0000883984-19-000035 | 10-Q | XBRL Viewer

Lessee, Operating Leases [Text Block]

Leases

Adoption of ASC Topic 842, "Lease Accounting"

We adopted ASU No. 2016-02, Leases (ASC Topic 842), effective January 1, 2019 on a modified retrospective transition method through a cumulative-effect adjustment at the beginning of the first quarter of 2019. We elected the 'package of practical expedients', which permitted us not to reassess our prior conclusions about lease identification, lease classification and initial direct costs. We did not elect the use-of-hindsight or the practical expedient pertaining to land easements; the latter not being applicable to us. We elected the short-term lease recognition exemption for all leases that qualify. This means, for those leases that qualify, we did not recognize right-of-use ("ROU") assets or lease liabilities, and this includes not recognizing ROU assets or lease liabilities for existing short-term leases of those assets in transition. Furthermore, we elected the practical expedient to not separate lease and non-lease components for all of our leases, non-lease components are primarily common area maintenance charges that we combine with the lease component when applying this ASU.

The impact of adopting this standard was the recognition of ROU assets and lease liabilities for our operating leases of $40.4 million as of January 1, 2019. The adoption of ASC 842 did not have a material impact on our consolidated earnings and had no impact on our cash flows.

Leases

We determine if an arrangement is a lease at inception. Most operating leases with a term greater than one year are included in operating lease ROU assets, accrued liabilities, and other long-term liabilities on our condensed consolidated balance sheets.

Operating lease ROU assets and operating lease liabilities are recognized based on the present value of the future minimum lease payments over the lease term at commencement date. Most of our leases do not provide an implicit rate, therefore we use our incremental borrowing rate, which is the rate incurred to borrow on a collateralized basis over a similar term based on the information available at commencement date. The operating lease ROU asset excludes lease incentives and initial direct costs incurred. Our lease terms include options to extend when it is reasonably certain that we will exercise that option. All of our operating leases have stated lease payments, which may include fixed rental increases. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term.

We have operating leases for corporate offices, sales and support offices, device service centers and certain equipment. Our leases have original lease terms of one year to fifteen years, some of which include options to extend the leases for up to an additional five years. For all of our leases, we do not include optional periods of extension in our current lease terms for the exercise of options to extend is not reasonably certain.

The following table presents the components of our lease cost (in thousands):



	For the three months ended September 30, 2019		For the nine months ended September 30, 2019
Operating lease cost	$	2,996	$	7,528

Short-term lease cost	49		229

Total lease cost	$	3,045	$	7,757

The following table presents the supplemental cash flow information related to our leases (in thousands):



	For the nine months ended September 30, 2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	7,161

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	2,495

The following table presents the supplemental balance sheet information related to our leases (in thousands, except lease term and discount rate):



	As of September 30, 2019
Operating leases
Operating lease right-of-use assets	$	35,787

Accrued liabilities	$	7,150
Other long-term liabilities	29,791
Total operating lease liabilities	$	36,941

Weighted Average Remaining Lease Term
Operating leases	6 years

Weighted Average Discount Rate
Operating leases	5.57		%

As of September 30, 2019, the maturities of our lease liabilities for each of the next five years is approximately (in thousands):



	Operating Leases
Remainder of 2019	$	2,169
2020	8,409
2021	7,060
2022	6,470
2023	6,118
Thereafter	13,569
Total Lease Payments	43,795
Less imputed interest	(6,854		)
Total	$	36,941

As of December 31, 2018, the maturities of our operating lease liabilities for each of the next five years were approximately (in thousands):



	Operating Leases
2019	$	8,326
2020	8,572
2021	6,489
2022	5,914
2023	5,615
Thereafter	13,235
Total Lease Payments⁽¹⁾	$	48,151

______________________________

⁽¹⁾The lease payment maturities as of December 31, 2018 are not calculated at present value.

During the third quarter 2019, we signed a ten-year lease for a 610,806 square foot warehouse. The commencement of the lease is not expected until the first quarter of 2020 subject to the completion of landlord buildouts which will make the space available for use. Over the ten-year lease term, we expect the lease payments to total at least $21.8 million.

Net Income Per Share:

9 Months Ended

Sep. 30, 2019

Earnings Per Share [Abstract]

Net Income Per Share [Text Block]

Net Income Per Share

Basic earnings per share is computed by dividing net income by the weighted-average number of common shares outstanding during the period. Diluted earnings per share is computed by dividing net income by the weighted-average number of common shares outstanding during the period plus dilutive securities. Dilutive securities include outstanding common stock options and unvested restricted stock units, less the number of shares that could have been purchased with the proceeds from the exercise of the options, using the treasury stock method. Options that are anti-dilutive, where their exercise price exceeds the average market price of the common stock are not included in the treasury stock method calculation. There were 20,116 and 18 anti-dilutive securities for the three months ended September 30, 2019 and 2018, respectively. There were 9,375 and 3,694 anti-dilutive securities for the nine months ended September 30, 2019 and 2018, respectively.

The following table presents the calculation of net earnings per common share (“EPS”) — basic and diluted (in thousands, except per share data):



	Three months ended September 30,				Nine months ended September 30,
	2019		2018		2019		2018
Net income	$	26,563	$	219	$	80,394	$	36,148
Weighted-average number of common shares outstanding (for basic calculation)	20,666		20,474		20,607		20,362
Dilutive securities	821		1,159		949		1,226
Weighted-average common and common equivalent shares outstanding (for diluted calculation)	21,487		21,633		21,556		21,588
EPS — basic	$	1.29	$	0.01	$	3.90	$	1.78
EPS — diluted	$	1.24	$	0.01	$	3.73	$	1.67

Derivative Financial Instruments (Notes)

9 Months Ended

Sep. 30, 2019

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Derivative Instruments and Hedging Activities Disclosure [Text Block]

Derivatives and Hedging Activities

Hedge Accounting and Hedging Program

The purpose of our hedging program is to manage the foreign currency exchange rate risk on forecasted expenses denominated in currencies other than the functional currency of the operating unit. We do not issue derivatives for trading or speculative purposes.

In May 2017, we entered into a two-year cross-currency par forward contract to hedge a portion of our Mexico forecasted expenses denominated in Pesos ("MXN"). To receive hedge accounting treatment, all hedging relationships are formally documented at the inception of the hedge, and the hedges must be highly effective in offsetting changes to future cash

flows on hedged transactions. The par forward contract is designated and qualifies as a cash flow hedge. Our derivative instrument is recorded at fair value on the condensed consolidated balance sheets and is classified based on the instrument's maturity date. We record changes in the intrinsic value of the effective portion of the gain or loss on the derivative instrument as a component of Other Comprehensive Income and we reclassify that gain or loss into earnings in the same line item associated with the forecasted transaction and in the same period during which the hedged transaction affects earnings. This contract matured May 1, 2019. This derivative instrument had a fixed forward rate of 20.01MXN/USD over the term of the contract.

In January 2018, we entered into an additional six-month cross-currency par forward contract that extends our current hedge of a portion of our Mexico forecasted expenses denominated in MXN. The total notional amount of this outstanding derivative as of September 30, 2019 was approximately 61.3 million MXN. The term of the six-month contract is May 1, 2019 to November 1, 2019. The derivative instrument matures in equal monthly amounts at a fixed forward rate of 20.43 MXN/USD over the term of the six-month contract.

In November 2018, we entered into a one-year cross-currency par forward contract again extending the hedge of a portion of our Mexico forecasted expenses denominated in MXN. The total notional amount of this outstanding derivative as of September 30, 2019 was approximately 398.0 million MXN. The term of the one-year hedge is November 1, 2019 to November 3, 2020. The derivative instrument matures in equal monthly amounts at a fixed forward rate of 22.109 MXN/USD.

The following table presents the fair values of our derivative instruments included within the Condensed Consolidated Balance Sheet as of September 30, 2019 and December 31, 2018 (in thousands):



	Derivatives
	Condensed Consolidated Balance Sheet Location	September 30, 2019		December 31, 2018
Derivatives designated as cash flow hedging instruments
Foreign exchange forward contract:
	Prepaid expenses and other current assets	$	1,300	$	187
	Other assets	279		545
Total derivatives designated as cash flow hedging instruments		$	1,579	$	732

The following table presents the amounts affecting the Condensed Consolidated Statements of Operations for the three and nine months ended September 30, 2019 and 2018 (in thousands):



	Line Item in the Condensed Consolidated Statements of Operations	Three months ended September 30,				Nine months ended September 30,
		2019		2018		2019		2018
Derivatives designated as cash flow hedging instruments
Foreign exchange forward contracts	Cost of goods sold	$	229	$	192	$	573	$	687

We recognized the following (losses) gains on our foreign exchange contracts designated as a cash flow hedge (in thousands):



	Amount of (Loss) Gain Recognized in Other Comprehensive Income on Derivatives					Amount of Gain Reclassified From Accumulated Other Comprehensive Income into Income
	Three months ended September 30,						Three months ended September 30,
	Three months ended September 30,						Three months ended September 30,
	2019			2018		Location of Gain Reclassified From Accumulated Other Comprehensive Income into Income	2019		2018
Derivatives designated as cash flow hedges:
Foreign exchange forward contract	$	(264	)	$	1,743	Cost of goods sold	$	229	$	192
Total derivatives designated as cash flow hedging instruments	$	(264	)	$	1,743		$	229	$	192



	Amount of Gain Recognized in Other Comprehensive Income on Derivatives				Amount of Gain Reclassified From Accumulated Other Comprehensive Income into Income
	Nine months ended September 30,					Nine months ended September 30,
	Nine months ended September 30,					Nine months ended September 30,
	2019		2018		Location of Gain Reclassified From Accumulated Other Comprehensive Income into Income	2019		2018
Derivatives designated as cash flow hedges:
Foreign exchange forward contract	$	1,421	$	2,256	Cost of goods sold	$	573	$	687
Total derivatives designated as cash flow hedging instruments	$	1,421	$	2,256		$	573	$	687

As of September 30, 2019, we expect approximately $1.4 million of the deferred gains on the outstanding derivatives in accumulated other comprehensive income to be reclassified to net income during the next 12 months concurrent with the underlying hedged transactions also being reported in net income.

