JuneSeptember 30, 2018, we had outstanding borrowings of approximately $407$202.3 million under the Second Amended Credit Agreement, with available borrowings of approximately $47.8$248.4 million, based on the leverage ratio required pursuant to the Second Amended Credit Agreement. Our interest rate as of JuneSeptember 30, 2018 was a fixed rate of 2.87% on $175$175.0 million as a result an interest rate swap

(see (see Note 11) and a variable floating rate of 3.84%3.99% on $232$27.3 million. Our interest rate as of December 31, 2017 was a fixed rate of 2.68% on $175 million as a result of an interest rate swap and a variable floating rate of 2.82% on $97 million.


Collateralized Debt Facility


On March 14,September 3, 2018, we renewed our loan agreement with HSBC Bank USA, National Association ("HSBC Bank") whereby HSBC Bank agreed to provide us with a loan in the amount of approximately $7.0 million. The loan matures on JulyJanuary 10, 2018,2019, with an extension available at our option, subject to certain conditions. The loan agreement bears interest at the three-monthsix-month London Inter-Bank Offered Rate (“LIBOR”) plus 1.0%, which resets quarterly.. The loan is secured by assets having a value not less than the currently outstanding loan balance. The loan contains covenants, representations and warranties and other terms customary for loans of this nature. As of JuneSeptember 30, 2018, our interest rate on the loan was a variable rate of 3.26%3.12%.


Future Payments


Future minimum principal payments on our long-term debt as of JuneSeptember 30, 2018, are as follows (in thousands):
Years Ending Future Minimum 
December 31 Principal Payments 
Remaining 2018 $3,750 
201922,000 
202017,500 
2021166,000 
Total future minimum principal payments $209,250 

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Years Ending  Future Minimum
December 31 Principal Payments
Remaining 2018 $14,485
2019 15,000
2020 17,500
2021 367,000
Total future minimum principal payments $413,985



11. Derivatives
 
General. Our earnings and cash flows are subject to fluctuations due to changes in interest rates and foreign currency exchange rates, and we seek to mitigate a portion of these risks by entering into derivative contracts. The derivatives we use are interest rate swaps and foreign currency forward contracts. We recognize derivatives as either assets or liabilities at fair value in the accompanying consolidated balance sheets, regardless of whether or not hedge accounting is applied. We report cash flows arising from our hedging instruments consistent with the classification of cash flows from the underlying hedged items. Accordingly, cash flows associated with our derivative programs are classified as operating activities in the accompanying consolidated statements of cash flows.


We formally document, designate and assess the effectiveness of transactions that receive hedge accounting initially and on an ongoing basis. Changes in the fair value of derivatives that qualify for hedge accounting treatment are recorded, net of applicable taxes, in accumulated other comprehensive income (loss), a component of stockholders’ equity in the accompanying consolidated balance sheets. For the ineffective portions of qualifying hedges, the change in fair value is recorded through earnings in the period of change. Changes in the fair value of derivatives not designated as hedging instruments are recorded in earnings throughout the term of the derivative.


Interest Rate Risk. A portion of our debt bears interest at variable interest rates and, therefore, we are subject to variability in the cash paid for interest expense. In order to mitigate a portion of this risk, we use a hedging strategy to reduce the variability of cash flows in the interest payments associated with a portion of the variable-rate debt outstanding under our Second Amended Credit Agreement that is solely due to changes in the benchmark interest rate.


Derivatives Designated as Cash Flow Hedges


On August 5, 2016, we entered into a pay-fixed, receive-variable interest rate swap with a current notional amount of $175.0 million with Wells Fargo to fix the one-month LIBOR rate at 1.12%. The variable portion of the interest rate swap is tied to the one-month LIBOR rate (the benchmark interest rate). On a monthly basis, the interest rates under both the interest rate swap and the underlying debt reset, the swap is settled with the counterparty, and interest is paid. The interest rate swap is scheduled to expire on July 6, 2021.


At JuneSeptember 30, 2018 and December 31, 2017, our interest rate swap qualified as a cash flow hedge. The fair value of our interest rate swap at JuneSeptember 30, 2018 was an asset of approximately $8.0$8.3 million, which was partially offset by approximately $2.1 million in

deferred taxes. The fair value of our interest rate swap at December 31, 2017 was an asset of approximately $5.7 million, which was offset by approximately $1.5 million in deferred taxes.


Foreign Currency Risk. We operate on a global basis and are exposed to the risk that our financial condition, results of operations, and cash flows could be adversely affected by changes in foreign currency exchange rates. To reduce the potential effects of foreign currency exchange rate movements on net earnings, we enter into derivative financial instruments in the form of foreign currency exchange forward contracts with major financial institutions. Our policy is to enter into foreign currency derivative contracts with maturities of up to two years. We are primarily exposed to foreign currency exchange rate risk with respect to transactions and balances denominated in Euros, British Pounds, Chinese Renminbi, Mexican Pesos, Brazilian Reals, Australian Dollars, Hong Kong Dollars, Swiss Francs, Swedish Krona, Canadian Dollars, Danish Krone, Japanese Yen, KoreaKorean Won, and Singapore Dollars. We do not use derivative financial instruments for trading or speculative purposes. We are not subject to any credit risk contingent features related to our derivative contracts, and counterparty risk is managed by allocating derivative contracts among several major financial institutions.


Derivatives Designated as Cash Flow Hedges


For derivative instruments that are designated and qualify as cash flow hedges, the effective portion of the gain or loss on the derivative instrument is reported as a component of other comprehensive income (loss) and reclassified into earnings in the same line item associated with the forecasted transaction and in the same period or periods during which the hedged transaction affects earnings. The remaining gain or loss on the derivative instrument in excess of the cumulative change in the present value of future cash flows of the hedged item, if any (i.e., the ineffective portion) or hedge components excluded from the assessment of effectiveness, are recognized in earnings during the current period. We enter into forward contracts on various foreign currencies to manage the risk associated with forecasted exchange rates which impact revenues, cost of sales, and operating
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expenses in various international markets. The objective of the hedges is to reduce the variability of cash flows associated with the forecasted purchase or sale of the associated foreign currencies.


We enter into approximately 100150 cash flow foreign currency hedges every month. As of JuneSeptember 30, 2018, we had entered into foreign currency forward contracts, which qualified as cash flow hedges, with the following notional amounts (in thousands and in local currencies):

CurrencySymbolForward Notional Amount
Canadian DollarCAD2,410
2,460 
Swiss FrancCHF1,158
1,215 
Chinese RenminbiCNY66,000
60,000 
Danish KroneDKK11,650
10,835 
EuroEUR12,870
12,270 
British PoundGBP2,975
3,355 
Mexican PesoJapanese Yen MXNJPY 94,275
330,000 
Mexican Peso MXN 93,575 
Swedish KronaSEK13,830
12,780 


Derivatives Not Designated as Cash Flow Hedges


We forecast our net exposure in various receivables and payables to fluctuations in the value of various currencies, and we enter into foreign currency forward contracts to mitigate that exposure. We enter into approximately 20 foreign currency fair value hedges every month. As of JuneSeptember 30, 2018, we had entered into foreign currency forward contracts related to those balance sheet accounts, with the following notional amounts (in thousands and in local currencies):


CurrencySymbolForward Notional Amount
Australian DollarAUD8,400
11,150 
Brazilian RealBRL8,500
Canadian DollarCAD3,098
Swiss FrancCHF255
Chinese RenminbiCNY95,228
Danish KroneDKK2,885
EuroEUR25,861
British PoundGBP1,584
Hong Kong DollarHKD11,000
Japanese YenJPY260,000
Korean WonKRW2,700,000
Mexican PesoMXN18,700
Swedish KronaSEK10,536
Singapore DollarSGD6,900


Balance Sheet Presentation of Derivatives. As of JuneSeptember 30, 2018, and December 31, 2017, all derivatives, both those designated as hedging instruments and those that were not designated as hedging instruments, were recorded gross at fair value on our consolidated balance sheets. We are not subject to any master netting agreements.


The fair value of derivative instruments on a gross basis is as follows (in thousands):
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   Fair ValueFair Value 
 Balance Sheet Location June 30, 2018 December 31, 2017Balance Sheet Location September 30, 2018December 31, 2017
Derivatives designated as hedging instrumentsDerivatives designated as hedging instruments    Derivatives designated as hedging instruments
Assets    Assets
Interest rate swap Other assets (long-term) $8,047
 $5,749
Interest rate swap Other assets (long-term) $8,284 $5,749 
Foreign currency forward contracts Prepaid expenses and other assets 700
 363
Foreign currency forward contracts Prepaid expenses and other assets 813 363 
Foreign currency forward contracts Other assets (long-term) 83
 35
Foreign currency forward contracts Other assets (long-term) 161 35 
    
Liabilities    Liabilities
Foreign currency forward contracts Accrued expenses (231) (468)Foreign currency forward contracts Accrued expenses (240)(468)
Foreign currency forward contracts Other long-term obligations (38) (82)Foreign currency forward contracts Other long-term obligations (56)(82)
    
Derivatives not designated as hedging instrumentsDerivatives not designated as hedging instruments    Derivatives not designated as hedging instruments
Assets    Assets
Foreign currency forward contracts Prepaid expenses and other assets $1,097
 $223
Foreign currency forward contracts Prepaid expenses and other assets $360 $223 
Liabilities    Liabilities
Foreign currency forward contracts Accrued expenses (228) (841)Foreign currency forward contracts Accrued expenses (475)(841)


Income Statement Presentation of Derivatives.


Derivatives Designated as Cash Flow Hedges


Derivative instruments designated as cash flow hedges had the following effects, before income taxes, on other comprehensive income and net earnings in our consolidated statements of income, consolidated statements of comprehensive income and consolidated balance sheets (in thousands):

Amount of Gain/(Loss) Recognized in OCI Amount of Gain/(Loss) Reclassified from AOCI 
Three Months Ended September 30, Three Months Ended September 30, 
2018201720182017
Derivative instrument Location in statements of income 
Interest rate swaps $664 $Interest Expense $428 $96 
Foreign currency forward contracts 543 100 Revenue 86 (101)
Cost of sales 26 250 
Amount of Gain/(Loss) Recognized in OCI Amount of Gain/(Loss) Reclassified from AOCI 
Nine Months Ended September 30, Nine Months Ended September 30, 
2018201720182017
Derivative instrument Location in statements of income 
Interest rate swaps $3,532 $(611)Interest Expense $998 $(8)
Foreign currency forward contracts 1,112 841 Revenue (299)(141)
Cost of sales 404 213 
 Amount of Gain/(Loss) recognized in OCI  Amount of Gain/(Loss) reclassified from AOCI
 Three Months Ended June 30,  Three Months Ended June 30,
 20182017  20182017
Derivative instrument  Location in statements of income
Interest rate swaps$748
$(893) Interest Expense$357
$
Foreign currency forward contracts394
353
 Revenue(234)(41)
    Cost of sales138
28
       
 Amount of Gain/(Loss) recognized in OCI  Amount of Gain/(Loss) reclassified from AOCI
 Six Months Ended June 30,  Six Months Ended June 30,
 20182017  20182017
Derivative instrument  Location in statements of income
Interest rate swaps2,868
(507) Interest Expense570
(104)
Foreign currency forward contracts568
741
 Revenue(385)(40)
    Cost of sales378
(37)


The net amount recognized in earnings during the three and sixnine months ended JuneSeptember 30, 2018 and 2017 due to ineffectiveness and amounts excluded from the assessment of hedge effectiveness were not significant.


As of JuneSeptember 30, 2018, approximately $464,000,$858,000, or $345,000$637,000 after taxes, was expected to be reclassified from accumulated other comprehensive income to earnings in revenue and cost of sales over the succeeding twelve months. As of JuneSeptember 30, 2018, approximately $2.2$2.6 million, or $1.6$2.0 million after taxes, was expected to be reclassified from accumulated other comprehensive income to earnings in interest expense over the succeeding twelve months.


