10-K Filing

ESTABLISHMENT LABS HOLDINGS INC. CIK: 1688757 FY 2022

Filing Information

Form Type	10-K
Accession Number	`0001688757-23-000022`
Period End Date	20221231
Filing Date	20230301
Fiscal Year	2022
Fiscal Period	FY
XBRL Instance	esta-20221231_htm.xml

Filing Contents

This filing contains the following financial statements:

Balance Sheet 70 Income Statement 60 Cash Flow Statement 152 Stockholders Equity 35 Comprehensive Income 12

Balance Sheet 70 line items

Line Item	Tag	Value	Unit	Period
Allowance for doubtful accounts	`AllowanceForDoubtfulAccountsReceivableCurrent`	$1.14M	USD	Point-in-time
Allowance for doubtful accounts	`AllowanceForDoubtfulAccountsReceivableCurrent`	$741.00K	USD	Point-in-time
Allowance for doubtful accounts	`AllowanceForDoubtfulAccountsReceivableCurrent`	$1.22M	USD	Point-in-time
Allowance for doubtful accounts	`AllowanceForDoubtfulAccountsReceivableCurrent`	$1.03M	USD	Point-in-time
Common stock, shares issued (in shares)	`CommonStockSharesIssued`	24.49M	shares	Point-in-time
Common stock, shares issued (in shares)	`CommonStockSharesIssued`	24.82M	shares	Point-in-time
Cash	`Cash`	$53.41M	USD	Point-in-time
Cash	`Cash`	$66.36M	USD	Point-in-time
Common stock, shares outstanding (in shares)	`CommonStockSharesOutstanding`	24.08M	shares	Point-in-time
Common stock, shares outstanding (in shares)	`CommonStockSharesOutstanding`	24.41M	shares	Point-in-time
Treasury stock, shares held (in shares)	`TreasuryStockCommonShares`	408,070.00	shares	Point-in-time
Accounts receivable, net of allowance for doubtful accounts of $741 and $1,221	`AccountsReceivableNetCurrent`	$35.42M	USD	Point-in-time
Accounts receivable, net of allowance for doubtful accounts of $741 and $1,221	`AccountsReceivableNetCurrent`	$24.44M	USD	Point-in-time
Treasury stock, shares held (in shares)	`TreasuryStockCommonShares`	408,070.00	shares	Point-in-time
Inventory, net	`InventoryNet`	$36.58M	USD	Point-in-time
Inventory, net	`InventoryNet`	$28.41M	USD	Point-in-time
Prepaid expenses and other current assets	`PrepaidExpenseAndOtherAssetsCurrent`	$7.01M	USD	Point-in-time
Prepaid expenses and other current assets	`PrepaidExpenseAndOtherAssetsCurrent`	$11.54M	USD	Point-in-time
Total current assets	`AssetsCurrent`	$113.27M	USD	Point-in-time
Total current assets	`AssetsCurrent`	$149.90M	USD	Point-in-time
Property and equipment, net of accumulated depreciation	`PropertyPlantAndEquipmentNet`	$18.66M	USD	Point-in-time
Property and equipment, net of accumulated depreciation	`PropertyPlantAndEquipmentNet`	$51.09M	USD	Point-in-time
Goodwill	`Goodwill`	$465.00K	USD	Point-in-time
Goodwill	`Goodwill`	$465.00K	USD	Point-in-time
Intangible assets, net of accumulated amortization	`IntangibleAssetsNetExcludingGoodwill`	$4.61M	USD	Point-in-time
Intangible assets, net of accumulated amortization	`IntangibleAssetsNetExcludingGoodwill`	$4.37M	USD	Point-in-time
Right-of-use operating lease assets, net	`OperatingLeaseRightOfUseAsset`	$2.21M	USD	Point-in-time
Right-of-use operating lease assets, net	`OperatingLeaseRightOfUseAsset`	$3.70M	USD	Point-in-time
Other non-current assets	`OtherAssetsNoncurrent`	$558.00K	USD	Point-in-time
Other non-current assets	`OtherAssetsNoncurrent`	$1.29M	USD	Point-in-time
Total assets	`Assets`	$139.53M	USD	Point-in-time
Total assets	`Assets`	$211.06M	USD	Point-in-time
Accounts payable	`AccountsPayableCurrent`	$20.03M	USD	Point-in-time
Accounts payable	`AccountsPayableCurrent`	$14.47M	USD	Point-in-time
Accrued liabilities	`AccruedLiabilitiesCurrent`	$16.24M	USD	Point-in-time
Accrued liabilities	`AccruedLiabilitiesCurrent`	$17.24M	USD	Point-in-time