Fair Value Measurement:

9 Months Ended

Sep. 30, 2019

Fair Value Disclosures [Abstract]

Fair Value Disclosures [Text Block]

Fair Value Measurement

Fair value is the price that would be received from selling an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. There are three levels of inputs that may be used to measure fair value:


•	Level 1: quoted prices in active markets for identical assets or liabilities;

•

Level 2: inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices in active markets for similar assets or liabilities, quoted prices for identical or similar assets or liabilities in markets that are not active, or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities; or


•	Level 3: unobservable inputs that are supported by little or no market activity and that are significant to the fair values of the assets or liabilities.

In 2017, we acquired HIS from Pfizer, and as a result of the acquisition we recognized an earn-out liability. Pfizer is entitled up to $225.0 million in cash if certain performance targets for the combined company for the three years ending December 31, 2019 are achieved. The initial value assigned to the contingent consideration was a result of forecasted product demand and operations of our business. The initial fair value of the earn-out was determined by employing a Monte Carlo simulation in a risk neutral framework. The underlying simulated variable was adjusted EBITDA. The adjusted EBITDA

volatility estimate was based on a study of historical asset volatility for a set of comparable public companies. The model includes other assumptions including the market price of risk, which was calculated as the weighted average cost of capital ("WACC") less the long-term risk free-rate. At each reporting date subsequent to the acquisition we re-measured the earn-out using the same methodology above and recognized any changes in value. If the probability of achieving the performance target significantly changes from what we initially anticipated, the change could have a significant impact on our financial statements in the period recognized. Our contingent earn-out liability is separately stated in our condensed consolidated balance sheets.

The following table provides a reconciliation of the Level 3 earn-out liability measured at estimated fair value as of December 31, 2018 to September 30, 2019 (in thousands):



	Earn-out Liability
Accrued balance, January 1, 2019	$	47,400
Change in fair value of earn-out (included in income from operations as a separate line item)	(47,400		)
Accrued balance, September 30, 2019	$	—

The fair value of the earn-out at September 30, 2019 changed from the fair value calculated at December 31, 2018 due to a change in the underlying cumulative adjusted EBITDA forecast. As of September 30, 2019, there is a remote probability that we will meet the performance targets necessary for payout of the earn-out, accordingly the liability has been reduced to zero.

The following table provides quantitative information about Level 3 inputs for fair value measurement of our earn-out liability as of December 31, 2018.



Simulation Input	As of December 31, 2018
Adjusted EBITDA Volatility	30.00	%
WACC	8.25	%
20-year risk free rate	2.87	%
Market price of risk	5.24	%
Cost of debt	5.25	%

The fair value of our investments is estimated using observable market-based inputs such as quoted prices, interest rates and yield curves or Level 2 inputs, which consisted of corporate bonds.

The fair value of our Level 2 forward currency contracts are estimated using observable market inputs such as known notional value amounts, spot and forward exchange rates. These inputs relate to liquid, heavily traded currencies with active markets which are available for the full term of the derivative.

There were no transfers between levels during the nine months ended September 30, 2019.

Our assets and liabilities measured at fair value on a recurring basis consisted of the following (Level 1, 2 and 3 inputs as defined above) (in thousands):



	Fair value measurements at September 30, 2019
	Total carrying value		Quoted prices in active markets for identical assets (level 1)		Significant other observable inputs (level 2)		Significant unobservable inputs (level 3)
Assets:
Available for sale securities:
Short-term	$	20,845	$	—	$	20,845	$	—
Long-term	—		—		—		—
Foreign exchange forwards:
Prepaid expenses and other current assets	1,300		—		1,300		—
Other assets	279		—		279		—
Total Assets	$	22,424	$	—	$	22,424	$	—



	Fair value measurements at December 31, 2018
	Total carrying value		Quoted prices in active markets for identical assets (level 1)		Significant other observable inputs (level 2)		Significant unobservable inputs (level 3)
Assets:
Available for sale securities:
Short-term	$	37,329	$	—	$	37,329	$	—
Long-term	2,025		—		2,025		—
Foreign exchange forwards:
Prepaid expenses and other current assets	187		—		187		—
Other assets	545		—		545		—
Total Assets	$	40,086	$	—	$	40,086	$	—

Liabilities:
Earn-out liability	$	47,400	$	—	$	—	$	47,400
Total Liabilities	$	47,400	$	—	$	—	$	47,400

Investments, Debt and Equity Securities [Abstract]

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Investment Securities (Notes)

9 Months Ended

Sep. 30, 2019

Investments in Debt and Marketable Equity Securities (and Certain Trading Assets) Disclosure [Text Block]

Investment Securities

Our investment securities currently consist of short-term and long-term corporate bonds. Our investment securities are considered available-for-sale and are “investment grade” and carried at fair value. Available-for-sale securities are recorded at fair value, and unrealized holding gains and losses are recorded, net of tax, as a component of accumulated other comprehensive income (loss). Unrealized losses on available-for-sale securities are charged against net earnings when a decline in fair value is determined to be other than temporary. Our management reviews several factors to determine whether a loss is other than temporary, such as the length and extent of the fair value decline, the financial condition and near term prospects of the issuer, and for equity investments, our intent and ability to hold the security for a period of time sufficient to allow for any anticipated recovery in fair value. The amortized cost of the debt securities are adjusted for the amortization of premiums computed under the effective interest method. Such amortization is included in investment income in other income on our condensed consolidated statements of operations. There have been no realized gains or losses on their disposal. Realized gains and losses are accounted for on the specific identification method. The scheduled maturities of the debt securities are between 2019 and 2020. All short-term investment securities are callable within one year.

Our short and long-term investment securities consisted of the following (in thousands):



	As of September 30, 2019
	Amortized Cost		Unrealized Holding Gains (Losses)		Fair Value
Short-term corporate bonds	$	20,845	$	—	$	20,845
Long-term corporate bonds	—		—		—
Total investment securities	$	20,845	$	—	$	20,845

	As of December 31, 2018
	Amortized Cost		Unrealized Holding Gains (Losses)		Fair Value
Short-term corporate bonds	$	37,329	$	—	$	37,329
Long-term corporate bonds	2,025		—		2,025
Total investment securities	$	39,354	$	—	$	39,354

Prepaids and Other Current Assets (Notes)

9 Months Ended

Sep. 30, 2019

Prepaid Expense and Other Assets, Current [Abstract]

Other Current Assets [Text Block]

Prepaid Expenses, Other Current Assets

Prepaid expenses and other current assets consist of the following (in thousands):



	September 30, 2019		December 31, 2018
Deposits	$	1,305	$	1,087
Other prepaid expenses and receivables	16,597		12,476
Receivables from Pfizer related to HIS business acquisition⁽¹⁾	—		20,137
Deferred costs	6,366		1,951
Prepaid insurance and property taxes	680		2,666
VAT/GST receivable	4,379		5,072
Deferred tax charge	1,180		1,180
Other	3,300		1,548
	$	33,807	$	46,117

______________________________

⁽¹⁾As of December 31, 2018, Pfizer had sold all of its shares of our common stock thereby ending its related-party relationship with us. We reclassified the December 31, 2018 related-party receivable due from Pfizer to prepaid expenses, other current assets for current year presentation purposes.

Inventories:

9 Months Ended

Sep. 30, 2019

Inventory Disclosure [Abstract]

Inventories [Text Block]

Inventories

Inventories are stated at the lower of cost or net realizable value with cost determined using the first-in, first-out method. Inventory costs consist of those costs directly attributable to products prior to sale including among other things raw material, labor and overhead. Inventories consisted of the following (in thousands)



	September 30, 2019		December 31, 2018
Raw material	$	110,954	$	104,104
Work in process	47,339		52,909
Finished goods	185,422		154,150
Total inventories	$	343,715	$	311,163

Property and Equipment:

9 Months Ended

Sep. 30, 2019

Property, Plant and Equipment [Abstract]

Property and Equipment [Text Block]

Property and Equipment

Property and equipment consisted of the following (in thousands):



	September 30, 2019			December 31, 2018
Machinery and equipment	$	213,957		$	203,431
Land, building and building improvements	228,960			212,283
Molds	59,749			59,700
Computer equipment and software	82,993			80,420
Furniture and fixtures	7,405			7,409
Instruments placed with customers⁽¹⁾	70,146			60,757
Construction in progress	85,908			70,864
Total property and equipment, cost	749,118			694,864
Accumulated depreciation	(305,031		)	(262,223		)
Property and equipment, net	$	444,087		$	432,641

______________________________

⁽¹⁾Instruments placed with customers consist of drug-delivery and monitoring systems placed with customers.

Depreciation expense was $14.8 million and $44.6 million for the three and nine months ended September 30, 2019, respectively, as compared to $15.1 million and $42.8 million for the three and nine months ended September 30, 2018, respectively.

Goodwill and Intangible Assets (Notes)

9 Months Ended

Sep. 30, 2019

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets Disclosure [Text Block]

Goodwill and Intangible Assets, Net

Goodwill

The following table presents the changes in the carrying amount of our goodwill (in thousands):



	Total
Balance as of January 1, 2019	$	11,195
Currency translation	(176		)
Balance as of September 30, 2019	$	11,019

Intangible Assets, Net

Intangible assets, carried at cost less accumulated amortization and amortized on a straight-lined basis, were as follows (in thousands):



	Weighted Average	September 30, 2019
	Amortization Life in Years	Cost		Accumulated Amortization		Net
Patents	10	$	21,736	$	13,161	$	8,575
Customer contracts ⁽¹⁾	12	9,990		5,419		4,571
Non-contractual customer relationships	9	57,602		18,413		39,189
Trademarks	4	425		425		—
Trade name	15	7,450		2,003		5,447
Developed technology	11	82,634		21,082		61,552
Total amortized intangible assets		$	179,837	$	60,503	$	119,334

IPR&D		$	12,310			$	12,310

Total intangible assets		$	192,147	$	60,503	$	131,644

______________________________

⁽¹⁾During the second quarter of 2019, we acquired certain assets from one of our distributors. We recorded $4.6 million in customer contracts related to that agreement.



