Document and Entity Information
Document and Entity Information - USD ($) $ in Millions | 12 Months Ended | ||
Dec. 31, 2018 | Feb. 28, 2019 | Jun. 30, 2018 | |
Document And Entity Information [Abstract] | |||
Document Type | 10-K | ||
Amendment Flag | false | ||
Document Period End Date | Dec. 31, 2018 | ||
Document Fiscal Year Focus | 2,018 | ||
Document Fiscal Period Focus | FY | ||
Trading Symbol | STIM | ||
Entity Registrant Name | NEURONETICS, INC. | ||
Entity Central Index Key | 1,227,636 | ||
Current Fiscal Year End Date | --12-31 | ||
Entity Filer Category | Non-accelerated Filer | ||
Entity Small Business | true | ||
Entity Emerging Growth Company | true | ||
Entity Ex Transition Period | false | ||
Entity Common Stock, Shares Outstanding | 18,054,628 | ||
Entity Shell Company | false | ||
Entity Well-known Seasoned Issuer | No | ||
Entity Voluntary Filers | No | ||
Entity Current Reporting Status | Yes | ||
Entity Public Float | $ 352.4 |
Balance Sheets
Balance Sheets - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 |
Current assets: | ||
Cash and cash equivalents | $ 104,583 | $ 29,147 |
Accounts receivable, net | 5,620 | 4,267 |
Inventory | 2,432 | 2,468 |
Prepaid expenses and other current assets | 1,838 | 1,123 |
Total current assets | 114,473 | 37,005 |
Property and equipment, net | 1,378 | 1,359 |
Other assets | 1,171 | 574 |
Total Assets | 117,022 | 38,938 |
Current liabilities: | ||
Accounts payable | 3,756 | 2,513 |
Accrued expenses | 7,548 | 7,511 |
Deferred revenue | 2,255 | 1,970 |
Total current liabilities | 13,559 | 11,994 |
Long-term debt, net | 30,395 | 29,556 |
Deferred revenue | 1,940 | 2,275 |
Deferred rent | 86 | 151 |
Convertible preferred stock warrant liability | 478 | |
Total Liabilities | 45,980 | 44,454 |
Commitments and contingencies (Note 15) | ||
Convertible preferred stock, $0.01 par value: 308,593 shares previously authorized prior to initial public offering, issuable in series; no and 304,958 shares issued and outstanding at December 31, 2018 and 2017, respectively; no liquidation value at December 31, 2018 | 187,136 | |
Stockholders’ Equity (Deficit): | ||
Preferred stock, $0.01 par value: 10,000 shares authorized; no shares issued or outstanding at December 31, 2018 and 2017, respectively | ||
Common stock, $0.01 par value: 200,000 shares authorized; 17,744 and 231 shares issued and outstanding at December 31, 2018 and 2017, respectively | 177 | 2 |
Additional paid-in capital | 291,908 | 4,292 |
Accumulated deficit | (221,043) | (196,946) |
Total Stockholders' Equity (Deficit) | 71,042 | (192,652) |
Total Liabilities, Convertible Preferred Stock and Stockholders’ Equity (Deficit) | $ 117,022 | $ 38,938 |
Balance Sheets (Parenthetical)
Balance Sheets (Parenthetical) - USD ($) | Dec. 31, 2018 | Dec. 31, 2017 |
Statement Of Financial Position [Abstract] | ||
Convertible preferred stock, par value | $ 0.01 | $ 0.01 |
Convertible preferred stock, authorized | 308,593,000 | 308,593,000 |
Convertible preferred stock, issued | 0 | 304,958,000 |
Convertible preferred stock, outstanding | 0 | 304,958,000 |
Liquidation preference | $ 0 | $ 108,324,000 |
Preferred stock, par value | $ 0.01 | $ 0.01 |
Preferred stock, shares authorized | 10,000,000 | 10,000,000 |
Preferred stock, shares issued | 0 | 0 |
Preferred stock, shares outstanding | 0 | 0 |
Common stock, par value | $ 0.01 | $ 0.01 |
Common stock, shares authorized | 200,000,000 | 200,000,000 |
Common stock, shares issued | 17,744,000 | 231,000 |
Common stock, shares outstanding | 17,744,000 | 231,000 |
Statements of Operations
Statements of Operations - USD ($) shares in Thousands, $ in Thousands | 3 Months Ended | 12 Months Ended | |||||||||
Dec. 31, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Income Statement [Abstract] | |||||||||||
Revenues | $ 15,635 | $ 13,737 | $ 13,252 | $ 10,152 | $ 12,108 | $ 10,491 | $ 10,308 | $ 7,526 | $ 52,776 | $ 40,433 | $ 34,228 |
Cost of revenues | 3,711 | 3,034 | 3,245 | 2,457 | 2,957 | 2,636 | 2,501 | 1,538 | 12,447 | 9,632 | 6,622 |
Gross Profit | 11,924 | 10,703 | 10,007 | 7,695 | 9,151 | 7,855 | 7,807 | 5,988 | 40,329 | 30,801 | 27,606 |
Operating expenses: | |||||||||||
Sales and marketing | 10,648 | 9,672 | 9,835 | 8,109 | 8,628 | 6,566 | 6,400 | 6,306 | 38,264 | 27,900 | 21,794 |
General and administrative | 4,715 | 3,238 | 3,078 | 2,636 | 2,837 | 2,256 | 1,837 | 1,642 | 13,667 | 8,572 | 6,926 |
Research and development | 2,222 | 2,125 | 2,330 | 1,555 | 1,919 | 1,843 | 2,147 | 2,028 | 8,232 | 7,937 | 8,223 |
Total operating expenses | 17,585 | 15,035 | 15,243 | 12,300 | 13,384 | 10,665 | 10,384 | 9,976 | 60,163 | 44,409 | 36,943 |
Loss from Operations | (5,661) | (4,332) | (5,236) | (4,605) | (4,233) | (2,810) | (2,577) | (3,988) | (19,834) | (13,608) | (9,337) |
Other (income) expense: | |||||||||||
Interest expense | 939 | 928 | 900 | 921 | 740 | 807 | 711 | 550 | 3,688 | 2,808 | 1,835 |
Other (income) expense, net | (457) | (299) | 1,360 | (29) | (49) | 136 | (420) | (24) | 575 | (357) | 62 |
Net Loss | $ (6,143) | $ (4,961) | $ (7,496) | $ (5,497) | $ (4,924) | $ (3,753) | $ (2,868) | $ (4,514) | $ (24,097) | $ (16,059) | $ (11,234) |
Net loss per share of common stock outstanding, basic and diluted | $ (0.35) | $ (0.29) | $ (30.60) | $ (24.43) | $ (23.34) | $ (19.35) | $ (16.58) | $ (27.03) | $ (2.69) | $ (86.34) | $ (76.95) |
Weighted-average common shares outstanding, basic and diluted | 17,655 | 17,382 | 245 | 226 | 211 | 194 | 173 | 167 | 8,948 | 186 | 146 |
Statement of Changes in Convert
Statement of Changes in Convertible Preferred Stock and Stockholders' Equity (Deficit) - USD ($) $ in Thousands | Total | Convertible Preferred Stock | Common Stock | Additional Paid-in Capital | Accumulated Deficit |
Beginning balance at Dec. 31, 2015 | $ (166,118) | $ 1 | $ 3,534 | $ (169,653) | |
Beginning balance, shares at Dec. 31, 2015 | 126,000 | ||||
Beginning balance, shares at Dec. 31, 2015 | 264,374,000 | ||||
Beginning balance at Dec. 31, 2015 | $ 172,311 | ||||
Issuance of restricted stock awards | $ 1 | (1) | |||
Issuance of restricted stock awards, shares | 42,000 | ||||
Exercises of stock options | 67 | 67 | |||
Exercises of stock options, shares | 19,000 | ||||
Share-based compensation expense | 161 | 161 | |||
Net loss | (11,234) | (11,234) | |||
Ending balance at Dec. 31, 2016 | (177,124) | $ 2 | 3,761 | (180,887) | |
Ending balance, shares at Dec. 31, 2016 | 187,000 | ||||
Ending balance, shares at Dec. 31, 2016 | 264,374,000 | ||||
Ending balance at Dec. 31, 2016 | $ 172,311 | ||||
Issuance of Series G convertible preferred stock, net of issuance costs | $ 14,825 | ||||
Issuance of restricted stock awards, shares | 11,000 | ||||
Exercises of stock options | 35 | 35 | |||
Exercises of stock options, shares | 33,000 | ||||
Share-based compensation expense | 496 | 496 | |||
Net loss | (16,059) | (16,059) | |||
Ending balance at Dec. 31, 2017 | $ (192,652) | $ 2 | 4,292 | (196,946) | |
Ending balance, shares at Dec. 31, 2017 | 231,000 | ||||
Ending balance, shares at Dec. 31, 2017 | 304,958,000 | 304,958,000 | |||
Ending balance at Dec. 31, 2017 | $ 187,136 | $ 187,136 | |||
Issuance of Series G convertible stock, net of issuance costs of $175, shares | 40,584,000 | ||||
Conversion of convertible preferred stock into common stock | 187,136 | $ (187,136) | $ 109 | 187,027 | |
Conversion of convertible preferred stock into common stock, shares | (304,958,000) | 10,994,000 | |||
Conversion of convertible preferred stock warrants into common stock warrants | 1,874 | 1,874 | |||
Issuance of common stock initial public offering, net of issuance costs of $3,463 | 96,535 | $ 64 | 96,471 | ||
Issuance of common stock initial public offering, net of issuance costs of $3,463, shares | 6,325,000 | ||||
Exercises of stock options | 503 | $ 2 | 501 | ||
Exercises of stock options, shares | 194,000 | ||||
Share-based compensation expense | 1,743 | 1,743 | |||
Net loss | (24,097) | (24,097) | |||
Ending balance at Dec. 31, 2018 | $ 71,042 | $ 177 | $ 291,908 | $ (221,043) | |
Ending balance, shares at Dec. 31, 2018 | 17,744,000 | ||||
Ending balance, shares at Dec. 31, 2018 | 0 |
Statement of Changes in Conve_2
Statement of Changes in Convertible Preferred Stock and Stockholders' Equity (Deficit) (Parenthetical) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2018 | Dec. 31, 2017 | |
Statement Of Stockholders Equity [Abstract] | ||
Issuance of series G convertible preferred stock issuance cost | $ 175 | |
Issuance of common stock in initial public offering, issuance costs | $ 3,463 |
Statements of Cash Flows
Statements of Cash Flows - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Cash Flows from Operating Activities: | |||
Net loss | $ (24,097) | $ (16,059) | $ (11,234) |
Adjustments to reconcile net loss to net cash used in operating activities: | |||
Depreciation and amortization | 882 | 596 | 673 |
Share-based compensation | 1,743 | 496 | 161 |
Non-cash interest expense | 839 | 722 | 391 |
Change in fair value of convertible preferred stock warrant liability | 1,396 | (271) | 108 |
Cost of rental units purchased by customers | 229 | 216 | 15 |
Changes in certain assets and liabilities: | |||
Accounts receivable, net | (1,353) | (690) | (123) |
Inventory | (435) | (1,068) | (646) |
Prepaid expenses and other assets | (237) | (175) | (156) |
Accounts payable | 606 | 788 | 734 |
Accrued expenses | (52) | 1,391 | 1,201 |
Deferred revenue | (49) | 2,915 | 363 |
Deferred rent | (63) | (5) | (28) |
Net Cash Used in Operating Activities | (20,591) | (11,144) | (8,541) |
Cash Flows from Investing Activities: | |||
Purchases of property and equipment and capitalized software | (1,011) | (594) | (324) |
Net Cash Used in Investing Activities | (1,011) | (594) | (324) |
Cash Flows from Financing Activities: | |||
Proceeds from issuance of common stock in initial public offering | 99,998 | ||
Payments of public offering costs | (3,463) | ||
Proceeds from exercises of stock options | 503 | 35 | 67 |
Proceeds from issuance of Series G convertible preferred stock, net | 14,825 | ||
Borrowings under credit facilities | 10,000 | 5,000 | |
Payments of debt issuance costs | (1,015) | (171) | |
Net Cash Provided by Financing Activities | 97,038 | 23,845 | 4,896 |
Net Increase (Decrease) in Cash and Cash Equivalents | 75,436 | 12,107 | (3,969) |
Cash and Cash Equivalents, Beginning of Year | 29,147 | 17,040 | 21,009 |
Cash and Cash Equivalents, End of Year | 104,583 | 29,147 | 17,040 |
Supplemental disclosure of cash flow information: | |||
Cash paid for interest | 2,786 | 2,043 | 1,406 |
Transfer of inventory to property and equipment | 365 | 296 | 531 |
Supplemental disclosure of non-cash investing and financing activities: | |||
Purchases of property and equipment and capitalized software in accounts payable and accrued expenses | 263 | 45 | 16 |
Conversion of convertible preferred stock into common stock | 187,136 | ||
Conversion of convertible preferred stock warrants into common stock warrants | $ 1,874 | ||
Deferred public offering costs included in accounts payable and accrued expenses | 55 | ||
Allocation of proceeds from debt financing to convertible preferred stock warrant liability | $ 290 | $ 135 |
Description of Business
Description of Business | 12 Months Ended |
Dec. 31, 2018 | |
Organization Consolidation And Presentation Of Financial Statements [Abstract] | |
Description of Business | 1. Neuronetics, Inc., or the Company, is a commercial stage medical technology company focused on designing, developing and marketing products that improve the quality of life for patients who suffer from psychiatric disorders. The Company’s first commercial product, the NeuroStar Advanced Therapy System, is a non-invasive and non-systemic office-based treatment that uses transcranial magnetic stimulation, or TMS, to create a pulsed, MRI-strength magnetic field that induces electrical currents designed to stimulate specific areas of the brain associated with mood. The system was cleared in 2008 by the United States Food and Drug Administration, or the FDA, to treat adult patients with major depressive disorder, or MDD, who have failed to achieve satisfactory improvement from prior antidepressant medication in the current episode. The Company intends to continue to pursue development of its NeuroStar Advanced Therapy System for additional indications. Initial Public Offering On July 2, 2018, the Company closed its initial public offering, or IPO, in which the Company issued and sold 6.325 million shares of its common stock, which included shares sold pursuant to an option granted to the underwriters to purchase additional shares, at a public offering price of $17.00 per share. The Company received net proceeds of $96.5 million after deducting underwriting discounts, commissions and other offering expenses paid by the Company. The Company’s common stock is listed on the Nasdaq Global Market under the trading symbol “STIM.” In addition, immediately prior to the closing of the IPO on July 2, 2018, (i) all of the Company’s outstanding shares of convertible preferred stock converted into an aggregate 11.0 million shares of common stock; (ii) all of the Company’s outstanding warrants to purchase convertible preferred stock converted into warrants to purchase common stock; and (iii) the Company filed an amended and restated certificate of incorporation to, among other things, decrease the number of shares of common stock, $0.01 par value per share, authorized for issuance to 200.0 million and to authorize the board of directors to issue up to 10.0 million shares of “blank check” preferred stock, $0.01 par value per share. Liquidity As of December 31, 2018, the Company had cash and cash equivalents of $104.6 million and an accumulated deficit of $221.0 million. The Company incurred negative cash flows from operating activities of $20.6 million, $11.1 million and $8.5 million for the years ended December 31, 2018, 2017 and 2016, respectively. The Company has incurred operating losses since its inception, and management anticipates that its operating losses will continue in the near term as the Company seeks to expand its sales and marketing initiatives to support its growth into existing and new markets and invest in additional research and development activities. The Company’s primary sources of capital to date have been from its IPO, private placements of its convertible preferred securities, borrowings under its credit facilities and revenues from sales of its products. As of December 31, 2018, the Company had $30.0 million of borrowings outstanding under its credit facility, which matures in March 2022. Management believes that the Company’s cash and cash equivalents as of December 31, 2018 and anticipated revenues from sales of its products are sufficient to fund the Company’s operations for at least the next 24 months after December 31, 2018. |
Basis of Presentation
Basis of Presentation | 12 Months Ended |
Dec. 31, 2018 | |
Accounting Policies [Abstract] | |
Basis of Presentation | 2. The accompanying financial statements have been prepared in accordance with United States generally accepted accounting principles, or GAAP. Any reference in these notes to applicable guidance is meant to refer to GAAP as found in the Accounting Standards Codification, or ASC, and Accounting Standards Updates, or ASUs, promulgated by the Financial Accounting Standards Board, or FASB. Use of Estimates The preparation of financial statements in accordance with GAAP and the rules and regulations of the United States Securities and Exchange Commission, or SEC, requires the use of estimates and assumptions, based on judgments considered reasonable, which affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. The Company bases its estimates and assumptions on historical experience, known trends and events and various other factors that management believes to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Although management believes its estimates and assumptions are reasonable when made, they are based upon information available at the time they are made. Management evaluates the estimates and assumptions on an ongoing basis and, if necessary, makes adjustments. Due to the risks and uncertainties involved in the Company’s business and evolving market conditions and given the subjective element of the estimates and assumptions made, actual results may differ from estimated results. The most significant estimates and judgments impact share-based compensation and the valuation of common stock prior to the IPO. Recapitalization The Company effected a 0.0345-for-1 reverse split of its common stock on June 14, 2018. The reverse split combined each approximately 29 shares of the Company’s issued and outstanding common stock into one share of common stock and correspondingly adjusted the conversion price of its outstanding convertible preferred stock. No fractional shares were issued in connection with the reverse split. Any fractional share resulting from the reverse split was rounded down to the nearest whole share, and in lieu of any fractional share, the Company paid in cash to the holders of such fractional shares an amount equal to the fair market value, as determined by the board of directors, of such fractional shares. All share, per share and related information presented in these financial statements and the related notes thereto have been retroactively adjusted, where applicable, to reflect the reverse stock split. |
Summary of Significant Accounti
Summary of Significant Accounting Policies | 12 Months Ended |
Dec. 31, 2018 | |
Accounting Policies [Abstract] | |
Summary of Significant Accounting Policies | 3. Cash and Cash Equivalents The Company considers all highly liquid investments purchased with an original maturity of three months or less to be cash equivalents. As of December 31, 2018 and 2017, cash equivalents consisted of money market funds. Concentrations of Credit Risk The Company’s cash is held on deposit in demand accounts at a large financial institution in amounts in excess of the Federal Deposit Insurance Corporation, or FDIC, insurance coverage limit of $250,000 per depositor, per FDIC-insured bank, per ownership category. Management has reviewed the financial statements of this institution and believes it has sufficient assets and liquidity to conduct its operations in the ordinary course of business with little or no credit risk to the Company. Financial instruments that potentially subject the Company to concentrations of credit risk principally consist of cash equivalents and accounts receivable. The Company limits its credit risk associated with cash equivalents by placing investments in highly-rated money market funds. The Company limits its credit risk with respect to accounts receivable by performing credit evaluations when deemed necessary, but it does not require collateral to secure amounts owed by its customers. Allowance for Doubtful Accounts The Company maintains allowances for doubtful accounts for estimated losses resulting from amounts deemed to be uncollectible from its customers. These allowances are for specific amounts on certain customer accounts based on facts and circumstances determined on a case-by-case basis. Inventory Inventory is stated at the lower of cost and net realizable value, with cost being determined on a first in, first out basis. The Company’s inventory is primarily comprised of finished goods. Property and Equipment and Capitalized Software Property and equipment are recorded at cost. Maintenance and repairs are charged to expense as incurred and costs of improvements and renewals are capitalized. Depreciation and amortization are recognized using the straight-line method based on the estimated useful lives of the related assets. The Company uses an estimated useful life of three years for computers and software, five years for laboratory and office equipment, six years for devices in the rental agreement program and the lesser of five years or the remaining life of the underlying facility lease for leasehold improvements. Software development costs relating to assets to be sold in the normal course of business are included in research and development and are expensed as incurred until technological feasibility is established. After technological feasibility is established, material software development costs are capitalized. The Company uses an estimated useful life of two years for capitalized software and amortizes these costs beginning at the product release. Impairment of Long-Lived Assets Long-lived assets, such as property and equipment, are tested for impairment when events or changes in circumstances indicate that the carrying value of the asset may not be recoverable. Impairment testing requires management to estimate the future net undiscounted cash flows of an asset using assumptions believed to be reasonable. Actual cash flows may differ from the estimates used in the impairment testing. If such assets are considered to be impaired, the Company recognizes an impairment loss when and to the extent that the estimated fair value of an asset is less than its carrying value. The Company has not recorded any impairment of its long-lived assets for the years ended December 31, 2018, 2017, and 2016. Warrant Liability The Company’s current and previous credit facilities required the Company to issue to the lender of warrants to purchase the Company’s convertible preferred stock at the date of borrowing. Because the convertible preferred stock warrants were a form of a contingently redeemable instrument, they were classified as liabilities on the Company’s balance sheet. At the date of borrowing, the Company bifurcated the estimated fair value of the convertible preferred stock warrants from the proceeds from borrowing, resulting