10-K Filing

ESTABLISHMENT LABS HOLDINGS INC. CIK: 1688757 FY 2023

Filing Information

Form Type	10-K
Accession Number	`0001688757-24-000034`
Period End Date	20231231
Filing Date	20240304
Fiscal Year	2023
Fiscal Period	FY
XBRL Instance	esta-20231231_htm.xml

Filing Contents

This filing contains the following financial statements:

Balance Sheet 66 Income Statement 57 Cash Flow Statement 146 Stockholders Equity 37 Comprehensive Income 12

Balance Sheet 66 line items

Line Item	Tag	Value	Unit	Period
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`	$1.14M	USD	Point-in-time
Allowance for doubtful accounts	`AllowanceForDoubtfulAccountsReceivableCurrent`	$1.84M	USD	Point-in-time
Common stock, shares issued (in shares)	`CommonStockSharesIssued`	24.82M	shares	Point-in-time
Common stock, shares issued (in shares)	`CommonStockSharesIssued`	26.50M	shares	Point-in-time
Cash and cash equivalents	`CashAndCashEquivalentsAtCarryingValue`	$40.03M	USD	Point-in-time
Cash and cash equivalents	`CashAndCashEquivalentsAtCarryingValue`	$66.36M	USD	Point-in-time
Common stock, shares outstanding (in shares)	`CommonStockSharesOutstanding`	24.41M	shares	Point-in-time
Common stock, shares outstanding (in shares)	`CommonStockSharesOutstanding`	26.09M	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 $1,841 and $741 at December 31, 2023 and 2022, respectively	`AccountsReceivableNetCurrent`	$35.42M	USD	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 $1,841 and $741 at December 31, 2023 and 2022, respectively	`AccountsReceivableNetCurrent`	$46.92M	USD	Point-in-time
Inventory, net	`InventoryNet`	$79.47M	USD	Point-in-time
Inventory, net	`InventoryNet`	$36.58M	USD	Point-in-time
Prepaid expenses and other current assets	`PrepaidExpenseAndOtherAssetsCurrent`	$11.54M	USD	Point-in-time
Prepaid expenses and other current assets	`PrepaidExpenseAndOtherAssetsCurrent`	$8.48M	USD	Point-in-time
Total current assets	`AssetsCurrent`	$174.90M	USD	Point-in-time
Total current assets	`AssetsCurrent`	$149.90M	USD	Point-in-time
Property and equipment, net of accumulated depreciation	`PropertyPlantAndEquipmentNet`	$77.20M	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`	$7.99M	USD	Point-in-time
Right-of-use operating lease assets, net	`OperatingLeaseRightOfUseAsset`	$3.70M	USD	Point-in-time
Right-of-use operating lease assets, net	`OperatingLeaseRightOfUseAsset`	$3.38M	USD	Point-in-time
Other non-current assets	`OtherAssetsNoncurrent`	$4.70M	USD	Point-in-time
Other non-current assets	`OtherAssetsNoncurrent`	$1.29M	USD	Point-in-time
Total assets	`Assets`	$211.06M	USD	Point-in-time
Total assets	`Assets`	$268.64M	USD	Point-in-time
Accounts payable	`AccountsPayableCurrent`	$20.03M	USD	Point-in-time
Accounts payable	`AccountsPayableCurrent`	$41.62M	USD	Point-in-time
Accrued liabilities	`AccruedLiabilitiesCurrent`	$17.24M	USD	Point-in-time
Accrued liabilities	`AccruedLiabilitiesCurrent`	$13.69M	USD	Point-in-time
Other liabilities, short-term	`OtherLiabilitiesCurrent`	$1.84M	USD	Point-in-time
Other liabilities, short-term	`OtherLiabilitiesCurrent`	$1.69M	USD	Point-in-time
