Cover Page
Cover Page - USD ($) | 12 Months Ended | ||
Dec. 31, 2020 | Jan. 31, 2021 | Jun. 30, 2020 | |
Cover [Abstract] | |||
Document Type | 10-K | ||
Document Annual Report | true | ||
Document Period End Date | Dec. 31, 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, $0.001 par value per share | ||
Trading Symbol | APEN | ||
Security Exchange Name | NASDAQ | ||
Entity Well-known Seasoned Issuer | No | ||
Entity Voluntary Filers | No | ||
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 Public Float | $ 34,656,093 | ||
Entity Common Stock, Shares Outstanding | 25,983,847 | ||
Documents Incorporated by Reference | DOCUMENTS INCORPORATED BY REFERENCE Portions of the Definitive Proxy Statement for the registrant’s 2021 Annual Meeting of Stockholders are incorporated by reference into Part III of this Annual Report on Form 10-K. The Definitive Proxy Statement will be filed no later than 120 days after the close of the registrant’s fiscal year ended December 31, 2020. | ||
Entity Central Index Key | 0001251769 | ||
Current Fiscal Year End Date | --12-31 | ||
Amendment Flag | false | ||
Document Fiscal Year Focus | 2020 | ||
Document Fiscal Period Focus | FY |
Consolidated Balance Sheets
Consolidated Balance Sheets - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 |
Current assets: | ||
Cash and cash equivalents | $ 36,235 | $ 29,905 |
Accounts receivable, net of allowance for doubtful accounts of $634 and $658, respectively | 8,218 | 9,232 |
Inventory | 10,306 | 8,865 |
Prepaid expenses and other current assets | 3,771 | 2,998 |
Total current assets | 58,530 | 51,000 |
Restricted cash | 965 | 1,016 |
Property, equipment and right-of-use assets | 6,221 | 6,612 |
Goodwill | 5,290 | 5,290 |
Intangible assets, net of accumulated amortization of $13,231 and $11,648, respectively | 6,017 | 7,831 |
Other assets | 414 | 2,833 |
Total assets | 77,437 | 74,582 |
Current liabilities: | ||
Accounts payable | 3,675 | 9,902 |
Accrued expenses | 7,357 | 8,438 |
Current portion of long-term debt | 636 | 34,449 |
Total current liabilities | 11,668 | 52,789 |
Long-term debt | 37,192 | 0 |
Convertible debt | 19,387 | 18,554 |
Long-term liabilities | 2,439 | 1,116 |
Total liabilities | 70,686 | 72,459 |
Commitments and contingencies | ||
Stockholders' equity: | ||
Common stock; $0.001 par value; 100,000,000 shares authorized; 25,819,329 and 20,951,963 shares issued and outstanding at December 31, 2020 and 2019, respectively | 26 | 21 |
Additional paid-in capital | 276,569 | 250,634 |
Accumulated other comprehensive income | 2,929 | 1,630 |
Accumulated deficit | (272,773) | (250,162) |
Total stockholders' equity | 6,751 | 2,123 |
Total liabilities and stockholders' equity | $ 77,437 | $ 74,582 |
Consolidated Balance Sheets (Pa
Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 |
Statement of Financial Position [Abstract] | ||
Allowance for doubtful accounts | $ 634 | $ 658 |
Accumulated amortization, intangible assets | $ 13,231 | $ 11,648 |
Common stock, par value (USD per share) | $ 0.001 | $ 0.001 |
Common stock, shares authorized (in shares) | 100,000,000 | 100,000,000 |
Common stock, shares issued (in shares) | 25,819,329 | 20,951,963 |
Common stock, shares outstanding (in shares) | 25,819,329 | 20,951,963 |
Consolidated Statements of Oper
Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Income Statement [Abstract] | ||
Revenues | $ 42,048 | $ 50,713 |
Cost of sales | 19,806 | 25,038 |
Gross margin | 22,242 | 25,675 |
Operating expenses: | ||
Sales and marketing | 17,355 | 28,730 |
General and administrative | 11,062 | 13,588 |
Research and development | 7,670 | 10,384 |
Amortization of intangible assets | 1,949 | 2,095 |
Settlement gain | 0 | (5,609) |
Total operating expenses | 38,036 | 49,188 |
Loss from operations | (15,794) | (23,513) |
Other expenses: | ||
Interest expense, net | 5,251 | 4,052 |
Other (income) expense | 1,424 | (408) |
Net loss before income taxes | (22,469) | (27,157) |
Income tax expense | 142 | 275 |
Net loss | (22,611) | (27,432) |
Other comprehensive income (loss): | ||
Foreign currency translation | 1,299 | (871) |
Comprehensive loss | $ (21,312) | $ (28,303) |
Net loss per share, basic and diluted (USD per share) | $ (0.99) | $ (1.27) |
Shares used in computing net loss per share, basic and diluted (shares) | 22,756,167 | 21,542,284 |
Consolidated Statements of Chan
Consolidated Statements of Changes in Stockholders’ Equity - USD ($) $ in Thousands | Total | Adoption of ASU 2016-02, Leases | Common Stock | Additional Paid-in Capital | Accumulated Other Comprehensive Income | Accumulated Deficit | Accumulated DeficitAdoption of ASU 2016-02, Leases |
Beginning balance (shares) at Dec. 31, 2018 | 21,899,522 | ||||||
Beginning balance at Dec. 31, 2018 | $ 28,830 | $ 78 | $ 22 | $ 249,115 | $ 2,501 | $ (222,808) | $ 78 |
Stockholders' Equity: | |||||||
Exercise of common stock options (shares) | 17,158 | ||||||
Exercise of common stock options | 31 | 31 | |||||
Exchange for warrants (in shares) | (1,000,000) | ||||||
Exchange of common stock for warrants | $ (1) | 1 | |||||
Issuance of restricted stock units (shares) | 35,283 | ||||||
Stock-based compensation | 1,487 | 1,487 | |||||
Foreign currency translation | (871) | (871) | |||||
Net loss | $ (27,432) | (27,432) | |||||
Ending balance (shares) at Dec. 31, 2019 | 20,951,963 | 20,951,963 | |||||
Ending balance at Dec. 31, 2019 | $ 2,123 | $ 21 | 250,634 | 1,630 | (250,162) | ||
Stockholders' Equity: | |||||||
Exercise of common stock options (shares) | 5,982 | ||||||
Exercise of common stock options | 14 | 14 | |||||
Exchange for warrants (in shares) | 2,105,836 | ||||||
Exchange of common stock for warrants | $ 2 | (2) | |||||
Issuance of restricted stock units (shares) | 85,223 | ||||||
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, net of issuance costs of $1,721 (shares) | 2,480,000 | ||||||
Issuance of common stock, net of issuance costs of $1,721 | 23,262 | $ 3 | 23,259 | ||||
Conversion of convertible debt (in shares) | 25,528 | ||||||
Conversion of convertible debt | 83 | 83 | |||||
Stock-based compensation | 2,114 | 2,114 | |||||
Foreign currency translation | 1,299 | 1,299 | |||||
Net loss | $ (22,611) | (22,611) | |||||
Ending balance (shares) at Dec. 31, 2020 | 25,819,329 | 25,819,329 | |||||
Ending balance at Dec. 31, 2020 | $ 6,751 | $ 26 | $ 276,569 | $ 2,929 | $ (272,773) |
Consolidated Statements of Ch_2
Consolidated Statements of Changes in Stockholders’ Equity (Parenthetical) $ in Thousands | 12 Months Ended |
Dec. 31, 2020USD ($) | |
Statement of Stockholders' Equity [Abstract] | |
Stock issuance costs | $ 1,721 |
Consolidated Statements of Cash
Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Cash flows from operating activities: | ||
Net loss | $ (22,611) | $ (27,432) |
Adjustments to reconcile net loss to net cash used in operating activities: | ||
Depreciation and amortization | 3,730 | 4,060 |
Amortization of deferred financing costs | 656 | 620 |
Non-cash interest | 1,501 | 540 |
Provision for doubtful accounts receivable | 52 | 212 |
Inventory impairment | 50 | 162 |
Stock-based compensation | 2,114 | 1,487 |
Unrealized foreign exchange on intercompany payables | 1,208 | (214) |
Settlement gain | 0 | (5,609) |
Changes in operating assets and liabilities: | ||
Accounts receivable | 1,079 | 1,852 |
Inventory | (1,559) | 872 |
Prepaid expenses and other assets | 56 | (120) |
Accounts payable and accrued expenses | (7,088) | (2,052) |
Net cash used in operating activities | (20,812) | (25,622) |
Cash flows from investing activities: | ||
Purchases of property and equipment | (486) | (805) |
Purchases of intangibles and other assets | (144) | (175) |
Proceeds from sale of equipment | 0 | 18 |
Divestiture of Surgical product line | 2,000 | 2,000 |
Net cash provided by investing activities | 1,370 | 1,038 |
Cash flows from financing activities: | ||
Proceeds from exercise of stock options | 14 | 31 |
Proceeds from long-term debt | 2,824 | 35,000 |
Proceeds from convertible debt | 0 | 20,000 |
Proceeds from issuance of common stock | 23,262 | 0 |
Payments of deferred financing costs | (487) | (2,857) |
Payment of long-term debt | 0 | (21,668) |
Net cash provided by financing activities | 25,613 | 30,506 |
Effect of exchange rate changes on cash | 108 | (8) |
Net increase in cash, cash equivalents and restricted cash | 6,279 | 5,914 |
Cash, cash equivalents and restricted cash at beginning of year | 30,921 | 25,007 |
Cash, cash equivalents and restricted cash at end of year | 37,200 | 30,921 |
Supplemental disclosure of cash flow information: | ||
Cash paid for interest | 3,182 | 3,470 |
Cash paid for income taxes | 192 | 328 |
Right-of-use assets recognized in exchange for new lease obligations (non-cash) | $ 1,146 | $ 2,890 |
Organization and Business Descr
Organization and Business Description | 12 Months Ended |
Dec. 31, 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 gastroenterologists and surgeons for a variety of procedures related to closing gastrointestinal defects and managing surgical or endoscopic adverse events and obesity 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. In December 2020, the Company received 510(k) approval for the X-Tack Endoscopic HeliX Tacking System. All devices are regulated by the U.S. Food and Drug Administration (the "FDA") or an equivalent regulatory body outside the U.S. |
Significant Accounting Policies
Significant Accounting Policies | 12 Months Ended |
Dec. 31, 2020 | |
Accounting Policies [Abstract] | |
