Cover Page
Cover Page - shares | 9 Months Ended | |
Sep. 30, 2020 | Oct. 30, 2020 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Document Quarterly Report | true | |
Document Period End Date | Sep. 30, 2020 | |
Document Transition Report | false | |
Entity File Number | 001-35706 | |
Entity Registrant Name | APOLLO ENDOSURGERY, INC. | |
Entity Incorporation, State or Country Code | DE | |
Entity Tax Identification Number | 16-1630142 | |
Entity Address, Address Line One | 1120 S. Capital of Texas Highway | |
Entity Address, Address Line Two | Building 1, Suite #300 | |
Entity Address, City or Town | Austin | |
Entity Address, State or Province | TX | |
Entity Address, Postal Zip Code | 78746 | |
City Area Code | 512 | |
Local Phone Number | 279-5100 | |
Title of 12(b) Security | Common stock, par value $0.001 per share | |
Trading Symbol | APEN | |
Security Exchange Name | NASDAQ | |
Entity Current Reporting Status | Yes | |
Entity Interactive Data Current | Yes | |
Entity Filer Category | Non-accelerated Filer | |
Entity Small Business | true | |
Entity Emerging Growth Company | false | |
Entity Shell Company | false | |
Entity Common Stock, Shares Outstanding | 25,783,554 | |
Entity Central Index Key | 0001251769 | |
Current Fiscal Year End Date | --12-31 | |
Amendment Flag | false | |
Document Fiscal Year Focus | 2020 | |
Document Fiscal Period Focus | Q3 |
Condensed Consolidated Balance
Condensed Consolidated Balance Sheets - USD ($) $ in Thousands | Sep. 30, 2020 | Dec. 31, 2019 |
Current assets: | ||
Cash and cash equivalents | $ 37,430 | $ 29,905 |
Accounts receivable, net of allowance for doubtful accounts of $596 and $658, respectively | 8,222 | 9,232 |
Inventory, net | 10,041 | 8,865 |
Prepaid expenses and other current assets | 2,748 | 2,998 |
Total current assets | 58,441 | 51,000 |
Restricted cash | 765 | 1,016 |
Property, equipment and right-of-use assets, net | 6,743 | 6,612 |
Goodwill | 5,290 | 5,290 |
Intangible assets, net of accumulated amortization of $12,737 and $11,648, respectively | 6,469 | 7,831 |
Other assets | 2,985 | 2,833 |
Total assets | 80,693 | 74,582 |
Current liabilities: | ||
Accounts payable | 3,359 | 9,902 |
Accrued expenses | 7,343 | 8,438 |
Current portion of long-term debt | 8,326 | 34,449 |
Total current liabilities | 19,028 | 52,789 |
Long-term debt | 29,451 | 0 |
Convertible debt | 19,389 | 18,554 |
Long-term liabilities | 2,406 | 1,116 |
Total liabilities | 70,274 | 72,459 |
Commitments and contingencies | ||
Stockholders' equity: | ||
Common stock; $0.001 par value; 100,000,000 shares authorized; 23,677,676 and 20,951,963 shares issued and outstanding at September 30, 2020 and December 31, 2019, respectively | 24 | 21 |
Additional paid-in capital | 275,883 | 250,634 |
Accumulated other comprehensive income | 3,780 | 1,630 |
Accumulated deficit | (269,268) | (250,162) |
Total stockholders' equity | 10,419 | 2,123 |
Total liabilities and stockholders' equity | $ 80,693 | $ 74,582 |
Condensed Consolidated Balanc_2
Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands | Sep. 30, 2020 | Dec. 31, 2019 |
Statement of Financial Position [Abstract] | ||
Allowance for doubtful accounts | $ 596 | $ 658 |
Accumulated amortization | $ 12,737 | $ 11,648 |
Common stock, par value (USD per share) | $ 0.001 | $ 0.001 |
Common stock, shares authorized (shares) | 100,000,000 | 100,000,000 |
Common stock, shares issued (shares) | 23,677,676 | 20,951,963 |
Common stock, shares outstanding (shares) | 23,677,676 | 20,951,963 |
Condensed Consolidated Statemen
Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2020 | Sep. 30, 2019 | Sep. 30, 2020 | Sep. 30, 2019 | |
Income Statement [Abstract] | ||||
Revenues | $ 12,826 | $ 11,259 | $ 29,188 | $ 38,724 |
Cost of sales | 5,840 | 5,826 | 14,136 | 18,884 |
Gross margin | 6,986 | 5,433 | 15,052 | 19,840 |
Operating expenses: | ||||
Sales and marketing | 4,178 | 6,495 | 12,773 | 21,995 |
General and administrative | 2,374 | 3,159 | 7,870 | 10,219 |
Research and development | 1,522 | 2,128 | 5,484 | 8,245 |
Amortization of intangible assets | 486 | 510 | 1,472 | 1,591 |
Settlement gain | 0 | 0 | 0 | (5,609) |
Total operating expenses | 8,560 | 12,292 | 27,599 | 36,441 |
Loss from operations | (1,574) | (6,859) | (12,547) | (16,601) |
Other expenses: | ||||
Interest expense, net | 1,335 | 1,221 | 3,895 | 2,849 |
Other (income) expense, net | (353) | 498 | 2,574 | 655 |
Net loss before income taxes | (2,556) | (8,578) | (19,016) | (20,105) |
Income tax expense | 41 | 80 | 90 | 131 |
Net loss | (2,597) | (8,658) | (19,106) | (20,236) |
Other comprehensive income: | ||||
Foreign currency translation | (253) | 176 | 2,150 | 207 |
Comprehensive loss | $ (2,850) | $ (8,482) | $ (16,956) | $ (20,029) |
Net loss per share, basic and diluted (USD per share) | $ (0.11) | $ (0.40) | $ (0.88) | $ (0.93) |
Shares used in computing net loss per share, basic and diluted (shares) | 23,110,524 | 21,401,044 | 21,798,336 | 21,743,218 |
Condensed Consolidated Statem_2
Condensed Consolidated Statements of Changes in Stockholders’ Equity - USD ($) $ in Thousands | Total | Common Stock | Additional Paid-in Capital | Accumulated Other Comprehensive Income | Accumulated Deficit |
Beginning balance (in shares) at Dec. 31, 2018 | 21,899,522 | ||||
Beginning balance at Dec. 31, 2018 | $ 28,908 | $ 22 | $ 249,115 | $ 2,501 | $ (222,730) |
Exercise of common stock options, shares | 5,621 | ||||
Exercise of common stock options | 11 | 11 | |||
Exchange of shares for warrants (in shares) | (1,000,000) | ||||
Exchange of common stock for warrants | $ (1) | 1 | |||
Issuance of restricted stock units (in shares) | 29,826 | ||||
Stock based compensation | 1,059 | 1,059 | |||
Foreign currency translation | 207 | 207 | |||
Net loss | (20,236) | (20,236) | |||
Ending balance (in shares) at Sep. 30, 2019 | 20,934,969 | ||||
Ending balance at Sep. 30, 2019 | 9,949 | $ 21 | 250,186 | 2,708 | (242,966) |
Beginning balance (in shares) at Jun. 30, 2019 | 21,933,102 | ||||
Beginning balance at Jun. 30, 2019 | 18,037 | $ 22 | 249,791 | 2,532 | (234,308) |
Exercise of common stock options, shares | 1,867 | ||||
Exercise of common stock options | 4 | 4 | |||
Exchange of shares for warrants (in shares) | (1,000,000) | ||||
Exchange of common stock for warrants | $ (1) | 1 | |||
Stock based compensation | 390 | 390 | |||
Foreign currency translation | 176 | 176 | |||
Net loss | (8,658) | (8,658) | |||
Ending balance (in shares) at Sep. 30, 2019 | 20,934,969 | ||||
Ending balance at Sep. 30, 2019 | $ 9,949 | $ 21 | 250,186 | 2,708 | (242,966) |
Beginning balance (in shares) at Dec. 31, 2019 | 20,951,963 | 20,951,963 | |||
Beginning balance at Dec. 31, 2019 | $ 2,123 | $ 21 | 250,634 | 1,630 | (250,162) |
Exercise of common stock options, shares | 1,150 | ||||
Exercise of common stock options | 2 | 2 | |||
Issuance of restricted stock units (in shares) | 79,766 | ||||
Issuance of common stock for convertible debt interest (in shares) | 164,797 | ||||
Issuance of common stock for convertible debt interest | 467 | 467 | |||
Issuance of common stock (in shares) | 2,480,000 | ||||
Issuance of common stock, net of issuance costs of $1,721 | 23,262 | $ 3 | 23,259 | ||
Stock based compensation | 1,521 | 1,521 | |||
Foreign currency translation | 2,150 | 2,150 | |||
Net loss | $ (19,106) | (19,106) | |||
Ending balance (in shares) at Sep. 30, 2020 | 23,677,676 | 23,677,676 | |||
Ending balance at Sep. 30, 2020 | $ 10,419 | $ 24 | 275,883 | 3,780 | (269,268) |
Beginning balance (in shares) at Jun. 30, 2020 | 21,196,387 | ||||
Beginning balance at Jun. 30, 2020 | (10,579) | $ 21 | 252,038 | 4,033 | (266,671) |
Issuance of restricted stock units (in shares) | 1,289 | ||||
Issuance of common stock (in shares) | 2,480,000 | ||||
Issuance of common stock, net of issuance costs of $1,721 | 23,262 | $ 3 | 23,259 | ||
Stock based compensation | 586 | 586 | |||
Foreign currency translation | (253) | (253) | |||
Net loss | $ (2,597) | (2,597) | |||
Ending balance (in shares) at Sep. 30, 2020 | 23,677,676 | 23,677,676 | |||
Ending balance at Sep. 30, 2020 | $ 10,419 | $ 24 | $ 275,883 | $ 3,780 | $ (269,268) |
Condensed Consolidated Statem_3
Condensed Consolidated Statements of Changes in Stockholders’ Equity (Parenthetical) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended |
Sep. 30, 2020 | Sep. 30, 2020 | |
Statement of Stockholders' Equity [Abstract] | ||
Issuance costs | $ 1,721 | $ 1,721 |
Condensed Consolidated Statem_4
Condensed Consolidated Statements of Cash Flows - USD ($) | 9 Months Ended | |
Sep. 30, 2020 | Sep. 30, 2019 | |
Cash flows from operating activities: | ||
Net loss | $ (19,106,000) | $ (20,236,000) |
Adjustments to reconcile net loss to net cash used in operating activities: | ||
Depreciation and amortization | 2,820,000 | 3,108,000 |
Amortization of deferred financing costs | 487,000 | 470,000 |
Non-cash interest | 1,104,000 | 214,000 |
Provision for doubtful accounts receivable | 34,000 | 209,000 |
Inventory impairment | 0 | 80,000 |
Stock based compensation | 1,521,000 | 1,059,000 |
Unrealized foreign exchange on intercompany payables | 2,366,000 | 950,000 |
