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General and Summary of Significant Accounting Policies Other (expense) income, net (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Other (expense) income, net [Line Items]
Gain (Loss) on Disposition of Other Assets	$ (4,366)	$ (1,608)	$ (153)
miscellaneous income, net	348	(1,823)	166
Other Income Disclosure, Nonoperating	(232)	(13,223)	(5,905)
Foreign Currency Transaction Gain (Loss), Realized	$ 3,786	(9,792)	$ (5,918)
Financed Receivables Cost		$ (2,600)

General and Summary of Significant Accounting Policies Future Estimated Amortization Expense (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Intangible Asset, Acquired, Finite-Lived [Line Items]
Finite-Lived Intangible Assets, Amortization Expense, Next Twelve Months	$ 136,384
Finite-Lived Intangible Assets, Amortization Expense, Year Two	120,367
Finite-Lived Intangible Assets, Amortization Expense, Year Three	119,768
Finite-Lived Intangible Assets, Amortization Expense, Year Four	116,676
Finite-Lived Intangible Assets, Amortization Expense, Year Five	54,191
Finite-Lived Intangible Assets, Amortization Expense, after Year Five	80,014
Finite-Lived Intangible Assets, Net	$ 627,400	$ 728,412

General and Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2025

Accounting Policies [Abstract]

Schedule of Inventory, Current [Table Text Block]

Inventories consist of the following (in thousands):


	As of December 31,
	2025		2024
Raw materials	$	265,383	$	265,275
Work in process	38,097		37,528
Finished goods	312,379		281,873
Total	$	615,859	$	584,676

Property, Plant and Equipment [Table Text Block]

Property, plant and equipment consists of the following (in thousands):


	As of December 31,
	2025		2024
Machinery and equipment	$	434,959	$	400,861
Land, building and building improvements	176,972		177,089
Molds	107,296		96,318
Computer equipment and software	116,259		122,208
Furniture and fixtures	23,055		27,871
Instruments placed with customers(1)	148,441		124,290
Construction in progress	90,748		87,006
Total property, plant and equipment, cost	1,097,730		1,035,643
Accumulated depreciation	(645,913)		(592,897)
Property, plant and equipment, net	$	451,817	$	442,746

_______________________________

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

All property, plant and equipment are stated at cost. We use the straight-line method for depreciating property, plant and equipment over their estimated useful lives. Estimated useful lives are:


Buildings			15 - 30 years
Building improvements			15 - 30 years
Machinery and equipment and molds			2 - 15 years
Furniture, fixtures and office equipment			2 - 5 years
Computer equipment and software			3 - 5 years
Instruments placed with customers			3 - 10 years

Schedule of Goodwill

The following table presents the changes in the carrying amount of our goodwill for 2025, 2024 and 2023 (in thousands):


	Total
Balance as of January 1, 2023	$	1,449,258



Currency translation	23,188
Balance as of December 31, 2023	1,472,446



Currency translation	(39,674)
Balance as of December 31, 2024	1,432,772



Currency translation	66,982
Balance as of December 31, 2025	$	1,499,754

Schedule of Indefinite-Lived Intangible Assets

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


	Weighted-Average Amortization Life in Years	December 31, 2025
		Cost		Accumulated Amortization		Net
Patents	10	$	40,582	$	25,455	$	15,127
Customer contracts	12	9,959		7,356		2,603
Non-contractual customer relationships	8	561,199		304,287		256,912
Trademarks	1	5,425		5,425		—
Trade name	15	18,249		9,574		8,675
Developed technology(1)	10	637,589		293,506		344,083
Non-compete	3	9,100		9,100		—
Total amortized intangible assets		$	1,282,103	$	654,703	$	627,400

Internally developed software(2)		$	6,159			$	6,159

Total intangible assets		$	1,288,262	$	654,703	$	633,559

_______________________________

(1) Developed technology primarily consists of acquired patented technologies and internally developed software. Upon completion of development, the assets are amortized over their estimated useful lives.

(2) Internally developed software will be reclassified to developed technology and amortized when the projects are complete and the assets are ready for their intended use. During 2025, we reclassified $11.4 million to developed technology.


	Weighted-Average Amortization Life in Years	December 31, 2024
		Cost		Accumulated Amortization		Net
Patents	10	$	36,811	$	22,913	$	13,898
Customer contracts	12	9,818		6,994		2,824
Non-contractual customer relationships	8	546,404		236,267		310,137
Trademarks	1	5,425		5,425		—
Trade name	15	18,239		8,357		9,882
Developed technology(1)	10	619,540		227,869		391,671
Non-compete	3	9,100		9,100		—
Total amortized intangible assets		$	1,245,337	$	516,925	$	728,412

Internally developed software(2)		$	12,377			$	12,377

Total intangible assets		$	1,257,714	$	516,925	$	740,789

_______________________________

(2) Internally developed software will be reclassified to developed technology and amortized when the projects are complete and the assets are ready for their intended use. During 2024, we reclassified $33.2 million to developed technology.

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

As of December 31, 2025, estimated annual amortization for our intangible assets for each of the next five years and thereafter is approximately (in thousands):


2026	$	136,384
2027	120,367
2028	119,768
2029	116,676
2030	54,191
Thereafter	80,014
Total	$	627,400

Equity Method Investments

Our investment in unconsolidated affiliates consist of the following (in thousands):


	As of December 31,
	2025		2024
Otsuka ICU Medical LLC	$	128,662	$	—
Other equity method investment	2,924		3,038
	$	131,586	$	3,038

Interest Income and Interest Expense Disclosure

Interest expense, net

The following table presents interest expense, net (in thousands):


	As of December 31,
	2025		2024		2023
Interest expense	$	(93,338)	$	(106,541)	$	(102,727)
Interest income	10,307		10,788		7,508
Interest expense, net	$	(83,031)	$	(95,753)	$	(95,219)

Schedule of Other Nonoperating Income (Expense)

Other expense, net

The following table presents other expense, net (in thousands):


	As of December 31,
	2025		2024		2023
Foreign exchange gains (losses), net	$	3,786	$	(9,792)	$	(5,918)
Loss on disposition of assets	(4,366)		(1,608)		(153)
Other miscellaneous income (expense) , net	348		(1,823)		166
Other expense, net	$	(232)	$	(13,223)	$	(5,905)

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):


	Year ended December 31,
	2025		2024		2023
Net income (loss)	$	732	$	(117,688)	$	(29,655)
Weighted-average number of common shares outstanding (basic)	24,640		24,388		24,091
Dilutive securities	264		—		—
Weighted-average common and common equivalent shares outstanding (diluted)	24,904		24,388		24,091
EPS — basic	$	0.03	$	(4.83)	$	(1.23)
EPS — diluted	$	0.03	$	(4.83)	$	(1.23)

Total anti-dilutive stock options and restricted stock awards (shares in thousands)	40		42		129

SEC Schedule, Article 12-09, Valuation and Qualifying Accounts (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Warranty and return reserve - inventory	$ 29,345	$ 42,221	$ 57,796	$ 50,819
Warranty and Return Reserve costs	6,102	2,571	20,290
Warranty and return reserve - inventory - charged to other accounts	(18,978)	(18,146)	(13,313)
Warranty and return reserve - inventory write-offs	0	0	0
SEC Schedule, 12-09, Allowance, Credit Loss
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	11,470	11,064	8,530
Charged to Costs and Expenses	2,416	5,800	838
Charged to Other Accounts	420	(5,394)
Write-off/ Disposals	0	0	0
Balance at End of Period	14,306	11,470	11,064
SEC Schedule, 12-09, Valuation Allowances and Reserves, Deduction			1,696
SEC Schedule, 12-09, Reserve, Warranty
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	6,870	7,505	5,863
Charged to Costs and Expenses	5,635	(1,441)	1,627
Charged to Other Accounts	498	806	15
Write-off/ Disposals	0	0	0
Balance at End of Period	13,003	6,870	7,505
SEC Schedule, 12-09, Valuation Allowance, Deferred Tax Asset
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	90,950	8,452	11,166
Charged to Costs and Expenses	8,916	78,592	0
Charged to Other Accounts	2,840	3,906	(2,714)
Write-off/ Disposals	0	0	0
Balance at End of Period	$ 102,706	$ 90,950	$ 8,452

General and Summary of Significant Accounting Policies Intangible Assets #2 (Details) - USD ($)	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Accounting Policies [Abstract]
indefinte lived intangibles put in use	$ 11,400,000	$ 33,200,000
Amortization of Intangible Assets	131,400,000	134,300,000	$ 132,100,000
Cost, Amortization	$ 4,500,000	$ 1,700,000	$ 0

- Definition

The aggregate expense charged against earnings to allocate the cost of intangible assets (nonphysical assets not used in production) in a systematic and rational manner to the periods expected to benefit from such assets.

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+ Details

Share Based Award Stock Option Plans (Details) - 2011 Plan [Member]	12 Months Ended
	Dec. 31, 2025 shares
Stock Incentive Plans [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Number of Additional Shares Authorized	2,200,000
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant	8,500,000

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2025

Stockholders' Equity Note [Abstract]

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

The components of AOCI, net of tax, were as follows (in thousands):


	Foreign Currency Translation Adjustments		Unrealized Gains (Losses) on Cash Flow Hedges		Other Adjustments		Total
Balance as of January 1, 2023	$	(122,973)	$	40,779	$	1,216	$	(80,978)
Other comprehensive income before reclassifications	46,189		12,096		603		58,888
Amounts reclassified from AOCI	—		(30,991)		—		(30,991)
Other comprehensive income (loss)	46,189		(18,895)		603		27,897
Balance as of December 31, 2023	$	(76,784)	$	21,884	$	1,819	$	(53,081)
Other comprehensive (loss) income before reclassifications	(70,158)		14,042		—		(56,116)
Amounts reclassified from AOCI	—		(30,204)		—		(30,204)
Other comprehensive loss	(70,158)		(16,162)		—		(86,320)
Balance as of December 31, 2024	$	(146,942)	$	5,722	$	1,819	$	(139,401)
Other comprehensive income (loss) before reclassifications	119,917		(950)		60		119,027
Amounts reclassified from AOCI	—		(14,256)		—		(14,256)
Other comprehensive income (loss)	119,917		(15,206)		60		104,771
Balance as of December 31, 2025	$	(27,025)	$	(9,484)	$	1,879	$	(34,630)

Consolidated Statements of Income - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
REVENUES:
Revenues	$ 2,231,262	$ 2,382,046	$ 2,259,126
Cost of Goods Sold	1,409,223	1,557,264	1,519,253
Gross profit	822,039	824,782	739,873
OPERATING EXPENSES:
Selling, general and administrative	625,210	638,762	606,693
Research and development	87,495	88,615	85,344
Restructuring, strategic transaction and integration expenses	66,505	59,840	41,258
Change in fair value of contingent earn-out	0	(5,399)	(16,247)
Total operating expenses	779,210	781,818	717,048
Income from operations	42,829	42,964	22,825
Interest Expense, Net	(83,031)	(95,753)	(95,219)
OTHER EXPENSE, NET	(232)	(13,223)	(5,905)
Gain (Loss) on Disposition of Business	44,792	0	0
Income (Loss) from Continuing Operations before Equity Method Investments, Income Taxes, Noncontrolling Interest, Total	4,358	(66,012)	(78,299)
(Provision) benefit for income taxes	(2,437)	(51,676)	48,644
Income (Loss) from Continuing Operations before Equity Method Investments	1,921	(117,688)	(29,655)
Income (Loss) from Equity Method Investments	(1,189)	0	0
Net Income (Loss)	$ 732	$ (117,688)	$ (29,655)
Basic	$ 0.03	$ (4.83)	$ (1.23)
Diluted	$ 0.03	$ (4.83)	$ (1.23)
WEIGHTED AVERAGE NUMBER OF SHARES
Basic (in shares)	24,640	24,388	24,091
Diluted (in shares)	24,904	24,388	24,091

Discontinued Operations and Disposal Groups

12 Months Ended

Dec. 31, 2025

Discontinued Operations and Disposal Groups [Abstract]

Disposal Groups, Including Discontinued Operations, Disclosure

ASSETS HELD FOR SALE AND DISPOSAL OF BUSINESS

Assets Held For Sale

On November 12, 2024, we entered into a purchase agreement (the "Agreement") with Otsuka Pharmaceutical Factory America, Inc., a Delaware corporation ("OPF") to divest a controlling interest in our IV Solutions business. We concluded the initial criteria for classification as held for sale were met, and accordingly we presented the IV Solution's net assets as held for sale in our consolidated balance sheet.

The following table summarizes the carrying values of the assets and liabilities presented as held for sale in our consolidated balances sheet as of December 31, 2024 (in thousands):


Assets:	2024
Accounts receivable, net of allowance of $465 at December 31, 2024	$	13,331
Inventories	88,656
Prepaid expenses and other current assets	4,140
Property, plant and equipment, net	155,426
Other assets	22,829
Total assets held for sale	$	284,382

Liabilities:
Accounts payable	$	13,533
Accrued liabilities	19,378
Total liabilities held for sale	$	32,911

Net assets held for sale	$	251,471

Disposal of IV Solutions Business

On May 1, 2025, we sold to OPF a 60% ownership interest in the joint venture, an entity we formed in 2025 and to which we contributed the net assets of our IV Solutions business. Upon the sale and as a result of a loss of control, we derecognized the net assets that comprised our IV Solutions business and recorded our retained 40% ownership interest at its estimated fair value as an equity method investment in the joint venture (see Note 1: Basis of Presentation and Significant Accounting Policies). We have the ability to exercise significant influence over operating and financial policies of the joint venture, primarily through having two of the five seats on its Board of Directors.

Cash proceeds received from the sale, subject to conventional purchase price adjustments, were $211.2 million. We also are entitled to contingent consideration if the joint venture exceeds planned revenues or gross margin for the year ended December 31, 2026. Additionally, we have agreed to provide commercial, logistics, administrative, and other services, including continuing to provide certain manufacturing services for component parts for a period of up to five years from transaction close (see below table). Certain logistic and warehouse costs incurred on behalf of and reimbursed by the joint venture are pass-through expenses and net to zero within cost of goods sold in the consolidated statement of operations. Other services are provided in exchange for fixed fee arrangements or reimbursement of our costs, depending on the respective terms of service negotiated. Fees charged for the services are recorded as reductions to the costs incurred to provide such services in the consolidated statement of operations. Those services provided under fixed price arrangements were determined to be at less than fair value and, as such, we recognized an unfavorable contract liability of $20.2 million to account for the difference between the fair value of services to be provided and the estimated cost of providing such services over the five years from transaction close. The unfavorable contract liability is presented within other long-term liabilities in our consolidated balance sheet, with the current portion included in accrued liabilities. This liability is being released to our consolidated statement of operations as reduction to the costs incurred to provide the respective services within selling, general and administrative expenses.

During 2025, we recognized $9.2 million in fixed and variable service fees related to reimbursed expenses under the various transition service agreements and $2.9 million related to the release of the unfavorable contract liability. The fees, reimbursements and release of unfavorable contract liability serve to reduce the same line items as their respective incurred expenses within cost of goods sold or selling, general, and administrative expenses in our consolidated statement of operations.

Fair value for our retained 40% ownership interest was determined using a market approach based on the proceeds received from OPF for its 60% controlling ownership interest. Fair value for services was estimated using a market approach based on observable margins for comparable services and the difference between the fair value of services and the estimated cost to provide the services through the term of the services agreement was discounted using our effective borrowing rate.

The combined effect of the transaction was a gain of $44.8 million, comprising the sum of a $45.6 million gain from the disposal of a 60% ownership interest in the joint venture, a $19.4 million gain from the difference between the fair value of our retained 40% ownership interest in the joint venture and our carrying value of that same proportionate ownership interest, and a $20.2 million unfavorable contract liability recorded upon disposition. The gain is presented as a separate line item in our consolidated statement of operations. No gain related to contingent consideration was recorded. We will record such gain, if any, if and when the measurement period has ended and we have concluded that a payment will be received.

As part of the transaction, we provided OPF a call option to acquire our retained 40% ownership in the joint venture. Additionally, OPF provided us with a put option giving us the right to compel OPF to purchase our retained 40% ownership interest in the joint venture. The call and put options are exercisable at certain specified dates and for specified amounts based on certain historical financial metrics as set forth in the joint venture's Operating Agreement beginning five years after the closing. The call and put options were not recorded in our consolidated financial statements since they do not meet the definition of a derivative specifically due to the absence of a net settlement feature.

Related Party Transactions

We account for our retained 40% interest in the joint venture as an equity method investment (see Note 1: Basis of Presentation and Significant Accounting Policies), having the ability to exercise significant influence over operating and financial policies of the joint venture, primarily through having two of the five seats on its Board of Directors. Additionally, in connection with the closing of the transaction on May 1, 2025, we entered into certain agreements with OPF, which cover the governance of the joint venture and require us to provide certain commercial, logistics, manufacturing supply, administrative, and other services for a period of up to five years from transaction close.

The following table presents consolidated financial statement data resulting from transactions with the joint venture (in thousands):


	Year ended December 31,
		2025
Consolidated statement of operations:
Manufacturing services agreement revenue (net revenue)		$	11,886
Manufacturing services agreement cost of goods sold (costs of good sold)		$	11,131

Service fees - Otsuka ICU Medical LLC (cost of goods sold)		$	969
Service fees - Otsuka ICU Medical LLC (selling, general & administrative)		$	8,206

Equity in losses of unconsolidated affiliates		$	(1,189)

The joint venture is a pass-through entity for income tax purposes and, as such, does not record income tax at the entity level. We record our equity in losses of unconsolidated affiliates before any related income tax recognized as a separate line item in our consolidated statements of operations. Income taxes on our share of the joint venture's earnings are included within (provision) benefit for income taxes in our consolidated statements of operations.

As of December 31, 2025, a $0.8 million related-party receivable from the joint venture was included within prepaid expenses and other current assets in our consolidated balance sheet.

General and Summary of Significant Accounting Policies Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Goodwill [Roll Forward]
GOODWILL	$ 1,432,772	$ 1,472,446	$ 1,449,258
Goodwill, Foreign Currency Translation, Gain (Loss)	66,982	(39,674)	23,188
GOODWILL	$ 1,499,754	$ 1,432,772	$ 1,472,446

- Definition

Amount, after accumulated impairment loss, of asset representing future economic benefit arising from other asset acquired in business combination or from joint venture formation or both, that is not individually identified and separately recognized.

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-SubTopic 20
-Name Accounting Standards Codification
-Section 45
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482598/350-20-45-1

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-Section S99
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-URI https://asc.fasb.org/1943274/2147479581/805-30-50-4

+ Details

Share Based Award Share Award data (Details)	Dec. 31, 2025 $ / shares
Share-Based Payment Arrangement [Abstract]
Share Price	$ 142.67

Accrued Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Payables and Accruals [Abstract]
Salaries and benefits	$ 70,526	$ 60,815
Incentive compensation	60,799	59,445
Contract with Customer, Liability, Current	33,843	30,358
Accrued liability Italy payment scheme	24,597	23,937
Accrued Product Field Action.	27,777	32,844
Other	97,795	99,524
Accrued liabilities	$ 315,337	$ 306,923

Consolidated Balance Sheets (Parenthetical) - USD ($)	Dec. 31, 2025	Dec. 31, 2024
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 14,383,000	$ 12,977,000
Convertible preferred stock, par value	$ 1.00	$ 1.00
Convertible preferred stock, authorized shares	500,000	500,000
Convertible preferred stock, outstanding shares	0	0
Common stock, par value	$ 0.10	$ 0.10
Common stock, shares authorized	80,000,000	80,000,000
Common stock, shares issued	24,688,000	24,518,000
Common stock, shares outstanding	24,688,000	24,517,000
Treasury Stock, Common, Shares	172	571

Stockholders' Equity

12 Months Ended

Dec. 31, 2025

Stockholders' Equity Note [Abstract]

Stockholders' Equity Note Disclosure [Text Block]

STOCKHOLDERS' EQUITY

Treasury Stock

In August 2019, our Board of Directors approved a common stock purchase plan to purchase up to $100.0 million of our common stock. This plan has no expiration date. We have $100.0 million remaining on this purchase plan. We did not purchase any of our common stock under our common stock purchase plan in 2024, 2023 or 2022. We are limited on share purchases in accordance with the terms and conditions of our Senior Secured Credit Facilities (see Note 12: Long-Term Obligations).

In 2025, we withheld 61,693 shares of our common stock from employee vested restricted stock units in consideration for $8.8 million in payments for the employees' share award income tax withholding obligations. We had 172 shares remaining in treasury at December 31, 2025.

In 2024, we withheld 114,787 shares of our common stock from employee vested restricted stock units in consideration for $12.0 million in payments for the employees' share award income tax withholding obligations. We had 571 shares remaining in treasury at December 31, 2024.

In 2023, we withheld 59,377 shares of our common stock from employee vested restricted stock units in consideration for $9.4 million in payments for the employees' share award income tax withholding obligations. We had 2,428 shares remaining in treasury at December 31, 2023.

We use treasury stock to issue shares for stock option exercises and restricted stock grants.

Accumulated Other Comprehensive (Loss) Income ("AOCI")

The components of AOCI, net of tax, were as follows (in thousands):


	Foreign Currency Translation Adjustments		Unrealized Gains (Losses) on Cash Flow Hedges		Other Adjustments		Total
Balance as of January 1, 2023	$	(122,973)	$	40,779	$	1,216	$	(80,978)
Other comprehensive income before reclassifications	46,189		12,096		603		58,888
Amounts reclassified from AOCI	—		(30,991)		—		(30,991)
Other comprehensive income (loss)	46,189		(18,895)		603		27,897
Balance as of December 31, 2023	$	(76,784)	$	21,884	$	1,819	$	(53,081)
Other comprehensive (loss) income before reclassifications	(70,158)		14,042		—		(56,116)
Amounts reclassified from AOCI	—		(30,204)		—		(30,204)
Other comprehensive loss	(70,158)		(16,162)		—		(86,320)
Balance as of December 31, 2024	$	(146,942)	$	5,722	$	1,819	$	(139,401)
Other comprehensive income (loss) before reclassifications	119,917		(950)		60		119,027
Amounts reclassified from AOCI	—		(14,256)		—		(14,256)
Other comprehensive income (loss)	119,917		(15,206)		60		104,771
Balance as of December 31, 2025	$	(27,025)	$	(9,484)	$	1,879	$	(34,630)

- Definition

The entire disclosure for equity.

+ References

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+ Details

Consolidated Statements of Stockholders Equity - USD ($) $ in Thousands	Total	Common Stock Shares [Member]	Common Stock [Member]	Additional Paid-in Capital [Member]	Treasury Stock, Common	Retained Earnings [Member]	Accumulated Other Comprehensive Income (Loss) [Member]
Balance at Dec. 31, 2022	$ 2,089,928		$ 2,399	$ 1,331,249	$ (243)	$ 837,501	$ (80,978)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of restricted stock and exercise of stock options, including excess income tax benefits	4,022		15	(5,324)	9,331
Purchase of treasury stock,treasury stock acquired in lieu of cash payment on stock option exercises and income tax withholding obligations	(9,350)			0	(9,350)
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	40,563			40,563
Adjustments to Additional Paid in Capital, Other				5
Other comprehensive income, net of tax	27,902						27,897
Net Income (Loss)	(29,655)					(29,655)
Balance at Dec. 31, 2023	2,123,410		2,414	1,366,493	(262)	807,846	(53,081)
Balance, Shares at Dec. 31, 2022		23,995,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of restricted stock and exercise of stock options, shares issued		208,000
Treasury Stock, Shares		(59,000)
Balance, Shares at Dec. 31, 2023		24,144,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of restricted stock and exercise of stock options, including excess income tax benefits	10,939		38	(1,261)	12,162
Purchase of treasury stock,treasury stock acquired in lieu of cash payment on stock option exercises and income tax withholding obligations	(11,992)			0	(11,992)
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	46,883			46,883
Adjustments to Additional Paid in Capital, Other				3
Other comprehensive income, net of tax	(86,317)						(86,320)
Net Income (Loss)	(117,688)					(117,688)
Balance at Dec. 31, 2024	$ 1,965,235		2,452	1,412,118	(92)	690,158	(139,401)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of restricted stock and exercise of stock options, shares issued		489,000
Treasury Stock, Shares		(115,000)
Balance, Shares at Dec. 31, 2024	24,517,000	24,518,000
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of restricted stock and exercise of stock options, including excess income tax benefits	$ 6,106		17	(2,747)	8,836
Purchase of treasury stock,treasury stock acquired in lieu of cash payment on stock option exercises and income tax withholding obligations	(8,766)			0	(8,766)
APIC, Share-based Payment Arrangement, Increase for Cost Recognition	55,758			55,758
Adjustments to Additional Paid in Capital, Other				(11)
Other comprehensive income, net of tax	104,760						104,771
Net Income (Loss)	732					732
Balance at Dec. 31, 2025	$ 2,123,825		$ 2,469	$ 1,465,118	$ (22)	$ 690,890	$ (34,630)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of restricted stock and exercise of stock options, shares issued		232,000
Treasury Stock, Shares		(62,000)
Balance, Shares at Dec. 31, 2025	24,688,000	24,688,000

Income Taxes Income (Loss) from Continuing Operations (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Income (Loss) from Continuing Operations before Income Taxes, Domestic	$ (31,495)	$ (116,024)	$ (136,980)
Income (Loss) from Continuing Operations before Income Taxes, Foreign	35,853	50,012	58,681
Loss before income taxes	$ 4,358	$ (66,012)	$ (78,299)

Statement of Comprehensive Income (Statement) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Net Income (Loss)	$ 732	$ (117,688)	$ (29,655)
Other Comprehensive Income (Loss), Net of Tax [Abstract]
Other Comprehensive (Loss) Income, Cash Flow Hedge, Gain (Loss), after Reclassification and Tax	(15,206)	(16,162)	(18,895)
Foreign currency translation adjustment, net of taxes of $0 for all periods	119,917	(70,158)	46,189
Other Comprehensive (Income) Loss, Defined Benefit Plan, after Reclassification Adjustment, after Tax	(60)	0	(603)
Other Comprehensive (loss) income, Net of Tax	104,771	(86,320)	27,897
Comprehensive loss	$ 105,503	$ (204,008)	$ (1,758)

- Definition

Amount after tax of increase (decrease) in equity from transactions and other events and circumstances from net income and other comprehensive income, attributable to parent entity. Excludes changes in equity resulting from investments by owners and distributions to owners.

+ References + Details

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

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+ Details

- Definition

Amount after tax and reclassification adjustments of other comprehensive income (loss).

+ References

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+ Details

Accrued Liabilities an Other Long-term Liabilities (Tables)

12 Months Ended

Dec. 31, 2025

Accrued Liabilities and Other Liabilities [Abstract]

Schedule of Accrued Liabilities [Table Text Block]

Accrued liabilities consist of the following (in thousands):


	As of December 31,
	2025		2024
Salaries and benefits	$	70,526	$	60,815
Incentive compensation	60,799		59,445



Deferred revenue	33,843		30,358
Italy medical device payback provision(1)	24,597		23,937
Field service corrective action(2)	27,777		32,844



















Other	97,795		99,524
	$	315,337	$	306,923

_____________________________

(1) Related to potential payments associated with the Italy Medical Device Payback ("IMDP") as a result of 2015 legislation enacted requiring medical device companies to make payments to the Italian government based on regional expenditure ceilings (see Note 15: Commitments and Contingencies for further details).

(2) Primarily includes field corrective actions associated with certain products in connection with a 2021 Warning Letter (as defined below) received by Smiths Medical from the FDA following an inspection of Smiths Medical's Oakdale, Minnesota Facility (see Note 15: Commitments and Contingencies for further details).

Restructuring, Strategic Transaction and Integration Strategic Transaction and Integration Expenses (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Restructuring and Related Activities [Abstract]
Strategic Transaction and Integration	$ 36.5	$ 40.2	$ 35.6

General and Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2025

Accounting Policies [Abstract]

Business Description and Basis of Presentation [Text Block]

Nature of Operations

ICU Medical, Inc. ("ICU" or "we"), a Delaware corporation, develops, manufactures and sells innovative medical products used in infusion therapy, vascular access, and vital care applications. ICU's product portfolio includes ambulatory, syringe, and large volume IV pumps and safety software; dedicated and non-dedicated IV sets, needlefree IV connectors, and peripheral IV catheters; closed system transfer devices and pharmacy compounding systems; as well as a range of respiratory, anesthesia, patient monitoring, and temperature management products. We also offer IV Solutions products through a commercial relationship with the joint venture.

We sell the majority of our products globally through our direct sales force and through independent distributors throughout the U.S. and internationally. We also sell certain products on an original equipment manufacturer basis to other medical device manufacturers.

Basis of Presentation

All subsidiaries are wholly owned and are included in the consolidated financial statements. All intercompany balances and transactions have been eliminated. Results of operations of companies purchased are included from the dates of acquisition.

The consolidated financial statements reflect all adjustments, which are normal and recurring in nature, necessary for fair financial statement presentation. These consolidated financial statements were prepared in accordance with accounting principles generally accepted in the U.S. ("GAAP").