Derivatives Not Designated as Hedging Instruments


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The following gains/(losses) from these derivative instruments were recognized in our consolidated statements of income for the periods presented (in thousands):
Three Months Ended September 30, Nine Months Ended September 30, 
2018201720182017
Derivative Instrument Location in statements of income 
Foreign currency forward contracts Other expense $1,143 $(1,459)$3,181 $(4,150)


    Three Months Ended June 30, Six Months Ended June 30,
    20182017 20182017
Derivative Instrument Location in statements of income      
Foreign currency forward contracts Other expense $3,153
$(1,834) $2,038
$(2,692)



12. Fair Value Measurements. Our financial assets and (liabilities) carried at fair value measured on a recurring basis as of JuneSeptember 30, 2018 and December 31, 2017, consisted of the following (in thousands):
   Fair Value Measurements UsingFair Value Measurements Using 
 Total Fair Quoted prices in Significant other SignificantTotal Fair Quoted prices in Significant other Significant 
 Value at active markets observable inputs unobservable inputsValue at active markets observable inputs unobservable inputs 
Description June 30, 2018 (Level 1) (Level 2) (Level 3)Description September 30, 2018(Level 1) (Level 2) (Level 3) 
        
Interest rate contracts (1)
 $8,047
 $
 $8,047
 $
Interest rate contracts (1)
$8,284 $— $8,284 $— 
Foreign currency contract assets, current and long-term (2)
 $1,880
 $
 $1,880
 $
Foreign currency contract assets, current and long-term (2)
$1,334 $— $1,334 $— 
Foreign currency contract liabilities, current and long-term (3)
 $(497) $
 $(497) $
Foreign currency contract liabilities, current and long-term (3)
$(771)$— $(771)$— 
        
   Fair Value Measurements UsingFair Value Measurements Using 
 Total Fair Quoted prices in Significant other SignificantTotal Fair Quoted prices in Significant other Significant 
 Value at active markets observable inputs unobservable inputsValue at active markets observable inputs unobservable inputs 
Description December 31, 2017 (Level 1) (Level 2) (Level 3)Description December 31, 2017(Level 1) (Level 2) (Level 3) 
        
Interest rate contracts (1)
 $5,749
 $
 $5,749
 $
Interest rate contracts (1)
$5,749 $— $5,749 $— 
Foreign currency contract assets, current and long-term (2)
 $621
 $
 $621
 $
Foreign currency contract assets, current and long-term (2)
$621 $— $621 $— 
Foreign currency contract liabilities, current and long-term (3)
 $(1,391) $
 $(1,391) $
Foreign currency contract liabilities, current and long-term (3)
$(1,391)$— $(1,391)$— 
(1)  The fair value of the interest rate contracts is determined using Level 2 fair value inputs and is recorded as other assets or other long-term obligations in the consolidated balance sheets.
(2)  The fair value of the foreign currency contract assets (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as prepaid expenses and other assets or other long-term assets in the consolidated balance sheets.
(3)  The fair value of the foreign currency contract liabilities (including those designated as hedging instruments and those not designated as hedging instruments) is determined using Level 2 fair value inputs and is recorded as accrued expenses or other long-term obligations in the consolidated balance sheets.


Certain of our business combinations involve the potential for the payment of future contingent consideration, generally based on a percentage of future product sales or upon attaining specified future revenue milestones. See Note 5 for further information regarding these acquisitions. The contingent consideration liability is re-measured at the estimated fair value at each reporting period with the change in fair value recognized within operating expenses in the accompanying consolidated statements of income. We measure the initial liability and re-measure the liability on a recurring basis using Level 3 inputs as defined under authoritative guidance for fair value measurements. Changes in the fair value of our contingent consideration liability during the three and six-monthnine-month periods ended JuneSeptember 30, 2018 and 2017,, consisted of the following (in thousands):

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Three Months Ended June 30, Six Months Ended June 30,Three Months Ended September 30, Nine Months Ended September 30, 
2018 2017 2018 20172018201720182017
Beginning balance$10,928
 $705
 $10,956
 $683
Beginning balance $10,912 $5,572 $10,956 $683 
Contingent consideration liability recorded as the result of acquisitions (see Note 5)
 4,900
 
 4,900
Contingent consideration liability recorded as the result of acquisitions (see Note 5) — 5,500 — 10,400 
Fair value adjustments recorded to income during the period99
 (18) 86
 19
Fair value adjustments recorded to income during the period (828)20 (741)39 
Contingent payments made(115) (15) (130) (30)Contingent payments made (53)(15)(184)(45)
Ending balance$10,912
 $5,572
 $10,912
 $5,572
Ending balance $10,031 $11,077 $10,031 $11,077 


As of JuneSeptember 30, 2018, approximately $10.6$9.8 million in contingent consideration liability was included in other long-term obligations and approximately $301,000$280,000 was included in accrued expenses in our consolidated balance sheet. As of December 31, 2017, approximately $10.7 million in contingent consideration liability was included in other long-term obligations and $289,000 was included in accrued expenses in our consolidated balance sheet. The cash paid to settle the contingent consideration liability recognized at fair value as of the acquisition date (including measurement-period adjustments) has been reflected as a cash outflow from financing activities in the accompanying consolidated statements of cash flows.


During the year ended December 31, 2016, we sold a cost method investment for cash and for the right to receive additional payments based on various contingent milestones. We determined the fair value of the contingent payments using Level 3 inputs

defined under authoritative guidance for fair value measurements, and we recorded a contingent receivable asset, which as of JuneSeptember 30, 2018 and December 31, 2017 had a value of approximately $474,000$308,000 and $760,000, respectively. We record any changes in fair value to operating expenses as part of our cardiovascular segment in our consolidated statements of income. During the three and sixnine months ended JuneSeptember 30, 2018, we recorded a loss on the contingent receivable asset of approximately $79,000$167,000 and $132,000,$299,000, respectively and received payments of approximately $0 and $153,000, respectively. As of JuneSeptember 30, 2018, approximately $184,000 was included in other long-term assets and approximately $290,000the contingent receivable asset was included in other receivables as a current asset in our consolidated balance sheet. As of December 31, 2017, approximately $319,000 was included in other long-term assets and approximately $441,000 was included in other receivables as a current asset in our consolidated balance sheet.


The recurring Level 3 measurement of our contingent consideration liability and contingent receivable includes the following significant unobservable inputs at JuneSeptember 30, 2018 and December 31, 2017 (amounts in thousands):

Contingent consideration asset or liability Fair value at June 30, 2018 Valuation technique Unobservable inputs RangeContingent consideration asset or liability Fair Value at
September 30, 2018
Valuation technique Unobservable inputs Range 
Revenue-based payments $10,912
 Discounted cash flow Discount rate 9.9% - 15%Revenue-based payments $10,031 Discounted cash flow Discount rate 9.9% - 15% 
contingent liability   Projected year of payments 2018-2037contingent liability Projected year of payments 2018-2037 
   
Contingent receivable $474
 Discounted cash flow Discount rate 10%Contingent receivable $308 Discounted cash flow Discount rate 10%  
asset   Probability of milestone payment 54%asset Weighted-average probability of milestone payment 35%  
   Projected year of payments 2018-2019Projected year of payments 2018-2019
   
Contingent consideration asset or liability Fair value at December 31, 2017 Valuation technique Unobservable inputs RangeContingent consideration asset or liability Fair Value at December 31, 2017 Valuation technique Unobservable inputs Range 
Revenue-based payments $10,956
 Discounted cash flow Discount rate 9.9% - 15%Revenue-based payments $10,956 Discounted cash flow Discount rate 9.9% - 15% 
contingent liability   Probability of milestone payment 100%contingent liability Probability of milestone payment 100%  
   Projected year of payments 2018-2037Projected year of payments 2018-2037
   
Contingent receivable $760
 Discounted cash flow Discount rate 10%Contingent receivable $760 Discounted cash flow Discount rate 10%  
asset   Probability of milestone payment 75%asset Weighted-average probability of milestone payment 75%  
   Projected year of payments 2018-2019Projected year of payments 2018-2019
 
The contingent consideration liability and contingent receivable are re-measured to fair value each reporting period using projected revenues, discount rates, probabilities of payment, and projected payment dates. Projected contingent payment amounts are discounted back to the current period using a discounted cash flow model. Projected revenues are based on our
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most recent internal operational budgets and long-range strategic plans. An increase (decrease) in either the discount rate or the time to payment, in isolation, may result in a significantly lower (higher) fair value measurement. A decrease in the probability of any milestone payment may result in lower fair value measurements. Our determination of the fair value of the contingent consideration liability and contingent receivable could change in future periods based upon our ongoing evaluation of these significant unobservable inputs. We intend to record any such change in fair value to operating expenses in our consolidated statements of income.


During the three and six-monthnine-month periods ended JuneSeptember 30, 2018, we had losses of approximately $29,000$0 and $86,000,$86,000, respectively, compared to losses of approximately $1,000$67,000 and $19,000$86,000 for the three and six-monthnine-month periods ended JuneSeptember 30, 2017, respectively, related to the measurement of non-financial assets at fair value on a nonrecurring basis subsequent to their initial recognition.recognition (see Note 13).


We believe the carrying amount of cash and cash equivalents, receivables, and trade payables approximate fair value because of the immediate, short-term maturity of these financial instruments. Our long-term debt re-prices frequently due to variable rates and entails no significant changes in credit risk and, as a result, we believe the fair value of long-term debt approximates carrying value. The fair value of assets and liabilities whose carrying value approximates fair value is determined using Level 2 inputs, with the exception of cash and cash equivalents, which are Level 1 inputs.





13. Goodwill and Intangible Assets. The changes in the carrying amount of goodwill for the six-monthnine-month period ended JuneSeptember 30, 2018 were as follows (in thousands):
2018 
Goodwill balance at January 1 $238,147 
Effect of foreign exchange (881)
Additions as the result of acquisitions 11,757 
Goodwill balance at September 30 $249,023 
 2018
Goodwill balance at January 1$238,147
Effect of foreign exchange(906)
Additions as the result of acquisitions11,757
Goodwill balance at June 30$248,998


As of JuneSeptember 30, 2018, we had recorded $8.3 million of accumulated goodwill impairment charges. All of the goodwill balance as of JuneSeptember 30, 2018 and December 31, 2017, is related to our cardiovascular segment.


Other intangible assets at JuneSeptember 30, 2018 and December 31, 2017, consisted of the following (in thousands):
September 30, 2018
Gross Carrying
Amount
Accumulated
Amortization
Net Carrying
Amount
Patents $18,676 $(4,665)$14,011 
Distribution agreements 8,012 (5,509)2,503 
License agreements 24,913 (6,895)18,018 
Trademarks 21,514 (6,039)15,475 
Covenants not to compete 1,028 (993)35 
Customer lists 35,590 (21,987)13,603 
In-process technology 920 — 920 
Total $110,653 $(46,088)$64,565 

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June 30, 2018December 31, 2017
Gross Carrying
Amount
 
Accumulated
Amortization
 
Net Carrying
Amount
Gross Carrying
Amount
Accumulated
Amortization
Net Carrying
Amount
Patents$18,196
 $(4,334) $13,862
Patents $16,528 $(3,737)$12,791 
Distribution agreements8,192
 (5,278) 2,914
Distribution agreements 7,262 (4,686)2,576 
License agreements23,845
 (6,419) 17,426
License agreements 23,783 (5,568)18,215 
Trademarks21,516
 (5,550) 15,966
Trademarks 16,224 (4,686)11,538 
Covenants not to compete1,028
 (985) 43
Covenants not to compete 1,028 (968)60 
Customer lists35,737
 (20,680) 15,057
Customer lists 31,935 (18,482)13,453 
In-process technology920
 
 920
In-process technology 920 — 920 
     
Total$109,434
 $(43,246) $66,188
Total $97,680 $(38,127)$59,553 

 December 31, 2017
 
Gross Carrying
Amount
 
Accumulated
Amortization
 
Net Carrying
Amount
Patents$16,528
 $(3,737) $12,791
Distribution agreements7,262
 (4,686) 2,576
License agreements23,783
 (5,568) 18,215
Trademarks16,224
 (4,686) 11,538
Covenants not to compete1,028
 (968) 60
Customer lists31,935
 (18,482) 13,453
In-process technology920
 
 920
      
Total$97,680
 $(38,127) $59,553


Aggregate amortization expense for the three and six-monthnine-month periods ended JuneSeptember 30, 2018 was approximately $10.4$10.5 million and $18.9$29.4 million, respectively. Aggregate amortization expense for the three and six-monthnine-month periods ended JuneSeptember 30, 2017 was approximately $6.2$7.0 million and $12.4$19.4 million, respectively.