in the recognition of a debt discount, and recorded a warrant liability on its balance sheet. This warrant liability was revalued at each reporting period, with changes in fair value recorded in the Company’s statement of operations as a component of other income or expense. The valuation of the warrant liability was based upon estimates of the fair value of the underlying convertible preferred stock and the related volatility and expected term for an illiquid instrument, which could vary significantly from period to period. Immediately prior to the closing of the IPO on July 2, 2018, all of the Company’s outstanding convertible preferred stock warrants converted into common stock warrants. The warrant liability was remeasured at its estimated fair value and reclassified to additional paid-in capital on the Company’s balance sheet. Deferred Debt Issuance Costs The Company capitalizes direct costs incurred to obtain debt financing and amortizes these costs to interest expense over the term of the debt using the effective interest method. These costs are recorded as a debt discount are netted against the related debt on the Company’s balance sheet. Revenue Recognition Revenue is recognized when title and risk of ownership has been transferred, provided that persuasive evidence of an arrangement exists, the price is fixed and determinable and collectability is reasonably assured. Transfer of title and risk of ownership occurs when the product is shipped or transferred to the customer. The Company sells to end users in the United States and to third-party distributors outside the United States and does not provide return rights. Sales to distributors outside the United States are in U.S. dollars. The Company generates revenues from sales of NeuroStar Advanced Therapy Systems and treatment sessions. NeuroStar Advanced Therapy System revenue consists primarily of a capital component, including updates to the equipment, attributable to the initial sale of the NeuroStar system unit. NeuroStar Advanced Therapy Systems can be purchased outright or on a rent-to-own basis by certain customers. Treatment session revenue primarily includes sales of NeuroStar treatment sessions and SenStar treatment links. The NeuroStar treatment sessions are access codes delivered electronically in the United States. The SenStar treatment links are disposable units containing single-use access codes that are sold and used outside the United States. Access codes are purchased separately by customers, primarily on an as-needed basis, and are required by the NeuroStar Advanced Therapy System in order to deliver the treatment sessions. The Company’s NeuroStar Advanced Therapy System sales in the United States typically have a post-sale training obligation. This obligation is fulfilled after product shipment, and the Company defers recognizing revenue until training occurs. In accordance with the accounting guidance related to multiple element arrangements, the Company defers the fair value attributable to the post-shipment training and recognizes such revenue when the obligation is fulfilled. The Company bases the fair value of the training using stand-alone service rates. The Company’s sales to its third-party distributors outside the United States do not have these post-sale obligations. The Company’s treatment sessions have no post-sale obligations and no return rights. Revenues on the sales of treatment sessions are recognized upon delivery. Revenue related to operating leases for the Company’s NeuroStar Advanced Therapy System is recognized over the term of the lease. Revenue attributable to the NeuroStar Advanced Therapy Systems purchased on a rent-to-own basis are accounted for as operating leases and revenue is recognized on a straight-line basis over the term of the lease. The Company provides a one to two-year warranty for systems sold in the United States. Terms of product warranty differ amongst its third-party distributors outside the United States but are generally three years or less. The Company provides for the estimated cost to repair or replace products under any warranty at the time of sale. The Company also offers its customers in the United States annual service contracts. Revenue from the sale of annual service contracts is recognized on a straight-line basis over the period of the applicable contract. The Company also earns revenue from customers from services outside of their warranty term or annual service contracts. Such service revenue is recognized as the services are provided. Research and Development Expenses Research and development activities are expensed as incurred. Costs incurred in obtaining technology licenses are charged immediately to research and development expense if the technology licensed has not reached technological feasibility and has no alternative future uses. Share-based Compensation The Company recognizes the grant-date fair value of share-based awards issued as compensation as expense on a straight-line basis over the requisite service period, which is generally the vesting period of the award. To date, the Company has not issued awards where vesting is subject to market conditions. There was one performance grant in 2018 to the board of directors subject to completion of the IPO, which was achieved in July 2018. The fair value of restricted stock awards and restricted stock units is estimated at the time of grant, based on the grant date fair value of the Company’s common stock. The fair value of stock options is estimated at the time of grant using the Black-Scholes option pricing model, which requires the use of inputs and assumptions such as the fair value of the underlying common stock, exercise price of the option, expected term, risk-free interest rate, expected volatility and dividend yield, the most critical of which is the fair value of the Company’s common stock prior to the IPO. The fair value of each grant of stock options awarded during the years ended December 31, 2018, 2017 and 2016 was determined using the following methods and assumptions: • Fair Value of Common Stock. Valuation of Privately-Held-Company Equity Securities Issued as Compensation • Expected Term. • Risk-free Interest Rate. • Expected Volatility. • Dividend Yield. The inputs and assumptions used to estimate the fair value of share-based payment awards represent management’s best estimates and involve inherent uncertainties and the application of management’s judgment. As a result, if factors change and management uses different inputs and assumptions, the Company’s share-based compensation expense could be materially different for future awards. Income Taxes Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in operations in the period that includes the enactment date. A valuation allowance is recorded to the extent it is more likely than not that some portion or all of the deferred tax assets will not be realized. Unrecognized income tax benefits represent income tax positions taken on income tax returns that have not been recognized in the financial statements. The Company recognizes the benefit of an income tax position only if it is more likely than not (greater than 50%) that the tax position will be sustained upon tax examination, based solely on the technical merits of the tax position. Otherwise, no benefit is recognized. The tax benefits recognized are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. The Company accrues interest and related penalties are classified as income tax expense in the statements of operations. The Company does not anticipate significant changes in the amount of unrecognized income tax benefits over the next year. As of December 31, 2018 and 2017, the Company had deferred tax assets of $53.8 million and $47.3 million, respectively; these deferred tax assets are primarily attributable to federal and state net operating loss carryforwards. Although the loss carryforwards are available to offset future taxable income, they will begin to expire in 2020 for state and 2023 for federal. In addition, prior ownership changes may create a limitation in the Company’s ability to use the net operating loss carryforwards for federal and state income tax purposes. These loss carryforwards have been fully offset by a valuation allowance because management does not consider realization of these deferred tax assets to be more likely than not. Corporate tax reform was enacted on December 22, 2017 and is effective for the Company for year ended December 31, 2017. The provisions of the corporate tax reform did not have any impact to the Company due to the full valuation allowance position. As a result of the reduced corporate rate, the Company’s deferred tax assets were revalued from 34% to 21%, which was fully offset by a reduction in the valuation allowance. In connection with the corporate tax reform, the Medical Device Tax was suspended for another two years. |
Recent Accounting Pronouncement
Recent Accounting Pronouncements | 12 Months Ended |
Dec. 31, 2018 | |
New Accounting Pronouncements And Changes In Accounting Principles [Abstract] | |
Recent Accounting Pronouncements | 4. JOBS Act Accounting Election The Company is an emerging growth company, as defined in the Jumpstart Our Business Startups Act of 2012, or the JOBS Act. Under the JOBS Act, emerging growth companies can delay adopting new or revised accounting standards issued subsequent to the enactment of the JOBS Act until such time as those standards apply to private companies. The Company has elected to use this extended transition period for complying with new or revised accounting standards that have different effective dates for public and private companies until the earlier of the date that it (i) is no longer an emerging growth company or (ii) affirmatively and irrevocably opts out of the extended transition period provided in the JOBS Act. As a result, these financial statements may not be comparable to companies that comply with the new or revised accounting pronouncements as of public company effective dates. In May 2014, the FASB issued ASU 2014-09, “ Revenue from Contracts with Customers (Topic 606) Revenue from Contracts with Customers (Topic 606): Deferral of the Effective Date In April 2016 and May 2016, the FASB issued ASU 2016-10, “ Revenue from Contracts with Customers (Topic 606): Identifying Performance Obligations and Licensing Revenue from Contracts with Customers (Topic 606): Narrow-Scope Improvements and Practical Expedients The new revenue standard provides a single comprehensive model for accounting for revenue from contracts with customers. The model requires that revenue recognized reflects the actual consideration to which the entity expects to be entitled in exchange for the goods or services defined in the contract, including in situations with multiple performance obligations. In addition, the standard requires quantitative and qualitative disclosures of the nature, amount, timing, and uncertainty of revenue and cash flows arising from contracts with customers, as well as any judgements related to the standard. The new revenue standard is principles-based and interpretation of those principles may vary from company to company based on their unique circumstances. It is possible that interpretation, industry practice, and guidance may evolve as companies and the accounting profession work to implement this new standard. The Company will continue to monitor industry activities and any additional guidance provided by regulators, standards setters, or the accounting profession. The Company has also implemented internal controls and processes to enable the preparation of financial information and has reached conclusions on key accounting assessments related to the standard. The new standard can be adopted using one of two methods: the full retrospective method, which requires the standard to be applied to each prior period presented, or the modified retrospective method, which requires the cumulative effect of adoption to be recognized as an adjustment to opening retained earnings in the period of adoption. The Company adopted the standard on January 1, 2019, using the modified retrospective approach and applying the completed contracts practical expedient, with the cumulative effect of adoption recorded within retained earnings on January 1, 2019. However, the Company concluded that all sales prior to January 1, 2019 are completed contracts, as all or substantially all the revenue related to these sales has been recognized as of that date. Therefore, there was no cumulative effect of adoption recorded within retained earnings on January 1, 2019. The Company determined that the new guidance will not have a material impact on its revenue recognition practices for NeuroStar Advance Therapy Systems and Treatment Sessions. However, the standard changes the Company’s accounting treatment for incremental costs to obtain a contract, including sales commissions. The incremental costs of obtaining a contract are those that an entity incurs to obtain a contract with a customer that it would not have incurred if the contract had not been obtained. Historically, the Company expensed incremental costs to obtain a contract as incurred, including the sales commissions paid for NeuroStar Advance Therapy Systems and Treatment Sessions. Under Topic 606, the Company will capitalize a portion of the sales commissions paid on NeuroStar Advanced Therapy Systems sold after January 1, 2019 and amortize the expense on a straight-line basis over a seven-year period, which is consistent with the transfer of specific anticipated Treatment Session contracts to customers. Additionally, the standard changes the Company’s accounting treatment for milestone payments, specifically related to a future contingent milestone payment in the Company’s distribution agreement with Teijin Pharma Limited, or Teijin. Teijin is required to pay the Company a milestone payment tied to Japanese Ministry of Health, Labour and Welfare, or JMHLW, issuing reimbursement for use of its products for the treatment of MDD in Japan. The initial reimbursement amount received from JMHLW is subject to a revision period based the completion of post marketing surveillance studies, which in turn would cause a revision in the milestone payment. The Company estimated the revenue likely to be earned, subject to the constraint that the amount recorded is not probable of a significant revenue reversal, by probability weighting likely reimbursement outcomes and the related milestone payment amounts. As a result of this analysis, the Company concluded that the new guidance will not have an impact on the Company’s revenue as of the adoption date. In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842), with guidance regarding the accounting for and disclosure of leases. The update requires lessees to recognize all leases, including operating leases, with a term greater than 12 months on the balance sheet. This update also requires lessees and lessors to disclose key information about their leasing transactions. This guidance will be effective for public companies for annual and interim periods beginning after December 15, 2018. For all other entities, including emerging growth companies, this standard will be effective for annual reporting periods beginning after December 15, 2019, and interim periods within annual periods beginning after December 15, 2020. Early adoption is permitted. As a lessee, leases will be classified as either finance or operating, with classification affecting the pattern of expense recognition in the income statement. As a lessor, leases will be classified as either direct financing, sales-type, or operating, with classification affecting the pattern of revenue recognition and related expense, in the income statement. Additionally, the new standard requires quantitative and qualitative disclosures of amount, timing, and judgments related to the accounting for leases and the related cash flows. The leases standard is required to be applied to leases in existence as of the date of initial application using a modified retrospective transition approach; a full retrospective transition approach is not permitted. The Company adopted the standard on January 1, 2019, using the effective date modified retrospective method transition. Under this adoption method, comparative periods are presented in accordance with Topic 840 and do not include any retrospective adjustments to reflect the adoption of Topic 842. The Company elected the package of practical expedients permitted under the transition guidance within the new standard, which among other things, allows the Company to carryforward the historical lease classification. The Company made an accounting policy election to keep leases with an initial term of 12 months or less off the balance sheet. The Company will recognize those lease payments in the Statements of Operations on a straight-line basis over the lease term. The Company made an accounting policy election to present all funds collected from lessees for sales and other similar taxes net of the related sales tax expense. As a lessee, the Company will recognize additional right of use assets and lease liabilities of approximately $1.0 million as of January 1, 2019. The right of use asset and lease liabilities primarily relate to the Company’s current non-cancelable office lease with an expiration date in 2021. Certain costumers have purchased NeuroStar Advanced Therapy Systems on a rent-to-own basis. Prior to adoption of Topic 842, revenue attributable to the NeuroStar Advanced Therapy Systems purchased on a rent-to-own basis were accounted for as operating leases and revenue is recognized on a straight-line basis over the term of the lease. Given the package of practical expedients elected, the Company will continue this revenue recognition for NeuroStar Advanced Therapy Systems sold on a rent-to-own basis as of December 31, 2018. By granting a customer the right to use a NeuroStar Advanced Therapy System, the Company is performing a revenue generating activity and the revenue recognition should be consistent with the framework in Topic 606. Due to developing customer purchase history, the Company has recently determined customers who purchase NeuroStar Advanced Therapy Systems on a rent-to-own basis are now reasonably certain to exercise the purchase option at the end of the lease. Therefore, NeuroStar Advanced Therapy Systems purchased on a rent-to-own basis will be accounted for as sales-type leases. As a sales-type lease classification under Topic 842, selling profit or loss will be recognized at lease commencement and the underlying NeuroStar Advance Therapy System will be derecognized. The Company will record a corresponding lease receivable equal to the present value of the future lease payments, adjusted prospectively by interest income and payments. As of January 1, 2019, there was no impact on the Company’s financial statements related to the NeuroStar Advanced Therapy Systems purchased on a rent-to-own basis. In June 2018, the FASB issued ASU 2018-07, Compensation—Stock Compensation (Topic 718): “ Improvements to Nonemployee Share-Based Payment Accounting |
Fair Value Measurement and Fina
Fair Value Measurement and Financial Instruments | 12 Months Ended |
Dec. 31, 2018 | |
Fair Value Disclosures [Abstract] | |
Fair Value Measurement and Financial Instruments | 5. The carrying values of cash equivalents, accounts receivable, prepaids and other current assets, and accounts payable on the Company’s balance sheets approximated their fair values as of December 31, 2018 and 2017 due to their short-term nature. The carrying values of the Company’s current credit facility approximated its fair value as of December 31, 2018 and 2017 due to its variable interest rate. Certain of the Company’s financial instruments are measured at fair value using a three-level hierarchy that prioritizes the inputs used to measure fair value. This hierarchy maximizes the use of observable inputs and minimizes the use of unobservable inputs. The three levels of inputs used to measure fair value are as follows: Level 1 Inputs are quoted prices for identical instruments in active markets. Level 2 Inputs are quoted prices for similar instruments in active markets; quoted prices for identical or similar instruments in markets that are not active; or model-derived valuations whose inputs are observable or whose significant value drivers are observable. Level 3 Inputs are unobservable and reflect the Company’s own assumptions, based on the best information available, including the Company’s own data. The following tables set forth the carrying amounts and fair values of the Company’s financial instruments as of December 31, 2018 and 2017 (in thousands): December 31, 2018 Fair Value Measurement Based on Carrying Amount Fair Value Quoted Prices In Active Markets (Level 1) Significant other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Assets Money market funds (cash equivalents) $ 87,062 $ 87,062 $ 87,062 $ - $ - December 31, 2017 Fair Value Measurement Based on Carrying Amount Fair Value Quoted Prices In Active Markets (Level 1) Significant other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Assets Money market funds (cash equivalents) $ 11,149 $ 11,149 $ 11,149 $ - $ - Liabilities Convertible preferred stock warrant liability $ 478 $ 478 $ - $ - $ 478 The fair value of the convertible preferred stock warrant liability was estimated using the Black-Scholes option pricing model and the following inputs and assumptions as of December 31, 2017: December 31, 2017 Series E Series F Estimated fair value of convertible preferred stock $ 9.57 $ 11.01 Exercise price $ 19.55 $ 9.73 Remaining term (in years) 5.0 3.1 - 7.0 Risk-free interest rate 2 % 2.0% - 2.3% Expected volatility 43 % 43% - 44% Dividend yield 0 % 0 % The following table presents the changes in Level 3 instruments measured on a recurring basis for the years ended December 31, 2018 and 2017 (in thousands): Balance at December 31, 2016 $ 459 Issuance of warrants 290 Change in fair value (271 ) Balance at December 31, 2017 478 Change in fair value 1,396 Reclassification to additional paid in capital (1,874 ) Balance at December 31, 2018 $ - |