Settlement gain | 0 | (5,609,000) |
Changes in operating assets and liabilities: | ||
Accounts receivable | 930,000 | 2,074,000 |
Inventory | (1,286,000) | (1,042,000) |
Prepaid expenses and other assets | 387,000 | (319,000) |
Accounts payable and accrued expenses | (7,274,000) | 97,000 |
Net cash used in operating activities | (18,017,000) | (18,945,000) |
Cash flows from investing activities: | ||
Purchases of property and equipment | (431,000) | (466,000) |
Purchases of intangibles and other assets | (117,000) | (181,000) |
Proceeds from sale of equipment | 0 | 18,000 |
Net cash used in investing activities | (548,000) | (629,000) |
Cash flows from financing activities: | ||
Proceeds from exercise of stock options | 2,000 | 11,000 |
Proceeds from issuance of common stock | 23,262,000 | 0 |
Proceeds from long-term debt | 2,824,000 | 35,000,000 |
Proceeds from convertible debt | 0 | 20,000,000 |
Payments of deferred financing costs | (260,000) | (2,737,000) |
Payment of long-term debt | 0 | (21,668,000) |
Net cash provided by financing activities | 25,828,000 | 30,606,000 |
Effect of exchange rate changes on cash | 11,000 | (63,000) |
Net change in cash, cash equivalents and restricted cash | 7,274,000 | 10,969,000 |
Cash, cash equivalents and restricted cash at beginning of year | 30,921,000 | 25,007,000 |
Cash, cash equivalents and restricted cash at end of period | 38,195,000 | 35,976,000 |
Supplemental disclosure of cash flow information: | ||
Cash paid for interest | 2,398,000 | 2,634,000 |
Cash paid for income taxes | 52,000 | 132,000 |
Right-of-use assets recognized in exchange for lease obligations (non-cash) | $ 1,152,000 | $ 2,789,000 |
Organization and Business Descr
Organization and Business Description | 9 Months Ended |
Sep. 30, 2020 | |
Organization, Consolidation and Presentation of Financial Statements [Abstract] | |
Organization and Business Description | Organization and Business Description Apollo Endosurgery, Inc. is a Delaware corporation with both domestic and foreign wholly-owned subsidiaries. Throughout these Notes, "Apollo" and the "Company" refer to Apollo Endosurgery, Inc. and its consolidated subsidiaries. Apollo is a medical technology company primarily focused on the design, development, and commercialization of innovative medical devices to advance gastrointestinal therapeutic endoscopy. The Company develops and distributes devices that are used by surgeons and gastroenterologists for a variety of procedures related to gastrointestinal defect and complication management or bariatric (weight loss) intervention. The Company's core products include the OverStitch™ Endoscopic Suturing System ("ESS") and the Orbera® Intragastric Balloon System ("IGB"), which together comprise the Company's Endoscopy products. The Company also offers Apollo Care, a digital and remotely delivered aftercare program. All devices are regulated by the U.S. Food and Drug Administration (the "FDA") or an equivalent regulatory body outside the U.S. The Company has offices in the United Kingdom and Italy that oversee commercial activities outside the U.S. and a products manufacturing facility in Costa Rica. All other activities are managed and operated from facilities in Austin, Texas. Liquidity and Capital Resources The Company has experienced operating losses since inception and expects its negative cash flows from operating activities to continue. To date, the Company has funded its operating losses through equity offerings and the issuance of debt instruments. The Company’s ability to fund operations and meet debt covenant requirements will depend on its level of future revenue and operating cash flow and its ability to access additional funding through either equity offerings, issuances of debt instruments or both. At December 31, 2019 and March 31, 2020, substantial doubt existed about the Company's ability to continue as a going concern due to the temporary reduction in sales resulting from the COVID-19 pandemic and the uncertainty regarding how long COVID-19 would impact the Company's business. As a result, the auditor's opinion on the Company's audited financial statements for the year ended December 31, 2019 includes an explanatory paragraph stating that losses and negative cash flows from operations and uncertainty in generating sufficient cash to meet operations raise substantial doubt about the Company's ability to continue as a going concern. In July 2020, the Company issued shares of common stock and pre-funded warrants for aggregate gross proceeds of approximately $25,000 and entered into the Sixth Amendment to the loan and security agreement with Solar Capital, Ltd. that waives the minimum revenue covenant requirements for the remainder of 2020 and also decreased the minimum liquidity requirement from $20,000 to $12,500. Management believes the Company's existing cash and cash equivalents, product revenues, and available debt and equity financing arrangements will be sufficient to meet covenant, liquidity and capital requirements for at least the next twelve months. Management evaluates the Company's liquidity requirements, alternative uses of capital, capital needs and available resources on an on-going basis. As a result of this process, the Company has in the past, and may in the future, explore alternatives to finance its business plan, including, but not limited to, sales of common stock, preferred stock, convertible securities or debt financings, reduction of planned expenditures, or other sources. |
Significant Accounting Policies
Significant Accounting Policies | 9 Months Ended |
Sep. 30, 2020 | |
Accounting Policies [Abstract] | |
Significant Accounting Policies | Significant Accounting Policies (a) Basis of Presentation The Company prepared its interim condensed consolidated financial statements in conformity with accounting principles generally accepted in the United States of America ("GAAP"). They do not include all of the information and footnotes required by GAAP for complete financial statements. The accompanying condensed consolidated financial statements include the Company's accounts and the accounts of its wholly-owned subsidiaries. The Company has eliminated all intercompany balances and transactions. The Company has made estimates and judgments affecting the amounts reported in its condensed consolidated financial statements and the accompanying notes. The actual results that the Company experiences may differ materially from the Company's estimates. The accounting estimates that require the Company's most significant, difficult and subjective judgments include revenue recognition, impairment of long-lived assets and goodwill, and valuation of inventory. (b) Unaudited Interim Results In management's opinion, the unaudited financial information for the interim periods presented includes all adjustments necessary for a fair presentation of the results of operations, financial position, and cash flows. All adjustments are of a normal recurring nature unless otherwise disclosed. Revenues, expenses, assets and liabilities can vary during each quarter of the year. Therefore, the results and trends in these interim financial statements may not be the same as those for the full year. This interim information should be read in conjunction with the audited consolidated financial statements in the Company's Annual Report on Form 10-K for the year ended December 31, 2019. (c) Recent Accounting Pronouncements On January 1, 2020, the Company adopted the provision of Accounting Standards Update ("ASU") 2017-04, Intangibles - Goodwill and Other: Simplifying the Test for Goodwill Impairment (“ASU 2017-04”). The adoption did not result in any financial statement adjustment or change to the Company's critical accounting policies. Due to the impact of the COVID-19 pandemic on the business, the Company performed an updated interim goodwill impairment test as of September 30, 2020 and concluded no impairment was required. In March 2020, ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting |
Concentrations
Concentrations | 9 Months Ended |
Sep. 30, 2020 | |
Risks and Uncertainties [Abstract] | |
Concentrations | Concentrations Consolidated financial instruments that potentially subject the Company to a concentration of credit risk principally consist of cash and cash equivalents and accounts receivable. At September 30, 2020, the Company's cash, cash equivalents and restricted cash are held in deposit accounts at five different banks totaling $38,195. The Company has not experienced any losses in such accounts, and management does not believe the Company is exposed to any significant credit risk. Management further believes that credit risk in the Company's accounts receivable is substantially mitigated by the Company's evaluation process, relatively short collection terms, and the high level of creditworthiness of its customers. The Company continually monitors the compliance of its customers with the Company's payment terms, but generally requires no collateral. The Company had one customer representing approximately 15% of the Company's net accounts receivable balance as of December 31, 2019. There were no concentrations greater than 10% of the Company's net accounts receivable as of September 30, 2020. The Company had no single customer that comprised more than 10% of the Company's total revenues for the three and nine months ended September 30, 2020 and 2019. |