Other liabilities, short-term	`OtherLiabilitiesCurrent`	$1.69M	USD	Point-in-time
Other liabilities, short-term	`OtherLiabilitiesCurrent`	$1.18M	USD	Point-in-time
Total current liabilities	`LiabilitiesCurrent`	$31.89M	USD	Point-in-time
Total current liabilities	`LiabilitiesCurrent`	$38.96M	USD	Point-in-time
Note payable, Oaktree, net of debt discount and issuance costs	`LongTermLineOfCreditNoncurrentOaktree`	$175.46M	USD	Point-in-time
Note payable, Oaktree, net of debt discount and issuance costs	`LongTermLineOfCreditNoncurrentOaktree`	-	USD	Point-in-time
Note payable, Madryn, net of debt discount and issuance costs	`LongTermLineOfCredit`	$51.91M	USD	Point-in-time
Note payable, Madryn, net of debt discount and issuance costs	`LongTermLineOfCredit`	-	USD	Point-in-time
Madryn put option	`DerivativeLiabilitiesNoncurrent`	$703.00K	USD	Point-in-time
Madryn put option	`DerivativeLiabilitiesNoncurrent`	-	USD	Point-in-time
Operating lease liabilities, non-current	`OperatingLeaseLiabilityNoncurrent`	$3.20M	USD	Point-in-time
Operating lease liabilities, non-current	`OperatingLeaseLiabilityNoncurrent`	$1.90M	USD	Point-in-time
Other liabilities, long-term	`OtherLiabilitiesNoncurrent`	$1.63M	USD	Point-in-time
Other liabilities, long-term	`OtherLiabilitiesNoncurrent`	$2.39M	USD	Point-in-time
Total liabilities	`Liabilities`	$88.79M	USD	Point-in-time
Total liabilities	`Liabilities`	$219.25M	USD	Point-in-time
Commitments and contingencies (Note 15)	`CommitmentsAndContingencies`	-	USD	Point-in-time
Commitments and contingencies (Note 15)	`CommitmentsAndContingencies`	-	USD	Point-in-time
Common shares - zero par value, unlimited amount of shares authorized at December 31, 2022 and 2021; 24,815,908 and 24,488,335 shares issued at December 31, 2022 and 2021, respectively; 24,407,838 and 24,080,265 shares outstanding at December 31, 2022 and 2021, respectively	`CommonStockValue`	$223.64M	USD	Point-in-time
Common shares - zero par value, unlimited amount of shares authorized at December 31, 2022 and 2021; 24,815,908 and 24,488,335 shares issued at December 31, 2022 and 2021, respectively; 24,407,838 and 24,080,265 shares outstanding at December 31, 2022 and 2021, respectively	`CommonStockValue`	$219.74M	USD	Point-in-time
Additional paid-in-capital	`AdditionalPaidInCapital`	$36.58M	USD	Point-in-time
Additional paid-in-capital	`AdditionalPaidInCapital`	$49.91M	USD	Point-in-time
Treasury shares, at cost, 408,070 shares held at December 31, 2022 and 2021	`TreasuryStockCommonValue`	$2.85M	USD	Point-in-time
Treasury shares, at cost, 408,070 shares held at December 31, 2022 and 2021	`TreasuryStockCommonValue`	$2.85M	USD	Point-in-time
Accumulated deficit	`RetainedEarningsAccumulatedDeficit`	$-206.38M	USD	Point-in-time
Accumulated deficit	`RetainedEarningsAccumulatedDeficit`	$-281.59M	USD	Point-in-time
Accumulated other comprehensive income	`AccumulatedOtherComprehensiveIncomeLossNetOfTax`	$3.66M	USD	Point-in-time
Accumulated other comprehensive income	`AccumulatedOtherComprehensiveIncomeLossNetOfTax`	$2.71M	USD	Point-in-time
Total shareholders (deficit) equity	`StockholdersEquity`	$39.61M	USD	Point-in-time
Total shareholders (deficit) equity	`StockholdersEquity`	$-8.19M	USD	Point-in-time
Total shareholders (deficit) equity	`StockholdersEquity`	$74.96M	USD	Point-in-time
Total shareholders (deficit) equity	`StockholdersEquity`	$50.74M	USD	Point-in-time
Total liabilities and shareholders equity	`LiabilitiesAndStockholdersEquity`	$139.53M	USD	Point-in-time
Total liabilities and shareholders equity	`LiabilitiesAndStockholdersEquity`	$211.06M	USD	Point-in-time