Significant Accounting Policies | Significant Accounting Policies (a) Principles of Consolidation The consolidated financial statements include the accounts of the Company and all of its wholly-owned subsidiaries. All significant intercompany accounts and transactions have been eliminated. (b) Use of Estimates The preparation of consolidated financial statements in conformity with accounting principles generally accepted in the U.S. ("U.S. GAAP") requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenues and expenses during the reporting periods. Actual results are likely to differ from those estimates, and such differences may be material to the consolidated financial statements. Significant items subject to such estimates and assumptions include revenue recognition, going concern assessment, useful lives of intangibles and long-lived assets, long-lived asset and goodwill impairment, allowance for doubtful accounts, and valuation of inventory. (c) Cash and Cash Equivalents The Company considers all highly liquid investments with a remaining maturity at date of purchase of three months or less to be cash equivalents. (d) Restricted Cash The Company entered into irrevocable letters of credit with three banks to secure obligations under lease agreements and performance based obligations. These letters of credit are secured by cash balances totaling $965 and $1,016 which are recorded in restricted cash on the consolidated balance sheet as of December 31, 2020 and 2019, respectively. (e) Accounts Receivable The Company generally extends credit to certain customers without requiring collateral. The Company provides an allowance for doubtful accounts based on management's evaluation of the collectability of accounts receivable. Accounts receivable are written off when it is deemed uncollectible. Accounts receivable of $115 and $127 were written off during the years ended December 31, 2020 and 2019, respectively. (f) Inventory Inventory is stated at the lower of cost or net realizable value. Charges for excess and obsolete inventory are based on specific identification of obsolete inventory items and an analysis of inventory items approaching expiration date. The Company records estimated excess and obsolescence charges to cost of sales. The Company's inventories are stated using the weighted average cost approach, which approximates actual costs. (g) Fair Value Measurements The carrying amounts of the Company's financial instruments, which primarily include cash and 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 is estimated by management to approximate $41,100 and $38,000 at December 31, 2020 and 2019, respectively. The Company's convertible debt is estimated by management to approximate $20,500 and $20,000 at December 31, 2020 and 2019, respectively. 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. (h) Property and Equipment Property and equipment are carried at cost less accumulated depreciation. Depreciation is computed using the straight-line method over the estimated useful lives of the related assets, except for leasehold improvements, which are depreciated straight-line over the shorter of the estimated useful life or the life of the lease. Major renewals and betterments are capitalized. Validation costs (including materials and labor) that are required to bring machinery to working condition are capitalized. Expenditures for repairs and maintenance and minor replacements are charged to expense as incurred. (i) Leases Lease arrangements are generally recognized at lease commitment. Operating lease right-of-use assets and liabilities are recognized at commencement based on the present value of lease payments over the lease term, except for leases with an initial term of 12 months or less, for which lease expense is recognized as incurred over the lease term. Right-of-use assets represent the Company’s right to use an underlying asset during the reasonably certain lease term, and lease liabilities represent the Company’s obligation to make lease payments arising from the lease. Lease terms may include options to extend or terminate the lease when its reasonably certain that the Company will exercise that option. The Company primarily uses its incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. Operating lease right-of-use assets include any lease payments related to initial direct costs and prepayments and excludes lease incentives. Lease expense is recognized on a straight-line basis over the lease term. The Company has lease agreements with lease and non-lease components, which are generally accounted for separately. (j) Goodwill and Other Intangible Assets Goodwill is not amortized but is tested annually for impairment or more frequently if impairment indicators exist. For annual and interim goodwill impairment tests, the Company first assesses qualitative factors before performing a quantitative assessment of the fair value of a reporting unit. If it is determined on the basis of qualitative factors that the fair value of the reporting unit is more likely than not less than the carrying amount, a quantitative impairment test is required. The Company's evaluation of goodwill completed on December 31, 2020 and 2019 resulted in no impairment losses. Definite-lived intangible assets consist of customer relationships, product technology, trade names, patents and trademarks and capitalized software which are amortized over their estimated useful lives. Costs to extend the lives of and renew patents and trademarks are capitalized when incurred. (k) Valuation of Long-Lived Assets Long-lived assets, including definite-lived intangible assets, are monitored and reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of any such asset may not be recoverable. The determination of recoverability is based on an estimate of undiscounted cash flows expected to result from the use of an asset and its eventual disposition. The estimate of undiscounted cash flows is based upon, among other things, certain assumptions about expected future operating performance. The Company's estimates of undiscounted cash flows may differ from actual cash flows. If the sum of the undiscounted cash flows is less than the carrying value of the asset, an impairment charge is recognized, measured as the amount by which the carrying value exceeds the fair value of the asset. The Company's evaluation of long-lived assets for the years ended December 31, 2020 and 2019 resulted in no impairment losses. (l) Revenue Recognition The Company's principal source of revenues is from the sale of its products. Revenue is recognized when control of the promised goods is transferred to the customer, in an amount that reflects the consideration expected to be entitled to in an exchange for those goods. Generally, these are met under the Company's agreements with most customers upon product shipment. This includes sales to distributors, who sell the products to their customers, take title to the products and assume all risks of ownership at the time of shipment. The Company's distributors are obligated to pay within specified terms regardless of when, if ever, they sell the products. Customers and distributors generally have the right to return or exchange products purchased from the Company for up to thirty days from the date of product shipment. At the end of each period, the Company determines the extent to which its revenues need to be reduced to account for expected returns and exchanges. Certain customers may receive volume rebates or discounts, which are accounted for as variable consideration. The Company estimates these amounts based on the expected amount to be provided to customers and reduces recognized revenues. The Company records deferred revenues when cash payments are received in advance of the transfer of goods. The Company accounts for taxes collected from customers and remitted to governmental authorities on a net basis. Accordingly, such amounts are excluded from revenues. Amounts billed to customers related to shipping and handling are included in revenues. Shipping and handling costs related to revenue producing activities are included in cost of sales. In connection with the December 2018 sale of the Surgical product line, the Company entered into a transition services agreement, supply agreement and distribution agreement. Transition service fees were recognized as revenue when the support was provided in accordance with the prices established in the transition services agreement. Product sold under the supply agreement is recognized as revenue when product is shipped at the prices established in the supply agreement net of the cost to produce the product. Transition service and supply agreement revenue are included in other revenue. All transition, distribution, and manufacturing services were completed as of December 31, 2020. (m) Research and Development Research and development costs are expensed as incurred. (n) Stock-based Compensation Plans The Company recognizes compensation costs for all stock-based awards based upon each award's estimated fair value as determined on the date of grant. The Company utilizes the Black-Scholes option-pricing model to determine the fair value of stock option awards. Compensation cost is recognized on a straight-line basis over the respective vesting period of the award. Adjustments for actual forfeitures are made in the period which they occur. (o) Advertising The Company expenses advertising costs as incurred. The Company incurred approximately $227 and $1,648 in advertising costs during the years ended December 31, 2020 and 2019, respectively. (p) Income Taxes The Company accounts for deferred income taxes using the asset and liability method. Under this method, deferred income taxes arise from temporary differences between the tax basis of assets and liabilities and their reported amounts in the financial statements, which will result in taxable or deductible amounts in the future. Temporary differences are then measured using the enacted tax rates and laws. Valuation allowances are established, when necessary, to reduce deferred tax assets to the amount that is more-likely than-not to be realized. Determining the appropriate amount of valuation allowance requires management to exercise judgment about future operations. In the ordinary course of business, there are many transactions for which the ultimate tax outcome is uncertain. The Company regularly assesses uncertain tax positions in each of the tax jurisdictions in which it has operations and accounts for the related consolidated financial statement implications. The amount of unrecognized tax benefits is adjusted when information becomes available or when an event occurs indicating a change is appropriate. The Company includes interest and penalties related to its uncertain tax positions as part of income tax expense. (q) Foreign Currency The Company translates foreign assets and liabilities at exchange rates in effect at the balance sheet dates, and the revenues and expenses using average rates during the year. The resulting foreign currency translation adjustments are recorded as a separate component of accumulated other comprehensive income in the accompanying consolidated balance sheets. Exchange rate fluctuations on short-term intercompany loans are included in other expense in the consolidated statement of operations and comprehensive loss. (r) Recent Accounting Pronouncements 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 | 12 Months Ended |
Dec. 31, 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 December 31, 2020, the Company's cash and cash equivalents and restricted cash are held in deposit accounts at five different banks totaling $37,200. 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 no concentrations greater than 10% of the Company's net accounts receivable balance as of December 31, 2020. There was one customer representing approximately 15% of the Company's net accounts receivable as of December 31, 2019. The Company had no single customer that comprised more than 10% of the Company's total revenues for the years ended December 31, 2020 and 2019. |
Inventory
Inventory | 12 Months Ended |
Dec. 31, 2020 | |
Inventory Disclosure [Abstract] | |
Inventory | Inventory Inventory consists of the following as of December 31: 2020 2019 Raw materials $ 2,344 $ 2,834 Work in progress 558 532 Finished goods 7,404 5,499 Total inventory $ 10,306 $ 8,865 |
Property, Equipment and Right-o
Property, Equipment and Right-of-Use Assets | 12 Months Ended |
Dec. 31, 2020 | |
Property, Plant and Equipment [Abstract] | |