Inventory
Inventory | 9 Months Ended |
Sep. 30, 2020 | |
Inventory Disclosure [Abstract] | |
Inventory | Inventory Inventory consists of the following as of: September 30, 2020 December 31, 2019 (unaudited) Raw materials $ 2,417 $ 2,834 Work in progress 754 532 Finished goods 6,870 5,499 Total inventory $ 10,041 $ 8,865 The Company recorded inventory impairment charges of $40 and $80 for the three and nine months ended September 30, 2019, respectively. There were no inventory impairment charges during the same periods of 2020. Finished goods included $133 of consigned inventory at September 30, 2020. |
Property, Equipment and Right-o
Property, Equipment and Right-of-Use Assets | 9 Months Ended |
Sep. 30, 2020 | |
Property, Plant and Equipment [Abstract] | |
Property, Equipment and Right-of-Use Assets | Property, Equipment and Right-of-Use Assets Property, equipment and right-of-use assets consists of the following: Depreciable Lives September 30, 2020 December 31, 2019 (unaudited) Equipment 5 years $ 7,520 $ 7,491 Right-of-use assets 1-5 years 4,014 2,890 Furniture, fixtures and tooling 4-8 years 2,155 2,233 Computer hardware 3-5 years 1,240 1,261 Leasehold improvements 3-5 years 1,743 1,671 Construction in process 377 198 17,049 15,744 Less accumulated depreciation (10,306) (9,132) Property, equipment and right-of-use assets, net $ 6,743 $ 6,612 The Company recorded depreciation expense of $435 and $1,346 for the three and nine months ended September 30, 2020 and $436 and $1,411 for the three and nine months ended September 30, 2019, respectively. There were no impairment charges for the three and nine months ended September 30, 2020 and 2019. The Company disposed of $275 of property, equipment and right-of-use assets no longer utilized during the nine months ended September 30, 2020. The Company has operating leases for office space in Texas, the United Kingdom, and Italy, and for the manufacturing facility in Costa Rica. In September 2020, the Company extended the lease of the manufacturing facility in Costa Rica. The Company also has various operating lease agreements for equipment and vehicles. As of September 30, 2020, the maturities of the Company's operating lease liabilities are as follows: 2020 $ 285 2021 982 2022 565 2023 490 2024 428 Thereafter 1,579 Total lease payments 4,329 Less imputed interest (1,149) Total operating lease liabilities $ 3,180 Operating lease liabilities of $774 and $932 are included in accrued expenses |
Other Assets
Other Assets | 9 Months Ended |
Sep. 30, 2020 | |
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract] | |
Other Assets | Other AssetsIncluded in other assets as of September 30, 2020 and December 31, 2019 is $2,698 and $2,511 for the non-current portion of the remaining $5,000 receivable due from ReShape Lifesciences Inc. ("ReShape"), respectively, for the remaining unpaid consideration from the divestiture of the Surgical product line, which consisted of the Lap-Band® System and related laparoscopic accessories, in December 2018. Interest on the receivable accretes at 10% annually. Imputed interest income on the ReShape receivable was $105 and $317 for the three and nine months ended September 30, 2020 and $151 and $474 for the three and nine months ended September 30, 2019, respectively, and is included within interest expense, net. |
Accrued Expenses
Accrued Expenses | 9 Months Ended |
Sep. 30, 2020 | |
Payables and Accruals [Abstract] | |
Accrued Expenses | Accrued Expenses Accrued expenses consists of the following as of: September 30, 2020 December 31, 2019 (unaudited) Accrued employee compensation and expenses $ 3,797 $ 3,183 Accrued professional service fees 912 653 Lease liability 774 932 Accrued insurance and taxes 471 271 Accrued interest 309 467 Accrued returns and rebates 127 216 Settlement liability — 1,625 Other 953 1,091 Total accrued expenses $ 7,343 $ 8,438 In April 2019, the Company entered into a settlement agreement with Allergan, Inc. to resolve a dispute related to amounts charged for inventory purchases and transition services provided through 2016, after the Company’s asset acquisition of the obesity intervention business in December 2013. The settlement agreement provided for a payment of $3,250 to completely discharge all remaining possibility for these charges. The Company recognized a gain of $5,609 in 2019 as a result of this settlement agreement. |
Long-Term Debt
Long-Term Debt | 9 Months Ended |
Sep. 30, 2020 | |
Debt Disclosure [Abstract] | |
Long-Term Debt | Long-Term Debt Long-term debt consists of the following as of: September 30, 2020 December 31, 2019 (unaudited) Term loan facility $ 35,000 $ 35,000 PPP loan 2,824 — Payment-in-kind interest 1,029 517 Deferred financing costs (1,076) (1,068) Less current portion (8,326) (34,449) Long-term debt $ 29,451 $ — Term Loan Facility In March 2019, the Company entered into a Term Loan Facility (the "Credit Agreement") with Solar Capital Ltd. ("Solar") to borrow $35,000. The Credit Agreement matures on September 1, 2023, with principal payments beginning in March 2021, and bears interest at the greater of LIBOR or 1.35575%, plus 7.5%. Interest only is payable in arrears until March 1, 2021. Principal payments are due on a straight-line basis after the interest-only period concludes. An additional 4.9% of the outstanding amount will be due at end of the loan term and an additional 4.5% fee of the Term Loan funded amount will be due at the earlier of an Exit Event (as defined in the Credit Agreement) or if the Company achieves trailing twelve-month revenue of $100,000 before March 15, 2029. The Credit Agreement provides that the Company may borrow an additional $5,000 upon its request, subject to further credit approval. The Credit Agreement, collateralized by substantially all of the Company's assets, includes customary affirmative covenants, negative covenants and financial covenants, including a minimum liquidity requirement and minimum product revenues. The Company used $22,372 of the proceeds of the Credit Agreement to repay its previous senior secured credit agreement in full including interest. Unamortized deferred financing costs and discount of $388 were written off in March 2019 in connection with the repayment. The Credit Agreement was amended in March 2020, April 2020, and July 2020. These amendments, among other things, (i) waive the trailing six-month Endoscopy revenue requirements through the end of 2020, (ii) reduce the minimum liquidity requirement to $12,500, (iii) establish a minimum LIBOR interest rate, (iv) increase the final fee due at the end of the loan term to 5.0% from 4.9%, (v) permitted the Company to enter into a loan under the Small Business Administration’s ("SBA") Paycheck Protection Program ("PPP") established under the Coronavirus Aid, Relief, and Economic Security ("CARES") Act, and (vi) waived the financial statement covenant default associated with the going concern opinion of the Company's independent registered public accounting firm for the year ended December 31, 2019. In connection with the July 2020 amendment and concurrent equity raise, the Company reclassified the term loan facility from current liabilities to the scheduled maturity of the principal payments set out in the Credit Agreement. As of September 30, 2020, the Company was in compliance with all financial covenants. PPP Loan In March 2020, the CARES Act was signed into law providing certain economic aid packages for qualified entities. In April 2020, the Company was granted a loan of $2,824 under the PPP established under the CARES Act. The Loan matures on February 27, 2023 and bears interest at a rate of 1.0% per annum with equal interest and principal payments beginning on September 27, 2021. Under the terms of the CARES Act, PPP loan recipients can apply for and be granted forgiveness for all or a portion of the loan granted under the PPP, with such forgiveness to be determined, subject to limitations, based on the use of the loan proceeds for payment of payroll costs, rent, utilities, and interest on debt. The terms of any forgiveness may also be subject to further requirements in any regulations and guidelines the SBA may adopt. In June 2020, the PPP Flexibility Act was signed into law which, among other things, (i) extended the covered forgiveness period from 8 weeks after the date of PPP funding to 24 weeks after the date of PPP funding, (ii) reduced the required amount of payroll expenditures from 75% to 60%, (iii) removed the prior ban on borrowers taking advantage of payroll tax deferral after loan forgiveness and (iv) extended the repayment deferral period to be the earlier of (a) the date forgiveness funds are received or (b) 10 months from the end of the covered period. As of September 30, 2020, the Company has incurred more than $2,824 in qualifying expenses during the covered period; however the Company is not able to determine the amount, if any, that might be forgiven until completion of the covered period. Interest expense on the Company's long term debt was $1,054 and $3,144 for the three and nine months ended September 30, 2020 and $1,284 and $3,504 for the three and nine months ended September 30, 2019, respectively. Principal payments of the Company's long-term debt are as follows: 2020 $ — 2021 12,294 2022 15,883 2023 9,647 2024 — Thereafter — $ 37,824 |