Total current liabilities	`LiabilitiesCurrent`	$38.96M	USD	Point-in-time
Total current liabilities	`LiabilitiesCurrent`	$57.15M	USD	Point-in-time
Note payable, Oaktree, net of debt discount and issuance costs	`LongTermDebtNoncurrent`	$188.74M	USD	Point-in-time
Note payable, Oaktree, net of debt discount and issuance costs	`LongTermDebtNoncurrent`	$175.46M	USD	Point-in-time
Operating lease liabilities, non-current	`OperatingLeaseLiabilityNoncurrent`	$2.71M	USD	Point-in-time
Operating lease liabilities, non-current	`OperatingLeaseLiabilityNoncurrent`	$3.20M	USD	Point-in-time
Other liabilities, long-term	`OtherLiabilitiesNoncurrent`	$1.65M	USD	Point-in-time
Other liabilities, long-term	`OtherLiabilitiesNoncurrent`	$1.63M	USD	Point-in-time
Total liabilities	`Liabilities`	$250.25M	USD	Point-in-time
Total liabilities	`Liabilities`	$219.25M	USD	Point-in-time
Commitments and contingencies (Note 14)	`CommitmentsAndContingencies`	-	USD	Point-in-time
Commitments and contingencies (Note 14)	`CommitmentsAndContingencies`	-	USD	Point-in-time
Common shares zero par value, unlimited amount of shares authorized at December 31, 2023 and 2022; 26,495,250 and 24,815,908 shares issued at December 31, 2023 and 2022, respectively; 26,087,180 and 24,407,838 shares outstanding at December 31, 2023 and 2022, respectively	`CommonStockValue`	$315.63M	USD	Point-in-time
Common shares zero par value, unlimited amount of shares authorized at December 31, 2023 and 2022; 26,495,250 and 24,815,908 shares issued at December 31, 2023 and 2022, respectively; 26,087,180 and 24,407,838 shares outstanding at December 31, 2023 and 2022, respectively	`CommonStockValue`	$223.64M	USD	Point-in-time
Additional paid-in-capital	`AdditionalPaidInCapital`	$49.91M	USD	Point-in-time
Additional paid-in-capital	`AdditionalPaidInCapital`	$63.75M	USD	Point-in-time
Treasury shares, at cost, 408,070 shares held at December 31, 2023 and 2022	`TreasuryStockCommonValue`	$2.85M	USD	Point-in-time
Treasury shares, at cost, 408,070 shares held at December 31, 2023 and 2022	`TreasuryStockCommonValue`	$2.85M	USD	Point-in-time
Accumulated deficit	`RetainedEarningsAccumulatedDeficit`	$-360.10M	USD	Point-in-time
Accumulated deficit	`RetainedEarningsAccumulatedDeficit`	$-281.59M	USD	Point-in-time
Accumulated other comprehensive income	`AccumulatedOtherComprehensiveIncomeLossNetOfTax`	$2.71M	USD	Point-in-time
Accumulated other comprehensive income	`AccumulatedOtherComprehensiveIncomeLossNetOfTax`	$1.96M	USD	Point-in-time
Total shareholders equity (deficit)	`StockholdersEquity`	$18.39M	USD	Point-in-time
Total shareholders equity (deficit)	`StockholdersEquity`	$50.74M	USD	Point-in-time
Total shareholders equity (deficit)	`StockholdersEquity`	$74.96M	USD	Point-in-time
Total shareholders equity (deficit)	`StockholdersEquity`	$-8.19M	USD	Point-in-time
Total liabilities and shareholders equity (deficit)	`LiabilitiesAndStockholdersEquity`	$211.06M	USD	Point-in-time
Total liabilities and shareholders equity (deficit)	`LiabilitiesAndStockholdersEquity`	$268.64M	USD	Point-in-time