We evaluate long-lived assets, including amortizing intangible assets, for impairment whenever events or changes in circumstances indicate that their carrying amounts may not be recoverable. We perform the impairment analysis at the asset group for which the lowest level of identifiable cash flows are largely independent of the cash flows of other assets and liabilities. During the three months ended September 30, 2018, we compared the carrying value of the amortizing intangible assets acquired in our July 2015 acquisition of certain assets from Quellent, LLC, all of which pertained to our cardiovascular segment, to the undiscounted cash flows expected to result from the asset group and determined that the carrying amount was not recoverable. We then determined the fair value of the amortizing assets related to the Quellent acquisition based on estimated future cash flows discounted back to their present value using a discount rate that reflects the risk profiles of the underlying activities. Some of the factors that influenced our estimated cash flows were slower than anticipated sales growth in the products acquired from our Quellent acquisition and uncertainty about future sales growth. The excess of the carrying value compared to the fair value was recognized as an intangible asset impairment charge. We recorded an impairment charge for Quellent of approximately $657,000. We did not record any impairment charges during the three and nine months ended September 30, 2017.

Estimated amortization expense for the developed technology and other intangible assets for the next five years consists of the following as of JuneSeptember 30, 2018 (in thousands):

Year Ending December 31 
Remaining 2018 $10,140 
2019 39,647 
2020 38,386 
2021 31,025 
2022 29,141 


Year Ending December 31 
Remaining 2018$20,132
201939,154
202037,881
202130,488
202228,688


14. Commitments and Contingencies. In the ordinary course of business, we are involved in various claims and litigation matters. These claims and litigation matters may include actions involving product liability, intellectual property, contract disputes, and employment or other matters that are significant to our business. Based upon our review of currently available information, we do not believe any such actions are likely to be, individually or in the aggregate, materially adverse to our business, financial condition, results of operations or liquidity.


In October 2016, we received a subpoena from the U.S. Department of Justice seeking information on certain of our marketing and promotional practices. We are in the process of responding to the subpoena, which we anticipate will continue during 2018. We have incurred, and anticipate that we will continue to incur, substantial costs in connection with the matter. The investigation is ongoing and at this stage we are unable to predict its scope, duration or outcome. Investigations such as this may result in the imposition of, among other things, significant damages, injunctions, fines or civil or criminal claims or penalties against our company or individuals. Legal expenses we incurred in responding to the U.S. Department of Justice subpoena for the three and six-monthnine-month periods ended JuneSeptember 30, 2018 were approximately $1.6 million$946,000 and $3.3$4.3 million, respectively.


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In the event of unexpected further developments, it is possible that the ultimate resolution of any of the foregoing matters, or other similar matters, if resolved in a manner unfavorable to us, may be materially adverse to our business, financial condition, results of operations or liquidity. Legal costs for these matters, such as outside counsel fees and expenses, are charged to expense in the period incurred.




15. Issuance of Common Stock. On July 30, 2018, we closed a public offering of 4,025,000 shares of common stock and received proceeds of approximately $205.4 million, which is net of approximately $12.0 million in underwriting discounts and commissions, and we paid approximately $366,000 in other direct costs incurred in connection with this equity offering. The net proceeds from the offering were used primarily to repay outstanding borrowings (principally revolving credit loans) under our Second Amended Credit Agreement.

On March 28, 2017, we closed a public offering of 5,175,000 shares of common stock and received proceeds of approximately $136.6 million, which is net of approximately $8.8 million in underwriting discounts and commissions, and approximately $816,000 in other direct cost incurred and paid by us in connection with this equity offering. The net proceeds from the offering were used primarily to repay outstanding indebtedness under our Second Amended Credit Agreement (including our term loan and revolving credit loans).


16. Subsequent Events. On July 30, 2018, we closed a public offering of 4,025,000 shares of common stock and received proceeds of approximately $205.4 million, which is net of approximately $10.4 million in underwriting discounts and commissions, and we paid approximately $500,000$816,000 in other direct costs incurred in connection with this equity offering. The net proceeds from the offering were used primarily to repay outstanding borrowings (including our term loan and revolving credit loansloans) under our Second Amended Credit Agreement.





16. Subsequent Events. On October 1, 2018, we signed a definitive merger agreement (the "Cianna Merger Agreement") to acquire Cianna Medical, Inc. ("Cianna"). The transaction is subject to the satisfaction or waiver (in accordance with the provisions of the Cianna Merger Agreement) of certain closing conditions, including the approval of Cianna stockholders, clearance under the Hart-Scott-Rodino Antitrust Improvements Act and other customary closing conditions. We anticipate that the transaction will close during the fourth quarter of 2018.

Subject to the terms and conditions of the Cianna Merger Agreement, we propose to pay up to $200 million in connection with the acquisition of Cianna, as follows:
• $135 million in cash at closing, subject to standard adjustments for working capital and other matters;
• an earn-out payment of $15 million payable upon the achievement by Cianna of certain manufacturing capacity and manufacturing cost milestones on or before June 30, 2019; and
• earn-out payments of up to $50 million in the aggregate, payable at the rate of 175% of the amount which annual net sales of Cianna products in each of 2019, 2020, 2021 and 2022 exceed annual net sales of Cianna products in the applicable preceding fiscal year.

Cianna claims to have developed the first non-radioactive, wire-free breast localization system. Its SCOUT® and SAVI® Brachy technologies are FDA-cleared and address what we believe are unmet needs in the delivery of radiation therapy, tumor localization and surgical guidance. We are currently evaluating the accounting treatment of the proposed transaction contemplated by the Cianna Merger Agreement.


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ITEM 2. MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS


Disclosure Regarding Forward-Looking Statements


This report includes “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”). All statements in this report, other than statements of historical fact, are “forward-looking statements” for purposes of these provisions, including, without limitation, any projections of earnings, revenues or other financial items, any statements of the plans and objectives of our management for future operations, any statements concerning proposed new products or services, any statements regarding the integration, development or commercialization of the business or any assets acquired from other parties, any statements regarding future economic conditions or performance, and any statements of assumptions underlying any of the foregoing. All forward-looking statements included in this report are made as of the date hereof and are based on information available to us as of such date. We assume no obligation to update any forward-looking statement. In some cases, forward-looking statements can be identified by the use of terminology such as “may,” “will,” “expects,” “plans,” “anticipates,” “intends,” “seeks,” “believes,” “estimates,” “potential,” “forecasts,” “continue,” or other forms of these words or similar words or expressions, or the negative thereof or other comparable terminology. Although we believe that the expectations reflected in the forward-looking statements contained herein are reasonable, there can be no assurance that such expectations or any of the forward-looking statements will prove to be correct. Actual results will likely differ, and could differ materially, from those projected or assumed in the forward-looking statements. Prospective investors are cautioned not to unduly rely on any such forward-looking statements.


Our future financial condition and results of operations, as well as any forward-looking statements, are subject to inherent risks and uncertainties, including the following:


risks relating to managing growth, particularly if accomplished through acquisitions and the integration of acquired businesses;
• risks relating to the proposed acquisition of Cianna, including the possibility that conditions to the closing of the proposed transaction will not be satisfied, uncertainties as to whether we will achieve operational and financial results from the proposed Cianna acquisition which are comparable to Cianna’s experience or our forecasts, unknown costs and risks associated with Cianna’s business and operations, and risks and uncertainties relating to our internal models;
risks relating to protecting our intellectual property;
claims by third parties that we infringe their intellectual property rights, which could cause us to incur significant legal or licensing expenses and prevent us from selling our products;
greater scrutiny and regulation by governmental authorities, including risks relating to the subpoena we received in October 2016 from the U.S. Department of Justice seeking information on our marketing and promotional practices;
risks relating to physicians’ use of our products in unapproved circumstances;
regulatory clearance processes of the FDA and other governmental authorities and any failure to obtain and maintain required regulatory clearances and approvals;
disruption of our critical information systems or material breaches in the security of our systems;
failure to comply with export control laws, customs laws, domestic procurement laws, sanctions laws and other laws governing our operations in the U.S. and other countries, which could subject us to civil or criminal penalties, other remedial measures and legal expenses;
risks relating to significant adverse changes in, or our failure to comply with, governing regulations;
restrictions and limitations in our debt agreements and instruments, which could affect our ability to operate our business and our liquidity;
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expending significant resources for research, development, testing and regulatory approval or clearance of our products under development and any failure to develop the products, any failure of the products to be effective or any failure to obtain approvals for commercial use;
violations of laws targeting fraud and abuse in the healthcare industry;
risks relating to healthcare reform legislation negatively affecting our financial results, business, operations or financial condition;

changes in the regulatory approval process and requirements in foreign countries, which could force us to incur additional expense or experience delays or uncertainties;
loss of key personnel;
product liability claims;claims and recalls;
failure to report adverse medical events to the FDA, which may subject us to sanctions that may materially harm our business;
failure to maintain or establish sales capabilities on our own or through third parties, which may result in our inability to commercialize any of our products in countries where we lack direct sales and marketing capabilities;
the addressable market for our product groups potentially being smaller than our estimates;
demands for price concessions resulting from consolidations in the healthcare industry, group purchasing organizations, public procurement policies or other factors beyond our control;
our inability to compete in markets, particularly if there is a significant change in relevant practices or technology;
the effect of evolving U.S. and international laws and regulations regarding privacy and data protection;
fluctuations in foreign currency exchange rates negatively impacting our financial results;
termination or interruption of, or a failure to monitor, our supply relationships or increases in the price of our component parts, finished products, third-party services or raw materials, particularly petroleum-based products;
our inability to accurately forecast customer demand for our products or manage our inventory;
changes in international and national economic and industry conditions;
inability to generate sufficient cash flow to fund our debt obligations, capital expenditures, and ongoing operations;operations, including rapid increases in demand for our products;
risks relating to our revenues being derived from a few products and medical procedures;
risks relating to work stoppage, transportation interruptions, severe weather and natural disasters;
fluctuations in our effective tax rate adversely affecting our business, financial condition or results of operations;
limits on reimbursement imposed by governmental and other programs;
failure to comply with applicable environmental laws and regulations;
volatility of the market price of our common stock;
dilution as a result of future equity offerings; and
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other factors and risks referenced in our press releases and described or referenced in our reports and other documents filed with the Securities and Exchange Commission.


All forward-looking statements attributable to us or persons acting on our behalf are expressly qualified in their entirety by these cautionary statements. Our actual results will likely differ, and may differ materially, from anticipated results. Financial estimates are subject to change and are not intended to be relied upon as predictions of future operating results, and we assume no obligation to update or disclose revisions to those estimates. If we do update or correct one or more forward-looking statements, investors and others should not conclude that we will make additional updates or corrections. Additional factors that may have a direct bearing on our operating results are discussed in Part I, Item 1A “Risk Factors” in the 2017 Form 10-K.


Disclosure Regarding Trademarks



This report includes trademarks, tradenames and service marks that are our property or the property of other third parties. Solely for convenience, such trademarks and tradenames sometimes appear without any “™” or “®” symbol. However, failure to include such symbols is not intended to suggest, in any way, that we will not assert our rights or the rights of any applicable licensor, to these trademarks and tradenames.




OVERVIEW


The following discussion and analysis of our financial condition and results of operations should be read in conjunction with the consolidated financial statements and related condensed notes thereto, which are included in Part I of this Report.


We design, develop, manufacture and market single-use medical products for interventional and diagnostic procedures. For financial reporting purposes, we report our operations in two operating segments: cardiovascular and endoscopy. Our cardiovascular segment consists of cardiology and radiology devices, which assist in diagnosing and treating coronary arterial disease, peripheral vascular disease and other non-vascular diseases and includes embolotherapeutic, cardiac rhythm management, electrophysiology, critical care and interventional oncology and spine devices. Our endoscopy segment focuses on the gastroenterology, pulmonary and thoracic surgery specialties, with a portfolio consisting primarily of stents, dilation balloons, certain inflation devices, guidewires, and other disposable products. Within those two operating segments, we offer products focused in five core product groups: peripheral intervention, cardiac intervention, interventional oncology and spine, cardiovascular and critical care and endoscopy.