Convertible Debt
Convertible Debt | 9 Months Ended |
Sep. 30, 2020 | |
Debt Disclosure [Abstract] | |
Convertible Debt | Convertible Debt Convertible debt consists of the following as of: September 30, 2020 December 31, 2019 (unaudited) Convertible debt $ 20,600 $ 20,000 Deferred financing costs (1,211) (1,446) Total convertible debt $ 19,389 $ 18,554 In August 2019, the Company issued $20,000 aggregate principal amount of 6.0% convertible senior debentures due 2024 (the "Convertible Debt"), primarily to existing stockholders and officers of the Company. Interest on the Convertible Debt is payable semi-annually in shares of the Company's common stock on January 1 and July 1 of each year at a rate of 6.0% per year. The number of shares of common stock required to settle the amount of interest payable will be based on the volume-weighted average price ("VWAP") of the Company's common stock for the 10 consecutive trading days immediately preceding the applicable interest payment date. However, in the event that the trailing 10-trading day VWAP of the Company's common stock is less than $2.50 per share, interest accrued and payable for the applicable interest payment period will accrete to the principal amount then outstanding. The Convertible Debt will mature on August 12, 2024 unless earlier converted or repurchased in accordance with its terms. In January 2020, the Company issued 164,797 shares of the Company's common stock to holders of the Convertible Debt in fulfillment of $467 of accrued interest as of December 31, 2019. In July 2020, outstanding interest of $600 was accreted to the principal amount of the Convertible Debt. As of September 30, 2020, accrued interest on the Convertible Debt is $309. The Convertible Debt converts, at the option of the holders, into shares of the Company's common stock at an initial conversion price of $3.25 per share, subject to adjustment. If the VWAP of the Company's common stock has been at least $9.75 (subject to adjustment) for at least 20 trading days during any 30 consecutive trading day period, the Company may force the conversion of all or any part of the outstanding principal amount of the Convertible Debt, accrued and unpaid interest and any other amounts then owing, subject to certain conditions. Interest expense on the Convertible Debt was $388 and $1,144 for the three and nine months ended September 30, 2020 and $208 for both the three and nine months ended September 30, 2019. |
Stock Based Compensation
Stock Based Compensation | 9 Months Ended |
Sep. 30, 2020 | |
Share-based Payment Arrangement [Abstract] | |
Stock Based Compensation | Stock Based Compensation In June 2017, the 2017 Equity Incentive Plan (the "2017 Plan") was approved by the Company's stockholders and replaced the Company's 2016 Equity Incentive Plan (the "2016 Plan"), which was the successor to the 2006 Stock Option Plan (the "2006 Plan" and collectively with the 2016 Plan, the "Prior Plans"). Grants will no longer be made under the Prior Plans, but the awards that remain outstanding will continue to be governed by the terms of the applicable Prior Plan and the applicable award agreement. A summary of the stock option activity under the Company's 2017 Plan and Prior Plans (collectively, the "Equity Plans") as of September 30, 2020 is presented below. Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Aggregate Intrinsic Value Options outstanding, December 31, 2019 1,927,194 $ 5.01 7.5 years $ 87 Options granted 1,216,942 2.08 Options exercised (1,150) 1.76 Options forfeited (133,073) 4.18 Options outstanding, vested and expected to vest, September 30, 2020 3,009,913 3.86 7.8 years — Options exercisable 1,331,243 $ 5.14 6.1 years $ — Shares subject to awards granted under the 2017 Plan which expire, are repurchased, or are canceled or forfeited will again become available for issuance under the 2017 Plan. The shares available will not be reduced by awards settled in cash or by shares withheld to satisfy tax withholding obligations. Only the net number of shares issued upon the exercise of options by means of a net exercise will be deducted from the shares available under the 2017 Plan. The fair value of stock option grants has been estimated at the date of grant using the Black-Scholes option pricing model with the following weighted average assumptions: Nine Months Ended Nine Months Ended Risk free interest rate 0.4% 2.2% Expected dividend yield —% —% Estimated volatility 73.8% 64.6% Expected life 5.8 years 5.8 years Additional information regarding options is as follows: Nine Months Ended Nine Months Ended Weighted-average grant date fair value of options granted during the period $ 1.31 $ 2.04 Aggregate intrinsic value of options exercised during the period $ — $ 10 The aggregate intrinsic value in the tables above represents the total pre-tax value of the options shown, calculated as the difference between the Company’s closing stock price on September 30, 2020 and the exercise prices of the options shown, multiplied by the number of in-the money options. This is the aggregate amount that would have been received by the option holders if they had all exercised their options on September 30, 2020 and sold the shares thereby received at the closing price of the Company’s common stock on that date. This amount changes based on the closing price of the Company’s common stock. The total compensation cost recognized for stock-based awards was $586 and $1,521 for the three and nine months ended September 30, 2020 and $390 and $1,059 for the three and nine months ended September 30, 2019, respectively. Unrecognized compensation expense related to unvested options was approximately $2,627 at September 30, 2020, with a remaining amortization period of 2.2 years. A summary of the restricted stock unit activity under the Company's Equity Plans as of September 30, 2020 is presented below. Units Weighted Average Grant Date Fair Value Aggregate Intrinsic Value Unvested units, December 31, 2019 243,695 $ 4.06 $ 695 Restricted stock units granted 517,978 2.08 Restricted stock units vested (79,766) 4.06 Restricted stock units forfeited (4,302) 2.08 Unvested units, September 30, 2020 677,605 $ 2.56 $ 1,145 Unrecognized compensation expense related to unvested restricted stock units was approximately $1,437 at September 30, 2020, with a remaining amortization period of 2.4 years. |
Income Taxes
Income Taxes | 9 Months Ended |
Sep. 30, 2020 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | Income Taxes The provision for income taxes for the three and nine months ended September 30, 2020 and 2019 primarily consists of foreign income taxes. The Company has established a valuation allowance due to uncertainties regarding the realization of deferred tax assets based on the Company's lack of earnings history and potential limitations pursuant to changes in ownership under Internal Revenue Code Section 382. On March 27, 2020, the Coronavirus Aid, Relief, and Economic Security ("CARES") Act was signed into law making several changes to the Internal Revenue Code; however, the tax law changes in the Act did not have a material impact on the Company’s income tax provision. As of September 30, 2020, the Company has no unrecognized tax benefits or accrued interest or penalties associated with uncertain tax positions. |
Net Loss Per Share
Net Loss Per Share | 9 Months Ended |
Sep. 30, 2020 | |
Earnings Per Share [Abstract] | |
Net Loss Per Share | Net Loss Per ShareThe basic and diluted net loss per common share presented in the condensed consolidated statements of operations and comprehensive loss is calculated by dividing net loss by the weighted average number of common shares outstanding during the period, without consideration for common stock equivalents. Potentially dilutive shares, which include warrants for the purchase of common stock, convertible debt, restricted stock units, and options outstanding under the Company's equity incentive plans, are considered to be common stock equivalents and are only included in the calculation of diluted net loss per share when their effect is dilutive. Potentially dilutive securities that are not included in the calculation of diluted net loss per share attributable to common stockholders because to do so would be anti-dilutive are as follows (in common stock equivalent shares on a weighted-average basis): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Warrants for common stock 14,725,241 736,980 5,744,225 383,858 Convertible debt 6,385,483 3,304,235 6,292,599 1,113,515 Common stock options 3,009,913 2,004,749 2,459,202 1,716,127 Restricted stock units 677,605 233,774 437,640 150,366 24,798,242 6,279,738 14,933,666 3,363,866 |