Property, Equipment and Right-of-Use Assets | Property, Equipment and Right-of-Use Assets Property and equipment consists of the following as of December 31: Depreciable Lives 2020 2019 Equipment 5 years $ 7,452 $ 7,491 Right-of-use assets 1 - 5 years 4,031 2,890 Furniture, fixtures and tooling 4 - 8 years 2,156 2,233 Computer hardware 3 - 5 years 1,244 1,261 Leasehold improvements 3 - 7 years 1,744 1,671 Construction in process 466 198 17,093 15,744 Less accumulated depreciation (10,872) (9,132) Property, equipment and right-of-use assets $ 6,221 $ 6,612 The Company recorded depreciation expense of $1,779 and $1,859 for the years ended December 31, 2020 and 2019, respectively. There were no impairment charges for the years ended December 31, 2020 or 2019. The Company disposed of $405 of fully depreciated property, equipment and right-of-use assets no longer being utilized during the year ended December 31, 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 December 31, 2020, the maturities of the Company's operating lease liabilities are as follows: 2021 $ 983 2022 566 2023 488 2024 424 2025 404 Thereafter 1,172 Total lease payments 4,037 Less imputed interest (1,032) Total operating lease liabilities $ 3,005 Operating lease liabilities of $675 and $2,330 are included in accrued expense long-term liabilities |
Intangible Assets
Intangible Assets | 12 Months Ended |
Dec. 31, 2020 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Intangible Assets | Intangible Assets Intangible assets consist of the following as of December 31: Useful Life 2020 2019 Customer relationships 9 years $ 8,301 $ 8,301 Orbera technology 12 years 4,600 4,600 Trade names 10 years 1,700 1,700 Patents and trademarks 5 years 2,597 2,453 Capitalized software 1 - 5 years 2,050 2,425 19,248 19,479 Less accumulated amortization (13,231) (11,648) Intangible assets, net $ 6,017 $ 7,831 The Company recorded amortization expense of $1,951 and $2,201 during 2020 and 2019, respectively. Additionally, $144 and $161 related to the extension and renewal of patents and trademarks was capitalized during 2020 and 2019, respectively. Amortization for the next five years is as follows: 2021 $ 1,851 2022 1,674 2023 908 2024 624 2025 564 Thereafter 396 Total $ 6,017 |
Other Assets
Other Assets | 12 Months Ended |
Dec. 31, 2020 | |
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract] | |
Other Assets | Other AssetsIncluded in other assets as of December 31, 2019 was $2,511 for the non-current portion of the receivable due from ReShape, which has been reclassified to other current assets as of December 31, 2020. Interest on the receivable accretes 10% annually. Imputed interest income on the ReShape receivable was $416 and $619 for the years ended December 31, 2020 and 2019, respectively, and is included within interest expense, net. |
Accrued Expenses
Accrued Expenses | 12 Months Ended |
Dec. 31, 2020 | |
Payables and Accruals [Abstract] | |
Accrued Expenses | Accrued Expenses Accrued expenses consists of the following as of December 31: 2020 2019 Accrued employee compensation and expenses $ 3,946 $ 3,183 Lease liability 675 932 Accrued interest 616 467 Accrued professional service fees 358 653 Accrued insurance and taxes 442 271 Accrued returns and rebates 129 216 Settlement liability — 1,625 Other 1,191 1,091 Total accrued expenses $ 7,357 $ 8,438 |
Long-Term Debt
Long-Term Debt | 12 Months Ended |
Dec. 31, 2020 | |
Debt Disclosure [Abstract] | |
Long-Term Debt | Long-Term Debt Long-term debt consists of the following as of December 31: 2020 2019 Term loan facility $ 35,000 $ 35,000 PPP loan 2,824 — Deferred interest 1,217 517 Deferred financing costs (1,213) (1,068) Less current portion (636) (34,449) Long-term debt $ 37,192 $ — Term Loan Facility In March 2019, the Company entered into a Term Loan Facility (the "Credit Agreement") with Solar to borrow $35,000. The Credit Agreement, as amended by the Seventh Amendment, matures on September 1, 2024, with principal payments beginning in March 2022, and bears interest at LIBOR, subject to a minimum floor, plus 7.5%. Principal payments are due on a straight-line basis after the interest-only period concludes. An additional 7.0% of the outstanding amount will be due at end of the loan term and an additional 5.5% fee 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 December 4, 2030. The Credit Agreement, collateralized by substantially all of the Company's assets, includes the 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 our 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, July 2020 and December 2020. These amendments, among other things, (i) waived the trailing six-month Endoscopy revenue requirements through the end of 2020, (ii) reduced the minimum liquidity requirement to $12,500, (iii) extended the interest only period until March 1, 2022 (or September 1, 2022 if certain revenue milestones are achieved in 2021) and extended the maturity date to September 1, 2024 (or March 1, 2025 if certain revenue milestones are achieved in 2021), (iv) 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, (v) increased the final fee due at the end of the loan term to 7.0% from 4.9%, (vi) increased the fee due at certain exit or trigger events from 4.5% to 5.5%, (vii) waived the financial statement covenant default associated with the going concern opinion of our independent registered public accounting firm for the year ended December 31, 2019, and (viii) established a minimum LIBOR interest rate. In connection with these amendments and concurrent with the equity raise in July 2020, 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 December 31, 2020, the Company was in compliance with all financial covenants. In February 2021, we entered into the Eighth Amendment to the Credit Agreement which established the revenue covenant requirements for 2021 (see Note 1 8 ). PPP Loan In March 2020, the CARES Act was signed into law providing certain economic aid packages for qualified entities. In April 2020, we were 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 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. In December 2020, the Company applied for forgiveness of the full amount of the $2,824 loan from the SBA. We will continue to include this PPP loan within our long-term debt until we receive confirmation of forgiveness from the SBA. Interest expense on the Company's long term debt was $4,212 and $4,579 for the years ended December 31, 2020 and 2019, respectively. Principal payments of the Company's long-term debt are as follows: 2021 $ 627 2022 13,550 2023 14,314 2024 9,333 2025 — Thereafter — Total $ 37,824 |
Convertible Debt
Convertible Debt | 12 Months Ended |
Dec. 31, 2020 | |
Debt Disclosure [Abstract] | |
Convertible Debt | Convertible debt Convertible debt consists of the following as of December 31: 2020 2019 Convertible debt principal $ 20,519 $ 20,000 Deferred financing costs (1,132) (1,446) Convertible debt $ 19,387 $ 18,554 In August 2019, the Company issued $20,000 aggregate principal amount of 6.0% convertible senior debentures (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 our 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, 2026, as amended in December 2020, unless earlier converted or repurchased in accordance with its terms. In January 2020, we 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 December 31, 2020, accrued interest on the Convertible Debt was $616. The Convertible Debt converts, at the option of the holders, into shares of our common stock at an initial conversion price of $3.25 per share, subject to adjustment. If the VWAP of our common stock has been at least $9.75 (subject to adjustment) for at least 20 trading days during any 30 consecutive trading day period, we 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. In December 2020, $81 of the Convertible Debt was converted into 25,528 shares of common stock. Interest expense on the Convertible Debt was $1,531 and $588 for the years ended December 31, 2020 and 2019, respectively. |
Stockholders' Equity
Stockholders' Equity | 12 Months Ended |
Dec. 31, 2020 | |
Equity [Abstract] | |
Stockholders' Equity | Stockholders' Equity (a) Authorized Stock The Company’s amended and restated certificate of incorporation, authorizes the Company to issue 115,000,000 shares of common and preferred stock, consisting of 100,000,000 shares of common stock with $0.001 par value and 15,000,000 shares of preferred stock with $0.001 par value. The Company has reserved common shares for issuance upon the exercise of the authorized and issued common stock options and warrants. (b) Warrants Warrants consist of the following as of December 31, 2020: Warrant Expiration Date Number of shares Exercise price per share December 29, 2021 40,456 $13.70 February 27, 2022 163,915 $21.29 No expiration 16,412,964 $0.001 Total number of warrants outstanding 16,617,335 Weighted average exercise price of warrants outstanding $0.24 In July 2020, the Company issued and sold (i) 2,480,000 shares of common stock, par value $0.001 per share at a purchase price of $1.25 per share, or the Shares, and (ii) pre-funded warrants to purchase up to 17,520,000 shares of common stock, or the Warrant Shares, at a purchase price of $1.249 per warrant, or the Warrants, for aggregate proceeds of approximately $25,000. In October 2020, 2,107,036 of these Warrants were exercised. No warrants expired during the year ended December 31, 2020. |
Stock Option Plans
Stock Option Plans | 12 Months Ended |
Dec. 31, 2020 | |
Share-based Payment Arrangement [Abstract] | |