	Weighted Average	December 31, 2018
	Amortization Life in Years	Cost		Accumulated Amortization		Net
Patents	10	$	19,399	$	12,147	$	7,252
Customer contracts	9	5,319		5,272		47
Non-contractual customer relationships	9	57,916		13,363		44,553
Trademarks	4	425		425		—
Trade name	15	7,456		1,618		5,838
Developed technology	11	82,857		15,361		67,496
Total amortized intangible assets		$	173,372	$	48,186	$	125,186

IPR&D		$	8,235			$	8,235

Total intangible assets		$	181,607	$	48,186	$	133,421

Intangible assets with definite lives are amortized on a straight-line basis over their estimated useful lives. During the three and nine months ended September 30, 2019, intangible asset amortization expense was $4.4 million and $12.4 million, respectively, as compared to $4.1 million and $12.2 million for the three and nine months ended September 30, 2018, respectively.

As of September 30, 2019 estimated annual amortization for our intangible assets for each of the next five years is approximately (in thousands):



Remainder of 2019	$	4,809
2020	16,669
2021	16,366
2022	16,222
2023	16,073
Thereafter	49,195
Total	$	119,334

Accrued Liabilities (Notes)

9 Months Ended

Sep. 30, 2019

Accounts Payable and Accrued Liabilities Disclosure [Text Block]

Accrued Liabilities and Other Long-Term Liabilities

Accrued liabilities consist of the following (in thousands):



	September 30, 2019		December 31, 2018
Salaries and benefits	$	28,273	$	20,538
Incentive compensation	13,026		42,913
Accrued supply chain restructuring costs	23,751		—
Operating lease liability-ST	7,150		—
Accrued product field action	1,705		5,316
Third-party inventory	—		1,089
Consigned inventory	—		1,118
Accrued sales taxes	2,134		2,941
Restructuring accrual	6,996		1,046
Deferred revenue	7,441		3,814
Accrued other taxes	3,253		3,213
Accrued professional fees	7,098		15,996
Legal accrual	621		1,400
Distribution fees	4,578		3,977
Warranties and returns	886		1,124
Accrued freight	12,108		10,953
Contract liabilities-ST	3,045		—
Contract settlement	1,667		2,083
Accrued research and development	—		1,451
Other	6,324		9,848
	$	130,056	$	128,820

Other long-term liabilities consist of the following (in thousands):



	September 30, 2019		December 31, 2018
Contract liabilities-LT	$	3,716	$	14,020
Contract settlement	417		1,667
Operating lease liability-LT	29,791		—
Benefits	763		962
Accrued rent	1,669		1,779
Deferred revenue	251		468
Other	1,007		1,696
	$	37,614	$	20,592

Income Taxes:

9 Months Ended

Sep. 30, 2019

Income Tax Disclosure [Abstract]

Income Tax Disclosure [Text Block]

Income Taxes

Income taxes were accrued at an estimated effective tax rate of 19% and 14% for the three and nine months ended September 30, 2019, respectively, as compared to 85% and (4)% for the three and nine months ended September 30, 2018, respectively.

The effective tax rate for the three and nine months ended September 30, 2019 differs from the federal statutory rate of 21% principally because of the effect of the mix of U.S. and foreign incomes, state income taxes, global intangible low-taxed income ("GILTI") and tax credits, and by the following discrete tax items recognized during the interim periods:


•	Excess tax benefits recognized on stock option exercises and the vesting of restricted stock units during the three and nine months ended September 30, 2019 of $0.3 million and $7.7 million, respectively.


•	The revaluation of the contingent consideration during the nine months ended September 30, 2019 resulted in a tax expense of $11.4 million.


•	The repatriation of certain intellectual property and assets from one of our foreign subsidiaries to the U.S. parent resulted in a net tax benefit of $3.8 million.


•	A return-to-provision adjustment for the year ended December 31, 2018 included a tax expense of $2.2 million primarily due to changes in estimates for GILTI.

The effective tax rate for the three and nine months ended September 30, 2018 differs from the federal statutory rate of 21% principally because of the effect of the mix of U.S. and foreign incomes, state income taxes and tax credits. The effective tax rate during the three and nine months ended September 30, 2018 included a discrete tax benefit of $1.6 million and $12.8 million, respectively, related to the excess tax benefits recognized on stock option exercises and the vesting of restricted stock units during the period. The effective tax rate for the nine months ended September 30, 2018 was also impacted by a contract settlement. The contract settlement resulted in a discrete tax benefit of $5.7 million.

Long-Term Obligations (Notes)	9 Months Ended
Long-Term Obligations (Notes)	Sep. 30, 2019
LOng-Term Obligations Disclosure [Abstract]
Long-term Debt [Text Block]	Long-Term Obligations Five-year Senior Secured Revolving Credit Facility ("Credit Facility") On November 8, 2017, we entered into a Credit Facility with various lenders for $150.0 million, with Wells Fargo Bank, N.A. as the administrative agent, swingline lender and issuing lender. As of September 30, 2019, we had no borrowings and $150.0 million of availability under the Credit Facility. The Credit Facility matures on November 8, 2022. Debt Covenants The Credit Facility contains certain financial covenants pertaining to Consolidated Fixed Charge Coverage and Consolidated Total Leverage Ratios. In addition, the Credit Facility has restrictions pertaining to limitations on debt, liens, negative pledges, loans, advances, acquisitions, other investments, dividends, distributions, redemptions, repurchases of equity interests, fundamental changes and asset sales and other dispositions, prepayments, redemptions and purchases of subordinated debt and other junior debt, transactions with affiliates, dividend and payment restrictions affecting subsidiaries, changes in line of business, fiscal year and accounting practices and amendment of organizational documents and junior debt documents. The Consolidated Leverage Ratio is defined as the ratio of Consolidated Total Funded Indebtedness on such date, to Consolidated Adjusted EBITDA, as defined under the Credit Facility Agreement, for the most recently completed four fiscal quarters. The maximum Consolidated Leverage Ratio is not more than 3.00 to 1.00. The Consolidated Fixed Charge Coverage Ratio is defined as the ratio of: (a) Consolidated Adjusted EBITDA less the sum of (i) capital expenditures, (ii) federal, state, local and foreign income taxes paid in cash and (iii) cash restricted payments made after the closing date, to (b) Consolidated Fixed Charges for the most recently completed four fiscal quarters, calculated on a pro forma basis. The minimum Consolidated Fixed Charge Coverage Ratio is 2.00 to 1.00. We were in compliance with all financial covenants as of September 30, 2019.

Stockholders' Equity (Notes)

9 Months Ended

Sep. 30, 2019

Stockholders' Equity Attributable to Parent [Abstract]

Stockholders' Equity Note Disclosure [Text Block]

Stockholders' Equity

Treasury Stock

In August 2019, our Board of Directors approved a new share purchase plan to purchase up to $100.0 million of our common stock. This plan replaced our existing plan and has no expiration date. During the nine months ended September 30, 2019, we did not purchase any shares of our common stock under our stock purchase plans. As of September 30, 2019, all of the $100.0 million available for purchase was remaining under the plan. We are currently limited on share purchases in accordance with the terms and conditions of our Credit Facility (see Note 16: Long-Term Obligations).

For the nine months ended September 30, 2019, we withheld 79,313 shares of our common stock from employee vested restricted stock units in consideration for $18.5 million in payments made on the employee's behalf for their minimum statutory income tax withholding obligations. Treasury stock is used to issue shares for stock option exercises, restricted stock grants and employee stock purchase plan stock purchases.

Accumulated Other Comprehensive Income (Loss)

The components of accumulated other comprehensive income ("AOCI"), net of tax, were as follows (in thousands):



	Foreign Currency Translation Adjustments			Unrealized Gains on Cash Flow Hedges			Other Adjustments		Total
Balance as of January 1, 2019	$	(17,682	)	$	638		$	99	$	(16,945	)
Other comprehensive (loss) income before reclassifications	(1,592		)	768			6		(818		)
Amounts reclassified from AOCI	—			(118		)	—		(118		)
Other comprehensive (loss) income	(1,592		)	650			6		(936		)
Balance as of March 31, 2019	$	(19,274	)	$	1,288		$	105	$	(17,881	)
Other comprehensive income before reclassifications	2,838			513			—		3,351
Amounts reclassified from AOCI	—			(144		)	—		(144		)
Other comprehensive income	2,838			369			—		3,207
Balance as of June 30, 2019	$	(16,436	)	$	1,657		$	105	$	(14,674	)
Other comprehensive loss before reclassifications	(7,533		)	(201		)	—		(7,734		)
Amounts reclassified from AOCI	—			(174		)	—		(174		)
Other comprehensive loss	(7,533		)	(375		)	—		(7,908		)
Balance as of September 30, 2019	$	(23,969	)	$	1,282		$	105	$	(22,582	)