Income Statement 57 line items

Line Item	Tag	Value	Unit	Period
Revenue	`RevenueFromContractWithCustomerExcludingAssessedTax`	$161.70M	USD	Annual
Revenue	`RevenueFromContractWithCustomerExcludingAssessedTax`	$126.68M	USD	Annual
Revenue	`RevenueFromContractWithCustomerExcludingAssessedTax`	$165.15M	USD	Annual
Cost of revenue	`CostOfRevenue`	$41.28M	USD	Annual
Cost of revenue	`CostOfRevenue`	$55.10M	USD	Annual
Cost of revenue	`CostOfRevenue`	$58.17M	USD	Annual
Gross profit	`GrossProfit`	$106.59M	USD	Annual
Gross profit	`GrossProfit`	$106.98M	USD	Annual
Gross profit	`GrossProfit`	$85.40M	USD	Annual
Sales, general and administrative	`SellingGeneralAndAdministrativeExpense`	$125.98M	USD	Annual
Sales, general and administrative	`SellingGeneralAndAdministrativeExpense`	$92.23M	USD	Annual
Sales, general and administrative	`SellingGeneralAndAdministrativeExpense`	$145.57M	USD	Annual
Research and development	`ResearchAndDevelopmentExpense`	$20.27M	USD	Annual
Research and development	`ResearchAndDevelopmentExpense`	$26.43M	USD	Annual
Research and development	`ResearchAndDevelopmentExpense`	$18.32M	USD	Annual
Total operating expenses	`OperatingExpenses`	$172.00M	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`	$-65.03M	USD	Annual
Interest income	`InvestmentIncomeInterest`	$87.00K	USD	Annual
Interest income	`InvestmentIncomeInterest`	$23.00K	USD	Annual
Interest income	`InvestmentIncomeInterest`	$1.02M	USD	Annual
Interest expense	`InterestExpense`	$11.76M	USD	Annual
Interest expense	`InterestExpense`	$9.06M	USD	Annual
Interest expense	`InterestExpense`	$15.39M	USD	Annual
Change in fair value of derivative instruments	`GainLossOnDerivativeInstrumentsNetPretax`	$737.00K	USD	Annual
Change in fair value of derivative instruments	`GainLossOnDerivativeInstrumentsNetPretax`	-	USD	Annual
Change in fair value of derivative instruments	`GainLossOnDerivativeInstrumentsNetPretax`	$703.00K	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 income (expense), net	`OtherNonoperatingIncomeExpense`	$-6.27M	USD	Annual
Other income (expense), net	`OtherNonoperatingIncomeExpense`	$-3.18M	USD	Annual
Other income (expense), net	`OtherNonoperatingIncomeExpense`	$816.00K	USD	Annual
Loss before income taxes	`IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest`	$-39.71M	USD	Annual
Loss before income taxes	`IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest`	$-78.58M	USD	Annual
Loss before income taxes	`IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest`	$-72.82M	USD	Annual
Benefit (provision) for income taxes	`IncomeTaxExpenseBenefit`	$2.38M	USD	Annual
Benefit (provision) for income taxes	`IncomeTaxExpenseBenefit`	$-81.00K	USD	Annual
Benefit (provision) for income taxes	`IncomeTaxExpenseBenefit`	$1.43M	USD	Annual
Net loss	`NetIncomeLoss`	$-75.21M	USD	Annual
Net loss	`NetIncomeLoss`	$-78.50M	USD	Annual
Net loss	`NetIncomeLoss`	$-41.14M	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`	$-3.07	USD	Annual
Basic net loss per share (in dollars per share)	`EarningsPerShareBasic`	$-3.08	USD	Annual
Diluted net loss per share (in dollars per share)	`EarningsPerShareDiluted`	$-3.07	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`	$-1.72	USD	Annual
Weighted average outstanding shares used for basic net loss per share (in shares)	`WeightedAverageNumberOfSharesOutstandingBasic`	24.46M	shares	Annual
Weighted average outstanding shares used for basic net loss per share (in shares)	`WeightedAverageNumberOfSharesOutstandingBasic`	25.60M	shares	Annual
Weighted average outstanding shares used for basic net loss per share (in shares)	`WeightedAverageNumberOfSharesOutstandingBasic`	23.97M	shares	Annual
Weighted average outstanding shares used for diluted net loss per share (in shares)	`WeightedAverageNumberOfDilutedSharesOutstanding`	23.97M	shares	Annual
Weighted average outstanding shares used for diluted net loss per share (in shares)	`WeightedAverageNumberOfDilutedSharesOutstanding`	25.60M	shares	Annual
Weighted average outstanding shares used for diluted net loss per share (in shares)	`WeightedAverageNumberOfDilutedSharesOutstanding`	24.46M	shares	Annual