Certain reclassifications have been made to the prior year financial statements and footnotes to conform to the presentation used in the current year. On the consolidated balance sheet, we combined prepaid income taxes with the "prepaid expenses and other current assets" line item. On the consolidated statement of cash flows, we combined provision for doubtful accounts, provision for warranty, returns and field action, and usage of spare parts with the "other" line item. In Note 10: Prepaid Expenses and Other Current Assets we combined deferred tax charge, foreign exchange contracts, and VAT/GST receivable with the "other" line item. In Note 11: Accrued Liabilities we combined operating lease liability, restructuring accrual, accrued sales taxes and other taxes, accrued freight, accrued audit and professional services, distribution fees, warranties and returns, legal accrual, defined benefit plan, foreign exchange forward contracts, and accrued interest with the "other" line item. These reclassifications were made to conform to current year presentation and had no impact on the reported results of operations.

Segment Reporting, Policy

We operate as a single operating and reportable segment. Our Chief Operating Decision Maker ("CODM"), the Chief Executive Officer, reviews financial information presented on a consolidated basis for purposes of allocating resources and assessing performance. See Note 5: Segment Data.

Use of Estimates, Policy [Policy Text Block]

Preparing financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amount of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ from those estimates.

Cash and Cash Equivalents, Policy [Policy Text Block]

Cash equivalents are short-term, highly liquid investments that are readily convertible to known amounts of cash and have original maturities of three months or less from the date of purchase.

Credit Loss, Financial Instrument [Policy Text Block]

Accounts receivable are stated at net realizable value. An allowance is provided for estimated collection losses based on an assessment of various factors. We consider prior payment trends, the age of the accounts receivable balances, the financial status of our customers and other factors to estimate the cash which ultimately will be received. Such amounts cannot be known with certainty at the financial statement date. We regularly review individual past due balances for collectability.

Inventory, Policy [Policy Text Block]

Inventories are stated at the lower of cost or net realizable value with cost determined using the first-in, first-out method.

Property, Plant and Equipment, Policy [Policy Text Block]

All property, plant and equipment are stated at cost. We use the straight-line method for depreciating property, plant and equipment over their estimated useful lives. Estimated useful lives are:


Buildings			15 - 30 years
Building improvements			15 - 30 years
Machinery and equipment and molds			2 - 15 years
Furniture, fixtures and office equipment			2 - 5 years
Computer equipment and software			3 - 5 years
Instruments placed with customers			3 - 10 years

We capitalize expenditures that materially increase the life of the related assets; maintenance and repairs are expensed as incurred. The costs and related accumulated depreciation applicable to property, plant and equipment sold or retired are removed from the accounts and any gain or loss is reflected in the statements of operations at the time of disposal. Depreciation expense was $69.3 million, $85.2 million and $96.7 million in 2025, 2024 and 2023, respectively, of which $62.2 million, $73.7 million, and $75.4 million, respectively, are included in cost of goods sold.

Goodwill and Intangible Assets, Goodwill, Policy [Policy Text Block]

Goodwill

We test goodwill for impairment on an annual basis in the month of November, or more frequently if an event occurs or circumstances change that would indicate that impairment may exist. Generally, we first perform a qualitative assessment to determine whether it is more likely than not that the fair value of the reporting unit is less than its carrying amount. If, based on an assessment of relevant qualitative factors, we determine that this is not the case, then the quantitative impairment test is not required to be performed. Conversely, if we determine based on the qualitative assessment that it is more likely than not that the fair value of the reporting unit is less than its carrying amount, we will perform the quantitative impairment test. For the quantitative impairment test, we calculate the estimated fair value of the reporting unit. If the estimated fair value of the reporting unit is less than its carrying amount, the goodwill of the reporting unit is determined to be impaired. An impairment charge is recorded in an amount equal to the excess of the carrying amount over its estimated fair value, limited to the total amount of goodwill allocated to the reporting unit. In 2025, we performed a qualitative assessment and concluded that it was more likely than not that the fair value of our reporting unit exceeded its carrying amount, and therefore, no further impairment testing was required. We concluded that there was no impairment of goodwill during fiscal 2025, 2024, or 2023.

Goodwill and Intangible Assets, Intangible Assets, Policy [Policy Text Block]

Intangible assets, carried at cost less accumulated amortization and amortized on a straight-lined basis

Impairment or Disposal of Long-Lived Assets, Policy [Policy Text Block]

Long-Lived Assets

We periodically evaluate the recoverability of long-lived assets whenever events and changes in circumstances indicate that the carrying amount of an asset may not be fully recoverable. When indicators of impairment are present, the carrying values of the assets are evaluated in relation to the operating performance and future undiscounted cash flows of the underlying business. The net book value of the underlying asset is adjusted to fair value if the sum of the expected discounted cash flows is less than book value. Fair values are based on estimates of market prices and assumptions concerning the amount and timing of estimated future cash flows and discount rates, reflecting varying degrees of perceived risk. We did not have any long-lived asset impairments in 2025, 2024 or 2023.

Assets Held for Sale

We classify a long-lived asset or disposal groups as held for sale in the period in which all of the following criteria are met: (1) management, having the authority to approve the action, commits to a plan to sell the asset or disposal group; (2) the asset or disposal group is available for immediate sale in its present condition subject only to terms that are usual and customary for sales of such assets or disposal groups; (3) an active program to locate a buyer and other actions required to complete the plan to sell the asset or disposal group have been initiated; (4) the sale of the asset or disposal group is probable, and transfer of the asset or disposal group is expected to qualify for recognition as a completed sale within one year, except if events or circumstances beyond our control extend the period of time required to sell the asset or disposal group beyond one year; (5) the asset or disposal group is being actively marketed for sale at a price that is reasonable in relation to its current fair value; and (6) actions required to complete the plan indicate that it is unlikely that significant changes to the plan will be made or that the plan will be withdrawn. We initially measure a long-lived asset or disposal group that is classified as held for sale at the lower of its carrying value or fair value less any costs to sell and immediately recognize any estimated losses. Conversely, gains are not recognized on the sale of a long-lived asset or disposal group until the date of sale. Each reporting period that a long-lived asset or disposal group remains as held for sale, the carrying value of the long-lived asset or disposal group is adjusted for subsequent changes in fair value less cost to sell, losses are recognized for a subsequent write-down to fair value less cost to sell and gains are recognized for an increase in fair value less cost to sell although limited to the amount of any previous cumulative losses recognized. We cease depreciation and amortization of a long-lived asset, or assets within a disposal group, upon their designation as held for sale. See Note 3: Assets Held For Sale and Disposal of Business.

Investment, Policy [Policy Text Block]

Investments

Investments in Unconsolidated Affiliates

We hold equity method investments in certain entities. We apply the equity method of accounting for investments in unconsolidated affiliates when we determine we have a significant influence, but not a controlling interest in the investee. We determine whether we have significant influence by considering key factors such as ownership interest, representation on the board of directors, participation in policy making decisions, business relationship and material intra-entity transactions, among other factors. Our equity method investments are reported at cost and adjusted each period for our share of the investee's

income or (loss) and dividend paid, if any. We eliminate any intra-entity profits to the extent of our beneficial interest. For our other equity method investment, we report our proportionate share of the investee's income or (loss) resulting from this investment in other income, net in our consolidated statements of operations. We assess our equity method investments for impairment on an annual basis or whenever events or circumstances indicate that the carrying value of the investment may not be recoverable.

On April 24, 2025, the Company completed the formation of ICU Medical Pearl LLC (n/k/a Otsuka ICU Medical LLC (“joint venture”)) and transferred the assets, liabilities and operations that comprise the IV Solutions business to the joint venture. Pursuant to the agreement, we sold 60% of our IV Solutions business to Otsuka Pharmaceutical Factory America, Inc. a Delaware corporation ("OPF") and the Company retained 40% ownership interest in the business. The initial investment, which includes a step up in basis on the retained 40% interest of $19.4 million, was recorded in the amount of $129.9 million. As provided under the joint venture's Operating Agreement, each of OPF and the ICU Medical Entities have been granted certain exclusive call and put options, respectively, with respect to the ICU Medical Entities' remaining ownership interest in the joint venture. Such options are exercisable at certain specified dates and for such amounts as are set forth in the Operating Agreement beginning five years after the transaction closing. If exercised, they could effectively eliminate the Company’s ownership interest. See Note 3: Assets Held for Sale and Disposal of Business for more information.

We also own approximately 20.0% non-marketable equity interest in a nonpublic company and entered into a three-year distribution agreement where we have the exclusive rights to market, sell and distribute the company's products in exchange for a cash payment of $3.3 million. In addition, we were granted an exclusive license for all of the seller's intellectual property. At the expiration of the distribution agreement we have the right but not the obligation to acquire the remaining interest in the business.

Income Tax, Policy [Policy Text Block]

Income Taxes

Deferred taxes are determined based on the differences between the financial statements and the tax bases using rates as enacted in the laws. A valuation allowance is established if it is “more likely than not” that all or a portion of the deferred tax assets will not be realized.

We recognize interest and penalties related to unrecognized tax benefits in the tax provision (see Note 13: Income Taxes for accrued interest and penalties). We recognize liabilities for uncertain tax positions when it is more likely than not that a tax position will not be sustained upon examination and settlement with various taxing authorities. Liabilities for uncertain tax positions are measured based upon the largest amount of benefit that is greater than 50% likely of being realized upon ultimate settlement.

Foreign Currency Transactions and Translations Policy [Policy Text Block]

Foreign Currency

Generally, the functional currency of our international subsidiaries is the local currency. Generally, we translate the financial statements of these subsidiaries to U.S. dollars at the exchange rate in effect at the balance sheet date and revenues and expenses are translated at the average monthly exchange rates during the year. Certain of our international subsidiaries consolidate first with another subsidiary that utilizes a functional currency other than U.S. dollars. In those cases, we follow a step by step translation process utilizing the same sequence as the consolidation process. Translation adjustments are recorded

as a component of accumulated other comprehensive loss, a separate component of stockholders' equity on our consolidated balance sheets and the effect of exchange rate changes on cash and cash equivalents are reflected on our consolidated statements of cash flows. Gains and losses for transactions denominated in a currency other than the functional currency of the entity are included in our consolidated statements of operations in other expense, net (see Other expense, net table below).

Revenue [Policy Text Block]

Revenue Recognition

We recognize revenues when we transfer control of promised goods to our customers, which for the majority of our sales of products sold on a standalone basis to our distributors and end customers for direct sales, is deemed to be at point of shipment. Our software license renewals are considered to be transferred to a customer at a point in time at the start of each renewal period, therefore revenue is recognized at that time.

Our variable consideration includes distributor chargebacks, product returns and end customer rebates, with distributor chargebacks representing the majority and subject to the greatest judgment.

Chargebacks are the difference between the prices we charge our distribution customers at the time they purchase our products and the contracted prices we have with the end customer, most often in the U.S. and Canada. When a distributor sells our products to one of our contracted end customers, the distributor typically will claim a refund from us for the chargeback amount which we process as a credit to the distributor.

In estimating the transaction price to present as net revenue for sales to distributors, we must estimate the expected chargeback amount that we will refund to the distributor after they sell our product to a contracted end customer. Determining the appropriate chargeback reserve requires judgment around the following assumptions:

(i) The estimated chargeback amount (the difference between the price we invoice the distributor and the contractually agreed price with specified end customers); and

(ii) The estimated period of time between the sale to the distributor and the receipt of a chargeback claim.

For purposes of estimating the expected chargeback amount, we utilize actual recent historical chargebacks paid to the specific distributor for similar products as determined at either a product or product-family level. While individual chargeback rates can vary significantly depending on the product and contracted prices with distributors and end customers, our chargeback reserve estimate is not overly sensitive to those individual price changes due to the long-term nature of our distributor and end customer contracts as well as consistency in purchasing patterns. Additionally, the use of the actual chargeback history to calculate an average chargeback rate has historically resulted in a reasonable estimation of overall current contract rates.

For purposes of estimating the period of time between the sale to the distributor and the receipt of a chargeback claim, we utilize several sources of information including actual inventory quantities of our products on hand at distributors. This inventory on hand information is received from the distributors or, when specific quantities are not provided, estimated by using the targeted days of inventory on hand for distributors. Historical experience of actual chargebacks paid has indicated that use of this information has reasonable predictive value of outstanding chargebacks and accounts for the variability of purchasing

patterns and expected timing and volume of sales to end customers. The value of the chargeback reserve generally represents approximately two months of obligation due to the timing difference between the initial sale to a distributor and the processing of a chargeback claim after the product is sold to the end customer.

The chargeback reserve estimates change from period-to-period primarily based on changes in revenue from/and the inventory levels of distributors. Our judgments regarding the information used to calculate the chargeback reserve are consistent from period to period; however, on a regular basis, we evaluate the adequacy of the chargeback reserve to reassess and ensure that the variable consideration is appropriately constrained, and the likelihood of future revenue reversal is not probable. We

use metrics including chargeback provision as a percentage of gross revenue, movements in inventory on hand at distributors, trends in accrued versus paid chargebacks and impacts from price changes and similar metrics.

The chargeback reserve reflects a reasonable estimate of the amount of consideration using the expected value method and is recorded as a reduction of accounts receivable, net on the consolidated balance sheets.

We also offer certain volume-based rebates to both our distribution and end customers, which we record as variable consideration when calculating the transaction price. Rebates are offered on both a fixed and tiered/variable basis. In both cases, we use information available at the time, including current contractual requirements, our historical experience with each customer and forecasted customer purchasing patterns, to estimate the most likely rebate amount.

We also warrant products against defects and have a policy permitting the return of defective products, for which we accrue and expense at the time of sale using information available at that time and our historical experience. We also provide for extended service-type warranties, which we consider to be separate performance obligations. We allocate a portion of the transaction price to the extended service-type warranty based on its estimated relative selling price, and recognize revenue over the period the warranty service is provided.

Arrangements with Multiple Deliverables

In certain circumstances, we enter into arrangements in which we provide multiple deliverables to our customers. These bundled arrangements typically consist of the sale of infusion systems equipment, along with annual software licenses and related software implementation services, software maintenance services and extended warranties. Our most significant judgments related to these arrangements are (i) identifying the various performance obligations and (ii) estimating the relative standalone selling price of each performance obligation, typically using a directly observable method or calculated on a cost plus margin basis method. Revenue related to the bundled equipment, software and software implementation services are typically combined into a single performance obligation and recognized upon implementation. As annual software licenses are renewed, we recognize revenue for the license at a point in time, at the start of each annual renewal period. The transaction price allocated to the extended service-type warranty is recognized as revenue over the period the warranty service is provided. Consumables and IV Solutions are separate performance obligations, recognized at a point in time.

Pension and Other Postretirement Plans, Policy [Policy Text Block]

Post-retirement and Post-employment Benefits

We sponsor a Section 401(k) retirement plan ("plan") for employees. Our contributions to our 401(k) plan were approximately $16.9 million, $19.1 million and $19.2 million in 2025, 2024 and 2023, respectively. We also have post-retirement and post-employment obligations related to employees located in certain international countries. These obligations are immaterial to our financial statements taken as a whole.

Research and Development Expense, Policy [Policy Text Block]

Research and Development

The majority of our research and development costs are expensed as incurred. In certain circumstances when an asset will have an alternative future use we capitalize the costs related to those assets. Research and development costs include salaries and related benefits, consulting fees, production supplies, samples, travel costs, utilities and other miscellaneous administrative costs.

Earnings Per Share, Policy [Policy Text Block]

Net Income (Loss) Per Share

Basic earnings per share is computed by dividing net income (loss) by the weighted-average number of common shares outstanding for the period. Diluted earnings per share is computed by dividing net income (loss) by the weighted-average number of common shares outstanding plus any dilutive potential securities. Dilutive potential 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. Restricted stock units that are anti-dilutive are not included in the treasury stock method. Due to the net loss for the years ended December 31, 2024 and 2023, both basic and diluted net loss per share are computed by dividing net loss by the weighted-average number of common shares outstanding for the period. With net losses the inclusion of any potential securities is antidilutive, accordingly, basic and diluted net loss per share are the same in periods with losses.

Income Taxes Tax Holiday (Details) - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Income Tax Holiday [Line Items]
Income Tax Holiday, Aggregate Dollar Amount	$ 12.5	$ 11.1
Income Tax Holiday, Income Tax Benefits Per Share	$ 0.51	$ 0.45

Fair Value Measurement Fair Value Measurements, Recurring Basis (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Interest Rate Derivative Assets, at Fair Value	$ 3,745	$ 11,038
Assets, Fair Value Disclosure	5,572	23,478
Liabilities, Fair Value Disclosure	5,250	7,391
Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets, Fair Value Disclosure	0	0
Liabilities, Fair Value Disclosure	0	0
Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets, Fair Value Disclosure	5,572	23,478
Liabilities, Fair Value Disclosure	5,250	7,391
Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets, Fair Value Disclosure	0	0
Liabilities, Fair Value Disclosure	0	0
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	1,093	6,716
Interest Rate Derivative Assets, at Fair Value	3,745	11,038
Prepaid Expenses and Other Current Assets [Member] \| Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	0	0
Interest Rate Derivative Assets, at Fair Value	0	0
Prepaid Expenses and Other Current Assets [Member] \| Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	1,093	6,716
Interest Rate Derivative Assets, at Fair Value	3,745	11,038
Prepaid Expenses and Other Current Assets [Member] \| Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	0	0
Interest Rate Derivative Assets, at Fair Value	0	0
Other Assets [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	70
Interest Rate Derivative Assets, at Fair Value	664	5,724
Other Assets [Member] \| Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	0
Interest Rate Derivative Assets, at Fair Value	0	0
Other Assets [Member] \| Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	70
Interest Rate Derivative Assets, at Fair Value	664	5,724
Other Assets [Member] \| Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contract, Asset, Fair Value Disclosure	0
Interest Rate Derivative Assets, at Fair Value	0	0
Accrued Liabilities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contracts, Liability, Fair Value Disclosure	479	7,391
Interest Rate Derivative Liabilities, at Fair Value	1,508
Accrued Liabilities \| Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contracts, Liability, Fair Value Disclosure	0	0
Interest Rate Derivative Liabilities, at Fair Value	0
Accrued Liabilities \| Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contracts, Liability, Fair Value Disclosure	479	7,391
Interest Rate Derivative Liabilities, at Fair Value	1,508
Accrued Liabilities \| Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contracts, Liability, Fair Value Disclosure	0	$ 0
Interest Rate Derivative Liabilities, at Fair Value	0
Other Liabilities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contracts, Liability, Fair Value Disclosure	67
Interest Rate Derivative Liabilities, at Fair Value	3,196
Other Liabilities \| Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contracts, Liability, Fair Value Disclosure	0
Interest Rate Derivative Liabilities, at Fair Value	0
Other Liabilities \| Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contracts, Liability, Fair Value Disclosure	67
Interest Rate Derivative Liabilities, at Fair Value	3,196
Other Liabilities \| Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Foreign Currency Contracts, Liability, Fair Value Disclosure	0
Interest Rate Derivative Liabilities, at Fair Value	$ 0

Segment Reporting (Tables)

12 Months Ended

Dec. 31, 2025

Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]

Schedule of Segment Reporting Information, by Segment

The following table presents information about our segment revenue, segment profit or loss, and significant segment expenses (in thousands):


	Year ended December 31,
	2025		2024		2023
REVENUES	$	2,231,262	$	2,382,046	$	2,259,126
Less:
Standard COGS(1)	1,007,545		1,193,994		1,114,294
Quality remediation/recall(2)	40,459		19,126		58,243
Other COGS(3)	326,914		344,144		346,716
Tariff expense(4)	34,305		—		—
Selling, general and administrative	625,210		638,762		606,693
Research and development	87,495		88,615		85,344

Restructuring and integration	66,505		59,840		41,258
Other segment items(5)	(54,867)		(2,964)		(17,850)
Interest expense	93,338		106,541		102,727
Income tax provision (benefit)	2,437		51,676		(48,644)
Equity in losses of unconsolidated affiliates	1,189		—		—
Consolidated net income (loss)	$	732	$	(117,688)	$	(29,655)

_______________

(1) Represents the average annual budgeted cost of producing each good sold in the period.

(2) Represents significant labor and material costs to replace or repair a product outside the scope of standard warranty and compliance costs related to quality systems and manufacturing operations.

(3) Includes costs related to capitalized manufacturing variances to standard COGS, supply chain and logistics costs including freight, inventory management and reserves, hardware service, quality and regulatory, and operations and supply chain management costs.

(4) For the year ended 2025, total tariff expense includes $3.1 million in tariffs typically grouped within standard COGS and $31.2 million typically grouped within other COGS. Prior year comparative data for tariff-related expenses is not presented as these costs were historically integrated within broad general ledger accounts and are not practicable to discretely calculate without unreasonable effort.

(5) Includes changes in fair value of contingent earn-out, interest income, gain/loss on disposition of assets, gain/loss on foreign exchange, other miscellaneous income/expense and gain on sale of business.

Schedule of Disclosure on Geographic Areas, Long-Lived Assets in Individual Foreign Countries by Country

The table below presents our gross long-lived assets, consisting of property, plant and equipment, by country or region (in thousands):


	As of December 31,
	2025		2024
Costa Rica	$	168,678	$	156,149
Mexico	127,389		111,043
Other LATAM	71,054		55,451
Canada	1,982		5,284
Italy	35,468		29,124



Spain	21,532		17,141
Czech Republic	14,111		11,909
Other Europe	11,485		11,445
APAC	28,239		27,550
Total Foreign	$	479,938	$	425,096
United States	617,792		610,547
Worldwide Total	$	1,097,730	$	1,035,643

Share Based Award RSU and PRSU Roll forward (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
2023 PRSU Goal Shares	6,431
2024 PRSU Goal Shares	221,016
2025 PRSU Goal Shares	73,170
Restricted Stock and Performance Restricted Stock Units [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number	635,376	551,011
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value	$ 132.21	$ 133.47
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period	266,503
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period, Weighted Average Grant Date Fair Value	$ 141.86
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period	(169,541)
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period, Intrinsic Value, Amount Per Share	$ 152.03
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Forfeited in Period	(12,597)
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Forfeitures, Intrinsic Value, Amount Per Share	$ 124.59
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Outstanding, Weighted Average Remaining Contractual Terms	9 months 18 days
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Aggregate Intrinsic Value, Nonvested	$ 90,649
Performance restricted stock units expected to vest	935,993

Document and Entity Information Document - USD ($)	12 Months Ended
Document and Entity Information Document - USD ($)	Dec. 31, 2025	Jan. 31, 2026	Jun. 30, 2025
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2025
Document Transition Report	false
Entity File Number	001-34634
Entity Registrant Name	ICU MEDICAL INC/DE
Entity Central Index Key	0000883984
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2025
Document Fiscal Period Focus	FY
Amendment Flag	false
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	33-0022692
Entity Address, Address Line One	951 Calle Amanecer
Entity Address, City or Town	San Clemente
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	92673
City Area Code	949
Local Phone Number	366-2183
Title of 12(b) Security	Common stock, par value $0.10 per share
Trading Symbol	ICUI
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Entity Shell Company	false
Entity Public Float			$ 3,225,011,330
Entity Common Stock, Shares Outstanding		24,690,275
Documents Incorporated by Reference	Portions of the Proxy Statement for registrant’s 2026 Annual Meeting of Stockholders filed or to be filed pursuant to Regulation 14A within 120 days following registrant’s fiscal year ended December 31, 2025, are incorporated by reference into Part III of this Report.
Document Financial Statement Error Correction [Flag]	false

Revenue Disaggregation of Revenue by Geography (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Disaggregation of Revenue [Line Items]
Revenues	$ 2,231,262	$ 2,382,046	$ 2,259,126
UNITED STATES
Disaggregation of Revenue [Line Items]
Revenues	$ 1,356,114	$ 1,532,104	$ 1,440,017
Percent of total revenue	61.00%	64.00%	64.00%
EMEA [Member]
Disaggregation of Revenue [Line Items]
Revenues	$ 411,684	$ 393,530	$ 373,571
APAC [Domain]
Disaggregation of Revenue [Line Items]
Revenues	232,903	232,820	241,699
Other foreign countries [Member]
Disaggregation of Revenue [Line Items]
Revenues	$ 230,561	$ 223,592	$ 203,839
International Sales [Domain]
Disaggregation of Revenue [Line Items]
Percent of total revenue	39.00%	36.00%	36.00%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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- Definition

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

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+ Details

General and Summary of Significant Accounting Policies Investments-Equity Method (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Schedule of Equity Method Investments [Line Items]
Equity Method Investments	$ 131,586	$ 3,038
us-gaap_Otsuka ICU Medical LLC
Schedule of Equity Method Investments [Line Items]
Equity Method Investments	128,662	0
us-gaap_OtherInvestmentsMember
Schedule of Equity Method Investments [Line Items]
Equity Method Investments	$ 2,924	$ 3,038

- Definition

This item represents the carrying amount on the entity's balance sheet of its investment in common stock of an equity method investee. This is not an indicator of the fair value of the investment, rather it is the initial cost adjusted for the entity's share of earnings and losses of the investee, adjusted for any distributions (dividends) and other than temporary impairment (OTTI) losses recognized.

+ References + Details

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Discontinued Operations and Disposal Groups (Tables)

12 Months Ended

Dec. 31, 2025

Discontinued Operations and Disposal Groups [Abstract]

Disposal Groups, Including Discontinued Operations

The following table summarizes the carrying values of the assets and liabilities presented as held for sale in our consolidated balances sheet as of December 31, 2024 (in thousands):


Assets:	2024
Accounts receivable, net of allowance of $465 at December 31, 2024	$	13,331
Inventories	88,656
Prepaid expenses and other current assets	4,140
Property, plant and equipment, net	155,426
Other assets	22,829
Total assets held for sale	$	284,382

Liabilities:
Accounts payable	$	13,533
Accrued liabilities	19,378
Total liabilities held for sale	$	32,911

Net assets held for sale	$	251,471

Schedule of Related Party Transactions

The following table presents consolidated financial statement data resulting from transactions with the joint venture (in thousands):


	Year ended December 31,
		2025
Consolidated statement of operations:
Manufacturing services agreement revenue (net revenue)		$	11,886
Manufacturing services agreement cost of goods sold (costs of good sold)		$	11,131

Service fees - Otsuka ICU Medical LLC (cost of goods sold)		$	969
Service fees - Otsuka ICU Medical LLC (selling, general & administrative)		$	8,206

Equity in losses of unconsolidated affiliates		$	(1,189)

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

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+ Details

Revenue (Notes)

12 Months Ended

Dec. 31, 2025

Revenue from Contract with Customer [Abstract]

Revenue from Contract with Customer [Text Block]

REVENUE

Revenue Recognition

Our business units are Consumables, Infusion Systems and Vital Care. The vast majority of our sales of these products within these business units are made on a stand-alone basis to hospitals and distributors. Revenue is typically recognized upon transfer of control of the products, which we deem to be at point of shipment. For purposes of revenue recognition for our

software licenses and renewals, we consider the control of these products to be transferred to a customer at a certain point in time; therefore, we recognize revenue at the start of the applicable license term.

Payment is typically due in full within 30 days of delivery or the start of the contract term. Revenue is recorded in an amount that reflects the consideration we expect to be entitled to in exchange for those goods or services. We include variable consideration in net sales only to the extent that a significant reversal in revenue is not probable when the uncertainty is resolved. Our variable consideration includes distributor chargebacks, product returns and end customer rebates with distributor chargebacks representing the majority and subject to the greatest judgment (see Note 1: Basis of Presentation and Significant Accounting Policies).

We also offer certain volume-based rebates to both our distribution and end customers, which is recorded as variable consideration when calculating the transaction price. Rebates are offered on both a fixed and tiered/variable basis. In both cases, we use information available at the time, including current contractual requirements, our historical experience with each customer and forecasted customer purchasing patterns, to estimate the most likely rebate amount. We also warrant products against defects and have a policy permitting the return of defective products. We also provide for extended service-type warranties, which we consider to be separate performance obligations. We allocate a portion of the transaction price to the extended service-type warranty based on its estimated relative selling price, and recognize revenue over the period the warranty service is provided. See Note 1: Basis of Presentation and Significant Accounting Policies for further discussion.

Arrangements with Multiple Performance Obligations

We also enter into arrangements which include multiple performance obligations, (see Note 1: Basis of Presentation and Summary of Significant Accounting Policies). The most significant judgments related to these arrangements include:

•Identifying the various performance obligations of these arrangements.

•Estimating the relative standalone selling price of each performance obligation, typically using a directly observable method or calculated on a cost plus margin basis method.

Revenue disaggregated

The following table represents our revenues disaggregated by product line (in thousands) and our disaggregated product line revenue as a percentage of total revenue:


	Year ended December 31,
	2025				2024				2023
Product line	Revenue		% of Revenue		Revenue		% of Revenue		Revenue		% of Revenue
Consumables	$	1,109,130	50	%	$	1,038,869	44	%	$	969,129	43	%
Infusion Systems	684,208		31	%	652,410		27	%	629,043		28	%
Vital Care	437,924		19	%	690,767		29	%	660,954		29	%




Total Revenues	$	2,231,262	100	%	$	2,382,046	100	%	$	2,259,126	100	%

We report revenue on a "where sold" basis, which reflects the revenue within the country or region in which the ultimate sale is made to our external customer.