	Foreign Currency Translation Adjustments			Unrealized Gains on Cash Flow Hedges			Other Adjustments			Total
Balance as of January 1, 2018	$	(14,578	)	$	(365	)	$	(16	)	$	(14,959	)
Other comprehensive income before reclassifications	15,397			1,993			2			17,392
Amounts reclassified from AOCI	—			(179		)	—			(179		)
Other comprehensive (loss) income	15,397			1,814			2			17,213
Balance as of March 31, 2018	$	819		$	1,449		$	(14	)	$	2,254
Other comprehensive income before reclassifications	(17,687		)	(1,602		)	3			(19,286		)
Amounts reclassified from AOCI	—			(198		)	—			(198		)
Other comprehensive (loss) income	(17,687		)	(1,800		)	3			(19,484		)
Balance as of June 30, 2018	$	(16,868	)	$	(351	)	$	(11	)	$	(17,230	)
Other comprehensive income before reclassifications	(5,415		)	1,323			6			(4,086		)
Amounts reclassified from AOCI	—			(145		)	—			(145		)
Other comprehensive (loss) income	(5,415		)	1,178			6			(4,231		)
Balance as of September 30, 2018	$	(22,283	)	$	827		$	(5	)	$	(21,461	)

Commitments and Contingencies:	9 Months Ended
Commitments and Contingencies:	Sep. 30, 2019
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies [Text Block]	Commitments and Contingencies Legal Proceedings Beginning in November 2016, purported class actions were filed in the U.S. District Court for the Northern District of Illinois against Pfizer, Inc. subsidiaries, Hospira, Inc., Hospira Worldwide, Inc. and certain other defendants relating to the intravenous saline solutions part of the HIS business. Plaintiffs seek to represent classes consisting of all persons and entities in the U.S. who directly purchased intravenous saline solution sold by any of the defendants from January 1, 2013 until the time the defendants’ allegedly unlawful conduct ceases. Plaintiffs allege that U.S. manufacturer defendants conspired together to restrict output and artificially fix, raise, maintain and/or stabilize the prices of intravenous saline solution sold throughout the U.S. in violation of federal antitrust laws. Plaintiffs seek treble damages (for themselves and on behalf of the putative classes) and an injunction against defendants for alleged price overcharges for intravenous saline solution in the U.S. since January 1, 2013. On July 5, 2018, the District Court granted defendants’ motion to dismiss the operative complaint for failing to state a valid antitrust claim, but allowed the plaintiffs to file a second amended complaint. On September 6, 2018, plaintiffs filed a second amended complaint adding new allegations in support of their conspiracy claims and adding ICU as a defendant. All defendants have filed a motion to dismiss this second amended complaint. Briefing is complete and we are awaiting the Court's ruling. On February 3, 2017, we completed the acquisition of the HIS business from Pfizer. This litigation is the subject of a claim for indemnification against us by Pfizer and a cross-claim for indemnification against Pfizer by us under the HIS stock and asset purchase agreement. In addition, in August 2015, the New York Attorney General issued a subpoena to Hospira, Inc. requesting that the company provide information regarding certain business practices in the intravenous solutions part of the HIS business. Separately, in April 2017, we received a grand jury subpoena issued by the United States District Court for the Eastern District of Pennsylvania, in connection with an investigation by the U.S. Department of Justice, Antitrust Division. The subpoenas call for production of documents related to the manufacturing, selling, pricing and shortages of intravenous solutions, including saline, as well as communications among market participants regarding these issues. On December 10, 2018, we were informed by the U.S. Department of Justice, Antitrust Division, that their investigation has been closed. In April 2018, the U.S. Department of Justice issued a HIPAA subpoena to Hospira, Inc., requesting production of documents and records regarding the manufacturing, production, testing, quality and validation of the Sapphire™ infusion pumps, sets and related accessories distributed by the company. We have coordinated with Pfizer to produce the requested records to the Department of Justice. In March 2018, a dispute with a product partner resulted in a redefinition of our contractual arrangement and in the rights and remedies determined under such arrangement. The resolution of the dispute resulted in a $28.9 million net charge to the condensed consolidated statement of operations. In addition, during the fourth quarter of 2018, we incurred $12.7 million in additional contract settlement charges related to this arrangement as a result of the write-off of assets and additional expenses associated with the restructuring of products. From time to time, we are involved in various legal proceedings, most of which are routine litigation, in the normal course of business. Our management does not believe that the resolution of the unsettled legal proceedings that we are involved with will have a material adverse impact on our financial position or results of operations. Off-Balance Sheet Arrangements In the normal course of business, we have agreed to indemnify our officers and directors to the maximum extent permitted under Delaware law and to indemnify customers as to certain intellectual property matters or other matters related to sales of our products. There is no maximum limit on the indemnification that may be required under these agreements. Although we can provide no assurances, we have never incurred, nor do we expect to incur, any material liability for indemnification. Contingencies We have a contractual earn-out arrangement in connection with our acquisition of the HIS business, whereby Pfizer may be entitled up to an additional $225.0 million in cash upon achievement of certain performance targets for the company for the three years ending December 31, 2019 (see Note 8: Fair Value Measurement). As of September 30, 2019, there is a remote probability that we will meet the performance targets by December 31, 2019, accordingly the estimated fair value of the contingent earn-out as of September 30, 2019 has been reduced to zero. Commitments We have non-cancellable operating lease agreements where we are contractually obligated to pay certain lease payment amounts (see Note 5: Leases).

Collaborative and Other Arrangements (Notes)	9 Months Ended
Collaborative and Other Arrangements (Notes)	Sep. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Collaborative Arrangement Disclosure [Text Block]	Collaborative and Other Arrangements On February 3, 2017, we entered into two Manufacturing and Supply Agreements ("MSAs"), (i) whereby Pfizer will manufacture and supply us with certain agreed upon products for an initial five-year term with a one-time two-year option to extend and (ii) whereby we will manufacture and supply Pfizer certain agreed upon products for a term of five or ten years depending on the product, also with a one-time two-year option to extend. The MSAs provide each party with mutually beneficial interests and both of the MSAs are to be jointly managed by both Pfizer and ICU. The initial supply price, which will be annually updated, is in full consideration for all costs associated with the manufacture, documentation, packaging and certification of the products.

Subsequent Event (Notes)	9 Months Ended
Subsequent Event (Notes)	Sep. 30, 2019
Subsequent Events [Abstract]
Subsequent Events [Text Block]	Subsequent Events On November, 8 2019, we acquired Pursuit Vascular, Inc. for approximately $75.0 million in cash and a potential contingent earn-out of up to $50.0 million.

Restructuring, Strategic Transaction and Integration (Tables)

9 Months Ended

Sep. 30, 2019

Restructuring, Strategic Transaction and Integration [Abstract]

Restructuring and Related Costs [Table Text Block]

The following table summarizes the details of changes in our restructuring-related accrual for the period ended September 30, 2019 (in thousands):



	Accrued Balance January 1, 2019		Charges Incurred		Payments			Accrued Balance September 30, 2019
Severance pay and benefits	$	677	$	5,349	$	(1,900	)	$	4,126
Employment agreement buyout	739		—		(279		)	460
Facility closure expenses	—		3,095		(595		)	2,500
	$	1,416	$	8,444	$	(2,774	)	$	7,086

Revenue (Tables)

9 Months Ended

Sep. 30, 2019

Revenue from Contract with Customer [Abstract]

Disaggregation of Revenue [Table Text Block]

The following table represents our revenues disaggregated by geography (in thousands):



	For the three months ended September 30,				For the nine months ended September 30,
Geography	2019		2018		2019		2018
Europe, the Middle East and Africa	$	31,474	$	30,759	$	96,830	$	104,150
Other Foreign	53,398		51,569		156,353		154,278
Total Foreign	84,872		82,328		253,183		258,428
United States	222,599		244,841		697,502		801,234
Total Revenues	$	307,471	$	327,169	$	950,685	$	1,059,662

The following table represents our revenues disaggregated by product (in thousands):



	For the three months ended September 30,				For the nine months ended September 30,
Product line	2019		2018		2019		2018
Infusion Consumables	$	119,745	$	117,797	$	357,994	$	361,490
IV Solutions	98,159		114,433		313,976		394,198
Infusion Systems	78,932		81,456		244,523		263,271
Critical Care	10,635		13,483		34,192		40,703
Total Revenues	$	307,471	$	327,169	$	950,685	$	1,059,662

Contract with Customer, Asset and Liability [Table Text Block]

The following table presents our changes in the contract balances for the nine months ended September 30, 2019 and 2018 (in thousands):



	Contract Liabilities
Beginning balance, January 1, 2019	$	(4,282	)
Equipment revenue recognized	3,619
Equipment revenue deferred due to implementation	(6,869		)
Software revenue recognized	2,955
Software revenue deferred due to implementation	(3,115		)
Ending balance, September 30, 2019	$	(7,692	)

Beginning balance, January 1, 2018	$	(7,066	)
Equipment revenue recognized	3,136
Equipment revenue deferred due to implementation	(4,086		)
Software revenue recognized	5,649
Software revenue deferred due to implementation	(5,507		)
Ending balance, September 30, 2018	$	(7,874	)

Leases (Tables)

9 Months Ended

Sep. 30, 2019

Lease, Cost [Table Text Block]

The following table presents the components of our lease cost (in thousands):



	For the three months ended September 30, 2019		For the nine months ended September 30, 2019
Operating lease cost	$	2,996	$	7,528

Short-term lease cost	49		229

Total lease cost	$	3,045	$	7,757

Leases Supplemental Cash Flow (Tables)

9 Months Ended

Sep. 30, 2019

Cash Flow, Supplemental Disclosures [Text Block]

The following table presents the supplemental cash flow information related to our leases (in thousands):



	For the nine months ended September 30, 2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	7,161

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	2,495

Leases Supplemental Balance Sheet (Tables)

9 Months Ended

Sep. 30, 2019

Assets and Liabilities, Leases [Table Text Block]

The following table presents the supplemental balance sheet information related to our leases (in thousands, except lease term and discount rate):



	As of September 30, 2019
Operating leases
Operating lease right-of-use assets	$	35,787

Accrued liabilities	$	7,150
Other long-term liabilities	29,791
Total operating lease liabilities	$	36,941

Weighted Average Remaining Lease Term
Operating leases	6 years

Weighted Average Discount Rate
Operating leases	5.57		%

Leases Maturity (Tables)

9 Months Ended

Sep. 30, 2019

Lessee, Operating Lease, Liability, Maturity [Table Text Block]

As of September 30, 2019, the maturities of our lease liabilities for each of the next five years is approximately (in thousands):



	Operating Leases
Remainder of 2019	$	2,169
2020	8,409
2021	7,060
2022	6,470
2023	6,118
Thereafter	13,569
Total Lease Payments	43,795
Less imputed interest	(6,854		)
Total	$	36,941

As of December 31, 2018, the maturities of our operating lease liabilities for each of the next five years were approximately (in thousands):



	Operating Leases
2019	$	8,326
2020	8,572
2021	6,489
2022	5,914
2023	5,615
Thereafter	13,235
Total Lease Payments⁽¹⁾	$	48,151

______________________________

⁽¹⁾The lease payment maturities as of December 31, 2018 are not calculated at present value.