Income Statement 60 line items

Line Item	Tag	Value	Unit	Period
Revenue	`RevenueFromContractWithCustomerExcludingAssessedTax`	$84.68M	USD	Annual
Revenue	`RevenueFromContractWithCustomerExcludingAssessedTax`	$161.70M	USD	Annual
Revenue	`RevenueFromContractWithCustomerExcludingAssessedTax`	$126.68M	USD	Annual
Cost of revenue	`CostOfRevenue`	$32.17M	USD	Annual
Cost of revenue	`CostOfRevenue`	$41.28M	USD	Annual
Cost of revenue	`CostOfRevenue`	$55.10M	USD	Annual
Gross profit	`GrossProfit`	$85.40M	USD	Annual
Gross profit	`GrossProfit`	$106.59M	USD	Annual
Gross profit	`GrossProfit`	$52.50M	USD	Annual
Sales, general and administrative	`SellingGeneralAndAdministrativeExpense`	$66.62M	USD	Annual
Sales, general and administrative	`SellingGeneralAndAdministrativeExpense`	$125.98M	USD	Annual
Sales, general and administrative	`SellingGeneralAndAdministrativeExpense`	$92.23M	USD	Annual
Research and development	`ResearchAndDevelopmentExpense`	$20.27M	USD	Annual
Research and development	`ResearchAndDevelopmentExpense`	$18.32M	USD	Annual
Research and development	`ResearchAndDevelopmentExpense`	$13.79M	USD	Annual
Total operating expenses	`OperatingExpenses`	$80.42M	USD	Annual
Total operating expenses	`OperatingExpenses`	$110.54M	USD	Annual
Total operating expenses	`OperatingExpenses`	$146.25M	USD	Annual
Loss from operations	`OperatingIncomeLoss`	$-25.14M	USD	Annual
Loss from operations	`OperatingIncomeLoss`	$-39.66M	USD	Annual
Loss from operations	`OperatingIncomeLoss`	$-27.92M	USD	Annual
Interest income	`InvestmentIncomeInterest`	$87.00K	USD	Annual
Interest income	`InvestmentIncomeInterest`	$15.00K	USD	Annual
Interest income	`InvestmentIncomeInterest`	$23.00K	USD	Annual
Interest expense	`InterestExpense`	$9.37M	USD	Annual
Interest expense	`InterestExpense`	$9.06M	USD	Annual
Interest expense	`InterestExpense`	$11.76M	USD	Annual
Change in fair value of derivative instruments	`GainLossOnDerivativeInstrumentsNetPretax`	$737.00K	USD	Annual
Change in fair value of derivative instruments	`GainLossOnDerivativeInstrumentsNetPretax`	$1.63M	USD	Annual
Change in fair value of derivative instruments	`GainLossOnDerivativeInstrumentsNetPretax`	$703.00K	USD	Annual
Change in fair value of contingent consideration	`BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1`	-	USD	Annual
Change in fair value of contingent consideration	`BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1`	$-304.00K	USD	Annual
Change in fair value of contingent consideration	`BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1`	-	USD	Annual
Loss on extinguishment of debt	`GainsLossesOnExtinguishmentOfDebt`	$-19.02M	USD	Annual
Loss on extinguishment of debt	`GainsLossesOnExtinguishmentOfDebt`	-	USD	Annual
Loss on extinguishment of debt	`GainsLossesOnExtinguishmentOfDebt`	-	USD	Annual
Other expense, net	`OtherNonoperatingIncomeExpense`	$-6.27M	USD	Annual
Other expense, net	`OtherNonoperatingIncomeExpense`	$-2.68M	USD	Annual
Other expense, net	`OtherNonoperatingIncomeExpense`	$-3.18M	USD	Annual
Loss before income taxes	`IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest`	$-39.71M	USD	Annual
Loss before income taxes	`IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest`	$-72.82M	USD	Annual
Loss before income taxes	`IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest`	$-38.02M	USD	Annual
Provision for income taxes	`IncomeTaxExpenseBenefit`	$2.38M	USD	Annual
Provision for income taxes	`IncomeTaxExpenseBenefit`	$104.00K	USD	Annual
Provision for income taxes	`IncomeTaxExpenseBenefit`	$1.43M	USD	Annual
Net loss	`NetIncomeLoss`	$-38.12M	USD	Annual
Net loss	`NetIncomeLoss`	$-41.14M	USD	Annual
Net loss	`NetIncomeLoss`	$-75.21M	USD	Annual
Basic net loss per share (in dollars per share)	`EarningsPerShareBasic`	$-3.08	USD	Annual
Basic net loss per share (in dollars per share)	`EarningsPerShareBasic`	$-1.72	USD	Annual
Basic net loss per share (in dollars per share)	`EarningsPerShareBasic`	$-1.63	USD	Annual
Diluted net loss per share (in dollars per share)	`EarningsPerShareDiluted`	$-1.72	USD	Annual
Diluted net loss per share (in dollars per share)	`EarningsPerShareDiluted`	$-3.08	USD	Annual
Diluted net loss per share (in dollars per share)	`EarningsPerShareDiluted`	$-1.63	USD	Annual
Weighted average common shares outstanding, basic (in shares)	`WeightedAverageNumberOfSharesOutstandingBasic`	23.32M	shares	Annual
Weighted average common shares outstanding, basic (in shares)	`WeightedAverageNumberOfSharesOutstandingBasic`	23.97M	shares	Annual
Weighted average common shares outstanding, basic (in shares)	`WeightedAverageNumberOfSharesOutstandingBasic`	24.46M	shares	Annual
Weighted average common shares outstanding, diluted (in shares)	`WeightedAverageNumberOfDilutedSharesOutstanding`	23.97M	shares	Annual
Weighted average common shares outstanding, diluted (in shares)	`WeightedAverageNumberOfDilutedSharesOutstanding`	24.46M	shares	Annual
Weighted average common shares outstanding, diluted (in shares)	`WeightedAverageNumberOfDilutedSharesOutstanding`	23.32M	shares	Annual