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


	Year ended December 31,
Geography	2025		2024		2023
United States	$	1,356,114	$	1,532,104	$	1,440,017
Europe, the Middle East and Africa	411,684		393,530		373,571
Asia-Pacific	232,903		232,820		241,699
Other Foreign	230,561		223,592		203,839
Total Revenues	$	2,231,262	$	2,382,046	$	2,259,126

Domestic sales accounted for 61%, 64% and 64% of total revenue in 2025, 2024 and 2023, respectively. International sales accounted for 39%, 36% and 36% of total revenue in 2025, 2024 and 2023, respectively.

Contract balances

Our contract balances (deferred revenue) are recorded in accrued liabilities and other long-term liabilities in our consolidated balance sheet (see Note 11: Accrued Liabilities). The following table presents the changes in our contract balances for the years ended December 31, 2024 and 2023, (in thousands):


	Contract Liabilities
Beginning balance, January 1, 2024	$	42,177

Equipment revenue recognized	(56,182)
Equipment revenue deferred due to implementation	55,932
Software revenue recognized	(28,292)
Software revenue deferred due to implementation	29,913
Government grant income recognized(1)	(2,072)
Government grant income deferred	—
Other deferred revenue recognized	(2,576)
Other deferred revenue	503
Ending balance, December 31, 2024	39,403

Equipment revenue recognized	(65,792)
Equipment revenue deferred due to implementation	74,836
Software revenue recognized	(35,715)
Software revenue deferred due to implementation	31,373
Government grant income recognized(1)	(2,066)
Government grant income deferred	—
Other deferred revenue recognized	(1,983)
Other deferred revenue	1,177
Ending balance, December 31, 2025	$	41,233

____________________________

(1) The government grant income deferred is amortized over the life of the related depreciable asset as a reduction to depreciation expense.

During 2025, we recognized $35.5 million in revenue that was included in the opening contract balances as of December 31, 2024.

As of December 31, 2025, revenue from remaining performance obligations is as follows (in thousands):


	Recognition Timing
	<12 Months		> 12 Months
Equipment revenue	$	24,530	$	372
Software revenue	6,361		1,719
Government grant deferred income(1)	2,064		5,277
Other deferred revenue(2)	888		22
Total	$	33,843	$	7,390

____________________________

(1) The government grant deferred income is amortized over the life of the related depreciable asset as a reduction to depreciation expense.

(2) Other deferred revenue includes pump development programs, purchased training and extended warranty.

Costs to Obtain a Contract with a Customer

As part of the cost to obtain a contract, we may pay incremental commissions to sales employees upon entering into a sales contract. Under ASC Topic 606, we have elected to expense these costs as incurred as the period of benefit is less than one year.

Practical expedients and exemptions

In addition to the practical expedient applied to sales commissions, under ASC Topic 606, we elected to apply the practical expedient for shipping and handling costs incurred after the customer has obtained control of a good. We will continue to treat these costs as a fulfillment cost rather than as an additional promised service.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
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+ Details

Prepaids and Other Current Assets (Notes)

12 Months Ended

Dec. 31, 2025

Prepaid Expense and Other Assets [Abstract]

Prepaids, other current assets and other noncurrent assets [Text Block]

PREPAID EXPENSES AND OTHER CURRENT ASSETS

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


	As of December 31,
	2025		2024
Other prepaid expenses and receivables	$	23,390	$	17,312

Deferred costs	13,110		9,060
Prepaid insurance and property taxes	8,923		10,284



Interest rate contracts*	3,745		11,038

Prepaid income taxes	16,549		11,244
Other*	20,500		22,593
	$	86,217	$	81,531

_______________________

*See Note 8: Derivatives and Hedging Activities

General and Summary of Significant Accounting Policies Income Taxes - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Accounting Policies [Abstract]
Income Tax Examination, Interest Accrued	$ 2,400	$ 2,600
Income Tax Examination, Penalties Accrued	$ 1,000	$ 1,600

Principal Payments (Details)	3 Months Ended			12 Months Ended
Principal Payments (Details)	Dec. 31, 2025 USD ($)	Sep. 30, 2025 USD ($)	Mar. 31, 2025 USD ($)	Dec. 31, 2025 USD ($)	Dec. 31, 2024 USD ($)
Debt Disclosure [Abstract]
Debt Instrument, Periodic Payment, Principal				$ 302,800,000	$ 51,000,000.0
DebtInstrumentAdditionalPrepaymentPrincipal	$ 30,000,000.0	$ 25,000,000.0	$ 35,000,000.0
Term A principal payment % First 2 Years	0.00625			0.00625
Term A Principal Payment % Year 3 and 4	0.0125			0.0125
Term A Principal Payment % in Year 5	0.01875			0.01875
Term Loan B Principal Payment %	0.0025			0.0025

Revenue Remaining Performance Obligation Recognition Timing (Details) $ in Thousands	Dec. 31, 2025 USD ($)
Short Term
Revenue Recognition Timing [Line Items]
Revenue, Remaining Performance Obligation, Amount	$ 33,843
Short Term \| Equipment revenue [Member]
Revenue Recognition Timing [Line Items]
Revenue, Remaining Performance Obligation, Amount	24,530
Short Term \| Software revenue [Member]
Revenue Recognition Timing [Line Items]
Revenue, Remaining Performance Obligation, Amount	6,361
Short Term \| Government Grant Revenue
Revenue Recognition Timing [Line Items]
Revenue, Remaining Performance Obligation, Amount	2,064
Short Term \| Other deferred revenue
Revenue Recognition Timing [Line Items]
Revenue, Remaining Performance Obligation, Amount	888
Long Term
Revenue Recognition Timing [Line Items]
Revenue, Remaining Performance Obligation, Amount	7,390
Long Term \| Equipment revenue [Member]
Revenue Recognition Timing [Line Items]
Revenue, Remaining Performance Obligation, Amount	372
Long Term \| Software revenue [Member]
Revenue Recognition Timing [Line Items]
Revenue, Remaining Performance Obligation, Amount	1,719
Long Term \| Government Grant Revenue
Revenue Recognition Timing [Line Items]
Revenue, Remaining Performance Obligation, Amount	5,277
Long Term \| Other deferred revenue
Revenue Recognition Timing [Line Items]
Revenue, Remaining Performance Obligation, Amount	$ 22

Share Based Award Stock Option Activity (Details) - Share-based Payment Arrangement, Option [Member] $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2025 USD ($) $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options, Outstanding, Number \| shares	108,140
Granted \| shares	0
Exercised \| shares	(63,197)
Forfeited or expired \| shares	0
Options, Outstanding, Number \| shares	44,943
Exercisable \| shares	44,943
Vested and Expected to Vest \| shares	44,943
Options, Outstanding, Weighted Average Exercise Price \| $ / shares	$ 136.12
Weighted Average Exercise Price \| $ / shares	0
Options, Exercises in Period, Weighted Average Exercise Price \| $ / shares	96.61
Options, Nonvested Options Forfeited, Weighted Average Grant Date Fair Value \| $ / shares	0
Options, Outstanding, Weighted Average Exercise Price \| $ / shares	191.68
Exercise Price Range, Exercisable Options, Weighted Average Exercise Price \| $ / shares	191.68
Options, Vested and Expected to Vest, Outstanding, Weighted Average Exercise Price \| $ / shares	$ 191.68
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Term	3 years 8 months 15 days
Options, Exercisable, Weighted Average Remaining Contractual Term	3 years 8 months 15 days
Options, Vested and Expected to Vest, Outstanding, Weighted Average Remaining Contractual Term	3 years 8 months 15 days
Options, Outstanding, Intrinsic Value \| $	$ 202
Options, Exercisable, Intrinsic Value \| $	202
Options, Vested and Expected to Vest, Outstanding, Aggregate Intrinsic Value \| $	$ 202

Income Taxes Operating Loss Carryforwards (Details) $ in Thousands	Dec. 31, 2025 USD ($)
Operating Loss Carryforwards [Line Items]
Deferred Tax Assets, Operating Loss Carryforwards	$ 27,700
Operating Loss Carryforwards, Valuation Allowance	20,400
us-gaap_DeferredTaxAssetsOperatingLossCarryforwards, net	7,300
Foreign Tax Jurisdiction [Member]
Operating Loss Carryforwards [Line Items]
Operating Loss Carryforwards	106,800
Deferred Tax Assets, Operating Loss Carryforwards	7,300
Operating Loss Carryforwards, Valuation Allowance	$ 6,300

Income Taxes Tax Provision (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Current Federal Tax Expense (Benefit)	$ (10,147)	$ 16,589	$ (8,235)
Current State and Local Tax Expense (Benefit)	1,627	4,256	5,035
Current Foreign Tax Expense (Benefit)	24,731	25,164	24,500
Current Income Tax Expense (Benefit)	16,211	46,009	21,300
Deferred Federal Income Tax Expense (Benefit)	(1,947)	1,294	(43,042)
Deferred State and Local Income Tax Expense (Benefit)	(2,288)	14,850	(14,657)
Deferred Foreign Income Tax Expense (Benefit)	(9,539)	(10,477)	(12,245)
Deferred Income Tax Expense (Benefit)	(13,774)	5,667	(69,944)
(Provision) benefit for income taxes	$ 2,437	$ 51,676	$ (48,644)

Debt (Tables)

12 Months Ended

Dec. 31, 2025

Debt Disclosure [Abstract]

Schedule of Extinguishment of Debt

The following table summarizes the accounting treatment applied to the various costs, distinguishing between fees paid to lenders and those paid to third parties based on modification or extinguishment status:


	Extinguishment expense		Capitalize		Remains capitalized
Term Loan
Original unamortized debt discount	$	1,807			$	6,400
Original unamortized debt costs	374				1,276
New lender fees			1,626
New debt issuance costs - third party			937

Revolver
Original unamortized debt discount	246				1,502
Original unamortized debt costs	36				221
New lender fees			1,199
New debt issuance costs - third party			618
	$	2,463	$	4,380	$	9,399

Interest Margin and Commitment Fee [Table Text Block]

The applicable Interest Margins and the Commitment Fee with respect to the New Revolving Credit Facility and the New Term Loan A Facility is determined by reference to the leverage ratio in effect from time to time as set forth in the table below:


Leverage Ratio	Applicable Margin for Eurocurrency Rate Loans and RFR Loans	Applicable Margin for Base Rate Loans	Commitment Fee Rate
Greater than 4.00 to 1.0	2.25%	1.25%	0.35%
Less than or equal to 4.00 to 1.0 but greater than 3.00 to 1.0	2.00%	1.00%	0.30%
Less than or equal to 3.00 to 1.0 but greater than 2.50 to 1.0	1.75%	0.75%	0.25%
Less than or equal to 2.50 to 1.0 but greater than 2.00 to 1.0	1.50%	0.50%	0.20%
Less than or equal to 2.00 to 1.0 but greater than 1.75 to 1.0	1.25%	0.25%	0.15%
Less than or equal to 1.75 to 1.0	1.00%	—%	0.10%

Applicable Margin on Loan Type

The applicable margin for the Term Loan B is determined by reference to the leverage ratio in effect from time to time as set forth in the following table:


Leverage Ratio	Applicable Margin for Term SOFR Loans	Applicable Margin for Base Rate Loans
Greater than 2.75 to 1.0	2.50%	1.50%
Less than 2.75 to 1.0	2.25%	1.25%

Schedule of Long-Term Debt Instruments

The carrying values of our long-term debt consist of the following (in thousands):


	2025 Effective Interest Rate		As of December 31,				2024 Effective Interest Rate
			2025		2024
Senior Secured Credit Facilities:
New Credit Facilities:
Term Loan A — principal	7.02	%	$	750,000
Revolving Credit Facility — principal	—		—
Prior Credit Facilities:
Term Loan A — principal					770,313		8.03	%
Term Loan B — principal	7.56	%	544,500		826,625		8.38	%
Revolving Credit Facility — principal					—		—	%
Less unamortized debt issuance costs(1)			(9,833)		(14,080)
Total carrying value of long-term debt			1,284,667		1,582,858
Less current portion of long-term debt			18,750		51,000
Long-term debt, net			$	1,265,917	$	1,531,858

_______________________________

(1) In 2025, comprised of $5.3 million and $4.5 million relating to the Term Loan A and the Term Loan B, respectively. In 2024, comprised of $6.1 million and $8.0 million relating to the Term Loan A and the Term Loan B, respectively.

Schedule of Maturities of Long-Term Debt

As of December 31, 2025, the aggregate amount of principal repayments of our long-term debt (including any current portion) for each of the next five years is approximately (in thousands):


2026	$	18,750
2027	18,750
2028	37,500
2029	582,000
2030	637,500
Thereafter	—
Total	$	1,294,500

Interest expense on long-term debt

The following table presents the total interest expense related to our long-term debt (in thousands):


	Year Ended December 31,
	2025		2024		2023
Contractual interest	$	93,888	$	125,012	$	125,550
Amortization of debt issuance costs	8,903		6,807		6,814
Commitment fee — Revolving Credit Facility	1,355		1,524		1,518
Total long-term debt-related interest expense	$	104,146	$	133,343	$	133,882

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(22))
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-Topic 210
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480566/210-10-S99-1

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 942
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-Name Accounting Standards Codification
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-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477314/942-235-S99-2

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 235
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-Name Accounting Standards Codification
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-Paragraph 4
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480738/235-10-S50-4

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
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-Name Accounting Standards Codification
-Section S99
-Paragraph 3
-Subparagraph (SX 210.12-04(a))
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-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-3

Reference 5: http://www.xbrl.org/2003/role/exampleRef
-Topic 470
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-Name Accounting Standards Codification
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-Paragraph 69B
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Reference 6: http://www.xbrl.org/2003/role/exampleRef
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Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
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-URI https://asc.fasb.org/1943274/2147481112/505-10-50-7

+ Details

Income Taxes Effective tax rate (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Effective Income Tax Rate Reconciliation [Line Items]
Income Tax Reconciliation, Foreign Income Tax Rate Differential		$ (4,231)	$ (2,506)
Effective Income Tax Rate Reconciliation, Foreign Income Tax Rate Differential		6.40%	3.20%
Income Tax Reconciliation, Income Tax Expense (Benefit), at Federal Statutory Income Tax Rate	$ 915	$ (13,862)	$ (16,443)
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent	21.00%	21.00%	21.00%
Income Tax Reconciliation, State and Local Income Taxes	$ 479	$ 701	$ (6,057)
Effective Income Tax Rate Reconciliation, State and Local Income Taxes	11.00%	(1.10%)	7.70%
Effective Income Tax Rate Reconciliation, Cross-Border Tax Effect, Amount	$ 810
Effective Income Tax Rate Reconciliation, Cross-Border Tax Effect, Percent	18.60%
Income Tax Reconciliation, Tax Credits	$ (3,606)	$ (10,985)	$ (9,824)
Effective Income Tax Rate Reconciliation, Tax Credits	(82.80%)	16.60%	12.50%
Effective Income Tax Rate Reconciliation, GILTI, Amount		$ 2,977	$ (2,658)
Effective Income Tax Rate Reconciliation, GILTI, Percent		4.50%	(3.40%)
Income Tax Reconciliation, Foreign Income Tax Rate Differential		$ (4,231)	$ (2,506)
Effective Income Tax Rate Reconciliation, Foreign Income Tax Rate Differential		6.40%	3.20%
Effective Income Tax Rate Reconciliation, Tax Expense (Benefit), Share-based Payment Arrangement, Amount		$ 2,824	$ (289)
Effective Income Tax Rate Reconciliation, Tax Expense (Benefit), Share-based Payment Arrangement, Percent		(4.30%)	0.40%
Effective Income Tax Rate Reconciliation, FDII, Amount		$ (3,756)	$ (3,299)
Effective Income Tax Rate Reconciliation, FDII, Percent		5.70%	4.20%
Effective Income Tax Rate Reconciliation, Contingent Consideration		$ 838	$ 3,407
Effective Income Tax Rate Reconciliation, Contingent Consideration, Percent		(1.30%)	(4.40%)
Effectiveincometaxreconciliation,nondeductiblecompensation	$ 6,353	$ 1,880	$ 3,268
Effectivetaxratereconciliationnondeductiblecomppercent	145.80%	(2.80%)	(4.20%)
EffectiveIncomeTaxRateReconciliationTaxReserveReleases	$ (6,508)	$ (2,216)	$ (6,884)
Effective IncomeTaxRateReconciliationTaxReserveReleasesPercent	(1.494)	0.033	0.088
Effective Income Tax Rate Reconciliation, Legal Settlement		$ (2,100)	$ 0
Effective Income Tax Rate Reconciliation Legal Settlement Percent		0.032	0
Effective Income Tax Rate Reconciliation, Change in Deferred Tax Assets Valuation Allowance, Amount	$ 6,193	$ 81,713	$ 0
Effective Income Tax Rate Reconciliation, Change in Deferred Tax Assets Valuation Allowance, Percent	142.10%	(123.80%)	0.00%
Effective Income Tax Rate Reconciliation, Tax Exempt Income, Amount	$ 936
Effective Income Tax Rate Reconciliation, Tax Exempt Income, Percent	21.50%
Effective Income Tax Rate Reconciliation, Other Adjustments, Amount	$ (1,193)	$ (431)	$ (545)
Effective Income Tax Rate Reconciliation, Other Adjustments, Percent	(27.40%)	0.70%	0.70%
(Provision) benefit for income taxes	$ 2,437	$ 51,676	$ (48,644)
Effective Income Tax Rate, Continuing Operations	55.80%	(78.30%)	62.10%
(Provision) benefit for income taxes	$ 2,437	$ 51,676	$ (48,644)
COSTA RICA
Effective Income Tax Rate Reconciliation [Line Items]
Income Tax Reconciliation, Foreign Income Tax Rate Differential	$ (8,645)
Effective Income Tax Rate Reconciliation, Foreign Income Tax Rate Differential	(198.40%)
Income Tax Reconciliation, Foreign Income Tax Rate Differential	$ (8,645)
Effective Income Tax Rate Reconciliation, Foreign Income Tax Rate Differential	(198.40%)
Foreign Tax Jurisdiction, Other
Effective Income Tax Rate Reconciliation [Line Items]
Income Tax Reconciliation, Foreign Income Tax Rate Differential	$ 6,703
Effective Income Tax Rate Reconciliation, Foreign Income Tax Rate Differential	153.80%
Income Tax Reconciliation, Foreign Income Tax Rate Differential	$ 6,703
Effective Income Tax Rate Reconciliation, Foreign Income Tax Rate Differential	153.80%

Cybersecurity Risk Management and Strategy Disclosure	12 Months Ended
Cybersecurity Risk Management and Strategy Disclosure	Dec. 31, 2025
Cybersecurity Risk Management, Strategy, and Governance [Line Items]
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]	We have developed and implemented a cybersecurity risk management program intended to protect the confidentiality, integrity, and availability of our critical systems and information. We leverage guidance from the National Institute of Standards and Technology Cybersecurity Framework (“NIST CSF”), which provides an outline of enterprise security processes and controls, to inform the design and assessment of our cybersecurity risk management program. This does not imply that we meet any particular technical standards, specifications, or requirements, only that we use the NIST CSF as a guide to help us identify, assess, and manage cybersecurity risks relevant to our business. Our cybersecurity risk management program is overseen by a cross-functional team comprised of our business-functional and IT employees. Our cybersecurity risk management program is integrated into our overall risk management program, and shares common methodologies, reporting channels and governance processes that apply across the risk management program to other legal, compliance, strategic, operational, and financial risk areas. Key elements of our cybersecurity risk management program include but are not limited to the following: •risk assessments designed to help identify material risks from cybersecurity threats to our critical systems and information; •evaluations of our readiness to assess, respond and, as applicable, recover from potential cybersecurity incidents; •the use of external service providers, where appropriate, to assess, test or otherwise assist with aspects of our security processes; •cybersecurity training to educate our employees (including senior management and incident response personnel), consultants, and other users about their individual responsibilities regarding protecting our IT systems and data; •a third-party risk management process for key service providers, based on our assessment of their criticality to our operations and respective risk profile. We have not identified risks from known cybersecurity threats, including as a result of any prior cybersecurity incidents, that have materially affected or are reasonably likely to materially affect us, including our operations, business strategy, results of operations, or financial condition. We face risks from cybersecurity threats that, if realized, are reasonably likely to materially affect us, including our operations, business strategy, results of operations or financial condition. For more information, see the section titled “Risk Factor—Market and Other External Risks—Failure to protect our information technology systems against security breaches, service interruptions, or misappropriation of data could disrupt operations, compromise sensitive data, and expose us to liability, possibly causing our business and reputation to suffer.”
Cybersecurity Risk Management Processes Integrated [Flag]	true
Cybersecurity Risk Management Positions or Committees Responsible [Flag]	true
Cybersecurity Risk Management Expertise of Management Responsible [Text Block]	Our ISC members includes, among others, our CIO and our Director of IT Security, Risk and Compliance who have a combined 20 years of risk management experience encompassing cybersecurity and technology security, such as threat assessments, risk management, cybersecurity insurance, incident response, end user awareness and vulnerability management. Our management team takes steps to stay informed about and monitor efforts to prevent, detect, mitigate, and remediate cybersecurity risks and incidents through various means, which may include: briefings from internal security personnel; threat intelligence and other information obtained from governmental, public or private sources, including external consultants engaged by us; and alerts and reports produced by security tools deployed in our IT environment.

Transfers and Servicing

12 Months Ended

Dec. 31, 2025

Transfers and Servicing [Abstract]

Transfers and Servicing of Financial Assets

ACCOUNTS RECEIVABLE PURCHASE PROGRAM

On January 19, 2023, we entered into a revolving $150 million uncommitted receivables purchase agreement with Bank of The West ("BOW"), which was subsequently acquired by BMO in February 2023. This agreement provided for a less expensive form of capital. The discount rate applied to sold receivables equals a rate per annum equal to the sum of (i) an applicable margin, plus (ii) Term SOFR for a period equal to the discount period which is calculated with respect to the payment terms of the specific receivable. The accounts receivable sold have payment terms ranging between 30 and 60 days, and are related to customer accounts with good credit history. The transfer of the purchased accounts receivable under the agreement is intended to be an absolute and irrevocable transfer constituting a true sale as the transferred receivables have been isolated beyond the reach of the Company and our creditors, even in bankruptcy or other receivership. We do not retain effective control over the sold receivables and BMO has the right upon purchase to pledge and/or exchange the transferred assets without restrictions. The Company acts as collection agent for BMO and collection services are undertaken by our accounts receivable personnel in their normal course of business and collected funds are remitted to BMO. We do not have any continuing involvement with the sold receivables other than the collection services which does not provide us with more than a trivial benefit. The discount rate has been negotiated net of consideration for the collection services, the cost of collection is immaterial to the Company; therefore, we did not separately record any related servicing assets or liabilities related to the sold receivables.

The following table presents information in connection with the purchase program (in thousands):


	Year Ended December 31,
	2025		2024
Trade receivables sold(1)	$	10,009	$	435,438
Cash received in exchange for trade receivables sold(2)	9,978		432,803
Loss on sale of receivables(3)	32		2,635

_______________________________

(1) Represents carrying value of trade receivables sold to BMO.

(2) Cash proceeds received from BMO.

(3) Reflected in other expense, net in our consolidated statement of operations.

As of December 31, 2025, and 2024, there were no outstanding balances to be collected on behalf of BMO.

- Definition

The entire disclosure for a transferor's continuing involvement in financial assets that it has transferred in a securitization or asset-backed financing arrangement, the nature of any restrictions on assets reported by an entity in its statement of financial position that relate to a transferred financial asset (including the carrying amounts of such assets), how servicing assets and servicing liabilities are reported, and (for securitization or asset-backed financing arrangements accounted for as sales) when a transferor has continuing involvement with the transferred financial assets and transfers of financial assets accounted for as secured borrowings, how the transfer of financial assets affects an entity's financial position, financial performance, and cash flows.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
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-Name Accounting Standards Codification
-Section 50
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Derivatives and Hedging Activities Foreign Exchange Forward Contracts(Details)	Dec. 31, 2025 USD ($)
Derivative [Line Items]
Derivative, Notional Amount	$ 24,300,000
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	600,000
other currencies
Derivative [Line Items]
Derivative, Notional Amount	400,000
Mexico, Pesos
Derivative [Line Items]
Derivative, Notional Amount	3,300,000
Japan, Yen
Derivative [Line Items]
Derivative, Notional Amount	7,500,000
Euro Member Countries, Euro
Derivative [Line Items]
Derivative, Notional Amount	3,500,000
Australia, Dollars
Derivative [Line Items]
Derivative, Notional Amount	6,500,000
United States of America, Dollars
Derivative [Line Items]
Derivative, Notional Amount	$ 3,100,000

Income Taxes Tax Carryforwards (Details) $ in Thousands	Dec. 31, 2025 USD ($)
Tax Credit Carryforward [Line Items]
Tax Credit Carryforward, Valuation Allowance	$ 10,000
Tax Credit Carryforward, Amount	21,500
Deferred Tax Assets, Tax Credit Carryforwards	31,500
Research Tax Credit Carryforward
Tax Credit Carryforward [Line Items]
Tax Credit Carryforward, Valuation Allowance	$ 18,100

Debt Maturity (Details) $ in Thousands	Dec. 31, 2025 USD ($)
Debt Disclosure [Abstract]
Long-Term Debt, Maturity, Year One	$ 18,750
Long-Term Debt, Maturity, Year Two	18,750
Long-Term Debt, Maturity, Year Three	37,500
Long-Term Debt, Maturity, Year Four	582,000
Long-Term Debt, Maturity, Year Five	637,500
Long-Term Debt, Maturity, after Year Five	0
Long-Term Debt, Gross	$ 1,294,500

Prepaid Expenses and Other Current Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Prepaid Assets Current [Line Items]
Other Prepaid Expense, Current	$ 23,390	$ 17,312
Deferred Costs and Other Assets	13,110	9,060
Prepaid insurance and property taxes	8,923	10,284
Interest Rate Derivative Assets, at Fair Value	3,745	11,038
Prepaid income taxes	16,549	11,244
Other Assets, Current	20,500	22,593
Prepaid expenses and other current assets	86,217	81,531
Prepaid Expenses and Other Current Assets [Member]
Prepaid Assets Current [Line Items]
Interest Rate Derivative Assets, at Fair Value	$ 3,745	$ 11,038

Share Based Award Stock Based Compensation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Share-Based Payment Arrangement [Abstract]
Stock compensation	$ 55,758	$ 46,883	$ 40,563
Tax benefit from stock-based compensation cost	5,900	$ 5,524	$ 5,379
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount	$ 48,500
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition	10 months 24 days

Derivatives and Hedging Activities Interest Rate Contracts(Details) $ in Thousands	Dec. 31, 2025 USD ($)
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Interest Rate Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months, Net	$ (2,300)
Interest Rate Swap
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative, Fixed Interest Rate	1.32%
Derivative Interest Rate Floor	(0.15%)
Derivative Asset, Notional Amount	$ 181,600
us-gaap_InterestRateSwap 2
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative, Fixed Interest Rate	1.17%
Derivative Interest Rate Floor	0.35%
Derivative Asset, Notional Amount	$ 46,900
us-gaap_InterestRateSwap 3
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative, Fixed Interest Rate	3.88%
Maximum [Member] \| Interest Rate Swap
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative Liability, Notional Amount	$ 300,000
Maximum [Member] \| us-gaap_InterestRateSwap 2
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative Liability, Notional Amount	750,000
Maximum [Member] \| us-gaap_InterestRateSwap 3
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative Liability, Notional Amount	300,000
Minimum [Member] \| Interest Rate Swap
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative Liability, Notional Amount	150,000
Minimum [Member] \| us-gaap_InterestRateSwap 2
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative Liability, Notional Amount	$ 46,900

General and Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2025

Accounting Policies [Abstract]

Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block]

BASIS OF PRESENTATION AND SIGNIFICANT ACCOUNTING POLICIES

Nature of Operations

Basis of Presentation

Segment Reporting

Use of Estimates

Cash and Cash Equivalents

Cash equivalents are short-term, highly liquid investments that are readily convertible to known amounts of cash and have original maturities of three months or less from the date of purchase.

Accounts Receivable

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 include material, labor and overhead related to the manufacturing of our products.