Accounts Receivable
Accounts Receivable | 12 Months Ended |
Dec. 31, 2018 | |
Receivables [Abstract] | |
Accounts Receivable | 6. The following table presents the composition of accounts receivable, net as of December 31, 2018 and 2017 (in thousands): December 31, 2018 2017 Gross accounts receivable - trade $ 6,120 $ 4,684 Less: Allowances for doubtful accounts (500 ) (417 ) Accounts receivable, net $ 5,620 $ 4,267 Bad debt expense was $0.2 million, $0.1 million and $0.1 million for the years ended December 31, 2018, 2017 and 2016, respectively. The following table presents a rollforward of the allowance for doubtful accounts (in thousands): Balance at Beginning Period Bad Debt Expense Recognized Write-offs of Uncollectible Balances Balance at End of Period Year ended December 31, 2016 $ (274 ) (75 ) 6 $ (343 ) Year ended December 31, 2017 $ (343 ) (116 ) 42 $ (417 ) Year ended December 31, 2018 $ (417 ) (153 ) 70 $ (500 ) |
Property and Equipment and Capi
Property and Equipment and Capitalized Software | 12 Months Ended |
Dec. 31, 2018 | |
Property Plant And Equipment [Abstract] | |
Property and Equipment and Capitalized Software | 7. The following table presents the composition of property and equipment, net as of December 31, 2018 and 2017 (in thousands): December 31, 2018 2017 Laboratory equipment $ 150 $ 150 Office equipment 487 487 Computer equipment and software 1,050 680 Manufacturing equipment 273 273 Leasehold improvements 172 153 Rental equipment 1,262 1,447 Property and equipment, gross 3,394 3,190 Less: Accumulated depreciation (2,016 ) (1,831 ) Property and equipment, net $ 1,378 $ 1,359 As of December 31, 2018 and 2017, the Company had capitalized software costs, net of $1.0 million and $0.4 million, respectively, which are included in “Other assets” on the balance sheet. Depreciation and amortization expense was $0.9 million, $0.6 million and $0.7 million for the years ended December 31, 2018, 2017 and 2016, respectively. |
Accrued Expenses
Accrued Expenses | 12 Months Ended |
Dec. 31, 2018 | |
Payables And Accruals [Abstract] | |
Accrued expenses | 8. The following table presents the composition of accrued expenses as of December 31, 2018 and 2017 (in thousands): December 31, 2018 2017 Compensation and related benefits $ 4,909 $ 4,465 Consulting and professional fees 342 461 Research and development expenses 191 497 Sales and marketing expenses 127 620 Warranty 629 570 Sales tax payable 606 322 Interest payable 251 188 Other 493 388 Accrued expenses $ 7,548 $ 7,511 |
Debt
Debt | 12 Months Ended |
Dec. 31, 2018 | |
Debt Disclosure [Abstract] | |
Debt | 9. The following table presents the composition of debt as of December 31, 2018 and 2017 (in thousands): December 31, 2018 2017 Outstanding principal $ 30,000 $ 30,000 Accrued final payment fees 1,468 940 Less debt discounts (1,073 ) (1,384 ) Total long-term debt, net 30,395 29,556 Less current portion of long-term debt - - Long-term debt, net $ 30,395 $ 29,556 For the year ended December 31, 2018, the Company recognized interest expense of $3.7 million, of which $2.9 million was cash and $0.8 million was non-cash interest expense related to the amortization of deferred debt issuance costs and accrual of final payment fees. For the year ended December 31, 2017, the Company recognized interest expense of $2.8 million, of which $2.1 million was cash and $0.7 million was non-cash interest expense related to the amortization of deferred debt issuance costs and accrual of final payment fees. For the year ended December 31, 2016, the Company recognized interest expense of $1.8 million, of which $1.4 million was cash and $0.4 million was non-cash interest expense related to the amortization of deferred debt issuance costs and accrual of final payment fees. Current Credit Facility In March 2017, the Company entered into a new loan and security agreement with Oxford Finance LLC, or Oxford, for a credit facility that replaced its previous $25.0 million credit facility with Oxford and which allowed it to borrow up to $35.0 million in three tranches of term loans: a Term A Loan in the amount of $25.0 million, which was drawn down immediately upon closing in March 2017, a Term B Loan in the amount of $5.0 million, which was drawn down in December 2017, and a Term C Loan in the amount of $5.0 million, which became available to the Company upon the achievement of $45.0 million of trailing twelve month revenues during the second quarter of 2018. Upon achieving the required revenue milestone, the Company had 60 days to notify Oxford if it elected to borrow the Term C Loan. As a result of completing its IPO on July 2, 2018 and receiving the net proceeds therefrom, the Company elected not to borrow the additional $5.0 million, and it is no longer available to the Company. Each term loan accrues interest from the date of borrowing through the date of repayment at a floating per annum rate of interest, which resets monthly and is equal to the greater of (a) 8.15% or (b) the 30-day U.S. LIBOR on the last business day of the month plus 7.38%. The Company was also required to issue to Oxford at the date of each borrowing warrants to purchase its Series F or later series of convertible preferred stock with a seven-year term and in an amount equal to 3.95% of the first $5.0 million of each tranche borrowed. The credit facility matures and all amounts borrowed thereunder are due on March 1, 2022. As of December 31, 2018, the Company had borrowed and had outstanding an aggregate of $30.0 million of principal under the credit facility. The Term A Loan featured an interest-only period through March 2019, during which time the Company was required to make monthly interest payments, after which time the Company was required to make monthly payments of principal and interest based on a 36-month amortization schedule. However, due to the achievement of $45.0 million of revenues during the fourth quarter of 2018, the interest-only period was extended for an additional 12 months through March 2020, after which time the Company will be required to make monthly payments of principal and interest based on a 24-month amortization schedule. In connection with the drawdown of the Term A Loan, the Company issued to Oxford a warrant to purchase shares of its Series F convertible preferred stock. On July 2, 2018, this convertible preferred stock warrant converted into a warrant to purchase 20,303 shares of the Company’s common stock at an exercise price of $9.73 per share. The warrant will expire in March 2024. The Term B Loan featured an interest-only period through March 2019, during which time the Company was required to make monthly interest payments, after which time the Company was required to make monthly payments of principal and interest based on a 36-month amortization schedule. However, due to the achievement of $45.0 million of revenues during the fourth quarter of 2018, the interest-only period was extended for an additional 12 months through March 2020, after which time the Company will be required to make monthly payments of principal and interest based on a 24-month amortization schedule. In connection with the drawdown of the Term B Loan, the Company issued to Oxford a warrant to purchase shares of its Series F convertible preferred stock. On July 2, 2018, this convertible preferred stock warrant converted into a warrant to purchase 20,303 shares of the Company’s common stock at an exercise price of $9.73 per share. The warrant will expire in December 2024. In addition to principal and interest payments due under the credit facility, the Company is required to make final payment fees to Oxford due upon the earlier of prepayment or maturity of each tranche, which increased as a result the extension of the interest-only period and are now equal to 8.5% and 7.5% of the principal amounts of the Term A and Term B Loans, respectively. The Company accrues the estimated final payment fees using the effective interest rate, with a charge to non-cash interest expense, over the term of borrowing for each tranche. As of December 31, 2018, the effective interest rates for the Term A and Term B Loans were 11.87% and 12.14%, respectively. As of December 31, 2017, the effective interest rates for the Term A and Term B Loans were 10.7% and 11.6%, respectively. If the Company prepays its term loans prior to their respective scheduled maturities, it will also be required to make prepayment fees to Oxford equal to 3% if prepaid on or before the first anniversary of funding, 2% if prepaid after the first and on or before the second anniversary of funding, or 1% if prepaid after the second anniversary of funding of the principal amounts borrowed. The Company’s obligations under the credit facility are secured by a first priority security interest in substantially all of its assets, other than its intellectual property. The Company has agreed not to pledge or otherwise encumber any of its intellectual property. The loan and security agreement related to the credit facility includes a financial maintenance covenant that requires the Company to achieve at least 75% of its trailing 12-month forecasted revenues, as measured each month in accordance with a forecast that the Company provided to Oxford upon signing the agreement and future forecasts that the Company is required to deliver to Oxford each year for the life of the credit facility, as well as customary affirmative and negative covenants. The Company was in compliance with all of the covenants under its credit facility as of December 31, 2018. The loan and security agreement related to the credit facility contains events of default, including, without limitation, events of default upon: (i) failure to make payment pursuant to the terms of the agreement; (ii) violation of covenants; (iii) material adverse changes to the Company’s business; (iv) attachment or levy on the Company’s assets or judicial restraint on its business; (v) insolvency; (vi) significant judgments, orders or decrees for payments by the Company not covered by insurance; (vii) incorrectness of representations and warranties; (viii) incurrence of subordinated debt; (ix) revocation of governmental approvals necessary for the Company to conduct its business; and (x) failure by the Company to maintain a valid and perfected lien on the collateral securing the borrowing. Based on a 24-month amortization of the outstanding principal amounts of the Term A and Term B Loans beginning on April 1, 2020 as discussed above, the following table sets forth by year the Company’s required future principal payments (in thousands): Year: Principal Payments 2019 $ - 2020 11,250 2021 15,000 2022 3,750 Total principal payments $ 30,000 Previous $25.0 Million Credit Facility Prior to March 2017, the Company had a $25.0 million credit facility in place with Oxford, which it entered into in February 2014 and which allowed it to borrow up to $25.0 million in three tranches of term loans: a Term A Loan in the amount of $15.0 million, a Term B Loan in the amount of $5.0 million and a Term C Loan in the amount of $5.0 million, which was never drawn down. Each term loan accrued interest at per annum rates ranging from 8.5% to 8.9%. This facility featured an interest-only period on all tranches through March 2017, and the Company was also required to issue convertible preferred stock warrants to Oxford at the time of borrowing of each tranche. These convertible preferred stock warrants converted into common stock warrants immediately prior to the closing of the Company’s IPO on July 2, 2018. In addition to principal and interest payments due under the previous $25.0 million credit facility, the Company was required to make final payment fees to Oxford upon the earlier of prepayment or maturity and equal to 8.5% and 4.7% of the principal amounts of the Term A and Term B Loans, respectively. The Company accrued final payment fees using the effective interest rate, with a charge to non-cash interest expense, over the term of borrowing and until its entry into the current credit facility in March 2017, at which time the Company paid Oxford $1.0 million in satisfaction of all final payment fee liabilities due under the prior credit facility. Management evaluated whether the current credit facility entered into in March 2017 represented a debt modification or extinguishment in accordance with ASC 470-50, Debt—Modifications and Extinguishments. Upon determining that the change in cash flows between the previous and current credit facilities was not greater than 10%, management accounted for the transaction as a debt modification. As of March 2017, the unamortized balance of deferred debt issuance costs incurred in connection with the $25.0 million credit facility, and certain additional deferred debt issuance costs incurred in connection with entry into the current credit facility, are being amortized to interest expense through March 2022 utilizing the effective interest method. |
Convertible Preferred Stock and
Convertible Preferred Stock and Stockholders' Deficit | 12 Months Ended |
Dec. 31, 2018 | |
Equity [Abstract] | |
Convertible Preferred Stock and Stockholders' Deficit | 10. Initial Public Offering On July 2, 2018, the Company closed its IPO, in which the Company issued and sold 6.325 million shares of its common stock, which included shares sold pursuant to an option granted to the underwriters to purchase additional shares, at a public offering price of $17.00 per share. The Company received net proceeds of $96.5 million after deducting underwriting discounts, commissions and other offering expenses paid by the Company. In addition, immediately prior to the closing of the IPO on July 2, 2018, (i) all of the Company’s outstanding shares of convertible preferred stock converted into an aggregate of 11.0 million shares of common stock; (ii) all of the Company’s outstanding warrants to purchase convertible preferred stock converted into warrants to purchase common stock; and (iii) the Company filed an amended and restated certificate of incorporation to, among other things, decrease the number of shares of common stock, $0.01 par value per share, authorized for issuance to 200.0 million and to authorize the board of directors to issue up to 10.0 million shares of “blank check” preferred stock, $0.01 par value per share. Common Stock The Company’s amended and restated certificate of incorporation as of December 31, 2018 authorized the issuance of 200.0 million shares of common stock, $0.01 par value per share, of which 17.744 million were issued and outstanding as of December 31, 2018. Prior to the IPO, the Company was required to reserve and keep available out of its authorized but unissued shares of common stock a number of shares sufficient to effect the conversion into common stock of all outstanding shares of convertible preferred stock and convertible preferred stock warrants, convertible preferred stock or common stock warrants issuable upon borrowing the Term C Loan under the current credit facility, stock options granted and shares available for grant under its stock incentive plan. The following table summarizes the total number of shares of the Company’s common stock issued and reserved for issuance as of December 31, 2018 and 2017 (in thousands): December 31, 2018 2017 Shares of common stock issued 17,744 231 Shares of common stock reserved for issuance for: Convertible preferred stock outstanding: Series A-1 - 166 Series A-2 - 898 Series B - 697 Series C - 1,063 Series D - 1,705 Series E - 1,534 Series F - 3,531 Series G - 1,400 Convertible preferred stock warrants outstanding: Series E - 14 Series F - 91 Warrants issuable upon Term C Loan borrowing - 20 Common stock warrants outstanding 105 - Stock options outstanding 2,711 2,444 Restricted stock units outstanding 43 - Shares available for grant under stock incentive plan 1,312 246 Shares available for sale under employee stock purchase plan 244 - Total shares of common stock issued and reserved for issuance 22,159 14,040 Each share of common stock entitles the holder to one vote on all matters submitted to a vote of the Company’s stockholders. Holders of common stock are entitled to receive any dividends that the Company’s board of directors may declare out of funds legally available for that purpose on a non-cumulative basis. The Company has never paid, and for the foreseeable future does not expect to pay, a dividend on its common stock. Convertible Preferred Stock Prior to the filing of the July 2, 2018 amended certificate of incorporation, the Company’s amended certificate of incorporation authorized the issuance of 308.6 million shares of convertible preferred stock, $0.01 par value per share, of which the Company had designated and issued Series A-1, Series A-2, Series B, Series C, Series D, Series E, Series F and Series G shares. Series A-1 through Series E shares of convertible preferred stock are referred to collectively as Junior Securities and are subordinate to shares of Series G and Series F convertible preferred stock. All of the Company’s convertible preferred stock was classified outside of stockholders’ equity (deficit) because the shares contained deemed liquidation rights that were a contingent redemption feature not solely within the control of the Company. The following table summarizes the Company’s outstanding convertible preferred stock as of December 31, 2017: Shares Authorized and Designated (in thousands) Shares Issued and Outstanding (in thousands) Carrying Value (in thousands) Liquidation Value per Share Liquidation Value (in thousands) Series A-1 4,800 4,800 $ 900 $ 0.0617 $ 296 Series A-2 25,385 25,385 16,428 $ 0.2052 5,209 Series B 17,000 17,000 16,859 $ 0.3168 5,386 Series C 20,958 20,958 34,841 $ 0.5253 11,009 Series D 49,426 49,426 29,970 $ 0.2874 14,205 Series E 44,873 44,471 29,800 $ 0.5144 22,876 Series F 105,567 102,334 43,513 $ 0.3356 34,343 Series G 40,584 40,584 14,825 $ 0.3696 15,000 Balance at December 31, 2017 308,593 304,958 $ 187,136 $ 108,324 Conversion Each share and series of convertible preferred stock was convertible into common stock at any time at the option of the holder thereof at the conversion price then in effect (each subject to adjustments upon the occurrence of certain dilutive events). As of July 2, 2018, the conversion price for Series A-1, Series D, Series E, Series F and Series G shares was equal to the original issue price, resulting in a common stock conversion ratio of 1:0.0345. As of July 2, 2018, as a result of past anti-dilution adjustments, the conversion price for Series A-2, Series B and Series C shares was below the original issue price, resulting in common stock conversion ratios of 1:0.03539, 1:0.04103 and 1:0.05071, respectively. Immediately prior to the closing of the IPO on July 2, 2018, all of the Company’s outstanding shares of convertible preferred stock converted into 11.0 million shares of common stock. Liquidation Preferences As of December 31, 2017 In the event of a liquidation, dissolution or winding up of the Company, either voluntary or involuntary, or in the event of a deemed liquidation event, which includes a sale of the Company as defined in the Company’s certificate of incorporation, holders of Series G convertible preferred stock were entitled to receive, in preference to all other stockholders, an amount equal to their original investment amount plus any declared and unpaid dividends. If upon the occurrence of such event the assets and funds available for distribution are insufficient to pay such holders the full amount to which they are entitled, then the entire assets and funds legally available for distribution would be distributed ratably among the holders of the Series G convertible preferred stock in proportion to the full amounts to which they would otherwise be entitled. After payment in full of the liquidation preference of the Series G convertible preferred stock, holders of Series F convertible preferred stock were entitled to receive, in preference to all holders of Junior Securities and common stock, an amount equal to their original investment amount plus any declared and unpaid dividends. If upon the occurrence of such event the assets and funds available for distribution are insufficient to pay such holders the full amount to which they are entitled, then the entire remaining assets and funds legally available for distribution would be distributed ratably among the holders of the Series F convertible preferred stock in proportion to the full amounts to which they would otherwise be entitled. After payment in full of the liquidation preferences of the Series G and Series F convertible preferred stock, holders of Junior Securities were entitled to receive an amount equal to $59.2 million in the aggregate. If upon the occurrence of such event the assets and funds available for distribution are insufficient to pay such holders the full amount to which they are entitled, then the entire assets and funds legally available for distribution would be distributed ratably among the holders of the Junior Securities in proportion to the full amounts to which they would otherwise be entitled. After payment in full of the liquidation preferences of the Series G, Series F and Junior Securities convertible preferred stock, holders of Series F convertible preferred stock were entitled