Cash Flow Statement 146 line items

Line Item	Tag	Value	Unit	Period
Net loss	`NetIncomeLoss`	$-75.21M	USD	Annual
Net loss	`NetIncomeLoss`	$-78.50M	USD	Annual
Net loss	`NetIncomeLoss`	$-41.14M	USD	Annual
Depreciation and amortization	`DepreciationandAmortizationExcludingDebtDiscountPremium`	$3.87M	USD	Annual
Depreciation and amortization	`DepreciationandAmortizationExcludingDebtDiscountPremium`	$4.17M	USD	Annual
Depreciation and amortization	`DepreciationandAmortizationExcludingDebtDiscountPremium`	$3.72M	USD	Annual
Provision for doubtful accounts	`ProvisionForDoubtfulAccounts`	$200.00K	USD	Annual
Provision for doubtful accounts	`ProvisionForDoubtfulAccounts`	$111.00K	USD	Annual
Provision for doubtful accounts	`ProvisionForDoubtfulAccounts`	$1.22M	USD	Annual
Provision for inventory obsolescence	`InventoryWriteDown`	$338.00K	USD	Annual
Provision for inventory obsolescence	`InventoryWriteDown`	$1.58M	USD	Annual
Provision for inventory obsolescence	`InventoryWriteDown`	$1.39M	USD	Annual
Change in reserve for PP&E impairment	`PropertyPlantAndEquipmentWriteDown`	$341.00K	USD	Annual
Change in reserve for PP&E impairment	`PropertyPlantAndEquipmentWriteDown`	$-341.00K	USD	Annual
Change in reserve for PP&E impairment	`PropertyPlantAndEquipmentWriteDown`	-	USD	Annual
Provision for deferred income taxes	`DeferredIncomeTaxExpenseBenefit`	$-3.71M	USD	Annual
Provision for deferred income taxes	`DeferredIncomeTaxExpenseBenefit`	$86.00K	USD	Annual
Provision for deferred income taxes	`DeferredIncomeTaxExpenseBenefit`	$7.00K	USD	Annual
Share-based compensation	`ShareBasedCompensation`	$10.41M	USD	Annual
Share-based compensation	`ShareBasedCompensation`	$13.36M	USD	Annual
Share-based compensation	`ShareBasedCompensation`	$14.36M	USD	Annual
Loss from disposal of property and equipment	`GainLossOnSaleOfPropertyPlantEquipment`	$-170.00K	USD	Annual
Loss from disposal of property and equipment	`GainLossOnSaleOfPropertyPlantEquipment`	$-280.00K	USD	Annual
Loss from disposal of property and equipment	`GainLossOnSaleOfPropertyPlantEquipment`	$-229.00K	USD	Annual
Unrealized foreign currency (gain)/loss, net	`ForeignCurrencyTransactionGainLossUnrealized`	$4.18M	USD	Annual
Unrealized foreign currency (gain)/loss, net	`ForeignCurrencyTransactionGainLossUnrealized`	$-4.20M	USD	Annual
Unrealized foreign currency (gain)/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`	$717.00K	USD	Annual
Amortization of right-to-use asset	`OperatingLeaseRightOfUseAssetAmortizationExpense`	$406.00K	USD	Annual
Amortization of right-to-use asset	`OperatingLeaseRightOfUseAssetAmortizationExpense`	$469.00K	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`	$703.00K	USD	Annual
Change in fair value of derivative instruments	`UnrealizedGainLossOnDerivatives`	$737.00K	USD	Annual
Change in fair value of derivative instruments	`UnrealizedGainLossOnDerivatives`	-	USD	Annual
Stock compensation in lieu of cash fees	`StockCompensationIssuedInLieuOfCashFees`	-	USD	Annual
Stock compensation in lieu of cash fees	`StockCompensationIssuedInLieuOfCashFees`	-	USD	Annual
Stock compensation in lieu of cash fees	`StockCompensationIssuedInLieuOfCashFees`	$495.00K	USD	Annual
Interest capitalized for construction in progress	`InterestCostsCapitalizedConstructionInProgress`	-	USD	Annual