Inventories consist of the following (in thousands):


	As of December 31,
	2025		2024
Raw materials	$	265,383	$	265,275
Work in process	38,097		37,528
Finished goods	312,379		281,873
Total	$	615,859	$	584,676

Property, Plant and Equipment

Property, plant and equipment consists of the following (in thousands):


	As of December 31,
	2025		2024
Machinery and equipment	$	434,959	$	400,861
Land, building and building improvements	176,972		177,089
Molds	107,296		96,318
Computer equipment and software	116,259		122,208
Furniture and fixtures	23,055		27,871
Instruments placed with customers(1)	148,441		124,290
Construction in progress	90,748		87,006
Total property, plant and equipment, cost	1,097,730		1,035,643
Accumulated depreciation	(645,913)		(592,897)
Property, plant and equipment, net	$	451,817	$	442,746

_______________________________

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

All property, plant and equipment are stated at cost. We use the straight-line method for depreciating property, plant and equipment over their estimated useful lives. Estimated useful lives are:


Buildings			15 - 30 years
Building improvements			15 - 30 years
Machinery and equipment and molds			2 - 15 years
Furniture, fixtures and office equipment			2 - 5 years
Computer equipment and software			3 - 5 years
Instruments placed with customers			3 - 10 years

Goodwill

The following table presents the changes in the carrying amount of our goodwill for 2025, 2024 and 2023 (in thousands):


	Total
Balance as of January 1, 2023	$	1,449,258



Currency translation	23,188
Balance as of December 31, 2023	1,472,446



Currency translation	(39,674)
Balance as of December 31, 2024	1,432,772



Currency translation	66,982
Balance as of December 31, 2025	$	1,499,754

Intangible Assets

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


	Weighted-Average Amortization Life in Years	December 31, 2025
		Cost		Accumulated Amortization		Net
Patents	10	$	40,582	$	25,455	$	15,127
Customer contracts	12	9,959		7,356		2,603
Non-contractual customer relationships	8	561,199		304,287		256,912
Trademarks	1	5,425		5,425		—
Trade name	15	18,249		9,574		8,675
Developed technology(1)	10	637,589		293,506		344,083
Non-compete	3	9,100		9,100		—
Total amortized intangible assets		$	1,282,103	$	654,703	$	627,400

Internally developed software(2)		$	6,159			$	6,159

Total intangible assets		$	1,288,262	$	654,703	$	633,559

_______________________________


	Weighted-Average Amortization Life in Years	December 31, 2024
		Cost		Accumulated Amortization		Net
Patents	10	$	36,811	$	22,913	$	13,898
Customer contracts	12	9,818		6,994		2,824
Non-contractual customer relationships	8	546,404		236,267		310,137
Trademarks	1	5,425		5,425		—
Trade name	15	18,239		8,357		9,882
Developed technology(1)	10	619,540		227,869		391,671
Non-compete	3	9,100		9,100		—
Total amortized intangible assets		$	1,245,337	$	516,925	$	728,412

Internally developed software(2)		$	12,377			$	12,377

Total intangible assets		$	1,257,714	$	516,925	$	740,789

_______________________________

(2) Internally developed software will be reclassified to developed technology and amortized when the projects are complete and the assets are ready for their intended use. During 2024, we reclassified $33.2 million to developed technology.

Amortization expense was $131.4 million, $134.3 million and $132.1 million in 2025, 2024 and 2023, respectively, of which $4.5 million, $1.7 million, and $— million, respectively, are included in cost of goods sold.

As of December 31, 2025, estimated annual amortization for our intangible assets for each of the next five years and thereafter is approximately (in thousands):


2026	$	136,384
2027	120,367
2028	119,768
2029	116,676
2030	54,191
Thereafter	80,014
Total	$	627,400

Our intangible assets that are not subject to amortization are reviewed annually for impairment or more often if there are indications of possible impairment. We perform our annual intangible assets impairment test in November of each year. We did not have any intangible asset impairments in 2025, 2024 or 2023.

Long-Lived Assets

Assets Held for Sale

Investments

Investments in Unconsolidated Affiliates

Our investment in unconsolidated affiliates consist of the following (in thousands):


	As of December 31,
	2025		2024
Otsuka ICU Medical LLC	$	128,662	$	—
Other equity method investment	2,924		3,038
	$	131,586	$	3,038

Our recorded share of the investee's loss was $1.3 million for the year ended December 31, 2025. Our recorded share of the investee's loss was not material for the years ended December 31, 2024 and 2023. We did not receive any dividend distributions from these investments during 2025, 2024 and 2023.

Income Taxes

Foreign Currency

Revenue Recognition

Our variable consideration includes distributor chargebacks, product returns and end customer rebates, with distributor chargebacks representing the majority and subject to the greatest judgment.

(i) The estimated chargeback amount (the difference between the price we invoice the distributor and the contractually agreed price with specified end customers); and

(ii) The estimated period of time between the sale to the distributor and the receipt of a chargeback claim.

Arrangements with Multiple Deliverables

Shipping Costs

Costs to ship finished goods to our customers are included in cost of goods sold on the consolidated statements of operations.

Post-retirement and Post-employment Benefits

Research and Development

Interest expense, net

The following table presents interest expense, net (in thousands):


	As of December 31,
	2025		2024		2023
Interest expense	$	(93,338)	$	(106,541)	$	(102,727)
Interest income	10,307		10,788		7,508
Interest expense, net	$	(83,031)	$	(95,753)	$	(95,219)

Other expense, net

The following table presents other expense, net (in thousands):


	As of December 31,
	2025		2024		2023
Foreign exchange gains (losses), net	$	3,786	$	(9,792)	$	(5,918)
Loss on disposition of assets	(4,366)		(1,608)		(153)
Other miscellaneous income (expense) , net	348		(1,823)		166
Other expense, net	$	(232)	$	(13,223)	$	(5,905)

In 2024, other miscellaneous income (expense), net primarily includes $(2.6) million in fees related to our accounts receivable purchase program

Net Income (Loss) Per Share

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


	Year ended December 31,
	2025		2024		2023
Net income (loss)	$	732	$	(117,688)	$	(29,655)
Weighted-average number of common shares outstanding (basic)	24,640		24,388		24,091
Dilutive securities	264		—		—
Weighted-average common and common equivalent shares outstanding (diluted)	24,904		24,388		24,091
EPS — basic	$	0.03	$	(4.83)	$	(1.23)
EPS — diluted	$	0.03	$	(4.83)	$	(1.23)

Total anti-dilutive stock options and restricted stock awards (shares in thousands)	40		42		129

New Accounting Pronouncements

Recently Issued Accounting Standards Not Yet Adopted

In October 2023, the FASB issued ASU 2023-06, Disclosure Improvements - Codification Amendments in Response to the SEC's Disclosure Update and Simplification Initiative. The amendments in this update modify the disclosure or presentation requirements of a variety of Topics in the Accounting Standards Codification ("ASC") in response to the SEC’s Release No. 33-10532, Disclosure Update and Simplification Initiative, and align the ASC’s requirements with the SEC’s regulations. For entities within the scope, the guidance will be applied prospectively with the effective date for each amendment to be the date on which the SEC's removal of that related disclosure from Regulation S-X or Regulation S-K becomes effective, with early adoption prohibited. If the SEC has not removed the related disclosure from its regulations by June 30, 2027, the amendments will be removed from the Codification and will not become effective. We are currently assessing what impact this guidance will have on the Company's consolidated financial statements and related disclosures.

In November 2024, the FASB issued ASU 2024-03, Disaggregation of Income Statement Expenses. The guidance requires disclosure of disaggregated income statement expense information about specific categories (including purchases of inventory, employee compensation, depreciation, and intangible asset amortization) in the notes to financial statements. In January 2025, FASB released ASU 2025-01 to clarify the guidance will be effective for annual periods beginning after December 15, 2026. This update will be applicable to our Annual Report on Form 10-K for the fiscal year December 31, 2027, with early application permitted. We are currently assessing the effect of this update on the Company's consolidated financial statements and related disclosures.

In November 2025, the FASB issued ASU 2025-09, Derivatives and Hedging. The guidance aims to more closely align hedge accounting with the economics of an entity's risk management activities and to better reflect those strategies in financial reporting by enabling entities to achieve and maintain hedge accounting for highly effective economic hedges of forecasted transactions. This update will be effective for fiscal years beginning after December 15, 2026, and interim periods periods within those annual reporting periods. Early adoption is permitted. We are currently assessing the effect of this update on the Company's consolidated financial statements and related disclosures.

Recently Adopted Accounting Pronouncements

In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740) - Improvements to Income Tax Disclosures. The amendments in this update expand disclosures in an entity’s income tax rate reconciliation table and cash taxes paid information. The update was effective for annual periods beginning with the Company's fiscal year 2025. The Company adopted the requirements of this ASU in Note 13: Income Taxes of this Annual Report.

There have been no other recent accounting pronouncements or changes in accounting pronouncements that are of significance or potential significance to us during the year.

Leases (Notes)

12 Months Ended

Dec. 31, 2025

Leases [Abstract]

Lessee, Operating and Finance Lease

LEASES

We determine if an arrangement is a lease at inception. Our operating lease assets are separately stated in operating lease right-of-use ("ROU") assets and our financing lease assets are included in other assets on our consolidated balance sheets. Our lease liabilities are included in accrued liabilities and other long-term liabilities on our consolidated balance sheets. We have elected not to recognize an ROU asset and lease liability for leases with terms of twelve months or less.

Lease ROU assets and 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. Our lease ROU assets exclude 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 leases have stated lease payments, which may include fixed rental increases.

Our leases are for corporate, research and development and sales and support offices, manufacturing and distribution facilities, 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 because we determined the exercise of options to extend is not reasonably certain.

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


	Year ended December 31,
	2025		2024		2023
Operating lease cost	$	18,386	$	22,037	$	24,024
Finance lease cost — interest	388		182		125
Finance lease cost — reduction of ROU asset	1,937		1,158		1,035
Short-term lease cost	7		9		29
Total lease cost	$	20,718	$	23,386	$	25,213

Interest expense on our finance leases is included in interest expense, net in our consolidated statements of operations. The reduction of the operating and finance ROU assets is included as noncash lease expense in costs of goods sold and selling, general and administrative expenses in our consolidated statements of operations.

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


	Year ended December 31,
	2025		2024		2023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	17,324	$	24,251	$	24,604
Operating cash flows from finance leases	$	388	$	182	$	125

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	13,756	$	12,580	$	15,873
Finance leases	$	4,063	$	1,809	$	1,028

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


	As of December 31,
	2025			2024
Operating leases
Operating lease right-of-use assets	$	54,470		$	53,295

Accrued liabilities	$	13,825		$	15,695
Other long-term liabilities	43,951			40,777
Total operating lease liabilities	$	57,776		$	56,472

Weighted-Average Remaining Lease Term
Operating leases	6.3 years			5.8 years

Weighted-Average Discount Rate
Operating leases	5.40		%	4.90		%

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


	As of December 31,
	2025			2024
Finance leases
Other assets	$	5,599		$	3,259

Accrued liabilities	$	2,095		$	1,066
Other long-term liabilities	3,729			2,332
Total finance lease liabilities	$	5,824		$	3,398

Weighted-Average Remaining Lease Term
Finance leases	3.0 years			3.5 years

Weighted-Average Discount Rate
Finance leases	6.29		%	5.63		%

As of December 31, 2025, the maturities of our operating and finance lease liabilities for each of the next five years are approximately (in thousands):


	Operating Leases		Finance Leases
2026	$	15,917	$	2,391
2027	13,088		2,000
2028	9,842		1,464
2029	7,833		468
2030	4,663		58
Thereafter	16,356		—
Total Lease Payments	67,699		6,381
Less imputed interest	(9,923)		(557)
Total	$	57,776	$	5,824

Share Based Award (Tables)

12 Months Ended

Dec. 31, 2025

Share-Based Payment Arrangement [Abstract]

Schedule of stock compensation and related tax benefits [Table Text Block]

The table below summarizes compensation costs and related tax benefits (in thousands):


	Year ended December 31,
	2025		2024		2023
Stock compensation expense	$	55,758	$	46,883	$	40,563
Tax benefit from stock-based compensation cost	$	5,900	$	5,524	$	5,379

Share-based Payment Arrangement, Option, Activity [Table Text Block]

A summary of our stock options outstanding as of and for the year ended December 31, 2025 is as follows:


	Shares	Weighted-Average Exercise Price Per Share		Weighted-Average Contractual Life (Years)	Aggregate Intrinsic Value
Outstanding at December 31, 2024	108,140	$	136.12
Granted	—	$	—
Exercised	(63,197)	$	96.61
Forfeited or expired	—	$	—
Outstanding at December 31, 2025	44,943	$	191.68	3.71	$	202
Exercisable at December 31, 2025	44,943	$	191.68	3.71	$	202
Vested December 31, 2025	44,943	$	191.68	3.71	$	202

Exercised Options Data [Table Text Block]

The following table presents information regarding stock option activity (in thousands):


	Year ended December 31,
	2025		2024		2023
Intrinsic value of options exercised	$	2,437	$	18,651	$	8,441
Cash received from exercise of stock options	$	6,106	$	10,939	$	4,022
Tax benefit from stock option exercises	$	174	$	1,034	$	1,733

Share-based Payment Arrangement, Restricted Stock Unit, Activity [Table Text Block]

The table below summarizes our restricted stock award activity (dollars in thousands):


	Year ended December 31,
	2025		2024		2023
PRSU
Shares granted	67,800		150,218		78,213
Shares earned (1)	14,515		142,735		49,314
Grant-date fair value per share	$	141.97	$	104.52	$	190.02
Grant-date fair value	$	9,626	$	15,701	$	14,862
Intrinsic value vested	$	2,078	$	15,145	$	8,024

RSU
Shares granted	198,703		223,899		156,111
Grant-date fair value per share	$	141.83	$	105.94	$	173.10
Grant-date fair value	$	28,181	$	23,721	$	27,024
Intrinsic value vested	$	22,014	$	11,963	$	14,179

Nonvested Restricted Stock Shares Activity [Table Text Block]

The table below provides a summary of our PRSU and RSU activity as of and for the year ended December 31, 2025:


	Number of Units	Grant-Date Fair Value Per Share		Weighted-Average Contractual Life (Years)	Aggregate Intrinsic Value (in thousands)
Non-vested at December 31, 2024	551,011	$	133.47
Granted	266,503	$	141.86

Vested	(169,541)	$	152.03
Forfeited	(12,597)	$	124.59
Non-vested at December 31, 2025	635,376	$	132.21	0.8	$	90,649
Expected to vest at December 31, 2025 (1)	935,993

____________________________________

(1) As of December 31, 2025, the additional goal shares expected to vest include the following: 2023 PRSUs 6,431 shares; 2024 PRSUs 221,016 shares; and 2025 PRSUs 73,170 shares.

Segment Reporting Text (Details) - USD ($) $ in Millions	12 Months Ended
Segment Reporting Text (Details) - USD ($) $ in Millions	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Segment Reporting [Abstract]
Segment, Expenditure, Addition to Long-Lived Assets	$ 97.0	$ 90.2	$ 93.7
Segment Reporting, CODM, Individual Title and Position or Group Name [Extensible Enumeration]	Chief Executive Officer [Member]
Segment Reporting, CODM, Profit (Loss) Measure, How Used, Description	Our CODM uses net profit (loss) to manage our business activities on a consolidated basis and to evaluate and assess the performance of the Company when determining how to allocate capital resources. Our segment performance is monitored and resource allocation is determined during the annual budget/forecast processes.

Restructuring, Strategic Transaction and Integration (Details 2) - USD ($)	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Restructuring Cost and Reserve [Line Items]
Restructuring Reserve, Beginning Balance	$ 9,945,000	$ 3,568,000
Restructuring Costs	30,046,000	19,571,000
Payments for Restructuring	(27,539,000)	(13,319,000)
Restructuring Reserve, Accrual Adjustment	(900,000)	327,000
Restructuring Reserve, Foreign Currency Translation Gain (Loss)	(596,000)	202,000
Restructuring Reserve, Ending Balance	12,148,000	9,945,000
Employee Severance [Member]
Restructuring Cost and Reserve [Line Items]
Restructuring Reserve, Beginning Balance	9,538,000	2,811,000
Restructuring Costs	11,083,000	18,299,000
Payments for Restructuring	(13,805,000)	(11,687,000)
Restructuring Reserve, Accrual Adjustment	(900,000)	327,000
Restructuring Reserve, Foreign Currency Translation Gain (Loss)	(495,000)	212,000
Restructuring Reserve, Ending Balance	6,411,000	9,538,000
Facility Closing [Member]
Restructuring Cost and Reserve [Line Items]
Restructuring Reserve, Beginning Balance	407,000	757,000
Restructuring Costs	18,963,000	1,272,000
Payments for Restructuring	(13,734,000)	(1,632,000)
Restructuring Reserve, Accrual Adjustment	0	0
Restructuring Reserve, Foreign Currency Translation Gain (Loss)	(101,000)	(10,000)
Restructuring Reserve, Ending Balance	$ 5,737,000	$ 407,000

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Derivatives and Hedging Activities (Notes)

12 Months Ended

Dec. 31, 2025

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 purposes of our cash flow hedging programs are to manage the foreign currency exchange rate risk on forecasted revenues and expenses denominated in currencies other than the functional currency of the operating unit, and to manage floating interest rate risk associated with future interest payments on variable-rate term loans issued in 2022 and refinanced in 2025. We do not issue derivatives for trading or speculative purposes.

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 derivative instruments we utilize, including various foreign exchange contracts and interest rate swaps, are designated and qualify as cash flow hedges. Our derivative instruments are recorded at fair value on the consolidated balance sheets and are classified based on the instrument's maturity date. We record changes in the fair value of the effective portion of the gain or loss on the derivative instrument as a component of other comprehensive (loss) 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.

Foreign Currency Exchange Rate Risk

Foreign Exchange Forward Contracts

We enter into foreign exchange forward contracts to hedge a portion of our forecasted foreign currency-denominated revenues and expenses to minimize the effect of foreign exchange rate movements on the related cash flows. These contracts are agreements to buy or sell a quantity of a currency at a predetermined future date and at a predetermined exchange rate. Our current foreign exchange forward contracts hedge exposures principally denominated in Mexican Pesos ("MXN"), Euros, Japanese Yen ("JPY"), Chinese Renminbi ("CNH"), Canadian Dollar ("CAD"), U.S. Dollar ("USD") and Australian Dollar ("AUD") and have varying maturities with an average term of approximately nine months. The total notional amount of these outstanding derivative contracts as of December 31, 2025 was $24.3 million, which included the notional equivalent of $3.3 million in MXN, $7.5 million in JPY, $3.5 million in Euros, $6.5 million in AUD, $3.1 million in USD and $0.4 million in other foreign currencies, with terms currently through December 2025.

Floating Interest Rate Risk

In 2022, we entered into interest rate swaps to reduce the interest rate volatility on our variable-rate term loan A and variable-rate term loan B (see Note 12: Long-Term Obligations). We exchange, at specified intervals, the difference between fixed and floating interest amounts calculated by reference to an agreed-upon notional amount. Effective March 30, 2022, the term loan A swap, as amended, has an initial notional amount of $300.0 million, reducing to $150.0 million evenly on a quarterly basis through its final maturity on March 30, 2027. We pay a fixed rate of 1.32% and will receive the greater of 3-

month USD SOFR or (0.15)%. The total notional amount of this outstanding derivative as of December 31, 2025 was approximately $181.6 million. Effective March 30, 2022, the term loan B swap, as amended, has an initial notional amount of $750.0 million, reducing to $46.9 million evenly on a quarterly basis through its final maturity on March 30, 2026. We pay a fixed rate of 1.17% and receive the greater of 3-month USD SOFR or 0.35%. The total notional amount of this outstanding derivative as of December 31, 2025 was approximately $46.9 million. In June 2023, we entered into an additional interest rate swap that hedges both term loan A and term loan B interest payments. The total notional amount of the swap is $300.0 million. The hedge matures on June 30, 2028. We pay a fixed rate of 3.88% and receive 3-months USD SOFR. These forward-starting swaps effectively convert the relevant portion of the floating-rate term loans to fixed rates.

The following table presents the fair values of our derivative instruments included within the consolidated balance sheets (in thousands):


	Derivatives Designated as Cash Flow Hedging Instruments
Consolidated Balance Sheet Location	Foreign Exchange Forward Contracts		Interest Rate Swaps		Gross Derivatives

As of December 31, 2025
Prepaid expenses and other current assets	$	1,093	$	3,745	$	4,838
Other assets	70		664		734
Total assets	$	1,163	$	4,409	$	5,572

Accrued liabilities	$	479	$	1,508	$	1,987
Other long-term liabilities	67		3,196		3,263
Total liabilities	$	546	$	4,704	$	5,250

	Derivatives Designated as Cash Flow Hedging Instruments
As of December 31, 2024	Foreign Exchange Forward Contracts		Forward-Starting Interest Rate Swaps		Gross Derivatives
Prepaid expenses and other current assets	$	6,716	$	11,038	$	17,754
Other assets	—		5,724		5,724
Total assets	$	6,716	$	16,762	$	23,478

Accrued liabilities	$	7,391	$	—	$	7,391
Other long-term liabilities	—		—		—
Total liabilities	$	7,391	$	—	$	7,391

The following table presents the effects of our derivative instruments designated as cash flow hedges on the Consolidated Statements of Operations (in thousands):


	Gain Reclassified From Accumulated Other Comprehensive (Loss) Income into Income
	Location of Gain in the Consolidated Statements of Operations	Year Ended December 31,
		2025		2024		2023
Derivatives designated as cash flow hedging instruments:
Foreign exchange forward contracts	Total revenues	$	1,237	$	2,981	$	296
Foreign exchange forward contracts	Cost of goods sold	1,147		91		7,852
Foreign exchange forward contracts	Other expense, net(1)	—		—		229
Foreign exchange forward contracts	Interest expense(2)	—		—		13
Interest rate swaps	Interest expense	12,042		27,132		32,444
Total derivatives designated as cash flow hedging instruments		$	14,426	$	30,204	$	40,834

_______________________________

(1) Represents location of gain reclassified from accumulated other comprehensive (loss) income into other expense, net as a result of ineffectiveness.

(2) Represents location of gain reclassified from accumulated other comprehensive (loss) income into interest expense as a result of a forecasted transaction being no longer probable of occurring.

We recognized the following (losses) gains on our derivative instruments designated as cash flow hedges in other comprehensive loss before reclassifications to income (in thousands):


	Amount of Gain (Loss) Recognized in Other Comprehensive Loss
	Year Ended December 31,
	2025		2024		2023
Derivatives designated as cash flow hedging instruments:
Foreign exchange forward contracts	$	3,508	$	(1,912)	$	10,788
Interest rate swaps	(5,015)		15,954		5,200
Total derivatives designated as cash flow hedging instruments	$	(1,507)	$	14,042	$	15,988

As of December 31, 2025, we expect an estimated $0.6 million in deferred gains on the outstanding foreign exchange forward contract and an estimated $2.3 million in deferred gains on the forward-starting interest rate swaps will be reclassified from accumulated other comprehensive loss to net income during the next 12 months concurrent with the underlying hedged transactions also being reported in net (loss) income.

- Definition

The entire disclosure for derivative instruments and hedging activities including, but not limited to, risk management strategies, non-hedging derivative instruments, assets, liabilities, revenue and expenses, and methodologies and assumptions used in determining the amounts.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
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+ Details

Stockholders' Equity (Details) - USD ($) $ in Millions	12 Months Ended
Stockholders' Equity (Details) - USD ($) $ in Millions	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Equity, Class of Treasury Stock [Line Items]
Treasury stock purchase plan	$ 100.0
Treasury stock purchase plan remaining available	$ 100.0
Share-based Payment Arrangement, Shares Withheld for Tax Withholding Obligation	61,693	114,787	59,377
Payment, Tax Withholding, Share-based Payment Arrangement	$ 8.8	$ 12.0	$ 9.4
Treasury Stock, Common, Shares	172	571	2,428

Debt Interest Expense (Details) - USD ($)	12 Months Ended
Debt Interest Expense (Details) - USD ($)	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Debt Disclosure [Abstract]
Interest Expense, Debt, Excluding Amortization	$ 93,888,000	$ 125,012,000	$ 125,550,000
Amortization of Debt Issuance Costs and Discounts	8,903,000	6,807,000	6,814,000
Line of Credit Facility, Commitment Fee Amount	1,355,000	1,524,000	1,518,000
Interest Expense, Debt	$ 104,146,000	$ 133,343,000	$ 133,882,000

Income Taxes Income tax disclosure (Tables)

12 Months Ended

Dec. 31, 2025

Income Tax Disclosure [Abstract]

Schedule of Income before Income Tax, Domestic and Foreign [Table Text Block]

Income from continuing operations before taxes consisted of the following (in thousands):


	Year Ended December 31,
	2025		2024		2023
United States	$	(31,495)	$	(116,024)	$	(136,980)
Foreign	35,853		50,012		58,681
	$	4,358	$	(66,012)	$	(78,299)

Schedule of Components of Income Tax Expense (Benefit) [Table Text Block]

The provision (benefit) for income taxes consisted of the following (in thousands):


	Year Ended December 31,
	2025		2024		2023
Current:
Federal	$	(10,147)	$	16,589	$	(8,235)
State	1,627		4,256		5,035
Foreign	24,731		25,164		24,500
	$	16,211	$	46,009	$	21,300
Deferred:
Federal	$	(1,947)	$	1,294	$	(43,042)
State	(2,288)		14,850		(14,657)
Foreign	(9,539)		(10,477)		(12,245)
	(13,774)		5,667		(69,944)
	$	2,437	$	51,676	$	(48,644)

Schedule of Effective Income Tax Rate Reconciliation [Table Text Block]

The following table is a reconciliation of the provision for income taxes at the U.S. federal statutory rate of 21% to our effective tax rate for the year ended December 31, 2025 in accordance with the guidance in ASU No. 2023-09:


	Year Ended December 31,
	2025
(In thousands, except percentages)	Amount		Percent
U.S. federal statutory tax rate	$	915	21.0	%
State and local income taxes, net of federal income tax effect*	479		11.0	%
Foreign tax effects:
Costa Rica
Statutory tax rate differences between Costa Rica and United Sates	(8,645)		(198.4)	%
Other foreign jurisdictions	6,703		153.8	%
Effect of cross-border tax laws	810		18.6	%
Tax credits:
Research and development tax credits	(3,606)		(82.8)	%
Changes in valuation allowances	6,193		142.1	%
Nontaxable or nondeductible items:
Section 162(m)	6,353		145.8	%
Other	936		21.5	%
Changes in unrecognized tax benefits	(6,508)		(149.4)	%
Other adjustments	(1,193)		(27.4)	%
Total provision for income taxes	$	2,437	55.8	%

Schedule of Deferred Tax Assets and Liabilities [Table Text Block]

The components of our deferred income tax assets (liabilities) are as follows (in thousands):


	As of December 31,
	2025		2024
Deferred tax asset:


Accruals/other	$	45,020	$	41,947



Acquired future tax deductions	7,606		7,869
Stock-based compensation	4,650		3,940

Tax credits	22,477		17,068

Inventory reserves	20,100		25,015

Section 163(j) - interest expense limitation	25,153		27,078


Chargebacks, discounts, customer concessions	32,759		52,709
Capitalized research and development	66,396		56,975
Valuation allowance	(102,706)		(90,950)
	$	121,455	$	141,651
Deferred tax liability:
State income taxes	$	5,525	$	5,886


Depreciation and amortization	127,795		160,368




	$	133,320	$	166,254

Deferred tax (liability) asset, net	$	(11,865)	$	(24,603)

Schedule of Unrecognized Tax Benefits Roll Forward

The following table summarizes our cumulative gross unrecognized tax benefits (in thousands):


	Year Ended December 31,
	2025		2024		2023
Beginning balance	$	72,819	$	78,558	$	54,053
Increases to prior year tax positions	2,373		1,945		2,347
Increases due to acquisitions					—
Increases to current year tax positions	4,778		4,441		34,607

Decreases to prior year tax positions	(851)		(406)		(2,455)

Decrease related to lapse of statute of limitations	(7,080)		(10,062)		(9,591)
Decrease related to settlements with tax authorities	(78)		(1,133)		(403)
Decrease related to exchange rate fluctuations	(146)		(524)		—
Ending balance	$	71,815	$	72,819	$	78,558

Income Taxes Paid

We adopted ASU 2023-09 on a prospective basis for the year ended December 31, 2025 and have included the following table as a result of our adoption, which presents income taxes paid (net of refunds received) for the year ended December 31, 2025:


	Year Ended December 31, 2025
Federal	$	8,949

State	4,245

Foreign:
Italy	7,230
Japan	2,158
Netherlands	1,989
Other	4,305
Ending Balance	28,876

Below is a summary of income taxes paid for the years ended December 31, 2024 and December 31, 2023:


	As of December 31,
	2024		2023
Cash paid during the year for:
Income taxes, net of refunds	$	25,253	$	35,809

Audit Information	12 Months Ended
Audit Information	Dec. 31, 2025
Auditor [Line Items]
Auditor Name	DELOITTE & TOUCHE LLP
Auditor Location	Costa Mesa, California
Auditor Firm ID	34

Accrued Liabilities an Other Long-term Liabilities

12 Months Ended

Dec. 31, 2025

Accrued Liabilities and Other Liabilities [Abstract]

Accounts Payable and Accrued Liabilities Disclosure [Text Block]

ACCRUED LIABILITIES

Accrued liabilities consist of the following (in thousands):


	As of December 31,
	2025		2024
Salaries and benefits	$	70,526	$	60,815
Incentive compensation	60,799		59,445



Deferred revenue	33,843		30,358
Italy medical device payback provision(1)	24,597		23,937
Field service corrective action(2)	27,777		32,844



















Other	97,795		99,524
	$	315,337	$	306,923

_____________________________

SEC Schedule, Article 12-09, Valuation and Qualifying Accounts

12 Months Ended

Dec. 31, 2025

SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]

SEC Schedule, 12-09, Schedule of Valuation and Qualifying Accounts Disclosure


			Additions (Reductions)
(Amounts in thousands) Description	Balance at Beginning of Period		Charged to Costs and Expenses		Charged to Other Accounts		Write-off/ Disposals		Balance at End of Period
For the year ended December 31, 2023:
Allowance for doubtful accounts	$	8,530	$	838	$	1,696	$	—	$	11,064
Warranty and return reserve - accounts receivable	$	5,863	$	1,627	$	15	$	—	$	7,505
Warranty and return reserve - inventory/accrued(1)	$	50,819	$	20,290	$	(13,313)	$	—	$	57,796
Deferred tax asset valuation allowance	$	11,166	$	—	$	(2,714)	$	—	$	8,452