Cash Flow Statement 152 line items

Line Item	Tag	Value	Unit	Period
Net loss	`NetIncomeLoss`	$-38.12M	USD	Annual
Net loss	`NetIncomeLoss`	$-41.14M	USD	Annual
Net loss	`NetIncomeLoss`	$-75.21M	USD	Annual
Depreciation and amortization	`DepreciationandAmortizationExcludingDebtDiscountPremium`	$3.72M	USD	Annual
Depreciation and amortization	`DepreciationandAmortizationExcludingDebtDiscountPremium`	$3.35M	USD	Annual
Depreciation and amortization	`DepreciationandAmortizationExcludingDebtDiscountPremium`	$3.87M	USD	Annual
Provision for doubtful accounts	`ProvisionForDoubtfulAccounts`	$200.00K	USD	Annual
Provision for doubtful accounts	`ProvisionForDoubtfulAccounts`	$375.00K	USD	Annual
Provision for doubtful accounts	`ProvisionForDoubtfulAccounts`	$111.00K	USD	Annual
Provision for inventory obsolescence	`InventoryWriteDown`	$338.00K	USD	Annual
Provision for inventory obsolescence	`InventoryWriteDown`	$1.18M	USD	Annual
Provision for inventory obsolescence	`InventoryWriteDown`	$1.58M	USD	Annual
Provision for fixed asset obsolescence	`FixedAssetWriteDown`	-	USD	Annual
Provision for fixed asset obsolescence	`FixedAssetWriteDown`	-	USD	Annual
Provision for fixed asset obsolescence	`FixedAssetWriteDown`	$341.00K	USD	Annual
Provision for deferred income taxes	`DeferredIncomeTaxExpenseBenefit`	$7.00K	USD	Annual
Provision for deferred income taxes	`DeferredIncomeTaxExpenseBenefit`	$86.00K	USD	Annual
Provision for deferred income taxes	`DeferredIncomeTaxExpenseBenefit`	$-274.00K	USD	Annual
Share-based compensation	`SharebasedCompensationAndIssuanceOfStockOrWarrantsForServicesAndClaims`	$10.41M	USD	Annual
Share-based compensation	`SharebasedCompensationAndIssuanceOfStockOrWarrantsForServicesAndClaims`	$13.36M	USD	Annual
Share-based compensation	`SharebasedCompensationAndIssuanceOfStockOrWarrantsForServicesAndClaims`	$5.72M	USD	Annual
Loss from disposal of property and equipment	`GainLossOnSaleOfPropertyPlantEquipment`	$-170.00K	USD	Annual
Loss from disposal of property and equipment	`GainLossOnSaleOfPropertyPlantEquipment`	$-170.00K	USD	Annual
Loss from disposal of property and equipment	`GainLossOnSaleOfPropertyPlantEquipment`	$-229.00K	USD	Annual
Unrealized foreign currency loss, net	`ForeignCurrencyTransactionGainLossUnrealized`	$-2.39M	USD	Annual
Unrealized foreign currency loss, net	`ForeignCurrencyTransactionGainLossUnrealized`	$-4.20M	USD	Annual
Unrealized foreign currency loss, net	`ForeignCurrencyTransactionGainLossUnrealized`	$-1.73M	USD	Annual
Loss on extinguishment of debt	`GainsLossesOnExtinguishmentOfDebt`	$-19.02M	USD	Annual
Loss on extinguishment of debt	`GainsLossesOnExtinguishmentOfDebt`	-	USD	Annual
Loss on extinguishment of debt	`GainsLossesOnExtinguishmentOfDebt`	-	USD	Annual
Amortization of right-to-use asset	`OperatingLeaseRightOfUseAssetAmortizationExpense`	$469.00K	USD	Annual
Amortization of right-to-use asset	`OperatingLeaseRightOfUseAssetAmortizationExpense`	$363.00K	USD	Annual
Amortization of right-to-use asset	`OperatingLeaseRightOfUseAssetAmortizationExpense`	$406.00K	USD	Annual
Gain from write-off of liability	`GainLossOnWriteOffOfDeferredTaxLiabilityShareBasedPaymentArrangement`	-	USD	Annual
Gain from write-off of liability	`GainLossOnWriteOffOfDeferredTaxLiabilityShareBasedPaymentArrangement`	$1.87M	USD	Annual
Gain from write-off of liability	`GainLossOnWriteOffOfDeferredTaxLiabilityShareBasedPaymentArrangement`	$736.00K	USD	Annual
Change in fair value of derivative instruments	`UnrealizedGainLossOnDerivatives`	$737.00K	USD	Annual
Change in fair value of derivative instruments	`UnrealizedGainLossOnDerivatives`	$1.63M	USD	Annual
Change in fair value of derivative instruments	`UnrealizedGainLossOnDerivatives`	$703.00K	USD	Annual
Change in fair value of contingent consideration	`BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1`	-	USD	Annual