Stock Option Plans | Stock Option Plans Plans 2017 Plan The Company's 2017 Equity Incentive Plan (the "2017 Plan") was approved in June 2017 by the Company's stockholders. The 2017 plan covers employees, consultants, and nonemployee directors of the Company and provides for the grant of incentive stock options, nonstatutory stock options, stock appreciation rights, restricted stock awards, restricted stock units, performance stock awards, performance cash awards, and other stock awards to purchase shares of the Company's common stock. Options to date have been granted to employees at 100% of the fair value at the date of the grant. The fair value, vesting period, and expiration dates of the options granted are determined by the Board of Directors at the time of grant. The maximum term of options granted under the 2017 Plan is 10 years from the date of grant. Options generally vest over a period of time, typically not more than 5 years. The plan's reserve is automatically increased by 4% of the total number of shares outstanding at the prior year end for a period of ten 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 stock appreciation rights or options exercised by means of a net exercise will be deducted from the shares available under the 2017 Plan. Certain of the outstanding options were granted under prior equity incentive plans which are no longer in effect. As of December 31, 2020, the Company has 438,581 shares of common stock reserved for issuance under the 2017 Plan. 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 December 31, 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 (5,982) $2.31 Options forfeited (216,208) $4.13 Options outstanding, vested and expected to vest, December 31, 2020 2,921,946 $3.86 7.6 years $1,664 Options exercisable 1,364,859 $5.17 6.0 years $143 The fair value for options under the Equity Plans was estimated at the date of grant using the Black-Scholes option pricing model. The Black-Scholes model requires estimating dividend yield, volatility, risk-free rate of return during the service period and the expected term of the award. The expected dividend yield assumption is based on the Company’s expectation of zero future dividend payouts. The volatility assumption is based on the historical volatilities of the Company’s common stock and of comparable public companies. The risk free rate of return assumption utilizes yields on U.S. treasury zero-coupon bonds with maturity that is commensurate with the expected term for awards issued to employees and the contractual term for awards issued to non-employees. The expected term is derived using the simplified method and represents the weighted average period that the stock awards are expected to remain outstanding. 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 for the years ended December 31: 2020 2019 Risk free interest rate 0.4% 2.2% Expected dividend yield —% —% Estimated volatility 73.8% 64.6% Expected life 5.8 years 6.0 years Additional information regarding options is as follows: 2020 2019 Stock-based compensation cost $2,114 $1,487 Weighted-average grant date fair value of options granted during the period $1.31 $2.08 Aggregate intrinsic value of options exercised during the period $8 $20 The aggregate intrinsic value in the table above represents the total pre-tax value of the options shown, calculated as the difference between the Company’s closing stock price on December 31, 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 December 31, 2020 and sold the shares thereby received at the closing price of the Company’s stock on that date. This amount changes based on the closing price of the Company’s stock. Annually the Company grants options to its sales and marketing personnel that begin to time vest only upon the individual's achievement of a certain revenue target. In 2020, no options were determined to have met the underlying conditions. The remaining performance shares were unearned and forfeited. Unrecognized compensation expense related to unvested options was approximately $2,121 at December 31, 2020, with a remaining amortization period of less than 2.0 years. A summary of the restricted stock unit activity under the Company's Equity Plans as of December 31, 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 (85,223) $4.08 Restricted stock units forfeited (11,784) $2.08 Unvested units, December 31, 2020 664,666 $2.55 $2,260 Unrecognized compensation expense related to unvested restricted stock units was approximately $1,251 at December 31, 2020, with a remaining amortization period of 2.2 years. |
Commitments and Contingencies
Commitments and Contingencies | 12 Months Ended |
Dec. 31, 2020 | |
Commitments and Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | Commitments and Contingencies (a) Risk Management The Company maintains various forms of insurance that the Company's management believes are adequate to reduce the exposure to these risks to an acceptable level. (b) Employment Agreements Certain executive officers are entitled to payments if they are terminated without cause or as a result of a change in control. Upon termination without cause, and not as a result of death or disability, each of such officers is entitled to receive a payment of base salary for three three (c) Litigation Management believes there are no claims or actions pending or threatened against the Company, the ultimate disposition of which would have a material impact on the Company's consolidated financial position, results of operations or cash flows. |
Defined Contribution Plan
Defined Contribution Plan | 12 Months Ended |
Dec. 31, 2020 | |
Retirement Benefits [Abstract] | |
Defined Contribution Plan | Defined Contribution PlanThe Company sponsors defined contribution plans for employees in the U.S. and Europe. The cost of these plans, including employer contributions, was $504 and $698 for the years ended December 31, 2020 and 2019 respectively. |
Income Taxes
Income Taxes | 12 Months Ended |
Dec. 31, 2020 | |
Income Tax Disclosure [Abstract] | |
Income Taxes | Income Taxes Income tax expense of $142 and $275 for the years ended December 31, 2020 and 2019, respectively is composed of foreign income taxes on earnings generated by foreign subsidiaries. Deferred income taxes reflect the net effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes. Significant components of the Company's deferred taxes at December 31 are as follows: 2020 2019 Deferred tax assets: Capitalized transaction costs $ 279 $ 330 Intangible assets 1,100 1,105 Inventory valuation 28 242 Research and development credit 4,123 4,055 Interest expense carryforward 3,121 2,188 Foreign timing differences 578 238 Other 1,095 873 Net operating loss carryforwards 53,666 50,702 63,990 59,733 Deferred tax liabilities: Unremitted foreign earnings (463) (453) Depreciable assets (93) (185) (556) (638) Total net deferred tax assets 63,434 59,095 Less valuation allowance (63,243) (59,049) Net deferred tax assets (included in other assets) $ 191 $ 46 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. The valuation allowance increased by $4,194 during the year ended December 31, 2020, primarily as a result of changes in net operating loss. 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 December 31, 2020, the Company has no unrecognized tax benefits or accrued interest or penalties associated with uncertain tax positions. The Company's provision for income taxes differs from the expected tax expense amount computed by applying the statutory federal income tax rate of 21% to income before income taxes as a result of the following: 2020 2019 Tax at U.S. statutory rate $ (4,719) $ (5,703) State taxes, net of deferred benefit (536) (1,051) Foreign tax rate differential (327) (330) Foreign taxes (13) 22 Permanent differences 702 442 Research and development tax credit (313) (408) Other 365 478 Deferred tax adjustment 756 (1) Unremitted foreign earnings 33 6 Valuation allowance - current year 4,194 6,820 Income tax expense $ 142 $ 275 Income tax expense consists of the following: 2020 2019 Current taxes: U.S. state $ 11 $ — International 279 321 Total current income tax expense 290 321 Deferred taxes: International (148) (46) Total deferred income tax expense (148) (46) Income tax expense $ 142 $ 275 As of December 31, 2020, the Company had U.S. federal net operating loss carryforwards of approximately $223,602, of which $79,764 has an unlimited life and the remaining amount will expire in varying amounts beginning in 2025 if not utilized. The Company's July 2017 stock offering qualified as an ownership change under section 382 which resulted in a reduction of $100,825 in the Company’s U.S. federal net operating losses that will not be utilizable in the future, thus federal net operating loss carryforwards available to the Company as of December 31, 2020 were $122,777. However, the Company's deferred tax asset value for this section 382 reduction is not reflected in the table above until written off in a future tax return. There have been no additional section 382 reductions through December 31, 2020. The deferred tax asset associated with net operating loss carryforwards has been offset by a valuation allowance due to the uncertainty that the Company will achieve taxable income necessary to utilize the net operating loss carryforward in the future. The Company had state net operating loss carryforwards of approximately $108,111 which will begin to expire in varying amounts beginning in 2021, if not utilized. The Company had foreign net operating losses of approximately $2,382 which do not expire. |
Net Loss Per Share
Net Loss Per Share | 12 Months Ended |
Dec. 31, 2020 | |
Earnings Per Share [Abstract] | |
Net Loss Per Share | Net Loss Per ShareThe basic and diluted net loss per common share presented in the consolidated statement 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 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): Year Ended December 31 2020 2019 Warrants for common stock 8,068,615 590,672 Convertible debt 6,310,621 2,440,904 Common stock options 2,520,029 1,699,410 Restricted stock units 487,636 169,808 17,386,901 4,900,794 |
Segment and Geographic Informat
Segment and Geographic Information | 12 Months Ended |
Dec. 31, 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: Year Ended December 31, 2020 Year Ended December 31, 2019 U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 15,774 $ 9,955 $ 25,729 61.2 % $ 14,944 $ 13,365 $ 28,309 55.8 % IGB 5,045 9,739 14,784 35.2 % 5,162 11,678 16,840 33.2 % Total Endoscopy 20,819 19,694 40,513 96.4 % 20,106 25,043 45,149 89.0 % Surgical — — — — % — 3,712 3,712 7.3 % Other 1,453 82 1,535 3.6 % 1,815 37 1,852 3.7 % Total revenues $ 22,272 $ 19,776 $ 42,048 100.0 % $ 21,921 $ 28,792 $ 50,713 100.0 % % Total revenues 53.0 % 47.0 % 43.2 % 56.8 % Total distributor sales were 35.2% and 33.9% of total OUS revenues for the years ended December 31, 2020 and 2019, respectively. Sales in the next largest individual country outside the U.S. were 7.6% for both the years ended December 31, 2020 and 2019. The following table represents property, equipment and right-of-use assets based on the physical location of the asset: 2020 2019 U.S. $ 2,149 $ 2,934 Costa Rica 3,641 3,039 Other 431 639 Total property, equipment and right-of-use assets $ 6,221 $ 6,612 |
Subsequent Events
Subsequent Events | 12 Months Ended |
Dec. 31, 2020 | |
Subsequent Events [Abstract] | |
Subsequent Events | Subsequent EventsIn February 2021, the Company entered into the Eighth Amendment to the Credit Agreement which established the revenue covenant requirements for 2021. |
Significant Accounting Polici_2
Significant Accounting Policies (Policies) | 12 Months Ended |
Dec. 31, 2020 | |
Accounting Policies [Abstract] | |
Principles of Consolidation | Principles of ConsolidationThe consolidated financial statements include the accounts of the Company and all of its wholly-owned subsidiaries. All significant intercompany accounts and transactions have been eliminated. |
Use of Estimates | Use of EstimatesThe preparation of consolidated financial statements in conformity with accounting principles generally accepted in the U.S. ("U.S. GAAP") requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated financial statements and the reported amounts of revenues and expenses during the reporting periods. Actual results are likely to differ from those estimates, and such differences may be material to the consolidated financial statements. Significant items subject to such estimates and assumptions include revenue recognition, going concern assessment, useful lives of intangibles and long-lived assets, long-lived asset and goodwill impairment, allowance for doubtful accounts, and valuation of inventory. |