For the three-month period ended JuneSeptember 30, 2018, we reported sales of approximately $224.8$221.7 million, up approximately $38.3$42.3 million or 20.5%23.6%, over sales from the three-month period ended JuneSeptember 30, 2017 of approximately $186.5$179.3 million. For the six-monthnine-month period ended JuneSeptember 30, 2018, we reported sales of approximately $427.8$649.5 million, up approximately $70.2$112.5 million or 19.6%21.0%, over sales from the six-monthnine-month period ended JuneSeptember 30, 2017 of approximately $357.6$537.0 million.
 
Gross profit as a percentage of sales decreasedincreased to 44.5%46.0% for the three-month period ended JuneSeptember 30, 2018 as compared to 45.1%44.9% for the three-month period ended JuneSeptember 30, 2017. Gross profit as a percentage of sales decreased to 44.0%44.7% for the six-monthnine-month period ended JuneSeptember 30, 2018 as compared to 44.8% for the six-monthnine-month period ended JuneSeptember 30, 2017.


Net income for the three-month period ended JuneSeptember 30, 2018 was approximately $10.9$16.6 million, or $0.21$0.30 per diluted share, as compared to $9.5a net loss of $(3.6) million, or $0.19$(0.07) per diluted share, for the three-month period ended JuneSeptember 30, 2017. Net income for the six-monthnine-month period ended JuneSeptember 30, 2018 was approximately $16.2$32.8 million, or $0.31$0.62 per diluted share, as compared to $24.3$20.7 million, or $0.50$0.42 per diluted share, for the six-monthnine-month period ended JuneSeptember 30, 2017.


Recent Developments and Trends


In addition to the trends identified in the 2017 Form 10-K under the heading “Management’s Discussion and Analysis of Financial Condition and Results of Operations - Overview,” and the impact of previously announced acquisitions, we believe that our business in 2018 will continue to be impacted by the following recent events and trends:


In February• On October 1, 2018, we acquired certain divested assets from BD for an aggregate purchase price of $100.3 million. The acquired assets includesigned the soft tissue core needle biopsy products sold under the tradenames of Achieve® Programmable Automatic Biopsy System, Temno® Biopsy System, Tru-Cut® Biopsy Needles as well as Aspira® Pleural Effusion Drainage Kits, and the Aspira® Peritoneal Drainage System. During the three and six-month periods ended June 30, 2018, our net sales of BD products were approximately $12.2 million and $18.5 million, respectively.

On April 6, 2018, we entered into long-term agreements with NinePoint Medical, Inc. (“NinePoint”),Cianna Merger Agreement, pursuant to which we (a) becamepropose to acquire Cianna. The proposed transaction has been approved by the exclusive worldwide distributor forboards of directors of both companies, and is subject to the NvisionVLE® Imaging Systemsatisfaction or waiver (in accordance with Real-time Targeting™ using Optical Coherence Tomography (OCT) and (b) acquired an option to purchase up to 100%the provisions of the outstanding equityCianna Merger Agreement) of certain closing conditions, including the approval of Cianna stockholders, clearance under the Hart-Scott-Rodino Antitrust Improvements Act and other customary closing conditions. We anticipate that the transaction will close during the fourth quarter of 2018.

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• We received FDA 510(k) clearance for a series of new tracheal/bronchial mini-stents which will be sold in NinePoint both in exchange for total consideration of $10.0 million. In addition, we made a loan to NinePoint for $10.5 million. We believe the NinePoint products will enhance the product offerings of our Endotek division (in our endoscopy segment) andoperating segment. We also received 510(k) clearance for our EmboCube™ product line, which will be another step to adding therapy and disease-state products tosold in our portfolio. The NinePoint products have 510(k) clearanceembolization devices product group in the United States, and NinePoint is preparingour cardiovascular operating segment.

• During 2018, a CE mark application. During the period from April 6, 2018 to June 30, 2018, our net sales of NinePoint products were approximately $1.1 million.

In May 2018, we entered into an agreement for the acquisition of product distribution agreements for the DirectACCESS FirstChoice™ Ultra High Pressure PTA Balloon Catheter and executed a distribution agreement for the QXMédical Q50® PLUS Stent Graft Balloon Catheter.


A competitor recently experienced substantial global supply shortages due to internal issues, which has resulted in increased demand for our Merit Laureate® Hydrophilic Guide Wires, our offering of microcatheters (including the Merit Maestro®, SwiftNINJA® and the recently introduced Pursue™ Microcatheter), our Impress® Diagnostic Catheters and our vascular sheaths (including the recently introduced Prelude IDeal™ and PreludeEASE™ product offerings). We estimate that the impact of the increased demand for our products on our net sales for the three months ended September 30, 2018 was approximately $4.0 million.


Additionally, we expect that (a) our net sales for the remainder of 2018 will be positively impacted by recently-awarded tenders, anticipated releases of new products and commencement of production of the Laurane product line in our Irish facility, and (b) our net income for the remainder of 2018 will be positively impacted by continued manufacturing efficiencies, cost-saving measures, and sales of our biopsy and drainage products, partially offset by several demand-based factors, including changes in our product mix, increases in revenue in certain markets served by distributors, and increases in labor costs and logistical expenses of addressing global supply requirements.





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Results of Operations


The following table sets forth certain operational data as a percentage of sales for the three and six-monthnine-month periods ended JuneSeptember 30, 2018 and 2017, as indicated:

Three Months Ended September 30, Nine Months Ended September 30, 
2018 2017 2018 2017 
Net sales 100%  100%  100%  100%  
Gross profit 46.0  44.9  44.7  44.8  
Selling, general and administrative expenses 29.9  30.5  30.9  31.6  
Research and development expenses 6.6  7.2  6.8  7.2  
Intangible asset impairment charges 0.3  —  0.1  —  
Contingent consideration expense (benefit) (0.3) —  (0.1)  
Acquired in-process research and development expenses —  6.7  0.1  2.3  
Income from operations 9.5  0.5  6.9  3.7  
Other income (expense) - net (0.8) (1.7) (1.2) 0.9  
Income (loss) before income taxes 8.7  (1.2) 5.7  4.6  
Net income (loss) 7.5  (2.0) 5.1  3.9  
 Three Months Ended June 30, Six Months Ended June 30,
 2018 2017 2018 2017
Net sales100% 100% 100% 100%
Gross profit44.5 45.1 44.0 44.8
Selling, general and administrative expenses30.7 30.8 31.3 32.2
Research and development expenses6.8 7.1 6.9 7.2
Contingent consideration expense (benefit)0.1 0.0 0.1 0.0
Acquired in-process research and development expenses0.1 0.0 0.1 0.0
Income from operations6.7 7.2 5.6 5.3
Other income (expense) - net(1.6) (1.1) (1.4) 2.2
Income before income taxes5.1 6.1 4.2 7.5
Net income4.9 5.1 3.8 6.8


Sales


Sales for the three-month period ended JuneSeptember 30, 2018 increased by 20.5%23.6%, or approximately $38.3$42.3 million, compared to the corresponding period in 2017. Sales for the six-monthnine-month period ended JuneSeptember 30, 2018 increased by 19.6%21.0%, or approximately $70.2$112.5 million, compared to the corresponding period in 2017. Listed below are the sales by product category within each of our two financial reporting segments for the three and six-monthnine-month periods ended JuneSeptember 30, 2018 and 2017 (in thousands, other than percentage changes):


  Three Months Ended June 30,   Six Months Ended June 30,Three Months Ended September 30, Nine Months Ended September 30, 
% Change 2018 2017 % Change 2018 2017% Change 2018 2017 % Change 2018 2017 
Cardiovascular    
    
Cardiovascular
Stand-alone devices30.2% $92,496
 $71,056
 30.5% $175,742
 $134,709
Stand-alone devices32.3%  $90,975 $68,749 31.1%  $266,717 $203,459 
Custom kits and procedure trays6.9% 33,992
 31,797
 10.9% 67,264
 60,672
Custom kits and procedure trays8.8%  33,095 30,411 10.2%  100,359 91,082 
Inflation devices16.9% 24,305
 20,789
 18.9% 46,724
 39,296
Inflation devices14.3%  22,893 20,033 17.3%  69,617 59,329 
Catheters21.4% 39,374
 32,429
 17.0% 73,239
 62,605
Catheters27.8%  40,591 31,751 20.6%  113,830 94,357 
Embolization devices4.7% 12,724
 12,158
 2.5% 25,310
 24,685
Embolization devices1.2%  12,395 12,252 2.1%  37,706 36,936 
CRM/EP18.0% 13,496
 11,434
 6.7% 23,962
 22,451
CRM/EP28.1%  12,201 9,527 13.1%  36,163 31,977 
Total20.4% 216,387
 179,663
 19.7% 412,241
 344,418
Total 22.8%  212,150 172,723 20.7%  624,392 517,140 
        
Endoscopy        Endoscopy
Endoscopy devices22.3% 8,423
 6,886
 18.2% 15,603
 13,200
Endoscopy devices43.8%  9,509 6,614 26.7%  25,112 19,815 
        
Total20.5% $224,810
 $186,549
 19.6% $427,844
 $357,618
Total 23.6%  $221,659 $179,337 21.0%  $649,504 $536,955 
Note: Certain revenue categories for 2017 have been adjusted from prior disclosure to reflect changes in product classifications to be consistent with updates in Merit's management of its product portfolios during 2018.


Cardiovascular Sales. Our cardiovascular sales for the three-month period ended JuneSeptember 30, 2018 were approximately $216.4$212.2 million, up 20.4%22.8% when compared to the corresponding period for 2017 of approximately $179.7$172.7 million. Sales for the three-month period ended JuneSeptember 30, 2018 were favorably affected by increased sales of (a) our stand-alone devices (particularly our MAPTM Merit Angioplasty Packs, Prelude SYNC® Radial Compression Device, Medallion® Syringes, Merit Laureate® Hydrophilic Guide Wires, EN Snare® Endovascular Snare Systems, wires and wires,tubing, as well as sales fromof products acquired in connection with our prior acquisitions, including the BD product lines and Catheter Connections, Osseon, and Laurane)Connections) of approximately $21.4$22.2 million, up 30.2%32.3% from the corresponding period for 2017; (b) catheters (particularly our Impress® Diagnostic Catheters, Prelude® and Prelude® Radial Sheath product lines, and our Merit Maestro® Microcatheters) of
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approximately $6.9$8.8 million, up 21.4%27.8% from the corresponding period for 2017; (c) CRM/EP products (particularly our custom kitsHeartspan® Transseptal Sheaths, Steerable Sheaths and procedure traysTransseptal Needles) of approximately $2.2$2.7 million, (which includes sales from our acquisition of ITL), up 6.9%

28.1% from the corresponding period for 2017; and (d) inflation devices (particularly our basixTOUCH® and BasixCompak® product lines)inflation kits sold through our OEM relationships) of approximately $3.5$2.9 million, up 16.9%14.3% from the corresponding period for 2017.


Our cardiovascular sales for the six-monthnine-month period ended JuneSeptember 30, 2018 were approximately $412.2$624.4 million, up 19.7%20.7%, when compared to the corresponding period for 2017 of approximately $344.4$517.1 million. Sales for the six-monthnine-month period ended JuneSeptember 30, 2018 were favorably affected by increased sales of (a) our stand-alone devices (particularly our MAPTM Merit Angioplasty Packs, Prelude SYNC® Radial Compression Device, Merit Laureate® Hydrophilic Guide Wires, EN Snare® Endovascular Snare Systems, Medallion® Syringes, stopcocks, tubing and wires, as well as sales from products acquired in connection with our acquisitions, including the BD product lines, Argon critical care division, Catheter Connections, Osseon, and Laurane) of approximately $41.0$63.3 million, up 30.5%31.1% from the corresponding period for 2017; (b) catheters (particularly our Impress® Diagnostic Catheters, ReSolve® Locking Drainage Catheters, Prelude® and Prelude® Radial Sheath product lines, and our Merit Maestro® Microcatheters) of approximately $10.6$19.5 million, up 17.0%20.6% from the corresponding period for 2017; (c) our custom kits and procedure trays of approximately $6.6 million (which includes sales from our acquisition of ITL), of approximately $9.3 million, up 10.9%10.2% from the corresponding period for 2017; and (d) inflation devices (particularly our BASIXTouch®BASIXTouch™ and BasixCompak®BasixCompak™ product lines)lines, as well as our inflation kits sold through our OEM relationships) of approximately $7.4$10.3 million, up 18.9%17.3% from the corresponding period for 2017.