Fair Value Measurements
Fair Value Measurements | 9 Months Ended |
Sep. 30, 2020 | |
Fair Value Disclosures [Abstract] | |
Fair Value Measurements | Fair Value Measurements The carrying amounts of the Company's financial instruments, which primarily include cash, cash equivalents, and restricted cash, accounts receivable, accounts payable and accrued expenses, approximate their fair values due to their short maturities. The fair value of the Company's long-term debt and Convertible Debt is estimated by management to approximate $40,400 and $20,600, respectively at September 30, 2020. Management's estimates are based on comparisons of the characteristics of the Company's obligations, comparable ranges of interest rates on recently issued debt, and maturity. Such valuation inputs are considered a Level 3 measurement in the fair value valuation hierarchy. The accounting guidance defines fair value, establishes a consistent framework for measuring fair value and expands disclosure for each major asset and liability category measured at fair value on either a recurring or nonrecurring basis. Fair value is defined as an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the accounting guidance establishes a three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value as follows: Level 1: Observable inputs such as quoted prices in active markets; Level 2: Inputs, other than the quoted prices in active markets, that are observable either directly or indirectly; and Level 3: Unobservable inputs in which there is little or no market data, which require the reporting entity to develop its own assumptions. |
Segment and Geographic Informat
Segment and Geographic Information | 9 Months Ended |
Sep. 30, 2020 | |
Segment Reporting [Abstract] | |
Segment and Geographic Information | Segment and Geographic Information Operating segments are defined as components of an enterprise for which separate financial information is available and evaluated regularly by the chief operating decision maker, or decision-making group, in deciding how to allocate resources and in assessing performance. The Company globally manages the business within one reportable segment. Segment information is consistent with how management reviews the business, makes investing and resource allocation decisions and assesses operating performance. Product sales by product group and geographic market, based on the location of the customer, whether the U.S. or outside the U.S. ("OUS") for the periods shown were as follows: Three Months Ended September 30, 2020 Three Months Ended September 30, 2019 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 4,734 $ 2,928 $ 7,662 59.7 % $ 3,711 $ 2,949 $ 6,660 59.2 % IGB 1,853 3,021 4,874 38.0 % 1,088 2,633 3,721 33.0 % Total Endoscopy 6,587 5,949 12,536 97.7 % 4,799 5,582 10,381 92.2 % Surgical — — — — % — 640 640 5.7 % Other 272 18 290 2.3 % 228 10 238 2.1 % Total revenues $ 6,859 $ 5,967 $ 12,826 100.0 % $ 5,027 $ 6,232 $ 11,259 100.0 % % Total revenues 53.5 % 46.5 % 44.6 % 55.4 % Nine Months Ended September 30, 2020 Nine Months Ended September 30, 2019 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 10,873 $ 7,211 $ 18,084 62.0 % $ 10,498 $ 10,339 $ 20,837 53.8 % IGB 3,511 6,688 10,199 34.9 % 4,005 8,552 12,557 32.4 % Total Endoscopy 14,384 13,899 28,283 96.9 % 14,503 18,891 33,394 86.2 % Surgical — — — — % — 3,670 3,670 9.5 % Other 854 51 905 3.1 % 1,632 28 1,660 4.3 % Total revenues $ 15,238 $ 13,950 $ 29,188 100.0 % $ 16,135 $ 22,589 $ 38,724 100.0 % % Total revenues 52.2 % 47.8 % 41.7 % 58.3 % Total distributor sales were 30.4% and 31.4% of total OUS revenues for the three and nine months ended September 30, 2020 and 34.4% and 31.8% of total OUS revenues for the three and nine months ended September 30, 2019, respectively. In March 2020, the Company entered into a distributor agreement with a third party Brazilian medical device distribution company and ceased its direct sales operations in Brazil. Sales in the largest individual country outside the U.S. was 8.9% and 8.4% of total revenues for the three and nine months ended September 30, 2020 and 6.8% and 8.2% for the three and nine months ended September 30, 2019, respectively. The following table represents property, equipment and right-of-use assets, net based on the geographic location of the asset: September 30, 2020 December 31, 2019 (unaudited) United States $ 2,338 $ 2,934 Costa Rica 3,961 3,039 Other 444 639 Total property, equipment and right-of-use assets, net $ 6,743 $ 6,612 |
Subsequent Events
Subsequent Events | 9 Months Ended |
Sep. 30, 2020 | |
Subsequent Events [Abstract] | |
Subsequent Events | Subsequent EventsIn October 2020, pursuant to the terms of the Securities Purchase Agreement, 2,105,836 warrants were automatically exchanged for shares of the Company's common stock following the special stockholders meeting held on October 7, 2020 to approve the issuance of shares upon the exercise of certain warrants in accordance with Nasdaq listing rules. |
Significant Accounting Polici_2
Significant Accounting Policies (Policies) | 9 Months Ended |
Sep. 30, 2020 | |
Accounting Policies [Abstract] | |
Organization and Business Description | Apollo Endosurgery, Inc. is a Delaware corporation with both domestic and foreign wholly-owned subsidiaries. Throughout these Notes, "Apollo" and the "Company" refer to Apollo Endosurgery, Inc. and its consolidated subsidiaries. Apollo is a medical technology company primarily focused on the design, development, and commercialization of innovative medical devices to advance gastrointestinal therapeutic endoscopy. The Company develops and distributes devices that are used by surgeons and gastroenterologists for a variety of procedures related to gastrointestinal defect and complication management or bariatric (weight loss) intervention. The Company's core products include the OverStitch™ Endoscopic Suturing System ("ESS") and the Orbera® Intragastric Balloon System ("IGB"), which together comprise the Company's Endoscopy products. The Company also offers Apollo Care, a digital and remotely delivered aftercare program. All devices are regulated by the U.S. Food and Drug Administration (the "FDA") or an equivalent regulatory body outside the U.S. The Company has offices in the United Kingdom and Italy that oversee commercial activities outside the U.S. and a products manufacturing facility in Costa Rica. All other activities are managed and operated from facilities in Austin, Texas. |
Recent Accounting Pronouncements | Recent Accounting Pronouncements On January 1, 2020, the Company adopted the provision of Accounting Standards Update ("ASU") 2017-04, Intangibles - Goodwill and Other: Simplifying the Test for Goodwill Impairment (“ASU 2017-04”). The adoption did not result in any financial statement adjustment or change to the Company's critical accounting policies. Due to the impact of the COVID-19 pandemic on the business, the Company performed an updated interim goodwill impairment test as of September 30, 2020 and concluded no impairment was required. In March 2020, ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting |
Net Loss Per Share | The basic and diluted net loss per common share presented in the condensed consolidated statements of operations and comprehensive loss is calculated by dividing net loss by the weighted average number of common shares outstanding during the period, without consideration for common stock equivalents. Potentially dilutive shares, which include warrants for the purchase of common stock, convertible debt, restricted stock units, and options outstanding under the Company's equity incentive plans, are considered to be common stock equivalents and are only included in the calculation of diluted net loss per share when their effect is dilutive. |
Inventory (Tables)
Inventory (Tables) | 9 Months Ended |
Sep. 30, 2020 | |
Inventory Disclosure [Abstract] | |
Schedule of Inventory | Inventory consists of the following as of: September 30, 2020 December 31, 2019 (unaudited) Raw materials $ 2,417 $ 2,834 Work in progress 754 532 Finished goods 6,870 5,499 Total inventory $ 10,041 $ 8,865 |
Property, Equipment and Right_2
Property, Equipment and Right-of-Use Assets (Tables) | 9 Months Ended |
Sep. 30, 2020 | |
Property, Plant and Equipment [Abstract] | |
Schedule of Property and Equipment | Property, equipment and right-of-use assets consists of the following: Depreciable Lives September 30, 2020 December 31, 2019 (unaudited) Equipment 5 years $ 7,520 $ 7,491 Right-of-use assets 1-5 years 4,014 2,890 Furniture, fixtures and tooling 4-8 years 2,155 2,233 Computer hardware 3-5 years 1,240 1,261 Leasehold improvements 3-5 years 1,743 1,671 Construction in process 377 198 17,049 15,744 Less accumulated depreciation (10,306) (9,132) Property, equipment and right-of-use assets, net $ 6,743 $ 6,612 |
Operating Lease Maturity | As of September 30, 2020, the maturities of the Company's operating lease liabilities are as follows: 2020 $ 285 2021 982 2022 565 2023 490 2024 428 Thereafter 1,579 Total lease payments 4,329 Less imputed interest (1,149) Total operating lease liabilities $ 3,180 |