to receive an additional liquidation preference at an amount equal to $0.1678 per share. If upon the occurrence of such event the assets and funds available for distribution are insufficient to pay such holders the full amount to which they would be entitled, then the entire assets and funds legally available for distribution would be distributed ratably among the holders of the Series F convertible preferred stock in proportion to the full amounts to which they would otherwise be entitled. After payment in full of the liquidation preferences of the Series G, Series F and Junior Securities convertible preferred stock and the additional liquidation preference for holders of Series F convertible preferred stock, holders of common stock and holders of Junior Securities, Series F and Series G convertible preferred stock would be entitled to receive a liquidation preference until the amount distributed to holders of the Series F convertible preferred stock equals $1.0068 plus declared but unpaid dividends on each share and then to the holders of common stock and holders of Junior Securities and Series G convertible preferred stock until the aggregate amount distributed to such holders equals the amount distributed to holders of Series F convertible preferred stock divided by the Series F ownership percentage. After payments of the above liquidation preferences have been made, any remaining assets would be distributed ratably to holders of common stock and holders of Series G, Series F and Junior Securities convertible preferred stock on an “as-converted” basis. As of July 2, 2018 Immediately prior to the closing of the IPO on July 2, 2018, all of the Company’s outstanding shares of convertible preferred stock converted into 11.0 million shares of common stock, resulting in the elimination of the Company’s outstanding liquidation preferences. Dividends Each class of convertible preferred stock was entitled to receive non-cumulative annual dividends at a rate of 9.0%, if and when declared by the Company’s board of directors. The holders of Series G convertible preferred stock were entitled to dividends in preference to holders of any other class or series of the Company’s stock. The holders of Series F convertible preferred stock were entitled to dividends in preference to all holders of Junior Securities and holders of common stock. The holders of Junior Securities were entitled to dividends in preference to holders of common stock. In the event a dividend was declared to common stockholders, holders of each class of convertible preferred stock would also receive an equivalent dividend on an “as-converted” basis. Voting The holders of each class of convertible preferred stock were entitled to one vote for each share of common stock into which their shares of convertible preferred stock may be converted and, subject to certain convertible preferred stock class votes specified in the Company’s certificate of incorporation or as required by law, the holders of convertible preferred stock and common stock vote together on an “as-converted” basis. Common Stock Warrants The following table summarizes the Company’s outstanding common stock warrants as of December 31, 2018: Warrants Outstanding (in thousands) Exercise Price Expiration Date 14 $ 19.55 Dec-2022 30 $ 9.73 Feb-2021 20 $ 9.73 Aug-2023 20 $ 9.73 Mar-2024 21 $ 9.73 Dec-2024 105 Convertible Preferred Stock Warrants The following table summarizes the Company’s outstanding convertible preferred stock warrants as of December 31, 2017: Warrants Outstanding (in thousands) Exercise Price Expiration Date Series E 402 $ 0.6746 Dec-2022 Series F 878 $ 0.3356 Feb-2021 Series F 589 $ 0.3356 Aug-2023 Series F 589 $ 0.3356 Mar-2024 Series F 588 $ 0.3356 Dec-2024 3,046 |
Loss Per Share
Loss Per Share | 12 Months Ended |
Dec. 31, 2018 | |
Earnings Per Share [Abstract] | |
Loss Per Share | 11. The Company’s basic loss per common share is computed by dividing the net loss by the weighted-average number of shares of common stock outstanding during the period. The Company’s restricted stock awards (non-vested shares) are issued and outstanding at the time of grant but are excluded from the Company’s computation of weighted-average shares outstanding in the determination of basic loss per share until vesting occurs. A net loss cannot be diluted, so when the Company is in a net loss position, basic and diluted loss per common share are the same. If in the future the Company achieves profitability, the denominator of a diluted earnings per common share calculation will include both the weighted-average number of shares outstanding and the number of common stock equivalents, if the inclusion of such common stock equivalents would be dilutive. Dilutive common stock equivalents potentially include warrants, stock options and non-vested restricted stock awards and units using the treasury stock method, along with the effect, if any, from the potential conversion of outstanding securities, such as convertible preferred stock. The following potentially dilutive securities outstanding as of December 31, 2018, 2017 and 2016 have been excluded from the denominator of the diluted loss per share of common stock outstanding calculation (in thousands): December 31, 2018 2017 2016 Stock options 2,711 2,444 1,826 Non-vested restricted stock awards 4 16 22 Non-vested restricted stock units 43 - - Convertible preferred stock warrants - 105 64 Common stock warrants 105 - - Shares of convertible preferred stock “as-converted” - 10,994 9,594 |
Share-based Compensation
Share-based Compensation | 12 Months Ended |
Dec. 31, 2018 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |
Share-based Compensation | 12. The amount of share-based compensation expense recognized by the Company by location in its statements of operations for the years ended December 31, 2018, 2017 and 2016 is as follows (in thousands): Year ended December 31, 2018 2017 2016 Cost of revenues $ 21 $ 18 $ 5 Sales and marketing 926 141 49 General and administrative 646 226 70 Research and development 150 111 37 Total $ 1,743 $ 496 $ 161 2018 Equity Incentive Plan In June 2018, the Company adopted the 2018 Equity Incentive Plan, or 2018 Plan, which authorized the issuance of up to 1.4 million shares in the form of restricted stock, stock appreciation rights and stock options to the Company’s directors, employees and consultants. The amount and terms of grants are determined by the Company’s board of directors. All stock options granted to date have had exercise prices equal to the fair value, as determined by the closing price as reported by the Nasdaq Global Market on the date of grant, of the underlying common stock on the date of grant. The contractual term of stock options is up to 10 years, and stock options are exercisable in cash or as otherwise determined by the board of directors. Generally, stock options vest 25% upon the first anniversary of the date of grant and the remainder ratably monthly thereafter for 36 months. As of December 31, 2018, there were 1.3 million shares available for future issuance under the 2018 Plan. 2003 Stock Incentive Plan In April 2003 (and as subsequently amended), the Company adopted the 2003 Stock Incentive Plan, or 2003 Plan, which authorized the issuance of up to 3.1 million shares in the form of restricted stock, stock appreciation rights and stock options to the Company’s directors, employees and consultants. The amount and terms of grants are determined by the Company’s board of directors. All stock options granted to date have had exercise prices equal to the estimated fair value, as determined by the board of directors, of the underlying common stock on the date of the grant. The contractual term of stock options is up to 10 years, and stock options are exercisable in cash or as otherwise determined by the board of directors. Generally, stock options vest 25% upon the first anniversary of the date of grant and the remainder ratably monthly thereafter for 36 months. As of December 31, 2018, there were no shares available for future issuance under the 2003 Plan. As of the closing of the IPO, all shares available for issuance under the 2003 Plan were carried over to the newly adopted 2018 Plan. Stock Options The following table summarizes the Company’s stock option activity for the years ended December 31, 2018, 2017 and 2016: Number of Shares under Option (in thousands) Weighted- average Exercise Price per Option Weighted- average Remaining Contractual Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding at December 31, 2015 1,767 $ 2.52 Granted 255 $ 2.45 Exercised (19 ) $ 3.58 Forfeited (161 ) $ 5.68 Expired (16 ) $ 19.63 Outstanding at December 31, 2016 1,826 $ 2.07 Granted 967 $ 3.03 Exercised (33 ) $ 1.05 Forfeited (316 ) $ 2.66 Outstanding at December 31, 2017 2,444 $ 2.39 Granted 584 $ 8.33 Exercised (194 ) $ 2.60 Forfeited (123 ) $ 3.73 Outstanding at December 31, 2018 2,711 $ 3.59 7.3 $ 42,773 Exercisable at December 31, 2018 1,613 $ 2.22 6.2 $ 27,921 Vested and expected to vest at December 31, 2018 2,711 $ 3.59 7.3 $ 42,773 The Company recognized share-based compensation expense related to stock options of $1.6 million, $0.4 million and $0.2 million for the years ended December 31, 2018, 2017 and 2016, respectively. As of December 31, 2018, there was $3.1 million of total unrecognized compensation cost related to non-vested stock options which the Company expects to recognize over a weighted-average period of 3.1 years. The weighted-average grant-date fair value of stock options granted during the years ended December 31, 2018, 2017 and 2016 was estimated at $5.03, $1.45 and $1.16 per option. The total intrinsic value of stock options exercised during the years ended December 31, 2018, 2017 and 2016 was $3.3 million, $0.1 million and de minimis, respectively. For the years ended December 31, 2018, 2017 and 2016, the grant-date fair value of stock options was estimated at the time of grant using the following weighted-average inputs and assumptions in the Black-Scholes option pricing model: 2018 2017 2016 Estimated fair value of common stock $ 8.41 $ 2.90 $ 2.32 Exercise price $ 8.41 $ 2.90 $ 2.32 Expected term (in years) 6.0 6.0 6.0 Risk-free interest rate 2.7 % 2.0 % 1.4 % Expected volatility 65.3 % 48.0 % 44.2 % Dividend yield 0 % 0 % 0 % In April 2018, the Company’s board of directors granted options to purchase 54,794 shares of common stock to the members of the board. These options have an exercise price of $5.22 and vest in 12 equal monthly installments beginning in March 2018; however, the entire grant was subject to forfeiture if an initial public offering of the Company’s common stock did not occur by December 31, 2018. The estimated grant-date fair value of the options awards was $0.2 million. Upon the closing of the IPO on July 2, 2018, the Company recognized the fair value of the vested portion of the awards as share-based compensation expense, with the unvested portion to be recognized as share-based compensation expense ratably over the remaining service period. Restricted Stock Awards and Restricted Stock Units The following table summarizes the Company’s restricted stock award and restricted stock unit activity for the years ended December 31, 2018, 2017 and 2016: Non-vested Restricted Stock Awards (in thousands) Weighted- average Grant-date Fair Value Non-vested Restricted Stock Units (in thousands) Weighted- average Grant-date Fair Value Non-vested at December 31, 2015 - $ - - $ - Granted 42 $ 2.03 - $ - Vested (20 ) $ 2.03 - $ - Non-vested at December 31, 2016 22 $ 2.03 - $ - Granted 11 $ 4.06 - $ - Vested (17 ) $ 2.90 - $ - Non-vested at December 31, 2017 16 $ 2.32 - $ - Granted - $ - 43 $ 25.21 Vested (12 ) $ 2.32 - $ 25.92 Non-vested at December 31, 2018 4 $ 2.32 43 $ 25.21 The Company recognized share-based compensation expense related to restricted stock awards and restricted stock units of $0.2 million, $0.1 million and de minimis during the years ended December 31, 2018, 2017 and 2016, respectively. As of December 31, 2018, there was $0.9 million of unrecognized compensation cost related to non-vested restricted stock awards and restricted stock units which the Company expects to recognize over a weighted-average period of 3.4 years. The total fair value at the vesting date of restricted stock awards and restricted stock units vested during the years ended December 31, 2018, 2017 and 2016 was $0.2 million, $0.1 million and de minimis, respectively. |
Employee Benefit Plans
Employee Benefit Plans | 12 Months Ended |
Dec. 31, 2018 | |
Compensation And Retirement Disclosure [Abstract] | |
Employee Benefit Plans | 13. 401(k) Defined Contribution Plan The Company maintains a 401(k) defined contribution retirement plan which covers all of its employees. Employees are eligible to participate on the first of the month following their date of hire. Under the 401(k) plan, participating employees may defer up to 100% of their pre-tax salary but not more than statutory limits. There is currently no employer matching of employee contributions and employee contributions vest immediately. 2018 Employee Stock Purchase Plan In July 2018, the Company adopted the 2018 Employee Stock Purchase Plan, or 2018 ESPP, with an initial 0.2 million share reserve, subject to automatic annual increases on January 1st of each year for a period of up to ten years, as defined in the plan document. The purpose of the 2018 ESPP is to enhance employee interest in the success and progress of the Company by encouraging employee ownership of common stock of the Company. The 2018 ESPP provides the opportunity to purchase the Company’s common stock at a 15% discount to the market price through payroll deductions or lump sum cash investments. As of December 31, 2018, the Company had not yet approved any offering under the plan. |
Income Taxes
Income Taxes | 12 Months Ended |
Dec. 31, 2018 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | 14. The Company’s loss before income taxes was $24.1 million, $16.1 million and $11.2 million for the years ended December 31, 2018, 2017 and 2016, respectively, and was generated entirely in the United States. The Company did not record current or deferred income tax expense or benefit during the years ended December 31, 2018, 2017 and 2016. A reconciliation of the statutory United States federal income tax rate to the Company’s effective tax rate is as follows: Tax Year ended December 31, 2018 2017 2016 U.S. federal statutory income tax rate 21.0 % 34.0 % 34.0 % State and local taxes, net of federal benefit 3.8 % 2.7 % 2.6 % Nondeductible expenses 0.7 % -0.3 % -1.2 % Research and development credits 0.6 % 1.3 % 2.0 % Tax rate change and true-up 0.6 % -138.0 % -1.2 % Change in valuation allowance -26.7 % 100.3 % -36.2 % Effective income tax rate 0.0 % 0.0 % 0.0 % The tax effects of temporary differences that gave rise to significant portions of the deferred tax assets were as follows (in thousands): December 31, 2018 2017 Deferred tax assets: Net operating loss carryforwards $ 46,352 $ 41,430 Research and development credits 3,208 3,059 Share-based compensation 523 316 Accruals 853 753 Interest expense - 163(j) 592 - Capitalized start-up costs 1,295 1,530 Other temporary differences 951 253 Gross deferred tax assets 53,774 47,341 Less: Valuation allowance (53,774 ) (47,341 ) Net deferred taxes $ - $ - In assessing the realizability of the net deferred tax asset, the Company considers all relevant positive and negative evidence in determining whether it is more likely than not that some portion or all of the deferred income tax assets will not be realized. The realization of the gross deferred tax assets is dependent on several factors, including the generation of sufficient taxable income prior to the expiration of the net operating loss carryforwards. The Company believes that it is more likely than not that the Company’s deferred income tax asset associated with its net operating losses will not be realized in the immediate future. As such, there is a full valuation allowance against the net deferred tax assets as of December 31, 2018 and 2017. The valuation allowance increased / (decreased) by $6.4 and $(16.1) million during the years ended December 31, 2018 and 2017, respectively, due primarily to the generation of net operating losses and the federal tax rate reduction during the periods. December 31, 2018 2017 Balance at the beginning of the period $ 47,341 $ 63,449 Amounts charges to expense $ 6,433 $ 6,099 Tax rate change (34% to 21%) - (22,207 ) Balance at the end of the period $ 53,774 $ 47,341 The following table summarizes carryforwards of federal net operating losses and tax credits as of December 31, 2018 (in thousands): Amount Expiration Beginning in Federal net operating losses $ 187 2023 State net operating losses $ 112 2020 Research and development credits $ 3 2023 Under the Tax Reform Act of 1986 (the Act), the net operating loss and tax credit carryforwards are subject to review and possible adjustment by the Internal Revenue Service and state tax authorities. Net operating loss and tax credit carryforwards may become subject to an annual limitation in the event of certain cumulative changes in the ownership interest of significant shareholders over a three-year period in excess of 50 percent, as defined under Sections 382 and 383 of the Internal Revenue Code, respectively, as well as similar state provisions. This could limit the amount of tax attributes that can be utilized annually to offset future taxable income or tax liabilities. The amount of the annual limitation is determined based on the value of the Company immediately prior to the ownership change. Subsequent ownership changes may further affect the limitation in future years. The Company has not done an analysis to determine whether or not ownership changes, as defined by the Act, have occurred since inception. The Company will recognize interest and penalties related to uncertain tax positions in income tax expense. As of December 31, 2018, the Company had no accrued interest or penalties related to uncertain tax positions and no amounts have been recognized in the Company’s statements of operations. Due to net operating loss and tax credit carry forwards that remain unutilized, income tax returns for tax years from inception through 2017 remain subject to examination by the taxing jurisdictions. In December 2017, the Tax Cuts and Jobs Act (the “2017 Tax Act”) was enacted. The 2017 Tax Act includes a number of changes to existing U.S. tax laws that impact the company, most notably a reduction of the U.S. corporate income tax rate from 35 percent to 21 percent for tax years beginning after December 31, 2017. The 2017 Tax Act also provides for a one-time transition tax on certain foreign earnings and the acceleration of depreciation for certain assets placed into service after September 27, 2017 as well as prospective changes beginning in 2018, including repeal of the domestic manufacturing deduction, acceleration of tax revenue recognition, capitalization of research and development expenditures, additional limitations on executive compensation and limitations on the deductibility of interest. On December 22, 2017, the SEC staff issued Staff Accounting Bulletin No. 118 (“SAB 118”), which provided guidance on accounting for the federal tax rate change and other tax effects of the Tax Act. SAB 118 provided a measurement period that should not extend beyond one year from the Tax Act enactment date for companies to complete the accounting under ASC 740, Income Taxes. In connection with our adoption of the Tax Act and in consideration of SAB 118, there were no changes made to the provisional amounts recognized in 2017 in connection with the enactment of the Tax Reform Act. The accounting for the income tax effects of the Tax Reform Act is complete as of December 31, 2018. |
Commitments and Contingencies
Commitments and Contingencies | 12 Months Ended |
Dec. 31, 2018 | |
Commitments And Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | 15. Executive Employment Agreements The Company has entered into an employment agreement and offer letters with certain key executives, providing for compensation and severance in certain circumstances, as defined in the agreements. Leases In January 2013, the Company entered into a 93-month lease for its headquarters office and warehouse. The Company also rents certain office equipment. The Company recognizes rent expense on a straight-line basis over the lease period and has accrued for rent expense incurred but not yet paid. Landlord allowances for tenant improvements are deferred and recognized as a reduction to rent expense on a straight-line basis and over the remaining lease term. Rent expense under operating leases was $0.5 million, $0.5 million and $0.6 for the years ended December 31, 2018, 2017 and 2016, respectively. The following is a schedule of future minimum annual payments at December 31, 2018 under non-cancelable operating lease agreements (in thousands): For the years ending December 31, 2019 $ 547 2020 560 2021 88 Total future minimum lease payments $ 1,195 Legal Matters The Company is subject from time to time to various claims and legal actions arising during the ordinary course of its business. Management believes that there are currently no claims or legal actions that would reasonably be expected to have a material adverse effect on the Company’s results of operations, financial condition or cash flows. |
Distribution Agreement with Tei
Distribution Agreement with Teijin Pharma Limited | 12 Months Ended |
Dec. 31, 2018 | |
Organization Consolidation And Presentation Of Financial Statements [Abstract] | |