Endoscopy Sales. Our endoscopy sales for the three-month period ended JuneSeptember 30, 2018 were approximately $8.4$9.5 million, up 22.3%43.8%, when compared to sales in the corresponding period of 2017 of approximately $6.9$6.6 million. Our endoscopy sales for the six-monthnine-month period ended JuneSeptember 30, 2018 were approximately $15.6$25.1 million, up 18.2%26.7%, when compared to sales in the corresponding period of 2017 of approximately $13.2$19.8 million. In each case, the increase was primarily related to an increase in sales of our EndoMAXX® fully covered esophageal stent, Elation® Balloon Dilator, productsthe Aspira® Peritoneal Drainage System acquired from BD and products sold pursuant to our distribution agreement with NinePoint.


International Sales. International sales for the three-month period ended JuneSeptember 30, 2018 were approximately $100.4$95.6 million, or 44.6%43.1% of net sales, up 27.9%25.3% when compared to the corresponding period in 2017. The increase in our international sales for the secondthird quarter of 2018 compared to the secondthird quarter of 2017 was primarily related to (a) sales increases in China of approximately $6.7$3.9 million, or 35.4%20.8% when compared to the corresponding period in 2017, (b) sales increases in Japan of approximately $2.3$4.9 million, or 24.8%61.7% when compared to the corresponding period in 2017, and (c) sales associated with our acquisition of certain product lines from BD.


International sales for the six-monthnine-month period ended JuneSeptember 30, 2018 were approximately $193.3$288.9 million, or 45.2%44.5% of net sales, up 31.2%29.2% when compared to the six-monthnine-month period ended JuneSeptember 30, 2017. The increase in our international sales was primarily related to (a) sales increases in China of approximately $12.6$16.5 million, or 34.3%29.8% when compared to the corresponding period in 2017, (b) sales increases in Japan of approximately $3.8$8.7 million, or 21.7%34.0% when compared to the corresponding period in 2017, and (c) sales associated with our acquisition of certain product lines from BD.


Gross Profit


Our gross profit as a percentage of sales decreasedincreased to 44.5%46.0% for the three-month period ended JuneSeptember 30, 2018, compared to 45.1%44.9% for the three-month period ended JuneSeptember 30, 2017. This increase was primarily related to changes in product mix including the addition of products acquired from BD with average margins of 80%, and increased efficiencies gained from our operations team.

Gross profit as a percentage of sales decreased to 44.0%44.7% for the six-monthnine-month period ended JuneSeptember 30, 2018, compared to 44.8% for the six-monthnine-month period ended JuneSeptember 30, 2017. These decreases wereThis decrease was primarily due to integration costs associated with the BD acquisition and increased amortization as a result of acquisitions, increased inventory obsolescence,which was partially offset by changes in product mix, including the addition of products acquired from BD with average margins of approximately 80%, and increased freight costs associated with filling our global pipeline.manufacturing efficiencies.


Operating Expenses


Selling, General and Administrative Expense.Selling, general and administrative ("SG&A") expenses increased approximately $11.7 million, or 20.4%21.3%, for the three-month period ended JuneSeptember 30, 2018 compared to the three-month period ended JuneSeptember 30, 2017. As a percentage of sales, SG&A expenses were 30.7%29.9% of sales for the three
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-month period ended September 30, 2018, compared to 30.5% for the three-month period ended June 30, 2018, compared to 30.8% the three-month period ended JuneSeptember 30, 2017. SG&A expenses increased approximately $18.8$30.5 million, or 16.3%17.9%, for the six-monthnine-month period ended JuneSeptember 30, 2018 compared to the six-monthnine-month period ended JuneSeptember 30, 2017. As a percentage of sales, SG&A expenses decreased to 31.3%30.9% of sales for the six-monthnine-month period ended JuneSeptember 30, 2018, compared to 32.2%31.6% of sales for the six-monthnine-month period ended JuneSeptember 30, 2017. The increase in SG&A expense was primarily related to acquisition and integration costs for our acquisition of BD, increased headcount and increased amortization as a result of acquisitions, which was partially offset by a reduction in legal expenses incurred in responding to the pending subpoena from the Department of Justice when compared to SG&A expenses in the corresponding periods of 2017.


Research and Development Expenses. Research and development ("R&D") expenses for the three-month period ended JuneSeptember 30, 2018 were approximately $15.3$14.5 million, up 15.0%, when compared to R&D expenses in the corresponding period

of 2017 of approximately $13.3 million. R&D expenses for the six-month period ended June 30, 2018 were approximately $29.6 million, up 14.7%13.1%, when compared to R&D expenses in the corresponding period of 2017 of approximately $25.8$12.8 million. ThisR&D expenses for the nine-month period ended September 30, 2018 were approximately $44.2 million, up 14.2%, when compared to R&D expenses in the corresponding period of 2017 of approximately $38.7 million. The increase in R&D expenses was largely due to hiring additional research and development personnel to support various new core and acquired product developments.


Operating Income


The following table sets forth our operating income by financial reporting segment for the three and six-monthnine-month periods ended JuneSeptember 30, 2018 and 2017 (in thousands):

Three Months Ended September 30, Nine Months Ended September 30, 
Three Months Ended June 30, Six Months Ended June 30,2018201720182017
2018 2017 2018 2017
Operating Income   
    
Operating Income (Loss) Operating Income (Loss)
Cardiovascular$12,663
 $11,493
 $19,060
 $15,475
Cardiovascular$18,199 $(1,207)$37,263 $14,239 
Endoscopy2,451
 1,869
 4,835
 3,496
Endoscopy2,862 2,086 7,692 5,611 
Total operating income$15,114
 $13,362
 $23,895
 $18,971
Total operating income $21,061 $879 $44,955 $19,850 
(1) Operating income for the 2017 periods has been adjusted from prior disclosure to reflect changes in product classifications between our operating segments, which were made to be consistent with updates in the management of our product portfolios in 2018.

Cardiovascular Operating Income. Our cardiovascular operating income for the three-month period ended JuneSeptember 30, 2018 was approximately $12.7$18.2 million, compared to an operating incomeloss of approximately $11.5$(1.2) million for the three-month period ended JuneSeptember 30, 2017. Our cardiovascular operating income for the six-monthnine-month period ended JuneSeptember 30, 2018 was approximately $19.1$37.3 million, compared to operating income of approximately $15.5$14.2 million for the six-monthnine-month period ended JuneSeptember 30, 2017. The increase in cardiovascular operating income was primarily related to the acquired in-process research and development charge recorded in the third quarter of 2017, which did not repeat in the third quarter of 2018, and increased sales and improved gross margins in the third quarter of 2018, which waswere partially offset by a lower gross margin percentage, acquisition and integration-related costs, increased headcount, increased amortization as a result of acquisitions, and expenses associated with foreign market expansion.


Endoscopy Operating Income. Our endoscopy operating income for the three-month period ended JuneSeptember 30, 2018 was approximately $2.5$2.9 million, compared to approximately $1.9$2.1 million for the three-month period ended JuneSeptember 30, 2017. Our endoscopy operating income for the six-monthnine-month period ended JuneSeptember 30, 2018 was approximately $4.8$7.7 million, compared to approximately $3.5$5.6 million for the six-monthnine-month period ended JuneSeptember 30, 2017. ThisThe increase for the three and nine months ended September 30, 2018 compared to the same periods of 2017, was primarily the result of higher sales (principally related to sales of the NinePoint productproducts of approximately $1.1 million)$1.4 million and $2.5 million, during the three and nine months ended September 30, 2018, respectively) and lower SG&A expenses as a percentage of sales.


Effective Tax Rate


Our effective income tax rate for the three-month periods ended JuneSeptember 30, 2018 and 2017 was 5.4%14.3%, and 16.2%(61.9)%, respectively. The change in the effective tax rate for the third quarter of 2018 compared to the third quarter of 2017 is primarily due to the discrete tax impact of the in-process research and development charge attributable to the IntelliMedical acquisition completed in the third quarter of 2017, which was not deductible for tax purposes.

Our effective income tax rate for the six-monthnine-month periods ended JuneSeptember 30, 2018 and 2017 was 9.6%12.0% and 9.4%15.8%, respectively. The decrease in the effective income tax rate for the second quarter of 2018 compared to the second quarter of 2017 was primarily caused by a decrease in the federal statutory tax rate, as well asdue to a discrete tax benefit related to share-based payment awards. Despite the decrease resulting from these items, the effective tax rate for the six months ended June 30, 2018 is relatively unchanged when compared to the corresponding period in 2017 due to the nontaxable gain on the bargain purchase recorded in connection with the 2017 acquisition

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Other Income (Expense)
Our other income (expense) for the three-month periods ended JuneSeptember 30, 2018 and 2017 was approximately $(3.5)$(1.7) million, and $(2.0)$(3.1) million, respectively. The increasedecrease in other expense was primarilyprimarily a result of increased interest expense duethe bargain purchase gain related to higher debt balances used to finance the BDacquisition of the Argon critical care division which was adjusted during the third quarter of 2017 and other acquisitions.fluctuations in the currency gains and losses during the third quarter of 2018.


Our other income (expense) for the six-monthnine-month periods ended JuneSeptember 30, 2018 and 2017 was approximately $(6.0)$(7.6) million, and $7.8$4.8 million, respectively. The change in other income (expense) for these periods was primarily a result of the bargain purchase gain related to the acquisition of the Argon critical care division the first quarter of 2017, which did not recur in 2018, and increased interest expense in 2018 due to higher average debt balances used to finance the BD and other acquisitions.


Net Income


Our net income for three-month periods ended JuneSeptember 30, 2018 and 2017 was approximately $10.9$16.6 million and $9.5$(3.6) million, respectively. The increase in net income was primarily due to increased sales and improvement in our gross margin. In addition, the net loss for the three months ended September 30, 2017 was primarily due to the acquired in-process research and development expenses of $12.1 million primarily attributable to the IntelliMedical acquisition, which were partially offset by a decreasedid not recur in gross profit as a percentage of sales. 2018. 

Our net income for six-monthnine-month periods ended JuneSeptember 30, 2018 and 2017 was approximately $16.2$32.8 million and $24.3$20.7 million, respectively. The decreaseincrease in net income was primarily related to increased sales, lower SG&A expenses as a percentage of sales and the gain on bargain purchaseacquired in-process research and development expenses of $11.6$12.1 million reported in 2017 attributable to the IntelliMedical acquisition, which did not recur in 2018, partially offset by the gain on bargain purchase in 2017 of approximately $10.8 million related to the acquisition of the Argon critical care division, which was partially offset by increased sales in the six months ended June 30, 2018 compared to the same period in 2017.division.




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LIQUIDITY AND CAPITAL RESOURCES


Capital Commitments, Contractual Obligations and Cash Flows


At JuneSeptember 30, 2018 and December 31, 2017, we had cash and cash equivalents of approximately $43.5$52.0 million and $32.3 million respectively, of which approximately $41.9$46.9 million and $30.4 million, respectively, were held by foreign subsidiaries. The 2017 Tax Act one-time repatriation tax liability effectively taxes the undistributed earnings previously deferred from U.S. income taxes. We have not provided for foreign withholding tax on the undistributed earnings from our non-U.S. subsidiaries because such earnings are currently considered to be indefinitely reinvested. We are still analyzing how the 2017 Tax Act impacts our existing accounting position to indefinitely reinvest foreign earnings and have yet to determine whether we plan to change our position. The cash held by our foreign subsidiaries for indefinite reinvestment is used to fund the operating activities of our foreign subsidiaries and for further investment in foreign operations.


In addition, cash held by our subsidiary in China is subject to local laws and regulations that require government approval for the transfer of such funds to entities located outside of China. As of JuneSeptember 30, 2018 and December 31, 2017, we had cash and cash equivalents of approximately $22.9$21.0 million and $13.1 million, respectively, held by our subsidiary in China.