Interest capitalized for construction in progress	`InterestCostsCapitalizedConstructionInProgress`	$1.76M	USD	Annual
Interest capitalized for construction in progress	`InterestCostsCapitalizedConstructionInProgress`	$3.57M	USD	Annual
Non-cash interest expense and amortization of debt discount	`AmortizationOfFinancingCostsAndDiscounts`	$8.12M	USD	Annual
Non-cash interest expense and amortization of debt discount	`AmortizationOfFinancingCostsAndDiscounts`	$2.07M	USD	Annual
Non-cash interest expense and amortization of debt discount	`AmortizationOfFinancingCostsAndDiscounts`	$13.28M	USD	Annual
Accounts receivable	`IncreaseDecreaseInAccountsReceivable`	$6.70M	USD	Annual
Accounts receivable	`IncreaseDecreaseInAccountsReceivable`	$12.33M	USD	Annual
Accounts receivable	`IncreaseDecreaseInAccountsReceivable`	$11.56M	USD	Annual
Inventory	`IncreaseDecreaseInInventories`	$10.90M	USD	Annual
Inventory	`IncreaseDecreaseInInventories`	$7.64M	USD	Annual
Inventory	`IncreaseDecreaseInInventories`	$42.23M	USD	Annual
Prepaid expenses and other current assets	`IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets`	$1.61M	USD	Annual
Prepaid expenses and other current assets	`IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets`	$-2.64M	USD	Annual
Prepaid expenses and other current assets	`IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets`	$4.49M	USD	Annual
Other assets	`IncreaseDecreaseInOtherNoncurrentAssets`	$-90.00K	USD	Annual
Other assets	`IncreaseDecreaseInOtherNoncurrentAssets`	$750.00K	USD	Annual
Other assets	`IncreaseDecreaseInOtherNoncurrentAssets`	$-318.00K	USD	Annual
Accounts payable	`IncreaseDecreaseInAccountsPayable`	$4.96M	USD	Annual
Accounts payable	`IncreaseDecreaseInAccountsPayable`	$4.38M	USD	Annual
Accounts payable	`IncreaseDecreaseInAccountsPayable`	$18.96M	USD	Annual
Accrued liabilities	`IncreaseDecreaseInAccruedLiabilities`	$-1.66M	USD	Annual
Accrued liabilities	`IncreaseDecreaseInAccruedLiabilities`	$4.73M	USD	Annual
Accrued liabilities	`IncreaseDecreaseInAccruedLiabilities`	$2.81M	USD	Annual
Operating lease liabilities	`IncreaseDecreaseInOperatingLeaseLiabilities`	$-408.00K	USD	Annual
Operating lease liabilities	`IncreaseDecreaseInOperatingLeaseLiabilities`	$-689.00K	USD	Annual
Operating lease liabilities	`IncreaseDecreaseInOperatingLeaseLiabilities`	$-378.00K	USD	Annual
Other liabilities	`IncreaseDecreaseInOtherOperatingLiabilities`	$143.00K	USD	Annual
Other liabilities	`IncreaseDecreaseInOtherOperatingLiabilities`	$117.00K	USD	Annual
Other liabilities	`IncreaseDecreaseInOtherOperatingLiabilities`	$97.00K	USD	Annual
Net cash used in operating activities	`NetCashProvidedByUsedInOperatingActivities`	$-27.53M	USD	Annual
Net cash used in operating activities	`NetCashProvidedByUsedInOperatingActivities`	$-52.17M	USD	Annual
Net cash used in operating activities	`NetCashProvidedByUsedInOperatingActivities`	$-88.51M	USD	Annual
Purchases of property and equipment	`PaymentsToAcquirePropertyPlantAndEquipment`	$2.85M	USD	Annual
Purchases of property and equipment	`PaymentsToAcquirePropertyPlantAndEquipment`	$7.91M	USD	Annual
Purchases of property and equipment	`PaymentsToAcquirePropertyPlantAndEquipment`	$2.42M	USD	Annual
Cash used in asset acquisitions	`PaymentstoAcquireAssetsIncludingReceivablesHeld`	$434.00K	USD	Annual