Cash and Cash Equivalents | Cash and Cash EquivalentsThe Company considers all highly liquid investments with a remaining maturity at date of purchase of three months or less to be cash equivalents. |
Restricted Cash | Restricted CashThe Company entered into irrevocable letters of credit with three banks to secure obligations under lease agreements and performance based obligations. |
Accounts Receivable | Accounts ReceivableThe Company generally extends credit to certain customers without requiring collateral. The Company provides an allowance for doubtful accounts based on management's evaluation of the collectability of accounts receivable. Accounts receivable are written off when it is deemed uncollectible. |
Inventory | InventoryInventory is stated at the lower of cost or net realizable value. Charges for excess and obsolete inventory are based on specific identification of obsolete inventory items and an analysis of inventory items approaching expiration date. The Company records estimated excess and obsolescence charges to cost of sales. The Company's inventories are stated using the weighted average cost approach, which approximates actual costs. |
Fair Value Measurements | Fair Value Measurements The carrying amounts of the Company's financial instruments, which primarily include cash and 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 is estimated by management to approximate $41,100 and $38,000 at December 31, 2020 and 2019, respectively. The Company's convertible debt is estimated by management to approximate $20,500 and $20,000 at December 31, 2020 and 2019, respectively. 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. |
Property and Equipment | Property and EquipmentProperty and equipment are carried at cost less accumulated depreciation. Depreciation is computed using the straight-line method over the estimated useful lives of the related assets, except for leasehold improvements, which are depreciated straight-line over the shorter of the estimated useful life or the life of the lease. Major renewals and betterments are capitalized. Validation costs (including materials and labor) that are required to bring machinery to working condition are capitalized. Expenditures for repairs and maintenance and minor replacements are charged to expense as incurred. |
Leases | LeasesLease arrangements are generally recognized at lease commitment. Operating lease right-of-use assets and liabilities are recognized at commencement based on the present value of lease payments over the lease term, except for leases with an initial term of 12 months or less, for which lease expense is recognized as incurred over the lease term. Right-of-use assets represent the Company’s right to use an underlying asset during the reasonably certain lease term, and lease liabilities represent the Company’s obligation to make lease payments arising from the lease. Lease terms may include options to extend or terminate the lease when its reasonably certain that the Company will exercise that option. The Company primarily uses its incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. Operating lease right-of-use assets include any lease payments related to initial direct costs and prepayments and excludes lease incentives. Lease expense is recognized on a straight-line basis over the lease term. The Company has lease agreements with lease and non-lease components, which are generally accounted for separately. |
Goodwill and Other Intangible Assets | Goodwill and Other Intangible Assets Goodwill is not amortized but is tested annually for impairment or more frequently if impairment indicators exist. For annual and interim goodwill impairment tests, the Company first assesses qualitative factors before performing a quantitative assessment of the fair value of a reporting unit. If it is determined on the basis of qualitative factors that the fair value of the reporting unit is more likely than not less than the carrying amount, a quantitative impairment test is required. The Company's evaluation of goodwill completed on December 31, 2020 and 2019 resulted in no impairment losses. Definite-lived intangible assets consist of customer relationships, product technology, trade names, patents and trademarks and capitalized software which are amortized over their estimated useful lives. Costs to extend the lives of and renew patents and trademarks are capitalized when incurred. |
Valuation of Long-Lived Assets | Valuation of Long-Lived AssetsLong-lived assets, including definite-lived intangible assets, are monitored and reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of any such asset may not be recoverable. The determination of recoverability is based on an estimate of undiscounted cash flows expected to result from the use of an asset and its eventual disposition. The estimate of undiscounted cash flows is based upon, among other things, certain assumptions about expected future operating performance. The Company's estimates of undiscounted cash flows may differ from actual cash flows. If the sum of the undiscounted cash flows is less than the carrying value of the asset, an impairment charge is recognized, measured as the amount by which the carrying value exceeds the fair value of the asset. |
Revenue Recognition | Revenue Recognition The Company's principal source of revenues is from the sale of its products. Revenue is recognized when control of the promised goods is transferred to the customer, in an amount that reflects the consideration expected to be entitled to in an exchange for those goods. Generally, these are met under the Company's agreements with most customers upon product shipment. This includes sales to distributors, who sell the products to their customers, take title to the products and assume all risks of ownership at the time of shipment. The Company's distributors are obligated to pay within specified terms regardless of when, if ever, they sell the products. Customers and distributors generally have the right to return or exchange products purchased from the Company for up to thirty days from the date of product shipment. At the end of each period, the Company determines the extent to which its revenues need to be reduced to account for expected returns and exchanges. Certain customers may receive volume rebates or discounts, which are accounted for as variable consideration. The Company estimates these amounts based on the expected amount to be provided to customers and reduces recognized revenues. The Company records deferred revenues when cash payments are received in advance of the transfer of goods. The Company accounts for taxes collected from customers and remitted to governmental authorities on a net basis. Accordingly, such amounts are excluded from revenues. Amounts billed to customers related to shipping and handling are included in revenues. Shipping and handling costs related to revenue producing activities are included in cost of sales. In connection with the December 2018 sale of the Surgical product line, the Company entered into a transition services agreement, supply agreement and distribution agreement. Transition service fees were recognized as revenue when the support was provided in accordance with the prices established in the transition services agreement. Product sold under the supply agreement is recognized as revenue when product is shipped at the prices established in the supply agreement net of the cost to produce the product. Transition service and supply agreement revenue are included in other revenue. All transition, distribution, and manufacturing services were completed as of December 31, 2020. |
Research and Development | Research and DevelopmentResearch and development costs are expensed as incurred. |
Stock-based Compensation Plans | Stock-based Compensation PlansThe Company recognizes compensation costs for all stock-based awards based upon each award's estimated fair value as determined on the date of grant. The Company utilizes the Black-Scholes option-pricing model to determine the fair value of stock option awards. Compensation cost is recognized on a straight-line basis over the respective vesting period of the award. Adjustments for actual forfeitures are made in the period which they occur. |
Advertising | AdvertisingThe Company expenses advertising costs as incurred. |
Income Taxes | Income Taxes The Company accounts for deferred income taxes using the asset and liability method. Under this method, deferred income taxes arise from temporary differences between the tax basis of assets and liabilities and their reported amounts in the financial statements, which will result in taxable or deductible amounts in the future. Temporary differences are then measured using the enacted tax rates and laws. Valuation allowances are established, when necessary, to reduce deferred tax assets to the amount that is more-likely than-not to be realized. Determining the appropriate amount of valuation allowance requires management to exercise judgment about future operations. In the ordinary course of business, there are many transactions for which the ultimate tax outcome is uncertain. The Company regularly assesses uncertain tax positions in each of the tax jurisdictions in which it has operations and accounts for the related consolidated financial statement implications. The amount of unrecognized tax benefits is adjusted when information becomes available or when an event occurs indicating a change is appropriate. The Company includes interest and penalties related to its uncertain tax positions as part of income tax expense. |
Foreign Currency | Foreign CurrencyThe Company translates foreign assets and liabilities at exchange rates in effect at the balance sheet dates, and the revenues and expenses using average rates during the year. The resulting foreign currency translation adjustments are recorded as a separate component of accumulated other comprehensive income in the accompanying consolidated balance sheets. Exchange rate fluctuations on short-term intercompany loans are included in other expense in the consolidated statement of operations and comprehensive loss. |
Recent Accounting Pronouncements | Recent Accounting Pronouncements 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 consolidated statement 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) | 12 Months Ended |
Dec. 31, 2020 | |
Inventory Disclosure [Abstract] | |
Schedule of Inventory | Inventory consists of the following as of December 31: 2020 2019 Raw materials $ 2,344 $ 2,834 Work in progress 558 532 Finished goods 7,404 5,499 Total inventory $ 10,306 $ 8,865 |
Property, Equipment and Right_2
Property, Equipment and Right-of-Use Assets (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Property, Plant and Equipment [Abstract] | |