Cash flows provided by operating activities. Cash provided by operating activities during the six-monthnine-month periods ended JuneSeptember 30, 2018 and 2017 was primarily the result of net income excluding non-cash items, offset by shifts in working capital. Our working capital as of JuneSeptember 30, 2018 and December 31, 2017 was approximately $231.4$247.8 million and $200.5 million, respectively. The increase in working capital as of JuneSeptember 30, 2018 compared to December 31, 2017 was primarily the result of increases in trade receivables and inventories which were partially offset by an increase in trade payables and accrued expenses. As of JuneSeptember 30, 2018 and December 31, 2017, we had a current ratio of 2.662.77 to 1 and 2.73 to 1, respectively.


During the six-monthnine-month period ended JuneSeptember 30, 2018, our inventory balance increased approximately $14.0$26.2 million, from approximately $155.3 million as of December 31, 2017 to approximately $169.3$181.4 million as of JuneSeptember 30, 2018. The increase in the inventory balance was due to several factors, including acquisitions and expansion to support increased sales and the opening of new modified direct sales markets. The trailing twelve-month inventory turns as of JuneSeptember 30, 2018 was 2.90,2.84, compared to 2.91 for the twelve-month period ended December 31, 2017.
Cash flows provided by financing activities. Cash provided by financing activities for the six-monthnine-month period ended JuneSeptember 30, 2018 was approximately $138.1$140.4 million compared to approximately $57.6$95.7 million for the six-monthnine-month period ended JuneSeptember 30, 2017, an increase of approximately $80.5$44.7 million. The increase in net cash provided from financing activities was primarily the result of additional borrowings in 2018 to fund the acquisition of assets from BD, NinePoint and DirectACCESS, partially offset by a decrease inhigher proceeds from the issuance of common stock (as no public equity offering was undertaken in 2018 (compared to the six-month period ended June 30, 2018).proceeds we received from issuance of common stock in 2017), partially offset by higher net debt repayments in 2018.

On March 14,September 3, 2018, we renewed our loan agreement with HSBC Bank USA, National Association ("HSBC Bank") whereby HSBC Bank agreed to provide us with a loan in the amount of approximately $7.0 million. The loan matures on JulyJanuary 10, 2018,2019, with an extension available at our option, subject to certain conditions. The loan agreement bears interest at the three-monthsix-month LIBOR rate, plus 1.0%, which resets quarterly.. The loan is secured by assets equal tohaving a value not less than the currently outstanding loan balance. The loan contains covenants, representations and warranties and other terms customary for loans of this nature. As of JuneSeptember 30, 2018, our interest rate on the loan was a variable rate of 3.26%3.12%.


The Second Amended Credit Agreement provides for a term loan of $150 million and a revolving credit commitment up to an aggregate amount of $375 million, which includes a reserve of $25 million to make swingline loans from time to time. The term loan is payable in quarterly installments in the amounts provided in the Second Amended Credit Agreement until the maturity date of July 6, 2021, at which time the term and revolving credit loans, together with accrued interest thereon, will be due and payable. At any time prior to the maturity date, we may repay any amounts owing under all revolving credit loans, term loans, and all swingline loans in whole or in part, subject to certain minimum thresholds, without premium or penalty, other than breakage costs.


Revolving credit loans denominated in dollars and term loans made under the Second Amended Credit Agreement bear interest, at our election, at either a Base Rate or Eurocurrency Base Rate (as such terms are defined in the Second Amended Credit Agreement) plus the applicable margin, which increases as our Consolidated Total Leverage Ratio (as defined in the Second Amended Credit Agreement) increases. Revolving credit loans denominated in an Alternative Currency (as defined in the Second Amended Credit Agreement) bear interest at the Eurocurrency rate plus the applicable margin. Swingline loans bear interest at the Base Rate plus the applicable margin. Upon an event of default, the interest rate may be increased by 2.0%. The revolving credit commitment will also carry a commitment fee of 0.15% to 0.40% per annum on the unused portion.


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The Second Amended Credit Agreement is collateralized by substantially all our assets. The Second Amended Credit Agreement contains covenants, representations and warranties and other terms customary for loans of this nature. The Second Amended Credit Agreement requires that we maintain certain financial covenants, as follows:
Covenant Requirement 
Consolidated Total Leverage Ratio (1)
January 1, 2018 and thereafter 3.5 to 1.0 
Consolidated EBITDA (2)
1.25 to 1.0 
Consolidated Net Income (3)
$0 
Facility Capital Expenditures (4)
$30 million 
Covenant Requirement
Consolidated Total Leverage Ratio (1)
January 1, 2018 and thereafter3.5 to 1.0
Consolidated EBITDA (2)
1.25 to 1.0
Consolidated Net Income (3)
$0
Facility Capital Expenditures (4)
$30 million
(1)
Maximum Consolidated Total Leverage Ratio (as defined in the Second Amended Credit Agreement) as of any fiscal quarter end.
(2)
Minimum ratio of Consolidated EBITDA (as defined in the Second Amended Credit Agreement and adjusted for certain expenditures) to Consolidated Fixed Charges (as defined in the Second Amended Credit Agreement) for any period of four consecutive fiscal quarters.
(3)
Minimum level of Consolidated Net Income (as defined in the Second Amended Credit Agreement) for certain periods, and subject to certain adjustments.
(4)
Maximum level of the aggregate amount of all Facility Capital Expenditures (as defined in the Second Amended Credit Agreement) in any fiscal year.


Additionally, the Second Amended Credit Agreement contains customary events of default and affirmative and negative covenants for transactions of this type. As of JuneSeptember 30, 2018, we believe we were in compliance with all covenants set forth in the Second Amended Credit Agreement.


As of JuneSeptember 30, 2018, we had outstanding borrowings of approximately $407.0$202.3 million under the Second Amended Credit Agreement (an increase(a decrease in long-term debtoutstanding borrowings under the Second Amended Credit Agreement of approximately $132.6$69.8 million from December 31, 2017, which was principally due to applying the proceeds of the July 2018 common stock offering toward our acquisitionoutstanding debt balance in the third quarter of assets from BD, NinePoint and DirectACCESS),2018, partially offset by increased debt levels in the first six months of 2018 to fund acquisitions) with available borrowings of approximately $47.8$248.4 million, based on the leverage ratio required pursuant to the Second Amended Credit Agreement. Our interest rate as of JuneSeptember 30, 2018 was a fixed rate of 2.87% on $175.0 million as a result of an interest rate swap (see Note 11 to our condensed consolidated financial statements included in Part I, Item 1 of this Quarterly Report) and a variable floating rate of 3.84%3.99% on $232.0$27.3 million. Our interest rate as of December 31, 2017 was a fixed rate of 2.68% on $175.0 million as a result of an interest rate swap and a variable floating rate of 2.82% on $97.0 million.


As discussed in Note 1615 to our condensed consolidated financial statements included in Part I, Item 1 of this Quarterly Report, the net proceeds from our offering of common stock, which closed on July 30, 2018, were used primarily to repay outstanding borrowings (primarily revolving credit loans) under the Second Amended Credit Agreement.


Cash flows used in investing activities.Our cash flows used in investing activities for the six-monthnine-month period ended JuneSeptember 30, 2018 was approximately $162.5$182.8 million compared to approximately $73.7$134.9 million for the six-monthnine-month period ended JuneSeptember 30, 2017, an increase of approximately $88.8$47.8 million. This increase was primarily a result of an increase of approximately $63.8$19.3 million in net cash paid for acquisitions during the sixnine months ended JuneSeptember 30, 2018, compared to the sixnine months ended JuneSeptember 30, 2017 (see Note 5 to our condensed consolidated financial statements included in Part I, Item 1 of this Quarterly Report), combined with a $13.8$17.5 million increase in capital expenditures for property and equipment. Capital expenditures for property and equipment were approximately $31.6$47.0 million and $17.8$29.5 million for the six-monthnine-month periods ended JuneSeptember 30, 2018 and 2017, respectively.


We currently believe that our existing cash balances, anticipated future cash flows from operations and borrowings under the Second Amended Credit Agreement will be adequate to fund our current and currently planned future operations for the next twelve months and the foreseeable future. In the event we pursue and complete significant transactions or acquisitions in the future, additional funds will likely be required to meet our strategic needs, which may require us to raise additional funds in the debt or equity markets.


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Off-Balance Sheet Arrangements


Under SEC regulations, we are required to disclose our off-balance sheet arrangements that have or are reasonably likely to have a current or future effect on our financial condition, such as changes in financial condition, revenues or expenses,

results of operations, liquidity, capital expenditures or capital resources that are material to investors. As of JuneSeptember 30, 2018, we have no off-balance sheet arrangements.


Critical Accounting Policies and Estimates


The SEC has requested that all registrants address their most critical accounting policies. The SEC has indicated that a “critical accounting policy” is one which is both important to the representation of the registrant’s financial condition and results and requires management’s most difficult, subjective or complex judgments, often as a result of the need to make estimates about the effect of matters that are inherently uncertain. We base our estimates on past experience and on various other assumptions our management believes to be reasonable under the circumstances, the results of which form the basis for making judgments about carrying values of assets and liabilities that are not readily apparent from other sources. Actual results will differ, and may differ materially, from these estimates under different assumptions or conditions. Additionally, changes in accounting estimates could occur in the future from period to period. Our management has discussed the development and selection of our most critical financial estimates with the audit committee of our Board of Directors. The following paragraphs identify our most critical accounting policies:

Inventory Obsolescence. Our management reviews on a quarterly basis inventory quantities on hand for unmarketable and/or slow-moving products that may expire prior to being sold. This review includes quantities on hand for both raw materials and finished goods. Based on this review, we provide adjustments for any slow-moving finished good products or raw materials that we believe will expire prior to being sold or used to produce a finished good and any products that are unmarketable. This review of inventory quantities for unmarketable and/or slow moving products is based on forecasted product demand prior to expiration lives.

Forecasted unit demand is derived from our historical experience of product sales and production raw material usage. If market conditions become less favorable than those projected by our management, additional inventory write-downs may be required. During the years ended December 31, 2017, 2016 and 2015, we recorded obsolescence expense of approximately $6.1 million, $3.9 million and $2.8 million, respectively, and wrote off approximately $2.9 million, $2.8 million and $2.5 million, respectively. Based on this historical trend, we believe that our inventory balances as of JuneSeptember 30, 2018 have been accurately adjusted for any unmarketable and/or slow moving products that may expire prior to being sold.

Allowance for Doubtful Accounts. A majority of our receivables are with hospitals which, over our history, have demonstrated favorable collection rates. Therefore, we have experienced relatively minimal bad debts from hospital customers. In limited circumstances, we have written off bad debts as the result of the termination of our business relationships with foreign distributors. The most significant write-offs over our history have come from U.S. and international distributors.

We maintain allowances for doubtful accounts relating to estimated losses resulting from the inability of our customers to make required payments. These allowances are based upon historical experience and a review of individual customer balances. If the financial condition of our customers were to deteriorate, resulting in an impairment of their ability to make payments, additional allowances may be required.

Stock-Based Compensation. We measure stock-based compensation cost at the grant date based on the value of the award and recognize the cost as an expense over the term of the vesting period. Judgment is required in estimating the fair value of share-based awards granted and their expected forfeiture rate. If actual results differ significantly from these estimates, stock-based compensation expense and our results of operations could be materially impacted.

Income Taxes. Under our accounting policies, we initially recognize a tax position in our financial statements when it becomes more likely than not that the position will be sustained upon examination by the tax authorities. Such tax positions are initially and subsequently measured as the largest amount of tax positions that has a greater than 50% likelihood of being realized upon ultimate settlement with the tax authorities assuming full knowledge of the position and all relevant facts. Although we believe that our provisions for unrecognized tax positions are reasonable, we can make no assurance that the final tax outcome of these matters will not be different from that which we have reflected in our income tax provisions and accruals. The tax law is subject to varied interpretations, and we have taken positions related to certain matters where the law is subject to interpretation. Additionally, changes in tax law - such as the 2017 Tax Act - may be subject to evolving interpretation over a period of time
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following their enactment. Such differences and evolving interpretations could have a material impact on our income tax provisions and operating results in the period(s) in which we make such determination.