Cash used in asset acquisitions	`PaymentstoAcquireAssetsIncludingReceivablesHeld`	$525.00K	USD	Annual
Cash used in asset acquisitions	`PaymentstoAcquireAssetsIncludingReceivablesHeld`	-	USD	Annual
Cost incurred for intangible assets	`PaymentsToAcquireIntangibleAssets`	$1.33M	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`	$15.31M	USD	Annual
Capital expenditures on construction in progress	`PaymentsToAcquireOtherProductiveAssets`	$2.86M	USD	Annual
Capital expenditures on construction in progress	`PaymentsToAcquireOtherProductiveAssets`	$29.92M	USD	Annual
Net cash used in investing activities	`NetCashProvidedByUsedInInvestingActivities`	$-7.16M	USD	Annual
Net cash used in investing activities	`NetCashProvidedByUsedInInvestingActivities`	$-24.55M	USD	Annual
Net cash used in investing activities	`NetCashProvidedByUsedInInvestingActivities`	$-34.79M	USD	Annual
Issuance of common stock, net of underwriters discount and issuance costs	`ProceedsFromIssuanceOfCommonStock`	-	USD	Annual
Issuance of common stock, net of underwriters discount and issuance costs	`ProceedsFromIssuanceOfCommonStock`	$84.54M	USD	Annual
Issuance of common stock, net of underwriters discount and issuance costs	`ProceedsFromIssuanceOfCommonStock`	-	USD	Annual
Borrowings under Oaktree credit agreement, net of debt discount and issuance costs	`ProceedsFromLongTermLinesOfCredit`	-	USD	Annual
Borrowings under Oaktree credit agreement, net of debt discount and issuance costs	`ProceedsFromLongTermLinesOfCredit`	-	USD	Annual
Borrowings under Oaktree credit agreement, net of debt discount and issuance costs	`ProceedsFromLongTermLinesOfCredit`	$168.09M	USD	Annual
Repayment of Madryn debt agreement	`RepaymentsOfLinesOfCredit`	-	USD	Annual
Repayment of Madryn debt agreement	`RepaymentsOfLinesOfCredit`	-	USD	Annual
Repayment of Madryn debt agreement	`RepaymentsOfLinesOfCredit`	$71.68M	USD	Annual
Repayments on finance leases	`FinanceLeasePrincipalPayments`	-	USD	Annual
Repayments on finance leases	`FinanceLeasePrincipalPayments`	$26.00K	USD	Annual
Repayments on finance leases	`FinanceLeasePrincipalPayments`	$175.00K	USD	Annual
Proceeds from stock option exercises	`ProceedsFromStockOptionsExercised`	$2.17M	USD	Annual
Proceeds from stock option exercises	`ProceedsFromStockOptionsExercised`	$3.87M	USD	Annual
Proceeds from stock option exercises	`ProceedsFromStockOptionsExercised`	$4.58M	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`	$484.00K	USD	Annual
Net cash provided by financing activities	`NetCashProvidedByUsedInFinancingActivities`	$4.05M	USD	Annual
Net cash provided by financing activities	`NetCashProvidedByUsedInFinancingActivities`	$86.23M	USD	Annual
Net cash provided by financing activities	`NetCashProvidedByUsedInFinancingActivities`	$100.25M	USD	Annual
Effect of exchange rate changes on cash and cash equivalents	`EffectOfExchangeRateOnCashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$-358.00K	USD	Annual
Effect of exchange rate changes on cash and cash equivalents	`EffectOfExchangeRateOnCashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$-465.00K	USD	Annual
Effect of exchange rate changes on cash and cash equivalents	`EffectOfExchangeRateOnCashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$513.00K	USD	Annual