Change in fair value of contingent consideration	`BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1`	$-304.00K	USD	Annual
Change in fair value of contingent consideration	`BusinessCombinationContingentConsiderationArrangementsChangeInAmountOfContingentConsiderationLiability1`	-	USD	Annual
Interest capitalized for construction in progress	`InterestCostsCapitalizedConstructionInProgress`	-	USD	Annual
Interest capitalized for construction in progress	`InterestCostsCapitalizedConstructionInProgress`	-	USD	Annual
Interest capitalized for construction in progress	`InterestCostsCapitalizedConstructionInProgress`	$1.76M	USD	Annual
Amortization of debt discount	`AmortizationOfFinancingCostsAndDiscounts`	$2.07M	USD	Annual
Amortization of debt discount	`AmortizationOfFinancingCostsAndDiscounts`	$8.12M	USD	Annual
Amortization of debt discount	`AmortizationOfFinancingCostsAndDiscounts`	$1.69M	USD	Annual
Accounts receivable	`IncreaseDecreaseInAccountsReceivable`	$12.33M	USD	Annual
Accounts receivable	`IncreaseDecreaseInAccountsReceivable`	$6.70M	USD	Annual
Accounts receivable	`IncreaseDecreaseInAccountsReceivable`	$-3.81M	USD	Annual
Inventory	`IncreaseDecreaseInInventories`	$-4.79M	USD	Annual
Inventory	`IncreaseDecreaseInInventories`	$10.90M	USD	Annual
Inventory	`IncreaseDecreaseInInventories`	$7.64M	USD	Annual
Prepaid expenses and other current assets	`IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets`	$-1.13M	USD	Annual
Prepaid expenses and other current assets	`IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets`	$4.49M	USD	Annual
Prepaid expenses and other current assets	`IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets`	$1.61M	USD	Annual
Other assets	`IncreaseDecreaseInOtherNoncurrentAssets`	$750.00K	USD	Annual
Other assets	`IncreaseDecreaseInOtherNoncurrentAssets`	$-90.00K	USD	Annual
Other assets	`IncreaseDecreaseInOtherNoncurrentAssets`	$277.00K	USD	Annual
Accounts payable	`IncreaseDecreaseInAccountsPayable`	$-636.00K	USD	Annual
Accounts payable	`IncreaseDecreaseInAccountsPayable`	$4.38M	USD	Annual
Accounts payable	`IncreaseDecreaseInAccountsPayable`	$4.96M	USD	Annual
Accrued liabilities	`IncreaseDecreaseInAccruedLiabilities`	$4.73M	USD	Annual
Accrued liabilities	`IncreaseDecreaseInAccruedLiabilities`	$3.11M	USD	Annual
Accrued liabilities	`IncreaseDecreaseInAccruedLiabilities`	$2.81M	USD	Annual
Operating lease liabilities	`IncreaseDecreaseInOperatingLeaseLiabilities`	$-378.00K	USD	Annual
Operating lease liabilities	`IncreaseDecreaseInOperatingLeaseLiabilities`	$-318.00K	USD	Annual
Operating lease liabilities	`IncreaseDecreaseInOperatingLeaseLiabilities`	$-408.00K	USD	Annual
Other liabilities	`IncreaseDecreaseInOtherOperatingLiabilities`	$990.00K	USD	Annual
Other liabilities	`IncreaseDecreaseInOtherOperatingLiabilities`	$117.00K	USD	Annual
Other liabilities	`IncreaseDecreaseInOtherOperatingLiabilities`	$143.00K	USD	Annual
Net cash used in operating activities	`NetCashProvidedByUsedInOperatingActivities`	$-27.53M	USD	Annual
Net cash used in operating activities	`NetCashProvidedByUsedInOperatingActivities`	$-12.51M	USD	Annual
Net cash used in operating activities	`NetCashProvidedByUsedInOperatingActivities`	$-52.17M	USD	Annual
Purchases of property and equipment	`PaymentsToAcquirePropertyPlantAndEquipment`	$2.11M	USD	Annual
Purchases of property and equipment	`PaymentsToAcquirePropertyPlantAndEquipment`	$2.42M	USD	Annual
Purchases of property and equipment	`PaymentsToAcquirePropertyPlantAndEquipment`	$2.85M	USD	Annual
Cash used in asset acquisitions	`PaymentstoAcquireAssetsIncludingReceivablesHeld`	$1.65M	USD	Annual
Cash used in asset acquisitions	`PaymentstoAcquireAssetsIncludingReceivablesHeld`	$434.00K	USD	Annual
Cash used in asset acquisitions	`PaymentstoAcquireAssetsIncludingReceivablesHeld`	$525.00K	USD	Annual
Cost incurred for intangible assets	`PaymentsToAcquireIntangibleAssets`	$1.48M	USD	Annual