Goodwill and Intangible Asset Impairment and Contingent Consideration. We allocate any excess purchase price over the fair value of the net tangible and identifiable intangible assets acquired in a business combination to goodwill. We test our goodwill balances for impairment as of July 1 of each year, or whenever impairment indicators arise. We utilize several reporting units in

evaluating goodwill for impairment. We assess the estimated fair value of reporting units using a combination of a guideline public company market-based approach and a discounted cash flow income-based approach. If the carrying amount of a reporting unit exceeds the fair value of the reporting unit, an impairment charge is recognized in an amount equal to the excess of the carrying amount of the reporting unit goodwill over the implied fair value of that goodwill. This analysis requires significant judgment, including estimation of future cash flows and the length of time they will occur, which is based on internal forecasts, and a determination of a discount rate based on our weighted average cost of capital. During our annual test of goodwill balances in 2017,2018, which was completed during the third quarter of 2017,2018, we determined that the fair value of each reporting unit with goodwill exceeded the carrying amount by a significant amount.

We evaluate the recoverability of intangible assets subject to amortization whenever events or changes in circumstances indicate that an asset's carrying amount may not be recoverable. This analysis requires similar significant judgments as those discussed above regarding goodwill, except that undiscounted cash flows are compared to the carrying amount of intangible assets to determine if impairment exists. In-process technology intangible assets, which are not subject to amortization until projects reach commercialization, are assessed for impairment at least annually and more frequently if events occur that would indicate a potential reduction in the fair value of the assets below their carrying value. During the fourththird quarter of 2017,2018, we compared the carrying value of the amortizing intangible assets acquired in our July 2015 acquisition of certain assets from Distal Access,Quellent, LLC to the undiscounted cash flows expected to result from the asset group and determined that the carrying amount was not recoverable. We then determined the fair value of the amortizing assets related to the Distal AccessQuellent acquisition based on estimated future cash flows discounted back to their present value using a discount rate that reflects the risk profiles of the underlying activities. Some of the factors that influenced our estimated cash flows were slower than anticipated sales growth in the products acquired from our Distal AccessQuellent acquisition and uncertainty about future sales growth. The excess of the carrying value compared to the fair value was recognized as an intangible asset impairment charge. We recorded an impairment charge for Distal AccessQuellent of approximately $809,000$657,000 during the fourththird quarter of 2017.2018.


Contingent consideration is an obligation by the buyer to transfer additional assets or equity interests to the former owner upon reaching certain performance targets. Certain of our business combinations involve the potential for the payment of future contingent consideration, generally based on a percentage of future product sales or upon attaining specified future revenue milestones. In connection with a business combination, any contingent consideration is recorded on the acquisition date based upon the consideration expected to be transferred in the future. We utilize a discounted cash flow method, which includes a probability factor for milestone payments, in valuing the contingent consideration liability. We re-measure the estimated liability each quarter and record changes in the estimated fair value through operating expense in our consolidated statements of income. Significant increases or decreases in our estimates could result in changes to the estimated fair value of our contingent consideration liability, as the result of changes in the timing and amount of revenue estimates, as well as changes in the discount rate or periods.



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ItemITEM 3.QUANTITATIVE AND QUALITATIVE DICSLOSURESDISCLOSURES ABOUT MARKET RISK


Currency Risk


Our principal market risk relates to changes in the value of the following currencies relative to the U.S. Dollar (USD):
Euro (EUR)
Chinese Yuan Renminbi (CNY), and
British Pound (GBP).


We also have a limited market risk relating to the following currencies (among others):
Hong Kong Dollar (HKD),
Mexican Peso (MXN),
Australian Dollar (AUD),
Canadian Dollar (CAD),
Brazilian Real (BRL),
Swiss Franc (CHF),
Swedish Krona (SEK),
Danish Krone (DKK),
Singapore Dollars (SGD),
South Korean Won (KRW), and
Japanese Yen (JPY).


Our consolidated financial statements are denominated in, and our principal currency is, the U.S. Dollar. For the six-monthnine-month period ended JuneSeptember 30, 2018, a portion of our net sales (approximately $143.4$213.8 million, representing approximately 33.5%32.9% of our aggregate net sales), was attributable to sales that were denominated in foreign currencies. All other international sales were denominated in U.S. Dollars.


Our Euro-denominated revenue represents our largest single currency risk. However, our Euro-denominated expenses associated with our European operations (manufacturing sites, a distribution facility and sales representatives) provide a natural hedge. Accordingly, changes in the Euro, and in particular a strengthening of the U.S. Dollar against the Euro, generally have a positive effect on our operating income. As we continue to expand our operations in China, we have been increasingly exposed to currency risk related to our CNY-denominated revenue. In general, a strengthening of the U.S. Dollar against CNY has a negative effect on our operating income. The following table presents the USD impact to reported operating income related to a hypothetical positive and negative 10% exchange rate fluctuation in the value of the U.S. Dollar relative to both the EUR and CNY (annual amounts):

(in thousands) (in thousands)
USD Relative to Other CurrencyUSD Relative to Other Currency 
10% Strengthening10% Weakening10% Strengthening 10% Weakening 
Impact to Operating Income of: Impact to Operating Income of:
EUR$4,300
$(4,300)EUR$3,400 $(3,400)
CNY$(5,800)$5,800
CNY$(6,200)$6,200 




During the three and sixnine months ended JuneSeptember 30, 2018, exchange rate fluctuations of foreign currencies against the U.S. Dollar had the following impact on sales, cost of sales and gross profit (in thousands, except basis points):

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Three Months Ended Six Months EndedThree Months Ended Nine Months Ended 
June 30, 2018 June 30, 2018September 30, 2018September 30, 2018
Currency Impact to Reported Amounts Currency Impact to Reported AmountsCurrency Impact to Reported Amounts Currency Impact to Reported Amounts 
Increase/(Decrease)Percent Increase/(Decrease) Increase/(Decrease)Percent Increase/(Decrease)Increase/(Decrease) Percent Increase/(Decrease) Increase/(Decrease) Percent Increase/(Decrease) 
Net Sales$3,645
1.6% $8,798
2.1%Net Sales $(1,418)(0.6)% $7,380 1.1%  
Cost of Sales$2,521
2.1% $4,596
2.0%Cost of Sales $(838)0.7%  $5,434 1.5%  
Gross Profit (1)
$1,124
1.1% $4,202
2.3%
Gross Profit (1)
$(2,256)(2.2)% $1,945 0.7%  
(1) Represents approximately 22 basis points decrease and 8 basis points increase in gross margin percentage for the three and six months ended June 30, 2018, respectively
(1) Represents approximately 72 basis points decrease and 21 basis points decrease in gross margin percentage for the three and nine months ended September 30, 2018, respectively. (1) Represents approximately 72 basis points decrease and 21 basis points decrease in gross margin percentage for the three and nine months ended September 30, 2018, respectively.
The impact to sales for the three and six months ended JuneSeptember 30, 2018 was primarily a result of favorableunfavorable impacts due to sales denominated in EUR, CNY and GBP.BRL. The impact to cost of sales was primarily a result of unfavorable impacts from EUR fluctuations related to manufacturing costs from our facilities in Europe denominated in EUR and favorable MXN fluctuations on our manufacturing costs from our facility in Tijuana, Mexico denominated in MXN.


We forecast our net exposure related to sales and expenses denominated in foreign currencies. As of JuneSeptember 30, 2018, we had entered into foreign currency forward contracts, which qualified as cash flow hedges, with the following notional amounts (in thousands and in local currencies):

CurrencySymbolForward Notional Amount
Canadian DollarCAD2,410
2,460 
Swiss FrancCHF1,158
1,215 
Chinese RenminbiCNY66,000
60,000 
Danish KroneDKK11,650
10,835 
EuroEUR12,870
12,270 
British PoundGBP2,975
3,355 
Mexican PesoJapanese Yen MXNJPY 94,275
330,000 
Mexican Peso MXN 93,575 
Swedish KronaSEK13,830
12,780 


We also forecast our net exposure in various receivables and payables to fluctuations in the value of various currencies, and we enter into foreign currency forward contracts to mitigate that exposure. As of JuneSeptember 30, 2018, we had entered into the following foreign currency forward contracts (which were not designated as hedging instruments) related to those balance sheet accounts (amounts in thousands and in local currencies):


CurrencySymbolForward Notional Amount
Australian DollarAUD8,400
11,150 
Brazilian RealBRL8,500
Canadian DollarCAD3,098
Swiss FrancCHF255
Chinese RenminbiCNY95,228
Danish KroneDKK2,885
EuroEUR25,861
British PoundGBP1,584
Hong Kong DollarHKD11,000
Japanese YenJPY260,000
Korean WonKRW2,700,000
Mexican PesoMXN18,700
Swedish KronaSEK10,536
Singapore DollarSGD6,900


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See Note 11 to our condensed consolidated financial statements included in Part I, Item 1 of this Quarterly Report for a discussion of our foreign currency forward contracts.


Interest Rate Risk. As discussed in Note 10 to our condensed consolidated financial statements, as of JuneSeptember 30, 2018, we had outstanding borrowings of approximately $407.0$202.3 million under the Second Amended Credit Agreement, an increasea decrease in long-term debtoutstanding borrowings under the Second Amended Credit Agreement of approximately $132.6$69.8 million from December 31, 2017, which was principally due to applying the proceeds of the July 2018 common stock offering toward our acquisitionoutstanding debt balance in the third quarter of assets from BD, NinePoint and DirectACCESS.2018, partially offset by increased debt levels in the first six months of 2018, primarily to fun acquisitions. Accordingly, our earnings and after-tax cash flow are increasingly affected by changes in interest rates. On August 5, 2016, we entered into a pay-fixed, receive-variable interest rate swap with Wells Fargo, which as of JuneSeptember 30, 2018 had a notional amount of $175 million, to fix the one-month LIBOR rate at 1.12%. The interest rate swap is scheduled to expire on July 6, 2021. This instrument is intended to reduce our exposure to interest rate fluctuations and was not entered into for speculative purposes. Excluding the amount that is subject to a fixed rate under the interest rate swap and assuming the current level of borrowings remained the same, it is estimated that our interest expense and income before income taxes would change by approximately $2.3$0.3 million annually for each one percentage point change in the average interest rate under these borrowings.


In the event of an adverse change in interest rates, our management would likely take actions to mitigate our exposure. However, due to the uncertainty of the actions that would be taken and their possible effects, additional analysis is not possible at this time. Further, such analysis would not consider the effects of the change in the level of overall economic activity that could exist in such an environment.



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ItemITEM 4.CONTROLS AND PROCEDURES
 
Evaluation of Disclosure Controls and Procedures
 
Our management is responsible for establishing and maintaining adequate disclosure controls and procedures for our company. Consequently, our management, with the participation of our chief executive officer and chief financial officer, evaluated the effectiveness of our disclosure controls and procedures pursuant to Rule 13a-15 under the Exchange Act as of JuneSeptember 30, 2018. 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. In addition, the design of disclosure controls and procedures must reflect the fact that there are resource constraints and that management is required to apply its judgment in evaluating the benefits of possible controls and procedures relative to their costs. Based on that evaluation, our chief executive officer and chief financial officer concluded that our disclosure controls and procedures are designed at a reasonable assurance level and are effective to provide reasonable assurance that information we are required to disclose in reports that we file or submit under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in Securities and Exchange Commission 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.


Changes in Internal Control Over Financial Reporting
 
During the quarter ended JuneSeptember 30, 2018, there were no changes in our internal control over financial reporting that materially affected, or are reasonably likely to materially affect, our internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f) under the Securities Exchange Act of 1934).

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PART II - OTHER INFORMATION




ITEM 1. LEGAL PROCEEDINGS
See Note 14 “Commitments and Contingencies” set forth in the notes to our condensed consolidated financial statements included in Part I, Item 1 of this Quarterly Report.


ITEM 1A. RISK FACTORS
In addition to other information set forth in this Report, readers should carefully consider the factors discussed in Part I, Item 1A. "Risk Factors" of the 2017 Form 10-K, as well as the amended and updated risk factors included below (which replace equivalent risk factors disclosed in Part I, Item 1A. "Risk Factors" of the 2017 Form 10-K). Such risk factors could materially affect our business, financial condition or future results.


The risks described in our 2017 Form 10-K and in the amended and updated risk factors below are not the only risks we face. Additional risks and uncertainties not currently known to us or that we currently deem to be immaterial also may materially and adversely affect our business, financial condition and/or operating results.