Schedule of Property and Equipment | Property and equipment consists of the following as of December 31: Depreciable Lives 2020 2019 Equipment 5 years $ 7,452 $ 7,491 Right-of-use assets 1 - 5 years 4,031 2,890 Furniture, fixtures and tooling 4 - 8 years 2,156 2,233 Computer hardware 3 - 5 years 1,244 1,261 Leasehold improvements 3 - 7 years 1,744 1,671 Construction in process 466 198 17,093 15,744 Less accumulated depreciation (10,872) (9,132) Property, equipment and right-of-use assets $ 6,221 $ 6,612 |
Schedule of Lease Maturity | As of December 31, 2020, the maturities of the Company's operating lease liabilities are as follows: 2021 $ 983 2022 566 2023 488 2024 424 2025 404 Thereafter 1,172 Total lease payments 4,037 Less imputed interest (1,032) Total operating lease liabilities $ 3,005 |
Intangible Assets (Tables)
Intangible Assets (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Goodwill and Intangible Assets Disclosure [Abstract] | |
Schedule of Intangible Assets | Intangible assets consist of the following as of December 31: Useful Life 2020 2019 Customer relationships 9 years $ 8,301 $ 8,301 Orbera technology 12 years 4,600 4,600 Trade names 10 years 1,700 1,700 Patents and trademarks 5 years 2,597 2,453 Capitalized software 1 - 5 years 2,050 2,425 19,248 19,479 Less accumulated amortization (13,231) (11,648) Intangible assets, net $ 6,017 $ 7,831 |
Schedule of Amortization Expense | Amortization for the next five years is as follows: 2021 $ 1,851 2022 1,674 2023 908 2024 624 2025 564 Thereafter 396 Total $ 6,017 |
Accrued Expenses (Tables)
Accrued Expenses (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Payables and Accruals [Abstract] | |
Schedule of Accrued Expenses | Accrued expenses consists of the following as of December 31: 2020 2019 Accrued employee compensation and expenses $ 3,946 $ 3,183 Lease liability 675 932 Accrued interest 616 467 Accrued professional service fees 358 653 Accrued insurance and taxes 442 271 Accrued returns and rebates 129 216 Settlement liability — 1,625 Other 1,191 1,091 Total accrued expenses $ 7,357 $ 8,438 |
Long-Term Debt (Tables)
Long-Term Debt (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Debt Disclosure [Abstract] | |
Schedule of Long-term Debt | Long-term debt consists of the following as of December 31: 2020 2019 Term loan facility $ 35,000 $ 35,000 PPP loan 2,824 — Deferred interest 1,217 517 Deferred financing costs (1,213) (1,068) Less current portion (636) (34,449) Long-term debt $ 37,192 $ — |
Schedule of Maturities of Long-term Debt | Principal payments of the Company's long-term debt are as follows: 2021 $ 627 2022 13,550 2023 14,314 2024 9,333 2025 — Thereafter — Total $ 37,824 |
Convertible Debt (Tables)
Convertible Debt (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Debt Disclosure [Abstract] | |
Convertible Debt | Convertible debt consists of the following as of December 31: 2020 2019 Convertible debt principal $ 20,519 $ 20,000 Deferred financing costs (1,132) (1,446) Convertible debt $ 19,387 $ 18,554 |
Stockholders' Equity (Tables)
Stockholders' Equity (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Equity [Abstract] | |
Schedule of Warrants | Warrants consist of the following as of December 31, 2020: Warrant Expiration Date Number of shares Exercise price per share December 29, 2021 40,456 $13.70 February 27, 2022 163,915 $21.29 No expiration 16,412,964 $0.001 Total number of warrants outstanding 16,617,335 Weighted average exercise price of warrants outstanding $0.24 |
Stock Option Plans (Tables)
Stock Option Plans (Tables) | 12 Months Ended |
Dec. 31, 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 December 31, 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 (5,982) $2.31 Options forfeited (216,208) $4.13 Options outstanding, vested and expected to vest, December 31, 2020 2,921,946 $3.86 7.6 years $1,664 Options exercisable 1,364,859 $5.17 6.0 years $143 |
Schedule of Fair Value of Stock Options | 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 for the years ended December 31: 2020 2019 Risk free interest rate 0.4% 2.2% Expected dividend yield —% —% Estimated volatility 73.8% 64.6% Expected life 5.8 years 6.0 years |
Schedule of Other Stock Option Information | Additional information regarding options is as follows: 2020 2019 Stock-based compensation cost $2,114 $1,487 Weighted-average grant date fair value of options granted during the period $1.31 $2.08 Aggregate intrinsic value of options exercised during the period $8 $20 |
Schedule of Restricted Stock Unit Activity | A summary of the restricted stock unit activity under the Company's Equity Plans as of December 31, 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 (85,223) $4.08 Restricted stock units forfeited (11,784) $2.08 Unvested units, December 31, 2020 664,666 $2.55 $2,260 |
Income Taxes (Tables)
Income Taxes (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Income Tax Disclosure [Abstract] | |
Schedule of Deferred Tax Assets and Liabilities | Significant components of the Company's deferred taxes at December 31 are as follows: 2020 2019 Deferred tax assets: Capitalized transaction costs $ 279 $ 330 Intangible assets 1,100 1,105 Inventory valuation 28 242 Research and development credit 4,123 4,055 Interest expense carryforward 3,121 2,188 Foreign timing differences 578 238 Other 1,095 873 Net operating loss carryforwards 53,666 50,702 63,990 59,733 Deferred tax liabilities: Unremitted foreign earnings (463) (453) Depreciable assets (93) (185) (556) (638) Total net deferred tax assets 63,434 59,095 Less valuation allowance (63,243) (59,049) Net deferred tax assets (included in other assets) $ 191 $ 46 |
Schedule of Effective Income Tax Rate | The Company's provision for income taxes differs from the expected tax expense amount computed by applying the statutory federal income tax rate of 21% to income before income taxes as a result of the following: 2020 2019 Tax at U.S. statutory rate $ (4,719) $ (5,703) State taxes, net of deferred benefit (536) (1,051) Foreign tax rate differential (327) (330) Foreign taxes (13) 22 Permanent differences 702 442 Research and development tax credit (313) (408) Other 365 478 Deferred tax adjustment 756 (1) Unremitted foreign earnings 33 6 Valuation allowance - current year 4,194 6,820 Income tax expense $ 142 $ 275 |
Schedule of Components of Income Tax Expense (Benefit) | Income tax expense consists of the following: 2020 2019 Current taxes: U.S. state $ 11 $ — International 279 321 Total current income tax expense 290 321 Deferred taxes: International (148) (46) Total deferred income tax expense (148) (46) Income tax expense $ 142 $ 275 |
Net Loss Per Share (Tables)
Net Loss Per Share (Tables) | 12 Months Ended |
Dec. 31, 2020 | |
Earnings Per Share [Abstract] | |
Schedule of Antidilutive Securities Excluded from Computation of Diluted Loss Per Share | Potentially dilutive securities 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): Year Ended December 31 2020 2019 Warrants for common stock 8,068,615 590,672 Convertible debt 6,310,621 2,440,904 Common stock options 2,520,029 1,699,410 Restricted stock units 487,636 169,808 17,386,901 4,900,794 |
Segment and Geographic Inform_2
Segment and Geographic Information (Tables) | 12 Months Ended |
Dec. 31, 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: Year Ended December 31, 2020 Year Ended December 31, 2019 U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 15,774 $ 9,955 $ 25,729 61.2 % $ 14,944 $ 13,365 $ 28,309 55.8 % IGB 5,045 9,739 14,784 35.2 % 5,162 11,678 16,840 33.2 % Total Endoscopy 20,819 19,694 40,513 96.4 % 20,106 25,043 45,149 89.0 % Surgical — — — — % — 3,712 3,712 7.3 % Other 1,453 82 1,535 3.6 % 1,815 37 1,852 3.7 % Total revenues $ 22,272 $ 19,776 $ 42,048 100.0 % $ 21,921 $ 28,792 $ 50,713 100.0 % % Total revenues 53.0 % 47.0 % 43.2 % 56.8 % |
Schedule of Long-Lived Assets by Geographic Area | The following table represents property, equipment and right-of-use assets based on the physical location of the asset: 2020 2019 U.S. $ 2,149 $ 2,934 Costa Rica 3,641 3,039 Other 431 639 Total property, equipment and right-of-use assets $ 6,221 $ 6,612 |
Organization and Business Des_2
Organization and Business Description (Details) - USD ($) $ in Thousands | 12 Months Ended | |||
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019 | Dec. 31, 2018 | |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||
Divestiture of Surgical product line | $ 2,000 | $ 2,000 | ||
Surgical Product Line | Disposal | ||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||
Notes receivable | $ 17 | |||
Surgical Product Line | Disposal | Forecast | ||||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||||
Divestiture of Surgical product line | $ 3 |
Significant Accounting Polici_3
Significant Accounting Policies (Narrative) (Details) - USD ($) | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Restricted Cash | ||
Restricted cash | $ 965,000 | $ 1,016,000 |
Accounts Receivable | ||
Accounts receivable write-offs | 115,000 | 127,000 |
Fair Value Measurements | ||
Long-term debt, fair value | 41,100,000 | 38,000,000 |
Goodwill and Other Intangible Assets | ||
Goodwill impairment loss | 0 | 0 |
Valuation of Long-Lived Assets | ||
Impairment of long-lived assets | 0 | 0 |
Advertising Expense | ||
Advertising costs | 227,000 | 1,648,000 |
Convertible debt | ||
Fair Value Measurements | ||
Convertible debt, fair value | $ 20,500,000 | $ 20,000,000 |
Concentrations (Details)
Concentrations (Details) $ in Thousands | 12 Months Ended |
Dec. 31, 2020USD ($)bank | |
Risks and Uncertainties [Abstract] | |
Number of banks | bank | 5 |
Cash and cash equivalents and restricted cash | $ | $ 37,200 |
Accounts Receivable | One Customer | Customer Concentration Risk | |
Concentration Risk [Line Items] | |
Concentration risk, percentage | 15.00% |
Inventory (Details)
Inventory (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Inventory Disclosure [Abstract] | ||
Raw materials | $ 2,344 | $ 2,834 |
Work in progress | 558 | 532 |
Finished goods | 7,404 | 5,499 |
Total inventory, net | 10,306 | 8,865 |
Inventory impairment | 50 | $ 162 |
Consigned inventory | $ 140 |
Property, Equipment and Right_3
Property, Equipment and Right-of-Use Assets (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Property, Plant and Equipment [Line Items] | ||
Right-of-use assets | $ 4,031 | $ 2,890 |
Property and equipment, gross | 17,093 | 15,744 |
Less accumulated depreciation | (10,872) | (9,132) |
Property, equipment and right-of-use assets | $ 6,221 | 6,612 |
Minimum | ||
Property, Plant and Equipment [Line Items] | ||
Depreciable Lives | 1 year | |
Maximum | ||
Property, Plant and Equipment [Line Items] | ||
Depreciable Lives | 5 years | |
Equipment | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | $ 7,452 | 7,491 |
Depreciable lives | 5 years | |
Furniture, fixtures and tooling | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | $ 2,156 | 2,233 |
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 | $ 1,244 | 1,261 |
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 | $ 1,744 | 1,671 |
Leasehold improvements | Minimum | ||