Accrued Expenses (Tables)
Accrued Expenses (Tables) | 9 Months Ended |
Sep. 30, 2020 | |
Payables and Accruals [Abstract] | |
Schedule of Accrued Expenses | Accrued expenses consists of the following as of: September 30, 2020 December 31, 2019 (unaudited) Accrued employee compensation and expenses $ 3,797 $ 3,183 Accrued professional service fees 912 653 Lease liability 774 932 Accrued insurance and taxes 471 271 Accrued interest 309 467 Accrued returns and rebates 127 216 Settlement liability — 1,625 Other 953 1,091 Total accrued expenses $ 7,343 $ 8,438 |
Long-Term Debt (Tables)
Long-Term Debt (Tables) | 9 Months Ended |
Sep. 30, 2020 | |
Debt Disclosure [Abstract] | |
Schedule of Long-term Debt | Long-term debt consists of the following as of: September 30, 2020 December 31, 2019 (unaudited) Term loan facility $ 35,000 $ 35,000 PPP loan 2,824 — Payment-in-kind interest 1,029 517 Deferred financing costs (1,076) (1,068) Less current portion (8,326) (34,449) Long-term debt $ 29,451 $ — |
Schedule of Maturities of Long-term Debt | Principal payments of the Company's long-term debt are as follows: 2020 $ — 2021 12,294 2022 15,883 2023 9,647 2024 — Thereafter — $ 37,824 |
Convertible Debt (Tables)
Convertible Debt (Tables) | 9 Months Ended |
Sep. 30, 2020 | |
Debt Disclosure [Abstract] | |
Schedule of Convertible Debt | Convertible debt consists of the following as of: September 30, 2020 December 31, 2019 (unaudited) Convertible debt $ 20,600 $ 20,000 Deferred financing costs (1,211) (1,446) Total convertible debt $ 19,389 $ 18,554 |
Stock Based Compensation (Table
Stock Based Compensation (Tables) | 9 Months Ended |
Sep. 30, 2020 | |
Share-based Payment Arrangement [Abstract] | |
Schedule of Stock Option Activity | A summary of the stock option activity under the Company's 2017 Plan and Prior Plans (collectively, the "Equity Plans") as of September 30, 2020 is presented below. Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Aggregate Intrinsic Value Options outstanding, December 31, 2019 1,927,194 $ 5.01 7.5 years $ 87 Options granted 1,216,942 2.08 Options exercised (1,150) 1.76 Options forfeited (133,073) 4.18 Options outstanding, vested and expected to vest, September 30, 2020 3,009,913 3.86 7.8 years — Options exercisable 1,331,243 $ 5.14 6.1 years $ — |
Schedule of Stock Options, Valuation Assumptions | The fair value of stock option grants has been estimated at the date of grant using the Black-Scholes option pricing model with the following weighted average assumptions: Nine Months Ended Nine Months Ended Risk free interest rate 0.4% 2.2% Expected dividend yield —% —% Estimated volatility 73.8% 64.6% Expected life 5.8 years 5.8 years |
Schedule of Other Stock Option Information | Additional information regarding options is as follows: Nine Months Ended Nine Months Ended Weighted-average grant date fair value of options granted during the period $ 1.31 $ 2.04 Aggregate intrinsic value of options exercised during the period $ — $ 10 |
Schedule of Restricted Stock Unit Activity | A summary of the restricted stock unit activity under the Company's Equity Plans as of September 30, 2020 is presented below. Units Weighted Average Grant Date Fair Value Aggregate Intrinsic Value Unvested units, December 31, 2019 243,695 $ 4.06 $ 695 Restricted stock units granted 517,978 2.08 Restricted stock units vested (79,766) 4.06 Restricted stock units forfeited (4,302) 2.08 Unvested units, September 30, 2020 677,605 $ 2.56 $ 1,145 |
Net Loss Per Share (Tables)
Net Loss Per Share (Tables) | 9 Months Ended |
Sep. 30, 2020 | |
Earnings Per Share [Abstract] | |
Schedule of Antidilutive Securities Excluded from Computation of Diluted Loss Per Share | Potentially dilutive securities that are not included in the calculation of diluted net loss per share attributable to common stockholders because to do so would be anti-dilutive are as follows (in common stock equivalent shares on a weighted-average basis): Three Months Ended September 30, Nine Months Ended September 30, 2020 2019 2020 2019 Warrants for common stock 14,725,241 736,980 5,744,225 383,858 Convertible debt 6,385,483 3,304,235 6,292,599 1,113,515 Common stock options 3,009,913 2,004,749 2,459,202 1,716,127 Restricted stock units 677,605 233,774 437,640 150,366 24,798,242 6,279,738 14,933,666 3,363,866 |
Segment and Geographic Inform_2
Segment and Geographic Information (Tables) | 9 Months Ended |
Sep. 30, 2020 | |
Segment Reporting [Abstract] | |
Schedule of Product Sales by Product Group and Geographic Market | Product sales by product group and geographic market, based on the location of the customer, whether the U.S. or outside the U.S. ("OUS") for the periods shown were as follows: Three Months Ended September 30, 2020 Three Months Ended September 30, 2019 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 4,734 $ 2,928 $ 7,662 59.7 % $ 3,711 $ 2,949 $ 6,660 59.2 % IGB 1,853 3,021 4,874 38.0 % 1,088 2,633 3,721 33.0 % Total Endoscopy 6,587 5,949 12,536 97.7 % 4,799 5,582 10,381 92.2 % Surgical — — — — % — 640 640 5.7 % Other 272 18 290 2.3 % 228 10 238 2.1 % Total revenues $ 6,859 $ 5,967 $ 12,826 100.0 % $ 5,027 $ 6,232 $ 11,259 100.0 % % Total revenues 53.5 % 46.5 % 44.6 % 55.4 % Nine Months Ended September 30, 2020 Nine Months Ended September 30, 2019 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 10,873 $ 7,211 $ 18,084 62.0 % $ 10,498 $ 10,339 $ 20,837 53.8 % IGB 3,511 6,688 10,199 34.9 % 4,005 8,552 12,557 32.4 % Total Endoscopy 14,384 13,899 28,283 96.9 % 14,503 18,891 33,394 86.2 % Surgical — — — — % — 3,670 3,670 9.5 % Other 854 51 905 3.1 % 1,632 28 1,660 4.3 % Total revenues $ 15,238 $ 13,950 $ 29,188 100.0 % $ 16,135 $ 22,589 $ 38,724 100.0 % % Total revenues 52.2 % 47.8 % 41.7 % 58.3 % |
Schedule of Long-Lived Assets by Geographic Area | The following table represents property, equipment and right-of-use assets, net based on the geographic location of the asset: September 30, 2020 December 31, 2019 (unaudited) United States $ 2,338 $ 2,934 Costa Rica 3,961 3,039 Other 444 639 Total property, equipment and right-of-use assets, net $ 6,743 $ 6,612 |
Organization and Business Des_2
Organization and Business Description (Details) - USD ($) | 1 Months Ended | |
Jul. 31, 2020 | Jun. 30, 2020 | |
Term loan facility | Sixth Amendment | ||
Debt Instrument [Line Items] | ||
Minimum liquidity requirement | $ 12,500,000 | $ 20,000,000 |
Warrant | ||
Debt Instrument [Line Items] | ||
Proceeds from issuance of warrants | $ 25,000,000 |
Concentrations (Details)
Concentrations (Details) $ in Thousands | 12 Months Ended | |||
Dec. 31, 2019USD ($) | Sep. 30, 2020USD ($)bank | Sep. 30, 2019USD ($) | Dec. 31, 2018USD ($) | |
Concentration Risk [Line Items] | ||||
Number of banks | bank | 5 | |||
Cash and cash equivalents and restricted cash | $ | $ 30,921 | $ 38,195 | $ 35,976 | $ 25,007 |
One Customer | Accounts Receivable | Customer Concentration Risk | ||||
Concentration Risk [Line Items] | ||||
Concentration risk, percentage | 15.00% |
Inventory (Details)
Inventory (Details) - USD ($) | 3 Months Ended | 9 Months Ended | |||
Sep. 30, 2020 | Sep. 30, 2019 | Sep. 30, 2020 | Sep. 30, 2019 | Dec. 31, 2019 | |
Inventory Disclosure [Abstract] | |||||
Raw materials | $ 2,417,000 | $ 2,417,000 | $ 2,834,000 | ||
Work in progress | 754,000 | 754,000 | 532,000 | ||
Finished goods | 6,870,000 | 6,870,000 | 5,499,000 | ||
Total inventory | 10,041,000 | 10,041,000 | $ 8,865,000 | ||
Inventory impairment | 0 | $ 40,000 | 0 | $ 80,000 | |
Consigned inventory | $ 133,000 | $ 133,000 |
Property, Equipment and Right_3
Property, Equipment and Right-of-Use Assets (Details) - USD ($) | 3 Months Ended | 9 Months Ended | |||
Sep. 30, 2020 | Sep. 30, 2019 | Sep. 30, 2020 | Sep. 30, 2019 | Dec. 31, 2019 | |
Property, Plant and Equipment [Line Items] | |||||
Right-of-use assets | $ 4,014,000 | $ 4,014,000 | $ 2,890,000 | ||
Property and equipment, gross | 17,049,000 | 17,049,000 | 15,744,000 | ||
Less accumulated depreciation | (10,306,000) | (10,306,000) | (9,132,000) | ||
Property, equipment and right-of-use assets, net | 6,743,000 | 6,743,000 | 6,612,000 | ||
Depreciation | 435,000 | $ 436,000 | 1,346,000 | $ 1,411,000 | |
Impairment charges | $ 0 | $ 0 | 0 | $ 0 | |
Disposals | $ 275,000 | ||||
Minimum | |||||
Property, Plant and Equipment [Line Items] | |||||
Depreciable Lives, Right of use assets | 1 year | 1 year | |||
Maximum | |||||
Property, Plant and Equipment [Line Items] | |||||
Depreciable Lives, Right of use assets | 5 years | 5 years | |||
Equipment | |||||
Property, Plant and Equipment [Line Items] | |||||
Property and equipment, gross | $ 7,520,000 | $ 7,520,000 | 7,491,000 | ||
Depreciable Lives | 5 years | ||||
Furniture, fixtures and tooling | |||||
Property, Plant and Equipment [Line Items] | |||||
Property and equipment, gross | 2,155,000 | $ 2,155,000 | 2,233,000 | ||
Furniture, fixtures and tooling | Minimum | |||||
Property, Plant and Equipment [Line Items] | |||||
Depreciable Lives | 4 years | ||||
Furniture, fixtures and tooling | Maximum | |||||