Net Income Per Share (Tables)

9 Months Ended

Sep. 30, 2019

Earnings Per Share [Abstract]

Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]

The following table presents the calculation of net earnings per common share (“EPS”) — basic and diluted (in thousands, except per share data):



	Three months ended September 30,				Nine months ended September 30,
	2019		2018		2019		2018
Net income	$	26,563	$	219	$	80,394	$	36,148
Weighted-average number of common shares outstanding (for basic calculation)	20,666		20,474		20,607		20,362
Dilutive securities	821		1,159		949		1,226
Weighted-average common and common equivalent shares outstanding (for diluted calculation)	21,487		21,633		21,556		21,588
EPS — basic	$	1.29	$	0.01	$	3.90	$	1.78
EPS — diluted	$	1.24	$	0.01	$	3.73	$	1.67

Derivative Financial Instruments (Tables)

9 Months Ended

Sep. 30, 2019

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Schedule of Cash Flow Hedging Instruments, Statements of Financial Performance and Financial Position, Location [Table Text Block]

The following table presents the fair values of our derivative instruments included within the Condensed Consolidated Balance Sheet as of September 30, 2019 and December 31, 2018 (in thousands):



	Derivatives
	Condensed Consolidated Balance Sheet Location	September 30, 2019		December 31, 2018
Derivatives designated as cash flow hedging instruments
Foreign exchange forward contract:
	Prepaid expenses and other current assets	$	1,300	$	187
	Other assets	279		545
Total derivatives designated as cash flow hedging instruments		$	1,579	$	732

The following table presents the amounts affecting the Condensed Consolidated Statements of Operations for the three and nine months ended September 30, 2019 and 2018 (in thousands):



	Line Item in the Condensed Consolidated Statements of Operations	Three months ended September 30,				Nine months ended September 30,
		2019		2018		2019		2018
Derivatives designated as cash flow hedging instruments
Foreign exchange forward contracts	Cost of goods sold	$	229	$	192	$	573	$	687

Schedule of Cash Flow Hedges Included in Accumulated Other Comprehensive Income (Loss) [Table Text Block]

We recognized the following (losses) gains on our foreign exchange contracts designated as a cash flow hedge (in thousands):



	Amount of (Loss) Gain Recognized in Other Comprehensive Income on Derivatives					Amount of Gain Reclassified From Accumulated Other Comprehensive Income into Income
	Three months ended September 30,						Three months ended September 30,
	Three months ended September 30,						Three months ended September 30,
	2019			2018		Location of Gain Reclassified From Accumulated Other Comprehensive Income into Income	2019		2018
Derivatives designated as cash flow hedges:
Foreign exchange forward contract	$	(264	)	$	1,743	Cost of goods sold	$	229	$	192
Total derivatives designated as cash flow hedging instruments	$	(264	)	$	1,743		$	229	$	192



	Amount of Gain Recognized in Other Comprehensive Income on Derivatives				Amount of Gain Reclassified From Accumulated Other Comprehensive Income into Income
	Nine months ended September 30,					Nine months ended September 30,
	Nine months ended September 30,					Nine months ended September 30,
	2019		2018		Location of Gain Reclassified From Accumulated Other Comprehensive Income into Income	2019		2018
Derivatives designated as cash flow hedges:
Foreign exchange forward contract	$	1,421	$	2,256	Cost of goods sold	$	573	$	687
Total derivatives designated as cash flow hedging instruments	$	1,421	$	2,256		$	573	$	687

Fair Value Measurement (Tables)

9 Months Ended

Sep. 30, 2019

Fair Value Disclosures [Abstract]

Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block]

The following table provides a reconciliation of the Level 3 earn-out liability measured at estimated fair value as of December 31, 2018 to September 30, 2019 (in thousands):



	Earn-out Liability
Accrued balance, January 1, 2019	$	47,400
Change in fair value of earn-out (included in income from operations as a separate line item)	(47,400		)
Accrued balance, September 30, 2019	$	—

Fair Value Measurement Inputs and Valuation Techniques [Table Text Block]

The following table provides quantitative information about Level 3 inputs for fair value measurement of our earn-out liability as of December 31, 2018.



Simulation Input	As of December 31, 2018
Adjusted EBITDA Volatility	30.00	%
WACC	8.25	%
20-year risk free rate	2.87	%
Market price of risk	5.24	%
Cost of debt	5.25	%

Fair Value, Assets Measured on Recurring Basis [Table Text Block]

Our assets and liabilities measured at fair value on a recurring basis consisted of the following (Level 1, 2 and 3 inputs as defined above) (in thousands):



	Fair value measurements at September 30, 2019
	Total carrying value		Quoted prices in active markets for identical assets (level 1)		Significant other observable inputs (level 2)		Significant unobservable inputs (level 3)
Assets:
Available for sale securities:
Short-term	$	20,845	$	—	$	20,845	$	—
Long-term	—		—		—		—
Foreign exchange forwards:
Prepaid expenses and other current assets	1,300		—		1,300		—
Other assets	279		—		279		—
Total Assets	$	22,424	$	—	$	22,424	$	—



	Fair value measurements at December 31, 2018
	Total carrying value		Quoted prices in active markets for identical assets (level 1)		Significant other observable inputs (level 2)		Significant unobservable inputs (level 3)
Assets:
Available for sale securities:
Short-term	$	37,329	$	—	$	37,329	$	—
Long-term	2,025		—		2,025		—
Foreign exchange forwards:
Prepaid expenses and other current assets	187		—		187		—
Other assets	545		—		545		—
Total Assets	$	40,086	$	—	$	40,086	$	—

Liabilities:
Earn-out liability	$	47,400	$	—	$	—	$	47,400
Total Liabilities	$	47,400	$	—	$	—	$	47,400

Investment Securities (Tables)

9 Months Ended

Sep. 30, 2019

Investments, Debt and Equity Securities [Abstract]

Available-for-sale Securities [Table Text Block]

Our short and long-term investment securities consisted of the following (in thousands):



	As of September 30, 2019
	Amortized Cost		Unrealized Holding Gains (Losses)		Fair Value
Short-term corporate bonds	$	20,845	$	—	$	20,845
Long-term corporate bonds	—		—		—
Total investment securities	$	20,845	$	—	$	20,845

	As of December 31, 2018
	Amortized Cost		Unrealized Holding Gains (Losses)		Fair Value
Short-term corporate bonds	$	37,329	$	—	$	37,329
Long-term corporate bonds	2,025		—		2,025
Total investment securities	$	39,354	$	—	$	39,354

Prepaids and Other Current Assets (Tables)

9 Months Ended

Sep. 30, 2019

Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Table Text Block]

Prepaid expenses and other current assets consist of the following (in thousands):



	September 30, 2019		December 31, 2018
Deposits	$	1,305	$	1,087
Other prepaid expenses and receivables	16,597		12,476
Receivables from Pfizer related to HIS business acquisition⁽¹⁾	—		20,137
Deferred costs	6,366		1,951
Prepaid insurance and property taxes	680		2,666
VAT/GST receivable	4,379		5,072
Deferred tax charge	1,180		1,180
Other	3,300		1,548
	$	33,807	$	46,117

Inventories (Tables)

9 Months Ended

Sep. 30, 2019

Inventory Disclosure [Abstract]

Schedule of Inventory, Current [Table Text Block]



	September 30, 2019		December 31, 2018
Raw material	$	110,954	$	104,104
Work in process	47,339		52,909
Finished goods	185,422		154,150
Total inventories	$	343,715	$	311,163

Property and Equipment (Tables)

9 Months Ended

Sep. 30, 2019

Property, Plant and Equipment [Abstract]

Property, Plant and Equipment [Table Text Block]

Property and equipment consisted of the following (in thousands):



	September 30, 2019			December 31, 2018
Machinery and equipment	$	213,957		$	203,431
Land, building and building improvements	228,960			212,283
Molds	59,749			59,700
Computer equipment and software	82,993			80,420
Furniture and fixtures	7,405			7,409
Instruments placed with customers⁽¹⁾	70,146			60,757
Construction in progress	85,908			70,864
Total property and equipment, cost	749,118			694,864
Accumulated depreciation	(305,031		)	(262,223		)
Property and equipment, net	$	444,087		$	432,641

Goodwill and Intangible Assets (Tables)

9 Months Ended

Sep. 30, 2019

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Goodwill [Table Text Block]

The following table presents the changes in the carrying amount of our goodwill (in thousands):



	Total
Balance as of January 1, 2019	$	11,195
Currency translation	(176		)
Balance as of September 30, 2019	$	11,019

Schedule of Intangible Assets and Goodwill [Table Text Block]

Intangible assets, carried at cost less accumulated amortization and amortized on a straight-lined basis, were as follows (in thousands):



	Weighted Average	September 30, 2019
	Amortization Life in Years	Cost		Accumulated Amortization		Net
Patents	10	$	21,736	$	13,161	$	8,575
Customer contracts ⁽¹⁾	12	9,990		5,419		4,571
Non-contractual customer relationships	9	57,602		18,413		39,189
Trademarks	4	425		425		—
Trade name	15	7,450		2,003		5,447
Developed technology	11	82,634		21,082		61,552
Total amortized intangible assets		$	179,837	$	60,503	$	119,334

IPR&D		$	12,310			$	12,310

Total intangible assets		$	192,147	$	60,503	$	131,644

______________________________

⁽¹⁾During the second quarter of 2019, we acquired certain assets from one of our distributors. We recorded $4.6 million in customer contracts related to that agreement.