Property, Plant and Equipment [Line Items] | ||
Depreciable lives | 3 years | |
Leasehold improvements | Maximum | ||
Property, Plant and Equipment [Line Items] | ||
Depreciable lives | 7 years | |
Construction in process | ||
Property, Plant and Equipment [Line Items] | ||
Property and equipment, gross | $ 466 | $ 198 |
Property, Equipment and Right_4
Property, Equipment and Right-of-Use Assets (Lease Narrative) (Details) - USD ($) | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Property, Plant and Equipment [Abstract] | ||
Depreciation expense | $ 1,779,000 | $ 1,859,000 |
Impairment charge | 0 | 0 |
Disposal of property and equipment | 405,000 | |
Lease liability | $ 675,000 | $ 932,000 |
Lease liability extensible list | us-gaap:AccountsPayableAndAccruedLiabilitiesCurrent | us-gaap:AccountsPayableAndAccruedLiabilitiesCurrent |
Operating lease, liability, noncurrent | $ 2,330,000 | |
Operating lease, liability, noncurrent extensible list | us-gaap:OtherLiabilitiesNoncurrent | |
Operating lease, payments | $ 1,156,000 | $ 1,233,000 |
Operating lease, weighted average remaining lease term | 5 years | |
Operating lease, weighted average discount rate | 8.90% |
Property, Equipment and Right_5
Property, Equipment and Right-of-Use Assets (Lease Maturity) (Details) $ in Thousands | Dec. 31, 2020USD ($) |
Property, Plant and Equipment [Abstract] | |
2021 | $ 983 |
2022 | 566 |
2023 | 488 |
2024 | 424 |
2025 | 404 |
Thereafter | 1,172 |
Total lease payments | 4,037 |
Less imputed interest | (1,032) |
Total operating lease liabilities | $ 3,005 |
Intangible Assets (Other Intang
Intangible Assets (Other Intangible Assets) (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Finite-Lived Intangible Assets [Line Items] | ||
Intangible assets, gross | $ 19,248 | $ 19,479 |
Less accumulated amortization | (13,231) | (11,648) |
Total | 6,017 | 7,831 |
Amortization of intangible assets | $ 1,951 | 2,201 |
Customer relationships | ||
Finite-Lived Intangible Assets [Line Items] | ||
Useful life | 9 years | |
Intangible assets, gross | $ 8,301 | 8,301 |
Orbera technology | ||
Finite-Lived Intangible Assets [Line Items] | ||
Useful life | 12 years | |
Intangible assets, gross | $ 4,600 | 4,600 |
Trade names | ||
Finite-Lived Intangible Assets [Line Items] | ||
Useful life | 10 years | |
Intangible assets, gross | $ 1,700 | 1,700 |
Patents and trademarks | ||
Finite-Lived Intangible Assets [Line Items] | ||
Useful life | 5 years | |
Intangible assets, gross | $ 2,597 | 2,453 |
Cost incurred to extend and renew patents and trademarks | 144 | 161 |
Capitalized software | ||
Finite-Lived Intangible Assets [Line Items] | ||
Intangible assets, gross | $ 2,050 | $ 2,425 |
Capitalized software | Minimum | ||
Finite-Lived Intangible Assets [Line Items] | ||
Useful life | 1 year | |
Capitalized software | Maximum | ||
Finite-Lived Intangible Assets [Line Items] | ||
Useful life | 5 years |
Intangible Assets (Amortization
Intangible Assets (Amortization Expense) (Details) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 |
Goodwill and Intangible Assets Disclosure [Abstract] | ||
2021 | $ 1,851 | |
2022 | 1,674 | |
2023 | 908 | |
2024 | 624 | |
2025 | 564 | |
Thereafter | 396 | |
Total | $ 6,017 | $ 7,831 |
Other Assets (Details)
Other Assets (Details) - Surgical Product Line - Disposal - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||
Noncurrent receivable | $ 2,511 | |
Interest income | $ 416 | $ 619 |
Discount Rate | ||
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items] | ||
Discount rate | 10.00% |
Accrued Expenses (Details)
Accrued Expenses (Details) - USD ($) $ in Thousands | 1 Months Ended | 12 Months Ended | |
Apr. 30, 2019 | Dec. 31, 2020 | Dec. 31, 2019 | |
Payables and Accruals [Abstract] | |||
Accrued employee compensation and expenses | $ 3,946 | $ 3,183 | |
Lease liability | 675 | 932 | |
Accrued interest | 616 | 467 | |
Accrued professional service fees | 358 | 653 | |
Accrued insurance and taxes | 442 | 271 | |
Accrued returns and rebates | 129 | 216 | |
Settlement liability | 0 | 1,625 | |
Other | 1,191 | 1,091 | |
Total accrued expenses | 7,357 | 8,438 | |
Litigation payment | $ 3,250 | 1,625 | |
Settlement gain | $ 0 | $ 5,609 |
Long-Term Debt (Schedule of Lon
Long-Term Debt (Schedule of Long-term Debt) (Details) - USD ($) $ in Thousands | Dec. 31, 2020 | Mar. 31, 2020 | Dec. 31, 2019 |
Debt Instrument [Line Items] | |||
Deferred financing costs | $ (1,213) | $ (1,068) | |
Less current portion | (636) | (34,449) | |
Long-term debt | 37,192 | 0 | |
Deferred interest | |||
Debt Instrument [Line Items] | |||
Long-term debt, gross | 1,217 | 517 | |
PPP loan | |||
Debt Instrument [Line Items] | |||
Long-term debt, gross | 2,824 | $ 2,824 | 0 |
Line of Credit | Term loan facility | |||
Debt Instrument [Line Items] | |||
Long-term debt, gross | $ 35,000 | $ 35,000 |
Long-Term Debt (Narrative) (Det
Long-Term Debt (Narrative) (Details) - USD ($) | Apr. 30, 2020 | Mar. 31, 2020 | Dec. 31, 2020 | Jul. 31, 2020 | Mar. 31, 2019 | Dec. 31, 2020 | Dec. 31, 2019 |
Debt Instrument [Line Items] | |||||||
Line of credit | $ 37,824,000 | $ 37,824,000 | |||||
Interest expense | 4,212,000 | $ 4,579,000 | |||||
PPP loan | |||||||
Debt Instrument [Line Items] | |||||||
Long-term debt, gross | $ 2,824,000 | 2,824,000 | 2,824,000 | 0 | |||
Effective percentage | 1.00% | ||||||
Line of Credit | Term loan facility | |||||||
Debt Instrument [Line Items] | |||||||
Line of credit | $ 35,000,000 | ||||||
Percent of outstanding amount | 7.00% | ||||||
Commitment fee percentage | 5.50% | ||||||
Twelve month revenue | $ 100,000,000 | ||||||
Increase in minimum liquidity covenant | 12,500,000 | 12,500,000 | |||||
Long-term debt, gross | $ 35,000,000 | $ 35,000,000 | $ 35,000,000 | ||||
Line of Credit | Term loan facility | LIBOR | |||||||
Debt Instrument [Line Items] | |||||||
Basis spread on variable rate | 7.50% | ||||||
Line of Credit | Senior Secured Credit Facility | |||||||
Debt Instrument [Line Items] | |||||||
Repayments of debt | $ 22,372,000 | ||||||
Unamortized deferred financing costs | $ 388,000 | ||||||
Line of Credit | Fifth Amendment | |||||||
Debt Instrument [Line Items] | |||||||
Percent of outstanding amount | 7.00% | 4.90% | 5.50% | 4.50% |
Long-Term Debt (Schedule of Mat
Long-Term Debt (Schedule of Maturity of Long-term Debt) (Details) $ in Thousands | Dec. 31, 2020USD ($) |
Debt Disclosure [Abstract] | |
2021 | $ 627 |
2022 | 13,550 |
2023 | 14,314 |
2024 | 9,333 |
2025 | 0 |
Thereafter | 0 |
Total | $ 37,824 |
Convertible Debt (Schedule of C
Convertible Debt (Schedule of Convertible Debt) (Details) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 |
Debt Instrument [Line Items] | ||
Deferred financing costs | $ (1,213) | $ (1,068) |
Long-term debt | 37,192 | 0 |
Convertible debt | ||
Debt Instrument [Line Items] | ||
Convertible debt principal | 20,519 | 20,000 |
Deferred financing costs | (1,132) | (1,446) |
Long-term debt | $ 19,387 | $ 18,554 |
Convertible Debt (Narrative) (D
Convertible Debt (Narrative) (Details) $ / shares in Units, $ in Thousands | 1 Months Ended | 12 Months Ended | ||||
Dec. 31, 2020USD ($)shares | Jan. 31, 2020shares | Aug. 31, 2019USD ($)d$ / shares | Dec. 31, 2020USD ($)shares | Dec. 31, 2019USD ($) | Jul. 31, 2020USD ($) | |
Debt Instrument [Line Items] | ||||||
Proceeds from convertible debt | $ 0 | $ 20,000 | ||||
Accrued interest | $ 616 | 616 | 467 | |||
Conversion of convertible debt | $ 81 | 83 | ||||
Interest expense | $ 4,212 | 4,579 | ||||
Common Stock | ||||||
Debt Instrument [Line Items] | ||||||
Convertible securities (shares) | shares | 25,528 | 25,528 | ||||
Convertible debt | ||||||
Debt Instrument [Line Items] | ||||||
Proceeds from convertible debt | $ 20,000 | |||||
Interest rate | 6.00% | |||||
Share Price | $ / shares | $ 2.50 | |||||
Convertible securities (shares) | shares | 164,797 | |||||
Accrued interest | $ 616 | $ 616 | 467 | |||
Outstanding interest | $ 600 | |||||
Interest expense | $ 1,531 | $ 588 | ||||
Convertible debt | Conversion Ratio Less Than 2.50 | ||||||
Debt Instrument [Line Items] | ||||||
Consecutive trading days | d | 10 | |||||
Convertible debt | Conversion Ratio Of 3.25 | ||||||
Debt Instrument [Line Items] | ||||||
Consecutive trading days | d | 30 | |||||
Conversion price (USD per share) | $ / shares | $ 3.25 | |||||
Stock price trigger (USD per share) | $ / shares | $ 9.75 | |||||
Threshold trading days | d | 20 |
Stockholders' Equity (Authorize
Stockholders' Equity (Authorized Stock) (Details) - $ / shares | Dec. 31, 2020 | Dec. 31, 2019 |
Equity [Abstract] | ||
Preferred and common stock, shares authorized | 115,000,000 | |
Common stock, shares authorized (in shares) | 100,000,000 | 100,000,000 |
Common stock, par value (USD per share) | $ 0.001 | $ 0.001 |
Preferred stock, shares authorized | 15,000,000 | |
Preferred stock, par value (USD per share) | $ 0.001 |
Stockholders' Equity (Warrants)
Stockholders' Equity (Warrants) (Details) - USD ($) $ / shares in Units, $ in Thousands | 1 Months Ended | |||
Jul. 31, 2020 | Dec. 31, 2020 | Oct. 31, 2020 | Dec. 31, 2019 | |
Class of Warrant or Right [Line Items] | ||||
Total number of warrants outstanding (shares) | 16,617,335 | |||
Exercise price (USD per share) | $ 0.24 | |||
Number of shares issued in transaction (in shares) | 2,480,000 | |||
Common stock, par value (USD per share) | $ 0.001 | $ 0.001 | ||
Sale of stock, price per share (USD per share) | $ 1.25 | |||
Warrants to purchase (shares) | 0 | |||
December 29, 2021 | ||||
Class of Warrant or Right [Line Items] | ||||
Total number of warrants outstanding (shares) | 40,456 | |||
Exercise price (USD per share) | $ 13.70 | |||
February 27, 2022 | ||||
Class of Warrant or Right [Line Items] | ||||
Total number of warrants outstanding (shares) | 163,915 | |||
Exercise price (USD per share) | $ 21.29 | |||
No expiration | ||||
Class of Warrant or Right [Line Items] | ||||
Total number of warrants outstanding (shares) | 16,412,964 | |||
Exercise price (USD per share) | $ 0.001 | |||
Warrant | ||||
Class of Warrant or Right [Line Items] | ||||
Warrants to purchase (shares) | 17,520,000 | 2,107,036 | ||
Purchase price per warrant (USD per share) | $ 1.249 | |||
Proceeds from issuance of warrants | $ 25,000 |
Stock Option Plans (Plans) (Det
Stock Option Plans (Plans) (Details) - 2017 Plan | 12 Months Ended |
Dec. 31, 2020shares | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | |
Percentage of fair value | 100.00% |
Maximum term of options granted | 10 years |
Vesting period | 5 years |
Percentage of outstanding stock | 4.00% |
Common stock reserved for issuance (in shares) | 438,581 |
Stock Option Plans (Stock Optio
Stock Option Plans (Stock Option Activity) (Details) - Equity Plans - Stock Option - USD ($) $ / shares in Units, $ in Thousands | 12 Months Ended | |
Dec. 31, 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) | (5,982) | |
Options forfeited (in shares) | (216,208) | |
Options outstanding, ending balance (in shares) | 2,921,946 | 1,927,194 |
Options exercisable (in shares) | 1,364,859 | |
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) | 2.31 | |