Property, Plant and Equipment [Line Items] | |||||
Depreciable Lives | 8 years | ||||
Computer hardware | |||||
Property, Plant and Equipment [Line Items] | |||||
Property and equipment, gross | 1,240,000 | $ 1,240,000 | 1,261,000 | ||
Computer hardware | Minimum | |||||
Property, Plant and Equipment [Line Items] | |||||
Depreciable Lives | 3 years | ||||
Computer hardware | Maximum | |||||
Property, Plant and Equipment [Line Items] | |||||
Depreciable Lives | 5 years | ||||
Leasehold improvements | |||||
Property, Plant and Equipment [Line Items] | |||||
Property and equipment, gross | 1,743,000 | $ 1,743,000 | 1,671,000 | ||
Leasehold improvements | Minimum | |||||
Property, Plant and Equipment [Line Items] | |||||
Depreciable Lives | 3 years | ||||
Leasehold improvements | Maximum | |||||
Property, Plant and Equipment [Line Items] | |||||
Depreciable Lives | 5 years | ||||
Construction in process | |||||
Property, Plant and Equipment [Line Items] | |||||
Property and equipment, gross | $ 377,000 | $ 377,000 | $ 198,000 |
Property, Equipment and Right_4
Property, Equipment and Right-of-Use Assets (Lease Maturity) (Details) $ in Thousands | Sep. 30, 2020USD ($) |
Property, Plant and Equipment [Abstract] | |
2020 | $ 285 |
2021 | 982 |
2022 | 565 |
2023 | 490 |
2024 | 428 |
Thereafter | 1,579 |
Total lease payments | 4,329 |
Less imputed interest | (1,149) |
Total operating lease liabilities | $ 3,180 |
Property, Equipment and Right_5
Property, Equipment and Right-of-Use Assets (Lease Narrative) (Details) - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | |||
Sep. 30, 2020 | Sep. 30, 2019 | Sep. 30, 2020 | Sep. 30, 2019 | Dec. 31, 2019 | |
Property, Plant and Equipment [Abstract] | |||||
Operating lease, current | $ 774 | $ 774 | $ 932 | ||
Operating lease, current, financial statement location | us-gaap:AccountsPayableAndAccruedLiabilitiesCurrent | us-gaap:AccountsPayableAndAccruedLiabilitiesCurrent | us-gaap:AccountsPayableAndAccruedLiabilitiesCurrent | ||
Operating lease, noncurrent | $ 2,406 | $ 2,406 | $ 1,116 | ||
Operating lease, noncurrent, financial statement location | us-gaap:LiabilitiesNoncurrentAbstract | us-gaap:LiabilitiesNoncurrentAbstract | us-gaap:LiabilitiesNoncurrentAbstract | ||
Cash paid within operating cash flows for operating leases | $ 286 | $ 306 | $ 870 | $ 958 | |
Weighted average remaining lease term | 5 years 3 months 18 days | 5 years 3 months 18 days | |||
Weighted average discount rate, percent | 9.00% | 9.00% |
Other Assets (Details)
Other Assets (Details) - Surgical Product Line - Disposal - USD ($) $ in Thousands | 3 Months Ended | 9 Months Ended | |||
Sep. 30, 2020 | Sep. 30, 2019 | Sep. 30, 2020 | Sep. 30, 2019 | Dec. 31, 2019 | |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||
Non-current receivable | $ 2,698 | $ 2,698 | $ 2,511 | ||
Remaining receivable | $ 5,000 | ||||
Interest income | $ 105 | $ 151 | $ 317 | $ 474 | |
Discount Rate | |||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | |||||
Interest on the receivable percentage | 10.00% |
Accrued Expenses (Details)
Accrued Expenses (Details) - USD ($) $ in Thousands | 1 Months Ended | 3 Months Ended | 9 Months Ended | 12 Months Ended | ||
Apr. 30, 2019 | Sep. 30, 2020 | Sep. 30, 2019 | Sep. 30, 2020 | Sep. 30, 2019 | Dec. 31, 2019 | |
Payables and Accruals [Abstract] | ||||||
Accrued employee compensation and expenses | $ 3,797 | $ 3,797 | $ 3,183 | |||
Accrued professional service fees | 912 | 912 | 653 | |||
Lease liability | 774 | 774 | 932 | |||
Accrued insurance and taxes | 471 | 471 | 271 | |||
Accrued interest | 309 | 309 | 467 | |||
Accrued returns and rebates | 127 | 127 | 216 | |||
Settlement liability | 0 | 0 | 1,625 | |||
Other | 953 | 953 | 1,091 | |||
Total accrued expenses | 7,343 | 7,343 | 8,438 | |||
Settlement agreement | $ 3,250 | |||||
Settlement gain | $ 0 | $ 0 | $ 0 | $ 5,609 | $ 5,609 |
Long-Term Debt (Schedule of Lon
Long-Term Debt (Schedule of Long-term Debt) (Details) - USD ($) $ in Thousands | Sep. 30, 2020 | Dec. 31, 2019 |
Debt Instrument [Line Items] | ||
Deferred financing costs | $ (1,076) | $ (1,068) |
Less current portion | (8,326) | (34,449) |
Long-term debt | 29,451 | 0 |
Payment-in-kind interest | ||
Debt Instrument [Line Items] | ||
Long-term debt | 1,029 | 517 |
PPP loan | ||
Debt Instrument [Line Items] | ||
Long-term debt | 2,824 | 0 |
Term loan facility | Term loan facility | ||
Debt Instrument [Line Items] | ||
Long-term debt | $ 35,000 | $ 35,000 |
Long-Term Debt (Narrative) (Det
Long-Term Debt (Narrative) (Details) - USD ($) | Apr. 30, 2020 | Mar. 31, 2019 | Sep. 30, 2020 | Sep. 30, 2019 | Sep. 30, 2020 | Sep. 30, 2019 | Mar. 31, 2020 | Dec. 31, 2019 |
Debt Instrument [Line Items] | ||||||||
Line of credit | $ 37,824,000 | $ 37,824,000 | ||||||
Interest expense | 1,054,000 | $ 1,284,000 | 3,144,000 | $ 3,504,000 | ||||
PPP loan | ||||||||
Debt Instrument [Line Items] | ||||||||
Long-term debt | 2,824,000 | 2,824,000 | $ 0 | |||||
Interest rate | 1.00% | |||||||
Term loan facility | Term loan facility | ||||||||
Debt Instrument [Line Items] | ||||||||
Line of credit | $ 35,000,000 | |||||||
Interest rate if basis spread on variable rate is not used | 1.35575% | |||||||
Percent of outstanding amount due | 4.90% | |||||||
Commitment fee percentage | 4.50% | |||||||
Twelve month revenue amount | $ 100,000 | |||||||
Increase in limit | $ 5,000,000 | |||||||
Long-term debt | $ 35,000,000 | $ 35,000,000 | $ 35,000,000 | |||||
Term loan facility | Term loan facility | LIBOR | ||||||||
Debt Instrument [Line Items] | ||||||||
Basis spread on variable rate | 7.50% | |||||||
Term loan facility | Senior Secured Credit Facility | ||||||||
Debt Instrument [Line Items] | ||||||||
Repayments of debt | $ 22,372,000 | |||||||
Unamortized deferred financing costs and discount | $ 388,000 | |||||||
Term loan facility | Fifth Amendment and Limited Waiver | ||||||||
Debt Instrument [Line Items] | ||||||||
Percent of outstanding amount due | 5.00% | |||||||
Increase in minimum liquidity requirement | $ 12,500,000 |
Long-Term Debt (Schedule of Mat
Long-Term Debt (Schedule of Maturity of Long-term Debt) (Details) $ in Thousands | Sep. 30, 2020USD ($) |
Debt Disclosure [Abstract] | |
2020 | $ 0 |
2021 | 12,294 |
2022 | 15,883 |
2023 | 9,647 |
2024 | 0 |
Thereafter | 0 |
Line of credit | $ 37,824 |
Convertible Debt (Schedule of C
Convertible Debt (Schedule of Convertible Debt) (Details) - USD ($) $ in Thousands | Sep. 30, 2020 | Dec. 31, 2019 |
Debt Instrument [Line Items] | ||
Deferred financing costs | $ (1,076) | $ (1,068) |
Long-term debt | 29,451 | 0 |
Convertible debt | ||
Debt Instrument [Line Items] | ||
Convertible debt | 20,600 | 20,000 |
Deferred financing costs | (1,211) | (1,446) |
Long-term debt | $ 19,389 | $ 18,554 |
Convertible Debt (Narrative) (D
Convertible Debt (Narrative) (Details) $ / shares in Units, $ in Thousands | 1 Months Ended | 3 Months Ended | 9 Months Ended | ||||
Jan. 31, 2020shares | Aug. 31, 2019USD ($)d$ / shares | Sep. 30, 2020USD ($) | Sep. 30, 2019USD ($) | Sep. 30, 2020USD ($) | Sep. 30, 2019USD ($) | Dec. 31, 2019USD ($) | |
Debt Instrument [Line Items] | |||||||
Proceeds from convertible debt | $ 0 | $ 20,000 | |||||
Accrued interest | $ 309 | 309 | $ 467 | ||||
Interest expense | 1,054 | $ 1,284 | 3,144 | 3,504 | |||
Convertible debt | |||||||
Debt Instrument [Line Items] | |||||||
Proceeds from convertible debt | $ 20,000 | ||||||
Interest rate | 6.00% | ||||||
Stock price (USD per share) | $ / shares | $ 2.50 | ||||||
Issuance of common stock for convertible debt interest (in shares) | shares | 164,797 | ||||||
Fulfillment of accrued interest | 600 | 600 | $ 467 | ||||
Interest expense | $ 388 | $ 208 | $ 1,144 | $ 208 | |||
Convertible debt | Conversion Ratio Less Than 2.50 | |||||||
Debt Instrument [Line Items] | |||||||
Consecutive trading days (in days) | d | 10 | ||||||
Convertible debt | Conversion Ratio Of 3.25 | |||||||
Debt Instrument [Line Items] | |||||||
Consecutive trading days (in days) | d | 30 | ||||||
Conversion price (USD per share) | $ / shares | $ 3.25 | ||||||
Stock price trigger (USD per share) | $ / shares | $ 9.75 | ||||||
Trading days (in days) | d | 20 |
Stock Based Compensation (Stock
Stock Based Compensation (Stock Option Activity) (Details) - Stock Option - USD ($) $ / shares in Units, $ in Thousands | 9 Months Ended | 12 Months Ended |
Sep. 30, 2020 | Dec. 31, 2019 | |
Options | ||
Options outstanding, beginning balance (in shares) | 1,927,194 | |
Options granted (in shares) | 1,216,942 | |
Options exercised (in shares) | (1,150) | |
Options forfeited (in shares) | (133,073) | |
Options vested and expected to vest (in shares) | 3,009,913 | |
Options exercisable (in shares) | 1,331,243 | |
Weighted Average Exercise Price | ||
Weighted average exercise price, beginning balance (in USD per share) | $ 5.01 | |
Options granted (in USD per share) | $ 2.08 | |
Options exercised (in USD per share) | 1.76 | |
Options forfeited (in USD per share) | 4.18 | |
Options vested and expected to vest (in USD per share) | 3.86 | |
Options exercisable (in USD per share) | $ 5.14 | |