We may be unable to successfully manage growth, particularly if accomplished through acquisitions, and the integration of acquired businesses may present significant challenges that could harm our operations.


Successful implementation of our business strategy will require that we effectively manage any associated growth. To manage growth effectively, our management will need to continue to implement changes in certain aspects of our business, to improve our information systems, infrastructure and operations to respond to increased demand, to attract and retain qualified personnel, and to develop, train, and manage an increasing number of management-level and other employees. Growth could place an increasing strain on our management, sales and other personnel, and on our financial, product design, marketing, distribution and other resources, and we could experience operating difficulties. Any failure to manage growth effectively could have a material adverse effect on our business, operations or financial condition.


Over the past several years, we have completed a series of significant acquisitions. As we grow through acquisitions and, atAt any given time, we may be considering a number of potential further acquisitions and strategic transactions, certain of which may also be significant. As we grow through acquisitions, we face the additional challenges of integrating the operations, culture, information management systems and other characteristics of the acquired entity with our own. Efforts to integrate future acquisitions may be hampered by delays, the loss of certain employees, suppliers or customers, proceedings resulting from employment terminations, culture clashes, unbudgeted costs, and other issues, which may occur at levels that are more severe or prolonged than anticipated. Additionally, past and future acquisitions may increase the risks of competition we face by, among other things, extending our operations into industry segments and product lines where we have few existing customers or qualified sales personnel and limited expertise. For example, although we acquired certain tunneled home drainage catheter and soft tissue core needle biopsy products from BD in February 2018, BD retained other products that directly compete with the products we acquired. As BD is a larger company with a more well-established market presence in such product lines, we may be unable to realize expected benefits from the acquisition in the timeframe anticipated or at all.


On October 1, 2018, we entered into the Cianna Merger Agreement, pursuant to which we propose to acquire Cianna. Completion of the proposed transaction is subject to customary closing conditions, including, among others, (i) obtaining antitrust approvals in the United States, (ii) subject to certain exceptions, the accuracy of the representations and warranties of the parties, and (iii) material compliance by the parties with their pre-closing obligations under the Cianna Merger Agreement. In addition to risks and uncertainties generally associated with our acquisition strategy, some of which are identified in the preceding paragraphs, the proposed Cianna acquisition presents risks and uncertainties which are unique to that transaction, including the possibility that conditions to the closing of the proposed transaction, including regulatory conditions, will not be satisfied; our potential inability to successfully manage the proposed transaction, integrate the acquired operations and achieve projected financial results, product development and other anticipated benefits of the proposed acquisition; uncertainties as to whether we will achieve sales, gross margin, cost of goods sold, cash flow and other results from the proposed transaction which are consistent with Cianna’s business and operations; unknown costs and risks associated with the business and operations of Cianna; and inherent risks and uncertainties relating to our internal models and projections.

We have incurred, and will likely continue to incur, significant expenses in connection with negotiating and consummating various acquisition and other strategic transactions, and we may inherit significant liabilities in connection with prospective acquisitions or other strategic transactions, including regulatory, infringement, product liability, discrimination or other legal
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claims or issues. In addition, we may not realize competitive advantages, synergies or other benefits anticipated in connection with any such acquisition or other transaction. If we do not adequately identify targets for, or manage issues related to, our future acquisitions and similar transactions, such transactions may have an adverse effect on our business, operations or financial condition.


Use of our products in unapproved circumstances could expose us to liabilities.
   
The marketing clearances and approvals from the FDA and other regulators of certain of our products are, or are expected to be, limited to specific uses. We are prohibited from marketing or promoting any uncleared or unapproved use of our product. However, physicians may use these products in ways or circumstances other than those strictly within the scope of the regulatory approval or clearance. The use of our products for unauthorized purposes could arise from our sales personnel or distributors violating our policies by providing information or recommendations about such unauthorized uses. Consequently, claims may be asserted by the FDA or other enforcement agencies that we are not in compliance with applicable laws or regulations or have improperly

promoted our products for uncleared or unapproved uses. The FDA or such other agencies could require a recall of products or allege that our promotional activities misbrand or adulterate our products or violate other legal requirements, which could result in investigations, prosecutions, fines or other civil or criminal actions.
   
The FDA regulatory clearance process is expensive, time-consuming and uncertain, and the failure to obtain and maintain required regulatory clearances and approvals could prevent us from commercializing our products.
   
Before we can introduce a new device or a new use of or a claim for a cleared device in the United States, we must generally obtain clearance from the FDA through the 510(k) premarket notification process or approval through a PMAPremarket Approval ("PMA") application, unless an exemption from premarket review or an alternative procedure, such as a de novo risk based classification or a humanitarian device exemption, applies. The FDA clearance and approval processes for medical devices are expensive, uncertain and time-consuming.
   
If human clinical trials of a medical device are required for FDA clearance or approval and the device presents a significant risk, the sponsor of the trial must file an IDEInvestigational Device Exemption ("IDE") application with the FDA prior to commencing such trials in the U.S. Submission of an IDE application does not ensure that the IDE will become effective. If the IDE application is approved, there can be no assurance that the FDA will determine that the data derived from the trials support the safety and effectiveness of the device or warrant the continuation of clinical trials. For clinical trials involving a device that does not present a significant risk, the sponsor is not required to obtain FDA approval of an IDE, but the sponsor must obtain the review and approval of an institutional review board. Both significant risk and non-significant risk trials are subject to additional FDA regulations, including a requirement to obtain informed consent, reporting and recordkeeping requirements, and other requirements. We, the FDA, or the institutional review board, may suspend a clinical trial at any time for various reasons, including a belief that the risks to study subjects outweigh the anticipated benefits.
   
Changes to 510(k) cleared or PMA approved devices, including manufacturing changes, product enhancements and product line extensions, may require a new 510(k) clearance or approval of a PMA supplement. For devices marketed under an approved PMA, we must submit a PMA supplement to the FDA for review and approval prior to making a change to the device that affects the safety or effectiveness of the device, including changes to the design, manufacturing or labeling of the device. Likewise, for 510(k)-cleared devices, we must obtain new FDA 510(k) clearance when there is a major change or modification in the intended use, or a change or modification of the device that could significantly affect the safety or effectiveness of the device. In some cases, clinical data may be required to support a PMA supplement or 510(k) premarket notification for a device modification.
   
The FDA requires every manufacturer to make the determination regarding the need for a new 510(k) submission or a PMA supplement in the first instance, but the FDA may review the manufacturer’s decisions not to seek a new 510(k) or PMA supplement. We may make changes to our cleared products without seeking additional clearances or approvals if we determine such clearances or approvals are not necessary and document the basis for that conclusion. However, the FDA may disagree with our determination or may require additional information, including clinical data, to be submitted before a determination is made, in which case we may be required to delay the introduction and marketing of our modified products, redesign our products, conduct clinical trials to support any modifications and pay significant regulatory fines or penalties. In addition, the FDA may not approve or clear our products for the indications that are necessary or desirable for successful commercialization.
   
There is no assurance that we will be able to obtain the necessary regulatory clearances or approvals for any product on a timely basis or at all. Further, the FDA may change its clearance and approval policies, adopt additional regulations or revise existing
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regulations, or take other actions which may prevent or delay approval or clearance of our products under development or impact our ability to modify our currently cleared products on a timely basis. Delays in receipt of, or failure to obtain, regulatory clearances for any product enhancements or new products we develop would result in delayed or no realization of revenue from such product enhancements or new products and in substantial additional costs, which could decrease our profitability.
   
In addition, we are required to continue to comply with applicable FDA and other regulatory requirements once we have obtained clearance or approval for a product. We cannot assure you that we will successfully maintain the clearances or approvals we have received or may receive in the future. The loss of previously received clearances or approvals, or the failure to comply with existing or future regulatory requirements could also have a material adverse effect on our business.
   
Our products may cause or contribute to adverse medical events that we are required to report to the FDA or other governmental authorities, and if we fail to do so, we may be subject to sanctions that may materially harm our business.
   
Our products are subject to medical device reporting regulations, which require us to report to the FDA any information that reasonably suggests one of our products may have caused or contributed to a death or serious injury, or one of our products malfunctioned and, if the malfunction were to recur, this device or a similar device that we market would be likely to cause or

contribute to a death or serious injury. Our obligation to report under the medical device reporting regulations is triggered on the date on which we become aware of information that reasonably suggests a reportable adverse event occurred. We may fail to report adverse events of which we become aware within the prescribed timeframe. We may also fail to recognize that we have become aware of a reportable adverse event, especially if it is not reported to us as an adverse event or if it is an adverse event that is unexpected or if the product characteristic that caused the adverse event is removed in time from our products. If we fail to comply with our medical device reporting obligations, the FDA could issue warning letters or untitled letters, take administrative actions, commence criminal prosecution, impose civil monetary penalties, demand or initiate a product recall, seize our products, or delay the clearance of our future products.
   
We generally offer a limited warranty for the return of product due to defects in quality and workmanship. We attempt to estimate our potential liability for future product returns and establish reserves on our financial statements in amounts that we believe will be sufficient to address our warranty obligations; however, our actual liability for product returns may significantly exceed the amount of our reserves. If we underestimate our potential liability for future product returns, or if unanticipated events result in returns that exceed our historical experience, our financial condition and operating results could be materially harmed.
   
We may be unable to accurately forecast customer demand for our products and manage our inventory.
   
To ensure adequate supply, we must forecast our inventory needs and place orders with our suppliers based on estimates of future demand for particular products. Our ability to accurately forecast demand for our products could be negatively affected by many factors, including our failure to accurately manage our expansion strategy and customer acceptance of new products, product introductions by our competitors, an increase or decrease in customer demand for our products or for products of our competitors, unanticipated changes in general market conditions or regulatory matters and weakening of economic conditions or consumer confidence in future economic conditions. Inventory levels in excess of customer demand may result in inventory write-downs or write-offs, which would impact our gross margin. Conversely, if we underestimate customer demand for our products, our manufacturing facilities may not be able to deliver products to meet our order requirements, which could damage our reputation and customer relationships.
   
Our forecasts of customer demand and related decisions that we make about production levels may not take into account potential opportunities created by regulatory issues, supply disruptions or other challenges experienced by our competitors. We generally do not know the extent and cannot predict the duration of these challenges experienced by our competitors. As a result, our estimates about related increased demand for our products are inherently uncertain and subject to change. If our estimates incorrectly forecast the extent or duration of this increased demand, or the product types to which it relates, our revenues, margins and earnings could be adversely affected.





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ITEM 6. EXHIBITS


The following exhibits required by Item 601 of Regulation S-K are filed herewith or have been filed previously with the SEC as indicated below:
Exhibit No.Description
3.1
3.1 
3.2
10.1
10.231.1 
10.3
31.1
31.2
32.1
32.2
101The following financial information from the quarterly report on Form 10-Q of Merit Medical Systems, Inc. for the quarter ended June 30, 2018, formatted in XBRL (eXtensible Business Reporting Language): (i) Consolidated Statements of Income, (ii) Consolidated Balance Sheets, (iii) Consolidated Statements of Comprehensive Income, (iv) Consolidated Statements of Cash Flows, and (v) Condensed Notes to the Consolidated Financial Statements

(1)101.Def Incorporated by reference from our Current Report on Form 8-K filed on May 31, 2018 (as amended).Definition Linkbase Document 

(2)101.Pre Incorporated by reference from our Form S-8 filed on June 4, 2018.Presentation Linkbase Document 
101.Lab Labels Linkbase Document 
101.Cal Calculation Linkbase Document 
101.Sch Schema Document 
101.Ins Instance Document - the instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document 




1. Incorporated by reference from our Current Report on Form 8-K filed on May 31, 2018 (as amended).

2. Incorporated by reference from our Form S-8 filed on June 4, 2018.


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SIGNATURES
 
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.


MERIT MEDICAL SYSTEMS, INC.
REGISTRANT


Date: AugustNovember 9, 2018By:/s/ FRED P. LAMPROPOULOS
Fred P. Lampropoulos, President and
Chief Executive Officer
Date: AugustNovember 9, 2018By:/s/ RAUL PARRA
Raul Parra
Chief Financial Officer and Treasurer
 



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