Distribution Agreement with Teijin Pharma Limited | 16 . In October 2017, the Company entered into a seven-and-a-half-year distribution agreement with Teijin Pharma Limited, or Teijin, for the exclusive distribution of its NeuroStar Advanced Therapy System to customers who will treat patients with MDD in Japan. Under the distribution agreement, Teijin is generally restricted from selling competing products in Japan. The distribution agreement provides that the Company will have primary responsibility for obtaining reimbursement approval for use of NeuroStar Advanced Therapy System for the treatment of MDD in Japan, and Teijin will promote the sales of NeuroStar Advanced Therapy System for treatment of MDD in Japan. The Company has agreed to provide sales and technical support training to Teijin for its NeuroStar Advanced Therapy Systems. Teijin is required to purchase minimum dollar values of NeuroStar Advanced Therapy Systems and treatment sessions from the Company following reimbursement approval by the Japanese Ministry of Health, Labour and Welfare, or JMHLW, for TMS treatment for MDD (or, if such approval requires certified training on the NeuroStar Advanced Therapy System by a third party, then upon the first psychiatrist being issued his or her training certification). In 2017, under the distribution agreement with Teijin, the Company received an upfront payment of $0.75 million and a milestone payment of $2.0 million following JMHLW’s approval of marketing the NeuroStar Advanced Therapy System for the treatment of MDD in Japan. These upfront and milestone payments have been deferred and are being recognized as revenue over the seven- and one-half year term of the agreement. Teijin is required to pay the Company a milestone payment tied to JMHLW issuing reimbursement for use of its products for the treatment of MDD in Japan. The distribution agreement is scheduled to expire on March 31, 2025, subject to earlier termination if we or Teijin breach the agreement, Teijin fails to maintain distributor-level permits and approvals, Teijin fails to purchase from us specified dollar values of its sales forecasts, reimbursement for treatment of MDD using the NeuroStar Advanced Therapy System is not obtained from JMHLW by specified dates or such reimbursement is below specified minimums, Teijin reasonably believes that it is not commercially reasonable to continue distributing the NeuroStar Advanced Therapy System in Japan or bankruptcy related events occur. The term of the distribution agreement will be automatically extended for two years unless either party gives the other party at least two years’ prior written of notice of non-renewal, except that the Company cannot decline to renew the agreement if Teijin has purchased 100% of its sales forecasts over the term of the agreement. |
Geographical Segment Informatio
Geographical Segment Information | 12 Months Ended |
Dec. 31, 2018 | |
Segments Geographical Areas [Abstract] | |
Geographical Segment Information | 17. Operating segments are defined as components of an enterprise about which separate discrete information is available for evaluation by the chief operating decision maker, or decision making group, in deciding how to allocate resources and in assessing performance. The Company currently operates in one business segment as it is managed and operated as one business. A single management team that reports to the chief operating decision maker comprehensively manages the entire business. The Company does not operate any material separate lines of business or separate business entities with respect to its products or product development. The Company’s revenue was generated in the following geographic regions for the years indicated (in thousands): Revenue by Geography Year ended December 31, 2018 2017 Amount % of Revenues Amount % of Revenues United States $ 51,477 98 % $ 39,853 99 % International 1,299 2 % 580 1 % Total revenues $ 52,776 100 % $ 40,433 100 % |
Supplementary Financial Informa
Supplementary Financial Information (Unaudited) | 12 Months Ended |
Dec. 31, 2018 | |
Quarterly Financial Information Disclosure [Abstract] | |
Supplementary Financial Information (Unaudited) | 18. ) Selected financial information for the quarterly periods noted is as follows: Three Months ended March 31, 2018 June 30, 2018 September 30, 2018 December 31, 2018 (in thousands except per share data) Revenues $ 10,152 $ 13,252 $ 13,737 $ 15,635 Cost of revenues 2,457 3,245 3,034 3,711 Gross Profit 7,695 10,007 10,703 11,924 Operating expenses: Sales and marketing 8,109 9,835 9,672 10,648 General and administrative 2,636 3,078 3,238 4,715 Research and development 1,555 2,330 2,125 2,222 Total operating expenses 12,300 15,243 15,035 17,585 Loss from Operations (4,605 ) (5,236 ) (4,332 ) (5,661 ) Other (income) expense: Interest expense 921 900 928 939 Other (income) expense, net (29 ) 1,360 (299 ) (457 ) Net Loss $ (5,497 ) $ (7,496 ) $ (4,961 ) $ (6,143 ) Net loss per share of common stock outstanding, basic and diluted $ (24.43 ) $ (30.60 ) $ (0.29 ) $ (0.35 ) Weighted-average common shares outstanding, basic and diluted 226 245 17,382 17,655 Three Months ended March 31, 2017 June 30, 2017 September 30, 2017 December 31, 2017 (in thousands except per share data) Revenues $ 7,526 $ 10,308 $ 10,491 $ 12,108 Cost of revenues 1,538 2,501 2,636 2,957 Gross Profit 5,988 7,807 7,855 9,151 Operating expenses: Sales and marketing 6,306 6,400 6,566 8,628 General and administrative 1,642 1,837 2,256 2,837 Research and development 2,028 2,147 1,843 1,919 Total operating expenses 9,976 10,384 10,665 13,384 Loss from Operations (3,988 ) (2,577 ) (2,810 ) (4,233 ) Other (income) expense: Interest expense 550 711 807 740 Other (income) expense, net (24 ) (420 ) 136 (49 ) Net Loss $ (4,514 ) $ (2,868 ) $ (3,753 ) $ (4,924 ) Net loss per share of common stock outstanding, basic and diluted $ (27.03 ) $ (16.58 ) $ (19.35 ) $ (23.34 ) Weighted-average common shares outstanding, basic and diluted 167 173 194 211 Quarterly computations of net loss per share amounts are made independently for each quarterly reporting period, and the sum of the per share amounts for the quarterly reporting periods may not equal the per share amounts for the year-to-date reporting period. Net loss per share for the three months ended September 30, 2018 and December 31, 2018 include, on a weighted-average basis, the 11.0 million shares of common stock issued upon the conversion of all outstanding shares of convertible preferred stock immediately prior to the closing of the IPO and 6.325 million shares of common stock issued upon the closing of the IPO on July 2, 2018. |
Summary of Significant Accoun_2
Summary of Significant Accounting Policies (Policies) | 12 Months Ended |
Dec. 31, 2018 | |
Accounting Policies [Abstract] | |
Use of Estimates | Use of Estimates The preparation of financial statements in accordance with GAAP and the rules and regulations of the United States Securities and Exchange Commission, or SEC, requires the use of estimates and assumptions, based on judgments considered reasonable, which affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. The Company bases its estimates and assumptions on historical experience, known trends and events and various other factors that management believes to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Although management believes its estimates and assumptions are reasonable when made, they are based upon information available at the time they are made. Management evaluates the estimates and assumptions on an ongoing basis and, if necessary, makes adjustments. Due to the risks and uncertainties involved in the Company’s business and evolving market conditions and given the subjective element of the estimates and assumptions made, actual results may differ from estimated results. The most significant estimates and judgments impact share-based compensation and the valuation of common stock prior to the IPO. |
Recapitalization | Recapitalization The Company effected a 0.0345-for-1 reverse split of its common stock on June 14, 2018. The reverse split combined each approximately 29 shares of the Company’s issued and outstanding common stock into one share of common stock and correspondingly adjusted the conversion price of its outstanding convertible preferred stock. No fractional shares were issued in connection with the reverse split. Any fractional share resulting from the reverse split was rounded down to the nearest whole share, and in lieu of any fractional share, the Company paid in cash to the holders of such fractional shares an amount equal to the fair market value, as determined by the board of directors, of such fractional shares. All share, per share and related information presented in these financial statements and the related notes thereto have been retroactively adjusted, where applicable, to reflect the reverse stock split. |
Cash and Cash Equivalents | Cash and Cash Equivalents The Company considers all highly liquid investments purchased with an original maturity of three months or less to be cash equivalents. As of December 31, 2018 and 2017, cash equivalents consisted of money market funds. |
Concentration of Credit Risk | Concentrations of Credit Risk The Company’s cash is held on deposit in demand accounts at a large financial institution in amounts in excess of the Federal Deposit Insurance Corporation, or FDIC, insurance coverage limit of $250,000 per depositor, per FDIC-insured bank, per ownership category. Management has reviewed the financial statements of this institution and believes it has sufficient assets and liquidity to conduct its operations in the ordinary course of business with little or no credit risk to the Company. Financial instruments that potentially subject the Company to concentrations of credit risk principally consist of cash equivalents and accounts receivable. The Company limits its credit risk associated with cash equivalents by placing investments in highly-rated money market funds. The Company limits its credit risk with respect to accounts receivable by performing credit evaluations when deemed necessary, but it does not require collateral to secure amounts owed by its customers. |
Allowance for Doubtful Accounts | Allowance for Doubtful Accounts The Company maintains allowances for doubtful accounts for estimated losses resulting from amounts deemed to be uncollectible from its customers. These allowances are for specific amounts on certain customer accounts based on facts and circumstances determined on a case-by-case basis. |
Inventory | Inventory Inventory is stated at the lower of cost and net realizable value, with cost being determined on a first in, first out basis. The Company’s inventory is primarily comprised of finished goods. |
Property and Equipment and Capitalized Software | Property and Equipment and Capitalized Software Property and equipment are recorded at cost. Maintenance and repairs are charged to expense as incurred and costs of improvements and renewals are capitalized. Depreciation and amortization are recognized using the straight-line method based on the estimated useful lives of the related assets. The Company uses an estimated useful life of three years for computers and software, five years for laboratory and office equipment, six years for devices in the rental agreement program and the lesser of five years or the remaining life of the underlying facility lease for leasehold improvements. Software development costs relating to assets to be sold in the normal course of business are included in research and development and are expensed as incurred until technological feasibility is established. After technological feasibility is established, material software development costs are capitalized. The Company uses an estimated useful life of two years for capitalized software and amortizes these costs beginning at the product release. |
Impairment of Long-Lived Assets | Impairment of Long-Lived Assets Long-lived assets, such as property and equipment, are tested for impairment when events or changes in circumstances indicate that the carrying value of the asset may not be recoverable. Impairment testing requires management to estimate the future net undiscounted cash flows of an asset using assumptions believed to be reasonable. Actual cash flows may differ from the estimates used in the impairment testing. If such assets are considered to be impaired, the Company recognizes an impairment loss when and to the extent that the estimated fair value of an asset is less than its carrying value. The Company has not recorded any impairment of its long-lived assets for the years ended December 31, 2018, 2017, and 2016. |
Warrant Liability | Warrant Liability The Company’s current and previous credit facilities required the Company to issue to the lender of warrants to purchase the Company’s convertible preferred stock at the date of borrowing. Because the convertible preferred stock warrants were a form of a contingently redeemable instrument, they were classified as liabilities on the Company’s balance sheet. At the date of borrowing, the Company bifurcated the estimated fair value of the convertible preferred stock warrants from the proceeds from borrowing, resulting in the recognition of a debt discount, and recorded a warrant liability on its balance sheet. This warrant liability was revalued at each reporting period, with changes in fair value recorded in the Company’s statement of operations as a component of other income or expense. The valuation of the warrant liability was based upon estimates of the fair value of the underlying convertible preferred stock and the related volatility and expected term for an illiquid instrument, which could vary significantly from period to period. Immediately prior to the closing of the IPO on July 2, 2018, all of the Company’s outstanding convertible preferred stock warrants converted into common stock warrants. The warrant liability was remeasured at its estimated fair value and reclassified to additional paid-in capital on the Company’s balance sheet. |
Deferred Debt Issuance Costs | Deferred Debt Issuance Costs The Company capitalizes direct costs incurred to obtain debt financing and amortizes these costs to interest expense over the term of the debt using the effective interest method. These costs are recorded as a debt discount are netted against the related debt on the Company’s balance sheet. |
Revenue Recognition | Revenue Recognition Revenue is recognized when title and risk of ownership has been transferred, provided that persuasive evidence of an arrangement exists, the price is fixed and determinable and collectability is reasonably assured. Transfer of title and risk of ownership occurs when the product is shipped or transferred to the customer. The Company sells to end users in the United States and to third-party distributors outside the United States and does not provide return rights. Sales to distributors outside the United States are in U.S. dollars. The Company generates revenues from sales of NeuroStar Advanced Therapy Systems and treatment sessions. NeuroStar Advanced Therapy System revenue consists primarily of a capital component, including updates to the equipment, attributable to the initial sale of the NeuroStar system unit. NeuroStar Advanced Therapy Systems can be purchased outright or on a rent-to-own basis by certain customers. Treatment session revenue primarily includes sales of NeuroStar treatment sessions and SenStar treatment links. The NeuroStar treatment sessions are access codes delivered electronically in the United States. The SenStar treatment links are disposable units containing single-use access codes that are sold and used outside the United States. Access codes are purchased separately by customers, primarily on an as-needed basis, and are required by the NeuroStar Advanced Therapy System in order to deliver the treatment sessions. The Company’s NeuroStar Advanced Therapy System sales in the United States typically have a post-sale training obligation. This obligation is fulfilled after product shipment, and the Company defers recognizing revenue until training occurs. In accordance with the accounting guidance related to multiple element arrangements, the Company defers the fair value attributable to the post-shipment training and recognizes such revenue when the obligation is fulfilled. The Company bases the fair value of the training using stand-alone service rates. The Company’s sales to its third-party distributors outside the United States do not have these post-sale obligations. The Company’s treatment sessions have no post-sale obligations and no return rights. Revenues on the sales of treatment sessions are recognized upon delivery. Revenue related to operating leases for the Company’s NeuroStar Advanced Therapy System is recognized over the term of the lease. Revenue attributable to the NeuroStar Advanced Therapy Systems purchased on a rent-to-own basis are accounted for as operating leases and revenue is recognized on a straight-line basis over the term of the lease. The Company provides a one to two-year warranty for systems sold in the United States. Terms of product warranty differ amongst its third-party distributors outside the United States but are generally three years or less. The Company provides for the estimated cost to repair or replace products under any warranty at the time of sale. The Company also offers its customers in the United States annual service contracts. Revenue from the sale of annual service contracts is recognized on a straight-line basis over the period of the applicable contract. The Company also earns revenue from customers from services outside of their warranty term or annual service contracts. Such service revenue is recognized as the services are provided. |
Research and Development Expenses | Research and Development Expenses Research and development activities are expensed as incurred. Costs incurred in obtaining technology licenses are charged immediately to research and development expense if the technology licensed has not reached technological feasibility and has no alternative future uses. |
Share-based Compensation | Share-based Compensation The Company recognizes the grant-date fair value of share-based awards issued as compensation as expense on a straight-line basis over the requisite service period, which is generally the vesting period of the award. To date, the Company has not issued awards where vesting is subject to market conditions. There was one performance grant in 2018 to the board of directors subject to completion of the IPO, which was achieved in July 2018. The fair value of restricted stock awards and restricted stock units is estimated at the time of grant, based on the grant date fair value of the Company’s common stock. The fair value of stock options is estimated at the time of grant using the Black-Scholes option pricing model, which requires the use of inputs and assumptions such as the fair value of the underlying common stock, exercise price of the option, expected term, risk-free interest rate, expected volatility and dividend yield, the most critical of which is the fair value of the Company’s common stock prior to the IPO. The fair value of each grant of stock options awarded during the years ended December 31, 2018, 2017 and 2016 was determined using the following methods and assumptions: • Fair Value of Common Stock. Valuation of Privately-Held-Company Equity Securities Issued as Compensation • Expected Term. • Risk-free Interest Rate. • Expected Volatility. • Dividend Yield. The inputs and assumptions used to estimate the fair value of share-based payment awards represent management’s best estimates and involve inherent uncertainties and the application of management’s judgment. As a result, if factors change and management uses different inputs and assumptions, the Company’s share-based compensation expense could be materially different for future awards. |
Income Taxes | Income Taxes Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in operations in the period that includes the enactment date. A valuation allowance is recorded to the extent it is more likely than not that some portion or all of the deferred tax assets will not be realized. Unrecognized income tax benefits represent income tax positions taken on income tax returns that have not been recognized in the financial statements. The Company recognizes the benefit of an income tax position only if it is more likely than not (greater than 50%) that the tax position will be sustained upon tax examination, based solely on the technical merits of the tax position. Otherwise, no benefit is recognized. The tax benefits recognized are measured based on the largest benefit that has a greater than 50% likelihood of being realized upon ultimate settlement. The Company accrues interest and related penalties are classified as income tax expense in the statements of operations. The Company does not anticipate significant changes in the amount of unrecognized income tax benefits over the next year. As of December 31, 2018 and 2017, the Company had deferred tax assets of $53.8 million and $47.3 million, respectively; these deferred tax assets are primarily attributable to federal and state net operating loss carryforwards. Although the loss carryforwards are available to offset future taxable income, they will begin to expire in 2020 for state and 2023 for federal. In addition, prior ownership changes may create a limitation in the Company’s ability to use the net operating loss carryforwards for federal and state income tax purposes. These loss carryforwards have been fully offset by a valuation allowance because management does not consider realization of these deferred tax assets to be more likely than not. Corporate tax reform was enacted on December 22, 2017 and is effective for the Company for year ended December 31, 2017. The provisions of the corporate tax reform did not have any impact to the Company due to the full valuation allowance position. As a result of the reduced corporate rate, the Company’s deferred tax assets were revalued from 34% to 21%, which was fully offset by a reduction in the valuation allowance. In connection with the corporate tax reform, the Medical Device Tax was suspended for another two years. |