For the year ended December 31, 2024:
Allowance for doubtful accounts(2)	$	11,064	$	5,800	$	(5,394)	$	—	$	11,470
Warranty and return reserve - accounts receivable	$	7,505	$	(1,441)	$	806	$	—	$	6,870
Warranty and return reserve - inventory/accrued(3)	$	57,796	$	2,571	$	(18,146)	$	—	$	42,221
Deferred tax asset valuation allowance(4)	$	8,452	$	78,592	$	3,906	$	—	$	90,950

For the year ended December 31, 2025:
Allowance for doubtful accounts	$	11,470	$	2,416	$	420	$	—	$	14,306
Warranty and return reserve - accounts receivable	$	6,870	$	5,635	$	498	$	—	$	13,003
Warranty and return reserve - inventory/accrued(3)	$	42,221	$	6,102	$	(18,978)	$	—	$	29,345
Deferred tax asset valuation allowance	$	90,950	$	8,916	$	2,840	$	—	$	102,706

Leases Finance Lease Maturity (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Leases [Abstract]
Finance Lease, Liability, to be Paid, Year One	$ 2,391
Finance Lease, Liability, to be Paid, Year Two	2,000
Finance Lease, Liability, to be Paid, Year Three	1,464
Finance Lease, Liability, to be Paid, Year Four	468
Finance Lease, Liability, to be Paid, Year Five	58
Finance Lease, Liability, to be Paid, after Year Five	0
Finance Lease, Liability, Payment, Due	6,381
Finance Lease, Liability, Undiscounted Excess Amount	(557)
Finance Lease, Liability	$ 5,824	$ 3,398

Share Based Award RSU and PRSU (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Modified PRSU Incremental Expense	$ 2,100
Performance Shares [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period	67,800	150,218	78,213
Performance Shares Earned	14,515	142,735	49,314
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period, Weighted Average Grant Date Fair Value	$ 141.97	$ 104.52	$ 190.02
Grant date fair value performance restricted stock units	$ 9,626	$ 15,701	$ 14,862
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Aggregate Intrinsic Value, Vested	$ 2,078	$ 15,145	$ 8,024
Restricted Stock Units (RSUs) [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period	198,703	223,899	156,111
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period, Weighted Average Grant Date Fair Value	$ 141.83	$ 105.94	$ 173.10
Grant date fair value of restricted stock units granted	$ 28,181	$ 23,721	$ 27,024
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Aggregate Intrinsic Value, Vested	$ 22,014	$ 11,963	$ 14,179

Leases Lease Cost (Details) - USD ($) $ in Thousands	12 Months Ended
Leases Lease Cost (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Leases [Abstract]
Operating Lease, Cost	$ 18,386	$ 22,037	$ 24,024
Finance Lease, Interest Expense	388	182	125
Finance Lease, Right-of-Use Asset, Amortization	1,937	1,158	1,035
Short-term Lease, Cost	7	9	29
Lease, Cost	$ 20,718	$ 23,386	$ 25,213

Derivatives and Hedging Activities (Tables)

12 Months Ended

Dec. 31, 2025

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 consolidated balance sheets (in thousands):


	Derivatives Designated as Cash Flow Hedging Instruments
Consolidated Balance Sheet Location	Foreign Exchange Forward Contracts		Interest Rate Swaps		Gross Derivatives

As of December 31, 2025
Prepaid expenses and other current assets	$	1,093	$	3,745	$	4,838
Other assets	70		664		734
Total assets	$	1,163	$	4,409	$	5,572

Accrued liabilities	$	479	$	1,508	$	1,987
Other long-term liabilities	67		3,196		3,263
Total liabilities	$	546	$	4,704	$	5,250

	Derivatives Designated as Cash Flow Hedging Instruments
As of December 31, 2024	Foreign Exchange Forward Contracts		Forward-Starting Interest Rate Swaps		Gross Derivatives
Prepaid expenses and other current assets	$	6,716	$	11,038	$	17,754
Other assets	—		5,724		5,724
Total assets	$	6,716	$	16,762	$	23,478

Accrued liabilities	$	7,391	$	—	$	7,391
Other long-term liabilities	—		—		—
Total liabilities	$	7,391	$	—	$	7,391

Derivative Instruments, Gain (Loss)

The following table presents the effects of our derivative instruments designated as cash flow hedges on the Consolidated Statements of Operations (in thousands):


	Gain Reclassified From Accumulated Other Comprehensive (Loss) Income into Income
	Location of Gain in the Consolidated Statements of Operations	Year Ended December 31,
		2025		2024		2023
Derivatives designated as cash flow hedging instruments:
Foreign exchange forward contracts	Total revenues	$	1,237	$	2,981	$	296
Foreign exchange forward contracts	Cost of goods sold	1,147		91		7,852
Foreign exchange forward contracts	Other expense, net(1)	—		—		229
Foreign exchange forward contracts	Interest expense(2)	—		—		13
Interest rate swaps	Interest expense	12,042		27,132		32,444
Total derivatives designated as cash flow hedging instruments		$	14,426	$	30,204	$	40,834

_______________________________

(1) Represents location of gain reclassified from accumulated other comprehensive (loss) income into other expense, net as a result of ineffectiveness.

(2) Represents location of gain reclassified from accumulated other comprehensive (loss) income into interest expense as a result of a forecasted transaction being no longer probable of occurring.

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

We recognized the following (losses) gains on our derivative instruments designated as cash flow hedges in other comprehensive loss before reclassifications to income (in thousands):


	Amount of Gain (Loss) Recognized in Other Comprehensive Loss
	Year Ended December 31,
	2025		2024		2023
Derivatives designated as cash flow hedging instruments:
Foreign exchange forward contracts	$	3,508	$	(1,912)	$	10,788
Interest rate swaps	(5,015)		15,954		5,200
Total derivatives designated as cash flow hedging instruments	$	(1,507)	$	14,042	$	15,988

Leases (Details)	12 Months Ended
Leases (Details)	Dec. 31, 2025
Lessee, Lease, Description [Line Items]
Optiontoextendinyears	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

Restructuring, Strategic Transaction and Integration (Details 1) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Restructuring and Related Activities [Abstract]
Restructuring, strategic transaction and integration	$ 66,500	$ 59,800	$ 41,300
Restructuring and Related Cost, Incurred Cost	$ 30,000	$ 19,600	$ 5,700

Discontinued Operations and Disposal Groups Related Party (Details) - Equity Method Investee $ in Thousands	12 Months Ended
	Dec. 31, 2025 USD ($)
Related Party Transaction [Line Items]
Manufacturing services agreement revenue	$ 11,886
Related Parties Amount in Cost of Sales	11,131
Related party - Equity in earnings of unconsolidated affiliates	(1,189)
Related party payable	800
Cost of Sales [Member]
Related Party Transaction [Line Items]
Service fees - Otsuka ICU Medical LLC	969
Selling, General and Administrative Expenses
Related Party Transaction [Line Items]
Service fees - Otsuka ICU Medical LLC	$ 8,206

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483326/850-10-50-3

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480738/235-10-S50-1

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(k)(2))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-1

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(k)(1))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 310
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481990/310-10-45-13

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(c)(2)(i))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(c)(2)(ii))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(g)(3))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479134/946-220-S99-1

+ Details

Leases (Tables)

12 Months Ended

Dec. 31, 2025

Leases [Abstract]

Lease, Cost

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


	Year ended December 31,
	2025		2024		2023
Operating lease cost	$	18,386	$	22,037	$	24,024
Finance lease cost — interest	388		182		125
Finance lease cost — reduction of ROU asset	1,937		1,158		1,035
Short-term lease cost	7		9		29
Total lease cost	$	20,718	$	23,386	$	25,213

Supplemental Cash Flow Information Leases

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


	Year ended December 31,
	2025		2024		2023
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	17,324	$	24,251	$	24,604
Operating cash flows from finance leases	$	388	$	182	$	125

Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	13,756	$	12,580	$	15,873
Finance leases	$	4,063	$	1,809	$	1,028

Supplemental Balance Sheet Information Leases

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


	As of December 31,
	2025			2024
Operating leases
Operating lease right-of-use assets	$	54,470		$	53,295

Accrued liabilities	$	13,825		$	15,695
Other long-term liabilities	43,951			40,777
Total operating lease liabilities	$	57,776		$	56,472

Weighted-Average Remaining Lease Term
Operating leases	6.3 years			5.8 years

Weighted-Average Discount Rate
Operating leases	5.40		%	4.90		%

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


	As of December 31,
	2025			2024
Finance leases
Other assets	$	5,599		$	3,259

Accrued liabilities	$	2,095		$	1,066
Other long-term liabilities	3,729			2,332
Total finance lease liabilities	$	5,824		$	3,398

Weighted-Average Remaining Lease Term
Finance leases	3.0 years			3.5 years

Weighted-Average Discount Rate
Finance leases	6.29		%	5.63		%

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

As of December 31, 2025, the maturities of our operating and finance lease liabilities for each of the next five years are approximately (in thousands):


	Operating Leases		Finance Leases
2026	$	15,917	$	2,391
2027	13,088		2,000
2028	9,842		1,464
2029	7,833		468
2030	4,663		58
Thereafter	16,356		—
Total Lease Payments	67,699		6,381
Less imputed interest	(9,923)		(557)
Total	$	57,776	$	5,824

Income Taxes:

12 Months Ended

Dec. 31, 2025

Income Tax Disclosure [Abstract]

Income Tax Disclosure [Text Block]

INCOME TAXES

Income from continuing operations before taxes consisted of the following (in thousands):


	Year Ended December 31,
	2025		2024		2023
United States	$	(31,495)	$	(116,024)	$	(136,980)
Foreign	35,853		50,012		58,681
	$	4,358	$	(66,012)	$	(78,299)

The provision (benefit) for income taxes consisted of the following (in thousands):


	Year Ended December 31,
	2025		2024		2023
Current:
Federal	$	(10,147)	$	16,589	$	(8,235)
State	1,627		4,256		5,035
Foreign	24,731		25,164		24,500
	$	16,211	$	46,009	$	21,300
Deferred:
Federal	$	(1,947)	$	1,294	$	(43,042)
State	(2,288)		14,850		(14,657)
Foreign	(9,539)		(10,477)		(12,245)
	(13,774)		5,667		(69,944)
	$	2,437	$	51,676	$	(48,644)

We have accrued for tax contingencies for potential tax assessments, and in 2025 we recognized a $1.0 million net decrease, most of which related to federal, state, and foreign tax reserves net of the release of various federal and foreign tax reserves.

During 2025, on a prospective basis, we adopted ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Taxes Disclosures. The following table is a reconciliation of the provision for income taxes at the U.S. federal statutory rate of 21% to our effective tax rate for the year ended December 31, 2025 in accordance with the guidance in ASU No. 2023-09:


	Year Ended December 31,
	2025
(In thousands, except percentages)	Amount		Percent
U.S. federal statutory tax rate	$	915	21.0	%
State and local income taxes, net of federal income tax effect*	479		11.0	%
Foreign tax effects:
Costa Rica
Statutory tax rate differences between Costa Rica and United Sates	(8,645)		(198.4)	%
Other foreign jurisdictions	6,703		153.8	%
Effect of cross-border tax laws	810		18.6	%
Tax credits:
Research and development tax credits	(3,606)		(82.8)	%
Changes in valuation allowances	6,193		142.1	%
Nontaxable or nondeductible items:
Section 162(m)	6,353		145.8	%
Other	936		21.5	%
Changes in unrecognized tax benefits	(6,508)		(149.4)	%
Other adjustments	(1,193)		(27.4)	%
Total provision for income taxes	$	2,437	55.8	%

___________________________

*For the year ended December 31, 2025, state and local income taxes in Minnesota made up the majority (greater than 50 percent) of the tax effect in this category.

The following table is a reconciliation of the provision for income taxes at the U.S. federal statutory rate of 21% to our effective tax rate for the years ended December 31, 2024 and 2023 in accordance with the guidance prior to the adoption of ASU No. 2023-09:


	Year Ended December 31,
	2024				2023
(In thousands, except percentages)	Amount		Percent		Amount		Percent
U.S. federal statutory tax rate	$	(13,862)	21.0	%	$	(16,443)	21.0	%
State income taxes, net of federal income tax effect	701		(1.1)	%	(6,057)		7.7	%
Tax credits	(10,985)		16.6	%	(9,824)		12.5	%
Global intangible low-taxed income	2,977		(4.5)%		(2,658)		3.4%
Foreign income tax differential	(4,231)		6.4	%	(2,506)		3.2	%
Stock-based compensation	2,824		(4.3)	%	(289)		0.4	%
Foreign-derived intangible income	(3,756)		5.7	%	(3,299)		4.2	%
Contingent consideration	(838)		1.3	%	(3,407)		4.4	%
Section 162(m)	1,880		(2.8)	%	3,268		(4.2)	%
Tax reserve releases	(2,216)		3.3	%	(6,884)		8.8	%
Legal settlement	(2,100)		3.2	%	—		—	%
Valuation allowance	81,713		(123.8)	%	—		—	%
Other	(431)		0.7	%	(545)		0.7	%
Total provision (benefit) for income taxes	$	51,676	(78.3)	%	$	(48,644)	62.1	%

Tax credits in 2024 and 2023 consist principally of research and developmental tax credits.

The components of our deferred income tax assets (liabilities) are as follows (in thousands):


	As of December 31,
	2025		2024
Deferred tax asset:


Accruals/other	$	45,020	$	41,947



Acquired future tax deductions	7,606		7,869
Stock-based compensation	4,650		3,940

Tax credits	22,477		17,068

Inventory reserves	20,100		25,015

Section 163(j) - interest expense limitation	25,153		27,078


Chargebacks, discounts, customer concessions	32,759		52,709
Capitalized research and development	66,396		56,975
Valuation allowance	(102,706)		(90,950)
	$	121,455	$	141,651
Deferred tax liability:
State income taxes	$	5,525	$	5,886


Depreciation and amortization	127,795		160,368




	$	133,320	$	166,254

Deferred tax (liability) asset, net	$	(11,865)	$	(24,603)

The Company regularly assesses the realizability of deferred tax assets and records a valuation allowance to reduce the deferred tax assets to the amount that is more likely than not to be realized. In assessing the realizability of our deferred tax assets, we weigh all available positive and negative evidence. This evidence includes, but is not limited to, historical earnings, scheduled reversal of taxable temporary differences, tax planning strategies and projected future taxable income. Due to the weight of objectively verifiable negative evidence, the Company recorded a change to the valuation allowance against certain U.S. federal and state deferred tax assets, resulting in a $8.7 million tax expense and $2.8 million foreign currency translation and derivative instrument adjustments, for the tax years ending December 31, 2025. The significant piece of objectively verifiable negative evidence evaluated was the recent U.S. cumulative losses. Our ability to use our deferred tax assets depends on the amount of taxable income in future periods.

Tax Holidays and Carryforwards

The Company has income tax net operating loss ("NOL") carryforwards related to our foreign operations of approximately $106.8 million which will expire at various dates from 2026 to indefinite carryforward periods. We have recorded a net deferred tax asset of $7.3 million, $27.7 million gross deferred tax asset net of tax reserves of $20.4 million, related to our foreign NOL carryforwards. The deferred tax assets recognized for these foreign NOLs are presented net of tax reserves. We believe that it is more likely than not that the benefit from certain foreign NOL carryforwards will not be realized. In recognition of this risk, we have provided a valuation allowance of $6.3 million on the $7.3 million net deferred tax assets related to these foreign NOL carryforwards.

Other carryforwards include state research and development (“R&D”) tax credit carryforwards. We have recorded a net deferred tax asset of $21.5 million, $31.5 million gross deferred tax asset net of tax reserves of $10.0 million. We believe that it is more likely than not that the benefit from certain state R&D tax credit carryforwards will not be realized. A valuation allowance of $18.1 million has been provided on the $21.5 million of state R&D credit carryforwards. The majority of the state R&D credit carryforwards have an indefinite carryforward period.

A substantial portion of our manufacturing operations in Costa Rica operate under various tax holiday and tax incentive programs due to expire in whole or in part in 2029. Certain of the holidays may be extended if specific conditions are met. The net impact of these tax holiday and tax incentives was an increase to our net earnings by $12.5 million or $0.51 per diluted share in 2025 and by $11.1 million or $0.45 per diluted share in 2024.

Foreign currency translation and derivative instrument adjustments, and related tax effects, are an element of “other comprehensive income” and are not included in net income.

As of December 31, 2025, we have estimated $349 million of undistributed foreign earnings and profits. Such earnings were previously subject to U.S. tax as a result of the Tax Act and much of any future remittances would generally be subject to no U.S. tax as a result of dividends received deductions and/or foreign tax credit relief. We intend to invest substantially all of our foreign subsidiary earnings, as well as our capital in our foreign subsidiaries, indefinitely outside of the U.S. in those jurisdictions in which we incur significant additional costs upon repatriation of such amounts.

We are subject to taxation in the U.S. and various states and foreign jurisdictions. Our U.S. federal income tax returns for tax years 2022 and forward are subject to examination by the Internal Revenue Service. Our principal state income tax returns for tax years 2012 and forward are subject to examination by the state tax authorities. The total gross amount of unrecognized tax benefits as of December 31, 2025 was $71.8 million which, if recognized, would impact the effective tax rate. We believe that adequate provision has been made for any adjustments that may result from tax examinations. However, the outcome of tax examinations cannot be predicted with certainty. We recognize accrued interest and penalties related to unrecognized tax benefits as a component of income tax expense. We recognized $0.6 million of interest expense and $0.1 million of penalties in income tax benefit during 2025 and released $0.8 million of interest expense and $0.6 million of penalties in 2025. In total, we have accrued for interest and penalties of $2.4 million and $1.0 million, respectively as of December 31, 2025, and $2.6 million and $1.6 million, respectively, as of December 31, 2024.

The following table summarizes our cumulative gross unrecognized tax benefits (in thousands):


	Year Ended December 31,
	2025		2024		2023
Beginning balance	$	72,819	$	78,558	$	54,053
Increases to prior year tax positions	2,373		1,945		2,347
Increases due to acquisitions					—
Increases to current year tax positions	4,778		4,441		34,607

Decreases to prior year tax positions	(851)		(406)		(2,455)

Decrease related to lapse of statute of limitations	(7,080)		(10,062)		(9,591)
Decrease related to settlements with tax authorities	(78)		(1,133)		(403)
Decrease related to exchange rate fluctuations	(146)		(524)		—
Ending balance	$	71,815	$	72,819	$	78,558

In December 2022, the European Union (EU) agreed to implement Pillar Two, the OECD’s global minimum tax rate of 15% for multinationals that meet a global revenue threshold. All of the EU countries and some of the non-EU countries in which we operate have enacted or have announced plans to enact legislation to adopt Pillar Two. The Pillar Two legislation has been effective since our fiscal year beginning January 1, 2024. For fiscal year 2025, we considered the impact of Pillar Two in our tax provision and effective tax rate. However, the Pillar Two rules continue to evolve and their application may alter our tax obligations in certain countries where we operate for fiscal periods beyond 2025 as we continue to assess the impact of tax legislation in these jurisdictions.

On July 4, 2025, the U.S. enacted H.R. 1 "A bill to provide for reconciliation pursuant to Title II of H. Con. Res. 14", commonly referred to as the One Big Beautiful Bill Act (“OBBBA”). The OBBBA includes significant provisions, such as the permanent extension of certain expiring provisions of the Tax Cuts and Jobs Act, modifications to the international tax framework and the restoration of favorable tax treatment for certain business provisions. The legislation has multiple effective dates, with certain provisions effective in 2025 and others implemented through 2027. We will assess its future impact on our consolidated financial statements as additional guidance becomes available as uncertainty remains regarding the timing and interpretation by tax authorities in affected jurisdictions. To the extent known, the impact is included in our tax provision and effective tax rate for the year ended December 31, 2025.

Cash Taxes Paid


	Year Ended December 31, 2025
Federal	$	8,949

State	4,245

Foreign:
Italy	7,230
Japan	2,158
Netherlands	1,989
Other	4,305
Ending Balance	28,876

Below is a summary of income taxes paid for the years ended December 31, 2024 and December 31, 2023:


	As of December 31,
	2024		2023
Cash paid during the year for:
Income taxes, net of refunds	$	25,253	$	35,809

- Definition

The entire disclosure for income tax.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 942
-SubTopic 740
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477617/942-740-50-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
-Paragraph 1
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-Publisher FASB
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482685/740-10-50-12

Reference 5: http://www.xbrl.org/2003/role/exampleRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

General and Summary of Significant Accounting Policies Property and Equipment #1 (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	$ 1,097,730	$ 1,035,643
Accumulated Depreciation	645,913	592,897
Net property and equipment	451,817	442,746
Machinery and Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	434,959	400,861
Land, Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	176,972	177,089
Molds [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	107,296	96,318
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	116,259	122,208
Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	23,055	27,871
Instruments Placed with Customers [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	148,441	124,290
Construction in Progress [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, cost	$ 90,748	$ 87,006

Revenue (Tables)

12 Months Ended

Dec. 31, 2025

Revenue from Contract with Customer [Abstract]

Disaggregation of Revenue [Table Text Block]

The following table represents our revenues disaggregated by product line (in thousands) and our disaggregated product line revenue as a percentage of total revenue:


	Year ended December 31,
	2025				2024				2023
Product line	Revenue		% of Revenue		Revenue		% of Revenue		Revenue		% of Revenue
Consumables	$	1,109,130	50	%	$	1,038,869	44	%	$	969,129	43	%
Infusion Systems	684,208		31	%	652,410		27	%	629,043		28	%
Vital Care	437,924		19	%	690,767		29	%	660,954		29	%




Total Revenues	$	2,231,262	100	%	$	2,382,046	100	%	$	2,259,126	100	%

We report revenue on a "where sold" basis, which reflects the revenue within the country or region in which the ultimate sale is made to our external customer.

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


	Year ended December 31,
Geography	2025		2024		2023
United States	$	1,356,114	$	1,532,104	$	1,440,017
Europe, the Middle East and Africa	411,684		393,530		373,571
Asia-Pacific	232,903		232,820		241,699
Other Foreign	230,561		223,592		203,839
Total Revenues	$	2,231,262	$	2,382,046	$	2,259,126

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


	Contract Liabilities
Beginning balance, January 1, 2024	$	42,177

Equipment revenue recognized	(56,182)
Equipment revenue deferred due to implementation	55,932
Software revenue recognized	(28,292)
Software revenue deferred due to implementation	29,913
Government grant income recognized(1)	(2,072)
Government grant income deferred	—
Other deferred revenue recognized	(2,576)
Other deferred revenue	503
Ending balance, December 31, 2024	39,403

Equipment revenue recognized	(65,792)
Equipment revenue deferred due to implementation	74,836
Software revenue recognized	(35,715)
Software revenue deferred due to implementation	31,373
Government grant income recognized(1)	(2,066)
Government grant income deferred	—
Other deferred revenue recognized	(1,983)
Other deferred revenue	1,177
Ending balance, December 31, 2025	$	41,233

Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction

As of December 31, 2025, revenue from remaining performance obligations is as follows (in thousands):


	Recognition Timing
	<12 Months		> 12 Months
Equipment revenue	$	24,530	$	372
Software revenue	6,361		1,719
Government grant deferred income(1)	2,064		5,277
Other deferred revenue(2)	888		22
Total	$	33,843	$	7,390

Share Based Award Options exercised data (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Share-Based Payment Arrangement [Abstract]
Intrinsic value of options exercised	$ 2,437	$ 18,651	$ 8,441
Cash received from exercise of stock options	6,106	10,939	4,022
Tax benefit from stock option exercises	$ 174	$ 1,034	$ 1,733

Fair Value Measurement Smiths Medical(Details) $ in Millions	12 Months Ended
	Dec. 31, 2024 USD ($)	Dec. 31, 2025	Jan. 06, 2022 USD ($)
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Ownership requirement for Earnout Payment		0.500
Smiths Medical
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
contingent consideration gross	$ 100.0
Business Combination, Contingent Consideration, Liability			$ 53.5

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Debt Extinguishment Fees (Details) $ in Thousands	12 Months Ended
Debt Extinguishment Fees (Details) $ in Thousands	Dec. 31, 2025 USD ($)
Extinguishment of Debt [Line Items]
Capitalized Debt Issuance Costs to Survive Refinancing	$ 9,399
Total Newly Capitalized Debt Issuance Costs	4,380
Total Debt Extinguishment Expense	2,463
Old Credit Facility Unamortized Issuance Costs Extinguished
Extinguishment of Debt [Line Items]
Debt Discount Costs	1,807
Debt Issuance Costs, Gross	374
Debt Discount Line of Credit	246
Debt Issuance Costs, Line of Credit Arrangements, Gross	36
New Lender Fees Capitalized
Extinguishment of Debt [Line Items]
Debt Discount Costs	1,626
Debt Issuance Costs, Gross	937
Debt Discount Line of Credit	1,199
Debt Issuance Costs, Line of Credit Arrangements, Gross	618
Rollover Capitalization
Extinguishment of Debt [Line Items]
Debt Discount Costs	6,400
Debt Issuance Costs, Gross	1,276
Debt Discount Line of Credit	1,502
Debt Issuance Costs, Line of Credit Arrangements, Gross	$ 221

Revenue Contract Liabilities (Details) - USD ($)	12 Months Ended
Revenue Contract Liabilities (Details) - USD ($)	Dec. 31, 2025	Dec. 31, 2024
Revenue from Contract with Customer [Abstract]
Deferred Revenue, Revenue Recognized	$ 35,500,000
COntract Liability Rollforward [Roll Forward]
Contract with Customer, Liability	(39,403,000)	$ (42,177,000)
Contract with Customer, Liability	(41,233,000)	(39,403,000)
Equipment revenue [Member]
COntract Liability Rollforward [Roll Forward]
Increase (Decrease) in Deferred Revenue	(65,792,000)	(56,182,000)
Deferred Revenue, Additions	74,836,000	55,932,000
Software revenue [Member]
COntract Liability Rollforward [Roll Forward]
Increase (Decrease) in Deferred Revenue	(35,715,000)	(28,292,000)
Deferred Revenue, Additions	31,373,000	29,913,000
Government Grant Revenue
COntract Liability Rollforward [Roll Forward]
Increase (Decrease) in Deferred Revenue	(2,066,000)	(2,072,000)
Other deferred revenue
COntract Liability Rollforward [Roll Forward]
Increase (Decrease) in Deferred Revenue	(1,983,000)	(2,576,000)
Deferred Revenue, Additions	$ 1,177,000	$ 503,000

Fair Value Measurement (Tables)

12 Months Ended

Dec. 31, 2025

Fair Value Disclosures [Abstract]

Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block]

The following table provides a reconciliation of our Level 3 earn-out liabilities measured at estimated fair value based on an initial valuation and updated quarterly for the years ended December 31, 2024 and 2023 (in thousands):


	Earn-out Liability
Contingent earn-out liability, January 1, 2023	$	25,572
Change in fair value of contingent earn-out (included in income from operations as a separate line item)(1)	(16,247)
Other(2)	(496)
Transfer of Mediverse earn-out liability into Level 2(3)	(3,379)
Currency translation	41
Contingent earn-out liability, December 31, 2023	5,491


Change in fair value of contingent earn-out (included in income from operations as a separate line item)(4)	(5,399)
Currency translation	(92)
Contingent earn-out liability, December 31, 2024	—

Schedule of Fair Value, Assets and Liabilities 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 as of December 31, 2025
	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:






Foreign exchange contracts:
Prepaid expenses and other current assets	$	1,093	$	—	$	1,093	$	—
Other assets	70		—		70		—
Interest rate contracts:
Prepaid expenses and other current assets	3,745		—		3,745		—
Other assets	664		—		664		—

Total Assets	$	5,572	$	—	$	5,572	$	—

Liabilities:


Foreign exchange contracts:
Accrued liabilities	$	479	$	—	$	479	$	—
Other long-term liabilities	67		—		67		—
Interest rate swaps:
Accrued liabilities	1,508		—		1,508		—
Other long-term liabilities	3,196		—		3,196		—

Total Liabilities	$	5,250	$	—	$	5,250	$	—


	Fair value measurements as of December 31, 2024
	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:






Foreign exchange contracts:
Prepaid expenses and other current assets	6,716		—		6,716		—

Interest rate contracts:
Prepaid expenses and other current assets	11,038		—		11,038		—
Other assets	5,724		—		5,724		—
Total Assets	$	23,478	$	—	$	23,478	$	—

Liabilities:


Foreign exchange contracts:
Accrued liabilities	7,391		—		7,391		—

Total Liabilities	$	7,391	$	—	$	7,391	$	—

Applicable Margin Based on Leverage Ratio Term Loan A(Details)	12 Months Ended
	Dec. 31, 2025
Term Loan A
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin Base Rate Loans	0.0075
greaterthan4.00to1.00
Applicable Margin Based on Leverage Ratio [Line Items]
Line of Credit Facility, Commitment Fee Percentage	0.35%
greaterthan4.00to1.00 \| Term Loan A
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin for Eurocurrency Rate Loans and RFR Loans	0.0225
Applicable Margin Base Rate Loans	0.0125
less than or equal to 4.00 to 1.00 but greater than 3.00 to100
Applicable Margin Based on Leverage Ratio [Line Items]
Line of Credit Facility, Commitment Fee Percentage	0.30%
less than or equal to 4.00 to 1.00 but greater than 3.00 to100 \| Term Loan A
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin for Eurocurrency Rate Loans and RFR Loans	0.0200
Applicable Margin Base Rate Loans	0.0100
less than or equal 3.00 to 1.00 but greater than 2.50to1.00
Applicable Margin Based on Leverage Ratio [Line Items]
Line of Credit Facility, Commitment Fee Percentage	0.25%
less than or equal 3.00 to 1.00 but greater than 2.50to1.00 \| Term Loan A
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin for Eurocurrency Rate Loans and RFR Loans	0.0175
Applicable Margin Base Rate Loans	0.0075
less than or equal to 2.50 to1.00 but greater than 2.00 to1.00
Applicable Margin Based on Leverage Ratio [Line Items]
Line of Credit Facility, Commitment Fee Percentage	0.20%
less than or equal to 2.50 to1.00 but greater than 2.00 to1.00 \| Term Loan A
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin for Eurocurrency Rate Loans and RFR Loans	0.0150
Applicable Margin Base Rate Loans	0.0050
less than or equal to 2.00 to 1.00
Applicable Margin Based on Leverage Ratio [Line Items]
Line of Credit Facility, Commitment Fee Percentage	0.15%
less than or equal to 2.00 to 1.00 \| Term Loan A
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin for Eurocurrency Rate Loans and RFR Loans	0.0125
Applicable Margin Base Rate Loans	0.0025
less than or equal to 1.75 to 1.0
Applicable Margin Based on Leverage Ratio [Line Items]
Line of Credit Facility, Commitment Fee Percentage	0.10%
less than or equal to 1.75 to 1.0 \| Term Loan A
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin for Eurocurrency Rate Loans and RFR Loans	0.0100
Applicable Margin Base Rate Loans	0

Applicable Margin Based on Leverage Ratio Term Loan B (Details) - Term Loan B	Dec. 31, 2025
greater than 2.75 to1.00
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin Term SOFR Loans	0.0250
Applicable Margin Base Rate Loans	0.0150
less than 2.75 to1.00
Applicable Margin Based on Leverage Ratio [Line Items]
Applicable Margin Term SOFR Loans	0.0225
Applicable Margin Base Rate Loans	0.0125

General and Summary of Significant Accounting Policies Intangible Assets #1 (Details) - USD ($)	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Finite-Lived Intangible Assets [Line Items]
Cost	$ 1,282,103,000	$ 1,245,337,000
Accumulated Amortization	654,703,000	516,925,000
Finite-Lived Intangible Assets, Net	627,400,000	728,412,000
Intangible Assets, Gross (Excluding Goodwill)	1,288,262,000	1,257,714,000
INTANGIBLE ASSETS, net	633,559,000	740,789,000
indefinte lived intangibles put in use	$ 11,400,000	$ 33,200,000
Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted-Average Amortization Life in Years	10 years	10 years
Cost	$ 40,582,000	$ 36,811,000
Accumulated Amortization	25,455,000	22,913,000
Finite-Lived Intangible Assets, Net	$ 15,127,000	$ 13,898,000
Customer Contracts [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted-Average Amortization Life in Years	12 years	12 years
Cost	$ 9,959,000	$ 9,818,000
Accumulated Amortization	7,356,000	6,994,000
Finite-Lived Intangible Assets, Net	$ 2,603,000	$ 2,824,000
Customer-Related Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted-Average Amortization Life in Years	8 years	8 years
Cost	$ 561,199,000	$ 546,404,000
Accumulated Amortization	304,287,000	236,267,000
Finite-Lived Intangible Assets, Net	$ 256,912,000	$ 310,137,000
Trademarks [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted-Average Amortization Life in Years	1 year	1 year
Cost	$ 5,425,000	$ 5,425,000
Accumulated Amortization	5,425,000	5,425,000
Finite-Lived Intangible Assets, Net	$ 0	$ 0
Trade Names [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted-Average Amortization Life in Years	15 years	15 years
Cost	$ 18,249,000	$ 18,239,000
Accumulated Amortization	9,574,000	8,357,000
Finite-Lived Intangible Assets, Net	$ 8,675,000	$ 9,882,000
Developed Technology Rights [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted-Average Amortization Life in Years	10 years	10 years
Cost	$ 637,589,000	$ 619,540,000
Accumulated Amortization	293,506,000	227,869,000
Finite-Lived Intangible Assets, Net	$ 344,083,000	$ 391,671,000
Noncompete Agreements [Member]
Finite-Lived Intangible Assets [Line Items]
Weighted-Average Amortization Life in Years	3 years	3 years
Cost	$ 9,100,000	$ 9,100,000
Accumulated Amortization	9,100,000	9,100,000
Finite-Lived Intangible Assets, Net	0	0
In Process Research and Development [Member]
Finite-Lived Intangible Assets [Line Items]
Cost	$ 6,159,000	$ 12,377,000

General and Summary of Significant Accounting Policies Interest (Expense) Income, net (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Accounting Policies [Abstract]
Interest Expense, Operating and Nonoperating	$ (93,338)	$ (106,541)	$ (102,727)
Interest Income, Other	10,307	10,788	7,508
Interest Income (Expense), Nonoperating	$ (83,031)	$ (95,753)	$ (95,219)

- Definition

Amount of interest expense classified as operating and nonoperating. Includes, but is not limited to, cost of borrowing accounted for as interest expense.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-22

Reference 2: http://www.xbrl.org/2003/role/exampleRef
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-URI https://asc.fasb.org/1943274/2147482785/280-10-55-48

Reference 3: http://www.xbrl.org/2003/role/exampleRef
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-URI https://asc.fasb.org/1943274/2147482785/280-10-55-49

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Paragraph 1
-Subparagraph (i)
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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-URI https://asc.fasb.org/1943274/2147482810/280-10-50-24

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section 45
-Paragraph 3
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147479105/946-220-45-3

+ Details

Segment Reporting (Notes)

12 Months Ended

Dec. 31, 2025

Segment Reporting, Disclosure of Entity's Reportable Segments [Abstract]

Segment Reporting Disclosure

SEGMENT DATA

The Company has a single operating and reportable segment. The segment is organized by and derives revenues from the manufacture and sale of our medical products which are used in infusion therapy, vascular access, and vital care applications. Our product portfolio includes ambulatory, syringe, and large volume IV pumps and safety software; dedicated and non-dedicated IV sets, needlefree IV connectors, IV catheters, and sharps safety products; closed system transfer devices and pharmacy compounding systems; as well as a range of respiratory, anesthesia, patient monitoring, and temperature management products. We also offer IV Solutions products through a commercial relationship with the joint venture. Our product lines, as disclosed in Note 4: Revenue, were determined to be a single operating segment as discrete financial information by product-line is limited to revenue and standard cost. Other cost of sale expenses, which include above-site manufacturing costs, manufacturing variances and supply chain costs including freight and warehousing are not allocated to individual product lines. Similarly, quality, regulatory and other operating expenses are only provided to our chief operating decision maker ("CODM") at the consolidated level.

The accounting policies of our single reportable segment are the same as those described in Note 1: Basis of Presentation and Significant Accounting Policies.

For information on disaggregation of revenues by product-line and geography, see Note 4: Revenue.

Our chief executive officer is our CODM. Our CODM uses net profit (loss) to manage our business activities on a consolidated basis and to evaluate and assess the performance of the Company when determining how to allocate capital resources. Our segment performance is monitored and resource allocation is determined during the annual budget/forecast processes. The measure of segment assets is reported on the consolidated balance sheets as total assets. In 2025, 2024 and 2023, expenditures for additions to long-lived assets were $97.0 million, $90.2 million, and $93.7 million, respectively.

The following table presents information about our segment revenue, segment profit or loss, and significant segment expenses (in thousands):


	Year ended December 31,
	2025		2024		2023
REVENUES	$	2,231,262	$	2,382,046	$	2,259,126
Less:
Standard COGS(1)	1,007,545		1,193,994		1,114,294
Quality remediation/recall(2)	40,459		19,126		58,243
Other COGS(3)	326,914		344,144		346,716
Tariff expense(4)	34,305		—		—
Selling, general and administrative	625,210		638,762		606,693
Research and development	87,495		88,615		85,344

Restructuring and integration	66,505		59,840		41,258
Other segment items(5)	(54,867)		(2,964)		(17,850)
Interest expense	93,338		106,541		102,727
Income tax provision (benefit)	2,437		51,676		(48,644)
Equity in losses of unconsolidated affiliates	1,189		—		—
Consolidated net income (loss)	$	732	$	(117,688)	$	(29,655)

_______________

(1) Represents the average annual budgeted cost of producing each good sold in the period.

(2) Represents significant labor and material costs to replace or repair a product outside the scope of standard warranty and compliance costs related to quality systems and manufacturing operations.

For information on depreciation and amortization expense, see Note 1: Basis of Presentation and Significant Accounting Policies.

Significant Customers

We sell products worldwide, on credit terms on an unsecured basis, as an OEM supplier, to independent medical supply distributors and directly to end customers. The manufacturers and distributors, in turn, sell our products to healthcare providers. In 2025, 2024 and 2023, we had net sales to a single distributor of 18%, 18% and 16%, respectively of consolidated worldwide net sales.

Geographic Information

The table below presents our gross long-lived assets, consisting of property, plant and equipment, by country or region (in thousands):


	As of December 31,
	2025		2024
Costa Rica	$	168,678	$	156,149
Mexico	127,389		111,043
Other LATAM	71,054		55,451
Canada	1,982		5,284
Italy	35,468		29,124



Spain	21,532		17,141
Czech Republic	14,111		11,909
Other Europe	11,485		11,445
APAC	28,239		27,550
Total Foreign	$	479,938	$	425,096
United States	617,792		610,547
Worldwide Total	$	1,097,730	$	1,035,643

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482810/280-10-50-21

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

General and Summary of Significant Accounting Policies Property and Equipment #3 (Details) - USD ($)	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Accounting Policies [Abstract]
Depreciation	$ 69,300,000	$ 85,200,000	$ 96,700,000
Cost, Depreciation	$ 62,200,000	$ 73,700,000	$ 75,400,000

Segment Reporting Information, by Segment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Revenues	$ 2,231,262	$ 2,382,046	$ 2,259,126
Tariff expense	34,305	0	0
Selling, general and administrative	625,210	638,762	606,693
Research and development	87,495	88,615	85,344
Restructuring, strategic transaction and integration expenses	66,505	59,840	41,258
(Provision) benefit for income taxes	2,437	51,676	(48,644)
Income (Loss) from Equity Method Investments	(1,189)	0	0
Net Income (Loss)	732	(117,688)	(29,655)
Standard OCOS
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Tariff expense	3,100
Other OCOC
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Tariff expense	31,200
Operating Segments
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Revenues	2,231,262	2,382,046	2,259,126
Manufacturing Costs	1,007,545	1,193,994	1,114,294
Inventory Recall Expense	40,459	19,126	58,243
Other Cost and Expense, Operating	326,914	344,144	346,716
Selling, general and administrative	625,210	638,762	606,693
Research and development	87,495	88,615	85,344
Restructuring, strategic transaction and integration expenses	66,505	59,840	41,258
Segment Reporting, Other Segment Item, Amount	(54,867)	(2,964)	(17,850)
Interest Expense, NonOperating	93,338	106,541	102,727
(Provision) benefit for income taxes	2,437	51,676	(48,644)
Income (Loss) from Equity Method Investments	1,189	0	0
Net Income (Loss)	$ 732	$ (117,688)	$ (29,655)

Fair Value Measurement Roll Forward (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Contingent Earn-out Liability	$ 0	$ 5,491	$ 25,572
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability, Gain (Loss) Included in Earnings	(5,399)	(16,247)
Fair Value, Measurement with Unobservable Inputs Reconciliation, Liability, Transfers out of Level 3		(3,379)
Currency translation on earn-out	$ (92)	$ 41
Fair Value, Liability, Recurring Basis, Unobservable Input Reconciliation, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]		Change in fair value of contingent earn-out
Pursuit Vascular, Inc. [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Other Transfer		$ (496)

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Derivatives and Hedging Activities Derivative Balance Sheet Location (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024
Derivatives, Fair Value [Line Items]
Derivative Liability	$ 5,250	$ 7,391
Derivative Asset, Current	4,838	17,754
Derivative Asset, Noncurrent	734	5,724
Derivative Liability, Current	1,987	7,391
Derivative Liability, Noncurrent	$ 3,263	$ 0
Derivative, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Revenues	Revenues
Derivative Liability, Statement of Financial Position [Extensible Enumeration]	Liabilities and Equity
Derivative Asset, Current, Statement of Financial Position [Extensible Enumeration]	Prepaid expenses and other current assets	Prepaid expenses and other current assets
Derivative Asset, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other Assets	Other Assets
Derivative Asset, Statement of Financial Position [Extensible Enumeration]	Assets
Derivative Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accrued liabilities	Accrued liabilities
Derivative Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other Accrued Liabilities, Noncurrent	Other Accrued Liabilities, Noncurrent
Foreign Exchange Forward [Member] \| Designated as Hedging Instrument [Member]
Derivatives, Fair Value [Line Items]
Derivative Asset	$ 1,163	$ 6,716
Interest Rate Swap
Derivatives, Fair Value [Line Items]
Derivative Liability	4,704	0
Derivative Asset, Current	3,745	11,038
Derivative Asset, Noncurrent	664	5,724
Derivative Liability, Current	1,508	0
Derivative Liability, Noncurrent	3,196	0
Interest Rate Swap \| Designated as Hedging Instrument [Member]
Derivatives, Fair Value [Line Items]
Derivative Asset	4,409	16,762
Derivative Financial Instruments, Assets \| Designated as Hedging Instrument [Member]
Derivatives, Fair Value [Line Items]
Derivative Asset	5,572	23,478
Foreign Exchange Contract
Derivatives, Fair Value [Line Items]
Derivative Liability	546	7,391
Derivative Asset, Current	1,093	6,716
Derivative Asset, Noncurrent	70	0
Derivative Liability, Current	479	7,391
Derivative Liability, Noncurrent	$ 67	$ 0

Income Taxes Deferred income tax assets (liabilities) (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Deferred tax assets and liabilities [Line Items]
Deferred Tax Assets, Valuation Allowance	$ 8,700
Non-current deferred tax asset	121,455	$ 141,651
Deferred Tax Liabilities, Net	11,865	24,603
Deferred Tax Assets, Operating Loss Carryforwards	27,700
Accumulated Foreign Currency Adjustment Attributable to Parent [Member]
Deferred tax assets and liabilities [Line Items]
Deferred Tax Assets, Valuation Allowance	2,800
Non-current deferred tax asset, gross total [Member]
Deferred tax assets and liabilities [Line Items]
Deferred Tax Assets, Tax Deferred Expense, Reserves and Accruals, Other	45,020	41,947
Noncurrent deferred tax asset - acquired future tax deductions	7,606	7,869
Deferred Tax Assets, Tax Deferred Expense, Compensation and Benefits, Share-based Compensation Cost	4,650	3,940
Noncurrent deferred tax asset - tax credits state	22,477	17,068
Deferred Tax Assets, Inventory	20,100	25,015
Deferred Tax Asset, Section 163(j)	25,153	27,078
Noncurrentdeferredtaxassetchargebacksdiscountscustomerconcessions	32,759	52,709
Deferred Tax Asset, In-Process Research and Development	66,396	56,975
Deferred Tax Assets, Valuation Allowance	102,706	90,950
Noncurrent deferred tax liability [Member]
Deferred tax assets and liabilities [Line Items]
Noncurrent deferred tax liability - state income taxes	5,525	5,886
Noncurrent deferred tax liability - depreciation and amortization	127,795	160,368
Deferred Tax Liabilities, Net	$ 133,320	$ 166,254

Credit Facility Text (Details) $ in Thousands	12 Months Ended
Credit Facility Text (Details) $ in Thousands	Dec. 31, 2025 USD ($)	Dec. 31, 2024 USD ($)
Debt Disclosure [Abstract]
Interest Percentage Added to Federal Funds Rate	0.0050
Interest Percentage Added to Base Rate	0.0100
Revolver Sub limits	$ 50,000
Long-term Debt Type [Line Items]
Long-Term Debt, Gross	$ 1,294,500
Ter SOFR Interest Rate % Adjustment for Base Rate Loans	0.0010
Maximum [Member]
Long-term Debt Type [Line Items]
Term SOFR Adjustment Interest Rate Adjustment Term SOFR Loans	0.0025
Minimum [Member]
Long-term Debt Type [Line Items]
Term SOFR Adjustment Interest Rate Adjustment Term SOFR Loans	0.0010
Revolving Credit Facility
Long-term Debt Type [Line Items]
Long-Term Debt, Gross	$ 500,000
Term Loan A
Long-term Debt Type [Line Items]
Proceeds from Issuance of Debt	850,000
Long-Term Debt, Gross	750,000	$ 770,313
Debt Conversion, Original Debt, Amount	$ 559,700
Debt Instrument, Maturity Date	Oct. 31, 2030
Applicable Margin Base Rate Loans	0.0075
Applicable Margin Term SOFR Loans	0.0175
Term Loan B
Long-term Debt Type [Line Items]
Proceeds from Issuance of Debt	$ 850,000
Long-Term Debt, Gross	544,500	$ 826,625
Debt Conversion, Original Debt, Amount	$ 190,000
Debt Instrument, Maturity Date	Jan. 06, 2029

Commitments and Contingencies Contingencies (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Jan. 06, 2022
Business Combination [Line Items]
Contingent Earn-out Liability		$ 0	$ 5,491	$ 25,572
Short-term contingent consideration-gross			1,000
Long-term contingent consideration-gross	$ 1,500
Product Liability Accrual, Period Expense	700	5,200
Product Liability Accrual, Component Amount	33,000
Loss Contingency Accrual, Payments	2,500
Loss Contingency Accrual, Provision	3,800
Foreign Distibutor [Member]
Business Combination [Line Items]
contingent consideration gross	6,000
Contingent Earn-out Liability	3,400
Foreign Infusion System Supplier
Business Combination [Line Items]
contingent consideration gross			$ 2,500
Smiths Medical
Business Combination [Line Items]
contingent consideration gross		$ 100,000
Business Combination, Contingent Consideration, Liability					$ 53,500
Product Liability Accrual, Component Amount	$ 20,400

Fair Value Measurement (Notes)

12 Months Ended

Dec. 31, 2025

Fair Value Disclosures [Abstract]

Fair Value Disclosures [Text Block]

FAIR VALUE MEASUREMENTS

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. Fair value is estimated by applying the following hierarchy, which prioritizes the inputs used to measure fair value into three levels and bases the categorization within the hierarchy upon the lowest level of input that is available and significant to the fair value measurement:

•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.

Contingent earn-out liabilities

In August 2021, we entered into an agreement with one of our international distributors whereby that distributor would not compete with us in a specific territory for a three-year period that ended September 2024. The terms of the agreement included a contingent earn-out payment. The contingent earn-out payment could not exceed $6.0 million and was to be earned based on certain revenue targets over a twelve-month measurement period determined by the highest four consecutive quarters commencing over a two-year period starting on the closing date of the agreement and provided that the distributor is in compliance with its obligations under the agreement. The estimated fair value of the contingent earn-out was calculated using a probability-weighted cash flow model based on historical revenue streams and the likelihood that the revenue targets will be met. As of December 31, 2023, the earn-out measurement period ended. The fair value of the contingent earn-out was determined to be $3.4 million and was paid out in the first quarter of 2024.

In November 2021, we acquired a small foreign infusion systems supplier. Total consideration for the acquisition includes a potential earn-out payment of up to $2.5 million, consisting of (i) a cash payment of $1.0 million contingent on the achievement of certain revenue targets for the annual period ending December 31, 2022 and, separately, (ii) a cash payment of $1.5 million contingent on obtaining certain product-related regulatory certifications by May 26, 2024. As of December 31, 2022, the measurement period related to the contingent earn-out based on certain revenue targets ended and based on the actual revenue achieved during the measurement period, the fair value of the contingent earn-out was determined to be zero as the minimum threshold for earning the earn-out was not met. As of December 31, 2024, the earn-out measurement period related to certain product-related regulatory certifications had ended and the product-related regulatory certification had not been achieved, accordingly, the estimated fair value for the contingent consideration was reduced to zero.

In 2022, we acquired Smiths Medical with a combination of cash consideration and share consideration issued at closing. Total consideration for the acquisition included a potential earn-out payment of $100.0 million in cash contingent on our common stock achieving a certain volume-weighted average price (the "Price Targets") from the closing date to either the third or fourth anniversary of closing and provided Smiths beneficially owns at least 50.0% of the shares of common stock issued at closing at the time the Price Target is achieved. The initial estimated fair value of the earn-out was determined to be $53.5 million using a Monte Carlo simulation model. The model utilized several assumptions including volatility and the risk-free interest rate. The assumed volatility is based on the average of the historical volatility of our common stock price and the implied volatility of certain at-the-money traded options. The risk-free interest rate is equal to the yield on U.S. Treasury securities at constant maturity for the period commensurate with the term of the earn-out. At each reporting date subsequent to the acquisition, we remeasured the earn-out liability and recognized any changes in its fair value in our consolidated statements of operations. If the probability of achieving the Price Targets during their respective measurement periods was significantly greater than initially anticipated, the realization of an additional liability and related expense would have had a significant impact on our consolidated financial statements in the period recognized. During 2024, Smiths sold all of their remaining shares of common stock of ICU Medical, Inc. The sale of these shares rendered Smiths unable to achieve the contingent consideration based on certain price targets during the third and fourth anniversary of closing as Smiths no longer met the required minimum beneficial ownership percentage. Accordingly, the valuation of the contingent earn-out liability as of December 31, 2024 was zero.

Our contingent earn-out liabilities are separately stated on our consolidated balance sheets.


	Earn-out Liability
Contingent earn-out liability, January 1, 2023	$	25,572
Change in fair value of contingent earn-out (included in income from operations as a separate line item)(1)	(16,247)
Other(2)	(496)
Transfer of Mediverse earn-out liability into Level 2(3)	(3,379)
Currency translation	41
Contingent earn-out liability, December 31, 2023	5,491


Change in fair value of contingent earn-out (included in income from operations as a separate line item)(4)	(5,399)
Currency translation	(92)
Contingent earn-out liability, December 31, 2024	—

_______________________________

(1) Primarily relates to the change in fair value of our Smiths Medical earn-out.

(2) Primarily relates to the reclassification to accrued liabilities of a holdback liability not subject to unobservable inputs when determining the fair market value.

(3) The Mediverse earn-out was transferred out of Level 3 and into Level 2 in the fourth quarter of 2023 when the amount of the actual payment was known, and subsequently settled during first quarter of 2024.

(4) Relates to the change in fair value of our Smiths Medical earn-out and the earn-out with one of our small foreign infusion systems suppliers, both of which were written down to zero as of December 31, 2024.

Investments, Foreign Currency Contracts and Interest Rate Contracts

Our investments historically consist of corporate, government bonds and U.S. treasury securities. The fair value of our corporate and government bonds are estimated using observable market-based inputs such as quoted prices, interest rates and yield curves or Level 2 inputs. The fair value of our U.S. treasury securities are based on quoted market prices in active markets and are included in the Level 1 fair value hierarchy.

The fair value of our Level 2 forward currency contracts is 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.

The fair value of our Level 2 interest rate swaps is estimated using a pricing model that reflects the terms of the contracts, including the period to maturity, and relies on observable market inputs such as known notional value amounts and USD interest rate curves.

Other than the Mediverse earn-out liability described above, there were no transfers between levels in 2024 or 2023.

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 as of December 31, 2025
	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:






Foreign exchange contracts:
Prepaid expenses and other current assets	$	1,093	$	—	$	1,093	$	—
Other assets	70		—		70		—
Interest rate contracts:
Prepaid expenses and other current assets	3,745		—		3,745		—
Other assets	664		—		664		—

Total Assets	$	5,572	$	—	$	5,572	$	—

Liabilities:


Foreign exchange contracts:
Accrued liabilities	$	479	$	—	$	479	$	—
Other long-term liabilities	67		—		67		—
Interest rate swaps:
Accrued liabilities	1,508		—		1,508		—
Other long-term liabilities	3,196		—		3,196		—

Total Liabilities	$	5,250	$	—	$	5,250	$	—


	Fair value measurements as of December 31, 2024
	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:






Foreign exchange contracts:
Prepaid expenses and other current assets	6,716		—		6,716		—

Interest rate contracts:
Prepaid expenses and other current assets	11,038		—		11,038		—
Other assets	5,724		—		5,724		—
Total Assets	$	23,478	$	—	$	23,478	$	—

Liabilities:


Foreign exchange contracts:
Accrued liabilities	7,391		—		7,391		—

Total Liabilities	$	7,391	$	—	$	7,391	$	—

- Definition

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

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (bbb)(1)
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Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Topic 820
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-Section 55
-Paragraph 107
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-URI https://asc.fasb.org/1943274/2147482078/820-10-55-107

Reference 3: http://www.xbrl.org/2003/role/exampleRef
-Topic 820
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-Paragraph 100
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482078/820-10-55-100

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Subparagraph (c)(3)
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-URI https://asc.fasb.org/1943274/2147482106/820-10-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Paragraph 6A
-Subparagraph (a)
-Publisher FASB
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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-SubTopic 10
-Name Accounting Standards Codification
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Topic 820
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
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-Subparagraph (e)
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 820
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Income Taxes Paid (Details) - USD ($) $ in Thousands	12 Months Ended
Income Taxes Paid (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Income Taxes Paid [Line Items]
Cash paid during the year for income taxes	$ 28,876	$ 25,253	$ 35,809
Domestic Tax Jurisdiction
Income Taxes Paid [Line Items]
Cash paid during the year for income taxes	8,949
State and Local Jurisdiction [Member]
Income Taxes Paid [Line Items]
Cash paid during the year for income taxes	4,245
ITALY
Income Taxes Paid [Line Items]
Cash paid during the year for income taxes	7,230
JAPAN
Income Taxes Paid [Line Items]
Cash paid during the year for income taxes	2,158
NETHERLANDS
Income Taxes Paid [Line Items]
Cash paid during the year for income taxes	1,989
Foreign Tax Jurisdiction, Other
Income Taxes Paid [Line Items]
Cash paid during the year for income taxes	$ 4,305

General and Summary of Significant Accounting Policies Inventory (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Accounting Policies [Abstract]
Raw Materials	$ 265,383	$ 265,275
Work in Process	38,097	37,528
Finished Goods	312,379	281,873
Total	$ 615,859	$ 584,676

Leases Supplemental Cash Flow Lease Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Leases [Abstract]
Operating Lease, Payments	$ 17,324	$ 24,251	$ 24,604
Finance Lease, Interest Payment on Liability	388	182	125
Right-of-Use Asset Obtained in Exchange for Operating Lease Liability	13,756	12,580	15,873
Right-of-Use Asset Obtained in Exchange for Finance Lease Liability	$ 4,063	$ 1,809	$ 1,028

Segment Reporting (Details) $ in Thousands	12 Months Ended
Segment Reporting (Details) $ in Thousands	Dec. 31, 2025 USD ($)	Dec. 31, 2024 USD ($)	Dec. 31, 2023
Revenues from External Customers and Long-Lived Assets [Line Items]
% Revenue to a Single Distributor	0.18	0.18	0.16
Total property and equipment, cost	$ 1,097,730	$ 1,035,643
COSTA RICA
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, cost	168,678	156,149
MEXICO
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, cost	127,389	111,043
Other LATAM [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, cost	71,054	55,451
CANADA
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, cost	1,982	5,284
ITALY
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, cost	35,468	29,124
SPAIN
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, cost	21,532	17,141
CZECHIA
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, cost	14,111	11,909
Europe [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, cost	11,485	11,445
Asia Pacific [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, cost	28,239	27,550
Foreign [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, cost	479,938	425,096
UNITED STATES
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, cost	$ 617,792	$ 610,547

Restructuring, Strategic Transaction and Integration Schedule of Restructuring and Related Costs (Tables)

12 Months Ended

Dec. 31, 2025

Restructuring and Related Activities [Abstract]

Restructuring and Related Costs [Table Text Block]

The following table summarizes the activity in our restructuring-related accrual by major type of cost (in thousands):


	Employee & Related Costs		Facility & Other Closure Costs		Total
Accrued balance, January 1, 2024	$	2,811	$	757	$	3,568

Charges incurred	18,299		1,272		19,571
Payments	(11,687)		(1,632)		(13,319)
Other adjustments(1)	327		—		327
Currency translation	(212)		10		(202)
Accrued balance, December 31, 2024	$	9,538	$	407	$	9,945

Charges incurred	11,083		18,963		30,046
Payments	(13,805)		(13,734)		(27,539)
Other adjustments(2)	(900)		—		(900)
Currency translation	495		101		596
Accrued balance, December 31, 2025	$	6,411	$	5,737	$	12,148

_______________________________________________

(1) Relates to adjustments to accrued restructuring charges as a result of merging Smiths Medical entities during 2024.

(2) Relates to prior year accrued restructuring charges for estimated severances costs that were reclassed to other accounts during the first quarter of 2025.