Cost incurred for intangible assets	`PaymentsToAcquireIntangibleAssets`	$1.49M	USD	Annual
Cost incurred for intangible assets	`PaymentsToAcquireIntangibleAssets`	$1.45M	USD	Annual
Capital expenditures on construction in progress	`PaymentsToAcquireOtherProductiveAssets`	$317.00K	USD	Annual
Capital expenditures on construction in progress	`PaymentsToAcquireOtherProductiveAssets`	$29.92M	USD	Annual
Capital expenditures on construction in progress	`PaymentsToAcquireOtherProductiveAssets`	$2.86M	USD	Annual
Net cash used in investing activities	`NetCashProvidedByUsedInInvestingActivities`	$-7.16M	USD	Annual
Net cash used in investing activities	`NetCashProvidedByUsedInInvestingActivities`	$-34.79M	USD	Annual
Net cash used in investing activities	`NetCashProvidedByUsedInInvestingActivities`	$-5.56M	USD	Annual
Borrowings under Oaktree debt agreement, net of debt discount and issuance costs	`ProceedsFromLongTermLinesOfCredit`	-	USD	Annual
Borrowings under Oaktree debt agreement, net of debt discount and issuance costs	`ProceedsFromLongTermLinesOfCredit`	$168.09M	USD	Annual
Borrowings under Oaktree debt agreement, net of debt discount and issuance costs	`ProceedsFromLongTermLinesOfCredit`	-	USD	Annual
Repayment of Madryn debt agreement	`RepaymentsOfLinesOfCredit`	$71.68M	USD	Annual
Repayment of Madryn debt agreement	`RepaymentsOfLinesOfCredit`	-	USD	Annual
Repayment of Madryn debt agreement	`RepaymentsOfLinesOfCredit`	-	USD	Annual
Repayments on finance leases	`FinanceLeasePrincipalPayments`	$26.00K	USD	Annual
Repayments on finance leases	`FinanceLeasePrincipalPayments`	$277.00K	USD	Annual
Repayments on finance leases	`FinanceLeasePrincipalPayments`	$175.00K	USD	Annual
Proceeds from issuance of common shares, net of underwriters discount and issuance costs	`ProceedsFromIssuanceOfCommonStock`	-	USD	Annual
Proceeds from issuance of common shares, net of underwriters discount and issuance costs	`ProceedsFromIssuanceOfCommonStock`	-	USD	Annual
Proceeds from issuance of common shares, net of underwriters discount and issuance costs	`ProceedsFromIssuanceOfCommonStock`	$63.85M	USD	Annual
Proceeds from stock option exercises	`ProceedsFromStockOptionsExercised`	$3.87M	USD	Annual
Proceeds from stock option exercises	`ProceedsFromStockOptionsExercised`	$4.58M	USD	Annual
Proceeds from stock option exercises	`ProceedsFromStockOptionsExercised`	$1.25M	USD	Annual
Tax payments related to shares withheld upon vesting of restricted stock	`PaymentsRelatedToTaxWithholdingForShareBasedCompensation`	$356.00K	USD	Annual
Tax payments related to shares withheld upon vesting of restricted stock	`PaymentsRelatedToTaxWithholdingForShareBasedCompensation`	$4.00K	USD	Annual
Tax payments related to shares withheld upon vesting of restricted stock	`PaymentsRelatedToTaxWithholdingForShareBasedCompensation`	$154.00K	USD	Annual
Net cash provided by financing activities	`NetCashProvidedByUsedInFinancingActivities`	$64.67M	USD	Annual
Net cash provided by financing activities	`NetCashProvidedByUsedInFinancingActivities`	$4.05M	USD	Annual
Net cash provided by financing activities	`NetCashProvidedByUsedInFinancingActivities`	$100.25M	USD	Annual
Effect of exchange rate changes on cash	`EffectOfExchangeRateOnCashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$-465.00K	USD	Annual
Effect of exchange rate changes on cash	`EffectOfExchangeRateOnCashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$267.00K	USD	Annual
Effect of exchange rate changes on cash	`EffectOfExchangeRateOnCashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$-358.00K	USD	Annual
Net (decrease)/increase in cash	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect`	$12.94M	USD	Annual
Net (decrease)/increase in cash	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect`	$-31.11M	USD	Annual