Net (decrease)/increase in cash and cash equivalents	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect`	$-26.32M	USD	Annual
Net (decrease)/increase in cash and cash equivalents	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect`	$12.94M	USD	Annual
Net (decrease)/increase in cash and cash equivalents	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect`	$-31.11M	USD	Annual
Cash at beginning of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$66.36M	USD	Point-in-time
Cash at beginning of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$84.52M	USD	Point-in-time
Cash at beginning of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$40.03M	USD	Point-in-time
Cash at beginning of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$53.41M	USD	Point-in-time
Cash and cash equivalents at end of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$66.36M	USD	Point-in-time
Cash and cash equivalents at end of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$84.52M	USD	Point-in-time
Cash and cash equivalents at end of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$40.03M	USD	Point-in-time
Cash and cash equivalents at end of period	`CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents`	$53.41M	USD	Point-in-time
Cash paid for interest	`InterestPaidNet`	$5.36M	USD	Annual
Cash paid for interest	`InterestPaidNet`	$6.93M	USD	Annual
Cash paid for interest	`InterestPaidNet`	$5.69M	USD	Annual
Cash paid for income taxes	`IncomeTaxesPaidNet`	$2.17M	USD	Annual
Cash paid for income taxes	`IncomeTaxesPaidNet`	$2.12M	USD	Annual
Cash paid for income taxes	`IncomeTaxesPaidNet`	$652.00K	USD	Annual
Unpaid balance for property and equipment	`CapitalExpendituresIncurredButNotYetPaid`	$2.85M	USD	Annual
Unpaid balance for property and equipment	`CapitalExpendituresIncurredButNotYetPaid`	$1.13M	USD	Annual
Unpaid balance for property and equipment	`CapitalExpendituresIncurredButNotYetPaid`	$22.00K	USD	Annual
Unpaid balance for intangible assets	`NoncashOrPartNoncashAcquisitionIntangibleAssetsAcquired1`	-	USD	Annual
Unpaid balance for intangible assets	`NoncashOrPartNoncashAcquisitionIntangibleAssetsAcquired1`	-	USD	Annual
Unpaid balance for intangible assets	`NoncashOrPartNoncashAcquisitionIntangibleAssetsAcquired1`	$2.91M	USD	Annual
Equity consideration in an asset acquisition	`NoncashOrPartNoncashAcquisitionNoncashEquityInstrumentConsideration`	-	USD	Annual
Equity consideration in an asset acquisition	`NoncashOrPartNoncashAcquisitionNoncashEquityInstrumentConsideration`	$250.00K	USD	Annual
Equity consideration in an asset acquisition	`NoncashOrPartNoncashAcquisitionNoncashEquityInstrumentConsideration`	-	USD	Annual
Consideration payable related to asset acquisition	`NoncashConsiderationPayableRelatedtoAssetAcquisition`	-	USD	Annual
Consideration payable related to asset acquisition	`NoncashConsiderationPayableRelatedtoAssetAcquisition`	-	USD	Annual
Consideration payable related to asset acquisition	`NoncashConsiderationPayableRelatedtoAssetAcquisition`	$546.00K	USD	Annual
Cashless option exercises	`NoncashProceedsFromStockOptionsExercised`	$1.64M	USD	Annual
Cashless option exercises	`NoncashProceedsFromStockOptionsExercised`	$4.50M	USD	Annual
Cashless option exercises	`NoncashProceedsFromStockOptionsExercised`	-	USD	Annual