Finance Leases Supplemental Balance Sheet Information (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Leases [Abstract]
Finance Lease, Right-of-Use Asset, after Accumulated Amortization	$ 5,599	$ 3,259
Finance Lease, Liability, Current	2,095	1,066
Finance Lease, Liability, Noncurrent	3,729	2,332
Finance Lease, Liability	$ 5,824	$ 3,398
Finance Lease, Weighted Average Remaining Lease Term	3 years	3 years 6 months
Finance Lease, Weighted Average Discount Rate, Percent	6.29%	5.63%

Prepaids and Other Current Assets (Tables)

12 Months Ended

Dec. 31, 2025

Prepaid Expense and Other Assets [Abstract]

Schedule of Other Current Assets

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


	As of December 31,
	2025		2024
Other prepaid expenses and receivables	$	23,390	$	17,312

Deferred costs	13,110		9,060
Prepaid insurance and property taxes	8,923		10,284



Interest rate contracts*	3,745		11,038

Prepaid income taxes	16,549		11,244
Other*	20,500		22,593
	$	86,217	$	81,531

Statement of Comprehensive Income (Paranthetical) - USD ($)	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Other Comprehensive Income (Loss), Tax, Parenthetical Disclosure [Abstract]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), after Reclassification, Tax	$ (727,000)	$ 0	$ (5,951,000)
Other Comprehensive Income (Loss), Foreign Currency Translation Adjustment, Tax	0	0	0
Other Comprehensive (Income) Loss, Defined Benefit Plan, after Reclassification Adjustment, Tax	$ 0	$ 0	$ 0

Consolidated Statements of Cash Flows - USD ($)	12 Months Ended
Consolidated Statements of Cash Flows - USD ($)	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
CASH FLOWS FROM OPERATING ACTIVITIES:
Net Income (Loss)	$ 732,000	$ (117,688,000)	$ (29,655,000)
Depreciation and amortization	200,741,000	219,512,000	228,774,000
Operating Lease, Right-of-Use Asset, Amortization Expense	17,251,000	21,344,000	21,910,000
Stock compensation	55,758,000	46,883,000	40,563,000
Loss on Disposition of Property Plant Equipment, net	5,900,000	2,522,000	2,109,000
Debt issuance cost amortization	6,178,000	6,807,000	6,814,000
Change in fair value of contingent earn-out	0	(5,399,000)	(16,247,000)
Income (Loss) from Equity Method Investments	1,189,000	0	0
Gain (Loss) on Disposition of Business	(44,792,000)	0	0
Gain (Loss) on Extinguishment of Debt	2,463,000	0	0
Other	24,471,000	32,621,000	47,536,000
Increase (Decrease) in Accounts Receivable	8,876,000	(46,844,000)	48,635,000
Increase (Decrease) in Inventories	(26,252,000)	16,829,000	(6,079,000)
Increase (Decrease) in Prepaid Expense and Other Assets	(10,958,000)	(8,829,000)	11,672,000
Increase (Decrease) in Other Operating Assets	(6,982,000)	(23,154,000)	(24,695,000)
Accounts payable	6,998,000	12,531,000	(68,301,000)
Accrued liabilities	(36,967,000)	20,668,000	(14,479,000)
Income taxes, including excess tax benefits and deferred income taxes	(24,759,000)	26,230,000	(82,356,000)
Net cash provided by (used in)operating activities	179,847,000	204,033,000	166,201,000
CASH FLOWS FROM INVESTING ACTIVITIES:
Purchases of property, plant and equipment	(88,043,000)	(79,373,000)	(83,893,000)
Proceeds from Divestiture of Businesses	211,185,000	0	0
Proceeds from sale of assets	8,059,000	746,000	1,501,000
Intangible asset additions	(8,972,000)	(10,833,000)	(9,777,000)
Proceeds from sale of investment securities	0	500,000	4,222,000
Net cash used in by investing activities	122,229,000	(88,960,000)	(87,947,000)
CASH FLOWS FROM FINANCING ACTIVITIES:
Proceeds from issuance of long-term debt, net of lender debt issuance costs	313,000	0	0
Payments of Debt Issuance Costs	(2,825,000)	0	0
Repayments of Long-term obligations	(302,750,000)	(51,000,000)	(29,688,000)
Payment of third-party debt issuance costs	1,555,000
Proceeds from exercise of stock options	6,106,000	10,939,000	4,022,000
Payments on finance leases	(2,048,000)	(1,147,000)	(963,000)
Payment for Contingent Consideration Liability, Financing Activities	0	(2,600,000)	0
Purchase of treasury stock	(8,766,000)	(11,992,000)	(9,350,000)
Net cash (used in) provided by financing activities	(311,525,000)	(55,800,000)	(35,979,000)
Effect of Exchange Rate on Cash [Abstract]
Effect of Exchange Rate on Cash, Cash Equivalent, Restricted Cash, and Restricted Cash Equivalent, Continuing Operation	8,846,000	(4,929,000)	3,163,000
Cash, Cash Equivalents, Restricted Cash and Restricted Cash Equivalents, Period Increase (Decrease), Including Exchange Rate Effect, Total	(603,000)	54,344,000	45,438,000
Cash, Cash Equivalent, Restricted Cash, and Restricted Cash Equivalent, Continuing Operation	307,963,000	308,566,000	254,222,000
SUPPLEMENTAL DISCLSOURE OF CASH FLOW INFORMATION
Interest Paid, Excluding Capitalized Interest, Operating Activity	83,742,000	99,717,000	95,913,000
SUPPLEMENTAL DISCLOSURE OF NON-CASH INVESTING ACTIVITIES
Accounts payable for property, plant and equipment	4,453,000	$ 7,443,000	$ 6,570,000
Issuance of long-term debt to refinance existing credit facility supplemental	750,000,000
Direct payoff of a portion of the existing credit facility	(749,687,000)
Transfer to Investments	$ 129,851,000

Derivatives and Hedging Activities Derivative Instruments and Hedging Activities - Cash Flow Hedge Activity Included in Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Other Comprehensive Income (Loss), before Tax	$ (1,507)	$ 14,042	$ 15,988
Cash Flow Hedging [Member] \| Foreign Exchange Forward [Member]
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Other Comprehensive Income (Loss), before Tax	3,508	(1,912)	10,788
Cash Flow Hedging [Member] \| Interest Rate Swap
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Other Comprehensive Income (Loss), before Tax	$ (5,015)	$ 15,954	$ 5,200

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

- Definition

Amount before tax, after reclassification adjustments of other comprehensive income (loss).

+ References + Details

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
CURRENT ASSETS:
Cash, Cash Equivalent, Restricted Cash, and Restricted Cash Equivalent, Continuing Operation	$ 307,963	$ 308,566
Accounts receivable, net of allowance for doubtful accounts of $14,383 at December 31, 2025 and $12,977 at December 31, 2024	180,515	182,828
Inventories	615,859	584,676
Prepaid expenses and other current assets	86,217	81,531
Assets held for sale	0	284,382
Total current assets	1,190,554	1,441,983
PROPERTY, PLANT AND EQUIPMENT, net	451,817	442,746
Operating Lease, Right-of-Use Assets	54,470	53,295
GOODWILL	1,499,754	1,432,772
INTANGIBLE ASSETS, net	633,559	740,789
Deferred Income Tax Assets	25,891	24,211
Other Assets	62,877	65,097
Equity Method Investments	131,586	3,038
TOTAL ASSETS	4,050,508	4,203,931
CURRENT LIABILITIES:
Accounts payable	154,374	148,020
Accrued liabilities	315,337	306,923
Current portion of long-term debt	18,750	51,000
Income tax payable	10,400	17,328
Liabilities held for sale	0	32,911
Total current liabilities	498,861	556,182
Long-Term Debt	1,265,917	1,531,858
Other Accrued Liabilities, Noncurrent	89,536	66,745
Deferred Income Tax	37,756	48,814
Income Tax Liability	34,613	35,097
COMMITMENTS AND CONTINGENCIES	0	0
STOCKHOLDERS' EQUITY:
Convertible preferred stock, $1.00 par value Authorized-500 shares; Issued and outstanding - none	0	0
Common stock, $0.10 par value - Authorized-80,000 shares; Issued 24,688 and 24,518 shares at December 31, 2025 and 2024, respectively, and outstanding 24,688 and 24,517 shares at December 31, 2025 and 2024, respectively.	2,469	2,452
Additional paid-in capital	1,465,118	1,412,118
Treasury Stock, at cost	(22)	(92)
Retained earnings	690,890	690,158
Accumulated other comprehensive loss	(34,630)	(139,401)
Total stockholders' equity	2,123,825	1,965,235
TOTAL LIABILITIES AND STOCKHOLDERS' EQUITY	$ 4,050,508	$ 4,203,931

Fair Value Measurement Text Pursuit (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2023	Dec. 31, 2024	Dec. 31, 2022
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Contingent Earn-out Liability		$ 5,491	$ 0	$ 25,572
Short-term contingent consideration-gross		1,000
Long-term contingent consideration-gross	$ 1,500
Foreign Distibutor [Member]
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
contingent consideration gross	6,000
Contingent Earn-out Liability	$ 3,400
Foreign Infusion System Supplier
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
contingent consideration gross		$ 2,500

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

General and Summary of Significant Accounting Policies New Accounting Pronouncements (Details)	12 Months Ended
	Dec. 31, 2025
Accounting Policies [Abstract]
Accounting Standards Update and Change in Accounting Principle	Recently Issued Accounting Standards Not Yet Adopted In October 2023, the FASB issued ASU 2023-06, Disclosure Improvements - Codification Amendments in Response to the SEC's Disclosure Update and Simplification Initiative. The amendments in this update modify the disclosure or presentation requirements of a variety of Topics in the Accounting Standards Codification ("ASC") in response to the SEC’s Release No. 33-10532, Disclosure Update and Simplification Initiative, and align the ASC’s requirements with the SEC’s regulations. For entities within the scope, the guidance will be applied prospectively with the effective date for each amendment to be the date on which the SEC's removal of that related disclosure from Regulation S-X or Regulation S-K becomes effective, with early adoption prohibited. If the SEC has not removed the related disclosure from its regulations by June 30, 2027, the amendments will be removed from the Codification and will not become effective. We are currently assessing what impact this guidance will have on the Company's consolidated financial statements and related disclosures. In November 2024, the FASB issued ASU 2024-03, Disaggregation of Income Statement Expenses. The guidance requires disclosure of disaggregated income statement expense information about specific categories (including purchases of inventory, employee compensation, depreciation, and intangible asset amortization) in the notes to financial statements. In January 2025, FASB released ASU 2025-01 to clarify the guidance will be effective for annual periods beginning after December 15, 2026. This update will be applicable to our Annual Report on Form 10-K for the fiscal year December 31, 2027, with early application permitted. We are currently assessing the effect of this update on the Company's consolidated financial statements and related disclosures. In November 2025, the FASB issued ASU 2025-09, Derivatives and Hedging. The guidance aims to more closely align hedge accounting with the economics of an entity's risk management activities and to better reflect those strategies in financial reporting by enabling entities to achieve and maintain hedge accounting for highly effective economic hedges of forecasted transactions. This update will be effective for fiscal years beginning after December 15, 2026, and interim periods periods within those annual reporting periods. Early adoption is permitted. We are currently assessing the effect of this update on the Company's consolidated financial statements and related disclosures. Recently Adopted Accounting Pronouncements In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740) - Improvements to Income Tax Disclosures. The amendments in this update expand disclosures in an entity’s income tax rate reconciliation table and cash taxes paid information. The update was effective for annual periods beginning with the Company's fiscal year 2025. The Company adopted the requirements of this ASU in Note 13: Income Taxes of this Annual Report. There have been no other recent accounting pronouncements or changes in accounting pronouncements that are of significance or potential significance to us during the year.

- Definition

The entire disclosure for change in accounting principle. Includes, but is not limited to, nature, reason, and method of adopting amendment to accounting standards or other change in accounting principle.

+ References

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-URI https://asc.fasb.org/250/tableOfContent

Reference 30: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 40
-Name Accounting Standards Codification
-Section 65
-Paragraph 1
-Subparagraph (e)(1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480175/815-40-65-1

+ Details

Debt (Details) - USD ($)	12 Months Ended
Debt (Details) - USD ($)	Dec. 31, 2025	Dec. 31, 2024
Debt Instrument [Line Items]
Long-Term Debt, Gross	$ 1,294,500,000
Line of Credit Facility, Fair Value of Amount Outstanding		$ 0
Debt Instrument, Unamortized Discount (Premium) and Debt Issuance Costs, Net	(9,833,000)	(14,080,000)
Debt, Long-Term and Short-Term, Combined Amount	1,284,667,000	1,582,858,000
Debt, Current	18,750,000	51,000,000
Long-Term Debt, Excluding Current Maturities	1,265,917,000	$ 1,531,858,000
Revolving Credit Facility
Debt Instrument [Line Items]
Long-Term Debt, Gross	500,000,000.0
Line of Credit Facility, Fair Value of Amount Outstanding	$ 0
Debt Instrument, Interest Rate During Period	0.00%	0.00%
Term Loan A
Debt Instrument [Line Items]
Long-Term Debt, Gross	$ 750,000,000	$ 770,313,000
Debt Instrument, Unamortized Discount (Premium) and Debt Issuance Costs, Net	$ 5,300,000	$ 6,100,000
Debt Instrument, Interest Rate During Period	7.02%	8.03%
Term Loan B
Debt Instrument [Line Items]
Long-Term Debt, Gross	$ 544,500,000	$ 826,625,000
Debt Instrument, Unamortized Discount (Premium) and Debt Issuance Costs, Net	$ 4,500,000	$ 8,000,000.0
Debt Instrument, Interest Rate During Period	7.56%	8.38%

Transfers and Servicing (Details) - USD ($) $ in Thousands	12 Months Ended
Transfers and Servicing (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Transfers and Servicing [Abstract]
accounts receivable purchase program	$ 150,000
Trade receivables sold	10,009	$ 435,438
Cash received in exchange for trade receivables sold	9,978	432,803
Gain (Loss) on Sale of Accounts Receivable	$ 32	$ 2,635

Debt

12 Months Ended

Dec. 31, 2025

Debt Disclosure [Abstract]

Debt Disclosure [Text Block]

LONG-TERM OBLIGATIONS

Amended Credit Agreement

On October 31, 2025 (the "Closing Date"), ICU Medical, Inc., as Borrower, entered into Amendment No. 2 to the Existing Credit Agreement (the "Amendment") with Wells Fargo Bank and certain other financial institutions (the “Lenders”) to refinance the existing Term Loan A and the existing Revolving Credit Facility under the Credit Agreement dated as of January 6, 2022 (as amended by Amendment No. 1, dated as of October 5, 2022, the "Existing Credit Agreement," and as further amended by the Amendment, the "Amended Credit Agreement").

The Amendment includes new credit facilities (the "New Credit Facilities") that consists of a $750.0 million senior secured Term Loan A and a new $500.0 million revolving credit facility. The proceeds from the New Term Loan A were primarily used by the borrower to (i) directly repay the $559.7 million outstanding principal amount of the existing Term Loan A in full (the "Refinancing") under the Existing Credit Agreement, and (ii) directly repay $190.0 million of the outstanding

balance of the Term Loan B under the Existing Credit Agreement. These direct payoffs have been excluded from the proceeds from and payments on long-term debt within the consolidated cash flows.

The refinancing was evaluated on a lender-by-lender basis to determine the appropriate accounting treatment. For those lenders who did not participate in the New Credit Facilities, we accounted for that portion of the refinancing as an extinguishment of debt. For those lenders who participated in both the Existing Credit Facilities and the New Credit Facilities ("Continuing Lenders"), we determined that the terms were not substantially different, accordingly, this portion of the refinancing was accounted for as a debt modification, whereby existing unamortized debt discount and issuance costs remained on the balance sheet and new debt discount/issuance costs were capitalized. The following table summarizes the accounting treatment applied to the various costs, distinguishing between fees paid to lenders and those paid to third parties based on modification or extinguishment status:


	Extinguishment expense		Capitalize		Remains capitalized
Term Loan
Original unamortized debt discount	$	1,807			$	6,400
Original unamortized debt costs	374				1,276
New lender fees			1,626
New debt issuance costs - third party			937

Revolver
Original unamortized debt discount	246				1,502
Original unamortized debt costs	36				221
New lender fees			1,199
New debt issuance costs - third party			618
	$	2,463	$	4,380	$	9,399

The Term Loan unamortized balances are reflected as a direct deduction from the face amount of the corresponding term loans on the consolidated balance sheets. These costs are being amortized to interest expense over the respective terms of the loans using the effective interest method. The Revolving Credit Facility unamortized balances are included in prepaid expenses and other current assets on our consolidated balance sheets. These costs are being amortized to interest expense over the term of the Revolving Credit Facility using the straight-line method.

There were no penalties paid as a result of the early termination.

Maturity Dates

The final maturity date of the New Credit Facilities is October 31, 2030, subject to a springing maturity provision under which the New Credit Facilities will mature 91 days after the scheduled maturity of the New Credit Facilities at that time. Pursuant to the terms and conditions of the Credit Agreement, the maturity dates of the Term Loans and the Revolving Credit Facility may be extended upon our request, subject to the consent of the Lenders.

Interest Rate Terms

The interest rates and fees under the New Credit Facilities are primarily the same as those under the existing credit facility under the Existing Credit Agreement, except that the New Credit Facilities do not include a credit spread adjustment and include an additional pricing tier applicable when the Company's leverage ratio is below 1.75x.

In general, the Term Loans and borrowings under the Revolving Credit Facility denominated in U.S. dollars bear interest, at our option, on either: (1) the Base Rate, as defined below, plus the applicable margin, as indicated below ("Base Rate Loans") or (2) the Adjusted Term Secured Overnight Financing Rate ("Adjusted Term SOFR"), as defined below, plus the applicable margin, as indicated below ("Term SOFR Loans").

The Base Rate is defined as the highest of (a) the Prime Rate, (b) the Federal Funds Rate plus 0.50% and (c) Adjusted Term SOFR (as defined below) for a one-month period plus, in each case, 1.00%.

Adjusted Term SOFR is the rate per annum equal to (a) the Term SOFR plus (b) the Term SOFR Adjustment. Term SOFR is the forward-looking term rate based on SOFR and is calculated separately for Term SOFR Loans and Base Rate Loans, as specified in the Credit Agreement. The Term SOFR Adjustment is a percentage per annum of 0.10% for Base Rate Loans and between 0.10% to 0.25% for Term SOFR Loans based on the applicable interest period.

Revolving Credit Facility Commitment Fees

The proceeds from any future borrowings under the Revolving Credit Facility may be used for working capital and other general corporate purposes. The Revolving Credit Facility has a per annum commitment fee determined by reference to the leverage ratio in effect from time to time as set forth in the table below.

Applicable Interest Margins

The Term Loan A and borrowings under the Revolving Credit Facility have an initial applicable margin of 0.75% per annum for Base Rate Loans and 1.75% per annum for Term SOFR Loans.


Leverage Ratio	Applicable Margin for Eurocurrency Rate Loans and RFR Loans	Applicable Margin for Base Rate Loans	Commitment Fee Rate
Greater than 4.00 to 1.0	2.25%	1.25%	0.35%
Less than or equal to 4.00 to 1.0 but greater than 3.00 to 1.0	2.00%	1.00%	0.30%
Less than or equal to 3.00 to 1.0 but greater than 2.50 to 1.0	1.75%	0.75%	0.25%
Less than or equal to 2.50 to 1.0 but greater than 2.00 to 1.0	1.50%	0.50%	0.20%
Less than or equal to 2.00 to 1.0 but greater than 1.75 to 1.0	1.25%	0.25%	0.15%
Less than or equal to 1.75 to 1.0	1.00%	—%	0.10%

The applicable margin for the Term Loan B is determined by reference to the leverage ratio in effect from time to time as set forth in the following table:


Leverage Ratio	Applicable Margin for Term SOFR Loans	Applicable Margin for Base Rate Loans
Greater than 2.75 to 1.0	2.50%	1.50%
Less than 2.75 to 1.0	2.25%	1.25%

Principal Payments

Principal payments on the Term Loans are due on the last day of each calendar quarter.

The Term Loan A amortizes in nineteen consecutive quarterly installments, each equal to 0.625% of the original principal amount in each of the first two years, 1.25% in each of the third and fourth years and 1.875% in the fifth year, with a final payment of the remaining outstanding principal balance due on the maturity date.

The Term Loan B matures in twenty-seven consecutive quarterly installments, each equal to 0.25% of the original principal amount, with a final payment of the remaining outstanding principal balance due on the maturity date.

We may borrow, prepay and re-borrow amounts under the Revolving Credit Facility, in accordance with the terms and conditions of the Credit Agreement, with all outstanding amounts due at maturity.

For the year ended December 31, 2025 and 2024, total principal payments on the Term Loans were $302.8 million and $51.0 million, respectively. During the first, third and fourth quarter of 2025, we made a prepayment of $35.0 million, $25.0 million and $30.0 million, respectively, on Term Loan B. During the second quarter of 2025, we made a prepayment of $200 million on Term Loan A, which was paid with the proceeds from the sale of our IV Solutions business, see Note 3: Assets Held For Sale and Disposal of Business.

Interest Payments

Interest payments on Base Rate Loans are payable quarterly in arrears on the last business day of each calendar quarter and the applicable maturity date. Interest periods on Term SOFR Loans are determined, at our option, as either one, three or six months and will be payable on the last day of each interest period and the applicable maturity date. In the case of any interest periods of more than three months' duration, the interest payment are payable on each day prior to the last day of such interest period that occurs at three-month intervals.

The commitment fee on the Revolving Credit Facility is payable quarterly in arrears on the third business day following the last day of each calendar quarter and at the maturity date. The commitment fee is included in interest expense in our consolidated statements of operations.

Guarantors and Collateral

Our obligations under the Credit Agreement are unconditionally guaranteed, on a joint and several basis, by ICU Medical, Inc. and certain of our existing subsidiaries.

Debt Covenants

The Amended Credit Agreement contains affirmative and negative covenants, including certain financial covenants. The negative covenants include restrictions regarding the incurrence of liens and indebtedness, certain merger and acquisition transactions, asset sales and other dispositions, other investments, dividends, share purchases and payments affecting subsidiaries, changes in nature of business, fiscal year or organizational documents, prepayments and redemptions of subordinated and other junior debt, transactions with affiliates, and other matters.

The New Credit Facilities are subject to certain financial covenants, which include (i) a new Maximum Secured Net Leverage Ratio of 4.50 to 1.00, tested at the end of each quarter, with a step-down to 4.00 to 1.00 starting with the quarter ending June 30, 2027; provided that in the event the Borrower or its restricted subsidiaries consummate a material acquisition, the Borrower may elect (on no more than one occasion) to cause the Secured Net Leverage Ratio financial covenant level set forth above to be increased by 0.50x for each of the four fiscal quarters ending immediately after the consummation of such material acquisition, and (ii) a Minimum Interest Coverage Ratio of 3.00 to 1.00, which remains unchanged from the Existing Credit Agreement.

We were in compliance with all financial covenants as of December 31, 2025.

The Credit Agreement contains customary events of default, including, among others: non-payments of principal and interest; breach of representations and warranties; covenant defaults; cross-defaults and cross-acceleration to certain other material indebtedness; the existence of bankruptcy or insolvency proceedings; certain events under ERISA; material judgments; and a change of control. If an event of default occurs and is not cured within any applicable grace period or is not waived, the administrative agent and the Lenders are entitled to take various actions, including, without limitation, the acceleration of all amounts due and the termination of commitments under the New Credit Facilities.

Prior Credit Facilities

Before the Refinancing, our Existing Credit Facility included (i) a five-year Tranche A term loan of $850.0 million (the "Term Loan A"), (ii) a seven-year Tranche B term loan of $850.0 million (the "Term Loan B") and (iii) a five-year revolving credit facility of $500.0 million (the "Revolving Credit Facility"), with separate sub-limits of $50.0 million for letters of credit and swingline loans. Whereas the Term Loan A and the Revolving Credit Facility were refinanced by the Amendment, the Term Loan B continues to be governed by the original terms of the Existing Credit Agreement. The maturity date for the Term Loan B is January 6, 2029. Pursuant to the terms and conditions of the Existing Credit Agreement, the maturity date of the Term Loan B may be extended upon our request, subject to the consent of the Lenders.

The carrying values of our long-term debt consist of the following (in thousands):


	2025 Effective Interest Rate		As of December 31,				2024 Effective Interest Rate
			2025		2024
Senior Secured Credit Facilities:
New Credit Facilities:
Term Loan A — principal	7.02	%	$	750,000
Revolving Credit Facility — principal	—		—
Prior Credit Facilities:
Term Loan A — principal					770,313		8.03	%
Term Loan B — principal	7.56	%	544,500		826,625		8.38	%
Revolving Credit Facility — principal					—		—	%
Less unamortized debt issuance costs(1)			(9,833)		(14,080)
Total carrying value of long-term debt			1,284,667		1,582,858
Less current portion of long-term debt			18,750		51,000
Long-term debt, net			$	1,265,917	$	1,531,858

_______________________________

As of December 31, 2025, the aggregate amount of principal repayments of our long-term debt (including any current portion) for each of the next five years is approximately (in thousands):


2026	$	18,750
2027	18,750
2028	37,500
2029	582,000
2030	637,500
Thereafter	—
Total	$	1,294,500

The following table presents the total interest expense related to our long-term debt (in thousands):


	Year Ended December 31,
	2025		2024		2023
Contractual interest	$	93,888	$	125,012	$	125,550
Amortization of debt issuance costs	8,903		6,807		6,814
Commitment fee — Revolving Credit Facility	1,355		1,524		1,518
Total long-term debt-related interest expense	$	104,146	$	133,343	$	133,882

We currently hedge against the contractual interest expense on our long-term debt (see Note 8: Derivatives and Hedging Activities).

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 8A
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480434/815-10-50-8A

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480738/235-10-S50-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(c))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-1

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481544/470-10-50-6

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481544/470-10-50-6

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 405
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 405
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)(3)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 405
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)(2)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 405
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)(1)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 405
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477092/405-40-50-1

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1B

Reference 12: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 470
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org/470/tableOfContent

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 835
-SubTopic 30
-Name Accounting Standards Codification
-Section 45
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482925/835-30-45-2

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1B

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1B

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1B

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1C

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1C

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1C

Reference 20: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1E
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1E

Reference 21: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1I

Reference 22: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1I

Reference 23: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481139/470-20-50-1I

+ Details

General and Summary of Significant Accounting Policies Property and Equipment #2 (Details)	Dec. 31, 2025
Building [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	15 years
Building [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	30 years
Building Improvements [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	15 years
Building Improvements [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	30 years
Machinery and Equipment [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	2 years
Machinery and Equipment [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	15 years
Furniture, fixtures and molds [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	2 years
Furniture, fixtures and molds [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	5 years
Computer Equipment and Software [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	3 years
Computer Equipment and Software [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	5 years
Instruments Placed with Customers [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	3 years
Instruments Placed with Customers [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	10 years

Discontinued Operations and Disposal Groups Text (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from Divestiture of Businesses	$ 211,185	$ 0	$ 0
us-gaap_TSA Fees	9,200
us-gaap_ReleaseofProvisionForLossOnContracts	2,900
Gain (Loss) on Disposition of Business	44,792	$ 0	$ 0
IV Solutions
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from Divestiture of Businesses	211,200
Gain (Loss) on Disposition of Business	44,800
Gain on Sale of Noncontrolling Interest In Disposal Group Before FMV of Retained Interest	45,600
Retained Interest, Fair Value Disclosure	19,400
Loss on Contracts	$ 20,200

Commitments and Contingencies	12 Months Ended
Commitments and Contingencies	Dec. 31, 2025
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies Disclosure [Text Block]	COMMITMENTS AND CONTINGENCIES Legal Proceedings 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 related to sales of our products. There is no maximum limit on the indemnification that may be required under these agreements. We have never incurred, nor do we expect to incur, any liability for indemnification. Contingencies Prior to being acquired, during 2021, Smiths Medical received a Warning Letter from the FDA following an inspection of Smiths Medical’s Oakdale, Minnesota Facility (the "2021 Warning Letter"). The 2021Warning Letter cited, among other things, failures to comply with FDA's medical device reporting requirements and failures to comply with applicable portions of the Quality System Regulation. A provision for the estimated costs related to the field service corrective actions identified as of the closing date of the acquisition was recorded on the opening acquired balance sheet of Smiths Medical. The initial estimate recorded was based on a probability-weighted estimate of the costs required to settle the obligation related to known field corrective actions. The actual costs to be incurred are dependent upon the scope of the work necessary to achieve regulatory clearance, including potential additional field corrective actions, and could differ from the original estimate. For the years ended December 31, 2025 and 2024, we recorded a net reversal to the provision of $0.7 million and a net reversal to the provision of $5.2 million, respectively, to adjust the estimated cost to complete the field corrective actions to the amounts expected to be incurred based on historical experience. As of December 31, 2025, approximately $20.4 million of the $33.0 million accrued field service corrective action represents outstanding fulfillment costs to complete work under the 2021 Warning Letter. On February 5, 2026, the FDA notified us that the 2021 Warning Letter has been closed. In 2015, legislation was enacted in Italy which requires medical device companies to make payments to the Italian government if Italy's medical device expenditures for certain years exceeded annual regional expenditure ceilings. Since its enactment, the legislation has been subject to appeals in the Italy court system. In the third quarter of 2024, Italy's Constitutional Court issued two judgments, one of which confirmed the legitimacy of the legislation on the IMDP. In September 2025, the Italian government enacted a law that allows medical device companies to settle certain historical periods (2015-2018) for 25% of the original assessed value. During the third quarter of 2025, we settled the liability related to the 2015-2018 historical periods and paid $2.5 million. Additionally, we recorded a release of $3.8 million in previously established reserves. The release is included in total revenues in our consolidated statements of operations. See Note 11: Accrued Liabilities for details on amounts accrued for potential payments related to the IMDP. In April 2025, we received a warning letter from the FDA following an inspection of Smiths Medical's Oakdale, Minnesota Facility that occurred from July 23, 2024 through August 9, 2024 (the "2025 Warning letter"). The 2025 Warning Letter noted changes we made to the MedFusion™ Model 4000 Syringe Infusion Pump and CADD™ Solis VIP Ambulatory Infusion Pump that could affect the safety or effectiveness of these devices and therefore require new 510(k) clearance. We are seeking clearance for its next generation of MedFusion and updated CADD infusion pumps and submitted 510(k) applications to the FDA in July 2025. We cannot, however, give any assurances that the FDA will be satisfied with its response or its expected timing to address the matters cited in the 2025 Warning Letter. Until the matters cited in the 2025 Warning Letter are resolved to the FDA’s satisfaction, additional legal or regulatory action may be taken without further notice. As a result, the outcome and the financial impact of the 2025 Warning Letter cannot be predicted at this time. Accordingly, no loss has been recorded for the 2025 Warning Letter, and the likelihood of loss is not considered probable and reasonably estimable as of December 31, 2025. Commitments We have non-cancelable operating lease agreements where we are contractually obligated to pay certain lease payment amounts (see Note 6: Leases).