	Weighted Average	December 31, 2018
	Amortization Life in Years	Cost		Accumulated Amortization		Net
Patents	10	$	19,399	$	12,147	$	7,252
Customer contracts	9	5,319		5,272		47
Non-contractual customer relationships	9	57,916		13,363		44,553
Trademarks	4	425		425		—
Trade name	15	7,456		1,618		5,838
Developed technology	11	82,857		15,361		67,496
Total amortized intangible assets		$	173,372	$	48,186	$	125,186

IPR&D		$	8,235			$	8,235

Total intangible assets		$	181,607	$	48,186	$	133,421

Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]

As of September 30, 2019 estimated annual amortization for our intangible assets for each of the next five years is approximately (in thousands):



Remainder of 2019	$	4,809
2020	16,669
2021	16,366
2022	16,222
2023	16,073
Thereafter	49,195
Total	$	119,334

Accrued Liabilities (Tables)

9 Months Ended

Sep. 30, 2019

Schedule of Accrued Liabilities [Table Text Block]

Accrued liabilities consist of the following (in thousands):



	September 30, 2019		December 31, 2018
Salaries and benefits	$	28,273	$	20,538
Incentive compensation	13,026		42,913
Accrued supply chain restructuring costs	23,751		—
Operating lease liability-ST	7,150		—
Accrued product field action	1,705		5,316
Third-party inventory	—		1,089
Consigned inventory	—		1,118
Accrued sales taxes	2,134		2,941
Restructuring accrual	6,996		1,046
Deferred revenue	7,441		3,814
Accrued other taxes	3,253		3,213
Accrued professional fees	7,098		15,996
Legal accrual	621		1,400
Distribution fees	4,578		3,977
Warranties and returns	886		1,124
Accrued freight	12,108		10,953
Contract liabilities-ST	3,045		—
Contract settlement	1,667		2,083
Accrued research and development	—		1,451
Other	6,324		9,848
	$	130,056	$	128,820

Other long-term liabilities consist of the following (in thousands):



	September 30, 2019		December 31, 2018
Contract liabilities-LT	$	3,716	$	14,020
Contract settlement	417		1,667
Operating lease liability-LT	29,791		—
Benefits	763		962
Accrued rent	1,669		1,779
Deferred revenue	251		468
Other	1,007		1,696
	$	37,614	$	20,592

Stockholders' Equity (Tables)

9 Months Ended

Sep. 30, 2019

Stockholders' Equity Attributable to Parent [Abstract]

Schedule of Accumulated Other Comprehensive Income (Loss) [Table Text Block]

The components of accumulated other comprehensive income ("AOCI"), net of tax, were as follows (in thousands):



	Foreign Currency Translation Adjustments			Unrealized Gains on Cash Flow Hedges			Other Adjustments		Total
Balance as of January 1, 2019	$	(17,682	)	$	638		$	99	$	(16,945	)
Other comprehensive (loss) income before reclassifications	(1,592		)	768			6		(818		)
Amounts reclassified from AOCI	—			(118		)	—		(118		)
Other comprehensive (loss) income	(1,592		)	650			6		(936		)
Balance as of March 31, 2019	$	(19,274	)	$	1,288		$	105	$	(17,881	)
Other comprehensive income before reclassifications	2,838			513			—		3,351
Amounts reclassified from AOCI	—			(144		)	—		(144		)
Other comprehensive income	2,838			369			—		3,207
Balance as of June 30, 2019	$	(16,436	)	$	1,657		$	105	$	(14,674	)
Other comprehensive loss before reclassifications	(7,533		)	(201		)	—		(7,734		)
Amounts reclassified from AOCI	—			(174		)	—		(174		)
Other comprehensive loss	(7,533		)	(375		)	—		(7,908		)
Balance as of September 30, 2019	$	(23,969	)	$	1,282		$	105	$	(22,582	)



	Foreign Currency Translation Adjustments			Unrealized Gains on Cash Flow Hedges			Other Adjustments			Total
Balance as of January 1, 2018	$	(14,578	)	$	(365	)	$	(16	)	$	(14,959	)
Other comprehensive income before reclassifications	15,397			1,993			2			17,392
Amounts reclassified from AOCI	—			(179		)	—			(179		)
Other comprehensive (loss) income	15,397			1,814			2			17,213
Balance as of March 31, 2018	$	819		$	1,449		$	(14	)	$	2,254
Other comprehensive income before reclassifications	(17,687		)	(1,602		)	3			(19,286		)
Amounts reclassified from AOCI	—			(198		)	—			(198		)
Other comprehensive (loss) income	(17,687		)	(1,800		)	3			(19,484		)
Balance as of June 30, 2018	$	(16,868	)	$	(351	)	$	(11	)	$	(17,230	)
Other comprehensive income before reclassifications	(5,415		)	1,323			6			(4,086		)
Amounts reclassified from AOCI	—			(145		)	—			(145		)
Other comprehensive (loss) income	(5,415		)	1,178			6			(4,231		)
Balance as of September 30, 2018	$	(22,283	)	$	827		$	(5	)	$	(21,461	)

Restructuring, Strategic Transaction and Integration Restructuring, Strategic Transaction and Integration (Details) - USD ($)
$ in Millions

3 Months Ended

9 Months Ended

Sep. 30, 2019

Sep. 30, 2018

Sep. 30, 2019

Sep. 30, 2018

Restructuring and Related Activities [Abstract]

Restructuring, Impairment, and Other Activities Disclosure [Text Block]

Restructuring, Strategic Transaction and Integration

Restructuring and strategic transaction and integration expenses were $8.0 million and $69.4 million for the three and nine months ended September 30, 2019, respectively, as compared to $24.0 million and $64.3 million for the three and nine months ended September 30, 2018, respectively.

Restructuring

During the three and nine months ended September 30, 2019, restructuring charges were $0.8 million and $8.4 million, respectively, primarily related to severance and facility closure costs. These charges are primarily related to a one-time charge to move our U.S. pump service depot to our existing Salt Lake City facility and other plant restructuring. Restructuring charges are included in the restructuring, strategic transaction and integration line item in our condensed consolidated statement of operations.

During the year ended December 31, 2015, we incurred restructuring charges related to an agreement with Dr. Lopez, a member of our Board of Directors and a former employee in our research and development department, pursuant to which we bought out Dr. Lopez's right to employment under his then-existing employment agreement. The buy-out, including payroll taxes, is paid in equal monthly installments until December 2020.

The following table summarizes the details of changes in our restructuring-related accrual for the period ended September 30, 2019 (in thousands):



	Accrued Balance January 1, 2019		Charges Incurred		Payments			Accrued Balance September 30, 2019
Severance pay and benefits	$	677	$	5,349	$	(1,900	)	$	4,126
Employment agreement buyout	739		—		(279		)	460
Facility closure expenses	—		3,095		(595		)	2,500
	$	1,416	$	8,444	$	(2,774	)	$	7,086

Strategic transaction and integration expenses

We incurred and expensed $7.2 million and $61.0 million in strategic transaction and integration expenses during the three and nine months ended September 30, 2019, respectively, as compared to $23.5 million and $61.3 million during the three and nine months ended September 30, 2018, respectively. The strategic transaction and integration expenses during the three months ended September 30, 2019 and the three and nine months ended September 30, 2018 were primarily related to the integration of the Hospira Infusion Systems ("HIS") business acquired in 2017 from Pfizer. The nine months ended September 30, 2019 also included a one-time strategic supply chain restructuring charge of $22.1 million, which reduces our contracted commitments to our third party manufacturer and charges related to our Pfizer separation costs and clean-up, which included a $12.7 million non-cash write-off of related assets.

Restructuring, strategic transaction and integration

$ 8.0

$ 24.0

$ 69.4

$ 64.3

Restructuring Costs

$ 0.8

$ 8.4

Restructuring, Strategic Transaction and Integration (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2019 USD ($)
Restructuring Cost and Reserve [Line Items]
Restructuring Reserve	$ 1,416
Restructuring Charges	8,444
Payments for Restructuring	2,774
Restructuring Reserve	7,086
Employee Severance [Member]
Restructuring Cost and Reserve [Line Items]
Restructuring Reserve	677
Restructuring Charges	5,349
Payments for Restructuring	1,900
Restructuring Reserve	4,126
Special Termination Benefits [Member]
Restructuring Cost and Reserve [Line Items]
Restructuring Reserve	739
Restructuring Charges	0
Payments for Restructuring	279
Restructuring Reserve	460
Facility Closing [Member]
Restructuring Cost and Reserve [Line Items]
Restructuring Reserve	0
Restructuring Charges	3,095
Payments for Restructuring	595
Restructuring Reserve	$ 2,500

Restructuring, Strategic Transaction and Integration Strategic Transaction and Integration (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Restructuring and Related Activities [Abstract]
Strategic Transaction and Integration	$ 7.2	$ 23.5	$ 61.0	$ 61.3
Supplychainrestructuringcosts			22.1
Cleanupcosts			$ 12.7

Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
Revenue (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Disaggregation of Revenue [Line Items]
Revenues	$ 307,471	$ 327,169	$ 950,685	$ 1,059,662
Infusion Systems [Member]
Disaggregation of Revenue [Line Items]
Revenues	78,932	$ 81,456	244,523	$ 263,271
Equipment revenue [Member]
Disaggregation of Revenue [Line Items]
Revenue, Remaining Performance Obligation, Amount	6,300		6,300
Software revenue [Member]
Disaggregation of Revenue [Line Items]
Revenue, Remaining Performance Obligation, Amount	$ 1,400		$ 1,400

Revenue Disaggregated Revenue by Geography (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Disaggregation of Revenue [Line Items]
Revenues	$ 307,471	$ 327,169	$ 950,685	$ 1,059,662
EMEA [Member]
Disaggregation of Revenue [Line Items]
Revenues	31,474	30,759	96,830	104,150
Other foreign countries [Member]
Disaggregation of Revenue [Line Items]
Revenues	53,398	51,569	156,353	154,278
Foreign [Member]
Disaggregation of Revenue [Line Items]
Revenues	84,872	82,328	253,183	258,428
UNITED STATES
Disaggregation of Revenue [Line Items]
Revenues	$ 222,599	$ 244,841	$ 697,502	$ 801,234

Revenue Disaggregated Revenue by Product Line (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Disaggregation of Revenue [Line Items]
Revenues	$ 307,471	$ 327,169	$ 950,685	$ 1,059,662
Infusion Consumables [Member]
Disaggregation of Revenue [Line Items]
Revenues	119,745	117,797	357,994	361,490
IV Solutions [Member]
Disaggregation of Revenue [Line Items]
Revenues	98,159	114,433	313,976	394,198
Infusion Systems [Member]
Disaggregation of Revenue [Line Items]
Revenues	78,932	81,456	244,523	263,271
Critical Care [Member]
Disaggregation of Revenue [Line Items]
Revenues	$ 10,635	$ 13,483	$ 34,192	$ 40,703

Revenue Contract Liabilities (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Movement in Deferred Revenue [Roll Forward]
Contract with Customer, Liability	$ (4,282)	$ (7,066)
Contract with Customer, Liability	(7,692)	(7,874)
Equipment revenue [Member]
Movement in Deferred Revenue [Roll Forward]
Deferred Revenue, Additions	(6,869)	(4,086)
Increase (Decrease) in Deferred Revenue	3,619	3,136
Software revenue [Member]
Movement in Deferred Revenue [Roll Forward]
Deferred Revenue, Additions	(3,115)	(5,507)
Increase (Decrease) in Deferred Revenue	$ 2,955	$ 5,649

Leases (Details) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
Leases (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Sep. 30, 2019
Leases [Abstract]
Operating Lease, Cost	$ 2,996	$ 7,528
Short-term Lease, Cost	49	229
Lease, Cost	$ 3,045	$ 7,757

Leases Cash Flow, Operating Activities, Lessee (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2019 USD ($)
Leases [Abstract]
Operating Lease, Payments	$ 7,161
Right-of-Use Asset Obtained in Exchange for Operating Lease Liability	$ 2,495

Leases Assets and Liabilities, Lessee (Details) - USD ($)
$ in Thousands

Sep. 30, 2019

Dec. 31, 2018

Operating Lease, Right-of-Use Asset

$ 35,787

$ 0

^[1]

Operating Lease, Liability, Current

7,150

$ 0

Operating Lease, Liability, Noncurrent

29,791

Operating Lease, Liability

$ 36,941

Operating Lease, Weighted Average Remaining Lease Term

6 years

Operating Lease, Weighted Average Discount Rate, Percent

5.57%

[1]	December 31, 2018 balances were derived from audited consolidated financial statements.

Leases Maturity (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Leases [Abstract]
Lessee, Operating Lease, Liability, Payments, Due Next Twelve Months		$ 8,326
Lessee, Operating Lease, Liability, Payments, Remainder of Fiscal Year	$ 2,169
Lessee, Operating Lease, Liability, Payments, Due Year Two	8,409	8,572
Lessee, Operating Lease, Liability, Payments, Due Year Three	7,060	6,489
Lessee, Operating Lease, Liability, Payments, Due Year Four	6,470	5,914
Lessee, Operating Lease, Liability, Payments, Due Year Five	6,118	5,615
Lessee, Operating Lease, Liability, Payments, Due after Year Five	13,569	13,235
Lessee, Operating Lease, Liability, Payments, Due	43,795	$ 48,151
Lessee, Operating Lease, Liability, Undiscounted Excess Amount	(6,854)
Operating Lease, Liability	$ 36,941

Leases Text (Details) - USD ($) $ in Millions	9 Months Ended
Leases Text (Details) - USD ($) $ in Millions	Sep. 30, 2019	Mar. 31, 2019
Lessee, Lease, Description [Line Items]
subsequenteventleasesminimumpayments	$ 21.8
New Accounting Pronouncement or Change in Accounting Principle, Effect of Adoption, Quantification	$ 40.4
Lessee, Operating Lease, Option to Extend	5 years
Minimum [Member]
Lessee, Lease, Description [Line Items]
Lessee, Operating Lease, Term of Contract		1 year
Maximum [Member]
Lessee, Lease, Description [Line Items]
Lessee, Operating Lease, Term of Contract		15 years

Net Income Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	20,116	18	9,375	3,694
Net Income	$ 26,563	$ 219	$ 80,394	$ 36,148
Weighted average number of common shares outstanding (for basic calculation)	20,666,000	20,474,000	20,607,000	20,362,000
Dilutive securities	821,000	1,159,000	949,000	1,226,000
Diluted (in shares)	21,487,000	21,633,000	21,556,000	21,588,000
EPS - basic	$ 1.29	$ 0.01	$ 3.90	$ 1.78
Diluted (In dollars per share)	$ 1.24	$ 0.01	$ 3.73	$ 1.67

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

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The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

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Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

The consolidated profit or loss for the period, net of income taxes, including the portion attributable to the noncontrolling interest.

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+ Details

Net Income Per Share (Details 1) - shares	3 Months Ended		9 Months Ended
Net Income Per Share (Details 1) - shares	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Earnings Per Share [Abstract]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	20,116	18	9,375	3,694

Derivative Financial Instruments (Details) $ in Millions, $ in Millions	Sep. 30, 2019 USD ($)	Sep. 30, 2019 MXN ($)
Derivative [Line Items]
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	$ 1.4
Hedge 1 [Member]
Derivative [Line Items]
Derivative, Forward Exchange Rate	20.01	20.01
Hedge 2 [Member]
Derivative [Line Items]
Derivative, Forward Exchange Rate	20.43	20.43
Derivative Asset, Notional Amount		$ 61.3
Hedge 3 [Member] [Member]
Derivative [Line Items]
Derivative, Forward Exchange Rate	22.109	22.109
Derivative Asset, Notional Amount		$ 398.0

Derivative Financial Instruments Derivative Instruments and Hedging Activities - FV of Derivative Instruments Included Within Consolidated Balance Sheet (Details) - Foreign Exchange Forward [Member] - Designated as Hedging Instrument [Member] - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Prepaid Expenses and Other Current Assets [Member]
Derivatives, Fair Value [Line Items]
Derivative Asset	$ 1,300	$ 187
Other Assets [Member]
Derivatives, Fair Value [Line Items]
Derivative Asset	279	545
Derivative Financial Instruments, Assets [Member]
Derivatives, Fair Value [Line Items]
Derivative Asset	$ 1,579
Derivative Financial Instruments, Liabilities [Member]
Derivatives, Fair Value [Line Items]
Derivative Liability		$ 732

Derivative Financial Instruments Derivative Instruments and Hedging Activities - Amounts Affecting Consolidated Statements of Income (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Derivative Instruments, Gain (Loss) [Line Items]
Derivative, Gain (Loss) on Derivative, Net	$ 229	$ 192	$ 573	$ 687

Derivative Financial Instruments Derivative Instruments and Hedging Activities - Cash Flow Hedge Activity Included in Accumulated Other Comprehensive Income (Loss) (Details) - Cost of Sales [Member] - Foreign Exchange Forward [Member] - Cash Flow Hedging [Member] - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative Instruments, Gain Recognized in Other Comprehensive Income (Loss), Effective Portion	$ (264)	$ 1,743	$ 1,421	$ 2,256
Derivative Instruments, Gain Reclassified from Accumulated OCI into Income, Effective Portion	$ 229	$ 192	$ 573	$ 687

Fair Value Measurement Fair Value Measurements, Recurring Basis (Details) - USD ($)
$ in Thousands

Sep. 30, 2019

Dec. 31, 2018

$ 20,845

$ 37,329

^[1]

2,025

^[1]

40,086

Prepaid Expenses and Other Current Assets [Member]

22,424

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Foreign Currency Contract, Asset, Fair Value Disclosure

1,300

187

Other Assets [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Foreign Currency Contract, Asset, Fair Value Disclosure

279

545

Fair Value, Inputs, Level 1 [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Fair Value, Inputs, Level 1 [Member] | Prepaid Expenses and Other Current Assets [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Foreign Currency Contract, Asset, Fair Value Disclosure

Fair Value, Inputs, Level 1 [Member] | Other Assets [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Foreign Currency Contract, Asset, Fair Value Disclosure

Fair Value, Inputs, Level 2 [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

20,845

37,329

2,025

40,086

Fair Value, Inputs, Level 2 [Member] | Prepaid Expenses and Other Current Assets [Member]

22,424

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Foreign Currency Contract, Asset, Fair Value Disclosure

1,300

187

Fair Value, Inputs, Level 2 [Member] | Other Assets [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Foreign Currency Contract, Asset, Fair Value Disclosure

279

545

Fair Value, Inputs, Level 3 [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Fair Value, Inputs, Level 3 [Member] | Prepaid Expenses and Other Current Assets [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Foreign Currency Contract, Asset, Fair Value Disclosure

Fair Value, Inputs, Level 3 [Member] | Other Assets [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Foreign Currency Contract, Asset, Fair Value Disclosure

$ 0

Earn-out liability [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Earn-out liability [Member] | Fair Value, Inputs, Level 1 [Member]

47,400

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Earn-out liability [Member] | Fair Value, Inputs, Level 2 [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Earn-out liability [Member] | Fair Value, Inputs, Level 3 [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Liabilities, Total [Member]

47,400

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Liabilities, Total [Member] | Fair Value, Inputs, Level 1 [Member]

47,400

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Liabilities, Total [Member] | Fair Value, Inputs, Level 2 [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Liabilities, Total [Member] | Fair Value, Inputs, Level 3 [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Fair Value, Liability, Recurring Basis, Still Held, Unrealized Gain (Loss)

$ 47,400

[1]	December 31, 2018 balances were derived from audited consolidated financial statements.