Stockholders Equity 37 line items

Line Item	Tag	Value	Unit	Period
Beginning balance (in shares)	`CommonStockSharesIssued`	24.82M	shares	Point-in-time
Beginning balance (in shares)	`CommonStockSharesIssued`	26.50M	shares	Point-in-time
Beginning balance	`StockholdersEquity`	$18.39M	USD	Point-in-time
Beginning balance	`StockholdersEquity`	$50.74M	USD	Point-in-time
Beginning balance	`StockholdersEquity`	$74.96M	USD	Point-in-time
Beginning balance	`StockholdersEquity`	$-8.19M	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
Warrant exercises	`StockIssuedDuringPeriodValueWarrantExercises`	-	USD	Annual
Issuance of common stock, net of underwriters discount and issuance costs	`StockIssuedDuringPeriodValueNewIssues`	$84.54M	USD	Annual
Issuance of common shares, post-IPO	`StockIssuedDuringPeriodValueIssuedAfterInitialPublicOffering`	$490.00K	USD	Annual
Issuance of common stock in lieu of cash compensation	`StockIssuedDuringPeriodValueIssuedForServices`	$255.00K	USD	Annual
Stock option exercises (in shares)	`StockIssuedDuringPeriodSharesStockOptionsExercised`	349,967.00	shares	Annual
Stock option exercises	`StockIssuedDuringPeriodValueStockOptionsExercised`	$6.67M	USD	Annual
Stock option exercises	`StockIssuedDuringPeriodValueStockOptionsExercised`	$6.08M	USD	Annual
Stock option exercises	`StockIssuedDuringPeriodValueStockOptionsExercised`	$3.87M	USD	Annual
Shares withheld to cover strike price upon cashless option exercise	`ShareBasedPaymentArrangementSharesWithheldForCashlessOptionExerciseValue`	$3.00K	USD	Annual
Share-based compensation	`StockIssuedDuringPeriodValueShareBasedCompensation`	$14.36M	USD	Annual
Share-based compensation	`StockIssuedDuringPeriodValueShareBasedCompensation`	$10.41M	USD	Annual
Share-based compensation	`StockIssuedDuringPeriodValueShareBasedCompensation`	$13.36M	USD	Annual
Shares withheld to cover income tax obligation upon vesting of restricted stock	`AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation`	$484.00K	USD	Annual
Shares withheld to cover income tax obligation upon vesting of restricted stock	`AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation`	$356.00K	USD	Annual
Shares withheld to cover income tax obligation upon vesting of restricted stock	`AdjustmentsRelatedToTaxWithholdingForShareBasedCompensation`	$4.00K	USD	Annual
Foreign currency translation gain (loss)	`OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent`	$784.00K	USD	Annual
Foreign currency translation gain (loss)	`OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent`	$-942.00K	USD	Annual
Foreign currency translation gain (loss)	`OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent`	$-752.00K	USD	Annual
Net loss	`NetIncomeLoss`	$-75.21M	USD	Annual
Net loss	`NetIncomeLoss`	$-78.50M	USD	Annual
Net loss	`NetIncomeLoss`	$-41.14M	USD	Annual
Ending balance (in shares)	`CommonStockSharesIssued`	24.82M	shares	Point-in-time
Ending balance (in shares)	`CommonStockSharesIssued`	26.50M	shares	Point-in-time
Ending balance	`StockholdersEquity`	$18.39M	USD	Point-in-time
Ending balance	`StockholdersEquity`	$50.74M	USD	Point-in-time
Ending balance	`StockholdersEquity`	$74.96M	USD	Point-in-time
Ending balance	`StockholdersEquity`	$-8.19M	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`	$-75.21M	USD	Annual
Net loss	`NetIncomeLoss`	$-78.50M	USD	Annual
Net loss	`NetIncomeLoss`	$-41.14M	USD	Annual
Foreign currency translation gain (loss)	`OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent`	$784.00K	USD	Annual
Foreign currency translation gain (loss)	`OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent`	$-942.00K	USD	Annual
Foreign currency translation gain (loss)	`OtherComprehensiveIncomeForeignCurrencyTransactionAndTranslationAdjustmentNetOfTaxPortionAttributableToParent`	$-752.00K	USD	Annual
Other comprehensive income (loss)	`OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent`	$-942.00K	USD	Annual
Other comprehensive income (loss)	`OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent`	$-752.00K	USD	Annual
Other comprehensive income (loss)	`OtherComprehensiveIncomeLossNetOfTaxPortionAttributableToParent`	$784.00K	USD	Annual
Comprehensive loss	`ComprehensiveIncomeNetOfTax`	$-40.35M	USD	Annual
Comprehensive loss	`ComprehensiveIncomeNetOfTax`	$-76.15M	USD	Annual
Comprehensive loss	`ComprehensiveIncomeNetOfTax`	$-79.25M	USD	Annual

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