Insider Trading Arrangements	12 Months Ended
Insider Trading Arrangements	Dec. 31, 2025
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

General and Summary of Significant Accounting Policies Post-retirement and Post-employment Benefits (Details) - USD ($)	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Accounting Policies [Abstract]
Pension and Other Postretirement Benefits Cost (Reversal of Cost)	$ 16,900,000	$ 19,100,000	$ 19,200,000

Discontinued Operations and Disposal Groups (Details) - USD ($)	Dec. 31, 2025	Dec. 31, 2024
Discontinued Operations and Disposal Groups [Abstract]
Disposal Group, Including Discontinued Operation, Accounts, Notes and Loans Receivable, Net		$ 13,331,000
Disposal Group, Including Discontinued Operation, Inventory		88,656,000
Disposal Group, Including Discontinued Operation, Prepaid and Other Assets		4,140,000
Disposal Group, Including Discontinued Operation, Property, Plant and Equipment		155,426,000
Disposal Group, Including Discontinued Operation, Other Assets		22,829,000
Assets held for sale	$ 0	284,382,000
Disposal Group, Including Discontinued Operation, Accounts Payable		13,533,000
Disposal Group, Including Discontinued Operation, Accrued Liabilities		19,378,000
Liabilities held for sale	$ 0	32,911,000
Disposal Group, Net assets held for sale		251,471,000
Disposal group, accounts receivable allowance for credit losses		$ 465,000

Revenue Disaggregation of Revenue - Product Line (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Disaggregation of Revenue [Line Items]
Revenues	$ 2,231,262	$ 2,382,046	$ 2,259,126
Percentage of revenue	100.00%	100.00%	100.00%
Infusion Consumables [Member]
Disaggregation of Revenue [Line Items]
Revenues	$ 1,109,130	$ 1,038,869	$ 969,129
Percentage of revenue	50.00%	44.00%	43.00%
Infusion Systems [Member]
Disaggregation of Revenue [Line Items]
Revenues	$ 684,208	$ 652,410	$ 629,043
Percentage of revenue	31.00%	27.00%	28.00%
Vital Care
Disaggregation of Revenue [Line Items]
Revenues	$ 437,924	$ 690,767	$ 660,954
Percentage of revenue	19.00%	29.00%	29.00%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

Transfers and Servicing (Tables)

12 Months Ended

Dec. 31, 2025

Transfers and Servicing [Abstract]

Transfer of Financial Assets Accounted for as Sales

The following table presents information in connection with the purchase program (in thousands):


	Year Ended December 31,
	2025		2024
Trade receivables sold(1)	$	10,009	$	435,438
Cash received in exchange for trade receivables sold(2)	9,978		432,803
Loss on sale of receivables(3)	32		2,635

_______________________________

(1) Represents carrying value of trade receivables sold to BMO.

(2) Cash proceeds received from BMO.

(3) Reflected in other expense, net in our consolidated statement of operations.

Income Taxes Unrecognized tax benefits Text (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Unrecognized Tax Benefits	$ 71,815	$ 72,819	$ 78,558	$ 54,053
Unrecognized Tax Benefits, Interest on Income Taxes Expense	600
Unrecognized Tax Benefits, Income Tax Penalties Expense	100
Income Tax Examination, Interest Accrued	2,400	2,600
Income Tax Examination, Penalties Accrued	1,000	$ 1,600
us-gaap_ReleasedUnrecognizedTaxBenefitsInterestOnIncomeTaxesExpense	800
us-gaap_ReleasedUnrecognizedTaxBenefitsIncomeTaxPenaltiesExpense	$ 600

Insider Trading Policies and Procedures	12 Months Ended
Insider Trading Policies and Procedures	Dec. 31, 2025
Insider Trading Policies and Procedures [Line Items]
Insider Trading Policies and Procedures Adopted	true

General and Summary of Significant Accounting Policies-Equity Method Investment Text (Details) - USD ($)	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Equity Securities without Readily Determinable Fair Value [Line Items]
Equity Method Investment, Difference Between Carrying Amount and Underlying Equity	$ 19,400,000
Transfer to Investments	129,851,000
Equity Method Investment, Aggregate Cost			$ 3,300,000
Income (Loss) from Equity Method Investments	(1,189,000)	$ 0	$ 0
us-gaap_Otsuka ICU Medical LLC
Equity Securities without Readily Determinable Fair Value [Line Items]
Transfer to Investments	$ 129,900,000
nonpublic company
Equity Securities without Readily Determinable Fair Value [Line Items]
Equity Method Investment, Ownership Percentage			20.00%
us-gaap_Otsuka ICU Medical LLC
Equity Securities without Readily Determinable Fair Value [Line Items]
Equity Method Investment, Ownership Percentage	40.00%
JVandVI
Equity Securities without Readily Determinable Fair Value [Line Items]
Income (Loss) from Equity Method Investments	$ 1,300,000

General and Summary of Significant Accounting Policies Foreign Currency (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Foreign Currency [Abstract]
Foreign Currency Transaction Gain (Loss), Realized	$ (3,786)	$ 9,792	$ 5,918

Restructuring, Strategic Transaction and Integration (Notes)

12 Months Ended

Dec. 31, 2025

Restructuring and Related Activities [Abstract]

Restructuring and Related Activities Disclosure [Text Block]

RESTRUCTURING, STRATEGIC TRANSACTION AND INTEGRATION

Restructuring, strategic transaction and integration expenses were $66.5 million, $59.8 million and $41.3 million in 2025, 2024 and 2023, respectively.

Restructuring

Restructuring charges net of any reversed accruals were $30.0 million, $19.6 million and $5.7 million in 2025, 2024 and 2023, respectively, which are included in the above restructuring, strategic transaction and integration expenses in our consolidated statement of operations.

In 2025, we incurred restructuring charges primarily related to facility closure costs and severance expenses. We adjusted certain severance restructuring accrued balances, shown in the table below under "Other adjustments", to reclass prior year accrued restructuring charges for estimated severance costs to other accounts.

In 2024, we incurred restructuring charges primarily related to severance expenses. We adjusted certain severance restructuring accrued balances, shown in the table below under "Other adjustments", as a result of merging Smiths Medical entities during 2024.

In 2023, we incurred restructuring charges primarily related to severance expenses. We adjusted certain facility and severance restructuring accrued balances to reverse certain accrued balances that will not be utilized.

The following table summarizes the activity in our restructuring-related accrual by major type of cost (in thousands):


	Employee & Related Costs		Facility & Other Closure Costs		Total
Accrued balance, January 1, 2024	$	2,811	$	757	$	3,568

Charges incurred	18,299		1,272		19,571
Payments	(11,687)		(1,632)		(13,319)
Other adjustments(1)	327		—		327
Currency translation	(212)		10		(202)
Accrued balance, December 31, 2024	$	9,538	$	407	$	9,945

Charges incurred	11,083		18,963		30,046
Payments	(13,805)		(13,734)		(27,539)
Other adjustments(2)	(900)		—		(900)
Currency translation	495		101		596
Accrued balance, December 31, 2025	$	6,411	$	5,737	$	12,148

_______________________________________________

(1) Relates to adjustments to accrued restructuring charges as a result of merging Smiths Medical entities during 2024.

(2) Relates to prior year accrued restructuring charges for estimated severances costs that were reclassed to other accounts during the first quarter of 2025.

Strategic Transaction and Integration Expenses

We incurred $36.5 million, $40.2 million and $35.6 million in strategic transaction and integration expenses in 2025, 2024 and 2023, respectively, which are included in restructuring, strategic transaction and integration expenses in our consolidated statement of operations. The strategic transaction and integration expenses during 2025, 2024 and 2023 were primarily related to consulting expenses and employee costs incurred to integrate our Smiths Medical business acquired in 2022. During 2025, transaction costs also included expenses related to the sale of a 60% ownership in our IV Solutions business.

General and Summary of Significant Accounting Policies Net Income Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Accounting Policies [Abstract]
Net Income (Loss)	$ 732	$ (117,688)	$ (29,655)
Weighted average number of common shares outstanding (basic)	24,640,000	24,388,000	24,091,000
Weighted Average Number Diluted Shares Outstanding Adjustment	264,000	0	0
Weighted Average common and common equivalent shares outstandding (diluted)	24,904,000	24,388,000	24,091,000
Basic	$ 0.03	$ (4.83)	$ (1.23)
Diluted	$ 0.03	$ (4.83)	$ (1.23)
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount	40	42	129

- Definition

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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-URI https://asc.fasb.org/1943274/2147482689/260-10-45-60B

Reference 20: http://www.xbrl.org/2003/role/disclosureRef
-Topic 220
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(25))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147483621/220-10-S99-2

Reference 21: http://www.xbrl.org/2003/role/disclosureRef
-Topic 942
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-04(27))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147478524/942-220-S99-1

Reference 22: http://www.xbrl.org/2003/role/disclosureRef
-Topic 944
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.7-04(23))
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477250/944-220-S99-1

Reference 23: http://www.xbrl.org/2003/role/disclosureRef
-Topic 260
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 7
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147482689/260-10-45-7

Reference 24: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 65
-Paragraph 4
-Subparagraph (f)(4)
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481538/470-20-65-4

+ Details

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

Income Taxes Undistributed foreign earnings (Details) $ in Millions	Dec. 31, 2025 USD ($)
Income Tax Disclosure [Abstract]
Undistributed Earnings of Foreign Subsidiaries	$ 349.0

Share Based Award Share awards (Notes)

12 Months Ended

Dec. 31, 2025

Share-Based Payment Arrangement [Abstract]

Share-based Payment Arrangement [Text Block]

SHARE-BASED AWARDS

2011 Stock Incentive Plan (the "2011 Plan")

Our stock incentive plan is intended to attract, retain and provide incentives for our employees and directors. Shares to be issued under this plan will be issued either from authorized but unissued or reacquired shares.

In 2025, our stockholders approved an amendment to the 2011 plan that increased the shares available for issuance under the 2011 plan by 2.2 million shares, bringing the total common shares reserved for issuance under the 2011 plan as of December 31, 2025 to 8.5 million shares.

We currently grant restricted stock units ("RSUs") and performance restricted stock units ("PRSUs") to eligible employees and directors under the 2011 Plan. We have not granted stock options under the 2011 Plan since 2022. Shares subject to awards other than options and stock appreciation rights are charged against the 2011 Plan's share reserve as 2.09 shares for 1 share issued.

Stock-based Compensation Expense

We incur stock compensation expense for RSUs and PRSUs and in years prior to 2024 also for stock options. As of 2023, our outstanding stock options were all fully vested. We receive a tax benefit on stock compensation expense and direct tax benefits from the exercise of stock options and vesting of restricted stock units.

The table below summarizes compensation costs and related tax benefits (in thousands):


	Year ended December 31,
	2025		2024		2023
Stock compensation expense	$	55,758	$	46,883	$	40,563
Tax benefit from stock-based compensation cost	$	5,900	$	5,524	$	5,379

As of December 31, 2025, we had $48.5 million of unamortized stock compensation cost which we will recognize as an expense over a weighted-average period of approximately 0.9 years.

Time-based Stock Options

We have not granted time-based stock options since 2022. Our outstanding options expire no more than ten years from date of grant.

A summary of our stock options outstanding as of and for the year ended December 31, 2025 is as follows:


	Shares	Weighted-Average Exercise Price Per Share		Weighted-Average Contractual Life (Years)	Aggregate Intrinsic Value
Outstanding at December 31, 2024	108,140	$	136.12
Granted	—	$	—
Exercised	(63,197)	$	96.61
Forfeited or expired	—	$	—
Outstanding at December 31, 2025	44,943	$	191.68	3.71	$	202
Exercisable at December 31, 2025	44,943	$	191.68	3.71	$	202
Vested December 31, 2025	44,943	$	191.68	3.71	$	202

The intrinsic values for options exercisable, outstanding and vested or expected to vest at December 31, 2025 are based on our closing stock price of $142.67 at December 31, 2025 and are before applicable taxes.

The following table presents information regarding stock option activity (in thousands):


	Year ended December 31,
	2025		2024		2023
Intrinsic value of options exercised	$	2,437	$	18,651	$	8,441
Cash received from exercise of stock options	$	6,106	$	10,939	$	4,022
Tax benefit from stock option exercises	$	174	$	1,034	$	1,733

Stock Awards

In 2025, we granted PRSUs to our executive officers. For the executive officers other than the CEO, COO, CFO, President and the CVP, GC, the PRSUs will vest as to one-third of the total number of PRSUs underlying the award on the first, second and third anniversaries of the applicable grant date, subject to a determination by the CEO and Compensation Committee that the officers have met their individual performance goals for the applicable year and continued service through such vesting date. For the CEO, COO, CFO, President and the CVP, GC, the PRSUs will cliff-vest on March 7, 2028, subject to continued service through such vesting date and the achievement of minimum three-year cumulative adjusted revenue and

minimum three-year cumulative adjusted EBITDA, commencing on January 1, 2025 and ending on December 31, 2027, which when reviewed against a predetermined vesting matrix could result in the vesting of 0% to 250% of the awarded PRSUs.

In 2024, we granted PRSUs to our executive officers and certain other non-executive employees. The PRSUs will cliff-vest on March 8, 2026, subject to continued service through such vesting date and the achievement of minimum two-year cumulative adjusted EBITDA, commencing on January 1, 2024 and ending on December 31, 2025, which when reviewed against a predetermined vesting matrix could result in the vesting of 0% to 250% of the awarded PRSUs. We also granted certain other one-off PRSU awards to non-executive employees with various performance requirements, whereby the PRSUs will be earned if the minimum requirements are met. The performance period related to the annual 2024 PRSUs ended on December 31, 2025 and in February 2026 the Compensation Committee determined that 250% of the PRSUs awarded were earned based on the cumulative adjusted EBITDA achieved.

In 2023, we granted PRSUs to our executive officers. For the executive officers other than the CEO, COO, CFO and the CVP, GC, the PRSUs will vest as to one-third of the total number of PRSUs underlying the award on the first, second and third anniversaries of the applicable grant date, subject to a determination by the CEO and Compensation Committee that the officers have met their individual performance goals for the applicable year and continued service through such vesting date. In February 2024, 2025 and 2026, the Compensation Committee made the determination that the executive officers other than the CEO, CFO, COO and CVP, GC met their individual performance goals for 2023, 2024 and 2025 with respect to the PRSUs subject to annual vesting, as outlined above, and therefore one-third of their 2023 PRSUs vested at 100% during 2024 and 2025 and one-third will vest during 2026 subject to continued service through March 15, 2026. For the CEO, COO, CFO, and CVP, GC, the PRSUs will cliff-vest on March 15, 2026, subject to continued service through such vesting date and the achievement of minimum three-year adjusted revenue and adjusted EBITDA compound annual growth rates, commencing on January 1, 2023 and ending on December 31, 2025, which when reviewed against a predetermined vesting matrix could result in the vesting of 0% to 250% of the awarded PRSUs. The performance period related to the annual 2023 PRSUs awarded to the CEO, COO, CFO and CVP, GC ended on December 31, 2025 and in February 2026 the Compensation Committee determined that 117% of the PRSUs awarded were earned based on the three-year adjusted revenue and adjusted EBITDA achieved.

In 2022, we granted our annual PRSUs to our executive officers and certain other non-executive employees. These PRSUs cliff-vested on March 7, 2024, subject to continued service through such vesting date and the achievement of net synergy savings targets related to the Smiths Medical acquisition achieved during the performance period commencing on January 1, 2022 and ending on December 31, 2023, which when reviewed against predetermined targets could have resulted in the vesting of 0% to 200% of the awarded PRSUs. We also granted certain other one-off PRSU awards to non-executive employees with various performance requirements, whereby the PRSUs will be earned if the minimum requirements are met within a specified time period. The performance period related to the annual 2022 PRSUs ended on December 31, 2023 and in February 2024 the Compensation Committee determined that 200% of the PRSUs awarded were earned based on the actual net synergy savings related to the Smiths Medical acquisition achieved during the performance period, and therefore the 2022 PRSUs vested in during 2024.

In 2021, we granted PRSUs to our executive officers. For the executive officers other than the CEO, COO and the CFO, the PRSUs vested as to one-third of the total number of PRSUs underlying the award on the first, second and third anniversaries of the applicable grant date, subject to a determination by the CEO and Compensation Committee that the officers had met their individual performance goals for the applicable years and continued service through such vesting date. In February 2022, 2023 and 2024, the Compensation Committee made the determination that the executive officers other than the CEO, CFO and COO met their individual performance goals for 2021, 2022 and 2023, respectively, and therefore one-third of their 2021 PRSUs vested during each of 2022, 2023 and 2024. For the CEO, COO and the CFO, the PRSUs cliff-vested on March 8, 2024, subject to continued service through such vesting date and the achievement of minimum three-year cumulative adjusted revenue dollar target growth rate and adjusted EPS dollar target growth rate targets, commencing on January 1, 2021 and ending on December 31, 2023, which when reviewed against a predetermined vesting matrix could have resulted in the vesting of 0% to 250% of the awarded PRSUs. The performance period related to the 2021 CEO, COO and CFO PRSUs ended on December 31, 2023 and in February 2024 the Compensation Committee determined that 110% of the awarded PRSUs were earned based on the actual cumulative adjusted revenue dollar target growth rate and adjusted EPS dollar target growth rate achieved during the performance period.

In 2020, we granted PRSUs to our executive officers. For the executive officers other than the CEO, COO and the CFO, the PRSUs vested as to one-third of the total number of PRSUs underlying the award on the first, second and third

anniversaries of the applicable grant date, subject to a determination by the CEO and Compensation Committee that the officers had met their individual performance goals for the applicable years and continued service through such vesting date. In February 2021, 2022, and 2023, the Compensation Committee made the determination that the executive officers other than the CEO, CFO and COO met their individual performance goals for 2020, 2021 and 2022, respectively, and therefore one-third of their 2020 PRSUs awarded vested during 2021, 2022 and 2023. For the CEO, COO and the CFO, the PRSUs cliff-vested on March 6, 2023, subject to continued service through such vesting date and the achievement of minimum three-year cumulative adjusted revenue dollar target growth rate and adjusted EPS dollar target growth rate targets, which when reviewed against a predetermined vesting matrix such PRSUs originally had the potential to vest from 0% to 250% of the awarded PRSUs. During February 2021, the Compensation Committee, modified the potential vesting percentages related to the 2020 PRSU awards for the CEO, COO and CFO, as the original potential percentages were established immediately before the onset of the COVID-19 pandemic. The Compensation Committee determined to adjust the CEO, COO and CFO's potential to earn from between 0% and 250% of the awarded PRSUs, to an increased potential to earn between 50% and 300% of the award granted, subject to the same minimum threshold revenue and EPS targets set forth above to be achieved by the Company. The additional compensation expense as a result of modifying the 2020 PRSUs granted to our CEO, COO and CFO totaled $2.1 million recognized over the remaining amortization period from the date of modification. The performance period related to the 2020 CEO, COO and CFO PRSUs ended on December 31, 2022 and in February 2023 the Compensation Committee determined that 188% of the awarded PRSUs were earned based on the actual cumulative adjusted revenue dollar growth rate and adjusted EPS dollar target growth rate achieved during the performance period.

Restricted stock units are granted annually to our non-employee directors and vest on the first anniversary of the grant date, or the date of our annual meeting, whichever occurs first.

In 2025, 2024 and 2023, we granted RSUs to certain employees that typically vest ratably on the anniversary of the grant over three years. We recognize forfeitures as they occur.

The grant-date fair market value of our PRSUs and RSUs is determined by our stock price on the grant date.

The table below summarizes our restricted stock award activity (dollars in thousands):


	Year ended December 31,
	2025		2024		2023
PRSU
Shares granted	67,800		150,218		78,213
Shares earned (1)	14,515		142,735		49,314
Grant-date fair value per share	$	141.97	$	104.52	$	190.02
Grant-date fair value	$	9,626	$	15,701	$	14,862
Intrinsic value vested	$	2,078	$	15,145	$	8,024

RSU
Shares granted	198,703		223,899		156,111
Grant-date fair value per share	$	141.83	$	105.94	$	173.10
Grant-date fair value	$	28,181	$	23,721	$	27,024
Intrinsic value vested	$	22,014	$	11,963	$	14,179

_______________________________

(1) PRSU shares earned in 2025, where both performance and service conditions have been met, were related to performance awards granted to executives in 2023 and PRSUs granted to certain other employees in 2024. PRSU shares earned in 2024, where both performance and service conditions have been met, were related to performance awards granted to executives and certain other employees in 2021, 2022 and 2023. PRSU shares earned in 2023, where both performance and service conditions have been met, were related to performance awards granted to executives and certain other employees in 2020, 2021 and 2022.

The table below provides a summary of our PRSU and RSU activity as of and for the year ended December 31, 2025:


	Number of Units	Grant-Date Fair Value Per Share		Weighted-Average Contractual Life (Years)	Aggregate Intrinsic Value (in thousands)
Non-vested at December 31, 2024	551,011	$	133.47
Granted	266,503	$	141.86

Vested	(169,541)	$	152.03
Forfeited	(12,597)	$	124.59
Non-vested at December 31, 2025	635,376	$	132.21	0.8	$	90,649
Expected to vest at December 31, 2025 (1)	935,993

____________________________________

(1) As of December 31, 2025, the additional goal shares expected to vest include the following: 2023 PRSUs 6,431 shares; 2024 PRSUs 221,016 shares; and 2025 PRSUs 73,170 shares.

Derivatives and Hedging Activities Derivative Instruments and Hedging Activities - Amounts Affecting Consolidated Statements of Income (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative, Gain (Loss) on Derivative, Net	$ 14,426	$ 30,204	$ 40,834
Foreign Exchange Contract
Derivative Instruments and Hedging Activities Disclosures [Line Items]
hedging ineffectiveness recognized in earnings	0	0	229
Foreign Exchange Contract \| Cash Flow Hedging [Member]
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative, Gain (Loss) on Derivative, Net	0	0	13
Foreign Exchange Contract \| Cash Flow Hedging [Member] \| Trading Revenue
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative, Gain (Loss) on Derivative, Net	(1,237)	(2,981)	(296)
Foreign Exchange Contract \| Cash Flow Hedging [Member] \| Cost of Sales [Member]
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative, Gain (Loss) on Derivative, Net	(1,147)	(91)	(7,852)
Interest Rate Swap \| Cash Flow Hedging [Member]
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Derivative, Gain (Loss) on Derivative, Net	$ (12,042)	$ (27,132)	$ (32,444)

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Leases Lease Maturity (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Leases [Abstract]
Lessee, Operating Lease, Liability, Payments, Remainder of Fiscal Year	$ 15,917
Lessee, Operating Lease, Liability, Payments, Due Year Two	13,088
Lessee, Operating Lease, Liability, Payments, Due Year Three	9,842
Lessee, Operating Lease, Liability, Payments, Due Year Four	7,833
Lessee, Operating Lease, Liability, Payments, Due Year Five	4,663
Lessee, Operating Lease, Liability, Payments, Due after Year Five	16,356
Lessee, Operating Lease, Liability, Payments, Due	67,699
Lessee, Operating Lease, Liability, Undiscounted Excess Amount	(9,923)
Operating Lease, Liability	$ 57,776	$ 56,472

Stockholders' Equity Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Accumulated Other Comprehensive Income (Loss) [Line Items]
Accumulated other comprehensive loss	$ (34,630)	$ (139,401)	$ (53,081)	$ (80,978)
Other Comprehensive Income (Loss), before Reclassifications, Net of Tax	119,027	(56,116)	58,888
Reclassification from Accumulated Other Comprehensive Income, Current Period, Net of Tax	(14,256)	(30,204)	(30,991)
Other Comprehensive (loss) income, Net of Tax	104,771	(86,320)	27,897
Accumulated Other Comprehensive Income (Loss), Foreign Currency Translation Adjustment, Net of Tax	(27,025)	(146,942)	(76,784)	(122,973)
AOCI, Cash Flow Hedge, Cumulative Gain (Loss), after Tax	(9,484)	5,722	21,884	40,779
Accumulated Other Comprehensive (Income) Loss, Defined Benefit Plan, after Tax	1,879	1,819	1,819	$ 1,216
Other Comprehensive Income (Loss), Foreign Currency Transaction and Translation Adjustment, Net of Tax	119,917	(70,158)	46,189
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax	(950)	14,042	12,096
Other Comprehensive (Income) Loss, Defined Benefit Plan, before Reclassification Adjustment, after Tax	60	0	603
Other Comprehensive Income (Loss), Foreign Currency Transaction and Translation Reclassification Adjustment from AOCI, Realized upon Sale or Liquidation, Net of Tax	0	0	0
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	(14,256)	(30,204)	(30,991)
Other Comprehensive Income (Loss), Defined Benefit Plan, Gain (Loss), Reclassification Adjustment from AOCI, after Tax	0	0	0
Other Comprehensive (Loss) Income, Cash Flow Hedge, Gain (Loss), after Reclassification and Tax	(15,206)	(16,162)	(18,895)
Other Comprehensive (Income) Loss, Defined Benefit Plan, after Tax and Reclassification Adjustment, Attributable to Parent	$ 60	$ 0	$ 603

Leases Supplemental Balance Sheet Lease information (Details) - USD ($) $ in Thousands	Dec. 31, 2025	Dec. 31, 2024
Leases [Abstract]
Operating Lease, Right-of-Use Assets	$ 54,470	$ 53,295
Operating Lease, Liability, Current	13,825	15,695
Operating Lease, Liability, Noncurrent	43,951	40,777
Operating Lease, Liability	$ 57,776	$ 56,472
Operating Lease, Weighted Average Remaining Lease Term	6 years 3 months 18 days	5 years 9 months 18 days
Operating Lease, Weighted Average Discount Rate, Percent	5.40%	4.90%
Lessee, Lease, Description [Line Items]
Operating Lease, Right-of-Use Assets	$ 54,470	$ 53,295
Operating Lease, Liability, Current	13,825	15,695
Operating Lease, Liability, Noncurrent	$ 43,951	$ 40,777
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accrued liabilities	Accrued liabilities
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List]	Liabilities, Other than Long-Term Debt, Noncurrent	Other Accrued Liabilities, Noncurrent
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Other Assets	Other Assets
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accrued liabilities
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other Accrued Liabilities, Noncurrent	Other Accrued Liabilities, Noncurrent
Finance Lease, Liability, Statement of Financial Position [Extensible Enumeration]		Accrued liabilities

Income Taxes Change in taxes payable (Details) $ in Millions	12 Months Ended
	Dec. 31, 2025 USD ($)
Income Tax Disclosure [Abstract]
Increase (Decrease) in Income Taxes Payable	$ 1.0

Income Taxes Unrecognized tax benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2025	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Unrecognized tax benefits roll forward [Roll Forward]
Unrecognized Tax Benefits	$ 71,815	$ 72,819	$ 78,558	$ 54,053
Unrecognized Tax Benefits, Increases Resulting from Prior Period Tax Positions	2,373	1,945	2,347
Unrecognized Tax Benefits, Increase Resulting from Acquisition			0
Unrecognized Tax Benefits, Increases Resulting from Current Period Tax Positions	4,778	4,441	34,607
Unrecognized Tax Benefits, Decrease Resulting from Prior Period Tax Positions	(851)	(406)	(2,455)
Unrecognized Tax Benefits, Reductions Resulting from Lapse of Applicable Statute of Limitations	(7,080)	(10,062)	(9,591)
Unrecognized Tax Benefits, Decrease Resulting from Settlements with Taxing Authorities	78	1,133	403
Unrecognized Tax Benefits, Decrease Resulting from Foreign Currency Translation	$ (146)	$ (524)	$ 0