Fair Value Measurement and Fi_2
Fair Value Measurement and Financial Instruments (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Fair Value Disclosures [Abstract] | |
Schedule of Carrying Amounts and Fair Values of Financial Instruments | The following tables set forth the carrying amounts and fair values of the Company’s financial instruments as of December 31, 2018 and 2017 (in thousands): December 31, 2018 Fair Value Measurement Based on Carrying Amount Fair Value Quoted Prices In Active Markets (Level 1) Significant other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Assets Money market funds (cash equivalents) $ 87,062 $ 87,062 $ 87,062 $ - $ - December 31, 2017 Fair Value Measurement Based on Carrying Amount Fair Value Quoted Prices In Active Markets (Level 1) Significant other Observable Inputs (Level 2) Significant Unobservable Inputs (Level 3) Assets Money market funds (cash equivalents) $ 11,149 $ 11,149 $ 11,149 $ - $ - Liabilities Convertible preferred stock warrant liability $ 478 $ 478 $ - $ - $ 478 |
Summary of Fair Value Inputs and Assumptions | The fair value of the convertible preferred stock warrant liability was estimated using the Black-Scholes option pricing model and the following inputs and assumptions as of December 31, 2017: December 31, 2017 Series E Series F Estimated fair value of convertible preferred stock $ 9.57 $ 11.01 Exercise price $ 19.55 $ 9.73 Remaining term (in years) 5.0 3.1 - 7.0 Risk-free interest rate 2 % 2.0% - 2.3% Expected volatility 43 % 43% - 44% Dividend yield 0 % 0 % |
Summary of Changes in Instruments Measured on Recurring Basis | The following table presents the changes in Level 3 instruments measured on a recurring basis for the years ended December 31, 2018 and 2017 (in thousands): Balance at December 31, 2016 $ 459 Issuance of warrants 290 Change in fair value (271 ) Balance at December 31, 2017 478 Change in fair value 1,396 Reclassification to additional paid in capital (1,874 ) Balance at December 31, 2018 $ - |
Accounts Receivable (Tables)
Accounts Receivable (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Receivables [Abstract] | |
Composition of Accounts Receivable, Net | The following table presents the composition of accounts receivable, net as of December 31, 2018 and 2017 (in thousands): December 31, 2018 2017 Gross accounts receivable - trade $ 6,120 $ 4,684 Less: Allowances for doubtful accounts (500 ) (417 ) Accounts receivable, net $ 5,620 $ 4,267 |
Allowance for Doubtful Accounts | The following table presents a rollforward of the allowance for doubtful accounts (in thousands): Balance at Beginning Period Bad Debt Expense Recognized Write-offs of Uncollectible Balances Balance at End of Period Year ended December 31, 2016 $ (274 ) (75 ) 6 $ (343 ) Year ended December 31, 2017 $ (343 ) (116 ) 42 $ (417 ) Year ended December 31, 2018 $ (417 ) (153 ) 70 $ (500 ) |
Property and Equipment and Ca_2
Property and Equipment and Capitalized Software (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Property Plant And Equipment [Abstract] | |
Summary of Composition of Property and Equipment, Net | The following table presents the composition of property and equipment, net as of December 31, 2018 and 2017 (in thousands): December 31, 2018 2017 Laboratory equipment $ 150 $ 150 Office equipment 487 487 Computer equipment and software 1,050 680 Manufacturing equipment 273 273 Leasehold improvements 172 153 Rental equipment 1,262 1,447 Property and equipment, gross 3,394 3,190 Less: Accumulated depreciation (2,016 ) (1,831 ) Property and equipment, net $ 1,378 $ 1,359 |
Accrued Expenses (Tables)
Accrued Expenses (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Payables And Accruals [Abstract] | |
Summary of Composition of Accrued Expenses | The following table presents the composition of accrued expenses as of December 31, 2018 and 2017 (in thousands): December 31, 2018 2017 Compensation and related benefits $ 4,909 $ 4,465 Consulting and professional fees 342 461 Research and development expenses 191 497 Sales and marketing expenses 127 620 Warranty 629 570 Sales tax payable 606 322 Interest payable 251 188 Other 493 388 Accrued expenses $ 7,548 $ 7,511 |
Debt (Tables)
Debt (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Debt Disclosure [Abstract] | |
Summary of Composition of Debt | The following table presents the composition of debt as of December 31, 2018 and 2017 (in thousands): December 31, 2018 2017 Outstanding principal $ 30,000 $ 30,000 Accrued final payment fees 1,468 940 Less debt discounts (1,073 ) (1,384 ) Total long-term debt, net 30,395 29,556 Less current portion of long-term debt - - Long-term debt, net $ 30,395 $ 29,556 |
Summary of Future Principal Payments | Based on a 24-month amortization of the outstanding principal amounts of the Term A and Term B Loans beginning on April 1, 2020 as discussed above, the following table sets forth by year the Company’s required future principal payments (in thousands): Year: Principal Payments 2019 $ - 2020 11,250 2021 15,000 2022 3,750 Total principal payments $ 30,000 |
Convertible Preferred Stock a_2
Convertible Preferred Stock and Stockholders' Deficit (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Summary of Common Stock Issued and Reserved for Issuance | The following table summarizes the total number of shares of the Company’s common stock issued and reserved for issuance as of December 31, 2018 and 2017 (in thousands): December 31, 2018 2017 Shares of common stock issued 17,744 231 Shares of common stock reserved for issuance for: Convertible preferred stock outstanding: Series A-1 - 166 Series A-2 - 898 Series B - 697 Series C - 1,063 Series D - 1,705 Series E - 1,534 Series F - 3,531 Series G - 1,400 Convertible preferred stock warrants outstanding: Series E - 14 Series F - 91 Warrants issuable upon Term C Loan borrowing - 20 Common stock warrants outstanding 105 - Stock options outstanding 2,711 2,444 Restricted stock units outstanding 43 - Shares available for grant under stock incentive plan 1,312 246 Shares available for sale under employee stock purchase plan 244 - Total shares of common stock issued and reserved for issuance 22,159 14,040 |
Summary of Outstanding Convertible Preferred Stock | The following table summarizes the Company’s outstanding convertible preferred stock as of December 31, 2017: Shares Authorized and Designated (in thousands) Shares Issued and Outstanding (in thousands) Carrying Value (in thousands) Liquidation Value per Share Liquidation Value (in thousands) Series A-1 4,800 4,800 $ 900 $ 0.0617 $ 296 Series A-2 25,385 25,385 16,428 $ 0.2052 5,209 Series B 17,000 17,000 16,859 $ 0.3168 5,386 Series C 20,958 20,958 34,841 $ 0.5253 11,009 Series D 49,426 49,426 29,970 $ 0.2874 14,205 Series E 44,873 44,471 29,800 $ 0.5144 22,876 Series F 105,567 102,334 43,513 $ 0.3356 34,343 Series G 40,584 40,584 14,825 $ 0.3696 15,000 Balance at December 31, 2017 308,593 304,958 $ 187,136 $ 108,324 |
Convertible Preferred Stock | |
Summary of Outstanding Warrants | The following table summarizes the Company’s outstanding convertible preferred stock warrants as of December 31, 2017: Warrants Outstanding (in thousands) Exercise Price Expiration Date Series E 402 $ 0.6746 Dec-2022 Series F 878 $ 0.3356 Feb-2021 Series F 589 $ 0.3356 Aug-2023 Series F 589 $ 0.3356 Mar-2024 Series F 588 $ 0.3356 Dec-2024 3,046 |
Common Stock | |
Summary of Outstanding Warrants | The following table summarizes the Company’s outstanding common stock warrants as of December 31, 2018: Warrants Outstanding (in thousands) Exercise Price Expiration Date 14 $ 19.55 Dec-2022 30 $ 9.73 Feb-2021 20 $ 9.73 Aug-2023 20 $ 9.73 Mar-2024 21 $ 9.73 Dec-2024 105 |
Loss Per Share (Tables)
Loss Per Share (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Earnings Per Share [Abstract] | |
Schedule of Potentially Dilutive Securities Outstanding Excluded from Diluted Loss Per Share Calculation | The following potentially dilutive securities outstanding as of December 31, 2018, 2017 and 2016 have been excluded from the denominator of the diluted loss per share of common stock outstanding calculation (in thousands): December 31, 2018 2017 2016 Stock options 2,711 2,444 1,826 Non-vested restricted stock awards 4 16 22 Non-vested restricted stock units 43 - - Convertible preferred stock warrants - 105 64 Common stock warrants 105 - - Shares of convertible preferred stock “as-converted” - 10,994 9,594 |
Share-Based Compensation (Table
Share-Based Compensation (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |
Summary of Share-Based Compensation Expense | The amount of share-based compensation expense recognized by the Company by location in its statements of operations for the years ended December 31, 2018, 2017 and 2016 is as follows (in thousands): Year ended December 31, 2018 2017 2016 Cost of revenues $ 21 $ 18 $ 5 Sales and marketing 926 141 49 General and administrative 646 226 70 Research and development 150 111 37 Total $ 1,743 $ 496 $ 161 |
Summary of Stock Option Activity | The following table summarizes the Company’s stock option activity for the years ended December 31, 2018, 2017 and 2016: Number of Shares under Option (in thousands) Weighted- average Exercise Price per Option Weighted- average Remaining Contractual Life (in years) Aggregate Intrinsic Value (in thousands) Outstanding at December 31, 2015 1,767 $ 2.52 Granted 255 $ 2.45 Exercised (19 ) $ 3.58 Forfeited (161 ) $ 5.68 Expired (16 ) $ 19.63 Outstanding at December 31, 2016 1,826 $ 2.07 Granted 967 $ 3.03 Exercised (33 ) $ 1.05 Forfeited (316 ) $ 2.66 Outstanding at December 31, 2017 2,444 $ 2.39 Granted 584 $ 8.33 Exercised (194 ) $ 2.60 Forfeited (123 ) $ 3.73 Outstanding at December 31, 2018 2,711 $ 3.59 7.3 $ 42,773 Exercisable at December 31, 2018 1,613 $ 2.22 6.2 $ 27,921 Vested and expected to vest at December 31, 2018 2,711 $ 3.59 7.3 $ 42,773 |
Summary of Weighted-average Inputs and Assumptions used to Estimate Grant-date Fair Value of Stock Options | For the years ended December 31, 2018, 2017 and 2016, the grant-date fair value of stock options was estimated at the time of grant using the following weighted-average inputs and assumptions in the Black-Scholes option pricing model: 2018 2017 2016 Estimated fair value of common stock $ 8.41 $ 2.90 $ 2.32 Exercise price $ 8.41 $ 2.90 $ 2.32 Expected term (in years) 6.0 6.0 6.0 Risk-free interest rate 2.7 % 2.0 % 1.4 % Expected volatility 65.3 % 48.0 % 44.2 % Dividend yield 0 % 0 % 0 % |
Summary of Restricted Stock Award and Restricted Stock Unit Activity | The following table summarizes the Company’s restricted stock award and restricted stock unit activity for the years ended December 31, 2018, 2017 and 2016: Non-vested Restricted Stock Awards (in thousands) Weighted- average Grant-date Fair Value Non-vested Restricted Stock Units (in thousands) Weighted- average Grant-date Fair Value Non-vested at December 31, 2015 - $ - - $ - Granted 42 $ 2.03 - $ - Vested (20 ) $ 2.03 - $ - Non-vested at December 31, 2016 22 $ 2.03 - $ - Granted 11 $ 4.06 - $ - Vested (17 ) $ 2.90 - $ - Non-vested at December 31, 2017 16 $ 2.32 - $ - Granted - $ - 43 $ 25.21 Vested (12 ) $ 2.32 - $ 25.92 Non-vested at December 31, 2018 4 $ 2.32 43 $ 25.21 |
Income Taxes (Tables)
Income Taxes (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Income Tax Disclosure [Abstract] | |
Schedule of Reconciliation of Statutory Federal Income Tax Rate | A reconciliation of the statutory United States federal income tax rate to the Company’s effective tax rate is as follows: Tax Year ended December 31, 2018 2017 2016 U.S. federal statutory income tax rate 21.0 % 34.0 % 34.0 % State and local taxes, net of federal benefit 3.8 % 2.7 % 2.6 % Nondeductible expenses 0.7 % -0.3 % -1.2 % Research and development credits 0.6 % 1.3 % 2.0 % Tax rate change and true-up 0.6 % -138.0 % -1.2 % Change in valuation allowance -26.7 % 100.3 % -36.2 % Effective income tax rate 0.0 % 0.0 % 0.0 % |
Schedule of Deferred Tax Assets | The tax effects of temporary differences that gave rise to significant portions of the deferred tax assets were as follows (in thousands): December 31, 2018 2017 Deferred tax assets: Net operating loss carryforwards $ 46,352 $ 41,430 Research and development credits 3,208 3,059 Share-based compensation 523 316 Accruals 853 753 Interest expense - 163(j) 592 - Capitalized start-up costs 1,295 1,530 Other temporary differences 951 253 Gross deferred tax assets 53,774 47,341 Less: Valuation allowance (53,774 ) (47,341 ) Net deferred taxes $ - $ - |
Summary of Valuation Allowance | December 31, 2018 2017 Balance at the beginning of the period $ 47,341 $ 63,449 Amounts charges to expense $ 6,433 $ 6,099 Tax rate change (34% to 21%) - (22,207 ) Balance at the end of the period $ 53,774 $ 47,341 |
Summary of Net Operating Loss Carryforwards and Tax Credits | The following table summarizes carryforwards of federal net operating losses and tax credits as of December 31, 2018 (in thousands): Amount Expiration Beginning in Federal net operating losses $ 187 2023 State net operating losses $ 112 2020 Research and development credits $ 3 2023 |
Commitments and Contingencies (
Commitments and Contingencies (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Commitments And Contingencies Disclosure [Abstract] | |
Schedule of Future Minimum Annual Payments Under Non-Cancelable Operating Lease Agreements | The following is a schedule of future minimum annual payments at December 31, 2018 under non-cancelable operating lease agreements (in thousands): For the years ending December 31, 2019 $ 547 2020 560 2021 88 Total future minimum lease payments $ 1,195 |
Geographical Segment Informat_2
Geographical Segment Information (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Segments Geographical Areas [Abstract] | |
Summary of Revenue Generated in Geographic Regions for Years Indicated | The Company’s revenue was generated in the following geographic regions for the years indicated (in thousands): Revenue by Geography Year ended December 31, 2018 2017 Amount % of Revenues Amount % of Revenues United States $ 51,477 98 % $ 39,853 99 % International 1,299 2 % 580 1 % Total revenues $ 52,776 100 % $ 40,433 100 % |
Supplementary Financial Infor_2
Supplementary Financial Information (Unaudited) (Tables) | 12 Months Ended |
Dec. 31, 2018 | |
Quarterly Financial Information Disclosure [Abstract] | |
Summary of Selected Financial Information for Quarterly Periods | Selected financial information for the quarterly periods noted is as follows: Three Months ended March 31, 2018 June 30, 2018 September 30, 2018 December 31, 2018 (in thousands except per share data) Revenues $ 10,152 $ 13,252 $ 13,737 $ 15,635 Cost of revenues 2,457 3,245 3,034 3,711 Gross Profit 7,695 10,007 10,703 11,924 Operating expenses: Sales and marketing 8,109 9,835 9,672 10,648 General and administrative 2,636 3,078 3,238 4,715 Research and development 1,555 2,330 2,125 2,222 Total operating expenses 12,300 15,243 15,035 17,585 Loss from Operations (4,605 ) (5,236 ) (4,332 ) (5,661 ) Other (income) expense: Interest expense 921 900 928 939 Other (income) expense, net (29 ) 1,360 (299 ) (457 ) Net Loss $ (5,497 ) $ (7,496 ) $ (4,961 ) $ (6,143 ) Net loss per share of common stock outstanding, basic and diluted $ (24.43 ) $ (30.60 ) $ (0.29 ) $ (0.35 ) Weighted-average common shares outstanding, basic and diluted 226 245 17,382 17,655 Three Months ended March 31, 2017 June 30, 2017 September 30, 2017 December 31, 2017 (in thousands except per share data) Revenues $ 7,526 $ 10,308 $ 10,491 $ 12,108 Cost of revenues 1,538 2,501 2,636 2,957 Gross Profit 5,988 7,807 7,855 9,151 Operating expenses: Sales and marketing 6,306 6,400 6,566 8,628 General and administrative 1,642 1,837 2,256 2,837 Research and development 2,028 2,147 1,843 1,919 Total operating expenses 9,976 10,384 10,665 13,384 Loss from Operations (3,988 ) (2,577 ) (2,810 ) (4,233 ) Other (income) expense: Interest expense 550 711 807 740 Other (income) expense, net (24 ) (420 ) 136 (49 ) Net Loss $ (4,514 ) $ (2,868 ) $ (3,753 ) $ (4,924 ) Net loss per share of common stock outstanding, basic and diluted $ (27.03 ) $ (16.58 ) $ (19.35 ) $ (23.34 ) Weighted-average common shares outstanding, basic and diluted 167 173 194 211 |
Description of Business - Addit
Description of Business - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands | Jul. 02, 2018 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 |
Description Of Business [Line Items] | ||||
IPO closing date | Jul. 2, 2018 | |||
Net proceeds from initial public offering | $ 99,998 | |||
Common stock, par value per share | $ 0.01 | $ 0.01 | ||
Common stock, shares authorized for issuance | 200,000,000 | 200,000,000 | ||
Preferred stock, shares authorized for issuance | 10,000,000 | 10,000,000 | ||
Preferred stock, par value per share | $ 0.01 | $ 0.01 | ||
Cash and cash equivalents | $ 104,583 | $ 29,147 | ||
Accumulated deficit | 221,043 | 196,946 | ||
Cash flows from operating activities | 20,591 | $ 11,144 | $ 8,541 | |
$35.0 Million Credit Facility | Oxford Finance LLC | ||||
Description Of Business [Line Items] | ||||
Borrowings outstanding under credit facility | $ 30,000 | |||
Credit facility maturity date | Mar. 1, 2022 | |||
Common Stock | ||||
Description Of Business [Line Items] | ||||
Common stock shares issued and sold | 6,325,000 | 6,325,000 | ||
Convertible preferred stock converted into common stock | 11,000,000 | 10,994,000 | ||
Initial Public Offering | ||||
Description Of Business [Line Items] | ||||
Net proceeds from initial public offering | $ 96,500 | |||
Common stock, par value per share | $ 0.01 | |||
Common stock, shares authorized for issuance | 200,000,000 | |||
Preferred stock, shares authorized for issuance | 10,000,000 | |||
Preferred stock, par value per share | $ 0.01 | |||
Initial Public Offering | Common Stock | ||||
Description Of Business [Line Items] | ||||
Common stock shares issued and sold | 6,325,000 | |||
Issuance price per share | $ 17 | |||
Convertible preferred stock converted into common stock | 11,000,000 |
Basis of Presentation - Additio
Basis of Presentation - Additional Information (Details) | Jun. 14, 2018 | Dec. 31, 2018 |
Accounting Policies [Abstract] | ||
Reverse stock split description | 0.0345-for-1 reverse split | |
Reverse stock split, Conversion ratio | 0.0345 |
Summary of Significant Accoun_3
Summary of Significant Accounting Policies - Additional Information (Detail) | 12 Months Ended | ||
Dec. 31, 2018USD ($) | Dec. 31, 2017USD ($) | Dec. 31, 2016USD ($) | |
Summary Of Significant Accounting Policies [Line Items] | |||
Cash held on deposits at financial institution in excess of FDIC Insured limit | $ 250,000 | ||
Impairment of long-lived assets | 0 | $ 0 | $ 0 |
Gross deferred tax assets | $ 53,774,000 | $ 47,341,000 | |
Deferred tax asset revaluation percentage | 21.00% | 34.00% | 34.00% |
Medical device tax suspension period | 2 years | ||
State | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Operating loss carryforwards begin to expire year | 2,020 | ||
Federal | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Operating loss carryforwards begin to expire year | 2,023 | ||
Measurement Input, Expected Dividend Rate | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Dividend yield percentage | 0 | ||
Minimum | US | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Product warranty period | 1 year | ||
Maximum | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Deferred tax asset revaluation percentage | 35.00% | ||
Maximum | US | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Product warranty period | 2 years | ||
Maximum | Non US | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Product warranty period | 3 years | ||
Computers and Software | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Property and equipment estimated useful life | 3 years | ||
Laboratory and Office Equipment | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Property and equipment estimated useful life | 5 years | ||
Devices in Rental Agreement Program | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Property and equipment estimated useful life | 6 years | ||
Leasehold Improvements | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Property and equipment estimated useful life | 5 years | ||
Capitalized Software | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Property and equipment estimated useful life | 2 years |
Recent Accounting Pronounceme_2
Recent Accounting Pronouncements - Additional Information (Details) - USD ($) | 12 Months Ended | |
Dec. 31, 2018 | Jan. 01, 2019 | |
Lessee Lease Description [Line Items] | ||
Current non-cancelable office lease, expiration date | 2,021 | |
ASU 2016-12 | Subsequent Event | ||
Lessee Lease Description [Line Items] | ||
Cumulative effect on retained earnings | $ 0 | |
ASU 2016-02, Leases | Scenario Plan | ||
Lessee Lease Description [Line Items] | ||
Operating ease, right of use assets | 1,000,000 | |
Operating lease liabilities | $ 1,000,000 |
Fair Value Measurement and Fi_3
Fair Value Measurement and Financial Instruments - Schedule of Carrying Amounts and Fair Values of Financial Instruments (Details) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 |
Carrying Amount | Convertible preferred sock warrant liability | ||