Weighted Average Remaining Contractual Term | ||
Weighted Average Remaining Contractual Term | 7 years 6 months | |
Options vested and expected to vest | 7 years 9 months 18 days | |
Options exercisable | 6 years 1 month 6 days | |
Aggregate Intrinsic Value | ||
Aggregate intrinsic value | $ 87 | |
Options vested and expected to vest | $ 0 | |
Options exercisable | $ 0 |
Stock Based Compensation (Fair
Stock Based Compensation (Fair Value of Stock Options) (Details) - Stock Option | 9 Months Ended | |
Sep. 30, 2020 | Sep. 30, 2019 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Risk free interest rate | 0.40% | 2.20% |
Expected dividend yield | 0.00% | 0.00% |
Estimated volatility | 73.80% | 64.60% |
Expected life | 5 years 9 months 18 days | 5 years 9 months 18 days |
Stock Based Compensation (Addit
Stock Based Compensation (Additional Information) (Details) - USD ($) $ / shares in Units, $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2020 | Sep. 30, 2019 | Sep. 30, 2020 | Sep. 30, 2019 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||||
Share-based compensation | $ 586 | $ 390 | $ 1,521 | $ 1,059 |
Unrecognized compensation expense related to unvested options | 2,627 | $ 2,627 | ||
Remaining amortization period | 2 years 2 months 12 days | |||
Common stock options | ||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||||
Weighted-average grant date fair value of options granted during period (in USD per share) | $ 1.31 | $ 2.04 | ||
Aggregate intrinsic value of options exercised during the period | $ 0 | $ 10 | ||
Restricted stock units | ||||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||||
Remaining amortization period | 2 years 4 months 24 days | |||
Unrecognized compensation expense related to unvested restricted stock units | $ 1,437 | $ 1,437 |
Stock Based Compensation (Restr
Stock Based Compensation (Restricted Stock Units Activity) (Details) - Restricted stock units - USD ($) $ / shares in Units, $ in Thousands | 9 Months Ended | |
Sep. 30, 2020 | Dec. 31, 2019 | |
Units | ||
Unvested Units (shares) | 243,695 | |
Restricted stock units granted (shares) | 517,978 | |
Restricted stock units vested (shares) | (79,766) | |
Restricted stock units forfeited (shares) | (4,302) | |
Unvested Units (shares) | 677,605 | |
Weighted Average Grant Date Fair Value | ||
Unvested Units (USD per share) | $ 4.06 | |
Restricted stock units granted (USD per share) | 2.08 | |
Restricted stock units vested (USD per share) | 4.06 | |
Restricted stock units forfeited (USD per share) | 2.08 | |
Unvested Units (USD per share) | $ 2.56 | |
Aggregate Intrinsic Value | ||
Aggregate Intrinsic Value | $ 1,145 | $ 695 |
Income Taxes (Details)
Income Taxes (Details) | Sep. 30, 2020USD ($) |
Income Tax Disclosure [Abstract] | |
Unrecognized tax benefits | $ 0 |
Accrued interest | 0 |
Tax penalties | $ 0 |
Net Loss Per Share (Details)
Net Loss Per Share (Details) - shares | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2020 | Sep. 30, 2019 | Sep. 30, 2020 | Sep. 30, 2019 | |
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||||
Antidilutive securities excluded from computation of diluted loss per share (in shares) | 24,798,242 | 6,279,738 | 14,933,666 | 3,363,866 |
Warrants for common stock | ||||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||||
Antidilutive securities excluded from computation of diluted loss per share (in shares) | 14,725,241 | 736,980 | 5,744,225 | 383,858 |
Convertible debt | ||||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||||
Antidilutive securities excluded from computation of diluted loss per share (in shares) | 6,385,483 | 3,304,235 | 6,292,599 | 1,113,515 |
Common stock options | ||||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||||
Antidilutive securities excluded from computation of diluted loss per share (in shares) | 3,009,913 | 2,004,749 | 2,459,202 | 1,716,127 |
Restricted stock units | ||||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||||
Antidilutive securities excluded from computation of diluted loss per share (in shares) | 677,605 | 233,774 | 437,640 | 150,366 |
Fair Value Measurements (Detail
Fair Value Measurements (Details) $ in Thousands | Sep. 30, 2020USD ($) |
Fair Value Disclosures [Abstract] | |
Fair value of long-term debt | $ 40,400 |
Convertible debt, fair value | $ 20,600 |
Segment and Geographic Inform_3
Segment and Geographic Information (Segment Information) (Details) $ in Thousands | 3 Months Ended | 9 Months Ended | ||
Sep. 30, 2020USD ($) | Sep. 30, 2019USD ($) | Sep. 30, 2020USD ($)segment | Sep. 30, 2019USD ($) | |
Segment Reporting [Abstract] | ||||
Number of reportable segments | segment | 1 | |||
Revenue, Major Customer [Line Items] | ||||
Revenues | $ 12,826 | $ 11,259 | $ 29,188 | $ 38,724 |
Segment Revenue | Product Risk | ||||
Revenue, Major Customer [Line Items] | ||||
Percentage of revenue or sales | 100.00% | 100.00% | 100.00% | 100.00% |
U.S. | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | $ 6,859 | $ 5,027 | $ 15,238 | $ 16,135 |
U.S. | Segment Revenue | Product Risk | ||||
Revenue, Major Customer [Line Items] | ||||
Percentage of revenue or sales | 53.50% | 44.60% | 52.20% | 41.70% |
OUS | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | $ 5,967 | $ 6,232 | $ 13,950 | $ 22,589 |
OUS | Segment Revenue | Product Risk | ||||
Revenue, Major Customer [Line Items] | ||||
Percentage of revenue or sales | 46.50% | 55.40% | 47.80% | 58.30% |
OUS | Distributor Sales | Product Risk | ||||
Revenue, Major Customer [Line Items] | ||||
Percentage of revenue or sales | 30.40% | 34.40% | 31.40% | 31.80% |
Non-US, Next Largest Single Country | Distributor Sales | Product Risk | ||||
Revenue, Major Customer [Line Items] | ||||
Percentage of revenue or sales | 8.90% | 6.80% | 8.40% | 8.20% |
ESS | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | $ 7,662 | $ 6,660 | $ 18,084 | $ 20,837 |
ESS | Segment Revenue | Product Risk | ||||
Revenue, Major Customer [Line Items] | ||||
Percentage of revenue or sales | 59.70% | 59.20% | 62.00% | 53.80% |
ESS | U.S. | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | $ 4,734 | $ 3,711 | $ 10,873 | $ 10,498 |
ESS | OUS | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | 2,928 | 2,949 | 7,211 | 10,339 |
IGB | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | $ 4,874 | $ 3,721 | $ 10,199 | $ 12,557 |
IGB | Segment Revenue | Product Risk | ||||
Revenue, Major Customer [Line Items] | ||||
Percentage of revenue or sales | 38.00% | 33.00% | 34.90% | 32.40% |
IGB | U.S. | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | $ 1,853 | $ 1,088 | $ 3,511 | $ 4,005 |
IGB | OUS | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | 3,021 | 2,633 | 6,688 | 8,552 |
Total Endoscopy | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | $ 12,536 | $ 10,381 | $ 28,283 | $ 33,394 |
Total Endoscopy | Segment Revenue | Product Risk | ||||
Revenue, Major Customer [Line Items] | ||||
Percentage of revenue or sales | 97.70% | 92.20% | 96.90% | 86.20% |
Total Endoscopy | U.S. | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | $ 6,587 | $ 4,799 | $ 14,384 | $ 14,503 |
Total Endoscopy | OUS | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | 5,949 | 5,582 | 13,899 | 18,891 |
Surgical | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | $ 0 | $ 640 | $ 0 | $ 3,670 |
Surgical | Segment Revenue | Product Risk | ||||
Revenue, Major Customer [Line Items] | ||||
Percentage of revenue or sales | 0.00% | 5.70% | 0.00% | 9.50% |
Surgical | U.S. | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | $ 0 | $ 0 | $ 0 | $ 0 |
Surgical | OUS | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | 0 | 640 | 0 | 3,670 |
Other | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | $ 290 | $ 238 | $ 905 | $ 1,660 |
Other | Segment Revenue | Product Risk | ||||
Revenue, Major Customer [Line Items] | ||||
Percentage of revenue or sales | 2.30% | 2.10% | 3.10% | 4.30% |
Other | U.S. | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | $ 272 | $ 228 | $ 854 | $ 1,632 |
Other | OUS | ||||
Revenue, Major Customer [Line Items] | ||||
Revenues | $ 18 | $ 10 | $ 51 | $ 28 |
Segment and Geographic Inform_4
Segment and Geographic Information (Long-Lived Assets by Geographic Area) (Details) - USD ($) $ in Thousands | Sep. 30, 2020 | Dec. 31, 2019 |
Revenues from External Customers and Long-Lived Assets [Line Items] | ||
Total property, equipment and right-of-use assets, net | $ 6,743 | $ 6,612 |
U.S. | ||
Revenues from External Customers and Long-Lived Assets [Line Items] | ||
Total property, equipment and right-of-use assets, net | 2,338 | 2,934 |
Costa Rica | ||
Revenues from External Customers and Long-Lived Assets [Line Items] | ||
Total property, equipment and right-of-use assets, net | 3,961 | 3,039 |
Other | ||
Revenues from External Customers and Long-Lived Assets [Line Items] | ||
Total property, equipment and right-of-use assets, net | $ 444 | $ 639 |
Subsequent Events (Details)
Subsequent Events (Details) | Oct. 31, 2020shares |
Warrant | Subsequent Event | |
Subsequent Event [Line Items] | |
Issued warrants to purchase shares, number of shares (in shares) | 2,105,836 |