Fair Value Measurement Fair Value Measurement (Details) $ in Millions	9 Months Ended
	Sep. 30, 2019 USD ($)
Fair Value Disclosures [Abstract]
contingent consideration gross	$ 225.0

Fair Value Measurement Fair Value Liabilities Measured on Recurring Basis, Unobservable Inputs (Details) - USD ($)
$ in Thousands

9 Months Ended

Sep. 30, 2019

Dec. 31, 2018

^[1]

Fair Value Disclosures [Abstract]

$ (47,400)

CONTINGENT EARN-OUT LIABILITY

$ 0

$ 47,400

[1]	December 31, 2018 balances were derived from audited consolidated financial statements.

Fair Value Measurement Fair Value Inputs, Liabilities, Quantitative Information (Details)	Dec. 31, 2018
MeasurementinputadjustedEBITDAvolatility [Domain]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Business Combination, Contingent Consideration, Liability, Measurement Input	0.3000
Measurement Input, Discount Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Business Combination, Contingent Consideration, Liability, Measurement Input	0.0825
Measurement Input, Risk Free Interest Rate [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Business Combination, Contingent Consideration, Liability, Measurement Input	0.0287
Measurement Input, Price Volatility [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Business Combination, Contingent Consideration, Liability, Measurement Input	0.0524
Measurement Input, Cost of Debt [Domain]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Business Combination, Contingent Consideration, Liability, Measurement Input	0.0525

Investment Securities (Details) $ in Thousands	9 Months Ended
Investment Securities (Details) $ in Thousands	Sep. 30, 2019 USD ($)
Debt Securities, Available-for-sale [Line Items]
Gain (Loss) on Sale of Investments	$ 0

Investment Securities Table (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Debt Securities, Available-for-sale [Line Items]
Debt Securities, Available-for-sale, Current	$ 20,845		$ 37,329
Debt Securities, Available-for-sale, Noncurrent	0		2,025
Debt Securities, Available-for-sale, Amortized Cost	20,845		39,354
Debt Securities, Available-for-sale, Unrealized Loss	0	$ 0
Debt Securities, Available-for-sale, Maturity, Allocated and Single Maturity Date, within One Year, Fair Value	20,845		37,329
Debt Securities, Available-for-sale, Maturity, Allocated and Single Maturity Date, after One Through Five Years, Fair Value	0		2,025
Debt Securities, Available-for-sale	20,845		39,354
Available-for-sale Debt Security Current [Member]
Debt Securities, Available-for-sale [Line Items]
Debt Securities, Available-for-sale, Continuous Unrealized Loss Position, Less than 12 Months, Accumulated Loss	0		0
Available-for-sale Debt Security Noncurrent [Member]
Debt Securities, Available-for-sale [Line Items]
Debt Securities, Available-for-sale, Continuous Unrealized Loss Position, Less than 12 Months, Accumulated Loss	$ 0		$ 0

Prepaids and Other Current Assets Prepaids and Other Assets (Details) - USD ($)
$ in Thousands

Sep. 30, 2019

Dec. 31, 2018

Prepaid Expense and Other Assets, Current [Abstract]

Deposit Assets

$ 1,305

$ 1,087

Other Receivables

20,137

Other Prepaid Expense, Current

16,597

12,476

Deferred Costs and Other Assets

6,366

1,951

Prepaid insurance and property taxes

680

2,666

Prepaid Taxes

4,379

5,072

Deferred tax charge

1,180

Other Assets, Current

3,300

1,548

Prepaid expenses and other current assets

$ 33,807

$ 46,117

^[1]

[1]	December 31, 2018 balances were derived from audited consolidated financial statements.

Inventories (Details) - USD ($)
$ in Thousands

Sep. 30, 2019

Dec. 31, 2018

Inventory Disclosure [Abstract]

Inventory, Raw Materials, Net of Reserves

$ 110,954

$ 104,104

Inventory, Work in Process, Net of Reserves

47,339

52,909

Inventory, Finished Goods, Net of Reserves

185,422

154,150

Total

$ 343,715

$ 311,163

^[1]

[1]	December 31, 2018 balances were derived from audited consolidated financial statements.

Property and Equipment (Details) - USD ($)
$ in Thousands

Sep. 30, 2019

Dec. 31, 2018

Net property and equipment

$ 749,118

$ 694,864

Accumulated depreciation

(305,031)

(262,223)

444,087

432,641

^[1]

Machinery and Equipment, Gross

213,957

203,431

Furniture and Fixtures, Gross

7,405

7,409

Construction in Progress, Gross

85,908

70,864

Land, Buildings and Improvements [Member]

228,960

212,283

Molds [Member]

Computer Equipment and Software [Member]

59,749

59,700

Instruments Placed with Customers [Member]

82,993

80,420

Goodwill, Foreign Currency Translation Gain (Loss)

$ 70,146

$ 60,757

[1]	December 31, 2018 balances were derived from audited consolidated financial statements.

Property and Equipment Text (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Property, Plant and Equipment [Abstract]
Depreciation	$ 14.8	$ 15.1	$ 44.6	$ 42.8

Goodwill and Intangible Assets Goodwill Table (Details)
$ in Thousands

9 Months Ended

Sep. 30, 2019

USD ($)

Goodwill [Line Items]

GOODWILL

$ 11,195

^[1]

(176)

GOODWILL

$ 11,019

[1]	December 31, 2018 balances were derived from audited consolidated financial statements.

Goodwill and Intangible Assets Intangibles Table (Details) - USD ($)
$ in Thousands

9 Months Ended

12 Months Ended

Sep. 30, 2019

Dec. 31, 2018

Finite-Lived Intangible Assets, Accumulated Amortization

$ 179,837

$ 173,372

60,503

48,186

Indefinite-lived Intangible Assets (Excluding Goodwill)

119,334

125,186

12,310

8,235

Intangible Assets, Gross (Excluding Goodwill)

192,147

181,607

INTANGIBLE ASSETS, net

$ 131,644

$ 133,421

^[1]

Patents [Member]

10 years

Finite-Lived Intangible Assets, Accumulated Amortization

$ 21,736

$ 19,399

13,161

12,147

Customer Contracts [Member]

$ 8,575

$ 7,252

12 years

9 years

Finite-Lived Intangible Assets, Accumulated Amortization

$ 9,990

$ 5,319

5,419

5,272

$ 4,571

$ 47

9 years

Finite-Lived Intangible Assets, Accumulated Amortization

$ 57,602

$ 57,916

18,413

13,363

$ 39,189

$ 44,553

Trademarks [Member]

4 years

Finite-Lived Intangible Assets, Accumulated Amortization

$ 425

425

$ 0

Trade Names [Member]

15 years

Finite-Lived Intangible Assets, Accumulated Amortization

$ 7,450

$ 7,456

2,003

1,618

Developed Technology Rights [Member]

$ 5,447

$ 5,838

11 years

Finite-Lived Intangible Assets, Accumulated Amortization

$ 82,634

$ 82,857

21,082

15,361

$ 61,552

$ 67,496

[1]	December 31, 2018 balances were derived from audited consolidated financial statements.

Goodwill and Intangible Assets Text (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization of Intangible Assets	$ 4.4	$ 4.1	$ 12.4	$ 12.2

Goodwill and Intangible Assets 5-Year Amortization (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Finite-Lived Intangible Assets, Amortization Expense, Next Twelve Months	$ 4,809
Finite-Lived Intangible Assets, Amortization Expense, Year Two	16,669
Finite-Lived Intangible Assets, Amortization Expense, Year Three	16,366
Finite-Lived Intangible Assets, Amortization Expense, Year Four	16,222
Finite-Lived Intangible Assets, Amortization Expense, Year Five	16,073
Finite-Lived Intangible Assets, Amortization Expense, after Year Five	49,195
Finite-Lived Intangible Assets, Net	$ 119,334	$ 125,186

Accrued Liabilities (Details) - USD ($)
$ in Thousands

9 Months Ended

12 Months Ended

Sep. 30, 2019

Dec. 31, 2018

Accruedsupplychainrestructuring

Salaries and benefits

$ 28,273

$ 20,538

Incentive compensation

13,026

42,913

23,751

Operating Lease, Liability, Current

7,150

Accrued Product Field Action

1,705

5,316

Third-party Inventory

1,089

Consigned inventory

1,118

Sales taxes

2,134

2,941

Restructuring accrual

6,996

1,046

Contract with Customer, Liability, Current

7,441

3,814

Accrued other taxes

3,253

3,213

Accrued Professional Fees

7,098

15,996

Legal accrual

621

1,400

Distribution Fees

4,578

3,977

Warranties and returns

886

1,124

Accrued freight

12,108

10,953

UnfavorablecontractliabilityST

3,045

contract settlement-ST

1,667

2,083

Accrued research and development expense

1,451

Other

6,324

9,848

Accrued liabilities

$ 130,056

$ 128,820

^[1]

[1]	December 31, 2018 balances were derived from audited consolidated financial statements.

Accrued Liabilities Long-term liabilities (Details) - USD ($)
$ in Thousands

Sep. 30, 2019

Dec. 31, 2018