Liabilities | ||
Total liabilities | $ 478 | |
Fair Value | Convertible preferred sock warrant liability | ||
Liabilities | ||
Total liabilities | 478 | |
Significant Unobservable Inputs (Level 3) | Convertible preferred sock warrant liability | ||
Liabilities | ||
Total liabilities | 478 | |
Money market funds | Carrying Amount | ||
Assets | ||
Total assets | $ 87,062 | 11,149 |
Money market funds | Fair Value | ||
Assets | ||
Total assets | 87,062 | 11,149 |
Money market funds | Quoted Prices In Active Markets (Level 1) | ||
Assets | ||
Total assets | $ 87,062 | $ 11,149 |
Fair Value Measurement and Fi_4
Fair Value Measurement and Financial Instruments - Summary of Fair Value Inputs and Assumptions (Details) | 12 Months Ended |
Dec. 31, 2017$ / shares | |
Estimated Fair Value of Convertible Preferred Stock | Series E | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Fair value assumption | $ 9.57 |
Estimated Fair Value of Convertible Preferred Stock | Series F | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Fair value assumption | 11.01 |
Exercise Price | Series E | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Exercise price | 19.55 |
Exercise Price | Series F | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Exercise price | $ 9.73 |
Remaining Term (in years) | Series E | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Remaining term (in years) | 5 years |
Remaining Term (in years) | Series F | Minimum | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Remaining term (in years) | 3 years 1 month 6 days |
Remaining Term (in years) | Series F | Maximum | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Remaining term (in years) | 7 years |
Risk-free Interest Rate | Series E | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Risk-free interest rate | 2 |
Risk-free Interest Rate | Series F | Minimum | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Risk-free interest rate | 2 |
Risk-free Interest Rate | Series F | Maximum | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Risk-free interest rate | 2.3 |
Expected Volatility | Series E | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Risk-free interest rate | 43 |
Expected Volatility | Series F | Minimum | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Risk-free interest rate | 43 |
Expected Volatility | Series F | Maximum | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Risk-free interest rate | 44 |
Measurement Input, Expected Dividend Rate | Series E | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Risk-free interest rate | 0 |
Measurement Input, Expected Dividend Rate | Series F | |
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis Valuation Techniques [Line Items] | |
Risk-free interest rate | 0 |
Fair Value Measurement and Fi_5
Fair Value Measurement and Financial Instruments - Summary of Changes in Instruments Measured on Recurring Basis (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2018 | Dec. 31, 2017 | |
Fair Value Assets And Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Abstract] | ||
Balance at December 31, 2016 | $ 478 | $ 459 |
Issuance of warrants | 290 | |
Change in fair value | 1,396 | (271) |
Reclassification to additional paid in capital | (1,874) | |
Balance at December 31, 2017 | $ 0 | $ 478 |
Accounts Receivable - Compositi
Accounts Receivable - Composition of Accounts Receivable, Net (Details) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 |
Receivables [Abstract] | ||||
Gross accounts receivable - trade | $ 6,120 | $ 4,684 | ||
Less: Allowances for doubtful accounts | (500) | (417) | $ (343) | $ (274) |
Accounts receivable, net | $ 5,620 | $ 4,267 |
Accounts Receivable - Additiona
Accounts Receivable - Additional Information (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Receivables [Abstract] | |||
Bad debt expense | $ 153 | $ 116 | $ 75 |
Accounts Receivable - Allowance
Accounts Receivable - Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Receivables [Abstract] | |||
Balance at Beginning of Period | $ (417) | $ (343) | $ (274) |
Bad Debt Expense Recognized | (153) | (116) | (75) |
Write-offs of Uncollectible Balances | 70 | 42 | 6 |
Balance at End of Period | $ (500) | $ (417) | $ (343) |
Property and Equipment and Ca_3
Property and Equipment and Capitalized Software - Summary of Composition of Property and Equipment, Net (Details) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 |
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | $ 3,394 | $ 3,190 |
Less: Accumulated depreciation | (2,016) | (1,831) |
Property and equipment, net | 1,378 | 1,359 |
Laboratory Equipment | ||
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | 150 | 150 |
Office Equipment | ||
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | 487 | 487 |
Computer Equipment and Software | ||
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | 1,050 | 680 |
Manufacturing Equipment | ||
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | 273 | 273 |
Leasehold Improvements | ||
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | 172 | 153 |
Rental Equipment | ||
Property Plant And Equipment [Line Items] | ||
Property and equipment, gross | $ 1,262 | $ 1,447 |
Property and Equipment and Ca_4
Property and Equipment and Capitalized Software - Additional Information (Details) - USD ($) $ in Millions | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Property Plant And Equipment [Line Items] | |||
Depreciation and amortization expense | $ 0.9 | $ 0.6 | $ 0.7 |
Other Assets [Member] | |||
Property Plant And Equipment [Line Items] | |||
Capitalized software cost, net | $ 1 | $ 0.4 |
Accrued Expenses - Summary of C
Accrued Expenses - Summary of Composition of Accrued Expenses (Details) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 |
Payables And Accruals [Abstract] | ||
Compensation and related benefits | $ 4,909 | $ 4,465 |
Consulting and professional fees | 342 | 461 |
Research and development expenses | 191 | 497 |
Sales and marketing expenses | 127 | 620 |
Warranty | 629 | 570 |
Sales tax payable | 606 | 322 |
Interest payable | 251 | 188 |
Other | 493 | 388 |
Accrued expenses | $ 7,548 | $ 7,511 |
Debt - Summary of Composition o
Debt - Summary of Composition of Debt (Details) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 |
Debt Disclosure [Abstract] | ||
Outstanding principal | $ 30,000 | $ 30,000 |
Accrued final payment fees | 1,468 | 940 |
Less debt discounts | (1,073) | (1,384) |
Total long-term debt, net | 30,395 | 29,556 |
Long-term debt, net | $ 30,395 | $ 29,556 |
Debt - Additional Information (
Debt - Additional Information (Details) - USD ($) $ / shares in Units, shares in Thousands | Jul. 02, 2018 | Feb. 28, 2017 | Mar. 31, 2017 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 |
Debt Instrument [Line Items] | ||||||
Interest expense | $ 3,700,000 | $ 2,800,000 | $ 1,800,000 | |||
Cash interest expense | 2,900,000 | 2,100,000 | 1,400,000 | |||
Non-cash interest expense | $ 800,000 | $ 700,000 | $ 400,000 | |||
Debt instrument, final payment fee | $ 1,000,000 | |||||
$35.0 Million Credit Facility | ||||||
Debt Instrument [Line Items] | ||||||
Percentage of forecasted revenue to be achieved | 75.00% | |||||
$35.0 Million Credit Facility | Prepaid on or Before First Anniversary of Funding | ||||||
Debt Instrument [Line Items] | ||||||
Prepayment fees percentage | 3.00% | |||||
$35.0 Million Credit Facility | Prepaid After First and on or Before Second Anniversary of Funding | ||||||
Debt Instrument [Line Items] | ||||||
Prepayment fees percentage | 2.00% | |||||
$35.0 Million Credit Facility | Prepaid After Second Anniversary of Funding | ||||||
Debt Instrument [Line Items] | ||||||
Prepayment fees percentage | 1.00% | |||||
$35.0 Million Credit Facility | Oxford Finance LLC | ||||||
Debt Instrument [Line Items] | ||||||
Line of credit facility, maximum borrowing capacity | $ 25,000,000 | 35,000,000 | ||||
Borrowings outstanding under credit facility | $ 30,000,000 | |||||
Available borrowing achievement of trailing twelve month revenues | 45,000,000 | |||||
Debt instrument, interest rate | 8.15% | |||||
Warrants term | 7 years | |||||
Percentage of borrowing capacity of tranche | 3.95% | |||||
Borrowing capacity of tranche | $ 5,000,000 | |||||
Credit facility maturity date | Mar. 1, 2022 | |||||
$35.0 Million Credit Facility | Oxford Finance LLC | LIBOR | ||||||
Debt Instrument [Line Items] | ||||||
Debt instrument, description of variable rate basis | 30-day U.S. LIBOR | |||||
Basis spread on variable rate | 7.38% | |||||
$35.0 Million Credit Facility | Term A Loan | ||||||
Debt Instrument [Line Items] | ||||||
Interest-only period | 2019-03 | |||||
Amortization period without interest-only period extension | 36 months | |||||
Extension of interest-only period upon achievement of revenues | 12 months | |||||
Interest-only period upon achievement of revenues | 2020-03 | |||||
Amortization period upon extension of interest-only period | 24 months | |||||
Increase in final payment fees percentage upon extension interest only periods | 8.50% | |||||
Effective interest rates | 11.87% | 10.70% | ||||
$35.0 Million Credit Facility | Term A Loan | Common Stock | ||||||
Debt Instrument [Line Items] | ||||||
Warrants to purchase shares | 20,303 | |||||
Warrants, exercise price | $ 9.73 | |||||
Warrants expiration period | 2024-03 | |||||
$35.0 Million Credit Facility | Term A Loan | Oxford Finance LLC | ||||||
Debt Instrument [Line Items] | ||||||
Borrowings outstanding under credit facility | 25,000,000 | |||||
$35.0 Million Credit Facility | Term B Loan | ||||||
Debt Instrument [Line Items] | ||||||
Interest-only period | 2019-03 | |||||
Amortization period without interest-only period extension | 36 months | |||||
Extension of interest-only period upon achievement of revenues | 12 months | |||||
Interest-only period upon achievement of revenues | 2020-03 | |||||
Amortization period upon extension of interest-only period | 24 months | |||||
Increase in final payment fees percentage upon extension interest only periods | 7.50% | |||||
Effective interest rates | 12.14% | 11.60% | ||||
$35.0 Million Credit Facility | Term B Loan | Common Stock | ||||||
Debt Instrument [Line Items] | ||||||
Warrants to purchase shares | 20,303 | |||||
Warrants, exercise price | $ 9.73 | |||||
Warrants expiration period | 2024-12 | |||||
$35.0 Million Credit Facility | Term B Loan | Oxford Finance LLC | ||||||
Debt Instrument [Line Items] | ||||||
Borrowings outstanding under credit facility | 5,000,000 | |||||
$35.0 Million Credit Facility | Term C Loan | Oxford Finance LLC | ||||||
Debt Instrument [Line Items] | ||||||
Line of credit facility, current borrowing capacity | $ 5,000,000 | |||||
Notification period for lenders to borrow loan upon achieving required revenue milestone | 60 days | |||||
Line of credit facility additional borrowing capacity | $ 5,000,000 | |||||
$25.0 Million Credit Facility | Oxford Finance LLC | ||||||
Debt Instrument [Line Items] | ||||||
Line of credit facility, maximum borrowing capacity | $ 25,000,000 | |||||
$25.0 Million Credit Facility | Term A Loan | ||||||
Debt Instrument [Line Items] | ||||||
Final payment fees percentage | 8.50% | |||||
$25.0 Million Credit Facility | Term A Loan | Minimum | ||||||
Debt Instrument [Line Items] | ||||||
Debt instrument, accrued interest rate | 8.50% | |||||
$25.0 Million Credit Facility | Term A Loan | Maximum | ||||||
Debt Instrument [Line Items] | ||||||
Debt instrument, accrued interest rate | 8.90% | |||||
$25.0 Million Credit Facility | Term A Loan | Oxford Finance LLC | ||||||
Debt Instrument [Line Items] | ||||||
Borrowings outstanding under credit facility | $ 15,000,000 | |||||
$25.0 Million Credit Facility | Term B Loan | ||||||
Debt Instrument [Line Items] | ||||||
Final payment fees percentage | 4.70% | |||||
$25.0 Million Credit Facility | Term B Loan | Minimum | ||||||
Debt Instrument [Line Items] | ||||||
Debt instrument, accrued interest rate | 8.50% | |||||
$25.0 Million Credit Facility | Term B Loan | Maximum | ||||||
Debt Instrument [Line Items] | ||||||
Debt instrument, accrued interest rate | 8.90% | |||||
$25.0 Million Credit Facility | Term B Loan | Oxford Finance LLC | ||||||
Debt Instrument [Line Items] | ||||||
Borrowings outstanding under credit facility | $ 5,000,000 | |||||
$25.0 Million Credit Facility | Term C Loan | Oxford Finance LLC | ||||||
Debt Instrument [Line Items] | ||||||
Line of credit facility, current borrowing capacity | $ 5,000,000 |
Debt - Schedule of Future Princ
Debt - Schedule of Future Principal Payments (Details) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 |
Debt Instrument [Line Items] | ||
Total principal payments | $ 30,000 | $ 30,000 |
Term A and Term B Loans | ||
Debt Instrument [Line Items] | ||
2,020 | 11,250 | |
2,021 | 15,000 | |
2,022 | 3,750 | |
Total principal payments | $ 30,000 |
Convertible Preferred Stock a_3
Convertible Preferred Stock and Stockholders' Deficit - Additional Information (Details) - USD ($) | Jul. 02, 2018 | Dec. 31, 2018 | Jun. 30, 2018 | Dec. 31, 2017 |
Stockholders Deficit [Line Items] | ||||
IPO closing date | Jul. 2, 2018 | |||
Net proceeds from initial public offering | $ 99,998,000 | |||
Common stock, par value per share | $ 0.01 | $ 0.01 | ||
Common stock, shares authorized for issuance | 200,000,000 | 200,000,000 | ||
Preferred stock, shares authorized for issuance | 10,000,000 | 10,000,000 | ||
Preferred stock, par value per share | $ 0.01 | $ 0.01 | ||
Common stock, shares issued | 17,744,000 | 231,000 | ||
Common stock, shares outstanding | 17,744,000 | 231,000 | ||
Convertible preferred stock, shares authorized | 308,593,000 | 308,593,000 | ||
Convertible preferred stock, par value | $ 0.01 | $ 0.01 | ||
Liquidation preference | $ 0 | $ 108,324,000 | ||
Convertible preferred stock non-cumulative dividends rate | 9.00% | |||
Common stock voting rights | one | |||
Convertible Preferred Stock | ||||
Stockholders Deficit [Line Items] | ||||
Convertible preferred stock converted into common stock | (304,958,000) | |||
Convertible preferred stock, shares authorized | 308,600,000 | |||
Convertible preferred stock, par value | $ 0.01 | |||
Oxford Finance LLC | ||||
Stockholders Deficit [Line Items] | ||||
Convertible preferred stock converted to common stock, ratio | 2898.55% | |||
Series D Convertible Preferred Stock | ||||
Stockholders Deficit [Line Items] | ||||
Convertible preferred stock, shares authorized | 49,426,000 | |||
Convertible preferred stock converted to common stock, ratio | 2898.55% | |||
Liquidation preference | $ 14,205,000 | |||
Series E Convertible Preferred Stock | ||||
Stockholders Deficit [Line Items] | ||||
Convertible preferred stock, shares authorized | 44,873,000 | |||
Convertible preferred stock converted to common stock, ratio | 2898.55% | |||
Liquidation preference | $ 22,876,000 | |||
Series F Convertible Preferred Stock | ||||
Stockholders Deficit [Line Items] | ||||
Convertible preferred stock, shares authorized | 105,567,000 | |||
Convertible preferred stock converted to common stock, ratio | 2898.55% | |||
Liquidation preference | $ 34,343,000 | |||
Additional liquidation preference | $ 0.1678 | |||
Additional liquidation preference per share due | $ 1.0068 | |||
Series G Convertible Preferred Stock | ||||
Stockholders Deficit [Line Items] | ||||
Convertible preferred stock, shares authorized | 40,584,000 | |||
Convertible preferred stock converted to common stock, ratio | 2898.55% | |||
Liquidation preference | $ 15,000,000 | |||
Series A-2 Convertible Preferred Stock | ||||
Stockholders Deficit [Line Items] | ||||
Convertible preferred stock, shares authorized | 25,385,000 | |||
Convertible preferred stock converted to common stock, ratio | 2825.65% | |||
Liquidation preference | $ 5,209,000 | |||
Series B Convertible Preferred Stock | ||||
Stockholders Deficit [Line Items] | ||||
Convertible preferred stock, shares authorized | 17,000,000 | |||
Convertible preferred stock converted to common stock, ratio | 2437.24% | |||
Liquidation preference | $ 5,386,000 | |||
Series C Convertible Preferred Stock | ||||
Stockholders Deficit [Line Items] | ||||
Convertible preferred stock, shares authorized | 20,958,000 | |||
Convertible preferred stock converted to common stock, ratio | 1971.99% | |||
Liquidation preference | $ 11,009,000 | |||
Junior Securities | ||||
Stockholders Deficit [Line Items] | ||||
Liquidation preference | $ 59,200,000 | |||
Common Stock | ||||
Stockholders Deficit [Line Items] | ||||
Common stock shares issued and sold | 6,325,000 | 6,325,000 | ||
Convertible preferred stock converted into common stock | 11,000,000 | 10,994,000 | ||
Initial Public Offering | ||||
Stockholders Deficit [Line Items] | ||||
IPO closing date | Jul. 2, 2018 | |||
Net proceeds from initial public offering | $ 96,500,000 | |||
Common stock, par value per share | $ 0.01 | |||
Common stock, shares authorized for issuance | 200,000,000 | |||
Preferred stock, shares authorized for issuance | 10,000,000 | |||
Preferred stock, par value per share | $ 0.01 | |||
Initial Public Offering | Common Stock | ||||
Stockholders Deficit [Line Items] | ||||
Common stock shares issued and sold | 6,325,000 | |||
Issuance price per share | $ 17 | |||
Convertible preferred stock converted into common stock | 11,000,000 |
Convertible Preferred Stock a_4
Convertible Preferred Stock and Stockholders' Deficit - Summary of Common Stock Issued and Reserved for Issuance (Details) - shares | Dec. 31, 2018 | Jul. 31, 2018 | Dec. 31, 2017 |
Stockholders Deficit [Line Items] | |||
Shares of common stock issued | 17,744,000 | 231,000 | |
Shares of common stock reserved for issuance for: | |||
Total shares of common stock issued and reserved for issuance | 22,159,000 | 14,040,000 | |
Series A-1 Convertible Preferred Stock | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 166,000 | ||
Series A-2 Convertible Preferred Stock | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 898,000 | ||
Series B Convertible Preferred Stock | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 697,000 | ||
Series C Convertible Preferred Stock | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 1,063,000 | ||
Series D Convertible Preferred Stock | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 1,705,000 | ||
Series E Convertible Preferred Stock | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 1,534,000 | ||
Series F Convertible Preferred Stock | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 3,531,000 | ||
Series G Convertible Preferred Stock | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 1,400,000 | ||
Series E Convertible Preferred Stock Warrants | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 14,000 | ||
Series F Convertible Preferred Stock Warrants | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 91,000 | ||
Common Stock Warrants Outstanding | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 105,000 | ||
Warrants Issuable Upon Term C Loan Borrowing | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 20,000 | ||
Shares Available for Sales Under Employee Stock Purchase Plan | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 244,000 | 200,000 | |
Stock Options Outstanding | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 2,711,000 | 2,444,000 | |
Shares Available for Grant Under Stock Incentive Plan | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 1,312,000 | 246,000 | |
Restricted Stock Units Outstanding | |||
Shares of common stock reserved for issuance for: | |||
Shares of common stock reserved for issuance | 43,000 |
Convertible Preferred Stock a_5
Convertible Preferred Stock and Stockholders' Deficit - Summary of Outstanding Convertible Preferred Stock (Details) - USD ($) | Dec. 31, 2018 | Dec. 31, 2017 |
Class Of Stock [Line Items] | ||
Shares Authorized and Designated | 308,593,000 | 308,593,000 |
Shares Issued | 0 | 304,958,000 |
Shares Outstanding | 0 | 304,958,000 |
Carrying Value | $ 187,136,000 | |
Liquidation Value | $ 0 | $ 108,324,000 |
Series A-1 Convertible Preferred Stock | ||
Class Of Stock [Line Items] | ||
Shares Authorized and Designated | 4,800,000 | |
Shares Issued | 4,800,000 | |
Shares Outstanding | 4,800,000 | |
Carrying Value | $ 900,000 | |
Liquidation Value per Share | $ 0.0617 | |
Liquidation Value | $ 296,000 | |
Series A-2 Convertible Preferred Stock | ||
Class Of Stock [Line Items] | ||
Shares Authorized and Designated | 25,385,000 | |
Shares Issued | 25,385,000 | |
Shares Outstanding | 25,385,000 | |
Carrying Value | $ 16,428,000 | |
Liquidation Value per Share | $ 0.2052 | |
Liquidation Value | $ 5,209,000 | |
Series B Convertible Preferred Stock | ||
Class Of Stock [Line Items] | ||
Shares Authorized and Designated | 17,000,000 | |
Shares Issued | 17,000,000 | |
Shares Outstanding | 17,000,000 | |
Carrying Value | $ 16,859,000 | |
Liquidation Value per Share | $ 0.3168 | |
Liquidation Value | $ 5,386,000 | |
Series C Convertible Preferred Stock | ||
Class Of Stock [Line Items] | ||
Shares Authorized and Designated | 20,958,000 | |
Shares Issued | 20,958,000 | |
Shares Outstanding | 20,958,000 | |
Carrying Value | $ 34,841,000 | |
Liquidation Value per Share | $ 0.5253 | |
Liquidation Value | $ 11,009,000 | |
Series D Convertible Preferred Stock | ||
Class Of Stock [Line Items] | ||
Shares Authorized and Designated | 49,426,000 | |
Shares Issued | 49,426,000 | |
Shares Outstanding | 49,426,000 | |
Carrying Value | $ 29,970,000 | |
Liquidation Value per Share | $ 0.2874 | |
Liquidation Value | $ 14,205,000 | |
Series E Convertible Preferred Stock | ||
Class Of Stock [Line Items] | ||
Shares Authorized and Designated | 44,873,000 | |
Shares Issued | 44,471,000 | |
Shares Outstanding | 44,471,000 | |
Carrying Value | $ 29,800,000 | |
Liquidation Value per Share | $ 0.5144 | |