Net (decrease)/increase in cash	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect`	$46.87M	USD	Annual
Cash at beginning of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$84.52M	USD	Point-in-time
Cash at beginning of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$53.41M	USD	Point-in-time
Cash at beginning of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$37.66M	USD	Point-in-time
Cash at beginning of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$66.36M	USD	Point-in-time
Cash at end of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$84.52M	USD	Point-in-time
Cash at end of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$53.41M	USD	Point-in-time
Cash at end of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$37.66M	USD	Point-in-time
Cash at end of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$66.36M	USD	Point-in-time
Cash paid for interest	`InterestPaidNet`	$6.96M	USD	Annual
Cash paid for interest	`InterestPaidNet`	$6.93M	USD	Annual
Cash paid for interest	`InterestPaidNet`	$5.36M	USD	Annual
Cash paid for income taxes	`IncomeTaxesPaidNet`	$652.00K	USD	Annual
Cash paid for income taxes	`IncomeTaxesPaidNet`	$316.00K	USD	Annual
Cash paid for income taxes	`IncomeTaxesPaidNet`	$2.12M	USD	Annual
Unpaid balance for property and equipment	`CapitalExpendituresIncurredButNotYetPaid`	$1.13M	USD	Annual
Unpaid balance for property and equipment	`CapitalExpendituresIncurredButNotYetPaid`	$210.00K	USD	Annual
Unpaid balance for property and equipment	`CapitalExpendituresIncurredButNotYetPaid`	$22.00K	USD	Annual
Consideration payable related to asset acquisition	`NoncashConsiderationPayableRelatedtoAssetAcquisition`	-	USD	Annual
Consideration payable related to asset acquisition	`NoncashConsiderationPayableRelatedtoAssetAcquisition`	$546.00K	USD	Annual
Consideration payable related to asset acquisition	`NoncashConsiderationPayableRelatedtoAssetAcquisition`	$858.00K	USD	Annual
Inventory acquired in an asset acquisition	`NoncashOrPartNoncashAcquisitionFixedAssetsAcquired1`	$1.01M	USD	Annual
Inventory acquired in an asset acquisition	`NoncashOrPartNoncashAcquisitionFixedAssetsAcquired1`	-	USD	Annual
Inventory acquired in an asset acquisition	`NoncashOrPartNoncashAcquisitionFixedAssetsAcquired1`	-	USD	Annual
Issuance of common shares in settlement of contingent consideration	`NoncashIssuanceOfCommonSharesInPartialSettlementOfContingentConsideration`	-	USD	Annual
Issuance of common shares in settlement of contingent consideration	`NoncashIssuanceOfCommonSharesInPartialSettlementOfContingentConsideration`	-	USD	Annual
Issuance of common shares in settlement of contingent consideration	`NoncashIssuanceOfCommonSharesInPartialSettlementOfContingentConsideration`	$618.00K	USD	Annual
Intangible assets acquired in an asset acquisition	`NoncashorPartNoncashTransferFromRestrictedCashToPrepaidExpensesAndOtherCurrentsAssets`	-	USD	Annual
Intangible assets acquired in an asset acquisition	`NoncashorPartNoncashTransferFromRestrictedCashToPrepaidExpensesAndOtherCurrentsAssets`	-	USD	Annual
Intangible assets acquired in an asset acquisition	`NoncashorPartNoncashTransferFromRestrictedCashToPrepaidExpensesAndOtherCurrentsAssets`	$138.00K	USD	Annual
Cashless option exercises	`NoncashProceedsFromStockOptionsExercised`	$1.64M	USD	Annual
Cashless option exercises	`NoncashProceedsFromStockOptionsExercised`	-	USD	Annual
Cashless option exercises	`NoncashProceedsFromStockOptionsExercised`	-	USD	Annual
Interest capitalized for construction in progress	`NonCashInterestCostsCapitalizedConstructionInProgressSupplementalDisclosure`	$1.76M	USD	Annual
Interest capitalized for construction in progress	`NonCashInterestCostsCapitalizedConstructionInProgressSupplementalDisclosure`	-	USD	Annual
Interest capitalized for construction in progress	`NonCashInterestCostsCapitalizedConstructionInProgressSupplementalDisclosure`	-	USD	Annual