Options forfeited (in USD per share) | 4.13 | |
Weighted average exercise price, ending balance (in USD per share) | 3.86 | $ 5.01 |
Options exercisable (in USD per share) | $ 5.17 | |
Weighted Average Remaining Contractual Term | ||
Weighted average remaining contractual term | 7 years 7 months 6 days | 7 years 6 months |
Options exercisable | 6 years | |
Aggregate Intrinsic Value | ||
Aggregate intrinsic value | $ 1,664 | $ 87 |
Options exercisable | $ 143 |
Stock Option Plans (Fair Value
Stock Option Plans (Fair Value of Stock Options) (Details) - Stock Option | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 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 | 6 years |
Stock Option Plans (Additional
Stock Option Plans (Additional Information) (Details) - USD ($) $ / shares in Units, $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Stock-based compensation | $ 2,114 | $ 1,487 |
Stock Option | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Stock-based compensation | $ 2,114 | $ 1,487 |
Weighted-average grant date fair value of options granted during the period (USD per share) | $ 1.31 | $ 2.08 |
Aggregate intrinsic value of options exercised during the period | $ 8 | $ 20 |
Unrecognized compensation expense related to unvested options | $ 2,121 | |
Remaining amortization period, less then | 2 years | |
Performance Shares | ||
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] | ||
Options granted (in shares) | 0 |
Stock Option Plans (Restricted
Stock Option Plans (Restricted Stock Units Activity) (Details) - Restricted stock units - USD ($) $ / shares in Units, $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Units | ||
Shares outstanding beginning balance (in shares) | 243,695 | |
Restricted stock units granted (in shares) | 517,978 | |
Restricted stock units vested (in shares) | (85,223) | |
Restricted stock units forfeited (in shares) | (11,784) | |
Shares outstanding ending balance (in shares) | 664,666 | |
Weighted-Average Grant Date Fair Value | ||
Units outstanding beginning balance (in USD per share) | $ 4.06 | |
Restricted stock units granted (in USD per share) | 2.08 | |
Restricted stock units vested (in USD per share) | 4.08 | |
Restricted stock units forfeited (in USD per share) | 2.08 | |
Units outstanding ending balance (in USD per share) | $ 2.55 | |
Intrinsic value | $ 2,260 | $ 695 |
Compensation not yet recognized | $ 1,251 | |
Remaining amortization period, less then | 2 years 2 months 12 days |
Commitments and Contingencies (
Commitments and Contingencies (Employment Agreements) (Details) | 12 Months Ended |
Dec. 31, 2020 | |
Minimum | |
Other Commitments [Line Items] | |
Period for salary and benefits payment | 3 months |
Maximum | |
Other Commitments [Line Items] | |
Period for salary and benefits payment | 12 months |
Executive Officer | |
Other Commitments [Line Items] | |
Period following change in control | 12 months |
Executive Officer | Minimum | |
Other Commitments [Line Items] | |
Period for salary and benefits payment | 3 months |
Executive Officer | Maximum | |
Other Commitments [Line Items] | |
Period for salary and benefits payment | 24 months |
Defined Contribution Plan (Deta
Defined Contribution Plan (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Retirement Benefits [Abstract] | ||
Cost of defined contribution plan | $ 504 | $ 698 |
Income Taxes (Narrative) (Detai
Income Taxes (Narrative) (Details) - USD ($) | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Operating Loss Carryforwards [Line Items] | ||
Income tax expense | $ 142,000 | $ 275,000 |
Valuation allowance - current year | 4,194,000 | $ 6,820,000 |
Unrecognized tax benefits | 0 | |
Domestic Tax Authority | ||
Operating Loss Carryforwards [Line Items] | ||
Operating loss carryforwards | 223,602,000 | |
Operating loss carryforwards, unlimited life | 79,764,000 | |
Operating loss carryforwards, reduction due to ownership change | 100,825,000 | |
Operating loss carryforwards, net | 122,777,000 | |
State and Local Jurisdiction | ||
Operating Loss Carryforwards [Line Items] | ||
Operating loss carryforwards | 108,111,000 | |
Foreign Tax Authority | ||
Operating Loss Carryforwards [Line Items] | ||
Operating loss carryforwards | $ 2,382,000 |
Income Taxes (Deferred Tax Asse
Income Taxes (Deferred Tax Assets Liabilities) (Details) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 |
Deferred tax assets: | ||
Capitalized transaction costs | $ 279 | $ 330 |
Intangible assets | 1,100 | 1,105 |
Inventory valuation | 28 | 242 |
Research and development credit | 4,123 | 4,055 |
Interest expense carryforward | 3,121 | 2,188 |
Foreign timing differences | 578 | 238 |
Other | 1,095 | 873 |
Net operating loss carryforwards | 53,666 | 50,702 |
Deferred tax assets, gross | 63,990 | 59,733 |
Deferred tax liabilities: | ||
Unremitted foreign earnings | (463) | (453) |
Depreciable assets | (93) | (185) |
Total deferred tax liabilities | (556) | (638) |
Total net deferred tax assets | 63,434 | 59,095 |
Less valuation allowance | (63,243) | (59,049) |
Net deferred tax assets (included in other assets) | $ 191 | $ 46 |
Income Taxes (Effective Income
Income Taxes (Effective Income Tax Rate) (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Income Tax Disclosure [Abstract] | ||
Tax at U.S. statutory rate | $ (4,719) | $ (5,703) |
State taxes, net of deferred benefit | (536) | (1,051) |
Foreign tax rate differential | (327) | (330) |
Foreign taxes | (13) | 22 |
Permanent differences | 702 | 442 |
Research and development tax credit | (313) | (408) |
Other | 365 | 478 |
Deferred tax adjustment | 756 | (1) |
Unremitted foreign earnings | 33 | 6 |
Valuation allowance - current year | 4,194 | 6,820 |
Income tax expense | $ 142 | $ 275 |
Income Taxes (Income Tax Expens
Income Taxes (Income Tax Expense) (Details) - USD ($) $ in Thousands | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Current taxes: | ||
U.S. state | $ 11 | $ 0 |
International | 279 | 321 |
Total current income tax expense | 290 | 321 |
Deferred taxes: | ||
International | (148) | (46) |
Total deferred income tax expense | (148) | (46) |
Income tax expense | $ 142 | $ 275 |
Net Loss Per Share (Details)
Net Loss Per Share (Details) - shares | 12 Months Ended | |
Dec. 31, 2020 | Dec. 31, 2019 | |
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||
Antidilutive securities excluded from computation of diluted loss per share | 17,386,901 | 4,900,794 |
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 | 8,068,615 | 590,672 |
Convertible debt | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||
Antidilutive securities excluded from computation of diluted loss per share | 6,310,621 | 2,440,904 |
Common stock options | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||
Antidilutive securities excluded from computation of diluted loss per share | 2,520,029 | 1,699,410 |
Restricted stock units | ||
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items] | ||
Antidilutive securities excluded from computation of diluted loss per share | 487,636 | 169,808 |
Segment and Geographic Inform_3
Segment and Geographic Information (Segment Information) (Details) $ in Thousands | 12 Months Ended | |
Dec. 31, 2020USD ($)segment | Dec. 31, 2019USD ($) | |
Revenue, Major Customer [Line Items] | ||
Number of reportable segments | segment | 1 | |
Revenues | $ 42,048 | $ 50,713 |
U.S. | ||
Revenue, Major Customer [Line Items] | ||
Revenues | 22,272 | 21,921 |
Other | ||
Revenue, Major Customer [Line Items] | ||
Revenues | $ 19,776 | $ 28,792 |
Revenue | Product Risk | ||
Revenue, Major Customer [Line Items] | ||
Percentage of total revenue | 100.00% | 100.00% |
Revenue | Product Risk | U.S. | ||
Revenue, Major Customer [Line Items] | ||
Percentage of total revenue | 53.00% | 43.20% |
Revenue | Product Risk | Other | ||
Revenue, Major Customer [Line Items] | ||
Percentage of total revenue | 47.00% | 56.80% |
Distributor Sales | Product Risk | Other | ||
Revenue, Major Customer [Line Items] | ||
Percentage of total revenue | 35.20% | 33.90% |
Distributor Sales | Product Risk | Non US Next Largest Single Country | ||
Revenue, Major Customer [Line Items] | ||
Percentage of total revenue | 7.60% | 7.60% |
ESS | ||
Revenue, Major Customer [Line Items] | ||
Revenues | $ 25,729 | $ 28,309 |
ESS | U.S. | ||
Revenue, Major Customer [Line Items] | ||
Revenues | 15,774 | 14,944 |
ESS | Other | ||
Revenue, Major Customer [Line Items] | ||
Revenues | $ 9,955 | $ 13,365 |
ESS | Revenue | Product Risk | ||
Revenue, Major Customer [Line Items] | ||
Percentage of total revenue | 61.20% | 55.80% |
IGB | ||
Revenue, Major Customer [Line Items] | ||
Revenues | $ 14,784 | $ 16,840 |
IGB | U.S. | ||
Revenue, Major Customer [Line Items] | ||
Revenues | 5,045 | 5,162 |
IGB | Other | ||
Revenue, Major Customer [Line Items] | ||
Revenues | $ 9,739 | $ 11,678 |
IGB | Revenue | Product Risk | ||
Revenue, Major Customer [Line Items] | ||
Percentage of total revenue | 35.20% | 33.20% |
Total Endoscopy | ||
Revenue, Major Customer [Line Items] | ||
Revenues | $ 40,513 | $ 45,149 |
Total Endoscopy | U.S. | ||
Revenue, Major Customer [Line Items] | ||
Revenues | 20,819 | 20,106 |
Total Endoscopy | Other | ||
Revenue, Major Customer [Line Items] | ||
Revenues | $ 19,694 | $ 25,043 |
Total Endoscopy | Revenue | Product Risk | ||
Revenue, Major Customer [Line Items] | ||
Percentage of total revenue | 96.40% | 89.00% |
Surgical | ||
Revenue, Major Customer [Line Items] | ||
Revenues | $ 0 | $ 3,712 |
Surgical | U.S. | ||
Revenue, Major Customer [Line Items] | ||
Revenues | 0 | 0 |
Surgical | Other | ||
Revenue, Major Customer [Line Items] | ||
Revenues | $ 0 | $ 3,712 |
Surgical | Revenue | Product Risk | ||
Revenue, Major Customer [Line Items] | ||
Percentage of total revenue | 0.00% | 7.30% |
Other | ||
Revenue, Major Customer [Line Items] | ||
Revenues | $ 1,535 | $ 1,852 |
Other | U.S. | ||
Revenue, Major Customer [Line Items] | ||
Revenues | 1,453 | 1,815 |
Other | Other | ||
Revenue, Major Customer [Line Items] | ||
Revenues | $ 82 | $ 37 |
Other | Revenue | Product Risk | ||
Revenue, Major Customer [Line Items] | ||
Percentage of total revenue | 3.60% | 3.70% |
Segment and Geographic Inform_4
Segment and Geographic Information (Long-Lived Assets by Geographic Area) (Details) - USD ($) $ in Thousands | Dec. 31, 2020 | Dec. 31, 2019 |
Revenues from External Customers and Long-Lived Assets [Line Items] | ||
Total property and equipment, net | $ 6,221 | $ 6,612 |
U.S. | ||
Revenues from External Customers and Long-Lived Assets [Line Items] | ||
Total property and equipment, net | 2,149 | 2,934 |
Costa Rica | ||
Revenues from External Customers and Long-Lived Assets [Line Items] | ||
Total property and equipment, net | 3,641 | 3,039 |
Other | ||
Revenues from External Customers and Long-Lived Assets [Line Items] | ||
Total property and equipment, net | $ 431 | $ 639 |
Uncategorized Items - apen-2020
Label | Element | Value |
Accounting Standards Update [Extensible List] | us-gaap_AccountingStandardsUpdateExtensibleList | us-gaap:AccountingStandardsUpdate201602Member |