Liquidation Value | $ 22,876,000 | |
Series F Convertible Preferred Stock | ||
Class Of Stock [Line Items] | ||
Shares Authorized and Designated | 105,567,000 | |
Shares Issued | 102,334,000 | |
Shares Outstanding | 102,334,000 | |
Carrying Value | $ 43,513,000 | |
Liquidation Value per Share | $ 0.3356 | |
Liquidation Value | $ 34,343,000 | |
Series G Convertible Preferred Stock | ||
Class Of Stock [Line Items] | ||
Shares Authorized and Designated | 40,584,000 | |
Shares Issued | 40,584,000 | |
Shares Outstanding | 40,584,000 | |
Carrying Value | $ 14,825,000 | |
Liquidation Value per Share | $ 0.3696 | |
Liquidation Value | $ 15,000,000 |
Convertible Preferred Stock a_6
Convertible Preferred Stock and Stockholders' Deficit - Summary of Outstanding Common Stock Warrants (Details) - $ / shares shares in Thousands | 12 Months Ended | |
Dec. 31, 2018 | Dec. 31, 2017 | |
Class Of Warrant Or Right [Line Items] | ||
Warrants Outstanding | 105 | 3,046 |
Exercise Price $19.55 | ||
Class Of Warrant Or Right [Line Items] | ||
Warrants Outstanding | 14 | |
Exercise price | $ 19.55 | |
Expiration Date | 2022-12 | |
Exercise Price $9.73 | ||
Class Of Warrant Or Right [Line Items] | ||
Warrants Outstanding | 30 | |
Exercise price | $ 9.73 | |
Expiration Date | 2021-02 | |
Exercise Price $9.73 | ||
Class Of Warrant Or Right [Line Items] | ||
Warrants Outstanding | 20 | |
Exercise price | $ 9.73 | |
Expiration Date | 2023-08 | |
Exercise Price $9.73 | ||
Class Of Warrant Or Right [Line Items] | ||
Warrants Outstanding | 20 | |
Exercise price | $ 9.73 | |
Expiration Date | 2024-03 | |
Exercise Price $9.73 | ||
Class Of Warrant Or Right [Line Items] | ||
Warrants Outstanding | 21 | |
Exercise price | $ 9.73 | |
Expiration Date | 2024-12 |
Convertible Preferred Stock a_7
Convertible Preferred Stock and Stockholders' Deficit - Summary of Outstanding Convertible Preferred Stock Warrants (Details) - $ / shares shares in Thousands | 12 Months Ended | |
Dec. 31, 2017 | Dec. 31, 2018 | |
Class Of Warrant Or Right [Line Items] | ||
Warrants Outstanding | 3,046 | 105 |
Series E Convertible Preferred Stock Warrants | ||
Class Of Warrant Or Right [Line Items] | ||
Warrants Outstanding | 402 | |
Exercise price | $ 0.6746 | |
Expiration Date | 2022-12 | |
Series F Convertible Preferred Stock Warrants | ||
Class Of Warrant Or Right [Line Items] | ||
Warrants Outstanding | 878 | |
Exercise price | $ 0.3356 | |
Expiration Date | 2021-02 | |
Series F Convertible Preferred Stock Warrants | ||
Class Of Warrant Or Right [Line Items] | ||
Warrants Outstanding | 589 | |
Exercise price | $ 0.3356 | |
Expiration Date | 2023-08 | |
Series F Convertible Preferred Stock Warrants | ||
Class Of Warrant Or Right [Line Items] | ||
Warrants Outstanding | 589 | |
Exercise price | $ 0.3356 | |
Expiration Date | 2024-03 | |
Series F Convertible Preferred Stock Warrants | ||
Class Of Warrant Or Right [Line Items] | ||
Warrants Outstanding | 588 | |
Exercise price | $ 0.3356 | |
Expiration Date | 2024-12 |
Loss Per Share - Schedule of Po
Loss Per Share - Schedule of Potentially Dilutive Securities Outstanding Excluded from Diluted Loss Per Share Calculation (Details) - shares shares in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Stock Options Outstanding | |||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | |||
Potentially dilutive securities outstanding excluded from diluted loss per share | 2,711 | 2,444 | 1,826 |
Non-vested Restricted Stock Awards | |||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | |||
Potentially dilutive securities outstanding excluded from diluted loss per share | 4 | 16 | 22 |
Non-vested Restricted Stock Units | |||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | |||
Potentially dilutive securities outstanding excluded from diluted loss per share | 43 | ||
Common Stock Warrants | |||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | |||
Potentially dilutive securities outstanding excluded from diluted loss per share | 105 | ||
Convertible Preferred Stock Warrants | |||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | |||
Potentially dilutive securities outstanding excluded from diluted loss per share | 105 | 64 | |
Shares of Convertible Preferred Stock "as-converted" | |||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | |||
Potentially dilutive securities outstanding excluded from diluted loss per share | 10,994 | 9,594 |
Share-Based Compensation - Summ
Share-Based Compensation - Summary of Share-Based Compensation Expense (Details) - USD ($) $ in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items] | |||
Total | $ 1,743 | $ 496 | $ 161 |
Cost of Revenues | |||
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items] | |||
Total | 21 | 18 | 5 |
Sales and Marketing | |||
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items] | |||
Total | 926 | 141 | 49 |
General and Administrative | |||
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items] | |||
Total | 646 | 226 | 70 |
Research and Development | |||
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items] | |||
Total | $ 150 | $ 111 | $ 37 |
Share-Based Compensation - Addi
Share-Based Compensation - Additional Information (Details) - USD ($) $ / shares in Units, $ in Thousands | 1 Months Ended | 12 Months Ended | ||
Apr. 30, 2018 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||||
Share-based compensation expenses | $ 1,743 | $ 496 | $ 161 | |
Weighted-average grant-date fair value of stock options granted | $ 5.03 | $ 1.45 | $ 1.16 | |
Intrinsic value of stock options exercised | $ 3,300 | $ 100 | ||
Options to purchase shares | 54,794 | |||
Option exercise price | $ 5.22 | |||
Stock option vesting period, monthly installment | 12 months | |||
Estimated grant-date fair value of option awards | $ 200 | |||
Stock Options Outstanding | ||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||||
Share-based compensation expenses | 1,600 | $ 400 | $ 200 | |
Unrecognized compensation cost related to non-vested stock options | $ 3,100 | |||
Non-vested awards not yet recognized weighted-average period for recognition | 3 years 1 month 6 days | |||
Options to purchase shares | 584,000 | 967,000 | 255,000 | |
Restricted Stock Awards and Restricted Stock Units | ||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||||
Share-based compensation expenses | $ 200 | $ 100 | ||
Non-vested awards not yet recognized weighted-average period for recognition | 3 years 4 months 24 days | |||
Unrecognized compensation cost related to non-vested restricted stock | $ 900 | |||
Fair value of restricted stock vested | $ 200 | $ 100 | ||
2018 Equity Incentive Plan | ||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||||
Vesting terms of stock options | stock options vest 25% upon the first anniversary of the date of grant and the remainder ratably monthly thereafter for 36 months | |||
Shares available for future issuance | 1,300,000 | |||
2018 Equity Incentive Plan | First Anniversary of Date of Grant | ||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||||
Vesting percentage of stock options | 25.00% | |||
2018 Equity Incentive Plan | Maximum | ||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||||
Number of shares authorized for issuance | 1,400,000 | |||
Maximum contractual term of stock options | 10 years | |||
2003 Stock Incentive Plan | ||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||||
Vesting terms of stock options | stock options vest 25% upon the first anniversary of the date of grant and the remainder ratably monthly thereafter for 36 months | |||
Shares available for future issuance | 0 | |||
2003 Stock Incentive Plan | First Anniversary of Date of Grant | ||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||||
Vesting percentage of stock options | 25.00% | |||
2003 Stock Incentive Plan | Maximum | ||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||||
Number of shares authorized for issuance | 3,100,000 | |||
Maximum contractual term of stock options | 10 years |
Share-Based Compensation - Su_2
Share-Based Compensation - Summary of Stock Option Activity (Details) - USD ($) $ / shares in Units, $ in Thousands | 1 Months Ended | 12 Months Ended | ||
Apr. 30, 2018 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||||
Number of Shares under Option, Granted | 54,794 | |||
Stock Options Outstanding | ||||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | ||||
Number of Shares under Option, Outstanding, Beginning balance | 2,444,000 | 1,826,000 | 1,767,000 | |
Number of Shares under Option, Granted | 584,000 | 967,000 | 255,000 | |
Number of Shares under Option, Exercised | (194,000) | (33,000) | (19,000) | |
Number of Shares under Option, Forfeited | (123,000) | (316,000) | (161,000) | |
Number of Shares under Option, Expired | (16,000) | |||
Number of Shares under Option, Outstanding, Ending balance | 2,711,000 | 2,444,000 | 1,826,000 | |
Number of Shares under Option, Exercisable | 1,613,000 | |||
Number of Shares under Option, Vested and expected to vest | 2,711,000 | |||
Weighted-average Exercise Price per Option, Outstanding, Beginning balance | $ 2.39 | $ 2.07 | $ 2.52 | |
Weighted-average Exercise Price per Option, Granted | 8.33 | 3.03 | 2.45 | |
Weighted-average Exercise Price per Option, Exercised | 2.60 | 1.05 | 3.58 | |
Weighted-average Exercise Price per Option, Forfeited | 3.73 | 2.66 | 5.68 | |
Weighted-average Exercise Price per Option Expired | 19.63 | |||
Weighted-average Exercise Price per Option, Outstanding, Ending balance | 3.59 | $ 2.39 | $ 2.07 | |
Weighted-average Exercise Price per Option, Exercisable | 2.22 | |||
Weighted-average Exercise Price per Option, Vested and expected to vest | $ 3.59 | |||
Weighted-average Remaining Contractual Life, Outstanding | 7 years 3 months 18 days | |||
Weighted-average Remaining Contractual Life, Exercisable | 6 years 2 months 12 days | |||
Weighted-average Remaining Contractual Life, Vested and expected to vest | 7 years 3 months 18 days | |||
Aggregate Intrinsic Value, Outstanding | $ 42,773 | |||
Aggregate Intrinsic Value, Exercisable | 27,921 | |||
Aggregate Intrinsic Value, Vested and expected to vest | $ 42,773 |
Share-Based Compensation - Su_3
Share-Based Compensation - Summary of Weighted-average Inputs and Assumptions used to Estimate Grant-date Fair Value of Stock Options (Details) - $ / shares | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract] | |||
Estimated fair value of common stock | $ 8.41 | $ 2.90 | $ 2.32 |
Exercise price | $ 8.41 | $ 2.90 | $ 2.32 |
Expected term (in years) | 6 years | 6 years | 6 years |
Risk-free interest rate | 2.70% | 2.00% | 1.40% |
Expected volatility | 65.30% | 48.00% | 44.20% |
Dividend yield | 0.00% | 0.00% | 0.00% |
Share-Based Compensation - Su_4
Share-Based Compensation - Summary of Restricted Stock Award and Restricted Stock Unit Activity (Details) - $ / shares shares in Thousands | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Restricted Stock Awards [Member] | |||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||
Non-vested, Beginning balance | 16 | 22 | |
Granted | 11 | 42 | |
Vested | (12) | (17) | (20) |
Non-vested, Ending balance | 4 | 16 | 22 |
Weighted-average Grant-date Fair Value, Non-vested, Beginning balance | $ 2.32 | $ 2.03 | |
Weighted-average Grant-date Fair Value, Granted | 4.06 | $ 2.03 | |
Weighted-average Grant-date Fair Value, Vested | 2.32 | 2.90 | 2.03 |
Weighted-average Grant-date Fair Value, Non-vested, Ending balance | $ 2.32 | $ 2.32 | $ 2.03 |
Restricted Stock Units Outstanding | |||
Share Based Compensation Arrangement By Share Based Payment Award [Line Items] | |||
Granted | 43 | ||
Non-vested, Ending balance | 43 | ||
Weighted-average Grant-date Fair Value, Granted | $ 25.21 | ||
Weighted-average Grant-date Fair Value, Vested | 25.92 | ||
Weighted-average Grant-date Fair Value, Non-vested, Ending balance | $ 25.21 |
Employee Benefit Plans - Additi
Employee Benefit Plans - Additional Information (Details) - shares shares in Thousands | 1 Months Ended | 12 Months Ended |
Jul. 31, 2018 | Dec. 31, 2018 | |
Defined Benefit Plan Disclosure [Line Items] | ||
Defined contribution retirement plan, plan name | 401(k) plan | |
2018 ESPP | ||
Defined Benefit Plan Disclosure [Line Items] | ||
Shares of common stock reserved for issuance | 200 | 244 |
Common stock purchase price, discount rate | 15.00% | |
Maximum | 2018 ESPP | ||
Defined Benefit Plan Disclosure [Line Items] | ||
Period of automatic annual increase in the share reserve | 10 years | |
401(k) Plan | ||
Defined Benefit Plan Disclosure [Line Items] | ||
Defined contribution retirement plan, maximum employee contribution deferred | 100.00% |
Income Taxes - Additional Infor
Income Taxes - Additional Information (Details) - USD ($) | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Income Taxes [Line Items] | |||
Loss before income taxes | $ 24,100,000 | $ 16,100,000 | $ 11,200,000 |
Deferred income tax expense or benefit | 0 | 0 | 0 |
Current Income Tax Expense (Benefit) | 0 | 0 | $ 0 |
Increase/ (decrease) in valuation allowance | 6,400,000 | $ (16,100,000) | |
Accrued interest or penalties related to uncertain tax positions | 0 | ||
Interest or penalties related to uncertain tax positions recognized in statements of operations and comprehensive loss | $ 0 | ||
Deferred tax asset revaluation percentage | 21.00% | 34.00% | 34.00% |
Maximum | |||
Income Taxes [Line Items] | |||
Deferred tax asset revaluation percentage | 35.00% |
Income Taxes - Schedule of Reco
Income Taxes - Schedule of Reconciliation of Statutory Federal Income Tax Rate (Details) | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Income Tax Disclosure [Abstract] | |||
U.S. federal statutory income tax rate | 21.00% | 34.00% | 34.00% |
State and local taxes, net of federal benefit | 3.80% | 2.70% | 2.60% |
Nondeductible expenses | 0.70% | (0.30%) | (1.20%) |
Research and development credits | 0.60% | 1.30% | 2.00% |
Tax rate change and true-up | 0.60% | (138.00%) | (1.20%) |
Change in valuation allowance | (26.70%) | 100.30% | (36.20%) |
Effective income tax rate | 0.00% | 0.00% | 0.00% |
Income Taxes - Schedule of Defe
Income Taxes - Schedule of Deferred Tax Assets (Details) - USD ($) $ in Thousands | Dec. 31, 2018 | Dec. 31, 2017 |
Deferred tax assets: | ||
Net operating loss carryforwards | $ 46,352 | $ 41,430 |
Research and development credits | 3,208 | 3,059 |
Share-based compensation | 523 | 316 |
Accruals | 853 | 753 |
Interest expense - 163(j) | 592 | |
Capitalized start-up costs | 1,295 | 1,530 |
Other temporary differences | 951 | 253 |
Gross deferred tax assets | 53,774 | 47,341 |
Less: Valuation allowance | $ (53,774) | $ (47,341) |
Income Taxes - Summary of Valua
Income Taxes - Summary of Valuation Allowance (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2018 | Dec. 31, 2017 | |
Income Tax Disclosure [Abstract] | ||
Balance at the beginning of the period | $ 47,341 | $ 63,449 |
Amounts charges to expense | 6,433 | 6,099 |
Tax rate change (34% to 21%) | (22,207) | |
Balance at the end of the period | $ 53,774 | $ 47,341 |
Income Taxes - Summary of Val_2
Income Taxes - Summary of Valuation Allowance (Parenthetical) (Details) | 12 Months Ended | ||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Income Tax Disclosure [Abstract] | |||
Tax rate change | 21.00% | 34.00% | 34.00% |
Income Taxes - Summary of Net O
Income Taxes - Summary of Net Operating Loss Carryforwards and Tax Credits (Details) $ in Thousands | 12 Months Ended |
Dec. 31, 2018USD ($) | |
Income Taxes [Line Items] | |
Net operating losses, Amount | $ 187 |
Net operating losses, Amount | 112 |
Net operating losses, Amount | $ 3 |
Federal | |
Income Taxes [Line Items] | |
Net operating loss carryforwards, Expiration beginning | 2,023 |
State | |
Income Taxes [Line Items] | |
Net operating loss carryforwards, Expiration beginning | 2,020 |
Research and Development Credits | |
Income Taxes [Line Items] | |
Net operating loss carryforwards, Expiration beginning | 2,023 |
Commitments and Contingencies -
Commitments and Contingencies - Additional Information (Details) - USD ($) $ in Millions | 12 Months Ended | |||
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | Jan. 31, 2013 | |
Commitments And Contingencies Disclosure [Abstract] | ||||
Lease term | 93 months | |||
Operating leases, rent expense, net | $ 0.5 | $ 0.5 | $ 0.6 |
Commitments and Contingencies_2
Commitments and Contingencies - Schedule of Future Minimum Annual Payments Under Non-Cancelable Operating Lease Agreements (Details) $ in Thousands | Dec. 31, 2018USD ($) |
Commitments And Contingencies Disclosure [Abstract] | |
2,019 | $ 547 |
2,020 | 560 |
2,021 | 88 |
Total future minimum lease payments | $ 1,195 |
Distribution Agreement with T_2
Distribution Agreement with Teijin Pharma Limited - Additional Information (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2018 | Dec. 31, 2017 | |
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items] | ||
Term of distribution agreement | 7 years 6 months | |
Distribution agreement, renewal period | 2 years | |
Distribution term agreement | The term of the distribution agreement will be automatically extended for two years unless either party gives the other party at least two years’ prior written of notice of non-renewal, except that the Company cannot decline to renew the agreement if Teijin has purchased 100% of its sales forecasts over the term of the agreement. | |
Teijin | Distribution Agreement | ||
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items] | ||
Agreement expiry date | Mar. 31, 2025 | |
Extended term of agreement | 2 years | |
Related party purchased percentage of sales forecasts over agreement term. | 100.00% | |
Upfront Payment | ||
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items] | ||
Payment received | $ 750 | |
Milestone Payment | ||
Collaborative Arrangements And Noncollaborative Arrangement Transactions [Line Items] | ||
Payment received | $ 2,000 |
Geographical Segment Informat_3
Geographical Segment Information - Additional Information (Details) | 12 Months Ended |
Dec. 31, 2018Segment | |
Segments Geographical Areas [Abstract] | |
Number of operating business segment | 1 |
Geographical Segment Informat_4
Geographical Segment Information - Summary of Revenue Generated in Geographic Regions for Years Indicated (Details) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended | |||||||||
Dec. 31, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Segment Reporting Information [Line Items] | |||||||||||
Revenues | $ 15,635 | $ 13,737 | $ 13,252 | $ 10,152 | $ 12,108 | $ 10,491 | $ 10,308 | $ 7,526 | $ 52,776 | $ 40,433 | $ 34,228 |
Revenues | Geographic Concentration | |||||||||||
Segment Reporting Information [Line Items] | |||||||||||
Revenues | $ 52,776 | $ 40,433 | |||||||||
Percentage of Revenues | 100.00% | 100.00% | |||||||||
Revenues | United States | Geographic Concentration | |||||||||||
Segment Reporting Information [Line Items] | |||||||||||
Revenues | $ 51,477 | $ 39,853 | |||||||||
Percentage of Revenues | 98.00% | 99.00% | |||||||||
Revenues | International | Geographic Concentration | |||||||||||
Segment Reporting Information [Line Items] | |||||||||||
Revenues | $ 1,299 | $ 580 | |||||||||
Percentage of Revenues | 2.00% | 1.00% |
Supplementary Financial Infor_3
Supplementary Financial Information (Unaudited) - Summary of Selected Financial Information for Quarterly Periods (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 3 Months Ended | 12 Months Ended | |||||||||
Dec. 31, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016 | |
Quarterly Financial Information Disclosure [Abstract] | |||||||||||
Revenues | $ 15,635 | $ 13,737 | $ 13,252 | $ 10,152 | $ 12,108 | $ 10,491 | $ 10,308 | $ 7,526 | $ 52,776 | $ 40,433 | $ 34,228 |
Cost of revenues | 3,711 | 3,034 | 3,245 | 2,457 | 2,957 | 2,636 | 2,501 | 1,538 | 12,447 | 9,632 | 6,622 |
Gross Profit | 11,924 | 10,703 | 10,007 | 7,695 | 9,151 | 7,855 | 7,807 | 5,988 | 40,329 | 30,801 | 27,606 |
Operating expenses: | |||||||||||
Sales and marketing | 10,648 | 9,672 | 9,835 | 8,109 | 8,628 | 6,566 | 6,400 | 6,306 | 38,264 | 27,900 | 21,794 |
General and administrative | 4,715 | 3,238 | 3,078 | 2,636 | 2,837 | 2,256 | 1,837 | 1,642 | 13,667 | 8,572 | 6,926 |
Research and development | 2,222 | 2,125 | 2,330 | 1,555 | 1,919 | 1,843 | 2,147 | 2,028 | 8,232 | 7,937 | 8,223 |
Total operating expenses | 17,585 | 15,035 | 15,243 | 12,300 | 13,384 | 10,665 | 10,384 | 9,976 | 60,163 | 44,409 | 36,943 |
Loss from Operations | (5,661) | (4,332) | (5,236) | (4,605) | (4,233) | (2,810) | (2,577) | (3,988) | (19,834) | (13,608) | (9,337) |
Other (income) expense: | |||||||||||
Interest expense | 939 | 928 | 900 | 921 | 740 | 807 | 711 | 550 | 3,688 | 2,808 | 1,835 |
Other (income) expense, net | (457) | (299) | 1,360 | (29) | (49) | 136 | (420) | (24) | 575 | (357) | 62 |
Net Loss | $ (6,143) | $ (4,961) | $ (7,496) | $ (5,497) | $ (4,924) | $ (3,753) | $ (2,868) | $ (4,514) | $ (24,097) | $ (16,059) | $ (11,234) |
Net loss per share of common stock outstanding, basic and diluted | $ (0.35) | $ (0.29) | $ (30.60) | $ (24.43) | $ (23.34) | $ (19.35) | $ (16.58) | $ (27.03) | $ (2.69) | $ (86.34) | $ (76.95) |
Weighted-average common shares outstanding, basic and diluted | 17,655 | 17,382 | 245 | 226 | 211 | 194 | 173 | 167 | 8,948 | 186 | 146 |
Supplementary Financial Infor_4
Supplementary Financial Information (Unaudited) - Additional Information (Details) - shares shares in Thousands | Jul. 02, 2018 | Dec. 31, 2018 |
Supplementary Financial Information [Line Items] | ||
IPO closing date | Jul. 2, 2018 | |
Common Stock | ||
Supplementary Financial Information [Line Items] | ||
Conversion of convertible preferred stock into common stock, shares | 11,000 | 10,994 |
Common stock shares issued and sold | 6,325 | 6,325 |