Stockholders Equity 35 line items

Line Item	Tag	Value	Unit	Period
Beginning balance, common stock (in shares)	`CommonStockSharesIssued`	24.49M	shares	Point-in-time
Beginning balance, common stock (in shares)	`CommonStockSharesIssued`	24.82M	shares	Point-in-time
Beginning balance	`StockholdersEquity`	$39.61M	USD	Point-in-time
Beginning balance	`StockholdersEquity`	$-8.19M	USD	Point-in-time
Beginning balance	`StockholdersEquity`	$74.96M	USD	Point-in-time
Beginning balance	`StockholdersEquity`	$50.74M	USD	Point-in-time
Beginning balance, treasury stock (in shares)	`TreasuryStockCommonShares`	408,070.00	shares	Point-in-time
Beginning balance, treasury stock (in shares)	`TreasuryStockCommonShares`	408,070.00	shares	Point-in-time
Issuance of common stock, net of underwriters discount and issuance costs	`StockIssuedDuringPeriodValueNewIssues`	$63.85M	USD	Annual
Issuance of common shares in settlement of contingent consideration	`StockIssuedDuringPeriodValueConversionOfConvertibleSecurities`	$618.00K	USD	Annual
Stock option exercises (in shares)	`StockIssuedDuringPeriodSharesStockOptionsExercised`	301,412.00	shares	Annual
Stock option exercises	`StockIssuedDuringPeriodValueStockOptionsExercised`	$3.87M	USD	Annual
Stock option exercises	`StockIssuedDuringPeriodValueStockOptionsExercised`	$1.25M	USD	Annual
Stock option exercises	`StockIssuedDuringPeriodValueStockOptionsExercised`	$6.08M	USD	Annual
Shares withheld to cover strike price upon cashless option exercise	`ShareBasedPaymentArrangementSharesWithheldForCashlessOptionExerciseValue`	$3.00K	USD	Annual
Share-based compensation	`StockIssuedDuringPeriodValueShareBasedCompensation`	$13.36M	USD	Annual
Share-based compensation	`StockIssuedDuringPeriodValueShareBasedCompensation`	$10.41M	USD	Annual
Share-based compensation	`StockIssuedDuringPeriodValueShareBasedCompensation`	$5.72M	USD	Annual
Shares withheld to cover income tax obligation upon vesting of restricted stock	`AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation`	$4.00K	USD	Annual
Shares withheld to cover income tax obligation upon vesting of restricted stock	`AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation`	$154.00K	USD	Annual
Shares withheld to cover income tax obligation upon vesting of restricted stock	`AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation`	$356.00K	USD	Annual
Foreign currency translation gain (loss)	`OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent`	$2.18M	USD	Annual
Foreign currency translation gain (loss)	`OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent`	$784.00K	USD	Annual
Foreign currency translation gain (loss)	`OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent`	$-942.00K	USD	Annual
Net loss	`NetIncomeLoss`	$-38.12M	USD	Annual
Net loss	`NetIncomeLoss`	$-41.14M	USD	Annual
Net loss	`NetIncomeLoss`	$-75.21M	USD	Annual
Ending balance, common stock (in shares)	`CommonStockSharesIssued`	24.49M	shares	Point-in-time
Ending balance, common stock (in shares)	`CommonStockSharesIssued`	24.82M	shares	Point-in-time
Ending balance	`StockholdersEquity`	$39.61M	USD	Point-in-time
Ending balance	`StockholdersEquity`	$-8.19M	USD	Point-in-time
Ending balance	`StockholdersEquity`	$74.96M	USD	Point-in-time
Ending balance	`StockholdersEquity`	$50.74M	USD	Point-in-time
Ending balance, treasury stock (in shares)	`TreasuryStockCommonShares`	408,070.00	shares	Point-in-time
Ending balance, treasury stock (in shares)	`TreasuryStockCommonShares`	408,070.00	shares	Point-in-time

Comprehensive Income 12 line items

Line Item	Tag	Value	Unit	Period
Net loss	`NetIncomeLoss`	$-38.12M	USD	Annual
Net loss	`NetIncomeLoss`	$-41.14M	USD	Annual
Net loss	`NetIncomeLoss`	$-75.21M	USD	Annual
Foreign currency translation gain (loss)	`OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent`	$2.18M	USD	Annual
Foreign currency translation gain (loss)	`OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent`	$784.00K	USD	Annual
Foreign currency translation gain (loss)	`OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent`	$-942.00K	USD	Annual
Other comprehensive gain (loss)	`OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent`	$-942.00K	USD	Annual
Other comprehensive gain (loss)	`OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent`	$784.00K	USD	Annual
Other comprehensive gain (loss)	`OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent`	$2.18M	USD	Annual
Comprehensive loss	`ComprehensiveIncomeNetOfTax`	$-76.15M	USD	Annual
Comprehensive loss	`ComprehensiveIncomeNetOfTax`	$-40.35M	USD	Annual
Comprehensive loss	`ComprehensiveIncomeNetOfTax`	$-35.94M	USD	Annual

Data is extracted from SEC EDGAR XBRL filings. Values shown are as reported in the filing.